Search PubMed⌕ Search

Biomedical subjects

S L Berk

Publications and source records attributed to S L Berk.

At least 73 records · Page 4Linked to original sources
PubMed1986

Nosocomial pneumococcal bacteremia.

In five years we studied 56 episodes of pneumococcal bacteremia. Twenty-three (41%) were nosocomial and 33 (59%) community acquired. Most of our patients were elderly men with multiple underlying diseases; however, those patients with nosocomial infections had a significantly higher incidence of malignant neoplasms (57% vs 24%), poor functional status (70% vs 25%), and ultimately fatal underlying disease (61% vs 21%). Alcoholism was more common among the patients with community-acquired bacteremia (45% vs 17%). Nosocomial infections carried a significantly higher overall mortality (73.9% vs 45.4%). The mortality directly related to the pneumococcal bacteremia was also higher (52% vs 39%), but not significantly. Most of the isolated strains were serotypes present in the new pneumococcal vaccine, which only one study patient had received. Mixed pneumococcal bacteremia with gram-negative bacilli was more frequent in nosocomial infections. Streptococcus pneumoniae can be a nosocomial pathogen in elderly, debilitated patients. Pneumococcal vaccination should be incorporated in a hospital-based prevention program for high-risk patients.

Aged↗
PubMed1986

Vaccinating the elderly: recommendations and rationale.

Pneumococcal vaccination is given only once. It is not currently recommended that patients who have been given the 14-valent vaccine be revaccinated with the newer 23-valent vaccine. Vaccination is more difficult for influenza than for pneumococcal pneumonia. An understanding of the annual changes in influenza vaccine recommendations requires some knowledge of the virus' ability to undergo antigenic variation and produce different strains each year.

Aged↗
PubMed1986

Clinical and microbiologic consequences of amikacin use during a 42-month period.

In June 1980, 23% of our Pseudomonas aeruginosa isolates and 53% of our Serratia species were resistant to gentamicin and tobramycin. During a 3 1/2-year period of almost exclusive amikacin usage, we noted a fall in overall resistance of gram-negative organisms to tobramycin and gentamicin from 18.8% and 19.3% to 15.2% and 16.2%, respectively. This fall in resistance was most notable for Escherichia coli, Proteus mirabilis, and Serratia species. During this period there was no increase in amikacin resistance. Age, hospitalization, prior antibiotic therapy, and Foley catheter use were predisposing factors in acquiring amikacin-resistant organisms. Amikacin-resistant gram-negative bacilli were usually sensitive to newer penicillins or cephalosporins.

Age Factors↗
PubMed1985

Pneumonia caused by gram-negative bacilli.

Gram-negative bacillary pneumonia has become an increasingly important disease in immunosuppressed, elderly, and hospitalized patients. The clinical features, etiologic agents, population at risk, treatment, and outcome in patients with well-documented gram-negative pneumonia were compared in two groups of patients: those with bacteremic pneumonia and those with nonbacteremic pneumonia documented by transtracheal aspiration. Clinical features were frequently subtle in both groups. A wide range of gram-negative bacilli were implicated as pathogens and pneumonias documented by transtracheal aspiration were frequently mixed infections. Pseudomonas aeruginosa and Serratia marcescens were the most common pathogens causing bacteremic pneumonias, whereas Escherichia coli and Klebsiella were more common in the nonbacteremic group. Gram-negative bacillary pneumonia was frequently a lethal disease despite two-drug therapy, particularly in bacteremic patients.

Age Factors↗
PubMed1985

Pulmonary strongyloidiasis. Diagnosis by sputum gram stain.

Sputum Gram stain was diagnostic for pulmonary strongyloidiasis in four patients from Tennessee with chronic obstructive lung disease treated with steroids. The case reports of these patients and photomicrographs of the larval forms by Gram stain are presented. Sputum Gram stain may be a useful procedure to screen for pulmonary strongyloidiasis in steroid-treated patients with chronic lung disease who come from an endemic area.

Aged↗
PubMed1985

Klebsiella oxytoca isolates in a general hospital.

