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Mycobacterium senegalense catheter-related bloodstream infection

Badarol Hisham N, Madon M, Masri SN, Amin-Nordin S

BMJ Case Rep, 2024 Apr 30;17(4).
PMID: 38688568 DOI: 10.1136/bcr-2024-259761

Catheter-related bloodstream infection (CRBSI) is one of the common healthcare-acquired infections imposing a high burden of morbidity and mortality on the patients. Non-tuberculous mycobacterium is a rare aetiology for CRBSI and poses challenges in laboratory diagnosis and clinical management. This is a case of a woman in her early 60s with underlying end-stage renal failure, diabetes mellitus and hypertension presented with a 2-week history of high-grade fever postregular haemodialysis, vomiting, lethargy and altered mental status.Blood cultures from a permanent catheter and peripheral taken concurrently yielded Mycobacterium senegalense, identified by matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry, which established the diagnosis of CRBSI atypically presented with concurrent acute intracranial bleeding and cerebrovascular infarction at initial presentation. She was started on a combination of oral azithromycin, oral amikacin and intravenous imipenem, and the permanent catheter was removed. Despite the treatments instituted, she developed septicaemia, acute myocardial infarction and macrophage activation-like syndrome, causing the patient's death.
Fulltext Applying interprofessional simulation to improve knowledge, attitude and practice in hospital- acquired infection control among health professionals

Saraswathy T, Nalliah S, Rosliza AM, Ramasamy S, Jalina K, Shahar HK, et al.

BMC Med Educ, 2021 Sep 09;21(1):482.
PMID: 34503488 DOI: 10.1186/s12909-021-02907-1

BACKGROUND: This study aimed at determining the effectiveness of an innovative approach using interprofessional simulation scenarios (IPSS) in improving knowledge, attitude, and practice (KAP) of hospital-acquired infection control (HAIC) among health professionals.
METHODS: The interventional study was conducted in a teaching hospital in Malaysia. Purposive sampling was used to recruit participants from surgical, intensive care, and other units. Thirty-six health professionals in the experimental and forty in the control group completed the study. All subjects participated in an interactive lecture and demonstrated four IPSS on HAIC i.e. (i) taking blood specimen (ii) bedsore dressing (iii) collecting sputum for acid-fast bacilli and (iv) intermittent bladder catheterization. Each team consisted of a doctor and a nurse. A self-administered questionnaire on KAP on HAIC was completed by respondents during the pre-, immediately and, post-intervention. An independent t-test was conducted to measure the significance between the experimental and control group.
RESULTS: The mean scores for KAP among the experimental group increased following the intervention. Significant differences in scores were seen between the two groups post-intervention (p
Fulltext Group B streptococcal bacteremia in a major teaching hospital in Malaysia: a case series of eighteen patients

Eskandarian N, Neela V, Ismail Z, Puzi SM, Hamat RA, Desa MN, et al.

Int J Infect Dis, 2013 Sep;17(9):e777-80.
PMID: 23453715 DOI: 10.1016/j.ijid.2013.01.011

Group B Streptococcus (GBS) is a leading cause of infections such as meningitis and septicemia in neonates and pregnant women; however the significance of invasive GBS disease has not been clearly defined in non-pregnant adults.
Fulltext Analgesic nephropathy as a cause of end-stage renal disease in Malaysia

Segasothy M, Suleiman AB, Hasnah A, Salbiah N, Shaharom CM, Siti Sabzah H, et al.

