Biomedical subjects
R Hone
Publications and source records attributed to R Hone.
Q fever endocarditis.
Despite a worldwide distribution of Coxiella burnetii, only single cases of Q fever endocarditis have been reported outside Great Britain and Australia. We present 10 patients; five were female, only four had a history of environmental exposure, and the mitral valve was involved as commonly as the aortic stenosis, and three patients had a prosthetic valve. We confirm the importance of hepatic involvement, thrombocytopenia and hypergammaglobulinemia as diagnostic features. Diagnosis was established by finding and elevated complement-fixing antibody to Phase I C. burnetii antigen. Tetracycline, with or without lincomycin or cotrimoxazole, was used in nine patients, and one patient received cotrimoxazole as as the sole antibiotic agent. Optimal duration of therapy is unknown. In one patient, relapse followed when treatment was stopped after 18 months. Valve replacement was necessary in five patients, because of hemodynamic problems. Five patients died, and the means survival is 36 months with a range of five to 66 months. We suggest that Q fever endocarditis is frequently missed, and we recommend clinicians to consider the diagnosis in all cases of culture-negative endocarditis.
Severe staphylococcal infections treated with vancomycin.
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Cefotaxime in the management of acute lower respiratory tract infection.
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Bacteraemia in Dublin due to gentamicin-resistant Staphylococcus aureus.
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Antibiotic usage in a surgical unit.
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In vitro activity of mecillinam and mecillinam/ampicillin combinations on Proteus species.
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Ivestigation of coagulase-negative staphylococci from infections in surgical patients.
All available isolates of coagulase-negative staphylococci from patients admitted to a unit for cardiac surgery during a 14-month period were examined. During this time 382 operations, in 220 of which a prosthetic valve was implanted, were performed. 65 patients suffered 76 episodes of postoperative infection. All coagulase-negative staphylococci isolated were classified by biochemical typing, bacteriophage typing and testing of anitbiotic susceptibility. The results of this investigation were reported and discussed especially from an epidemiological point of view.
Letter: Methicillin-resistant staphylococcus aureus.
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A clinical study of infections caused by methicillin-resistant Staphylococcus aureus.
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Characteristics of methicillin resistant Staphylococcus aureus.
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Faecal carriage of staphylococcus aureus in infantile enteritis due to enteropathic Escherichia coli.
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Infantile enteritis in Dublin caused by Escherichia coli 0142.
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Listeria monocytogenes meningitis in a healthy adult.
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Erysipelothrix rhusiopathiae endocarditis: a preventable zoonosis?
BACKGROUND: Erysipelothrix rhusiopathiae is a bacterium ubiquitous in the environment. It can cause a variety of diseases and the risk of infection is closely related to the level of occupational exposure to infected or colonised animals. AIMS: To discuss the clinical features and treatment of this zoonosis, to increase awareness of this pathogen and to emphasise the need for meticulous attention to hygienic work practices in reducing the risk of infection. METHOD: A case report of a farmer with E. rhusiopathiae endocarditis and the management of the infection. RESULTS: The patient was successfully treated with valve replacement surgery and antimicrobial therapy. CONCLUSIONS: Early identification of this microorganism is essential for appropriate treatment of endocarditis. Greater awareness and safe work practices can help reduce the risk of human infection by this microorganism.
Q fever endocarditis revisited.
A diagnosis of Q fever endocarditis was made in 7 patients, 6 with predisposing factors and 3 with occupational risk factors. Prompt recognition of Coxiella burnettii endocarditis is required when clinical signs of endocarditis such as fever, anaemia, elevated liver transaminases, congestive cardiac failure are accompanied by negative blood cultures. Serological evidence of elevated antibody titres to Phase I and Phase II antigens of Coxiella burnettii are diagnostic. Prolonged antimicrobial therapy combined with surgery has resulted in the marked reduction of mortality from 50 per cent of 17 per cent when Q fever endocarditis is revisited almost 20 yr later.
Staphylococcus aureus sensitivity to various antibiotics--a national survey in Ireland 1993.
The sensitivity of Staphylococcus aureus (S. aureus) to methicillin, penicillin, gentamicin, erythromycin, ciprofloxacin, fusidic acid and mupirocin was tested in 1152 clinical isolates from nine hospital microbiology departments. In all cases standard methods for culture and sensitivity were employed using either the Stokes' or a modified Stokes' method for susceptibility testing. The isolates were recovered from 1150 patients (606 men, 544 women; mean age: 41 years) and only those deemed relevant to the patient's clinical condition were included. Of the total 1152 isolates, 454 were regarded as hospital acquired, 506 were community acquired and the source of the remaining 192 isolates was unknown. The overall percentages of S. aureus sensitive to the tested antibiotics were as follows: methicillin 85%, penicillin 8%, gentamicin 89%, ciprofloxacin 85%, erythromycin 80%, fusidic acid 96%, mupirocin 98%. The sensitivity of the methicillin resistant strains to the other antibiotics tested was generally low except for fusidic acid and mupirocin, both of which retain good activity against methicillin resistant S. aureus (MRSA).