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M C Cummings

Publications and source records attributed to M C Cummings.

30 records · Page 2Linked to original sources
PubMed1995

Bacterial vaginosis in lesbians: a sexually transmitted disease.

Sexual transmission of bacterial vaginosis (BV), a common syndrome in sexually active women, has not been previously established. Because no male counterpart for BV has been found, a population of lesbians is an ideal one in which to test the hypothesis that BV is sexually transmitted. We studied 103 homosexual women (lesbians) who sought gynecologic care at a community clinic and in a private gynecology practice in New York City. Participants were asked to refer their sexual partners for evaluation. In this cross-sectional prevalence study, all participants were evaluated for the presence of BV, and pairs of monogamous sexual partners were analyzed for concordance of their vaginal secretions. Twenty-nine (28.7%) of the 101 participants from whom satisfactory vaginal wash samples were available had BV. There were 21 pairs of monogamous partners. Of 11 index women who had BV, eight (72.7%) had partners who also had BV. Of 10 index women who did not have BV, only one (10%) had a partner with BV. The likelihood of a partner's having BV was 19.7 times greater if the index case had BV (P < .008; 95% CI, 2.1-588.0). We conclude that with respect to BV, lesbians in monogamous relationships usually have concordant vaginal secretions. This concordance probably reflects the sexual transmission of BV between lesbians.

Female↗
PubMed1993

Identification of mycoplasmas in urine from persons infected with human immunodeficiency virus.

Voided urine samples from persons with and without human immunodeficiency virus (HIV) infection were examined for mycoplasmas. Mycoplasma hominis organisms were identified in cultures of urine from 32 (18%) of 180 HIV-positive individuals and from 8 (21%) of 38 HIV-negative individuals. In contrast, glucose-utilizing mycoplasmas were identified in the urine of 30 (17%) of the HIV-positive individuals and in none of those who were HIV-negative. Assays of growth inhibition around disks containing specific antisera identified 14 of the 30 glucose-utilizing mycoplasmas as Mycoplasma fermentans. Four isolates were presumptively identified as Mycoplasma pirum. Growth on solid media was insufficient to permit the identification of the species of the other 12 isolates by growth inhibition.

Adult↗
PubMed1993

PCNA immunostaining in breast cancer.

Expression of proliferating cell nuclear antigen (PCNA) has been shown to be of prognostic value in patients with certain types of cancer. The aim of this study was to determine if the abundance of PCNA is inversely correlated with survival of patients with breast cancer. Paraffin blocks were available from 68 patients, all of whom had been followed clinically for at least 5 years. Sections from 20 patients showed no reactivity to PCNA and were excluded from the study because it was not possible to distinguish between true negatives and false negatives (those due to poor fixation of the original specimens). The PCNA index (the number of stained cancer cells as a percentage of the total number of cancer cells present) was calculated for the remaining 48 patients. Results were analysed by Wilcoxon's rank sum test (two tailed) and Pearson's correlation coefficient. There was no statistical difference between the PCNA indices of those patients dead from their disease within 5 years of diagnosis compared with those alive and without signs of breast cancer at 5 years. There was also no correlation between PCNA index and size of the cancer, involvement of axillary lymph nodes, time to recurrence or time to death. There was, however, a significant correlation between PCNA index and histological grade (P = 0.029). It appears that PCNA staining of stored paraffin sections is of little prognostic value in patients with breast cancer.

Antibodies, Monoclonal↗
PubMed1990

Increase in resistance of Mycoplasma hominis to tetracyclines.

Isolates of Mycoplasma hominis collected from patients in Boston and New York between 1976 and 1989 were studied. Minimal metabolism-inhibiting concentrations (MMCs) were determined by use of a terminal color change-broth dilution method, as well as by an agar inoculum-broth dilution method. Both methods gave comparable results. Tetracycline MMCs for 3 (7.0%) of 43 isolates of M. hominis collected from 1976 to 1979 were 8 micrograms/ml or more, but they were 8 micrograms/ml or more for 11 (20.3%) of 54 isolates collected from 1980 to 1983 (P = 0.083) and 16 (26.6%) of 60 isolates collected from 1984 to 1989 (P = 0.019). Similarly, doxycycline MMCs for 0 of 43 isolates of M. hominis collected from 1976 to 1979 were 8 micrograms/ml or more, but they were 8 micrograms/ml or more for 8 (14.8%) of 54 strains isolated from 1980 to 1983 (P = 0.0082) and 10 (16.6%) of 60 strains isolated from 1984 to 1989 (P = 0.0047). The susceptibility of M. hominis to clindamycin did not change. We conclude that isolates of M. hominis in the northeastern United States have become more resistant to tetracycline and doxycycline over the past decade.

