Jack A. Barnett

Serratia marcescens infections from inhalation therapy medications: nosocomial outbreak.

Abstract An outbreak of nosocomial infections caused by non-pigmentedSerratia marcescensis described. There were 655 bacterial isolates from 374 patients during a 10-month period; 50.4% of isolates...

Local immune response in experimental pyelonephritis

Experiments using an in vitro method of assessing protein synthesis by (14)C amino acid incorporation were designed to determine whether pyelonephritic kidneys were capable of local antibody production. Unilateral pyelonephritis was produced in rabbits by intravenous injection of E. coli 0-75 while one ureter was transiently occluded. The capability of protein and immunoglobulin synthesis by pyelonephritic kidneys, contralateral kidneys, normal kidneys, and spleens from normal and pyelonephritic animals was measured. Enhanced protein and immunoglobulin syntheses by pyelonephritic kidneys were first detected by the 11th day after infection and persisted through day 120. In individual experiments the pyelonephritic kidney produced 6-170 times more soluble protein than did the contralateral, uninfected kidney. In seven experiments, IgG comprised a mean of 72% of the total protein synthesized by the pyelonephritic kidney, compared with a mean of 19% in the contralateral kidney. IgA accounted for 10 and 9%, respectively. In these experiments 0.6-17% of the synthesized IgG was precipitable by somatic antigen of the E. coli 0-75. The capability of the pyelonephritic kidney to synthesize soluble protein was quantitatively similar to that of spleens from infected animals. The proportion of synthesized protein which was immunoglobulin G, however, was greater in the pyelonephritic kidney than in the spleen. Furthermore, specific antibody synthesis by the pyelonephritic kidney persisted longer than did synthesis by the spleen of the same animal. These studies provide evidence that in experimental pyelonephritis a significant local immune response occurs which is represented primarily by the production of IgG. Local immunoglobulin formation and specific antibody synthesis may be important factors in determining patterns of host resistance.

Clinical and laboratory features of epidemic St. Louis encephalitis.

Abstract An epidemic of St. Louis encephalitis in Dallas, Tex., in 1966 again showed the characteristic clinical and epidemiological features of this disease: the occurrence of encephalitis in elde...

Escherichia coli bacteremia in the squirrel monkey. I. Effect of cobra venom factor treatment.

Squirrel monkeys were significantly depleted of complement by a nontoxic protein constituent of cobra venom, and the influence of cobra factor (CoF) treatment on the course of Escherichia coli bacteremia was studied. Striking neutropenia occurred rapidly in control animals while the rate of occurrence of neutropenia was 20 to 30 times slower in the CoF-treated animals, suggesting that the E. coli-induced neutropenia was at least partially a complement-mediated response. In the CoF-treated monkeys, the initial rate of clearance of the E. coli from the circulation tended to be slower and the resultant levels of bacteremia were higher than in control animals. These observations are consistent with a hypothesis that complement-mediated neutrophilic leucocyte function is an important host defense mechanism in gram-ngeative bacillary bacteremia.

Microbiologic study of wound infections in tornado casualties

Cultures for aerobic, anaerobic, fungal, and mycobacterial organisms were performed on 59 tornado-associated wounds in 47 patients. Most impressive was the frequent identification of aerobic gram-negative bacilli. Seventy-five percent of the wounds cultured organisms, yet the infections were generally benign and self-limited. Evidence is presented which favors a soil, rather than nosocomial, source for the bacteria in the wounds of the hospitalized patients. The guidelines for treatment of tornado-induced wounds include removal of environmental debris, antitetanus prophylaxis, and delayed primary wound closure.

Chronic meningitis--a clinical dilemma.

Lumbar puncture should be performed promptly and carefully on the patient with even a trace of meningeal irritation. The best approach to the clinical dilemma of chronic meningitis is a methodical, stepwise assessment of diagnostic possibilities as indicated by the cell count and sugar concentration of the cerebrospinal fluid. An approach to management based on categorization of patients according to these variables is outlined, and antimicrobial treatment schedules are presented.

Opsonic Property of Multiple Myeloma Serum.

Summary The opsonic activity of serum from 7 patients with multiple myeloma was studied in a phagocytic system employing human leucocytes and a strain of E. coli 0-4. It was demonstrated that these patients have sufficient heat-labile opsonin to promote phagocytosis and intracellular killing of the ingested organisms. The presence of myeloma protein did not interfere with this property.

Clinical Features of Epidemic St. Louis Encephalitis.

Excerpt Epidemic St. Louis Encephalitis (SLE), which occurred in Dallas in late summer 1966, afforded the opportunity for sequential prospective clinical studies. Concurrently, patients having cent...