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Enterococci: Emerging Drug Resistant Bacteria In Hospital Acquired Infections At Hospital Kuala Lumpur, Malaysia 肠球菌:新出现的耐药细菌在医院获得性感染在吉隆坡医院,马来西亚
Pub Date : 2010-12-31 DOI: 10.5580/abb
R. Ibrahim, M. Mohamad, Mahmudur Rahman
Enterococci are the most common pathogens in hospital acquired infections. Some of them are resistant to Vancomycin(VRE) and some are susceptible to Vancomycin (VSE). The present study was carried out to identify enterococci from clinical cases and to illustrate their clinical features and drug resistance characteristics. Antibiotics susceptibility of the identified bacteria was determined by disk diffusion method and E-test. Drug resistance properties were evaluated against ampicillin, gentamicin, vancomycin, teicoplanin and linezolid. Relating to clinical features, 244 cases of enterococci infected patients were identified at hospital Kuala Lumpur (HKL) Malaysia based on clinical information from the hospital. Of the patients 21% had history of urinary tract infections, 17.2% end stage renal disease, 12.2% sepsis, 8.4% malignancy, 12.2% had head injury and neurological problems, 4.2% diabetes mellitus and other clinical manifestations .In case of Vancomycin resistant enterococci infection, the clinical features of the patients were: end stage renal failure 3/6 (50%) and others with diabetes mellitus, interstitial lung disease and nephrotic syndrome. The patients of the enterococci infections were more prevalent in nephrology-urology unit (39%) and medical wards (including ICU, 23%) The findings would serve as an alert to the clinicians of the emergence of infections by enterococci and encourage implementation of appropriate infection control measures in order to curb further rise in prevalence.
肠球菌是医院获得性感染中最常见的病原体。有的对万古霉素耐药,有的对万古霉素敏感。本研究旨在从临床病例中鉴定肠球菌,并阐明其临床特征和耐药特征。采用纸片扩散法和e -试验对鉴定出的细菌进行药敏试验。对氨苄西林、庆大霉素、万古霉素、替可普宁和利奈唑胺的耐药特性进行了评价。关于临床特征,根据马来西亚吉隆坡(HKL)医院提供的临床信息,确定了244例肠球菌感染患者。患者中21%有尿路感染史,17.2%有终末期肾病,12.2%有败血症,8.4%有恶性肿瘤,12.2%有头部损伤和神经系统问题,4.2%有糖尿病等临床表现。万古霉素耐药肠球菌感染患者的临床特征为:终末期肾功能衰竭3/6(50%),其他患者合并糖尿病、肺间质性疾病和肾病综合征。肠球菌感染患者以肾泌尿科(39%)和内科病房(包括ICU, 23%)的发生率较高,提示临床医生应重视肠球菌感染的出现,并采取相应的感染控制措施,以抑制患病率的进一步上升。
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引用次数: 2
All Ceramic Veneers- A Case Reort 所有陶瓷贴面-一个案例报告
Pub Date : 2010-12-31 DOI: 10.5580/213
Geeta Paul, R. Paul, M. Virdi, Priyank Banthia, Prerna Mathur
The challenge to copy nature and at the same time to maintain oral harmony is a complex theme in the field of anterior tooth restoration .The know how about the synthesis of form, function and superficial structure and the color finish of the natural teeth, together form the basis of aesthetic restorations. Metal free restorations have a strong ceramic core onto which layering ceramic is applied to achieve natural appearance. These have unique light optic relation feature that facilitates the reproduction of natural teeth .This article presents a case report in which teeth discolored due to tetracycline staining were aesthetically managed by all ceramic veneers.
