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[Antibiotics in a hospital hygienic perspective].

https://arctichealth.org/en/permalink/ahliterature159260
Source
Ugeskr Laeger. 2007 Dec 3;169(49):4254-6
Publication Type
Article
Date
Dec-3-2007
Author
Niels Frimodt-Møller
Bente Gahrn-Hansen
Author Affiliation
Statens Serum Institut, Afdelingen for Antibiotikaresistens og Sygehushygiejne. NFM@ssi.dk
Source
Ugeskr Laeger. 2007 Dec 3;169(49):4254-6
Date
Dec-3-2007
Language
Danish
Publication Type
Article
Keywords
Anti-Bacterial Agents - administration & dosage - adverse effects
Antibiotic Prophylaxis
Cross Infection - microbiology - prevention & control
Denmark
Drug Resistance, Multiple, Bacterial
Drug Utilization
Humans
Infection Control - methods
Risk factors
Abstract
Antibiotic consumption has increased by around 50% in Danish hospitals over the last 7 years. In percentages, the highest increase has been among broad spectrum antibiotics such as cephalosporins, crabapenems and fluoroquinolones. The consequence of this is selection of resistant bacteria and fungi. Control of antibiotic resistance requires implementation of different strategies: better and more rapid diagnosis of infectious origin, restriction on antibiotic use, e.g. through re-evaluation every 2-3 days of patients receiving antibiotics, optimization of dosing and duration of treatment, preferred use of narrow spectrum antibiotics and optimization of hospital hygiene.
PubMed ID
18208702 View in PubMed
Less detail

Clonal relationship of recent invasive Haemophilus influenzae serotype f isolates from Denmark and the United States.

https://arctichealth.org/en/permalink/ahliterature13780
Source
J Med Microbiol. 2004 Nov;53(Pt 11):1161-5
Publication Type
Article
Date
Nov-2004
Author
Brita Bruun
Bente Gahrn-Hansen
Henrik Westh
Mogens Kilian
Author Affiliation
Department of Clinical Microbiology, Statens Serum Institut, Artillerivej 5, DK 2300 Copenhagen S, Denmark.
Source
J Med Microbiol. 2004 Nov;53(Pt 11):1161-5
Date
Nov-2004
Language
English
Publication Type
Article
Keywords
ATP-Binding Cassette Transporters - genetics
Aged
Bacteremia - microbiology
Bacterial Proteins - genetics
Bacterial Typing Techniques
Cholangitis - microbiology
DNA, Bacterial - genetics - isolation & purification
Denmark
Enzymes - analysis
Epidemiology, Molecular
Epiglottitis - microbiology
Female
Haemophilus Infections - microbiology
Haemophilus influenzae - classification - genetics - isolation & purification
Humans
Liver Abscess - microbiology
Male
Meningitis, Haemophilus - microbiology
Middle Aged
Osteoarthritis - microbiology
Polymerase Chain Reaction
Polysaccharides - genetics
Respiratory Tract Infections - microbiology
Serotyping
United States
Abstract
Surveillance performed after the introduction of general Haemophilus influenzae serotype b (Hib) vaccination in Denmark identified 13 cases of invasive bacteraemic H. influenzae serotype f (Hif) disease in adults over a period of 7 years. Bacteraemic respiratory tract infections accounted for 61 % of cases, but meningitis, epiglottitis and osteoarthritis were also seen. Recent Danish isolates were compared to recent American isolates, historical Hif strains and non-Hif invasive strains. Results of conventional serotyping were confirmed by PCR detection of the serotype-f-specific cap and bexA gene sequences. Multilocus enzyme electrophoresis typing revealed that recent Danish and American isolates belonged to a single Hif clone, which may be undergoing expansion. The need for accurate serotyping of H. influenzae to enable reliable monitoring for Hib replacement by other capsular types is emphasized.
PubMed ID
15496397 View in PubMed
Less detail

Ear infections with Shewanella alga: a bacteriologic, clinical and epidemiologic study of 67 cases.

