Search PubMed⌕ Search

Biomedical subjects

D W Fraser

Publications and source records attributed to D W Fraser.

At least 55 records · Page 3Linked to original sources
PubMed1981

Two outbreaks of sternal wound infection due to organisms of the Mycobacterium fortuitum complex.

Two outbreaks of postoperative wound infections due to organisms of the Mycobacterium fortuitum complex (Mycobacterium chelonei and M. fortuitum) occurred among patients who underwent open-heart surgery. In one hospital, 19 of 80 patients who underwent cardiac surgery within a 10-week period developed sternal infection with M. chelonei. In the second hospital, four of nine patients who underwent cardiac surgery within a two-week period developed sternal incisional infection with M. fortuitum. Although epidemiologic investigations uncovered factors that were significantly associated with the development of infection, the source of the infections could not be determined. The results of numerous cultures were negative, but because the investigations were conducted at least two months after many of the patients had had surgery, the materials in use at the time of the surgery were not available for culture. These results emphasize that physicians should be aware that rapidly growing mycobacteria may produce postoperative wound infections.

Adult↗
PubMed1981

Sporadic legionellosis in the United States: the first thousand cases.

As of 30 September 1979, 1005 confirmed cases of sporadic legionellosis caused by Legionella pneumophila serogroups 1 to 4 in U.S. residents had been reported to the Centers for Disease Control; 19% were fatal. All but 2% of the 1005 cases were associated with pneumonia documented by chest radiograph. About 75% of the cases occurred in June through October. The risk of acquiring sporadic legionellosis was increased among males and persons 50 years or older; persons with renal disease necessitating dialysis or transplantation, with chronic bronchitis or emphysema, with diabetes mellitus, and with cancer (10 selected sites or types); persons who smoke; and persons being treated with immunosuppressive drugs. Increasing age and chronic bronchitis or emphysema were associated with increased risk of death. The sensitivity of culturing L. pneumophila from specimens positive by direct immunofluorescence was estimated to be 45%. The distribution of serogroups 1, 2, 3, and 4 of L. pneumophila in 57 fresh, not previously examined direct fluorescent antibody-positive specimens was 84%, 11%, 4%, and 2%, respectively; all 26 strains isolated from these specimens were of one of these four serogroups.

Adolescent↗
PubMed1981

Isolation of Legionella pneumophila from hospital shower heads.

Legionella pneumophila serogroup 6 was isolated from nine of 16 shower heads in a Chicago hospital ward where three patients had contracted Legionnaires' disease caused by serogroup 6 L. pneumophila. Each patient had showered there 2 to 10 days before the onset of disease symptoms. We also isolated the bacteria in two other hospitals, and found the same serogroups as had been causing Legionnaires' disease in those hospitals: serogroup 1 in Pittsburgh and serogroups 1 and 4 in Los Angeles. However, showers from hospital wards where no patients had contracted Legionnaires' disease also yielded L. pneumophila. Shower heads at the Chicago hospital were sterilized with ethylene oxide but rapidly became recontaminated, suggesting that the potable water at these hospitals may have contained the organism. The question of whether aerosols of shower water or other exposures to potable water containing L. pneumophila may cause nosocomial Legionnaires' disease has not been resolved but deserves further study.

Baths↗
PubMed1981

A cluster of Acinetobacter Pneumonia in foundry workers.

In a 3-month period, three men who had worked for 5 to 19 years as welders or grinders of steel castings in a foundry acquired pneumonia caused by Acinetobacter calcoaceticus variety anitratus serotype 7J. Two of the men died, and postmortem examination showed mixed-dust pneumoconiosis with iron particles in the lungs. A calcoaceticus variety anitratus serotype 7J was isolated from the air in the foundry but the source was not found. The prevalence of antibody titers of 64 or greater to the 7J strain was significantly higher among foundry workers (15%) than among community controls (2%) (p less than 0.01). Sampling showed that the concentrations of total and metallic particles (especially iron) and of free silica in air inhaled by welders and grinders at the foundry frequently exceeded acceptable levels. These findings suggest that chronic exposure to such particles may increase susceptibility to infection by this organism, which rarely affects healthy people.

