Search PubMed⌕ Search

Biomedical subjects

D J Flournoy

Publications and source records attributed to D J Flournoy.

At least 19 recordsLinked to original sources
PubMed2000

Increasing antimicrobial resistance in gram-negative bacilli isolated from patients in intensive care units.

BACKGROUND: We investigated gram-negative bacilli from patients in intensive care units to determine whether antimicrobial resistance was increasing. METHODS: Minimal inhibitory concentrations were determined by broth microdilution on 334 gram-negative bacilli collected in 1990, 1995, and 1998. RESULTS: During the 3 study years, the types of gram-negative bacilli encountered in our intensive care units changed with proportional increases of Pseudomonas sp and decreases of inducible enterics. Dramatic increases in resistance for ceftazidime, cefotaxime, and piperacillin were paralleled between respiratory-tract isolates and inducible enterics. By 1998, ticarcillin was more active than piperacillin against most isolates except Escherichia coli and Klebsiella sp, and most isolates became more resistant to gentamicin and tobramycin. CONCLUSIONS: Continuous changes in the types of gram-negative bacilli and antimicrobial resistance complicate empirical selection of antimicrobials in the intensive care units. These complications will place more emphasis on communication and strategy formations among health care workers (nurses, physicians, laboratorians, and pharmacists) in an effort to treat infections in a timely and effective manner.

Ampicillin Resistance↗
PubMed2000

Isolation of fungi from rose bush thorns.

Rose bush thorns from plants in the Oklahoma City area were cultured to determine the prevalence and species of fungi present. One hundred fifty isolates grew from thorns on 103 plants. All thorns harbored at least one species, while one thorn had five species of fungi. Of the 21 fungal species isolated, all are known human pathogens, although most rarely cause disease in immunocompetent individuals. Alternarium sp., Bipolaris sp., Aspergillus niger, Curvularia sp., and Fusarium sp. were the most common fungi, accounting for 75% of the isolates. Sporothrix schenckii, an organism often associated with rose bushes, was found on thorns of only two plants. Findings of this study suggest that since fungi are common inhabitants of roses, individuals who experience rose-thorn punctures are at increased risk of acquiring fungal infections, especially if they are immunocompromised.

Fungi↗
PubMed1995

Interpretation of multiple isolate urine cultures in adult male patients.

A retrospective analytical study examined the records of 220 adult males (mean age 64.9 years) to determine the relative probability that multiple urine culture isolates (MUI) represent urinary tract infection (UTI) versus contamination or colonization. Nonculture laboratory data were used to determine the likelihood of UTI. Patients were classified into three categories: group 1 (those with single isolate cultures; n = 110), group 2 (those with MUI and either symptomatic UTI or an underlying pathologic condition; n = 71) and group 3 (those with MUI and either surgically altered urinary passages or absence of UTI symptoms; n = 39). Nonculture laboratory data suggested UTI in 48.2% of patients in group 1, 46.5% in group 2, and 23.1% in group 3. Patients in groups 1 or 2 with cultures yielding isolate counts of 10(5) colony forming units/mL were 6.2 times more likely to be classified as having a UTI (by nonculture laboratory data) compared with patients having only one or more of these two criteria. This study proposes a more objective approach to interpretation of MUI cultures using the results of nonculture laboratory data, clinical profiles, and colony counts.

Aged↗
PubMed1994

Antimicrobial susceptibilities of bacteria from nursing home residents in Oklahoma.

In vitro antimicrobial susceptibilities for 2,832 isolates from nursing home patients in Oklahoma (1992) were compiled retrospectively. An appreciable proportion of antimicrobial resistance was detected for ampicillin, sulfamethoxazole-trimethoprim and ciprofloxacin among gram-negative bacilli. Of 301 Staphylococcus aureus isolates tested, 70% were resistant to methicillin and 72% resistant to ciprofloxacin. Vancomycin resistance occurred in 22% of Enterococcus faecium isolates. These findings herald a high incidence of antimicrobial resistance in nursing home residents.

Aged↗
PubMed1994

Microbiological flora and nail polish: a brief report.

Removing nail polish and prosthetic nails from operating room (OR) personnel prior to scrubbing and from patients prior to hand surgery is recommended but not practiced in many hospitals. There is concern that nail polish can act as a vehicle for the transfer of infectious agents. This study was designed to determine the incidence of microbiological flora of nail polish in a clinical setting.

