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Biomedical subjects

T J Inglis

Publications and source records attributed to T J Inglis.

At least 37 records · Page 2Linked to original sources
PubMed1993

Antibacterial activity of sucralfate against Escherichia coli, Staphylococcus aureus and Pseudomonas aeruginosa in batch and continuous culture.

The antibacterial effect of varying concentrations of sucralfate was studied on Escherichia coli, Pseudomonas aeruginosa and Staphylococcus aureus grown in both agitated batch and continuous culture. The minimum inhibitory concentrations estimated with the two methods were in close agreement, ranging from 5 to 15 mg sucralfate/ml, concentrations easily attainable in gastric juice after a standard adult dose. Batch culture results indicated a dose-dependent effect. This study provides further evidence for an antibacterial effect by sucralfate against a range of species associated with respiratory tract infection in ventilated patients.

Escherichia coli↗
PubMed1993

Staphylococcal pneumonia in ventilated patients: a twelve-month review of cases in an intensive care unit.

We reviewed staphylococcal lower respiratory tract infections in our intensive care unit over a 12-month period. Staphylococcus aureus was isolated from tracheal aspirates more commonly in patients with intracranial trauma (P < 0.001), between one and six days (mean = 3) after admission to the intensive care unit. Bacteriophage typing of all S. aureus lower respiratory tract isolates from the 17 patients with head injury did not provide evidence for a common external source of infection or patient-to-patient transmission.

Bacteriophage Typing↗
PubMed1993

Evidence for dynamic phenomena in residual tracheal tube biofilm.

It has been proposed recently that a dynamic physical process occurring in the tracheal tube might account for the dissemination of bacteria and biofilm fragments into the lungs during mechanical ventilation, and the subsequent development of ventilator-associated pneumonia. In this study of tracheal tubes from consecutive adult intensive care patients, biofilms were detected radiographically in 45 of 50 tubes, and were found at the lower end of the tube more often than at the upper end (P < 0.005). In 37 of 50 tracheal tubes, the maximum biofilm thickness was equal to or greater than the 0.5 mm required for gas-liquid interaction in a tube with an i.d. of 8.5 mm. In 23 of 50 tubes, wave-like patterns were found. Five tubes had no biofilm inside the bevelled tip and another six showed evidence of biofilm loss for a greater distance from the tip. These observations suggest that the distribution of tracheal tube biofilm is caused at least in part by dynamic phenomena in the tracheal tube.

Equipment Contamination↗
PubMed1993

Penetration of an aerosol, produced by film atomization, through the carinal bifurcation.

We have measured the size of spots produced by atomization of simulated biofilm particles from a tracheal tube. Draughtsman's ink was atomized from 8.5-mm i.d. Portex tracheal tubes, using an airflow of 1 litre s-1, and trapped on vertical acetate sheets. The spots produced by these particles were compared with the spot size after entrainment and dissemination from an ink-lined tracheal tube through a bifurcating tracheobronchial tube towards a glass plate. Spot dimensions were measured by computer-assisted image analysis of a video image. The smallest particles observed on the acetate sheets were 4-17 microns in size. In the bifurcating tube experiment, large particles were deposited around the carinal bifurcation, but smaller particles traversed the bend. The smallest spot size observed (7 microns minimum; 17 microns median) corresponds to particles small enough to penetrate further into the lower respiratory tract. Travel via a tube similar to the carinal bifurcation suggests that fragments of biofilm entrained in the tracheal tube could be propelled deeper into the respiratory tract during the inspiratory phase of mechanical ventilation.

Aerosols↗
PubMed1992

Infection control in intensive care units: U.K. national survey.

A completed questionnaire was returned by 246 (85%) intensive care units participating in a national survey of infection control practice in intensive care. Thirty-three units had no provision for isolating patients in single side wards. Sixty percent of responding ICU had fewer than one washbasin per bedspace. Several units reported using ventilator filters or tubing more frequently than is currently recommended. Excessive numbers of catheter urine specimens were sent for laboratory examination by some units. A small number of units used open urinary drainage systems. A significant proportion of ICU had no formally recognized policy on the management of intravascular cannulae. Only 8% of ICU in the U.K. were using a selective decontamination regimen, and nine of these (50%) had no full time consultant microbiologist available to supervise the recommended microbiological management. The majority of ICU received a regular visit (greater than or equal to one per week) from a microbiologist. Proposals are made on the development of a specialized infection control service in order to reduce the risk of nosocomial infection in intensive care, and to improve on existing resource management.

Adult↗
PubMed1992

Gastroduodenal dysfunction as a cause of gastric bacterial overgrowth in patients undergoing mechanical ventilation of the lungs.

