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T V Riley

Publications and source records attributed to T V Riley.

124 records · Page 7Linked to original sources
PubMed1984

Routine culturing for Clostridium difficile?

In order to determine whether routine culturing for Clostridium difficile was warranted or whether culturing a selected group of patients was adequate, we conducted a prospective trial of culturing all stool specimens for C. difficile. A total of 408 specimens from 297 patients was studied. Two hundred and eighteen stool specimens from 169 patients were selected on the basis of fulfilling one or more of the following criteria; (i) the stools were loose or watery; (ii) leukocytes and/or red cells were seen on direct microscopic examination; (iii) there was a history of antibiotic therapy; (iv) there was a diagnosis or history of inflammatory bowel disease. Fifty-three stools from 33 (19.5%) of these patients either yielded C. difficile by culture or had C. difficile cytotoxin demonstrable in fecal extracts. C. difficile was cultured in only one of 190 stools from the remaining 128 patients. Hence routine culturing of all stool specimens does not appear warranted provided that an accurate clinical history can be obtained and a careful macroscopic and microscopic examination is carried out.

Clostridium↗
PubMed1983

Diarrhoea associated with Clostridium difficile in a hospital population.

The incidence of disease associated with Clostridium difficile was investigated in a general hospital population over a period of six months. In 26 (14.5%) of 179 patients studied, C. difficile was either isolated or faecal cytotoxin was detected. The incidence of other enteropathogenic bacteria, except Aeromonas hydrophila, was low. Faecal cytotoxin was not detected in nine patients (35%), and non-cytotoxigenic strains of C. difficile were isolated from these patients. In seven patients, a selective broth was required to isolate C. difficile, suggesting their presence in low numbers. Although some C. difficile diarrhoeal disease which was not associated with antibiotic therapy was recorded, prior exposure to antibiotic agents still appears to be the major predisposing factor in this population. Faecal cytotoxin detection, sigmoidoscopy, and rectal biopsy were not reliable investigations for disease associated with C. difficile; hence, we advocate increased emphasis on isolation of the causative organism. Routine culturing for C. difficile in a hospital population appears to be warranted.

Australia↗
PubMed1983

A selective broth for Clostridium difficile.

A selective broth for the isolation of Clostridium difficile from stool specimens is described. The broth contains gentamicin, cycloserine and cefoxitin (GCC broth) and gives rapid presumptive evidence of the presence of C. difficile using gas-liquid chromatography. The broth may also be used for the detection of cytotoxin. Final recovery of C. difficile was significantly improved with an increase in isolation rate of 20% in patients in whom fecal cytotoxin could be detected and 125% in patients where fecal cytotoxin could not be detected. Until the pathogenesis of C. difficile-associated diseases is more clearly defined we would stress the importance of isolating the organism, and we advocate the use of a selective broth such as GCC to improve the isolation rate.

Cefoxitin↗
PubMed1982

Chronic osteomyelitis due to Clostridium difficile.

Osteomyelitis caused by anaerobic bacteria is rarely reported, and a case of chronic osteomyelitis of the femur may be the first in which Clostridium difficile was the causative agent. The organism was isolated over several months and, although initially sensitive to penicillin, it developed resistance during this time. The organism's repeated isolation may have been due to the presence of resistant spores. Although the patient had no gastrointestinal symptoms the source of the organism was probably the patient's own gastrointestinal tract. Infection from the environment cannot, however, be excluded. Treatment was finally successful with metronidazole.

Adult↗
PubMed1982

A bacteriocin typing scheme for Bacteroides.

Epidemiological studies of Bacteroides spp. have been hindered because a suitable typing method is not available. In preliminary studies, 50 strains of Bacteroides were screened against each other for bacteriocin production and sensitivity; 54% of them produced bacteriocin(s) and more than 90% were sensitive to at least one bacteriocin. After calculation of similarity values for these 50 isolates, a typing set of six bacteriocinogenic strains was selected for a typing method based on bacteriocin sensitivity. With this typing set c. 90% of strains could be typed and tests of reproducibility suggested that acceptable accuracy and discrimination could be obtained without applying any one-reaction or two-reaction difference rules. Isolates from four hospitals gave a similar spectrum of typing patterns with 18 bacteriocin types being demonstrated. There was not correlation between bacteriocin type and species of Bacteroides.

