Viruses in the family Picornaviridae are classified into nine genera. Within the family Picornaviridae, two species: Encephalomyocarditis virus and Theilovirus, are listed under the genus Cardiovirus. A novel Theilovirus, Saffold virus (SAFV), was first reported in 2007. Since then, numerous SAFV isolates have been detected around the world and genetic recombinations have been reported among them. In 2009, SAFV-Penang was isolated from a febrile child with influenza-like illness in Malaysia. SAFV-Penang is a genotype 3 SAFV. In this study we investigated the genome features of SAFV-Penang to exclude the possibility it is a recombinant variant. SAFV-Penang was found not to be a recombinant variant but to have three unique non-synonymous substitutions, alanine [A689], lysine [K708] and isoleucine [I724] in the VP1 protein.
From 2005 to 2009, the Institute for Medical Research (IMR), Kuala Lumpur, Malaysia received 488 serum and blood samples from hospitalized patients on the East Coast of Peninsular Malaysia, suspected of having dengue infection. In this study we determined the prevailing dengue serotypes using a real time polymerase chain reaction assay (RT-PCR). All 4 dengue virus serotypes were found circulating during the study period; however the predominant serotype varied. In 2005 and 2006, the predominant serotypes circulating were DENV-1 and DENV-3, in 2007, DENV-1 and DENV-2 were predominant, and in 2008 and 2009, DENV-3 was the predominant serotype.
Forty clinical isolates of Vibrio parahaemolyticus were studied for the production of the thermostable direct hemolysin (TDH), and the TDH-related hemolysin (TRH) including the respective encoding genes, tdh and trh. The presence of TDH and its encoding genes were found amongst 95% of the strains, whereas the TRH was absent amongst these isolates. Thirty-two isolates were found to be plasmid-free, whereas eight isolates possessed plasmids with sizes ranging from 2.4 > or = 23 kb. Using a DNA probe coding for the homologous region of the tdh and trh, it was found that the tdh genes were present on the chromosomal DNA.
A study was carried out on 49 H. pylori-positive and 11 H. pylori-negative patients to determine the reactivity of peripheral blood lymphocytes (PBL) to phytohemagglutinin (PHA) and acid glycine extract (AGE) of H. pylori, and to identify cells responsible for imunosuppression. Based on response to PHA stimulation, cell-mediated immunity of all patients were competent. In some patients, however, response to AGE of H. pylori was suppressed by plastic adherent cells. This study provided evidence of the presence of plastic adherent suppressor cells which suppressed PBL response to AGE of H. pylori but not to PHA suggesting that immunosuppression is antigen specific. There is also an indication that immunosuppression may be species-specific as PBL devoid of plastic adherent cells only responded to stimulation by AGE of H. pylori but not that to AGE of C. jejuni.
A total of 52 clinical strains of Helicobacter pylori were characterized on the basis of preformed enzyme production with API ZYM kits. Using the biotyping schemes as defined by Reina and Alomar (1989), Kung et al (1989) and Matsumoto et al (1996), 15.3% (8/52), 13.5% (7/52) and 11.5% (6/52) of the isolates were not biotypable, respectively. Two enzymes, valine arylamidase and cystine arylamidase could be additionally used to differentiate between isolates. Our isolates were either negative or positive for both the enzymes or positive only for cystine arylamidase. We propose the incorporation of these two enzymes into the Matsumoto et al (1996) biotyping scheme to biotype strains into additional enzyme biotypes.
Two commercial serological kits, Pylori-set (Orion Diagnostica, Finland) and Helico-G (Cambridge Biomedical Ltd, UK), and an in-house ELISA were evaluated with sera from 24 Helicobacter pylori-positive and 146 H. pylori-negative dyspeptic patients. Sensitivity, specificity, positive and negative predictive values of Pylori-set were lower than that of Helico-G and in-house ELISA. Helico-G was more sensitive (91.7%) than in-house ELISA (83.3%) and both had comparable negative predictive values of 98.3% and 97.3%, respectively. However, specificity (97.9%) and positive predictive value (86.9%) of an in-house ELISA were much higher than specificity (80.1%) and positive predictive value (43.1%) of Helico-G. Kappa index of agreement between the three serological tests (Pylori-set, Helico-G or in-house ELISA) and the presence of H. pylori in antral biopsies was very low (k = 0.13; z = 1.9; p > 0.05), moderate (k = 0.49; z = 7.1; p < 0.0001), or substantial (k = 0.82; z = 10.8; p < 0.0001), respectively. Overall, statistical evaluations demonstrated that both commercial kits were not as reliable as the in-house ELISA for serodiagnosing H. pylori infection.
