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Fulltext Virulence Gene Profile, Antimicrobial Resistance and Multilocus Sequence Typing of Salmonella enterica Subsp. enterica Serovar Enteritidis from Chickens and Chicken Products

Zakaria Z, Hassan L, Sharif Z, Ahmad N, Mohd Ali R, Amir Husin S, et al.

Animals (Basel), 2022 Jan 01;12(1).
PMID: 35011203 DOI: 10.3390/ani12010097

This study was undertaken to determine the virulence, antimicrobial resistance and molecular subtypes of Salmonella in the Central Region of Peninsular Malaysia. A total of 45 Salmonella Enteritidis were detected from live chicken (cloacal swab), and chicken products (fresh and ready-to-eat meat) samples upon cultural isolation and serotyping. Similarly, an antimicrobial susceptibility test based on the Kirby Bauer disk diffusion method as well as antimicrobial resistance AMR genes, virulence determinants and multilocus sequence typing (MLST) typing were conducted after the Whole Genome Sequencing and analysis of the isolates. The results indicate that sequence types ST1925 (63.7%), and ST11 (26.5%) were the predominant out of the seven sequence types identified (ST292, ST329, ST365, ST423 and ST2132). The phenotypic antimicrobial profile corresponds to the genotypic characterization in that the majority of the isolates that exhibited tetracycline, gentamycin and aminoglycoside resistance; they also possessed the tetC and blaTEM β-Lactam resistance genes. However, isolates from cloacal swabs showed the highest number of resistance genes compared to the chicken products (fresh and ready-to-eat meat) samples. Furthermore, most of the virulence genes were found to cluster in the Salmonella pathogenicity island (SPI). In this study, all the isolates were found to possess SPI-1, which codes for the type III secretion system, which functions as actin-binding proteins (SptP and SopE). The virulence plasmid (VP) genes (spvB, spvC) were present in all genotypes except ST365. The findings of this study, particularly with regard to the molecular subtypes and AMR profiles of the Salmonella Enteritidis serotype shows multidrug-resistance features as well as genetic characteristics indicative of high pathogenicity.
Guinea pig genital tract lipidome reveals in vivo and in vitro regulation of phosphatidylcholine 16:0/18:1 and contribution to Chlamydia trachomatis serovar D infectivity

Wali S, Gupta R, Yu JJ, Mfuh A, Gao X, Guentzel MN, et al.

Metabolomics, 2016 Apr;12(4).
PMID: 27642272

INTRODUCTION: Chlamydia trachomatis (Ct), is the leading cause of sexually transmitted infections worldwide. Host transcriptomic- or proteomic profiling studies have identified key molecules involved in establishment of Ct infection or the generation of anti Ct-immunity. However, the contribution of the host metabolome is not known.
OBJECTIVES: The objective of this study was to determine the contribution of host metabolites in genital Ct infection.
METHODS: We used high-performance liquid chromatography-mass spectrometry, and mapped lipid profiles in genital swabs obtained from female guinea pigs at days 3, 9, 15, 30 and 65 post Ct serovar D intravaginal infection.
RESULTS: Across all time points assessed, 13 distinct lipid species including choline, ethanolamine and glycerol were detected. Amongst these metabolites, phosphatidylcholine (PC) was the predominant phospholipid detected from animals actively shedding bacteria i.e., at 3, 9, and 15 days post infection. However, at days 30 and 65 when the animals had cleared the infection, PC was observed to be decreased compared to previous time points. Mass spectrometry analyses of PC produced in guinea pigs (in vivo) and 104C1 guinea pig cell line (in vitro) revealed distinct PC species following Ct D infection. Amongst these, PC 16:0/18:1 was significantly upregulated following Ct D infection (p < 0.05, >twofold change) in vivo and in vitro infection models investigated in this report. Exogenous addition of PC 16:0/18:1 resulted in significant increase in Ct D in Hela 229 cells.
CONCLUSION: This study demonstrates a role for host metabolite, PC 16:0/18:1 in regulating genital Ct infection in vivo and in vitro.
Fulltext Quantification of Gait Stability During Incline and Decline Walking: The Responses of Required Coefficient of Friction and Dynamic Postural Index

Abdul Yamin NAA, Basaruddin KS, Abu Bakar S, Salleh AF, Mat Som MH, Yazid H, et al.

