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Biomedical subjects

P M Southern

Publications and source records attributed to P M Southern.

At least 19 recordsLinked to original sources
PubMed1998

Does examination of urinary sediment identify individuals with Gulf War syndrome? A pilot study.

BACKGROUND: Many veterans who were involved in the Persian Gulf theater of operations have had a variety of unexplained physical complaints, collectively called the Gulf War syndrome or similar names. There has been much debate on the issue and numerous publications, both in the medical and the lay press. A method for examining urinary sediment that was developed in an effort to identify nonculturable bacteria has been used in Gulf War veterans and was the basis for intensive antimicrobial therapy in many of them. METHODS: We evaluated eight Gulf War veterans with complaints compatible with Gulf War syndrome. Subjects were from various parts of the United States. A detailed history and physical examination were performed. Urine was obtained before and after prostatic massage (men) or before and after pelvic examinations (women) and was tested by a previously described microscopic method as well as by culture and conventional Gram stain. Age- and sex-matched healthy control subjects were tested similarly and concurrently. RESULTS: Two female Gulf War veterans had findings of Candida albicans and Klebsiella pneumoniae by conventional culture. The same organism types were seen both by the special method and by conventional Gram stain. All other subjects and controls were completely indistinguishable. CONCLUSION: Examining the urinary sediment by this elaborate method does not differentiate persons with Gulf War syndrome from normal, healthy control subjects who were never in the Persian Gulf area.

Adult↗
PubMed1997

Algaemia due to Prototheca wickerhamii in a patient with myasthenia gravis.

Prototheca wickerhamii is a rare cause of systemic infection in humans. While some cases occur in previously healthy individuals, others are associated with a variety of preexisting diseases. Here we present, for the first time, a case of P. wickerhamii algaemia in a patient with myasthenia gravis. The patient was successfully treated with amphotericin B.

Aged↗
PubMed1997

Antibiotics update.

Some of the newer antimicrobial agents that have either appeared on the market, will probably soon appear, or that are being used in other parts of the world and are therefore worthy of our interest will be reviewed. The agents reviewed fall into the following four classes: antibacterial, antifungal, antiparasitic, and antiviral.

Anti-Bacterial Agents↗
PubMed1996

Bacteremia due to Agrobacterium tumefaciens (radiobacter). Report of infection in a pregnant women and her stillborn fetus.

Agrobacterium tumefaciens (radiobacter) is usually a plant pathogen, but is isolated occasionally from human clinical specimens, frequently along with other bacteria. Agrobacterium tumefaciens (radiobacter) has been isolated from blood, central intravenous catheters, peritoneal fluid, urine, and cellulitis aspirates, often in immunocompromised individuals. This report details the isolation of A. tumefaciens (radiobacter) from the blood of a pregnant woman, as well as from the blood of her stillborn, premature fetus. It is, to our knowledge, the first report of such an occurrence.

Adult↗
PubMed1996

Mycetoma due to Madurella grisea acquired in Mexico.

Mycetomas due to Madurella grisea have been reported from South America, Central America, the Caribbean Islands, Africa and Asia, but only rarely from Mexico. We report a case of mycetoma due to M. grisea acquired in northern Mexico

Adolescent↗
PubMed1996

Pseudomeningitis again. Association with cytocentrifuge funnel and Gram-stain reagent contamination.

OBJECTIVE: To report an "epidemic" of pseudomeningitis related to cytocentrifuge funnel and Gram-stain reagent contamination, and our evaluation and responses. DESIGN: Investigation was stimulated by the recognition of Gram-stained, smear-positive, culture-negative cerebrospinal fluid (CSF) specimens. Cytofunnels, glass slides, Gram-staining reagents, and an automated Gram-staining apparatus were subjected to repeated staining and culture. Control stains and cultures using fetal bovine serum (simulated CSF) were performed for comparison. SETTING: The clinical microbiology laboratory of Parkland Memorial Hospital, a large acute-care teaching hospital. SPECIMENS: Cerebrospinal fluid specimens were submitted to the clinical microbiology laboratory in the course of routine patient care. MAIN OUTCOME MEASURES: Gram's stains and cultures of test and control preparations. RESULTS: Most of the smear-positive, culture-negative, original CSF specimens contained Gram-positive bacilli or Gram-negative bacilli. Smears of cytofunnels revealed similar organisms, and cultures revealed Bacillus species. Cytofunnels from several lots were culture-positive. Glass slides were not contaminated. Of 25 CSF specimens stained during the initial week of investigation, 23 were negative by culture and two grew Cryptococcus neoformans (from acquired immunodeficiency syndrome patients). Control stains and cultures of simulated CSF were negative. Gram-stain reagents were frequently smear-positive, and cultures repeatedly yielded Flavimonas oryzihabitans from the crystal violet well of an automated Gram-staining apparatus. These latter contaminants could not be eliminated consistently. INTERVENTIONS: No alternative sources of cytofunnels were found. The Gram-staining apparatus was cleaned and reagents changed frequently. Cytocentrifugation and use of automated Gram staining was discontinued for CSF and other normally sterile fluids. The laboratory staff was repeatedly educated about the problem. CONCLUSIONS: Contamination of cytocentrifuge funnels and an automated Gram-staining apparatus contributed to an "epidemic" of pseudomeningitis. The problem was corrected by education of the laboratory staff and by altered management of CSF and other sterile body fluid specimens.

