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Biomedical subjects

M W Humble

Publications and source records attributed to M W Humble.

17 recordsLinked to original sources
PubMed1992

Attitudes and concerns amongst laboratory staff regarding handling of HIV positive biological specimens.

AIMS: to ascertain attitudes and concerns of laboratory staff towards handling of HIV positive biological samples. METHOD: an anonymous questionnaire regarding various aspects of biological sample handling was distributed to laboratory staff from the Wellington Area Health Board laboratories. RESULTS: of a total of 133 laboratory staff (response rate: 56.4%), five were seriously considering leaving, and another ten would have chosen another career if given prior information in regard to handling HIV positive biological samples. Of the responders, 22.8% and 38.3% considered that their employer does not provide adequate safety measures and education respectively in regard to HIV. CONCLUSIONS: handling of HIV positive biological samples does not greatly contribute to attrition amongst laboratory staff. Given the concern of laboratory staff for safety and education in regard to HIV, a continuous in-service educational programme would be desirable.

Attitude of Health Personnel↗
PubMed1991

The BACTEC TB system in the laboratory diagnosis of mycobacterial infection.

OBJECT: to compare the BACTEC TB system with our conventional multimedia system for the isolation of mycobacteria from clinical specimens. METHODS: specimens received over a two year period were cultured into BACTEC 12B vials and onto a variety of solid and liquid media routinely used by us for the isolation of mycobacteria. Cultures were observed regularly for bacterial growth, and examined for the presence of mycobacteria by acid fast microscopy. All results were recorded. At the end of the two year period the results for the two methods were compared. RESULTS: of the 4443 specimens cultured by both methods, 260 were positive for mycobacteria. Sensitivity and specificity were 88.31% and 99.35% respectively for the BACTEC, and 84.41% and 99.96% respectively for our routine multimedia system. Tuberculosis was confirmed by the BACTEC TB system in six patients who were otherwise culture negative. One of these patients had tuberculous meningitis. Three patients culture positive for M tuberculosis by our routine method, were negative by the BACTEC. Twenty-nine false positive cultures were detected, 27 by the BACTEC TB system alone. CONCLUSIONS: the BACTEC TB system is a rapid and sensitive system for the detection of mycobacteria in clinical specimens, and has proved to be a useful adjunct to our routine multimedia system. However, decreased specificity, particularly with lower respiratory tract specimens, means that positive results from these sites can be reported less confidently when they are detected by the BACTEC TB system alone. This negates some of the advantages of the BACTEC TB system for the detection of mycobacterial disease of the lungs.

Bacteriological Techniques↗
PubMed1990

Streptococcus zooepidemicus cellulitis and bacteraemia in a renal transplant recipient.

A case of renal transplant recipient with Streptococcus zooepidemicus (Lancefield group C) cellulitis and bacteraemia is described. Human infections with this organism are very rare and this is the first case report of cellulitis caused by S. zooepidemicus. While animals are the reservoir for most human infections, a source was not defined in this patient.

Adult↗
PubMed1987

Disinfection of metal and plastic pelvic specula in general practice.

One hundred and sixteen general practices in Wellington were surveyed about their use and disinfection of gynaecological specula. Two thirds of the practices used metal specula which were adequately disinfected by boiling for at least one hour. Of the 46 practices that used plastic specula, only four always disposed of them, as recommended, after use. Aldehyde or halogen disinfectants which are effective against all important sexually-transmitted disease (STD) organisms were used by only 13 of the 42 practices that recycled specula. The remaining 29 practices used quaternary ammonium or diguanide disinfectants which may not be effective against all STD organisms.

Disinfection↗
PubMed1985

Experience with full-dose hepatitis B vaccine in Wellington Hospital staff.

Full-dose intramuscular hepatitis B vaccine was given to 42 staff in the dental and renal departments at Wellington Hospital. Immune levels of anti-HBs were obtained in 41 of 42 (98%) staff six months after the first dose of vaccine. In 3 of 38 (8%) staff given three doses of vaccine, anti-HBs levels fell to below the immune range 18 months after the first dose, and a fourth booster dose was given, with subsequent restoration of immune levels of anti-HBs. The commonest side-effect noticed was temporary soreness at the injection site, which occurred in 33% of doses. Two staff experienced positional vertigo after the first and second doses of vaccine, and the third dose was therefore omitted.

Dental Staff, Hospital↗
PubMed1985

Treatment of pneumonia with imipenem/cilastatin.

