exudates and Streptococcal-Infections

Group B Streptococcus (GBS) is a major cause of several infectious diseases in humans and fish. This study was conducted to compare human and fish-derived GBS in terms of their antimicrobial susceptibility, serotype, virulence and pili genes and sequence type (ST), and to determine whether there is a potential linkage of zoonotic transmission in Malaysia. GBS isolated from humans and fish had similar phenotypic characteristics and differed in virulence gene profile, antimicrobial susceptibility, serotype and sequence type. Fish GBS isolates had lower genetic diversity and higher antibiotic susceptibility than human isolates. We report a rare detection of the potentially fish-adapted ST283 in human GBS isolates. Both human and fish ST283 shared several phenotypic and genotypic features, including virulence and pilus genes and antimicrobial susceptibility, illustrating the value of monitoring GBS within the One Health scope. In this study, two human GBS ST283 isolates belonging to the variant common in fish hosts were identified, raising awareness of the zoonotic potential between the different species in Malaysia.

Topics: Animals; Anti-Infective Agents; Cichlids; Humans; Malaysia; Streptococcal Infections; Streptococcus agalactiae; Tilapia

Disease outbreaks have been seen as the major threat to sustainable aquaculture worldwide. Injectable vaccines have been one of the few strategies available to control the diseases, however, the adoption of this technology globally is limited. Genetic selection for disease resistance has been proposed as the alternative strategy in livestock and aquaculture. Economic analysis for such strategies is lacking and this study assesses the economic worth of using tilapia fingerlings resistant to Streptococcosis in both cage and pond production systems. The paper also assesses the profitability of paying the higher price for such fingerlings. Partial-budgeting was used to develop a stochastic simulation model that considers the benefits and costs associated with the adoption of tilapia fingerlings resistant to Streptococcosis at the farm level, in one production cycle. In both ponds and cage production systems, the use of genetically selected Streptococcus resistant tilapia fingerlings was found to be profitable where Streptococcus infection is prevalent. In the cages and ponds where Streptococcus related mortality was ≥ 10%, the Nile tilapia aquaculture was found to be profitable even if the amount paid for genetically selected Streptococcus resistant tilapia fingerlings was 100% higher than the amount paid for standard fingerlings.

Topics: Animals; Aquaculture; Cichlids; Fish Diseases; Malaysia; Ponds; Streptococcal Infections; Streptococcus agalactiae; Tilapia

Neonatal invasive Group A Streptococcus (GAS) infection is a rare occurrence nowadays. Prior maternal vaginal colonization is an important factor in early neonatal disease. We report a case of invasive and fatal infection in a neonate. At Day 1 of life, a term baby was found to be lethargic, with poor feeding, and later became unresponsive. Consequently, the baby was immediately brought to the Emergency Department of Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan via ambulance. Despite the active resuscitation efforts in the hospital, the baby died. An autopsy was carried out to determine the cause of death. The mother was noted to have puerperal pyrexia secondary to vaginal discharge. Her high vaginal swab culture was positive for GAS. GAS was also isolated from the intracardiac blood, pleural fluid, peritoneal fluid, and umbilical swab of the baby, giving evidence to the aetiology of the mortality. Vaginal colonization of GAS is an important factor for high morbidity and mortality for both mother and infant due to its invasiveness and virulence.

Topics: Female; Humans; Infant; Infant, Newborn; Malaysia; Morbidity; Sepsis; Streptococcal Infections; Streptococcus

Streptococcus Suis (S.suis) is increasingly being recognised as a potentially preventable emerging zoonotic infection in humans with a global distribution. It is a major cause of meningitis especially among those in contact with pigs and has also been associated with a toxic shock syndrome.. We report the first two human cases from Sabah, Borneo, Malaysia which expands the global reach of this important pathogen. Here, we illustrate their epidemiological risk factors, clinical presentation and resulting sequelae of both patients.. The continued public health threat of zoonotic infections such as S.suis, highlights the need for accurate epidemiological surveillance, regulation of pig farming, slaughtering and continued advocacy of best practices for pork preparation and consumption.