We have studied 15 patients undergoing mechanical ventilation of the lungs for evidence of a relationship between gastroduodenal dysfunction and gastric bacterial overgrowth. Duodenal reflux was detected by quantitative measurement of conjugated bilirubin in gastric aspirate specimens. The pH and bacterial content of these specimens were analysed. A minority of specimens with pH less than 3.5 contained measurable numbers of viable bacteria. The total bacterial count and the count of Gram negative bacteria correlated significantly with specimen pH in both cases (P less than 0.001, in both). In the 72 specimens of gastric aspirate with pH greater than 3.5, the presence of Gram negative bacteria was associated significantly with detectable bilirubin (P less than 0.001). The total bacterial count was greater also in specimens containing bilirubin (P = 0.009). These results suggest that gastroduodenal dysfunction may promote gastric bacterial overgrowth, contributing to the development of ventilator-associated pneumonia.

Adult↗
PubMed1990

Postoperative autologous transfusion in cardiac surgery. A prospective, randomised study.

To investigate the safety and efficacy of postoperative autologous blood transfusion (AT) using the Shiley hardshell venous reservoir, a prospective, randomised, controlled study was carried out in two matched groups of twenty patients undergoing elective coronary artery bypass surgery. The mean volume of shed mediastinal blood reinfused in the first 6 h postoperatively was 371.7 +/- 63.23 ml. Use of homologous blood was reduced from 760.5 +/- 108.37 ml in the control patients to 466.25 +/- 87.44 ml in the AT patients, a reduction of 38.7% (p less than 0.05). There was no statistically significant difference in the clinical outcome, overall blood loss, use of platelets, fresh frozen plasma and colloids, haematological indices, renal and hepatic functions, or clotting mechanism, although there was a reduction in the fibrinogen level in the patients who received AT (p less than 0.05). Mediastinal blood did not clot and was defibrinogenated. It contained significant levels of haemoglobin (8.175 +/- 0.506 g/dl), platelets (96.55 +/- 10.39 per mm3 10(3)), protein (42.5 +/- 1.13 g/l), calcium (2.385 +/- 0.054 mmol/l) and was well oxygenated (PO2 = 20.46 +/- 0.81 kPa). No patients developed bacteraemia or had any AT-related infections. We conclude that postoperative autologous transfusion using the Shiley hardshell venous reservoir is a safe and efficient method for reducing postoperative homologous blood requirement after coronary artery bypass surgery.

Adult↗
PubMed1989

Tracheal tube biofilm as a source of bacterial colonization of the lung.

Biofilm formation in tracheal tubes, its bacterial content, and its interaction with ventilator gas flow were investigated. At least 50 mg (dry weight) of biofilm was found in 30 of 40 tracheal tubes used in intensive care patients for 2 h to 10 days. Electron microscopy showed bacteria in this layer, and quantitative studies showed that bacterial counts could reach up to 10(6)/cm of tube length. Bacteria were cultured from the patient side of 18 of 78 heat and moisture exchanger-microbiological filter units removed from ventilator circuits. Particles were shown to detach from tracheal tube luminal biofilm and were projected up to 45 cm from the tracheal tube tip. Following contamination of the tracheal tube biofilm with a patient's own gastrointestinal flora, entrainment of bacteria in the inspiratory gas flow provides a mechanism for initial and repeated lung colonization.

Bacteria↗
PubMed1988

Cialit preserved cartilage: failure to guarantee sterility.

Homograft cartilage preserved in Cialit solution became contaminated with Pseudomonas fluorescens, making it unsuitable for reconstructive surgery. Cialit solution has no virucidal activity, and the risk of viral infections such as AIDS and hepatitis is a further reason not to use it as a storage solution for cartilage.

Cartilage↗
PubMed1986

Properties of methicillin-resistant Staphylococcus aureus colonizing patients in a burns unit.

One hundred cultures of methicillin-resistant Staphylococcus aureus (MRSA) were isolated from patients in a Regional Burns Unit between December 1984 and May 1985. These organisms produced large amounts of beta-lactamase which readily hydrolyzed flucloxacillin but they were sensitive to teicoplanin, dicloxacillin and cephalothin at 37.5 degrees C. The MRSA strains did not differ from methicillin-sensitive isolates in sensitivity to unsaturated fatty acids, survival in serum and plasma or desiccation. However, each culture of this strain was negative or only weakly-positive for bound coagulase and cell bound protein A. Few (eight out of 44) cultures contained plasmids and the resistance to four antibacterials was not transferable in mixed cultures. No attempt was made to isolate patients colonized with MRSA which were rarely isolated elsewhere in the hospital.

Anti-Bacterial Agents↗