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Biomedical subjects

B F Farber

Publications and source records attributed to B F Farber.

At least 37 records · Page 2Linked to original sources
PubMed1989

Antipsoriatic effects of zidovudine in human immunodeficiency virus-associated psoriasis.

Four patients with psoriasis complicating human immunodeficiency virus (HIV) infection showed marked improvement in their psoriasis after being treated with oral zidovudine. The antipsoriatic effect persisted in two patients in spite of worsening helper T cell depletion. The antipsoriatic effect appeared to be dose-dependent and was associated with the development of erythrocyte macrocytosis, a known side effect of zidovudine. Zidovudine is useful for the therapy of HIV-associated psoriasis and should be tested for efficacy in non-HIV-associated psoriasis.

Acquired Immunodeficiency Syndrome↗
PubMed1987

High-level aminoglycoside resistance mediated by aminoglycoside-modifying enzymes among viridans streptococci: implications for the therapy for endocarditis.

Two strains of Streptococcus mitis with high-level resistance to streptomycin and kanamycin were identified from a collection of multiple-resistant streptococci. The strains were resistant to penicillin-streptomycin and penicillin-kanamycin synergy but were synergistically killed by penicillin-gentamicin. Both strains adenylylated streptomycin at the 3'' position. Neither strain could be cured of its streptomycin resistance by novobiocin, acridine orange, or ethidium bromide. Attempts to pass the resistance into two recipients were unsuccessful. Agarose gel electrophoresis and cesium chloride gradients failed to reveal plasmid bands. This is the first report of high-level streptomycin resistance mediated by modifying enzymes among viridans streptococci. It is possible that endemic streptomycin resistance among viridans streptococci will develop.

Drug Synergism↗
PubMed1986

Interaction between rifampin and fusidic acid against methicillin-resistant coagulase-positive and -negative staphylococci.

We studied the interaction between rifampin and fusidic acid against a group of staphylococci. Of the 20 coagulase-positive strains studied, checkerboard studies revealed synergy in 3 and indifference in 17; time-kill studies revealed synergy in 18 of 19 coagulase-positive strains at both 24 and 48 h. Of the 19 coagulase-negative strains, checkerboard studies revealed synergy in 6 and indifference in 13; time-kill studies revealed synergy in 6 of 18 coagulase-negative strains at 24 h and in 17 of 18 coagulase-negative strains at 48 h. The combination of rifampin and fusidic acid warrants further evaluation in the therapy of staphylococcal disease.

Coagulase↗
PubMed1984

Fulminant hospital-acquired toxic shock syndrome.

Fatal toxic shock syndrome developed in a previously healthy 19-year-old man following arthroscopy. The fulminant presentation led to an initial diagnosis of pulmonary embolus. Toxic shock syndrome must now be considered in the differential diagnosis of cardiovascular catastrophes.

Acute Disease↗
PubMed1984

A pseudo-outbreak of Streptomyces infections linked to laboratory construction.

Over a four-week period, nine isolates of Streptomyces species were identified from seven blood cultures, one infected gortex graft, and one cerebrospinal fluid (CSF) specimen. None of the patients were clinically infected or received antimicrobial therapy. Blood culture collecting tubes, iodoform prep solutions, BAC-TEC filters, and alcohol prep pads were cultured but did not reveal a source of contamination. Six additional clinical specimens became positive, and the occurrence of construction in the laboratory was considered as a source of the contaminating organism. Blood agar plates were placed for 20 minutes in an area undergoing construction. Streptomyces grew in heavy concentrations on nine of ten plates in the construction site, but only one colony on ten plates grew from a hallway not undergoing construction. Isolation of the organism ceased with cessation of the construction. The authors conclude that the Streptomyces pseudo-outbreak was related to construction around the laboratory, with probable airborne contamination of clinical specimens.

Air Microbiology↗
PubMed1984

A prospective study of nosocomial infections in a chronic care facility.

To elucidate the epidemiology of nosocomial infections occurring in nursing homes and chronic care facilities, the authors undertook a prospective study of patients requiring two different levels of nursing care. The overall rate of infection was higher on the intermediate care ward than on the nursing home ward (1.35 versus 0.67 infections/100 patient care days). Pneumonias and symptomatic urinary tract infections accounted for 49 per cent of all infections. Eight of ten cases of pneumonia occurring on the nursing home ward were diagnosed in the winter months, and no case was diagnosed in the summer months. Resistance to gentamicin, tobramycin, ampicillin, and trimethoprim-sulfa was common among organisms causing symptomatic urinary tract infections.

Adult↗
PubMed1984

Ribosomal resistance of clinical enterococcal to streptomycin isolates.

The mechanism of high-level resistance to streptomycin was studied in 12 clinical isolates of Streptococcus faecalis. Six strains produced streptomycin-modifying enzymes. Each of three enzyme-negative strains tested demonstrated ribosomal resistance to streptomycin. Lack of ribosomal susceptibility is a significant cause of high-level streptomycin resistance among clinical enterococcal isolates.

Drug Resistance, Microbial↗
PubMed1983

Retrospective study of the toxicity of preparations of vancomycin from 1974 to 1981.

