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Biomedical subjects

P H Azimi

Publications and source records attributed to P H Azimi.

At least 37 records · Page 2Linked to original sources

Transfusion-acquired hepatitis A in a premature infant with secondary nosocomial spread in an intensive care nursery.

An outbreak of hepatitis A involving 15 nurses, two premature infants, and the mother of one infant occurred in an intensive care nursery. The infants became infected after receiving blood transfusions from a donor who shortly thereafter experienced symptoms compatible with hepatitis A and was later found to have serologic evidence of acute hepatitis A. Hepatitis was not suspected clinically in the infants but was documented serologically. One of the infants had an ileostomy with liquid intestinal drainage. Her mother and most, if not all, of the nurses acquired hepatitis from this infant. All 15 nurses had contact with this infant, whereas only four nurses had contact with the second infant. The amount of contact nurses had with this infant clearly was related to their risk of infection. Nurses not actually assigned to this infant but who reported some contact had a significantly lower attack rate than those assigned to the infant. Among assigned nurses, those assigned to more than one shift had 4.7 times the risk of acquiring hepatitis than those assigned to one shift only. No specific nursing techniques or personal habits were documented as being significant risk factors in the infected group of nurses.

Adult↗

Esophagitis associated with Candida infection in a neonate.

A 14-day old infant with stomatitis due to Candida albicans presented with frequent emesis and was found to have esophagitis by barium esophagram. She responded promptly to oral Mycostatin suspension: her emesis subsided and the stomatitis resolved. Repeat esophagram on the seventh day of therapy showed complete resolution of the esophageal mucosal abnormalities. Although Candida stomatitis is common in infants, the incidence and appropriate therapy of Candida esophagitis as a complication in otherwise normal infants are unknown. This patient responded well to frequent therapy with an oral, nonabsorbable antifungal agent.

Candidiasis↗

Serology of Chlamydia trachomatis in infants.

Sera from 502 infants with pneumonia were tested for antibodies to Chlamydia trachomatis by the microimmunofluorescence test; 175 (34.9%) were positive for IgM antibodies (titer, greater than or equal to 1:32). Chlamydiae were recovered from 42 (46.2%) of 91 IgM antibody-positive infants as compared with six (3.3%) of 181 IgM antibody-negative infants (P less than 0.0001). Two (4%) of 46 of the infants with inclusion conjunctivitis, but not pneumonia, had titers of IgM antibody of greater than or equal to 1:32; both shed the organism from the rectum. IgM antibody to C. trachomatis is not maternally transmitted to infants and was detected at a low rate (1.1%) in infants with nonpneumonic conditions. Diagnosis of pneumonia due to Chlamydia in infants by isolation of the agent is slow and unreliable. High levels of IgM antibody (greater than 1:32) appear to reflect a systemic chlamydial infection and offer the possibility of a same-day diagnosis. Thus, the detection of specific IgM antibodies to C. trachomatis may be the method of choice in diagnosing chlamydial pneumonia in infants.

Antibodies, Viral↗

In vitro activity of moxalactam alone and in combination with penicillin against common meningeal pathogens.

Moxalactam demonstrated marked activity against beta-lactamase-positive and -negative Haemophilus influenzae, Streptococcus pneumoniae, and Neisseria meningitidis by both standard minimal inhibitory concentration testing and growth curve studies. Moxalactam was ineffective against S. pneumoniae partially susceptible to penicillin G. Moxalactam (5 micrograms/ml) and penicillin (1 microgram/ml) in combination were indifferent to each other's antibacterial activity, exerting neither synergism nor antagonism against these organisms.

Bacteria↗

Susceptibility of Haemophilus influenzae type b to cefaclor and influence of inoculum size.

Cefaclor appeared to be an effective antibiotic against both beta-lactamase-positive and beta-lactamase-negative strains of Haemophilus influenzae type b when tested with 10(5) colony-forming units per ml. With inocula in excess of 10(6) colony-forming units per ml, these organisms were neither inhibited nor killed at concentrations of 400 micrograms/ml. This inoculum effect was also demonstrated in time-kill curve studies.

Cefaclor↗

The role of cefamandole in the treatment of Haemophilus influenzae infections in infants and children.

