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S Bygdeman

Publications and source records attributed to S Bygdeman.

At least 37 records · Page 2Linked to original sources

Analysis of serovar distribution as a tool in epidemiological studies in gonorrhoea.

During one year 738 gonococcal isolates from 731 consecutive patients with gonorrhoea were collected and classified by co-agglutination using W I and W II/III specific monoclonal antibodies. Eight W I and 30 W II/III serovars (serovariants) were seen. In both serogroups the most frequent serovar among isolates from women and heterosexual men differed from that among isolates from homosexual men. Forty-two per cent of the serovars, were confined only to one subpopulation, i.e. women, heterosexual men or homosexual men, representing 19 (3%) of the 738 isolates. Out of these 19 isolates 42% were acquired abroad compared with 12% of the 653 isolates in the serovars shared between two or all three subpopulations (p less than 0.005). Imported W I isolates were often of the same serovar that dominated in Stockholm. W II/III isolates acquired abroad were often of unusual serovars (p less than 0.0005) and might be a source of future changes of the serovar pattern in Sweden. In this way we can follow the introduction of new serovars into our society and their circulation between the subpopulations.

Adult↗

Gonorrhoea in heterosexual men. Correlation between gonococcal W serogroup, Chlamydia trachomatis infection and objective symptoms.

Among 292 heterosexual men with gonorrhoea seen during one year, 59 (20%), had a co-existing chlamydial infection. Of the men infected with a serogroup WI strain 30% had a chlamydial infection compared with 16% of those infected with a serogroup W II/III strain (p less than 0.01). Heterosexual men infected with WI strains had less objective symptoms as judged by the number of leucocytes per high power field and by discharge, than men infected with W II/III strains (p less than 0.05 and p less than 0.01, respectively).

Chlamydia Infections↗

Influence of chlorhexidine in ethanol and in isopropanol on the bacterial colonization of the umbilicus of newborns.

The effect of daily treatment with 0.5% chlorhexidine in 70% ethanol and in 70% isopropanol, respectively, on navel colonization and on rates of infection in newborns has been studied in 438 infants in two maternity wards during a 3-month period. In spite of isopropanol being reported as a more efficient skin disinfectant than ethanol in several experimental models, no significant differences were seen in the frequency of navel colonization or in infection rates between the two treatment groups. The colonization rate with S. aureus was lower in this than in an earlier investigation on navel disinfection with chlorhexidine in ethanol performed in the same wards. This may reflect a progressive effectiveness of the treatment due to fewer S. aureus sources in the nursery. For practical reasons we continue to recommend daily navel disinfection with 0.5% chlorhexidine in 70% ethanol on healthy newborns in hospital nurseries.

1-Propanol↗

Antimicrobial susceptibility testing and phenotyping of Neisseria gonorrhoeae isolated from patients with ophthalmia neonatorum in Nairobi, Kenya.

Antimicrobial susceptibility testing, auxotyping-serotyping, and plasmid analysis were performed on 41 ocular isolates, 7 nasopharyngeal isolates, and 18 cervical isolates of Neisseria gonorrhoeae obtained during a recent treatment trial of gonococcal ophthalmia neonatorum in Nairobi, Kenya. Fourteen distinct serovar-auxotype patterns were observed with IB-1/Pro-strains which accounted for 59% of the isolates. Infection with multiple types of gonococci appeared to occur in 22% of the mothers since 4 of 18 paired maternal cervical and neonatal ocular isolates had mismatched serovar-auxotype patterns. Among 10 treatment failure isolates only 1 had a mismatched serovar-auxotype pattern. Six (15%) of the ocular isolates were penicillinase-producing N. gonorrhoeae (PPNG). Five had the 4.4-megadalton (Md) beta-lactamase plasmid and one had the 3.2-Md beta-lactamase plasmid. The 24.5-Md plasmid was found in 5 of 6 PPNG strains and in 8 of 35 non-PPNG strains (P less than 0.02). For most antimicrobial agents, PPNG and non-PPNG strains showed similar patterns of susceptibility. Ceftriaxone was the most active of the antibiotics tested, with all strains having an MIC less than or equal to 0.06 mg/liter. Among non-PPNG strains, 15 (43%) had a penicillin MIC greater than or equal to 2 mg/liter and were considered intrinsically resistant to penicillin. Overall, non-PPNG intrinsically resistant strains had greater resistance to other antibiotics than did non-intrinsically resistant strains (P less than or equal to 0.006). The Mtr phenotype was found in 53% of these strains.

Drug Resistance, Microbial↗

Influence of ethanol with and without chlorhexidine on the bacterial colonization of the umbilicus of newborn infants.

