Displaying publications 41 - 60 of 115 in total

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  1. Dual panel multiplex PCR assay for rapid detection of medically important fungi and resistant species of candida and aspergillus
    Jacinta Santhanam, Mohd Hanif Jainlabdin, Ang LC, Tzar Mohd Nizam
    Sains Malaysiana, 2018;47:489-498.
    Invasive fungal infections (IFIs) have risen dramatically in recent years among high risk immunocompromised patients.
    Rapid detection of fungal pathogens is crucial to timely and accurate antifungal therapy. Two multiplex polymerase
    chain reaction (PCR) assays were developed to detect major fungal species that cause invasive infections and identify
    resistant species. Genus specific primers for Candida, Aspergillus, Fusarium and species specific primers for Candida
    glabrata, Candida krusei and Aspergillus terreus which are known to be clinically resistant species, were designed from
    the internal transcribed spacer (ITS) regions of ribosomal ribonucleic acid (rRNA) gene complex. Both assays were
    performed simultaneously to promote rapid detection of fungal isolates based on distinct amplicon sizes. Inclusion of the
    universal fungal primers ITS 1 and ITS 4 in the genus specific assay produced a second amplicon for each isolate which
    served to confirm the detection of a fungal target. The limit of detection for the genus specific assay was 1 nanogram
    (ng) deoxyribonucleic acid (DNA) for Aspergillus fumigatus and Candida albicans, 0.1 ng DNA for Fusarium solani, while
    the species-specific assay detected 0.1 ng DNA of A. terreus and 10 picogram (pg) DNA of C. krusei and C. glabrata. The
    multiplex PCR assays, apart from universal detection of any fungal target, are able to detect clinically important fungi
    and differentiate resistant species rapidly and accurately, which can contribute to timely implementation of effective
    antifungal regime.
    Matched MeSH terms: Immunocompromised Host
  2. Fulltext Caecal Perforation from Primary Intestinal Tuberculosis in Pregnancy
    Lwin S, Lau Lee Jing N, Suharjono H, Kipli MB, Moe Nwe T, San Yi M, et al.
    Case Rep Gastrointest Med, 2017;2017:2173724.
    PMID: 28912984 DOI: 10.1155/2017/2173724
    The incidence of tuberculosis (TB) is rising worldwide, despite the efficacy of the BCG vaccination. Populations at greatest risk of contracting TB are migrant communities, as well as immunocompromised individuals. The diagnosis of extrapulmonary TB (EPTB) can often present as a diagnostic conundrum, due to its nonspecific and varied presentation, often mimicking inflammatory bowel disease or malignancy. We present a case of caecal TB in pregnancy, which resulted in caecal perforation, a right hemicolectomy, and severe preterm delivery. The aim of this case report is to discuss the diagnosis of extrapulmonary TB, as well as its subsequent management in pregnancy.
    Matched MeSH terms: Immunocompromised Host
  3. Fulltext A rare case of Ralstonia mannitolilytica infection in an end stage renal patient on maintenance dialysis during municipal water contamination
    Lim CTS, Lee SE
    Pak J Med Sci, 2017 10 27;33(4):1047-1049.
    PMID: 29067090 DOI: 10.12669/pjms.334.13112
    Ralstonia mannitolilytica is a gram negative soil bacterium. Ralstonia infection though rare, has become the emerging nosocomial pathogens in hospital settings. Various clinical manifestations had been described as well as the mode of transmission. Despite its low virulence factor, it is able to survive under harsh condition and this may potentially cause significant morbidity and mortality especially in immunocompromised patients. Outbreak of Ralstonia mannitolilytica infections in the hospital are typically associated with contaminated medical supplies or instruments. We described here a case of Ralstonia mannitolilytica infection in a dialysis patient that occurred during the municipal reservoir water contamination crisis. In this report, we will also describe the behaviour of Ralstonia genus and its 4 main species, namely R. pickettii, R. solanacearum, R. insidiosa, and R. mannitolilytica and the choices of antibiotic therapy based on literature review.
