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Evaluation of certain veterinary drug residues in food. Sixty-second report of the Joint FAO/WHO Expert Committee on food additives.

This report represents the conclusions of a Joint FAO/WHO Expert Committee convened to evaluate the safety of residues of certain veterinary drugs in food and to recommend maximum levels for such residues in food. The first part of the report considers conclusions on specific toxicological end-points, lipid-soluble residues of veterinary drugs with MRLs in milk, statistical methods for the estimation of MRLs, and the Committee's review and comments on documents provided by Codex Committees. Summaries follow of the Committee's evaluations of toxicological and residue data on a variety of veterinary drugs: five antibacterial agents (cefuroxime, chloramphenicol, flumequine, lincomycin, pirlimycin), four insecticides (cyhalothrin, cypermethrin and alpha-cypermethrin, doramectin, phoxim), and two production aids (melengestrol acetate, ractopamine). The Committee's comments on chloramphenicol found at low levels in animal products are also summarized. Annexed to the report is a summary of the Committee's recommendations on these drugs, including acceptable daily intakes and proposed maximum residue limits.

Animals↗

[Microbial view and optimal antibiotic therapy in acute purulent ENT diseases].

The aim of the study was elaboration of optimal antibiotic treatment in acute pyoinflammatory ENT pathology basing on the results of updated microbial tests and basic rules of microflora suppression by antibiotics. A total of 200 patients were examined. Of them, acute purulent sinusitis was diagnosed in 15, acute purulent otitis media in 25, paratonsillar abscess in 12 cases. Their microflora was studied for antibiotic sensitivity, the ability to form beta-lactamase was evaluated, microbiological examination of the content from purulent foci was made. It was found that the majority of acute purulent ENT diseases were caused by streptococci, gram-negative microorganisms (H. influenzae, M. catarrhalis, Klebsiella spp. et al), staphylococci and obligate anaerobes most of which produce beta-lactamase (up to 79%). From 88 to 100% pathogens were sensitive to amoxicillin/clavulanate, 18-59% -- to cephasoline, lincomycin or ampicillin. The treatment with antibiotics of different groups was assessed by dynamics of clinical symptoms and results of repeated microbiological analyses. The optimal antibiotic to start therapy of patients with acute purulent ENT diseases was amoxicillin/clavulanate in a new form -- 1000 mg (twice a day for 7 days).

Acute Disease↗

[Short coupled variant of torsade de pointes: our experience and review of the literature].

We present three cases of short-coupled variant of torsade de pointes with review of the literature. These women presented with syncope or presyncope due to torsade de pointes initiated by a short-coupled premature ventricular beat and without evidence of prolonged QT. There were no electrolyte disturbances in all cases, no apparent structural heart disease in two cases and a mild interventricular septum hypertrophy in the other case. One patient took spiramycin and metronidazole and another was taking pheniramin and lincomycin without any evidence of cause to effect relationship. One patient responded to verapamil but died suddendly after 44 months of follow-up. The two others recieved implantable cardioverter-defibrillators and verapamil per os. They still alive 46 and 54 months later. Short-coupled variant of torsade de pointes have a high incidence of sudden death, so it is very important for physicians to identify and treat it promptly. Long-term verapamil treatement is effective but still insufficient and patients should be considered for implantable cardioverter-defibrillator therapy.

Administration, Oral↗

Induction and characterization of streptomycin-resistant mutants in Capsicum praetermissum.

Streptomycin-resistant mutants were isolated from mutagenised cotyledon explants of Capsicum praetermissum Heiser & Smith. The explants were mutagenised with N-ethyl-N-nitrosourea, which resulted in a high frequency of streptomycin-resistant mutants (18.0%) and a low frequency of chlorophyll-deficient (albino) mutants (8.0%). Complete streptomycin-resistant plantlets were obtained after rooting of the regenerated green shoots on rooting medium containing 1.0 mg L-1 IAA and 500 mg L-1 streptomycin sulphate. Leaf-segment assay of these plantlets revealed that they were resistant to streptomycin but sensitive to chloramphenicol, kanamycin, lincomycin, and spectinomycin. Reciprocal crosses between streptomycin-resistant and -sensitive plants showed a non-Mendelian transmission of resistance by female parents.

Capsicum↗

[Borrelia burgdorferi may be the causal agent of sarcoidosis].

