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Biomedical subjects

J H Andrew

Publications and source records attributed to J H Andrew.

At least 19 recordsLinked to original sources
PubMed1999

Bartonella henselae associated with Parinaud's oculoglandular syndrome.

Bartonella henselae was recovered from the conjunctival scraping of a 38-year-old woman who presented with a 2-week history of tender preauricular lymphadenopathy and a 1-day history of a red left eye. Dry adherent colonies were observed on agar plates at 21 days of incubation, and the isolate was identified through conventional and molecular tests. Polymerase chain reaction (PCR) amplification of a specific region of the 16S rRNA gene and confirmation by a separate PCR reaction with hybridization of the product with a B. henselae-specific probe confirmed the isolate as B. henselae. This is the first reported isolation of the causative agent of cat scratch disease from ocular tissue in a patient with Parinaud's oculoglandular syndrome.

Adult↗
PubMed1996

Preventing endoscopic retrograde cholangiopancreatography related sepsis: a randomized controlled trial comparing two antibiotic regimes.

Current antibiotic prophylaxis for endoscopic retrograde cholangiopancreatography (ERCP) is not standardized and may be inadequate. We aimed to evaluate the efficacy of 3 days of additional oral antibiotics in the prevention of ERCP-related sepsis. One hundred and fifty-six patients were randomized prospectively to receive either intravenous ticarcillin and clavulinic acid (Timentin; SmithKline Beecham, Dandenong, Victoria, Australia), pre-ERCP (group I) or Timentin and 3 days of oral amoxycillin and clavulinic acid (Augmentin; SmithKline Beecham, Dandenong, Victoria, Australia), group II). Blood cultures were taken 30 min after the procedure. The occurrence of sepsis, defined as a temperature over 38 degrees C, occurring in the first 7 days was recorded and the risk factors for the development of sepsis were evaluated. Four patients had significant positive blood cultures despite the prior administration of Timentin. Sepsis occurred in 10% of group I patients, but only 3% of group II patients (relative risk 3.30; 95% confidence intervals 0.74-14.8). The performance of sphincterotomy and the presence of common bile duct stones were significant risk factors for the development of sepsis. We would recommend 3 days of additional oral Augmentin after a single dose of intravenous antibiotics in patients at increased risk of sepsis, which would include those with bile duct stones and/or those undergoing a therapeutic procedure.

Amoxicillin↗
PubMed1995

Chlamydia trachomatis conjunctivitis. Prevalence and association with genital tract infection.

OBJECTIVES: To determine the prevalence of Chlamydia trachomatis in acute conjunctivitis (non-trachoma) in Australia and to examine the source of transmission. DESIGN: A prospective survey of 400 consecutive patients presenting with acute conjunctivitis to the Royal Victorian Eye and Ear Hospital Emergency Department, Melbourne, from May to November 1991. Patients identified with chlamydial conjunctivitis during the survey period and in the following two months were assessed for concomitant genital infection. RESULTS: Chlamydia was the causative organism in 2% of patients with acute conjunctivitis. Of 15 patients with chlamydial conjunctivitis, 11 presented with disease in one eye only, and the same number had had symptoms for longer than two weeks. Many had been seen previously by experienced ophthalmologists, yet there were long delays in making a definitive diagnosis. Ten of the 12 adult patients who were assessed had signs of concomitant genital tract infection, although none had past or current genital tract symptoms. Serotyping of chlamydial isolates from the genital tract and eye showed concordance in individual patients. CONCLUSION: Most cases of ocular chlamydia infection have a genital source. Therefore, it is essential that all patients with chlamydial conjunctivitis and their sexual partners are examined and treated for concomitant genital infection.

Acute Disease↗
PubMed1993

Bacteriology and drug susceptibility of tuberculosis at St Vincent's Hospital, Melbourne 1962-1991.

39,000 specimens were examined for the growth of Mycobacterium tuberculosis over a 27-year period (1962-1989) at St Vincent's Hospital, Melbourne. The culture positive rate was 2.0% overall but was as high as 3.5% for tissue specimens and less than 1% for specimens of pleural fluid. There were 329 culture positive patients over a 29-year period (1962-1991) of whom 34 (10.5%) yielded an isolate resistant to at least one anti-tuberculosis drug and 19 (5.8%) were resistant to isoniazid. An overall increase in the rate of drug resistance together with important ethnic group differences were noted.

Drug Resistance, Microbial↗
PubMed1993

Culture-positive tuberculosis at St Vincent's Hospital, Melbourne, 1962-1989.

The disease type and demography of patients with culture confirmed tuberculosis (TB) diagnosed at St Vincent's Hospital, Melbourne between the years 1962 to 1989 were reviewed. Four hundred and eighty-two patients with culture-positive TB were identified whose origins were as follows: Australia 194; Northern Europe 38; The Mediterranean 98; Asia 60 and other or unknown 92. Patients whose country of birth was in Asia or the Mediterranean area accounted for 57% of patients in the 1980s; they presented at a younger age, with a higher proportion of extrapulmonary disease and a more equal sex distribution than did Australian born patients. The main types of extrapulmonary disease also differed for the various ethnic groups. The overall proportion of patients with an isolate resistant to at least one of the anti-TB drugs was 10.0% but in the Asian born was 21.7%. This survey, the longest series of bacteriologically confirmed cases of TB reported from a single institution in Australasia, has identified several changes in how TB is presenting for diagnosis.