Acinetobacter↗
PubMed1993

Sputum quality: can you tell by looking?

BACKGROUND: Nurses are responsible for the collection of sputum samples for culture in most institutions, yet they receive little formal training on what a good specimen looks like. METHODS: Three hundred thirty-three consecutively collected expectorated sputum samples and tracheal aspirates were examined to determine the relationship of macroscopic specimen appearance (watery, mucoid, mucopurulent) to specimen quality (good, fair, poor). RESULTS: Of the expectorated sputum samples, 21% were watery, 65% were mucoid, and 14% were mucopurulent. Sixty-five percent of the expectorated sputum samples were good or fair, regardless of appearance. Eighty-seven percent of mucopurulent expectorated sputum samples were good or fair. In the remaining nonmucopurulent specimens, however, there were no predictable markers of specimen quality. CONCLUSIONS: The only specimens that were predictably good were those that were mucopurulent yellow, yellow, or tracheal aspirates.

Humans↗
PubMed1993

Incidence of bacteria from clean-catch and catheterized urine of nursing home residents.

Urine cultures from 1990 through 1992 were analyzed to determine the incidence of common isolates in residents from over 50 nursing homes in Oklahoma. Of all 11,480 isolates in clean-catch and catheterized specimens, the most common were: Escherichia coli (24% of all isolates), Pseudomonas aeruquinosa (11%), Proteus mirabilis (10%), Enterococcus faecalis (8%), Klebsiella pneumoniae (7%), Providencia stuartii (5%), and Staphylococcus aureus (4%). The most striking findings of this study were the similarities in frequencies of isolates from clean-catch and catheterized urines, the common occurrence of P. stuartii, and the low proportion of urea-splitting P. stuartii isolates from catheterized specimens.

Aged↗
PubMed1993

Problems in diagnosing infections in the elderly.

Elderly individuals often present with altered signs and symptoms to infectious diseases. Altered signs and symptoms may result from underlying illnesses, physiological changes of the elderly, or chemotherapy. Increased awareness of the occurrence of altered signs and symptoms can facilitate determining the medical diagnosis and treatment of the elderly.

Aged↗
PubMed1993

Methicillin-resistant Staphylococcus aureus: long-term routes of acquisition in hospital patients.

Five hundred fifty three patients and two personnel (1986-1991) were categorized according to acquisition route of methicillin-resistant Staphylococcus aureus (MRSA) and initial culture date. Of the 555, there were 218 with nosocomial infections, 100 with nosocomial colonizations, 92 with community-acquired infections, and 145 with community-acquired colonizations. Nosocomial infections occurred significantly more often than nosocomial colonizations, community-acquired infections, or colonizations (p < 0.001). Results of this study show that over a long period, our patients acquired MRSA by different routes, none of which were related to seasons of the year. Although seasonal outbreaks of epidemic MRSA are important, an awareness of the occurrence of endemic MRSA is also important because it serves as a reminder that MRSA reservoirs are continuously present in some institutions.

Cross Infection↗
PubMed1993

The relationship of organism pathogenicity and route of acquisition to antimicrobial susceptibilities.

Three hundred forty-eight isolates of methicillin-resistant Staphylococcus aureus were classified as representing nosocomial or community acquired infection or colonization. They were then tested against 11 antimicrobials, and the percentage of isolates that were susceptible to each antimicrobial was compared statistically among the classes. There were statistically significant (P value < 0.05, chi-square analysis) differences among isolates from several classes for chloramphenicol, imipenem, tetracycline, sulfamethoxazole-trimethoprim, ciprofloxacin, and gentamicin.

Anti-Bacterial Agents↗
PubMed1992

A pseudo-outbreak of Methylobacterium mesophilica isolated from patients undergoing bronchoscopy.

An unusual, slow growing, pink-pigmented gram-negative bacillus was isolated from bronchoscopy specimens of seven patients over a three-month period. The organism was identified as Methylobacter mesophilica. None of the patients were believed to be infected with Methylobacter mesophilica. The results of environmental cultures showed that the organism was present in tap water from the bronchoscopy room.

Adult↗