Evidence that sustained growth suppression of intestinal anaerobic bacteria reduces the risk of acute graft-versus-host disease after sibling marrow transplantation.

The influence of intestinal bacterial decontamination on the occurrence of grades II to IV acute graft-versus-host disease (GVHD) was retrospectively analyzed in 194 predominantly adult patients treated by genotypically identical sibling marrow transplantation under conditions of strict protective isolation and intestinal antimicrobial decontamination. Forty-five patients (23%) developed acute GVHD and univariate analysis identified four features that significantly increased the risk for this reaction: chronic myeloid leukemia as the underlying disease, as compared with all other disease categories (P < .0001); female marrow donors for male recipients, as compared with other gender combinations (P < .

[Criteria for the establishment of limits for antibacterial chemotherapy].

The safety of patients asks for stringent standards when fixing limit values of the minimal inhibition concentration (MIC) in mg/l. It should be possible to recognize resistant bacterial strains with a low error on the basis of the recommendations of the bacteriological laboratory which are eventually important for therapy. Attention is drawn to the use of recognized methods such as DIN 58940 and 58944 and the participation in interlaboratory studies.

Bone marrow transplantation in acute leukemia.

In Essen 142 bone marrow transplantations were carried out between December 1975 and February 1985. In 74 cases the indication was acute leukemia in relapse (n = 23) or in first or consecutive remission (n = 51). The conditioning regimen consisted of cyclophosphamide or the combination of cyclophosphamide and total body irradiation.

Bacteriological data on a prospective multicenter study of the effect of two different regimens for selective decontamination in patients with acute leukaemia.

In this paper we described the results of bacteriological monitoring of oropharynx and stool samples from granulocytopenic patients with leukaemia who received oral infection prophylaxis with two different regimens for selective decontamination of the digestive tract. Patients were prospectively randomized either into a group receiving non-absorbable antimicrobial drugs for selective decontamination (polymyxin and neomycin: group A) or into a group receiving polymyxin and co-trimoxazole (group B). The oropharynx was, or became, free of gram-negative bacilli within one week of treatment in 94% and 90%, respectively, of the patients in group A and group B.

Bone marrow transplantation in severe aplastic anemia and acute or chronic leukemia.

In Essen 121 bone marrow transplantations were carried out. The indications were severe aplastic anemia (n = 18), acute leukemia in relapse (n = 20), acute leukemia in remission (n = 46) or chronic myeloid leukemia (n = 37). The conditioning regimen consisted of cyclophosphamide or the combination of cyclophosphamide and total body irradiation.

[Bacteriology and chemotherapy].

In a farewell lecture the relevance of bacteriology for the education of medical students is described. In the times of Koch and Pasteur the bacteriological diagnostic of epidemic diseases was the main problems, to day it is the isolation and differentiation of the patient's own bacteria which give the background for resistance or sensitivity tests to chemotherapeutics. The choice of antimicrobial substances depends not only on the sensitivity of the individual bacterial strain or the toxicology of certain substances but also on the necessity to preserve the normal microecology of the gut and other biotopes.

Bone marrow transplantation for chronic granulocytic leukaemia.

Twenty-one patients with chronic granulocytic leukaemia underwent marrow transplantation. The donors were human-lymphocyte antigen-identical siblings in 19 cases. In the remaining 2 cases the donor was a parent in one and an identical twin in the other.

[Gnotobiotic studies on SPF mice in relation to a study of tumor development in the colon after cholecystectomy].

The relation between cholecystectomy and colon carcinogenesis has not been fully elucidated. As bacteria may be involved in the carcinogenic process, we investigated the effect of cholecystectomy and dimethylhydrazine (DMH) administration to SPF NMRI mice with regard to tumour genesis and bacterial colonisation of the intestine. It results from this study that cholecystectomy does not influence tumour genesis and that 6-7 months post operationem and DMH administration tumours and bacteria originally not found in the animals develop: clostridia, eubacteria spec.

Laminar air flow versus barrier nursing in marrow transplant recipients.

Forty-eight patients with acute leukaemia in relapse (n = 14), acute leukaemia in complete remission (n = 19), chronic myeloid leukaemia (n = 8) or severe aplastic anaemia (n = 7) received a marrow transplant. The first 26 patients were nursed in laminar-air-flow plastic isolators while the next 22 patients were treated in barrier nursing rooms. Gnotobiotic parameters and morbidity in the 2 groups are compared.

[Nalidixic acid: urinary levels during short-term therapy with reduced doses].

The acute inflammation of the lower afferent urinary tract is a superficial mucosal infection so long as structural and functional anomalies are excluded. A single or brief administration of antibacterially active substances with high urine concentrations can shorten uncomplicated attacks of infection and diminish the symptoms. The investigation of the urinary concentration of biologically active metabolites after administration of a daily dose of 2 g nalidixic acid revealed values which ensure that the minimum inhibitory concentrations in the afferent urinary tract are exceeded.

The "clostridial effect" of selective decontamination of the human gut with trimethoprim/sulphamethoxazole in neutropenic patients.

During 59 periods of hospitalisation, 39 patients with either acute myeloid leukemia (22), acute lymphatic leukemia (9), acute undifferentiated leukemia (1), blastic crisis of chronic myeloid leukemia (6) or high-grade malignant non-Hodgkin lymphoma (1) were subjected to aggressive polychemotherapy after selective decontamination of the gut. The patients were given an amphotericin B suspension in a dosage of 1.2 g/day for two days, after which one tablet of trimethoprim/sulphamethoxazole (TMP/SMZ) (160 mg TMP and 800 mg SMZ) t.

Excretion of azlocillin and mezlocillin by the normal pancreas and in acute pancreatitis in dogs and rats.

Dogs and rats were studied to evaluate the excretion of two new acyl-ureidopenicillins, azlocillin and mezlocillin, in the pancreatic fluid. After intravenous administration of 55 mg X kg-1 of either drug, an extremely low concentration (less than 3.0 micrograms X ml-1) of both antibiotics was measured in pancreatic juice of conscious dogs.

Pharmacokinetics of ticarcillin during cisplatin chemotherapy.

Cancer chemotherapeutic agents and antimicrobial antibiotics are often given concomitantly. Cisplatin, which has become increasingly important in cancer treatment, has shown nephrotoxicity as a dose-limiting feature. The alpha-carboxy-penicillin ticarcillin (tc) has a wide spectrum of antimicrobial activity, especially against Pseudomonas.

Evaluation of the MS-2 automated antimicrobial susceptibility testing system: report of a European collaborative study.

The MS-2 is an instrument for rapid automated testing of antimicrobial susceptibility. Its performance was evaluated by comparison with disc diffusion and MIC tests in a collaborative study in four European laboratories. Tests on independently isolated organisms showed the MS-2 to be in essential agreement with conventional methods in 94.

[Bone marrow transplantation for aplastic anaemia and acute leukaemia (author's transl)].

Twenty-six bone marrow transplantations were performed at the West Germany Tumour Centre at Essen between December 1975 and December 1981. Three patients had aplastic anaemia, 23 acute leukaemia. Of the leukaemia patients 13 had a recurrence and ten were in full remission at the time of the transplantation.

[Determination of sensitivity of rapid growing bacteria by the MS-2-system. A comparison with conventional methods (author's transl)].

The sensitivity of 333 gramnegative and grampositive isolates against 10 antimicrobial agents was determined by the MS-2 system (Abbott Diagnostics, Div. of Abbott Lab., Dallas, Texas).