Search PubMed⌕ Search

Biomedical subjects

J K Todd

Publications and source records attributed to J K Todd.

At least 55 records · Page 3Linked to original sources
PubMed1984

Polymicrobial bacteremia in pediatric patients.

Of 1,352 positive pediatric blood cultures during a 3.6-year period, two or more microorganisms grew from 72 cultures (5.3%), representing 60 patients. Based on predefined operational criteria for clinical interpretation of blood cultures, these cases were retrospectively classified as polymicrobial bacteremia (each organism, ie, a pathogen, 30%), mixed bacteremia/contaminant (20%), or multiple contaminants (50%). Considered individually, gram-positive organisms were isolated more frequently but were more often judged to be contaminants than the less common gram-negative organisms, which were more often thought to be true pathogens. Although one child did have a combined Streptococcus pneumoniae/Hemophilus influenzae bacteremia, these more common pediatric pathogens were underrepresented in those patients with polymicrobial bacteremia, from whom Enterobacteriaceae, streptococci, staphylococci, and anaerobes were more commonly isolated. Hospitalization for a predisposing illness and/or a focus of infection occurred in 88% of the children with confirmed polymicrobial bacteremia.

Adolescent↗
PubMed1984

Primary plate identification of group A Streptococcus on a selective medium. Efficiency in an office practice.

The efficiency of group A Streptococcus detection and identification in an office practice was studied using a selective blood agar plate containing sulfamethoxazole and trimethoprim and primary plate bacitracin disk speciation. All results were confirmed by conventional bacteriologic and immunologic techniques the next day by a reference laboratory. In all, 1,591 cultures were processed, of which 156 (10%) could be confirmed the next morning to have group A Streptococcus by primary disk susceptibility interpretation. Bacitracin-resistant beta-hemolytic colonies, which could be immunologically confirmed as group A Streptococcus grew from only three cultures (0.1%). Fifty-six (3%) of the cultures had too few beta-hemolytic colonies to determine bacitracin susceptibility, of which 47 were later proved to be group A Streptococcus. On all preliminary negative cultures, 1% demonstrated group A Streptococcus after incubation for an additional 24 hours. If a selective blood agar plate with primary bacitracin disk susceptibility speciation is used in an office laboratory setting, 99% of all cultures can be accurately interpreted within 24 hours of incubation, providing that those plates with limited growth of beta-hemolytic colonies are thereafter immunologically tested for group A Streptococcus antigen.

Agar↗
PubMed1984

Phenotypic distinctiveness of Staphylococcus aureus strains associated with toxic shock syndrome.

Twenty Staphylococcus aureus strains from patients with toxic shock syndrome (TSS) and 20 from control patients (non-TSS) with infection but no clinical evidence of TSS were compared phenotypically in a collaborative, blinded, randomized study. TSS strains were significantly (P less than 0.05) more likely than non-TSS strains to produce various previously described but related toxic shock-associated proteins (pyrogenic exotoxin C, enterotoxin F, and TSS marker protein), as well as differing in other distinctive phenotypic characteristics, such as hemolysis, bacteriocin susceptibility, arsenate resistance, pigment production, and casein proteolysis. TSS strains were significantly less likely to carry plasmids than control strains. A combination of two variables--proteolysis and toxic shock-associated protein production--statistically accounted for all other phenotypic variations between TSS and non-TSS strains. Only proteolysis covaried with all other significant variables, suggesting a primary role in the phenotypic distinctiveness of TSS S. aureus strains and possibly in the pathogenesis of TSS.

Bacterial Proteins↗
PubMed1984

Toxic shock syndrome in children aged 10 years or less.

Eight children aged 10 years or less had toxic shock syndrome, and medical records were reviewed for seven of them. There were four boys and three girls, ranging in age from 5 5/12 to 10 8/12 years; all seven met the Centers for Disease Control case definition of toxic shock syndrome. One boy died. The illness was generally characterized by fever, followed by erythroderma, gastrointestinal complaints, and mucous membrane hyperemia. Based on the need for supplemental oxygen or mechanical ventilation, the girls tended to have milder courses than the boys. In four of four cultures performed prior to the institution of antibiotic therapy. Staphylococcus aureus grew from one or more sites. One boy also met the case definition of Kawasaki syndrome and has had multiple coronary artery aneurysms demonstrated in early and late follow-up. Toxic shock syndrome in these children was similar to published descriptions of toxic shock syndrome in series of adult patients, except that, as a group, the children had a greater incidence of respiratory embarrassment.

