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Biomedical subjects

I Phillips

Publications and source records attributed to I Phillips.

At least 199 records · Page 11Linked to original sources
PubMed1985

Sch 34343: in-vitro antibacterial activity and susceptibility to beta-lactamases.

The in-vitro activity of the penem Sch 34343 was assessed in comparison with third-generation cephalosporins, aztreonam and imipenem. Sch 34343 was active, with MICs generally 2 mg/1 or less, against a broad spectrum of organisms amongst which were staphylococci (including methicillin-resistant strains), streptococci (though enterococci were less susceptible with Sch 34343 MICs mostly 4-8 mg/1), anaerobes (including the Bacteroides fragilis group), Haemophilus influenzae and Neisseria gonorrhoeae. It was also active against the Enterobacteriaceae though Enterobacter cloacae and Serratia spp. were somewhat less susceptible than other members of this group. Sch 34343 lacked useful activity against most species of Pseudomonas (including Ps. aeruginosa) but was active against Ps. acidovorans and some isolates of Ps. cepacia. Sch 34343 showed a high degree of resistance to plasmid-determined and most chromosomally-determined beta-lactamases; however, it was hydrolysed rapidly by enzymes from some isolates of Aeromonas hydrophila and more slowly by enzymes from Ps. maltophilia and Bact. melaninogenicus subspecies intermedius. We did not observe any reduction in sensitivity to Sch 34343 for most beta-lactamase-producing organisms, including strains of Enterobacter spp. and Citrobacter freundii that were resistant to most other beta-lactams.

Aeromonas↗
PubMed1985

Flucloxacillin concentration in serum and wound exudate during open heart surgery.

Per-operative serum and wound fluid concentrations achieved by two flucloxacillin dosage regimens were measured in twelve patients undergoing open heart surgery. One 500 mg bolus dose given after the induction of anaesthesia in six patients resulted in adequate serum concentrations (means decreasing from 69 to 9 mg/l) during surgery, but low wound fluid concentrations (mean 4.6 mg/l, range less than 2-7.8 mg/l) at the time of closure. An additional 500 mg bolus dose given after bypass in six further patients gave more satisfactory wound concentrations (mean 16 mg/l, range 8.6-22.5 mg/l). Disc absorption is a useful technique for assaying antibiotics in wound fluid, but the results are difficult to interpret since they represent a sum of concentrations in a complex and changing mixture of interstitial tissue fluid, blood and cardioplegia solution.

Cloxacillin↗
PubMed1985

Two regimens of sultamicillin in treating uncomplicated gonorrhoea.

Sultamicillin is a covalent union of ampicillin and the beta lactamase inhibitor, sulbactam (CP-45,899). Two studies were conducted to assess its efficacy in treating uncomplicated gonorrhoea. In the first study treatment comprised sultamicillin 1.5 g and probenecid 1 g; 124 (89.2%) of 139 patients responded including seven of 11 patients harbouring beta lactamase (penicillinase) producing strains of Neisseria gonorrhoeae (PPNG). In the second study sultamicillin 2.25 g and probenecid 1 g were given; 122 (93.8%) of 130 patients responded. Only two of seven pharyngeal infections resolved, and if pharyngeal infections are excluded the overall cure rate rose to 95.3%. Thirteen of 14 patients infected with PPNG strains were cured by the larger dose. Side effects were mild and transitory. It may be concluded that sultamicillin 2.25 g plus probenecid 1 g is an effective regimen to treat uncomplicated rectal and genital gonorrhoea and is useful for treating infections with PPNG strains. Most beta lactamase resistant antimicrobials must be given parenterally; sultamicillin is given by mouth.

Administration, Oral↗
PubMed1985

The emergence of resistance and the therapy of septicaemia.

There were 658 positive blood cultures in St. Thomas' Hospital during 1982-1984, from which 301 Enterobacteriaceae were isolated. Most were of species that do not usually produce inducible class I beta-lactamases but 39 of the isolates were of species that do. Many of these strains were resistant to the older cephalosporins but resistance to cefuroxime was uncommon and resistance to ceftazidime or cefotaxime was confined to five isolates of Enterobacter cloacae (four of which were from patients who had been previously treated with beta-lactams). In only two cases did initially cefuroxime-sensitive strains unambiguously develop resistance during treatment (one strain each of Enterobacter aerogenes and Citrobacter freundii--both treated with amoxycillin).

