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Evaluation of the efficacy of antibacterial medical gloves in the ICU setting

Kahar Bador M, Rai V, Yusof MY, Kwong WK, Assadian O

J Hosp Infect, 2015 Jul;90(3):248-52.
PMID: 25982193 DOI: 10.1016/j.jhin.2015.03.009

Inappropriate use of medical gloves may support microbial transmission. New strategies could increase the safety of medical gloves without the risk of patient and surface contamination.

Matched MeSH terms: Cross Infection/prevention & control; Infection Control/methods*; Infection Control/standards
Fulltext Public Health Risks of Multiple-Drug-Resistant Enterococcus spp. in Southeast Asia

Daniel DS, Lee SM, Dykes GA, Rahman S

Appl Environ Microbiol, 2015 Sep;81(18):6090-7.
PMID: 26150452 DOI: 10.1128/AEM.01741-15

Enterococci rank as one of the leading causes of nosocomial infections, such as urinary tract infections, surgical wound infections, and endocarditis, in humans. These infections can be hard to treat because of the rising incidence of antibiotic resistance. Enterococci inhabiting nonhuman reservoirs appear to play a critical role in the acquisition and dissemination of antibiotic resistance determinants. The spread of antibiotic resistance has become a major concern in both human and veterinary medicine, especially in Southeast Asia, where many developing countries have poor legislation and regulations to control the supply and excessive use of antimicrobials. This review addresses the occurrence of antibiotic-resistant enterococci in Association of Southeast Asian Nations countries and proposes infection control measures that should be applied to limit the spread of multiple-drug-resistant enterococci.

Matched MeSH terms: Cross Infection/microbiology*; Cross Infection/epidemiology*; Infection Control/methods
Environmental contamination in the hospital as a possible source for nosocomial infection with methicillin-resistant Staphylococcus aureus

Ghaznavi-Rad E, Ghasemzadeh-Moghaddam H, Shamsudin MN, Hamat RA, Sekawi Z, Aziz MN, et al.

Infect Control Hosp Epidemiol, 2010 Dec;31(12):1302-3.
PMID: 21028965 DOI: 10.1086/657587
Matched MeSH terms: Cross Infection/diagnosis*; Cross Infection/microbiology*; Cross Infection/prevention & control; Infection Control/methods
Case report post-splenectomy sepsis in thalassemic patients

Zarina AL, Hamidah A, Zulkifli SZ, Jamal R

Southeast Asian J. Trop. Med. Public Health, 2005 Mar;36(2):471-3.
PMID: 15916058

Thalassemia is the commonest hemoglobinopathy in Malaysia. Patients with thalassemia major are transfusion dependent, and a large proportion of them will require splenectomy. As this particular group of patients is immunocompromized, overwhelming sepsis is a recognized complication. We report a series of three patients who all developed intra-abdominal abscesses following splenectomy.

Matched MeSH terms: Cross Infection/drug therapy; Cross Infection/microbiology*; Surgical Wound Infection/drug therapy; Surgical Wound Infection/microbiology*
Fulltext Methicillin-resistant Staphylococcus aureus (mrsa) in a Malaysian hospital

Cheong I, Tan SC, Wong YH, Zainudin BM, Rahman MZ

Med J Malaysia, 1994 Mar;49(1):24-8.
PMID: 8057986

Between August 1990 to November 1991, 905 of 2583 (35.4%) isolates of Staphylococcus aureus were found to be methicillin-resistant in a general hospital in Malaysia. A detailed study of 539 of these isolates showed a high prevalence of methicillin resistant Staphylococcus aureus (MRSA) in the surgical/orthopaedic wards, paediatric wards and the special care unit. The yield of MRSA was highest from wounds/ulcers/skin swabs accounting for 64.2 per cent followed by 6.9 per cent in blood cultures. Vancomycin remains the drug of choice with no resistance detected. The resistance to ciprofloxacin was 6.7 per cent, rifampicin 4.5 per cent and fusidic acid 2.0 per cent. Most isolates were resistant to aminoglycosides. In view of the high prevalence of MRSA in this hospital, the authorities must introduce more effective measures to control its spread as a nosocomial pathogen. Otherwise it may seriously disrupt the efficient delivery of health care services in the country.

