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Biomedical subjects

E L Teare

Publications and source records attributed to E L Teare.

At least 37 records · Page 2Linked to original sources

Human enteric pathogens identified in a London teaching hospital and a rural public health laboratory: 1994.

Two microbiology laboratories, one serving an inner city hospital and one a rural public health laboratory, collected data on the outcome of examining faecal specimens in 1994. Overall, 6.7% of the investigations were positive, but the rates were lower for hospital inpatients, for recently described pathogens, and in the absence of relevant clinical details; rates were higher for patients with a history of foreign travel. No benefit was gained by examining more than two specimens from any patient. Clostridium difficile was the only investigation frequently positive among patients already in hospital, and virological tests were often positive in patients investigated by general practitioners.

Communicable Diseases↗

The development of an infection control link-nurse programme in a district general hospital.

Management of hospital-acquired infection is costly, and a vital part of risk management. It is also closely linked with the quality of patient care. Information regarding hospital-acquired infection is increasingly being sought by both purchasers and providers. This paper describes the setting up and development of an infection control link-nurse system over a four-year period in a district general hospital. It gives practical details of methodology and problems encountered. Emphasis is given to the incorporation of infection control principles into ward and departmental standard setting. Having set up the system, subsequent monitoring of the process by a clinical audit programme is described. The importance of the responsibility of staff, at ward and departmental level, in high-level infection control practice is discussed.

Hospitals, District↗

Methicillin resistant Staphylococcus aureus in three adjacent health districts of south-east England 1986-91.

The experiences with methicillin-resistant Staphylococcus aureus (MRSA) of two contiguous Health Districts during 1986-91 and of a third mutually adjacent District in south-east England during 1989-91 were compared. Although the three Districts were in many ways similar, the nature of the problems posed by MRSA differed. The Districts had dealt with MRSA independently but had evolved similar strategies for coping with the organism. In two Districts a gradual relaxation of case-finding and of infection control precautions applied to individual patients and outbreaks, was followed by a reduction in the number of new patient-isolates identified from routine bacteriology specimens. Standardization of MRSA isolation rates for patient throughput and for length of hospital stay showed the examination of crude total isolates to provide misleading comparisons of relative risks of acquiring MRSA in different specialties. It was also found that patients discharged from specialties with short inpatient stays were more likely to have MRSA detected after discharge by their physicians working in the local community served by the hospitals but there was no evidence of spread outside hospital. It is suggested that good all-round standards of infection control practice are more important than specific radical policies in dealing with endemic MRSA.

Colony Count, Microbial↗

An outbreak of Salmonella saint-paul infection associated with beansprouts.

In March 1988, there was an outbreak of infection by a strain of Salmonella saint-paul with a distinctive antigenic marker. A total of 143 reports were received between 1 March and 7 June. Preliminary investigations suggested that raw beansprouts were a possible source of infection and a case-control study confirmed the association. S. saint-paul of the epidemic type was isolated from samples of beansprouts on retail sale in different cities in the United Kingdom and from mung bean seeds on the premises of the producer who was most strongly associated with cases. In addition, Salmonella virchow PT34 was isolated from samples of raw beansprouts and was subsequently associated with seven cases of infection. Four other serotypes of salmonella were also isolated from beansprouts. On 8 April the public were advised to boil beansprouts for 15 seconds before consumption, and the premises of the one producer associated with many cases were closed. As a result of these actions there was a significant decrease in the number of infections with S. saint-paul.

Adolescent↗

Failure of influenza vaccine to prevent two successive outbreaks of influenza A H1N1 in a school community.

Forty nine of the 149 boys (33%) at a preparatory school fell ill at the beginning of the autumn term 1986 with symptoms of influenza. One hundred and eighty two of the 470 pupils (39%) in the senior part of the same school had similar symptoms of influenza at the beginning of the spring term 1987. A new variant of influenza A H1N1 virus was isolated from both outbreaks and shown to be antigenically similar to A/Taiwan/1/86. The attack rate among pupils who had previously received trivalent influenza vaccine containing A/Chile/1/83 H1N1 antigen was not significantly different from the rate among those who had never been vaccinated. It is concluded that annual vaccination of all boarding school pupils may be inappropriate.

Disease Outbreaks↗

An outbreak of puerperal fever caused by group C streptococci.

Between 19 February and 18 April 1987, 33 confirmed cases of puerperal fever caused by Streptococcus equisimilis serotype T204 occurred at three hospitals in and around Chelmsford. Most of the cases (70%) occurred on one ward, in which toilet seats and a shower are believed to have aided transmission, although insufficient data were obtained to exclude a role for person-to-person spread. Possession of M-protein antigen was demonstrated in the outbreak strain.

Adult↗

The presence of M proteins in outbreak strains of Streptococcus equisimilis T-type 204.

Cultures of Streptococcus equisimilis (Lancefield group C) from three outbreaks of illness were found to carry the T-protein antigen 204. Strains of this type were not otherwise represented in a collection of 743 cultures of these 'pyogenes-like' streptococci isolated from other outbreaks of infection or as random isolates. Two of the three outbreaks were of pharyngitis. The third arose in a maternity unit where the organism was isolated from mothers with puerperal fever, from staff and also from the environment. Representative strains were found to carry M-protein antigens as judged by their ability to survive and multiply in fresh normal human blood. Comparison of absorbed rabbit antiserum to the M antigens in opsonic and precipitin tests showed that a distinct M antigen was present on isolates from one outbreak of sore throat and that all cultures from the other two incidents shared a common M antigen. Samples of serum were also available from patients in the outbreak of puerperal sepsis. Most patients developed antibodies to one or more streptococcal antigens including the M protein, streptolysin O, streptokinase and the hyaluronidase specific for strains of group C and group G streptococci.

Antigens, Bacterial↗

Chlamydia trachomatis as a cause of neonatal conjunctivitis.

Chlamydia trachomatis was identified in 37 of 73 consecutive neonates with purulent conjunctivitis, including four delivered by caesarean section with intact membranes. Most (28/37) presented in the first week. Infection was significantly associated with referral from the community. Genital C. trachomatis infection was present in 13 of 35 parents of affected infants.

Chlamydia trachomatis↗

Conventional tissue culture compared with rapid immunofluorescence for identifying Chlamydia trachomatis in specimens from patients attending a genitourinary clinic.

Specimens collected from 182 patients with histories suggesting chlamydial disease were examined by conventional culture and direct immunofluorescence techniques. Chlamydia trachomatis was identified by both methods in 57% of all patients. There was no significant difference between the two methods in detecting C trachomatis. Where a tissue culture service is not already established, cost analysis in individual departments may justify the use of the immunofluorescence method.

Bacteriological Techniques↗