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Biomedical subjects

P Noone

Publications and source records attributed to P Noone.

At least 73 records · Page 4Linked to original sources
PubMed1978

Monitoring aminoglycoside use in patients with severely impaired renal function.

Twenty patients with severely impaired renal function, 17 of wnom had recently transplanted kidneys, were treated with aminoglycosides for severe infections acquired in hospital. Serum aminoglycoside concentrations were closely monitored and dosages adjusted individually to obtain peak and trough concentrations that ensured adequate treatment while avoiding toxicity. Causative organisms were susceptible to treatment in 21 out of 26 episodes of infection (81%), and 12 of the 17 patients (71%) in whom organisms were isolated were cured. Nephrotoxicity attributable to aminoglycosides alone was not observed during the 35 courses of treatment. Ototoxicity occurred in only one patient, who had excessively high serum concentrations of amikacin. Serum aminoglycoside concentrations were directly affected by carbenicillin and flucytosine. The concurrent administration of cephradine and cephalexin with gentamicin may have produced nephrotoxicity. We conclude that aminoglycosides, when carefully monitored, are effective and safe in patients with severely impaired renal function.

Aminoglycosides↗
PubMed1978

Pleuropulmonary lung infection by anaerobic bacteria.

Two patients with severe pleuropulmonary infection caused by non-sporing anaerobic bacteria are described. One had an empyema with foul-smelling pus and developed bacteraemia, and the other developed a lung abscess. Both were successfully treated with antibiotics and drainage, chest surgery being avoided. The successful diagnosis and treatment of these patients involved close liaison between clinical and laboratory staff.

Adult↗
PubMed1978

The use of a fluorescence typing method in an epidemiological study of Klebsiella infection in a London hospital.

The fluorescent antibody technique was used to investigate an epidemic of Klebsiella infection in a urological ward and to trace the probable source to a contaminated sink in the treatment room. It was also shown that cross infections by particular capsular types were very common within each ward. Certain types of Klebsiella occurred in cut flower water but could not be associated with the types infecting the patients. Antibiotic resistance patterns within one capsular type were found to vary whether the type was from different sources in one patient or from different patients in the same ward. One capsular type was observed to develop resistance to increasing numbers of antibiotics over a 3-year period. This was probably due to the acquisition of R-plasmids. There also appeared to be a relation between capsular type and the site of infection. The frequency of Klebsiella infections in the urological wards dropped significantly after up-grading the treatment room, improving catheter storage and reducing ampicillin use.

Anti-Bacterial Agents↗
PubMed1978

Bacteraemia.

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Adult↗
PubMed1977

Outbreak of necrotising enterocolitis caused by Clostridium butyricum.

12 hospital-born babies had necrotising enterocolitis, of varying severity, within six weeks, 5 of them within ten days. The usually described predisposing causes were absent in most, though no baby was exclusively breast -fed. Evidence of the presence of Clostridium butyricum was found in the blood of 9 out of 10 babies examined. Cl. butyricum is probably a primary, not a secondary invader.

Clostridium↗
PubMed1977

Prophylactic systemic antibiotics in colorectal surgery.

The prophylactic value of gentamicin combined with either lincomycin or metronidazole in 52 patients undergoing colorectal surgery was investigated. The results confirmed the value of this practice. In a control group, the sepsis-rate was 48% with 1 death attributable to sepsis, compared with a sepsis-rate of 4% in the treated group. The combination of gentamicin and lincomycin was effective against sepsis but pseudomembranous colitis developed in 2 of the 14 patients treated with this combination of drugs. Lincomycin was discontinued, and when metronidazole was substituted the results were equally good and there were no toxic side-effects.

Abscess↗
PubMed1976

A new serotyping method for Klebsiella species: development of the technique.

A new serotyping method for Klebsiella species using indirect immunofluorescence is described. Nonspecific fluorescence has been minimized by carrying out the capsular antigen-antibody reaction at pH 9.0. Commercial antisera have been tested with the 72 antigenic types of Klebsiella, and appropriate dilutions of each pool and specific antisera have been proposed for use in routine typing. Dilutions were chosen to allow strong fluorescence with each type and its specific antiserum and minimal fluorescence with cross reacting antisera. Where the pool antisera gave a weak reaction for one or more of the component types, it is recommended that the specific antisera for these types be added to the pool dilution. The few remaining cross reactions, with the pool and specific antisera in test dilution, are listed in a table. The unique cross reacting patterns of particular types have been found to be useful in identification. Typing Klebsiella by the fluorescent antibody technique is easy to perform and interpret; the results are reproducible, and it is less expensive than the existing capsular swelling method as it is more sensitive and requires less concentrated antisera. This new method of typing should facilitate detailed epidemiological studies of the mode of transmission of Klebsiella species in hospitals and thus allow more effective infection control measures to be instituted.

Cross Reactions↗
PubMed1976

A new serotyping method for Klebsiella species: evaluation of the technique.

A new indirect fluorescent typing method for Klebsiella species is compared with an established method, capsular swelling. The fluorescent antibody (FA) technique was tested with standards and unknowns, and the results were checked by capsular swelling. Several unknowns were sent away for confirmation of typing, by capsular swelling. The FA method was also tried by a technician in the routine department for blind identification of standards. Fluorescence typing gives close correlation with the established capsular swelling technique but has greater sensitivity; allows more econimical use of expensive antisera; possesses greater objectivity as it requires less operator skill in the reading of results; resolves most of the cross reactions observed with capsular swelling; and has a higher per cent success rate in identification.

Evaluation Studies as Topic↗