Topics: Adult; Animals; Borneo; Humans; Malaysia; Male; Streptococcal Infections; Streptococcus suis; Sus scrofa; Zoonoses

Sore throats may be due to either viral or group A beta hemolytic streptococcus (GABHS) infections; but diagnosis of the etiology of a sore throat is difficult, often leading to unnecessary antibiotic prescriptions and consequent increases in bacterial resistance. Scoring symptoms using the McIsaac clinical decision rule can help physicians to diagnose and manage streptococcal infections leading to sore throat and have been recommended by the Ministry of Health, Malaysia. In this paper, we offer the first assessment of the effectiveness of the McIsaac rule in a clinical setting in Malaysia.. This study is a retrospective review of 116 pediatric patients presenting with sore throat. Group A comprised patients before the implementation of the McIsaac rule and Group B comprised patients after the implementation.. Unnecessary throat swab cultures were reduced by 40% (P = 0.003). Redundant antibiotic prescriptions were reduced by 26.5% (P = 0.003) and the overall use of antibiotics was reduced by 22.1% (P = 0.003). The pediatricians' compliance rate to McIsaac rule criteria was 45% before implementation of the McIsaac rule, but improved to 67.9% (P = 0.0005) after implementation.. The McIsaac rule is an effective tool for the management of sore throat in children in Malaysia.

Topics: Algorithms; Anti-Bacterial Agents; Child, Preschool; Decision Making; Decision Support Systems, Clinical; Female; Hospitals; Hospitals, Pediatric; Humans; Malaysia; Male; Pharyngitis; Retrospective Studies; Streptococcal Infections; Streptococcus; Treatment Outcome

A total of 103 group B streptococci (GBS) including 22 invasive, 21 non-invasive, and 60 colonizing isolates were collected in a Malaysian hospital (June 2010-October 2011). Isolates were characterized by conventional and molecular serotyping and analyzed for scpB, lmb, hylB, cylE, bac, bca and rib gene content. Antimicrobial susceptibility to penicillins, macrolides, lincosamides, quinolones and tetracyclines was determined using disk diffusion and the MICs for penicillin were determined by E-test. Molecular serotyping for all eight serotypes (Ia, Ib, II-VII) was in full accordance with conventional serotyping. Overall, taking CS and MS together, serotype VI was the most common capsular type (22.3 %) followed by VII (21.4 %), III (20.4 %), Ia (17.5 %), V (9.7 %), II (7.7 %) and IV (1 %). Susceptibility to beta-lactam antimicrobials was prevalent (100 %). Resistance rates for erythromycin, clindamycin and tetracycline were 23.3 %, 17.5 % and 71.8 %, respectively. PCR-virulence gene screening showed the presence of cylE, lmb, scpB and hylB in almost all the isolates while rib, bca, and bac genes were found in 29.1 %, 14.6 % and 9.7 % of the isolates. Certain genes were significantly associated with specific serotypes, namely, rib with serotypes Ia, II, III and VI; bca and bac with serotypes II and III. Furthermore, serotype Ia was significantly more common among patients with invasive infections (p < 0.01) and serotype VI isolates were significantly more common among carriers (p < 0.05). In summary, serotype distribution correlates with virulence gene content will be useful in epidemiological studies and design of vaccines.

Topics: Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Drug Resistance, Bacterial; Female; Genotype; Humans; Infant, Newborn; Malaysia; Male; Microbial Sensitivity Tests; Middle Aged; Molecular Typing; Pregnancy; Serogroup; Streptococcal Infections; Streptococcus agalactiae; Virulence; Virulence Factors; Young Adult

Topics: Animals; Anti-Bacterial Agents; Bass; Cichlids; Drug Resistance, Bacterial; Fish Diseases; Fisheries; Malaysia; Streptococcal Infections; Streptococcus agalactiae; Tilapia

