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Biomedical subjects

J Bommer

Publications and source records attributed to J Bommer.

141 records · Page 8Linked to original sources
PubMedDate not supplied

Anaphylactoid reactions in dialysis patients: role of ethylene-oxide.

To determine whether anaphylactoid reactions during dialysis are the result of allergy to ethylene oxide (EtO) used for sterilisation of dialysis equipment, EtO-specific cytophilic antibodies on basophils were detected by means of a sensitive protease-release assay. Antibodies were found in 2 of 44 healthy controls, 2 of 16 staff members, 4 of 17 patients with preterminal uraemia, and 35 of 83 dialysis patients. 22 of the dialysis patients with antibodies, but only 9 of those without had anaphylactoid reactions during dialysis. Symptoms were more common in patients with antibodies. Symptoms and antibodies were less in a unit where dialysers were rinsed more thoroughly, and were increased in patients with a history of atopy. EtO antibodies decreased or became undetectable in patients who were dialysed with non-EtO-sterilised equipment for eight weeks, and symptoms improved strikingly. On re-exposure to EtO-sterilised material, symptoms returned and EtO-induced protease release increased. EtO sterilisation of dialysis equipment should be discontinued.

Adult↗
PubMedDate not supplied

Elimination of Staphylococcus aureus in hemodialysis patients.

Staphylococcus aureus infection and its complications are of great concern in the care of hemodialysis patients. Nasal contamination with S. aureus seems to be the main source of cutaneous contamination. The decontamination and recontamination of the skin of hemodialysis patients after using mupirocin nasal ointment was followed in a placebo control study. After 10 days of therapy with mupirocin nasal ointment, 25 of 33 (73%) patients were free of nasal S. aureus contamination in the nares (control subjects 2 of 21, 10%). At the same time, the prevalence of positive skin cultures for S. aureus decreased from 30 of 33 (90%) to 11 of 33 (33%) patients. However, during the ensuing 130 days, 14 of 25 (58%) patients with negative nasal cultures became recontaminated, while the skin became recontaminated in 11 of 22 (50%) patients. In 10 of 14 S. aureus recontaminated patients the original S. aureus lysotype was documented by specific phage reaction. Four of fourteen patients had a new S. aureus lysotype. Mupirocin nasal ointment eradicated S. aureus transiently in 75% of the patients but continuously in only 11 of 33 (30%) patients.

Administration, Intranasal↗