Studies on the bionomics and host-parasite relationship of Robertsiella kaporensis and Malaysian Schistosoma were investigated. The study was divided into 4 parts: cultivation of snails, R. kaporensis, and maintenance of Malaysian Schistosoma life cycle, daily cercarial shedding cycle in R. kaporensis, miracidial load and cercarial shedding pattern and the infectivity of Malaysian Schistosoma cercariae. R. kaporensis were cultured in the laboratory with the use of plastic container provided with fine sand. The snails were fed with diatoms and Saraca leaves. The development period for the snail eggs was about 20-30 days, the young grew to maturity in 14-15 weeks, and the average growth rate of snails was 0.23 mm per week. The daily cercarial shedding cycle of snails had shown that the peak emergence of cercariae of Malaysian Schistosoma occurred at night, between 6-10 pm. The miracidial load which yielded the best results in terms of percentage infection rates of snails and cercarial output was the miracidial concentration of 8 miracidia per snail. The study on infectivity of Malaysian Schistosoma cercariae has shown that there was a decrease in infectivity of the cercariae to mammalian hosts as the cercariae increased in age. The percentage infection rate of mice and numbers of worms recovered were highest in mice infected with cercariae of 0-1/2 hr. old. Infection of cercariae fell rapidly after the cercariae were 16 hr. old.
There are regional patterns in snake-bites. Bites by cobras have a high incidence in Thailand and in the Philippines with a high case fatality rate. Among the venomous snakes of haemorrhagic nature, bites by Trimeresurus species such as green pit viper, Taiwan habu and Taiwan bamboo viper are important in Thailand and Taiwan for their high incidence of bite, although the case fatality rates are low. Bites by Malayan pit vipers are also important in Thailand and Malaysia because of their high incidence. Bites by sea snakes are more common in Malaysia than in the Philippines and Thailand.
Serum ferritin and haemoglobin estimates were carried out on 78 first time blood donors with a view to determining iron store status. Of these 30 were Malays, 20 were Chinese and 28 were Indians. The ferritin level in Malay donors ranged from 16-160 mg/ml (mean 83 +/- 49.4 mg/ml in chinese donors is ranged from 36-500 mg/ml (mean 242.8 +/- 132 mg/ml), and in the Indian donors it ranged from 5 - 270 mg/ml (mean 94.6 +/- 67.9 mg/ml). The haemoglobin concentration for the whole group was 14.9 +/- 1.49 g/dl. There was no correlation of haemoglobin concentration with serum ferritin levels.
The incidence of HBsAg in random blood donors was found to be twice that of the prisoner population. The anti-HBe however, was about twice that in the prisoners when compared with the random blood donors. Both the random blood donors and the prisoners had similar incidence of HBeAg. The percentage frequency of HBsAg positivity with anti-HBe positivity was also similar in both groups. The 18 normal non-blood donors did not have HBsAg, HBeAg or anti-HBe.
A study of Kuala Lumpur blood donors for HBsAG, anti-HBc and DNA polymeraes showed that 5.5% in the sample population was positive for HBsAG, 50.1% for anti-HBc and 10.1% for DNA polymerase activity. There was no significant difference of the HBsAG among the Malay, Chinese and Indian groups. However, a significant difference was observed for the anti-HBc and DNA polymerase activity between the Indian and the Malay/Chinese groups. Both analysis were significantly lower in the Indians but there was no significant difference between the Chinese and the Malays.
This comparative cross-sectional study was conducted in the pediatric daycare unit, Hospital Universiti Sains Malaysia to determine the prevalence of craniofacial deformities (CFD) and the association between these deformities and different clinical presentations among thalassemia patients. Patients were classified as either craniofacial deformity positive (CFD+) or craniofacial deformity negative (CFD-) by two examiners based on the presence or absence of deformity of the cheeks, frontal and/or maxillary bones. Fifteen clinical parameters were compared between the groups. Nineteen out of 43 patients (44.2%; confidence interval, 30.2-58.2%) had craniofacial deformities (CFD+). Both groups were comparable among the clinical parameters studied. Patients in the CFD+ group did not start their blood transfusions significantly earlier than the CFD- group (p = 0.50) and had a nonsignificantly lower mean pretransfusion hemoglobin level than the CFD- group (p = 0.71). Patients receiving regular monthly blood transfusions had a nonsignificantly smaller percentage of CFD than those transfused less often (p = 0.495). CFD+ patients had a splenectomy at a nonsignificantly younger age than CFD- patients (p = 0.36). HbE/beta thalassemia patients were not significantly less likely to develop CFD than other varieties (p = 0.50) and males had a nonsignificantly higher percentage of CFD than females (p = 0.29). This study shows CFD in thalassemia patients are still prevalent but no significant associated factors were found; however, a nonsignificantly higher prevalence of CFD was observed in patients with signs of severe disease and less efficient treatment.
