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Biomedical subjects

W M McCormack

Publications and source records attributed to W M McCormack.

At least 109 records · Page 6Linked to original sources

Isolation of Mycoplasma hominis from blood cultures in patients with postpartum fever.

Eight women with postpartum fever are presented in whom Mycoplasma hominis was isolated from cultures of their blood. Clinical disease consisted of a mild although often prolonged febrile illness, and all but one recovered without appropriate antimicrobial therapy. Five patients demonstrated elevated convalescent titers of mycoplasmacidal antibodies. The isolates of M. hominis were recovered from routine blood cultures in the diagnostic bacteriology laboratory using blind subcultures to blood agar plates. These cases lend support to the concept that endometritis with M. hominis is a cause of postpartum fever and suggest that these organisms may be recovered with increased frequency if minor changes in standard bacteriologic technique are introduced.

Bacteriological Techniques↗

Microbiology of the vagina in children: normal and potentially pathogenic organisms.

Vaginal cultures from 100 healthy girls, 2 months to 15 years of age, were examined for the presence of normal and potentially pathogenic microorganisms. Corynebacterium vaginale, yeast species, and genital mycoplasmas were isolated from vaginal cultures from 13.5 %, 28%, and 28% of the girls examined, respectively. Colonization with these organisms was not associated with signs or symptoms of vaginitis. Neisseria gonorrhoeae was isolated from a 4-year-old with purulent vaginitis. Trichomonas vaginalis was recovered from two 13-year-olds, both of whom had an abnormal vaginal discharge. Vaginal antibody to Chlamydia trachomatis was found in two girls 4 and 13 years of age. In neither girl was the organism recovered from the vaginal culture. Chlamydia trachomatis was recovered from the vaginal culture of another 4-year-old who had no abnormal findings on examination. Cultures from 59 of the girls were examined for aerobic and facultatively anaerobic bacteria. Diphtheroids and Staphylococcus epidermidis were the most frequently isolated organisms. Lactobacilli were isolated most frequently from the older girls, whereas enteric organisms were isolated most frequently from the younger girls.

Adolescent↗

Microbiological investigation of Bartholin's gland abscesses and cysts.

Percutaneous aspirates from intact Bartholin's gland cysts (12) and abscesses (34) were examined for bacteria and genital mycoplasmas. Aspirates from 10 of the 12 patients with Bartholin's gland cysts were sterile. Aspirates from the other two cysts contained organisms that are part of the vaginal microbial flora. Of the 34 abscesses, 24 (70.6 per cent) contained bacteria. Eight abscesses contained gram-negative rods in pure culture and four contained gonococci in pure culture. Twelve abscesses contained one or more vaginal organisms including anaerobic gram-negative rods (eight isolates), anaerobic gram-positive cocci (eight), Staphylococcus epidermidis (four), and microaerophilic streptococci (three). Although most of the patients had genital mycoplasmas isolated from vaginal cultures, Mycoplasma hominis was isolated from only one and Ureaplasma urealyticum from none of the aspirates.

Abscess↗

Clinical spectrum of gonococcal infection in women.

The medical records of 278 women infected with Neisseria gonorrhoeae during a 6-month period were reviewed. These represented 75% of the infections in women at Boston City Hospital during this time. Women who presented to the venereal-disease clinic because they had had contact with an infected man and women who were found to be infected during routine examinations in the obstetrics-and-gynaecology clinic were usually free of symptoms or had non-specific symptoms such as vaginal discharge. However, these women accounted for only 108 (39%) of the 278 infections. Most of the infections were in women who presented to the emergency-care areas of the hospital with symptomatic gonococcal infections. At least 86 (31%) of the 278 infections were in women who had pelvic inflammatory disease. These data indicate that the clinical spectrum of gonococcal infection varies according to where the patients are seen and that the widely held concept that most gonococcal infections in women are asymptomatic may be erroneous.

Adolescent↗

Vaginal colonization with group B streptococcus: a study in college women.

Vaginal specimens for culture of group B Streptococcus and anonymous questionnaires were obtained from 499 college women. Group B Streptococcus was isolated from 90 (18.0%) of the participants. A selective broth medium was more sensitive for detection of vaginal isolates (85 of 493; 17.2%) than was direct inoculation of blood agar plates (44 of 466; 9.4%). The most prevalent serotypes among the isolates were type III (37.9%) and type II (25.3%). Logit analysis identified four factors associated with a higher prevalence of vaginal colonization with group B Streptococcus. These organisms were isolated significantly more often from (1) women who had an intrauterine device (50% vs. 18.6%; P less than 0.001), (2) sexually experienced women (20% vs. 7.1%; P less than 0.02), (3) women studied during the first half of the menstrual cycle (26.5% vs. 14.5%; P less than 0.01), and (4) women 20 years of age or younger (21.4% vs. 14.8%; P less than 0.05). The prevalence of colonization with group B Streptococcus was not related to sexual practices, history of venereal disease, use of oral contraceptives, presence of gynecologic symptoms, use of antibiotics, race, educational level, marital status, or history of pregnancy.

