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Biomedical subjects

M Gratten

Publications and source records attributed to M Gratten.

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

Multiple colonization of the upper respiratory tract of Papua New Guinea children with Haemophilus influenzae and Streptococcus pneumoniae.

Nasal secretions from Papua New Guinea children were cultured using selective agents, to determine the prevalence of multiple colonization for both S. pneumoniae and H. influenzae. 29.5% of 156 and 53% of 93 carriage positive subjects harbored more than one type of S. pneumoniae and H. influenzae respectively. Of 95 strains of pneumococci isolated from multiply colonized children, 40% were relatively resistant to benzylpenicillin. In more than one half of the children in this group both penicillin sensitive and resistant serotypes coexisted. Significantly more penicillin resistant pneumococci were isolated from children with ready access to primary and regional health care services. Among H. influenzae the prevalence of multiple isolations due to nonencapsulated variants only, and encapsulated plus nonencapsulated organisms was similar. The commonest biotypes were types I, II, III and V, and each was similarly associated with multiple carriage.

Child↗
PubMed1987

Serum concentrations of penicillin after intramuscular administration of procaine, benzyl, and benethamine penicillin in children with pneumonia.

Serum concentrations of penicillin were measured in 37 children with pneumonia. The mean serum concentration of penicillin was greater than 1.0 microgram/mL for 11 hours after intramuscular administration of 48,000 U/kg benethamine penicillin compound (nine children), for 26 hours after 48,000 U/kg aqueous procaine penicillin (10 children), and for 40 hours after 79,000 U/kg aqueous procaine penicillin (seven children). After intramuscular administration of 35,000 U/kg benzyl penicillin in 11 children, the serum concentration was 13.3 +/- 7.4 micrograms/mL (mean +/- SD) 30 minutes after the injection, and 4.9 +/- 3.2 micrograms/mL after 3 hours. Our findings lend support to the World Health Organization recommendation that children with mild pneumonia in developing countries be given daily intramuscular injections of 50,000 U/kg aqueous procaine penicillin.

Child↗
PubMed1986

Colonisation of Haemophilus influenzae and Streptococcus pneumoniae in the upper respiratory tract of neonates in Papua New Guinea: primary acquisition, duration of carriage, and relationship to carriage in mothers.

In order to determine the age of acquisition and duration of carriage of the first strains of Haemophilus influenzae and Streptococcus pneumoniae in the upper respiratory tract of Papua New Guinea children, 25 babies were recruited at, or shortly after birth. Nasal secretions from mothers and children were cultured at 1- to 2-weekly intervals. H. influenzae and S. pneumoniae were acquired within the neonatal period by 60% of the infants, and all were colonised by both organisms within the first 3 months of life. Carriage periods for H. influenzae ranged from 6 to 221 days (mean, 74 days), and for S. pneumoniae from 5 to 290 days (mean, 96 days). Penicillin resistance was detected in 36% of the first acquired strains of pneumococci. Mothers, generally either did not carry H. influenzae or S. pneumoniae, or harboured types different to those first acquired by their infants. However, one-third of mothers subsequently became colonised with H. influenzae and S. pneumoniae types similar to those carried by their babies.

Carrier State↗
PubMed1985

Absorption of chloramphenicol sodium succinate after intramuscular administration in children.

Because it is thought that chloramphenicol is poorly absorbed after intramuscular administration, we compared blood levels of chloramphenicol after intramuscular administration with those after intravenous administration in children with a variety of diagnoses. Fifty-seven children were studied on 62 occasions while they were receiving chloramphenicol sodium succinate (25 mg of chloramphenicol per kilogram of body weight) intramuscularly every six hours. The peak level of chloramphenicol was 19.5 +/- 5.99 micrograms per milliliter (mean +/- S.D.) in 11 children after the first dose and 31.4 +/- 12.99 micrograms per milliliter in 51 children after two or more doses. The lowest peak level after intramuscular administration was 13 micrograms per milliliter, which is in the therapeutic range of 10 to 30 micrograms per milliliter. Thirteen children were studied on 17 occasions while they were receiving chloramphenicol sodium succinate (25 mg of chloramphenicol per kilogram) intravenously every six hours. The peak level of chloramphenicol was 19.4 +/- 6.37 micrograms per milliliter in eight children after the first dose and 28.2 +/- 11.09 micrograms per milliliter in nine children after two or more doses. The area under the serum level curve was not significantly different after intramuscular and intravenous administration. We conclude that chloramphenicol sodium succinate is well absorbed after intramuscular administration. This route is cheaper, it demands less staff time, and it does not carry the risks of sepsis and overhydration associated with intravenous therapy.

Absorption↗
PubMed1985

The aetiology of purulent meningitis in highland children: a bacteriological study.

Of 155 highlands children with purulent culture-positive meningitis studied from March 1980 to September 1984, 84% were aged twelve months or less and 92% were infected with either Haemophilus influenzae, Streptococcus pneumoniae or both organisms. Other pathogens were Neisseria meningitidis (8 isolations), Streptococcus pyogenes (2 isolations) and Streptococcus agalactiae and Klebsiella species (1 of each). Among H. influenzae isolates, serotype b strains predominated (83%) and most (96%) belonged to biotype I or II. Infections due to non-b haemophili included serotype a (9 strains), serotype f (1 strain) and non-serotypable variants (3 strains). Of 67 S. pneumoniae strains 22% were resistant to benzylpenicillin, with minimal inhibitory concentrations of 0.1-1.0 micrograms/ml. The commonest serotypes were types 5 (11 isolates), type 7 (9 isolates) and types 2, 6 and 46 (6 of each). No resistance to chloramphenicol was detected in either H. influenzae or S. pneumoniae and only one of 56 strains of H. influenzae was insensitive to betalactam antibiotics. The known case fatality rate in this study was 37%. More children with pneumococcal infection died (46%) than those with haemophilus infection (30%), though the difference was not statistically significant; 79% of all deaths occurred in children aged less than twelve months. There is an urgent need for H. influenzae and S. pneumoniae vaccines that are effective in young children.