    Matched MeSH terms: Immunocompromised Host
  4. Septicaemia due to Vibrio vulnificus: A tropical infection not to be taken lightly
    Ding CH, Wahab WA, Saaid MS, Mokhtar MN, Abdullah FA, Azaharuddin I
    Trop Biomed, 2024 Jun 01;41(2):157-159.
    PMID: 39154267 DOI: 10.47665/tb.41.2.004
    Vibrio vulnificus is a halophilic gram-negative bacillus that can cause fulminant septicaemia in immunocompromised patients. A 67-year-old man who was immunosuppressed as a result of cytotoxic chemotherapy presented with a brief history of fever, lethargy, myalgia, and reduced oral intake. He had recently travelled to the beach to consume seafood. His blood pressure was 81/47 mm Hg, necessitating fluid resuscitation followed by inotropic support and admission to the intensive care unit. His blood culture was positive for curved gram-negative bacilli. The isolate was oxidase-positive and produced an acid butt with an alkaline slant in triple sugar iron agar. Matrix-assisted laser desorption ionization-time of flight mass spectrometry conclusively identified the isolate as V. vulnificus. Intravenous ceftazidime plus ciprofloxacin were administered, and by the fifth day of admission, he was successfully transferred out to the general ward. In total, the patient completed a 14-day course of antibiotic therapy.
    Matched MeSH terms: Immunocompromised Host
  5. A comparative analysis of blood and faecal-based laboratory methods in the diagnosis of extraintestinal microsporidia infection
    Mohamed Yusoff PS, Arifin N, Periyasamy P, Tumian NR, Ismail F, Raja Sabudin RZA, et al.
    Malays J Pathol, 2024 Aug;46(2):299-306.
    PMID: 39207007
    Diagnosis of extraintestinal microsporidiosis is always hampered due to non-specific symptoms and difficulty in diagnosis. This study aimed to compare the diagnostic utility of blood and faecal-based polymerase chain reaction (PCR) to detect microsporidiosis in immunocompromised patients. A total of 42 immunocompromised patients consisting of HIV-infected and chemotherapy-treated patients were enrolled. Paired faecal and blood samples were collected and subjected to PCR to detect Enterocytozoon bieneusi and Encephalitozoon spp. Faecal samples were microscopically screened for microsporidia spores. Overall, 42.9% (18/42) of patients were positive for microsporidiosis. Of this, 19.0% (8/42) and 4.8% (2/42) were positive by blood and stool PCR respectively. Meanwhile, 33.3% (14/42) of the faecal specimens were microscopically positive. Among the positive patients, 22.2% (4/18) had microsporidia confirmed by blood PCR and stool microscopy, suggestive of dissemination. Interestingly, the stool specimen in which microsporidia spores were detected via microscopy is not positive via PCR method. This highlights the limitation of the faecal-based detection method and the important use of blood samples for diagnosing extraintestinal microsporidiosis. Only E. bieneusi species were detected in all PCR-positive samples. This study highlights the diagnostic value of blood PCR in diagnosing extraintestinal microsporidiosis infections.
    Matched MeSH terms: Immunocompromised Host
  6. Nasal eschar: a warning sign of potentially fatal invasive fungal sinusitis in immunocompromised children
    Idris N, Lim LH
    J Pediatr Hematol Oncol, 2012 May;34(4):e134-6.
    PMID: 22430585 DOI: 10.1097/MPH.0b013e31824410e3
    Most invasive fungal sinusitis occurs in immunocompromised adult patients. We present the case study of a 12-year-old boy diagnosed with acute myeloblastic leukemia undergoing chemotherapy. He developed a progressive darkening discoloration over the dorsum of the nose that turned into an eschar. Nasal endoscopy revealed extensive necrotic tissue in the nasal cavity mucosa, inferior and middle turbinates, and septal cartilage that extended to the eschar of the skin over the nasal dorsum. Histopathology showed aspergillus invasive fungal rhinosinusitis.