This study was carried out to determine the antibody responses and protective capacity of an inactivated recombinant vaccine expressing the cell wall surface anchor family protein of Streptococcus agalactiae following oral vaccination against streptococcosis in tilapia. Tilapia were vaccinated orally with 10(6) CFU/mL of the recombinant vaccine incorporated in feed (feed-based recombinant vaccine) (vaccinated group or Group 1), 10(6) CFU/mL of pET-32 Ek/LIC vector without cell wall surface anchor family protein (control group or Group 2), 10(6) CFU/mL of formalin-killed cells of S. agalactiae vaccine incorporated in feed was also prepared (feed-based vaccine) (vaccinated group or Group 3), and unvaccinated control group or Group 4 (fed with commercial pellets). During the course of study, serum, mucus and gut lavage fluid were collected to evaluate the antibody levels via enzyme-linked immunosorbent assay (ELISA). The results showed that tilapia immunized with the feed-based recombinant vaccine developed a strong and significantly (P < 0.05) higher IgM antibody response in serum, mucus and gut lavage fluid samples compared to groups 2, 3 and 4. Following heat intervenes and intraperitoneal challenge, the rate of survivors (RPS) was 70% for the vaccinated group, and 0% for the rest of the groups. Therefore, the study revealed that the feed-based recombinant vaccine significantly provides high protection against high dose challenge in heat stress environment and enhances the production of the mucosal and humoral immunity.

Topics: Analysis of Variance; Animal Feed; Animals; Bacterial Vaccines; Base Sequence; DNA Primers; Enzyme-Linked Immunosorbent Assay; Fish Diseases; Isopropyl Thiogalactoside; Malaysia; Molecular Sequence Data; Polymerase Chain Reaction; Streptococcal Infections; Streptococcus agalactiae; Tilapia; Vaccines, Synthetic

Group B Streptococcus (GBS) is a leading cause of infections such as meningitis and septicemia in neonates and pregnant women; however the significance of invasive GBS disease has not been clearly defined in non-pregnant adults.. We reviewed the hospital records of 18 cases with GBS bacteremia who attended the Universiti Kebangsaan Malaysia Medical Centre from June 2010 to October 2011. We analyzed the clinical findings of both bacteremic adults and neonates and compared them to previous studies of GBS bacteremia. Serotyping was done by latex agglutination test using 10 distinct antisera (Ia, Ib, and II-IX).. During the period of 1 year and 4 months, there were 18 patients with GBS bacteremia. Five cases occurred in neonates, one in a parturient woman, and 12 in other adults. All neonates with bacteremia were males and two of them were premature. Septicemia was the most common clinical presentation in neonates. They were treated with intravenous (IV) penicillin G and gentamicin. The adults included nine men (69%) and four women (31%). Their mean age was 60 years and all patients had more than two underlying conditions. The most common clinical syndrome was pneumonia (n=6, 46.5%). The others were peritonitis (n=3, 23.1%), primary bacteremia (n=2, 15.5%), septic arthritis (n=2, 15.5%), skin and soft tissue infection (n=1, 7.7%), meningitis (n=1, 8%), urinary tract infection (n=1, 8%), and intravascular device infection (n=1, 7.7%). Cardiovascular diseases (n=7, 53.8%) were the most common underlying conditions, and diabetes mellitus (n=5, 38.5%) was second. The other co-morbid conditions were hyperlipidemia (n=3, 23.1%), renal disease (n=3, 23.1%), liver disease and/or alcohol abuse (n=3, 23.1%), autoimmune disease or immunosuppressive condition (n=2, 15.5%), malignancy (n=2, 15.5%), respiratory disease (n=1, 8%), and postpartum condition (n=1, 8%), as well as miscellaneous conditions including intravenous drug abuse, HIV infection, and trauma (n=2, 15.5%). Polymicrobial bacteremia was found in five (45.4%) cases and Staphylococcus aureus was the most common concurrent bacterial isolate. Of the 18 GBS isolates in both adults and neonates, serotype Ia was predominant (38.9%), followed by VI (27.8%), V (11.1%), and III (5.5%); the remaining 16.7% were non-typeable.. GBS bacteremia is a significant problem and is associated with serious underlying disease, which may result in a high rate of mortality, not only in neonates and pregnant women, but also in non-pregnant adults.

