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Non-typhoid Salmonella gastroenteritis

Lee WS, Puthucheary SD, Boey CC

J Paediatr Child Health, 1998 Aug;34(4):387-90.
PMID: 9727185

OBJECTIVE: To study the clinical features of non-typhoid Salmonella gastroenteritis and the incidence, risk factors and outcome of invasive complications in urban Malaysian children. To describe the serotypes of Salmonella species isolated and the pattern of antibiotic susceptibility.
METHODOLOGY: Retrospective review of a group of 131 children with non-typhoid Salmonella gastroenteritis seen at the University Hospital, Kuala Lumpur, Malaysia from January 1994 to December 1996.
RESULTS: Sixty-seven percent were infants below one year of age. Fever and vomiting were seen in nearly half of children. Seven children (5.3%) had invasive complications: 5 bacteraemia and 2 meningitis. Age below 6 months, fever > 38.0 degrees C, and dehydration on admission were significantly associated with invasive complications. The commonest serotypes isolated were S. enteritidis, S. paratyphi B, and S. bovis-morbificans. A total of 94-100% of isolates were susceptible to commonly prescribed antibiotics.
CONCLUSIONS: Children with Salmonella gastroenteritis below 6 months of age who are febrile and dehydrated should be treated empirically with antibiotics until the result of blood culture is available.

Matched MeSH terms: Microbial Sensitivity Tests
Retropharyngeal abscess: recent trends

Sharma HS, Kurl DN, Hamzah M

Auris Nasus Larynx, 1998 Dec;25(4):403-6.
PMID: 9853664

Retropharyngeal abscess (RPA) is relatively rare today. A study of 17 cases of RPA treated at our hospital in the past 10 years showed a shift in the disease from children below 6 years of age (41%) to older children and adults (58%). Upper respiratory tract infection (URTI) was found to be the commonest (52%) aetiological predisposing factor in all age groups. Other aetiological factors were septicaemia (11%) in children below the age of 6 years and trauma due to foreign body (35%) in the older children and adult age groups. Klebsiella, Staphylococcus and Streptococcus were the commonest species of microorganisms grown from pus. The changing clinical trends, microbiology, choice of antibiotics, usefulness of radiology, and complications of this potentially fatal illness are discussed.

Matched MeSH terms: Microbial Sensitivity Tests
Resistance in gonococci isolated in the WHO Western Pacific Region to various antimicrobials used in the treatment of gonorrhoea, 1997. WHO Western Pacific Gonococcal Antimicrobial Surveillance Programme-WHO WPR GASP

Commun. Dis. Intell., 1998 Dec 24;22(13):288-91.
PMID: 9893340

The World Health Organization Western Pacific Region Gonococcal Antimicrobial Surveillance Programme (WHO WPR GASP) is a multicentric long term programme of continuous surveillance of the antibiotic susceptibility of Neisseria gonorrhoeae. In 1997 the programme examined the susceptibility of 8,594 isolates of gonococci to various antimicrobials in 15 focal points. The trend toward increased antimicrobial resistance noted in earlier years continued. The proportion of quinolone resistant gonococci reported from most centres was either maintained or else increased. More than half of the isolates tested in China-Hong Kong, China, Japan, Korea, and the Philippines had altered quinolone susceptibility and increases in the number and percentage of quinolone resistant strains were noted in most, but not all, of the other centres. Resistance to the penicillins was again widespread, and chromosomally mediated resistance was a significant factor. Penicillinase-producing Niesseria gonorrhoeae (PPNG) were present in all centres. All isolates were sensitive to the third generation cephalosporins and only a very few isolates in China were spectinomycin resistant. High level tetracycline resistance was concentrated in a number of centres including Singapore, Malaysia, the Philippines and Vietnam. The proportion of tetracycline resistant Neiserria gonorrhoeae (TRNG) in most of the remaining centres was less than 10 per cent.

Matched MeSH terms: Microbial Sensitivity Tests
Epidemiology of Streptococcus pneumoniae infection in Malaysia

Rohani MY, Raudzah A, Ng AJ, Ng PP, Zaidatul AA, Asmah I, et al.

