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Introduction: This study aims to gain experience with continuous electronic registration of data regarding postoperative wound infection following heart surgery., Methodology: Every patient undergoing cardiac surgery from February 1999 to May 1999 was included in a prospective study and followed for 30 days. Data regarding type of operation, development of postoperative wound infection, risk factors for wound infection and a risk stratification were submitted electronically to a central database., Results: All 180 operations were registered in the database, and risk variables were registered for all patients but one (99.4%). A spot test comprising 32% of 131 operations registered at the time of the spot test, showed a predictive value of a correctly applied diagnosis of wound infection at 78%. Only 4/7 (57%) of infections in the spot test were registered in the database. All deep wound infections were registered during the study period., Conclusion: Data, including risk stratification, in relation to postoperative wound infection following heart surgery can be registered continuously in a central database. Registration of all wound infections, however, requires several resources and may be incomplete. The present registration's good level of cover concerning deep wound infection and risk variables indicates, that deep wound infection may provide a meaningful indicator of clinical quality, although good risk variables still need to be developed.

At some vaccination centres, it seems to be a clinical observation, that there is a reduction in the number of attacks of herpes labialis following yellow fever vaccination. We therefore conducted a double blind, prospective, randomized study to evaluate the efficacy of yellow fever vaccination against recurrent herpes labialis. Twenty-four patients with culture proven herpes labialis were allocated to either yellow fever vaccination or placebo (saline), with 12 persons in each group. After vaccination/ placebo the patients were followed for one year. The patients returned a letter every other month with information concerning the number of attacks during the period. Comparison of the data from the two groups after one year revealed no significant difference in the number of attacks between the two groups. In conclusion evaluation of the data from this study does not confirm the clinical observation that yellow fever vaccination may act as prophylaxis against herpes labialis.

During purification of the translation initiation factor IF2 from ompT+ strains of Escherichia coli the IF2 is partially degraded in the presence of membrane debris during the first steps of purification. This is a result of proteolytic cleavage by outer membrane protease OmpT [1]. Here we have investigated the activity of OmpT in 51 clinical E. coli isolates of human origin, by a time dependent OmpT activity assay using IF2 as target protein. The activity of OmpT in the outer cell membrane is highly variable among wild type E.coli strains, ranging from no detectable activity in 65% of the strains to a very high activity in 5 strains (10%). The OmpT activity is closely related to the assay temperature and to the growth temperature of the cells, and can be reduced or even eliminated by lowering the temperature of growth. The results open the possibility of using non-denaturing gel electrophoresis of crude cell lysates as a screening method in population genetic studies of initiation factor IF2 and other cytoplasmic proteins which are cleaved by OmpT.

A case of septicaemia in a seven-day-old infant with a gentamicin-resistant strain of Enterobacter cloacae prompted an epidemiological survey in a neonatal unit. Another 18 patients harboured gentamicin-resistant Enterobacteriaceae without symptoms. Control of the outbreak was achieved by cohort nursing, strict hygiene and reduction of aminoglycoside consumption by 50%. Efficiency of the measures was monitored by weekly faecal samples from all patients. All strains produced the aminoglycoside modifying enzyme AAC(3)II. The resistance was plasmid-mediated.

TBE is caused by a Flavivirus and is endemic in certain areas of Central and Eastern Europe, such as Austria, the south of Germany, Hungary, Czechoslovakia, Poland, the former Yugoslavia and SNG and certain areas of Sweden and Finland. Recent developments in the Eastern European countries have made them popular with Danish travellers, who are thus exposed to infection. Until now TBE has been a very rare disease in Denmark. The clinical course is biphasic being preceded by an incubation period of ten days. After the initial phase with uncharacteristic symptoms, a period af about five days follows where the patient has no symptoms. About one-third of the patients develop meningo-encephalitis where paresis can be seen. The course of the disease is often prolonged. The prognosis is good in terms of full recovery and low mortality. The diagnosis is made serologically with haemagglutination-inhibition test or ELISA-technique. Differential diagnosis includes other causes of viral encephalitis and Lyme disease with neurological manifestations, when there is a history of tick-bites. Vaccination provides good protection and is recommended for certain travellers with trips of some duration in endemic areas.

Eighty-six women were admitted for abdominal hysterectomy. Preoperatively, 43 women were culture-positive for Gardnerella vaginalis from the cervical os, and 43 women were culture-negative. Postoperatively, 18 patients developed inflammation; among those 14 patients from the culture-positive group were infected, whereas only 4 patients from the culture-negative group developed inflammation. The difference between occurrence of G. vaginalis and the absence of the bacteria in patients with postoperative infection is highly significant. No such increased risk of postoperative infection was correlated to the isolation of any other microorganism looked for viz. aerobic and anaerobic bacteria, yeasts, viruses or chlamydiae. G. vaginalis may play a causative role in the development of posthysterectomy infection.

