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B Cookson

Publications and source records attributed to B Cookson.

25 records · Page 2Linked to original sources
PubMed1989

Staff carriage of epidemic methicillin-resistant Staphylococcus aureus.

Twenty-six nurses were repeatedly screened for carriage of epidemic methicillin-resistant Staphylococcus aureus (EMRSA) immediately before and after duty periods in which they solely attended six patients widely colonized with two EMRSA strains distinguishable by plasmid analysis. EMRSA carriage was detected in 13 nurses. Three EMRSA carriage patterns emerged: transient carriage in 12 nurses, when the EMRSA was isolated from noses or fingers of nurses after duty but was gone before their next day's duty; short-term nasal carriage, seen on occasion in 4 of these 12 nurses, when EMRSA carriage was detected on two consecutive screens; and persistent nasal carriage, seen in 1 nurse only, when the EMRSA was seen on more than two consecutive occasions. All but one of these incidents of carriage could be explained by close patient, rather than environmental, exposure and occurred despite an intensive control programme. Transient or short-term carriage in nurses probably resulted in transfer of the EMRSA between patients. Staff decontamination should be considered following a period of cohort nursing of EMRSA patients, especially if staff members are shortly to nurse unaffected patients. Our findings may explain some of the difficulties in controlling EMRSA.

Air Microbiology↗
PubMed1986

Scrum kidney: epidemic pyoderma caused by a nephritogenic Streptococcus pyogenes in a rugby team.

In December, 1984, an outbreak of pyoderma affected five scrum players in the St Thomas' Hospital rugby team. The causative organism, Streptococcus pyogenes, was acquired during a match against a team experiencing an outbreak of impetigo, and was transmitted to two front row players of another team a week later, and to two girlfriends of affected St Thomas' players a month later. The strain was M-type 49, tetracycline-resistant, and virulent. It caused salpingitis in a girlfriend and acute glomerulonephritis in one rugby player. No case of subclinical glomerulonephritis was detected in eight patients with pyoderma. Screening of the St Thomas' Hospital team revealed four further cases of non-streptococcal skin infection, with evidence for contemporaneous spread of Staphylococcus aureus. Teams should not field players with sepsis, and it may be advisable to apply a skin antiseptic to traumatised skin after the match.

Acute Disease↗
PubMed1986

Strategies for typing and properties of epidemic methicillin-resistant Staphylococcus aureus.

Isolates of 17 strains of epidemic methicillin-resistant Staphylococcus aureus from outbreaks in ten hospitals in the UK were investigated with a variety of techniques both to explore their properties and to type them in order to confirm or refute known or suspected epidemiology. The techniques consisted of a biotyping system, peptidoglycan analysis, testing of antibiotic sensitivity to 21 agents, various phage-typing methods including heat shock, plasmid pattern analysis, and heat cure derivation of plasmid-less isogenic strains. All strains resembled those originally isolated in Australia, being in the possession of a large number of chromosomal resistance factors, pigmentation, ability to produce lipase and large molecular weight plasmids (c.15 Md to c.23 Md) which conferred resistance to gentamicin, propamidine, ethidium bromide, cetrimide and chlorhexidine. Some strains also had a c.3 Md plasmid conferring chloramphenicol resistance and others a c.1 Md cryptic plasmid. A large percentage of the population was resistant to 25 mg/l methicillin at 37 degrees C, an unusual feature. All the strategies, with the exception of peptidoglycan analysis, contributed to typing of the strains.

Bacteriophage Typing↗
PubMed1980

Evaluation of amikacin dosage regimes in the low and very low birthweight newborn.

The recommended neonatal dosage regime for amikacin of 15 mg/kg/day was found to be unsatisfactory in four neonates and a loading dose of 10 mg/kg did not improve levels in two further newborns with normal renal function. Fourteen neonates on 20 mg/kg/day regime achieved satisfactory levels; peak values were 21.5 +/- 4.5 microgram/ml and trough levels 3.34 +/- 2.05 microgram/ml. Peak time ranged from 17 to 60 minutes and varied with the dose given. The half-life was related to plasma creatinine, urea, post-natal age and weight. Thirteen neonates with pre-existing renal impairment were managed by alteration of dosage interval or quantity given. Side-effects were confined to eosinophilia in six infants, and no definite nephrotoxicity or gross eighth nerve damage was demonstrated.

Amikacin↗