liu.seSearch for publications in DiVA
Endre søk
Begrens søket
12 1 - 50 of 61
RefereraExporteraLink til resultatlisten
Permanent link
Referera
Referensformat
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Annet format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annet språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
Treff pr side
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sortering
  • Standard (Relevans)
  • Forfatter A-Ø
  • Forfatter Ø-A
  • Tittel A-Ø
  • Tittel Ø-A
  • Type publikasjon A-Ø
  • Type publikasjon Ø-A
  • Eldste først
  • Nyeste først
  • Skapad (Eldste først)
  • Skapad (Nyeste først)
  • Senast uppdaterad (Eldste først)
  • Senast uppdaterad (Nyeste først)
  • Disputationsdatum (tidligste først)
  • Disputationsdatum (siste først)
  • Standard (Relevans)
  • Forfatter A-Ø
  • Forfatter Ø-A
  • Tittel A-Ø
  • Tittel Ø-A
  • Type publikasjon A-Ø
  • Type publikasjon Ø-A
  • Eldste først
  • Nyeste først
  • Skapad (Eldste først)
  • Skapad (Nyeste først)
  • Senast uppdaterad (Eldste først)
  • Senast uppdaterad (Nyeste først)
  • Disputationsdatum (tidligste først)
  • Disputationsdatum (siste først)
Merk
Maxantalet träffar du kan exportera från sökgränssnittet är 250. Vid större uttag använd dig av utsökningar.
  • 1.
    André, Malin
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för hälsa och samhälle, Allmänmedicin.
    Eriksson, M
    Mölstad, Sigvard
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för hälsa och samhälle, Allmänmedicin.
    Strålby Lundborg, C
    Jacobsson, A
    Odenholt, I
    The management of infections in children in general practice in Sweden: A repeated 1-week diagnosis-prescribing study in 5 counties in 2000 and 20022005Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 37, nr 11-12, s. 863-869Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    A diagnosis-prescribing study was performed in 5 Swedish counties during 1 week in November in 2000 and repeated in 2002. The aim of the present study was to analyse data for children 0-15 y of age who consulted a general practitioner with symptoms of an infection. During the 2 weeks studied, 4049 children were consulted. Respiratory tract infections (RTI) were the predominant diagnoses, above all among the youngest children, while the proportion of urinary tract infections and skin infections increased with increasing age. Between the y 2000 and 2002, the proportion of children allocated the diagnosis streptococcal tonsillitis and pneumonia decreased (p<0.01 and p<0.001, respectively) while the proportion of common cold increased (p <0.001). Antibiotic prescribing decreased from 55% to 48% (p <0.001) for respiratory infections between the years studied. The only significant changes in type of antibiotics prescribed were the increase of isoxazolylpenicillins (p<0.001) used for skin infection and the decrease of macrolides (p=0.001). A diagnostic test was used in more than half of the consultations. Of children allocated a RTI diagnosis, 36% were prescribed antibiotics when a C-reactive protein test was performed compared to 58% in those not tested. Further studies are needed in general practice to determine the optimal use of near-patient tests in children with RTI. © 2005 Taylor & Francis.

  • 2.
    André, Malin
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Allmänmedicin.
    Vernby, Åsa
    KI .
    Odenholt, Inga
    Lund univ .
    Stålby Lundborg, Cecilia
    KI .
    Axelsson, Inge
    Oslo .
    Eriksson, Margareta
    Karolinska univ sjukhuset .
    Rundhagen, Arne
    Växjö sjukhus .
    Schwan, Åke
    Uppsala univ .
    Mölstad, Sigvard
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Allmänmedicin.
    Diagnosis-prescribing surveys in 2000, 2002 and 2005 in Swedish general practice: Consultations, diagnosis, diagnostics and treatment choices2008Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 40, nr 8, s. 648-654Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study is to present diagnostic patterns, diagnostics used and antibiotic treatment in relation to guidelines in 3 repeated diagnosis-prescription studies conducted simultaneously in general practice in 5 Swedish counties, during 1 week in November 2000, 2002 and 2005. General practitioners (GPs) at the participating health centres were asked to complete a form for all patients with symptoms of an infectious disease. During the studied periods a total of 15,371 consultations was registered. Consultations with GPs diagnosed as respiratory tract infection (RTI), especially consultations for sore throat, decreased considerably between y 2000 and 2005. The percentage of patients allocated an RTI diagnosis and prescribed an antibiotic declined significantly from 54% to 49% and the decline was most pronounced among children. Penicillin V remained the dominant antibiotic prescribed throughout the study periods. For lower urinary tract infections there was a significant change in choice of prescribed antibiotics with an increase for pivmecillinam and nitrofurantoin and a decrease for trimethoprim, in accordance with recommendations. The results indicate a quite close adherence to current guidelines, with changes in the pattern of consultations as well as in the management of infectious diseases in general practice in Sweden.

  • 3.
    Augustinsson (Nilsdotter-Augustinsson), Åsa
    et al.
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Infektionsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Medicincentrum, Infektionskliniken i Östergötland.
    Frydén, Anders
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Medicinsk mikrobiologi. Linköpings universitet, Hälsouniversitetet.
    Lindgren, Per-Eric
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Medicinsk mikrobiologi. Linköpings universitet, Hälsouniversitetet.
    Stendahl, Olle
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Medicinsk mikrobiologi. Linköpings universitet, Hälsouniversitetet.
    Öhman, Lena
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Infektionsmedicin. Linköpings universitet, Hälsouniversitetet.
    Interaction of staphylococcus epidermidis from infected hip prostheses with neutrophil granulocytes2001Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 33, nr 6, s. 408-412Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This study focuses on the interaction of Staphylococcus epidermis isolated from granulation tissue covering infected hip prostheses and neutrophil granulocytes. Bacterial strains isolated from normal flora were used as controls. The bacteria were well characterized with routine methods and further characterized with random amplified polymorphic DNA analyses and slime tests. Phagocytosis and chemiluminescence (CL) assays were used in the neutrophil interaction studies. The prostheses strains were ingested to a lesser extent than strains from normal flora (p ≤ 0.001). There was no significant difference between the prostheses strains and the normal flora strains in terms of total CL response. However, the extracellular CL response from the neutrophils was lower in comparison with the normal flora when interacting with the prostheses strains. The results of this study support the notion that S. epidermidis strains isolated from infected hip prostheses have an enhanced capacity to resist phagocytosis and that most of these strains elicit a reduced inflammatory response, measured as the production of extracellular oxidative metabolites from the neutrophils, compared to normal flora.

  • 4.
    Bernfort, Lars
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för hälsa och samhälle, Centrum för utvärdering av medicinsk teknologi.
    Sennfält, Karin
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för hälsa och samhälle, Centrum för utvärdering av medicinsk teknologi.
    Reichard, Olle
    Dept of Infectious Diseases Karolinska Institutet.
    Cost-effectiveness of peginterferon alfa-2b in combination with ribavirin as initial treatment for chronic hepatitis C in Sweden2006Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 38, s. 497-505Artikkel i tidsskrift (Fagfellevurdert)
  • 5.
    Cardell, Kristina
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Infektionsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Infektionskliniken US.
    Frydén, Aril
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Infektionsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Infektionskliniken US.
    Normann, Bengt
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Infektionsmedicin. Linköpings universitet, Hälsouniversitetet.
    Intradermal hepatitis B vaccination in health care workers. Response rate and experiences from vaccination in clinical practise1999Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 31, nr 2, s. 197-200Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Health care workers at risk for hepatitis B virus infection are recommended for vaccination. Low-dose intradermal (i.d.) administration of vaccine has been suggested as a less expensive alternative to intramuscular (i.m.) inoculation. To evaluate the i.d. vaccination route, health care workers were included in a prospective study. The subjects were vaccinated with 0.1 ml (= 2 microg) recombinant vaccine (Engerix B, SmithKline Beecham) i.d. at 0, 1 and 6 months. Two months after the third vaccination, measurement of the anti-HBs level was conducted. An anti-HBs level > or =10 IU/l was considered protective. Those with an anti-HBs level <10 IU/l were given a fourth dose with new serological control after another 2 months. The results are based on the 1406 subjects that it was possible to evaluate. The seroconversion rate to protective anti-HBs level after 3 doses was 68% and after 3 or 4 doses 89%. Factors associated with a lower response rate were increasing age (p<0.05) and smoking (p<0.001). Sex or body mass index had no influence on the results. Vaccination technique seems to be of utmost importance when the i.d. route is used. Well instructed and experienced nurses are required and quality control with follow-up of overall seroconversion rate within each centre is needed.

  • 6.
    Claesson, Carina
    et al.
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Klinisk mikrobiologi. Linköpings universitet, Hälsouniversitetet.
    Hällgren, Anita
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Klinisk mikrobiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Medicincentrum, Infektionskliniken i Östergötland.
    Nilsson, Maud
    Linköpings universitet, Institutionen för molekylär och klinisk medicin. Linköpings universitet, Hälsouniversitetet.
    Svensson, Erik
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Klinisk mikrobiologi. Linköpings universitet, Hälsouniversitetet.
    Hanberger, Håkan
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Infektionsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Medicincentrum, Infektionskliniken i Östergötland.
    Nilsson, Lennart
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Klinisk mikrobiologi. Linköpings universitet, Hälsouniversitetet.
    Susceptibility of staphylococci and enterococci to antimicrobial agents at different ward levels in four north European countries2007Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 39, nr 11-12, s. 1002-1012Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    A multicentre susceptibility study was performed on staphylococci and enterococci isolated from patients at 3 different ward levels: primary care centres (PCCs), general hospital wards (GHWs) and intensive care units (ICUs), in Denmark, Finland, Norway and Sweden. There was a markedly higher incidence of resistance among CoNS in ICUs compared to GHWs and PCCs. Resistance rates were low among S. aureus isolates and no differences were found between the ward levels. Oxacillin resistance was found among 1.6% of S. aureus and 47% of CoNS isolates. 14% of CoNS and 0.9% of S. aureus isolates were glycopeptide intermediate. The prevalence of E. faecium isolates in this study differed significantly between the ward levels with the lowest prevalence found at PCCs. High level gentamicin resistant (HLGR) enterococci occurred in 11-25% of E. faecium and 6-20% of E. faecalis isolates. The HLGR rate was significantly higher among E. faecalis from hospitalized patients (GHWs and ICUs) compared to patients at PCCs. For enterococcal isolates, no other significant differences in antimicrobial resistance were found between the ward levels. All enterococci were teicoplanin susceptible, but decreased susceptibility to vancomycin was found among 2.0% and 0.6% of the E. faecium and E. faecalis isolates, respectively.

  • 7. Dannetun, E.
    et al.
    Tegnell, A.
    Department of Epidemiology, Swedish Inst. Infect. Dis. Control, Solna, Sweden.
    Normann, Bengt
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin.
    Garpenholt, O.
    Garpenholt, Ö., Örebro County Council, Department of Health, Örebro, Sweden.
    Giesecke, J.
    Department of Epidemiology, Swedish Inst. Infect. Dis. Control, Solna, Sweden.
    Influenza vaccine coverage and reasons for non-vaccination in a sample of people above 65 years of age, in Sweden, 1998-20002003Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 35, nr 6-7, s. 389-393Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Influenza vaccination for the elderly has been shown to be effective. The Swedish national recommendations are that people over 65 y, and especially those with chronic cardiac and/or pulmonary disease, should be immunized annually. However, implementation of such programmes has often been far from successful. The aims of this study were to estimate vaccine coverage and especially reasons for not being vaccinated in a group of elderly people who were all clearly included in the national recommendations. The study investigated people over the age of 65 y who lived in special apartments, 'service homes', connected to the community care for the elderly in the municipality of Linköping, Sweden. The data were collected from the middle of May to the middle of July during 3 years, 1998, 1999 and 2000. Data were gathered by interviewing a sample of 210 tenants each year. All interviews were conducted using a standard questionnaire. The vaccination coverage for influenza in this population was found to be as low as around 30%. The main reason reported for non-vaccination was a lack of knowledge of the recommendations. The results clearly demonstrate that the single most important factor needed to attain high coverage is information, both to the people defined to be at risk and to health-care professionals.

  • 8.
    Darelid, Johan
    et al.
    Department of Infectious Diseases, Ryhov Hospital, Jönköping, Sweden.
    Bengtsson, Lars
    Värnamo Hospital, Stockholm, Sweden.
    Gästrin, Bengt
    National Bacteriological Laboratory, Stockholm, Sweden.
    Hallander, Hans
    National Bacteriological Laboratory, Stockholm, Sweden.
    Löfgren, Sture
    Department of Clinical Bacteriology, Ryhov Hospital, Jönköping, Sweden.
    Malmvall, Bo-Eric
    Department of Infectious Diseases, Ryhov Hospital, Jönköping, Sweden.
    Olinder-Nielsen, Ann-Margareth
    Department of Infectious Diseases, Ryhov Hospital, Jönköping, Sweden.
    Thelin, Ann-Christin
    Värnamo Hospital, Stockholm, Sweden.
    An outbreak of Legionnaires’ Disease in a Swedish Hospital1994Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 26, nr 4, s. 417-425Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    We report a nosocomial outbreak of Legionella pneumophila serogroup (sg) 1 infection at the general hospital, Värnamo, Sweden. From December 1990 to February 1991, 28 patients and 3 staff fell ill with pneumonia and 3 died. L. pneumophila sg 1 together with several other Legionellae were isolated from the hot water supply to 17 of 20 hospital wards, probably being spread by aerosolization via shower nozzles. Raising the hospital's hot water temperature from 45°C to 65°C, together with heat disinfection of the shower equipment, arrested the outbreak within a week. Keeping the hot water temperature < 60°C without chlorination eliminated L. pneumophila from < 75% of the wards. During a period of 2 years after the outbreak we have diagnosed only 1 case of nosocomial legionellosis at the hospital despite an active surveillance program.

