Changing epidemiology of pediatric Staphylococcus aureus bacteremia in Denmark from 1971 through 2000.

Background: Staphylococcus aureus is known to be a leading cause of bacteremia in childhood, and is associated with severe morbidity and increased mortality. To determine developments in incidence and mortality rates, as well as risk factors associated with outcome, we analyzed data from 1971 through 2000.

Methods: Nationwide registration of S.

Increasing incidence but decreasing in-hospital mortality of adult Staphylococcus aureus bacteraemia between 1981 and 2000.

Staphylococcus aureus is a leading cause of bacteraemia. This study analysed temporal trends from 18,702 adult cases of S. aureus bacteraemia in Denmark between 1981 and 2000.

Hearing loss and cochlear damage in experimental pneumococcal meningitis, with special reference to the role of neutrophil granulocytes.

Hearing loss is a well-known sequelae from meningitis, affecting up to 25% of survivors. However, the principal components of the infectious and inflammatory reaction responsible for the sensorineural hearing loss remain to be identified. The present study aimed to investigate the impact of an augmented neutrophil response on the development of hearing loss and cochlear damage in a model of experimental pneumococcal meningitis in rats.

Blocking of leukocyte accumulation in the cerebrospinal fluid augments bacteremia and increases lethality in experimental pneumococcal meningitis.

The role of leukocyte accumulation in the cerebrospinal fluid (CSF) in the evolution of the pathophysiological changes that occur in bacterial meningitis is unclear. Here, we investigate how leukocyte recruitment to the CSF, modulated by the leukocyte blocker fucoidin, affects the extent of brain damage and outcome in pneumococcal meningitis in rats treated with ceftriaxone from 28 h after infection. Rats treated with fucoidin from time of infection had an excess risk of a fatal outcome compared to rats not receiving fucoidin (25/63 versus 5/34, p=0.

Susceptibility testing of urinary isolates of Escherichia coli to mecillinam using NCCLS methodology.

Criteria for susceptibility testing of mecillinam against 533 isolates of Escherichia coli and a further 309 Enterobacteriaceae, according to NCCLS methodology, were determined. Correlation of MIC to inhibition zones was good for all species. For urinary isolates of E.

Attenuation of the bacterial load in blood by pretreatment with granulocyte-colony-stimulating factor protects rats from fatal outcome and brain damage during Streptococcus pneumoniae meningitis.

A model of pneumococcal meningitis in young adult rats receiving antibiotics once the infection was established was developed. The intent was to mimic clinical and histopathological features of pneumococcal meningitis in humans. The primary aim of the present study was to evaluate whether medical boosting of the peripheral neutrophil count affected the outcome of the meningitis.

Simple, rapid latex agglutination test for serotyping of pneumococci (Pneumotest-Latex).

The "gold standard" for epidemiological typing of Streptococcus pneumoniae (pneumococcus) is the capsular reaction test (Neufeld test) with antisera against the 90 pneumococcal polysaccharide capsules, i.e., serotyping.

Urinary concentrations and urine ex-vivo effect of mecillinam and sulphamethizole.

Healthy adult volunteers received 1 g of sulphamethizole orally (n = 10) and later 400 mg of pivmecillinam (274 mg of mecillinam) (n = 9). All urine was collected in defined periods over 24 h, and the drug concentrations in urine were determined. For sulphamethizole, the maximum urine concentration for seven subjects was reached in 0-3 h, and for the remaining three in 3-6 h.

Tentative interpretative zone diameters for fusidic acid Neosensitabs on Mueller Hinton agar and three blood containing media.

Two hundred and ninety-two staphylococci were tested using fusidic acid Neosensitabs, a semiconfluent inoculum on Mueller Hinton agar and three blood containing agar media in order to investigate the interpretative zone diameters published by the manufacturer (Rosco). Zone diameters were, as expected, smaller on blood containing agar compared with Mueller Hinton agar. Many susceptible strains were intermediate on Danish Blood agar using the current breakpoints.

Evaluation of different disk diffusion/media combinations for detection of methicillin resistance in Staphylococcus aureus and coagulase-negative staphylococci.

In order to find a disk diffusion method with both high sensitivity and specificity for determination of methicillin resistance primarily for S. aureus but also for coagulase-negative staphylococci we screened several methodological variants using a material of 66 S. aureus comprising of 11 methicillin-susceptible, 18 borderline-resistant, and 37 methicillin-resistant strains.

Selection of resistant Streptococcus pneumoniae during penicillin treatment in vitro and in three animal models.

Pharmacokinetic (PK) and pharmacodynamic (PD) properties for the selection of resistant pneumococci were studied by using three strains of the same serotype (6B) for mixed-culture infection in time-kill experiments in vitro and in three different animal models, the mouse peritonitis, the mouse thigh, and the rabbit tissue cage models. Treatment regimens with penicillin were designed to give a wide range of T(>MIC)s, the amounts of time for which the drug concentrations in serum were above the MIC. The mixed culture of the three pneumococcal strains, 10(7) CFU of strain A (MIC of penicillin, 0.

Evaluation of fusidic acid in therapy of experimental Staphylococcus aureus meningitis.

Objectives: Combination therapy that includes fusidic acid, an antimicrobial agent highly active against staphylococci, has been recommended in the treatment of patients with Staphylococcus aureus meningitis. The aim of this study was to evaluate the pharmacokinetic, CSF bactericidal and anti-inflammatory properties of fusidic acid.

