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Biomedical subjects

C V Sanders

Publications and source records attributed to C V Sanders.

At least 73 records · Page 4Linked to original sources
PubMed1983

Interlaboratory variation of antibiograms of methicillin-resistant and methicillin-susceptible Staphylococcus aureus strains with conventional and commercial testing systems.

Laboratory-prepared (conventional) and commercial susceptibility testing systems were compared by using a group of methicillin-resistant (MR) and methicillin-susceptible (MS) strains of Staphylococcus aureus. A group of 25 MR and 15 MS S. aureus strains were coded and tested blindly by disk diffusion, agar dilution, broth microdilution, Sensititre, Micro-Media, Sceptor, API 3600S, MicroScan, Autobac I, and MS-2 systems. All systems were incubated at 35 degrees C and read with either a manual or automated reader at the recommended times. Where applicable, systems were also read at 48 h. Among the conventional assays, the broth and agar dilution methods were comparable, both detecting 88% of the MR strains at 24 h and detecting 92 and 96%, respectively, at 48 h. The disk diffusion method was less efficient, detecting only 36 and 72% at 24 and 48 h, respectively. Detection of cephalothin resistance was low for all systems at both time periods, with agar dilution and disk diffusion being the most and least efficient, respectively. Some variability was also seen with detection of resistance to clindamycin and gentamicin. Among the MS strains, variability among the conventional systems occurred with methicillin, gentamicin, ampicillin, and penicillin. Comparison of the commercial systems with manual readers with the broth microdilution method (reference method) showed that for MR strains, the Sceptor system gave identical results at 24 and 48 h. Sensititre detected 68 and 88% of the MR strains, whereas Micro-Media was least effective detecting 12 and 80% at 24 and 48 h, respectively. None of the commercial systems detected cephalothin resistance well, with only one strain being indicated by the Sceptor and Sensititre systems at 48 h. Slight differences were also seen among the systems with clindamycin and gentamicin. With regard to the MS strains, variability among the systems was seen with methicillin, penicillin, ampicillin, clindamycin, and gentamicin. Among commercial systems with automated readers, the API system detected a greater number of MR strains than did the reference method at 24 and 48 h, 96 and 100%, respectively. The MicroScan method was comparable to the reference method detecting 80 and 88% of the MR strains at both time periods, respectively. Both Autobac I and MS-2 were much less effective in detecting MR strains, noting only 32 and 16%, respectively, at the 3- to 6-h readings. Poor detection of cephalothin resistance among MR strains was evident in all systems. Variability also occurred among the systems with clindamycin, gentamicin, and ampicillin. A single strain of the MR group was reported to be vancomycin resistant by the API system. Among the MS group, the greatest variability was seen with methicillin. Less variability occurred with penicillin, ampicillin, gentamicin, and vancomycin.

Humans↗
PubMed1983

The telescoping plugged catheter in suspected anaerobic infections. A controlled series.

The results of bacterial cultures from transtracheal aspiration and from aspirations obtained by a new telescoping plugged catheter were compared in specimens taken from 13 patients with suspected anaerobic infections of the lower respiratory tract. When all bacterial isolates (potential aerobic pathogens, aerobic nonpathogens, and anaerobes) were counted with transtracheal aspiration as the standard method for comparison, cultures of material obtained by the telescoping plugged catheter technique yielded 22 false negatives and 14 false positives. The results of the 2 methods were in complete agreement in only 3 paired specimens cultured aerobically and in only 6 paired specimens cultured anaerobically. When only potential aerobic pathogens and anaerobes were considered with transtracheal aspiration as the standard method for comparison, cultures of material obtained by the telescoping plugged catheter technique yielded 11 false negatives and 7 false positives, and the results of the 2 methods were in complete agreement in 9 paired specimens cultured aerobically and 6 paired specimens cultured anaerobically. Our results suggest that fiberoptic bronchoscopy using the telescoping plugged catheter technique may be an acceptable method for collecting specimens from the lower respiratory tract, but further studies comparing this method with transtracheal aspiration are needed.

Adult↗
PubMed1982

Piperacillin v Carbenicillin in the therapy for serious infections.

