Matthew Dryden - Academia.edu (original) (raw)
Papers by Matthew Dryden
Infectious Diseases and Therapy, 2020
Aim: Exploratory analyses evaluated patient characteristics and outcomes among patients with comp... more Aim: Exploratory analyses evaluated patient characteristics and outcomes among patients with complicated skin and soft tissue infection (cSSTI) in the phase 3 COVERS study who were admitted to an intensive care unit (ICU). Methods: Adults with cSSTI (surface area C 75 cm 2) and evidence of systemic inflammation and/or underlying comorbidities were randomized 2:1 to intravenous ceftaroline fosamil Digital Features To view digital features for this article go to https://doi.org/10.6084/m9.figshare. 12006168.
The Journal of Applied Laboratory Medicine, 2018
Background Currently it can take up to 5 days to rule out bloodstream infection. With the low yie... more Background Currently it can take up to 5 days to rule out bloodstream infection. With the low yield of blood cultures (approximately 10%), a significant number of patients are potentially exposed to inappropriate therapy that can lead to adverse events. More rapid rule out can accelerate deescalation or cessation of antimicrobial therapy, improving patient outcomes. Methods A method is described, termed enzymatic template generation and amplification (ETGA), that universally and sensitively detects DNA polymerase activity liberated from viable bacteria and fungi isolated from blood culture samples as a measure of bloodstream infection. ETGA was applied in a diagnostic test format to identify negative blood cultures after an overnight incubation. Performance data for a prototype (Cognitor) and automated (Magnitor) version of the test are presented. Results The Cognitor manual assay displayed analytical reactivity for a panel of the 20 most prevalent causes of bloodstream infection, w...
![Research paper thumbnail of Corrigendum to 'Panton-Valentine Leucocidin (PVL) Staphylococcus aureus a position statement from the International Society of Chemotherapy' [International Journal of Antimicrobial Agents 51/1 (2018) 16-25]](https://attachments.academia-assets.com/104817898/thumbnails/1.jpg)
](International journal of antimicrobial agents, Jul 20, 2018
Le infezioni in medicina : rivista periodica di eziologia, epidemiologia, diagnostica, clinica e terapia delle patologie infettive, 2017
A case of amoebic colitis and liver abscess is described in a previously fit 59-year old man who ... more A case of amoebic colitis and liver abscess is described in a previously fit 59-year old man who had been given the incorrect diagnosis of ulcerative colitis. His symptoms were so severe that a colectomy was being considered. The patient had a significant travel history including trips to Morocco, the Gambia and Cape Verde, putting him at risk of acquiring amoebic disease. However, this history was not ascertained until much later on in the disease process. The case highlighted crucial learning points including the importance of taking a lifelong travel history, the difficulties in telling ulcerative colitis and amoebic colitis apart both clinically and histopathologically, and the importance of sending multiple stool samples for parasitological microscopy analysis in patients being investigated for inflammatory bowel disease.
Journal of the Royal Society of Medicine, 1999
our patient this treatment was only partly successful. Endoscopic clearance of the diverticulum m... more our patient this treatment was only partly successful. Endoscopic clearance of the diverticulum may solve the problem2; but, failing non-operative treatment, diverticulectomy should be considered. This can be a difficult operation with a high morbidity, especially for diverticula in the juxtapapillary region. Smith3 reported a case very similar to ours. A giant duodenal diverticulum obstructed the third part of the duodenum and had to be resected.
Open Forum Infectious Diseases, 2016
International journal of antimicrobial agents, Jan 27, 2017
A number of novel antimicrobial drugs with activity against Gram positive bacterial pathogens hav... more A number of novel antimicrobial drugs with activity against Gram positive bacterial pathogens have been licensed in the past four years. These drugs have the potential to enrich the group of intravenous drugs already available that are in common use against methicillin resistant Staphylococcus aureus, vancomycin resistant Enterococcus, and other antibiotic resistant Gram positive pathogens. The advantages and disadvantages of these drugs are not yet fully realized. Here we review the five most promising newly approved compounds: ceftaroline, ceftobiprole, oritavancin, dalbavancin and tedizolid. The advantages of their dosing regimens, their mechanisms of action, adverse effect profiles, evidence for their clinical usefulness, and the unique characteristics that distinguish them from one another and from older drugs are reviewed.
