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  1. Woh PY, Ng C
    Trop Biomed, 2024 Sep 01;41(3):298-309.
    PMID: 39548784 DOI: 10.47665/tb.41.3.010
    Rice is often associated with Bacillus cereus (B. cereus) food poisoning. This review aims to explore the food poisoning activity, antimicrobial resistance, and control measures of B. cereus in rice from 1974 to October 2023. We searched for eligible studies from the PubMed database based on explicit criteria following the PRISMA checklist. A total of 117 articles were collected, and the final analysis included 29 studies. Quality appraisal was performed using AMSTAR 2, SANRA 2, and Critical Appraisal Tool standards. B. cereus can grow and multiply in food to cause emetic vomiting or diarrheal syndrome. The primary etiology of B. cereus contamination is improper food handling and storage temperature during the cooking, cooling, and reheating stages of rice. The alarming rise of antimicrobial resistance in B. cereus to beta-lactam antibiotics necessitates alternatives from natural antimicrobial preservatives such as carvacrol, chitosan, or trans-cinnamaldehyde to prevent microbial infestation and toxin production. Implementing food safety strategies tailored to specific food settings, such as restaurants and factorymanufactured ready-to-eat rice, is critical for preventing food contamination by B. cereus. Given the heat-resistant spores and intoxication properties of B. cereus, it is important to develop effective interventions and hygienic protocols from farm to fork.
  2. Sahimin N, Alias SN, Woh PY, Edah MA, Mohd Zain SN
    Trop Biomed, 2014 Sep;31(3):422-31.
    PMID: 25382468 MyJurnal
    The quantitative buffy coat (QBC) technique and conventional Giemsa thin blood smear was compared to determine the sensitivity and specificity of the technique in detecting blood parasitic infection of the rodent populations from four urban cities in Peninsular Malaysia. A total of 432 blood samples from four rat species (Rattus norvegicus, Rattus rattus diardii, Rattus exulans and Rattus argentiventer) were screened using both techniques and successfully detected two blood protozoan species (Trypanosoma lewisi and Plasmodium sp.) with Trypanosoma lewisi predominantly infecting the population. Results showed that Giemsa-stained thin film (GTF) was the better detection method on blood parasitemia (46.7%) compared to Quantitative Buffy Coat method (38.9%) with overall detection technique sensitivity and specificity at 83.2% and 74.8% respectively. The sensitivity in detection of Trypanosoma lewisi was 84.4% with value slightly lower for Plasmodium sp. infections at 76.6%. Statistical analysis proved that GTF technique was significantly more sensitive in the detection of blood protozoan infections in the rodent population compared to QBC (p<0.05).
  3. Woh PY, Thong KL, Lim YAL, Behnke JM, Lewis JW, Mohd Zain SN
    Asia Pac J Public Health, 2017 Oct;29(7):599-607.
    PMID: 29037053 DOI: 10.1177/1010539517735856
    This study used microbial indicators to assess the hygiene status of 383 migrant food handlers from 3 urban cities in Peninsular Malaysia. Microbiological analysis revealed that all the hand swabs tested 99.5% positive for aerobic plate counts (mean [M] ± standard deviation [SD] = 3.57 ± 0.83 log10CFU [colony forming unit]), 20.8% positive for total coliform/ Escherichia coli (M ± SD = 0.30 ± 0.67 log10CFU), and 63.4% positive for Staphylococcus aureus (M ± SD = 1.38 ± 1.26 log10CFU). In addition, aerobic plate counts and Staphylococcus aureus counts exceeded the acceptable standard levels. Bacterial counts were found to be significantly associated with subjects' country of origin ( P = .019) and working responsibilities ( P = .001). Our findings indicate high probability of transmission of pathogenic bacteria from the food handlers' hands to customers during meal preparation and serving. This calls for improvements in personal hygiene and sanitation standards by the relevant health authorities among migrant food handlers.
  4. Woh PY, Thong KL, Behnke JM, Lewis JW, Zain SNM
    J Food Prot, 2017 Aug;80(8):1378-1383.
    PMID: 28722485 DOI: 10.4315/0362-028X.JFP-16-342
    Asymptomatic Salmonella carriers who work as food handlers pose food safety and public health risks, particularly during food preparation, and this has serious implications for the disease burden in society. Therefore, we conducted a study to determine the number of Salmonella carriers in a migrant cohort in several food establishments in three major cities in Peninsular Malaysia. Sociodemographic data and stool samples were collected and analyzed using standard methods of detection and isolation. Antimicrobial susceptibility tests of the positive samples were also performed. A total of 317 migrant food handlers, originating from South and Southeast Asian countries, were recruited voluntarily. Nine (2.8%) stool samples were confirmed to be Salmonella positive. PCR serotyping and pulsed-field gel electrophoresis identified four serotypes as Typhimurium (n = 3), Corvallis (n = 2), Hadar (n = 1), Agona (n = 1) and two unknown serovars. Antimicrobial susceptibility tests revealed that all nine isolates were susceptible to amoxicillin-clavulanic acid, cefotaxime, ceftazidime, ceftriaxone, and gentamycin. However, seven isolates were found to be multidrug resistant to ampicillin, chloramphenicol, trimethoprim-sulfamethoxazole, sulfonamides, streptomycin, and tetracycline. This study highlights that carriers of nontyphoidal Salmonella exist among migrant food handlers, which poses a health risk to consumers through food contamination. Our results indicate a need for authorities to enhance food safety awareness in the migrant workers and to reevaluate current health screening methods to include preventive measure such as mandatory stool screening as part of the preemployment and routine health examinations.
  5. Benacer D, Woh PY, Mohd Zain SN, Amran F, Thong KL
    Microbes Environ, 2013;28(1):135-40.
    PMID: 23363618
    Leptospira species were studied in water and soils from selected urban sites in Malaysia. A total of 151 water (n=121) and soil (n=30) samples were collected from 12 recreational lakes and wet markets. All samples were filtered and inoculated into semi-solid Ellinghausen and McCullough modified by Johnson and Harris (EMJH) media supplemented with additional 5-fluorouracil. The cultures were then incubated at 30°C and observed under a dark field microscope with intervals of 10 days. A PCR assay targeting the rrs gene was used to confirm the genus Leptospira among the isolates. Subsequently, the pathogenic status of the isolates was determined using primer sets G1/G2 and Sapro1/Sapro2, which target the secY and rrs genes, respectively. The isolates were identified at serogroup level using the microscopic agglutination test (MAT) while their genetic diversity was assessed by pulsed field gel electrophoresis (PFGE). Based on dark field microscopy, 23.1% (28/121) water and 23.3% (7/30) soil cultures were positive for Leptospira spp. Of the 35 positive cultures, only 8 were pure and confirmed as Leptospira genus by PCR assay. Two out of 8 isolates were confirmed as pathogenic, 5 were saprophytic and one was intermediate. These 8 isolates were negative for the 25 reference hyperimmune rabbit sera tested in the MAT. PFGE showed that all 8 of these environmental Leptospira spp. were genetically diverse. In conclusion, the presence of pathogenic Leptospira spp. in the urban Malaysian environment may indicate and highlight the importance of water screening, especially in recreational lakes, in order to minimize any chance of Leptospira infection.
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