Valine requirements for immune and growth responses in broilers from 3 to 6 weeks of age

Four experiments were conducted to evaluate valine (Val) requirements in Ross 508 broilers from 3 to 6 weeks of age. Common diets were fed to broilers until 3 weeks of age. Growth and carcass measurements were taken in all experiments. Immune responsiveness measurements were taken in Experiments 1 and 2. Birds given 7.2 g Val/kg of diet in Experiment 1 had more abdominal fat than birds given 8.2 g Val/kg of diet, but there were no differences in growth or other carcass measurements. Because growth performance was not reduced in birds given 7.2 g Val/kg of diet, Val concentration was reduced to 6.4 g Val/kg of diet in Experiments 2 and 3. Increasing Val from 6.4 to 8.7 g Val/kg of diet resulted in linear increases for BW gain, feed efficiency and Val intake in male birds, and Val intake in female birds. Quadratic responses to increasing dietary Val were not observed in any experiment. There were no effects of Val on innate or adaptive immunity. A nonessential amino acid mixture containing the same nitrogen content as the L-Val additions in Experiment 4 was added and tends to support the idea that the responses to Val were specific and not due to increases in total nitrogen. Dose responses to Val resulted in male, but not female, birds given 7.3 g Val/kg of diet having improved BW gain and feed efficiency compared with birds receiving 6.4 g Val/kg of diet.

Wildlife in dry lake and associated habitats in western New South Wales

Intermittently and occasionally flooded lakes are common in arid and semi-arid Australia. The wetldry nature of these lakes means that they provide habitat for terrestrial fauna when dry and aquatic fauna when flooded. The fauna of dry lakes in western New South Wales is largely unknown. This study reports on species of small mammals and reptiles trapped in a dry lake in south-western New South Wales, and contrasts them with species trapped in surrounding woodland and shrubland habitats. Information on bird species in these habitats was also drawn on. Small mammals, reptiles and birds showed considerable partitioning between the habitats in the study area. The dry lake provided the main habitat for the two small mammals Smznthopsis crassicaudata and Planlgale gdesi. Reptiles were most speciose and most abundant in the blue bush (Maireana spp.) shrubland, but some reptile species were mainly or entirely confined to the dry lake habitats, or to black box (Eucalyptus largzjlorens) woodland. Birds in the study region were most abundant and most speciose in the black box woodland, with some species confined to blue bush shrubland. The study showed that conservation of all the habitats investigated is necessary to retain the suite of vertebrate species that occupy these landscapes. Key words: small mammals, reptiles, birds, arid zone, dry lake, shrubland, woodland, biodiversity: Australia

The epidemiology of dermatologic and venereologic disease in a deployed operational setting

We studied the epidemiology, morbidity, and etiology of dermatologic and non-human immunodeficiency virus venereologic disease (Derm/STD) aboard a deployed aircraft carrier to revise Derm/STD training objectives for shipboard primary care providers. Onboard supplies for treatment of Derm/STD were also evaluated. Over 3 months, 929 Derm/STD patients were treated for 1,320 diagnoses generating 2,011 visits. Derm/STD caused 22% of the total morbidity. Pyoderma alone accounted for nearly one-half of that morbidity and involved many work-center groups. Air wing, aircraft maintenance, and engineering work-center groups had lower burdens of pyoderma. Bacterial cultures were performed on 248 exudative dermatoses. Staphylococcus aureus was the dominant pathogen and was overwhelmingly sensitive in vitro to common, inexpensive antibiotics. Strategies to encourage prevention, earlier diagnosis, and rapid treatment of Derm/STD by deployed primary care providers are discussed.

Malaria among United States troops in Somalia

PURPOSE

United States military personnel deployed to Somalia were at risk for malaria, including chloroquine-resistant Plasmodium falciparum malaria. This report details laboratory, clinical, preventive, and therapeutic aspects of malaria in this cohort.

