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Fulltext Pattern of organisms and antibiotics used in treating diabetes foot infection

Joehaimey, J., M. Anwar Hau A., Kamil, M.K., Jaya Purany, S.P., Saadon, I., Chee Huan, P., et al.

International Medical Journal Malaysia, 2016;15(1):25-30.
MyJurnal

Introduction: The aim of this study is to determine the most common organisms isolated in diabetic foot infection and the most utilised antibiotic regimes as the first line of treatment.
Methods: This is a retrospective record review of the National Orthopaedic Registry Malaysia among diabetes mellitus type 2 patients who had foot infections. All identified cases admitted to 18 government hospitals in Malaysia from the 1st January 2008 until the 31st December, 2009 were included in the study.
Results: A total of 416 patients were included in the study. The most common organisms cultured were Proteus species (17.5%), Klebsiella species (17.1%) and Staphylococcus aureus (17.9%), while the most commonly used antibiotic was ampicillin/sulbactam (67.5%). None of the patients was appropriately treated with metronidazole, cefoperazone or fucidic acid. All patients were given appropriate antibiotics to treat Serratia infection.
Conclusion: Significant number of patients with diabetic foot infections were not treated using appropriate antibiotics as the first line treatment.

Matched MeSH terms: Anti-Bacterial Agents
Mycoplasma hominis, Ureaplasma urealyticum and Chlamydia trachomatis Respiratory Colonization in Malaysian Preterm Infants

Ng KF, Kee Tan K, Chok MC, Zamil Mohd Muzzamil N, Choo P, Paramasivam U, et al.

J Trop Pediatr, 2017 Dec 01;63(6):447-453.
PMID: 28334949 DOI: 10.1093/tropej/fmx011

This prospective observational study aims to determine the incidence, predictors and clinical features of Mycoplasma hominis (MH), Ureaplasma urealyticum (UU) and Chlamydia trachomatis (CT) respiratory colonization in infants <37 weeks of gestation. A total of 200 preterm newborns admitted to a tertiary center in Malaysia between 2013 and 2015 for increased breathing effort had their respiratory secretions tested for these bacteria by polymerase chain reaction. Fifteen of the 200 (7.5%) infants were detected to have these organisms in their respiratory tracts. Preterm prelabor rupture of membrane was associated with positive detection (odds ratio: 3.7; 95% confidence interval: 1.2-11.3). Seventy-three of the 200 (36.5%) infants were given macrolide for presumed infection but only 4.1% (3 of 73) were positive for these organisms. The incidence of UU respiratory colonization among preterm infants in our center is lower than other published reports, while the frequency of MH and CT isolation is comparable with many studies. There should be judicious use of empirical antibiotics for presumed UU, MH and CT infection in preterm infants.

Matched MeSH terms: Anti-Bacterial Agents
Fulltext Bile Sensing: The Activation of Vibrio parahaemolyticus Virulence

Letchumanan V, Chan KG, Khan TM, Bukhari SI, Ab Mutalib NS, Goh BH, et al.

Front Microbiol, 2017;8:728.
PMID: 28484445 DOI: 10.3389/fmicb.2017.00728

Bacteria must develop resistance to various inhospitable conditions in order to survive in the human gastrointestinal tract. Bile, which is secreted by the liver, and plays an important role in food digestion also has antimicrobial properties and is able to disrupt cellular homeostasis. Paradoxically, although bile is one of the guts defenses, many studies have reported that bacteria such as Vibrio parahaemolyticus can sense bile and use its presence as an environmental cue to upregulate virulence genes during infection. This article aims to discuss how bile is detected by V. parahaemolyticus and its role in regulating type III secretion system 2 leading to human infection. This bile-bacteria interaction pathway gives us a clearer understanding of the biochemical and structural analysis of the bacterial receptors involved in mediating a response to bile salts which appear to be a significant environmental cue during initiation of an infection.

Matched MeSH terms: Anti-Bacterial Agents
Fulltext Detection and antibiotic susceptibility profiles of Listeria monocytogenes in wildlife and water samples in Kubah National Park, Sarawak, Malaysia

Lesley, M.B., Velnetti, L., Fazira, A.A., Kasing, A., Samuel, L., Micky, V., et al.

