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Biomedical subjects

W A Gillespie

Publications and source records attributed to W A Gillespie.

At least 37 records · Page 2Linked to original sources

Comparison of hexachlorophane and chlorhexidine powders in prevention of neonatal infection.

The protective effect of treating the skin of newborn infants with powders containing 1% chlorhexidine or 0.33% hexachlorophane was compared. Each was equally effective in preventing colonisation and infection by Staphylococcus aureus. In contrast, the skin became profusely colonised by coagulase-negative staphylococci, irrespective of the powder used. Venous blood concentrations of chlorhexidine were low or undetectable in the few infants whose blood was analysed.

Chlorhexidine↗

Urinary tract infection in young women, with special reference to Staphylococcus saprophyticus.

Acute urinary tract infections in young women attending a clinic for sexually transmitted diseases were caused by the same bacteria, in the same proportions, as those that caused infections in women students. Staphylococcus saprophyticus biotype 3 (formerly called Micrococcus subgroup 3) was the commonest organism after coliform bacilli and caused about 30% of the infections. It was uncommon in women over 25 years of age and rarely caused asymptomatic bacteriuria in pregnancy. Most infections, irrespective of the causative organism, started soon after sexual intercourse, but neither the staphylococci nor the other organisms were associated with promiscuity, as judged by numbers of sexual partners or the incidence of sexually transmitted diseases. There was no evidence that the staphylococci were sexually transmitted. The reasons for the virulence of Staph. saprophyticus and its predilection for the urinary tract of young women remain unknown.

Adult↗

Routine laboratory assessment of postoperative chest infection: a prospective study.

Postoperative chest infection was studied prospectively in 73 patients in order to evaluate standard laboratory methods of sputum examination and to relate the results to the patients' clinical state and to antibiotic therapy. When a culture medium selective for haemophilus was used in addition to unselective media, homogenisation of the specimen gave no advantage. Laboratory and clinical findings usually corresponded well. Profuse growths of Streptococcus pneumoniae or Haemophilus influenzae were clearly associated with clinical evidence of chest infection but other Gramnegative bacilli and Staphylococcus aureus much less so. Coliforms were more prominent after antibiotic therapy.

Adult↗

The relevance of growth rates in urine to the pathogenesis of urinary-tract infections due to Micrococcus subgroup 3 (Staphylococcus saprophyticus biotype 3).

A novobiocin-resistant "biotype" of Micrococcus subgroup 3 (Staphylococcus saprophyticus) is known to be a primary pathogen of the female urinary tract and to cause infections as severe as those produced by Escherichia coli. The growth characteristics of this virulent biotype were compared in vitro with those of other Micrococcaceae and of E. coli to determine whether rapid growth explains the virulence of the biotype. Nutrient broth was shown to have growth-supporting qualities that differed from those of urine and it was therefore unsuitable for these studies. In urine, the virulent biotype grew more slowly, had a longer lag period, and reached much lower final viable counts than did Escherichia coli. Surprisingly, the virulent biotype also grew more slowly and reached a lower final viable count than did several other Micrococcaceae isolated from the urinary tract of healthy women. Urine from women who had suffered a recent infection with the virulent biotype had growth-supporting properties similar to those of urine from healthy women. Experiments with filtered forestream urine suggested that urethral secretions do not contain a factor determining growth rates of this organism in urine. The possibility that virulent strains adapt to rapid growth in urine was excluded. No evidence was obtained that the virulent biotype inhibits the growth of other Micrococcaceae in urine. Ability to grow rapidly in urine does not therefore explain the virulence of novobiocin-resistant strains of subgroup-3 micrococci.

Adult↗

Micrococcal urinary-tract infections in young women.

In a prospective study in young women, novobiocin-resistant subgroup-3 micrococci were the second commonest cause, after Escherichia coli; of acute urinary infections. Proteus mirabilis was the only other causative organism. Symptoms, pyuria, or possible aetiological factors were the same in micrococcal and coliform infections. The infecting micrococcus "biotype" was only rarely found among the normal flora of the genitourinary tract of young women, though other micrococci and staphylococci were commonly present. Evidently, the infecting micrococci are selectively pathogenic in the urinary tract. Micrococcal infections, like coliform infections; commonly followed sexual intercourse, but there was no evidence that the micrococci were sexually transmitted. The infecting biotype was rarely found in the male urethra or prepuce.

Drug Resistance, Microbial↗

Absorption of hexachlorophane from dusting powder on newborn infant's skin.

In a maternity hospital in which the umbilicus and trunk of healthy newborn infants were treated with 0.33% hexachlorophane dusting powder, the hexachlorophane content of blood was measured in mothers before delivery, in infants' umbilical samples at birth, and at 8 days of age in capillary blood samples. One mother and her baby had rather high blood concentrations of hexachlorophane, probably derived from a toilet preparation used before admission to hospital. Hexachlorophane was absent or barely detectable in the other mothers' blood and in the infants' umbilical blood. The hexachlorophane concentrations in the blood of 8-day-old infants ranged from nil to 0.166 mug./ml. (mean 0.066 mug./ml.). These were much less than the concentrations reported to be toxic in animals.In a previous trial now reported here, a dusting powder containing chlorhexidine instead of hexachlorophane was found to delay the separation of the umbilical cord.

Anti-Infective Agents, Local↗

Antibiotic resistance and transmissible R-factors in the intestinal coliform flora of healthy adults and children in an urban and a rural community.

Faeces of healthy adults and of children under the age of 5, none of whom were attending hospital or receiving antibiotics, were examined for the presence of antibiotic resistant coliform bacilli.A higher proportion of children (67%) than of adults (46%) carried resistant strains and this difference was observed in both the rural and urban groups.Rural members of both age groups more often carried resistant organisms than urban members. Among rural adults, the incidence of drug-resistant strains was 63% in those whose occupation involved close contact with farm animals, compared with 29% in those with other occupations. The survey took place before the implementation of the Swann Report could have influenced the use of antibiotics in animal foodstuffs.Transmissible R-factors were demonstrated in 61% of the resistant strains. The incidence of transmissible resistance was similar among adults and children in town and country.

Adult↗