AY MICRO D BIOLOGY TO QUARTERLY MAGAZINE OF THE SOCIETY FOR GENERAL MICROBIOLOGY 39:3 AUG 2012 E U ss AL I I R HARRY SMITH MEMO SMITH HARRY 22337_Chloramphenicol Ad_Micro Today_AW:1 11/4/12 17:10 Page 1 CHLORAMPHENICOL Widely distributed throughout the body, including CSF1 Oral levels comparable to i.v. levels2 3 COVER IMAGE Rarely implicated with C.difficile S Prof. Peter Owen, FEATURES REGULARS Microbiology Department, T Editorial Moyne Institute, Trinity 143 154 N College Dublin 145 News Harry Smith in Birmingham: past recollections and ongoing New Honorary member TE AGM agenda Effective against serious development N … and much more infections including: CHARLES PENN O 1,2 H. influenzae A personal view of Harry Smith and his legacy at 149 Council 11–12 1,2 C Typhoid Birmingham. 150 Microshorts MRSA4 EDITOR 5 152 Conferences VRSA Dr Paul Hoskisson 156 1,2 170 Gradline Neisseria EDITORIAL BOARD Pride in a century-long tradition of 1,2 Publish or perish / Legionella Professor Mark Harris microbiology in Birmingham Collaborate or stagnate 2012 Rickettsia1,2 Dr Karen Robinson MARK PALLEN & IAN HENDERSON 6-9 Professor Joanna Verran C.difficile As the new Institute of Microbiology and Infection 174 Outreach 1 MANAGING E. coli opens its doors, how has the legacy of Harry Smith SGM at RHS Chelsea EDITOR & DESIGN AUG Ian Atherton been built upon? 176 Policy EDITORIAL ASSISTANT Interview with Imran Khan, Yvonne Taylor CaSE Abbreviated Prescribing Information respiration and death within a few hours of the onset of symptoms. Chloramphenicol Capsules BP 250mg Overdose: Stop chloramphenicol immediately if signs of adverse events develop. Treatment is mainly supportive. If an allergy develops, ADDRESS 184 Hot off the Press Presentation: Capsules containing 250mg chloramphenicol BP. oral antihistamines may be used. In severe overdosage e.g. Gray Baby Society for 39:3 Indications: Typhoid fever and life-threatening infections, particularly Syndrome, reduce plasma levels of chloramphenicol rapidly. Resin 160 those caused by Haemophilus Influenzae, where other antibiotics will haemoperfusion (XAD-4) has been reported to substantially increase General Microbiology, 186 Reviews not suffice. chloramphenicol clearance. Molecular mimicry and Posology: For oral administration. Pack size and Price: 60 capsules £377.00 Marlborough House, 188 Comment: Adults and elderly: 50mg/kg body weight daily in 4 divided doses. Legal Category: POM. Basingstoke Road, microbial physiology in neisserial For severe infections (meningitis, septicaemia), this dose may be Market Authorisation Number: PL17736/0075. Don’t destroy research doubled initially, but must be reduced as soon as clinically possible. Market Authorisation Holder: Chemidex Pharma Limited, 7 Egham Spencers Wood, pathogenicity Children: Not recommended. Business Village, Crabtree Road, Egham, Surrey TW20 8RB, UK. NIGEL L. BROWN Contra-indications: Known hypersensitivity or toxic reaction to Date of preparation: April 2012. Reading RG7 1AG CHRISTOPH TANG & JEFF COLE chloramphenicol or to any of the excipients. Should not be used See Chloramphenicol Summary of Product Characteristics for full tel. 0118 988 1800 for the prophylaxis or treatment of minor infections; during active prescribing information. Harry Smith’s belief in the importance of in immunisation; in porphyria patients; in patients taking drugs liable fax 0118 988 5656 to depress bone marrow function; during pregnancy, labour or by email [email protected] vivo studies led him to the discovery of the key breast-feeding mothers. Adverse events should be reported. Reporting forms and OTHER FEATURES Special warnings and precautions for use: Use only if other treatments information can be found at www.mhra.gov.uk/yellowcard. web www.sgm.ac.uk determinants in pathogenesis. are ineffective. Use should be carefully monitored. Reduce dose and monitor plasma levels in hepatic or renal impairment in the elderly and Adverse events should also be reported to Essential 148 SGM journals go in patients concurrently treated with interacting drugs. Generics on 01784 477167. © 2012 Interactions: Chloramphenicol prolongs the elimination, increasing the Society for General mobile blood levels of drugs including warfarin, phenytoin, sulphonylureas, tolbutamide. Doses of anticonvulsants and anticoagulants may need to References Microbiology (SGM) be adjusted if given concurrently. Complex effects (increased/decreased 1. Sweetman S.C. (ed), Martindale: The Complete Drug Reference. 149 SGM journals plasma levels) requiring monitoring of chloramphenicol plasma levels [online] London: Pharmaceutical Press ISSN 1464-0570 have been reported with co-administration of penicillins and rifampicin. <http://www.medicinescomplete.com/> (Accessed on 22 August 2011). 