Wolfgang R Heizmann

Orgamed Consuling

This corrects the article DOI: 10.1186/s13017-016-0089-y

Intra-abdominal infections (IAI) are an important cause of morbidity and are frequently associated with poor prognosis, particularly in high-risk patients. The cornerstones in the management of complicated IAIs are timely effective source control with appropriate antimicrobial therapy. Empiric antimicrobial therapy is important in the management of...

Necrotizing skin and soft tissue infections (NSTI) form a group of aggressive diseases that require radical debridement for infection control. Simultaneously, a high-dose broad spectrum antibiotic regimen needs to be initiated with control of septic complications in the intensive care setting. The aim of this work is to analyze the efficacy and saf...

Introduction Tigecycline is an established treatment option for infections with multiresistant bacteria (MRB). It retains activity against many strains with limited susceptibility to other antibiotics. Efficacy and safety of tigecycline as monotherapy or in combination regimens were investigated in a prospective noninterventional study involving 1,...

According to the available data, the number of participating intensive care units increased by 180 and that of surgical wards by 249, whereas the total increase in cases of nosocomial infection due to Staphylococcus aureus came to 202, with the proportion of MRSA infection reduced from 32.8% to 26.4%. What was not explained was the extent to which...

Objectives Tigecycline is an approved treatment for complicated skin and soft-tissue infections (cSSTIs). The efficacy of tigecycline as monotherapy or in combination with other antibacterials in the treatment of cSSTI in routine practice is described. Patients and methods Individual patient-level data were pooled from five European observational s...

Objectives: There is limited information on the use of tigecycline in real-life clinical practice. This analysis aims to identify and understand tigecycline prescribing patterns and associated patient outcomes for approved indications. Patients and methods: A pooled analysis of patient-level data collected on the prescription of tigecycline in f...

Objectives: Tigecycline is a broad-spectrum antibiotic approved for the treatment of complicated intra-abdominal infections (cIAIs). The efficacy of tigecycline when administered as monotherapy or in combination with other antibacterials in the treatment of cIAIs in routine clinical practice is described. Patients and methods: Individual patient...

Objectives: Tigecycline is approved for the treatment of complicated skin and soft-tissue infections (cSSTIs) and complicated intra-abdominal infections (cIAIs) in adults. In this analysis the safety and tolerability profile of tigecycline (used alone or in combination) for the treatment of patients with approved indications of cSSTI and cIAI were...

Objectives: Antimicrobial drug resistance is a growing problem in Europe and, even with differences in epi- demiology, it is of great concern. The treatment of complicated skin and soft-tissue infections (cSSTIs) and com- plicated intra-abdominal infections (cIAIs) is hindered further by pathogens that are resistant to methicillin, carbapenems, thi...

This large prospective non-interventional study investigated the effects of tigecycline either as single agent or in combination with other antimicrobial agents in 1,025 patients treated in clinical routine at German hospitals. Sixty-five percent of the patients had APACHE II scores >15, indicating high overall disease severity. Complicated intra-a...

Mortality of sepsis is still high. Crucial for therapeutic response are the early start of treatment as well as the choice of antibiotics or antibiotic combinations. β-lactam antibiotics with bactericidal mode of action are often recommended in guidelines. But this antibiotic class can trigger the immune system to a maximum by releasing cell wall c...

Only few data are available on the efficacy of tigecycline in critically ill patients. This prospective, multicenter, non-interventional study investigated the efficacy and safety of tigecycline in hospitalized, severely ill patients with complicated intra-abdominal infections (cIAI) and/or complicated skin and soft tissue infections (cSSTI). Docum...

The clinical significance of isolation of Candida albicans from mucous membranes of the respiratory or intestinal tract from patients in intensive care units is still debatable. Many patients are colonized; however despite the increased risk, relatively few invasive infections are detectable. This is the rationale why antimycotic therapy in this se...

