Displaying publications 1 - 20 of 95 in total

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  1. 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
  2. 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*
  3. Pyogenic Granuloma Formation Following Ahmed Valve Glaucoma Implant
    Chendran P, Seng Fai T, Wan Abdul Halim WH, Md Din N
    J Glaucoma, 2019 10;28(10):e162-e164.
    PMID: 31368915 DOI: 10.1097/IJG.0000000000001334
    Ocular pyogenic granuloma is a benign tumor seen after ocular insult secondary to ocular surgeries, trauma or infection. Although benign, intervention is sometimes necessary. Previous authors have reported pyogenic granuloma formation following oculoplastic surgeries. We report a pyogenic granuloma after an Ahmed glaucoma valve implantation. A 65-year-old gentleman presented with right eye redness associated with pain and swelling ~2 months after Ahmed glaucoma valve implantation. Examination found a sessile growth on the tube extruding puss with signs of endophthalmitis. The glaucoma drainage device was explanted and culture results grew Staphylococcus aureus. This article discusses the formation of pyogenic granuloma on a glaucoma drainage device and its management.
    Matched MeSH terms: Vancomycin/therapeutic use
  4. Antibacterial action of a heat-stable form of L-amino acid oxidase isolated from king cobra (Ophiophagus hannah) venom
    Lee ML, Tan NH, Fung SY, Sekaran SD
    Comp Biochem Physiol C Toxicol Pharmacol, 2011 Mar;153(2):237-42.
    PMID: 21059402 DOI: 10.1016/j.cbpc.2010.11.001
    The major l-amino acid oxidase (LAAO, EC 1.4.3.2) of king cobra (Ophiophagus hannah) venom is known to be an unusual form of snake venom LAAO as it possesses unique structural features and unusual thermal stability. The antibacterial effects of king cobra venom LAAO were tested against several strains of clinical isolates including Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Escherichia coli using broth microdilution assay. For comparison, the antibacterial effects of several antibiotics (cefotaxime, kanamycin, tetracycline, vancomycin and penicillin) were also examined using the same conditions. King cobra venom LAAO was very effective in inhibiting the two Gram-positive bacteria (S. aureus and S. epidermidis) tested, with minimum inhibitory concentration (MIC) of 0.78μg/mL (0.006μM) and 1.56μg/mL (0.012μM) against S. aureus and S. epidermidis, respectively. The MICs are comparable to the MICs of the antibiotics tested, on a weight basis. However, the LAAO was only moderately effective against three Gram-negative bacteria tested (P. aeruginosa, K. pneumoniae and E. coli), with MIC ranges from 25 to 50μg/mL (0.2-0.4μM). Catalase at the concentration of 1mg/mL abolished the antibacterial effect of LAAO, indicating that the antibacterial effect of the enzyme involves generation of hydrogen peroxide. Binding studies indicated that king cobra venom LAAO binds strongly to the Gram-positive S. aureus and S. epidermidis, but less strongly to the Gram-negative E. coli and P. aeruginosa, indicating that specific binding to bacteria is important for the potent antibacterial activity of the enzyme.
    Matched MeSH terms: Vancomycin/pharmacology
  5. Comparative genome analysis of multiple vancomycin-resistant Enterococcus faecium isolated from two fatal cases
    Lim SY, Yap KP, Teh CS, Jabar KA, Thong KL
    Infect Genet Evol, 2017 04;49:55-65.
    PMID: 28039075 DOI: 10.1016/j.meegid.2016.12.029
    Enterococcus faecium is both a commensal of the human intestinal tract and an opportunistic pathogen. The increasing incidence of enterococcal infections is mainly due to the ability of this organism to develop resistance to multiple antibiotics, including vancomycin. The aim of this study was to perform comparative genome analyses on four vancomycin-resistant Enterococcus faecium (VREfm) strains isolated from two fatal cases in a tertiary hospital in Malaysia. Two sequence types, ST80 and ST203, were identified which belong to the clinically important clonal complex (CC) 17. This is the first report on the emergence of ST80 strains in Malaysia. Three of the studied strains (VREr5, VREr6, VREr7) were each isolated from different body sites of a single patient (patient Y) and had different PFGE patterns. While VREr6 and VREr7 were phenotypically and genotypically similar, the initial isolate, VREr5, was found to be more similar to VRE2 isolated from another patient (patient X), in terms of the genome contents, sequence types and phylogenomic relationship. Both the clinical records and genome sequence data suggested that patient Y was infected by multiple strains from different clones and the strain that infected patient Y could have derived from the same clone from patient X. These multidrug resistant strains harbored a number of virulence genes such as the epa locus and pilus-associated genes which could enhance their persistence. Apart from that, a homolog of E. faecalis bee locus was identified in VREr5 which might be involved in biofilm formation. Overall, our comparative genomic analyses had provided insight into the genetic relatedness, as well as the virulence potential, of the four clinical strains.
