Displaying publications 1 - 20 of 43 in total

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  1. Fulltext Non-O1 Vibrio cholerae septicaemia: a case report
    Tan KK, Sin KS, Ng AJ, Yahya H, Kaur P
    Singapore Med J, 1994 Dec;35(6):648-9.
    PMID: 7761898
    Non-O1 vibrio cholerae infections are associated with sporadic cases of gastroenteritis and extraintestinal infections. Septicaemia due to non-O1 vibrio cholerae is rare and are mainly reported in adults, particularly in immunocompromised patients. We report a case of non-O1 vibrio cholerae septicaemia and gastroenteritis in an 8-year-old child. The patient presented with bloody diarrhoea, fever and severe dehydration. Non-O1 vibrio cholerae were isolated from blood and stool cultures. The clinical course was uneventful after starting appropriate rehydration and supportive therapy.
    Matched MeSH terms: Bacteremia/microbiology*
  2. Fatality of a wild Bornean orangutan (Pongo pygmaeus morio): behavior and death of a wounded juvenile in Danum Valley, North Borneo
    Kanamori T, Kuze N, Bernard H, Malim TP, Kohshima S
    Primates, 2012 Jul;53(3):221-6.
    PMID: 22350273 DOI: 10.1007/s10329-012-0297-3
    Reports of wild great ape fatalities have been very limited, and only two have described wild orangutan deaths. We found a wounded juvenile female Bornean orangutan on 7 October 2006 in the Danum Valley, Sabah, Malaysia, and observed the individual's behavior for 7 days until her death on 13 October 2006. The 5-6-year-old orangutan, which we had observed since 2004, was wounded in the left brachium, back, and right hand. The individual's behavior changed after injury; the mean nest-nest active time became significantly shorter than before injury (from 12 h 3 min to 9 h 33 min), the mean waking time became significantly later (0552-0629 hours) and the mean bedtime became significantly earlier (from 1747 to 1603 hours). In the activity budget, resting increased significantly from 28.0 to 53.3%. Traveling and feeding decreased significantly from 23.5 to 12.7% and from 45.6 to 32.8%, respectively. The rate of brachiation during traveling and nest making decreased, whereas ground activity increased from 0 to 9%. We observed one vomiting incident and four occurrences of watery diarrhea during the 7 days before the individual died. The results of an autopsy performed by a local veterinarian suggested that the cause of death was septicemia because of Pseudomonas aeruginosa infection of the severely contaminated wounds. The morphology and distribution of the wounds suggested they had been incurred during an attack by a large animal with fangs and/or claws. This juvenile female became independent of its mother at ~4-5 years of age, slightly earlier than average. This individual might have been vulnerable to predatory attack because of her small body size (~5 kg at death) and lack of the mother's protection.
    Matched MeSH terms: Bacteremia/microbiology
  3. Fulltext Central venous catheter-related blood stream infections: incidence and an analysis of risk factors
    Tan CC, Zanariah Y, Lim KI, Balan S
    Med J Malaysia, 2007 Dec;62(5):370-4.
    PMID: 18705468
    Six hundred and fifty-five central venous catheters (CVC) in 496 patients in the intensive care unit of Hospital Sultanah Aminah were studied to determine the incidence and risk factors for central venous catheter-related blood stream infection (CR-BSI). CR-BSI was diagnosed in 38 catheters, giving an incidence of 9.43 CR-BSI per 1000 catheter days. The mean duration in situ was 8.4 +/- 4.9 days for infected CVCs and 6.0 +/- 3.8 days for non infected CVCs (p = 0.001). CVCs inserted in ICU had the highest infection rate (9.4%) compared to those inserted in the operating theatre (1.4%) and ward (2.8%) (p = 0.001). The highest rate of CR-BSI occurred with 4-lumen catheters (usually inserted when patients needed total parenteral nutrition) with a percentage of 15.8%. The majority of the CVCs (97.9%) were inserted via the subclavian or the internal jugular routes and there was no statistical difference in CR-BSI between them (p = 0.83). Number of attempts more than one had a higher rate of CR-BSI compared to single attempt with percentage of 7.0% vs 4.8% (p = 0.22). The top two organisms were Klebseilla pneumoniae and Pseudomonas aeruginosa. In conclusion, the incidence of CR-BSI in our ICU was 9.43 CR-BSI per 1000 catheter days. The risk factors were duration of CVC in situ, venue of insertion and use of 4 lumen catheter for total parenteral nutrition. The site of insertion, number of lumen up to 3 lumens and the number of attempts were not risk factors.