Med J Malaysia, 1986 Jun;41(2):134-8.
PMID: 3821608

We questioned 180 patients with end-stage renal disease on maintenance haemodialysis, chronic ambulatory peritoneal dialysis and those who had undergone renal transplantation at the Department of Nephrology, General Hospital, Kuala Lumpur. Twelve patients (6.7%) had consumed excessive quantities ofanalgesics prior to the institution of long-term dialysis or transplantation. Primary renal disease was considered to be analgesic nephropathy in seven patients (3.9%); in five patients (2.8%), analgesic abuse could have been a contributory factor to end-stage renal failure. Analgesic nephropathy is hence an uncommon cause of end-stage renal disease in Malaysia. However, it is important to be aware of the problem and to institute preventive measures as the cost of treatment for end-stage renal disease is prohibitive.
Fulltext Prevailing Knowledge on the Bioavailability and Biological Activities of Sulphur Compounds from Alliums: A Potential Drug Candidate

Subramanian MS, Nandagopal Ms G, Amin Nordin S, Thilakavathy K, Joseph N

Molecules, 2020 Sep 09;25(18).
PMID: 32916777 DOI: 10.3390/molecules25184111

Allium sativum (garlic) is widely known and is consumed as a natural prophylactic worldwide. It produces more than 200 identified chemical compounds, with more than 20 different kinds of sulfide compounds. The sulfide compounds particularly are proven to contribute to its various biological roles and pharmacological properties such as antimicrobial, antithrombotic, hypoglycemic, antitumour, and hypolipidemic. Therefore, it is often referred as disease-preventive food. Sulphur-containing compounds from A. sativum are derivatives of S-alkenyl-l-cysteine sulfoxides, ajoene molecules, thiosulfinates, sulfides, and S-allylcysteine. This review presents an overview of the water-soluble and oil-soluble sulphur based phytochemical compounds present in garlic, highlighting their mechanism of action in treating various health conditions. However, its role as a therapeutic agent should be extensively studied as it depends on factors such as the effective dosage and the suitable method of preparation.
Diagnosis of neonatal meningitis: is it time to use polymerase chain reaction?

Zurina Z, Hoo NPJ, Amin-Nordin S, Joseph NMS, Nunis MA

Med J Malaysia, 2021 Jan;76(1):101-103.
PMID: 33510118

Group B Streptococcus (GBS) is a predominant causative pathogen of neonatal meningitis that is associated with a high rate of mortality and morbidity. The establishment of antenatal screening and intrapartum chemoprophylaxis has led to a significant reduction in the incidence rate of invasive GBS disease in developed countries. However, these strategies are not routinely practiced in most developing countries. To ensure good recovery of infants affected with GBS, a prompt diagnostic strategy and appropriate therapy are essential. We highlight here the case of a preterm male infant diagnosed with early-onset of GBS meningitis diagnosed by using polymerase chain reaction (PCR) method on the cerebrospinal fluid (CSF) of the infant. Initially the pathogen was not isolated in both blood and CSF cultures as sampling was performed after the administration of antibiotics. Hence, PCR was a crucial diagnostic test in facilitating the detection of the pathogen in CSF. We believe that PCR is a potentially fast and precise diagnostic method for infection in a newborn.
Fulltext Mycobiome in the Gut: A Multiperspective Review

Chin VK, Yong VC, Chong PP, Amin Nordin S, Basir R, Abdullah M

Mediators Inflamm, 2020;2020:9560684.
PMID: 32322167 DOI: 10.1155/2020/9560684

Human gut is home to a diverse and complex microbial ecosystem encompassing bacteria, viruses, parasites, fungi, and other microorganisms that have an undisputable role in maintaining good health for the host. Studies on the interplay between microbiota in the gut and various human diseases remain the key focus among many researchers. Nevertheless, advances in sequencing technologies and computational biology have helped us to identify a diversity of fungal community that reside in the gut known as the mycobiome. Although studies on gut mycobiome are still in its infancy, numerous sources have reported its potential role in host homeostasis and disease development. Nonetheless, the actual mechanism of its involvement remains largely unknown and underexplored. Thus, in this review, we attempt to discuss the recent advances in gut mycobiome research from multiple perspectives. This includes understanding the composition of fungal communities in the gut and the involvement of gut mycobiome in host immunity and gut-brain axis. Further, we also discuss on multibiome interactions in the gut with emphasis on fungi-bacteria interaction and the influence of diet in shaping gut mycobiome composition. This review also highlights the relation between fungal metabolites and gut mycobiota in human homeostasis and the role of gut mycobiome in various human diseases. This multiperspective review on gut mycobiome could perhaps shed new light for future studies in the mycobiome research area.
Fulltext Self-assessment, attitude and perception of interprofessional learning in hospital acquired infection control practices among health professionals in Klang Valley, Malaysia

