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Biomedical subjects

R B Kundsin

Publications and source records attributed to R B Kundsin.

At least 37 records · Page 2Linked to original sources
PubMed1981

Ureaplasma urealyticum incriminated in perinatal morbidity and mortality.

Perinatal morbidity and mortality are associated with colonization of the chorionic surface of the placenta by Ureaplasma urealyticum or Mycoplasma hominis or both. These organisms are more strongly associated with unfavourable gestational outcome than group B streptococci. Chlamydia trachomatis does not appear to be important in the etiology of reproductive casualties. The mechanisms linking the mycoplasmas to perinatal disorders and death are not clear but merit investigation.

Critical Care↗
PubMed1980

In vitro antimicrobial activity of rosoxacin against Neisseria gonorrhoeae, Chlamydia trachomatis, and Ureaplasma urealyticum.

The antimicrobial activity of rosoxacin, a new quinoline antibacterial compound, was determined against the causative organisms of three sexually transmitted diseases. Rosoxacin demonstrated a high degree of activity against Neisseria gonorrhoeae clinical isolates, with the minimal inhibitory concentrations for 50% of these being 0.03 microgram/ml. The corresponding minimal inhibitory concentrations for penicillin, ampicillin, tetracycline, and spectinomycin were 0.25 U/ml, 0.125 microgram/ml, 0.25 microgram/ml, and 16 microgram/ml, respectively. Eleven strains of Chlamydia trachomatis were inhibited by 5 microgram of rosoxacin per ml, and each of seven Ureaplasma urealyticum strains was inhibited by 2 to 8 microgram of rosoxacin per ml. The results of these susceptibility studies, coupled with those of an earlier evaluation of the pharmacokinetics of rosoxacin, provide support for extending or undertaking clinical evaluations of this compound against infections with N. gonorrhoeae, C. trachomatis, and U. urealyticum.

4-Quinolones↗
PubMed1980

Detection of endotoxin on sterile catheters used for cardiac catheterization.

Pyrogen reactions during cardiac catheterization are an alarming complication that frightens patients and baffles many physicans. This report describes a simple, reproducible, precise technique for the measurement of endotoxin-like activity on the inner and outer surfaces of catheters intended for intravascular insertion. This technique is useful in documenting the cause of patient reactions. Quality control procedures should be instituted following the manufacture of angiographic catheters so that pyrogen-free products are availabe for patient use. Catheters processed in a hospital are easily contaminated with fever-producing lipopolysaccharides from tap water or from bacterial growth in residual moisture. Sterilization by steam or ethylene oxide does not destroy these lipopolysaccharides. Consequently, reprocessing reusable catheters must include concern for removing lipopolysaccharides as well as sterilization.

Cardiac Catheterization↗
PubMed1980

Potential hazards associated with microbial contamination of in-line filters during intravenous therapy.

The survival and multiplication of Enterobacter agglomerans, Klebsiella pneumoniae, Serratia marcescens, and Pseudomonas aeruginosa in 0.45- and 0.22-micrometer in-line filter sets during simulated infusions were studied to evaluate the ability of each filter type to prevent infusions of these bacteria into patients. Bacteria were found to proliferate in the upstream compartment of sets housing both filter porosities. None of the 0.22-micrometer in-line filters were penetrated by the test bacteria. In contrast, P. aeruginosa was observed to penetrate each 0.45-micrometer in-line filter examined within 12 h of continuous infusion. Tribe Klebsielleae organisms penetrated a proportion of the 0.45-micrometer filters usually between 48 and 72 h of infusion. In addition, the elution of endotoxin from gram-negative bacteria trapped in the filter set during infusion is reported. Collected infusion filtrate exhibited a trend of increasing endotoxin-like activity with an increasing duration of infusion. In the case of E. agglomerans, mean peak levels of approximately 65 pg of Escherichia coli endotoxin per ml were attained after 72 h. Other bacteria produced similar results, except mean peak levels ranged from 5 to 30 pg/ml. It was noted that endotoxin-like activity was not detected in filtrate eluted from contaminated filter sets during the initial 24 h of infusion. We conclude that to avoid potential hazards of bacterial penetration and endotoxin production during continuous use of in-line filter sets, the 0.22-micrometer filter type must be employed and replaced every 24 h.

