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P Kragsbjerg

Publications and source records attributed to P Kragsbjerg.

At least 19 recordsLinked to original sources
PubMed2004

Similar inflammatory response in human whole blood to live Streptococcus pneumoniae of different serotypes.

Differences in inflammatory responses in human adult whole blood to live pneumococcal serotypes 3, 7F, 9V and 23F were investigated. Using flow cytometry and ELISA, oxidative burst, expression of activation markers CD11b/CD18, and in-vitro production of tumour necrosis factor-alpha, interleukin-6 (IL-6) and interleukin-8 were measured. There was no significant difference between the serotypes regarding any of the variables investigated, although there was a trend towards higher concentrations of IL-6 induced by serotypes 9V and 23F. In the present experimental model, the serotypes of Streptococcus pneumoniae shown previously to cause different degrees of inflammation were found to cause a similar inflammatory response in human whole blood.

CD11b Antigen↗
PubMed2003

Correlations between serum amyloid A protein and C-reactive protein in infectious diseases.

Serum amyloid A (SAA) protein is an acute phase reactant that has recently become of increasing interest as a marker for disease and treatment monitoring. We have correlated SAA levels to those of C-reactive protein (CRP) in sera from 98 patients admitted to an infectious diseases clinic because of viral and bacterial infections, including hepatitis A and B, cytomegalovirus infection, varicellae-zoster, infectious mononucleosis, influenza A, bacterial pneumonia, streptococcal pharyngitis, bacterial sepsis and severe bacterial sepsis. The study population was chosen from the clinical setting as representatives of these frequently encountered patient groups. SAA levels correlated significantly with CRP levels (r2=0.757, p<0.001) for the entire studied population. Furthermore, positive correlations were found in viral (r2=0.572, p<0.001) and bacterial (r2=0.666, p<0.001) infections. Positive correlations were also observed when the values were compared in accordance with CRP levels higher and lower than 100 mg/L (r2=0.689, p<0.001; CRP>100; r2=0.397, p<0.001; CRP<100). Because SAA is more sensitive than CRP for the detection of minor inflammatory stimuli, as in the viral and low CRP groups, we conclude that SAA can be of use in several viral infections, as well as in non-invasive and early invasive bacterial infections.

Bacterial Infections↗
PubMed2001

The effects of live Streptococcus pneumoniae and tumor necrosis factor-alpha on neutrophil oxidative burst and beta 2-integrin expression.

OBJECTIVE: To study the effects of TNF-alpha and live Streptococcus pneumoniae on human neutrophil oxidative burst and beta 2-integrin expression using flow cytometry. METHODS: Six clinical isolates of S. pneumoniae (serotypes 3, 19A, 22F, 6A, 33F and 9N) from patients with bacteremic pneumonia or upper respiratory tract infections were studied. Whole blood was incubated either alone, with TNF-alpha or with S. pneumoniae or with both TNF-alpha and pneumococci at a ratio of one neutrophil per 1--5 bacteria. After 30 min of incubation, the tubes were put into ice, fixed and analysed. RESULTS: S. pneumoniae caused an increase in oxidative burst but not greater than that caused by TNF-alpha alone. When whole blood was preincubated with TNF-alpha for 30 min before the addition of pneumococci, a further increase in the oxidative burst response was seen. The variation in CD11b expression was not significant. Both S. pneumoniae and TNF-alpha caused increases in CD18 expression. The addition of TNF-alpha directly with the bacteria caused no further increase, but preincubation of blood with TNF-alpha 30 min before the addition of the bacteria caused a significant increase in CD18 expression. CONCLUSIONS: Live S. pneumoniae stimulates polymorphonuclear leukocytes to produce an oxidative burst and increases expression of CD18, and these effects are enhanced by TNF-alpha.

Bacteremia↗
PubMed2001

Recurrent Pneumococcal bacteraemia and meningitis in an asplenic adult with possible unusual focus.

An unusual case of a dental infection leading to osteitis of the mandible and possibly to 4 episodes of invasive pneumococcal disease in an asplenic adult is presented. The patient had 2 episodes of pneumococcal meningitis with bacteraemia and 2 episodes of bacteraemia without meningitis during a 1-y period. Investigations using bone and leukocyte scintigraphy revealed only a focal uptake in the right mandibular bone. The pneumococcal strains isolated during the 4 episodes were all serotype 23F, and fully susceptible to penicillin.

Adult↗
PubMed2000

The effects of live Neisseria meningitidis and tumour necrosis factor-alpha on neutrophil oxidative burst and beta2-integrin expression.

