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R Maskell

Publications and source records attributed to R Maskell.

At least 37 records · Page 2Linked to original sources

Streptococci as urinary pathogens.

In a 2-month prospective study of streptococci isolated from urine specimens in the laboratory, 242 strains of catalase-negative gram-positive cocci or coccobacilli were isolated in substantial numbers from 11,725 specimens. These comprised 10% of the important isolates. Species identification of all isolates was undertaken. 74 (30%) of the isolates were of species other than Streptococcus faecalis and S agalactiae. 79 (33%) were not detected on cysteine-lactose-electrolyte-deficient agar after overnight incubation in a carbon dioxide incubator. 20 of the 24 isolates of coccobacilli were Gardnerella vaginalis. Many of the isolates of fastidious species were accompanied by pyuria. An isolation protocol practicable in busy laboratories is proposed.

Adolescent

A blind controlled trial of phase-contrast microscopy by two observers for evaluating the source of haematuria.

Two observers, unaware of each other's findings and of the diagnosis, examined red cells in the urine of 109 patients by phase-contrast microscopy. All specimens were examined uncentrifuged by inverted microscopy, and 48 of the 109 were also examined under a light microscope after centrifugation. We were unable to confirm with either method the close correlation between red-cell morphology and diagnosis reported in previous studies, and our 2 observers differed in their interpretation on 38% of occasions. Proteinuria associated with the presence of casts in uncentrifuged urine examined by inverted microscopy was a better indication than red-cell morphology of renal parenchymal disease.

Centrifugation

Staphylococcus saprophyticus as a urinary pathogen: a six year prospective survey.

Over six years (1978-83, inclusive) weekly laboratory records of organisms causing urinary tract infection in women aged 15-25 not attending hospital were kept prospectively and analysed. The incidence of infection with Staphylococcus saprophyticus defined by age and sex was confirmed. This organism caused an increasing proportion of infections in young women over the six years studied, and these infections showed noticeable seasonality. All but four isolates of S saprophyticus were sensitive to all the commonly used antimicrobial agents that were tested. This might be because the organism is not often present in the body as a commensal and therefore not subject to the selection pressures exerted by such agents. As infection with S saprophyticus has different clinical connotations from infection with other coagulase negative staphylococci it should be differentiated from them in routine laboratory practice.

Adolescent

CAPD peritonitis.

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Bacteria

Urinary infection in adult men: a laboratory perspective.

During a 10-week period all mid-stream urine specimens from males aged 15 years and upwards, excluding hospital in-patients, with symptoms suggesting urinary tract infection were examined by techniques capable of detecting aerobes and fastidious organisms. Five hundred and eighty-five such specimens were received; 85% were sent by general practitioners and 182 were from men aged less than 45 years, indicating that urinary symptoms are commoner in young men than is usually believed and that diagnosis and treatment are usually undertaken by general practitioners. One hundred and seventy-nine specimens yielded aerobic pathogens and 140 yielded fastidious organisms; 70% of the former and 33% of the latter showed pyuria. Only 12% of the 196 specimens showing pyuria yielded a negative culture. The possibility of prostatic infection and its relevance to treatment are discussed. Some post-treatment data are presented.

Adolescent

Fastidious bacteria and the urethral syndrome: a 2-year clinical and bacteriological study of 51 women.

A two-year study of 51 women has shown a highly significant relation between high counts of fastidious organisms in the urine and the presence of symptoms. The patients, even when symptom-free, differed in this respect from a control group who had not had urinary symptoms for 2 years and from a group on long-term low-dose prophylaxis for recurrent urinary infection. The history, physical signs, and natural history of urinary symptoms in these patients were consistent with a diagnosis of urethral or paraurethral infection.

Adolescent

Laboratory diagnosis and oral treatment of CAPD peritonitis.

The laboratory diagnosis of 50 consecutive episodes of peritonitis in patients undergoing continuous ambulatory peritoneal dialysis (CAPD) was studied. The technique which yielded the highest rate (84%) of positive bacteriological diagnoses was inoculation and subculture of thioglycollate broth. Cloudiness of fluid to the naked eye was an accurate predictor of a raised white cell count. A minimum laboratory protocol for the bacteriological diagnosis of CAPD peritonitis was devised and has been in use satisfactorily since the completion of the study. Antibiotic treatment was given orally in the first instance in 43 episodes and was successful in 34.

Administration, Oral

Comparison of urine bag-changing regimens in elderly catheterised patients.

Daily and weekly bag-changing regimens were compared in 12 elderly catheterised patients with reference to their clinical condition, leakage or blockage of the catheters, and the bacteriological state of the urine. Latex Foley catheters were used for the first 3 months and silastic catheters for the second 3 months of study. All patients had bacteriuria throughout the study, and the average number of bacterial species isolated from each specimen was 3.8. There were no significant clinical or bacteriological differences between the patients on daily and those on weekly bag change. Although significantly more episodes of pyrexia were recorded during latex than during silastic catheterisation there was no correlation between these episodes and the bacteriological state of the urine. Of the 9 courses of antibacterial treatment given during the 6 months, 7 were for indications other than urinary tract infection. There were no episodes of acute pyelonephritis. There were 148 episodes of pyrexia unrelated to any clinical symptoms or signs. Only 2 were treated with antibiotics; the remainder subsided without treatment.

Aged