Adult↗

Quantitative bacteriology of the vaginal flora.

Quantitative bacteriology was performed on vaginal secretions from healthy adult women. The analysis included a single sample from 17 college students and 35 samples from five volunteers collected at intervals of three to five days throughout the menstrual cycle. Mean concentrations in all 52 specimens were 10(8.1) aerobic bacteria/g and 10(9.1) anaerobic bacteria/g. The rank of predominant organisms, according to rates of recovery in concentrations of greater than 10(5) colony-forming units/g, was anaerobic and facultative Lacrobacillus species, Peptococcus species, Bacteroides species, Staphylococcus epidermidis, Corynebacterium species, Peotostreptococcus species, and Eubacterium species. Sequential samples collected throughout the menstrual cycle showed relatively consistent mean levels of anaerobes and a significant decrease in concentrations of aerobes in premenstrual specimens compared with those in the specimens collected in the week following onset of menses. Analysis of sequential specimens from each of the five individuals showed considerable variation in species recovered. These data indicate that the vaginal flora in healthy adult women is a dynamic ecosystem in which anaerobes are usually the numerically dominant bacteria.

Adolescent↗

Vaginal colonization with Corynebacterium vaginale (Haemophilus vaginalis).

Vaginal cultures for Corynebacterium vaginale and confidential questionnaires were obtained from unselected young women who consulted a gynecologist in a student health service. In all, 466 women were studied, 150 (32.2%) of whom were colonized with C. vaginale. Logit analysis defined four factors that were significantly associated with colonization with C. vaginale: nonwhite race, use of oral contraceptives, no history of marriage, and a history of pregnancy. Sexual experience had little influence on colonization; C. vaginale was isolated from 16 (29%) of 56 sexually inexperienced women and from 40 (41%) of 98 women who had had intercourse with six or more men. After a few patients with trichomoniasis were excluded, there was no association between colonization with C. vaginale and an abnormal vaginal discharge, either as reported by the participant or as noted by the examining physician.

Black People↗

In vitro activity of p-hydroxybenzyl penicillin (penicillin X) and five other penicillins against Neisseria gonorrhoeae: comparisons of strains from patients with uncomplicated infections and from women with pelvic inflammatory disease.

Minimum inhibitory concentrations (MICs) of six penicillins against 95 strains of Neisseria gonorrhoeae from patients with uncomplicated anogenital infections and 22 strains from women with pelvic inflammatory disease were determined by an agar plate dilution method, using an inocula replicator. Against all 117 strains, the order of activity observed was: BL-P1654 > penicillin X > penicillin G > ampicillin > amoxicillin = carbenicillin. MICs against strains isolated from women with gonococcal pelvic inflammatory disease were significantly higher than those against isolates from uncomplicated infections: BL-P1654, P < 0.001; penicillin X, P < 0.001; penicillin G, P < 0.001; ampicillin, P < 0.001; and amoxicillin, P < 0.05. MICs of penicillin G were >/=0.125 mug/ml against 33 (36%) of the 92 strains from patients with uncomplicated infections, as contrasted with 15 (68%) of the 22 isolates from women with pelvic inflammatory disease (P < 0.01). The means of the MICs of penicillin G were 0.06 mug/ml for the former and 0.14 mug/ml for the latter.

Female↗

Hepatotoxicity of erythromycin estolate during pregnancy.

Women in the second half of pregnancy, who were infected with genital mycoplasmas and who gave written informed consent, were randomly assigned to receive capsules of identical appearance containing erythromycin estolate, clindamycin hydrochloride, or a placebo for 6 weeks. Levels of serum glutamic oxalacetic transaminase (SGOT) were determined before and during treatment by a fluorometric method. All pretreatment levels of SGOT were normal (<41 units). Participants who received erythromycin estolate had significantly more abnormally elevated levels of SGOT (16/161, 9.9%) than did those who received clindamycin (4/168, 2.4%, P < 0.01) or those who received placebo (3/165, 1.8%, P < 0.01). Elevated levels of SGOT ranged from 44 to 130 U. Serum bilirubin levels were normal. Gamma-glutamyl transpeptidase activity was abnormal in six of six participants who had abnormal levels of SGOT while receiving erythromycin estolate. There were few associated symptoms, and all levels of SGOT returned to normal after cessation of treatment. The treatment of pregnant women with erythromycin estolate may be inadvisable.