International Food Research Journal, 2016;23(1):360-365.
MyJurnal

This study was conducted to detect the presence of Listeria monocytogenes (L. monocytogenes)
and screen for its antibiotic susceptibility characteristic from wildlife and water samples at
Kubah National Park, Sarawak, Malaysia. Samples collected were incubated and streaked on
selective medium PALCAM agar to confirm the presence of Listeria spp. before they were
further tested using molecular analysis. Specific Polymerase Chain Reaction (PCR) assay were
performed to target specific virulence gene, haemolysin gene, hlyA to further distinguish the
presence of this pathogenic bacteria in the samples. Overall, out of the 30 samples tested, 10
samples were confirmed as to contain L. monocytogenes strains and selected to subsequent
antibiotic susceptibility test. Susceptibility patterns to 10 antibiotics were investigated
among the L. monocytogenes strains. All strains were uniformly resistant to tetracycline and
erythromycin. On the other hand, all strains were sensitive to gentamycin and tobramycin. The
multiple antibiotic resistance shown by the strains in this study indicate the potential health
hazard associated with the possible transmission between wildlife and water to its surrounding
environment especially visitors and workers of Kubah National Park, Sarawak, Malaysia.

Matched MeSH terms: Anti-Bacterial Agents
Fulltext Role of ampicillin-sulbactam: a district hospital’s experience in treating diabetic foot ulcers

Ng, C. S., Vadivelu, M., Chan, K. Y.

International e-Journal of Science, Medicine & Education, 2009;3(2):28-30.
MyJurnal

Abstract: Ampicillin-sulbactam combination is the most frequently prescribed antibiotic in diabetic foot ulcers. We conducted a retrospective study to evaluate the antibiotic sensitivity of bacteria isolated to this antibiotic. In 33 patients with diabetic foot ulcer (September 2008-March 2009), 67% were culture positive in which Citrobacter spp accounted for 36% of these isolates. The rest isolated included Pseudomonas aeruginosa (22%), Proteus spp (18%), Acinetobacter spp (9%), Klebsiella pneumoniae (5%), Escherichia coli (5%) and Staphylococcus aureus (5%). These isolates were more likely to be ampicillin-resistant (n=18) than were ampicillin-sensitive isolates (n=4). Ampicillin resistance has raised our concern about current practice of prescribing ampicillin/ sulbactam as monotherapy for majority of our patients with such ulcers.

Matched MeSH terms: Anti-Bacterial Agents
Fulltext Severe respiratory sequelae of H1N1: clinical features, management and outcome – a review

Ismail A. Hamid, Marzida Mansor, Siok, Gracie Yan Ong, Kumar, N.M.

International e-Journal of Science, Medicine & Education, 2010;4(2):-.
MyJurnal

Since the outbreak of the novel influenza H1N1 in April 2009 in Mexico, more then half a million cases have been recorded with more then 6000 deaths.In contrast to seasonal flu, this virus appears to have a predilection for the young, obese and pregnant.It’s most important and almost fatal complication is Acute Respiratory Distress Syndrome (ARDS). Intensive care units (ICU) around the world have scrambled to upgrade various treatment modalities including high frequency oscillation ventilation, inotropes, antivirals and antibiotics in an effort to reduce the mortality arising out of this complication. More importantly, this complication appears reversible if adequate and early therapy is instituted. In particular, rescue therapies that allow the lung to rest appear to have brought success in some clinical settings. This article describes the experiences of seven centers that have used various modalities as rescue therapy in patients having Acute Respiratory Distress Syndrome (ARDS). The experiences in 13 patients at the University of Michigan, 58 in Mexico, 168 in Canada, 180 patients at Leicester UK, 194 in Australia and New Zealand and case reports from Hong Kong and Singapore are described.

Matched MeSH terms: Anti-Bacterial Agents
Fulltext Urinary tract infections in pregnancy

Loh KY, Sivalingam N

Malays Fam Physician, 2007;2(2):54-57.
MyJurnal

Urinary tract infections frequently affect pregnant mothers. This problem causes significant morbidity and healthcare expenditure. Three common clinical manifestations of UTIs in pregnancy are: asymptomatic bacteriuria, acute cystitis and acute pyelonephritis. Escherichia coli remains the most frequent organism isolated in UTIs. All pregnant mothers should be screened for UTIs in pregnancy and antibiotics should be commenced without delay. Urine culture and sensitivity is the gold standard in diagnosing UTIs. Without treatment, asymptomatic bacteriuria in pregnancy is associated with preterm delivery, intrauterine growth retardation, low birth weight, maternal hypertension, pre-eclampsia and anaemia. Acute pyelonephritis can lead to maternal sepsis. Recurrent UTIs in pregnancy require prophylactic antibiotic treatment.