    Matched MeSH terms: Vancomycin Resistance/genetics
  6. Fulltext Methicillin-resistant Staphylococcus aureus nosocomial infection trends in Hospital Universiti Sains Malaysia during 2002-2007
    Al-Talib HI, Yean CY, Al-Jashamy K, Hasan H
    Ann Saudi Med, 2010 Sep-Oct;30(5):358-63.
    PMID: 20697171 DOI: 10.4103/0256-4947.67077
    Methicillin-resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen that causes severe morbidity and mortality in many hospitals worldwide. The aim of the present study was to assess the burden of MRSA nosocomial infection, its association with factors of interest, and its antimicrobial susceptibility.
    Matched MeSH terms: Vancomycin/pharmacology
  7. A nanoplex PCR assay for the rapid detection of vancomycin and bifunctional aminoglycoside resistance genes in Enterococcus species
    Yean CY, Yin LS, Lalitha P, Ravichandran M
    BMC Microbiol, 2007 Dec 11;7:112.
    PMID: 18070365
    BACKGROUND: Enterococci have emerged as a significant cause of nosocomial infections in many parts of the world over the last decade. The most common enterococci strains present in clinical isolates are E. faecalis and E. faecium which have acquired resistant to either gentamicin or vancomycin. The conventional culture test takes 2-5 days to yield complete information of the organism and its antibiotic sensitivity pattern. Hence our present study was focused on developing a nanoplex PCR assay for the rapid detection of vancomycin and bifunctional aminoglycoside resistant enterococci (V-BiA-RE). This assay simultaneously detects 8 genes namely 16S rRNA of Enterococcus genus, ddl of E. faecalis and E. faecium, aacA-aphD that encodes high level gentamicin resistance (HLGR), multilevel vancomycin resistant genotypes such as vanA, vanB, vanC and vanD and one internal control gene.

    RESULTS: Unique and specific primer pairs were designed to amplify the 8 genes. The specificity of the primers was confirmed by DNA sequencing of the nanoplex PCR products and BLAST analysis. The sensitivity and specificity of V-BiA-RE nanoplex PCR assay was evaluated against the conventional culture method. The analytical sensitivity of the assay was found to be 1 ng at the DNA level while the analytical specificity was evaluated with 43 reference enterococci and non-enterococcal strains and was found to be 100%. The diagnostic accuracy was determined using 159 clinical specimens, which showed that 97% of the clinical isolates belonged to E. faecalis, of which 26% showed the HLGR genotype, but none were vancomycin resistant. The presence of an internal control in the V-BiA-RE nanoplex PCR assay helped us to rule out false negative cases.

    CONCLUSION: The nanoplex PCR assay is robust and can give results within 4 hours about the 8 genes that are essential for the identification of the most common Enterococcus spp. and their antibiotic sensitivity pattern. The PCR assay developed in this study can be used as an effective surveillance tool to study the prevalence of enterococci and their antibiotic resistance pattern in hospitals and farm animals.

    Matched MeSH terms: Vancomycin/pharmacology
  8. Fulltext Antimicrobial activity and the presence of virulence factors and bacteriocin structural genes in Enterococcus faecium CM33 isolated from ewe colostrum
    Nami Y, Haghshenas B, Haghshenas M, Yari Khosroushahi A
    Front Microbiol, 2015;6:782.
