The laboratory diagnosis of gonorrhoea in the female

No Abstract

Standardisation of the nitro-blue tetrazohm test and factors affecting its clinical application

Attempting to standardise the nitro-blue tetrazolium (NBT) test, the following modifications of previously described procedures were introduced. bucoeytsrich plasma obtained by simple gravitation at 37OC was mixed with NBT reagent which had previously been centrifuged to remove undissolved particles. Thick swan were made and stained with dilute haematoxylin, and physical manipulation during the various procedures was reduced to a minimum. Reconstitution of the buffy coat in fresh normal serum did not alter the NBT result. ormal NET readings were obtained in pregnant females, and women on contraceptive hormonal preparations.S. Afr. Med. J., 48, 209 (1974)

An investigation into wound infection and abscess formation in a mine

Click on the link to view

A study of summer diarrhoea in white children in Johannesburg

No Abstract

The Recent Cholera Outbreak in the South Mrican Gold Mining Industry

A large-scale cholera surveillance programme was introduced in South Africa in November 1973 as a result of the progressive southward spread of cholera in Africa. Moore's technique for the isolation of Salmonella paratyphi was modified for cholera detection. The method proved to be very sensitive and it was possible to detect Vibrio cholerae in main sewer lines after its casual and transient introduction by an unidentified carrier. Transmission occurred in the acc!im<:tisation centre, probably through the drinking of water contaminated after it had been drawn from the tap. Faecal contamination of the environment was demonstrated, and V. cho/erae was isolated from the floor, onto which it had been disseminated from the perianal region by means of profuse perspiration. Perpetuation of cholera was probably aided by a faecally contaminated air-humidifying water reservoir, the water of which experimentally allows survival and multiplication of V. cholerae for a week and longer. Prophylactic treatment of selected high-risk groups of people was administered in the form of doxycycline, which appeared to result in rapid termination of the epidemic. Mass vaccination of all mine personnel (20 000) was carried out to reduce the incidence of clinical cholera and the bacterial load

Factors associated with airway colonisation and invasion due to Klebsiella spp.

The clinical significance of a heavy growth of Klebsiella spp. in sputum was studied in 54 patients. All but 3 patients had significant factors potentially associated with respiratory tract colonisation or invasion. Risk factors identified for colonisation of the airway and for invasive disease were similar. Patients with commnunity-acquired Klebsiella infections were more likely to have underlying chronic respiratory diseases. Prior antibiotic use was a risk factor for nosocomial infections which occurred more conunonly with antibiotic-resistant organisms.The most commmon diagnoses were airway colonisation, acute community-acquired chest infections, and nosocomial chest infections. Primary acute conununity-acquired pneumonia was unconunon.The sensitivity and specificity of the sputum Gram stain (in the setting of positive sputum cultures) in suggesting the presence of invasive disease due to Klebsiella spp. were 42% and 69% respectively

Evaluation of the GenoType MTBDRsl Version 2.0 Assay for second-line drug resistance detection of Mycobacterium tuberculosis isolates in South Africa

Early detection of resistance to second-line antituberculosis drugs is important for the management of multidrug-resistant tuberculosis (MDR-TB). The GenoType MTBDRsl version 2.0 (VER 2.0) line probe assay has been redesigned for molecular detection of resistance-conferring mutations of fluoroquinolones (FLQ) (gyrA and gyrB genes) and second-line injectable drugs (SLID) (rrs and eis genes). The study evaluated the diagnostic performance of the GenoType MTBDRsl VER 2.0 assay for the detection of second-line drug resistance compared with phenotypic drug susceptibility testing (DST), using the Bactec MGIT 960 system on Mycobacterium tuberculosis complex isolates from South Africa. A total of 268 repository isolates collected between 2012 and 2014, which were rifampin monoresistant or MDR based on DST, were selected. MTBDRsl VER 2.0 testing was performed on these isolates and the results analyzed. The MTBDRsl VER 2.0 sensitivity and specificity indices for culture isolates were the following: FLQ, 100% (95% confidence interval [CI] 95.8 to 100%) and 98.9% (95% CI, 96.1 to 99.9%); SLID, 89.2% (95% CI, 79.1 to 95.6%) and 98.5% (95% CI, 95.7 to 99.7%). The sensitivity and specificity observed for individual SLID were the following: amikacin, 93.8% (95% CI, 79.2 to 99.2%) and 98.5% (95% CI, 95.5 to 99.7%); kanamycin, 89.2% (95% CI, 79.1 to 95.6%) and 98.5% (95% CI, 95.5 to 99.7%); and capreomycin, 86.2% (95% CI, 68.3 to 96.1%) and 95.9% (95% CI, 92.2 to 98.2%). An interoperator reproducibility of 100% and an overall interlaboratory performance of 93% to 96% were found. The overall improvement in sensitivity and specificity with excellent reproducibility makes the GenoType MTBDRsl VER 2.0 a highly suitable tool for rapid screening of clinical isolates for second-line drug resistance for use in high-burden TB/HIV settings.CTB NICD/NHLShttp://jcm.asm.org2017-09-30Medical Microbiolog

Salmonellae and shigellae in a group of Bantu school children in the eastern Transvaal lowveld

No Abstract

Streptococcus milleri causing infection in man

We describe the microbiological and morphological characteristics of 151 strains of Streptococcus milleri isolated during the course of routine bacteriological investigations. Although these strains formed a fairly heterogeneous group, several constant features were identified which typify the species. Strept. milleri emerged as a major cause of pyogenic infection, clinical disease being characterized by localized collections of pus in almost every organ system. Bacteraemia due to Strept. milleri was a significant indicator of the presence of an occult abscess. Endocarditis was rare. The penicillins or erythromycin remain the drugs of choice for treating infections caused by this organism