Serum antibody to Borrelia burgdorferi was measured in 33 patients with sarcoidosis who were confirmed clinically and pathologically. The results showed that 81.8% of the patients were positive. In addition, a strain of Borrelia burgdorferi was isolated from a patient's blood. Fourteen patients received ceftriaxone 2 g per day and/or penicillin 12 million per day and a patient received lincomycin 1.2 g per day. The antibody titer of the patients turned to normal level, their SACE turned to normal range, and chest X-ray findings were markedly improved in 3 cases after the treatment. According to the facts mentioned above, we consider that Borrelia burgdorferi may be the causal agent of sarcoidosis and sarcoidosis might be a special type of Lyme disease.

Adult↗

[The local prevalence of group B streptococcus in pregnant women and newborn infants].

In this study, group B streptococcus (GBS) were investigated in vaginal swabs obtained from 76 pregnant women and in samples of newborn infants obtained from different areas of their bodies. GBS were determined in 5.2% of women and 3.96% of infants. GBS were recovered in 15.4% of the women in their first pregnancy and in 13.3% of women in their second pregnancy. GBS could not isolated from the women in their third and more pregnancies. All eight species of GBS were sensitive to AMP + Sulbactam, Clavulanic acid + Amox, Lincomycin, Clindamycin, Penicillin G and SMZ + TMP.

Adolescent↗

Antibiotic susceptibility of Streptococcus pneumoniae isolated from clinical materials (author's transl).

We tested the drug-susceptibility of 112 strains of Streptococcus pneumoniae isolated from various clinical materials since January 1975 to May 1976, and observed the changes of susceptibility of this pathogen. All strains tested remained very sensitive to benzylpenicillin and cephaloridine, but 59.8% of strains were resistant to tetracycline and 44.7% to chloramphenicol, and about 90% of chloramphenicol-resistant strains were also resistant to tetracycline. The percentage of resistant strains to tetracycline or chloramphenicol is increasing. Cross-resistance between tetracycline and doxycycline or chloramphenicol and thiamphenicol was observed. On this time we found three strains resistant to macrolides. Two of these strains were resistant to erythromycin, josamycin, oleandomycin, spiarmycin, mydecamycin, lincomycin, clindamycin and tetracycline, but one was resistant to josamycin, spiramycin, mydecamycin and chloramphenicol.

Anti-Bacterial Agents↗

[Antimicrobial sensitivity of Haemophilus influenzae strains isolated from children].

Antibiotic susceptibility of 1308 Haemophilus sp. strains isolated in children was evaluated over a 6-year period. Based on their source and clinical presentation all strains were divided in three groups. The first group consisted of 1264 strains obtained by throat and nasal swab; the second of 30 mucosal strains isolated in children manifesting non-invasive infection and the third of 14 invasive strains, Haemophilus influenzae(Hi)tip b, isolated from blood, CSF, pleural and synovial effusion. The isolates of the first and the second group demonstrated high susceptibility (90%) to chloramphenicol, erythromycin, and ceftriaxone, lower (70-90%) ampicillin and trimethoprim-sulfamethoxazole and low susceptibility (less than 25%) to penicillin, lincomycin and cefalexin. Invasive strains of Hi tip b were resistant to multiple drugs, showing susceptibility exclusively to chloramphenicol, erythromycin and ceftriaxone. Guidance for the treatment of the invasive and non-invasive infections and chemoprophylaxis are discussed.

Child↗

[A two-year prospective survey on nosocomial infections].

A two-year randomized prospective survey on nosocomial infections in hospitalized patients of Hua Shan Hospital from 1985 to 1987 was carried out. Altogether 1,826 patients were enrolled in the study, the incidence of nosocomial infection being 13.1%. The incidence in dermatology ward was the highest (19.8%), then in order of frequency; medical ward 16.5%, surgical ward 14.8%, ward of neurology 13.7%, ward of neurosurgery 12.7% etc. Regarding the location of infection, lower respiratory tract infection was the most frequent (45.2%), followed by urinary tract infection (18%), wound infection (10%), biliary tract infection (7.5%), and bacteremia (5%). Out of 271 nosocomial strains of pathogens, 180 were Gram negative organisms (66.4%), among which P. aeruginosa accounted for 13.3%, K. pneumonia 12.2%, E. coli 8.9%, Acinetobacter sp 7.7%, and Enterobacter sp 7.7%. Gram positive cocci accounted for 22.9%; fungi 10.7%, candida sp. being the commonest. Results of bacterial susceptibility testing showed that the nosocomial strains were more resistant to commonly used antibiotics than the community strains, such as the resistance of E coli to ampicillin, P. aeruginosa to polymyxin B, S. aureus to lincomycin and gentamicin. Multiply factor analysis was done by Logistic regression model in 1,826 hospitalized patients, nine factors being statistically significant. Nosocomial infection is becoming increasingly important, it is imperative to have more intensive epidemiological surveillance data and to take effective control measures.