Three groups of women were examined by culture for Gardnerella vaginalis and Candida. Group I consisted of 427 women, who complained spontaneously of vaginal discharge, group II of 311 women who did not complain of vaginal discharge until questioned prior to gynaecological examination, and group III of 100 women who denied vaginal discharge. Groups I and II also had cultures made for Trichomonas vaginalis and Neisseria gonorrhoica. In group I with spontaneous complaints the one-year prevalence rate of vaginal discharge was 3.4%. Candida, Trichomonas vaginalis and Neisseria gonorrhoica were cultured in 24%, 8% and 1% respectively. Gardnerella vaginalis was cultured in half of the women in all groups. A characteristic discharge or a positive microscopic finding was related to high concentration of Gardnerella vaginalis. A characteristic discharge even without spontaneous complaints of vaginal discharge was related to a high prevalence of Gardnerella vaginalis. Women complaining from discharge had higher concentrations of Gardnerella vaginalis than non-complaining. This leads to the conclusion that clinical disease may not be present unless concentrations of Gardnerella vaginalis have risen above some minimum level. The Gardnerella vaginalis syndrome defined by positive culture, clinical finding and microscopy was found in 20% of symptomatic women.

Three cases of imported Legionnaires' disease are reported. All 3 patients became ill after their return to Denmark from a holiday tour in northern Italy. High titers of antibodies to Legionella pneumophila in the indirect immunofluorescence (IF) test confirmed the diagnosis. The fact that the onset of illness was within 10 days of the last day the patients spent in Italy strongly suggests that the disease was imported to Denmark from Italy. 10 of the 77 tourists who participated in the study had IF titers of at least 256. Of these 6 had clinical signs of Legionnaires' disease. An additional case of legionella infection occurred months after the case described in this report and was probably contracted in Italy.

A longitudinal, prospective study of herpesvirus hominis (HVH, herpes simplex virus) was carried out in immunosuppressed renal allograft recipients using serologic, virologic and clinical techniques. The final study group consisted of 37 patients of which 31 were followed for at least 2 months and 26 for more than 1 year. A 4-fold rise or more in HVH complement-fixing antibody in relation to titers measured at the time of transplantation was found in 11 patients. Eight of these 11 patients had clinically recognizable herpetic lesions. An additional 9 patients had lesions without titer rise being demonstrable. The 20 of the 37 patients studied (54%) had evidence of active infection with HVH. Because of pain and discomfort herpetic sores were of clinical importance in 11 patients and lasted for 1 month or more in 9. Herpetic keratitis was seen in 3 and left permanent damage to sight in 2. Multiple, extensive, prolonged and sometimes destructive herpetic lesions affected 5 (16%) of all patients studied.

Twenty-four women with uncomplicated acute lower urinary tract infections proven by significant pretreatment bacteriuria (greater than or equal to 10(5) cfu/ml) were treated with a single oral dose of either 200 or 400 mg fleroxacin. Patients were checked for response to treatment five to nine days post therapy. Of the 24 patients initially included in the study, five were not available for assessment of efficacy. In 17 of the remaining 19 women bacteriological cure was achieved.

Hysterectomy was performed in three patients because of persistent irregular vaginal bleeding. Before the operation samples were taken from the cervical os for cultivation of Gardnerella vaginalis, yeasts, viruses, Chlamydia trachomatis, and aerobic and anaerobic bacteria. Immediately after the operation, the uterus was opened under sterile conditions and samples obtained from the isthmus and fundus of the uterine cavity were examined microbiologically. In all three patients G. vaginalis was grown in pure culture from the fundus. Serum antibody titres against G. vaginalis were significantly raised in all three patients, and histology revealed mononuclear cells in the endometrium. The isolation of G. vaginalis from the endometrium of patients with clinical and histological signs of inflammation and with antibodies to G. vaginalis in serum indicates that the organism may play a causative role in endometritis.

Of 291 patients who received renal allotransplants in 1964-74, 94 patients developed 121 bacteremic episodes within the first 6 months after transplantation. The death rate was 38%. The bacteremic episodes occurred mainly during the first 2-3 months after transplantation. In 65% of the episodes bacteremia was secondary to urinary tract infections. The bacteria fourn were most often gram-negative rods such as Escherichia coli, Klebsiella and Proteus. Predisposing factors were ureteral complications such as leakage or necrosis of the ureter, leucopenia, immunosuppression, and source of the kidney. The frequency of bacteremia was the same in patients with infectious and non-infectious primary renal disease.