Showing papers in "European Journal of Clinical Microbiology & Infectious Diseases in 1984"
TL;DR: The physical properties and mode of replication of HSV are briefly described, and an outline of the different clinical manifestations associated with HSV infection is presented.
Abstract: Infections with herpes simplex virus (HSV) are extremely common. HSV infection may be asymptomatic or may cause any one of a wide variety of disease syndromes. In this review, the physical properties and mode of replication of HSV are briefly described, and an outline of the different clinical manifestations associated with HSV infection is presented. Principles of diagnosis, treatment, and prevention of these infections are also discussed.
419 citations
TL;DR: The pharmacokinetics of ciprofloxacin was examined after a single oral dose of 250 mg and a single intravenous dose of 100 mg respectively in six healthy male volunteers in an open, randomized crossover study.
Abstract: The pharmacokinetics of ciprofloxacin (Bay o 9867) was examined after a single oral dose of 250 mg and a single intravenous dose of 100 mg respectively in six healthy male volunteers in an open, randomized crossover study. Although ciprofloxacin concentrations were measured in serum, plasma and urine by HPLC with fluorimetric detection and by microbiological assay, all pharmacokinetic calculations are based on the highly sensitive HPLC method only. The mean serum concentration of ciprofloxacin peaked approximately 1 h after the oral dose (0.94 mg/l). The elimination half-life was about 4 h and the renal clearance was 4.75 ml/min . kg; both were independent of the route of administration. The total clearance (9.62 ml/min . kg) was about twofold higher than the renal clearance. The volume of distribution of the central compartment was calculated to be 0.161 l/kg and the total volume at steady state was 2.0 l/kg. About 27% of the oral dose was excreted in urine, whereas the urinary recovery of the i.v. dose was 46%. The absolute bioavailability of ciprofloxacin was found to be approximately 60%. Ciprofloxacin appears to follow first-order, three compartment model kinetics.
136 citations
TL;DR: In mouse protection studies (intraperitoneal infection) ciprofloxacin was significantly more effective than norfloxACin, ampicillin, trimethoprim-sulfamethoxazole, and also showed excellent activity againstseudomonas infections.
Abstract: The antibacterial activity of ciprofloxacin (Bay o 9867) was compared with those of norfloxacin, nalidixic acid, trimethoprim-sulfamethoxazole, cefaclor, sisomicin and cefotaxime in in vitro and mouse protection studies. Approximately 300 clinical isolates of clinically important gram-positive and gram-negative species were used. The median MICs of ciprofloxacin against gram-positive and gram-negative bacteria ranged from ≤0.015–1 mg/l. Ciprofloxacin was 2–8 fold more active than norfloxacin and 100-fold more active than nalidixic acid. It also had a wider spectrum of activity against gram-positive organisms including even enterococci. No cross-resistance was observed between ciprofloxacin andβ-lactam antibiotics or aminoglycosides. Only acidic pH conditions decreased its activity. Ciprofloxacin showed rapid bactericidal action against organisms in both the logarithmic and stationary growth phases. In mouse protection studies (intraperitoneal infection) ciprofloxacin was significantly more effective than norfloxacin, ampicillin, trimethoprim-sulfamethoxazole, and also showed excellent activity againstPseudomonas infections.
122 citations
TL;DR: It is suggested that host mechanisms can influence changes in the proportions of Haemophilus influenzae strains colonizing the host.
Abstract: To determine normal proportions of pharyngealHaemophilus species, qualitative and quantitative mapping of the species in the pharynx of ten healthy children and ten healthy adults was carried out using a selective and a non-selective medium.Haemophilus organisms were present in all samples, comprising approximately 10 % of the total cultivable flora (range 0.6–36.9 %).Haemophilus parainfluenzae was a member of the normal flora throughout life, constituting 74% of pharyngealHaemophilus organisms.Haemophilus segnis andHaemophilus paraphrophilus occurred more frequently in samples from adults, whereasHaemophilus haemolyticus was present in only one sample. Non-encapsulatedHaemophilus influenzae strains, usually of multiple biotypes, were present in 80% of the children but accounted for a mean of only 1.8 % of the total flora. Their number decreased with increasing age; 40 % of the adults harboredHaemophilus influenzae but only of a single biotype which constituted a minor proportion of the total flora (mean 0.15%). These findings suggest that host mechanisms can influence changes in the proportions ofHaemophilus influenzae strains colonizing the host.
