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Biomedical subjects

A G Skidmore

Publications and source records attributed to A G Skidmore.

13 recordsLinked to original sources
PubMed1991

Sterilization and disinfection in the physician's office.

OBJECTIVE: To review the principles and practice of sterilization and disinfection of medical instruments in the office setting. DATA SOURCES: Searches of MEDLINE for articles published from 1980 to 1990 on disinfection, sterilization, cross infection, surgical instruments and iatrogenic disease, bibliographies, standard texts and reference material located in a central processing department. STUDY SELECTION: We reviewed surveys of decontamination practices in physicians' offices, reviews of current recommendations for office decontamination procedures, case reports of cross infection in offices and much of the standard reference material on decontamination theory and practice. DATA SYNTHESIS: There have been few surveys of physicians' decontamination practices and few case reports of cross infection. Office practitioners have little access to practical information on sterilization and disinfection. CONCLUSION: The increasing threat of cross infection from medical instruments calls for greater knowledge about decontamination. We have adapted material from various sources and offer a primer on the subject.

Cross Infection↗
PubMed1985

Prevalence of type-specific group B streptococcal antibody in human sera: a study of 405 pregnant women.

Presence of immunoglobulin G antibody against the five standard serotypes of group B streptococcus was measured by means of indirect immunofluorescence in the sera of 405 women at the time of delivery in the obstetric hospital in Vancouver. Antibody to all five serotypes was present in 22% of women whereas only 9.6% had no detectable antibody to any serotype. Among 47 women with group B streptococcus vaginal colonization, IgG antibody was detected against the homologous colonizing serotype in 100%, 75%, 78%, 89%, and 100% of sera for serotypes Ia, Ib, Ic, II, and III, respectively. This contrasted with the women who had heterologous group B streptococcal vaginal colonization or no colonization in whom 71% had serum IgG antibody to serotype Ia, 36% to Ib, 51% to Ic, 66% to II, and 60% to III. Overall the serum antibody titers were low, and few women had titers greater than 1:20 for any of the five standard serotypes.

Antibodies, Bacterial↗
PubMed1985

In vitro activities of enoxacin, ticarcillin plus clavulanic acid, aztreonam, piperacillin, and imipenem and comparison with commonly used antimicrobial agents.

A total of 745 gram-negative and 313 gram-positive clinical isolates were tested against enoxacin, ticarcillin plus clavulanic acid, aztreonam, imipenem, and piperacillin and compared with commonly used antimicrobial agents. Ticarcillin plus clavulanic acid, imipenem, and piperacillin were active against Pseudomonas aeruginosa and Acinetobacter spp. and most Pseudomonas spp. Aztreonam was active against members of the family Enterobacteriaceae but was less effective against the nonfermenters. Enoxacin was active against the Enterobacteriaceae, P. aeruginosa, the staphylococci, and most Acinetobacter spp. but was less active against Pseudomonas spp. and streptococci. Imipenem was very active against all gram-positive and -negative organisms tested except for Pseudomonas maltophilia.

Anti-Bacterial Agents↗
PubMed1983

Metronidazole in the treatment of intra-abdominal sepsis.

A study of antibiotic treatment of intra-abdominal sepsis was conducted between May 1978 and May 1981. In the first phase, clindamycin (C) was compared with metronidazole (M), each combined with tobramycin (T), in a prospective, double-blind, randomized study. Twenty-three patients received C + T and 34 patients received M + T. The two groups were similar with respect to age, gender, underlying disease, presence of abscess, clinical condition, severity of illness, duration of illness before treatment and bacteriology. Anaerobic organisms outnumbered facultative and aerobic organisms. Bacteroides fragilis and Escherichia coli predominated. In the C + T group of patients, 74% had a good response. In the M + T group, 83% had good results. Adverse effects were few and minor in the two treatment groups. Three patients on C + T and one who received M + T followed by C + T died of infections; two patients died of underlying disease. In the second, open phase of the study, M + T was used to treat 45 patients with 46 courses. Twenty patients had intra-abdominal abscesses, which represented all grades of severity of illness. Five patients received long-term corticosteroid therapy. Almost half the patients had peritonitis complicating appendicitis. Good results were obtained in 81%. One patient died of the underlying disease and one died of infection complicating severe trauma and hypovolemic shock.