  • 9.
    Darelid, Johan
    et al.
    Department of Infectious Diseases, Ryhov Hospital, Jönköping, Sweden.
    Hallander, Hans
    The Swedish Institute for Infectious Disease Control, Stockholm, Sweden.
    Löfgren, Sture
    The Department of Clinical Bacteriology, Ryhov Hospital, Jönköping, Sweden.
    Malmvall, Bo-Eric
    Department of Infectious Diseases, Ryhov Hospital, Jönköping, Sweden.
    Olinder-Nielsen, Ann-Margareth
    Department of Infectious Diseases, Ryhov Hospital, Jönköping, Sweden.
    Community spread of legionella pneumophila serogroup 1 in temporal relation to a nosocomial outbreak2001Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 33, nr 3, s. 194-199Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    To clarify whether a nosocomial outbreak of legionnaires' disease in the Värnamo hospital in Sweden was part of a wider outbreak in the Värnamo community a number of investigations were performed. First, the proportion of cases of legionnaires' disease in a group with nosocomially acquired pneumonia (11%) was compared to the proportion within a group with community-acquired pneumonia (14%) and the difference was found not to be significant (p>0.05). Second, the proportion of the nursing staff at the Värnamo hospital with an elevated antibody titre (≥ 16) to Legionella pneumophila serogroup (sg) 1 (33%, 84/258) was compared to the proportion in a group of local residents of Värnamo community (26%, 25/96) and found not to be significant; in contrast, comparison with the proportion in a group from the assistant nursing staff at another hospital 60 km away (5%, 4/80) was highly significant (p<0.001). Furthermore, Legionella species were cultured from samples drawn from the hospital water supply as well from the water supply from municipal buildings. In 1996 a follow-up study was conducted, which showed that <1% of the assistant nurses and local residents had an elevated titre to L. pneumophila sg 1. These results indicate that there was a temporary spread of L. pneumophila sg 1 in the Värnamo community at the beginning of 1991, both in the local hospital and the surrounding community. This implies that physicians should be aware of community-acquired cases of legionnaires' disease when a nosocomial outbreak is detected.

  • 10.
    Darelid, Johan
    et al.
    Department of Infectious Diseases, Ryhov Hospital, Jönköping, Sweden.
    Löfgren, Sture
    Department of Clinical Bacteriology, Ryhov Hospital, Jönköping, Sweden.
    Malmvall, Bo-Eric
    Department of Infectious Diseases, Ryhov Hospital, Jönköping, Sweden.
    Olinder-Nielsen, Ann-Margareth
    Department of Infectious Diseases, Ryhov Hospital, Jönköping, Sweden.
    Briheim, Gunnar
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Infektionsmedicin. Linköpings universitet, Hälsouniversitetet.
    Hallander, H.
    Swedish Inst. Infect. Dis. Control, Stockholm, Sweden.
    Legionella pneumophila serogroup 1 antibody kinetics in patients with Legionnaires' disease: implications for serological diagnosis2003Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 35, nr 1, s. 15-20Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    To evaluate current serological criteria for Legionella pneumophila serogroup 1 (Lp1), the antibody response was prospectively studied in all patients hospitalized for Legionnaires' disease in a Swedish county during 11 y (n = 62). A 4-fold or greater rise in antibody titre to ≥ 128 (the minimum convalescent antibody level for diagnosis, as recommended by the Centers for Disease Control and Prevention), using the indirect immunofluorescence antibody test, was found in 21/52 (40%) of tested patients. By referring to the titre levels in healthy residents from the local population (World Health Organization criteria), 45/52 (87%) cases were confirmed serologically. In 21 patients followed longitudinally for 10 y, the median antibody titre fell from 256 (range 32-1024) to 16 (range 2-128) in 3 y. No booster reactions were observed in any patient. After 10 y, the geometric mean titre of this clinical cohort had reached the same level as observed in the background population 5 y earlier. Titre levels in subjects exposed to Legionella from a municipal water system indicate that only 1 out of 10 of all infections are identified clinically. Indirect immunofluorescent antibody testing with local reference sera is a sensitive method for laboratory confirmation of Lp1 in an unselected pneumonia population.

  • 11.
    Ekerfelt, Christina
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan.
    Masreliez, C
    Svenvik, M
    Ernerudh, Jan
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Klinisk immunologi. Östergötlands Läns Landsting, Laboratoriemedicinskt centrum, Klinisk immunologi och transfusionsmedicin.
    Roberg, Magnus
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Infektionsmedicin. Östergötlands Läns Landsting, Medicincentrum, Infektionskliniken i Östergötland.
    Forsberg, Pia
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Infektionsmedicin. Östergötlands Läns Landsting, Medicincentrum, Infektionskliniken i Östergötland.
    Antibodies and T-cell reactivity to Borrelia burgdorferi in an asymptomatic population: A study of healthy blood donors in an Inland town district in the South-East of Sweden2001Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 33, nr 11, s. 806-808Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    To address the issue of whether Borrelia infection can be asymptomatic, blood donors with no history of borreliosis (n = 408) were screened for antibodies against Borrelia burgdorferi. Seropositive individuals (n = 17) were further investigated with respect to Borrelia-specific T-cell reactivity, using an interferon-? ELISPOT assay. Anti-Borrelia antibodies as well as Borrelia-specific T-cell responses were evident in 9 asymptomatic donors, strongly supporting a current or previous asymptomatic Borrelia infection.

  • 12.
    Erlandsson, Marcus
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Burman, Lars G.
    Swedish Institute for Infectious Disease Control, Stockholm, Sweden.
    Cars, Otto
    Swedish Institute for Infectious Disease Control, Stockholm, Sweden.
    Gill, Hans
    Linköpings universitet, Institutionen för medicinsk teknik, Medicinsk informatik. Linköpings universitet, Tekniska högskolan.
    Nilsson, Lennart E.
    Walther, Sten
    Linköpings universitet, Institutionen för medicin och hälsa, Fysiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Thorax-kärlkliniken.
    Hanberger, Håkan
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Infektionsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Medicincentrum, Infektionskliniken i Östergötland.
    ICU-STRAMA Study Group,
    Prescription of antibiotic agents in Swedish intensive care units is empiric and adequate2007Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 39, nr 1, s. 63-69Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Since the prescription of antibiotics in the hospital setting is often empiric, particularly in the critically ill, and therefore fraught with potential error, we analysed the use of antibiotic agents in Swedish intensive care units (ICUs). We examined indications for antibiotic treatment, agents and dosage prescribed among 393 patients admitted to 23 ICUs at 7 tertiary care centres, 11 secondary hospitals and 5 primary hospitals over a 2-week period in November 2000. Antibiotic consumption was higher among ICU patients in tertiary care centres with a median of 84% (range 58-87%) of patients on antibiotics compared to patients in secondary hospitals (67%, range 35-93%) and in primary hospitals (38%, range 24-80%). Altogether 68% of the patients received antibiotics during the ICU stay compared to 65% on admission. Cefuroxime was the most commonly prescribed antibiotic before and during admission (28% and 24% of prescriptions, respectively). A date for decision to continue or discontinue antibiotic therapy was set in 21% (6/29) of patients receiving prophylaxis, in 8% (16/205) receiving empirical treatment and in 3% (3/88) when culture-based therapy was given. No correlation between antibiotic prescription and laboratory parameters such as CRP levels, leukocyte and thrombocyte counts, was found. The treatment was empirical in 64% and prophylactic in 9% of cases. Microbiological data guided prescription more often in severe sepsis (median 50%, range 40-60% of prescriptions) than in other specified forms of infection (median 32%, range 21-50%). The empirically chosen antibiotic was found to be active in vitro against the pathogens found in 55 of 58 patients (95%) with a positive blood culture. This study showed that a high proportion of ICU patients receive antimicrobial agents and, as expected, empirical-based therapy is more common than culture-based therapy. Antibiotics given were usually active in vitro against the pathogen found in blood cultures. We ascribe this to a relatively modest antibiotic resistance problem in Swedish hospitals.

  • 13.
    Erlandsson, Marcus
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Infektionsmedicin. Linköpings universitet, Hälsouniversitetet.
    Gill, Hans
    Linköpings universitet, Institutionen för medicinsk teknik, Medicinsk informatik. Linköpings universitet, Tekniska högskolan.
    Nilsson, Lennart E.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Klinisk mikrobiologi. Linköpings universitet, Hälsouniversitetet.
    Walther, Sten
    Department of Anaesthesiology, Ullevål University Hospital, University of Oslo, Oslo, Norway.
    Giske, Christian G.
    Division of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden.
    Jonas, Daniel
    Institute of Environmental Medicine and Hospital Epidemiology, University Medical Centre, Freiburg, Germany.
    Hanberger, Håkan
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Infektionsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Medicincentrum, Infektionskliniken i Östergötland.
    Nordlinder, David
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Infektionsmedicin. Linköpings universitet, Hälsouniversitetet.
    Antibiotic susceptibility patterns and clones of Pseudomonas aeruginosa in Swedish ICUs2008Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 40, nr 6-7, s. 487-494Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Pseudomonas aeruginosa is 1 of the bacteria most adaptive to anti-bacterial treatment. Previous studies have shown nosocomial spread and transmission of clonal strains of P. aeruginosa in European hospitals. In this study we investigated antibiotic susceptibility and clonality in 101 P. aeruginosa isolates from 88 patients admitted to 8 Swedish ICUs during 2002. We also compared phenotypes and genotypes of P. aeruginosa and carried out cluster analysis to determine if phenotypic data can be used for surveillance of clonal spread. All isolates were collected on clinical indication as part of the NPRS II study in Sweden and were subjected to AFLP analysis for genotyping. 68 isolates with unique genotypes were found. Phenotyping was performed using MIC values for 5 anti-pseudomonal agents. Almost 6% of the isolates were multi-drug resistant (MDR), and this figure rose to almost 8% when intermediate isolates were also included. We found probable clonal spread in 9 cases, but none of them was found to be an MDR strain. Phenotypical cluster analysis produced 40 clusters. Comparing partitions did not demonstrate any significant concordance between the typing methods. The conclusion of our study is that cross-transmission and clonal spread of MDR P. aeruginosa does not present a clinical problem in Swedish ICUs, but probable cross-transmission of non-MDR clones indicate a need for improved hygiene routines bedside. The phenotype clusters were not concordant with genotype clusters, and genotyping is still recommended for epidemiological tracking.

  • 14.
    Faresjö, Tomas
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Allmänmedicin. Linköpings universitet, Hälsouniversitetet.
    Arvidsson, Lina
    Linköpings universitet, Institutionen för medicin och hälsa. Linköpings universitet, Hälsouniversitetet.
    Boberg, Pontus
    Linköpings universitet, Institutionen för medicin och hälsa. Linköpings universitet, Hälsouniversitetet.
    Hagert, Britt
    Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Gursky, Elin A
    ANSER, Arlington, Virginia, USA.
    Timpka, Toomas
    Linköpings universitet, Institutionen för medicin och hälsa, Socialmedicin och folkhälsovetenskap. Linköpings universitet, Hälsouniversitetet.
    Swedish nursing and medical students high vaccination adherence during the influenza A (H1N1) pandemic 2009: Insights for pandemic preparedness2012Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 44, nr 3, s. 237-241Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to analyze Swedish health science student decision-making regarding vaccination against pandemic influenza during a national mass vaccination campaign. A questionnaire was distributed to 430 students during the influenza A (H1N1) pandemic in 2009. The data from medical and nursing students were compared and a multiple logistic regression model was applied to identify items independently associated with the decision to be vaccinated. The overall survey response rate was 90%. More medical (93.2%) than nursing students (84.8%) reported that they had received the vaccine (p andlt; 0.01). Only the perception that benefits can outweigh possible side effects was significantly (p andlt; 0.001) associated with the decision to get vaccinated. We recommend that, during pandemics, health science universities focus vaccination information for students on objective risk communication. It should be taken into account that the pandemic information provided by authorities to the general public also affects health care students.

  • 15. Foberg, U
    et al.
    Frydén, Aril
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Infektionsmedicin. Linköpings universitet, Hälsouniversitetet.
    Isaksson, Barbro
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för mikrobiologi och molekylär medicin. Linköpings universitet, Hälsouniversitetet.
    Jahrling, P
    Johnson, A
    McKee, K
    Niklasson, B
    Normann, Bengt
    Linköpings universitet, Institutionen för klinisk och experimentell medicin.
    Peters, C
    Bengtsson, M
    Viral haemorrhagic fever in Sweden: experiences from management of a case.1991Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 23, nr 2, s. 143-151Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The first recognized case in Scandinavia with potential man to man transmission of viral haemorrhagic fever occurred in Linköping, Sweden, in January 1990. Following a visit to Kenya a 21-year-old male student suffered a very severe illness including extremely prolonged high grade fever, rash, disseminated intravascular coagulation with thrombocytopenia and severe bleedings. This necessitated one month of intensive care support including respirator treatment. The patient was discharged after 2 1/2 months in good condition, with a partial femoral nerve paresis. About 100 medical personnel were exposed to aerosol or blood before a strict containment regimen was established. No secondary cases occurred.

