Biomedical subjects
Publications and source records attributed to R Ansorg.
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An application mode of the indirect fluorescent antibody technique is described which allows the differentiation of soma and flagella of Ps. aeruginosa cells on the morphological and serological level simultaneously and the determination of the topic specificity of Ps. aeruginosa antisera. Antisera prepared by immunization of rabbits with formalinized semisolid agar cultures react with somatic and flagellar antigens (anti-OH-sera), while antisera made with heated cultures strain somatic antigens exclusively (anti-O-sera). Anti-OH-sera absorbed by heated cultures of the strain used for immunization lead to selective fluorescent staining of flagellar antigens (anti-H-sera). The reaction between somatic antigens and antisomatic antibodies is inhibited by coating substances which are removed by washing the cells. The masking effects of thermovariable and correlates with the viscosity of the cell suspension. The somatic antigens of washed cells are thermostabile, whereas the flagellar antigens are destroyed after heating at 60 degrees C. The strains representative of serogroups 0:1-0:12 of Habs show numerous uni- and bilateral relationships of the somatic antigens. However, group-specific reacting anti-O-sera are obtained by dilution of absorption of the overlapping antisomatic antibodies. The flagellae of the representative strains belong to two flagellae types: one type shows a complex, the other a uniform antigen structure. They do not include all flagellar antigens existing in Ps; aeruginosa;
In 24 patients with normal renal function the serum concentration of gentamicin was checked during a period of 3--5 days. The biological test is simple and rapid to perform. The patients were given doses of 80--240 mg gentamicin per day. Even at doses of 240 mg/day no accumulation of the drug occurred. Intramuscular application of an 80 mg maximum dose of gentamicin did not result in any toxic serum concentrations. The measurement of peak concentrations--1 h after application--is therefore jus aimed at correcting too low dosages. The median values of the serum peak concentrations are 4--6 microgram/ml in the case of single dose application of 80 mg and 3 microgram/ml in the case of single dose application of 40 mg. Consequently serum concentrations effective against moderately susceptible bacteria (MIC = 1--4 microgram/ml) do not act for a sufficiently long time, since the half-life for elimination is 2 h. Daily dosages of up to 240 mg (3X80 mg) gentamicin are only effective in infections caused by very susceptible bacteria with a MIC up to 1 microgram/ml.
19 preterm and 2 newborn infants received gentamicin in dosages of 2.5 mg/kg every 12 h. Successive determinations of serum concentrations show, that the levels of gentamicin are adequate for therapy even in preterm infants with low birth weight. Concentrations 30 min after injection (c30min) and base-line-concentrations vary widely. 74% of the 30 min-serum levels are observed within the desired therapeutic range, between 3 and 10 microgram/ml. 16% of the levels measured 30 min after intravenous or intraarterial injection are higher than the known range for potential ototoxicity of 10 microgram/ml. 10% of the 30 min-levels are around 2 microgram/ml, so that the therapeutic efficacy during the following interval of application is doubtful. There is no evidence of accumulation of the drug for periods of treatment up to 7--20 days. The average serum half-life in premature infants with a gestational age of less than 32 weeks and a birth-weight of less than 2000 g is 5--6,7 h. Those with a gestational age of greater than 32 weeks and a birth-weight of greater than 2000 g, and full-term infants show a gentamicin half-life of 2.9h. To determine the actual serum concentration of gentamicin, the rapid and easy disc-agarose-diffusion test using B. subtilis is useful and suitable for routine therapy control.
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The concentrations of active agent were determined in the bile and serum after oral administration of ampicillin and pivampicillin to 12 patients 7-9 days after surgical revision of the common bile duct. Orally, pivampicillin is more rapidly absorbed, maxima of active agent and the mean serum concentrations are higher compared with ampicillin. The rate of absorption and serum concentrations after giving ampicillin and pivampicillin depend on the type of diet. Pivampicillin produces higher concentrations of active agent in the bile of the common bile duct more rapidly than ampicillin. The mean concentration of active substance in the bile is distinctly above the serum concentrations.