Epidemiol Infect, 1999 Feb;122(1):77-82.
PMID: 10098788

During a 1-year period from October 1995 to September 1996, 273 isolations of Streptococcus pneumoniae were made from various types of clinical specimens. The majority of the isolates (39.2%) were from sputum whilst 27.5% were from blood, CSF and other body fluids. The organism was isolated from patients of all age groups, 31.1% from children aged 10 years and below, 64.7% of which come from children aged 2 years or below. The majority of the isolates belong to serotypes 1, 6B, 19B, 19F and 23F. Serotypes 1 and 19B were the most common serotypes associated with invasive infection. About 71.9% of the invasive infections were due to serotypes included in the available 23 valent polysaccharide vaccine. The rates of resistance to penicillin and erythromycin were 7.0 and 1.1% respectively. Our findings show that the serotypes of S. pneumoniae causing most invasive infections in Malaysia are similar to those in other parts of the world and the available vaccine may have a useful role in this population.

Matched MeSH terms: Microbial Sensitivity Tests
Antibiotics in chronic suppurative otitis media: a bacteriologic study

Indudharan R, Haq JA, Aiyar S

Ann Otol Rhinol Laryngol, 1999 May;108(5):440-5.
PMID: 10335703

Conservative medical management of chronic suppurative otitis media (CSOM) is an important step in achieving a dry ear. Topical antibiotic ear drops and aural toilet form the mainstay of medical management of noncholesteatomatous CSOM. This study analyzes the causal organisms and their sensitivity to various antibiotics. Out of 382 swabs examined, the major organisms isolated were Pseudomonas aeruginosa (27.2%), followed by Staphylococcus aureus (23.6%). The sensitivity of P. aeruginosa was 100% to ceftazidime, 98.9% to ciprofloxacin, 96.3% to gentamicin, and 95.4% to polymyxin B, whereas the sensitivity of S. aureus was 98.6% to ciprofloxacin, 97.4% to cloxacillin sodium, 96.5% to cotrimoxazole, and 90.7% to gentamicin. Pseudomonas aeruginosa was almost completely resistant to ampicillin (97.6%) and chloramphenicol (96.6%), whereas S. aureus was almost completely resistant to ampicillin (73.8%) and polymyxin B (98.3%). Among the available topical antibiotic preparations for use in the ear, we found that ciprofloxacin and gentamicin are the best choices.

Matched MeSH terms: Microbial Sensitivity Tests*
Spread of drug-resistant Streptococcus pneumoniae in Asian countries: Asian Network for Surveillance of Resistant Pathogens (ANSORP) Study

Song JH, Lee NY, Ichiyama S, Yoshida R, Hirakata Y, Fu W, et al.

Clin Infect Dis, 1999 Jun;28(6):1206-11.
PMID: 10451154

Antimicrobial susceptibility of 996 isolates of Streptococcus pneumoniae from clinical specimens was investigated in 11 Asian countries from September 1996 to June 1997. Korea had the greatest frequency of nonsusceptible strains to penicillin with 79.7%, followed by Japan (65.3%), Vietnam (60.8%), Thailand (57.9%), Sri Lanka (41.2%), Taiwan (38.7%), Singapore (23.1%), Indonesia (21.0%), China (9.8%), Malaysia (9.0%), and India (3.8%). Serotypes 23F and 19F were the most common. Pulsed-field gel electrophoresis (PFGE) of 154 isolates from Asian countries showed several major PFGE patterns. The serotype 23F Spanish clone shared the same PFGE pattern with strains from Korea, Japan, Singapore, Taiwan, Thailand, and Malaysia. Fingerprinting analysis of pbp1a, pbp2x, and pbp2b genes of 12 strains from six countries also showed identical fingerprints of penicillin-binding protein genes in most strains. These data suggest the possible introduction and spread of international epidemic clones into Asian countries and the increasing problems of pneumococcal drug resistance in Asian countries for the first time.

Matched MeSH terms: Microbial Sensitivity Tests
Isolation and molecular characterization of vancomycin-resistant Enterococcus faecium in Malaysia

Son R, Nimita F, Rusul G, Nasreldin E, Samuel L, Nishibuchi M

Lett Appl Microbiol, 1999 Aug;29(2):118-22.
PMID: 10499300

Nineteen strains of vancomycin-resistant Enterococcus faecium isolated from 10 of 75 (13.3%) tenderloin beef samples were examined for resistance to selected antibiotics, presence of plasmids, and genetic diversity by random amplification of polymorphic DNA analysis. All strains showed multiple resistant to the antibiotics tested. Multiple antibiotic indexing of the vancomycin-resistant E. faecium strains showed that all (100%) originated from high risk contamination environments where antibiotics were often used. Plasmids ranging in size from 1.5 to 36 megadalton were detected in 15 of 19 (79%) strains. Thus, three plasmid profiles and eight antibiotypes were observed among the E. faecium strains. A high degree of polymorphism was obtained by combining the results of the two primers used; with the 19 E. faecium strains being differentiated into 19 RAPD-types. These preliminary results suggest that RAPD-PCR has application for epidemiologic studies and that resistance patterns and plasmid profiling could be used as an adjunct to RAPD for the typing of E. faecium in the study area.