  • 16.
    Friberg, Örjan
    et al.
    Cardiothoracic Surgery Örebro University Hospital Örebro.
    Jones, Ian
    Clinical Chemistry Örebro University Hospital Örebro.
    Sjöberg, Lennart
    Clinical Microbiology Örebro University Hospital Örebro.
    Söderquist, Bo
    Clinical Microbiology Örebro University Hospital Örebro.
    Vikerfors, Thomas
    Infectious Diseases Örebro University Hospital Örebro.
    Källman, Jan
    Infectious Diseases Örebro University Hospital Örebro.
    Antibiotic concentrations in serum and wound fluid after local gentamicin or intravenous dicloxacillin prophylaxis in cardiac surgery2003Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 35, nr 4, s. 251-254Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    One important aim of antibiotic prophylaxis in cardiac surgery is preventing mediastinitis and thus it would appear to be relevant to study the antibiotic concentrations in pericardial/mediastinal fluid. Local administration of gentamicin in the wound before sternal closure is a novel way of antibiotic prophylaxis and could be effective against bacteria resistant to intravenous antibiotics. This study measured dicloxacillin concentrations in 101 patients in serum and wound fluid following intravenous administration of dicloxacillin. Similarly, concentrations of gentamicin in serum and wound fluid were determined in 30 patients after administration of 260 mg gentamicin in the wound at sternal closure. Median dicloxacillin concentrations in serum and wound fluid at sternal closure were 59.4 and 55.35 mg/l, respectively. Gentamicin levels in the wound were very high (median 304 mg/l), whereas serum concentrations were low (peak median 2.05 mg/l). Dicloxacillin, 1 g given intravenously, according to the clinical protocol, resulted in levels in serum and wound fluid at sternal closure likely to prevent Staphylococcus aureus infections. Locally administered gentamicin resulted in high local concentrations, potentially effective against agents normally considered resistant.

  • 17.
    Hanberger, Håkan
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Infektionsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Infektionskliniken i Östergötland.
    Edlund, Charlotta
    Medical Product Agency, Uppsala.
    Furebring, Mia
    Uppsala University.
    Giske, Christian G.
    MTC – Karolinska Institutet, Karolinska University Hospital, Stockholm.
    Melhus, Åsa
    Uppsala University.
    Nilsson, Lennart E
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Klinisk mikrobiologi. Linköpings universitet, Hälsouniversitetet.
    Petersson, Johan
    Karolinska Institutet, Stockholm.
    Sjölin, Jan
    Uppsala University.
    Ternhag, Anders
    Swedish Institute for Communicable Disease Control, Solna.
    Werner, Maria
    Södra Älvsborgs Sjukhus, Borås.
    Eliasson, Erik
    Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm, Sweden.
    Rational use of aminoglycosides - Review and recommendations by the Swedish Reference Group for Antibiotics (SRGA)2013Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 45, nr 3, s. 161-175Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    The Swedish Reference Group for Antibiotics (SRGA) has carried out a risk–benefit analysis of aminoglycoside treatment based on clinical efficacy, antibacterial spectrum, and synergistic effect with beta-lactam antibiotics, endotoxin release, toxicity, and side effects. In addition, SRGA has considered optimal dosage schedules and advice on serum concentration monitoring, with respect to variability in volume of drug distribution and renal clearance. SRGA recommends that aminoglycoside therapy should be considered in the following situations: (1) progressive severe sepsis and septic shock, in combination with broad-spectrum beta-lactam antibiotics, (2) sepsis without shock, in combination with broad-spectrum beta-lactam antibiotics if the infection is suspected to be caused by multi-resistant Gram-negative pathogens, (3) pyelonephritis, in combination with a beta-lactam or quinolone until culture and susceptibility results are obtained, or as monotherapy if a serious allergy to beta-lactam or quinolone antibiotics exists, (4) serious infections caused by multi-resistant Gram-negative bacteria when other alternatives are lacking, and (5) endocarditis caused by difficult-to-treat pathogens when monotherapy with beta-lactam antibiotics is not sufficient. Amikacin is generally more active against extended-spectrum beta-lactamase (ESBL)-producing and quinolone-resistant Escherichia coli than other aminoglycosides, making it a better option in cases of suspected infection caused by multidrug-resistant Enterobacteriaceae. Based on their resistance data, local drug committees should decide on the choice of first-line aminoglycoside. Unfortunately, aminoglycoside use is rarely followed up with audiometry, and in Sweden we currently have no systematic surveillance of adverse events after aminoglycoside treatment. We recommend routine assessment of adverse effects, including hearing loss and impairment of renal function, if possible at the start and after treatment with aminoglycosides, and that these data should be included in hospital patient safety surveillance and national quality registries.

  • 18.
    Hanberger, Håkan
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för mikrobiologi och molekylär medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Infektionskliniken i Östergötland.
    Fredrikson, Mats
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet.
    Ternhag, Anders
    Swedish Institute Communicable Disease Control, Sweden .
    Giske, Christian G.
    Karolinska University Hospital, Sweden .
    Letter: Rational use of aminoglycosides - author response2013Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 45, nr 8, s. 655-656Artikkel i tidsskrift (Annet vitenskapelig)
    Abstract [en]

    n/a

  • 19. Hedlund, J
    et al.
    Örtquist, Å
    Swedish Infectious Diseases, Soc Pneu Study Group
    Augustinsson (Nilsdotter-Augustinsson), Åsa
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Infektionsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Medicincentrum, Infektionskliniken i Östergötland.
    Follin, Per
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Infektionsmedicin. Östergötlands Läns Landsting, Medicincentrum, Infektionskliniken i Östergötland.
    Management of patients with community-acquired pneumonia treated in hospital in Sweden.2002Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 34, s. 887-892Artikkel i tidsskrift (Fagfellevurdert)
  • 20.
    Hugosson, Svante
    et al.
    Departments of Otorhinolaryngology, Örebro Medical Center Hospital, Örebro, Sweden.
    Silfverdal, Sven-Arne
    Departments of Paediatrics, Örebro Medical Center Hospital, Örebro, Sweden.
    Garpenholt, Örjan
    Departments of Clinical Microbiology and Immunology, Örebro Medical Center Hospital, Örebro, Sweden.
    Esbjörner, Elisabeth
    Departments of Paediatrics, Örebro Medical Center Hospital, Örebro, Sweden.
    Lindquist, Bo
    Departments of Paediatrics, Örebro Medical Center Hospital, Örebro, Sweden.
    Vikerfors, Thomas
    Departments of Infectious Diseases, Örebro Medical Center Hospital, Örebro, Sweden.
    Werner, Bo
    Departments of Community Medicine and Public Health, Örebro Medical Center Hospital, Öebro, Sweden.
    Olcén, Per
    Departments of Clinical Microbiology and Immunology, Örebro Medical Center Hospital, Örebro, Sweden.
    Invasive Haemophilus influenzae Disease: Epidemiology and Clinical Spectrum Before Large-scale H. influenzae Type b Vaccination1995Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 27, nr 1, s. 63-67Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In a prospective study between January 1987 and December 1992, 103 patients with invasive Haemophilus influenzae (Hi) infection were identified in a well-defined population before large-scale Haemophilus influenzae type b (Hib) vaccination was introduced. The incidence (cases/100,000/year) of invasive Hi infection was 5.9 for the whole population, 55 for children 0-4 years old and as high as 2.8 for adults. Hib was the predominant cause of the infection (83 cases) in children but, in adults, 13/39 (30%) cases were caused by non-typable Hi and 6/39 (19%) by Hi serotype f. Three patients (3%) died and 6 (5.8%) suffered a permanent sequel from the infection. All patients with such a sequel had invasive Hib infection. No significant difference between patients 0-6 years old and matched controls regarding the frequency of subnormal serum levels of immunoglobulins was found.

  • 21.
    Hällgren, Anita
    et al.
    Linköpings universitet, Institutionen för molekylär och klinisk medicin. Linköpings universitet, Hälsouniversitetet.
    Burman, Lars G
    Swedish Institute for Infectious Disease Control, Solna, Sweden.
    Isaksson, Barbro
    Linköpings universitet, Institutionen för molekylär och klinisk medicin. Linköpings universitet, Hälsouniversitetet.
    Olsson-Liljeqvist, Barbro
    Swedish Institute for Infectious Disease Control, Solna, Sweden.
    Nilsson, Lennart
    Linköpings universitet, Institutionen för molekylär och klinisk medicin. Linköpings universitet, Hälsouniversitetet.
    Saeedi, Baharak
    Linköpings universitet, Institutionen för molekylär och klinisk medicin. Linköpings universitet, Hälsouniversitetet.
    Walther, Sten
    Linköpings universitet, Institutionen för molekylär och klinisk medicin. Linköpings universitet, Hälsouniversitetet.
    Hanberger, Håkan
    Linköpings universitet, Institutionen för molekylär och klinisk medicin. Linköpings universitet, Hälsouniversitetet.
    Rectal colonization and frequency of enterococcal cross-transmission among prolonged-stay patients in two Swedish intensive care units2005Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 37, nr 8, s. 561-571Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aims of this study were to gain insight into the dynamics of the rectal flora during prolonged ICU stay, with a particular focus on colonization and cross-transmission with resistant pathogens, and to evaluate methods for the rapid isolation of relevant bacteria from rectal swabs. Patients admitted to a general intensive care unit (GICU) or a cardiothoracic ICU (TICU) at the University Hospital of Linköping, Sweden, between 1 November 2001 and January 2002 with a length of stay > 5 d were included (n = 20). Chromogenic UTI agar medium was used for discrimination of different species, and appropriate antibiotics were added to detect resistance. Direct plating was compared to enrichment broth for a subset of specimens. The study showed an early alteration in rectal flora, with a dramatic decrease in Gram-negative rods in favour of Gram-positive bacteria. An ampicillin- and high-level gentamicin resistant clone of Enterococcus faecium was found in 6 of 10 patients in the GICU and 2 of 11 patients in the TICU. Enrichment broth did not enhance the detection of Gram-negative bacteria compared to direct plating on Chromogenic UTI medium, but enrichment broths were needed for optimal detection of resistant Gram-positive bacteria.

  • 22.
    Issa, Mohamed
    et al.
    Department of Microbiology and Parasitology, College of Medicine, Juba University, Sudan and Reference Laboratory of Meningitis, Department of Bacteriology, National Health Laboratory, Khartoum, Sudan.
    Mölling, Paula
    National Reference Laboratory for Pathogenic Neisseria, Department of Clinical Microbiology, Örebro University Hospital, Örebro, Sweden.
    Bäckman, Anders
    National Reference Laboratory for Pathogenic Neisseria, Department of Clinical Microbiology, Örebro University Hospital, Örebro, Sweden.
    Unemo, Magnus
    National Reference Laboratory for Pathogenic Neisseria, Department of Clinical Microbiology, Örebro University Hospital, Örebro, Sweden.
    Sulaiman, Nageeb
    Reference Laboratory of Meningitis, Department of Bacteriology, National Health Laboratory, Khartoum, Sudan.
    Olcén, Per
    National Reference Laboratory for Pathogenic Neisseria, Department of Clinical Microbiology, Örebro University Hospital, Örebro, Sweden.
    PCR of Cerebrospinal Fluid for Diagnosis of Bacterial Meningitis During Meningococcal Epidemics: an Example from Sudan2003Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 35, nr 10, s. 719-723Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Meningococcal disease is feared due to its rapid progression and high case fatality rate, especially in the African meningitis belt, where epidemics of meningococcal meningitis appear cyclically. Culture, direct microscopy and antigen detection are the basic methods for diagnosis and species identification of bacterial meningitis. These methods are known to have limitations, especially in developing countries. The aim of the present study was to document the application of PCR technology for the diagnosis of bacterial meningitis in cerebrospinal fluid (CSF) samples (n = 52) collected during epidemics in Sudan. In the application of PCR for detection of the causative agent of bacterial meningitis (based on the 16S rRNA gene), bacterial DNA was identified in 49 samples. Common bacterial species causing bacterial meningitis could be detected in 31 of the CSF samples (27 meningococci), while 18 contained DNA, mainly from normally contaminating bacteria. A specific PCR for group A meningococci (based on the sacC gene) was positive in 27 of the CSF samples. The results show that PCR technology is a sharpedged tool for confirmation of a diagnosis of meningococcal meningitis and for obtaining a direct genogrouping of group A meningococci in CSF. It is important to stress the use of direct and specific PCRs to avoid interference by contaminating bacteria, a great problem in samples from areas in the meningitis belt.

  • 23.
    Issa, Mohamed
    et al.
    Dept. of Microbiology/Parasitology, College of Medicine, Juba University, Juba, Sudan and Reference Laboratory for Meningitis, Department of Bacteriology, National Health Laboratory, Khartoum, Sudan.
    Mölling, Paula
    National Reference Laboratory for Pathogenic Neisseria, Department of Clinical Microbiology, Örebro University Hospital, Örebro, Sweden.
    Unemo, Magnus
    National Reference Laboratory for Pathogenic Neisseria, Department of Clinical Microbiology, Örebro University Hospital, Örebro, Sweden.
    Bäckman, Anders
    National Reference Laboratory for Pathogenic Neisseria, Department of Clinical Microbiology, Örebro University Hospital, Örebro, Sweden.
    Mosaad, Mohamed
    Reference Laboratory for Meningitis, Department of Bacteriology, National Health Laboratory, Khartoum, Sudan.
    Sulaiman, Nageeb
    Reference Laboratory for Meningitis, Department of Bacteriology, National Health Laboratory, Khartoum, Sudan.
    Olcén, Per
    National Reference Laboratory for Pathogenic Neisseria, Department of Clinical Microbiology, Örebro University Hospital, Örebro, Sweden.
    Neisseria meningitidis serogroup W-135 isolated from healthy carriers and patients in Sudan after the Hajj in 20002003Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 35, nr 4, s. 230-233Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The first epidemic in the world of meningococcal disease due to serogroup W-135 was reported during the Hajj in 2000, with subsequent spread. The aims of the present study were to investigate whether the Hajj 2000 Neisseria meningitidis serogroup W-135 had also been carried to Sudan in the eastern part of the African meningitis belt, by examining healthy Sudanese pilgrims (Hajj 2000) and members of their families, and whether the strain was causing meningitis. The phenotypic character of W-135 meningococci from Sudanese carriers (n = 5) and patients (n = 2) 1 y later was similar to W-135 strains associated with Hajj 2000. The present study, using the combination of the 2 molecular techniques; sequencing of the porA gene for variable regions (VR1, VR2 and VR3) and pulsed-field gel electrophoresis of the entire genome (using SpeI and NheI), shows that the Hajj 2000 serogroup W-135 clone (P1.5,2,36-2 of the ET-37 complex) most probably was introduced into Sudan, by pilgrims returning from the Hajj 2000. This strain has not been diagnosed before in Sudan. Close epidemiological surveillance is required to identify a possible new emerging meningitis epidemic.