The clinical significance of isolation of Candida albicans from mucous membranes of the respiratory or intestinal tract from patients in intensive care units is still debatable. Many patients are colonized; however despite the increased risk, relatively few invasive infections are detectable. This is the rationale why antimycotic therapy in this se...

Action of chemotherapeutics on bacteria can be described as “bacteriostatic” or “bactericidal”. In vitro, “bactericidal” agents are able to kill ≥ 99.9% bacteria of the inoculum within 18–24 h. However, “bactericidal” or “bacteriostatic” effects are dependent on several variables, e.g., inoculum, species, or medium. The number of bacteria found in...

Action of chemotherapeutics on bacteria can be described as "bacteriostatic" or "bactericidal". In vitro, "bactericidal" agents are able to kill >or= 99.9% bacteria of the inoculum within 18-24 h. However, "bactericidal" or "bacteriostatic" effects are dependent on several variables, e.g., inoculum, species, or medium. The number of bacteria found...

Levels of the inflammation marker calprotectin in gingival crevicular fluid correspond to clinical and biochemical parameters of periodontal inflammation. Neutrophil granulocytes (polymorphonuclear neutrophils: PMNs) are supposed to be the main source of calprotectin in gingival crevicular fluid, but evidence is still lacking. The influence of peri...

Methicillin-resistente Staphylococcus aureus-Stmme (MRSA) sind inzwischen in vielen Lndern verbreitete Erreger, denen eine besondere Aufmerksamkeit geschenkt wird. In der vorliegenden bersichtsarbeit werden der Resistenzmechanismus, die Epidemiologie der Verbreitung im Krankenhaus (H-MRSA) bzw. in Einrichtungen des Gesundheitswesens (HCA-MRSA) und...

Zusammenfassung Eine Kombination aus ß-Laktam-Antibiotikum und ß-Laktamase-Inhibitor (Clavulansäure, Tazobactam, Sulbactam) erweitert das Wirkungsspektrum des Antibiotikums (z. B. Anaerobier) und führt dazu, dass Erreger mit ß-Laktamase-Bildung zumindest teilweise wieder sensibel gegenüber dem Antibiotikum als eigentlich wirksamer Substanz werden....

Combination of beta-lactam antibiotics and beta-lactamase inhibitors (clavulanic acid, tazobactam, sulbactam) extends the spectrum of the beta-lactam (e. g. anaerobes) and makes pathogens with beta-lactamase production at least partially sensitive to the antibiotic. In Germany, tazobactam and sulbactam are both licensed for therapy of severe infect...

Though guidelines for the management of urinary tract infections (UTI) exist in several European countries, little is known about GPs' adherence, and the appropriateness of their management with regard to antibiotic resistance. To describe German GPs' management of female patients with symptoms of UTI, to assess the diagnostic accuracy of dipsticks...

A cross-sectional study was performed to determine the prevalence of antibiotic resistance in women with uncomplicated and complicated lower urinary tract infection (UTI) in Germany. In 36 (of 118 invited) general practices, urine cultures and resistance testing were performed during 4 months on all women presenting with symptoms of UTI. Each patie...

To explore the prevalence and microbiology of urinary tract infection (UTI) in symptomatic men in a primary care setting and to determine the appropriateness of patient management of these conditions by the general practitioners. A cross-sectional survey was carried out matching documentation of symptoms and management with urine culture and result...

Since the middle of the 1980s,? reports of invasive infections caused by streptococcus pyogenes are increasing world wide. In a retrospective study the frequency, symptoms, course, therapeutic possibilities, and microbiological characterization of this disease were examined. In the study, all 10 patients (seven females/ three males, average age 45....

A previously healthy 32-year-old woman was admitted with shock symptoms 5 days after an uneventful home delivery. She developed a fever up to 39.5 degrees C during the days after delivery with sore throat, diarrhoea and muscle aches in all limbs. On physical examination there were swellings of the arms and lower legs as well as macular and vesicula...