Clindamycin↗
PubMedDate not supplied

Evaluation of ofloxacin in the treatment of uncomplicated gonorrhea.

In an open study, a single oral dose of 400 mg of ofloxacin was administered to 40 men and 20 women who required treatment for uncomplicated gonococcal infection. Thirty-six men and 13 women were evaluable. Ofloxacin eradicated 49 of 49 urethral or endocervical gonococcal infections and 1 of 1 pharyngeal infection. There were 55 pretreatment isolates of Neisseria gonorrhoeae available for antimicrobial susceptibility testing. Twenty-four (43.6%) produced penicillinase. Eighteen (32.7%) isolates that did not produce penicillinase had penicillin MICs greater than or equal to 1.0 micrograms/mL. Twelve (21.8%) isolates had tetracycline MICs greater than or equal to 16 micrograms/mL. The geometric mean minimal inhibitory concentrations (range) for 55 pretreatment N. gonorrhoeae isolates were: ofloxacin, 0.014 (.0078-.03) micrograms/mL; penicillin, 6.30 (.125-128) micrograms/mL; and tetracycline 1.61 (.03-128) micrograms/mL. There were few side effects. Ofloxacin appears to be an effective and safe oral therapy for the treatment of infections caused by N. gonorrhoeae including infections due to penicillin- and tetracycline-resistant strains.

Adult↗
PubMedDate not supplied

Comparison of enoxacin and ceftriaxone in the treatment of uncomplicated gonorrhea.

BACKGROUND AND OBJECTIVES: The increasing prevalence of resistant strains of Neisseria gonorrhoeae has prompted investigation of new agents for the treatment of this sexually transmitted disease. GOAL OF THIS STUDY: This study compared the efficacy and safety of a single oral dose of enoxacin to intramuscular ceftriaxone in the treatment of uncomplicated anogenital infection with N. gonorrhoeae. STUDY DESIGN: A randomized open trial was conducted at a sexually transmitted diseases clinic in Brooklyn, New York. Adults with uncomplicated gonorrhea were randomly assigned to receive 400 mg of enoxacin or 250 mg of ceftriaxone. A follow-up examination was conducted 5 to 9 days later. RESULTS: 59 women and 23 men were enrolled; 40 women and 19 men were evaluable. Enoxacin eradicated 18 of 19 endocervical, 10 of 10 urethral, 5 of 5 anorectal, and 3 of 3 pharyngeal gonococcal infections. Ceftriaxone eradicated 20 of 21 pharyngeal gonococcal infections. Fifty-nine pretreatment isolates of N. gonorrhoeae were available for antimicrobial susceptibility testing. The geometric mean minimal inhibitory concentration was 0.03 mg/1 for enoxacin and 0.005 mg/l for ceftriaxone. There were few sides effects in either group, and both drugs were ineffective against concomitant infection with Chlamydia trachomatis. CONCLUSION: Oral enoxacin appears to be a safe and effective method of treatment for anogenital infections caused by N. gonorrhoeae.

Administration, Oral↗
PubMedDate not supplied

Susceptibility of isolates of Neisseria gonorrhoeae to penicillin and tetracycline in Brooklyn, 1988-1992.