    PMID: 26284059 DOI: 10.3389/fmicb.2015.00782
    Screening of lactic acid bacteria (LAB) isolated from ewe colostrum led to the identification and isolation of Enterococcus faecium CM33 with interesting features like high survival rates under acidic or bile salts condition, high tolerance for the simulated gastrointestinal condition, and high adhesive potential to Caco-2 cells. According the inhibition of pathogen adhesion test results, this strain can reduce more than 50% adhesion capacity of Escherichia coli, Shigella flexneri, Klebsiella pneumoniae, Listeria monocytogenes, and Staphylococcus aureus to Caco-2 cells. Based on the antibiotic sensitivity test findings, E. faecium CM33 was susceptible to gentamycin, vancomycin, erythromycin, ampicillin, penicillin, tetracycline, and rifampicin, but resistant to chloramphenicol, clindamycin, and kanamycin. Upon assessment of the virulence determinants for E. faecium CM33, this strain was negative for all tested virulence genes. Furthermore, the genome of this strain was evaluated for the incidence of the known enterocin genes by specific PCR amplification and discovered the genes encoding enterocins A, 31, X, and Q. Based on this study findings, the strain E. faecium CM33 can be considered as a valuable nutraceutical and can be introduced as a new potential probiotic.
    Matched MeSH terms: Vancomycin
  9. Fulltext Improving the appropriateness of therapeutic drug monitoring sampling in Hospital Sultanah Nur Zahirah, Kuala Terengganu
    Lukman Nul Hakim Md Khairi, Farah Syakirah Ahmad, Aimi Shazana Muhammad Anuar, Nurul Ain Wan Omar, Nurul Najmi Muhammad, Nurulhayati Abd. Jamal, et al.
    Q Bulletin, 2020;1(29):28-35.
    MyJurnal
    Therapeutic drug monitoring (TDM) is a valuable clinical tool in optimisation of drug regimens. However, improper utilisation of TDM may lead to significant resource wastage and expose patients to avoidable trauma, toxicity, therapeutic failure and prolonged hospitalisation. This study aimed to reduce the percentage of inappropriate TDM sampling to our proposed standard of less than 20% within a four-month intervention period. A cross-sectional study was undertaken from January to December 2015 at the inpatient setting of Hospital Sultanah Nur Zahirah. Gentamicin and Vancomycin analytes were studied because these analytes accounted for 69.2% of total samples received in 2014. TDM Monitoring Form was used to collect sampling and dosage information to assess sampling appropriateness. A closed-ended self-administered questionnaire was distributed to a group of medical doctors to assess their knowledge on appropriate Gentamicin and Vancomycin TDM sampling method pre- and post-intervention. Prior to the intervention phase in October to December 2014, 79.4% of TDM were inappropriately sampled. The main contributing factors were inadequate knowledge among medical doctors, lack of sampling reminders for new TDM requests, and misunderstanding on sampling information for repeated TDM requests. 60-minute face-to-face educational sessions on TDM sampling method were conducted specifically for staff at the General Medical and Paediatric Departments, and two continuing medical education (CME) slots were held at the hospital level. Guidelines on TDM sampling was initiated and laminated copies were distributed to all wards. Implementation of TDM Alert System which consisted of digital reminders and physical stickers was also introduced. The interventions were able to reduce the inappropriate sampling percentage from 79.4% to 41.8% post-intervention, and to 19.1% in the recent monitoring phase of January until June 2019. Continuous close monitoring and sustainable implementation of the measures are vital as TDM sampling appropriateness may affect clinical interpretation of the results.
    Matched MeSH terms: Vancomycin
  10. 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
  11. Susceptibility pattern of Staphylococcus aureus isolated in Malaysian hospitals
    Rohani MY, Raudzah A, Lau MG, Zaidatul AA, Salbiah MN, Keah KC, et al.
    Int J Antimicrob Agents, 2000 Jan;13(3):209-13.
    PMID: 10724026
    Isolates of 390 Staphylococcus aureus were tested against 13 different antibiotics by a disc diffusion method as recommended by the National Committee for Clinical Laboratory Standards (NCCLS). Strains were isolated from blood (5.7%), cerebrospinal fluid (0.5%), respiratory tract (11.8%), pus and wound (73.3%), urine (1.8%), genital specimens (1.0%) and other specimens (4.3%). Only 4.6% of the isolates were fully susceptible to all the drugs tested. Resistance to penicillin was 94.1%, methicillin, 39.7%, chloramphenicol, 8.5%, ciprofloxacin, 29.2%, clindamycin, 2.1%, erythromycin, 45.9% gentamicin, 40.5%; rifampicin, 3.3% tetracycline, 47.2%, co-trimoxazole, 38.5%, mupirocin, 2.8%, fusidic acid, 3.6%. None of the isolates was resistant to vancomycin. The susceptibility of methicillin-resistant strains to erythromycin, gentamicin, tetracycline and ciprofloxacin was low, while clindamycin, fusidic acid, mupirocin, and rifampicin remained active.