The effect of daily treatments with 70% ethanol and with 0.5% chlorhexidine in 70% ethanol, respectively, on navel colonization in newborns has been studied in 624 infants in two maternity wards during a four-month period. Staphylococcus aureus, group B and G streptococci, E. coli and anaerobes were significantly less often isolated from newborns whose umbilical cord was treated with chlorhexidine in ethanol than from those treated with ethanol only. Staphylococcus epidermidis and enterococci, on the other hand, were significantly more often isolated from the chlorhexidine-ethanol than from the ethanol group. More infants without colonization of the umbilicus on their fourth day of life were found in the chlorhexidine in ethanol than in the ethanol group. The infants in the ethanol group were colonized with significantly more bacterial species than the infants in the other group. Signs of dissemination of group B and group G streptococci between babies were seen more often in the group of infants treated with ethanol than in the one treated with chlorhexidine-ethanol.

Chlorhexidine↗

Moisture exchangers do not prevent patient contamination of ventilators. A microbiological study.

Thirty-three mechanically ventilated patients in an intensive care unit were studied in order to verify a claim that the Servo humidifier acts as a bacterial barrier. The Servo humidifier was used on all patients. It was changed once daily, and the connecting tubes were changed once weekly. Daily bacterial cultures were taken from the trachea of the patient as well as from the humidifier, the tubing and the ventilator. In 25 of the patients, the same bacterial strain as in the trachea of the patient could not be isolated from the outside of the humidifier, from the tubing or the ventilator. In eight patients a breakthrough of bacterial strains from the trachea through the humidifier could be demonstrated. In four of these eight patients the breakthrough strains appeared to establish themselves in the respirator environment, while in the other four they appeared only temporarily outside the humidifier. The clinical importance of the establishment of a bacterial strain in the ventilator is not clear, but it seems prudent that the introduction of the Servo humidifier should not lead to less stringent cleaning and/or disinfection routines of ventilators and tubing than before.

Candida albicans↗

Ventilation - perfusion relationship during hip arthroplasty.

Ventilation-perfusion relationships (VA/Q) were studied during hip arthroplasty, using a multiple inert-gas elimination technique. True shunt (VA/Q = O) increased on 10 out of 16 prosthesis-anchoring occasions, while "low" VA/Q values (O less than VA/Q less than 0.1) increased on 2 occasions only. Pao2 fell by 1-2 kPa. "High" VA/Q values (10 less than VA/Q less than 100) appeared or increased with the insertion of the prosthesis, while dead space (VA/Q greater than 100) was unaltered. Cardiac output did not change. Pulmonary artery pressure fell and airway peak pressure rose by approximately 2 mmHg. It is possible that the blood flow is forced from non-dependent to dependent lung regions by the altered pressure in airways and blood vessels, creating a "high" VA/Q in upper and shunt regions and a "low" VA/Q in lower lung regions.

Aged↗

Epidemiology of gonorrhoea: serogroup, antibiotic susceptibility and auxotype patterns of consecutive gonococcal isolates from ten different areas of Sweden.

Consecutively isolated gonococcal strains from 10 representative geographical areas in Sweden were serogrouped according to the previously described W antigen class. The majority of the strains were antibiotic susceptibility tested and approximately one fourth of them were auxotyped. Statistically significant differences of the serogroup patterns were demonstrated between the 2 largest towns, which represented highly urbanized areas where serogroup W II dominated, and the middle sized towns with adjoining rural districts, where serogroup W I dominated. The serogroup patterns of the strains isolated in 3 university towns were representative for Sweden as a whole. Statistically significant differences were demonstrated between urban and rural areas with regard to the susceptibility of gonococci to beta-lactam antibiotics. About 95% of serogroup W I strains were highly sensitive to ampicillin whereas about 65% and 90% of W II and W III strains, respectively, showed decreased susceptibility. The majority of the auxotyped strains belonged to 4 main types: Pro-, Pro-Arg-Ura-, AHU- and prototrophic. The majority of the AHU- strains belonged to serogroup W I and were highly susceptible to beta-lactam antibiotics and tetracycline. Many of the Pro-Arg-Ura-strains belonged to 2 particular subserogroups within serogroup W II and showed increased resistance to beta-lactam antibiotics. Serological classification of gonococci by co-agglutination is a simple and rapid technique without need of special equipment. It could serve 2 purposes: 1) as a confirmation test for gonococci cultured from clinical specimens; 2) for serogrouping of gonococcal isolates to study the epidemiology of gonorrhoea with regard to geographical areas, race, sexual preference, treatment failure and other demographic and medical factors.

Cross-Sectional Studies↗

Gonococcal W serogroups in Scandinavia. A study with polyclonal and monoclonal antibodies.

