Antibiotic susceptibilities and resistance genes of Ureaplasma parvum isolated in South Africa.

OBJECTIVES: There is only limited information on the antimicrobial susceptibilities and resistance genes of Ureaplasma parvum in South Africa. This study was designed to detect and characterize resistance genes in U. parvum. METHODS: Fifteen U. parvum isolates were investigated employing the broth microdilution method (tetracycline, doxycycline, ofloxacin, erythromycin, azithromycin and josamycin). Gene analyses were performed on target regions of: tet(M); gyrA, gyrB, parC and parE; erm(A), erm(B), erm(C) and erm(E); msr(A), msr(B), msr(C) and msr(D); 23S rRNA operons; and L4 and L22 ribosomal proteins. RESULTS: Seven of the U. parvum isolates were fully susceptible to the antibiotics tested. Five strains exhibited resistance to tetracycline (MICs 16-256 mg/L), one strain was resistant to ofloxacin (MIC 128 mg/L) and four strains were resistant to macrolides (MICs 128 mg/L); two strains showed dual resistance to tetracycline and erythromycin. The five tetracycline-resistant strains were found to have mosaic tet(M) genes, with one strain containing different specific regions to those previously described. Mutations in the L22 ribosomal protein were seen in three strains that were resistant to erythromycin (two strains) and erythromycin + azithromycin (one strain). For a further strain that was resistant to erythromycin and azithromycin, possible mechanisms of resistance remained elusive. CONCLUSIONS: This is the first report of quinolone, erythromycin and azithromycin resistance development in U. parvum from South Africa. A point mutation in parC (Pro-57 → Leu) and two novel mutations in parE (Ile-73 → Thr and a methionine insertion at codon 86) were found in an ofloxacin-resistant strain. The study reinforces the adaptability of U. parvum to develop resistance and acquire, modify and maintain transposon-located resistance genes.

Antimicrobial and antimalarial activity of Cussonia species (Araliaceae).

ETHNOPHARMACOLOGICAL RELEVANCE: Cussonia species are used in African traditional medicine mainly against pain, inflammation, gastro-intestinal problems, malaria and sexually transmitted diseases. AIM OF THE STUDY: To summarise ethnomedicinal uses of Cussonia and to find scientific evidence in support of selected main uses. MATERIALS AND METHODS: Using the minimum inhibitory concentration (MIC) method, leaves of 13 Cussonia species, Schefflera umbellifera and Seemannaralia gerrardii were tested against pathogens associated with diarrhoea (Enterococcus faecalis and Escherichia coli), sexually transmitted infections (Neisseria gonorrhoeae and Trichomonas vaginalis) and general infectious diseases (Staphylococcus aureus and Pseudomonas aeruginosa). Antimalarial sensitivity was studied using Plasmodium falciparum and the [(3)H]-hypoxanthine incorporation assay. Cytotoxic effects on a T-cell leukaemia (Jurkat) cell line were determined using the tetrazolium-based cellular toxicity assay. RESULTS: Methanolic extracts were active against Pseudomonas aeruginosa (MIC of 1.0-1.5 mg/mL), Trichomonas vaginalis (MIC of 0.8-1.3 mg/mL) and Staphylococcus aureus (Cussonia arborea, 1.8 mg/mL). All samples were active against Neisseria gonorrhoeae (MIC of 0.02-0.7 mg/mL). The methanol extract of Cussonia arborea was the most active against Plasmodium falciparum (13.68 microg/mL) and showed anticancer properties (5.60 microg/mL). CONCLUSIONS: The traditional use of Cussonia species to treat sexually transmitted diseases and Plasmodium infections appears to have a scientific basis.

Drug-susceptibility patterns of Mycobacterium tuberculosis in Mpumalanga province, South Africa: possible guiding design of retreatment regimen.

Multidrug-resistant tuberculosis (MDR-TB) has been a cause of concern in both developed and developing countries. The prevalence of drug resistance in Mycobacterium tuberculosis (MTB) isolates (n=692) from Mpumalanga province was assessed. In total, 692 (64%) MTB strains from cases with pulmonary TB were tested for susceptibility against rifampicin, isoniazid, ethambutol, and streptomycin using the MGIT 960 instrument. Two hundred and nine (30.2%) strains were resistant to one or more drugs. Resistance to one drug ranged from 1.4% for ethambutol to 17.7% for rifampicin. The prevalence of MDR-TB ranged from 6.7% for three drugs to 34% for four drugs, with significant predictors being patients' age-groups of 25-54 years (p=0.0012) and >55 years (p=0.007). The result showed a high level (58.4%) of MDR-TB from cases in Mpumalanga province. To achieve a higher cure rate in this province, drug-susceptibility tests must be done for every case.

Possible radiation injury at Koeberg Nuclear Power Station. Organization of medical care.

Any injured patient from Koeberg Nuclear Power Station will be treated in the conventional manner as an acute surgical emergency; this has priority over decontamination. The ideal situation is decontamination at Koeberg before ambulance transferral to the Tygerberg Radiation Casualty Facility, but if this is not possible or complete, decontamination can be accomplished by a trained team in the unit. Teamwork is the essence at the place of injury, during transfer, in the decontamination area, in the operating theatre and during the postoperative phase. No surgical management is appropriate or complete without the very necessary guidance and advice from a physicist and the Advisory Group for Radiation Casualties.