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Biomedical subjects

M R Jacobs

Publications and source records attributed to M R Jacobs.

249 records · Page 14Linked to original sources
PubMed1978

Prevalence of Toxoplasma antibodies in Southern Africa.

An indirect fluorescent antibody survey of the prevalence of Toxoplasma antibodies was carried out on sera from 4 regions of Southern Africa (Natal, Eastern Cape, Western Cape, and South West Africa and Botswana). The overall prevalence of seropositivity at a titre of 1/16 or higher was 20% (of 3379 sera tested), the highest prevalence occurring in Blacks (34%) and Indians (33%) of Natal, and the lowest in San (Bushmen) (9%) and Whites (12%) of South West Africa and Botswana. Differences in prevalence in these areas, and between different ethnic groups, are discussed and compared with previous studies in Southern Africa. Climatic factors affecting prevalence and transmission are compared in relation to cyst and oöcyst survival. The marked differences in prevalence between the San (9%) and the Negroid Dama (27%), both inhabiting the arid Kalahari Desert, are discussed with reference to the lifestyles of these groups.

Antibodies↗
PubMed1978

The immune response in iron-deficient children. Isohaemagglutinin titres and antibody response to immunization.

The primary antibody response of iron-deficient children to diphtheria and typhoid immunization was measured. In 5 children immunized with diphtheria toxoid, there was no increase in antitoxin titre. Of 8 children who were given typhoid vaccine, 6 showed an increase in Salmonella typhi O agglutinin titre. All the iron-deficient children had normal isohaemagglutinin titres.

Anemia, Hypochromic↗
PubMed1978

Escherichia coli gastro-enteritis in adults.

Two cases of gastro-enteritis in South African adults are reported. Stool cultures performed on both patients yielded pure growths Escherichia coli. One isolate was shown to have invasive ability, and the other to produce heatstable enterotoxin. Neither strain belonged to a 'classic' enteropathogenic serotype associated with infantile gastro-enteritis.

Adult↗
PubMed1975

The value of radiation therapy in uterine sarcoma.

Fifty-eight cases of leiomyosarcoma of the uterus and 47 endometrial sarcomas of the uterus are reviewed based on the pertinent information related to recurrence patterns. The following conclusions are made: 1) Cases of endometrial sarcoma should receive preoperative pelvic irradiation, or postoperative pelvic irradiation if a diagnosis is not made until the postoperative period. This plan will probably be of most benefit, if at all, in stage 1 disease. 2) A case for pelvic irradiation as an adjuvant to surgery in leiomyosarcoma cannot be made from a review of this material, either from a viewpoint of recurrence patterns or radio-responsiveness.

Adult↗
PubMedDate not supplied

Cefditoren in vitro activity and spectrum: a review of international studies using reference methods.

Cefditoren, a broad-spectrum orally administered cephalosporin ester, has documented in vitro efficacy against many Gram-positive and -negative pathogens and stability against clinically important beta-lactamases. We have reviewed the microbiology and the pharmacokinetic/pharmacodynamic literature regarding the spectrum and potency of this newer agent against the major etiologic agents of community-acquired respiratory infection, (Streptococcus pneumoniae, Hemophilus influenzae and Moraxella catarrhalis), as well as the Enterobacteriaceae and non-enteric Gram-negative bacilli, staphylococci, and other aerobic and anaerobic Gram-positive cocci. The level of cefditoren activity against S. pneumoniae (MIC(90,) 0.5 microg/mL) was superior to all marketed oral cephalosporins and at least equal to amoxicillin +/- clavulanate. H. influenzae (MIC(90,) 0.016-0.03 microg/mL) and M. catarrhalis (MIC(90,) 0.06-0.5 microg/mL) were also very susceptible to cefditoren. In contrast to cefixime and ceftibuten, cefditoren was active against oxacillin-susceptible staphylococci (MIC(90,) < or = 1 microg/mL) at a level comparable to cefuroxime axetil, cefaclor or cefprozil. Enterococci, Pseudomonas aeruginosa and most anaerobes (Gram-negative) were not cefditoren-susceptible, but most Enterobacteriaceae, beta-haemolytic and viridans group streptococci were highly susceptible. Furthermore, an overview of key in vitro susceptibility testing methods and issues including disk diffusion testing and Etest (AB BIODISK, Solna, Sweden) method accuracy, interpretive criteria, and pharmacodynamic considerations for the selection of a breakpoint concentration are provided. The rapid bactericidal nature of the antibacterial activity of cefditoren, its post antibiotic effect, penicillin binding protein targets, and extent of beta-lactamase stability are all favorable qualities. In conclusion, this orally administered (BID) beta-lactam possesses promise for use against commonly isolated problematic respiratory tract pathogens such as penicillin-non-susceptible pneumococci and beta-lactamase-positive M. catarrhalis or H. influenzae. Success in the clinical trials will further define the role of cefditoren in this era of emerging resistant bacterial pathogens.

