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1.
J Antimicrob Chemother ; 47(5): 693-6, 2001 May.
Article in English | MEDLINE | ID: mdl-11328787

ABSTRACT

This study investigated the antibiotic susceptibilities of 67 isolates of viridans streptococci from 61 cases of bacteraemia in immunocompromised paediatric patients with malignancy. The majority of patients (87%) had received prior courses of empirical antibiotic therapy, which consisted of ceftazidime plus amikacin during period 1 and piperacillin/tazobactam plus amikacin during period 2. Susceptibility to vancomycin and quinupristin/dalfopristin was 100%. Susceptibility to beta-lactam antibiotics varied. For period 1, the geometric mean MICs of all beta-lactams tested against blood culture isolates (n = 31) exceeded those against isolates (n = 36) collected from blood after the change in empirical therapy (by 3.3-fold for ceftazidime, 2.8-fold for piperacillin/tazobactam and 1.6-fold for penicillin). The selection of a beta-lactam antibiotic for empirical therapy must be made with care, as repeated courses of certain agents may be more likely to select for viridans streptococci with diminished susceptibility.


Subject(s)
Anti-Bacterial Agents/therapeutic use , Neutropenia/drug therapy , Streptococcus/drug effects , Anti-Bacterial Agents/pharmacology , Bacteremia/drug therapy , Bacteremia/microbiology , Blood/microbiology , Fever/etiology , Humans , Microbial Sensitivity Tests , Neutropenia/blood , Neutropenia/complications , Neutropenia/microbiology , Penicillin Resistance , Streptococcus/isolation & purification
2.
J Med Microbiol ; 49(4): 367-370, 2000 Apr.
Article in English | MEDLINE | ID: mdl-10755632

ABSTRACT

Coagulase-negative staphylococcal bacteraemia in immunocompromised patients is often associated with the use of central venous catheters, while the proposed origin of viridans streptococci causing bacteraemia in this patient group is the oral cavity. This report describes an episode of polymicrobial bacteraemia caused by Staphylococcus epidermidis and Streptococcus oralis followed by several further episodes of S. epidermidis bacteraemia in a 15-year-old boy after bone marrow transplantation. Pulsed-field gel electrophoresis (PFGE) of SmaI chromosomal DNA digests was used to compare blood culture and oral isolates of S. epidermidis and Str. oralis. The results indicated that the mouth was the source of both S. epidermidis and Str. oralis causing the first episode of bacteraemia. PFGE further demonstrated that the central venous catheter was the origin of a second strain of S. epidermidis responsible for subsequent episodes of staphylococcal bacteraemia. Both the oral mucosa and central venous lines should be considered as potential sources of organisms, including coagulase-negative staphylococci, associated with bacteraemia in immunocompromised patients.


Subject(s)
Bacteremia/microbiology , Bone Marrow Transplantation , Staphylococcal Infections/microbiology , Staphylococcus epidermidis/isolation & purification , Streptococcal Infections/microbiology , Streptococcus oralis/isolation & purification , Adolescent , DNA, Bacterial/analysis , Electrophoresis, Gel, Pulsed-Field , Humans , Immunocompromised Host , Male , Microbial Sensitivity Tests , Mouth Mucosa/microbiology , Staphylococcus epidermidis/classification , Staphylococcus epidermidis/drug effects , Staphylococcus epidermidis/genetics , Streptococcus oralis/classification , Streptococcus oralis/drug effects , Streptococcus oralis/genetics
3.
J Infect ; 36(1): 126-7, 1998 Jan.
Article in English | MEDLINE | ID: mdl-9515685

ABSTRACT

We report a case of Aspergillus flavus endocarditis in a 6-year-old boy with stage IV neuroblastoma with no pre-existing cardiac disease. The infection was successfully treated with high-dose liposomal amphotericin (AmBisome) once daily. Recurrence was prevented with itraconazole oral solution once daily as maintenance therapy. Adjunctive surgery was not required. The patient's cardiac function was uncompromised, but subsequent death from progressive neuroblastoma prevented long-term follow-up.