  • 24.
    Järemo, Petter
    Department of Internal Medicine, The Vrinnevi Hospital, Norrköping, Sweden.
    Evidence that Chlamydia pneumoniae affects platelet activity in patients with acute myocardial infarction and ST-segment elevations2001Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 33, nr 10, s. 747-748Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This study concerns platelet activity at myocardial infarctions and possible relationships with Chlamydia pneumoniae seroreactivity. Fourteen patients with acute myocardial infarction and ST-segment elevations were enrolled. They all received thrombolytic therapy. The subjects were examined within 24 h after hospital admission (Day 1) and after 6 months of recovery. On Day 1, C. pneumoniae IgM antibody titres were analysed and on Day 1 and during recovery C. pneumoniae IgG and soluble P-selectin were determined. P-selectin was used to estimate platelet activation. C. pneumoniae IgM titres at the infarction were closely related to both Day 1 IgG titres (r = 0.6; p < 0.05) and to IgG levels after 6 months (r = 0.8; p < 0.01). These results indicate a possible reactivation of a chronic infection. C. pneumoniae IgM was related to platelet activation. The correlation coefficient was r = 0.7 (p < 0.01) when comparing IgM titres with Day 1 plasma P-selectin. A similar relationship was found when comparing IgM and recovery P-selectin (r = 0.8; p < 0.01). The pathogen appears to contribute to platelet responses occurring during myocardial infarctions with ST-segment elevations. It is concluded that an ongoing reactivation of a chronic infection is related to increased platelet activity.

  • 25.
    Klingspor, Lena
    et al.
    Huddinge.
    Törnqvist, Ewa
    Örebro.
    Johansson, Anders
    Uppsala.
    Petrini, Björn
    KS.
    Forsum, Urban
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Klinisk mikrobiologi. Östergötlands Läns Landsting, Laboratoriemedicinskt centrum, Klinisk mikrobiologi.
    Hedin, Göran
    Västerås.
    A prospective epidemiological survey of candidaemia in Sweden2004Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 36, nr 1, s. 52-55Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    A prospective epidemiological survey of candidaemia was performed in central Sweden from January 1998 to December 1999. In total, 191 episodes were reported with an overall rate of 0.32/1000 admissions. Candida albicans was identified in 128 cases (67%), followed by Candida glabrata in 30 (15.7%) and Candida parapsilosis in 14 (7.3%). Predisposing factors included surgery (31.4%), intensive care (18.8%), solid tumour or haematological malignancy (15.7%), and foetal immaturity (15.7%). Now-albicans Candida species were more prevalent among patients with haematological malignancies (56%), compared to surgical (30%) and ICU patients (19%). The crude mortality rate of candidaemia was 31%. The highest mortality rate was observed in patients with haematological malignancies (41.2%), age > 70 y (41%), surgery (38.5%) and infections with > 1 Candida species (40%) or C. glabrata (38%).

  • 26. Lundborg, CS
    et al.
    Olsson, E
    Mölstad, Sigvard
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Allmänmedicin.
    Antibiotic prescribing in outpatients: a 1-week diagnosis-prescribing study in 5 counties in Sweden2002Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 34, nr 6, s. 442-448Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    A diagnosis-antibiotic prescribing study initiated by the Swedish Strategic Programme for the Rational Use of Antimicrobial Agents and Surveillance of Resistance was performed in 5 counties in Sweden (total 1,290,000 inhabitants) during 1 week in November 2000. The aims of the study were to analyse diagnoses and antibiotics prescribed for outpatients and to appraise the feasibility of the data collection method. Physicians in primary care and departments of ENT, paediatrics and infectious diseases completed a questionnaire for each patient with an infectious disease complaint, including information about age, sex, diagnosis, diagnostic methods used and treatment. When an antibiotic was prescribed, the type and duration of treatment were noted. A total of 7, 071 forms were returned, of which 7,029 included information on diagnosis, infections of the respiratory tract, urinary tract and the skin or soft tissues were responsible for 70%, 14% and 10% of the visits, respectively. Antibiotics were prescribed in 59% of all cases and phenoxymethylpenicillin was the most commonly prescribed antibiotic. Of the forms returned, 94% emanated from primary care centres. In conclusion, this study provides information on the treatment pattern associated with various diagnoses and the pattern of use of various antibiotics. Such a study is relatively simple to perform and entails only a small extra workload for the participants.

  • 27.
    Maller, Rolf
    et al.
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Infektionsmedicin. Linköpings universitet, Hälsouniversitetet.
    Emanuelsson, Britt- Marie
    Isaksson, Barbro
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för mikrobiologi och molekylär medicin. Linköpings universitet, Hälsouniversitetet.
    Nilsson, Lennart
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för mikrobiologi och molekylär medicin. Linköpings universitet, Hälsouniversitetet.
    Amikacin once daily: a new dosing regimen based on drug pharmacokinetics.1990Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 22, nr 5, s. 575-579Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Once-daily dosing of amikacin is a novel therapy regimen which seems pharmacokinetically appropriate for the primary group of patients considered for aminoglycoside therapy. In this study of 29 elderly patients with serious infections, amikacin 11 mg/kg or 15 mg/kg bw was administered as a short-term (30 min) intravenous infusion. The amikacin serum concentration-time profile was best described by a bi-exponential equation with a half-life of about 4.8 h. A triexponential equation was not applicable because the slow terminal elimination phase was not detected during the 24 h dosing interval. In practice, a uni-exponential equation is often used, and this may lead to incorrect conclusions about the elimination rate of amikacin. Amikacin clearance provides more direct information about elimination of amikacin than does serum half-life. Thus, there was a better correlation between the individual amikacin clearances and creatinine clearances (r = 0.89), than between the serum half-lives of amikacin and the creatinine clearances (r = 0.71). For elderly patients a smaller dose of amikacin than the regular daily dose of 15 mg/kg bw, i.e. about 11 mg/kg bw, seems recommendable, when it is given once daily. From the data obtained it is also obvious that once-daily dosing of amikacin does not eliminate the need for checking serum concentrations of the drug.

  • 28.
    Malm, Kerstin
    et al.
    Örebro University Hospital, Sweden .
    Ekermo, Bengt
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Transfusionsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Klinisk immunologi och transfusionsmedicin.
    Hillgren, Kristina
    Maria Beroendecentrum, Centre for Dependency Disorders, Stockholm, Sweden.
    Britton, Sven
    Karolinska University Hospital, Sweden .
    Fredlund, Hans
    Örebro University Hospital, Sweden .
    Andersson, Soren
    Örebro University Hospital, Sweden .
    Prevalence of human T-lymphotropic virus type 1 and 2 infection in Sweden2012Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 44, nr 11, s. 852-859Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Prevalence data on human T-lymphotropic virus types 1 and 2 (HTLV-1/2) in Sweden have not been updated since 1995. The seroprevalence among blood donors at that time was 0.2/10,000. A few years earlier, a high prevalence of HTLV-2 was found in intravenous drug users (IDUs) in Stockholm (3.4%). The objective of this study was to update information on the seroprevalence of HTLV in several study groups. Methods: Serum samples from pregnant women, hepatitis C virus (HCV)-positive individuals, and IDUs in Stockholm were investigated for HTLV-1/2 antibodies. Data from the mandatory HTLV-1/2 screening (2003-2006) of in vitro fertilization (IVF) clients were compiled, as well as data from new blood donors. Results: Eight out of 35,000 IVF patients were positive for anti-HTLV-1/2 (seroprevalence 2.3 per 10,000). Of the anti-HCV-positive individuals (n = 355), 1 sample was HTLV-1-positive (28.2 per 10,000). From 1995 to 2007, 18 HTLV-positive new blood donors were identified out of approximately 550,000 individuals tested (0.3 per 10,000). Thirty-five of 1079 tested IDUs were screening reactive. Conclusions: Since the start of screening in 1994, there has been no increased seroprevalence of HTLV-1/2 among blood donors in Sweden. Seroprevalence among Swedish IVF patients is 10 times higher than among blood donors. This finding is comparable to a 2003 European seroprevalence study of pregnant women in 7 countries. However, the possibility that the IVF group includes individuals with a higher risk of acquiring sexually transmitted infections, including HTLV, than the general population cannot be ruled out.

  • 29.
    Mölstad, Sigvard
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för hälsa och samhälle, Allmänmedicin.
    Stålby Lundborg, C
    Stockholm.
    Karlsson, A-K
    Uppsala.
    Cars, O
    Uppsala.
    Antibiotic prescription rates vary markedly between 13 european countries2002Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 34, s. 366-371Artikkel i tidsskrift (Fagfellevurdert)
  • 30.
    Nayeri, Fariba
    et al.
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Infektionsmedicin. Linköpings universitet, Hälsouniversitetet.
    Almer, Sven
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Gastroenterologi och hepatologi. Linköpings universitet, Hälsouniversitetet.
    Brudin, Lars
    Department of Clinical Physiology, County Hospital, Kalmar.
    Nilsson, Ingela
    Department of Clinical Chemistry, County Hospital, Kalmar.
    Åkerlind, Britt
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Klinisk mikrobiologi. Linköpings universitet, Hälsouniversitetet.
    Forsberg, Pia
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Infektionsmedicin. Linköpings universitet, Hälsouniversitetet.
    High hepatocyte growth factor levels in faeces during acute infectious gastroenteritis2003Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 35, nr 11-12, s. 858-862Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Hepatocyte growth factor (HGF) is a potent mitogen of mature epithelial cells which is produced after organ injuries and acts as a trigger for regeneration in the impaired organ. The aim of the present study was to investigate local production of HGF during infectious gastroenteritis. We measured the concentration of HGF in serum and faeces in 49 patients with acute infectious gastroenteritis (bacterium=30, virus=10, amoebae=1, and probable infection=8) at the time of referral to hospital and at convalescence (n=31). The values were compared with normal healthy vaccination volunteers (n=11) as well as patients with acute non-infectious diarrhoea (n=10). The presence of HGF in faeces was confirmed by ELISA and Western immunoblot. HGF concentrations in faeces was significantly higher in the patients with infectious gastroenteritis compared to the control groups (p<0.0001). Using a cut-off concentration of 20 ng/g, the overall sensitivity of faeces HGF to distinguish infectious gastroenteritis (bacterial, viral, probable infection) was 98% with a specificity of 100%. At convalescence all patients had normal values. There was no significant correlation between HGF concentrations in faeces and serum. Determination of faeces HGF may identify cases of transmittable diarrhoea requiring isolation at an early stage.

  • 31.
    Nayeri, Fariba
    et al.
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Infektionsmedicin. Linköpings universitet, Hälsouniversitetet.
    Brudin, Lars
    Department of Clinical Physiology, County Hospital, Kalmar.
    Darelid, Johan
    Department of Infectious Diseases, County Hospital, Jönköping.
    Nilsson, Ingela
    Department of Clinical Chemistry, County Hospital, Kalmar, Sweden.
    Frydén, Aril
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Infektionsmedicin. Linköpings universitet, Hälsouniversitetet.
    Söderström, Claes
    Department of Infectious Diseases, County Hospital, Kalmar, Sweden.
    Forsberg, Pia
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Infektionsmedicin. Linköpings universitet, Hälsouniversitetet.
    Hepatocyte growth factor may act as an early therapeutic predictor in pneumonia2002Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 34, nr 7, s. 500-504Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    High serum levels of hepatocyte growth factor (HGF) may reflect the regenerative effect and enhanced local and systemic production of this cytokine after organ injuries. The possibility of using serial serum HGF values in order to predict the results of therapy for pneumonia was investigated in this study. In a prospective multicenter study we investigated the serum levels of HGF and CRP before and within 48 h after treatment in 70 patients with pneumonia. Serum levels of HGF before treatment were significantly higher than the HGF levels of a normal population (p < 0.0001). Within 48 h serum HGF levels had decreased significantly in those patients who ultimately responded to the initial antibiotic therapy (p < 0.0001). Serum HGF levels at 48 h were unchanged or increased in cases in whom the initial therapy was ineffective and had to be changed. CRP and HGF levels were significantly correlated. Using multivariate logistic regression analysis it was found that individual changes in acute serum HGF levels and serum HGF levels obtained within 48 h could predict the results of therapy at least as significantly (p < 0.003) as CRP (p = 0.05), although CRP levels were known and used by the physician to decide whether or not to change the initial therapy. We conclude that serial control of serum HGF levels can be used as an early indicator to predict the results of therapy during treatment of pneumonia.

