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Biomedical subjects

H Thadepalli

Publications and source records attributed to H Thadepalli.

At least 109 records · Page 6Linked to original sources
PubMed1979

Principles and practice of antibiotic therapy for post-traumatic abdominal injuries.

Improved surgical techniques, the use of modern antibiotics and better understanding of the microbiologic characteristics of abdominal sepsis have lead to a satisfying clinical outcome in instances of abdominal trauma which once meant almost certain death. Yet many questions remain unanswered. Future development of several newer antibiotics may further improve the rate of complications. A study of host defense mechanisms may provide additional clues to prevent long term morbidity. Hopefully, future studies will encourage the use of a single antibiotic in the treatment of abdominal trauma. While the newer antibiotics are being investigated, certain older antibiotics, such as penicillin, chloramphenicol and tetracycline, merit additional evaluation under controlled, prospective, randomized, comparative clinical trials.

Abdomen↗
PubMed1979

Anaerobic infections of the female genital tract.

The anaerobic flora of the cervix undergoes cyclic change during menstruation and pregnancy. The etiopathogenesis of anaerobic infections of the female genital tract is described. The in vitro susceptibility of the cervical microflora to various antibiotics presented and treatment of anaerobic infections of the female genital tract briefly is discussed.

Abortion, Septic↗
PubMed1979

Skin and soft tissue polymicrobial infections from intravenous abuse of drugs.

Skin and soft tissue infections were studied in 21 seriously ill narcotic addicts who had been admitted to hospital. Subcutaneous abscesses were present in 14 patients; cellulitis was noted in 3, pyomyositis in 2 and necrotizing fasciitis in 2. In four patients there was septicemia. Infections in 14 patients (66.6 percent) were associated with anaerobic bacteria, which were the exclusive isolates in 6 patients. In seven patients (33.3 percent) isolates were exclusively aerobic bacteria and in eight both aerobes and anaerobes were present. The anaerobic isolates were clostridia (six), peptostreptococci (five), bacteroides (five), peptococci (three), and one of each of Veillonella, Propionibacterium, Eubacterium, Fusobacterium and Actinomyces. Staphylococcus aureus, generally thought to be the most common cause of subcutaneous infections in addicts, was found only in four (19 percent) patients. The other aerobic isolates were Klebsiella (five) and Enterobacter (four) species. When clinical features or the Gram stain of pus suggest that anaerobic bacteria may be present, antibiotic therapy should be directed against both aerobic and anaerobic bacteria until culture results are available.

Abscess↗
PubMed1978

Microflora of the cervix during normal labor and the puerperium.

The normal flora of the cervix was studied in 50 healthy women in labor and on the third day postpartum. Aerobic bacteria were the exclusvie isolates in 25% of these women, and 75% had anaerobic bacteria in addition to aerobes. Anaerobes were always found in association with aerobes. The most frequent isolate of Bacteroides was Bacteroides melaninogenicus, found in 20% of the women during labor and 14% during the puerperium. Bacteroides fragilis was distinctly absent during labor but was found in 6.8% of the women during the puerperium. Clostridia were found in 1% but histotoxic clostridia were not found. None had gram-negative diplococci (Neisseria or Veillonella). Gram-negative diplococci and spore-bearing bacilli visible by gram strain and B. fragilis demonstrated by culture, if present in the cervical specimens obtaineduring labor, should be considered abnormal.

Bacteria↗
PubMed1978

In vitro activity of cefaclor against aerobic and anaerobic bacteria.

Cefaclor (CCL), a new cephalosporin, was tested in vitro against 602 (271 anaerobic and 331 aerobic) clinical isolates in comparison with cephalothin, cefazolin, cephradine, and cefamandole. Sixteen micrograms of CCL per ml inhibited 68% of all aerobes tested and 80% of the 211 enteropathogenic organisms (Escherichia coli, Salmonella, and Shigella) isolated from cases of infantile diarrhoea. CCL inhibited 88% of gram-positive anaerobic cocci and 72% of Bacteroides other than B. fragilis at a concentration of 16 mug/ml. B. fragilis and Clostridia were resistant to CCL. Increased inoculum of E. coli from 10(5) to 10(9) increased the minimal inhibitory concentration of CCL and cefamandole by fourfold against 7 of the 64 strains tested. All seven were beta-lactamase negative. No antimicrobial synergism was noted between CCL and penicillin. The in vitro efficacy of CCL, an oral cephalosporin, against enteropathogenic E. coli, if proven safe, may be tested in vivo against such infections.

Aerobiosis↗
PubMed1978

Antimicrobial effect of amniotic fluid.

The antimicrobial effect of amniotic fluid (AF) obtained during the first (AF1) and second (AF2) trimesters was compared with the third (AF3) against anaerobic bacteria, such as Bacteroides fragilis ss. fragilis (6 strains), Eubacterium lentum (3 strains), and Peptostreptococcus anaerobius (4 strains). Escherichia coli (5 strains) served as a positive control. AF1 supported the growth of all 4 anaerobes (except B fragilis for 4 hours) for the entire 24-hour period tested. AF2 supported the growth of E coli and B fragilis for 24 hours but temporarily inhibited P anaerobius and E lentum. In contrast, AF3 inhibited all bacteria tested for 8 hours or more. It is concluded that AF1 is the least inhibitory, AF3 the most, and AF2 intermediate for the organisms tested. Lack of antimicrobial effect of AF on anaerobic bacteria may be one explanation for the higher incidence of anaerobic infections during absortion than during the prenatal period.

Amniotic Fluid↗
PubMed1978

Amniotic fluid contamination during internal fetal monitoring.