Centrifugation↗
PubMed1996

Susceptibility of corneal and conjunctival pathogens to ciprofloxacin.

Ciprofloxacin 0.3% ophthalmic solution has been shown to be effective in the treatment of bacterial keratitis and conjunctivitis, and many physicians use ciprofloxacin as sole therapy in these conditions. In this retrospective study, we found seven of 84 isolates from corneal and conjunctival cultures that were resistant to ciprofloxacin. All of the resistant organisms were gram positive. Six of the isolates (Staphylococcus aureus, Staphylococcus hominis, and four isolates of the Streptococcus viridans group) were from corneal cultures, and one (Staphylococcus aureus) was from a conjunctival culture. Yearly records of systemic isolates from 1988 to 1993 (n = 35,308) demonstrated a statistically significant decrease in susceptibility for several organisms that are common pathogens in the conjunctiva and cornea: Pseudomonas aeruginosa (95-90%, p = 0.001); Staphylococcus aureus (96-87%, p < 0.0001); Staphylococcus spp., coagulase negative (97-81%, p < 0.0001); Enterococcus spp. (92-79%, p < 0.0001); Acinetobacter anitratus (97-77%, p = 0.0006); and Enterobacter cloacae (100-96%, p = 0.03). Although the susceptibility of corneal and conjunctival isolates in this series remained relatively high (91.7%), a much larger series of systemic isolates that are common ocular pathogens revealed a statistically significant increase in resistance to ciprofloxacin over the preceding 5 years.

Anti-Infective Agents↗
PubMed1992

Apophysomyces elegans as an agent of zygomycosis in a patient following trauma.

Apophysomyces elegans was isolated from the subcutaneous tissue, muscle and bone of a patient who had fallen from a height of 55 feet. Broad, sparsely septate hyphae were present in the tissue. Surgical debridement of wounds and amphotericin B treatment were not sufficient in controlling rapid tissue necrosis. Ultimately, amputation of the two affected limbs was necessary.

Accidents↗
PubMed1992

Incidence of Mycobacterium avium-intracellulare complex bacteremia in human immunodeficiency virus-positive patients.

The product-limit incidence of Mycobacterium avium-intracellulare complex (MAC) bacteremia in 1006 human immunodeficiency virus (HIV)-positive patients followed at one institution over a 3-year period from the day of AIDS diagnosis with monthly lysis-centrifugation blood cultures was 21% +/- 2% SE at 1 year and 43% +/- 3% at 2 years. The product-limit incidence of MAC bacteremia at 1 year after the patients' first CD4 cell count was related to both the CD4 cell count and to whether they had an AIDS diagnosis (both P less than .0001) but not to age, sex, or race. This incidence was 39% +/- 6% for CD4 cell counts of less than 10/mm3, 30% +/- 5% for 10-19/mm3, 20% +/- 4% for 20-39/mm3, 15% +/- 4% for 40-59/mm3, 8% +/- 3% for 60-99/mm3, and 3% +/- 1% for 100-199/mm3. MAC may eventually infect most if not all HIV-positive patients who do not die from another HIV-related event.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Protective effect of KCl loading in gentamicin nephrotoxicity.

Aminoglycoside nephrotoxicity in experimental animals can be reduced by calcium loading, inducing diabetes, and giving thyroid hormone, while a potassium deficient diet enhances aminoglycoside nephrotoxicity. This study investigated whether potassium loading protects against gentamicin nephrotoxicity in the rat. In part I, group GK ate a diet containing 3.5% potassium and drank 0.2 mol/L KCl. Pair-fed rats eating a standard diet, group G, ate a 1% potassium diet and drank water. After 10 days, each group received gentamicin subcutaneously, 60 mg/kg twice daily for 8 days. The control groups, K and C, received the high or normal potassium diet, respectively. To control for a protective effect from a high solute load, the effect of equimolar NaCl loading was studied in group GNa and Na. At the end of the 8 days of gentamicin, inulin clearance was significantly higher in GK compared with G(0.6 +/- 0.1 v 0.3 +/- 0.1 mL/min per 100 g body weight [BW], P less than 0.05), but group GNa (0.4 +/- 0.1 mL/min per 100 g BW) was not different from group G. Morphological studies demonstrated that potassium-loaded rats (group GK) had significantly less proximal tubular necrosis compared with rats on a standard potassium diet, group G. Sodium loading did not protect against cellular necrosis. Part II studied renal function, cortical Na,K-adenosine triphosphatase (ATPase) and gentamicin accumulation after 2 days of gentamicin to determine the early functional and biochemical effects of potassium loading before overt renal functional impairment.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1987

Bacteremia due to Neisseria cinerea: report of two cases.

We report two cases of bacteremia due to Neisseria cinerea. One was a 2.5-yr-old boy with otitis media and pneumonia, who responded to treatment with amoxicillin. The other was a 47-yr-old man with underlying ethanol abuse who developed severe polymicrobial sepsis due to apparent intraabdominal disease. This man died despite extensive antimicrobial therapy.

