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V Krause

Publications and source records attributed to V Krause.

36 records · Page 2Linked to original sources
PubMed1999

Investigation of a cluster of Staphylococcus aureus invasive infection in the top end of the Northern Territory.

INTRODUCTION: Staphylococcus aureus invasive infection remains a serious condition associated with considerable morbidity and mortality. Following notification of five cases at Royal Darwin Hospital (RDH), we searched for related cases, determined their epidemiological characteristics and attempted to identify the source of this apparent cluster. METHODS: We reviewed RDH microbiology records between June 1996 and April 1997 for S. aureus isolates with similar antibiograms to notified cases. We used antibiotic resistance patterns, bacteriophage typing and two molecular typing techniques to subtype implicated isolates. Hospital records were reviewed for admission details and associated costs were estimated. RESULTS: Fifty-four cluster-related isolates occurred in 47 separate presentations. The peak incidence was in the wet season. The most important risk factor for staphylococcal invasive infection was the presence of skin sores/scabies in 17/54 cases (31%), followed by intravascular line use in 14/54 (26%), open trauma in 11/54 (20%), underlying end stage renal failure and alcoholism each in ten of 54 (18%). The mean admission length was 30 days and antibiotics were given for an average of 23 days. Death due to S. aureus infection occurred in eight of 47 (17%) presentations. S. aureus pneumonia was community acquired in 12/13 patients (92%) and six of 13 (46%) died. Ten of 13 (80%) pneumonia patients had at least one other focus of S. aureus infection. The cost of antibiotics and hospital bed per presentation was approximately $16,000. Presentations with skin sores/scabies cost considerably more ($31,000). No common epidemiologic features were found for community or hospital acquired cases. CONCLUSION: Considerable mortality and cost was attributable to cases of S. aureus invasive infection during this cluster; particularly those with community acquired pneumonia or skin sores/scabies. Staphylococcal antibiotic cover should be considered early for unwell patients presenting to hospital with pneumonia and other signs of potential S. aureus infection. It is appropriate to target public health efforts to prevent skin sores and to provide adequate treatment when they occur.

Adolescent↗
PubMed1999

A retrospective search for lyssavirus in humans in the Northern Territory.

BACKGROUND: Following the 1996 discovery of a rabies-like lyssavirus in Australian flying foxes, it was unclear whether this was a new epizootic or an unrecognised, previously existing disease. OBJECTIVE: To review cases of unexplained encephalitis in the Northern Territory (NT) to test available clinical specimens for lyssavirus and survey the use of diagnostic tests by clinicians. METHODS: The NT hospital morbidity database was searched from January 1992 to September 1996 for all Royal Darwin Hospital (RDH) cases with an ICD-9 code encompassing encephalitis or viral meningitis. Final diagnoses were determined by hospital record review. For cases of unexplained encephalitis, we assessed the use of diagnostic tests and located clinical specimens for testing for lyssavirus-specific inclusion bodies via immunohistochemistry, immunofluorescence and reverse-transcriptase polymerase chain reaction (RT-PCR). RESULTS: Encephalitis occurred in 34/154 (22%) cases located by the search; 53% (18/34) of encephalitis cases were unexplained. Of these, 24% had no serology performed and 47% had no blood cultures taken. Four (22%) died and two had autopsies. These were the only two cases with clinical specimens available for testing. They were negative for lyssavirus. None of the 71 cases coded as viral meningitis had unexplained encephalitis. CONCLUSION: There was a considerable proportion of unexplained illness among NT cases of encephalitis. IMPLICATIONS: Clinicians should test for lyssavirus in patients with encephalitic symptoms and a postmortem should be sought where death is unexplained. Specimens should be stored to enable testing for emerging infectious diseases.

Diagnosis, Differential↗
PubMed1999

An outbreak of salmonellosis linked to a marine turtle.

In September 1998, an outbreak of gastroenteritis occurred in a coastal Aboriginal community in the Northern Territory over a seven day period. An investigation was conducted by the Center for Disease Control, Territory Health Services. Thirty-six cases were detected and 17% (n=6) were hospitalized. Salmonella chester was isolated from eight of nine stool specimens. Sixty-two percent of cases interviewed (n=28) reported consumption of a green turtle (Chelonia mydas) within a median of 24 hours prior to onset of illness. Of the remainder, all but two were contacts of other cases. Salmonella chester was isolated from a section of partially cooked turtle meat. There are no previous published reports of salmonellosis associated with consumption of sea turtles despite them being a popular food source in coastal communities in the Pacific.

Adolescent↗
PubMed1997

An outbreak of influenza B among workers on an oil rig.

An outbreak of influenza B occurred in December 1996 on an oil rig in Darwin Harbour. The outbreak affected 56% of the workers on the rig. An outbreak in December is outside the usual Australian influenza season of June to September, but is consistent with other tropical regions, where outbreaks can occur throughout the year. Influenza vaccination could prevent similar outbreaks in confined workplaces.

