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Biomedical subjects

J F John

Publications and source records attributed to J F John.

At least 73 records · Page 4Linked to original sources
PubMed1982

Effect of peritoneal dialysis solution on the antimicrobial activity of cephalosporins.

We studied the effect of peritoneal dialysis solution (PDS) on the antibacterial activity of seven cephalosporins, gentamicin, tobramycin and amikacin. The six bacterial species employed in the study survived in a wide range of concentrations of PDS, however, Staphylococcus aureus did not survive beyond 24 h in PDS. There were no physical incompatibilities between any of the antibiotics and PDS. None of the cephalosporins was bactericidal in PDS, whereas, the bactericidal concentrations of the aminoglycosides in PDS approximated those of aminoglycosides in broth. We conclude from these in vitro data that cephalosporins may not be ideal agents for intraperitoneal therapy when they are administered in PDS.

Amikacin↗
PubMed1981

Mycobacterium fortuitum pulmonary infection associated with an antigen-selective defect in cellular immunity.

In this study we describe the first example of a well documented case of pulmonary infection caused by Mycobacterium fortuitum shown to be associated with an antigen-selective defect in cell-mediated immunity to this organism. Immunologic parameters were evaluated before, during and after antibiotic treatment with amikacin. A defect in cellular immunity to purified protein derivative from Myco. fortuitum, shown to be antigen-selective as indicated by normal responsiveness to purified protein derivative from Mycobacterium tuberculosis and several other common recall antigens, accompanied the prolonged infection by this organism. During the first three months of treatment with amikacin, the patient's clinical status improved coincident with the eradication of the organism from the sputum. During the next three months of therapy with amikacin, however, a generalized defect in cellular immunity developed, and the lung disease again progressed. The deteriorating clinical condition was presumably related to a generalized cellular immune anergy or hyporesponsiveness induced by the amikacin therapy. After three more months of treatment, the organism became resistant to the drug and reappeared in sputum cultures. Since amikacin therapy was discontinued, the patient's general immune responsiveness returned to normal. He did, however, remain unresponsive to purified protein derivative from Mycobacterium fortuitum.

Amikacin↗
PubMed1981

Characteristics of Serratia marcescens containing a plasmid coding for gentamicin resistance in nosocomial infections.

Strains of gentamicin-resistant Serratia marcescens (GRSM) that originated in a crowded neurosurgical close observation unit (COU) became established during a 2.5-year interval at several affiliated hospitals in Charleston, South Carolina. Most patients with GRSM had colonization or infection of the urinary tract associated with indwelling bladder catheters. Infected patients in the COU more often had pyuria and less often received systemic steroids than COU patients not harboring GRSM. However, length of stay, use of urinary catheters, exposure to systemic antibiotics, and exposure to gentamicin were not significantly different between the two groups. Of the strains of GRSM, 92% contained a conjugative 41-megadalton plasmid tht encoded resistance to ampicillin, carbenicillin, tetracycline, kanamycin, gentamicin, and tobramycin and elaborated similar aminoglycoside 3-acetyltransferases. Seven 41-megadalton plasmids from outbreak strains and a 41-megadalton plasmid from a 1973 isolate of GRSM gave identical DNA fragments after restriction endonuclease digestion.

Aminoglycosides↗
PubMed1980

Use, misuse, and cost of parenteral cephalosporins at a county hospital.

We reviewed total usage of parenteral cephalosporins at a county hospital during 1978 with regard to appropriateness, pattern of use, and cost. In addition, we determined the impact of replacing cephalothin with cephapirin in the hospital formulary. During the 12-month study 366 patients received 409 courses of parenteral cephalosporins: 167 received cefazolin, 160 received cephapirin, and 35 received a combination of cefazolin and cephapirin. The surgical service prescribed 87% of the cephapirin and 92% of the cefazolin. Parenteral cephalosporins were used 62% of the time for prophylaxis and 38% of the time for therapy. Usage was judged inappropriate in 47% of all courses based on our criteria; 25% of the therapeutic courses were judged inappropriate, compared to 60% of the prophylactic courses. Pharmacy costs of cefazolin used as prophylaxis were more than twice the cost for cephapirin. Cost of a mean therapeutic course for cefazolin was 43% higher than for cephapirin. Antibiotic audits and continued education combined with judicial substitution of therapeutic equivalents should limit the inappropriate use and expense of parenteral cephalosporins for large as well as small hospitals.

Cefazolin↗
PubMed1980

Activity of cephalosporins against methicillin-susceptible and methicillin-resistant, coagulase-negative staphylococci: minimal effect of beta-lactamase.

