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  1. Fulltext Non-typhoidal Salmonella blood stream infection in Kuwait: Clinical and microbiological characteristics
    Albert MJ, Bulach D, Alfouzan W, Izumiya H, Carter G, Alobaid K, et al.
    PLoS Negl Trop Dis, 2019 04;13(4):e0007293.
    PMID: 30986214 DOI: 10.1371/journal.pntd.0007293
    Non-typhoidal Salmonella (NTS) bacteremia is a significant cause of morbidity and mortality worldwide. It is considered to be an emerging and neglected tropical disease in Africa. We studied this in two tertiary hospitals-Al Farwaniya and Al Amiri-in Kuwait, a subtropical country, from April 2013-May 2016. NTS bacteremia was present in 30 of 53,860 (0.75%) and 31 of 290,36 (1.33%) blood cultures in the two hospitals respectively. In Al Farwaniya hospital, one-third of the patients were from some tropical developing countries of Asia. About 66% of all patients (40/61) had diarrhea, and of these, 65% had the corresponding blood serovar isolated from stool culture. A few patients had Salmonella cultured from urine. Patients were either young or old. Most of the patients had co-morbidities affecting the immune system. Two patients each died in both hospitals. The number of different serovars cultured in each hospital was 13, and most infections were due to S. Enteritidis (all sequence type [ST]) 11) and S. Typhimurium (all ST19) except in a subgroup of expatriate patients from tropical developing countries in Al Farwaniya hospital. About a quarter of the isolates were multidrug-resistant. Most patients were treated with a cephalosporin with or without other antibiotics. S. Enteritidis and S. Typhimurium isolates were typed by pulsed field-gel electrophoresis (PFGE) and a selected number of isolates were whole-genome sequenced. Up to four different clades were present by PFGE in either species. Whole-genome sequenced isolates showed antibiotic-resistance genes that showed phenotypic correlation, and in some cases, phenotypes showed absence of specific genes. Whole-genome sequenced isolates showed presence of genes that contributed to blood-stream infection. Phylogeny by core genome analysis showed a close relationship with S. Typhimurium and S. Enteritidis from other parts of the world. The uniqueness of our study included the finding of a low prevalence of infection, mortality and multidrug-resistance, a relatively high prevalence of gastrointestinal infection in patients, and the characterization of selected isolates of S. Typhimurium and S. Enteritidis serovars by whole-genome sequencing that shed light on phylogeny, virulence and resistance. Similarities with studies from developing countries especially Africa included infection in patients with co-morbidities affecting the immune system, predominance of S. Typhimurium and S. Enteritidis serovars and presence of drug-resistance in isolates.
    Matched MeSH terms: Salmonella Infections/microbiology*
  2. Studies of bacterial disease in West Malaysian. Orang Asli (aborigines): previously unrecorded Salmonella Serotypes
    Anandan J, Lim TW, Haug NL
    Med J Malaya, 1969 Jun;23(4):269-71.
    PMID: 4242174
    Matched MeSH terms: Salmonella Infections/microbiology
  3. Characterization of drug resistant Salmonella enterica serotype Typhimurium by antibiograms, plasmids, integrons, resistance genes and PFGE
    Benacer D, Thong KL, Watanabe H, Puthucheary SD
    J Microbiol Biotechnol, 2010 Jun;20(6):1042-52.
    PMID: 20622506
    Forty-seven Salmonella Typhimurium (33 zoonotic, 14 clinical) strains were tested for antimicrobial resistance using the standard disk diffusion method. Presence of relevant resistance genes and class 1 integrons were investigated by using PCR. Pulsed-field gel electrophoresis (PFGE) and plasmid profiling were carried out to determine the genomic diversity of Salmonella Typhimurium. Approximately 57.4% of S. Typhimurium were multidrug resistant (MDR) and showed high resistance rates to tetracycline (70.2%), sulphonamides (57.4%), streptomycin (53.1%), ampicillin (29.7%), nalidixic acid (27.6%), kanamycin (23.4%), chloramphenicol (21.2%) and trimethoprim (19.1%). Resistance towards cephalosporins was noted for cephalothin (27.6%), cephradine (21.2%), amoxicillin clavulanic acid (17.0%) and cephalexin (17.0%). Resistance genes, blaTEM, strA, aadA, sul1, sul2, tet(A), tet(B) and tet(C) were detected among the drug resistant strains. Thirty-three strains (70.2%) carried class 1 integrons, which were grouped in 9 different profiles. DNA sequencing identified sat, aadA, pse-1 and dfrA genes in variable regions on class 1 integrons. Thirty-five strains (74.4%) were subtyped to 22 different plasmid profiles, each with 1 - 6 plasmids (2.0 to 95 kb). PFGE subtyped the 47 strains into 39 profiles. In conclusion, high rates of multidrug-resistance were found among the Malaysian Salmonella Typhimurium strains. The emergence of multidrug-resistant Salmonella Typhimurium to cephalosporin antibiotics was also observed. The strains were very diverse and no persistent clone was observed. The emergence of MDR Salmonella Typhimurium is a worldwide problem and this report provides information for the better understanding of the prevalence and epidemiology of MDR S. Typhimurium in Malaysia.
