[Clinical significance of bacterial beta-lactamase production in the treatment of urinary tract infections with oral beta-lactam-antibiotics]. / Klinische Bedeutung der beta-Lactamase-Produktion von Bakterien bei der Therapie der Harnwegsinfektionen mit oralen beta-Lactam-Antibiotika.

In 649 urological patients with urinary tract infections (UTI) a total of 1114 bacterial strains were isolated and their beta-lactamase production was investigated by a qualitative, micro-iodometric method. Approximately 40% of all strains, 33% of E. coli species and 8% of Proteus mirabilis species were enzyme producers. All of the isolates of E. coli and Proteus mirabilis defined as non-producers were sensitive to ampicillin and cephalothin in the agar diffusion test. The beta-lactamase producers of these two species did not show the same pattern: almost all of them were ampicillin-resistant, but most were cephalothin-sensitive. The other species were all found to be either producers or non-producers. Therapeutic comparisons in altogether 138 UTI patients treated with ampicillin or cephalexin, two antibiotics with different beta-lactamase stability, confirmed the positive correlation between enzyme production and therapeutic failure in both groups. Cephalexin, however, tended to be more effective than ampicillin against enzyme-producing species.

[Frequency and significance of infections due to Yersinia enterocolitica in "acute appendicitis" (author's transl)]. / Häufigkeit und Bedeutung von Yersinia-enterocolitica-Infektionen bei "akuter Appendizitis".

In 352 patients who were hospitalized with symptoms of an acute appendicitis, Yersinia infection were determined in 18.2% of the cases by cultural and serological methods. Infections due to Y. enterocolitica (Y. e.) serovar 0:3 were approximately 6 times more frequent than those due to Y. e. serovar 0:9. Yersinia pseudotuberculosis (Y. pstbc.) could only be isolated in one patient from a mesenterial lymph node. In another case Yersinia serovar 0:6 could be isolated as well as Y. e. serovar 0:3. The majority of the infections were found in the age group 9-12 years. The incidence was highest in the summer months June-August.

[Yersinia enterocolitica IHA-test (author's transl)]. / Yersinia-enterocolitica-IHA-Test.

612 serum specimens were examined for antibodies against Yersinia enterocolitica (Y.e.) with the Widal technique, and an indirect (passive) hemagglutination test. The Widal test was carried out with antigens of Y.e. serovar 0:3 and 0:9. Human erythrocytes coated with antigens of both serovarieties were used for the Y.e.-IHA-test. This test system showed higher agglutinin titres than the Widal reaction. Both methods were equivalent concerning their specificity. The Y.e. IHA-test is suitable for screening enteric diseases to determine infections caused by. Y. enterocolitica. This test is easy to set up and can be used for routine diagnostics since it can be carried out and interpreted quickly and objectively.

[Determination of O-agglutinins against Yersinia enterocolitica by the indirect hemagglutination test (author's transl)]. / Zum Nachweis von O-Agglutininen gegen Yersinia enterocolitica im indirekten Hämagglutinationstest.

O-agglutinins against Yersinia enterocolitica serovar 03 and serovar 09 in serum specimens were determined by the indirect (passive) hemagglutination test and the Widal technique. The hemagglutination test was carried out in microtitre plates with formalized and sensitized turkey erythrocytes. Cell wall antigens (lipopolysaccharides) were prepared by the phenol-water method. The indirect hemagglutination test had a high sensitivity and specificity. Moreover, this test has the advantage of being easier to set up and read than the bacteria agglutination. No unspecific reactions were observed.

[Enteritis caused by atypical Yersinia (author's transl)]. / Enteritis durch "atypische" Yersinien.

For the first time in the Federal Republic of Germany Yersinia species "frederiksenii", "kristensenii", "serovar 0 : 6" (each once) and "serovar 0 : 5" (twice) were found in the stool of 5 patients with gastroenteritic complaints. Serum agglutinins against these species could not be demonstrated. Other enteropathogenic microorganisms were excluded microscopically, by culture and serologically. These Yersinia isolates were resistant against penicillin G, ampicillin, carbenicillin, ticarcillin, and cefalotin.