Thangarajoo S, Rosliza AM, Nalliah S, Karim J, Shohaimi S, Ramasamy S, et al.

BMC Med Educ, 2021 Apr 26;21(1):243.
PMID: 33902577 DOI: 10.1186/s12909-021-02610-1

BACKGROUND: Interprofessional learning (IPL) is a key challenge in Malaysia in incorporating the current profession-specific medical education into the interprofessional learning curriculum. Safe practices would be enhanced with improved collaboration among the health professionals when they learn with, from, and about each other. The main objective of this study was to determine the significant differences in self-assessment, attitude, and perception of interprofessional learning among doctors and nurses in a teaching hospital in Klang Valley, Malaysia. The second objective was to determine if there is any significant difference in the selected demography factors, mean and total scores between doctors and nurses in self-assessment, attitude, and perceptions of IPL aspects.
METHODS: A total of doctors (39) and nurses (37) were recruited for an interventional study on the interprofessional learning approach on hospital acquired infection control. The participants responded to the University of West England Interprofessional (UWEIP) questionnaire at baseline consisting of four dimensions in IPL aspects; Self-assessment on communication and teamwork skills (CTW), interprofessional learning (IPL), interprofessional interaction (IPI), and interprofessional relationship (IPR). The Cronbach alpha value for the total questionnaire was established at 0.79.
RESULTS: The majority of doctors scored positive in CTW, IPL, IPR, and neutral in IPI. Nurses' also recorded the highest positive scores in CTW, IPL, and IPR, and neutral in IPI. Negative scores were found in CTW and IPI. A significant difference was revealed between doctors and nurses in IPL attitude; p = 0.024 and there was no significant difference in other dimensions (p > .05). Results also found a significant difference between participants' and non-participants of IPL training sessions; p = 0.009.
CONCLUSIONS: This study revealed the infusion of interprofessional learning training among the health professionals displayed better self-assessments, attitudes, and perceptions towards collaborative practices.
Human leukocyte antigen (HLA) class II association in chronic hepatitis B patients with hepatocellular carcinoma in a Malay population: A pilot study

Krishnan PB, Abdullah M, Hudu SA, Sekawi Z, Tan SS, Amin-Nordin S

Trop Biomed, 2019 Sep 01;36(3):703-708.
PMID: 33597492

Asian countries account for almost three quarter of hepatocellular carcinoma (HCC) reported globally and chronic hepatitis B infection is one of the main contributors. Clinical observations show that Malay patients with chronic hepatitis B and HCC tend to have a worse outcome, when compared to other two major races in Malaysia. The objectives of this study was to determine the frequency of human leukocyte antigen (HLA) class II alleles in chronic hepatitis B patients with HCC among Malays compared to the general population to identify potential associations of HLA alleles with this disease. HLA class II typing was performed in chronic hepatitis B patients with hepatocellular carcinoma (n=12) by -polymerase chain reaction, sequence specific primer (PCR-SSP) method. There were higher allelic frequencies of certain HLA-DQB1 and HLA-DRB1 alleles; HLA-DQB1*03 (07) (41.7%), and HLA-DRB1*12 (41.7% vs 28.6%) and compared to controls (41.7% vs 29.7%). However, there was no significant statistical correlation found when compared with the normal healthy general population. This study provides an insight into the HLA Class II association with chronic hepatitis B and hepatocellular carcinoma in Malays. However, findings from this study should be validated with a larger number of samples using a high resolution HLA typing.
Colistin-associated nephrotoxicity among patients in intensive care units (ICU) of hospitals in Selangor