  • 32.
    Nayeri, Fariba
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Infektionsmedicin. Östergötlands Läns Landsting, Medicincentrum, Infektionskliniken i Östergötland.
    Cameron, Robert
    Chryssanthou, Erja
    Johansson, Lars
    Söderström, Claes
    Candida glabrata prosthesis infection following pyelonephritis and septicaemia.1997Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 29, s. 635-638Artikkel i tidsskrift (Fagfellevurdert)
  • 33.
    Nayeri, Fariba
    et al.
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Infektionsmedicin. Linköpings universitet, Hälsouniversitetet.
    Nilsson, I.
    Department of Clinical Chemistry, County Hospital, Kalmar.
    Brudin, Lars
    Department of Clinical Physiology, County Hospital, Kalmar.
    Frydén, Aril
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Infektionsmedicin. Linköpings universitet, Hälsouniversitetet.
    Söderström, C.
    Departmenf of Infectious Diseases, Count Hospital, Kalmar, Sweden.
    High serum hepatocyte growth factor levels in the acute stage of community-acquired infectious diseases2002Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 34, nr 2, s. 127-130Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Acute serum levels of hepatocyte growth factor (HGF) were studied in 6 clinical groups with (i) gastroenteritis, (ii) skin and soft tissue infection, (iii) urinary tract infection, (iv) septicemia, (v) influenza, and (vi) chronic hepatitis C in comparison with a normal control group using an enzyme-linked immunosorbent assay method. We found that serum HGF levels were significantly higher in patients with acute infectious diseases (p < 0.0001) compared to patients with chronic viral hepatitis and healthy controls. Serum HGF and CRP levels were correlated significantly (r = 0.65, p < 10-7). We conclude that serum HGF levels are elevated in patients with acute infectious diseases.

  • 34.
    Nayeri, Fariba
    et al.
    Department of Infectious Diseases, Count Hospital, Kalmar, Sweden.
    Nilsson, Ingela
    Department of Clinical Chemistry, County Hospital, Kalmar.
    Skude, Gunnar
    Department of Clinical Chemistry, County Hospital, Kalmar.
    Brudin, Lars
    Department of Clinical Physiology, County Hospital, Kalmar, Sweden.
    Söderström, Claes
    Department of Infectious Diseases, Count Hospital, Kalmar, Sweden.
    Hepatocyte growth factor (HGF) in patients with pneumonia: a comparison between survivors and non-survivors1998Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 30, nr 4, s. 405-409Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Hepatocyte growth factor (HGF) is a multifunctional growth factor. After lung injury HGF is secreted in the lung and promotes reconstruction of the damaged organ. We measured, retrospectively, the serum HGF concentrations collected on admission in 55 patients with bacterial pneumonia, using an enzyme-linked immunosorbent assay (ELISA). The patients were divided into 3 groups: Group 1 was survivors with normal liver function (n=14), Group 2 was survivors with abnormal liver function (n=31) and Group 3 was non-survivors (n=10). Median concentrations of HGF were elevated in Groups 1 and 2; and no statistically significant difference between these 2 groups was found. Group 3 had a median HGF concentration within the reference range, significantly lower than both Group 1 and Group 2. In addition LDH was significantly higher in non-survivors as compared with survivors. The combination of LDH and HGF concentrations discriminated between survivors and non-survivors (sensitivity 0.90 and specificity 0.96). The results support the hypothesis that increased levels of HGF might be a natural part of the healing process of lung injury, irrespective of liver involvement, and that patients without increased HGF levels, especially those with concomitant liver function impairment, may have a poor prognosis.

  • 35.
    Neumark, Thomas
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Allmänmedicin. Linköpings universitet, Hälsouniversitetet.
    Brudin, Lars
    Linköpings universitet, Institutionen för medicin och hälsa, Klinisk fysiologi. Linköpings universitet, Hälsouniversitetet.
    Mölstad, Sigvard
    Linköpings universitet, Institutionen för medicin och hälsa, Allmänmedicin. Linköpings universitet, Hälsouniversitetet.
    Use of rapid diagnostic tests and choice of antibiotics in respiratory tract infections in primary healthcare: A 6-y follow-up study2010Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 42, nr 2, s. 90-96Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this retrospective study of electronic patient records in primary health care in Kalmar County, Sweden, was to describe consultations for respiratory tract infections (RTIs) in relation to age, choice of antibiotics and the use of rapid diagnostic tests. During the period 1999-2005, 240,445 visits for RTI were recorded. Children aged andlt;2 y and especially those aged 2-16 y with acute otitis media (AOM), showed decreasing consultations between 2000 and 2005. The consultations for sore throat declined during the study period in all age groups and in 65% of these, antibiotics were prescribed, primarily penicillin V (82%). In sore throat, a positive Strep-A test result was followed by antibiotic prescription in about 92% of cases, when negative, the antibiotic prescription rate was 40%. C-reactive protein (CRP) was analyzed in 36% of all consultations for RTI. In common cold and acute bronchitis, the prescription rates of antibiotics rose with rising CRP. The results show that near-patient tests were used extensively, but often not in accordance with the guidelines. Antibiotic use decreased mainly as a consequence of declined visiting frequencies. This indicates that the new guidelines for AOM and sore throat may have influenced patient consultation habits more than physician prescribing habits.

  • 36.
    Neumark, Thomas
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Allmänmedicin. Linköpings universitet, Hälsouniversitetet.
    Ekblom, Maria
    Department of Oto-Rhino-Laryngology, Kalmar County Hospital, Kalmar, Sweden.
    Brudin, Lars
    Linköpings universitet, Institutionen för medicin och hälsa, Klinisk fysiologi. Linköpings universitet, Hälsouniversitetet.
    Groth, Anita
    Department of Laboratory Medicine, NÄL, Trollhättan, Sweden.
    Eliasson, Ingvar
    Department of Laboratory Medicine, NÄL, Trollhättan, Sweden.
    Mölstad, Sigvard
    Linköpings universitet, Institutionen för medicin och hälsa, Allmänmedicin. Linköpings universitet, Hälsouniversitetet.
    Petersson, Ann-Cathrine
    Department of Clinical Microbiology Lund, University and regional laboratories Region Skåne, Sweden.
    Törngren, Annika
    Department of Oto-Rhino-Laryngology, Kalmar County Hospital, Kalmar, Sweden.
    Spontaneously draining acute otitis media in children: An observational study of clinical findings, microbiology and clinical course2011Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 43, nr 11-12, s. 891-898Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Conclusion: The study indicates that an active ‘‘wait and see’’ policy during the first 3 days can be justified in most children with otorrhea but antibiotics should be considered in children who initially present with abundant purulent secretion and pulsating eardrum.

    Objectives: To study the clinical recovery of acute otitis media (AOM) with otorrhea in children managed initially without antibiotics.

    Methods: Children aged 2-16, presenting with AOM and spontaneous otorrhea, were followed. Specimens for bacterial investigations were obtained, and symptoms were registered on daily basis. The main outcome measures were the frequency of patients treated with antibiotics due to persisting AOM within 9 days in relation to clinical and bacteriologic findings and new AOM within 3 months.

    Results: Twelve of 71 children who completed the trial received antibiotics during the first nine days due to lack of improvement, one child after 16 days due to recurrent AOM and six had new AOM after 30 days. A.otitidis was found in 23 samples, S.pneumoniae in 12, S.pyogenes in 6, F.nucleatum in five. M.pneumoniae, C.pneumoniae and F.necrophorum could not be detected Antibiotics were prescribed more extensively to patients with pulsating eardrum and abundant purulent secretion. All patients with presence of S.pyogenes received antibiotics.

  • 37.
    Nilsson, Lennart E
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Klinisk mikrobiologi. Linköpings universitet, Hälsouniversitetet.
    Frimodt-Moller, Niels
    National Centre for Antimicrobials and Infection Control.
    Vaara, Martti
    Helsinki University Hospital.
    Skov Simonsen, Gunnar
    University Hospital N Norway.
    Comparative activity of tigecycline and tetracycline on Gram-negative and Gram-positive bacteria revealed by a multicentre study in four North European countries2011Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 43, nr 9, s. 707-713Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: This study involves a multicentre surveillance of tigecycline and tetracycline activity against Gram-negative and Gram-positive bacteria from primary care centres (PCCs), general hospital wards (GHWs) and intensive care units (ICUs) in Denmark (n = 9), Finland (n = 10), Norway (n = 7) and Sweden (n = 19). Methods: The hospitals were each asked to test 30 consecutive Gram-positive and 30 Gram-negative clinical isolates. Supportive information accompanying each isolate included the study centre, ward level (PCC, GHW, or ICU), patient identification and source of the isolate. Minimum inhibitory concentrations (MICs) for tetracycline and tigecycline were determined with the Etest. Results: The isolates collected comprised 1610 Gram-negative and 1767 Gram-positive clinical isolates. The study showed low rates of non-susceptibility (intermediate (I) and resistant (R)) to tigecycline: andlt; 1% in Escherichia coli, though other Enterobacteriaceae showed higher rates (Enterobacter cloacae (7%), Klebsiella pneumoniae (9%) and Serratia spp. (23%)). The overall non-susceptibility rate for tigecycline in Enterobacteriaceae with species-related breakpoints for tigecycline was 6% (4% excluding Serratia spp.). The activity of tigecycline against Haemophilus influenzae and Acinetobacter spp. was high with a MIC(50) of 0.25 mg/l and MIC(90) of 1 mg/l. The prevalence of non-susceptibility to tigecycline among Gram-positive bacteria was andlt; 1%. The corresponding figure for tetracycline was 14%. The activity of tigecycline against Streptococcus pneumoniae was high with MIC(50) and MIC(90) of 0.125 mg/l. Conclusion: Tigecycline showed good overall in vitro activity against Gram-positive and Gram-negative isolates, including both tetracycline-susceptible and resistant isolates. Most non-susceptibility to tigecycline among Enterobacteriaceae other than E. coli was I (6%), rather than R (andlt; 1%). This indicates a problem setting interpretive species-related tigecycline breakpoints for Enterobacteriaceae other than E. coli.

  • 38.
    Nilsson, Lennart
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Pediatrik. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Barn- och ungdomskliniken i Linköping.
    Faldella, Giacomo
    Instituto Clinico di Pediatri,a Bologna, Spanien.
    Jacquet, Jeanne-Marie
    GlaxoSmithKline Belgium.
    Storsaeter, Jann
    GlaxoSmithKline Solna, Sverige.
    Silfverdahl, Sven-Arne
    Barnkliniken, Örebro.
    Ekholm, Leif
    BVC, Örebro.
    A fourth dose of DTPa-IPV vaccine given to 4-6 year old children in Italy and Sweden following primary vaccination at 3, 5 and 11-12 months of age2005Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 37, nr 3, s. 221-229Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Healthy 4-6 y old children from Italy and Sweden immunized with DTPa and inactivated or oral polio vaccines at 3, 5 and 11-12 months of age, received 1 dose of combined DTPa-IPV (n = 211) or DTPa+IPV as separate doses (n = 205) in a randomized trial. The pre-booster seroprotection rates were similar in each group and were above 60% against all antigens except diphtheria (31.3% and 37.0%) and PT (21.5% and 25.9%) in the DTPa-IPV and DTPa+IPV groups, respectively. At least 99.5% of subjects had seroprotective antibody levels against diphtheria, tetanus and polioviruses and ≥96% showed a vaccine response to each pertussis antigen after vaccination. Post-booster antibody levels increased at least 51-fold for anti-diphtheria and anti-tetanus, at least 18-fold for anti-pertussis antibodies and at least 32-fold for antibodies against all 3 poliovirus types, compared to prior levels. DTPa-IPV was comparable to DTPa+IPV in terms of seroprotection rates and mean antibody levels against each vaccine antigen. Similar reactogenicity profiles were observed between groups including swelling >50 mm [13% (9.1, 18.7) vs 17% (12.4, 23.4)] or involving an adjacent joint [0% (-,-) vs 1.5% (0.3, 4.3)] and were consistent with previous reports. The combined DTPa-IPV vaccine could be used to add DTP valences to the IPV vaccine currently given to children in Scandinavia and Italy at 4-6 y of age and reinforce protection against 4 diseases. © 2005 Taylor & Francis.

  • 39.
    Odenholt, I
    et al.
    Malmö.
    Bylander-Groth, A
    Malmö.
    Frimodt-Möller, N
    Köpenhamn.
    Skinlo Rokstad, K
    Bergen.
    Mölstad, Sigvard
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för hälsa och samhälle, Allmänmedicin.
    Differences in antibiotic prescribing patterns between general general practitioners in Scandinavia: A questionnaire study2002Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 34, s. 602-609Artikkel i tidsskrift (Fagfellevurdert)
  • 40. Olinder-Nielsen, Ann-Margreth
    et al.
    Granert, Carl
    Forsberg, Pia
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Infektionsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Medicincentrum, Infektionskliniken i Östergötland.
    Friman, Vanda
    Vietorisz, Auli
    Björkander, Janne
    Immunoglobulin prophylaxis in 350 adults with IgG subclass deficiency and recurrent respiratory tract infections: A long-term follow-up2007Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 39, nr 1, s. 44-50Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    350 adult patients in Sweden were included in a retrospective study covering more than 2000 patient-y, to evaluate the efficacy of immunoglobulin (Ig) prophylaxis. All patients had selective or combined IgG subclass deficiency, without IgA deficiency, and suffered from recurrent respiratory tract infections (RTIs). The patients had been given Ig prophylaxis for 0.5-21 y (mean 5.5 y). In total, 164/350 of the patients had a concomitant lung disease. Because of the heterogeneity of this retrospective material we evaluated only those patients with 4 or more antibiotic-demanding (i.e. presumably bacterial) episodes of RTI per y treated with an Ig dose of about 100 mg/kg/week (132/350). The frequency of antibiotic treated RTIs prior to and during latest y/s of Ig prophylaxis was compared. No difference in response could be found between patients with and without chronic lung diseases. In 92/132 a ≥ 50% reduction of the rate of episodes of antibiotic-demanding RTIs was recorded (p < 0.001). The overall reduction of the RTI frequency was for IgG1 57%, IgG2 59%, IgG3 63% and for the combinations 61% (all p< 0.001).