The effects of human recombinant tumour necrosis factor-alpha (TNF-alpha) on neutrophil (PMNL) oxidative burst and on CD11b/CD18 and CD14 expression after stimulation with pathogenic or nonpathogenic Neisseria meningitidis were studied using chemiluminescence and flow cytometry. PMNL oxidative burst increased more when stimulated with the apathogenic 29E strain than with the pathogenic B strain both when studied by chemiluminescence and by flow cytometry. When TNF-alpha was added to whole blood or PMNL together with bacteria a significant increase in the oxidative burst was seen for the B strain only. When whole blood was preincubated for 30 min with TNF-alpha the increase in oxidative burst was significant for both meningococcal strains. TNF-alpha caused a significant increase in PMNL CD 11b/CD18 expression after 30 min of incubation at 37 degrees C. TNF-alpha added simultaneously with the bacteria induced a significant increase in PMNL CD11b/CD18 in both strains. Incubation with the B strain alone caused a low but significant increase in CD11b/CD18 expression, but the addition of TNF-alpha increased this expression to the same high level as incubation with TNF-alpha alone or the 29E strain alone. Only TNF-alpha and the 29E strain caused significant increases in CD14 expression. In conclusion, human PMNLs react differentially when stimulated with pathogenic and nonpathogenic N. meningitidis and the activating effect of TNF-alpha is variable depending on the bacteria involved.

Antigens, CD↗
PubMed1998

Cytokine responses in patients with pneumonia caused by Chlamydia or Mycoplasma.

The serum concentrations of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), and interferon-gamma (IFN-gamma) were measured by enzyme immunoassays in 44 patients with Chlamydia (n = 13) or Mycoplasma (n = 14) pneumonia or influenza A infection (n = 17) and in 20 control subjects. The levels of IFN-gamma were raised in 29/44 patients. The concentrations of IL-6 were raised in 32/44 patients. Raised levels of TNF-alpha were seen in 26/44 but there was no significant difference between the levels of the different groups of patients. All three cytokines indicated clinical recovery when acute and convalescent samples from 10 patients with Chlamydia pneumonia were analyzed. IFN-gamma, IL6 and TNF-alpha are present in the circulation in the majority of patients with Chlamydia and Mycoplasma pneumonia and in influenza A infection. We suggest that repeated measurement of cytokines, such as IL-6, IFN-gamma and TNF-alpha, may be useful in the management of lower respiratory tract infections but further studies are needed to define the value of cytokine measurements in acute pneumonia.

Adolescent↗
PubMed1997

Chronic active mononucleosis.

A 16-year-old girl with 3 clinical episodes of mononucleosis during a period of more than 2 year is presented. The patient had persistently elevated VCA-IgM antibodies during follow-up for 15 months until she became EBNA-positive. This is a case of prolonged primary EBV infection and late seroconversion as clinical restitution and development of EBNA antibodies occurred 2 year after the onset of clinical illness.

Adolescent↗
PubMed1996

Dynamics of blood cytokine concentrations in patients with bacteremic infections.

Cytokines play a major role in the pathophysiology of sepsis and septic shock. Using enzyme immunoassays the acute serum levels of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), granulocyte-colony stimulating factor (G-CSF), interleukin-8 (IL-8), and leukemia inhibitory factor (LIF) were investigated in 90 patients with positive blood cultures and clinical signs of infection. In 27 patients samples were obtained on admission, after 1, 4, 12, 18, and 24 h, and then daily. The acute serum levels of IL-6, TNF-alpha, G-CSF, and IL-8 were significantly higher among patients with severe sepsis. Patients with Gram-negative infection had significantly higher levels of TNF-alpha on admission than did patients with Gram-positive infections (p = 0.0008). The levels of IL-6, G-CSF and, to some extent, TNF-alpha decreased rapidly in survivors within the first 24 h of admission to hospital and institution of treatment. LIF was detected in 8/90 in both survivors and nonsurvivors.

Adult↗
PubMed1995

Deep soft-tissue infections caused by Streptococcus pneumoniae.

Three cases of deep soft-tissue infections caused by Streptococcus pneumoniae are presented. All patients were previously healthy adults. The first case was a man with a protracted illness in whom pelvic and inguinal abscesses developed at the site of a scar from a traumatic injury several years earlier. The second patient, a woman, had mastitis with systemic symptoms. The third patient was a woman who developed a gluteal abscess after an intramuscular injection of a contraceptive. Cellulitis and deep soft-tissue infections caused by Streptococcus pneumoniae are uncommon, but may occur even in immunocompetent adults.

Adult↗
PubMed1995

Diagnostic value of blood cytokine concentrations in acute pneumonia.

