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Fulltext Intraperitoneal Antibiotic Utilization among Continuous Ambulatory Peritoneal Dialysis (CAPD) Patients with Peritonitis at a Tertiary Hospital Setting in Malaysia

Ahmad M, Zin CS, Ab Rahman AF

J Pharm Bioallied Sci, 2020 Nov;12(Suppl 2):S737-S742.
PMID: 33828370 DOI: 10.4103/jpbs.JPBS_298_19

Introduction: Patients receiving continuous ambulatory peritoneal dialysis (CAPD) are commonly associated with peritonitis. However, little is known about the utilization of antibiotics for the treatment of peritonitis in these patients.
Objectives: This study aimed to evaluate the patterns of intraperitoneal (IP) antibiotic utilization for the treatment of peritonitis in CAPD patients.
Materials and Methods: This is a retrospective study conducted at a tertiary hospital setting in Malaysia. Medical records of CAPD patients who were diagnosed with peritonitis and registered with National Kidney Registry from 2013 to 2018 were reviewed. Types of antibiotics used and its dose and duration were recorded and reported using the anatomical therapeutic chemical/defined daily dose (ATC/DDD) system.
Results: A total of 105 peritonitis episodes were recorded from 72 patients. The most common first-line empirical antibiotic combinations used were ceftazidime/cefazolin (40%, n = 42), followed by cefepime/cefazolin (30.5%, n = 32) and ceftazidime/cloxacillin (25.7%, n = 27). The definitive therapy for culture-proven CAPD-related peritonitis (CAPD-P) showed that vancomycin was the most frequently prescribed antibiotic (31.7%, n = 26/82), followed by amikacin (14.6%, n = 12/82), meropenem (11%, n = 9/82) and ampicillin (11%, n = 9/82). Ciprofloxacin was among the least prescribed definitive antibiotics for CAPD-P (2.4%, n = 2/82) but the DDD/100 patient-days estimates showed that it had the highest therapeutic intensity.
Conclusion: There are various IP antibiotics used for CAPD-P and the most common empirical therapy was the combination of ceftazidime and cefazolin while vancomycin is predominantly used for definitive therapy. Future studies to evaluate the clinical outcomes of the antibiotic use should be conducted to have a better insight on the efficacy of the peritonitis treatment.

Matched MeSH terms: Vancomycin
Fulltext Genetic variability of vancomycin-resistant Enterococcus faecium and Enterococcus faecalis isolates from humans, chickens, and pigs in Malaysia

Getachew Y, Hassan L, Zakaria Z, Abdul Aziz S

Appl Environ Microbiol, 2013 Aug;79(15):4528-33.
PMID: 23666337 DOI: 10.1128/AEM.00650-13

Vancomycin-resistant enterococci (VRE) have been reported to be present in humans, chickens, and pigs in Malaysia. In the present study, representative samples of VRE isolated from these populations were examined for similarities and differences by using the multilocus sequence typing (MLST) method. Housekeeping genes of Enterococcus faecium (n = 14) and Enterococcus faecalis (n = 11) isolates were sequenced and analyzed using the MLST databases eBURST and goeBURST. We found five sequence types (STs) of E. faecium and six STs of E. faecalis existing in Malaysia. Enterococcus faecium isolates belonging to ST203, ST17, ST55, ST79, and ST29 were identified, and E. faecium ST203 was the most common among humans. The MLST profiles of E. faecium from humans in this study were similar to the globally reported nosocomial-related strain lineage belonging to clonal complex 17 (CC17). Isolates from chickens and pigs have few similarities to those from humans, except for one isolate from a chicken, which was identified as ST203. E. faecalis isolates were more diverse and were identified as ST4, ST6, ST87, ST108, ST274, and ST244, which were grouped as specific to the three hosts. E. faecalis, belonging to the high-risk CC2 and CC87, were detected among isolates from humans. In conclusion, even though one isolate from a chicken was found clonal to that of humans, the MLST analysis of E. faecium and E. faecalis supports the findings of others who suggest VRE to be predominantly host specific and that clinically important strains are found mainly among humans. The infrequent detection of a human VRE clone in a chicken may in fact suggest a reverse transmission of VRE from humans to animals.

