Displaying publications 1 - 20 of 88 in total

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  1. Samsudin, N.I.P., Roslan, N.A., Nor-Khaizura, M.A.R., Hasan, H.
    MyJurnal
    Maintaining the quality of bakery products is vital for consumers’ health and preference. Since bakery products are intermediate-moisture foods, spoilage by moulds is among the major causes of shelf life reduction. In the present work, the effects of substituting banana purée with banana powder to extend the shelf life of banana cakes were investigated over a ten-day storage period. Three types of banana cake were made using banana purée (control), laboratory-formulated powder (LP), and commercial powder (CP). Results indicated a significant difference in moisture contents and water activities between all treatments in which LP and CP exhibited mould growth at day 9 compared to day 5 in control. For fungal load, LP yielded the lowest CFU by the end of storage period. Although significant differences in texture and appearance were noted between all treatments, untrained sensory panellists scored LP as acceptable. Further works are therefore warranted to assess LP’s commercialisation potentials.
  2. Abd Rahman, R., Mohamad, D., Ab Ghani, Z., Hasan, H., Abdullah, N.A.
    MyJurnal
    The objective of the study was to asses the adhesion of Streptococcus mutans on nanofilled and microfilled composite resin and glass ionomer cement restorative materials. Glass ionomer cements; KetacTM N100 (nanofilled) and Fuji IITM LC (microfilled) and composite resins; FiltekTM Z350 (nanofilled) and FiltekTM Z250 (microhybrid) were packed in acrylic mould of 2 mm thickness and 5 mm diameter. All samples were light-cured and polished with Sof-Lex discs. All materials were cultured with the exponential phase of S. mutans cultivation. Surface roughness values were assessed using Atomic Force Microscope (AFM, Ambios, USA) at time intervals (7hrs, 24 hrs, 7 days, 14 days and 21 days). The morphology of S. mutans on materials was observed after 24 hour incubation of S. mutan on materials under Scanning Electron Microscope (SEM, Quanta FEG 450). Within groups, results showed that both nanofilled materials had lower surface roughness and less adhesion of S. mutans compared to microfilled materials. This study would enhance the clinical knowledge especially in aesthetic area and improve the longevity of the dental restoration.
  3. Hasan H, Aljunid SM
    BMC Public Health, 2019 Feb 19;19(1):208.
    PMID: 30782152 DOI: 10.1186/s12889-019-6520-z
    BACKGROUND: Job satisfaction influences staff retention, motivation, and performance in providing services. A considerable amount of published studies has reported on the job satisfaction level of healthcare workers, but to date, very few studies focused on Community-Based Rehabilitation (CBR) workers. This study aimed to explore the job satisfaction level among Community-Based Rehabilitation (CBR) workers and associated factors related to their overall job satisfaction.

    METHODS: A one-year survey was conducted in three states of the east coast region of Peninsular Malaysia involving 204 CBR workers selected through universal sampling method where all CBR staff who fulfilled the inclusion criteria were selected as participants. Self-completed questionnaires consisted of 20 association factors on six-point Likert scale responses were distributed. Total mean satisfaction level and mean associated factors were reported in this study.

    RESULTS: The results showed that the majority of the participants were between 20 and 40 years old (72%), female (96%), Malay (99%) and had 1-5 years of working experience. The mean total satisfaction score was 79.8 ± SD = 7.85. The highest mean satisfaction level for the associated factor was 4.6 ± SD = 0.59 with about 95% of the participants were satisfied that "CBR programme is a challenging work", while the lowest satisfaction level for associated factor was on "salary of community-based rehabilitation staff is acceptable", with mean score of 2.3 ± SD = 0.97 with about 59% of the participants felt dissatisfied. The results of this study determined that the highest dissatisfied factors among CBR workers were on salary.

    CONCLUSION: These findings provided useful information for policymakers to evaluate this issue for a sustainable CBR programme in the future.

