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L S Tompkins

Publications and source records attributed to L S Tompkins.

69 records · Page 4Linked to original sources
PubMed1986

Polymicrobial early postpartum endometritis with facultative and anaerobic bacteria, genital mycoplasmas, and Chlamydia trachomatis: treatment with piperacillin or cefoxitin.

A protected, triple-lumen transcervical culture method was used to recover organisms from the endometrium. At least one facultative or one anaerobic species of bacteria was recovered from 82% of the patients, and genital mycoplasmas were recovered from 76% of the women with endometritis. Bacteria together with genital mycoplasmas were present in 61% of the women, bacteria alone were present in 20%, genital mycoplasmas alone were present in 16%, and Chlamydia trachomatis was isolated from 2% of the patients. The most common organisms included Gardnerella vaginalis, Peptococcus spp., Bacteroides spp., Staphylococcus epidermidis, group B Streptococcus, and Ureaplasma urealyticum. A randomized, double-blind regimen of either piperacillin or cefoxitin was equally successful in treating the postpartum endometritis.

Bacteriuria↗
PubMed1986

Endometrial cultures obtained by a triple-lumen method from afebrile and febrile postpartum women.

Transfundal endometrial cultures obtained from afebrile women who delivered vaginally were uniformly free of bacteria and contained Ureaplasma urealyticum in only 2 of 14 women. A protected triple-lumen transcervical method to obtain an endometrial culture recovered organisms from 6 (43%) of the 14 women. Compared with cultures from afebrile women, organisms were recovered from 51 (93%) of 55 febrile postpartum women by using the triple-lumen transcervical culture method (P less than .001). Among febrile women there was a correlation between the recovery of group B Streptococcus, enterococcus, Gardnerella vaginalis, Staphylococcus aureus, and anaerobic bacteria from the cervix and their recovery from the endometrium. Protected transcervical methods used to obtain postpartum endometrial cultures reduce cervical contamination, but semiquantitation of the culture is useful to further increase culture specificity.

Cervix Uteri↗
PubMed1986

Cloned, random chromosomal sequences as probes to identify Salmonella species.

We have developed and evaluated a new technique--chromosomal probe fingerprinting--to differentiate between strains of Salmonella species by using sequences of cloned chromosomal DNA as probes to highlight restriction site heterogeneity. Chromosomal probe fingerprint patterns were compared with other strain-typing methods and epidemiological data. Seventeen isolates of Salmonella typhimurium recovered from 11 outbreaks had six unique chromosomal probe fingerprint patterns. Most strains of Salmonella dublin, including some that had identical plasmid profiles and restriction endonuclease analysis patterns, could be distinguished by this method. On the other hand, eight of nine isolates of Salmonella enteritidis had a common chromosomal probe fingerprint pattern, although there were differences in plasmid profiles and the isolates had been collected over a lengthy time interval from widely disparate geographic locations. These results suggest clonal dissemination of some Salmonella serovars.

Chromosomes, Bacterial↗
PubMed1985

Instability of antibiotic resistance in a strain of Staphylococcus epidermidis isolated from an outbreak of prosthetic valve endocarditis.

Plasmid profiles, phage typing, antibiograms, and biotyping were used to characterize Staphylococcus epidermidis isolated from multiple cultures of blood of four patients with prosthetic valve endocarditis. Epidemiological evidence implicated a common source for these infections. Of 20 clinically significant isolates, 14 exhibited variations from the prototype pattern of multiple resistance to five antibiotics. All isolates tested appeared to be the same strain by phage typing. Of 18 isolates available for plasmid analysis, 10 contained six plasmids of identical size, whereas eight differed from the prototype profile in the loss of one to three plasmids. Loss of resistance to gentamicin, chloramphenicol, erythromycin, and clindamycin but not to methicillin was associated with the loss of specific plasmids. Because antibiotic resistance in this strain of S. epidermidis was unstable, the use of antibiograms alone was not a reliable means of evaluating the relatedness of these multiple isolates.

Anti-Bacterial Agents↗
PubMed1985

Recombinant DNA and other direct specimen identification techniques.

DNA molecules and monoclonal antibodies can now be employed in the clinical laboratory to detect microorganisms in clinical samples. DNA probes are produced by cloning specific gene sequences which then react with homologous target DNA in the sample by DNA hybridization. Monoclonal antibodies are also produced by selection, cloning, and tagging, much like DNA probes. Both methods appear to be highly sensitive, specific, and rapid in the detection of microorganisms.

Antibodies, Monoclonal↗
PubMed1984

Development of a DNA probe for the structural gene of the 2"-O-adenyltransferase aminoglycoside-modifying enzyme.

Analysis of aminoglycoside-resistant Enterobacteriaceae isolated from patients at the Seattle Veterans Administration Medical Center indicated that a single 68-kilobase R factor was responsible for the epidemic spread of low-level resistance to gentamicin, kanamycin, and tobramycin. An examination, by means of the phosphocellulose paper binding assay, of resistant strains carrying this R factor resulted in the identification of a 2"-O-adenyltransferase [ANT(2")]-modifying enzyme. This enzyme was later detected in strains containing 150-kilobase plasmids. For more convenient monitoring of the dissemination of the ANT(2") gene among clinical isolates at the medical center, a DNA probe was developed by cloning of the ANT(2") structural gene from the 68-kilobase factor into pBR322. A 310-base pair Ava I restriction fragment isolated from the interior of the cloned ANT(2") gene was radiolabeled and used in Southern hybridization gels as a probe for plasmids isolated from aminoglycoside-resistant organisms. The probe proved to be highly specific and was more sensitive than enzymologic techniques for detection of the ANT(2") gene in clinical isolates with complex aminoglycoside resistance phenotypes.