Topics: Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Bacteremia; Cross Infection; Female; Hospitals, Teaching; Humans; Infant, Newborn; Malaysia; Male; Middle Aged; Retrospective Studies; Streptococcal Infections; Streptococcus agalactiae; Treatment Outcome

There is limited information about pneumococcal carriage among healthy children in Malaysia. Therefore, this study was conducted to determine the prevalence rate, serotype distribution, susceptibility pattern, and pneumococcal surface protein A (PspA) family types of Streptococcus pneumoniae isolates in the nasal carriage of children 5 years old or younger in three day care centers in Kuala Lumpur, Malaysia.. Nasal swabs were collected from 195 healthy children, age 5 years or younger, from June to December 2010. S pneumoniae was identified by phenotypic and genotypic methods. The serotyping was performed using Pneumotest kit (Statens Serum Institut, Copenhagen, Denmark) and the susceptibility pattern was determined by using the E-test method (AB Biodisk, Solna, Sweden). PspA family typing was done using polymerase chain reaction.. S pneumoniae was found in the nasal carriage of 35.4% of children (69 of 195) and penicillin resistance was found in 23.2% (16 of 69). Among the 69 isolates, multidrug-resistant S pneumoniae (MDRSP) was present in 20.3%. All 16 penicillin-resistant S pneumoniae (PRSP) isolates were resistant to erythromycin and 14 PRSPs (87.5%) were resistant to co-trimoxazole. The six most common serotypes were 6A, 23F, 19A, 6B, 19F, and 15C, which were found in 87% of all isolates. Of the 69 isolates, 24.6% belonged to PspA family 1, 71.0% to PspA family 2, and 4.3% to PspA family 3.. Twenty-eight of the isolates (40.6%) belonged to serotypes included in the pneumococcal polysaccharide vaccines (PCV) 7 and 10, whereas 48 (69.5%) were included in PCV13. The high rate of PRSP and MDRSP supports the need for continuing surveillance of pneumococcal carriage. The major PspA families were 1 and 2 (95.7%), thus making them suitable candidates for future vaccines.

Topics: Bacterial Proteins; Carrier State; Child Day Care Centers; Child, Preschool; Cross-Sectional Studies; Female; Humans; Infant; Malaysia; Male; Microbial Sensitivity Tests; Nasal Mucosa; Polymerase Chain Reaction; Prevalence; Serotyping; Streptococcal Infections; Streptococcus pneumoniae

Topics: Animals; Anti-Bacterial Agents; Disease Outbreaks; Disk Diffusion Antimicrobial Tests; Fish Diseases; Malaysia; Perciformes; Streptococcal Infections; Streptococcus agalactiae

Group C Streptococcus dysgalactiae (GCSD) is a pathogen of farmed fish. Almost all GCSD isolates from Asian countries, including Japan, Taiwan, Malaysia, and China, have a serum opacity factor (SOF-FD). Although the SOF-FD sequences in different GCSD isolates are identical, different opacification activities are observed. Three types of variations were observed in the upstream sequence of the sof-FD gene in GCSD isolates with different SOF-FD activities. Type 1 was characterized by insertion of an IS981-like element into the upstream region of the sof-FD gene. In Type 2, an IS981-like element was inserted into the upstream region in a direction opposite to that in Type 1. In Type 3, no IS element was inserted. Type 1 was predominant among Japanese isolates (129 of 133). Isolates from other Asian countries were generally Type 3 (13 of 16). Except for 1 strain, Type 1 strains exhibited opacification activities with optical densities (ODs)>0.6, while Type 2 and Type 3 strains have low opacification activities (ODs >0.2). Only Type 1 strains have putative -10 and -35 promoter regions upstream of the sof-FD gene, and the expression level of the sof-FD gene was higher in Type 1 strains than in Type 2 and Type 3 strains.

