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Biomedical subjects

J E Patterson

Publications and source records attributed to J E Patterson.

At least 73 records · Page 4Linked to original sources
PubMed1993

Epidemiological typing of Moraxella catarrhalis by using DNA probes.

Small-fragment restriction enzyme analysis and DNA-DNA hybridization were used to compare 60 strains of Moraxella catarrhalis isolated from various geographic locations. Restriction enzyme analysis with HaeIII resulted in 46 different patterns, 7 of which were shared by more than one isolate. Hybridizations with two DNA probes resulted in 18 different patterns, 11 of which were shared by more than one isolate. Strains with the same restriction enzyme pattern always had the same hybridization pattern. However, of the 50 strains that shared the 11 hybridization patterns, 39 could be further differentiated by restriction enzyme analysis. We found that hybridization is a method that is specific for the epidemiological typing of M. catarrhalis, but because of limited sensitivity, combination with small-fragment restriction enzyme analysis may be necessary to better determine the relatedness of strains.

Bacterial Typing Techniques↗
PubMed1992

Pseudoepidemic of Nocardia asteroides associated with a mycobacterial culture system.

Nocardia isolations increased from 0.7 to 11.7/1,000 acid-fast bacillus and mycological cultures (P less than 0.000001). Only three isolations from one patient represented infection. Pseudoepidemic strain identity was confirmed by DNA fingerprinting; the isolate causing infection was distinct. The end of the pseudoepidemic was associated with changing the needle sterilizer and prolonging needle sterilization time on the BACTEC 460 machine. To our knowledge, this is the first reported Nocardia asteroides pseudoepidemic.

Cross Infection↗
PubMed1991

Association of contaminated gloves with transmission of Acinetobacter calcoaceticus var. anitratus in an intensive care unit.

PURPOSE: Acinetobacter calcoaceticus var. anitratus is an important nosocomial pathogen that has been associated with environmental reservoirs. An increased isolation rate of A. anitratus in our intensive care units (ICUs), from 0.03% (two of 7,800) to 0.5% (seven of 1,300) (p less than 0.00003), prompted an investigation. PATIENTS, METHODS, AND RESULTS: Ten patients were admitted to the surgical ICU and nine to the medical ICU during the outbreak period (late December 1987 to January 1988). Controls were all patients on the units who were not infected or colonized with the transmitted strain of A. anitratus. Three patients had A. anitratus pneumonia. A throat culture prevalence survey demonstrated three patients colonized with A. anitratus. Cases were placed in a cohort and symptomatic cases treated. An epidemiologic investigation was conducted to identify reservoirs and modes of transmission. Latex gloves were being used for universal precautions without routine changing of gloves between patients. Environmental sources culture-positive for A. antitratus included a small volume medication nebulizer and gloves in use for patient care. Plasmid typing showed that plasmid profiles of isolates from two symptomatic patients, two colonized patients, the nebulizer, and the gloves were identical. Other A. anitratus ICU isolates had distinct plasmid profiles. All patients with the transmitted strain had been in the surgical ICU. The need for changing gloves between patients and contaminated body sites was reinforced. CONCLUSION: Gloves, used incorrectly for universal precautions, may potentially transmit A. anitratus.

Acinetobacter Infections↗
PubMed1991

Evidence for clonal spread of a single strain of beta-lactamase-producing Enterococcus (Streptococcus) faecalis to six hospitals in five states.

Beta-lactamase-producing (Bla+) enterococci have been reported in three state and two countries. Pulsed-field gel electrophoresis was used to compare 14 Bla+ Enterococcus (Streptococcus) faecalis isolated from hospitalized patients in seven states and three continents. The restriction endonuclease digestion patterns of isolates from Connecticut, Massachusetts, Lebanon, and Argentina were all markedly different, indicating that these were different strains. However, isolates from Delaware, Texas, Pennsylvania (Philadelphia and Pittsburgh), Florida, and Virginia were similar, indicating that these isolates were derivatives of a single strain. This conclusion was supported by hybridization using individual fragments as probes. Spread of Bla+ enterococci within the hospital setting was also demonstrated. These findings illustrate the value of pulsed-field gel electrophoresis for epidemiologic analyses and support the importance of identifying and containing organisms with new resistance properties in an effort to decrease their transmission to and from, as well as within, hospitals.

Argentina↗
PubMed1991

Reliability of performance measurements obtained using the stability testing and rehabilitation station (STARStation).

