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Biomedical subjects

D S Ford

Publications and source records attributed to D S Ford.

At least 19 recordsLinked to original sources
PubMed2001

Contamination of gowns, gloves, and stethoscopes with vancomycin-resistant enterococci.

OBJECTIVE: [corrected] To measure directly the rate of contamination, during routine patient examination, of gowns, gloves, and stethoscopes with vancomycin-resistant enterococci (VRE). SETTING: A large, academic, tertiary-care hospital. PATIENTS: Between January 1997 and December 1998, 49 patients colonized or infected with VRE were entered in the study. DESIGN: After routine examination, the examiner's glove fingertips, gown (the umbilical region and the cuffs), and stethoscope diaphragm were pressed onto Columbia colistin-nalidixic acid (CNA) agar plates with 5% sheep blood plus vancomycin 6 pg/mL. The stethoscope diaphragm was sampled again after cleaning with a 70% isopropanol wipe. RESULTS: VRE were isolated from at least 1 examiner site (gloves, gowns, or stethoscope) in 33 (67%) of 49 cases. Gloves were contaminated in 63%, gowns in 37%, and stethoscopes in 31%. All three items were positive for VRE in 24%. One case each had stethoscope and gown contamination without glove contamination. Only 1 (2%) of 49 stethoscopes was positive after wiping with an alcohol swab. Contamination at any site was more likely when the patient had a colostomy or ileostomy. Patients identified by rectal-swab culture alone were as likely to contaminate their examiners as were those identified by clinical specimens. CONCLUSIONS: Our study revealed a high rate of examiner contamination with VRE. The similar risk of contamination identified by surveillance and clinical cases reinforces concerns that patients not known to be colonized with VRE could serve as sources for dissemination. Wiping with alcohol is effective in decontaminating stethoscopes.

Academic Medical Centers↗
PubMed1999

International reference reagents: antihuman globulin. An ISBT/ICSH joint working party report. International Society of Blood Transfusion. International Committee for Standardization in Haematology.

An international working party has conducted a study designed to select a suitable reference reagent for antihuman globulin, to replace those first made available in 1987. The chosen preparation contains levels of anti-IgG and anti-C3 (anti-C3c and anti-C3d) potency that are considered suitable to serve for reference when evaluating either polyspecific antihuman globulin reagents or those containing their separate monospecific components. The reference material is available in 2-ml freeze-dried aliquots from seven assigned distribution centres.

Coombs Test↗
PubMed1997

Emergence and dissemination of a highly vancomycin-resistant vanA strain of Enterococcus faecium at a large teaching hospital.

We prospectively identified patients at the Massachusetts General Hospital from whom vancomycin-resistant enterococci (VRE) were isolated from a clinical specimen from 1 January 1991 through 31 December 1995. VRE strains were available from 139 (82%) of the 169 patients with clinical cases. Of these, 39 (28%) were identical or closely related by pulsed-field gel electrophoresis (i.e., VRE type A strain), including 38 (43%) of 89 VRE strains in 1995. By multivariate analysis, acquisition of the VRE type A strain was associated with receipt of clindamycin (odds ratio [OR] = 10.5), 15 or more days of hospitalization before the first isolation of VRE (OR = 2.9), and residence on one of the general medical floors (OR = 7.8). The VRE type A strain was a vanA strain of Enterococcus faecium and was highly resistant to all antimicrobial agents tested except chloramphenicol. These findings document the rapid dissemination of a highly resistant strain of E. faecium among patients and among other extant VRE strains at the Massachusetts General Hospital in 1995.

Adolescent↗
PubMed1996

Burkholderia cepacia respiratory tract acquisition: epidemiology and molecular characterization of a large nosocomial outbreak.

In 1994 we investigated a large outbreak of Burkholderia (formerly Pseudomonas) cepacia respiratory tract acquisition. A case patient was defined as any patient with at least one sputum culture from which B. cepacia was isolated from 1 January to 31 December 1994. Seventy cases were identified. Most (40 [61%]) occurred between 1 February and 31 March 1994; of these, 35 (86%) were mechanically ventilated patients, 30 of whom were in an intensive-care unit (ICU) when B. cepacia was first isolated. Compared with control patients who were mechanically ventilated in an ICU, these 30 case-patients were significantly more likely to have been ventilated for 2 or more days (30/30 v. 15/30; P < 0.001) or to have been intubated more than once (12/30 v. 2/30; OR = 9.3, 95% CI 1.6-68.8; P = 0.002) before the first isolation of B. cepacia. By multivariate analysis, the 35 mechanically ventilated case-patients were significantly more likely to have received a nebulized medication (OR = 11.9, 95% CI = 1.6-553.1; P < 0.001) and a cephalosporin antimicrobial (OR = 11.9, 95% CI = 1.6-553.1) in the 10 days before the first isolation of B. cepacia, compared with B. cepacia-negative control-patients matched by date and duration of most recent mechanical ventilation. Although B. cepacia was not cultured from medications or the hospital environment, all outbreak strains tested had an identical DNA restriction endonuclease digestion pattern by pulsed-field gel electrophoresis. Review of respiratory therapy procedures revealed opportunities for contamination of nebulizer reservoirs. This investigation suggests that careful adherence to standard procedures for administration of nebulized medications is essential to prevent nosocomial respiratory infections.

