One hundred strains of Haemophilus ducreyi isolated in Thailand from patients with chancroid were tested by the agar dilution method against 10 antimicrobial agents and typed by outer membrane protein pattern by using sodium dodecyl sulfate gel electrophoresis. All strains produced beta-lactamase and were resistant to tetracycline, kanamycin, and sulfonamides. Most had a decreased susceptibility to trimethoprim (MIC for 50% of the strains [MIC50], 0.5 ,ig/ml) and chloramphenicol (MIC50, 8 ,ug/ml). Strains were susceptible to ciprofloxacin (MIC90, 0.001 ,ug/ml), ceftriaxone (MIC50, 0.0015 ,ug/ml), erythromycin (MIC50, 0.015 ,ug/ml), rosoxacin (MIC50, 0.03 ,ig/ml), and spectinomycin (MIC50, 8 ,ug/ml). The degree of antimicrobial resistance found in Thailand is higher than that reported for H. ducreyi isolated in other regions. Five different outer membrane protein patterns were found by analyzing proteins in the range of 29 to 61 kilodaltons, but 98% of the Thai strains fell into three patterns which did not differ greatly. Outer membrane protein patterns of Thai strains were also seen in strains from other geographic areas. A new outer membrane protein type was found among nine strains isolated in Singapore.
A study was performed to examine compounds that might improve the selectivity of the primary isolation medium for Haemophilus ducreyi. The susceptibility of 40 H. ducreyi strains to 34 antimicrobial agents, including 10 antibiotics, 3 quaternary ammonium compounds, 3 phenolic derivatives, 3 acridines, and 15 heavy metal compounds, was investigated by using an agar plate dilution technique. Results were compared with the susceptibilities of other gramnegative rods which may be contaminants on isolation media. The minimal inhibitory concentration range for colistin (16 to 128 p.g/ml) indicated that this antibiotic might be of use as a selective agent. H. ducreyi was susceptible to spectinomycin (minimal inhibitory concentration range, 16 to 64 t.g/ml), thiamphenicol (0.12 to 1 pug/ml), chloramphenicol (0.12 to 0.5 ig/ml), and streptomycin (4 to 32 ,g/ml) and moderately susceptible to kanamycin (2 to 8 ,ug/ml). For the heavy metal compounds, a high susceptibility was seen with copper(II) chloride (2 to 8 p,g/ml, corresponding to a concentration of 0.75 to 3 ,ug of Cu2+ ions per ml), sodium selenite (1 to 4 ,ug/ml, or 0.45 to 1.83 p.g of Se-ions per ml), and phenylmercury acetate (0.12 to 0.5 ,ug/ml). The minimal inhibitory concentrations of quaternary ammonium compounds, acridines, and phenolic derivatives were between 1 and 32 pg/ml, 8 and 32 ,ug/ml, and 8 and 250 ,ug/ml, respectively.The isolation of Haemophilus ducreyi from clinical material is often difficult because of a lack of sensitivity and specificity of the primary isolation medium. Several diagnostic criteria have been proposed in the past, but most of these have a low accuracy or yield low recovery rates (1,2,6,8). As a consequence, the diagnosis of chancroid is often based on the exclusion of other sexually transmitted diseases causing genital ulcers and on the clinical aspects of the lesions (5, 9). The isolation medium developed by Hammond et al. (7) and its subsequent modifications (3, 4, 10) contain vancomycin. While effectively inhibiting the gram-positive flora, this medium does not inhibit gram-negative rods which often contaminate isolation plates, particularly when vaginal or cervical specimens are cultured.In this study, the activity of 34 antimicrobial agents, including 10 antibiotics, 3 quaternary ammonium and 15 heavy metal compounds, 3 acridines, and 3 phenolic derivatives was evaluated against 40 strains of H. ducreyi. Eighteen clinical isolates ofEnterobacteriaceae were tested in the same way to define the relative susceptibilities to the same agent. The aim of the study was to select a compound that would enhance the selectivity of the isolation medium. MATERIALS AND METHODS Strains
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