在复制自然的同时保持口腔的和谐是前牙修复领域的一个复杂的主题,了解自然牙的形状、功能和表面结构的综合以及自然牙的颜色处理,共同构成了美学修复的基础。无金属修复体具有坚固的陶瓷核心,在其上应用分层陶瓷以实现自然外观。这些具有独特的光-光学关系特征,有利于自然牙齿的再现。本文报道了一例因四环素染色而变色的牙齿采用全瓷贴面美学处理的病例。
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引用次数: 0
Midline Diastema Closure Following Post-Orthodontic Treatment Relapse Using Metal Free Restorations 正畸治疗复发后使用无金属修复体中线闭口
Pub Date : 2010-12-31 DOI: 10.5580/23a0
R. Paul, Geeta Paul, R. Paul, T. Juneja, M. Virdi
Porcelain is known to be the most aesthetic material for dental restorations. It can imitate nature and at the same time maintain oral harmony which is a complex theme in the field of anterior tooth restoration. The knowhow about the synthesis, form, function and superficial structure and the color finish of the natural teeth, together form the basis of aesthetic restoration. A new generation of ceramic substance which distinguishes itself by unique light optic relation feature has facilitated the reproduction of natural teeth. The concept which has been outlined in this article informs about a systematic and rationale advance in the field of anterior tooth restoration while fulfilling highly aesthetic requirement. This case study presents the management of midline diastema using two different types of metal free ceramics
众所周知,瓷器是牙齿修复中最美观的材料。它既能模仿自然,又能保持口腔和谐,是前牙修复领域的一个复杂课题。自然牙的合成、形态、功能、表面结构及颜色处理等知识,共同构成美学修复的基础。新一代的陶瓷材料以其独特的光-光关系特征,促进了天然牙齿的再生。本文所概述的概念在满足高度美学要求的同时,在前牙修复领域取得了系统的和基本的进展。本案例研究介绍了使用两种不同类型的无金属陶瓷治疗中线隔膜的方法
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引用次数: 0
Community-Acquired Mecithillin-Resistant Staphylococcus Aureus : A Case Report on Necrotizing Fasciitis And Deep Vein Thrombosis In Adolescent Boy 社区获得性耐甲氧西林金黄色葡萄球菌:青少年男孩坏死性筋膜炎及深静脉血栓1例报告
Pub Date : 2010-12-31 DOI: 10.5580/cc5
Abdullah Alanazi, J. Alenazi, Suliman Alola, E. Banyan, M. Shalaan
Staphylococcus aureus (S. Aureus) is the most common species of staphylococci to cause Staph infections. The infections caused by S. aureus were not difficult to manage. However, in recent past, S. aureus is transformed to its variant forms, including, Methicillin-resistant S. aureus (MRSA) by acquiring methicillin resistant gene (mec A gene). Previously, the MRSA was known for its origin from hospitals, but more recently, it is known to be acquired, from the communities too. Here we report the case presentation of a male adolescent with complicated fibular osteomyelitis, necrotizing fasciitis and deep vein thrombosis caused by Community acquired (CA) MRSA. The preliminary complaint of the patient was swelling in right foot and leg associated with high fever, pain, dyspnea and cough. The clinical presentation fit him as acute respiratory distress syndrome and hence antibiotics (ceftixone and vancomycin) were started. Doppler ultrasound revealed deep vein thrombosis (DVT). Analysis of blood culture showed the presence of MRSA. Hence rifampin and gentamicin were added and ceftrixon was discontinued. MRI revealed ostiomyelitis in the distal part of fibula. The bone infection was so severe that despite of using the three antibiotics, the patient remained febrile with increased leukocytes and neutrophills, the ankle redness became confined with malleollus on each side and the sepsis remained uncontrollable. Repeated MRI showed inflammatory findings, including cellulitis, pyogenic myositis, deep fasciitis and fibular periosteal reactions, suggestive of necrotizing fasciitis. Upon confirmation of fasciitis, fasciotomy with debridement and irrigations was done in multiple sessions and a high dose intravenous immunoglobulin was administered as an adjuvant therapy, resulting in reversal of the disease progression. In light of reports in the literature, we replaced antibiotics with immunoglobulins as a post surgery treatment, which worked well.
