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Biomedical subjects

M S Simberkoff

Publications and source records attributed to M S Simberkoff.

At least 73 records · Page 4Linked to original sources
PubMed1980

Pneumococcal capsular polysaccharide vaccination in adult chronic hemodialysis patients.

PCP vaccine was administered to 21 adult hemodialysis patients and 25 control patients with no renal nor hepatic dysfunction. Antibody concentrations measured by the RIA technique were lower in the hemodialysis than in the control patients in both prevaccination sera and specimens obtained 3 to 4 weeks following vaccination. However, 6 months after vaccination, RIA GMACs in hemodialysis and control subjects were more nearly alike. OTs against Streptococcus pneumoniae, types 1 and 3, were measured in paired sera from vaccine recipients. Opsonic activity against S. pneumoniae, type I, was detected as frequently in the 3 to 4 week postvaccine sera of the dialysis as in those of control patients. However, there was a poor correlation between OTs and RIA-ACs against this organism. There was good correlation between OT and RIA-AC against type 3 pneumococci in 3 to 4 week postvaccine sera, and significantly more control patients had opsonic activity detectable in these specimens. No clinical S. pneumoniae infections have been observed in vaccine recipients. However, continued follow-up will be necessary to document the degree to which hemodialysis patients are protected by pneumococcal vaccines and the relationship between protection and antibody concentration or OTs.

Antibodies, Bacterial↗
PubMed1979

Association of teichoic acid antibody with metastatic sequelae of catheter-associated Staphylococcus aureus bacteremia: a failure of the two-week antibiotic treatment.

A patient with Staphylococcus aureus bacteremia associated with an infected intravenous catheter was treated with oxacillin for two weeks. During that period all blood cultures were sterile, he rapidly became afebrile, and there were no signs of endocarditis or metastatic abscesses. However, serum antibodies against staphylococcal teichoic acid, initially undetectable by the agar gel immunodiffusion technic, became positive during the second week of treatment. Three weeks after discharge, the patient was readmitted to the hospital because of back pain and weakness in the lower extremities. Vertebral osteomyelitis and a spinal epidural abscess caused by Staph. aureus of the same phage type as the bacteremic isolate were demonstrated. This case illustrates the importance of careful follow-up of patients with Staph. aureus bacteremia and the potential value of serial measurement of teichoic acid antibodies in detecting clinically inapparent complications of infection.

Abscess↗
PubMed1979

Bactericidal and bacteriostatic action of chloramphenicol against memingeal pathogens.

The bacteriostatic and bactericidal effects of chloramphenicol, ampicillin, tetracycline, and sulfisoxazole were compared against several potential meningeal pathogens. Chloramphenicol is bactericidal at clinically achievable concentrations against Haemophilus influenzae, Streptococcus pneumoniae, and Neisseria meningitidis. It is bacteriostatic against gram-negative bacilli of the family Enterobacteriaceae and against Staphylococcus aureus. Chloramphenicol has proven highly efficacious in the treatment of bacterial meningitis caused by those organisms against which it is bactericidal at low concentrations. Because leukocytic phagocytosis in the subarachnoid space is inefficient, we propose that bactericidal activity in cerebrospinal fluid is important for optimal therapy of bacterial meningitis. Chloramphenicol does not provide such activity in meningitis caused by enteric gram-negative bacilli.

Ampicillin↗
PubMed1978

Antibiotics: how to use them in 1977-1978. Cases 21, 22, and 23.

Self-assessment case studies illustrating prudent selection of antimicrobial agents in septic shock following urinary catheterization, bacteremia and skin lesions in an immunocompromised patient, and endocarditis in a patient with a prosthetic heart valve.

Adult↗
PubMed1978

Bactericidal and opsonic activity of cirrhotic ascites and nonascitic peritoneal fluid.

BA and OA of sera and uninfected ascitic fluid from patients with alcoholic cirrhosis were assayed against gram-negative enteric bacilli. This was compared with BA and OA in normal serum and in peritoneal fluid obtained at laparoscopy or laparotomy from noncirrhotic patients. Cirrhotic sera showed significantly reduced BA and OA against one of the organisms tested, Serratia marcescens. It had reduced OA but normal BA against E. coli. Ascitic fluid was markedly deficient in BA and OA against all strains tested when compared to both cirrhotic sera and nonascitic peritoneal fluid. Immunoglobulin and complement concentrations in cirrhotic ascites were reduced. Ascites did not inhibit the BA or OA of normal serum. However, replacement experiments suggested that the diminished activity of ascites was largely the result of its reduced complement concentration. The demonstrated deficit in both BA and OA of ascites may be a factor in the frequency of spontaneous enteric bacillary peritonitis in the cirrhotic patient.

Adult↗
PubMed1978

Hepatitis associated with high-dose oxacillin therapy.

A prospective survey of liver function during oxacillin sodium therapy revealed five cases of drug-related abnormalities among 41 patients. In each instance, the serum transaminase level was increased from normal to greater than 100 units. The serum alkaline phosphatase level was mildly elevated and bilirubin levels remained normal. All of the patients were asymptomatic. Hepatic dysfunction was reversible on withdrawal of oxacillin therapy and substitution of a cephalosporin or clindamycin. The observed abnormalities in liver function were associated with a daily oxacillin sodium dose of greater than or equal to 12 gm as well as with heroin addiction and staphylococcal endocarditis.

Adult↗