The effects of ethylenediaminetetraacetic acid and of four other chelating agents on seven strains of gram-negative bacteria are described. Changes in viability, cell lysis, and release of intracellular materials from suspensions in various buffers, pH 7.8 or 9.2, were observed. Cyclohexane-1,2-diaminotetraacetic acid was the most toxic compound, whereas iminodiacetic acid and nitrilotriacetic acid had little bactericidal activity. The activity of the five drugs appeared to be related to their chelating ability. Of the bacterial strains used, Pseudomonas aeruginosa NCTC 1999 and NCTC 6750 were the most susceptible, and Klebsiella aerogenes K1 was the most resistant. In contrast, the two strains of P. aeruginosa were the most resistant to the nonchelating antibacterial agents cetrimide, chlorhexidine, and benzalkonium chloride.

Pattern of Electrolyte Imbalance in Hospitalized DiabeticPatients 22% were on oral anti-diabetic agents and 6% were on medical nutrition therapy. Among the co-morbidities, hypertention was the most prevalent (61%), followed by ischaemic heart disease (24%), chronic kidney disease (21%), dyslipidaemia (8%) and fatty liver (4%). Diabetic peripheral neuropathy was present in 41% cases, nephropathy in 13% cases and retinopathy in 12% cases. Over all 78% (100 patients had electrolyte imbalance out of 128 patients) of patients had some sort of electrolyte imbalance, irrespective of cause of admission. Hyponatraemia was the most common electrolyte imbalance in this study (80%), followed by hypomagnaesemia (38%), hypokalaemia (36%) and hyperkalaemia (14%). In 11% cases there were hyponatraemia, hypokalaemia and hypomagnaesemia. Regarding the precipitating factors, vomiting was most common (51%). In 28% cases electrolyte imbalance was precipitated by various drugs. Diarrhea and renal failure were responsible in a minority of cases. In 4% cases no cause could be identified. No death occurred.Conclusion: From this cross-sectional study it can be concluded that, electrolyte imbalance is common in hospitalized diabetic patients. Serum electrolytes should be checked routinely in hospitalized diabetic patients irrespective of their purpose of admission.

The effects of ethylenediaminetetraacetic acid and related chelating agents on the susceptibility of Pseudomonas aeruginosa and other strains of gram-negative bacteria to some fi-lactam antibiotics and some non-antibiotic antibacterial agents have been studied by two methods: (i) the determination of minimal inhibitory concentrations in the presence and absence of a chelating agent; and (ii) pretreatment with a chelating agent, followed by exposure for up to 120 min at 37 C to a fl-lactam drug in a nutrient medium or to the other type of antibacterial agent in a non-nutrient environment. The pretreatment technique gave the more significant results, especially with chlorhexidine, cetrimide, and benzalkonium chloride. Chelating agents that had previously been found to give a low order of activity as measured by effects on bacterial viability nevertheless appeared to induce some changes in the surface layers of the treated organisms, rendering them susceptible to sub-inhibitory concentrations of non-antibiotic drugs.Haque and Russell (2) have recently shown that two strains of Pseudomonas aeruginosa were considerably more susceptible to ethylenediaminetetraacetic acid (EDTA) and related chelating agents than were other, nonPseudomonas strains of gram-negative bacteria. Of the chelating agents studied, nitriloacetic acid (NTA) and iminodiacetic acid (IDA) had little or no inhibitory activity even when used at concentrations 10 times higher than the other substances. It was also found (2) that the two strains of P. aeruginosa were the most resistant to nonchelating antibacterial agents such as cetrimide, chlorhexidine, and benzalkonium chloride.Leive (3-5) has shown that pretreatment of Escherichia coli with EDTA rendered the cells susceptible to actinomycin D; this method has since been adopted by other workers using E. coli or other strains and various antibacterial agents (11). Thus a study has been made of the effect of pretreatment, or simultaneous treatment, with EDTA or other chelating agents on the susceptibility of P. aeruginosa and some other gram-negative strains to some fi-lactam antibiotics (cephaloridine, ampicillin, carbenicillin) and to other antibacterial agents (benzalkonium chloride, cetrimide, chlorhexidine).MATERIALS AND METHODS Bacterial strains. These consisted of P. aeruginosa NCTC 6750 and NCTC 1999, E. coli R+TEM and R-TEM, Enterobacter cloacae P99 and P99M, and Klebsiella aerogenes KJ. Cultures were grown overnight at 37 C on 150 ml of nutrient agar (Oxoid, Ltd., London) in Roux flasks; the cells were collected, washed twice with tris(hydroxymethyl)aminomethane (Tris) buffer (10-2 M, pH 7.8), and resuspended to a density of about 10' viable cells/ml in the same buffer.Antibacterial agents. Carbenicillin sodium and ampicillin sodium were purchased from Beecham

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