Displaying publications 1 - 20 of 38 in total

Abstract:
Sort:
  1. A 5-year retrospective study of melioidosis cases treated in a district specialist hospital
    Tang RY, Lim SH, Lam JE, Nurasykin S, Eileen T, Chan YW
    Med J Malaysia, 2019 12;74(6):472-476.
    PMID: 31929471
    INTRODUCTION: Melioidosis is caused by Burkholderia pseudomallei, a gram-negative aerobic bacillus, found in the soil and surface water. Treating melioidosis has been a challenge in district hospitals due to high usage of broad spectrum antibiotics and prolonged hospitalisation. This study is to review the patients' demography, clinical presentations and microbiological data.

    METHODS: A 5-year retrospective study was carried out on patients admitted with culture positive for melioidosis from year 2013 to 2017 in Hospital Teluk Intan, Perak.

    RESULTS: There were a total of 46 confirmed cases of melioidosis. Majority of the patients were working in the agricultural and farming (28.6%), and factories (25.7%). Thirty-one patients had diabetes mellitus (71.1%). Presentations of patients with melioidosis included pneumonia (54.3%), skin and soft tissue infection (19.6%), deep abscesses (15.2%) and bone and joint infections (13%). An average of 5.8 days was needed to confirm the diagnosis of melioidosis via positive culture. However, only 39.4% of these patients were started on ceftazidime or carbapenem as the empirical therapy. The intensive care unit (ICU) admission rate for melioidosis was 46% and the mortality rate was 52%. Our microbial cultures showed good sensitivity towards cotrimoxazole (97.1%), ceftazidime (100%) and carbapenem (100%).

    CONCLUSION: Melioidosis carries high mortality rate, especially with lung involvement and bacteremia. Physicians should have high clinical suspicion for melioidosis cases to give appropriate antimelioidosis therapy early.

