MyMedR

Fulltext Rapid detection of methicillin-resistant Staphylococcus aureus by a newly developed dry reagent-based polymerase chain reaction assay

Al-Talib H, Yean CY, Al-Khateeb A, Hasan H, Ravichandran M

J Microbiol Immunol Infect, 2014 Dec;47(6):484-90.

PMID: 23927820 DOI: 10.1016/j.jmii.2013.06.004

Methicillin-resistant Staphylococcus aureus (MRSA) is a major pathogen responsible for significant numbers of nosocomial and community-acquired infections worldwide. Molecular diagnosis for MRSA nasal carriers is increasingly important for rapid detection and screening of MRSA colonization because the conventional methods are time consuming and labor intensive. However, conventional polymerase chain reaction (PCR) tests still require cold-chain storage as well as trained personnel, which makes them unsuitable for rapid high-throughput analysis. The aim of this study was to develop a thermostabilized PCR assay for MRSA in a ready-to-use form that requires no cold chain.

Fulltext Comparison of methicillin-resistant Staphylococcus aureus strains isolated in 2003 and 2008 with an emergence of multidrug resistant ST22: SCCmec IV clone in a tertiary hospital, Malaysia

Lim KT, Hanifah YA, Mohd Yusof MY, Ito T, Thong KL

J Microbiol Immunol Infect, 2013 Jun;46(3):224-33.

PMID: 23523045 DOI: 10.1016/j.jmii.2013.02.001

Infections caused by methicillin-resistant Staphylococcus aureus (MRSA) continue to be a problem for clinicians worldwide. The objective of this study was to determine the changes in antibiograms of MRSA and their genotypic characteristics.

Fulltext Determination of phenotypes and pneumococcal surface protein A family types of Streptococcus pneumoniae from Malaysian healthy children

Yatim MM, Masri SN, Desa MN, Taib NM, Nordin SA, Jamal F

J Microbiol Immunol Infect, 2013 Jun;46(3):180-6.

PMID: 22763088 DOI: 10.1016/j.jmii.2012.04.004

There is limited information about pneumococcal carriage among healthy children in Malaysia. Therefore, this study was conducted to determine the prevalence rate, serotype distribution, susceptibility pattern, and pneumococcal surface protein A (PspA) family types of Streptococcus pneumoniae isolates in the nasal carriage of children 5 years old or younger in three day care centers in Kuala Lumpur, Malaysia.

Fulltext A case of acute respiratory distress syndrome associated with novel H1N1 treated with intravenous immunoglobulin G

Chong JL, Sapari S, Kuan YC

J Microbiol Immunol Infect, 2011 Aug;44(4):319-22.

PMID: 21524955 DOI: 10.1016/j.jmii.2010.07.001

Influenza A "novel H1N1" with severe acute respiratory distress syndrome (ARDS) is a serious illness that poses a challenge to clinicians managing such cases. This case report reveals a patient with ARDS secondary to influenza A with deteriorating clinical status, who improved tremendously after intravenous immunoglobulin G (IV IgG). Patients with H1N1 associated with ARDS may be given a trial of IV IgG. More case reports and trials are required to ascertain the efficacy of IV IgG and the best dosage and timing of starting IV IgG in relation to antiviral therapy.

Fulltext Visceral leishmaniasis (kala-azar) and malaria coinfection in an immigrant in the state of Terengganu, Malaysia: A case report

Ab Rahman AK, Abdullah FH

J Microbiol Immunol Infect, 2011 Feb;44(1):72-6.

PMID: 21531357 DOI: 10.1016/j.jmii.2011.01.014

Malaria is endemic in Malaysia. Leishmaniasis is a protozoan infection rarely reported in Malaysia. Here, a 24-year-old Nepalese man who presented with prolonged fever and hepatosplenomegaly is reported. Blood film examination confirmed a Plasmodium vivax malaria infection. Despite being adequately treated for malaria, his fever persisted. Bone marrow examination showed presence of Leishman-Donovan complex. He was successfully treated with prolonged course of amphotericin B. The case highlights the importance of awareness among the treating physicians of this disease occurring in a foreign national from an endemic region when he presents with fever and hepatosplenomegaly. Coinfection with malaria can occur although it is rare. It can cause significant delay of the diagnosis of leishmaniasis.

