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Biomedical subjects

I Phillips

Publications and source records attributed to I Phillips.

At least 271 records · Page 15Linked to original sources

In vitro antibacterial activity and susceptibility of the cephalosporin Ro 13-9904 to beta-lactamases.

The in vitro activity of Ro 13-9904 was assessed against clinical isolated of common bacteria. Its activity against most enterobacteria was similar to that of cefotaxime and moxalactam, but it was even more active than these compounds against all Proteus species. It was also highly active against Haemophilus influenzae and Neisseria gonorrhoeae, including beta-lactamase producers. Like cefotaxime and moxalactam, Or 13-9904 was approximately eightfold more active than carbenicillin against most isolates of Pseudomonas aeruginosa and also active against highly carbenicillin-resistant isolates, but it was relatively inactive against moderately carbenicillin-resistant isolates. Ro 13-9904 also resembled cefotaxime and moxalactam in that it was active, though less so than cephaloridine, against staphylococci and streptococci, except for methicillin-resistant staphylococci and Streptococcus faecalis, which were resistant to it. It was less active than cefoxitin but slightly more active than ampicillin against both Bacteroides fragilis and other Bacteroides spp. Ro 13-9904 was resistant to most beta-lactamases but was attacked by enzymes from B. fragilis, isolates of indole-positive Proteus species, and also by a cefoxitin-hydrolyzing enzyme from an isolate of Enterobacter cloacae.

Bacteria↗

Assessment of transport and isolation methods for gonococci.

Urethral discharge from men was diluted to give heavy and light inocula and cultured on seven different solid culture media, including two transport/isolation media, or held in three types of semi-solid transport medium for varying periods and then cultured. The amount of growth was quantitated and the performance of the different systems compared. Fresh non-selective media were best, with up to two failures in 254 cultures on each medium. With selective media there were 9-23 failures with heavy inocula and 22-47 failures with dilute inocula. For Transgrow or the Jembec system incubation before holding at ambient temperature was better than holding followed by incubation. Transport media yielded good results if cultures were set up within six hours; only minor losses occurred after 24 hours.

Bacteriological Techniques↗

Infective endocarditis, 1970-1979. A study of culture-positive cases in St. Thomas' Hospital.

Ninety-three episodes of culture-positive endocarditis occurred in 88 patients in the years 1970 to 1979. Streptococci caused two-thirds of the cases, with Streptococcus mitior and Streptococcus sanguis most common. Among the Group D streptococci, Streptococcus bovis was much more common than Streptococcus faecalis. Staphylococci accounted for a quarter of the episodes. Streptococcal endocarditis was commonest in the elderly, whereas staphylococcal endocarditis occurred at all ages. Degenerative heart disease was the underlying cardiac factor in nearly half the streptococcal cases, but staphylococci most often affected normal heart valves. When prosthetic valves were infected endocarditis of early onset was staphylococcal but that of late onset was streptococcal. Narcotic abuse was a common cause of staphylococcal endocarditis, second only to surgical wound infection following valve replacement. Streptococci affected the mitral and aortic valves equally but the staphylococci more usually involved mitral or tricuspid valves. The overall mortality was 36 per cent but was much higher for staphylococcal than streptococcal endocarditis.

Adolescent↗

Phenylethylamine in paranoid chronic schizophrenia.

Phenylethylamine (PEA) is an endogenous amine that is structurally and pharmacologically related to amphetamine. Urinary PEA excretion is significantly higher in paranoid chronic schizophrenics than in nonparanoid chronic schizophrenics and normal controls. Diet, hospitalization, and medication do not account for differences in PEA concentrations. These findings offer some indication that PEA may be an endogenous amphetamine.

Chronic Disease↗

Prophylactic peroperative intravenous metronidazole in elective colorectal surgery.

