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Aim: The aim has been to create and maintain a list of all medical candidates from the University of Southern Denmark, Odense., Materials and Methods: All medical graduates from 1972 to 2001 are included. Surveys have been performed 1997 (25) and 2000. Appr. 50% came from grammar schools in the County of Funen, 20-25% from other counties in Southern Denmark, i.e. Southern Jutland, and 15% from Copenhagen or from Northern Jutland. In the 1990'es more came from Northern Jutland., Results: The duration of the medical study increased from a modus of 6-7 years in the 1970'es to a modus of 7-8 years since 1980. About 45% became general practitioners after four to 25 years (median 14 years), one third of them in the County of Funen, and another third in Southern Jutland. In the 1997 survey 25% became consultants after 11-17 years (median 14 years), in the 2000 survey it increased to 35% after 11-25 years (median still 14 years). The cumulated death rate was 7% for the ages 30-58 years, significantly lower than that of the general population. At twenty years after graduation 85% were medical specialists, at ten years the rate was 40%. Education in anaesthesiology, ophthalmology, oto-rhino-laryngology, and oncology took less than ten years, general medicine 12 years, and 15 years for internal medicine and even longer for surgery, paediatrics, and psychiatry., Conclusion: The medical school, Odense, recruits 82% of its students from Southern Denmark. Of the graduates since 1975 who became general practitioners two thirds have settled in Southern Denmark, of the consultants one half. It is not yet possible to predict when new surveys will be feasible. This article is a continuation of the study of the first survey published in Ugeskr Laeger 2000;162:1547-51 (25).

The aim was to create and maintain a registration of all medical graduates from Odense University from the first graduates in 1972 and to describe the graduates' background and subsequent professional employment. All graduates from 1972 to 1998 are included. About 55% of the graduates came from secondary schools in the country og Funen, 20% from southern Jutland and 15% from Copenhagen and Jutland north of Vejle. About 45% became general practitioners after 5-22 years (median 11 years), a third of them in the county of Funen. Twenty-five percent became consultants after 11-17 years (median 14 years), twenty-five percent of these in the county of Funen. The cumulated death rate was 5% for the ages 30-55 years. At 17 years after graduation 83% had become specialists, at ten years the number was 55%. In conclusion, Odense University recruits 75% of its medical students from southern Denmark. Of the graduates that become general practitioners, about two-thirds are employed in southern Denmark, for consultants the corresponding figure is 50%.

Seventy-eight patients with culture-positive epidural catheters were studied. Fifty-nine had symptoms of exit site infection and 11 patients had clinical meningitis, two of whom also had en epidural abscess. This corresponds to a local infection incidence of at least 4.3% and an incidence of central nervous system infection of at least 0.7% at Odense University Hospital. The patients with generalized symptoms of infection had been catheterized for a longer time, and were older than patients with only local symptoms of infection. The microorganisms isolated from the epidural catheters were coagulase- negative staphylococci (41%), Staphylococcus aureus (35%), Gram-negative bacilli (14%) and other bacteria (10%). The Gram-negative bacilli and S. aureus caused serious infections more frequently than the others. We discuss the symptoms and diagnosis of spinal epidural abscess and propose prophylactic and diagnostic guidelines for epidural catheter-related infections.

Fifty-nine patients were operated or punctured in 60 incidents of brain abscess from 1963-1989, twice as many in men as in women. The number of cases tripled in 1980 to an incidence of 3.6 per million inhabitants per year, supposedly due to the advent of computerized tomography. Simultaneously, the aetiology changed from staphylococci and Gram negative rods to dominance of streptococci and Haemophilus aphrophilus. Apart from temporal abscesses, there was no correlation between localisation in the brain and the bacterial species isolated. Ninety-five per cent of the specimens from untreated patients gave growth, but so did specimens from six of 18 patients treated with relevant antibiotics up to 11 days before puncture. Therefore, we recommend removal of pus by excision or puncture.

From Nov. 15 to Dec. 17, 1977, Pseudomonas cepacia was isolated from the blood of 16 patients in Odense, Denmark, and Nijmegen, Holland, 2--5 days after an operation with general anaesthesia. The fever started 14--70 h after operation and lasted 2--4 days. All patients recovered. 14/15 patients examined 7--51 days later had agglutinating antibody titres of 400-3,200 against the epidemic strain. Ps. cepacia with identical biochemical characters and sensitivity pattern was isolated from unbroken vials containing the anaesthetic fentanyl, which had been given to all 16 patients. Two batches were contaminated, one heavily so (10(4)--10(5) cfu/0.1 ml). Seven other batches examined yielded no growth. The preservative added to the vials was a mixture of methyl- and propyl-p-hydroxybenzoates which not only allowed growth of the Ps. cepacia strain but could also serve as a carbon source as did citric and malonic acids. The concentration of preservative was not reduced in contaminated vials. The vials had not been sterilized after closure; too much reliance had been placed on an aseptic technique and insufficient preservatives.

The in vitro susceptibility to cephalothin and cefuroxime of 195 isolates of methicillin-resistant coagulase-negative staphylococci was determined by the agar-diffusion test, using 7.5% NaCl-supplemented agar. The distribution of the inhibition zone diameters for isolates of S. epidermidis (S. biotype 1) as well as for S. haemolyticus (S. biotype 4) was trimodal. While 4% of the isolates were found susceptible to cefuroxime, 39% of the S. epidermidis/S. hominis (S. biotype 1) isolates and 34% of the S. haemolyticus (S. biotype 4) isolates were found susceptible to cephalothin by this method. Eight of these isolates (six S. epidermidis, two S. haemolyticus) were selected for susceptibility testing by the tube-dilution method, together with four isolates (three S. haemolyticus, one S. epidermidis) found resistant to cephalothin by the agar-diffusion test. The first-mentioned isolates were all found susceptible to cephalothin with MICs less than or equal to 2 micrograms/l, while the last-named all were resistant with MICs greater than or equal to 16 micrograms/ml. Population analyses revealed sub-populations of highly resistant bacteria in all methicillin-resistant isolates of S. epidermidis (S. biotype 1), as well as in all isolates of S. haemolyticus (S. biotype 4). We thus concluded that methicillin-resistance in isolates of coagulase-negative staphylococci implies resistance to cephalosporins and that the difference between S. epidermidis and S. haemolyticus as regards cephalosporin-susceptibility is quantitative and not qualitative. Eighty-nine per cent of the 195 methicillin-resistant isolates in this study were resistant to penicillin and at least one more antibiotic. We therefore think that resistance to penicillin and one or more non-beta-lactam antibiotics strongly suggests methicillin-resistance and that such isolates should be further tested on hypertonic media.

Population analyses of susceptibility to ampicillin in ampicillin-susceptible and ampicillin-resistant strains of Achromobacter xylosoxidans revealed the existence of ampicillin-resistant subpopulations in ampicillin-susceptible isolates. Bacteria resistant to a concentration four times the one that inhibited the majority population had a frequency of 10(-3) to 10(-4). Strains isolated from aqueous environments are often found susceptible to ampicillin, while sporadic cases of infections with A. xylosoxidans are often caused by ampicillin-resistant strains. We suggest that the isolation from clinical specimens of ampicillin-susceptible strains, therefore, may be an indication of nosocomial infections due to recently contaminated aqueous solutions or medical equipment.