Matched MeSH terms: Vancomycin Resistance*
Fulltext Contact lens related Elizabethkingia meningoseptica keratitis-a first Southeast ASEAN case report & literature review

Ang, Wen-Jeat, Embong Zunaina, Raja Omar Raja Norliza, Abdul Jalil Fadzillah

Journal of Biomedical and Clinical Sciences, 2017;2(1):1-4.
MyJurnal

We describe the first clinical case of contact lens related corneal ulcer caused by Elizabethkingia meningosepticaregistered in Southeast Asia. A 20-year-old female student who wasa regular soft contact lens wearer, presented with pain, photophobia and blurring of vision of the right eye for 3 days. On slit lamp examination, there was a small paracentral anterior stromal infiltrate with an overlying epithelial defect. Microbiological cultures from corneal scrapings, contact lens and its casing were positive for E.meningoseptica. Due to high likelihood of contact lens contamination causing keratitis, topical fortified gentamicin0.9% and ceftazidime 5% were administered empirically. Topical vancomycin 5% was later added tailoring to the culture and sensitivity of the organism. After 8 weeks of treatment, the keratitis subsided and corneal epithelial defect completely healed with residual corneal opacity. Even though uncommon, contact lens related E.meningosepticakeratitis can occur in healthy immunocompetent individuals with no ocular comorbidities.

Matched MeSH terms: Vancomycin
Fulltext A Review on Antistaphylococcal Secondary Metabolites from Basidiomycetes

Vallavan V, Krishnasamy G, Zin NM, Abdul Latif M

Molecules, 2020 Dec 11;25(24).
PMID: 33322256 DOI: 10.3390/molecules25245848

Fungi are a rich source of secondary metabolites with several pharmacological activities such as antifungal, antioxidant, antibacterial and anticancer to name a few. Due to the large number of diverse structured chemical compounds they produce, fungi from the phyla Ascomycota, Basidiomycota and Muccoromycota have been intensively studied for isolation of bioactive compounds. Basidiomycetes-derived secondary metabolites are known as a promising source of antibacterial compounds with activity against Gram-positive bacteria. The continued emergence of antimicrobial resistance (AMR) poses a major challenge to patient health as it leads to higher morbidity and mortality, higher hospital-stay duration and substantial economic burden in global healthcare sector. One of the key culprits for AMR crisis is Staphylococcus aureus causing community-acquired infections as the pathogen develops resistance towards multiple antibiotics. The recent emergence of community strains of S. aureus harbouring methicillin-resistant (MRSA), vancomycin-intermediate (VISA) and vancomycin-resistant (VRSA) genes associated with increased virulence is challenging. Despite the few significant developments in antibiotic research, successful MRSA therapeutic options are still needed to reduce the use of scanty and expensive second-line treatments. This paper provides an overview of findings from various studies on antibacterial secondary metabolites from basidiomycetes, with a special focus on antistaphylococcal activity.

Matched MeSH terms: Vancomycin
The relationship between trough concentration of vancomycin and effect on methicillin-resistant Staphylococcus aureus in critically ill patients

Cheong JY, Makmor-Bakry M, Lau CL, Abdul Rahman R

S. Afr. Med. J., 2012 Jul;102(7):616-9.
PMID: 22748440

The incidence of methicillin-resistant Staphylococcus aureus (MRSA) infections in intensive care units in Malaysia is significant. Invasive MRSA infections are commonly treated with vancomycin. In clinical practice, the serum vancomycin trough concentration is used as a surrogate marker of vancomycin efficacy. A low concentration of vancomycin may result in less effective therapy and increase the risk of bacterial resistance. We evaluated the relationship between the resolution of MRSA infections and trough concentrations of vancomycin.

