Burkholderia pseudomallei is a causative agent of melioidosis that can infect humans and animals in endemic countries,specifically in Southeast Asia and tropical Australia.A fundamental component for the pathogenesis ...Burkholderia pseudomallei is a causative agent of melioidosis that can infect humans and animals in endemic countries,specifically in Southeast Asia and tropical Australia.A fundamental component for the pathogenesis of Burkholderia pseudomallei is the capability of the bacterium to enter,survive,replicate,and cause disease in a host cell by inducing the host cell fusion.Cell fusion results in multinucleated-giant cell formation,thus enabling the dissemination of Burkholderia pseudomallei intracellularly.cGAS reacts to Burkholderia pseudomallei infection by activating the cGAS-STING pathway and subsequently limiting host's aberrant cell division and cellular replication by inducing autophagic cell death.In this review,we discuss the host-pathogen interactions between the typeⅥsecretion system 5(T6SS-5)of Burkholderia pseudomallei and human cGAS pathway in melioidosis infections.Since T6SS-5 is a main virulent factor in Burkholderia pseudomallei and the c GAS pathway is vital for host immune response,elucidating their functions is important for better understanding the pathogenesis of Burkholderia pseudomallei.展开更多
Objective:To determine the risk factors and outcomes of imipenem-resistant Acinetobacter baumannii(IRAB) bloodstream infection(BSI) cases,since there is very little publication on Aeinetobacter baumannii infections fr...Objective:To determine the risk factors and outcomes of imipenem-resistant Acinetobacter baumannii(IRAB) bloodstream infection(BSI) cases,since there is very little publication on Aeinetobacter baumannii infections from Malaysia.Methods:A cross sectional study of 41 cases(73.2%) of imipenem-sensitive Acinetobacter baumanii(ISAB) and 15 cases(26.8%) of IRAB was conducted in a teaching hospital which was located at North-Eastern state of Malaysia.Results:There was no independent risk factor for IRAB BSI identified but IRAB BSI was significantly associated with longer bacteraemic days[OR 1.23(95%CI 1.01,1.50)].Although prior use of carbepenems and cephalosporin were higher among IRAB than ISAB group,statistically they were not significant.There was no significant difference in term of outcomes between the two groups.Conclusions:Although statistically not significant,this analysis compliments previous publication highlighting the importance of appropriate empiric antibiotic usage in hospital especially carbepenems and need further evaluation with bigger subjects.展开更多
Objective:To discuss the prevalence,clinical and laboratory presentations of relapse typhoid fever.Methods:All relapse cases were reviewed to identify the clinical and laboratory presentation of the relapse typhoid fe...Objective:To discuss the prevalence,clinical and laboratory presentations of relapse typhoid fever.Methods:All relapse cases were reviewed to identify the clinical and laboratory presentation of the relapse typhoid fever.Results:Two hundred and forty six patients were admitted to a teaching tertiary hospital in North-eastern state of Malaysia and fourteen(5.69%) relapse cases were identified.The duration of relapse after the patient was discharged was(25.0±9.9) d.The patients presented with fever,diarrhoea,headache,abdominal pain and constipation. The duration of fever before admission in the initial episode[(8.6±4.2) d]was significantly longer than the relapse episode[(5.0±2.5) d](P=0.019).Four patients have hepatomegaly in initial episode and ten in relapse episode(P=0.852).The defervescence days of initial episodes was (3.2±2.2) d,comparing to relapse episode[(2.0±1.8) d]which was statistically not significant (P=0.124).Conclusion:Assumption of the relapse typhoid fever is milder comparing to original episodes based on observation and is not supported by statistical analysis.展开更多