PATIENTS AND METHODS

The study took place in US military field hospitals in Somalia, with US troops deployed to Somalia between December 1992 and May 1993. Centralized clinical care and country-wide disease surveillance facilitated standardized laboratory diagnosis, clinical records, epidemiologic studies, and assessment of chemoprophylactic efficacy.

RESULTS

Forty-eight cases of malaria occurred among US troops while in Somalia; 41 of these cases were P falciparum. Risk factors associated with malaria included: noncompliance with recommended chemoprophylaxis (odds ratio [OR] 2.4); failure to use bed nets (OR 2.6); and failure to keep sleeves rolled down (OR 2.2). Some patients developed malaria in spite of mefloquine (n = 8) or doxycycline (n = 5) levels of compatible with chemoprophylactic compliance. Five mefloquine failures had both serum levels > or = 650 ng/mL and metabolite:mefloquine ratios over 2, indicating chemoprophylactic failure. All cases were successfully treated, including 1 patient who developed cerebral malaria.

CONCLUSIONS

P falciparum malaria attack rates were substantial in the first several weeks of Operation Restore Hope. While most cases occurred because of noncompliance with personal protective measures or chemoprophylaxis, both mefloquine and doxycycline chemoprophylactic failures occurred. Military or civilian travelers to East Africa must be scrupulous in their attention to both chemoprophylaxis and personal protection measures.

Dengue fever in U.S. troops during Operation Restore Hope, Somalia, 1992-1993

Dengue fever (DF) was considered to be a potential cause of febrile illness in U.S. troops deployed to Somalia during Operation Restore Hope in 1992-1993. A prospective study of hospitalized troops with fever and a seroepidemiologic survey of 530 troops were conducted. Among 289 febrile troops hospitalized, 129 (45%) did not have an identified cause of their fever. Dengue (DEN) virus was recovered from 41 (43%) of 96 of these patients by inoculation of admission sera into C6/36 cell cultures. Thirty-nine (41%) of the isolates were identified as DEN-2 and two (2%) as DEN-3 by an indirect immunofluorescent antibody assay. An additional 18 (49%) of 37 culture-negative cases were shown by immunoglobulin M (IgM) antibody capture enzyme-linked immunosorbent assay to have anti-DEN virus antibody. All identified DF cases recovered within 1-2 weeks; no case of dengue hemorrhagic fever or shock syndrome was observed. A seroepidemiologic survey of a unit (n = 494) with 17 culture or serologically identified DF cases and a 13% attack rate of unidentified febrile illness revealed a 7.7% prevalence of anti-DEN virus IgM antibody. Failure to use bed nets was the only identified risk factor for DEN infection (adjusted odds ratio = 2.2, 95% confidence interval = 1.4-3.0). These data indicate that DF was an important cause of febrile illness among US troops in Somalia, and demonstrate the difficulties in preventing DEN infection in troops operating in field conditions.

Illness in Journalists and Relief Workers Involved in International Humanitarian Assistance Efforts in Somalia, 1992-93