Matched MeSH terms: Anti-Bacterial Agents
Emergence of antibiotic resistant Streptococcus pneumoniae in malaysia

Farida Jamal

Malaysian Journal of Child Health, 1997;9(2):174-177.
MyJurnal

Streptococcus pneumoniae is an important cause of community acquired infections, particularly pneumonia, acute otitis media, sinusitis and exacerbations of chronic bronchitis. Together with Haemophilus influenzae, it is an important cause of childhood meningitis. It is also a major cause of bacterial meningitis among adults. The emergence of Streptococcus pneumoniae resistant to penicillin and other antibiotics in recent years has complicated the management of pneumococcal infections world-wide'. In some areas, penicillin resistant strains have become the predominant pneumococcal isolates2. Multiply resistant strains and those resistant to second and third generation cephalosporins are also increasingly reported'. Treatment of meningitis and acute otitis media caused by such strains is particularly problematic. (Copied from article).

Matched MeSH terms: Anti-Bacterial Agents
Fulltext Clostridium difficile Infection: clinico-epidemiological perspective

Syuhada, N., Azimatun, N.A., Alfizah, H., Tzar, M.N., Ramliza, R.

Medicine & Health, 2013;8(2):64-72.
MyJurnal

Clostridium difficile infection (CDI) causes mild to severe diarrhoea and pseudomembranous colitis in patients who had prior antibiotic exposure. Despite CDI being prevalent worldwide, its epidemiological data is scanty in Malaysia. This study aimed to determine the prevalence and incidence of CDI at Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Stool specimens from 147-suspected CDI patients were obtained from 1 November 2011 until 31 October 2012. The presence of C. difficile toxin A and/or B were detected using a commercial immunochromatographic kit (Wampole™ Tox A/B Quik Chek). Surveillance data was collected from patients’ medical records to establish the demographic and clinical characteristics. The overall prevalence and incidence of CDI in UKMMC was 6.1% and 5.2 cases per 10 000 patient-days, respectively. Among nine CDI patients, 77.8% were males and 55.6% were Chinese. CDI was most common in medical wards (88.9%). The median age was 60 years and the median length of hospital stay was 13 days. Majority (88.9%) of CDI patients received antibiotics eight weeks prior to CDI. Penicillin-beta-lactamase inhibitors were the most common antecedent antibiotics. Five (55.6%) CDI patients received acid suppressant medications. The in-hospital mortality rate was 22.2%. In conclusion, the prevalence and incidence of CDI at UKMMC is relatively low and occurs sporadically.

Matched MeSH terms: Anti-Bacterial Agents
Fulltext Pseudomonas aeruginosa: epidemiology of bactereremia and antimicrobial susceptibility pattern in a teaching hospital in Kuala Lumpur

Nadeem, S.R., Rina, K., Hamimah, H., Savithri, D.P.

JUMMEC, 2006;9(1):14-19.
MyJurnal

A cross-sectional study of 109 patients with Pseudomonas aeruginosa bacteremia from the University of Malaya Medical Centre (UMMC) in the years 2000 and 2001 was conducted to describe epidemiological features, underlying diseases, possible source of infection, early mortality among patients as well as the antibiotic susceptibility pattern of patients' isolates. Further analysis of the 87 patient records that were available revealed that the mean age was 48.5 years (SD ± 25.1). Fifty-two per cent of cases were male and 48% female. Seventy-nine per cent of infections were nosocomially acquired, 33% of bacteremias were polymicrobial, 47% of patients had a continuous bladder drainage catheter (CBD) in situ, 33% had a central venous catheter (CVL) present at the time of bacteremia and 30% were ventilated. Sixty-eight per cent of patients had an underlying immunosuppressed state and 26% had undergone surgery involving general anesthesia in the week prior to isolating P. aeruginosa. Among the 23 patients with early mortality, 61% were on inappropriate antimicrobials. Most of the patients' isolates were sensitive to imipenem (86%), ciprofloxacin (81%), ceftazidime (79%), gentamicin (78%) and cefoperazone (77%). Among the community acquired strains, however, there was 100% sensitivity to imipenem, ceftazidime, cefoperazone and ciprofloxacin.