In a prospective double-blind randomised trial 83 patients undergoing elective colorectal surgery were given either preoperative intravenous metronidazole or intravenous normal saline. No other antimicrobials were given. Bowel preparation was the same for both groups. Deep post-operative wound sepsis occurred in 6 of 44 (13-6%) patients on metronidazole but in 20 of 39 (51-2%) control untreated patients. Anaerobes were responsible for all cases of deep sepsis in the metronidazole group (in 5 of the 6 cases aerobes were also isolated), and for 16 of the 20 cases of deep sepsis in the control group (all with aerobes). Superficial infection in the metronidazole group was caused by aerobes. Anastomotic leakage occurred in 5 of the 6 patients who developed deep sepsis on metronidazole and in 10 of 20 patients on placebo. Peroperative intravenous metronidazole dramatically reduced postoperative sepsis but failed to prevent infection in the presence of anastomotic breakdown.

Bacterial Infections↗

Anaerobic axillary abscess.

Fifty-two patients with axillary abscesses were seen during two years. Staphylococcus aureus was isolated from 34, anaerobic bacteria from 12, and skin flora from five; in one case the pus was sterile. Seven patients with hidradenitis suppurativa had recurrent infection with abscess formation, which was bilateral in three. Anaerobes were isolated in five of these cases and skin flora alone in two. Anaerobes are secondary invaders in this condition, and histological examination shows that the primary abnormality is obstruction of pilosebaceous follicles and apocrine glands, associated with keratin plugging of the follicles. Chemotherapy offers little hope of cure, although metronidazole removes the offensive smell of the discharge. Radical surgery is usually indicated.

Abscess↗

Anaerobic subareolar breast abscess.

15 non-puerperal women with breast abscess were seen during one year. In 8, anaerobes were cultured from pus obtained from the abscess, in 6, Staphylococcus aureus was grown, and in 1 the pus was sterile on culture. All 7 breast abscesses in puerperal women seen during the same period were staphylococcal. The anaerobic abscesses were all subareolar; they were recurrent in 4 patients and were associated with retracted nipples in 7. The anaerobes isolated were those found as normal commensals in the oropharynx and vagina but did not include the colonic commensal Bacteroides fragilis. Squamous metaplasia with keratin plugging of the breast ducts was identified histologically in the 2 non-puerperal patients in whom duct excision was performed. Surgical treatment of the underlying duct abnormality is important in the management of recurrent non-puerperal subareolar breast abscess.

Abscess↗

Reassessment of histone gene expression during cell cycle in human cells by using homologous H4 histone cDNA.

The representation of H4 histone mRNA sequences in RNAs isolated from G1 and S phase HeLa cells was assessed by use of a homologous H4 histone cDNA. S phase cells were obtained by double thymidine block, and G1 cells were obtained by double thymidine block or mitotic selective detachment. Nuclear and cytoplasmic RNAs from S phase cells hybridized with H4 histone cDNA as did nuclear and cytoplasmic RNAs from G1 cells synchronized by double thymidine block. In contrast, significant levels of hybridization were not observed between H4 histone cDNA and nuclear, polysomal, or postpolysomal cytoplasmic RNAs of G1 cells synchronized by mitotic selective detachment. Double thymidine block yields a G1 cell population containing 20-25% S phase cells whereas the G1 population obtained by mitotic detachment contains less than 0.1% S phase cells. The ability of H4 histone cDNA to hybridize with the RNAs from G1 cells obtained after release from double thymidine block can therefore be explained by the presence of S phase cells in such a G1 population--an artifact of the synchronization procedure. We interpret these results to be consistent with the presence of H4 histone mRNA sequences during the S but not G1 phase of the cell cycle in continuously dividing HeLa S3 cells.

Cell Cycle↗

A taxonomic study of clinical isolates of Pseudomonas pickettii, 'P. thomasii' and 'group IVd' bacteria.

On the basis of cluster analysis, average similarities within and between groups, and DNA base composition of selected strains, Pseudomonas pickettii appeared to be a distinct species comprising several biotypes. Although some or all of these biotypes, represented by subclusters in our computer study, may ultimately warrant recognition as separate species, our results were not conclusive enough to warrant such a proposal at present. Most strains tentatively named 'P. thomasii' could be included in P. pickettii so that the name P. pickettii, which was validly published whilst 'P. thomasii' was not, takes priority over 'P. thomasii'. Strains of Group Va (Tatum et al., 1974) examined were also included in P. pickettii. Group IVd (King, 1964) did not appear to be a natural group but some of the strains could also be included in P. pickettii.

