Human intestinal spirochetosis, characterized by end-on attachment of densely packed spirochetes to the epithelial surface of the large intestines as a fringe has been associated with the weakly beta-hemolytic spirochetes Brachyspira aalborgi and Brachyspira (Serpulina) pilosicoli. In this study, fluorescent in situ hybridization with oligonucleotide probes targeting 16S or 23S rRNA of B. aalborgi, B. pilosicoli, and the genus Brachyspira was applied to 40 sections of formalin-fixed, paraffin-embedded intestinal biopsy specimens from 23 Danish and 15 Norwegian patients with histologic evidence of intestinal spirochetosis. Five biopsy specimens from patients without intestinal spirochetosis and three samples from pigs with experimental B. pilosicoli colitis were examined as well. In addition, the 16S ribosomal DNAs of two clinical isolates of B. aalborgi were sequenced, and a PCR procedure was developed for the identification of B. aalborgi in cultures. The genotypic characteristics of the two clinical isolates showed very high (99.5%) similarity with two existing isolates, the type strain of B. aalborgi and a Swedish isolate. Hybridization with the Brachyspira genus-specific probe revealed a brightly fluorescing fringe of spirochetes on the epithelia of 39 biopsy specimens, whereas 1 biopsy specimen was hybridization negative. The spirochetes in biopsy specimens from 13 Danish and 8 Norwegian patients (55.3%) were identified as B. aalborgi. The spirochetes in the biopsy specimens from the other 17 patients hybridized only with the Brachyspira probe, possibly demonstrating the involvement of as-yet-uncharacterized Brachyspira spirochetes in human intestinal spirochetosis.Human intestinal spirochetosis (HIS) is a condition of the large intestinal mucosa microscopically characterized by colonization and extensive end-on attachment of densely packed spirochetes to the epithelial surface (16). The spirochetes are easily demonstrated in hematoxylin-eosin-stained biopsy sections as a diffuse blue fringe 3 to 6 m thick. The colonization is usually associated with no or only minor morphologic and inflammatory reactions in the mucosa (16,17,23,36). Ultrastructurally, spirochetes are attached perpendicular to the epithelial membrane between the microvilli, which appear shorter or depleted (11,17,23,36). However, more severe lesions with spirochetal invasion of the epithelium and the adjacent lamina propria together with purulent discharge may occur (15,27,30,42). HIS is a morphological description based on microscopic examination of biopsy samples. Hence, most reports have outlined histologic and electron microscopic findings, whereas there have been only a few reports of concurrent culturing of spirochetes from the same individuals (11,15,17,36), and two species, Brachyspira aalborgi and Brachyspira (Serpulina) pilosicoli, have been identified (17,36).Recently, the phylogeny of intestinal spirochetes has been studied by multilocus enzyme electrophoresis (20, 21), polyacrylamide gel electrophoresis (7), pulsed-field gel el...

On the weekend of 21-22 May, it was reported that 101 patients and 76 employees at the two Aalborg Hospitals

All episodes of bacteraemia during a 15-year period (1981-1995) in the County of Northern Jutland, Denmark, were analysed with regard to antibiotic resistance. A total of 8840 isolates from 7938 episodes of bacteraemia was identified. Over time, no changes in bacterial aetiology were noted. Three isolates of Staphylococcus aureus were methicillin resistant (0.2%) and six were gentamicin resistant (0.4%). Among coagulase-negative staphylococci a 14% increase in resistance to penicillin was observed (95% confidence intervals, CI: 2-26%). Likewise, the frequency of resistance to methicillin, gentamicin and erythromycin increased, the corresponding figures being 38% (CI: 26-50%), 26% (CI: 14-38%) and 32% (CI: 16-50%), respectively, whereas a 14% decrease in resistance to streptomycin was recorded (CI: 4-24%). A 20% (CI: 2-37%) increase of coagulase-negative staphylococci resistant to three or more antibiotics was observed. The frequency of ampicillin resistance increased by 9% among Escherichia coli (CI: 4-13%) and by 10% (CI: 6-14%) in all Enterobacteriaceae. Among Enterobacteriaceae the level of resistance to third-generation cephalosporins, carbapenems, aminoglycosides and fluoroquinolones remained low (< 1 YO). The frequency of resistance to three or more antibiotics remained fairly stable among Enterobacteriaceae, although a slight increase was noted among E. coli (5%; CI: 0-10%) The recommended regimen for empirical antibiotic treatment in this region (a combination of penicillin G or ampicillin and an aminoglycoside) provided an overall coverage of 94% (CI: 94-95%), although a slight decrease was noted at the end of the period. In conclusion, acquired antibiotic resistance was maintained at a low level compared with most other European countries and regions during the 15-year period studied.

Summary. 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.

The renal elimination of vancomycin has been determined in 18 patients. In 4 anuric patients in intermittent haemodialysis the dosage of vancomycin necessary to treat infections with penicillin‐resistant strains of Staphylococcus aureus was determined. In 14 patients with varying degrees of renal insufficiency vancomycin, creatinine and 125iothalamate clearances were measured and found to be closely correlated. After administration of the initial vancomycin dose and attainment of the serum concentration desired, the maintenance dose can be calculated on the basis of the GFR.