Biomedical subjects

M A Noble

Publications and source records attributed to M A Noble.

At least 73 records · Page 4Linked to original sources

PubMed1984

Cleaning of anaesthesia breathing circuits and tubings: a Canadian survey.

A cross-Canada survey of 38 university-affiliated hospitals with over 250 beds was undertaken to examine the procedures for cleaning anaesthetic tubings and circuits. Twenty-eight (74 per cent) hospitals responded. Gluteraldehyde was the most commonly used method (13/28), and pasteurization was the second most used method (9/28). These two methods are described and recommendations are made for basic requirements for disinfection.

Anesthesiology↗

PubMed1984

Rapid determination of 5-fluorocytosine levels in blood.

Levels of 5-fluorocytosine in blood were rapidly calculated by determining the amount of competition in the creatinine iminohydrolase (creatinine deiminase; EC 3.5.4.21) assay for creatinine with the Kodak Ektachem system (Eastman Kodak Co., Rochester, N.Y.). The correlation with bioassay values was extremely high (r = 0.982). Standards and samples were highly stable over time.

Aminohydrolases↗

PubMed1983

Ataxia in Listeria monocytogenes infections of the central nervous system.

From 1976 to 1981 Listeria monocytogenes was second only to Neisseria meningitidis as the cause of bacterial infections of the central nervous system in adults at our hospital. None of the patients with Listeria infection was immunosuppressed or had an underlying malignancy. Ataxia was an initial feature in five of the eight patients, and in three of them it persisted beyond their discharge from the hospital. Ataxia was not a feature of the clinical picture of 14 other adult patients with meningococcal and pneumococcal meningitis. Our data indicate that L monocytogenes should be suspected as the etiologic agent in an adult with ataxia and infection of the central nervous system.

Adult↗

PubMed1983

Examination of the morphology of bacteria adhering to peritoneal dialysis catheters by scanning and transmission electron microscopy.

We examined Tenckhoff peritoneal catheters by scanning and transmission electron microscopy to study the morphology of bacterial adherence. Two catheters were removed from uninfected patients, three from patients with exit site infections, four from patients with peritonitis, and one from a patient with both exit site infection and peritonitis. Infecting organisms included three of Staphylococcus aureus and one each of Enterobacter sp., Staphylococcus epidermidis, Achromobacter xylosoxidans, Serratia sp., Klebsiella sp., and Candida albicans. Considerable morphological variation in adherence to the peritoneal dialysis apparatus occurred. No inflammatory cells were ever seen in association with infected cuffs, only two of the five patients with peritonitis had inflammatory cells associated with their catheters. In both instances, these cells tended to occur in clumps and demonstrated no flattening when in contact with the surface. Colonization of the catheter was uneven--bacteria tended to occur in clusters. Extensive matrix formation was evident in several instances, and condensation of this matrix onto the bacteria during the dehydration process rendered clumps of bacterial cells amorphous at times. Bacteria were adherent to the subcutaneous cuff in those patients with exit site infections. Gram-negative bacteria attached to individual dacron fibers of the cuff, often several layers deep. Gram-positive bacteria tended to adhere in clusters.

Bacteria↗

PubMed1983

Detection and identification of group B streptococci by use of pigment production.

Pigment production by group B streptococci (GBS) is a useful test for identification of the organisms. The test is positive in 99.5% of beta-haemolytic strains. No false-positives are noted. Non-haemolytic strains do not produce pigment. Islam's media less agar can be used as a one-step broth detector of GBS in mixed cultures. This may have application for the detection of GBS in women in labour. When used as an identification system for GBS, serum-starch broth can be further modified by reduction of serum and starch concentrations by at least 80%.

Bacteriological Techniques↗

PubMed1982

Q fever in maritime Canada.

Only nine cases of Q fever were recorded in Canada in the 20 years prior to 1978. In the 18 months from August 1979 to January 1981 the disease was diagnosed serologically in six patients from the Maritime provinces. All were epidemiologically unrelated and none had been exposed to animals. Five had pneumonia and one had chronic Q fever with probable prosthetic valve endocarditis. Three of the five pneumonia patients presented with signs and symptoms of an acute lower respiratory tract infection and were indistinguishable clinically from other patients with atypical pneumonias. The other two with pneumonia presented with nonresolving pulmonary infiltrates and complained of decreased energy. Four of the five pneumonia patients responded well to treatment with erythromycin; the fifth required two courses of tetracycline. The patient with chronic Q fever had a large amount of cryoglobulins in his serum and evidence of immune complex disease. These cases indicate that Q fever should be considered as a possible cause of atypical pneumonia in Canada.

