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Biomedical subjects

H G Robson

Publications and source records attributed to H G Robson.

At least 19 recordsLinked to original sources
PubMed2001

Susceptibility of the Bacteroides fragilis group to newer quinolones and other standard anti-anaerobic agents.

The susceptibilities of 200 clinical isolates of the Bacteroides fragilis group to four quinolones (moxifloxacin, clinafloxacin, trovafloxacin and ciprofloxacin) were determined, as well as to cefoxitin, clindamycin, metronidazole, imipenem and ticarcillin-clavulanic acid. The results for the latter five agents were compared with those of a study on 200 isolates done 6 years previously. Clinafloxacin and trovafloxacin were the most active agents tested with MIC90s lower than all other antimicrobials except imipenem. Susceptibility rates for imipenem, ticarcillin- clavulanic and metronidazole continue to be high, although resistant strains are emerging. For ticarcillin-clavulanic acid and metronidazole, MIC90s increased four- to eight-fold for the B. fragilis species between the two study periods.

Anti-Infective Agents↗
PubMed1999

Simple strategy for direct identification of medically important yeast species from positive blood culture vials.

We compared direct inoculation of the Auxacolor yeast identification system from positive blood culture vials to standard identification with the API 20C AUX (API 20C), using 44 prospectively collected clinical specimens and 25 seeded blood culture vials. Direct inoculation of the Auxacolor system was accurate and more rapid than standard identification with the API 20C.

Blood↗
PubMed1998

An outbreak of Serratia marcescens infections related to contaminated chlorhexidine.

An outbreak of Serratia marcescens infections occurred in a university tertiary-care hospital. Alcohol-free chlorhexidine solutions were contaminated with S marcescens. The majority of patient and chlorhexidine strains had similar pulsed field-gel electrophoresis banding patterns. Chlorhexidine was recalled, and the rate of S marcescens isolation returned to baseline. Chlorhexidine without alcohol should not be used as an antiseptic.

Anti-Infective Agents, Local↗
PubMed1996

Control of construction-associated nosocomial aspergillosis in an antiquated hematology unit.

OBJECTIVE: To determine the incidence of aspergillosis in patients with leukemia or bone marrow transplants during a construction-associated outbreak, and the effect of an environmental control program for Aspergillus. DESIGN: Clinical, microbiological, and pathological records were reviewed retrospectively once the outbreak was appreciated, and prospectively thereafter, to determine the presence or absence of aspergillosis and duration of neutropenia. SETTING: A university tertiary-care center with a single designated hematology-oncology unit. PATIENTS: From January 1988 to September 1993, there were 141 patients with leukemia or bone marrow transplants identified as being neutropenic during 231 admissions to this specialized unit. INTERVENTIONS: Installation of wall-mounted portable high-efficiency particulate air (HEPA)-filter air purifiers, application of copper-8-quinolinolate-formulated paint, replacement of perforated ceiling tiles with nonperforated type, sealing of all windows, replacement of horizontal, dust-accumulating blinds with vinyl, opaque, roller shades, and systematic and regular cleaning of surfaces. RESULTS: Thirty-six cases of nosocomial aspergillosis were diagnosed during this period. The incidence density (ID) in the preconstruction period was 3.18 per 1,000 days at risk. During construction activity-before the implementation of a control strategy-the ID increased dramatically to 9.88 per 1,000 days at risk. With infection control measures implemented and continued construction work, the ID decreased to 2.91 per 1,000 days at risk, comparable to the preconstruction baseline rate. CONCLUSIONS: An environmental control strategy incorporating widely available technology may have played an important role in controlling this outbreak of construction-associated invasive aspergillosis.

Air Pollution, Indoor↗
PubMed1992

Fatal septicemia due to Mycoplasma arginini: a new human zoonosis.