Cephalosporins↗
PubMedDate not supplied

A prospective microbiologic surveillance program to detect and prevent the transfusion of bacterially contaminated platelets.

After two patients received bacterially contaminated platelet transfusions, a prospective surveillance program was instituted to perform Gram staining and microbiologic culturing of platelets at the time of transfusion. In 12 months, 3141 random-donor platelet pools (prepared from 14,481 units) and 2476 single-donor apheresis units were cultured. All single-donor apheresis units were sterile, but 6 (0.19%) of the random-donor pools were found to be bacterially contaminated, with 1 unit of 5 in the pool being the source in each case. Contaminants were Staphylococcus epidermidis (4 cases), Bacillus cereus (1), and Staphylococcus aureus (1) at counts of 0.5 x 10(2) to 10(11) colony-forming units per mL in platelet pools and 10(3) to 10(13) colony-forming units per mL in source units. The contamination rate for units transfused at < or = 4 days (1.8/10,000) was significantly lower than that at 5 days (11.9/10,000; p < 0.05), as was the magnitude of contamination (p < 0.05). Use of the pretransfusion Gram stain on 4- and 5-day-old platelet pools was 100 percent sensitive (4/4 true positives) and 99.93 percent specific (1 false positive) in detecting contaminated pools. These data define the extent and magnitude of platelet bacterial contamination and demonstrate the efficacy of the pretransfusion Gram stain on platelet units stored for 4 and 5 days in preventing the transfusion of heavily contaminated units. It is concluded that the risk of platelet contamination is related to the duration of component storage.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Laboratory surveillance of synergy between and resistance to trimethoprim and sulfonamides.

Results of susceptibility tests of Enterobacteriaceae isolated at 14 different centers demonstrate synergy between trimethoprim (TMP) and sulfamethoxazole (SMZ) against sulfonamide-susceptible isolates, which account for between less than 50% and greater than 75% of the isolates at different centers. Only 1%-4% of the isolates of Escherichia coli or Proteus mirabilis from the five centers in the United States were found to be resistant when tested with a disk containing both TMP and SMZ, but greater than 8% of such isolates from five of the other centers were resistant to the combination disk. A larger percentage of isolates of Klebsiella pneumoniae or Serratia marcescens were resistant, but the number varied from center to center. In the United States, resistance of human and animal isolates of Salmonella to the TMP-SMZ combination was almost completely absent, although greater than 50% of the animal isolates were resistant to sulfonamides. At a center that tested TMP and SMZ resistance with separate disks, resistance to TMP was found to be 30 times more common in sulfonamide-resistant than in sulfonamide-susceptible E. coli. This ratio may be useful as a monitor as treatment with TMP alone increases.

Bacteria↗
PubMedDate not supplied

Efficacy and safety of sequential treatment with parenteral sulbactam/ampicillin and oral sultamicillin for skeletal infections in children.

