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Biomedical subjects

H Chmel

Publications and source records attributed to H Chmel.

At least 37 records · Page 2Linked to original sources
PubMed1988

Serratia odorifera biogroup 1 causing an invasive human infection.

Serratia odorifera biogroup 1 was isolated from the blood and urine of an alcoholic male with cirrhosis and signs of septic shock. The organism is rarely reported to occur in clinical specimens. This is the first case in which the organism was found to be responsible for invasive human infection.

Aged↗
PubMed1986

Importance of exfoliatin toxin A production by Staphylococcus aureus strains isolated from clustered epidemics of neonatal pustulosis.

Clustered epidemics of pustulosis due to Staphylococcus aureus occurred in two geographically distant newborn nurseries. In nurseries A and B an attack rate of pustulosis of 0.8 and 2.0 cases per 100 live births occurred, respectively. Experimental phage type 1046/1116 belonging to phage group II dominated clustered epidemics in nursery A, while group II phage type 3A/3C/55/71 and 3A/3C/55 occurred in nursery B. Other group II strains also occasionally produced clustered epidemics. These epidemic strains were found to be making heat-stable dermal exfoliatin toxin A (ETA) which had a pI of 6.8 and a molecular weight of 32,000 and 33,000. ETA-bearing strains did not make bacteriocin. Children infected with ETA-producing strains developed extensive bullous pustulosis. Surveillance cultures of personnel revealed an ETA-bearing strain in only one person. This strain was not the same phage type as the epidemic cluster. In contrast, ETA-bearing epidemic strains were found in the inanimate environment of both nurseries. ETA protein acts as an important virulence factor in the production of neonatal pustulosis infection and appears to be linked with the ability of S. aureus organisms to stick to the inanimate environment.

Animals↗
PubMed1986

Graft infection and bacteremia with a tolerant L-form of Streptococcus sanguis in a patient receiving hemodialysis.

I report a case of a tolerant L-form Streptococcus sanguis infection involving an artificial vascular access site that was probably acquired from a nonhuman source; this is the first report of such an infection in a human. Gram stains from the infected access site and blood cultures revealed an aberrant form which could only be recovered by passage through hypertonic sucrose media before being reisolated and subsequently identified as S. sanguis. The same organism was isolated from a pet dog of the patient. The organism was also felt to be tolerant to penicillin. The patient was successfully treated by removal of the artificial graft and intravenous erythromycin therapy. Microorganisms acquired from nonhuman sources are potential pathogens in the immunocompromised patient.

Aged↗
PubMed1985

Recovery of blood-borne bacteria from human urine.

Recovery from the urine of organisms causing bacteraemia may depend on the bacterial species involved. The survival of the more common species of bacteria which cause bacteraemia was examined in human urine, serum and normal saline. All species survived well or grew in serum. Haemophilus influenzae, Streptococcus pneumoniae, Streptococcus sanguis and group A streptococci were killed in all urine samples. The number of colony-forming units of Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus and group B streptococci either remained the same or increased in the urine, while the numbers of Escherichia coli and Klebsiella pneumoniae increased rapidly. These data suggest that the observed differences in recovery from urine of these bacterial species that cause bacteraemia are related to the viability of the species in human urine.

Bacteria↗
PubMed1984

Antibiotic monitoring as a surveillance tool for nosocomial infections.

A programme for surveillance of nosocomial infections utilizing antibiotic review was developed and carried out at Saint Barnabas Medical Center, Livingston, New Jersey, USA. Over a 6-month period 1083 charts were reviewed on the surgical units by an infection control practitioner utilizing two methods of surveillance for nosocomial infections. The first method utilized positive laboratory cultures, admission data and head nurse interviews. The second method used a prevalence study of all surgical patients on antibiotic therapy and all positive culture reports. A comparison of both methods revealed that all nosocomial infections were realized using antibiotic review. It was also noted that 16.2 per cent of nosocomial infections were missed by not using antibiotic review as a surveillance tool. We also noted that the overall percentage of patients with nosocomial infections not cultured was 10.5 per cent. Our conclusions were that antibiotic review is a useful instrument that can successfully be incorporated into any currently existing infection control surveillance programme.

Anti-Bacterial Agents↗
PubMed1984

Fungal and yeast infections of the central nervous system. A clinical review.

In the past 20 years, there has been a marked increase in the number of reported cases of meningitis and brain abscess due to fungi and yeasts. This increase is due in part to better diagnostic techniques and greater awareness of the possibility of fungal invasion of the nervous system; but the increase can also be attributed to a growing pool of severely compromised hosts, many of whom are undergoing treatment with adrenal glucocorticoids or immunosuppressive agents. The diagnosis and treatment of aspergillosis, blastomycosis, candidiasis, coccidioidomycosis, cryptococcosis, infections caused by dematiaceous fungi, histoplasmosis, paracoccidioidomycosis, petriellidosis, and sporotrichosis, as well as relatively rare infections of the central nervous system caused by other fungi, are discussed. The efficacy of amphotericin B and 5-fluorocytosine in the treatment of CNS fungal and yeast infections is also evaluated.

Adult↗
PubMed1984

Recurrent streptococcal cellulitis complicating radical hysterectomy and radiation therapy.

Reported is a rare complication of radical hysterectomy and radiation therapy, recurrent streptococcal cellulitis. Two patients had 14 episodes over a nine-year period, characterized by high fever and systemic toxicity. The streptococcal cellulitis was atypical in its presentation and its causative organism. The rash was bilateral in patches, flat, irregular in outline, and without induration. The causative microorganisms, a group B and G streptococcus, were isolated from blood and skin cultures. Therapy in such patients may have to be prolonged because of the alterations in normal anatomy resulting from surgery and radiation.