https://arctichealth.org/en/permalink/ahliterature34231
Source
Clin Microbiol Infect. 1997 Jun;3(3):329-334
Publication Type
Article
Date
Jun-1997
Author
Hanne M. Holt
Per Søgaard
Bente Gahrn-Hansen
Author Affiliation
Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark.
Source
Clin Microbiol Infect. 1997 Jun;3(3):329-334
Date
Jun-1997
Language
English
Publication Type
Article
Abstract
OBJECTIVE: To present bacteriologic and clinical data on 67 patients from the island of Funen, Denmark, with Shewanella alga, a bacterium rarely seen in Scandinavia, isolated from ear swabs. Included in the study is an examination of the occurrence of S. alga in sea water around the island. METHODS: Bacteriologic examination and antibiotic susceptibility testing of 67 clinical isolates, 11 sea-water isolates and two reference strains were conducted. Clinical information was obtained from the referring physicians. RESULTS: During 6 months S. alga was isolated from 67 patients, in 33 cases in pure culture. Seventy per cent of the patients were children between 3 and 15 years old who had clinical symptoms of acute or chronic otitis media. Previous ear disease was common (76%). Most of the cases (85%) occurred in August or September, and 47 of 55 patients reported contact with sea water shortly before symptoms developed. From seven of the patients, S. alga was isolated more than once. The species was also isolated from five of 10 bathing areas around the island of Funen. CONCLUSIONS: The patients were probably infected with S. alga during sea-water bathing in the unusually warm summer of 1994. Infections with marine bacteria are possible in countries with a temperate climate; patients with previous ear disease are at special risk.
PubMed ID
11864129 View in PubMed
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[General practitioners who use CRP have a lower antibiotic prescribing rate to patients with sinusitis--secondary publication].

https://arctichealth.org/en/permalink/ahliterature173870
Source
Ugeskr Laeger. 2005 Jun 20;167(25-31):2775-7
Publication Type
Article
Date
Jun-20-2005
Author
Lars Bjerrum
Bente Gahrn-Hansen
Anders P Munck
Author Affiliation
Forskningsenheden for Almen Praksis i Odense, Syddansk Universitet, Odense Universitetshospital, DK-5000 Odense C. lbjerrum@health.sdu.dk
Source
Ugeskr Laeger. 2005 Jun 20;167(25-31):2775-7
Date
Jun-20-2005
Language
Danish
Publication Type
Article
Keywords
Acute Disease
Adult
Aged
Anti-Bacterial Agents - therapeutic use
C-Reactive Protein - analysis
Denmark
Drug Prescriptions
Drug Utilization
Family Practice
Female
Humans
Male
Middle Aged
Physician's Practice Patterns
Respiratory Tract Infections - drug therapy
Sinusitis - drug therapy
Abstract
Sinusitis is associated with overuse of antibiotics. The aim of this study was to determine whether GPs who use the CRP rapid test (CRP) have a lower antibiotic prescribing rate for sinusitis. During a three-week period, a group of GPs registered all patients with respiratory tract infections (n = 17,792). GPs using CRP prescribed antibiotics for 59% and GPs not using CRP prescribed antibiotics for 78% of the patients with sinusitis. CRP was the factor exerting the greatest influence on the prescribing of antibiotics. Implementing CRP in general practice may lead to a reduction in antibiotic prescribing to patients with sinusitis.
PubMed ID
16014265 View in PubMed
Less detail

Health Alliance for Prudent Prescribing, Yield and Use of Antimicrobial Drugs in the Treatment of Respiratory Tract Infections (HAPPY AUDIT).