[Piperacillin: pharmacokinetic studies on the biliary and renal excretion (author's transl)]. / Piperacillin: Kinetische Studien über biliäre und renale Ausscheidung.

9 patients (6 female, 3 male) with either cholelithiasis or choledocholithiasis submitted to cholecystectomy were studied during the postoperative period. Sodium 6-[D-(--)-alpha-(4-ethyl-2,3-dioxo-1-piperazinylcarbonylamino)-alpha-phenyl-ace tamido]penicillinate (piperacillin) was administered in single i.v. doses of 2 and 4 g on the 4th and 6th postoperative days. Serum samples were taken at intervals of 20 min over a period of 3 h post injection and bile was collected via T-tube drainage in 20-min periods also for 180 min. The total urine outputs were collected for the periods 0--6 h, 6--12 h and 12--24 h after administration of the drug. The maximum concentration of piperacillin in the bile was observed 60--120 min post administration. The values in the bile were found to exceed the corresponding serum concentrations 30--40fold. Within 3 h 9.6 (+/- 6.5)% and 13.4 (+/- 5.0)% were eliminated in the bile after 2 and 4 g injections, respectively. The percentage of the administered drug excreted in the urine within 24 h was 56.3% (2 g i.v.) and 66.0% (4 g i.v.).

[In vitro studies with piperacillin. Effectiveness against enterobacteriaceae and pseudomonas aeruginosa compared to other antibiotics (author's transl)]. / In-vitro-Untersuchungen von Piperacillin. Ein Vergleich mit anderen beta-Lactam-Antibiotika bei Enterobacteriaceae und Pseudomonas aeruginosa.

The in vitro activity of piperacillin, a new semisynthetic penicillin was compared with the inhibitory effect of other broad-spectrum penicillins and beta-lactamase stable cephalosporins. The examination was carried out by agar diffusion test with 1699 gram-negative strains. The antibacterial activity of piperacillin was generally superior to that of the other penicillins. Less than one per cent. of pseudomonas aeruginosa strains tested was resistant against piperacillin. Only klebsiella spp. showed a higher sensitivity against cefoxitin and cefuroxime.

[Enteritis due to yersinia enterocolitica in children (author's transl)]. / Enteritis durch Yersinia enterocolitica im Kindesalter.

1922 stool specimens of children aged less than 14 years were screened for enteropathogenic bacteria over the past two years. In 24 cases Yersinia enterocolitica serovar 03 and 09, respectively, was identified. 16 of them suffered from acute gastroenteritis, 8 showed symptoms of pseudoappendicitis. All patients exhibited high agglutinin titers against the respective reference strains which were maintained for up to 4 months. All isolated strains had identical sensitivity patterns against the chemotherapeutics tested. Other enteropathogenic bacteria isolated at the same time are mentioned.

[Infections in man induced by Yersinia enterocolitica serovar 09 and 04 (author's transl)]. / Erkrankungen durch Yersinia enterocolitica Serovar 09 und 04 beim Menschen.

Yersinia enterocolitica serovar 09 was isolated from stool specimens of two patients suffering from serious enteritis and pseudo-appendicitis, respectively. Both patients exhibited high titers of serum-agglutinins against the isolated strains. The Widal reaction against brucella-antigens was also found positive. In addition, the isolation of Yersinia enterocolitica serovar 04 from a suppurating wound is reported.

[Infections caused by Yersinia enterocolitica: bacteriological, serological, epidemiological and immunological findings in 51 cases (author's transl)]. / Erkrankungen durch Yersinia enterocolitica. Bakteriologisch-serologische, epidemiologische und immunologische Befunde bei 51 Erkrankungen.

