Displaying publications 21 - 40 of 106 in total

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  1. Razak M, Ismail MM, Omar A
    Med J Malaysia, 1998 Sep;53 Suppl A:83-5.
    PMID: 10968187
    We review 81 cases of acute haematogenous osteomyelitis from 1983 to 1990 to establish current pattern of clinical presentation, modes of treatment and success of therapy. Majority of the patient (70%) presented within a week of symptom and significant number of them came with fever and swelling of the affected limb. Sedimentation rate was found to be raised in all of them. Fifty-four (55%) of them were treated surgically. The average antibiotic time was one week by intravenous administration followed by additional oral therapy for period up to four weeks. Average follow-up was 9 months. Six of them (7.5%) end up with various complication which was believed to be due to delay in getting medical treatment.
    Matched MeSH terms: Bacteremia/complications*; Bacteremia/therapy
  2. Riley PA, Parasakthi N
    Malays J Pathol, 1996 Jun;18(1):31-4.
    PMID: 10879222
    In an attempt to reduce costs, the role of Bactec anaerobic blood culture in the detection of bacteraemia and fungaemia in children was evaluated. Results from 3167 sets of aerobic and anaerobic blood cultures from children admitted to the University Hospital, Kuala Lumpur during a one year period, were analysed. Four hundred and eight (12.9%) sets of blood cultures were positive, of which 348 sets (11.0%) from 201 patients were clinically significant. Of the 348 significant positive sets, organisms were isolated on 177 (50.9%) occasions from both aerobic and anaerobic bottles, on 136 (39.1%) occasions from the aerobic bottle only and 35 (10.0%) occasions from the anaerobic bottle only. No strict anaerobes were isolated, but clinically significant isolates recovered from the anaerobic bottle only included Klebsiella pneumoniae, Salmonella species, Enterobacter cloacae, Staphylococcus aureus, coagulase negative staphylococci, Streptococcus pneumoniae and Group B streptococcus. Patients with bacteraemia diagnosed solely by anaerobic culture were distributed evenly across the various paediatric subspecialities. When results from the anaerobic bottles were excluded, the overall isolation rate was reduced from 11% to 9.9%. Potential financial savings resulting from omission of anaerobic cultures must be balanced against the small number of bacteraemic episodes that could be missed. Undiagnosed bacteraemia may result in increased morbidity and mortality with its own attendant financial implications.
    Matched MeSH terms: Bacteremia/blood; Bacteremia/diagnosis*
  3. Ahmad NS, Tan TL, Arifin KT, Ngah WZW, Yusof YAM
    PLoS One, 2020;15(3):e0230285.
    PMID: 32160261 DOI: 10.1371/journal.pone.0230285
    The aim of this study was to determine the association between secretory phospholipase A2 group IIA (sPLA2-IIA) and eicosanoid pathway metabolites in patients with bacterial sepsis syndrome (BSS). Levels of sPLA2-IIA, eicosanoids prostaglandin (PG)E2, PGD synthase were quantified in the sera from patients confirmed to have bacterial sepsis (BS; N = 45), bacterial severe sepsis/septic shock (BSS/SS; N = 35) and healthy subjects (N = 45). Cyclooxygenase (COX)-1 and COX-2 activities were analyzed from cell lysate. Serum levels of sPLA2-IIA, PGE2, and PGDS increased significantly in patients with BS and BSS/SS compared to healthy subjects (p<0.05). COX-2 activity was significantly increased in patients with BS compared to healthy subjects (p<0.05), but not COX-1 activity. Binary logistic regression analysis showed that sPLA2-IIA and PGE2 were independent factors predicting BSS severity. In conclusion, high level of sPLA2-IIA is associated with eicosanoid metabolism in patients with BSS.
    Matched MeSH terms: Bacteremia/blood*; Bacteremia/pathology
  4. O'Brien CR, Krockenberger MB, Martin P, Parkes H, Kidd M, Malik R
    J Feline Med Surg, 2003 Apr;5(2):83-9.
