1.Species distribution and clinical profiles of coagulasenegative staphylococci (CoNS) isolated from blood cultures among paediatric patients in Hospital Kuala Lumpur
Siti Norbaya Masri ; Wan Nazirah Wan Abu Bakar ; Rosni Ibrahim ; Mohamed Asyraf Noh ; Salbiah Hj Nawi
The Medical Journal of Malaysia 2020;75(3):266-273
Introduction: Coagulase-negative staphylococci (CoNS) is
often considered as a culture contaminants but it can
potentially be pathogenic to patients with risk factors. A
combination of species identification and clinical criteria
has been suggested in determining true CoNS bacteraemia.
Objectives: To identify the species distribution, antibiotic
susceptibility patterns and clinical profiles of CoNS isolated
from blood cultures among paediatric patients in Hospital
Kuala Lumpur (HKL).
Methods: This study involved CoNS isolation from blood
cultures of paediatric in-patients of the Paediatric Institute
HKL. Isolates were identified to species level using
Analytical Profile Index Staph identification strips and
antimicrobial susceptibility pattern following Kirby-Bauer
Disc Diffusion method. The clinical profiles of patients were
obtained from their medical records.
Results: Eleven CoNS species were identified from 148
isolates. Staphylococcus epidermidis was the most frequent
species isolated (67.6%). The majority of the isolates
showed resistance to penicillin (85.8%); while 70.3% were
methicillin-resistant (MR) CoNS, which demonstrated a
significant association with true infection (p=0.021).
Predictors for significant CoNS infection included
thrombocytopaenia, presence of predisposing factors,
nosocomial infection, blood collected from peripheral vein,
and CoNS isolated from two consecutive blood cultures. The
most common predisposing factors for the isolation of
CoNS were the presence of peripheral (54.1%) and central
venous catheters (35.1%).
Conclusion: CoNS can cause significant bloodstream
infections. The isolation of CoNS from blood cultures should
be carefully interpreted by considering the predictive
factors. Local data regarding predictive factors of patients
with culture-positive CoNS, species distribution and
antimicrobial susceptibility pattern are useful to determine
the significance of blood culture results and care
management of patients
2.Enterococcal species distribution, antibiotic susceptibility and Van gene frequency among patients at a tertiary hospital in Sabah
Nur Nashyiroh Izayati Mastor ; Vijay Kumar Subbiah ; Wan Nazirah Wan Abu Bakar ; Khurshida Begum ; M. Jahangir Alam ; Mohammad Zahirul Hoque
Malaysian Journal of Microbiology 2023;19(no.6):628-635
Aims:
Enterococcus bacteria, including some strains that are resistant to antibiotics like vancomycin can pose a threat to public health. The purpose of this study is to identify the species, antibiotic susceptibility profile and VanA/VanB gene frequencies in Enterococci isolated from patients at a tertiary hospital in Kota Kinabalu, Sabah.
Methodology and results :
Various bodily fluid specimens were collected from 162 patients between July 2019 and June 2021. Species confirmation and susceptibility testing were performed using an automated system. Subsequently, PCR was used to determine the presence of VanA and VanB genes. Species identification revealed the presence of five enterococcal species, namely E. faecalis (91), E. faecium (64), E. gallinarum (3) E. casseliflavus (2), along with one isolate each of E. hirae and E. avium. Overall, resistance to antibiotics like ampicillin, quinolones, tetracycline, gentamicin-syn, nitrofurantoin, glycopeptides and linezolid was generally low (<50%). However, a significant number of isolates displayed high resistance to erythromycin (>50% of samples), while resistance to tetracycline was more moderate. The frequencies of VanA and VanB genes were low (0.6 and 0%, respectively) and they were only detected in E. faecium.
Conclusion, significance and impact of study
The results indicate that while the prevalence of vancomycin-resistant enterococci (VRE) may be low, there is an increasing incidence of multidrug-resistant enterococci, particularly with regards to erythromycin.