Rashizal Sazli MR, Syed Mohamed AF, Wan Mazuan WM, Ling SM, Mahmud A, Amin Nordin S

Med J Malaysia, 2017 04;72(2):100-105.
PMID: 28473672 MyJurnal

INTRODUCTION: The increasing trend of extensively drugresistant gram negative bacteria responsible for nosocomial infections has prompted resurgence colistin usage. Colistin-induced nephrotoxicity is a concern with disparity in the reported rates between previous studies. This study aims to evaluate colistin-induced nephrotoxicity among Malaysian population.
METHODS: The medical records of ICU patients receiving colistin therapy in Hospital Serdang and Hospital Sungai Buloh from 2010 to 2012 were retrospectively reviewed. Demographics data, treatment characteristic as well as culture result and creatinine level were documented. Nephrotoxicity was determined based on RIFLE criteria.
RESULTS: A total of 100 patients were included. Median daily dose, cumulative dose and duration of colistin therapy were 3.0 MIU (IQR: 4, range 1-12), 17.8 MIU (IQR: 31.5, range 2-180) and seven days (IQR: 4, range 1-30). Nephrotoxicity was found in 23% of the study population. All cases were reversible but marginally associated with higher mortality. No statistical association exist between age, gender and race as well as administration routes with nephrotoxicity by univariable analysis. The association of dose and duration with nephrotoxicity was also not significant by univariable analysis. After adjustment for confounders, statistical association between the independent variables and dependent variable remains not significant.
CONCLUSION: Lower dose and shorter duration in local settings contribute to lack of association between colistin therapy and nephrotoxicity in this study. Higher dosing regimen with loading dose application has been introduced in the latest National Antibiotic Guideline. Further evaluation of colistin-induced nephrotoxicity and potential risk factors is therefore warranted.
Fulltext Elevated interleukin-25 and its association to Th2 cytokines in systemic lupus erythematosus with lupus nephritis

Selvaraja M, Abdullah M, Arip M, Chin VK, Shah A, Amin Nordin S

PLoS One, 2019;14(11):e0224707.
PMID: 31697750 DOI: 10.1371/journal.pone.0224707

Systemic lupus erythematosus (SLE) is an autoimmune disorder that is associated with lupus nephritis, initiated by the deposition of immune complexes in the kidney; subsequently, this induces the overexpression of cytokines. Lupus nephritis is known as one of the major clinical manifestations that affect the disease severity in SLE patients. An increased number of resident periglomerular and immune cells in the kidney has the potential to affect the equilibrium of different immune cell subsets, such as Th1, Th2, Th17, and Tregs, which may be central to the induction of tissue damage in kidney by exerting either proinflammatory or anti-inflammatory effects, or both. This equilibrium has yet to be confirmed, as new players such as IL-25 remain undiscovered. IL-25 is a cytokine of the IL-17 family, which stimulates Th2-mediated immune response when overly expressed. Thus, the aim of this research is to determine the plasma levels of IL-25 and Th2-associated cytokines (IL-4, IL-5, IL-6, IL-9, IL-10, IL-13) in SLE patients with (SLE-LN) and without lupus nephritis. Sixty-four (n = 64) SLE patients and fifteen (n = 15) healthy individuals were recruited. This study demonstrated that the IL-9, IL-10 and IL-25 had significantly increased expressions in SLE-LN, followed by SLE without LN, compared to healthy controls. Meanwhile, IL-5 and IL-6 had significantly reduced. No significant difference was observed with IL-13, while the level of IL-4 was undetectable. Furthermore, IL-9 and IL-10 were significantly correlated with the IL-25, and IL-25, IL-9 and IL-10 were positively correlated with the disease severity score, SLEDAI. In conclusion, IL-25 and its associated Th2 cytokines (IL-9 and IL-10) may be involved in SLE pathogenesis. These cytokines could be potential biomarkers in monitoring and predicting the disease severity during SLE pathogenesis.
Evaluation of Tween 80 incorporated media to increase pathogen isolation from peritoneal fluid of CAPD patients at Hospital Kuala Lumpur

Ganapathy Pillay S, Mohd Amin SDW, Masri SN, Joseph NM, Amran F, Van Belkum A, et al.

