Salmonella-induced enteritis. Clinical, serotypes and treatment.

Salmonella-induced enteritis is a widespread cause of morbidity and mortality especially in developing countries. The frequency of different Salmonella serotypes in different areas varies according to time and locality. The prevalence of different Salmonella serotypes in Yanbu area was studied in 136 stool cultures from patients admitted with gastroenteritis, to the medical ward of Royal Commission Hospital in the period 1/6/1991 to 30/10/1991. Fifteen different Salmonella serotypes were determined among 31 positive Salmonella isolates and all were of the gastroenteric group, diarrhoeagenic but noninvasive. The most common serotype was S. typhimurium (45.16%) followed by S. enteritidis (9.62%) then S. virchow (6.46%). Other forms of Salmonella were isolated from one patient each 3.23%, S. paratyphi B java, S. heidelberg, S. livingstone, S. infantis, S. bovis morbificans, S. corvallis, S. eastbourne, S. give, S. senftenberg, S. poona, S. adelaide, and S. johannesburg. Saudi patients comprised about 71% and 29% were patients of four different nationalities. Antibiograms of these cultures proved to be all sensitive to norfloxacin with different forms of resistance to chloramphenicol, ampicillin and trimethoprim. Norfloxacin proved to be effective in the treatment of resistant forms of Salmonella with negligible side effects and wide safety range.

Campylobacter diarrhoea and an association of recent disease with asymptomatic shedding in Egyptian children.

A hospital-based case-control diarrhoea survey was conducted in Cairo, Egypt to determine the age-specific frequency of campylobacter infection among diarrhoeic and non-diarrhoeic children aged new born to 5 years. Campylobacter was the most common bacterial enteropathogen isolated from diarrhoeic stools. The overall prevalence of campylobacter isolations was 25.9% from stools of 143 diarrhoeic children compared to 15.2% of 132 non-diarrhoeic control children (P = 0.028) during the 4-month period of study. Children less than 1 year of age were at greatest risk of campylobacter infection with 32.6% of diarrhoeic patients culture positive, compared to 14.3% of controls. Asymptomatic shedding in controls was positively associated with a recent diarrhoeal episode (P = 0.019) and may be an important source of new infections.

Bacteriuria following vaginal delivery.

Vaginal delivery may predispose to bacteriuria, as it entails repeated vaginal examination, compression of the bladder and sometimes urethral catheterization. One hundred and forty pregnant women were studied. Three samples of urine were used for cultures; the first at start of labor, the second 24 h after labor, and the third 14 days later. Culture plates were examined for total colony count, which was multiplied by 10 to give an estimate of the number of organisms/ml. Type of organism was identified. Nine of 112 women (8%) developed bacteriuria for the first time after labor. Of these, premature rupture of membranes occurred in four, prolonged labor in two, and cervical and vaginal tears in two others. Detection and treatment of postpartum bacteriuria could decrease the incidence of urinary tract infection.

Comparative clinicopathological and bacteriological studies in schistosomiasis mansoni.

FIFTY MALE Egyptian inpatients with active colonic mansoniasis were studied clinicopathologically, endoscopically, radiologically and bacteriologically. This was done to find out the pattern of colonic and urinary enterobacteria and serum antisalmonella agglutinins in various stages of mansoniasis. Cases are divided into three groups (A, B and C) according to the stage of their hepato-splenomegally. Their clinical presentations were dysentery, rectal bleeding, abdominal distension, anaemia, endocrinal changes and general weakness. Oesophageal varices were diagnosed in 19.8% of group C patients. Distal colonic polyps were noticed in 25% and 4% of group A and B cases respectively, while colonic ulcers were found in 20% of patients of either group. The total number of bilharzia ova per gram of fresh colonic biopsy was highest in group A and lowest in group C subjects. Mucosal and submucosal bilharzial granulation tissue formation together with mucosal hypertrophy were conspicuous among group A and B patients. Hematoxylin and eosin stain was of good diagnostic value and the rest of the stains used did not show any fungi or fibrinoid deposits.

Salmonellosis in Indonesia: phage type distribution of Salmonella paratyphi A.

The distribution of phage types among 221 human strains of Salmonella paratyphi A in Indonesia was studied. Approximately 50% were phage type 5, a rare type elsewhere in the world. Most other isolates were the cosmopolitan phage type 1. The ratio of phage type 1-5 was compared for two cities on Java, Jakarta and Yogyakarta. The ratios were significantly different, phage type 5 predominating in Jakarta. The ratio of phage types among 10 S. paratyphi A strains isolated from Jakarta river water was similar to that found in Jakarta patients.

A second controlled field trial of a serogroup A meningococcal polysaccharide vaccine in Alexandria.

The encouraging results of an earlier controlled field trial of the serogroup A meningococcal polysaccharide vaccine in the prevention of clinical disease prompted this study, the aim of which was to evaluate further the effectiveness of another lot of this type of vaccine, the duration of immunity, and the effectiveness against meningococcal carriage. A controlled field trial was carried out in early 1973 on 176 646 schoolchildren 6-15 years of age, of whom half received the serogroup A polysaccharide vaccine and the other half tetanus toxoid as a control. The incidence of cerebrospinal meningitis caused by serogroup A meningococci was 89% lower in the immunized group than in the controls for one year only. With regard to its effect on carriage, the vaccine was found to reduce to less than half the rate of new acquisition of serogroup A meningococci during the period immediately following immunization. The duration of the carrier state was also shortened in the immunized group.

A controlled field trial of a serogroup A meningococcal polysaccharide vaccine.

A controlled field trial of a serogroup A meningococcal polysaccharide vaccine was conducted at three locations in Egypt during the winter cerebrospinal meningitis (CSM) season of 1971-72. The study population consisted of schoolchildren 6-15 years of age. No cases of serogroup A meningococcal CSM occurred in the group of students vaccinated with the test vaccine whereas 8 cases occurred in the control group vaccinated with tetanus toxoid, and 151 cases occurred in an unvaccinated contrast group. The case rate was significantly different between the test and control groups as well as between the test and contrast groups but was similar between the control and contrast groups. The previously demonstrated safety of the vaccine was confirmed. A significant serological response was elicited in the majority of the vaccinated students.