Biomedical subjects
B Chattopadhyay
Publications and source records attributed to B Chattopadhyay.
The colonization of patients in an intensive treatment unit with gram-negative flora: the significance of the oral route.
An extensive survey of patients and the environment in a newly refurbished intensive care unit showed that the principle species on patients in sites other than the rectum were Pseudomonas aeruginosa, Klebsiella pneumoniae, Serratia marcescens, Acinetobacter anitratus and Enterobacter cloacae. Multiple episodes of cross-infection were occurring with 10 different strains of these organisms. Three oral solutions (mouthwashes, 'Clinifeeds' and residual water from nasogastric aspiration apparatus) were heavily contaminated with coliforms including some epidemic strains and this corresponded with the finding that colonization with the above species usually occurred first in the mouth or respiratory tract. Attempts to eliminate contamination of the solutions reduced colonization and cross-infection by over 50%, but did not eradicate it. Two sinks without heat-traps on the drains possibly provided a long term reservoir of epidemic strains.
Faecal carriage rate of Yersinia species.
A total of 1,203 unselected routine faecal samples from 1,006 patients were cultured for Yersinia species by a cold enrichment technique. Seventy-five specimens (6.1%) from 63 patients were culture-positive for Yersinia spp. Fifty-two were Yersinia enterocolitica, 22 Yersinia frederiksenii and 1 Yersinia intermedia. The predominant Y. enterocolitica isolates belonged to biotype 1 - serotype 0:6, 30 or serotype 0:5, 27. Y. frederiksenii strains were non-typable. Forty isolates were recovered from 33 patients with gastroenteritis. During the study period 83 Salmonella spp. from 33 patients, 17 Shigella sonnei from 13 patients and 13 Campylobacter jejuni from 12 patients were cultured. Yersinia spp. was isolated in association with salmonella on three occasions, twice with rotavirus and once each with Shigella sonnei, Campylobacter jejuni and Trichuris trichiura.
Aeromonas hydrophila in chlorinated water supplies.
Methods for the isolation and enumeration of Aeromonas hydrophila in water supplies are described. Examination of 286 chlorinated samples collected between July and October showed that 19% of otherwise uncontaminated waters contained Aerom. hydrophila, rising to 71% of those from which Escherichia coli was isolated. The isolation rate during January and February was only 7% for all samples. On the basis of these results, tap water is a likely source of the aeromonads found in human intestinal flora.
Problems with diagnosis and antibiotic treatment of frequency and dysuria syndrome.
Explore the source record for details and available documents.
The role of Gardnerella vaginalis in 'non-specific' vaginitis.
Explore the source record for details and available documents.
Isolation of Gardnerella vaginalis from routine genito-urinary tract specimens.
Routine screening of 2374 high vaginal swabs yielded 132 cultures (5.6 per cent) which were positive for Gardnerella vaginalis. Thirty-four of the strains were isolated together with Candida albicans and 46 with Trichomonas vaginalis. One hundred and twenty (90.9 per cent) of the isolates were from females between the ages of 16 and 40 years. One hundred and nineteen (90 per cent) patients sought medical advice because of a history of discharge (88) or inflammation (31). The other 13 (10 per cent) had some other complaint or underlying disease. All 132 strains hydrolysed hippurate and fermented starch. Ninety-three (70.5 per cent) were isolated from swabs without clue cells. Seventy-seven were from nonpurulent samples; the remainder were from samples with varying numbers of pus cells. All but two strains appeared sensitive to metronidazole when tested with discs containing 50 micrograms, but none when discs contained 5 micrograms of the drug. During the study C. albicans was isolated from 571 swabs (24 per cent) and T. vaginalis was found in 112 (4.7 per cent); in 19 (0.8 per cent) swabs both were detected. Five of 71 (7 per cent) specimens of uncentrifuged urine with more than 100 pus cells/microliter and two of 30 (6.6 per cent) seminal fluids with moderate numbers of pus cells yielded moderate to profuse growth of G. vaginalis. The patients concerned were not receiving antibiotics and other significant organisms had not been found by conventional cultural techniques.
Methods for the isolation of Aeromonas hydrophila and Plesiomonas shigelloides from faeces.
Two solid selective media, xylose deoxycholate citrate agar (XDCA) and bile salts brilliant green agar (BBG) and an enrichment broth-alkaline peptone water, were evaluated for the isolation of Aeromonas hydrophila and Plesiomonas shigelloides. Alkaline peptone water and XDCA are useful for recovery of Aeromonas but not Plesiomonas, whereas BBG is satisfactory for both organisms.