China↗

[Antibiotic sensitivity of El Tor Vibrio cholerae after exposure to various pesticides and mineral fertilizers].

The strains of El Tor Vibrio cholerae were exposed to different concentrations of pesticides (fazolone, treflane, prometrine, magnesium chlorate, omait and gardon) and mineral fertilizers (superphosphate, ammophos and carbamide) for 2 to 135 days. The subcultures of various ages were tested for their sensitivity to 16 antibiotics. The whole of 229 cultures were tested. There was a general tendency to lowering of the El Tor vibrio sensitivity to the majority of the antibiotics tested. The vibrio strains resistant to the antibiotics widely used in medical practice i. e. levomycetin, streptomycin, tetracycline, lincomycin, neomycin and kanamycin were isolated.

Anti-Bacterial Agents↗

[Sensitivity and resistance of aerobic bacteria isolated from patients with periodontitis towards antibiotics and bacteriophages (comparative analysis)].

In order to examine sensitivity and resistance of isolated aerobic bacteria from periodontitis materials towards antibiotics and bacteriophages, there has been studied exudations taken from 737 patients' periodontic pockets or the tissue taken from curettage. According to the rate of identified microorganisms, they have been arranged as follows: S. epidermidis 39,34+/-1,56%; S. pyogenes 18,84+/-1,25%; M. catarrhalis 17,09+/-1,2%; S. aureus 10,71+/-0,99%; E.coli-5,66+/-0,74%; Diphtheroids in 1,13+/-0,33%; S. Mucilaginosus 1,02+/-0,32%, proteus vulgaris - 0,72+/-0,27%; H. parainfluenzae - 0,72+/-0,27%; S. intermedium 0,61+/-0,24%; P. aeruginosa - 0,61+/-0,24%; H. influenzae - 0,51+/-0,22%, S. saprophiticus - 0,51+/-0,22%; S. viridans - 0,51+/-0,22%; S. pneumoniae - 0,41+/-0,2%; K. pneumoniae - 0,41+/-0,22%; S. haemoliticus - 0,41+/-0,2%; B. adolescentics - 0,3+/-0,17%; L. acidophilus -0,3+/-0,17%; S. salivarius-0,1+/-0,1%. It has been stated that percentage of polyresistant strains is growing. While having aerobic infections of periodontitis, kefzol, cephazolin, cephamezin, zinaceph, klaphoran, cephdazidim (cephalosporins I, II, II generation); tetracycline, doxycycline, (tetracyclines); 5-noks, cyprophloxacyne (chinolons I, II generation); ryphamphcyne (rymphamicynes); but standby medicines may be also considered: penicillin G, procaine penicillin (penicillines); streptomycin, kanamicin, gentamicin (aminoglycosides); lincomycin, clindamycin, (lincosamides); eritromycin, macropen (macrolides); chloramphenicol. Since the resistance of microbial strains was not developed towards bacteriophages during the treatment it is considerable to apply simultaneously the bacteriophages and standby antibiotics.

Anti-Bacterial Agents↗

[Isolation and identification of a bacterial strain JS018 capable of degrading several kinds of organophosphate pesticides].

Organophosphate pesticides are used widely all over the world and play an important role in plant pest control. However these pesticides are considered as pollutants and harmful to human health. To search for microorganisms that can degrade organophosphate pesticides with high efficiency, a bacterial strain, coded as JS018, was isolated and screened from the soil in the vicinity of Shanming Pesticides Factory, Shanming, Fujian. Laboratory tests showed that the bacterium could degrade several kinds of organophosphate pesticides, such as Parathion-methyl and phoxin. The strain's degrading rates on phoxin, Parathion-methyl, hostathion and dichlorvos in LB liquid fermentation medium for 36 h were 99%, 96%, 80.4% and 69.0% respectively. The bacterial colonies on LB plate appeared shiny and pale-pink in color. The bacteria were Gram-negative coccoids, 0.5 - 0.7 microm in diameter. They grew well at 30 - 38 degrees C and pH 7.0 - 9.0. The optimal temperature and pH for cell growth was 32 degrees C and pH 7.5 - 8.0, respectively. They did not grow in medium containing 6% or more NaCl. The antibiotic susceptibility tests showed that the strain was resistant to ampicillin, penicillin and lincomycin. It was sensitive to kanamycin, tetracycline and gentamicin. Laboratory tests also showed that the strain could ferment D-glucose, trehalose, melezitose and ethanol. It was negative in the production of indole and hydrogen sulfide. It could not liquefy gelatin, utilize citrate, nor ferment L-arabinose, sucrose, D-mannitol, D-xylose, fructose, D-galactose, maltose or lactose. The catalase, urease and nitrate reduction were positive. Based on its morphological, physiological and biochemical properties as well as the 16S rDNA sequence analysis result, the strain was tentatively identified as Roseomonas sp.

