The leaves of Carapa guianensis have been used to treat ulcers, skin parasites, and skin problems. The ethanolic extract of C. guianensis leaf was evaluated for its antibacterial and wound healing activity using excision, incision and dead space wound models in rats. The animals were randomly divided into two groups (n = 6) in all the models. In the excision wound model test group animals were treated topically with the leaf extract (250 mg kg−1 body weight) whereas, control animals were treated with petroleum jelly. In the incision and dead space wound models, the test group animals were treated with extract (250 mg kg−1 day−1) orally by mixing in drinking water and the control group animals were maintained with plain drinking water. Healing was assessed by the rate of wound contraction, period of epithelialization, skin breaking strength, granulation tissue weight and hydoxyproline content. On Day 15 extract-treated animals exhibited 100% reduction in the wound area when compared to controls (95%) with significant decrease in the epithelialization period. The extract failed to demonstrate antibacterial activity. Skin breaking strength (P < .001), wet (P < .002) and dry (P < .02) granulation tissue and hydroxyproline content (P < .03) were significantly higher in extract treated animals. The increased rate of wound contraction, skin breaking strength and hydroxyproline content supports potential application of C. guianensis in wound healing.

In 2006, the first isolate of KPC-2-producing Pseudomonas aeruginosa in the world was identified in Colombia. Recently, similar strains have been reported in Puerto Rico. We now report KPC-2-producing P. aeruginosa in Trinidad and Tobago. Surveillance for similar strains is warranted, considering their wide geographic spread and known association with mobile genetic elements. CASE REPORTA 63-year-old male patient was admitted to a hospital in Mount Hope, Trinidad and Tobago, with hematuria, dysuria, fever, and chills. He had no history of travel abroad. Four months prior to his presentation, he had a left hip fracture caused by a fall and was hospitalized at another regional hospital for 10 weeks without any surgical intervention but with conservative care. He had remained bedridden since the fracture.Upon physical examination, he appeared chronically ill, was stuporous, febrile (38°C), severely pale, and dehydrated, had bedsores on the buttocks and sacral area, and had a urinary catheter. He had swelling of the left thigh, which was tender and warm to the touch, with subcutaneous emphysema.Blood and urine specimens were submitted for culture. Radiological investigations of the pelvis and legs revealed a fracture of the neck of the left femur, with subcutaneous emphysema and fluid collection along the lateral compartment of the thigh, extending to the inguinal region, hip joint, and left lower abdominal wall.He was given gentamicin, ceftazidime, and metronidazole. A fasciotomy was performed, revealing gas gangrene. Two liters of greenish yellow pus from the anterior compartment of the left thigh, extending to the left lower abdomen, was drained. This pus was cultured.Blood and urine cultures were negative. However, the culture of the pus from surgery yielded Pseudomonas aeruginosa. Antimicrobial susceptibility testing using the MicroScan WalkAway 96 SI system (Siemens) revealed that the isolate was resistant to all tested antimicrobials, including gentamicin, ceftazidime, ciprofloxacin, and carbapenems. Meropenem monotherapy was given despite in vitro resistance, while efforts were made to procure polymyxin B or colistin; unfortunately, these efforts were unsuccessful, and the patient died 10 days postadmission.The P. aeruginosa isolate was sent to the International Center for Medical Research and Training, Cali, Colombia, where the MIC was determined using the Clinical and Laboratory Standards Institute (CLSI)-approved broth microdilution method (2). Ertapenem, imipenem, and meropenem MICs were Ͼ128 g/ml. This isolate was also resistant to ceftazidime (MIC, 128 g/ml), cefepime (MIC, Ͼ128 g/ml), aztreonam (MIC, Ͼ128 g/ml), piperacillin-tazobactam (MICs, Ͼ256 and 4 g/ml), and ciprofloxacin (MIC, Ͼ8 g/ml) and remained susceptible only to polymyxin B (MIC, 2 g/ml).A three-dimensional test to screen for carbapenemases was performed as reported previously (10) with some modifications. This test uses a carbapenem-susceptible organism as an indicator for carbapenemases in a cellular extract. To detect the carbapenemase...

We conclude that only one major PFGE genotype of MRSA clone is circulating among the three major regional hospitals in Trinidad and Tobago suggesting one of three possible scenarios of microevolution: (1) all were from the dissemination of a single epidemic MRSA clone prevailing in these hospitals in Trinidad and Tobago; or (2) MRSA in Trinidad and Tobago is evolving more slowly than in other countries; or (3) that if other MRSA clones have been present in Trinidad and Tobago, they have not persisted.

We conducted a study to determine quantitatively and qualitatively the presence of Campylobacter spp., Escherichia coli, staphylococci, total coliforms, total aerobic bacteria, and Salmonella on broiler carcasses from selected small retail processors in Trinidad. We used standard media and procedures for detection and quantification. All carcass and weep samples were positive for aerobic bacteria, E. coli, total coliforms, and staphylococci. Significant differences in the mean counts of aerobic bacteria were observed for samples of carcass (P = 0.001), weep (P = 0.038), and liver and heart (P = 0.017). There was a significant difference (P < 0.05) in the prevalence of E. coli and Campylobacter for liver and heart samples and gizzard samples across various areas (health divisions) in Trinidad and for Campylobacter jejuni and Campylobacter coli for offal samples. The prevalence of Salmonella in carcass, drip, gizzard, and liver and heart samples was 7.3, 3.1, 2.1, and 1.0%, respectively, and three serotypes, Salmonella Kiambu (53.8%), Salmonella Kentucky (38.5%), and Salmonella Mbandaka (7.7%) were isolated. Of the six groups of microbes considered with respect to sale activity, the differences in the prevalence of Campylobacter in medium-activity sale shops (95.8%) and low-activity sale shops (83.3%) and the mean counts of staphylococci for medium-activity sale shops (5.5 +/- 0.9) and low-activity sale shops (5.1 +/- 0.8) were statistically significant (P < 0.05). Carcasses rinsed in a stagnant system had a significantly higher (P < 0.05) prevalence (92.3%) and mean count per milliliter (3.1 +/- 0.7) for Campylobacter compared with 77.8% and 2.7 +/- 0.7 for shops that rinsed with constantly running water. The frequency of rinse water change significantly (P = 0.04) affected the prevalence of Salmonella on carcasses. It is recommended that a quality control system be introduced for these shops, particularly with respect to evisceration and rinsing practices.