Biomedical subjects
Publications and source records attributed to K Bidgood.
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OBJECTIVE: To determine the prevalence of bacterial vaginosis in women undergoing first trimester suction termination of pregnancy and to evaluate the efficacy of metronidazole in reducing the risk of post abortal pelvic infection in women with bacterial vaginosis. DESIGN: Randomised double-blind placebo-controlled trial. SETTING: Two teaching hospitals and one district general hospital. SAMPLE: Two hundred and seventy-three women with bacterial vaginosis undergoing termination of pregnancy. METHODS: Women with bacterial vaginosis, diagnosed using modified Spiegel's criteria, were individually randomised to receive either a 2 g metronidazole suppository or identical placebo per-operatively. Participants, doctors and investigators were blinded to treatment allocation. Participants were asked to complete a questionnaire about post-operative symptoms, visits to the general practitioner, antibiotic treatment, readmission to hospital, contraception and emotional response after one month. RESULTS: The prevalence of bacterial vaginosis was 29.3% (326/1,111). Intention-to-treat analysis showed that post-operative upper genital tract infection developed in 12/142 (8.5%) women allocated to metronidazole and 21/131 (16.0%) women randomised to placebo, a difference of 7.6% (95% confidence intervals -15.4 to +0.2%; relative risk 0.53. 0.27 to 1.03, P = 0.055). The effect of prophylaxis was similar when the analysis was restricted to women receiving the allocated treatment and with complete follow up. There was no difference in the risk of readmission to hospital and the frequencies of self reported symptoms in the two groups were similar. CONCLUSION: This randomised placebo-controlled trial among women with bacterial vaginosis provides weak evidence that metronidazole decreases the risk of upper genital tract infection after first trimester suction termination of pregnancy but a chance finding could not confidently be excluded. Large well-conducted randomised trials with long term outcome measures are now needed to determine the most effective antibiotic combinations and strategy for prevention of post-abortal pelvic infection.
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We report the cloning of the Aspergillus niger glucose oxidase gene and its use to elevate glucose oxidase productivity in A. niger by increasing the gene dosage. In addition, the gene has been introduced into A. nidulans where it provides the novel capacity to produce glucose oxidase. A plasmid, in which DNA encoding the mature form of glucose oxidase was preceded by a Saccharomyces cerevisiae secretion signal, effected high-level production of extracellular glucose oxidase in this yeast.
Continuous turbidimetric monitoring of cultures of staphylococci and streptococci exposed to teicoplanin or vancomycin revealed considerable inhibitory activity at concentrations below the conventionally-determined minimum inhibitory concentration. Teicoplanin was more active than vancomycin against low inocula, but exhibited a larger inoculum effect. A modest decline in susceptibility to teicoplanin and vancomycin could be induced by sequential exposure to the drugs. Such variants gradually reverted to susceptibility on passage in antibiotic-free broth. The morphological consequences of exposure to the two antibiotics were similar as judged by scanning electron microscopy.
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