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Biomedical subjects

S S Long

Publications and source records attributed to S S Long.

51 records · Page 3Linked to original sources
PubMed1983

Biotype of Haemophilus influenzae: correlation with virulence and ampicillin resistance.

Biotype and serotype were determined for 473 isolates of Haemophilus influenzae from 399 children. Patients with invasive disease usually had serotypable (86%) and biotype 1 (80%) isolates. Respiratory isolates from well children and children whose illness was not caused by H. influenzae were rarely serotypable (1%) or biotype 1 (8%). Respiratory isolates from children whose illness was possibly or probably related to H. influenzae and isolates from children with cystic fibrosis were more frequently biotype 1, serotypable, or both (P less than 0.01 for all comparisons). Ten (67%) of 15 children with acute otitis media due to H. influenzae had tympanocentesis isolates which were biotype 1; only one isolate was serotypable. Isolates from inflamed conjunctivae had biotypes and serotypes similar to respiratory isolates from well children. Ampicillin resistance was less frequent among biotype 1 isolates (9%) compared with other biotypes (19%) (P less than 0.01). The data suggest that H. influenzae is biochemically heterogeneous and that noncapsular factors, frequently predictable by biotype, contribute to virulence.

Ampicillin↗
PubMed1983

Nasopharyngeal flora and acute otitis media.

A semiquantitative nasopharyngeal culture was found to be sensitive and specific in predicting middle ear pathogens in children with acute bacterial otitis media. In nasopharyngeal specimens with growth of at least 1,000 colonies, the tympanocentesis isolate was present and was either the predominant isolate or accounted for 50% of growth in 16 of 16 children. Data suggest that virulence of nasopharyngeal organisms plays a role in the pathogenesis of acute otitis media. Qualitative differences were found in the nasopharyngeal flora of children with bacterial otitis media as compared with children with clinical otitis media and sterile tympanocentesis cultures, children with uncomplicated upper respiratory illness, and healthy children. Abundant growth of Haemophilus influenzae (greater than or equal to 50% total colony count) was associated with children with bacterial otitis media, and abundant Branhamella catarrhalis was associated with the others (P less than or equal to 0.01). Abundant growth of Streptococcus pneumoniae occurred frequently and regardless of clinical category. Antibiotic treatment of children with otitis media resulted in rapid quantitative and qualitative changes in nasopharyngeal flora.

Acute Disease↗
PubMed1983

Absorption of oral vancomycin - possible associated toxicity.

We report a case of an anephric child who accumulated significant concentrations of vancomycin during oral therapy for Clostridium difficile pseudomembranous colitis. Sustained serum vancomycin levels of 34 microgram/ml and CSF level of 4.2 microgram/ml were documented during an unexplained clinical syndrome of fever and encephalopathy. Discontinuation of drug and performance of hemodialysis reduced serum concentrations to 24 microgram/ml and were associated with rapid resolution of symptoms. Patients with renal impairment and intestinal disease who receive oral vancomycin may absorb and accumulate significant amounts of drug.

Administration, Oral↗
PubMed1981

Pseudomonas maltophilia bacteremia in children undergoing open heart surgery.

Pseudomonas maltophilia was isolated from intraoperative blood cultures in eight of 13 children undergoing open heart surgery during a five-week period. Antibiograms were identical and included resistance to prophylactic antibiotics. The source of the outbreak was traced to contamination of both the calibration device used on the pressure monitoring system and the sensor surface of transducers used in this system. In a mock system, calibration with a contaminated device resulted in recovery of the organism from transducer dome fluid. Dye studies confirmed the integrity of the transducer membrane but demonstrated reflux of dome fluid into the monitoring line fluid. A case-control study revealed no patient- or surgery-related factors predisposing to P maltophilia bacteremia and no excess of morbidity or mortality in patients as a result of bacteremia. The outbreak was confined to patients undergoing open heart surgery and was terminated abruptly by sterilization of transducers and revision of the calibration device.

Cardiac Surgical Procedures↗
PubMed1981

Bacteremia due to Bacteroides fragilis after elective appendectomy in renal transplant recipients.

Bacteremia caused by Bacteroides fragilis occurred in four of 75 children after renal transplantation, and B. fragilis was the most common cause of postoperative bacteremia. Bacteroides bacteremia was significantly associated with performance of elective appendectomy at the time of transplantation (P less than 0.01) and with profound lymphocytopenia (P = 0.01). No patient received antibiotics at the time of surgery or prior to the first positive blood culture, yet B. fragilis was the single organism isolated from blood and abscesses in these patients. A role for lymphocytes in containment of B. fragilis has not been suggested previously, although unexplained occurrence of bacteroides bacteremia in immunocompromised patients has occasionally been reported. Lymphocytes themselves may be important in this host-bacterium interaction, or lymphocytopenia may be the marker for a more generalized deficiency in host defenses.

Adolescent↗
PubMed1977

Development of anaerobic fecal flora in healthy newborn infants.

Stool samples from 196 healthy infants less than ten days of age were cultured to delineate bacterial colonization patterns of the intestine. By one week of age, isolation rates of Bacteroides fragilis and other anaerobic bacteria in term infants following vaginal delivery and formula feeding approach that of adults. Differences in gestational age, type of delivery, and type of feeding are associated with significantly different colonization patterns of anaerobic and aerobic bacteria in the first week after birth.