Objective:To investigate the prevalence,clinical and bacteriological features and outcome of extrapulmonary tuberculosis in patients attending a tertiary care hospital at Kota Bharu,Kelantan.Methods:All culture positi...Objective:To investigate the prevalence,clinical and bacteriological features and outcome of extrapulmonary tuberculosis in patients attending a tertiary care hospital at Kota Bharu,Kelantan.Methods:All culture positive tuberculosis cases recorded in Hospital Universiti Sains Malaysia at Kota Bharu during five years period from 2003-2007 were included in the study.Mycobacterium detected in samples originating from sites other than lungs was considered as a case of extrapulmonary tuberculosis.Age,site of infection,bacteriological findings and outcomes were analyzed.Results:Out of 437 tuberculosis cases recorded from 2002-2006,59 cases had culture positive extrapulmonary tuberculosis.Their mean age was 37 years and 44%were between the ages of 20-40 years.About 63%were negative for acid-fast bacilli by Z-N stain.Of the 59,97%was Mycobacterium tuberculosisc(M.tuberculosis) while two(3%) were atypical Mycobacterium Runyon Group-Ⅳ.Only 3 (5%) were isoniazid resistant.Extrapulmonary sites involved were lymph nodes 19(31%),central nervous system 12(20%),pleural 11(19%) spine 8(14%).,renal 3(5.1%) and others 6(10.2%).In this series, 11(18%) were positive for HIV.There was no significant association between extrapulmonary tuberculosis and HIV status.The outcome of CNS tuberculosis was the poorest with a mortality rate of 25%.Conclusion: M.tuberculosis is the predominant organism in extrapulmonary tuberculosis and culture is the most effective method for its diagnosis.展开更多
Infectious conjunctivitis is a very common presentation to medical professional and ophthalmologist all over the world.Although its typically self-limiting and treatable in almost all of the cases,but we need to be aw...Infectious conjunctivitis is a very common presentation to medical professional and ophthalmologist all over the world.Although its typically self-limiting and treatable in almost all of the cases,but we need to be aware of the rare and potentially life threatening if the cause is not promptly identified and treated accordingly.In our case report,we highlighted the rare case of Neisseria meningitidis as a primary cause of keratoconjunctivitis.Neisseria meningitidis is a rare etiology of keratoconjunctivitis and its ocular presentations are quite similar with other bacterial or viral infection.The infection may potentially fatal if systemic invasion occurred,however with immediate and proper treatment the outcome is satisfactory.Early diagnosis and proper antibiotic treatment are critical to prevent systemic spread of the infection.Public health intervention is needed to prevent outbreak of the disease.展开更多
基金supported by the Ministry of Higher Education Malaysia for Fundamental Research Grant Scheme with Project Code:FRGS/1/2019/SKK11/USM/02/5。
文摘Burkholderia pseudomallei is a causative agent of melioidosis that can infect humans and animals in endemic countries,specifically in Southeast Asia and tropical Australia.A fundamental component for the pathogenesis of Burkholderia pseudomallei is the capability of the bacterium to enter,survive,replicate,and cause disease in a host cell by inducing the host cell fusion.Cell fusion results in multinucleated-giant cell formation,thus enabling the dissemination of Burkholderia pseudomallei intracellularly.cGAS reacts to Burkholderia pseudomallei infection by activating the cGAS-STING pathway and subsequently limiting host's aberrant cell division and cellular replication by inducing autophagic cell death.In this review,we discuss the host-pathogen interactions between the typeⅥsecretion system 5(T6SS-5)of Burkholderia pseudomallei and human cGAS pathway in melioidosis infections.Since T6SS-5 is a main virulent factor in Burkholderia pseudomallei and the c GAS pathway is vital for host immune response,elucidating their functions is important for better understanding the pathogenesis of Burkholderia pseudomallei.
