Displaying publications 1 - 20 of 54 in total

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  1. Zueter AM, Abumarzouq M, Yusof MI, Wan Ismail WF, Harun A
    J Infect Dev Ctries, 2017 Jan 30;11(1):28-33.
    PMID: 28141587 DOI: 10.3855/jidc.7612
    INTRODUCTION: Melioidosis involving bone, joints, and soft tissue is rare and reported usually following dissemination of disease from infection elsewhere in the body; to a lesser degree, it can also be reported as the primary manifestation of melioidosis.
    METHODOLOGY: The orthopedic registry at Hospital University Sains Malaysia from 2008 until 2014 was retrospectively reviewed and was followed by molecular typing of Burkholderia pseudomallei.
    RESULTS: Out of 20 cases identified, 19 patients were confirmed to have osteoarticular and/or soft-tissue melioidosis. The majority of the patients were males (84%), and 16 patients had underlying diabetes mellitus with no significant estimated risk with the disease outcomes. Bacterial genotype was not associated with the disease as a risk. Death was a significant outcome in patients with bacteremic infections (p = 0.044).
    CONCLUSION: Patients with lung or skin melioidosis require careful treatment follow-up to minimize the chance for secondary osteoarticular infection. Human risk factors remain the leading predisposing factors for melioidosis. Early laboratory and clinical diagnosis and acute-phase treatment can decrease morbidity and mortality.
  2. Zakaria Z, Zainordin NA, Sim BL, Zaid M, Haridan US, Aziz AT, et al.
    J Infect Dev Ctries, 2014 Jul;8(7):869-75.
    PMID: 25022297 DOI: 10.3855/jidc.4283
    INTRODUCTION: The latest revised version of the World Health Organization's dengue classification was released in 2009. A handful of studies have taken initiatives to evaluate the old and revised guidelines to determine early signs and symptoms of severe dengue. This retrospective study aimed to compare the classification of dengue using both the 1997 and 2009 guidelines in a selected cohort of dengue patients from Peninsular Malaysia between 2008 and 2012.
    METHODOLOGY: Adult dengue patients were recruited from tertiary hospitals in two different states, Selangor and Kelantan, in Peninsular Malaysia. Their clinical manifestations were assessed.
    RESULTS: A total of 281 confirmed dengue patients were enrolled; the mean duration of illness at admission was five days. Of these, 88.6%, 10.7%, and 0.7% were classified according to the 1997 guidelines as having dengue fever (DF), dengue hemorrhagic fever (DHF), and dengue shock syndrome (DSS), respectively. When the WHO 2009 guidelines were applied, 17.1%, 78.3%, and 4.6% were classified as dengue without warning signs, dengue with warning signs, and severe dengue, respectively.
    CONCLUSIONS: Our data suggests that the revised WHO 2009 guidelines stratify a much larger proportion of patients into a category that requires a higher level of medical and nursing care.
  3. Yuen HL, Shamala D, Thong KL
    J Infect Dev Ctries, 2008 Aug 30;2(4):313-23.
    PMID: 19741295
    BACKGROUND: Heat shock proteins (HSPs) are known to be involved in the pathogenesis of Salmonella enterica serovar Typhi (S. Typhi), the causative agent of typhoid fever. The objective of this study was to apply a phage display library to identify mimotopes of two HSPs, HSP90 and DnaK in S. Typhi.

    METHODOLOGY: A 12-mer random peptide library expressed on the surface of the filamentous phage, M13, was used to select the mimotopes of two S. Typhi heat shock proteins by biopanning with monoclonal antibodies (mAbs), DnaK and HSP90. The immunogenicity of the selected peptides was determined through binding affinity with polyclonal antibodies from pooled typhoid-confirmed patients' sera and purified HSPs mAb using Western blotting and ELISA.