Forty patients with suspected non-CNS Hib infections were treated with cefamandole at a dosage of 100 to 150 mg/kg/day. Hib was isolated from 19 patients; three of the isolates were Blac+. All patients responded well without complications except for two children, both infected with Blac+ organisms, who subsequently developed meningitis, one three weeks following treatment for buccal cellulitis and bacteremia, the other while being treated with cefamandole for empyema. All strains of Hib were uniformly susceptible to cefamandole regardless of beta-lactamase production when tested with an inoculum of 10(4) cfu/ml. With 10(7) cfu/ml an inoculum effect was seen which was more pronounced with Blac+ strains. Moreover, "heavy" inoculum of Blac+ strains inactivated cefamandole in four to eight hours resulting in bacterial overgrowth. Similar results were obtained for ampicillin; chloramphenicol killed all strains regardless of inoculum size or beta-lactamase production. We conclude that cefamandole may be hydrolyzed by Blac+ organisms when present in large numbers, resulting in treatment failure. Extreme care should be taken in the choice of cefamandole for young infants with Hib infections, since this antibiotic neither cures nor prevents meningitis.

Cefamandole↗

Acid-fast actinomyces in a child with pulmonary actinomycosis.

Open-lung biopsy in a child with chronic pneumonia revealed branched gram-positive acid-fast organisms, later identified as Actinomyces israelii. Like Nocardia asteroides, A israelii can be acid fast by the commonly used Putt stain. The pneumonia was cured with 12 weeks of penicillin treatment.

Actinomyces↗

Congenital malaria due to Plasmodium falciparum.

Malaria manifested during the first few months of life may be result of acquisition during pregnancy, at the time of delivery, or by mosquito bite after birth. Both congenital and perinatal malaria are acquired by the transmission of parasitized maternal erythrocytes across the placenta. An infant is described whose mother was diagnosed to have malaria at six months of gestation. The infant developed intermittent fever at 5 weeks of age and presented with anemia and hepatosplenomegaly at 3 months of age at which time Plasmodium falciparum parasites were found on examination of thick smears of the infant's blood. IgG and IgM antimalarial antibodies were detected in maternal blood, but only IgG antibodies were found in the infant's blood at delivery and at the time of diagnosis. These transplacentally transmitted antibodies may afford transient protection for the infant and thus delay the onset of clinical manifestations. Due to the absence of an exoerythrocytic life cycle in congenitally acquired malaria, chloroquine is the drug of choice for treatment. Infections with chloroquine-resistant strains require multiple drug therapy.

Chloroquine↗

Listeria monocytogens: synergistic effects of ampicillin and gentamicin.

Listeria monocytogenes infections are most common in newborn infants and persons with impaired defense mechanisms. There are reports of successful treatment with ampicillin alone: however, there is uncertainty as to what regimen constitutes the most effective therapy. The purpose of this study was to illustrate the in-vitro synergism between ampicillin and gentamicin against L. monocytogenes. Seven strains of L. monocytogenes isolated from bloods or cerebrospinal fluids of infants and three control strains obtained from the Center for Disease Control were tested. Minimal inhibitory concentrations of ampicillin and gentamicin were determined in Todd-Hewitt broth with an inoculum of 10(5) organisms/ml. Killing curves were determined for ampicillin 6 microgram/ml, gentamicin, 0.5 microgram/ml, and the combination of ampicillin, 6 microgram/ml, plus gentamicin, 0.5 microgram/ml. Incubation of approximately 10(7) organisms/ml with these concentrations of ampicillin and gentamicin caused no significant reduction in the viable bacterial population in 24 hours. The combination, on the other hand, was bactericidal in all seven strains isolated from patients and one control strain. The authors believe the ultimate test of the superiority of this combination to ampicillin alone must come from clinical studies. However, the synergistic and bactericidal effects of ampicillin with gentamicin may be very desirable in treatment of newborns and patients with underlying disease.

Ampicillin↗

Clinical and laboratory investigation of cefamandole therapy of infections in infants and children.

Cefamandole nafate was effective in the treatment of a variety of infections caused by Staphylococcus aureus, Streptococcus pyogenes group A, Streptococcus pneumoniae, and Haemophilus influenzae in infants and children. The infections included periorbital cellulitis and ethmoiditis, bacteremia, cellulitis, pneumonia, and lymphadenitis. In vitro, cefamandole was effective in inhibiting the growth of H. influenzae isolated from blood or cerebrospinal fluid of patients with meningitis or sepsis. In two patients rash developed and cefamandole was discontinued. Other significant adverse effects were not noted.

Adolescent↗

Infection in newborn siblings.

Two newborn siblings, one with meningitis and one with sepsis due to Listeria monocytogenes, were born to a healthy, 33-year-old woman. She had had a spontaneous abortion prior to the birth of these infants. In spite of negative cultures, persistence of this bacterium in the mother's genital tract and perinatal acquisition of infection is suspected.

Diarrhea, Infantile↗