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D S Gilmore

Publications and source records attributed to D S Gilmore.

21 records · Page 2Linked to original sources

Pseudomonas aeruginosa and Klebsiella pneumoniae on the perinea of males with spinal cord injuries.

Pseudomonas aeruginosa colonization is found in a high percentage of males with spinal cord injury. The perineum is the body site most frequently colonized, and specific serotypes may persist for weeks. We examined patients for the presence of P. aeruginosa and Klebsiella pneumoniae on the perineum and adjacent body sites by using contact plates. P. aeruginosa, K. pneumoniae, or both were cultured from perineal swabs of 22 male patients. Wells (2.5 cm2) containing agar medium selective for these organisms were used to examine samples from 32 sites adjacent to the perineum in each patient. P. aeruginosa was most frequently cultured from samples taken from the perineum, the scrotum, and the penile shaft. K. pneumoniae isolation was more variable; this organism was most commonly found on the perineum and scrotum. Rectal swabs, obtained through a proctoscope, were positive for P. aeruginosa in four of eight patients with this organism on the perineum and positive for K. pneumoniae in eight of nine patients with this organism on the perineum. These studies more clearly define the extent of the colonization of the perineum and adjacent body sites which provides potential reservoirs of P. aeruginosa and K. pneumoniae.

Humans↗

Effects of bathing on Pseudomonas and Klebsiella colonization in patients with spinal cord injuries.

This study of Pseudomonas aeruginosa and Klebsiella pneumoniae colonization in humans with spinal cord injuries who were using the external urinary collection system showed that meticulous bathing with the bar soap issued by the hospital did not eliminated colonization and was frequently associated with the shifting of these bacteria to adjacent sites on the body. Bacterial counts of the skin showed that bathing did reduce the numbers of P. aeruginosa and K. pneumoniae found on the skin surface and temporarily eliminated these bacteria from some sites. The persistence of these organisms for long periods, even when patients were meticulously bathed, indicates that P. aeruginosa and K. pneumoniae may become part of the resident flora in these patients.

Bacteriuria↗

Low mortality among patients with spinal cord injury and bacteremia.

We reviewed 103 episodes of bacteremia in 93 patients with spinal cord injury who had bacteremia during initial hospitalization (39 patients) or readmission (54 patients) during 1978-1988. Eighteen episodes (18%) were due to polymicrobial infections. Urinary tract infections (47%), infected pressure areas (19%), and pneumonia (9%) were the most frequent primary infections and sources of the bacteremia. The bacteria most frequently associated with urinary tract infections were enterococci (26%), Escherichia coli (26%), Pseudomonas species (20%), and Klebsiella pneumoniae (12%). Bacteria most frequently isolated from patients with infected pressure areas were anaerobes and Staphylococcus aureus. Bacteremia was the cause of death for 8 patients (9%). The urinary tract was identified only once as the source of gram-negative bacteremia in an immunocompetent patient who died. The reason for the low mortality in patients with spinal cord injury is unclear.

Adolescent↗