International wound journal, Jan 21, 2015
Reactive oxygen species (ROS) play a pivotal role in the orchestration of the normal wound-healin... more Reactive oxygen species (ROS) play a pivotal role in the orchestration of the normal wound-healing response. They act as secondary messengers to many immunocytes and non-lymphoid cells, which are involved in the repair process, and appear to be important in coordinating the recruitment of lymphoid cells to the wound site and effective tissue repair. ROS also possess the ability to regulate the formation of blood vessels (angiogenesis) at the wound site and the optimal perfusion of blood into the wound-healing area. ROS act in the host's defence through phagocytes that induce an ROS burst onto the pathogens present in wounds, leading to their destruction, and during this period, excess ROS leakage into the surrounding environment has further bacteriostatic effects. In light of these important roles of ROS in wound healing and the continued quest for therapeutic strategies to treat wounds in general and chronic wounds, such as diabetic foot ulcers, venous and arterial leg ulcers a...
International journal of antimicrobial agents, Jan 24, 2015
As a follow-up to our 2009 survey, in order to explore opinion and practice on the epidemiology a... more As a follow-up to our 2009 survey, in order to explore opinion and practice on the epidemiology and management of meticillin-resistant Staphylococcus aureus (MRSA) in Europe, we conducted a second survey to elicit current opinions on this topic, particularly around antibiotic choice, dose, duration and route of administration. We also aimed to further understand how the management of MRSA has evolved in Europe during the past 5 years. Members of an expert panel of infectious diseases specialists convened in London (UK) in January 2014 to identify and discuss key issues in the management of MRSA. Following this meeting, a survey was developed comprising 36 questions covering a wide range of topics on MRSA complicated skin and soft-tissue infection and nosocomial pneumonia management. The survey instrument, a web-based questionnaire, was sent to the International Society of Chemotherapy for distribution to registered European infection societies and their members. This article reports...
Current opinion in infectious diseases, 2015
A number of novel antibiotics in different classes have been registered and licensed in recent ye... more A number of novel antibiotics in different classes have been registered and licensed in recent years for complicated skin and soft tissue infections or acute bacterial skin and skin structure infections. Many of these have activity against resistant gram-positive bacteria (linezolid, daptomycin, oritavancin, dalbavancin and tedizolid). In addition, two have gram-negative activity (ceftaroline and tigecycline). The licence for the clinical use of these agents is very narrow, but the clinical need is much broader. This is a personal opinion of the prospective clinical roles for these novel antibiotics. All were found to be noninferior to standard comparators in registration trials. There are few data on their use in other clinical conditions outside the narrow confines of the registration trials. 'Off-label' use is likely to be more common than the licensed use, and data need to be collected on clinical and microbiological efficacy and adverse effects in real life. There is no...
The Journal of antimicrobial chemotherapy, 2014
There is increasing demand for prosthetic joint surgery and patients are becoming more challengin... more There is increasing demand for prosthetic joint surgery and patients are becoming more challenging due to an ageing population often with comorbidities and immunosuppression. While prosthetic joint infection (PJI) rates are generally low, infection can be catastrophic for the patient and hence prevention of infection is critical. Infection, when it does occur, is further complicated by the global rise in antimicrobial resistance. This article introduces a series of papers on the epidemiology of PJI, its diagnosis, use of novel inflammatory markers and molecular techniques, clinical presentation, importance of biofilms, treatment guidelines and, finally, various strategies and novel antibiotic treatment regimens.