J Healthc Eng, 2022;2022:7716821.
PMID: 36275397 DOI: 10.1155/2022/7716821

This study aims to investigate the gait stability response during incline and decline walking for various surface inclination angles in terms of the required coefficient of friction (RCOF), postural stability index (PSI), and center of pressure (COP)-center of mass (COM) distance. A customized platform with different surface inclinations (0°, 5°, 7.5°, and 10°) was designed. Twenty-three male volunteers participated by walking on an inclined platform for each inclination. The process was then repeated for declined platform as well. Qualysis motion capture system was used to capture and collect the trajectories motion of ten reflective markers that attached to the subjects before being exported to a visual three-dimensional (3D) software and executed in Matlab to obtain the RCOF, PSI, as well as dynamic PSI (DPSI) and COP-COM distance parameters. According to the result for incline walking, during initial contact, the RCOF was not affected to inclination. However, it was affected during peak ground reaction force (GRF) starting at 7.5° towards 10° for both walking conditions. The most affected PSI was found at anterior-posterior PSI (APSI) even as low as 5° inclination during both incline and decline walking. On the other hand, DPSI was not affected during both walking conditions. Furthermore, COP-COM distance was most affected during decline walking in anterior-posterior direction. The findings of this research indicate that in order to decrease the risk of falling and manage the inclination demand, a suitable walking strategy and improved safety measures should be applied during slope walking, particularly for decline and anterior-posterior orientations. This study also provides additional understanding on the best incline walking technique for secure and practical incline locomotion.
Fulltext The high-affinity human IgG receptor Fc gamma receptor I (FcγRI) is not associated with vascular leakage of dengue

Mohamad Zamberi Z, Zakaria Z, Abdul Aziz AT, Heng BS, Zaid M, Chong CL, et al.

J Negat Results Biomed, 2015;14:1.
PMID: 25566870 DOI: 10.1186/s12952-014-0020-6

Dengue is a major public health problem in many tropical and sub-tropical countries. Vascular leakage and shock are identified as the major causes of deaths in patients with severe dengue. Studies have suggested the potential role of Fc gamma receptors I (FcγRI) in the pathogenesis of dengue. We hypothesized that the circulating level of Fcγ receptor I could potentially be used as an indicator in assisting early diagnosis of severe dengue.
Temporal proteomic profiling of Chlamydia trachomatis-infected HeLa-229 human cervical epithelial cells

Tan GM, Lim HJ, Yeow TC, Movahed E, Looi CY, Gupta R, et al.

Proteomics, 2016 05;16(9):1347-60.
PMID: 27134121 DOI: 10.1002/pmic.201500219

Chlamydia trachomatis is the leading causative agent of bacterial sexually transmitted infections worldwide which can lead to female pelvic inflammatory disease and infertility. A greater understanding of host response during chlamydial infection is essential to design intervention technique to reduce the increasing incidence rate of genital chlamydial infection. In this study, we investigated proteome changes in epithelial cells during C. trachomatis infection by using an isobaric tags for relative and absolute quantitation (iTRAQ) labeling technique coupled with a liquid chromatography-tandem mass spectrometry (LC-MS(3) ) analysis. C. trachomatis (serovar D, MOI 1)-infected HeLa-229 human cervical carcinoma epithelial cells (at 2, 4 and 8 h) showed profound modifications of proteome profile which involved 606 host proteins. MGST1, SUGP2 and ATXN10 were among the top in the list of the differentially upregulated protein. Through pathway analysis, we suggested the involvement of eukaryotic initiation factor 2 (eIF2) and mammalian target of rapamycin (mTOR) in host cells upon C. trachomatis infection. Network analysis underscored the participation of DNA repair mechanism during C. trachomatis infection. In summary, intense modifications of proteome profile in C. trachomatis-infected HeLa-229 cells indicate complex host-pathogen interactions at early phase of chlamydial infection.
Fulltext Seroprevalence report on tick-borne encephalitis virus and Crimean-Congo hemorrhagic fever virus among Malaysian's farm workers

Mohd Shukri M, Ling Kho K, Ghane Kisomi M, Lani R, Marlina S, Muhd Radzi SF, et al.

BMC Public Health, 2015;15:704.
PMID: 26205588 DOI: 10.1186/s12889-015-1901-4

Tick-borne encephalitis virus (TBEV) and Crimean-Congo haemorrhagic fever virus (CCHFV) are important tick-borne viruses. Despite their wide geographical distribution and ease of acquisition, the prevalence of both viruses in Malaysia is still unknown. This study was conducted to determine the seroprevalence for TBEV and CCHFV among Malaysian farm workers as a high-risk group within the population.
Fulltext Antiviral activity of silymarin against chikungunya virus

Lani R, Hassandarvish P, Chiam CW, Moghaddam E, Chu JJ, Rausalu K, et al.

