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Postoperative candida infection
Injury Oct. 1970
INJURY; THE BRITISH JOURNAL OF ACCIDENT SURGERY
158
e m b o l i s m r e m a i n s a m a j o r cause of death, n o t only in the surgery o f t r a u m a b u t in all m a j o r operations, especially those involving the pelvis. Experience o f r o u t i n e a n t i c o a g u l a t i o n d u r i n g t h e past two years has clearly s h o w n a decrease o f t h r o m b o - e m b o l i s m b o t h after surgery a n d after conservative treatment. I n some instances, especially in older patients, disturbed liver function d e m a n d s s o m e caution, t h o u g h complications f r o m a n t i c o a g u l a t i o n have been few. T h e a d m i n i s t r a t i o n o f a n t i c o a g u l a n t s is tailed off w h e n the p a t i e n t is discharged a n d this has h a d n o h a r m f u l effects ( c f T u b i a n a a n d D u p a r c , 1961; H a r r i s a n d others, 1967). Acknowledgement I wish to record m y t h a n k s to Professor Sven R e h n b e r g , h e a d o f the Surgical D e p a r t m e n t o f
Koskela article.
Hospital,
Helsinki,
for
reading this
REFERENCES HARRIS, W. H., SALZMAN, E. W., and DESANTIS, R. W. (1967), ' T h e Prevention of Thromboembolic Disease by Prophylactic Anticoagulation. A Controlled Study in Elective Hip Surgery ', J. Bone Jt Surg., 49A, 81. RISKA, E. B. (1970), ' F a c t o r s influencing Primary Mortality in the Treatment of Hip Fractures', Injury, 2, 107. SEVITT, S., and GALLAGHER,N. G. (1959), ' Prevention of Venous Thrombosis and Pulmonary Embolism in Injured Patients. A Trial of Anticoagulant Prophylaxis with Phenindione in Middle-aged and Elderly Patients with Fractured Necks of the Femur', Lancet, 2, 981. TUBIANA, R., and DUPARC, J. (1961), ' Prevention of Thrombo-embolic Complications in Orthopaedic and Accident Surgery ', J. Bone Jt Surg., 43B, 7.
Requests for reprints shouM be addressed to:--Dr. E. B. Riska, Department of Orthopaedics and Traumatology, University Central Hospital, Helslnki 26, Finland.
ABSTRACTS BACTERIA AND INFECTION
Neomycin-resistant Dwarf Colonies of Staphylococcus Aureus Dwarf-colony variants of Staph. aureus resistant to aminoglucoside antibiotics (which include neomycin and kanamycin) were produced by growing sensitive organisms in media containing either a long-chain fatty acid (linoleic acid) or an aminoglucoside antibiotic (paromomycin). Dwarf-colony variants persisted better than the parent organisms on normal skin. Treatment with aminoglucoside antibiotics might therefore select staphylococci which have better capacity to survive on the skin of carriers. LACEY,R. W. (1969), ' D w a r f Colony Variants of Staphylococcus aureus Resistant to Aminoglucoside Antibiotics and to a Fatty Acid ', J. reed. Microbiol., 2, 187.
Postoperative Candida Infection Endocarditis due to Candida albicans or Candida parapsilosis after aortic valve homografts on 6 patients was associated with high titres of agglutinins to Candida spp. Raised titres of agglutinins developed in 14 out of 62 other patients during the second week after open-heart operations, and were thought to show the presence of otherwise undetected candida infection. MURRAY, I. G., BUCKLEY, H. R., and TURNER, G. C. (1969), 'Serological Evidence of Candida Infection after Open Heart Surgery ', J. reed. Microbiol., 2, 463.
Typing of Proteus When two unrelated strains of Proteus swarm towards each other across an agar plate, a macroscopic ' d i t c h ' due to mutual inhibition occurs in the
lawn of growth where the two swarming fronts meet (the Dienes phenomenon); no Dienes line appeared at the junction of identical strains. This has been used for some years as the basis for a method of typing Proteus spp. The author has reassessed the value of this method, and finds that 48 strains were found to be divisible into 35 Dienes types. Replicate isolations from the same patient almost always showed identity of Dienes type. Because of its simplicity, specificity, and reproducibility the Dienes typing method is considered valuable in studies on the sources and routes of cross-infection with Proteus spp. SKIRROW, M. B. (1969), ' T h e Dienes (Mutual Inhibition) Test in Investigation of Proteus Infections ', J. med. Microbiol., 2, 471.
Resistogram Typing of Bacteria The pattern of sensitivity and resistance of bacteria to a range of chemical compounds other than antibiotics is used as a method of typing. Preliminary studies with Escherichia coil showed good agreement between serological and ' resistogram ' typing results. ELEK, S. D., and HIGNEY,L. (1970), ' Resistogram Typing--a New Epidemiological Tool ', J. med. Microbiol., 3, 103.
Virulence of Staphylococcus Aureus A strain of Staphylococcus aureus passaged in rabbits showed a large increase in virulence for the rabbit. Passaged strains grown in vitro were less virulent than those grown in vivo; the former died but the latter multiplied in rabbit serum and in lysates of polymorphonuclear leucocytes. It is suggested that resistance to serum and polymorphonuclear bactericidins is an important attribute of the virulence of staphylococci. ADLAM, C., PEARCE,J. H., and SMITH,H. (1970), 'Virulence Mechanisms of Staphylococci grown in vivo and in vitro ', J. med. Microbiol., 3, 147.
