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Biomedical subjects

H R Ingham

Publications and source records attributed to H R Ingham.

At least 73 records · Page 4Linked to original sources

Bacteriological study of otogenic cerebral abscesses: chemotherapeutic role of metronidazole.

In nine consecutive patients with otogenic cerebral abscesses a mixed growth of aerobic and obligate anaerobic bacteria was isolated from the pus in five patients, and in the remaining four obligate anaerobes were the sole isolates. The commonest obligate anaerobe isolated was Bacteroides fragilis, which was present in all but one patient. The patients were all treated with metronidazole for the anaerobic organisms and with appropriate chemotherapy against the aerobic organisms isolated. All the patients recovered and only one was left with a neurological deficit. As otogenic cerebral abscesses constitute a major proportion of all cerebral abscesses, the use of metronidazole against obligate anaerobic bacteria, which tend to dominate in such abscesses, should reduce the high mortality from this condition.

Adolescent↗

Metronidazole compared with penicillin in the treatment of acute dental infections.

The efficacy of metronidazole in the treatment of acute dental infections was investigated and compared with parenteral penicillin in a controlled trial. All 37 patients in the trial responded satisfactorily and metronidazole appeared to be as effective as parenteral penicillin. A further 24 patients treated with metronidazole also responded satisfactorily. Bacteriological studies of pus obtained from 25 patients revealed the presence of many species of obligate anaerobes. Since metronidazole is only active against obligate anaerobic bacteria it is concluded that these organisms are the important pathogens in acute dental infections.

Adult↗

The API ZYM system in the identification of Gram-negative anaerobes.

The API ZYM reactions of type species of Gram-negative anaerobes representative of those encountered in human infections and of 56 clinical isolates of such organisms, identified by conventional techniques, were investigated. The API ZYM test clearly distinguished between the different genera and species examined and appears to provide a simple, reliable method for the identification of this group of organisms.

Bacteriological Techniques↗

Cerebral abscess.

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Anaerobiosis↗

The effect of carbon dioxide on the sensitivity of Bacteroides fragilis to certain antibiotics in vitro.

The effect of 10% carbon dioxide on the sensitivity to four antibiotics of 10 strains of Bacteroides fragilis was studied. The minimum inhibitory concentrations of erythromycin and lincomycin hydrochloride for these strains were four to 32 times higher, when grown in hydrogen plus 10% carbon dioxide, than the values obtained when the strains were grown in pure hydrogen. A similar effect was obtained by growing the strains in hydrogen on an acid medium. Except for Haemophilus influenzae and Clostridium tertium the sensitivity to erythromycin and lincomycin hydrochloride of other species of bacteria examined was not affected by the atmosphere in which the tests were carried out. 7-Chlorolincomycin and rifamycin B diethylamide, to which the strains of B. fragilis were uniformly sensitive, were not significantly affected by additional carbon dioxide. The possible mechanisms underlying this phenomenon and its clinical implications are discussed, and a case report describing the successful use of erythromycin in the treatment of a cerebral abscess due to B. fragilis is presented. In a recent study in this laboratory of the sensitivity to antibiotics of B. fragilis the majority of strains were found to be inhibited by 0.15 mug/ml of erythromycin and by 0.55 mug/ml of lincomycin hydrochloride (Ingham, Selkon, Codd, and Hale, 1968). After this work had been completed hydrogen plus 10% carbon dioxide was substituted for pure hydrogen in the anaerobic technique. Strains of B. fragilis isolated on routine culture now appeared to be relatively resistant to erythromycin and lincomycin hydrochloride when their sensitivity was examined by the disc diffusion method. A more detailed investigation of this phenomenon was carried out, the results of which are reported here. The opportunity was also taken to examine the susceptibility of B. fragilis to two new antibiotics, namely, 7-chlorolincomycin and rifamycin B diethylamide.

Anti-Bacterial Agents↗

Two cases of cryptococcal meningitis, one treated with 5-fluorocytosine.

Cryptococcal meningitis occurred in two patients in the North of England. One, an elderly woman who was ill for 12 months with an obscure indolent meningitis until use of steroid drugs resulted in an acute exacerbation during which cryptococci were isolated, was treated successfully with amphotericin B. The other, a student from New Guinea with subacute meningitis, could not tolerate amphotericin B but responded to two courses of oral treatment with 5-fluorocytosine 100-200 mg./kg./ day without any appreciable side-effects. Further trials of this drug in the treatment of cryptococcosis are recommended.

Adolescent↗

Haemophili from eyes.

The identity of haemophili isolated in our laboratories from eye swabs was investigated. Ten out of 114 strains belonged to capsulated types of H. influenzae. Seventy-six strains were submitted to tests for the identification of H. aegyptius (the Koch-Weeks bacillus), but none was proved to belong to this species. An unexpectedly high proportion of the haemophilus strains, including most of those with capsules, came from patients with lachrymal duct obstruction.

Agglutination Tests↗