Search PubMed⌕ Search

Biomedical subjects

C T Keane

Publications and source records attributed to C T Keane.

At least 73 records · Page 4Linked to original sources
PubMed1989

A new methicillin- and gentamicin-resistant Staphylococcus aureus in Dublin: molecular genetic analysis.

In June 1985 two new strains of methicillin- and gentamicin-resistant Staphylococcus aureus (MGRSA) were isolated in a Dublin hospital. Of these, one strain spread rapidly, affecting a total of 65 patients during the following 18 months, and subsequently spread to a second Dublin hospital. Detailed laboratory studies, including plasmid screening, plasmid restriction enzyme digest pattern analysis, hybridisation analysis, location of resistance determinants, and bacteriophage typing with a set of experimental S. aureus typing phages, demonstrated that the "new" MGRSA organisms, termed Phenotype III Dublin isolates, were completely distinct from, and unrelated to, the MGRSA strains responsible for serious nosocomial infections in Dublin hospitals during the decade before June 1985. These Phenotype III isolates were very similar to MGRSA organisms isolated in a Baghdad hospital during 1984. Data from plasmid curing, plasmid transfer and hybridisation experiments indicated that 20% of the Phenotype-III isolates expressed chromosomally encoded, high level resistance to ethidium bromide (MIC 120 micrograms/ml), and that this was possibly due to chromosomal integration of a penicillinase-like plasmid.

Autoradiography↗
PubMed1989

Enterotoxin production by Staphylococcus aureus isolates from cases of septicaemia and from healthy carriers.

In a prospective study, 52 Staphylococcus aureus isolates from individual patients with septicaemia and 27 nasal strains from separate, healthy carriers were compared for production of a range of extracellular proteins and toxins. Whereas there was no difference (p greater than 0.05) between septicaemic and nasal isolates with respect to incidence of alpha, beta, gamma and delta haemolysins, toxic shock syndrome toxin-1 or staphylokinase production, the incidence of enterotoxin A, B, and C production was higher among isolates from septicaemia (p less than 0.01). Of the isolates from septicaemia, 33 (63%) produced enterotoxins A, B, C or D alone or in combination. Only three (11%) of the nasal isolates produced a single enterotoxin, enterotoxin D. Of the isolates from septicaemia, 67% were hospital-acquired and greater than 25% of these were endemic, methicillin-resistant (MRSA) strains. All MRSA strains produced either enterotoxin A, or enterotoxin B, or both. These findings suggest a possible role for enterotoxins in the pathogenesis of S. aureus disease other than food poisoning.

Bacterial Toxins↗
PubMed1989

New method for detecting slime production by coagulase negative staphylococci.

An alternative method for detecting the production of slime by coagulase negative staphylococci was compared with the routinely used Christensen method on 124 isolates of coagulase negative staphylococci from carriage sites, blood cultures, and infected peritoneal dialysis fluids. The alternative method requires the use of a specially prepared solid medium--brain heart infusion broth, supplemented with 5% sucrose, and Congo red stain. Of the 124 tests, there was complete agreement between methods in 107 and only one strain was clearly negative by Christensen's method while positive on Congo red agar. The Congo red method is rapid, sensitive, and reproducible and has the advantage that colonies remain viable on the medium. It is also not subject ot interbatch variation of media which sometimes affects the reproducibility of the Christensen method.

Bacteriological Techniques↗
PubMed1989

Severe pneumococcal infection: a one year survey.

Invasive pneumococcal infection is a major health problem with considerable mortality. In most patients the diagnosis is relatively straightforward but this study points out that in many, especially children, it is difficult because of a lack of clinical signs of septicaemia. While chronic respiratory disease is a major predisposing factor, malignancy and immune disorders are also common underlying features. Certain risk groups may benefit considerably from vaccination. The treatment of established infection is now complicated by the emergence of resistant strains, but penicillin remains the mainstay of therapy.

Adolescent↗
PubMed1989

The role of dipsticks in the diagnosis of urinary tract infection.

Dipsticks containing indicators for the presence of leucocytes (nephur test) and bacteria (nitrate test) were performed on 1134 urine samples obtained from children attending a Urinary Tract Infection Clinic. These dipstick results were compared with the results of standard leucocyte counts and culture of the same urines. The nitrite test was disappointing in diagnosing infection as it was positive in only 81.4% of urines with positive cultures. However, if it was combined with a nephur test only 3.9% of infections were missed. Conversely a positive nitrite test indicated with 91.3% accuracy that the urine was infected. Combined negative nephur and nitrite tests were 98.6% accurate in excluding urinary tract infection.

Evaluation Studies as Topic↗
PubMed1988

The expanded spectrum of toxocaral disease.