Disease Outbreaks↗
PubMed1997

[Intratumor pO2, S-phase fraction and p53 status in cervix carcinomas].

PURPOSE: Investigation whether tumor tissue oxygenation is influenced by proliferation or p53-status in cervical cancers. MATERIAL AND METHODS: From April 1995 through December 1996, 28 patients with locally advanced cervical cancers (age 36 to 78 years; FIGO stages: 10 patients IIB, 16 patients IIIB, 2 patients IVA) underwent intratumoral measurement of pO2 prior to definitive radiotherapy. The histological specimens were examined for grading and quantitative immunohistological expression of the MIB-antigen and p53-protein. Proliferation was estimated by measuring the S-phase fraction with flow cytometry. RESULTS: The median pO2-values showed a broad variation from 2.2 through 60.4 mm Hg, median 19.7 mm Hg. The S-phase fraction varied from 4.2 through 34.2% (median 11.6%), MIB-positive cells from 20 through 100% (median 74%), and immunohistologically p53-positive cells from 0 through 95% (median 2%). The patients were divided in 2 groups according to the pretreatment pO2. Tumors with a pO2 above the median had a lower S-phase fraction than tumors with a pO2 below the median, 10.4 +/- 3.8% versus 16.3 +/- 5.5%, p < 0.02. MIB and p53 were not different in both groups (MIB: 68.1 +/- 27.7% versus 75.0 +/- 18.4%, p = 0.1; p53: 26.4 +/- 38.5% versus 18.1 +/- 19.8%, n. s.). Grade of differentiation and FIGO stage had no impact on pO2. CONCLUSION: Locally advanced cervical cancers with a poor oxygenation have a higher proliferative activity. Tumor proliferation may play a causative role for the development of hypoxia as suspected from radiobiological theories.

Adult↗
PubMed1997

Success of a scabies control program in an Australian aboriginal community.

OBJECTIVE: To adapt, implement and evaluate a model of scabies control in an Australian Aboriginal community. METHODS: After initially examining the population, we offered all residents treatment with 5% permethrin cream. Visits were made during the ensuing 25 months to rescreen and to treat new-cases of scabies and contacts. RESULTS: The prevalence of scabies was reduced from 28.8% before the program to < 10% during the entire period (from 32.3% to < 10% in children) (P < 0.01 for each visit). The initial prevalence of pyoderma in children was 69.4%, which was reduced and maintained at approximately one-half that rate during the last 16 months (P < 0.004 for the last 4 visits). Residual pyoderma in children was significantly less severe and no longer scabies-related. CONCLUSIONS: This simplified model of scabies control had a substantial effect on scabies prevalence and on pyoderma prevalence and severity which was sustained for > 2 years. It could prove useful for other communities with high rates of scabies and pyoderma.

Administration, Topical↗
PubMed1996

Investigation of notifications of hepatitis C in 1994: the experience of three health departments.

Laboratories must notify health departments of cases of hepatitis C in Queensland, the Northern Territory (NT) and the Australian Capital Territory (ACT). Our objectives were to estimate the minimum proportion of notified cases of hepatitis C that were recent infections and to determine the risk factors for infection of the notified cases. We conducted a retrospective investigation of all eligible notifications received at the health departments in Queensland, the Northern Territory and the Australian Capital Territory. Of the 963 notifications about which information was received, 16 per cent were repeat notifications. These were excluded from further analysis. In Queensland, 7 per cent, and in both NT and ACT, 3 per cent of the notifications were considered to be recent infections. The most common risk factor reported for both recent and all other hepatitis C cases was a history of injecting drug use, although the proportion of cases with that history was different in NT from ACT and Queensland. Cases were tested because of screening programs: for drugs and alcohol, in sexually transmitted diseases clinics and prison; and because of clinical indications such as a risk factor, symptoms, or results of liver function tests. Another common reason for testing was a request from a patient. A significant proportion of recorded notifications was repeat notifications. Most notifications were of patients who had become infected more than 12 months ago and the most common risk factor was injecting drug use. There was not a high proportion of cases with unknown risk factors.

Age Distribution↗
PubMed1989

Acetylator phenotype and short-course chemotherapy for tuberculosis in Papua New Guinea.

In Papua New Guinea the slow acetylator phenotype is unusual and peripheral neuropathy during isoniazid therapy is uncommon. Acetylator status and other factors influencing isoniazid-induced peripheral neuropathy are discussed, and statistics from Papua New Guinea are presented. The relevance of acetylator phenotype to other side-effects of isoniazid is less well defined. Prophylactic pyridoxine supplementation during short-course chemotherapy for tuberculosis is not generally necessary in the daily 'A' regimen, but should be maintained in the twice-weekly (high-dose isoniazid) 'B' regimen for adults and children over 20 kg.

Acetylation↗
PubMed1984

Dynamics of Listeria monocytogenes type 4b infection in pregnant and infant rats.