Primary infections caused by Klebsiella species are uncommon, but the organism is an important nosocomial pathogen. We report the predisposing factors, clinical features and outcome of 44 hospitalized patients in whom Klebsiella oxytoca was isolated. Twenty-one (48%) isolates were community-acquired and 23 (52%) were considered nosocomial in origin. Most of the patients were elderly males with serious underlying diseases. There were significant differences between those patients who acquired Klebsiella oxytoca in the hospital and in the community. Nosocomially acquired organisms were associated with a higher mortality (52% vs. 24%) (p less than 0.05), a higher incidence of infection vs. colonization (83% vs. 57%) (p less than 0.05), and a higher percentage of cases of pneumonia (43% vs. 19%) (p less than 0.05). The clinical features, the hospital service and the patients' underlying diseases were similar when patients who died and those who survived were compared. Patients who died were exposed to antibiotics more often prior to the positive culture with K. oxytoca (p less than 0.05). K. oxytoca is a significant pathogen in hospitalized elderly patients. It is likely to cause infections, especially pneumonia, and carry a high mortality. The organism can become endemic within the hospital setting with continued carriage and nosocomial spread.

Age Factors↗
PubMed1985

Type 8 pneumococcal pneumonia: an outbreak on an oncology ward.

An outbreak of four cases of type 8 Streptococcus pneumoniae pneumonia occurred on an Oncology Ward during a five-day period. All four patients had underlying malignancy and were in close proximity to each other on an open ward. No other patients or hospital personnel had type 8 S pneumoniae on throat or nasopharyngeal cultures. The implications of the outbreak with respect to transmission of this disease and role of pneumococcal vaccination are discussed.

Cross Infection↗
PubMed1985

In vitro susceptibilities and beta-lactamase production of 53 clinical isolates of Branhamella catarrhalis.

We tested 53 clinical isolates of Branhamella catarrhalis recovered from patients with respiratory symptoms to determine the susceptibility of the isolates to 25 antimicrobial agents, including the newer beta-lactam antibiotics. Of the 53 strains, 46 (86.7%) were beta-lactamase producers. All the strains were susceptible to the majority of the new penicillins and cephalosporins. The combinations of amoxacillin-clavulanic acid and ticarcillin-clavulanic acid were also very active against the beta-lactamase-producing strains.

Anti-Bacterial Agents↗
PubMed1985

In vitro activity of fosfomycin, alone and in combination, against methicillin-resistant Staphylococcus aureus.

We tested 148 strains of clinical isolates of methicillin-resistant Staphylococcus aureus against fosfomycin alone and in combination with methicillin, cefamandole, gentamicin, trimethoprim, and vancomycin. Fosfomycin inhibited 90% of the 148 methicillin-resistant S. aureus strains at a concentration of 4 micrograms/ml. Synergism was observed in 97 strains (66%) with fosfomycin-cefamandole and in 69 strains (46%) with fosfomycin-methicillin. The combinations of fosfomycin with vancomycin, gentamicin, and trimethoprim were indifferent in most strains.

Cross Infection↗
PubMed1985

Meningitis.

Explore the source record for details and available documents.

Age Factors↗
PubMed1984

Survey of physician acceptance of the pneumococcal vaccine.

A group of 251 randomly selected physicians completed a survey designed to study their attitudes toward, knowledge about, and use of pneumococcal vaccine. Eighty-five percent of respondents believed the vaccine had been proven effective. For the use of the vaccine, respondents supported broad indications, including chronic lung disease, alcoholism, and congestive heart failure. Some respondents expressed concern about the safety of the vaccine. Physicians who learned about the vaccine from continuing medical education programs, colleagues, and pharmaceutical representatives were likely to use the vaccine more often than those who did not.

Attitude of Health Personnel↗
PubMed1984

Gastric microbial flora in patients with gastrointestinal disease.

We designed a prospective study to test the hypothesis that the stomach may be a bacterial reservoir in some patients and function as a potential source of aspiration-induced bacterial pneumonia. Quantitative cultures of fasting gastric contents were obtained in 100 consecutive patients having fiberoptic endoscopy for evaluation of gastrointestinal disease. Culture results were correlated with gastric pH and gastrointestinal pathology. Patients with gastric ulcer disease had a significantly higher incidence of bacterial growth than those with duodenal ulcer. Patients who had had gastrectomy were more likely than any others to have gram-negative bacilli in their stomach. A somewhat high frequency of other common pneumonic pathogens in gastric contents was also noted. The significance of these findings in the production of pneumonia in the elderly is discussed.

Bacteria↗