113 citations
108 citations
TL;DR: Clinical cross-resistance in Escherichia coli at least, need not necessarily apply to such highly active 4-quinolone antibacterial agents, as ciprofloxacin and, to a lesser extent, ofloxac in and norfloxACin were so highly active that the most resistance exhibited by any mutant fell well within the serum drug concentration ranges attainable in humans.
Abstract: The activity of ten 4-quinolone drugs was tested against five Escherichia coli mutants. Mutational resistance was found to reduce the activity of all ten drugs, indicating that they display biochemical cross-resistance with each other. However, ciprofloxacin and, to a lesser extent, ofloxacin and norfloxacin were so highly active that the most resistance exhibited by any mutant fell well within the serum drug concentration ranges attainable in humans. Hence, clinical cross-resistance in Escherichia coli at least, need not necessarily apply to such highly active 4-quinolone antibacterial agents.
102 citations
TL;DR: Ciprofloxacin was found to be the most active of a group of 4-quinolone antibiotics tested against the SA2 f strain of Chlamydia trachomatis and showed similar activity to that of oxytetracycline against clinical isolates of Mycoplasma hominis and Ureaplasma urealyticum.
Abstract: Ciprofloxacin was found to be the most active of a group of 4-quinolone antibiotics tested against the SA2 f strain ofChlamydia trachomatis (MBC and MIC 1.0 mg/l). Against genital isolates ofChlamydia trachomatis, Ciprofloxacin was twice as active as rosoxacin. Ciprofloxacin showed similar activity to that of oxytetracycline against clinical isolates ofMycoplasma hominis andUreaplasma urealyticum, and was 8-fold more active than rosoxacin against the latter.
73 citations
TL;DR: To determine whether ciprofloxacin might be efficacious in therapy for chronic bacterial prostatitis, its diffusion into prostatic fluid was studied in ten healthy volunteers.
Abstract: To determine whether ciprofloxacin might be efficacious in therapy for chronic bacterial prostatitis, its diffusion into prostatic fluid was studied in ten healthy volunteers. One hour after administering 500 mg ciprofloxacin, the concentration of ciprofloxacin was measured by the agar diffusion method and bioassay. Serum levels were twice as high as in seminal fluid; however, 12 and 24 hours later concentration in seminal fluid was tenfold higher than in serum. Split ejaculates were examined to determine the secretory pattern of ciprofloxacin into seminal fluid. The two fractions also showed tenfold concentration. Ciprofloxacin concentration in expressed prostatic secretion ranged from 15 to 0.9 mg/l, thus indicating pronounced diffusion of ciprofloxacin into the prostatic fluid.
69 citations
TL;DR: The fact that Haernophilus influenzae can also cause a post-pneumonectomy empyema indicates the expanding role of this microorganism in a great variety of diseases in adults, independent of its serotype or biotype.
Abstract: between serotype and biotype of this microorganism in causing invasive disease in children (7), a recent paper on pneumonia and acute febrile tracheobronchitis in adults (8) stressed the significance of nonserotypable Haemophilus influenzae as the cause of 26 out of 3 0 episodes of pneumonia, and all 14 episodes of acute febrile tracheobronchitis were caused by biotype III. This biotype seams to predominate along with biotype II in expectorated sputum of patients with chronic bronchitis without clinical signs of infection (8). It could be conjectured that our patient harbored Haemophilus influenzae biotype III in his bronchial tree and that there was contamination of the pleural cavity at surgery. Otherwise exogenous contamination during surgery would be a likely explanation. We belive that this is the first report o~ a case ofHaemophilus influenzae empyema post-pneumonectomy. The negative blood cultures, the absence of fistula and the early clinical picture make contamination during surgery the most likely explanation of pathogenesis. The fact that Haernophilus influenzae can also cause a post-pneumonectomy empyema indicates the expanding role of this microorganism in a great variety of diseases in adults, independent of its serotype or biotype.