    Matched MeSH terms: Bacteremia/microbiology*
  4. Ceftriaxone resistance and genes encoding extended-spectrum β-lactamase among non-typhoidal Salmonella species from a tertiary care hospital in Kuala Lumpur, Malaysia
    Karunakaran R, Tay ST, Rahim FF, Lim BB, Sam IC, Kahar-Bador M, et al.
    Jpn J Infect Dis, 2012;65(5):433-5.
    PMID: 22996219
    The prevalence of ceftriaxone resistance and the associated genes encoding extended-spectrum β-lactamase (ESBL) was determined in 149 non-duplicate non-typhoidal Salmonella isolated in 2008-2009 from patients in a tertiary care hospital in Kuala Lumpur, Malaysia. The resistance rate to ceftriaxone was 2.7% (2/74) in 2008, 4.0% (3/75) in 2009, and 3.4% (5/149) overall. CTX-M ESBL genes were detected in 2 of the 5 ceftriaxone-resistant isolates. The prevalence of ceftriaxone resistance, although low, is a concern because it limits therapeutic options. Continued surveillance of ceftriaxone resistance is important to monitor its trends.
    Matched MeSH terms: Bacteremia/microbiology
  5. Methicillin-resistant Staphylococcus aureus bacteraemia, 2003-2015: Comparative evaluation of changing trends in molecular epidemiology and clinical outcomes of infections
    Niek WK, Teh CSJ, Idris N, Sit PS, Lee YQ, Thong KL, et al.
    Infect Genet Evol, 2020 11;85:104567.
    PMID: 32980576 DOI: 10.1016/j.meegid.2020.104567
    Methicillin-resistant Staphylococcus aureus (MRSA) is a prominent pathogen causing invasive infections such as bacteraemia. The continued excessive use of antibiotics to treat MRSA infections has resulted in the evolution of antimicrobial resistant of S. aureus. This study aims to perform a comparative evaluation of changing trends in molecular epidemiology of MRSA and clinical characteristics of patients. This study shows that ST22-MRSA-IV has gradually replaced ST239-MRSA-III as the predominant MRSA clone in the tertiary teaching hospital studied. Independent predictors of mortality among patients included devices in situ at the time of infection, pre-exposure to macrolides, catheter-related bloodstream infection and mono-microbial infection. Hence, our study affirmed community-associated MRSA, which was previously identified from individuals without any exposure to healthcare settings, has now emerged in healthcare settings, causing healthcare-associated MRSA infections.
    Matched MeSH terms: Bacteremia/microbiology*
  6. Mycobacterium senegalense catheter-related bloodstream infection
    Badarol Hisham N, Madon M, Masri SN, Amin-Nordin S
    BMJ Case Rep, 2024 Apr 30;17(4).
    PMID: 38688568 DOI: 10.1136/bcr-2024-259761
    Catheter-related bloodstream infection (CRBSI) is one of the common healthcare-acquired infections imposing a high burden of morbidity and mortality on the patients. Non-tuberculous mycobacterium is a rare aetiology for CRBSI and poses challenges in laboratory diagnosis and clinical management. This is a case of a woman in her early 60s with underlying end-stage renal failure, diabetes mellitus and hypertension presented with a 2-week history of high-grade fever postregular haemodialysis, vomiting, lethargy and altered mental status.Blood cultures from a permanent catheter and peripheral taken concurrently yielded Mycobacterium senegalense, identified by matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry, which established the diagnosis of CRBSI atypically presented with concurrent acute intracranial bleeding and cerebrovascular infarction at initial presentation. She was started on a combination of oral azithromycin, oral amikacin and intravenous imipenem, and the permanent catheter was removed. Despite the treatments instituted, she developed septicaemia, acute myocardial infarction and macrophage activation-like syndrome, causing the patient's death.
    Matched MeSH terms: Bacteremia/microbiology
  7. Novel Vibrio vulnificus sequence type 540 infection in a hepatitis patient
    Chua HS, Soh YH, Ibrahim S, Abdullah NH, Che Mat Seri NAA, AbuBakar S, et al.
    Trop Biomed, 2024 Jun 01;41(2):220-223.
