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Biomedical subjects

M S Dryden

Publications and source records attributed to M S Dryden.

28 records · Page 2Linked to original sources
PubMed1991

Active intervention dramatically reduces CAPD-associated infection.

In 1987 a preventive programme was initiated to address the problem of high hospital and community-acquired CAPD infection. It concentrated on reducing Staphylococcus aureus carriage, improving aseptic operative technique, intensive training for nursing staff and patients in stringent aseptic care of the exit site, and avoidance of contact of the exit site with unsterile water. This programme was associated with an overall 10-fold reduction in exit site infection, a 2-fold reduction in peritonitis, and a 4.5-fold reduction in catheter loss from infection. These reductions have been sustained. Preventing infection in CAPD patients requires persistence and commitment but improves the patient's quality of life and reduces the cost of treatment.

Asepsis↗
PubMed1988

The microbial causes of diarrhoea in patients infected with the human immunodeficiency virus.

Diarrhoea is common in patients infected with the human immunodeficiency virus (HIV). We sought the cause of diarrhoea in all HIV antibody-positive patients with diarrhoea who presented at St Stephen's Hospital, London over a period of 15 months. Altogether, 441 specimens from 179 patients were examined. Infective causes were found in 86 (48%) patients. Protozoa were the most common infecting organisms (30% patients). Of these, Cryptosporidium sp. was the most frequent (9.5% patients), followed by Entamoeba histolytica and Giarda lamblia. 'Non-pathogenic' protozoa (NPP) were also common (15% patients), often in the absence of generally recognised pathogens. A case controlled study failed to show a significant difference in the rate of isolation of NPP in HIV antibody-positive patients with diarrhoea compared with HIV antibody-positive patients without diarrhoea. Bacterial causes of diarrhoea were found as follows: Salmonella spp., Campylobacter spp. and Shigella sonnei; Mycobacterium avium-intracellulare (MAI) was isolated from the faeces of eight (4.5%) patients. Isolation of MAI from faeces was associated with disseminated MAI infection. This study has shown that two commonly isolated pathogens, namely Cryptosporidium sp. and MAI, can be identified quickly and reliably by the same modified Ziehl-Neelson staining of concentrated faeces.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Disseminated Mycobacterium avium-intracellulare infection and red cell hypoplasia in patients with the acquired immune deficiency syndrome.

During a period of 14 months in 1985 and 1986, infection with Mycobacterium avium-intracellulare (MAI) complex was diagnosed in 10 of 76 patients with Human Immunodeficiency Virus (HIV)-associated infection. In eight of the 10 patients, the infection was disseminated. All eight patients were anaemic. A bone marrow aspirate and/or trephine biopsy performed in six of them revealed evidence of red cell hypoplasia. MAI was cultured from all six samples of bone marrow. The strains of MAI isolated were resistant to conventional antituberculous drugs but were susceptible in vitro to ansamycin, ethionamide and cycloserine. None of the eight patients responded clinically to antituberculous therapy. The eight anaemic patients had pronounced constitutional symptoms. We suggest that severe anaemia and constitutional symptoms in patients with HIV-associated disease should prompt a search for evidence of disseminated MAI infection.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Cryptosporidial diarrhoea in AIDS and its treatment.

Of 234 patients with AIDS diagnosed at St. Stephen's Hospital between January 1981 and June 1987, 26 (11%) were found to have cryptosporidiosis. Stool examination was positive in all patients, but an average of three specimens (range 1-6) were required before a positive diagnosis was made. Other methods of diagnosis included jejunal and rectal biopsy and aspiration of the duodenal contents. Twenty three (89%) lived for six months from the time of diagnosis and 16 (60%) were alive at one year. Only five patients died as a direct result of cryptosporidial infection, while 10 other patients died from another complication of AIDS. Fifteen patients were enrolled in a prospective controlled study of erythromycin or spiramycin in the treatment of cryptosporidial diarrhoea. Most patients showed a significant response to antibiotic therapy but treatment was limited because of side effects. All patients responded to antidiarrhoeal agents, particularly long acting morphine sulphate. Three of our patients recently given zidovudine (AZT) have responded with a cessation of diarrhoea and cryptosporidia are no longer isolated from the stools.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Comparison of methods for isolating Mycobacterium avium-intracellulare from blood of patients with AIDS.

A variety of blood culture media were compared to determine the optimal method for the isolation of Mycobacterium avium-intracellulare (MAI) from the blood of patients with AIDS. Simulated laboratory blood cultures and clinical blood cultures were tested. Glucose broth, Bactec aerobic medium, Kirschner's medium, and Bactec Middlebrook medium supported the growth of MAI. The Isolator system, a lysis centrifugation method, facilitated the most rapid isolation of MAI (p = 0.001). The Bactec Middlebrook medium gave the most rapid detection rate (p = 0.001) as acid fast bacilli could be stained by the Ziehl-Neelson method before colonies were isolated in the Isolator system. The growth index readings did not reliably predict mycobacterial growth in the two radiometric media tested. Although several methods may be used to isolate MAI from blood, the most rapid and sensitive method is the Isolator system used in combination with the Bactec Middlebrook medium.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Toxigenic Bacillus cereus as a cause of wound infections in the tropics.

A bacteriological survey was conducted on clinically infected traumatic wounds in members of an Operation Raleigh expedition, who were working in the Costa Rican rain forest. Bacillus cereus was isolated from the wounds of 14 of 18 patients, usually in pure and heavy growth. Most of the isolates were strongly toxigenic by in vivo pathogenicity tests. The organism was also isolated from the nose in 15 cases and the throat in five cases. The findings indicate that B. cereus was the principle pathogen in this series of traumatic wounds.

Adolescent↗
PubMed1987

Pathogenic role of Bacillus cereus in wound infections in the tropics.

A bacteriological survey was undertaken on clinically infected traumatic wounds amongst a group of young and fit Operation Raleigh members, who were living and working in a remote area of Costa Rican rain forest. All infected wounds were swabbed before treatment and, where possible, at intervals during treatment. Swabs were also obtained from the nose and throat of each patient. All swabs were stored by desiccation in sterile silica gel for culture at a later date. Culture revealed a high rate of isolation of Bacillus cereus from the wounds. The organism was commonly isolated in pure and heavy growth. Contamination by B. cereus was considered and excluded experimentally. Preliminary toxological studies have shown that the majority of the isolates produce a necrotic exotoxin, in keeping with the clinical findings. These results suggest that B. cereus caused significant sepsis in this series of traumatic wounds.

Adolescent↗