Salmonella lamphun: first isolation of a new Salmonella serovar in Thailand.

Two isolates of a new Salmonella serovar, Salmonella Lamphun were discovered from animal feeds in Thailand, in 2003, which belongs to group C, with antigenic formula 6,8:y: 1,2. Both isolates were susceptible to all antimicrobials tested. The pulsed field gel electrophoresis pattern of both isolates comprises 11 DNA fractions sized 48, 65, 77, 105, 110, 170, 244, 330, 337,453 and 1,135 kbp. Up to April 2005, no human or animal infection by this new Salmonella serovar was reported.

Distribution of Chlamydia trachomatis serovars among female prostitutes and non-prostitutes in Thailand, and non-prostitutes in Japan during the mid-90s.

The distribution of Chlamydia trachomatis serovars in Thailand and Japan during the same period of the mid-90s was determined. Seventy-one C . trachomatis specimens isolated from female patients who visited the Venereal Diseases Center at Bangkok, Thailand in 1994 were used in this study. Of these, 56 patients were prostitutes. Forty-seven specimens obtained from female non-prostitutes who attended the Department of Obstetrics and Gynecology, Saitama Medical School, Japan during the period from 1993 to 1995 were also used in this study. DNA was extracted from these specimens and typing of C. trachomatis serovars was performed by the polymerase chain reaction-restriction fragment length polymorphism method. The identified serovars among prostitutes of Thailand (n = 56)/non-prostitutes of Thailand (n = 15)/non-prostitutes of Japan (n = 47) were as follows: Ba 1/0/2, D 8/1/15, E 11/2/8, F 16/9/8, G 4/0/7, H 3/2/3, I 1/0/1, J 3/0/0, and K 10/1/4. Serovar F was most prevalent (35.2%) in both prostitutes and non-prostitutes from Thailand, followed by serovar E (18.3%). On the other hand, serovar D was the most frequent serovar in non-prostitutes in Japan (31.9%) followed by serovars F (17.0%) and E (17.0%). A difference in the distribution of C. trachomatis serovars of Thailand and Japan was noted.

Comparison of leptospiral serovars identification by serology and cultivation in northeastern region, Thailand.

Blood from patients suspected of leptospirosis 148 specimens were cultured for leptospira. Twenty two specimens were positive (15%). The isolated leptospira were tested against the 24 serovars of standard antisera by Microscopic Agglutination Test (MAT). It was found that all 22 leptospira isolates reacted strongly against L. autumnalis, except 1 isolate that also reacted against serovar djasiman. The patient's sera were collected from only 14 cases. When the sera of the 14 patients were tested with the 24 reference serovars by MAT it was found that sera reacted the most against L. australis and in decreasing order against L. bratislava, L. autumnalis, L. rachmati, L. copenhageni, L. javanica. There had some cross reactions against several serovars in a single patient. The present study showed inconsistency between culture results and serum assays. Since sera showed cross reactivities against several serovars, it was not possible to determine which serovar was etiologic. Therefore, the isolation of leptospira though time consuming is specific in the identification of the serovar.

Occurrence of extended-spectrum beta-lactamase in clinical isolates of Klebsiella pneumoniae in a University Hospital, Thailand.

The occurrence and antimicrobial susceptibility of extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae in patients attending Siriraj Hospital in Bangkok from August 2000 to January 2001 were determined. ESBL-producing isolates were screened with four different methods: disk diffusion according to the National Committee for Clinical Laboratory Standards (NCCLS) guidelines, Etest ESBL (CT/CTL and TZ/TZL), Oxoid combination discs and MIC Etest strip. Antimicrobial susceptibility testing were determined by a microdilution automatic method (VITEX system, bioMerieux). Of 22,178 clinical specimens, 400 (1.8%) K. pneumoniae were isolated Of 26% (104/400) of these isolates were suspected to be ESBL-producing. Rates of detection of ESBL-producing K. pneumoniae were 18.67%, 30% and 23.78% for blood, sputum and urine samples, respectively. Susceptibility testing has revealed that all 70 tested isolates including 53 isolates from blood and sputum and 17 isolates from urine samples were susceptible to imipenem (MIC< or =4 mg/L). None of the tested isolates were susceptible to cephalosporins, cephamycin and aztreonam. Rate of susceptibility to ciprofloxacin, levofloxacin, gentamicin and tobramycin were 60%, 64%, 28% and 9%, respectively, for isolates from blood and sputum; 71%, 71%, 18% and 6% for urinary isolates. The present findings revealed a high occurrence rate of multi-drug resistance ESBL-producing K. pneumoniae in patients attending the university hospital. Imipenem was highly active against ESBL-producing K. pneumoniae.

