MALAYSIAN JOURNAL OF - Volume 18... · 2018-04-18 · Malaysian Journal of Public Health Medicine,...

Malaysian Journal of Public Health Medicine, Vol. 18 (Suppl 1) 2018 Third International Conference on Tropical Medicine and Infectious Diseases, 15 - 17August 2017

ii

MALAYSIAN JOURNAL OF

e-ISSN: 2590-3829 ISSN: 1675-0306 2018 – Volume 18 (Suppl. 1)

Official Publication of the

MALAYSIAN PUBLIC HEALTH PHYSICIANS’ ASSOCIATION

PUBLIC HEALTH

MEDICINE


iii

OfficialJournal ofMalaysian Public Health Physicians’Association

MJPHM

EDITORIAL BOARD

Chief Editor

Prof. Dato’ Dr. Syed Mohamed Aljunid

International Centre for Casemix and Clinical Coding,

Faculty of Medicine, National University of Malaysia

Deputy Chief Editor

Prof. Dr. Sharifa Ezat Wan Puteh

(Universiti Kebangsaan Malaysia)

Members:

Dato’ Prof. Dr Lokman Hakim Sulaiman Ministry of Health Malaysia Assoc. Prof. Dr Retneswari Masilamani UCSI University, Malaysia Assoc Prof. Dr. Mohamed Rusli Abdullah University Sains Malaysia Assoc. Prof. Saperi Sulong University Kebangsaan Malaysia Prof. Dr. Maznah Dahlui University Malaya Dr. Roslan Johari Ministry of Health Malaysia Dr. Othman Warijo Dr. Amin Sah bin Ahmad

Ministry of Health Malaysia Ministry of Health Malaysia

Dr. Ghazali bin Chik Ministry of Health Malaysia Dr. Sabrina binti Che Abd Rahman Ministry of Health Malaysia Dr. Mariam binti Mohamad Universiti Teknologi MARA (UiTM) Dr. Amrizal Muhd Nur National University of Malaysia

Chief Editor Malaysian JournalofPublicHealthMedicine(MJPHM)

International Centre for Casemix and Clinical Coding

UniversitiKebangsaan MalaysiaMedicalCentre(UKMMC)

Jalan Yaacob Latif, 56000 Cheras, Kuala Lumpur

Malaysia

ISSN:1675–0306

TheMalaysian JournalofPublic HealthMedicineispublishedtwiceayear

Copyright reserved @ 2001

Malaysian Public HealthPhysicians’ Association

SecretariateAddress:

The Secretariate

International Centre for Casemix and Clinical Coding

UniversitiKebangsaan MalaysiaMedicalCentre(UKMMC)

Jalan Yaacob Latif, 56000 Cheras, Kuala Lumpur

Malaysia

Tel: 03-91456986/6987/6988 Faks: 03-91456685, Email: [email protected]

mailto:[email protected]


iv

OfficialJournal ofMalaysian Public Health Physicians’Association

MJPHM

THIRD INTERNATIONAL CONFERENCE ON TROPICAL MEDICINE

AND INFECTIOUS DISEASES

15

th – 17

thAUGUST 2017

PREMIERA HOTEL, KUALA LUMPUR, MALAYSIA

EDITORIAL BOARD

Members:

Prof. Dr. Osman Ali

Community Based Department, Faculty of Medicine

Universiti Kuala Lumpur

Royal College of Medicine Perak

Masitah Ismail

Laboratory Based Department, Faculty of Medicine



Hikmah Mohamad Idi

Preclinical Department, Faculty of Medicine




v

CONTENTS PLENARY PL1-01 MICROBES AS WEAPONS OF MASS DESTRUCTION – POTENTIAL THREATS AND

PREPAREDNESS 1

Byung-Il Yeh

SYMPOSIUM 1 - VACCINATION

SP1-01 ISSUES IN CHILDHOOD VACCINATION 2 Aminah Bee Mohd Kassim SP1-02 QUALITY CONTROL IN VACCINES 3 B. Sekar

SYMPOSIUM 2 - ANTIMICROBIAL DRUG RESISTANCE SP2-01 DRUG RESISTANT BACTERIA IN HEALTH CARE SETTING AND COMMUNITY 4 Yuki Uehara

SYMPOSIUM 3 - METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS SP3-01 EMERGENCE OF COMMUNITY-ASSOCIATED METHICILLIN-RESISTANT Staphylococcus

aureus(MRSA) IN INDIGENOUS POPULATION WITH PARTICULAR REFERENCE TO AUSTRALIA

5

Asha Bowen SP3-02 METHICILLIN-RESISTANT Staphylococcus aureus IN THE COMMUNITY IN MALAYSIA 6 Cheah Tong Soon

SYMPOSIUM 4 SP4-01 WESTERN AUSTRALIA MUMPS OUTBREAK HIGHLY VACCINATED ABORIGINAL PEOPLE;

LESSON LEARNED 7

Darren Westphal

SYMPOSIUM 5 SP5-01 DIARRHOEAL DISEASES IN CHILDREN 8 Rashidul Haque

SYMPOSIUM 6 SP6-01 INFLUENZA SURVEILLANCE IN SOUTHERN VIETNAM 9 Nguyen Vu Thuong

SYMPOSIUM 7 - ZIKA VIRUS: SOUTH ASIA‟S EXPERIENCE SP7-01 ZIKA VIRUS - VIETNAM‟S EXPERIENCE 10 Luong Chan Quang SP7-02 ZIKA VIRUS - INDONESIA‟S EXPERIENCE 11 Elizabeth Jane Soepardi


vi

SYMPOSIUM 8 - ZIKA VIRUS: SOUTHEAST ASIA‟S AND SOUTH AMERICA‟S EXPERIENCE SP8-01 ZIKA VIRUS - MALAYSIA‟S EXPERIENCE 12 Rose Nani Mudin SP8-02 ZIKA VIRUS - SOUTH AMERICA‟S EXPERIENCE 13 Rodrigo Teixeira Amancio

INDUSTRY SYMPOSIUM IS1-01 INFLUENZA VACCINATION IN HIGH RISK POPULATION 14 Wan Noraini Wan Mohamed Noor IS1-02 DENGUE: VACCINE PREVENTABLE DISEASES 15 Petrick Periyasamy

ORAL PRESENTATION OP1-01

DEVELOPMENT AND VALIDATION OF AN IN-HOUSE ELISA FOR DETECTION OF T. gondii SPECIFIC IMMUNOGLOBULIN G ANTIBODIES IN HUMAN SERA

16

Koganti K OP1-02

COMPUTATIONAL STRUCTURAL, FUNCTIONAL CLASSIFICATION AND IDENTIFICATION OF NOVEL DRUG TARGET IN Burkholderia cepacia ATCC 25416

17

Revati K, Kumar S OP1-03 EVALUATION OF THE ANTIMICROBIAL EFFECT OF EXPIRED ORAL ANTIBIOTICS 18 Alghasham Kawthar OP1-04

INFECTION DUE TO “BRAIN-EATING AMOEBAE”: NOVEL CHEMOTHERAPEUTIC APPROACH

19

Yu TYO, Khan NA, Siddiqui R OP1-05

EMPIRICAL TREATMENT AND SUSCEPTIBILITY PATTERN OF PATHOGENS IN UROSEPSIS: DOES IT MATCH? A STUDY FROM A TERTIARY CARE CENTER

20

Anandhalakshmi S, Sandhya Bhat K, Sudhagar M, Patricia Anitha K,Sangeetha A V, Desdemona Rasitha, Reba Kanungo

OP1-06

ANTI-DERMATOPHYTOSIS AND ANTI-METHICILLIN-RESISTANT Staphylococcus aureus (ANTI-MRSA) POTENTIAL OF Quercus infectoria (MANJAKANI) AND Cassia alata (GELENGGANG)

21

Razak MFA, Omar MHand Wasiman MI OP1-07 PREVALENCE OF HOOKWORM IN STOOLS OF NEGRITO ORANG ASLI IN MALAYSIA 22 Sakinah MOHD SOFIAN, Azdayanti MUSLIM, Syahrul Azlin SHAARI, Zaini MOHD-ZAIN

OP1-08

SPECIES-SPECIFIC PCR FOR DETECTION OF Candida SPECIES IN IMMUNOCOMPROMISED PATIENTS

23

Harmal Nabil Saad, Tajudin Tajmul Rizwan, Yong Rafidah Abd Rahman, Sekawi Zamberi, Chong Pei Pe

OP1-09

PREVALENCE STUDY ON INTESTINAL PARASITIC INFECTIONS AMONG STUDENTS FROM UITM PUNCAK ALAM CAMPUS

24

Yusof H, Richard RL, Lim YAL

OP1-10

PREVALENCE AND BURDEN OF Ascaris lumbricoidesAMONG ORANG ASLI IN KAMPUNG KACHAU LUAR, ULU SEMENYIH SELANGOR

25

Mehru Nisha, Muhammad Aiman Bin Robani

OP1-11 PREVALENCE OF SOIL TRANSMITTED HELMINTH INFECTIONS AMONG NEGRITO 26


vii

POPULATIONS IN MALAYSIA MUSLIM Azdayanti, MOHD SOFIAN Sakinah, SHAARI Syahrul AZLIN, LEONG Kok-Hoong,

HOH Boon-Peng, LIM Yvonne Ai-Lian

OP1-12

BRAIN-EATING Amoebae: SILVER NANOPARTICLES CONJUGATION ENHANCED EFFICACY OF ANTI-AMOEBIC DRUGS AGAINST Naegleria fowleri

27

Rajendran K, Anwar A, Khan NA, Shah MR, Siddiqui R OP1-13

VENTILATOR ASSOCIATED PNEUMONIA (VAP) INCIDENCE AND DRUG-RESISTANT BACTERIAL PREPONDERANCE; A FACT TO PONDER

28

Asir GJ, Vidya J, Vadivu S, Sujitha E, Kanungo R

OP1-14

PYRROLIDONE COMPOUNDS AS POTENTIALLY SAFE AND EFFICACIOUS ANTI-MRSA AGENTS

29

Johari SA, Mastura M, Sharifah Aminah SM, Mohd Fazli M, Azman M & Mohamad Jemain MR

OP1-15

ALARMING CEPHALOSPORIN AND FLUOROQUINOLONES RESISTANCE OF Salmonella IN A TERTIARY CARE HOSPITAL IN INDIA

30

Koganti K OP1-16

THE 2015 MIDDLE EASTERN RESPIRATORY SYNDROME EPIDEMIC IN SOUTH KOREA: HOW TO REDUCE TRANSMISSION IN CASE OF EPIDEMICS

31

Lee, W, Choo, D, Chung, D, Kim, E, Lee, J, Chung, S, and Park, S

OP1-17

SCREENING FOR LATENT TB INFECTION IN CHILDREN: A REVIEW OF CURRENT PRACTICE IN NORTH CENTRAL LONDON TB SCREENING SERVICE

32

Nazi, N OP1-18 MARK RELEASE AND RECAPTURE OF MALAYSIAN STRAINS Aedes albopictus(SKUSE) 33 Rozilawati H, Mohd Masri S, Tanaselvi K, Nazni WA, Lee HL

OP1-19

EVALUATION OF A FIELD-DEPLOYABLE REVERSE TRANSCRIPTION-INSULATED ISOTHERMAL PCR FOR RAPID AND SENSITIVE ON-SITE DETECTION OF ZIKA VIRUS

34

Carossino, M, Li, Y., Lee, P.A., Tsai, C., Chou, P., Williams, D., Skillman, A., Cook, F., Brown, G., Chang, H. G., Wang, H.T., Balasuriya, U.R.B.

OP1-20

OCCURRENCES OF ANIMAL ALLERGENS AMONG LABORATORY WORKERS AND RESEARCHERS

35

Vellayan Subramaniam, Qurratu Aini Aniqah Binti Sekaria, Gurmeet Kaur Surindar Singh OP1-21

THE RISK FACTORS OF TUBERCULOSIS (TB) COINFECTION AMONGHIV/AIDS PATIENTS IN BADUNG REGIONAL GENERAL HOSPITAL

36

Krisnahari KL, Citrajaya H, Sawitri AA

OP2-01 STRATEGIES FOR IMPROVED MANAGEMENT OF Acanthamoeba KERATITIS 37 Abjani F, Siddiqui R, Khan NA OP2-02 RABIES: WHAT NEEDS TO BE DONE TO PREVENT OUTBREAK 38 Gurmeet Kaur Surindar Singh, Vellayan Subramaniam OP2-03 PREVALENCE OF Leptospira IN ABATTOIR WORKERS, SLAUGHTERED ANIMALS AND

ABATTOIR ENVIRONMENT IN CAVITE, PHILIPPINES 39

Tabo, N.A., Villanueva, S.Y.A.M., and Gloriani, N.G.