A unique coryneform bacterium was isolated from a patient with bacterial vaginosis. Chemotaxonomical investigations demonstrated that the unknown bacterium belonged to the genus Corynebacterium. The yellow-pigmented, slightly lipophilic, oxidative, urea-hydrolyzing bacterium could be phenotypically readily differentiated from the other members of t...

Due to the increasing use of parenteral therapeutic measures the infection of intravascular devices remains a clinical problem despite better knowledge of routes of infection, improved catheter care, or use of tunnelled catheters. By use of quantitative blood cultures the diagnosis of catheter infection can safely be made without the need to remove...

HISTORY AND CLINICAL FINDINGS: Two hard, pressure-sensitive nodules developed in the lower jaw of a 22-year-old woman. After a dental cause had been excluded, she was treated for suspected tonsillitis with Ceftibuten. Erythrocyte sedimentation rate was increased to 18 mm in the first hour. There were no other significant biochemical findings and fi...

The antimicrobial susceptibility of 196 recent clinical isolates of anaerobic bacteria to ampicillin alone, ampicillin plus 1 mug/ml sulbactam, ampicillin plus 5 mug/ml sulbactam, and cefoxitin was studied by means of agar dilution tests. The ampicillin/sulbactam combination was most effective against species of the Bacteroides fragilis group, the...

An open, multicentre study was performed in hospital in-patients at a total of 12 German hospitals to investigate the efficacy and tolerability of sulbactam combined with mezlocillin, piperacillin or cefotaxime in severe bacterial infections. A total of 155 patients were recruited into the study, of whom 48 were suffering from respiratory tract inf...

Anamnese und klinischer Befund: Bei einer 22jährigen Frau bildeten sich in kurzer Zeit zwei harte, druckschmerzhafte Knoten am linken Unterkiefer. Nach Ausschluß einer dentogenen Ursache wurde sie unter dem Verdacht auf Tonsillitis 8 Tage erfolglos antibiotisch mit Ceftibuten behandelt. Die Blutsenkungsgeschwindigkeit war auf 18 mm in der ersten St...

Multiresistant staphylococci (Staphylococcus aureus and coagulase-negative staphylococci) have become a major problem in hospital hygiene, and a strict observation of hygienic guidelines (disinfection of hands, of the environment or a disinfective body bath) is necessary to prevent intra-hospital spreading. We investigated the efficacy of seven dis...

A total of 59 clinical isolates of Gardnerella vaginalis from women with bacterial vaginosis (BV) were studied with respect to presumptive identification by diagnostic disks, api20STREP and apiZYM. In addition, enzyme patterns of 57 fluorogenic substrates and total fatty acid patterns were determined. During the study two different biotypes were ob...

Unlabelled: G. vaginalis is an important pathogen in the aetiology of bacterial vaginosis. Therefore, we investigated the influence of transport systems in isolation, a scoring system for Gram stains, and susceptibility to antimicrobial agents. The comparison between a simple (Transwab) and a sophisticated (Port-A-Cul) system showed no differences...

During a period of three and a half months 7 neonates from a neonatal intensive care unit became infected by F. meningosepticum, serotype B. The pathogens could be isolated from the tracheal secretions and--less frequently--from throat swabs, gastric juice and nose swabs. Environmental sampling led to the isolation of F. meningosepticum from the hu...

Clostridium difficile and/or toxin B were isolated from the faeces of 3 (1.6%) of 184 patients within the first two days of hospitalisation in the University of Tübingen, Gynaecological Clinic. With following stool samples from a total of 117 patients the isolation rate of C. difficile was examined in relation to the treatment with antibiotics. Fro...

Clostridium difficile und/oder dessen Toxin waren bei 3 (1,6%) von 184 Patientinnen während der ersten zwei Tage des Aufenthaltes in der Universitätsfrauenklinik Tübingen im Stuhl nachweisbar. Von insgesamt 117 dieser Patientinnen konnte mit nachfolgenden Stuhlproben die Isolierungsfrequenz von C. difficile in Abhängigkeit von der stationären Antib...

