Introduction: bacteremia continues to be one of the major causes of morbidity and mortality despite the existence of numerous antimicrobial agents. this study aimed to provide a Malaysian perspective on paediatric community-acquired bacteraemia based on the documentation of epidemiology and antimicrobial profile of the isolated pathogens. Method: A retrospective study was conducted by analysing clinical details, blood cultures and antimicrobial susceptibility testing results in children between the ages of 0 to 13 years old, who were admitted to selayang Hospital over an 11-year period from 2001 until 2011. there were 222 bacteraemia cases and the median age was 11.7 months. the highest number (39%) of bacteraemia cases occurred between ages one month to one year. the three most commonly isolated aetiological agents were Staphylococcus aureus (17.1%), nontyphoidal Salmonella (16.2%), and Streptococcus pneumoniae (12.6%). Almost 8% of the Staphylococcus aureus isolates were methicillin resistant, while nontyphoidal Salmonella (Nts) isolates demonstrated 18.4%, 10.5% and 2.6% resistance towards ampicillin, trimethoprim-sulfamethoxazole and ciprofloxacin respectively. All Nts isolates were sensitive to ceftriaxone. Streptococcus pneumoniae isolates showed 17.9% resistance to penicillin. skin and soft tissue infections as well as lower respiratory tract infections (63.2%) were the main foci of infections in Staphylococcus aureus bacteraemia. Acute gastroenteritis (80.0%) and pneumonia (60.8%) were the main presentations of Nts and Streptococcus pneumoniae bacteraemia respectively. Overall mortality rate was 8.1%. Conclusion: Knowledge on the local epidemiology and antibiotic resistance pattern serves as a significant platform in improving the empiric antibiotic therapy for patients with community acquired bacteraemia.
Anti-Infective Agents ; Bacteremia

bacteremia continues to be one of the major causes of morbidity and mortality despite the existence of numerous antimicrobial agents. this study aimed to provide a Malaysian perspective on paediatric community-acquired bacteraemia based on the documentation of epidemiology and antimicrobial profile of the isolated pathogens.

SUMMARY Introduction: Urinary tract infection (UTI) is a common bacterial infection affecting children and therefore, prompt recognition and accurate antimicrobial management are vital to prevent kidney damage. This study aims to determine the bacterial pathogens and their patterns of antimicrobial resistance in children presenting with UTI. Methods: A retrospective study of 721 cases, involving children between the ages of 1-day old to 13 years old with culture-proven UTI in Selayang Hospital, Malaysia between January 2007 and December 2011. The bacterial pathogens and antibiotic resistance patterns in the total population, prophylaxis and no prophylaxis groups were studied. Results: The 3 most common organisms isolated in the total population were E.Coli (41.6%), Klebsiella spp. (21.2%) and Enterococcus spp. (11.0%). With regards to the antibiotic resistance, E.Coli resistance rates to ampicillin, cefuroxime and gentamicin were 67.7%, 15.3% and 7.3% respectively. Ampicillin-resistance was also highest in Klebsiella spp. (84.3%), Enterococcus spp. (15.5%) and Proteus spp. (55.5%). Conclusion: E.coli remains to be the leading bacterial pathogen causing UTI in children, with ampicillin-resistance occurring in more than half of these cases. Therefore, accurate choice of antibiotics is important to ensure optimal outcome. In our study, cefuroxime and gentamicin have lower antibiotic resistance rates and can be used in the treatment of UTI in children.
Urinary Tract Infections

INTRODUCTIONThe present study aimed to determine the impact of an extended infection control training programme, which was conducted for all interns posted to the Department of Paediatrics, on the incidence of paediatric intensive care unit (PICU)-acquired bloodstream infections (BSIs) in University Malaya Medical Centre, Malaysia.

METHODSThe development of nosocomial BSIs during the baseline period (1 January-31 October 2008) and intervention period (1 November-31 December 2009) was monitored. During the intervention period, all paediatric interns underwent training in hand hygiene and aseptic techniques for accessing vascular catheters.

RESULTSA total of 25 patients had PICU-acquired BSIs during the baseline period, while 18 patients had PICU-acquired BSIs during the intervention period (i.e. infection rate of 88 per 1,000 and 41 per 1,000 admissions, respectively). The infections were related to central venous catheters (CVCs) in 22 of the 25 patients who had PICU-acquired BSIs during the baseline period and 11 of the 18 patients who had PICU-acquired BSIs during the intervention period. Thus, the incidence rates of catheter-related BSIs were 25.2 per 1,000 CVC-days and 9.3 per 1,000 CVC-days, respectively (p < 0.05). The Paediatric Risk of Standardised Mortality III score was an independent risk factor for PICU-acquired BSIs and the intervention significantly reduced this risk.

CONCLUSIONThe education of medical interns on infection control, a relatively low-cost intervention, resulted in a substantial reduction in the incidence of PICU-acquired BSIs.

Catheter-Related Infections ; prevention & control ; Catheterization, Central Venous ; adverse effects ; Catheters, Indwelling ; adverse effects ; Central Venous Catheters ; adverse effects ; Child, Preschool ; Cross Infection ; prevention & control ; Female ; Hand Hygiene ; Humans ; Infant ; Infection Control ; methods ; Intensive Care Units, Pediatric ; Internship and Residency ; Malaysia ; Male ; Pediatrics ; education ; Proportional Hazards Models

Introduction: The trend of childhood obesity is on the rise and hence leading towards the increase in obesity related complications. Early recognition of obesity in children and accurate parental perception of the status of the weight of their children is vital. Furthermore, identification of sociodemographic risk factors contributing to obesity is crucial in order to identify children who are in the risk group and thus prevent potential complications. This study is aimed to establish the parental perception of the status of the weight of their children. Secondly, the study also to identify the sociodemographic risk factors associated with obesity in children. Methods: This was a cross-sectional study involving 245 children from 5 to 12 years of age. Following informed consent, the children were classified into either normal (body mass index (BMI) >5th to <85th percentile), overweight (BMI >85th to <95th percentile) or obese (BMI >95th percentile) groups. Parents responded to questionnaires which assessed their perception and sociodemographic factors. Results: A total of 157 participants (64.1%) had normal BMI while 41(16.7%) were overweight and 47(19.2%) were obese. More parents of overweight and obese group had misperceptions of their children’s weight status (p=0.001). Families with higher household income, children with higher birth weight, higher education of mothers and family history of obesity and type 2 diabetes had increased risk of higher BMI among their children (p=0.029, p=0.013, p=0.041 and p=0.001 respectively). Conclusions: Most parents of either overweight or obese children had inaccurate perception of the status of weight of their children. Higher household income, birth weight and education level of the mothers as well as history of diabetes and obesity in the family are associated with increased risk of childhood obesity