PubMed Health⌕ Search

Biomedical subjects

S de Marie

Publications and source records attributed to S de Marie.

15 recordsLinked to original sources
PubMed1992

Blood culture bottles are superior to lysis-centrifugation tubes for bacteriological diagnosis of spontaneous bacterial peritonitis.

The conventional method of ascitic fluid culturing was compared with the bedside inoculation of ascites into blood culture bottles and into lysis-centrifugation tubes. The conventional culture method was compared with the blood culture bottle method in 31 episodes of spontaneous bacterial peritonitis (SBP). Cultures were positive with the conventional culture method in 11 (35%) episodes and with the blood culture bottle method in 26 (84%) episodes (P less than 0.001). The lysis-centrifugation tube method was compared with the blood culture bottle method in 24 episodes of SBP. Cultures were positive with the lysis-centrifugation tube method in 11 (46%) episodes and with the blood culture bottle method in 19 (79%) episodes (P less than 0.05). Moreover, the blood culture bottle method also shortened the time needed for the detection of bacterial growth. In conclusion, bedside inoculation of ascites into blood culture bottles should be used routinely for patients with suspected SBP. Culturing of ascites in lysis-centrifugation tubes is more laborious than and inferior to that in blood culture bottles.

Ascites↗
PubMed1992

Liposomal and lipid formulations of amphotericin B. Clinical pharmacokinetics.

Amphotericin B remains a very important drug for the treatment of fungal infections despite its toxicity. Encapsulation of amphotericin B into liposomes appears to reduce the toxic effects and to improve the clinical efficacy, allowing higher dosages to be given. The exact mechanism behind the reduced toxicity is not yet known. Amphotericin B is widely distributed after intravenous administration as the deoxycholate solubilisate. The highest concentrations are found in the liver, spleen and kidney. Protein binding and binding to the tissues is very high. The fate of the drug in the body is not known in detail. Renal and biliary excretion are both low and no metabolites have been identified. The drug is still detectable in the liver, spleen and kidney for as long as 1 year after stopping therapy. The pharmacokinetics of the different liposomal amphotericin B or lipid complexes of amphotericin B, which were recently developed, are quite diverse. A number of these preparations, such as amphotericin B lipid complex (ABLC), 'AmBisome' and amphotericin B colloidal dispersion (ABCD) are in clinical development. Their pharmacokinetics depend to a large extent on the composition and particle size of the liposomes or lipid complexes. Relatively large structures such as ABLC are rapidly taken up by the mononuclear phagocyte system, whereas smaller liposomes remain in the circulation for prolonged periods. In all studies only the total amphotericin B (both free and liposome- or lipid-associated) concentrations were determined. There is a need for studies correlating clinical efficacy and tolerability of liposomal amphotericin B with the pharmacokinetic properties of these formulations.

Amphotericin B↗
PubMed1990

Difficult-to-treat infections.

The most common problems in the management of serious bacterial infections were reviewed. As illustrations, the diagnostic and therapeutic strategies in two types of deep-seated infections--both associated with a poor penetration of antibiotics--were discussed: (1) In suppurative central venous thrombophlebitis, conservative therapy frequently fails; if so, one should promptly switch to a surgical approach; (2) in most patients with a parapharyngeal space infection, a non-surgical approach can be recommended including early diagnosis by computed tomography (CT), CT-guided needle aspiration, prompt administration of benzylpenicillin in high and frequent dosages or continuously, and follow-up by CT. This regimen may prevent radical surgery even in the presence of deep neck or mediastinal abscesses.

Anti-Bacterial Agents↗
PubMed1989

Clinical evaluation of pneumococcal meningitis in adults over a twelve-year period.

A retrospective study was performed to review the clinical features and outcome of 39 episodes of pneumococcal meningitis in 36 adult patients over a 12-year period. Overall mortality was 33.3%. Only a few of the deaths were directly related to the central nervous system disease and most of them were due to cardiorespiratory failure. Univariate analysis showed that death was more likely to occur in patients with advanced age, an absence of neck stiffness, a high pulse rate, an associated pneumonia, internal complications, or a long duration of the disease (greater than 7 days) before treatment was started. Patients who died had a higher erythrocyte sedimentation rate and serum bilirubin level and a lower serum sodium level than those who survived. Discriminant analysis showed the development of internal complications to be the strongest predictive factor of a poor outcome of illness. Two other important predictors of a poor outcome were the absence of neck stiffness and associated pneumonia. The history of a skull fracture or head surgery was significantly correlated with a better than average prognosis. The incidence of sequelae in survivors at the time of discharge amounted to 72%. None of the clinical features were significantly correlated with the development of sequelae, except a higher cerebrospinal fluid protein content.

Adolescent↗
PubMed1989

Suppurative thrombophlebitis of the superior vena cava.

A 22-year-old woman, a neurosurgical comatose patient developed suppurative thrombophlebitis of the superior vena cava due to Klebsiella pneumoniae, as a complication of catheterisation for parenteral nutrition. The diagnosis was established by gallium scan, computed tomography and digital vascular imaging. Conservative treatment with antibiotics and heparin resulted in the emergence of a resistant mutant of the causative agent. The infection could only be eradicated after surgical thrombectomy.

Adult↗
PubMed1988

Emergence of bacterial resistance to cefamandole in vivo due to outer membrane protein deficiency.