    TRIAL REGISTRATION: This study has been registered for trial as 'retrospective registered' in the Australian New Zealand Clinical Trials Registry (ANZCTR) (registration no.: ACTRN 12618001101279 ) on 5th October 2018.

  4. Deris ZZ, Hasan H, Siti Suraiya MN
    J Infect Dev Ctries, 2010 Aug 04;4(7):430-5.
    PMID: 20818090
    BACKGROUND: Melioidosis is an important public health problem causing community acquired sepsis in the northeastern part of Malaysia.

    METHODOLOGY: From January 2001 to December 2005, we reviewed case reports of all bacteraemic melioidosis admitted to a tertiary teaching hospital, Hospital Universiti Sains Malaysia.

    RESULTS: Thirty-five patients had positive blood culture for meliodosis and 27 case reports were traceable for further analysis. The mean age was 46.8 + 20.0 years. Twenty patients (74.1%) were male. The main clinical presentation was fever that occurred in 23 (85.2%) patients. Eighteen patients (66.7%) had lung involvement and three patients had liver abscess. Two patients presented with scrotal swelling, one of whom further developed Fournier's Gangrene. Nineteen (70.4%) patients had underlying diabetes, five of whom were newly diagnosed during the admission. Thirteen (48.1%) patients were treated with high-dose ceftazidime and six (22.2%) patients were treated with imipenem. Eight (29.6%) patients were not given anti-melioidosis therapy because the causative agents were not identified until after the patients died. The patients were admitted 16.8 days + 18.1. Seventeen patients (63.0%) died in this series, 13 patients of whom died within four days of admission.

    CONCLUSIONS: The wide range of clinical presentations and the fatal outcomes of melioidosis require a high level of suspicion among physicians to develop an early appropriate therapy and reduce the mortality rate.

