140 results on '"Montgomerie JZ"'
Search Results
2. Treatment of enterococcal pyelonephritis with trovafloxacin and rifampin: in vitro-in vivo contrast.
- Author
-
Montgomerie JZ and Schick DG
- Subjects
- Animals, Drug Interactions, Drug Therapy, Combination blood, Drug Therapy, Combination urine, Female, Gram-Positive Bacterial Infections blood, Naphthyridines blood, Naphthyridines urine, Pyelonephritis blood, Rats, Rats, Sprague-Dawley, Rifampin blood, Rifampin urine, Anti-Bacterial Agents, Anti-Infective Agents, Drug Therapy, Combination therapeutic use, Enterococcus faecalis drug effects, Fluoroquinolones, Gram-Positive Bacterial Infections drug therapy, Naphthyridines therapeutic use, Pyelonephritis drug therapy, Rifampin therapeutic use
- Abstract
The in vitro bactericidal interaction of trovafloxacin and rifampin against Enterococcus spp. has indicated that antagonism occurs between these two antimicrobial agents. This drug combination was examined in vivo in rats with experimental pyelonephritis. The rats received trovafloxacin, rifampin, or both drugs. On the basis of the mean log10 CFU of Enterococcus faecalis from the kidneys, there was no evidence that trovafloxacin and rifampin were antagonistic in vivo. more...
- Published
- 1998
- Full Text
- View/download PDF
Catalog
3. The 28K protein in urinary bladder, squamous metaplasia and urine is triosephosphate isomerase.
- Author
-
Montgomerie JZ, Gracy RW, Holshuh HJ, Keyser AJ, Bennett CJ, and Schick DG
- Subjects
- Carcinoma, Squamous Cell pathology, Carcinoma, Squamous Cell urine, Catalysis, Cell Line, Female, Humans, Male, Triose-Phosphate Isomerase urine, Urinary Bladder Diseases pathology, Urinary Bladder Diseases urine, Urinary Bladder Neoplasms pathology, Urinary Bladder Neoplasms urine, Carcinoma, Squamous Cell enzymology, Triose-Phosphate Isomerase isolation & purification, Urinary Bladder Diseases enzymology, Urinary Bladder Neoplasms enzymology
- Abstract
Objectives: The objective of this study was to establish the identity of a protein found in high concentrations in squamous metaplasia of the bladder., Design and Methods: The protein was isolated and subjected to a series of physical, chemical, and catalytic studies., Results: In the normal urothelium the protein was confined to a juxtanuclear pattern on the luminal side of the umbrella cells; in squamous metaplasia and squamous cell carcinoma the protein was increased and exhibited a more diffuse intracellular distribution. The protein was found to be identical to triosephosphate isomerase (EC 5.3.1.1; TPI) with respect to its immunological properties, native and subunit molecular weights, electrophoretic mobility, catalytic activity, and amino acid sequence., Conclusions: While the basis for the altered distribution of TPI remains to be established, the increased amounts of the protein in urine or bladder tissue may be indicative of squamous metaplasia, squamous cell carcinoma, or other bladder injuries. more...
- Published
- 1997
- Full Text
- View/download PDF
4. In vitro activity of the combination of trovafloxacin and other antibiotics against enterococci.
- Author
-
Schick DG, Canawati HN, and Montgomerie JZ
- Subjects
- Ampicillin pharmacology, Ampicillin Resistance, Antibiotics, Antitubercular pharmacology, Dose-Response Relationship, Drug, Drug Resistance, Microbial, Drug Synergism, Drug Therapy, Combination pharmacology, Gentamicins pharmacology, Humans, Microbial Sensitivity Tests, Novobiocin pharmacology, Rifampin pharmacology, Sulbactam pharmacology, Teicoplanin pharmacology, Vancomycin pharmacology, Anti-Bacterial Agents pharmacology, Anti-Infective Agents pharmacology, Ciprofloxacin pharmacology, Enterococcus drug effects, Enterococcus faecalis drug effects, Fluoroquinolones, Naphthyridines pharmacology
- Abstract
The activities of trovafloxacin and ciprofloxacin against 38 strains of non-beta-lactamase-producing enterococci, resistant to ampicillin, 34 strains susceptible to ampicillin, and 3 vancomycin-resistant enterococci were studied. Trovafloxacin was more active than ciprofloxacin against all the enterococci studied. The ampicillin-resistant strains were more susceptible than the ampicillin-susceptible strains to both agents. The effect of combining trovafloxacin with gentamicin, ampicillin-sulbactam, novobiocin, rifampin, teicoplanin, and vancomycin was determined for 17 strains by the checkerboard method. An additive effect by inhibition was seen with all antibiotics studied. The results by killing varied with the different agents studied. Gentamicin, ampicillin-sulbactam, and novobiocin produced an additive killing effect with trovafloxacin. Reduced killing was seen when rifampin, vancomycin, or teicoplanin were added to trovafloxacin. more...
- Published
- 1997
- Full Text
- View/download PDF
5. Infections in patients with spinal cord injuries.
- Author
-
Montgomerie JZ
- Subjects
- Bacteremia microbiology, Fever etiology, Humans, Methicillin Resistance, Pneumonia, Bacterial microbiology, Pressure Ulcer microbiology, Staphylococcal Infections etiology, Urinary Tract Infections microbiology, Bacterial Infections microbiology, Cross Infection microbiology, Spinal Cord Injuries complications, Staphylococcus aureus isolation & purification
- Published
- 1997
- Full Text
- View/download PDF
6. Ciprofloxacin-resistant Escherichia coli emerging in a rehabilitation medical center.
- Author
-
Canawati HN, el-Farra R, Seymour J, Shimashita J, Dunn D, and Montgomerie JZ
- Subjects
- Bacteriuria drug therapy, Bacteriuria epidemiology, Bacteriuria microbiology, DNA Gyrase, DNA Topoisomerases, Type II genetics, Drug Resistance, Microbial, Escherichia coli enzymology, Escherichia coli genetics, Escherichia coli Infections epidemiology, Genes, Bacterial, Humans, Los Angeles epidemiology, Microbial Sensitivity Tests, Mutation, Rehabilitation Centers, Retrospective Studies, Time Factors, Anti-Infective Agents pharmacology, Ciprofloxacin pharmacology, Escherichia coli drug effects, Escherichia coli Infections drug therapy, Escherichia coli Infections microbiology
- Abstract
A retrospective review of laboratory records from 1988 to 1996 has shown an increased rate of ciprofloxacin-resistant (cip(r)) Escherichia coli in our rehabilitation center. Resistance increased from 0.6% in 1989 to 5.9% in 1996. Of 7870 E. coli strains isolated during this period, 257 cip(r)-E. coli were recovered from 257 patients. The majority (96%) of these resistant strains were isolated from the urine samples. One hundred and twenty strains of cip(r)-E. coli were also resistant to four other fluoroquinolones. MICs ranging from 64 to 512 micrograms/mL were observed in 75% of the strains and > or = 1028 micrograms/mL in 6.4% of the strains. Resistance to ciprofloxacin was due to possible mutations in topoisomerase gyrA. more...
- Published
- 1997
- Full Text
- View/download PDF
7. Urethral cultures in female patients with a spinal cord injury.
- Author
-
Montgomerie JZ, McCary A, Bennett CJ, Young M, Matias B, Diaz F, Adkins R, and Anderson J
- Subjects
- Adult, Anti-Bacterial Agents therapeutic use, Bacteriuria drug therapy, Enterococcus isolation & purification, Female, Gram-Negative Aerobic Bacteria isolation & purification, Humans, Spinal Cord Injuries urine, Urinary Catheterization, Bacteriuria microbiology, Spinal Cord Injuries microbiology, Urethra microbiology
- Abstract
Quantitative cultures of the urethral meatus were obtained from women with SCI undergoing intermittent catheterization. When compared with the urethral cultures of a group of female subjects, women with SCI had a greater number of isolates of Klebsiella pneumonia and Pseudomonas aeruginosa in the urethral flora. However there was not a significantly greater number of isolates or log numbers of E. coli or Enterococcus sp. in the urethral flora. The E. coli and Enterococcus sp. isolated from the urine were not isolated from the urethra of female patients with SCI in one third of the patients. This poor correlation between the simultaneous urethral and urine cultures of female subjects with SCI may reflect colonization of the urine with organisms that were unable to adhere to the mucosa and colonize the urethra. To what extent these organisms colonize or are temporary residents may be important in the pathogenicity of the infection. more...
