Nongonococcal septic arthritis at a major teaching hospital in Riyadh, Saudi Arabia.

Twenty five (25) consecutive cases of nongonococcal septic arthritis admitted to King Khalid University Hospital were retrospectively reviewed. The patients were mostly adults (64%) and Staphylococcus aureus was the most common bacterial species isolated (69%). Predisposing factors were identified in 52% of patients, including diabetes mellitus in seven patients, pre-existing joint disease in two patients and the infection followed intra-articular steroid injections in two patients. All patients were treated with appropriate antibiotics; however, 11 (44%) patients were left with permanent joint damage.

High level resistance to aminoglycosides in enterococci from Riyadh.

Enterococci with high level of aminoglycosides resistance are being reported from different parts of the world with increasing frequency. Treatment of infections caused by such isolates is associated with a high incidence of failure or relapse. This is attributed to the loss of the synergetic effect of aminoglycosides and cell wall active agents against isolates exhibiting this type of resistance. To determine the prevalence of enterococci with high level resistance to aminoglycosides in Riyadh, Saudi Arabia, 241 distinct clinical isolates were examined by disk diffusion method using high content aminoglycosides disks. Seventy-four isolates (30%) were resistant to one or more of the aminoglycosides tested. The most common pattern of resistance was that to streptomycin and kanamycin. Of the 241 isolates tested, 29 (12%) were resistant to high levels of gentamicin, 35 (15%) to tobramycin, 65 (27%) to kanamycin and 53 (22%) to streptomycin. The highest rate of resistance to a high level of gentamicin was found among enterococcal blood isolates (30%). Eighteen of the isolates were identified as Enterococcus faecium, 13 (72%) of these showed high level resistance to two or more of the aminoglycosides tested.

Seasonal variation of culture positive brucellosis at a major teaching hospital.

Brucellosis is one of the main zoonoses in the world. In Saudi Arabia, it was recognized as a major health problem in 1983G and since then many measures have been implemented to control the disease. We conducted a study to determine the yearly incidence and seasonal variation of blood culture positive brucellosis (Brucella cases) diagnosed at King Khalid University Hospital (KKUH) in Riyadh between 1985G and 1991G. The results showed that there was a fivefold decline in the incidence of Brucella cases over the seven years of the study from 8.6 cases/1000 admissions in 1985G to 1.4 cases/1000 admissions in 1991G. The disease showed a prevalence that extended throughout year with the majority of cases occurring during spring, summer and early fall. The possible reasons for the seasonal variation and decreasing incidence of brucellosis noted in this study are discussed.

Enteric fever due to multi-resistant Salmonella typhi.

Five cases of enteric fever due to multi-resistant Salmonella typhi are reported. Four of these patients most probably contracted the disease in India and the fifth in Egypt. All of them were successfully treated either with ceftriaxone or ciprofloxacin.

Prevalence of pathogenic intestinal parasites among preschool children in Al-Medina district, Saudi Arabia.

The prevalence of pathogenic intestinal parasites among preschool children in Al-Medina district, Saudi Arabia, was determined through a randomized multistage sampling of 8000 preschool children. Duplicate specimens from each child were examined using a simple sedimentation technique. The overall prevalence of intestinal parasites among children screened was 18.4%. The most common parasite isolated was Giardia lamblia (14.5%). This was followed by Entamoeba histolytica (2.7%), Enterobius vermicularis (1.4%), Ascaris lumbricoides (1.0%) and others. Out of the 1462 children positive for parasites, 183 (12.5%) had mixed parasitic infections. Prevalence among preschool children was highly associateed with older age, rural residence, non-municipal water supply, inadequate latrine type, low level of parental education, abdominal pain, and diarrhea.

Association of anti-cardiolipin antibodies with vascular thrombosis and neurological manifestation of Behçets disease.

We have studied 44 patients with Behçet's Disease (BD) to look for any correlation of arterial and venous thrombosis or central nervous system (CNS) manifestations with anti-cardiolipin antibodies (ACLA). Twenty patients were positive for ACLA by MELISA method. Ten patients had IgG antibody, four had IgM and six had both IgG and IgM. Of these patients, 11 had a history of vascular thrombosis and thrombophlebitis and nine had CNS manifestations. The association of ACLA with vascular thrombosis or CNS manifestation of Behçet's disease was statistically not significant.

Antibacterial activity of citreamicin-alpha (LL-E 19085 alpha) against gram-positive cocci.

In vitro antibacterial activity of 429 clinical isolates of gram-positive cocci was tested against citreamicin-alpha (LL-E 19085-alpha) by the agar dilution method. The microorganisms consisted of 313 isolates of staphylococci and 116 strains of streptococci. In vitro activity of citreamicin-alpha was compared with ampicillin, augmentin, cephalothin, erythromycin and vancomycin. MICs of citreamicin-alpha for staphylococci ranged between 0.12-4.0 micrograms/ml and 0.03-0.12 micrograms/ml for Streptococcus pyogenes. Enterococci, however, were relatively more resistant, requiring 2.0 micrograms/ml of this drug to inhibit 64% of the 62 isolates tested. In vitro activity of this antibacterial agent was far superior to that of ampicillin, augmentin, cephalothin and erythromycin, but equal to or slightly inferior to that of vancomycin.

Transferrin C subtypes in patients with rheumatoid arthritis.

Transferrin (Tf) subtypes were investigated in 128 patients with rheumatoid arthritis (RA) and the frequencies of TfC subtypes were compared with the results in normal individuals. The frequencies of the Tf genes: C1, C2, C3, D1, and D2 were 0.4765, 0.3867, 0.0742, 0.0390 and 0.0234, respectively. The frequency of TfC2 gene was significantly higher in these patients (0.3867) compared to the value in the control group (C2 = 0.247). The relative risk of RA in association with TfC1C2 type was 2.0, while it was 0.18 in association with TfC1C1 type and the results were statistically significant. This paper confirms the significant association between TfC2 and RA. Furthermore, it appears from our results that TfC1 homozygous phenotype is protective for the development of RA. The results are discussed in the light of earlier suggestions that the TfC2 subtype confers an increased risk of cellular damage by enhancing hydroxyl radical formation, although it is possible that there exists a genetic linkage of Tf variant to some other locus which is influencing susceptibility to RA.