PubMed Health⌕ Search

Biomedical subjects

W A Gillespie

Publications and source records attributed to W A Gillespie.

At least 19 recordsLinked to original sources
PubMed1989

Microbiology of the urethral (frequency and dysuria) syndrome. A controlled study with 5-year review.

In a clinical and microbiological study of women with urinary frequency and dysuria (excluding those with bacterial cystitis), 41 patients were compared with 42 control subjects. No difference was found between patients and controls in the incidence of infection by Chlamydia trachomatis or other sexually transmitted organisms. The numbers of lactobacilli and other fastidious organisms in the urine of patients with either mild or severe symptoms were similar and did not differ from the numbers in the urine of control subjects. The numbers of leucocytes in urine were also similar in both patients and controls. Our findings support the view that the urethral syndrome is not caused by bacterial or chlamydial infection.

Adult↗
PubMed1988

Bacteriuria and bacteraemia in patients with long-term indwelling catheters--a domiciliary study.

Men with indwelling catheters and men and women with suprapubic catheters were studied in their homes. Urine and blood were cultured and body temperature recorded after every catheter change. Nearly all patients had infected urine after 4 weeks of catheterisation, and all had bacteriuria after longer periods, usually with a mixture of organisms. Culture on selective media revealed a wider range of organisms than was detected on routine C.L.E.D. and blood agar with antibiotic sensitivity disks, but routine culture gave adequate information for clinical purposes. Bacteraemia was demonstrated after 20 of 197 changes of urethral catheter and after one of 19 changes of suprapubic catheter; but no patient had pyrexia or other symptoms. However, two had rigors on other occasions. When assessing "risk factors" for blood-stream infection in catheterised patients, it is important to record the total incidence of bacteraemia, asymptomatic as well as symptomatic.

Bacteria↗
PubMed1987

Bladder irrigation with chlorhexidine for the prevention of urinary infection after transurethral operations: a prospective controlled study.

The value of postoperative bladder irrigation with the antiseptic agent chlorhexidine was assessed in a randomized prospective controlled study of men after transurethral operations. In patients with sterile preoperative urine the incidence of postoperative bacteriuria was 12.8 per cent, compared to 36.7 per cent in control patients. The difference is significant (chi-square 5.54, p less than 0.02). On the other hand, chlorhexidine irrigation did not eliminate pre-existing infection. Small amounts of chlorhexidine were demonstrated in the blood of some patients. There was no evidence of damage to the bladder and no toxic side effects.

Administration, Intravesical↗
PubMed1984

Bacteraemia during prostatectomy and other transurethral operations: influence of timing of antibiotic administration.

The relation between the timing of prophylactic antibiotic administration and the occurrence of bacteraemia during transurethral operations was studied in 112 patients whose urine was infected before operation. Blood cultures taken during operation were positive in 15 (60%) of 25 patients who did not receive appropriate antibiotics, in 13 (21%) of 63 patients who were given appropriate antibiotics less than 24 h before operation, and in none of 24 patients in whom antibiotic "cover" was started more than 24 h before operation. In all cases the bacteraemia was transient. No patient developed septicaemia. The implications of these findings for the optimum timing of antibiotic administration to patients with preoperative bacteriuria are discussed.

Anti-Bacterial Agents↗
PubMed1983

Does the addition of disinfectant to urine drainage bags prevent infection in catheterised patients?

The value of adding chlorhexidine to urine drainage bags of male patients treated with indwelling catheters after prostatectomy and other transurethral operations was assessed in a randomised, prospective, controlled was assessed in a randomised, prospective, controlled study. Chlorhexidine kept the contents of all drainage bags sterile, but the frequency of urinary infection in the chlordexidine group (51%) did not differ significantly from that in the control group (45%). Most infections were endogenous, caused by organisms which probably came from the patient's own urethra. It was concluded that the method has no value in urology units where standards of catheter care and closed drainage are properly maintained. Controlled studies in other types of catheterised patients are needed, especially when the risks of cross-infection are high.

Catheters, Indwelling↗
PubMed1983

Antimicrobial agents for the prevention of urinary tract infection in transurethral surgery.

Chemoprophylaxis and disinfection of the operation site for the prevention of bacteriuria after a transurethral operation were assessed in controlled, prospective studies in men with sterile urine preoperatively. The majority of the control patients (65 per cent) suffered postoperative bacteriuria compared to 38.6 per cent after perioperative disinfection with chlorhexidine and 10 per cent or less after each of 2 other regimens (intramuscular cephradine followed by oral nitrofurantoin and chlorhexidine disinfection followed by oral nitrofurantoin). The latter regimen is preferred since it avoids the use of agents with systemic action.

