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Severe infection with multidrug-resistant Salmonella choleraesuis in a young patient with primary sclerosing cholangitis

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World Journal of Gastroenterology 2017年第11期23卷 2086-2089页

作者： Philip G Ferstl Claudia Reinheimer Katalin Jozsa Stefan Zeuzem volkhard AJ Kempf Oliver Waidmann Georgios Grammatikos Department for Internal Medicine I/Gastroenterology and Hepatology University Hospital Frankfurt Institute for Medical Microbiology and Infection Control University Hospital Frankfurt University Center for Infectious Diseases(UCI) University Hospital Frankfurt

Massive global spread of multidrug-resistant(MDR) Salmonella spp. expressing extended-spectrum beta-lactamase(ESBL) and additional resistance to fluoroquinolones has often been attributed to high international mobility as well as excessive use of oral antibiotics in livestock farming. However, MDR Salmonella spp. have not been mentioned as a widespread pathogen in clinical settings so far. We demonstrate the case of a 25-year-old male with primary sclerosing cholangitis who tested positive for MDR Salmonella enterica serotype Choleraesuis expressing ESBL and fluoroquinolone resistance. The pathogen was supposedly acquired during a trip to Thailand, causing severe fever, cholangitis andpancreatitis. To our knowledge, this is the first report of Salmonella enterica serotype Choleraesuis in Europe expressing such a multidrug resistance pattern. ESBL resistance of Salmonella enterica spp. should be considered in patients with obstructive biliary tract pathology and travel history in endemic countries.

关键词： Biliary physiology Infectious disease Multidrug resistance Primary sclerosing cholangitis Salmonella choleraesuis

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基于生态保护的河流与近海水域的管理

中国水利 2005年第21期 37-39页

作者： volkhard Wetzel 肖发光德国联邦水文学会

德国是人口居住稠密的国家,大部分地区因经济和社会发展的需要而被开发利用,纯天然的自然环境已所剩无几。为了保护剩下的宝贵资源,与河流、近海水域管理有关的工程活动应以生态保护为导向,以尽量减少,甚至要努力防止对环境的不良影响... 详细信息

德国是人口居住稠密的国家,大部分地区因经济和社会发展的需要而被开发利用,纯天然的自然环境已所剩无几。为了保护剩下的宝贵资源,与河流、近海水域管理有关的工程活动应以生态保护为导向,以尽量减少,甚至要努力防止对环境的不良影响。为了实现这个目标,德国联邦水文学会已经成功制定并实施了大量的以生态保护为导向的指导方针。

关键词：生态保护河流近海水域

西南非洲刚果离岸近海沉积麻坑下的气体运移与气体水合物聚集的三维地震与声波成像

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海洋地质 2006年第3期22卷 71-80页

作者： Lars Zuhlsdorff[德国] volkhard Spie[德国] 梁蓓雯（译）徐华宁（校）

早期的刚果盆地位于南纬5°刚果峡谷北部，其中的麻坑是气体水合物大量存在且有明显的流体渗漏的典型。麻坑位于刚果离岸的大陆边缘处，以近海沉积为特征。德国R／VMeteor调查船在M47／3与M56航次中，为使每一深度的横向与垂向分辨率最... 详细信息

早期的刚果盆地位于南纬5°刚果峡谷北部，其中的麻坑是气体水合物大量存在且有明显的流体渗漏的典型。麻坑位于刚果离岸的大陆边缘处，以近海沉积为特征。德国R／VMeteor调查船在M47／3与M56航次中，为使每一深度的横向与垂向分辨率最优化并将较深部的处理与表面表现相联系，采集了地震、声学与海表面测绘等系列数据。数据上可观察到不同规模的海底塌陷与反相散射振幅，以及地震反射振幅的局部变化，包括柱状空白带与断层和其它潜在的流体通道附近的强振幅带：大多数的观测结果可能与流体活动出口有关，海底录像与取样结果也证实这些观测结果。由于此位置与渗流相关的过程叠合了一个非常确定的地质背景，因此刚果盆地的麻坑为气体水合物基本控制参数的研究提供了一个天然的试验条件。

关键词：多范围地震与声学研究海底麻坑气体水合物浅层气流体运移近海沉积被动大陆边缘

Influence of antibiotic-regimens on intensive-care unit-mortality and liver-cirrhosis as risk factor

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World Journal of Gastroenterology 2016年第16期22卷 4201-4210页

作者： Mireen Friedrich-Rust Beate Wanger Florian Heupel Natalie Filmann Reinhard Brodt volkhard AJ Kempf Johanna Kessel Thomas A Wichelhaus Eva Herrmann Stefan Zeuzem Joerg Bojunga Department of Internal Medicine I (Gastroenterology Pulmonology Endocrinology) J.W. Goethe-University Hospital Institute of Biostatistics and Mathematical Modeling Faculty of Medicine J.W. Goethe-University Department of Internal Medicine II (Infectious Disease Oncology Hematology) J.W. Goethe-University Hospital Institute of Medical Microbiology and Infection Control J.W. Goethe-University Hospital

AIM: To assess the rate of infection, appropriateness of antimicrobial-therapy and mortality on intensive care unit(ICU). Special focus was drawn on patients with liver ***: The study was approved by the local ethical committee. All patients admitted to the Internal Medicine-ICU between April 1, 2007 and December 31, 2009 were included. Data were extracted retrospectively from all patients using patient charts and electronic documentations on infection, microbiological laboratory reports, diagnosis and therapy. Due to the large hepatology department and liver transplantation center, special interest was on the subgroup of patients with liver cirrhosis. The primary statistical-endpoint was the evaluation of the influence of appropriate versusinappropriate antimicrobial-therapy on ***: Charts of 1979 patients were available. The overall infection-rate was 53%. Multiresistantbacteria were present in 23% of patients with infection and were associated with increased mortality(p < 0.000001). patients with infection had significantly increased in-hospital-mortality(34% vs 17%, p < 0.000001). Only 9% of patients with infection received inappropriate initial antimicrobial-therapy, no influence on mortality was observed. Independent risk-factors for in-hospital-mortality were the presence of septicshock, prior chemotherapy for malignoma and infection with pseudomonas spp. Infection and mortality-rate among 175 patients with liver-cirrhosis was significantly higher than in patients without liver-cirrhosis. Infection increased mortality 2.24-fold in patients with cirrhosis. patients with liver cirrhosis were at an increased risk to receive inappropriate initial antimicrobial ***: The results of the present study report the successful implementation of early-goal-directed therapy. Liver cirrhosis patients are at increased risk of infection, mortality and to receive inappropriate therapy. Increasing burden are multiresistant-b

关键词： Intensive care unit Sepsis-bundle Early goal-directed therapy Liver cirrhosis Mortality