Originalartikel: Et paradigmeskifte
A paradigm shift
Bibl Læger 2016;208:304-23.
Clinical microbiology identifies microorganisms in patient samples and is essential for categorization and treatment of infectious diseases. At the end of the 19th century, the germ theory of disease gradually replaced the previous miasmatic theory, which postulated that the origin of epidemics was due to rotting organic matter that polluted the air with so-called miasma. While scabies and favus were recognized as parasitic human diseases in the first half of the 19th century, the progress of bacteriology around 1880 was decisive for the new understanding of infectious diseases. Moreover, improved microscopes and techniques for preparation and propagation of pure bacterial cultures in the laboratory were crucial for the development. In this article, Danish medical discussions and controversies prior to the acceptance of the germ theory are exemplified.
Originalartikel: Mikrobiologi som medicinsk laboratoriedisciplin i Danmark
Hans Jørn Kolmos
Medical microbiology as a laboratory discipline in Denmark.
Bibl Læg 2016;208:324-41.
The physiologist Peter Ludvig Panum (1820-1885) and the bacteriologist Carl Julius Salomonsen (1847-1924) played key roles in establishing medical microbiology as a laboratory discipline in Denmark. Panum was a professor of physiology at Copenhagen University. In 1867, he established the first Danish laboratory with facilities to study bacteria, and here he supervised Salomonsen and other young scientists. Panum himself made significant contributions to microbiology by describing the clinical effects of “putrid poison”, which shows striking similarities with bacterial endotoxins. He realized that “putrid poison” could be a bacterial product and predicted a future therapy with antibacterial and antitoxin agents. Salomonsen was the first Danish medical doctor to perform bacterial examinations in order to establish the cause of a patient’s disease. These studies took place in 1873-1874, while he served as a young doctor at Kommunehospitalet, the Municipality Hospital in Copenhagen. He continued his microbiology career at Copenhagen university, first as a lecturer of bacteriology (launched in 1883 and considered the first of its kind in Europe), later as professor of general pathology. He was a pioneer of the production of diphtheria serum and a driving force behind the creation of Statens Serum Institut, where he served as a director 1902-1910.
Originalartikel: Kai Adolf Jensen, professor i almindelig patologi
Kai Adolf Jensen, professor of general pathology
Bibl Læger 2016;208:344-61.
Kai Adolf Jensen (1894-1971) became responsible for diagnosis of tuberculosis at Statens Serum Institut. He developed an improved medium for cultivation of mycobacteria allowing discrimination between Mycobacterium tuberculosis and M. bovis (Löwenstein-Jensen medium). He was also responsible for the Bacillus Calmette-Guérin vaccine production and supervised many young scientists’ doctoral theses on the aspects of tuberculosis. He became internationally recognized, and he revealed an important scientific fraud in the laboratory of the Austrian professor Ernst Löwenstein (1878-1950), who claimed that he could detect M. tuberculosis in blood cultures as a cause of a multitude of diseases. He was a pioneer in eradication of bovine tuberculosis in Denmark which became the first country in the world where this happened. Kai Adolf Jensen held the position as professor of general pathology from 1940 to 1965. In 1941, during the German occupation of Denmark in 1940-1945, he isolated a penicillin-producing Penicillium mold, which Leo Pharmaceutical Company used in the production of penicillin, and consequently Danish patients could be treated during the war. Soon thereafter, Danish penicillin was exported to a number of countries. Kai Adolf Jensen supervised many young scientists in the field of antibiotics and chemotherapy, and he had a unique impact on treatment of infections in Denmark.
Et billede fra min hverdag I
Jeanette Drost Thomsen
Originalartikel: Hans Lautrop – en pioner inden for dansk mikrobiologi
Wilhelm C. Frederiksen, Brita Bruun & Mogens Kilian
Hans Lautrop – a pioneer in clinical microbiology
Bibl Læger 2016;208:364-71.
Hans Lautrop (1912-1987) succeeded Dr. Martin Kristensen (1888-1984) as head of the Department of Diagnostic Bacteriology at Statens Serum Institut in 1958, a position he held until his retirement in 1977. He played a crucial role in the establishment of clinical microbiology as a medical specialty in Denmark in 1966, and he organized the training programme for the coming medical specialists. He was an eminent teacher who was personally in charge of the theoretical and practical training in bacteriology, besides supervising doctoral theses and other scientific publications for his protégés. Hans Lautrop was the first president of the Danish Society of Clinical Microbiology, established in 1969. He was also a key player in the decentralization of clinical microbiological laboratories in Denmark. He made significant contributions to bacterial taxonomy, mainly within Gram-negative bacilli (e.g. Pseudomonas, Moraxella and Pasteurella). He established international collaborations with scientists with similar interests, often based on study tours to their laboratories. His deep insight into taxonomic principles led to his membership of the International Committee on Bacteriological Nomenclature and some of its subcommittees. He also contributed to several editions of “Bergey’s Manual of Determinative Bacteriology”, and was a member of its Board of Trustees in 1975-1980, whereby he was conducive in renaming it “Bergey’s Manual of Systematic Bacteriology”.
