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Biomedical subjects

B Rudensky

Publications and source records attributed to B Rudensky.

98 records · Page 6Linked to original sources
PubMedDate not supplied

Chitotriosidase deficiency in survivors of Candida sepsis.

The existence of chitotriosidase, a human chitinolytic enzyme, hydrolyzes artificial chitotrioside substrates, but its specific function in humans is unknown. The homologous chitinases have an anti-fungal action in plants. In patients with Gaucher disease, chitotriosidase activity is markedly elevated and is a marker for response to specific treatment. In all populations, 6% of individuals are enzyme deficient but completely healthy. It was hypothesized that chitotriosidase deficient persons may be more vulnerable to fungal infections. Thus, the objective of the study was to ascertain the prevalence of homozygosity for the mutation of chitotriosidase among survivors of Candida sepsis. The prevalence of homozygosity among survivors was similar to that in the normal population. Although the cohort is the largest of its kind, since only survivors were tested, further studies should include all patients with Candida sepsis for comparison of survival rates among deficient versus sufficient individuals, and thereby elucidate if this enzyme has an anti-fungal function in man. Several theories are considered to explain the results.

Adult↗
PubMedDate not supplied

Antibiotic use on the surgical services of two Jerusalem hospitals, as determined by surveillance and influenced by an intervention program.

The use of antimicrobial drugs on the surgical services of two hospitals in Jerusalem, Israel, was surveyed prospectively. At one hospital (C), the use of these drugs was controlled: at the other (N), the use was not controlled. At both hospitals the cephalosporins accounted for approximately 21% of the antimicrobial drug-group courses (AMDGCs), however, they accounted for only 11% of the antimicrobial days (AMDs) at C but 22% at N. Prophylaxis after surgical procedures accounted for the initiation of 36% and 33% of the AMDGCs at C and N, respectively. The geometric mean of the duration of prophylactic courses of drug therapy was 3.2 days at C and 3.9 days at N (P less than 0.01). Excessively prolonged prophylaxis accounted for approximately 61% (388 AMDs) of prophylactic use at N and 55% (646 AMDs) at C. At C the proportion of patients receiving prophylaxis in high-risk surgical operations increased from 39% to 97% after the introduction of protocols for prophylaxis, but the average quantity of antimicrobial drugs administered per patient decreased by 38%.

Adolescent↗
PubMedDate not supplied

Comparison of peritoneal fluid culture results from adults and children undergoing CAPD.

BACKGROUND: Peritonitis is a common complication in patients with end-stage renal disease treated by continuous ambulatory peritoneal dialysis (CAPD). Empirical treatment is based on the organisms that are most frequently isolated and their susceptibilities. OBJECTIVE: To analyze and then compare peritoneal fluid culture results from adult and pediatric patients on CAPD, with respect to micro-organisms and antimicrobial susceptibilities. DESIGN: Three-year retrospective review of peritoneal fluid cultures from adults and children on CAPD. RESULTS: We isolated 481 organisms from 378 peritoneal fluid specimens, collected from 135 patients (45 children, 90 adults). There were 191 episodes of peritonitis in children (mean 4.2+/-3.5, range 1 - 15) compared to 187 in adults (2.1+/-1.9, range 1 - 10) (p< 0.001). Two or more episodes occurred in 30 of 45 children (67%) compared to 33 of 90 adults (37%) (p < 0.001).The number of different organisms/patient as well as the total number of isolates/patient were significantly greater in children (respectively, 2.8+/-2.3, range 1 - 12; and 5.3+/-5.2, range 1 - 27) than in adults (2.0+/-1.3, range 1 - 6; and 2.7+/-2.4, range 1 - 10) (p< 0.005). After Staphylococcus epidermidis, S. aureus was the most frequently isolated organism, occurring in 18% of episodes in adults and 12% of episodes in children (p< 0.01). Twenty-two of 33 fungal isolates (67%) in children were Candida parapsilosis compared to 3 of 24 (12%) in adults (p < 0.001). Subanalysis of multiple episodes revealed that Pseudomonas and Candida occurred significantly more often in children (p< 0.01), whereas S. aureus occurred more often in adults (p< 0.001). In polymicrobial episodes S. epidermidis occurred more often in adults (p < 0.05). Significant differences in susceptibilities to ampicillin, ceftriaxone, chloramphenicol, and gentamicin were found between children and adults (p< 0.05 - 0.001). CONCLUSIONS: CAPD-associated peritonitis occurs significantly more often in children than adults. Significant differences in microbial etiology and susceptibilities were found between pediatric and adult patients. Each dialysis unit should periodically analyze peritoneal fluid culture results from its CAPD patients. These data can then be used for optimization of empirical antimicrobial therapy of peritonitis.

Adult↗
PubMedDate not supplied

Neonatal coxsackievirus group B infections: experience of a single department of neonatology.

Coxsackie infections in 14 infants born in a single neonatal unit were studied. The clinical presentation was mild nonspecific disease in eight infants and an overwhelming multiorgan disease in six. Three infants with systemic disease died. Vertical transmission of the virus from a colonized mother was documented in five mothers who infected seven infants. The remaining seven infants were infected horizontally, presumably from infected personnel. Coxsackie B1 was isolated in four of the cases and type B3 in two cases of systemic disease. Intravenous gammaglobulin combined with human leukocyte interferon was utilized in three cases of overwhelming disease and two infants of these infants survived.

Acyclovir↗
PubMedDate not supplied

Prevalence of HBsAg carriers in pregnant women in Jerusalem: risk for horizontal transmission to family members.

A prospective study was undertaken in Jerusalem to quantitate the HBsAg prevalence rate in pregnant women, to assess the effect of ethnic origin on HBsAg prevalence rates, and to determine the impact of HBsAg carrier state on hepatitis B virus horizontal transmission in the family. Of the 6,572 women screened at the time of delivery, 42 (0.64%) were found to be HBsAg positive. Although the percentage of Moslem women was 3.4% of the total study population, they accounted for 23.8% of the HBsAg positive mothers. This resulted in a prevalence rate of 4.48% as compared to only 0.5% in the Jewish population (P < 0.01). Nine percent of siblings born to HBsAg positive mothers and 29% of the husbands were found to be horizontally infected.

Carrier State↗
PubMedDate not supplied

Value of a rapid enzyme-linked immunosorbent assay for maternal vaginal group B Streptococcus colonization.

Because group B streptococci maternal colonization is a risk factor for the development of neonatal sepsis, a commercially available rapid test was evaluated for its ability to detect intrapartum maternal colonization. A total of 180 paired vaginal swabs were cultured for group B streptococci and assayed by the Equate test. Of the 15 positive cultures, only 1 was detected by the Equate test, resulting in a sensitivity of 7% and a false-negative rate of 93%. The Equate test detected group B streptococci colonization only at a concentration of > or = 10(7) colony-forming units. These results indicate that the Equate test is not adequately sensitive for screening intrapartum populations for group B streptococci colonization.

Colony Count, Microbial↗