Alcoholism↗
PubMed1987

Susceptibility in vitro of Nocardia species to antimicrobial agents.

Fifty-four clinical isolates of Nocardia spp. were tested in vitro for susceptibility to several antimicrobial agents. Of these, 89% were susceptible to ciprofloxacin, 86% to imipenem, 85% to fusidic acid, and 71% to cefotaxime. Some of the agents may be suitable alternative or adjunctive drugs to sulfonamides and aminoglycosides for chemotherapy of Nocardial infections.

Anti-Bacterial Agents↗
PubMed1986

Five cases of Haemophilus segnis appendicitis.

The clinical, histological, and bacteriological findings in five cases of acute appendicitis caused by Haemophilus segnis are reported. This is the first documentation of appendicitis associated with this organism.

Adolescent↗
PubMed1985

Evaluation of antibiotic susceptibility testing by agar dilution and the Micro Media system (Fox Panel).

The susceptibilities of 350 gram-positive cocci and 638 gram-negative bacilli to various antimicrobial agents were compared by using the Micro-Media system (MMS) (Fox Panel) (Micro-Media Systems, Inc., Potomac, Md.) and a standard agar dilution procedure. Major discrepancies occurred with enterococci, among which 48 of 53 isolates (91%) were found to be resistant to penicillin G by agar dilution and reported as susceptible by the MMS. Other large discrepancies occurred with Staphylococcus aureus and Acinetobacter calcoaceticus subsp. anitratus, among which more than 40% of the isolates were judged to be resistant to ampicillin by agar dilution and susceptible by the MMS. In terms of overall agreement in interpretation of MICs by the two systems, an agreement of greater than 84% was seen for both gram-positive and gram-negative organisms when ampicillin and cephalothin (68 and 78% agreement for gram-positive cocci, respectively) were excluded. These disagreements in MIC interpretations may result in part from the small number of organisms tested per well (4,000 CFU) in the MMS, as compared with 10,000 CFU per test in the agar dilution method.

Acinetobacter↗
PubMed1984

Use of the Becton-Dickinson urine culture tube with the Abbott MS-2 urine screening system.

Urine specimens were obtained from 312 obstetric outpatients by sterile midstream technique and aliquots placed in both Becton-Dickinson urine culture tubes and sterile conventional tubes. Quantitative cultures were made from each tube, and each tube was screened for bacteria with the Abbott MS-2 urine screening system. The time required to detect bacteriuria was recorded for both specimens. Isolates from specimens containing greater than or equal to 50,000/ml gram-positive cocci or greater than or equal to 100,000/ml gram-negative bacilli were identified and antimicrobial susceptibility tests performed. Delayed (24 hr) quantitative cultures were done from Becton-Dickinson tubes. By these criteria, 124 urine specimens were positive in both conventional and Becton-Dickinson tubes. Escherichia coli (n = 72), Klebsiella pneumoniae (n = 20), Enterobacter cloacae (n = 8), Proteus mirabilis (n = 4), group B streptococcus (n = 12), and enterococcus (n = 8) were isolated. Time for detection of positive urine samples was similar in both types of tubes. Delayed cultures had significant numbers of false-positive results. Antimicrobial susceptibility results did not appear to be influenced greatly by Becton-Dickinson tube transport. The MS-2 cannot adequately discriminate cultures containing less than 50,000 colony-forming units/ml of urine. The Becton-Dickinson tube appears to be compatible for use with the MS-2 for purposes of screening for bacteriuria.

Adult↗
PubMed1984

Evaluation of the MS-2 and Lumac systems for the rapid screening of urine specimens.

The authors have evaluated the MS-2 (Abbott) and Lumac (3M) systems for the rapid screening of urine specimens for bacteriuria. These systems, which can detect significant levels of microorganisms in urine in five hours (MS-2) or 30 minutes (Lumac), were compared with a standard overnight plate culture method. Three hundred fifty-eight voided urine specimens were examined. The two systems compared equally at greater than 10(5) colony-forming units (CFU)/mL in terms of false-positive results (11%), false-negative results (2%), sensitivity (98%), specificity (approximately equal to 86%), and positive predictive value (98%), although the Lumac was found to have a lower negative predictive value (by 10%) than the MS-2. The only organism not recognized by the MS-2 at greater than 10(5) CFU/mL was a Lactobacillus; whereas the only specimens missed by the Lumac at greater than 10(5) CFU/mL were two pure cultures of Escherichia coli. At counts of greater than 10(4) to 10(5) CFU/mL, both systems missed numerous (15 of 21 isolates for the MS-2; 12 of 9 isolates for the Lumac) gram-positive cocci. The Lumac system was the most costly, being 3.6 times as expensive as the standard plate method. Although both systems greatly reduce the time required to process urine specimens, the large number of false-positive results, false-negative results at greater than 10(4) to 10(5) CFU/mL, as well as cost suggest that a careful evaluation of a laboratory's specific needs for urine cultures be made to determine whether or not such rapid urine screening systems are appropriate.

Bacteria↗