MyMedR

Displaying publications 41 - 60 of 8749 in total

Abstract:

Sort:

Nutritional status and dietary intake of children with acute leukaemia during induction or consolidation chemotherapy

Tan SY, Poh BK, Nadrah MH, Jannah NA, Rahman J, Ismail MN

J Hum Nutr Diet, 2013 Jul;26 Suppl 1:23-33.
PMID: 23701375 DOI: 10.1111/jhn.12074

The assessment of nutritional status among paediatric patients is important for the planning and execution of nutritional strategies that strive to optimise the quality of life and growth among sick children. The present study aimed to evaluate the nutritional status and dietary intake among children with acute leukaemia.

Matched MeSH terms: Obesity/epidemiology
Fulltext Interleukin-6 via sputum induction as biomarker of inflammation for indoor particulate matter among primary school children in Klang Valley, Malaysia

Nazariah SS, Juliana J, Abdah MA

Glob J Health Sci, 2013 Jul;5(4):93-105.
PMID: 23777726 DOI: 10.5539/gjhs.v5n4p93

In the last few years, air within homes have been indicates by various and emerging body as more serious polluted than those outdoor. Prevalence of respiratory inflammation among school children aged 8 and 10 years old attending national primary schools in urban and rural area were conducted in Klang Valley. Two population studies drawn from the questionnaires were used to investigate the association between indoor particulate matter (PM2.5 & PM10) in a home environment and respiratory implication through the understanding of biological responses. Approximately 430 healthy school children of Standard 2 and Standard 5 were selected. Indication of respiratory symptoms using adaptation questionnaire from American Thoracic Society (1978). Sputum sample collection taken for biological analysis. IL-6 then was analyse by using ELISA techniques. Indoor PM2.5 and PM10 were measured using Dust Trak Aerosol Monitor. The mean concentration of PM2.5 (45.38 µg/m3) and PM10 (80.07 µg/m3) in urban home environment is significantly higher compared to those in rural residential area (p=0.001). Similar trend also shows by the prevalence of respiratory symptom. Association were found with PM2.5 and PM10 with the level of IL-6 among school children. A greater exposure to PM2.5 and PM10 are associated with higher expression of IL-6 level suggesting that the concentration of indoor particulate in urban density area significantly influence the health of children.

Matched MeSH terms: Malaysia/epidemiology
Fatal septicemic shock associated with Strongyloides stercoralis infection in a patient with angioimmunoblastic T-cell lymphoma: a case report and literature review

Abdelrahman MZ, Zeehaida M, Rahmah N, Norsyahida A, Madihah B, Azlan H, et al.

Parasitol Int, 2012 Sep;61(3):508-11.
PMID: 22575692 DOI: 10.1016/j.parint.2012.04.005

Strongyloides stercoralis infection can persist in the host for several decades, and patients with cancer and other clinical conditions who are exposed to immunosuppressive therapy are at risk of developing hyperinfection.

Matched MeSH terms: Malaysia/epidemiology
Vitamin D levels: its relationship to bone mineral density response and disease activity in premenopausal Malaysian systemic lupus erythematosus patients on corticosteroids

Yeap SS, Othman AZ, Zain AA, Chan SP

Int J Rheum Dis, 2012 Feb;15(1):17-24.
PMID: 22324943 DOI: 10.1111/j.1756-185X.2011.01653.x

AIM: To determine if baseline vitamin D levels would influence the gain in bone mineral density (BMD) in female systemic lupus erythematosus (SLE) patients on corticosteroids (CS) taking bone-active medication.

METHOD: Premenopausal SLE patients participating in a trial assessing the efficacy of calcium alone, calcitriol and calcium, and alendronate and calcium, on BMD in patients on CS, were studied. Patients were randomly allocated to the treatment groups at the start of the study and followed up for 2 years. Serum 25-hydroxy vitamin D [25(OH)D] was measured at baseline.