Matched MeSH terms: Cross Infection/drug therapy; Cross Infection/microbiology*; Cross Infection/epidemiology*; Cross Infection/prevention & control; Infection Control
Six-year study on peripheral venous catheter-associated BSI rates in 262 ICUs in eight countries of South-East Asia: International Nosocomial Infection Control Consortium findings

Rosenthal VD, Bat-Erdene I, Gupta D, Rajhans P, Myatra SN, Muralidharan S, et al.

J Vasc Access, 2021 Jan;22(1):34-41.
PMID: 32406328 DOI: 10.1177/1129729820917259

BACKGROUND: Short-term peripheral venous catheter-associated bloodstream infection rates have not been systematically studied in Asian countries, and data on peripheral venous catheter-associated bloodstream infections incidence by number of short-term peripheral venous catheter days are not available.
METHODS: Prospective, surveillance study on peripheral venous catheter-associated bloodstream infections conducted from 1 September 2013 to 31 May 2019 in 262 intensive care units, members of the International Nosocomial Infection Control Consortium, from 78 hospitals in 32 cities of 8 countries in the South-East Asia Region: China, India, Malaysia, Mongolia, Nepal, Philippines, Thailand, and Vietnam. For this research, we applied definition and criteria of the CDC NHSN, methodology of the INICC, and software named INICC Surveillance Online System.
RESULTS: We followed 83,295 intensive care unit patients for 369,371 bed-days and 376,492 peripheral venous catheter-days. We identified 999 peripheral venous catheter-associated bloodstream infections, amounting to a rate of 2.65/1000 peripheral venous catheter-days. Mortality in patients with peripheral venous catheter but without peripheral venous catheter-associated bloodstream infections was 4.53% and 12.21% in patients with peripheral venous catheter-associated bloodstream infections. The mean length of stay in patients with peripheral venous catheter but without peripheral venous catheter-associated bloodstream infections was 4.40 days and 7.11 days in patients with peripheral venous catheter and peripheral venous catheter-associated bloodstream infections. The microorganism profile showed 67.1% were Gram-negative bacteria: Escherichia coli (22.9%), Klebsiella spp (10.7%), Pseudomonas aeruginosa (5.3%), Enterobacter spp. (4.5%), and others (23.7%). The predominant Gram-positive bacteria were Staphylococcus aureus (11.4%).
CONCLUSIONS: Infection prevention programs must be implemented to reduce the incidence of peripheral venous catheter-associated bloodstream infections.

Matched MeSH terms: Cross Infection/microbiology; Cross Infection/mortality; Cross Infection/epidemiology*; Cross Infection/therapy; Infection Control
Critical care nurses' knowledge in preventing nosocomial pneumonia

Soh KL, Koziol-Mclain J, Wilson J, Soh KG

Aust J Adv Nurs, 2007 Mar-May;24(3):19-25.
PMID: 17518161

The purpose of this study was to identify knowledge deficits concerning nosocomial pneumonia (NP) prevention among critical care nurses. The study also determined whether NP knowledge was associated with nurse characteristics.

Matched MeSH terms: Cross Infection/prevention & control*
Fulltext Disinfection and the control of nosocomial infection

Lim VKE

Med J Malaysia, 1995 Dec;50(4):289-90.
PMID: 8668044
Matched MeSH terms: Cross Infection/prevention & control*
Fulltext Microbial diseases in Malaysia: recent experiences

Arokiasamy JT

Med J Malaysia, 1996 Mar;51(1):4-11.
PMID: 10967972

Microbial diseases continue to occur in Malaysia despite the marked socio-economic development that has been taking place in the country along with improvements in the medical, health, and environmental sectors. This paper highlights the continuing presence of the numerous microbial diseases including the emergence of new problems such as AIDS. Local publications dealing with work on several microbial diseases is reviewed to show that this group of diseases will pose challenges for a long while. Undoubtedly several other diseases that were relatively unrecognised in the past are increasingly being identified owing to recent availability of diagnostic facilities and equipments. The need for continued vigilance is emphasised.

Matched MeSH terms: Cross Infection/mortality
Fulltext Laboratory acquired murine typhus--a case report

Norazah A, Mazlah A, Cheong YM, Kamel AG

Med J Malaysia, 1995 Jun;50(2):177-9.
PMID: 7565191

A 34-year-old laboratory worker developed murine typhus after an accidental splashing of Rickettsia typhi over her right eye and lips. Indirect immunoperoxidase test showed a four-fold increase in titre to Rickettsia typhi. She responded well to doxycycline.