Methods: The pharmacokinetics, treatment efficacy and parameters of the meningeal inflammatory response were studied in rabbits, using an experimental meningitis model against S.

Effects of sulfamethizole and amdinocillin against Escherichia coli strains (with various susceptibilities) in an ascending urinary tract infection mouse model.

Resistance to antibiotics used for the treatment of urinary tract infections (UTIs) is increasing worldwide. The impact of in vitro resistance on clinical outcome in UTIs requires further study, since most studies of both humans and animals have evaluated only the efficacy of antibiotics toward bacteria susceptible in vitro. We were interested in evaluating the relationship between the in vitro antibacterial effect and the in vivo efficacy after antibiotic treatment.

In vitro susceptibility of Staphylococcus aureus towards amoxycillin-clavulanic acid, penicillin-clavulanic acid, dicloxacillin and cefuroxime.

Sixty-three Staphylococcus aureus isolates with a wide distribution in quantitative beta-lactamase production were tested in vitro against amoxycillin and penicillin in combination with clavulanic acid to establish the influence of total amount of beta-lactamase present on the ability of clavulanic acid to protect against beta-lactamase degradation. The beta-lactamase stability of cefuroxime and dicloxacillin was also evaluated. MIC was determined by agar dilution using Mueller-Hinton agar with both a conventional as well as a 100 times higher inoculum.

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

Infections caused by Staphylococcus aureus comprise relatively benign local skin infections, as well as serious generalised conditions. In Denmark, more than 85% of all S. aureus isolates are found resistant to penicillin, whereas resistance to methicillin is rare (< 1%) and therefore one of the penicillinase-stable penicillins is still the drug of choice.

Susceptibility of Danish Escherichia coli strains isolated from urinary tract infections and bacteraemia, and distribution of sul genes conferring sulphonamide resistance.

Antibiotic resistance of urinary tract pathogens has increased worldwide. Our aim was to provide information regarding resistance patterns of Escherichia coli in urinary tract infections (UTIs) and E. coli bacteraemia in Denmark.

Validation of FLEXICULT SSI-Urinary Kit for use in the primary health care setting.

The efficacy of the FLEXICULT SSI-Urinary Kit for point-of-care diagnosis and susceptibility testing of urinary tract pathogens was evaluated. The kit, which was exclusively developed for urine culture in the primary health care setting, is designed as an ordinary Petri dish divided into 6 compartments: I large one for quantitative analysis and 5 smaller ones for susceptibility testing. The agar in each small compartment contains 1 of 5 antimicrobials (trimethoprim, sulfamethoxazole, ampicillin, nitrofurantoin and mecillinam) at a concentration adjusted to the breakpoint, and growth in these compartments indicates resistance.

Treatment and outcome of Staphylococcus aureus bacteremia: a prospective study of 278 cases.

Background: Staphylococcus aureus bacteremia is still a serious problem, and the optimal treatment is under debate. Only a few studies concerning treatment are available.

Methods: The study population was all patients with a positive blood culture result for S aureus in Copenhagen County, Denmark, from May 1994 through April 1996.

Evaluation of seven different enzyme-linked immunosorbent assays for serodiagnosis of Staphylococcus aureus bacteremia.

Objective: Serologic assays for Staphylococcus aureus antibodies were evaluated regarding their ability to differentiate between uncomplicated and complicated S. aureus bacteremia, between S. aureus and non-S.

In vitro antimicrobial susceptibility of Aerococcus urinae to 14 antibiotics, and time-kill curves for penicillin, gentamicin and vancomycin.

Aerococcus urinae is a newcomer in clinical and microbiological practice, causing urinary tract infections, bacteraemia/septicaemia and/or endocarditis. This study presents for the first time an evaluation of the activity of a representative panel of antibiotics against a large number of A. urinae isolates.

Transient intestinal carriage after ingestion of antibiotic-resistant Enterococcus faecium from chicken and pork.

Background: Antibiotic-resistant enterococci are often present in retail meats, but it is unclear whether the ingestion of these contaminants leads to sustained intestinal carriage.

Methods: We conducted a randomized, double-blind study in 18 healthy volunteers. Six ingested a mixture of 10(7) colony-forming units (CFU) of two glycopeptide-resistant strains of Enterococcus faecium obtained from chicken purchased at a grocery store, six ingested 10(7) CFU of a streptogramin-resistant strain of E.

Correlation of MIC methods and tentative interpretive criteria for disk diffusion susceptibility testing using NCCLS methodology for fusidic acid.

Three hundred and eight staphylococci and 43 Streptococcus pyogenes were tested by agar dilution, microbroth dilution, E-test, and disk diffusion using 5, 10 and 50 microg disks, as outlined by the NCCLS, in order to correlate the different MIC methods and to establish tentative species specific interpretive zone diameter breakpoints for fusidic acid. MIC results of the three methods were comparable. For Staphylococcus aureus, using MIC breakpoints of < or = 0.

Penicillin pharmacodynamics in four experimental pneumococcal infection models.

Clinical and animal studies indicate that with optimal dosing, penicillin may still be effective against penicillin-nonsusceptible pneumococci (PNSP). The present study examined whether the same strains of penicillin-susceptible pneumococci (PSP) and PNSP differed in their pharmacodynamic responses to penicillin by using comparable penicillin dosing regimens in four animal models: peritonitis, pneumonia, and thigh infection in mice and tissue cage infection in rabbits. Two multidrug-resistant isolates of Streptococcus pneumoniae type 6B were used, one for which the penicillin MIC was 0.