Adolescent↗
PubMed1995

The first example of anti-Gya detected in Hong Kong.

The incidence of anti-Gya is known to be extremely rare, and only a few examples have been reported in Japanese persons and in Caucasians. This case history reports the first example of anti-Gya detected in a Chinese person. The propositus is an 83-year-old male patient whose anti-Gya was revealed because of incompatibility of all units of blood tested by a saline indirect antiglobulin test (SIAT). Although the antibody had a titer of 512 by SIAT, 10 units of Gy(a+) red cells were transfused without any adverse effect.

Journal Article↗
PubMed1994

African American college students' health behaviors and perceptions of related health issues.

The authors identify specific health-related behaviors of African American college students and compare them with the students' perceptions of corresponding health issues. Among students surveyed, the rate of cigarette smoking (4%) was very low compared with smoking rates found in a national survey (14%); but alcohol consumption was relatively high (63%), although lower than the national average of 91%. More men than women smoked, but more women than men reported they drank alcoholic beverages. Most students (90.2%) said they did not usually eat breakfast, 73.6% reported that their diets were not nutritionally balanced, and the majority (55.4%) were not involved in daily physical activity. More than half (63%) of the students reported satisfactorily handling stress, and 74.1% indicated that they were sexually active. Respondents perceived the most important health issues facing college students as HIV/AIDS and sexually transmitted diseases (STDs), birth control, date rape, stress management, suicide, and alcohol and other drugs.

Adolescent↗
PubMed1994

A new low-frequency red cell antigen, 'SARAH'.

There are more than 100 low-frequency antigens (LFAs) which have been given International Society of Blood Transfusion (ISBT) numbers as members of systems, collections or the 700 series. In addition, there are a number of well-known (to reference laboratories) unpublished LFAs. The presence of an LFA was suspected when 2 sera were found to react with a single example of K homozygous cells. Anti-K reacting with K homozygotes was eliminated on testing with other KK cells. Testing of the reactive cell with antibodies to known LFAs and the reactive sera with cells known to carry LFAs failed to identify the specificity. A study on the family of the cell donor showed inheritance of the antigen in two generations. Further testing, which included immunoblotting and RFLPs, was carried out in Australia, the UK, Canada and the USA. By March 1993 all published LFAs had been excluded, and an application was made to the ISBT to have the antigen, SARAH, assigned a 700 series number. In April the number 700.052 was provisionally designated for this new antigen.

Adult↗
PubMed1992

Acute leukemia with t(1;3)(p36;q21), evolution to t(1;3)(p36;q21), t(14;17)(q32;q21), and loss of red cell A and Le(b) antigens.

At transformation of refractory anemia with ring sideroblasts to acute nonlymphocytic leukemia (ANLL) the bone marrow cells of a 75-year-old woman showed three different karyotypes, i.e., 46,XX,46,XX,t(1;3)(p36;q21) and 46,XX,t(1;3)(p36;q21),t(14;17)(q32;q21). She received no antileukemic therapy, and 1 year later, all her bone marrow cells were t(1;3)(p36;q21),t(14;17)(q32;q21). In association with the onset and first 11 months of ANLL, the platelet count increased 10-fold to a peak of 750 x 10(9)/L, providing further evidence that the t(1;3)(p36;q21) translocation causes stimulation of thrombopoiesis. Six months after transformation, her red cells showed reduced expression of A and Leb antigens. Serum alpha-n-3-acetylgalactosaminyl transferase (blood group A transferase) and red cell adenylate kinase were both reduced. The genes for both these substances are at 9q34, which suggests an abnormality here, although cytogenetically chromosome 9 appeared normal. This is the first case with t(1;3)(p36;q21) to show concurrent loss of red cell antigens and the first report detailing the course of untreated ANLL with t(1;3)(p36;q21).

