[A proposal for new values in significant bacteriuria].
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Bacteriological Techniques↗
Biomedical subjects
S Bengtsson
Publications and source records attributed to S Bengtsson.
Isolated fracture of the lateral malleolus requires no treatment. 49 prospective cases of supination-eversion type II ankle fractures.
54 patients with isolated SE II fractures through the lateral malleolus, with 2 mm maximum dislocation, were treated with an elastic bandage and immediate weight bearing. 2 patients suffered dislocation but both should not, on reassessment, have been included in the study. 49 of the remaining patients were assessed after an average of 1.5 years. All but 4 patients had very minor, if any, symptoms. The average sick leave was 6.3 weeks and the patients were back to normal activity in about 4 months. This virtual nontreatment was safe and beneficial to both the patients and the health service.
Adolescent↗
Oral cefadroxil prophylaxis in hip fracture surgery. Serum concentrations studied in 17 patients.
Serum concentration-time curves were determined in seventeen 82 (60-90) year-old patients undergoing trochanteric hip fracture surgery after receiving 1 g of cefadroxil per os. All the patients attained a serum level of antibiotic high enough to inhibit the growth of Staphylococcus aureus and S. epidermidis. When orally administered, cefadroxil should be given within 2 hours before surgery.
Aged↗
Synthesis and binding properties of the fluorinated substituted benzamide [3H]NCQ 115, a new selective dopamine D2 receptor ligand.
[3H]NCQ 115 [R)-5-bromo-2,3-dimethoxy-N-[1-([2,5-3H]-4- fluorobenzyl)-2-pyrrolidinyl)methyl)benzamide) was prepared by acylation of (R)-(2-aminomethyl)-1- ([2,5-3H]-4-fluorobenzyl)pyrrolidine, which was obtained in a stereo-conservative synthesis from (R)-prolinamide. Purification by reversed phase high performance liquid chromatography (HPLC) gave [3H]NCQ 115 with a radiochemical purity of greater than 99% and a specific activity of 0.97 GBq/mumol (36 Ci/mmol). Saturation analyses, association and dissociation kinetics as well as binding competition with several compounds of various classes were performed with [3H]NCQ 115 in rat striatal homogenates. Saturation analyses in vitro showed that [3H]NCQ 115 bound to a single binding site with a Kd = 214 pM and Bmax = 35.4 fmol/mg. The binding of [3H]NCQ 115 was dependent upon sodium ions, since the number of binding sites was altered when sodium ions were excluded from the incubation medium. NCQ 115 inhibited the binding of [3H]raclopride to dopamine D2 receptors with high affinity (Ki = 147 pM), having much lower affinity for other receptors. The affinity of this substituted 1-benzyl-2-pyrrolidinylmethyl benzamide was confined to the (R)-enantiomer, which contrasts with that of the corresponding N-ethyl derivatives such as FLB 457, raclopride, eticlopride, sulpiride and NCQ 298, where the pharmacological activity is found in the (S)-enantiomer. It can be concluded that [3H]NCQ 115 binds to dopamine D2 receptors in the rat striatum with high affinity and high selectivity. [3H]NCQ 115 can also be used for in vivo binding studies of the brain. [18F]NCQ 115 may be a suitable ligand for positron emission tomography (PET) studies of the human brain in vivo.
Animals↗
Potential antipsychotic agents 5. Synthesis and antidopaminergic properties of substituted 5,6-dimethoxysalicylamides and related compounds.
A series of 3-substituted 5,6-dimethoxysalicylamides III (9-13 and 15) has been synthesized from the corresponding 2,5,6-trimethoxybenzoic acids. Relaxation times T1 and carbon chemical shifts of the methoxy groups in III showed that the 6-methoxy group adopts a nearly perpendicular orientation and the 5-methoxy group takes on a more coplanar orientation with respect to the ring plane in solution. The salicylamides III display a very high and stereoselective affinity for the [3H]spiperone and [3H]raclopride binding sites in vitro. Regioisomeric salicylamides IV also exhibit pronounced, but lower than III, affinity for the [3H]spiperone binding site. The structural requirements were further assessed by studies of the related amino analogues 23 and 24 and hydroxy analogue 27. The 3-bromo compound 11 (FLB 463) was studied in various in vivo models and compared with the dopamine-D2 antagonists sulpiride, raclopride, eticlopride, and haloperidol. The high potency of 11 to selectively block dopamine-D2 receptors in vitro and in vivo combined with indications on a low potential for motor side effects makes it a very interesting new member of the class of substituted salicylamides.
Animals↗
Susceptibility to beta-lactam antibiotics and gentamicin of gram-negative bacilli isolated from hospitalized patients: a Swedish multicenter study.
