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  1. Liam CK
    Med J Malaysia, 2005 Jun;60(2):249-65; quiz 266.
    PMID: 16114172
    Matched MeSH terms: Community-Acquired Infections/epidemiology
  2. Lim VKE
    Med J Malaysia, 2003 Jun;58(2):156-8.
    PMID: 14569734 MyJurnal
    Matched MeSH terms: Community-Acquired Infections/epidemiology
  3. Nor Shamsudin M, Sekawi Z, van Belkum A, Neela V
    J Med Microbiol, 2008 Sep;57(Pt 9):1180-1181.
    PMID: 18719195 DOI: 10.1099/jmm.0.47844-0
    Matched MeSH terms: Community-Acquired Infections/epidemiology
  4. Peto L, Nadjm B, Horby P, Ngan TT, van Doorn R, Van Kinh N, et al.
    Trans R Soc Trop Med Hyg, 2014 Jun;108(6):326-37.
    PMID: 24781376 DOI: 10.1093/trstmh/tru058
    Community-acquired pneumonia (CAP) is a major cause of adult mortality in Asia. Appropriate empirical treatment depends on knowledge of the pathogens commonly responsible. However, assessing the aetiological significance of identified organisms is often difficult, particularly with sputum isolates that might represent contamination with oropharyngeal flora.
    Matched MeSH terms: Community-Acquired Infections/epidemiology*
  5. Sam IC, Abdul-Murad A, Karunakaran R, Rampal S, Chan YF, Nathan AM, et al.
    Int J Infect Dis, 2010 Sep;14 Suppl 3:e36-40.
    PMID: 20153233 DOI: 10.1016/j.ijid.2009.10.005
    OBJECTIVES: The clinical impact of seasonal influenza is understudied in tropical countries. The aim of this study was to describe the clinical features and seasonal pattern of influenza in children hospitalized in Malaysia, and to identify predictors of severe disease.
    METHODS: Children hospitalized with community-acquired, laboratory-confirmed influenza at a teaching hospital in Kuala Lumpur, Malaysia during 2002-2007 were identified retrospectively. Clinical data were collected, and predictors of severe disease were identified by multivariate logistic regression. All influenza cases from 1982 to 2007 were also analyzed for seasonal patterns.
    RESULTS: A total of 132 children were included in the study, 48 (36.4%) of whom had underlying medical conditions. The mean age was 2.5 years and 116 (87.9%) were <5 years old. The most common presenting features were fever or history of fever, cough, rhinitis, vomiting, and pharyngitis. Severe influenza was seen in 16 patients (12.1%; nine previously healthy), including 12 (9.1%; eight previously healthy) requiring intensive care. There were three (2.3%) deaths. Severe disease was associated with age <12 months, female sex, and absence of rhinitis on admission. Influenza was seen year-round, with peaks in November-January and May-July.
    CONCLUSIONS: Seasonal influenza has a considerable impact on children hospitalized in Malaysia, in both the healthy and those with underlying medical conditions.

    Study site: University Malaya Medical Centre (UMMC)
    Matched MeSH terms: Community-Acquired Infections/epidemiology
  6. Sam IC, Kahar-Bador M, Chan YF, Loong SK, Mohd Nor Ghazali F
    Diagn Microbiol Infect Dis, 2008 Dec;62(4):437-9.
    PMID: 18842374 DOI: 10.1016/j.diagmicrobio.2008.07.016
    The 1st 9 clinical isolates of multisensitive community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) from Malaysia carry SCCmec type IV and predominantly cause skin and soft-tissue infections. Seven were classified as nosocomially acquired. There was considerable clonal diversity, with both pandemic and novel multilocus sequence types detected. CA-MRSA rates appear to be increasing in our hospital, warranting close surveillance.
    Matched MeSH terms: Community-Acquired Infections/epidemiology
  7. Chan PW, Lum LC, Ngeow YF, Yasim MY
    PMID: 11556595
    Mycoplasma pneumoniae is increasingly recognized as an important cause of community acquired pneumonia (CAP) in children. We determined the importance of M. pneumoniae as a causative agent in 170 children aged 1 month to 15 years who were hospitalized with CAP over a 6-month period. The diagnosis of M. pneumoniae infection was based on serological evidence obtained by a particle agglutination test (SERODIA-MYCO II). A positive serological diagnosis was made if the acute phase serum titer was more than 1:160 or paired samples taken 2-4 weeks apart showed a four-fold or greater rise in the serum titer. M. pneumoniae was identified as the causative agent in 40 (23.5%) children. Children with M. pneumoniae infection were more likely to be older than 3 years (OR 4.0 95%CI 1.8-9.1, p<0.001), Chinese (OR 4.3 95%CI 2.0-8.9, p<0.001), have a duration of illness longer than 7 days prior to admission (OR 6.0 95%CI 2.7-13.5, p<0.001) and have perihilar interstitial changes on chest X-ray (OR 4.6 95%CI 2.2-9.9, p<0.001). A significant number of hospital admissions for CAP in Malaysian children can be attributed to M. pneumoniae. It is important to identify these children so as to administer the most appropriate antibiotic treatment.
    Matched MeSH terms: Community-Acquired Infections/epidemiology
  8. Ngeow YF, Weil AF, Khairullah NS, Yusof MY, Luam L, Gaydos C, et al.
    J Paediatr Child Health, 1997 Oct;33(5):422-5.
    PMID: 9401887
    OBJECTIVE: The incidence of Chlamydia pneumoniae and Chlamydia trachomatis infection was studied among infants and young children admitted to hospital for the management of lower respiratory tract infections, over a 12 month period.

