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Biomedical subjects

Thomas V Riley

Publications and source records attributed to Thomas V Riley.

23 records · Page 2Linked to original sources

Clostridium difficile-associated diarrhea: epidemiological data from Western Australia associated with a modified antibiotic policy.

The incidence of Clostridium difficile-associated diarrhea (CDAD) has increased dramatically in hospitals worldwide during the past 2 decades. In Western Australia, this increase was most obvious during the 1980s, when there was also an increase in the use of third-generation cephalosporin antibiotics. A study of the epidemiology of CDAD and the use of third-generation cephalosporins during 1993-2000 was undertaken. From 1993 through 1998, the incidence of CDAD remained relatively stable (2-3 cases per 1000 discharges annually). Then, a significant decrease in the incidence occurred, from 2.09 cases per 1000 discharges (95% confidence interval [CI], 1.71-2.47) in 1998 to 0.87 cases per 1000 discharges (95% CI, 0.63-1.11) in 1999 (P<.0001); this decrease persisted into 2000. A decrease in third-generation cephalosporin use occurred during the period of the study because of changes in the prescribing policy. These findings suggest that a reduction in the use of third-generation cephalosporins can reduce the occurrence of CDAD.

Adult↗

Mechanism of action of Melaleuca alternifolia (tea tree) oil on Staphylococcus aureus determined by time-kill, lysis, leakage, and salt tolerance assays and electron microscopy.

The essential oil of Melaleuca alternifolia (tea tree) has broad-spectrum antimicrobial activity. The mechanisms of action of tea tree oil and three of its components, 1,8-cineole, terpinen-4-ol, and alpha-terpineol, against Staphylococcus aureus ATCC 9144 were investigated. Treatment with these agents at their MICs and two times their MICs, particularly treatment with terpinen-4-ol and alpha-terpineol, reduced the viability of S. aureus. None of the agents caused lysis, as determined by measurement of the optical density at 620 nm, although cells became disproportionately sensitive to subsequent autolysis. Loss of 260-nm-absorbing material occurred after treatment with concentrations equivalent to the MIC, particularly after treatment with 1,8-cineole and alpha-terpineol. S. aureus organisms treated with tea tree oil or its components at the MIC or two times the MIC showed a significant loss of tolerance to NaCl. When the agents were tested at one-half the MIC, only 1,8-cineole significantly reduced the tolerance of S. aureus to NaCl. Electron microscopy of terpinen-4-ol-treated cells showed the formation of mesosomes and the loss of cytoplasmic contents. The predisposition to lysis, the loss of 260-nm-absorbing material, the loss of tolerance to NaCl, and the altered morphology seen by electron microscopy all suggest that tea tree oil and its components compromise the cytoplasmic membrane.

Anti-Infective Agents, Local↗

Evaluation of blood culture systems for detection of the intestinal spirochaete Brachyspira (Serpulina) pilosicoli in human blood.

The anaerobic intestinal spirochaete Brachyspira (Serpulina) pilosicoli has been isolated from the bloodstream of French patients by manual blood culture systems. The purpose of this study was to determine whether the automated and manual blood culture systems used in Australia are suitable for growth and detection of this organism. Strains of B. pilosicoli were added to human blood to give concentrations ranging from 1 x 10(4) to 1 x 10(1) spirochaetes/ml and 10-ml volumes were inoculated into the media. Three strains of B. pilosicoli grew slowly in all manual Hemoline and BBL Septi-Chek formulations tested. Subcultures taken between 2 and 10 days after inoculation yielded growth only after incubation for a further 5-8 days. Growth and automated detection were achieved in the BACTEC system with Anaerobic/F medium with or without Fastidious Organism Supplement. Minimum time to signal for nine strains varied between 5.6 and 14.9 days, with a minimum concentration of 10(1) spirochaetes/ml of blood being detected. None of nine strains gave a positive signal in the BacT/Alert system when FAN Anaerobic culture bottles were used; however, four strains were detected by subculture taken at 7 or 14 days after inoculation. When Anaerobic medium was used in the BacT/Alert system, two of three strains gave a signal and the other strain grew and was detected by subculture. Spirochaetaemias caused by B. pilosicoli may be unrecognised because detection time by the signal or subculture exceeds 5 days.

Bacteremia↗

Erysipelothrix rhusiopathiae: bacteriology, epidemiology and clinical manifestations of an occupational pathogen.

Erysipelothrix rhusiopathiae has been recognised as a cause of infection in animals and man since the late 1880s. It is the aetiological agent of swine erysipelas, and also causes economically important diseases in turkeys, chickens, ducks and emus, and other farmed animals such as sheep. The organism has the ability to persist for long periods in the environment and survive in marine locations. Infection in man is occupationally related, occurring principally as a result of contact with animals, their products or wastes. Human infection can take one of three forms: a mild cutaneous infection known as erysipeloid, a diffuse cutaneous form and a serious although rare systemic complication with septicaemia and endocarditis. While it has been suggested that the incidence of human infection could be declining because of technological advances in animal industries, infection still occurs in specific environments. Furthermore, infection by the organism may be under-diagnosed because of the resemblance it bears to other infections and the problems that may be encountered in isolation and identification. Diagnosis of erysipeloid can be difficult if not recognised clinically, as culture is lengthy and the organism resides deep in the skin. There have been recent advances in molecular approaches to diagnosis and in understanding of Erysipelothrix taxonomy and pathogenesis. Two PCR assays have been described for the diagnosis of swine erysipelas, one of which has been applied successfully to human samples. Treatment by oral and intramuscular penicillin is effective. However, containment and control procedures are far more effective ways to reduce infection in both man and animals.

Animals↗