Hypocarnitinemia in disorders of organic acid metabolism.

The patient was treated with oxytetracycline and metronidazole (there was no history of recent use of either ampicillin or augmentin). The infected ulcer improved and six days later the Enterobacter cloacae could no longer be isolated. The strain was sensitive in vitro to tetracycline. This case shows that an augmentinresistant organism can be sensitive to ampicillin. Isolates should therefore be tested against both antibacterial agents. We believe this to be the first reported isolation of an ampicillinsensitive, augment in-resistant organism. Enterobacter cloacae, however, is not a common pathogen and this is likely to be a rare phenomenon. Public Health Laboratory, St Mary’s General Hospital, Portsmouth J. CRUMP S. CANSDALE