PubMed Health⌕ Search

Biomedical subjects

I C Bowler

Publications and source records attributed to I C Bowler.

At least 19 recordsLinked to original sources
PubMed2001

Prevalence of glycopeptide and aminoglycoside resistance in Enterococcus and Listeria spp. in low microbial load diets of neutropenic hospital patients.

Low microbial load diets for patients with haematological malignancy were examined for enterococci and listeria using pre-enrichment, enrichment and selective plating. Enterococci were highly prevalent and their ecology diverse; 100/211 samples yielded 132 isolates made up of 67 strains distinguishable by PFGE. Listeria monocytogenes was not found. Screening of enterococci for antibiotic resistance showed low level vancomycin resistance (6-12 microg/ml) in six isolates of E. gallinarum and high level streptomycin resistance (> or = 1000 microg/ml) in eight isolates from various foods. No strains showing high level glycopeptide or gentamicin resistance were found. The high prevalence of enterococci in food processed for safety indicates a possible route for the acquisition of antibiotic-resistant strains by vulnerable hospital patients.

Aminoglycosides↗
PubMed2001

Evaluation of a patient-empowering hand hygiene programme in the UK.

Partners in Your Care, a patient education behavioral model for increasing handwashing compliance and empowering the patient with responsibility for their care was evaluated in an acute care hospital in Oxford, UK. A controlled prospective intervention study comparing medical and surgical patients was performed. Ninety-eight patients were eligible for the study. Thirty-nine patients (40%) agreed to participate in the programme Partners in Your Care by asking all healthcare workers who were going to have direct contact with them "Did you wash your hands?" Compliance with the programme was measured through soap/alcohol usage and handwashings per bed day before and after its introduction. Partners in Your Care increased handwashing on average 50%. Healthcare workers washed hands more often with surgical patients than with medical (P< 0.05). Alcohol gel was used on less than 1% of occasions. Sixty-two percent of patients in study felt at ease when asking healthcare workers "Did you wash your hands?" Seventy-eight percent received a positive response (washed hands). All patients asked nurses, but only 35% asked physicians. Partners in Your Care increased handwashing compliance in the UK. This programme empowers patients with responsibility for their care, provides infection control staff with a continuing means for providing handwashing education without additional staff and can save costs for a hospital.

Hand Disinfection↗
PubMed2000

Successful treatment of Rhodococcus equi pulmonary infection in a renal transplant recipient.

The rhodococcus is a mycobacterium-like organism which is normally a pathogen in foals. It usually spreads by direct contact or by aerosol from horse faeces and causes pyogranulomatous pulmonary infections. Occasionally, it acts opportunistically to infect immuno-compromised human hosts, most commonly those with the acquired immune deficiency syndrome (AIDS). Here we report a pulmonary infection by Rhodococcus equi in a renal transplant recipient who was successfully treated. The literature on this infection in transplant recipients is also reviewed with respect to manifestations and treatment.

Actinomycetales Infections↗
PubMed1999

Outcome following haemodialysis catheter-related Staphylococcus aureus bacteraemia.

Staphylococcus aureus is a frequent cause of haemodialysis access-related bacteraemia. The propensity for this organism to seed from the bloodstream to distant sites is well recognized, but the rate at which this occurs is poorly defined in patients with removable haemodialysis catheters. This retrospective study identified 47 patients with 50 episodes of S. aureus haemodialysis catheter-related bacteraemia between August 1993 and December 1995. Adverse events were recorded until February 1996. Thirty of 50 episodes (60%) were apparently uncomplicated. Bacterial seeding to heart valves or distant sites was documented in eight episodes (16%), of which six occurred during antibiotic therapy. A further 12 patients had persistent bacteraemia in the absence of a defined focus of infection, the last positive blood culture ranging from 2-19 days (mean 6.6, median 5) after removal of the haemodialysis catheter and commencing appropriate antibiotic treatment. The serious nature of this infection confirms the need for prevention, together with effective strategies for investigation and treatment in this patient population.

Adult↗
PubMed1998

The diagnosis of large joint sepsis.

