RESUMO
Treatment failures with standard doses of penicillin have been observed in the Sexually Transmitted Diseases (STD) clinics in Trindad and Tobago. In the absence of an ongoing surveillance system, the antimicrobial susceptibility of 518 Neisseria gonorrhoeae strains was determined in order to guide treatment. 39 (7.6 percent) strains were resistant to penicillin, including 27 (5.2 percent) positive for beta-lactamase; that is penicillinase-producing Neisseria gonorrhoeae (PPNG). 51 (10 percent) strains were resistant to tetracycline, with 26 (5.0 percent) of these exhibiting high levels of resistance compatible with tetracycline resistant Neisseria gonorrhoeae (TRNG). Six strains showed evidence of having both PPNG and TRNG plasmids, and five strains showed chromosomally-mediated resistance to both penicillin and tetracycline. The overall resistance rate to penicillin and tetracycline was 17.7 percent. There was no resistance to spectinomycin, cefuroxine, ceftriaxone and norfloxacin. The resistance rates demonstrated in this study are sufficently significant to preclude the use of penicillin and tetracycline in the STD clinics and to justify the use of newer antimicrobials. It is essential that resistance patterns be monitored by continued surveillance.(AU)
Assuntos
Adulto , Feminino , Humanos , Masculino , Neisseria gonorrhoeae/efeitos dos fármacos , Resistência às Penicilinas , Resistência a Tetraciclina , Neisseria gonorrhoeae/isolamento & purificação , Trinidad e Tobago/epidemiologiaRESUMO
The susceptibility of Staphylococcus aureus strains isolated from human clinical and non-clinical sources in Trinidad to bacteriophages and antimicrobial agents was determined. The ability of the strains to produce enterotoxins and toxin shock syndrome toxin-1 (TSST-1) was also investigated. Of the 554 strains tested, 454 (81.8 percent) were susceptible to international phage set (IPS) phages with strains isolated from bacteriuria (57.1 percent) and bacteremia (53.3 percent) having a low sensitivity compared to isolates from aspirates (87.3 percent) and anterior nares (97.4 percent). All sources combined, strains were most susceptible to phages belonging to several groups (mixed). Overall, 419 (75.6 percent) strains were resistant to one or more of nine antimicrobial agents tested. Resistance to penicillin was most prevalent, with 413 (74.5 percent) strains found to be resistant. Prevalence of resistance to tetracycline, gentamicin, oxacillin, cefuroxime and ciprofloxacin was 5.1 percent, 2.0 percent, 0.7 percent, 0.4 percent and 0.4 percent respectively. Of the 554 strains tested, 307 (55.4 percent) produced staphylococcal enterotoxins A (SEA), B (SEB), C (SEC) and D (SED) singly or in combination. Strains recovered from high vaginal swabs were least enterotoxigenic (40.0 percent) as compared to umbilical infection isolates which were most enterotoxigenic (78.9 percent). TTST-1 was produced by 95 (19.0 percent) out of 449 strains tested, with isolates from bacteriuria found to be most toxigenic (33.3 percent). It was concluded that the S. aureus strains tested were highly susceptible to bacteriophages and antimicrobial agents (except penicillin) and that enterotoxigenic and TSST-1 producers were widespread and have an aetiologic potential.(Au)
Assuntos
Humanos , Antibacterianos/farmacologia , Bacteriófagos/fisiologia , Enterotoxinas/biossíntese , Staphylococcus aureus/metabolismo , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/efeitos dos fármacos , Staphylococcus aureus/virologia , Trinidad e TobagoRESUMO
Treatment failures of 20 percent with standard doses of penicillin have been observed in our sexually transmitted disease (STD) clinics in the treatment of gonorrhoea. A large number of Neisseria gonorrhoeae strains (547) from various STD clinics were tested against selected antimicrobials in order to determine the most appropriate alternative treatment regimen. Using an agar dilution technique and testing for the presence of beta-lactamase production, it was determined that less than 1 percent of Neisseria gonorrhoeae strains were sensitive to penicillin, 85 percent were moderately sensitive and 15 percent were completely resistant to penicillin. More than 5 percent of the strains produced beta-lactamase. Tetracycline resistance was seen in 57 percent of the strains, and 7.3 percent of the strains were resistant to cefuroxime. There was no resistance to spectinomycin, ceftriaxone or norfloxacin. STD clinics in Trinidad and Tobago can no longer rely on penicillin and tetracycline in the treatment gonorrhoea. Protocols will have to include spectinomycin, ceftriaxone or norfloxacin (AU)
Assuntos
Neisseria gonorrhoeae/efeitos dos fármacos , Resistência Microbiana a Medicamentos , Gonorreia/tratamento farmacológicoRESUMO
As part of a systemic study of antibiotic resistance pattern of bacteria in the Caribbean, organisms were collected from hospital laboratories in Barbados and Trinidad in May-June, 1991. Three hundred and twenty-eight gram-negative aerobic bacilli (BNB) were tested for antibiotic resistance by Kirby-Bauer disc susceptibility test method. The percentage of resistance to ampicillin, carbenicillin and amoxicillin/clavulanic acid was 63 percent, 52 percent and 27 percent, respectively. The gentamicin resistance of GNB was 7.6 percent, and none of the isolates were resistant to amikacin. The percentage resistance of GNB isolates from Trinidad against all antibiotics was higher than the isolates tested from Barbados. Interestingly, 26 percent of isolates obtained from outpatients were resistant to cotrimoxzole as compared to 16 percent in inpatients in Trinidad. A systematic study of antibiotic resistance among gram-negative bacteria in the Caribbean is recommended for prudent use of antibiotics (AU)
Assuntos
Resistência Microbiana a Medicamentos , Bactérias Aeróbias , Barbados , Trinidad e TobagoRESUMO
Forty-four of 219 animals from Trinidad and Grenada, W.I., yielded 20 serotypes of Salmonella, 16 of which are known to have been associated with human infection in the United States in recent years. Toads (Bufo marinus) provided the greatest number of isolates. Other carriers were mammals, vultures, lizards, a treefrog and a cave cockroach.(AU)