Within two years 51 infections caused by Yersinia enterocolitica were diagnosed by bacteriological and (or) serological tests (Yersinia enterocolitica Serovar 03 in 48, Serovar 09 in two and Serovar 04 in one). The latter was isolated from the discharge of a badly healing superinfected wound. In the other 50 there was feverish enteritis, in 12 with arthritic complaints. Of the latter 12 nine had the antigen HLA-B27. This investigation demonstrated a slight increase in cases during the cold months. Men were more frequently affected than women and 38 were older than 16 years. In-vitro sensitivity of the isolated Yersinia strains against various chemotherapeutic agents was also tested.

[Antimycotic sensitivity of yeast from clinical specimens (author's transl)]. / Antimykotika-Empfindlichkeit von Hefen aus klinischem Untersuchungsmaterial im Blättchendiffusionstest.

The sensitivity against 5 antimycotics was examined with 353 yeast strains of 13 species from clinical material. The tests were carried out by means of the disc diffusion test on Bacto yeast morphology agar under standardized conditions. 33 (6.3%) of the isolates were resistant against 5-fluorocytosine, 11 (2.1%) strains showed no sensitivity against the imidazolyl antimycotics clotrimazole or miconazole. The resistant strains belonged to the species Candida albicans and Candida tropicalis. All of the isolates were sensitive to the polyene antimycotics nystatin and pimaricin (natamycin).

[Frequency and drug sensitivity of "Klebsiella oxytoca" in human clinical material (author's transl)]. / Häufigkeit und Hemmstoffempfindlichkeit von "Klebsiella oxytoca" in menschlichem Untersuchungsmaterial

962 Klebsiella strains were isolated from a total of 15422 clinical samples. 782 of these were characterized as the species Klebsiella pneumoniae, 170 as "Klebsiella oxytoca" and 10 as Klebsiella ozaenae. 95 of the Klebsiella oxytoca strains originated from samples of the respiratory tract, 13 from purulent materials, 1 from blood and 61 from urine samples. Among further biochemical criteria indole formation, lacking gas formation at 45 degrees C in lactose peptone water medium and delayed gelatine liquefaction were used to differentiate Klebsiella oxytoca from other enterobacteriaceae. In addition the drug resistance patterns were determined.

[Septicaemia caused by Yersinia enterocolitica (author's transl)]. / Sepsis durch Yersinia enterocolitica. Diagnostik, Klinik, Infektionsquelle

Yersinia enterocolitica (serotype 3 of Winblad, or O-group 1 of Knapp) was isolated from two blood cultures of a 52-year-old patient with chronic hepatitis, pancytopenia and paroxysmal nocturnal haemoglobinuria who had been hospitalised because of septic temperatures and chills. The serum-agglutinin titre was 1:10.000 both against the isolated strain and a reference strain (MyO; serotype 3). The titre had decreased to 1:2.500 and 1:640, respectively, in serum samples taken ten and 40 days later. The causative organism was not isolated from stool specimens, but the patient had been treated with antibiotics. Strains identical biochemically, serologically and by lysotypi-g were found in the stool specimens of the patient's wife and dog. The agglutinin titres were 1:320 in the wife and 1:20 in the dog. A son, who was living in the same house, had a negative stool culture and serology.

[Isolation of Yersinia enterocolitica in acute ileitis]. / Isolierung von yersinia enterocolitica bei akuter ileitis

2246 stool specimens were specifically testet for Yersinia enterocolitica during 1973/74. In one case it was possible to isolate a strain of Yersinia enterocolitica (0-group I of Knapp/Serotype 3 of Winblad) from the feces of a patient suffering of acute ileitis. A high agglutinine-titer was serologically detected against a bacterial suspension of the isolated strain as well as of a reference strain (Serotype 3 of Winblad). The antibody-titer was 1 : 3200 by the first examination and dropped to 1 : 160 after two months. A reisolation attempt was unsuccessful.