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L R Ashdown

Publications and source records attributed to L R Ashdown.

At least 37 records · Page 2Linked to original sources
PubMed1989

Enzyme-linked immunosorbent assay for the diagnosis of clinical and subclinical melioidosis.

An enzyme-linked immunosorbent assay (ELISA) for the detection of specific IgG and IgM antibody to Pseudomonas pseudomallei was developed. The IgG-ELISA was compared with the indirect fluorescence assay for IgG antibody (IgG-IFA) and the indirect hemagglutination (IHA) test in studies with serum specimens from persons from endemic areas for melioidosis and from persons from nonendemic areas of Australia. The sensitivity and specificity of the IgG-ELISA were 90% and 99%, respectively, comparable to those obtained with the IgG-IFA. The IgG-ELISA was more sensitive than the IHA test (74%) and was more suitable than the IgG-IFA as a serologic screening test for melioidosis. The IgM-ELISA was compared with the IgM-IFA as a marker of disease stage in patients with melioidosis. There was good diagnostic agreement between the tests; 92% of patients with active disease gave IgM-ELISA titers greater than or equal to 1:5,120 and 93% of patients with subclinical melioidosis had IgM-ELISA titers less than or equal to 1:1,280. Of the overlap group of patients with a borderline IgM-ELISA titer of 1:2,560, approximately 33% were clinical cases. An uncommon disease stage consisting of a self-limited, short-term, flu-like, pyrexial illness accompanied by elevated serum IgM-ELISA titers (greater than or equal to 1:5,120) was seen in a small number of patients residing in endemic Australia.

Adolescent↗
PubMed1988

In vitro activities of the newer beta-lactam and quinolone antimicrobial agents against Pseudomonas pseudomallei.

Imipenem was highly active and bactericidal against all 100 strains of Pseudomonas pseudomallei tested, followed in activity by piperacillin, carumonam, ceftazidime, cefotaxime, and ceftriaxone. The addition of clavulanic acid significantly increased the activities of both amoxicillin and ticarcillin. Ciprofloxacin and norfloxacin showed poor activity against test strains.

4-Quinolones↗
PubMed1987

Subacute pulmonary melioidosis in a temperate climate.

Previous reports of cases of melioidosis that were seen in nonendemic areas of Australia describe recrudescences of latent infection. We describe the case of a patient who presented in the cooler climate of Melbourne with a probable primary, subacute pulmonary infection with Pseudomonas pseudomallei. This case illustrates several points that bear consideration in the management of atypical pneumonia and, more specifically, pulmonary melioidosis. Historical and occupational clues are easily missed or unrecognized, while a persistent growth of gentamicin-resistant Pseudomonas species should arouse suspicion. Septicaemic melioidosis carries a poor prognosis, and treatment should be early and aggressive; use of the newer, third-generation cephalosporin agents should be considered. Given active support in a well-equipped intensive care unit, together with appropriate antibiotic therapy, patients may eventually be cured of this infection, but a high mortality rate is still encountered.

Anti-Bacterial Agents↗
PubMed1984

Melioidosis in Far North Queensland. A clinical and epidemiological review of twenty cases.

During the last 4 years, 20 cases of clinical melioidosis were diagnosed in the geographical area between Tully and Thursday Island. Sixteen were diagnosed by culture of Pseudomonas pseudomallei, and four by positive serology with appropriate clinical features. Most cases occurred during or after a heavy wet season. All patients were adult, and males predominated. Farmers and stockmen represented predisposed populations due to their prolonged soil contact. Ten patients were white Australians, six were Aborigines and four were Torres Strait Islanders. Twelve cases were first diagnosed by positive blood culture and four by sputum culture. The primary site of infection was pulmonary in 14 cases, genitourinary tract in one case, subcutaneous tissues in one case, and joints in two cases. In cases of fulminating infection metastatic abscesses were commonly found in many organs; typically lungs, liver, kidneys and spleen. Six patients had acute fulminating disease and died. Fourteen patients successfully responded to appropriate therapy, but relapse occurred in three, all of whom had an alcohol problem and showed poor drug compliance. The presence of diabetes mellitus in six patients confirmed the important known association of these two diseases. In three fulminating and four subacute infections the serology was negative at the time of diagnosis by culture. Antibiotic therapy for the different forms of this disease is reviewed, and a laboratory protocol for the rapid reporting of positive culture results is included.

Adult↗
PubMed1984

The prevalence of human melioidosis in Northern Queensland.

Sera from 9,047 individuals from Northern Queensland were examined for the presence of hemagglutinating antibodies to Pseudomonas pseudomallei, the causative agent of melioidosis, and 512 (5.7%) were found to have titers of 1:40 or greater. The distribution of positive reactors in various groups was uneven, and significantly higher prevalences of positive antibody titers were found in the sera from Aborigines (7.9-10.6%), Torres Strait Islanders (7.8%), Vietnamese refugees (29%) and from persons with certain medical conditions including chronic alcoholism (15%), chronic infections (14.8%), diabetes mellitus (8.6%) and liver disease (12.9%). There were significantly fewer positive reactors (1.4%) amongst the armed forces stationed in Northern Queensland. At present, the boundaries of the major endemic region of Australia extend north from Rockhampton along the coast to Darwin and inland, west from Rockhampton to Tennant Creek in central Australia. Townsville was found to have the highest prevalence (5.2%) of positive reactors of all urban populations of Northern Queensland. The extent of the disease is such that it can no longer be considered a rare infection in Northern Queensland.

