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The in-vivo activity of ceftazidime, cefotetan, imipenem/cilastatin, piperacillin and gentamicin against two strains of Klebsiella pneumoniae was evaluated in a model of experimental septicaemia in neuropenic mice. Single agent therapy with the aminoglycoside was highly effective against both strains. Among the beta-lactams, ceftazidime and cefotetan were nearly as active as gentamicin, whereas imipenem/cilastatin was slightly less effective, and the results achieved with piperacillin were markedly inferior. [ABSTRACT FROM AUTHOR]

After administration of 150mg netilmicin samples of CSF and blood were obtained. In one group of nine patients with no or only slight impairment of the blood–CSF–barrier 29 samples of CSF were assayed for netilmicin concentrations. All samples, obtained after the first dose, failed to reveal detectable drug levels. Drug levels up to 0.18 mg/1 were detected in samples of CSF of three patients after 3 to 22 doses. Only the lumbar CSF of one patient contained netilmicin concentrations higher than 1.0 mg/1. In comparison 19 samples of CSF, obtained from patients with meningitis after more than one dose of netilmicin, had levels of 0–27–50 mg/1. Three CSF samples from patients out of this group, collected after the first dose of netilmicin failed to show any drug activity. [ABSTRACT FROM PUBLISHER]

The clinical symptomatology of bacterial septicemias was analysed in 417 patients of a University Hospital in West Berlin. Sepsis was caused by Gram-negative organisms in 229 cases, and by Gram-positive bacteria in 177 cases; 11 cases presented with a mixed type sepsis involving both Gram-positive and Gram-negative pathogens. With the exception of a drop in blood pressure, observed appreciably more often in Gram-negative infections (42.4% of the cases as compared with only 25.4% in the case of septicemia due to Gram-positive organisms, (p less than 0.01), no significant clinical differences were seen between Gram-negative and Gram-positive sepsis. Pathophysiological changes (thrombopenia, leukopenia, coagulopathies) that are considered classical reactions to endotoxin, were also observed in Gram-positive infections. The overall prognosis of septicemia was determined largely by the severity of the underlying pathological condition.

Two cases of encephalitis due to Listeria monocytogenes with lethal outcome are presented. The infection occurred during immunosuppressive treatment for panarteritis nodosa and sarcoidosis, respectively. The pathological-anatomical findings were a diffuse purulent meningoencephalitis in the first case and a focal rhombencephalitis with necrotizing inflammation of brainstem and cerebellum in the second one. Listerial infections of the adult are gaining increasing importance as severe complications of immunosuppressive treatment.

Two months after a severe febrile attack a liver biopsy was performed in a 23 years old female patient with strongly elevated serological antibody levels of toxoplasma infection. The immunohistological investigation of the liver specimen showed the typical demonstration of Toxoplasma gondii in the liver parenchyma. Except a slightly elevated gamma-GT no signs of a "hepatitis" could be demonstrated.

Using the model of an experimental Pseudomonas septicemia in mice, the protective effect of specific antipseudomonal immunoglobulin from rabbits was examined. During bacterial spreading in the bloodstream, a protective effect could be demonstrated under certain conditions. The degree of protection was equivalent to that achieved by active immunization. After bacterial colonization and replication in parenchymal organs no further therapeutic effect could be detected.

Fifty drug addicts with parenteral heroin abuse and tentative diagnosis of acute hepatitis were examined by means of biochemical and serological tests and by liver biopsy. Diagnosis of acute hepatitis was confirmed in 23 patients. 12 patients were examined by liver biopsy a second time 2 months to 18 months later, 3 patients underwent liver biopsy three times. In 80% of the patients markers of hepatitis B (HBsAg, anti-HBs and anti-HBc) were found in the sera. There is some evidence of not only hepatitis B, but also hepatitis non-A, non-B in parenteral drug addicts leading to protracted forms of acute hepatitis and chronic hepatitis.

The entity of the variable pictures of an illness summed up by the description "toxic shock syndrome" has been focussed on by a great number of publications in Northern America since 1978, but has been described scarcely until yet in Germany. An etiological relationship with formerly described "toxic scarlet fever" and "Kawasaki syndrome" is to be discussed. This case in charge deals with a 25-year-old female patient, who developed acutely without any former disease during her menstruation an illness of severe clinical presentation. The findings were high fever, arterial hypotension, and reversible renal failure, watery diarrhea and vomitus , different cutaneous manifestations and signs of disseminated intravascular coagulation, and severe thrombocytopenia with bleeding mucosal ulcerations. Massive growth of Staphylococcus aureus was demonstrable as well as growth of Proteus mirabilis and E. coli in a culture of vaginal smear.

