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R Frei

Publications and source records attributed to R Frei.

At least 19 recordsLinked to original sources
PubMed1992

[Swiss quality control in bacteriology and mycology 1989-1991].

Since 1983 there has been a voluntary quality assessment scheme (QAS) for bacteriology and mycology laboratories in Switzerland directed by the Committee for Quality Control of the Swiss Society for Microbiology. For the first time, the results of this QAS for the period between 1989 and 1991 are made available to a wider public. During the period in question, a steadily increasing number of participants received three samples containing microorganisms four times a year for identification and susceptibility testing. A mean percentage value of a point rating, with a maximum of 12 points, was calculated every year for each laboratory. Values of < or = 75% were defined as insufficient. For a first evaluation, laboratories were assigned to the categories of cantonal (and university) laboratories (C/U), private laboratories (P), and hospital laboratories (H, in hospitals which are neither university nor other tertiary care centres). Significant differences were detected between C/U and P on the one hand and H on the other. As a rule, H obtained poorer results than the two categories, examined fewer specimens, and their percentage with results < or = 75% was significantly higher. The second evaluation classified laboratories according to their recognition by the Swiss Federal Department of Public Health (FDPH). For statistical reasons, H had to be grouped with C/U. Nevertheless, their share of non-recognized laboratories was exceedingly high (15 out of 17 participants in 1991). Recognized laboratories constantly showed a better performance than non-recognized laboratories, examined more specimens, and their number of laboratories obtaining results < or = 75% was much lower.(ABSTRACT TRUNCATED AT 250 WORDS)

Accreditation↗
PubMed1991

Killing of nongrowing and adherent Escherichia coli determines drug efficacy in device-related infections.

Antimicrobial therapy of device-related infections often fails, despite the in vitro susceptibility of the infecting strain. Therefore, alternative laboratory-based in vitro tests are required to predict the outcome. Fleroxacin, ciprofloxacin, aztreonam, and co-trimoxazole were tested against Escherichia coli ATCC 25922 in vitro and in the tissue-cage animal model. The importance of early treatment was evaluated by starting the drugs either 30 min before or 4, 12, and 24 h after bacterial challenge. Results were compared with the in vitro drug efficacy against nongrowing and adherent Escherichia coli ATCC 25922. The alternative in vitro tests correlated highly with the outcome in the tissue-cage animal model. In the prophylaxis group (drug given 30 min before bacterial challenge), co-trimoxazole was less efficacious than the other three drugs (P less than 0.001). In delayed treatment, ciprofloxacin showed the highest cure rate. It was also more potent than the other drugs against nongrowing and adherent E. coli ATCC 25922. The efficacies of aztreonan, fleroxacin, and ciprofloxacin dropped significantly (P less than 0.01) when the time interval between bacterial challenge and the start of treatment was delayed to greater than 4 h. These data emphasize (i) the need for proper timing of prophylaxis in patients undergoing implant surgery, and (ii) the possibility of successful treatment of established device-related infections with drugs which kill not only growing but also nongrowing and adherent bacteria.

Animals↗
PubMed1990

Correlation between in vivo and in vitro efficacy of antimicrobial agents against foreign body infections.

Implant-associated infections are often resistant to antibiotic therapy. Routine sensitivity tests fail to predict therapeutic success. Therefore experimental in vitro tests were sought that would better correlate with drug efficacy in device-related infections. The activity of six different antibiotics against methicillin-resistant Staphylococcus epidermidis was investigated. In vivo studies were performed with the guinea pig tissue-cage animal model; in vitro studies with minimum inhibiting and bactericidal concentrations, time-kill studies of growing and stationary-phase microorganisms, the killing of glass-adherent S. epidermidis. Drug efficacy on stationary and adherent microorganisms, but not minimum inhibiting concentrations, predicted the outcome of device-related infections. Rifampin cured 12 of 12 infections and was also the most efficient drug in any experimental in vitro test. Similarly, the failure of ciprofloxacin to eradicate foreign body infections correlated with its low efficacy on stationary-phase and adherent S. epidermidis.

Animals↗
PubMed1988

[A Candida krusei epidemic in a hematology department].