Age Factors↗
PubMed1984

Aetiology of pneumonia in children in Goroka Hospital, Papua New Guinea.

To determine the aetiology of pneumonia in 83 children admitted to Goroka Hospital, Papua New Guinea, lung aspirates and blood were cultured for bacteria. Haemophilus infuenzae, Streptococcus pneumoniae, or both, were isolated from 43 (52%) of the children, other bacteria from 8 (10%), and no bacteria from 32 (39%). Of the 32 strains of H influenzae tested, 18 (56%) were non-serotypable, 8 (25%) were serotypes other than type b, and only 6 (19%) were type b. Viruses were isolated from lung or nasopharyngeal aspirates from 18 (29%) of the 62 children for whom viral cultures were done. It seems that, although viruses may initiate infection, death from pneumonia in children in developing countries is often due to H influenzae, S pneumoniae, or both. Antibiotic therapy would prevent many of these deaths. There is an urgent need for vaccines, effective in children less than 6 months old, that protect against all strains of H influenzae, and S pneumoniae.

Biopsy, Needle↗
PubMed1984

Distribution and relationship to serotype of Haemophilus influenzae biotypes isolated from upper respiratory tracts of children and adults in Papua New Guinea.

The relationship between serotypes and biotypes of 505 carriage strains of Haemophilus influenzae isolated from the upper respiratory tracts of well children, children with pneumonia, and healthy adults was studied. All except serotype c were significantly associated with one or two specific biotypes (P less than 0.001). No encapsulated organisms belonging to biotypes V, VI, or VII were encountered. No significant difference in the interaction of biotypes and serotypes isolated from well and sick children was present. Both encapsulated and nonserotypable biotype I H. influenzae strains were commonly carried in the upper respiratory tracts of healthy Melanesian children. The distribution of nonserotypable H. influenzae strains occurred throughout all biotypes, and the frequency of nonencapsulated biotype III and IV strains differed significantly from serotypable organisms with the same biotype (P less than 0.001).

Adult↗
PubMed1984

The bacteriology of skin sores in Goroka children.

The bacteriology of infected skin lesions was studied in paediatric outpatients. Thirty-nine untreated lesions were studied: 37 (95%) grew beta haemolytic streptococci (46% group A, 3% group B, 23% group C, 26% group G), 21 (54%) grew Staphylococcus aureus and 13 (33%) grew Corynebacterium haemolyticum. No attempt was made to selectively isolate Corynebacterium diphtheriae in this study. Vincent's organisms were seen in 13 (37%) of 35 gram stains from untreated lesions, including eight (73%) of 11 tropical ulcers. Twenty-three (92%) of the 25 strains of S. aureus isolated from untreated sores were resistant to penicillin.

Child↗
PubMed1983

Haemophilus influenzae biotype VII.

A hitherto unreported biotype of Haemophilus influenzae is described. The isolate is noncapsulate and fails to decarboxylate ornithine or hydrolyze urea but is a strong indole producer. Its frequency is low. It is suggested that this newly recognized biotype of H. influenzae be designated biotype VII.

Haemophilus influenzae↗
PubMed1981

The laboratory diagnosis of opportunistic infections caused by uncommon bacteria in Papua New Guinea.

Flavobacterium meningosepticum, Chromobacterium violaceum and Listeria monocytogenes are opportunistic pathogens of man and are occasional but important causes of infections in neonates, infants and adults in Papua New Guinea. Mortality is high. Flavobacterium meningosepticum should be suspected when a weak indole producing oxidase positive Gram-negative bacillus producing a discrete yellow non-diffusing pigment at room temperature and showing a resistant antibiotic sensitivity pattern is isolated from the blood and/or C.S.F. of a neonate. Chromobacterium violaceum can be presumptively identified if a Gram-negative bacillus producing an intense non-diffusing violet pigment is cultured, commonly in associated with multiple abscess formation in the host. The isolation of a slender Gram-positive bacillus from C.S.F. or blood which produces catalase and acetylmethylcarbinol is consistent with Listeria monocytogenes. This organism forms discretely beta haemolytic colonies on blood agar and attacks the carbohydrates salicin and trehalose.

Bacterial Infections↗
PubMed1981

Nasal carriage of pathogenic bacteria in Kalauna Village, Goodenough Island.

Nasal swabs from 62 villagers of Kalauna, Goodenough Island were cultured. Streptococcus pneumoniae was isolated from 16 of 25 adults (64%) and 36 of 37 children (97%). Significant regional clustering of prevalent pneumococcal serotypes were seen among families in core hamlets. Five of 20 adults (20%) and 30 of 37 children (81%) grew Haemophilus influenzae all of which were biotypable. A variety of faecal Gram negative bacilli comprising enterobacteria, Alcaligenes species and an aeromonad were isolated from 30 of 62 (48%) swabs.

Alcaligenes↗