Subject(s)
Attitude of Health Personnel , Cardiopulmonary Resuscitation , Defibrillators , Emergency Medical Services/legislation & jurisprudence , Heart Arrest/therapy , Cardiopulmonary Resuscitation/education , Cardiopulmonary Resuscitation/ethics , Cardiopulmonary Resuscitation/psychology , Defibrillators/ethics , Defibrillators/psychology , Education, Medical, Continuing , Emergency Medical Services/methods , Heart Arrest/psychology , Humans , Supreme Court Decisions , United StatesABSTRACT
Of 326 high vaginal swabs taken during the antenatal period, Group B Streptococcus (GBS) was isolated from the birth canal in 46 women, giving a carrier rate of 14.1%, which is within the often quoted range of between 5% - 25% in different parts of the world. Carriage rates were similar at different gestations. In a subgroup of 34 women, 2 swabs taken at least 5 weeks apart yielded results which were discordant in over one fifth of the time. This knowledge of the natural history of GBS carriage questions the practice of treating asymptomatic carriers of GBS in the antenatal period to prevent transmission of GBS to the neonate. The group of women with positive swabs in the antenatal period did not have a significantly higher incidence of preterm labour and/or prelabour rupture of membranes (PROM) compared with the group of women with negative swabs. Routine screening of the antenatal population for GBS carrier status prior to 32 weeks gestation may not identify women at high risk of PROM or preterm labour.
Subject(s)
Carrier State/microbiology , Fetal Membranes, Premature Rupture/microbiology , Obstetric Labor, Premature/microbiology , Pregnancy Complications, Infectious/microbiology , Streptococcal Infections/microbiology , Streptococcus agalactiae/isolation & purification , Vaginosis, Bacterial/microbiology , Adult , Carrier State/diagnosis , Carrier State/prevention & control , Female , Fetal Membranes, Premature Rupture/diagnosis , Fetal Membranes, Premature Rupture/prevention & control , Gestational Age , Humans , Infant, Newborn , Mass Screening , Obstetric Labor, Premature/diagnosis , Obstetric Labor, Premature/prevention & control , Pregnancy , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/prevention & control , Streptococcal Infections/diagnosis , Streptococcal Infections/prevention & control , Streptococcus agalactiae/pathogenicity , Vagina/microbiology , Vaginal Smears , Vaginosis, Bacterial/diagnosis , Vaginosis, Bacterial/prevention & controlABSTRACT
We compared multiplex polymerase chain reaction (PCR) and culture for detecting the presence of Legionella pneumophila and Legionella spp in cooling tower water samples. Multiplex PCR was performed after phenol extraction of DNA from the samples. The set of primers for the PCR assay involved the 5S rRNA (Legionella spp) and the mip (macrophage infectivity potentiator gene, specific for L. pneumophila) genes as target sequences for amplification. Both the sensitivity and the specificity of the PCR assay were 100% when the 5S rRNA gene was used as target sequence. Isolation of Legionellae from the samples was observed only with the PCR-positive samples. We propose that PCR be used as a screening test before attempting to culture Legionellae from cooling tower water samples.
Subject(s)
Air Conditioning , Legionella/isolation & purification , Water Microbiology , Base Sequence , DNA Primers , Fluorescent Antibody Technique, Direct , Legionella/genetics , Molecular Sequence Data , Polymerase Chain Reaction , Sensitivity and Specificity , SingaporeABSTRACT
The in vitro activities of 17 antimicrobial agents alone or in combination against 70 clinical isolates of Acinetobacter baumannii from Singapore were determined by broth microdilution. The MICs of amoxicillin, ampicillin, ceftazidime, ceftriaxone, gentamicin, and piperacillin for 90% of the strains were > or = 128 micrograms/ml. Addition of sulbactam to ampicillin produced improved activity, whereas adding tazobactam to piperacillin did not. The MICs of amikacin, ciprofloxacin, and imipenem for 90% of the strains were 32, 32, and 16 micrograms/ml, respectively.
Subject(s)
Acinetobacter/drug effects , Anti-Bacterial Agents/pharmacology , Humans , Microbial Sensitivity TestsABSTRACT
The first study of the prevalence in Singapore of enterococci with high-level resistance to aminoglycosides has been made in the National University Hospital. From March to June 1992, 225 isolates were studied by means of three methods: (1) use of brain-heart infusion (BHI) agar incorporating the antibiotic; (2) microdilution of the antibiotic in broth; and (3) use of high content antibiotic discs. The BHI agar was the reference method. Of the total, 49 (22%) isolates were resistant to gentamicin, 86 (38%) to streptomycin, 82 (36%) to kanamycin and 93 (41%) to one or more of the agents. Results of the disc diffusion method correlated completely with the BHI agar method. The broth microdilution method showed a 100, 90 and 96% sensitivity in relation to gentamicin, streptomycin and kanamycin, respectively, and a specificity of 100% for all three aminoglycosides. Statistical significance (P < 0.01 to P < 0.001) was demonstrated in (1) a greater incidence of enterococci with high-level resistance to aminoglycosides among blood isolates; (2) gentamicin resistance predicting kanamycin high-level resistance; and (3) more resistance to gentamicin, streptomycin and kanamycin among Enterococcus faecium isolates compared to those of Enterococcus faecalis. Beta-lactamase activity was not detected.
Subject(s)
Anti-Bacterial Agents/pharmacology , Enterococcus faecalis/isolation & purification , Enterococcus faecium/isolation & purification , Gram-Positive Bacterial Infections/epidemiology , Aminoglycosides , Drug Resistance, Microbial , Enterococcus faecalis/drug effects , Enterococcus faecium/drug effects , Humans , Kanamycin Resistance , Prevalence , Sensitivity and Specificity , Singapore/epidemiologyABSTRACT
The amount of protamine required for the neutralisation of heparin following cardiopulmonary bypass was determined by a Protamine Titration Assay using the principle of the dose--response curve and the patient's estimated blood volume. In 300 open heart surgery patients, infusion of the determined dose of protamine normalised the Activated Clotting Time (ACT) to baseline levels in 97% of these patients and produced adequate hemostasis. Our present study showed that the dose of protamine dropped to 75% of the dose calculated by conventional method of heparin to protamine ratio of 1:1. This had minimised the adverse effects of excessive protamine administration and optimised coagulation control after extracorporeal circulation.
Subject(s)
Extracorporeal Circulation , Heart Diseases/surgery , Heparin Antagonists , Heparin/administration & dosage , Protamines/administration & dosage , Adolescent , Adult , Aged , Child , Child, Preschool , Dose-Response Relationship, Drug , Heparin/pharmacokinetics , Humans , Infant , Infant, Newborn , Middle Aged , Protamines/pharmacokinetics , Whole Blood Coagulation TimeSubject(s)
Glucose/analysis , Chromatography, Gas , Electrochemistry , Enzymes, Immobilized , Glucose OxidaseABSTRACT
No abstract available.