Biodegradation, Environmental↗

Risk factors and clinical outcomes of penicillin resistant S. pneumoniae community-acquired pneumonia in Khon Kaen, Thailand.

To determine the prevalence, risk factors and clinical outcomes of penicillin-resistant S. pneumoniae (PRSP) in community-acquired pneumonia (CAP), a cross-sectional study was conducted between January 1995 and December 2004 at Srinagarind Hospital, Khon Kaen, Thailand. Patients hospitalized with CAP and culture proved to be S. pneumoniae were included. PRSP was found in 22 of 64 (34.4%) patients. The MIC levels of penicillin non-susceptible strains ranged between 0.25 and 0.75 microg/ml. Resistance to other antibiotics ranked: cotrimoxazole (51.6%), tetracycline (26.6%), erythromycin (20.6%), lincomycin (18.7%), chloramphenicol (12.5%) and ampicillin (1.6%). None of the isolates was resistant to cephalothin. The significant risk factors for PRSP infection were previous antibiotic use within 3 months (Adjusted OR 40.83, 95% CI 3.71 to 449.41) and alcoholism (Adjusted OR 8.82, 95% 1.25 to 62.46). Bacteremia and empyema thoracis were found more commonly in PRSP than PSSP infection, but not statistically significant. Pneumonia-related mortality was nearly the same, PRSP 9.1% vs PSSP 9.5% (p = 0.96). The reason why the clinical outcomes of these two groups were not different may be the patients were infected with mildly resistant organisms. Thus, pneumonia caused by intermediate-level penicillin resistant S. pneumoniae appears to be adequately treated with beta-lactams or aminopenicillin antibiotics. The MIC levels of penicillin resistance should be monitored further. The need for antibiotics active against drug-resistant S. pneumoniae was required if high-level penicillin resistance was detected.

Adolescent↗

[Antibiotic sensitivity tests of methicillin-resistant staphylococci].

In this study, 231 Methicillin-Resistant Staphylococcus (MRS) and 76 Methicillin-Susceptible Staphylococcus (MSS) strains were investigated. 23 antibiotics were tested by using Modified Kirby-Bauer Technique. The highest resistance ration in MRS strains were found for lincomycin, clindamycin and ampicillin with the ratios of 61.0%, 59.3%, and 56.2% respectively. And the lowest resistance ratios were measured for vancomycin, ciprofloxacin and ofloxacin 0.5%, 8.2%, 10.8% respectively. It was found that, resistance of MRS strains to 17 antibiotics were significantly higher than resistance of MSS strains, but not for sulbactam-ampicillin, cefoperazone, ceftriaxone, vancomycin, ciprofloxacin, ofloxacin and netilmicin.

Anti-Bacterial Agents↗

Antimicrobial penetration into polymorphonuclear leukocytes and alveolar macrophages.

Infections caused by intracellular organisms often involve the lung and may be implicated in chronic disease. These intracellular bacteria may be protected from otherwise lethal concentrations of extracellular antimicrobials. Knowledge of the intracellular concentration of usual antimicrobials used to treat pneumonia may allow physicians to refine their initial choice of therapy. Lipid-insoluble antimicrobials, such as penicillin, cephalosporins, aminoglycosides, trimethoprim, and imipenem penetrate poorly into cells, if they penetrate at all. Isoniazid, tetracycline, and lincomycin have intermediate intracellular penetration, and chloramphenicol, rifampin, ethambutol, quinolones, and lincosamides, plus macrolides, are avidly concentrated. Nonetheless, to date it has been difficult to correlate intracellular concentrations of antimicrobials with cellular killing or clinical outcome. Information derived from a more standardized approach to the evaluation of antimicrobial agent intracellular penetration will be useful in improving the direct application of in vitro study results to the clinical care of patients with pneumonia.

