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J S Cheesbrough

Publications and source records attributed to J S Cheesbrough.

30 records · Page 2Linked to original sources
PubMed1986

A prospective study of the mechanisms of infection associated with hemodialysis catheters.

Seventy-four subclavian hemodialysis catheters inserted into 53 patients were studied prospectively. Sixteen of 64 assessable catheterization periods were complicated by clinically documented catheter-related sepsis, and 13 had an associated bacteremia. One patient died from catheter-related sepsis, and in two others, sepsis contributed to death. Staphylococci accounted for 11 bacteremias. Semiquantitative culture of the catheters indicated that 28 were significantly colonized. Comparison of these isolates with skin cultures from the insertion site suggested that the origin of the colonizing organisms was the skin (10 cases), intralumenal contamination (16 cases), or both routes (2 cases). Comparison of cultures taken during catheter insertion with those at removal rarely suggested that organisms introduced at insertion caused subsequent colonization. This study has demonstrated that infectious complications from using subclavian hemodialysis catheters exceed reported rates for all other modes of vascular access used for hemodialysis, as well as other indications for central venous catheterization.

Bacteria↗
PubMed1985

A morphological study of bacterial colonisation of intravenous cannulae.

In an investigation of bacterial colonisation of intravascular cannulae, 16 peripheral venous cannulae of the Venflon variety and 24 chronic haemodialysis cannulae were studied after removal from patients. Studies of colonisation included semi-quantitative microbiological culture and scanning electronmicrographic (SEM) observations. The microbiological findings indicated colonisation of the intravascular portion of the catheter in 4 of 16 Venflon cannulae and 18 of 26 haemodialysis cannulae, largely with skin commensal organisms. The results of the SEM studies were in broad agreement with the microbiological observations. Surface defects on the cannulae were shown to be associated with microbial colonisation which occurred either as isolated colonies or in association with a cellular fibrinous matrix. These observations are illustrated and discussed.

Bacillus↗
PubMed1985

A case of herpes zoster associated encephalitis with rapid response to acyclovir.

A case of herpes zoster encephalitis which responded very rapidly to acyclovir is presented. The differential serum: cerebrospinal fluid antibody response was followed and its value in making the diagnosis is discussed. The penetration of acyclovir into the cerebrospinal fluid was measured, and found to be in agreement with predicted values.

Acyclovir↗
PubMed1985

Studies on the microbiological safety of the valved side-port of the 'Venflon' cannula.

A randomized prospective study was conducted to assess the effect of inserting a bacteria-retaining filter into the side-port of 'Venflon' cannulae. Observations were made on 109 cannulae with filters and 100 without. Although there was a trend towards a reduced rate of side-port colonization in the cannulae with filters this was not paralleled by any reduction in the incidence of local inflammation or colonization of the intravascular segment (IVS) of the cannula. Of the 37 cannulae with positive cultures from the skin at the cannula insertion site 22 yielded indistinguishable bacteria from the IVS, while only three of the 25 positive side-port cultures were similarly associated. It is concluded that in the majority of cases, organisms isolated from the IVS originate on the skin and that organisms introduced via the side-port rarely lead to IVS colonization.

Catheterization↗
PubMed1985

The management of splenic abscess.

We report three patients with splenic abscess whom we attempted to treat without recourse to open surgery. Medical treatment alone was successful in one case, and medical treatment combined with percutaneous drainage was successful in the second. Splenectomy was required in the third case after failure of medical treatment and complications of percutaneous drainage. The difficulties in diagnosing splenic abscess are reviewed and the indications for splenectomy or percutaneous drainage, as opposed to medical treatment are considered.

Abscess↗
PubMed1984

The complications of intravenous cannulae incorporating a valved injection side port.

In a series of 519 intravenous cannulae with valved injection side-ports the incidence of cannula-related local inflammation was 25.2% and bacteraemia 0.2%. Severe local inflammation was associated with a longer mean duration of cannulation, 59.4 v. 81.4 h (P = less than 0.05). There was no significant association between the presence of local inflammation and microbial colonization of either the intravascular segment of the cannula, the adjacent skin, or the side-port. The data suggest that colonization of the cannulae was usually secondary to prior skin colonization. Side-port colonization did not predispose to cannula colonization. Organisms colonizing the side-port were biologically different and were possibly derived from the skin of medical attendants. In the final 157 patients, randomized to receive either isopropyl alcohol or 0.5% chlorhexidine in 70% spirit skin preparation, there was no difference in the incidence of either local inflammation or microbial colonization.

Catheterization↗