Biochemical and hematological manifestations of HIV/AIDS in Chiang Mai, Thailand.

HIV/AIDS is a multifactorial and multi-step disease. No single treatment against AIDS can save a patient. Our last report showed that vitamin A, vitamin E and beta-carotene were decreased while malondialdehyde (MDA) was increased. This report aims to evaluate biochemical and hematological parameters in HIV/AIDS patients in Chiang Mai, Thailand by holistic approaches. Sera from HIV/AIDS patients were examined for sugar, cholesterol, uric acid, total protein, albumin, urea, creatinine, AST, ALT, ALP, total/direct bilirubin, vitamin E, MDA, total antioxidant capacity (TAC), beta-carotene, complete blood cell counts, platelet count, CD4 count, prothrombin time, partial prothrombin time and soluble Fas (sFas). The results found that sFas levels in sera prior to holistic approach was not different from reference values and not significantly correlate with CD4 and absolute lymphocyte count. sFas could not serve as putative marker for CD4 destruction. After 3 months CD4 count, MDA, vitamin E and TAC did not change statistically. This approach had no effect on liver and kidney functions, red blood cell, white blood cell, platelet counts, and blood clotting factors. This presentation may be some alternative approaches to combat HIV infections and AIDS, leading to stabilize or extend survival time which should further be elucidated.

Total antioxidant capacity in plasma of HIV-infected patients.

Total antioxidant capacity (TAC) of fasting EDTA plasma of 33 healthy and 64 HIV-infected patients was determined using H(2)O(2)-peroxidase-ABTS technique. The results revealed that the average TAC in HIV-infected patients was significantly lower than those in healthy normal persons. (0.161 +/- 0.097 vs 0.269 +/- 0.081 mmol/L Trolox equivalent, p < 0.05). Total lymphocytes were also counted using Hycel automatic cell counter and absolute CD4 numbers using Coulter CD4 manual kit. It was interesting that CD4 count was not correlated with the clinical symptoms of the patients. This paper suggests that prediction of severity and monitoring of the disease should be performed by determining both total lymphocyte count and total antioxidant capacity.

Cytochemical and immunological phenotying of acute nonlymphoblastic leukemia in Thai patients.

Using morphology and cytochemical reaction, we could subclassify-according to FAB classification, 51 of our 56 cases of acute nonlymphoblastic leukemia (ANLL) as M1-M5. Five cases were undifferentiated. Using the immunophenotypic method, we could subclassify 51 of these patients as M1-M4. In addition, 3 cases of undifferentiated leukemia by the prior method were each classified as M1, M3, and myelo-megakaryoblastic leukemia. Correlation of ANLL subtype classification according to each method was not good. However, combination of both methods, using immunophenotypic analysis as a supplement would better subclassify the disease. One of the remaining 2 cases of undifferentiated leukemia was also shown to be myelo-megakaryoblastic leukemia by a positive platelet peroxidase reaction by ultrastructural cytochemistry. Thus, combination of these 3 methods could diagnose and subclassify 55 of the 56 cases (98%) of our ANLL patients.

Heat-stable and heat-labile components of nonspecific acid phosphatase detected in Pseudomonas pseudomallei.

In a whole cell assay system with p-nitrophenyl phosphate as substrate, strains of Pseudomonas pseudomallei showed a two-peak pattern in pH activity curve of acid phosphatase, suggesting the presence of two enzyme components different in pH optimum (4.2 and 5.2). The component of 5.2 pH optimum was detected in the outer membrane fraction and the activity was resistant to heating at 70 C for 30 min. The other component of 4.2 pH optimum was heat-labile. No substantial difference was observed in the enzymatic activity between R and S type colonies.

Growth and survival of Pseudomonas pseudomallei in acidic environments.

A study was made on the growth and survival of Pseudomonas pseudomallei in culture environments differing in nutrients, initial pH, and aeration, in comparison with Pseudomonas cepacia and Pseudomonas aeruginosa. The observations led us to a view that P. pseudomallei has the highest adaptability to acidic environments among the three species. Unlike the other species, it grew in heart infusion broth of initial pH 4.5 under aeration and survived keeping a high level (10(9) per ml) of viable counts for as long as 30 days. This sort of adaptation was found to be more evident in the media of poor nutrition and under limited aeration.

In vitro susceptibilities of Pseudomonas pseudomallei to 27 antimicrobial agents.

Clinical isolates of Pseudomonas pseudomallei isolated in Thailand from 1981 to 1989 were tested for their in vitro susceptibilities to 27 antimicrobial agents, including older and newer quinolones, broad-spectrum cephems, carbapenems, monobactams, penicillins, tetracyclines, chloramphenicol, rifamycin, sulfamethoxazole, trimethoprim, and fosfomycin. Tosufloxacin, meropenem, CS-533, and minocycline were active against P. pseudomallei at levels comparable to or even greater than those of antimicrobial agents tested in previous studies, such as ciprofloxacin, ceftazidime, imipenem, carumonam, and piperacillin. Drug-resistant P. pseudomallei was found in only 1% of the isolates. The drug-resistant P. pseudomallei isolates displayed a unique pattern of susceptibility to the above-listed drugs.