    Matched MeSH terms: Melioidosis/drug therapy*
  2. A case of chronic melioidosis responding to tetracycline therapy
    Jegathesan M, Chye GH, Chik T, Singh RB
    Med J Malaya, 1972 Dec;27(2):150-2.
    PMID: 4268042
    Matched MeSH terms: Melioidosis/drug therapy*
  3. Acute septicaemic melioidosis: a report of seven cases
    Puthucheary SD, Lin HP, Yap PK
    Trop Geogr Med, 1981 Mar;33(1):19-22.
    PMID: 7245336
    A report is presented of seven patients with acute septicaemic melioidosis seen at the University Hospital, Kuala Lumpur, Malaysia, during 1976-1979. All had associated disorders which rendered them more susceptible to infection. As prognosis depends on early diagnosis it is important that this disease be considered in the differential diagnosis of a septicaemic illness in such patients from endemic areas. The treatment of choice is a combination of tetracyclines and chloramphenicol, initially used in massive doses, and continued for at least six month to prevent relapses.
    Matched MeSH terms: Melioidosis/drug therapy
  4. An 11-Year Analysis of Emergency Presentations of Melioidosis in Northeastern Malaysia
    Yazid MB, Fauzi MH, Hasan H, Md Noh AY, Deris ZZ
    J Immigr Minor Health, 2017 Jun;19(3):774-777.
    PMID: 27160769 DOI: 10.1007/s10903-016-0429-8
    A neglected tropical disease, melioidosis is known to have variability in clinical presentations. Here, we described clinical features that should alert the physicians on the possibility of melioidosis. In this review of 86 cases from 2001 to 2011, the common presentations of melioidosis in the Emergency Department (ED), Hospital Universiti Sains Malaysia were; male gender (79.1 %), in working age group (47.8 ± 15.2 year-old), worked in contact with soil (73.3 %), presented with fever (91.9 %), in rainy season (55.8 %), have underlying diabetes mellitus (79.1 %), have leukocytosis (67.4 %) and high blood glucose (62.8 %) during presentation. In 34.9 % of cases, the antimicrobials were initiated at the ED and only 10.5 % include antimelioid drugs. Thirty-one patients (36.0 %) died due to melioidosis and 51.6 % of this were within 48 h of admission. Despite high mortality rate, the clinical awareness on the possibility of melioidosis among emergency physicians is still low and need to be strengthened.
    Matched MeSH terms: Melioidosis/drug therapy
  5. Fulltext An imported case of acute melioidosis caused by ST881 Burkholderia pseudomallei
    Zong Z, Wang X, Deng Y
    Southeast Asian J. Trop. Med. Public Health, 2016 Mar;47(2):219-22.
    PMID: 27244959
    A previously healthy Chinese male working in Malaysia returned to China with high fever. A blood culture showed Burkholderia pseudomallei strain WCBP1. This isolate was sequenced, showing type, ST881, which appears to be present in Malaysia. WCP1 had unusual susceptibility to aminoglycosides and habored the Yersinia-like fimbrial gene cluster for virulence. The patient's condition deteriorated rapidly but he recovered after receiving meropenem and intensive care support. Melioidosis is a potential problem among Chinese imigrant workers with strains new to China being identified.
    Matched MeSH terms: Melioidosis/drug therapy
  6. An unusual neurological complication from a garden-variety organism: post-melioidosis parkinsonism
    Ng CS, Azmin S, Law ZK, Sahathevan R, Wan Yahya WN, Remli R, et al.
    Med J Aust, 2015 Apr 06;202(6):333-4.
    PMID: 25832163
    Matched MeSH terms: Melioidosis/drug therapy*
  7. Fulltext Anti-malarial and anti-inflammatory effects of Gleichenia truncata mediated through inhibition of GSK3β
    Suhaini S, Liew SZ, Norhaniza J, Lee PC, Jualang G, Embi N, et al.
    Trop Biomed, 2015 Sep;32(3):419-33.
    PMID: 26695202 MyJurnal
    Gleichenia truncata is a highland fern from the Gleicheniaceae family known for its traditional use among indigenous communities in Asia to treat fever. The scientific basis of its effect has yet to be documented. A yeast-based kinase assay conducted in our laboratory revealed that crude methanolic extract (CME) of G. truncata exhibited glycogen synthase kinase-3 (GSK3)-inhibitory activity. GSK3β is now recognized to have a pivotal role in the regulation of inflammatory response during bacterial infections. We have also previously shown that lithium chloride (LiCl), a GSK3 inhibitor suppressed development of Plasmodium berghei in a murine model of malarial infection. The present study is aimed at evaluating G. truncata for its anti-malarial and anti-inflammatory effects using in vivo malarial and melioidosis infection models respectively. In a four-day suppressive test, intraperitoneal injections of up to 250 mg/kg body weight (bw) G. truncata CME into P.berghei-infected mice suppressed parasitaemia development by >60%. Intraperitoneal administration of 150 mg/kg bw G. truncata CME into Burkholderia pseudomallei-infected mice improved survivability by 44%. G. truncata CME lowered levels of pro-inflammatory cytokines (TNF-α, IFN-γ) in serum and organs of B. pseudomallei-infected mice. In both infections, increased phosphorylations (Ser9) of GSK3β were detected in organ samples of animals administered with G. truncata CME compared to controls. Taken together, results from this study strongly suggest that the anti-malarial and anti-inflammatory effects elicited by G. truncata in part were mediated through inhibition of GSK3β. The findings provide scientific basis for the ethnomedicinal use of this fern to treat inflammation-associated symptoms.
