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J E Bross

Publications and source records attributed to J E Bross.

7 recordsLinked to original sources
PubMed1994

Risk factors for Clostridium difficile stool cytotoxin b among critically ill patients: role of sucralfate.

To identify risk factors other than antimicrobial exposure for Clostridium difficile stool cytotoxin b, subjects admitted to critical care units over 18 months and who had stool cytotoxin assays were evaluated. Twenty-two cases (cytotoxin b-positive) were compared with 125 controls (cytotoxin b-negative). Cases and controls were similar with respect to age, sex, therapeutic index severity score, duration of hospitalization before cytotoxin b testing, and antimicrobial exposure. Adjusted odds ratios (OR) revealed white blood cell count of > 12,000 on the day of stool sampling (OR, 4.0; 95% confidence interval [CI], 1.3-12.4) and sucralfate exposure (OR, 0.15; 95% CI, 0.05-0.42) as significant independent positive and negative risk factors, respectively. Sucralfate exposure may decrease risk for C. difficile stool cytotoxin b by interfering with its detection, altering toxin production, or inhibiting colonization by the organism. Additional evaluation is needed to elucidate the mechanisms involved.

Aged↗
PubMed1993

Risk factors for urinary lithotripsy-associated sepsis.

OBJECTIVES: To identify risk factors for sepsis following urinary extracorporeal shock wave lithotripsy (ESWL). DESIGN: Retrospective case-control study with two control groups. SETTING: A rural, 570-bed, regional referral center. RESULTS: Six cases (four bacteremias and two fungemias) were compared with two sets of 18 controls. Cases had a higher frequency and number of urinary tract infections prior to the procedure and tended to have larger stone size. CONCLUSIONS: Patients undergoing ESWL who are at high risk for infectious complications may be identified by preprocedure evaluation. Such patients may require alternative prophylactic regimens and close postprocedure follow-up.

Bacteremia↗
PubMed1990

Pyogenic sacroiliitis in a rural population.

We describe 10 cases of pyogenic sacroiliitis occurring in a rural population. Seven were male and 3 were female with a mean age of 22.4 years. None was a recent intravenous drug abuser. Five patients had a history of recent pelvic trauma. 99mTechnetium scintiscans revealed increased sacroiliac (SI) joint uptake in 8 of 8 cases. Blood cultures were positive in 60% of patients. Staphylococcus aureus was isolated in 7 cases from blood and/or SI aspirates and Hemophilus influenzae type B in one case. Nine of 10 patients recovered completely. One underwent arthrodesis for recurrent SI pain without evidence of relapse of infection. Median followup was 18 months.

Adolescent↗
PubMedDate not supplied

Nocardial meningitis: case reports and review.

Twenty-eight episodes of nocardial central nervous system infection fulfilling criteria for meningitis were reviewed. In 21 cases Nocardia was cultured from cerebrospinal fluid (CSF). Associated predisposing conditions were present in 75% of cases. The typical presentation was subacute to chronic meningitis characterized by fever (68%), stiff neck (64%), and headache (55%). CSF studies revealed neutrophilic pleocytosis (83% of cases, greater than 500 white blood cells/mm3), hypoglycorrhachia (64%, less than 40 mg of glucose/dL), and elevated protein level (61%, greater than 100 mg/dL). In 43% of cases there was an associated brain abscess. Patients with brain abscess had more frequent and severe aberrations in mental status as well as higher initial white blood cell counts in CSF. Mortality was 52% for the 23 cases diagnosed antemortem and 57% overall. Compared with patients who died, survivors were younger, had lower initial CSF glucose levels, and were less likely to have brain abscess. Diagnosis was often delayed, and nocardial infection was rarely suspected before positive culture reports or autopsy findings became available.

Adult↗