Matched MeSH terms: Microbial Sensitivity Tests
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: Microbial Sensitivity Tests
Molecular characterization of Vibrio cholerae O1 and non-O1 from human and environmental sources in Malaysia

Radu S, Ho YK, Lihan S, Yuherman, Rusul G, Yasin RM, et al.

Epidemiol Infect, 1999 Oct;123(2):225-32.
PMID: 10579441

A total of 31 strains of Vibrio cholerae O1 (10 from outbreak cases and 7 from surface water) and non-O1 (4 from clinical and 10 from surface water sources) isolated between 1993 and 1997 were examined with respect to presence of cholera enterotoxin (CT) gene by PCR-based assays, resistance to antibiotics, plasmid profiles and random amplified polymorphic DNA (RAPD) analysis. All were resistant to 9 or more of the 17 antibiotics tested. Identical antibiotic resistance patterns of the isolates may indicate that they share a common mode of developing antibiotic resistance. Furthermore, the multiple antibiotic resistance indexing showed that all strains tested originated from high risk contamination. Plasmid profile analysis by agarose gel electrophoresis showed the presence of small plasmids in 12 (7 non-O1 and 5 O1 serotypes) with sizes ranging 1.3-4.6 MDa. The CT gene was detected in all clinical isolates but was present in only 14 (6 O1 serotype and 8 non-O1 serotype) isolates from environmental waters. The genetic relatedness of the clinical and environmental Vibrio cholerae O1 and non-O1 strains was investigated by RAPD fingerprinting with four primers. The four primers generated polymorphisms in all 31 strains of Vibrio cholerae tested, producing bands ranging from < 250 to 4500 bp. The RAPD profiles revealed a wide variability and no correlation with the source of isolation. This study provides evidence that Vibrio cholerae O1 and non-O1 have significant public health implications.

Matched MeSH terms: Microbial Sensitivity Tests
In vitro evaluation of cefepime and other broad-spectrum beta-lactams for isolates in Malaysia and Singapore medical centers. The Malaysia/Singapore Antimicrobial Resistance Study Group

Biedenbach DJ, Lewis MT, Jones RN

Diagn Microbiol Infect Dis, 1999 Dec;35(4):277-83.
PMID: 10668586

The degree of activity of several beta-lactam antimicrobial agents was assessed in Malaysia (four medical centers) and Singapore (two medical centers) tested against 570 clinical isolates. The organisms were tested locally by the Etest (AB BIODISK, Solna, Sweden) method, validated by concurrent use of quality assurance strains (94.1% accurate performance overall). Ten groups of bacteria were tested against cefepime, cefpirome, ceftazidime, ceftriaxone, piperacillin/tazobactam, oxacillin, and imipenem. Among the tested Escherichia coli and Klebsiella spp., the occurrence of extended spectrum beta-lactamase-producing phenotypes was 5.6-7.0% and 36.7-38.0%, respectively. These strains remained most susceptible (97.5-100.0%) to cefepime and imipenem. Ceftazidime-resistant Enterobacter spp. (21.4% resistant), Citrobacter spp. (15.0%), indole-positive Proteus spp. (6.0%), and Serratia spp. (9.7%) were not resistant to cefepime, and only one strain was resistant to imipenem. Imipenem was generally most potent against non-fermentative Gram-negative bacilli such as Acinetobacter spp. and Pseudomonas aeruginosa. All tested beta-lactams were active against the oxacillin-susceptible staphylococci, except ceftazidime (MIC90, 12 micrograms/mL; 63.2-84.8% susceptibility rates). Overall spectrums of activity (rank by % resistance) favored imipenem (3.5%) > cefepime (7.7%) > cefpirome (8.9%) > piperacillin/tazobactam (13.2%) > ceftriaxone (14.7%) > ceftazidime (16.9%). No significant differences in resistance patterns were noted between monitored nations, and these results indicate emerging, elevated rates of resistance versus the studied broad-spectrum beta-lactams in Malaysia and Singapore. Results provide benchmark data for future studies using quantitative methods to determine antimicrobial resistance in these geographic areas.

