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Biomedical subjects

H D Isenberg

Publications and source records attributed to H D Isenberg.

At least 73 records · Page 4Linked to original sources
PubMed1985

Disseminated Sporothrix schenckii infection with arthritis in a patient with acquired immunodeficiency syndrome.

Patients with the acquired immune deficiency syndrome are susceptible to a wide spectrum of opportunistic infections. We report a 34-year-old man who developed systemic sporotrichosis involving the skin and joints, and whose illness terminated in subacute encephalopathy and Pneumocystis carinii pneumonia. Fungal arthritis is another infection to which patients with this syndrome are subject.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Microbiologic efficacy of a surgically constructed nipple valve.

The efficacy of a surgically constructed nipple valve in preventing reflux of colonic bacteria into the small bowel was evaluated. The nipple valve significantly decreased the number of S. marcescens, a marker bacterium, in the small bowel when compared with plain ileocolic anastomosis. In this study, the nipple valve prevented the reflux of bacteria similar to an intact ileocecal valve which suggests that the nipple valve is an effective bacteriologic barrier and may be used as a substitute for the ileocecal valve in patients with short bowel syndrome.

Animals↗
PubMed1984

Clinical laboratory and epidemiological investigations of a Streptococcus pyogenes cluster epidemic in a newborn nursery.

Streptococcus pyogenes, nontypable with available M antisera, T type 12, and reactive in the serum opacity test, produced various lesions in 10 newborn infants during a 2-month period. All infants except one were discharged from the nursery before overt disease manifestations. Colonization studies of newborn infants showed a streptococcal carrier rate of 19% (27 of 140). Only 1 of 154 staff members yielded the same streptococcus from the throat, but it could not be implicated as the source for the outbreak. Cohorting of infants and chlorhexidine gluconate hand washing by staff members helped in terminating this cluster epidemic.

Antigens, Bacterial↗
PubMed1984

Collaborative evaluation of the UniScept quantitative antimicrobial susceptibility test.

UniScept (Analytab Products, Plainview, N.Y.) is a commercially prepared microdilution antimicrobial susceptibility system for the determination, in a single tray, of antimicrobial MICs for gram-negative and gram-positive bacteria and those isolated from urinary tract infections. The system showed excellent correlation with the reference microdilution approach for organisms from clinical specimens and with stock and reference cultures. Intra- and interlaboratory reproducibility was high.

Anti-Bacterial Agents↗
PubMed1984

Calcospherites in pituitary prolactinomas. A hypothesis for their formation.

Calcospherites are being reported with increasing frequency in pituitary prolactinomas. Ultrastructural study of such a case, along with the recent characterization of the molecular composition of prolactin granules, has led us to hypothesize that a unique intracellular milieu exists in which calcification can be initiated and can proceed to calcospherite formation.

Adult↗
PubMed1984

The nipple valve as a sphincter substitute for the ileocecal valve: prevention of bacterial overgrowth in the small bowel.

We evaluated the bacteriologic effect of a nipple valve substitute for the ileocecal valve in a canine model. Resection of the ileocecal valve and the distal 40% of the jejunoileum with end-to-end anastomosis was carried out in 10 dogs. In five of the dogs chosen randomly, a nipple valve was constructed at the anastomosis; in the remainder , a two-layer jejunocolostomy was formed. Microbiologic samples were taken at operation in the ascending colon and at three sites in the small intestine before resection and at reoperation 4 weeks later. These revealed a dramatic increase in anaerobic bacteria in the distal jejunum following jejunocolostomy without valve insertion but no increase following jejunocolostomy with nipple valve. There was a seven-log difference between the two groups in the mean anaerobic bacterial counts (P less than 0.05) measured 60 cm proximal to the anastomosis at the second operation. Results of aerobic cultures were similar but less dramatic. We conclude that construction of a nipple valve jejunocolostomy prevents anaerobic bacterial colonization of the proximal small bowel and may therefore be useful in the treatment or prevention of short bowel syndrome.

Animals↗
PubMed1983

Chronic haematogenous osteomyelitis; studies on an experimental model.