RESULTS: Thirty-eight patients were studied. One (2%) patient had osteoporosis, nine (24%) had osteopenia and all others had normal BMD. The mean baseline 25(OH)D levels were 21.6 ± 4.6 ng/mL (± 1 SD). Twelve (32%) patients had vitamin D deficiency [25(OH)D < 20 ng/mL]. There was a significant negative correlation between SLEDAI scores and 25(OH)D levels, that is, patients with high SLEDAI scores had significantly lower 25(OH)D levels (P = 0.033). Left femoral neck BMD was significantly lower in the deficient compared to insufficient group (P = 0.042). There was a trend toward better BMD gain at 2 years in the vitamin D insufficient compared to the deficient group, which did not reach statistical significance.

CONCLUSION: This study showed that in female SLE patients, low vitamin D levels are associated with higher disease activity and suggests that patients who have higher vitamin D levels have a better BMD response during treatment with bone-active agents.

Matched MeSH terms: Malaysia/epidemiology
An age-adjusted seroprevalence study of Toxoplasma antibody in a Malaysian ophthalmology unit

Singh S, Khang TF, Andiappan H, Nissapatorn V, Subrayan V

Trans R Soc Trop Med Hyg, 2012 May;106(5):322-6.
PMID: 22480791 DOI: 10.1016/j.trstmh.2012.01.009

Toxoplasma gondii is a public health risk in developing countries, especially those located in the tropics. Widespread infection may inflict a substantial burden on state resources, as patients can develop severe neurological defects and ocular diseases that result in lifelong loss of economic independence. We tested sera for IgG antibody from 493 eye patients in Malaysia. Overall age-adjusted seroprevalence was estimated to be 25% (95% CI: [21%, 29%]). We found approximately equal age-adjusted seroprevalence in Chinese (31%; 95% CI: [25%, 38%]) and Malays (29%; 95% CI: [21%, 36%]), followed by Indians (19%; 95% CI: [13%, 25%]). A logistic regression of the odds for T. gondii seroprevalence against age, gender, ethnicity and the occurrence of six types of ocular diseases showed that only age and ethnicity were significant predictors. The odds for T. gondii seroprevalence were 2.7 (95% CI for OR: [1.9, 4.0]) times higher for a patient twice as old as the other, with ethnicity held constant. In Malays, we estimated the odds for T. gondii seroprevalence to be 2.9 (95% CI for OR: [1.8, 4.5]) times higher compared to non-Malays, with age held constant. Previous studies of T. gondii seroprevalence in Malaysia did not explicitly adjust for age, rendering comparisons difficult. Our study highlights the need to adopt a more rigorous epidemiological approach in monitoring T. gondii seroprevalence in Malaysia.

Matched MeSH terms: Malaysia/epidemiology
Susceptibility to aplastic anemia is associated with HLA-DRB1*1501 in an aboriginal population in Sabah, Malaysia

Dhaliwal JS, Wong L, Kamaluddin MA, Yin LY, Murad S

Hum Immunol, 2011 Oct;72(10):889-92.
PMID: 21762745 DOI: 10.1016/j.humimm.2011.06.013

The incidence of aplastic anemia is reported to be higher in Asia than elsewhere. We studied the frequency of human leukocyte antigen (HLA) DRB1 alleles in aplastic anemia patients from 2 genetically similar aboriginal groups, the Kadazan and the Dusun, and compared them with genetically matched community and hospital controls. HLA-DRB1*15 was significantly higher in the patients compared with controls (p = 0.005), confirming similar findings in Japanese and Caucasian studies. Further testing indicated a significantly higher frequency of HLA-DRB1*1501 in patients compared with controls (p = 0.0004) but no significant difference in the frequency of HLA-DRB1*1502. The high frequency of HLA-DRB1*15 in the Kadazan and Dusun population combined with the wide variety of environmental factors associated with aplastic anemia could be the reason for the elevated incidence of aplastic anemia in the Kadazan and Dusun in Sabah.

