ABSTRACT
@#extraintestinal infections among Thai children,especially infants, and leading to overwhelming antibioticuse.Materials and Methods: In this retrospective review, datacollected during 2006-2015 from the medical charts ofpatients with evidence of infection, caused by anySalmonellaserogroup or clinical form, were examined. Weaimed to assess the clinical manifestations, antibioticsusceptibility, and antibiotic use in children with Salmonellagastroenteritis over the ten years’ period.Results: A total of 419 patients had non-typhoidalSalmonellainfection. Four-hundred (95.5%) patients werediagnosed with acute gastroenteritis, which was common inchildren aged <12 months (72.3%). The clinical features ofpatients with gastroenteritis included fever (74.5%),diarrhoea with bloody mucus (60.5%), watery diarrhoea(39.5%), and vomiting (19.8%). Serogroup B was mostcommonly detected in the stool specimens. Thesusceptibility of non-typhoidal Salmonellato ampicillin,norfloxacin, and co-trimoxazole was 36.3%, 98.0%, and80.5%, respectively. Serogroup B was the most resistantstrain, which was sensitive to ampicillin in only 21.6% ofspecimens, while it showed high susceptibility tonorfloxacin and co-trimoxazole (98.1 and 84.0%,respectively). Third-generation cephalosporin andfluoroquinolone were most commonly prescribed. Conclusions: Acute gastroenteritis is the most commonform of Salmonellainfection. Gastroenteritis caused byserogroup B is still the most common infection, whichmostly occurs among infants under one year of age. Themajority of stool specimens were still susceptible toantimicrobial agents, especially fluoroquinolone and co-trimoxazole; however, there was an overuse of antibioticswithout proper indications.
ABSTRACT
@#life-threatening condition causing multisystem involvementsuch as cytopenia, hepatosplenomegaly, and death. Dengueinfection is one of the leading causes of HLH. We reviewedthree cases of children at HRH Princess Maha ChakriSirindhorn Medical Center, Faculty of Medicine,Srinakharinwirot University, Nakhon Nayok, Thailand, withdengue fever who subsequently developed HLH, based onthe HLH-2004 diagnostic criteria. Following treatment withdexamethasone and intravenous immunoglobulin, there wasa dramatic response including defervescence andimprovement of cytopenia, hyperfibrinogenemia, andhyperferritinemia. Key features for diagnosis of denguefever complicated by HLH include a history of prolongedfever exceeding seven days, splenomegaly, and worseningcytopenia. Early recognition and treatment are crucial for asuccessful outcome.
ABSTRACT
The objective of this study is to evaluate the patterns of nasal colonization of Staphylococcus aureus and its susceptibility patterns among medical students before and after their rotations in the hospital. Nasal swabs were obtained from 128 medical students for microbiological study and susceptibility testing prior to working in the hospital [the first], following the first rotation [the second] and at the end of the rotation schedule in the hospital [the last]. The probable risk factors for nasal carriage were recorded for assessment. S. aureus was isolated at the first, second and last swabs with colonization rates of 29.7%, 30.5% and 39.4%, respectively. The prevalence rate of colonization of S. aureus showed a statistically significant increase [P< 0.05]. There was a persistent colonization of S. aureus at the rate of 20.3%. No participants showed methicillin-resistant S. aureus. The susceptibility of S. aureus to erythromycin and clindamycin was 36.8%, 41% and 34% at the first, second and last swabs, respectively. There was no significant correlation between nasal carriage of S. aureus and its potential risk factors. After clinical rotation in the hospital, the prevalence rate of asymptomatic nasal carriage of S. aureus increased and the S. aureus isolated has shown a relatively high resistance to erythromycin and clindamycin
Subject(s)
Humans , Female , Male , Carrier State , Nose , Microbial Sensitivity Tests , Students, Medical , Follow-Up StudiesABSTRACT
To determine the epidemiology of the nasal carriage of Staphylococcus aureus and its susceptibility pattern among preclinical medical students at the HRH Princess Maha Chakri Sirindhorn Medical Center, Srinakharinwirot University. Nasal swabs were taken from 128 preclinical medical students prior to working at the hospital. Susceptibility testing of S. aureus was performed using Kirby Bauer's disc diffusion method. Of the 128 participants, 38/128 [29.7%; 95% confidence interval [CI] = 21.8%, 37.6%] were carriers of S. aureus. No methicillin-resistant S. aureus was detected by the cefoxitin disk diffusion test. Resistance of S. aureus to erythromycin, clindamycin, tetracycline, chloramphenicol and fusidic acid was observed at the following rates: 63.2% [95% CI; 47.8%, 78.5%], 63.2% [95% CI; 47.8%, 78.5%], 34.2% [95% CI; 19.1%, 49.3%], 2.6% [95% CI; -2.5%, 7.7%] and 2.6% [95% CI; -2.5%, 7.7%], respectively. There was no statistically significant correlation between nasal carriage of S. aureus and possible risk factors. The prevalence of asymptomatic nasal carriage of S. aureus was higher than reported by previous literature in Thailand, and S. aureus isolates exhibited relatively high resistance to erythromycin and clindamycin