    Matched MeSH terms: Melioidosis/drug therapy*
  8. Fulltext Antimicrobial susceptibility and genetic characterisation of Burkholderia pseudomallei isolated from Malaysian patients
    Khosravi Y, Vellasamy KM, Mariappan V, Ng SL, Vadivelu J
    ScientificWorldJournal, 2014;2014:132971.
    PMID: 25379514 DOI: 10.1155/2014/132971
    Burkholderia pseudomallei, the causative agent of melioidosis, is intrinsically resistant to many antibiotics. Ceftazidime (CAZ), the synthetic β-lactam, is normally used as the first-line antibiotic therapy for treatment of melioidosis. However, acquired CAZ resistance can develop in vivo during treatment with CAZ, leading to mortality if therapy is not switched to a different antibiotic(s) in a timely manner. In this study, susceptibilities of 81 B. pseudomallei isolates to nine different antimicrobial agents were determined using the disk diffusion method, broth microdilution test and Etest. Highest percentage of susceptibility was demonstrated to CAZ, amoxicillin/clavulanic acid, meropenem, imipenem, and trimethoprim/sulfamethoxazole. Although these drugs demonstrated the highest percentage of susceptibility in B. pseudomallei, the overall results underline the importance of the emergence of resistance in this organism. PCR results showed that, of the 81 B. pseudomallei, six multidrug resistant (MDR) isolates carried bpeB, amrB, and BPSS1119 and penA genes. Genotyping of the isolates using random amplified polymorphic DNA analysis showed six different PCR fingerprinting patterns generated from the six MDR isolates clusters (A) and eight PCR fingerprinting patterns generated for the remaining 75 non-MDR isolates clusters (B).
    Matched MeSH terms: Melioidosis/drug therapy
  9. Antimicrobial susceptibility patterns of Burkholderia pseudomallei among melioidosis cases in Kedah, Malaysia
    Hassan MR, Vijayalakshmi N, Pani SP, Peng NP, Mehenderkar R, Voralu K, et al.
    Southeast Asian J. Trop. Med. Public Health, 2014 May;45(3):680-8.
    PMID: 24974653
    Burkholderia pseudomallei, the causative agent of melioidosis is an important cause of morbidity and mortality particularly among diabetics. We evaluated 228 isolates of B. pseudomallei for antimicrobial sensitivity during 2005-2010 using the disc diffusion technique, of which 144 were obtained from blood culture. More than 90% of the strains were susceptible to cefoperazone, ceftazidime, chloramphenicol and imipenem. Eighty-two percent of the isolates were susceptible to tetracycline and amoxicillin/clavulanate. The susceptibilities to ciprofloxacin was 78% and to trimethoprim-sulfamethoxezole was 47%. The susceptibilities to aminoglycoside antibiotics were low (21% to gentamicin and 6% to amikacin). The susceptibilities were similar between isolates from females and males, bacteremic and abacteremic cases, diabetics and non-diabetics, pneumonia and non-pneumonia cases and between those who died and those who survived. Our findings show antibiotic susceptibility patterns are not a major factor in determining outcomes of B. pseudomallei infection. Monitoring the drug susceptibilities among B. pseudomallei isolates needs to be conducted regularly to guide empiric therapy for melioidosis, as it causes high mortality, especially among diabetic cases.
    Matched MeSH terms: Melioidosis/drug therapy
  10. Cases of melioidosis in a university teaching hospital in Malaysia
    Raja NS
    J Microbiol Immunol Infect, 2008 Apr;41(2):174-9.
    PMID: 18473106
    Melioidosis is an infectious disease caused by Burkholderia pseudomallei that is endemic in Southeast Asia and northern Australia and has also been reported from non-endemic areas of the world. Little is known about the antimicrobial susceptibility pattern and the demography of melioidosis patients in Malaysia.
    Matched MeSH terms: Melioidosis/drug therapy
  11. Clinical characteristics and outcomes of bacteraemic melioidosis in a teaching hospital in a northeastern state of Malaysia: a five-year review
    Deris ZZ, Hasan H, Siti Suraiya MN
    J Infect Dev Ctries, 2010 Aug 04;4(7):430-5.
    PMID: 20818090
    BACKGROUND: Melioidosis is an important public health problem causing community acquired sepsis in the northeastern part of Malaysia.

