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Biomedical subjects

S Lauwers

Publications and source records attributed to S Lauwers.

At least 19 recordsLinked to original sources
PubMed1992

Genotypic and phenotypic methods for the investigation of a nosocomial Legionella pneumophila outbreak and efficacy of control measures.

To determine the source of a nosocomial outbreak of Legionella pneumophila serogroup 1 infection and the efficacy of control measures, clinical and environmental isolates were characterized by molecular subtyping and disease surveillance was conducted. The outbreak involved 32 cases (relative risk, 4.0; P less than .001 vs. previous period). Water colonization with L. pneumophila serogroup 1 and patients' exposure to faucet use incriminated the water system as the environmental source. Monoclonal antibody typing showed that patient isolates belonged mainly to type Pontiac and water isolates mainly to type Bellingham (P less than .001). By four genotypic techniques, outbreak-related isolates from patients and the water system were found to be clonally related and distinct from control strains (P less than .001). Heat and UV light treatment of the water system showed a protective efficacy of 88% (95% confidence interval, 75%-94%). These findings indicate that phenotypic variation may interfere with monoclonal antibody typing of legionellae and that waterborne legionellosis can be controlled by physical disinfection.

Belgium↗
PubMed1992

Outbreak of recurrent abdominal cramps associated with Arcobacter butzleri in an Italian school.

In the autumn of 1983, an outbreak of recurrent abdominal cramps occurred in a nursery and primary school in the Rovigo area in Italy. None of the 10 affected children had diarrhea. An atypical Campylobacter-like organism was isolated from feces in all cases. Conventional enteropathogens were searched for but not detected. The Campylobacter-like organism was identified as Arcobacter butzleri by using sodium dodecyl sulfate-polyacrylamide gel electrophoresis of whole-cell proteins and cellular fatty acid analysis. Its identity was confirmed by DNA-DNA hybridizations versus Arcobacter reference strains. All of the preserved outbreak strains have identical protein profiles and phenotypic characteristics and belong to serogroup 1 of the Lior serotyping scheme on the basis of slide agglutination of crude and absorbed antisera of A. butzleri reference strains versus heat-labile antigens of live bacteria. These data point to an epidemiological relationship. The successive timing of the cases suggests person-to-person transmission.

Campylobacter↗
PubMed1992

Contribution of the 13C-urea breath test to the detection of Helicobacter pylori gastritis in children.

Serology, 13C-urea breath test, histology, Campylobacter-like organism testing, and culture were performed in 95 consecutive children to evaluate the contribution of these tests to the detection of Helicobacter pylori infection. In analyses considering any combination of three positive tests as "gold standard" for diagnosing H pylori infection, 26 children were Helicobacter positive (27%), which is only one patient more than the number of children with only a positive culture. The accuracy of culture was excellent when "any combination of three positive tests" was used as the gold standard (sensitivity 96%, specificity 100%, positive predictive value 100% [false positivity 0%], negative predictive value 99% [false-negative results 1%]). The results of invasive and noninvasive tests were comparable. When culture was considered as "gold standard," the sensitivity of serology and 13C-urea breath test was 96%; the specificity was 96% and 93%, respectively; the positive predictive value was 89% and 83% (false-positive results in 11% and 17%); and the negative predictive value for both was 99% (false-negative results in 1%). It is concluded that culture can be used as gold standard, but that non-invasive tests such as serology and/or 13C-urea breath test can be used to diagnose H pylori infection in children, since each has at least 95% sensitivity and 92% specificity.

Adolescent↗
PubMed1992

Intraventricular rifampicin in severe tuberculous meningo-encephalitis.

We present a patient acutely ill from severe tuberculous meningo-encephalitis, in whom acute hepatic and renal failure, due to intercurrent septic shock, precluded the administration of full systemic dosage of antituberculous drugs. Daily direct intraventricular administration of 5 mg rifampicin, via a subcutaneous Ommaya reservoir connected to a catheter placed in the right lateral cerebral ventricle, resulted in rapid improvement without neurological sequelae. Intraventricular rifampicin administration for 50 consecutive days was well-tolerated without local or systemic side-effects. In well-selected patients with severe tuberculous meningo-encephalitis, intraventricular rifampicin may safely and highly effectively be added to systemic antituberculous therapy.