Cefamandole therapy in a patient with suppurative thrombophlebitis failed due to selection of a resistant variant of the causative organism Klebsiella pneumoniae. Analysis of the resistance mechanism revealed that in the resistant variant one of the major outer membrane proteins, OmpF, was missing. Resistance of this type has implications for therapy with other antibiotics including non-beta-lactam antibiotics. This report demonstrates the role of outer membrane permeation in the emergence of bacterial resistance during antibiotic therapy.

Adult↗
PubMed1987

Association of meningococcal serotypes with the course of disease: serotypes 2a and 2b in the Netherlands, 1959-1981.

Case histories of 692 patients with meningococcal disease due to serogroup B, C, or W (W-135) were reviewed to study the association of the serotypes 2a and 2b with the course of disease. The case-fatality rate in group B disease was significantly associated with serotype 2b (B:2b) strains (P = 0.03). Age and year of admission did not account for this association. Septicemia was also found more frequently with B:2b than with other B serotypes, but neurological complications and sequelae were not. Neither C:2a nor W:2a was associated with a higher case-fatality rate, with more cases of septicemia, or with more sequelae than were other C or W serotypes. We concluded that the 2b antigen, although not likely a causal factor, is a virulence marker among group B strains and that the protective effect of a vaccine containing this protein (among others) needs to be studied.

Antigens, Bacterial↗
PubMed1987

Association of meningococcal serogroups with the course of disease in the Netherlands, 1959-83.

To study the association of meningococcal serogroups with the course of disease, we reviewed the case histories of 1221 patients. The meningococci from these patients constituted a sample from isolates collected and serogrouped systematically in the Netherlands since 1959. Of these 1221 isolates, 64% were serogroup B. The overall case fatality rate was 5.1%, and the rate was lowest for patients with serogroup A infections (2.3%) and highest for serogroup W135 (18%) (P < 0.01). The occurrence of septicaemia without meningitis (case fatality rate 15.3%) was similarly distributed among the serogroups (A, 4.0%; W135, 30%). Sequelae occurred in 7.9% of patients (loss of hearing, 3.2%) and were remarkably prevalent after disease due to minor serogroups (X and Y: 4 out of 12). In a log-linear analysis, both age and serogroup were significantly associated with case fatality rate and with the occurrence of septicaemia and sequelae. It is argued that these data are representative, despite the problems inherent in a retrospective investigation. The course and outcome of meningococcal disease appear to be related to the Neisseria meningitidis serogroup and to host factors.

Adolescent↗
PubMed1986

Meningococcal disease in The Netherlands, 1959-1981: the occurrence of serogroups and serotypes 2a and 2b of Neisseria meningitidis.

By means of a filter radioimmunoassay and the use of monoclonal anti-2a and anti-2b antibodies, we have serotyped 3164 of 3688 strains of Neisseria meningitidis isolated from patients in The Netherlands between 1959 and 1981. Serotypes 2a and 2b were distributed differently among the major serogroups A, B, C, and W-135. Neither of the types was found among group A strains. Type 2b strains of serogroup B emerged in 1965, causing a country-wide epidemic which reached a peak incidence in March and April of 1966 and continued to predominate within group B until 1979. Type 2a strains of serogroup C were responsible for a substantial number of sporadic cases over a long period without any association with outbreaks or with a shift in the pattern of the serogroup. After the appearance of group W-135 in 1971, W-135 strains caused a small non-focal epidemic wave. The upsurge of disease due to virulent sub-populations of strains B:2b and C:2a appeared to be closely related to a basic pattern of regular cyclical waves with peak intervals which differed for serogroups A, B, and C. In recent years both serotype 2a and 2b strains within the different serogroups fell to insignificant numbers. Our results show that retrospective large-scale serotyping of collected strains provides insight into the epidemiological patterns of endemic meningococcal disease.

Antibodies, Bacterial↗
PubMedDate not supplied

Paravertebral abscess due to nondiphtheria coryneform bacteria as a complication of ingrown toenails.

A patient developed a paravertebral abscess due to nondiphtheria coryneform bacteria following infected ingrown toenails. Both the causative role of this uncommon pathogen and the unusual origin were established by cultures of tissue from the toes, blood and an aspirate of the paravertebral abscess. The microorganism was tentatively identified as an atypical variant of Arcanobacterium haemolyticum.

Abscess↗
PubMedDate not supplied

Clinical infections and nonsurgical treatment of parapharyngeal space infections complicating throat infection.

The clinical features and management of eight patients with parapharyngeal space infection who presented with swelling of the neck subsequent to sore throat are described. In four patients the interval between the initial throat symptoms and swelling was 2 days or less, and the disease was rapidly progressive with stridor or a descending mediastinitis. In the other four cases, this interval was longer (4 to 14 days) and the infection was fairly localized. Computed tomography was useful for making the diagnosis, establishing that the infection had spread into other deep neck spaces and the mediastinum, distinguishing abscesses from diffuse cellulitis, guiding drainage aspiration, and assessing the response to therapy. None of the patients underwent extensive surgical drainage of the deep neck spaces. A nonsurgical approach with antibiotics, including high doses of benzylpenicillin, and computed tomography-guided selective needle aspirations proved successful. Even patients with distinct abscesses were completely cured.

Abscess↗