  • 41.
    Olofsson, Magnus
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Hälsouniversitetet.
    Lindgren, Per-Eric
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Medicinsk mikrobiologi. Linköpings universitet, Hälsouniversitetet.
    Östgren, Carl Johan
    Linköpings universitet, Institutionen för medicin och hälsa, Allmänmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i västra Östergötland, Primärvården i västra länsdelen.
    Midlöv, P.
    Department of Clinical Sciences in Malmö, Lund University, Sweden.
    Mölstad, Sigvard
    Linköpings universitet, Institutionen för medicin och hälsa, Allmänmedicin. Linköpings universitet, Hälsouniversitetet.
    Colonization with Staphylococcus aureus in Swedish nursing homes: A cross-sectional study2012Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 44, nr 1, s. 3-8Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Screening for bacterial colonization among risk populations could provide better estimates of the volume of the bacteria-related disease reservoir and the level of antimicrobial resistance, than do conventional laboratory reports. Methods: Two hundred and one participants at 10 Swedish nursing homes were screened for colonization with Staphylococcus aureus between January and October 2009. Of the 201 participants, 61 (30%) were male. The median age was 86 y. All participants were systematically sampled from the nasal mucosa, the pharyngeal mucosa, the groin, and active skin lesions, if any. Results: Ninety-nine of 199 participants (50%) were colonized with S. aureus. The colonization rate was 34% for the nose, 35% for throat, 10% for groin, and 54% for active skin lesions. An antibiotic-resistant S. aureus isolate was identified in 8.5% of all participants regardless of colonization status. A total of 24 resistant isolates were detected, and 21 of these were resistant to fluoroquinolones. There was no case of colonization with methicillin-resistant S. aureus (MRSA). Conclusions: The presence of resistant isolates was generally low, and the greater part of the resistance was fluoroquinolone-related. To achieve reasonable precision, screening programmes of this kind must include samples from both the nose and throat, and, although low, the prevalence of antimicrobial resistance in Swedish nursing homes still calls for reflection on how to use the fluoroquinolones wisely. © 2012 Informa Healthcare.

  • 42.
    Orvelid, Paula
    et al.
    Department of Clinical Microbiology and Immunology, Örebro Medical Center Hospital, Örebro, Sweden.
    Bäckman, Anders
    Department of Clinical Microbiology and Immunology, Örebro Medical Center Hospital, Örebro, Sweden.
    Olcén, Per
    Department of Clinical Microbiology and Immunology, Örebro Medical Center Hospital, Örebro, Sweden.
    PCR Identification of the Group A Neisseria Meningitidis Gene in Cerebrospinal Fluid1999Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 31, nr 5, s. 481-483Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to develop a PCR method for direct identification of Neisseria meningitidis serogroup A in cerebrospinal fluid. The assay makes use of unique sites within the gene cassette responsible for expression of the (α1→6)-linked N-acetyl-D-mannosamine-1-phosphate serogroup A capsule. A total of 67 different N. meningitidis strains and 12 clinical samples of CSF, culture positive for N. meningitidis, were examined. All the strains and samples of N. meningitidis serogroup A were correctly identified by an amplified PCR product of 519 bp. The PCR method for identification is specific for the group A gene of N. meningitidis. The assay may contribute to reducing recurrent, devastating epidemics of meningococcal infection by providing a diagnostic tool for grouping in developing countries where problems with false negative cultures are common and vaccination against serogroup A meningococci may be required.

  • 43.
    Pettersson, Eva
    et al.
    KI .
    Vernby, Åsa
    KI .
    Mölstad, Sigvard
    Unit of Research and Development in Primary Care, Jönköping.
    Stålby, Cecilia
    KI .
    Infections and antibiotic prescribing in Swedish nursing homes: A cross-sectional study2008Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 40, s. 393-398Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to present and assess the treatment of infections in Swedish nursing homes. It included 58 nursing homes with 3002 residents. During 3 months, nurses in the nursing homes recorded all infections requiring a physician's opinion. Of the 889 infectious episodes, 84% were treated with antibiotics. Many of the antibiotics were issued after indirect contact with the physician (38%). Indications for antibiotics were in 55% of the cases urinary tract infections (UTI), in 17% skin and soft-tissue infections and in 15% respiratory tract infections (RTI). The most common antibiotics were penicillins (38%), followed by quinolones (23%) and trimethoprim (18%). For the major indication, lower UTI in women, half of the cases were not treated according to the recommendations. The main concerns were length of treatment and overprescribing of quinolones. For the second major diagnosis, pneumonia, the high use of doxycycline could be questioned. Continuing education on infections and their treatment in nursing homes is needed. Training should preferably include both physicians and nurses as a high proportion of antibiotics is issued without direct contact with the physician.