The disc agar-diffusion-test using Bacillus subtilis ATCC 6051 as test organism is a simple and rapid method for routine testing of antibacterial agents in urine specimens. The test records urine levels which are expected under medium dosage, and in many cases even lower concentrations of renal excreted antibiotics. Out of 5655 analysed urine samples 22% contain antibacterial substances. In urine specimens over which information was volunteered that either no chemotherapy had been administered or that more than a three day's interval free of therapy existed, inhibitory substances are found in 8% and 27% respectively. Urine specimens which are supposedly collected from patients under current chemotherapy do not show therapeutic relevant antibiotic levels in 26%. Between urine specimens with and without antibacterial activity there is no significant difference in the incidence of viable counts of 10-4-10-5/ml and 10-5/ml. From urine samples with antibacterial content increases in the numbers of multiple resistant strains of E. coli, Proteus spp., Pseudom. aerug. and Enterobacter spp. together with high numbers of Candida spp. are observed.
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A microbiological check-up was made on 17 patients with choledocholithiasis while they were undergoing EPT and control ERCP. The endoscopes were contaminated in 56% of the 34 procedures. In 9% of the interventions there were indications that mouth flora had been transferred to the duodeno-biliary region. Bacteriaemia occurred in 3 (17%) patients in connection with EPT. After a mean of four months following EPT, the colony count and the number of germs in the duodenal and biliary juice tended to increase; bacteria of the Klebsiella-Enterobacter-Serratia group became dominant. More than 80% of the bile and blood isolates were sensitive to cefotaxime, cefamandole and co-trimoxazole. To minimize the risk of infection following EPT and ERCP, repeated controls of the disinfection of the endoscopes and periendoscopic antibiotic prophylaxis are suggested.
In an open study 31 patients undergoing bone marrow transplantation for various haematological diseases received fluconazole as prophylaxis or treatment of fungal infections. In 26 of these patients an antecedent oral prophylaxis with polyene antimycotics had failed to prevent infections with Candida species. Five of the 31 patients received fluconazole as primary prophylaxis because of non-compliance for polyene antimycotics. Fluconazole was administered orally at a daily dose of 100 mg and 200 mg, respectively (n = 29), or intravenously at a dose of 100 mg and 400 mg (n = 2). Cure or efficient prophylaxis was achieved in 22/31 patients (71%) after a median of 52 (9 to 493+) treatment days. In three patients (10%) Candida was eradicated but the infection reappeared 14-28 days after cessation of the drug; in 6 patients (20%) the infection was persistent or progressive. Four patients developed lethal Aspergillus infection while on fluconazole medication. A moderate and reversible elevation of liver function tests under therapy was observed in 9 patients and was possibly attributable to fluconazole in three of them (10%). One patient developed tremor which resolved after cessation of fluconazole. No other adverse drug reactions could be noted. We conclude that fluconazole is a relatively safe and effective drug for the prevention and treatment of superficial and, possibly, deep Candida infections in severely immunocompromised patients. However, it is presumably without preventive value in Aspergillus infections.
Aspergillus fumigatus isolates (n = 6) from a lung transplant recipient, one isolate from a patient who had been on the same ward and a reference strain (NCPF 2140) were compared using three typing methods: SDS-PAGE, immunoblotting with serum from the transplant patient and random amplified polymorphic DNA (RAPD) assay. Neither the SDS-PAGE, immunoblot nor RAPD assay with single primers revealed differences between the eight isolates. Digestion of one primer product with the endonuclease EcoRI discriminated between the six patient isolates and the other two strains. The RAPD assay using pairwise combined primers showed identical patterns for the patient's strains but differentiated between the two other strains. It is concluded that any single technique may fail to detect strain differences and that a spectrum of typing methods is necessary in order to reveal or to exclude cross-infections with Aspergillus fumigatus.
Extracts of the traditionally used medicinal plants Entada abyssinica (stem bark), Terminalia spinosa (young branches), Harrisonia abyssinica (roots), Ximenia caffra (roots), Azadirachta indica (stem bark), Zanha africana (stem bark) and Spilanthes mauritiana (roots and flowers) were investigated for fungistatic and fungicidal activity against Candida spp. and Aspergillus spp. by a microtitre serial dilution technique. Entada abyssinica, T. spinosa, X. caffra, A. indica, and Z. africana showed activity against various Candida species. The minimum inhibitory concentrations (MICs) ranged from 0.006 to > 8 mg ml-1 and the minimum fungicidal concentrations (MFCs) from 0.06 to > 8 mg ml-1. Extracts from S. mauritiana (both roots and flowers) exhibited no activity against Candida spp., but against Aspergillus spp., the MIC and MFC values ranged from 0.13 to 0.25 mg ml-1 and from 0.13 to 1 mg ml-1 respectively. It is concluded that the extracts contain compounds with high antifungal potency.