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Biomedical subjects

M A Calder

Publications and source records attributed to M A Calder.

At least 19 recordsLinked to original sources
PubMed1988

Imipenem-cilastatin in the treatment of respiratory infections in patients with chronic airways obstruction.

Chest infections with organisms resistant to conventional antibiotics are common in patients with chronic lung disease. We have studied the use of imipenem in 40 (28 M 12 F) patients admitted for treatment of chest infections. Patients were treated with imipenem 0.5 g four times daily by intravenous infusion for 6.3 +/- 1.6 (S.D.) days. Forty-six respiratory pathogens were cultured from 36 patients including 18 Haemophilus influenzae, 6 H. parainfluenzae, 6 Streptococcus pneumoniae, 8 Pseudomonas aeruginosa, and 6 Branhamella catarrhalis. Forty-three of the 46 isolates were sensitive to imipenem, 28 to ampicillin, 33 to tetracycline and 35 to cotrimoxazole. Thirty-eight of the 40 patients improved clinically, and 34 of the 36 patients with positive sputum culture had no pathogens in their sputum after treatment. Twenty patients developed minor phlebitis at the infusion site but there were few other side effects. Imipenem may prove useful in the treatment of chest infections, particularly when the organism is resistant to conventional antibiotics.

Adult↗
PubMed1987

Characterisation of Branhamella catarrhalis and differentiation from Neisseria species in a diagnostic laboratory.

To distinguish Branhamella catarrhalis from Neisseria species a study of 140 strains was made on simple laboratory media, with particular reference to deoxyribonuclease (DNase) production, superoxol reaction, and growth characteristics. All 97 clinical isolates of B catarrhalis (58 of which were beta-lactamase positive) and eight strains of B catarrhalis from the National Collection of Type Cultures were DNase positive and superoxol positive. None grew on modified New York City medium, modified Thayer Martin medium, MacConkey agar, crystal violet blood agar, nor under anaerobic conditions. Of the 16 different non-pathogenic Neisseria species tested, all were DNase negative, eight (50%) were superoxol reaction negative, and 13 (81%) grew on crystal violet blood agar. Using simple laboratory media, DNase, and superoxol tests, it was possible to identify B catarrhalis and to distingish it from pathogenic and non-pathogenic Neisseria species.

Deoxyribonucleases↗
PubMed1987

Pneumococcal serotypes in sputum isolates during acute respiratory illness in Edinburgh.

During the years 1978-83 serotyping was carried out on all sputum isolates of pneumococci obtained from patients in the chest wards of the City Hospital, Edinburgh. In 402 patients with acute respiratory illness the peak isolation rates occurred from January to April, and the serotype distribution was similar to that seen in previous UK studies, the commonest types being 3, 6, 9, 19, 23, and 8. The overall mortality rate was 8.7%, the serotype distribution in fatal cases reflecting the distribution of the whole group. The presence of mixed infection, predominantly with Haemophilus influenzae, was associated with a lower mortality rate of 3.5%. Nearly all patients (92%) were either elderly or had a chronic underlying disease and only one death occurred in a patient under 70 years who had no pre-existing disease. Of the pneumococcal serotypes isolated from the 292 patients with chronic chest disease, 82% are included in the new 23 valent pneumococcal vaccine and the efficacy of this needs to be assessed further in high risk patients.

Aged↗
PubMed1987

Mycobacterium malmoense infections in Scotland: an increasing problem.

