During the last 10 to 15 years, Aerococcus-like organisms have been isolated from urinary tract specimens from hospitalized patients at Bispebjerg Hospital, Copenhagen, Denmark, with signs of urinary tract infection, and a single strain has been deposited at the National Collection of Type Cultures (NCTC 12142). An additional 63 isolates from the urine specimens of as many patients with suspected urinary tract infection have been identified from seven departments of clinical microbiology in Denmark. Clinical information indicates that this organism may be involved in urinary tract infection. These strains and ten previously collected strains, two of which were from blood cultures, were characterized phenotypically. By comparing the results with data on other gram-positive, catalase-negative cocci or coccobacillary organisms, the identified organisms seem to represent a separate taxon.
Of 85 strains of Bacillus cereus isolated in Norway from dairy products, 59% were found to be enterotoxigenic, and 15% were psychrotrophic. Six of the isolates (7%) were identified as potential psychrotrophic food-poisoning strains as they were both enterotoxigenic and exhibited good growth at 6 degrees C. Enterotoxin production was detected using the Western immunoblot technique, and a commercially available reversed passive latex agglutination (RPLA) assay (Unipath BCET-RPLA TD950). Both methods gave essentially the same results. In a separate study, the Western immunoblot and RPLA assays were used in a conjunction with the in vivo vascular permeability reaction (VPR) assay to determine enterotoxin production among 25 isolates of Bacillus cereus referred to the PHLS Food Hygiene Laboratory from incidents of diarrhoeal- and emetic-syndrome food poisoning and non-gastrointestinal infections. Eighty-four percent of these isolates were found to be enterotoxigenic by the Western immunoblot and the RPLA assays, and these results were in good agreement with those obtained by the VPR assay. In both studies, the BCET-RPLA kit proved to be a simple and reliable means for determining enterotoxin production by strains of Bacillus cereus.
Free ranging reindeer (Rangifer tarandus tarandus) are driven into corral systems and handled each summer on the Seward Peninsula (Alaska, USA). During June and July of 1995-96 reindeer calves were inspected for injury, handled, weighed, and randomly treated with long-acting oxytetracycline. Calves that returned to subsequent handlings within the same year, received treatment only if they had been treated during their first handling. The effects of prophylactic antibiotic treatment and other factors, including weight, handling related injury, and sex on post-handling survival in reindeer calves were evaluated. Return rates of yearlings in 1996 and 1997 were analyzed using logistic regression. Weight change of calves between handlings was examined using a general linear model. Calf weight and handling injury were the only factors that significantly affected calf survival. No factor had a significant effect on calf weight change between handlings. Apparently, long-acting oxytetracycline was not an effective prophylactic treatment for this capture operation. The benefits of prophylactic antibiotic treatment have not been quantified and further studies of the effects and efficacy of prophylactic treatments are recommended. Ineffective treatments should be avoided because they may add additional stress to the captured animal. Managers should evaluate the potential effectiveness of a prophylactic treatment before indiscriminately applying one. Preventing calf injuries was the most effective method of reducing post-handling mortality in this study and should be given a high priority in the design of capture operations.
OBJECTIVE: To examine the association between blood transfusion and bacterial infective complications after resection for colorectal adenocarcinoma. DESIGN: Retrospective cohort study. SETTING: District hospital; Norway. SUBJECTS: 446 consecutive patients having resection of colorectal adenocarcinoma. MAIN OUTCOME MEASURES: Postoperative bacterial infective morbidity in hospital. RESULTS: 112 patients (25%) developed postoperative infections in hospital. Univariate analysis showed that the development of infection was significantly associated with increasing age (p=0.02), rectal compared with colonic cancer (p=0.002), preoperative radiotherapy (p=0.005), blood loss during operation (p=0.001), the extent of the primary tumour (T stage): T4 compared with T1-T3 (p=0.004), the presence of regional lymph node metastasis (N stage): N1-N3 compared with N0 (p=0.01), operating surgeon 1 (p=0.009), operating surgeon 2 (p=0.03), and blood transfusion (p
The bacteriological study of feces from 458 patients with acute enteric diseases revealed that in 3.2% of cases (in summer in 8.1% of cases) the disease was caused by Aeromonas. In Aeromonas strains isolated from river water in the Volga delta, from fish and from raw meat the same pathogenicity factors occurred as in strains isolated from patients (hemolysin, DNA-ase, protease, lecithinase, amylase, adhesins, capacity of binding Congo red).