Matched MeSH terms: Laboratory Infection*
Fulltext Adult allogeneic bone marrow transplantation: initial experience in the University Hospital, Kuala Lumpur

Teh A, Bosco JJ, Leong KW, Saw MH, Menaka N, Devashanti P

Med J Malaysia, 1997 Mar;52(1):26-32.
PMID: 10968050

Prior to 1993, bone marrow transplantation for adult patients was not available in Malaysia. Adult allogeneic bone marrow transplantation commenced in Malaysia when the first transplant was conducted at the University Hospital, Kuala Lumpur on 2 November 1993. Up till July 1995, 10 adult bone marrow transplants had been conducted at the University Hospital. Five patients had acute myeloid leukaemia in first remission, 4 had chronic myeloid leukaemia and 1 had acute lymphoblastic leukaemia in first partial remission. The age range of patients at the time of transplant is 16-40 years (mean 25.5 years). All patients engrafted successfully and the survival for the first 100 days post-transplant is 90%. One patient demonstrated haematological relapse post-transplant but achieved remission with donor buffy-coat infusion. The mean drug cost incurred was RM28,269 for the first 100 days. Locally available adult allogeneic bone marrow transplantation is safe, affordable and has comparable results with reputable overseas transplant centres.

Matched MeSH terms: Infection/etiology
Fulltext Childhood burns at the Paediatric Institute Kuala Lumpur

Ibrahim SB, Omar MB, Gan EC, Rauf A, Johari NB, Yusof HB

Med J Malaysia, 1995 Sep;50(3):221-5.
PMID: 8926898

A prospective study of 94 burned children was carried out from January 1993 to October 1994. Scalding was the predominant cause of injury affecting mainly toddlers between 1 and 3 years old. Ninety-six per cent of the injuries occurred at home. There was 1 death following an 81% flame burns. An intense campaign to make parents aware of the hazards is required as almost all the injuries were preventable.

Matched MeSH terms: Wound Infection/epidemiology
Iron and infection: the clinical evidence

Oppenheimer SJ

Acta Paediatr Scand Suppl, 1989;361:53-62.
PMID: 2485586

Iron deficiency is prevalent in childhood in the developed and developing countries. Programs of presumptive therapy, mass supplementation and food fortification have been introduced in many countries. The unresolved debate over the interaction of iron and infection in the clinical setting prompts re-evaluation of these practices. Situations of iron overload are associated with increased susceptibility to certain infections, although the exact mechanisms may vary with the main pathology. Iron treatment has been associated with acute exacerbations of infection, in particular malaria. In most instances parenteral iron was used. In the neonate parenteral iron is associated with serious E. coli sepsis. In one country, with endemic malaria, parenteral iron was associated with increased rates of malaria and increased morbidity due to respiratory disease in infants. In contrast in non-malarious countries studies of oral iron supplementation have if anything shown a reduction in infectious morbidity. Methodological problems in the latter reports indicate the need for further controlled prospective studies with accurate morbidity recording if informed recommendations are to be made.

Matched MeSH terms: Infection/etiology*
Fulltext Aeromonas hydrophila hand infection complicating an open Rolando fracture: a case report

Sambandan S

Med J Malaysia, 1985 Mar;40(1):38-40.
PMID: 3831733

A case of Aeromonas hydrophila infection complicating an open Rolando's fracture of the hand is reported. Only two cases, both complicating open tibial fractures have been reported in the literature previously.' ,2 The organism was resistant to the usual antimicrobial (ampicillin and cloxacillin) used in the management of open fractures at University Hospital, Kuala Lumpur. The severity of the infection is largely dependent on the resistance of the host, and could vary from a locally spreading necrotizing cellulitis without systemic signs to a frank septicaemia with serious consequences. Early diagnosis with adequate debridement of the wound and appropriate antimicrobial to which the organisms are sensitive, are essential for effective control.