BMJ (Clinical research ed.), Jan 19, 2012
Environmental Science & Technology, 2014
The branching ratios for the reaction of the OH radical with the primary and secondary alkylamine... more The branching ratios for the reaction of the OH radical with the primary and secondary alkylamines: methylamine (MA), dimethylamine (DMA), and ethylamine (EA), have been determined using the technique of pulsed laser photolysis-laser-induced fluorescence. Titration of the carbon-centered radical, formed following the initial OH abstraction, with oxygen to give HO2 and an imine, followed by conversion of HO2 to OH by reaction with NO, resulted in biexponential OH decay traces on a millisecond time scale. Analysis of the biexponential curves gave the HO2 yield, which equaled the branching ratio for abstraction at αC-H position, r(αC-H). The technique was validated by reproducing known branching ratios for OH abstraction for methanol and ethanol. For the amines studied in this work (all at 298 K): r(αC-H,MA) = 0.76 ± 0.08, r(αC-H,DMA) = 0.59 ± 0.07, and r(αC-H,EA) = 0.49 ± 0.06 where the errors are a combination in quadrature of statistical errors at the 2σ level and an estimated 10% systematic error. The branching ratios r(αC-H) for OH reacting with (CH3)2NH and CH3CH2NH2 are in agreement with those obtained for the OD reaction with (CH3)2ND (d-DMA) and CH3CH2ND2 (d-EA): r(αC-H,d-DMA) = 0.71 ± 0.12 and r(αC-H,d-EA) = 0.54 ± 0.07. A master equation analysis (using the MESMER package) based on potential energy surfaces from G4 theory was used to demonstrate that the experimental determinations are unaffected by formation of stabilized peroxy radicals and to estimate atmospheric pressure yields. The branching ratio for imine formation through the reaction of O2 with α carbon-centered radicals at 1 atm of N2 are estimated as r(CH2NH2) = 0.79 ± 0.15, r(CH2NHCH3) = 0.72 ± 0.19, and r(CH3CHNH2) = 0.50 ± 0.18. The implications of this work on the potential formation of nitrosamines and nitramines are briefly discussed.
Journal of Antimicrobial Chemotherapy, 2014
There is global concern that antimicrobial resistance is a major threat to healthcare. Antimicrob... more There is global concern that antimicrobial resistance is a major threat to healthcare. Antimicrobial use is a primary driver of resistance but little information exists about the variation in antimicrobial use in individual hospitals in England over time or comparative use between hospitals. The objective of this study was to collate, analyse and report issue data from pharmacy records of 158 National Health Service (NHS) acute hospitals. Methods: This was a cohort study of inpatient antibacterial use in acute hospitals in England analysed over 5 years through a data warehouse from IMS Health, a leading provider of information, services and technology for the healthcare industry. Around 98% of NHS hospitals were included in a country with a population of 50 million residents. Results: There was a dramatic change in the usage of different groups of antibacterials between 2009 and 2013 with a marked reduction in the use of first-generation cephalosporins by 24.7% and second-generation cephalosporins by 41%, but little change in the use of third-generation cephalosporins (+5.7%) and fluoroquinolones (+1.6%). In contrast, use of co-amoxiclav, carbapenems and piperacillin/tazobactam increased by 60.1%, 61.4% and 94.8%, respectively. There was wide variation in the total and relative amounts of antibacterials used between individual hospitals. Conclusions: Longitudinal analysis of antibacterial use demonstrated remarkable changes in NHS hospitals, probably reflecting governmental and professional guidance to mitigate the risk of Clostridium difficile infection. The wide variation in usage between individual hospitals suggests potential for quality improvement and benchmarking. Quality measures of optimal hospital antimicrobial prescribing need urgent development and validation to support antimicrobial stewardship initiatives.
BMC Research Notes, 2015
Background: Antimicrobial resistance continues to be a global issue in healthcare organisations. ... more Background: Antimicrobial resistance continues to be a global issue in healthcare organisations. Honey has long been shown to possess wound healing and antimicrobial properties that are dependent on a number of physical and chemical properties of the honey. We tested the antimicrobial activity of a medicinal honey, Surgihoney® (SH) and two prototype modified honeys made by Apis mellifera (honeybee) against Staphylococcus aureus (NCIMB 9518). We also examined the modified honey prototypes for the ability to generate reactive oxygen species (ROS) by changing the level of production of hydrogen peroxide from the samples. Methods: Surgihoney® (SH) was compared with two modified honeys, Prototype 1 (PT1) and Prototype 2 (PT2) using a bioassay method against a standard strain of Staphylococcus aureus. Further work studied the rate of generation of ROS hydrogen peroxide from these preparations. Results: Surgihoney® antimicrobial activity was shown to be largely due to ROS hydrogen peroxide production. By modification of Surgihoney®, two more potent honey prototypes were shown to generate between a two-and threefold greater antibacterial activity and up to ten times greater ROS peroxide activity. Conclusions: Surgihoney® is a clinically available wound antiseptic dressing that shows good antimicrobial activity. Two further honey prototypes have been shown to have antimicrobial activity that is possible to be enhanced due to demonstrated increases in ROS peroxide activity.