Enteral nutrition may appear as a risk factor for infection in intensive care patients if bacterial growth is not prevented. The authors have tested in the microbiology laboratory, 4 types of pumps (3 cooling machines: SEC Nutridose/Climadose, Peters NPR 3000, Vial "Alaska" and 1 flow regulator Sherwood Kangaroo 330) using food contaminated with a low inoculum of Klebsiella pneumoniae. Bacterial growth was investigated periodically in the food container and in the feeding tube during the testing of the pumps. Results showed that external refrigeration is the best cooling method. But after 8 hours of working, the best results were obtained with the flow regulator associated with a container cooled by an ice pocket. These in vitro results can be extended in vivo by taking care of changing the sterile tubings for each new dose of food.
An analysis of lethal outcomes following thermal traumas during the recent 8 years has shown sepsis to occupy one of the leading places as a cause of death of burned people. During the recent years the incidence of early sepsis has been increased. This kind of sepsis develops in the period of shock and acute toxemia, is often of lightening character, possesses certain specific morphological features and is caused predominantly by gram-negative flora threatening to patients with critical burns of more than 40% of the body surface.
The indigenous oropharyngeal microflora is complex and consists of many different aerobic and anaerobic microorganisms. Nonindigenous pathogenic microorganisms do not normally colonize the oropharynx due to several different defense mechanisms such as cell specific bacterial attachment, secretion of antibacterial substances and immunoglobulins. Also microbial interactions play an important role in the prevention of new colonization of the oropharynx. Suppression of the indigenous flora by antibiotics promote new colonization. Patients that are severely compromised by disease may be infected by colonizing microorganisms. At special risk are patients with low neutrophil count and patients that are prone to aspiration pneumonia. Thus new colonization should be prevented in such risk patients. Careful monitoring of systemic antimicrobial therapy is essential and decontamination of oropharynx with local antimicrobial agents may be of value.
Cephalosporins, especially cefazolin, are widely used in the prevention of postoperative wound infections after cardiac operations. As more and more Staphylococcus aureus and Staphylococcus epidermidis strains are becoming resistant to cephalosporins and other antibiotics, alternative agents, such as glycopeptides, are often used as prophylaxis. We performed a multicenter double-blind randomized controlled trial comparing teicoplanin, a glycopeptide antibiotic, with cefazolin.
A total of 3027 adult patients undergoing elective coronary artery bypass grafting, valve operations, or both were randomized to a single dose of teicoplanin (15 mg/kg) or a 2-day course of cefazolin (2 g initial dose, followed by 1 g every 8 hours for 6 more doses). Patients were followed up for a total of 6 months postoperatively. The primary objective was to compare, between groups, the incidence of surgical infections up to 30 days postoperatively. Secondary objectives were incidence of other infections, other complications, and death.
A total of 3027 patients were randomized to receive either teicoplanin (n = 1518) or cefazolin (n = 1509). Thirty days postoperatively, there was a trend to more deep sternotomy wound infections in the teicoplanin group (31 vs 18, P =. 087), which became significant by 6 months (36 vs 19, P =.032). One hundred percent of the gram-positive strains infecting patients were susceptible to teicoplanin, whereas 8.3% were resistant to cefazolin. Pneumonia and urinary tract infections were more common in the teicoplanin group. Deep wound infections of the leg were more common in the cefazolin group.
Cefazolin was more effective prophylaxis than teicoplanin against postoperative wound infections after elective cardiac operations. Infection rates were low with either treatment.