163 microshorts Paracetamol prolongs chloramphenicol half-life. Chloramphenicol may 2. Feder, H. Chloramphenicol: What we have learned in the last Decade. 22337 increase the plasma levels of calcineurin inhibitors e.g. ciclosporin Southern Medical Journal. 1986; 79(9): 1129-34. 3. Kelly, C., LaMont, T. PRINTED BY Bacillus anthracis: despite what you 178 F erreting out the and tacrolimus. Barbiturates such as phenobarbitone increase Patient information: Antibiotic-associated diarrhea (Clostridium difficile). Latimer Trend & Co. Ltd, the metabolism of chloramphenicol, resulting in reduced plasma www.uptodate.com. (Accessed on 11 August 2011). 4. Fluit, A.C., have heard it’s not all bad facts behind the H5N1 chloramphenicol concentrations. In addition, there may be a decrease Wielders, C.L.C., Verhoef, J., and Schmitz, F.J. Epidemiology and Plymouth, UK in the metabolism of phenobarbitone with concomitant chloramphenicol Susceptibility of 3,051 Staphylococcus aureus Isolates from 25 LES BAILLIE controversy use. There is a small risk that chloramphenicol may reduce the University Hospitals Participating in the European SENTRY Study. contraceptive effect of oestrogens. Chloramphenicol reduces the Journal of Clinical Microbiology. 2001; 39(10): 3727-3732. 5. Weigel LM The secret of Bacillus anthracis lies in the potency of response to hydroxocobalamin. Chloramphenicol is contra-indicated et al. High-Level Vancomycin-Resistant Staphylococcus aureus (VRSA) ROY D. SLEATOR in patients taking drugs liable to suppress bone marrow function Associated with a Polymicrobial Biofilm. Antimicrobial Agents and its toxin, the central role of which in anthrax was e.g. carbamazepine, sulphonamides, phenylbutazone, penicillamine, Chemotherapy. Published online ahead of print on 30 October 2006. 181 Deciphering infectious cytotoxic agents, some antipsychotics including clozapine and http://aac.asm.org/cgi/reprint/AAC.00576-06v1.pdf. (Accessed on discovered by Harry Smith. particularly depot antipsychotics, procainamide, nucleoside reverse 22 August 2011). 6. Ensminger, P., Counter, F., Thomas, L., Lebbehuse, diseases transcriptase inhibitors, propylthiouracil. P. Susceptibility, Resistance Development, and Synergy of Antimicrobial Pregnancy and Lactation: The use of chloramphenicol is contra-indicated Combinations Against Clostridium difficile. Current Microbiology. Essential Generics: Chloramphenical Ad B. CHERIE MILLAR & as the drug crosses the placenta and is excreted in breast milk. 1982; 7: 59-62. 7. Poilane, I., Bert, F., Cruaud, P., Nicolas-Chanoine, Effects on ability to drive and use machines: No significant effect MH., Collignon, A. Interest of the disk diffusion method for screening PETER J.A. MOORE on driving ability. Clostridium difficile isolates with decreased susceptibility to antibiotics. Undesirable Effects: Reversible dose related bone marrow depression, PathologieBiologie (Paris). 2007; 55(8-9): 429-33. 8. Cattoir, V., irreversible aplastic anaemia, increased bleeding time, hypersensitivity Ould-Hocine, ZF.,Legrand, P. Antimicrobial susceptibility of Clostridium reactions including allergic skin reactions, optic neuritis leading to difficile clinical isolates collected from 2001 to 2007 in a French CAPSULES The views expressed 166 blindness, ototoxicity, acidotic cardiovascular collapse, nausea, vomiting, university hospital. PathologieBiologie (Paris). 2008; 56(7-8): 407-11. glossitis, stomatitis, diarrhoea, enterocolitis, Gray Baby Syndrome 9. Brazier, JS., Levett, PN., Stannard, AJ., Phillips, KD., Willis, AT. mm Bleed: 3 mm Supply as hi-res PDF Job no: by contributors are not Influenza research at Birmingham particularly in the newborn, which consists of abdominal distension, Antibiotic susceptibility of clinical isolates of clostridia. Journal of PIP: 106-5796 210 necessarily those of EG/CH/APR/2012/08 pallid cyanosis, vomiting, progressing to vasomotor collapse, irregular Antimicrobial Chemotherapy. 1985; 15(2): 181-5. x CLIVE SWEET the Society; nor can the 297 AAH: CHL600B claims of advertisers be It should not be forgotten that Harry Smith carried ALLIANCE: O65995 guaranteed. out innovative research with influenza virus. Trim size: Trim Journal: Microbiology Today Journal: Microbiology Today MOVIANTO: CHL25060 For further information, please contact: Essential Generics, 7 Egham Business Village, Crabtree Road, Egham, Surrey TW20 8RB, UK Welcome to the August issue of Microbiology Today ITORIAL dedicated to the D E memory of the late Professor Harry Smith CBE FRS. THE SAD NEWS of Professor Harry Smith’s death reached me by text message via Ian Henderson while I was at a conference in Mexico in December 2011. While I had never met Harry 2012 2012 personally, it was clear to me that G as a Society we needed