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Quantitative aerobic and anaerobic cultures of deep tissue were performed on amputated infected lower limbs of 13 diabetic patients immediately after surgery. Dissection was made through intact skin distant from any preexisting ulcer. The results were compared with those obtained from: (i) ulcer swabs (pre-and postamputation), (ii) curettage of the ulcer base, and (iii) needle aspiration after normal saline injection. Anaerobic transport media were used for anaerobic cultures before prompt transfer to the anaerobic chamber. A mean of 4.7 bacterial species per specimen was seen (2.3 aerobes, 2.4 anaerobes). Mean logo growth per gram of tissue was as follows: (i) aerobes plus anaerobes = 6.99, (ii) aerobes = 6.42, and (iii) anaerobes = 7.65. There was poor concordance between the deep tissue culture results and the results from other modalities of culture collection,

IntroductionMotorcycle injuries contribute a substantial number of deaths and hospital admissions in Kenya. There is paucity of data to inform prevention strategies to address the issue. Therefore, the current study sought to explore the characteristics of 2 and 3-wheeler related road traffic injuries (RTIs) in Kenya.MethodsA cross-sectional survey of motorcycle drivers involved in a RTI in the preceding 3 months was conducted in 11 urban and rural sites in Kenya's Thika town through face- to -face structured interviews. Drivers’ demographic information, comprehensive crash characteristics and socioeconomic impact of injury data were collected.ResultsOf 200 drivers injured, 98% were male, with average age of 28.4 years (SD±6.6). Of these drivers, 33% were not wearing any protective equipment. Negligence was the most reported cause of crash (33%), followed by slippery roads (21.0%) and speeding (17.5%). The risk of sustaining a bodily injury was 1.3 times higher in drivers who had not received prevention education compared to those who had received such education. People injured at night were 5 times more likely to sustain a bodily injury compared to those injured during the day. Only 8.5% of the drivers reported the injury incident to the police.ConclusionMajority of motorcycle related injuries in Thika town occur among young, productive, working-age male drivers. A high proportion of injuries are due to negligence on riding while not wearing any protective equipment compounded by lack of injury prevention education. Initiatives to foster helmet wearing, provision of high-quality affordable helmets, responsible driving and advocacy for stronger legislation, are recommended.

Forty isolates of methicillin-resistant Staphylococcus aureus were tested for in vitro susceptibility to cephalothin, cefamandole, cefotaxime, and moxalactam, using the disk diffusion and microbroth dilution methods at incubation temperatures of 30 and 35°C. Resistance to all four antibiotics was more clearly evident at an incubation temperature of 30°C.Methicillin-resistant Staphylococcus aureus infections are being seen with increasing frequency in the United States (5,8,11,15,17). The resistance of these microorganisms to the semisynthetic penicillins has posed therapeutic problems, and clinical failures have been reported with earlier cephalosporins despite apparent in vitro susceptibility to these drugs (1,11,14).In a recent communication (7) we reported discordant in vitro disk susceptibility results for the effect of cephalothin on methicillin-resistant S. aureus when the incubation temperature was changed from 35 to 30°C. Similar observations had been reported previously with methicillin and other semisynthetic penicillins (2, 6, 16). We also showed in our study that additional isolates of methicillin-resistant S. aureus may show resistance to cephalothin by tube dilution susceptibility testing at an incubation temperature of 30°C rather than 35°C.We studied the antibiotic susceptibility of methicillin-resistant S. aureus isolated at our institution to other cephalosporins, including a second-generation cephalosporin (cefamandole) and third-generation cephalosporins (cefotaxime and moxalactam), to determine whether results similar to those of cephalothin can be observed.Forty clinical isolates of methicillin-resistant S. aureus, each from a different patient, were studied. These isolates were recovered from a variety of clinical specimens from January 1978 to April 1979. The isolates were identified by conventional methods (12).Antibiotic disk susceptibility testing was performed by the method of Bauer and associates (4) and by the agar overlay technique (3). A 30-,ug disk was used for each of the four antibiotics studied. One set of plates was incubated at 30°C and the other was incubated at 35°C for 18 to 24 h. The criteria for inhibitor zone diameter standards for cephalothin and cefamandole were obtained from previously published data (13), and those for cefotaxime and moxalactam were obtained from their respective manufacturers. These criteria are listed in Table 1.We determined minimum inhibitory concentrations (MIC) by a microbroth dilution technique in Mueller-Hinton broth (BBL Microbiology Systems, Cockeysville, Md.), using the method of Gavan and Barry (10). One set of tubes was incubated at 30°C and the other was incubated at 35°C for 18 to 24 h. All samples were run in duplicate. A known methicillinsusceptible strain of S. aureus (ATCC 25923) and a known methicillin-resistant strain from our culture collection were tested simultaneously each time the test was performed. Isolates with an MIC of 10 ,ug/ml or less were considered susceptible, and those with an MIC of 20 ,ug/ml or more were consi...