PubMed Health⌕ Search

Biomedical subjects

S Tabaqchali

Publications and source records attributed to S Tabaqchali.

At least 127 records · Page 7Linked to original sources

Gardnerella vaginalis and anaerobic bacteria in genital disease.

In a study of Gardnerella vaginalis and anaerobic bacteria in non-specific vaginitis (NSV) and other genital disease 89 patients attending a genital medicine clinic had vaginal samples examined for conventional pathogens and for quantitative analysis of G vaginalis and aerobic and anaerobic bacterial flora. The overall incidence of G vaginalis was 20%; G vaginalis (mean concentration 7.0 log10/g of secretion) occurred predominantly in patients with NSV (57%) but also in sexual contacts of non-specific urethritis (NSU) (37.5%) and in patients with other conditions (11.8%). G vaginalis is therefore a relatively common isolate in patients with vaginal discharge. The concentration of aerobic and anaerobic bacteria ranged from 4.9-11.0 log10/g of secretion with an anaerobe-to-aerobe ratio of 10:1. Anaerobic bacteria, particularly anaerobic Gram-positive cocci (mean concentrations 7.7 log10/g), were present in patients with NSV and in association with G vaginalis, but they also occurred in other clinical groups and with other pathogens, particularly Trichomonas vaginalis. Anaerobic bacteria may therefore play an important role in the pathogenesis of vaginal infections.

Anaerobiosis↗

Colonization of the gastric contents in critically ill patients.

In a study of 28 ventilated patients in the ICU, cimetidine was ineffective in maintaining gastric pH above 4. Quantitative and qualitative bacteriological examination of daily gastric aspirates showed that when the pH was above 4, there was rapid colonization with high counts of organisms, predominantly coliforms. Progressive colonization by yeasts, independent of pH, was noted in nearly one-half of the patients. Gastric colonization has possible implications in terms of crossinfection of development of aspiration pneumonia. As these are seriously ill patients with compromised gastrointestinal (GI) barriers and decreased immunity, the large numbers of bacteria or their endotoxins may contribute to the high incidence of septicemia.

Bacteria↗

Quantitative methods for studies on vaginal flora.

Three recently described methods for quantitative sampling of the bacterial flora of the vagina were evaluated and none proved satisfactory. In a third of the samples, paired swabs showed large differences between the two weights of vaginal secretion collected by this method, and the recovery rate of bacteria deliberately added to test swabs was unsatisfactorily low. A calibrated loop gave a wide variation in the amount of secretion collected, due to variations in density and viscosity of the secretion. When secretion was collected with a calibrated pipette, it was often difficult to expel the collected volume from the pipette for testing. The simple weight-based method was devised in which a loop was used to collect an undefined volume of secretion for weighting in a tube of transport medium before homogenisation and quantitative bacteriological testing. Initial assessment indicates this to be a satisfactory method for quantitative studies of the vaginal bacterial flora.

Bacteria↗

Inhibition of Clostridium difficile by faecal streptococci.

The inhibitory activity of seven strains of faecal streptococci against 34 strains of Clostridium difficile was examined in vitro after growth of the streptococci for 24 and 48 h. All strains of C. difficile were inhibited at 48 h but at 24 h the inhibition was variable. Streptococcus faecium, a group D streptococcus and an ungroupable streptococcus exhibited the most striking inhibitory activity. Lowering of pH of the medium occurred at the site of inhibition, but the pH change alone did not explain the inhibition of C. difficile. This antagonism may be related in vivo to the resistance to intestinal colonisation by C. difficile exhibited by the normal bowel flora, and in vitro to failures to isolate C. difficile from faecal specimens.

Clostridium↗

Comparison of antisera in the fluorescent antibody test for detection of Bacteroides spp in clinical specimens.

Twenty-two known strains of the Bacteroides fragilis group of organisms and 67 clinical specimens from a variety of sites were examined by fluorescent antibody test (IFA) using two different antisera fro the rapid detection of B fragilis group of organisms. A previously reported Barts' pooled antisera was compared with a commercially produced Fluoretec kit antisera and the findings were related to routine anaerobic culture and gas liquid chromatography for short chain fatty acids. The Barts' antisera was more sensitive (88%) but less specific (88%) than the kit (sensitivity 50%, specificity 98%). This indicates that Barts' antisera picks up more positive cultures than the kit. The predictive value of a positive test was 82% for Barts' antisera and 93% for the kit. There were higher numbers of false-negatives with the kit (13/26) than with the Barts' (3/26). The predictive value of a negative test was 92% for Barts' antisera and 75% for the kit, indicating that a negative IFA test with Barts' antisera is a reliable index of the absence of the B fragilis group of organisms from clinical specimens. The implications for the use of this test in a routine laboratory are discussed.

Bacteroides↗

Synovial fluid lactic acid measurement in the diagnosis and management of septic arthritis.

An improved method of lactic acid estimation by gas liquid chromatography (GLC) is described. Synovial fluid lactic acid estimation was performed on 52 patients (15 with septic arthritis and 37 with non-septic arthropathies) and compared to routine microbiological methods and white cell counts. Lactic acid was found to be a useful and rapid test for differentiating between septic and non-septic arthritis being markedly raised (greater than 12 mmol/l) in all the septic joints. Raised lactic acid concentrations were of particular diagnostic value in patients in whom antibiotic therapy had commenced before joint aspiration. The results of lactic acid estimation on sequential samples were helpful in assessing the response of septic arthritis to treatment.

Arthritis↗

Clostridium difficile and cytotoxin in routine faecal specimens.