    RESULTS: Five rounds of biopanning resulted in enrichment of phage clones expressing the binding motifs TDxSTRP and FPSHYWLYPPPT, respectively. The selected peptides showed strong immunoreactivity with patients' sera. Thus, monoclonal antibodies against HSP and patient sera can select common mimotopes from the random peptide library.

    CONCLUSION: These findings may provide fundamental information for further studies on diagnostic application or vaccine design against this aetiologic agent of typhoid fever.

  4. Wong SY, Manikam R, Muniandy S
    J Infect Dev Ctries, 2015 Sep;9(9):936-44.
    PMID: 26409734 DOI: 10.3855/jidc.5882
    INTRODUCTION: Chronic wounds represent a major health burden worldwide. It has been hypothesized that the polymicrobial nature of wounds plays an important role in their healing process. Thus, a review of pathogen frequency and susceptibility patterns in wounds is necessary to provide appropriate guidelines for antimicrobial usage.
    METHODOLOGY: In this study, microbiota and antimicrobial resistance in both acute and chronic wound patients treated at the University of Malaya Medical Centre, Malaysia, were compared. Wound swabs from 84 patients with acute wounds and 84 patients with chronic wounds were collected. The specimens were cultured using standard microbiological techniques. Isolates were then tested for antibiotic sensitivity with the broth microdilution method.
    RESULTS: Of 210 pathogenic bacteria isolates, Staphylococcus aureus (49; 23.3%) and Pseudomonas aeruginosa (31; 14.8%) were the most prevalent bacteria found in wounds. Staphylococcus aureus was found significantly more often in patients with chronic wounds (41; 48.8%) than in patients with acute wounds (8; 9.5%), while Staphylococcus epidermidis was found predominantly in acute wounds (15; 17.9%). At the time of study, patients with chronic wounds (58.3%) had received more antibiotic treatments in the past previous 12 months compared with patients with acute wounds (16.7%). In the antibiotic susceptibility test, Staphylococcus spp. revealed highest resistance towards penicillin and ampicillin. Isolates showed no decrease in susceptibility against a number of newly developed antibiotics (linezolid, daptomycin, and tigecycline).
    CONCLUSIONS: Our finding showed that bacteria diversity and antimicrobial-resistant strains are more frequently found in chronic wounds than in acute wounds.
  5. Wong CK, Ng KS, Choo SQR, Lee CJ, Teo YP, Liew SM, et al.
    J Infect Dev Ctries, 2023 Aug 31;17(8):1138-1145.
    PMID: 37699097 DOI: 10.3855/jidc.16967
    INTRODUCTION: The all-cause mortality for tuberculosis is 1 in every 10 patients in Malaysia. The currently available national surveillance database does not record patients' variables such as socio-economic factors, existing co-morbidities, and risk behavior for investigation. An electronic medical record system can capture this missing information and use it to determine all-cause mortality factors more accurately. Our study aims to determine the factors associated with all-cause mortality in a cohort of tuberculosis patients in a Malaysian tertiary hospital which is equipped with an electronic medical record system.

    METHODOLOGY: Records of patients diagnosed with tuberculosis from 1st January 2018 to 30th September 2019 were retrieved. Sociodemographic and clinical data were extracted. Treatment outcomes and all-cause mortality were recorded at 1 year after diagnosis. Univariate, multivariate, and stepwise regression were used to determine the factors associated with all-cause mortality.

    RESULTS: Four-hundred and seventy-one patients were reviewed. The mean age was 46.6 ± 19.7 years. The all-cause mortality rate at one year of diagnosis was 15.3%. Factors identified were age [aOR 1.026 (95% CI: 1.004-1.049)], chronic kidney disease [aOR 3.269 (1.508-7.088)], HIV positive status [aOR 4.743 (1.505-14.953)], active cancer [aOR 5.758 (1.605-20.652)], liver disease [aOR 6.220 (1.028-37.621)], and moderate to advanced chest X-ray findings [aOR 3.851 (1.033-14.354)].