    PMID: 12670433
    Melioidosis was diagnosed in two cats at necropsy. The first cat presented with jaundice and anaemia but died of overwhelming sepsis soon after admission, despite blood transfusion and other supportive measures. The second cat died several days after developing neurological signs; an infected digital wound may have been the primary focus of infection in this patient. The cats had presumably acquired the infection in Malaysia and northern Australia, respectively, and in both cases disease may have represented reactivation of a latent infection brought on by the stress of relocation. The epidemiology, clinical presentation, diagnosis and treatment of melioidosis are discussed from a feline perspective.
    Matched MeSH terms: Bacteremia/diagnosis; Bacteremia/veterinary
  5. Lim CL, Spelman D
    Infect Dis Health, 2019 08;24(3):124-133.
    PMID: 30928569 DOI: 10.1016/j.idh.2019.02.001
    BACKGROUND: Treatment of ESBL- and AmpC-producing Enterobacteriaceae bacteremia is often complicated by lack of appropriate antibiotics. We aimed to determine the predictors of mortality and impact of empirical antibiotics.

    METHODS: A retrospective observational study was performed on consecutive adult cases of ESBL and AmpC bacteremia at the Alfred Hospital from 2014 through April 2018.

    RESULTS: Among 110 patients with ESBL (88.2%) and AmpC (14.5%) bacteremia episodes, 96.4% had comorbidities such as hematological malignancy (30%). Approximately 45% were on immunosuppressive drugs, while 69% had recent antibiotic exposure. Over 84% of bacteremias were hospital acquired or healthcare associated. Urinary tract was the main source of infection (40%) with E. coli being the commonest organism (66.4%). The isolates were least resistant to gentamicin (21.8%), which was often appropriately used in empirical therapy. About 34% of patients presented with severe sepsis or shock. The 30-day mortality rate was 20% with no correlation with inappropriate empirical antibiotics (52%). There was no significant mortality difference between carbapenem use in empirical and definitive therapy. Respiratory source [OR 11.77, 95% CI 1.30-106.85; p = 0.03], severe sepsis or shock [OR 5.17, 95% CI 1.37-19.55; p = 0.02] and inappropriate definitive therapy [OR 27.93, 95%CI 3.69-211.35; p = 0.001] were independent predictors for mortality.

    CONCLUSION: The choice and appropriateness of empirical therapy were not associated with mortality in ESBL and AmpC bacteremia. Prudent use of carbapenem is reasonable with gentamicin as alternative. Emphasis should be on prompt resuscitation in severe sepsis and early detection of ESBL and AmpC to facilitate appropriate switch to definitive therapy.

    Matched MeSH terms: Bacteremia/complications; Bacteremia/drug therapy*; Bacteremia/microbiology; Bacteremia/mortality
  6. Abdul Rahman Z, Hamzah SH, Hassan SA, Osman S, Md Noor SS
    J Infect Dev Ctries, 2013 Jun;7(6):448-52.
    PMID: 23771288 DOI: 10.3855/jidc.2535
    INTRODUCTION: Coagulase-negative staphylococci (CoNS) are a group of micro-organisms that are increasingly implicated as a cause of significant infection and the leading cause of bloodstream infection (BSI). One important predictor of true BSI is the isolation of CoNS from multiple blood cultures, presuming that the isolates represent the same species. Thus the objective of this study was to determine the significance of repeated CoNS isolated from blood cultures.
    METHODOLOGY: This was a prospective laboratory study which was initiated in June 2007 and lasted until July 2008. CoNS isolates were obtained from patients who had two positive blood cultures within a 14-day interval. CoNS were identified to the species level using an API-Staph, and antibiotics susceptibility testing was performed according to Clinical and Laboratory Standards Institute specifications. Strain relatedness was confirmed using pulsed-field gel electrophoresis.
    RESULTS: During the study period, 202 CoNS-positive samples were isolated from 101 patients. The most common species isolated was Staphylococcus epidermidis (59.0%), and 83.2% of the patients isolated the same species of CoNS from repeated blood cultures. Among the isolates of the same species, only 40.7% had the same antibiogram. CoNS with the same species and antibiogram had 93.3% probability of belonging to the same strain. Most (65.5%) of the patients were treated with antibiotics, primarily from the glycopeptides group.
