Emerging nalidixic acid and ciprofloxacin resistance in non-typhoidal Salmonella isolated from patients having acute diarrhoeal disease

Background: Non-typhoidal Salmonella are one of the key etiological agents of diarrhoeal disease. The appearance of multiple drug resistance along with resistance to quinolones in this bacterium poses a serious therapeutic problem. We determined the prevalence of nalidixic acid and ciprofloxacin resistance in non-typhoidal Salmonella isolated from faecal samples of patients with acute diarrhoeal disease attending the outpatient and inpatient department of a hospital in Saudi Arabia during the years 1999 to 2002

Methods: Non-typhoidal Salmonella were isolated from faecal samples. Antimicrobial susceptibility was tested by the disc diffusion test. MICs to nalidixic acid and ciprofloxacin were determined by the agar dilution method

Results: During the study period, 524 strains of non-typhoidal Salmonella were isolated. Strains belonging to serogroup C1 were the commonest [41.4%] followed by serogroups B and D [15.6% and 14.5%, respectively]. Resistance to ampicillin was observed in 22.9% and to trimethoprim/sulfamethoxazole in 18.5% of the strains. Nalidixic acid resistance was encountered in 9.9% and ciprofloxacin resistance in 2.3% of the strains. Resistance to nalidixic acid significantly increased from 0.1% in 1999 to 5.5% in 2002 [P=0.0007] and ciprofloxacin resistance increased significantly from 0.1% in 1999 to 0.9% in 2002 [P=0.0001]. MICs to nalidixic acid and ciprofloxacin were determined among 29 nalidixic acid-resistant strains of non-typhoidal Salmonella isolated during 2002. The MIC was >256 microg/mL to nalidixic acid and 8 to 16 microg/mL to ciprofloxacin

Conclusion: The increasing rates of antimicrobial resistance encountered among non-typhoidal Salmonella necessitate the judicious use of these drugs in humans. Moreover, these findings support the concern that the use of quinolones in animal feed may lead to an increase in resistance and should be restricted

Validity of self-reporting questionnaire and rahim anxiety depression scale

The Self-Reporting Questionnaire and Rahim Anxiety-Depression Scale are instruments used for screening minor psychiatric morbidity. The aim of this study is to test and compare their validity and reliability in a sample of Saudi adult diabetic patients. a random sample of 226 adult diabetics and an equal number of matched normal subjects were interviewed using a structured questionnaire including socio-demographic and clinical characteristics, as well as the self-Reporting Questionnaire and Rahim Anxiety-Depression Scale. A sub-sample of 49 patients were further clinically according to DSM-IV diagnostic criteria. Indices of inter-rater and test-retest reliability were in the range of 84% to 88%. Validity measures, reached by comparing the results of the screening tests with the blind clinical judgement of qualified psychiatrists, showed ranges of sensitivity between 70% and 94%, specificity between 72% and 84%, overall accuracy rate between 71% and 84%, and odds ratio between 6.3 to 48. Factor Analysis extracted 5 factors: one of predominantly depressive symptoms, 2 of somatic complaints, one of psychic anxiety, and one of neurasthenic manifestations. Compared to Self-Reporting Questionnaire, Rahim Anxiety-Depression scale gave consistently higher values in all tested indices of validity. The 3 instruments seen reliable and valid in screening psychiatric morbidity in diabetic patients Rahim Anxiety-Depression Scale, which incorporates all the items of Self-Reporting Questionnaire and Somatization Sub-scale, was found superior to Self-Reporting Questionnaire alone, and it allowed for probing the severity, as well as the frequency, of reported symptoms

Validity of self-reporting questionnaire and Rahim Anxiety Depression Scale

The Self-Reporting Questionnaire and Rahim Anxiety-Depression Scale are instruments used for screening minor psychiatric morbidity. The aim of this study is to test and compare their validity and reliability in a sample of Saudi adult diabetic patients. A random sample of 226 adult diabetics and an equal number of matched normal subjects were interviewed using a structured questionnaire including socio-demographic and clinical characteristics, as well as the Self-Reporting Questionnaire and Rahim Anxiety-Depression Scale. A sub-sample of 49 patients were further clinically assessed according to DSM-IV diagnostic criteria. Indices of inter-rater and test-retest reliability were in the range of 84% to 88%. Validity measures, reached by comparing the results of the screening tests with the blind clinical judgement of qualified psychiatrists, showed ranges of sensitivity between 70% and 94%, specificity between 72% and 84%, overall accuracy rate between 71% and 84%, and odds ratio between 6.3 to 48. Factor Analysis extracted 5 factors: one of predominantly depressive symptoms, 2 of somatic complaints, one of psychic anxiety, and one of neurasthenic manifestations. Compared to Self-Reporting Questionnaire, Rahim Anxiety-Depression Scale gave consistently higher values in all tested indices of validity. The 3 instruments seem reliable and valid in screening psychiatric morbidity in diabetic patients. Rahim Anxiety-Depression Scale, which incorporates all the items of Self-Reporting Questionnaire and Somatization Sub-scale, was found superior to Self-Reporting Questionnaire alone, and it allowed for probing the severity, as well as the frequency, of reported symptoms