A filterable agent in throat washings of patients with infectious mononucleosis.
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Quality assurance (QA) in health care is being introduced in developing countries also. However, QA still meets resistance from some clinicians. A prospective voluntary surgical audit was set up in the ENT department of a university teaching hospital in Saudi Arabia. Roles, responsibilities and objectives were defined and designated facilities were provided. There were 2125 admissions and 2389 operations in a 3-yr period. The stated objectives were achieved concerning resource management, post-graduate training, and, especially, the successful establishment of surgical audit as an on-going and open-forum activity in a developing country. We conclude that other clinicians can feel encouraged by our positive experience and implement QA.
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A recent increase in numbers of beta-lactamase-producing strains of aerobic and anaerobic Gram-negative bacteria in upper respiratory tract infections has been associated with increased failure rates of penicillins in eradication of these infections. These organisms include Staphylococcus aureus, Haemophilus influenzae, Branhamella catarrhalis and Bacteroides spp. These infections include chronic otitis media, chronic sinusitis and mastoiditis, and chronic recurrent tonsillitis. The indirect pathogenicity of these organisms is apparent through their ability not only to survive penicillin therapy but also to protect penicillin-susceptible pathogens from these drugs. The direct and indirect virulence characteristics of these bacteria require the administration of appropriate antimicrobial therapy directed against all pathogens in mixed infections.
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