Biomedical subjects
Publications and source records attributed to I A Porter.
An estimate of the benefits which would result from a ban on the sale of non-pasteurized milk in Scotland has been assessed by costing a recent outbreak of milk-borne salmonellosis in the Grampian Region. The cost of such a ban would not exceed the benefits under any but the most severe assumptions about the values attached to intangible benefits.
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Four elderly patients with salmonella septicaemia complicated by irreversible endotoxic shock and acute renal failure are described. The organism isolated from three of the patients with Salmonella typhimurium, which is not usually invasive; the fourth patient was infected with S. abony. The factors associated with the severe systemic infections are discussed. Clinical and haematological findings suggested disseminated intravascular coagulation, and this was subsequently confirmed histologically in each patient by the identification of haematoxylinophil bodies in the pulmonary and renal microcirculations.
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Pseudomonas aeruginosa was isolated from the ears of 18 of the 25 members of a team of competitive swimmers who complained of painful discharging ears. This group of swimmers trained twice daily in the pool, in the early morning and late afternoon. In contrast swabbing of the ears of a similar group of 54 competitive swimmers who used the pool only in the afternoon revealed only one swimmer with P. aeruginosa. Investigation of the swimming pool revealed that chlorination was often inadequate when the first group of swimmers were training in the early morning. Strains of P. aeruginosa were isolated from various sites around the pool and from the bag of a vacuum used to clean the pool. Pyocin typing, serotyping and phage typing were performed on all isolates. The dominant strain recovered from the swimmers' ears was found to be almost identical to that from the vacuum bag and belonged to serotype 0--11 which has been particularly associated with outbreaks of P. aeruginosa infection in whirlpools in the United States. These results support the hypothesis that there is a direct correlation between the development of otitis externa and swimming in water contaminated with P. aeruginosa.
Campylobacter jejuni was isolated from the stools of 148 patients with symptoms and 57 symptomless subjects, and from a milk sock filter, following an outbreak of enteritis associated with consumption of unpasteurized milk. The incubation period ranged from 2-11 days with a peak at 5 days. There were no secondary cases. The attack rate was around 50%. Cases occurred in all age groups but were maximal in the 1-10 age group. Recovery from symptoms was complete in the majority in less than 1 week. No long term excretors were identified. There were no differences between culture positive individuals, with or without symptoms, in age or sex distribution or duration of excretion.
110 patients with uncomplicated gonococcal urethritis were treated with 2 g spectinomycin (Trobicin) intramuscularly. Seventy-five patients were available for follow-up and there was only one treatment failure, giving a cure rate of 98-6%. Of the 99 gonococcal isolates, 59 were sensitive to 5 microng/ml of spectinomycin or less and 40 were sensitive to 10 microng/ml. In a small sample of patients 2 g spectinomycin intramuscularly produced a serum concentration averaging 100 microng/ml after one hour.
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The numbers of vaginal swabs, faecal specimens, throat swabs, and urine specimens submitted by 104 city general practitioners to the bacteriology laboratory at Aberdeen differed widely. The doctors who made most use of the laboratory service rarely did so equally for all four investigations but usually for only one or two. Similarly, those who used the service least often made frequent use of one particular investigation. Further studies are needed to identify and evaluate the reasons for the apparently substantial disagreement among general practitioners concerning the value of these diffferent bacteriological investigations in general practice.
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