Matched MeSH terms: Microbial Sensitivity Tests
In-vitro susceptibilities of Streptococcus pneumoniae strains isolated in Malaysia to six antibiotics

Rohani MY, Parasakthi N, Raudzah A, Yasim MY

J Antimicrob Chemother, 1999 Dec;44(6):852-3.
PMID: 10590295
Matched MeSH terms: Microbial Sensitivity Tests
Anticandidal and antidermatophytic activity of Cinnamomum species essential oils

Mastura M, Nor Azah MA, Khozirah S, Mawardi R, Manaf AA

Cytobios, 1999;98(387):17-23.
PMID: 10490360
Matched MeSH terms: Microbial Sensitivity Tests
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: Microbial Sensitivity Tests
Plant-derived and semi-synthetic calanolide compounds with in vitro activity against both human immunodeficiency virus type 1 and human cytomegalovirus

Xu ZQ, Kern ER, Westbrook L, Allen LB, Buckheit RW, Tseng CK, et al.

Antivir Chem Chemother, 2000 Jan;11(1):23-9.
PMID: 10693651

Plant-derived and semi-synthetic calanolide compounds with anti-human immunodeficiency virus type 1 (HIV-1) activity were tested for anti-human cytomegalovirus (HCMV) activity in both cytopathic effect inhibition and plaque reduction assays. The results indicated that the anti-HCMV activity of calanolide compounds does not correlate with their activity against HIV-1. The semi-synthetic 12-keto derivatives tended to be more active against HCMV than the corresponding 12-OH congeners, which were more active against HIV-1. It appeared that the 7,8-unsaturated double bond in the chromene ring played a certain role in maintaining activities against both HCMV and HIV-1. Saturation of the double bond increased the EC50 values against both viruses, with concomitant increase in toxicity. The calanolide compounds reported here are the first non-nucleoside analogues capable of inhibiting both HIV-1 and HCMV and, therefore, may be useful chemoprophylactic agents for HCMV in HIV-infected people or vice versa.

Matched MeSH terms: Microbial Sensitivity Tests
Fulltext A case of primary drug resistant tuberculosis

Jeyakumar D

Med J Malaysia, 2000 Mar;55(1):129-31.
PMID: 11072497

A young man presented with primary multi-drug resistant tuberculosis. The institution of second-line regimes with insufficient efficacy due to clinical inexperience, unreliable sensitivity reports and the inavailability of second-line drugs led to the development of an organism that was resistant to ten anti-tuberculous drugs. Accurate sensitivity testing done in an overseas laboratory enabled the institution of a six-drug regimen that has resulted in clinical cure.

Matched MeSH terms: Microbial Sensitivity Tests
Fulltext Tetracycline resistant cholera in Kelantan

Ranjit K, Nurahan M

Med J Malaysia, 2000 Mar;55(1):143-5.
PMID: 11072502 MyJurnal

Sensitivity testing on Vibrio cholerae isolates during an epidemic in 1998 in Kelantan identified strains resistant to tetracycline. This prompted a change in the usual management of cholera in Kelantan. The antibiotic of choice was changed from tetracycline to erythromycin.

Matched MeSH terms: Microbial Sensitivity Tests
Analysis of plasmid and chromosomal DNA of multidrug-resistant Salmonella enterica serovar typhi from Asia

Mirza S, Kariuki S, Mamun KZ, Beeching NJ, Hart CA

J Clin Microbiol, 2000 Apr;38(4):1449-52.
PMID: 10747124

Molecular analysis of chromosomal DNA from 193 multidrug-resistant (MDR) Salmonella enterica serovar Typhi isolates from 1990 to 1995 from Pakistan, Kuwait, Malaysia, Bangladesh, and India produced a total of five major different pulsed-field gel electrophoresis (PFGE) patterns. Even within a particular country MDR S. enterica serovar Typhi DNA was found to be in different PFGE groups. Similar self-transferable 98-MDa plasmids belonging to either incompatibility group incHI1 or incHI1/FIIA were implicated in the MDR phenotype in S. enterica serovar Typhi isolates from all the locations except Quetta, Pakistan, where the majority were of incFIA. A total of five different PFGE genotypes with six different plasmids, based on incompatibility and restriction endonuclease analysis groups, were found among these MDR S. enterica serovar Typhi isolates.