Topics: Animals; Bacterial Proteins; China; DNA Transposable Elements; Fish Diseases; Genotype; Japan; Malaysia; Mutagenesis, Insertional; Peptide Hydrolases; Perciformes; Phylogeny; Polymerase Chain Reaction; Sequence Analysis, DNA; Streptococcal Infections; Streptococcus; Taiwan

Streptococcal toxic shock syndrome is a serious health problem in developed and developing countries. We here report a case of severe protracted disease after a minor skin infection in a young traveler returning from West Malaysia which was caused by an unusual emm-type strain harboring speG and smeZ superantigen genes.

Topics: Adult; Antigens, Bacterial; Female; Foot; Germany; Humans; Malaysia; Shock, Septic; Skin Diseases, Bacterial; Streptococcal Infections; Streptococcus pyogenes; Superantigens; Travel

Colorectal cancer (CRC) is the second most common cause of cancer mortality among men and women worldwide; the risk of its occurrence has been shown to be increased by chronic bacterial infections. A case control study was therefore carried out at Hospital Universiti Sains Malaysia (HUSM) to determine the incidence of colorectal cancer associated with S. bovis infection. A total of 166 stool specimens were collected from diseased patients and healthy individuals and S. bovis isolates were identified. Suspected colon tumor and cancer cases were diagnosed and confirmed. It was found that overall prevalence of S. bovis was 41 (24.7%) out of 166 cases studied. Some 41(48.6%) of these S. bovis isolates was found in patients with colonic polyps, adenocarcinomas, inflammatory bowel disease (IBD) and chronic gastrointestinal tract (GIT). It was also found that colorectal cancer incidence was 24.7%, adenocarinomas accounting for 51% with the highest incidence in the sigmoid part of the colon. Among the IBD and chronic GIT cases, ulcerative colitis featured in the majority of cases (41.4%). In conclusion, there is a high incidence of colorectal cancer associated with S. bovis.

Topics: Adenocarcinoma; Adult; Case-Control Studies; Chronic Disease; Colorectal Neoplasms; Female; Gastrointestinal Diseases; Humans; Incidence; Inflammatory Bowel Diseases; Malaysia; Male; Prevalence; Prognosis; Risk Factors; Streptococcal Infections; Streptococcus bovis

Group B Streptococcus (GBS) infection was studied in 49 patients collected at convenience (convenience sampling), excluding infants and women with genital tract- and pregnancy-related isolates, according to the availability of stocked isolates and easy accessibility to epidemiological data. The data were examined both prospectively and retrospectively from 2003-2005 at a tertiary-level multidisciplinary hospital in Kuala Lumpur, Malaysia. Skin and soft-tissue infections in 35 patients (71.4%) were the most common clinical presentation, while diabetes mellitus was the most common underlying condition (35 patients, 71.4%). All GBS isolates were sensitive to penicillin, and most isolates tested were sensitive to erythromycin (97.7%). Serotyping of 45 GBS isolates using a commercial serotyping kit revealed that the most common serotype was Ia (22.2%), followed by VI (17.8%), III and V (13.3% each). Others included Ib, II, IV, VIII, and VII; 13.3% were nontypeable. The findings of this pilot study are limited by the small sample size, the sampling method and the possibility that the cases are not wholly representative of the University Malaya Medical Centre population. Further studies from our hospital with larger numbers and using probabilistic sampling techniques are required to confirm the relatively high occurrence of serotype VI (the second most common serotype) in the population studied.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Child; Child, Preschool; Female; Humans; Malaysia; Male; Microbial Sensitivity Tests; Middle Aged; Prospective Studies; Retrospective Studies; Serotyping; Streptococcal Infections; Streptococcus agalactiae

Topics: Adolescent; Adult; Belgium; Contact Tracing; Disease Outbreaks; Female; Football; Humans; Hygiene; Malaysia; Male; Middle Aged; Soft Tissue Infections; Soft Tissue Injuries; Streptococcal Infections; Streptococcus pyogenes; Surveys and Questionnaires; Travel; Wound Infection