Anti-Bacterial Agents↗
PubMed1985

Lung abscess and empyema.

Forty-eight patients presenting with lung abscess or empyema were studied between 1976 and 1984. The clinical features, diagnostic techniques and management are discussed. Aerobes were cultured from specimens obtained in 37.5 per cent of cases, both aerobes and anaerobes in 54.2 per cent and anaerobes alone in only 8.3 per cent. Bacteroides fragilis was not isolated. Forty-two per cent of patients had previously received antibiotics, but fully sensitive organisms were grown from 17 of 20 specimens from this group. Forty-five per cent of aerobes and 17.8 per cent of anaerobes were resistant to penicillin. There were no specific clinical features which distinguished the patients with a lung abscess from those with an empyema, nor between those with an underlying abnormality and those in whom the infection arose in a previously normal lung. Lung abscesses should be treated medically with intensive physiotherapy and appropriate antibiotics; penicillin can no longer be considered the antibiotic of choice. If the cavity fails to drain satisfactorily, further investigations should be undertaken to exclude a tumour or other underlying abnormality.

Adolescent↗
PubMed1984

Necrobacillosis: a forgotten disease.

Over four years five previously healthy young adults developed necrobacillosis , a severe septicaemic illness caused by Fusobacterium necrophorum. The infections were characterised by sore throat followed by rigors and the formation of metastatic abscesses and all caused considerable diagnostic confusion.

Adolescent↗
PubMed1984

Staphylococcus aureus bacteraemia: 400 episodes in St Thomas's Hospital.

Four hundred episodes of Staphylococcus aureus bacteraemia occurred in St Thomas's Hospital from 1969 to 1983, accounting for 17.5% of all episodes of bacteraemia. The mortality was 24%, half attributable to underlying disease, and was highest in patients over 50. Almost 60% of the bacteraemias were acquired in hospital, and the source of the organism was generally obvious, with vascular access sites the most common (37%). Bone and joint infections accounted for 11.5% of episodes and endocarditis for 7%. Most staphylococci were resistant to penicillin only; three isolates were resistant to methicillin and five to fusidic acid. Microbiologists seldom influenced directly the choice of initial antibiotic treatment (though this usually conformed to the hospital's antibiotic prescribing policy) but had considerable influence over definitive treatment, usually cloxacillin or flucloxacillin alone or in combination with fusidic acid. S aureus bacteraemia is easy to identify and treat, though underlying disease may influence the outcome. Efforts should be made to prevent the largely iatrogenic disease.

Adolescent↗
PubMed1984

Muscarinic binding in suicides.

Supersensitive muscarinic cholinergic receptors may underlie mood, neuroendocrine, and sleep disturbances in depression. To test this hypothesis, we examined muscarinic binding sites in the brains of suicides and controls in a matched-pair design, using the radioligand 3H-quinuclidinyl benzilate (QNB) and focusing on regions (frontal cortex, hypothalamus, and pons) mediating those functions. Receptor densities and binding affinities did not differ between suicide and control brains in any brain region studied, although there was a trend for both density and affinity to be lower in hypothalami from suicides. We discuss the implications of these findings for the cholinergic-adrenergic balance hypothesis of depression and the methodological limitations of our preliminary study.

Acetylcholine↗
PubMed1984

Some factors affecting the efficiency of settle plates.

An evaluation has been made of some of the factors which may affect the efficiency of settle plates. Water loss was found to be linear with time. Although the count was reduced over an 8 h period the reduction was not statistically significant. No difference in total bacterial counts could be detected between four, 1/2 h exposures and one, 2 h exposure. The addition of water and the surface area of the plates had no effect on the total count.

Agar↗
PubMed1984

The in-vitro activity of ciprofloxacin compared with that of norfloxacin and nalidixic acid.