Matched MeSH terms: Wound Infection/etiology*
Fulltext The use of cefotaxime in serious and problem surgical infections

Balasegaram M, Devanand MR, Singh B

Med J Malaysia, 1980 Sep;35(1):68-72.
PMID: 6265744

Cefotaxime [HR 756], a third generation cephalosporin with pronounced antibacterial activity
against the Enterobacteriaceae, was assessed in serious and problem antibiotic resistant infection. Good clinical success was achieved without observed untoward effects. The study suggests that due to its properties, cefotaxime could be used as a first-line antibiotic provided that the clinical situation warrants the use of a cephalosporin or aminoglycoside.
Key words - cefotaxime [HR 756], serious surgical infection, antibiotic resistant infection.

Matched MeSH terms: Surgical Wound Infection/drug therapy*
Management of odontogenic infection in paediatric patients: a retrospective clinical study

Lim SW, Lee WS, Mani SA, Kadir K

Eur Arch Paediatr Dent, 2020 Feb;21(1):145-154.
PMID: 31332632 DOI: 10.1007/s40368-019-00466-0

PURPOSE: To investigate the outpatient and inpatient management of odontogenic infections among paediatric patients attending a university hospital.
METHODS: A retrospective study (2013-2015) was carried out which involved retrieving relevant data from past records (manual/electronic) of paediatric patients (under 18-years-old) who presented with odontogenic infections to the Paediatric Dentistry and Oral and Maxillofacial clinic. Data collected was organised using descriptive statistics with SPSS version 12.0.1.
RESULTS: A total of 153 patients were identified, of which 83.7% were managed as outpatients. Odontogenic infections were more common in females (52.9%) and preschool children (58.2%). The most cases were seen in 2014 and maximum number of cases per month was 12. Common presentations were pain (62.1%), intraoral swelling (37.9%) and spontaneous pus discharge from the tooth and/or surrounding tissues (67.3%) with higher involvement of primary right molars. Dental panoramic tomograph was the most common radiographic investigation done. Outpatients were commonly managed chairside with pulpal opening (46.1%) at the paediatric dental clinic and 7% underwent extraction under general anaesthesia in day-care setting. Inpatients were admitted for 3 days on average and most commonly definitive care was extraction under local/general anaesthesia (68%). There were 22.7% outpatients and 72.0% inpatients who were prescribed antibiotics.
CONCLUSIONS: Overall, treatment and medications prescribed adhered to current guidelines. There was a tendency to solely prescribe antibiotics in 8.6% of outpatients which is contrary to recommendations.

Matched MeSH terms: Infection*
Fulltext Knowledge and practice among nurses on management of tuberculosis in a teaching hospital

Hng, S.H., Siti Nabihah, S., Siti Nabilah, S.

Medicine & Health, 2018;13(1):153-164.
MyJurnal

Tuberculosis (TB) has become a worldwide public concern with 10.4 million new cases reported in 2015 and 1.4 million deaths. More importantly, an increase in trend in TB incidence among healthcare workers has become a major concern. Therefore, the present study was conducted to explore the knowledge and practice towards TB and the factors associated with it among nurses in a teaching hospital. The present study used cross-sectional design and stratified sampling method. A total of 275 nurses in a teaching hospital participated in this study. The knowledge and practice on management of TB was measured using a structured questionnaire. Majority of the respondents had good knowledge and practice on management of TB represented by 70.2% and 63.3%, respectively. However, knowledge gap (1.8%) and practice gap (0.4%) were identified in method of sputum collection. Work place setting was the only demographic factor found significantly associated with level of knowledge and practice (p=0.028). Level of knowledge and practice on management of TB identified among nurses was not associated with many socio-demographic factors. Nurses as frontline healthcare workers are at high risk of being exposed due to frequent contact with various patients especially those who are undiagnosed and TB suspect patients. Hence, implementation of TB Infection Control (TBIC) measures is important to minimize the risk of infection and cross-infection within hospital.

