Blood culture isolates from children admitted to Medical Unit III,Yangon Children's Hospital, 1998

A one year study (August 1998-July 1999) of bacteremia in febrile children was carried out in the Medical Unit (III), Yangon Children's Hospital (YCH), Myanmar, to determine: (1) the bacteria responsible for fever of five days or more in children; (2) the antibiotic sensitivity pattern of these bacteria. Children aged one month to 12 years who had fever for five days or more and who did not receive antibiotics within the first 48 hours irrespective of the diagnosis were included in this study. A total of 120 patients fulfilled the criteria. Bacteria could be isolated from 65 cases (54.2%). The commonest organism isolated was Salmonella typhi (43.1%). Others included Escherichia coli (12.3%), Staphylococcus aureus (7.7%), Pseudomonas aeruginosa (7.7%); Streptococcus, Shigella, Diplococcus, Klebsiella and Acinetobacter were also isolated. The Salmonella typhi were resistant to conventional antibiotics (ampicillin, amoxicillin, chloramphenicol, and co-trimoxazole); however, they were sensitive to amikacin, netilmicin, nalidixic acid, and cephalothin. A cluster of enteric fever cases from Mingalartaungnyunt township was noticed and was reported to the Directorate of Health. Changes in the incidence and etiology of bacteremia in hospitals are well documented. Sentinel surveys of bacteremia in major hospitals should be carried out in order to detect the changing patterns of bacteremia and antibiotic sensitivity; such surveys will be of great help in establishing local antibiotic policies.     

Long-term safety follow-up of children from a randomized-controlled phase Ⅱb proof-of-concept efficacy study of the live,attenuated,tetravalent dengue vaccine (CYD-TDV) in Thailand

Objective:To investigate the long-term safety of a tetravalent dengue vaccine(CYD-TDV)in children in a phase Ⅱ b follow-up study in Thailand.Methods:In the phase Ⅱb study,children aged 4-11 years were randomized(2:1)to receive three injections of CYD-TDV or serve as control at 6-month intervals,with 25 months' active follow-up(active phase).This study was an additional four-year passive surveillance for hospitalized virologically-confirmed dengue(VCD;hospital phase).Cases of hospitalized VCD,severe hospitalized VCD,vaccine-related serious adverse events,and deaths were reported for the total population,with post-hoc analyses by enrollment age(9 and≥9 years).Results:Of 3 997 participants receiving≥1 injection,80.1% were recruited to the hospital phase[2 131(CYD-TDV);1 072(control)].Eighty-five hospitalized VCD cases were reported in the CYD-TDV group and 46 in the control group during the four-year hospital phase[relative risk(RR):0.93,95% confidence interval(Cl):0.64-1.36].The RR over six years of follow-up was 0.77(95% CI:0.57-1.05).In those aged≥9 years,the cumulative RRs in the active phase,hospital phase,and entire six years were 0.28(95% CI:0.08-0.81),0.51(95% CI:0.25-1.05),and 0.42(95% CI:0.24-0.75),respectively.In the overall population,there were ten severe hospitalized VCD cases in the CYD-TDV group and five in the control group over six years(RR:1.00,95% CI:0.31-3.75).Conclusions:Over six years of follow-up,in children aged ≥9 years,CYD-TDV administration is associated with a reduced risk of hospitalized VCD.     

Individual and combined effects of cadmium and copper on the growth response of Chlorella vulgaris

The individual and combined effects of cadmium and copper on the growth response of the green alga, Chlorella vulgaris, were examined. The effects of pH alone, and in combination with copper were also evaluated. An increase in cadmium and copper concentrations caused a significant reduction in the growth of C. vulgaris cells, and the corresponding EC₅₀ values were 1.02 and 4.01 mg L⁻¹, respectively. For a pH range of 2–7, the inhibitory effect due to increased copper concentrations (coupled with the resulting drop in pH) was significantly higher than the impact due to increased acidity (by addition of HCl) alone. At lower metal concentrations (5 mg L⁻¹ Cu + < 2 mg L⁻¹ Cd or 2.5 mg L⁻¹ Cd + < 4 mg L⁻¹ Cu), a combination of copper and cadmium appeared to have a stronger inhibitory effect on cell growth than that of a single metal. In contrast, at higher metal concentrations (5 mg L⁻¹ Cu + > 2 mg L⁻¹ Cd or 2.5 mg L⁻¹ Cd + > 4 mg L⁻¹ Cu), the effect of a single metal exhibited a significantly stronger effect compared to a combination of the two metals. ©1999 John Wiley & Sons, Inc. Environ Toxicol 14: 347–353, 1999     

Serological evidence for increased human exposure to Burkholderia pseudomallei following the tsunami in southern Thailand

A serological study was performed to determine recent human exposure to Burkholderia pseudomallei (the cause of melioidosis) in residents of southern Thailand affected by the tsunami of 26 December 2004. The findings were suggestive of increased recent exposure in both tsunami survivors and uninjured bystanders. Survivors of the Thailand tsunami may be at increased risk of melioidosis.