In Vitro Effect of Rifampin on Mycobacteria

Rifampin inhibited 20 strains of Mycobacterium tuberculosis in concentrations of 0.005 to 0.02 mug/ml in 7H-9 broth with Tween 80 and killed all or nearly all of the inoculum in four to eight times greater concentrations. In the same medium without Tween 80, as well as on 7H-10 agar, about 16 to 64 times these amounts were required to produce the same effect. Rifampin was also active against M. kansasii and some of the nonchromogenic mycobacteria. The incidence of mycobacterial cells resistant to rifampin within the cultures studied was in the range of one to four per 10(8) to 10(9) colony-forming units with concentrations of 4 to 125 mug of rifampin per ml. Only one of the Battey cultures and that of M. fortuitum yielded cells resistant to rifampin at 125 mug/ml but not at 500 mug/ml. The same strains yielded more than double that number of organisms resistant to streptomycin and up to 100 times more organisms resistant to isoniazid. All three drugs stopped the growth or reduced the mycobacterial population in growing cultures after contact for 24 to 48 hr. Complete inhibition of growth was produced by rifampin at 1.0 mug/ml in an average of 6 days and by streptomycin at 5.0 mug/ml in 3 days. After an average contact of 10.7 days with rifampin, five of seven strains resumed growth and all strains began regrowth after exposure to streptomycin for 9.4 days. The marked susceptibility of M. tuberculosis and of atypical mycobacteria to rifampin in vitro and the relatively low incidence of resistant mutants suggests that this agent may have clinical usefulness in the treatment of tuberculosis and some other mycobacterioses.     

Bacterial Metabolism of Mevalonic Acid

Soluble cell-free extracts of actinomycete S4 grown on media containing mevalonate catalyze acetoacetate formation from mevalonate, mevaldate, and β-hydroxy-β-methylglutaryl-coenzyme A (CoA). Conversion of mevalonate to acetoacetate involves formation of free β-hydroxy-β-methylglutaryl-CoA, but not free mevaldate. The reaction favors mevalonate oxidation, and nicotinamide adenine dinucleotide, rather than nicotinamide adenine dinucleotide phosphate, acts as oxidant.     

Cholelithiasis and Cholecystitis in Childhood

Six cases of cholecystitis and cholelithiasis confirmed by x-ray examination and surgical operation were observed in a ten-year period. Due to the wide variability in signs and symptoms in children, cholecystitis and cholelithiasis can be diagnosed only with a high degree of clinical suspicion and roentgenological examination. Gallbladder disease is uncommon in childhood but should be considered in children with vague abdominal pains or bouts of unexplained jaundice. If a normal appendix is found at laparotomy in the “acute abdomen,” the surgeon would be wise to palpate other specific organs within the abdomen, including the liver and gallbladder.The treatment of choice is cholecystectomy. The prognosis for recovery is excellent if there is no complicating systemic disease.     

Direct Cord Reading Medium for Isolation of Mycobacteria

A study of growth and colony morphology of mycobacteria was performed on 7H10 medium and compared with the same medium to which WR 1339 was added. Collection strains of human, bovine, and atypical mycobacteria, in addition to 1,199 sputa, were planted on both media. The results showed that WR 1339 modifies the growth and colony morphology of human, bovine, atypical group I, and, to a lesser degree, atypical groups II, III, and IV mycobacteria. The great majority of human and bovine strains exhibit definite cords when examined at a magnification of 100 times. The colonies are larger when WR 1339 is added, especially if there is a small number of colonies. The addition of WR 1339 spreads the growth on the surface of the agar, producing a thin but larger colony as compared with 7H10 medium alone on which the colonies grow more vertically, thus producing thick but smaller colonies. WR 1339 spreads the growth, producing thin and transparent colonies where the cords are oriented in uniplane and easily visible directly on the isolation media. Half of the positive sputum cultures were easily identified at 12 days. The presence of typical cords permits a quick screening diagnosis of species directly on the isolation media and, in most instances, elimination of the possibility of atypical or contaminating colonies.     

Kurze Mitteilungen

Zusammenfassung Ein Paar Türkentauben brütete vom 29. 1. bis 15. 2. 1966 auf einem Straßenbaum in Berlin-Tempelhof. Es wurde nur ein Ei gelegt. Nach 17 Tagen schlüpfte das gelbbedaunte Junge. Es ist dann kurz danach, wahrscheinlich beim Umherkriechen auf dem Nestrand, erfroren. Die Umstände, unter denen die Brut erfolgte, waren äußerst ungünstig. Die Temperatur lag seit dem 7. 2. 1966 dauernd unter Null (–9 und –13 Grad). Die brütende Taube hatte von Anfang an auf dem Nestrand brüten müssen, da die Mulde schon vor der Eiablage völlig mit Schnee bedeckt war. Der brütende Vogel war mehrere Tage und Nächte von einem hohen Schneewall umgeben, der sich auf dem Nest gebildet hatte. Dieses Nest wurde von Mai 1964 an viermal von einem Türkentaubenpaar zum Brüten benutzt. Es wird vermutet, daß zum mindesten der eine Partner, der Tauber, während der ganzen Zeit derselbe geblieben ist.     

Use of hospital services by homeless families in an inner London health district.

Over the past decade the number of families in London who were considered officially to be homeless appreciably increased. In response to this many families have been given temporary accommodation, usually in bed and breakfast hotels, while awaiting permanent rehousing. About 200 of the roughly 600 hotels in London that provide such accommodation are located in the area of the former Paddington and North Kensington Health Authority, now part of Parkside Health Authority. The use made by the homeless population of hospital services was studied by finding out the numbers of inpatients admitted to hospital and the numbers presenting to the walk in paediatric clinic and the casualty department at one hospital. These figures were compared with those for local residents and the overall workload. The bed and breakfast population were high users of inpatient beds, the casualty department, and the paediatric clinic. Overall, about one tenth of the beds were used by these people. The health authority receives no additional funding for this group of patients. Further research is needed to find out if the high use of hospital services made by these patients reflects their increased morbidity or their inability to obtain primary care services.