基金Supported by Universiti Sains Malaysia(No:304/PPSP/6131378)
文摘Objective:To determine the risk factors and outcomes of imipenem-resistant Acinetobacter baumannii(IRAB) bloodstream infection(BSI) cases,since there is very little publication on Aeinetobacter baumannii infections from Malaysia.Methods:A cross sectional study of 41 cases(73.2%) of imipenem-sensitive Acinetobacter baumanii(ISAB) and 15 cases(26.8%) of IRAB was conducted in a teaching hospital which was located at North-Eastern state of Malaysia.Results:There was no independent risk factor for IRAB BSI identified but IRAB BSI was significantly associated with longer bacteraemic days[OR 1.23(95%CI 1.01,1.50)].Although prior use of carbepenems and cephalosporin were higher among IRAB than ISAB group,statistically they were not significant.There was no significant difference in term of outcomes between the two groups.Conclusions:Although statistically not significant,this analysis compliments previous publication highlighting the importance of appropriate empiric antibiotic usage in hospital especially carbepenems and need further evaluation with bigger subjects.
文摘Objective:To discuss the prevalence,clinical and laboratory presentations of relapse typhoid fever.Methods:All relapse cases were reviewed to identify the clinical and laboratory presentation of the relapse typhoid fever.Results:Two hundred and forty six patients were admitted to a teaching tertiary hospital in North-eastern state of Malaysia and fourteen(5.69%) relapse cases were identified.The duration of relapse after the patient was discharged was(25.0±9.9) d.The patients presented with fever,diarrhoea,headache,abdominal pain and constipation. The duration of fever before admission in the initial episode[(8.6±4.2) d]was significantly longer than the relapse episode[(5.0±2.5) d](P=0.019).Four patients have hepatomegaly in initial episode and ten in relapse episode(P=0.852).The defervescence days of initial episodes was (3.2±2.2) d,comparing to relapse episode[(2.0±1.8) d]which was statistically not significant (P=0.124).Conclusion:Assumption of the relapse typhoid fever is milder comparing to original episodes based on observation and is not supported by statistical analysis.
文摘Objective:To investigate the prevalence,clinical and bacteriological features and outcome of extrapulmonary tuberculosis in patients attending a tertiary care hospital at Kota Bharu,Kelantan.Methods:All culture positive tuberculosis cases recorded in Hospital Universiti Sains Malaysia at Kota Bharu during five years period from 2003-2007 were included in the study.Mycobacterium detected in samples originating from sites other than lungs was considered as a case of extrapulmonary tuberculosis.Age,site of infection,bacteriological findings and outcomes were analyzed.Results:Out of 437 tuberculosis cases recorded from 2002-2006,59 cases had culture positive extrapulmonary tuberculosis.Their mean age was 37 years and 44%were between the ages of 20-40 years.About 63%were negative for acid-fast bacilli by Z-N stain.Of the 59,97%was Mycobacterium tuberculosisc(M.tuberculosis) while two(3%) were atypical Mycobacterium Runyon Group-Ⅳ.Only 3 (5%) were isoniazid resistant.Extrapulmonary sites involved were lymph nodes 19(31%),central nervous system 12(20%),pleural 11(19%) spine 8(14%).,renal 3(5.1%) and others 6(10.2%).In this series, 11(18%) were positive for HIV.There was no significant association between extrapulmonary tuberculosis and HIV status.The outcome of CNS tuberculosis was the poorest with a mortality rate of 25%.Conclusion: M.tuberculosis is the predominant organism in extrapulmonary tuberculosis and culture is the most effective method for its diagnosis.
文摘Infectious conjunctivitis is a very common presentation to medical professional and ophthalmologist all over the world.Although its typically self-limiting and treatable in almost all of the cases,but we need to be aware of the rare and potentially life threatening if the cause is not promptly identified and treated accordingly.In our case report,we highlighted the rare case of Neisseria meningitidis as a primary cause of keratoconjunctivitis.Neisseria meningitidis is a rare etiology of keratoconjunctivitis and its ocular presentations are quite similar with other bacterial or viral infection.The infection may potentially fatal if systemic invasion occurred,however with immediate and proper treatment the outcome is satisfactory.Early diagnosis and proper antibiotic treatment are critical to prevent systemic spread of the infection.Public health intervention is needed to prevent outbreak of the disease.
