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Biomedical subjects

A M Kambal

Publications and source records attributed to A M Kambal.

At least 19 recordsLinked to original sources
PubMed1998

Evaluation of a Brucella enzyme immunoassay test (ELISA) in comparison with bacteriological culture and agglutination.

An ELISA test for IgG and IgM antibrucella antibodies was found to be effective in diagnosis of human brucellosis. Assays for IgG and IgM in 30 culture-positive cases gave significant ELISA values. By the standard agglutination test, 10% of these cases gave readings less than 1:160. These are considered insignificant, taking 1:160 as the accepted cut-off value. Moreover, in an extra 135 samples from suspected brucella cases, where only serology was requested (77.6% of all cases), 7.4% were found to have IgM brucella antibodies by ELISA. In all of these, the corresponding agglutination titres were less than 1:80 and hence reported as insignificant. We report the detection of IgG and IgM antibodies in samples from patients with both acute and chronic disease. In few patients with acute disease, only IgM was detected. These findings are discussed in comparison with earlier studies. Finally, the ELISA test, in addition to measuring antibody classes directly, also detects incomplete antibodies. By this, it can efficiently replace the 2 mercaptoethanol test (2ME) and the Coomb's antihuman-globulin test. This saves considerable laboratory cost and time.

Agglutination Tests↗
PubMed1997

Childhood pneumococcal bacteraemia in Riyadh, Saudi Arabia.

Forty-nine children with pneumococcal bacteraemia seen during a 5-year period (1 January 1991 to 31 December 1995) at King Khalid University Hospital were studied. The majority (61.2%) were under 2 years of age. The focus of infection was pneumonia, pharyngitis or undetermined in 28.6%, 18.4% and 20.4%, respectively. Diseases that had probably predisposed them to pneumococcal bacteraemia (mainly nephrotic syndrome) were encountered in 24.5% of cases. Forty-five per cent of the cases occurred during the summer season and in 29% the disease was nosocomially acquired. No death was recorded in this series and the reasons for this are discussed. Detection of pneumococcal antigens from blood taken for culture was successful in 96% of cases; this test is important in the diagnosis of pneumococcal bacteraemia in partially treated patients. Antimicrobial susceptibility testing showed 20.4% of the isolates to be relatively penicillin-resistant. Resistance to other antimicrobial agents was also recorded and multiple resistance was noted in 22% of isolates. There was a significant difference between the ceftriaxone MIC of the relatively penicillin-resistant strains compared with penicillin-sensitive strains. The emergence and the steady increase in the numbers of relatively penicillin-resistant pneumococcal strains in Saudi Arabia during the last 10 years are discussed.

Adolescent↗
PubMed1997

Spectrum of Haemophilus influenzae type b disease in children at a university hospital in Riyadh, Saudi Arabia.

During a period of 5 years, 42 cases of invasive Haemophilus influenzae type b (Hib) disease were studied. An outstanding finding in our patients was occult bacteraemia, which was detected in 13 (31 per cent) patients. Other clinical conditions encountered were nine (21 per cent) patients with pneumonia, nine (21 per cent) with meningitis, six (14 per cent) with cellulitis, three (7 per cent) with arthritis, one (2 per cent) with epiglottitis, and one (2 per cent) with urinary tract infection. The mean age of children was 21 months (range 1-156 months); the majority (62 per cent) belonged to the age group 7-18 months. There were 24 females and 18 males. Eighty-one per cent of these patients were Saudi nationals. Five isolates (12 per cent) of Hib were resistant to ampicillin and similar numbers were resistant to chlorampenicol. Twenty-five children (60 per cent) were treated with ampicillin, nine (21 per cent) with chlorampenicol and eight (19 per cent) with ceftriaxone. All patients made complete recovery.

Adolescent↗
PubMed1997

Non-group A streptococci: are they pathogens in the throat?