Matched MeSH terms: Microbial Sensitivity Tests
Antimicrobial susceptibility of bifidobacteria

Yazid AM, Ali AM, Shuhaimi M, Kalaivaani V, Rokiah MY, Reezal A

Lett Appl Microbiol, 2000 Jul;31(1):57-62.
PMID: 10886616

Eighteen Bifidobacterium strains were tested for their susceptibility to a range of antimicrobial agents. All the strains tested, including the reference culture Lactobacillus acidophilus CH2, were susceptible to several groups of antimicrobial agents, they were cephalosporin (cefamandole, cefazolin, cefaperazone, cefoxitin), polypeptide (bacitracin), macrolide (erythromycin), penicillin (amoxicillin), phenicol (chloramphenicol) and beta-lactam (imipenem). Fourteen strains were resistant to more than 10 antibiotics. The reference culture was resistant to only three antibiotics. The results showed that bifidobacteria are resistant to a wide range of antimicrobial agents.

Matched MeSH terms: Microbial Sensitivity Tests
Efficacy of a 1-week pantoprazole triple therapy in eradicating Helicobacter pylori in Asian patients

Goh K, Parasakthi N, Cheah P, Ranjeev C, Rosmawati M, Tan Y, et al.

J Gastroenterol Hepatol, 2000 Aug;15(8):910-4.
PMID: 11022833

BACKGROUND: The aim of the present paper was to determine the efficacy and tolerability of a 1-week treatment regimen consisting of pantoprazole and two antibiotics: clarithromycin and amoxycillin, in the eradication of Helicobacter pylori.
METHODS: The patients selected had unequivocal evidence of H. pylori infection based on urease test, culture and histology on antral and corpus biopsies obtained at endoscopy. Patients received pantoprazole 40 mg twice a day, clarithromycin 500 mg twice a day and amoxycillin 1 g twice a day for 1 week and were assessed for successful eradication at least 4 weeks after completion of therapy by repeat gastroscopy and gastric biopsies. Eradication was defined as absence of bacteria in both antral and corpus biopsies tested by culture, histology and urease test.
RESULTS: One hundred and six patients were recruited for the study. The mean age was 48.0 years (range: 23-74 years). Four patients defaulted follow up and five patients were not compliant (taking less than 85%) with medications. Eradication rates on per-protocol analysis were: 88/97 (90.7%; 95% CI: 83.1-95.7); and on intention-to-treat analysis they were: 88/106 (83.0%; 95% CI: 75.9-90.2). Side-effects were in general mild and tolerable: 57 of 106 (53.7%) patients complained of a bitter taste; 15 (14.1%) complained of giddiness; 10 (9.4%) complained of increased abdominal pain; 11 (11.5%) complained of lethargy and 16 (15.1%) complained of loose motions. Pre-treatment metronidazole resistance was encountered in 57/74 strains (77.0%). Clarithromycin resistance was not encountered in any of the strains.
CONCLUSIONS: The pantoprazole 1-week triple therapy with amoxycillin and clarithromycin is effective in H. pylori eradication. The treatment was well tolerated by patients. Metronidazole resistance was reported in a high percentage of strains isolated from patients. Clarithromycin resistance was, however, not detected in any of the strains.

Matched MeSH terms: Microbial Sensitivity Tests
Screening of Zingiberaceae extracts for antimicrobial and antioxidant activities

Habsah M, Amran M, Mackeen MM, Lajis NH, Kikuzaki H, Nakatani N, et al.

J Ethnopharmacol, 2000 Oct;72(3):403-10.
PMID: 10996279

Dichloromethane and methanol extracts of 13 Zingiberaceae species from the Alpinia, Costus and Zingiber genera were screened for antimicrobial and antioxidant activities. The antimicrobial activity of most of the extracts was antibacterial with only the methanol extract of Costus discolor showing very potent antifungal activity against only Aspergillus ochraceous (MID, 15.6 microg per disc). All the extracts showed strong antioxidant activity comparable with or higher that of alpha-tocopherol.

Matched MeSH terms: Microbial Sensitivity Tests

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