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Biomedical subjects

J A Ulrich

Publications and source records attributed to J A Ulrich.

At least 19 recordsLinked to original sources

Antimicrobial effect of chlorhexidine and povidone-iodine on vaginal bacteria.

The antimicrobial potency of 4 per cent chlorhexidine gluconate was compared with that of 10 per cent povidone-iodine (1 per cent free iodine) on the vaginal bacteria of 150 premenopausal, non-pregnant women. From 30 of the women blood samples were taken before and at either 15, 30 or 60 minutes after vaginal cleansing with chlorhexidine for chlorhexidine analysis. Five minutes after applying either chlorhexidine or povidone-iodine almost 99 per cent of bacteria present on the lateral wall of the vagina were killed. Chlorhexidine was significantly more effective than povidone-iodine. Serosanguineous , mucoid or white-yellowish vaginal discharge did not alter the effectiveness of either antimicrobial agent. In contrast to povidone-iodine, vaginally applied chlorhexidine was not absorbed in measurable amounts (sensitivity of detection method: 0 X 1 mg/l) into the bloodstream. Chlorhexidine may therefore prove of value for treating vaginitis especially during pregnancy and also for combating microbes such as Group B streptococci which are potentially harmful to the newly-born child.

Absorption↗

Comparison of 4% chlorhexidine gluconate in a detergent base (Hibiclens) and povidone-iodine (Betadine) for the skin preparation of hemodialysis patients and personnel.

The abnormal cutaneous flora of hemodialysis (HD) patients might contribute to their frequent septic complications. We compared the effects of 13 wk of Betadine and 13 wk of Hibiclens on the skin flora of HD patients and personnel. Skin cultures were obtained weekly immediately prior to the disinfection, preceding each triweekly HD treatment, and monthly, at 2 and 4 hr postdisinfection. Total bacterial counts from predisinfection cultures were not significantly altered over either 13-wk treatment period. Hibiclens reduced total bacterial counts (p less than 0.01) and eradicated cutaneous staphylococci (p = 0.032) at both 2 and 4 hr postdisinfection significantly more than did Betadine. No reduction of staphylococcal sensitivity to either germicidal agent could be demonstrated. Neither agent was associated with severe adverse reactions and Hibiclens could not be detected in the blood. Hibiclens appears to offer short-term advantages over Betadine in the HD setting because of significantly longer duration of antibacterial activity.

Allied Health Personnel↗

Nasal and cutaneous flora among hemodialysis patients and personnel: quantitative and qualitative characterization and patterns of Staphylococcal carriage.

Staphylococcal sepsis is a leading cause of morbidity and mortality among chronic hemodialysis (HD) patients. We studied nasal and cutaneous flora of HD patients and personnel and their patterns of staphylococcal carriage. HD patients had significantly increased cutaneous total bacterial colony counts (p less than 0.01) as well as both nasal (p less than 0.0001) and cutaneous (p less than 0.0001) carriage of Staphylococcus aureus compared to personnel. Cutaneous staphylococcal carriage could be significantly correlated with nasal carriage (p less than 0.01). Cutaneous streptococcal species and gram-negative bacilli were not different between patients and personnel. Staphylococcal phage typing of nasal isolates from staphylococcal carriers revealed a mean of 90% of isolates from each subject belonging to a predominant phage type. Predominant nasal staphylococcal phage types corresponded with respective predominant cutaneous phage types in 93% of HD patients carriers. These studies substantiate autoinoculation of S. aureus from the nasal vestibule to the skin overlying the vascular access site.

Adolescent↗

Vaginal absorption of povidone-iodine.

In 12 nonpregnant women, total iodine, protein-bound iodine, inorganic iodine, and thyroxine values were measured in serum before and 15, 30, 45 or 60 minutes after a two-minute vaginal disinfection with povidone-iodine (Betadine). Only 15 minutes after application, serum iodine levels were raised and remained significantly elevated 30, 45 and 60 minutes after disinfection. Serum concentrations of total iodine and inorganic iodine were increased up to fivefold to 15-fold, respectively; during the relative short period of observation, thyroxine levels were not altered. An overload of iodine can suppress thyroid hormonogenesis, and the fetal and neonatal thyroid glands are especially sensitive. In pregnant women, vaginitis should not be treated with povidone-iodine because of the possible development of iodine-induced goiter and hypothyroidism in the fetus and newborn. The risk is especially high when povidone-iodine is used repeatedly.

Absorption↗

A bacteriologic basis for the clinical presentations of necrotizing enterocolitis.

