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  1. 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: Anti-Bacterial Agents/pharmacology*
  2. Fulltext Antibiotic resistance in the community
    Lim VKE
    Med J Malaysia, 2003 Jun;58(2):156-8.
    PMID: 14569734 MyJurnal
    Matched MeSH terms: Anti-Bacterial Agents/therapeutic use*
  3. Antimicrobial susceptibility and distribution of non-typhoidal Salmonella serovars isolated in Malaysian children
    Lee WS, Puthucheary SD, Parasakthi N, Choo KE
    J Trop Pediatr, 2003 Feb;49(1):37-41.
    PMID: 12630719
    There is widespread resistance of Salmonella species to commonly prescribed antimicrobials the world over. We aimed to determine the antimicrobial susceptibility and serovar distribution of non-typhoidal Salmonella (NTS) isolated from blood cultures of Malaysian children. Positive isolates of NTS from blood cultures obtained from children admitted to the pediatric wards of University of Malaya Medical Center (UMMC), a large urban hospital from Kuala Lumpur (1991-2001), and Hospital Kota Bharu (HKB), from the predominantly rural state of Kelantan (1991-1999), Malaysia, were reviewed retrospectively. Serovar distribution and antimicrobial susceptibility were ascertained. A total of 64 and 55 isolates of NTS were obtained from blood cultures of children admitted to UMMC and HKB, respectively. The commonest serovar isolated was Salmonella enteritidis in both centers. The NTS isolated were highly sensitive to the antimicrobials tested: ampicillin 98 per cent, chloramphenicol 98 per cent, gentamicin 97 per cent, trimethoprim-sulfamethoxazole (TMP-SMX) 98 per cent, and ceftriaxone 100 per cent in UMMC; ampicillin 100 per cent, chloramphenicol 87 per cent, kanamycin 100 per cent, streptomycin 96 per cent, TMP-SMX 93 per cent, and tetracycline 89 per cent in HKB. There were only one and five multi-resistant isolates in UMMC and HKB, respectively. In conclusion, NTS isolated from blood cultures of Malaysian children from Kuala Lumpur and Kota Bharu were highly sensitive to commonly prescribed antibiotics. We speculate that this is due to the restriction of sales of antimicrobials in Malaysia except by prescription. Continuing vigilance and frequent antmicrobial surveillance is necessary.
    Matched MeSH terms: Anti-Bacterial Agents/pharmacology*
  4. Prevalence and resistance to antibiotics for Aeromonas species from retail fish in Malaysia
    Radu S, Ahmad N, Ling FH, Reezal A
    Int J Food Microbiol, 2003 Mar 25;81(3):261-6.
    PMID: 12485753
    A total of 87 market fish samples representing five types of fish were evaluated for the presence of Aeromonas spp. Of the samples examined, 69%, 55%, 11.5% and 2.3% harbored Aeromonas spp., A. veronii biovar sobria, A. hydrophila and A. caviae, respectively. The 60 isolated Aeromonas spp. strains were further examined for hemolytic activity, resistance to antimicrobial agents and presence of plasmids. Hemolytic activity varied widely among the isolated strains. Though all the isolates demonstrated resistance to three or more of the antibiotics tested, all were susceptible to ceptazidime. Thirty-four (56.7%) of the sixty isolates harbored plasmids, with sizes ranging from 2.3 to 15.7 kb. These results indicate that hemolytic, multiple antibiotic resistant and genetically diverse aeromonads are easily recovered from fish in this region.
    Matched MeSH terms: Anti-Bacterial Agents/pharmacology*
  5. 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: Anti-Bacterial Agents/therapeutic use*
  6. Fulltext Post meningitic sensori-neural hearing loss in children--alterations in hearing level
    Yeat SW, Mukari SZ, Said H, Motilal R
    Med J Malaysia, 1997 Sep;52(3):285-90.