  • 44.
    Rastad, AA
    et al.
    Univ Lund, Dept Infect Dis & Med Microbiol, Div Infect Dis, SE-22185 Lund, Sweden Dept Microbiol, Linkoping, Sweden Med Prod Agcy, Uppsala, Sweden Karolinska Inst, Dept Clin Virol, Huddinge, Sweden Karolinska Inst, Dept Clin Pharmacol, Huddinge, Sweden Dept Paediat, Boras, Sweden Karolinska Inst, Dept Clin Microbiol, Stockholm, Sweden Staten Legmiddelskontroll, Oslo, Norway Univ Uppsala Hosp, Dept Infect Dis, S-75185 Uppsala, Sweden Univ Lund, Dept Infect Dis, Lund, Sweden Karolinska Inst, Dept Paediat, Huddinge, Sweden Karolinska Inst, Dept Haematol, Huddinge, Sweden Dept Paediat, Lund, Sweden Swedish Inst Infect Dis Control, Solna, Sweden Gothenburg Univ, Dept Paediat, Gothenburg, Sweden Univ Uppsala Hosp, Dept Paediat, S-75185 Uppsala, Sweden Med Prod Agcy, Uppsala, Sweden Karolinska Inst, Dept Paediat, Stockholm, Sweden Karolinska Inst, Dept Infect Dis, Huddinge, Sweden.
    Andersson, J
    Beermann, B
    Univ Lund, Dept Infect Dis & Med Microbiol, Div Infect Dis, SE-22185 Lund, Sweden Dept Microbiol, Linkoping, Sweden Med Prod Agcy, Uppsala, Sweden Karolinska Inst, Dept Clin Virol, Huddinge, Sweden Karolinska Inst, Dept Clin Pharmacol, Huddinge, Sweden Dept Paediat, Boras, Sweden Karolinska Inst, Dept Clin Microbiol, Stockholm, Sweden Staten Legmiddelskontroll, Oslo, Norway Univ Uppsala Hosp, Dept Infect Dis, S-75185 Uppsala, Sweden Univ Lund, Dept Infect Dis, Lund, Sweden Karolinska Inst, Dept Paediat, Huddinge, Sweden Karolinska Inst, Dept Haematol, Huddinge, Sweden Dept Paediat, Lund, Sweden Swedish Inst Infect Dis Control, Solna, Sweden Gothenburg Univ, Dept Paediat, Gothenburg, Sweden Univ Uppsala Hosp, Dept Paediat, S-75185 Uppsala, Sweden Med Prod Agcy, Uppsala, Sweden Karolinska Inst, Dept Paediat, Stockholm, Sweden Karolinska Inst, Dept Infect Dis, Huddinge, Sweden.
    Bohlin, AB
    Univ Lund, Dept Infect Dis & Med Microbiol, Div Infect Dis, SE-22185 Lund, Sweden Dept Microbiol, Linkoping, Sweden Med Prod Agcy, Uppsala, Sweden Karolinska Inst, Dept Clin Virol, Huddinge, Sweden Karolinska Inst, Dept Clin Pharmacol, Huddinge, Sweden Dept Paediat, Boras, Sweden Karolinska Inst, Dept Clin Microbiol, Stockholm, Sweden Staten Legmiddelskontroll, Oslo, Norway Univ Uppsala Hosp, Dept Infect Dis, S-75185 Uppsala, Sweden Univ Lund, Dept Infect Dis, Lund, Sweden Karolinska Inst, Dept Paediat, Huddinge, Sweden Karolinska Inst, Dept Haematol, Huddinge, Sweden Dept Paediat, Lund, Sweden Swedish Inst Infect Dis Control, Solna, Sweden Gothenburg Univ, Dept Paediat, Gothenburg, Sweden Univ Uppsala Hosp, Dept Paediat, S-75185 Uppsala, Sweden Med Prod Agcy, Uppsala, Sweden Karolinska Inst, Dept Paediat, Stockholm, Sweden Karolinska Inst, Dept Infect Dis, Huddinge, Sweden.
    Brandt, C
    Eriksson, M
    Ewald, U
    Univ Lund, Dept Infect Dis & Med Microbiol, Div Infect Dis, SE-22185 Lund, Sweden Dept Microbiol, Linkoping, Sweden Med Prod Agcy, Uppsala, Sweden Karolinska Inst, Dept Clin Virol, Huddinge, Sweden Karolinska Inst, Dept Clin Pharmacol, Huddinge, Sweden Dept Paediat, Boras, Sweden Karolinska Inst, Dept Clin Microbiol, Stockholm, Sweden Staten Legmiddelskontroll, Oslo, Norway Univ Uppsala Hosp, Dept Infect Dis, S-75185 Uppsala, Sweden Univ Lund, Dept Infect Dis, Lund, Sweden Karolinska Inst, Dept Paediat, Huddinge, Sweden Karolinska Inst, Dept Haematol, Huddinge, Sweden Dept Paediat, Lund, Sweden Swedish Inst Infect Dis Control, Solna, Sweden Gothenburg Univ, Dept Paediat, Gothenburg, Sweden Univ Uppsala Hosp, Dept Paediat, S-75185 Uppsala, Sweden Med Prod Agcy, Uppsala, Sweden Karolinska Inst, Dept Paediat, Stockholm, Sweden Karolinska Inst, Dept Infect Dis, Huddinge, Sweden.
    Gothberg, S
    Univ Lund, Dept Infect Dis & Med Microbiol, Div Infect Dis, SE-22185 Lund, Sweden Dept Microbiol, Linkoping, Sweden Med Prod Agcy, Uppsala, Sweden Karolinska Inst, Dept Clin Virol, Huddinge, Sweden Karolinska Inst, Dept Clin Pharmacol, Huddinge, Sweden Dept Paediat, Boras, Sweden Karolinska Inst, Dept Clin Microbiol, Stockholm, Sweden Staten Legmiddelskontroll, Oslo, Norway Univ Uppsala Hosp, Dept Infect Dis, S-75185 Uppsala, Sweden Univ Lund, Dept Infect Dis, Lund, Sweden Karolinska Inst, Dept Paediat, Huddinge, Sweden Karolinska Inst, Dept Haematol, Huddinge, Sweden Dept Paediat, Lund, Sweden Swedish Inst Infect Dis Control, Solna, Sweden Gothenburg Univ, Dept Paediat, Gothenburg, Sweden Univ Uppsala Hosp, Dept Paediat, S-75185 Uppsala, Sweden Med Prod Agcy, Uppsala, Sweden Karolinska Inst, Dept Paediat, Stockholm, Sweden Karolinska Inst, Dept Infect Dis, Huddinge, Sweden.
    Lind, A
    Univ Lund, Dept Infect Dis & Med Microbiol, Div Infect Dis, SE-22185 Lund, Sweden Dept Microbiol, Linkoping, Sweden Med Prod Agcy, Uppsala, Sweden Karolinska Inst, Dept Clin Virol, Huddinge, Sweden Karolinska Inst, Dept Clin Pharmacol, Huddinge, Sweden Dept Paediat, Boras, Sweden Karolinska Inst, Dept Clin Microbiol, Stockholm, Sweden Staten Legmiddelskontroll, Oslo, Norway Univ Uppsala Hosp, Dept Infect Dis, S-75185 Uppsala, Sweden Univ Lund, Dept Infect Dis, Lund, Sweden Karolinska Inst, Dept Paediat, Huddinge, Sweden Karolinska Inst, Dept Haematol, Huddinge, Sweden Dept Paediat, Lund, Sweden Swedish Inst Infect Dis Control, Solna, Sweden Gothenburg Univ, Dept Paediat, Gothenburg, Sweden Univ Uppsala Hosp, Dept Paediat, S-75185 Uppsala, Sweden Med Prod Agcy, Uppsala, Sweden Karolinska Inst, Dept Paediat, Stockholm, Sweden Karolinska Inst, Dept Infect Dis, Huddinge, Sweden.
    Lindroth, Margaretha
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Medicinsk mikrobiologi.
    Ljungman, P
    Univ Lund, Dept Infect Dis & Med Microbiol, Div Infect Dis, SE-22185 Lund, Sweden Dept Microbiol, Linkoping, Sweden Med Prod Agcy, Uppsala, Sweden Karolinska Inst, Dept Clin Virol, Huddinge, Sweden Karolinska Inst, Dept Clin Pharmacol, Huddinge, Sweden Dept Paediat, Boras, Sweden Karolinska Inst, Dept Clin Microbiol, Stockholm, Sweden Staten Legmiddelskontroll, Oslo, Norway Univ Uppsala Hosp, Dept Infect Dis, S-75185 Uppsala, Sweden Univ Lund, Dept Infect Dis, Lund, Sweden Karolinska Inst, Dept Paediat, Huddinge, Sweden Karolinska Inst, Dept Haematol, Huddinge, Sweden Dept Paediat, Lund, Sweden Swedish Inst Infect Dis Control, Solna, Sweden Gothenburg Univ, Dept Paediat, Gothenburg, Sweden Univ Uppsala Hosp, Dept Paediat, S-75185 Uppsala, Sweden Med Prod Agcy, Uppsala, Sweden Karolinska Inst, Dept Paediat, Stockholm, Sweden Karolinska Inst, Dept Infect Dis, Huddinge, Sweden.
    Naver, L
    Univ Lund, Dept Infect Dis & Med Microbiol, Div Infect Dis, SE-22185 Lund, Sweden Dept Microbiol, Linkoping, Sweden Med Prod Agcy, Uppsala, Sweden Karolinska Inst, Dept Clin Virol, Huddinge, Sweden Karolinska Inst, Dept Clin Pharmacol, Huddinge, Sweden Dept Paediat, Boras, Sweden Karolinska Inst, Dept Clin Microbiol, Stockholm, Sweden Staten Legmiddelskontroll, Oslo, Norway Univ Uppsala Hosp, Dept Infect Dis, S-75185 Uppsala, Sweden Univ Lund, Dept Infect Dis, Lund, Sweden Karolinska Inst, Dept Paediat, Huddinge, Sweden Karolinska Inst, Dept Haematol, Huddinge, Sweden Dept Paediat, Lund, Sweden Swedish Inst Infect Dis Control, Solna, Sweden Gothenburg Univ, Dept Paediat, Gothenburg, Sweden Univ Uppsala Hosp, Dept Paediat, S-75185 Uppsala, Sweden Med Prod Agcy, Uppsala, Sweden Karolinska Inst, Dept Paediat, Stockholm, Sweden Karolinska Inst, Dept Infect Dis, Huddinge, Sweden.
    Norrby, SR
    Univ Lund, Dept Infect Dis & Med Microbiol, Div Infect Dis, SE-22185 Lund, Sweden Dept Microbiol, Linkoping, Sweden Med Prod Agcy, Uppsala, Sweden Karolinska Inst, Dept Clin Virol, Huddinge, Sweden Karolinska Inst, Dept Clin Pharmacol, Huddinge, Sweden Dept Paediat, Boras, Sweden Karolinska Inst, Dept Clin Microbiol, Stockholm, Sweden Staten Legmiddelskontroll, Oslo, Norway Univ Uppsala Hosp, Dept Infect Dis, S-75185 Uppsala, Sweden Univ Lund, Dept Infect Dis, Lund, Sweden Karolinska Inst, Dept Paediat, Huddinge, Sweden Karolinska Inst, Dept Haematol, Huddinge, Sweden Dept Paediat, Lund, Sweden Swedish Inst Infect Dis Control, Solna, Sweden Gothenburg Univ, Dept Paediat, Gothenburg, Sweden Univ Uppsala Hosp, Dept Paediat, S-75185 Uppsala, Sweden Med Prod Agcy, Uppsala, Sweden Karolinska Inst, Dept Paediat, Stockholm, Sweden Karolinska Inst, Dept Infect Dis, Huddinge, Sweden.
    Pauksen, K
    Univ Lund, Dept Infect Dis & Med Microbiol, Div Infect Dis, SE-22185 Lund, Sweden Dept Microbiol, Linkoping, Sweden Med Prod Agcy, Uppsala, Sweden Karolinska Inst, Dept Clin Virol, Huddinge, Sweden Karolinska Inst, Dept Clin Pharmacol, Huddinge, Sweden Dept Paediat, Boras, Sweden Karolinska Inst, Dept Clin Microbiol, Stockholm, Sweden Staten Legmiddelskontroll, Oslo, Norway Univ Uppsala Hosp, Dept Infect Dis, S-75185 Uppsala, Sweden Univ Lund, Dept Infect Dis, Lund, Sweden Karolinska Inst, Dept Paediat, Huddinge, Sweden Karolinska Inst, Dept Haematol, Huddinge, Sweden Dept Paediat, Lund, Sweden Swedish Inst Infect Dis Control, Solna, Sweden Gothenburg Univ, Dept Paediat, Gothenburg, Sweden Univ Uppsala Hosp, Dept Paediat, S-75185 Uppsala, Sweden Med Prod Agcy, Uppsala, Sweden Karolinska Inst, Dept Paediat, Stockholm, Sweden Karolinska Inst, Dept Infect Dis, Huddinge, Sweden.
    Ransjo, U
    Univ Lund, Dept Infect Dis & Med Microbiol, Div Infect Dis, SE-22185 Lund, Sweden Dept Microbiol, Linkoping, Sweden Med Prod Agcy, Uppsala, Sweden Karolinska Inst, Dept Clin Virol, Huddinge, Sweden Karolinska Inst, Dept Clin Pharmacol, Huddinge, Sweden Dept Paediat, Boras, Sweden Karolinska Inst, Dept Clin Microbiol, Stockholm, Sweden Staten Legmiddelskontroll, Oslo, Norway Univ Uppsala Hosp, Dept Infect Dis, S-75185 Uppsala, Sweden Univ Lund, Dept Infect Dis, Lund, Sweden Karolinska Inst, Dept Paediat, Huddinge, Sweden Karolinska Inst, Dept Haematol, Huddinge, Sweden Dept Paediat, Lund, Sweden Swedish Inst Infect Dis Control, Solna, Sweden Gothenburg Univ, Dept Paediat, Gothenburg, Sweden Univ Uppsala Hosp, Dept Paediat, S-75185 Uppsala, Sweden Med Prod Agcy, Uppsala, Sweden Karolinska Inst, Dept Paediat, Stockholm, Sweden Karolinska Inst, Dept Infect Dis, Huddinge, Sweden.
    Rebbel, H
    Univ Lund, Dept Infect Dis & Med Microbiol, Div Infect Dis, SE-22185 Lund, Sweden Dept Microbiol, Linkoping, Sweden Med Prod Agcy, Uppsala, Sweden Karolinska Inst, Dept Clin Virol, Huddinge, Sweden Karolinska Inst, Dept Clin Pharmacol, Huddinge, Sweden Dept Paediat, Boras, Sweden Karolinska Inst, Dept Clin Microbiol, Stockholm, Sweden Staten Legmiddelskontroll, Oslo, Norway Univ Uppsala Hosp, Dept Infect Dis, S-75185 Uppsala, Sweden Univ Lund, Dept Infect Dis, Lund, Sweden Karolinska Inst, Dept Paediat, Huddinge, Sweden Karolinska Inst, Dept Haematol, Huddinge, Sweden Dept Paediat, Lund, Sweden Swedish Inst Infect Dis Control, Solna, Sweden Gothenburg Univ, Dept Paediat, Gothenburg, Sweden Univ Uppsala Hosp, Dept Paediat, S-75185 Uppsala, Sweden Med Prod Agcy, Uppsala, Sweden Karolinska Inst, Dept Paediat, Stockholm, Sweden Karolinska Inst, Dept Infect Dis, Huddinge, Sweden.
    Ostlund, MR
    Sigurs, N
    Univ Lund, Dept Infect Dis & Med Microbiol, Div Infect Dis, SE-22185 Lund, Sweden Dept Microbiol, Linkoping, Sweden Med Prod Agcy, Uppsala, Sweden Karolinska Inst, Dept Clin Virol, Huddinge, Sweden Karolinska Inst, Dept Clin Pharmacol, Huddinge, Sweden Dept Paediat, Boras, Sweden Karolinska Inst, Dept Clin Microbiol, Stockholm, Sweden Staten Legmiddelskontroll, Oslo, Norway Univ Uppsala Hosp, Dept Infect Dis, S-75185 Uppsala, Sweden Univ Lund, Dept Infect Dis, Lund, Sweden Karolinska Inst, Dept Paediat, Huddinge, Sweden Karolinska Inst, Dept Haematol, Huddinge, Sweden Dept Paediat, Lund, Sweden Swedish Inst Infect Dis Control, Solna, Sweden Gothenburg Univ, Dept Paediat, Gothenburg, Sweden Univ Uppsala Hosp, Dept Paediat, S-75185 Uppsala, Sweden Med Prod Agcy, Uppsala, Sweden Karolinska Inst, Dept Paediat, Stockholm, Sweden Karolinska Inst, Dept Infect Dis, Huddinge, Sweden.
    Stahle, L
    Univ Lund, Dept Infect Dis & Med Microbiol, Div Infect Dis, SE-22185 Lund, Sweden Dept Microbiol, Linkoping, Sweden Med Prod Agcy, Uppsala, Sweden Karolinska Inst, Dept Clin Virol, Huddinge, Sweden Karolinska Inst, Dept Clin Pharmacol, Huddinge, Sweden Dept Paediat, Boras, Sweden Karolinska Inst, Dept Clin Microbiol, Stockholm, Sweden Staten Legmiddelskontroll, Oslo, Norway Univ Uppsala Hosp, Dept Infect Dis, S-75185 Uppsala, Sweden Univ Lund, Dept Infect Dis, Lund, Sweden Karolinska Inst, Dept Paediat, Huddinge, Sweden Karolinska Inst, Dept Haematol, Huddinge, Sweden Dept Paediat, Lund, Sweden Swedish Inst Infect Dis Control, Solna, Sweden Gothenburg Univ, Dept Paediat, Gothenburg, Sweden Univ Uppsala Hosp, Dept Paediat, S-75185 Uppsala, Sweden Med Prod Agcy, Uppsala, Sweden Karolinska Inst, Dept Paediat, Stockholm, Sweden Karolinska Inst, Dept Infect Dis, Huddinge, Sweden.
    Sawe, J
    Univ Lund, Dept Infect Dis & Med Microbiol, Div Infect Dis, SE-22185 Lund, Sweden Dept Microbiol, Linkoping, Sweden Med Prod Agcy, Uppsala, Sweden Karolinska Inst, Dept Clin Virol, Huddinge, Sweden Karolinska Inst, Dept Clin Pharmacol, Huddinge, Sweden Dept Paediat, Boras, Sweden Karolinska Inst, Dept Clin Microbiol, Stockholm, Sweden Staten Legmiddelskontroll, Oslo, Norway Univ Uppsala Hosp, Dept Infect Dis, S-75185 Uppsala, Sweden Univ Lund, Dept Infect Dis, Lund, Sweden Karolinska Inst, Dept Paediat, Huddinge, Sweden Karolinska Inst, Dept Haematol, Huddinge, Sweden Dept Paediat, Lund, Sweden Swedish Inst Infect Dis Control, Solna, Sweden Gothenburg Univ, Dept Paediat, Gothenburg, Sweden Univ Uppsala Hosp, Dept Paediat, S-75185 Uppsala, Sweden Med Prod Agcy, Uppsala, Sweden Karolinska Inst, Dept Paediat, Stockholm, Sweden Karolinska Inst, Dept Infect Dis, Huddinge, Sweden.
    Sonnerborg, A
    Univ Lund, Dept Infect Dis & Med Microbiol, Div Infect Dis, SE-22185 Lund, Sweden Dept Microbiol, Linkoping, Sweden Med Prod Agcy, Uppsala, Sweden Karolinska Inst, Dept Clin Virol, Huddinge, Sweden Karolinska Inst, Dept Clin Pharmacol, Huddinge, Sweden Dept Paediat, Boras, Sweden Karolinska Inst, Dept Clin Microbiol, Stockholm, Sweden Staten Legmiddelskontroll, Oslo, Norway Univ Uppsala Hosp, Dept Infect Dis, S-75185 Uppsala, Sweden Univ Lund, Dept Infect Dis, Lund, Sweden Karolinska Inst, Dept Paediat, Huddinge, Sweden Karolinska Inst, Dept Haematol, Huddinge, Sweden Dept Paediat, Lund, Sweden Swedish Inst Infect Dis Control, Solna, Sweden Gothenburg Univ, Dept Paediat, Gothenburg, Sweden Univ Uppsala Hosp, Dept Paediat, S-75185 Uppsala, Sweden Med Prod Agcy, Uppsala, Sweden Karolinska Inst, Dept Paediat, Stockholm, Sweden Karolinska Inst, Dept Infect Dis, Huddinge, Sweden.
    Uhnoo, I
    Univ Lund, Dept Infect Dis & Med Microbiol, Div Infect Dis, SE-22185 Lund, Sweden Dept Microbiol, Linkoping, Sweden Med Prod Agcy, Uppsala, Sweden Karolinska Inst, Dept Clin Virol, Huddinge, Sweden Karolinska Inst, Dept Clin Pharmacol, Huddinge, Sweden Dept Paediat, Boras, Sweden Karolinska Inst, Dept Clin Microbiol, Stockholm, Sweden Staten Legmiddelskontroll, Oslo, Norway Univ Uppsala Hosp, Dept Infect Dis, S-75185 Uppsala, Sweden Univ Lund, Dept Infect Dis, Lund, Sweden Karolinska Inst, Dept Paediat, Huddinge, Sweden Karolinska Inst, Dept Haematol, Huddinge, Sweden Dept Paediat, Lund, Sweden Swedish Inst Infect Dis Control, Solna, Sweden Gothenburg Univ, Dept Paediat, Gothenburg, Sweden Univ Uppsala Hosp, Dept Paediat, S-75185 Uppsala, Sweden Med Prod Agcy, Uppsala, Sweden Karolinska Inst, Dept Paediat, Stockholm, Sweden Karolinska Inst, Dept Infect Dis, Huddinge, Sweden.
    Stopner, BA
    Univ Lund, Dept Infect Dis & Med Microbiol, Div Infect Dis, SE-22185 Lund, Sweden Dept Microbiol, Linkoping, Sweden Med Prod Agcy, Uppsala, Sweden Karolinska Inst, Dept Clin Virol, Huddinge, Sweden Karolinska Inst, Dept Clin Pharmacol, Huddinge, Sweden Dept Paediat, Boras, Sweden Karolinska Inst, Dept Clin Microbiol, Stockholm, Sweden Staten Legmiddelskontroll, Oslo, Norway Univ Uppsala Hosp, Dept Infect Dis, S-75185 Uppsala, Sweden Univ Lund, Dept Infect Dis, Lund, Sweden Karolinska Inst, Dept Paediat, Huddinge, Sweden Karolinska Inst, Dept Haematol, Huddinge, Sweden Dept Paediat, Lund, Sweden Swedish Inst Infect Dis Control, Solna, Sweden Gothenburg Univ, Dept Paediat, Gothenburg, Sweden Univ Uppsala Hosp, Dept Paediat, S-75185 Uppsala, Sweden Med Prod Agcy, Uppsala, Sweden Karolinska Inst, Dept Paediat, Stockholm, Sweden Karolinska Inst, Dept Infect Dis, Huddinge, Sweden.
    Management of infections caused by respiratory syncytial virus2001Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 33, nr 5, s. 323-328Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This is a consensus document compiled by the Medical Products Agency in Sweden and the Swedish Reference Group for Antiviral Therapy on management of respiratory syncytial virus (RSV) infections. Prophylaxis against RSV infections using palivizumab, a commercially available humanized monoclonal IgG, antibody preparation, is recommended for children <2 y of age with chronic respiratory diseases requiring continuous treatment (oxygen and/or inhalations and/or steroids) during the previous 6 months and children 6 months old who were born before gestational week 26. Ribavirin inhalation treatment may be considered in high-risk infants with clinical symptoms indicating a serious course of an RSV infection. Treatment with ribavirin in combination with intravenous polyclonal immunoglobulin should be considered in patients who have received an allogenic stem cell transplantation or organ transplantation with >1 episode of rejection treatment and who have mild or moderate RSV pneumonia. Evidence-based documentation for treatment of other groups of patients is lacking.

