Spectrum and antibiotic sensitivity of bacteria contaminating the upper gut in patients with malabsorption syndrome from the tropics

BACKGROUND: Various causes of malabsorption syndrome (MAS) are associated with intestinal stasis that may cause small intestinal bacterial overgrowth (SIBO). Frequency, nature and antibiotic sensitivity of SIBO in patients with MAS are not well understood. METHODS: Jejunal aspirates of 50 consecutive patients with MAS were cultured for bacteria and colony counts and antibiotic sensitivity were performed. Twelve patients with irritable bowel syndrome were studied as controls. RESULTS: Culture revealed growth of bacteria in 34/50 (68%) patients with MAS and 3/12 controls (p < 0.05). Colony counts ranged from 3 × 10(2 )to 10(15 )(median 10(5)) in MAS and 100 to 1000 (median 700) CFU/ml in controls (p 0.003). 21/50 (42%) patients had counts ≥10(5 )CFU/ml in MAS and none of controls (p < 0.05). Aerobes were isolated in 34/34 and anaerobe in 1/34. Commonest Gram positive and negative bacteria were Streptococcus species and Escherichia coli respectively. The isolated bacteria were more often sensitive to quinolones than to tetracycline (ciprofloxacin: 39/47 and norfloxacin: 34/47 vs. tetracycline 19/47, <0.01), ampicillin, erythromycin and co-trimoxazole (21/44, 14/22 and 24/47 respectively vs. tetracycline, p = ns). CONCLUSIONS: SIBO is common in patients with MAS due to various causes and quinolones may be the preferred treatment. This needs to be proved further by a randomized controlled trial

Chemical characteristics of coastal rainwater from Puducherry to Neithavasal, Southeastern coast of India

The chemistry of the rainwater indirectly reflects the composition of the ions in the atmosphere. The study of the rainwater gains its own importance as it forms the basis for the agricultural, domestic and drinking water. Twelve rainwater samples were collected along the southeastern coast of India during southwest monsoon. The samples were analyzed for the major anions (Cl−, SO4 2−, PO4 3− and HCO3 −) and cations (Na+, K+, Ca2+ and Mg2+). The majority of the samples reflect acidic pH. The general dominance of the cations is in the order of Na+ > Ca2+ > K+ > Mg2+ and that of anions is HCO3 − > Cl− > SO4 2− > PO4 3−. The water is classified as calcium bicarbonate to sodium bicarbonate type. The decrease of pH value also increases the pCO2. In order to study the impact of acidic and alkaline species on rainwater, correlation coefficients were determined for establishing the relationship between different ions. Good correlation was established between cations, and sulfate has no correlation with other ions and pH. Factor analysis reveals that land use pattern, marine source and methanogenesis from the tidal influenced mangroves play a major role in determining the rainwater chemistry of the region