Leslie Spence. Recipient of the Canadian Association of Medical Microbiology Founder's Award for 1999

The Founder's Award for Distinction in Medical Microbiology was established in 1992 to honour the contribution of members of the Canadian Association of Medical Microbiology (CAMM) to the field of Medical Microbiology and Infectious Diseases. Previous awardees have been Dr. C. R. Amies and Dr. R. D. Stuart (1993), Dr. P. Middleton (1994), Dr. S. Michael Dixon (1995), Dr. I. L. R. Duncan (1996) and Dr. J. A. Smith (1998). (AU)

Pruritus ani: common infections and treatment

Pruritus ani is a manifestation of a wide spectrum of disease conditions. Infections form a minor aetiological fraction but includes organisms from the various microbiological subdiciplines. Fungal causes of pruritus ani usually come from the normal flora, and can be diagnosed in the office, by microscopy using a mixture of potassium hydroxide and dimethyl sulfoxide. Parasites causing pruritus ani may be transmitted by direct contact, the faeco-oral route or sexually. Treatment of scabies and enterobiasis should involve simultaneous treatment of family members. Articles of clothing and bed sheets must be exposed to heat. Lindane (gamma benzene hexachloride) should not be used in pregnant women and children under the age of two years to avoid potential neurotoxicity. Irrespective of the aetiology severe pruritus ani predisposes to secondary bacterial infection (AU)

Considerations for implementing an antibiotic policy in hospital practice

An antibiotic policy should aim for the safe, effective and economical use of antimicrobial drugs, and to prevent their indiscriminate use and development of resistant bacterial strains. The term 'antibiotic' is used as a general term for all antimicrobial drugs. Antibiotics prescriptions should be based on clinical evidence of bacterial infection, preferably substantiated by appropriate laboratory culture and sensitivity tests. Viral infections are not an indication for antibiotic prescriptions. Patient factors to be considered for choice and dose of an antibiotic are age, pregnancy, lactation, renal and hepatic impairment. Immunodeficient patients should receive only bactericidal drugs. Severity of infection determines the route of administration. Duration of therapy should not exceed five days, unless specifically prescribed by the physician. An antibiotic should, if started as an empirical therapy not be changed before a minimum of three days trial. Prescriptions of drugs such as aztreonam, imipenem, vancomycin, piperacillin and amphotericin are to be restricted due to cost and toxicity and should be reviewed by the microbiologist(AU)

Diarrhoeal diseases surveillance in Trinidad and Tobago

Between July 28th and December 28th, 1991, 2,935 cases of diarrhoeal illness were reported to the National Surveillance Unit of the Ministry of Health, in response to the intensified surveillance activities of the Cholera Preparedness Programme. The cases notified included 1,656 children less than five years of age (56.4 percent) and 1,279 persons over age five. The average number of reported cases per week was 133 with a range of 62-202 cases. A review of certain laboratory indicators was recently undertaken in order to assess the ease with which cholera would spread locally if introduced into Trinidad and Tobago. This analysis is based on data produced by the Trinidad Public Health Laboratory (AU)

The presence of Coxiella-like organisms in commercial foetal bovine sera

During routine passaging of chicken embryo fibroblasts minute extracellular organisms were observed to develop in the cultures. These organisms could be detected in three different batches of commercial sera from three different suppliers. Passage of the organisms into laboratory guinea pigs resulted into their detection in the mononuclear leukocytes. The biological characteristics of these organisms are similiar to those of Coxiella, already described by previous workers. The present results indicate that commercial sera could serve as vehicles of these organisms (AU)