  5. Hasan H, Parker A, Pollard SJT
    Sci Total Environ, 2021 Feb 10;755(Pt 1):142868.
    PMID: 33348485 DOI: 10.1016/j.scitotenv.2020.142868
    We explore the interplay between preventative risk management and regulatory style for the implementation of water safety plans in Malaysia and in England and Wales, two jurisdictions with distinct philosophies of approach. Semi-structured interviews were conducted with 32 water safety professionals in Malaysia, 23 in England and Wales, supported by 6 Focus Group Discussions (n = 53 participants). A grounded theory approach produced insights on the transition from drinking water quality surveillance to preventative risk management. Themes familiar to this type of regulatory transition emerged, including concerns about compliance policy; overseeing the risk management controls of regulatees with varied competencies and funds available to drive change; and the portfolio of interventions suited to a more facilitative regulatory style. Because the potential harm from waterborne illness is high where pathogen exposures occur, the transition to risk-informed regulation demands mature organisational cultures among water utilities and regulators, and a laser-like focus on ensuring risk management controls are delivered within water supply systems.
  6. Hasan H, Abdul Aziz AF, Aljunid SM
    Health Soc Care Community, 2021 01;29(1):215-226.
    PMID: 33189086 DOI: 10.1111/hsc.13084
    The Community-Based Rehabilitation (CBR) services under the Malaysian Ministry of Women, Family and Community Development have provided two types of services for disabled children: centre-based and home-based care since 1984. A cross-sectional study was conducted among parents and caregivers with children receiving treatment at CBRs on the east coast of Peninsular Malaysia, to determine the level of satisfaction with the services provided. Respondents were recruited via multi-staged sampling, and simple randomisation at CBR level. Respondents self-administered the Physical Therapy Satisfaction Questionnaire (PTSQ) and provided sociodemographic data. A total of 297 respondents were recruited and all the questionnaires were returned complete, making the response rate 100%. Total satisfaction scores and factors influencing respondents' satisfaction for both groups were analysed. The mean total satisfaction score for centre-based and home-based were 84.69 (SD = 10.01) and 75.30 (SD = 12.23; t = 7.160, p ≤ .001) respectively. Ninety-eight per cent of centre-based and 89% of home-based respondents were satisfied with the current services. There were significantly mean differences in the satisfaction level of respondents of different states respectively (Kelantan mean 84.92 10.83, Terengganu mean 77.49 11.16 and Pahang mean 77.47 12.93, p ≤ .001). Factors associated with satisfaction were education (p = .002), occupation (p = <0.001), monthly income (p = .001) and source of income (p = .001). In conclusion, majority of parents and caregivers were satisfied with current services provided at CBR and satisfaction with services was dependent on CBR centre location and education and financial earning capacity.
  7. Salmuna ZN, Hashim S, Hasan H, Harun A, Abdul Rahman Z, Ismail N, et al.
    IIUM Medical Journal Malaysia, 2019;18(3):144-152.
    MyJurnal
    Influenza-like illnesses (ILI) were defined as a triad of cough, sore throat and fever. The aim of this study is to determine the changes in knowledge, perceptions and practices towards preventive measures of succumbing to ILI before and after hajj among Malaysian hajj pilgrims.Methodology: An open-labeled randomized control trial study performed on five hundred Malaysian hajj pilgrims in the year 2013. After validated pre-hajj questionnaires completed, 250 subjects were given health education, benzalkonium-based handrub and demonstration of the handrub usage together with pamphlets and labelled as an intervention group. Another 250 subjects from another flight batch were given the same questionnaires without health education with unmedicated hand lotion as a control group. The knowledge, perception, practices and compliances to the handrub practice in both groups were compared with the pre-hajj results. Results: No significant difference between pre and post hajj knowledge and practice among hajj pilgrims in intervention group. Pre hajj perception score [ M (IQR) = 30 (5.00), Z= -2.441, p < 0.05 ] is much higher compared to post hajj perception [ M (IQR) = 29 (6.00), Z = -2.441, p < O.O5 ]. No significant difference between pre and post hajj knowledge, perception and practices among hajj pilgrims in control group. Hand hygiene compliance was not improved with provision of health education and free handrub supply. Conclusion: No significant changes in knowledge, perceptions and practices of Malaysian hajj pilgrims pre and post-hajj in both groups. Provision of handrub did not improved hajj pilgrims compliance.