A total of 3,184 paediatric patients with sporadic pharyngitis was studied at King Khalid University Hospital in Riyadh, Saudi Arabia. In addition, 478 children without pharyngitis who were matched for age and sex were included as controls. Group A beta-haemolytic streptococci (beta HS) were detected significantly more often among the children with pharyngitis than among the controls (8.4% vs 2.3%; p < 0.0001). In contrast, total non-group A and group C beta HS were isolated at lower frequency from the sick than control children (0.9% vs 2.5% and 0.2% vs 1.2% respectively; p < 0.01) while other non-group A beta HS such as groups B, G and F were each isolated in similar frequency from both the sick and control children. We conclude that non-group A beta HS appear not to be as important as aetiological agents of sporadic pharyngitis in these children.

Adolescent↗
PubMed1995

Tuberculosis presenting as immune thrombocytopenic purpura.

Various haematological abnormalities commonly occur in active tuberculosis (TB). However, thrombocytopenia is rare and immune thrombocytopenic purpura (ITP) is mentioned only in few case reports. We found that of 846 cases with active TB, 9 (1%) presented with ITP as the only abnormality. Three out of these 9 cases had disseminated miliary TB, 3 an abdominal abscess or lymphadenitis, and 3 pulmonary TB; none had palpable splenomegaly. All patients had purpura and the platelet count varied between 4 and 21 x 10(9)/l, and the bone marrow showed increased megakaryocytes. All tuberculous patients showed initially a poor platelet count response to steroid therapy. The platelet count returned to normal 2-6 weeks after oral prednisone combined with antituberculous drugs.

Adult↗
PubMed1995

Antimicrobial resistance and prevalence of extended spectrum beta-lactamase among clinical isolates of gram-negative bacteria in Riyadh.

The activity of ciprofloxacin, imipenem and 12 other commonly used antibiotics was evaluated against 106 documented clinical isolates from a medical Intensive Care Unit (ICU). The resistance rates to ceftriaxone, cefotaxime, aztreonam and ceftazidime were 42, 25, 24 and 21%, respectively. Apart from Pseudomonas aeruginosa, all isolates were sensitive to ciprofloxacin and imipenem. Complete cross resistance among tested beta-lactam groups was uniformly evident in Enterobacter cloacae, Citrobacter freundii and P. aeruginosa. On the other hand, penicillins and second generation cephalosporins showed cross resistance among Escherichia coli and Klebseilla pneumoniae isolates. Induction experiments indicate that 70 and 62% of P. aeruginosa and E. cloacae or C. freundii produce class I cephalosporinase, respectively. Among all tested isolates, plasmid mediated extended spectrum beta-lactamase (ESBL) was detected in one isolate of K. pneumoniae. The plasmid mediated beta-lactamase is transferable and inhibited by beta-lactamase inhibitors. The transconjugates not only expressed resistance to extended spectrum beta-lactams and aztreonam but also toward tested aminoglycoside antibiotics, with the exception of gentamicin. The obtained transconjugates conferred high level resistance to ceftazidime and aztreonam but considerably low resistance to ceftriaxone and cefotaxime. The isoelectric point for the extended-spectrum beta-lactamase is 8.2.

Anti-Bacterial Agents↗
PubMed1992

An outbreak of infection due to Staphylococcus aureus phage type 52 in a neonatal intensive care unit.

An outbreak of infection due to Staphylococcus aureus phage-type 52, resistant only to penicillin, occurred in children's wards primarily in a neonatal intensive care unit. The outbreak involved 86 infants; the majority presented with conjunctivitis, wound infections, boils, omphalitis and otitis externa. Seven per cent of these infants (six of 86) also had septicaemia. In addition, 6% (five of 86) were colonized by this phage type and the most common site of carriage was the umbilicus. The outbreak was contained by eradication of nasal carriage among the staff members and also by standard infection control measures.

Bacteriophage Typing↗
PubMed1991

Septicaemia in febrile neutropenic children with cancer in Saudi Arabia.

The pattern of sepsis among 56 children admitted for various forms of cancer to the King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia during a 6-year period, was retrospectively reviewed. A total of 148 febrile neutropenic episodes occurred and 55 of these, in 40 patients, were associated with positive blood cultures. The isolates were Gram-positive bacteria in 54% of instances, Gram-negative bacteria in 39.4% and Candida in 6.6% and polymicrobial sepsis occurred in five patients. Profound neutropenia (neutrophil counts less than 0.1 x 10(9) l-1) significantly predisposed to Gram-negative sepsis (P less than 0.02), which was responsible for about one-third of deaths in this series. Central venous catheters were present prior to 49% of the septicaemic episodes, but were not significantly associated with either increased Gram-negative or Gram-positive bacterial sepsis. However, all four cases of candidaemia occurred in patients with a central venous catheter in situ, and it is recommended that early empirical treatment for candida be considered in all febrile neutropenic cancer patients with central venous catheters.

