Biomedical subjects
Publications and source records attributed to F K Gould.
An outbreak of multiresistant Acinetobacter anitratus respiratory tract infection occurred over a 30-day-period in six patients admitted to an intensive care unit. Standard precautions failed to curtail the outbreak, which was finally attributed to ineffective disinfection of reusable ventilator tubing.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Fresh clinical isolates of Salmonella spp. and Streptococcus pyogenes were analysed by pyrolysis-mass spectrometry (Py-MS). The results formed the basis of mathematically derived characterizations of individual strains and these were compared with the results of phage typing for the salmonellas and M protein typing for the streptococci. Py-MS was shown to be a rapid and reproducible method for inter-strain comparisons, giving evidence of identity and non-identity between strains that agreed well with the results of conventional tests. Py-MS has potential value as a rapid, relatively inexpensive and highly discriminatory method of epidemiological analysis in bacterial disease.
In a series of 61 consecutive patients undergoing heart, heart and lung, and lung transplantation, 24 patients were known to be cytomegalovirus (CMV) antibody negative on the day of transplantation. Enzyme linked immunosorbent assays (ELISA) for CMV IgG were performed on donor samples on the day of operation. In 16 of the 24 susceptible patients the test was negative and the only preventive measure taken was the use of blood and blood products from CMV-antibody negative blood donors. None of these patients acquired primary infection with CMV. In another six patients the donor serum was found to contain CMV specific IgG, and in these patients, including one heart and lung transplant recipient, prophylaxis with CMV specific hyperimmune globulin was given. All six patients developed CMV IgM antibodies and in five there was an associated but clinically mild illness. None of these patients required treatment. In the remaining two patients ELISA tests on the donor sera gave equivocal results and hyperimmune globulin was withheld. Both patients developed primary CMV infection of greater severity than those given hyperimmune globulin and one required treatment. Reference tests confirmed that the donor sera contained CMV antibodies. Primary CMV infection in susceptible patients after heart transplantation can be avoided by the use of screened blood and blood products where the organ donor is seronegative to CMV and it can be improved by the use of prophylactic hyperimmune globulin where the donor is CMV antibody positive.
Of 423 patients undergoing elective cranial and spinal operations, infections due to Staphylococcus aureus occurred in 3 of 217 (1.4%) receiving penicillin for 1 day, in none of 206 receiving penicillin for 5 days. There was no significant difference in rates of infection between the two groups receiving penicillin. It is concluded that penicillin for 1 day is as effective as penicillin for 5 days, in the prevention of wound infections due to S. aureus.
Three cases of pulmonary Legionella bozemanii infection in immunocompromised patients are described. The diagnosis was made by culture in each case and would not otherwise have been made, and it is recommended that a culture specific for Legionella species should be included in the investigation of patients with suspected opportunist pulmonary infections.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Six conventional biochemical tests were combined to produce an identification scheme. These tests included decarboxylation of lysine and ornithine, fermentation of glucose and cellobiose, indole production and urease production. Three hundred antibiotic resistant coliforms from urine specimens were tested by this scheme and also by the API 20E for comparison. Two hundred and seventy nine (93%) of organisms were correctly identified using the six tests, 17 (5.7%) were referred for further study, and four (1.3%) were misidentified. It is concluded that this combination of tests provides an inexpensive, accurate, and rapid tool for identification.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
We report six patients colonised with a multiply resistant strain of Streptococcus pneumoniae.
A 30 year old man with Hodgkin's disease, clinically in remission, presented with blurred vision in one eye due to a choroiditis. He developed headaches 10 days after commencing oral steroids and was subsequently found to have cryptococcal meningitis. The meningitis and choroiditis resolved on antifungal medication. This is the first case of cryptococcal choroiditis recorded in the United Kingdom.
Explore the source record for details and available documents.
Twenty-five consecutive unequivocal cases of Staphylococcus aureus endocarditis in a single centre over 5 years were reviewed. Despite an unusually high proportion of prosthetic infections an early mortality of only 16% was observed. Analysis reveals that early diagnosis and prompt effective antibiotic chemotherapy were important factors in achieving this low mortality. Monotherapy with an isoxazolyl penicillin (flucloxacillin) was shown to be as effective as combination therapies, and there was a significant association between the use of aminoglycosides and subsequent renal damage.