ABO Blood-Group System↗
PubMed1992

Haemolytic disease of the newborn probably due to anti-ELO, an antibody to a low frequency red cell antigen.

Investigation of mild bilirubinaemia and a positive direct antiglobulin test in a 2 day old baby revealed that the mother's serum contained an antibody against the low frequency antigen ELO, which was present on the father's red cells. Family studies showed that the ELO antigen segregates from Rh, Gc, ADA and PGM1. The ELO antigen is enzyme resistant and therefore not likely to be part of the MNS or Duffy systems. No abnormalities were detected in immunoblotting studies. Although insufficient samples were available to attempt elution of the antibody from the cord cells, it is probable that this case represents the first reported haemolytic disease of the newborn due to anti-ELO.

Adult↗
PubMed1989

A family exhibiting the cis-AB genotype.

Studies on blood samples from a 30-year-old woman of Korean origin, her husband and children, showed the presence of the cis-AB genotype in the mother and one child. The cis-AB red cells showed abnormal reactions with both polyclonal and monoclonal anti-B reagents and an elevated level of H antigen. The serum contained weak anti-B that reacted with normal B antigen but not with that on cis-AB cells. Normal levels of A substance but reduced levels of B and H substances were present in the saliva. Conversely, the serum showed reduced A and normal B and H blood group transferase activity.

ABO Blood-Group System↗
PubMed1988

Replicate tests for the detection and correction of errors in anti-human globulin (AHG) tests: optimum conditions and quality control.

Replicate blind AHG tests with weak IgG anti-D sensitised red cells revealed that 32% of workers caused 5 per cent or more false negative errors by using excessive agitation in reading techniques. The common quality control procedure of adding strongly sensitised cells to all negative AHG tests cannot reveal this type of error. Furthermore, strongly sensitised control cells may create an illusion of safety because AHG giving a false negative test with weak antibody in a serum sample may still show a reassuringly strong positive in the control test. "In-house" assessment of all staff and automatic cell-washers by blind replicate tests is recommended as an effective way of improving AHG test performance, thus reducing many of the errors involving false negative AHG tests seen year after year in External Proficiency Trials.

Antibodies↗
PubMed1981

Acanthocytosis and haemolytic anaemia due to the McLeod blood group.

A fourteen-year-old boy presenting with marked acanthocytosis of the red blood cells and a compensated haemolytic anaemia was shown to have the McLeod blood type. Only three other individuals have been reported as having this abnormality of the Kell blood group system without evidence of chronic granulomatous disease. Serological typing for the McLeod phenotype should be undertaken in males with unexplained acanthocytosis, and CPK estimation may provide a screening test for this condition.

Acanthocytes↗
PubMed1977

A further example of Kp1/Ko exhibiting depression of some Kell group antigens.

This paper gives details of a family in which there are numerous examples of the heterozygous Kdegree state. The study was initiated by the presence of anti-Kpb in the serum of the propositus. Reactions with anti-K, anti-Ku, anti-Jsb and anti-K13 confirm that the Kdegree gene in trans with Kpa results in weaker expression of these Kell antigens. One example of anti-K showed some evidence of dosage effect with kKpb/Kdegree cells, but these results were not confirmed by quantitation studies.

Blood Group Antigens↗
PubMedDate not supplied

A case of polyagglutination with features of Th and Tk activation associated with an acquired B antigen.

A case is reported of polyagglutination with features of both Tk and Th activation associated with an acquired B antigen. Reactions with polybrene, Glycine soja, and Bandeiraea simplicifolia II indicated the presence of Tk activation. However, the reactivity of the patient's erythrocytes with Arachis hypogoea was greatly reduced by treatment with ficin, indicating the concomitant presence of Th activation.

ABO Blood-Group System↗
PubMedDate not supplied

A monoclonal anti-C4d that demonstrates a specificity related to anti-Ch.

A monoclonal anti-C4d reagent, L003, agglutinated untreated and trypsin-treated C4A Rodgers(Rg)- and C4B Chido(Ch)-coated red cells. Inhibition of the agglutination, regardless of the Rg/Ch phenotype of the C4 coat, showed Ch specificity, more precisely, for the Ch1 determinant. C4A allotypes that express Ch1 and Ch3 rather than Rg1 and Rg2, and C4B allotypes that express Rg1 rather than Ch1, Ch2, or Ch3 confirmed that the inhibition specificity in serologic tests was anti-Ch1 and not anti-C4B.

Animals↗