    Matched MeSH terms: Salmonella Infections/microbiology
  4. Fulltext Non-typhoidal Salmonella bacteraemia: epidemiology, clinical characteristics and its' association with severe immunosuppression
    Dhanoa A, Fatt QK
    Ann Clin Microbiol Antimicrob, 2009;8:15.
    PMID: 19445730 DOI: 10.1186/1476-0711-8-15
    Non-typhoidal Salmonella (NTS) is increasingly recognized as an important pathogen associated with bacteraemia especially in immunosuppressed patients. However, there is limited data specifically describing the clinical characteristics and outcome amongst the immunosuppressed patients.
    Matched MeSH terms: Salmonella Infections/microbiology*
  5. Salmonella serotypes isolated from man in Malaysia over the 10-year period 1973-1982
    Jegathesan M
    J Hyg (Lond), 1984 Jun;92(3):395-9.
    PMID: 6376627
    The results of serotyping of 10 953 salmonella isolates from humans over a 10-year period, 1973-82 at the Bacteriology Division, Institute for Medical Research, Malaysia are presented. A total of 104 serotypes from 22 'O' groups were encountered; 95 isolates were considered untypable. The three most predominant serotypes, namely Salmonella typhi, S. typhimurium and S. weltevreden together accounted for 54.1% of all isolates whilst the 25 most frequent serotypes accounted for 93.6% of the total. Whilst the commoner serotypes occurred regularly throughout the study period, the rarer ones tended to appear only in one year, when they might be associated with an outbreak, and never again. The pattern of serotypes, though quite similar to the one seen in neighbouring Singapore, is different from those experienced in other places such as Hong Kong, Jakarta, Bangladesh and Manchester.
    Matched MeSH terms: Salmonella Infections/microbiology*
  6. Ceftriaxone resistance and genes encoding extended-spectrum β-lactamase among non-typhoidal Salmonella species from a tertiary care hospital in Kuala Lumpur, Malaysia
    Karunakaran R, Tay ST, Rahim FF, Lim BB, Sam IC, Kahar-Bador M, et al.
    Jpn J Infect Dis, 2012;65(5):433-5.
    PMID: 22996219
    The prevalence of ceftriaxone resistance and the associated genes encoding extended-spectrum β-lactamase (ESBL) was determined in 149 non-duplicate non-typhoidal Salmonella isolated in 2008-2009 from patients in a tertiary care hospital in Kuala Lumpur, Malaysia. The resistance rate to ceftriaxone was 2.7% (2/74) in 2008, 4.0% (3/75) in 2009, and 3.4% (5/149) overall. CTX-M ESBL genes were detected in 2 of the 5 ceftriaxone-resistant isolates. The prevalence of ceftriaxone resistance, although low, is a concern because it limits therapeutic options. Continued surveillance of ceftriaxone resistance is important to monitor its trends.
    Matched MeSH terms: Salmonella Infections/microbiology*
  7. Molecular analysis of ciprofloxacin resistance among non-typhoidal Salmonella with reduced susceptibility to ciprofloxacin isolated from patients at a tertiary care hospital in Kuala Lumpur, Malaysia
    Karunakaran R, Tay ST, Rahim FF, Lim BB, Puthucheary SD
    Jpn J Infect Dis, 2014;67(3):157-62.
