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Biomedical subjects

E Abrutyn

Publications and source records attributed to E Abrutyn.

At least 73 records · Page 4Linked to original sources
PubMed1982

An outbreak of Achromobacter xylosoxidans related to diagnostic tracer procedures.

In December, 1978, an investigation was undertaken to determine the source of infection in five patients in one hospital with hospital-associated bacteremia due to Achromobacter xylosoxidans. Review of their records showed that each had a diagnostic tracer procedure preceding the bacteremia and that no other procedures were common to all. Further investigation revealed that patients from three other hospitals were studied using diagnostic tracer materials from the index hospital. Five patients with confirmed A. xylosoxidans bacteremia and four suspected cases were identified in these hospitals, and all had a scan before the bacteremia was detected. No other A. xylosoxidans isolates were identified in any of the hospitals in the preceding two years. Although not confirmed, the source appeared to be stored non-bacteriostatic saline. Effective control measures included a sterility testing program and use of pre-packaged single dose vials of saline. Diagnostic tracer studies should be added to the list of procedures known to cause hospital-acquired bacteremias.

Aged↗
PubMed1981

Hydrotherapy: an outbreak of Pseudomonas aeruginosa wound infections related to Hubbard tank treatments.

During a 2-week period, Pseudomonas aeruginosa wound infections developed in 11 patients, 10 of whom had had hydrotherapy in Hubbard tanks before isolation of the organism from their wounds. All 10 patients had clinical evidence of disease including a temperature of greater than 100.4F, purulent wound drainage and positive culture for P. aeruginosa. These 10 patients comprised almost 60% of all patients who had received hydrotherapy during these 2 weeks. The index case had extensive cellulitis of the leg and positive wound cultures for P. aeruginosa throughout the epidemic period. Investigation revealed that the outbreak had begun coincident with the discontinuation of the use of sodium hypochlorite as a tank disinfectant and had stopped when its use had been resumed. The temporal association between the start and end of the epidemic and the use of sodium hypochlorite indicates that this agent may prevent cross-contamination and infection among patients receiving hydrotherapy.

Cross Infection↗
PubMed1979

Induction and prevention of experimental arteriovenous fistula infections.

Arteriovenous fistulae (AVF) between the femoral vessels were prepared in 20 rabbits to determine if local endovascular infections could be induced and if antibiotic prophylaxis could prevent infection. Twenty-four hours after bacterial challenge with 10(6) Staphylococcus aureus all 20 AVF were culture positive, whereas 19 of the 20 contralateral, unoperated femoral vessels were sterile. Two rabbits with AVF, followed for 30 days after receiving staphylocci, had intermittently positive blood cultures and had positive cultures of the AVF and heart valves at autopsy. Two groups of ten rabbits with AVF received either prophylactic oxacillin or vancomycin 0.5 h before bacterial challenge. Only 2 of 10 animals receiving oxacillin and 1 of 10 receiving vancomycin had positive AVF cultures at 24 h, a significant reduction in the incidence of endovascular infection compared with that in controls (P less than 0.001 by Fisher's exact test). This model, which reliably results in infection, can be used to study the pathophysiology, prevention, and treatment of AVF infections.

Animals↗
PubMed1979

Disseminated actinomycosis with spinal cord compression: report of two cases.

We studied two patients with vertebral actinomycosis and symptoms of spinal cord compression. Both patients had a chronic illness characterized by multiple draining skin lesions, weight loss, and progressive leg weakness. They responded to antibiotic therapy and corticosteroids without neurosurgical intervention. The patients were treated with antibiotics for 12 months, and remained well, without major neurologic disorder, for 2 years after stopping medication.

Actinomyces↗
PubMed1979

Summertime pneumonias in Philadelphia in 1976. An epidemiologic study.

Summertime pneumonias in Philadelphia during 1976 were studied epidemiologically, and the epidemiologic, clinical, and laboratory features of pneumonia cases serologically positive for Legionnaires' disease were compared with features of serologically negative cases. Both groups were similar in many respects, but in patients with Legionnaires' disease diarrhea and neurologic findings were significantly more frequent (P = 0.01 and P = 0.05 respectively). A diagnosis of Legionnaires' disease was also suggested by an elevated serum creatinine phosphokinase level (P = 0.02) and the presence of occult blood in the urine with fewer than six erythrocytes per highpower field. Abnormalities in renal function tests or liver function tests were commoner in patients with Legionnaires' disease (P = 0.05). Radiographic features, however, could not be used to separate pneumonia cases. The high frequency of extrapulmonary manifestations involving the gastrointestinal tract, the central nervous system, kidneys, and liver suggests that Legionnaires' disease is a multisystemic disorder possibly caused by a toxin-producing organism.

