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Biomedical subjects

F R Falkiner

Publications and source records attributed to F R Falkiner.

At least 37 records · Page 2Linked to original sources
PubMed1984

Pseudomonas aeruginosa cross-infection following endoscopic retrograde cholangiopancreatography.

In a 6 week period, three of 50 patients developed Pseudomonas aeruginosa septicaemia following Endoscopic Retrograde Cholangiopancreatography (ERCP). Pseudomonas aeruginosa serotype 10 was isolated from each of the patients and from the endoscope. The outbreak was related to inadequate disinfection of the air and water channel of the endoscope. Following the introduction of a modified decontamination technique, which involved rinsing the air and water channel with glutaraldehyde, no further cases of pseudomonas infection occurred, and the organism could not be isolated from the instrument. Obstruction of the biliary tract was a predisposing factor in the development of infection; and administration of antibiotics immediately following the procedure failed to prevent it. This may have been due to inadequate dosage. We suggest that patients presenting for ERCP, in whom obstruction of the biliary tract is suspected, should come prepared for immediate drainage of the obstructed system at the time of the procedure.

Adult↗
PubMed1984

Simultaneous outbreaks of infection due to Serratia marcescens in a general hospital.

Seventy isolates of Serratia marcescens were obtained from 30 patients in different units of one hospital between April 1982 and February 1983. No common source was found. Not all isolates were multi-resistant and nearly all that were, fell into two main groups, A and B. These groups were defined by phage typing and cephalosporin sensitivity, all apart from one Group B isolate were multi-resistant, whereas Group A isolates contained multi-resistant and sensitive strains. Plasmid screening, resistance transfer studies and plasmid elimination experiments demonstrated that the multi-resistant phenotype was due to a 120 Mdal transmissible plasmid. Resistance to cephalosporins was chromosomally encoded.

Anti-Bacterial Agents↗
PubMed1984

Bacteraemia during prostatectomy and other transurethral operations: influence of timing of antibiotic administration.

The relation between the timing of prophylactic antibiotic administration and the occurrence of bacteraemia during transurethral operations was studied in 112 patients whose urine was infected before operation. Blood cultures taken during operation were positive in 15 (60%) of 25 patients who did not receive appropriate antibiotics, in 13 (21%) of 63 patients who were given appropriate antibiotics less than 24 h before operation, and in none of 24 patients in whom antibiotic "cover" was started more than 24 h before operation. In all cases the bacteraemia was transient. No patient developed septicaemia. The implications of these findings for the optimum timing of antibiotic administration to patients with preoperative bacteriuria are discussed.

Anti-Bacterial Agents↗
PubMed1983

Septicemia after transurethral prostatectomy.

Septicemia occurred in 18 of 1,604 patients subjected to transurethral resection (TUR) of the prostate. Six patients died postoperatively, 4 of septicemia. In 11 patients septicemia was provoked by TUR in the presence of urinary infection and in the absence of appropriate antibiotic cover. Septicemia was provoked by catheter removal in 2 similarly infected patients. In the remaining 5 patients the urine was sterile at operation but became infected prior to catheter removal, and this maneuver precipitated septicemia.

Humans↗
PubMed1983

Staphylococcal nasal carriage in medical students with varying clinical exposure.

Nasal carriage and antibiotic sensitivities of coagulase-positive and coagulase-negative staphylococci were assessed among medical students of three different years. Although carriage rates did not change, there was a trend towards multiple resistance with increasing hospital exposure. Gentamicin resistance in Staphylococcus albus showed a similar trend. The relevance of these findings to current views on the origin of gentamicin resistance is discussed.

Anti-Bacterial Agents↗
PubMed1983

Antimicrobial agents for the prevention of urinary tract infection in transurethral surgery.

Chemoprophylaxis and disinfection of the operation site for the prevention of bacteriuria after a transurethral operation were assessed in controlled, prospective studies in men with sterile urine preoperatively. The majority of the control patients (65 per cent) suffered postoperative bacteriuria compared to 38.6 per cent after perioperative disinfection with chlorhexidine and 10 per cent or less after each of 2 other regimens (intramuscular cephradine followed by oral nitrofurantoin and chlorhexidine disinfection followed by oral nitrofurantoin). The latter regimen is preferred since it avoids the use of agents with systemic action.

