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M S Ibelings

Publications and source records attributed to M S Ibelings.

7 recordsLinked to original sources
PubMed2005

Rapid identification of Candida spp. in peritonitis patients by Raman spectroscopy.

This prospective study evaluated Raman spectroscopy for the identification of clinically relevant Candida spp. in peritonitis patients. A Raman database was developed by measuring spectra from 93 reference strains belonging to ten different Candida spp. Clinical samples were obtained from the surgical department and intensive care unit of a tertiary university hospital. In total, 88 peritoneal specimens from 45 patients with primary, secondary or tertiary peritonitis were included. Specimens were cultured initially on a selective Sabouraud medium that contained gentamicin to suppress bacterial growth. For conventional identification, a chromogenic medium was used for presumptive identification, followed by use of the Vitek 2 system for definitive identification (requiring a total time of 48-96 h). Raman measurements were taken on overnight cultures from Sabouraud-gentamicin medium. Thirty-one samples were positive for Candida by culture. Using multivariate statistical analyses, a prediction accuracy of 90% was obtained for Raman spectroscopy, which appears to offer an accurate and rapid (12-24 h) alternative for the identification of Candida spp. in peritonitis patients. The reduced turn-around time is of great clinical importance for the treatment of critically ill patients with invasive candidiasis in intensive care units.

Candida↗
PubMed1998

[NSAID-use delays the diagnosis of 'acute abdomen'].

In three patients with abdominal pain, two men aged 63 and 18 years and a woman aged 46 years, the use of NSAIDs reduced the symptoms. They were in fact suffering from peritonitis due to gastrointestinal perforation, but the decision to operate was delayed because of the relatively mild presentation. The strong analgesic, antipyretic and anti-inflammatory properties of NSAIDs can reduce the symptoms, signs and laboratory findings of peritonitis.

Abdomen, Acute↗
PubMed1998

[Right-sided diverticulitis mimicking acute appendicitis].

The probability diagnosis in two patients, women aged 43 and 41 years, who for the last few days had had pain in the right lower abdomen, without nausea or vomiting, was acute appendicitis; a third patient, a woman aged 49 with the same symptoms, had undergone appendectomy in the past. Peroperative findings and, in two patients, microscopy of the resected specimen showed diverticulitis in the caecum or ascending colon. This is an uncommon disease, which mimicks acute appendicitis. Treatment depends on the severity of the inflammation. In the absence of perforation or abscess, conservative treatment suffices. Otherwise, resection of the colon is necessary.

Acute Disease↗
PubMed1994

[Dutch results of the European study of the prevalence of infections during intensive care (EPIIC). I. Who is at risk?].

OBJECTIVE: Evaluation of the point prevalence of infections acquired in an intensive care unit (ICU) and determination of risk factors for ICU patients. DESIGN: Descriptive study. SETTING: 78 Dutch ICUs. METHOD: Collecting data by detailed questionnaires for each patient admitted to one of the participating ICUs, on one specified day: April 29th, 1992. Follow-up lasted 6 weeks. RESULTS: Included in the study were 472 patients; 176 (37%) suffered from an infection, of which 74 (16%) was ICU-acquired. The most important risk factors were: a longer ICU stay (relative risk (RR) 4.23 (95% confidence interval: 3.32-5.40), 99.37 (22.26-434.50) and 146.79 (32.83-656.30) for ICU stays of 3-4 days, 1-2 and more than 3 weeks respectively, in comparison with 0-2 days), correlated with severity of disease (organ dysfunction) and more medical interventions (intubation, urine catheter). The ICU infection risk was lower after elective surgery than after ICU admission without surgery; after emergency surgery the ICU infection risk was higher. During follow-up 63 (14%) patients died. Patients suffering from an ICU infection had a higher mortality risk; the strongest prognostic factor in determining the mortality risk was the APACHE II score (RR: 13 (3.89-42.69) with a score between 16-26 and RR > 100 (7.67-1377.93) with score > 31). CONCLUSION: ICU-acquired infections are a serious problem. Programmes for infection prevention and control need to be adjusted.

APACHE↗
PubMed1994

[Dutch results of the European study of prevalence of infection during intensive care (EPIIC). II. Nature of the infections].

OBJECTIVE: Evaluation of the point prevalence of ICU-acquired infections, the type of infection, the bacteriological cultures and the antibiotics used. DESIGN: Point prevalence study. SETTING: 78 Dutch ICUs, as part of ICUs in 17 West-European countries. METHOD: Collecting data by detailed questionnaires for each patient admitted to one of the participating ICUs, on one specified day: April 29th, 1992. Follow-up lasted 6 weeks. RESULTS: The most frequently diagnosed ICU-acquired infections were pneumonia and infections of the lower respiratory tract (together 63%), followed by urinary tract infections (16%), sepsis (16%) and wound infections (11%). The most frequently cultured pathogens were Gram-negative bacteria (92%), especially Enterobacteriaceae (34%) and Pseudomonas aeruginosa (30%), followed by Staphylococcus (37%), Enterococcus (20%) and surprisingly: 10% fungi. The most-prescribed antibiotics were the cephalosporins (30%), followed by broad-spectrum penicillins (17%), metronidazole (17%) and aminoglycosides (13%). On the day of this survey there was in the Netherlands no infection with MRSA (Methicillin Resistant Staphylococcus aureus), although gentamicin resistant coagulase-negative Staphylococcus and ciprofloxacin-resistant P. aeruginosa were present. In most of the hospitals in the Netherlands, microbiologists, infectious disease specialists (84%) and infection control nurses (51%) take part in the ICU team. Half of the hospitals use selective decontamination. CONCLUSION: ICU-acquired infections are a real threat to the ICU patient. Despite a cautious antibiotics management in the Netherlands, resistance remains a serious problem.

Adolescent↗
PubMed1991

[Experiences with congenital duodenal obstruction in the Sophia Kinderziekenhuis].

In the department of Paediatric Surgery, Sophia Children's Hospital, University Hospital, Rotterdam, we investigated whether the presence of Down's syndrome influenced the chances of survival of patients with a congenital duodenal obstruction. The retrospective study comprised all 109 patients admitted to the Sophia Children's Hospital with a congenital duodenal obstruction in the period 1971-1989. The additional presence of Down's syndrome itself did not influence the prognosis. The presence of other additional anomalies (especially cardiac anomalies) did influence the mortality rate. In the past these anomalies--which are present more frequently in association with Down's syndrome--were responsible for the higher mortality in children with both a congenital duodenal obstruction and Down's syndrome. We conclude that with the availability of the current medical (especially cardio-surgical) techniques, it may be expected that the mortality rate of duodenal obstruction will be the same in patients with and without Down's syndrome (10%). Only non-medical, non-technical arguments can be of overriding importance in the decision whether a newborn child suffering from both a duodenal obstruction and Down's syndrome will or will not be operated on.

Abnormalities, Multiple↗