Matched MeSH terms: Malaysia/epidemiology
Liver cirrhosis in Malaysia: peculiar epidemiology in a multiracial Asian country

Qua CS, Goh KL

J Gastroenterol Hepatol, 2011 Aug;26(8):1333-7.
PMID: 21443669 DOI: 10.1111/j.1440-1746.2011.06732.x

To determine the etiology of liver cirrhosis and risk factors for hepatocellular carcinoma (HCC) in a multiracial Asian population.

Matched MeSH terms: Malaysia/epidemiology
Statin use prior to ischemic stroke onset is associated with decreased in-hospital mortality

Hassan Y, Al-Jabi SW, Aziz NA, Looi I, Zyoud SH

Fundam Clin Pharmacol, 2011 Jun;25(3):388-94.
PMID: 20608996 DOI: 10.1111/j.1472-8206.2010.00846.x

Statins can reduce the risk of stroke in at-risk populations and improve survival after acute ischemic stroke (AIS) among patients with previous statin use. This study aimed to investigate the impact of statin use before AIS onset on in-hospital mortality and identify the factors related to in-hospital mortality among patients with and without previous statin use. A retrospective cohort study of all patients with AIS attending hospital from June 1, 2008 to December 31, 2008. Data were collected from medical records including demographic information, diagnostic information, risk factors, previous statin use, and vital discharge status. Chi-square, Fisher's exact tests, student's t-test, and Mann-Whitney U test, whatever appropriate, were used to test the significance between the variables, and multiple logistic regression was used to identify factors associated with in-hospital mortality. Altogether, 386 patients with AIS were studied, of which 113 (29.3%) had a documented previous statin use. A total of 62 (16.1%) patients with AIS died in hospital. In-hospital mortality was significantly lower among previous statin users (P = 0.013). The presence of atrial fibrillation (AF) increased in-hospital mortality among patients with or without previous statin use. The independent predictors for in-hospital mortality among AIS patients without previous statin use were the presence of diabetes mellitus (P = 0.047), AF (P = 0.045), and renal impairment (P < 0.001). The prophylactic administration of statins significantly reduces post-AIS in-hospital mortality. Furthermore, the identification of predictors of in-hospital mortality might reduce death rates and enhance the application of specific therapeutic and management strategies to patients at a high risk of dying.

Matched MeSH terms: Malaysia/epidemiology
Prevalence and risk factors for peripheral artery disease in an Asian population with diabetes mellitus

Tavintharan S, Ning Cheung, Su Chi Lim, Tay W, Shankar A, Shyong Tai E, et al.

Diab Vasc Dis Res, 2009 Apr;6(2):80-6.
PMID: 20368197 DOI: 10.1177/1479164109336043

We describe the prevalence and risk factors for PAD in Asian Malays with diabetes. A population-based study of 3,280 (78.7% response) Malay persons aged 40-80 years in Singapore was conducted. ABI was measured in all participants with a history of diabetes (N=634). PAD was defined to be present if ABI

Matched MeSH terms: Singapore/epidemiology
[A case of chronic schistosomiasis four years after infestation]

Pedalino M, Vercesi E, Manini C, Piras D, Di Primio OG, Vella R, et al.

Urologia, 2010 Oct-Dec;77 Suppl 17:38-41.
PMID: 21308673

Authors present a case of bilharziosis incidentally diagnosed in a patient undergoing TURB for suspected bladder cancer. The patient, who in 2005 had gone to Malaysia, had been suffering from recurrent hemorrhagic cystitis since 2007, which were treated with antibiotic therapy. In November 2009 he presented to our observation for persistent hematuria, underwent ultrasound examination, fibroscopy and TURB diagnostics for suspicious lesions. The histopathology diagnosis found granulomatous lesions with typical parasites eggs due to schistosomiasis eggs. As a consequence of that, the patient underwent medical therapy. The pathologist's role becomes nullifying not only for the diagnosis of parasitic infections but also for the exclusion or evidence of urothelial squamous neoplasia. The low incidence of this rare parasitic disease in European tourists and the presence of immigrants in our country require to spread the knowledge of these parasites and the most simple tests for early detection.