    CONCLUSION: Speciation and antibiogram of CoNS from repeated blood cultures are adequate in determining the significance of repeated CoNS isolated from blood cultures.
    Matched MeSH terms: Bacteremia/microbiology; Bacteremia/epidemiology*
  7. Ariffin N, Hasan H, Ramli N, Ibrahim NR, Taib F, Rahman AA, et al.
    Am J Infect Control, 2012 Aug;40(6):572-5.
    PMID: 22854380 DOI: 10.1016/j.ajic.2012.02.032
    Intrahospital variations in antimicrobial profiles may be related to many factors. This study compared causative agents of nosocomial bloodstream infections between a neonatal intensive care unit (NICU) that adopted a ward-tailored antibiotic policy and adult intensive care units (ICUs). Data on organisms from blood cultures obtained from the respective wards between 2005 and 2009 were analyzed. Compared with the adult ICUs, the NICU had a higher frequency of Enterobacteriacae and lower frequencies of typical hospital-acquired pathogens (eg, Klebsiella pneumoniae, 17.4% vs 10.0% [P < .001]; Acinetobacter baumannii, 3.9% vs 11.6% [P < .001]). Antibiotic resistance of gram-negative organisms was also significantly lower in the NICU, including resistance to imipenem (5.7% vs 32.1%; P < .001), amikacin (8.8% vs 30.3%), and ceftriaxone (36.1% vs 74.6%; P < .001). This could possibly be due to the ward-tailored antibiotic policy adopted by the NICU but not by the other ICUs.
    Matched MeSH terms: Bacteremia/microbiology*; Bacteremia/epidemiology
  8. Abdulamir AS, Hafidh RR, Abu Bakar F
    PMID: 21247505 DOI: 10.1186/1756-9966-30-11
    Streptococcus bovis (S. bovis) bacteria are associated with colorectal cancer and adenoma. S. bovis is currently named S. gallolyticus. 25 to 80% of patients with S. bovis/gallolyticus bacteremia have concomitant colorectal tumors. Colonic neoplasia may arise years after the presentation of bacteremia or infectious endocarditis of S. bovis/gallolyticus. The presence of S. bovis/gallolyticus bacteremia and/or endocarditis is also related to the presence of villous or tubular-villous adenomas in the large intestine. In addition, serological relationship of S. gallolyticus with colorectal tumors and direct colonization of S. gallolyticus in tissues of colorectal tumors were found. However, this association is still under controversy and has long been underestimated. Moreover, the etiological versus non-etiological nature of this associationis not settled yet. Therefore, by covering the most of up to date studies, this review attempts to clarify the nature and the core of S. bovis/gallolyicus association with colorectal tumors and analyze the possible underlying mechanisms.
    Matched MeSH terms: Bacteremia/complications; Bacteremia/microbiology
  9. Baskaran ND, Gan GG, Kamarulzaman A, Sam IC
    Int J Infect Dis, 2007 Nov;11(6):513-7.
    PMID: 17459753
    OBJECTIVES: This study was initiated to determine the local profile of blood culture isolates and antibiotic sensitivities in febrile neutropenic patients following chemotherapy, and to establish if any modifications to treatment guidelines are necessary.
    DESIGN: A total of 116 episodes of febrile neutropenia admitted to the adult hematology ward at a university medical center in Malaysia were studied retrospectively from January 2004 to January 2005.
    RESULTS: The study showed 43.1% of febrile neutropenic episodes had established bacteremia. Gram-negative bacteria accounted for 60.3% of isolates. Sensitivities of Gram-negative bacteria to the antibiotics recommended in the Infectious Diseases Society of America (IDSA) guidelines were 86.1-97.2%. Coagulase-negative staphylococci were the most common Gram-positive organisms isolated (23.3%). The majority of these were methicillin-resistant.
