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Biomedical subjects

N A Simmons

Publications and source records attributed to N A Simmons.

At least 19 recordsLinked to original sources

Optimum sampling time for detection of dental bacteraemia in children.

A total of 458 blood cultures were taken from 229 children aged 2 to 16 yr. Each 6 ml sample was taken starting at one of the following times after the extraction of a single tooth: 10 s, 30 s, 60 s, 90 s, 120 s, 180 s, 600 s and continuously over 2.5 min. The samples were cultured in the BACTEC radiometric culture system and when positive the bacteria isolated were speciated. At 30 s 56% of the samples were positive, the highest proportion, in contrast to only 38% of positive samples at 90 s and 28% at 600 s. Over 50% of the organisms found were Viridans streptococci.

Adolescent

An outbreak of pemphigus neonatorum.

During the summer of 1987, an epidemic of pemphigus neonatorum took place at Guy's Hospital. It involved more than 80 neonates in the maternity unit. Swabs from the umbilical stumps of the babies and from the noses of several attending midwives yielded Staphylococcus aureus of phage-type Group II 3A/3C. Despite an extensive disinfection policy, which included identification and treatment of carriers, the outbreak persisted for 3 months. Final resolution came only after detailed epidemiological research revealed those midwives most likely to be involved. After these had been singled out for further treatment, the outbreak ended. The epidemic strains were later subjected to reverse phage-typing, plasmid profiling and in vivo testing for production of epidermolytic toxin in order to confirm true carriers and cases. Retrospective analysis identified those persons most likely to have been responsible for propagation of the epidemic strain. The exact course of the outbreak was then clarified.

Cross Infection

Outbreak of staphylococcal scalded skin syndrome among neonates.

Over a period of 2 months, 12 babies born in the maternity unit at Guy's Hospital developed staphylococcal scalded skin syndrome in two distinct outbreaks. Staphylococci isolated from the babies, together with those from the mothers and attending medical staff were phage-typed. All isolates from the babies were of type 3A/3C. During the first outbreak only one carrier of the epidemic strain (a paediatrician) was found but a further 12 persons were identified as possible carriers during the second outbreak. In order to confirm the link between outbreaks, all phage group II isolates were subjected to reverse phage-typing, testing for metal-ion resistance, plasmid profiling and in-vivo testing for production of epidermolytic toxin. It was shown that the same epidemic strain of toxin-producing Staphylococcus aureus was responsible for both outbreaks. The affected neonates responded rapidly to a short course of intravenous flucloxacillin. The outbreak ceased after appropriate treatment of all carriers and the implementation of an extensive disinfection policy within the maternity unit.

Carrier State

Non-ulcer dyspepsia and short term De-Nol therapy: a placebo controlled trial with particular reference to the role of Campylobacter pylori.

This double blind randomised study tested the effectiveness of colloidal bismuth subcitrate (De-Nol) in non-ulcer dyspepsia (NUD) and if any benefit is associated with clearance of Campylobacter pylori (C pylori) from the gastric mucosa. Sixty six patients with dyspepsic symptoms, normal abdominal ultrasound, and upper GI endoscopy, were randomly allocated to placebo or De-Nol for eight weeks. Antral biopsies were taken for bacteriological and histological examination, and endoscopies and clinical questionnaires were administered before and after treatment. Fifty two patients (25 on De-Nol and 27 on placebo) completed the trial. De-Nol cleared C pylori from 10 of the 12 C pylori positive patients (83.3%), whereas placebo did not clear C pylori from any of the eight C pylori positive patients (p less than 0.01). In patients receiving De-Nol gastritis improved (p less than 0.01) and symptomatic response was better (p less than 0.001) compared with placebo. In the placebo group seven of the 19 C pylori negative patients became positive: this was associated with significant deterioration of symptoms, a phenomenon not seen in the De-Nol treated group.

Adolescent