    CONCLUSIONS: On average, one in seven patients diagnosed with TB died within a year in a Malaysian tertiary hospital. Identification of this vulnerable group using the associated factors found in this study may help to reduce the risk of mortality through early intervention strategies.

  6. Tham HW, Balasubramaniam VR, Chew MF, Ahmad H, Hassan SS
    J Infect Dev Ctries, 2015 Dec 30;9(12):1338-49.
    PMID: 26719940 DOI: 10.3855/jidc.6422
    INTRODUCTION: Dengue virus (DENV) is principally transmitted by the Aedes aegypti mosquito. To date, mosquito population control remains the key strategy for reducing the continuing spread of DENV. The focus on the development of new vector control strategies through an understanding of the mosquito-virus relationship is essential, especially targeting the midgut, which is the first mosquito organ exposed to DENV infection.
    METHODOLOGY: A cDNA library derived from female adult A. aegypti mosquito midgut cells was established using the switching mechanism at the 5' end of the RNA transcript (SMART), in combination with a highly potent recombination machinery of Saccharomyces cerevisiae. Gal4-based yeast two-hybrid (Y2H) assays were performed against DENV-2 proteins (E, prM, M, and NS1). Mammalian two-hybrid (M2H) and double immunofluorescence assays (IFA) were conducted to validate the authenticity of the three selected interactions.
    RESULTS: The cDNA library was of good quality based on its transformation efficiency, cell density, titer, and the percentage of insert size. A total of 36 midgut proteins interacting with DENV-2 proteins were identified, some involved in nucleic acid transcription, oxidoreductase activity, peptidase activity, and ion binding. Positive outcomes were obtained from the three selected interactions validated using M2H and double IFA assays.
    CONCLUSIONS: The identified proteins have different biological activities that may aid in the virus replication pathway. Therefore, the midgut cDNA library is a valuable tool for identifying DENV-2 interacting proteins. The positive outcomes of the three selected proteins validated supported the quality of the cDNA library and the robustness of the Y2H mechanisms.
  7. Tan YF, Teng CL, Chua KB, Voon K
    J Infect Dev Ctries, 2017 Mar 31;11(3):215-219.
    PMID: 28368854 DOI: 10.3855/jidc.9112
    INTRODUCTION: Pteropine orthoreovirus (PRV) is an emerging zoonotic respiratory virus that has spilled over from bats to humans. Though initially found only in bats, further case studies have found viable virus in ill patients.

    METHODOLOGY: PubMed was queried with the keywords of Nelson Bay orthoreovirus OR Pteropine orthoreovirus OR Melaka orthoreovirus OR Kampar orthoreovirus, and returned 17 hits.

    RESULTS: Based on prevalence studies, the presence of PRV has been reported in Malaysia and Vietnam, both developing countries. Other case reports also provide further evidence of the presence of PRV in the Southeast Asian region. Despite the absence of PRV in their home countries, travellers from Hong Kong and Japan to Indonesia have returned to their countries ill with this virus, indicating that local communities in Indonesia might be affected by this virus.

    CONCLUSIONS: This work aims to bring to light this emerging zoonotic respiratory virus circulating among developing countries in Southeast Asia. To improve the understanding of PRV of the medical and scientific community in the Southeast Asian region, this work introduces the general features of PRV, reports of imported PRV, prevalence, and clinical features of PRV. Gaps in knowledge about PRV have also been identified in this work, and we hope that future studies can be undertaken to improve our understanding of this virus.

  8. Tan KK, Tan YC, Chang LY, Lee KW, Nor'e SS, Yee WY, et al.
    J Infect Dev Ctries, 2017 Jun 01;11(5):420-425.
    PMID: 30943180 DOI: 10.3855/jidc.7598
    INTRODUCTION: Currently available tests have limitations for the identification of Brucella species and strains, and their genetic lineage. The genome sequence of the rpoB gene encoding the β-subunit of DNA-dependent RNA polymerase was investigated for its use in genotyping Brucella melitensis.