The microbial aetiology of large joint sepsis is changing now that joint replacement therapy is becoming common place. The clinical history and examination may give important clues about the likelihood of infection and the possible involvement of unusual organisms. Newly introduced technology to improve the sensitivity of tests for the presence of micro-organisms in synovial fluid has not yet made a significant contribution to routine management. New imaging techniques such as magnetic resonance imaging are likely to improve patient management, but their utility is still under assessment. Arthroscopic biopsy to obtain material for culture and histology is particularly important in suspected chronic septic arthritis. Prosthetic joint infections present a particular challenge to microbiologists since the organisms involved are often found in small numbers and are common skin contaminants. Optimal microbiological management involves the taking of multiple (> or = 5) samples, careful processing to resuscitate organisms whilst avoiding contamination, and careful interpretation of results in the light of the clinical and histological picture.

Acute Disease↗
PubMed1998

Treated bacterial endocarditis as a histological mimic of fungal infection.

Histological assessment of cardiac valve tissue contributes to the diagnosis of infective endocarditis and is of particular importance in cases in which no organism is cultured. Antibiotic treatment of bacterial endocarditis may lead to abnormal bacterial morphology and staining characteristics. Although in many cases the presence of some residual bacteria of normal appearance makes the diagnosis straightforward, in some only abnormal bacteria may be seen. Unless the appearances of these are interpreted with caution, the presence of larger spherical organisms with the staining properties of a yeast may lead to an erroneous diagnosis of fungal infection.

Anti-Bacterial Agents↗
PubMed1996

The value of cerebrospinal fluid enrichment culture in the diagnosis of acute bacterial meningitis.

The records of cerebrospinal fluid (CSF) examinations for the three-year period ending 30 September 1991 were studied retrospectively. From 3,161 examinations, 66 pathogens were detected, 64 of which were from primary agar plate culture. Enrichment broth culture yielded 219 isolates of which 217 were likely contaminants. Only two pathogens were isolated by enrichment, and in both samples the CSF leucocyte counts were abnormal. The use of enrichment broth culture should be confined to CSF specimens with abnormal leucocyte counts and/or Gram stains.

Acute Disease↗
PubMed1996

When should healthcare workers be screened for methicillin-resistant Staphylococcus aureus?

The role of screening of healthcare workers (HCWs) in the control of methicillin-resistant Staphylococcus aureus (MRSA) is controversial. It is recommended in guidelines by expert groups in both North America and the United Kingdom, although the role of MRSA carriage by HCWs in outbreaks is not clearly defined. The present report describes the spread of a distinct strain of MRSA to patients by a single HCW on three separate occasions over 27 months. The isolates from this HCW and patient contacts were shown to be indistinguishable by antibiogram and repetitive extragenic palindromic polymerase chain reaction (REP/PCR); none were typeable by lytic phage-typing. Throat carriage of the MRSA probably recurred in this HCW, despite attempts to eradicate it on three occasions. Over the same period, nine other small clusters were seen in the Oxford Hospital Group, involving 66 patients and 22 HCWs colonized, or occasionally infected, with a variety of MRSA strains. In none of these instances could HCWs be implicated in the initiation of an outbreak. The advantages of a screening policy include the determination of the full extent of MRSA-colonization and work exclusion; the disadvantages include detection of transient nasal carriage, disruption of staff routine and stigmatization. Screening of HCWs can be a valuable tool in the control of MRSA outbreaks but it should be used selectively. This strategy remains an important part of a control programme.

Cost-Benefit Analysis↗
PubMed1996

Native-valve endocarditis caused by Staphylococcus lugdunensis.

Coagulase-negative staphylococci cause about 5% of native-valve endocarditis. Staphylococcus lugdunensis, a recently-described species of coagulase-negative staphylococci, has been reported to cause destructive native-valve endocarditis with a high mortality. We report four consecutive cases of definite Staphylococcus lugdunensis native-valve endocarditis by the Duke criteria over a 4-year period. All patients required urgent aortic valve replacement 1-5 days after admission, and recovered. An intriguing, aspect in the presentation of these patients was a history of vasectomy and inguinal skin breaks in the immediate period preceding the occurrence of endocarditis.

Adult↗