Antibiotic sensitivity testing in enteric Salmonella.
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Biomedical subjects
Publications and source records attributed to A Yardumian.
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To see whether the introduction of screening tests for post-transfusion non-A, non-B hepatitis (NANBH) in the UK would be worth while, the incidence of such hepatitis was assessed among patients receiving blood during operations at five hospitals served by the North London Blood Transfusion Centre. 387 patients, who each received blood or blood components from an average of 3 donors were followed up prospectively and blood samples were taken every 2 weeks for 3 months and then each month for a further 3 months. 229 patients also provided a sample at 12 months. All available patient and donor samples were tested for alanine aminotransferase concentrations and for antibody to hepatitis C virus (anti-HCV) by ELISA. Repeatedly anti-HCV positive samples were submitted to supplementary HCV assays. 1 of the 387 patients showed biochemical evidence of acute post-transfusion NANBH after exclusion of non-viral causes. Anti-HCV developed in this patient and the seroconversion was confirmed by recombinant immunoblot assay and polymerase chain reaction. Serum from 1 of the 8 donors whose blood he received was positive for anti-HCV by all three methods. In another patient HCV seroconversion was shown by ELISA but alanine aminotransferase concentrations remained normal throughout follow-up. His samples and those of his 2 donors were negative for HCV by the polymerase chain reaction. A third patient showed rises in alanine aminotransferase compatible with post-transfusion NANBH, but serology and polymerase chain reaction assays for HCV were negative for her samples and those of her donors. Anti-HCV reactivity likely to be false positive (negative by both confirmatory tests and no adverse effects in recipients) was seen in 6 of 1283 donors. This study, despite its being carried out in the part of the UK with the highest frequency of infectious markers in blood donations, has shown a very low incidence of post-transfusion NANBH.
An evaluation of the Coulter VCS (volume, conductivity, light scatter) automated differential counter demonstrated satisfactory correlations with manual 800-cell differential counts for neutrophils, lymphocytes, monocytes and eosinophils. For the detection of abnormal cells, 12.2% of samples gave false-negative results on the VCS, and 13.4% gave false-positive results. However, only 0.8% of the false-negatives would be expected to be picked up by a standard 100-cell manual differential count. Carry-over accorded to manufacturer's specifications and throughput was 60 samples/h. Reference normal ranges have been established and the instrument's precision and performance with leucopenic and neonatal blood samples assessed.
An assessment of the three part differential provided by the Coulter STKR blood counter showed good correlation when compared with an 800 cell manual differential. Satisfactory flagging of eosinophilia, basophilia, and the presence of immature cells was found. The use of variables derived from the STKR in conjunction with interpretive reporting and user-defined flagging enabled this department to reduce considerably the numbers of films requiring manual differential counts.
Patients affected by sickle cell disease encounter varied and often severe clinical problems directly related to their condition and are at greater risk than the general population from particular infections, thrombosis and certain surgical pathologies. The current clinical management policies for the severe acute problems arising in these patients, and measures undertaken to prevent these where possible, are discussed.
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Shoshin beriberi, a fulminant form of heart failure due to thiamine deficiency has a different presentation to the classical form of beriberi heart failure. It is characterized by a cold periphery, low blood pressure, renal shutdown and a severe metabolic acidosis. The true incidence is unknown. Two patients were seen within a few months in a general hospital and in both dietary deficiency of thiamine was a major factor.
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