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Biomedical subjects

R B Kundsin

Publications and source records attributed to R B Kundsin.

At least 19 recordsLinked to original sources
PubMed1999

Prospective study of Chlamydia pneumoniae IgG seropositivity and risks of future myocardial infarction.

BACKGROUND: Chlamydia pneumoniae has been hypothesized to play a role in atherothrombosis. However, prospective data relating exposure to Chlamydia pneumoniae and risks of future myocardial infarction (MI) are sparse. METHODS AND RESULTS: In a prospective cohort of nearly 15 000 healthy men, we measured IgG antibodies directed against Chlamydia pneumoniae in blood samples collected at baseline from 343 study participants who subsequently reported a first MI and from an equal number of age- and smoking-matched control subjects who did not report vascular disease during a 12-year follow-up period. The proportion of study subjects with IgG antibodies directed against Chlamydia increased with age and cigarette consumption. However, prevalence rates of Chlamydia IgG seropositivity were virtually identical at baseline among men who subsequently reported first MI compared with age- and smoking-matched control subjects. Specifically, the relative risks of future MI associated with Chlamydia pneumoniae IgG titers >/=1:16, 1:32, 1:64, 1:128, and 1:256 were 1.1, 1.0, 1.1, 1.0, and 0.8, respectively (all probability values not significant). There was no association in analyses adjusted for other risk factors, evaluating early as compared with late events, or among nonsmokers. Further, there was no association between seropositivity and concentration of C-reactive protein, a marker of inflammation that predicts MI risk in this cohort. CONCLUSIONS: In a large-scale study of socioeconomically homogeneous men that controlled for age, smoking, and other cardiovascular risk factors, we found no evidence of association between Chlamydia pneumoniae IgG seropositivity and risks of future MI.

Adult↗
PubMed1996

Ureaplasma urealyticum infection of the placenta in pregnancies that ended prematurely.

OBJECTIVE: To investigate the relationship between Ureaplasma urealyticum infection of the placenta and premature onset of labor. METHODS: We studied 647 pregnancies that resulted in the live birth of an infant weighing less than 1501 g. The chorionic surface of the placenta was cultured for U urealyticum, Mycoplasma hominis, and group B streptococci. RESULTS: The rate of ureaplasma isolation increased with increasing interval between rupture of membranes and delivery. When analyses were limited to the 96 singleton pregnancies that ended within 1 hour of rupture of membranes and before the 29th week of gestation, U urealyticum was prominently associated with an increased risk of premature onset of labor (P = .008 unadjusted, and P = .05 when adjustment was made for all potential confounders). Ureaplasma infection rate was lowest in pregnancies terminated because of severe maternal preeclampsia or progressive fetal growth restriction. CONCLUSION: Ureaplasma urealyticum infection is associated with premature onset of labor and with increasing duration of time between rupture of membranes and delivery. Eradication of ureaplasmas from the urogenital tract of women and their partners, ideally before conception, should be considered.

Adult↗
PubMed1994

Histology and Ureaplasma urealyticum culture in 63 cases of first trimester abortion.

The association between chorioamnionitis caused by Ureaplasma urealyticum and preterm delivery has been well documented. In contrast, a pathogenic role for Ureaplasma has been postulated in early spontaneous abortions, but definitive evidence for this association has been lacking. In 42 early spontaneous abortions and 21 elective abortions (both first trimester), the chorion was cultured for Ureaplasma. Each case was evaluated histologically for four features of inflammation and one feature of degeneration. For comparison, 32 selected placentas from third trimester preterm deliveries (11 with positive Ureaplasma cultures) were examined histologically for umbilical vasculitis and acute chorioamnionitis. In abortion specimens, Ureaplasma cultures were positive in 11 of 42 early spontaneous abortions (26%) versus 0 of 21 elective abortions (EABs). None of the five histologic features correlated with positive Ureaplasma cultures in early spontaneous abortions. In contrast, in preterm placentas, umbilical vasculitis, and acute chorioamnionitis correlated strongly with positive Ureaplasma cultures. The authors conclude that in premature delivery, U urealyticum chorionic culture positivity is associated with histologic chorioamnionitis; and in abortions, Ureaplasma chorionic culture positivity correlates with early spontaneous abortions (vs elective abortions), but not with histologic inflammation. This suggests that mechanisms of Ureaplasma pathogenesis other than acute inflammation should be considered in future studies of early spontaneous abortions.