Anti-Bacterial Agents↗

[Common pathogens in burn infection and changes in their drug sensitivity].

This paper reports common pathogens in burn infection and changes in their drug sensitivity from 1985 to 1988. Gram negative rods constituted 55.7% of all pathogens, while 40.5% were gram positive cocci. The former group consisted of 173 strains of Pseudomonas aeruginosa (28.5%), 55 Proteus (9.1%), 33 Serratia (5.4%), 23 Klebsiella (3.8%) 19, Acinetobacter (3.1%), 18 Enterobacter (3.0%) and 17 E. coli (2.8%). Among gram-positive cocci, Staphylococcus aureus accounted for 32.8%, Staphylococcus epidermidis accounted for 5.6%, and Streptococcus faecalis accounted for 2.1%. All the gram-negative rods and gram-positive cocci showed more resistance against various antibiotics. Ps. aeruginosa were resistant to 24 commonly used antibiotics. However, ciprofloxacin, ceftaztdime and piperacillin were comparatively effective, the sensitivity rates were 92.9%, 91.5% and 78.3%, respectively. Ps. aeruginosa showed a sensitivity rate of 92.5% and 86.1% to amikacin and polymyxin-B, respectively, from 1980 to 1984, but the rates were lowered to 65.9% and 17.3%, respectively, from 1985 to 1988. Staphylococcus aureus showed a sensitivity rate of 88.9% to ciprofloxacin, 76.1% to ceftazidime, 71.4% to amikacin, 48.5% to piperacillin, 63.1% to cefuroxime. This organism showed a sensitivity rate of 87.3%, 83.9%, 81.7% and 82.8% to amikacin, cefoperozone, leucomycin and lincomycin, respectively, from 1980 to 1984, but the sensitivity rates declined to 71.4%, 56.8%, 60.8% and 43.7%, respectively, from 1985 to 1988.

Amikacin↗

[Endolymphatic therapy of children with chronic osteomyelitis of the long tubular bones].

A study was made of the clinical efficacy and immune status in 40 children with chronic osteomyelitis of long tubular bones. Of these, 13 patients received antibiotics endolymphatically and 27 patients were given conventional antibiotic therapy (intramuscularly, intravenously). In view of the predominance of the staphylococcal flora, endolymphatic therapy included the use of gentamycin and lincomycin, the treatment course lasted up to 10 days. Endolymphatic antibacterial therapy has been demonstrated to produce a beneficial clinical effect there was a decrease in fever duration, the amount of postoperative complications, and the duration of inpatient treatment. After endolymphatic therapy the patients' blood manifested a more remarkable, as compared to the control group, rise of the absolute count of T lymphocytes, "active" population of T lymphocytes, together with an increase of the functional activity of lymphocytes in blast transformation, and a reduction, to an equal degree, of the neutrophil and monocyte counts, attesting to a decline of antigenic load of phagocytes. In patients who received antibiotics endolymphatically, the general blood analysis showed a decrease of neutrophilia and marked lymphocytosis. All this mirrored the intensity of immunity activation.

Adolescent↗

[The pharyngeal beta-hemolytic streptococcal carrier state among blood donors].

459 blood donors aged 18-50 years were examined in 1987-1988 in Moscow. Among them, carrier state with respect to beta-hemolytic streptococci was detected in 107 donors (23.3%). The number of carriers gradually decreased with the increase of age of the examined donors. Group C streptococci occurred least of all (6.9%). Group A beta-hemolytic streptococci were isolated in 16.7% of the carriers. The isolation rate of streptococci from blood achieved its maximum in autumn and winter months and did not depend on preceding diseases, unhealthy working conditions, the rhesus factor and, with the exception of group A streptococci, the blood group. Among tonsillectomized donors carrier state with respect to beta-hemolytic streptococci occurred 2.2 times less frequently than among donors who had not undergone tonsillectomy. Carrier state with respect to beta-hemolytic streptococci was accompanied by higher levels of salivary sIgA antibodies to polysaccharide A, serum antibodies to polysaccharide A and circulating polysaccharide A. All beta-hemolytic streptococci were sensitive to erythromycin. All groups of streptococci showed the highest percentage of cultures resistant to gentamicin and tetracycline. In 100% of cases group A streptococci were sensitive to benzylpenicillin, methicillin, ampicillin, erythromycin and lincomycin.

Age Factors↗