Background: Journalists and relief workers participating in international relief efforts in Somalia following the intervention of outside armed forces in late 1992, were faced with a number of threats to their health. Principally these threats were from endemic infectious diseases and trauma. Methods: In-patient, emergency clinic, and laboratory records of U.S. military field hospitals, which provided the only available sophisticated medical care in Somalia during most of the study period (December 15, 1992, to February 15, 1993), were reviewed to determine the number of workers evaluated and the causes of their illnesses. In addition, two questionnaire surveys were conducted to elucidate risk factors for illness in these groups. Results: One hundred and thirty-eight journalists and relief workers, primarily from Europe and North America, were evaluated at a hospital for a variety of common travel-associated health problems, including diarrhea (33%), acute respiratory infection (21%), other febrile illnesses (11%), hepatitis (2%), major trauma (6%), and minor trauma (13%). Documented infectious disease pathogens included Plasmodium falciparum (7 cases), Shigella sp (3 cases), enterotoxigenic Escherichia coli (ETEC) (3 cases), dengue virus-2 (2 cases), and hepatitis E virus (3 cases). Two relief workers were killed by gunshot wounds. In the questionnaire surveys of 104 journalists and 98 relief workers, 84% of respondents reported that they had received some pretravel medical advice, but only 70% sought a medical consultation in person. Thirty-four percent were not receiving a recommended antimalarial chemoprophylaxis regimen, and only 10% obtained a fluoroquinolone antimicrobial drug for self treatment of diarrhea. Sixty-four percent of both groups combined, reported having had diarrhea, and 26% experienced a nondiarrheal febrile illness. Sixty-eight percent reported that their work performance was adversely affected by illness. In multivariate logistic regression analyses, factors associated with an increased risk of diarrhea were age < 35 years (OR 1.5, 95% CI 1.1-1.9); residence in Somalia for more than 21 days (OR 1.7, 95% CI 1.3-2.1); and regular consumption of local food and water (OR 3.8, 95% CI 3.4-4.2). Factors associated with nondiarrheal febrile illness were age < 35 years (OR 1.4, 95% CI 1.1-1.8); residence in Somalia for more than 21 days (OR 1.8, 95% CI 1.4-2.2); and not having had an in-person pretravel medical consultation (OR 2.0, 95% CI 1.5-3.0). Conclusions: These data indicate that journalists and relief workers who traveled to Somalia in response to the massive humanitarian crisis themselves experienced substantial health problems. Improved pretravel medical preparation might prevent or limit illness in these unique groups and improve the efficiency of future disaster response efforts. (J Travel Med 2:70-76, 1995)

Diarrheal disease among military personnel during Operation Restore Hope, Somalia, 1992-1993

The potential for widespread diarrheal disease was regarded as a substantial threat to U.S. troops participating in the early phases of Operation Restore Hope in Somalia. Outpatient surveillance of 20,859 U.S. troops deployed during the first eight weeks, however, indicated that a mean of only 0.8% (range 0.5-1.2%) of personnel sought care for diarrhea each week, and in three epidemiologic surveys, < 3% of troops reported experiencing a diarrheal illness per week. Despite these low overall attack rates, diarrhea accounted for 16% of 381 hospital admissions and 20% of 245 patients admitted with a temperature > or = 38.5 degrees C. Sixty-one specimens were obtained from inpatients and 52 were obtained from outpatients. Shigella sp. were isolated from 33%, enterotoxigenic Escherichia coli from 16%, Giardia lamblia from 4%, and rotavirus from 1% of 113 stool samples obtained from inpatient (61) and outpatient (52) troops with diarrhea. Bacterial isolates obtained in Somalia were resistant to doxycycline (78%), ampicillin (54%), and sulfamethoxazole (49%), but uniformly sensitive to ciprofloxacin. With the exception of 10 Shigella sonnei isolates that were linked epidemiologically to one eating facility, bacterial pathogens occurred sporadically and demonstrated a wide variation of serotypes and antibiotic sensitivity patterns. Additionally, three of 11 paired sera collected from persons with nausea, vomiting, and watery diarrhea demonstrated a four-fold or greater increase in titer to Norwalk virus antibody. These data indicate that large outbreaks of diarrheal disease did not occur; however, highly drug-resistant enteric bacteria, and to a lesser extent viral and parasitic pathogens, were important causes of morbidity among U.S. troops in Somalia.

Diarrheal disease aboard a U.S. Navy ship after a brief port visit to a high risk area

In August 1988, a study was conducted to determine the etiology and risk factors associated with travelers' diarrhea among U.S. military personnel after a 5-day port visit to Alexandria, Egypt. Twenty-one percent of the 2,747 evaluated crew members of the USS John F. Kennedy reported an episode of acute diarrhea, which led to 155 sick-call visits and at least 110 lost man-days. The most common pathogen identified was enterotoxigenic Escherichia coli, and all isolated bacterial enteropathogens were sensitive to quinolone drugs. Independent risk factors for the development of diarrhea included: (1) consuming any meal ashore and specifically eating meats, desserts, or a buffet meal; and (2) a recent history of travelers' diarrhea. These data indicate that even brief port visits to developing countries pose a major threat to the health of U.S. shipboard personnel.

