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Biomedical subjects

P D Meers

Publications and source records attributed to P D Meers.

At least 19 recordsLinked to original sources
PubMed1992

Partial characterization of an endemic strain of a methicillin- and aminoglycoside-resistant Staphylococcus aureus (MARSA) homogeneously resistant to beta-lactam antibiotics.

Selected strains of methicillin- and aminoglycoside-resistant Staphylococcus aureus (MARSA) were subjected to a preliminary examination. They were representative of a larger group collected in a routine clinical microbiology laboratory over a period of 2 years. MARSA was endemic in the associated hospital. The characteristics investigated were antimicrobial resistance, the production of beta-lactamase, free and bound coagulase, protein A, DNA-ase, urease, lipase and pigment. The MARSA strains were generally indistinguishable, other than in their antimicrobial resistances. The resistance to methicillin was completely homogeneous. Except with imipenem, growth extended to the edge of discs containing methicillin and the other beta-lactam antibiotics tested when the strains were cultured at 37 degrees C on media without added salt. Homogeneous resistance may confer an epidemiological advantage on strains of this phenotype.

Aminoglycosides↗
PubMed1991

Community-acquired legionellosis in Singapore.

Patients admitted to hospital with chest infections were examined serologically to see if these were due to Legionella pneumophila. Each of the 219 samples of serum collected from 177 patients was examined by two standard tests. The tests, which generally agreed, identified three individuals (1.7% of the group) who had sufficient antibody to suggest that they were suffering from current legionellosis. Serological evidence of previous infection was discovered (with differing degrees of certainty) in 26 (14.7%) of the others. The study showed that legionellosis is endemic in Singapore, and so must be taken into account in the differential diagnosis of cases of pneumonia.

Adult↗
PubMed1990

The impact of methicillin- and aminoglycoside-resistant Staphylococcus aureus on the pattern of hospital-acquired infection in an acute hospital.

Infections due to methicillin- and aminoglycoside-resistant Staphylococcus aureus (MARSA) appeared in a new teaching hospital shortly after it opened. The effect this had on the pattern of hospital-acquired infections in the four years that followed is described. No control measures were applied and MARSA became endemic. New infections appeared at a rate of about four for each 1000 patients discharged. It established itself at different levels of incidence in various specialist units, patients under intensive care being most severely affected. MARSA was implicated in half of all hospital-acquired infections due to S. aureus but it was not more pathogenic than its more sensitive counterpart. It had little impact on the life of the hospital.

Aminoglycosides↗
PubMed1990

Bacteriostatic and bactericidal actions of boric acid against bacteria and fungi commonly found in urine.

Boric acid has been used for over 20 years to preserve urine while in transit for bacteriological examination. It has been suggested that it may be toxic for some urinary pathogens. To investigate this several strains of bacteria and fungi commonly found in urine were exposed to different concentrations of boric acid in nutrient broth. Viable counts were made at the outset and at intervals for up to 24 hours at room temperature to detect bacteriostatic or bactericidal effects. At concentrations between 10 and 20 g/l boric acid was bacteriostatic or fungistatic for very nearly all the common urinary pathogens. At 10 g/l boric acid was weakly bactericidal for some strains of Acinetobacter calcoaceticus and Pseudomonas aeruginosa, though higher concentrations were bacteriostatic only. Group B streptococci varied in their response to boric acid, but for most of them 10 or 20 g/l was satisfactorily bacteriostatic. It is concluded that boric acid is rarely toxic, and when it is, the effect is usually sufficiently delayed to be of only theoretical importance.

Acinetobacter↗
PubMed1989

Boric acid converts urine into an effective bacteriostatic transport medium.

Results of an experiment designed to assess the usefulness of boric acid for preserving urine before its bacteriological examination are reported. Boric acid at a concentration of 20 g/l was found to be usefully bacteriostatic, largely eliminating the false positive results obtained with unpreserved specimens when delay before culture was more than 90 min. The effect lasted for up to 48 h. There was no evidence that borate is toxic to the urinary pathogens encountered in naturally infected urine. Borate also preserves white blood cells in urine and thereby marginally improved the diagnosis of pyuria. The results confirm that boric acid may with benefit be added to bottles used for transporting specimens of urine to the laboratory.

Bacteria↗
PubMed1989

The specificity of a rapid method of assay for the presence of Legionella species in water.

A rapid method of assay, using a monoclonal antibody linked to alkaline phosphatase, was used for the detection of the Pontiac subgroup of Legionella pneumophila serogroup 1. It was tested for its specificity against 53 strains of Legionella recently isolated from the environment in Singapore and Malaysia. The specificity and sensitivity of this method of assay was confirmed, though there is some concern that the specificity was too narrow, and there are reservations about the criteria suggested for interpreting the results.

Bacteriological Techniques↗
PubMed1989

Legionella species, serogroups and subgroups found in the environment in Singapore.

Over a period of seven months, 87 samples of water collected from 48 air-conditioning cooling-towers on 15 sites in Singapore yielded 19 strains of Legionella. Legionellas were found in 7 of the 15 sites. The strains isolated fell into 7 species, serogroups or subgroups of the genus Legionella. Only 11% of them belonged to the more pathogenic Pontiac subgroup of Legionella pneumophila serogroup 1.

Disease Outbreaks↗
PubMed1988

Infection control in developing countries.

