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Biomedical subjects

W D Hendriks

Publications and source records attributed to W D Hendriks.

27 records · Page 2Linked to original sources
PubMed1983

The use of a human donor flora for recontamination following antibiotic decontamination.

A method to prevent endogenous infections in patients and laboratory animals with an impaired immune capacity is the total decontamination of the gastrointestinal tract. This is performed by oral administration of nonabsorbable antibiotics. One of the disadvantages of total decontamination is the fact that especially after termination of this treatment the decontaminated individual is easily colonized with organisms from the environment. This is the result of the elimination of the anaerobic part of the microflora, which is responsible for the so-called colonization resistance (CR). This CR is the resistance against exogenous microorganisms to colonize the gastrointestinal tract. In the absence of an anaerobic flora, the colonizing microorganisms can reach abnormally high faecal concentrations, thus increasing the risk for infection. In mice, the implantation of an anaerobic, mouse-derived flora after termination of total decontamination resulted in the restoration of a good CR, as could be shown by orally challenging the animals with a strain of Escherichia coli. Therefore, an anaerobic microflora, free of potentially pathogenic microorganisms, which was isolated from a healthy human volunteer was administered to monkeys and patients after a decontamination period in an attempt to restore CR. In the monkeys, this human donor flora (HDF) did not reduce the faecal concentration of microorganisms that had colonized the gastrointestinal tract before the donor microflora had been established, in contrast to the findings in some of the patients. Qualitative analysis of the microflora of patients which were contaminated with the human donor flora showed that the CR is not of the same quality as is found in healthy individuals. This can be the result of the impaired immune capacity of the patients at the time of HDF implantation. However, the results obtained show that implantation of the HDF in monkeys and patients after a decontamination period allows reconventionalization without an undue risk of microbial infection.

Animals↗
PubMed1981

Isolation efficiency and its clinical importance in patients with burns.

Nine severely burned patients were submitted to reverse isolation in a mass airflow system. Their burns became colonized by Enterobacteriaceae biotypes which were not found in the patients own flora on admission. They were, therefore, probably derived from the food which was obtained from the central kitchen. These strains did not cause bacteriaemia. Suggestions to improve the isolation efficiency are made.

Bacteria↗
PubMed1981

Recontamination after gastrointestinal decontamination with non-absorbable antibiotics.

In an attempt to restore the colonization resistance we administered anaerobic microflora to prevent an abnormal colonization of the intestine after antibiotic treatment had been discontinued. After the antibiotics had been discontinued and before the donor flora had been administered and had colonized the intestine, microorganisms present were "unopposed" and expanded to a high density. A mouse model was used to investigate which antibiotics negatively influenced the donor flora and reduced the colonization resistance when administered intraperitoneally. Erythromycin, clindamycin and carbenicillin suppressed the donor flora permanently, as could be seen by the reduced colonization resistance. Benzylpenicillin, ampicillin, doxycycline and the combination gentamicin-cephalothin affected the colonization resistance as long as these agents were present. Gentamicin alone and cephalothin and oxytetracycline had no effect on the colonization resistance.

Absorption↗
PubMed1975

Orthotopic liver transplantation: an experimental study on the prevention of infections with Gram-negative organisms.

Infection with Gram-negative bacteria is frequently the cause of death in human liver transplantation. In experimental liver transplantation in mongrel dogs we detected Gram-negative septicaemia in 73% of our first 15 cases; maximal survival was 26 days. In a second series of 27 orthotopic liver transplantations in tissue-typed littermate dogs and littermate pigs the standard surgical technique and aftercare were changed with regard to four factors: an end-to-end common bile duct anastomosis was made instead of a gallbladder to duodenum anastomosis; the continuous postoperative bacteriostatic antibiotic therapy was changed to a single 2-day course of bactericidal antibiotics; preoperative selective bowel decontamination combined with postoperative protective isolation was introduced; the dosage of azathioprine used for immunosuppression was reduced..

Ampicillin↗
PubMed1974

Bacteriological evaluation of a laminar cross-flow tunnel for surgery under operational conditions.

A transportable surgery cross-flow unit has been tested under ;operational conditions'. By the use of artificial aerosols and a volunteer surgical team, or dummies, it was found that, at an air velocity of 0.45 m./sec., a detectable transfer to above the table occurred only when quite highly concentrated aerosols (of more than 10(3.6) bacteria/m.(3) of air or more) existed underneath the table. The short disappearance time under these conditions and the quite stable flow pattern above the table found when a surgical team was working, standing along both sides of the table, make it unlikely that an aerosol of detectable concentration can develop during surgery, at this site. The chance that particles, liberated from the heads of the surgical team, settle on the table, was found to be strongly reduced when a cross-flow tunnel operated at an air velocity of 0.45 m./sec. The transfer from outside the unit to the inside was prevented by closing the upper part of the open front side.

Aerosols↗