Studies of cervicovaginal smears for the presence of actinomycetes

Cytologic and direct fluorescent antibody techniques were used to detect the presence of Actinomyces israelii and Arachnia propionica in cervicovaginal smears collected from 100 women, 94 of whom did not use intrauterine contraceptive devices. In no case were these organisms found. The possible significance of these results is discussed.

Detection of enterotoxigenic Escherichia coli in water by filter hybridization with three enterotoxin gene probes

The DNA hybridization assay for genes encoding for Escherichia coli enterotoxins was used to examine water specimens in Thailand. In a reconstruction experiment, the DNA hybridization assay was 10(4) times more sensitive than testing random E. coli in the Y-1 adrenal and suckling mouse assays in identifying enterotoxigenic E. coli (ETEC) in water. Drinking and bathing water collected from 2 of 10 different homes of individuals with ETEC-associated diarrhea and 6% (5 of 78) and 11% (11 of 78) of drinking and bathing water samples collected from homes of individuals with diarrhea without ETEC infections, as well as 6% (5 of 77) and 8% (6 of 77) of drinking and bathing water collected from homes in which no inhabitants had diarrhea, were homologous with the DNA probes. Ten E. coli from each of the 31 water specimens which contained bacteria which were homologous with the DNA probes were tested in the Y-1 adrenal and suckling mouse assay. In only 2 of these 31 specimens could ETEC be identified with the standard assays. The DNA hybridization assay is a much more sensitive means of detecting organisms carrying genes coding for enterotoxin production than testing 10 individual colonies in the Y-1 adrenal and suckling mouse assays. This novel application of recombinant DNA technology provides a sensitive method of detecting organisms carrying genes coding for enterotoxin, and this method will be useful in defining the epidemiology of ETEC.

Contamination of weaning foods and transmission of enterotoxigenic Escherichia coli diarrhoea in children in rural Bangladesh

In longitudinal studies of infectious diseases and nutrition in Bangladesh, we determined the degree of bacterial contamination of traditional weaning foods and evaluated the role of these foods in the transmission of diarrhoeal diseases. 41% of samples of food items fed to weaning aged children contained Escherichia coli; these organisms were used as indicators of faecal contamination. Milk and foods prepared particularly for infants were more frequently and heavily contaminated with E. coli than was boiled rice, and E. coli levels were found to be related to the storage of cooked foods at high environmental temperatures. 50% of drinking water specimens also contained E. coli, but colony counts were approximately 10-fold lower than in food specimens. The proportion of a child's food samples that contained E. coli was significantly related to the child's annual incidence of diarrhoea associated with enterotoxigenic E. coli. This observation underscores the importance of seeking locally available foods that are hygienic as well as nutritious to supplement the diets of breastfeeding children in developing countries.

Drug-pyridoxal phosphate interactions

In this review it has been pointed out that vitamin B6 and its vitamers can be involved in many interactions with a number of drugs, as well as with the actions of various endocrines and neurotransmitters. Nutritional deficiencies, especially of vitamins and proteins, can affect the manner in which drugs undergo biotransformation, and thereby may also modify the therapeutic efficacy of certain drugs. The differences between nutritional vitamin B6 deficiency and the hereditary disorder producing pyridoxine dependency are discussed. In addition to a pyridoxine deficiency being able to adversely affect drug actions, the improper supplementation with vitamin B6 can in some instances also adversely affect drug efficacy. A decrease by pyridoxine in the efficacy of levodopa used in the treatment of Parkinsonism is an example. The interrelationships and enzymatic interconversions among pyridoxine vitamers, both phosphorylated and non-phosphorylated, are briefly discussed, particularly regarding their pharmacokinetic properties. The ways in which the normal biochemical functions of vitamin B6 may be interfered with by various drugs are reviewed. (1) The chronic administration of isoniazid for the prevention or treatment of tuberculosis can produce peripheral neuropathy which can be prevented by the concurrent administration of pyridoxine. An acute toxic overdose of isoniazid causes generalized convulsions, and the intravenous administration of pyridoxine hydrochloride will prevent or stop these seizures. (2) The acute ingestion of excessive monosodium glutamate will, in some individuals, cause a group of symptoms including among others headache, weakness, stiffness, and heartburn, collectively known as the 'Chinese Restaurant Syndrome.' These symptoms can be prevented by prior supplementation with vitamin B6. The beneficial effect is ascribed to the correction of a deficiency in the activity of glutamic oxaloacetic transaminase, an enzyme that is dependent on pyridoxal phosphate. Some interesting relationships are pointed out between vitamin B6, picolinic acid, and zinc. It is postulated that the intestinal absorption of zinc is facilitated by picolinic acid, a metabolite of tryptophan. The derivation of picolinic acid from tryptophan depends on the action of the enzyme kynureninase, which is dependent on pyridoxal phosphate; therefore, the adequate absorption of zinc is indirectly dependent on an adequate supply of vitamin B6. The formation of pyridoxal phosphate, on the other hand, appears to be indirectly dependent on Zn2++ which activates pyridoxal kinase.(ABSTRACT TRUNCATED AT 400 WORDS)

Complications of diphtheria seen during the 1978 outbreak in Khartoum

Twenty-nine cases of complicated diphtheria infection occurring during an epidemic in Khartoum are reviewed. The organism was a Corynebacterium diphtheriae subsp. gravis with an unusual property of fermenting sucrose. Eighteen patients were detected during prospective follow-up, where as 11 presented initially with a complication. Complications were mostly seen among pre-school children (65.5%). A routine immunization course had been completed in only two of the patients. Neurological complications were the commonest, lasting for more than two weeks, and five of the six deaths were due to cardiovascular complications.

Puerperal sepsis in Port Moresby, Papua New Guinea

Because puerperal sepsis is the second most common cause of maternal death in Papua New Guinea some aspects of its aetiology and prevention have been investigated. 91% of 125 women with puerperal fever were found to have post-partum uterine infection. The anaerobes Bacteroides and Peptostreptococcus singly or together, were the commonest causes, while Streptococcus pyogenes was the predominant aerobic species. Antibiotic sensitivity patterns were established, and chloramphenicol was found to be the most active agent against anaerobic and most aerobic strains. Endocervical cultures obtained from 103 ante-partum and 50 afebrile post-partum women demonstrated all the species associated with post-partum genital infection in this study. An analysis of the records of all patients was made to determine the redisposing factors associated with puerperal fever; only operative delivery was found to be significant, especially when it followed prolonged labour. Metronidazole given to 72 women before induction of labour was associated with puerperal fever in 4%, compared with 21% in matched controls.