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Biomedical subjects

I Phillips

Publications and source records attributed to I Phillips.

At least 289 records · Page 16Linked to original sources
PubMed1978

The identification of pseudomonads and related bacteria in a clinical laboratory.

Non-fermenting, catalase-positive Gram-negative bacilli that grow on nutrient agar are often isolated in clinical laboratories. We have applied biochemical techniques appropriate to a typical clinical microbiology laboratory, and for the most part described in Cowan and Steel's Manual for the identification of medical bacteria (Cowan, 1974), to 428 clinical isolates and have evolved a scheme for their identification. Organisms were subdivided into groups on the basis of three tests, namely the glucose oxidation-fermentation test and tests for oxidase activity and motility. A choice was then made among other tests to produce indentification tables, containing only the most useful tests, for the various groups. The most complicated table has only 16 tests. This simple system identified 96.5% of the 428 organisms, as well as many subsequent isolates of the more common organisms.

Acinetobacter↗
PubMed1978

A computer system for clinical microbiology.

The Department of Clinical Microbiology at St Thomas' Hospital has been producing bacteriological reports on a computer for more than three years and is now producing some 2300 reports per week. The system is operated entirely by laboratory staff without special training, and involves the use of optical mark reader (OMR) forms as worksheets, automatic validation and release of most reports, the use of local terminals, and scrutiny of reports by pathologists using a visual display unit. The OMR worksheet records not only the final result but also most of the tests and observations made on the samples; it is the only working document used by technicians. One specialist clinic submits its laboratory requests on an OMR form, which is subsequently used to record the results. The reports are printed and also filed in the computer to produce analyses for hospital, laboratory, and clinical management.

Computers↗
PubMed1978

Performance of converted pressure cookers and two conventional jars for anaerobic bacterial culture.

The simple conversion of commercial pressure cookers into inexpensive anaerobic jars is described. These containers were shown to be as good as the small conventional BBL polycarbonate GasPak and large vented 150 gas-replacement jars when assessed by means of three biological indicators: Pseudomonas aeruginosa, Bacteroides melaninogenicus, and Bacteroides fragilis. Ps. aeruginosa seeded on Simmond's citrate agar was shown to be the most sensitive indicator of the three for traces of oxygen.

Anaerobiosis↗
PubMed1978

Determination of antibiotic sensitivities by the Sensititre system.

The Sensititre system provides antibiotics dried in microtitre trays in appropriate concentrations for the determination of minimum inhibitory concentrations (MIC) when organisms are added in liquid culture medium and incubated overnight. Results with a variety of media--for Gram-negative bacilli tested with ampicillin, carbenicillin, cephaloridine, and gentamicin, staphylococci with penicillin, cloxacillin, fusidic acid, and gentamicin, and streptococci with penicillin, ampicillin, cephaloridine, and erythromycin--were usually very similar to those of agar dilution tests. Discrepant results are found in a few situations, and in some cases, especially those involving borderline resistance to fusidic acid and gentamicin among staphylococci and Gram-negative bacilli, we have been unable to suggest modfication to produce the right results. Despite these problems, fortunately few and identifiable, we recommend the system especially for use in laboratories that determine the MICs infrequently.

Anti-Bacterial Agents↗
PubMed1978

Flucloxacillin in bone.

Ten patients undergoing total hip replacement for osteoarthritis were each given intramuscular flucloxacillin about two hours preoperatively; bone and serum were sampled simultaneously at operation. Trabecular and compact bone were separated, partly dried, reduced to powders, and then extracted with buffer. The concentration of flucloxacillin in bone washings and serum was determined by well-diffusion assay. The mean concentration of flucloxacillin in serum was 8.9 mg/l, in trabecular bone washings, 1.3 mg/l, and in compact bone washings 0.9 mg/l. The amount of blood contaminating the bone washings was measured, and was calculated to account for at most 26% of the flucloxacillin present. The significance of these findings is discussed in relation to the prophylactic use of flucloxacillin in hip replacement surgery.

Aged↗
PubMed1978

Food as a source of Klebsiella species for colonisation and infection of intensive care patients.

Food prepared for intensive care patients was frequently contaminated with Klebsiella species. Sixty-eight per cent of nasogastric feeds were contaminated with up to 10(4) klebsiellae per ml. Hospital kitchens were the source of contamination. Three patients ingested klebsiellae and subsequently excreted the same serotype in their faeces. Over a four-week period there was a correlation between kitchen, food, faecal, and clinical serotypes of klebsiellae. Serotypes ingested by intensive care patients occurred more frequently in clinical isolates from intensive care patients than from other hospital patients. Patients often acquired a food strain that had been ingested by another patient on the same ward.

Cross Infection↗
PubMed1978

The activity of cephalosporins on beta-lactamase-producing Neisseria gonorrhoeae.

The antibacterial activity of cephaloridine, cephalothin, cephalexin, cephradine, cefazolin, cefamandole, cefuroxime and cefoxitin was determined for six beta-lactamase-producing gonococci isolated in Great Britain and the USA. Cefuroxime was most active against small and large inocula, then cefoxitin, while cephaloridine was least active. Cefamandole was more active than cefazolin and cephalothin, but only on small inocula, and these three antibiotics, with the slightly inferior cephalexin and cephradine, all had moderate activity against large inocula. The inoculum effect (or lack of it) with cephaloridine, cefamandole, cefoxitin, and possibly cefazolin and cephalothin, may be explicable in terms of the level of their susceptibility to enzymic degradation, but this appears not to be true of the inoculum effect with cefuroxime, cephalexin and cephradine. The enzymes from the various strains had closely similar isoelectric points, apparently the same as that for TEM I from E. coli.

Amidohydrolases↗
PubMed1977

Hands as route of transmission for Klebsiella species.

Seventeen per cent of the staff of an intensive care ward were found to have Klebsiella spp contaminating their hands, and these strains could be related to serotypes infecting or colonising patients in the ward on the same day. We identified some simple ward procedures that resulted in contamination of nurses' hands with 100-1000 klebsiellae per hand. Klebsiellae survived on artifically inoculated hands for up to 150 minutes. Handwashing with chlorhexidine hand cleanser reliably gave 98-100% reduction in hand counts, and the introduction of routine handwashing by staff before moving from one patient to the next was associated with a significant and sustained reduction in the number of patients colonised or infected with Klebsiella spp. Staff clothing was occasionally contaminated, but ward air and dust rarely contained klebsiellae.

Chlorhexidine↗
PubMed1977

Gentamicin-resistant Klebsiella aerogenes in a urological ward.

A gentamicin-resistant strain of Klebsiella aerogenes was isolated from the urine of 17 patients out of 237 admitted to a male urological ward between Jan. 21 and May 9, 1977. The factors most frequently associated with K. aerogenes in the urine were catheterisation and antibiotic therapy. Often the epidemic strain (type K16) was found not only in the patients' faeces but also on more remote skin sites such as hands, knees, groins, and the umbilicus. Resistance to gentamicin and many other antibiotics was R-factor mediated. Barrier nursing of colonised patients, stringent staff handwashing with chlorhexidine, and the use of disposable aprons seemed to contain the outbreak. Hand carriage was demonstrated in one nurse 62 days after she had left the ward.

Bacteriuria↗