69 citations
TL;DR: Serum concentrations and urinary excretion of ciprofloxacin were studied in female and male volunteers following a single oral administration of 100 mg, 250 mg, 500 mg or 1000 mg and increased proportionally to the increasing dose administered but independently of sex.
Abstract: Serum concentrations and urinary excretion of ciprofloxacin were studied in female and male volunteers following a single oral administration of 100 mg, 250 mg, 500 mg or 1000 mg. Serum and urine concentrations increased proportionally to the increasing dose administered but independently of sex. Twenty-five percent of the administered dose was excreted in the urine as unmetabolized ciprofloxacin within the first 24 hours after oral administration. Renal clearance averaged 5 ml/min × kg.
66 citations
TL;DR: It is shown that maintenance of bactericidal levels of penicillin were particularly important in curing severe infection in rats with impaired defense.
Abstract: An experimental Streptococcus pneumoniae pneumonia was used to study the influence of continuous versus intermittent administration of penicillin G on therapeutic efficacy in normal rats and in rats whose phagocytic capacities were impaired by decomplementation with cobra venom factor. Response to antibiotic treatment was evaluated with respect to numbers of bacteria in left lung, blood and pleural fluid. Penicillin treatment was started 36 h after bacterial inoculation, and continued for four days. With intermittent intramuscular administration of penicillin normal rats were cured after daily doses of 4 mg/kg at 12 h intervals, whereas decomplemented rats recovered only after daily doses of 100 or 102 mg/kg at 12 h or 8 h intervals, respectively. When penicillin was administered by way of continuous infusion, daily doses of 3.5 mg/kg were required for a cure of infections in both normal rats and in decomplemented rats. This treatment resulted in a constant level of 0.05 micrograms of penicillin per ml, which was slightly above the minimum bactericidal concentration for the infecting strain. These findings show that maintenance of bactericidal levels of penicillin were particularly important in curing severe infection in rats with impaired defense.
TL;DR: The inhibitory quotients for urine, serum and bronchial secretion showed that ciprofloxacin had the broadest spectrum of all agents tested and covered all clinically significant bacteria.
Abstract: The antibacterial activity of ciprofloxacin was compared to those of norfloxacin, pefloxacin, pipemidic acid, nalidixic acid, nitrofurantoin, sulfamethoxazole, trimethoprim, cephradine and amoxycillin. Agar dilution tests were performed with 631 clinical isolates from urinary and respiratory tract, infections. Ciprofloxacin was found to be the most active drug tested against all gram-negative organisms and streptococci, with the exception of Streptococcus faecalis and Streptococcus pneumoniae. MIC 90 values of ciprofloxacin were as follows: for Enterobacteriaceae, 0.03–0.23 mg/1, Pseudomonas aeruginosa,0.37 mg/1, Haemophilus influenzae, < 0.015 mg/1, Staphylococcus aureus, 0.75 mg/1, Streptococcus pneumoniae, 1.89 mg/1, and Streptococcus faecalis, 0.95 mg/l. The inhibitory quotients for urine, serum and bronchial secretion showed that ciprofloxacin had the broadest spectrum of all agents tested and covered all clinically significant bacteria.
TL;DR: According to these preliminary findingsα-interferon may have an adjuvant effect on hepatitis B vaccination.
Abstract: To determine the effect of interferon on the production of antibodies against hepatitis B virus, recombinantα-interferon was added only to the fifth vaccine injection in a non-responder group and to all three initial vaccine injections in a low-responder group. In the non-responder group, 27 % of the hemodialysis patients, 7 % of the renal transplant patients, and both medical staff members tested developed low serum concentrations of anti-HBs (< 25 mU/ml). Whereas in the low-responder group 60 % of the hemodialysis patients developed the same amount of antibodies as a placebo group of comparable patients (⩾ 25 mU/ml), 78% of the renal transplant patients showed a 25 % higher antibody concentration than a placebo group (half < 25 mU/ml;half < 50 mU/ml). According to these preliminary findingsα-interferon may have an adjuvant effect on hepatitis B vaccination.