This pilot study assessed the efficacy, safety and tolerance of intravenously administered imipenem/cilastatin in the treatment of adults hospitalised with community acquired pneumonia. Thirteen patients were treated with 500 mg imipenem and 500 mg cilastatin eight hourly for a minimum of five days. Eleven patients (85%) had a clinical cure; (Legionella pneumophila was the pathogen in four, Streptococcus pneumoniae in one, Branhamella catarrhalis in one, no pathogen identified in five). One patient had a partial response (Staphylococcus aureus); and one patient was a treatment failure (Haemophilus influenzae and Klebsiella ozaenae). Clinical and laboratory side effects were mild, reversible and did not require treatment to be stopped. We conclude that the combination of imipenem and cilastatin was effective as a single agent in the treatment of the majority of these patients with hospital referred community acquired pneumonia.

Adult↗
PubMed1983

Outbreak of co-trimoxazole- and gentamicin-resistant Klebsiella aerogenes bacteremia in neutropenic patients receiving oral co-trimoxazole prophylaxis.

Over a five-day period, three neutropenic patients developed bacteremia with an identical strain of Klebsiella aerogenes (serotype K16) resistant to co-trimoxazole and gentamicin. All three patients had received prophylaxis with oral co-trimoxazole before the onset of bacteremia. This report outlines some of the problems associated with co-trimoxazole prophylaxis.

Aged↗
PubMed1982

Third-generation cephalosporins: comparative antibacterial activity against routine clinical isolates.

The in vitro antibacterial activity of five third-generation cephalosporins (thienamycin, ceftazidime, cefotaxime, moxalactam and cefoperazone) was compared with that of three second-generation cephalosporins (cefoxitin, cefamandole and cefuroxime) against 313 routine clinical isolates. Thienamycin, ceftazidime, cefotaxime and moxalactam had superior activity against coliform bacilli compared to cefoxitin, cefamandole and cefuroxime. Only three cephalosporins (ceftazidime, thienamycin and cefoperazone) had significant activity against Pseudomonas aeruginosa. Both third-and second-generation cephalosporins had similar activity against gram-positive cocci, except for thienamycin, which was the most active cephalosporin against Staphylococcus aureus and Streptococcus faecalis. No single cephalosporin showed overall superiority in antibacterial activity, but thienamycin and ceftazidime were the most active against the range of bacteria tested.

Bacteria↗
PubMed1981

Antimicrobial susceptibility of Haemophilus influenzae isolates in Wellington hospital.

103 strains of Haemophilus influenzae isolated during June to October 1980 were tested for susceptibility to seven antimicrobials using the Dynatech MIC 2000 system. Six strains (5.8 percent) were resistant to ampicillin (one type b, five untypable) and all of these produced beta-lactamase. Two of these six strains were isolated from blood; one untypable strain in an adult with pneumonia, and one type b strain in a child with acute epiglottitis. No resistance to the other six antimicrobials was found, except for one strain resistant to tetracycline. All isolates were biotyped, but there were no correlation between biotype and antimicrobial resistance.

Ampicillin↗
PubMed1980

Staphylococcal bacteraemia, fusidic acid, and jaundice.

Fusidic acid was used to treat 131 out of 250 patients with staphylococcal bacteraemia over 10 years. Other antimicrobial agents were given to the 119 remaining patients. Thirty-seven patients were already jaundiced before antibiotic treatment was started. Jaundice developed during treatment in 38 out of 112 patients given fusidic acid (34%) and in two out of 101 patients given other antimicrobials. The incidence of jaundice was higher in patients given fusidic acid intravenously (48%) rather than by mouth (13%). Jaundice appeared within 48 hours after the administration of fusidic acid in 93% of these cases. When the drug was stopped serum bilirubin concentrations fell to normal values within four days in those patients in whom they had been previously normal and who survived the bacteraemic episode. Fusidic acid was associated with increasing jaundice in 13 of 19 patients (68%) already jaundiced before it was given. In six out of 32 patients who developed jaundice while receiving intravenous fusidic acid serum alkaline phosphatase activity was raised suggestive of cholestatic jaundice. The mechanism in the remaining patients was unknown. Fusidic acid, particularly the intravenous preparation, in invaluable in treating severe staphylococcal infection but should be used with caution in patients with abnormal liver function. Patients receiving intravenous fusidic acid should be given the oral form of the drug as soon as their clinical condition permits.

Adolescent↗
PubMed1976

Imported methicillin-resistant Staphylococcus aureus infection: a case report.

The first isolate of a methicillin-resistant strain of Staphylococcus aureus at the Wellington Hospital was made on 31 March 1976, from a man who had emigrated from the United Kingdom in 1973. The infection was successfully treated with co-trimoxazole and fucidin. The epidemiological implications of this infection are discussed.

Cloxacillin↗