Matched MeSH terms: Schistosomiasis haematobia/epidemiology
Subclinical coronary artery disease in Asian rheumatoid arthritis patients who were in remission: a pilot study

Ma NH, Teh CL, Rapaee A, Lau KB, Fong AY, Hi S, et al.

Int J Rheum Dis, 2010 Aug;13(3):223-9.
PMID: 20704618 DOI: 10.1111/j.1756-185X.2010.01533.x

INTRODUCTION: Rheumatoid arthritis (RA) patients who have active disease with longer disease duration have been reported to have increased risk of cardiovascular events compared to the normal population.
OBJECTIVE: The primary aim of our study is to ascertain the prevalence of significant asymptomatic coronary artery disease (CAD) in Asian RA patients who are in remission using multi-detector computed tomography (MDCT). The secondary aims of our study are the usage of pulse wave velocity and the biomarkers N-terminal pro-brain natriuretic peptide (NT-proBNP) and high-senstivity C-reactive protein (hs-CRP) to detect subclinical atherosclerosis in RA patients.
METHODS: We performed a comparative cross-sectional study of 47 RA patients who were in remission with a control group of non-RA patients with a history of atypical chest pain in Sarawak General Hospital from November 2008 to February 2009. All patients underwent 64-slice MDCT, assessment of arterial stiffness using the SphygmoCor test and blood analysis for NT-proBNP and hsCRP.
RESULTS: There were 94 patients in our study with a mean age of 50 +/- 8.8 years. The RA and control patients in each group were matched in terms of traditional CV risk factors. Our RA patients had a median disease duration of 3 years (IQR 5.5). MDCT showed evidence of CAD in nine (19.1%) RA patients and three (6.4%) control patients (P = 0.06). There was no significant association between pulse wave velocity (PWV) and presence of CAD in our RA group. There was no significant correlation between PWV with levels of proBNP or hsCRP in our RA patients.
CONCLUSIONS: In our current pilot study with the limitation of small sample size, RA was not associated with an increased risk of CAD in our RA patients who were in remission. Larger studies of CAD in Asian RA patients are needed to confirm our current finding.
Study site: Sarawak General Hospital, Kuching, Sarawak, Malaysia

Matched MeSH terms: Malaysia/epidemiology
Public sources of information and information needs for pandemic influenza A(H1N1)

Wong LP, Sam IC

J Community Health, 2010 Dec;35(6):676-82.
PMID: 20411411 DOI: 10.1007/s10900-010-9271-4

Providing health information during disease outbreaks is a fundamental component of outbreak control strategies. This study aimed to explore sources of influenza A(H1N1)-related information, specific information needs and preferences of the lay public during the peak of the outbreak. A cross-sectional, population-based, computer-assisted telephone interview of 1,050 respondents was conducted in Malaysia between July 11 and September 12, 2009. Newspaper, television and family were three main sources of information about A(H1N1). There were substantial ethnic differences; the Malays were significantly more likely to identify television as main source, while newspapers and family were identified as the main sources by the Chinese and Indians, respectively. Overall, the two main information needs identified were prevention and treatment. The Malays expressed lesser need for overall information than other ethnic groups. The three most preferred sources of information were television, newspapers and healthcare providers. There were significant positive correlations between amount of information received with knowledge (r = 0.149), perceived susceptibility to infection (r = 0.177), and other behavioral responses. Health information dissemination should be dedicated to meeting the information needs of diverse sociodemographic and ethnic groups. The findings highlight the importance of providing information that increases awareness and behavioral changes in disease prevention yet reduce fear.