INJURY; THE BRITISH JOURNAL OF ACCIDENT SURGERY
158
e m b o l i s m r e m a i n s a m a j o r cause of death, n o t only in the surgery o f t r a u m a b u t in all m a j o r operations, especially those involving the pelvis. Experience o f r o u t i n e a n t i c o a g u l a t i o n d u r i n g t h e past two years has clearly s h o w n a decrease o f t h r o m b o - e m b o l i s m b o t h after surgery a n d after conservative treatment. I n some instances, especially in older patients, disturbed liver function d e m a n d s s o m e caution, t h o u g h complications f r o m a n t i c o a g u l a t i o n have been few. T h e a d m i n i s t r a t i o n o f a n t i c o a g u l a n t s is tailed off w h e n the p a t i e n t is discharged a n d this has h a d n o h a r m f u l effects ( c f T u b i a n a a n d D u p a r c , 1961; H a r r i s a n d others, 1967). Acknowledgement I wish to record m y t h a n k s to Professor Sven R e h n b e r g , h e a d o f the Surgical D e p a r t m e n t o f
Koskela article.
Hospital,
Helsinki,
for
reading this
REFERENCES HARRIS, W. H., SALZMAN, E. W., and DESANTIS, R. W. (1967), ' T h e Prevention of Thromboembolic Disease by Prophylactic Anticoagulation. A Controlled Study in Elective Hip Surgery ', J. Bone Jt Surg., 49A, 81. RISKA, E. B. (1970), ' F a c t o r s influencing Primary Mortality in the Treatment of Hip Fractures', Injury, 2, 107. SEVITT, S., and GALLAGHER,N. G. (1959), ' Prevention of Venous Thrombosis and Pulmonary Embolism in Injured Patients. A Trial of Anticoagulant Prophylaxis with Phenindione in Middle-aged and Elderly Patients with Fractured Necks of the Femur', Lancet, 2, 981. TUBIANA, R., and DUPARC, J. (1961), ' Prevention of Thrombo-embolic Complications in Orthopaedic and Accident Surgery ', J. Bone Jt Surg., 43B, 7.
Requests for reprints shouM be addressed to:--Dr. E. B. Riska, Department of Orthopaedics and Traumatology, University Central Hospital, Helslnki 26, Finland.
ABSTRACTS BACTERIA AND INFECTION
Neomycin-resistant Dwarf Colonies of Staphylococcus Aureus Dwarf-colony variants of Staph. aureus resistant to aminoglucoside antibiotics (which include neomycin and kanamycin) were produced by growing sensitive organisms in media containing either a long-chain fatty acid (linoleic acid) or an aminoglucoside antibiotic (paromomycin). Dwarf-colony variants persisted better than the parent organisms on normal skin. Treatment with aminoglucoside antibiotics might therefore select staphylococci which have better capacity to survive on the skin of carriers. LACEY,R. W. (1969), ' D w a r f Colony Variants of Staphylococcus aureus Resistant to Aminoglucoside Antibiotics and to a Fatty Acid ', J. reed. Microbiol., 2, 187.
Postoperative Candida Infection Endocarditis due to Candida albicans or Candida parapsilosis after aortic valve homografts on 6 patients was associated with high titres of agglutinins to Candida spp. Raised titres of agglutinins developed in 14 out of 62 other patients during the second week after open-heart operations, and were thought to show the presence of otherwise undetected candida infection. MURRAY, I. G., BUCKLEY, H. R., and TURNER, G. C. (1969), 'Serological Evidence of Candida Infection after Open Heart Surgery ', J. reed. Microbiol., 2, 463.
Typing of Proteus When two unrelated strains of Proteus swarm towards each other across an agar plate, a macroscopic ' d i t c h ' due to mutual inhibition occurs in the
lawn of growth where the two swarming fronts meet (the Dienes phenomenon); no Dienes line appeared at the junction of identical strains. This has been used for some years as the basis for a method of typing Proteus spp. The author has reassessed the value of this method, and finds that 48 strains were found to be divisible into 35 Dienes types. Replicate isolations from the same patient almost always showed identity of Dienes type. Because of its simplicity, specificity, and reproducibility the Dienes typing method is considered valuable in studies on the sources and routes of cross-infection with Proteus spp. SKIRROW, M. B. (1969), ' T h e Dienes (Mutual Inhibition) Test in Investigation of Proteus Infections ', J. med. Microbiol., 2, 471.
Resistogram Typing of Bacteria The pattern of sensitivity and resistance of bacteria to a range of chemical compounds other than antibiotics is used as a method of typing. Preliminary studies with Escherichia coil showed good agreement between serological and ' resistogram ' typing results. ELEK, S. D., and HIGNEY,L. (1970), ' Resistogram Typing--a New Epidemiological Tool ', J. med. Microbiol., 3, 103.
Virulence of Staphylococcus Aureus A strain of Staphylococcus aureus passaged in rabbits showed a large increase in virulence for the rabbit. Passaged strains grown in vitro were less virulent than those grown in vivo; the former died but the latter multiplied in rabbit serum and in lysates of polymorphonuclear leucocytes. It is suggested that resistance to serum and polymorphonuclear bactericidins is an important attribute of the virulence of staphylococci. ADLAM, C., PEARCE,J. H., and SMITH,H. (1970), 'Virulence Mechanisms of Staphylococci grown in vivo and in vitro ', J. med. Microbiol., 3, 147.