Sci Rep, 2015;5:11421.
PMID: 26078201 DOI: 10.1038/srep11421

The mosquito-borne chikungunya virus (CHIKV) causes chikungunya fever, with clinical presentations such as severe back and small joint pain, and debilitating arthritis associated with crippling pains that persist for weeks and even years. Although there are several studies to evaluate the efficacy of drugs against CHIKV, the treatment for chikungunya fever is mainly symptom-based and no effective licensed vaccine or antiviral are available. Here, we investigated the antiviral activity of three types of flavonoids against CHIKV in vitro replication. Three compounds: silymarin, quercetin and kaempferol were evaluated for their in vitro antiviral activities against CHIKV using a CHIKV replicon cell line and clinical isolate of CHIKV of Central/East African genotype. A cytopathic effect inhibition assay was used to determine their activities on CHIKV viral replication and quantitative reverse transcription PCR was used to calculate virus yield. Antiviral activity of effective compound was further investigated by evaluation of CHIKV protein expression using western blotting for CHIKV nsP1, nsP3, and E2E1 proteins. Briefly, silymarin exhibited significant antiviral activity against CHIKV, reducing both CHIKV replication efficiency and down-regulating production of viral proteins involved in replication. This study may have important consequence for broaden the chance of getting the effective antiviral for CHIKV infection.
Fulltext Prevalence of plasmid-bearing and plasmid-free Chlamydia trachomatis infection among women who visited obstetrics and gynecology clinics in Malaysia

Yeow TC, Wong WF, Sabet NS, Sulaiman S, Shahhosseini F, Tan GM, et al.

BMC Microbiol, 2016 Mar 18;16:45.
PMID: 26987367 DOI: 10.1186/s12866-016-0671-1

BACKGROUND: The 7.5 kb cryptic plasmid of Chlamydia trachomatis has been shown to be a virulence factor in animal models, but its significance in humans still remains unknown. The aim of this study was to investigate the prevalence and potential involvement of the C. trachomatis cryptic plasmid in causing various clinical manifestations; including infertility, reproductive tract disintegrity, menstrual disorder, and polycystic ovarian syndrome (PCOS) among genital C. trachomatis-infected patients.
RESULTS:A tot l of 180 female patients of child bearing age (mean 30.9 years old, IQR:27-35) with gynecological complications and subfertility issues, who visited Obstetrics and Gynecology clinics in Kuala Lumpur, Malaysia were recruited for the study. Prevalence of genital chlamydial infection among these patients was alarmingly high at 51.1% (92/180). Of the 92 chlamydia-infected patients, 93.5% (86/92) were infected with plasmid-bearing (+) C. trachomatis while the remaining 6.5% (6/92) were caused by the plasmid-free (-) variant. Our data showed that genital C. trachomatis infection was associated with infertility issues, inflammation in the reproductive tract (mucopurulent cervicitis or endometriosis), irregular menstrual cycles and polycystic ovarian syndrome (PCOS). However, no statistical significance was detected among patients with plasmid (+) versus plasmid (-) C. trachomatis infection. Interestingly, plasmid (+) C. trachomatis was detected in all patients with PCOS, and the plasmid copy numbers were significantly higher among PCOS patients, relative to non-PCOS patients.
CONCLUSION: Our findings show a high incidence of C. trachomatis infection among women with infertility or gynecological problems in Malaysia. However, due to the low number of plasmid (-) C. trachomatis cases, a significant role of the plasmid in causing virulence in human requires further investigation of a larger cohort.
KEYWORDS: Chlamydia trachomatis; Infertility; Plasmid; Reproductive system disorders
Study site: Obstetrics and Gynecology clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
Erratum: prevalence of plasmid-bearing and plasmid-free chlamydia trachomatis infection among women who visited obstetrics and gynecology clinics in Malaysia

Yeow TC, Wong WF, Sabet NS, Sulaiman S, Shahhosseini F, Tan GM, et al.

BMC Microbiol, 2016 May 23;16(1):95.
PMID: 27215275
Electrochemical exfoliation of graphite in nanofibrillated kenaf cellulose (NFC)/surfactant mixture for the development of conductive paper

Ardyani T, Mohamed A, Abu Bakar S, Sagisaka M, Umetsu Y, Hafiz Mamat M, et al.