Historiske noter: Otto Friderich Müller – bakteriologen på Frederiksdal Slot
Otto Friderich Müller – the bacteriologist at Frederiksdal Castle
Bibl Læger 2016;208;372-81.
In 1753, Otto Friderich Müller (1730-1784) became a private tutor at Frederiksdal Castle close to Copenhagen. He remained so for 18 years. During these years, he also became a dedicated naturalist, studying the surrounding nature also using microscopes. He became editor of five volumes of “Flora Danica” and of “Zoologia Danica”. His microscopical studies dealt with infusoria, posthumously published as “Animalcula infusoria”, describing 379 species. Most of these were species of Protozoa, but a few were bacteria, one in the genus Monas and six in the genus Vibrio. Two of the six Vibrio species have remained recognized up until recent times: V. spirillum (Spirillum volutans) and V. serpens (Aquaspirillum serpens). Müller was the first Danish microbiologist. He realized that bacteria constituted a natural group of organisms, and he established a classification system for microorganisms based solely on morphology.
Et billede fra min hverdag II
Originalartikel: Det frelsende mug - Samarbejder og kampe om den første danske penicillin
The healing mould. Rivalry and co-operation concerning the first Danish penicillin
Bibl Læger 2016;208:384-413.
In this article, the first attempts made by two Danish pharmaceutical companies to develop and massproduce the first Danish penicillin, in the years spanning 1942 and 1943, are investigated. Penicillin was originally developed and mass-produced in Great Britain and the USA during World War 2. Massive government interventions into business and science in the USA and Great Britain laid the foundation for the large scientific development that was penicillin. The technological development that made penicillin possible became the midwife of the biomedical pharmaceutical industry after the war. In Denmark, this development happened during the German occupation of Denmark, and one pharmaceutical company had successfully managed to make and mass-produce penicillin before Denmark was liberated in May 1945. In this article the process leading to the creation of the first Danish penicillin is investigated briefly.
Et billede fra min hverdag III
John-Erik Stig Hansen
Originalartikel: Dansk antibiotikapolitik gennem tiderne
Danish antibiotic policy over the years
Bibl Læger 2016;208:416-24.
The increase in antibiotic resistance is the cause of much concern. In Denmark, resistance has remained low, and penicillin is still the main antibiotic used in primary care. An early understanding of the relationship between extended antibiotic use and resistance was seen among Danish physicians, and this was learned the hard way during the epidemic of methicillin-resistant Staphylococcus aureus from 1965-1975. Understanding the clonal outbreak as related to consumption of tetracyclin and streptomycin in hospitals curbed the epidemic. Clinical microbiology as a medical specialty was introduced in 1966. The first national antibiotic guideline was published in the pharmaceutical reference book in 1984 and extended courses in antibiotic use were established for hospital and primary care physicians. An outbreak of vancomycin-resistant Enterococcus faecium in production animals (caused by continued use of the growth promoter avoparcin) illustrated the misuse of antibiotics in husbandry. Growth promoters were then banned by the European Union. The Danish monitoring program (DANMAP) was initiated in 1996, followed in 1998 by the Microbial Threat Conference in Copenhagen that laid the foundation for an EU recommendation on rational antibiotic use.
Originalartikel: Dansk stafylokokovervågning og -forskning 1955-2015
Henrik Westh, Robert Skov, Hans Jørn Kolmos & Vibeke Rosdahl
Danish staphylococcus surveillance and research 1955-2015
Bibl Læger 2016;208:425-34.
Staphylococcus aureus is a resourceful microorganism and has shown a constant ability to acquire multiple resistance and virulence genes over the last 60 years. Typing of S. aureus has led to the understanding of clonal expansion. Phage typing was introduced in 1955, and controlling S. aureus led to the establishment of the Staphylococcus Laboratory at Statens Serum Institut in Copenhagen in 1957. From the late 1950s, all S. aureus bacteraemic isolates have been collected along with relevant epidemiological data. This article describes the clonal evolution of S. aureus in Denmark along with the evolution of typing methods moving from phage typing, pulsed-field gel electrophoresis, spa-typing with multilocus sequence typing to whole genome sequencing. An epidemic curve for methicillinresistant S. aureus (MRSA) was seen in Denmark from 2003, and a reinforcement of the search and destroy policy led to new national guidelines for MRSA in 2006. The policy has so far kept MRSA from becoming endemic in Danish hospitals, although a number of large MRSA outbreaks have craved extensive handling. Over the latest ten years, CC398 from pigs has become a major contributor to MRSA in the Danish population.
Et billede fra min hverdag IV
Peter Qvortrup Geisling
Interview: Økosystemet mennesket – En samtale med museumsinspektør Adam Bencard om symbiosen mellem menneske og mikrobe