  8. Hashairi F, Hasan H, Azlan K, Deris ZZ
    Trop Biomed, 2011 Dec;28(3):599-605.
    PMID: 22433889 MyJurnal
    An understanding of common pathogens and their antibiotic sensitivity patterns is critical for proper management of sepsis in Emergency Department (ED). The goal of the study was to identify common organisms isolated from blood cultures of patients attended to ED and their antimicrobial susceptibility. Beginning from 2002, all cases of positive blood culture collected by the ED, Hospital Universiti Sains Malaysia (HUSM) were recorded and analysed. Over the period of eight years, we documented 995 cases of positive blood cultures. Of these samples, 549 (55.2%) were Gram-negative bacteria; 419 (42.1%) were Gram-positive bacteria; 10 (1.0%) were anaerobic organisms; 10 (1.0%) were fungus; and 7 (0.7%) cases were mixed organisms. Gram-negative bacteria were observed to develop more resistance to antimicrobial agents, especially those commonly used in an outpatient setting with less than 80% sensitivity to ampicillin, cotrimoxazole and ciprofloxacin. By contrast, there has been no marked change in the sensitivity trends of Gram-positive bacteria over the same period. In conclusion, ED physicians are more equipped to initiate empirical antimicrobial therapy especially when dealing with possibility of Gram-negative sepsis.
    Study site: Emergency department, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia
  9. Abu Hasan H, Abdullah SR, Kofli NT, Kamarudin SK
    Bioresour Technol, 2012 Nov;124:355-63.
    PMID: 22995166 DOI: 10.1016/j.biortech.2012.08.055
    This study determined the most effective microbes acting as ammonia-oxidising (AOB) and manganese-oxidising bacteria (MnOB) for the simultaneous removal of ammonia (NH(4)(+)-N) and manganese (Mn(2+)) from water. Two conditions of mixed culture of bacteria: an acclimatised mixed culture (mixed culture: MC) in a 5-L bioreactor and biofilm attached on a plastic medium (stages of mixed culture: SMC) in a biological aerated filter were isolated and identified using Biolog MicroSystem and 16S rRNA sequencing. A screening test for determining the most effective microbe in the removal of NH(4)(+)-N and Mn(2+) was initially performed using SMC and MC, respectively, and found that Bacillus cereus was the most effective microbe for the removal of NH(4)(+)-N and Mn(2+). Moreover, the simultaneous NH(4)(+)-N and Mn(2+) removal (above 95% removal for both NH(4)(+)-N and Mn(2+)) was achieved using a biological aerated filter under various operating conditions. Thus, the strain could act as an effective microbe of AOB and a MnOB for the simultaneous removal of NH(4)(+)-N and Mn(2+).
  10. Hasan H, Davids K, Chow JY, Kerr G
    Hum Mov Sci, 2016 Aug;48:102-11.
    PMID: 27155962 DOI: 10.1016/j.humov.2016.04.008
    The purpose of this study was to observe effects of wearing textured insoles and clinical compression socks on organisation of lower limb interceptive actions in developing athletes of different skill levels in association football. Six advanced learners and six completely novice football players (15.4±0.9years) performed 20 instep kicks with maximum velocity, in four randomly organised insoles and socks conditions, (a) Smooth Socks with Smooth Insoles (SSSI); (b) Smooth Socks with Textured Insoles (SSTI); (c) Compression Socks with Smooth Insoles (CSSI) and (d), Compression Socks with Textured Insoles (CSTI). Reflective markers were placed on key anatomical locations and the ball to facilitate three-dimensional (3D) movement recording and analysis. Data on 3D kinematic variables and initial ball velocity were analysed using one-way mixed model ANOVAs. Results revealed that wearing textured and compression materials enhanced performance in key variables, such as the maximum velocity of the instep kick and increased initial ball velocity, among advanced learners compared to the use of non-textured and compression materials. Adding texture to football boot insoles appeared to interact with compression materials to improve kicking performance, captured by these important measures. This improvement in kicking performance is likely to have occurred through enhanced somatosensory system feedback utilised for foot placement and movement organisation of the lower limbs. Data suggested that advanced learners were better at harnessing the augmented feedback information from compression and texture to regulate emerging movement patterns compared to novices.
  11. Abd Rahim MH, Lim EJ, Hasan H, Abbas A
    J Microbiol Methods, 2019 09;164:105672.
    PMID: 31326443 DOI: 10.1016/j.mimet.2019.105672
    PURPOSE: This study aimed to assess the effect of nitrogen, salt and pre-culture conditions on the production of lovastatin in A. terreus ATCC 20542.