Carbohydr Polym, 2020 Jan 15;228:115376.
PMID: 31635739 DOI: 10.1016/j.carbpol.2019.115376

The effect of incorporating common dodecyl anionic and cationic surfactants such as dodecyltrimethylammonium bromide (DTAB), dodecylethyldimethylammonium bromide (DDAB), and sodium dodecylsulfate (SDS) in nanocomposites of reduced graphene oxide and nanocellulose are described. The stabilization and electrical properties of the nanocomoposites of reduced graphene oxide (RGO) and nanofibrillated kenaf cellulose (NFC) were characterized using four-point probe electrical conductivity measurements. Raman spectroscopy, field emission scanning electron microscopy, and high-resolution transmission electron microscopy were used to investigate dispersion morphology and the quality of RGO inside the NFC matrices. Small-angle neutron scattering (SANS) was used to study the aggregation behavior of the aqueous surfactant systems and RGO dispersions. The cationic surfactant DTAB proved to be the best choice for stabilization of RGO in NFC, giving enhanced electrical conductivity five orders of magnitude higher than the neat NFC. The results highlight the effects of hydrophilic surfactant moieties on the structure, stability and properties of RGO/NFC composites.
Highly branched triple-chain surfactant-mediated electrochemical exfoliation of graphite to obtain graphene oxide: colloidal behaviour and application in water treatment

Jamaluddin NA, Mohamed A, Abu Bakar S, Ardyani T, Sagisaka M, Suhara S, et al.

Phys Chem Chem Phys, 2020 Jun 14;22(22):12732-12744.
PMID: 32462145 DOI: 10.1039/d0cp01243b

The generation of surfactant-assisted exfoliated graphene oxide (sEGO) by electrochemical exfoliation is influenced by the presence of surfactants, and in particular the hydrophobic tail molecular-architecture. Increasing surfactant chain branching may improve the affinity for the graphite surfaces to provide enhanced intersheet separation and stabilisation of exfoliated sheets. The resulting sEGO composites can be readily used to remove of a model pollutant, the dye, methylene blue (MB), from aqueous solutions by providing abundant sites for dye adsorption. This article explores relationships between surfactant structure and the performance of sEGO for MB adsorption. Double-branched and highly branched triple-chain graphene-compatible surfactants were successfully synthesised and characterised by 1H NMR spectroscopy. These surfactants were used to produce sEGO via electrochemical exfoliation of graphite, and the sEGOs generated were further utilised in batch adsorption studies of MB from aqueous solutions. The properties of these synthesised surfactants were compared with those of a common single-chain standard surfactant, sodium dodecyl-sulfate (SDS). The structural morphology of sEGO was assessed using Raman spectroscopy and field emission scanning electron microscopy (FESEM). To reveal the links between the hydrophobic chain structure and the sEGO adsorption capacity, UV-visible spectroscopy, zeta potential, and air-water (a/w) surface tension measurements were conducted. The aggregation behaviour of the surfactants was studied using small-angle neutron scattering (SANS). The highly branched triple-chain surfactant sodium 1,4-bis(neopentyloxy)-3-(neopentylcarbonyl)-1,4-dioxobutane-2-sulfonate (TC14) displayed enhanced exfoliating efficiency compared to those of the single-and double-chain surfactants, leading to ∼83% MB removal. The findings suggest that highly branched triple-chain surfactants are able to offer more adsorption sites, by expanding the sEGO interlayer gap for MB adsorption, compared to standard single-chain surfactants.
Fulltext Optimization of a High-Performance Poly(diallyl dimethylammonium chloride)-alumina-perfluorooctanoate Intercalated Ultrafiltration Membrane for Treating Emulsified Oily Wastewater via Response Surface Methodology Approach

Raji YO, Othman MHD, Nordin NAHSM, Adam MR, Said KAM, Abdulyekeen KA, et al.

