PubMed Health⌕ Search

Biomedical subjects

M L Grayson

Publications and source records attributed to M L Grayson.

64 records · Page 4Linked to original sources
PubMed1990

Antimicrobial resistance in the intensive care unit.

Antimicrobial resistance remains a major clinical problem in the intensive care unit despite the introduction of potent new antibiotics and the application of infection control measures. Impaired antibiotic permeability, antibiotic inactivation and alteration of antibiotic target sites, typically in concert, are mechanisms by which this resistance occurs. Resistance traits may be chromosomally mediated, in which case they may be expressed constitutively or inducibly, or may be mediated by plasmids and/or transposons that may confer resistance to multiple drugs and facilitate spread to other organisms. Bacteria in which clinically significant resistance has now become a potential problem include methicillin-resistant staphylococci, enterococci, a wide variety of Enterobacteriaceae, Pseudomonas aeruginosa, Pseudomonas cepacia, and Xanthomonas (Pseudomonas) maltophilia. Judicious limitation in the use of antimicrobials, especially in prophylactic regimens; use of antibiotics in appropriate doses; and, where possible, avoidance of drugs to which resistance has been shown to emerge rapidly in a specific clinical setting will help to minimize the evolution and spread of resistant bacterial isolates.

Cross Infection↗
PubMed1989

Gastroenteritis associated with Campylobacter cinaedi.

The atypical Campylobacter spp. are being associated increasingly with gastroenteritis in certain population groups. We report the clinical and laboratory features of four cases (in three homosexual men and one heterosexual man) of gastroenteritis that was associated with Campylobacter cinaedi. The infection that was caused by this organism clinically was indistinguishable from other mild gut infections and resolved spontaneously without treatment. Faecal microscopy was unhelpful in the diagnosis. Successful culture of C. cinaedi required incubation of the specimen at 37 degrees C under microaerophilic conditions on cephalothin-free media--a procedure that usually is not undertaken in culturing for the more-common faecal pathogens. C. cinaedi needs to be considered in the investigation of the cause of diarrhoea in population groups such as homosexual men.

Campylobacter↗
PubMed1989

Effect of varying pH on the susceptibility of Campylobacter pylori to antimicrobial agents.

The susceptibility of 22 clinical isolates of Campylobacter pylori to eight antimicrobial agents was studied under varying pH conditions. Macrolides (erythromycin, dirythromycin), clindamycin and to a lesser extent quinolones lost efficacy at lowered pH. The activity of ampicillin and metronidazole remained relatively stable throughout the pH range tested. The effect of pH an antimicrobial efficacy may warrant consideration when selecting an antibiotic to clear Campylobacter pylori in vivo, since the pH of the gastric submucous environment is not known for certain.

Anti-Bacterial Agents↗
PubMed1988

Preventive health advice for Australian travellers to Bali.

Five hundred travellers to Bali were surveyed with a predeparture questionnaire to assess the source and nature of health advice for international travel that is provided to Australian tourists. Eighty-seven per cent of travellers received some health advice for travel from either their family doctor, travel agent or both. Eighty-nine per cent of travellers were advised to be immunized against typhoid and 75% of travellers were advised to receive a cholera vaccination; the proportion of travellers who underwent such therapy was the same irrespective of the standard of their accommodation in Bali or their likely risk of exposure to these infections. A gamma-globulin injection was recommended to 18% of travellers and tetanus vaccine was recommended to 35% of travellers. General antimalarial measures were discussed with 59% of travellers, and 88% of travellers were advised to take antimalarial medications. Combined prophylaxis with chloroquine and a sulpha drug (usually dapsone--pyrimethamine [Maloprim]) was recommended most frequently (39% of travellers), with chloroquine alone (27% of travellers) or a sulpha drug alone (14% of travellers) also being prescribed commonly. A history of drug allergy was sought in 46% of the travellers who were advised to take antimalarial agents, and 41% of travellers were informed of possible side-effects of the antimalarial drugs. This survey showed that health advice about predeparture immunizations and antimalarial prophylaxis frequently differs from current recommendations of the Commonwealth Department of Community Services and Health and the World Health Organization.

Adolescent↗
PubMed1988

Psittacosis--a review of 135 cases.

We reviewed retrospectively 135 cases of serologically-confirmed psittacosis that were admitted to Fairfield Hospital between January 1, 1972 and March 31, 1986. The average age of the patients was 46 years. The majority (85%) of patients described a history of recent exposure to birds. The clinical features, investigations, treatment and subsequent response were analysed in 129 patients. Psittacosis was a well-defined illness that was characterized by an abrupt onset of fever, rigors, sweats, and prominent headache, and a mild dry cough which appeared late frequently. However, respiratory symptoms were absent in 18% of patients. Diarrhoea and sore throat were occasional complaints. Over 90% of cases had an abnormal chest x-ray film, or abnormal chest signs, or a combination of both. Most patients had a normal leukocyte count. Tetracycline drugs were used for treatment in 87% of the patients. Defervescence occurred in 92% of patients after 48 h of tetracycline treatment. There were no recrudescences of psittacosis and no fatalities. The clinical diagnosis of psittacosis can be made early usually, particularly in the presence of pneumonitis on a chest x-ray film and a positive history of bird contact. Treatment with doxycycline (100 mg twice a day for 14 days) is recommended.

Adolescent↗
PubMedDate not supplied

In vitro activity of sparfloxacin (AT-4140, CI-978, PD 131501), a new quinolone antimicrobial agent.

In vitro activity of sparfloxacin (AT-4140, CI-978, PD 131501) against clinical bacterial isolates was compared with those of ciprofloxacin and vancomycin or imipenem. Sparfloxacin was more active or equal to ciprofloxacin against most Gram-positive species and against Bacteroides fragilis, and it inhibited virtually all Enterobacteriaceae at 1.0 micrograms/ml or less.

Anti-Infective Agents↗
PubMedDate not supplied

Fecal colonization with vancomycin-resistant enterococci in Australia.

To assess the rate of fecal vancomycin-resistant enterococci (VRE) colon ization in Austalia, we examined specimens from 1,085 healthy volunteers. VRE was cultured from 2(0.2%) of 1,085 specimens; both were vanB Enter ococcus faecium, identical by pulsed-field gel electrophoresis, but with a pattern rare in Melbourne hospitals.

Adult↗