- Published
- 1997
- Full Text
- View/download PDF
8. Wound infections following spinal fusion with posterior segmental spinal instrumentation.
- Author
-
Perry JW, Montgomerie JZ, Swank S, Gilmore DS, and Maeder K
- Subjects
- Adolescent, Adult, Anti-Bacterial Agents therapeutic use, Child, Child, Preschool, Female, Follow-Up Studies, Humans, Male, Retrospective Studies, Spinal Fusion adverse effects, Surgical Wound Infection etiology, Surgical Wound Infection microbiology, Surgical Wound Infection therapy
- Abstract
Twenty-three of 238 patients (9.7%) developed wound infections following segmental spinal instrumentation. When the infected group and a matched control group were compared, the infected group had a significantly higher number of patients with cerebral palsy and myelodysplasia (nonambulatory), patients with wound hematomas, patients with fusions that extended into the sacral region, and patients who were incontinent of urine. A high incidence of infections with gram-negative aerobic bacilli correlated with the extension of the surgery into the sacral region and bowel and/or bladder incontinence. Prophylactic antibiotics with broader coverage for gram-negative bacilli may be warranted for these procedures. Postoperative wound infections were managed by surgical drainage and debridement as well as antibiotics. Removal of the hardware was not necessary to control the infection in these patients who underwent segmental spinal instrumentation. more...
- Published
- 1997
- Full Text
- View/download PDF
9. Treatment of urinary tract infections in persons with spinal cord injury: a review.
- Author
-
Montgomerie JZ
- Abstract
Despite improvements in the techniques to drain the urinary bladder in patients with spinal cord injury (SCI), urinary tract infection (UTI) remains one of the most common complications of SCI. Despite many studies of the management of UTIs, differences of opinion remain. This has resulted from the use of different definitions of UTI, including the definitions of "significant" bacteriuria, "asymptomatic" bacteriuria, the inclusion (or exclusion) of "soft" symptoms, evidence of few complications from the infection and other risks of infection. The need to treat patients with high fever who may have bacteremia and patients with symptoms is clear. Broad coverage may be necessary until the results of culture are available because of the frequent presence of resistant bacteria colonizing the perineum or bowel. Eradication of bacteriuria is not a reasonable goal in many patients with indwelling catheters. The treatment of patients with asymptomatic bacteriuria (those patients without symptoms or pyuria) remains controversial. Asymptomatic bacteriuria is often treated in recently injured inpatients and those that have their first infection and is not treated in persons in whom asymptomatic bacteriuria is detected more than one year following the injury. Selection of the antibiotics depends on the symptoms of UTI, but at the risk of developing colonization of the urinary tract, perineum, or bowel with resistant gram-negative bacilli. more...
- Published
- 1994
- Full Text
- View/download PDF
10. Methicillin-resistant Staphylococcus aureus (MRSA) colonization in patients with spinal cord injury.
- Author
-
Maeder K, Ginunas VJ, Montgomerie JZ, and Canawati HN
- Subjects
- Anti-Bacterial Agents therapeutic use, Colony Count, Microbial, Disease Outbreaks, Drug Combinations, Humans, Los Angeles, Rehabilitation Centers, Staphylococcal Infections drug therapy, Staphylococcal Infections epidemiology, Methicillin Resistance, Spinal Cord Injuries complications, Staphylococcal Infections complications, Staphylococcus aureus physiology
- Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) colonization has been a problem in the Rancho Los Amigos Medical Center (RLAMC) since 1978. This study reviews the latest 2 years' use of a protocol to prevent the spread of MRSA while allowing spinal cord injured patients to continue to participate in the rehabilitation program. The protocol included management in a private room, bathing with hexachlorophene, monitoring positive sites and clearing patients after 3 weeks of negative cultures. Clusters of cases were investigated by obtaining nasal cultures from the personnel. Sixty-seven of 584 (11%) SCI patients were colonized from July 1989 to July 1991. The prevalence of MRSA colonization was significantly greater in the pressure ulcer management service (PMS) 49/184 (27%) than in the rehabilitation spinal injury service (SIS) 18/400 (5%). The body sites colonized were wounds (58/67), nares (37/67), throat (30/67), urine (27/67) and perineum (17/67). Oral therapy with combinations of sulfamethoxazole trimethoprim (SXT) or Novobiocin with rifampin together with topical antibiotics (nares and wound sites), used in nine patients with healing wounds or recent flap surgery, resulted in clearing of the colonization in all cases. Identification and treatment of carriers in the personnel and use of preadmission screening cultures for MRSA in patients with pressure ulcers resulted in reduced inpatient admission. more...
- Published
- 1993
- Full Text
- View/download PDF
11. Hematogenous endophthalmitis due to Candida tropicalis: report of two cases and review.
- Author
-
Cohen M and Montgomerie JZ
- Subjects
- Adult, Amphotericin B therapeutic use, Blood microbiology, Candida isolation & purification, Drug Therapy, Combination, Endophthalmitis drug therapy, Eye Infections, Fungal drug therapy, Female, Flucytosine therapeutic use, Humans, Male, Middle Aged, Candidiasis drug therapy, Candidiasis microbiology, Endophthalmitis microbiology, Eye Infections, Fungal microbiology
- Abstract
Candida tropicalis is a well-documented pathogen affecting humans. There is limited clinical and experimental evidence that C. tropicalis causes hematogenous endophthalmitis. We report two cases of C. tropicalis endophthalmitis and review 12 cases reported in the literature. Clinical presentation was similar to that described for Candida albicans endophthalmitis. Therapy with amphotericin B, with or without flucytosine, resulted in resolution of the lesions except in one patient, for whom enucleation of the eye was necessary to control the infection. None of the patients were leukopenic. more...
- Published
- 1993
- Full Text
- View/download PDF
12. Randomized double-blinded trial of rifampin with either novobiocin or trimethoprim-sulfamethoxazole against methicillin-resistant Staphylococcus aureus colonization: prevention of antimicrobial resistance and effect of host factors on outcome.
- Author
-
Walsh TJ, Standiford HC, Reboli AC, John JF, Mulligan ME, Ribner BS, Montgomerie JZ, Goetz MB, Mayhall CG, and Rimland D
- Subjects
- Adolescent, Adult, Aged, DNA, Neoplasm analysis, Double-Blind Method, Drug Therapy, Combination adverse effects, Female, Humans, Male, Middle Aged, Nasal Cavity microbiology, Novobiocin adverse effects, Novobiocin therapeutic use, Outcome Assessment, Health Care, Rifampin therapeutic use, Trimethoprim, Sulfamethoxazole Drug Combination adverse effects, Trimethoprim, Sulfamethoxazole Drug Combination therapeutic use, Drug Therapy, Combination therapeutic use, Methicillin Resistance, Staphylococcal Infections drug therapy, Staphylococcus aureus, Wound Infection drug therapy
- Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) is a major pathogen in hospitals. Current antimicrobial regimens for eradicating colonizing strains are not well defined and are often complicated by the emergence of resistance. The combination of novobiocin plus rifampin in vitro and in vivo was found to prevent the emergence of resistant populations of initially susceptible strains of MRSA, particularly resistance to rifampin. We therefore studied, in a randomized, double-blind, multicenter comparative trial, the combination of novobiocin plus rifampin versus trimethoprim-sulfamethoxazole (T/S) plus rifampin in order to determine the efficacy of each regimen in eradicating MRSA colonization and to further characterize the host factors involved in the response to this antimicrobial therapy. Among the 126 individuals enrolled in the study, 94 (80 patients; 14 hospital personnel) were evaluable. Among the 94 evaluable subjects, no significant demographic or medical differences existed between the two treatment groups. Successful clearance of the colonizing MRSA strains was achieved in 30 of 45 (67%) subjects receiving novobiocin plus rifampin, whereas successful clearance was achieved in 26 of 49 (53%) subjects treated with T/S plus rifampin (P = 0.18). The emergence of resistance to rifampin developed more frequently in 14% (7 of 49) of subjects treated with T/S plus rifampin than in 2% (1 of 45) of subjects treated with novobiocin plus rifampin (P = 0.04). Restriction endonuclease studies of large plasmid DNA demonstrated that the same strain was present at pretherapy and posttherapy in most refractory cases (24 of 29 [83%] subjects). Among the 56 successfully treated subjects, clearance of MRSA was age dependent: 29 of 36 (80%) subjects in the 18- to 49-year-old age group, 19 of 35 (54%) subjects in the 50- to 69-year-old age group, and 8 of 23 (35%) in the 70- to 94-year-old age group (P < 0.01). Clearance was also site dependent; culture-positive samples from wounds were related to a successful outcome in only 22 (48%) of 46 subjects, whereas culture-positive samples from sites other than wounds (e.g., nares, rectum, and sputum) were associated with a success rate of 34 of 48 (71%) subjects (P = 0.02). Foreign bodies in wounds did not prevent the eradication of MRSA by either regimen. T/S plus rifampin was less effective in clearing both pressure and other wounds, whereas novobiocin plus rifampin was equally effective in clearing both pressure and other wounds. There were no significant differences in toxicity between the two regimens. Thus, the combination of novobiocin plus rifampin, in comparison with T/S plus rifampin, was more effective in preventing the emergence of resistance to rifampin and demonstrated a trend toward greater activity in clearing the MRSA carrier state. The response to either combination depended on host factors, particularly age and the site of MRSA colonization. more...