    METHODOLOGY: From January 2001 to December 2005, we reviewed case reports of all bacteraemic melioidosis admitted to a tertiary teaching hospital, Hospital Universiti Sains Malaysia.

    RESULTS: Thirty-five patients had positive blood culture for meliodosis and 27 case reports were traceable for further analysis. The mean age was 46.8 + 20.0 years. Twenty patients (74.1%) were male. The main clinical presentation was fever that occurred in 23 (85.2%) patients. Eighteen patients (66.7%) had lung involvement and three patients had liver abscess. Two patients presented with scrotal swelling, one of whom further developed Fournier's Gangrene. Nineteen (70.4%) patients had underlying diabetes, five of whom were newly diagnosed during the admission. Thirteen (48.1%) patients were treated with high-dose ceftazidime and six (22.2%) patients were treated with imipenem. Eight (29.6%) patients were not given anti-melioidosis therapy because the causative agents were not identified until after the patients died. The patients were admitted 16.8 days + 18.1. Seventeen patients (63.0%) died in this series, 13 patients of whom died within four days of admission.

    CONCLUSIONS: The wide range of clinical presentations and the fatal outcomes of melioidosis require a high level of suspicion among physicians to develop an early appropriate therapy and reduce the mortality rate.

    Matched MeSH terms: Melioidosis/drug therapy*
  12. Fulltext Cutaneous melioidosis in a healthy Danish man after travelling to South-East Asia
    Bodilsen J, Langgaard H, Nielsen HL
    BMJ Case Rep, 2015 Jan 16;2015.
    PMID: 25596295 DOI: 10.1136/bcr-2014-207340
    A healthy Danish man presented with infected prepatellar bursitis 8 months after being involved in a car accident in Malaysia resulting in exposure of a laceration of his knee to stagnant water. Tissue samples grew Burkholderia pseudomallei and diagnostic work up revealed no secondary foci. The patient was successfully treated with surgical debridement and 3 months of oral trimethoprim-sulfamethoxazole. At 6 months follow-up the patient was without relapse.
    Matched MeSH terms: Melioidosis/drug therapy
  13. Fulltext Disseminated melioidosis in early pregnancy - an unproven cause of foetal loss
    Chang CY, Lau NLJ, Currie BJ, Podin Y
    BMC Infect Dis, 2020 Mar 06;20(1):201.
    PMID: 32143598 DOI: 10.1186/s12879-020-4937-8
    BACKGROUND: Melioidosis is a potentially life-threatening infection caused by the Gram-negative bacterium Burkholderia pseudomallei. Melioidosis is difficult to diagnose due to its diverse clinical manifestations, which often delays administration of appropriate antibiotic therapy.

    CASE PRESENTATION: Melioidosis is uncommon in pregnancy but both spontaneous abortion and neonatal melioidosis have been reported. We report a case of bacteraemic melioidosis in a young woman with a subsequent spontaneous abortion, with B. pseudomallei cultured from a high vaginal swab as well as blood.

    CONCLUSION: It remains unclear in this and previously reported cases as to whether the maternal melioidosis was sexually transmitted.

