Search PubMed⌕ Search

Biomedical subjects

G D Overturf

Publications and source records attributed to G D Overturf.

At least 37 records · Page 2Linked to original sources
PubMed1989

Delayed cerebrospinal fluid sterilization in infants with Hemophilus influenzae type b meningitis.

Cerebrospinal fluid (CSF) sterilization after greater than 24 h of intravenous antibiotic therapy (delayed CSF sterilization) was noted in two infants treated with ceftizoxime and ceftazidime for bacterial meningitis. A case-control study was conducted of children between 6 w and 6 y of age treated between 1975 and 1985 at one institution for bacterial meningitis to determine risk factors for delayed CSF sterilization. Hemophilus influenzae type b was isolated from all children (n = 5) with delayed CSF sterilization, compared with only 78% of all children in the study (n = 83). In children with H. influenzae type b disease, children less than 6 mo of age were at higher risk than older children for delayed CSF sterilization (odds ratio = 7.5, 95% confidence limits = 1.4, 40.0). Factors not associated with delayed CSF sterilization included time of follow-up lumbar puncture, CSF total or differential white blood cell count, and CSF protein and glucose concentrations. Despite the in vitro antimicrobial susceptibility of H. influenzae type b to ceftizoxime and ceftazidime, delayed CSF sterilization may occur in infants receiving these antibiotics for bacterial meningitis.

Age Factors↗
PubMed1989

Staphylococcus intermedius in canine gingiva and canine-inflicted human wound infections: laboratory characterization of a newly recognized zoonotic pathogen.

Staphylococcal gingival flora was characterized in cultures from 135 dogs. Staphylococcus intermedius was isolated in 39% of the cultures, S. aureus was isolated in 10%, and both were isolated in 2.0%. S. aureus was isolated more often from dogs of working breeds with weights of greater than 40 lb (ca. 18 kg) and with outdoor habitats than was S. intermedius, which was associated with dogs of nonworking breeds with weights of less than 40 lb and indoor habitats. S. intermedius was distinguished from S. aureus by the following characteristics: coagulation of rabbit plasma at 4 h (26 versus 100%, respectively), hemolysis of sheep blood at 24 h (30 versus 79%, respectively), and mannitol fermentation at 24 h (4 versus 93%, respectively). A clear separation of the two species was apparent only with the acetoin (modified Voges-Proskauer) reaction (100% of the S. aureus isolates versus 0% of the S. intermedius isolates) and beta-galactosidase activity on the API Staph-Ident strip (0% of the S. aureus isolates and 100% of the S. intermedius isolates). Susceptibilities of S. intermedius and S. aureus were 72 and 7%, respectively, to penicillin G, and 100% of both species to oxacillin. Fourteen previously collected strains of coagulase-positive staphylococci from infected canine-inflicted human wounds were reanalyzed; 3 of 14 (21%) isolates were S. intermedius. We conclude that S. intermedius is a common canine gingival flora and is responsible for some canine-inflicted human wound infections, thus representing a newly recognized zoonotic pathogen.

Animals↗
PubMed1989

Frequency of Staphylococcus intermedius as human nasopharyngeal flora.

Staphylococcus intermedius, a veterinary flora and pathogen, has recently been isolated from humans with infected dog bite wounds. The frequency of S. intermedius as a human nasopharyngeal flora was determined by culturing samples from 144 veterinary college staff members. This bacterium was isolated from only one individual (0.7%). It appears that S. intermedius is a true zoonotic opportunistic pathogen.

Adolescent↗
PubMed1988

The effect of prophylactic acetaminophen administration on reactions to DTP vaccination.

To determine the effect of prophylactic acetaminophen on reactions after diphtheria and tetanus toxoids and pertussis vaccination, 282 children received either acetaminophen or placebo in a double-blind, randomized fashion before and 3, 7, 12, and 18 hours after vaccination. Fever and local and systemic reactions were monitored. Switching to known acetaminophen was permitted if the patient's temperature was 38.9 degrees C or higher or for moderate pain. Overall, the reaction score of acetaminophen recipients was significantly less than that of placebo recipients. The rates of occurrence of fever and fussiness and the degree of pain at the injection site were significantly reduced by acetaminophen administration. Children who received acetaminophen were less likely to be switched to "open" acetaminophen than placebo recipients. It is concluded that prophylactic acetaminophen as given in this study had a moderating effect on fever, pain, and fussiness after diphtheria and tetanus toxoids and pertussis immunization.

Acetaminophen↗
PubMed1988

Predictors of short-term prognosis in patients with pulmonary tuberculosis.

We evaluated 191 consecutive adults with pulmonary tuberculosis in order to develop methods to determine which patients should be initially hospitalized. Using stepwise discriminant analysis, we found the six factors that were most strongly associated with an unfavorable short-term outcome (respiratory failure or death): lymphopenia, advanced age, concomitant smear-positive extrapulmonary tuberculosis, alcoholism, a high percentage of neutrophils on the differential white blood cell count, and lack of radiographic evidence of cavitation. We derived a scoring system incorporating these variables and separated patients into high- and low-risk groups. The system was prospectively validated by applying it to a separate group of 179 patients. Lymphocyte-transformation tests in 32 patients revealed an association between clinical markers of poor prognosis and minimal lymphocyte proliferation to a heat-killed strain of Mycobacterium tuberculosis.