    Matched MeSH terms: Vancomycin Resistance
  12. 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
  13. Fulltext Antibiotic resistance and plasmid profile of Escherichia coli isolated from ducks in Penang, Malaysia
    Adzitey F., Ali, G.R.R., Huda, N., Ting, S.L.
    International Food Research Journal, 2013;20(3):1473-1478.
    MyJurnal
    Fifty five (n=55) isolates of Escherichia coli isolated from ducks in Penang, Malaysia were examined for their susceptibility to eleven different antibiotics and assayed for the presence of plasmid DNAs. All the 55 Escherichia coli isolates were resistant (100%) to vancomycin. Higher resistance (= 60) occurred for tetracycline 51 (92.7%), ampicillin 40 (72.7%), streptomycin 37 (67.3%), and sulfamethoxazole-trimethophrim 37 (67.3%). No and low resistance was observed for nitrofurantoin (0%) and gentamicin (1.8%), respectively. The isolates also showed some intermediate resistances to all antibiotics examined except for vancomycin. The 55 Escherichia coli isolates exhibited 23 different antibiotic resistant patterns with MAR index ranging from 0.09-0.82. Majority of the Escherichia coli isolates exhibited resistant pattern of VA-C-OFX-SXT-TE-AMP-NA-KF and VA-S-C-OFX-SXT-TE-AMP-NA-KF with MAR index of 0.73 and 0.82, respectively. The smallest plasmid DNA size was 1.2 kb and the largest plasmid DNA size was 81.5 kb. 51 (93%) of the duck Escherichia coli isolates harbored plasmids. The was no direct correlation between plasmid DNA sizes and antibiotic resistant among the duck Escherichia coli isolates. Thus, the antibiotic resistant of the Escherichia coli isolates could mostly be mediated by chromosomes instead of plasmids. This study also suggests that the use of antibiotics in duck farming in Penang, Malaysia needs to be controlled to prevent the spread of multiple antibiotic resistant Escherichia coli isolates.
    Matched MeSH terms: Vancomycin
  14. Fulltext Incidence and antibiogram of Vibrio parahaemolyticus in processed and frozen bivalve mollusks in Kuala Terengganu, Malaysia
    Tang, J.Y.H., Wan-Rosli, W.F., Abdul-Razak, N.H., Yeo, C.C., Abu Bakar, C.A., Son, R.
    International Food Research Journal, 2014;21(4):1349-1353.
    MyJurnal
    This study aimed to investigate the prevalence and antibiogram of Vibrio parahaemolyticus in processed bivalve molluscs in Kuala Terengganu. A total of 80 seafood samples, namely mussels (n=20), carpet clams (n=20), cockles (n=20) and scallops (n=20), were subjected to PCR and conventional plating method for the detection of V. parahaemolyticus. V. parahaemolyticus was found in green mussels (55%), carpet clam (80%), cockles (40%) and scallops (55%). Fifty-five V. parahaemolyticus isolates were subjected to 9 types antibiotic sensitivity test using discs diffusion method. All isolates were susceptible to Tetracycline and Gentamycin. Isolates showed high resistance towards Vancomycin (52.73%), Penicillin (45.45%) and Amplicillin (32.73%). Resistance towards Amikacin, Ciprofloxacin and Norfloxacin were found to be 1.82%. It can be concluded that local bivalve molluscs were contaminated with V. parahaemolyticus and isolates showed resistance towards certain antibiotics. Therefore, consumption of raw or semi-cooked bivalve molluscs is not advisable.
    Matched MeSH terms: Vancomycin
  15. Fulltext Consumption of raw oysters: a risk factor for Vibrio parahaemolyticus infection
    New, C.Y., Kantilal, H.K., Tan, M.T.H., Nakaguchi, Y., Nishibuchi, M., Son, R.
    International Food Research Journal, 2014;21(6):2459-2472.
