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R P D Cooke

Publications and source records attributed to R P D Cooke.

11 recordsLinked to original sources
PubMed2006

Nasopharyngeal aspiration for diagnosis of pulmonary tuberculosis.

BACKGROUND: Confirmation of pulmonary tuberculosis (PTB) in young children is difficult as they seldom expectorate sputum. AIM: To compare sputa obtained by nasopharyngeal aspiration and by sputum induction for staining and culture of Mycobacterium tuberculosis. PATIENTS AND METHODS: Patients from Mulago Hospital, Kampala with symptoms suggestive of PTB were considered for inclusion in the study. Those with a positive tuberculin test and/or a chest radiograph compatible with tuberculosis were recruited. Infection with human immunodeficiency virus (HIV) was confirmed by duplicate enzyme-labelled immunosorbent assay or in children <15 months by polymerase chain reaction (PCR). Direct PCR was undertaken on 82 nasopharyngeal aspirates. RESULTS: Of 438 patients referred, 94 were recruited over a period of 5 months. Median (range) age was 48 (4-144) months. Of 63 patients tested, 69.8% were infected with HIV. Paired and uncontaminated culture results were available for 88 patients and smear results for 94 patients. Nasopharyngeal aspirates were smear-positive in 8.5% and culture-positive in 23.9%. Induced sputa were smear-positive in 9.6% and culture positive in 21.6%. Overall, 10.6% were smear-positive, 25.5% were culture-positive and 26.6% had smear and/or culture confirmed tuberculosis. Direct PCR on nasopharyngeal aspirates had a sensitivity of 62% and specificity of 98% for confirmation of culture-positive tuberculosis. CONCLUSIONS: Nasopharyngeal aspiration is a useful, safe and low-technology method for confirmation of PTB and, like sputum induction, can be undertaken in outpatient clinics.

Child↗
PubMed2004

Hazards of water.

Explore the source record for details and available documents.

Air Conditioning↗
PubMed2003

An evaluation of Cidex OPA (0.55% ortho-phthalaldehyde) as an alternative to 2% glutaraldehyde for high-level disinfection of endoscopes.

Cidex OPA (0.55% ortho-phthalaldehyde) is marketed as a safer alternative to 2% glutaraldehyde for endoscope decontamination. As clinical experience is limited, an evaluation was undertaken in a busy endoscopy unit. Cidex OPA cycle dilution was monitored by manufacturer's test strips and high-pressure liquid chromatography (HPLC). Eight endoscopy staff completed daily occupational health questionnaires before and after its introduction. Patient throughput times were assessed in view of Cidex OPAs reduced disinfection time. HPLC confirmed that Cidex OPA levels are maintained above 0.3% for at least 50 cycles. Indicator strips proved generally reliable when tested by pharmacy staff. However, busy endoscopy staff found the indicator strips difficult to interpret, with 28 out of 223 (12.5%) test results being inappropriately recorded as 'fails'. Two hundred and two questionnaires were completed and no short-term health problems were noted. Apart from bronchoscopy lists, patient turnaround times were not improved. The increased cost of changing to Cidex OPA was estimated as pound 7691 per annum. Staining of washer-disinfectors was of concern as it proved very difficult to remove.

Disinfectants↗
PubMed2003

ABC chromogenic agar: a cost-effective alternative to standard enteric media for Salmonella spp. isolation from routine stool samples.

Salmonellosis is the second most common cause of bacterial gastroenteritis, yet the yield from routine stool culture is low. Commonly used selective enteric media have poor specificities for salmonella identification, resulting in a high laboratory workload. A special chromogenic medium, ABC agar, is a promising alternative but its cost-effectiveness has not been evaluated in diagnostic laboratories. A collaborative study is therefore undertaken in two district general hospitals laboratories. Routine stool samples (n=866) were subcultured onto ABC agar half plates after selective enrichment in selenite broth. Similarly, 246 and 620 stool samples were subcultured onto desoxycholate lactose sucrose (DCLS) and xylose lactose desoxycholate (XLD) whole agar plates, respectively. Salmonella spp. were isolated from only 14 (1.6%) of stool samples tested. Specificity was significantly higher for ABC (98%) than DCLS (67%) or XLD (78%) agars. Welcan workload units (ABC 4.8, XLD and DCLS both 7.3) and costs per specimen (ABC 1.26 pounds sterling, DCLS 3.81 pounds sterling and XLD 1.83 pounds sterling) were similarly lower with ABC agar. The results indicate that ABC chromogenic agar offers improvements in specificity, workload and costs over conventional enteric media for Salmonella spp. isolation.

Agar↗
PubMed2002

Trimethoprim versus gentamicin for the prevention of bacteriuria following transrectal biopsy of the prostate--do patients need additional anaerobic cover?

OBJECTIVES: To study the incidence of aerobic and anaerobic bacteriuria in patients undergoing transrectal ultrasound-guided biopsies of the prostate. A comparative assessment of efficacy of trimethoprim with gentamicin for the prevention of bacteriuria following the transrectal biopsy of the prostate. To assess the need for additional prophylaxis against anaerobes for patients undergoing transrectal biopsies of the prostate gland. PATIENTS AND METHODS: In a pilot study during 1995-1997, all the patients undergoing transrectal ultrasound-guided biopsy of the prostate were randomised to receive either trimethoprim or gentamicin prophylaxis prior to the procedure. Midstream urine (MSU) samples were taken just prior to biopsy and 72 h later. A patient questionnaire to determine the symptoms of urinary tract infection (UTI) accompanied the 72-hour MSU request form. Urine samples were cultured aerobically, using a semiquantitative technique if dipstick analysis revealed the presence of blood, pus cell or nitrite. In addition to the routine aerobic culture, post-biopsy samples were also cultured for anaerobes by direct and enrichment methods. Bacteriuria was defined as a pure or mixed growth of 10(5) colony-forming units/ml. Fisher's test of exact probability was used for statistical analysis. RESULTS: 115 patients were available for final analysis. 53 had received gentamicin and 62 trimethoprim. Four patients had pre-existing bacteriuria (3.5%), 3 in the trimethoprim group and 1 in the gentamicin group. Post-operative bacteriuria developed in 5 patients given gentamicin (9.4%) and 1 given trimethoprim (1.6%). This difference was not statistically significant (p = 0.085). Post-procedure bacteriuria was asymptomatic in all but 1 case. Anaerobes were detected in only 5 MSUs (4.3%) post-biopsy. CONCLUSION: Though there was no statistical significant difference in the rates of bacteriuria following administration of trimethoprim and gentamicin, data appear to favour trimethoprim prophylaxis. Further studies are warranted. Transrectal biopsy of the prostate is associated with a low incidence of anaerobic UTI. In view of the very low incidence of anaerobic bacteriuria, routine antibacterial prophylaxis against anaerobes does not appear to be justified.

Bacteria, Anaerobic↗