Biomedical subjects
Publications and source records attributed to I Phillips.
Three clinically typical cases of multiple pyogenic liver abscesses are presented. In all three cases Streptococus milleri was isolated from the pus and in two cases it was isolated from blood cultures also. The patients were successfully treated by surgical drainage and antibiotics.
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Haemophilus influenzae meningitis though common in childhood is rarely seen in the adult. During the past four years eight cases of H. influenzae meningitis have been seen in St. Thomas's Hospital and four of these were in patients over 20 years old. There was a possible predisposing condition in two patients. In each case there was difficulty in identification of the organism in the Gram-stained film of the cerebrospinal fluid deposit.
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A 61-year-old woman presented with malaise, intermittent fever, weight loss, and epigastric pain. Histoplasma capsulatum was eventually isolated from a liver biopsy and from the bone marrow and the patient was successfully treated with amphotericin B.
We have compared, in a clinical laboratory, three methods for estimating the concentration of gentamicin in serum. The adenylase method is most accurate, but requires considerable skilled technical time and expensive apparatus. The urease method requires an accurate pH meter but is otherwise inexpensive, but in our hands, although it produces results most rapidly, it also requires considerable technician time and is least accurate. The agar diffusion method requires no expensive apparatus, least technician time, and produces results of acceptable accuracy. It does, however, take longer than the other two methods to produce results.
An examination of 99 field and reference strains of Citrobacter freundii showed 79% of them to be resistant to cephaloridine and sensitive to carbenicillin, while 96% of 45 field and reference strains of Citrobacter koseri examined were sensitive to cephaloridine and resistant to carbenicillin. Susceptibility tests with these two antibiotics are therefore useful in separating the two species of Citrobacter.
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The in vitro antibacterial activity of cefamandole, a new cephalosporin antibiotic, was compared with that of cephaloridine, cephalothin, and cephalexin against 1,213 strains of gram-positive and gram-negative bacteria recently isolated from clinical sources. The decreasing order of activity of the four agents against gram-positive cocci was cephaloridine, cephalothin, cefamandole, and cephalexin. However, cefamandole was the most active of the four against Haemophilus species and gram-negative bacilli susceptible to cephalosporins. It was also active against many strains resistant to the other cephalosporins, such as Enterobacter species and indole-positive Proteus species, but there was a marked inoculum effect with all of these organisms, and minimal bactericidal concentrations were usually considerably higher than minimal inhibitory concentrations. Cefamandole, like other cephalosporins, had no useful activity against Pseudomonas species.