PubMed Health⌕ Search

Biomedical subjects

J Philpott-Howard

Publications and source records attributed to J Philpott-Howard.

48 records · Page 3Linked to original sources
PubMed1990

Prospective study of bacterial infection in acute liver failure: an analysis of fifty patients.

Fifty consecutive patients admitted with acute liver failure, minimal grade II encephalopathy, were studied prospectively to determine the incidence, timing and cause of bacterial infection, the relationship to clinical criteria for infection; and the influence of early microbiological diagnosis on clinical outcome. There were 53 proven bacterial infections in 40 patients, whereas in 5 of the remaining 10 patients infection was suspected on clinical grounds in the absence of significant cultures. Seven patients (14%) had more than one bacterial infection, and four patients had simultaneous infections caused by different organisms at each site. Fourteen infections (26.4%) were associated with bacteremia, and in six of these no source was found. Twenty-five infections (47.1%) arose from the respiratory tract, 12 (22.6%) from the urinary tract and 2 (3.7%) from central venous cannulas. Thirty-seven (69.8%) of the 53 infections were due to gram-positive bacteria; Staphylococcus aureus accounted for 19 (35.8%) of all the infections. Thirty patients died (60%), 28 of whom had bacterial infection at some time; in 24 of these the infection was diagnosed less than 24 hr before death. All nine deaths that occurred more than 7 days after admission were directly attributable to microbial infection. Clinical features such as elevated temperature and elevated peripheral white blood cell count were poor indicators of bacterial infection because these were absent in 30.2% of cases. These data show that there is a high incidence of bacterial infection early in the course of acute liver failure and suggest that prophylactic antimicrobial therapy, although unproven, might be justified.

Acute Disease↗
PubMed1990

Fulminant fungal sinusitis following intensive chemotherapy.

Three cases of fulminant fungal sinusitis in patients undergoing intensive chemotherapy for haematological malignancies are described. Predisposing factors included courses of broad-spectrum antibiotics for febrile episodes. The presentation of sinusitis was acute, with facial pain and swelling, progressing to proptosis and visual disturbance. CT scanning is the investigation of choice to assess the extent of disease and subsequent response to treatment. Management requires urgent drainage, systemic and local antifungal therapy and decompressive procedures if necessary. Aggressive management can achieve good local control, but the long-term outlook remains poor.

Acute Disease↗
PubMed1987

Four outbreaks of nosocomial systemic candidiasis.

Candida albicans has recently been described as a cause of nosocomial infection. This paper reports four further outbreaks occurring over a 12-month period in England. There were 13 systemic cases and 6 deaths. The outbreaks were defined by morphotyping and the new technique of immunoblot fingerprinting. Control of the outbreaks was produced by the implementation of strict cross-infection control policies without recourse to systemic chemoprophylaxis.

Adolescent↗
PubMed1983

Cefotetan activity against Gram-negative aerobes and anaerobes.

The activity of cefotetan has been determined against strains of bacteroides, Haemophilus influenzae and klebsiella. The activity against bacteroides was lower than that of cefoxitin and moxalactam. The activity against multi-resistant klebsiella was very high, most strains requiring a concentration of 0.06 mg/l for inhibition. The stability to various beta-lactamases was demonstrated by testing the compound against beta-lactamase-producing H. influenzae and Enterobacteriaceae.

Anaerobiosis↗
PubMed1983

Accuracy of methods used for susceptibility testing of Haemophilus influenzae in United Kingdom laboratories.

Antibiotic susceptibility test reports on 1841 strains of Haemophilus influenzae from 25 microbiology laboratories were compared with results obtained with the same strains at The London Hospital Medical College. Of strains found to be sensitive to the antibiotics tested, 0.5% were reported as tetracycline-resistant, 1.6% as ampicillin-resistant, and 6.2% as trimethoprim-resistant. Of strains found to be resistant to these antibiotics, 37% were reported as tetracycline-sensitive, 27% as ampicillin-sensitive, and 66.7% as trimethoprim-sensitive. Factors found to be of significance in improving accuracy of sensitivity reporting included use of chromogenic cephalosporin and low-content antibiotic discs for detection of ampicillin resistance, and use of lysed blood agar rather than chocolated blood agar to detect trimethoprim sensitivity.

Ampicillin↗
PubMed1983

Activity of cephalosporin antibiotics against Haemophilus influenzae.

Minimum inhibitory concentrations (MICs) of nine cephalosporins were determined for 90 isolates of Haemophilus influenzae including 70 amoxycillin-resistant strains. Cefotaxime was the most active of the parenteral antibiotics tested, with a modal MIC of 0.03 mg/l, compared with ceftazidime 0.12 mg/l, cefamandole 0.25 mg/l, cefuroxime 0.5 mg/l and cefathiamidine 4 mg/l. Cefaclor was the most active of the oral cephalosporins tested, with a modal MIC of 2 mg/l compared with cephalexin 8 mg/l and cephradine 32 mg/l. Amoxycillin-sensitive and beta-lactamase-producing haemophili had similar MICs for all cephalosporins. Twenty amoxycillin-resistant beta-lactamase non-producing strains showed high MICs for all beta-lactams tested. A cell permeability barrier is postulated as a mechanism of resistance in these strains.

Amoxicillin↗
PubMed1982

Increase in antibiotic resistance in Haemophilus influenzae in the United Kingdom since 1977: report of study group.

A survey of antibiotic resistance in Haemophilus influenzae was carried out in the United Kingdom with 25 laboratories participating. The incidence of resistance in the 1841 strains examined was: tetracycline 3.1%, ampicillin 6.2%, chloramphenicol 1.03%, trimethoprim 1.4%, and sulphamethoxazole 1.5%. Of the 115 strains resistant to ampicillin, 106 produced beta-lactamase. Seventy-nine strains were capsulate, none of which was chloramphenicol resistant, but nine produced beta-lactamase (11.4%). Comparison of these figures of antibiotic resistance with those from a similar survey performed in 1977 showed a significant increase in resistance of H influenzae to ampicillin, chloramphenicol, and trimethoprim.

Ampicillin↗
PubMedDate not supplied

Amniotic fluid gram stain and leukocyte count in the prediction of intrauterine infection in preterm prelabour amniorrhexis.

The purpose of the study was to examine the sensitivity and specificity of the amniotic fluid Gram stain and leukocyte count in the prediction of positive fetal blood and amniotic fluid cultures in 80 patients with preterm prelabour amniorrhexis. Amniocentesis and cordocentesis were performed and amniotic fluid and fetal blood were cultured for aerobic and anaerobic bacteria. Amniotic fluid was also cultured for Ureaplasma urealyticum and Mycoplasma hominis. The sensitivity of the Gram stain in the prediction of positive fetal blood and amniotic fluid cultures was 50 and 40% and the respective false positive rates were 12 and 4%. In the detection of aerobic or anaerobic infection of the amniotic fluid, the sensitivity and false positive rate of the Gram stain were 80 and 3% respectively. This compared favourably with the respective values of 66 and 35% for amniotic fluid leukocyte count > 30/mm3. Positive amniotic fluid Gram stain provides useful prediction of intra-uterine infection with aerobic or anaerobic organisms.

Amniocentesis↗