    CONCLUSIONS: Carbapenem monotherapy, as recommended in the 2002 IDSA guidelines, is effective treatment for the infections most often encountered at our center. Combination therapy with an aminoglycoside should be considered when using ceftazidime, cefepime or piperacillin-tazobactam, particularly in high-risk patients. Vancomycin should be used if a Gram-positive organism is suspected or isolated.
    Matched MeSH terms: Bacteremia*; Bacteremia/microbiology*
  10. Riley PA, Parasakthi N, Liam CK
    Clin Infect Dis, 1996 May;22(5):867-8.
    PMID: 8722957
    Matched MeSH terms: Bacteremia/complications*; Bacteremia/drug therapy
  11. Feld R
    Int J Antimicrob Agents, 2008 Nov;32 Suppl 1:S30-3.
    PMID: 18778919 DOI: 10.1016/j.ijantimicag.2008.06.017
    Bloodstream infections (bacteraemia) account for approximately 25-30% of febrile episodes in patients with febrile neutropenia (FN). In developed countries, Gram-positive pathogens predominate. Mortality is higher in Gram-negative bacteraemia. A recent study involving 2142 patients with FN was reviewed, including 168 patients with Gram-negative bacteraemia (mortality 18%), 283 patients with Gram-positive bacteraemia (mortality 5%) and 48 patients with polymicrobial bacteraemia (mortality 13%). Among patients who received prophylactic antibiotics, Gram-positive bacteraemia was far more common than Gram-negative bacteraemia (75% vs. 25%), compared with approximately 50% of each in patients without prophylactic antibiotics. Patients with a Multinational Association for Supportive Care in Cancer (MASCC) score <15 had a 36% mortality compared with 3% if the MASCC score was >21. The MASCC score may help risk stratification of patients with FN and bacteraemia, although these data require confirmation. In two series of patients from developing countries (Lebanon and Malaysia), Gram-negative bacteraemia was more common and mortality was higher. In developing countries, Gram-negative bacteraemia may be more frequent due to less use of prophylactic antibiotics and central lines. Laboratory markers may have predictive and prognostic value for bacteraemia in patients at the onset of FN, including mannose-binding lectin, interleukin (IL)-6, IL-8 and procalcitonin, but further studies are required before they can be recommended. New therapies are required to lower the mortality in patients with FN with a high risk for bacteraemia.
    Matched MeSH terms: Bacteremia/mortality; Bacteremia/epidemiology*
  12. Fadzilah MN, Faizatul LJ, Hasibah MS, Sam IC, Bador MK, Gan GG, et al.
    J Med Microbiol, 2009 Jan;58(Pt 1):142-143.
    PMID: 19074667 DOI: 10.1099/jmm.0.004622-0
    A 17-year-old man with acute lymphoblastic leukaemia had fever and diarrhoea during a febrile neutropenic episode. A spiral-shaped, Gram-negative anaerobic bacterium was isolated from blood, and confirmed as Anaerobiospirillum succiniciproducens by 16S rRNA sequencing. The patient responded to imipenem.
    Matched MeSH terms: Bacteremia/drug therapy; Bacteremia/microbiology*
  13. Gopal Katherason S, Naing L, Jaalam K, Kamarul Iman Musa K, Nik Abdullah NM, Aiyar S, et al.
    Trop Biomed, 2010 Aug;27(2):308-16.