To assess the association between symptomatic relapse of inflammatory bowel disease (IBD) and superinfection with enteropathogenic microorganisms, we determined prospectively the incidence of infections with enteropathogenic bacteria, protozoa, and helminths in patients with confirmed longstanding IBD. Sixty-four patients with IBD (49 with Crohn's...

Ewingella americana (family Enterobacteriaceae) was isolated separately from both eyes of a 30-year-old woman. Clinical signs and symptoms included adhesive eyelids, itching and edematous upper and lower lids. Therapy with amoxicillin-clavulanate resulted in the relief of symptoms. Ewingella americana can be isolated worldwide, but seems to be a ra...

An open multicenter study on inpatients of 12 german hospitals was performed to investigate efficacy and safety of sulbactam in combination with mezlocillin, piperacillin or cefotaxim in severe bacterial infections. In total 155 patients were enrolled. The following infections were diagnosed: 48 lower respiratory tract infections, 66 intraabdominal...

To assess the in vitro activity of cefpodoxime against anaerobic respiratory tract and oropharyngeal pathogens 77 strains belonging to 18 gram-negative and 7 gram-positive species were studied by means of agar dilution tests. For comparison cefuroxime, amoxicillin, amoxicillin + clavulanic acid and clindamycin were also tested. Cefpodoxime was foun...

Rapid diagnosis and reporting in medical microbiology is becoming more and more important. In recent years, introduction of automated instruments as well as of computer assisted diagnosis contributed to this aim. These methods, however, are very expensive. A more cost efficient and simple to perform method for rapid diagnosis is the use of specific...

The in vitro activities of different daptomycin concentrations in combination with metronidazole (4 mg/l) or/and mezlocillin (8 mg/l) were investigated on mixed bacterial cultures involving gram-positive facultative cocci. Bacteroides fragilis group strains and Escherichia coli. When Streptococcus faecalis alone or together with E. coli was culture...

The structural intactness of many biopolymers in mummified tissues is well documented. By way of contrast no functional evidence of an isolated protein is known. The well defined air dried mummy of a deceased 16±2 year male teenager 1200 B.C. prompted us to search for the possible presence and function of Cu2Zn2Superoxide dismutase or remnants ther...

For rapid identification of Escherichia coli in routine diagnosis of urinary tract specimens we applied the 4-methylumbelliferyl-β-D-glucuronide-(MUG)-fluorescence method. Urinary tract specimens were inoculated directly on Fluorocult-brolacin-(CLED)-agar and examined for blue fluorescence and positive indole reaction 20 h later. Enterobacteriaceae...

The in vitro activity of daptomycin-metronidazole combinations against mixed cultures of gram-positive facultative cocci and strains of the Bacteroides fragilis group was investigated. Metronidazole did not influence the high activity of daptomycin against strains of Staphylococcus aureus, Staphylococcus epidermidis and Enterococcus faecalis in the...

Bacterial interactions in mixed infections may interfere with antimicrobial therapy. The in-vitro efficacy of ampicillin alone, combination sulbactam/ampicillin, and metronidazole was studied. Strains of Bacteroides fragilis, Escherichia coli, and Enterococcus faecalis, alone and in association, were tested by means of a broth dilution method. Mini...

Ein 24jähriger Patient erkrankte nach seiner Rückkehr von einem USA-Aufenthalt mit Diarrhoe, hohem Fieber und einem auffälligen Exanthem mit Beteiligung der Handinnenflächen und Fußsohlen. Aufgrund der Anamnese mit einem Zeckenbiß in den USA wurde schließlich die Verdachtsdiagnose einer Rickettsiose gestellt. Während der Therapie mit zweimal 100 mg...

