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Biomedical subjects

R C Aber

Publications and source records attributed to R C Aber.

At least 37 records · Page 2Linked to original sources
PubMed1982

Sensitivity of 341 non-fermentative gram-negative bacteria to seven beta-lactam antibiotics.

Susceptibility of 341 isolates of non-fermentative gram-negative bacteria to carbenicillin, piperacillin, cefoperazone, moxalactam, cefotaxime, ceftizoxime, and N-formimidoyl thienamycin was determined by the agar dilution and disc diffusion methods. Piperacillin was the most active agent against Pseudomonas aeruginosa, thienamycin the most active against Pseudomonas fluorescens and Pseudomonas putida, and moxalactam the most active against Pseudomonas maltophilia. Piperacillin and thienamycin were the most active agents against the other Pseudomonas species studied. Thienamycin proved to have excellent activity against Acinetobacter calcoaceticus--90% of strains were inhibited by less than or equal to 1 microgram/ml. The two most active drugs against Alcaligenes species were piperacillin and thienamycin, both of which inhibited 90% of isolates at a concentration of 2 micrograms/ml. All drugs were active against Moraxella species. The broad sensitivity spectrum of piperacillin, thienamycin, and the third-generation cephalosporins against non-fermentative gram-negative bacteria indicates their potential use in infections caused by these organisms.

Acinetobacter↗
PubMed1982

Cavitary pulmonary nodule caused by Haemophilus influenzae in a renal transplant recipient.

Primary Haemophilus influenzae lung abscess has not previously been reported in renal transplant recipients. Our patient had a single cavitary pulmonary nodule and a subacute clinical course. This case demonstrates that infections in immunosuppressed patients may behave in uncharacteristic fashion, and exhaustive attempts must be made to secure the diagnosis so that proper therapy can be instituted.

Adult↗
PubMed1982

Malignant external otitis: long-term (months) antimicrobial therapy.

Since Chandler's initial report in 1968 on "malignant external otitis" (MEO), this entity has been recognized in its earlier stages with increasing frequency. As a result of this, the availability of new antimicrobial agents, and the judicious use of surgery, there has been an improvement in the results of therapy. There remains, however, a subgroup of patients who continue to experience a significant mortality from this infection. A review and selected discussion of our experience with MEO from 1976 to 1979 is presented. Six patients have been diagnosed and successfully treated for MEO. They presented with problems ranging from severe otalgia to multiple cranial neuropathy. For the most part, therapy consisted of the now standard aminoglycoside and carbenicillin combination. Two of the patients were in the high mortality risk group. One of these patients developed an osteomyelitis which extended across the skull base resulting in bilateral cranial neuropathies. His therapy included surgery as well as long-term (months) outpatient treatment with tobramycin and carbenicillin with an excellent result. The second patient was treated similarly. The efficacy of this approach is discussed as well as the usefulness of radionuclide bone scanning in assessing the course and therapy of patients with MEO.

Aged↗
PubMed1982

Potassium iodide as a cause of prolonged fever.

A 73-year-old man was initially seen with a 15-year history of intermittent fevers and had been treated for culture-negative subacute bacterial endocarditis. He had been taking potassium iodide as a bronchorrheic agent for approximately the same 15-year period, and, when potassium iodide therapy was discontinued, the fever resolved and has not recurred during 2 1/2 years of observation. The possible mechanisms of fever caused by potassium iodide and current clinical indications for potassium iodide use are described.

Aged↗
PubMed1981

Epidemiologic typing of nosocomial microorganisms.

Hospital epidemiologists often rely upon "typing" of microorganisms to help determine their genetic relatedness. Most general clinical microbiology laboratories can determine biologic profiles (biotypes) and antimicrobial susceptibility patterns (antibiograms) of bacteria commonly isolated from specimens; occasionally serologic typing (serotype) is also performed. Special interest laboratories can provide serologic typing, bacteriophage susceptibility patterns (phage typing), bacteriocin production patterns, bacteriocin susceptibility patterns, plasmid analyses and chromosomal DNA analyses for a variety of bacteria, mycobacteria and fungi of nosocomial interest. Such laboratories can also provide serologic typing, restriction enzyme analyses and other special studies of viruses and related microorganisms. A useful and effective "typing" system should be (1) standardized, (2) reproducible, (3) sensitive, (4) stable, (5) available, (6) inexpensive, (7) applicable to a wide range of microorganisms, and (8) field tested in conjunction with epidemiologic investigation. Results should be reported in a standard manner with some discussion of the implications and limitations of the reported results. We suggest that a registry of typing methods be established to facilitate application of available methods to appropriate epidemiologic investigations.

Bacteria↗
PubMed1981

Oropharyngeal colonization with aerobic gram-negative bacilli in respiratory therapists: period prevalence.