Adult↗

PubMed1982

Staphylococcus saprophyticus as a cause of urinary tract infections.

Our objectives in this study were to elucidate various aspects of the epidemiology of Staphylococcus saprophyticus. This organism was isolated from the midstream urine specimens of 7.5% of 145 college women with frequency and urgency of urination and dysuria, but from only 0.07% of 14,835 urine specimens from adult inpatients at the Victoria General Hospital. It was found to be part of the urethral flora of only 2% of healthy women. Other staphylococci which formed part of the urethral flora of 100 healthy women included S. epidermidis (59 women), S. hominis (15 women), S. haemolyticus (13 women), S. warneri (9 women), and S. aureus (6 women). Finally, we determined that resistance to the 5-micrograms novobiocin disk has a 93% positive predictive accuracy as a presumptive test for S. saprophyticus.

Adolescent↗

PubMed1981

Causes of atypical pneumonia: results of a 1-year prospective study.

In a protocol study of cases of atypical pneumonia over a 1-year period an etiologic agent was established in 16 cases: Legionella pneumophila in 8, Coxiella burnetii in 3, Chlamydia trachomatis in 2, Mycoplasma pneumoniae in 1, para-influenza 3 virus in 1 and cytomegalovirus in 1. In the remaining 11 cases no agent was identified; the illnesses in these cases tended to be less severe. The pneumonia took much longer to resolve in the patients with Legionnaires' disease than in all the other patients (mean interval from onset of symptoms to clearing of the chest roentgenogram: 69 days v. an average of 16 days). However, the length of stay in hospital was similar for the three groups: those with Legionnaires' disease, those with atypical pneumonia of unknown cause and those with atypical pneumonia of various other established causes. L. pneumophila infection may explain a proportion of atypical pneumonias that previously could not be diagnosed, although in this series the cause of 41% of the pneumonias remained unexplained.

Chlamydia Infections↗

PubMed1981

Resistance to aminoglycoside antibiotics of gram-negative bacilli isolated in Canadian hospitals.

A survey was made of the frequency of resistance to amikacin, gentamicin and tobramycin among aerobic gram-negative bacilli isolated over a 4-week period in 1979 at six large, geographically separated Canadian hospitals. In the entire series of 4407 isolates the frequency of resistance was 2.5% to amikacin, 8.1% to gentamicin, 5.9% to tobramycin and 1.7% to all three. Most (81%) of the resistant bacteria were acquired by the patients after admission to hospital. The frequency of resistance to the three aminoglycoside antibiotics in each hospital largely reflected the local rate of cross-infection by endemic strains of resistant bacteria.

Amikacin↗

PubMed1981

Hemolysin and K antigens in relation to serotype and hemagglutination type of Escherichia coli isolated from extraintestinal infections.

Escherichia coli isolated from cases of bacteremia and from a variety of urinary tract infections were characterized according to serotype (O:H antigenicity), K type (possession of K1, K2, K3, K12, or K13), hemagglutination (HA) type, and production of beta-hemolysin. Results obtained with the bacteremia and urinary tract infection isolates were similar except for more hemolytic isolated from urine than from blood (42 versus 29%) and more K1+ isolates from blood than from urine (50 versus 29%). A close correlation was found between Ha type VI (production of fimbriae which mediate mannose-resistant HA of human and African green monkey erythrocytes) and the production of hemolysin or K1 capsular antigen or both. Most (95 of 98, or 95%) of the HA type VI+ blood isolates and most (146 of 164, or 89%) of the HA type VI+ urine isolates produced hemolysin or K1 or both, in contrast to 22 and 26%, respectively, of those belonging to HA types other than HA type VI. Also, 76% of all hemolytic and 70% of all K1+ isolates belonged to HA type VI. Remarkably few of the HA type VI+ isolates (13%) and even fewer of the HA type VI- isolates (3%) produced both K1 and hemolysin; these belonged mainly to serotypes O16:H6, O18:H7 and O2:H4. Other major serogroups were usually K1+/hemolysin- (O1, O7) or K1-/hemolysin+ (O2, O4, O6). At least 74% (262 of 351) and possibly as many as 83% (293 of 351) of those isolates which produced mannose-resistant HA of human erythrocytes were classified as HA type VI+; 31 isolates produced mannose-resistant HA with all erythrocytes tested. Taking serogroup and serotype into consideration, we conclude that the E. coli fimbrial hemagglutinin(s) responsible for the HA type VI phenotype will prove to be the same as the virulence-associated mannose-resistant adhesins of uropathogenic E. coli which other investigators have characterized as unique fimbrial antigens detectable by mannose-resistant HA of human erythrocytes.

Antigens, Bacterial↗

PubMed1980