OP2-04 IN-SILICO FUNCTIONAL AND STRUCTURAL CLASSIFICATION OF HYPOTHETICAL

PROTEINS FROM Streptococcus pyogens 40

Farina W, Kumar S OP2-05 PREVALENCE OF “BRAIN-EATING Amoebae” IN PUBLIC WATER SUPPLIES IN MALAYSIA 41 Khan, Naveed Ahmed; Siddiqui, Ruqaiyyah; Gabriel, Shobana OP2-06 ACUTE FEBRILE ILLNESS IN WEST PAHANG - AN ANALYSIS OF 341 HOSPITALIZED 42


viii

PATIENTS Mohd Thabit AA, Wan Ahmad Kamil WMR, Mohd Din MR, Arumugam M, Wan Azman SS,

Gian Singh SS, Abdullah R, Rosli NA

OP2-07 ANIMALS LIVING IN POLLUTED ENVIRONMENTS ARE POTENTIAL SOURCE OF

ANTIBACTERIAL 43

Foo YMW, Siddiqui R, Khan NA OP2-08 TEMPERATURE EFFECT ON THE ADULT AEDES Albopictus (SKUSE) LIFE DEMOGRAPHIC 44 Rozilawati H, Mohd Masri S, Tanaselvi K, Nazni WA, and Lee HL

OP2-09 HUMAN RIGHTS AND SOCIAL STIGMA REVIEW FOR LEPROSY PATIENTS IN KOREA 45 Park, SY

POSTER PRESENTATION PP1-01

PRECISE IDENTIFICATION OF DIFFERENT STAGES OF A TICK, Ixodes granulatusSUPINO, 1897 (ACARI: IXODIDAE)

46

Ernieenor FCL, Yaakop S, Mariana A, Ernna G, Shukor MN

PP1-02

A SCOPING REVIEW ON THE ASSOCIATION OF Burkholderia pseudomalleiWITH ENVIRONMENTAL AND CLIMATIC FACTORS

47

Yuvaneswary Veloo, Lim Kuang Hock, Siti Hajar Shahruddin, Ameerah Su’ad Abdul Shakor, Noor Safiza Mohammad Nor

PP1-03

EFFECTIVENESS OF SULFADOXINE AND PYRIMETHAMINE IN PREVENTION OF MALARIA IN PREGNANCY: IN SILICO PHARMACOLOGICAL MODEL

48

Htay, Mila Nu Nu, Hastings, Ian M; Hodel, Eva Maria; Kay, Katherine PP1-04

PRELIMINARY ANALYSIS ON THE EFFECT OF PROLONGED INCUBATION PERIOD IN BLOOD ON THE GENE EXPRESSION OF Burkholderia pseudomallei

49

Hii SYF, Ahmad N, Amran F. PP1-05

MOLECULAR CHARACTERIZATION OF METHICILLIN-RESISTANT Staphylococcus aureusCLINICAL ISOLATES COLLECTED FROM A TERTIARY TEACHING HOSPITAL IN KUALA LUMPUR OVER TWO YEAR PERIOD

50

Niek, W.K.,Teh, S.J., Kamarulzaman, A., Sam, I.C, Syed Omar, S.F., Sulaiman, H., Thong, K.L., Ponnampalavanar, S.

PP1-06

SEROTYPE DISTRIBUTION AND ANTIBIOTIC RESISTANCE AMONG INVASIVE PNEUMOCOCCAL ISOLATED FROM CHILDREN LESS THAN 5 YEARS OLD

51

Revathy Arushothy, Norazah Ahmad, Rohaidah Hashim, Nazirah Samsudin, Sakina Zainal PP1-07

SEROLOGICAL CROSS-REACTIONS BETWEEN Bartonella henselae, Bartonella quintana, Coxiella burnetiiAND Chlamydia SPECIES: IMPLICATIONS FOR DIAGNOSIS

52

Tay B.Y., Mohamed Zahidi J., Yee C. Y., Dolhan NQ, Arushothy R., Amran F. PP1-08

SEXUALLY TRANSMITTED INFECTION AWARENESS AND INFORMATION SEEKING ONLINE AMONG YOUNG PEOPLE

53

Shakir, S. M. M., Wong, L. P., Abdullah, K. L., Adam, P. PP1-09

CHARACTERIZATION, DISTRIBUTION AND GENETIC DIVERSITY OF Salmonella typhiIN MALAYSIA

54

Abd Hazis, N.H.,Hashim, R., Ahmad, N., Amran, F. PP1-10

COMMUNITY MOBILIZATION IN SUSTAINABLE DENGUE CONTROL BY USING SOCIAL MEDIA VIA „WHATSAPP‟ IN KINTA DISTRICT “PRELIMINARY STUDY”

55

Devarajah N,Loges V

PP1-11

KNOWLEDGE AND PRACTICE OF SALON WORKERS ON HEPATITIS B AND HEPATISTIS C VIRUS TRANSMISSION

56

Azmi NAB, Roslee AHB, Salam NAZB, Nazri NBM, Roy CKR


ix

PP1-12

THE ATTITUDE AND PERCEPTION OF YOUNG MALAY ADULTS IN IPOH, PERAK REGARDING CHILDHOOD VACCINATIONS

57

Azizan, Muhammad Hidayat, Mohamad Fakhruddin, Mohamad Nan, Resni, Mona PP1-13

GENETIC DIVERSITY OF Plasmodium knowlesiAMONG HUMANS AND MACAQUES POPULATION USING MICROSATELLITES MARKERS

58

NoorAzian MY,Afiqah SH, Mohd Ridzuan MAR, Nurhainis OS, Shamilah H

PP1-14

PREVALENCE OF ECTOPARASITIC INFESTATIONS: HEAD LICE AND SCABIES AMONG ORANG ASLI SCHOOL

59

Soe MM, Ismail S., Sugathan S., Singh D., Sinniah B., and Hassan AKR. PP1-15

GENETIC RELATEDNESS AND ANTIBIOTIC RESISTANCE PROFILING OF SalmonellaentericaSEROVAR ALBANY FROM FOOD AND ENVIRONMENTAL ISOLATES OBTAINED FROM WET-MARKETS IN MALAYSIA

60

Abatcha Mustapha Goni, Mohd Esah Effarizah,Gulam Rusul PP1-16 COMMON INFECTIONS IN THE ELDERLY PRESENTING TO PRIMARY CARE 61 CHAN SC, TEOH LC,HUSSAIN R. SAADI PP1-17 DISTRIBUTION OF EYE DISEASES IN KASUNGU DISTRICT, MALAWI, CENTRAL AFRICA 62 Kang, R., Kim, J., Chung, P., Hwang, H., Kim, J.S., Kim, H., Baek, S., and Talama, G PP1-18 HIV IN KASUNGU DISTRICT OF CENTRAL MALAWI - A DESCRIPTIVE CROSS SECTION

STUDY

63

Yoon, J., Kim, K. M., Lim, S., Kim, S., Chung, R., Park, S., Kachingwe, J., and Talama, G

PP2-01 SEASONAL INFLUENZA B VIRUS STRAINS CIRCULATING IN MALAYSIA FROM 2005 TO

2015 64

Mohd Zawawi, Z.,Tengku Abdul Rashid, T.R., Yusof, M.A., Thayan, R. PP2-02 TIME SERIES ANALYSIS OF DENGUE INCIDENCE IN PETALING, SELANGOR 65 Noraishah, MS, Rafiza, S and Mohd Shahar, AR PP2-03 FIRST REPORT OF VANCOMYCIN-INTERMEDIATE STAPHYLOCOCCUS AUREUS (VISA) IN

MALAYSIA 66

Hashim R., Baharudin S., Zulbadrisham NH.,Zainal S., Hamzah H., Dahalan NA., Amran F. and Ahmad N.

PP2-04 DISCOVERY OF NOVEL ANTIBACTERIAL(S) 67 Noor Akbar, Ruqaiyyah Siddiqui, Naveed Ahmed Khan PP2-05 KNOWLEDGE, ATTITUDE AND PRACTICE OF INFECTION CONTROL AMONG CLINICAL

YEAR MEDICAL STUDENTS OF A PRIVATE MEDICAL SCHOOL IN MALAYSIA 68

Sandheep Sugathan, Davinder Singh, Myint Myint Soe, Zatul Iffah Binti Mohamad Zabhi, Syafia Nabilah Binti Mohamad

PP2-06 PERFORMANCE OF GENEXPERT MTB/RIF ASSAY FOR RAPID DETECTION

OF Mycobacterium tuberculosis AND RIFAMPICIN RESISTANCE - A VALIDATION STUDY 69

Ramachandran Vignesh, Chinnambedu R Swathirajan, Sunil S Solomon, Pachamuthu Balakrishnan

PP2-07 KNOWLEDGE, ATTITUDE AND PRACTICE OF DENGUE AND ITS RELATED FACTORS AMONG VILLAGERS IN KAWASAN RUKUN TETANGGA (KRT) AULONG, SELATAN, LARUT, MATANG AND SELAMA, TAIPING PERAK

70

Hussain R. Saadi, Nur Farah Nabilah Bt. Shuib, Puteri Nurul Syuhadah Bt. Idris, Siti Fatimah Bt. Zainuddin, Muhammad Abdul Azim B. Mustapha, Shanna Asyeqeen Bt. Adzman, Hamizah Bt. Abdullah and Nur Farina Bt. Derahman.

PP2-08 KNOWLEDGE, PRACTICE OF PREVENTIVE MEASURES AND UNDERSTANDING HEALTH

PROMOTION RELATED TO DENGUE AMONG VILLAGERS IN KAMPONG SRI KINTA, IPOH-PERAK

71

http://www.sciencedirect.com/science/article/pii/S0956713515302528


x

Hussain R. Saadi, S Davinder, Rahul Sharma, Ahmad M. Harizan, Aqila M. Noor and Zharif F. Rahim

PP2-09 BETA-D-GLUCAN, A POLYSACCHARIDE AGAINST DENGUE VIRUS INFECTION IN VITRO 72 Ravindran Jaganathan PP2-10 CUTANEOUS LEISHMANIASIS IN IRAQ 73 Noor Abdulhaleem, Hind Younis, Mohammed Abdullah, Aliyu Mahmuda, Roslaini Abd

Majid, Leslie Than Thian Lung, Wan Omar Abdullate and Zasmy Unyah

PP2-11 ASSURANCE OF SAFE FOOD FOR ALL WITH HARMONIZATION OF STANDARDS SET

THROUGH INTERNATIONAL EFFORTS 74

Ahmed MK PP2-12 NUTRITIONAL STATUS OF ORANG ASLI SCHOOL CHILDREN IN SELECTED VILLAGES OF

PERAK 75

Soe MM,Sugathn S., Sabaridah I, Singh D., Sinniah B., and Hassan AKR PP2-13 ANTHROPOMETRIC PARAMETERS OF INDIGENOUS PEOPLES IN VARIOUS LOCALITIES IN

NORTHERN PENINSULAR MALAYSIA IN RELATION TO BLOOD PRESSURE, DIET AND LIFESTYLE

76

Nik Asyraf Nik Aziz, Abdul Karim Russ Hassan, Sandheep Sugathan PP2-14 ANTIBIOTIC SUSCEPTIBILITY OF Staphylococcus aureus FROM SUBURBAN POPULATION

AND CHILDREN OF WELFARE HOMES IN PERAK, MALAYSIA 77

Nur Amirah R., Cheah T. S. and Davinder B. S. PP2-15 ANTIBIOTICRESISTANT Staphylococcus aureusFROM INDIGENOUS AND URBAN POOR

COMMUNITY IN PERAK 78

Unwaniah, A. R., Cheah, T. S., and Sabaridah, I. PP2-16 MEASLES: AN INSIGHT INTO AWARENESS OF THE DISEASE AND ITS VACCINATION

AMONG PARENTS IN A RESIDENTIAL AREA IN IPOH, PERAK 79

Davinder S, Sandheep S, Siti Munirah MY, Nuruljannah A, Mohd Fadlin Syafiq MF. PP2-17 INTESTINAL PARASITIC INFECTIONS AMONG ORANG ASLI CHILDREN IN RELATION WITH

SELECTED SOCIODEMOGRAPHIC FACTORS 80

Ismail S, Soe MM, Sinniah B, Hassan AKR, Singh D, Sugathan S. PP2-18 A DESCRIPTIVE STUDY ON PREVALENCE OF OPPORTUNISTIC INFECTION AMONG

HIV/AIDS INDIVIDUALS IN OUTPATIENT CLINIC IN A HOSPITAL IN IPOH 81

Farah Farzana Binti Ansari, Sharmila Nani and V.Gopalakrishnan PP2-19 A RETROSPECTIVE STUDY OF DIRECTED BLOOD DONATIONS IN THE KASUNGU DISTRICT

OF MALAWI 82

Chung, D., Shen, F., Lee, S., Ko, J., Kong, T. K., Choe, J. Y., and Talama, PP2-20 INFECTIONS WITH METHICILLIN-RESISTANT Staphylococcus aureus (MRSA) IN

PATIENTS ATTENDING TENGKU AMPUAN AFZAN HOSPITAL (HTAA) IN KUANTAN, PAHANG, MALAYSIA

83

Mustafa Mahmud M.I.A., Alarosi M.A., Amjad N.M. and Saxena A.


1

PLENARY PL1-01

Microbes as Weapons of Mass Destruction –Potential Threats and Preparedness Byung-Il Yeh Wonju College of Medicine, Yonsei University, Republic of Korea

On the 28th, May in 2015 a news that the live Bacillus anthrax bacteria was delivered to American Forces at Pyungtaek and Osan Camp in South Korea knocked Koreans completely. Eight days before then, MERS (Middle East Respiratory Syndrome) began to be prevalent in South Korea and this is one of the reasons anthracis couldn‟t attract big attentions but many people began to recognize Biological Warfare Agents(BWAs) is available at present ages. Anthrax is one of the diseases provoked by biological warfare agents which were well known by worldwide White Powder terror attack just after airplane terror in America, 2001. In 1975, Biological Warfare Convention (BWC) was established to control and check the spread of BWAs, which are composed of microbiological and toxic agents. Historically, microbiological warfare agents have caused big changes such as falls of Aztec and Inca Civilization by smallpox outbreak. During the Second World War, Japanese and German Army operated the 731 Unit and Auschwitz concentration camp to perform human experiments to test the effects of microbiological and chemical warfare agents. In fact, the possibility to use BWAs to defeat enemies during the war is not so high, and only toxic agents can be used to kill some important people like an example of Jong-nam Kim at Kuala Lumpur Airport last year. They are considered as one of the big threats because it‟s very cheap and easy to develop. I‟m going to discuss why BWAs constitute menaces and how we can prevent the threats of BWAs.


