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Biomedical subjects

D A Bremner

Publications and source records attributed to D A Bremner.

At least 19 recordsLinked to original sources
PubMed1991

Cryptococcal meningitis in Auckland 1969-89.

Twenty-six patients with cryptococcal meningitis were seen in Auckland between 1969 and 1989. The incidence of cryptococcal meningitis in Auckland residents was 0.12 cases/100,000/year. Ten (38%) of the patients were Maori or Pacific Island Polynesians. Nineteen (73%) had a predisposing cause, including immunosuppressive therapy in nine and the acquired immunodeficiency syndrome (AIDS) in seven. The most common presenting syndrome was a subacute or chronic meningitis. Other clinical syndromes included a slowly progressive ataxia, polyradiculopathy, and headache with vomiting. In two patients, the symptoms of meningitis were overshadowed by those of systemic cryptococcal infection. Delay in making the diagnosis was common. The most sensitive method for diagnosing cryptococcal meningitis was the cerebrospinal fluid cryptococcal antigen test. Antifungal therapy cured 17 of the 25 (68%) treated patients overall, 15 of the 19 (79%) without AIDS and six of the seven with no underlying disease.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Plasma and dialysate levels of pefloxacin and its metabolites in CAPD patients with peritonitis.

Six patients with acute peritonitis undergoing continuous ambulatory peritoneal dialysis for end-stage renal failure received an 800 mg loading dose of pefloxacin mesylate orally followed by 400 mg twice daily orally for 10 or 21 days. Plasma and dialysate levels of both pefloxacin and its metabolites were measured. Plasma levels in excess of the MIC for all infective bacteria were achieved within 90 min and in dialysate within 4 h. No significant accumulation of pefloxacin or its metabolite norfloxacin was noted. However, both serum and dialysate levels of the metabolite pefloxacin N-oxide rose continuously during treatment. Plasma and dialysate levels of all three agents fell rapidly during the five days after treatment had stopped. No major side effects were observed, although two patients developed Achilles tendonitis.

Adult↗
PubMed1988

Clinically significant Streptococcus anginosus (Streptococcus milleri) infections: a review of 186 cases.

We describe clinically significant infections due to Streptococcus anginosus in 186 patients; 114 (61.3%) males and 72 (38.7%) females, median age 42 years, range 9 months to 93 years. In 101 (54.3%) cases S anginosus alone caused infection and in 85 (45.7%) cases it was associated with other microorganisms. Abscesses accounted for 110 (59.1%) infections. Sites of infection were: miscellaneous skin and soft tissue, 64 (34.4%), intraabdominal 41 (22%), head and neck 34 (18.3%), pleuropulmonary 22 (11.8%), genitourinary 9 (4.8%), musculoskeletal 6 (3.2%), endocarditis 5 (2.7%) and primary bacteraemia 5 (2.7%). Treatment consisted of antibiotic therapy which was often prolonged, median 30 days, range 2-90 days, and surgery in 159 (85.5%). S anginosus infection was a contributory factor in two of the three deaths which occurred.

Abscess↗
PubMed1988

In-vitro activity of fleroxacin compared with three other quinolones.

The in-vitro activity of fleroxacin (Ro23-6240), a new synthetic quinolone, was compared with that of three other quinolones against 665 clinical isolates of aerobic bacteria by the agar dilution technique. Fleroxacin showed similar activity to norfloxacin, enoxacin and pefloxacin against most isolates of Enterobacteriaceae, Neisseria meningitidis, N. gonorrhoeae, Haemophilis influenzae, Staphylococcus spp. and streptococcus faecalis. Fleroxacin was the most active quinolone against Enterobacter spp. Fleroxacin was not as active against Pseudomonas aeruginosa, but the MIC90 (4 mg/l) is still below the reported peak serum level after a standard oral dose of 400 mg.

Anti-Infective Agents↗
PubMed1987

Streptococcus suis bacteraemia.

Streptococcus suis is a zoonotic pathogen which causes meningitis, arthritis and septicaemia in pigs, and rarely meningitis or septicaemia in humans. This organism has recently been isolated from pigs in New Zealand, where it appears to be widely distributed in pig herds. This case is the first report of human infection in New Zealand.

Adult↗
PubMed1987

Susceptibility of gentamicin sensitive and resistant gram negative bacilli to ceftazidime.

The in-vitro activity of ceftazidime was compared with other third-generation cephalosporins and gentamicin against 409 isolates. Ceftazidime was the most active agent against Enterobacter sp., Proteus mirabilis, Serratia sp., Proteus sp. and Pseudomonas aeruginosa. It was less active against Escherichia coli and Klebsiella than moxalactam and cefotaxime but more active than cefoperazone. Against gentamicin resistant E. coli, Klebsiella, Enterobacter and P. aeruginosa, ceftazidime was more active than moxalactam, cefotaxime or cefoperazone but was as active as moxalactam against gentamicin-resistant Proteus sp. and more active than cefotaxime and cefoperazone.

Ceftazidime↗
PubMed1986

Relapsing peritonitis in a patient undergoing continuous ambulatory peritoneal dialysis due to Corynebacterium aquaticum.

Corynebacterium aquaticum was the cause of peritonitis in a 33-year-old diabetic woman on continuous ambulatory peritoneal dialysis (CAPD). This case represents the first reported instance of CAPD peritonitis due to this organism. Moreover, the organism was recovered from fibrin clots removed from dialysate bags when the patient was on antibiotic therapy. Routine cultural methods failed to reveal the organism at that time. The organism is described and key points differentiating it from similar organisms are emphasised. The world literature on C. aquaticum infections is reviewed.

