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Biomedical subjects

T J Marrie

Publications and source records attributed to T J Marrie.

At least 163 records · Page 9Linked to original sources
PubMed1983

A scanning and transmission electron microscopic study of the surfaces of intrauterine contraceptive devices.

We studied 10 intrauterine contraceptive devices by scanning and transmission electron microscopy. All the devices had material adherent to them. The amount of this material varied considerably. Many different morphologic types of bacteria were observed adherent to the devices, often buried in a thick biofilm. Occasionally a microcolony containing only a single bacterial morphotype was observed. Electron microprobe analysis revealed the presence of calcium in the biofilm formed by bacterial colonization. Very few types of bacteria were recovered by our cultural technique, suggesting that material must be scraped from the surface of the device, homogenized, and then cultured by means of selective media. An understanding of the mechanisms of adherence of bacteria to these devices could lead to the development of a device which will resist bacterial colonization.

Actinomyces↗
PubMed1983

Pneumonia in renal transplant patients.

Between January 1976 and March 1982, 28 episodes of pneumonia occurred in 26 renal transplant patients. The overall mortality rate was 46%. Of the 16 patients with nosocomial pneumonia 9 (56%) died, whereas of the 12 patients with community-acquired pneumonia 4 (33%) died. In all 9 cases of unknown cause the response to empiric treatment was prompt, whereas in 4 of the 10 cases of monomicrobial pneumonia and 8 of the 9 cases of polymicrobial pneumonia the patient died. Cytomegalovirus was the sole cause of the pneumonia in two patients and a contributing cause, along with aerobic gram-negative bacteria, in another five, four of whom also had a fungal infection. Two patients, both of whom survived, had nosocomial Legionnaires' disease.

Adult↗
PubMed1983

Endocarditis due to Q fever in Nova Scotia: experience with five patients in 1981-1982.

Q fever endocarditis is rarely reported in North America; only four cases have been documented since 1953. In 1981-1982, five cases were identified in the Victoria General Hospital, Halifax, Nova Scotia. Four patients were from widely separated areas of Nova Scotia and one was from Prince Edward Island. Four patients with long-standing valvular abnormalities, including two with prosthetic valves, presented with recurrent febrile episodes. The fifth patient, who was previously well, had recurrent septic embolic episodes. Clinical features and laboratory findings were variable. Diagnosis by serology was confirmed in four patients by culture of Coxiella burnetii from excised tissue. Histopathology varied from nonspecific inflammatory changes to two more distinctive patterns; electron microscopy showed C burnetii in two patients. Therapy with tetracycline and trimethoprim-sulfamethoxazole was beneficial, although three patients required valve replacement for hemodynamic deterioration. Q fever endocarditis may be more common than is recognized, and serological investigations should be performed in all cases of culture-negative endocarditis.

Adult↗
PubMed1983

Ataxia in Listeria monocytogenes infections of the central nervous system.

From 1976 to 1981 Listeria monocytogenes was second only to Neisseria meningitidis as the cause of bacterial infections of the central nervous system in adults at our hospital. None of the patients with Listeria infection was immunosuppressed or had an underlying malignancy. Ataxia was an initial feature in five of the eight patients, and in three of them it persisted beyond their discharge from the hospital. Ataxia was not a feature of the clinical picture of 14 other adult patients with meningococcal and pneumococcal meningitis. Our data indicate that L monocytogenes should be suspected as the etiologic agent in an adult with ataxia and infection of the central nervous system.

Adult↗
PubMed1983

Scanning electron microscopic study of uropathogen adherence to a plastic surface.

We used a polyethylene surface to study the adherence of various urinary pathogens to a representative inert surface. The bacteria were suspended in filter-sterilized urine during this adhesion study, and differential adhesion was clearly demonstrated. Pseudomonas aeruginosa adhered most avidly and formed large microcolonies that were surrounded by an extensive amorphous matrix. Staphylococcus saprophyticus also formed microcolonies on the surface of the plastic droppers. In general, piliated strains of Escherichia coli adhered less avidly than the other organisms, but more avidly than nonpiliated strains; however, one piliated strain of E. coli adhered very poorly and behaved like a nonpiliated strain.

Adhesiveness↗
PubMed1983

Examination of the morphology of bacteria adhering to peritoneal dialysis catheters by scanning and transmission electron microscopy.