BACKGROUND: The role of cytokines in the pathogenesis of pneumonia is still poorly understood. In a previous study the diagnostic value of measuring blood concentrations of interleukin 6 and interferon gamma was established. In the present study the value of blood concentrations of interleukin 8, granulocyte-colony stimulating factor, and lactoferrin as markers of bacteraemic pneumonia is evaluated. METHODS: The circulating concentrations of interleukin 8 (IL-8), granulocyte-colony stimulating factor (G-CSF), and lactoferrin were measured in 14 patients with bacteraemic pneumococcal pneumonia and 49 patients with atypical pneumonia or influenza A infection using enzyme immunoassays. RESULTS: Serum G-CSF concentrations were higher in the group with bacteraemic pneumococcal pneumonia, and G-CSF values correlated with the white blood cell count and levels of C-reactive protein (CRP). The levels of IL-8 were higher in the group with bacteraemic pneumococcal pneumonia than the groups with Chlamydia pneumonia, Legionella pneumonia, or influenza A infection, but there was no difference when compared with the group with Mycoplasma pneumonia. A white blood cell count of > 15 x 10(9)/l was highly suggestive of bacteraemic pneumonia. The concentrations of lactoferrin were raised in all groups except those with influenza A infection, but no difference was found between the different aetiological groups. A correlation was found between lactoferrin and white blood cell counts. CONCLUSIONS: Serum G-CSF and IL-8 concentrations are potential markers of bacteraemic pneumonia.

Acute Disease↗
PubMed1995

Serum concentrations of interleukin-6, tumour necrosis factor-alpha, and C-reactive protein in patients undergoing major operations.

OBJECTIVE: To investigate the kinetics of interleukin-6 (IL-6), tumour necrosis factor-alpha (TNF-alpha) and C-reactive protein after a surgical operation. DESIGN: Prospective study. SETTING: Teaching hospital, Sweden. SUBJECTS: 28 patients undergoing cardiac operations, joint replacement, or gastric restrictive operations. INTERVENTIONS: Samples of serum were taken before operation; at 0, 6, and 12 hours; and then daily for six days. OUTCOME MEASURES: IL-6, TNF-alpha, and C-reactive protein concentrations at specified time points, and their correlation with complications and outcome. RESULTS: The IL-6 concentration peaked soon after operation, and that of C-reactive protein 48-96 hours later. Serum IL-6 concentrations were highest in the eight patients undergoing cardiac operations. In one patient an infective complication occurred resulting in secondary peaks of IL-6 and C-reactive protein. Three patients who developed postoperative circulatory and respiratory instability had no additional changes in cytokine concentrations. The overall concentrations of IL-6 were raised above 100 pg/ml for a mean of 36 hours after operation and those of C-reactive protein were over 100 mg/l for a mean of 106 hours (p < 0.0001). Serum TNF-alpha concentrations were low in all patients. CONCLUSION: The maximum serum concentrations of IL-6 and C-reactive protein after surgical operations were comparable to those in patients with sepsis. If IL-6 and C-reactive protein analyses are used in the diagnosis of infective complications, evaluation of the results should be related to the length of time between the operation and sampling, and to the clinical findings. The shorter period during which IL-6 was raised compared with C-reactive protein indicates that IL-6 may be a more useful marker of postoperative infective complications.

Aged↗
PubMed1994

Detection of bacterial DNA in cerebrospinal fluid by an assay for simultaneous detection of Neisseria meningitidis, Haemophilus influenzae, and streptococci using a seminested PCR strategy.

Primers specific to conserved and variable regions in the 16S rRNA sequence were selected from the partially sequenced 16S rRNA genes of Neisseria meningitidis, Haemophilus influenzae, Streptococcus pneumoniae, S. agalactiae, and Staphylococcus epidermidis. The PCR assay was divided into two DNA amplifications. The first resulted in a general bacterial amplicon, and the second resulted in a species-specific amplicon. The high specificity of the PCR assay was documented after testing bacteria of 28 different species (133 strains). A total of 304 clinical cerebrospinal fluid samples, including 125 samples from patients with bacterial meningitis, were assayed to investigate the diagnostic sensitivity and specificity for bacterial meningitis. The assay showed high sensitivity (0.94) and specificity (0.96) with the clinical samples, although some false results were obtained, the reasons for which are discussed. With agarose gel electrophoresis for detection of the PCR products, the detection limit for meningococci in cerebrospinal fluid was 3 x 10(2) CFU/ml.

Base Sequence↗
PubMed1994

Pneumococcal meningitis in adults.