Base Composition↗

An assessment of the Microcult-GC culture test.

Microcult-GC, a miniaturised culture test, was compared with an established selective culture method for laboratory confirmation of gonorrhoea. Microcult-GC correlated 94% with the control method in identifying gonococci in male urethral specimens. Microcult-GC testing of 130 gonococci-negative vaginal swabs gave only 4.6% false-positive oxidase results, which could probably have been readily refuted by Microcult Gram stain. The test may be difficult to interpret for rectal specimens and is not appropriate for pharyngeal cultures.

Adult↗

Assessment of a selective medium for the isolation of Neisseria gonorrhoeae.

Specimens of urethral pus from 312 men with gonorrhoea were diluted and inoculated on to non-selective and selective media, the latter containing vancomycin, colistin, nystatin, and trimethoprim. Although three (1%) isolates of Neisseria gonorrhoeae were inhibited by trimethoprim 4 mg/1 and 10 by vancomycin 2 mg/1, only two failed to grow on a selective medium from large inocula but eight strains sensitive to vancomycin failed to grow on a selective medium from a light inoculum. These few failures do not appear to negate the value of the selective medium.

Culture Media↗

Antibiotic sensitivity of anaerobic bacteria.

Antibiotic sensitivity tests on most anaerobic organisms isolated from a given patient are seldom of use to that individual. This is because both isolation and sensitivity testing of this group of bacteria take so long. It is thus vital that the microbiologist should be able to supply to the clinician the cumulated results of past experience, ideally his own, but if not, then the experience of others, taking into account geographical variations whenever possible. Because of the possibility of geographical variation, it is important that every institution should carry out sensitivity testing on easily isolated and rapidly growing bacteria. Bacteroides fragilis is probably the most common of these, and because it is among the more resistant anaerobes and is present in the majority of anaerobic infections, it is often used as an "indicator" both of the diagnosis and of the likely response to a given drug regimen.

Aminoglycosides↗

Gonorrhoea in women. Diagnostic, clinical, and laboratory aspects.

Examination of the case-notes of all women seen at a large metropolitan clinic during 1976 showed 607 episodes of gonorrhoea (92.3% of all such cases seen in the hospital), of which 3 were in prepubertal girls. Gonorrhoea occurred more often and at an earlier age in Negroids than in Caucasians. In about 30% of patients gonococci could be found in only one of the sites tested (cervix 18%, urethra 6%, rectum 4.8%, and throat 1.5%). Microscopical examination of gram-stained cervical and rectal samples was of value, but that of urethral samples made no significant contribution to the diagnosis. 31% of the gonococcal isolates showed diminished sensitiivty to penicillin, but none showed significant resistance to spectinomycin, kanamycin, or sulphamethoxazole. The complication rate was lower than that reported from the United States. Overall, 40% of patients were symptom-free. The presence of other infection significantly increased the probability of a patient with gonorrhoea having symptoms. "Epidemiological" treatment would have led to the unnecessary treatment of 142 females and would have included only 4 of 16 patients with gonorrhoea who defaulted before treatment could be given.

Adult↗

Epidemiological patterns of Klebsiella colonization and infection in an intensive care ward.

Twenty-four per cent of 2315 patients admitted to the intensive care unit of St Thomas's Hospital in the 4 year period from November 1969 became colonized or infected with Klebsiella species. Capsular typing of 986 klebsiella isolates from 551 patients showed that there were 695 patient-isolates, mostly derived from the respiratory tract. Capsular types 47 and 21 were the commonest types and together accounted for 19.9% of the patient-isolates. The 14 commonest types accounted for 47.3% of all patient-isolates and all these strains showed clustering, strongly suggesting a changing common source, cross infection, or both.

Cross Infection↗