The level of socio-political and economic development achieved by a country determines the quality and quantity of the health care its citizens receive. These factors also govern the amount of attention given to hospital-acquired infection. The problems of infection control in 'developing' countries include, first, the international problems that arise from clashes of personality and viewpoint among those responsible for it, exacerbated in some places by ethnic or religious traditions. Second are problems imposed by factors that affect the spectrum of infectious disease, and third is a variable deficiency of human and financial resources. In the search for solutions, an analysis suggests that nurses are particularly suited to take the lead in the prevention of infection, so that a special initiative directed towards their education in the rapidly developing science of hospital infection and its control is likely to be the most cost effective and appropriate initial approach. This needs to be accompanied by parallel improvements in the education of medical undergraduates. Anything else should be applied in response to measured need, and then only as money and manpower permit. Careful thought is required to avoid squandering scarce resources by applying inappropriate infection control technology.

Communicable Disease Control↗
PubMed1987

Facts and fancies in hospital infection.

The history of infection in hospitals reveals that a surprising number of the practices that have been introduced at various times as control measures were based on original misconceptions. Curiously in this modern era, a significant number of these infections control practices, lacking a scientific basis, are still widely employed, and some of them have developed into increasingly expensive rituals. The escalating cost of medical care suggests that the time has come to examine these rituals to assess their cost-effectiveness and so decide on their future.

Cost-Benefit Analysis↗
PubMed1986

Yellow fever in Swansea, 1865.

A cargo of copper ore from Cuba was discharged at Swansea in mid-September 1865, during a spell of exceptionally hot weather. A small number of mosquitoes infected with the yellow fever virus, disembarking at the same time, established an epidemic of yellow fever in the town. In the next 25 days, at least 27 inhabitants were infected and 15 of them died. The quality of contemporary observation and recording has encouraged a re-examination of the events in the light of knowledge unavailable at the time. It cannot be assumed that the episode will not be repeated.

Animals↗
PubMed1984

Microbiological aspects of the 1980 national prevalence survey of infections in hospitals.

The records of the 1980 national prevalence survey of infection in hospitals were re-assessed from a microbiological point of view. Of 407 records of Escherichia coli, 71 per cent came from the urinary tract while the commonest source of Staphylococcus aureus was from skin infections. These yielded only 41 per cent of the 303 records. Proteus spp. were recorded 166 times, Pseudomonas spp. 115 times and Klebsiella spp. 101 times. These came mainly from the urinary tract but other sources were important. Streptococcus pneumoniae, Haemophilus influenzae, Mycobacterium tuberculosis and the viruses were associated with community infections while E. coli, Proteus spp., Pseudomonas spp., Klebsiella spp., Str. faecalis and non-aureus staphylococci were associated with hospital-acquired infections. The prevalence of bacteraemia was re-assessed.

Adolescent↗
PubMed1983

Bacteraemia in surgical patients with intravenous devices: a European multicentre incidence study. The European Working Party on Control of Hospital Infections.

A survey of the incidence of bacteraemia and the use of intravenous (IV) devices among 10,616 surgical patients was performed in 42 hospitals in eight countries. It was found that 63 per cent of the patients surveyed had an IV device inserted at some time during their hospital stay, with national variations between 40 and 99 per cent. The incidence of device-related thrombophlebitis was 10.3 per cent, with national variations between 7.8 and 28.4. Among the surgical patients not given IV therapy, 1.5/1000 had a bacteraemia, 0.5/1000 of them hospital-acquired. The corresponding figures for patients with a peripheral but no central IV device were 6.9 and 3.7, and for patients with a central venous catheter (CVC) 59.0 and 44.8, respectively. Even though there was a strong correlation between the incidence of bacteraemia and certain diagnoses there was also an independent correlation between it and CVCs or peripheral IV lines. No correlation was demonstrated between the number of catheter days per site for patients with a peripheral IV device, and hospital-acquired bacteraemia. This may be due to the low mean number of catheter days per site that was observed. There was a large and not easily explained national variation in the incidence of bacteraemia in patients with CVCs of between 16 and 108/1000.

Catheterization↗
PubMed1982

Urinary-tract infection and bacteraemia in hospitalized medical patients--a European multicentre prevalence survey on nosocomial infection.

A co-ordinated survey of 3899 medical patients in 169 wards, performed simultaneously in eight countries, showed a point-prevalence of urinary-tract infection (UTI) and bacteraemia of 12.6 and 1.6 per cent, respectively. One-half of the infections were acquired after the patients' admission. The bacteriological patterns of hospital- vs community-acquired infections were different, but showed no unexpected features. Antibiotic treatment was recorded in 22.3 per cent of the patients in this study, urinary-tract disinfectants, sulphonamides or penicillins being used in 95 per cent of those treated for UTI. The overall prevalence of urinary-tract drainage was 11.0 per cent with no significant difference between the two sexes. At ward level the rate of catheterized patients varied from below 5 per cent to more than 25 per cent, indicating--besides variations in the ward populations--differences in policies. The association between nosocomial UTI and the presence of an indwelling catheter and/or female sex was confirmed, while high age appeared to be a secondary risk factor among catheterized patients. The prevalence of nosocomial bacteraemia in patients with UTI was five times higher than in those without urinary-tract involvement, and a significant part of the nosocomial cases of both UTI and bacteraemia was clearly device-related. Guidelines for the use of indwelling catheters should be restrictive and provide for prompt removal. When introduced and followed they will effectively reduce nosocomial UTI and bacteraemia.

Age Factors↗