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Biomedical subjects

A T Willis

Publications and source records attributed to A T Willis.

At least 19 recordsLinked to original sources
PubMed1992

Comparison of Sentinel and Bactec blood culture systems.

AIMS: To evaluate the Sentinel automated blood culture system and to compare its performance with that of Bactec. METHODS: The Sentinel blood culture system was evaluated in three centres. The performance of the system was assessed in comparison with the routine blood culture method used in these centres, the Bactec system. RESULTS: Blood culture sets (n = 2180) consisting of Sentinel aerobic and anaerobic, and Bactec aerobic and anaerobic bottles yielded 218 (10%) clinically important isolates. One hundred and fifty five (71%) of the isolates were detected by both systems; 35 (16%) were detected by Sentinel only; and 28 (13%) by Bactec only. For the duration of the evaluation, the Sentinel system was deliberately configured so that it was impossible to detect positive results during the first 12 hours. The times to positivity after the first 12 hours were similar. Data gathered during and subsequent to the evaluation have been used by the manufacturer to refine the algorithm so that positive results can be detected at a minimum of 2.25 hours. CONCLUSIONS: After a period of familiarization the Sentinel system was considered easy to use. Sentinel is a useful addition to the methods available for the detection of bacteria in blood cultures.

Bacteriological Techniques↗
PubMed1985

Antibiotic susceptibility of clinical isolates of clostridia.

Over a 2 1/2 year period 361 clinical isolates of clostridia, representing 28 species, were tested for susceptibility to commonly used antimicrobial agents. Penicillin resistant strains were tested for their ability to produce beta-lactamase: of the commonly isolated species only Clostridium beijerinckii/butyricum produced the enzyme. Cl. perfringens exhibited a low incidence of resistance to all of the agents tested. Cl. difficile showed a high degree of resistance to penicillin and clindamycin, whilst all strains were sensitive to vancomycin. Chloramphenicol and amoxycillin/clavulanic acid were found to be highly active against most clostridia; metronidazole was the only agent to which no resistance was demonstrable.

Anti-Bacterial Agents↗
PubMed1985

Host factors predisposing to anaerobic infections.

Anaerobic bacterial infections of man are typically associated with locally comprised tissues and commonly also with a systemically compromised host. Thus, any condition that interferes with the systemic defence mechanisms of the host and thus predisposes to infection in general, increases the incidence of anaerobic infections also. It is generally true to say that anaerobic infections occur secondary to mechanical disruption of anatomical barriers, usually percutaneous in clostridial infections; in nonclostrial anaerobic infections the disrupted barriers are commonly mucosal surfaces where the offending organisms exist as the dominant part of normal bacterial floras. The most important single factor which enables anaerobes to flourish in the tissues is low oxygen tension which is usually the result in the first instance of a compromised blood supply and poor tissue perfusion. A variety of other predisposing factors may operate in concert, enabling the nonsporing anaerobes to cause a diversity of infective states in many different parts of the body. These host determinants are considered in relation to clostridial, nonclostridial and postsurgical anaerobic sepsis.

Bacteria, Anaerobic↗
PubMed1985

Pre-operative antimicrobial prophylaxis of infection.

Thoughtful and rational antimicrobial prophylaxis in surgical patients is an important and valued part of patient management, and is best defined as the prevention of postoperative morbidity due to infection. Firm indications for prophylaxis include procedures associated with a high incidence of postoperative infection, those associated with a low incidence of serious sepsis, and low risk procedures in compromised patients.

Anti-Infective Agents↗
PubMed1984

Treatment of anaerobic infections.

The anaerobic syndromes of gas gangrene and tetanus are due to systemic intoxications that develop following infection with clostridia at some site of trauma. Classically, these conditions developed as complications of accidental trauma, the spore-forming anaerobes being derived from the inanimate environment. While tetanus remains typically an exogenously derived disease, gas gangrene more frequently presents as an endogenously derived complication of elective surgery. Their treatment is briefly discussed, including the role of antimicrobial therapy. During the last decade there has been an increasing awareness of the importance of non-sporing anaerobes as a major cause of serious endogenously derived infections in man. They are not only a common cause of postoperative infection following appendicectomy, and acute and elective colorectal and gynaecological surgery, but they also cause a wide variety of infections at other sites, usually secondary to some preexisting pathology. In the management of these infections, surgical drainage of pus, when present, is of first importance. Systemic antimicrobial therapy, directed against the anaerobes is dramatically effective both in the management of established infections, and in their prevention in patients known to be at risk.

Anti-Bacterial Agents↗
PubMed1983

Metronidazole in the prevention of anaerobic infection.

One of the most common complications of appendectomy, or major colorectal surgery and gynecologic surgery, is surgical sepsis. Its incidence may vary from 2% to 4% for normal appendices, up to 20% for hysterectomy, and from 50% to 60% for some colonic operations including gangrenous or perforated appendices. During the last decade, one has become increasingly aware of the importance of non-spore-forming anaerobes as the major cause of serious sepsis associated with these types of operation. Studies carried out at the Luton and Dunstable Hospital, and subsequently at other centers, have shown that metronidazole, a specifically anaerobicidal agent without significant activity against aerobic organisms, is highly effective in preventing postoperative morbidity resulting from anaerobic infections. Moreover, its use has greatly modified the surgical approach in a number of conditions.