Catheterization, Central Venous↗
PubMed1990

Osteoarticular brucellosis in children.

The findings in 40 children (24 female, 16 male) with osteoarticular complications of brucellosis are presented. Raw milk was the main source of infection. Most patients had acute onset of fever, arthralgia, and myalgia. Arthritis was the presenting symptom in all patients, of whom two also had osteomyelitis. Arthritis was monoarticular in 28 (70%) of 40 cases with predilection for large weight-bearing joints. Spine and small joints were spared. Brucella melitensis was detected in 23/31 (74%) cases. Mild anaemia, leucopenia, increased liver enzymes, positive acute phase reactants, and low titres of autoantibodies were prominent non-specific laboratory findings. Bone scintigraphy was more helpful than conventional radiography in detecting hip and sacroiliac joint disease. Treatment with a combination of antibiotics for six weeks or more resulted in a cure rate of 92.5%. Early recognition of infection, prolonged treatment, and long term follow up should improve the outcome of patients.

Adolescent↗
PubMed1990

Childhood brucellosis: a study of 102 cases.

One hundred two children, 45 days to 14 years of age, with proven brucellosis were studied to illustrate the epidemiologic, clinical and laboratory findings and to assess the outcome of antimicrobial therapy. The main source of infection was the consumption of raw milk in 80% of the patients. The predominant presenting symptoms and signs were fever, arthralgia, malaise, weight loss, arthritis, hepatosplenomegaly and lymphadenopathy. Brucella melitensis was isolated from 75% of 87 patients. Diverse hematologic and biochemical abnormalities were found. Different durations and combinations of trimethoprim-sulfamethoxazole or tetracycline plus streptomycin or rifampin were used for therapy. Eight-five patients were followed for an average of 14 months. Twelve (85.7%) of 14 patients treated with two-antibiotic combinations for 3 weeks relapsed, as did 5 (8%) of 62 patients treated for at least 6 weeks (P less than 0.001). No relapses occurred in 9 patients treated with trimethoprim-sulfamethoxazole and rifampin for 8 to 12 weeks plus streptomycin for the first 3 weeks. Longer duration and combination of antibiotic therapy seem warranted to improve outcome and to prevent relapses.

Adolescent↗
PubMed1987

Isolation of Streptococcus milleri from clinical specimens.

During a period of 26 months, 80 strains of Streptococcus milleri were isolated from 80 patients with clinical evidence of infection. More than a third of the isolates were from lesions related to the gastro-intestinal tract and a quarter from abscesses of various other sites. The haemolytic activity and group antigenic profile of these isolates are discussed. In addition, the clinical significance of S. milleri isolated from various sites is evaluated.

Abscess↗
PubMed1986

Lower respiratory tract infection due to Branhamella catarrhalis, two case reports.

We describe two cases of lower respiratory tract infection due to Branhamella catarrhalis in elderly patients. The diagnosis was confirmed by isolation of the organism from the sputa in pure growth and also by response to treatment with appropriate antibiotics. Both patients had predisposing factors: one had chronic bronchial asthma and was also on corticosteroids during the illness and the other had chronic obstructive lung disease. Previously reported cases are reviewed.

Asthma↗
PubMed1985

Shigella flexneri bacteraemia.

Shigellosis is usually a non-invasive enteric disease, rarely accompanied by extra-intestinal manifestations. Shigella septicaemia is therefore reported in a child aged 10 months. In the laboratory the organism was resistant to ampicillin and only moderately susceptible to chloramphenicol. The patient responded well to cotrimoxazole to which the organism isolated was susceptible in vitro. We recommend that blood as well as faeces should be cultured in exceptionally ill patients with suspected or otherwise confirmed shigella infection.

Drug Combinations↗