We examined Tenckhoff peritoneal catheters by scanning and transmission electron microscopy to study the morphology of bacterial adherence. Two catheters were removed from uninfected patients, three from patients with exit site infections, four from patients with peritonitis, and one from a patient with both exit site infection and peritonitis. Infecting organisms included three of Staphylococcus aureus and one each of Enterobacter sp., Staphylococcus epidermidis, Achromobacter xylosoxidans, Serratia sp., Klebsiella sp., and Candida albicans. Considerable morphological variation in adherence to the peritoneal dialysis apparatus occurred. No inflammatory cells were ever seen in association with infected cuffs, only two of the five patients with peritonitis had inflammatory cells associated with their catheters. In both instances, these cells tended to occur in clumps and demonstrated no flattening when in contact with the surface. Colonization of the catheter was uneven--bacteria tended to occur in clusters. Extensive matrix formation was evident in several instances, and condensation of this matrix onto the bacteria during the dehydration process rendered clumps of bacterial cells amorphous at times. Bacteria were adherent to the subcutaneous cuff in those patients with exit site infections. Gram-negative bacteria attached to individual dacron fibers of the cuff, often several layers deep. Gram-positive bacteria tended to adhere in clusters.

Bacteria↗
PubMed1983

A scanning electron microscopic study of urine droppers and urine collecting systems.

In this study we have shown extensive microbial colonization of the surface of urine droppers and urine collecting systems from bacteriuric patients. In all instances there was an extensive background matrix and fibrous strands interconnected the bacteria. A "slime" layer completely encased bacteria on occasion. These observations suggest that incorporation of blockers of bacterial adhesion into the surfaces of these devices should be explored as one method of delaying, or in some cases preventing, catheter-acquired bacteriuria.

Bacteria↗
PubMed1983

Radiographic analysis of the course of Legionella pneumonia.

The radiographic findings in the acute phase of Legionella pneumonia are generally non-specific and have been previously documented. A retrospective assessment of 12 patients with this bacterial pneumonia revealed that resolution of the radiographic findings was prolonged in five. The predominant feature in such patients is the transient finding of interstitial consolidation following the air-space consolidation, not unlike that of Mycoplasma or viral pneumonia. Eventual return to normal was evident in three patients and residual parenchymal fibrosis was noted in two patients.

Adult↗
PubMed1982

Q fever in maritime Canada.

Only nine cases of Q fever were recorded in Canada in the 20 years prior to 1978. In the 18 months from August 1979 to January 1981 the disease was diagnosed serologically in six patients from the Maritime provinces. All were epidemiologically unrelated and none had been exposed to animals. Five had pneumonia and one had chronic Q fever with probable prosthetic valve endocarditis. Three of the five pneumonia patients presented with signs and symptoms of an acute lower respiratory tract infection and were indistinguishable clinically from other patients with atypical pneumonias. The other two with pneumonia presented with nonresolving pulmonary infiltrates and complained of decreased energy. Four of the five pneumonia patients responded well to treatment with erythromycin; the fifth required two courses of tetracycline. The patient with chronic Q fever had a large amount of cryoglobulins in his serum and evidence of immune complex disease. These cases indicate that Q fever should be considered as a possible cause of atypical pneumonia in Canada.

Adult↗
PubMed1982

Hand carriage of aerobic Gram-negative rods by health care personnel.

A quantitative culture technique (hand washed in a glove containing broth for 30 s) was used to determine the frequency of hand carriage of aerobic Gram-negative rods by various groups of health care workers and 104 control subjects. Overall, 31% of health care workers carried aerobic Gram-negative rods on their hands compared to 59% of control subjects (P < 0.001). Enterobacter agglomerans accounted for 40% of the isolates, and other Enterobacter spp. 7%. Other organisms included Acinetobacter calcoaceticus 21%, Serratia spp. 11%, Klebsiella spp. 10%, Moraxella spp. 3%, Pseudomonas spp. 3%, Proteus spp. 1.5%, Escherichia coli 1%; Morganella morganii, Citrobacter freundii, Aeromonas sp. and an isolate that was not speciated accounted for 0.5% each. We conclude that endemic hand carriage of aerobic Gram-negative rods by health care personnel is common, but significantly less than that of control subjects. Enterobacter agglomerans is found so frequently on the hands of control subjects that it must be considered part of the normal hand flora.

Acinetobacter↗
PubMed1982

Hand carriage of aerobic gram-negative rods may not be transient.