https://arctichealth.org/en/permalink/ahliterature97221
Source
BMC Fam Pract. 2010;11:29
Publication Type
Article
Date
2010
Author
Lars Bjerrum
Anders Munck
Bente Gahrn-Hansen
Malene Plejdrup Hansen
Dorte Jarboel
Carl Llor
Josep Maria Cots
Silvia Hernández
Beatriz González López-Valcárcel
Antoñia Pérez
Lidia Caballero
Walter von der Heyde
Ruta Radzeviviene
Arnoldas Jurgutis
Anatoliy Reutskiy
Elena Egorova
Eva Lena Strandberg
Ingvar Ovhed
Sigvard Molstad
Robert vander Stichele
Ria Benko
Vera Vlahovic-Palcevski
Christos Lionis
Marit Rønning
Author Affiliation
Research Unit of General Practice, University of Southern Denmark, Odense, Denmark. lbjerrum@sund.ku.dk
Source
BMC Fam Pract. 2010;11:29
Date
2010
Language
English
Publication Type
Article
Keywords
Anti-Infective Agents - therapeutic use
Clinical Audit - methods
Drug Resistance, Bacterial
Drug Utilization Review - methods
European Union
Family Practice
Health Care Coalitions
Humans
Intervention Studies
Physician's Practice Patterns - standards
Prevalence
Respiratory Tract Infections - drug therapy
Abstract
BACKGROUND: Excessive and inappropriate use of antibiotics is considered to be the most important reason for development of bacterial resistance to antibiotics. As antibiotic resistance may spread across borders, high prevalence countries may serve as a source of bacterial resistance for countries with a low prevalence. Therefore, bacterial resistance is an important issue with a potential serious impact on all countries. The majority of respiratory tract infections (RTIs) are treated in general practice. Most infections are caused by virus and antibiotics are therefore unlikely to have any clinical benefit. Several intervention initiatives have been taken to reduce the inappropriate use of antibiotics in primary health care, but the effectiveness of these interventions is only modest. Only few studies have been designed to determine the effectiveness of multifaceted strategies in countries with different practice setting. The aim of this study is to evaluate the impact of a multifaceted intervention targeting general practitioners (GPs) and patients in six countries with different prevalence of antibiotic resistance: Two Nordic countries (Denmark and Sweden), two Baltic Countries (Lithuania and Kaliningrad-Russia) and two Hispano-American countries (Spain and Argentina). METHODS/DESIGN: HAPPY AUDIT was initiated in 2008 and the project is still ongoing. The project includes 15 partners from 9 countries. GPs participating in HAPPY AUDIT will be audited by the Audit Project Odense (APO) method. The APO method will be used at a multinational level involving GPs from six countries with different cultural background and different organisation of primary health care. Research on the effect of the intervention will be performed by analysing audit registrations carried out before and after the intervention. The intervention includes training courses on management of RTIs, dissemination of clinical guidelines with recommendations for diagnosis and treatment, posters for the waiting room, brochures to patients and implementation of point of care tests (Strep A and CRP) to be used in the GPs'surgeries. To ensure public awareness of the risk of resistant bacteria, media campaigns targeting both professionals and the public will be developed and the results will be published and widely disseminated at a Working Conference hosted by the World Association of Family Doctors (WONCA-Europe) at the end of the project period. DISCUSSION: HAPPY AUDIT is an EU-financed project with the aim of contributing to the battle against antibiotic resistance through quality improvement of GPs' diagnosis and treatment of RTIs through development of intervention programmes targeting GPs, parents of young children and healthy adults. It is hypothesized that the use of multifaceted strategies combining active intervention by GPs will be effective in reducing prescribing of unnecessary antibiotics for RTIs and improving the use of appropriate antibiotics in suspected bacterial infections.
PubMed ID
20416034 View in PubMed
Less detail

[Malaria in the county of Funen 1987-1999]

https://arctichealth.org/en/permalink/ahliterature52277
Source
Ugeskr Laeger. 2002 Apr 8;164(15):2038-41
Publication Type
Article
Date
Apr-8-2002
Author
Maren Kathrine Hornstrup
Bente Gahrn-Hansen
Jesper Hallas
Kjartan Seyer-Hansen
Author Affiliation
Klinisk mikrobiologisk afdeling, Odense Universitetshospital, J. B. Winsløwsvej 21, 2. DK-5000 Odense C. b.gahrn-hansen@ouh.fyns-amt.dk
Source
Ugeskr Laeger. 2002 Apr 8;164(15):2038-41
Date
Apr-8-2002
Language
Danish
Publication Type
Article
Keywords
Antimalarials - administration & dosage
Denmark - epidemiology - ethnology
Emigration and Immigration
English Abstract
Humans
Malaria - epidemiology - prevention & control - transmission
Malaria, Falciparum - epidemiology - prevention & control - transmission
Patient compliance
Travel
Abstract
INTRODUCTION: We describe epidemiological, prophylactic, and clinical aspects of imported malaria in the county of Funen, 1987-1999. MATERIAL AND METHODS: The medical records of 136 patients were reviewed for age, gender, nationality, place of exposure, chemoprophylaxis, time lag from departure to diagnosis, Plasmodium species, treatment, and complications. Data on prescribed chemoprophylaxis dispensed from the pharmacies in the county of Funen were recorded. RESULTS: Seventy-two per cent of the patients were Danish, 28% foreigners. Sixty per cent of the cases were caused by P. falciparum, of more than 90% which was acquired in sub-Saharan Africa. Cases of benign malaria were most often acquired in SE Asia. In the 49 patients with falciparum malaria, who had taken chemoprophylaxis, only 31 (63%) were fully compliant. Compliance was 76% in patients taking chloroquine phosphate + proguanil and 36% in patients taking only chloroquine phosphate. Six patients had complications, but all recovered. DISCUSSION: Contributory causes in a large number of the reported cases of imported malaria in this study were no chemoprophylaxis or poor compliance. With respect to falciparum malaria, prescription of non-recommended chemoprophylaxis also contributed. Chemoprophylaxis dispensed from the pharmacies on Funen over recent years indicates that general practitioners are aware of altered recommendations.
PubMed ID
11985003 View in PubMed
Less detail