Subject(s)
Amphotericin B/therapeutic use , Antifungal Agents/therapeutic use , Aspergillosis/drug therapy , Aspergillus flavus , Endocarditis/drug therapy , Neuroblastoma/complications , Aspergillosis/complications , Aspergillosis/microbiology , Child , Endocarditis/complications , Endocarditis/microbiology , Fatal Outcome , Humans , Male
5.
Thorax ; 50(11): 1194-8, 1995 Nov.
Article in English | MEDLINE | ID: mdl-8553277

ABSTRACT

BACKGROUND: While there are reports on the outcome in adults and teenagers with cystic fibrosis of colonisation with Burkholderia (Pseudomonas) cepacia, there is little information in children. METHODS: In December 1991 only one of 115 children with cystic fibrosis attending a paediatric centre was colonised with B cepacia. Over the next 12 months there was a rapid increase with 23 (20%) becoming colonised; eighteen (79%) of these became colonised in hospital at a time that overlapped with the admission of a B cepacia positive child. Three different bacteriocin types were isolated, with one type (S22/PO) being present in 17 (74%) patients. The outcome for children who became colonised with B cepacia was compared with that in 33 children who continued to be colonised with Pseudomonas aeruginosa alone. RESULTS: Children colonised with B cepacia were older and more poorly nourished than those colonised with P aeruginosa, but did not have poorer pulmonary function. After colonisation, the forced expiratory volume in one second (FEV1) deteriorated between consecutive annual tests, with the average deterioration being greater in those with higher initial levels. Five children with B cepacia died from respiratory failure although none showed a fulminant deterioration. Introduction of segregation measures within hospital led to a dramatic decrease in the number of newly colonised patients. CONCLUSIONS: This study provides further evidence for person-to-person spread of B cepacia and confirms the effectiveness of simple isolation measures in interrupting spread. Colonisation with B cepacia and P aeruginosa in children is associated with a more rapid decline in lung function and a significantly increased mortality compared with cases colonised with P aeruginosa alone.


Subject(s)
Burkholderia Infections/transmission , Burkholderia cepacia , Cross Infection/transmission , Cystic Fibrosis/complications , Disease Outbreaks , Adolescent , Burkholderia Infections/prevention & control , Burkholderia cepacia/isolation & purification , Child , Child Nutrition Disorders/complications , Child, Preschool , Cystic Fibrosis/microbiology , Cystic Fibrosis/mortality , Cystic Fibrosis/physiopathology , Disease Outbreaks/prevention & control , Disease Transmission, Infectious , Female , Humans , Infant , Male , Pseudomonas aeruginosa/isolation & purification , Respiratory Function Tests
7.
J Clin Pathol ; 45(1): 42-5, 1992 Jan.
Article in English | MEDLINE | ID: mdl-1740513

ABSTRACT

AIMS: To evaluate the Uristat test, an indirect enzyme linked immunosorbent assay for the qualitative detection of antibodies in urine, as a screening, and in the diagnosis of urinary tract infection in the elderly. METHODS: Semiquantitative culture was compared with conventional microscopy, dipstick analysis and the ELISA. In the ELISA, 371 urine samples were examined for antibodies to an antigen mixture of six common urinary pathogens. RESULTS: The sensitivity was 91% and the specificity 25% for the ELISA. The negative predictive value was 81% and the positive predictive value was 43%. CONCLUSIONS: In its present form the Uristat test has no clear advantages over conventional bacteriological techniques for screening urine samples for infection in an elderly population.


Subject(s)
Enzyme-Linked Immunosorbent Assay/methods , Urinary Tract Infections/diagnosis , Aged , Aged, 80 and over , False Negative Reactions , False Positive Reactions , Female , Humans , Male , Reagent Strips , Sensitivity and Specificity
8.
Vet Microbiol ; 10(3): 219-29, 1985 Apr.
Article in English | MEDLINE | ID: mdl-2988183

ABSTRACT

Out of a sample of 200 rumens from sheep slaughtered in Edinburgh, papillomas were found in 25. They occurred as fibro-papillomas, mostly along the pillar of muscle between the dorsal and ventral rumen, and were often multiple. No inclusion bodies were seen in the lesions or papilloma virus particles on electron microscopy. Homogenisation of papillomatous tissue followed by various methods of purification did not yield identifiable virus particles, and viral DNA was not detected. Immunoperoxidase staining showed a very small number of positive cells at or on the surface of 6 out of 10 lesions examined. Thus, it seems probable that virus particles are not found in large numbers in the rumen papillomas of sheep, unlike the situation in ovine skin warts, but are present in a few epithelial cells which are rapidly shed from the surface of the mucous membrane.


Subject(s)
Neoplasms/veterinary , Papilloma/veterinary , Papillomaviridae/isolation & purification , Rumen/microbiology , Sheep Diseases/epidemiology , Animals , Antigens, Viral/analysis , DNA, Viral/analysis , Immunoenzyme Techniques , Neoplasms/epidemiology , Neoplasms/microbiology , Neoplasms/pathology , Papilloma/epidemiology , Papilloma/microbiology , Papilloma/pathology , Sheep , Sheep Diseases/microbiology , Sheep Diseases/pathology
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