Search

Bacterial adhesion on titanium implant surfaces has a strong influence on healing and long-term outcome of dental implants. Parameters like surface roughness and chemical composition of the implant surface were found to have a significant impact on plaque formation. The purpose of this study was to evaluate the influence of two physical hard coatings on bacterial adhesion in comparison with control surfaces of equivalent roughness. Two members of the oral microflora, Streptococcus mutans and Streptococcus sanguis were used. Commercially pure titanium discs were modified using four different surface treatments: physical vapour deposition (PVD) with either titanium nitride (TiN) or zirconium nitride (ZrN), thermal oxidation and structuring with laser radiation. Polished titanium surfaces were used as controls. Surface topography was examined by SEM and estimation of surface roughness was done using a contact stylus profilometer. Contact angle measurements were carried out to calculate surface energy. Titanium discs were incubated in the respective bacterial cell suspension for one hour and single colonies formed by adhering bacteria were counted by fluorescence microscopy. Contact angle measurements showed no significant differences between the surface modifications. The surface roughness (Ra) of all surfaces examined was between 0.14 and 1.00 microm. A significant reduction of the number of adherent bacteria was observed on inherently stable titanium hard materials such as TiN and ZrN and thermically oxidated titanium surfaces compared to polished titanium. In conclusion, physical modification of titanium implant surfaces such as coating with TiN or ZrN may reduce bacterial adherence and hence improve clinical results.

Most mucocutaneous surfaces of humans harbor a rich indigenous microbial flora with predominance of anaerobes. Anaerobic infections are usually endogenous indicating that they originate from the host's own flora. Important exceptions are botulism, tetanus, food poisoning by Clostridium perfringens, some cases of gas gangrene and cases of hospital-acquired C. difficile-induced diarrhea. Endogenous anaerobic infections often occur in adjacent to the mucosal surfaces. Other organs are infected by penetration or hematogenous spread. A predisposing condition to anaerobic infections is a low redox potential resulting from tissue destruction, foreign bodies, malignancy or vascular insufficiency. A mixed anaerobic-aerobic infection is often found in abscesses or tissue necrosis. Antimicrobial therapy must take into account that anaerobic infections are often associated with aerobic bacteria.

The national strategy for the use of chemotherapeutics under which there is a distinction between therapeutics and growth promoters for all uses (human medicine, veterinary medicine, animal nutrition) has resulted in a distinct reduction of the selection pressure and a decrease of the OTC resistance among Enterobacteriaceae in the eastern German Länder (formerly GDR) due to a reduction of OTC feeding after 1981 and the final prohibition in 1983. In the following years Enterobacteriaceae were investigated as infectious pathogens for humans and animals using antibiograms. On the one hand, the OTC resistance of porcine and bovine E. coli strains decreased only by 27% and 17%, respectively, during the 1980 to 1988 period, on the other, the OTC resistance of bovine S. typhimurium dropped by 65%, porcine S. typhimurium by 50%, bovine S. dublin by 50%, porcine S. choleraesuis by 30% to a resistance level of about 13% (1989) demonstrating a reduced pressure of resistance. At the same time, OTC resistance became diminished from 50% and 70%, respectively, to 30% also in Enterobacteriaceae (E. coli, Klebsiella) and enterococci isolated from urine and wound infections of patients in the non-agricultural population although therapeutic habits had remained unchanged. The results shown point to a spreading of resistance plasmids which has to be expected far beyond the field of OTC use, for example after the use of antibacterial growth promoters in livestock farming. Control measures should be introduced.

Die Vergleichsstudie umfaste insgesamt 60 Patienten mit chronischen Harnwegsinfektionen. 29 Patienten erhielten Cinoxacin und 31 Nalidixinsaure uber einen Zeitraum von zehn Tagen. Die Therapie verlief bei funf Patienten in der Cinoxacin-Gruppe und neun Patienten in der Nalidixinsaure-Gruppe erfolglos. 11 Patienten in der Cinoxacin-Gruppe und 13 Patienten in der Nalidixinsaure-Gruppe gaben Nebenwirkungen an, die mit der Behandlung in Zusammenhang gebracht werden konnten. Die am haufigsten aufgetretenen Reaktionen waren gastrointestinale Storungen und zentralnervose Erscheinungen. In allen Fallen kam es nach Beendigung der Therapie zu einer raschen Ruckbildung der Nebenwirkungen.

