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Biomedical subjects

H Ludlam

Publications and source records attributed to H Ludlam.

28 records · Page 2Linked to original sources
PubMed1986

Scrum kidney: epidemic pyoderma caused by a nephritogenic Streptococcus pyogenes in a rugby team.

In December, 1984, an outbreak of pyoderma affected five scrum players in the St Thomas' Hospital rugby team. The causative organism, Streptococcus pyogenes, was acquired during a match against a team experiencing an outbreak of impetigo, and was transmitted to two front row players of another team a week later, and to two girlfriends of affected St Thomas' players a month later. The strain was M-type 49, tetracycline-resistant, and virulent. It caused salpingitis in a girlfriend and acute glomerulonephritis in one rugby player. No case of subclinical glomerulonephritis was detected in eight patients with pyoderma. Screening of the St Thomas' Hospital team revealed four further cases of non-streptococcal skin infection, with evidence for contemporaneous spread of Staphylococcus aureus. Teams should not field players with sepsis, and it may be advisable to apply a skin antiseptic to traumatised skin after the match.

Acute Disease↗
PubMed1982

Anaerobic periurethral flora of healthy women and women susceptible to urinary-tract infection.

The anaerobic periurethral microbial flora of 25 healthy women was compared with that of 29 women attending the urinary-tract-infection clinic at the Royal Free Hospital. The latter group consisted of 19 patients receiving long-term prophylactic antimicrobial therapy and 10 with proven recurrent urinary-tract infection not receiving prophylactic treatment. The numbers and species of anaerobes isolated from each group were similar. Lactobacillus spp. were the most frequently isolated organisms in each group and the most numerous. Bacteroides spp. were the next most frequently isolated. In any one subject, the anaerobic flora varied considerably during the study period of approximately 6 months. Thus, the anaerobic flora is not affected by recurrent urinary-tract infection in the past nor by the use of prophylactic chemotherapy. It does not appear to exert a protective role against the initiation of urinary-tract infection.

Adult↗
PubMed1981

Lactobacilli do not cause frequency and dysuria syndrome.

Mid-stream specimens (MSU) of urine were collected from 142 healthy women (pregnant and non-pregnant) and cultured for lactobacilli and other fastidious bacteria. The latter either require CO2 or are obligate anaerobes. Lactobacilli were present in counts of 10(4)/ml or more in 34.8% of the women, and in counts of 10(5)/ml or more in 20.2%. Besides lactobacilli, which were the bacteria most frequently isolated, anaerobic gram-positive cocci (peptococci and peptostreptococci) were often found. This flora is typical of that of the lower vagina, and none of these women had either symptoms of urinary infection of pyuria. Therefore, the bacteria isolated were commensals or contaminants. Cultures of MSUs taken from 26 women with symptoms of dysuria and/or frequency, but without significant numbers of conventional pathogens such as Escherichia coli, contained commensals and contaminants of the same variety and in similar numbers. Urine samples from 50% of these patients contained at least 10(4) lactobacilli/ml and 27% had 10(5) or more/ml. Lactobacilli were absent from the suprapubic urine specimens cultured from a further 44 women. There was no significant difference between the isolation rate of lactobacilli in urine cultures from healthy women and the rate in women with dysuria and frequency.

Chlamydia Infections↗
PubMedDate not supplied

Comparative trial of trimethoprim and co-trimoxazole in recurrent urinary infections.

Eighty-nine patients with a history of recurrent urinary infection who required immediate treatment for significant bacteriuria were treated with either trimethoprim (300 mg at night) or with the standard course of co-trimoxazole (two tablets 12-hourly) for seven days. Cure rates one week after the end of treatment were 74.4% and 80.4%, respectively. During the following month the relapse rate was lower in the group given trimethoprim than among those who had received co-trimoxazole. Consequently, the cure rates six weeks after the start of treatment were 71.4% in the trimethoprim group and 58.5% in the co-trimoxazole group. These results suggest that in this type of patient, it may be possible to reduce the incidence of bacteriological relapse by giving antibiotics in larger doses and at less frequent intervals than are at present generally recommended.

Adult↗
PubMedDate not supplied

Spirited accounts.

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Anecdotes as Topic↗