    PMID: 39154277 DOI: 10.47665/tb.41.2.014
    Vibrio vulnificus infection is associated with high morbidity and mortality in high-risk patients. Poor prognoses could lead to >50% mortality rate. The present report describes a case of V. vulnificus bacteremia in a cirrhotic patient with underlying hepatitis C. He presented with generalised abdominal pain associated with distention and could not ambulate for one week. He also complained of fever for six days and pruritus for 10 days. Tea-coloured urine was noted in continuous bag drainage. The abdomen was distended but soft, with mild tenderness palpated over the left lumbar and iliac region. Blood investigation indicated ongoing infection and inflammation. The aerobic blood culture was identified using the matrix-assisted laser desorption/ionisation-time of flight mass spectrometry and confirmed via 16S rDNA sequencing as V. vulnificus. Multilocus sequence typing of the isolated V. vulnificus revealed a novel sequence type, ST540. The patient responded well to the intravenous cefoperazone and was then discharged with a four day-course of oral ciprofloxacin, 500 mg twice daily after completing the intravenous cefoperazone for 10 days. Clinical history and physical examination are important for early antibiotic therapy initiation and appropriate surgical intervention. Furthermore, bacterial strain typing is also essential for epidemiological surveillance and potentially anticipating the pathogen's virulence traits, which are vital in controlling and preventing the spread of infection.
    Matched MeSH terms: Bacteremia/microbiology
  8. Should all children admitted with community acquired pneumonia have blood cultures taken?
    Lai EM, Nathan AM, de Bruyne JA, Chan LL
    Indian J Pediatr, 2015 May;82(5):439-44.
    PMID: 25179241 DOI: 10.1007/s12098-014-1565-6
    OBJECTIVE: To evaluate the yield of blood cultures and the impact of blood culture results on the adjustment of empiric antibiotic treatment in children hospitalised with community acquired pneumonia (CAP).

    METHODS: This was a prospective study conducted at a tertiary hospital in Malaysia, from 1st August 2010 until 31st July 2011. Children aged between 1 mo and 12 y who were admitted for CAP and had blood cultures performed before starting intravenous antibiotics were recruited. Children with congenital pneumonia, immunodeficiency, chronic cardiac or respiratory disorders, nosocomial pneumonia or those on corticosteroids, were excluded. Decision for admission was made by the attending Accident and Emergency physician.

    RESULTS: One hundred and seventy-one children were enrolled. The median age was 13 mo (range: 38 d-10 y 3 mo) and 59 % were males. Blood cultures were positive in 1.2 % (2/171) of patients while the contamination rate was 1.8 % (3/171). Doctors altered antibiotics based on blood culture results in only one patient.

    CONCLUSIONS: Both the yield and the impact of blood culture results on the adjustment of empiric antibiotic treatment were very small. There was a high contamination rate. The recommended practice of performing blood cultures in all children admitted with CAP should be reviewed.

    Matched MeSH terms: Bacteremia/microbiology*
  9. Fulltext The significance of coagulase-negative staphylococci bacteremia in a low resource setting
    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
  10. Fulltext Citrobacter koseri bacteraemia complicated by paraspinal abscess and spondylodiscitis--a case report
    Shaharuddin NR, Leong CL, Chidambaram SK, Lee C
    Med J Malaysia, 2012 Jun;67(3):337-9.
    PMID: 23082432
    Paraspinal abscess and spondylodiscitis due to Citrobacter koseri is a very rare condition. We report a remarkable case of Citrobacter koseri bacteraemia complicated by paraspinal abscess and spondylodiscitis in a patient who has successfully been treated in our hospital. Our patient demonstrates one of the common challenges in the practice of infectious disease medicine, wherein an innocuous presentation may and often underlie a serious infection. This case report elucidates to us that the diagnosis of a paraspinal abscess and spondylodiscitis requires a high index of suspicion in at risk patient presenting with compatible signs and symptoms.
    Matched MeSH terms: Bacteremia/microbiology*
  11. Comparison of antimicrobial resistance in neonatal and adult intensive care units in a tertiary teaching hospital
    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*
  12. Fulltext The association of Streptococcus bovis/gallolyticus with colorectal tumors: the nature and the underlying mechanisms of its etiological role
    Abdulamir AS, Hafidh RR, Abu Bakar F
    J Exp Clin Cancer Res, 2011;30:11.
    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/microbiology
  13. Fulltext First isolation of Burkholderia tropica from a neonatal patient successfully treated with imipenem
    Deris ZZ, Van Rostenberghe H, Habsah H, Noraida R, Tan GC, Chan YY, et al.
    Int J Infect Dis, 2010 Jan;14(1):e73-4.
    PMID: 19482535 DOI: 10.1016/j.ijid.2009.03.005
    We report the first case of a human Burkholderia tropica infection. The patient was a premature neonate who had necrotizing enterocolitis with bowel perforation requiring surgical intervention. The stoma care and difficulties in feeding were a chronic problem. At the age of almost 4 months he developed septicemia due to B. tropica. Three consecutive blood cultures grew this organism. The organism was cleared from the blood after a course of imipenem and resolution of post-operative ileus. Our case suggests that environmental and plant pathogens can cause human infection especially in those in an immunocompromised condition.