Matched MeSH terms: Malaysia/epidemiology
Diagnostic challenges in tuberculous otitis media

Tang IP, Prepageran N, Ong CA, Puraviappan P

J Laryngol Otol, 2010 Aug;124(8):913-5.
PMID: 20426886 DOI: 10.1017/S0022215110000265

To demonstrate the different clinical presentations of tuberculous otitis media and the management of selected cases.

Matched MeSH terms: Malaysia/epidemiology
C-erbB-2 onco-protein expression in breast cancer: relationship to tumour characteristics and short-term survival in Universiti Kebansaan Malaysia Medical Centre

Sharifah NA, Lee BR, Clarence-Ko CH, Tan GC, Shiran MS, Naqiyah I, et al.

Asian Pac J Cancer Prev, 2008 Oct-Dec;9(4):663-70.
PMID: 19271345

Breast cancer is the commonest cancer affecting females in Malaysia, contributing 31% of all newly diagnosed cases amongst Malaysian women. The present retrospective cohort study evaluated the relationship between cerbB- 2 onco-protein overexpression with various tumour characteristics and survival rate of breast cancer patients treated at the Universiti Kebangsaan Malaysia Medical Centre (UKMMC) between 1996-2000. CerbB- 2 oncoprotein overexpression was determined by immunohistochemistry (IHC) and tumors showing 2+ positivity were verified by Fluorescence In Situ Hybridization (FISH). One hundred and seventy two patients were eligible for the study with a short-term follow-up (median) of 5.1 years. C-erbB-2 oncoprotein overexpression correlated with lymph node positivity, oestrogen receptor (ER) and progesterone receptor (PR) negativity. Univariate analyses showed shorter disease free survival (DFS) and overall survival (OS) in patients with cerbB- 2 oncoprotein overexpression, Malay ethnicity, higher tumour grade, lymph node positivity, ER and PR negativity. In a subgroup of patients with c-erbB-2 oncoprotein overexpression, a shorter OS was observed in those with lymph node positivity, ER and PR negativity. In multivariate prognostic analysis, lymph node status, ER status and tumour grading were the strongest independent prognostic factors for both OS and DFS. However, c-erbB-2 status was not a significantly independent prognostic factor, even in subsets with lymph node positive or negative group. C-erbB-2 oncoprotein overexpression correlated well with lymph node status, ER and PR. Shorter OS and DFS were significantly observed in patients with c-erbB-2 oncoprotein overexpression. Lymph node status, ER status and tumour grading were the only three independent prognostic factors for OS and DFS in this study. Although c-erbB-2 expression is obviously important from a biological standpoint, multivariate analysis showed that it is not an independent prognostic indicator in breast carcinoma in the local population.

Matched MeSH terms: Malaysia/epidemiology
Requirements for the development of a hand transplantation program

Gordon CR, Siemionow M

Ann Plast Surg, 2009 Sep;63(3):262-73.
PMID: 19692900 DOI: 10.1097/SAP.0b013e31818d45e9

Since 1998, 42 hand transplants in 30 patients have been performed in countries such as France, United States, China, Austria, Malaysia, Italy, Belgium, Poland, Spain, and Germany. Now, with recent improvements in immunosuppression, the clinical applicability may expand and the ethical obstacles may soon be overcome, allowing multiple US institutions to perform hand allotransplantation. The main purpose of this article is to facilitate access to pertinent details in regards to hand transplantation, such as donor/recipient selection criteria, immunosuppressive therapies, and associated complications. It is a comprehensive literature review compiled from published reports from multiple hand transplant programs throughout the world. Due to its inherent complexity, hand transplantation should only be attempted at institutions within the US capable of orchestrating a specialized multidisciplinary team, and each institution's protocol should be extremely detailed and individualized.