    METHODOLOGY: Respiratory secretions were examined for chlamydiae by cell culture, enzyme-linked immunosorbent assay and polymerase chain reaction-enzyme immunoassay. Sera were tested by micro-immunofluorescence for chlamydial IgG, IgM and IgA. Other bacterial and viral pathogens were also looked for by standard cultural and serological methods.

    RESULTS: Of 87 patients aged 2 months-3 years, an aetiologic diagnosis was made in 41 (47.1%). C. pneumoniae and C. trachomatis were each detected in 1 (1.2%) of the patients. Among common bacterial pathogens, Haemophilus influenzae (13.8%) and Streptococcus pneumoniae (8.1%) were the most frequently identified. Respiratory viruses and elevated Mycoplasma pneumoniae antibodies were found in 10.3% and 9.1% of patients, respectively.

    CONCLUSION: Chlamydiae are infrequent causes of community-acquired acute lower respiratory tract infections in infants and very young children in Malaysia.

    Matched MeSH terms: Community-Acquired Infections/epidemiology
  9. AhbiRami R, Zuharah WF
    PLoS Negl Trop Dis, 2020 03;14(3):e0008075.
    PMID: 32218580 DOI: 10.1371/journal.pntd.0008075
    The massive flood in Malaysia's east coast in December 2014 has placed Kelantan in a possible dengue outbreak risk. At this point, community awareness is essential in preventing disease spread. However, no data on knowledge, attitude, and practice (KAP) of dengue in Kelantan have existed in relevance to flood disaster, although such information is necessary for the vector control programs. The purpose of this study is to assess the KAP regarding dengue among school children from flooded and unflooded areas and to evaluate the effectiveness of the dengue health education program in improving their KAP level. A school-based pre- and post-tests design was utilized in this study whereby a booklet on dengue was distributed during the interphase of the tests. The information collected was on the socio-demographic, KAP and the source of dengue information. We statistically compared the KAP between the two study sites and the pre- and post-test scores to evaluate the health education program. A total of 203 students participated in the survey, and 51.7% of them were flood victims. When comparing the baseline KAP, the respondents from the unflooded area had higher knowledge scores compared to those from the flooded area (P<0.05), while non-significant differences were observed in the attitude and practice between the two study areas (P>0.05). The health education program significantly improved knowledge and practice in the flooded area and knowledge only in the unflooded area (P<0.05). The multinomial regression analysis suggests that age and dengue history are the primary determinants that influence the high practice level in both areas. We suggest the need to increase routine dengue health education programs to all age groups targeting both high and low dengue risk areas, and the necessity to ensure the translation of positive knowledge and attitude changes into real dengue preventive practices.
    Matched MeSH terms: Community-Acquired Infections/epidemiology
  10. Subakir H, Chong YM, Chan YF, Hasan MS, Jamaluddin MFH, Pang YK, et al.
    J Med Microbiol, 2020 Jan;69(1):49-51.
    PMID: 31750812 DOI: 10.1099/jmm.0.001108
    Introduction.Burkholderia pseudomallei (melioidosis) is an important cause of community-acquired pneumonia (CAP) in the tropics. Selective medium is recommended for laboratory diagnosis with non-sterile respiratory samples, while PCR is not routinely used due to variable reported performance. The effectiveness of these diagnostic modalities varies by site.Aim. To compare selective media and real-time PCR (qPCR) with routine media in detecting B. pseudomallei in CAP respiratory samples in a low-incidence setting in Kuala Lumpur, Malaysia.Methodology. Respiratory samples were routinely cultured on blood, chocolate and MacConkey agar (RESP-ROUTINE), and compared to culture on selective Ashdown medium (RESP-SELECTIVE) and qPCR. The gold standard was routine culture of B. pseudomallei from any site (ALL-ROUTINE).Results.B. pseudomallei was detected in 8/204 (3.9 %) samples. Overall sensitivity rates