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Biomedical subjects

P J Say

Publications and source records attributed to P J Say.

17 recordsLinked to original sources
PubMed1997

Evaluation of the microparticle enzyme immunoassay Abbott IMx Select Chlamydia and the importance of urethral site sampling to detect Chlamydia trachomatis in women.

OBJECTIVE: To evaluate the commercial microparticle enzyme immunoassay (MEIA), Abbott IMx Select Chlamydia, for the detection of Chlamydia trachomatis in women and to compare its performance with endocervical cell culture. Also, to determine whether sampling the urethral site is an important part of chlamydial diagnosis in women. SETTING: The Auckland, Manukau, and Waitakere Sexual Health Clinics, Auckland, New Zealand and the Department of Clinical Microbiology, Auckland Hospital, Auckland, New Zealand. PATIENTS: The study population consisted of 622 consecutive women who attended the three sexual health clinics. METHODS: The IMx Chlamydia assay was performed on an IMx analyser, following a specimen treatment procedure. All reactive samples from the IMx Chlamydia assay were confirmed using the IMx Chlamydia blocking antibody reagent. The Syva direct fluorescent antibody (DFA) test was used to aid in resolving discrepancies. The cell culture technique was performed in shell vials using cycloheximide treated McCoy cells, which were stained using a fluorescein conjugated monoclonal antibody. RESULTS: When compared against the endocervical cell culture, the IMx Chlamydia had a sensitivity of 82.1% (23/28) and a specificity of 99.3% (590/594). When compared against an expanded gold standard, the IMx Chlamydia and endocervical cell culture had sensitivities of 84.4% (27/32) and 87.5% (28/32), specificities of 100% (590/590) and 100% (590/590), positive predictive values of 100% (27/27) and 100% (28/28), negative predictive values of 99.2% (590/595) and 99.3% (590/594), and accuracies of 99.2% (617/622) and 99.4% (618/622), respectively. The prevalence rate by endocervical cell culture and the expanded gold standard were 4.5% and 5.1%, respectively. Additional urethral cell culture testing revealed a further nine patients positive from this site only, giving a 28% (9/32) increase in the number of patients diagnosed for chlamydia, thus giving an overall prevalence of 6.6% (41/622). CONCLUSIONS: The IMx Chlamydia assay is an easy and rapid test to perform, it is cost effective, and shows similar performance to endocervical cell culture in the female population studied and is thus an excellent alternative to culture for the diagnosis of C trachomatis. The study also showed the importance of urethral site sampling in these women, as endocervical testing alone will underestimate the prevalence of chlamydial genital infection.

Chlamydia Infections↗
PubMed1993

Unlinked anonymous monitoring of HIV prevalence at sexually transmitted disease clinics.

AIM: To determine the prevalence of HIV infection among patients attending the four sexually transmitted disease (STD) clinics in two metropolitan areas of New Zealand. METHODS: The population studied comprised everyone who attended between August 1991 and August 1992 because of concern about a possible new episode of an STD and who had a blood specimen taken for hepatitis B (or syphilis) serology. The study involved unlinked anonymous testing of left-over blood specimens, following ethical guidelines that have been proposed internationally. RESULTS: Among 8478 specimens tested, 23 (2.7 per 1000) were found to be HIV positive. The seroprevalence rates per 1000 among women, heterosexual men, and homosexual or bisexual men were 1.1, 1.3, and 44, respectively. All but five of the infected people were either known to be HIV positive or had an identifiable test during their clinic attendance. CONCLUSIONS: The seroprevalence rates are similar to those reported from STD clinics in England, and suggest that heterosexual transmission of HIV infection has not yet been extensive in New Zealand.

Adolescent↗
PubMed1989

Rhodococcus equi: an emerging opportunistic pathogen?

Human infection with Rhodococcus equi is apparently rare with most published reports describing the development of lung abscesses in immunocompromised hosts. Of only 18 cases of infection previously recorded, four have recently occurred in patients with the acquired immune deficiency syndrome (AIDS). In Australasia, R. equi has frequently been isolated from soil and infected farm animals yet no human infections have been reported thus far. Three cases of R. equi infection have occurred in New Zealand and, collectively, they cover a wider spectrum of disease than that previously recognised. The natural history of R. equi infections, their clinical features and treatment are described in the light of our recent experience.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Chlamydia trachomatis isolation in women attending a VD clinic in Auckland, New Zealand.

Chlamydia trachomatis was isolated from 120 of 504 women (24%) attending a VD clinic at Auckland Hospital. Epidemiological correlates indicated a sexual mode of transmission. The only symptom of significance was lower abdominal pain. Cervicitis was more common in women with chlamydia, especially if they were on hormonal contraceptives. Chlamydia was isolated more commonly in women with gonorrhoea (52%) and genital warts (37%). The high incidence of asymptomatic and unsuspected infection emphasizes the need for routine chlamydial culture in VD clinics.

Adolescent↗
PubMed1983

Unsuspected Chlamydia trachomatis in females attending a sexually transmitted diseases clinic.

One hundred and five women attending Auckland sexually transmitted diseases clinic were reviewed because of positive cervical cultures for Chlamydia trachomatis. Their average age was 19 years, 70% were European; 28% were Maori. In half the patients the positive culture was a chance finding and therefore treatment was delayed resulting in six patients (12%) developing pelvic inflammatory disease. Eight out of nine male contacts, subsequently traced, had asymptomatic urethritis, one having epididymitis. One patient had no evidence of urethritis but was chlamydia positive. Associated pathogens present in the women were Neisseria gonorrhoeae (26%), Trichomonas vaginalis (6%), Gardnerella vaginalis (46%) and Candida albicans (19%). These findings support a need for routine chlamydial testing in female patients attending sexually transmitted diseases clinics and epidemiological treatment of female contacts of men with non-specific urethritis.

Adult↗
PubMed1981

Piperacillin in surgical infections: a clinical trial.

Piperacillin was administered in eighteen patients with mixed infections. Three had osteomyelitis, two had peritonitis, two had gangrenous toes, one had bronchopneumonia, and the other ten had leg ulcers of various types accompanies by cellulitis. In eleven patients one of the infecting organisms was Pseudomonas aeruginosa, and another had Pseudomonas maltophilia. All had appropriate surgical treatment, which in nine patients included skin grafting in the presence of Pseudomonas aeruginosa. All the patients were clinically cured except for one with osteomyelitis who relapsed and was found to have a residual sequestrum. None of the skin grafts failed. In other patient who underwent grafting, cloxacillin was also given because she had a beta-lactamase-producing staphylococcus. The only adverse reaction was thrombophlebitis of the vein used for drug administration in 15 out of 18 patients. One hundred and five other isolates of Pseudomonas aeruginosa were tested in the laboratory against piperacillin and resistance to the drug was found to be rare. It was concluded that piperacillin is a safe drug to use, is effective against a wide range of organisms, and is particularly effective in preventing the destruction of skin grafts by Pseudomonas aeruginosa. It is likely to be ineffective against beta-lactamase-producing staphylococci, and when these are present also, it would be wise to use another drug such as cloxacillin in addition.

Clinical Trials as Topic↗
PubMed1980

Ocular cryptococcosis in New Zealand.

A patient with unexplained lung abscess six years previously, developed chronic meningitis, and later, bilateral chorioretinitis. The organism found was Cryptococcus neoformans. The patient was successfully treated with amphotericin B and 5-fluorocytosine.

Adult↗