Etiology of acute diarrhea among United States military personnel deployed to South America and west Africa

A study of acute diarrhea was conducted from 1985 to 1987 among U.S. military personnel participating in routine shipboard exercises in South America and West Africa and ground troops deployed to coastal Ecuador. An enteropathogen was identified in 146 (51%) of 289 acute cases of diarrhea. Enterotoxigenic Escherichia coli, found in 50 (17%) patients with diarrhea, was the most commonly identified enteropathogen. Viral enteropathogens were also found in a high percentage of acute cases of diarrhea: rotavirus was detected in 11% of the patients and Norwalk virus infection in 10%. Most enteric pathogens were acquired in equal frequencies in South America and West Africa, except for rotavirus infection which was identified more often in West Africa and enteroaggregative E. coli infection which was identified more often in South America. Bacterial enteropathogens were frequently resistant to trimethoprim/sulfamethoxazole, but no resistance to quinolone drugs was observed, indicating that quinolone drugs have become important agents for the treatment of diarrhea in South America and West Africa.

Specific detection of Campylobacter jejuni and Campylobacter coli by using polymerase chain reaction

Development of a routine detection assay for Campylobacter jejuni and Campylobacter coli in clinical specimens was undertaken by using the polymerase chain reaction (PCR). An oligonucleotide primer pair from a conserved 5' region of the flaA gene of C. coli VC167 was used to amplify a 450-bp region by PCR. The primer pair specifically detected 4 strains of C. coli and 47 strains of C. jejuni; but it did not detect strains of Campylobacter fetus, Campylobacter lari, Campylobacter upsaliensis, Campylobacter cryaerophila, Campylobacter butzleri, Campylobacter hyointestinalis, Wolinella recta, Helicobacter pylori, Escherichia coli, Shigella spp., Salmonella spp., Vibrio cholerae, Citrobacter freundii, or Aeromonas spp. By using a nonradioactively labeled probe internal to the PCR product, the assay could detect as little as 0.0062 pg of purified C. coli DNA, or the equivalent of four bacteria. In stools seeded with C. coli cells, the probe could detect between 30 and 60 bacteria per PCR assay. The assay was also successfully used to detect C. coli in rectal swab specimens from experimentally infected rabbits and C. jejuni in human stool samples.

Use of differential agar media for detection of cloned DNA fragments in the tetracycline and chloramphenicol resistance genes of pBR322

A method for detecting newly cloned DNA fragments in pBR322-based vectors was devised for use in DNA probe production. Escherichia coli strain DH5 containing plasmids with different resistance patterns to tetracycline (Tc) and chloramphenicol (Cm) were grown on nonpigmented media, blotted, transferred, and incubated for 2 h on MacConkey agar containing Tc or Cm. Resistant colonies changed color to pink as they began fermenting the lactose on the agar, while sensitive colonies remained white but were still viable and could be subcultured. This method can be applied to the detection of other plasmids with insertional inactivation of Tc or Cm resistance marker genes following successful cloning experiments, especially if pUC18 or M13 is not a possible vector. It eliminates 1 day of culture and the labor involved in individually transferring hundreds of colonies.

