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Biomedical subjects

H R Ingham

Publications and source records attributed to H R Ingham.

At least 37 records · Page 2Linked to original sources

Pathogenic synergism.

Microbial synergy is well recognized but its role in the pathogenesis of human infections is poorly understood and probably underestimated. Recent experiments with animal models and in vitro studies should facilitate a more objective and critical assessment of the contribution to various infections by microorganisms, individually and collectively.

Actinomycosis↗

Motile curved bacilli. Isolation and investigation.

Motile curved bacilli seen in vaginal secretions have been isolated on Columbia agar supplemented with 5% human blood and vitamin K. Growth occurred both anaerobically and in 5% oxygen, but not under more aerobic conditions. There were two distinct groups of these organisms, distinguishable by morphology, biochemical activity, antigenic pattern and susceptibility to metronidazole. All isolates were sensitive to a wide range of antimicrobial agents, with the exception of nalidixic acid and polymyxin. One group was resistant to metronidazole.

Anti-Bacterial Agents↗

An open study of the use of ceftazidime in Gram-negative infections.

An open study of the use of ceftazidime in patients with Gram-negative infections was undertaken in a district general hospital. Ceftazidime was used in three groups of patients: 17 adults with infections due to Pseudomonas sp. or multi-resistant enterobacteria, three children with cystic fibrosis who had chest infections, and two premature neonates with severe pseudomonal pneumonia. The infections in the adult group included respiratory tract (6), urinary tract (4), wound infection (3), abdominal sepsis (2), osteomyelitis and panophthalmitis. In this group, ceftazidime was given as 1-2 g tid intravenously. In three patients, gentamicin was used concurrently and in four metronidazole was added. 76% of the adult group achieved complete clinical cure, all three cystic fibrosis cases improved markedly, and the two neonates showed complete resolution of the pneumonia. No adverse biochemical or haematological side effects occurred, although one patient developed an urticarial skin rash on the last day of a ten-day treatment course which resolved after discontinuing the ceftazidime.

Adult↗

Characteristics of motile curved rods in vaginal secretions.

Motile curved rods seen in vaginal secretions have been isolated on Columbia agar supplemented with 5% human blood and vitamin K. Growth occurred anaerobically and in 5% oxygen but not in more aerobic conditions. There were two distinct groups of these organisms, distinguishable by morphology, biochemical activity and susceptibility to metronidazole. All isolates were sensitive to a wide range of antimicrobial agents, with the exception of nalidixic acid and polymyxin, but one group was resistant to metronidazole. There was little difference between the results of tests of susceptibility to aminoglycosides or to metronidazole performed in anaerobic and microaerophilic conditions. Motile curved rods were isolated from 18 of 80 patients with a clinical diagnosis of non-specific vaginitis, but from only two of 39 without the disease.

Anti-Bacterial Agents↗

Brain abscess.

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Adrenal Cortex Hormones↗

Phagocytosis and killing of bacteria in aerobic and anaerobic conditions.

Phagocytosis and intracellular killing of several facultative anaerobes were observed in aerobic and anaerobic conditions. The presence of anaerobes affected these processes. Bacteroides asaccharolyticus and B. fragilis were killed by phagocytes only at bacterial concentrations less than 1 x 10(7) cfu/ml; at higher concentrations of the anaerobes, killing of B. fragilis and concomitant facultative anaerobes was inhibited. This effect appeared to be due to an interaction, in appropriate reducing conditions, between anaerobe and serum, which allowed engulfment of organisms by phagocytes but markedly impaired intracellular killing.

Aerobiosis↗

Fifteen-year review of the mortality of brain abscess.

Ninety consecutive cases of brain abscess admitted to this center between 1964 and 1978 have been reviewed. The overall mortality has fallen in three consecutive 5-year periods from 42 to 21 to 9.7%. A number of factors seem to be responsible for this. Early surgical intervention was associated with the reduction in mortality between the first and second 5-year periods. Recognition of the significance and extent of cerebral edema, confirmed since computed tomographic (CT) scans have been available, led to a greater use of steroids during the last 5-year period, but the number of patients thus treated was too small to permit an assessment of any effect on mortality. There is no evidence to suggest a change in the natural history of the disease, and surgical management has not altered significantly. Experience with CT scanning in this center in the diagnosis of brain abscess is limited. It is therefore not possible no assess whether any improvement in mortality may have arisen from the early and accurate diagnosis obtainable with this technique. Improvement in culture technique has been of major importance, leading to a better understanding of the bacteriology of brain abscesses. This has allowed a more rational antibiotic program to be instituted, in particular the use of agents active against obligate anaerobes.

Anti-Bacterial Agents↗