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Biomedical subjects

C L Golledge

Publications and source records attributed to C L Golledge.

At least 19 recordsLinked to original sources
PubMed1992

A case of human melioidosis originating in south-west Western Australia.

OBJECTIVE: To report the first human case of autochthonous melioidosis in temperate Australia (latitude 31 degrees 10'S) and to describe the extent of the presence of the causative agent, Pseudomonas pseudomallei, in southwest Western Australia. CLINICAL FEATURES: A 45-year-old man living on a hobby farm was admitted to hospital for investigation of lung lesions, weight loss and low grade fevers. P. pseudomallei was cultured from material from an aspiration biopsy of a mediastinal mass. INTERVENTION AND OUTCOME: The patient was successfully treated with a regimen of ceftazidime and trimethoprim-sulfamethoxazole. A review of epidemiological data showed that, since 1967, P. pseudomallei has been cultured from animals and soil in a region 50-250 km north-west of Perth, Western Australia, and that pockets of endemicity are found in the districts of Toodyay (where our patient's farm was), Chittering, Ballidu, Gidgegannup, Badgingarra, and Wongan Hills. CONCLUSION: The persistence of the bacterium in animals and soil in south-west Western Australia demonstrates abundantly that P. pseudomallei can exist opportunely beyond its traditional tropical habitat. It is likely that there will be further clinical cases of melioidosis originating in this region, and that the boundaries of endemicity in Australia will expand further.

Animals↗
PubMed1992

Vancomycin and teicoplanin: something old, something new.

OBJECTIVE: To compare and contrast the pharmacology, activity and clinical efficacy of two glycopeptide antibiotics, vancomycin and teicoplanin. DATA SOURCES: English language literature search using MEDLINE, Index Medicus, relevant textbooks and product information literature. STUDY SELECTION: Over 200 publications were examined extending back to the period of initial Phase I trials with vancomycin. DATA EXTRACTION AND SYNTHESIS: Many publications covered similar ground and came to the same conclusions. In these instances one or two of the best pieces were chosen as cited reference material. Conflicting results and conclusions are discussed and an attempt is made to interpret the findings. CONCLUSION: Vancomycin and teicoplanin show differences in activity both in vitro and in vivo. Vancomycin is superior against coagulase-negative staphylococci and reliable dosage regimens are available. Teicoplanin, however, needs to be given in significantly larger doses than initially thought necessary to maximise clinical efficacy. Teicoplanin has a lower incidence of side effects but in clinical practice this advantage is small. Vancomycin remains the glycopeptide of choice for the treatment of infections due to Gram-positive bacteria.

Anti-Bacterial Agents↗
PubMed1992

Ciprofloxacin and Clostridium difficile-associated diarrhoea.

Recent reports have implicated ciprofloxacin as a cause of Clostridium difficile-associated diarrhoea. This problem was examined in three ways. First, the MIC of ciprofloxacin for C. difficile was determined. The MIC range was 8-32 mg/L, with C. difficile were 'treated' with ciprofloxacin and clindamycin in a test-tube, and the growth of C. difficile monitored. The clindamycin-treated emulsions supported growth of C. difficile, while the ciprofloxacin-treated and control emulsions did not differ significantly and failed to support the growth of C. difficile. Finally, 213 patients on ciprofloxacin monotherapy were investigated. Twenty-nine patients were given ciprofloxacin as treatment for diarrhoea, while a further 15 patients developed diarrhoea while being treated. None of these 44 patients harboured C. difficile. Faecal samples from 73 of the remaining 169 patients who did not have or develop diarrhoea were investigated for C. difficile, but none was positive. It was concluded that ciprofloxacin is unlikely to promote C. difficile-associated diarrhoea.

Ciprofloxacin↗
PubMed1991

Corynebacterium minutissimum infection.

Two cases of infection due to Corynebacterium minutissimum are described. On the basis of biochemical tests the organisms were thought at first to be Corynebacterium jeikeium. Methods of distinguishing between these species and the role of C. minutissimum in the pathogenesis of erythrasma and other skin infections are discussed.

Adult↗
PubMed1991

Diarrheal disease due to Clostridium difficile in general practice.

A total of 288 stool samples from patients attending their general practitioners was examined for the presence of Clostridium difficile. C. difficile or its cytotoxin was found in 16 patients (5.5%) and was the most common enteric pathogen detected. Most patients had only mild to moderate diarrhea but in the majority of patients the diarrhea was protracted. Eleven of the 16 patients had received antimicrobial agents in the 3 mths preceding onset of diarrhea and there was good circumstantial evidence that 2 other patients had also been exposed. None of the patients had a history of any inflammatory bowel disease or possible occupational exposure. The prescribing habits of general practitioners with regard to antimicrobial agents were monitored for a 1 yr period. Tetracyclines and amoxycillin accounted for approximately 25% each of all prescriptions dispensed. Ten of the 16 patients were treated with antimicrobials (mainly metronidazole) and in most cases the diarrhea resolved. We conclude that C. difficile may be a significant cause of community-acquired diarrhea.

Adult↗
PubMed1990

Necrobacillosis--primary anaerobic septicaemia due to Fusobacterium necrophorum.

Necrobacillosis is a severe septicaemic illness caused by an anaerobic Gram-negative bacillus, Fusobacterium necrophorum. It occurs predominantly in young people and is characterised by oropharyngeal infection and subsequent metastatic complications, frequently involving the lungs and/or large joints. We report four recent cases in previously healthy young men, describing the clinical features of the disease (including autopsy findings), and the problems associated with diagnosis and treatment.

Adolescent↗
PubMed1990

Septicemia caused by vancomycin-resistant Pediococcus acidilactici.

A case of septicemia caused by vancomycin-resistant Pediococcus acidilactici is discussed. This appears to be the first reported case of septicemia caused by this organism. The characteristics and antimicrobial susceptibilities of this organism are described.

Bacterial Infections↗
PubMed1989

Extended spectrum cephalosporins and Clostridium difficile.

There is little information about how commonly the newer cephalosporins cause diarrhoea due to Clostridium difficile. In this study of 111 patients with C. difficile-associated diarrhoea, 106 had received antimicrobial agents in the four weeks before detection of C. difficile. The relative risk for each antimicrobial agent was greatest with clindamycin, followed by cefotaxime, cephamandole and ceftriaxone. There was no statistically significant difference in risk between the cephalosporins evaluated. Narrower spectrum penicillins, anti-pseudomonal penicillins and aminoglycosides were not potent inciting agents.

Cephalosporins↗
PubMed1988

Mycotic aneurysm of the thoracic aorta caused by Salmonella typhimurium.

A fatal case of mycotic aneurysm of the thoracic aorta is described. Salmonella typhimurium was isolated from blood cultures and from cultures of a post-mortem sample of the aneurysm. A review of the literature showed that while endovascular infection is a recognized complication of salmonellal septicaemia in the elderly, infection of the thoracic aorta by Salmonella spp. is rare. A combination of surgery and antibiotic therapy always is required for a successful outcome.

Aged↗