Norfloxacin compared to trimethoprim/sulfamethoxazole for the treatment of travelers' diarrhea among U.S. military personnel deployed to South America and West Africa

A randomized treatment trial of travelers' diarrhea was carried out among U.S. military personnel participating in routine exercises in several port cities in South America and West Africa. A 5-day, twice daily course of either norfloxacin (400 mg) or trimethoprim/sulfamethoxazole (TMP/SMX, 160/800 mg) was given to 142 volunteers. At the end of 5 days of treatment, diarrhea had resolved in 100% of 73 patients receiving norfloxacin and 97.1% (67/69) receiving TMP/SMX. A probable bacterial pathogen was determined in 44% of 142 subjects: 49% of the norfloxacin group and 39% of the TMP/SMX group. The most common pathogens detected were enterotoxigenic Escherichia coli in 20% of cases and rotavirus in 15%. Resistance to TMP/SMX was present in 20 (27%) bacterial isolates, while no resistance to norfloxacin was found. Eight of 10 patients in the TMP/SMX treatment group who had TMP/SMX-resistant bacterial enteropathogens improved clinically. Both norfloxacin and TMP/SMX were clinically effective in the treatment of travelers' diarrhea in this military population.

Diarrheal disease during Operation Desert Shield

BACKGROUND

Under combat conditions infectious disease can become a major threat to military forces. During Operation Desert Shield, there were numerous outbreaks of diarrhea among the U.S. forces. To evaluate the causes of and risk factors for diarrheal disease, we collected clinical and epidemiologic data from U.S. troops stationed in northeastern Saudi Arabia.

METHODS

Between September and December 1990, stool cultures for enteric pathogens were obtained from 432 military personnel who presented with diarrhea, cramps, vomiting, or hematochezia. In addition, a questionnaire was administered to 2022 soldiers in U.S. military units located in various regions of Saudi Arabia.

RESULTS

A bacterial enteric pathogen was identified in 49.5 percent of the troops with gastroenteritis. Enterotoxigenic Escherichia coli and Shigella sonnei were the most common bacterial pathogens. Of 125 E. coli infections, 39 percent were resistant to trimethoprim-sulfamethoxazole, 63 percent to tetracycline, and 48 percent to ampicillin. Of 113 shigella infections, 85 percent were resistant to trimethoprim-sulfamethoxazole, 68 percent to tetracycline, and 21 percent to ampicillin. All bacterial isolates were sensitive to norfloxacin and ciprofloxacin. After an average of two months in Saudi Arabia, 57 percent of the surveyed troops had at least one episode of diarrhea, and 20 percent reported that they were temporarily unable to carry out their duties because of diarrheal symptoms. Vomiting was infrequently reported as a primary symptom, but of 11 military personnel in whom vomiting was a major symptom, 9 (82 percent) had serologic evidence of infection with the Norwalk virus.

CONCLUSIONS

Gastroenteritis caused by enterotoxigenic E. coli and shigella resistant to a number of drugs was a major problem that frequently interfered with the duties of U.S. troops during Operation Desert Shield.

Effects of breeding and environment on body condition of maned ducks, Chenonetta jubata

Body weights and fat levels of non-breeding maned ducks on the southern tablelands of New South Wales and in the Australian Capital Territory were high during spring and summer, and low during autumn and winter. During the non-breeding season, paired females were fatter than unpaired females but fat levels of paired and unpaired males did not differ. Protein levels of females did not vary significantly with season, but protein levels of males were lower in winter. Females undergoing rapid follicle development before laying were fatter than non-breeding birds in the same months. Before laying, females stored fat but not protein for egg production. They used 44% of their pre-laying fat while laying, and a further 47% of the body fat present at the beginning of incubation was used during it. Laying and incubating maned ducks, and ducks with young, were less fat than non-breeding birds in the same months. Body condition of maned ducks was related to food availability, whether breeding or not, to the stage of breeding, and in females to pair status.

Polynucleotide sequence relationships among flagellin genes of Campylobacter jejuni and Campylobacter coli

DNA probes that encode a complete flagellin gene and various internal regions of the Campylobacter coli VC167 flagellin genes were hybridized to 30 strains of C. coli or C. jejuni from 20 different Lior serogroups. The results indicated a high overall degree of homology among all of the strains examined. Although the most variable regions occurred within the middle of the gene, significant DNA homology was observed among many serogroups in this region of the molecule.