2

SYMPOSIUM 1 - VACCINATION SP1-01

Issues in Childhood Vaccination Aminah Bee Mohd Kassim Family Health Development Division, Ministry of Health (MOH), Malaysia

Immunisation is a simple, safe and effective way of protecting children against certain diseases. However WHO estimates that 29% of deaths among children 1-59 months of age could have been prevented through vaccination. Recently there has been a surge in the number of cases of vaccine preventable disease and this has been attributed to the increasing number of vaccine refusal. However issues on childhood immunisation is not solely attributed to vaccine refusals. There are two main causes that affect childhood immunisation. One is provider related, that is factors inhibiting or limiting immunization programmes such as poor governance, low commitment, weak surveillance etc. The other cause is recipient related namely factors such as beliefs and attitude, medical reasons, accessibility etc. In ensuring high immunisation coverage, Ministry of Health (MOH) has increased its efforts in training of health personnel, health promotion and education, and the use of social media to reach the community.


3

SP1-02

Quality Control in Vaccines B. Sekar Pasteur Institute of India, Coonoor, Nilgiris, Tamil Nadu, India

Vaccine, a biological product is derived from living organisms with a molecular composition too complex to be defined by physical or chemical means. The quality control in vaccine manufacturing always relied on three components: I. Control of the starting materials; II. Control of the production process; and III. Control of the final product; and these can be assured through implementation of the following principles: i)Characterization of starting materials: The use of adequately characterized homogeneous starting materials of defined origin and acceptable quality mainly relies heavily on testing and also on supplier audits to ensure that the relevant characteristics remain unaltered between lots. ii)Validation of the production process: Validation is the establishment of documented evidence that a system does what it is supposed to do. It involves the systematic study of systems, facilities and processes aimed at determining whether they perform their intended functions adequately and consistently, to provide a high degree of assurance that uniform batches of vaccine will be produced to meet the required specifications. iii)Demonstration of consistency of production: A validated vaccine production process will result in a consistent product. This means that the critical process parameters of the vaccine, usually measured by the in-process and final product specifications, are consistently met through validated analytical methods using standard testing procedures for different production runs, to ensure, that the vaccine concerned will be safe and effective when administered to the target population. iv)Independent lot release: Independent lot release by a National Regulatory Authority provides a vital check on a manufacturer's performance in controlling a production process and the test methods. As a minimum, it is based on review of the summary lot protocols, which contain details of that particular lot. In addition, some selected laboratory testing can be carried out. v)Post-marketing surveillance: Is an important tool for monitoring vaccine safety and efficacy by measuring case reduction. Adverse events, although rare, occasionally follow immunization with vaccines. These events are occasionally due to intrinsic characteristics of the vaccine, but mostly due to other causes- as a result of programmatic errors, mainly mishandling of vaccines and/or inadequate immunization practices.


4

SYMPOSIUM 2 - ANTIMICROBIAL DRUG RESISTANCE

SP2-01

Drug Resistant Bacteria in Health Care Setting and Community Yuki Uehara Juntendo University, Tokyo, Japan

Healthcare- and community-associated drug resistant bacteria are the worldwide concern, but it is difficult to monitor resistant bacteria in appropriate ways because the recent definition of healthcare- or community-associated strains is based on clinical information, such as exposure to hospital environment, long-term care facility, hemodialysis and surgery.To discuss on feasible and sustainable monitoring of resistant bacteria by reviewing the epidemiology of community-associated MRSA (CA-MRSA) and healthcare-associated MRSA (HA-MRSA) in Japan.Molecular typing of MRSA strains sent to our laboratory, with referring the data of Japan National Infection Surveillance (JANIS) and other published articles.After 2010, our laboratory found: 1) Transmission of PVL-positive MRSA including USA300 in households, which was recognized as CA-MRSA skin and soft tissue infection (SSTI). 2) Transmission of USA300-like strains as HA-MRSA SSTI or bacteremia in NICU, 3) A regional, pediatric cluster of ST834-SCCmec IVc-tst (+) CA-MRSA SSTI, and 4) SCCmec II and SCCmec IV with multiple subtypes were equally isolated as CA-MRSA and HA-MRSA in a Japanese hospital. A large investigation of MRSA isolated from skin or pus in outpatient setting also reported that SCCmec II and SCCmec IV were comparably isolated after 2010 in Japan but clinical definition of CA-MRSA or HA-MRSA was not known. JANIS data of 2015 showed all 1,436 institutes participating in JANIS experienced MRSA cases, but the prevalence of CA-MRSA was unclear. Large strain-based surveillance is beneficial to know the nationwide status of MRSA, but strains with clinical information were advantageous to know differentiation of CA-MRSA and HA-MRSA, detailed molecular typing, uniqueness of Japan and clinical picture of diseases.Annual fixed-point surveillance of MRSA with clinical information seems reasonable to monitor the change of epidemiology.


5

SYMPOSIUM 3 - METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS

SP3-01

Emergence of Community-Associated Methicillin-Resistant Staphylococcus aureus (MRSA) in Indigenous Population with Particular Reference to Australia Asha Bowen Department of Infectious Diseases, Princess Margaret Hospital for Children and University of Western Australian

Indigenous Australians suffer a disproportionate burden of Staphylococcus aureus infection, compared to their non-Indigenous counterparts. The burden is more than six-fold higher and predominantly driven by skin and soft tissue infections. In addition, the burden of methicillin resistant S. aureus (MRSA) is higher in Indigenous Australians, with the proportion of MRSA infections continuing to rise. Panton valentine leucocidin (PVL) positive clones including sequence type (ST) 93 cause severe disease with necrotising pneumonia, multifocal abscesses and other deep tissue collections seen frequently in Indigenous patients. In northern Australia, MRSA infections now account for 50% of S. aureus bacteremia with these infections predominantly affecting Indigenous people. Novel treatments to improve patient outcomes are needed, as mortality from MRSA bacteremia exceeds methicillin susceptible S. aureus (MSSA) bacteremia. One such study underway is exploring the utility of flucloxacillin in addition to vancomycin for treatment of MRSA bacteremia (the CAMERA trial). The pilot study showed a non-significant reduction in time to resolution of bacteremia from 3 days to 2 days. New agents have recently been identified to treat MRSA skin and soft tissue infections. These may improve the outcomes of Indigenous Australian patients with MRSA infections and will be discussed.


6

SP3-02

Methicillin-resistant Staphylococcus aureus in the Community in Malaysia Cheah Tong Soon Universiti Kuala Lumpur Royal College of Medicine Perak, Ipoh

In Malaysia previous studies on community-acquired methicillin-resistant Staphylococcus aureus (MRSA) are mainly based on isolates from patients in hospitals. In the present investigation, a cross sectional study was conducted and nasal swabs were collected from the individuals who were present at the collecting centres. The following populations were involved in the study: indigenous peoples (234), individuals in the urban poor community (164), people in the suburban community (184) and children from welfare homes (95) in Perak. Written consents were obtained from the individuals before the collection of samples. Nasal swab samples were collected from both anterior nares of the volunteers. The nasal swabs were placed in a transport medium and stored in an ice chest and brought back to the laboratory for microbiological investigations. The isolates were identified as Staphylococcus aureus based on the morphology, detection of clumping factor and protein A using a rapid slide agglutination test (BactiStaph Remel, USA). The methicillin-resistant phenotype of staphylococci was identified with penicillin binding protein (PBP2‟) latex agglutination test (Oxoid, UK) according to the manufacturer‟s instructions. Extraction of S. aureus DNA was conducted with Plasmid DNA kit (Bio Basics, USA) and mecA was detected using PCR. Detection of Panton-Valentine Leucocidin (PVL) gene was conducted on the S. aureus isolates. Fifty-eight out of 234 (24.8%) nasal swabs from the indigenous people were positive for S. aureus, while 36 out of 164 (22%) of the urban poor community had S. aureus. A total of 6 S. aureus isolates from the indigenous people and another 3 isolates from the urban poor community had mecA gene respectively. One isolate from urban poor community had PVL gene. Twenty-five out of 184 (13.6%) nasal swabs from of the suburban community were positive for S. aureus, while 22 out of 95 (23.2%) children from the welfare homes had S. aureus. Three S. aureus isolates from the welfare homes carried mecA gene and none from the suburban populations. The PVL gene was not detected in all the 3 isolates. The findings of MRSA in indigenous population, urban poor community and welfare home children constitute a first record in Malaysia. Similarly the presence of PVL gene in the S. aureus isolate from the urban poor population is reported for the first time in this country. The significance of these findings in relation to the studied populations in the community in this country will be discussed.


7

SYMPOSIUM 4

SP4-01

Western Australia Mumps Outbreak Highly Vaccinated Aboriginal People; Lesson Learned Darren Westphal Communicable Disease Control Directorate, Public Health Division, Department of Health, Western Australia

On average, 23 mumps cases are notified annually in Western Australia (WA). This primarily reflects overseas acquisition with limited local transmission of mumps. In 2007 and 2008 there was a genotype J mumps outbreak largely affecting remote-living Aboriginal Western Australians. We describe an even larger genotype G mumps outbreak that commenced in the same remote region in March 2015 before spreading to other remote parts of the state and metropolitan boarding schools.Mumps is notifiable in Australia. Cases were either laboratory confirmed or epidemiologically linked to a laboratory-confirmed case. Laboratory diagnosis was by polymerase chain reaction and/or serology. Case information was ascertained through follow-up by Public Health Nurses/Practitioners. We described demographic characteristics, vaccination status, and outbreak control activities including a third dose of the measles-mumps-rubella vaccine (MMR). Between 3 March 2015 and 31 December 2016, 893 outbreak-related mumps cases were notified. Of these, 89% were Aboriginal and 51% were male. The highest proportion of cases was among Aboriginal Australians aged between 10-19 years. Of cases <40 years, 15% were partially and 83% fully vaccinated against mumps. In communities where a third dose of MMR was offered, further transmission may have been prevented.This is another example of a growing number of mumps outbreaks reported in recent years among highly vaccinated populations. It is exceptional that this outbreak disproportionately affected remote-living Aboriginal Western Australians and just 7 years after the first outbreak. The third dose of MMR appeared to be an effective outbreak control method. Further studies that help to explain the apparent higher susceptibility of Aboriginal people in WA to mumps are planned.


8

SYMPOSIUM 5

SP5-01

Diarrhoeal Diseases in Children Rashidul Haque Infectious Disease Division, International Centre for Diarrheal Disease Research, Bangladesh

According to the WHO Diarrheal disease is the second leading cause of death in children under five years old, and responsible for killing around 500,000 children every year. Diarrheal disease is also associated with malnutrition in children.Diarrheal diseases account for 1 in 9 child deaths worldwide. Over the last two decades, we have made steady progress in reducing death due to diarrhea in children, with total deaths declining from 2.5 million in 2001 to 0.5 million in 2015. This remarkable reduction was possible due to the inception and success of many universal programs like expanded program on immunization, program for control of diarrheal diseases and new knowledge gained over the years on the etiology, management and prevention of diarrhea. Public health interventions rely on estimates of pathogen specific burden for prioritisation. Previous estimates of the infectious causes of diarrhoea have been derived from studies that used varying approaches for pathogen detection, including different bacterial culture media, stool concentration techniques, and detection methods. Molecular detection of diarrheal pathogens have been developed recently and been used to reassess estimates of pathogen-specific diarrhoea causes and incidence at the population level. Two multi-center studies have been completed recently and provided diarrhoea aetiology using quantitative molecular diagnostics for 32 enteropathogens. Use of quantitative real-time PCR led to revised estimates of global diarrhoeal burden. The most attributable pathogens were Shigellaspp, rotavirus, adenovirus 40/41, heat-stable enterotoxin-producing E. coli, entero aggregative E. coli, Cryptosporidium spp, Campylobacter spp, Giardia and Norovirus. For prevention of diarrheal diseases, Rotavirus vaccine has been introduced in more than 40 countries. Cholera vaccine has been developed and large scale phase III trials have been conducted. Shigella and ETEC vaccines are under development and phase II studies are underway. Cost-effective interventions is important to reduce the burden of diarrhea among children.


9

SYMPOSIUM 6

SP6-01

Influenza Surveillance in Southern Vietnam Nguyen Vu Thuong Pasteur Institute in Ho Chi Minh City, Vietnam

Vietnam established its national influenza surveillance system in 2006, with an aim to understand and monitor the epidemiological pattern and extent of influenza infection among patients with influenza-like illness (ILI), severe acute respiratory infection (SARI), and severe viral pneumonia (SVP). In southern Vietnam, this surveillance system includes 2 sentinel sites for ILI, 4 sentinel sites for SARI, and all district and higher-level hospitals for SVP. Our current analysis of data for the period 2012-2016 showed the high prevalence of influenza virus infection among 2,741 samples collected from ILI patients (23.7%). Influenza A virus subtype H3N1 was detected in 53 per cent of the sample-positive patients with ILI. Among 2,332 SARI patients recruited and tested, the influenza viruses and other pathogens were identified in 482 (20.7%) and 495 (21.2%) individuals, respectively. The influenza viruses were present in over a quarter of SVP patients (26.2%). Of note, the highly pathogenic avian influenza (HPAI) A (H5N1) virus was detected in 7 SVP patients over 2012-2014: 3 cases in 2012, 2 cases in 2013, and 2 cases in 2014. For two years (2015-2016), there has been no detection of the HPAI A viruses among patients with SVP. An additional effort has been recently made to explore the microbial causative agents of SVP among the sample-negative patients. With a high burden of influenza and the critical threat of HPAI A (H5N1) virus in southern Vietnam, continuing influenza surveillance is important for a better understanding of the epidemiological trends of influenza types, especially the circulation of the HPAI A viruses.