TL;DR: According to the findings Enzygnost is the most sensitive method, but Rotalex is more valuable for screening a small number of faecal samples.
Abstract: The following six methods for detecting rotavirus in human faecal samples were compared: electron microscopy, immune electron microscopy, immunofluorescence in cell culture, two enzyme immunoassays (Rotazyme, Enzygnost) and a latex agglutination test (Rotalex). Specimens were collected from 112 children with diarrhoea. The relative sensitivities of the different assays for human rotavirus were as follows: electron microscopy, 84%; immunofluorescence, 86%; Rotalex, 88%; Rotazyme, 89%; immune electron microscopy, 93%; Enzygnost, 98%. According to our findings Enzygnost is the most sensitive method, but Rotalex is more valuable for screening a small number of faecal samples. No false-positive results were observed in the two enzyme immunoassays or in Rotalex.
TL;DR: It is likely that the use of lectins in diagnostic microbiology will continue to grow, as factors such as specificity, stability, assay rapidity, and costs combine to make lectins attractive diagnostic reagents.
Abstract: Current literature suggests that lectins are becoming valuable reagents for the laboratory identification of infectious agents. The identification of bacteria, fungi, or protozoa may be confirmed if they bind to or agglutinate with certain lectins. Assay kits utilizing specific lectin agglutination reactions, coupled with conventional enzyme determinations, have been proposed for several bacteria. Factors such as specificity, stability, assay rapidity, and costs combine to make lectins attractive diagnostic reagents. It is likely that the use of lectins in diagnostic microbiology will continue to grow.
TL;DR: All diseases coupled with activation of the T4ymphocyte-macrophage axis should lead to increased neopterin levels, and results in patients with allograft rejection, autoimmune diseases, infections with intracellular microorganisms and malignancy support this view.
Abstract: Neopterin, a pyrazino-[2, 3-d]-pyrimidine derivative (Figure 1) which originates biosynthetically from guanosine triphosphate, has been found to be elevated in patients suffering from certain types of cancer or viral diseases (1). Neopterin has been demonstrated in vitro and in vivo to be a specific indicator of the solicitation of Tqymphocytes (2, 3). All diseases coupled with activation of the T4ymphocyte-macrophage axis should lead to increased neopterin levels. Results in patients with allograft rejection (unpublished observation of authors), autoimmune diseases, infections with intracellular microorganisms and malignancy support this view (4, 5, 6).
TL;DR: Pleuropulmonary infections were the most common manifestations followed by epiglottitis, meningitis and septicaemia of unknown origin and both encapsulated and non-typable strains were found to be potentially pathogenic.
Abstract: A retrospective study was conducted on invasiveHaemophilus influenzae infections in adults (⩾ 16 years) for the period 1971–1983 in two regions in Sweden. The annual incidence was determined to be 1.1 per 100,000. Predisposing factors included advanced age, bronchopulmonary diseases, alcoholism, traumatic head injury, malignant diseases and pregnancy. Pleuropulmonary infections were the most common manifestations followed by epiglottitis, meningitis and septicaemia of unknown origin. A death rate of 8 % was established. Both encapsulated and non-typable strains were found to be potentially pathogenic, but the non-typable strains had a lower virulence.
TL;DR: Minimal inhibitory concentrations indicated that ciprofloxacin was highly active against gram-negative bacilli of the Enterobacteriaceae and Pseudomonas groups, notably against strains resistant to gentamicin.
Abstract: The in vitro activity of ciprofloxacin against a wide range of bacterial isolates was assessed in comparison with norfloxacin, enoxacin, co-trimoxazole and penicillin (or ampicillin) where appropriate. Minimal inhibitory concentrations (MICs) indicated that ciprofloxacin was highly active against gram-negative bacilli of the Enterobacteriaceae and Pseudomonas groups, notably against strains resistant to gentamicin. Similarly, Staphylococcus aureus (including methicillin-resistant strains) and Haemophilus influenzae were susceptible, regardless of penicillinase production. Norfloxacin and enoxacin were less active than ciprofloxacin against the majority of species tested, although enoxacin blood levels were generally higher. Most co-trimoxazole-resistant strains were susceptible to the quinoline group of drugs.