A total of 952 blood and 1543 urine isolates of gram-negative bacilli from hospitalized patients in 1986-1987 were consecutively collected by 10 Swedish laboratories and tested for susceptibility to 8 beta-lactam antibiotics and to gentamicin. The isolates were mostly Escherichia coli (58% and 44%, respectively) and Klebsiella sp. (17% and 18%). Resistance to ampicillin in blood and urine isolates was found in 35% and 45%, respectively, to piperacillin in 5% and 6%, to cephalothin in 26% and 34%, to cefuroxime in 12% and 22%, to cefotaxime in 3% and 5%, to ceftazidime in 1% and 1%, to imipenem in 0.5% and 0.1%, to aztreonam in 3% and 2%, and to gentamicin in 0.8% and 0%. Resistance of clinically important gram-negative bacilli to new beta-lactam antibiotics and to gentamicin is infrequent in Sweden.
Ampicillin↗
In vitro aminoglycoside resistance of gram-negative bacilli and staphylococci isolated from blood in Sweden 1980-1984.
The in vitro susceptibility to gentamicin, tobramycin, amikacin and netilmicin in septicaemia isolates was followed during 1980-1984 in 6-8 Swedish laboratories. The bacterial distribution was similar over the years and was dominated by Escherichia coli and staphylococci. Resistance to gentamicin was found in 2.3-3.6%, to tobramycin in 1.4-3.4%, to amikacin and netilmicin in 0.5-0.9%. Production of aminoglycoside modifying enzymes was observed among resistant strains.
Amikacin↗
A dose response study with bacampicillin in uncomplicated gonorrhoea.
In a systematic study of dose-response relationship 883 patients with uncomplicated gonorrhoea were given single oral doses of 400, 800 or 1600 mg bacampicillin, with 1 g probenecid. A single dose of bacampicillin 800 mg plus probenecid was the minimum effective dose in patients with fully ampicillin-sensitive strains. In patients with gonococci showing reduced sensitivity to ampicillin, 1600 mg bacampicillin was required to reach a cure rate above 95%. Bacampicillin was well tolerated in all treatment groups. Side-effects were reported in 4.6% of the courses of treatment. The most frequent adverse reaction was loose stools (1.9%), which was noted more often after the 1600 mg dose but was considered to be of no or very little clinical importance.
Administration, Oral↗
Wound infections after surgery in a modern operating suite: clinical, bacteriological and epidemiological findings.
A prospective study of 2983 operations in general and orthopaedic surgery during 3 years performed in four operating theatres in a modern operating suite was carried out in order to evaluate the importance of airborne infection. Weekly nose-and-throat samples were taken from the surgical staff and pre-operative samples were taken from the nose, throat, skin and perineum of the patients. The air contamination was followed by using settle plates, which showed low mean counts of total bacteria of between 9 and 15 c.f.u./m(2)/min, with mean counts of Staph. aureus of between 0.03 and 0.06 c.f.u./m(2)/min. No correlation was found between the total number of bacteria and the incidence of post-operative infections or between the amount of Staph. aureus in the air and post-operative Staph. aureus infections. It was concluded that further increases in ventilation could, at best, only marginally affect the incidence of post-operative infection.The post-operative wound-infection rate was 9.0%. In various types of surgery, the infection rates varied from 5.3% in clean operations to 47.6% in dirty surgery. About one third of the infections were classified as moderate or severe.Adverse patient factors, such as immunodeficiency, steroid treatment, intensive care, etc., increased the rate to 15.0%; in ;normal' patients it was 3.8%.Among the bacteria isolated, gram-negative bacilli (31% of wounds), often together with other bacteria, and Staph. aureus (28%) predominated, but in 25% no specimens were taken.Of 76 post-operative Staph. aureus infections, 32 were caused by the patients' own strains, and of the remaining 44 infections, 22, or 8% of all infections, could be traced to strains present in the air and/or the respiratory tracts of staff during the operation.The length of pre-operative hospital stay had no influence on the carrier rate of Staph. aureus in patients. The incidence of post-operative wound infection was significantly higher in patients carrying Staph. aureus and was even higher if these bacteria were found on the skin.Patients with wound infections stayed, on an average, 15 days longer than patients without infections. In serious infections the increase in duration of stay was > 20 days. Although infections were commoner in older patients, the average additional hospital stay of infected patients did not increase with age. If the post-operative infections studied in a concurrent retrospective study are taken into account more than 12 000 bed-days were due to post-surgical wound infections in the period studied or, in other words, some 12 beds (corresponding to 5.5% of the total) were always occupied by infected patients.
Air Microbiology↗
A clinical dose-response study of bacampicillin in uncomplicated gonorrhoea.
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Ampicillin↗
Azidocillin levels in tracheobronchial secretions.
Concentrations of azidocillin in serum and tracheobronchial secretions were followed in 20 patients after an oral dose of 0.75 g of the drug. Serum concentrations were followed for 4 h and the concentration in tracheobronchial secretion was determined in samples taken through a fibreoptic bronchoscope 1--2 h after administration. The concentration in secretions varied between hardly measurable levels and 1.1 micrograms/ml. No correlation between levels in serum and tracheobronchial secretion was found. A slight tendency to higher secretion levels was found when the bronchoscopy showed signs of tracheobronchitis.
Administration, Oral↗
[Campylobacter causing enteritis].
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Adult↗
[Postoperative wound infections in a new central surgery department].
