Mycoplasma hominis sternal wound infection and bacteraemia.

Mycoplasma hominis is a rare cause of bacteraemia in adult males. We believe this report to be the first of Mycoplasma hominis bacteraemia and wound infection complicating cardiac surgery. Because of difficulties in isolating the organism, cases may be missed.

Antibiotic pharmacoeconomics: an attempt to find the real cost of hospital antibiotic prescribing.

Antibiotics account for a large part of all hospital pharmacy budgets, but the actual cost of their prescription is unknown. These costs include intravenous administration, labour, serum antibiotic assay, monitoring of haematological and biochemical indices, disposal of sharps and adverse effects. An in-house method of costing antibiotic therapy is presented, to quantify these hidden expenses.

Lower prevalence of anti-hepatitis C antibody in dialysis and renal transplant patients in Ireland.

It is well recognised that haemodialysis and renal transplant patients are at increased risk of developing non-A, non-B hepatitis. Recently the genome of hepatitis C virus (HCV), the major causative agent for non-A, non-B hepatitis, has been isolated. Anti-HCV seroprevalence was assessed in all haemodialysis patients (266) in Ireland who in March 1990 had been dialysed for at least 6 months.

Interaction and dose equivalence of salbutamol and salmeterol in patients with asthma.

Objective: To examine the pharmacological interaction of salmeterol and salbutamol and to derive an estimate of dose equivalence of salmeterol for airway and systemic effects in patients with asthma.

Design: Randomised double blind crossover study.

Subjects: 12 patients with mild asthma.

Cytomegalovirus infection as a complication of OKT3 therapy in kidney transplant recipients.

We compared the incidence of clinical CMV illness in 25 renal transplant recipients treated with OKT3 for steroid resistant cellular rejection with 88 renal transplant patients treated only with conventional immunosuppression (cyclosporin A and steroids). Nine (36%) patients in the OKT3 group developed CMV illness compared to (2.3%) amongst those treated conventionally (p < 0.

Susceptibility of urinary pathogens in a Dublin teaching hospital.

The range and resistance patterns of organisms causing urinary tract infections (UTI) vary with time and place. A prospective study of midstream urine (MSU) specimens, received over a 3 month period, was therefore undertaken. The antibiotic sensitivities of 528 isolates from 196 domiciliary and 332 hospitalised patients with significant bacteriuria (> 10(5) organisms/ml) were determined using the modified Stokes method.

Use of the polymerase chain reaction to detect Toxoplasma gondii in human blood samples.

Aims: To assess the value of detecting Toxoplasma gondii in human blood samples using the polymerase chain reaction (PCR).

Methods: Blood samples in lithium heparin were examined from 34 patients with suspected toxoplasmosis, and six healthy volunteers with or without the addition of doubling dilutions of toxoplasma tachyzoites. Products of a nested PCR, using oligonucleotide primers of the B1 gene, were analysed by electrophoresis and stained by ethidium bromide.

Technique for calculation of the true costs of antibiotic therapy.

An in-house method for costing antibiotic therapy is presented which quantifies hidden costs including costs arising from intravenous administration, labour, serum antibiotic assay, monitoring of haematological and biochemical indices and disposal of sharp instruments. A study of various hospital procedures relating directly to antibiotic therapy was undertaken in an acute medical ward, which involved determination of staff members performing various procedures, consumables used and time taken. Results of this study facilitated accurate quantification of hidden costs of i.

High-level resistance to gentamicin in Enterococcus faecium.

During a six-month period in a hospital in Ireland, four patients were infected (isolation from blood cultures) and two were colonized (isolation from rectal swabs) with strains of Enterococcus faecium highly resistant to gentamicin. MICs of gentamicin were greater than 1000 mg/L for all six strains, and each possessed a plasmid of approximately 50 MDa. Resistance to gentamicin was transferable by conjugation from two of the six strains, and was associated with transfer of the 50 MDa plasmid.

Post-infectious encephalomyelitis associated with Mycoplasma pneumoniae and Legionella pneumophila infection.

A case of severe acute encephalomyelitis associated with a serological diagnosis of both Mycoplasma pneumoniae and Legionella pneumophila infection is reported. Serological co-positivity between these two pathogens has been reported previously, and has, in general, been attributed to cross-reactivity. This is the first documented case of co-infection using more sensitive and specific serological techniques.

Zoonotic infections in Northern Ireland farmers.

Evidence of past zoonotic infection was investigated serologically in randomly selected Northern Ireland farmers. The percentage of farmers with antibody was: Brucella abortus (0.7), Leptospira interrogans serovars (8.

In vitro antimicrobial activity of imipenem in combination with vancomycin or teicoplanin against Staphylococcus aureus and Staphylococcus epidermidis.

The interaction between imipenem and two glycopeptides against staphylococci was examined for potential synergy. Imipenem in combination with vancomycin or teicoplanin exerted a synergistic or additive effect against a majority of Staphylococcus aureus and Staphylococcus epidermidis isolates tested by the checkerboard method. Synergistic inhibitory effects were frequently accompanied by synergistic bactericidal effects.

Evaluation of two rapid methods for identifying and biotyping Haemophilus influenzae.

Several rapid method kits (one to four hours) have become available for the identification of Haemophilus and related genera. Two kits (the "Rapid NH" system and the "RIM Haemophilus" system), which include the identification and biotyping of H influenzae, were investigated for the rapid identification and biotyping of 193 isolates of H influenzae and the results compared with those obtained by more standard overnight methods. The kits were convenient to use and gave reliable and rapid speciation of all isolates.

Septicaemia in patients with temporary and permanent endocardial pacemakers.

Twenty-four patients with staphylococcal septicaemia due to permanent (14) and temporary (10) endocardial pacemakers were reviewed. With permanent pacemakers local inflammation was usually present and the onset of septicaemia rapid. If patients were treated with high dose intravenous flucloxacillin combined with removal, recovery was usual.

Comparison of identification of Enterobacteriaceae by API 20E and Sensititre Autoidentification System.

Of 251 isolates of the Enterobacteriaceae identified to species level by API 20E, 208 (83%) were similarily identified by the Sensititre Autoidentification System. Both systems shared a common problem in that discrimination between species of the genera Klebsiella, Enterobacter, and Serratia was poor. The eight digit biocode generated by the Sensititre system for individual isolates is not reproducible and therefore not of epidemiological value.

Gentamicin-resistant enterococci and endocarditis.

We report a case of endocarditis associated with a highly gentamicin-resistant enterococcus that failed to respond to conventional antibiotic combination therapy. Clinical resolution was achieved following cardiac surgery and antimicrobial treatment dictated by in vitro testing of the patient's organism. Laboratories should test blood culture isolates of enterococci for high level gentamicin resistance.