The findings agree with the reported prevalence of 10% to 12% in other communities in the Kingdom of Saudi Arabia, but lower than the rates in Western countries. The lower rates are probably related to sociocultural factors.

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 the 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. In spite of the growing number of countries declared brucella-free, the disease remains one of the main zoonotic infections throughout many parts of the world with major economical and public health implications. 1About 500,000 new cases occur annually worldwide, with predominance in the Middle East, the Mediterranean countries, South America and Central Asia.2,3 The first indication that the disease exists in Saudi Arabia appeared in the ARAMCO Epidemiology Bulletin, the 15th week issue of 1968G; 4 since then, sporadic cases have been reported in the literature.The disease was only recognized as a major public health problem in 1983G when Kambal et al reported their experience with brucellosis in Riyadh, Saudi Arabia.5 This report stimulated the initiation of many projects to study the clinical aspects and epidemiology of the disease. [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] One such project was a countrywide, cross-sectional survey of 23,000 randomly selected subjects. The results of this survey indicated a high exposure rate of 35% and an active disease in 2% of the population screened. 10 The government, recognizing the magnitude of the problem, has adopted a brucella control program focused on the eradication of this disease. This comprised public education and mass vaccination of livestock. No data is yet available on the trend of incidence of brucellosis over the last few years in Saudi Arabia. We conducted a study to determine the yearly incidence and seasonal variation of blood culture positive brucella cases over a seven year period. Material and MethodsKing Khalid University Hospital (KKUH) is a 630-bed teaching hospital which provides both primary and tertiary care. The microbiology laboratory records of the hospital were retrospectively reviewed over a seven year period from 1 January 1985G to 31 December 1991G.The total number of blood cultures performed and the number of positives for different organisms were determined for each month. To evaluate the trend in incidence of blood cultures positive for Brucella species in relation to other organisms, the annual number of positive blood cultures for Brucella species ...

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 μg/ml and 0.03-0.12 μg/ml for Streptococcus pyogenes. Enterococci, however, were relatively more resistant, requiring 2.0 μg/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.

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Mitwalli, Non-Clostridial Gas-Forming Infections in Diabetic Patients. 1995; 15(1): 71-73 The ability of microorganisms to produce gas in infected tissue has long been recognized. Although this was originally linked to Clostridium perferingens and other clostridial species, 1 subsequent reports indicated that other bacteria including facultative coliforms, staphylococci, streptococci and other anaerobes are capable of causing gasforming infections.2,3 These infections range from mild disease with no gangrene to extensive disease with widespread tissue destruction that may lead to death. Most gas-forming infections in diabetics occur in association with diabetic foot ulcers.3 Other sites are less frequently involved. We report gas-forming infection due to Escherichia coli in two diabetic patients with involvement of the knee joint in one patient and the vertebral body and epidural space in the other. To the best of our knowledge, involvement of these sites in diabetic patients were not previously described. Case Reports Case 1A 70-year-old Saudi male with a history of noninsulin-dependent diabetes mellitus for six years and longstanding osteoarthritis of the right knee presented to the orthopedic clinic with painful swelling of the right knee of four days' duration and exacerbation of osteoarthritis was diagnosed. Therapeutic aspiration was performed and he was sent home on nonsteroidal anti-inflammatory drugs and cloxacillin. Next morning, he returned to the emergency room complaining of severe pain in the right knee, fever and shortness of breath. On examination, he was ill-looking and confused. Temperature was 39.8°C, blood pressure 100/60 mm/Hg, pulse rate 117/min and respiratory rate 26/min. The right knee was swollen, painful and warm. There was diffuse crepitus in the region of the right knee and the adjacent areas.