Endotoxins↗
PubMed1980

The application of a freeze-microwave thaw technique to central admixture services.

The establishment of a centralized, intravenous solution/admixture drug program in a hospital enhances the quality of patient care. Costs for personnel, equipment, and space have constrained the growth of such a service in the past. A method of preparation for admixture units, which capitalizes on the economics of volume and employs personnel at levels of training consistent with need, is proposed. This technique, utilizing freezing, long-term storage at -20 degrees C, and thawing by exposure in a microwave oven minutes before intended use, surmounts the real and perceived difficulties in many planned or existing admixture programs. A strong element of prospective quality control can be introduced. Where demand is insufficient to justify a separate activity, cooperative arrangements among hospitals will bring all the advantages of central admixture to each. It appears that reductions can be made in the pharmacy hours devoted to admixture. Waste of any unused, reconstituted drugs or prepared units that were not administered may be diminished. Thus, there may be substantial savings for existing admixture programs, if the technique described is adopted. The ultimate form of implementation in each institution, as always, is dependent upon the special "personality" of the hospital.

Anti-Bacterial Agents↗
PubMed1980

Activity of antibiotic admixtures subjected to different freeze-thaw treatments.

The freezing of antibiotic admixtures has been proposed as a potentially useful method by which the efficiency of admixture services might be improved. The time involved in thawing, however, has discouraged the implementation of this practice. This study describes a technique of thawing frozen antibiotic admixtures contained in minibags in commercially available microwave ovens. A quantitative microbiological agar gel diffusion assay was employed to determine the effect of such treatment on the antibiotic activity of the admixture. Admixtures containing cephalothin sodium, cefazolin sodium, cefamandole nafate, cefoxitin sodium, penicillin G potassium, ampicillin sodium, oxacillin sodium, carbenicillin disodium, and gentamicin sulfate in dextrose 5% solution were frozen at -20 degrees C for 30 days. The admixtures were assayed immediately before freezing, and again after either thawing technique: that is, upon exposure of the minibags to room temperature air or to microwave radiation. Assays were also performed 8 and 24 hours after thawing in order to assess antibiotic stability following each freeze-thaw treatment. It was discovered that, with the exception of ampicillin sodium, each of the antibiotics studied could be frozen and thawed as described without significant loss of activity, and were stable for 24 hours after thawing. The application of a freeze microwave-thaw technique to central admixture services can be seen as a cost-effective method of circumventing many of the problems associated with existing programs.

Anti-Bacterial Agents↗
PubMed1980

The role of mycoplasma among 81 consecutive pregnancies: a prospective study.

1. Among 41 previously positive and treated pregnant patients who were retreated when pregnant, the fetal wastage was 15%. 2. Among 40 previously negative or never cultured pregnant patients, the fetal wastage was 25%. 3. The incidence of previous major fertility surgery was 32% for the previously positive patients, but only 7% for the previously negative patients. 4. All of the 43 1-year-old children whose mothers received Vibramycin during early pregnancy have now been reported to be normal.

Doxycycline↗
PubMed1979

Survival of Ureaplasma urealyticum on different kinds of swabs.

The survival of Ureaplasma urealyticum on five different types of swabs routinely used for obtaining clinical specimens is limited to 1 h. Wooden applicator sticks inhibit the alkaline color change in broth and result in a significant loss of isolates if broth alone is used.

Humans↗
PubMed1978

Significance of appropriate techniques and media for isolation and identification of Ureaplasma urealyticum from clinical specimens.

Controversy over the association of Ureaplasma urealyticum with reproductive failure may be due to methods used to isolate the microorganism. U. urealyticum isolations from clinical material should be done simultaneously in broth and on Shepard's differential agar medium (A7) containing manganese sulfate. Urine sediments result in a 9% (P = 0.0002) higher rate of isolation than than cervical and urethral swabs. Primary isolations may not display standard textbook morphology. Isolated colonies may be present, but brown streaks in cervical mucus or a coalescent haze around epithelial cells in urine sediment may also be seen in areas of concentrated growth. The broth and agar media used, method of incubation, type of specimen, and method of storing specimens before culture are all factors which influence the recovery of U. urealyticum.