Malays J Pathol, 2021 Aug;43(2):261-268.
PMID: 34448790

INTRODUCTION: Continuous ambulatory peritoneal dialysis (CAPD)-associated peritonitis remains a major complication in patients on CAPD leading to increased morbidity and mortality. Successful therapy of peritonitis is highly dependent on a positive microbiological culture because narrow spectrum antibiotics are essential to efficiently combat infection. Therefore, this study evaluated the performance of Tween 80 containing media at three different concentrations (0.1%, 1.0% and 2.0%) to increase the pathogen yield from peritoneal fluid in comparison with the standard culture media.
MATERIALS AND METHODS: Peritoneal fluid samples (n=121) obtained from CAPD patients suspected of peritonitis at Hospital Kuala Lumpur were analysed macroscopically and microscopically prior to culture. All samples were cultured on seven different culture media, including sheep blood agar, MacConkey agar, Sabouraud dextrose agar, brain heart infusion agar and Tween 80 incorporated blood agar. All plates were incubated at an optimum temperature up to 48 hours.
RESULTS AND CONCLUSION: Among all the culture media investigated, 0.1% to 2.0% Tween 80 incorporated blood agar yielded the highest positive culture (23/121) in comparison with all other standard media, thus lowering the negative culture rate among CAPD patients. Statistical analysis by Chi Square revealed significant differences (p <0.001) between the three concentrations of Tween 80 tested in this study. Among the three different concentrations of Tween 80 optimised in this study, blood agar containing 0.1% Tween 80 generated the best results, achieved by optimum growth of all Gram-positive organisms, Gram-negative organisms and yeast cells simultaneously. Using a small amount of detergent at low cost significantly increased the pathogen yield during CAPD-associated peritonitis.
Evaluation of Methadone Treatment in Malaysia: Findings from the Malaysian Methadone Treatment Outcome Study (MyTOS)

Ali N, Aziz SA, Nordin S, Mi NC, Abdullah N, Paranthaman V, et al.

Subst Use Misuse, 2018 01 28;53(2):239-248.
PMID: 29116878 DOI: 10.1080/10826084.2017.1385630

BACKGROUND: Opioid misuse and dependence is a global issue with a huge negative impact. In Malaysia, heroin is still the main illicit drug used, and methadone maintenance treatment (MMT) has been used since 2005.
OBJECTIVE: To evaluate the effectiveness of MMT.
METHODS: This was a cross-sectional study conducted in 103 treatment centers between October and December 2014 using a set of standard questionnaires. Data were analyzed using SPSS Statistics 20.
RESULTS: There were 3254 respondents (93.6% response rate); of these 17.5% (n = 570) transferred to another treatment center, 8.6% (n = 280) died, 29.2% (n = 950) defaulted, and 7.6% (n = 247) were terminated for various reasons. Hence, 1233 (37%) respondents' baseline and follow-up data were further analyzed. Respondents had a mean age of 39.2 years old and were mainly male, Malay, Muslim, married (51.1%, n = 617), and currently employed. Few showed viral seroconversion after they started MMT (HIV: 0.5%, n = 6; Hepatitis B: 0.3%, n = 4; Hepatitis C: 2.7%, n = 29). There were significant reductions in opioid use, HIV risk-taking score (p < 0.01), social functioning (p < 0.01), crime (p < 0.01), and health (p < 0.01). However, there were significant improvements in quality of life in the physical, psychological, social, and environmental domains. Factors associated with change were being married, employed, consuming alcohol, and high criminality at baseline. Lower methadone dosage was significantly associated with improvements in the physical, psychological, and environmental domains.
Conclusion/Importance: The MMT program was found to be successful; hence, it should be expanded.
Fulltext Deploying a Novel Approach to Prepare Silver Nanoparticle Bellamya bengalensis Extract Conjugate Coating on Orthopedic Implant Biomaterial Discs to Prevent Potential Biofilm Formation