- Published
- 1993
- Full Text
- View/download PDF
13. 28 K in squamous metaplasia of the bladder in patients with spinal cord injury.
- Author
-
Montgomerie JZ, Holshuh HJ, Keyser AJ, Bennett CJ, and Schick DG
- Subjects
- Adult, Aged, Epithelium metabolism, Epithelium pathology, Female, Glycoproteins immunology, Histocytochemistry, Humans, Male, Metaplasia metabolism, Metaplasia pathology, Middle Aged, Spinal Cord Injuries metabolism, Urinary Bladder metabolism, Urinary Catheterization, Glycoproteins metabolism, Spinal Cord Injuries pathology, Urinary Bladder pathology
- Abstract
Antibody to 28 K was used to examine sections of bladder biopsies obtained by cystoscopy from 14 patients with spinal cord injury (SCI). Most of the biopsies were obtained from patients with indwelling catheters during the investigation for possible malignancy. Sections of bladder were stained by the streptavidin procedure. The 28 K in the normal transitional epithelium of the bladder was in the superficial cells (umbrella cells). All the biopsies from patients with indwelling urethral catheters showed areas of squamous metaplasia usually associated with evidence of chronic inflammation. Cystitis cystica glandularis was also seen in one patient. Staining was most marked in the areas of squamous metaplasia with intracellular granular staining. The basal layers were not well stained. With marked squamous metaplasia, there was a superficial hyperkeratotic layer that stained variably and often did not stain at all. Staining was less marked in areas of hyperplasia, regenerating urothelium, and cystitis cystica glandularis. These findings raise the possibility that the presence of 28 K glycoprotein in the tissues or released into the urine may be used as an indicator of squamous metaplasia and chronic inflammation of the bladder. more...
- Published
- 1993
- Full Text
- View/download PDF
14. Increased frequency of large R-plasmids in Klebsiella pneumoniae colonizing patients with spinal cord injury.
- Author
-
Montgomerie JZ, John JF, Atkins LM, Gilmore DS, and Ashley MA
- Subjects
- Conjugation, Genetic, DNA Restriction Enzymes, Drug Resistance, Microbial genetics, Humans, Klebsiella pneumoniae classification, Klebsiella pneumoniae isolation & purification, R Factors genetics, Time Factors, Gentamicins, Klebsiella pneumoniae genetics, R Factors analysis, Spinal Cord Injuries microbiology
- Abstract
From 1978 to 1988 strains of gentamicin-susceptible (Gms) and gentamicin-resistant (Gmr) Klebsiella pneumoniae were saved from annual surveillance cultures of the perineal region of patients with spinal cord injury (SCI). Of 38 strains selected for further study (24 Gms and 14 Gmr), there were 23 different serotypes (two nontypable). Fourteen Gms as well as 14 Gmr strains displayed no common plasmid patterns, but all contained a large plasmid of 168-208 kb. Among the 14 Gmr strains, nine had large conjugative plasmids of approximately the same size (166-193 kb), which conferred to a susceptible Escherichia coli host an identical resistance pattern: ampicillin, chloramphenicol, gentamicin, piperacillin, trimethoprim-sulfamethoxazole, tetracycline, and tobramycin. Of the nine transconjugants, eight contained a single plasmid. One transconjugant contained a 168- and 80-kb plasmid. Restriction endonuclease digestion patterns of the R-plasmids revealed minimal similarity. We conclude that, during a 10-year period, different large R-plasmids have spread among multiple serotypes of K. pneumoniae in spinal cord injury (SCI) patients in one rehabilitation hospital. We hypothesize that other genes located on large, R-, and non-R-plasmids may confer an additional advantage for colonization by K. pneumoniae in SCI patients. more...
- Published
- 1993
- Full Text
- View/download PDF
15. Nonmucinous nature of the surface material of the bladder mucosa.
- Author
-
Keyser AJ, Montgomerie JZ, and Howard EB
- Subjects
- Animals, Cytoplasmic Granules ultrastructure, Epithelial Cells, Humans, Male, Mice, Mucous Membrane cytology, Rabbits, Rats, Rats, Wistar, Staining and Labeling, Urinary Bladder cytology
- Abstract
The urinary bladder is lined by transitional epithelium, also known as urothelium. Some investigators have described a material known as mucin, which lines the luminal surface of the urothelium, but its nature is not well understood. The authors examined sections of bladder from rat, mouse, rabbit, and man and found that, although they reacted differently to common histochemical stains for complex carbohydrates, none showed any material that stained as mucin on the surface of the mucosa. Rather, intracellular granules that have varying staining characteristics in different animals were found on the luminal side of the urothelium. The authors speculate, based on their histochemical findings, that some form of mucin may be present in the urothelial granules in man and that studies on animals may not be applicable to man. more...
- Published
- 1992
- Full Text
- View/download PDF
16. Postoperative wound infections following myocutaneous flap surgery in spinal injury patients.
- Author
-
Garg M, Rubayi S, and Montgomerie JZ
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Anti-Bacterial Agents therapeutic use, Female, Humans, Male, Middle Aged, Premedication, Pressure Ulcer pathology, Spinal Cord Injuries complications, Surgical Wound Infection microbiology, Surgical Wound Infection prevention & control, Spinal Cord Injuries surgery, Surgical Flaps, Surgical Wound Infection pathology
- Abstract
Severe pressure ulcers in patients with spinal cord injury are frequently treated by using musculocutaneous (m-c) flap surgery. There have been few studies of the use of perioperative antibiotics to prevent postoperative infection in this setting. We reviewed 74 m-c flap surgeries in 53 patients (41 male and 12 female) from October 1989 for one year. The sites involved were ischial (31), sacral (24), trochanteric (18), deltoid (2), olecranon (1) and posterior thigh (1). An antibiotic was usually administered perioperatively for 5 days. Patients were followed for a median of 30 (8-96) weeks. Postoperative infections occurred at a median of 12 (4-25) days in 6 of 74 (8%) surgeries. The organisms cultured from the 6 infected wounds were: Bacteroides sp. (4), Proteus mirabilis (2), E. coli (2), MRSA (2), and others (6--each isolated once). These results indicate that antibiotics did not prevent postoperative infection in approximately 8% of patients undergoing m-c surgery. The frequency of isolation of Bacteroides sp. from these infections suggests that anaerobic bacteria may persist in healing pressure ulcers and perioperative antibiotics might include coverage for anaerobic bacteria. more...
- Published
- 1992
- Full Text
- View/download PDF
17. Effect of external urinary collection system on colonization and urinary tract infections with Pseudomonas and Klebsiella in men with spinal cord injury.
- Author
-
Gilmore DS, Schick DG, Young MN, and Montgomerie JZ
- Subjects
- Contraceptive Devices, Male adverse effects, Drainage instrumentation, Humans, Klebsiella Infections microbiology, Male, Pseudomonas Infections microbiology, Quadriplegia etiology, Spinal Cord Injuries complications, Urinary Tract Infections complications, Colony Count, Microbial, Klebsiella Infections etiology, Pseudomonas Infections etiology, Spinal Cord Injuries therapy, Urinary Catheterization adverse effects, Urinary Tract Infections etiology
- Abstract
Urinary tract infection of men with spinal cord injuries has been associated with a high incidence of colonization of the patients with gram-negative bacilli. We have examined the factors influencing colonization of 119 patients with Pseudomonas and Klebsiella and studied methods of reducing this colonization. The urethra, perineum, rectum, and drainage bag of all patients were cultured on selective media at two week intervals until discharge. The use of the external urinary collection system (EUCS) was discontinued in a group of patients at night, in an attempt to reduce colonization. Pseudomonas and Klebsiella were isolated from one or more body sites in 65 percent and 69 percent of total culture days. The urethra, perineum, rectum, and drainage bags were reservoirs of Pseudomonas and Klebsiella in men with spinal cord injuries, even in the absence of urinary tract infections. The EUCS proved to be an important factor influencing colonization. Pseudomonas and Klebsiella colonization was higher in patients using the EUCS. Removal of the EUCS at night reduced urethral colonization with Pseudomonas, but did not significantly reduce urethral colonization with Klebsiella. The prevalence of bacteriuria with Pseudomonas and Klebsiella was not significantly influenced by the use of the EUCS. more...
- Published
- 1992
- Full Text
- View/download PDF
18. 28K antigen in the urothelium.
- Author
-
Montgomerie JZ, Keyser AJ, Holshuh HJ, and Schick DG
- Subjects
- Epithelium chemistry, Humans, Antigens analysis, Carcinoma, Squamous Cell chemistry, Urinary Bladder chemistry, Urinary Bladder Neoplasms chemistry
- Abstract
We have been investigating the nature of the mucosal lining of human urinary bladder. Surface material was obtained from bladders at autopsy and used for biochemical analysis. Western immunoblotting and tissue immunochemistry identified a molecule of Mr 28,000 (28K) which is present within surface cells of the urothelium (umbrella cells). Antiserum to 28K stained sections of the bladder of two patients with squamous cell carcinoma of the bladder and other patients with squamous metaplasia. We consider 28K to be a component of the normal human bladder surface that is increased in patients with squamous metaplasia and may also be present in squamous cell carcinoma of the bladder. more...
- Published
- 1992
- Full Text
- View/download PDF
19. Septic ischial bursitis in patients with spinal cord injury.
- Author
-
Rubayi S and Montgomerie JZ
- Subjects
- Adolescent, Adult, Bursitis microbiology, Female, Humans, Ischium, Male, Meningomyelocele complications, Paraplegia complications, Bursitis etiology, Spinal Cord Injuries complications, Staphylococcal Infections etiology, Staphylococcus epidermidis isolation & purification, Streptococcal Infections etiology
- Abstract
Septic ischial bursitis is described in 4 patients with spinal cord injury. In these patients a pre-existing ischial bursitis probably became secondarily infected. Because these patients lack sensation, diagnosis may be difficult. The disease process in one patient with a prolonged fever was only recognized after a leucocyte scan detected an abscess extending to the thigh. At surgery it was found that the infection extended from the ischial bursa to the upper lateral thigh. Infection in these patients was due to beta hemolytic streptococcus, S. aureus, and S. epidermidis. The patients all responded well to local drainage and excision of the bursa. more...
- Published
- 1992
- Full Text
- View/download PDF
20. Low mortality among patients with spinal cord injury and bacteremia.
- Author
-
Montgomerie JZ, Chan E, Gilmore DS, Canawati HN, and Sapico FL
- Subjects
- Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Bacteremia etiology, Female, Humans, Male, Middle Aged, Retrospective Studies, Risk Factors, Bacteremia mortality, Pneumonia complications, Pressure Ulcer complications, Spinal Cord Injuries complications, Urinary Tract Infections complications
- Abstract
We reviewed 103 episodes of bacteremia in 93 patients with spinal cord injury who had bacteremia during initial hospitalization (39 patients) or readmission (54 patients) during 1978-1988. Eighteen episodes (18%) were due to polymicrobial infections. Urinary tract infections (47%), infected pressure areas (19%), and pneumonia (9%) were the most frequent primary infections and sources of the bacteremia. The bacteria most frequently associated with urinary tract infections were enterococci (26%), Escherichia coli (26%), Pseudomonas species (20%), and Klebsiella pneumoniae (12%). Bacteria most frequently isolated from patients with infected pressure areas were anaerobes and Staphylococcus aureus. Bacteremia was the cause of death for 8 patients (9%). The urinary tract was identified only once as the source of gram-negative bacteremia in an immunocompetent patient who died. The reason for the low mortality in patients with spinal cord injury is unclear. more...
- Published
- 1991
- Full Text
- View/download PDF
21. Cefpirome, alone and in combination with gentamicin for enterococcal pyelonephritis in the rodent model.
- Author
-
Sapico FL, Ginunas VJ, Montgomerie JZ, and Canawati HN
- Subjects
- Ampicillin pharmacology, Animals, Cephalosporins pharmacology, Disease Models, Animal, Drug Therapy, Combination therapeutic use, Gentamicins pharmacology, Male, Pyelonephritis microbiology, Random Allocation, Rats, Vancomycin pharmacology, Cefpirome, Cephalosporins therapeutic use, Enterococcus faecalis drug effects, Gentamicins therapeutic use, Pyelonephritis drug therapy, Streptococcal Infections drug therapy
- Abstract
The in vitro and in vivo activity of cefpirome (CF) against Enterococcus faecalis GK strain was examined. The ratio of minimal inhibitory to bactericidal concentration (MIC/MBC) values in microgram/ml were (a) ampicillin 0.8/1.5; (b) gentamicin 2/25; (c) vancomycin, 0.8/50; and (d) CF, 8/32. A time-kill study using 10(7) organisms per milliliter showed a drop of 3 logs10 at 4 hr in the tube containing cefpirome (10 micrograms/ml) as well as the tube containing cefpirome (5 micrograms/ml) plus gentamicin (GM) (2 micrograms/ml), as compared to the control and the tube containing GM at 4 micrograms/ml. At 8 and 24 hr, however, regrowth to control levels occurred. Of this enterococcal strain consisting of 10(8) organisms, 1 ml was then injected intravenously by tail vein into 150 male Wistar rats weighing 120 g each. Eleven days after injection, 10 rats were killed and the remaining ones were randomized into four treatment groups: (a) untreated control; (b) BM, 0.9 mg; (c) CF, 10 mg; and (d) CF + GM. The rats received the injections intramuscularly twice daily. At least 10 rats from each group were killed for quantitative kidney cultures at 1, 2, and 4 weeks after start of therapy. At the end of 4 weeks of therapy, the results were significantly better in the combination group compared to the other three groups. more...
- Published
- 1991
- Full Text
- View/download PDF
22. Vertebral osteomyelitis.
- Author
-
Sapico FL and Montgomerie JZ
- Subjects
- Diagnosis, Differential, Humans, Osteomyelitis diagnosis, Osteomyelitis therapy, Prognosis, Spinal Diseases diagnosis, Spinal Diseases therapy, Osteomyelitis etiology, Spinal Diseases etiology
- Abstract
Vertebral osteomyelitis can be caused by a variety of microorganisms. The hematogenous pyogenic form is characteristically a disease of people over age 50, predominantly in the male population, and most frequently caused by S. aureus. In IVDAs, however, younger patients and a heavier predominance of males are seen, and P. aeruginosa is one of the most commonly seen pathogens. The disease is generally monomicrobial, unless it is secondary to a contiguous process such as a pressure sore, in which polymicrobial infection with participation of anaerobes is the general rule. Lumbar, greater than thoracic, greater than cervical involvement is the rule in the general population, but cervical spine involvement is frequently seen more often than thoracic involvement in IVDAs. Diabetic patients are over-represented among patients with vertebral osteomyelitis, and they also have a tendency for higher morbidity and mortality. Simultaneous involvement of adjacent vertebral end plates and the intervening disk is the general rule. The vertebrae are generally involved, and the posterior elements of the spine are involved infrequently. Posterior element involvement is seen more commonly in actinomycosis, coccidioidomycosis, and neoplasms. Newer diagnostic modalities, such as CT, MRI, and radionuclide scans, may detect the disease earlier than conventional radiographs. Immunobilization by bed rest and appropriate antimicrobial therapy are generally sufficient in the therapy of pyogenic, as well as tuberculous, vertebral osteomyelitis. In selected circumstances, such as in the presence of marked instability of the spine, the presence of new neurologic deficits, or with progression of previous neurologic deficits, surgical intervention may be necessary. With prompt diagnosis and proper management, the prognosis should generally be good. more...
- Published
- 1990
23. Ceftazidime in treatment of urinary tract infection in patients with spinal cord injury: comparison with moxalactam.
- Author
-
Montgomerie JZ, Gilmore DS, Canawati HN, and Morrow JW
- Subjects
- Adult, Humans, Male, Prospective Studies, Randomized Controlled Trials as Topic, Recurrence, Urinary Tract Infections etiology, Ceftazidime therapeutic use, Moxalactam therapeutic use, Spinal Cord Injuries complications, Urinary Tract Infections drug therapy
- Abstract
Ceftazidime was compared with moxalactam in the treatment of urinary tract infections in patients with spinal cord injury. Patients received ceftazidime or moxalactam, 500 mg twice daily for five days. Urine specimens were collected by urethral catheter. Adequate follow-up was obtained in 26 patients treated with ceftazidime and 13 patients treated with moxalactam. The infecting bacteria were not cultured in significant numbers from the urine of any patients after two to four days of antibiotics, except for 1 patient who had Pseudomonas aeruginosa persisting in the urine while receiving ceftazidime. At five to nine days after completing antibiotic therapy, the cure rate was 42 percent for ceftazidime and 15 percent for moxalactam. The rate of reinfection was significantly lower in the ceftazidime group than the moxalactam group. more...
- Published
- 1990
- Full Text
- View/download PDF
24. Specialty conference. Infectious disease emergencies. Part V: patients presenting with localized infections.
- Author
-
Oill PA, Montgomerie JZ, Cryan WS, and Edwards JE
- Subjects
- Animals, Arthritis, Infectious diagnosis, Arthritis, Infectious therapy, Bacterial Infections diagnosis, Bacterial Infections therapy, Cellulitis, Dacryocystitis etiology, Diagnosis, Differential, Eye Diseases etiology, Fascia, Gas Gangrene, Humans, Inflammation, Mucormycosis, Myositis etiology, Pressure Ulcer complications, Staphylococcal Infections, Streptococcal Infections, Emergencies, Infections
- Published
- 1977
25. Effect of antiseptic agents on skin flora of the perineum of men with spinal cord injury.
- Author
-
Gilmore DS, Montgomerie JZ, Graham IE, Schick DG, and Jimenez EM
- Subjects
- Adolescent, Adult, Carbanilides pharmacology, Chlorhexidine pharmacology, Humans, Hydrogen-Ion Concentration, Klebsiella pneumoniae drug effects, Klebsiella pneumoniae isolation & purification, Male, Middle Aged, Penis microbiology, Povidone-Iodine pharmacology, Pseudomonas aeruginosa drug effects, Pseudomonas aeruginosa isolation & purification, Random Allocation, Soaps pharmacology, Anti-Infective Agents, Local pharmacology, Perineum microbiology, Spinal Cord Injuries microbiology
- Abstract
Male patients with spinal cord injury are frequently colonized with P. aeruginosa and K. pneumoniae on the perineum. Regular bathing with bar soap has not influenced this colonization. We have attempted to remove these bacteria using antiseptic agents. The number of P. aeruginosa, K. pneumoniae and total aerobic bacteria on the perineum and the penile shaft was determined before and after cleaning with bar soap, chlorhexidine, povidone-iodine and pHresh. Povidone-iodine and chlorhexidine had no advantage over bar soap or pHresh in the removal of P. aeruginosa or K. pneumoniae from the perineum of patients with spinal cord injury. more...
- Published
- 1984
- Full Text
- View/download PDF
26. Methicillin-resistant Staphylococcus aureus bacteriuria.
- Author
-
Sapico FL, Montgomerie JZ, Canawati HN, and Aeilts G
- Subjects
- Adult, Aged, Cephalosporins therapeutic use, Female, Humans, Male, Middle Aged, Penicillin Resistance, Staphylococcal Infections urine, Staphylococcus aureus drug effects, Bacteriuria drug therapy, Methicillin antagonists & inhibitors, Staphylococcus aureus isolation & purification
- Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) bacteriuria was detected in 11 of 41 patients colonized or infected with MRSA. The patients with bacteriuria generally were older than 40 years of age, five were diabetic, seven had prior indwelling uretheral catheters, two had undergone other urologic manipulations, and only one was clinically symptomatic. Eight patients received variable combinations of antibiotic therapy prior to the diagnosis of MRSA bacteriuria, and seven were still on antibiotic therapy at the time the bacteriuria was detected. Bacteriuria lasted four days to 14 weeks, and was eradicated promptly with cephalosporin therapy in five six patients. Bacteriuria in the untreated patients cleared spontaneously in one month. A single MRSA serotype (83A) predominated. The MRSA isolates were resistant in vitro to most antibiotics except vancomycin. Resistant colonies were observed within cephalothin disc zones of inhibition at 30C (resistance was confirmed by microtube-dilution sensitivity testing). MRSA disc sensitivity testing for cephalothin may be unreliable when performed at 35C. more...
- Published
- 1981
- Full Text
- View/download PDF
27. Susceptibility of Acinetobacter calcoaceticus var. anitratus (Herellea vaginicola) to minocycline.
- Author
-
Montgomerie JZ, Pickett MJ, Yoshimori RN, Chow AW, and Guze LB
- Subjects
- Enterobacteriaceae drug effects, Escherichia coli drug effects, Klebsiella pneumoniae drug effects, Microbial Sensitivity Tests, Proteus drug effects, Acinetobacter drug effects, Minocycline pharmacology, Tetracyclines pharmacology
- Abstract
The in vitro activity of minocycline against Acinetobacter calcoaceticus var. anitratus (Herellea vaginicola) was examined. All strains of A. anitratus were inhibited by minocycline at concentrations of 0.4 mug/ml or less. The strains studied were considerably more susceptible to minocycline than tetracycline. No difference between the susceptibility to minocycline and tetracycline was seen with Escherichia coli, Klebsiella pneumoniae, Enterobacter and Proteus sp. A regression line of the log minimal inhibitory concentration (MIC) values and the diameter of the zone of inhibition, determined by the Kirby-Bauer technique, showed good linear correlation for minocycline. Comparison of the disk diffusion results and MICs indicated that an inhibitory zone size of 19 mm produced by a 30-mug minocycline disk was equivalent to a MIC of 3.1 mug/ml, a serum concentration achieved by oral administration of the drug. When the zone of inhibition was greater than 19 mm, however, there was poor correlation with the MIC for Enterobacteriaceae. more...
- Published
- 1976
- Full Text
- View/download PDF
28. Factors affecting virulence in Escherichia coli urinary tract infections.
- Author
-
Montgomerie JZ
- Subjects
- Animals, Antigens, Bacterial, Escherichia coli immunology, Escherichia coli pathogenicity, Humans, Mice, Virulence, Escherichia coli Infections, Urinary Tract Infections etiology
- Abstract
The prevalence of E. coli relative to other bacteria in the urinary tract is assumed to be the result of its proximity to and its close relationship with the gastrointestinal tract. Strains on E. coli may establish themselves more readily in the urinary tract, and/or invade the upper urinary tract, if they have a number of different virulence factors. The relative importance of these factors in the development of urinary tract infection, with or without renal involvement, is not clear. In addition, the means by which these factors may increase the virulence of E. coli are not understood, although there seems to be some evidence that the K antigens alter resistance to phagocytosis and serum bactericidal activity %9,10]. The main reason that certain E. coli serotypes are cultured from the urinary tract, however, still seems to be their dominance in the stool. The broader question of why certain O serotypes of E. coli dominate the bowel flora has not been examined adequately. The studies suggesting that the K antigen is a significant virulence factor seem to be in conflict with other studies indicating the dominance of certain serotypes of E. coli in the stool and in urinary tract infections. A resolution of this dilemma may possibly be found in the recent observations of Dr. Frits Orskov [20] and others discussed elsewhere at this meeting that the K and O serotypes appear to be interrelated. more...
- Published
- 1978
- Full Text
- View/download PDF
29. Parenteral clindamycin therapy for severe anaerobic infections.
- Author
-
Chow AW, Montgomerie JZ, and Guze LB
- Subjects
- Abscess drug therapy, Actinomyces isolation & purification, Adult, Anaerobiosis, Bacteroides isolation & purification, Chloramphenicol therapeutic use, Clindamycin administration & dosage, Clindamycin adverse effects, Clindamycin blood, Clindamycin metabolism, Evaluation Studies as Topic, Female, Fusobacterium isolation & purification, Humans, Infusions, Parenteral, Male, Microbial Sensitivity Tests, Peptococcus isolation & purification, Peptostreptococcus isolation & purification, Phosphates, Sepsis drug therapy, Sepsis mortality, Streptococcus isolation & purification, Wound Healing, Bacterial Infections drug therapy, Clindamycin therapeutic use
- Published
- 1974
30. Pyelonephritis. XIX. Immunization against enterococcal pyelonephritis.
- Author
-
Guze LB, Montgomerie JZ, Harwick HJ, and Kalmanson GM
- Subjects
- Animals, Pyelonephritis immunology, Rats, Streptococcal Infections immunology, Enterococcus faecalis immunology, Immunization, Pyelonephritis prevention & control, Streptococcal Infections prevention & control
- Abstract
A study has been done of immunization against Streptococcus faecalis pyelonephritis in the rat. Intravenous, subcutaneous, and bladder immunizations were tested with intravenous and retrograde challenge. Logarithmic and stationary growth phase organisms were used separately for both immunization and challenge. The only instance of significant, but incomplete, protection was in animals immunized subcutaneously or intravenously and challenged intravenously with log phase organisms. No correlation was found between circulating antibody response and infection. Serum bactericidal activity was not increased by immunization or infection. more...
- Published
- 1976
31. Virulence of enterococci in experimental pyelonephritis.
- Author
-
Montgomerie JZ, Kalmanson GM, and Guze LB
- Subjects
- Animals, Disease Models, Animal, Enterococcus faecalis pathogenicity, Rats, Streptococcus pathogenicity, Virulence, Pyelonephritis etiology, Streptococcal Infections complications
- Published
- 1977
- Full Text
- View/download PDF
32. Pseudomonas colonization in patients with spinal cord injury.
- Author
-
Montgomerie JZ and Morrow JW
- Subjects
- Bacteriuria microbiology, Carrier State, Disease Reservoirs, Female, Humans, Male, Perineum microbiology, Pseudomonas Infections microbiology, Pseudomonas aeruginosa isolation & purification, Urethra microbiology, Urinary Catheterization, Urinary Tract Infections etiology, Cross Infection microbiology, Pseudomonas isolation & purification, Spinal Cord Injuries microbiology
- Abstract
Pseudomonas has been an important cause of urinary tract infection in patients with spinal cord injuries. To determine the possible reservoirs of Pseudomonas, colonization with Pseudomonas was studied in 52 inpatients and 28 outpatients with spinal cord injuries. Body sites, the environment, and hospital staff were cultured. There was a high prevalence of colonization of the urethra, perineum, and rectum. Pseudomonas was isolated from one or more of these sites in 85% of male inpatients and in 71% of male outpatients. Significant bacteriuria with Pseudomonas was found in 37% of inpatients and 13% of male outpatients. Urethral colonization in men was significantly associated with the use of the external urethral catheter. Culturing the patient's perineum was a sensitive indicator of patient colonization. The urinary drainage bag was another frequent reservoir of Pseudomonas. More than one-half of these patients did not have significant bacteriuria and presumably the drainage bag was colonized from the urethra or perineum. The rates of urethral, perineal, and rectal carriage were higher than those described previously. These rates may be accounted for by the use of the external urethral catheters. Other factors, such as rectal manipulation, and fecal incontinence may be important in these groups of patients. more...
- Published
- 1978
- Full Text
- View/download PDF
33. Correlation of tissue infection with bacteriuria.
- Author
-
Mulvihill S and Montgomerie JZ
- Subjects
- Animals, Kidney microbiology, Mice, Urinary Bladder microbiology, Bacteriuria microbiology, Pseudomonas Infections microbiology, Pseudomonas aeruginosa growth & development, Urinary Tract Infections microbiology
- Published
- 1982
- Full Text
- View/download PDF
34. Pseudomonas urinary tract infection in mice.
- Author
-
Montgomerie JZ, Tuddenham WJ, Howard EB, and Morrow JW
- Subjects
- Animals, Edema etiology, Female, Hemorrhage etiology, Lymphocytes, Mice, Necrosis, Time Factors, Kidney pathology, Kidney Diseases pathology, Pseudomonas Infections pathology, Urinary Bladder pathology, Urinary Bladder Diseases pathology
- Abstract
When Pseudomonas aeruginosa was injected through a catheter into the bladder. Hemorrhage, edema, and vessel engorgement were seen 1 h after challenge. At 3 hours we observed microulceration of the bladder, which rapidly healed and was rarely present after 24 h. Pseudomonas was cultured from 50% of the kidneys at 1 week, and the number of kidneys infected decreased over 4 weeks. more...
- Published
- 1980
- Full Text
- View/download PDF
35. Spontaneous bacterial peritonitis.
- Author
-
Hoefs JC, Canawati HN, Sapico FL, Hopkins RR, Weiner J, and Montgomerie JZ
- Subjects
- Anti-Bacterial Agents therapeutic use, Ascitic Fluid cytology, Ascitic Fluid microbiology, Autopsy, Bacterial Infections blood, Bacterial Infections drug therapy, Bacterial Infections microbiology, Bacterial Infections mortality, Female, Humans, Leukocyte Count, Male, Middle Aged, Peritonitis blood, Peritonitis drug therapy, Peritonitis microbiology, Peritonitis mortality, Prognosis, Bacterial Infections diagnosis, Peritonitis diagnosis
- Abstract
Forty-three patients with spontaneous bacterial peritonitis (SBP) between 1973 and 1978 were identified. Criteria for SBP included a positive ascites culture and polymorphonuclear cell concentration greater than 250 cells per mm3. Chronic liver disease was documented by varices in 91%, severe histologic fibrosis or cirrhosis in 94%, splenomegaly in 91%, and past hospitalization for liver disease in 57% of the patients. SBP was detected within 7 days of admission in 17 patients (40%) and within 35 days in 38 patients. Single organisms were isolated from 38 patients and multiple organisms from 5 patients. Twenty-six of 43 patients survived the episode of SBP, but only 13 survived the hospitalization. Analysis of the survival curve from the onset of SBP revealed a rapid death rate and a slow death rate set of patients. Rapid death (less than or equal to 7 days from SBP onset) correlated with a lack of prior hospitalization for liver disease (p less than 0.001), hepatomegaly (p less than 0.001), increased serum bilirubin (p less than 0.005), serum creatinine (p less than 0.05), and peripheral white blood cell concentrations (p less than 0.05). Survival during hospitalization was associated with prior hospitalization with liver disease (p less than 0.001) and chills during the episode of SBP (p less than 0.001). The 43 patients were divided into Group 1 patients on the basis of a serum bilirubin greater than 8 mg% and/or serum creatinine greater than 2.1 mg%; Group 2 patients had lower values. Survival was greater in Group 2 patients with advanced, relatively quiescent liver disease compared to Group 1 patients for both the episode of SBP (91 vs. 29%; p less than 0.001) and for hospitalization (50 vs. 9%; p less than 0.05). Death in Group 2 patients was related to inadequate antibiotic therapy (p less than 0.05), nonhepatic factors, and new onset of renal failure. Although SBP in the setting of severe acute liver injury has a dismal prognosis, SBP with minimal acute liver injury has a relatively good prognosis for hospital survival even with advanced chronic liver disease. Long-term survival is also possible since 4 of 9 patients with prolonged follow-up have survived 3 years. more...
- Published
- 1982
- Full Text
- View/download PDF
36. Quantitative aerobic and anaerobic bacteriology of infected diabetic feet.
- Author
-
Sapico FL, Canawati HN, Witte JL, Montgomerie JZ, Wagner FW Jr, and Bessman AN
- Subjects
- Aerobiosis, Anaerobiosis, Bacterial Infections etiology, Diabetes Complications, Female, Foot Diseases etiology, Gangrene etiology, Gangrene microbiology, Humans, Male, Species Specificity, Ulcer etiology, Ulcer microbiology, Bacteria isolation & purification, Bacterial Infections microbiology, Diabetes Mellitus microbiology, Foot Diseases microbiology
- Abstract
Quantitative aerobic and anaerobic cultures of deep tissue were performed on amputated infected lower limbs of 13 diabetic patients immediately after surgery. Dissection was made through intact skin distant from any preexisting ulcer. The results were compared with those obtained from: (i) ulcer swabs (pre- and postamputation), (iii) curettage of the ulcer base, and (iii) needle aspiration after normal saline injection. Anaerobic transport media were used for anaerobic cultures before prompt transfer to the anaerobic chamber. A mean of 4.7 bacterial species per specimen was seen (2.3 aerobes, 2.4 anaerobes). Mean log10 growth per gram of tissue was as follows: (i) aerobes plus anaerobes = 6.99, (ii) aerobes = 6.42, and (iii) anaerobes = 7.65. There was poor concordance between the deep tissue culture results and the results from other modalities of culture collection, though the results from other modalities of culture collection, though the results from curettage and saline aspiration were slightly better than those obtained from ulcer swabs. The most frequently isolated organisms were enterococci, anaerobic streptococci, and species of Proteus, Clostridium, and Bacteroides. When anti-microbial therapy is indicated for this patient population, the possibility of the concomitant presence of aerobes as well as anaerobes should be considered. more...
- Published
- 1980
- Full Text
- View/download PDF
37. Klebsiella pneumoniae colonization in patients with spinal cord injury.
- Author
-
Montgomerie JZ, Gilmore DS, Graham IE, Schick DG, Ashley MA, Morrow JW, and Bruce SK
- Subjects
- Female, Humans, Male, Penis microbiology, Perineum microbiology, Serotyping, Sex Characteristics, Urethra microbiology, Urinary Catheterization, Klebsiella pneumoniae isolation & purification, Spinal Cord Injuries microbiology
- Abstract
Klebsiella pneumoniae colonization of 53 patients with spinal cord injury was studied. Cultures of multiple body sites from patients, the environment, food, and hospital personnel were obtained. K. pneumonaie was cultured from one or more body sites in 46% of male patients. Significant bacteriuria was found in 10% of male patients. Positive cultures of the urethra and perineum for K. pneumoniae were significantly associated with the use of the external condom catheter (p less than 0.05, Fisher's exact test). K. pneumoniae colonization increased with length of stay in the hospital. Serotype 64, the predominant serotype found, was isolated only from patients who had been in the hospital for at least 4 wk and primarily in those patients using the external condom catheter. Urinary drainage bags were frequently colonized with K. pneumoniae at a time when the patients did not have significant bacteriuria. Colonized male patients were found to be the primary reservoir of K. pneumoniae and may serve as the major source for cross-contamination. more...
- Published
- 1987
- Full Text
- View/download PDF
38. Short-course aminoglycoside therapy in patients with spinal cord injury. Standard dose versus low dose.
- Author
-
Sapico FL, Lindquist LB, Montgomerie JZ, Jimenez EM, and Morrow JW
- Subjects
- Adult, Clinical Trials as Topic, Humans, Injections, Intramuscular, Proteus Infections drug therapy, Providencia, Pseudomonas Infections drug therapy, Random Allocation, Recurrence, Urinary Bladder, Neurogenic etiology, Amikacin administration & dosage, Anti-Bacterial Agents administration & dosage, Bacterial Infections drug therapy, Kanamycin analogs & derivatives, Spinal Cord Injuries complications, Tobramycin administration & dosage, Urinary Tract Infections drug therapy
- Abstract
Twenty-nine patients with spinal cord injury and asymptomatic urinary tract infection were treated with standard or reduced doses of tobramycin and amikacin. The patients received five days of intramuscular antibiotics. Most of the patients in the tobramycin groups had Pseudomonas aeruginosa infection and most of those in the amikacin group had either Proteus rettgeri or Providencia stuartii infections. Only 1 patient had a positive urine antibody coating test. High antibiotic concentrations were demonstrated in the urine of all patients during therapy. Urine cultures were obtained two and seven days after completion of therapy. Forty-eight per cent of the patients were cured, while 31 per cent showed persistence or relapse, and 21 per cent had reinfection with other bacteria. No significant differences in results were observed between the standard-dose and low-dose regimens and between the amikacin and tobramycin groups. The low success rate of the regimens used may indicate the need to evaluate alternative therapeutic regimens to treat urinary tract infections in this special group of patients. more...
- Published
- 1980
- Full Text
- View/download PDF
39. Vertebral osteomyelitis in intravenous drug abusers: report of three cases and review of the literature.
- Author
-
Sapico FL and Montgomerie JZ
- Subjects
- Adult, Anti-Bacterial Agents therapeutic use, Female, Heroin administration & dosage, Humans, Injections, Intravenous, Male, Middle Aged, Osteomyelitis drug therapy, Osteomyelitis microbiology, Osteomyelitis surgery, Pseudomonas aeruginosa isolation & purification, Heroin adverse effects, Osteomyelitis chemically induced, Substance-Related Disorders
- Abstract
Three cases of vertebral osteomyelitis in intravenous drug abusers are described, and 64 cases in the literature are reviewed. The patients were almost exclusively heroin users from the United States, were predominantly male, and were frequently of black or Hispanic ethnic background. Symptoms were present for less than threemonths in 81% of patients. On admission to the hospital, fever was seen in 42%, transient neurologic deficits in 15%, elevated erythrocyte sedimentation rate in 91%, and leukocytosis in 35%. Twenty-two percent of patients with initially normal X rays had spinal abnormalities detected by tomography and technetium bone scan. A strikingly high incidence (27%) of cervical spine involvement was found. Gram-negative aerobic bacilli accounted for 82% of infections, and Pseudomonas species comprised 66% of the total. Ninety-two percent of the patients responded to parenteral antibiotic therapy administered for four weeks or longer. Patients experiencing relapses responded to a second course of therapy. The prognosis for intravenous drug abusers with vertebral osteomyelitis appeared to be good with appropriate therapy, and no deaths or permanent neurologic sequelae were seen. more...
- Published
- 1980
- Full Text
- View/download PDF
40. Colonization of patients with spinal cord injury with Pseudomonas aeruginosa and Klebsiella pneumoniae at different institutions.
- Author
-
Montgomerie JZ, Madorsky JG, Gilmore DS, and Graham IE
- Subjects
- Adult, Bacteriuria, Female, Humans, Male, Middle Aged, Perineum microbiology, Spinal Cord Injuries urine, Urinary Catheterization, Klebsiella pneumoniae isolation & purification, Pseudomonas aeruginosa isolation & purification, Spinal Cord Injuries microbiology
- Abstract
Colonization of patients with Pseudomonas aeruginosa and Klebsiella pneumoniae was studied in patients with spinal cord injury at two institutions in Los Angeles County. The method of care of patients was similar at both institutions. A high prevalence of perineal colonization with P. aeruginosa and K. pneumoniae and similar serotypes of Pseudomonas were seen at both institutions. This colonization probably reflects the type of bladder management in patients with spinal cord injury. It would be of interest to examine other facilities to determine if colonization is influenced by techniques or local factors. more...
- Published
- 1987
- Full Text
- View/download PDF
41. Methicillin-resistant-Staphylococcus aureus colonization and infection in a rehabilitation facility.
- Author
-
Aeilts GD, Sapico FL, Canawati HN, Malik GM, and Montgomerie JZ
- Subjects
- Adolescent, Adult, Aged, Bacteriophage Typing, California, Child, Child, Preschool, Female, Humans, Male, Middle Aged, Penicillin Resistance, Personnel, Hospital, Staphylococcus aureus drug effects, Staphylococcus aureus growth & development, Time Factors, Cross Infection epidemiology, Hospitals, Special, Methicillin pharmacology, Rehabilitation Centers, Staphylococcal Infections epidemiology
- Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) colonization and infection in a rehabilitation hospital (Rancho Los Amigos Hospital [RLAH]) were studied from October 1977 to May 1980. Eighty-four episodes of MRSA colonization or infection were observed in 81 patients (attack rate, 0.44 per 100 admissions). The MRSA was considered to have been acquired at RLAH in 65% of the episodes and from transferring hospitals in 34%. The infection rate was 35% among MRSA-colonized patients, and only one death was attributed to MRSA infection. Colonization for more than 100 days occurred most frequently in wounds and anterior nares. All but two of the MRSA isolates were resistant to aminoglycosides, and 80% of those typed belonged to phage type 83A. The patients were allowed to continue participation in rehabilitation programs. Spread of the MRSA occurred in wards where intensive medical and nursing care was being practiced. There was no evidence of MRSA spread in the services with less intense medical and nursing care and where physical and occupational therapy was continued. Patients in a rehabilitation hospital with MRSA colonization may receive intensive physical and occupational therapy as long as special precautions are observed to prevent MRSA spread. more...
- Published
- 1982
- Full Text
- View/download PDF
42. Association of hydroxamate siderophore (aerobactin) with Escherichia coli isolated from patients with bacteremia.
- Author
-
Montgomerie JZ, Bindereif A, Neilands JB, Kalmanson GM, and Guze LB
- Subjects
- Animals, Escherichia coli analysis, Escherichia coli growth & development, Humans, Mice, Urinary Tract Infections microbiology, Escherichia coli pathogenicity, Hydroxamic Acids analysis, Iron Chelating Agents analysis, Sepsis microbiology
- Abstract
Clinical isolates of Escherichia coli were examined for the presence of hydroxamate siderophore (aerobactin). The incidence of aerobactin-positive strains of E. coli from the blood was greater than the incidence of these strains isolated from other sites. The presence of aerobactin and the virulence of strains of E. coli in urinary tract infection were also examined in mice. The presence of aerobactin in the strains of E. coli correlated with virulence as measured by proportion of deaths but not with renal infection. These results suggest that the presence of aerobactin may be a significant factor in the invasion of the blood stream. more...
- Published
- 1984
- Full Text
- View/download PDF
43. Pericarditis. Hemodynamic and diagnostic features of pericardial disease.
- Author
-
Montgomerie JZ, Lewis AJ, Fiala M, Locks MO, Yoshikawa TT, and Turner JA
- Subjects
- Acute Disease, Adolescent, Adult, Aged, Electrocardiography, Female, Humans, Male, Middle Aged, Pericardial Effusion, Pericarditis, Constrictive diagnosis, Hemodynamics, Pericarditis diagnosis
- Published
- 1975
44. E. coli adherence to bladder epithelial cells of mice.
- Author
-
Montgomerie JZ, Turkel S, Kalmanson GM, and Guze LB
- Subjects
- Adhesiveness, Animals, Epithelial Cells, In Vitro Techniques, Mice, Virulence, Escherichia coli, Urinary Bladder cytology
- Abstract
Adherence of E. coli to bladder cells was studied by mixing E. coli with cells scraped from the surface of the normal mouse bladder. E. coli adherence to bladder epithelium did not correlate with renal infection, the ability of E. coli to resist phagocytosis, the growth of the strains, the presence of K-antigen or dulcitol fermentation. There was also no correlation with proportion of deaths, motility, or rough mutation. Pili were observed in three of the 22 strains of E. coli and their presence was not associated with increased virulence. In this model of renal infection neither adherence of E. coli to bladder epithelial cells nor the presence of pili were significant virulence factors. more...
- Published
- 1980
- Full Text
- View/download PDF
45. Cefsulodin in treatment of Pseudomonas urinary tract infection in patients with spinal cord injury. Comparison with aminoglycosides.