  • 45.
    Rodhe, Nils
    et al.
    Uppsala univ .
    Löfgren, Sture
    Ryhov Jönköping .
    Matussek, Andreas
    Ryhov Jönköping .
    André, Malin
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Allmänmedicin.
    englund, lars
    Englund, Lars
    uppsala univ .
    Kûhn, Inger
    KI .
    Mölstad, Sigvard
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Allmänmedicin.
    Asymptomatic bacteriuria in the elderly: High prevalence and high turnover of strains2008Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980Artikkel i tidsskrift (Fagfellevurdert)
  • 46.
    Rudolf, Frauke
    et al.
    INDEPTH Network, Guinea Bissau .
    Lemvik, Grethe
    INDEPTH Network, Guinea Bissau .
    Abate, Ebba
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för mikrobiologi och molekylär medicin. Linköpings universitet, Hälsouniversitetet. University of Gondar, Ethiopia .
    Verkuilen, Jay
    CUNY, NY USA .
    Schön, Thomas
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Medicinsk mikrobiologi. Linköpings universitet, Hälsouniversitetet.
    Francisco Gomes, Victor
    INDEPTH Network, Guinea Bissau .
    Eugen-Olsen, Jesper
    INDEPTH Network, Guinea Bissau .
    Ostergaard, Lars
    Aarhus University Hospital, Denmark .
    Wejse, Christian
    INDEPTH Network, Guinea Bissau .
    TBscore II: Refining and validating a simple clinical score for treatment monitoring of patients with pulmonary tuberculosis2013Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 45, nr 11, s. 825-836Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: The TBscore, based on simple signs and symptoms, was introduced to predict unsuccessful outcome in tuberculosis patients on treatment. A recent inter-observer variation study showed profound variation in some variables. Further, some variables depend on a physician assessing them, making the score less applicable. The aim of the present study was to simplify the TBscore. Methods: Inter-observer variation assessment and exploratory factor analysis were combined to develop a simplified score, the TBscore II. To validate TBscore II we assessed the association between start score and failure (i.e. death or treatment failure), responsiveness using Cohens effect size, and the relationship between severity class at treatment start and a decrease andlt; 25% in score from the start until the end of the second treatment month and subsequent mortality. Results: We analyzed data from 1070 Guinean (2003-2012) and 432 Ethiopian (2007-2012) pulmonary tuberculosis patients. For the refined score, items with less than substantial agreement (kappa andlt;= 0.6) and/or not associated with the underlying constructs were excluded. Items kept were: cough, dyspnea, chest pain, anemia, body mass index (BMI) andlt; 18 kg/m(2), BMI andlt; 16 kg/m(2), mid upper arm circumference (MUAC) andlt; 220 mm, and MUAC andlt; 200 mm. The effect sizes for the change between the start of treatment and the 2-month follow-up were 0.51 in Guinea-Bissau and 0.68 in Ethiopia, and for the change between the start of treatment and the end of treatment were 0.68 in Guinea-Bissau and 0.74 in Ethiopia. Severity class placement at treatment start predicted failure (p andlt; 0.001 Guinea-Bissau, p = 0.208 Ethiopia). Inability to decrease at least 25% in score was associated with a higher failure rate during the remaining 4 months of treatment (p = 0.063 Guinea-Bissau, p = 0.008 Ethiopia). Conclusion: The TBscore II could be a useful monitoring tool, aiding triage at the beginning of treatment and during treatment.

  • 47.
    Rybczynska, Helena
    et al.
    Medical Faculty, Lund University, Sweden.
    Melander, Eva
    Department of Hospital Infection Control, University and Regional Laboratories Region Skåne, Lund and Malmö, Sweden.
    Johansson, Hugo
    Department of Hospital Infection Control, University and Regional Laboratories Region Skåne, Lund and Malmö, Sweden.
    Lundberg, Fredrik
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Barn- och ungdomskliniken i Linköping. Department of Neonatology, Skåne University Hospital, Malmö, Sweden.
    Efficacy of a once-a-week screening programme to control extended-spectrum beta-lactamase-producing bacteria in a neonatal intensive care unit2014Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 46, nr 6, s. 426-432Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Extended-spectrum beta-lactamase (ESBL)-producing bacteria are an escalating problem threatening health. Devastating consequences can result in neonatal intensive care units (NICU) due to these bacteria. The aim of this study was to investigate the efficacy of once-a-week screening (July 2010 to September 2012) versus screening on demand (April 2008 to June 2010).

    Materials and methods: The investigation was an open retrospective descriptive study comparing 2 unpaired groups, the first exposed to screening on demand and the second to screening once a week. All other infection control measures were unchanged. Both groups were cared for in the NICU of Skåne University Hospital. Parameters compared were the proportion of cultured neonates, prevalence, time before detection, number of secondary cases, and clinical infections due to ESBL-producing bacteria.

    Results: The proportion of cultured neonates increased from 28% to 49% (p < 0.05) in period 2. The time from admission to detection was 8 days shorter in period 2 (p < 0.05). Secondary cases decreased from 44% to 9% (p < 0.05), and clinical infections from 4 to 0 cases (p < 0.05). During period 2, the prevalence of colonization was 1.77%.

    Conclusions: Once-a-week screening is a strategy to control the epidemiology of unwanted pathogens among newborn infants. It provides the opportunity for early intervention, thereby avoiding secondary cases and infections. Premature neonates in particular benefit from this approach. The prevalence of ESBL of 1.77% is low from an international perspective. ESBL appear to be introduced onto the ward by mothers colonized with ESBL.

  • 48.
    Saeedi, Baharak
    et al.
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Klinisk mikrobiologi. Linköpings universitet, Hälsouniversitetet.
    Hällgren, Anita
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Klinisk mikrobiologi. Linköpings universitet, Hälsouniversitetet.
    Isaksson, Barbro
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Klinisk mikrobiologi. Linköpings universitet, Hälsouniversitetet.
    Jonasson, Jon
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Klinisk mikrobiologi. Linköpings universitet, Hälsouniversitetet.
    Nilsson, Lennart
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Klinisk mikrobiologi. Linköpings universitet, Hälsouniversitetet.
    Hanberger, Håkan
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Infektionsmedicin. Linköpings universitet, Hälsouniversitetet.
    Genetic relatedness of Enterococcus faecalis isolates with high-level gentamicin resistance from patients with bacteraemia in the south east of Sweden 1994-20012004Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 36, nr 6-7, s. 405-409Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    High-level gentamicin resistant (HLGR) enterococci (Enterococcus faecalis and Enterococcus faecium) have become a substantial nosocomial problem in many countries. In this study, we investigated the prevalence of HLGR enterococci and their genetic relatedness in blood culture isolates from patients with bacteraemia admitted to the 3 hospitals in Östergötland, a county in the south east of Sweden, during 1994–2001. 36 of 250 E. faecalis (14%) and 4 of 106 E. faecium isolates (4%) were shown by PCR to carry the aac(6′)-Ie-aph(2″)-Ia aminoglycoside modifying gene and these isolates were also classified as HLGR enterococci by the gentamicin antibiotic disk diffusion method. A majority of HLGR E. faecalis isolates (83%) belonged to the same cluster of genetically related isolates, according to the pulsed-field gel electrophoresis (PFGE) patterns, whereas all 4 HLGR E. faecium isolates had unique PFGE patterns. In conclusion, our study showed that in contrast to studies from many other countries, the presence of HLGR enterococci was more common in E. faecalis than in E. faecium and appeared the first time in 1996 and 1999, respectively. Bacteraemia with HLGR enterococci in Östergötland was mainly due to the spread of a cluster related of E. faecalis strains.

  • 49.
    Samuelsson, Annika
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Klinisk mikrobiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Klinisk mikrobiologi. Östergötlands Läns Landsting, Centrum för hälso- och vårdutveckling, Vårdhygien.
    Isaksson, Barbro
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Klinisk mikrobiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Klinisk mikrobiologi. Östergötlands Läns Landsting, Centrum för hälso- och vårdutveckling, Vårdhygien.
    Chabok, Abbas
    Uppsala University, Sweden .
    Jonasson, Jon
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Molekylär och immunologisk patologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Klinisk patologi och klinisk genetik.
    Nilsson, Lennart E
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Klinisk mikrobiologi. Linköpings universitet, Hälsouniversitetet.
    Eriksson, Olle
    Linköpings universitet, Institutionen för datavetenskap, Statistik. Linköpings universitet, Filosofiska fakulteten.
    Hanberger, Håkan
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Infektionsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Infektionskliniken i Östergötland.
    Changes in the aerobic faecal flora of patients treated with antibiotics for acute intra-abdominal infection2012Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 44, nr 11, s. 820-827Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: An open observational study was performed to investigate changes in the rectal flora and antibiotic susceptibility among faecal bacteria in patients treated with antibiotics for acute intra-abdominal infection. Methods: One hundred and forty patients with acute intra-abdominal infection requiring antibiotic treatment and hospitalization were included. Eight surgical units from the southern part of Sweden participated, between January 2006 and November 2007. Antibiotic treatments were according to local guidelines. Rectal swabs were obtained on admission (sample 1) and 2-14 days after the end of antibiotic treatment (sample 2). Aerobic bacteria and yeasts were analysed. The material was divided into 2 groups: 1 group with Enterobacteriaceae and 1 group with non-fermentative Gram-negative bacteria. The susceptibility to antibiotics in each group was compared between samples 1 and 2. Results: The main finding of this study on patients with severe intra-abdominal infections was a shift in the aerobic faecal flora following antibiotic treatment, from Escherichia coli to other more resistant Enterobacteriaceae, Enterococcus faecium, and yeasts. The susceptibility to cephalosporins and piperacillin-tazobactam decreased in Enterobacteriaceae. Conclusions: Following antibiotic treatment, a shift in the aerobic rectal flora to species with intrinsic antibiotic resistance was observed. This indicates that the emergence of resistance is not due to new mutations, but rather to selection of more resistant species. This should be taken into account when designing treatments for secondary intra-abdominal infections.

  • 50.
    Schön, Thomas
    et al.
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Medicinsk mikrobiologi. Linköpings universitet, Hälsouniversitetet.
    Gebre, Negussie
    Armauer Hansen Research Institute, Addis Ababa, Ethiopia.
    Sundqvist, Tommy
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Medicinsk mikrobiologi. Linköpings universitet, Hälsouniversitetet.
    Anderaye, Getachew
    Black Lion Hospital, Department of Internal Medicine, Addis Ababa University, Addis Ababa, Ethiopia.
    Britton, Sven
    Armauer Hansen Research Institute, Addis Ababa, Ethiopia.
    Effects of HIV co-infection and chemotherapy on the urinary levels of nitric oxide metabolites in patients with pulmonary tuberculosis1999Inngår i: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 31, nr 2, s. 123-126Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The presence of nitric oxide (NO) and its role as a factor in host defence against intracellular pathogens in human macrophages is controversial. We measured the metabolites of NO (nitrite (NO 2 -) and nitrate (NO 3 -)) in urine from Ethiopian patients suffering from tuberculosis. The urinary level of NO 2 -/NO 3 - in a group of healthy Ethiopians was 1020 ± 471 μM (n = 22). Untreated HIV negative patients with active pulmonary tuberculosis (1574 ± 588 μM, p < 0.01, n = 12) and household contacts to tuberculosis patients (1949 ± 812 μM, p = 0.006; n = 7) had significantly higher levels of urinary NO 2 -/NO 3 -, than the control group. Untreated HIV positive patients with pulmonary tuberculosis did not have increased levels of urinary NO 2 -/NO 3 -, (1101 ± 614 μM, n = 6). Some of the HIV negative untreated patients with pulmonary tuberculosis (1710 ± 519 μM, n = 6) were followed up after treatment and showed a reduction in the levels of urinary NO 2 -/NO 3 - 1 week after treatment (945 ± 599 μM, p < 0.05). We conclude that HIV negative patients with active pulmonary tuberculosis have increased urinary levels of nitric oxide metabolites with a reduction following specific anti-tuberculous chemotherapy.

12 1 - 50 of 61
RefereraExporteraLink til resultatlisten
Permanent link
Referera
Referensformat
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Annet format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annet språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf