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Lee A, Gilpin D. Balancing the benefits of antimicrobial therapy with the threat of antimicrobial resistance development. J Cyst Fibros 2021; 20:377-378. [PMID: 34103153 DOI: 10.1016/j.jcf.2021.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/15/2021] [Accepted: 04/19/2021] [Indexed: 11/24/2022]
Affiliation(s)
- Andrew Lee
- Halo Research Group, Queen's University Belfast, Belfast, UK; Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK.
| | - Deirdre Gilpin
- Halo Research Group, Queen's University Belfast, Belfast, UK; School of Pharmacy, Queen's University Belfast, Belfast, UK
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Gilpin D, Hoffman LR, Ceppe A, Muhlebach MS. Phenotypic characteristics of incident and chronic MRSA isolates in cystic fibrosis. J Cyst Fibros 2021; 20:692-698. [PMID: 34103251 DOI: 10.1016/j.jcf.2021.05.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 05/19/2021] [Accepted: 05/22/2021] [Indexed: 01/02/2023]
Abstract
BACKGROUND Chronic methicillin resistant Staphylococcus aureus (MRSA) in CF is associated with worse outcomes compared to early or intermittent infection. This observation could be related to adaptive bacterial changes such as biofilm formation or anaerobic growth. METHODS MRSA isolates stored from incident and during chronic (>2 years) infection were included at two study sites. MRSA isolates were characterised by spa-typing, antimicrobial susceptibility testing, biofilm formation and haemolysis under aerobic and anaerobic culture conditions. RESULTS Paired MRSA isolates from 49 patients were included. Mean age at incident infection was 9.7±1.2 years with mild to moderate lung disease (FEV1 74±4% predicted). Twenty-five subjects showed progression of disease/symptoms after onset of MRSA with significantly increased use of antibiotics. Most isolates belonged to t002 (38%) and t008 (36%) spa-types and 8 patients had a change in spa-type over time. Antimicrobial susceptibility testing showed few differences between incident and late isolates but significantly lower MIC under anaerobic vs. aerobic conditions for vancomycin, fusidic acid, rifampin but higher MIC for trimethoprim-sulfamethoxazole. Biofilm formation and haemolysis did not differ by stage of infection or disease course but both were lower under anaerobic conditions (biofilm p=0.018; haemolysis p=0.002) in multi-variate analyses that included study site, growth condition and stage of infection. CONCLUSIONS Persistent MRSA infection is frequently associated with clinical decline. Anaerobic growth conditions, which occur in CF airways, affect the expression of virulence factors and antibiotic susceptibility of MRSA more than duration of infection.
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Affiliation(s)
- Deirdre Gilpin
- Department of Pharmacy Services, Queens University, Belfast, UK.
| | - Lucas R Hoffman
- Department of Pediatrics, University of Washington, Seattle Children's Hospital, Seattle, WA, USA.
| | - Agathe Ceppe
- Marisco Lung Institute, University of North Carolina, Chapel Hill, NC, USA.
| | - Marianne S Muhlebach
- Marisco Lung Institute, University of North Carolina, Chapel Hill, NC, USA; Department of Pediatrics, University of North Carolina, Chapel Hill, NC, USA.
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Gilpin D, Carson G, Hoffman L, Tunney M, Muhlebach M. ePS6.02 Does spa type play a role in establishment of chronic MRSA infection? J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30288-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Allen D, Kelly J, Gilpin D, Bell S, Tunney M. Detection and characterisation of bacteria causing lung infection in people with Cystic Fibrosis (CF) by surface-enhanced Raman spectroscopy (SERS). Access Microbiol 2019. [DOI: 10.1099/acmi.ac2019.po0267] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Danielle Allen
- 2School of Chemistry and Chemical Engineering, Queen’s University Belfast, Belfast, United Kingdom
- 1School of Pharmacy, Queen’s University Belfast, Belfast, United Kingdom
| | - Jessica Kelly
- 2School of Chemistry and Chemical Engineering, Queen’s University Belfast, Belfast, United Kingdom
| | - Deirdre Gilpin
- 1School of Pharmacy, Queen’s University Belfast, Belfast, United Kingdom
| | - Steven Bell
- 2School of Chemistry and Chemical Engineering, Queen’s University Belfast, Belfast, United Kingdom
| | - Michael Tunney
- 1School of Pharmacy, Queen’s University Belfast, Belfast, United Kingdom
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Sherrard L, Einarsson G, Johnston E, O'neill K, Mcilreavey L, Mcgrath S, Gilpin D, Murray M, Lavelle G, Mcelvaney G, Boucher R, Muchlebach M, Elborn J, Tunney M. P053 Use of extended-quantitative culture does not predict an imminent pulmonary exacerbation. J Cyst Fibros 2018. [DOI: 10.1016/s1569-1993(18)30350-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Kenny C, Magill D, Gilpin D, Kulakov L, Carson G, McGrath J, Tunney M. 92 Bacteriophage induction in Pseudomonas aeruginosa isolates by cigarette smoke extract (CSE) and e-cigarette smoke extract (ECSE). J Cyst Fibros 2017. [DOI: 10.1016/s1569-1993(17)30456-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Payne J, Ingram R, Elborn J, Gilpin D, Juarez-Perez V, Tunney M. 194 Effect of multiple doses of ALX-009, a novel combination of hypothiocyanite and lactoferrin, on microbial load in cystic fibrosis (CF) sputum. J Cyst Fibros 2017. [DOI: 10.1016/s1569-1993(17)30558-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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McGettigan C, Jonhston E, Elborn J, Downey D, Tunney M, Gilpin D. 149 Comparison of culture and quantitative PCR for bacterial quantification in CF sputum. J Cyst Fibros 2017. [DOI: 10.1016/s1569-1993(17)30513-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Valtis Y, Wachter K, Chande R, Mashili F, Kisenge R, Walker T, Kennedy N, Maling S, Bhandari S, Teichman M, Barron E, Gilpin D, Bonis P, Weintraub R. Expanding access to evidence-based medicine to physicians and medical
students in resource-poor settings to improve medical education. Ann Glob Health 2016. [DOI: 10.1016/j.aogh.2016.04.578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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McGown KA, Bengoechea J, Dumigan A, Elborn J, Tunney M, Gilpin D. 54 Cigarettes, e-cigarettes and Pseudomonas aeruginosa: interactions in the CF lung? J Cyst Fibros 2016. [DOI: 10.1016/s1569-1993(16)30294-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Gilpin D, Carson G, Lee A, McGrath S, Elborn J, Tunney M. 129 Susceptibility of Staphylococcus aureus isolates from patients with and without cystic fibrosis to ceftobiprole. J Cyst Fibros 2016. [DOI: 10.1016/s1569-1993(16)30367-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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McGown K, Tunney M, McGrath S, Elborn J, Gilpin D. S22 The Effect Of Cigarette Smoke On Important Pathogens In Copd Lung Infection. Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Choi SY, Rodríguez H, Gunaratne HQN, Puga AV, Gilpin D, McGrath S, Vyle JS, Tunney MM, Rogers RD, McNally T. Dual functional ionic liquids as antimicrobials and plasticisers for medical grade PVCs. RSC Adv 2014. [DOI: 10.1039/c3ra46425c] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
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Döring G, Bragonzi A, Paroni M, Aktürk FF, Cigana C, Schmidt A, Gilpin D, Heyder S, Born T, Smaczny C, Kohlhäufl M, Wagner TOF, Loebinger MR, Bilton D, Tunney MM, Elborn JS, Pier GB, Konstan MW, Ulrich M. BIIL 284 reduces neutrophil numbers but increases P. aeruginosa bacteremia and inflammation in mouse lungs. J Cyst Fibros 2013; 13:156-63. [PMID: 24183915 DOI: 10.1016/j.jcf.2013.10.007] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 10/14/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND A clinical study to investigate the leukotriene B(4) (LTB(4))-receptor antagonist BIIL 284 in cystic fibrosis (CF) patients was prematurely terminated due to a significantly increased risk of adverse pulmonary events. We aimed to establish the effect of BIIL284 in models of Pseudomonas aeruginosa lung infection, thereby contributing to a better understanding of what could have led to adverse pulmonary events in CF patients. METHODS P. aeruginosa DNA in the blood of CF patients during and after acute pulmonary exacerbations and in stable patients with non-CF bronchiectasis (NCFB) and healthy individuals was assessed by PCR. The effect of BIIL 284 treatment was tested in an agar bead murine model of P. aeruginosa lung infection. Bacterial count and inflammation were evaluated in lung and other organs. RESULTS Most CF patients (98%) and all patients with NCFB and healthy individuals had negative P. aeruginosa DNA in their blood. Similarly, the P. aeruginosa-infected mice showed bacterial counts in the lung but not in the blood or spleen. BIIL 284 treatment decreased pulmonary neutrophils and increased P. aeruginosa numbers in mouse lungs leading to significantly higher bacteremia rates and lung inflammation compared to placebo treated animals. CONCLUSIONS Decreased airway neutrophils induced lung proliferation and severe bacteremia in a murine model of P. aeruginosa lung infection. These data suggest that caution should be taken when administering anti-inflammatory compounds to patients with bacterial infections.
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Affiliation(s)
- Gerd Döring
- Institute of Medical Microbiology and Hygiene, Universitätsklinikum Tübingen, Tübingen, Germany
| | - Alessandra Bragonzi
- Infection and Cystic Fibrosis Unit, Division of Immunology, Transplantation and Infectious Diseases, San Raffaele Scientific Institute, Milano, Italy.
| | - Moira Paroni
- Infection and Cystic Fibrosis Unit, Division of Immunology, Transplantation and Infectious Diseases, San Raffaele Scientific Institute, Milano, Italy
| | - Firdevs-Fatma Aktürk
- Institute of Medical Microbiology and Hygiene, Universitätsklinikum Tübingen, Tübingen, Germany
| | - Cristina Cigana
- Infection and Cystic Fibrosis Unit, Division of Immunology, Transplantation and Infectious Diseases, San Raffaele Scientific Institute, Milano, Italy
| | - Annika Schmidt
- Institute of Medical Microbiology and Hygiene, Universitätsklinikum Tübingen, Tübingen, Germany
| | | | - Susanne Heyder
- Klinik Schillerhöhe, Robert-Bosch Krankenhaus, Gerlingen, Germany
| | - Torsten Born
- Universitätsklinikum Frankfurt, Frankfurt, Germany
| | | | - Martin Kohlhäufl
- Klinik Schillerhöhe, Robert-Bosch Krankenhaus, Gerlingen, Germany
| | | | | | | | | | | | - Gerald B Pier
- Division of infectious Diseases, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Michael W Konstan
- Case Western Reserve University, UH Rainbow Babies & Children's Hospital, Cleveland, OH, USA
| | - Martina Ulrich
- Institute of Medical Microbiology and Hygiene, Universitätsklinikum Tübingen, Tübingen, Germany
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Boeckstyns M, Boyce D, Vasenius J, Kaplan F, Peimer C, Blazar P, Gilpin D, Smith T, Tursi J, Cohen B, Szczypa P, Gerber R. SAT0434 Recurrence rates in patients with dupuytren’s contracture 3 years after successful treatment with collagenase clostridium histolyticum. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.3380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Gilpin D, Coleman S, Tursi J, Jones N, Szczypa P. SAT0425 Multiple, concurrent injections of collagenase clostridium histolyticum injections into dupuytren’s cords in the same hand. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.3371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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McClean P, Tunney M, Parsons C, Gilpin D, Baldwin N, Hughes C. Infection control and meticillin-resistant Staphylococcus aureus decolonization: the perspective of nursing home staff. J Hosp Infect 2012; 81:264-9. [PMID: 22727826 DOI: 10.1016/j.jhin.2012.05.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2012] [Accepted: 05/08/2012] [Indexed: 11/16/2022]
Abstract
BACKGROUND Infection control and meticillin-resistant Staphylococcus aureus (MRSA) in nursing homes have started to assume greater importance in practice and policy. AIM To explore infection control and MRSA decolonization in nursing homes in Northern Ireland from the perspective of nursing home staff. METHODS Semi-structured interviews with nursing home managers and focus group discussions with nursing home staff were conducted, transcribed verbatim and analysed via the framework method. FINDINGS Six one-to-one interviews and six focus group discussions (N = 7, 6, 6, 5, 5 and 4 participants, respectively) were conducted. Three overarching themes with inter-related subthemes were identified as influencing infection control and MRSA decolonization in the nursing homes: organizational factors (e.g. time, financial resources, environment, management and culture), external factors [e.g. hospitals, regulation and general practitioners (GPs)], and residents and families. It was reported that when the workload was unmanageable, aspects of infection control were not adhered to and more financial resources were necessary. There was conflict in maintaining an environment that was both 'homely' and clinical, and it was difficult to achieve good infection control practices with confused residents, some families, GPs and members of staff who were resistant to change. Support for MRSA decolonization in nursing homes was tempered by the risk of recolonization, particularly from hospital admissions. CONCLUSIONS Infection control and MRSA decolonization in the nursing home environment appear to be affected by many factors, some of which may be beyond the direct control of staff.
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Affiliation(s)
- P McClean
- School of Pharmacy, Queen's University Belfast, 97 Lisburn Road, Belfast, UK
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McClean P, Tunney M, Gilpin D, Parsons C, Hughes C. Antimicrobial prescribing in nursing homes in Northern Ireland: results of two point-prevalence surveys. Drugs Aging 2012; 28:819-29. [PMID: 21970309 DOI: 10.2165/11595050-000000000-00000] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
BACKGROUND In 2005, the European Commission recommended that all member states should establish or strengthen surveillance systems for monitoring the use of antimicrobial agents. There is no evidence in the literature of any surveillance studies having been specifically conducted in nursing homes (NHs) in Northern Ireland (NI). OBJECTIVE The aim of this study was to determine the prevalence of antimicrobial prescribing and its relationship with certain factors (e.g. indwelling urinary catheterization, urinary incontinence, disorientation, etc.) in NH residents in NI. METHODS This project was carried out in NI as part of a wider European study under the protocols of the European Surveillance of Antimicrobial Consumption group. Two point-prevalence surveys (PPSs) were conducted in 30 NHs in April and November 2009. Data were obtained from nursing notes, medication administration records and staff in relation to antimicrobial prescribing, facility and resident characteristics and were analysed descriptively. RESULTS The point prevalence of antimicrobial prescribing was 13.2% in April 2009 and 10.7% in November 2009, with a 10-fold difference existing between the NHs with the highest and lowest antimicrobial prescribing prevalence during both PPSs. The same NH had the highest rate of antimicrobial prescribing during both April (30.6%) and November (26.0%). The group of antimicrobials most commonly prescribed was the penicillins (April 28.6%, November 27.5%) whilst the most prevalent individual antimicrobial prescribed was trimethoprim (April 21.3%, November 24.3%). The majority of antimicrobials were prescribed for the purpose of preventing urinary tract infections (UTIs) in both April (37.8%) and in November (46.7%), with 5% of all participating residents being prescribed an antimicrobial for this reason. Some (20%) antimicrobials were prescribed at inappropriate doses, particularly those which were used for the purpose of preventing UTIs. Indwelling urinary catheterization and wounds were significant risk factors for antimicrobial use in April [odds ratio {OR} (95% CI) 2.0 (1.1, 3.5) and 1.8 (1.1, 3.0), respectively] but not in November 2009 [OR (95% CI) 1.6 (0.8, 3.2) and 1.2 (0.7, 2.2), respectively]. Other resident factors, e.g. disorientation, immobility and incontinence, were not associated with antimicrobial use. Furthermore, none of the NH characteristics investigated (e.g. number of beds, hospitalization episodes, number of general practitioners, etc.) were found to be associated with antimicrobial use in either April or November 2009. CONCLUSIONS This study has identified a high overall rate of antimicrobial use in NHs in NI, with variability evident both within and between homes. More research is needed to understand which factors influence antimicrobial use and to determine the appropriateness of antimicrobial prescribing in this population in general and more specifically in the management of recurrent UTIs.
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Affiliation(s)
- Pamela McClean
- School of Pharmacy, Queen's University Belfast, Belfast, UK
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McClean P, Tunney M, Gilpin D, Parsons C, Hughes C. Antimicrobial prescribing in residential homes. J Antimicrob Chemother 2012; 67:1781-90. [DOI: 10.1093/jac/dks085] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Elbaz W, Metwally L, Mcauley M, Gilpin D, McGrath S, Einarsson G, McCaughan J, Moore J, Goldsmith C, Elborn J, Tunney M. Susceptibility of Pseudomonas aeruginosa isolates cultured from cystic fibrosis patients to temocillin. J Cyst Fibros 2010. [DOI: 10.1016/s1569-1993(10)60156-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Wei L, McGrath S, Gillanders L, Gilpin D, Drain M, Elborn J, Tunney M. Antimicrobial susceptibility of Pseudomonas aeruginosa isolates cultured from patients with cystic fibrosis (CF) and non-CF bronchiectasis. J Cyst Fibros 2010. [DOI: 10.1016/s1569-1993(10)60155-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Brady A, Loughlin R, Gilpin D, Kearney P, Tunney M. In vitro activity of tea-tree oil against clinical skin isolates of meticillin-resistant and -sensitive Staphylococcus aureus and coagulase-negative staphylococci growing planktonically and as biofilms. J Med Microbiol 2006; 55:1375-1380. [PMID: 17005786 DOI: 10.1099/jmm.0.46558-0] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The susceptibility of Staphylococcus aureus [meticillin-resistant (MRSA) and meticillin-sensitive (MSSA)] and coagulase-negative staphylococci (CoNS), which respectively form part of the transient and commensal skin flora, to tea-tree oil (TTO) was compared using broth microdilution and quantitative in vitro time–kill test methods. MRSA and MSSA isolates were significantly less susceptible than CoNS isolates, as measured by both MIC and minimum bactericidal concentration. A significant decrease in the mean viable count of all isolates in comparison with the control was seen at each time interval in time–kill assays. However, the only significant difference in the overall mean log10 reduction in viable count between the groups of isolates was between CoNS and MSSA at 3 h, with CoNS isolates demonstrating a significantly lower mean reduction. To provide a better simulation of in vivo conditions on the skin, where bacteria are reported to grow as microcolonies encased in glycocalyx, the bactericidal activity of TTO against isolates grown as biofilms was also compared. Biofilms formed by MSSA and MRSA isolates were completely eradicated following exposure to 5 % TTO for 1 h. In contrast, of the biofilms formed by the nine CoNS isolates tested, only five were completely killed, although a reduction in viable count was apparent for the other four isolates. These results suggest that TTO exerts a greater bactericidal activity against biofilm-grown MRSA and MSSA isolates than against some biofilm-grown CoNS isolates.
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Affiliation(s)
- Aaron Brady
- Clinical and Practice Research Group, School of Pharmacy, Queen's University Belfast, Medical Biology Centre, 97 Lisburn Road, Belfast BT9 7BL, UK
| | - Ryan Loughlin
- Clinical and Practice Research Group, School of Pharmacy, Queen's University Belfast, Medical Biology Centre, 97 Lisburn Road, Belfast BT9 7BL, UK
| | - Deirdre Gilpin
- Clinical and Practice Research Group, School of Pharmacy, Queen's University Belfast, Medical Biology Centre, 97 Lisburn Road, Belfast BT9 7BL, UK
| | - Paddy Kearney
- Microbiology Department, United Hospitals Trust, Antrim, BT41, UK
| | - Michael Tunney
- Clinical and Practice Research Group, School of Pharmacy, Queen's University Belfast, Medical Biology Centre, 97 Lisburn Road, Belfast BT9 7BL, UK
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Gilpin D, Baldwin N, Hughes C, Kearney P, Gardiner D, Tunney M. P4.02 Characterisation of Methicillin Resistant Staphylococcus aureus in Nursing Homes in the Northern Health and Social Services (NHSSB) in Northern Ireland. J Hosp Infect 2006. [DOI: 10.1016/s0195-6701(06)60064-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Moore JE, McIlhatton B, Buchanan J, Gilpin D, Shaw A, Hall V, Murphy PG, Elborn JS. Occurrence of Burkholderia cepacia in the hospital environment. Ir J Med Sci 2005; 171:131-3. [PMID: 15736349 DOI: 10.1007/bf03170498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AIM To determine the prevalence of Burkholderia cepacia from the environment in a regional adult cystic fibrosis (CF) care centre. METHODS Two hundred and eighty-five environmental samples were taken from inpatient and outpatient environments within the CF centre. Following a non-selective enrichment step, broths were plated onto a selective medium and B. cepacia isolates were confirmed by phenotypic tests and also genotypically by species specific 16S rRNA PCR. RESULTS B. cepacia was not detected from commonly shared items of equipment, staff hands, staff uniforms or toilets. In addition, the organism was not detected in toilet bowls, even in the B. cepacia unit. With regard to positive environments for B. cepacia, 4/10 (40%) of the outside surfaces and inner rims of patients' plastic disposable sputum collection containers and 4/17 (23.5%) of air from patients' rooms, following physiotherapy, were positive. CONCLUSIONS All positive samples originated in the B. cepacia segregation area of the inpatient wards and B. cepacia was not detected in the non-cepacia area of the CF centre. Consequently, these two positive sites should therefore be treated as high risk, where organisms may be potentially transmitted from environment to patient. As there is now evidence to suggest differences in the virulence and hence clinical outcome of certain of the genomovars of this organism, this study may be important in highlighting the areas that patients who are B. cepacia positive should avoid, to minimise the risk of transmission and acquisition of this organism within the CF cepacia population. These results indicate that effective infection control procedures are required in patients' rooms following physiotherapy, for prevention of B. cepacia transmission and to avoid the transmission of different genomovar types within CF patients, who are already colonised with this pathogen.
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Affiliation(s)
- J E Moore
- Northern Ireland Public Health Laboratory, Department of Bacteriology, Belfast City Hospital, Northern Ireland.
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McNeilly F, McNair I, O'Connor M, Brockbank S, Gilpin D, Lasagna C, Boriosi G, Meehan B, Ellis J, Krakowka S, Allan GM. Evaluation of a porcine circovirus type 2-specific antigen-capture enzyme-linked immunosorbent assay for the diagnosis of postweaning multisystemic wasting syndrome in pigs: comparison with virus isolation, immunohistochemistry, and the polymerase chain reaction. J Vet Diagn Invest 2002; 14:106-12. [PMID: 11939330 DOI: 10.1177/104063870201400203] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Quantitative virus isolation, immunohistochemistry, polymerase chain reaction (PCR) assay, and a porcine circovirus 2 (PCV2)-specific antigen-capture enzyme-linked immunosorbent assay (ELISA) were used for differentiation between clinical and subclinical PCV2 infections of swine. Tissue samples from pigs experimentally infected with PCV2 and field cases of postweaning multisystemic wasting syndrome and PCV2-associated reproductive disorders were used in this evaluation. In initial studies on 6 PCV2 pools using 3 previously published PCR protocols for PCV2 detection, quantitative virus isolation, and antigen-capture ELISA, substantial differences in sensitivity were identified among these procedures. Examination of tissue samples from diseased and clinically normal pigs indicated that immunohistochemistry, quantitative virus isolation, and antigen-capture ELISA could be used to differentiate between clinical and subclinical PCV2 infections, but the PCR assay could not. Because subclinical infections of pigs with PCV2 are common, the use of nonquantitative PCR as a diagnostic tool for PCV2-related diseases should be discouraged and the PCV2-specific antigen-capture ELISA evaluated further.
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Affiliation(s)
- F McNeilly
- Department of Agriculture and Rural Development for Northern Ireland, Veterinary Sciences Division, Stormont, Belfast
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27
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Patrick S, Gilpin D, Stevenson L. Detection of intrastrain antigenic variation of Bacteroides fragilis surface polysaccharides by monoclonal antibody labelling. Infect Immun 1999; 67:4346-51. [PMID: 10456873 PMCID: PMC96751 DOI: 10.1128/iai.67.9.4346-4351.1999] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Bacteroides fragilis is a constituent of the normal resident microbiota of the human intestine and is the gram-negative obligately anaerobic bacterium most frequently isolated from clinical infection. Surface polysaccharides are implicated as potential virulence determinants. We present evidence of within strain immunochemical variation of surface polysaccharides in populations that are noncapsulate by light microscopy as determined by monoclonal antibody labelling. Expression of individual epitopes can be enriched from a population of an individual strain by use of immunomagnetic beads. Also, individual colonies in which either >94% or <7% of the bacteria carry an individual epitope retain this level of expression when subcultured into broth. In broth cultures where >94% of the bacteria carry a given epitope, there is no enrichment for other epitopes recognized by different polysaccharide-specific monoclonal antibodies. This intrastrain variation has important implications for the development of potential vaccines or immunodiagnostic tests.
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Affiliation(s)
- S Patrick
- Department of Microbiology and Immunobiology, School of Medicine, Queen's University of Belfast, Belfast BT12 6BN, United Kingdom.
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28
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Abstract
We have found that the standard portals described limit arthroscopic access to and visualization of some areas of the radiocarpal joint. We describe a radial anterior portal, which we believe is useful in the arthroscopic treatment of wrist conditions and describe its use in clinical practice.
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Affiliation(s)
- S Tham
- Hand and Upper Limb Unit, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
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29
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Abstract
We report the use of the Mitek anchor with a limited approach for repair of avulsion of the biceps tendon from the radius in four middle-aged men. All regained a full range of movement with minimal loss of power.
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Affiliation(s)
- S J Barnes
- Princess Alexandra Hospital, Brisbane, Australia
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30
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Abstract
A novel repair of the distal urethra with glanular and preputial reconstruction is described for distal penile hypospadias; 52 consecutive patients underwent this procedure without catheter splintage or urinary diversion. All voided without problems on the day of operation; 44 (85%) were treated as day cases, while the remaining 8 boys stayed in hospital for at least 1 night post-operatively for reasons not associated with the operation. Follow-up was complete and ranged from 15 to 30 months (mean 18). There was no evidence of meatal stenosis, phimosis or urethral stricture; 26 boys (50%) had associated chordee pre-operatively which was incompletely corrected in 2 (8%). These have a minor degree of chordee of glans on penile shaft and neither has required further treatment. Four boys (8%) developed partial wound breakdown which necessitated reconstruction in 2 and both of these have now been treated successfully. Functional and cosmetic results are excellent.
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Affiliation(s)
- D Gilpin
- Northern Ireland Paediatric Surgical Service, Belfast
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31
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Gilpin D. Intussusception of the appendix. Ulster Med J 1989; 58:193-5. [PMID: 2603275 PMCID: PMC2448204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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32
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Abstract
The literature on the psychodynamics and treatment of transsexualism indicates a pathological mother-son relationship, yet uniformly recommends a male therapist. A case of a six-year-old boy with transsexual symptoms treated by a female therapist is presented, and there is a discussion of the theory and implications arising from the case.
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