    Matched MeSH terms: Immunocompromised Host*
  7. Treatment of chronic hepatitis B virus infection in special groups of patients: decompensated cirrhosis, immunosuppressed and paediatric patients
    Merican I
    J Gastroenterol Hepatol, 2000 May;15 Suppl:E71-8.
    PMID: 10921386
    Matched MeSH terms: Immunocompromised Host*
  8. Fulltext Efficacy and safety of posaconazole for the prevention of invasive fungal infections in immunocompromised patients: a systematic review with meta-analysis and trial sequential analysis
    Wong TY, Loo YS, Veettil SK, Wong PS, Divya G, Ching SM, et al.
    Sci Rep, 2020 09 03;10(1):14575.
    PMID: 32884060 DOI: 10.1038/s41598-020-71571-0
    Invasive fungal infections are a potentially life-threatening complication in immunocompromised patients. The aim of this study was to assess the efficacy and safety of posaconazole as compared with other antifungal agents for preventing invasive fungal infections in immunocompromised patients. Embase, CENTRAL, and MEDLINE were searched for randomized conweekmonthtrolled trials (RCTs) up to June 2020. A systematic review with meta-analysis of RCTs was performed using random-effects model. Trial sequential analysis (TSA) was conducted for the primary outcome to assess random errors. A total of five RCTs with 1,617 participants were included. Posaconazole prophylaxis was associated with a significantly lower risk of IFIs (RR, 0.43 [95% CI 0.28 to 0.66, p = 0.0001]) as compared to other antifungal agents. No heterogeneity was identified between studies (I2 = 0%). No significant associations were observed for the secondary outcomes measured, including risk reduction of invasive aspergillosis and candidiasis, clinical failure, all-cause mortality, and treatment-related adverse events, except for infection-related mortality (RR, 0.31 [95% CI 0.15 to 0.64, p = 0.0001]). Subgroup analysis favoured posaconazole over fluconazole for the prevention of IFIs (RR, 0.44 [95% CI 0.28 to 0.70, p = 0.0004]). TSA confirmed the prophylactic benefit of posaconazole against IFIs. Posaconazole is effective in preventing IFIs among immunocompromised patients, particularly those with hematologic malignancies and recipients of allogenic hematopoietic stem cell transplantation.
    Matched MeSH terms: Immunocompromised Host/drug effects*
  9. Fulltext PET-CT as an effective imaging modality in the staging and follow-up of post-transplant lymphoproliferative disorder following solid organ transplantation
    Noraini AR, Gay E, Ferrara C, Ravelli E, Mancini V, Morra E, et al.
    Singapore Med J, 2009 Dec;50(12):1189-95.
    PMID: 20087557
    To establish the role of positron-emission tomography (PET)-computed tomography (CT) in post-transplant lymphoproliferative disorder (PTLD) patients, compared to conventional imaging (ultrasonography/CT/magnetic resonance imaging) in relation to its accuracy, sensitivity and specificity.
    Matched MeSH terms: Immunocompromised Host*
  10. Rhodococcus equi--an emerging human pathogen in immunocompromized hosts: a report of four cases from Malaysia
    Puthucheary SD, Sangkar V, Hafeez A, Karunakaran R, Raja NS, Hassan HH
    Southeast Asian J Trop Med Public Health, 2006 Jan;37(1):157-61.