    METHODOLOGY: Complete rpoB gene sequences of globally distributed Brucella melitensis strains were analyzed. Single nucleotides polymorphisms (SNPs) of the rpoB gene sequences were identified and used to type Brucella melitensis strains.

    RESULTS: Six DNA polymorphisms were identified, of which two (nucleotides 3201 and 558) were novel. Analysis of the geographical distribution of the strains revealed a spatial clustering pattern with rpoB type 1 representing European and American strains, rpoB type 2 representing European, African, and Asian strains, rpoB type 3 representing Mediterranean strains, and rpoB type 4 representing African (C3201T) and European (C3201T/T558A) strains.

    CONCLUSIONS: We report the discovery of two novel SNPs of rpoB gene that can serve as useful markers for epidemiology and geographical tracking of B. melitensis.

  9. Subahir MN, Jeffree MS, Hassan MR, Razak MFA, Mohamad SNG, Fong SY, et al.
    J Infect Dev Ctries, 2019 04 30;13(4):274-277.
    PMID: 32045370 DOI: 10.3855/jidc.11199
    INTRODUCTION: Norovirus (NoV) is a contagious virus causing acute gastroenteritis and is mainly responsible for diarrheal outbreak in closed settings. The aims of this study were to describe the epidemiological characteristic of an outbreak in a boarding school, to assess the extent of the outbreak and to implement appropriate control measures.

    METHODOLOGY: A descriptive study was conducted to describe the epidemiological characteristics of the outbreak. Data on demographic details, onset of abdominal symptoms, food intake history and contact with ill person three days prior to illness were obtained.

    RESULTS: Twelve fresh stool and 14 food samples were tested for NoV and enteric pathogens, respectively. Out of 745 students, 42 (5.6%) were infected during this outbreak. Predominant clinical features were diarrhea (76.1%), vomiting (71.4%) and abdominal pain (67%). Eight (67%) stool samples and six (43.9%)food samples were positive for NoV and total coliforms, respectively. The dissemination of the disease was due to poor hygiene practices among students. Quarantine was imposed until the last case on September 28, 2016. The outbreak was declared over on September 30, 2016.

    CONCLUSIONS: A NoV outbreak was determined first time in Malaysia. Environmental assessment showed poor hygienic conditions in the school's kitchen. The number of infected students increased considerably despite the implementation of preventive and control measures. Quarantine was effective to stop the outbreak which is characteristics of NoV outbreak.

  10. Steven MC, Solomon PD, Arumugam P, Rasali R, Dominic AC, Md Ideris H, et al.
    J Infect Dev Ctries, 2024 Feb 29;18(2):299-302.
    PMID: 38484359 DOI: 10.3855/jidc.18292
    INTRODUCTION: Given the stagnating progress in the fight against dengue in Kota Kinabalu, there is an urgent need to use other strategies to complement the existing vector control, focusing on larviciding. Unmanned aerial vehicle (UAV) technology has been used in vector control programs in many countries. The aim of this study was to determine the feasibility of using UAVs for larviciding to control Aedes mosquitoes in urban areas.

    METHODOLOGY: The Hexarotor Agro Drone (Polardrone Sdn Bhd, Malaysia) was used to carry out larviciding using Vectobac® manufactured by Valent BioSciences LLC, Libertyville, USA. The drone flew at a height of 10 feet and at a speed of 5 m/s. A total of 32 items with 10 larvae in each item were placed to test the effectiveness of larviciding using UAV.

    RESULTS: Out of 32 items used, 4 containers had a 100% larva mortality (13.3% mortality). The drone was not able to reach the designated spraying route that had been pre-programmed. This was due to interference with the electromagnetic waves emitted from the home satellite dishes, that were in front of the houses along the route.

    CONCLUSIONS: This trial showed that UAVs will be more suitable for use in larviciding in an open area without electromagnetic disturbances from electric house poles and satellite TV dishes that are commonly present in urban areas.