Genetic fingerprinting and antimicrobial susceptibility profiles of Pseudomonas aeruginosa hospital isolates in Malaysia

Lim KT, Yasin RM, Yeo CC, Puthucheary SD, Balan G, Maning N, et al.

J Microbiol Immunol Infect, 2009 Jun;42(3):197-209.

PMID: 19812853

Pseudomonas aeruginosa is the third most common pathogen causing nosocomial infections. The objective of this study was to investigate the antimicrobial resistance profiles and genetic diversity of hospital isolates of P. aeruginosa and to investigate the presence of several resistance genes and integrons.

Resistance to extended-spectrum beta-lactams by the emergence of SHV-12 and the loss of OmpK35 in Klebsiella pneumoniae and Escherichia coli in Malaysia

Palasubramaniam S, Muniandy S, Navaratnam P

J Microbiol Immunol Infect, 2009 Apr;42(2):129-33.

PMID: 19597644

In addition to beta-lactamase production, loss of porins confers resistance to extended-spectrum beta-lactams in Klebsiella pneumoniae and Escherichia coli infection. This study describes the detection of SHV-12 extended-spectrum beta-lactamase (ESBL) subtype and the loss of OmpK35 porin in 4 strains of K. pneumoniae and E. coli.

Detection and characterization of class 1 integrons among carbapenem-resistant isolates of Acinetobacter spp. in Malaysia

Hwa WE, Subramaniam G, Navaratnam P, Sekaran SD

J Microbiol Immunol Infect, 2009 Feb;42(1):54-62.

PMID: 19424559

To detect and characterize class 1 integrons among carbapenem-resistant strains of Acinetobacter spp. at University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia.

Cases of melioidosis in a university teaching hospital in Malaysia

Raja NS

J Microbiol Immunol Infect, 2008 Apr;41(2):174-9.

PMID: 18473106

Melioidosis is an infectious disease caused by Burkholderia pseudomallei that is endemic in Southeast Asia and northern Australia and has also been reported from non-endemic areas of the world. Little is known about the antimicrobial susceptibility pattern and the demography of melioidosis patients in Malaysia.

Antimicrobial susceptibility pattern of clinical isolates of Pseudomonas aeruginosa in a tertiary care hospital

Raja NS, Singh NN

J Microbiol Immunol Infect, 2007 Feb;40(1):45-9.

PMID: 17332906

BACKGROUND AND PURPOSE: Pseudomonas aeruginosa is an important cause of morbidity and mortality in hospitalized, critically ill patients and patients with underlying medical conditions such as cystic fibrosis, neutropenia, and iatrogenic immunosuppression. The prevalence of multiresistant P. aeruginosa isolates has been increasing. The aim of this study was to determine the antimicrobial susceptibility patterns in P. aeruginosa strains isolated at a university teaching hospital in Kuala Lumpur, Malaysia.
METHODS: The Laboratory Information System of the microbiology department was retrospectively reviewed to determine the susceptibility patterns of P. aeruginosa isolates to anti-pseudomonal antibiotics, from January to June 2005. Disk diffusion methods were employed and results were interpreted according to National Committee for Clinical Laboratory Standards guidelines.
RESULTS: 505 clinical isolates of P. aeruginosa were tested. Major sources of these isolates included respiratory tract, wound, urine and blood. The rates of antimicrobial resistance of isolates were 6.73% to amikacin, 12.9% to gentamicin, 10.1% to netilmicin, 10.9% to ceftazidime, 11.3% to ciprofloxacin, 9.9% to imipenem, 10.8% to piperacillin, 9.4% to piperacillin-tazobactam and 0% to polymyxin B. Of the 505 isolates, 29 (5.74%) were found to be multidrug-resistant; these were most commonly isolated from respiratory tract specimens of patients in surgical units, followed by respiratory tract specimens in patients in medical units.
CONCLUSIONS: The data in this study showed low rates of antibiotic resistance among P. aeruginosa isolates. Combinations of aminoglycosides plus beta-lactams or quinolones should be the appropriate choice for empirical therapy in P. aeruginosa infections. Active antibiotic susceptibility testing and surveillance should be continued in order to curtail the problem of antibiotic resistance.