Aminoglycosides↗
PubMed1982

Multiply antibiotic-resistant Staphylococcus aureus: introduction, transmission, and evolution of nosocomial infection.

A burn patient with a multiply antibiotic-resistant Staphylococcus aureus infection was transferred to Harborview Medical Center from a burn unit in another state. Despite standard wound precautions, transmission to 34 patients occurred during the subsequent 15 months. Twenty-seven of the patients were infected. Disease included pneumonia, empyema, bacteremia, endocarditis, osteomyelitis, and burn and wound infections. Seventeen of the 34 patients died. Phage typing and plasmid analysis showed the spread of multiply resistant S. aureus from the burn unit to the surgical intensive care unit where a study evaluating the use of chloramphenicol in cases of bowel sepsis was in progress. During this period the organism became resistant to chloramphenicol by acquiring either of two chloramphenicol R-plasmids. Using plasmid profiles and antibiograms, four epidemic strains were identified that assisted in identifying patient and personnel reservoirs. The outbreak was controlled only after rifampin was added to vancomycin treatment of infected patients, which correlated with eradication of the carrier state.

Adult↗
PubMed1981

Use of agarose gel electrophoresis of plasmid deoxyribonucleic acid to fingerprint gram-negative bacilli.

Agarose gel electrophoresis of the plasmid deoxyribonucleic acids from 60 gram-negative bacilli recovered during investigations of nosocomial epidemics was used to fingerprint the strains. This method was as specific at differentiating bacterial strains as more conventional phenotyping methods. In all cases, plasmid band fingerprints of epidermic strains isolates were identical whereas coisolate plasmid deoxyribonucleic acid patterns were different. Agarose gel electrophoresis of plasmid deoxyribonucleic acid is proposed as a method which can be used in conventional microbiology laboratories as an adjunct to or, possibly, replacement for other methods of identifying bacterial strains.

Bacteria↗
PubMed1980

Molecular analysis of R-factors from multiresistant nosocomial isolates.

During an epidemic of infections at the Seattle Veterans Hospital, Washington, due to a multiresistant strain of Serratia marcencens, other enteric species were isolated that had antibiograms nearly identical to those of the epidemic S. marcescens. In 11 instances, these multiresistant species were isolated from specimens that also contained the epidemic serratia strain. All isolates of the epidemic serratia strain contained a conjugative 45-megadalton R-factor (pLST1000) coding for intermediate resistance to three amino-glycosides (minimal inhibitory concentrations, 4--8 micrograms/ml) and high-level resistance to ampicillin, carbenicillin, cephalothin, streptomycin, and sulfonamide. With the use of agarose gel electrophoresis and restriction endonuclease cleavage patterns after digestion with EcoRI, BamH1, and HindIII, it was determined that eight different enteric strains of six different species isolated from the patients contained an R-factor that was molecularly identical to the one isolated from the epidemic strain of S. marcescens. Thus, the epidemic of multiresistant infections at this hospital was caused both by the spread of an epidemic strain and an "epidemic plasmid." The molecular characteristics of pLST1000 appear to be different from previously described multiresistant plasmids.

Aminoglycosides↗
PubMed1979

Infection due to Corynebacterium species in marrow transplant patients.

A Corynebacterium species consistently resistant to all antibiotic therapy except vancomycin caused bacteremia in 32 of 284 (11%) marrow transplant patients. Twenty-one patients had colonization or infection before bacteremia. Twenty-six of the 32 patients were males, and males older than 16 years were infected significantly more often than females over 16, or than all patient under 16. A case-control study showed that infected patients had greater exposure to antibiotics; more often had failure of engraftment and persistent granulocytopenia; were in laminar air-flow rooms less often; and had greater inhospital mortality. Cultural surveillance showed that 17 of 42 marrow transplant patients were colonized with Corynebacterium species. Likelihood of colonization appeared related to age, sex, and duration of hospitalization. Prevalence of colonization in other populations was 1% in nonhospitalized healthy adults and 13% in adults in a general hospital. Corynebacterium species infections occur primarily in adult males with granulocytopenia, mucocutaneous defects, and receiving intensive antibiotic therapy.

Adolescent↗
PubMed1978

Toxic and allergic manifestations of antimicrobials.

All antimicrobial drugs may produce toxic and allergic reactions. Penicillins and cephalosporins cause the greatest number of allergic reactions and should not be used for treatment of minor infections in patients with a history of an adverse reaction. If no alternative antibiotic will suffice for treatment of a serious infection, skin testing is necessary. Two commonly used antimicrobials, clindamycin and isoniazid, can have potentially fatal toxic effects.

Anti-Bacterial Agents↗
PubMedDate not supplied

Infections caused by nondiphtheria corynebacteria.

After decades of confusion about their microbiologic classification and clinical significance, the nondiphtheria corynebacteria have emerged as important pathogens. Although isolation of these organisms may represent contamination with skin flora, several species, including Corynebacterium ulcerans, Corynebacterium pseudotuberculosis (Corynebacterium ovis), Corynebacterium haemolyticum, Corynebacterium pseudodiptheriticum, Corynebacterium equi, Corynebacterium bovis, Corynebacterium xerosis, and corynebacteria of group JK, clearly cause disease in humans. Most of these organisms infect animals, which are the source of human infection with some species. Some nondiptheria species of Corynebacterium produce recognizable clinical syndromes such as granulomatous lymphadenitis, pneumonitis, pharyngitis, cutaneous infections, and, most commonly, endocarditis. Certain species infect healthy hosts, while others predominantly attack immunocompromised individuals. Several species produce toxins, including a diphtheria-like toxin, a dermonecrotic toxin, and a soluble hemolysin. A microbiologic scheme of identification of the genus Corynebacterium and its major defined species is presented.

Animals↗