Preliminary efficacy and safety of oral suspension SH, combination of five chinese medicinal herbs, in people living with HIV/AIDS ; the phase I/II study.

OBJECTIVE: To evaluate the preliminary efficacy and safety of the mixture of drug extracts from 5 Chinese medicinal herbs (SH), in the treatment of Human Immunodeficiency Virus (HIV) infection among people living with HIV/AIDS (PLWHA). DESIGN: Open-label study. SETTING: Sanpatong Hospital, Chiang Mai, Thailand. SUBJECTS: HIV-1 infected adults with a CD4 cell count of more than 200 cell/mm3 and HIV-1 RNA > 20,000 copies/ml. MATERIAL AND METHOD: Patients received an oral suspension of SH, a combination of 5 Chinese medicinal herbs namely Glycyrrhiza glaba L., Artemisia capillaris Thumb., Morus alba L., Astragalus membranaceus(Fisch.) Bge., Carthamus tinctorius L., 5 g or 30 ml, in 3 divided doses after meals, plus sulfamethozaxole/ trimethoprim, 400/80 mg tablet, once daily after breakfast for 12 weeks. During the treatment and the follow up period, the absolute CD4 cell count and the plasma HIV-1 RNA were monitored. Adverse events were observed. RESULTS: Of the 28 enrolled patients, the number of positive response patients with reduction of plasma HIV-1 RNA more than 0.5 log during the treatment and follow up period were 4-10 (14.2-35.7%) while the number of negative response patients who had plasma HIV-1 RNA rising at least 0.5 log were 2-4 (0-14.2%). The means viral load at week 0 (baseline), 12 and 20 were 4.94, 4.83 and 4.76 log copies/ml, which were slightly declined Whilst, the mean absolute CD4 cell count of week 0 (baseline), 4, 8, 12, and 20 fluctuated within the baseline, range of 382.1, 404.2, 359.4, 404.1, 360.2 cell/mm3, respectively. All subjects had good compliance without any serious adverse events. CONCLUSION: Under the condition used, SH drug therapy is safe. Satisfactory positive response, by decreased viral load of more than 0.5 log, was found in 14%-35% of HIV-positive patients. However, the immunologic response, an increase of CD4 cell count was not clearly demonstrated. The clinical benefit of SH needs more thorough scientific support before being prescribed as adjunctive therapy for treating PLWHA.

Chlamydophila pneumoniae infection among young children with respiratory diseases in Thailand.

A total of 136 children aged 5 years and under with respiratory tract diseases were examined for Chlamydophila pneumoniae infection. By means of the micro-immunofluorescence test, an acute infection was suggested in 37 (27.2%) of them. Infection was found in 23 (43.4%) of 53 children with bronchitis, seven (70.0%) of 10 with pharyngitis, and two (22.2%) of nine with pneumonia. C. pneumoniae DNA was detected in seven of 55 children by means of nasopharyngeal swabs, and serological evidence was present in all of seven. Five of them were suggested the acute infection and four of the five showed IgG titers increasing four times and over. By age distribution, five of the seven DNA-positive children were 1 year old, and the remaining two were 2 and 4 years old, respectively. The clinical findings of the seven DNA-positive children were characterized as indicative of bronchitis (n = 4), pharyngitis (n = 2), and pneumonia (n = 1). In Thailand, C. pneumoniae infection occurs frequently among children aged 5 years and under, and may cause pharyngitis, bronchitis, and sometimes pneumonia. However, it is suggested that C. pneumoniae infection is not a major cause of severe pneumonia among children in that age group.