O. Martin Williams
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View article: The DEXACELL Trial – a protocol for a pragmatic, multicentre, double-blind, placebo-controlled, randomised, parallel group, phase 3 superiority trial to assess the effectiveness and cost-effectiveness of DEXAmethasone as an adjunctive therapy for the management of CELLulitis in adults presenting to urgent secondary care in the UK
The DEXACELL Trial – a protocol for a pragmatic, multicentre, double-blind, placebo-controlled, randomised, parallel group, phase 3 superiority trial to assess the effectiveness and cost-effectiveness of DEXAmethasone as an adjunctive therapy for the management of CELLulitis in adults presenting to urgent secondary care in the UK Open
Introduction: Cellulitis is a common bacterial skin infection causing significant pain, swelling, and impact on daily activities, frequently leading to emergency department presentations and hospital admissions. While antibiotics are the m…
View article: 56 Persistent cluster of carbapenemase-producing Klebsiella pneumoniae among patients attending hospital ward X in England
56 Persistent cluster of carbapenemase-producing Klebsiella pneumoniae among patients attending hospital ward X in England Open
View article: <i>Pseudomonas guariconensis</i> Necrotizing Fasciitis, United Kingdom
<i>Pseudomonas guariconensis</i> Necrotizing Fasciitis, United Kingdom Open
We describe a case of necrotizing fasciitis in the United Kingdom in which Pseudomonas guariconensis was isolated from multiple blood culture and tissue samples. The organism carried a Verona integron-encoded metallo-β-lactamase gene and e…
View article: The Natural History of Antibiotic-Treated Lower Limb Cellulitis: Analysis of Data Extracted From a Multicenter Clinical Trial
The Natural History of Antibiotic-Treated Lower Limb Cellulitis: Analysis of Data Extracted From a Multicenter Clinical Trial Open
Background Although cellulitis is a relatively common skin infection, there remains uncertainty about management, particularly the length and route of antimicrobials required. Further information on the symptomatology and biomarker changes…
View article: Serotype Distribution and Disease Severity in Adults Hospitalized with <i>Streptococcus pneumoniae</i> Infection, Bristol and Bath, UK, 2006‒2022
Serotype Distribution and Disease Severity in Adults Hospitalized with <i>Streptococcus pneumoniae</i> Infection, Bristol and Bath, UK, 2006‒2022 Open
Ongoing surveillance after pneumococcal conjugate vaccination (PCV) deployment is essential to inform policy decisions and monitor serotype replacement. We report serotype and disease severity trends in 3,719 adults hospitalized for pneumo…
View article: Detection, survival, and persistence of Staphylococcus capitis NRCS-A in neonatal units in England
Detection, survival, and persistence of Staphylococcus capitis NRCS-A in neonatal units in England Open
S. capitis NRCS-A can be readily recovered from the NICU environment, even in units with no recent reported clinical cases of S. capitis infection, highlighting a need for appropriate national guidance on cleaning within the neonatal care …
View article: Parapneumonic effusions related to <i>Streptococcus pneumoniae</i> : serotype and disease severity trends from 2006 to 2018 in Bristol, UK
Parapneumonic effusions related to <i>Streptococcus pneumoniae</i> : serotype and disease severity trends from 2006 to 2018 in Bristol, UK Open
Rationale Streptococcus pneumoniae epidemiology is changing in response to vaccination and some data suggest that empyema incidence is increasing. However, differences exist between the UK and US studies. We describe trends in the clinical…
View article: Trends in serotype distribution and disease severity in adults hospitalised with<i>Streptococcus pneumoniae</i>infection in Bristol and Bath: a retrospective cohort study, 2006-2022
Trends in serotype distribution and disease severity in adults hospitalised with<i>Streptococcus pneumoniae</i>infection in Bristol and Bath: a retrospective cohort study, 2006-2022 Open
Ongoing surveillance is essential to inform policy decisions and monitor serotype replacement following pneumococcal conjugate vaccination (PCV) deployment. We report serotype and disease severity trends in this retrospective cohort of hos…
View article: UK consensus definitions for necrotising otitis externa: a Delphi study
UK consensus definitions for necrotising otitis externa: a Delphi study Open
Objective To establish consensus definitions for necrotising otitis externa (NOE) to facilitate the diagnosis and exclusion of NOE in clinical practice and expedite future high-quality study of this neglected condition. Design The work com…