  11. Soh KL, Shariff Ghazali S, Soh KG, Abdul Raman R, Sharif Abdullah SS, Ong SL
    J Infect Dev Ctries, 2012 Apr;6(4):333-9.
    PMID: 22505443
    INTRODUCTION: Ventilator-associated pneumonia (VAP) is the most common nosocomial infection in intensive care units (ICUs). One factor causing VAP is aspiration of oral colonisation, which may result from poor oral care practice. Oral care using tooth brushing can prevent formulation of dental plaque that can be a reservoir for microbes causing VAP.
    METHODOLOGY: A cross-sectional survey was conducted among 124 nurses, using a self-administered questionnaire, to determine methods used, frequency, and attitude of nurses toward oral care provided to mechanically ventilated patients in Malaysian ICUs.
    RESULTS: Methods for oral care and their frequency of use varied between nurses even in the same unit. Cotton with forceps was used by 73.4% of the nurses. Some nurses used forceps and gauze (65%) or spatulas and gauze (36%). Toothbrushes were used by 50.8% of the nurses. Nurses in this hospital reported to have positive attitude toward providing oral care.
    CONCLUSIONS: The survey showed the need to have standardised oral care protocols in ICUs to improve quality of oral care provided to ventilated patients.
  12. Singh S, Murali Sundram B, Rajendran K, Boon Law K, Aris T, Ibrahim H, et al.
    J Infect Dev Ctries, 2020 09 30;14(9):971-976.
    PMID: 33031083 DOI: 10.3855/jidc.13116
    INTRODUCTION: The novel coronavirus infection has become a global threat affecting almost every country in the world. As a result, it has become important to understand the disease trends in order to mitigate its effects. The aim of this study is firstly to develop a prediction model for daily confirmed COVID-19 cases based on several covariates, and secondly, to select the best prediction model based on a subset of these covariates.

    METHODOLOGY: This study was conducted using daily confirmed cases of COVID-19 collected from the official Ministry of Health, Malaysia (MOH) and John Hopkins University websites. An Autoregressive Integrated Moving Average (ARIMA) model was fitted to the training data of observed cases from 22 January to 31 March 2020, and subsequently validated using data on cases from 1 April to 17 April 2020. The ARIMA model satisfactorily forecasted the daily confirmed COVID-19 cases from 18 April 2020 to 1 May 2020 (the testing phase).

    RESULTS: The ARIMA (0,1,0) model produced the best fit to the observed data with a Mean Absolute Percentage Error (MAPE) value of 16.01 and a Bayes Information Criteria (BIC) value of 4.170. The forecasted values showed a downward trend of COVID-19 cases until 1 May 2020. Observed cases during the forecast period were accurately predicted and were placed within the prediction intervals generated by the fitted model.

    CONCLUSIONS: This study finds that ARIMA models with optimally selected covariates are useful tools for monitoring and predicting trends of COVID-19 cases in Malaysia.

  13. Shakeel S, Rehman H, Hassali MA, Hashmi F
    J Infect Dev Ctries, 2020 Oct 31;14(10):1117-1124.
    PMID: 33175705 DOI: 10.3855/jidc.12714
    INTRODUCTION: With the increase in the incidence rate of COVID-19, healthcare professionals (HCPs) being at the frontline of the outbreak response are at higher risk of getting exposure and suffering from the infection. The present study aimed to evaluate the knowledge, attitude, and precautionary practices of HCPs towards COVID-19.

    METHODOLOGY: The current study was a descriptive, cross-sectional, online study directed to the HCPs working in a metropolitan city of Karachi, during February 2020 and March 2020 using a self-administered questionnaire. A systematic random sampling approach was adopted.