10

SYMPOSIUM 7 - ZIKA VIRUS: SOUTH ASIA‟S EXPERIENCE

SP7-01

Zika Virus- Vietnam‟s Experience Luong Chan Quang Department for Diseases Control and Prevention, Vietnam

For the past year, Vietnam has been working to detect and response for Zika virus (ZIKV) epidemic. A ZIKA surveillance system was established using the existing sentinel surveillance system for Dengue. More than 60 sites of southern provinces including either provincial or district hospitals were targeted. All participating sites collected blood and urine samples for ZIKV testing mainly from outpatients that met the case definition. A ZIKV patient was defined by the detection of ZIKV RNA by using real-time RT-PCR. From February to September of year 2016, only 2 ZIKV cases were detected among 1,139 clinical patients, with positive rate as 0.2%. While during last 3 months of year 2016, 211 ZIKV cases were detected among 1,044 clinical patients with positive rate as 20.2%, hundreds times more than previous period of time. Most of cases was adult when 86% ZIKV cases was above 20 years-old. Rash is the popular symptoms of ZIKV. 98% ZIKV patients got rash, in comparing to DENV and negative patients as 80% and 60%, in respectively. Most of ZIKV cases was sporadic in 10 provinces. No any cases had any epidemiolgical relationship. Few cluster of ZIKV was detected and all of them were members in the same family. As ZIKV is a mild disease, patients may like to visit private clinics as primary health facilities instead of hospitals. One additional sentinel ZIKV surveillance system was established in all private clinics in one epidemic district. In fact, most of patients (112 patients) went to district hospital, in comparing to 31 patients in private clinics of the same district. ZIKV positive rate in district hospital was as same as in private clinics. In conclusion, ZIKV surveillance system year 2016 can detect timely ZIKV cases and ZIKV epidemic in southern Vietnam, especially from district hospitals.


11

SP7-02

Zika Virus- Indonesia‟s Experience Elizabeth Jane Soepardi Surveillance and Health Quarantine, Ministry of Health (MOH), Indonesia

Zika global situation had been worsen since Brazil reported Zika to World Health Organization (WHO) in May 2015. WHO declared Zika as Public Health Emergency International Concern (PHEIC) on 1st February 2016. This condition worsen by the neurology impact for patient moreover the possibility Zika spread globally. Indonesia as the endemic country of dengue and classified by WHO as country with evidence of virus circulation before 2015 or area with ongoing transmission that is no longer in the new or re-introduction phase, but where there is no evidence of interruption. Provided by some research of Zika Virus (including the presence of antibody) in Indonesia which have done by Olson 1981, Olson 1983, Kwong 2013, Leung 2015 and Perkasa 2016.Indonesia has Zika strategic control in line with global strategic which consisting 4 components that are detection, prevention, care and support, and research. First, the detection point focus on using the Zika surveillance system installed before with strengthening public health laboratory capacity. The second point in prevention, Indonesia focus on vector control including the public engagement, supported by risk communication in normal or critical situation. For the care and support point, Indonesia focus on strengthening referral hospitals which have different classification and spread in all Indonesia‟s area. Then, the research point, Indonesia focus on Immunology study and integrated survey in human and vector. The Zika control and prevention in Indonesia is still lacking because there some problems like the limited amount of laboratory for confirmation of Zika; inadequacy of Zika detection (lacking information and capacity at clinician); and the limited care and support for the family who have baby with the microcephaly and other central nervous system (CNS) malformations potentially associated with Zika virus infection, or suggestive of congenital infection.


12

SYMPOSIUM 8 - ZIKA VIRUS: SOUTHEAST ASIA‟S AND SOUTH AMERICA‟S EXPERIENCE SP8-01

Zika Virus- Malaysia‟s Experience Rose Nani Mudin Vector Borne Disease Sector, Disease Control Division, Ministry of Health (MOH), Malaysia

In March 2015, Brazil notifies WHO of an illness characterized by skin rash in north-eastern states. WHO came out with Epidemiological Alert in May 2015, on the outbreaks of Zika fever in different regions of the world, demonstrate potential spread of this arbovirus across territories. Since then, Brazil has reported thousands of Zika confirmed cases including microcephaly and Guillain Barre Syndrom related to Zika virus infection. On February 1st, 2016, the Director-General of WHO declared that the recent association of Zika infection with clusters of microcephaly and other neurological disorders constitutes a Public Health Emergency of International Concern. Following the WHO announcement, Malaysia has established the National Zika Experts committee which consists of Public Health Physicians, Infectious Disease Specialists, clinicians, virologist and Health Education officers. This committee is responsible for the development of guidelines and policy on management of Zika virus and giving advice to the top level management on issue related to Zika infection. Ministry of Health Malaysia has developed a Standard Operation Procedure (SOP) for Surveillance and Management of Zika Virus Infection. In February 2016, through the Director General of Health instruction, the SOP has been distributed to all Health State Departments, Association of General Medical Practitioner, universities and the related agencies. The SOP includes strengthening the clinical surveillance in hospitals and clinics, lab surveillance, surveillance of Microcephaly and Guillain–Barré syndrome. Between 31st August 2016 until 14th December 2016, there were eight Zika confirmed cases reported in Malaysia. Two out of the eight cases were identified as French Polynesia strain through virus sequencing test and the remaining were from Micronesian strain. The laboratory Zika surveillance system that has been established earlier in mid-year 2015 by MOH, is further strengthened with the existence of this SOP. This surveillance is performed by National Public Health Laboratory (NPHL) and Institute for Medical Research (IMR) and from June 2015 until 19th November 2016, a total of 1,571 samples of blood and urine from patients who had similar symptoms to Zika virus, were found to be negative test results. Monitoring at the point of entry has been strengthen and Health Alert card on Zika has been distributed to visitors mainly from the country affected with Zika. In between January to November 2016, about 5,818,981 people have been screened at the point of entry. The preventive and control actions towards each case reported to MOH were conducted within 48 hours after the notification. These include search and destroy activity, thermal fog, ULV, larvaciding, health education activity including applying repellent and using of aerosol spray indoors and active case detection. In the current containment phase, focus will be on rapid response, early accurate diagnosis, research, risk assessment and strategic risk communication.


13

SP8-02

Zika Virus- South America‟s Experience Rodrigo Teixeira Amancio Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, Brazil

Zika virus (ZIKV) is a flavivirus, first isolated from a serum specimen from a rhesus monkey in the Zika Forest of Uganda in 1947, transmitted by many Aedes spp. mosquitoes, including Ae. africanus, Ae. luteocephalus, Ae. hensilli and Ae. Aegypti. After 2007, a geographic expansion of the virus was observed, including outbreaks in the Pacific region and, more recently, in South America. ZIKV infection, reached a huge global importance after, December 1, 2015, when The Pan American Health Organization (PAHO) and the World Health Organization (WHO) published an alert about a possible association with congenital abnormalities and Guillain-Barré syndrome (GBS), which later was stated as cause of GBS and of microcephaly and other congenital brain abnormalities. Brazil reported the first autochthonous case of Zika virus disease in April 2015, and subsequently, increasing numbers of cases have been diagnosed, observing concomitantly an outbreak of microcephaly, predominantly in the northeast, related to virus infection. In Brazil, during 2016, 215,319 suspected cases of Zika fever were registered, and among those, eight deaths caused by Zika virus were confirmed. In 2017, 9,351 suspected cases of Zika fever were computed, and among those 3,356 had laboratorial confirmation; none death related to Zika were laboratory confirmed. In Brazil the suspected cases and incidence of Zika Virus fever significantly decreased in 2017. Due to the complications related to Zika virus infection, in addition to the search for therapeutic strategies, etiological surveillance strategies are necessary to understand virus acquisition over time, as well as its spreading process, making possible to direct efforts to a better control of the Zika Virus infection. Data from South America will be presented, more specifically in Brazil, as well as the report of the experience we have with the infection by Zika virus in our country.


14

INDUSTRY SYMPOSIUM

IS1-01

Influenza Vaccination in High Risk Population Wan Noraini Wan Mohamed Noor Infectious Disease Surveillance Section Disease Control Division Ministry of Health Malaysia

Influenza is frequently mistaken with the common cold. Though they both share some similar symptoms, influenza is more severe and can lead to further complications. The influenza virus types A and B cause considerable morbidity and mortality worldwide. The WHO estimates there are 3-5 million severe cases and up to 500,000 deaths annually. Seasonal epidemics occur in temperate countries, while the disease occurs year-round in tropical regions. The burden of influenza in the tropics is understudied, although available evidence indicates it is similar to temperate countries. In Malaysia, the Malaysia Influenza Surveillance Protocol (MISP) outlines the epidemiology-based data collection which includes age-group categorization. The WHO recommends seasonal influenza vaccination for pregnant women as the highest priority, and other risk groups including children aged 6 months to 5 years, elderly individuals aged >65 years, individuals with chronic medical conditions (such as chronic heart or lung diseases, diabetes and HIV/AIDS), and healthcare workers. The rationale for vaccinating these high-risk groups will be outlined. Quadrivalent vaccines covering two influenza A types and both influenza B lineages are now recommended. However, vaccines are underused in Asia-Pacific countries such as Malaysia when compared to Europe and the Americas. Greater understanding and communication of the burden of disease in high-risk groups in Malaysia are required to inform policies to prevent influenza.


15

IS1-02

Dengue: Vaccine Preventable Diseases Petrick Periyasamy Infectious Diseases Unit, Medical Department, UKM Medical Centre

Dengue disease is the fastest spreading mosquito-borne viral disease globally. Malaysia reported a total of 101,357 dengue cases with 237 deaths in 2016. Dengue has four virus serotypes (DENV-1, DENV-2, DENV-3 and DENV-4). Dengue symptoms can range from mild undifferentiated fever to Dengue Shock Syndrome. Unfortunately, there is no specific antiviral therapy for this disease. Hence, the development of an effective tetravalent (against all four serotypes) dengue vaccine alongside efficient vector control measures is integral in reducing the Dengue disease burden globally. There are a few dengue vaccines which are currently in the different phases of development. Dengvaxia is the first and currently, the only licensed dengue vaccine in the world. It is a recombinant, live-attenuated tetravalent dengue vaccine and is administered as three doses, six months apart. There have been multiple clinical studies conducted on Dengvaxia with Phase III results highlighting the vaccine‟s efficacy against virologically-confirmed symptomatic dengue cases, severe dengue cases and hospitalised dengue cases. These clinical studies also highlighted the vaccine‟s safety profile with the common adverse events being fever, headache, and myalgia and injection site pain. The immunogenicity levels elicited in adults in comparison to the younger age groups (adolescent and children) are comparable, post-vaccination. Overall, 25 clinical studies have been conducted on this vaccine (involving more than 40,000 individuals) with 23 of these studies having achieved completion. The remaining two studies/Phase III studies are currently ongoing and will achieve completion in 2017. There have been 16 countries worldwide which have registered the dengue vaccine, with countries such as the Philippines and Brazil having both public and private programmes. Majority of the 16 countries which registered Dengvaxia have an age indication of 9-45 years old, with a few exceptions.


16

ORAL PRESENTATION

OP1-01

Development and Validation of an In-House ELISA for Detection of T. Gondii Specific Immunoglobulin G Antibodies in Human Sera Koganti K

Help Hospital, India

Urinary tract infections are common illness in the community. In India and many other low and middle income countries presumptive antibiotic therapy is given to majority of patients without performing urine cultures. This leads to alarming antibiotic resistance and significant economic burden to the patients when the initial presumptive antibiotic treatment fails. To assess antimicrobial resistance pattern of E.coli and the role of Polymyxin B in urinary tract infections. A prospective study was conducted at our hospital in Guntur, Andhra Pradesh over six months from November, 2016 to April, 2017. We collected isolates of E.coli from patients with febrile urinary tract infection. Identification of bacteria and antibiotic susceptibility testing were performed on Vitek 2 (automated identification and sensitivity equipment based on CLSI guidelines). Multi drug resistant E.coli were defined as strains resistant to at least two groups of antibiotics in addition to extended spectrum beta lactamase (ESBL) positivity. Out of 249 positive urinary cultures, 177 were E.coli isolates. Among the total 177 cases, 73 were males and 104 were females. Of these 162 (91.5%) were ESBL positive. Further 93 (52.5%) isolates were multidrug resistant. Of these 177 patients, 108 patients had history of recent antibiotic usage. Multi drug resistance was proportionately higher (62%) in those who were exposed to recent antibiotic therapy when compared to those who didn‟t use antibiotics (37.6%). The most frequently encountered comorbidity is diabetes, seen in 45 (25.4%) patients. Pyelonephritis was observed in 29 (16.3%) cases and relatively more common in those who were exposed to antibiotics recently, 17 (58.6%) cases vs 12 (41.4%) cases, when there wasn‟t prior antibiotic usage. Polymyxin B appears to be the only single most effective antibiotic with almost 100% sensitivity in 16 tested multidrug resistant isolates. (Polymyxin B was tested only in those multidrug resistant cases, when only two or less than two antibiotics were sensitive in those MDR E.coli isolates). There is an alarming increase of ESBL producing and multidrug resistant E.coli isolates in the last few years. Urine cultures must be done in all the patients before starting presumptive antibiotic treatment. Drugs like Polymyxin B should be kept as reserve and used only when really required.