Bacteriocins↗
PubMed1982

Reactive arthritis associated with Clostridium difficile.

A case of reactive arthritis in a patient with a previously documented history of Reiter's syndrome is described. The precipitating agent appears to have been Clostridium difficile. High levels of toxin were demonstrable in the faeces and neutralising antitoxin was detected in the patient's serum but not synovial fluid. Resolution of the polyarthropathy was slow despite successful eradication of the C. difficile with a course of vancomycin.

Adult↗
PubMed1982

Susceptibility of Bacteroides spp. to heavy metals.

The susceptibility of 105 strains of Bacteroides to arsenate, silver, nickel, cobalt, lead, cadmium, chromium, and mercuric ions was tested by using an agar dilution technique. All strains of Bacteroides were multiply resistant. Bacteroides fragilis was significantly more resistant to silver ions than other Bacteroides species and slightly more resistant to several other ions. Arsenate was the most active ion tested, with 75% of strains being susceptible. All 25 strains of B. fragilis tested against silver sulfadiazine were susceptible.

Bacteroides↗
PubMed1981

Agar dilution susceptibility of Bacteroides spp. to sulfamethoxazole and trimethoprim: correlation with a disk diffusion technique.

The minimum inhibitory concentrations of sulfamethoxazole and trimethoprim against 105 strains of Bacteroides spp. were determined by an agar dilution method, using Diagnostic Sensitivity Test agar supplemented with lysed blood. A total of 92% of the strains were susceptible to sulfamethoxazole alone (minimum inhibitory concentration, less than or equal to 50 microgram/ml), whereas only 28% were susceptible to trimethoprim alone (minimum inhibitory concentration, less than or equal to 1 microgram/ml). Susceptibility was also determined by a disk diffusion technique. For sulfamethoxazole, there was good correlation between inhibition zone diameters and minimum inhibitory concentrations. Hence, the disk diffusion test for susceptibility of Bacteroides spp. to sulfamethoxazole is suitable for routine laboratory testing. However, for trimethoprim there was a lack of correlation between the agar diffusion method and the minimum inhibitory concentrations. Three different methods for detecting synergy between sulfamethoxazole and trimethoprim against Bacteroides spp. were evaluated. With a checkerboard method, synergy was demonstrated in 96% of the strains which could be evaluated. However, this technique is unsuitable for routine testing. Two other techniques, which have been successfully used for detecting synergy with aerobic bacteria, were found to be unsatisfactory for Bacteroides spp.

Bacteroides↗
PubMed1981

Synovial fluid lactic acid levels in septic arthritis.

Synovial fluid lactic acid estimations were carried out on 50 samples by gas liquid chromatography. Specimens from 4 patients with bacteria arthritis, other than gonococcal, had a mean lactic acid concentration of 215 mg/dl. One patient with gonococcal arthritis had a synovial fluid lactic acid of 30 mg/dl. Forty-one patients with inflammatory arthritis and 4 patients with degenerative arthritis had mean synovial fluid lactic acid levels of 27 and 23 mg/dl respectively. The estimation of synovial fluid lactic acid is reliable in differentiating septic arthritis from inflammatory and degenerative arthritis except when the infecting organism is NEisseria gonorrhoeae.

Arthritis, Infectious↗
PubMed1976

Infection with Pseudomonas maltophilia hospital outbreak due to contaminated disinfectant.

Between August, 1973, and May, 1974, Pseudomonas maltophilia was isolated from 63 patients in the King Edward Memorial Hospital for Women, Subiaco, Western Australia. Primary cultures were obtained mainly from specimens of urine from adults, and from intraarterial catheter tips and umbilical swabs from neonates. In most cases the organism appeared to be a contaminant, but in seven it was responsible for infection. The source of the organism was deionized water used for diluting Savlon concentrate (chlorhexidine, 1-5%; cetrimide, 15%). In the 17 months since the method of preparation and distribution of Savlon to the wards was altered, Ps. maltophilia has not been isolated from either clinical specimens or hospital disinfectants.

Adult↗