A retrospective chart review of 98 patients treated with 100 courses of intravenous vancomycin was undertaken to better define its toxicity. Most of the patients carried diagnoses of Staphylococcus aureus or Staphylococcus epidermidis infection. Auditory toxicity was not seen, and fever and rash occurred in only 1 to 3% of the subjects. Phlebitis was noted in 13% of the cases and required discontinuation of therapy in 2%. Therapy was complicated by neutropenia (polymorphonuclear leukocyte count, less than or equal to 1,000 cells per cm3) in 2% of the patients but was rapidly reversible. Nephrotoxicity was uncommon (5%) and reversible in subjects receiving vancomycin alone, even when the therapy was continued. However, 35% of the patients receiving vancomycin with an aminoglycoside developed significant elevations in serum creatinine. Although this high incidence may have been due to the patient population selected or to the aminoglycoside therapy alone, the possibility of additive toxicity between vancomycin and the aminoglycosides should be considered.

Adolescent↗
PubMed1983

Multiply resistant viridans streptococci: susceptibility to beta-lactam antibiotics and comparison of penicillin-binding protein patterns.

A unique group of viridans streptococci has been found in South Africa. These organisms were isolated in close temporal and physical proximity to the isolation of penicillin-resistant pneumococci. The strains were resistant to penicillin, oxacillin, the cephalosporins (all generations), piperacillin, azlocillin, and mezlocillin but were susceptible to vancomycin. Penicillin-binding proteins of two penicillin-resistant South African strains of Streptococcus mitis differed markedly from those of two penicillin-susceptible strains but were identical to those seen in a penicillin-resistant strain isolated in Boston. Although both susceptible strains were identified as S. mitis with identical biochemical profiles, their penicillin-binding protein patterns differed from each other. This finding may have significance with regard to the need for additional taxonomic classification of the viridans streptococci.

Anti-Bacterial Agents↗
PubMed1983

Resistance to penicillin-streptomycin synergy among clinical isolates of viridans streptococci.

Viridans streptococci are thought to be highly susceptible to penicillin and streptomycin. We recently encountered a unique group of 15 isolates from South Africa epidemiologically related to the isolation of penicillin-resistant pneumococci. These organisms were highly resistant to penicillin (PCN) (minimal inhibitory concentration, 1 to 32 micrograms/ml) and streptomycin (SM) (minimal inhibitory concentration, greater than or equal to 2,000 micrograms/ml). Two additional organisms with high-level streptomycin resistance were identified when 168 clinical isolates from Boston were screened. Time-kill studies with four organisms resistant to high levels of SM demonstrated lack of synergy between PCN and SM but marked synergy between PCN and gentamicin. Adenylylating, acetylating, and phosphorylating activity could not be detected in three organisms studied, and novobiocin failed to cure the SM resistance. Protein synthesis by ribosomes isolated from these organisms was dramatically reduced in the presence of gentamicin but was relatively resistant to inhibition by SM.

Bacterial Proteins↗
PubMed1983

Vancomycin prophylaxis in cardiac operations: determination of an optimal dosage regimen.

Vancomycin is thought to be an acceptable alternative prophylactic antibiotic to the cephalosporins in penicillin allergic patients undergoing cardiopulmonary bypass. We studied the pharmacokinetics of vancomycin in 10 patients undergoing cardiopulmonary bypass. Our results suggest that the commonly used 500 mg dose (7 mg/kg) of vancomycin given preoperatively may provide serum concentrations during cardiopulmonary bypass which are not bactericidal for many S. epidermidis strains. Thus we believe that a higher initial dose, at least 15 mg/kg, should be given.

Cardiopulmonary Bypass↗
PubMed1981

Relation between surgical volume and incidence of postoperative wound infection.

We used a statewide program for the surveillance and reporting of infections acquired in the hospital to examine the relation between volume of surgery and the incidence of postoperative wound infection. Over a 29-month period 25,941 surgical procedures performed at 22 hospitals were studied. For all procedures studied, the mean number of operations performed was directly related to hospital size (number of beds). A highly significant inverse relation was found between the logarithm of the frequency of operation and the infection rate for appendectomy, herniorrhaphy, cholecystectomy, colon resection, and abdominal hysterectomy. (The relation was borderline [P = 0.055] for laminectomy and not significant for cesarean section.) Although these data clearly demonstrate higher morbidity in hospitals performing relatively little surgery, there are several possible explanations, and no conclusions for health policy can yet be drawn.

Data Collection↗
PubMed1981

Production of exoenzyme S by clinical isolates of Pseudomonas aeruginosa.

Exoenzyme S differs from toxin A and diphtheria toxin in that it does not adenosine diphosphate (ADP)-ribosylate elongation factor-2, but rather catalyzes the transfer of the ADP-ribose moiety of nicotinamide adenine dinucleotide to a number of different proteins in extracts of eucaryotic cells. Polyoma-transformed BHK-21 cells were isolated which were resistant to diphtheria toxin and toxin A. Extracts from these cells are ADP-ribosylated by exoenzyme S but not toxin A or diphtheria toxin, providing an assay which distinguishes between S and A activities. A total of 124 clinical isolates of P. aeruginosa were analyzed for production of toxin A and exoenzyme S. Exoenzyme S production was detected in 38% of the strains, whereas 80% of the strains produced toxin A.

ADP Ribose Transferases↗