Journal of Infection, 2012
Hospital outbreaks of group A streptococcal (GAS) infection can be devastating and occasionally r... more Hospital outbreaks of group A streptococcal (GAS) infection can be devastating and occasionally result in the death of previously well patients. Approximately one in ten cases of severe GAS infection is healthcare-associated. This guidance, produced by a multidisciplinary working group, provides an evidence-based systematic approach to the investigation of single cases or outbreaks of healthcare-associated GAS infection in acute care or maternity settings. The guideline recommends that all cases of GAS infection potentially acquired in hospital or through contact with healthcare or maternity services should be investigated. Healthcare workers, the environment, and other patients are possible sources of transmission. Screening of epidemiologically linked healthcare workers should be considered for healthcare-associated cases of GAS infection where no alternative source is readily identified. Communal facilities, such as baths, bidets and showers, should be cleaned and decontaminated between all patients especially on delivery suites, post-natal wards and other high risk areas. Continuous surveillance is required to identify outbreaks which arise over long periods of time. GAS isolates from in-patients, peri-partum patients, neonates, and post-operative wounds should be saved for six months to facilitate outbreak investigation. These guidelines do not cover diagnosis and treatment of GAS infection which should be discussed with an infection specialist.
Journal of Hospital Infection, 2010
The qacA/B gene(s) has become a major antiseptic resistance gene in MRSA, hence the prevalence of... more The qacA/B gene(s) has become a major antiseptic resistance gene in MRSA, hence the prevalence of qacA/B genes in the hospital environment must be considered. Their survival might be due either to selective pressure imposed by use of cationic antisceptic agents or due to cross-resistance and co-resistance between these agents and antibiotics. Epidemiological information on antiseptic susceptibility and the distribution of resistance genes is useful for nosocomial infection control.
Journal of Antimicrobial Chemotherapy, 2008
These guidelines have been developed by a Working Party convened on behalf of the British Society... more These guidelines have been developed by a Working Party convened on behalf of the British Society for Antimicrobial Chemotherapy. Their aim is to provide general practitioners and other communityand hospital-based healthcare professionals with pragmatic advice about when to suspect MRSA infection in the community, when and what cultures should be performed and what should be the management options, including the need for hospitalization.
Infectious Diseases and Therapy, 2020
Aim: Exploratory analyses evaluated patient characteristics and outcomes among patients with comp... more Aim: Exploratory analyses evaluated patient characteristics and outcomes among patients with complicated skin and soft tissue infection (cSSTI) in the phase 3 COVERS study who were admitted to an intensive care unit (ICU). Methods: Adults with cSSTI (surface area C 75 cm 2) and evidence of systemic inflammation and/or underlying comorbidities were randomized 2:1 to intravenous ceftaroline fosamil Digital Features To view digital features for this article go to https://doi.org/10.6084/m9.figshare. 12006168.
The Journal of Applied Laboratory Medicine, 2018
Background Currently it can take up to 5 days to rule out bloodstream infection. With the low yie... more Background Currently it can take up to 5 days to rule out bloodstream infection. With the low yield of blood cultures (approximately 10%), a significant number of patients are potentially exposed to inappropriate therapy that can lead to adverse events. More rapid rule out can accelerate deescalation or cessation of antimicrobial therapy, improving patient outcomes. Methods A method is described, termed enzymatic template generation and amplification (ETGA), that universally and sensitively detects DNA polymerase activity liberated from viable bacteria and fungi isolated from blood culture samples as a measure of bloodstream infection. ETGA was applied in a diagnostic test format to identify negative blood cultures after an overnight incubation. Performance data for a prototype (Cognitor) and automated (Magnitor) version of the test are presented. Results The Cognitor manual assay displayed analytical reactivity for a panel of the 20 most prevalent causes of bloodstream infection, w...