Aged↗
PubMed1978

Urinary tract infection in young women, with special reference to Staphylococcus saprophyticus.

Acute urinary tract infections in young women attending a clinic for sexually transmitted diseases were caused by the same bacteria, in the same proportions, as those that caused infections in women students. Staphylococcus saprophyticus biotype 3 (formerly called Micrococcus subgroup 3) was the commonest organism after coliform bacilli and caused about 30% of the infections. It was uncommon in women over 25 years of age and rarely caused asymptomatic bacteriuria in pregnancy. Most infections, irrespective of the causative organism, started soon after sexual intercourse, but neither the staphylococci nor the other organisms were associated with promiscuity, as judged by numbers of sexual partners or the incidence of sexually transmitted diseases. There was no evidence that the staphylococci were sexually transmitted. The reasons for the virulence of Staph. saprophyticus and its predilection for the urinary tract of young women remain unknown.

Adult↗
PubMed1977

Routine laboratory assessment of postoperative chest infection: a prospective study.

Postoperative chest infection was studied prospectively in 73 patients in order to evaluate standard laboratory methods of sputum examination and to relate the results to the patients' clinical state and to antibiotic therapy. When a culture medium selective for haemophilus was used in addition to unselective media, homogenisation of the specimen gave no advantage. Laboratory and clinical findings usually corresponded well. Profuse growths of Streptococcus pneumoniae or Haemophilus influenzae were clearly associated with clinical evidence of chest infection but other Gramnegative bacilli and Staphylococcus aureus much less so. Coliforms were more prominent after antibiotic therapy.

Adult↗
PubMed1976

The relevance of growth rates in urine to the pathogenesis of urinary-tract infections due to Micrococcus subgroup 3 (Staphylococcus saprophyticus biotype 3).

A novobiocin-resistant "biotype" of Micrococcus subgroup 3 (Staphylococcus saprophyticus) is known to be a primary pathogen of the female urinary tract and to cause infections as severe as those produced by Escherichia coli. The growth characteristics of this virulent biotype were compared in vitro with those of other Micrococcaceae and of E. coli to determine whether rapid growth explains the virulence of the biotype. Nutrient broth was shown to have growth-supporting qualities that differed from those of urine and it was therefore unsuitable for these studies. In urine, the virulent biotype grew more slowly, had a longer lag period, and reached much lower final viable counts than did Escherichia coli. Surprisingly, the virulent biotype also grew more slowly and reached a lower final viable count than did several other Micrococcaceae isolated from the urinary tract of healthy women. Urine from women who had suffered a recent infection with the virulent biotype had growth-supporting properties similar to those of urine from healthy women. Experiments with filtered forestream urine suggested that urethral secretions do not contain a factor determining growth rates of this organism in urine. The possibility that virulent strains adapt to rapid growth in urine was excluded. No evidence was obtained that the virulent biotype inhibits the growth of other Micrococcaceae in urine. Ability to grow rapidly in urine does not therefore explain the virulence of novobiocin-resistant strains of subgroup-3 micrococci.

Adult↗
PubMed1975

Micrococcal urinary-tract infections in young women.

In a prospective study in young women, novobiocin-resistant subgroup-3 micrococci were the second commonest cause, after Escherichia coli; of acute urinary infections. Proteus mirabilis was the only other causative organism. Symptoms, pyuria, or possible aetiological factors were the same in micrococcal and coliform infections. The infecting micrococcus "biotype" was only rarely found among the normal flora of the genitourinary tract of young women, though other micrococci and staphylococci were commonly present. Evidently, the infecting micrococci are selectively pathogenic in the urinary tract. Micrococcal infections, like coliform infections; commonly followed sexual intercourse, but there was no evidence that the micrococci were sexually transmitted. The infecting biotype was rarely found in the male urethra or prepuce.

Drug Resistance, Microbial↗
PubMed1974

Absorption of hexachlorophane from dusting powder on newborn infant's skin.

In a maternity hospital in which the umbilicus and trunk of healthy newborn infants were treated with 0.33% hexachlorophane dusting powder, the hexachlorophane content of blood was measured in mothers before delivery, in infants' umbilical samples at birth, and at 8 days of age in capillary blood samples. One mother and her baby had rather high blood concentrations of hexachlorophane, probably derived from a toilet preparation used before admission to hospital. Hexachlorophane was absent or barely detectable in the other mothers' blood and in the infants' umbilical blood. The hexachlorophane concentrations in the blood of 8-day-old infants ranged from nil to 0.166 mug./ml. (mean 0.066 mug./ml.). These were much less than the concentrations reported to be toxic in animals.In a previous trial now reported here, a dusting powder containing chlorhexidine instead of hexachlorophane was found to delay the separation of the umbilical cord.

Anti-Infective Agents, Local↗