17

OP1 – 02

Computational Structural, Functional Classification and Identification of Novel Drug Target in Burkholderia cepacia ATCC 25416 Revati K, Kumar S Management and Science University, Selangor, Malaysia

Burkholderia cepacia is an aerobic and a bacillus shaped gram negative bacteria. Burkholderia cepacia is known as opportunistic human pathogen since it causes infection to immunocompromised patients with underlying disease such as cystic fibrosis or chronic granulomatous disease causing these patients to suffer from pneumonia. Due to constant evolution of this species, Burkholderia cepacia became more resistant towards antibiotics and this made even more difficult to treat patients who are suffering from the infection of this species. The aim of our study is to functionally and structurally annotate 949 hypothetical proteins of Burkholderia cepacia ATCC 25416as well as to identify novel drug targets by using combination of various bioinformatics tools as well to identify the potential drug target by using subtractive genomics approach. Various protein databases such as CDART, Interproscan, SVMprot and Pfam was used for function prediction. CELLO was used for subcellular localization, subtractive genomic done by using blastp and DEG databases. These potential drug were modelled using phyre2 and finally Virulentpred was used for virulent prediction and drug bank was used novel drug target prediction. The result showed that 420 protein sequences have well defined functions out of which 26 potential drug target was identified through subtractive genomics and finally six novel drug target was identified.


18

OP1 – 03

Evaluation of the Antimicrobial Effect of Expired Oral Antibiotics Alghasham Kawthar Almoosa Hospital, Saudi Arabia

In spite of significant risks, as well as non-clinical importance due to loss of potency, stiff penalties against administration of expired medications are still not appropriately enforced by health policy makers in many developing countries, possibly because of little evidence to support that expired medications are hazardous. Drug expiration date, which is mostly two to three years after the drug is manufactured, except in some cases, is the specific date until which the medication will be effective, if stored under proper conditions of light, temperature and moisture but if not stored under suggested conditions, the medications may lose potency even before the expiration dates. Whereas, in spite of warnings that medications that have passed their expiration can pose significant risk, and that it is extremely important to properly dispose of expire medications to avoid serious injuries to older adults and children. Not all scientists still agree that expired medications are unsafe. It has even been reported that many drugs stored under reasonable conditions retain 90% of their potency for at least five years, and sometimes much longer, after the expiration date on the label, while some further claimed that expiration date is a very conservative marketing ploy by drug manufacturers to keep consumers in restocking their medicine cabinets. Some studies provided preliminary microbiological results on the appreciable reduction in vitro bacteriostatic potentials as well as higher resistance and multiple antibiotic resistance rahc among expired oral antibiotics apanit from less-efficacy, administration of expired antibiotics can lead to increased antibiotic resistance and clinical faultier as well as adverse drug reaction.


19

OP1- 04

Infection Due to “Brain-Eating Amoebae”: Novel Chemotherapeutic Approach Yu TYO, Khan NA, Siddiqui R Department of Biological Sciences, School of Science and Technology, Sunway University, Selangor, Malaysia

Naegleria fowleri is a protist pathogen that can cause lethal brain infection known as primary amoebic meningoencephalitis (PAM). The most distressing aspect is that the fatality rate has remained more than 98%, despite our advances in antimicrobial chemotherapy and supportive care. Amoebae enter through the nose to enter the central nervous system killing the host within days. This infection is associated with religious, recreational, and cultural practices such as swimming, ritual ablution and/or purifications, Ayurveda, and the use of neti pots for nasal irrigation. With increasing water scarcity and public reliance on water storage, there is a need for increased awareness of primary amoebic meningoencephalitis and the associated risk factors, particularly in developing countries. Currently, the drug of choice for treatment of N. fowleri infection is amphotericin B. However, its use is associated with multiple side effects. Moreover, as treatment is via the intravenous route, there is limited blood brain barrier (BBB) penetration. For the first time, here we propose the use of the intranasal route as a portal for administering drugs. In our study, we induced PAM by inoculating amoebae via natural intranasal route in the C57BL/6 mice. The intravenous and intranasal treatment is instituted once the symptoms of PAM develop over 4-5 days. The clinical and behavioural improvements are interpreted. The proposed route offers clear benefits over the conventional intravenous route, in that it will overcome BBB hindrance, minimal adverse effects, topical administration and dose adjustment at a faster pace, enable the use of water soluble drugs to attain minimum inhibitory concentration at the epicenter of infection, and have the potential in the successful treatment of infection due to brain-eating amoebae.


20

OP1-05

Empirical Treatment and Susceptibility Pattern of Pathogens in Urosepsis: Does It Match? A Study from a Tertiary Care Center Anandhalakshmi S, Sandhya Bhat K, Sudhagar M, Patricia Anitha K,Sangeetha A V, Desdemona Rasitha, Reba Kanungo Pondicherry Institute of Medical Sciences, India

Urosepsis is life-threatening infection, unless treated immediately. Empirical treatment with appropriate antibiotics lowers the risk of a poor outcome. However with increasing resistance among common uropathogens, there is a need to review the existing protocol. This study was conducted to determine the bacteriological profile, antibiotic susceptibility pattern of the uropathogens, its correlation with empiric therapy and the outcome associated with urosepsis. A prospective study was carried out on 66 confirmed cases of urosepsis from January 2016 to June 2017 after obtaining ethical clearance. Demographic details, risk factors, length of hospital stay, bacteriological profile, empirical antibiotic given and change in antibiotic following susceptibility report and outcome was recorded. Among the proven cases of urinary tract infection urosepsis accounted for 1.9%. Escherichia coli was the predominant isolate (94%). Organisms showed least resistance to imipenem (1.5%) followed by cefoperazone-sulbactam (11%) and piperacillin-tazobactam (8%). Among the urosepsis cases 63 of them were started on empirical antibiotic. Eighty percent of the empirical antibiotics given were found to be susceptible in vitro. The remaining 20% of cases where changed over to different antibiotic, based on susceptibility report. The mortality rate was 15.1% with a confidence interval of 15 ±3.5.The mortality rate of urosepsis in various studies ranges from 20 - 40%. In our study it was 15% which is comparatively less. The usage of appropriate empirical antibiotic and adherence to susceptibility report could have been the cause for lesser mortality rate. Usage of cefoperazone-sulbactam and piperacillin-tazobactam as empirical antibiotic followed by changeover based on susceptibility report had an overall favourable outcome. Hence review of current antimicrobial susceptibility of pathogens associated with serious infections, such as urosepsis, must be the cornerstone in management.


21

OP1-06

Anti-Dermatophytosis and Anti-Methicillin-Resistant Staphylococcus Aureus (Anti-MRSA) Potential of Quercus Infectoria (Manjakani) and Cassia Alata (Gelenggang) Razak MFA1, Omar MH2 and Wasiman MI2

1Bacteriology Unit, Institute for Medical Research, Kuala Lumpur, Malaysia 2Phytochemistry Unit, Institute for Medical Research, Kuala Lumpur, Malaysia

Extracts of Quercus infectoria (Manjakani) and Cassia alata (Gelenggang) have been known to show antifungal and antibacterial activities. There has been little or no report on anti-dermatophytes or anti-MRSA of Quercus infectoria and Cassia alata. In this research work, anti-dermatophytosis and anti-MRSA activities of Quercus infectoria and Cassia alata extracts were determined. Quercus infectoria and Cassia alata were extracted with ethanol. The crude extracts were dried and then reconstituted in ethanol as stock solution to the concentration of 40mg/ml. The extracts stock solutions were serially diluted in 100µl RPMI growth medium in 96-well microtiter plate and then each extract dilutions was inoculated with 5µl of cells or spores suspension of MRSA or dermatophytes fungus respectively. The microtiter plates were incubated until bacterial or fungal growth was visible and the minimum-inhibitory concentration (MIC) of the extracts against the MRSA or dermatophytes was determined. Quercus infectoria extract inhibited growth of Trichophyton rubrum, Trichophyton tonsurans, Trichophyton mentagrophytes and Microsporum canis with the MIC range 62.5-125 µg/ml [0.006 – 0.01% (w/v)] while the MIC on the two strains of MRSA was 62.5µg/ml [0.006% (w/v)]. Cassia alata extract inhibited growth of all dermatophytes and MRSA tested at MIC concentration higher than 500µg/ml. Under the conditions of this study it can be concluded that Quercus infectoria extract contains very active compounds that were inhibitory to both clinically important dermatophytes fungus and MRSA. Although Cassia alata has been used in traditional medicine for treatment of fungal infections, it contains antifungal compounds with low anti-dermatophytes and anti-MRSA activities.


22

OP1-07

Prevalence of Hookworm in Stools of Negrito Orang Asli in Malaysia Sakinah MOHD SOFIAN1, Azdayanti MUSLIM2,3, Syahrul Azlin SHAARI3, Zaini MOHD-ZAIN3

1Institute for Medical Molecular Biotechnology (IMMB), Universiti Teknologi MARA, Selangor, Malaysia 2Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia 3Cluster of Laboratory Medical Sciences, Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia

Hookworm is a common soil transmitted helminth (STH) affecting approximately 600 million people worldwide. It is prevalent in tropical countries, whereby the climate, moisture and temperature are most suitable for the development of hookworm‟s eggs and larvae. Previous studies in Malaysia had shown that Necator americanus is the main species responsible for infection in human. We conducted a cross-sectional study to determine the status of hookworm infection among Negrito Orang Asli in Malaysia. A total of 369 human stool samples were collected from all six sub-tribes of Negritos. Both direct faecal smear and formalin-ether concentration techniques were performed for screening of both eggs and larvae. A total of 79 (21.4%) Negritos were found to be infected with hookworms microscopically diagnosed by presence of eggs, none by larvae. According to sub-tribes, Kintaq showed the highest percentage (24.6%) of hookworm infection, followed by Batek (22.8%), Kensiu (19.3%), Jahai (14.0%), Lanoh (12.2%) and Mendriq (11.9%). Species identification has yet to be carried out. The results obtained would provide information on the sub-tribes to be targeted for sampling and future investigation.


23

OP1-08

Species-Specific PCR for Detection of CandidaSpecies in Immunocompromised Patients Harmal Nabil Saad1, Tajudin Tajmul Rizwan1, Yong Rafidah Abd Rahman1, Sekawi Zamberi2, Chong Pei Pei3 1Faculty of Medicine, Asia Metropolitan University, Malaysia 2Department of Medical Microbiology, Faculty of Medicine and Health Sciences, University Putra Malaysia, Malaysia 3Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, University Putra Malaysia, Malaysia

Candida species are a major cause of invasive infections in immunocompromised patients with a mortality rate of 50%. The newly emerging antifungal-resistant Candida species are increasingly common. Thus, rapid identification of these pathogens will facilitate specific therapy and patient management. This study aims to develop a species-specific PCR for detection and identificationof the newly emerging Candida species. New PCRs have been developed with novel species-specific primers for five Candida species: C. famata, C. guilliermondii, C. lusitaniae, C. metapsilosis and C. orthopsilosis. The newly designed primers targeted the ITS regions of the ribosomal DNA gene cluster. The specificity and sensitivity of this method were evaluated using different ATCC strains of Candida species (n=13), Aspergillus species (n=4), and two clinical isolates of Cryptococcus species to confirm the specificity of the designed primers. In addition, 44 blood samples taken from BacT/Alert blood culture bottles of immunocompromised patients were used for validation of the new PCR method.The PCR method achieved highly specific identification of the selected species, with no cross-reaction to the other tested fungal species. This method was able to detect 1 cell/ml of culture broth when tested repeatedly for the five targeted species of Candida in this study. Furthermore, the validation results using 44 blood samples from the immunocompromised patient‟s blood culture bottles showed high specificity and sensitivity of the developed method as confirmed by DNA sequencing. This study can offer the healthcare system a rapid diagnostic tool for detection of Candida infections up to species level. The species-specific PCR is easy to perform and inexpensive approach for the simultaneous detection and differentiation of Candida species in clinical samples.


24

OP1-09

Prevalence Study on Intestinal Parasitic Infections among Students from UiTM Puncak Alam Campus Yusof H1, Richard RL1, Lim YAL2

1Department of Medical Laboratory Technology, Faculty of Health Sciences, Universiti Teknologi MARA (UiTM), Puncak Alam Campus, Selangor, Malaysia 2Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia

Globally, intestinal parasitic infections are still considered as one of the major health concerns. Hence, various intervention measures had been carried out over the years to further eradicate this alarming issue. Although the infections are quite common in Malaysia and had been reported previously, there is still limited data on the occurrence of intestinal parasites among university students. Hence, the aim of this study was to monitor the prevalence of intestinal parasitic infections among Universiti Teknologi Mara (UiTM) Puncak Alam Campus students. A total of 118 students from various courses in Faculty of Health Sciences had participated in this study. In addition, each participant was given sterile stool container together with questionnaires and consent forms. The sample was then thoroughly checked to determine the sufficiency of the sample to proceed for further analysis. Samples were analyzed using separate concentration techniques: formalin-ether concentration and trichrome staining via light microscope. Findings revealed Blastocystis-like (39.8%), Entamoeba-like (2.5%) and Ascaris-like (0.8%) for formalin-ether concentration technique whilst Blastocystis-like (44.1%), Ascaris-like (2.5%) and hookworm-like (1.7%) were found positive by using trichrome staining method. Although the prevalence rate of intestinal parasites are considered low, there is still a need in educating the students on adapting proper personal hygiene and providing awareness on the importance of consuming cooked food and drinking boiling or filtered water. The findings from this study served as an evidence-based in monitoring the occurrence of intestinal parasitic infections as to improve the quality of life among the students.