Matched MeSH terms: Vancomycin/administration & dosage*; Vancomycin/pharmacology
Cefepime monotherapy for treatment of febrile neutropenia in children

Ariffin H, Ai CL, Lee CL, Abdullah WA

J Paediatr Child Health, 2006 Dec;42(12):781-4.
PMID: 17096713

Empirical therapy for children with febrile neutropenia has traditionally consisted of combination antibiotics, usually a beta-lactam and an aminoglycoside. However, recent trends and international guidelines have now made monotherapy a feasible option in the management of this group of patients. We prospectively evaluated the efficacy and safety of cefepime monotherapy in our population of paediatric cancer patients with febrile neutropenia.

Matched MeSH terms: Vancomycin/therapeutic use
Pyomyositis revisited

Kong NC, Asmah J, Lim VK, Ong PH, Adam PA

Ann Acad Med Singap, 1996 Jul;25(4):609-11.
PMID: 8893941

Pyomyositis, purportedly a common tropical infection affecting mainly healthy adults and children, appears to be most uncommon in this region. We report a case of pyomyositis caused by a Methicillin-resistant Staphylococcus aureus (MRSA) in a previously healthy army officer. This case serves to illustrate the difficulty in recognising this disease entity, which is why many cases may have been missed. With the increasing incidence of MRSA nosocomial infections, the emergence of MRSA in a hitherto community-acquired infection poses a major concern especially since intravenous drug abuse and acquired immune deficiency syndrome (AIDS) are on the rise in our country. We hope to inculcate greater awareness of this infection.

Matched MeSH terms: Vancomycin/therapeutic use
Fulltext Overcoming antibiotic resistance in the hospital: a never ending battle

Ariza Adnan

Medical Health Reviews, 2008;2008(1):29-44.
MyJurnal

The issue of antibiotic resistance has been around ever since the first antibiotic penicillin was introduced to the world. It continues to rise, becoming a major problem across the globe and Malaysia is no exception. Hospital is a critical component of the antibiotic resistance problem worldwide. The problems of antibiotic resistance are typically magnified in a hospital setting due to the common variables in the hospital environment that favour its development. These include a combination of highly susceptible patients, intensive and prolonged antibiotic use, and crossinfection resulting in nosocomial infections with highly resistant bacterial pathogens such as multi-resistant gram-negative rods, vancomycin resistant enterococci (VRE) and methicillinresistant Staphylococcus aureus (MRSA) as well as resistant fungal infections. Transmission of highly resistant bacteria from patient to patient within the hospital environment amplifies the problem of antibiotic resistance and may result in the infection of patients who are not receiving antibiotics. Transmission of antibiotic-resistant strains from hospital personnel to patients or vice versa may also occur. What are the available strategies and what works best in managing antibiotic resistance in the hospital? This review will highlight the seriousness of the resistance problem and identify actions that address it especially in the context of improving the problem in Malaysian hospitals.

Matched MeSH terms: Vancomycin-Resistant Enterococci
Fulltext Genotypically different clones of Staphylococcus aureus are diverse in the antimicrobial susceptibility patterns and biofilm formations

Atshan SS, Nor Shamsudin M, Lung LT, Sekawi Z, Pei Pei C, Karunanidhi A, et al.

Biomed Res Int, 2013;2013:515712.
PMID: 24455699 DOI: 10.1155/2013/515712

This study evaluated whether genotypically different clinical isolates of S. aureus have similar susceptibilities to individual antibiotics. It further aims to check the impact of biofilm on the in vitro activity of vancomycin, daptomycin, linezolid, and tigecycline against S. aureus clones. The study used a total of 60 different clinical MSSA and MRSA isolates. Susceptibilities were performed in planktonic cultures by macrobroth dilution and epsilon-test (E test) system. Biofilm production was determined using an adherent plate assay. The efficacy of antimicrobial activities against biofilms formation was checked using confocal laser scanning microscopy (CLSM). The study found that similar and different spa, MLST, and SCCmec types displayed high variation in their susceptibilities to antibiotics with tigecycline and daptomycin being the most effective. The biofilms were found resistant to high concentrations of most antibiotics tested with daptomycin being the most effective drug used in adhesive biofilms. A considerable difference exists among similar and various clone types against antibiotics tested. This variation could have contributed to the degree of virulence even within the same clonal genotype and enhanced heterogeneity in the infection potential. Thus, the development of a rapid and precise identification profile for each clone in human infections is important.