Among 137 members of 30 families, 6% (and 8% of those aged under 15 years) were seropositive for toxocara antibodies. In these seropositive subjects and in 84 patients known to have raised toxocara titres the commonest clinical features were abdominal pain, hepatomegaly, anorexia, nausea, vomiting, lethargy, sleep and behaviour disturbances, pneumonia, cough, wheeze, pharyngitis, cervical adenitis, headache, limb pains, and fever. 61% of patients with raised toxocara titres had recurrent abdominal pain. Eosinophilia was in many cases associated with a raised toxocara titre, but 27% of patients with high titres had normal eosinophil counts. Toxocariasis is common, especially in children, and is associated with clinical features that are generally regarded as non-specific but together form a recognisable symptom complex. Toxocariasis should be considered in the differential diagnosis of such symptoms and especially in recurrent abdominal pain, which might otherwise be labelled as idiopathic. The absence of eosinophilia does not exclude toxocariasis.

Adolescent↗
PubMed1988

Value of surveillance cultures in the management of neutropenic patients.

To assess whether bacteriological surveillance cultures can be used to predict infection in neutropenic patients, cultures were performed during the period of neutropenia of nose, throat and urine specimens collected once weekly and faeces specimens collected twice weekly. Seventy-six consecutively observed patients undergoing chemotherapy for haematological or non-haematological diseases were investigated. Severe infection including septicaemia, lower respiratory tract infection, anorectal lesion and urinary tract infection occurred in 32 patients. Enterobacter cloacae, Escherichia coli and Pseudomonas aeruginosa were the organisms most commonly involved. In the majority of cases of septicaemia the organisms were isolated from the faeces, often in pure culture, prior to the onset of septicaemia. Most of the isolates of Enterobacter cloacae were resistant to the empiric antibiotic therapy used in the unit and were able to colonise multiple sites, presumably increasing the risk of subsequent infection. Faecal culture is the most useful approach in bacteriological surveillance in neutropenic patients.

Adolescent↗
PubMed1988

Sources and outcome for methicillin-resistant Staphylococcus aureus bacteraemia.

Eighty-eight episodes of MRSA septicaemia occurring in 82 patients were studied prospectively. In 15 episodes bacteraemia was transient, in 36 non-fatal, in 33 fatal, while in four septicaemia was a major contributory factor in the patient's death. There were more patients aged over 60 years in the septicaemia groups compared to the transient bacteraemia group (P = 0.01), and patients with septicaemia were usually recently postoperative and/or suffering from severe underlying disease. Circulation access sites were the commonest source of the bacteraemic organisms with non-surgical wounds including burns, varicose ulcers and bed sores as the next most common. In four of the 16 burns patients, fatal septicaemia followed surgical debridement of infected burns. In only eight episodes was there no apparent source of bacteraemia.

Adolescent↗
PubMed1988

Circumcision and periurethral carriage of Proteus mirabilis in boys.

Swabs were taken for culture from the periurethral area and urethral meatus in 124 uncircumcised and 60 circumcised boys. Proteus mirabilis was grown from 28 (22.6%) swabs from uncircumcised boys and from only one (1.7%) swab from circumcised boys. This supports the idea that the prepuce may be the source of proteus urinary tract infection.

Adolescent↗
PubMed1988

Effect of treatment on Campylobacter pylori in peptic disease: a randomised prospective trial.

This study investigated the effect of colloidal bismuth subcitrate and cimetidine on Campylobacter pylori in peptic disease. In 74% of 135 patients with peptic disease diagnosed at endoscopy C pylori was detected before treatment. Compared with cimetidine, colloidal bismuth subcitrate significantly decreased the incidence of C pylori after six weeks of treatment (p less than 0.001). In the colloidal bismuth subcitrate group, subsequent healing of the lesion was correlated with the clearance of C pylori, unlike in the cimetidine group. C pylori was strongly associated with the presence of histological gastritis, which was decreased by colloidal bismuth subcitrate (p less than 0.001).

Adult↗
PubMed1988

Pulmonary infection due to methicillin-resistant Staphylococcus aureus.

Methicillin-resistant Staphylococcus aureus (MRSA) are now causing severe clinical infection on a worldwide basis. Pulmonary infection due to MRSA although widely reported is poorly documented. We report the predisposing factors, underlying diseases, treatment and outcome in 4 patients with pneumonia, 3 patients with empyema thoracis, 1 patient with pneumonia and empyema thoracis, 1 patient with pneumonia plus lobectomy wound infection and 2 patients with lung abscess. Vancomycin was highly effective in treatment, a finding compatible with experience treating other severe MRSA infections.

Adolescent↗