Abdomen↗
PubMed1982

Metronidazole and tobramycin in intra-abdominal sepsis.

In an open study of 49 episodes of intra-abdominal sepsis in 48 patients, metronidazole was used in combination with tobramycin, and each was given by intravenous infusion. All patients were also treated by appropriate surgical operation. The ages of the patients ranged from 21 to 89 years, and both sexes were equally represented. Twenty-two patients had abscesses drained. Thirty-eight of 49 treatment courses gave good results. Eight patients recovered, although slowly, and three were classified as failures. Of the failures, one instance was attributed to infection with Staphylococcus aureus, and recovery was satisfactory when cloxacillin sodium was given. The other two failures were due, in part, to shock caused by trauma and blood loss in one instance and disseminated anaplastic lymphoma in the other. No significant adverse effects were attributable to the antibiotics.

Abdomen↗
PubMed1981

Listeriosis at Vancouver General Hospital, 1965-79.

The records were reviewed of all patients treated at the Vancouver General Hospital over the 15 years from 1965 through 1979 for infections proved by culture to have been caused by Listeria monocytogenes. Although listeriosis is not common in humans, certain groups seem to be susceptible - immunocompromised patients, pregnant women, neonates and the elderly. All these groups were represented among the 22 cases reviewed. There were 17 adults, 3 of whom were pregnant women who had only a mild influenza-like illness. Of the remaining 14 adults 9 were immunocompromised and 5 apparently immunocompetent; 7 presented with meningitis and 7 with bacteremia only. Of the five infants with neonatal listeriosis, two had early-onset disease (bacteremia) and three had the late-onset form (meningitis). Seven patients were treated with penicillin alone, seven with ampicillin alone and eight with penicillin or ampicillin combined with kanamycin, gentamicin or chloramphenicol. There were eight deaths: several were directly attributable to the listeriosis, but in others the severity of the underlying illness was an important factor. Serotypes 1 and 4b were equally common among the 16 specimens of L. monocytogenes that were typed.

Adult↗
PubMed1980

Prospective, randomized, double-blind comparison of metronidazole and tobramycin with clindamycin and tobramycin in the treatment of intra-abdominal sepsis.

In a prospective, double-blind study, clindamycin was compared with metronidazole, each combined with tobramycin and all by the intravenous route in the treatment of intra-abdominal sepsis. Twenty-three patients received clindamycin and 34 patients received 35 courses of metronidazole. Analysis of the clinical responses of patients indicates that the two antibiotic regiments are of equal efficacy in that there was no difference between them in terms of defervescence or duration of infection. Few adverse effects were noted, and all appeared to be of a minor nature.

Abdomen↗
PubMed1979

Bacterial filters - are they necessary on anaesthetic machines?

At the Vancouver General Hospital the effectiveness of the system for decontamination of anaesthetic equipment was evaluated to determine the need for bacterial filters on anaesthetic machines. Two groups of patients were studied. Group I consisted of 33 patients, none of whom had clinical symptoms of respiratory tract disease. Group II consisted of 17 patients who had lower respiratory tract secretions. In the latter group 16 had chronic bronchitis and had cystic fibrosis. Of 550 bacterial cultures taken from the anaesthetic equipment immediately before and after anaesthesia in our 50 patients, only five yielded a growth of non-pathogenic bacteria. The results of this study indicate that bacterial colonization of anaesthetic equipment is of a low order and is adequately controlled by pasteurization even after use in patients with chronic lower respiratory tract disease. The use of bacterial filters does not appear justified if a strict regimen of cleaning and pasteurization is followed.

Adolescent↗