differed (P=0.03) for qPCR (100%), RESP-SELECTIVE (87.5%) and RESP-ROUTINE (50%). There was a trend towards lower median days to positive culture for RESP-SELECTIVE (1 day) compared to RESP-ROUTINE (2 days, P=0.08) and ALL-ROUTINE (2 days, P=0.06). Reagent costs for each additional detection were USD59 for RESP-SELECTIVE and USD354 for PCR.Conclusions. In a low-incidence setting, selective culture of respiratory samples on Ashdown was more sensitive and allowed quicker identification than routine media, at reasonable cost. Blood cultures are critical, confirming four cases missed by routine respiratory culture. Selective medium is useful in early pneumonia (pre-sepsis) and resource-limited settings where blood cultures are infrequently done. Real-time PCR is costly, but highly sensitive and useful for high-risk patients with diabetes, cancer or immunosuppressants, or requiring ventilation or intensive care.
    Matched MeSH terms: Community-Acquired Infections/epidemiology
  11. Ahmad N, Ruzan IN, Abd Ghani MK, Hussin A, Nawi S, Aziz MN, et al.
    J Med Microbiol, 2009 Sep;58(Pt 9):1213-1218.
    PMID: 19528158 DOI: 10.1099/jmm.0.011353-0
    Community-acquired meticillin-resistant Staphylococcus aureus (CA-MRSA) occurring among hospital isolates in Malaysia has not been reported previously. As CA-MRSA reported worldwide has been shown to carry SCCmec types IV and V, the aim of this study was to determine the SCCmec types of MRSA strains collected in Malaysia from November 2006 to June 2008. From a total of 628 MRSA isolates, 20 were SCCmec type IV, whilst the rest were type III. Further characterization of SCCmec type IV strains revealed 11 sequence types (STs), including ST22, with the majority being ST30/Panton-Valentine leukocidin positive. Eight out of nine CA-MRSA were ST30, one was ST80, and all were sensitive to co-trimoxazole and gentamicin. Five new STs designated ST1284, ST1285, ST1286, ST1287 and ST1288 were discovered, suggesting the emergence of novel clones of MRSA circulating in Malaysian hospitals. The discovery of the ST22 strain is a cause for concern because of its ability to replace existing predominant clones in certain geographical regions.
    Matched MeSH terms: Community-Acquired Infections/epidemiology
  12. Sit PS, Teh CS, Idris N, Sam IC, Syed Omar SF, Sulaiman H, et al.
    BMC Infect Dis, 2017 04 13;17(1):274.
    PMID: 28407796 DOI: 10.1186/s12879-017-2384-y
    BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is an established pathogen that causes hospital- and community-acquired infections worldwide. The prevalence rate of MRSA infections were reported to be the highest in Asia. As there is limited epidemiological study being done in Malaysia, this study aimed to determine the prevalence of MRSA infection and the molecular characteristics of MRSA bacteraemia.

    METHODS: Two hundred and nine MRSA strains from year 2011 to 2012 were collected from a tertiary teaching hospital in Malaysia. The strains were characterized by antimicrobial susceptibility testing, staphylococcal cassette chromosome mec (SCCmec) typing, detection of Panton-Valentine leukocidin (PVL) gene, multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE). Patient's demographic and clinical data were collected and correlated with molecular data by statistical analysis.

    RESULTS: Male gender and patient >50 years of age (p 

    Matched MeSH terms: Community-Acquired Infections/epidemiology
  13. Saleem Z, Hassali MA, Versporten A, Godman B, Hashmi FK, Goossens H, et al.
    Expert Rev Anti Infect Ther, 2019 04;17(4):285-293.
    PMID: 30755077 DOI: 10.1080/14787210.2019.1581063
    OBJECTIVES: In line with the recent global action plan for antimicrobial resistance, this is the first time such a comprehensive antimicrobial point prevalence survey has been undertaken in Pakistan, the sixth most populous country.

    METHODS: This point prevalence survey (PPS) was conducted in 13 hospitals among 7 different cities of Pakistan. The survey included all inpatients receiving an antibiotic on the day of PPS. A web-based application was used for data entry, validation, and reporting as designed by the University of Antwerp (www.global-pps.com).