TL;DR: The in vitro and animal model studies on optimal dosage of the newer third-generation cephalosporins are summarized and put into historical perspective and provide a rationale for dosage schedules that continuously maintain inhibitory serum and tissue concentrations throughout the dosage interval.
Abstract: The in vitro and animal model studies on optimal dosage of the newer beta-lactams are summarized and put into historical perspective. They provide a rationale for dosage schedules that continuously maintain inhibitory serum and tissue concentrations throughout the dosage interval. In vitro studies on the post-antibiotic effect (PAE) with beta-lactams revealed only short time periods of post-antibiotic growth suppression with gram-positive cocci and no post-antibiotic effect with gram-negative bacilli. A similar lack of persistent growth suppression was observed with beta-lactams in a neutropenic mouse thigh infection model for both gram-positive and gram-negative bacteria. In the same animal model, dosing regimens of beta-lactams which continuously provided serum concentrations above the MIC were more efficacious than those that did not. The newer third-generation cephalosporins have prolonged half-lives and can maintain serum levels above the MIC for most pathogens, even when dosed at widely spaced intervals.
TL;DR: An evaluation of results of numerous in vitro studies reveals that imipenem effectively inhibited growth of 53 of 55 bacterial species, the mean MIC90 being less than 8 mg/l, currently the most active drug available against anaerobic bacteria.
Abstract: A review is given of the microbiological properties of imipenem, a new carbapenem antibiotic with an exceptionally broad spectrum of antibacterial activity. An evaluation of results of numerous in vitro studies reveals that imipenem effectively inhibited growth of 53 of 55 bacterial species, the mean MIC90 being less than 8 mg/l. The MIC90 for cocci, with the exception of Staphylococcus epidermidis, is in the range of 0.01-3.1 mg/l. The MIC90 for all Enterobacteriaceae is equal to or less than 8 mg/l. Pseudomonas aeruginosa and other non-fermentative gram-negative bacteria are generally susceptible to imipenem, only Pseudomonas maltophilia and Pseudomonas cepacia showing intrinsic resistance. Imipenem is currently the most active drug available against anaerobic bacteria, the MIC usually being below 1 mg/l even for Bacteroides fragilis. Rare bacteria such as Nocardia asteroides, Listeria monocytogenes or fast growing Mycobacterium spp. which cause difficult-to-treat infections are also susceptible to imipenem. Increases in inoculum size have only a minimal effect on activity of the drug. In most species the MBC only slightly exceeded the MIC; however in the case of Streptococcus faecalis the MBC value was many times the MIC value. Synergism has been observed in combinations of imipenem with aminoglycosides, and antagonism in combinations with other beta-lactam antibiotics against Pseudomonas aeruginosa and Serratia marcescens. Imipenem is stable in the presence of the common chromosomal and plasmid-mediated enzymes. Induction of inactivating enzymes was observed in staphylococci, Pseudomonas aeruginosa and Serratia marcescens.
TL;DR: The susceptibility of 30 strains of Legionella pneumophila was evaluated and the minimal inhibitory concentrations (MICs) were determined by agar dilution technique on BCYEα agar with an inoculum of 104–105 colony forming units (CFU) per spot.
Abstract: The newer quinolone derivatives have been frequently reported to have excellent activity against many grampositive and gram-negative bacteria of clinical importance (1–3). Since data for Legionella species have been published in only one study (4), we evaluated the susceptibility of 30 strains of Legionella pneumophila (serogroup 1–7; 18 of clinical origin, 12 from environmental sources; 22 isolates from Europe, 8 strains from ATCC) and 8 strains of other Legionella species (Legionella micdadei, Legionella bozemanii, Legionella gormanii, Legionella dumoffii, Legionella oakridgensis, Legionella jordanis, Legionella longbeachae, all from ATCC). The minimal inhibitory concentrations (MICs) were determined by agar dilution technique on BCYEα agar with an inoculum of 104–105 colony forming units (CFU) per spot. Plates were incubated for two days at 35 °C in a moist atmosphere enriched with 5 % CO2. The last dilution at which there was no visible growth was defined as the MIC.
