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  1. Microbial Contamination of Extended Use Ophthalmic Drops in Ophthalmology Clinic
    Chua SW, Mustapha M, Wong KK, Ami M, Mohd Zahidin AZ, Nasaruddin RA
    Clin Ophthalmol, 2021;15:3147-3152.
    PMID: 34326630 DOI: 10.2147/OPTH.S320987
    Purpose: The objectives of this study were to determine the prevalence of microbial contamination of multi-user preserved ophthalmic drops (POD) in Ophthalmology Outpatient Clinic (OOC), to compare the rate of contamination between the dropper tip and the residual contents in the bottle, and to identify the contaminating organisms.

    Methods: This was an observational cross-sectional study using a convenience sampling method conducted in the OOC of Universiti Kebangsaan Malaysia Medical Center, Malaysia. The samples of POD bottles were divided into groups obtained after 14 days (T14) and after 30 days (T30) of use. The contamination rate at the dropper tip and in the residual contents was determined and the contaminating organisms were identified.

    Results: A total of 140 of 149 extended-use POD bottles were included. The prevalence of contamination was 30%. There was a statistically significant difference in the rate of contamination between samples T14 and T30 (19% and 11%, respectively; p=0.046). Proparacaine and tropicamide showed higher contamination rates in the T14 samples (p=0.027 and p=0.497, respectively) than in the T30 samples. The site of contamination was higher at the dropper tip than in the residual contents (p>0.05). Coagulase-negative Staphylococcus species were the most frequently identified contaminants (89%).

    Conclusion: The dropper tip was more contaminated than the residual contents, and coagulase-negative Staphylococcus species, which are common commensal flora of the ocular conjunctiva and skin, were the most frequently identified organisms.

  2. Antibiotic use in a co-infection of respiratory syncytial virus and pathogenic bacteria in children in a resource-limited setting in northeast Peninsular Malaysia
    Liew CSL, Guad RM, Taylor-Robinson AW, Teck KS, Mandrinos S, Duin EV, et al.
    Trop Biomed, 2024 Sep 01;41(3):310-315.
    PMID: 39548785 DOI: 10.47665/tb.41.3.011
    To investigate co-infection of bacterial isolates associated with respiratory syncytial virus (RSV) in children aged less than two years who were admitted to hospital with confirmed lower respiratory tract infection (LRTI) in Kelantan, Malaysia. The demographic data, clinical history, case management, haematological as well as infectious parameters (white blood cell differential and count, plus C-reactive protein, CRP) of the patients were systematically recorded. Less than one-third of cases were RSV-positive (21.03% and 26.23% were diagnosed as acute bronchiolitis or pneumonia, respectively). Blood cultures from approximately 10% of patients demonstrated growth of Haemophilus influenzae, Staphylococcus aureus, coagulase-negative Staphylococcus, Pseudomonas stutzeri, haemolytic Streptococcus group A, and Bacillus subtilis. Further analysis indicated that children with positive bacterial growth had an insignificant predictive value of CRP (2.32-7.16 mg/dl). The total white cell counts were 2.97-7.33 x 109sup>/L despite increased lymphocyte values in the bacteria-positive blood culture. Platelet counts were also within normal limits except for a single case of H. influenzae infection (685.50 x 109sup>/L). Interestingly, 95.01% of patients were treated with antibiotics; 66.23% of RSV infection cases were administered with a combination of antibiotics and 33.77% with only a single antibiotic. The data indicate that the use of antibiotics, either singly or in combination, is not always effective in treating LRTI in infants. Alternative therapeutic regimens should be considered, especially in Asian countries that may have limited resources.
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