In-vitro activity of ciprofloxacin (Bay 09867)
Explore the source record for details and available documents.
Asymptomatic gonorrhoea in a male patient.
A case of asymptomatic gonorrhoea in a male patient is described. Failure to isolate Neisseria gonorrhoea from his wife possibly demonstrates inhibitory effect of Candida albicans in vivo on the former organism.
Fatal neonatal septicaemia and meningitis due to Haemophilus influenzae acquired from the mother.
A fatal case of neonatal Haemophilus influenzae type b, septicaemia and meningitis is described. Although the mother was asymptomatic, maternal genital tract culture yielded H. influenzae which was indistinguishable from the strain found in the infant. Despite the rarity of this organism as a cause of neonatal sepsis, increased awareness is essential so that this important offending pathogen is not missed.
In vitro activity of ticarcillin plus clavulanic acid (BRL 28500, 'Timentin') against ticarcillin-resistant gram-negative rods.
A study was carried out to investigate the in vitro susceptibility of 211 clinical isolates of ticarcillin resistant (MICs greater than 128 micrograms/ml) Gram-negative rods to a combination of ticarcillin plus clavulanic acid. The combination demonstrated superior activity; 90% of the Proteus spp. and 50% of E. coli and Klebsiella spp. isolates were inhibited at a concentration of 64 micrograms/ml. It was 2 to 8-times more active than ticarcillin alone against E. coli, Proteus and Klebsiella spp. in half to three-quarters of the strains under test. This enhanced activity was only marginal, however, against Enterobacter, Acinetobacter, Citrobacter, Serratia and Pseudomonas spp. Against 161 ticarcillin sensitive strains the combination did not have any potentiation effect.
Septicaemia and its unacceptably high mortality in the elderly.
During a period of two years the overall mortality rate among 218 patients with septicaemia was 22.4 per cent. Mortality among patients of over 60 years of age, however, was 36.6 per cent compared with only 5.1 per cent for those below that age. This difference was highly significant (P less than 0.001). For pneumococcal septicaemia the figures were particularly disturbing, the death rate being 65 per cent for the former age group, but remaining nil for the latter. Of the 49 deaths, 44 (89.8 per cent) and five (10.2 per cent), respectively, were in those above and below that age. As death from septicaemia in the elderly seems to be unacceptably high, early institution of antibiotic therapy, even for the patient at home, is advocated so as to forestall the onset of shock. Although controversial and debatable this measure seems to be justified because it might significantly improve prognosis.
Comparison of in-vitro activity of latamoxef (moxalactam) and ceftazidime against Pseudomonas and Enterobacteriaceae resistant to first generation cephalosporins.
Explore the source record for details and available documents.
Faecal carriage rate of Aeromonas hydrophila.
Over a four and a half month period, 1004 unselected routine faecal specimens from 815 patients were cultured for Aeromonas hydrophila. Forty-two specimens (4.2%) representing 38 patients were culture-positive. The study specimens also yielded Salmonella on 116 occasions, Shigella on seven, Campylobacter species on six and other bacterial pathogens on 17 occasions, respectively. Seven specimens had A hydrophila together with another bacterial pathogen. In only 19 of 38 patients (50%) was A hydrophila possibly associated with gastrointestinal symptoms. All the Aeromonas isolates were resistant to ampicillin but sensitive to gentamicin, piperacillin, mecillinam, chloramphenicol, ceftazidime and colistin.
Liver abscess caused by Haemophilus parainfluenzae.
A case of liver abscess caused by Haemophilus parainfluenzae in an otherwise healthy adult is described which responded to medical management without surgery. This we believe to be the first reported case of liver abscess caused by this organism in the English medical literature.
Comparative in vitro activity of ticarcillin, piperacillin, azlocillin and mezlocillin.
The in vitro activity of ticarcillin, piperacillin, azlocillin and mezlocillin was determined against 403 clinical isolates. At MIC50, piperacillin was 2 to 8 times more active than the other three compounds against Pseudomonas, Escherichia coli, Proteus, Citrobacter, Acinetobacter and Salmonella species. Against Klebsiella, Enterobacter, Haemophilus, Bacteroides spp. and non-beta-lactamase producing Staphylococcus aureus the activity of piperacillin was similar to one or more of the most effective agents. However, azlocillin and mezlocillin were more active than piperacillin against enterococci. Ticarcillin was the least active in vitro. Despite these significant differences at MIC50 amongst the four compounds, they became much less discernible at MIC90, obviously due to beta-lactamase producing strains under study. The spectrum of activity of piperacillin encompasses those of azlocillin and mezlociLlin together except for Gram-positive organisms.