In order to determine whether hand carriage of aerobic Gram-negative rods is continuous we used the glove-handwash technique to sample the hands of two groups (four each) of health care workers with normal hands (surgical intensive care unit, medical ward) and one group (four) with hand dermatitis (HD) and a group (five) of control subjects -- secretaries with no exposure to patients. Each subject was sampled repeatedly over three to six weeks. The mean number of samples for each group was 25.2, 23.2, 19.8 and 25.8 respectively. The HD group had more samples positive for aerobic Gram-negative rods than did the other two groups of health care workers while the control group had more samples positive than any of the three health care groups. Using various typing schemes and the following definition of continuous carriage (the isolation of an organism of the same serotype, pyocin type or biotype from more than two handwash samples) we found that 4 of 11 subjects from whom Klebsiella pneumoniae was isolated carried this organism continuously; 2 of 3 carried Pseudomonas aeruginosa continuously and 4 of 5 of the control subjects carried the same biotype of Enterobacter agglomerans continuously. We conclude that continuous hand carriage of aeroic Gram-negative rods is common and, among health care workers, those with hand dermatitis carry Gram-negative rods more frequently and in greater numbers than health care workers without hand dermatitis.

Bacteria↗
PubMed1982

Antimicrobial susceptibility of Staphylococcus saprophyticus and urethral staphylococci.

The activity of eight antimicrobial agents was determined against 115 isolates of Staphylococcus saprophyticus. All were susceptible to ampicillin, cephalexin, and trimethoprim-sulfamethoxazole and resistant to nalidixic acid and novobiocin. A bimodal pattern of susceptibility to erythromycin was observed: 80% were inhibited by 0.25 microgram/ml, whereas 13% required greater than or equal to 128 micrograms/ml. The following urethral staphylococci were susceptible to ampicillin, cephalexin, and nitrofurantoin but resistant to nalidixic acid: S. epidermidis, S. hominis, S. haemolyticus, S. warneri, S. simulans, and S. cohnii.

Anti-Bacterial Agents↗
PubMed1982

Staphylococcus saprophyticus as a cause of urinary tract infections.

Our objectives in this study were to elucidate various aspects of the epidemiology of Staphylococcus saprophyticus. This organism was isolated from the midstream urine specimens of 7.5% of 145 college women with frequency and urgency of urination and dysuria, but from only 0.07% of 14,835 urine specimens from adult inpatients at the Victoria General Hospital. It was found to be part of the urethral flora of only 2% of healthy women. Other staphylococci which formed part of the urethral flora of 100 healthy women included S. epidermidis (59 women), S. hominis (15 women), S. haemolyticus (13 women), S. warneri (9 women), and S. aureus (6 women). Finally, we determined that resistance to the 5-micrograms novobiocin disk has a 93% positive predictive accuracy as a presumptive test for S. saprophyticus.

Adolescent↗
PubMed1982

A scanning and transmission electron microscopic study of an infected endocardial pacemaker lead.

We studied the pacemaker lead that had been removed from a patient who suffered three sequential episodes of Staphylococcus aureus bacteremia. This organism was recovered from the surface of the lead. Scanning electron microscopy showed differential colonization of the pacemaker lead. The metal tip, the inner surface and the internal wires were covered with a heavy biofilm of bacteria. The outer silastic surface had no biofilm adherent to it; instead, well-spaced bacterial cells were seen. These observations illustrate why infection of implantable devices persists despite intensive antibiotic chemotherapy.

Endocarditis, Bacterial↗
PubMed1982

Herpes simplex-hepatitus use of immunoperoxidase to demonstrate the viral antigen in hepatocytes.

In this paper we describe 2 patients with herpes simplex hepatitis. Submassive liver necrosis occurred in both patients, one of whom survived. Notable in the clinical course of both patients was the almost simultaneous occurrence of three events-fever, marked elevation of serum transaminases, and leukopenia. Using an immunoperoxidase staining technique we demonstrated herpes simplex viral antigen in the nucleus, cytoplasm, and cell membrane of affected hepatocytes.

Adult↗
PubMed1982

Rotavirus infection in a geriatric population.

An outbreak of gastroenteritis affected 19 of 34 geriatric patients and four of 23 staff assigned to the ward in a period of 3 1/2 weeks in January 1980. Fourteen of the 19 patients with gastroenteritis (17 were tested properly) and four of the ten asymptomatic patients (five asymptomatic patients were not tested) showed evidence of rotavirus infection by virus positivity and/or a significant antibody response to rotavirus. One of the four staff members with gastroenteritis showed serologic evidence (three were tested) of rotavirus infection. Nine of the 18 asymptomatic staff members (two remaining staff members were not tested) showed a fourfold rise in antibody to rotavirus but four had antibody titers of 1:32 or more. The patients had diarrhea for a mean of 2.6 days. Most of them had five or fewer diarrheal stools in one day. Six patients had a severe illness and two died. Thirteen of 15 symptomatic patients who had serum samples, collected during the acute and convalescent phases, tested manifested high titers (greater than or equal to 1:32) of complement-fixing antibody to rotavirus antigen.

Adult↗