    PMID: 10968099
    Post meningitic sensori-neural hearing loss was studied in forty new cases of bacterial meningitis and ten cases of viral meningitis treated at the Pediatric Institute, Kuala Lumpur Hospital from April 1991 to March 1992. Hearing assessment at 2 weeks, 3 months and 6 months following the diagnosis of meningitis using Brain Stem Evoked Response Audiometry showed that hearing loss was prevalent only in patients with bacterial meningitis. Hearing loss was detected in 32.5% of these patients during the acute phase of the disease, 22.8% after 3 months and 24.2% after 6 months. In 63.6% of the affected cases, hearing loss was bilateral. In 61.5% of the patients who had hearing loss during the acute phase of the disease, it was permanent, 16.7% had either partial or complete recovery and, 15.4% had deterioration in hearing level. In 2 cases the subsequent hearing level was unknown. The risk of developing sensori neural hearing loss was found to be significantly higher in patients who developed other neurological sequelae. The study highlights the importance of performing repeated hearing assessment in children with bacterial meningitis and the difficulty in appropriate selection of hearing aids in the early stages.
    Matched MeSH terms: Anti-Bacterial Agents/adverse effects
  7. 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: Anti-Bacterial Agents/pharmacology*
  8. Antimicrobial, antioxidant, antitumour-promoting and cytotoxic activities of different plant part extracts of Garcinia atroviridis griff. ex T. anders
    Mackeen MM, Ali AM, Lajis NH, Kawazu K, Hassan Z, Amran M, et al.
    J Ethnopharmacol, 2000 Oct;72(3):395-402.
    PMID: 10996278
    Crude extracts (methanol) of various parts, viz. the leaves, fruits, roots, stem and trunk bark, of Garcinia atroviridis were screened for antimicrobial, cytotoxic, brine shrimp toxic, antitumour-promoting and antioxidant activities. The crude extracts exhibited predominantly antibacterial activity with the root extract showing the strongest inhibition against the test bacteria at a minimum inhibitory dose (MID) of 15.6 microg/disc. Although all the extracts failed to inhibit the growth of most of the test fungi, significant antifungal activity against Cladosporium herbarum was exhibited by most notably the fruit (MID: 100 microg), and the leaf (MID: 400 microg) extracts. None of the extracts were significantly cytotoxic, and lethal towards brine shrimps. The root, leaf, trunk and stem bark extracts (except for the fruits) showed strong antioxidant activity exceeding that of the standard antioxidant, alpha-tocopherol. Antitumour-promoting activity (>95% inhibition) was shown by the fruit, leaf, stem and trunk bark extracts.
    Matched MeSH terms: Anti-Bacterial Agents/pharmacology*
  9. Update on the management of Helicobacter pylori infection, including drug-resistant organisms
    Goh KL
    J Gastroenterol Hepatol, 2002 Apr;17(4):482-7.
    PMID: 11982731
    Helicobacter pylori infection has many different clinical outcomes. Not all infected persons need to be treated. Therefore, indications for treatment have to be clear, and several consensus guidelines have been formulated to aid the medical practitioner in this decision-making process. Triple therapy with a proton pump inhibitor (PPI), in combination with amoxicillin and clarithromycin is the established treatment of choice. For patients with penicillin hypersensitivity, metronidazole can be substituted for amoxicillin. Bacterial resistance to antibiotics is a major factor adversely affecting treatment success. Resistance to metronidazole has been reported in up to 80%, and resistance to clarithromycin in 2-10% of strains cultured. Resistance to either one of the antibiotics has been reported to result in a drop in efficacy of up to 50%. Emergence of resistance to both metronidazole and clarithromycin following failed therapy is a cause for concern; this underlines the need to use the best available first-line therapy. To avoid the emergence of resistance to both key antibiotics, the combination of metronidazole and clarithromycin should be avoided where possible. For failed treatment, several strategies can be employed. These include ensuring better compliance with repeat therapy, and maximizing the efficacy of repeat treatment by increasing dosage and duration of treatment, as well as altering the choice of drugs. Quadruple therapy incorporating a bismuth compound with a PPI, tetracycline and metronidazole has been a popular choice as a "rescue" therapy. Ranitidine bismuth citrate has been shown to be able to overcome metronidazole and clarithromycin resistance; it may be a useful compound drug to use in place of a PPI in "rescue" therapies. In the case of persistent treatment failures, it is useful to consider repeating gastroscopy and obtaining tissue for culture, and then prescribe antibiotics according to bacterial susceptibility patterns. It is also important in refractory cases to review the original indication for treatment and determine the importance of the indication.
