Neonatal group B streptococcal infection.
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Biomedical subjects
Publications and source records attributed to M Dryden.
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Group B streptococcal infection is a leading cause of neonatal morbidity and mortality in the developed world. Data obtained in our region suggest that the incidence in the UK may be higher than previously reported, and together with the results of a pilot study indicate that preventive strategies based on maternal risk factors alone would prevent less than half the cases of neonatal disease.
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Pseudomonas septicaemia presenting with subcutaneous nodules, though rare, is well described in immunocompromized populations. It is, however, very uncommon in immunocompetent patients. We describe a case of a 42-year-old woman who presented with community-acquired. Pseudomonas aeruginosa septicaemia and subcutaneous nodules. No precipitating cause or immune dysfunction was found. She was successfully treated with appropriate antibiotics, respiratory and cardiovascular support in the Intensive Care Unit. The difficulty in eradicating the organism from the skin lesion and the need for investigating the immune function of septicaemia patients are discussed.
An adult white-handed gibbon (Hylobates lar) at a zoo in eastern Kansas was euthanized after developing a head tremor, generalized motor incoordination, and partial paresis of the right arm that persisted over 2 yr. Magnetic resonance imaging early in the course of the disease demonstrated a localized left frontal lobe cerebritis. Larvae morphologically consistent with a Baylisascaris species were seen in tissue sections of the cerebrum and cerebellum. Epizootiologic investigation, which included qualitative fecal flotations, evaluation of soil samples for nematode eggs, and necropsy examination of livetrapped raccoons (Procyon lotor), indicated that Baylisascaris procyonis was most likely to have caused the cerebrospinal nematodiasis in this gibbon.
STUDY DESIGN: A case of paraspinal abscess formation from Haemophilus paraphrophilus is presented. OBJECTIVES: To describe a case of paraspinal abscess formation from H. paraphrophilus, a fastidious commensal organism of the mouth and pharynx. A precise bacteriologic identification can be difficult; techniques for such identification are discussed. SUMMARY OF BACKGROUND DATA: Spinal abscess caused by H. paraphrophilus is unusual and can be very difficult to diagnose. METHODS: The etiology, clinical presentation, technical examinations, and treatment are reviewed. RESULTS: Prolonged antibiotic treatment was curative, although surgery was considered. CONCLUSIONS: Bacteriologic diagnoses in these rare infections are difficult. Antibiotic therapy was curative in the patient described.
An outbreak of eight cases of cryptosporidiosis in Hampshire over a period of eight weeks in the summer of 1996 was linked to use of one swimming pool. Cryptosporidial oocysts were not isolated from samples of backwash, but the presence of enterobius ova indicated faecal contamination and a case control study including the first four primary cases suggested an association with immersion in the pool. Even in small outbreaks case control studies can provide useful supportive evidence as to the possible source of infection.
Attachment classifications have been found to distinguish clinic-referred, oppositional preschool boys from controls, but there has been no previous effort to examine the relative contribution of attachment when behaviors from a social learning perspective are also considered. The present study examined the contribution of attachment and behavioral variables to the prediction of clinic referral for oppositional defiant disorder in a sample of preschool boys. We hypothesized that the attachment measures would offer better discrimination of clinic and control group boys at this age. This hypothesis was confirmed when the attachment measures were compared with the parent-child behaviors most strongly associated with social learning conceptualizations of disruptive problems (maternal commands and criticism, and child noncompliance), but rejected in a more stringent test in which the attachment measures were compared with the behavioral variables distinguishing the groups in this particular sample.
Cat exposure has been directly associated with the development of human Bartonella henselae infections, resulting in cat-scratch disease, bacillary angiomatosis, or bacteremia. The prevalence of serum antibody titers to B. henselae was determined for selected pet cats from 33 geographic locations throughout the United States and several areas in western Canada. Seroprevalences paralleled increasing climatic warmth (P < .02) and annual precipitation (P < .03). These warm, humid areas with the highest seroprevalence would also have the highest number of potential arthropod vectors. The southeastern United States, Hawaii, coastal California, the Pacific Northwest, and the south central plains had the highest average prevalences (54.6%, 47.4%, 40.0%, 34.3%, and 36.7%, respectively). Alaska, the Rocky Mountain-Great Plains region, and the Midwest had low average prevalences (5.0%, 3.7%, and 6.7%, respectively). Overall, 27.9% (175/628) of the cats tested were seropositive. The seroprevalence of B. henselae in cats varies throughout the United States and appears to be influenced by climate.
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Graft infection occurred in 11 of 322 patients (3.4%) who had insertion of a vascular prosthesis for peripheral vascular disease during a 4-year period. The groin was the most common site of infection and multiple resistant Staphylococcus aureus (MRSA) was the most common organism responsible. Six of 7 MRSA infections occurred following a procedure involving a previously placed graft and/or a groin incision. Prophylactic antibiotics effective against MRSA are recommended for patients having a revisional procedure, especially involving the groin.
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A study was performed to assess whether a model of vascular graft infection could be established in sheep carotid artery. Either a protein sealed Dacron or a polytetrafluoroethylene (PTFE) graft was used in 22 sheep while a control operation was performed on 4 animals. Staphylococcus aureus in concentrations of 10(2), 10(4), 10(6) or 10(8) colony-forming units (CFU) was inoculated into the wound before closure. No infection occurred with an inoculum of 10(2). The lowest concentration of organism producing infection was 10(4) for PTFE, 10(6) for Dacron and 10(8) for controls. Six of eleven Dacron grafts and seven of ten PTFE grafts became infected. The sheep carotid artery has proven a satisfactory model for studies of vascular graft infection.
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Thirteen patients with Aeromonas species septicemia were seen at Westmead Hospital between 1983 and 1987. In 10 patients (77%) septicemia was caused by A. sobria, and in 3 (23%) by A. hydrophila, A. caviae was not isolated. Chronic underlying illness was present in 10 patients (77%), hematological malignancy being the most common (46%). The average age of the patients was 65.8 years. Seven patients (54%) presented with clinical sepsis, diarrhea and abdominal pain. The biliary tract, lung and soft tissue were other primary sites of infection. Nosocomial infection occurred in 5 patients (38%). Cross-infection was not seen. Contact with fresh water or fish was observed in only 2 patients (15%). The majority of cases occurred in the warmer months of the year. The overall mortality was 46%. All isolates of Aeromonas species were resistant to ampicillin 8 mg/L. Ten isolates were resistant to tobramycin 1 mg/L, and 3 to tobramycin 4 mg/L. In contrast, 3 isolates were resistant to gentamicin 1 mg/L, and none to 4 mg/L. The isolates showed a varied pattern of resistance to other antibiotics tested, but all were susceptible to piperacillin 64 mg/L, imipenem 4 mg/L, ciprofloxacin 1 mg/L, and amikacin 16 mg/L.