During 1982-4 20 cases of Mycobacterium malmoense infection were identified in Scotland (13 male, seven female; age 34-82, median 62 years). Features of the disease were obtained from case notes and radiographs of 19 patients and were found to be indistinguishable from those of patients with pulmonary tuberculosis. Chronic chest disease, predominantly chronic airflow obstruction, was the most frequent associated disease. The organisms showed in vitro resistance in eight patients to rifampicin, in 19 patients to isoniazid, and in all patients to pyrazinamide and p-aminosalicylic acid. Nevertheless, all patients showed an early response to standard combination chemotherapy with rifampicin, isoniazid, and ethambutol, with or without pyrazinamide. Five have been cured and none had died of the infection, although four died of unrelated disease. Of nine patients still having treatment, five had relapsed after completing a course of antituberculosis drugs. All had received ethambutol for less than five months. The response to standard drugs was more satisfactory when the course included administration of ethambutol for at least nine months. Currently one new infection with M malmoense occurs in Scotland for every 40 with tuberculosis, and the incidence appears to be rising. In view of this, it is suggested that when tuberculosis is suspected the chemotherapeutic regimen should include ethambutol until the culture results are reported. If these then show M malmoense, ethambutol should be continued in the combination for at least nine months.

Adult↗
PubMed1986

Increase in bronchopulmonary infection due to branhamella catarrhalis.

In a six month prospective study during the winter Branhamella catarrhalis was isolated from the sputum of 63 patients with symptoms of bronchopulmonary infection: 49 isolates were in pure culture and 14 were with another pathogen, Haemophilus influenzae being the commonest (found with 10 of the 14 B catarrhalis isolates). Of 36 patients infected in the community, 26 required admission to hospital. The remaining 27 patients were infected while in hospital. Forty four of the 63 isolates produced beta lactamase; 26 of these had been acquired in the community. As a result 29 patients were treated inappropriately with ampicillin and did not respond to this treatment. beta Lactamase produced by B catarrhalis may also protect other pathogens normally susceptible to beta lactam antibiotics. Most patients had chronic lung diseases or lung cancer, but three otherwise healthy patients who did not smoke developed bronchitis. B catarrhalis contributed to the death of five patients. A survey of the antibiotic prescribing habits of the referring general practitioners together with the sensitivity results of B catarrhalis suggest that changes in antibiotic prescribing habits in the community may be responsible for the increase in B catarrhalis infection.

Adult↗
PubMed1986

Lack of immunoglobulin A1 protease production by Branhamella catarrhalis.

Clinical isolates of Branhamella catarrhalis from the sputum of 20 patients with acute bronchopulmonary infection were examined for synthesis of immunoglobulin A1 protease by immunoelectrophoresis. Ten strains produced beta-lactamase, and 10 were beta-lactamase negative. None of the strains demonstrated immunoglobulin A1 protease activity despite the fact that three different culture media were used.

Humans↗
PubMed1986

Mycobacterium gordonae: a new pathogen?

Mycobacterium gordonae is a slow growing scotochromogenic acid fast bacillus (Runyon group II) with specific cultural and biochemical characteristics. It is a contaminant of water, soil, and raw milk and is usually considered to be saprophytic and non-pathogenic in man. We have recently seen two cases of pulmonary disease that may have been due to M gordonae, and we now report these and review our recent experience of this organism.

Aged↗
PubMed1986

The incidence and antibiotic susceptibility of Branhamella catarrhalis in respiratory infections.

The incidence of Branhamella catarrhalis in respiratory infections at City Hospital, Edinburgh from January 1981 to April 1984 is described. Beginning in January 1982 there was an increased incidence associated with a high proportion of beta-lactamase-producing strains. The number of these strains increased: from January 1981 to April 1983, 61% of strains produced beta-lactamase, and 83% produced beta-lactamase from January to April 1984. 53% of patients were infected in hospital. Environmental studies showed that 7% of staff and 8% of patients were carriers; there was also circumstantial evidence of ward and patient-to-patient infection. The antimicrobial susceptibility of 54 clinical strains was tested: all strains were resistant to trimethoprim but were susceptible to clavulanic acid plus amoxycillin, chloramphenicol, erythromycin, co-trimoxazole, cefotaxime and cefuroxime. beta-Lactamase-negative strains were uniformly susceptible to penicillin and ampicillin.

Adult↗
PubMed1986

Bronchopulmonary infection due to B. catarrhalis. Clinical features and therapeutic response.

