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Biomedical subjects

P N Gaunt

Publications and source records attributed to P N Gaunt.

At least 19 recordsLinked to original sources
PubMed2000

Control of MRSA.

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Humans↗
PubMed1998

TRIUMPH over adversity.

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Clinical Laboratory Information Systems↗
PubMed1996

Ciprofloxacin resistant Campylobacter spp. in humans: an epidemiological and laboratory study.

From the end of April 1991 until the end of 1991, 2209 isolates of Campylobacter spp. have been collected in Plymouth PHL of which 91 (4.1%) were resistant to ciprofloxacin. None of the 91 patients involved had taken a quinolone, but 30/91 (33%) had travelled abroad (16 to the Iberian peninsula) in the three months preceding isolation of the ciprofloxacin-resistant Campylobacter spp. In the case-control study 12/15 (80%) of the cases had recently consumed poultry as had 20/24 (83%) of controls with enteritis due to ciprofloxacin-susceptible Campylobacter spp. A small study of poultry purchased from the supermarket revealed that only 1/37 campylobacters isolated from 64 UK bred chickens was resistant to ciprofloxacin, whereas 7/26 campylobacters isolated from 50 imported chickens were ciprofloxacin-resistant. Of the 75 clinical isolates of ciprofloxacin-resistant Campylobacter spp. subjected to detailed analysis, 68 were Campylobacter jejuni, six were Campylobacter lari, and one was Campylobacter coli. All isolates from man and poultry were resistant to ciprofloxacin, norfloxacin, sparfloxacin and tosufloxacin, and there was an association between fluoroquinolone-resistance and increased MICs of tetracycline. The range of susceptibility to erythromycin and kanamycin were typical of the species. gyrA from C. jejuni P6 (a case with history of travel to Spain) and C. jejuni P16 (isolate from imported chicken) contained point mutations corresponding to an amino acid substitution of isoleucine for threonine at codon 86. It has been suggested that veterinary use of quinolones, notably enrofloxacin, is providing a selective pressure for emergence of resistance to ciprofloxacin amongst human isolates. Now that enrofloxacin has been licensed for use in broiler flocks in the UK, it will be interesting to monitor the prevalence of resistance of campylobacters to quinolones in UK-produced poultry and in UK-acquired human infection.

Adult↗
PubMed1994

The need for security--a clinical view.

Systems which process patient health data of any kind are considered to be medical information systems. Some data can be categorized as non-personal, non-identifiable, or non-patient-based such as knowledge bases. Others are considered as highly sensitive because of the 'need to know' to deliver health care to patient. Access is not only justifiable for doctors and nurses, but, for specific purposes to administrative personnel and public health organisations. Of special concern are registers on sexually transmitted diseases, mental health and genetic diseases. In future, patients might gain more autonomy and also have access to some parts of their own record. Telematics allows them to update a data base and to consult a knowledge base. Clearly, physicians in charge of the cases have a responsibility that has been recognised by law in all Western countries. Access to patient's data should take into account this responsibility. Although most health professionals would still believe that confidentiality is the main issue, it appears that data integrity and availability are as important in the context of the 'paperless' electronic record. Information should be complete and correct, to be only accessed by authorized persons. The health care environment is characterised by an open nature of clinics that leaves them vulnerable to theft, damage and unauthorized access. Disclosure of information may affect the patient's social standing as well as their general health. The health professions lack sufficiently well-defined organisational structure, culture and perceptions to support security.

Computer Communication Networks↗
PubMed1993

Audit in infection control--data analysis and infections in the intensive care unit.

The importance of high standards of infection control practices in intensive care units is widely accepted. Despite this, few objective measures of the efficacy of such practices have been developed. This hampers clinical audit, which is essential if nosocomial infections are to be kept to a minimum. Small sample size, multiple dependent variables, difficulty in matching populations, and the covert effects of confounding factors and bias, all add to the problems of designing meaningful audit programmes in intensive care settings. Nevertheless, useful analysis can be attempted now that appropriate standards and scoring systems are available. Computer systems can simplify data collection, analysis and reporting but they are no substitute for careful preparation and good statistical technique.

Computers↗
PubMed1991

Information in infection control.

Effective infection control depends upon a clear understanding of the activities of surveillance, control, communication and management and of the nature and source of information required. Surveillance uses diverse information and computerization of hospital information provides the potential for automated detection of patients at risk of, or affected by, nosocomial infection. Routine visits to all hospital wards by the infection control team is widely advocated but is an inefficient use of a limited resource. 'Targeting' clinical areas with particular problems is more efficient but requires the means to find cases and perform risk assessment through surveillance. While microbiology laboratory reports are effective for case finding, sensitivity and specificity are low. The increasing use of computer held clinical data presents new opportunities for automated surveillance to guide the daily activities of the infection control team. It is essential to stress the importance of infection surveillance to those designing hospital information systems.

Cross Infection↗
PubMed1988

Single dose ciprofloxacin for the eradication of pharyngeal carriage of Neisseria meningitidis.

Single dose oral ciprofloxacin was given to all personnel in a naval training establishment as part of the management of an outbreak of meningococcal meningitis. Two thousand one hundred personnel received the drug and Neisseria meningitidis was eradicated from the pharynx of 97% of 570 who were swabbed two to four days later. In a cohort of 277 personnel who were followed for up to nine weeks, pharyngeal carriage was eliminated from 93% of 104 carriers. The overall prevalence of carriage fell from 19% to less than 1.5% as a result of the use of ciprofloxacin. Few side effects were encountered, compliance was good and meningococci resistant to the antibiotic were not found after therapy. A single oral dose of ciprofloxacin 500 mg eliminates pharyngeal carriage of N. meningitidis effectively and has few adverse reactions.

Carrier State↗
PubMed1986

Group G streptococcal infection of joints and joint prostheses.

Eight cases of septic arthritis caused by beta-haemolytic streptococci of Lancefield group G are presented and compared with others previously reported. Involvement of prosthetic joints is notable (25%) as is accompanying cellulitis (75%) which is probably related to the portal of entry of the organism. Other associated conditions were rheumatoid arthritis (38%) and malignant neoplastic disease (25%). Carriage of the group G streptococcus was detected in two of the eight patients. Serological tests for streptococcal antibodies were found to be less useful in the diagnosis of septic arthritis due to group G streptococci than culture of aspirated fluid. In the absence of endocarditis, which was not present in any of our patients, the prognosis appears to be good after treatment with appropriate antibiotics and open drainage of the joint. Both affected joint prostheses, however, required removal.

Adult↗