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Biomedical subjects

J Huebner

Publications and source records attributed to J Huebner.

25 records · Page 2Linked to original sources

Ribotyping of Pseudomonas aeruginosa strains isolated from surgical intensive care patients.

To elucidate the sources of Pseudomonas aeruginosa on a surgical intensive care unit, rDNA restriction fragment length polymorphism analysis (ribotyping) was applied to analyze strains isolated during a 4-month prospective study. Samples included 1635 from 153 patients, 2463 from 97 staff members, and 581 from the environment. Only 18 patients were colonized. Isolation from their animate and inanimate environment was very low, with 3 and 2 samples, respectively, being positive. Samples from tap water were negative. Ribotyping could easily distinguish 16 different digest patterns with identical follow-up isolates of the same patient. Horizontal transmission occurred only twice. The discriminatory power of ribosomal DNA in differentiating strains was dependent on the restriction enzymes used; among eight different enzymes, PvuII was the most sensitive, producing 15 different patterns. Ribotyping showed high sensitivity in typing P. aeruginosa isolates and confirmed that colonization occurs from endogenous rather than from exogenous sources.

Animals↗

In vitro activity of sodium bisulfite and heparin against staphylococci: new strategies in the treatment of catheter-related infection.

Device-related infections often persist until the device is removed because systemic antibiotic therapy fails frequently. In an in vitro model, the activity of sodium bisulfite (an antioxidant added to many drugs) heparin with chlorbutol or chlorcresol as preservatives, and their combination with cefpirom for treating the internal surface of polyurethane and silicone catheters colonized with Staphylococcus aureus and Staphylococcus epidermidis was studied. Sodium bisulfite (0.05%) markedly reduced catheter colonization. Heparin combined with chlorbutol, 1000 micrograms/mL of cefpirom, and 0.05% of sodium bisulfite was not more effective than sodium bisulfite alone. A lesser effect was shown by treating adherent bacteria on both catheters with heparin plus preservatives alone. Not only antibiotics but also other substances with antibacterial activity should be evaluated for treatment and prophylaxis of catheter-related infection.

Anti-Infective Agents, Local↗

Two-year follow up of bipolar hemiarthroplasty.

Forty-seven bipolar hemiarthroplasties were performed from January 1985 to December 1986. Twenty-three patients (24 hips) returned for a history, physical, and repeat radiographs. Ten primary press-fit and two cemented primary bipolar hemiarthroplasties were performed. Four patients underwent cemented and eight received press-fit revision bipolar hemiarthroplasties. Fourteen patients had simultaneous cancellous, reamed femoral head autograft, or allograft acetabular bone augmentation. Omitting one patient who had replacement for Lévi's pleonosteosis, the average acetabular migration among the remaining 23 patients was 4 mm of superior and 1.5 mm of medial progression. The mean modified d'Aubigne hip score was 33 for primary press-fit arthroplasty, 30 for primary cemented arthroplasty, 22 for press-fit revisions, and 32 for cemented bipolar revision arthroplasty. Morcellized bone graft tended to variably resorb with time. Among the press-fit stems, all but two patients complained of at least occasional thigh pain. All but one patient with primary press-fit hemiarthroplasty walked with a limp. We conclude that, although good early results can be obtained, significant number of patients will have groin and thigh pain. We have found no evidence either radiologically or clinically that nonstructural bone grafting with reamed femoral head will reliably incorporate or prevent further acetabular migration.

Acetabulum↗

In vitro susceptibility of methicillin-resistant Staphylococcus aureus and slime-producing and non-slime-producing coagulase-negative staphylococci to fusidic acid.

The in vitro susceptibility of 100 oxacillin-resistant Staphylococcus aureus and 100 oxacillin-resistant coagulase-negative staphylococci (CNS; 50 slime-negative and 50 slime-positive strains) was determined by agar dilution technique, with and without the addition of 50% human serum. All strains tested were highly sensitive to fusidic acid. S. aureus and CNS showed MIC50 values of 0.125 and 0.25 mg/l, respectively. MICs of all strains increased significantly in the presence of 50% human serum. Only minor differences were noted between the MICs of slime-producing and slime-deficient CNS.

Coagulase↗

Influence of architectural design on nosocomial infections in intensive care units--a prospective 2-year analysis.

Nosocomial infection rates in an old intensive care ward constructed in 1924 were compared with those in a new one constructed in 1986. The nosocomial infection rate in the old unit was 34.2% and that in the new unit 31.9%, with an average of 33%. The most frequent infections were: pneumonia, urinary tract infection, septicaemia and wound infection. After transfer of the intensive care unit (ICU) the incidence and profile of nosocomial infections remained the same. These findings suggest that the influence of architectural design has little impact on the incidence of nosocomial infections.

Cohort Studies↗

Shigellemia in AIDS patients: case report and review of the literature.

Shigella bacteremia in adult patients is rare and is usually associated with immunosuppressive diseases. To date, 12 HIV-positive patients with Shigella bacteremia have been reported in the medical literature. We report a case of Shigella dysenteriae bacteremia in a 39-year-old HIV-positive patient. Although the patient presented with bloody and watery diarrhea, stool cultures failed to grow enteric pathogens. The patient responded well to appropriate antibiotic therapy.

Acquired Immunodeficiency Syndrome↗