Appendectomy↗
PubMed1982

Anaerobic balanoposthitis.

To assess the causative role of non-sporing anaerobes in cass of erosive balanoposthitis, anaerobic culture was performed on purulent discharges from 104 patients with penile ulceration, a foul-smelling discharge, and a mixed and motile bacterial flora. Most of 29 culturally confirmed infections were due to mixed anaerobes and eight to single anaerobes. A rapid response to treatment with metronidazole also confirmed the anaerobic cause of the infection. Thus, acute anaerobic balanoposthitis can be readily diagnosed clinically and is easily treated.

Balanitis↗
PubMed1981

Campylobacter enteritis associated with the consumption of free school milk.

A large outbreak of campylobacter enteritis associated with the consumption of free school milk is described. The outbreak had an abrupt onset, and lasted for about 3 weeks; it involved mainly school children in the 2-4 and 5-7 year old age groups. During this period it was established from epidemiological and microbiological data that some 2500 children were infected. The source of the epidemic was almost certainly contaminated milk, although bacteriological proof could not be obtained. Biotyping of isolates was of considerable epidemiological value and showed the involvement of two distinct strains, one of which was dominant. Epidemiological evidence of limited person to person transmission of the infection was obtained; febrile convulsions as a prodromal sign of the illness was recognized for the first time. Strains of Campylobacter jejuni, and samples of patients' serum collected during this outbreak have enabled subsequent studies to be initiated on the serotyping of the responsible organism, on the serological response of patients infected with the organism, and on experimental infection of the bovine udder which demonstrated its potential as a source of C. jejuni in raw milk. A careful search of the literature suggests that this is the largest documented outbreak of campylobacter enteritis.

Animals↗
PubMed1981

Possible role of the anaerobe in tonsillitis.

Anaerobic bacteria were isolated from all tonsils removed from children at routine tonsillectomy; 75.6% of specimens yielded moderate to heavy growth and 80% of tonsils contained more than one anaerobic species. This recovery rate fell to 56% after a 10-day course of metronidazole before tonsillectomy--in only 14.6% of cases were anaerobes isolated in significant numbers. Surface swabbing of the tonsils permitted recovery of a similar spectrum of anaerobic bacteria but resulted in an overall loss of both aerobic and anaerobic pathogens. A comparison was made between the flora of acutely inflamed tonsils and "healthy' tonsils: over 90% of both groups yielded anaerobic bacteria, but they were present in significant numbers in 56.2% of swabs taken from acutely inflamed tonsils compared with 24% of swabs from "healthy' children. The isolation rate for anerobic pathogens was 37.5% and 16% respectively.

Acute Disease↗
PubMed1981

Serum, saliva, and sputum levels of metronidazole in acute exacerbations of chronic bronchitis.

We have evaluated the absorption and the penetration of metronidazole into the bronchial secretions and saliva in acute infective exacerbations of chronic bronchitis. Seventeen patients were given 400 mg orally three times daily for seven days and "steady state" levels were measured in serum, saliva, and sputum on the last day of treatment. Mean levels in the three biological fluids were not significantly different. Higher metronidazole levels in sputum tended to occur in patients with higher serum levels. In all but one patient, levels in serum and saliva were well within the therapeutic range. We conclude that this oral regimen results in therapeutic tissue levels in acute exacerbations of chronic bronchitis.

Absorption↗
PubMed1981

The role of nitroimidazole derivates in bacterial infections-metronidazole prophylaxis in appendectomy.

The commonest complication of appendicetomy is surgical sepsis, the incidence of which may vary from 4% for normal appendices to 77% for gangrenous or perforated appendices. Although some of these infections are relatively trivial others are serious or even life-threatening. In an effort to reduce the incidence of serious sepsis surgeons have used a variety of topical and systemic prophylactic antibacterial agents such as penicillin, ampicillin, tetracycline, lincomycin, tobramycin, cephalosporins, neomycin, bacitracin, polymyxin and povidone iodine. Although none of these prophylactic procedures has been consistently effective, appropriate systemic antibiotics generally reduce the incidence of intra-abdominal sepsis, while appropriate local treatment reduces the incidence of wound infection. Most reports on the chemoprophylaxis of sepsis after appendicectomy have been concerned solely with clinical aspects of infection and have not considered the nature of the infecting agents. During the last few years there has been an increasing awareness of the importance of non-sporing anaerobes as the major cause of sepsis after surgery of the gastrointestinal tract. Studies carried out at the Luton and Dunstable Hospital and subsequently at other centres have shown that systemic metronidazole, which is a specifically anaerobicidal agent, is highly effective in preventing the development of sepsis due to anaerobes in postappendicetomy patients.

Appendectomy↗
PubMed1980

A case of anaerobic middle ear infection with complications.

A case of anaerobic middle ear infection giving rise to an anaerobic bacteraemia and to a posterior fossa extradural abscess is described. The importance of anaerobic infections in E.N.T. practice is stressed and their treatment with metronidazole recommended.

Bacterial Infections↗
PubMed1980

Botulism.

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Botulism↗