Current trends of antibiotic sensitivity pattern of bacterial pathogens isolated from dysentery cases from clinics

A cross-sectional descriptive clinic based study was carried out among 150 dysentery cases attending the three general practitioners clinics from February 1998 to June 1999. The cases comprised 62 percent males and 38 percent females. The age range was from six months to 72 years. The siolated bacterial pathogens were Enteropathogenic Escherichia coli (EPEC) (8 percent);Enterotoxigenic Escherichia coli (ETEC) (6.7 percent); Shigella species (6.7 percent),out of which were Shigella flexneri (50 percent), Shigella dysenteriae (40 percent)and Shigella sonnei (10 percent). The antibiotic susceptibility revealed that EPEC were sensitive to amikacin, augmentin, furazolidone, gentamicin, netilmicin, norfloxacin, nalidixic acid (83.3 percent) each, sisomycin and chloramphenicol (75 percent)each, cephalothin, streptomycin and neomycin (66.7 percent) each, and septrin (58.3 percent). They were resistant to ampicillin (66.7 percent), tetracycline (75 percent), and carbenicillin (66.7 percent). Shigella species were sensitive to netilmicin (100 percent), norfloxacin (100 percent), amikacin, augmentin, furazoli-done, gentamicin (80 percent) each, cephalothin, nalidixic acid, neomycin, septrin (70 percent)each. They were sesistant to streptomycin (100 percent),chloramphenicol (80 percent), tetracycline (80 percent), carbenicillin (70 percent)and ampicillin (60 percent).

Current trends of antibiotic susceptibility pattern of bacterial pathogens isolated from dysentery cases from clinics

A cross-sectional descriptive clinic based study was carried out among 150 dysentery case attending the three general practioners' clinic from February 1998 to June 1999.The cases comprised 62 patients males and 38 percent females.The age range was from six month to 72 years.The isolated bacterial pathogens were Enteropathogenic Escherichia Coli (EPEC) (8 percent); Enterotoxigenic Escherichia coli (ETEC) (6.7 percent); shigella species (6.7 percent), out of which were Shigella Flexneri (50 percent), shigella dysenteiae (40 percent) and shigella sonnei(10 percent).The antibiotics susceptibility revealed that EPEC were sensitive to amikacin, augmentin, furazolidone, gentamicin, netilmicin, norfloxacin, nalidixic acid (83.3 per cent ) each; sisomycin and chloramphenicol (75 per cent ) each, cephalothin, streptomycin and neomycin (66.7 percent) each, septrin (58.3 percent).They were resistant to ampicillin (66.7 percent), tetracycline (75 percent) and carbinicillin (66.7 percent).Shigella species were sensitive to netilmicin (100 percent), norfloxacin (100 percent), amikacin, augamentin, furazolidone, gentamicin (80 percent) each, cephalothin, nalidixic acid, neomycin, septrin (70 percent) each.They were resistant to streptomycin (100 percent), chloramphenicol (80 percent), tetracycline (80 percent), carbenicillin (70 percent) and ampicillin (60 percent).

Survival of Vibrio Cholerae 01 and 0139 strains in some foods of Yangon

The purpose of this study was to determine the survival of Vibrio cholerae 01 and 0139 in foods which are usually offered by street vendors in Yangon. Survival was tested at room temperature (28 degree C-34 degree C) and 4 degree C in melon, mohinga, lethoke and sugar cane juice samples by artifical contamination of food samples. Both Vibrio cholerae 01 and 0139 could survive up to 4 hours at room temperature and up to 24 hours at 4 degree C. The growth was obvious in lethoke and sugar cane juice samples and static in melon and Mohinga samples.

Effect of sunlight in decontamination of coliforms and faecal coliforms from drinking water

Drinking water samples were collected during December 1997 to March 1998 from Mingalar market, Nyaungbinlay market, Thaketa, Pazundaung, Botataung, Lanmadaw, Anawrahta, Ahlone, Sanchaung and Papedan Townships, Yangon. The presumptive coliform and faecal coliform counts were tested on all water samples. The pH and temperature were also recorded during the experiment. The coliforms and faecal coliforms were identified by multiple tube method and the count of coliforms ranged from 17 to > 2400 MPN/100 ml and faecal coliform count ranged from <2 to 140 MPN/100 ml. The temperature ranged from 40 to 47C during the experiment. There was no association between coliform counts and temperature variation. Forty percent and 90 percent of the samples became free of coliforms after exposure to sunlight for six hours and seven hours, respectively. When exposed to sunlight, 33 percent and 77.8 percent of the samples became free of faecal coliforms after four and six hours respectively. Coliforms and faecal coliforms were totally absent after exposure for 12 hours. It was effective by using clear transparent plastic bottles but the opaque plastic bottles were not. After exposure to sunlight for 12 hours; regrowth of coliforms and faecal coliforms were not observed up to three months, provided that the exposed bottles were tightly closed.