- Author
-
Montgomerie JZ, Morrow JW, Canawati HN, Gilmore DS, Graham IE, and Ibraham MZ
- Subjects
- Adult, Amikacin therapeutic use, Aminoglycosides therapeutic use, Humans, Male, Middle Aged, Pseudomonas Infections etiology, Time Factors, Tobramycin therapeutic use, Urinary Tract Infections etiology, Anti-Bacterial Agents therapeutic use, Cefsulodin therapeutic use, Pseudomonas Infections drug therapy, Spinal Cord Injuries complications, Urinary Tract Infections drug therapy
- Abstract
Male patients with spinal cord injury and urinary tract infection with Pseudomonas aeruginosa were treated with cefsulodin (1.0 or 1.5 Gm) every six hours or an aminoglycoside (amikacin 5 mg/Kg or tobramycin 1 mg/Kg) every eight hours for seven days. The study was discontinued after treating 6 patients with aminoglycosides because of the poor results with these antibiotics. At five to nine days after completing treatment P. aeruginosa was eliminated from the urine of 12 to 15 patients (80%) treated with cefsulodin and 3 of 6 patients (50%) treated with an aminoglycoside. When examined at four to six weeks 5 of 15 (33%) of the cefsulodin group had persistent infection or relapse, while 5 of 6 (83%) infections treated with an aminoglycoside either persisted or relapsed. Cefsulodin was discontinued in 1 patient, known to be allergic to penicillin, because of hypersensitivity resulting in periorbital edema and rash. No other serious side effects were noted with cefsulodin or the aminoglycosides. These results indicate that cefsulodin is an effective antibiotic in the treatment of urinary tract infection with P. aeruginosa in patients with neurogenic bladder resulting from spinal cord injury and confirmed previous observations of a poor response of Pseudomonas urinary tract infection to aminoglycosides in this group of patients. more...
- Published
- 1986
- Full Text
- View/download PDF
46. Liquid protein diets and torsade de pointes.
- Author
-
Singh BN, Gaarder TD, Kanegae T, Goldstein M, Montgomerie JZ, and Mills H
- Subjects
- Adult, Arrhythmias, Cardiac drug therapy, Body Weight, Fasting adverse effects, Female, Humans, Obesity diet therapy, Phenytoin therapeutic use, Recurrence, Sodium blood, Syncope etiology, Ventricular Fibrillation etiology, Arrhythmias, Cardiac etiology, Death, Sudden, Diet, Reducing adverse effects, Dietary Proteins administration & dosage, Electrocardiography
- Abstract
Three women, aged 27, 33, and 35 years, experienced recurrent syncope five months after losing 36 to 41 kg using liquid protein diets. No abnormalities were noted during physical examination except in one who was hypothyroid. Serum potassium levels varied between 2.9 and 3.9 mEq/liter. The ECGs demonstrated prominent U waves, QUc prolongation, and ST and T wave abnormalities, with left axis deviation in two patients. Syncopal episodes were due to ventricular tachycardia and fibrillation, which were not responsive to conventional antiarrhythmic agents used in two patients. Patients using liquid protein diets may thus experience reversible QUc prolongation giving rise to serious arrhythmias that are probably best treated with drugs that shorten the QTc interval. Caution should be exercised in the use of liquid protein diets for weight reduction in obesity. more...
- Published
- 1978
47. Urinary tract infection after injection of pseudomonas into bladder.
- Author
-
Montgomerie JZ, Morrow JW, and Howard EB
- Subjects
- Animals, Disease Models, Animal, Female, Kidney Diseases microbiology, Kidney Diseases pathology, Mice, Pseudomonas Infections microbiology, Pseudomonas aeruginosa, Sepsis microbiology, Urinary Bladder Diseases microbiology, Urinary Bladder Diseases pathology, Urinary Tract Infections pathology, Urinary Tract Infections microbiology
- Abstract
Pseudomonas urinary tract infection was studied in female mice. The bladder was exposed by a lower midline incision and an overnight washed culture of Pseudomonas (0.05 ml.) was injected into the bladder. This resulted in infection of the kidneys in more than 50 per cent of mice at one week. At four hours, the microulceration of the bladder was observed with many Pseudomonas int the base of the ulcer. The presence of acute inflammation on the serosal surface of the bladder, the frequent death of the mice, the presence of cortical foci of polymorphonuclear leukocytes in the kidneys, and bacteremia suggested that bacteremia may play a significant role in the development of the renal infection in this model of urinary tract infection. Bacteria injected through the bladder wall of mice cannot be assumed to produce ascending infection of the kidney. more...
- Published
- 1981
- Full Text
- View/download PDF
48. Pseudomonas aeruginosa and Klebsiella pneumoniae on the perinea of males with spinal cord injuries.
- Author
-
Gilmore DS, Schick DG, and Montgomerie JZ
- Subjects
- Humans, Male, Rectum microbiology, Klebsiella pneumoniae isolation & purification, Perineum microbiology, Pseudomonas aeruginosa isolation & purification, Spinal Cord Injuries microbiology
- Abstract
Pseudomonas aeruginosa colonization is found in a high percentage of males with spinal cord injury. The perineum is the body site most frequently colonized, and specific serotypes may persist for weeks. We examined patients for the presence of P. aeruginosa and Klebsiella pneumoniae on the perineum and adjacent body sites by using contact plates. P. aeruginosa, K. pneumoniae, or both were cultured from perineal swabs of 22 male patients. Wells (2.5 cm2) containing agar medium selective for these organisms were used to examine samples from 32 sites adjacent to the perineum in each patient. P. aeruginosa was most frequently cultured from samples taken from the perineum, the scrotum, and the penile shaft. K. pneumoniae isolation was more variable; this organism was most commonly found on the perineum and scrotum. Rectal swabs, obtained through a proctoscope, were positive for P. aeruginosa in four of eight patients with this organism on the perineum and positive for K. pneumoniae in eight of nine patients with this organism on the perineum. These studies more clearly define the extent of the colonization of the perineum and adjacent body sites which provides potential reservoirs of P. aeruginosa and K. pneumoniae. more...
- Published
- 1982
- Full Text
- View/download PDF
49. Selective medium for isolation of Klebsiella pneumoniae.
- Author
-
Bruce SK, Schick DG, Tanaka L, Jimenez EM, and Montgomerie JZ
- Subjects
- Cross Infection microbiology, Enterobacteriaceae growth & development, Humans, Hydrogen-Ion Concentration, Klebsiella pneumoniae growth & development, Culture Media, Klebsiella pneumoniae isolation & purification
- Abstract
Selective media for Klebsiella pneumoniae have been important in studies of hospital-acquired infections. On an agar medium which included ornithine, raffinose, and Koser citrate, K. pneumoniae strains grew as yellow mucoid colonies at 24 h and there was some increase in colony size at 48 h. Other members of Enterobacteriaceae were inhibited or produced small pink colonies on this same medium. Pseudomonas, Providencia, Acinetobacter, and Proteus species did not grow or showed very poor growth. The growth and appearance of these bacteria were not influenced by pH changes over a pH range of 5.2 to 6.4. Of 368 swabs of body sites cultured on MacConkey agar and on the test medium, 121 K. pneumoniae isolates on MacConkey agar and the same number on the test medium resulted. There were no discrepancies between the two media. Upon direct plating of stool, however, more K. pneumoniae colonies were isolated on the test medium than on MacConkey agar. Colonies on the test medium were more readily selected and identified than the colonies on MacConkey agar. There was also no inhibition of K. pneumoniae growth on the test medium compared with blood agar medium. This medium may be useful for the selective isolation of K. pneumoniae. more...
- Published
- 1981
- Full Text
- View/download PDF
50. Persistence of polymicrobial abscesses in the poorly controlled diabetic host.
- Author
-
Bessman AN, Sapico FL, Tabatabai M, and Montgomerie JZ
- Subjects
- Abscess microbiology, Animals, Bacteroides Infections complications, Bacteroides fragilis, Blood Glucose analysis, Diabetes Complications, Diabetes Mellitus microbiology, Diabetes Mellitus, Experimental microbiology, Enterobacteriaceae Infections complications, Escherichia coli, Escherichia coli Infections complications, Female, Humans, Mice, Mice, Inbred C57BL, Rats, Abscess complications, Diabetes Mellitus, Experimental complications
- Abstract
Polymicrobial infections are frequently found in soft tissue infections of the lower extremities in diabetic patients. The relative susceptibility to and persistence of soft tissue polymicrobial infections of diabetic and nondiabetic mice using bacteria commonly found in clinical foot infections were studied. Subcutaneous abscesses were induced in three groups of diabetic and nondiabetic mice using: (1) E. coli and enterococcus, (2) enterococcus and Bacteroides fragilis (B. fragilis), and (3) E. coli and B. fragilis. Abscesses were removed at 1 and 2 wk for total colony counts. At 1 wk, there was a significantly greater bacterial growth in the abscesses of the diabetic mice compared with the nondiabetic mice only in the group injected with enterococcus and B. fragilis. There were significantly higher colony counts in the diabetic compared with the nondiabetic mice in all three groups at 2 wk after injection of the bacteria. Two weeks after injection of inocula containing B. fragilis, both in combination with E. coli or enterococcus, all nondiabetic mice had eradicated B. fragilis from the abscesses, but significant numbers of B. fragilis persisted in the abscesses of the diabetic mice. In the diabetic mice, the presence of enterococci was more synergistic for growth of B. fragilis than was the presence of E. coli. These studies demonstrate that the bacteria of polymicrobial soft tissue infections persist for a longer period of time in the diabetic compared with the nondiabetic host. In addition, B. fragilis has increased pathogenicity in the diabetic compared with the nondiabetic host, particularly in the presence of enterococci. more...
- Published
- 1986
- Full Text
- View/download PDF
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.