International journal of antimicrobial agents, Jul 20, 2018
Le infezioni in medicina : rivista periodica di eziologia, epidemiologia, diagnostica, clinica e terapia delle patologie infettive, 2017
A case of amoebic colitis and liver abscess is described in a previously fit 59-year old man who ... more A case of amoebic colitis and liver abscess is described in a previously fit 59-year old man who had been given the incorrect diagnosis of ulcerative colitis. His symptoms were so severe that a colectomy was being considered. The patient had a significant travel history including trips to Morocco, the Gambia and Cape Verde, putting him at risk of acquiring amoebic disease. However, this history was not ascertained until much later on in the disease process. The case highlighted crucial learning points including the importance of taking a lifelong travel history, the difficulties in telling ulcerative colitis and amoebic colitis apart both clinically and histopathologically, and the importance of sending multiple stool samples for parasitological microscopy analysis in patients being investigated for inflammatory bowel disease.
Journal of the Royal Society of Medicine, 1999
our patient this treatment was only partly successful. Endoscopic clearance of the diverticulum m... more our patient this treatment was only partly successful. Endoscopic clearance of the diverticulum may solve the problem2; but, failing non-operative treatment, diverticulectomy should be considered. This can be a difficult operation with a high morbidity, especially for diverticula in the juxtapapillary region. Smith3 reported a case very similar to ours. A giant duodenal diverticulum obstructed the third part of the duodenum and had to be resected.
Open Forum Infectious Diseases, 2016
International journal of antimicrobial agents, Jan 27, 2017
A number of novel antimicrobial drugs with activity against Gram positive bacterial pathogens hav... more A number of novel antimicrobial drugs with activity against Gram positive bacterial pathogens have been licensed in the past four years. These drugs have the potential to enrich the group of intravenous drugs already available that are in common use against methicillin resistant Staphylococcus aureus, vancomycin resistant Enterococcus, and other antibiotic resistant Gram positive pathogens. The advantages and disadvantages of these drugs are not yet fully realized. Here we review the five most promising newly approved compounds: ceftaroline, ceftobiprole, oritavancin, dalbavancin and tedizolid. The advantages of their dosing regimens, their mechanisms of action, adverse effect profiles, evidence for their clinical usefulness, and the unique characteristics that distinguish them from one another and from older drugs are reviewed.
International wound journal, Jan 21, 2015
Reactive oxygen species (ROS) play a pivotal role in the orchestration of the normal wound-healin... more Reactive oxygen species (ROS) play a pivotal role in the orchestration of the normal wound-healing response. They act as secondary messengers to many immunocytes and non-lymphoid cells, which are involved in the repair process, and appear to be important in coordinating the recruitment of lymphoid cells to the wound site and effective tissue repair. ROS also possess the ability to regulate the formation of blood vessels (angiogenesis) at the wound site and the optimal perfusion of blood into the wound-healing area. ROS act in the host's defence through phagocytes that induce an ROS burst onto the pathogens present in wounds, leading to their destruction, and during this period, excess ROS leakage into the surrounding environment has further bacteriostatic effects. In light of these important roles of ROS in wound healing and the continued quest for therapeutic strategies to treat wounds in general and chronic wounds, such as diabetic foot ulcers, venous and arterial leg ulcers a...
International journal of antimicrobial agents, Jan 24, 2015
As a follow-up to our 2009 survey, in order to explore opinion and practice on the epidemiology a... more As a follow-up to our 2009 survey, in order to explore opinion and practice on the epidemiology and management of meticillin-resistant Staphylococcus aureus (MRSA) in Europe, we conducted a second survey to elicit current opinions on this topic, particularly around antibiotic choice, dose, duration and route of administration. We also aimed to further understand how the management of MRSA has evolved in Europe during the past 5 years. Members of an expert panel of infectious diseases specialists convened in London (UK) in January 2014 to identify and discuss key issues in the management of MRSA. Following this meeting, a survey was developed comprising 36 questions covering a wide range of topics on MRSA complicated skin and soft-tissue infection and nosocomial pneumonia management. The survey instrument, a web-based questionnaire, was sent to the International Society of Chemotherapy for distribution to registered European infection societies and their members. This article reports...