25

OP1-10

Prevalence and Burden of Ascaris lumbricoides among Orang Asli in Kampung Kachau Luar, Ulu Semenyih Selangor Mehru Nisha, Muhammad Aiman Bin Robani Institute Of Medical Science Technology (Mestech), Universiti Kuala Lumpur, Malaysia

Ascaris Lumbricoides (roundworms), Trichuris trichuria (whipworms) and hookworms are categorized under soil-transmitted helminths (STHs). Malnutrition and growth impairment are the results of STH infection, and heavy infection can lead to death if not treated. In Malaysia, STH infection is common in Orang Asli due to their living habits, which explains why the aborigines or Orang Asli in Malaysia are always prone to STHs infection. This study was carried out to investigate the prevalence and burden of Ascaris lumbricoides among Orang Asli in Kampung Kachau Luar, Ulu Semenyih Selangor. Three different techniques were used to analyze and to identify the eggs of Ascaris lumbricoides from stools samples; such as wet smear techniques, sedimentation techniques and floatation techniques. The eggs were quantified using McMaster chamber. The prevalence rate was 32.1%. Among the various groups of risk factors tested using Chi-square test, four factors namely; no formal education (p=0.022), not using the toilet (p=0.011), not using soaps (p=0.025) and not drying hands after washing (p=0.001), significantly contributed to Ascaris lumbricoides infection in this village. It was found the villagers has light and moderate infection. The poor personal hygiene is the main reason why STH infection still thrives among Orang Asli community at Kachau Luar. It is proposed that health education activities on personal hygiene and deworming programmes should be conducted at Kampung Orang Asli Kachau Luar, Ulu Semenyih Selangor.


26

OP1-11

Prevalence of Soil Transmitted Helminth Infections among Negrito Populations in Malaysia MUSLIM Azdayanti1,2, MOHD SOFIAN Sakinah3, SHAARI Syahrul AZLIN 2, LEONG Kok-Hoong 4, HOH Boon-Peng 5, LIM Yvonne Ai-Lian 1

1Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia 2Cluster of Laboratory Medicine Sciences, Faculty of Medicine, Universiti Teknologi MARA (Sungai Buloh Campus), Selangor, Malaysia 3Institute for Medical Molecular Biotechnology (IMMB), Universiti Teknologi MARA (Sungai Buloh Campus), Selangor, Malaysia 4Department of Pharmacy, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia 5Faculty of Medicine & Health Sciences, UCSI University Kuala Lumpur Campus, Kuala Lumpur, Malaysia

Soil transmitted helminth (STH) infections are one of the world‟s most common infections affecting those from deprived or disadvantaged communities. In Malaysia, the prevalence of STH infections are still high especially among aboriginal population (Orang Asli).Thus far, more than 25 studies have been conducted on STH infections amongst Orang Asli in Peninsular Malaysia with the prevalence rate ranging from 13 % to 100 %. Although Orang Asli can be categorized into three major tribes, most of the studies have only focused on the Senoi and Proto-Malay tribes. Among the few reports published on Negrito communities, many failed to focus on the sub-tribe differences amongst the Negrito subtribes. In this study, we conducted a cross sectional survey on STH infection among all sub-tribes under Negrito population. We performed the direct faecal smear, formalin-ether sedimentation and Kato Katz techniques on stool samples. A total number of 383 participants were included in this study. Overall, the prevalence rate of STH infection was 86.2 % (95 % CI: 82.7 %, 89.6 %). By sub-tribes, it was interesting to note that the prevalence rate was up to 100 % in Mendriq sub-tribe followed by Kintaq (92.8 %), Bateq (87.7 %), Lanoh (85.1 %), Kensiu (81.3 %) and Jahai (77.9 %). The most predominant species was Trichuris trichuira with 71.5 % (95 % CI: 67.0%- 76.1 %), followed by Ascaris lumbricoides; 45.4 % (95 % CI: 40.4- 50.4 %) and hookworm; 20.9 % (95 % CI: 16.8 %-24.9 %). In addition, about 52.7 % from the infected individuals were suffering from polyparasitism. These communities were also found to be infected with other parasites such as Giardia lamblia, Entamoeba sp, Blastocytis sp, Isospora sp and undetermined flukes. These results suggested that the Negritos harboured greater diversity of parasites with very high prevalence rate compared to other major tribes of Orang Asli in Malaysia.


27

OP1- 12

Brain-Eating Amoebae: Silver Nanoparticles Conjugation Enhanced Efficacy of Anti-Amoebic Drugs against Naegleria Fowleri Rajendran K, Anwar A, Khan NA, Shah MR, Siddiqui R Sunway University, Selangor, Malaysia

Primary amoebic meningoencephalitis (PAM) due to Naegleria fowleri is a fulminating infection with fatal consequences. The most distressing aspect is that PAM almost always results in death despite advances in antimicrobial chemotherapy. Several drugs have shown promise including amphotericin B, nystatin and fluconazole, however their host cell toxicity at physiologically relevant concentration remains a challenge. Nanoparticles, sub-colloidal structures ranging in size from 10-100 nm, are effective drug carriers to enhance drug potency. The overall aim of the present study was to determine whether conjugation with silver nanoparticles enhance anti-amoebic potential of aforementioned drugs. Silver-conjugated drugs nanoparticles were synthesized. Briefly, silver solution was mixed with various drugs and reduced by adding sodium borohydride. The synthesis was confirmed using UV visible spectrophotometry. Further characterization using MALDI-MS showed silver-conjugated drugs ranging in size from 20-100 nm. To determine the amoebicidal effects, N. fowleri were incubated with silver-conjugated drugs nanoparticles. For controls, amoebae were also incubated with silver nanoparticles alone, and drugs alone. The findings showed that silver conjugation significantly enhanced anti-amoebic properties of

nystatin, amphotericin B and fluconazole at micromolar concentrations (5 μM), compared with drugs alone. Work is in progress to determine the effects of silver-conjugated drugs on host cells. Overall, these findings suggest that silver conjugation enhanced efficacy of anti-amoebic drugs and hold promise in the improved treatment of N. fowleri infection.


28

OP1-13

Ventilator Associated Pneumonia (VAP) Incidence and Drug-Resistant Bacterial Preponderance; A Fact to Ponder Asir GJ1, Vidya J1, Vadivu S2, Sujitha E1, Kanungo R1

1Pondicherry Institute of Medical Sciences, Pondicherry, India 2India Mahatma Gandhi Medical College, Pondicherry, India

Ventilator-associated pneumonia (VAP) is a common cause of nosocomial infection leading to mortality and morbidity. This study aims to identify microbial factors and infection control practices that influence the incidence of VAP.The incidence of VAP among patients admitted to the intensive care units (ICU) from January to December 2016 was calculated. The one year period was divided into 3 segments; 1st segment (January-April), 2nd segment (May-August), 3rd segment (September-December). Isolation rates of Gram Negative Bacteria (GNB) from respiratory samples and their resistance pattern were analyzed. A total of 14 patients had developed VAP during the study period. Incidence of VAP in the 1st, 2nd and 3rd segment of the year was 25.3, 15.2 and 4.1/1000 ventilator days respectively. Acinetobacter baumannii was the causative agent of VAP (100%) in all the 14 patients. Among all GNB isolated from respiratory specimen the isolation rate of A.baumannii was 84%, 64%, 59% during the 1st, 2nd and 3rd segment of the year. Isolation rates of organisms with extensive drug resistance (XDR) were 76%, 62%, 55% in the 1st, 2nd and 3rd segment of the year. The probable interventional factors were improvement in infection control practices like hand hygiene, usage of shoe covers, active environmental surveillance, restriction of ICU visitors during the 2nd segment of the year (May-August). The VAP incidence had drastically decreased in the later part of the year (4.1/1000 ventilator days) when compared to the earlier part of the year (25.3/1000 ventilator days). VAP incidence declined with a notable decrease in the isolation rates of A.baumannii and extensively drug resistant organisms. Directly proportional associations of VAP incidence with microbial factors were noted in the study. Infection control measures to curtail multidrug resistant organisms should be of prime concern.


29

OP1-14

Pyrrolidone Compounds as Potentially Safe and Efficacious Anti-MRSA Agents Johari SA1,2, Mastura M1, Sharifah Aminah SM2, Mohd Fazli M4, Azman M3& Mohamad Jemain MR5

1Antimicrobial Laboratory, Bioactivity Programme, Natural Products Division, Forest Research Institute Malaysia, Selangor, Malaysia 2Faculty of Applied Sciences, Institute of Science, Universiti Teknologi MARA (UiTM), Selangor, Malaysia 3Biotherapeutic Branch, Bioactivity Programme, Natural Products Division, Forest Research Institute Malaysia, Selangor, Malaysia, 4Organic Synthesis Laboratory, Institute of Science, Universiti Teknologi MARA (UiTM), Selangor, Malaysia 5Sultan Azlan Shah Allied Health Sciences College, Perak, Malaysia

Methicillin-resistant Staphylococcus aureus (MRSA) is a nosocomial-related, Gram-positive bacteria that have been known to display multidrug-resistance (MDR) properties towards a wide range of structurally-unrelated antibiotics and antimicrobial agents. Currently, only a handful of antibiotics could inhibit this dangerous pathogen. In our effort to find new antibacterial agents against MRSA, we have previously identified two synthetically-derived pyrrolidone alkaloids (MFM501 and MFM514) that showed good inhibitory activity (MIC value of 7.81 to 31.3 μg/ml) against 38 MDR MRSA and 13 methicillin-sensitive S. aureus (MSSA) isolates with low cytotoxicity against three normal cell-lines (WRL-68, Vero and 3T3) with IC50 values at > 625 µg/ml. To determine the safety and efficacy of MFM501 and MFM514 using in vivo techniques.An oral acute toxicity test in accordance to the OECD 420 guideline was carried out using against both derivatives using ICR mice. Additionally, a mice systemic infection model was applied to evaluate the efficacy of either active compound against a MRSA infection. In the acute toxicity test, MFM501 shows no toxicity effect on the treated mice at an estimated median acute toxicity value (LD50) of > 300 mg/kg and < 2000 mg/kg. On the other hand, MFM514 displayed a lower toxicity activity with LD50 value of > 2000 mg/kg and < 5000 mg/kg. For the efficacy test, MFM501 revealed a mean effective does (ED50) of 87.2 mg/kg via a single dose oral administration against MRSA-infected mice. In contrast, MFM514 exhibited better mice protection ability with ED50 value of 29.39 mg/kg in the similar experiment. Our data demonstrated that pyrrolidone compounds have the potential to be developed further as a new safe and efficacious anti-infective agent against MRSA infection.


30

OP1-15

Alarming Cephalosporin and Fluoroquinolones Resistance of Salmonellain a Tertiary Care Hospital in India Koganti K Help Hospital, India

Enteric fever caused by Salmonella enterica serovars typhi and paratyphi, is an endemic infection in many low and middle income countries like India. Cephalosporins and fluoroquinolones have been the drugs of choice for the past decade for enteric fever. This study was done to evaluate antimicrobial resistance patterns of Salmonella enteric serovars. A prospective study was conducted at our hospital in South India for three months from March, 2017 to May, 2017. 42 blood culture positive isolates of Salmonella species were studied. Blood cultures were performed on Versatrek (automated blood culture system) and identification and sensitivity performed on Vitek2 (automated identification and sensitivity system based on CLSI guidelines). Out of the 42 isolates studied, 39 are S.typhi and 3 are S.paratyphi. Alarming resistance was observed for three major cephalosporins tested. 38 (90.4%) of 42 isolates were resistant to ceftazidime, 29 (69%) were resistant to cefoperazone / sulbactam and 18(42.8%) were resistant to cefepime. Significant resistance to fluoroquinolones was also observed. 41(97.6%) of the 42 isolates were resistant to ciprofloxacin and all 42 (100%) were resistant to levofloxacin. Further, all the isolates showed good susceptibility to carbapenems. All 42 (100%) isolates were susceptible to imipenem, 39 (92.8%) of 42 were susceptible to meropenem and 33 (78.5%) of 42 to doripenem. Interestingly, very good susceptibility to cotrimoxazole (97.6%) was also observed. Our study shows that there is increasing resistance to cephalosporins and fluoroquinolones due to their extensive use without proper blood cultures and/or diagnosis of enteric fever. There is resurgence of susceptibility to cotrimaxazole, suggesting that it is useful in suspected cases of enteric fever. Regular antibiotic susceptibility studies appear to be mandatory to avoid increase in resistance of antibiotics in enteric fever.


31

OP1-16

The 2015 Middle Eastern Respiratory Syndrome Epidemic in South Korea: How to Reduce Transmission in Case of Epidemics Lee, W1, Choo, D2, Chung, D3, Kim, E4, Lee, J5, Chung, S6, and Park, S7

1Hong Kong University of Science and Technology, Hong Kong 2University of Virginia School of Medicine, Virginia, United States of America 3Brown University, United States of America 4Tufts University, Massachusetts, United States of America 5Cornell University, New York, United States of America 6Marymount University, Virginia, United States of America 7University of California Los Angeles, California, United States of America

In 2015, an unexpected Middle East Respiratory Syndrome (MERS-CoV) outbreak in South Korea caught the attention of the world. Although sustained community transmission has not been observed, MERS-CoV, like SARS-CoV, is transmissible from person-to-person. As a result, health care workers are at the greatest risk for infection. The objective of this study is to look at the potential reasons that the MERS-CoV outbreak occurred within South Korea that is often heralded as having a proficient healthcare system. After analyzing the causes, the study aims to offer suggestions that will prevent a future outbreak like MERS in the South Korean peninsula as well as propose methods and protocols that can be utilized by other nations to prevent epidemics. Since the study placed emphasis on searching for sources that reported specific statistics about the MERS outbreak within South Korea, it includes information from a variety of sources including the Ministry of Health and Welfare of South Korea and news articles that reported about the condition of MERS and patients that resulted from the South Korean outbreak. The study concludes that 44.1% of the infections arose from hospital inpatients and 34.9% arose from MERS patient family members, caretakers or visitors to the hospital.