    PMID: 24858603
    We investigated the prevalence of non-typhoidal Salmonella (NTS) with "reduced susceptibility to ciprofloxacin" (RS-Cip) (minimum inhibitory concentration [MIC], 0.12-1.0 μg/mL) as well as their resistance genes in 75 NTS isolates (53 from stool, 21 from blood, and 1 from urine) from patients at a tertiary care Malaysian hospital between January and December 2009. RS-Cip was detected in 24/75 (32.0%) isolates. Using the ciprofloxacin MIC interpretive criteria for Salmonella in the Clinical and Laboratory Standards Institute 2013 guidelines, 51/75 (68.0%) isolates were found to be sensitive, 22/75 (29.3%) were intermediate, and 2/75 (2.7%) were resistant to ciprofloxacin. The 24 isolates that were intermediate or resistant to ciprofloxacin were the same isolates categorized as having RS-Cip. Among the 23 tested isolates with RS-Cip, the qnrS gene was detected in 17/23 (73.9%) and single gyrA mutations were detected in 6/23 (26.1%) (Asp87Tyr [n = 3], Asp87Asn [n = 2], and Ser83Phe [n = 1]). A parC (Thr57Ser) mutation was detected in 13/23 (56.5%) isolates, coexisting with either a qnrS gene or a gyrA mutation. The high incidence of the qnrS gene among isolates with RS-Cip needs to be monitored because qnr genes can spread via plasmids and aid in the emergence of increased resistance levels.
    Matched MeSH terms: Salmonella Infections/microbiology*
  8. Pathogenicity and phenotypic analysis of sopB, sopD and pipD virulence factors in Salmonella enterica serovar typhimurium and Salmonella enterica serovar Agona
    Khoo CH, Sim JH, Salleh NA, Cheah YK
    Antonie Van Leeuwenhoek, 2015 Jan;107(1):23-37.
    PMID: 25312847 DOI: 10.1007/s10482-014-0300-7
    Salmonella is an important food-borne pathogen causing disease in humans and animals worldwide. Salmonellosis may be caused by any one of over 2,500 serovars of Salmonella. Nonetheless, Salmonella enterica serovar Typhimurium and Salmonella enterica serovar Agona are the second most prevalent serovars isolated from humans and livestock products respectively. Limited knowledge is available about the virulence mechanisms responsible for diarrheal disease caused by them. To investigate the contribution of sopB, sopD and pipD as virulence factors in intracellular infections and the uniqueness of these bacteria becoming far more prevalent than other serovars, the infection model of Caenorhabditis elegans and phenotypic microarray were used to characterize their mutants. The strains containing the mutation in sopB, sopD and pipD genes were constructed by using latest site-specific group II intron mutagenesis approach to reveal the pathogenicity of the virulence factors. Overall, we observed that the mutations in sopB, sopD and pipD genes of both serovars did not exhibit significant decrease in virulence towards the nematode. This may indicate that these virulence effectors may not be universal virulence factors involved in conserved innate immunity. There are significant phenotypic differences amongst strains carrying sopB, sopD and pipD gene mutations via the analysis of biochemical profiles of the bacteria. Interestingly, mutant strains displayed different susceptibility to chemical stressors from several distinct pharmacological and structural classes when compared to its isogenic parental strains. These metabolic and chemosensitivity assays also revealed multiple roles of Salmonella virulence factors in nutrient metabolism and antibiotic resistance.
    Matched MeSH terms: Salmonella Infections/microbiology
  9. Extra-intestinal non-typhoidal Salmonella infections in children
    Lee WS, Puthucheary SD, Parasakthi N
    Ann Trop Paediatr, 2000 Jun;20(2):125-9.
    PMID: 10945063
    Extra-intestinal non-typhoidal Salmonella (NTS) infections are uncommon in developed countries but common in developing ones. The risk factors, clinical features and outcome of children admitted to the Department of Paediatrics, University of Malaya Medical Center, Kuala Lumpur from 1978 to 1998 with extra-intestinal NTS infections were reviewed. All positive cultures of NTS, blood, cerebrospinal fluid, urine, synovial, pericardial and other body secretions (except stools), were included. Of the 98 cases reviewed, 56 were boys and 42 girls. The mean age was 2.1 years (range: newborn to 14 years). Twenty-seven children were severely immunocompromised and 21 had underlying chronic medical disorders. Bacteraemia was the most commonly detected type of infection and meningitis the commonest focal infection. The overall mortality rate was 15%. An immunocompromised state or underlying chronic medical disorder was associated with increased mortality. The three serotypes most commonly isolated were S. enteritidis, S. paratyphi B and S. typhimurium. Most isolates were sensitive to antibiotics commonly used in salmonellosis.