Matched MeSH terms: Anti-Bacterial Agents
Biliary ascariasis: a wandering worm

Lim, C.B., Munirah, A., Alias, M., Nandy, A.K., Thamby Dorai, C.R.

Malaysian Journal of Paediatrics and Child Health, 2000;12(1):68-71.
MyJurnal

Ascaris lumbricoides infection usually results in mild gastrointestinal symptoms. However, heavy worm load infections can cause major complications. In one-third of the latter cases, the worms enter the bile duct causing cholangitis, biliary colic and acute pancreatitis. We describe an eleven-year-old Indian boy who presented with high grade fever, vomiting of worms, jaundice and right hypochondria! pain. Examination revealed an ill, malnourished and jaundiced child. His abdomen was tender with positive Murphy's sign and hepatomegaly. Urgent ultrasound showed hepatomegaly with dilated intrahepatic and common bile ducts (CBD). There were tubular echogenic filling defects with central sonolucency along the long axis of the CBD. He was fasted, started on intravenous fluids and broad spectrum antibiotics. As there was no improvement after 24 hours, endoscopic retrograde cholangio-pancreaticography (ERCP) was performed: it showed worms in the CBD. A stent was inserted to decompress the bile ducts and to ensure biliary drainage. The patient improved, the fever settled, jaundice resolved, serum amylase and transaminase levels normalised. It was planned to remove the stent at a later date.

Matched MeSH terms: Anti-Bacterial Agents
Fulltext Frontal mucocele masked as upper lid abcess- a case report

Ng, WL, Umi Kalthum MN, Jemaima CH, Norshamsiah MD

Journal of Surgical Academia, 2016;6(1):43-45.
MyJurnal

Frontal mucocele is not commonly masked as upper lid abscess.A 72-year-old Chinese man with underlying hyperthyroidism complained of left upper eyelid swelling of 6 months duration. The swelling had persisted and worsen when intravenous antibiotic was changed oral type. Visual acuity on presentation was hand motion and reverse relative afferent pupillary defect was present. Because the swelling was large and resulted in mechanical ptosis and ophthalmoplegia, a CT imaging was performed, which showed huge left frontal mucocele eroding the supereromedial orbital rim. The left globe was displaced inferolaterally but there was no extension into brain parenchyma. Fundus examination showed pale optic disc with dull macula. Old laser marks were seen at peripheral fundus. Referral to ortholaryngologist was made and endoscopic sinus surgery and evacuation of mucopyocoele was done. Culture and sensitivity of the fluid showed no organism. He recovered well postoperatively with additional two weeks of antibiotics. We highlight the necessity of surgical drainage of mucocele, following a course of antibiotic.

Matched MeSH terms: Anti-Bacterial Agents
Fulltext Screening of antenatal mothers and prevention of perinatal group B streptococcal infection

Raj, M., Razali N,, Sulaiman, S.

JUMMEC, 2009;12(1):27-30.
MyJurnal

The objectives of this study were: (1) to detect group B streptococcus (GBS) carriers among antenatal patients during pregnancy ( 35 to 37 weeks) in the University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia, and (2) to give antibiotic prophylaxis during the intrapartum period for the GBS carrier patients. The aim is to prevent early onset of GBS infection in newborn. This pilot study was carried out from 1st July 2005 to 31st August 2005. It is a prospective study involving 56 pregnant women who were seen at the antenatal clinic in the UMMC between 35 to 37 weeks gestation. High vaginal swab and low vaginal together with endoanal swab were taken for culture and sensitivity. The antibiotic prophylaxis was started early in the intrapartum period for patients with positive culture for GBS. GBS was detected in 18 patients which contributes to about 32% of the study population. The proper choice of antibiotic is important in successful disease prevention.