Salmonella krefeld in Thailand: II. Molecular biology of drug resistance.

Human salmonellosis due to Salmonella krefeld is very rare. During 1976-1978, a large outbreak of S. krefeld gastroenteritis occurred in Thailand, mainly in children. The majority of strains were multiply drug resistant with high minimum inhibitory concentration (MIC). The MIC for these drugs were ampicillin (Ap) 256-4096 mg/l, chloramphenicol (Cm) 256-512 mg/l, kanamycin (Km) 512- greater than 4096 mg/l, streptomycin (Sm) greater than 1024 mg/l, sulfamethoxazole (Su) 4096- greater than 8192 mg/l, tetracycline (Tc) 64-128 mg/l and trimethoprim (Tp) 64-256 mg/l. Resistance to Su and Tp declined after the period of the epidemic. The resistance genes were found to be highly transferable at a rate of 10(-2) to 10(-4). All strains with more than five resistance markers had large molecular weight plasmids of 120-140 megadaltons. The restriction profile analysis of plasmids from isolates collected from various regions of the country showed similarity of DNA fragment pattern. These isolates were resistant to Ap, Cm, Km, Sm, Su and Tc.

Nationwide surveillance program to identify diarrhea-causing Escherichia coli in children in Thailand.

Escherichia coli strains isolated from children with diarrhea were collected from 16 hospitals in different districts in Thailand during 1985 and 1986 and submitted to the National Reference Laboratory. Isolates were identified by serogrouping or as enterotoxigenic E. coli (ETEC), enteroinvasive E. coli (EIEC), enteropathogenic E. coli (EPEC) adhesin factor (EAF) E. coli, or Shiga-like-toxin (SLT)-producing E. coli by DNA hybridization. EPEC strains of known serogroups were isolated from 10%, ETEC strains were isolated from 6%, EAF E. coli strains were isolated from 4%, EIEC strains were isolated from less than 1%, and SLT-producing E. coli strains were isolated from none of 393 children with diarrhea. Among 278 children whose ages were recorded, the highest rate of isolation of EAF E. coli was 11% (9 of 85) from children less than 6 months old. ETEC was isolated from 5% (4 of 85) of children less than 6 months old, from 10% (12 of 118) of children 6 to 23 months old, and from 1% (1 of 75) of children greater than 23 months old. EPEC strains of known serogroups were isolated from 18% (15 of 85) of children less than 6 months old, from 11% (13 of 118) of children 6 to 23 months old, and from 9% (7 of 75) of children greater than 23 months old. E. coli strains that hybridized with the EIEC probe were isolated from three children who were 20, 36, and 48 months old. Examining E. coli for hybridization with DNA probes for virulence determinants is a practical way of conducting nationwide surveillance of diarrhea-causing E. coli. Since only 33% (13 of 39) of EPEC serogroups hybridized with the EAF probe and none hybridized with the SLT probes, identification of EPEC by serogroups analysis, followed by serotyping, should continue to be used in the identification of EPEC.

High activity of acid phosphatase of Pseudomonas pseudomallei as a possible attribute relating to its pathogenicity.

Phosphatase activities were compared quantitatively among selected species of pseudomonads. P. pseudomallei showed the highest activity of a bell-shaped pH pattern with a peak at around pH 5.0. P. cepacia had a similar pattern of milder intensity. In contrast, P. aeruginosa revealed an alkaline phosphatase activity with a pH optimum higher than 8.0, but the level of activity was much lower than those of the above two species. The enzymatic reactions of other species were slight or negligible at their optimum pH in the same test system. These data were discussed in reference to their growth behavior in different pH environments and also in connection with such recent information that the high activity of microbial acid phosphatase may be a favorable attribute to their intracellular parasitism.

Subtypes of hepatitis B surface antigen in Southeast Asia.

The prevalences of hepatitis B surface antigen (HBs Ag) subtypes in Thais, Cambodians, and Vietnamese were compared with the prevalences in Americans residing in Southeast Asia. HBs Ag was found with approximately equal frequency in Thai (43 percent) and American (39 percent) patients with hepatitis. However, higher prevalences of HBs Ag were found in asympotomatic Thais (9.5 percent), Cambodians (11.9 percent), and Vietnamese (14.3 percent) than in asymptomatic Americans (0.7 percent). Among asymptomatic Thais, the ratio of HBs Ag/adr to HBs Ag/adw was approximately 10:1, with one exception: adw was not detected in a rural population of northern Thailand. The y determinant was not found in Thais. In contrast, both d and y determinants were found in Americans. These observations conform to a geographic pattern, with ad as the predominant combination in the Far East. In Southeast Asia determinants w and r are more useful epidemiologic markers than y and d.

Elimination of repeated clot formation in mouse ascitic fluid containing arbovirus antibodies.

Repeated clot formation in mouse ascitic fluids containing antiviral antibody was eliminated by acid precipitation of the fibrinogen.