    RESULTS: Out of 1954 patients, 1516 (77.6%) were treated with antibiotics. The top three most reported indications for antibiotic use were prophylaxis for obstetrics or gynaecological indications (16.5%), gastrointestinal indications (12.6%) and lower respiratory tract infections (12.0%). The top three most commonly prescribed antibiotics were ceftriaxone (35.0%), metronidazole (16.0%) and ciprofloxacin (6.0%). Out of the total indications, 34.2% of antibiotics were prescribed for community-acquired infections (CAI), 5.9% for healthcare-associated infections (HAI), and 57.4% for either surgical or medical prophylaxis. Of the total use for surgical prophylaxis, 97.4% of antibiotics were given for more than one day.

    CONCLUSIONS: Unnecessary prophylactic antibiotic use is extremely high, and broad-spectrum prescribing is common among hospitals in Pakistan. There is an urgent need to work on the  national action plan of Pakistan on antibiotic resistance to address this.

    Matched MeSH terms: Community-Acquired Infections/epidemiology
  14. Dhanoa A, Fatt QK
    PMID: 19445730 DOI: 10.1186/1476-0711-8-15
    Non-typhoidal Salmonella (NTS) is increasingly recognized as an important pathogen associated with bacteraemia especially in immunosuppressed patients. However, there is limited data specifically describing the clinical characteristics and outcome amongst the immunosuppressed patients.
    Matched MeSH terms: Community-Acquired Infections/epidemiology
  15. Liam CK, Pang YK, Poosparajah S
    Respirology, 2006 Nov;11(6):786-92.
    PMID: 17052309
    The aims of this study were to investigate the frequency of Mycobacterium tuberculosis as a cause of community-acquired pneumonia (CAP) requiring hospitalization in Malaysia, and to define the clinical features of pulmonary tuberculosis (PTB) that distinguish it from non-TB CAP.
    Matched MeSH terms: Community-Acquired Infections/epidemiology
  16. Ngeow YF, Suwanjutha S, Chantarojanasriri T, Wang F, Saniel M, Alejandria M, et al.
    Int J Infect Dis, 2005 May;9(3):144-53.
    PMID: 15840455
    In many parts of Asia, the inaccessibility and high cost of diagnostic tests have hampered the study of community-acquired pneumonia (CAP) caused by atypical respiratory pathogens.
    Matched MeSH terms: Community-Acquired Infections/epidemiology*
  17. Tan KK, Dang DA, Kim KH, Kartasasmita C, Kim HM, Zhang XH, et al.
    Hum Vaccin Immunother, 2018 01 02;14(1):95-105.
    PMID: 29125809 DOI: 10.1080/21645515.2017.1375073
    BACKGROUND: Few studies describe the community-acquired pneumonia (CAP) burden in children in Asia. We estimated the proportion of all CAP hospitalizations in children from nine hospitals across the Republic of Korea (high-income), Indonesia, Malaysia (middle-income), and Vietnam (low/middle-income).

    METHODS: Over a one or two-year period, children <5 years hospitalized with CAP were identified using ICD-10 discharge codes. Cases were matched to standardized definitions of suspected (S-CAP), confirmed (C-CAP), or bacterial CAP (B-CAP) used in a pneumococcal conjugate vaccine efficacy study (COMPAS). Median total direct medical costs of CAP-related hospitalizations were calculated.

    RESULTS: Vietnam (three centers): 7591 CAP episodes were identified with 4.3% (95% confidence interval 4.2;4.4) S-CAP, 3.3% (3.2;3.4) C-CAP and 1.4% (1.3;1.4) B-CAP episodes of all-cause hospitalization in children aged <5 years. The B-CAP case fatality rate (CFR) was 1.3%. Malaysia (two centers): 1027 CAP episodes were identified with 2.7% (2.6;2.9); 2.6% (2.4;2.8); 0.04% (0.04;0.1) due to S-CAP, C-CAP, and B-CAP, respectively. One child with B-CAP died. Indonesia (one center): 960 CAP episodes identified with 18.0% (17.0;19.1); 16.8% (15.8;17.9); 0.3% (0.2;0.4) due to S-CAP, C-CAP, and B-CAP, respectively. The B-CAP CFR was 20%. Korea (three centers): 3151 CAP episodes were identified with 21.1% (20.4;21.7); 11.8% (11.2;12.3); 2.4% (2.1;2.7) due to S-CAP, C-CAP, and B-CAP, respectively. There were no deaths.

    COSTS: CAP-related hospitalization costs were highest for B-CAP episodes: 145.00 (Vietnam) to 1013.3 USD (Korea) per episode.

    CONCLUSION: CAP hospitalization causes an important health and cost burden in all four countries studied (NMRR-12-50-10793).

    Matched MeSH terms: Community-Acquired Infections/epidemiology
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