Matched MeSH terms: Postoperative Complications/epidemiology
Applying the Multinational Association for Supportive Care in Cancer risk scoring in predicting outcome of febrile neutropenia patients in a cohort of patients

Baskaran ND, Gan GG, Adeeba K

Ann Hematol, 2008 Jul;87(7):563-9.
PMID: 18437382 DOI: 10.1007/s00277-008-0487-7

The purpose of this study was to determine if the Multinational Association for Supportive Care in Cancer (MASCC) risk-index score is able to predict the outcome of febrile neutropenia in patients with underlying hematological malignancy and to look at the other possible predictors of outcome. A retrospective study of 116 episodes of febrile neutropenia in patients who were admitted to the hematology ward of a local medical center in Malaysia between January 1st 2004 and January 31st 2005. Patient characteristics and the MASCC score were compared with outcome. The MASCC score predicted the outcome of febrile neutropenic episodes with a positive predictive value of 82.9%, a sensitivity of 93%, and specificity of 67%. Other predictors of a favorable outcome were those patients who had lymphomas versus leukemias, duration of neutropenia of less than 7 days, low burden of illness characterized by the absence of an infective focus and absence of lower respiratory tract infection, a serum albumin of >25 g/l, and the absence of gram-negative bacteremia on univariate analysis but only serum albumin level, low burden of illness, and presence of respiratory infection were significantly associated with unfavorable outcome after multivariate analysis. The MASCC score is a useful predictor of outcome in patients with febrile neutropenia with underlying hematological malignancies. This scoring system may be adapted for use in local settings to guide the clinical management of patients with this condition.

Matched MeSH terms: Malaysia/epidemiology
Pre-admission therapy for childhood acute diarrhoea--a hospital-based study

Ng YJ, Lo YL, Lee WS

J Clin Pharm Ther, 2009 Feb;34(1):55-60.
PMID: 19125903 DOI: 10.1111/j.1365-2710.2008.00985.x

Acute gastroenteritis (AGE) is a common illness among infants and children contributing to significant mortality and morbidity. As such, appropriate treatment received prior to hospital admission is of utmost importance. This retrospective observational study aimed to determine preadmission management in paediatric patients prior to hospital admission. Two hundred and twenty-two case notes of paediatric AGE patients were reviewed over a 12-month period. One hundred and fifty-four patients received medications prior to admission with 143 (92.9%) patients received known classes of medications. Antipyretic agents were the most commonly prescribed (69.2%), followed by antibiotics (38.5%), anti-emetics (35.7%), oral rehydration salts (29.4%) and antidiarrhoeals (28.0%). The mean duration of stay in hospital was slightly shorter in patients, who received prior medications than those who did not (2.22 vs. 2.32 days respectively). Seventy per cent of children admitted for AGE were treated suboptimally prior to hospital admission with oral rehydration salts being largely under-utilized, despite their proven efficacy and safety. Sex, race and age had no influence on the type of preadmission treatment. A greater effort should be made to educate the general public in the appropriate treatment of AGE.

Matched MeSH terms: Malaysia/epidemiology
Non-cardiac chest pain: prevalence of reflux disease and response to acid suppression in an Asian population

Mohd H, Qua CS, Wong CH, Azman W, Goh KL

J Gastroenterol Hepatol, 2009 Feb;24(2):288-93.
PMID: 19054255 DOI: 10.1111/j.1440-1746.2008.05702.x

Gastroesophageal reflux disease is thought to be the commonest cause of 'non-cardiac chest pain'. The use of proton-pump inhibitors resulting in improvement in the chest pain symptom would support this causal association.

Matched MeSH terms: Malaysia/epidemiology
A randomised study comparing the efficacy and safety of rosuvastatin with atorvastatin for achieving lipid goals in clinical practice in Asian patients at high risk of cardiovascular disease (DISCOVERY-Asia study)