Study site: Obstretic and gynaecological clinic, University Malaya Medical Centre (UMMC)

Matched MeSH terms: Anti-Bacterial Agents
Fulltext Otogenic Brain Abscess: A Retrospective Study of 10 Patients and Review of The iterature

Asma, A., Hazim, M.Y.S., Marina, M.B., Azizi, A.B., Suraya, A., Norlaili, M.T., et al.

Medicine & Health, 2007;2(2):133-138.
MyJurnal

Proper management of chronic otitis media may reduce the incidence of otogenic brain abscess. The aim of this study was to describe the clinical profile, treatment and surgical outcome of patients presenting with otogenic brain abscess. The medical record of patients in Universiti Kebangsaan Malaysia Medical Centre (UKMMC) with otogenic brain abscess were retrospectively analyzed from January 1997-January 2006. Within this eriod we had approximately 10,800 of follow up cases of chronic otitis media (COM) in our clinic. Ten patients (2 females, 8 males) with an average age of 42 (age range 11 to 69 years) were identified with otogenic brain abscess and included in this study. The mean follow-up period was 14 months. All patients had cholesteatoma. All patients had a history of chronic ear discharge, headache, otalgia and fever. Six of the 10 patients had cerebellar abscess and 4 had temporal lobe abscess. Cerebellar signs were present in 3 patients All the patients were treated with broad-spectrum antibiotics. In 5 patients, mastoid exploration was the primary surgical treatment and the brain abscesses were treated conservatively. In the other 5 patients, craniotomy and drainage were performed followed by mastoid exploration when their neurological conditions had stabilized. All our patients had uneventful recovery. There were no permanent cerebellar signs during the follow up and no mortality reported in our series. In this series we demonstrated that early diagnosis and proper treatment of otogenic abscess leads to good neurological outcome.

Matched MeSH terms: Anti-Bacterial Agents
Fulltext Management of upper respiratory tract infections in Kinta District, Perak

Hairul lzwan AR, Hazlee AH, Noridah O

Malaysian Journal of Public Health Medicine, 2003;3(2):10-13.
MyJurnal

Upper respiratory tract infections (URTI) are the most common diseases treated in the primary health care centres in Kinta District, Perak. Thus, aretrospectiire study was undertaken to examine the documentation of the presentation of patients diagnosed with URTI and their antibiotic treatment at two health care centres in Kinta district, The randomly selected case notes of 700 patients documented the following symptoms, fever (43 .29%) , cough (68.14%) , no cough (24.43%), nasal symptoms (35 .29%) , sore throat (46.00%), headache (13 .57%) , bodyache (3 .57%) , earache (1 .86%) and gastrointestinal symptom (0, 14%) . Analysis of results using 'sore throat score' and isuggested appropriate management’ adopted from a study by Wawen et al. revealed poor correlation between diagnosis of URTI and the need for antibiotic therapy. Therefore, a clinical score for patients with sore throat can be introduced to overcome inappropriate prescription of antibiotics.
Klinik Kesihatan Gopeng, Klinik Kesihatan Malim Nawar, Kinta district, Perak, Malaysia

Matched MeSH terms: Anti-Bacterial Agents
Fulltext Stem bark of Canarium Odontophyllum Miq. (dabai) as potential source of antimicrobial agent

Noor Fazdilah Mustari, Zafira Ayushah Zainul Alamin, Noraziah Mohammad Zin, Dayang Fredalina Basri

Jurnal Sains Kesihatan Malaysia, 2017;15(1):1-6.
MyJurnal

The objective of this study was to evaluate the antimicrobial potential of methanol, acetone and distilled water stem
bark extracts from Canarium odontophyllum against Staphylococcus aureus ATCC 25923, Bacillus cereus ATCC 6633,
Escherichia coli ATCC 25932, Pseudomonas aeruginosa ATCC 27853, Acinetobacter baumannii strain sensitive, Candida
albicans ATCC 64677, Candida glabrata ATCC 90028, Aspergillus niger and Fusarium solani M2781. The extracts from
C. odontophyllum stem bark from 3.125 mg/ml to 25 mg/ml were screened against the tested microorganisms using disc
diffusion method. The Minimum inhibitory concentration (MIC) and Minimum Bactericidal Concentration (MBC) of the
extracts against susceptible organisms were determined using microbroth dilution method and streak-plate technique,
respectively. From the antibacterial screening assay, the growth of S. aureus, B. cereus and A. baumannii were inhibited
by methanol extract whereas the acetone extract was capable of inhibiting all the tested microorganisms except E.coli,
F. solani and A. niger. The lowest MIC value for methanol extract was against A. baumannii (0.195 mg/ml) whereas
its MBC value was twice its MIC value (0.391 mg/ml), indicating that methanol extract was bacteriostatic against A.
baumannii. While for acetone extract, S. aureus showed bactericidal effect with equal MIC and MBC values at 0.195 mg/
ml. In conclusion, stem bark of C. odontophyllum has the potential to be the source of antibacterial agent and can be
exploited as an alternative phytoantimicrobial.