A total of 849 gonococcal strains from 659 patients in Copenhagen (Denmark), Helsinki (Finland), Oslo and Trondheim (Norway) and Stockholm (Sweden) were included in the study. Using coagglutination reagents with polyclonal and monoclonal antibodies the strains were serogrouped into the previously described gonococcal serogroups W I, W II and W III. W II strains were dominating in all five towns (60.0%-70.9% of the strains), but W III strains were rarely isolated. W I strains were more frequent among women than among men. With the monoclonal reagents, W I, W II and W III strains could be further subdivided into 12, 29 and two different serovariants (serovars), respectively. One of the W I serovars was dominating (76%-94% of W I strains) in all five towns, and apart from this serovar, only three to five other W I serovars were seen in each town. Of W II strains, on the other hand, a greater variety of serovars were seen: between six in Trondheim and 17 in Oslo, and no one was dominating as among W I strains. Different W II serovar patterns were found in the different towns. Even between the two participating laboratories in each of the towns, Oslo and Helsinki, differences were noted. The epidemiological value of this is discussed. Ten of the 11 beta-lactamase-producing gonococcal strains isolated belonged to unusual serovars. None of the monoclonal coagglutination patterns corresponded to a single polyclonal pattern. There were, however, some relations between the two systems. In earlier studies it was shown that in smaller Swedish towns W I strains dominated. A hyphothesis about protective anti-Protein I antibodies is discussed to explain the differences in distribution of W I and W II strains between smaller and larger towns and between women and men.

Adolescent↗

Platelet factor 4 plasma levels at rest and after exercise in patients with recent myocardial infarction.

Plasma levels of platelet factor 4 (PF 4) were determined in 30 patients with recent acute myocardial infarction. Comparisons were made with the levels in 26 age-matched controls. In another 15 patients, also with recent myocardial infarction, PF 4 plasma levels were determined before and immediately after a standardized exercise stress test. At rest, none of the patients had elevated PF 4 levels. Only one patient demonstrated an increase after exercise. These findings are in conflict with some recent reports. The importance of age-matched controls, the hazard of in vitro platelet activation and the possible effect of beta-blocking and calcium-antagonistic drugs on PF 4 plasma levels is discussed below.

Aged↗

Genetic linkage between serogroup specificity and antibiotic resistance in Neisseria gonorrhoeae.

In previous works statistically significant differences were demonstrated in antibiotic susceptibility between gonococcal strains of the recently described W serogroups, W I, W II and W III, respectively. Strains of serogroup W I were almost always sensitive to penicillin and other antibiotics while those of the W II and W III serogroups showed a higher incidence of decreased susceptibility. Transformation experiments were therefore undertaken with an antibiotic sensitive serogroup W I gonococcal strain as recipient and a multi-resistant W II strain as DNA-donor. Transformants, with increased resistance to penicillin and several other antibiotics as compared with the recipient, acquired the same serogroup specificity as the W II donor. With one of these W II transformants as donor and the sensitive W I strain as recipient all transformants acquired the same antibiotic susceptibility pattern as well as the same serogroup as the donor. SDS-PAGE, performed on sarkosyl extracted outer membrane proteins from donor, recipient and some transformants, showed an increase in the molecular weight of the Protein I of the outer membrane of the W II transformants as compared with that of the recipient strain. In rocket-line and crossed-line immunoelectrophoresis the W II transformants could not be distinguished from the W II donor strain. A genetic linkage between antibiotic multi-resistance and serogroup W II specificity was thus shown. This is in agreement with the demonstrated higher incidence of W II strains with increased antibiotic resistance as compared with that of serogroup W I strains.

Anti-Bacterial Agents↗

Deep vein thrombosis following hip surgery. Relation to activated factor X inhibitor activity: effect of heparin and dextran.

Activated factor X inhibitor (FXaI) activity was measured with a newly developed method during operation and during the postoperative period in 60 patients undergoing total hip replacement. The patients were randomly allotted to three groups. In two groups the effect of prophylactic treatment with dextran and low dose heparin were evaluated, while the third group served as a control. Postoperative deep vein thrombosis was diagnosed with plethysmography and venography and related to observed changes in inhibitor activity. The frequency of deep vein thrombosis was found to be 25, 47 and 33 per cent in the three groups respectively. With the test system for measurements of FXaI-activity which made it possible to determine both the overall ability of the plasma to neutralize FXa and the activity independent of any accelerator or antagonist of XaI-activity, it was possible to demonstrate inhibitor consumption in all groups including the heparin treated group where the overall inhibitor activity was increased. A marked decrease in inhibitor activity was usually observed in the patients developing postoperative thrombosis in the control group, while in the other groups the relationship was less clear.