    RESULTS: A total of 286 completed surveys were incorporated in the investigation with a response rate of 74.28%. The median (interquartile range, IQR) knowledge score was 18.79 (17.64-19.57). Physicians were found to be more knowledgeable (OR: 1.32, 95% CI: 0.17-4.26, p = 0.003) as compared to other HCPs. Similarly, the HCPs working in private work settings (OR: 1.94, 95% CI: 1.54-2.79, p=0.001), having more experience (OR = 1.82; 95% CI = 1.64-2.78; p < 0.005) were found to be more well-informed than HCPs working in public sector (OR = 0.81; 95% CI = 0.63-0.72; p = 0.004). The correlation between the knowledge and attitude of respondents was found to be significantly correlated (correlation coefficient: 0.13, p < 0.005).

    CONCLUSIONS: The findings of the study revealed that HCPs were well conversant and have an optimistic attitude towards COVID-19. Further contemplates are required to evaluate the understanding of HCPs at a national level so that viable mediations could be planned to combat this pandemic.

  14. Shaharir SS, Tumian NR, Yu Lin AB, Abdul Wahid SF
    J Infect Dev Ctries, 2013 Mar;7(3):286-8.
    PMID: 23493009 DOI: 10.3855/jidc.2691
    Tuberculosis is notoriously known to be a great mimicker of other diseases and may cause various haematologic abnormalities, especially with marrow involvement. A 61-year-old man who presented with right empyema and pancytopenia was diagnosed to have disseminated tuberculosis supported by the presence of caseating granuloma with Langhan's giant cells in the marrow and demonstration of acid-fast bacilli in the pleural fluid. Trilineage dysplasia from marrow aspirate was initially attributed to be reactive to the infection. A cytogenetic study was repeated after he showed poor response to a year of anti-tuberculosis treatment. The underlying primary myelodysplastic syndrome was unmasked when his cytogenetics showed trisomy 8. This case report has demonstrated the various haematological manifestations of tuberculosis and highlighted the importance of cytogenetic study in differentiating between primary and secondary myelodysplastic marrow changes.
  15. Oh AL, Goh LM, Nik Azim NA, Tee CS, Shehab Phung CW
    J Infect Dev Ctries, 2014 Feb;8(2):193-201.
    PMID: 24518629 DOI: 10.3855/jidc.3076
    INTRODUCTION: The widespread and inappropriate use of broad-spectrum antibiotics in surgical prophylaxis has led to reduced treatment efficacy, increased healthcare costs, and antibiotic resistance. This study aimed to explore the adherence of antibiotic usage in surgical prophylaxis to the national antibiotic guideline and the incidences of surgical site infection (SSI).
    METHODOLOGY: A three-month prospective observational study has been conducted in the surgical wards of Sarawak General Hospital (SGH) using a standardized surveillance form. Each patient was reviewed for up to 30 days post-operatively to determine the occurrence of SSI.
    RESULTS: A total of 87 patients were included within the study period. The majority of the cases were clean-contaminated wounds (60.9%). Most were hepatobiliary cases (37.9%), followed by colorectal cases (19.5%). The most preferred antibiotic used was cefoperazone (63.2%). The choices of antibiotics in 78.2% of the cases were consistent with the guideline. Around 80% of prophylactic antibiotics were given within one hour before operation and 27.6% were omitted from intraoperative re-dosing. Prophylactic antibiotics were discontinued within 24 hours post-operatively in 77% of the cases. Of those continued for > 24 hours, the majority (60%) were administered for unknown reasons. SSI was documented in 13.8% of the total cases studied. However, there was no significant association between choices of antibiotics and timing of surgical prophylaxis with SSI (p = 0.299 and p = 0.258 respectively).
    CONCLUSION: Overall guideline adherence rate was more than 70%. Areas of non-concordance to the guideline require further investigation.
  16. Oh AL, Hassali MA, Al-Haddad MS, Syed Sulaiman SA, Shafie AA, Awaisu A
    J Infect Dev Ctries, 2011 May;5(5):338-47.
    PMID: 21628809
    INTRODUCTION: Public knowledge and attitudes towards antibiotics play a vital role in the success of the treatment process. This study aimed to assess public knowledge and attitudes toward antibiotic usage which could serve as baseline data for future studies within a government hospital setting in Malaysia.
    METHODOLOGY: A self-administered cross-sectional survey involving 408 respondents was conducted using a validated questionnaire at an outpatient pharmacy department in Penang Hospital, Malaysia, from February to March 2009.
    RESULTS: Nearly 55% of the respondents had a moderate level of knowledge. Three quarters of the respondents (76.7%) could correctly identify that antibiotics are indicated for the treatment of bacterial infections. However, 67.2% incorrectly thought that antibiotics are also used to treat viral infections. About 59.1% of the respondents were aware of antibiotic resistance phenomena in relation to overuse of antibiotics. With regard to attitudes, 38% believed that taking antibiotics when having cold symptoms could help them to recover faster, while 47.3% expected antibiotics to be prescribed for common cold symptoms. Age, race and educational level were among the demographic characteristics significantly associated with knowledge and attitudes toward antibiotic use. Poor level of knowledge was found in less than one-third of the respondents whereas more than one-third of the respondents wrongly self-medicate themselves with antibiotics once they have a cold.
    CONCLUSION: Educational interventions are needed to promote prudent use of antibiotics among the public.
    Study site: outpatient pharmacy, Hospital Pulau Pinang, Malaysia
  17. Nor A'shimi MH, Alattraqchi AG, Mohd Rani F, A Rahman NI, Ismail S, Abdullah FH, et al.
    J Infect Dev Ctries, 2019 07 31;13(7):626-633.
    PMID: 32065820 DOI: 10.3855/jidc.11455
    INTRODUCTION: Acinetobacter baumannii is a Gram-negative nosocomial pathogen that has the capacity to develop resistance to all classes of antimicrobial compounds. However, very little is known regarding its susceptibility to biocides (antiseptics and disinfectants) and capacity to form biofilms, particularly for Malaysian isolates.