Adolescent↗
PubMed1988

Chest roentgenogram in pulmonary tuberculosis. New data on an old test.

The utility of routine admission chest roentgenograms (CXRs) was evaluated in detecting pulmonary tuberculosis and the relationship between roentgenographic patterns and the likelihood of finding acid-fast bacilli (AFB) on sputum smear. Of 58 patients whose chief complaints were unrelated to pulmonary tuberculosis, the CXR suggested tuberculosis in 52 cases (90 percent). In 45 cases, the emergency room physician failed to elicit the patient's respiratory symptoms and did not consider tuberculosis as a diagnostic possibility. In 18 individuals, the diagnosis was missed in the emergency room because of failure to obtain a CXR. Among patients whose roentgenograms showed cavitation or extensive alveolar infiltrate, sputum smears showed AFB in 98 percent of cases. If alveolar infiltrate was absent, or if the roentgenographic pattern was not that of adult reactivation disease, sputum smears revealed AFB in only one half of the cases. We conclude that routine admission CXRs are useful in hospitals serving populations where tuberculosis is still common, and the probability of detecting AFB on sputum smear is greatly influenced by the roentgenographic findings.

Adolescent↗
PubMed1987

Ampicillin-chloramphenicol-resistant Haemophilus influenzae: plasmid-mediated resistance in bacterial meningitis.

A 4-month-old infant with congenital heart disease and sepsis and arthritis, and subsequently meningitis, caused by an antibiotic-resistant strain of Haemophilus influenzae type b, failed to respond to sequential therapy with ampicillin and trimethoprim/sulfamethoxazole. Following treatment with ceftizoxime, the infant was well for 42 days, until he returned to the hospital and died. A total of 10 Haemophilus influenzae type b isolates, all outer membrane protein subtype 51, was isolated from the pretreatment blood and synovium, cerebrospinal fluid and subdural fluids, and the petrous pyramids at autopsy. Pretreatment isolates had no detectable plasmid DNA, chloramphenicol acetyltransferase or beta-lactamase; the minimal inhibitory concentration for ampicillin (AM) and chloramphenicol (CM) was 0.2 and 0.8 microgram/ml, respectively. However, all cerebrospinal fluid isolates had a 42-44 mD plasmid and produced chloramphenicol acetyltransferase and beta-lactamase; the minimal inhibitory concentration of these isolates to AM and CM were 12.5 and 25 micrograms/ml, respectively, and were also resistant to tetracycline and sulfonamide. Resistance to AM and CM was cotransferred by filter-mating conjugation at a frequency of one to two transconjugants per 10(5) to an Rd haemophilus recipient. Posttreatment isolates from the petrous pyramids also were resistant to AM and CM and produced chloramphenicol acetyltransferase and beta-lactamase activity, but had no plasmid DNA. These findings and data from genetic studies suggested that plasmid-bearing antibiotic-resistant Haemophilus influenzae type b was selected from a heterogenous population, and that the AM/CM resistance transposons were incorporated into the bacterial chromosome.

Ampicillin Resistance↗
PubMed1986

Pyogenic bacterial infections of the CNS.

The etiology of pyogenic infections of the brain and meninges varies principally by age, predisposing causes or conditions, and anatomic site of the infection. An appreciation of these factors, plus the prudent use of noninvasive anatomic diagnostic techniques (such as CT) and examination of the CSF, will provide a basis for the empiric use of appropriate antibiotics. The beta-lactam antibiotics remain the preferred drugs whenever possible because of their broad spectrum on antimicrobial activity, efficacy in CNS infections, low cost, and low toxicity.

Adult↗
PubMed1984

Treatment of bacterial meningitis with ceftizoxime.

Ceftizoxime was evaluated in the treatment of 18 patients (6 adults and 12 children) with bacterial meningitis. In seven patients Haemophilus influenzae was the causative agent, in three Neisseria meningitidis, in five Streptococcus pneumoniae, and in one each alpha-streptococcus and Escherichia coli; one case was culture negative. Ceftizoxime was administered intravenously in doses of 200 mg/kg per day. Clinical response was appropriate in all patients with a mean time of defervescence of 3.7 days, and sterile cerebrospinal fluid was obtained from all patients at 24 to 36 h after initiation of therapy. The mean concentration of ceftizoxime in 46 cerebrospinal fluid samples obtained during therapy was 8.53 micrograms/ml (range, less than 0.5 to 29.0 micrograms/ml). Ceftizoxime concentrations in cerebrospinal fluid samples were ten- to several hundredfold the bactericidal concentrations of the pathogens isolated from the cerebrospinal fluid. Ceftizoxime penetrates the meninges well during acute infection and appears to be an excellent candidate antibiotic in the treatment of bacterial meningitis.

Adult↗