Bacteriological quality of ice available around Yangon area

Fifty samples of ice from ice stalls of Ahlone, Botataung, Kamaryut, Kyaukmyaung, Mingalartaungnyunt, Myenigone, North and South Okkalapa, Thaketa and Thingangyun townships were collected randomly. Ice weights ranging from 654.9 to 2218.2 grams were tested for bacteriological quality. The study period lasted from August to November 1997. Total coliforms were present in all the ice samples (100 percent) and faecal coliforms were in (74 percent). The range of total coliform count was from five MPN/100ml to >2400 MPN/100ml and that of faecal coliform count was from two MPN/100ml to >2400 MPN/100ml. From this study it was known that ice were not suitable for drinking purpose.

Bacterial pathogens and drug susceptibility pattern: from diarrhoea cases of children

Stool specimens from 200 cases of children with ages of less than five years with history of acute diarrhoea from Yangon Children's Hospital were proceeded for isolation of bacterial pathogens. Enterotoxigenic Escherichia coli ETEC (15.5 per cent), enteropathogenic Escherichia coli EPEC (19 per cent), Shigellae (3.5 per cent), Salmonellae (2.5 per cent), ETEC + EPEC (6.5 per cent), ETEC+Shigellae (1.0 per cent) were isolated. Antibiotic susceptibility pattern of EPEC revealed that they were resistant to ampicillin (96 per cent), tetracycline (90 per cent), streptomycin (82 per cent), chloramphenicol (80 per cent) and septrin (61 per cent); but were sensitive to nalidixic acid (100 per cent), furazolidone (92 per cent), sisomycin (90 per cent), gentamicin (88 per cent), norfloxacin (70 per cent), and cephalothin (66 per cent). For Shigellae they were resistant to ampicillin (100 per cent), cephalothin, chloramphenicol, furazolidone, streptomycin (66.7 per cent) but were 100

sensitive to sisomycin, minocycline, norfloxacin, gentamicin; tobramycin (89 per cent), neomycin (67 per cent) and septrin (56 per cent). For Salmonellae they were resistant to ampicillin (100 per cent), chloramphenicol and tetracycline (80 per cent) but were 100 per cent sensitive to cephalothin, furazolidone, gentamicin, nalidixic acid, norfloxacin, septrin and sisomycin. For ETEC they were resistant to ampicillin (100 per cent), tetracycline (79 per cent), chloramphenicol (53 per cent) and septrin (53 per cent ). They were 100 per cent sensitive to cephalothin, furazolidone, gentamicin, nalidixic acid, neomycin, norfloxacin, septrin and sisomycin.

Different types of shigella species isolated from Infectious Diseases Hospital during 1996 and their antibiotic susceptibility patterns

Cross sectional descriptive hospital-based study using convenience sampling method was carried out among 53 dysentery cases admitted to Infectious Diseases Hospital from March to September 1996. It consisted of 67.9 per cent males and 32.1 per cent females. Their ages ranged from one year three months to 80 years. The duration of illness before attending the hospital was one to seven days. They passed motions 16 to 20 times per day. Volume of stool output was small in 62.3 per cent, moderate in 28.3 per cent, with mucus in 62.3 per cent and with blood and mucus in 35.9 per cent. Shigellae was isolated from 45.3 per cent of the cases: Shigella flexneri 2a (54.2 per cent), Shigella dysenteriae A type I (29.2 per cent), Shigella boydii (12.5 per cent) and Shigella sonnei (4.2 per cent). The antibiotic susceptibility pattern revealed that 87.5 per cent of shigellae were resistant to ampicillin, 83.3 per cent to chloramphenicol, 33.3 per cent to cephalothin, 37.5 per cent to furazolidone, 33.3 per cent to nalidixic acid, 83.3 per cent to streptomycin, 91.7 per cent to tetracycline and 33.3 per cent to norfloxacin respectively. It was also noted that 91.7 per cent of shigellae were sensitive to amikacin, 91.7 per cent to augmentin, 83.3 per cent to gentamicin, 58.3 per cent to minocycline, 91.7 per cent to neti1imicin, 66.7 per cent to neomycin, 75 per cent to sisomycin and 62.5 per cent to norfloxacin.