32

OP1-17

Screening for Latent TB Infection in Children: A Review of Current Practice in North Central London TB Screening Service Nazi, N St Georges’ Hospital NHS Trust, London, United Kingdom

Tuberculosis is a major global health problem. Parts of London have higher rates of TB than sub-Saharan Africa and Asia. Contact screening is a key component in preventing TB disease. Diagnosing paediatric latent TB infection is challenging. An audit on the current practice of screening children exposed to contacts of tuberculosis was conducted in 3 major teaching hospitals in North London. The primary aim was to look at how child contacts of TB are managed according to national UK guidelines published in 2016 from the National Institute of Clinical Excellence. The secondary aim was to review the changes in the national guidelines and the potential impact this has on patient management and TB services. 191 children (aged 0-16 years) were referred to the TB clinic between January 2015 to January 2016. 85% of patients were above 2 years old, 53% male. 31% of children were black African, 16% Asian, 14% mixed and 13% White. 65% of index cases were pulmonary, 45% being smear positive. All children were risk stratified based on age, previous BCG, size of tuberculin skin test (TST), results of Quantiferon test, to help aid decision making with regard to starting treatment. A child with a tuberculin skin test of 15 mm or more was regarded as a positive result for latent TB infection. In total there were 33 children identified with latent TB infection. 7 index cases had drug resistant TB, 3 of which were multi-drug resistant. There were 26 cases of children who had TST sizes between 5mm-13mm but were not treated. The current guideline from NICE recommends treating children exposed to pulmonary TB if they have a TST size of 5 mm or above, regardless of previous BCG vaccination history. This will lead to more children being treated for latent TB infection which will require more input from specialist TB services and has cost implications.


33

OP1-18

Mark Release and Recapture of Malaysian Strains Aedes albopictus (Skuse) Rozilawati H1, Mohd Masri S2, Tanaselvi K1, Nazni WA1, Lee HL1

1Medical Entomology Unit, Institute for Medical Research, Kuala Lumpur, Malaysia 2Strategic Resource Research Centre, Malaysian Agricultural Research Development Institute, Kuala Lumpur, Malaysia

The dispersal and flight range of a mosquito vector is one of the bionomic aspects that is important for pathogen transmission and dissemination. Despite being a vector of chikungunya, dengue and Zika virus, there is a paucity of data on the dispersal of Aedes albopictus in Malaysia. In order to determine the flight range of this mosquito species, experiment using standard Mark-Release-Recapture (MRR) technique has been conducted in an urban site in Kuala Lumpur. The mosquitoes were marked with fluorescent dye and released. The BG-Sentinel traps were used to recapture the mosquitoes. The trapped mosquitoes were then examined under UV light to identify those marked and recaptured. The result obtained from this study indicated that the flight range of the male Ae. albopictus was within 130 meter from the release point, showing that Ae. albopictus is a short range flyer. Therefore this will benefit the vector control agency in conducting Aedes prevention and control activity.


34

OP1-19

Evaluation of a Field-deployable Reverse Transcription-Insulated Isothermal PCR for Rapid and Sensitive On-site Detection of Zika Virus Carossino, M1, Li, Y.1, Lee, P.A.2, Tsai, C.2, Chou, P.2, Williams, D.3, Skillman, A.1, Cook, F.1, Brown, G.4, Chang, H. G.2, Wang, H.T.2, Balasuriya, U.R.B.1

1Maxwell H. Gluck Equine Research Center, Department of Veterinary Science, College of Agriculture, Food and Environment, University of Kentucky, Lexington, KY, USA 2GeneReach Biotechnology, Taichung, Taiwan 3University of Kentucky Medical Center, Chandler Hospital, Kentucky Blood Center, University of Kentucky, Lexington, KY, USA 4Department of Entomology, College of Agriculture, Food and Environment, University of Kentucky, Lexington, KY, USA

The recent emergence of Zika virus (ZIKV) in Brazil and its expansion throughout the world has highlighted the urgent need for a rapid and reliable assay suitable for viral detection at points of need (PON), which are essential for ZIKV control particularly in vulnerable areas with limited resources. A ZIKV RT-insulated isothermal PCR (RT-iiPCR) targeting the E gene has been available for rapid detection of ZIKV on a field-deployable POCKITTM device. The performance of ZIKV RT-iiPCR was compared to that of the Center for Disease Control and Prevention and the Pan American Health Organization RT-real time PCR (RT-qPCR) assays targeting the E and NS2B genes, respectively. Limits of detection were tested with serial dilutions of an in vitro transcribed RNA and ZIKV strains (African and Asian lineages). Exclusive specificity was evaluated with important flaviriruses and alphaviruses. ZIKV-spiked whole blood, plasma, serum, semen, and urine (n = ~120 each), and mosquito pool samples (n = 7) were tested by RT-iiPCR and the reference RT-qPCR assays to evaluate clinical performance. The PCR assays had limits of detection in the range of 10 to 100 genome equivalents/μl, and 10 plaque forming units/ml, with exclusive specificity for African and Asian lineages of ZIKV. Analysis of spiked whole blood, plasma, serum, semen, urine, and mosquito pool samples showed an agreement of 90% (k=0.8), 92% (k=0.82), 95% (k=0.86), 92% (k=0.81), 90% (k=0.79), and 100% (k=1), respectively, between the RT-iiPCR and the composite RT-qPCR. The RT-iiPCR showed an overall agreement of 92% (k=0.83; n = 481) with the reference RT-qPCR assays. The ZIKV RT-iiPCR has performance comparable to the reference RT-qPCR assays but provides much faster results (~1.5 h). The field-deployable RT-iiPCR/POCKIT system can serve as a PON diagnostic tool, significantly improving the quality of the health care system in vulnerable areas.


35

OP1-20

Occurrences of Animal Allergens among Laboratory Workers and Researchers Vellayan Subramaniam1, Qurratu Aini Aniqah Binti Sekaria1, Gurmeet Kaur Surindar Singh2 1Department of Pharmacology & Chemistry, Faculty of Pharmacy, Universiti Teknologi MARA (UiTM) Puncak Alam Campus, Selangor, Malaysia 2Department of Pharmaceutical Life Sciences, Faculty of Pharmacy, Universiti Teknologi MARA (UiTM) Puncak Alam Campus, Selangor, Malaysia

Laboratory animal allergy is an occupational symptom that affects people engaged with the use and care of laboratory animals. Animal urine, saliva, feces, and dander contain proteins that are associated with allergic reaction. The aim of this study was to determine the prevalence and preventive measures taken amongst researchers and laboratory workers exposed to laboratory animal allergens. A questionnaire comprising of four sections (i.e. demographic, occupational history, past health information and present symptoms of laboratory animal allergen) that was distributed to 267 respondents (192 female) working at five animal facilities in the UiTM. The majority of the respondent (94.4%) reported to have direct contact with laboratory animals and their excreta within their working environment. Handling soiled bedding (83.5%), stool (70.4%), urine (71.5%), and carcasses (59.9%) were among the duties carried out by the respondents exposing them to animal allergens. Animal dander is small enough to remain in the air for some time and adhere to clothes and skin. Several preventive measures were taken by the laboratory workers to reduce the risk of allergen exposure including using surgical masks, wearing protective glasses, laboratory coats, gloves and cap. The most common allergic reaction experienced by the respondents included itchy eyes (94.0%), frequent runny nose (90.3%), sneezing (89.1%), wheezing (88.8%) and nose congestion (64.8%) with fewer reporting asthma (18.7%) and shortness of breath (10.5%). It is important to reduce allergen exposure by taking appropriate preventive measures. However, prolonged exposure to allergens, lack of preventive awareness and highly sensitive individuals are the common causes of allergic reaction while working with laboratory animals.


36

OP1-21

The Risk Factors of Tuberculosis (TB) Coinfection among HIV/AIDS Patients in Badung Regional General Hospital Krisnahari KL1, Citrajaya H1*, Sawitri AA2

1Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia 2Department of Community and Preventive Medicine, Udayana University, Denpasar, Bali, Indonesia

TB coinfection is often found and still the leading cause of death in HIV/AIDS patients. Study about risk factors of TB coinfection in patients with HIV/AIDS is very limited in Indonesia, including Bali. This study aims to determine risk factors of TB coinfection among HIV/AIDS patients in Badung Regional General Hospital.Cross-sectional analytical study was conducted using 643 secondary data (medical records) of HIV/AIDS patients who were receiving treatment in Badung Regional General Hospital from February 2006 - September 2015. Sociodemographic risk factors (sex, marital status, age, education history, employment status, and drug consumption controller) and clinical risk factors (transmission risk factor, clinical stage, weight, CD4 count, and Hb levels) were analyzed. Analysis data used univariate, bivariate (chi-square) and multivariate (logistic regression).From 643 HIV/AIDS patients, it is found that 11.8% of patients experienced TB coinfection. The majority of HIV/AIDS patients with TB coinfection were male (81.6%), married (54.4%), aged 15-35 years (59.2%), working (64.5%), high school and college education (55.3%). The percentage of patients with sexual transmission risk factors and patients who have drug consumption controller were 95.9% and 75%. The majority of patients had bad clinical conditions. Multivariate analysis indicated variable that increase the risk factorof TB coinfection among HIV/AIDS patients was advance clinical stage (3rd and 4th) with odd ratio (OR) = 14.772 (95% CI = 4.815-45.320).Advance clinical stage contribute to increase TB coinfection risk among HIV/AIDS patients.


37

OP2-01

Strategies for Improved Management of Acanthamoeba Keratitis Abjani F, Siddiqui R, Khan NA Department of Biological Sciences, School of Science and Technology, Sunway University, Selangor, Malaysia

Acanthamoeba species has been well recognized as human pathogens to cause life threatening infection such as granulomatous amoebic encephalitis (GAE) and Acanthamoeba keratitis (AK). AK is a serious vision threatening infection, mostly observed in contact lens users and associated with blurred vision, photophobia, severe pain, corneal ring-infiltrate and can lead to blindness. Parasite has stages in its life cycle, a trophozoite form that converts itself into a highly resistant doubled walled cyst form under harsh conditions. As trophozoite form can be killed with relative ease, one possibility of preventing this serious infection as well as improving its treatment is to inhibit the ability of Acanthamoeba to switch into the resistant cyst form. Our previous studies showed that cyst wall is partly made of cellulose. The overall aim of this study was to inhibit differentiation using cellulose inhibitors. Methodology: Using encystation assays, we tested various cellulose synthesis inhibitors (cacodylic acid, dichlobenil, isoprenaline and di-methyl arsenic acid) and against amoebae transformation from trophozoite into cyst form. At micromolar concentrations, the results revealed that aforementioned inhibitors inhibited Acanthamoeba encystation by 70%, 80%, 57%, and 17% respectively, as compared with the control. A combination of cellulose targeting agents plus antiamoebic drug, exhibited significant amoebicidal effects compared with the cellulose targeting agents alone or chlorhexidine alone (P<0.05). These results suggest that targeting cellulose is an effective strategy for the rational development of therapeutic interventions. The ultimate goal is that such a compound will be included in the commercially available contact lens cleaning solutions as well as in the treatment regimen against Acanthamoeba keratitis.


38

OP2-02

Rabies: What Needs to Be Done to Prevent Outbreak Gurmeet Kaur Surindar Singh1,2,Vellayan Subramaniam3 1Department of Pharmaceutical Life Sciences, Faculty of Pharmacy, Universiti Teknologi MARA (UiTM) Puncak Alam Campus, Selangor, Malaysia 2Brain Degeneration and Therapeutics Group, Pharmaceutical and Life Sciences Community of Research, Universiti Teknologi MARA (UiTM), Selangor, Malaysia 3Department of Pharmacology & Chemistry, Faculty of Pharmacy, Universiti Teknologi MARA (UiTM) Puncak Alam Campus, Selangor, Malaysia

Rabies is an infectious viral disease affecting all warm-blooded animals clinically manifested by behavioural changes, nervous signs, paralysis and almost always, a fatal termination. The virus is currently classified as a member of the Rhabdo virus group of the genus Lyssavirus that spreads via infected saliva, mainly through bites or scratches. Rabies is a disease of concern to Malaysia. Rabies is a disease of public health importance due to its zoonotic nature and therefore warrants stringent control and eventual eradication. The disease is generally seen in the northern territories of Peninsular Malaysia bordering Thailand. However, recently four positive rabies cases have been reported in Serian, Sarawak with two deaths (siblings aged 4 and 6 years old) and two seriously ill (5 and 7 years old). These children were bitten by dog 2-3 months prior to the appearance of the symptoms. Four areas in Serian have been declared as rabies-infested areas. Currently, the strategies employed for the control of rabies in dogs primarily include pre-exposure vaccination and birth control programs to tackle overpopulation of street dogs. This is being accomplished through the involvement of governmental and non-governmental organizations, municipal corporations, and animal welfare organizations. The Sarawak State Health Department is currently conducting dog bite surveillance at all health clinics and hospitals to curb the rabies outbreak in the state. Interviews were also conducted at residential areas and those bitten by dogs were given treatment. All dog bite cases attended by medical officers should be brought to the attention of the local or district veterinary officers. Other approaches are registration of owned pet dogs and their vaccination against rabies annually, compulsory pet licensing, increasing the public awareness (through educational institutions, media, and co-operation) about prevention and control of rabies and the benefits of successful mass anti rabies vaccination. Compulsory vaccination in the immune-belt areas should be advocated. Other effort includes the enforcement of stringent rule and regulations for the importation and movement of dogs and quarantine regulations. Serological survey should also be advocated regularly. In conclusion, the border areas should be identified and monitored as well as advocating vaccination.