A 64-year-old slaughterhouse worker with advanced non-Hodgkin's lymphoma developed septicemia and pneumonia. Mycoplasma arginini, a wall-free prokaryote found in a variety of domestic animal hosts, was repeatedly isolated from blood and bronchial washings from the patient. Immunosuppression, in part caused by hypogammaglobulinemia, probably played a key role in predisposing the patient to a fatal infection. This case suggests that animal mycoplasmas should be considered in the list of infectious agents acquired by immunosuppressed hosts.

Bacteremia↗
PubMed1992

Susceptibilities of members of the Bacteroides fragilis group to 11 antimicrobial agents.

The susceptibilities of 200 clinical isolates of the Bacteroides fragilis group to 11 antimicrobial agents were determined by the broth microdilution method of the National Committee for Clinical Laboratory Standards. All isolates were susceptible to imipenem and ticarcillin-clavulanic acid. The rates of resistance to cefoxitin and clindamycin were low (4 and 6%, respectively), while those to ceftizoxime and cefotetan were higher (10.5 and 24%, respectively).

Anti-Bacterial Agents↗
PubMed1990

Tuberculous pancreatitis.

We describe a case of severe tuberculous pancreatitis in a 26-year-old woman with miliary tuberculosis. Recognition of this complication is important as it may interfere with adequate absorption of anti-tuberculous drugs and it can lead to unnecessary laparotomy.

Adult↗
PubMed1989

Strategies for molecular characterisation of methicillin- and gentamicin-resistant Staphylococcus aureus in a Canadian nosocomial outbreak.

Sixteen methicillin-resistant Staphylococcus aureus (MRSA) isolates, from a single nosocomial outbreak, were tested for molecular and phenotypic relationships. Two of the 16 outbreak strains were gentamicin resistant (Gmr) and the plasmids that they carried were characterised by reverse field electrophoresis, restriction endonuclease analysis and gene hybridisation. The gentamicin-resistant (Gmr) strains harboured two plasmids, a Gmr plasmid of 36.5 kb and a cryptic plasmid of 25.4 kb, whereas the other 14 isolates contained only the cryptic plasmid. Gentamicin resistance was encoded by a 2.5-kb HindIII fragment of the 32.8-kb plasmid and is similar to the 2.5-kb HindIII fragment also described for S. aureus Gmr plasmids from Australia and the USA. The Gmr plasmid was non-conjugal and was cured by ethidium bromide at a frequency of 4%. Two MRSA strains isolated subsequently from the same hospital were also Gmr and had identical plasmid and restriction endonuclease profiles to the two Gmr strains studied initially. Two other S. aureus isolates from the original carrier detected in this study and from his son were methicillin and gentamicin susceptible and had novel profiles. Since large plasmids show anomalous migration in agarose gels, more definitive analyses than simple plasmid identification should be considered when studying nosocomial outbreaks.

Cross Infection↗
PubMed1989

Recovery of Mycobacterium avium-M. intracellulare from blood specimens by using the routine BACTEC 6B blood culture system.

We describe a simple technique for recovery of Mycobacterium avium-M. intracellulare from blood culture specimens by using the BACTEC 460, a system used for routine blood cultures in many hospital laboratories. A total of 26 of 215 blood specimens (12%) from 11 of 48 patients (23%) with acquired immunodeficiency syndrome (AIDS) or AIDS-related complex yielded isolates of M. avium-M. intracellulare. Acid-fast staining of prepared specimens was positive for 16 of 26 cultures that ultimately yielded the organism.

Acquired Immunodeficiency Syndrome↗
PubMed1987

A prospective randomized trial of ceftazidime versus cefazolin/tobramycin in the treatment of hospitalized patients with pneumonia.