Matched MeSH terms: Vancomycin/pharmacology
Community-acquired vancomycin-resistant Enterococcus faecium: a case report from Malaysia

Raja NS, Karunakaran R, Ngeow YF, Awang R

J Med Microbiol, 2005 Sep;54(Pt 9):901-903.
PMID: 16091445 DOI: 10.1099/jmm.0.46169-0

Vancomycin-resistant enterococci (VRE) are formidable organisms renowned for their ability to cause infections with limited treatment options and their potential for transferring resistance genes to other Gram-positive bacteria. Usually associated with nosocomial infections, VRE are rarely reported as a cause of community-acquired infection. Presented here is a case of community-acquired infection due to vancomycin-resistant Enterococcus faecium. The patient had been applying herbal leaves topically to his cheek to treat a buccal space abscess, resulting in a burn of the overlying skin. From pus aspirated via the skin a pure culture of E. faecium was grown that was resistant to vancomycin with a MIC of >256 microg ml-1 by the E test and resistant to teicoplanin by disc diffusion, consistent with the VanA phenotype. The organism was suspected of contaminating the leaf and infecting the patient via the burnt skin. This case highlights the need for further studies on the community prevalence of VRE among humans and animals to define unrecognized silent reservoirs for VRE, which may pose a threat to public health.

Matched MeSH terms: Vancomycin Resistance*
Fulltext Characterization and risk factors of vancomycin-resistant Enterococci (VRE) among animal-affiliated workers in Malaysia

Getachew Y, Hassan L, Zakaria Z, Zaid CZ, Yardi A, Shukor RA, et al.

J Appl Microbiol, 2012 Nov;113(5):1184-95.
PMID: 22906187 DOI: 10.1111/j.1365-2672.2012.05406.x

This study determined the risk factors and characteristics of vancomycin-resistant Enterococci (VRE) among individuals working with animals in Malaysia.

Matched MeSH terms: Vancomycin Resistance*
Fulltext Hospital-acquired vancomycin-resistant enterococci: now appearing in Kuala Lumpur Hospital

Zubaidah AW, Ariza A, Azmi S

Med J Malaysia, 2006 Oct;61(4):487-9.
PMID: 17243529 MyJurnal

Hospital-acquired vancomycin-resistant enterococci (VRE) were first reported in the late 1980s and have since been an increasing problem worldwide. Kuala Lumpur Hospital thus far, to the best of our knowledge has been spared from this pathogen. We describe the first confirmed case of Enterococcus faecium exhibiting the van A phenotype in our hospital, in a patient with chronic renal failure who was successfully treated with linezolid. The microbiology laboratory plays an important role in the identification and detection of VRE.

Matched MeSH terms: Vancomycin Resistance/genetics*
Fulltext Synergistic effects of Persicaria odorata (daun kesom) leaf extracts with standard antibiotics on pathogenic bacteria

Ridzuan, P.M., Hairul Aini Hamzah, Anis Shah, Norazian Mohd Hassan, Baharudin Roesnita

International Medical Journal Malaysia, 2017;16(2):27-32.
MyJurnal

Antibacterial activity of different types of P. odorata leaf extracts was evaluated in combination with
standard antibiotics. Persicaria. odorata leaves were extracted with n-hexane (n-hex), dichloromethane
(DCM) and methanol (MeOH). Each extract was applied on vancomycin (30µg), erythromycin (15µg) and
gentamicin (10µg) discs, respectively. Disk diffusion method was used to evaluate the synergistic activity of
each combination on Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pyogenes,
Streptococcus pneumoniae, Pseudomonas aeruginosa, Salmonella typhi, and Escherichia coli. Minimum
inhibitory concentration (MIC) and gas chromatography mass spectrometry (GCMS) analysis was performed on
the active extract. Synergistic effects seen were mainly from the n-hex+antibiotics combinations, mainly on
the Gram-positive bacteria (7 additive, 5 antagonistic), with MIC range from 50 µg/ml to 100 µg/ml, as well
as Gram-negative bacteria (2 additive, 2 indifferent, 5 antagonistic). In particular, synergism showed by the
combination of n-hex+van were all additive against the susceptible bacteria. DCM extract combination
showed synergistic effects on three Gram-positive species (S. aureus, S. epidermidis, S. pyogenes).
Meanwhile, MeOH+antibiotics combination showed significant additive synergistic effects (p