One hundred seven patients were treated with either piperacillin (56) or carbenicillin (51) in an open randomized trial of hospitalized patients with pleuropulmonary (40), urinary tract (26), gynecologic (21), skin and soft-tissue (eight), joint (five), bone (three), and miscellaneous other infections (four). Patients with urinary tract infections were given 150 mg/kg/day of piperacillin sodium or 200 mg/kg/day or carbenicillin sodium in divided doses every six hours intravenously. Patients with other infections were given 250 mg/kg/day of piperacillin sodium and 450 mg/kg/day of carbenicillin sodium; 53/56 (95%) patients treated with piperacillin and 45/51 (88%) patients treated with carbenicillin were cured clinically. In general, the drugs were well tolerated. There were, however, more adverse experiences in the groups taking carbenicillin. Of special interest was the finding of liver function test abnormalities in 17/78 (21%) carbenicillin recipients (evaluative and nonevaluative cases). We concluded that piperacillin was effective and safe. It has potential for use in a great variety of infections.

Adult↗
PubMed1982

N-formimidoyl thienamycin (MK0787): in vitro activity against anaerobic bacteria.

The in vitro activity of N-formimidoyl thienamycin (MK0787) was tested against 239 anaerobic bacteria clinical isolates: 70 of Bacteroides fragilis, 18 of B. distasonis, 16 of B. thetaiotaomicron, 10 of B. vulgatus, 24 of Bacteroides spp., 22 of B. melaninogenicus (all three subspecies), 26 of Fusobacterium spp., 10 of Peptococcus spp., 15 of Peptostreptococcus spp., 15 of Clostridium perfringens, and 13 of Clostridium spp. Ninety-five percent of the isolates were inhibited by less than or equal to 0.125 microgram/ml, and all were inhibited by less than or equal to 4 micrograms/ml.

Anaerobiosis↗
PubMed1982

Moxalactam in the therapy of serious infections.

Sixty-seven patients were treated with moxalactam in a noncomparative trial of hospitalized patients; 32 had endometritis or chorioamnionitis, 12 had skin and soft tissue infections, 5 had osteomyelitis, 5 had pneumonia, 5 had urinary tract infections, 4 had arthritis, 2 had sepsis from an unknown source, 1 had endocarditis, and 1 had peritonitis. Bacteremia was present in 12 of these patients. Patients were given 3 to 12 g of moxalactam per day (mean, 6.24 g/day) in divided doses every 6 to 8 h. Seven patients were given intramuscular treatment for 3 to 20 days for part or all of their therapy. The rest were given intravenous treatment exclusively. Treatment was continued for 2 to 42 days (mean, 10 days). The dose and the duration of therapy were determined by the type of infection and the response of each patient. There were four treatment failures and one enterococcal-clostridial superinfection. Moxalactam was well tolerated. Allergic reactions led to the discontinuation of the antibiotic in three patients. Prolonged prothrombin and partial thromboplastin times were observed in 2 of 11 patients tested; in both instances in patients had severe underlying diseases, including malnutrition and alcoholism. Pain on intramuscular injection was noted in two patients receiving 1,500 mg, but not in five receiving a lower dose; in one case the pain forced the use of intravenous therapy after one dose, and in the other case the pain was mild and the patient was treated for 20 days. We concluded that moxalactam was effective in the treatment of the types of infections included in this study and produced few adverse reactions.

Bacterial Infections↗
PubMed1982

Candidal suppurative peripheral thrombophlebitis.

Transient candidemia is common with prolonged intravenous therapy. Sustained candidemia, however, usually indicates a persistent focus of infection. A complication of intravenous therapy not previously emphasized is persistent candidemia caused by candidal suppurative peripheral thrombophlebitis. We report six cases that appeared during intravenous therapy: the infection was characterized by a thrombosed peripheral vein at an intravenous site with manifestations for candida septicemia with or without disseminated candidiasis. In two patients, the source of the process was occult; the examination showed only a thrombosed noninflamed vein. In all cases, surgical exploration showed the thrombosed veins to be suppurative with positive cultures for Candida. Special stains, moreover, showed Candida in the luminal clot and the vascular wall. In the five surviving patients, cure was achieved by excision of the affected vein. Four received a short course of amphotericin B and 5-fluorocytosine, and one patient received amphotericin B only.

Adult↗
PubMed1982

Apparent ketoconazole failure in candidal cholecystitis.

Fungal acalculous cholecystitis is a rarely recognized complication of disseminated candidal infections. We report such a case of systemic candidiasis that developed in a man who was diabetic while he was receiving broad-spectrum antibiotic therapy for an infected foot ulcer. Ketoconazole, a new imidazole antifungal agent, was used successfully to treat the systemic candidal infection but it failed to eradicate the fungus in the biliary tract.

Antifungal Agents↗
PubMed1982

Use of single-agent antimicrobial therapy in the treatment of polymicrobial female pelvic infections.