Molecular screening for Candida orthopsilosis and Candida metapsilosis among Danish Candida parapsilosis group blood culture isolates: proposal of a new RFLP profile for differentiation.

https://arctichealth.org/en/permalink/ahliterature98433
Source
J Med Microbiol. 2010 Apr;59(Pt 4):414-20
Publication Type
Article
Date
Apr-2010
Author
Hossein Mirhendi
Brita Bruun
Henrik Carl Schønheyder
Jens Jørgen Christensen
Kurt Fuursted
Bente Gahrn-Hansen
Helle Krogh Johansen
Lene Nielsen
Jenny Dahl Knudsen
Maiken Cavling Arendrup
Author Affiliation
Department of Medical Mycology and Parasitology, Tehran University of Medical Sciences, Tehran, Iran.
Source
J Med Microbiol. 2010 Apr;59(Pt 4):414-20
Date
Apr-2010
Language
English
Publication Type
Article
Keywords
Alcohol Oxidoreductases - genetics
Candida - classification - genetics - isolation & purification
Candidiasis - diagnosis - microbiology
Fungemia - microbiology
Humans
Polymerase Chain Reaction
Polymorphism, Restriction Fragment Length
Abstract
Candida orthopsilosis and Candida metapsilosis are recently described species phenotypically indistinguishable from Candida parapsilosis . We evaluated phenotyping and molecular methods for the detection of these species among 79 unique blood culture isolates of the C. parapsilosis group obtained during the years 2004-2008. The isolates were screened by PCR amplification of the secondary alcohol dehydrogenase-encoding gene ( SADH) followed by digestion with the restriction enzyme Ban I, using C. parapsilosis ATCC 22019, C. orthopsilosis ATCC 96139 and C. metapsilosis ATCC 96144 as controls. Isolates with RFLP patterns distinct from C. parapsilosis were characterized by sequence analysis of the ITS1-ITS2, 26S rRNA (D1/D2) and SADH regions. Restriction patterns for the 3 species with each of 610 restriction enzymes were predicted in silico using 12 available sequences. By PCR-RFLP of the SADH gene alone, four isolates (5.1 %) had a pattern identical to the C. orthopsilosis reference strain. Sequence analysis of SADH and ITS (internal transcribed spacer) regions identified two of these isolates as C. metapsilosis. These results were confirmed by creating a phylogenetic tree based on concatenated sequences of SADH, ITS and 26S rRNA gene sequence regions. Optimal differentiation between C. parapsilosis, C. metapsilosis and C. orthopsilosis was predicted using digestion with NlaIII, producing discriminatory band sizes of: 131 and 505 bp; 74, 288 and 348 bp; and 131, 217 and 288 bp, respectively. This was confirmed using the reference strains and 79 clinical isolates. In conclusion, reliable discrimination was obtained by PCR-RFLP profile analysis of the SADH gene after digestion with NlaIII but not with BanI. C. metapsilosis and C. orthopsilosis are involved in a small but significant number of invasive infections in Denmark.
PubMed ID
20056771 View in PubMed
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Respiratory tract infections in general practice: considerable differences in prescribing habits between general practitioners in Denmark and Spain.