    MyJurnal
    Vibrio parahaemolyticus is recognized as a frequent causal agent of human gastroenteritis due to the consumption of raw, undercooked or mishandled seafood in many Asian countries. The number of V. parahaemolyticus cases reported is on the rise, and this becomes a concern to the Asian countries as seafood is favoured by Asians. This study aimed to detect and quantify V. parahaemolyticus in raw oysters and to determine the risk associated with the consumption of raw oysters. A total of 30 oyster samples were collected and analysed in this study. MPN-PCR and MPN-Plating methods were employed and carried out concurrently to determine the prevalence of V. parahaemolyticus in raw oysters. The results showed that the prevalence of total V. parahaemolyticus in oysters was 50.00% (15/30) where the MPN/g range was < 3 – > 11000 MPN/g for MPN-PCR method, and 40.00% (12/30) where the MPN/g range was < 3 – 4300 MPN/g for MPN-Plating method. MPN-PCR method was able to estimate the level of virulence (tdh+ and trh+) V. parahaemolyticus in the raw oysters where 10.00% (3/30) of samples were identified to be in a range of 3 – 30 MPN/g. A microbial risk assessment was conducted based on the enumeration data obtained from MPN-PCR method using @risk. The probability of illness annually was 1.76 X 10-6 with a prediction of 31 cases to occur with respect to the exposed Malaysian population, while the rate per 100,000 people was estimated to be at 0.104. In addition, the antibiogram of V. parahaemolyticus was determined using Kirby Bauer Disk Diffusion Test and the results indicated that the isolates were highly resistant towards Bacitracin (100.00%), Vancomycin (100.00%) and were least resistant to Chloramphenicol (8.70%). The MAR index of the isolates ranged from 0.17 to 0.50. In accordance with the results from this study, the consumption of raw oysters is a risk factor for V. parahaemolyticus infection and proactive actions should be taken to reduce the risk of the pathogen in order to improve public health.
    Matched MeSH terms: Vancomycin
  16. 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
  17. Fulltext Enterobacter gergoviae peritonitis in a patient on chronic ambulatory peritoneal dialysis - first reported case
    Anna Misya’il Abdul Rashid, Lim, Christopher Thiam Seong
    Malaysian Journal of Medicine and Health Sciences, 2017;13(2):67-69.
    MyJurnal
    Enterobacter gergoviae is a gram negative rod-shaped opportunistic organism reported to cause urinary and respiratory tract infections, but peritonitis caused by this organism is unknown. We report a case of 50-year-old patient on peritoneal dialysis (PD) presented with Enterobacter gergoviae peritonitis with septic shock. Despite Intraperitoneal (IP) cloxacillin 250mg qid and IP ceftazidime 1gram q24h and subsequent escalation with IP amikacin 2mg/kg q24h and IP vancomycin 15mg/kg q24h within the next 48 hours, his peritonitis remained refractory and required catheter removal. Although Enterobacter gergoviae is naturally sensitive to aminoglycosides, carbapenems and quinolones, it reacts differently to the beta lactam antibiotics. Their resistance to third-generation cephalosporins is fast emerging and treatment with third-generation cephalosporins may cause AmpC-overproducing mutants. The majority of
    Enterobacteriaceae, including Extended-spectrum beta-lactamases producers, remain susceptible to carbapenems. Our report provides an unfavourable course of E. gergoviae peritonitis likely due to acquired secondary drug resistance during the therapy period.
    Matched MeSH terms: Vancomycin
  18. Evaluation of reported adverse drug reactions in antibiotic usage: a retrospective study from a tertiary care hospital, Malaysia
    Arulappen AL, Danial M, Sulaiman SAS
    Front Pharmacol, 2018;9:809.
    PMID: 30177879 DOI: 10.3389/fphar.2018.00809
    Adverse drug reaction (ADR) primarily caused by many drugs including antibiotics. At present, the incidence and pattern of ADR caused by antibiotics have remained as neglected area in Malaysia. This study was conducted to determine the incidence and analyze the pattern of ADR caused by antibiotics among patients in a tertiary care hospital. It is a 2-year retrospective observational study conducted at Hospital Pulau Pinang, Malaysia. All eligible patients who had antibiotic prescribed belonging to any age group either from outpatient or inpatient that had experienced ADR was included in this study. The outcomes were measured with the aid of Naranjo's and Hartwig's scales. The incidence of the ADRs among patients prescribed with antibiotics in Hospital Pulau Pinang is about 1.1%. Vancomycin and Trimethoprim/Sulfamethoxazole both are considered to be the major contributors to ADR incidences. The skin was the most affected organ by ADRs followed by gastrointestinal system. Most of the severe ADRs were caused by Penicillin. The causality relationship of all the severe reactions was mostly probable. General Medicine unit had reported the highest number of ADRs caused by antibiotics. The common manifestations of ADRs are acute kidney injury and exanthem. In addition, majority of the ADRs caused by antibiotics were reversible. A large multicenter study is suggested to confirm the present findings.