Abortion, Spontaneous↗
PubMed1994

Antibiotic susceptibilities of AIDS-associated mycoplasmas.

Because mycoplasmas may be a cofactor in the progression of human immunodeficiency virus infection to AIDS, their susceptibilities to antibiotics need to be known in the event that appropriate therapy is required. The mycoplasmas studied were a stock culture strain of Mycoplasma fermentans, two strains of M. fermentans isolated from patients with AIDS, M. fermentans var. incognitus, Mycoplasma penetrans, and Mycoplasma pirum. The antibiotics tested were doxycycline, tetracycline, clindamycin, ofloxacin, erythromycin, azithromycin, and clarithromycin at levels consistent with the attainable levels in serum. By the macrodilution metabolic inhibition method, all six mycoplasma strains were susceptible to doxycycline, tetracycline, clindamycin, ofloxacin, azithromycin, and clarithromycin. M. penetrans was susceptible to erythromycin. The M. fermentans strains and M. pirum were resistant to erythromycin. The macrodilution metabolic inhibition method results showed agreement with the Sensititre Gram Positive MIC Panel results for tetracycline, clindamycin, and erythromycin. MICs of clarithromycin for all six mycoplasma isolates tested were low, indicating susceptibility.

AIDS-Related Opportunistic Infections↗
PubMed1993

A case of Ureaplasma urealyticum septic arthritis in a patient with hypogammaglobulinemia.

Patients with hypogammaglobulinemia have an increased susceptibility to certain infections. We describe the case of a patient with common variable hypogammaglobulinemia for whom the diagnosis of destructive monoarticular arthritis caused by Ureaplasma urealyticum was established after two nondiagnostic open biopsies had been performed. Mycoplasmal infection may involve a joint in hypogammaglobulinemic patients without causing macroscopic purulence in the joint. Histological examination of the bone may be helpful in the differentiation of an infectious process from the rheumatoidlike arthritis that occurs in such patients. Culture of involved bone in addition to synovium or synovial fluid may also be helpful in establishing the diagnosis.

Agammaglobulinemia↗
PubMed1993

Detection and isolation of Mycoplasma fermentans from urine of human immunodeficiency virus type 1-infected patients.

Mycoplasma fermentans (incognitus strain) has been linked with acquired immunodeficiency syndrome-associated nephropathy. Ten (23%) of 43 urine sediment specimens from 40 human immunodeficiency virus (HIV)-positive patients at different stages of acquired immunodeficiency syndrome disease tested positive in the polymerase chain reaction using a primer pair found in the insertion sequences specific to M fermentans. Mycoplasma fermentans was isolated from two HIV-positive patients' urine sediment specimens and on a repeated basis from one. All three culture-positive urine sediment specimens tested positive in the polymerase chain reaction. Fifty urine sediment specimens from age-matched HIV-negative healthy controls tested negative for M fermentans by polymerase chain reaction. Mycoplasma fermentans was not isolated from any of the control urine sediment specimens. Our results show a high prevalence of M fermentans in urine sediment specimens from HIV-positive patients but not from urine sediment specimens of HIV-negative healthy controls.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Ureaplasma urealyticum and Mycoplasma hominis in women with systemic lupus erythematosus.

OBJECTIVE: To determine the prevalence of genitourinary mycoplasma infection in women with systemic lupus erythematosus (SLE). METHODS: Urine specimens from 49 patients with SLE and 22 patients with chronic fatigue syndrome (CFS) were cultured for mycoplasma. Patient records were reviewed for medical history and SLE disease activity. RESULTS: Sixty-three percent of the SLE patients were culture positive, compared with 4.5% of the CFS patients (P less than 0.001). Neither corticosteroid treatment, SLE activity, nor age accounted for this difference. CONCLUSION: Genitourinary mycoplasma colonization occurs significantly more frequently in SLE than in CFS.

Cohort Studies↗
PubMed1985

Ureaplasma urealyticum: subcultures invalid for antibiotic susceptibility tests.