https://arctichealth.org/en/permalink/ahliterature182290
Source
Eur J Clin Pharmacol. 2004 Mar;60(1):23-8
Publication Type
Article
Date
Mar-2004
Author
Lars Bjerrum
Albert Boada
Josep M Cots
Carlos Llor
Dolors Forés Garcia
Bente Gahrn-Hansen
Anders Munck
Author Affiliation
Research Unit of General Practice, University of Southern Denmark, Winsløwsparken 19, 3rd floor, 5000 Odense C, Denmark. lbjerrum@health.sdu.dk
Source
Eur J Clin Pharmacol. 2004 Mar;60(1):23-8
Date
Mar-2004
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Anti-Bacterial Agents - adverse effects - therapeutic use
Denmark
Drug Prescriptions - statistics & numerical data
Drug Resistance, Microbial
Drug Utilization - trends
Family Practice - trends
Female
Humans
Male
Middle Aged
Pharmacoepidemiology - methods - statistics & numerical data
Physician's Practice Patterns - trends
Respiratory Tract Infections - diagnosis - drug therapy - epidemiology
Spain
Time Factors
Abstract
The prevalence of antibiotic resistance in a country reflects the local consumption of antibiotics. The majority of antibiotics are prescribed in general practice and most prescriptions are attributable to treatment of respiratory tract infections (RTIs). The aim of this study was to compare general practitioners' (GPs') prescribing of antibiotics for respiratory tract infections in a country with a high prevalence of antibiotic resistance (Spain) with a country with a low prevalence of antibiotic resistance (Denmark).
A group of GPs in Copenhagen and Barcelona registered all contacts ( n=2833) with patients with RTIs during a 3-week period between 1 November 2001 and 31 January 2002.
Overall, Spanish GPs treated a higher proportion of patients than Danish GPs. After adjusting for unequal distribution of age and sex, we found that Spanish GPs prescribed significantly more antibiotics to patients with focus of infection in tonsils and bronchi/lungs. Narrow-spectrum penicillin was the most used antibiotic in Denmark, representing 58% of all prescriptions issued, followed by macrolide and broad-spectrum penicillin. In Spain, prescriptions were distributed among a great number of compounds, with broad-spectrum penicillins and combinations of amoxicillin plus beta-lactamase inhibitors most frequently used.
The substantial difference in the way GPs manage respiratory tract infections in Denmark and Spain cannot be explained by different patterns of RTIs in general practice. The discrepancies indicate variations in national recommendations, different treatment traditions or different impact of pharmaceutical marketing.
PubMed ID
14689127 View in PubMed
Less detail

Seminational surveillance of fungemia in Denmark: notably high rates of fungemia and numbers of isolates with reduced azole susceptibility.

https://arctichealth.org/en/permalink/ahliterature29493
Source
J Clin Microbiol. 2005 Sep;43(9):4434-40
Publication Type
Article
Date
Sep-2005
Author
Maiken Cavling Arendrup
Kurt Fuursted
Bente Gahrn-Hansen
Irene Møller Jensen
Jenny Dahl Knudsen
Bettina Lundgren
Henrik C Schønheyder
Michael Tvede
Author Affiliation
Unit of Mycology and Parasitology, Statens Serum Institut, Copenhagen, Denmark. mad@ssi.dk
Source
J Clin Microbiol. 2005 Sep;43(9):4434-40
Date
Sep-2005
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Antifungal Agents - pharmacology
Azoles - pharmacology
Candida - drug effects
Candidiasis - epidemiology - microbiology
Child
Child, Preschool
Denmark - epidemiology
Drug Resistance, Fungal
Female
Fungemia - epidemiology - microbiology
Humans
Infant
Infant, Newborn
Male
Microbial Sensitivity Tests
Middle Aged
Abstract
The aim of this study was to present the first set of comprehensive data on fungemia in Denmark including the distribution of species and range of susceptibility to major antifungal compounds based on a seminational surveillance study initiated in 2003. The catchment area of the participating hospitals had a population of 2.8 million, or 53% of the Danish population. A total of 303 episodes of fungemia were registered (annual rate, 11 of 100,000 people or 0.49 of 1,000 hospital discharges). Candida species accounted for 97.4% of the fungal pathogens. C. albicans was the predominant species (63%), but the proportion varied from 57% to 72% among participating departments of clinical microbiology. C. glabrata was the second most frequent species (20%; range, 8% to 32%). C. krusei was a rare isolate (3%) and occurred only at two of the participating hospitals. Retrospective data retrieved from the Danish laboratory systems documented a continuous increase of candidemia cases since the early 1990s. For the 272 susceptibility-tested isolates, MICs of amphotericin B and caspofungin were within the limits expected for the species or genus. However, decreased azole susceptibility, defined as a fluconazole MIC of >8 microg/ml and/or itraconazole MIC of >0.125 microg/ml, was detected for 11 Candida isolates that were neither C. glabrata nor C. krusei. Including intrinsically resistant fungi, we detected decreased susceptibility to fluconazole and/or itraconazole in 87 (32%) current Danish bloodstream fungal isolates. We showed a continuous increase of fungemia in Denmark and an annual rate in 2003 to 2004 higher than in most other countries. The proportion of bloodstream fungal isolates with reduced susceptibility to fluconazole and/or itraconazole was also notably high.
PubMed ID
16145088 View in PubMed
Less detail

[Staphylococcus aureus infections--the clinical picture and treatment]

https://arctichealth.org/en/permalink/ahliterature13938
Source
Ugeskr Laeger. 2002 Aug 5;164(32):3759-63
Publication Type
Article
Date
Aug-5-2002

12 records – page 1 of 2.