Qamer S, Che-Hamzah F, Misni N, Joseph NMS, Al-Haj NA, Amin-Nordin S

Antibiotics (Basel), 2023 Sep 03;12(9).
PMID: 37760700 DOI: 10.3390/antibiotics12091403

This study is based on the premise of investigating antibacterial activity through a novel conjugate of silver nanoparticles (AgNPs) and antimicrobial peptides (AMPs) in line with a green synthesis approach by developing antimicrobial-coated implants to prevent bacterial resistance. The AMPs were obtained from Bellamya Bengalensis (BB), a freshwater snail, to prepare the nanocomposite conjugate, e.g., AgNPs@BB extract, by making use of UV-Visible spectroscopy. The antimicrobial assessment of AgNPs@BB extract conjugate was performed using the Resazurin Microtiter Assay Method (REMA), followed by the use of three biocompatible implant materials (titanium alloys, Ti 6AL-4V stainless steel 316L, and polyethylene). Finally, the coating was analyzed under confocal microscopy. The results revealed a significant reduction of biofilm formation on the surfaces of implants coated with conjugate (AgNPs@BB extract) in comparison to uncoated implants. For the MTT assay, no significant changes were recorded for the cells grown on the AgNPs/AMP++ sample in high concentrations. Staphylococcus epidermidis, however, showed more prominent growth on all implants in comparison to Staphylococcus aureus. It is evident from the results that Staphylococcus epidermidis is more susceptible to AgNPs@BB extract, while the minimum inhibitory concentration (MIC) value of AgNPs@BB extract conjugates and biosynthesized AgNPs was also on the higher side. This study indicates that AgNPs@BB extract carries antibacterial activity, and concludes that an excessive concentration of AgNPs@BB extract may affect the improved biocompatibility. This study recommends using robust, retentive, and antimicrobial coatings of AgNPs@BB extract for implantable biocompatible materials in accordance with the novel strategy of biomaterial applications.
Fulltext Association between dietary inflammatory index and body fat percentage among newly diagnosed breast cancer patients

Ng WH, Abu Zaid Z, Mohd Yusof BN, Amin Nordin S, Lim PY

Ann Med, 2023;55(2):2303399.
PMID: 38242100 DOI: 10.1080/07853890.2024.2303399

BACKGROUND: Obesity, particularly excessive body fat, is an established risk factor and substantial prognostic determinant in breast cancer. Recent studies suggested that diet-related inflammation plays a key role in obesity. This study aimed to determine the association between energy-adjusted dietary inflammatory index (E-DII) and body composition, particularly body fat percentage, among patients with newly diagnosed breast cancer.
MATERIALS AND METHODS: This cross-sectional study was conducted on 124 breast cancer outpatients within the first year of diagnosis and yet to commence oncological treatment. Body composition parameters [body weight, body mass index (BMI), body fat percentage, fat mass over fat-free mass ratio (FM/FFM), muscle mass, and visceral fat] were obtained using a bioelectrical impedance analyzer. Body fat percentage was categorized into two groups which were normal (<35%) and high (≥35%). The E-DII was calculated from the validated 165-items Food Frequency Questionnaire (FFQ) and categorized into three groups or tertiles. Multiple logistic regression analysis was used to determine the association between the E-DII and body fat percentage.
RESULTS: Mean body weight, body fat percentage, FM/FFM, and visceral fat increased as E-DII increased from the lowest tertile (T1) to the most pro-inflammatory tertile (T3) (p for trend <0.05). E-DII was positively associated with body fat percentage (OR 2.952; 95% CI 1.154-7.556; p = 0.024) and remained significant after adjustment for cancer stage, age, physical activity, ethnicity, smoking history, and presence of comorbidities. Compared to T1, participants in T3 had a significantly lower consumption of fiber, vitamin A, beta-carotene, vitamin C, iron, thiamine, riboflavin, niacin, vitamin B6, folic acid, zinc, magnesium, and selenium, but a higher intake of total fat, saturated fat, and monounsaturated fatty acids.
CONCLUSIONS: A higher E-DII was associated with increased body fat percentage, suggesting the potential of advocating anti-inflammatory diet to combat obesity among newly diagnosed breast cancer patients.
Fulltext Multilocus Sequence Typing Analysis of Invasive and Non-Invasive Group B Streptococcus of Hospital Origin in Malaysia