Ceftazidime and cefazolin/tobramycin were compared in the treatment of hospitalized patients with pneumonia. Iv doses 8-hourly were: ceftazidime--2 g, cefazolin--1.5 g, tobramycin--1.7 mg/kg. For patients with pseudomonas infection randomized to cefazolin/tobramycin, ticarcillin (3 g iv 4-hourly) was used instead of cefazolin. One hundred and ten of 129 patients were evaluable (ceftazidime = 52, cefazolin/tobramycin = 58). Seventy five cases (68%) had documented pathogens of which 81% were aerobic Gram-negative bacilli. Analysis of clinical response showed no difference in overall results (P = 0.77), or separate outcomes: cured (P = 0.85), improved (P = 0.62), failed (P = 0.53), or relapsed (P = 0.50). No differences in bacteriological response were noted either: eradication (P greater than 0.10), elimination with recurrence (P greater than 0.10), persistence (P greater than 0.10). The incidence of enterococcal and fungal colonization and superinfection was the same for both regimens. There was a greater incidence of Coombs' test positivity with ceftazidime (P less than 0.01) but greater nephrotoxicity with cefazolin/tobramycin (P less than 0.02). Ceftazidime appears to be as efficacious as cefazolin/tobramycin in the treatment of hospitalized patients with pneumonia, and is less nephrotoxic.

Adolescent↗
PubMed1985

A multicenter comparative trial of tobramycin and ticarcillin vs moxalactam and ticarcillin in febrile neutropenic patients.

During a multicenter prospective randomized trial in febrile neutropenic patients (neutrophil count, less than 1,000/cu mm), 103 episodes were treated with tobramycin sulfate plus ticarcillin disodium (TT) while 117 were treated with moxalactam plus ticarcillin disodium (MT). The majority of patients had an underlying diagnosis of leukemia (60%) and most (62.8%) had granulocyte counts of less than 100/cu mm at the start of therapy. The response rates for clinically or microbiologically documented episodes were 38 of 60 (55.1%) for TT and 38 of 64 (59.4%) for MT. The MT regimen appeared to be more effective for gram-positive infections (56% vs 33%) while TT appeared more effective for gram-negative infections (64% vs 40%). Nephrotoxicity attributable to study drugs occurred in only 2.3% of cases (one on each treatment arm). Prolongation of the prothrombin time was observed in only six of 78 (7.7%) in the TT arm as compared with 39 of 103 (38%) in the MT arm. Neither regimen was adequate for the unusually high frequency of gram-positive pathogens seen during this study.

Adolescent↗
PubMed1983

A multicentre prospective randomized trial comparing ceftazidime with cefazolin/tobramycin in the treatment of hospitalized patients with non-pneumococcal pneumonia.

A multicentre prospective randomized control trial was done to compare the efficacy and toxicity of ceftazidime with that of cefazolin/tobramycin in the treatment of hospitalized patients with non-pneumococcal pneumonia. The results for 50 patients are reported in this paper; 24 in the ceftazidime group and 26 in the cefazolin/tobramycin group. Measurements of clinical response show no differences between the two groups: the same is true for bacteriological response. Minimal toxicity was seen with both treatment groups. The results support the use of ceftazidime as single-drug treatment of hospitalized patients with pneumonia.

Adult↗
PubMed1981

Cerebrospinal fluid penicillin levels during therapy for latent syphilis.

Cerebrospinal fluid and serum penicillin levels were determined in patients with latent syphilis. Mean serum concentration one week after the third weekly dose of 2.4 million units penicillin G benzathine was 0.32 units/mL. Concurrent administration of probenecid orally produced a mean serum penicillin level of 0.41 units/mL. Doubled penicillin doses without and with daily orally administered probenecid resulted in mean serum concentrations of 0.75 and 1.00 units/mL, respectively. Two of six patients in the last group had CSF penicillin concentrations greater than 0.03 units/mL.

Adolescent↗
PubMed1981

Prosthetic valve infections.

Over a 10-year period, 25 patients were treated for prosthetic valve infections: 13 infections were of early onset (within 2 months of valve insertion) and 12 of late onset. Of the latter group 11 patients survived, 6 without reoperation. By contrast, 6 of the 13 with early infections died, 5 of them being among the group of 9 patients who did not undergo reoperation. Vegetations were found on most valves at autopsy or reoperation; they are a major threat to these patients. The authors believe that the mortality for early prosthetic valve infections can be reduced only by earlier prosthetic valve removal and replacement.

Anti-Bacterial Agents↗