A study to identify putative bacterial pathogens in infants with necrotizing enterocolitis (NEC) was begun in 1976. Cultures of blood and of peritoneal fluid obtained by paracentesis were carried out in 25 infants with NEC. Segments of intestine excised at operation were Gram stained. Of the 25 infants, 8 recovered with medical management and 17 required operations. The 8 medically treated infants had sterile peritoneal fluid and, with 2 exceptions, sterile blood cultures. Of the 17 operated infants, 16 had bacteria in their blood and/or peritoneal fluid. The majority of resected bowel specimens from these infants contained a confirmatory morphologic type of bacterium within the wall. The clinical course of 8 infants with clostridia was compared to that of 8 infants with gram-negative enteric bacteria (Klebsiella, E. coli, or Bacteroides fragilis). The infants with clostridia were sicker. They had more extensive pneumatosis intestinalis, a higher incidence of portal venous gas, more rapid progression to gangrene, and more extensive gangrene. Infants with gram-negative rods had lower birth weights and lower platelet counts than the clostridial group. The difference in mortality between the two groups was not significant. The inherent pathogenicity of the gut flora may influence the clinical course of NEC. Among infants who develop intestinal gangrene, the clostridia appear to be more virulent than gram-negative enteric bacteria.

Clostridium↗

Fatty acids of dermatophytes.

The cellular fatty acids (C11-C20) from 18 species and strains within the genera Microsporum, Trichophyton, and Epidermophyton were determined by gas liquid chromatography. In addition, the effects of incubation time and temperature on fatty acid composition were investigated in selected species. The dermatophytes investigated represented anthropophilic, geophilic, and zoophilic species. Linoleic (18:2), oleic (18:1), and palmitic acid (16:0), accounted for 83.6-94.5% of the fatty acids of dermatophytes. Fatty acid composition and degree of unsaturation did not show any correlations with taxonomic status or ecological group. Incubation time influenced fatty acid composition slightly, but tendencies towards unsaturation and chain elongation were not observed. Elevated incubation temperature (37 degrees C) tended to increase the degree of total fatty acid unsaturation.

Animals↗

Bacterial contamination of an automated water path B-scanner.

Water path delay B-scanners are subject to bacterial contamination of the water bath. The most predominant organism has been Pseudomonas aeruginosa. To date, such contamination has not been eradicated completely. A rigid program of maintenance and surveillance is necessary to protect patients.

Pseudomonas aeruginosa↗

Antimicrobial effect of chlorhexidine on bacteria of groin, perineum and vagina.

The antimicrobial effects of two chlorhexidine preparations, Hibiclens and Hibitane Tincture, were evaluated in 154 obstetric patients. Both agents produced bacterial kills of over 99% on skin bacteria of groin and perineum ten and 30 minutes after their application. Five minutes after vaginal cleansing with Hibiclens more than 99% of bacteria originally present were destroyed. Even though both preparations proved to be potent bactericidal agents, Hibitane Tincture cannot be recommended as a perigenital antiseptic since it causes vulvar irritation due to its high isopropanol content. With Hibiclens application to groin and perineal skin no side effects were observed. In one of 51 patients treated vaginally with Hibiclens a rather strong burning sensation occurred, without any aftereffect. Hibiclens seems to be a promising antiseptic for obstetric and gynecologic patients.

Antisepsis↗

Comparison of over-the-counter agents for tinea pedis.

To evaluate the relative effectiveness of the treatment of tinea pedis, we performed a double-blind study comparing undecylenic acid ointment, tolnaftate cream, and a placebo. Ninety patients with clinically and mycologically proven tinea pedis took part in this clinical trial. Our results showed both agents to be superior to the placebo, but there was no significant difference in effectiveness between the two active agents. We observed no side effects with the preparations used.

Clinical Trials as Topic↗

Fulminant necrotising enterocolitis associated with Clostridia.

5 infants with no growth of bacteria on cultures of blood and peritoneal fluid recovered from necrotising enterocolitis after medical treatment alone. 12 infants with positive cultures required surgery. 5 of these 12, who did not harbour clostridia, had a mild clinical course and all 5 survived segmental bowel resection. The 7 infants who harboured clostridia had a more severe clinical course and 4 died. In 3 of 4 infants with Clostridium perfringens, the necrotising enterocolitis was fulminant, characterised by severe pneumatosis intestinalis, extensive gangrene, early intestinal perforation, and a fatal outcome.

Ascitic Fluid↗

Topical clotrimazole in tinea pedis.

Clotrimazole is a new antifungal agent which is effective topically in dermatophytosis, cutaneous candidiasis, and tinea vesicolor. The authors performed a controlled double-blind clinical trial comparing topical clotrimazole with its vehicle in the treatment of 66 patients with dermatophytic infections of the skin of the feet. Clotrimazole proved to be effective in the treatment of tinea pedis of both the interdigital and the plantar hyperkeratotic types.

Administration, Topical↗