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Biomedical subjects

G E Bignardi

Publications and source records attributed to G E Bignardi.

At least 19 recordsLinked to original sources
PubMed1999

Surveillance of neonatal group B streptococcal infection in Sunderland.

Surveillance of neonatal group B streptococcus infection in Sunderland identified 15 confirmed cases (with positive cultures from blood or CSF) in three years from 1995 to 1997, equivalent to an incidence of 1.42 per 1000 live births, not much lower than the estimate of 1.8 used in the United States to justify the introduction of preventative policies. Confirmed early-onset cases may represent only a fraction of the true number of cases, and a modified risk factor-based policy was introduced in Sunderland in June 1998.

Female↗
PubMed1998

Risk factors for Clostridium difficile infection.

A systematic review of the literature to identify risk factors associated with Clostridium difficile infection was conducted. Two main outcomes were considered: C. difficile diarrhoea and C. difficile carriage. A qualitative assessment, based on a set of defined and consistently applied criteria, appeared to be the best approach for risk factors other than antibiotic use, as an approach based on meta-analysis would have utilized only the information provided by a minority of the studies. Risk factors for which there was evidence suggestive or consistent with an association with C. difficile diarrhoea were: increasing age (excluding infancy), severity of underlying diseases, non-surgical gastrointestinal procedures, presence of a nasogastric tube, anti-ulcer medications, stay on ITU, duration of hospital stay, duration of antibiotic course, administration of multiple antibiotics. For malignant haematological disorders there was evidence of an association only with C. difficile carriage, but there were no suitable studies to explore a possible association of this risk factor with symptomatic infection. Antibiotic use lent itself to quantitative assessment with meta-analysis using logistic regression. Exposure to an antibiotic was shown to be statistically significantly associated with both C. difficile diarrhoea and C. difficile carriage. The meta-analysis approach enabled the ranking of individual antibiotics in relation to the risk of C. difficile infection, though the 95% confidence intervals were often wide and overlapping. Antibiotics associated with a lower risk of C. difficile diarrhoea should be considered, especially when attempting to control a C. difficile outbreak or when prescribing for a patient with other C. difficile risk factors. This systematic review of the literature enabled the identification of features it would be desirable to consider in future epidemiological studies.

Anti-Bacterial Agents↗
PubMed1998

The new viral haemorrhagic fever infection control guidelines.

This paper is a critical review of the infection control guidelines on the Management and Control of Viral Haemorrhagic Fevers issued in 1997 by the Advisory Committee on Dangerous Pathogens. It is suggested that these guidelines are not realistic. An alternative set of more workable guidelines, possibly approved by one of the microbiological associations or one of the regional microbiology groups, should be the way forward.

Guidelines as Topic↗
PubMed1996

Detection of the mec-A gene and phenotypic detection of resistance in Staphylococcus aureus isolates with borderline or low-level methicillinresistance.

Eighty-three isolates of Staphylococcus aureus for which MICs of methicillin of 4-16 mg/L had previously been recorded were tested for the presence of the mecA gene with a DNA probe and a PCR assay. There was complete agreement between the results obtained by these methods; 39 isolates were mecA-positive and 44 were mecA-negative. Using the presence of mecA as the defining standard, several phenotypic methods for determining resistance to methicillin were evaluated and a high-inoculum, agar-incorporation breakpoint test was found to offer the best combination of high sensitivity and high specificity. However twenty-seven of the 44 mecA-negative strains were methicillin-resistant according to agar dilution MICs (MIC > 4 mg/L on at least one of the four media used) but none had MICs exceeding 32 mg/L. One of the mecA-positive strains had a methicillin MIC of only 8 mg/L and did not appear to be heteroresistant. The clinical significance of these two groups of 'atypical' isolates may need further investigation. This study highlights the problems of detecting reliably S. aureus with low level methicillin resistance by phenotype methods and the usefulness of direct detection of the mecA gene.

Bacterial Proteins↗
PubMed1996

Cultural conflict in a bacteriology department: Apollo v. Athena.

Aims to explore the employees' perception of the organizational culture, as well as their cultural preference, and assess what might be the implications of any differences between the two. A questionnaire, largely based on one previously used by Charles Handy, was given to the MLSOs and the medical staff working in a bacteriology department. Analysis of the replies showed that there was a conflict between what was perceived as the existing culture and the preferred culture, and that the intensity of this conflict was associated with either stress or job dissatisfaction. The increased pace of changes affecting this department and the nature of the workforce profile, with many highly qualified and skilled employees, also suggested that a cultural change might be appropriate. Contains a number of recommendations which are budget neutral and which aim to achieve cultural change and increasing motivation.

Bacteriology↗
PubMed1994

False-positive Mycobacterium avium-intracellulare cultures with the Bactec 460 TB system.

Isolation of Mycobacterium avium-intracellulare from a number of specimens cultured with the Bactec 460 TB system was suspected to be due to carry-over contamination. The analysis of culture records and of the typing results confirmed this hypothesis. The problem seems to have been eliminated after replacement of the needle heater and increase of the needle temperature. We recommend that a number of precautions should be taken to reduce the risk of reporting false positive mycobacterial cultures.

Bacteriological Techniques↗
PubMed1994

Infectious osteitis pubis in an HIV seropositive female.

We report a case of infectious osteitis pubis following a first trimester abortion in a female seropositive for the human immunodeficiency virus (HIV). Joint aspiration yielded Pseudomonas aeruginosa and the patient was successfully treated with oral ciprofloxacin.

Abortion, Induced↗
PubMed1993

Use of the E test for methicillin sensitivity testing.

Performance of the E test for methicillin sensitivity testing was investigated using 21 methicillin-resistant and 28 methicillin-sensitive staphylococci. Thirty of the strains had previously given equivocal results with a strip diffusion method. The E test performed well with Mueller-Hinton agar plates incubated at 30 degrees C for 24 h but only after supplementation with 5% NaCl. Testing on agar without salt was necessary for the recognition of methicillin resistance in one strain. We recommend a breakpoint of 4 mg/L and heavy inocula. The E test can be controlled by testing a control strain on the same plate.

Culture Media↗
PubMed1993

How many microbiology consultants are needed?

It is difficult to measure medical staff workload and medical staff requirements in microbiology departments. A review of 14 job descriptions for consultant microbiologists showed that the number of hospital beds and the number of specimens are more reliable workload indices than the population figure. Ratios between beds or specimens and medical staff numbers may help to identify understaffed or overstaffed microbiology departments.

England↗
PubMed1990

Living with EMRSA-1.

Explore the source record for details and available documents.

Anti-Bacterial Agents↗