金黄色葡萄球菌(S. aureus)是引起葡萄球菌感染的最常见葡萄球菌。金黄色葡萄球菌引起的感染并不难控制。然而,近年来,金黄色葡萄球菌通过获得耐甲氧西林基因(mec A基因)转化为其变体形式,包括耐甲氧西林金黄色葡萄球菌(MRSA)。以前,人们知道MRSA起源于医院,但最近,人们知道它也可以从社区获得。在此,我们报告一例男性青少年由社区获得性(CA) MRSA引起的并发腓骨骨髓炎、坏死性筋膜炎和深静脉血栓形成的病例。患者的初步主诉为右脚和腿部肿胀并伴有高热、疼痛、呼吸困难和咳嗽。临床表现符合急性呼吸窘迫综合征,因此开始使用头孢替酮和万古霉素。多普勒超声示深静脉血栓形成。血培养分析显示存在MRSA。因此加入利福平和庆大霉素,停用头孢曲松。MRI显示腓骨远端骨脊髓炎。骨感染非常严重,尽管使用了三种抗生素,患者仍然发热,白细胞和中性粒细胞增加,脚踝红肿受限,两侧有内踝,脓毒症仍然无法控制。反复MRI显示炎症表现,包括蜂窝织炎、化脓性肌炎、深筋膜炎和腓骨骨膜反应,提示坏死性筋膜炎。确诊为筋膜炎后,进行了多次筋膜切开、清创和冲洗,并给予高剂量静脉注射免疫球蛋白作为辅助治疗,导致疾病进展逆转。根据文献报道,我们用免疫球蛋白代替抗生素作为术后治疗,效果很好。
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引用次数: 1
Detection of inducible clindamycin resistance in Staphylococcus aureus and coagulase-negative staphylococci - a study from South India 南印度金黄色葡萄球菌和凝固酶阴性葡萄球菌诱导克林霉素耐药的检测
Pub Date : 2010-12-31 DOI: 10.5580/1279
Shailesh Kumar, S. Umadevi, N. Joseph, A. Kali, J. Easow, S. Srirangaraj, G. Kandhakumari, R. Singh, Pravin M. V. Charles, S. Stephen
Background: Inducible clindamycin resistance is a major concern for the use of clindamycin to treat staphylococcal infections. Aims: To determine the prevalence of inducible clindamycin resistance in clinical isolates of Staphylococcus spp. and the susceptibility pattern of the isolates. Materials and Methods: A total of 300 isolates of Staphylococci spp. recovered from different clinical specimens were studied. All the Staphylococcus spp. were identified by conventional microbiological methods. Inducible clindamycin resistance was detected by double disk approximation test (Dtest).Results: Of the 300 isolates, 176 were identified as S. aureus, while 124 were coagulase negative staphylococci (CoNS). The rates of inducible clindamycin resistance in methicillin resistant S. aureus (MRSA), methicillin sensitive S. aureus (MSSA), methicillin resistant CoNS (MR-CoNS) and methicillin sensitive CoNS (MSCoNS) were 75.0%, 24%, 18.8% and 11.1%, respectively. The inducible clindamycin resistance was significantly more among MRSA compared to methicillin sensitive S. aureus (MSSA) (P value < 0.0001). Majority of the MRSA isolates were susceptible to clindamycin, vancomycin and linezolid, while most of them were resistant to erythromycin, gentamicin, ciprofloxacin, tetracycline and sulfamethoxazole-trimethoprim. Conclusion: In view of the significant in vitro inducible clindamycin resistance in Staphylococcus spp., we recommend that D test should be used as a mandatory method in microbiology laboratories to avoid misinterpretation of clindamycin result.
背景:诱导克林霉素耐药是使用克林霉素治疗葡萄球菌感染的主要问题。目的:了解葡萄球菌临床分离株诱导型克林霉素耐药情况及药敏型。材料与方法:对从不同临床标本中分离的葡萄球菌300株进行了研究。所有葡萄球菌均采用常规微生物学方法进行鉴定。采用双盘近似试验(Dtest)检测诱导型克林霉素耐药。结果:300株分离物中,鉴定为金黄色葡萄球菌176株,凝血酶阴性葡萄球菌124株。耐甲氧西林金黄色葡萄球菌(MRSA)、耐甲氧西林金黄色葡萄球菌(MSSA)、耐甲氧西林金黄色葡萄球菌(MR-CoNS)和耐甲氧西林金黄色葡萄球菌(MSCoNS)诱导克林霉素耐药率分别为75.0%、24%、18.8%和11.1%。与甲氧西林敏感金黄色葡萄球菌(MSSA)相比,MRSA对克林霉素的诱导性耐药明显增加(P值< 0.0001)。大部分MRSA菌株对克林霉素、万古霉素和利奈唑胺敏感,对红霉素、庆大霉素、环丙沙星、四环素和磺胺甲恶唑-甲氧苄啶耐药。结论:鉴于葡萄球菌具有明显的体外诱导克林霉素耐药性,建议微生物实验室将D试验作为强制性方法,避免对克林霉素结果的误读。
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引用次数: 4
Biologic Effects Of Aloe Vera Gel 芦荟凝胶的生物效应
Pub Date : 2010-12-31 DOI: 10.5580/c3f
N. Kathuria, Neelam Gupta, Manisha, R. Prasad, Nikita
Aloe vera is known for its many health benefits. It helps in improving the appearance of skin, treat digestive problems and boost immune systems. Use of aloe vera is beneficial in many oral conditions. Due to its anti bacterial qualities it is effective in fighting the bacteria and preventing bad breath, gingivitis, stomatitis and periodontitis. Acute mouth lesions are improved by direct application of aloe vera gel on herpetic viral lesions, apthous ulcers and cracks occurring at corner of mouth. Denture patients with sore spots and ill fitting complete or partial dentures can benefit by the use of aloe vera. It also promotes cell growth and act as detoxifying agent.