The association between faecal leukocytes and pathogens present in stool of children with diarrhoea and dysentery

A total of 378 cases of children with diarrhoea and dysentery admitted to Yangon Children's Hospital from March to mid-September, 1996 were studied. The study population comprised 233 males and 145 females. Faecal leukocytes were identified under a high power field microscope by wet mounting of methylene blue staining method. Those cells clearly identified with either round nucleus or as polymorphonuclear were noted and degenerated cells that could not be clearly identified were ignored. The bacterial pathogens and protozoal pthogens were identified by standard methods. Faecal leukocytes were present in 31.2 percent of total cases (diarrhoea 28.5 percent, dysentery 45.8 percent). The association between the presence of faecal leukocytes and isolated pathogens from the stools was analysed. It was found that faecal leukocytes were seen in stools which were associated with Shigella (25 percent), Shigella and Entamoeba histolytica (71.4 percent), Entamoeba histolytica (29.6 percent), enteropathogenic Escherichia coli and Entamoeba histolytica (41.7 per cent), enteropathogenic Escherichia coli (9.8 per cent ), Klebsiella spp. (50 per cent ) and Vibrios (50 per cent ).

The use of Moringa oleifera (dan-da-lun) seed for the sedimentation and decontamination of household water Part II: Community-based study

The seeds of Moringa oleifera were tested as clearing and sedimentation agents in household water in Thaung Gyi Lay village with 110 households. Questionnaires were completed for each household and follow-up visits were carried out to ascertain the hypothetical acceptability (attitude), initial acceptability (behaviour) and experimental acceptability. It was observed that 78.9 per cent of the people accepted to use Moringa oleifera seeds if these were easily available. For continuous use of Moringa oleifera seeds, 47.3 per cent wanted to use, 44.7 per cent could not decide and only three households (2.7 per cent) did not want to use these. It was observed that the taste and pH of water did not change after treatment with Moringa oleifera seeds. There was no complaint about the treated water. This study will highlight the acceptance to use Moringa oleifera seeds for the sedimentation of turbid water.

Cryptosporidiosis among children with diarrhoea and dysentery from Yangon Children's Hospital

Cryptosporidiosis among children who attended Yangon Children's Hospital from March to October 1996 was studied. A total of 396 stool samples were collected after admission to the hospital. Simultaneously, a set of questions was filled to ascertain the duration and motion of diarrhoea of children. Stool characteristics were also recorded. Cryptosporidium oocysts were detected by staining with Kinyoun's acid modified method by Haley and Standard 1973. Random samples of 238 male and 158 female children of ages ranging from one month to ten years old were included in this study. It was found that the duration of diarrhoea ranged from one to 150 days. Number of motions also ranged from one to 40 times per day. Diarrhoea with either blood or mucous (dysentery) was found in 61 cases (15.4 per cent). cryptosporidium oocysts were found in 5 cases (1.3 per cent) of children; three were from watery diarrhoea cases and two from dysentery cases. From the cases detected, the age range was from 10 months to five years and the duration of illness was from 3 to 30 days. Four cases were with moderate degree of dehydration and one case was associated with HIV infection.

The usefulness of Moringa oleifera (dan-da-lun) seed for the sedimentation and decontamination of turbid water from ponds and revers Part I: Laboratory investigations

The seeds of Moringa oleifera were tested as the clearing and sedimentation agents in tubid water from various sources (1) DMR pond (2) Yangon river (3) Bago River (4) Hline River (5) Hlinethaya Pond (6) artesian well from laydaunkkan and (7) Thanlyin River. the turbidity reduction of 80.00 to 99.5 percent paralled by a primary bacterial reduction of 90.00 to 99.99 per cent were obtained within the first one to two hours of treatment, the bacteria being concentrated in the coagulated sediment. It was observed that 100 mg (one ywe) of the seed powder served as a clearing agent in one litre of turbid water. However, the difference of clearing activity was not significant with different amounts of powder, lwhen 50 mg, 100 mg and 200 mg respectively were used with constant water quantity (one litre) within 24 hours. Moreover, the effect of the seeds could not alter the original pH of the tested water samples. The powder of M. oleifera leaves, bark and roots had no power to clear the turbidity of tested water samples.