    Matched MeSH terms: Salmonella Infections/microbiology*
  10. Non-typhoid Salmonella gastroenteritis
    Lee WS, Puthucheary SD, Boey CC
    J Paediatr Child Health, 1998 Aug;34(4):387-90.
    PMID: 9727185
    OBJECTIVE: To study the clinical features of non-typhoid Salmonella gastroenteritis and the incidence, risk factors and outcome of invasive complications in urban Malaysian children. To describe the serotypes of Salmonella species isolated and the pattern of antibiotic susceptibility.

    METHODOLOGY: Retrospective review of a group of 131 children with non-typhoid Salmonella gastroenteritis seen at the University Hospital, Kuala Lumpur, Malaysia from January 1994 to December 1996.

    RESULTS: Sixty-seven percent were infants below one year of age. Fever and vomiting were seen in nearly half of children. Seven children (5.3%) had invasive complications: 5 bacteraemia and 2 meningitis. Age below 6 months, fever > 38.0 degrees C, and dehydration on admission were significantly associated with invasive complications. The commonest serotypes isolated were S. enteritidis, S. paratyphi B, and S. bovis-morbificans. A total of 94-100% of isolates were susceptible to commonly prescribed antibiotics.

    CONCLUSIONS: Children with Salmonella gastroenteritis below 6 months of age who are febrile and dehydrated should be treated empirically with antibiotics until the result of blood culture is available.

    Matched MeSH terms: Salmonella Infections/microbiology
  11. Fulltext Reduced fluoroquinolone susceptibility in Salmonella enterica isolates from travelers, Finland
    Lindgren MM, Kotilainen P, Huovinen P, Hurme S, Lukinmaa S, Webber MA, et al.
    Emerg Infect Dis, 2009 May;15(5):809-12.
    PMID: 19402977 DOI: 10.3201/eid1505.080849
    We tested the fluoroquinolone susceptibility of 499 Salmonella enterica isolates collected from travelers returning to Finland during 2003-2007. Among isolates from travelers to Thailand and Malaysia, reduced fluoroquinolone susceptibility decreased from 65% to 22% (p = 0.002). All isolates showing nonclassical quinolone resistance were from travelers to these 2 countries.
    Matched MeSH terms: Salmonella Infections/microbiology
  12. Characterization of Salmonella serovars by PCR-single-strand conformation polymorphism analysis
    Nair S, Lin TK, Pang T, Altwegg M
    J Clin Microbiol, 2002 Jul;40(7):2346-51.
    PMID: 12089246
    PCR-restriction fragment length polymorphism (PCR-RFLP) and PCR-single-strand conformation polymorphism (PCR-SSCP) analyses were carried out on the 1.6-kb groEL gene from 41 strains of 10 different Salmonella serovars. Three HaeIII RFLP profiles were recognized, but no discrimination between the serovars could be achieved by this technique. However, PCR-SSCP analysis of the groEL genes of various Salmonella serovars produced 14 SSCP profiles, indicating the potential of this technique to differentiate different Salmonella serovars (interserovar differentiation). Moreover, PCR-SSCP could differentiate strains within a subset of serovars (intraserovar discrimination), as three SSCP profiles were produced for the 11 Salmonella enterica serovar Enteritidis strains, and two SSCP profiles were generated for the 7 S. enterica serovar Infantis and five S. enterica serovar Newport strains. PCR-SSCP has the potential to complement classical typing methods such as serotyping and phage typing for the typing of Salmonella serovars due to its rapidity, simplicity, and typeability.
    Matched MeSH terms: Salmonella Infections/microbiology
  13. Molecular characterization showed limited genetic diversity among Salmonella Enteritidis isolated from humans and animals in Malaysia
    Ngoi ST, Thong KL
    Diagn Microbiol Infect Dis, 2013 Dec;77(4):304-11.