The progression of acute haematogenous osteomyelitis into a chronic infection was investigated in a group of ten dogs in which the infection was produced by injection of micropaque barium mixed with Staphylococcus aureus or Salmonella Group C-2 into the tibial nutrient artery. Antibiotics were not used. Twenty four months later the infected limb of the surviving animals exhibited clinical, histological, radiological and microbiological changes which closely resembled those found in chronic haematogenous osteomyelitis (CHO) in humans. We observed spontaneous fractures, skin fistulae, bone sequestration and active bone remodelling. The original infecting bacteria were often replaced by different microorganisms because of skin fistulae or haematogenous contamination. Although the initial mortality was high the surviving animals showed signs of local and systemic symbiosis with the infecting bacteria. In two animals the previously infected and remodelled bone failed to show histological evidence of infection. This model may be useful in the study of a variety of factors affecting the natural history of CHO, particularly those encompassing the immunological response of the host.

Animals↗
PubMed1982

Correlation of the results of antibiotic synergy and susceptibility testing in vitro with results in experimental mouse infections.

Recent clinical isolates (approximately 150 strains) of the family Enterobacteriaceae were examined by agar diffusion, microdilution, and the Autobac automated system for their responses to beta-lactam antibiotics singly and in combination with amdinocillin (formerly called mecillinam). The ratio of ampicillin, carbenicillin, and cephalothin to amdinocillin was maintained at a 10:1 ratio in most of the evaluations. The same isolates were studied in mice challenged with 100 to 1000 LD50s and treated with graded doses of the antibiotics singly and in combination. Efficacy in vivo was based on the concentration of antibiotic in milligrams per kilograms (mg/kg) required to protect 50% of the animals (PD50). After a single administration of the antibiotics, plasma levels were determined in the critical time period (30 min to 4 hr) during which the acute, overwhelming systemic infections could be controlled by appropriate therapy. Regression curves comparing in vivo and in vitro results were used to establish cut-off points for categorizing bacterial susceptibility in each of the laboratory tests for the single agents and combinations. A high degree of synergism between amdinocillin and the beta-lactam agents was demonstrated in animals (54 to 78% of the strains examined) and to a lesser extent by laboratory methodologies. There was an excellent correlation of in vivo and in vitro responses to ampicillin, carbenicillin, and cephalothin alone and in combination with amdinocillin for those species for which the single antibiotics are generally indicated. The correlations validated the chosen cut-off points. The correlation of in vivo and in vitro responses to the single or combined antibiotics was generally poorer for those species not usually responsive to the single antibiotics. The greatest difficulty in predicting proper in vivo responses, based on the results of in vitro tests, was observed with amdinocillin.

Ampicillin↗
PubMed1981

Rapid screening for bacteriuria by light scatter photometry (Autobac): a collaborative study.

A total of 2,720 urine specimens from three laboratories were evaluated by Autobac (Pfizer Diagnostics) and were compared with simultaneous colony counts for evidence of bacteriuria. Of 599 specimens with a colony count of greater than or equal to 10(5) colony-forming units per ml, 93.8% were detected within 6 h. This detection rate increased to 97% of 447 positive urine specimens when only specimens from patients not on antimicrobials were evaluated. The majority (77.9%) of positive specimens were detected as early as 3 h. Those specimens with greater than or equal to 10(5) colony-forming units per ml, which were negative by Autobac at 6 h, included organisms which are frequently considered to be contaminants (diphtheroids, lactobacilli, alpha and gamma streptococci, yeasts, and Staphylococcus epidermidis), or were from patients who were being treated with antimicrobial agents. Of 2,121 urine specimens with colony counts of less than 10(5), 98.1% were correctly determined to be negative by Autobac at 3 h. This percentage decreased to 86.0 at 6 h. The majority of these false-positive specimens were those with colony counts of 10(4) to 10(5) colony-forming units per ml. There appeared to be no major difference in results from the three laboratories or among the four lots of broth used in this study.

Anti-Bacterial Agents↗
PubMed1981

Hospital cluster epidemic with Morganella morganii.