An epidemic of Oroya fever in the Peruvian Andes

Between February and October 1987, a febrile illness killed 14 persons and seriously affected at least 14 others in Shumpillan, a remote Peruvian mountain village of 353 people. The illness was characterized by fever, headache, chills, and pallor. The fatality rate of untreated cases was 88%. The patients, 71% of whom were male, were 1-75 years of age. Fatal illnesses progressed from lethargy to coma to death in 3-60 days. Patients treated empirically with chloramphenicol survived. Bartonella bacilliformis was isolated from the whole blood of 3 patients. A serologic study revealed a high prevalence of antibodies to B. bacilliformis in the villagers. It is concluded that the villagers suffered from an epidemic of Oroya fever.

Norfloxacin for the prophylaxis of travelers' diarrhea in U.S. military personnel

Norfloxacin, an oral fluoroquinolone (dose 400 mg daily), was compared to a placebo in a double blinded randomized trial for the prophylaxis of travelers' diarrhea. The study was of U.S. Navy and Marine Corps personnel on shore leave in Alexandria, Egypt. A total of 222 subjects were available (105 norfloxacin, 117 placebo). In the placebo group, 26% (30/117) developed acute diarrhea vs. 2% (2/105) in the norfloxacin group. There were no significant side effects in either group.

Illness and reservoirs associated with Giardia lamblia infection in rural Egypt: the case against treatment in developing world environments of high endemicity

A longitudinal investigation of the health effects and reservoirs of Giardia was undertaken during 1984-1985 in 40 households located in the rural Nile Delta region of Egypt. Stool specimens obtained once weekly for six months from 2-4-year-old children were cyst- or trophozoite-positive in 42% of the 724 examined. Only one child remained Giardia-negative during the study. The mean duration of excretion in Giardia-positive children was seven and one-half weeks with a range of one to 17 weeks. Mucus was present in 52% of all stools collected, and fecal leukocytes were observed with surprising frequency in the absence of identifiable pathogens. Clinical symptoms of illness were frequently observed within a month before or after Giardia excretion in stool of children, but a statistical inference of association was not demonstrated. Seventeen per cent of 697 specimens obtained from their mothers were Giardia-positive for a mean duration of four weeks and a range of one to 18 weeks. A total of 962 specimens were collected from 13 species of household livestock. Giardia was detected in 22 specimens from cows, goats, sheep, and one duck. Giardia cysts were detected in three of 899 samples of household drinking water. The ubiquity of the protozoan as well as the failure to show an association between infection and symptomatic illness argue against the administration of Giardia-specific drugs to children in settings where the risk of reinfection is high and for whom intestinal insults are both varied and constant.

Alkaline phosphatase-conjugated oligonucleotide probes for enterotoxigenic Escherichia coli in travelers to South America and West Africa

Several studies have demonstrated the usefulness of 32P-labeled recombinant DNA probes for identifying enterotoxigenic Escherichia coli (ETEC). The use of radioisotopes and X-ray development, however, severely handicaps the utility of DNA probes in most clinical laboratories. In this study, enzyme-labeled oligonucleotide probes for ETEC LT (heat-labile toxin) and ST (heat-stable toxin) genes were compared with the standard Y1 adrenal cell and suckling mouse assays for their ability to identify ETEC in a population of American adults experiencing acute episodes of diarrhea in South America and West Africa. The LT probe hybridized with 12% (64 of 529) of the E. coli colonies tested, whereas 11% (57 of 529) were positive by Y1 adrenal cell assay. DNA from 9% (47 of 529) of the E. coli colonies tested hybridized with the ST probe, whereas only 5% (28 of 529) produced ST as measured by the suckling mouse bioassay. For the patient samples tested, correlation between probe and bioassay for LT was 97%, or three discrepancies in 111 patients tested. Overall concordance of the ST probe and bioassay was 95%, or five discrepancies in 111 patients. Enzyme-labeled oligonucleotide probes represent a major advance in the diagnosis of ETEC-associated diarrheal disease and may be used in laboratories with minimal equipment.