    PMID: 16771229
    Rhodococcus equi, a recognized pathogen in horses, is emerging as a human opportunistic pathogen, especially in immunocompromized hosts. We describe four immunocompromized patients who had serious R. equi infections with an overall mortality of 75%. The natural habitat of R. equi is soil, particularly soil contaminated with animal manure. Necrotizing pneumonia is the commonest form of infection but extrapulmonary infections, such as wound infections and subcutaneous abscess, have also been described in humans. R. equi is cultured easily in ordinary non-selective media. Large, smooth, irregular colonies appear within 48 hours. It is a facultative, intracellular, nonmotile, non-spore forming, gram-positive coccobacillus, which is weakly acid-fast staining and bears a similarity to diphtheroids. It forms a salmon-colored pigment usually after 48 hours incubation. A particular characteristic of this organism is that it undergoes synergistic hemolysis with some bacteria on sheep blood agar. R. equi may be misidentified as diphtheroids, Mycobacterium species, or Nocardia. In vitro R. equi is usually susceptible to erythromycin, ciprofloxacin, vancomycin, aminoglycosides, rifampin, imipenem and meropenem. The organism can be difficult to eradicate, making treatment challenging. Increased awareness of the infection may help with early diagnosis and timely treatment.
    Matched MeSH terms: Immunocompromised Host*
  11. Fulltext Rhino-orbito-cerebral mucormycosis in an immunocompetent patient: case report and review of literature
    Shatriah I, Mohd-Amin N, Tuan-Jaafar TN, Khanna RK, Yunus R, Madhavan M
    Middle East Afr J Ophthalmol, 2012 Apr-Jun;19(2):258-61.
    PMID: 22623872 DOI: 10.4103/0974-9233.95269
    Rhino-orbito-cerebral mucormycosis is a fungal infection that can be fatal especially in immunocompromised patients. It is extremely rare in immunocompetent individuals. We describe here an immunocompetent patient who survived rhino-orbito-cerebral mucormycosis due to Saksenaea vasiformis, and provide a literature review of this rare entity.
    Matched MeSH terms: Immunocompromised Host*
  12. Subcutaneous Infection Associated with Trichosporon ovoides: A Case Report and Review of Literature
    Mohd Tap R, Sabaratnam P, Ramli NY, Hashim R, Mohd Fuat AR, Ng PP, et al.
    Mycopathologia, 2016 Apr;181(3-4):285-90.
    PMID: 26493614 DOI: 10.1007/s11046-015-9958-2
    Trichosporon species are opportunistic yeasts which can cause infections, especially in immunocompromised patients. This is a report of Trichosporon ovoides that caused subcutaneous infection in a patient with underlying ischemic heart disease. The identification of fungal isolate was confirmed by PCR sequencing of ITS and large subunit regions in rRNA gene. In vitro susceptibility study showed that the isolate was susceptible to amphotericin B, fluconazole and voriconazole, and resistant to caspofungin, anidulafungin and itraconazole. The lesion improved after treatment with oral fluconazole and topical miconazole.
    Matched MeSH terms: Immunocompromised Host*
  13. Right atrial tuberculoma: a diagnosis too late
    Ngow HA, Khairina WM
    Cardiol J, 2011;18(5):560-3.
    PMID: 21947994
    Solitary intra-cardiac cavity tuberculoma is extremely rare and often only diagnosed during a post-mortem. We report a case of right atrial tuberculoma causing right atrial outflow tract obstruction in an immune-compromised man. The diagnosis of cardiac tuberculoma was made through the detection of mycobacterium tuberculosis DNA by tuberculosis-polymerase chain reaction in the pericardial fluid. The patient succumbed five days after admission but an autopsy was refused by his family.
    Matched MeSH terms: Immunocompromised Host*
  14. Fulltext Effect of Recombinant Zoster Vaccine on Incidence of Herpes Zoster After Autologous Stem Cell Transplantation: A Randomized Clinical Trial
    Bastidas A, de la Serna J, El Idrissi M, Oostvogels L, Quittet P, López-Jiménez J, et al.
    JAMA, 2019 07 09;322(2):123-133.
    PMID: 31287523 DOI: 10.1001/jama.2019.9053
    Importance: Herpes zoster, a frequent complication following autologous hematopoietic stem cell transplantation (HSCT), is associated with significant morbidity. A nonlive adjuvanted recombinant zoster vaccine has been developed to prevent posttransplantation zoster.