    PMID: 24139970 DOI: 10.1016/j.diagmicrobio.2013.09.004
    Salmonella enterica serovar Enteritidis (S. Enteritidis) is the most common causative agent of non-typhoidal salmonellosis in Malaysia. We aimed to characterize S. Enteritidis isolated from humans and animals by analyzing their antimicrobial resistance profiles and genotypes. A total of 111 strains were characterized using multiple-locus variable-number tandem repeat analysis, pulsed-field gel electrophoresis, and antimicrobial susceptibility testing. Both typing methods revealed that genetically similar S. Enteritidis strains had persisted among human and animal populations within the period of study (2003-2008). Only 39% of the strains were multi-drug resistant (i.e., resistant to 3 or more classes of antimicrobial agents), with a majority (73%) of these in low-risk phase (multiple antibiotic resistant index <0.20). Limited genetic diversity among clinical and zoonotic S. Enteritidis suggested that animals are possible sources of human salmonellosis. The degree of multi-drug resistance among the strains was generally low during the study period.
    Matched MeSH terms: Salmonella Infections/microbiology*
  14. Fulltext Overview of Molecular Typing Tools for The Characterization of Salmonella enterica in Malaysia
    Ngoi ST, Teh CS, Chai LC, Thong KL
    Biomed Environ Sci, 2015 Oct;28(10):751-64.
    PMID: 26582097 DOI: 10.3967/bes2015.105
    Matched MeSH terms: Salmonella Infections/microbiology
  15. Molecular characterization of Salmonella enterica serovar Typhimurium isolated from human, food, and animal sources in Malaysia
    Ngoi ST, Lindstedt BA, Watanabe H, Thong KL
    Jpn J Infect Dis, 2013;66(3):180-8.
    PMID: 23698477
    Salmonella Typhimurium is an important nontyphoidal Salmonella serovar associated with foodborne diseases in many parts of the world. This organism is the major causative agent of nontyphoidal salmonellosis in Malaysia. We aimed to investigate the genetic profiles of the strains isolated from clinical, zoonotic, and dietary sources in Malaysia using multilocus variable number tandem repeat analysis (MLVA) and pulsed-field gel electrophoresis (PFGE). By focusing on the 5 common variable number tandem repeat (VNTR) loci, we found that PFGE (D = 0.99) was more discriminative than MLVA (D = 0.76). The low MLVA score might be because of a lack of VNTR loci STTR6 (81.0%) and STTR10pl (76.2%). Both subtyping methods suggested that our S. Typhimurium strains were largely endemic with limited genetic variation. Furthermore, we observed that biphasic S. Typhimurium strains were dominant (99%) and multidrug resistance was prevalent (50%) within our sample pool. The most frequently observed phenotypes were resistance to compound sulfonamides (49%), tetracycline (51%), and streptomycin (52%). In this study, we documented the genetic relationship, antimicrobial resistance characteristics, and flagellar-phase dominance among S. Typhimurium strains found in Malaysia.
    Matched MeSH terms: Salmonella Infections/microbiology*
  16. Fulltext Non-protein coding RNA genes as the novel diagnostic markers for the discrimination of Salmonella species using PCR
    Nithya R, Ahmed SA, Hoe CH, Gopinath SC, Citartan M, Chinni SV, et al.
    PLoS One, 2015;10(3):e0118668.
    PMID: 25774907 DOI: 10.1371/journal.pone.0118668
    Salmonellosis, a communicable disease caused by members of the Salmonella species, transmitted to humans through contaminated food or water. It is of paramount importance, to generate accurate detection methods for discriminating the various Salmonella species that cause severe infection in humans, including S. Typhi and S. Paratyphi A. Here, we formulated a strategy of detection and differentiation of salmonellosis by a multiplex polymerase chain reaction assay using S. Typhi non-protein coding RNA (sRNA) genes. With the designed sequences that specifically detect sRNA genes from S. Typhi and S. Paratyphi A, a detection limit of up to 10 pg was achieved. Moreover, in a stool-seeding experiment with S. Typhi and S. Paratyphi A, we have attained a respective detection limit of 15 and 1.5 CFU/mL. The designed strategy using sRNA genes shown here is comparatively sensitive and specific, suitable for clinical diagnosis and disease surveillance, and sRNAs represent an excellent molecular target for infectious disease.