Matched MeSH terms: Vancomycin
Synergy of flavone with vancomycin and oxacillin against vancomycin-intermediate Staphyloccus aureus

Bakar NS, Zin NM, Basri DF

Pak J Pharm Sci, 2012 Jul;25(3):633-8.
PMID: 22713953

This study evaluated in vitro activity of 9 flavonoids in combination with vancomycin or oxacillin against vancomycin-intermediate Staphylococcus aureus (VISA) ATCC 700699 by employing the checkerboard method to obtain Minimal inhibitory concentration (MIC) and fractional inhibitory concentration (FIC) index. Six flavonoids namely hesperitin, rutin, naringenin, flavones, naringin and 3, 7-dihyroxyflavone which exhibited notable inhibitory activity (MIC values < 3200 μg/ml) were further evaluated for combination assay with antibiotics. The combinations of vancomycin+flavone and oxacillin+flavone were found synergistic with the FIC index value 0.094 and 0.126, respectively. Other combinations showed an additive interaction (FIC index = 1.063) but no antagonistic reaction (FIC index > 4) were observed. In time kill studies, oxacillin-flavone combination at synergistic concentration demonstrated bactericidal effect at 24 h period with concentration-dependent manner on the VISA strain. Following 1 h exposure, the combination also produced persistent effect on the bacteria growth for 2.9 hrs at 1x sub-MIC and more than 24 h at 5x of sub-MIC and there was a significant difference between both concentrations (p<0.05). Vancomycin-flavone combination, however, showed no concentration-dependent effect and lower PAE values (1.159 h and 2.322 h at 1x and 5x sub-MIC, respectively) on the VISA strain. In conclusion, flavone markedly intensifies the susceptibility of oxacillin against VISA and the combination can be implicated for further interaction studies at molecular level.

Matched MeSH terms: Vancomycin/pharmacology*
Fulltext Preliminary Screening of Antibacterial Activity Using Crude Extracts of Hibiscus rosa sinensis

Arullappan S, Zakaria Z, Basri DF

Trop Life Sci Res, 2009 Dec;20(2):109-18.
PMID: 24575183 MyJurnal

Hibiscus rosa sinensis, a member of the Malvaceae family, is widely cultivated in the tropics as an ornamental plant. It is often planted as a fence or hedge plant, and has several forms of flowers with varying colours. It is also used in traditional medicine to induce abortion, ease menstrual cramps, assist in childbirth and relieve headache, fever and inflammation. In this study, we evaluated the antibacterial activity of H. rosa sinesis extract using a disc diffusion method. Crude petroleum ether extract, ethyl acetate extract and methanol extract from the leaves, stems and flowers of the plant were prepared using a cold extraction technique. These extracts were tested at concentrations ranging from 4 mg/disc to 0.017 mg/disc against methicillin-resistant Staphylococcus aureus (MRSA), Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa and Klebsiella pneumonia. The petroleum ether extract from the leaves, stems and flowers and methanol extract from the leaves showed inhibition zones with diameters > 12 mm against MRSA. Overall, the petroleum ether extract from flowers at concentrations of 4 mg/disc and 2 mg/disc displayed the strongest inhibition zones of 18.6 ± 2.85 mm and 18.5 ± 0.29 mm, respectively, as compared to vancomycin (30 μg/ml), which did not differ significantly from the 18.0 ± 0.10 mm size of the vancomycin (30 μg/ml) inhibition zone (p < 0.05). In conclusion, H. rosa sinensis extract is a potential antibacterial agent for treating MRSA infection.