    AIM: To determine the susceptibility of A. baumannii isolates to commonly-used biocides, investigate their biofilm-forming capacities and the prevalence of biocide resistance and biofilm-associated genes.

    METHODOLOGY: . The minimum inhibitory concentration (MIC) values of 100 A. baumannii hospital isolates from Terengganu, Malaysia, towards the biocides benzalkonium chloride (BZK), benzethonium chloride (BZT) and chlorhexidine digluconate (CLX), were determined by broth microdilution. The isolates were also examined for their ability to form biofilms in 96-well microplates. The prevalence of biocide resistance genes qacA, qacE and qacDE1 and the biofilm-associated genes bap and abaI were determined by polymerase chain reaction (PCR).

    RESULTS: Majority of the A. baumannii isolates (43%) showed higher MIC values (> 50 µg/mL) for CLX than for BZK (5% for MIC > 50 µg/mL) and BZT (9% for MIC > 50 µg/mL). The qacDE1 gene was predominant (63%) followed by qacE (28%) whereas no isolate was found harbouring qacA. All isolates were positive for the bap and abaI genes although the biofilm-forming capacity varied among the isolates.

    CONCLUSION: The Terengganu A. baumannii isolates showed higher prevalence of qacDE1 compared to qacE although no correlation was found with the biocides' MIC values. No correlation was also observed between the isolates' biofilm-forming capacity and the MIC values for the biocides.

  18. Muhammad Azami NA, Abdul Murad NA, Mohammed Nawi A, Salleh SA, Periyasamy P, Kori N, et al.
    J Infect Dev Ctries, 2021 12 31;15(12):1816-1824.
    PMID: 35044938 DOI: 10.3855/jidc.15277
    INTRODUCTION: During the second wave of the coronavirus disease 19 (COVID-19) pandemic, Malaysia reported several COVID-19 clusters related to healthcare workers. Thus, addressing and understanding the risk of exposure in healthcare workers is important to prevent future infection and reduce secondary COVID-19 transmission within the healthcare settings. In this study, we aim to assess exposure and prevention practices against COVID-19 among healthcare workers at the Hospital Canselor Tuanku Muhriz, a university teaching hospital based in Kuala Lumpur, Malaysia.

