Evaluation of an immunofluorescence test for the diagnosis of gonorrhoea

Sera from 336 Jamaicans were tested, using a mixture of local strains of N. gonorrhoeae as antigen in an indirect flourescent antibody test. (IFA) At 1:6 serum dilution, the sensitivity of test was high (100 percent in females with culture-proven gonorrhoea). Geometric mean titres in culture-negative females witha history of gonorrhoea contact were significantly higher than in females with non-gonococcal vaginitis (81 and 47 respectivity). There was no significant difference between the GMT of males with current uncomplicated gonorrhoea and controls (43 and 37 respectively). Absorption studies showed that N. gonorrhoeae-specific antibodies were present in 25 percent of culture-negative, 67 percent culture-positive patients and 20 percent of blood donors. The specificity of the test was markedly improved at 1:128 serum dilutions, when the predictive value of a positive result was 95 percent. We consider this IFA test to be a useful adjunct to the diagnosis of gonorrhoea. (AU)

Antibiotic resistance of N. gonorrhoeae in Jamaica - abstract

A total of 885 women and 515 men, who were symptomatic, were screened by culture for gonorrhoea. Men were screened initially with Gram stain. Of these, 313 women and 440 men were proven to have uncomplicated gonorrhoea and were randomly assigned to treatment with procaine penicillin (4.8 mega units) or ampicillin (3.5g) each with probenecid (1g). Of this number, 61 women and 120 men were subsequently excluded from the study, leaving 252 women and 320 men for analysis. In this report, only the first 148 men are analysed. Test of cure (TOC) was performed 3-7 days post-treatment. One hundred and eighty women and 129 men completed treatment and follow-up within this period. The TOC was done after 7 days in 72 women and 19 men; these late returnees were analysed separately. Eliminating the late TOC cases, the total failure rates for penicillin and ampicillin were 4.8 percent and 4.3 percent respectively; for men 5.2 percent and 7.0 percent, for women 4.5 percent and 2.2 percent. Of the 14 failures to both regimes followed up within 7 days, 5 had PPNG infections, 2 were reinfections and 1 had pelvic complications. Urethral swabs from males and endocervical swabs from females were inoculated on to Thayer-Martin medium and gonococcal isolattes were identified by standard methods. Isolates were tested for penicillinase production using chromogenic cephahalosporin. Using the agar dilution technique and supplemented Protease No. 3 agar, the MICs to penicillin, ampicillin, spectinomycin, tetracycline, erythromycin, sulfamethoxazole-trimethoprim (19:1), cefuroxime and thiamphenicol were determined on isolates from these patients. Preliminary data on the determination of auxotype indicated that the prototrophic and proline-requiring groups comprised over 60 percent of the isolates tested to date. However, several other auxotype groups, especially Orn- and Pro-Cit-Ura-, were prevalent as well. Plasmid analysis of the strains indicated that all the Pro-Cit-Ura- isolates were plasmid-free, a result noted by others, and that 26 percent of the isolates carried transfer plasmids. To date, 16 PPNG cases have been detected among the 440 male cases, and 1 among 277 female cases. The PPNG isolates harboured either the African (3.2 Md) or the Asian (4.8 Md) penicillinase-producing plasmids. This is the first time that PPNG strains have been identified in Jamaica (AU)

Safety and immunogenicity of a new Haemophilus influenzae type b vaccine in infants under one year of age

64 healthy infants, 2-3 months old, were randomly assigned to one of three vaccination groups which either diphtheria-pertussis-tetanus (DPT) vaccine, Haemophilus influenzae type b capsular polysaccharide polyribosyl-ribitol phosphate (PRP) vaccine, or PRP+P (with pertussis adjuvant) vaccine in three doses at intervals of two months. Local and systemic reactions occurred most frequently after DPT vaccination and least frequently for PRP alone. Data for 60 infants from whom complete sera sets were available indicated that 70 percent of the infants who received three doses of PRP+P showed two fold or greater increases in titers of antibody to PRP with final values above the level assumed to give protection against invasive H. influenzae type b disease (>0.15 ug/ml). In contrast, less than 10 percent of infants who received PRP vaccine alone showed 2-fold or greater increases (Summary)

Listeria monocytogenes infection in an immunosuppressed patient

A case of Listeria monocytogenes infection in a 22-year-old woman who received immunosuppressive therapy for malignant lymphoma is described. This is the first reported case of Listeria monocytogenes infection in a patient in Jamaica (AU)

Two cases of pasteurella multocida infections in Jamaica

Two cases of pasteurella multocida infections seen at the University Hospital are described. One was a restaurant chef with fulminating septicaemia and arthritis. The other was a female infant with meningitis. These systemic forms of P. multocida infections usually have a high mortality but both of these cases recovered fully. A high degree of vigilance and awareness on the part of both clinician and bacteriologist are necessary for the diagnosis of these infections (AU)

A preliminary qualitative survey of the bacterial flora of restaurants and bakeries in the city of Kingston, Jamaica

A preliminary survey of 53.3 per cent of restaurants and 88.3 per cent of bakeries in Kingston revealed the presence of a wide range of organisms, the majority of which were probably derived originally from the naso-pharynx, skin and intestinal tract of humans. Coagulase positive satphylococci, Esch.coli and Proteus are all agents of food poisoning, and although organisms of the Salmonella group were not found, the mechanism for their spread seemed to be present. A smaller percentage of bakeries was contaminated by naso-pharyngeal organisms and organisms from the skin of man. The picture was the same for enteric organisms with the exception of enterococcus, which occurred in a higher percentage of bakeries than in restaurants (AU)