    Objective: To assess the efficacy and adverse event profile of the recombinant zoster vaccine in immunocompromised autologous HSCT recipients.

    Design, Setting, and Participants: Phase 3, randomized, observer-blinded study conducted in 167 centers in 28 countries between July 13, 2012, and February 1, 2017, among 1846 patients aged 18 years or older who had undergone recent autologous HSCT.

    Interventions: Participants were randomized to receive 2 doses of either recombinant zoster vaccine (n = 922) or placebo (n = 924) administered into the deltoid muscle; the first dose was given 50 to 70 days after transplantation and the second dose 1 to 2 months thereafter.

    Main Outcomes and Measures: The primary end point was occurrence of confirmed herpes zoster cases.

    Results: Among 1846 autologous HSCT recipients (mean age, 55 years; 688 [37%] women) who received 1 vaccine or placebo dose, 1735 (94%) received a second dose and 1366 (74%) completed the study. During the 21-month median follow-up, at least 1 herpes zoster episode was confirmed in 49 vaccine and 135 placebo recipients (incidence, 30 and 94 per 1000 person-years, respectively), an incidence rate ratio (IRR) of 0.32 (95% CI, 0.22-0.44; P 

    Matched MeSH terms: Immunocompromised Host*
  15. Fulltext The use of an in-house modified double antibody sandwich ELISA to detect Aspergillus antigens in sera of immunosuppressed patients
    Samad SA, Rahman HA
    Singapore Med J, 1999 Aug;40(8):513-8.
    PMID: 10572490
    The purpose of this study was to retrospectively detect Aspergillus antigens in sera obtained from immunocompromised host using an in-house modified double antibody sandwich ELISA.
    Matched MeSH terms: Immunocompromised Host*
  16. First isolation of Candida wangnamkhiaoensis from the blood of immunocompromised paediatric patient
    Tap RM, Ho Betty LS, Ramli NY, Suppiah J, Hashim R, Sabaratnam P, et al.
    Mycoses, 2016 Nov;59(11):734-741.
    PMID: 27427490 DOI: 10.1111/myc.12509
    Candida wangnamkhiaoensis is a species clustered under the Hyphopichia clade has not ever been isolated from any clinical specimens. To the best of our knowledge, this is the first report of C. wangnamkhiaoensis associated with fungaemia in immunocompromised paediatric patient. The isolate was assigned a strain name as UZ1679/14, in which the identification was confirmed by a polymerase chain reaction-sequencing of the internal transcribed spacer (ITS) and large subunit (LSU) regions of the rRNA gene. Antifungal susceptibility pattern showed that the isolate was sensitive to anidulafungin, caspofungin, fluconazole and voriconazole. The patient clinically improved after the antifungal treatment with caspofungin.
    Matched MeSH terms: Immunocompromised Host*
  17. Case report post-splenectomy sepsis in thalassemic patients
    Zarina AL, Hamidah A, Zulkifli SZ, Jamal R
    Southeast Asian J Trop Med Public Health, 2005 Mar;36(2):471-3.
    PMID: 15916058
    Thalassemia is the commonest hemoglobinopathy in Malaysia. Patients with thalassemia major are transfusion dependent, and a large proportion of them will require splenectomy. As this particular group of patients is immunocompromized, overwhelming sepsis is a recognized complication. We report a series of three patients who all developed intra-abdominal abscesses following splenectomy.
    Matched MeSH terms: Immunocompromised Host*
  18. Toxoplasma gondii: determination of the onset of chronic infection in mice and the in vitro reactivation of brain cysts
    Chew WK, Wah MJ, Ambu S, Segarra I
    Exp Parasitol, 2012 Jan;130(1):22-5.