    METHODS: Different combinations of nitrogen sources, salts and pre-culture combinations were applied in the fermentation media and lovastatin yield was analysed chromatographically.

    RESULT: The exclusion of MnSO4 ·5H2O, CuSO4·5H2O and FeCl3·6H2O were shown to significantly improve lovastatin production (282%), while KH2PO4, MgSO4·7H2O, and NaCl and ZnSO4·7H2O were indispensable for good lovastatin production. Simple nitrogen source (ammonia) was unfavourable for morphology, growth and lovastatin production. In contrast, yeast extract (complex nitrogen source) produced the highest lovastatin yield (25.52 mg/L), while powdered soybean favoured the production of co-metabolites ((+)-geodin and sulochrin). Intermediate lactose: yeast extract (5:4) ratio produced the optimal lovastatin yield (12.33 mg/L) during pre-culture, while high (5:2) or low (5:6) lactose to yeast extract ratio produced significantly lower lovastatin yield (7.98 mg/L and 9.12 mg/L, respectively). High spore concentration, up to 107 spores/L was shown to be beneficial for lovastatin, but not for co-metabolite production, while higher spore age was shown to be beneficial for all of its metabolites.

    CONCLUSION: The findings from these investigations could be used for future cultivation of A. terreus in the production of desired metabolites.