Acute Kidney Injury↗
PubMed1991

Quality control in antimicrobial disk susceptibility testing: a Belgian multicenter study.

A Belgian multicenter trial was conducted to evaluate problems encountered with quality control results of antimicrobial disk susceptibility testing and to compare the performance of BBL disks and Rosco tablets. Over a period of four weeks 18 laboratories daily tested three reference strains against eight antibiotics. A standardised method was used by all participants. For all results together 10.4% and 7.3% of the measurements with BBL disks and Rosco tablets, respectively, were outside the recommended range. Major problems were observed for some specific strain-antibiotic combinations. Standard deviations were similar for both systems; their precision was comparable. The results suggest that cooperation between manufacturers and some reference laboratories could be improved in order to establish optimal quality control limits.

Anti-Bacterial Agents↗
PubMed1990

Results of screening for verocytotoxin-producing Escherichia coli in faeces in Belgium.

During an 18-month period all stools submitted to a microbiology laboratory in Belgium for culture were screened for Verocytotoxin-producing Escherichia coli (VTEC) serotype O157. In the stool samples from 3940 patients, eight (0.2%) VTEC O157 strains were isolated, seven of which were O157:H7. Additional screening for other serotypes of VTEC in 332 selected stool samples yielded four more strains (serotypes O2:K1:H6, O111:H-, O117:K1:H7 and O"C70/86":H-). The 0.3% isolation rate for all VTEC was comparable to that for Shigella spp. Eight children under 30 months and two adults suffered from uncomplicated gastroenteritis. A 5-month-old child and a 41-year-old woman presented with hemolytic uremic syndrome a few days after onset of a diarrheal episode.

Adult↗
PubMed1989

Postpartum bacteremia and placental colonization with genital mycoplasmas and pregnancy outcome.

The influence of placental colonization and postpartum bacteremia with genital mycoplasmas on the course of delivery and the immediate postpartum period was evaluated in 511 women who gave birth to live infants of at least 26 weeks' gestation. Genital mycoplasmas were isolated from the placenta in 153 patients (29.9%) and from blood in four patients (0.8%). These four isolates were all Ureaplasma urealyticum. Patients with genital mycoplasmas isolated from the placenta were delivered of infants with birth weights and gestational ages similar to those of infants of patients who did not have genital mycoplasmas in the placenta (3260 gm and 39.2 weeks versus 3272 gm and 39.3 weeks). No adverse effects of maternal postpartum bacteremia with genital mycoplasmas were observed, either in the mother or in the baby. We conclude that, whereas genital mycoplasmas frequently can be isolated from the placenta, there is no evident relationship between the presence of genital mycoplasmas and pregnancy outcome. In a few instances U. urealyticum has been isolated from the blood of afebrile postpartum women. In these women the presence of this bacteria is probably related to the birth process. This bacteremia does not precede an infectious complication.

Adult↗
PubMed1989

National study on the utilization of prophylactic antibiotics in surgery, Belgium, 1986.

During the last week of May 1986, a 1-week prospective study on antibiotic utilization in surgical patients was held in 104 (42%) of the 247 Belgian acute care hospitals. All surgical patients with a post-operative stay of at least 3 days were studied, involving 3112 patients. Each patient was observed for 7 days, starting from the day before surgery. Antibiotics were administered to 71.9% of all patients; 21.9% received therapeutic antibiotics and 52.9% prophylactic antibiotics; 2.9% received both. Of the 1285 patients undergoing a surgical procedure with no indication for antimicrobial prophylaxis, 50.7% nevertheless received prophylaxis; 92.8% of patients with a generally recognized indication for prophylaxis received antibiotic prophylaxis. Less than one fifth (17.1%) of all prophylactic courses were stopped on the day of the intervention whilst 26.3% were continued up to the fifth post-operative day or beyond. The most frequently prescribed drugs for this indication included first and second generation cephalosporins and nitroimidazoles. The number of different generic drugs utilized per hospital ranged from 1 to 18 (mean: 7.7).

Aged↗
PubMed1989

[Epidemiological aspects of Campylobacter infections in Belgium].

