Multidrug-resistant (MDR) Acinetobacter baumannii have caused nosocomial infections worldwide. Nowadays, there are no effective regimens to treat MDR- A. baumannii. Therefore, this study’s objective was to find out an effective antimicrobial combination against MDR-A. baumannii. This project consisted of four parts. Part 1 was an in vitro antimicrobial susceptibility test of MDR-A. baumannii collected from Thailand. Minimum inhibitory concentrations (MICs) were performed according to the Clinical and Laboratory Standards Institute (CLSI) guidelines using a broth microdilution technique. This study found that colistin was the most active against MDR-A. baumannii (MIC50 0.5µg/mL, MIC90 1µg/mL). In addition, 77% of MBL -producing A. baumannii were reported using the MBL Etest strips. This prevalence was higher than previously reported. Part 2 was conducted to compare antimicrobial susceptibility profiles of pre- and post-colistin exposure A. baumannii isolates. After colistin exposure, A. baumannii isolates became resistant to colistin but more susceptible to cefepime, doxycycline, meropenem and rifampicin. These findings suggested the potential of a synergistic activity of colistin combinations. Part 3 was a time-kill study that compared activity of colistin alone and in combination against MDR-A. baumannii. Time-kill assays were performed using a standard inoculum. Colistin monotherapy was rapidly bactericidal against these isolates; however, regrowth occurred at 24 hrs. On the other hand, colistin in combination with cefepime, doxycycline, meropenem or rifampicin demonstrated synergy and maintained bactericidal activity over 24 hrs (100%). Part 4 was designed to optimize meropenem dosing regimens using a PK-PD model. Three MDR-A. baumannii with colistin MICs (0.5-1µg/mL) and meropenem MICs (32-128µg/mL) were tested. The antimicrobial regimens alone and in combination evaluated were: colistin 2.5mg/kg every 12 hrs, meropenem 3g and 6g continuously infused (CI) over 24 hrs. Colistin monotherapy was rapidly bactericidal but regrowth did occur. Both combinations express synergy (100%). Nevertheless, colistin and high dose meropenem (6g CI over 24 hrs) was bactericidal and prevented regrowth over 24 hrs. In conclusion, MBL-producing A. baumannii is more prevalent than previously thought and colistin combined with a high dose meropenem (6g/day) has good potential to overcome multidrug- and carbapenem-resistant A. baumannii. These findings should be further evaluated in animal models and clinical practices. / text

published_or_final_version / Comparative Asian Studies / Master / Master of Arts

published_or_final_version / Comparative Asian Studies / Master / Master of Arts

No description available.

Bangkok’s expansion and population increase are both causes and consequences of rapid economic transformation and growth. In this light, the study examines the synergic conditions that are operating in the Bangkok region, that define the relationship between economic growth and spatial expansion. What is emerging is a chaotic tapestry of an urban and rural landscape which reflects a bonanza form of development and has accelerated in the last ten years. Moreover, there is evidence supporting an urban form that is emerging at Bangkok’s edge, extending up to 100 kilometres from the central city, which is neither city nor countryside. It is a settlement system characterised by an intense land use mix, where agriculture, industry, housing, and recreation all inflect upon each other. Within this region there has been a shift of labour from farm to off-farm sectors within the strictly defined rural areas. The dissertation argues for a new set of definitions to account for an extended urban settlement pattern which is sensitive to the prevailing heterogeneous space economy. The term Region Based Urbanization (RBU) is introduced to describe the phenomena in a region with 14 million people, now known as the Extended Bangkok Metropolitan Region (EBMR). Aside from affirming RBU as the predominant settlement form in the EBMR, there are three notable conclusions to this study: (i) Since the mid-nineteenth century diverse and disparate forms of dominant capital have contributed to outer city development. (ii) As the region diversifies, and further affirms its economic primacy within Thailand there is indication of increasing disparities and uneven development among socio-economic classes. (iii) There is empirical support to challenge traditional rural-urban transition models. Outer areas of the EBMR, which are defined as ‘rural’, are not only ‘holding’ population, but are the destination of a large migration from peripheral regions of the Kingdom.

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No description available.

This thesis is a contribution to the study of rural development and social change. The economy, polity and society of rural Thailand has undergone enormous transformations in the past century and a half. These centre on the penetration of rural communities by structures of state and capital. An important aspect of this is the emergence of 'differentiation' (or 'stratification'): i.e., the development of disparities between the economic status and circumstances of households in the same locality. This thesis reports data pertaining to intra-village differentiation which were collected during an anthropological study of a rural community in Central Thailand. Rural differentiation in Thailand is considered from a number of related perspectives. Macro-level, historical transformations of the Thai countryside are discussed, and an interpretive model of the consequent stratification discernible in the village study site is presented. Ongoing processes of differentiation, which focus on the monopolisation of local resources by rural elites in the context of the developing village, are delineated. Data pertaining to informants' economic related decisions and behaviours reveal that different strata of villagers hold dissimilar 'economic attitudes': rich villagers' economic decision-making accords with Western notions of economic 'rationality' , whilst poor villagers tended to be both non-accumulatory and apparently reckless in the economic arena. Middle ranking villagers tended toward economic quiescence. This phenomenon is explained by a reconstruction of some elements of poor villagers' underlying system of values of beliefs. The consequences of intra-village differentiation for social identities and relations are discussed by reference to the 'class hypothesis': i.e., that the continued experience of increasing differentiation gives rise to class identities and, hence, class based social relations. Data suggest that, whilst stratification informs social identities and interactions to some extent, at present this is over-ridden by other, noneconomic factors.

No description available.

Graduation date: 1980