  12. Zamani A, Zueter AR, Muhd Besari A, Hasan H, Harun A, Deris ZZ
    Trop Biomed, 2020 Sep 01;37(3):783-790.
    PMID: 33612791 DOI: 10.47665/tb.37.3.783
    Reduced susceptibility in Burkholderia pseudomallei during carbapenem therapy may lead to treatment failure. We isolated a clinical strain that had developed reduced susceptibility to carbapenems while on treatment. After reviewing the patient's clinical notes, the initial isolate (BUPS01/14) was exposed to carbapenem in vitro to mimic the clinical scenario. The stability of susceptibility of the carbapenem-exposed strain (BUPS01/14R) was examined by serial subculture in antibiotic-free broth. Biochemical and morphological comparison was performed by the VITEK® system and electron microscopy. MICs increased 32-fold following carbapenem exposure and became stable in the antibiotic-free environment. On electron microscopic examination, the BUPS01/14R cells were smoother and less wrinkled compared to BUPS01/14 cells. This report highlights a potential anti-melioidosis treatment failure due to the emergence of resistance while on carbapenem monotherapy. Further study of this strain is necessary to understand the mechanism of resistance at a molecular level.
  13. Hasan H, Davids K, Chow JY, Kerr G
    Eur J Sport Sci, 2017 Apr;17(3):294-302.
    PMID: 27739339 DOI: 10.1080/17461391.2016.1241829
    This study investigated effects of wearing compression garments and textured insoles on modes of movement organisation emerging during performance of lower limb interceptive actions in association football. Participants were six skilled (age = 15.67 ± 0.74 years) and six less-skilled (age = 15.17 ± 1.1 years) football players. All participants performed 20 instep kicks with maximum velocity in four randomly organised insoles and socks conditions, (a) Smooth Socks with Smooth Insoles (SSSI); (b) Smooth Socks with Textured Insoles (SSTI); (c) Compression Socks with Smooth Insoles (CSSI); and (d), Compression Socks with Textured Insoles (CSTI). Results showed that, when wearing textured and compression materials (CSSI condition), less-skilled participants displayed significantly greater hip extension and flexion towards the ball contact phase, indicating larger ranges of motion in the kicking limb than in other conditions. Less-skilled participants also demonstrated greater variability in knee-ankle intralimb (angle-angle plots) coordination modes in the CSTI condition. Findings suggested that use of textured and compression materials increased attunement to somatosensory information from lower limb movement, to regulate performance of dynamic interceptive actions like kicking, especially in less-skilled individuals.
  14. Rahim MHA, Hasan H, Harith HH, Abbas A
    Bioprocess Biosyst Eng, 2017 Dec;40(12):1753-1761.
    PMID: 28879627 DOI: 10.1007/s00449-017-1830-y
    This study investigates the effects of viscosity, friction, and sonication on the morphology and the production of lovastatin, (+)-geodin, and sulochrin by Aspergillus terreus ATCC 20542. Sodium alginate and gelatine were used to protect the fungal pellet from mechanical force by increasing the media viscosity. Sodium alginate stimulated the production of lovastatin by up to 329.0% and sulochrin by 128.7%, with inhibitory effect on (+)-geodin production at all concentrations used. However, the use of gelatine to increase viscosity significantly suppressed lovastatin, (+)-geodin, and sulochrin's production (maximum reduction at day 9 of 42.7, 60.8, and 68.3%, respectively), which indicated that the types of chemical play a major role in metabolite production. Higher viscosity increased both pellet biomass and size in all conditions. Friction significantly increased (+)-geodin's titre by 1527.5%, lovastatin by 511.1%, and sulochrin by 784.4% while reducing pellet biomass and size. Conversely, sonication produced disperse filamentous morphology with significantly lower metabolites. Sodium alginate-induced lovastatin and sulochrin production suggest that these metabolites are not affected by viscosity; rather, their production is affected by the specific action of certain chemicals. In contrast, low viscosity adversely affected (+)-geodin's production, while pellet disintegration can cause a significant production of (+)-geodin.
  15. Safdar MH, Hasan H, Afzal S, Hussain Z
    Mini Rev Med Chem, 2018;18(12):1047-1063.
    PMID: 29173165 DOI: 10.2174/1389557517666171123212039
    The immune system is an intricate and coordinated nexus serving as a natural defense to preclude internal and external pathogenic insults. The deregulation in the natural balance of immunological functions as a consequence of either over expression or under expression of immune cells tends to cause disruption of homeostasis in the body and may lead to development of numerous immune system disorders. Chalcone moieties (1,3-diphenyl-2-propen-1-one) have been well-documented as ideal lead compounds or precursors to design a wide range of pharmacologically active agents to down-regulate various immune disorders. Owing to their unique structural and molecular framework, these α, β-unsaturated carbonyl-based moieties have also gained remarkable recognition due to their other multifarious pharmacological properties including antifungal, anti-inflammatory, anti-malarial, antibacterial, anti-tuberculosis, and anticancer potential. Though a great number of methodologies are currently being employed for their synthesis, this review mainly focuses on the natural and synthetic chalcone derivatives that are exclusively synthesized via Claisen-Schmidt condensation reaction and their immunomodulatory prospects. We have critically reviewed the literature and provided convincing evidence for the promising efficacy of chalcone derivatives to modulate functioning of various innate and adaptive immune players including granulocytes, mast cells, monocytes, macrophages, platelets, dendritic cells, natural killer cells, and T-lymphocytes.
  16. Al-Talib HI, Yean CY, Al-Jashamy K, Hasan H
    Ann Saudi Med, 2010 Sep-Oct;30(5):358-63.
    PMID: 20697171 DOI: 10.4103/0256-4947.67077
