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Biomedical subjects

I E Graham

Publications and source records attributed to I E Graham.

7 recordsLinked to original sources

The effects of antiperspirant on the perineal skin flora of patients with spinal cord injury.

The relationship of pH and moisture to Pseudomonas aeruginosa and Klebsiella pneumoniae colonization of the perineal skin was studied in male patients with spinal cord injury. The increased pH of the perineal skin was significantly associated with the presence of P. aeruginosa but not other bacterial species. No correlation between colonization and moisture or pH and moisture was found. An antiperspirant produced a significant reduction in the number of total aerobic bacteria, total gram-negative bacilli, P. aeruginosa and K. pneumoniae over a 24-h period. Long-term use of the antiperspirant for 10 days did not alter the persistence of P. aeruginosa of the same serotypes on the perineum.

Adolescent↗

Colonization of patients with spinal cord injury with Pseudomonas aeruginosa and Klebsiella pneumoniae at different institutions.

Colonization of patients with Pseudomonas aeruginosa and Klebsiella pneumoniae was studied in patients with spinal cord injury at two institutions in Los Angeles County. The method of care of patients was similar at both institutions. A high prevalence of perineal colonization with P. aeruginosa and K. pneumoniae and similar serotypes of Pseudomonas were seen at both institutions. This colonization probably reflects the type of bladder management in patients with spinal cord injury. It would be of interest to examine other facilities to determine if colonization is influenced by techniques or local factors.

Adult↗

Klebsiella pneumoniae colonization in patients with spinal cord injury.

Klebsiella pneumoniae colonization of 53 patients with spinal cord injury was studied. Cultures of multiple body sites from patients, the environment, food, and hospital personnel were obtained. K. pneumonaie was cultured from one or more body sites in 46% of male patients. Significant bacteriuria was found in 10% of male patients. Positive cultures of the urethra and perineum for K. pneumoniae were significantly associated with the use of the external condom catheter (p less than 0.05, Fisher's exact test). K. pneumoniae colonization increased with length of stay in the hospital. Serotype 64, the predominant serotype found, was isolated only from patients who had been in the hospital for at least 4 wk and primarily in those patients using the external condom catheter. Urinary drainage bags were frequently colonized with K. pneumoniae at a time when the patients did not have significant bacteriuria. Colonized male patients were found to be the primary reservoir of K. pneumoniae and may serve as the major source for cross-contamination.

Female↗

Cefsulodin in treatment of Pseudomonas urinary tract infection in patients with spinal cord injury. Comparison with aminoglycosides.

Male patients with spinal cord injury and urinary tract infection with Pseudomonas aeruginosa were treated with cefsulodin (1.0 or 1.5 Gm) every six hours or an aminoglycoside (amikacin 5 mg/Kg or tobramycin 1 mg/Kg) every eight hours for seven days. The study was discontinued after treating 6 patients with aminoglycosides because of the poor results with these antibiotics. At five to nine days after completing treatment P. aeruginosa was eliminated from the urine of 12 to 15 patients (80%) treated with cefsulodin and 3 of 6 patients (50%) treated with an aminoglycoside. When examined at four to six weeks 5 of 15 (33%) of the cefsulodin group had persistent infection or relapse, while 5 of 6 (83%) infections treated with an aminoglycoside either persisted or relapsed. Cefsulodin was discontinued in 1 patient, known to be allergic to penicillin, because of hypersensitivity resulting in periorbital edema and rash. No other serious side effects were noted with cefsulodin or the aminoglycosides. These results indicate that cefsulodin is an effective antibiotic in the treatment of urinary tract infection with P. aeruginosa in patients with neurogenic bladder resulting from spinal cord injury and confirmed previous observations of a poor response of Pseudomonas urinary tract infection to aminoglycosides in this group of patients.

Adult↗

Category 1, 2, 3 and 4: a procedure-oriented isolation system.

A procedure-oriented isolation system, Category 1,2, 3, and 4, was introduced at a 547-bed, acute and rehabilitative medical center. The system consisted of four categories of isolation which followed a numerical sequence that represented the necessary attire needed to complete the procedure. After 1 year of use, personnel compared the procedure-oriented system with the previously-used system (Strict, Respiratory, Wound and Skin, Enteric, and Limited Barrier). Personnel found the procedure-oriented system easier to understand (84%) and follow (83%). Seventy-six percent felt their isolation techniques had improved with the new system. A reduction in the cross-infection rate with methicillin-resistant Staphylococcus aureus did coincide with the use of the new isolation system, however, no causal relationship was established. The Category 1, 2, 3, and 4 isolation system was well received by personnel and was found to be an effective alternative to the previous, more complicated system used in this setting. Further evaluation of this system in other settings would seem warranted.

California↗

Effect of antiseptic agents on skin flora of the perineum of men with spinal cord injury.

Male patients with spinal cord injury are frequently colonized with P. aeruginosa and K. pneumoniae on the perineum. Regular bathing with bar soap has not influenced this colonization. We have attempted to remove these bacteria using antiseptic agents. The number of P. aeruginosa, K. pneumoniae and total aerobic bacteria on the perineum and the penile shaft was determined before and after cleaning with bar soap, chlorhexidine, povidone-iodine and pHresh. Povidone-iodine and chlorhexidine had no advantage over bar soap or pHresh in the removal of P. aeruginosa or K. pneumoniae from the perineum of patients with spinal cord injury.

Adolescent↗

pH and water content of Pseudomonas aeruginosa- and Klebsiella pneumoniae-Colonized Perineal Skin of Men with spinal cord injuries.

Men with spinal cord injuries have a high incidence of Pseudomonas aeruginosa colonization of the perineum. Studies were carried out to determine whether colonization with Pseudomonas aeruginosa or Klebsiella pneumoniae is associated with changes in the pH or surface moisture of the perineal skin. Increased skin moisture correlated with a higher pH (P less than 0.01). In patients using the external urinary collection system, the pH was significantly higher on the perineum of patients colonized with P. aeruginosa or K. pneumoniae than on the perineum of patients not colonized with these bacteria. There was no correlation between moisture and colonization.

Humans↗