Aspartate Aminotransferases↗

Quantitative determination of antibody to capsular polysaccharide in infection with type III strains of group B Streptococcus.

The development of antibody in response to invasive infection with type III strains of group B Streptococcus was studied in sera from 31 infants and 4 adults by means of a quantitative radioactive antigen-binding assay. Low concentrations of antibody were consistently found in the acute sera of patients who developed clinical illness. Although adults with puerperal sepsis and infants with bone or joint infection uniformly demonstrated significant rises in serum antibody concentration after recovery, much lower levels of antibody were detected in convalescent sera from infants recovering from meningitis or sepsis. The median antibody concentration in sera from 43 parturients with type III strains of group B Streptococcus isolated from vaginal cultures whose neonates failed to develop symptomatic disease was significantly greater than that in sera from 29 mothers of infants with invasive, type III, group B streptococcal infection. Study of paired maternal and cord sera demonstrated a significant correlation between the antibody concentration in a mother's serum and that in her neonate.

Adolescent↗

Colonization with group B streptococci in girls under 16 years of age.

Cultures from the vagina, pharynx, and anal canal of 100 healthy girls, 2 months through 15 years of age, were examined for the presence of group B streptococci. Of the 100 participants, 20% were colonized at one or more of these three sites. Pharyngeal colonization was detected in 15% of the girls under 11 years of age and in 5% of those over 11 years of age. Colonization at anogenital sites were observed in 19% of participants under 3 years of age, in 25% of those 11 years of age and older, and in only 4% of those between the ages of 3 and 10 years (P less than .025). The concentration of serum antibody directed against the polysaccharide capsular antigen isolated from type III, group B Streptococcus appeared, in part, to be related to increasing age.

Adolescent↗

Comparison of methods for the isolation of genital mycoplasmas from men.

Two hundred nine men were studied to determine the optimal method of obtaining cultures for genital mycoplasma. Ureaplasma urealyticum (T-mycoplasmas) was isolated from 95 (45.5%) of the participants. Urethral cultures obtained by means of urethrogenital calcium alginate swabs identified 82 (86%) of the 95 colonized men. Urethral cultures taken with cotton-tipped applicators (76%) urine cultures (27%), and cultures of the coronal sulcus (24%) detected fewer colonized men. All men who were colonized with U. urealyticum were identified by one of the two urethral cultures. Mycoplasma hominis was recovered from 73 (34.9%) of the 209 men. Urethral cultures identified most of the circumcised men who were colonized with M. hominis (11 of 14; 79%). In contrast, cultures from the coronal sulcus detected most of the colonized uncircumcised men (49 of 59; 83%). More than 90% of the men who were colonized with M. hominis were identified by either urethral culture or culture of the coronal sulcus. A similar study was conducted among 143 normal college students yielded comparable results.

Bacteriological Techniques↗

Comparison of bacteriological methods for the isolation of group of B Streptococcus from vaginal cultures.

Three bacteriological techniques for the isolation of group B streptococci in vaginal cultures were compared. A selective broth medium (SBM) containing gentamicin and nalidixic acid was more sensitive for the detection of vaginal isolates (28/76, 36.8%) from 76 women enrolled in a venereal disease clinic than was an identical selective plate medium (SPM) (17/76, 25%). Similarly, SBM allowed identification of positive cultures from college women (82/459, 17.9%) significantly more often than direct inoculation of swabs onto nonselective blood agar medium (43/460, 9.4%; chi2 = 42.2, P = less than 0.001). Failure to isolate group B streptococci detected in SBM occurred in 32.1% cultures by SPM and 49.4% of cultures by nonselective agar medium. Multiple serotypes were detected in a single vaginal culture from approximately 5% of the patients studied. These data support the routine use of SBM for the most accurate identification of women vaginally colonized with group B Streptococcus.

Bacteriological Techniques↗

Enhancement by sodium chloride of the selectivity of thiosulfate citrate bile salts sucrose agar for isolating Vibrio cholerae biotype El Tor.

In this study we utilized the salt-tolerant characteristics of vibrios to develop a more selective medium by addition of NaCl to thiosulfate citrate bile salts sucrose (TCBS) agar. The effect of adding salt to TCBS agar varied greatly among brands of TCBS agar and between lots of the same brand. The addition of salt at concentrations as high as 1.5% (2.5% total NaCl) caused the inhibition of growth of three species of commonly encountered normal bowel flora and one strain of classical Vibrio cholerae but did not compromise the use of TCBS agar for isolation of V. cholerae biotype El Tor.

Agar↗