We tested the antibiotic susceptibilities of 100 Ureaplasma urealyticum strains from 99 patients using a broth-disk method and two types of inocula: urine sediments and overnight broth subcultures of the sediments. Of the 100 ureaplasma-positive urine sediments tested, nine (9%) of the ureaplasmas were found resistant to all four tetracyclines. When overnight broth cultures were used as the inoculum, 54 (54%) were found to be resistant to all four tetracyclines, an increase in resistance of 45 (45%). Thirty-seven susceptible strains remained susceptible upon subculture. The nine resistant strains remained resistant. Loss of susceptibility was not related to the pH or titer of ureaplasmas in the urine sediment inoculum but was related to the pH and titers when subcultures were used as the inoculum. Results of cultures following treatment, available for 53 patients, showed that treatment successes and treatment failures were significantly related to antibiotic susceptibility tests done with urine sediments but not to those done with broth subcultures as the inocula. Because reliable susceptibility testing is essential for appropriate therapy for U. urealyticum infections, all factors influencing this test need to be recognized and defined.

Anti-Bacterial Agents↗
PubMed1984

Association of Ureaplasma urealyticum in the placenta with perinatal morbidity and mortality.

We investigated the presence of ureaplasmas, mycoplasmas, chlamydiae, fungi, aerobic and anaerobic bacteria, and cytomegalovirus in fetal membranes and evaluated their association with perinatal morbidity and mortality. We cultured 801 placentas from three groups of subjects (144 who died in the perinatal period, 452 neonates admitted to the intensive-care unit, and 205 controls). Ureaplasma urealyticum, Mycoplasma hominis, or both were isolated from 21 per cent of placentas of premature and term infants who died in the perinatal period, 25 per cent of those admitted to intensive care, and 11 per cent of controls. Gestational age and birth weight were inversely related to isolation of ureaplasma, and chorioamnionitis was positively related to isolation. The presence of ureaplasmas in the placenta suggests the transcervical migration of these microorganisms from the lower genitourinary tract. These data show a strong association between ureaplasma infection of the placenta and low birth weight of the neonate and suggest that the association is causal.

Adult↗
PubMed1984

Placental evidence of cytomegalovirus infection of the fetus and neonate.

Nine cases of congenital cytomegalovirus infection were diagnosed at Brigham and Women's Hospital in Boston from September 1977 through July 1982. The majority of infected fetuses and newborn infants had intrauterine growth retardation, congenital malformations, microcephaly, or hydrops fetalis. In four cases, cytomegalovirus was recovered from placentas. Eight placentas were examined morphologically. Varying degrees of chronic villitis were noted in all. The most frequent lesion, found in six cases, was focal villous inflammation with mononuclear cell infiltrates. Lymphocytes predominated in this reaction. In three cases, however, the villi were also intensely infiltrated by plasma cells. Typical cytomegalic inclusion bodies were noted in these three placentas. The fetus and infants in whose placentas the plasmacytic villitis and inclusion bodies were discovered displayed the most severe manifestations of cytomegalovirus infection.

Cytomegalovirus Infections↗
PubMed1982

Effect of freezing and microwave thawing on the stability of six antibiotic admixtures in plastic bags.

The stability of six antibiotics in intravenous fluids in polyvinyl chloride containers after freezing and microwave-thawing is reported. Tobramycin sulfate 160 mg, amikacin sulfate 1 g, ticarcillin disodium 3 g, clindamycin phosphate 300 mg, nafcillin sodium 1 g, and ampicillin sodium was also diluted in plastic bags of 0.9% sodium chloride injection 50 ml. For each antibiotic except ampicillin sodium, three bags were prepared and assayed immediately for antibiotic content. Two of the bags were frozen at -20 degrees C for 30 days and then thawed, one by exposure to room-temperature air and the other by microwave radiation. Each was assayed immediately and after 8 and 24 hours storage at room temperature. The third bag was not frozen, but was stored at room temperature and assayed at 8 and 24 hours. Five bags of ampicillin sodium were prepared-three in 0.9% sodium chloride, which were frozen at -20, -30, and -70 degrees C, and two in 5% dextrose, which were frozen at -30 and -70 degrees C. All ampicillin solutions were stored 30 days, assayed, microwave-thawed, and assayed again. All antibiotics except ampicillin retained 90% or more potency when microwave-thawed after storage at -20 degrees C for 30 days, and after subsequent storage at room temperature for 24 hours. Ampicillin sodium was stable in 0.9% sodium chloride when stored at -30 or -70 degrees C, microwave-thawed, and stored up to eight hours at room temperature. Ampicillin sodium was stable in 5% dextrose when stored at -70 degrees C and microwaved-thawed, but its potency declined to 70.5% after eight hours storage at room temperature.

Anti-Bacterial Agents↗