Adolescent↗
PubMed1993

Two fatal infections in immunocompromised patients caused by Scedosporium inflatum.

Two fatal infections caused by Scedosporium inflatum in immunocompromised patients are described. One patient developed peritonitis with this fungus 3 mths post renal transplantation. After a stormy course in the intensive care unit he eventually died. The other patient was suffering from non-Hodgkin's lymphoma and showed persistent neutropenia. Progressive deterioration occurred, and disseminated fungal infection was found at post mortem. Both isolates were resistant to all commonly available antifungal agents.

Aged↗
PubMed1992

Fatal disseminated Scedosporium inflatum infection in a neutropenic immunocompromised patient.

Disseminated infection with the fungus Scedosporium inflatum in a neutropenic patient with non-Hodgkins lymphoma presented with the triad of muscle tenderness, papular skin lesions and fever, and progressed rapidly to a fatal outcome. This represents the first reported instance of fatal widely disseminated infection with this organism, and demonstrates that the triad of presenting clinical features, formerly reported to be pathognomic of systemic candidiasis, can no longer be regarded as specific for infection with a particular species of yeast or fungus.

Aged↗
PubMed1992

Comparison of five methods, including the PDM Epsilometer test (E test), for antimicrobial susceptibility testing of Pseudomonas aeruginosa.

The antimicrobial susceptibilities of 100 clinical isolates of Pseudomonas aeruginosa to six antipseudomonal antibiotics were tested by five methods: the National Committee for Clinical Laboratory Standards (NCCLS) methods for broth microdilution, agar dilution, and agar disk diffusion; the Vitek Automicrobic System method (Vitek Systems, Hazelwood, Mo.); and the PDM Epsilometer test (E test) (AB Biodisk, Solna, Sweden). The E test results showed excellent correlation with agar dilution results, with over 90% agreement within 1 doubling dilution between the E test and reference agar dilution MICs for all antimicrobial agents tested. The E test results also showed good correlation with the results from the reference agar disk diffusion method, with 90 to 99% complete agreement and 100% essential agreement on categories for all antibiotics tested (essential agreement is the agreement obtained when minor discrepancies are ignored). Comparison of categories with the E test and broth microdilution methods, using the broth microdilution method as the reference method, gave only 59% complete agreement for gentamicin, with 28 minor discrepancies and 13 very major discrepancies. Some discrepancies were observed between results from the E test and broth methods for gentamicin, with the broth microdilution and Vitek methods giving higher MICs than the E test and other methods using agar. The most recent NCCLS guidelines for broth dilution testing have reduced the recommended levels of cation supplementation, which may enhance future agreement between results for the aminoglycosides and P. aeruginosa on broth and on agar. We found that the E test offers a simple, labor-efficient, and accurate method for MIC determination on an agar medium.

Adult↗
PubMed1992

Comparison of the Sceptor Pseudomonas Plus MIC Panel with agar dilution for susceptibility testing of Pseudomonas aeruginosa.

The antimicrobial susceptibilities of 100 clinical isolates of Pseudomonas aeruginosa to gentamicin, amikacin, tobramycin, ticarcillin, piperacillin, and ceftazidime were determined by using the Sceptor system (BBL Microbiology Systems, Cockeysville, Md.), and the results were compared with those obtained using the National Committee for Clinical Laboratory Standards reference agar dilution method. Excellent correlation was observed for the aminoglycosides, with greater than 95% agreement within 1 doubling dilution of the reference agar dilution MIC, while ticarcillin and piperacillin showed lower percent agreement values of 91 and 88%, respectively.

Anti-Bacterial Agents↗
PubMed1991

Pig-bel but no pig: enteritis necroticans acquired in Australia.

OBJECTIVE: To report a case of enteritis necroticans acquired in Australia, and to review the history, epidemiology, pathogenesis, clinical features, management and prevention of this disease. CLINICAL FEATURES: A 44-year-old diabetic and alcoholic restaurateur of Chinese-Malay origin, who had been living in Australia for over 20 years, was admitted to hospital with bloody diarrhoea which progressed to fulminant toxaemia and circulatory collapse, and ultimately required laparotomy. Typical pathological features and the isolation of Clostridium perfringens type C from faeces confirmed the diagnosis of enteritis necroticans. INTERVENTION AND OUTCOME: He was treated initially with ampicillin, gentamicin, metronidazole and chloramphenicol, and later with penicillin and metronidazole, and he required large volumes of intravenously administered fluid and blood for his toxaemic, hypotensive state. Laparotomy was performed as a life-saving procedure. Despite a lengthy convalescence, the patient recovered. CONCLUSIONS: Enteritis necroticans is a rare disease in developed countries, however it is likely to be underdiagnosed. Clinicians are encouraged to be on the alert for signs of severity that may indicate the need for laparotomy in a predisposed individual with features of this condition.