    Matched MeSH terms: Anti-Bacterial Agents/therapeutic use*
  10. Empyema thoracis in hospitalized children in Kelantan, Malaysia
    Maziah W, Choo KE, Ray JG, Ariffin WA
    J Trop Pediatr, 1995 06;41(3):185-8.
    PMID: 7636941 DOI: 10.1093/tropej/41.3.185
    In this study, 31 cases of childhood empyema thoracis admitted over 4 1/2 years to the Hospital Universiti Sains Malaysia, in Kelantan, Malaysia, were retrospectively reviewed. Twenty-two males and nine females were included, with a mean age of 1.9 years (range: 26 days to 7 years). Frequent symptoms were fever, cough, and dyspnoea, while common signs were temperature above 38 degrees C, decreased breath sounds, dullness to chest percussion, and intercostal recession. Radiography demonstrated unilateral moderate to large effusions in 68 per cent of cases, while consolidated lung was seen in 45 per cent of patients. Pleural fluid cultures were positive for Staphylococcus aureus (48 per cent), Streptococcus pneumoniae (7 per cent), while no growth was seen in 42 per cent of cases. Ninety-four per cent of children had a blood leukocytosis above 10 000 cell/mm3, but blood cultures were negative in 21 out of 26 patients (81 per cent). Most cases were treated with a combination of intravenous antibiotics and chest tube drainage. Antibiotics and pleural tap(s) were used in the remainder. Patients stayed in hospital for an average of 20.7 days (range: 4-52 days). Surgical intervention was necessary in only four children. The mortality rate at the time of discharge was zero, with 100 per cent radiographic resolution among the 23 patients who were followed-up.
    Matched MeSH terms: Anti-Bacterial Agents/therapeutic use
  11. Comparison of E-test with agar dilution methods in testing susceptibility of N. gonorrhoeae to azithromycin
    Yasin RM, Suan KA, Meng CY
    Sex Transm Dis, 1997 May;24(5):257-60.
    PMID: 9153733
    BACKGROUND AND OBJECTIVES: The antimicrobial susceptibility pattern of Neisseria gonorrhoeae varies from one country to another and may also change with time. To monitor these variations and changes, it is desirable to have a method that is simple and reproducible. This study was undertaken to determine the in vitro susceptibility of N. gonorrhoeae to azithromycin and to assess the reliability of results obtained using E-test methodology for determination of the minimum inhibitory concentration (MIC) of azithromycin.

    STUDY DESIGN: The MICs for 135 clinical isolates of N. gonorrhoeae were determined by a modified Kirby-Bauer method recommended by the National Committee for Clinical Laboratory Standards against penicillin, cefuroxime, ceftriaxone, norfloxacin, tetracycline, kanamycin, spectinomycin, and azithromycin. The MIC of azithromycin was determined by both the E-test and agar dilution method. All tests were done simultaneously.

    RESULTS: The MIC of azithromycin to all 135 isolates ranged from 0.078 to 0.25 microgram/ml with the agar dilution method and from 0.016 to 0.50 microgram/ml with the E-test. The MIC50 and MIC90 of azithromycin were 0.064 microgram/ml and 0.125 microgram/ml, respectively, by the agar dilution method, whereas they are slightly higher by the E-test method. Seventy-six of the isolates were beta-lactamase producers and 69 were high-level tetracycline-resistant N. gonorrhoeae. There was no difference in the MIC50 and MIC90 of azithromycin in these groups of isolates. The percentage agreement within the acceptable +/-1 log2 dilution difference between MICs obtained by E-test and those obtained by the agar dilution method was 97.8%.

    CONCLUSIONS: Azithromycin has a very good in vitro antigonococcal activity, and the E-test is a reliable method to determine the MIC of azithromycin against N. gonorrhoeae.

    Matched MeSH terms: Anti-Bacterial Agents/pharmacology*
  12. Conjugal transfer of plasmids and antibiotic resistance among Escherichia coli isolated from animals in a rural area in Sarawak (Malaysia)
    Son R, Rusu G, Karim MI
    J Appl Microbiol, 1997 Feb;82(2):240-4.