TL;DR: Eight patients are presented in whom treatment with antineoplastic agents, in particular the folic acid antagonist methotrexate, precipitated Clostridium difficile-related diarrhoea and pseudomembranous colitis.
Abstract: Eight patients are presented in whom treatment with antineoplastic agents, in particular the folic acid antagonist methotrexate, precipitated Clostridium difficile-related diarrhoea and pseudomembranous colitis. The clinical presentation of these patients was identical to that encountered in patients developing antibiotic associated diarrhoea and colitis. Clostridium difficile-related diarrhoea and colitis should be suspected in any patient developing diarrhoea during the course of anti-neoplastic chemotherapy or within three weeks of its cessation. This complication is effectively treated with oral vancomycin.
TL;DR: It is confirmed that the organism is of low pathogenicity and children may be predisposed to infection with Kingella kingae.
Abstract: Four cases of endocarditis due to Kingella kingae are described in compromised patients. All had primary heart disease, and two had systemic lupus erythematosis and congenital heart defect respectively, in addition. Confirmation of Kingella kingae was made in one case at autopsy. The literature on 11 cases of endocarditis, 2 bacteremia, 4 osteomyelitis, 5 septic arthritis and 1 intervertebral disc infection, all caused by Kingella kingae, is reviewed. Our findings confirm that the organism is of low pathogenicity. Children may be predisposed to infection with Kingella kingae.
TL;DR: Of 20 isolates of the Bacteroides fragilis group, only three were encapsulated (C+) and these induced abscesses in mice, and those that had been inoculated with Klebsiella had pili-like and bacteriophage-like structures.
Abstract: Of 20 isolates of theBacteroides fragilis group, only three were encapsulated (C+) and these induced abscesses in mice. After coinoculation with live, formalized or capsular material from other bacteria seven other isolates formed abscesses. TheBacteroides recovered from these abscesses were C+; those that had been inoculated withKlebsiella had pili-like and bacteriophage-like structures. Once encapsulated, theBacteroides isolates induced abscesses when injected alone.
TL;DR: Improved identification keys have been devised which separate the taxonomic groups on the genus and species levels according to an appropriate set of biochemical characteristics.
Abstract: The current classification of recognized actinobacilli and pasteurellas does not allow differentiation of the two genera by their phenotypic features. Recent investigations of their genetic relationships have shown that several species hitherto assigned to the genusPasteurella are more closely related to the actinobacilli. Moreover, some recently described taxa were located by DNA-DNA hybridization in one or the other of the two genera. On the basis of the genetic system, improved identification keys have been devised which separate the taxonomic groups on the genus and species levels according to an appropriate set of biochemical characteristics.
TL;DR: In six previously healthy children and adults with typical acute appendicitis,Streptococcus pneumoniae was isolated from peritoneal swabs or periappendicular pus in pure culture or together with intestinal flora.
Abstract: In six previously healthy children and adults with typical acute appendicitis, Streptococcus pneumoniae was isolated from peritoneal swabs or periappendicular pus in pure culture (four patients) or together with intestinal flora. Pneumococci recovered by abdominal paracentesis are not pathognomonic of socalled primary or spontaneous peritonitis.
TL;DR: An enzyme-linked lectinosorbent assay (ELLA) has been developed for the rapid identification of Bacillus anthracis using two different lectin-conjugates and has high specificity.
Abstract: An enzyme-linked lectinosorbent assay (ELLA) has been developed for the rapid identification of Bacillus anthracis. Using two different lectin-conjugates, the ELLA test can differentiate Bacillus anthracis from closely related species, such as Bacillus cereus and Bacillus cereus var. mycoides, in approximately two hours. In addition to having high specificity, the test can also detect small numbers of the bacterium.