Evaluation of the routine use of the anaerobic bottle when using the BACTEC blood culture system

Karunakaran R, Raja NS, Quek KF, Hoe VC, Navaratnam P

J Microbiol Immunol Infect, 2007 Oct;40(5):445-9.

PMID: 17932606

The established practice of sending blood cultures in an aerobic-anaerobic pair of bottles has been questioned in recent years, and this study was conducted to evaluate the routine use of an anaerobic bottle in the BACTEC blood culture set at the University of Malaya Medical Centre, Kuala Lumpur, from January to December 2004. A total of 11,663 paired blood culture sets were received, of which 3326 were from pediatric patients and 8337 were from adult patients. The overall positive isolation rate was 15%; the positive isolation rate on excluding the anaerobic bottles was 13%. Overall, there were significantly more organisms isolated from the aerobic bottle (p<0.05); however, the best yield was obtained on using the paired aerobic-anaerobic bottles. Among the positive blood culture sets, organisms were isolated from the anaerobic bottle alone in 15.2% of the pediatric sets and in 18.1% of the adult sets. Organisms that grew more frequently in the anaerobic bottle were anaerobes and some facultative anaerobes; however, the difference was not statistically significant except for anaerobes in the adult sets. We recommend that when culturing blood, an aerobic-anaerobic pair of bottles be used rather than an aerobic-aerobic pair, to optimize the recovery of a wider spectrum of organisms, including obligatory anaerobes.

Etiology of blood culture isolates among patients in a multidisciplinary teaching hospital in Kuala Lumpur

Karunakaran R, Raja NS, Ng KP, Navaratnam P

J Microbiol Immunol Infect, 2007 Oct;40(5):432-7.

PMID: 17932604

Bloodstream infections are an important cause of morbidity and mortality among hospitalized patients and the surveillance of etiological agents in these infections is important for their prevention and treatment. Data on common organisms isolated from blood cultures from Malaysia are limited, and our aim was to identify the common bloodstream isolates in hospitalized patients at the University of Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia.

Chromobacterium violaceum infection in Taiwan: a case report and literature review

Chang CY, Lee YT, Liu KS, Wang YL, Tsao SM

J Microbiol Immunol Infect, 2007 Jun;40(3):272-5.

PMID: 17639170

Chromobacterium violaceum is a facultative anaerobic, Gram-negative bacillus which inhabits stagnant water in tropical and subtropical regions. We describe the case of an 80-year-old female patient with C. violaceum bacteremia due to traumatic wound infected by contaminated water and soil. She had persistent fever, hypotension and neutrophilic leukocytosis on admission. Two sets of blood cultures yielded C. violaceum. The patient was successfully treated with levofloxacin. Since the first case from Malaysia in 1927, about 150 cases have been reported in the world literature. To our knowledge, six other cases have been reported previously from Taiwan, including two children and four adults. Of the total of seven patients from Taiwan, four had a fatal outcome within several days, while the three survivors were apparently free of vital organ involvement. Although human infections caused by C. violaceum are rare, clinicians should be aware of this potentially fatal infection as part of the differential diagnosis of sepsis associated with a history of exposure to stagnant water.

Fulltext Melioidotic septic arthritis: a case report and literature review

Raja NS

J Microbiol Immunol Infect, 2007 Apr;40(2):178-82.

PMID: 17446969

Burkholderia pseudomallei, the causative agent of melioidosis, is endemic in southeast Asia and northern Australia. In recent years, the incidence of melioidosis has increased worldwide. Septic arthritis is a rare but well-recognized manifestation of melioidosis. Patients with underlying medical conditions, such as diabetes mellitus, renal impairment, cirrhosis, and malignancy are at greater risk. The presentations of melioidotic septic arthritis often mimic other disease processes and patients may not always be clinically septic. We present a case of septic arthritis due to B. pseudomallei in a 66-year-old male with diabetes mellitus presenting with a history of fever and ankle swelling. Follow-up ankle X-ray showed soft tissue swelling. Synovial fluid and blood samples grew B. pseudomallei. The patient improved gradually after parenteral administration of ceftazidime (2 g 8-hourly) and cotrimoxazole (1440 mg 8-hourly). He was discharged on oral cotrimoxazole (1440 mg 12-hourly), doxycycline (100 mg 12-hourly), and chloramphenicol (500 mg 6-hourly) for 6 months. This case highlights the possible occurrence of melioidotic septic arthritis, and the importance of prompt initiation of appropriate antimicrobials to achieve good outcomes.
Study site: Emergency department, University of Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia

Nasal carriage of Staphylococcus aureus among healthy adults

Choi CS, Yin CS, Bakar AA, Sakewi Z, Naing NN, Jamal F, et al.

