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Biomedical subjects

F J Roberts

Publications and source records attributed to F J Roberts.

68 records · Page 4Linked to original sources
PubMedDate not supplied

Yeast in blood cultures. Evaluation of factors influencing outcome.

Sixty episodes of candidemia occurring between January 1987 and September 1989 were retrospectively reviewed and the outcome was compared for three patient categories: neutropenic, postsurgical, and nonneutropenic nonsurgical. Because of increasing reports of resistant yeasts, minimal inhibitory concentrations (MICs) to amphotericin B (amB) were determined to examine its relationship to patient outcome. No significant differences between patient categories were found for selected risk factors, mortality, or species isolated, although there was a tendency for Candida tropicalis to occur in neutropenic patients. Statistical analysis using logistic regression showed that both an amB dose greater than 500 mg and a yeast MIC greater than 0.78 micrograms/ml were independent prognosticators of patient outcome.

Adult↗
PubMedDate not supplied

A three-year study of positive blood cultures, with emphasis on prognosis.

A study of 37,156 blood cultures over a 3-year period yielded 1,972 positive blood culture episodes, of which 63% were of clinical significance, 26% represented contamination, 7% represented transient bacteremia, and 3% were of indeterminate significance. Mortality curves were calculated for clinically significant bacteremia according to etiologic organism and source. Several curves with different shapes were demonstrated. Quantitative differences were noted between cases of bacteremia arising from different sources and caused by different organisms. No mortality was associated with bacteremia of bone and joint origin. Mortality from bacteremic pneumococcal pneumonia, bacteremia with Escherichia coli of urinary tract origin, endocarditis, and beta-hemolytic streptococcal bacteremia showed an early plateau effect, with a drop before day 20. Cases of bacteremia from intravascular sources other than endocarditis were associated with no initial mortality, but mortality rose progressively after day 5. Bacteremia related to most organisms and sources was associated with mortality that continued until at least day 20.

Adult↗
PubMedDate not supplied

A review of positive blood cultures: identification and source of microorganisms and patterns of sensitivity to antibiotics.

All strains of bacteria and fungi isolated from blood cultures of patients hospitalized in a large primary and tertiary care center were studied prospectively for determination of their clinical significance and probable source. In some instances the immediate mortality rate was also determined. The sensitivity patterns of all aerobic organisms to antibiotics were studied in relation to the role of antibiotic therapy. A positive culture was obtained from 6.8% of all blood specimens cultured and these positive cultures represented 639 episodes of bacteremia or fungemia. The organism isolated most of ten was Escherichia coli, and the most common known source was the urinary tract. Anaerobic organisms were isolated from 9.2% of the episodes of bacteremia, with the bowel being the most common probable source of infection. Antibiotic sensitivity testing revealed that all staphylococci were sensitive to methicillin, but only 22% were sensitive to penicillin. No penicillin-resistant pneumococci were encountered. The Enterobacteriaceae exhibited such a high sensitivity to gentamicin that comparison of its activity with that of other, newer aminoglycosides was impossible.

Aminoglycosides↗
PubMedDate not supplied

Comparison of 1% silver sulfadiazine with and without 1% chlorhexidine digluconate for topical antibacterial effect in the burnt infected rat.

The addition of 1% chlorhexidine digluconate to 1% silver sulfadiazine cream (CDSS) was compared with 1% silver sulfadiazine (SS) alone to assess the antibacterial effect of a once-daily application of the therapies on an experimental rat model with a 20% full-thickness burn wound seeded with 10(8) microorganisms originally isolated from infected wounds of burn patients. Separate series evaluated Staphylococcus aureus, Pseudomonas aeruginosa, Enterobacter cloacae, and Streptococcus faecalis. The mean concentration of all four organisms recovered after one week from biopsy specimens of full-thickness eschar was less in the CDSS-treated animals compared with the SS-treated animals. Microbial invasion into subjacent muscle was less frequent in animals seeded with S faecalis, while the mean concentration of bacteria recovered from muscle of animals seeded with S aureus and E cloacae was less in animals treated with CDSS compared with those treated with SS (P less than 0.05). The addition of 1% chlorhexidine digluconate to 1% silver sulfadiazine increased the antibacterial effectiveness of the latter agent.

Administration, Topical↗
PubMedDate not supplied

Fatal trichosporonosis is not related to tolerance to amphotericin B.

A case of disseminated trichosporonosis in a 45-year-old female suffering from acute lymphocytic leukaemia is reported. The patient died of that mycosis despite of therapy with amphotericin B for which the pathogen had been proven susceptible in vitro.

Amphotericin B↗
PubMedDate not supplied

Fine needle aspiration biopsy cytology in the diagnosis of inflammatory lesions.

In 42 fine needle aspirations (FNA), the cytologic findings were interpreted as either suppurative or granulomatous inflammation. The majority of these FNAs were performed in patients with a known history of malignancy in whom recurrent or residual malignancy was suspected clinically. In 13 cases, a specific microbiologic diagnosis was made on the basis of the aspirate, either by cytology or by culture. In the remaining 29 cases, no specific diagnosis was possible. Open biopsies were later performed in 9 of the 29 cases, revealing the presence of actinomycosis of the parotid in one case and of carcinoma of the breast in a second. Five additional patients in whom only inflammation was diagnosed on the aspirate subsequently proved to have tumor at the FNA site. FNA therefore is not absolutely reliable for the exclusion of malignancy and requires correlation with other data and appropriate follow-up. Aspiration did, however, rapidly provide solutions to otherwise confusing clinical problems in the majority of instances.

Aspergillosis↗