    PMID: 20962730 MyJurnal
    Nosocomial blood stream infection (or nosocomial bacteremia) is a common problem in hospitals worldwide, including Malaysia. A three-year prospective cohort study (October 2003-March 2007) of the incidences, risk factors, and patterns of the microorganisms causing bacteremia was conducted using a validated surveillance form in three intensive care units (ICUs) in Malaysia. Center for Disease Control criteria were used to diagnose bacteremia. Patients were monitored from admission until the end point of study, which was the first detection of bacteremia in the blood in each patient. The frequency of occurrence of bacteremia with clinical symptoms was 10.7% (n=23). Bacteremia was observed to occur within a mean length of stay of 10 days in ICU. The rate of device-related infection was 10.4% per device utilization days with a device utilization rate of 95.9%/1000 patient days. The total number of patient days was 2309 and the period of device utilization was 2211 days. The common bacteria detected were extended-spectrum beta-lactamases (ESBLs) Klebsiella pneumoniae (n=6); Pseudomonas aeruginosa (n=6); Acinetobacter species (n=5); Methicillin-resistant Staphylococcus aureus (MRSA)(n=3); and (non- ESBL) Klebsiella pneumoniae (n=2). Multivariable analysis using Cox Proportional Hazard Model showed that the predictors for developing bacteremia were cancer, MRSA carriage, duration of central venous catheter (CVC) infusion, frequency change of CVC, and the administration of hydrocortisone drugs. These results indicate that a combination of nursing and medical interventions as well as patients' severity of illness could lead to bacteremia in ICU. Strategic implementation of quality assurance measures in ICUs could help to control this problem.
    Matched MeSH terms: Bacteremia/microbiology*; Bacteremia/epidemiology
  14. Deris ZZ, Leow VM, Wan Hassan WM, Nik Lah NA, Lee SY, Siti Hawa H, et al.
    Trop Biomed, 2009 Dec;26(3):320-5.
    PMID: 20237446
    Vibrio cholerae infection is mainly caused acute diarrhoea disease. Bacteraemia due to non-O1 V. cholerae is rare and mainly reported in liver cirrhotic patients. We report one case of non-O1 V. cholerae bacteraemia in splenectomised thalassaemic patient who presented with septic shock secondary to abdominal sepsis. She had undergone emergency laporatomy and was managed in the intensive care unit for nine days. She was treated with meropenem and doxycyline and discharged well after fourteen days of admission. The V. cholerae was identified by API 20NE, serotype and polymerase chain reaction showed as non-O1, non-O139 strain. Besides known cholera-like toxin and El Tor hemolysin, with increasing reported cases of V. cholerae bacteraemia, there is possibility of other virulence factors that allow this organism to invade the bloodstream.
    Matched MeSH terms: Bacteremia/complications; Bacteremia/microbiology*
  15. Shaharir SS, Sulaiman Sahari N, Mohamed Fuad Z, Zukiman WZHW, Mohd Yusof NH, Sulong A, et al.
    Clin Rheumatol, 2018 Mar;37(3):837-847.
    PMID: 28971307 DOI: 10.1007/s10067-017-3855-7
    Non-tuberculous mycobacteria (NTM) are recognized as an important cause of human diseases and infections. It is commonly known to cause infections of the skin, soft tissue infections, and pulmonary infection as well as bacteraemia. We report a challenging case of severe mycobacterium abscessus bacteraemia in a pregnant lady with active systemic lupus erythematous (SLE). A comprehensive literature review of NTM infection among SLE patients was also performed, and pooled analysis of the reported cases, including our case, was done to determine the clinical characteristics and factors associated with poor outcome of NTM infection.
    Matched MeSH terms: Bacteremia/complications*; Bacteremia/drug therapy
  16. Siti Rohani AH, Tzar MN
    Med J Malaysia, 2013 Jun;68(3):267-8.
    PMID: 23749021 MyJurnal
    A 60-year old Malay man presented with an intermittent lowgrade fever for 3 days and worsening of right ankle ulcers. He was known to have ischaemic heart disease, diabetes mellitus type 2, hypertension and end stage renal failure and was on regular haemodialysis. The organisms isolated from the peripheral and central blood specimens were identified as Ochrobactrum anthropi, a rarely encountered gramnegative bacillus with a unique antibiotic susceptibility profile. His condition improved after removal of the catheters and administration of antibiotic therapy. This case report highlights the importance of being wary of such rare, opportunistic pathogens and good communication between the microbiologists and the clinicians.
    Matched MeSH terms: Bacteremia
  17. Dhanoa A, Singh VA, Mansor A, Yusof MY, Lim KT, Thong KL
    BMC Infect Dis, 2012;12:270.