Adult↗
PubMed1985

Early clinical experience with imipenem-cilistatin.

We treated 15 patients with 16 proven bacterial infections with imipenem-cilistatin. Nine isolates were gram positive cocci, the remaining ten being gram negative bacilli and all had MICs less than or equal to 2.0 mg/l. Eight patients had respiratory tract infections, four urinary tract infections and there were three others. Twelve of 16 infections were microbiologically cured. There were no important drug side effects or toxicity. Imipenem-cilistatin is a potentially useful formulation.

Adolescent↗
PubMed1985

Catheter-related sepsis in patients on intravenous nutrition: a prospective study of quantitative catheter cultures and guidewire changes for suspected sepsis.

One hundred and ninety-five central venous catheters used for intravenous nutrition in 113 patients were studied prospectively. Catheter-related sepsis (CRS), defined by recovery of the same organism from the catheter tip and peripheral blood cultures, occurred with only 3.3 per cent of catheters or 2.3 per 1000 days of therapy. In contrast, CRS was suspected with 30 per cent of catheters and catheter contamination occurred in 37 per cent. Contamination was defined by a positive catheter tip culture without recovery of the same organism from the blood. CRS was present in 4 of 12 cases (33 per cent) with greater than 1000 colony forming units on the catheter tip but in only 2 of 54 (4 per cent) with fewer organisms. Thirty-eight cases suspected of having CRS were randomized to have catheter removal and later replacement, or replacement over a guidewire. There were no significant differences in the catheter contamination rate but there were significantly fewer problems of insertion in the guidewire group. However, transfer of Klebsiella sp., during the guidewire procedure, resulted in subsequent sepsis in one case. It is concluded that replacement of catheters over a guidewire is a safe and convenient way of establishing whether sepsis is catheter-related. Because organisms may be transferred, the procedure is not an appropriate treatment for catheter-related sepsis.

Adolescent↗
PubMed1985

In-vitro activity of the monobactam Ro 17-2301 against clinical isolates of Enterobacteriaceae and Pseudomonas aeruginosa.

Ro 17-2301 is a monobactam antibiotic. Its in-vitro activity was compared with those of aztreonam, ampicillin, cefuroxime, ceftriaxone, ceftazidime, and gentamicin. Ro 17-2301 had qualitatively similar activity to aztreonam and activity superior to that all the other antibiotics against the Enterobacteriaceae, but against Pseudomonas aeruginosa ceftazidime had equal or marginally better activity.

Anti-Bacterial Agents↗
PubMed1979

The value of smears in the diagnosis of gonorrhoea in the female.

Of 332 consecutive patients attending the female venereal disease clinic, Auckland Hospital, 74 patients had gonorrhoea confirmed by culture, but gram stained slides were positive in only 36 of these patients. Five other patients had positive gram stained smears but were culture negative. The study showed the value of gram stained smear in the rapid diagnosis of gonorrhoea in the female.

Bacteriological Techniques↗
PubMed1979

Characterization of plasmids from antibiotic-resistant Shigella isolates by agarose gell electrophoresis.

Gel electrophoresis of DNA from 95 clinical isolates of Shigella sonnei and Shigella flexneri resistant to antibiotics revealed a heterogeneous plasmid population. Most of the plasmids were smaller than 6 megadaltons (Mdal). Six S. sonnei isolates with the most common antibiotic resistance pattern were characterized. They had two plasmids in common: one was a self-transmissible Fi+ plasmid of 46 Mdal encoding resistance to streptomycin and sulphafurazole. In addition, several cryptic plasmids ranging in size from 1.0 to 24.5 Mdal were present. Mobilization of the 5.5 Mdal SuSm plasmid and a 1.0 Mdal cryptic plasmid was demonstrated with all six S. sonnei isolates during conjugation. This mobilization was mediated by the 46 Mdal self-transmissible Fi+ R plasmid and also by a 24.5 Mdal Fi- plasmid carrying no known drug resistance determinants.

Anti-Bacterial Agents↗
PubMed1979

Transfer of plasmid-mediated antibiotic resistance in strains of Pseudomonas aeruginosa isolated in Auckland.

Of 422 clinical strains of Pseudomonas aeruginosa, 23 (5.5%) were resistant to gentamicin; 19 were also resistant to tobramycin and sisomycin, and one was resistant to tobramycin, sisomycin and amikacin. Of the gentamicin-resistant strains, 20 were also resistant to kanamycin. Sixteen strains with a high level of resistance to gentamicin (MIC greater than 160 microgram/ml) transferred all their resistance determinants to recipient strains of P. aeruginosa and four transferred some resistance determinants to P. aeruginosa but none transferred resistance to a recipient strain of E. coli K12. These results show that gentamicin resistance in strains of P. aeruginosa isolated in Auckland is mediated by R plasmids.

Anti-Bacterial Agents↗
PubMed1978

The transfer of antibiotic resistance by R plasmids in Shigellae.

Forty-five strains of Shigella species isolated at Auckland Hospital from 1972--1974 were investigated for antibiotic resistance. Forty-two strains were resistant to one or more antibiotics and 11 strains transferred antibiotic resistance by conjugation to E. coli.

Anti-Bacterial Agents↗