Matched MeSH terms: Anti-Bacterial Agents
A 10-years retrospective study on Severe Cutaneous Adverse Reactions (SCARs) in a tertiary hospital in Penang, Malaysia

Loo CH, Tan WC, Khor YH, Chan LC

Med J Malaysia, 2018 04;73(2):73-77.
PMID: 29703869 MyJurnal

INTRODUCTION: Severe cutaneous adverse drug reactions (SCARs) are not uncommon and potentially lifethreatening. Our objective is to study the patient characteristics, the pattern of implicated drugs and treatment outcome among patients with SCARs.
METHODS: A 10-year retrospective analysis of SCARs cases in Penang General Hospital was carried out from January 2006 to December 2015. Data collection is based on the Malaysian Adverse Drug Reactions Advisory Committee registry and dermatology clinic records.
RESULTS: A total of 189 cases of SCARs were encountered (F:M ratio; 1.2:1.0; mean age of 45 year). The commonest manifestation was Stevens-Johnson Syndrome [SJS] (55.0%), followed by toxic epidermal necrolysis [TEN] (23.8%), drug rash with eosinophilia and systemic symptoms [DRESS] (12.7%), acute generalised exanthematous pustulosis [AGEP] (4.8%), SJS/TEN overlap syndrome (2.6%) and generalised bullous fixed drug eruptions [GBFDE] (1.1%). Mean time to onset for TEN/SJS/Overlap syndrome was 10.5±13 days; AGEP, three days; GBFDE, 2.5±0.7 days, and DRESS, 29.4±5.7 days. The most common drugs implicated were antibiotics (33.3%), followed by allopurinol (18.9%) and anticonvulsant (18.4%). Out of 154 cases of SJS/TEN/overlap syndrome, allopurinol was the commonest causative agents (20.1%). In DRESS, allopurinol accounts for 45.8% of the cases. The mortality rate in SJS, TEN and DRESS were 1.9%, 13.3% and 12.5% respectively. No mortality was observed in AGEP and GBFDE.
CONCLUSION: The commonest manifestations of SCARs in our setting were SJS, TEN and DRESS. Allopurinol was the most common culprit. Thus, judicious allopurinol use is advocated and pre-emptive genetic screening for HLAB *5801 should be considered.

Matched MeSH terms: Anti-Bacterial Agents
Fulltext Synergistic effects of Persicaria odorata (daun kesom) leaf extracts with standard antibiotics on pathogenic bacteria

Ridzuan, P.M., Hairul Aini Hamzah, Anis Shah, Norazian Mohd Hassan, Baharudin Roesnita

International Medical Journal Malaysia, 2017;16(2):27-32.
MyJurnal

Antibacterial activity of different types of P. odorata leaf extracts was evaluated in combination with
standard antibiotics. Persicaria. odorata leaves were extracted with n-hexane (n-hex), dichloromethane
(DCM) and methanol (MeOH). Each extract was applied on vancomycin (30µg), erythromycin (15µg) and
gentamicin (10µg) discs, respectively. Disk diffusion method was used to evaluate the synergistic activity of
each combination on Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pyogenes,
Streptococcus pneumoniae, Pseudomonas aeruginosa, Salmonella typhi, and Escherichia coli. Minimum
inhibitory concentration (MIC) and gas chromatography mass spectrometry (GCMS) analysis was performed on
the active extract. Synergistic effects seen were mainly from the n-hex+antibiotics combinations, mainly on
the Gram-positive bacteria (7 additive, 5 antagonistic), with MIC range from 50 µg/ml to 100 µg/ml, as well
as Gram-negative bacteria (2 additive, 2 indifferent, 5 antagonistic). In particular, synergism showed by the
combination of n-hex+van were all additive against the susceptible bacteria. DCM extract combination
showed synergistic effects on three Gram-positive species (S. aureus, S. epidermidis, S. pyogenes).
Meanwhile, MeOH+antibiotics combination showed significant additive synergistic effects (p