    PMID: 22027550 DOI: 10.1016/j.exppara.2011.10.004
    Toxoplasma gondii is an intra-cellular parasite that infects humans through vertical and horizontal transmission. The cysts remain dormant in the brain of infected humans and can reactivate in immunocompromised hosts resulting in acute toxoplasmic encephalitis which may be fatal. We determined the onset and progression of brain cysts generation in a mouse model following acute toxoplasmosis as well as the ability of brain cysts to reactivate in vitro. Male Balb/c mice, (uninfected control group, n = 10) were infected orally (study group, n = 50) with 1000 tachyzoites of T. gondii (ME49 strain) and euthanized at 1, 2, 4, 8 and 16 weeks post infection. Brain tissue was harvested, homogenized, stained and the number of brain cysts counted. Aliquots of brain homogenate with cysts were cultured in vitro with confluent Vero cells and the number of cysts and tachyzoites counted after 1 week. Brain cysts but not tachyzoites were detected at week 2 post infection and reached a plateau by week 4. In vitro Vero cells culture showed similar pattern for cysts and tachyzoites and reactivation of cyst in vitro was not influenced by the age of the brain cysts.
    Matched MeSH terms: Immunocompromised Host
  19. Fulltext Evaluation of Immunoprotection Conferred by the Subunit Vaccines of GRA2 and GRA5 against Acute Toxoplasmosis in BALB/c Mice
    Ching XT, Fong MY, Lau YL
    Front Microbiol, 2016;7:609.
    PMID: 27199938 DOI: 10.3389/fmicb.2016.00609
    Toxoplasmosis is a foodborne disease caused by Toxoplasma gondii, an obligate intracellular parasite. Severe symptoms occur in the immunocompromised patients and pregnant women leading to fatality and abortions respectively. Vaccination development is essential to control the disease. The T. gondii dense granule antigen 2 and 5 (GRA2 and GRA5) have been targeted in this study because these proteins are essential to the development of parasitophorous vacuole (PV), a specialized compartment formed within the infected host cell. PV is resistance to host cell endosomes and lysosomes thereby protecting the invaded parasite. Recombinant dense granular proteins, GRA2 (rGRA2) and GRA5 (rGRA5) were cloned, expressed, and purified in Escherichia coli, BL21 (DE3) pLysS. The potential of these purified antigens as subunit vaccine candidates against toxoplasmosis were evaluated through subcutaneous injection of BALB/c mice followed by immunological characterization (humoral- and cellular-mediated) and lethal challenge against virulent T. gondii RH strain in BALB/c mice. Results obtained demonstrated that rGRA2 and rGRA5 elicited humoral and cellular-mediated immunity in the mice. High level of IgG antibody was produced with the isotype IgG2a/IgG1 ratio of ≈0.87 (p < 0.001). Significant increase (p < 0.05) in the level of four cytokines (IFN-γ, IL-2, IL-4, and IL-10) was obtained. The antibody and cytokine results suggest that a mix mode of Th1/Th2-immunity was elicited with predominant Th1-immune response inducing partial protection against T. gondii acute infection in BALB/c mice. Our findings indicated that both GRA2 and GRA5 are potential candidates for vaccine development against T. gondii acute infection.
    Matched MeSH terms: Immunocompromised Host
  20. Fulltext The use of an in-house biotin-avidin linked immunosorbent assay to detect Aspergillus antigens in sera of immunocompromised patients
    Abdul Samad S, Yusoff H, Fadilah SAW
    Med J Malaysia, 2001 Mar;56(1):32-8.
    PMID: 11503293
    A biotin-avidin-linked immunosorbent assay was developed to detect Aspergillus antigens in sera of immunocompromised patients. The assay was based on a double antibody sandwich ELISA using polyclonal antibodies raised against water-soluble antigens of Aspergillus fumigatus. Aspergillus antigens were positive in sera of 9 of 16 (56%) patients who were studied prospectively and in 13 of 73 (19%) patients studied retrospectively. The 9 prospectively studied patients who were antigen positive were febrile neutropenic hematological malignancy patients who exhibited a high risk of acquiring invasive aspergillosis.
    Matched MeSH terms: Immunocompromised Host
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