Alcoholism↗
PubMed1981

Relationship and significance of specific immunoglobulin M antibody response in clinical and subclinical melioidosis.

Thirty-six hospitalized patients with circulating antibody to pseudomonas pseudomallei were classified as having either clinical or subclinical melioidosis after full clinical examinations and supplementary radiological and culture investigations. Qualitative estimations of immunoglobulin M (IgM) antibody response were determined by complement fixation, indirect hemagglutination, and immunofluorescence, and the estimations were correlated with the clinical findings in each patient. An attempt was made to appraise the importance of IgM antibody, as determined by each test, in establishing the diagnosis of clinical melioidosis. Results obtained from serological tests were of no value in differentiating between active and latent infections. However, the IgM-immunofluorescent test appeared to be relevant to the diagnosis of clinical melioidosis, since the presence and absence of IgM-immunofluorescent antibody bore a close relation to clinical and subclinical disease, respectively. Surveillance studies indicated that the IgM-immunofluorescent test may be of value in monitoring the activity and treatment of the infection, since the results of the test were generally negative 3 to 6 months after administration of chemotherapy appropriate for melioidosis.

Antibodies, Bacterial↗
PubMed1981

Demonstration of human antibodies to Pseudomonas pseudomallei by indirect fluorescent antibody staining.

A rapid, reliable immunofluorescent assay for human antibodies to Pseudomonas pseudomallei was devised. The method was found to be sensitive and specific by inhibition tests and by tests for cross reactivity with antisera and cells of closely related pseudomonads other than Pseudomonas mallei. Preliminary studies suggest that the technique may be useful as a screening test for the detection of melioidosis and that demonstration of specific IgM by immunofluorescence may be of value in differentiating active from inactive infection.

Antibodies, Bacterial↗
PubMed1980

Meliodosis.

During the five-month wet season of 1977-1978 in Northern Queensland, six patients with bacteriologically proven melioidosis were successfully treated at the Townsville General Hospital, The clinical course and management of each case and laboratory findings are described. Factors which predisposed them to infection with Pseudomonas pseudomallei were diabetes mellitus, cancer, alcoholism, malnutrition, trauma, and pregnancy. Successful treatment of melioidosis relied on prompt laboratory diagnosis and appropriate chemotherapy together with surgical drainage of abscesses and management of concomitant diseases. The incidence of melioidosis in Northern Queensland has increased to the extent that it can no longer be considered a rare disease in this area. Because of increased internal and international travel, and displacement of refugees from endemic areas of Southeast Asia, physicians and microbiologists must maintain a high index of suspicion of melioidosis when dealing with patients after geographic exposure, as it is probable that, in the future, this disease witll be encountered more frequently in non-endemic areas.

Adult↗
PubMed1979

Tetracycline.

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Drug Resistance, Microbial↗
PubMed1979

Granuloma inguinale in Northern Queensland.

Thirteen cases of granuloma inguinale were diagnosed in just over a twelve-month period at the Australian Government Health Laboratory and the General Hospital, Townsville. Seven patients were males, four of whom were immates of Her Majesty's Prison, Townsville. Two of the patients were married, and two were sisters. All the female patients were pregnant at the time of diagnosis. The provisional diagnosis was confirmed by the presence of intracytoplasmic Donovan bodies in crushed tissue smears stained with Wright's stain and pinacyanole. The diagnosis of granuloma inguinale could not be reliably made from sections of formalin-fixed tissue alone. The clinical findings, methods of laboratory diagnosis, management and treatment of this disease are also described with an added emphasis on treatment during pregnancy.

Adult↗
PubMed1979

Identification of Pseudomonas pseudomallei in the clinical laboratory.

Ninety-one strains of Pseudomonas pseudomallei were tested in the API 20E system and in equivalent conventional tests. Except for utilisation of citrate there was good correlation between API and conventional tests. Seven-digit profiles were constructed from each strain after 48 hours' incubation, and numerical codes 2 006 727, 2 206 706, 2 206 707, and 2 206 727 accounted for 77% of strains tested. API 20 E, in combination with tests for heat stability of alkaline phosphatase, resistance to colistin and gentamicin, oxidative attack only of glucose, and acid from maltose, was found to provide a simple method for positive identification of all strains of this organism in two days.

Bacteriological Techniques↗
PubMed1979

An improved screening technique for isolation of Pseudomonas pseudomallei from clinical specimens.

A selective medium consisting of trypticase soy agar with 4% glycerol, 5 mg/l crystal violet, 50 mg/l neutral red and 4 mg/l of gentamicin was devised for isolation of Pseudomonas pseudomallei from clinical specimens. Absorption of neutral red was found to be suitable for differentiating this organism from other bacteria, while gentamicin was effective in selecting Ps. pseudomallei from organisms commonly found in clinical material. The medium was more suitable for screening clinical specimens than MacConkey's agar with colistin-S because it was more selective and allowed multiple specimens to be inoculated on a single plate. Eight thousand clinical specimens from an area endemic for melioidosis were screened on the selective medium. This resulted in the recovery of 8 isolates of Ps. pseudomallei that would not have been detected using routine culture media alone.

Antibodies, Bacterial↗