Anaerobiosis↗
PubMed1976

In vitro susceptibilities of anaerobic bacteria to josamycin.

A total of 132 strains of anaerobic bacteria were tested for susceptibility to josamycin, using a broth dilution technique. All strains of Peptococcus species, Peptostreptococcus species, and Bacteroides fragilis were inhibited by 2 mug or less per ml. Seventy percent of these susceptible strains were also killed by 2 mug or less of josamycin per ml. However, 2 of 12 Clostridium species and 6 of 10 Fusobacterium species had minimum inhibitory concentrations of 32 mug or more per ml.

Anaerobiosis↗
PubMed1976

Determinants of the developing oral flora in normal newborns.

The ability of Streptococcus species to selectively adhere to the oral epithelial cells of newborns was studied in vitro. On day 1 of life, mucosal cells from normal infants demonstrated selective attraction for the natural distribution of streptococci that would soon colonize these surfaces. Streptococcus salivarius and Streptococcus mitis adhered well in vitro to scraped cells from cheek and tongue surfaces. Streptococcus mutans, on the other hand, exhibited feeble or no adherence to cheek or tongue cells. Adherence of Escherichia coli to oral epithelial cells was also studied. The ability of strains of E. coli to adhere to cheek and tongue cells correlated solely with the presence of cell surface substances, probably pili. These observations, made on infants at the critical moment of their developing flora, strengthen the hypothesis that the ability of bacteria to adhere to surfaces is an important determinant of their ecological place in the oral microflora.

Cells, Cultured↗
PubMedDate not supplied

Infant botulism.

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Animals↗
PubMedDate not supplied

Study of antibiotic prophylaxis during burn wound debridement in children.

Twenty-three children completed a randomized, prospective, partially blinded study performed to assess the need and effectiveness of antibiotic prophylaxis at the time of burn wound debridement and grafting. Patients with a total body surface area (TBSA) burn less than 35% were randomized to receive cefazolin or placebo. Patients with burns of 35% or more TBSA were randomized to receive cefazolin or targeted antibiotics based on surveillance cultures. Blood cultures were obtained at commencement, immediately after, and 24 hours after surgical debridement. Quantitative cultures and histologic examination of biopsied burn wounds were performed. Burn wound infection occurred in three patients with burns of less than 35% TBSA, two in the cefazolin group and one in the placebo group. Quantitative tissue cultures and histologic examination did not predict either infection. During the four procedures in three patients with 35% or more TBSA, three were randomized to receive cefazolin, and one targeted antibiotics. All receiving cefazolin developed burn wound infection. Quantitative tissue culture was more than 10(5) colony-forming units per gram in all, whereas histologic examination was positive in one. In our patients with less than 35% burn, cefazolin was not necessary, and in those with 35% or more burn, it was not effective.

Antibiotic Prophylaxis↗
PubMedDate not supplied

In vitro susceptibility testing of topical antimicrobial agents used in pediatric burn patients: comparison of two methods.

One hundred and seventy-seven bacterial isolates obtained from pediatric burn victims were tested for in vitro susceptibility against bacitracin, silver sulfadiazine, mafenide acetate, nitrofurazone, and mupirocin by two methods: standard microbroth dilution and Nathan's agar well diffusion (NAWD). Nitrofurazone had the broadest spectrum of activity. Mupirocin was the most potent agent against methicillin-susceptible Staphylococcus aureus. Silver sulfadiazine showed activity against gram-positive organisms and higher minimum inhibitory concentration (MIC) values, and smaller zone sizes were seen for methicillin-resistant S. aureus and gram-negative bacilli. Bacitracin showed activity against S. aureus and Streptococcus pyogenes by the microbroth method; activity could not be assessed by NAWD. Mafenide acetate had the highest MICs for all isolates tested. Correlation between methods for all isolates tested was best for mupirocin and nitrofurazone. NAWD was labor intensive and difficult to interpret; MIC method was easy to perform and reproducible. Clinical correlation is necessary to establish breakpoints for interpretation of test results.

Administration, Topical↗
PubMedDate not supplied

Botulism in infancy.

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Animals↗
PubMedDate not supplied

Pyogenic arthritis in infants and children: a review of 95 cases.

The clinical and laboratory findings of 95 children with pyogenic arthritis were reviewed to assess etiologic agents, diagnostic tools and results of therapy. Despite obtaining specimens from multiple sites for culture and using antigen detection tests only 64% of patients had an etiologic agent determined. Haemophilus influenzae type b was the most common causative agent identified and 82% of such cases occurred in children between 6 and 24 months of age. Infection due to Staphylococcus aureus was not confined to any age group. Results of laboratory tests which measure inflammatory response were not always abnormal. Platelet count and sedimentation rate frequently rose as clinical improvement occurred. Roentgenograms and radionuclide studies were of little benefit. Therapy included immediate decompression of the joint space, articular rest and use of antibiotics delivered parenterally. Ninety percent of 70 patients who were followed for 1 month to 5 years (mean, 15.5 months) were cured. Eight children had clinically significant sequelae which affected length of extremity, stability of articulations and range of movement. Development of sequelae was significantly associated with infection at age less than 6 months, delay of 4 or more days in institution of medical or surgery treatment, infection due to S. aureus and most strikingly the involvement of the hip or shoulder with concomitant presence of osteomyelitis.

Anti-Bacterial Agents↗