Current opinion in infectious diseases, 2015
A number of novel antibiotics in different classes have been registered and licensed in recent ye... more A number of novel antibiotics in different classes have been registered and licensed in recent years for complicated skin and soft tissue infections or acute bacterial skin and skin structure infections. Many of these have activity against resistant gram-positive bacteria (linezolid, daptomycin, oritavancin, dalbavancin and tedizolid). In addition, two have gram-negative activity (ceftaroline and tigecycline). The licence for the clinical use of these agents is very narrow, but the clinical need is much broader. This is a personal opinion of the prospective clinical roles for these novel antibiotics. All were found to be noninferior to standard comparators in registration trials. There are few data on their use in other clinical conditions outside the narrow confines of the registration trials. 'Off-label' use is likely to be more common than the licensed use, and data need to be collected on clinical and microbiological efficacy and adverse effects in real life. There is no...
The Journal of antimicrobial chemotherapy, 2014
There is increasing demand for prosthetic joint surgery and patients are becoming more challengin... more There is increasing demand for prosthetic joint surgery and patients are becoming more challenging due to an ageing population often with comorbidities and immunosuppression. While prosthetic joint infection (PJI) rates are generally low, infection can be catastrophic for the patient and hence prevention of infection is critical. Infection, when it does occur, is further complicated by the global rise in antimicrobial resistance. This article introduces a series of papers on the epidemiology of PJI, its diagnosis, use of novel inflammatory markers and molecular techniques, clinical presentation, importance of biofilms, treatment guidelines and, finally, various strategies and novel antibiotic treatment regimens.
BMJ (Clinical research ed.), Jan 19, 2012
Environmental Science & Technology, 2014
The branching ratios for the reaction of the OH radical with the primary and secondary alkylamine... more The branching ratios for the reaction of the OH radical with the primary and secondary alkylamines: methylamine (MA), dimethylamine (DMA), and ethylamine (EA), have been determined using the technique of pulsed laser photolysis-laser-induced fluorescence. Titration of the carbon-centered radical, formed following the initial OH abstraction, with oxygen to give HO2 and an imine, followed by conversion of HO2 to OH by reaction with NO, resulted in biexponential OH decay traces on a millisecond time scale. Analysis of the biexponential curves gave the HO2 yield, which equaled the branching ratio for abstraction at αC-H position, r(αC-H). The technique was validated by reproducing known branching ratios for OH abstraction for methanol and ethanol. For the amines studied in this work (all at 298 K): r(αC-H,MA) = 0.76 ± 0.08, r(αC-H,DMA) = 0.59 ± 0.07, and r(αC-H,EA) = 0.49 ± 0.06 where the errors are a combination in quadrature of statistical errors at the 2σ level and an estimated 10% systematic error. The branching ratios r(αC-H) for OH reacting with (CH3)2NH and CH3CH2NH2 are in agreement with those obtained for the OD reaction with (CH3)2ND (d-DMA) and CH3CH2ND2 (d-EA): r(αC-H,d-DMA) = 0.71 ± 0.12 and r(αC-H,d-EA) = 0.54 ± 0.07. A master equation analysis (using the MESMER package) based on potential energy surfaces from G4 theory was used to demonstrate that the experimental determinations are unaffected by formation of stabilized peroxy radicals and to estimate atmospheric pressure yields. The branching ratio for imine formation through the reaction of O2 with α carbon-centered radicals at 1 atm of N2 are estimated as r(CH2NH2) = 0.79 ± 0.15, r(CH2NHCH3) = 0.72 ± 0.19, and r(CH3CHNH2) = 0.50 ± 0.18. The implications of this work on the potential formation of nitrosamines and nitramines are briefly discussed.
Journal of Antimicrobial Chemotherapy, 2014
There is global concern that antimicrobial resistance is a major threat to healthcare. Antimicrob... more There is global concern that antimicrobial resistance is a major threat to healthcare. Antimicrobial use is a primary driver of resistance but little information exists about the variation in antimicrobial use in individual hospitals in England over time or comparative use between hospitals. The objective of this study was to collate, analyse and report issue data from pharmacy records of 158 National Health Service (NHS) acute hospitals. Methods: This was a cohort study of inpatient antibacterial use in acute hospitals in England analysed over 5 years through a data warehouse from IMS Health, a leading provider of information, services and technology for the healthcare industry. Around 98% of NHS hospitals were included in a country with a population of 50 million residents. Results: There was a dramatic change in the usage of different groups of antibacterials between 2009 and 2013 with a marked reduction in the use of first-generation cephalosporins by 24.7% and second-generation cephalosporins by 41%, but little change in the use of third-generation cephalosporins (+5.7%) and fluoroquinolones (+1.6%). In contrast, use of co-amoxiclav, carbapenems and piperacillin/tazobactam increased by 60.1%, 61.4% and 94.8%, respectively. There was wide variation in the total and relative amounts of antibacterials used between individual hospitals. Conclusions: Longitudinal analysis of antibacterial use demonstrated remarkable changes in NHS hospitals, probably reflecting governmental and professional guidance to mitigate the risk of Clostridium difficile infection. The wide variation in usage between individual hospitals suggests potential for quality improvement and benchmarking. Quality measures of optimal hospital antimicrobial prescribing need urgent development and validation to support antimicrobial stewardship initiatives.