Adult↗
PubMed1988

Lung infection caused by Rhodococcus.

We report a case of lung infection, clinically resembling tuberculosis, caused by Rhodococcus rubropertinctus. The patient had no apparent immunosuppression which is unusual for disease caused by the 'rhodochrous' complex. The infection responded successfully to oral anti-tuberculous therapy, which included rifampicin, and to oral tetracycline.

Actinomycetales Infections↗
PubMed1988

A case of polymicrobial infective endocarditis involving Neisseria mucosa occurring in an intravenous drug abuser.

The incidence of polymicrobial endocarditis has increased markedly in recent years, in association with the increasing level of abuse of intravenous drugs. Neisseria mucosa, an upper respiratory tract commensal, is a rare cause of infective endocarditis. We report the first case of polymicrobial infective endocarditis involving Neisseria mucosa occurring in an intravenous drug abuser.

Adult↗
PubMed1988

Evaluation of the RapID ANA system as a four-hour method for anaerobe identification.

The RapID ANA system (Innovative Diagnostic Systems Inc., Atlanta, Ga, USA), a 4-hour micromethod for identifying clinically important anaerobic bacteria, was evaluated using 196 anaerobic clinical isolates and the results were compared with those obtained by applying conventional Virginia Polytechnic Institute (VPI) methodology. The identifications achieved by the RapID ANA system for 141 (72%) of these isolates agreed with the species identifications obtained using VPI methodology, without the need for additional tests. A further 40 (20%) were in agreement after performance of additional suggested tests, 11 (6%) were misidentified and 4 (2%) could not be identified using the RapID ANA system. Excellent agreement between the two methods was demonstrated for the Gram-positive cocci and good agreement for the Gram-negative bacilli. The RapID ANA system was suboptimal in the identification of Clostridium species other than C. perfringens.

Bacteria, Anaerobic↗
PubMed1988

Susceptibility of 114 isolates of the Bacteroides fragilis group to imipenem and eight other antimicrobial agents.

The minimal inhibitory concentrations (MICs) of the newer beta-lactam antibiotic, imipenem, were compared with those of cefoxitin, cefotetan, penicillin, amoxycillin, ticarcillin and metronidazole against 114 clinical isolates of the Bacteroides fragilis group of anaerobic organisms. The ability of clavulanic acid, a beta-lactamase inhibitor, to potentiate the in vitro activity of amoxycillin and ticarcillin was also studied. Using an agar dilution technique we found imipenem to be the most active beta-lactam antibiotic tested having an MIC50 of 0.25 microgram/ml and inhibiting all isolates at a concentration of 4 micrograms/ml. Metronidazole had comparable activity with a MIC50 of 0.5 microgram/ml and all isolates inhibited by 1 microgram/ml. Cefoxitin and cefotetan showed similar activity both with a MIC50 of 8 micrograms/ml against the B. fragilis group, while penicillin, amoxycillin and ticarcillin all had a MIC50 of 16 micrograms/ml. Clavulanic acid significantly reduced the MIC50 of amoxycillin and ticarcillin to 0.5 micrograms/ml and 0.25 micrograms/ml, respectively.

Anti-Bacterial Agents↗
PubMed1987

Susceptibility of cefotetan and Sch 34343 to beta-lactamases produced by strains of Bacteroides that hydrolyse cefoxitin or imipenem.

Eight strains of the Bacteroides fragilis group that produce unusual beta-lactamases were used to investigate the activity and susceptibility to hydrolysis of cefotetan, a new cephamycin and Sch 34343, a new penem. Cefoxitin and imipenem were also examined for comparison. Antibiotic titrations revealed that cefotetan was less active than cefoxitin against four of the eight strains, and that Sch 34343 was as active or more active than imipenem. Crude enzyme extracts degraded cefotetan more quickly than cefoxitin as judged by high pressure liquid chromatography. Three of the extracts were able to degrade imipenem completely within 1 h and these enzymes degraded Sch 34343 even more rapidly.

Anti-Bacterial Agents↗
PubMed1987

The effect of cultural conditions on the activity of LY146032 against staphylococci and streptococci.

The antibacterial activity of LY146032 was greatly potentiated in the presence of calcium ions. In the presence of a physiological concentration of calcium (ca 100 mg/l: 2.5 mM) the new compound was more active than vancomycin or teicoplanin against a selection of clinical isolates of staphylococci and streptococci. The requirement for calcium could not be satisfied by magnesium. The activity of LY146032 varied when tested in different culture media, including batches of Mueller-Hinton agar from different manufacturers. The highest minimum inhibitory concentrations of LY146032 were observed in tests on Iso-Sensitest agar, which contains little calcium. Supplementation of Iso-Sensitest agar with increasing concentrations of calcium caused a proportionate fall in the MIC of LY146032. Saponin-lysed horse blood; incubation in a CO2-rich atmosphere; and an increase in the bacterial inoculum from 10(3) to 10(6) cfu/spot had little effect on the activity of LY146032 in the presence or absence of calcium.

Anti-Bacterial Agents↗