    PMID: 12452600
    Thirty-six strains of Escherichia coli isolated from animals in Bario, a remote area in Sarawak, Malaysia, were examined for presence of plasmid DNA and their susceptibility to nine antimicrobial agents. Of the total 36 isolates, five bovine and six canine isolates were found to contain plasmid DNA ranging in sizes from 2.6 to 70 kilobases. All were susceptible to chloramphenicol, erythromycin, gentamicin, nalidixic acid and neomycin but resistance to ampicillin (47%), erythromycin (19%), streptomycin (25%) and tetracycline (11%) was observed. Resistance was associated with carriage of a 47 kb (SC98), 70 kb, (SC133) and 56 and 4.6 kb (SC119) plasmids which were transmissible to the Escherichia coli K12 recipient. It is concluded that animals form a potential reservoir of R plasmids carrying E. coli in the study area.
    Matched MeSH terms: Anti-Bacterial Agents/pharmacology*
  13. Fulltext The incidence of post-operative wound infection in orthopaedic surgery
    Dhillon KS, Kok CS
    Med J Malaysia, 1995 Sep;50(3):237-40.
    PMID: 8926901
    With the increase in the number of orthopaedic surgeons and the aggressive marketing by manufacturing companies, high technology orthopaedic surgery is being more frequently carried out in Malaysia. Post-operative sepsis complicating this type of surgery can have disastrous consequences. No data is available in this country on the incidence of post-operative infection in Orthopaedic Surgery. The aim of this study was to determine the incidence of post-operative infection. A retrospective survey of 703 patients undergoing elective Orthopaedic Surgery in the year 1991 was carried out. We found an overall post-operative infection rate of 6.8% and a deep infection rate of 3.3%. This figure of 3.3% is higher than the internationally accepted figure of less than 2%. A need for ongoing surveillance and concerned effort to reduce the infection rate is stressed.
    Matched MeSH terms: Anti-Bacterial Agents/therapeutic use
  14. Fulltext Antibiotic susceptibility of community-acquired Staphylococcus aureus
    Tan HS, Ngeow YF, Jamal F
    Med J Malaysia, 1986 Mar;41(1):24-9.
    PMID: 3796343
    55% of a sample of patients in a rural
    community, and 76% of a sample of patients and
    staff in the local district hospital were found to
    be nasal carriers for Staphylococcus aureus. The
    in vitro antibiotic susceptibility patterns of 46
    strains of S. aureus isolated in nasal carriers as
    well as of 43 strains in community-acquired skin
    infections were characterised. High levels of
    resistance were expressed to penicillin (73%),
    cephalexin (64%) and tetracycline (46%).
    Resistance to erythromycin (18%) was moderate.
    A few strains showed resistance to methicillin
    (5 isolates), vancomycin (4), [usidic acid (3),
    cotrimoxazole (1), and none to gentamicin.
    Penicillin can no longer be recommended for
    treating community-acquired S. aureus infections.
    Matched MeSH terms: Anti-Bacterial Agents/pharmacology*
  15. Serological ecology of Neisseria gonorrhoeae (PPNG and non-PPNG) strains: Canadian perspective
    Dillon JR, Bygdeman SM, Sandström EG
    Genitourin Med, 1987 Jun;63(3):160-8.
    PMID: 3111978
    One hundred and thirty eight penicillinase producing Neisseria gonorrhoeae (PPNG) and 239 non-PPNG strains were characterised serologically using a panel of seven monoclonal antibodies directed against protein 1A and seven against protein 1B. An association between serovar and susceptibility to antimicrobial agents, auxotype, and plasmid content was observed. Serogroup WI strains were more sensitive to penicillin, ampicillin, tetracycline, erythromycin, cefoxitin, and cefuroxime. Sixty five (82%) of the 79 WI strains were typed as being serovar Aedgkih, and 47 (72%) of these strains required arginine, uracil, and hypoxanthine for growth (AUH-). Seventy one (44%) of 160 WII/WIII strains were serovar Bacejk, and 42 (59%) of these required proline, citrulline, and uracil for growth (PCU-) and were plasmid free. Serovars Bcgk, Beghjk, Bacjk, and Bajk were associated with resistance to antimicrobial agents. Analysis of PPNG isolates showed a new serovar, Af, which was associated with strains imported from Malaysia and Singapore that required proline and ornithine for growth (Pro-Orn-) and carried the 24.5 megadalton transfer plasmid, the 2.6 megadalton cryptic plasmid, and the 4.5 megadalton penicillinase producing plasmid. Other associations between serovar and geographical location were noted.