A total of 1299 urine samples from kidney-transplant patients were tested for bacteriuria using the electrochemical rapid procedure. For germ counts of more than 10(5)/ml the registration rate was 97.6% after incubation for 1 hour and 100% after 2 h, providing the patients were not under the influence of antibiotics at the time of examination. Bacteria inhibitors in the urine delayed the reaction so that an incubation period of 2-3 hours was necessary. The electrochemical rapid procedure proved to be unsuitable in cases where small quantities of germs are expected to be discharged.

The chronic pyelonephritis is an unspecific, bacterial, focal, interstitial nephritis with faculative participation of the pyelon. It is differentiated between an obstructive (secondary) and non-obstructive (primary) form. It is referred to the importance of risk factors and risk groups deriving themselves from this. Without doubt, the chronic pyelonephritis is the most frequent renal disease which is confirmed by new statistics of morbidity. The diagnostics still renders difficulties. In a course poor in symptoms it is not thought of the existence of the disease. For the rational dignostics in practice a step plan is recommended. In every case diagnostics should precede therapy. A therapeutic nihilism is to be avoided. A schematic treatment used without criticism and without taking into consideration individual peculiarities, secondary diseases, pregnancy and so on is to be abandoned. Short-term therapy and long-term prevention must be tuned one to another and possibly rationally combined. A plan for the long-term control in the renal dispensary is proposed.

A total of 60 patients with chronic urinary tract infections were included in this comparative study. 29 patients received cinoxacin and 31 nalidixic acid for a period of ten days. There were five therapy failures in the cinoxacin group and nine in the nalidixic acid group. Drug-related side-effects were reported by 11 patients in the cinoxacin group and by 13 patients in the nalidixic acid group. Gastrointestinal and central nervous disturbances were the adverse reactions which occurred most frequently. In all cases side-effects disappeared quickly after therapy was discontinued.

Short-term antibiotic treatment is recommended in infections of the lower urinary tract but its effectiveness is questioned in the upper urinary tract infections. We compared a 5 and a 9 day treatment of experimental E. coli 022 pyelonephritis after unilateral nephrectomy in 127 mal Wistar rats. We used 9 mg gentamycin per kg b.w. twice daily. I131 hippurat excretion was not decreased during the 5 day treatment but was only temporarily diminished during the 9 day treatment. Histologically the severe acute pyelonephritis was decreased after the 9 day treatment but not after 5 days of treatment. Bacteriologically almost all the kidneys were sterile after the 9 day treatment but the majority of the kidneys showed the injected strain of E. coli after the 5 day treatment. The results indicated that the shortened treatment was much less effective in our acute experimental pyelonephritis.

40 uninephrectomized male Wistar rats with an experimental E.-coli-022-pyelonephritis (PN) were treated twice daily for 9 days with 30 mg trimethoprim and 150 mg sulfamethoxazole (TMP-SMO) i.p. Bacteriologically most of the kidneys became sterile. Histologically a significant reduction of the frequency of severe PN was found in the treated group. The biologic half-life of 131I-hippuran indicated a decrease of excretory function which was reversible. Urine osmolality and osmotic clearance were increased after oral water loading in 10 untreated control animals with PN but not in the treated group. The 9 day treatment had a favourable effect bacteriologically, histologically and also on renal function.

Fever reactions in dialysis patients may partly be traced back to the transmission of pyrogens from the rinsing solution compartment into the sanguiferous system. The pyrogen concentration increases with the germ contents of the rinsing solution, which, therefore, should be kept as low as possible by suitable desinfection measures. For the artificial kidney Gambro AK 3 a hot water desinfection of 90 minutes at 90 degrees C or a formalin desinfection of 30 minutes, respectively, for the artificial kidney Leuven IIIC the formalin or peracetic acid desinfection of 30 minutes each proved to be sufficient.

In 37 patients with significant bacteriuria in pregnancy antibody-determinations were carried out by means of bacterioagglutination and indirect hemagglutination. High antibody titres in serum could be detected in 13 patients with clinically acute pyelonephritis. Bacteriurias in connection with chronical pyelonephritis resulted in titres above normal values in few cases only. In no case there was a connection between asymptomatic bacteriurias and an increasing antibody titre.