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.     

Bone marrow transplantation in Ramathibodi Hospital: progress report.

Bone marrow transplantation has become the accepted treatment for several hematologic disorders. We have done 3 autologous and 6 allogeneic bone marrow transplantations at Ramathibodi Hospital since July 1989 in patients with acute lymphoblastic leukemia, acute non-lymphocytic leukemia, chronic myeloid leukemia, non-Hodgkin's lymphoma and severe aplastic anemia. Only one patient with aplastic anemia had late graft rejection, but the rest of them engrafted and did well during the median follow up period of 317 days (range: 39 to 962 days) post transplantation. None of the allogeneic BMT had graft-versus-host disease. We use cyclosporin and short course methotrexate for post transplantation immunosuppression.     

HIV Transmission by Seronegative Blood Components: Report of 2 Probable Cases

HIV seroconversion was reported in 2 haemophiliacs after having corrective orthopaedic surgery. They received solvent-detergent/heat-treated factor VIII concentrate, HIV-seronegative cryoprecipitate and fresh frozen plasma during the course of surgery. HIV seroconversion was found on days 31 and 71 after surgery. It is highly probable that the infections were acquired by transfusions of seronegative blood components. In countries with a relatively low prevalence of HIV infection, transmission of HIV by transfusion of derivatives of seronegative blood is occasionally reported as a rare complication of blood transfusion [1–3]. In Thailand the prevalence of HIV infection and the incidence of new infections in the general population and in blood donors has recently increased dramatically (fig. 1) [4–5]. As a result of these components prepared from HIV-seronegative blood donations pose a significant hazard to recipients because of the risk of viraemia during the ‘window period’ of HIV infection. Here we report HIV infection in 2 haemophilia patients treated with HIV-seronegative (using Fujirebio agglutination or second-generation Abbott ELISA) cryoprecipitate and fresh frozen plasma in 1991, prepared locally from single-unit donations. All donors were voluntary. Anti-HIV was tested in every unit of donor blood before processing to blood components. Although not proven, it is highly probable that the infections were acquired by transfusions of seronegative blood components.     

Red Cell ABH Antigens in Leukaemias and Lymphomas

The qualitative and quantitative determinations of A, B, and H antigens were studied in blood samples of 509 normal subjects and 114 patients. 11 of 53 (20.75%), 3 of 27 (11.11%), and 4 of 34 (11.76%) of adults with leukaemia, children with leukaemia and adults with lymphomas, respectively, show significantly lower antigenic scores than normal controls. Since all A, B and H antigens were found to be independently affected, the destruction of well-developed ABH antigens by a certain substance produced during the course of the disease was suspected.     

Autologous Blood Donation for Elective Gynaecological Surgery

The utilization and effectiveness of a hospital autologous blood donation programme for elective gynaecological surgery at Ramathibodi Hospital during April 1, 1988-March 31, 1991 were analyzed. A total of 438 patients or 98% of eligible patients were enrolled into the programme. Each patient gave 1 unit of blood within 14 days of undergoing gynaecological surgery. The untoward effects observed in the programme were higher than those found in the regular donors. However, these were very mild. Nearly 90% of the participants used no homologous blood during their hospitalization, 8% used only their autologous blood, while 2% used additional homologous transfusion. The released autologous components were subsequently administered to other recipients. The patients' acceptance was excellent. Autologous blood donation is a safe, inexpensive and feasible procedure for transfusion treatment in elective gynaecological surgery especially in developing countries.     

Immunoglobulins in leprosy

Serum immunoglobulins were estimated by the single radial immunodiffusion technique and the results were compared among various groups of leprosy patients. Most of the serum immunoglobulin classes are increased in lepromatous leprosy patients. Controls from different regions in Thailand and even from two populations in the same region show different results. This can lead to different interpretations of results in leprosy patients and may explain apparent discrepancies in earlier studies of serum immunoglobulins in leprosy.     

A 0203 variant (A0203S) in thais

A total of 50 randomized individuals previously serologically and or DNA class I typed as A2 were studied for A2 subtypings by using 12 WS HLA-A^*02 subtyping DNA typing kit. The subjects were consisted of 44 Central Thai (CT) and 6 Thai-Muslim (TM). A2 subtypes found in this study were A^*0201 A^*0203, ^*0203S, ^*0206 ^*0207, ^*0209, ^*0210, ^*0211,^* 0216, ^*0217 and ^*02. The most common HLA A^*02 subtyping was A^*0203 which was 19 out of 44 (43.18%) A2 CT subjects and 4 of 6 (66.7%) TM. The ratios of A^*0203 : A^*0203S were 11:8 and 4:1 among CT and TM respectively. A^*0203S was found to be segregated in an informative family. The primer mix 513A yielded positive reaction with A^*0203 while negative reaction was observed for A^*0203S. Other primer mixes in the kit gave the same reactions for A^*0203 and A^*0203S.     

Water soluble I blood group substance in the secretions of rhesus monkeys

Abstract. Water soluble I blood group substance is present in the milk and saliva of rhesus monkeys, but the antigen is not present on their red cells. The AB and I group antigens thus have a parallel distribution on the cells and in the secretions of these animals. The results support the conclusion of other workers that the ABO and I group antigens are closely interrelated.     

The HLA Antigens and Leprosy in Thailand

HLA-A and -B locus antigens were determined in 170 unrelated patients with leprosy and 100 healthy controls. There were no statistically significant deviations from expected antigen distribution in patients with any of the various forms of leprosy, though the number of patients studied is relatively small. There were some interesting trends, particularly a possible decrease in the number of tuberculoid patients with A9, and an increase in the proportions of lepromatous patients with B18 and B40. Limited evidence of a genetically controlled pre-disposition to the clinical manifestations of leprosy suggests that further studies with extended typing should be carried out on the HLA haplotype segregation in informative leprosy families. These should provide a clearer indication of the relevance of the HLA (including DR) and possibly of other non-HLA loci to the possible mechanism(s) of disease susceptibility.