Matched MeSH terms: Vancomycin
Fulltext Population pharmacokinetics of vancomycin in premature Malaysian neonates: identification of predictors for dosing determination

Lo YL, van Hasselt JG, Heng SC, Lim CT, Lee TC, Charles BG

Antimicrob Agents Chemother, 2010 Jun;54(6):2626-32.
PMID: 20385872 DOI: 10.1128/AAC.01370-09

The present study determined the pharmacokinetic profile of vancomycin in premature Malaysian infants. A one-compartment infusion model with first-order elimination was fitted to serum vancomycin concentration data (n = 835 points) obtained retrospectively from the drug monitoring records of 116 premature newborn infants. Vancomycin concentrations were estimated by a fluorescence polarization immunoassay. Population and individual estimates of clearance and distribution volume and the factors which affected the variability observed for the values of these parameters were obtained using a population pharmacokinetic modeling approach. The predictive performance of the population model was evaluated by visual inspections of diagnostic plots and nonparametric bootstrapping with replacement. Dosing guidelines targeting a value of > or =400 for the area under the concentration-time curve over 24 h in the steady state divided by the MIC (AUC(24)/MIC ratio) were explored using Monte Carlo simulation. Body size (weight), postmenstrual age, and small-for-gestational-age status are important factors explaining the between-subject variability of vancomycin pharmacokinetic parameter values for premature neonates. The typical population parameter estimates of clearance and distribution volume for a 1-kg premature appropriate-for-gestational-age neonate with a postmenstrual age of 30 weeks were 0.0426 liters/h and 0.523 liters, respectively. There was a 20% reduction in clearance for small-for-gestational-age infants compared to the level for the appropriate-for-gestational-age control. Dosage regimens based on a priori target response values were formulated. In conclusion, the pharmacokinetic parameter values for vancomycin in premature Malaysian neonates were estimated. Improved dosage regimens based on a priori target response values were formulated by incorporating body size, postmenstrual age, and small-for-gestational-age status, using Monte Carlo simulations with the model-estimated pharmacokinetic parameter values.

Matched MeSH terms: Vancomycin/administration & dosage*; Vancomycin/blood; Vancomycin/pharmacokinetics*
Fulltext Characterization of vancomycin-resistant Enterococcus isolates from broilers in Selangor, Malaysia

Getachew YM, Hassan L, Zakaria Z, Saleha AA, Kamaruddin MI, Che Zalina MZ

Trop Biomed, 2009 Dec;26(3):280-8.
PMID: 20237442 MyJurnal

Vancomycin-resistant Enterococcus (VRE) is an emerging nosocomial pathogen in humans. The use of antibiotics in human therapy and in the production of food animals has been incriminated in the emergence of this organism. The present study describes the distribution of VRE species, the vancomycin-resistant genes detected, the vancomycin resistance pattern observed, and the genetic diversity of the isolates found in live broiler chickens in Malaysia. Overall 140 VRE were isolated with species comprising Enterococcus faecalis (48%), Enterococcus faecium (25.7%), Enterococcus gallinarum (12.1%), Enterococcus casseliflavus (1.4%) and other Enterococcus species (12.8%). Vancomycin resistance gene vanA and intrinsic genes vanC1 and vanC2/3 were detected in the study population. VanA was detected in 15 (63.9%) of E. faecium, 23 (22.4%) of E. faecalis and in 3 (17.6%) E. gallinarum isolates. E-test was conducted on randomly selected 41 of the isolates and the minimum inhibition concentration (MIC) of vancomycin for five (11.9%) of tested isolates is more than 256 μg/ml. Genotypic analysis using random amplified polymorphic DNA (RAPD) showed genetic diversity within the Enterococcus species.

Matched MeSH terms: Vancomycin/pharmacology; Vancomycin Resistance/genetics*
Fulltext Enterococcus faecalis Endophthalmitis: Clinical Settings, Antibiotic Susceptibility, and Management Outcomes

Chen KJ, Lai CC, Chen HC, Chong YJ, Sun MH, Chen YP, et al.

