Bacterial isolation and antimicrobial susceptibilities in patients with infective endocarditis.

Infective endocarditis is life-threatening and urgent treatment is needed. We review here 6217 patients with infective endocarditis admitted to Siriraj Hospital during a 20 year period, 1982-2001. In this retrospective study, we obtained our data from hemoculture results. Bacterial pathogens were found in only 834 patients (13.41%). Of the five most common pathogens, nonfermentative gram-negative rods (N.F.) ranked first (20.94%), followed by coagulase-negative staphylococci (12.47%), viridans streptococci (10.23%), Staphylococcus aureus (9.29%), and Escherichia coli (8.59%). Of the N.F., the sensitivities were: cefoperazone/sulbactam (86%), piperacillin/tazobactam (86%), meropenem (84%), imipenem (83%), ceftazidime (78%), ofloxacin (85%), ciprofloxacin (71%), and co-trimoxazole (71%).

Evaluation of the urine dipstick analysis for detection of bacteriuria.

This retrospective study was performed to evaluate the urine dipstick [ Leukocyte esterase and nitrite test ] for detection of bacteriuria and pyuria. Of the 1000 specimens, 296 [ 29.6% ] had positive culture results. The dipstick[ either leukocyte esterase or nitrite test ] test for detection of bacteriuria had a sensitivity of 85%, specificity of 51%, positive predictive value of 42% and negative predictive value of 89%, and the leukocyte esterase test for the detection of pyuria had a sensitivity of 96%, specificity of 73%, positive predictive value of 75% and negative predictive value of 95%. The sensitivity and negative predictive value of the dipstick test in the pediatric group was the lowest values when compared with the other groups. We conclude that, 1.) The dipstick test may be used as a screening test for pyuria. 2.) This test can not be used as a screening test for urinary tract infection [UTI ]. 3.) In contrast to sex, age affect the results of the urine dipstick test. 4.) This test has good result in adult particularly old age but, not in children.

Bacterial fungal and aflatoxin contamination of medicinal herbs, spices and curry in Bangkok.

Thirty-nine samples of medicinal herbs, thirty-three samples of spices, one hundred and four samples of materials to prepare curry were randomly collected from various markets around Bangkok area during July 1983- June 1985. Fifteen percent of the medicinal herbs contained aflatoxin B1 20 to 150 parts per billion (ppb), and five percent contained aflatoxin G1 20 to 90 ppb. The aflatoxin contaminated medicinal herb samples revealed Aspergillus niger. Aflatoxin B1 contaminated eighteen percent and aflatoxin G1 contaminated twenty-four percent of spices, it amounts 80 to 760 ppb. In the curry group it was found that forty percent of 40 were contaminated by aflatoxin B1 and twenty percent was contaminated with aflatoxin G1 in amounts of 40 to 160 ppb. Culture for fungus A. Niger was predominant; otherwise gram negative bacteria such as Citrobacter sp., Entrerobacter sp. were identified. Aflatoxin B1 and G1 was found in sixty-nine and fifty-four percent of garlic, in amounts between 20 to 130 ppb. Culture for fungus also revealed A. niger. Only one sample from eleven samples of shrimp paste was contaminated with aflatoxin B1 with more than 30 ppb. Ten samples of fish sauce were savey for consumption. Forty percent of pepperoni was contaminated with aflatoxin B1 and also contaminated aflatoxin G1 fifty percent. Amount varical from 10 to 230 ppb. Aflatoxin B1 and G1 contaminated seventy to eight percent of curry. (uncooked), the amount varying from 10 to 270 ppb. Fifty-four samples of Chutni’s pasts (Nam Prix Pao) were contaminated with aflatoxin G1 amanta of 100 to 260 ppb. Twenty-nine to twenty-three percent of curry (canned) was contaminated with aflatoxin B1 and G1 respectively. Furthermore it was easily contaminated with other bacteria such as Staphylococcus aureus, Enterococci, Citrobacter sp. This study also proved that A. Niger can produce aflatoxin both B1 and G1 in glutinous rice and peanuts.