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Biomedical subjects

E G Smyth

Publications and source records attributed to E G Smyth.

At least 19 recordsLinked to original sources
PubMed1992

Susceptibility of urinary pathogens in a Dublin teaching hospital.

The range and resistance patterns of organisms causing urinary tract infections (UTI) vary with time and place. A prospective study of midstream urine (MSU) specimens, received over a 3 month period, was therefore undertaken. The antibiotic sensitivities of 528 isolates from 196 domiciliary and 332 hospitalised patients with significant bacteriuria (> 10(5) organisms/ml) were determined using the modified Stokes method. Escherichia coli accounted for 79% of domiciliary isolates and 57% in hospitalised patients. Gram positive organisms causing UTI have become increasingly common and were isolated from 8% and 15% of domiciliary and hospitalised patients respectively. Resistance levels for co-amoxiclav (Augmentin) were low (7% domiciliary, 14% hospitalised). However 46 Gram negative isolates (10%) had intermediate sensitivities to co-amoxiclav on disc testing. Breakpoint testing showed 89% of these to be sensitive at the urinary breakpoint but only 52% were sensitive at the systemic breakpoint. Forty nine percent of E. coli from hospital specimens were resistant to pipercillin, due to TEM-1 beta lactamase production. A 6% resistance level to ciprofloxacin in domiciliary E. coli is considerably higher than previous reports and gives cause for concern. Gentamicin resistance was found in 4% of Gram negative hospital isolates, a finding of some significance in the empiric treatment of septicaemia of urinary tract origin.

Anti-Bacterial Agents↗
PubMed1992

Post-infectious encephalomyelitis associated with Mycoplasma pneumoniae and Legionella pneumophila infection.

A case of severe acute encephalomyelitis associated with a serological diagnosis of both Mycoplasma pneumoniae and Legionella pneumophila infection is reported. Serological co-positivity between these two pathogens has been reported previously, and has, in general, been attributed to cross-reactivity. This is the first documented case of co-infection using more sensitive and specific serological techniques. The potential significance of these findings is discussed in the context of the considerable problems in the interpretation of serological data.

Acute Disease↗
PubMed1989

Prevalence and susceptibility of highly gentamicin resistant Enterococcus faecalis in a south London teaching hospital.

Combinations of aminoglycosides plus ampicillin usually are necessary for the satisfactory management of serious Enterococcus faecalis sepsis. A study in a South London hospital demonstrated that 7% of all E. faecalis, and 30% of those from blood cultures, were highly gentamicin resistant. Addition of gentamicin confers no benefit to the treatment of these organisms with ampicillin. We looked at the susceptibility pattern of these organisms in vitro and concluded that ampicillin plus ciprofloxacin offered the best available combination.

Anti-Bacterial Agents↗
PubMed1989

Septicaemia in patients with temporary and permanent endocardial pacemakers.

Twenty-four patients with staphylococcal septicaemia due to permanent (14) and temporary (10) endocardial pacemakers were reviewed. With permanent pacemakers local inflammation was usually present and the onset of septicaemia rapid. If patients were treated with high dose intravenous flucloxacillin combined with removal, recovery was usual. In patients with retained endocardial tips (6) we eradicated infection with medical treatment alone in four cases. We would advocate antistaphylococcal prophylaxis for patients undergoing revision in the presence of local inflammation and high dose intravenous flucloxacillin plus a second anti-staphylococcal antibiotic (e.g. gentamicin) in patients with septicaemia and a pacemaker in situ.

Adult↗
PubMed1989

Ciprofloxacin.

Ciprofloxacin is a useful, orally available, non-toxic broad-spectrum antibiotic. Despite its novel mode of action, resistance is arising and we feel the drug should be reserved for specific indications where it can be of enormous value.

Ciprofloxacin↗
PubMed1988

Group G streptococcal endocarditis: two case reports, a review of the literature and recommendations for treatment.

Two cases of endocarditis caused by a group G streptococcus are reported and the literature on group G streptococcal endocarditis is reviewed. The onset of illness is usually acute and the portal of entry for the organism through the skin. The left side of the heart is mainly involved and in about 50% cases the endocarditis arises on a normal valve. Most patients develop complications, both embolic and cardiac, and the mortality is high (36%). We suggest that patients with proven group G streptococcal endocarditis should be treated with large doses of benzyl penicillin and with an aminoglycoside for not less than 4 weeks. Patients with complications should be referred to a cardiothoracic centre. We should be glad to know details of complications, treatment and outcome in other cases of group G streptococcal endocarditis.

Acute Disease↗
PubMed1988

Clinicians' guide to antibiotics. Tetracycline.

Tetracyclines have a broad range of activity against many organisms and remain the antibiotics of choice for some diseases, including brucellosis, chlamydial infections and severe acne vulgaris. However, because of their side effects, increasing resistance and the alternative antibiotics now available, their clinical usefulness is limited.

Administration, Oral↗
PubMed1988

Clinicians' guide to antibiotics. Chloramphenicol.

Chloramphenicol, despite its well-recognized toxic side effects, is a cheap and useful antibiotic in the management of meningitis, typhoid, brain abscess and severe Haemophilus influenza infections. Where possible, drug levels should be monitored.

Anemia, Aplastic↗
PubMed1988

Vancomycin.

Vancomycin is an important antibiotic for the treatment of severe Gram-positive infection, especially in cases with resistant organisms or when the patient is allergic to penicillin. Because of its mode of action, pharmacokinetics and side effects, close liaison with the medical microbiologist is necessary.

Bacterial Infections↗