Microorganisms, 2021 Apr 24;9(5).
PMID: 33923356 DOI: 10.3390/microorganisms9050918

Enterococcus faecalis is known to cause severe acute endophthalmitis and often leads to poor visual outcomes in most ophthalmic infections. This retrospective study is to report the clinical settings, antimicrobial susceptibility patterns, and visual outcome of E. faecalis endophthalmitis at a tertiary referral institution in Taoyuan, Taiwan. E. faecalis endophthalmitis was diagnosed in 37 eyes of 37 patients. Post-cataract surgery was the most common cause (n = 27, 73%), followed by bleb-associated (n = 3, 8%), endogenous (n = 2, 5%), corneal ulcer-related (n = 2, 5%), post-vitrectomy (n = 1, 3%), post-pterygium excision (n = 1, 3%), and trauma (n = 1, 3%). Visual acuities upon presentation ranged from counting fingers to no light perception. Pars plana vitrectomy with intravitreal antibiotics were performed in 23 eyes (76%) as primary or secondary treatment. All isolates (37/37, 100%) were sensitive to vancomycin, penicillin, ampicillin, and teicoplanin. Six of 22 eyes (27%) were resistant to high-level gentamicin (minimum inhibitory concentration > 500 mg/L). Final visual acuities were better than 20/400 in 11 eyes (30%), 5/200 to hand motions in 4 eyes (11%), and light perception to no light perception in 22 eyes (59%). Three eyes were treated with evisceration. Compared with non-cataract subgroups, the post-cataract subgroup showed a significant difference of better visual prognosis (p = 0.016).

Matched MeSH terms: Vancomycin
Nanoparticle-laden contact lens for controlled release of vancomycin with enhanced antibiotic efficacy

Tong WY, Tan WN, Kamarul Azizi MA, Leong CR, El Azab IH, Lim JW, et al.

Chemosphere, 2023 Oct;338:139492.
PMID: 37451643 DOI: 10.1016/j.chemosphere.2023.139492

Vancomycin is the last resort antibiotic for the treatment of severe bacterial keratitis. Its clinical application is limited due to its hydrophilicity and high molecular weight. To overcome this, this study aims to develop nanoparticles-laden contact lens for controlled ocular delivery of vancomycin. Polyvinyl alcohol (PVA) was used as encapsulant material. The nanoparticles had a negative surface charge and an average size of 147.6 nm. A satisfactory encapsulation efficiency (61.24%) was obtained. The release profile was observed to be slow and sustained, with a release rate of 1.29 μL mg-1 h-1 for 48 h. Five out of 6 test bacteria were suppressed by vancomycin nanoparticles-laden contact lens. Vancomycin is generally ineffective against Gram-negative bacteria and unable to pass through the outer membrane barrier. In this study, vancomycin inhibited Proteus mirabilis and Pseudomonas aeruginosa. Nano-encapsulation enables vancomycin to penetrate the Gram-negative cell wall and further destroy the bacterial cells. On Hohenstein challenge test, all test bacteria exhibited significant reduction in growth when exposed to vancomycin nanoparticles-laden contact lens. This study created an effective and long-lasting vancomycin delivery system via silicone hydrogel contact lenses, by using PVA as encapsulant. The antibiotic efficacy and vancomycin release should be further studied using ocular in vivo models.

Matched MeSH terms: Vancomycin/pharmacology
Microbial analysis of Malaysian tempeh, and characterization of two bacteriocins produced by isolates of Enterococcus faecium

Moreno MR, Leisner JJ, Tee LK, Ley C, Radu S, Rusul G, et al.

J Appl Microbiol, 2002;92(1):147-57.
PMID: 11849339

Isolation of bacteriocinogenic lactic acid bacteria (LAB) from the Malaysian mould-fermented product tempeh and characterization of the produced bacteriocin(s).

Matched MeSH terms: Vancomycin Resistance/genetics

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