Acinetobacter Infections↗
PubMed1980

Toxic-shock syndrome in menstruating women: association with tampon use and Staphylococcus aureus and clinical features in 52 cases.

To determine the risk factors associated with toxic-shock syndrome (TSS) in menstruating women, we conducted a retrospective telephone study of 52 cases and 52 age-matched and sex-matched controls. Fifty-two cases and 44 controls used tampons (P < 0.02). Moreover, in case-control pairs in which both women used tampons, cases were more likely than controls to use tampons throughout menstruation (42 of 44 vs. 34 of 44, respectively; P < 0.05). There were no significant differences in brand of tampon used, degree of absorbency specified on label, frequency of tampon change, type of contraceptive used, frequency of sexual intercourse, or sexual intercourse during menstruation. Fourteen of 44 cases had one or more definite or probable recurrences during a subsequent menstrual period. In a separate study, Staphylococcus aureus was isolated from 62 of 64 women with TSS and from seven of 71 vaginal cultures obtained from healthy controls (P < 0.001).

Adolescent↗
PubMed1980

Pneumococcal disease after pneumococcal vaccination: an alternative method to estimate the efficacy of pneumococcal vaccine.

Trials of pneumococcal vaccine in healthy young adult populations suggest 75 to 95 per cent type-specific efficacy. Trials have not been done, however, in groups for which pneumococcal vaccine is currently recommended in the United States. To assess efficacy in the immunocompromised groups now receiving the vaccine, we compared serotypes of 35 isolates of Streptococcus pneumoniae isolated from blood or cerebrospinal fluid one month or longer after the patient had received commercially available pneumococcal vaccine with serotypes of 392 isolates from unvaccinated persons surveyed in a study of the nationwide distribution of pneumococcal serotypes. Proportions of infections with vaccine serotypes were unexpectedly similar. An alternative approach to estimation of vaccine efficacy suggested an average efficacy of 36 per cent in persons of all ages. The estimated efficacy was lowest in children two to 10 years old (less than or equal to 0 per cent) and in persons with preexisting diseases that are thought to predispose to pneumococcal disease (less than or equal to 0 per cent), and highest in the group over 10 years old (60 per cent). The possibility that efficacy is low in high-risk, immunocompromised populations makes it important to evaluate clinical efficacy and not just serum antibody responses in such groups.

Adolescent↗
PubMed1980

A controlled study of penicillin therapy of group A streptococcal acquisitions in Egyptian families.

A two-year controlled trial of benzathine penicillin G treatment of persons who acquired group A streptococci, identified by semimonthly throat cultures, was carried out in Egypt in 110 apparently normal families and 84 families with a child suspected of having rheumatic heart disease. Penicillin treatment was associated with a marked decrease in prevalence of the organism (19.0%-5.4%) and a modest decrease in introductions into families (0.79-0.54 single introductions per person per year) but no decrease in spread within nonrheumatic families. Results in suspected-rheumatic families were similar. It was concluded that the schedule of penicillin treatment used had a minimal effect on streptococcal spread and is unlikely to be an effective control tool. Spread within families was most intense in those episodes in which the household contacts were two to 14 years of age, the introducer had sought medical care, or the introducer ultimately carried the streptococcal strain for three or more months.

Egypt↗
PubMed1980

An outbreak of adenovirus type 3 disease at a private recreation center swimming pool.

In the period June 6--July 24, 1977, and outbreak of illness due to adenovirus type 3 (AV3) occurred in residents of a suburban community (Community A), Dekalb County, Georgia. Based on surveys, at least 105 cases occurred. The illness was primarily characterized by sore throat, fever, headache, and anorexia. Conjunctivitis affected only 34 of 105 (32%) of the individuals in two surveys. Frequent use of a private swimming pool was associated with illness in Community A residents. The outbreak coincided with a temporary defect in the pool filtration system which probably prevented maintenance of proper chlorine levels in the pool water, and suggested that the infection was spread by pool water. However, the predominant mode of transmission could not be shown conclusively to be waterborn rather than person-to-person.

Adenoviridae Infections↗