    METHODOLOGY: A total of 571 healthcare workers at COVID-19 and non-COVID-19 wards as well as the emergency department and laboratory staff at COVID-19 testing labs were recruited. The presence of novel human coronavirus (SARS-CoV-2) and IgM/IgG antibodies were confirmed in all healthcare workers. The healthcare workers responded to an online Google Forms questionnaire that evaluates demographic information and comorbidities, exposure and adherence to infection prevention and control measures against COVID-19. Descriptive analysis was performed using Statistical Package for the Social Sciences 24.0.

    RESULTS: Three healthcare workers (0.5%) tested positive for SARS-CoV-2, while the remaining 568 (99.5%) were negative. All were negative for IgM and IgG antibodies during recruitment (day 1) and follow-up (day 15). More than 90% of the healthcare workers followed infection prevention and control practices recommendations regardless of whether they have been exposed to occupational risk for COVID-19.

    CONCLUSIONS: The healthcare workers' high level of adherence to infection prevention practices at this hospital helped reduce and minimize their occupational exposure to COVID-19.

  19. Mokhtar KS, Rahman NA, Haron MS, Rahman NHA
    J Infect Dev Ctries, 2020 04 30;14(4):349-359.
    PMID: 32379711 DOI: 10.3855/jidc.11583
    INTRODUCTION: The prevalence of tuberculosis (TB) remains alarmingly high in developing countries, including Malaysia. Recognised as the leading global infectious disease, untreated TB can be fatal. TB is easily spread through the air, and any close contact with a TB patient can put others at risk. This study therefore aimed to investigate the level of awareness of TB among TB patients and how their attitudes affect self-preventive healthcare.

    METHODOLOGY: This cross-sectional study was conducted using a validated self-administered questionnaire at 18 hospitals in six states of Malaysia, namely, Selangor, Kuala Lumpur, Penang, Kelantan, Sabah, and Sarawak in 2015. The study sample comprised 1600 TB patients who were randomly selected using data obtained from the Disease Control Division, Ministry of Health Malaysia. A total of 1368 of the completed questionnaires were considered usable and included in the statistical analysis.

    RESULTS: Overall, the level of TB awareness was found to be high, and the respondents possessed positive attitudes towards TB and health-seeking behaviours. Self-preventive care among the TB patients was determined as being at a moderate level. With regard to contact with others, the patients were more comfortable around their families than their friends and neighbours.

    CONCLUSIONS: More health education programmes are recommended to cultivate positive attitudes towards TB, to encourage communities to have a better understanding of TB, and to create awareness among patients of the proper ways to practice self-preventive care.

  20. Mohan A, Yeong LC, Kumarasamy G, Manan K
    J Infect Dev Ctries, 2023 Jun 30;17(6):886-890.
    PMID: 37406064 DOI: 10.3855/jidc.17821
    A 12-year-old boy was admitted after 11 days of fever and 2 days of nasal obstruction as well as swelling of a right cervical lymph node. Nasal endoscopy and computed tomography of the neck showed a nasopharyngeal mass occupying the entire nasopharynx, extending into the nasal cavity, and obliterating the fossa of Rosenmuller. Abdominal ultrasonography revealed a small solitary splenic abscess. Although a nasopharyngeal tumor or malignancy was initially considered, biopsy of the mass showed only suppurative granulomatous inflammation, and bacterial culture from the enlarged cervical lymph node yielded Burkholderia pseudomallei. The symptoms, nasopharyngeal mass, and cervical lymph node enlargement resolved with melioidosis-directed antibiotic therapy. Although rarely reported, the nasopharynx may be an important primary site of infection in melioidosis patients, especially in pediatric patients.
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