Adult↗
PubMed1978

Acinetobacter calcoaceticus outbreak associated with peritoneal dialysis.

Investigation of an outbreak of contamination of dialysis drainage fluid with Acinetobacter calcoaceticus var. anitratus identified a previously unrecognized source for dialysis associated infections. Over a 4-month period, 25 peritoneal dialysis treatments were administered to 13 hospital patients. Of the 25 treatments for which culture results were available, 14 were associated with dialysis drainage fluid cultures positive for A. calcoaceticus. A water bath used to warm bottles of peritoneal dialysate before use was the reservoir for the bacteria, and investigation showed in vitro that bath water could contaminate the dialysate. It appears likely that the dialysate became contaminated when the prong of the fluid administration set was inserted through the rubber bung on the dialysate bottles. This outbreak illustrates the potential importance of environmental reservoirs in infections complicating peritoneal dialysis.

Acinetobacter↗
PubMed1977

Community-acquired Acinetobacter calcoaceticus var anitratus pneumonia.

Two patients had community-acquired Acinetobacter calcoaceticus var anitratus pneumonia. Both patients were alcoholic and one was cirrhotic. One patient died and the other received two weeks of gentamicin therapy and survived. Misinterpretation of the sputum Gram stain delayed diagnosis and institution of proper therapy in both cases. In addition to organisms sensitive to penicillins such as Neisseria or Haemophilus, Acinetobacter must be considered in the differential diagnosis of community-acquired Gram-negative coccobacillary pneumonia.

Acinetobacter↗
PubMed1977

Tissue persistence of gentamicin in man.

A two-compartment pharmcokinetic model was used to caracterize serum concentrations and to predict tissue accumulation of gentamicin in 47 treated patients. Postmortem tissues were obtained in six cases; in each instance, tissues yielded the predicted amount of drug. Slow release of tissue-bound gentamicin accounts for its prolonged retention in the body. The two-compartment model adequately predicts gentamicin accumulation from serum concentrations and explains why this antibiotic persists in serum and urine.

Adult↗
PubMed1977

Granulocyte function in patients with chronic renal failure: surface adherence, phagocytosis, and bactericidal activity in vitro.

The defects in host defense mechanisms that explain the enhanced susceptibility to infection of patients with chronic renal failure are not understood, and previous studies concerning function of polymorphonuclear leukocytes (PMNL), the major antibacterial defense, conflict. Therefore, the antimicrobial functions of PMNL obtained from chronically uremic patients and serum factors essential for PMNL activity were evaluated. The potential modifying effect of high concentrations of serum from uremic patients on PMNL of uremic patients was determined, and granulocyte adherence, an activity related to recruitment of cells to inflammatory sites, was measured. Phagocytosis of 14C-labeled Staphylococcus aureus and bactericidal activity were normal and unaffected by high concentrations of uremic serum. Serum from uremic patients opsonized staphylococci and yeast normally. Oxidative metabolism of PMNL [14C-1]glucose oxidation, O2 consumption, and quantitative protein iodination) was normal, as was PMNL adherence. If the uremic patient has an increased risk of infection, this risk cannot be ascribed to defects of PMNL responses that have been studied in these patients.

Adult↗
PubMed1977

Penicillinase-resistant penicillins plus gentamicin in experimental enterococcal endocarditis.

Previous in vitro studies demonstrating that the penicillinase-resistant penicillins act synergistically in combination with gentamicin against some enterococci have suggested that these combinations might be effective therapy for enterococcal infections in vivo. To determine the in vivo effectiveness of such combinations, we treated rabbits with enterococcal endocarditis with gentamicin and either nafcillin, oxacillin, or methicillin. Despite doses of the penicillins equivalent to 12 or 24 g/day in a 70-kg patient, the percentage of animals in each treatment group with sterile valves at autopsy after spontaneous death or sacrifice after 21 days of therapy was low. High-dose therapy with the penicillins did not significantly increase survival over the low-dose treatment groups. Thus, it seems prudent to include penicillin with a penicillinase-resistant penicillin and gentamicin as the initial therapy of patients with endocarditis possibly caused by enterococci.

Animals↗
PubMed1977

Allescheria (Petriellidium) boydii sinusitis in a compromised host.

The first case of Allescheria (Petriellidium) boydii sinusitis is reported. The organism was isolated from the maxillary sinus in an elderly, diabetic, chronic alcoholic man on maintenance hemodialysis who developed a syndrome resembling mucormycosis. Infections with A. boydii are infrequent and are most commonly limited to Madura foot. In addition, several cases of pulmonary and central nervous system involvement have been described. There is no established therapy for A. boydii, since the published data on antimicrobial sensitivity are limited. Our organism was inhibited by 1.25 mg of amphotericin B per ml and 0.15 mg of miconazide per ml.

Alcoholism↗