The in-vitro activity of ciprofloxacin , a new 4-quinolone, was compared with that of norfloxacin and nalidixic acid against recent clinical isolates of medically important bacteria. Overall, ciprofloxacin and norfloxacin had similar spectra of activity, but ciprofloxacin had somewhat greater intrinsic activity against most organisms. Minimum inhibitory concentrations (MIC) were in the range 0.004-4 mg/l for Enterobacteriaceae, 0.016-2 mg/l for Pseudomonas spp., 0.004-1 mg/l for Acinetobacter, 0.004-0.016 mg/l for Haemophilus influenzae, 0.001-0.004 for gonococci, 0.004-0.03 mg/l for Cmpylobacter , 0.12-2 mg/l for staphylococci, 0.25-4 mg/l for streptococci, 1-32 mg/l for the Bacteroides fragilis group and mostly in the range 0.25-8 mg/l for other obligate anaerobes. Resistant variants could be selected readily in vitro by culture on any of the three compounds investigated. However, while the MICs of nalidixic acid were high for these variants those of ciprofloxacin and norfloxacin were much lower.

Anti-Bacterial Agents↗
PubMed1984

Two curved rods in non-specific vaginitis.

Sixteen isolates from the vaginal discharge of women with bacterial vaginosis (non-specific vaginitis) and six provided by other investigators were divided into two groups on the basis of morphology and biochemical tests. Only one organism type was isolated from any one patient. The two groups differed in size, number of flagella, enzyme production, ability to ferment carbohydrates, hydrolyse hippurate and arginine, reduce nitrate, and produce ONPG, and in sensitivity to metronidazole. Both groups fermented glucose and maltose, produced succinate from glucose and alpha-glucosidase and leucine arylamidase.

Bacteria, Anaerobic↗
PubMed1983

Anaerobic vaginosis (non-specific vaginitis): clinical, microbiological, and therapeutic findings.

The effect of metronidazole on anaerobic vaginosis (non-specific vaginitis) was assessed in a double-blind, placebo-controlled study of 40 women. 19 of 20 women given metronidazole 400 mg twice a day for seven days were clinically and microbiologically cured by the time they completed treatment. All 20 women given a placebo were treatment failures, but when they were given a single 2 g dose of metronidazole, 15 showed clinical and microbiological cure a week later. 14 of the responders showed a recurrence of infection a month after treatment; this was probably due to reinfection, although persistence of infection cannot be ruled out. Findings in the clinic correlated closely with subsequent microbiological results in 133 out of 140 patient-visits, which suggests that there is no need for expensive and time-consuming laboratory investigations in this condition.

Aerobiosis↗
PubMed1983

Spectinomycin resistant gonococci.

A study was conducted examining the properties of 10 clinical isolates of spectinomycin resistant gonococci from patients attending clinics at St Mary's and St Thomas's Hospitals, London. All of the isolates produced beta-lactamase and contained plasmids of 2.6, 4.4, and 24.5 megadaltons and required proline for growth. None produced aminoglycoside modifying enzymes. Resistance to spectinomycin was transferred from some of the isolates by transformation but at a much lower frequency than resistance to streptomycin. The isolates from St Mary's Hospital were detected after therapy with spectinomycin, whereas those from St Thomas's Hospital were not. Four recent non-beta-lactamase producing gonococci isolated at St Mary's Hospital and two isolated at St Thomas's Hospital also were not related to use of spectinomycin.

Drug Resistance, Microbial↗
PubMed1983

Prosthetic valve endocarditis.

During 1965 to 1982, 32 episodes of infective endocarditis on prosthetic valves in 30 patients were treated at this hospital. In early endocarditis (presenting within four months of operation) staphylococci were the organisms most commonly responsible. Early endocarditis appears to be declining in incidence and is largely preventable; sternal sepsis was the main predisposing factor, requiring urgent and effective treatment. Streptococci were the most common organisms in late onset disease, but as with natural valve endocarditis a wide range or organisms was responsible. All but one of the patients with early onset disease were treated conservatively, but mortality was high; prompt surgical replacement of infected prostheses is probably indicated in such patients. Medical management was effective in most patients with late onset disease, and for them early surgical intervention may not be justified.

Adult↗