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C W Hoge

Publications and source records attributed to C W Hoge.

39 records · Page 3Linked to original sources

Use of a synthetic oligonucleotide probe to detect strains of non-serovar O1 Vibrio cholerae carrying the gene for heat-stable enterotoxin (NAG-ST).

A synthetic oligonucleotide probe was developed to identify the gene for the heat-stable enterotoxin (NAG-ST) of non-serovar O1 Vibrio cholerae. Of 103 non-O1 V. cholerae isolates from Thailand, 31 isolates from Mexico, and 47 isolates from patients in the United States, only 7 (all from Thailand) hybridized with the probe. Probe-positive strains produced significantly higher fluid accumulations in infant mice than probe-negative strains.

Amino Acid Sequence↗

Epidemiology and spectrum of Vibrio infections in a Chesapeake Bay community.

The clinical and epidemiologic features of vibrio infections occurring over 15 y in a hospital adjacent to the Chesapeake Bay were examined. Microbiologic techniques included the use of thiosulfate citrate bile salts sucrose (TCBS) medium on all stool specimens. Among 40 vibrio isolates from 32 patients, eight species were identified: V. parahaemolyticus (16), V. vulnificus (10), non-O1 V. cholerae (7), V. mimicus (3), V. hollisae (1), V. fluvialis (1), V. alginolyticus (1), and an unnamed halophilic vibrio. Sources included stool (13), wound (11), sputum (3), ear (3), bone (1), and gallbladder (1). While illnesses were diverse, they were relatively mild and self-limited with no mortality. The mild clinical spectrum and especially lack of mortality are in sharp contrast to the findings of previous reports. Even with the proximity to the bay and use of optimal isolation techniques, the demonstrated incidence of vibrio infections was low (1.6/100,000/y). The routine use of TCBS medium, which has been advocated for high-risk areas, was not cost-effective.

Adolescent↗

Enterococcal bacteremia: to treat or not to treat, a reappraisal.

The treatment of enterococcal bacteremia not associated with endocarditis has been controversial. We retrospectively reviewed 81 episodes of enterococcal bacteremia and categorized them as to their clinical significance, using a strict case definition. Of the 81 episodes, 41 met our criteria for clinical significance. Mortality was 51% among the 41 patients with clinically significant bacteremia and 50% among the 40 patients with bacteremia of uncertain clinical significance. Despite these equivalent overall mortality figures, antibiotic therapy specific for Enterococcus species was associated with reduced in-hospital mortality among patients with clinically significant infections (relative risk [RR] = 0.46, 95% confidence interval [CI] = 0.27-0.77); mortality was also reduced in the first 7 days after the detection of bacteremia, when death was relatively likely to be directly due to the bacteremic episode (RR = 0.17, CI = 0.04-0.74). The association between appropriate antibiotic therapy and reduced mortality remained statistically significant when adjustments were made for a number of other factors related to mortality, including age, underlying conditions, prior use of antibiotics, nosocomial acquisition, polymicrobial etiology, prior surgery, and source of infection. Thus enterococcal isolates from the blood, even when of doubtful clinical significance, are poor prognostic markers associated with high mortality. However, when the clinical significance of bacteremia is defined by strict criteria, specific therapy against Enterococcus species is associated with improved outcome.

Adult↗