J Microbiol Immunol Infect, 2006 Dec;39(6):458-64.

PMID: 17164947

Data on the carriage rate and antibiotic sensitivity pattern of Staphylococcus aureus strains prevalent in the community are not available for many developing countries including Malaysia. To estimate the extent of community S. aureus transmission, in particular methicillin-resistant S. aureus (MRSA), the prevalence of S. aureus nasal colonization in a population of healthy adults was determined. Factors associated with S. aureus nasal carriage and antibiotic sensitivity patterns of the isolates were also analyzed.

Disseminated invasive aspergillosis in an apparently immunocompetent host

Raja NS, Singh NN

J Microbiol Immunol Infect, 2006 Feb;39(1):73-7.

PMID: 16440127

Aspergillosis is a spectrum of diseases caused by members of the genus Aspergillus that continues to pose a significant threat to immunocompromised, organ transplant, neutropenic and cancer patients. In view of increasing risk factors leading to invasive aspergillosis, it is imperative for clinicians to be familiar with the clinical presentation, diagnostic methods and management of the disease. We describe a 34-year-old immunocompetent male patient receiving chemotherapy for Aspergillus fumigatus infection that had disseminated to lung, liver and spleen. A computed tomogram of thorax and abdomen showed thick-walled cavities of different sizes with air fluid levels, consolidation in both lungs and involvement of liver and spleen. His broncheoalveolar lavage and sputum specimens yielded A. fumigatus. Successful treatment of this infection was achieved with amphotericin B and itraconazole.

Pediatric melioidosis in Pahang, Malaysia

How HS, Ng KH, Yeo HB, Tee HP, Shah A

J Microbiol Immunol Infect, 2005 Oct;38(5):314-9.

PMID: 16211138

Melioidosis is much less common in children than in adults. This study investigated the incidence, demographic characteristics, presenting symptoms and outcome of pediatric melioidosis in Pahang, Malaysia. This retrospective study included patients < or =18 years old with positive body fluid cultures for Burkholderia pseudomallei from January 2000 to June 2003. Data on culture results were obtained from 2 referral hospitals. The incidence of pediatric melioidosis was 0.68/100,000 population per year. Of the 13 patients identified during the study period, 10 were male; 9 were Malays, 2 were Indians and 2 were aborigines. The mean age of these patients was 9.5 +/- 5.4 years. None of the patients had a previous history of confirmed melioidosis or predisposing factors for infection. Localized melioidosis was the most common presentation (46.2%) followed by melioidosis with septic shock (38.4%). Among patients with localized melioidosis, head and neck involvement (83.3%) was the most common presentation (2 patients with cervical abscesses, 1 with submandibular abscesses and 2 with acute suppurative parotitis) and another patient had right axillary abscess. All of the patients with septic shock had pneumonia and 2 of them had multi-organ involvement. The mortality among patients with septic shock was 80% and death occurred within 24 h of admission in all cases. In contrast, no complications or death occurred among patients with localized melioidosis. Melioidosis with septic shock is less common than localized melioidosis in pediatric patients, but is associated with very high mortality.

Fulltext Toxic effect of high concentration of sonochemically synthesized polyvinylpyrrolidone-coated silver nanoparticles on Citrobacter sp. A1 and Enterococcus sp. C1

Lau CP, Abdul-Wahab MF, Jaafar J, Chan GF, Abdul Rashid NA

J Microbiol Immunol Infect, 2017 Aug;50(4):427-434.

PMID: 26427880 DOI: 10.1016/j.jmii.2015.08.004

BACKGROUND/PURPOSE: Currently, silver nanoparticles (AgNPs) have gained importance in various industrial applications. However, their impact upon release into the environment on microorganisms remains unclear. The aim of this study was to analyze the effect of polyvinylpyrrolidone-capped AgNPs synthesized in this laboratory on two bacterial strains isolated from the environment, Gram-negative Citrobacter sp. A1 and Gram-positive Enterococcus sp. C1.

