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Biomedical subjects

E Seneviratne

Publications and source records attributed to E Seneviratne.

5 recordsLinked to original sources

Emergence of further serotypes of multiple drug-resistant Streptococcus pneumoniae in Queensland.

We describe 27 cases of multiple drug-resistant pneumococcal infection in Queensland children (7 cases) and adults (20 cases), between February 1995 and October 1996. Seven patients had invasive disease. Serotypes were those commonly associated with paediatric infections and included types 19F (15 strains), 14 (6), 23F (4), 6A (1) and 19A (1). No rifampicin or vancomycin resistance was encountered. However, pneumococci fully resistant to cotrimoxazole, erythromycin and tetracycline were isolated from 25 of 27 cases (93%). Strains with high level resistance to penicillin and chloramphenicol were also recovered from 16 (59%) and 19 (70%) patients respectively. Twelve of 16 penicillin-resistant isolates showed intermediate resistance to ceftriaxone and two strains were fully resistant to this antibiotic. Clones of types 19F and 14 pneumococci, each with two distinctive resistance patterns, appear to be established in south-east Queensland.

Adult

Transfusion related HIV infection: the Wellington experience.

A case of transfusion-related AIDS is described which is believed to be the first published case to occur in New Zealand in a nonhaemophiliac patient. The human immunodeficiency virus (HIV) positive donor was shown to be the source of infection in five further HIV positive recipients.

Acquired Immunodeficiency Syndrome

Relapse of antibiotic associated colitis: endogenous persistence of Clostridium difficile during vancomycin therapy.

This study reports 24 patients with antibiotic associated colitis due to Clostridium difficile. Fifteen patients were treated with vancomycin due to the severity of the colitis and in eight of these a clinical relapse of the colitis occurred after vancomycin therapy was stopped. Bacteriological investigations of these patients indicated that C difficile was able to persist in stool samples during vancomycin therapy in the absence of detectable cytotoxin. This was in contrast with the seven patients successfully treated with vancomycin without relapse, and those not treated with vancomycin where both stool cultures and cytotoxin assays became negative. These results suggest that patients being treated with vancomycin for antibiotic associated colitis due to C difficile should have stool cultures done during and after treatment. Persistence of the organism in the absence of detectable cytotoxin may identify those patients who relapse and lead to either recommencement of vancomycin or alternative therapeutic approaches.

Adolescent

Contamination and crossinfection with Clostridium difficile in an intensive care unit.

An outbreak of pseudomembranous colitis in an intensive care unit is described. This resulted in environmental contamination by Clostridium difficile. The outbreak could be traced to one patient who received several antibiotics over the preceding three months. A search was conducted for asymptomatic carriers among patient and staff but none were found. Aquisition of C. difficile from inanimate environmental sources was the most probable means of transmission of the organism. Its persistence in the hospital environment for several weeks, most likely as spores, suggests that patients who develop pseudomembranous colitis should be isolated, especially in areas of high antibiotic usage.

Aged