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Biomedical subjects

Martin Steinbakk

Publications and source records attributed to Martin Steinbakk.

6 recordsLinked to original sources
PubMed2006

Effects of phenotype and genotype on methods for detection of extended-spectrum-beta-lactamase-producing clinical isolates of Escherichia coli and Klebsiella pneumoniae in Norway.

Consecutive clinical isolates of Escherichia coli (n = 87) and Klebsiella pneumoniae (n = 25) with reduced susceptibilities to oxyimino-cephalosporins (MICs > 1 mg/liter) from 18 Norwegian laboratories during March through October 2003 were examined for bla(TEM/SHV/CTX-M) extended-spectrum-beta-lactamase (ESBL) genes, oxyimino-cephalosporin MIC profiles, ESBL phenotypes (determined by the ESBL Etest and the combined disk and double-disk synergy [DDS] methods), and susceptibility to non-beta-lactam antibiotics. Multidrug-resistant CTX-M-15-like (n = 23) and CTX-M-9-like (n = 15) ESBLs dominated among the 50 ESBL-positive E. coli isolates. SHV-5-like (n = 9) and SHV-2-like (n = 4) ESBLs were the most prevalent in 19 ESBL-positive K. pneumoniae isolates. Discrepant ESBL phenotype test results were observed for one major (CTX-M-9) and several minor (TEM-128 and SHV-2/-28) ESBL groups and in SHV-1/-11-hyperproducing isolates. Negative or borderline ESBL results were observed when low-MIC oxyimino-cephalosporin substrates were used to detect clavulanic acid (CLA) synergy. CLA synergy was detected by the ESBL Etest and the DDS method but not by the combined disk method in SHV-1/-11-hyperproducing strains. The DDS method revealed unexplained CLA synergy in combination with aztreonam and cefpirome in three E. coli strains. The relatively high proportion of ESBL-producing E. coli organisms with a low ceftazidime MIC in Norway emphasizes that cefpodoxime alone or both cefotaxime and ceftazidime should be used as substrates for ESBL detection.

Drug Resistance, Multiple, Bacterial↗
PubMed2006

[Whooping cough--an increasing problem in Norway].

BACKGROUND: The incidence of whooping cough has increased in recent years in Norway, especially amongst older children and adults; in 2004 it was 168/100,000. MATERIAL AND METHODS: This article is based on our own experience and a review of available literature, identified on Medline with the search word "pertussis". RESULTS AND INTERPRETATION: Whooping cough, a disease caused by the bacterium Bordetella pertussis, is transmitted via respiratory droplets. Sources of infection for infants are often their parents and siblings. Older children and adolescents contract whooping cough mostly in school, whereas adults usually get the disease from children or colleagues. The typical symptoms are bouts of violent coughing with the classic whoop and post-tussive vomiting. A milder clinical picture can be seen in vaccinated persons, reinfected patients, and in persons above the age of 15. Infants are most at risk of developing serious disease and have the highest numbers of hospitalizations, complications and mortality. But complications are also seen in adolescents and adults, including urinary incontinence, rib fractures and pneumonia. The diagnosis is made by culture or PCR in nasopharyngeal secretions, as well as by detection of antibodies to B. pertussis in serum. If treatment is indicated, macrolides are the drugs of choice; these shorten the duration of symptoms and the period of contagiousness if given in the early stages of the disease. To help combat whooping cough in Norway, from 2006 an extra vaccine booster dose will be given to children at the age of seven.

Adolescent↗
PubMed2005

Isolation of Bordetella pertussis in blood culture from a patient with multiple myeloma.

Bordetella pertussis is a fastidious aerobic, Gram-negative coccobacillus that causes the classical disease of whooping cough. We present a 63 years old man with multiple myeloma who was admitted to the medical department with cough, hoarseness and fever. Bronchopneumonia was suspected and two courses of beta-lactam antibiotics had beneficial effect on his clinical condition, but his respiratory symptoms persisted. Eventually, B. pertussis grew in an aerobic blood culture. Delayed treatment with clarithromycin had little or no effect on his cough. To our knowledge this is the third reported case of B. pertussis bacteraemia. All three patients have been immunocompromized. Growth in blood culture may be slow, and prolonged incubation (at least 6 days) of the blood culture bottles and subculture to a special culture medium is necessary for isolation of B. pertussis.

Anti-Bacterial Agents↗
PubMed2004

[Bite wound infections].

BACKGROUND: The lifetime risk of experiencing a bite wound, human or animal, is approximately 50%, and bite wounds account for approximately 1% of all visits to emergency departments. The majority of bite wounds are inflicted by dogs and cats. MATERIAL AND METHODS: A review of the literature on the diagnosis and treatment of bite wound infections is presented. RESULTS: The most common pathogens associated with bite wounds are Streptococcus species, Staphylococcus species, Pasteurella multocida, Capnocytophaga canimorsus and anaerobic bacteria. Sporadically other pathogens are isolated from bite wounds. Human bites differ from animal bites by higher prevalence of Staphylococcus aureus and Eikenella corrodens. INTERPRETATION: It is important to be aware of the possibility of complicating infections following bite wounds, particularly after cat bites. Phenoxymethyl penicillin should be the drug of choice in treatment of infections associated with cat and dog bites. However, in case of slow recovery or no improvement, simultaneous lymphadenopathy or pneumonia, S. aureus or Francisella tularensis should be suspected; ciprofloxacin is recommended. For human bite infections the recommend treatment is phenoxymethyl penicillin in combination with penicillinase-stable penicillin.

Animals↗
PubMed2003

[Long-term antibiotic suppressive therapy for an infected thoracic aorta graft].

BACKGROUND: Infections of arterial vascular grafts are among the most dreaded complications in vascular surgery. Infection in a thoracic aorta graft poses particular challenges. Depending on the local anatomy, extraanatomic bypass, otherwise the cornerstone in the management of infected vascular grafts, is usually impossible. MATERIAL AND METHODS: We present a case report on a patient with an infected thoracic aorta graft and discuss the choice of antibiotics for long-term suppressive therapy. RESULTS: In the course of the 52 months since the insertion of the aortic graft, the patient experienced eight serious episodes of staphylococcal septicaemia, with Staphylococcus aureus in blood culture on each occasion. A combination therapy of three orally administered anti-staphylococcal antibiotics has kept him free from recurrent septic episodes over the last 25 months, with a good quality of life and without signs of systemic infection. INTERPRETATION: Life-long antibiotic suppressive therapy for infected thoracic aorta graft offers the prospect of long-term survival with a good quality of life, even when there are recurrent serious septic complications. The choice of antibiotics should take into account the feasibility of the proposed treatment; parenteral antibiotics are not a realistic option in the long run. The antibiotics should be well absorbed after oral administration, have a high intrinsic activity against the offending pathogen, and be given at intervals leading to inhibitory blood concentrations throughout most of the day. In our patient, a triple combination therapy was necessary.

Administration, Oral↗