Matched MeSH terms: Anti-Bacterial Agents
Fulltext Actinomycosis of Distal Phalanx Twenty Years after Flap Reconstruction of Index Finger: A Case Report

Prashant N, Azuhairy A

Malays Orthop J, 2018 Mar;12(1):48-50.
PMID: 29725514 MyJurnal DOI: 10.5704/MOJ.1803.011

Actinomycosis is a chronic granulomatous suppurative infection caused by anaerobic bacteria from genus Actinomyces which are normal flora of mouth, colon and vagina. Actinomycosis of upper extremity is rare. We report a case of actinomycosis of the distal phalanx of finger many years after flap reconstruction. The patient presented with two months' history of chronic discharging sinus from the tip of his right index finger, which had sustained a degloving injury 20 years previously. It had been treated with an anterior chest wall flap which had healed uneventfully but was bulky due to excess tissue from the donor site. Radiograph revealed osetomyelitis changes of distal phalanx. Debulking surgery with curettage of the distal phalanx was done. Wound healing was uneventful. He was treated with six weeks of metronidazole and ciprofloxacin. The discharge from the distal phalanx cultured actinomycosis odontolyticus. Histopathology of the debrided tissue showed chronic inflammation. As far as we are aware, there are no reports of actinomycosis in a flap involving the finger treated previously with a chest wall skin flap. The infection was probably dormant for many years before manifesting as a discharging sinus. Although the finger flap was bulky, it was not problematic until it started to have serous discharge. With a thorough debridement of all infected tissue, six weeks of antibiotic was adequate. Ciprofloxacin was prescribed based on discharge culture sensitivity. Metronidazole was added as actinomycosis is anaerobic. Response was prompt as patient was not immunocompromised. At follow-up six months post-surgery the finger had recovered with good function. If not for the discharging sinus, patient would probably have tolerated his bulky finger for the rest of his life.

Matched MeSH terms: Anti-Bacterial Agents
Knowledge, attitude and perception regarding antimicrobial resistance and usage among ruminant farmers in Selangor, Malaysia

Sadiq MB, Syed-Hussain SS, Ramanoon SZ, Saharee AA, Ahmad NI, Mohd Zin N, et al.

Prev Vet Med, 2018 Aug 01;156:76-83.
PMID: 29891148 DOI: 10.1016/j.prevetmed.2018.04.013

The increasing public health problem of antimicrobial resistance (AMR) has been linked to the extensive antimicrobial use (AMU) in food animals. We conducted a survey among ruminant farmers in Selangor, Malaysia to assess their level of awareness on AMR, attitudes towards AMU, and determinants that influence their practices. The survey was developed in English and Malay, validated, and administered to ruminant farmers in Selangor. A total of 84 farmers (response rate of 55%) completed the structured questionnaire. They appeared to be little aware of AMR and the impact on animals and public health. Indications of inappropriate AMU include their misconception on conditions requiring antibiotic therapy and easy accessibility to antibiotics. More than 70% (60/84) of the respondents believed that all sick animals need to be given antimicrobials. Half of the farmers especially those involved in the production of small and large ruminants; namely mixed ruminant farmers (MRF) (63%, 31/49) indicated that antimicrobials do not have any side effects in animals. Sixty-four percent (54/84) of the farmers have stored antimicrobials in their farms of which the practice was more common (P = 0.02) among the MRF compared to the single ruminant farmers (SRF). Although most of the farmers felt good farm biosecurity will help reduce AMU, they were indifferent regarding using antimicrobials only when prescribed by a veterinarian and non-storage of antimicrobials for later uses. Farmers with larger herd size (>100 animals/herd) and few years of farming experience agreed more to the suggestions about their role and that of veterinarians respectively in reducing the drivers of AMR. These areas might need to be considered by advisors to inform ruminant farmers on AMR and to encourage them for prudent AMU in food-producing animals.

Matched MeSH terms: Anti-Bacterial Agents

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