In order to examine the dynamics of perinatal listeriosis, we established a rat model of infection using a strain of Listeria monocytogenes type 4b isolated from a human newborn infant. When injected subcutaneously, the median lethal dose (LD50) to the organism was lower for pregnant than nonpregnant animals (10(8) vs 10(9) colony forming units [cfu]). Susceptibility was greatest on the 16th day of gestation (67% mortality) as was the likelihood that the offspring had generalized infection (50%). In contrast, all five pregnant rats injected on the 9th day of gestation survived. None of the five went on to have a litter, thus suggesting that there was intrauterine death. The LD50 for infant (3-day-old) rats was 6 X 10(5) cfu; that for juveniles (13-day-old) 2.5 X 10(7) cfu (p less than 0.005). No differences were seen between infant or juvenile rats in the number of viable bacteria in homogenized liver, spleen and lung or in blood at 1 or 3 days after a weight-adjusted intraperitoneal bacterial challenge. However, 5 days after challenge, viable organisms were decreased in all of these sites for the juveniles while they were increased for the infants (p less than 0.001). Polymorphonuclear (PMN) and mononuclear cells appeared in the peritoneum in similar concentrations for infant and juveniles one day after intraperitoneal challenge. At 5 days the number of mononuclear cells was significantly greater for juveniles compared to infants (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Aging↗
PubMed1981

Characterization of ligand-binding activity of isolated murine Fc gamma receptor.

Fc gamma-binding macromolecules were isolated from 2 murine macrophage-like cell lines by affinity chromatography using various immunoglobulins coupled to Sepharose. P388D1 and J744.2 cells were radiolabeled with 125I using a modified lactoperoxidase method, washed cells were solubilized using NP-40, and the solubilized cell lysates were incubated at 4 degrees C with immunoadsorbents. Fc gamma receptor-like material was obtained from the IgG-Sepharose columns by elution at 4 degrees C with 0.5 N acetic acid containing 1% NP-40 into buffer for neutralization. Purified material thus obtained retained its ligand-binding activity, since approximately 30 to 60% rebound to IgG-Sepharose. Upon analysis by SDS polyacrylamide gel electrophoresis, putative Fc gamma receptor had an apparent m.w. of 50 to 65,000. Neither a comparable SDS-PAGE band nor receptor activity was isolated from a 3rd murine cell line, which lacks the Fc gamma receptor. Putative receptor obtained by elution from IgG2a-Sepharose rebound equally well to IgG2a-, IgG1- and IgG2b-Sepharose, but did not rebind to IgG3-, F(ab')2-, or BSA-Sepharose. Similarly, Fc gamma-binding macromolecules eluted from IgG2b-Sepharose rebound only to IgG2b-, IgG2a- and IgG1-Sepharose rebound only to IgG2b-, IgG2a- and IgG1-Sepharose. The rebinding of either receptor preparation was inhibited in a dose-dependent manner by both monomeric IgG2a and monomeric IgG2b, and myeloma protein from each subclass inhibited to the same extent. Therefore, the mouse Fc gamma receptor in its isolated state does not appear to discriminate between monomeric IgG2a and IgG2b.

Animals↗
PubMed1980

Improved cell surface radioiodination of macrophages.

Rabbit alveolar macrophages at high cell concentrations are inefficiently radiolabeled by the usual lactoperoxidase-catalyzed iodination method. Soluble macromolecules secreted by macrophages were found to inhibit the radioiodination of macrophages and other cells. A modified procedure is described which minimizes the presence of such inhibitory material and thereby considerably improves the radioiodination efficiency for both alveolar macrophages and the macrophage-like P388D1 cell line.

Animals↗
PubMed1980

Purification of Fc gamma receptor from rabbit alveolar macrophages that retains ligand-binding activity.

The Fc gamma receptor of rabbit alveolar macrophages was purified by affinity chromatography by using rabbit gamma-globulin (Rab gamma G) coupled to Sepharose. Macrophage preparations were efficiently labeled with 125I by using a modified lactoperoxidase method. After incubation of NP-40 cell lysates with Rab gamma G-Sepharose, elution at 4 degrees C with 0.5 N acetic acid containing 1% NP-40 and rapid neutralization allowed recovery of active Fc gamma receptor. Purified Fc gamma receptor retained its ligand-binding activity, since approximately 41 to 72% of labeled material specifically rebound to Rab gamma G-Sepharose. Active receptor also rebound to human IgG- and rat IgG-sepharose. Active Fc gamma receptor did not bind to Sepharose coupled to rabbit Fab, rabbit F(ab)'2 or human F(ab)'2 fragments, nor to Sepharose coupled to chicken IgG. Analysis of Fc gamma receptor by SDS polyacrylamide gels demonstrated a broad peak of radioactivity in the apparent m.w. range of 50,000 to 70,000 in 5.6% acrylamide gels and 35,000 to 55,000 in 9% gels. Labeled receptor with similar structural characteristics and ligand-binding activity was also obtained from highly purified adherent cell populations and from macrophages biosynthetically-labeled with [14C]glucosamine in culture.

Animals↗