    Methicillin-resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen that causes severe morbidity and mortality in many hospitals worldwide. The aim of the present study was to assess the burden of MRSA nosocomial infection, its association with factors of interest, and its antimicrobial susceptibility.
  17. Mohamad NI, Harun A, Hasan H, Deris ZZ
    Indian J Microbiol, 2018 Jun;58(2):244-247.
    PMID: 29651186 DOI: 10.1007/s12088-018-0722-4
    Although doxycycline is active against Burkholderia pseudomallei and has been used in the eradication stage of melioidosis therapy, it is not regularly used during the initial intensive phase. In order to assess its potential use in intensive phase therapy, we investigated in vitro pharmacodynamic activity of doxycycline and β-lactams alone and in combination against four Malaysian strains of B. pseudomallei. Using a checkerboard assay, the combinations of doxycycline and imipenem, doxycycline and ceftazidime, and doxycycline and amoxicillin-clavulanate tested against four strains showed indifferent effects with summation fractional inhibitory concentration values ranging from 0.62 to 2.12. Time-kill experiments also indicated that the combinations of doxycycline/β-lactam antibiotics against four tested strains did not fulfil synergy criteria, in which all combinations showed indifferent effects with - 1.36 to 1.26-log CFU/mL compared to the most active monotherapy regimen in each combination. No re-growth of bacteria was detected after the early killing in doxycycline/β-lactam combination regimens compared to β-lactam monotherapy regimens, in which 9 out of 10 were associated with re-growth of bacteria. As no synergistic activity was observed, this in vitro study showed that doxycycline offers no additional benefit to be used in combination with β-lactams in the intensive phase of therapy.
  18. Samsudin N, Chua WC, Hasan H, Hassan SA, Deris ZZ
    Malays J Pathol, 2024 Apr;46(1):95-102.
    PMID: 38682849
    Borderline oxacillin-resistant Staphylococcus aureus (BORSA) are mecA-negative strains with oxacillin minimum inhibitor concentration (MIC) close to the resistance breakpoint of ≥ 4μg/mL. Instead of producing penicillin-binding protein with low affinity to methicillin (oxacillin) mediated by mecA gene as in methicillin-resistant S. aureus (MRSA), BORSA strains are characterised by the hyperproduction of β-lactamase enzymes, thus able to break down methicillin. Common laboratory methods to detect MRSA such as cefoxitin disk diffusion alone may fail to detect methicillin resistance due to BORSA. We report five cases of BORSA blood-stream infections in a university teaching hospital. All isolates were found to be susceptible to cefoxitin using disk diffusion, resistant to oxacillin using automated MIC method, and did not harbour mecA gene. All patients were suscessfully treated with anti-MRSA antibiotics, and removal of primary sources were done if identified. A more cost-effective method for screening and diagnosis of BORSA is needed in addition to cefoxitin disk diffusion test, in order to monitor the spread, and to enable routine detection and treatment of this pathogen.
  19. Yazid MB, Fauzi MH, Hasan H, Md Noh AY, Deris ZZ
    J Immigr Minor Health, 2017 Jun;19(3):774-777.
    PMID: 27160769 DOI: 10.1007/s10903-016-0429-8
    A neglected tropical disease, melioidosis is known to have variability in clinical presentations. Here, we described clinical features that should alert the physicians on the possibility of melioidosis. In this review of 86 cases from 2001 to 2011, the common presentations of melioidosis in the Emergency Department (ED), Hospital Universiti Sains Malaysia were; male gender (79.1 %), in working age group (47.8 ± 15.2 year-old), worked in contact with soil (73.3 %), presented with fever (91.9 %), in rainy season (55.8 %), have underlying diabetes mellitus (79.1 %), have leukocytosis (67.4 %) and high blood glucose (62.8 %) during presentation. In 34.9 % of cases, the antimicrobials were initiated at the ED and only 10.5 % include antimelioid drugs. Thirty-one patients (36.0 %) died due to melioidosis and 51.6 % of this were within 48 h of admission. Despite high mortality rate, the clinical awareness on the possibility of melioidosis among emergency physicians is still low and need to be strengthened.
  20. Hamzan NI, Yean CY, Rahman RA, Hasan H, Rahman ZA
    Emerg Health Threats J, 2015;8:26011.
    PMID: 25765342 DOI: 10.3402/ehtj.v8.26011
    Background : Antibiotic resistance among Enterobacteriaceae posts a great challenge to the health care service. The emergence of carbapenem-resistant Klebsiella pneumoniae (CRKP) is attracting significant attention due to its rapid and global dissemination. The infection is associated with significant morbidity and mortality, thus creating challenges for infection control and managing teams to curb the infection. In Southeast Asia, there have been limited reports and subsequent research regarding CRKP infections. Thus, the study was conducted to characterize CRKP that has been isolated in our setting. Methods : A total of 321 K. pneumoniae were included in the study. Each isolate went through an identification process using an automated identification system. Phenotypic characterization was determined using disk diffusion, modified Hodge test, Epsilometer test, and inhibitor combined disk test. Further detection of carbapenemase genes was carried out using polymerase chain reaction and confirmed by gene sequence analysis. Results : All together, 13 isolates (4.05%) were CRKP and the majority of them were resistant to tested antibiotics except colistin and tigercycline. Among seven different carbapenemase genes studied (blaKPC, bla IMP, bla SME, bla NDM, bla IMI, bla VIM, and bla OXA), only two, bla IMP4 (1.87%) and bla NDM1 (2.18%), were detected in our setting. Conclusion : Evidence suggests that the prevalence of CRKP in our setting is low, and knowledge of Carbapenem-resistant Enterobacteriaceae and CRKP has improved and become available among clinicians.
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