A cluster epidemic of 13 Morganella morganii infections involving 11 patients occurred over a 3-month period in 1977. This epidemic was unusual in that it involved four services and five hospital floors. The outbreak was effectively terminated when strict asceptic techniques were reinforced.

Adult↗
PubMed1980

Nosocomial urinary-tract infections in a skilled nursing facility.

Fifty-five documented infections reported from an admission unit of a large skilled nursing facility (SNF) during a five-month period were analyzed. Of these, 45 (82 percent) were urinary-tract infections (UTIs), chiefly asymptomatic bacteriuria. Sixty-three percent of the UTIs were acquired in the SNF, and the remainder were acquired during the preceding stay in a general hospital. Statistically, Proteus species infections were more common among the SNF-acquired UTIs, whereas Pseudomonas aeruginosa infections were the most common among the hospital-acquired UTIs. The following recommendations are made: 1) for previously hospitalized elderly patients in whom urinary-tract sepsis develops soon after admission to an SNF, treatment should start with an antibiotic active against Pseudomonas aeruginosa while the results of cultures are pending; 2) symptomatic lower urinary-tract infections caused by SNF-acquired Proteus species should be treated with nalidixic acid or trimethoprimsulfamethoxazole; 3) the term "nosocomial infection" should be broadened to include infections acquired in long-term care institutions; and 4) infection surveillance should be started in selected long-term care institutions for the elderly as part of an expanded National Nosocomial Infections Survey.

Aged↗
PubMed1980

Collaborative investigation of the AutoMicrobic System Enterobacteriaceae biochemical card.

The Enterobacteriaceae biochemical card used in six separate laboratories to identify 170 representatives of Enterobacteriaceae. The AutoMicrobic System (Vitek Systems, Inc.) performed with an accuracy of 97.8% as compared with 98.1% by the standard method selected and 97.6% by a commerically prepared manual system approach. During this time, 5,450 clinical isolates belonging to Enterobacteriaceae were analyzed. Compared with the routine methods used in the various laboratories, the AutoMicrobic System identified 96.4% correctly

Bacteriological Techniques↗
PubMed1980

Microbiology of the canine nasal cavities.

The anterior and superior regions of canine nares yielded two distinct microbial populations consisting of 25 microbial species. Streptococci predominated in the anterior nose; clostridia and staphylococci were also quite prevalent. At least two distinct microorgranisms were cultured from most anterior sites. In contrast, sterile conditions prevailed in the superior nasal regions of at least 50% of the ninety-two animals. Various Bacillus sp. were recovered from the remainder.

Animals↗
PubMed1979

Clinical laboratory evaluation of automated microbial detection/identification system in analysis of clinical urine specimens.

More than 4,000 clinical urine specimens were evaluated with an automated microbial detection/identification system compared to a standarized manual analysis and the routine modalities used in five peer-group laboratories. The comparison indicates that the automated system recognizes the nine groups of significant microorganisms in urinary tract infections in hospitalized patients with the same efficiency as a standarized manual method. The automated system's ability to enumerate the bacterial populations in the original clinical specimen attained a high degree of accuracy.

Automation↗
PubMed1979

Microbiology of Legionnaires' disease bacterium.

Legionnaires' disease bacterium in tissue does not readily react with the Gram stain but can be seen by other stains and direct immunofluorescence. It is a slow-growing, aerobic, gram-negative rod that can be cultivated over a narrow temperature range on Mueller-Hinton agar supplemented either with complex biological mixtures or certain ferric salts and cysteine. The bacterium produces unique, branched-chain fatty acids, catalase, oxidase (weakly), and gelatinase and uses starch while ignoring other carbohydrates. Pigment production is related to tyrosine in the medium. In-vitro studies suggest susceptibility to all antibiotics except vancomycin, but a class 1 beta-lactamase has been demonstrated. Analysis of DNA confirmed the unrelatedness of this bacterium to previously recognized prokaryotes. Diagnosis of the disease has depended largely on serologic test findings and the demonstration of the bacterium in tissue and, occasionally, on isolation. Additional, simpler, and more rapid diagnostic tests should soon be available.

Bacteria↗