    Study site: Hospital Pulau Pinang
    Matched MeSH terms: Vancomycin
  19. Fulltext A rare complication of MRSA lid abscess and orbital abscess following strabismus surgery in a child
    Kenneth Teow, K. L., Nor Akmal, B., Jamalia, R., Safinaz, M. K.
    Journal of Surgical Academia, 2018;8(1):32-35.
    MyJurnal
    Strabismus is one of the most common ocular problems affecting the preschool population and the aim of strabismus surgery is to correct abnormal alignment of the eyes. A 5-year-old girl with strabismus underwent an uneventful surgery and was discharged on the same day with topical medications. Two days later, she returned with a painful right lower eyelid swelling, eye discharge and fever which started 1 day post-surgery. She was admitted for intravenous (IV) antibiotic. Symptoms initially improved after 24 hours of treatment, but later she had worsening eyelid swelling. An urgent CT scan of the orbit showed a right lower lid abscess with orbital cellulitis. Subsequently an examination under anaesthesia (EUA) and incision and drainage (I&D) of the lower lid abscess were performed. Culture from the pus grew Community Acquired Methicillin-resistant Staphylococcus aureus (CA-MRSA), sensitive to Vancomycin. At day 2 post I&D she subsequently developed another episode of localised right lower lid swelling. Another EUA was done but showed the lower lid and wound was free of pus. She was later found to have a toxic reaction to topical Gentamicin and hence this medication was stopped. She responded well to treatment and was discharged after completing her IV antibiotics. At 14 months outpatient follow up, she was well and orthophoric in primary gaze. While treating a disease, we should be opened to all possibilities and not to treat with multiple antibiotics once susceptibility is known
    Matched MeSH terms: Vancomycin
  20. Fulltext High Level Aminoglycoside Resistance And Distribution Of The Resistance Genes In Enterococcus faecalis And Enterococcus faecium From Teaching Hospital In Malaysia
    Moussa AA, Md Nordin AF, Hamat RA, Jasni AS
    Infect Drug Resist, 2019;12:3269-3274.
    PMID: 31695445 DOI: 10.2147/IDR.S219544
    Background: Enterococcus faecium and Enterococcus faecalis are among the predominant species causing hospital-acquired infections. Currently, enterococcal infections are treated using combination therapy of an aminoglycoside with cell-wall active agents, which led to high level aminoglycoside resistance (HLAR) and vancomycin resistance (VRE) among enterococci. The aim of this study was to determine the prevalence of HLAR and the distribution of the resistance genes among clinical E. faecalis and E. faecium isolates in Malaysia.

    Materials and methods: Seventy-five enterococci isolates recovered from different clinical sources were re-identified by subculturing on selective medium, Gram staining, biochemical profiling (API 20 Strep), and 16s rRNA sequencing. Antimicrobial susceptibility testing (AST) was performed using Kirby-Bauer disc diffusion, E-test, and broth microdilution methods. PCR amplification was used to detect the presence of aminoglycoside modifying enzyme (AME) genes [aac(6')-Ie-aph(2")-Ia, aph(2")-Ib, aph(2")-Ic, aph(2")-Id, aph(3')-IIIa]. Descriptive data analysis was used to analyze the antibiotic susceptibility profiles and the distribution of HLAR genes.

    Results: The majority of the isolates recovered from the clinical samples are E. faecalis (66.7%), with the highest recovery from the pus. The prevalence of HLGR (51%) is higher when compared to HLSR (45-49%). Analysis of the resistance genes showed that bifunctional genes aac(6')-Ie-aph(2")-Ia and aph(3')-IIIa contributed to the HLAR E. faecalis and E. faecium. The other AME genes [aph(2")-Ib, aph(2")-Ic, aph(2")-Id] were not detected in this study.

    Conclusion: This study provides the first prevalence data on HLAR and the distribution of the AME genes among E. faecalis and E. faecium isolates from Malaysia. These highlight the need for continued antibiotic surveillance to minimize its emergence and further dissemination.

    Matched MeSH terms: Vancomycin Resistance
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