A multilaboratory collaborative study was undertaken to determine whether the anaerobic disk diffusion test of Horn et al. could be performed reproducibly and accurately. Tests with nine different antimicrobial disks were evaluated. Reproducibility of the agar diffusion disk method was similar to that of the reference agar dilution test procedure....

A multilaboratory collaborative study was undertaken to determine whether the anaerobic disk diffusion test of Horn et al. could be performed reproducibly and accurately. Tests with nine different antimicrobial disks were evaluated. Reproducibility of the agar diffusion disk method was similar to that of the reference agar dilution test procedure....

Clavulanic acid is known to potentiate the activity of amoxycillin and ticarcillin against β-lactamase-producing Bacteroides species. In order to assess the usefulness of the clavulanate antibiotics in mixed infections with aerobes and anaerobes, artificially associated cultures of clinically significant Bacteroides species and facultative anaerobe...

Summary Infections due to coagulase negative staphylococci (CNS) are of growing concern mainly in patients hospitalized in intensive care units (ICU). The ability of CNS to adhere and to grow on plastic devices and resistance to many antibiotics, including oxacillin, contributes to their pathogenicity. Using the computer assisted system of the Medi...

In infections of polymicrobial etiology, it seems mandatory to combine an antibiotic with marginal activity against anaerobes with an anti-anaerobic drug, e.g. metronidazole or clindamycin. We investigated the effect of associations of anaerobic and facultatively anaerobic pathogens on MBCs of enoxacin, clindamycin, metronidazole, and combinations...

Two disposable carbon dioxide/hydrogen gas-generating systems (GasPak Plus and Anaerocult A) were compared by assessing growth of obligate anaerobic bacteria. Eighty strains representing 28 species of anaerobic bacteria commonly occurring at various body sites were seeded onto 4 brain heart chocolate agar plates using a spiral plater; and 1 plate e...

Summary To demonstrate the value of a computer assisted microbiological diagnosis and database system for clinical use, epidemiological aspects of three important infections were investigated: urinary tract, respiratory tract and wound infections. The first two examples presented revealed significant differences in incidence of pathogens between a...

To assess the activity of enoxacin, clindamycin and metronidazole, MICs of clinical isolates of saccharolytic intestinal Bacteroides spp. were determined, using the agar dilution method according to NCCLS guidelines. Checkerboard titrations of enoxacin-metronidazole and enoxacin-clindamycin were done on Wilkins-Chalgren agar; inoculation, incubatio...

Susceptibility of anaerobic clinical isolates from the United States, Canada, and Germany to sulbactam/ampicillin (1 + 2) (SBT/AMP), ampicillin alone (AMP), and cefoxitin (CFX) was determined with a standard agar dilution test. The isolates included 192 strains of Bacteroides fragilis, 132 strains of other Bacteroides spp., and 19 strains of Clostr...

Infections due to coagulase negative staphylococci (CNS) are of growing concern mainly in patients hospitalized in intensive care units (ICU). The ability of CNS to adhere and to grow on plastic devices and resistance to many antibiotics, including oxacillin, contributes to their pathogenicity. Using the computer assisted system of the Medical Micr...

To demonstrate the value of a computer assisted microbiological diagnosis and database system for clinical use, epidemiological aspects of three important infections were investigated: urinary tract, respiratory tract and wound infections. The first two examples presented revealed significant differences in incidence of pathogens between a single p...

The reliability of four commercially available broth microdilution systems (ATB ANA, MHK-Anaerob-Biotest, Dynatech MIC system, Sceptor Anaerobe MIC system) for routine susceptibility testing was evaluated using agar dilution and broth macrodilution as reference methods. Using the categories "susceptible", "moderately susceptible" and "resistant", t...

To assess the specificity and sensitivity of Fluorocult media for the identification of Escherichia coli, the beta-glucuronidase activities of 1,258 bacterial strains, as well as 20 strains of Candida spp., were investigated. Fluorescence of colonies combined with positive indole reaction resulted in specificities of 99.6 to 99.8%. Sensitivities we...