Matched MeSH terms: Cross Infection; Infection Control
Fulltext A Narrative Review of Antimicrobial Stewardship Interventions within In-patient Settings and Resultant Patient Outcomes

Shirazi OU, Ab Rahman NS, Zin CS

J Pharm Bioallied Sci, 2020 10 08;12(4):369-380.
PMID: 33679082 DOI: 10.4103/jpbs.JPBS_311_19

The overuse of antibiotics has led to various healthcare problems such as the emergence of resistance in infectious microbes and mortality due to antibiotic resistant healthcare associated infections (HAIs). An antimicrobial stewardship (AMS) program is the set of interventions used worldwide to enhance the rational use of antibiotics especially for the hospitalized patients. This review aimed to describe the characteristics of the implemented AMS programs in various hospitals of the world mainly focusing on the interventions and patients outcomes. The literature about AMS program was searched through various databases such as PubMed, Google Scholar, Science Direct, Cochran Library, Ovid (Medline), Web of Science and Scopus. In this review the literature pertaining to the AMS programs for hospitalized patients is sorted on the basis of various interventions that are categorized as formulary restriction (pre-authorization), guideline development, clinical pathway development, educative interventions and prospective audit. Moreover a clear emphasis is laid on the patient outcomes obtained as a result of these interventions namely the infection control, drop in readmission rate, mortality control, resistance control and the control of an overall cost of antibiotic treatment obtained mainly by curbing the overuse of antibiotics within the hospital wards. AMS program is an efficient strategy of pharmacovigilance to rationalize the antimicrobial practice for hospitalized patients as it prevents the misuse of antibiotics, which ultimately retards the health threatening effects of various antibiotics.

Matched MeSH terms: Cross Infection; Infection Control
Fulltext The forgotten sub-regional COVID-19 response layer. The case of the WHO Eastern Mediterranean Region

Ali Maher O, Elamein Boshara MA, Pichierri G, Cegolon L, Panu Napodano CM, Murgia P, et al.

J Infect Dev Ctries, 2021 04 30;15(4):478-479.
PMID: 33956646 DOI: 10.3855/jidc.14057

The response to the COVID-19 pandemic have been driven by epidemiology, health system characteristics and control measures in form of social/physical distancing. Guidance, information and best practices have been characterized by territorial thinking with concentration on national health system and social contexts. Information was to a large extent provided from global entities such as the World Health Organization (WHO), Centers for Disease Control and Prevention (CDC) and others. This bipolar response mechanism came to the detriment of regional and sub-regional levels. The development of the global pandemic was evaluated in terms of the performance of single countries without trying to reflect on possible regional or sub-regional results of similar characteristics in health system and social contexts. To have a clearer view of the issue of sub-regional similarities, we examined the WHO, Eastern Mediterranean Region. When examining the development of confirmed cases for countries in the region, we identified four different sub-groups similar in the development of the pandemic and the social distancing measure implemented. Despite the complicated situation, these groups gave space for thinking outside the box of traditional outbreaks or pandemic response. We think that this sub-regional approach could be very effective in addressing more characteristics and not geographically based analysis. Furthermore, this can be an area of additional conceptual approaches, modelling and concrete platforms for information and lessons learned exchange.

Matched MeSH terms: Infection Control/methods*
Highly sensitive and specific graphene/TiO2 impedimetric immunosensor based on plant-derived tetravalent envelope glycoprotein domain III (EDIII) probe antigen for dengue diagnosis

Siew QY, Pang EL, Loh HS, Tan MTT

Biosens Bioelectron, 2021 Mar 15;176:112895.
PMID: 33358432 DOI: 10.1016/j.bios.2020.112895

This study reports on the development of a novel impedimetric immunosensor design using plant-derived antigenic glycoprotein for the detection of dengue virus (DENV) IgG antibodies. The electrochemical immunosensor platform was constructed using screen-printed carbon electrode (SPCE) modified with graphene/titanium dioxide (G/TiO2) nanocomposite to improve the electrode in terms electrochemical performance and specific surface area. A plant-derived dengue envelope domain III (EDIII) protein was used as the antigenic probe protein in this immunosensing strategy. Under optimised sensing conditions, the immunosensor demonstrated high sensitivity towards DENV IgG in a wide linear working range (62.5-2000 ng/mL), with a limit of detection of 2.81 ng/mL. The immunosensor showed high specificity for discriminating DENV IgG against antibodies of other infectious disease, including the closely related Zika virus (ZIKV). The reliability of the immunosensor in serological diagnosis was verified by challenging the immunosensor against serum samples, compared to conventional enzyme-linked immunosorbent assay (ELISA). As shown by its remarkable performance throughout the study, the devised immunosensor is proposed as a reliable and practical diagnostic tool for the serological detection of dengue in realistic applications.

Matched MeSH terms: Zika Virus Infection*

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