    Matched MeSH terms: Salmonella Infections/microbiology*
  17. The great masquerade: Empyema thoracis as an unusual presentation of primary lung malignancy
    Nyanti LE, Kho SS, Tie ST
    Med J Malaysia, 2019 02;74(1):79-81.
    PMID: 30846667
    Primary lung malignancy presenting as empyema is rare, with a reported incidence of 0.3%. We report a case of a 60- year-old man presenting with unilateral pleural effusion; diagnostic thoracocentesis confirmed Salmonella empyema. Post-drainage, chest radiograph showed persisting right hemithorax opacity; subsequent computed tomography revealed a right lung mass with right upper lobe bronchus obliteration. Percutaneous biopsy confirmed advanced stage lung adenocarcinoma. We discuss the mechanism of post-obstructive pneumonia in lung cancerassociated empyema and the utility of bedside ultrasound in diagnosis of lung masses. Clinicians are alerted to the possibility of lung malignancy in elderly patients presenting with empyema.
    Matched MeSH terms: Salmonella Infections/microbiology
  18. Fulltext Dissemination of Salmonella enterica sequence types among ASEAN economic community countries
    Patchanee P, Boonkhot P, Kittiwan N, Tadee P, Chotinun S
    Southeast Asian J. Trop. Med. Public Health, 2015 Jul;46(4):707-19.
    PMID: 26867391
    Food-borne illness caused by Salmonella enterica remains a public health problem and results in economic loss worldwide. With the up-coming establish- ment of the ASEAN Economic Community (AEC) allowing unrestricted move- ment of labor and goods, there is a higher risk of pathogen transmission among the AEC countries. This study characterized and investigated the spatial and temporal associations of S. enterica strains isolated in AEC countries during 1940- 2012 compared with those isolated in northern-Thailand during 2011-2013. Of the 173 S. enterica strains examined, 68 sequence types (STs) and 32 clonal complexes (CCs) were identified by multi loci sequence typing. Twenty-one strains belonged to four sequence types new to AEC countries, and they constituted only two CCs. A number of strains originated from various countries with multiple hosts, were highlighted. There was evidence of strains circulating in the AEC region well over a decade. Such information will be important in formulating biosecurity measures, as well as in educating regarding the risk of disease transmission in AEC.
    Matched MeSH terms: Salmonella Infections/microbiology*
  19. Salmonellosis in persons infected with human immunodeficiency virus: a report of seven cases from Malaysia
    Puthucheary SD, Ng KP, Hafeez A, Raja NS, Hassan HH
    Southeast Asian J. Trop. Med. Public Health, 2004 Jun;35(2):361-5.
    PMID: 15691137
    Persons infected with human immunodeficiency virus (HIV) have an increased risk of salmonellosis when compared to the general population. We describe seven such patients with Salmonella bacteremia, of whom two had recurrent salmonellosis. In the latter two cases the infection was unusually severe, characterized by widespread infection, bacteremia and relapse, despite standard antimicrobial therapy. HIV-infected individuals will benefit from education on the source of Salmonella, mode of acquisition and prevention through safe food handling and food preparation practices. Because of the difficulty of eradicating Salmonella infection in patients with acquired immunodeficiency syndrome, long-term suppressive treatment with antimicrobials is warranted.
    Matched MeSH terms: Salmonella Infections/microbiology
  20. Fulltext Characteristics of childhood diarrhea associated with enterotoxigenic Escherichia coli in Malaysia
    Samuel S, Vadivelu J, Parasakthi N
    Southeast Asian J. Trop. Med. Public Health, 1997 Mar;28(1):114-9.
    PMID: 9322293
    Amongst 107 diarrheal cases studied a bacterial agent was isolated from 71 (66%) cases of which 60 (85%) were due to a single agent and the remaining 11 (15%) were of mixed infections. Enterotoxigenic Escherichia coli (ETEC) was isolated from 65 cases. Other pathogens isolated included Salmonella spp, Shigella spp and rotavirus. There was a higher isolation rate of ETEC from females and rotavirus from males. The infection rate was found to higher for the 0-2 year age group as compared to the 3-5 year age group. Amongst the ETEC isolated the STa 2 toxotype was the predominant type.
    Matched MeSH terms: Salmonella Infections/microbiology
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