BMC Research Notes, 2015
Background: Antimicrobial resistance continues to be a global issue in healthcare organisations. ... more Background: Antimicrobial resistance continues to be a global issue in healthcare organisations. Honey has long been shown to possess wound healing and antimicrobial properties that are dependent on a number of physical and chemical properties of the honey. We tested the antimicrobial activity of a medicinal honey, Surgihoney® (SH) and two prototype modified honeys made by Apis mellifera (honeybee) against Staphylococcus aureus (NCIMB 9518). We also examined the modified honey prototypes for the ability to generate reactive oxygen species (ROS) by changing the level of production of hydrogen peroxide from the samples. Methods: Surgihoney® (SH) was compared with two modified honeys, Prototype 1 (PT1) and Prototype 2 (PT2) using a bioassay method against a standard strain of Staphylococcus aureus. Further work studied the rate of generation of ROS hydrogen peroxide from these preparations. Results: Surgihoney® antimicrobial activity was shown to be largely due to ROS hydrogen peroxide production. By modification of Surgihoney®, two more potent honey prototypes were shown to generate between a two-and threefold greater antibacterial activity and up to ten times greater ROS peroxide activity. Conclusions: Surgihoney® is a clinically available wound antiseptic dressing that shows good antimicrobial activity. Two further honey prototypes have been shown to have antimicrobial activity that is possible to be enhanced due to demonstrated increases in ROS peroxide activity.
Journal of Infection, 2012
Hospital outbreaks of group A streptococcal (GAS) infection can be devastating and occasionally r... more Hospital outbreaks of group A streptococcal (GAS) infection can be devastating and occasionally result in the death of previously well patients. Approximately one in ten cases of severe GAS infection is healthcare-associated. This guidance, produced by a multidisciplinary working group, provides an evidence-based systematic approach to the investigation of single cases or outbreaks of healthcare-associated GAS infection in acute care or maternity settings. The guideline recommends that all cases of GAS infection potentially acquired in hospital or through contact with healthcare or maternity services should be investigated. Healthcare workers, the environment, and other patients are possible sources of transmission. Screening of epidemiologically linked healthcare workers should be considered for healthcare-associated cases of GAS infection where no alternative source is readily identified. Communal facilities, such as baths, bidets and showers, should be cleaned and decontaminated between all patients especially on delivery suites, post-natal wards and other high risk areas. Continuous surveillance is required to identify outbreaks which arise over long periods of time. GAS isolates from in-patients, peri-partum patients, neonates, and post-operative wounds should be saved for six months to facilitate outbreak investigation. These guidelines do not cover diagnosis and treatment of GAS infection which should be discussed with an infection specialist.
Journal of Hospital Infection, 2010
The qacA/B gene(s) has become a major antiseptic resistance gene in MRSA, hence the prevalence of... more The qacA/B gene(s) has become a major antiseptic resistance gene in MRSA, hence the prevalence of qacA/B genes in the hospital environment must be considered. Their survival might be due either to selective pressure imposed by use of cationic antisceptic agents or due to cross-resistance and co-resistance between these agents and antibiotics. Epidemiological information on antiseptic susceptibility and the distribution of resistance genes is useful for nosocomial infection control.
Journal of Antimicrobial Chemotherapy, 2008
These guidelines have been developed by a Working Party convened on behalf of the British Society... more These guidelines have been developed by a Working Party convened on behalf of the British Society for Antimicrobial Chemotherapy. Their aim is to provide general practitioners and other communityand hospital-based healthcare professionals with pragmatic advice about when to suspect MRSA infection in the community, when and what cultures should be performed and what should be the management options, including the need for hospitalization.