In February 1982 a questionnaire was sent to 2138 doctors in general practice in West Berlin, to obtain data relating to the incidence and treatment of infectious diseases. Replies were received from 453 (21%). Regular bacteriological tests were undertaken only for urinary tract infections, by 60% of those replying. The 453 doctors reported a total of 9280 cases of infectious disease during a one-week period, 6094 respiratory and 1723 urinary ones. Antibiotic prescriptions numbered 6118 during this period, 56.7% for respiratory and 27% for urinary tract infections. Indications for antibiotic treatment were predominantly decided on clinical grounds.

(6R-[6alpha,7beta(R)])-7-[(hydroxyphenylacetyl)amino]-3-([(1-methyl-1H-tetrazol-5-yl)-thio]methyl)-8-oxo-5-thia-1-azabicyclo[4,2,0]oct-2-ene-2-carbonic acid (cefamandole) levels have been determined in human renal tissue, serum, and urine of 17 patients undergoing therapeutic nephrectomies after 3 i.v. applications of 2 g cefamandole. As far as possible levels of renal cortex and renal medulla were investigated separately. The concentrations of the antibiotic in human renal tissues, removed in the interval from 2 h 10 min to 6 h 25 min after last application of the drug, were distinctly above the minimum inhibitory concentrations of most bacterial strains responsible for urinary tract infections and cases of chronic pyelonephritis. Concentrations of the drug were usually lower in renal parenchyma alterated by chronic inflammatory processes than in "normal tissue" of tumor kidneys. With separate determinations of drug levels in the cortical and medullary regions concentrations of the drug were usually higher in the cortical part of the kidney.

The improvement of bacteriological techniques for isolation and identification of anaerobes has led to an increased interest in anaerobic infections. However, anaerobes have only rarely been found in cases of purulent meningitis, representing less than 1 percent of all isolated pathogens. We observed anaerobic meningitis in a patient suffering from multiple lung abscesses from which anaerobic bacteria spread to the brain, causing formation of anaerobic brain abscesses and consecutive meningitis. Microbiological examinations for anaerobes should be performed in those cases of meningitis in which purulent infections of other organs with known or suspected anaerobic etiology are present or in which a traumatic lesion of the subarachnoid space has preceded the development of meningitis.

After administration of 150 mg netilmicin samples of CSF and blood were obtained. In one group of nine patients with no or only slight impairment of the blood-CSF-barrier 29 samples of CSF were assayed for netilmicin concentrations. All samples, obtained after the first dose, failed to reveal detectable drug levels. Drug levels up to 0.18 mg/l were detected in samples of CSF of three patients after 3 to 22 doses. Only the lumbar CSF of one patient contained netilmicin concentrations higher than 1.0 mg/l. In comparison 19 samples of CSF, obtained from patients with meningitis after more than one dose of netilmicin, had levels of 0.27-5.0 mg/l. Three CSF samples from patients out of this group, collected after the first dose of netilmicin failed to show any drug activity.

The article reports on the incidence, the conditions of occurrence, possibilities and successes of treatment with certain (combinations of) antibiotics, in dealing with cases of pseudomonas meningitis. The various possible substances used for treatment are discussed. Rates of penetration and CSF concentrations of azlocillin and cefsulodin are stated. Alternative possibilities for treatment are pointed out.

Levels of amikacin after systemic application of 350 mg were determined by the agar well diffusion method in 12 samples of CSF and serum of 7 patients with bacterial meningitis and in 2 samples of 2 patients with viral meningitis. Only in 2 samples of CSF drawn after the first systemic application of 350 mg i.m. no antibiotic activity was detectable. In 7 specimens of CSF levels of amikacin were greater than or equal to 3 microgram/ml. In 12 tests of CSF of neurosurgical patients with only slight impairment of the blood-CSF-barrier, taken for comparison reasons, only in 6 samples antibiotic activity was found. Only one test revealed CSF-concentration of amikacin higher then 3 microgram/ml.