Cellulitis↗
PubMed1983

Humoral reactions in human endocarditis due to Streptococcus bovis: evidence for a common S bovis antigen.

Humoral reactions to native culture filtrates of Streptococcus bovis were studied in patients with endocarditis by means of two-dimensional crossed immunoelectrophoresis. Serum from patients with S bovis endocarditis produced eight different precipitin arcs. Lex antigen cross-reacted with sera from patients with viridans streptococcal endocarditis, and TA antigen cross-reacted with ribitol teichoic acid-positive sera from patients with Staphylococcus aureus bacteremia. One antigen, common (c), was immunoreactive with all 10 sera from S bovis-infected patients. Antibody to this antigen was not found in sera from 77 patients with gram-positive bacteremia or in 29 other control sera. Common (c) antigen was found in all strains of S bovis isolated from patients. Rabbits immunized with formalinized S bovis cells of human origin also produced antibody to common (c) antigen. Common (c) may be an important antigen of S bovis and may in fact define this organism serologically.

Aged↗
PubMed1983

The significance of eubacterium bacteremia.

Eubacterium is a commensal of the human gastrointestinal tract. In rare instances this organism can become blood-borne. Nine cases of bacteremia were described and eight cases were found in the medical literature. Thirteen of the 17 cases (76%) had active gastrointestinal disease leading to the Eubacterium bacteremia. It is suggested that recovery of Eubacterium in blood culture should alert the clinician to the possibility of active gastrointestinal disease including occult neoplasms.

Adolescent↗
PubMed1982

Studies on multi-antibiotic resistant strains of Staphylococcus aureus.

Twenty-seven isolates of Staphylococcus aureus were found to be resistant to methicillin, nafcillin, tobramycin, gentamicin, amikacin, cefoxitin, clindamycin, erythromycin and chloramphenicol by disc diffusion testing and tube dilution studies; they were sensitive to cefamandole, cephalothin and vancomycin by disc testing. A discrepancy between minimum inhibitory and bactericidal concentrations was noted for the cephalosporins which was not appreciated on disc testing. All isolates were very sensitive to rifampin (minimum bactericidal concentration 0.3 mg/l). All isolates were susceptible to phage type 83A. A subpopulation of variant small-colony forms of Staphylococcus aureus was recovered when superinhibitory amounts of aminoglycosides and methicillin were used. The variant Staphylococcus aureus strains retained the same antibiotic susceptibility patterns and phage type as their parent strain of Staphylococcus aureus. Further studies are in progress concerning these isolates and their impact on the hospital flora at our institution.

Anti-Bacterial Agents↗
PubMed1982

Superinfection: another look.

Superinfection in the compromised host often poses a diagnostic and therapeutic dilemma for the physician who is concerned that a perplexing array of microorganisms might be involved. We believe that the differential diagnosis list can often be narrowed considerably by separating superinfection in the compromised host into five convenient categories: (1) infections due to the underlying disease itself; (2) infections due to the underlying disease plus therapy for that disease; (3) infections due solely to medicaments, operations, or procedures; (4) infections increased in severity but probably not in incidence; and (5) societally related infections. Use of this or a similar categorization should result in a more rational approach to differential diagnosis, should encourage a more focused diagnostic work-up, whould reduce the necessity for invasive procedures, should provide the microbiology laboratory information about specific organisms that should be sought sedulously, and should permit the selection of a more rational antimicrobial regimen prior to the availability of definitive microbiologic information.

Adult↗
PubMed1982

Serum immunoglobulins in Guillain-Barré syndrome.

Serum major class immunoglobulin concentrations were measured in 162 patients with Guillain-Barré Syndrome (GBS) and 85 normal controls. Significant elevations of IgM, A and G were found in the GBS group. Forty-four of 162 GBS patients (27%) had IgM concentrations greater than two standard deviations above the control mean. GBS patients with high serum IgM were young and 68% showed serologic evidence of recent infection with DNA core agents, cytomegalovirus, Epstein-Barr virus, or Mycoplasma pneumoniae. Longitudinal studies in seven patients with elevated serum IgM revealed that clinical improvement was accompanied by a marked decline in serum IgM. IgA and IgG changes were less consistent. Our findings indicate that the serum immunoglobulin response in GBS is polyclonal and follows the usual pattern seen in infections and other conditions with an immune component.

Adult↗
PubMed1981

Serum levels of arabinitol in the detection of invasive candidiasis in animals and humans.

Arabinitol is a pentitol generated in large quantitites by several species of Candida, including Candida albicans. The level of arabinitol in the sera of infected animals and humans was determined by gas-liquid chromatography of an acetone extract of the serum. Experimentally infected mice with pyelonephritis due to C. albicans had elevated levels of arabinitol; rabbits with pyelonephritis did not have elevated levels, nor did rabbits with catheter-induce cystitis, but rabbits with endocarditis developed elevated levels of arabinitol shortly before death. A prospective study in patients clinically suspected of having invasive candidiasis failed to show elevated levels of arabinitol in most. Mice and patients not colonized or infected with yeasts but with renal failure had high serum levels of arabinitol. The data indicate that an elevated level of arabinitol in the serum of a patient without renal disease is suggestive of invasive candidiasis, but normal serum levels do not contradict the diagnosis.

Adult↗