Over a five-month period 1239 unselected, routine faecal specimens from 856 patients were examined for Clostridium difficile. One hundred specimens representing 69 patients were culture-positive. Toxin was detected in the stool of ten. During the study period, there were 41 Salmonella, 12 Campylobacter and 9 Shigella infections. C difficile was isolated together with Salmonella from 12 patients. No patient required specific treatment for C difficile infection. The significance of these findings is discussed.

Adolescent↗

Fluorimetric determination of cefuroxime in body fluids.

A simple and accurate fluorimetric procedure for measuring cefuroxime in body fluids is described. A fluorescent product was produced by addition of hydrochloric acid, heating, and cooling, followed by addition of sodium hydroxide and further heating at 100 degree C. The fluorescence intensity of the final solution was measured in a fluorimeter at an excitation wavelength of 375 nm and an emission wavelength of 440 nm and related to the antibiotic concentration. Thin-layer chromatography of the final solution showed a single fluorescent spot (Rf value, 0.6). Freedom from interference from other therapeutic agents and endogenous substances, as well as the close correlation between this method and the standard microbiological assay method, was demonstrated. The simplicity and reliability of the fluorimetric assay method make it particularly suitable for clinical use.

Aspirin↗

Restorative proctocolectomy with ileal reservoir: a pathophysiological assessment.

A metabolic and physiological assessment was carried out in 14 patients who had undergone restorative proctocolectomy with ileal reservoir more than six months previously. The haemoglobin was normal in all but one and plasma electrolytes and serum albumin, calcium, phosphorus, and red cell folate estimations were normal in all. Five patients had low serum iron levels of whom one had an iron deficiency anaemia. The 24 hour faecal fat output was normal in all patients and there was no case of vitamin B12 malabsorption as judged by the Schilling test, although four patients had marginally low values. These were not associated with increased bacterial counts in the faeces within the reservoir and there was no evidence to support a diagnosis of stagnant loop syndrome. Inflammation of the reservoir mucosa was, however, associated with higher counts of aerobic bacteria than in cases where inflammation was absent. Subtotal villous atrophy or inflammation was seen in biopsies of the reservoir in six patients. The mean faecal output per 24 hours was 659 +/- 259 g and the mean reservoir volume was 330 +/- 78 ml. Mean resting anal canal pressure was significantly lower in patients with a mucous leakage per anum than in those without, while manometry of the reservoir showed no alteration of pressure over a period of one hour before and after a meal. A positive rectosphincteric reflex was observed in nine patients.

Adult↗

10 Years of infective endocarditis at St. Bartholomew's Hospital: analysis of clinical features and treatment in relation to prognosis and mortality.

A retrospective survey of patients with infective endocarditis at St. Bartholomew's Hospital in the decade 1966--75 showed a male/female ratio of 1.5/1. The commonest presenting features were malaise, fever, new cardiac symptoms, heart-failure, splenomegaly, and finger clubbing. The commonest problem during treatment was heart-failure. As in the two previous decades, viridans streptococci were the commonest causative organisms. Acute endocarditis was caused by Staphylococcus aureus. 6 patients' lives were saved by heart-valve replacement during medical treatment. Of 3 patients who relapsed, 1 died. The overall mortality at six months was 20%, compared with 40% in the two previous decades. Of the patients with proven subacute infective endocarditis thought to have received adequate antibiotic treatment, only 5 of 49 (10%) died; in a similar group of patients in the previous decade 19% died. Early surgical intervention probably accounts for the improved prognosis.

Acute Disease↗

Serratia marcescens in mixed aerobic infections of bone. A report of two patients.

Two patients with acute osteomyelitis of the foot caused by mixed aerobic organisms are described; sources of infection and predisposing factors are discussed. Serratia marcescens was isolated in each instance. Antimicrobial therapy which did cover this organism failed; a change to treatment directed against it succeeded.

Abscess↗

Rapid diagnosis of Bacteroides infections by indirect immunofluorescence assay of clinical specimens.

43 specimens from a variety of sites were directly examined by indirect immunofluorescence assay (I.F.A.) with specific antisera against the capsular polysaccharide of Bacteroides fragilis and pooled antisera against a number of serotypes of Bacteroides sp. (all of the former B. fragilis subspecies). The findings were compared with those of routine anaerobic bacteriology and gas liquid chromatography for short chain fatty acids. Examination by I.F.A. was a sensitive (100%) and specific (90.3%) means of identifying B. fragilis. Use of the pooled serum was sensitive (100%) but less specific (64.3%) than the capsular antiserum (90.3%) although it had the advantage of detecting Bacteroides species other than B. fragilis. The capsular serum I.F.A. gave 9.7% false positives and no false negatives. The predictive value of a positive identification of B. fragilis in a clinical specimen using this anticapsular serum I.F.A. test was 80%; with the pooled Bacteroides group-serum it was 60%. The predictive value of a negative test was 100% for both sera, indicating that a negative I.F.A. test is a reliable index of the absence of Bacteroides from the culture I.F.A. of clinical material provides a rapid (less than 2 h) specific and sensitive means for the diagnosis of B. fragilis infections and would be of use in a clinical laboratory.

Abdomen↗

The increasing isolation of Serratia species from clinical specimens.

A 14-month survey was undertaken in a diagnostic bacteriology laboratory to determine the incidence of Serratia spp. in routine clinical specimens. Gram-negative organisms with enterobacteria-like colonies were tested by a simple screening procedure. Fifty-eight strains of S. marcescens and two strains of S. liquefaciens were isolated from 59 patients. The strains were usually non-pigmented and exhibited multiple antibiotic resistance. Serotyping and determination of bacteriocine sensitivity patterns revealed that the majority of infections were sporadic, although episodes of cross-infection did occur. S. marcescens was considered to contribute significantly to morbidity and mortality in 53% of patients and appears to be of increasing importance in hospital-acquired infections.

Adult↗