RESUMO
The susceptibility of 39 toxin producing Clostridium difficile isolates from stools of hospitalized patients was determined, by disc diffusion, to six antibiotics. All but one isolate (toxin A negative) produced toxin A and Toxin B. A wide variation in susceptibility to clindamycin, tetracycline and chloramphenicol was noted. Erythromycin and cotrimoxazole showed a clear-cut discrimination in resistance and susceptibility, while all isolates were sensitive to vancomycin. Erythromycin sensitive isolates demonstrates a significant association with diarrhoea (60.9 percent, 14/23, p<0.001). These strains were predominantly found at the University Hospital of the West Indies (UHWI, 94.1 percent, 16/17). Strains resistant to erythromycin and clindamycin together were commonly found at the National Chest Hospital (NCH, 68.2 percent, 15/22). All erythromycin sensitive strains found at the NCH were from patients transfered to that hospital. These findings suggest that there is a common strain of C difficile (erythrmycin resistant) at the NCH different from that found at the UHWI; the resistant pattern seen with isolates from the NCH was typical of toxigenic serogroup C strain and could be typed by the disc diffusion method. Patients at the NCH who were colonized with either of the two strains of C difficile were likely to get diarrhoea, once there suppression of the normal microflora by antibiotics and colonic over growth with C difficile. (AU)
Assuntos
Adulto , Pessoa de Meia-Idade , Idoso , Feminino , Humanos , Masculino , Adolescente , Antibacterianos/farmacologia , Clostridioides difficile/efeitos dos fármacos , Enterocolite Pseudomembranosa/complicações , Testes de Sensibilidade Microbiana , Diarreia/etiologia , Clostridioides difficile/metabolismo , Enterocolite Pseudomembranosa/microbiologia , Idoso de 80 Anos ou mais , Toxinas Bacterianas/biossíntese , Enterotoxinas/biossíntese , Jamaica , Resultado do TratamentoRESUMO
The cow is a ruminant, and cow's milk has evolved to promote bacterial growth in the upper small bowel; whereas human milk has evolved to discourage bacterial growth. Examinations of the constituents of the two milks shows that their differences can be accounted for in terms of this difference in function. Children who are fed a calf's diet tend to develop a rumen. This may lead to chronic diarrhoea and malnutrition and may be a factor in diarrhoea ascribed to cow's-milk-protein allergy and lactose intolerance (Summary)
