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Biomedical subjects

H Thadepalli

Publications and source records attributed to H Thadepalli.

At least 127 records · Page 7Linked to original sources

Bacteriology of the human biliary tract and the duodenum.

Using the modern anaerobic transport media and meticulous culture techniques, 74 patients undergoing biliary tract surgery were studied. The biliary system was found to be sterile in 58 patients (78%). Fifteen patients had 35 isolates of aerobic and facultative bacteria. The most common ones were Klebsiella, Enterococcus, and Escherichia coli. The only anaerobe isolated was Clostridium perfringens. Eight of 17 patients (47%) with acute cholecystitis and five of 49 patients (10%) with chronic cholecystitis, harbored bacteria in the biliary system. This study suggests that anaerobes are rare in the human biliary system; therefore, if antibiotic therapy is considered, aerobic coverage should suffice.

Adolescent↗

In vitro activity of ticarcillin against anaerobic bacteria compared with that of carbenicillin and penicillin.

A total of 334 clinical anaerobic isolates were tested in an anaerobic glove box by the agar dilution technique for susceptibility to clinically achievable levels of ticarcillin, carbenicillin, and penicillin. Thirty-two micrograms or less of penicillin per milliliter inhibited 91% of all strains, whereas 100 mug of carbenicillin and ticarcillin per ml inhibited 95 and 98%, respectively. A total of 82% (85 strains) of Bacteroides were inhibited by penicillin, and 93 and 96% were inhibited by carbenicillin and ticarcillin, respectively. Thirteen (24%) of 55 strains of Bacteroides fragilis tested were resistant to 32 mug of penicillin per ml, and 6 (11%) and 3 (5%) were resistant to 100 mug of carbenicillin and ticarcillin per ml, respectively. Within the therapeutic range, ticarcillin was the most effective of the three penicillins tested against B. fragilis subsp. fragilis.

Anaerobiosis↗

Pulmonary mycetoma due to Coccidioides immitis.

Pulmonary mycetoma due to Coccidioides immitis has been reported on three occasions. The present case is the fourth such report occurring in a patient with widely disseminated disease. Spherules and hyphae were found in the specimen. While the active pulmonary and extra-pulmonary lesions responded well to therapy with amphotericin B, resection was required to eliminate the residual mycetoma and its attendant hemoptysis.

Adult↗

Osteolytic lesion indicating Pseudomonas sternal osteomyelitis.

Two cases of osteolytic lesion of the sternum were caused by Pseudomonas aeruginosa. Both were in heroin addicts, and both occurred as a delayed reaction to injury in an automobile accident. Bony curettage and appropriate antibiotic therapy were sufficient for diagnosis and cure. Tobramycin sulfate (3 mg/kg/day), a new aminoglycoside, was successfully used in both instances. Excision of the sternum was not necessary.

Accidents, Traffic↗

Rapid diagnosis of anaerobic infections by direct gas-liquid chromatography of clinical speciments.

Current methods to isolate and identify anaerobic bacteria are laborious and time consuming. It was postulated that the short-chain fatty acids (SCFA) produced by these organisms might serve as microbial markers in clinical material. 98 specimens of pus or serous fluid were analyzed by gas-liquid chromatography, and findings were compared with culture results. Good correlations were found for the recovery of anaerobic Gram-negative bacilli and the presence of isobutyric, butyric, and succinic acids. 19 of 20 specimens with significant amounts of these acids (greater than 0.01 mumol/ml) yielded bacteroides or fusobacteria. Culture of the single "false-positive" specimen failed to grow anaerobic Gram-negative bacilli, although clinical data and Gram-stain suggested their presence. 77 of 78 specimens which has insignificant concentrations of the marker acids failed to yield anaerobic, Gram-negative bacilli in culture. The single "false-negative" specimen yielded Bacteroides pneumosintes, an organism which does not ferment carbohydrates. It is concluded that direct gas-liquid chromatographic analysis of clinical specimens provides a rapid presumptive test for the presence of anaerobic, Gram-negative bacilli.

Bacterial Infections↗

Treatment of anaerobic pulmonary infections; carbenicillin compared to clindamycin and gentamicin.

Twenty-three patients with anaerobic infections of the lung were treated with either two antibiotics, clindamycin and gentamicin (11 patients) or with a single antibiotic, carbenicillin (12 patients). Cultures were obtained prior to therapy, either by transtracheal needle aspiration (17 patients) or thoracocentesis (six patients). Anaerobic bacteria were found in all. Fifteen patients had aerobic and facultative bacteria in addition. The anerobic isolates were peptostreptococci (12), peptococci (12), Bacteroides organisms (eight), clostridia (three), actinomycetes (two), eubacteria (one), and fusobacteria (one). Aerobes included streptococci (nine), enterococci (seven), Neisseria organisms (two), Klebsiella organisms (one), Citrobacter organisms (one), Pseudomonas organisms (one), Mycobacterium tuberculosis (two), and Nocardia (one). The two patients with pulmonary tuberculosis with anaerobic and superinfection received antituberculosis chemotherapy in addition. Therapeutic response was considered excellent in both groups. This suggests that carbenicillin may be used as a single antibiotic in the treatment of anaerobic and mixed infections of the lung.

Actinomycosis↗

Isolation of Clostridium in human infections: evaluation of 114 cases.

One hundred fifty-two strains of Clostridium were isolated from 144 patients over a 14-month-peroid. These included 23 recognized species and 23 strains that were unclassified. Soft tissues or abscesses yielded 84 strains of Clostridium. Intraabdominal sites predominated, but clostridia were recovered from empyema, carcinoma, frostbite with gas gangrene, muscle abscess, aortic graft, and brain abscess. Blood cultures yielded 65 strains of Clostridium from 49 patients, representing 0.3% of 16,314 blood cultures (or 2.6% of 2,168 positive cultures). Clostridium perfringens was most common in blood, accounting for 37 isolates (57%). Clostridial bacteremia was often unrelated to the clinical setting and was found in alcoholics with aspiration or Streptococcus pneumoniae pneumonia, pulmonary tuberculosis, empyema, meningococcemia, and infantile gastroenteritis. In 20 of the 49 patients (41%), aerobic or other anaerobic bacteria were cultured concurrently from the blood. Thus, clostridial bacteremia should be interpreted with caution since there may be little correlation with the patient's clinical condition.

Abscess↗