Aged↗

Flow-volume curves in healthy non-smokers and in smokers.

Maximum expiratory flow-volume curves were recorded in lung healthy non-smokers and in smokers. Multiple linear regression analysis was performed with regard to sex, age, height and weight. The regressions for maximum expiratory flow at 50% and 25% of vital capacity (MEF50 and MEF25, respectively) on age were significantly different for non-smokers and smokers, in males as well as females, but the large scatter around the regression line resulted in more than 50% of presently studied smokers to fall within 1 SD of the reference values for non-smokers. A skew distribution of MEF25 around the mean was observed at ages above 60 years and so set an upper limit for the linear regression. Above 60 years no linear age dependence was found for MEF25. There was a minor reduction (2%) in the residual standard deviation of the peak expiratory flow (PEF), MEF50 and MEF25 regressions when height was added as an independent variable besides age, while the addition of weight did not reduce the scatter. We conclude that the inter-individual variability in MEF50 and MEF25 is relatively large even when sex and age are accounted for and that there is no further benefit in including height or weight in the regression equations. The discriminating ability of the MEF50 and MEF25 variables is small, indicated by considerable overlapping between non-smokers and smokers.

Adolescent↗

Antibiotic susceptibility of Neisseria gonorrhoeae in relation to serogroups.

Susceptibility testings, by means of the agar-dilution method, were performed on nine antibiotics of 138 non-PPNG (beta-lactamase-producing = PPNG) strains, 17 of which originated from Thailand, and 88 PPNG isolates. The gonococcal strains were sero-grouped by the co-agglutination method and classified among the sero-groups W I, W II or W III. Statistically significant differences in antibiotic susceptibility between non-PPNG strains of the three sero-groups could be demonstrated with strains belonging to sero-group W I as the most sensitive and W III isolates as the most resistant. Non-PPNG strains from Thailand were significantly more resistant than the other non-PPNG isolates of the same sero-group. There was, however, no significant difference in resistance between non-PPNG strains from Thailand and PPNG isolates of the same sero-group. PPNG strains of sero-group W I were significantly more sensitive than PPNG strains of sero-group W II, whereas there was no significant difference between PPNG isolates of sero-groups W II and W III. Non-PPNG strains, not from Thailand, of sero-groups W I and W II were significantly more susceptible to non beta-lactam antibiotics than PPNG strains of corresponding sero-groups, while no such difference could be demonstrated for non-PPNG and PPNG isolates of sero-group W III.

Anti-Bacterial Agents↗

Gonorrhoea in men with homosexual contacts. Serogroups of isolated gonococcal strains related to antibiotic susceptibility, site of infection, and symptoms.

In 37 homosexual men the incidences of urethral, rectal, and pharyngeal gonorrhoea were 45.9%, 56.8%, and 27% respectively. Local symptoms were present in all men with urethral gonorrhoea but in only 25% of those with pharyngeal or rectal gonorrhoea or both. Infection at two sites was found in 29.7% of the patients. Forty-nine gonococcal isolates from the 37 patients were serogrouped by coagglutination into one of the serogroups WI, WII, and WIII, and their susceptibility to benzylpenicillin, ampicillin, cefuroxime, doxycycline, and spectinomycin tested. Only one gonococcal isolate from each patient was counted when two isolates belonged to the same serogroup and had the same antibiotic susceptibility. Thus, 15.4%, 76.9%, and 7.7% of the gonococcal strains belonged to serogroups WI, WII, and WIII respectively. There was a significantly lower incidence of WI strains and a significantly higher incidence of WII strains among men with homosexual contacts than among other patients with gonorrhoea from the same geographical region. Gonococcal strains of serogroup WI were significantly more resistant to all antibiotics tested, except to spectinomycin, than randomly chosen WI strains. Among WII and WIII strains the incidence of diminished susceptibility to all antibiotics tested was about the same.

Anti-Bacterial Agents↗

Serological classification of Neisseria gonorrhoeae by co-agglutination: a study of serological patterns in two geographical areas of Sweden.

Gonococcal strains, isolated in two different geographical areas of central Sweden (Stockholm and Orebro County) during two corresponding time periods, were subjected to serogrouping by the co-agglutination method with reagents covering the previously described serogroups W I, W II and W III. All strains tested could be grouped. Significant differences were found between the two geographical areas studied. Isolates from different sites on one and the same patient and strains from contact pairs gave identical results. The test results were reproducible, when the strains were exchanged between the two participating laboratories. The reagents distinguished Neisseria gonorrhoeae from other Neisseria species and other oxidase-positive bacteria. The potential of serogrouping gonococci for epidemiological studies by means of the co-agglutination method is discussed.

Agglutination Tests↗