To assess the activity of enoxacin, clindamycin and metronidazole, MICs of clinical isolates of saccharolytic intestinalBacteroides spp. were determined, using the agar dilution method according to NCCLS guidelines. Checkerboard titrations of enoxacin-metronidazole and enoxacin-clindamycin were done on Wilkins-Chalgren agar; inoculation, incubation...

Skin lesions caused or secondarily invaded by Corynebacterium diphtheriae are common in children in tropical countries, being a major reservoir of the organism and leading to early acquisition of immunity. Therefore, travelers living in close contact with the indigenous population are at risk of contracting the disease.

To assess the in vitro activity of flomoxef (6315-S), moxalactam, cefoxitin, cefotaxime, and clindamycin against anaerobes 197 clinical isolates (27 Bacteroides fragilis, 42 B. thetaiotaomicron, 10 B. vulgatus, 7 B. ovatus, 6 B. uniformis, 6 B. distasonis, 7 Bacteroides melaninogenicus group, 11 Bacteroides oralis group, 21 Clostridium difficile, 7...

The results of susceptibility tests performed by the Cobas-Bact system were compared with those of the NCCLS agar diffusion (Kirby-Bauer) and NCCLS agar dilution methods. A total of 998 clinical isolates were tested against 10 to 18 antimicrobial agents. Essential agreement (comprising full agreement and minor discrepancies) varied from 90.5% to 99...

Effect of a Combination of Ampicillin and Sulbactam on Clinical Isolates of Anaerobic Bacteria. The antimicrobial susceptibility of 182 recent clinical isolates of anaerobic bacteria to ampicillin alone, ampicillin plus 1 mg/l sulbactam, ampicillin plus 5 mg/l sulbactam, and cefoxitin was studied by means of agar dilution tests. The ampicillin-sulb...

The applicability of whole-cell protein patterns obtained by sodium dodecylsulfate-polyacrylamide gel electrophoresis as a typing method for Clostridium difficile was examined using a total of 227 strains isolated from 191 patients and their surroundings. Computer-aided densitometric analysis was used to establish a reliable standardization techniq...

Time and accuracy required for diagnosis are two of the most important factors in medical microbiology. Computer-assisted diagnosis is one tool to overcome these problems. The software of such systems, much more than the hardware, is of utmost importance and both have to fulfill several items. 1) High flexibility and integration within the already...

Computer-assisted diagnostic systems may accelerate transmission of microbiological reports and facilitate evaluation of the epidemiological situation and thus improve the collaboration between microbiologists and clinicians. This possible benefit is demonstrated by four examples. It became evident that incidences of pathogens in urinary tract and...

The aim of automated susceptibility testing systems like the Cobas Bact is to provide the clinicians with rapid and reliable results for the care of patients and to decrease the work load in microbiological laboratories. Because data about accuracy on mezlocillin, azlocillin and ciprofloxacin were lacking, we investigated 184 bacterial strains and...

The antimicrobial susceptibility of 195 recent clinical isolates of anaerobic bacteria was studied to ampicillin alone, ampicillin + 1 mg/l sulbactam, ampicillin + 5 mg/l sulbactam, and cefoxitin by means of agar dilution tests. The ampicillin-sulbactam combinations were the most effective drugs against species of the Bacteroides fragilis group, th...

The effectiveness of gastrointestinal and topical decontamination, as well as isolation in laminar airflow (LAF) units were investigated in 20 patients. On a weekly basis, surveillance cultures were taken. Environmental controls were taken on the medical ward outside the two LAF units and from the LAF unit itself when being used by a patient. The u...

Warm and cold water as well as water from wash basin drains and faucet aerators was examined to determine the number of viable and dead bacteria by culture and by staining and to establish the spectrum of species with special consideration of Legionella pneumophila. The relation between the number of Legionella pneumophila, the temperature, and the...