芦荟因其许多健康益处而闻名。它有助于改善皮肤外观,治疗消化问题,增强免疫系统。使用芦荟对许多口腔疾病都是有益的。由于它的抗菌特性,它可以有效地对抗细菌,防止口臭,牙龈炎,口炎和牙周炎。芦荟凝胶直接应用于疱疹病毒性病变,口腔溃疡和嘴角裂缝,可改善急性口腔病变。假牙患者疼痛点和不适合全或部分假牙可以受益于芦荟的使用。它还能促进细胞生长并起到解毒作用。
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引用次数: 14
Chikungunya confused with dengue in Malaysia: Clinical, serological and molecular perspective 基孔肯雅热在马来西亚与登革热混淆:临床、血清学和分子观点
Pub Date : 2010-12-31 DOI: 10.5580/647
Umi Kalsom Ali, I. Isahak, M. Rahman
This study was to observe clinical, serolgical and molecular diagnosis of chikungunya viral fever patients and its comparison with dengue viral fever. For that 49 serologically negative dengue patients but clinically dengue like symptomms were included. Clinical investigation was carried out recording different profiles of hospitalized patients. Serology was performed using the Onsite® Chikungunya IgM Combo rapid test and molecular test RT-PCR was performed to detect the virus in the patients sera. It was observed that out of them 19 (38.7 %) were serologically confirmed chikungunya infection. Interestingly molecular detection of the patients sera did not show the presence chikungunya virus but detected dengue virus from 9 patients’s sera. Classical clinical features of chikungunya virus infected patients were recorded to differentiate chikungunya from dengue, which were fever, arthralgia, myalgia and rash. Detection of chikungunya IgM in these cohort means that this virus is circulating throughout the year although not as many as dengue. Laboratory confirmation is important to differentiate chikungunya fever from dengue fever. This study adds some information in local data and hopefully can help the clinicians to clinically and laboratory diagnosis and management of chikungunya infection in outbreak and non-outbreak setting. Serology was proven to be useful in confirming chikungunya infection.
本研究旨在观察基孔肯雅病毒热患者的临床、血清学和分子诊断,并与登革热病毒热进行比较。其中包括49例血清学阴性但临床有登革热样症状的登革热患者。进行临床调查,记录住院患者的不同概况。采用Onsite®基孔肯雅IgM组合快速检测进行血清学检测,采用分子检测RT-PCR检测患者血清中的病毒。其中19例(38.7%)血清学确诊为基孔肯雅热感染。有趣的是,患者血清分子检测未发现基孔肯雅病毒,但在9例患者血清中检测到登革热病毒。记录基孔肯雅病毒感染患者的典型临床特征,以区分基孔肯雅与登革热,主要表现为发热、关节痛、肌痛和皮疹。在这些人群中检测到基孔肯雅IgM意味着这种病毒虽然没有登革热那么多,但全年都在传播。实验室确认对于区分基孔肯雅热和登革热很重要。本研究在当地数据中增加了一些信息,希望能帮助临床医生在暴发和非暴发环境中对基孔肯雅感染进行临床和实验室诊断和管理。已证明血清学在确认基孔肯雅热感染方面是有用的。
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引用次数: 12
Characterization of Bacillus cereus isolated from fermented cabbage and conventional optimization of extracellular protease production 发酵白菜蜡样芽孢杆菌的鉴定及胞外蛋白酶生产的常规优化
Pub Date : 2009-12-31 DOI: 10.5580/e7d
C. E. Kotlar, Ponce A.G, R. Sansevero, S. Roura
A strain of Bacillus cereus, isolated from fermented cabbage, was tested a laboratory scale in order to evaluate the production of extracellular protease on batch cultivation in Modified Basal Medium without agar (MB). Furthermore optimization of culture medium and cultivation conditions were carried out too.B. cereus spp. presented a typical growth kinetic with a short lag phase. The best conditions for B. cereus spp. growth were found at pH 7, 32oC and in MB with glucose. Respecting to protease production, the best expression were at pH 8 and 32oC. At this temperature the addition of modifiers in the fermentation media did not produce a significant improvement in the protease production. The novel properties of the protease liberated by this strain could have important benefic for the biotechnology industry.