Age Factors↗
PubMed1983

Nonculture techniques using blood specimens for the diagnosis of infectious disease.

Recent technological advances have increased the use of blood as a source for diagnosis of local and systemic infectious diseases. Traditionally, viable organisms may be cultured from the blood and others identified microscopically. The ability to detect microbial products by physicochemical, bioactivity, and antigenic techniques and the ability to detect specific immunoglobulin M (IgM) responses to infection improve our diagnostic capabilities but also present new problems in determining clinical relevance. The diagnostic use and reproducibility of new tests should be verified by comparative clinical field testing before implementation.

Antigen-Antibody Complex↗
PubMed1982

Toxic shock syndrome: a perspective through the looking glass.

Toxic shock syndrome associated with Staphylococcus aureus was first described in 1978, although cases of patients with similar findings were reported as far back as 1927. Various strict clinical definitions for toxic shock syndrome have been proposed that still should include exclusionary data (titers, cultures) when possible. Epidemiologic studies of toxic shock syndrome confirm that it occurs in males and nonmenstruating females, but more commonly in menstruating females, especially those using tampons. Microbiologic studies have identified phenotypic characteristics of S. aureus strains associated with toxic shock syndrome but none have been shown to be causally related. The attentiveness of the lay press to toxic shock syndrome research should not divert investigators from an orderly scientific process and appropriate critical review.

Female↗
PubMed1980

Pneumococcal empyema: outcome of medical management.

Physicians vary considerably in their opinion as to the duration of hospitalization and degree of surgical intervention for children with pneumococcal empyema. The development of pneumatoceles and persistence of fever or loculated pleural fluid are causes of debate and concern. We reviewed the records of 21 children with confirmed pneumococcal pneumonia. Ten of the 12 with no pleural fluid became afebrile within 48 hours of appropriate antibiotic therapy, whereas the nine with empyema remained febrile an average of 7.1 days (minimum estimate) in spite of documented sterile cultures within 24 hour in five of the patients. Although chest tube and thoracentesis drainage could not remove all the pleural fluid, and pneumatoceles developed in five of the nine children, long-term follow-up studies including chest roentgenograms and pulmonary function testing demonstrated a gradual but complete recovery that did not require long-term hospitalization, continued parenteral antibiotic therapy, or invasive surgical procedures.

Adolescent↗
PubMed1980

An epidemic of Reye syndrome associated with influenza A (H1N1) in Colorado.

An unusual cluster of Reye syndrome was associated with an outbreak of influenza A (H1N1) infections in the state of Colorado. Two of the 16 affected children had had prior episodes of Reye syndrome following respiratory infections, and one had had transverse myelitis following varicella. A serologic study of patients treated at a children's hospital and serum specimens submitted to the state health department revealed that approximately 59% of children in Colorado had been infected with the H1N1 strain of influenza A over a two-year period. Based upon this serologic survey, the minimum and maximum rates of Reye syndrome associated with H1N1 infections were calculated to be 2.5 and 4.3 cases per 100,000 H1N1 infections, respectively. A retrospective analysis of admissions to four referral hospitals in Denver failed to reveal any unusual clustering of Reye syndrome with outbreaks of influenza A H3N2 infections during 1975-1978. The reason for an association between Reye syndrome and the H1N1 strain but not the H3N2 strains of influenza A remains unclear.

Adolescent↗
PubMed1979

Subtraction serum bactericidal assay: a method for estimating in vivo effects of antibiotic combinations.

The subtraction serum bactericidal assay has been developed to assess the effects of the individual components of antibiotic combinations in serum specimens from patients with serious bacterial infection. The technique can be performed easily with conventional microtiter technology, and the results compare favorably with those obtained by conventional in vitro determinations of the additive and synergistic activity of fixed antibiotic combinations against various Enterobacteriaceae. Three combinations of gentamicin and ampicillin were used, and synergistic or additive activity was demonstrated against each of the 11 clinical isolates tested, but only with one or two of the antibiotic combinations. This finding suggests the clinical importance of a test that can determine the effects of the actual concentrations of individual antibiotics that are achieved in patients with serious infections that are being treated with antibiotic combinations.

Ampicillin↗