Nine children with osteomyelitis and/or septic arthritis were treated sequentially with parenteral sulbactam/ampicillin and oral sultamicillin. Causative pathogens were identified in six cases; all were susceptible to the combination of ampicillin and sulbactam. The mean duration of parenteral therapy was 7.1 days (6-11 days), and the average hospital stay was 10.3 days (6-18 days). Peak serum bactericidal titers of greater than or equal to 1:8 were achieved in all patients during parenteral therapy; only one child receiving oral therapy did not achieve a titer of greater than or equal to 1:4. At follow-up, all of the children were cured clinically and there was no evidence of relapse. Adverse reactions to oral therapy were minimal. The regimen of parenteral sulbactam/ampicillin and oral sultamicillin used sequentially is effective and safe for the treatment of skeletal infections in children. The use of this approach significantly reduced the duration of hospitalization.

Administration, Oral↗
PubMedDate not supplied

Alternaria infection in a patient with acquired immunodeficiency syndrome: case report and review of invasive alternaria infections.

A 31-year-old man with AIDS developed a necrotic lesion on his nasal septum due to Alternaria alternata. Excision and treatment with amphotericin B resulted in cure. This case expands the spectrum of opportunistic pathogens that infect patients with AIDS. Visceral and mucosal infections due to Alternaria have been reported in at least seven other patients.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Genetic analysis of serotype 23F Streptococcus pneumoniae isolates from several countries by penicillin-binding protein gene fingerprinting and pulsed-field gel electrophoresis.

We characterized 21 strains of serotype 23F Streptococcus pneumoniae isolated in various countries with various levels of penicillin susceptibility by penicillin-binding protein (PBP) gene fingerprinting and pulsed-field gel electrophoresis (PFGE). Pneumococci isolated in Israel, Hungary, Bulgaria, Slovakia, Rumania, France, the United States, Spain and Japan were included. These strains were classified into 12 and 18 groups by PBP gene fingerprinting and PFGE, respectively. Some of the pneumococci isolated in Spain, the United States and France appeared to be genetically related by PFGE, showed the same PBP gene pattern and had similar antimicrobial susceptibility patterns. One penicillin-susceptible Bulgarian strain, with a similar PFGE pattern but a different fingerprinting pattern, may be an ancestral recipient strain that became transformed into the resistant variants. Rumanian and Israeli strains were also genetically related by PFGE. These results indicate the existence of widely spread but related pneumococci in the world. PBP 2X gene profiles of pneumococci with MICs of 0.25 microg/ml were different from each other and from penicillin-susceptible pneumococci (PSP). PBP 2B gene profiles of these resistant strains were identical. PBP 2B gene profiles of pneumococci (penicillin MICs >/=0.5 microg/ml) were different from PSP. PBP gene profiles may not only be useful for genetic analysis but also for presumed penicillin susceptibility.

Bacterial Proteins↗
PubMedDate not supplied

The incidence of penicillin-resistant pneumococci in the Slovak Republic. Pneumococcus Study Group.

The prevalence of penicillin-resistant Streptococcus pneumoniae and multiresistant strains isolated in Europe from the early 1970s has continued to rise. Twenty-four microbiology laboratories in the Slovak Republic analyzed 4,018 S. pneumoniae strains isolated from September 1, 1993, to December 31, 1993. The overall resistance rate to penicillin was 3.4% in strains isolated from outpatients and 8.5% from inpatients with considerable variation between regions. The highest regional resistance rate to penicillin was 21% from outpatients in Levice, in the western Slovakia, and ranged between 13 and 52% in strains collected from hospitalized patients in 6 regions. Rates of penicillin-resistant pneumococci were significantly higher (p < or = 0.01) in children aged < or = 3 years. Two thirds of penicillin-resistant strains had intermediate levels of resistance (MICs 0.1-1 microgram/ml) and one third was resistant (MICs 2-8 micrograms/ml). Resistance to multiple classes of agents was found in 75.9% of penicillin-resistant strains. These data support continued surveillance of antimicrobial resistance in pneumococcal infections. Standardization of susceptibility testing methods and monitoring of clinical outcomes is of critical importance to this complex problem.

Child, Preschool↗