Membranes (Basel), 2021 Dec 01;11(12).
PMID: 34940457 DOI: 10.3390/membranes11120956

This research aimed to investigate the ultrafiltration of water from emulsified oily wastewater through the application of surface-functionalized ceramic membrane to enhance its water permeability based on optimized parameters using a cross-flow filtration system. The interactive effects of feed concentration (10-1000 ppm), pH (4-10), and pressure (0-3 bar) on the water flux and oil rejection were investigated. Central composite design (CCD) from response surface methodology (RSM) was employed for statistical analysis, modeling, and optimization of operating conditions. The analysis of variance (ANOVA) results showed that the oil rejection and water flux models were significant with p-values of 0.0001 and 0.0075, respectively. In addition, good correlation coefficients of 0.997 and 0.863 were obtained for the oil rejection and water flux models, respectively. The optimum conditions for pressure, pH, and feed concentration were found to be 1.5 bar, pH 8.97, and 10 ppm, respectively with water flux and oil rejection maintained at 152 L/m2·h and 98.72%, respectively. Hence, the functionalized ultrafiltration ceramic membrane enables the separation efficiency of the emulsified oil in water to be achieved.
Rational design of aromatic surfactants for graphene/natural rubber latex nanocomposites with enhanced electrical conductivity

Mohamed A, Ardyani T, Abu Bakar S, Sagisaka M, Umetsu Y, Hamon JJ, et al.

J Colloid Interface Sci, 2018 Apr 15;516:34-47.
PMID: 29360058 DOI: 10.1016/j.jcis.2018.01.041

HYPOTHESIS: Graphene nanoplatelets (GNPs) can be dispersed in natural rubber matrices using surfactants. The stability and properties of these composites can be optimized by the choice of surfactants employed as stabilizers. Surfactants can be designed and synthesized to have enhanced compatibility with GNPs as compared to commercially available common surfactants. Including aromatic groups in the hydrophobic chain termini improves graphene compatibility of surfactants, which is expected to increase with the number of aromatic moieties per surfactant molecule. Hence, it is of interest to study the relationship between molecular structure, dispersion stability and electrical conductivity enhancement for single-, double-, and triple-chain anionic graphene-compatible surfactants.
EXPERIMENTS: Graphene-philic surfactants, bearing two and three chains phenylated at their chain termini, were synthesized and characterized by proton nuclear magnetic resonance (1H NMR) spectroscopy. These were used to formulate and stabilize dispersion of GNPs in natural rubber latex matrices, and the properties of systems comprising the new phenyl-surfactants were compared with commercially available surfactants, sodium dodecylsulfate (SDS) and sodium dodecylbenzenesulfonate (SDBS). Raman spectroscopy, field emission scanning electron microscopy (FESEM), atomic force microscopy (AFM), and high-resolution transmission electron microscopy (HRTEM) were used to study structural properties of the materials. Electrical conductivity measurements and Zeta potential measurements were used to assess the relationships between surfactant architecture and nanocomposite properties. Small-angle neutron scattering (SANS) was used to study self-assembly structure of surfactants.
FINDINGS: Of these different surfactants, the tri-chain aromatic surfactant TC3Ph3 (sodium 1,5-dioxo-1,5-bis(3-phenylpropoxy)-3-((3phenylpropoxy)carbonyl) pentane-2-sulfonate) was shown to be highly graphene-compatible (nanocomposite electrical conductivity = 2.22 × 10-5 S cm-1), demonstrating enhanced electrical conductivity over nine orders of magnitude higher than neat natural rubber-latex matrix (1.51 × 10-14 S cm-1). Varying the number of aromatic moieties in the surfactants appears to cause significant differences to the final properties of the nanocomposites.
Carbon nanotubes from waste cooking palm oil as adsorbent materials for the adsorption of heavy metal ions

Abu Bakar S, Jusoh N, Mohamed A, Muqoyyanah M, Othman MHD, Mamat MH, et al.

Environ Sci Pollut Res Int, 2021 Dec;28(46):65171-65187.
PMID: 34231144 DOI: 10.1007/s11356-021-14918-y

In this work, waste cooking palm oil (WCPO)-based carbon nanotubes (CNTs) with encapsulated iron (Fe) nanoparticles have been successfully produced via modified thermal chemical vapor deposition method. Based on several characterizations, the dense WCPO-based CNT was produced with high purity of 89% and high crystallinity proven by low ID/IG ratio (0.43). Moreover, the ferromagnetic response of CNTs showed that the average coercivity and magnetization saturation were found to be 551.5 Oe and 13.4 emu/g, respectively. These produced WCPO-based CNTs were further used as heavy metal ions adsorbent for wastewater treatment application. Some optimizations, such as the effect of different adsorbent dosage, varied initial pH solution, and various heavy metal ions, were investigated. The adsorption studies showed that the optimum adsorbent dosage was 1.8 g/L when it was applied to 100 mg/L Cu (II) solution at neutral pH (pH 7). Further measurement then showed that high Cu (II) ion removal percentage (~80%) was achieved when it was applied at very acidic solution (pH 2). Last measurement confirmed that the produced WCPO-based CNTs successfully removed different heavy metal ions in the following order: Fe (II) > Zn (II) ≈ Cu (II) with the removal percentage in the range of 99.2 to 99.9%. The adsorption isotherm for Cu (II) was better fitted by Langmuir model with a correlation coefficient of 0.82751. WCPO-based CNTs can be a potential material to be applied as adsorbent in heavy metal ion removal.
Fulltext A comparison of assays for accurate copy number measurement of the low-affinity Fc gamma receptor genes FCGR3A and FCGR3B