In the context of a surveillance programme for infectious diseases in Belgium, a network of microbiological laboratories, since February 1983, weekly registers the isolation of a number of pathogenic agents, among which Campylobacter. Some epidemiological characteristics of Campylobacter in Belgium are discussed. Between 54 and 58% of the isolations are reported from males. About 50% of the cases are observed in children under 5 years of age. The mean weekly number of isolations per laboratory is rising in May and remains high until October-November.

Adolescent↗
PubMed1989

In vitro activity of amoxycillin plus clavulanic acid and ticarcillin plus clavulanic acid compared with that of other antibiotics against anaerobic bacteria.

The activity of amoxycillin/clavulanic acid (Augmentin) and ticarcillin/clavulanic acid (Timentin) was tested against 303 unselected clinical anaerobic isolates recently collected in seven Belgian university hospitals and compared with that of 11 other antimicrobial agents. Bacteroides spp. accounted for 52.1% of the isolates, Clostridium spp. for 23.4%, anaerobic cocci for 15.5%, nonsporeforming gram-positive bacilli for 4.6% and Fusobacterium spp. for 3.3%. Ticarcillin/clavulanic acid (fixed clavulanic acid concentration of 2 mg/l) was the most active drug with an overall susceptibility rate of 99.7%. Amoxycillin/clavulanic acid (fixed ratio of 2:1) and chloramphenicol inhibited 97.4% of the isolates, metronidazole 95.4%, piperacillin 92.4%, ticarcillin 91.4%, clindamycin 87.8%, cefotetan 81.2%, cefazolin 63.0%, cefuroxime 60.4%, erythromycin 57.8%, penicillin 57.1% and doxycycline 52.1%. beta-lactamases were detected exclusively in Bacteroides spp. isolates (79.1% positive).

Amoxicillin↗
PubMed1988

Serotypes of Ureaplasma urealyticum isolated from normal pregnant women and patients with pregnancy complications.

To compare the distribution of Ureaplasma urealyticum serotypes 1 to 10 in different patient populations, the serotypes of 240 U. urealyticum strains from 207 patients were determined by the indirect immunofluorescence test by using U. urealyticum antisera 1 to 10. Strains were obtained from the following four patient groups: group 1, 24 couples in which the women had a history of recurrent spontaneous abortion; group 2, 25 patients who had their first spontaneous abortion; group 3, 14 pregnant patients with pregnancy complications (premature delivery, intrauterine death); and group 4, 138 patients with uneventful pregnancies. The serotypes most often found in these 207 patients were as follows: serotype 3, 52.2%; serotype 6, 30.3%; serotype 10, 11.4%; serotype 1, 9.5%; serotype 4, 6.5%; serotype 8, 6.5%. Serotypes 2, 5, 7, and 9 were found in less than 1% of the patients. More than one serotype was found in 16.9% of the patients. The overall distribution of the 10 serotypes in the different groups was similar, except for that of serotype 4. Serotype 4 was isolated from 20.8% of the patients in group 1 and from 5.1% of the patients in group 4 (P less than 0.01). Results of this study indicate that U. urealyticum serotype 4 can be isolated more frequently from patients with a history of recurrent miscarriages than from normal pregnant women.

Abortion, Habitual↗
PubMed1988

Impact of primary prevention on the incidence of toxoplasmosis during pregnancy.

Until now, it was assumed that primary prevention of congenital toxoplasmosis was possible by means of specific hygienic measures. A prospective survey of pregnant women was made at a hospital in Brussels over the period 1979-1986 to assess the impact of such a prevention program. In the first study period (1979-1982), when no prophylactic measures were taught, 2986 consecutive women demonstrated a seroconversion rate of 1.43% among the nonimmunized subjects; 1.07% of the seropositive patients had high antibody levels in their first serum sample. In the second study period (1983-1986), all 3563 patients were instructed to adopt prophylactic measures. The seroconversion rate in seronegative patients and the percentage of patients with high initial antibody level were 0.95 and 1.26%, respectively. Although the percentage of seroconversion was reduced by 34% in the second study period, this difference did not attain significance. These results indicate that the impact of a primary prevention program aimed at reducing congenital toxoplasmosis is limited.

Animals↗
PubMed1987

The national prevalence survey of nosocomial infections in Belgium, 1984.