从发酵白菜中分离出一株蜡样芽孢杆菌,在不加琼脂的改良基础培养基(MB)上进行了批量培养,以评价其胞外蛋白酶的产量。并对培养基和培养条件进行了优化。蜡属植物的生长动力学表现为典型的短滞后期生长动力学。蜡样芽孢杆菌生长的最佳条件为pH 7、32℃和MB加葡萄糖。在pH为8和32℃的条件下,蛋白酶的产量最高。在这个温度下,在发酵培养基中添加改性剂对蛋白酶的产生没有显著的改善。该菌株释放的蛋白酶的新特性可能对生物技术工业有重要的好处。
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引用次数: 5
Isolation Of Fungi And Bacteria From Housefly (Musca Domestica L.) Larvae 家蝇真菌和细菌的分离幼虫
Pub Date : 2009-12-31 DOI: 10.5580/47d
Inocent C Omalu, V. Ayanwale, A. B. Ajalaruru, A. Z. Mohammed, J. Bala, V. Chukwuemeka
Housefly larvae were cultured on meat and collected for the isolation and identification of microorganisms associated with them. The microbes were cultured from both the gut and body surface of the maggot on nutrient agar (for bacteria) and potato dextrose agar (for fungi) and incubated at about 37°C for 48 hrs before observations. A variety of microorganisms, which includes the pathogenic Staphylococus aureus, pseudomonas sp. and Aspergillus niger and Aspergillus flavus were isolated.
在肉上培养家蝇幼虫,收集家蝇幼虫进行相关微生物的分离和鉴定。将蛆的肠道和体表微生物分别培养在营养琼脂(细菌)和马铃薯葡萄糖琼脂(真菌)上,在37℃左右孵育48小时后进行观察。分离出致病性金黄色葡萄球菌、假单胞菌、黑曲霉、黄曲霉等多种微生物。
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引用次数: 11
Purification and Characterization of Keratinase fromFeather Degrading Bacillus sp. 羽毛降解芽孢杆菌中角化酶的纯化及特性研究。
Pub Date : 2009-12-31 DOI: 10.5580/159b
Jeevana Lakshmi. Peddu, C. Chitturi, V. Lakshmi
Microorganisms producing keratinases are gaining prominence in recycling of poultry waste feather. Keratinase producing Bacillus sp. Isolated, were subjected to strain improvement along with optimisation of parameters of fermentation. Scaled up enzyme was partially purified and characterized to evaluate its application potential. Keratinase isolated from the bacillus species exhibited good stability with > 90% activity being retained for one month at refrigerated conditions and 50% activity was observed even after two months. At room temperature, the enzyme was active for 24 � 48 hours with optimum temperature of activity being 55∞C. The activity range was between 28∞C - 55∞C and pH optima was 8.5 which matched with optima for production of the enzyme. ~38kDa keratinase produced by the isolates was categorized into subtilisin group of serine proteinase based on the sensitivity to protease inhibitors, Keratinase from the test isolates was only marginally affected by surfactants, organic solvents. A significant enhancement in activity was observed in presence of reducing agents indicating possible versatile application potential for this enzyme with high stability
产生角化酶的微生物在家禽废羽毛的回收利用中日益突出。对分离得到的产角蛋白酶芽孢杆菌进行菌种改良,并对发酵条件进行优化。对放大酶进行了部分纯化和表征,以评价其应用潜力。从芽孢杆菌中分离出的角蛋白酶表现出良好的稳定性,在冷藏条件下保持一个月的活性大于90%,即使在两个月后也保持50%的活性。室温条件下,酶活性为24 ~ 48 h,最适活性温度为55∞C。酶活范围为28∞C ~ 55∞C, pH最优值为8.5,符合酶的最优产酶条件。根据对蛋白酶抑制剂的敏感性,分离株产生的~38kDa角化酶可归为丝氨酸蛋白酶枯草菌素组,表面活性剂、有机溶剂对分离株角化酶的影响较小。在还原剂的存在下,酶的活性显著增强,表明该酶具有高稳定性,具有广泛的应用潜力
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引用次数: 4
期刊
The Internet journal of microbiology
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