A possible mechanism of macrolide resistance among multiple resistant Campylobacter jejuni and Campylobacter coli isolated from Thai children during 1991-2000.

A total of 495 Campylobacterjejuni and 122 C. coli isolated from Thai children were screened for macrolide (erythromycin and azithromycin) resistance by disk diffusion assay. Minimum inhibitory concentrations for erythromycin, azithromycin, nalidixic acid, ciprofloxacin, tetracycline, streptomycin, gentamicin and chloramphenicol were further determined for these macrolide-resistant Campylobacter isolates. Presence of known point mutations resulting in reduced susceptibility to macrolides was investigated by PCR and DNA sequencing. Seventeen percent (23/122) of C. coli and 2.4% (12/495) of C. jejuni isolates were resistant to macrolides. By sequencing domain V of the 23S ribosomal DNA from all 35 macrolide-resistant isolates, a known point mutation of 23S rRNA associated with reduced susceptibility to macrolides was detected in all isolates except one. Among the macrolide-resistant isolates, all were multiply resistant to nalidixic acid and ciprofloxacin, of which the latter is the preferred antimicrobial used for diarrheal treatment in Thailand. Furthermore, most macrolide-resistant isolates were also resistant to tetracycline and streptomycin. The spread of macrolide and quinolone resistant Campylobacter should be monitored closely in Thailand and elsewhere as these antimicrobials are preferred drugs for treatment of diarrhea.

A study of risk factors associated with the prevalence of Cryptosporidium in villages around Lake Atitlan, Guatemala

Cryptosporidium parvum is an endemic, zoonotic coccidian parasitosis that is highly prevalent in third-world countries where waterborne fecal contamination of food and drink or person-to-person contact with oocysts are the most common methods of transmission of the enteric protozoan. This type of transmission of the parasite made the villages around Lake Atitlan, Guatemala a unique site to compare environmental risk factors with the level of Cryptosporidium infections in the local residents. The study was carried out in two villages, San Antonio Palopo and Santa Catarina Palopo, located in the highlands above the shores of the lake. Smears from stool specimens of patients with gastroenteritis were processed using Kinyoun's modified acid-fast stain and observed with light microscopy. Of the 100 residents examined from the two villages, 32 percent had Cryptosporidium infections. Female children had the highest prevalence of infection (44 percent in San Antonio Palopo and 46 percent in Santa Catarina Palopo, p<0.05), and they also had significantly higher infection rates than males, 50 percent vs. 17 percent, respectively. The prevalence rate was not influenced by the season of the year or by the location of the residents. We found differences in prevalence rates due to age and gender, and we suggest that the high infection rates of specific groups are associated with their exposure to the contaminated water supply from Lake Atitlan.

Metodologia de ensenanza de los metodos naturales de regulacion de la natalidad (especial referencia al metodo de ovulacion de Billings). / Teaching methodology of the natural methods of family planning (special reference to the Billings' ovulation method

Se presenta una metodologia modular y personalizada de ensenanza de los metodos naturales de regulacion de la natalidad, con especial referencia al metodo de la ovulacion de Billings. Se describen los resultados obtenidos en la aplicacion de esta metodologia durante un periodo de 22 meses en el consultorio de metodos naturales del Hospital Clinico de la Universidad de Chile. Se destaca el particular comportamiento de las ex-usuarias de dispositivo intrauterino. Se determina el tiempo y numero de sesiones de instruccion empleadas para todo el proceso, cada modulo y situaciones de fertilidad en particular. Se senalan posibles ventajas de caracter economico de la ensenanza del M.O, en relacion a los costos de la planificacion familiar por metodos artificiales

Incontinencia de orina de esfuerzo. / Urinary stress incontinence

1. Presentamos estudio de 93 pacientes tratada quirurgicamente por incontinencia de orina de esfuerzo, con estudio y seguimiento similares. 2. Se analizan 31 pacientes tratadas por via vaginal; 59 por via suprapubica, de las cuales 42 corresponden a operacion de Marshall-Marchetti-Krantz; 17 a operaciones de Burch, y 3 a operaciones combinadas con cincha de Mersilene. 3. Aplicando el criterio estandar, se obtuvo exito global en 84%, considerando tambien como fracasos las mejorias parciales. El exito obtenido por via vaginal fue de 80,6%; de Marshall-Marchetti-Krantz, de 88%; con tecnica de Burch, 82,3%, y para la tecnica con cincha de Mersilene, 100% de exito. 4. Se hacen consideraciones generales sobre la importancia de la eleccion de la via adecuada, no solo a la existencia de prolapso sino que a las condiciones de la paciente.5. Se comenta que la via suprapublica parece tener ventajas sobre la via vaginal, siendo esa la via de abordaje de preferencia de los autores. 6. Se discute la validez del tiempo de observacion para catalogar como exito o fracaso los resultados del tratamiento quirurgico de la incontinencia de orina de esfuerzo