Candida krusei is a rarely isolated opportunistic yeast which we observed in 12 immunocompromised patients over a four-month period. Epidemiologic investigations identified the source of the organism in a bottle containing contaminated lemon juice in the hospital kitchen. Since elimination of the source we found the yeast in only 3 additional cases (4% vs. 0.4% of all patients with positive yeast cultures) over 11 months. Upper respiratory tract was the most common site of colonization. 6 of 15 patients developed infections with C. krusei (4 pneumonia, 1 disseminated infection and 1 localized). 4 died from fungal infections. - The importance of infection control institutions for efficient epidemiologic investigation of nosocomial infections is discussed.

Adult↗
PubMed1988

[Adjustment to illness in patients with chronic physical diseases--initial experiences with the zurich illness adaptation questionnaire].

270 patients who suffered from gynaecological cancer, epilepsy or diabetes mellitus were examined with a newly developed questionnaire as to their coping behaviour. In order to assess the dimensions and reliability of the instrument, the data were evaluated by different statistical methods. For the three coping patterns established by factor analysis: anxiety/withdrawal, emotional neutrality/diversion and hope/facing of illness, significant correlations resulted with the variables age and sex. The outcome of the investigation suggests that if the disease takes a favourable turn, the chronically ill patient, similarly, copes with it in a favourable manner. For the differentiation and prominence of coping patterns, the patient's subjectively experienced impairment of his physical state of health seems to play an important role.

Adaptation, Psychological↗
PubMed1987

Clinical consequences of development of resistance to third generation cephalosporins.

Eighteen patients are described in whom initially sensitive microorganisms were replaced by resistant isolates during administration of ceftriaxone (n = 8), cefoperazone (n = 5), moxalactam (n = 4), cefotaxime (n = 2) or ceftazidime (n = 1), despite combination with aminoglycosides. All patients had documented gram-negative infections; in 12 patients underlying haematological diseases were present. Resistant strains of Enterobacter cloacae (14), Serratia marcescens (4), Klebsiella oxytoca (3), Pseudomonas aeruginosa (2) and Citrobacter freundii (2) emerged within 2 to 19 (mean 9) days after the beginning of treatment. In 12 patients relapse or secondary infections occurred. Seven of the patients with haematological disorders died. Resistance development was seen in 8 of 29 patients on ceftriaxone and 4 of 10 patients on moxalactam during prospective evaluations; the other drugs were used sporadically. Thus, selection of resistant bacteria is relatively frequent and may have serious clinical consequences in patients with impaired host-defense mechanisms.

Adolescent↗
PubMed1987

[Can layman volunteers for the elderly be mobilized?].

In order to improve the informal support system to the aged population it is necessary to improve the knowledge of the disabilities that burden everyday life and to gather information on specific needs. A pilot study in an urban area hints at the need for voluntary support by one third of the aged population. 88% declare their willingness to give voluntary support to others. The process of actual mobilization is then described.

Aged↗
PubMed1986

Use of ciprofloxacin in the treatment of Pseudomonas aeruginosa infections.

The therapeutic efficacy and safety of ciprofloxacin was studied in 30 patients with Pseudomonas aeruginosa infections. In 20 patients ciprofloxacin was given alone and in 10 patients (including 8 compromised hosts) in combination with an aminoglycoside (9) or azlocillin (1). Ciprofloxacin was given in doses of 500 mg orally or 200-300 mg i.v. every 12 h. In patients receiving only ciprofloxacin clinical cure with eradication of bacteria was obtained in 15 patients (75%) with infections of bone and joint (6), skin and soft tissue (4), lung (2), middle ear (2) and CSF (1). Two patients with lymphoma and Pseudomonas aeruginosa pneumonia died. In patients receiving combination therapy a definite therapeutic success was achieved in four (40%). Three patients with Pseudomonas aeruginosa septicemia died. In seven patients nine bacterial strains with decreasing susceptibility of ciprofloxacin (increase in MIC from less than or equal to 0.5 micrograms/ml to 2-16 micrograms/ml) were selected (6 Pseudomonas aeruginosa, 1 Enterobacter cloacae, 1 Serratia marcescens, 1 Staphylococcus aureus). Ciprofloxacin was well tolerated. This new quinolone seems to be suitable for single drug treatment of Pseudomonas aeruginosa infections in patients with normal host defense mechanisms, while its therapeutic potential in compromised hosts requires further evaluation.

Administration, Oral↗