The risk of infections associated with intrauterine fetal monitoring was evaluated in 30 consecutive labors. Amniotic fluid samples collected through the intrauterine catheter were found to be contaminated with bacteria in 15 of 30 consecutively monitored patients during labor. Aerobes were the exclusive isolates in eight, anaerobes in five and both in two patients. Eleven patients developed puerperal fever. One patient developed gonococcal amnionitis, and her newborn infant later developed gonococcal septicemia. The equipment--catheters and fetal scalp electrodes--was sterile. The overall risk of infection associated with internal monitoring in our study was 50% for amniotic fluid contamination and 37% for puerperal febrile morbidity.

Adolescent↗
PubMed1978

Diagnostic clues in metastatic lesions of endocarditis in addicts.

Gram stains and cultures of multiple extravascular sites showed the infecting organisms in 17 of 26 heroin addicts with endocarditis. In addition to routine blood cultures, the etiologic agent was cultured from Osler nodes and Janeway lesions in ten patients, subcutaneous abscesses in eight, pleural fluids in eight, joint aspirates in three, spinal fluids in three, pericardial fluids in two, muscle abscesses in two and endometrium in one patient. Gram-positive cocci were found in extravascular lesions in 11 of 12 patients with staphy-lococcal endocarditis and from as many as four different sites. In contrast, no Gram-positive cocci were seen in extravascular sites in any of eight patients with enterococcal endocarditis although six of them had peripheral lesions. Gram stain and culture of multiple extravascular sites appears to provide a valuable early clue to the nature of the etiologic agent in addict endocarditis.

Diagnosis, Differential↗
PubMed1978

Evaluation of carbenicillin and a comparison of clindamycin and gentamicin combined therapy in penetrating abdominal trauma.

Results of this study suggest that an antibiotic or antibiotics to be effective in abdominal trauma must cover both aerobic and anaerobic bacteria. A single drug, such as carbenicillin, appears to serve this purpose. If one is allergic to penicillin, then clindamycin along with gentamicin can be used. The routine use of an aminoglycoside in abdominal trauma is unnecessary. Aminoglycoside should be added to carbenicillin therapy only in patients with Klebsiella infections. Furthermore, we also support the recommendation made by others that antimicrobial therapy of abdominal trauma should begin preoperatively.

Abdominal Injuries↗
PubMed1978

Ticarcillin disodium in anaerobic infections.

Twenty-five patients were treated with ticarcillin disodium, 18 of whom had anaerobic infections that included pleuropulmonary infections (seven), mandibular osteomyelitis (four), perirectal abscess (two), sepsis, primary site unknown (one), liver abscess (one), pelvic abscess (one), decubitus ulcer (one), and synergistic gangrene (one). Seven had no anaerobic infections. Three had anaerobic septicemia. Culture results included anaerobes: peptococci (ten), peptostreptococci (ten), Bacteroides fragilis (six), Bacteroides not fragilis (ten), eubacteria (three), fusobacteria (two), Clostridium (one), Veillonella (one), and acidaminococcus (one); aerobes: Proteus (three), Klebsiella (two), Escherichia coli (two), and streptococci (two). Six patients with mixed aerobic infections initially received gentamicin sulfate in addition. The serum levels were 110 +/- 20 microgram/ml one hour after intravenous infusion of 5 g of ticarcillin disodium. All anaerobic isolates were susceptible at less than or equal to 100 microgram/ml and 85% by less than or equal to 25 microgram/ml of ticarcillin. Sixteen patients responded well to ticarcillin and two failed to respond. Our study suggests that ticarcillin is useful in the treatment of anaerobic infections.

Anaerobiosis↗
PubMed1977

Transtracheal aspiration in diagnosis of sputum-smear--negative tuberculosis.

Of 4,200 patients admitted to an acute-care county hospital, 126 (3%) were proved to have pulmonary tuberculosis, among whom 35 (28%) had several sputum smears negative for acid-fast bacilli. On transtracheal aspiration, 31 to 35 had acid-fast bacilli in the aspirate. Eighteen of these 35 (51%) patients had associated infections caused by aerobic or anaerobic bacteria. Tuberculin skin tests were negative in 14 of 35 patients with negative sputum specimens (40%). Ten of 18 patients (56%) with associated bacterial infections had negative skin tests to purified protein derivative. Smear and culture of transtracheal aspirate for tubercle bacilli may be invaluable in establishing the diagnosis when pulmonary tuberculosis is suspected.

Aerobiosis↗
PubMed1977

Antimicrobial effect of amniotic fluid against anaerobic bacteria.

Amniotic fluid samples were obtained at term and tested for their antimicrobial effect on anaerobes, Peptostreptococcus (Ps.) anaerobius, Peptococcus (Pc.) prevotii, Bacteroides (B.) fragilis, and B. coagulans with facultative Escherichia (E.) coli serving as control. Amniotic fluid had only temporary bacteriostatic effect on Pc. prevotii and B. fragilis for 8 to 16 hours. This effect lasted for only 8 hours on Ps. anaerobius. On the contrary, the bacteriostatic effect of amniotic fluid was well sustained on E. coli and B. coagulans, lasting for the entire test periods of 20 and 32 hours, respectively. At the end of the time intervals mentioned, Ps. anaerobius, Pc. prevotii, and B. fragilis exhibited logarithmic growth, confirming the earlier reports that it is not nutritionally deficient. Amniotic fluid exhibited temporary bacteriostatic effect on Ps. anaerobius, P. prevotii, and B. fragilis, but this effect was well sustained against B. coagulans.

Amniotic Fluid↗