Bacteriological Techniques↗
PubMed1977

Simple, direct broth-disk method for antibiotic susceptibility testing of Ureaplasma urealyticum.

A simple, direct broth-disk test, utilizing urine sediment as the inoculum and impregnated paper disks as the source of antibiotic, was developed and used to test the susceptibility of 54 isolates of Ureaplasma urealyticum (T-strain mycoplasmas) to minocycline, doxycycline, demeclocycline, tetracycline, and erythromycin. The concentration of each antibiotic was calculated to approximate the attainable blood level. Resistance or susceptibility to each antibiotic was determined by growth, indicated by a color change of the medium in each tube, comparable to that of a control culture without antibiotic. Of the 54 T-mycoplasmas tested, 46 (85.2%) were inhibited by 1 mug of minocycline per ml, 45 (83.3%) were inhibited by 1 mug of doxycycline per ml, 38 (72.2%) were inhibited by 1 mug of demeclocycline per ml, 18 (33.3%) were inhibited by 1 mug of tetracycline per ml, and only 2 (3.7%) were inhibited by 3 mug of erythromycin per ml. Seven (13%) of the 54 T-mycoplasmas tested were resistant to all five antibiotics. There was good correlation between results obtained by this direct broth-disk method and minimal inhibitory concentrations obtained by the direct broth dilution method.

Anti-Bacterial Agents↗
PubMed1976

Tetracycline-resistant T-mycoplasmas (Ureaplasma urealyticum) from patients with a history of reproductive failure.

The susceptibilities of T-mycoplasmas (Ureaplasma urealyticum) to minocycline, demeclocycline, doxycycline, tetracycline, and erythromycin were determined by a direct tube dilution test. T-mycoplasma-positive urine sediments of 105 patients with a history of reproductive failure were used as inocula. Minocycline was found to be the most active of the group of antibiotics commonly used to eradicate T-mycoplasma infection. Based on the median initial minimum inhibitory concentration, minocycline was the lowest with 0.03 mug/ml, followed by demeclocycline and doxycycline with 0.125 mug/ml, tetracycline with 0.25 mug/ml, and erythromycin with 2.0 mug/ml. Six T-mycoplasma isolates which had been cloned three times were also tested for susceptibility to the same five antibiotics. The same susceptibility pattern was found. Strains resistant to high concentrations of all antibiotics occurred. Strong positive correlation was seen in 21 patients between in vitro highly resistant strains and positive posttreatment cultures. These results indicate that empirical treatment of genital mycoplasma infections is not justified. Cultures should be taken pretreatment, susceptibility testing performed prior to treatment, and follow-up cultures done posttreatment.

Drug Resistance, Microbial↗
PubMed1976

Comparison of heat shocking and acridine orange treatment in phage typing of nontypable strains of Staphylococcus aureus.

Forty-five percent of 108 nontypable strains of Staphylococcus aureus from clinical and environmental sources were phage typable after heat shock and acridine orange treatment. Although phage patterns were produced by different types of treatment, the same phage groups were present, showing specificity. The newly typable strains appear to be similar in phage group distribution to the primary typable strains typed at the Peter Bent Brigham Hospital during the same time period. Ten of the originally nontypable S. aureus strains that showed lytic patterns after heat shock or acridine orange treatment were subcultured four times from the treated culture and then tested again with bacteriophages. Phage patterns were still present in 8 of the 10 strains without any further treatment. These findings are compatible with the findings of other workers, who have shown that the insensitivity of primary nontypable S. aureus strains to phage is linked to phage-resistant genes in extrachromosomal genetic elements that can be "cured" by both heat shock and acridine treatment.

Acridines↗
PubMed1976

Mycoplasmas in humans: significance of Ureaplasma urealyticum.

Isolation of mycoplasmas from clinical specimens has resulted in compelling evidence that in addition to M. pneumoniae, the documented pathogen, the T strain mycoplasmas are not always benign commensals colonizing the mucous membranes of the genitourinary tract of men and women, but may be actively involved in infection with sequelae expressed as nongonococcal urethritis and some form of reproductive wastage such as infertility, spontaneous abortion and premature births.

Abortion, Spontaneous↗