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Air Microbiology↗
Bacterial contamination in a modern operating suite, 2. Effect of a zoning system on contamination of floors and other surfaces.
In this investigation the bacterial contamination of surfaces such as walls and floors in a modern operating suite, together with surfaces of lamps in the operating theatres, and the clogs worn by staff, was studied. Counts of colony-forming units were made on impression plates containing blood-agar with Tween 80 for total bacterial counts, Baird Parker medium with egg yolk and tellurite for Staphylococcus aureus and trypticase peptone agar with neomycin and polymyxin for Clostridium spp. The areas examined were divided into the patients' route to the operating theatre, the staff's route, and the central area containing the operating rooms, anaesthetic rooms, and exit and scrub-up areas. In the patients' route counts of total organisms ranged from about 10000 to 30000/m2; for Staph. aureus the range was from 70 to 540/m2. In the staff's route the highest count was about 70000/m2 in the dressing area, and the numbers of Staph. aureus were about the same as along the patients' route. In the inner zone the counts were somewhat lower for both total organisms and Staph. aureus. Total counts on the floor from all areas of the inner zone were significantly higher just before the second operation than before the first operation on the same day. The total and Staph. aureus counts on walls, floors and lamps were the same after clean operations as after operations classified as "contaminated" or "dirty".
Air Microbiology↗
Bacterial contamination in a modern operating suite. 3. Importance of floor contamination as a source of airborne bacteria.
The redispersal factor for bacteria-carrying particles from a contaminated floor was determined after mopping, blowing and walking activity. Walking gave the highest redispersal factor, 3.5 X 10(-3) m-1, which was three times higher than for blowing and 17 times higher than for mopping. The mean die-away rate for the bacteria-carrying particles used was 1.9/h without ventilation and 14.3/h with ventilation. It was calculated that in the operating rooms less than 15% of the bacteria found in the air were redispersed floor bacteria.
Air Microbiology↗
Bacterial contamination in a modern operating suite. 4. Bacterial contamination of clothes worn in the suite.
Clean clothes in the staff dressing rooms were heavily contaminated with bacteria, mainly Bacillus sp., but Staphylococcus aureus were found on 14% and Clostridium sp. on 10% of the garments examined. A comparison of the occurrence of Staph. aureus on shirts worn by staff in wards and operating departments showed ward shirts to be contaminated more heavily and with more strains. Examination of sterile gowns worn by surgeons showed that 70% were contaminated with Staph. aureus after operation. Of the strains isolated 31% were identical with those carried by the surgeon or by the patient operated on, but for the remainder no source could be found.
Bacillus↗
Inhibitors of neuronal monoamine uptake. 2. Selective inhibition of 5-hydroxytryptamine uptake by alpha-amino acid esters of phenethyl alcohols.
A series of alpha-amino acid esters of substituted phenethyl alcohols was prepared and tested as inhibitors of the neuronal reuptake of noradrenaline and 5-hydroxytryptamine. Some of the compounds are potent and very selective in blocking the 5-hydroxytryptamine uptake, as evidenced by biochemical data and behavioral tests. The most promising agent, alaproclate [2-(4-chlorophenyl)-1,1-dimethylethyl 2-aminopropanoate hydrochloride (I, IV)], was selected for further studies as a potential antidepressant agent. A discussion on structure--activity relationships (SAR) is given. In an attempt to explain the selective action on the mechanism of 5-hydroxytryptamine uptake by the new inhibitors, their structures are compared with those of the two neurotransmitters. From the tentative pharmacophore and conformations of transmitter (5-HT) and inhibitor (alaproclate) derived from SAR, a hypothetic carrier site for 5-HT uptake is deduced in terms of geometry and electronic properties.
Animals↗
Bacterial contamination in a modern operating suite. 1. Effect of ventilation on airborne bacteria and transfer of airborne particles.
The effect of ventilation on airborne contamination was studied in a new operating suite containing operating rooms with conventional ventilation (17-20 turnovers/h) and operating rooms with zonal ventilation, where the turnover in the central part of the room was approximately 80/h. The efficacy of the ventilation was first examined with gas tracer experiments and found satisfactory. Experiments using potassium iodide particles showed the transfer between adjacent rooms in the suite to be less than 10(-3)% with closed doors and from 1% to 2.5 x 10(-2)% when the doors were opened once a minute. The transfer between two adjacent operating rooms was calculated to be approximately 10(-4)%. There is thus little risk of spread of airborne infection between operating rooms.Experiments with potassium iodide particles showed that in operating rooms with zonal ventilation the particle concentration in the centre of the room was about one-tenth that in the periphery; in conventionally ventilated operating rooms the concentration was about one-half. With bacteria-carrying particles generated by human activity the concentration in the centre of operating rooms with zonal ventilation was about half that in the periphery both during experimental activity and operations; in conventionally ventilated operating rooms it was about equal in both cases. Bacterial counts at the periphery were found to be lower in rooms with zonal ventilation ( approximately 50 c.f.u./m(3)) than in conventionally ventilated ( approximately 70 c.f.u./m(3)).
Air Microbiology↗