One hundred twenty patients with either postpartum endomyometritis or postgynecologic surgical infections were treated either with ticarcillin, clindamycin, or chloramphenicol. One hundred nine (91%) responded successfully to single-agent antimicrobial therapy. Most of the infections were polymicrobial, involving both aerobic and anaerobic bacteria. Forty patients were treated with ticarcillin, with 90% responding successfully; 48 were treated with chloramphenicol, with 94% responding successfully; and 32 were treated with clindamycin, with 88% responding successfully. Single-agent antimicrobial therapy appears to be appropriate for treating polymicrobial obstetric and gynecologic soft tissue infections.

Adolescent↗
PubMed1982

Presumed blastomycosis endophthalmitis.

A 49-year-old outdoor laborer had an endophthalmitis in one eye and small posterior segment lesions in the other, as well as raised lesions on his skin. The diagnosis of disseminated North American blastomycosis was established by the performance of a biopsy on one of the skin lesions. The ocular inflammation slowly improved with intravenous amphotericin B therapy, and the ocular lesions, presumably caused by Blastomyces dermatitidis, were followed clinically for six months. The patient died of a hospital-acquired pneumonia caused by Staphylococcus aureus.

Amphotericin B↗
PubMed1981

Single-dose cefaclor therapy of urinary tract infection. Evaluation of antibody-coated bacteria test and C-reactive protein assay as predictors of cure.

The efficacy of single-dose (cefaclor, 2 g orally) and multidose (cefaclor, 250 mg orally three times a day for 10 days) antibiotic regimens in the therapy of acute uncomplicated urinary tract infections (UTI) in nonpregnant women were compared. The patient's clinical status and results of urine cultures were compared in retrospect with the results of the antibody-coated bacteria (ACB) test and C-reactive protein (CRP) test in order to determine if either test would predict the patient's response. Overall, 10 of 30 patients (33 percent) and 18 of 22 patients (81 percent) given single doses and multidoses, respectively, had negative urine cultures four weeks after completion of therapy. A negative urine culture at four weeks correlated with a negative ACB test utilizing the less inclusive criteria for negativity (less than 5 bacteria with fluorescence in 5 minutes of search) but not with a negative ACB test utilizing the more inclusive criteria (less than 10 percent bacteria with fluorescence) or with a negative CRP test. The cure rate in the ACB-negative single-dose group (7 of 9 patients) utilizing the less inclusive criteria for negativity was similar to the cure rate in the ACB-negative multidose group (8 of 10 patients). This study suggests that the ACB test, if properly standardized, might permit identification of a population of patients with UTI who would respond to single-dose cefaclor therapy.

Adult↗
PubMed1980

The treatment of serious anaerobic infections.

Thirty-one adult patients with infections due to anaerobic bacteria were treated with cefamandole. Bacteroides fragilis group (17) and Bacteroides melaninogenicus (13) were the most frequent anaerobes isolated. Duration of therapy varied from 2 to 49 days. Results were judged satisfactory in 26 cases, and unsatisfactory in 1 case. Four cases could not be evaluated. Adverse reactions occurred in 16 patients and included positive direct Coomb's test without hemolysis, transient liver function abnormalities, phlebitis, reversible neutropenia, fever, eosinophilia, and toxic epidermal necrolysis. The more significant reactions were associated with prolonged therapy. None was lethal. These data suggest that cefamandole is effective in treatment of most anaerobic infections.

Aerobiosis↗
PubMed1980

Endocarditis from human-to-human transmission of Staphylococcus aureus.

Endocarditis due to Staphlyococcus aureus developed in two drug abusers who used the same paraphernalia for parenteral injections. The phage type of the organism isolated from the blood and nasal secretions of the first patient was identical to that of the organism isolated from the blood of the second patient. The epidemiologic and microbiologic data from our cases indicate human-to-human transmission of the responsible agent.

Adult↗
PubMed1979

Hepatitis B presenting with tenosynovitis.

A 31-year-old nurse's aide developed fever, malaise, migratory arthralgias, arthritis, and severe tenosynovitis six weeks after pricking her finger with a needle contaminated by blood from a patient having type B viral hepatitis. Although disseminated Neisseria gonorrhoeae infection was the initial diagnosis, her symptoms worsened on treatment with ampicillin. While the patient was on aspirin therapy, her symptoms improved dramatically and eventually resolved as she showed evidence, through laboratory findings, of an anicteric hepatitis B infection. Evidently tenosynovitis can be part of the hepatitis B prodrome.

Adult↗