Ezhumalai M, Muthanna A, Suhaili Z, Dzaraly ND, Amin-Nordin S, Amal MNA, et al.

Malays J Med Sci, 2020 Feb;27(1):134-138.
PMID: 32158353 MyJurnal DOI: 10.21315/mjms2020.27.1.14

The aim of this study was to study the genotype of a hospital collection of Group B Streptococcus (GBS) from invasive and non-invasive sites. Fifty-one pre-characterised human of GBS were re-identified and further analysed by multilocus sequence typing (MLST) in relation to previously published serotypes. Fifteen sequence types (ST) were found with ST1 being the most predominant. ST1 was also associated with majority of the invasive isolates. The genotypic distribution patterns of GBS in this study were largely in agreement with previous reports from other countries indicating the tendency of certain genotypes to prevail in human infection settings.
Fulltext Comparison of safety and immunogenicity of a Vi polysaccharide typhoid vaccine with a whole-cell killed vaccine in Malaysian Air Force recruits

Panchanathan V, Kumar S, Yeap W, Devi S, Ismail R, Sarijan S, et al.

Bull World Health Organ, 2001;79(9):811-7.
PMID: 11584728

To carry out a comparative study of the safety and immunogenicity of Vi polysaccharide vaccine against whole-cell killed (WCK) typhoid vaccine.
Pyrosequencing analysis of microbial community and food-borne bacteria on restaurant cutting boards collected in Seri Kembangan, Malaysia, and their correlation with grades of food premises

Abdul-Mutalib NA, Amin Nordin S, Osman M, Ishida N, Tashiro K, Sakai K, et al.

Int J Food Microbiol, 2015 May 4;200:57-65.
PMID: 25679309 DOI: 10.1016/j.ijfoodmicro.2015.01.022

This study adopts the pyrosequencing technique to identify bacteria present on 26 kitchen cutting boards collected from different grades of food premises around Seri Kembangan, a city in Malaysia. Pyrosequencing generated 452,401 of total reads of OTUs with an average of 1.4×10(7) bacterial cells/cm(2). Proteobacteria, Firmicutes and Bacteroides were identified as the most abundant phyla in the samples. Taxonomic richness was generally high with >1000 operational taxonomic units (OTUs) observed across all samples. The highest appearance frequencies (100%) were OTUs closely related to Enterobacter sp., Enterobacter aerogenes, Pseudomonas sp. and Pseudomonas putida. Several OTUs were identified most closely related to known food-borne pathogens, including Bacillus cereus, Cronobacter sakazaki, Cronobacter turisensis, Escherichia coli, E. coli O157:H7, Hafnia alvei, Kurthia gibsonii, Salmonella bongori, Salmonella enterica, Salmonella paratyphi, Salmonella tyhpi, Salmonella typhimurium and Yersinia enterocolitica ranging from 0.005% to 0.68% relative abundance. The condition and grade of the food premises on a three point cleanliness scale did not correlate with the bacterial abundance and type. Regardless of the status and grades, all food premises have the same likelihood to introduce food-borne bacteria from cutting boards to their foods and must always prioritize the correct food handling procedure in order to avoid unwanted outbreak of food-borne illnesses.
Fulltext Antibiotics for URTI and UTI -- prescribing in Malaysian primary care settings

Teng CL, Tong SF, Khoo EM, Lee V, Zailinawati AH, Mimi O, et al.

