[Treatment of upper respiratory tract infections].
Explore the source record for details and available documents.
Anti-Bacterial Agents↗
Biomedical subjects
R L Skov
Publications and source records attributed to R L Skov.
Evaluation of a new 3-h hybridization method for detecting the mecA gene in Staphylococcus aureus and comparison with existing genotypic and phenotypic susceptibility testing methods.
A new 3-h hybridization assay for detection of the staphylococcal mecA gene and the Staphylococcus aureus nuclease gene was evaluated by comparing the assay with existing genotypic and phenotypic methods. A total of 275 S. aureus strains were tested, including 257 epidemiologically unrelated strains (135 mecA-positive and 122 mecA-negative; collection I), and 18 strains with known borderline resistance to methicillin (collection II). Complete agreement was obtained for both collections when comparing the new assay with genotypic methods. We further evaluated a range of phenotypic susceptibility methods recommended in Europe and/or USA using the presence of the mecA gene as the defining standard. For collection I a high degree of agreement was found for both Etests (256 strains) and the oxacillin screen plate test (255 strains); the degree of agreement was lower for agar dilution methicillin (250 strains) and oxacillin 1 microg discs (239 strains). For the borderline strains a high degree of agreement was only obtained by the oxacillin screen plate test (17 of 18 strains). The other tests were less accurate, in the following order: agar dilution methicillin, Etest methicillin, Etest oxacillin and oxacillin discs with disagreement for four, five, nine and 13 strains, respectively. In conclusion, the new hybridization assay is a rapid and exact method for detecting the mecA gene and the S. aureus nuclease gene. This study confirms that phenotypic tests for methicillin resistance in S. aureus strains creates both false-susceptible and false-resistant results, especially for borderline resistant strains.
Bacterial Proteins↗
Systemic and deep-seated infections caused by Arcanobacterium haemolyticum.
Arcanobacterium haemolyticum has been implicated mainly in non-streptococcal pharyngitis and wound infections. Rarely, it has been reported to cause systemic infection, often in combination with other pathogens. Two cases of systemic and deep-seated infections caused by Arcanobacterium haemolyticum are reported, and the literature is reviewed. Sixteen cases of bacteremia and seven cases of non-bacteremic deep-seated have been published previously. Eight of the bacteremic and two of the non-bacteremic cases occurred in younger, apparently healthy immunocompetent patients. Six patients had infections of the central nervous system. The optimal treatment of infections caused by Arcanobacterium haemolyticum is not known. Although in vitro susceptibility tests have demonstrated tolerance of Arcanobacterium haemolyticum to penicillin, penicillins with or without aminoglycosides have been the most widely used antibiotics, in most cases with success.
Actinomycetaceae↗
Primary gastrointestinal non-Hodgkin's lymphoma in adults: a population-based clinical and histopathologic study.
OBJECTIVES: To analyse the clinical course and the histopathology of primary gastrointestinal non-Hodgkin's lymphoma (GI-NHL) in adult patients and to investigate a possible impact of Helicobacter pylori. DESIGN/SETTING: Retrospective study of all adult patients in Copenhagen county diagnosed during a 6-year period with NHL. SUBJECTS: A total of 55 patients with GI-NHL diagnosed during the period from 1985 to the end of 1990. RESULTS: Twenty-eight patients had primary lymphoma in the stomach, 14 in the small intestine, 11 in the large intestine and two patients had multifocal involvement. The dominant presenting symptoms were abdominal pain, weight loss, diarrhoea, constipation and fatigue. Acute emergency problems such as severe haemorrhage or perforation at initial presentation were unusual. According to the revised European-American lymphoma (REAL) classification, diffuse large B-cell lymphoma was the most frequent histologic subtype comprising 53% of the cases. Helicobacter pylori infection was documented in 15 of 25 evaluable patients (60%) with gastric lymphomas and was not associated with any specific histological subtype. Endoscopic procedures and barium X-rays were the diagnostic approaches with highest sensitivity. In total, 30 patients (58%) achieved complete remission, 10 (19%) achieved partial remission, and 12 (23%) did not respond to treatment. The overall 5 year survival rate was 0.36 without statistically significant difference between the histological subtypes. Likewise the presence of Helicobacter pylori did not affect survival. CONCLUSION: Primary GI-NHL is a heterogeneous disease entity with considerable therapeutic controversies. No specific clinical or histological phenotype was associated with the presence of Helicobacter pylori.
Adult↗
[Outbreak of methicillin resistant Staphylococcus aureus in a central hospital].
Until 1994, methicillin resistant Staphylococcus aureus (MRSA) were isolated from less than 60 patients annually in Denmark. We describe an outbreak of MRSA involving eight patients within a timespan of six weeks. Bacteriophage-typing and DNA typing using pulsed field gel electrophoresis revealed that three different strains of MRSA were involved in the outbreak. This emphasizes the importance of typing MRSA in order to clear up the spread in an outbreak. Of the eight patients four died, and in one case MRSA was thought to be the major cause of death. The expenses of the extra hygienic measures i.e. isolation of patients, medication and bacteriological surveillance were estimated to approximately DKK 80.000 pr. patient. Patients, who have been admitted to or worked at a hospital outside Scandinavia within the last six months, are potentially colonized with MRSA. Specific guidelines for hospital hygiene are necessary to prevent the spread of such strains.
Adult↗
beta-Lactamase production and genetic location in Staphylococcus aureus: introduction of a beta-lactamase plasmid in strains of phage group II.
Staphylococcus aureus strains of phage group II have increased in frequency in hospital-acquired infections during recent years. A total of 184 penicillin resistant group II strains from bacteraemia cases in the years 1961-1990 were analysed for the amount of beta-lactamase produced and the location of the beta-lactamase gene. Until 1977 all strains investigated had a chromosomally located beta-lactamase gene, but since then a 21 kb beta-lactamase plasmid has increased in occurrence among group II strains, especially among those strains typable only at high phage concentrations [100 x Routine Test Dilution (RTD) and 1000 x RTD]. In 1990, 84% of the group II strains contained this plasmid. Plasmid-containing strains produced more beta-lactamase than strains without the plasmid. S. aureus strains of the 94,96 complex, which since 1984 have decreased in frequency from 18 to 9% in 1993, have remained high producers of beta-lactamase.
Bacteriophage Typing↗
Fatal endocarditis due to Aerococcus urinae.
Aerococcus species are Gram-positive cocci having Gram-stain characteristics of staphylococci (i.e., form clusters), but biochemical and growth characteristics resembling streptococci and enterococci (i.e., catalase-negative, alpha-hemolytic growth on blood agar). A case of fatal endocarditis due to Aerococcus urinae is presented. Endocarditis should be suspected and, if confirmed, treated aggressively when A. urinae is recovered from blood cultures.
Aged↗
[Failure of fluoroquinolone treatment in pneumococcal pneumonia].
Based on a case story concerning the development of pneumococcal pneumonia in relation to treatment with a quinolone, use of such antibiotics in respiratory tract infections is discussed. In the light of in vitro results, animal experiments, and clinical reports of treatment failure of quinolones, we warn against the routine use of these antibiotics against respiratory tract infections. Quinolones may be useful in the treatment of verified Gram-negative respiratory tract infections, but should always be preceded by susceptibility testing.
Adult↗