Haridan US, Mokhtar U, Machado LR, Abdul Aziz AT, Shueb RH, Zaid M, et al.

PLoS One, 2015;10(1):e0116791.
PMID: 25594501 DOI: 10.1371/journal.pone.0116791

The FCGR3 locus encoding the low affinity activating receptor FcγRIII, plays a vital role in immunity triggered by cellular effector and regulatory functions. Copy number of the genes FCGR3A and FCGR3B has previously been reported to affect susceptibility to several autoimmune diseases and chronic inflammatory conditions. However, such genetic association studies often yield inconsistent results; hence require assays that are robust with low error rate. We investigated the accuracy and efficiency in estimating FCGR3 CNV by comparing Sequenom MassARRAY and paralogue ratio test-restriction enzyme digest variant ratio (PRT-REDVR). In addition, since many genetic association studies of FCGR3B CNV were carried out using real-time quantitative PCR, we have also included the evaluation of that method's performance in estimating the multi-allelic CNV of FCGR3B. The qPCR assay exhibited a considerably broader distribution of signal intensity, potentially introducing error in estimation of copy number and higher false positive rates. Both Sequenom and PRT-REDVR showed lesser systematic bias, but Sequenom skewed towards copy number normal (CN = 2). The discrepancy between Sequenom and PRT-REDVR might be attributed either to batch effects noise in individual measurements. Our study suggests that PRT-REDVR is more robust and accurate in genotyping the CNV of FCGR3, but highlights the needs of multiple independent assays for extensive validation when performing a genetic association study with multi-allelic CNVs.
Fulltext A multicentre study to determine the in vitro efficacy of flomoxef against extended-spectrum beta-lactamase producing Escherichia coli in Malaysia

Yap PSX, Chong CW, Ponnampalavanar S, Ramli R, Harun A, Tengku Jamaluddin TZM, et al.

PeerJ, 2023;11:e16393.
PMID: 38047021 DOI: 10.7717/peerj.16393

BACKGROUND: The high burden of extended-spectrum beta-lactamase-producing (ESBL)-producing Enterobacterales worldwide, especially in the densely populated South East Asia poses a significant threat to the global transmission of antibiotic resistance. Molecular surveillance of ESBL-producing pathogens in this region is vital for understanding the local epidemiology, informing treatment choices, and addressing the regional and global implications of antibiotic resistance.
METHODS: Therefore, an inventory surveillance of the ESBL-Escherichia coli (ESBL-EC) isolates responsible for infections in Malaysian hospitals was conducted. Additionally, the in vitro efficacy of flomoxef and other established antibiotics against ESBL-EC was evaluated.
RESULTS: A total of 127 non-repetitive ESBL-EC strains isolated from clinical samples were collected during a multicentre study performed in five representative Malaysian hospitals. Of all the isolates, 33.9% were isolated from surgical site infections and 85.8% were hospital-acquired infections. High rates of resistance to cefotaxime (100%), cefepime (100%), aztreonam (100%) and trimethoprim-sulfamethoxazole (100%) were observed based on the broth microdilution test. Carbapenems remained the most effective antibiotics against the ESBL-EC, followed by flomoxef. Antibiotic resistance genes were identified by PCR. The blaCTX-M-1 was the most prevalent ESBL gene, with 28 isolates (22%) harbouring blaCTX-M-1 only, 27 isolates (21.3%) co-harbouring blaCTX-M-1 and blaTEM, and ten isolates (7.9%) co-harbouring blaCTX-M-1, blaTEM and blaSHV. A generalised linear model showed significant antibacterial activity of imipenem against different types of infection. Besides carbapenems, this study also demonstrated a satisfactory antibacterial activity of flomoxef (81.9%) on ESBL-EC, regardless of the types of ESBL genes.

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