Three strains of Pseudomonas putrefaciens were isolated from routine clinical specimens at the University Hospital, Kuala Lumpur, Malaysia. Their cultural and biochemical characteristic, and antibiotic susceptibilities are presented. Characteristics of diagnostic value were stressed. Two isolates appeared to have played a pathogenic role in chronic otitis media.
Abstract. Salmonella enterica serovar Paratyphi B is known to cause either paratyphoid fever or gastroenteritis. Differentiation of Salmonella ser. Paratyphi B into biotype Java (d-tartrate fermenting, dT+) and biotype Paratyphi B (d-tartrate non-fermenting, dT) is important for Salmonella epidemiology. This study applied a PCR approach to differentiate the two biotypes to augment the conventional biochemical method and to determine the antibiograms and genomic diversity of Malaysian S. Paratyphi B. Among 100 strains tested (clinical, 86; non-humans, 14), only two clinical strains were confirmed as biotype Paratyphi B as indicated by both lead acetate test and PCR. Antibiotic resistance rates were as follows: streptomycin 18%, sulphonamides 13%, ampicillin 10%, chloramphenicol 4%, tetracycline 3%, cefotaxime 2%, cefpodoxime 2%, ceftazidime 2%, gentamicin 1% and trimethoprim 1%. None showed resistance towards amoxicillin-clavulanic acid, ceftiofur, ciprofloxacin, nalidixic acid and trimethoprim-sulphamethoxazole. Seven strains showed multidrug resistance towards 3 or more classes of antimicrobial agents. REP-PCR and PFGE generated 32 and 76 different profiles, respectively. PFGE (D = 0.99) was more discriminative than REP-PCR (D = 0.93) and antimicrobial susceptibility test (D = 0.48) in subtyping the strains. Strains isolated 18 years apart (1982 - 2008) from different localities in Malaysia were clonally related as demonstrated by REP-PCR and PFGE, indicating that these strains were stable and widely distributed. In some clusters, strains isolated from different sources (clinical, food and animal) were grouped together. Thus, biotype Java was the most common biotype of Salmonella ser. Paratyphi B in Malaysia. The PCR approach is highly recommended due to its simplicity, specificity and ease of operation. The level of antimicrobial resistance among Salmonella ser. Paratyphi B remained relatively low in Malaysia but the emergence of resistance to cephalosporins is a cause for concern.
Pulsed field gel electrophoresis (PFGE) and antimicrobial susceptibility analysis were undertaken on twenty-three strains of Salmonella enterica serovar Tshiongwe, an unusual serovar, which recently emerged in Malaysia. Antimicrobial susceptibility analysis showed that all the strains were sensitive to ampicilin, chloramphenicol, cotrimoxazole, and kanamycin. Twenty (87%) and 8 (3.5%) strains had resistance to tetracycline and streptomycin respectively. PFGE analysis subtyped 23 strains into 10 profiles (Dice coefficient of similarity, F = 0.7-1.0). The predominant profile, X1 was found in both clinical and environmental isolates and was widely distributed in different parts of Malaysia during the study period. In addition, isolates recovered from food, a hand-towel, apron and the surface of a table-top in one particular location had unique, indistinguishable profiles (X4/4a) and identical antibiograms. Similarly, isolates from cooked meat and a chopping board had PFGE profiles similar to some human isolates. These probably indicated cross-contamination and poor hygiene in food practices, hence contributing to Salmonellosis. Factors causing the emergence of this rare Salmonella serovar being responsible for food poisoning episodes during the study period remained unclear. The study reiterated the usefulness and versatility of PFGE in the molecular subtyping of this rare Salmonella serovar in Malaysia.
A total of 736 sera collected from cord blood babies, children and adults of both sexes and of different age groups in Malaysia were tested using indirect fluorescent antibody technique for Toxoplasma antibodies. The RH strain of Toxoplasma gondii zoites were used as antigen. One hundred and twenty five sera which were reactive at 1:64 or high titres were tested with IgM specific conjugate. Results of the present studies showed that the prevalence of Toxoplasma antibody was highest among the Malays and lowest among children than among adults. The significance of Toxoplasma specific IgM was discussed.