Browsing by Author "Forder, A A"

Now showing 1 - 4 of 4
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    Legionella infections : a review of the literature and a prospective serological study of the incidence of Legionnaires disease at Groote Schuur Hospital
    (1989) De Goveia, C; Forder, A A; Naude, W du Toit
    A prospective study of patients with pneumonia admitted to Groote Schuur Hospital took place over a one-year period in an attempt to assess the incidence of legionella pneumonia. Acute and convalescent serum samples were obtained from 113 patients. Eight patients (7,1%) showed a fourfold rise in antibody titre against Legionella pneumophila group 1 antigen by indirect immunofluorescent test (IFAT). The findings suggest that legionella pneumonia, although not common, should be considered in the aetiology of pneumonia at Groote Schuur Hospital. The results are presented and a review of the literature is undertaken.
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    Nosocomial infections in intensive care
    (1993) Hammond, Janet Margaret Justine; Potgieter, Peter; Forder, A A
    The objectives of this thesis are : 1) To provide a review of the literature on the significance, pathogenesis, diagnosis and management of secondary infections in the Intensive Care Unit. 2) To present the findings of a study of the technique of selective parenteral and enteral antisepsis regimen (SPEAR) in the patient population of the Respiratory ICU at Groote Schuur Hospital, aimed at reducing the incidence of secondary infection and, further to evaluate the study in terms of the effect of SPEAR on the incidence of secondary infection and its influence on the mortality due to secondary infection. 3) To present the findings of the effect of SPEAR on patient bacterial colonisation in the ICU, and to evaluate its longterm influence on the microbial flora of the ICU.
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    Studies of gastric aspirate nitrite, pH, bacterial flora and mutagenicity in man
    (1987) Coldrey, Norman A; Forder, A A; Dent, David Marshall
    Gastric aspirate specimens were collected from patients w~th clinically diagnosed gastric carcinoma and from non-carcinoma patients. The nitrite concentration and pH values of the aspirates were measured, the microorganisms present in selected specimens were isolated and identified, and the mutagenicity ratios of the aspirates were determined. The median nitrite concentration of the gastric aspirates from the carcinoma patients was significantly higher than that obtained for the non-carcinoma patients. A positive correlation was found between the nitrite concentration and the pH values of all the specimens tested, and a marked increase in nitrite levels at pH values above 6,0 was evident in specimens from the coloured ethnic "normal" subgroup. Gastric aspirate nitrite concentrations did not correlate with salivary values. The presence of microorganisms in gastric aspirates was shown to be pH dependent. Gastric aspirates with a pH < 2,0 were sterile, below pH 4,0 only acidophilic bacteria survived, whereas above pH 4,0, numerous species, predominantly members of the oral microflora, were isolated. The mean mutagenicity ratio of the gastric aspirates from the carcinoma patients was found to be significantly higher than that found for the control group. There was a positive correlation between the mutagenicity ratios of all the gastric specimens and pH with a maximum at a pH value of approximately 6,0.
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    A study to determine the efficacy of A 0,2 μm air venting final in-line intravenous filter in reducing the complications of intravenous therapy
    (1984) Stanford, J A; Folb, Peter I; Forder, A A
    The effect of a 0,2 μm air venting in-line filter on the incidence of post-infusion phlebitis was studied in a prospective, controlled, observer-blind investigation of 132 infusions. The filters were changed daily and the infusions were allowed to continue until no longer required, or until there was a reason for discontinuation. Microbiological evaluation of filters, skin at the site of cannulation immediately prior to removal of cannulae, and cannula tips was performed. Particle size analyses of the commonly used intravenous infusion fluids and medicines was also carried out. The incidence of phlebitis was significantly reduced by the inclusion of the filter in-line. The efficacy of the filter in reducing phlebitis was most pronounced when intravenous antimicrobial agents, especially the cephalosporins, were administered. Micro-organisms were isolated from 13% (28/209) of filters which originated from 31% (16/32) of infusions with filters in-line. A relationship could not be established between the number of filters used per infusion or the number of intravenous additives to the infusion system. Phlebitis was not associated with microbial contamination of cannula tips. Medicines for intravenous administration, especially the powders to be reconstituted prior to administration, were heavily contaminated with particulate matter prior to filtration.