    Matched MeSH terms: Melioidosis/drug therapy
  14. Fulltext Glycogen synthase kinase-3β inhibition improved survivability of mice infected with Burkholderia pseudomallei
    Tay TF, Maheran M, Too SL, Hasidah MS, Ismail G, Embi N
    Trop Biomed, 2012 Dec;29(4):551-67.
    PMID: 23202600
    The disease melioidosis, caused by the soil bacteria Burkholderia pseudomallei, often manifests as acute septicemia with high fatality. Glycogen synthase kinase-3β (GSK3β) plays a key role during the inflammatory response induced by bacteria. We used a murine model of acute melioidosis to investigate the effects of LiCl, a GSK3 inhibitor on experimental animal survivability as well as TNF-α, IL-1β, IFN-γ, IL-10 and IL-1Ra cytokine levels in blood, lung, liver and spleen of B. pseudomallei-infected mice. Our results showed that administration of 100 μg/g LiCl improved survivability of mice infected with 5 X LD50 of B. pseudomallei. Bacterial counts in spleen, liver and lungs of infected mice administered with LiCl were lower than non-treated controls. Our data also revealed that GSK3β is phosphorylated in the spleen, liver and lung of animals infected with B. pseudomallei. However in infected animals administered with LiCl, higher levels of pGSK3 were detected in the organs. Levels of proinflammatory cytokines (TNF-α, IL-1β and IFN-γ) and anti-inflammatory cytokines (IL-10 and IL-1Ra) in sera and organs tested were elevated significantly following B. pseudomallei infection. With GSK3β inhibition, pro-inflammatory cytokines (TNF-α, IFN-γ, IL-1β) were significantly decreased in all the samples tested whilst the levels of anti-inflammatory cytokines, IL-10 (spleen and lung) and IL-1Ra (spleen, liver and sera) were further elevated. This study represents the first report implicating GSK3β in the modulation of cytokine production during B. pseudomallei infection thus reiterating the important role of GSK3β in the inflammatory response caused by bacterial pathogens.
    Matched MeSH terms: Melioidosis/drug therapy*
  15. Fulltext Honeycomb and necklace signs in liver abscesses secondary to melioidosis
    Ong SCL, Alemam MMM, Zakaria NA, Abdul Halim NA
    BMJ Case Rep, 2017 Oct 19;2017.
    PMID: 29054959 DOI: 10.1136/bcr-2017-222342
    Melioidosis is endemic in Southeast Asia and tropical Australia with varying clinical features from benign skin lesions to fatal septicaemia. Imaging plays an important role in evaluation of the melioid liver abscesses. A 45-year-old man with underlying diabetes presented with fever and lethargy for 2 weeks and abdominal pain for 2 days. His liver was enlarged on examination. Blood investigations revealed mild leucocytosis and raised liver enzymes. Ultrasound showed multiple multiloculated hypoechoic lesions throughout the liver and spleen. CT of abdomen confirmed that some liver lesions were made up of asymmetric locules of varying sizes (honeycomb sign), while others had hypodense centre with small symmetric peripheral locules in radial fashion (necklace sign). Blood culture was positive for Burkholderia pseudomallei He was subsequently treated with ceftazidime for a month followed by oral trimethoprim-sulfamethoxazole for 3 months. Follow-up CT of abdomen a month after diagnosis and treatment showed resolving hepatic and splenic lesions.
    Matched MeSH terms: Melioidosis/drug therapy
  16. Imipenem for the treatment of melioidosis
    Minassian MA, Gage A, Price E, Sefton AM
    Int J Antimicrob Agents, 1999 Aug;12(3):263-5.
    PMID: 10461846
    Melioidosis is a protean disease caused by Burkholderia pseudomallei. It is rare in the UK and is generally only seen in patients with a travel history to endemic areas such as Thailand, Singapore and Malaysia. Cases may present with disseminated bacteraemic, non-disseminated bacteraemic, multi-focal bacteraemic or localized disease. Subclinical infections also occur. Following acquisition of the organism a patient may remain asymptomatic for several years before infection becomes clinically apparent. Factors such as diabetes, renal failure or other causes for a decrease in host immunity may precipitate the appearance of overt disease. The current treatment choice for severe melioidosis is parenteral ceftazidime followed by oral amoxycillin-clavulanic acid or a combination of co-trimoxazole, doxycycline and chloramphenicol. We report a case of melioidosis in a 59-year-old male diabetic from Bangladesh who initially responded to piperacillin-tazobactam but was changed to ceftazidime when a definitive diagnosis was made. His condition deteriorated on the latter antibiotic. He subsequently responded to imipenem. The patient's long-term outcome is still not known.
    Matched MeSH terms: Melioidosis/drug therapy*
  17. Imported melioidosis in a British native
    Jenkins DR, Lewis AM, Strachan CJ
    J Infect, 1990 Sep;21(2):221-2.
    PMID: 2230183
    Matched MeSH terms: Melioidosis/drug therapy
  18. In-vitro susceptibility of Pseudomonas pseudomallei isolated in Malaysia to some new cephalosporins and a quinolone
    Cheong YM, Joseph PG, Koay AS
    Southeast Asian J. Trop. Med. Public Health, 1987 Mar;18(1):94-6.
    PMID: 3477872
    The current drugs recommended for treatment of melioidosis are tetracycline, chloramphenicol and cotrimoxazole. Unfortunately these drugs are not the drug of choice in an acutely ill patient with septicaemia prior to the availability of laboratory results. With the discovery of the new cephalosporins which have a broad spectrum of activity clinicians are using them either alone or in combination with other antibiotics in such critical situations. Hence, an in-vitro study was carried out on the susceptibility of 41 strains of P. pseudomallei isolated in Malaysia, to these new cephalosporins and a new quinolone. The results showed that all the cephalosporins tested had some activity on the strains tested, with ceftazidime being the most active drug. Pefloxacin had very poor activity. However, further clinical studies are required to determine the duration, dosage and in-vivo activity of the antibiotics.
    Matched MeSH terms: Melioidosis/drug therapy
  19. Localized melioidosis
    Raja NS
    J Pak Med Assoc, 2003 Aug;53(8):373-4.
    PMID: 14558747
    Matched MeSH terms: Melioidosis/drug therapy
  20. Mediastinal melioidosis masquerading as malignancy of the lung
    Kho SS, Ho YF, Chan SK, Tie ST
    Lancet, 2021 03 13;397(10278):e8.
    PMID: 33714391 DOI: 10.1016/S0140-6736(21)00200-2
    Matched MeSH terms: Melioidosis/drug therapy*
Related Terms
Filters
Contact Us

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links