Aged↗
PubMed1983

Gentamicin and methicillin resistant Staphylococcus aureus in Dublin hospitals: clinical and laboratory studies.

Strains of Staphylococcus aureus resistant to gentamicin and methicillin first appeared in Dublin hospitals in 1976, and rapidly became widely disseminated. The number of patients infected or colonised increased throughout the period of study, especially in 1979 and 1980. Most isolates were from burns, surgical wounds and traumatic skin lesions. During the 12 months after first isolation of these multiply antibiotic resistant strains, colonisation or minor infection was the usual event. Invasive infection such as bacteraemia, deep wound sepsis and osteomyelitis was rarely seen. Subsequently, as the number of patients from whom these organisms were isolated increased, bacteraemia and other severe infection became more common. The predominant phage type of S. aureus changed with the progression of the outbreak. Isolates of different phage type were sometimes found in a single lesion, or in different sites in one patient. By the second half of 1980, most isolates were untypable or typed only with an experimental phage.

Bacteriophage Typing↗
PubMed1982

Does pseudomonas cross-infection occur between cystic-fibrosis patients.

Over a 12-months period respiratory Pseudomonas aeruginosa isolated from CF patients were typed by serology and pyocin production to determine whether cross-infection was occurring. Results of typing were interpreted in relation to the degree of contact patients had with each other. One strain appeared in 4 unrelated patients. However, since none of these patients had been in contact with each other the strains considered to have been acquired from the environment. Each of six pairs of siblings shared the same strain, but the pairs of strains were distinct from each other. These results suggest that the environment is the most important source of Pseudomonas strains for CF patients and that for cross-infection to occur prolonged intimate contact is required.

Adolescent↗
PubMed1982

Amikacin, gentamicin and tobramycin resistant Pseudomonas aeruginosa in a leukaemic ward. Epidemiology and genetic studies.

Four patients in a leukaemic ward were infected with multi-resistant Pseudomonas aeruginosa. Similar organisms were found in the environment and it appeared that lapses in aseptic routine contributed to the outbreak. Serological, bacteriophage and pyocin-typing revealed that a fifth patient was infected with a distinct strain, but agarose gel electrophoresis indicated that all patient and environmental strains carried the same plasmid. The plasmid had a molecular weight of 47 (s.d. +/- 2) X 10(6) dal and was transfer deficient. It conferred resistance to carbenicillin, gentamicin, kanamycin, streptomycin, sulphonamide, tetracycline and tobramycin and determined an aminoglycoside adenylyltransferase active against amikacin in-vitro and not in-vivo. Spread of this non-transferable plasmid to a different Ps. aeruginosa strain and dissemination of multi-resistant organisms led to serious infections.

Adult↗
PubMed1981

Colicin V production by clinical isolates of Escherichia coli.

Strains of Escherichia coli isolated from random fecal samples, urines of hospitalized and nonhospitalized patients who had urinary tract infections, and blood of patients with septicemia were examined for colicin V production. The percentage of ColV+ strains isolated from blood (31.6%) or from urines of hospitalized patients with urinary tract infections (26.2%) was significantly greater (P less than 0.01) than the percentage isolated from feces (13.6%). The colicin V immunity determinant of ColV,I-K94 conferred immunity to 26% of the type V colicins produced by clinical isolates. Of the ColV+ strains studied, 63.6% produced at least one other type of colicin.

Bacteriuria↗
PubMed1979

Differentiation of fluorescent pseudomonads by their effect on milk agar.

Eighty-six clinical isolates of fluorescent pseudomonads that did not produce pyocyanin on Diagnostic Sensitivity Test Agar or Cetrimide Agar were identified on the basis of their antibiotic sensitivity, production of pigment on King's "A" medium, growth at 42 degrees C, production of lecithinase and hydrolysis of gelatin. The identity of the strains was confirmed in tests with the ammonium salt sugars ethanol, glucose and mannitol. These tests were adequate for distinguishing between the three important fluorescent pseudomonads. The detection of casein hydrolysis on milk agar was assessed as a rapid method of distinguishing P. aeruginosa from the other species of fluorescent pseudomonads but proved unhelpful when compared with, or included in, a small set of tests. Most strains of P. aeruginosa and P. fluorescens hydrolysed casein.

Agar↗