Topics: Adolescent; Adult; Antistreptolysin; Child; Child, Preschool; Female; Glomerulonephritis; Hospitals, General; Humans; Infant; Malaysia; Male; Middle Aged; Rheumatic Fever; Streptococcal Infections; Streptococcus pyogenes

T-agglutination patterns of 190 strains of group A streptococci isolated between January 1989 and December 1993 from body fluids (10), throat culture (56), pus (51) and skin lesions (73) were determined. Mucoid colonial morphology was exhibited by 6.3% (12/190) of the strains on initial isolation. Type T-5,11,27,44 comprised 23.7%, followed by T-1,3,13,B3264 (11.1%), T-4,6 (8.4%) and T-8,25, Imp 19 (7.9%). About 42% (80/190) strains could not be characterized by T agglutination pattern. T-typing of 71 selected strains at WHO Collaborating Center, Minneapolis yielded similar results. Nineteen selected strains were further characterized by M-typing; only three strains were M-typeable. These strains were isolated from throat (M1), sputum (M5) and pus (M12). About 68% (48/71) isolates produced serum opacity factor. These data support the existence of as yet uncharacterized group A streptococcal serotypes in this region.

Topics: Agglutination Tests; Antigens, Bacterial; Bacteremia; Bacterial Outer Membrane Proteins; Bacterial Proteins; Bacterial Typing Techniques; Body Fluids; Carrier Proteins; Humans; Malaysia; Peptide Hydrolases; Pharynx; Serotyping; Skin; Streptococcal Infections; Streptococcus pyogenes; Suppuration

A prospective study of acute nephritis in children was conducted at the Universiti Sains Malaysia Hospital, Kubang Kerian between July 1987 and June 1988. One hundred and twenty four children were admitted with acute glomerulonephritis. The aim of the study was to determine the clinical pattern of the nephritis as well as its aetiology. The majority of our patients came from the lower socio-economic group and 54% of the families had incomes below the poverty line. Preceding skin infection was much more common than throat infection. The children showed a high incidence of complications: severe hypertension (43.6%), hypertensive encephalopathy (11.3%), clinical pulmonary oedema (36.3%), severe azotaemia (10.5%), and prolonged gross haematuria (13.7%). By using immunologic indices such as ASOT, anti-DNase B and complement 3, it was concluded that 121 of the 124 patients had post-streptococcal nephritis.

Topics: Acute Disease; Antistreptolysin; Child; Family Health; Glomerulonephritis; Humans; Malaysia; Prospective Studies; Socioeconomic Factors; Streptococcal Infections

Topics: Adult; Endocarditis, Bacterial; Enterococcus faecalis; Hospitals, General; Humans; Malaysia; Male; Middle Aged; Staphylococcal Infections; Streptococcal Infections; Substance-Related Disorders

A total of 350 strains of group B streptococci (308 from adults and 42 from neonates) were serotyped. The majority of the isolates from adult patients were from the genito-urinary tract and most of the neonatal isolates were from babies less than 10 days old. Serotype III was the predominant type among all groups of patients and accounted for 50.9% of all serotypes. The second and third most frequently occurring serotypes were II and Ic respectively. Together with type III they made up 87% of the isolates.

Topics: Adult; Female; Humans; Infant, Newborn; Malaysia; Male; Serotyping; Streptococcal Infections; Streptococcus agalactiae; Urogenital System

Topics: Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Malaysia; Male; Pregnancy; Streptococcal Infections; Streptococcus agalactiae

Topics: Carrier State; Child; Epidemiologic Methods; Ethnicity; Female; Humans; Malaysia; Male; Nasopharyngeal Diseases; Nasopharynx; Rheumatic Fever; Socioeconomic Factors; Streptococcal Infections; Streptococcus

Topics: Africa, Eastern; Africa, Southern; Africa, Western; Developing Countries; Emigration and Immigration; Endomyocardial Fibrosis; Environmental Exposure; Europe; Humans; India; Malaysia; Seasons; Socioeconomic Factors; South America; Sri Lanka; Streptococcal Infections; Tropical Climate; Tropical Medicine