Abdominal Fat and Percentage Water as Predictors of Body-Fat in Adult Maned Duck, Chenonetta-Jubata

We derived 10 best fit regression equations for estimating body fat mass in maned duck carcasses. Body fat can be estimated from abdominal fat mass (females, R*2=0.86; males, R*2=0.81), percentage water (combined sexes, R2=0.83), and the Child-Marshall index (combined sexes, R*2=0.91). We recommend that body fat be estimated by the Child-Marshall equation where carcasses can be dried, and by abdominal fat equations otherwise.

A newly recognized cause of travelers' diarrhea: enteroadherent Escherichia coli

Adherence to HEp-2 tissue culture cells has been proposed as a virulence characteristic of enteropathogenic Escherichia coli (EPEC). A preliminary study revealed that E. coli that adhered to HEp-2 cells, but did not produce conventional enterotoxins and did not belong to recognized EPEC serogroups, could be isolated from adults from the United States who acquired diarrhea in Mexico. The purpose of this study was to determine the prevalence of these enteroadherent E. coli (EAEC) in 188 travelers with diarrhea and in 92 well travelers. EAEC were found in 14.9% of patients with diarrhea and in 7.6% of well individuals. Compared with well travelers, patients with diarrhea in whom no recognized enteropathogen could be identified had a 30.4% prevalence of EAEC (P less than .0003). These results further support our finding that EAEC are associated with diarrhea in travelers to Mexico and may help to explain the effect of antibiotics in the prevention and therapy for travelers' diarrhea in patients with no recognized bacterial enteropathogens.

Comparison of methods for identification of Giardia lamblia

Stool specimens from children in daycare centers were screened for Giardia lamblia and intestinal amoebae by staining wet mounts with methylene blue and dilute Lugol's iodine. Merthiolate-iodine-formalin concentrations (MIFC) and permanent smears stained with Wheatley's trichrome method also were done. In addition, stools were preserved with polyvinyl alcohol (PVA) and 10% formalin and tested with trichrome and MIFC, respectively. The effectiveness of each method was based on a quantification scheme. Trichrome and MIFC were the best identification methods for cysts of G. lamblia. Trichrome was the superior method for identification of trophozoites. The other staining procedures were significantly less accurate. The use of preservatives did not improve recovery of G. lamblia compared with same morning processing of fresh stools. This study provides evidence that a permanent stain such as trichrome is an important tool for the diagnosis of G. lamblia and should be included in the processing of any diarrheal stool.

Comparative in vitro activities of ten antimicrobial agents against bacterial enteropathogens

The in vitro susceptibilities of 50 strains of Salmonella spp., 80 strains of Shigella spp., and 50 enterotoxigenic Escherichia coli, 14 Yersinia enterocolitica, 6 Aeromonas hydrophila, 4 Plesiomonas shigelloides, 9 Vibrio parahaemolyticus, and 30 Campylobacter jejuni strains that were recently isolated from worldwide sources were determined for 10 antimicrobial agents. The antimicrobial agents tested included ampicillin, bicozamycin, doxycycline, enoxacin (CI-919), erythromycin, furazolidone, amdinocillin, norfloxacin, trimethoprim, and trimethoprim-sulfamethoxazole. Ampicillin resistance occurred frequently in strains of Salmonella and Shigella spp. and enterotoxigenic E. coli strains. The most active agents against all of the bacteria tested were enoxacin and norfloxacin. Furazolidone and amdinocillin were also highly active against the majority of strains. Trimethoprim and trimethoprim-sulfamethoxazole were inhibitory at low concentrations against all test except C. jejuni isolates. The in vitro results of this study confirm the high prevalence of bacterial resistance to ampicillin. However, this work also identifies four antimicrobial agents, enoxacin, furazolidone, norfloxacin, and amdinocillin, that would be appropriate for further testing in clinical trials.