A retrospective study was conducted to examine the clinical features and outcome of 31 adult pneumococcal meningitis patients during the years 1981-92. The incidence was 1.0/100,000 adults/year. The case fatality rate was 16% (5/31), and in patients older than 70 years, 33% (3/9). Sequelae were seen in 29% (7/24), mostly otoneurologic symptoms. In 27/28 bacterial isolates the serotypes found were included in the 23-valent unconjugated polysaccharide vaccine in current use. All 28 isolates were fully sensitive to penicillin. 49/51 non-meningitis blood isolates had MIC values < or = 0.06 mg/l, 2 isolates had MIC values of 0.125 mg/l and 0.25 mg/l, and 50/50 were serotypes included in the 23-valent vaccine. Pneumococcal meningitis is a disease causing considerable mortality and morbidity. The relatively low case fatality rate found in the present study may be due to the patients' good health prior to admission, rapid specific microbiological diagnosis, absence of penicillin-resistant pneumococci among the meningitis strains, and immediate institution of specific and supportive therapy.

Adult↗
PubMed1993

Tumor necrosis factor-alpha (TNF alpha) in cerebrospinal fluid from patients with meningitis of different etiologies: high levels of TNF alpha indicate bacterial meningitis.

The levels of tumor necrosis factor (TNF)-alpha in cerebrospinal fluid (CSF) were analyzed in 139 patients with meningitis and in 20 control subjects. Elevated concentrations were observed in 42 (82%) of 51 patients with purulent bacterial meningitis (18/24 Haemophilus influenzae, 13/14 Streptococcus pneumoniae, 7/7 Neisseria meningitidis, and 4/6 with other purulent bacterial etiology). In contrast, elevated levels were found in only 5 of 78 individuals with nonbacterial meningitis (2/8 with herpes simplex type 2, 3/3 with varicella-zoster virus). Thus, the positive and negative predictive values were 0.89 for indicating a purulent bacterial meningitis. Raised CSF TNF alpha levels were observed in 7 of 8 patients with purulent bacterial meningitis in whom the routinely used parameters did not unequivocally indicate the diagnosis. Moderately increased levels were seen in 5 of 6 patients with Mycobacterium tuberculosis meningitis and in 1 of 4 cases of Borrelia burgdorferi. Thus, the present study indicates that concentrations of TNF alpha in CSF usually can discriminate between purulent bacterial and nonbacterial meningitis. These findings may contribute diagnostic guidance with routinely used CSF parameters.

Diagnosis, Differential↗
PubMed1993

Deep obstetrical and gynecological infections caused by non-typeable Haemophilus influenzae.

Six patients with deep obstetrical and gynecological infections due to non-typeable Haemophilus influenzae are presented. 3 patients had tubo-ovarian abscesses, 2 septic abortions and 1 postpartum sepsis. All our patients with tubo-ovarian abscesses had used intra-uterine contraceptive devices until admission and all had a protracted course of illness. Both patients with septic abortion had a severe course, one of them with disseminated intravascular coagulation demanding treatment in the intensive care unit. The patient with postpartum infection had a milder course. The possibility of infection with H. influenzae and the emergence of beta-lactamase producing strains warrant adequate culture procedures in women with obstetrical and gynecological infections in order to ensure proper treatment.

Abortion, Incomplete↗
PubMed1993

Association of pneumonia and lung cancer: the value of convalescent chest radiography and follow-up.

A retrospective study of 1011 hospitalized patients with pneumonia was undertaken to assess the value of routine convalescent chest radiography for detection of underlying lung cancer. To investigate the mode of clinical onset of pulmonary carcinoma, 232 inpatients with this diagnosis were also studied. The findings may be summarized as follows: 1) 13/1011 pneumonia patients were found to have previously undiagnosed pulmonary carcinoma; 2) many of these carcinomas (8/13) were disclosed by an acute chest X-ray; 3) pulmonary carcinoma was found by convalescent chest X-ray in 2/88 patients not feeling well and in 2/524 patients feeling well at follow-up, and none of these 4 patients benefitted from the carcinoma diagnosis; 4) ESR was of no value in detecting underlying pulmonary carcinoma at follow-up in patients with pneumonia; 5) of the 232 patients with pulmonary carcinoma, 29 (12.5%) presented with an acute respiratory tract infection; 6) most of these latter patients did not recover as expected and their correct diagnosis was made based on a chest X-ray performed because of persistent symptoms. We suggest that patients with radiologically verified pneumonia undergo clinical examination or are interviewed 4-5 weeks after the onset. If signs or symptoms of respiratory disease persist, chest X-ray should be performed. We consider, however, that routine convalescent chest radiography with the aim of detecting any underlying pulmonary tumour could be omitted if the patient has completely recovered 1 month after the acute onset of illness.

Adolescent↗