BACKGROUND AND OBJECTIVES: The aim of this analysis was to determine the rate of resistance of Neisseria gonorrhoeae to penicillin and tetracycline over 5 years. STUDY DESIGN: The authors studied 500 isolates of N. gonorrhoeae. Minimum inhibitory concentrations of various antimicrobial agents, including penicillins, tetracyclines, quinolones, cephalosporins, spectinomycin, and trospectomycin, were determined using agar dilution. Organisms that produced beta-lactamase were classified as penicillinase-producing N. gonorrhoeae, and those with tetracycline minimum inhibitory concentrations > 16 micrograms/ml were considered presumptive high-level tetracycline resistant. Organisms with Minimum inhibitory concentrations > 2.0 micrograms/ml were presumptively considered to have chromosomally mediated resistance to penicillin or tetracycline. Isolates with none of these forms of resistance were considered susceptible to penicillin and tetracycline. RESULTS: Penicillinase-producing N. gonorrhoeae represented 34.7%, 40.7%, and 44.9% of gonococcal isolates in 1988, 1989, and 1990, respectively. Only 14.3% and 15.0% of the isolates in 1991 and 1992 were penicillinase-producing N. gonorrhoeae. In 1988, 1.0% of isolates were chromosomally mediated penicillin resistant. In contrast, chromosomally mediated penicillin resistant gonococci represented 7.5% to 22.4% of isolates from 1989 to 1992. In 1988, 26.0% of isolates were high-level tetracycline resistant. The prevalence of presumptive high-level tetracycline resistant organisms decreased after 1988. From 1989 to 1992, only 8.2% to 14.8% of gonococcal isolates were presumptive high-level tetracycline resistant. No chromosomally mediated tetracycline resistant isolates were identified in 1988. In 1989 and 1990, 11.6% and 10.2%, respectively, of isolates were chromosomally mediated tetracycline resistant. Chromosomally mediated tetracycline resistant N. gonorrhoeae represented 2.0% of isolates in 1991 and 25.0% of isolates in 1992. All isolates tested were susceptible to the other antibiotics. CONCLUSION: Continued surveillance of sensitivity of contemporary gonococci to antimicrobial agents is important.

Female↗
PubMedDate not supplied

Evaluation of vaginal tampons for collection of specimens for detection of Chlamydial infection.

BACKGROUND AND OBJECTIVES: Previous studies have shown that self-inserted vaginal tampons can be used to obtain specimens for detection of Neisseria gonorrhoeae. There is a need to expand testing for infection with Chlamydia trachomatis to women who do not undergo regular gynecologic examinations. GOAL: To compare self-inserted tampons with clinician-obtained endocervical swabs for collection of samples to be examined for chlamydial infection. STUDY DESIGN: Women referred because of recently detected untreated chlamydial infection inserted a vaginal tampon. Two endocervical swabs were obtained after the tampon was removed. One swab was cultured for Chlamydia trachomatis. The other swab and the tampon were examined with the Testpack Chlamydia antigen detection test. RESULTS: Sixty-nine women were studied. Chlamydial infection was detected by culture in 75.4%, by Testpack (swab) in 63.8%, and by Testpack (tampon) in 52.2%. CONCLUSIONS: Tampon-obtained specimens evaluated in the Testpack Chlamydia test were relatively insensitive. More sensitive tests for the detection of Chlamydia trachomatis infection with self-obtained specimens should be evaluated.

Adult↗
PubMedDate not supplied

Comparison of methods for the detection of treponema pallidum in lesions of early syphilis.

BACKGROUND: The clinical diagnosis of primary and secondary syphilis can be difficult because of the wide variability of lesions. The available laboratory tests (dark-field microscopy and direct fluorescent antibody) require specialized microscopes and skilled technicians, and serologic tests are insensitive in early infection. METHODS: Dark-field microscopy and monoclonal antibody staining were compared to a new solid-phase enzyme-linked immunosorbent assay (Visuwell test) for detection of T. pallidum in lesion exudate of 188 patients with genital lesions. RESULTS: Sixty-four patients (34%) had lesions of early syphilis diagnosed by either dark-field, monoclonal antibody staining, or both. The Visuwell test and dark-field examination were positive in 52 (81.3%) and 55 (85.9%) of the 64 patients, respectively, whereas the monoclonal antibody staining technique demonstrated the presence of T. pallidum in 59 (92.2%) of the 64 patients. The Visuwell test gave a negative result in 111 of 124 patients who had negative dark-field and direct fluorescent antibody test results (89.5% specificity). CONCLUSIONS: The Visuwell test is an alternative method for evaluating genital ulcers but is less sensitive and specific than existing tests.

Enzyme-Linked Immunosorbent Assay↗