A national one-day prevalence survey of nosocomial infections was carried out in March 1984 in 106 Belgian acute-care hospitals involving 8723 patients of whom 6130 had undergone surgery. Three infections were studied: surgical wound infection, bacteraemia and urinary-tract infection. One or more of these three infections was recorded in 9.3% of all patients and in 11.8% of surgical patients. Prevalences increased with increasing duration of hospital stay and with higher ages, but the association of HAI with age was no longer significant after correction for duration of hospital stay. Prevalences varied considerably in different specialties. After adjustment for age and duration of stay, there was no association between perioperative antibiotic prophylaxis and the prevalence of the infections studied, but bias due to selection of higher risk patients in the antibiotic group was probable. Larger hospitals had a higher overall prevalence, but populations differed according to the size of the hospital. Bacteraemia was strongly associated with the presence of an intravenous catheter, and urinary-tract infection with a urinary catheter.

Adult↗
PubMed1987

Epidemiology and pathogenesis of ureaplasma urealyticum in spontaneous abortion and early preterm labor.

The role of U. urealyticum in spontaneous and recurrent spontaneous abortion was studied in 633 women. Cervical colonization with U. urealyticum was found in 42.6% of 310 normal pregnant women, in 41.6% of 84 patients who underwent induced abortion, in 41.5% of 41 normal fertile patients, in 53.3% of 122 patients with spontaneous abortion and in 64.5% of 76 patients with recurrent spontaneous abortion. The cervical isolation rate was significantly higher in patients with spontaneous abortion (p less than 0.05) and recurrent spontaneous abortion (p less than 0.005) than in normal pregnant women. Endometrial colonization was more frequent in patients with recurrent spontaneous abortion (27.6%) than in normal fertile women (9.7%) (p less than 0.05). Moreover, in 6 patients with intact membranes and uncontrollable preterm labor resulting in fetal loss (all between the 20th and 28th week of gestation) U. urealyticum was isolated in 5 of them from the cervix, in 4 patients from the placenta and in 2 out of 4 from the amniotic fluid. Histological examination of the placenta showed signs of chorioamnionitis in 5 patients. From this study we conclude that although U. urealyticum is a common inhabitant of the lower genital tract, it may play a role in the etiology of spontaneous abortion and uncontrollable preterm labor.

Abortion, Spontaneous↗
PubMed1987

Temocillin in the treatment of pyelonephritis in children.

Temocillin is a beta-lactamase-stable penicillin with a selective. Gram-negative spectrum of activity and a long half-life. Previous studies in adult patients have demonstrated its efficacy and safety in the treatment of Gram-negative infections. The aim of the study was to evaluate the clinical and bacteriological efficacy and safety of temocillin in children with complicated urinary tract infections. Twenty-two children, aged 3 months to 13 years (mean 5.8 years) were treated with temocillin i.v. at a dose of 25 mg/kg 12 hourly for a mean period of 5.9 days (range 3-12 days). Acute pyelonephritis was diagnosed in 21 patients (one case associated with septicaemia); one patient presented recurrent bacteriuria due to a multiresistant pathogen. Some 20/22 children presented an underlying condition complicating the urinary tract infection (UTl). The causative pathogens, isolated from the urine, were: E. coli (17), Proteus mirabilis (3), Enterobacter cloacae (1), enterococcus (1). The enterococcus and one Proteus mirabilis were found to be resistant to temocillin. Clinical improvement was obtained after 24-36 h in all children with temocillin-sensitive organisms. Bacteriological cure was obtained in all patients with temocillin-sensitive organisms. The two patients with temocillin-resistant pathogens were treated with another antibiotic. Follow-up treatment was given per os during +/- 2 weeks. No adverse reactions or abnormal laboratory values were noted. In the authors' limited experience temocillin proved to be effective and safe in the treatment of pyelonephritis often due to ampicillin-resistant strains in children.

Acute Disease↗
PubMed1986

Lymphocytic meningoradiculitis (Garin-Bujadoux Bannwarth): from syndrome to disease?

In two children with lymphocytic meningoradiculitis (Bannwarth's syndrome), IgG and IgM antibodies to Borrelia burgdorferi were demonstrated. Clinical and laboratory parameters of the syndrome are described and recent bacteriological and serological findings that link the syndrome to the American Lyme disease are discussed, as well as the effects of antibiotic treatment.

Animals↗