METHODS: Polyvinylpyrrolidone-capped AgNPs were synthesized by ultrasound-assisted chemical reduction. Characterization of the AgNPs involved UV-visible spectroscopy, Fourier transform infrared spectroscopy, X-ray diffraction, transmission electron microscopy, and energy dispersive X-ray spectroscopy. Citrobacter sp. A1 and Enterococcus sp. C1 were exposed to varying concentrations of AgNPs, and cell viability was determined. Scanning electron microscopy was performed to evaluate the morphological alteration of both species upon exposure to AgNPs at 1000 mg/L.

RESULTS: The synthesized AgNPs were spherical in shape, with an average particle size of 15 nm. The AgNPs had different but prominent effects on either Citrobacter sp. A1 or Enterococcus sp. C1. At an AgNP concentration of 1000 mg/L, Citrobacter sp. A1 retained viability for 6 hours, while Enterococcus sp. C1 retained viability only for 3 hours. Citrobacter sp. A1 appeared to be more resistant to AgNPs than Enterococcus sp. C1. The cell wall of both strains was found to be morphologically altered at that concentration.

CONCLUSION: Minute and spherical AgNPs significantly affected the viability of the two bacterial strains selected from the environment. Enterococcus sp. C1 was more vulnerable to AgNPs, probably due to its cell wall architecture and the absence of silver resistance-related genes.

Fulltext Polymerase chain reaction-restriction fragment length polymorphism method for differentiation of uropathogenic specific protein gene types

Lai YM, Zaw MT, Shamsudin SB, Lin Z

J Microbiol Immunol Infect, 2016 Aug;49(4):591-4.

PMID: 26212311 DOI: 10.1016/j.jmii.2015.06.002

The putative pathogenicity island (PAI) containing the uropathogenic specific protein (usp) gene and three small open reading frames (orfU1, orfU2, and orfU3) encoding 98, 97, and 96 amino acid proteins is widely distributed among uropathogenic Escherichia coli (UPEC) strains. This PAI was designated as PAIusp. Sequencing analysis of PAIusp has revealed that the usp gene can be divided into two types - uspI and uspII - based on sequence variation at the 3' terminal region and the number and position of orfUs differ from strain to strain. Based on usp gene types and orfU sequential patterns, PAIusp can be divided into four subtypes. Subtyping of PAIusp is a useful method to characterize UPEC strains. In this study, we developed a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method to differentiate usp gene types. This method could correctly identify the usp gene type in usp-positive UPEC strains in our laboratory.

Enterovirus 71: the virus, its infections and outbreaks

Ho M

J Microbiol Immunol Infect, 2000 Dec;33(4):205-16.

PMID: 11269363

Enterovirus 71 (EV71) was first recognized in 1974. Since then it has been implicated in 13 small and large outbreaks world-wide. Large outbreaks of hand, foot and mouth disease (HFMD), mostly benign, occurred in Japan in 1973 and 1978. Four outbreaks with brain stem encephalitis and significant numbers of deaths occurred in Bulgaria and Hungary in the late 1970's and in Malaysia and Taiwan in 1997 and 1998 respectively. During the latter two epidemics, pulmonary edema and hemorrhage often leading to quick deaths in children aged from 0.5 to 3 years old was first recognized. In Taiwan 78 deaths and over 100,000 cases of HFMD occurred. Coxsackie A16 cocirculated with EV 71, without however, causing any severe illnesses. The transmission of EV 71 was related to number of siblings in a household, rural residence and contact with cases of HFMD. Genotype analyses show that genotypes have changed with time in the United States and Japan. Recent isolates from Japan are similar to the isolates from Malaysia and Taiwan in 1997 and 1998, respectively. Even though genotype analysis has not identified specific sequences responsible for neurovirulence, the strains causing brain stem encephalitis and pulmonary edema in the Far East are similar and have arisen since 1997. Seroepidemiological studies in Taiwan suggest that children aged from 0.5 to 4 years old are most susceptible while the rest of the population are over 50% immune. Theoretically there is a pool of such susceptible subjects every few years. In prevention for another major outbreak, a simple, inactivated Salk type vaccine should be immediately prepared and made available.

Displaying publications 1 - 20 of 36 in total