    Matched MeSH terms: Anti-Bacterial Agents/pharmacology
  16. Serotype prevalence and antibiotic susceptibility of Shigella strains isolated in Malaysia during 1980 and 1981
    Jegathesan M
    J Diarrhoeal Dis Res, 1984 Jun;2(2):102-4.
    PMID: 6501820
    Matched MeSH terms: Anti-Bacterial Agents/pharmacology*
  17. Acute septicaemic melioidosis: a report of seven cases
    Puthucheary SD, Lin HP, Yap PK
    Trop Geogr Med, 1981 Mar;33(1):19-22.
    PMID: 7245336
    A report is presented of seven patients with acute septicaemic melioidosis seen at the University Hospital, Kuala Lumpur, Malaysia, during 1976-1979. All had associated disorders which rendered them more susceptible to infection. As prognosis depends on early diagnosis it is important that this disease be considered in the differential diagnosis of a septicaemic illness in such patients from endemic areas. The treatment of choice is a combination of tetracyclines and chloramphenicol, initially used in massive doses, and continued for at least six month to prevent relapses.
    Matched MeSH terms: Anti-Bacterial Agents/therapeutic use
  18. Fulltext In vitro activity of aminoglycosides, ureidopenicillins and cephalosporins against P. aeruginosa isolated in Kuala Lumpur
    Ngeow YS, Puthucheary SD, Lai PS
    Med J Malaysia, 1985 Sep;40(3):196-201.
    PMID: 3939567
    170 clinical isolates of Pseudomonas aeruginosa were tested for in vitro susceptibility to gentamicin, amikacin, tobramycin, netilmicin, kanamycin, streptomycin, cefotaxime, ceftriaxone, cefoperazone, ceftazidime, moxalactam, azlocillin, piperacillin and ticarcillin. Against 93 gentamicin-sensitive strains, the most active antibiotics were in descending order, ceftazidime, tobramycin, gentamicin, amikacin, and the ureidopenicillins. Against 77 gentamicin-resistant strains, only ceftazidime, amikacin and moxalactam had mode minimum inhibitory concentrations within achievable peak serum levels after standard therapeutic dosage. There was no correlation between cephalosporin resistance and aminoglycoside resistance except for cefoperazone, which, together with the ureidopenicillins and ticarcillin, showed marked decrease in activity against gentamicin-resistant strains.
    Matched MeSH terms: Anti-Bacterial Agents/pharmacology
  19. Acute organic brain syndrome due to drug-induced eosinophilia
    Ng SC, Lee MK, Teh A
    Postgrad Med J, 1989 Nov;65(769):843-4.
    PMID: 2616421
    A 72 year old man developed acute organic brain syndrome associated with marked eosinophilia following self medication with a variety of drugs. Investigations revealed no other known causes of eosinophilia. Withdrawal of drugs resulted in dramatic drop in eosinophil count paralleled by clinical resolution of neurological problems. To our knowledge drug-induced eosinophilia has not previously been associated with acute organic brain syndrome.
    Matched MeSH terms: Anti-Bacterial Agents/adverse effects
  20. Fulltext Susceptibility of 57 strains Ps. pseudomallei to some new B-lactams and other antibiotics
    Puthucheary SD, Parasakthi N
    Med J Malaysia, 1987 Dec;42(4):248-51.
    PMID: 3454397
    Fifty seven strains of Pseudomonas pseudomallei were tested for in vitro susceptibility to 15 antimicrobial agents. Amongst the generally recommended antibiotics for therapy of melioidosis, only 86%, 84% and 58% of the strains were found to be sensitive to trimethoprim-sulphamethoxazole, chloramphenicol and tetracycline respectively. Of the newer B-Iactams, in descending order of activity were, ceftazidime, ceftriaxone, cefotaxime, cefoperazone and cefuroxime. But on a weight for weight basis, ceftazidime was the most active agent and as such, may be considered in the therapy of acute septicaemic melioidosis."
    Matched MeSH terms: Anti-Bacterial Agents/pharmacology*
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