Eight cephalosporins were tested for their activity against methicillin-susceptible and methicillin-resistant, coagulase-negative staphylococci and for their resistance to beta-lactamase from methicillin-resistant, coagulase-negative staphylococci. Susceptibility testing by the agar plate method was evaluated for the effect of inoculum size and duration of incubation. Methicillin-susceptible, coagulase-negative staphylococci were highly susceptible to the cephalosporins, with cephapirin and cepahlothin showing the greatest activity, followed by cefazolin and cefamandole. Methicillin-resistant, coagulase-negative staphylococci displayed nearly total cross-resistance to the cephalosporins. Resistance increased with increasing inoculum size. Beta-Lactamases produced by methicillin-resistant, coagulase-negative staphylococci had a minimal hydrolytic effect on cepahlothin, cephapirin, cefazolin, and cefamandole and no measurable effect on cefoxitin. There was no correlation between the anti-staphylococcal activity and resistance to beta-lactamases.

Cephalosporins↗
PubMed1980

Polyarteritis overlap syndrome with extensive bowel infarction.

An elderly female with laboratory evidence of rheumatoid arthritis presented with malnutrition, elevated erythrocyte sedimentation rate, peripheral eosinophilia with eosinophilic infiltration of the pleura, uterus, skin and muscle without granuloma formation. She developed a necrotizing vasculitis of the mesenteric vessels without granuloma and died. This case illustrates that polyarteritis nodosa, even of the overlap type, may produce severe widespread mesenteric vasculitis.

Female↗
PubMed1979

Case report 89.

Explore the source record for details and available documents.

Adult↗
PubMed1979

Nephelometric detection of soluble immune complexes: methodology and clinical applications.

We have developed a method for the detection of immune complexes by laser nephelometry which is simple, reproducible, suitable for automation, and generally adaptable for diagnostic testing. Light dispersion by antigen-antibody complexes in the test samples is measured after addition of polymeric buffer, which enhances the aggregation of complexes but does not significantly affect unbound immunoglobulins. The method was used to measure immune complexes formed in vitro by incubation of tetanus toxoid with serum from a rabbit previously hyperimmunized with the same antigen, and to compare the levels of immune complexes in human sera obtained from normal adults and from 37 patients with collagen vascular diseases or endocarditis. When precautions were taken to avoid interference produced by the presence of lipoproteins or by freezing of the samples, the results obtained with human sera were consistent with those expected for normal controls and for patients with conditions thought to be associated with the presence of soluble immune complexes.

Animals↗
PubMed1978

Species identification of coagulase-negative staphylococci from urinary tract isolates.

A new scheme for identification of coagulase-negative staphylococci was applied to 138 consecutive urinary isolates of coagulase-negative staphylococci. The most common species were Staphylococcus epidermidis (53%), S. hominis (12%), and S. haemolyticus (10%). S. saprophyticus comprised only 5%. The disk method for antibiotic susceptibility for all species grouped together disclosed resistance most commonly to penicillin (35%), tetracycline (33%), methicillin (27%), and sulfonamide (24%). This pattern was also seen specifically with S. epidermidis. Further studies are needed to determine the incidence of species-specific antibiotic resistance and species-specific infection by site. This may be of particular interest in those patients with nosocomial infections due to coagulase-negative staphylococci.

Anti-Bacterial Agents↗
PubMed1977

Nosocomial infection rates at a General Army Hospital.

An eighteen month study of the incidence of nosocomial infections was conducted at a 436 bed general army hospital. The overall rate of nosocomial infection was 1.48 per cent, with a monthly range of 0.42 to 2.30 per cent. Gynecology had the highest rate of 5.8 per cent. Escherichia coli, klebsiella, and Staphylococcus aureus were the major hospital pathogens. No emergence of unusual drug resistance was observed during the course of the study. Further studies should be conducted to establish guidelines of surveillance for nurse-epidemiologists in this type of hospital.

Adolescent↗
PubMed1977

Spinal syphilis: the problem of fluorescent treponemal antibody in the cerebrospinal fluid.

Spinal manifestations of syphilis are now uncommon. Three adults with presumptive nontabetic spinal syphilis are presented. This paper should serve as a reminder to physicians that cases of late syphilis continue to occur and may be manifested as obscure spinal syndromes and be misdiagnosed unless the possibility of syphilis is constantly kept in mind. Some of the clinical dilemmas associated with the reactivity of fluorescent treponemal antibody in the cerebrospinal fluid are discussed,

Absorption↗
PubMed1976

Trimethoprim-sulfamethoxazole therapy of pulmonary melioidosis.

A 21-year-old-airman stationed in the Philippines presented with cavitary pulmonary melioidosis. When treated with trimethoprim-sulfamethoxazole, there was prompt resolution of his symptoms and the left upper lobe abscess cavity. It is suggested that this antimicrobial combination is an effective alternative regimen for pulmonary melioidosis.

Adult↗