View article: Parapneumonic effusions related to<i>Streptococcus pneumoniae</i>: serotype and disease severity trends from 2006 to 2018 in Bristol, UK
Parapneumonic effusions related to<i>Streptococcus pneumoniae</i>: serotype and disease severity trends from 2006 to 2018 in Bristol, UK Open
Rationale Streptococcus pneumoniae epidemiology is changing in response to vaccination and some data suggest empyema incidence is increasing. However, differences exist between UK and USA studies. We describe trends in the clinical phenoty…
View article: Identification and characterisation of <i>Klebsiella pneumoniae</i> and <i>Pseudomonas aeruginosa</i> clinical isolates with atypical β-lactam susceptibility profiles using Orbitrap liquid chromatography-tandem mass spectrometry
Identification and characterisation of <i>Klebsiella pneumoniae</i> and <i>Pseudomonas aeruginosa</i> clinical isolates with atypical β-lactam susceptibility profiles using Orbitrap liquid chromatography-tandem mass spectrometry Open
There is significant interest in the possibility of predicting antibacterial drug susceptibility directly though the analysis of bacterial DNA or protein. We report the use of Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa…
View article: Limited phylogenetic overlap between fluoroquinolone-resistant <i>Escherichia coli</i> isolated on dairy farms and those causing bacteriuria in humans living in the same geographical region
Limited phylogenetic overlap between fluoroquinolone-resistant <i>Escherichia coli</i> isolated on dairy farms and those causing bacteriuria in humans living in the same geographical region Open
Background Our primary aim was to test whether cattle-associated fluoroquinolone-resistant (FQ-R) Escherichia coli found on dairy farms are closely phylogenetically related to those causing bacteriuria in humans living in the same 50 × 50 …
View article: Trade-Offs between Antibacterial Resistance and Fitness Cost in the Production of Metallo-β-Lactamases by Enteric Bacteria Manifest as Sporadic Emergence of Carbapenem Resistance in a Clinical Setting
Trade-Offs between Antibacterial Resistance and Fitness Cost in the Production of Metallo-β-Lactamases by Enteric Bacteria Manifest as Sporadic Emergence of Carbapenem Resistance in a Clinical Setting Open
Meropenem is a clinically important antibacterial reserved for treatment of multiresistant infections. In meropenem-resistant bacteria of the family Enterobacterales , New Delhi metallo-β-lactamase 1 (NDM-1) is considerably more common tha…
View article: Limited Phylogenetic Overlap Between Fluoroquinolone-Resistant Escherichia coli Isolated on Dairy Farms and those Causing Bacteriuria in Humans Living in the Same Geographical Region
Limited Phylogenetic Overlap Between Fluoroquinolone-Resistant Escherichia coli Isolated on Dairy Farms and those Causing Bacteriuria in Humans Living in the Same Geographical Region Open
Synopsis Background Our primary aim was to test whether cattle-associated fluoroquinolone-resistant (FQ-R) Escherichia coli found on dairy farms were a significant cause of bacteriuria in humans living in the same 50 × 50 km geographical r…
View article: <i>Streptococcus Pneumoniae</i> septic arthritis in adults in Bristol and Bath, United Kingdom, 2006–2018: a 13-year retrospective observational cohort study
<i>Streptococcus Pneumoniae</i> septic arthritis in adults in Bristol and Bath, United Kingdom, 2006–2018: a 13-year retrospective observational cohort study Open
Few studies on adult pneumococcal septic arthritis are sufficiently large enough to assess both epidemiological trends following routine pneumococcal immunization and clinical disease. With major shifts in serotypes causing invasive pneumo…
View article: Trade-Offs Between Antibacterial Resistance and Fitness Cost in the Production of Metallo-β-Lactamase by Enteric Bacteria Manifest as Sporadic Emergence of Carbapenem Resistance in a Clinical Setting
Trade-Offs Between Antibacterial Resistance and Fitness Cost in the Production of Metallo-β-Lactamase by Enteric Bacteria Manifest as Sporadic Emergence of Carbapenem Resistance in a Clinical Setting Open
Meropenem is a clinically important antibacterial reserved for treatment of multi-resistant infections. In meropenem-resistant bacteria of the family Enterobacteriales, NDM-1 is considerably more common than IMP-1, despite both metallo-β-l…
View article: Urinary antigen testing for pneumococcal pneumonia: is there evidence to make its use uncommon in clinical practice?