The purpose of this study was to determine within- and between-day reliability of measurements of nondisabled subjects for the variables of force and velocity when a balance board (STARStation) was positioned at heights of 4.5 and 7.5 cm from the supporting surface. Twenty-four nondisabled subjects each completed six trials of board rotation at a self-selected velocity. Each trial consisted of 10 revolutions in a clockwise direction. Measurements were repeated within the same day for a second board position, and all tests were completed again on a second day. Descriptive statistics were computed for force and velocity, and intraclass correlation coefficients (ICCs) were calculated. Data were submitted to analyses of variance and follow-up tests. Results showed slight differences between the first three and last three trials. Intraclass correlation coefficients for within-subject reliability for the independent variable day ranged from .72 to .81, and ICCs for within-day reliability for the independent variable trial ranged from .46 to .81. Clinicians using such protocols should be aware of differences within and between days and recognize that measurements will be influenced by the number of trials completed.

Adult↗
PubMed1991

Epidemiology of an endemic strain of beta-lactamase-producing Enterococcus faecalis.

Three previously reported beta-lactamase-producing (Bla+) enterococci with distinct but related antibiotic resistance phenotypes, plasmid profiles, and plasmid restriction endonuclease digestion patterns were isolated at the West Haven Veterans Administration Medical Center in Connecticut (WH245, WH257, WH571) in July 1986 and March 1987. In this study, we analyzed the whole-cell DNA of these isolates by using pulsed-field gel electrophoresis of large chromosomal fragments generated by SmaI digestion. The three West Haven isolates showed very similar chromosomal restriction endonuclease digestion patterns; these patterns were distinct from those of Bla+ and Bla- enterococci from other geographic areas and from those of other West Haven enterococci, suggesting an endemic Bla+ strain at this institution. Clinical information regarding these isolates suggests that exposure to the genitourinary clinic, obstructive urinary tract disease, and frequent antibiotic therapy may have been common risk factors for acquisition of this endemic strain.

Aged↗
PubMed1991

The effect of chloroquine prophylaxis on yellow fever vaccine antibody response: comparison of plaque reduction neutralization test and enzyme-linked immunosorbent assay.

Weekly oral chloroquine prophylaxis for malaria has been associated with impaired antibody response to intradermal rabies vaccination. Experimental data indicate that chloroquine may inhibit yellow fever virus in vitro, yet there has been no clinical evidence to suggest that antibody response to yellow fever vaccine is impaired by concomitant oral administration of chloroquine. A prospective trial was undertaken to evaluate the antibody response to yellow fever 17D vaccine (Connaught Laboratories) of volunteers who were randomized to taking either chloroquine or no drug. Of fifty subjects, 28 were randomized to taking chloroquine, 22 were randomized to taking no drug. Yellow fever 17D vaccine was administered on day 0 and blood sampled on days 0, 14, 35 and 210. Chloroquine was administered weekly for four weeks. There was no significant difference in peak antibody titer by plaque reduction neutralization testing (PRNT) between the group that took chloroquine (mean log peak of reciprocal titer 1.43 +/- SD 0.60) with vaccine subcutaneously compared to vaccine-only group (mean log peak of reciprocal titer = 1.21 +/- 0.55). All fifty subjects seroconverted to yellow fever vaccine by day 210. ELISA testing was also performed on all subjects. The two tests showed good correlation (Spearman r = 0.675), although ELISA readings were positive by day 14 in significantly more subjects (p = .01). We conclude that routine anti-malarial doses of chloroquine do not affect antibody response to yellow fever 17D vaccine. ELISA testing, a less complex and less time-consuming test, correlates well with PRNT and is proposed for additional trials to measure yellow fever 17D vaccine response in flavivirus non-immune subjects.

Administration, Oral↗
PubMed1990

Molecular epidemiology of beta-lactamase-producing enterococci.

Plasmids from the first six reported beta-lactamase-producing (Bla+) enterococci were compared for genetic relatedness. Bla+ enterococcal plasmids from strains isolated in Houston, Tex.; Philadelphia, Pa.; Connecticut; and Pittsburgh, Pa., had heterogeneous HaeIII and MspI-ClaI restriction endonuclease digestion patterns. A staphylococcal beta-lactamase probe hybridized to all six Bla+ enterococcal plasmids, but hybridization was detected on different HaeIII and MspI-ClaI fragments of the six plasmids. An enterococcal gentamicin resistance (Gmr) probe hybridized to a common 3.9-kilobase HaeIII fragment from the five Gmr plasmids. The Houston plasmid was cross-hybridized to the other five strains, and moderate to extensive homology was demonstrated. Bla+ enterococcal plasmids from a broad geographic range are heterogeneous with respect to size and restriction endonuclease digestion patterns but contain homologous genetic material, including Bla+ and Gmr determinants.

Conjugation, Genetic↗
PubMed1990

Mycobacterium gordonae pseudoinfection associated with a contaminated antimicrobial solution.