    PMID: 23098162 DOI: 10.1186/1471-2334-12-270
    Methicillin-resistant Staphylococcus aureus (MRSA) has of late emerged as a cause of community-acquired infections among immunocompetent adults without risk factors. Skin and soft tissue infections represent the majority of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) clinical presentations, whilst invasive and life-threatening illness like necrotizing pneumonia, necrotizing fasciitis, pyomyositis, osteomyelitis and sepsis syndrome are less common. Although more widely described in the pediatric age group, the occurrence of CA-MRSA osteomyelitis in adults is an uncommonly reported entity.
    Matched MeSH terms: Bacteremia/diagnosis*; Bacteremia/microbiology; Bacteremia/pathology
  18. Hassan MR, Pani SP, Peng NP, Voralu K, Vijayalakshmi N, Mehanderkar R, et al.
    BMC Infect Dis, 2010;10:302.
    PMID: 20964837 DOI: 10.1186/1471-2334-10-302
    Melioidosis, a severe and fatal infectious disease caused by Burkholderia pseudomallei, is believed to an emerging global threat. However, data on the natural history, risk factors, and geographic epidemiology of the disease are still limited.
    Matched MeSH terms: Bacteremia/mortality; Bacteremia/epidemiology; Bacteremia/pathology
  19. Eskandarian N, Neela V, Ismail Z, Puzi SM, Hamat RA, Desa MN, et al.
    Int J Infect Dis, 2013 Sep;17(9):e777-80.
    PMID: 23453715 DOI: 10.1016/j.ijid.2013.01.011
    Group B Streptococcus (GBS) is a leading cause of infections such as meningitis and septicemia in neonates and pregnant women; however the significance of invasive GBS disease has not been clearly defined in non-pregnant adults.
    Matched MeSH terms: Bacteremia/diagnosis; Bacteremia/drug therapy; Bacteremia/microbiology*
  20. Annas S, Zamri-Saad M, Jesse FF, Zunita Z
    Microb Pathog, 2015 Nov;88:94-102.
    PMID: 26298001 DOI: 10.1016/j.micpath.2015.08.009
    Haemorrhagic septicaemia (HS) is an acute, septicaemic disease of cattle and buffalo of Asia and Africa caused by Pasteurella multocida B:2 or E:2. Buffaloes are believed to be more susceptible than cattle. In this study, 9 buffaloes of 8 months old were divided equally into 3 groups (Groups 1, 3, 5). Similarly, 9 cattle of 8 months old were equally divided into 3 groups (Groups 2, 4, 6). Animals of Groups 1 and 2 were inoculated with PBS while Groups 3 and 4 were inoculated subcutaneously with 10(5) cfu/ml of P. multocida B:2. Animals of Groups 5 and 6 were inoculated intranasally with the same inoculum. Both buffaloes and cattle that were inoculated subcutaneously succumbed to the infection at 16 h and 18 h, respectively. Two buffaloes that were inoculated intranasally (Group 5) succumbed at 68 h while the remaining cattle and buffaloes survived the 72-h study period. Endotoxin was detected in the blood of infected cattle (Group 4) and buffaloes (Groups 3 and 5) prior to the detection of P. multocida B:2 in the blood. The endotoxin was detected in the blood of buffaloes of Group 3 and cattle of Group 4 at 0.5 h post-inoculation while buffaloes of Group 5 and cattle of Group 6 at 1.5 h. On the other hand, bacteraemia was detected at 2.5 h in buffaloes of Group 3 and cattle of Group 4 and at 12 h in buffaloes of Group 5 and cattle of Group 6. Affected cattle and buffaloes showed lesions typical of haemorrhagic septicaemia. These included congestion and haemorrhages in the organs of respiratory, gastrointestinal and urinary tracts with evidence of acute inflammatory reactions. The severity of gross and histopathology lesions in cattle and buffalo calves that succumbed to the infection showed insignificant (p > 0.05) difference. However, inoculated buffalo and cattle that survived the infection showed significantly (p < 0.05) less severe gross and histopathological changes than those that succumbed. In general, cattle are more resistant to intranasal infection by P. multocida B:2 than buffaloes.
    Matched MeSH terms: Bacteremia
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