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Biomedical subjects

C S Block

Publications and source records attributed to C S Block.

At least 19 recordsLinked to original sources
PubMed1993

Mycobacterium simiae infection in Israeli patients with AIDS.

Mycobacterium simiae is an environmental organism that has rarely been associated with human disease. In Israel M. simiae is frequently isolated from clinical specimens, and it usually colonizes damaged lungs. Until now, only two cases of AIDS patients with M. simiae infection have been reported, and these patients were coinfected with Mycobacterium avium complex. Two Israeli patients with AIDS complicating hemophilia developed prolonged fever that was unresponsive to therapy with broad-spectrum antibiotics. One of them had cavitary pulmonary infiltrates. M. simiae was isolated from blood in both cases and from sputum and bone marrow in one case. The identity of the mycobacterium was confirmed at three reference laboratories. Both patients died of the infection. Thus, the possibility of M. simiae infection should be considered for AIDS patients who live in areas where this mycobacterium is prevalent.

AIDS-Related Opportunistic Infections↗
PubMed1987

Shigella bacteremia in adults. A report of five cases and review of the literature.

Shigella bacteremia is rare, occurring mainly in children. We describe five adult patients with Shigella bacteremia and review data on 22 cases reported in the English-language medical literature. Eighteen (67%) of 27 patients had either an underlying condition or were aged older than 65 years. Most patients had clinical signs of acute febrile gastroenteritis. However, in six patients, the organism was not isolated from stool. Species isolated from blood included Shigella flexneri in 11 patients, Shigella sonnei in eight, and Shigella boydii and Shigella dysenteriae in one patient each. Isolation of the bacterium from blood only was associated with a high mortality rate, in contrast to its isolation both from blood and stool. It is suggested that blood cultures should be obtained from elderly or immunocompromised patients with acute febrile gastroenteritis to detect shigellemia as well as bacteremia caused by other enteric pathogens, such as Salmonella or Campylobacter.

Adult↗
PubMed1980

Ampicillin-resistant Haemophilus influenzae in Johannesburg.

Surveys carried out using a chromogenic cephalosporin test for beta-lactamase production (ampicillin resistance) among isolates of Haemophilus influenzae in Johannesburg have indicated an appreciable prevalence, especially among children seen at the new Johannesburg Hospital. Of type b strains recovered from these children, 10,9% were ampicillin-resistant. Three of the last 10 cases of serious systemic H. influenzae infections encountered at the Johannesburg Hospital were caused by beta-lactamase-producing strains, all of these having been acquired in the community rather than in hospital. These findings suggest that the optimal initial starting treatment for serious systemic or life-threatening H. influenzae infections should include chloramphenicol, either alone or at least in conbination with ampicillin or a similar compound.

Adolescent↗
PubMed1980

Comparative in vitro appraisal of piperacillin, including its activity against Salmonella typhi.

Piperacillin was evaluated in vitro against 711 clinical isolates of aerobic and anerobic gram-positive and gram-negative bacteria, including 76 isolates of Salmonella typhi. Piperacillin minimum inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBCs) were compared with those of a range of beta-lactam, aminoglycoside, and other antimicrobial agents, and inoculum size effects were considered. The relationship between dilution and disk diffusion tests was studied by regression analysis. In addition, piperacillin was assessed in combination with aminoglycoside and other beta-lactam drugs. This investigation has confirmed the activity of piperacillin against a broad range of bacteria, including Pseudomonas, Enterobacteriaceae, Neisseria, beta-lactamase-negative Haemophilus influenzae, and Staphylococcus aureus as well as enterococci, Bacteroides fragilis, and other anaerobes. All strains of Pseudomonas aeruginosa were inhibited by </=32 mug/ml or less, demonstrating again the potential usefulness of piperacillin in the treatment of pseudomonal infections. S. typhi proved susceptible to piperacillin, all isolates being inhibited by 1 mug/ml. Inoculum size experiments showed that inocula of 10(8) CFU resulted in MICs and MBCs appreciably higher than those resulting from inocula of 10(6) CFU, and inocula of 10(2) CFU resulted in MICs and MBCs appreciably lower than those resulting from inocula of 10(4) CFU. Piperacillin was active against all gentamicin-resistant pseudomonads tested, but not against gentamicin-resistant klebsiellas and enterobacters. Combinations of piperacillin with tobramycin and amikacin were consistently synergistic against Pseudomonas and Serratia isolates. Less consistent results were shown when piperacillin was combined with aminoglycosides or cephalothin against Klebsiella and indole-positive Proteus isolates, although synergy was observed in most cases. Occasional antagonistic reactions were encountered with piperacillin-cephalothin or piperacillin-tobramycin combinations against the latter isolates.

Anti-Bacterial Agents↗
PubMed1979

Overwhelming pneumococcaemia 17 years after splenectomy. A case report.

We present a case of fulminant pneumococcaemia and disseminated intravascular coagulopathy in a young adult man 17 years after splenectomy. The clinical presentation, laboratory and postmortem findings are discussed. The diagnosis, management and prophylaxis of overwhelming infections in splenectomized patients are reviewed. The advent of pneumococcal and other vaccines could contribute significantly to the successful protection of asplenic patients against certain severe infections.