During a 3-month winter period, swab pharyngeal cultures for aerobic gram-negative bacilli were obtained weekly for 3 weeks from 44 hospital-based respiratory therapists and 53 nontherapist control hospital personnel. The swab cultures were inoculated directly onto MacConkey agar plates. Aerobic gram-negative bacilli were isolated from 9.1% of the respiratory therapists and from 9.4% of the control subjects. One respiratory therapist was colonized with the same organism on all three occasions, whereas all other colonized subjects were only transiently colonized. Thus, despite frequent exposure to patients and aerosols likely to contain aerobic gram-negative bacilli, respiratory therapists do no appear to have higher pharyngeal colonization rates than other hospital personnel.

Cross Infection↗
PubMed1980

Vertebral disc space infection and osteomyelitis due to Candida albicans in a patient with acute myelomonocytic leukemia.

A 67-year old man with acute myelomonocytic leukemia had Candida albicans fungemia during induction chemotherapy. Bilateral pulmonary infiltrates and hepatic granulomata containing yeast forms and septate hyphae developed, but cultures of the hepatic tissue failed to grow a fungus. Although his pulmonary and liver disease improved following appropriate therapy, vertebral osteomyelitis due to Candida albicans developed approximately 12-15 weeks after the original fungemia. The fungal osteomyelitis was successfully treated with amphotericin B and 5-fluorocytosine. This case illustrates the need for early diagnosis and aggressive treatment of fungal infections in patients with leukemia.

Aged↗
PubMed1980

Intra-abdominal abscess and fungemia caused by candida krusei.

A 73-year-old man with chronic lymphocytic leukemia experienced an intra-abdominal abscess caused by Candida krusei. Treatment with drainage alone led to dissemination of the infection and resultant C krusei fungemia. The fungemia responded to therapy with amphotericin B, but the patient died of multisystem failure. We stress the rarity of intra-abdominal infection and fungemia with this organism and the necessity for treatment of candidal intra-abdominal infection with antifungal agents. X

Abscess↗
PubMed1978

Antimicrobial susceptibility of flavobacteria.

Antimicrobial susceptibility patterns of 28 clinical isolates of Flavobacterium sp. were determined by standard disk diffusion technique and by antimicrobial dilution in agar. Rifampin, clindamycin, trimethoprim-sulfamethoxazole, cefoxitin, and vancomycin are among the antimicrobial agents which may be clinically useful to treat infections caused by flavobacteria. All 28 isolates were resistant to erythromycin with minimal inhibitory concentrations of 32 mug/ml or more. Currently recommended interpretive zones of inhibition by disk diffusion did not reliably predict antimicrobial susceptibility of the 28 flavobacteria isolates when compared with the agar dilution technique, and, therefore, a more direct measurement of minimal inhibitory or bactericidal concentration is recommended.

Anti-Bacterial Agents↗
PubMed1976

Nosocomial transmission of group B streptococci.

Group B streptococci are an important cause of infant septicemia and meningitis. A prospective study of group B streptococcal colonization in a 300-bed community hospital disclosed rates of 29% of 297 third-trimester women, 37% of 242 newborn infants, and 45% of 22 hospital personnel. Colonized parturients were more frequently black and anemic on admission for delivery. Infant colonization was statistically associated with a positive maternal genital culture, low birthweight, and prematurity. Nosocomial transmission of group B streptococci was strongly suggested by observations that 41% of colonized infants were born to culture-negative women and such infants became colonized later in their hospital stay than did colonized infants born to colonized women. Furthermore, hospital personnel working in the labor-delivery and nursery areas had a significantly higher prevalence of the organism than did personnel from other areas. Clearly, more information is needed about the epidemiology of group B streptococcal disease before appropriate and rational control measures can be recommended.

Adult↗
PubMed1975

Possible nosocomial transmission of group B streptococci in a newborn nursery.

Within a six-day period in March, 1974, three infants born at a hospital in central Arkansas developed meningitis caused by group B, type III Streptococci. Three factors suggested nosocomial transmission of the organism in the nursery: (1) the three infants were born in a six-day period, (2) four weeks after their infants' births, none of the parents had positive cultures for group B streptococci, and (3) 31% of infants born in the hospital in March were colonized with group B, type III streptococci, while in April, after control measures in the nursery were instituted, only 2% of infants were colonized with this type (p less than 0.0002). Colonized infants were treated with penicillin, but follow-up cultures at two and six weeks showed that half the infants tested were still colonized. The number of personnel colonized with group B streptococci was not significantly different in personnel exposed to infants when compared with those that were not, and handwashing and environmental cultures were negative for group B streptococci. The results of this investigation give additional support to the concept that nosocomial transmission of group B streptococci can occur and may be effectively interrupted by control measures in the nursery.

Cross Infection↗