Urinary antigen testing for pneumococcal pneumonia: is there evidence to make its use uncommon in clinical practice? Open
Microbiological confirmation of pneumonia caused by Streptococcus pneumoniae remains challenging as culture from blood or pleural fluid is positive in only 15–30% cases. It was hoped that a commercially available urine antigen test would i…
View article: Characterisation of cefotaxime-resistant urinary <i>Escherichia coli</i> from primary care in South-West England 2017-2018
Characterisation of cefotaxime-resistant urinary <i>Escherichia coli</i> from primary care in South-West England 2017-2018 Open
Objectives Third-generation cephalosporin-resistant Escherichia coli from community-acquired urinary tract infections (UTI) have been increasingly reported worldwide. In this study we sought to determine and characterise the mechanisms of …
View article: Assessment of Antibiotic Treatment of Cellulitis and Erysipelas
Assessment of Antibiotic Treatment of Cellulitis and Erysipelas Open
In this systematic review and meta-analysis, only low-quality evidence was found for the most appropriate agent, route of administration, and duration of treatment for patients with cellulitis; future trials need to use a standardized set …
View article: An 11-year analysis of microbial keratitis in the South West of England using brain–heart infusion broth
An 11-year analysis of microbial keratitis in the South West of England using brain–heart infusion broth Open
View article: Acute management of cellulitis: A review
Acute management of cellulitis: A review Open
Cellulitis is an acute localised skin infection, usually accompanied by symptoms such as fever and rigors, nausea, and vomiting. It most commonly affects the lower limbs, although it can involve any part of the skin. It presents as area of…
View article: The successful treatment of a multidrug-resistant <i>Achromobacter xylosoxidans</i> corneal ulcer with topical meropenem
The successful treatment of a multidrug-resistant <i>Achromobacter xylosoxidans</i> corneal ulcer with topical meropenem Open
Microbial keratitis is a common corneal condition, with many known risk factors. We present a case of an 88-year-old female patient with a multidrug-resistant Achromobacter xylosoxidans corneal ulcer in a previously failed second penetrati…
View article: Prediction of Fluoroquinolone Susceptibility Directly from Whole-Genome Sequence Data by Using Liquid Chromatography-Tandem Mass Spectrometry To Identify Mutant Genotypes
Prediction of Fluoroquinolone Susceptibility Directly from Whole-Genome Sequence Data by Using Liquid Chromatography-Tandem Mass Spectrometry To Identify Mutant Genotypes Open
Fluoroquinolone resistance in Gram-negative bacteria is multifactorial, involving target site mutations, reductions in fluoroquinolone entry due to reduced porin production, increased fluoroquinolone efflux, enzymes that modify fluoroquino…
View article: Prediction of cephalosporin and carbapenem susceptibility in multi-drug resistant Gram-negative bacteria using liquid chromatography-tandem mass spectrometry
Prediction of cephalosporin and carbapenem susceptibility in multi-drug resistant Gram-negative bacteria using liquid chromatography-tandem mass spectrometry Open
In vitro antibacterial susceptibility testing informs clinical decision making concerning antibacterial therapeutics. Predicting, in a timely manner, which bacterial infection will respond to treatment by a given antibacterial drug reduces…
View article: Prediction of fluoroquinolone susceptibility directly from whole genome sequence data using liquid chromatography-tandem mass spectrometry to identify mutant genotypes
Prediction of fluoroquinolone susceptibility directly from whole genome sequence data using liquid chromatography-tandem mass spectrometry to identify mutant genotypes Open
Fluoroquinolone resistance in bacteria is multifactorial, involving target site mutations, reductions in fluoroquinolone entry due to reduced porin production, increased fluoroquinolone efflux, enzymes that modify fluoroquinolones, and Qnr…
View article: Adjunctive clindamycin for cellulitis: a clinical trial comparing flucloxacillin with or without clindamycin for the treatment of limb cellulitis
Adjunctive clindamycin for cellulitis: a clinical trial comparing flucloxacillin with or without clindamycin for the treatment of limb cellulitis Open
Objective To compare flucloxacillin with clindamycin to flucloxacillin alone for the treatment of limb cellulitis. Design Parallel, double-blinded, randomised controlled trial. Setting Emergency department attendances and general practice …
View article: EXPERIENCE WITH Ponseti Protocol and Achilles Tenotomy in THE MANAGEMENT OF Clubfoot at the Lagos STATE UNIVERSITY TEACHING HOSPITAL, lagos, Nigeria.
EXPERIENCE WITH Ponseti Protocol and Achilles Tenotomy in THE MANAGEMENT OF Clubfoot at the Lagos STATE UNIVERSITY TEACHING HOSPITAL, lagos, Nigeria. Open
This study has shown that congenital idiopathic clubfeet can be managed with good outcome using the Ponseti protocol with a reduced frequency of Achilles tenotomy.
View article: Fatal Nosocomial MDR TB Identified through Routine Genetic Analysis and Whole-Genome Sequencing
Fatal Nosocomial MDR TB Identified through Routine Genetic Analysis and Whole-Genome Sequencing Open
To the Editor: In November 2012, a 44-year-old HIV-negative white man (patient 1) with fever, fatigue, and breathlessness sought care at a hospital in the United Kingdom. He had never traveled abroad but had biopsy-proven alcoholic cirrhos…