Aust Fam Physician, 2011 May;40(5):325-9.
PMID: 21597554

Background: Overprescription of antibiotics is a continuing problem in primary care. This study aims to assess the antibiotic prescribing rates and antibiotic choices for upper respiratory tract infections (URTI) and urinary tract infections (UTI) in Malaysian primary care.
Method: Antibiotic prescribing data for URTI and UTI was extracted from a morbidity survey of randomly selected primary care clinics in Malaysia.
Results: Analysis was performed of 1163 URTI and 105 UTI encounters. Antibiotic prescribing rates for URTI and UTI were 33.8% and 57.1% respectively. Antibiotic prescribing rates were higher in private clinics compared to public clinics for URTI, but not for UTI. In URTI encounters, the majority of antibiotics prescribed were penicillins and macrolides, but penicillin V was notably underused. In UTI encounters, the antibiotics prescribed were predominantly penicillins or cotrimoxazole.
Discussion: Greater effort is needed to bring about evidence based antibiotic prescribing in Malaysian primary care, especially for URTIs in private clinics.
Keywords: general practice, prescriptions, drug; upper respiratory tract infection; urinary tract infection; antibiotics, guideline; evidence based medicine
Study site: Klinik Kesihatan, Malaysia
Fulltext A persistent antimicrobial resistance pattern and limited methicillin-resistance-associated genotype in a short-term Staphylococcus aureus carriage isolated from a student population

Mat Azis N, Pung HP, Abdul Rachman AR, Amin Nordin S, Sarchio SNE, Suhaili Z, et al.

J Infect Public Health, 2017 Mar-Apr;10(2):156-164.
PMID: 27033676 DOI: 10.1016/j.jiph.2016.02.013

The aim of the present study was to assess and compare the antimicrobial susceptibility pattern against a panel of antibiotics and molecular and methicillin resistance-associated genotypes of 120 carriage S. aureus isolates previously isolated from a student population at two isolation events within a one-month interval. The antibiotic susceptibility of isolates was determined using the Kirby-Bauer disc-diffusion method (cefoxitin by Etest). The MRSA was screened using polymerase chain reaction for the presence of the mecA gene. The mecA-positive isolates were subjected to staphylococcal cassette chromosome (SCC) mec typing, multilocus sequence typing (MLST) and eBURST analysis. All isolates were characterized for the presence of the Panton-Valentine leukocidin (PVL) gene, an enterobacterial repetitive intergenic consensus-polymerase chain reaction (ERIC-PCR) pattern and the spa type. For the two occasions where S. aureus was isolated, the highest frequency of resistance was observed for penicillin (70% and 65%, respectively), with a lower rate against erythromycin and tetracycline (<12%). All isolates were susceptible to ciprofloxacin and gentamycin. As for methicillin resistance, eight isolates had minimum inhibitory concentrations (MIC) of resistant categories, but 10 isolates (8.33%) were positive for the mecA gene. The mecA-positive isolates belonged to SCCmec types I (n=9) and V (n=1). MLST was resolved for only three MRSAs, ST508 (n=1), ST88 (n=1) and ST96 (n=1). The results of the eBURST analysis showed that the MRSA isolates analyzed in the present study were potentially related to MRSA identified in other countries. Approximately half of the persistent S. aureus carriers harbored S. aureus of a similar spa type in the respective individuals during both isolation events. A persistent antimicrobial pattern and limited distinct MRSAs were observed over the short study period. The latter frequently exhibited SCCmec type I, commonly associated with hospital-acquired (HA) characteristics, but further delineation is needed to justify the origins of these bacteria.

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