A 50-year-old woman and a 31-year-old man with underlying liver disease presented with fever and signs of liver failure. The blood cultures in both cases yielded non-serogroup O1 Vibrio cholerae strains which were biochemically identical except that one strain was nonmotile. Despite treatment with antibiotics, the older patient died; the other patient survived. Both strains were found to be susceptible to most antibiotics tested in vitro. No apparent source of infection could be identified in either case.
Six newborns with Listeria monocytogenes infection were admitted to the same neonatal unit between 31 October and 3 December 1985. The index case, a preterm baby, was born to a mother who was febrile with an influenza-like illness at the time of delivery. This baby presented with Listeria sepsis and pneumonia. Another child was born from whose mother L. monocytogenes was isolated from the cervix with the same serotype as that in the CSF of her newborn. In the other cases blood and cervical cultures of the mothers were negative, while Listeria was isolated from the CSF of their babies. Five out of six infants developed meningitis between 9 and 12 days after birth. All isolates were serotype 4b and indistinguishable by phage typing. All babies were successfully treated without any major sequelae. Although cross-infection was strongly suggested, the source of the outbreak could not be established. This is the first documented report of human listeriosis in Kuwait.
Colicin typing, biotyping, phase typing and in vitro antimicrobial susceptibility testing were performed on clinical isolates of Shigella sonnei from three different geographical locations. Results of 93 strains from Kuwait, 61 strains from Saudi Arabia and 23 strains from Bangladesh were compared. Of 169 strains of S. sonnei tested, 75% belonged to colicin type 6/11. It was the most common colicin type in all three countries. However, differences in antimicrobial susceptibility patterns were observed. The resistance pattern in 62% of resistant strains from Kuwait was tetracycline – trimethoprim/sulpha-methoxazole – trimethoprim (TE-TMP/SMZ-TMP). Saudi Arabian strains were of the same resistance pattern with additional resistance to ampicillin (AM) AM-TE-TMP/SMZ-TMP (34%) which was seem more often than TE-TMP/SMZ-TMP (26%). Most of the strains (65%) from Bangladesh were sensitive to all the antimicrobial agents against which they were tested. Of the 8 strains which showed resistance, 50% were resistant to tetracycline alone. Study of carbohydrate fermentation of 12 sugars which were incubated for 21 days did not aid in discriminating different biotypes.
Objective: To study antimicrobial susceptibility pattern of clinical isolates of Haemophilus influenzae using E-test and compare the results with those of a study done in 1983. Methods: The antimicrobial susceptibility of 196 isolates of H. influenzae against nine antimicrobial agents (amoxicillin-clavulanic acid, ampicillin, cefaclor, cefotaxime, ceftriaxone, chloramphenicol, ciprofloxacin, clarithromycin, and trimethoprim-sulfamethoxazole) was performed by E-test on Haemophilus test medium. The results obtained were compared with those from an earlier study conducted here on 108 strains collected between October and December 1983. Results: Except for cefotaxime, which consistently showed an excellent in vitro activity (MIC90 = 0.047 mg/l), other antimicrobial agents presented a decline in their effectiveness. Among the newer antibiotics tested, all the strains were found to be sensitive to ciprofloxacin (MIC range = 0.004–0.0094 mg/l) whereas clarithromycin showed high MIC of 12 mg/l for 90% of the strains. There was a marked increase in the number of beta-lactamase-producing isolates from 4.6% in 1983 to 31.6% in the present study. Amongst 62 beta-lactamase-producing strains 14.5% exhibited resistance to amoxicillin-clavulanic acid (MIC >8 mg/l). Only 3.1% isolates were found to be of capsular type b in 1998 compared to 9.2% in 1983. No beta-lactamase-negative ampicillin-resistant (BLNAR) strain was isolated during the present study whereas only one strain (0.9%) was isolated in 1983. Conclusion: This study shows that despite a decrease in the number of type b and BLNAR H. influenzae isolates, there is an apparent increase in the trend to acquire resistance to several antimicrobial agents.
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