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Biomedical subjects

D F Looke

Publications and source records attributed to D F Looke.

17 recordsLinked to original sources
PubMed2001

The relationship of a clonal outbreak of Enterococcus faecium vanA to methicillin-resistant Staphylococcus aureus incidence in an Australian hospital.

Australian isolates of vancomycin-resistant enterococci (VRE) have been widely scattered geographically, predominantly polyclonal and of the VanB phenotype. Forty-nine VRE were isolated from 47 patients in our hospital from October 1996 to December 1999. Forty-four of these VRE were Enterococcus faecium with a vanA glycopeptide resistance genotype. Four isolates were pathogenic. Thirty-five VRE were from an outbreak in the Renal and Infectious Diseases Units over a four-month period. Pulsed-field gel electrophoresis (PFGE) demonstrated that 41 of the 49 VRE were indistinguishable or closely related. Enhanced environmental cleaning, strict contact isolation of colonized patients and reducing inpatient admissions terminated the epidemic. Cohorting of methicillin-resistant Staphylococcus aureus (MRSA)-positive patients was restricted because VRE patients occupied the isolation facilities. This resulted in a statistically significant increase in MRSA infections across the hospital. VRE epidemics have the ability to influence the epidemiology of other nosocomial pathogens when infection control resources are exhausted.

Australia↗
PubMed2001

Hypercalcaemia and elevated 1,25(OH)(2)D(3) levels associated with disseminated Mycobacterium avium infection in AIDS.

Hypercalcaemia may complicate granulomatous diseases, such as tuberculosis and sarcoidosis, and various AIDS-related opportunistic infections and malignancies. We report here two patients with AIDS and disseminated Mycobacterium avium infection who developed symptomatic hypercalcaemia several weeks after commencing antimycobacterial chemotherapy, and in whom inappropriately elevated 1,25(OH)(2)D(3)levels were documented. Although vitamin D supplementation may have contributed, no other cause for the hypercalcaemia was found. The biochemical and clinical similarities between these cases and other hypercalcaemic granulomatous diseases suggest a common mechanism related to macrophage activation and dysregulated vitamin D production.

AIDS-Related Opportunistic Infections↗
PubMed1999

Endemic nosocomial gram-negative bacteraemias resulting from contamination of intravenous heparin infusions.

Following several cases of Gram-negative bacteraemia secondary to intravenous heparin infusion contamination, we retrospectively reviewed nosocomial bacteraemias associated with heparin infusions at our institution. Thirty-one episodes of heparin-infusion related bacteraemia occurred in 30 patients over a 23-month period affecting 2% patients receiving heparin infusions for more than 48 h. Gram-negative bacteria were responsible for all bacteraemias. The care of infusions during clinical use was prospectively surveyed, revealing that approximately 20% of lines and cannulae were left for more than 72 h before replacement, and significant discordance occurred between line replacement and syringe and cannula exchange. We concluded that contamination of the infusions was probably extrinsic and secondary to manipulations of the system during use. Prolonged usage and discordant exchange of infusion components were likely important factors in initial contamination and subsequent bacterial proliferation. The problem resolved following the introduction of a policy for routine and simultaneous replacement of lines and syringes at 24-h intervals and upon cannula exchange.

Anticoagulants↗
PubMed1998

Three cases of dengue 1 virus infection from islands in the Gulf of Thailand.

Three Australian tourists who recently travelled to islands in the Gulf of Thailand developed febrile illnesses associated with myalgias, thrombocytopenia, and atypical lymphocytosis. Dengue 1 virus was isolated from all three patients. The patients' clinical features and serological and virological investigations are presented. These cases highlight the need for awareness of dengue amongst travellers and the preventive precautions required when visiting endemic regions. After the urgent exclusion of malaria, dengue should be considered in the differential diagnosis of febrile persons who have recently returned from endemic regions.

Adult↗
PubMed1996

Delay in appropriate therapy of Legionella pneumonia associated with increased mortality.

The prognostic significance of delayed therapy in Legionnaires' disease is poorly defined. Thirty-nine consecutive serologically confirmed cases of Legionnaires' disease were reviewed to examine whether an association exists between delayed therapy and prognosis. Clinical and laboratory factors predictive of mortality were also sought. Thirty-one cases (79%) were classified as having severe pneumonia at diagnosis. Thirty-six patients (92%) had community-acquired infection, and three patients (8%) had nosocomial disease. Ten patients died, resulting in a crude mortality rate of 26%. At the first assessment, variables noted for pneumonia associated with death were low diastolic blood pressure (p < 0.02), low serum albumin concentration (p < 0.04), and increased number of days from onset of pneumonia to hospitalisation (prodrome) (p < 0.02). However, multiple logistic regression analysis revealed that the prodrome was the only variable noted at diagnosis that achieved significance (p = 0.024). Mortality also correlated with both delay in the initiation of erythromycin therapy following admission (p < 0.001) and the total delay in starting erythromycin therapy (p < 0.001). It is therefore recommended that erythromycin be included early in the empiric therapy of severe community-acquired pneumonia.

Adult↗
PubMed1991

Corneal ulceration due to Nocardia asteroides.

A case of corneal ulceration due to infection with Nocardia asteroides is described. Microbiological examination of corneal scrapings permitted accurate diagnosis and suggested appropriate therapy. Nineteen other cases that have been described in the world literature are reviewed.

Adult↗
PubMed1990

Travellers' diarrhoea.

Travellers' diarrhoea may affect up to 50 per cent of travellers to developing countries. It is now known to be caused by a large number of different organisms with enterotoxigenic Escherichia coli as the major pathogen. By eating and drinking prudently, travellers can hope to reduce the chances of being affected. They should also be equipped with a strategy of rehydration and specific treatment so that the impact of the illness can be kept to a minimum.

Adult↗
PubMed1986

Weil's syndrome in a zoologist.

Weil's syndrome is an unusual form of leptospirosis in Australia. A case of Weil's syndrome in a zoologist is described and an Australian native animal identified as the probable source of the infection. People who are in close contact with Australian native fauna should take precautions to minimize their exposure to leptospires.

Adult↗
PubMed1984

Role of the lemon in disseminated candidiasis of heroin abusers.

The occurrence of several small outbreaks of disseminated candidiasis among heroin abusers in Australia suggests that a common source for infection was present in each incident. Because in all outbreaks so far described lemon juice has been used to dissolve heroin powder before injection, we decided to examine the ability of lemon juice to support the growth of Candida albicans. Lemons which were experimentally inoculated with small numbers of C. albicans promoted the rapid growth of the organism at room temperature. We propose that clinical infection results from the intravenous injection of a large inoculum of C. albicans from contaminated lemon juice. This is supported by the simultaneous occurrence of the disease in three drug abusers. We also propose that the lemon was contaminated by the heroin abusers, as disseminated candidiasis occurred only after the lemon was used a second time after being left at room temperature for one week.

Adult↗