    Matched MeSH terms: Bacteremia/microbiology
  14. Chromobacterium violaceum infection in Taiwan: a case report and literature review
    Chang CY, Lee YT, Liu KS, Wang YL, Tsao SM
    J Microbiol Immunol Infect, 2007 Jun;40(3):272-5.
    PMID: 17639170
    Chromobacterium violaceum is a facultative anaerobic, Gram-negative bacillus which inhabits stagnant water in tropical and subtropical regions. We describe the case of an 80-year-old female patient with C. violaceum bacteremia due to traumatic wound infected by contaminated water and soil. She had persistent fever, hypotension and neutrophilic leukocytosis on admission. Two sets of blood cultures yielded C. violaceum. The patient was successfully treated with levofloxacin. Since the first case from Malaysia in 1927, about 150 cases have been reported in the world literature. To our knowledge, six other cases have been reported previously from Taiwan, including two children and four adults. Of the total of seven patients from Taiwan, four had a fatal outcome within several days, while the three survivors were apparently free of vital organ involvement. Although human infections caused by C. violaceum are rare, clinicians should be aware of this potentially fatal infection as part of the differential diagnosis of sepsis associated with a history of exposure to stagnant water.
    Matched MeSH terms: Bacteremia/microbiology
  15. Fulltext Bacteremia in patients with febrile neutropenia after chemotherapy at a university medical center in Malaysia
    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/microbiology*
  16. Anaerobiospirillum succiniciproducens bacteraemia in a patient with acute lymphoblastic leukaemia
    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/microbiology*
  17. Fulltext Prospective surveillance of nosocomial device-associated bacteremia in three adult intensive units in Malaysia
    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*
  18. Fulltext Non-O1, non-O139 Vibrio cholerae bacteraemia in splenectomised thalassaemic patient from Malaysia
    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/microbiology*
  19. Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia: Correlations between clinical, phenotypic, genotypic characteristics and mortality in a tertiary teaching hospital in Malaysia
    Sit PS, Teh CSJ, Idris N, Ponnampalavanar S
    Infect Genet Evol, 2018 04;59:132-141.
    PMID: 29421224 DOI: 10.1016/j.meegid.2018.01.031
    Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia is a serious infection that can result in significant morbidity and mortality. A retrospective cohort study was conducted to determine the predictors of mortality in patient with MRSA bacteremia correlating with clinical, phenotypic and genotypic characteristics of the relevant strains. Most of the bacteremia cases were healthcare-associated (P bacteremia. All the strains were sensitive to vancomycin. Most MRSA strains causing bacteremia belonged to SCCmec type III-ST239 and exhibited pulsotype H. According to the multivariate analysis, age ≥ 60 years old (P = 0.022), female gender (P = 0.0003), pneumonia (P = 0.011) as source of infection as well as high APACHE II, Charlson comorbidity Index and Pitt's bacteremia scores were significantly associated with patient's mortality. There were emergence of MRSA clones such as SCCmec type I-ST152, SCCmec type V-ST45 and SCCmec type V-ST951 that was discovered for the first time in Malaysia. To our knowledge, this is the first study correlating the clinical, phenotypic and genotypic characteristics of patients with MRSA bacteremia as well as determining the risk factors for mortality in Malaysian hospital.
    Matched MeSH terms: Bacteremia/microbiology*
  20. Nosocomial outbreak of Enterobacter gergoviae bacteraemia in a neonatal intensive care unit
    Ganeswire R, Thong KL, Puthucheary SD
    J Hosp Infect, 2003 Apr;53(4):292-6.
    PMID: 12660126
    A nosocomial outbreak of bacteraemia, caused by Enterobacter gergoviae infected 11 babies, nine of whom were premature, and was investigated in the neonatal intensive care unit (NICU) of a general hospital in Johor Bahru, Malaysia. The strain that was isolated from the babies was also isolated from the dextrose saline used for the dilution of parenteral antibiotics and from the hands of a healthcare worker on duty in the nursery. Pulsed-field gel electrophoresis (PFGE) of Xba I-digested chromosomal DNA confirmed a possible cross-contamination of parenteral dextrose saline and the healthcare worker. Prompt and effective control measures were initiated within NICU and the nosocomial infection of E. gergoviae was brought to an abrupt end. To the best of our knowledge, this is the first documented outbreak of E. gergoviae in the NICU in a hospital in the state of Johor, Malaysia.
    Matched MeSH terms: Bacteremia/microbiology
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