Etiologic agents, clinical and laboratory characteristics of acute versus persistent diarrhoea in children who attended the Yangon Children's Hospital

To identify the etiologic agents, clinical and laboratory characteristics of acute and persistent diarrhoea in children less than 12 years of age, a hospital based prospective study was carried out for 18 months in Yangon Children's Hospital. A total of 487 children, 327 with acute and 160 with persistent diarrhoea participated in the study. Intestinal pathogens including bacterial agent 31 per cent, viral agent 6.3 per cent and protozoa 33 per cent were detected in 71 per cent of persistent diarrhoea cases, whereas in acute diarrhoea cases intestinal pathogens were identified in 64 per cent, among which bacterial, viral and protozoal agents were 28 per cent, 11.5 per cent and 25 per cent respectively. More than one enteric pathogen was detected in 13.7 per cent and 16.5 per cent of persistent and acute diarrhoea cases respectively. male children who suffered from diarrhoea were more than females and peak incidence of acute and persistent diarrhoea occurred in the 2-11 month age group. fever and vomiting were found more frequent in persistent than acute diarrhoea during second week of illness and differences were statistically significant. Shigella species, ETEC and e. histolytica were equally isolated from both acute and persistent diarrhoea whereas rota virus was found more ofter in acute than persistent diarrhoea. The presence of leucocytes and reducing substances in the stool was equally frequent.

Shigellosis among children attending the paediatric wards of hospitals in suburban areas

A total of 55 cases of children with dysentery admitted to the Defence Services Obstetric, Gynaecology and Children Hospital and North Okkalapa General Hospital were included in this study. It was found that 49.1 per cent of the children were suffering from shigella bacillary dysentery. The Shigella spp. isolated were: Shigella flexneri (44.4 per cent), Shigella dysenteriae (29.6 per cent), Shigella boydii (22.2 per cent) and Shigella sonnei (3.7 per cent). the distribution of Shigella spp. among the different age groups were 42.9 per cent in the age group of less than 6 months, 40 per cent in 6 to 12 months, 55 per cent in 13 to 24 months and 66.7 per cent in 25 to 60 months. Antibiotic susceptibility test revealed that these shigellae were resistant to ampicillin (84 per cent), chloramphenicol (76 per cent), streptomycin (84 per cent), tetracycline (64 per cent) and septrin (72 per cent); were fully sensitive to amikacin, gentamycin, netilmicin, norfloxacin and were less sensitive to cephalothin (76 per cent) and furazolidone (72 per cent).

The association of enteropathogenic Escherichia coli (EPEC) and gastroenteritis

A total of 619 cases of adults with gastroenteritis admitted to Yangon General Hospital, Workers' Hospital and Infectious Diseases Hospital were included in this study. It was observed that 33 percent were suffering from gastroenteritis due to enteropathogenic Escherichia coli (EPEC). The most prominent EPEC sero-groups encoutered were 01, 026, 055, 086, 0114, 0125 and 0128. The antibiotic sensitivity pattern showed that 87 percent of enteropathogenic Escherichia coli (EPEC) were resistant to ampicillin, 58 percent to chloramphenicol, 49 percent to streptomycin, 55 percent to benzyl penicillin, 44 percent and 21 percent respectively to tetracyclline and septrin. They were all sensitive to nalidixic acid but 97 percent to gentamicin, 96 percent to sisomycin and 95 percent to tobramycin respectively.

Antibacterial properties of essential oils from six medicinal plants

The essential oils obtained from six medicinal plants namely Vitex sp. (Kyaung-ban), Zingiber officinale (gyin), Cymbopogon citratus (sabalin), Curcuma longa (nanwin), Piper nigrum (ngayokekoung) and Coleus aromaticus (ziyarywethtu) were tested on 20 strains of bacteria. The bacteria comprised of 9 strains of Escherichia coli, 8 strains of Salmonella, and one strain each of Proteus morganii, Staphylococcus aureus, and Shigella sonnei. It was observed that Cymbopogon citratus and Coleus aromaticus were active on most bacteria tested.