Epidemiology of Salmonella enterica Serotype Typhi Infections in Korea for Recent 9 Years: Trends of Antimicrobial Resistance

The aim of this study is to characterize the epidemiological features of typhoid fever, categorized as class 1 notifiable disease in Korea and to analyze the recent change of antimicrobial resistance of Salmonella enterica serotype Typhi isolated nationwide. We retrospectively analyzed the 1,692 culture-proven cases from 1992 to 2000, using the data of the Korean National Institute of Health. The overall incidence of culture-proven typhoid fever was 0.41 per 100,000 population. It occurred all over the country, but the southeastern part of Korean peninsula had the higher incidence rate than other areas. There were several outbreaks suspected, of which two outbreaks were confirmed. The resistance rate against chloramphenicol showed mild increase, but the ampicillin, trimethoprim/sulfamethoxazole, kanamycin, or nalidixic acid resistance remained at the similar levels for the past 9 yr. There were 21 (1.3%) multidrug-resistant (MDR) strains isolated since 1992, and the number of those has increased. Two strains resistant to ciprofloxacin were first identified in Korea.

EDTA-dependent Pseudothrombocytopenia Confirmed by Supplementation of Kanamycin: A Case Report

EDTA-dependent pseudothrombocytopenia (PTCP) is the phenomenon of a spurious low platelet count due to EDTA-induced aggregation of platelets. Since the failure to recognize EDTA-dependent PTCP may result in incorrect diagnosis and inappropriate treatment, the recognition of this phenomenon is very important. We report an insidious case of EDTA-dependent PTCP confirmed by supplementation of kanamycin to anticoagulant in a 53-year-old women. Although sodium citrate and heparin usually prevented the aggregation of platelets in EDTA-dependent PTCP patients, these anticoagulants failed in preventing PTCP in our case. EDTA-dependent PTCP was confirmed by the findings that the clumping of platelets on microscopic evaluation was found in EDTA-anticoagulated blood samples, whereas thrombocytopenia and platelet aggregation were not revealed in the sample supplemented with kanamycin.

Agentes antituberculosos. Nuevas alternativas farmacológicas / Antituberculous drugs. New alternatives

La principal indicación de los fármacos antituberculosos de segunda línea es la presencia de tuberculosis resistente a drogas primarias. Comparados con los antituberculosos de primera línea, estos fármacos tienen una menor actividad antimicrobiana, más efectos colaterales, algunos son más caros y varios regímenes en los que se incluyen estas drogas son administradas por un mayor tiempo. Los principales fármacos son: ácido paraaminosalicílico (PAS), tiacetazona, clofazimina, etionamida, cicloserina, capreomicina, amikacina y kanamicina. Sus mecanismos de acción y de resistencia, así como su absorción, eliminación y efectos colaterales son diferentes para cada droga. Para el PAS y la tiacetazona los efectos colaterales más importantes son a nivel gastrointestinal; la clofazimina puede producir hiperpigmentación de la piel; la ciloserina puede originar síntomas neurológicos; los aminoglucósidos y la capreomicina generalmente causan trastornos vestibulococleares. Las contraindicaciones y las dosis de cada fármaco, de acuerdo a las posibles enfermedades concomitantes, son quizás de los aspectos a considerar más importantes cuando estas drogas son administradas

Susceptibility of south Indian strains of Mycobacterium tuberculosis to tuberactinomycin.

A total of 114 strains of Mycobacterium tuberculosis isolated from sputum samples of 114 patients of pulmonary tuberculosis in south India, were coded and tested for their in vitro susceptibility to tuberactinomycin (Tum) incorporated in Lowenstein-Jensen (LJ) medium. Of these strains, 95 (83.3%) and 15 (13.2%) were susceptible to Tum at 25 and 50 mg/l respectively. Only 4 (3.5%) strains were inhibited at 100 mg/l or more. Of the 37 drug sensitive strains, 2 (5.4%) were not susceptible to Tum at 25 mg/l compared to 17 (22.1%) of 77 strains-resistant to one or more of antituberculosis drugs (P less than 0.02). The drug susceptibility pattern of the strains revealed that there was no significant association of resistance between Tum and streptomycin or rifampicin or ethambutol or ethionamide or isoniazid. However, 15 (53.6%) of 28 kanamycin (K) resistant strains were not susceptible to Tum at 25 mg/l. This cross resistance between Tum and K was further studied in 24 and 15 K sensitive and resistant strains respectively, by correlating their proportion resistance at 16 mg/l and it was found to have a significant positive correlation (r = 0.55; P less than 0.01).

Flora conjuntival normal: estudio realizado en el preoperatorio de 100 pacientes / Normal conjuntival flora: study performed durin the preoperative time of 100 patients

Se estudiaron los exudados tomados de conjuntivas normales durante el preoperatorio de 100 pacientes de más de 14 años ingresados en el servicio de oftalmología del Hospital General "Lenin" de Holguín, en el período comprendido entre enero de 1987 y julio de 1988. Se relacionan variables que pudieran ejercer influencia en la mayor o menor incidencia, así como en las variaciones de los gérmenes: procedencia, cambios estacionales. Obtuvimos el 93% de positividad. Los microorganismos más frecuentes fueron: Estafilococo epidermidis, Estafilococo aureus y Proteus mirabilis. Los antimicrobianos más efectivos in vitro fueron: la amikacina, la kanamicina, y el ceporán

Kanamycin as a Ca++ Antagonist

In order to elucidate mechanisms of Ca++ antagonistic action of kanamycin in the biological system, the effects of kanamycin on Ca++ transport in sarcoplasmic reticulum of rabbit skeletal muscle and liver mitochondria were studied. At the same time, the effect of the agent on Bowditch and Woodworth phenomena of rabbit heart as well as the superprecipitation of actomyosin isolated from rabbit skeletal muscle were studied. Since kanamycin inhibits the Bowditch staircase phenomena in rabbit cardiac muscle, it is speculated that kanamycin inhibits Ca++ influx across the cell membrane which is required for the muscular contraction. Kanamycin also inhibits the Woodworth staircase phenomena, indicating a decrease in size of the Ca++ pool in cardiac muscle which may be brought about by an inhibition of Ca++ transport in sarcoplasmic reticulum and mitochondria. Actually, kanamycin was found to inhibit both the activities of Ca++ activated adenosine triphosphatases (ATPase) and Ca++ transport in sarcoplasmic reticulum and mitochondria. Kanamycin also inhibits both the development of superprecipitation and the activity of Ca++activated ATPase of skeletal actomyosin in rabbits. From the results obtained above, it may be concluded that kanamycin possesses a Ca++ antagonistic action in the biological system.