At Yale-New Haven Hospital, 46 specimens submitted for mycobacterial culture during an 8-week period in 1989 were positive for Mycobacterium gordonae, a nontuberculous acid-fast bacterium (AFB) of low pathogenicity. The specimens were submitted from 34 patients who came from various inpatient and outpatient services. Four patients were begun on antimycobacterial therapy on the basis of an AFB isolate which was later identified as M. gordonae. Isolation of M. gordonae was associated with use of the BACTEC TB system (BACTEC TB; Becton Dickinson Diagnostic Instrument Systems, Towson, Md.) and an antimicrobial solution, BACTEC PANTA PLUS (PANTA; Becton Dickinson Diagnostic Instrument Systems). The manufacturer reported that two lots (B9K1 and C9K1) of PANTA kits containing a single production lot (N8C1) of PANTA, which had been shipped to 173 laboratories, had been contaminated with M. gordonae. A survey of mycobacteriology laboratories in the United States revealed that, during April to July 1989, the M. gordonae isolation rate was 5.8/1,000 AFB specimens processed at laboratories that did not use BACTEC TB, 11.4/1,000 AFB specimens at laboratories that used BACTEC TB but not the implicated lot of PANTA, and 23.5/1,000 AFB specimens at laboratories that used BACTEC TB and the lot of implicated PANTA. Intrinsic contamination of PANTA was attributed to ineffective sterilization of water used in the manufacturing process and was not detected prior to product shipment because cultures for AFB were not part of the quality control regimen. This episode emphasizes that clinical laboratories can detect pseudoepidemics promptly if they are alert to abrupt increases in isolation rates, especially of unusual or generally nonpathogenic organisms.

Anti-Bacterial Agents↗
PubMed1990

Epidemiology of high-level gentamicin resistant enterococcal isolates from Zimbabwe.

High-level gentamicin resistance (minimum inhibitory concentration of greater than or equal to 2,000 mcg/ml) in Enterococcus faecalis has not previously been reported in Africa to our knowledge. Eight of 28 (29%) rectal swab specimens obtained from hospitalized patients in Zimbabwe had gentamicin resistant enterococci. Previous exposure to penicillins or aminoglycosides were risk factors for colonization with these organisms. This study documents the presence of high-level gentamicin resistant enterococci in Africa and suggests that penicillin or aminoglycoside usage may select for gentamicin resistant enterococcal plasmids in Africa.

Case-Control Studies↗
PubMed1989

Susceptibility and bactericidal activity studies of four beta-lactamase-producing enterococci.

beta-Lactamase-producing (Bla+) enterococci are rare but have been reported from several areas. We report another Bla+ enterococcus with high-level gentamicin resistance. Susceptibility and bactericidal activity studies of four Bla+ enterococci against potential alternative antibiotics, including ampicillin-sulbactam, daptomycin, teicoplanin, and vancomycin, are presented.

Anti-Bacterial Agents↗
PubMed1989

Evaluation of restriction endonuclease analysis as an epidemiologic typing system for Branhamella catarrhalis.

Restriction endonuclease analysis (REA) was evaluated as an epidemiologic typing tool to distinguish Branhamella catarrhalis strains. Fourteen beta-lactamase-producing strains were collected over a 16-month period at a hospital where a nosocomial outbreak of this organism was previously documented by REA. REA produced 12 distinct patterns which correlated with epidemiologic data. Chromosomal REA appears to be a useful technique for distinguishing B. catarrhalis strains.

Bacterial Infections↗
PubMed1989

Assuring safe travel for today's elderly.

The increased availability of time and resources has made travel attractive to many elderly patients. Both healthy and chronically ill geriatric patients can travel safely and without medical complications in many circumstances. Many of these patients, however, have special health needs that call for specific advice from practitioners. Patients with medical problems, such as chronic obstructive pulmonary disease, cardiovascular disease, thrombotic disease, sinus conditions, or diabetes, should be aware of possible complications involved in travel. In addition, medical advice regarding vaccinations, traveler's diarrhea, jet lag, and malaria prophylaxis should be tailored to this population. Such a prescribed regimen may make travel safe and feasible for many geriatric patients.

Aged↗
PubMed1988

A nosocomial outbreak of ampicillin-resistant Haemophilus influenzae type b in a geriatric unit.

A nosocomial outbreak of Haemophilus influenzae type b (Hib) bronchitis occurred in a geriatric unit. The three infected patients were grouped together in an isolation unit and treated. A prevalence survey was done by obtaining pharyngeal cultures from patients and staff in the unit. One patient and a nurse were asymptomatic pharyngeal carriers of Hib. One infected patient was bedridden, and his only known Hib contact was the nurse. Geographic clustering was the only significant risk factor, as determined by a case-control study. Carriers were treated with rifampin. The isolates were characterized for strain relatedness by using three methods. All produced beta-lactamase and all were serotype b. Plasmid profiles and restriction endonuclease analysis of bacterial DNA were performed; chromosomes were digested with the restriction endonucleases HindIII and HaeIII. Strains were confirmed as identical by using these methods and were different from two Hib control strains producing beta-lactamase. This study documents nosocomial transmission of Hib, by using molecular typing methods.

Aged↗