Zhu JR, Tomlinson B, Ro YM, Sim KH, Lee YT, Sriratanasathavorn C

Curr Med Res Opin, 2007 Dec;23(12):3055-68.
PMID: 18196620

BACKGROUND: Most studies investigating the benefits of statins have focused on North American and European populations. This study focuses on evaluating the lipid-lowering effects of rosuvastatin and atorvastatin in Asian patients.
OBJECTIVES: The DIrect Statin COmparison of LDL-C Values: an Evaluation of Rosuvastatin therapY (DISCOVERY)-Asia study is one of nine independently powered studies assessing the efficacy of starting doses of statins in achieving target lipid levels in different countries worldwide. DISCOVERY-Asia was a 12-week, randomised, open-label, parallel-group study conducted in China, Hong Kong, Korea, Malaysia, Taiwan, and Thailand.
RESULTS: A total of 1482 adults with primary hypercholesterolaemia and high cardiovascular risk (> 20%/10 years, type 2 diabetes, or a history of coronary heart disease) were randomised in a 2 : 1 ratio to receive rosuvastatin 10 mg once daily (o.d.) or atorvastatin 10 mg o.d. The percentage of patients achieving the 1998 European Joint Task Force low-density lipoprotein cholesterol (LDL-C) goal of < 3.0 mmol/L at 12 weeks was significantly higher in the rosuvastatin group (n = 950) compared with the atorvastatin group (n = 471) (79.5 vs. 69.4%, respectively; p < 0.0001). Similar results were observed for 1998 European goals for total cholesterol (TC), and the 2003 European goals for LDL-C and TC. LDL-C and TC levels were reduced significantly more with rosuvastatin compared with atorvastatin. Both drugs were well-tolerated and the incidence and type of adverse events were similar in each group.
TRIALS REGISTRATION: The trial registry summary is available at http://www.clinicaltrials.gov/; ClinicalTrials.gov Identifier: NCT00241488
CONCLUSIONS: This 12-week study showed that the starting dose of rosuvastatin 10 mg o.d. was significantly more effective than the starting dose of natorvastatin 10 mg o.d. at enabling patients with primary hypercholesterolaemia to achieve European goals for LDL-C and TC in a largely Asian population in real-life clinical practice. The safety profile of rosuvastatin 10 mg is similar to that of atorvastatin 10 mg in the Asian population studied here, and is consistent with the known safety profile of rosuvastatin in the white population.

Matched MeSH terms: Cardiovascular Diseases/epidemiology
Extended-spectrum beta-lactam resistance due to AmpC hyperproduction and CMY-2 coupled with the loss of OMPK35 in Malaysian strains of Escherichia coli and Klebsiella pneumoniae

Palasubramaniam S, Subramaniam G, Muniandy S, Parasakthi N

Microb Drug Resist, 2007;13(3):186-90.
PMID: 17949305

In this report, we describe the detection of AmpC and CMY-2 beta-lactamases with the loss of OmpK35 porin among seven sporadic strains of ceftazidime-resistant Klebsiella pneumoniae and ceftazidime-resistant Escherichia coli. Cefoxitin, which was used as a marker of resistance toward 7-alpha-methoxy-cephalosporins, exhibited high minimum inhibitory concentration (MIC) values ranging between 128 microg/ml and >256 microg/ml in all the strains. The presence of hyperproducing AmpC enzymes was indicated by the positive three-dimensional test. Isoelectric focusing (IEF) study confirmed the presence of AmpC enzymes in all the strains. The ampC gene was detected by PCR in all the strains and confirmed by DNA sequencing. Large plasmids in all the strains, ranging from 60 kb to 150 kb in size, most likely encode the ampC gene. Two E. coli strains out of the seven strains showed positive amplification of the bla(CMY-2) gene, an AmpC variant, and was confirmed by DNA sequence analyses. DNA hybridization confirmed the bla(CMY-2) gene to be plasmid-mediated in both of these strains. However, one of these two strains also mediated a chromosomal CMY gene. All the strains showed an absence of OmpK35 by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS/PAGE) and was confirmed by western blot analyses using raised polyclonal anti-OmpK35 antiserum. This suggests that, apart from CMY production, absence of OmpK35 porin also contributed to cefoxitin resistance resulting in extended-spectrum beta-lactam resistance among these isolates.

Matched MeSH terms: Malaysia/epidemiology

Filters

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

External Links