A total of 980 episodes of clinically and bacteriologically proven septicemia were included in four prospective 1-year studies at a 1,300-bed university hospital in Berlin between 1979 and 1989. The incidence was 8.1 per 1,000 admissions. The percentage of patients with severe underlying diseases increased significantly from 67% to 95% over the decade. Septicemia due to gram-positive bacteria decreased from 47.3% in 1979 to 43.7% in 1986 and increased again to 51.2% in 1989. Septicemia due to gram-negative organisms decreased constantly from 45.0% in 1979 to 39.8% in 1989. The most frequently isolated species were Escherichia coli (26.4%), Staphylococcus aureus (18.9%), coagulase-negative staphylococci (10.2%), enterococci (7.7%), viridans streptococci (6.4%), Klebsiella species (5.5%), and pneumococci (5.0%). The overall mortality rate decreased significantly from 33.6% in 1979 to 20.8% in 1989. Mortality for episodes of septicemia due to gram-positive bacteria (25.5%) was higher than that for septicemia due to gram-negative bacteria (18.3%). Mortality rates associated with polymicrobic and fungal septicemia were higher than the overall mortality rate.

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Dedicated to Professor Matthias Seefelder on the occasion of his 60th birthdayNumerous oligosaccharides, glycoproteins, glycolipids, and gangliosides contain N-acetyl-D-neuraminic acid

Die enzymatische Freisetzung von N‐Acetyl‐α‐D‐neuraminsäure im NMR‐Spektrometer ermöglichte es erstmals, die für unmeßbar schnell gehaltene Mutarotation dieses biochemisch wichtigen Zucker‐Derivats zu messen. Bis vor kurzem wurde angenommen, daß in wäßriger Lösung ausschließlich die β‐Form existiert.

Zusammenfassung: Die ^-NMR-Spektroskopie nen an C-3 (aNeuAc: 5[H(3e)] = 2.72, 6[H(3a)] = erweist sich als geeignete Methode, um die Kon-l.64; ]3NeuAc: 6[H(3e)] = 2.25, Ö[H(3a)] = 1.84) figuration des Spaltproduktes der Neuraminidasen findet man, daß die Neuraminidasen ./V-Acetylzu bestimmen. Der Verlauf der Hydrolyse von neuraminsäure in a.-anomerer Form aus dem Sub-NeuAca2 -» 3 GaljSl -»4Glc (20mM) durch die strat freisetzen. Neuraminidasen aus Clostridium perfringens und Arthrobacter ureafaciens (jeweils 50, 150 undZwei Vorstellungen zum Ablauf der enzymati-800 mU) in 50mM Na/K-Phosphatpuffer pD 5.4sehen Hydrolyse mit Abspaltung als W-Acetylwurde an Hand von l H-NMR-Spektren verfolgt.-D-neuraminsäure unter Erhalt der Konfigura-Mittels der charakteristischen Signale der Proto-tion an C-2 werden diskutiert.-NMR- Summary:The J H-NMR spectroscopy was used C-3 (oNeuAc: 6[H(3e)] = 2.72, 6[H(3a)] =1.64; to study the anomeric configuration of TV-acetyl-0NeuAc: 5[H(3e)] = 2.25, 5[H(3a)] = 1.84) the D-neuraminic acid released by the action of neu-product of the enzymatic cleavage was identified raminidase. The hydrolysis of NeuAca2 -» 3 Gal-to be the 7V-acetylneuraminic acid in the j31 -> 4Glc (20mM) by the enzymes of Clostri-a-anomeric form. dium perfringens and Arthrobacter ureafaciens Two hypotheses are discussed to explain how (50 mU, 150 mU and 800 mU, respectively) in the enzymatic hydrolysis may occur and how 50mM Na/K-phosphate buffer pD 5.4 was ob-N-acetyl-a-D-neuraminic acid leaves the catalytic served by recording the spectra. On the basis site of the neuraminidases with retention of the of the characteristic signals of the protons at C-2 configuration.