Adult↗
PubMed1978

Community versus hospital Staphylococcus aureus. Antimicrobial susceptibilities and some features of nasal carriage and acquisition.

Susceptibility of community and hospital isolates of Staphylococcus aureus to 15 drugs has been tested. The organisms were isolated from the noses of White adults admitted to two general surgical units. Approximately half of each group were resistant to beta-lactamase-labile penicillins. Hospital staphylococci displayed a greater degree of multiple drug resistance and resistance to methicillin and erythromycin than did community strains. A nasal carriage rate of 28.6% was found among White patients admitted. A comparative survey of 54 Black adults from a rural community revealed a significantly lower rate (14.8%). On non-carriers admitted to hospital, 21.9% acquired S. aureus nasally.

Anti-Bacterial Agents↗
PubMed1978

Bacillus cereus endocarditis. A case report.

Bacillus cereus may cause infective problems in compromised patients. No previous record of infective endocarditis due to this organism could be found. A 51-year-old White woman with B. cereus endocarditis after prosthetic mitral valve replacement is described. The problems of interpreting the significance of B. cereus bacteraemia, delayed diagnosis, and the inherent resistance of the organism are discussed.

Bacillus cereus↗
PubMed1978

Gentamicin-resistant gram-negative bacilli in hospital patients. Part II. In vitro aspects including susceptibility to tobramycin and amikacin.

A study of 259 clinical isolates of gentamicin-resistant Gram-negative bacili (GRNB) has revealed 99,2% crossresistance with tobramycin and 6,9% with amikacin. Resistance to all 3 drugs is transferable in vitro. Simultaneous transfer of resistance to ampicillin, carbenicillin, cephalothin, tetracycline, chloramphenicol, sulphonamides, co-trimoxazole, streptomycin and kanamycin was shown to occur, emphasizing the potential for the selection of aminoglycoside-resistant organisms by the use of many other drugs. All GRNB studied were multiresistant. While amikacin should prove useful for those infections caused by GRNB which require treatment, care should be exercised in its use, to minimize the emergence of large-scale amikacin resistance.

Amikacin↗
PubMed1978

Gentamicin-resistant gram-negative bacilli in hospital patients. Part I. Preliminary epidemiological assessment.

Gentamicin-resistant Gram-negative bacilli (GRNB) have been isolated from specimens received from 23 hospitals in and around Johannesburg. Most isolates are fermentative in nature. A pilot survey among inpatients at the Johannesburg Hospital revealed an intestinal carriage prevalence of 14,3%. A prospective study of intestinal acquisition showed that GRNB are acquired in hospital, and that colonization is associated with prior antibacterial therapy. Analysis of clinical specimens received from the Johannesburg Hospital from 1 July to 30 September 1976 has indicated that intensive care and urology units are worst affected. An assessment of the overall prevalence of GRNB in October 1976 revealed that 16,1% of all Gram-negative bacilli were resistant to gentamicin. Major contributing factors are the widespread use of systemic aminoglycoside antibiotics, and a high rate of cross-contamination. Measures aimed at minimizing these factors have been introduced by the Johannesburg Hospital administration.

Adolescent↗
PubMed1977

Early diagnosis of opportunistic systemic fungal and nocardial infections.

An approach to the expediting of the diagnosis of opportunistic systemic mycoses is presented. Communication between clinician and microbiologist is basic to this approach. The importance of the clinical assessment of the individual patient, coupled with a high index of suspicion, is stressed. Our experience with 11 of 42 cases of systemic mycosis over a 28-month period is analysed. For the diagnosis of fungaemia a method for the microscopical examination of peripheral blood is briefly evaluated, and a membrane filter blood culture technique is shown to be valuable, yielding results in 16-24 hours. In the absence of fungaemia the considered microscopical examination of suitable specimens, when feasible, is the most rapid method available. Serological methods may be helpful in early diagnosis, but this is often hampered by the absence of baseline sera and by the lengthy nature of some tests. Newer indirect methods such as gas chromatography are being developed but have not yet been used routinely.

Blood↗
PubMed1977

Aspergillus pneumonia--a cluster of four cases in an intensive care unit.

Four cases of Aspergillus pneumonia occurred in an intensive care unit within a short period. Clusters of cases of invasive aspergillosis are rare and have usually been attributed to excessive contamination of the environment. Extensive environmental studies were, however, negative. Three of the cases were diagnosed ante mortem. One patient survived after early initiation of treatment with amphotericin B.

Adult↗
PubMed1977

Torulopsis glabrata fungaemia. A report of two cases.

Two cases of Torulopsis glabrata fungaemia are presented. The literature on detection of micro-organisms in peripheral blood and on systemic T. glabrata infection is briefly reviewed. Microscopical examination of a buffy coat preparation, a simple and rapid procedure for diagnosing this condition, is described. A scheme of criteria which may be helpful in the diagnosis of clinically significant fungaemia is offered.

Adult↗