[Bacteriological studies in antibacterial chemotherapy?].
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Biomedical subjects
Publications and source records attributed to W Handrick.
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Two methods for detecting rotaviruses (latex agglutination, electron microscopy) have been compared on 80 faecal samples. These samples were obtained from infants between the age of four and 30 months hospitalized for acute gastroenteritis in the Children's Hospital, Karl Marx University at Leipzig, in 1982. Complete agreement among the two techniques was found in 75 specimens. Sensitivity of latex agglutination could be estimated at 95%, the specificity also at 95%. Only one sample reacted nonspecifically. Performance of the latex agglutination proved quite simple. The results indicate that latex agglutination is suitable for rapid screening of rotavirus induced gastroenteritis in clinical practice thus enabling the rate of nosocomial rotavirus infections in children's hospitals to be reduced.
The authors describe the signs and symptoms in 82 children and adolescents with infections due to Mycoplasma pneumoniae, diagnosed by the complement fixation reaction. They discuss the results in relation to other reports about mycoplasma infections.
In a survey the authors present the most important facts of diagnostic and therapy of bacterial infections in term and preterm neonates. It is a synthesis of an extensive study of the literature and of own experiences. Besides microbiological diagnostic and antibacterial chemotherapy one can find also suggestions concerning hematological and chemical diagnostic methods as well as of parenteral and oral nutrition and immunotherapy.
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From January 1975 to March 1985 37 newborns and infants with B streptococcal infections were treated in the Pediatric Hospital of the Karl Marx University in Leipzig. The percentage of B streptococcal infections of all neonatal bacterial infections rose in this time from 6.9% to 15.7%. There were 23 early onset type infections and 14 late infections; 12 of the 37 infants died. Septicemia and meningitis were the most important clinical features. The time of beginning of the clinical symptoms in the postnatal period and the results of serotyping suggest a connatal infection in most cases.
We saw 5 young infants with severe pneumonias due to RS virus (diagnosed serologically). Three of these infants were born as premature babies. Artificial ventilation was necessary in two cases. After the case reports follows a discussion of the most important problems of epidemiology, diagnostics and therapy of RS virus infections in young infants.
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It is reported on a premature infant who fell ill with an orchitis and epididymitis by Salmonella cholerae suis in the fourth week of life. The proof of the germs was carried out by means of two blood cultures as well as in the smear from the periorchium. The most important informations from literature concerning this subject are briefly reviewed.
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In 14 premature infants suffering from bacterial sepsis during the first week of life the daily renal sodium and potassium losses as well as the concentrations in serum of both electrolytes were measured before and during the period of infection. 24 hours before appearance of first clinical symptoms of sepsis the sodium concentration in urine increases and the balance becomes negative. Hyponatraemia occurs later and is in correlation with the clinical course of the disease. Thus, the hyponatraemia is caused more by shifting of sodium from the extracellular space than by renal sodium excretion. To prevent this hyponatraemia the sodium intake has to be increased to 6 mmol/kg X 24 h as a minimum and the fluid intake has to be decreased to 80 ml/kg X 24 h as a maximum in the same time when antibiotic treatment is started. A short-term control of serum electrolytes is an important premise for a sufficient treatment. Increased sodium concentrations in urine of more than 50 mmol/l or again increasing concentrations beyond the second day of life can be appreciated as early signs of neonatal sepsis.
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In a total of 223 children over one month old suffering from purulent meningitis, there was a predominance (n = 96) of meningococci over hemophilus influenzae (n = 68) and pneumococci (n = 59). Crucial to therapeutic strategy for purulent meningitis is early diagnosis, in our laboratory covering both liquor and blood cultures. Initial therapy has to take account of these three chief causal agents. We have not as yet observed any resistance to penicillin from meningococci or pneumococci, and none of the liquor-cultivated hemophilus influenzae stock has been resistant to ampicillin. In the first two years of life, initial therapy for bacterial meningitis should include ampicillin, a liberal (300-400 mg/kg KM/d) dosage continuing to be important after the onset of improvement. In view of the lack of resistance of the causal agents cultivated, we had hitherto no cell to deploy modern cephalosporins in cases of bacterial meningitis in children.