Beta-lactamase production in recent clinical isolates of Haemophilus influenzae and their susceptibility to cefaclor and other antimicrobial agents

The ability of 383 recent clinical isolates of Haemophilus influenzae to produce beta-lactamase was detected by using cefinase discs. It was found that 8% of the isolates elaborate this enzyme. Since cefaclor supposedly is not inactivated by beta-lactamases of H. influenzae, we studied the in vitro activity of this cephalosporin and compared it with other commonly used antimicrobial agents against isolates of H. influenzae from 383 patients at a tertiary care referral hospital in Riyadh, Saudi Arabia. Cefaclor was found to be most active, inhibiting 98% of the isolates tested, followed by amoxycillin/clavulanic acid and gentamicin [95%], chloramphenicol [93%], cephalothin [90%], ampicillin [87%], tetracycline [77%] trimethoprim-sulphamethoxazole [65%] and erythromycin [47%]

HIV infection in Saudi Arabia: occurrence, pattern of disease and future implications

Between 1985 and 1990, 96 people were identified as HIV1 Western blot positive. Of these, 87 were Saudi nationals and 61 attended a clinic dedicated for the management of HIV in Saudi Arabia. The demographic characteristics appear distinct from those previously described and include male predominance [male-female ratio 3 : 2], bimodal age distribution [childhood peak 6.4 +/- 3.2 years; adult peak 29 +/- 9.2 years] and a predominantly transfusion associated disease [44/71 patients]. However, other well known risk factors are represented. The sexual and maternal-fetal routes could emerge as the predominant mode of transmission in the future. Pneumocystis carinii pneumonia was the index diagnosis of AIDS in 9/17 patients [53%], Kaposi's sarcoma was present in only 2/17 [12%] Oro-pharyngeal candidiasis, CMV, herpes zoster, and cerebral toxoplasmosis were common opportunistic infections, whereas tuberculosis was rare and no case of Leishmania or Brucella was identified. Hepatitis C antibodies were present in 19/31 patients, of which 10 [53%] had raised liver enzymes. All had acquired their HIV via blood transfusion. The point prevalence for AIDS [at mean duration of seropositivity] for blood transfusion associated HIV was 36% [6.1 +/- 2.4 years], promiscuous sexual behaviour/intravenous drug abuse was 58% [3.5 +/- 1.7 years], haemophiliacs 4% [4.9 +/- 0.9 years] and maternal-fetal acquisition 0% [3.6 +/- 1.1 years] The apparent endemicity of HIV in Saudi Arabia and the important gaps in clinical attendees' comprehension of the disease, highlight the need for further epidemiological studies and appropriate health education measures

Liposomal amphotericin B treatment of aspergillosis in a renal transplant patient

A renal transplant recipient developed intracranial aspergillosis, and whilst receiving conventional amphotericin B therapy [1 mg/kg daily] developed acute anuric renal failure necessitating discontinuation of therapy. He then received liposomal amphotericin B [Ambisome] at 2 mg/kg daily with no recurrence of renal toxicity. Liposomal amphotericin B appears to be safe in the management of severe fungal infections in renal transplant patients in whom preservation of renal function is crucial