A study was made of the clinical features and therapeutic response of 144 patients from whose sputum Branhamella catarrhalis was isolated. Typically, features of bronchopulmonary infection with cough productive of moderate amounts of purulent sputum, fever and dyspnoea were present. Of 74 patients who were infected in the community, 50 required hospital admission. Nosocomial infection occurred in the remaining 70 patients. Most patients had chronic pulmonary diseases or carcinoma bronchus; pneumonia occurred in 12 patients. Acute tracheobronchitis developed in 4 healthy non-smokers after viral illnesses. B. catarrhalis contributed to the death of 8 patients. Overall, 59% of isolates produced beta-lactamase but the proportion had risen to 70% by the end of the study; half of these were community acquired. 41% of patients who were treated initially with ampicillin did not respond. Clavulanic acid plus amoxycillin, co-trimoxazole, erythromycin, tetracycline, cefuroxime and cefotaxime are useful alternative antibiotics. All strains of B. catarrhalis were resistant to trimethoprim.

Adult↗
PubMed1985

Branhamella catarrhalis prevalence in a hospital population.

The prevalence of environmental and nasopharyngeal carriage of Branhamella catarrhalis in hospital staff members and in-patients was higher than previous studies suggested. Pernasal swabs performed on 59 members of staff revealed four isolates of Branh. catarrhalis, two of which were beta-lactamase producers. Seven isolates, two beta-lactamase positive, were recovered from 89 in-patients none of whom had bronchopulmonary infection with Branh. catarrhalis. From 117 settle plates six isolates, one beta-lactamase positive, were recorded. Attempts to bacteriocine type the isolates failed. In the absence of a typing system for Branh. catarrhalis evidence of nosocomial spread remains circumstantial.

Adult↗
PubMed1985

Infection and Branhamella catarrhalis.

Of the Gram-negative cocci found in the nasopharynx to which any pathogenic status can be attributed, Neisseria meningitidis and Neisseria (Branhamella) catarrhalis have gained significant notoriety. Traditionally, B. catarrhalis is regarded as a nasopharyngeal commensal and thus there is, in general, considerable reluctance to accept that B. catarrhalis may be a pathogen when it is seen. Hence, it is under-reported or totally ignored though there is more awareness regarding its pathogenic potential, particularly as an increasingly high incidence of beta lactamase producing strains is being reported from many countries. The importance of this development concerns the choice of routine antibiotic therapy as ampicillin, to which this organism was previously sensitive, may no longer be effective.

Conjunctivitis↗
PubMed1984

Pneumococcal serotyping and antigen detection in pneumococcal pneumonia of adults.

A retrospective study of 125 patients presenting to the City Hospital, Edinburgh, with proven pneumococcal pneumonia showed that pneumococcus serotype 3 remains the most prevalent and that since 1970 the distribution of serotypes has remained virtually constant. The frequency of diagnosing pneumococcal pneumonia is increased by the use of countercurrent immuno-electrophoresis (CIE) of sputum. In this series, 25 per cent of patients with negative sputum culture but radiological evidence of pneumonia, were diagnosed by means of this method, which was overall more helpful in making the diagnosis than blood cultures. All nine deaths in this series were in those over 65 years of age.

Adolescent↗
PubMed1984

Antimicrobial susceptibility of Branhamella catarrhalis isolates from bronchopulmonary infections.

Fifty-four clinical isolates of Branhamella catarrhalis from patients with bronchopulmonary infections were studied. The MICs for 50 and 90% of the isolates and the geometric mean MICs were determined for 11 antimicrobial agents. All the strains were resistant to trimethoprim but were susceptible to clavulanate-potentiated amoxicillin (Augmentin; Beecham Research Laboratories, London), chloramphenicol, co-trimoxazole, erythromycin, cefotaxime, and cefuroxime. Beta-lactamase-negative strains were uniformly susceptible to penicillin and ampicillin.

Anti-Bacterial Agents↗