39

OP2-03

Prevalence of Leptospira in Abattoir Workers, Slaughtered Animals and Abattoir Environment in Cavite, Philippines Tabo, N.A.1,2, Villanueva, S.Y.A.M.2, and Gloriani, N.G.2

1Biological Sciences Department, College of Science and Computer Studies, De La Salle University-Dasmariñas, Philippines 2Department of Medical Microbiology, College of Public Health, University of the Philippines-Manila, Philippines

The aim of this study was to determine the prevalence of antibodies to Leptospira among abattoir workers and slaughtered animals, and Leptospira serovars in slaughtered animals and abattoir environment in Cavite, Philippines.Serum samples obtained from 46 abattoir workers and 69 slaughtered animals were subjected to microscopic agglutination test (MAT). The MAT-screening positive sera were further subjected to MAT quantitation with a cut-off titer of 400 in humans and 20 in animals. The urine of 69 slaughtered animals and 72 environmental samples were subjected to culture. Culture-positive samples were subjected to rrl-PCR, flaB-PCR and serotyping using monoclonal/polyclonal antibodies. The results showed that 15.2% of abattoir workers in selected abattoirs of Cavite province were positive for Leptospira-agglutinating antibodies that reacted with serovars Canicola, Hurtsbridge, Losbanos, Poi and Ratnapura. These workers were assigned in dehairing, abattoir cleaning and butchering of pigs, and gut removal, gut cleaning, hide removal, and butchering in cows. On the other hand, the overall Leptospira-seropositivity in slaughtered animals was 58.0%, 61.7% of which was in pigs and 33.3% in cows. The most frequently occurring serovar in both pigs and cows was Poi. Twenty five percent (18/72) of the environmental samples were positive for Leptospira. Of these, 5 samples were positive for flaB-PCR. These samples were considered as pathogenic and were observed in Noveleta, Imus City and Bacoor City abattoir. From the five pathogenic isolates, one isolate reacted with serogroup Grippotyphosa while the remaining four isolates did not react with any of the monoclonal and polyclonal antibodies. The presence of common serovars at the interface of both abattoir workers-slaughtered animals, and slaughtered animals-abattoir environment could indicate continual source of leptospires and could pose problems on human health. These serovars could be potential candidates for the development of vaccines and diagnostic tests.


40

OP2-04

In-Silico Functional and Structural Classification of Hypothetical Proteins from Streptococcus Pyogens Farina W, Kumar S Management & Science University, Shah Alam, Selangor, Malaysia

Streptococcus pyogenes also known as Group A Streptococcus (GAS) which grows in chain and cause infections to human especially in respiratory tract for example pharyngitis, tonsillitis and more. Recently, there are several reports against the development of resistant of S. pyogenes strains against the current usage of antibiotics. The aim of this study is to identify the potential drug target among hypothetical protein of Streptococcus pyogenes by functional classification and structural prediction. Out of 520 hypothetical protein of Streptococcus pyogenes, the functional prediction has classified 172 hypothetical proteins has domain function as an enzyme, 47 has domain function as a binding protein, 30 hypothetical proteins has a domain function as transport protein while the rest of the sequence cannot be functionally annotated by any of the SMART, PFAM, CDART tools. Among the functionally classified proteins, the drug targets has been identified using subtractive genomics. Among 67 drug targets identified through subtractive genomics, 25 drug targets have shown virulence through virulent prediction. The identified drug target through this study could facilitate a better understanding of the mechanism of virulence, drug resistance, and pathogenesis and for identification drug targets in Streptococcus pyogenes, which emphasizes future perspective to design rational drugs and vaccines.


41

OP2-05

Prevalence of “Brain-Eating Amoebae” in Public Water Supplies in Malaysia Khan, Naveed Ahmed; Siddiqui, Ruqaiyyah; Gabriel, Shobana Department of Biological Sciences, School of Science and Technology, Sunway University, Selangor, Malaysia.

Free-living amoebae (Acanthamoeba spp., Balamuthia mandrillaris, Naegleria fowleri) have gained increasing attention owing to their capacity to produce severe human and animal infections involving the brain. Infections due to free-living amoebae are often associated with water-related activities such as swimming, ablution, use of neti pots for nasal irrigation. This is of particular concern to tropical countries such as Malaysia with routine water recreational activities. The overall aim of this project was to determine the prevalence of pathogenic free-living amoebae in public water supplies in Malaysia by employing rapid molecular tools involving polymerase chain reaction. Using genus-specific probes, we employed multiplex polymerase chain reaction for the rapid and sensitive identification of pathogenic free-living amoebae, which detected as few as fifty cells within 4 – 5 hours. Using this method, we tested water samples from Selangor and detected the presence of pathogenic free-living amoebae in public water supplies. Work is ongoing to determine the presence of free-living amoebae from different regions of Malaysia. In conclusion, we have successfully employed molecular methods for the rapid identification of pathogenic free-living amoebae that can be used for clinical applications as well as to monitor water supplies for the presence of pathogenic amoebae.


42

OP2-06

Acute Febrile Illness in West Pahang - An Analysis of 341 Hospitalized Patients Mohd Thabit AA1, Wan Ahmad Kamil WMR1, Mohd Din MR2, Arumugam M2, Wan Azman SS2, Gian Singh SS3, Abdullah R2, Rosli NA4

1Department of Medicine, Bentong Hospital, Pahang, Malaysia 2Department of Medicine, Sultan Haji Ahmad Shah Hospital Temerloh, Pahang, Malaysia 3Department of Medicine, Kuala Lipis Hospital, Pahang, Malaysia 4Department of Public Health, UKM Medical Centre, Kuala Lumpur, Malaysia

Tropical acute febrile illness (TAFI) is one of the most common causes of patients presenting with fever which represents a spectrum of diseases that includes dengue fever, leptospirosis, malaria and melioidosis in Malaysia. In 1984, scrub typhus and typhoid were the most frequent diagnosis in Mentakab Hospital in West Pahang, Malaysia. However, multiple factors i.e. demographics and medical co-morbidities such as diabetes have changed the outcomes of TAFI making the management of the diseases more complex. To study the spectrum of TAFI in West Pahang, its respective demographic background, and the final outcome of these patients to improve the diagnostic approach and management of TAFI. A total of 341 acute febrile illness patients were prospectively studied at six hospitals comprising of three district and three specialist hospitals in the West Pahang region between January 2017 and June 2017 for the aetiology of TAFI, the demographic data which includes centre of study, age, gender, ethnic origin, occupation and their relations to clinical diagnosis and outcomes. Data analysis was done using SPSS version 20 with statistical significance calculated using multiple logistic regression for which p-value <0.05 was considered significant. The spectrum of TAFI in decreasing order, was dengue (34.5%), leptospirosis (22.2%), bacteremia (8.5%), melioidosis (6%) and malaria (4.3%). The majority of subjects were from the agricultural sector and contributes to the highest risk of melioidosis and malaria cases. A higher proportion of diabetics developed renal (64.6%) compared to liver (33.8%) complications. The aetiologies in about half of acute febrile illness patients in West Pahang, were dengue and leptospirosis. The factors like age, occupation, and medical co-morbidities particularly diabetes may be used to predict outcome of mortality and organ complications.


43

OP2-07

Animals Living in Polluted Environments are Potential Source of Antibacterial Foo YMW, Siddiqui R, Khan NA Department of Biological Sciences, School of Science and Technology, Sunway University, Selangor, Malaysia

Infectious diseases continue to be one of the leading causes of morbidity and mortality contributing to more than 15 million deaths annually. The emergence of multiple-drug resistant bacteria has further exacerbated the problem. The hypothesis is animals living in polluted environments are potential source of novel antimicrobials. Under polluted milieus, organisms such as cockroaches encounter different types of microbes, including superbugs. Such creatures survive the onslaught of superbugs and are able to ward off disease by producing antimicrobial substances. The aim of this study was to investigate the potential antibacterial activity in various tissues of animals living in polluted environments. Thus, the discovery of novel antibacterial from animals/pests living in polluted environments is a promising avenue of research. Among various animals, we selected snakes that feed on germ-infested rodents and rats that thrive in unhygienic conditions. Organ lysates were prepared and their bactericidal effects were determined against neuropathogenic E. coli K1, and methicillin-resistant Staphylococcus aureus (MRSA). Our findings revealed that various organ lysates of snake and fish exhibited antibacterial effects against MRSA, while organ lysates of rats and chicken exhibited bactericidal effects against MRSA and E. coli K1. Work is in progress to determine the identity of active molecule(s). It is hoped that the discovery of antimicrobial activity in the tissue lysates of animals living in polluted environments will stimulate research in finding antimicrobial agents from unusual sources, and has potential for the development of novel strategies in the control of infectious diseases.


44

OP2-08

Temperature Effect on the Adult Aedes albopictus (Skuse) Life Demographic Rozilawati H1, Mohd Masri S2, Tanaselvi K1, Nazni WA1, and Lee HL1

1Medical Entomology Unit, Institute for Medical Research, Kuala Lumpur, Malaysia 2Strategic Resource Research Centre, Malaysian Agricultural Research Development Institute, Kuala Lumpur, Malaysia

Aedes albopictus Skuse is the main vector transmitting chikungunya virus during recent outbreaks and is also the secondary vector for dengue and Zika viruses. As in other mosquito vectors, the bionomics of Ae. albopictus is subject to environmental factors such as temperature, which is the main environmental factor influencing the population growth. In this study, the effects of several constant temperatures at controlled relative humidity on the life demographics of Ae. albopictus were evaluated. The adult mosquitoes were exposed to several constant temperatures (20°C, 25°C, 30°C and 35°C) in environmental chambers. Most of the females needed only one blood meal to complete their gonotrophic cycle. The highest number of eggs oviposited by females was recorded at 25°C. Based on aged specific survivorship, the longevity of both sexes was significantly decreased with an increase in temperature. The survival rate was the highest during larval/pupae stage whereas the highest mortality rate occurred at the eggs stage. The sex ratio of emerged progenies did not differ significantly from 1:1, indicating the capability of population growth even at the highest temperature. The results of this study provided valuable baseline data on the effects of global warming on the bionomics of Malaysian Ae. albopictus and the possible effects on disease transmission.


45

OP2-09

Human Rights and Social Stigma Review for Leprosy Patients in Korea Park, SY University of California, Los Angeles, United States of America

Leprosy (Hansen‟s disease) is a chronic infectious disease that primarily affects the skin and peripheral nerves. Early diagnosis and treatment are crucial to prevent the nerve damage and physical abnormality, but persisting misconceptions and prejudice keep people from receiving the required treatment and the care. Despite being cured, people with leprosy are not only discriminated by the society and the government, but also encounter difficulty in getting married, receiving education, and obtaining job opportunities. Essentially, leprosy thus is more of a psychosocial problem than a public health problem. Such was also the case in Korea since the Japanese colonial period. Correspondingly, there were many cases where Koreans with leprosy had their human rights violated, ranging from isolation camps and sterilizations to forced manual labors. Therefore, this paper focuses on the corollaries faced by the Koreans with leprosy, due to their physical abnormalities, and subsequent mediation initiatives adopted by the government and religious organizations. Additionally, the paper compares such social inequality issues within Korea to those of Japan and India to assess the mediation initiatives adopted towards the resolution of these issues.


46

POSTER PRESENTATION

PP1-01

Precise Identification of Different Stages of a Tick, Ixodes granulatus Supino, 1897 (Acari: Ixodidae) Ernieenor FCL1, Yaakop S2, Mariana A1, Ernna G1, Shukor MN2

1Acarology Unit, Infectious Diseases Research Centre, Institute for Medical Research, Kuala Lumpur, Malaysia 2Centre for Insect Systematic, School of Environmental and Natural Resource Sciences, Faculty of Sciences and Technology, Universiti Kebangsaan Malaysia, Selangor, Malaysia

Identification of a local species of tick, Ixodes granulatusis essential because it has potential to be a vector for spotted fever group (SFG) rickettsia and tick typhus. The objective of this study is to identify different stages of I. granulatus based on morphological characters prior TO molecular identification, that aim significantly in confirming and identifying the nymphal stages of I. granulatus. Total of 14 individuals of adult, engorged and nymphal ticks collected from three different localities were examined morphologically using taxonomic keys, then was continue with Polymerase Chain Reaction using Cytochrome oxidase subunit I (COI). Clustering analysis based on COI sequences was carried out by constructing Neighbor-joining (NJ) and Maximum Parsimony (MP) tree to clarify the genetic variation and diversity of local I. granulatus. Based on external morphological characterizations, nine individuals (64.3%) were successfully identified as I. granulatus, while five individuals were recognized only as Ixodes sp.


47

PP1-02

A Scoping Review on the Association of Burkholderia Pseudomallei with Environmental and Climatic Factors Yuvaneswary Veloo, Lim Kuang Hock, Siti Hajar Shahruddin, Ameerah Su’ad Abdul Shakor, Noor Safiza Mohammad Nor Institute for Medical Research, Kuala Lumpur, Malaysia

Burkholderia pseudomallei, a gram negative bacillus and an environmental bacterium, is the causative agent of melioidosis, a severe and fatal infectious disease. Despite its pathogenic nature and high global prevalence and its usage as biological threat agent, there are very limited studies conducted on the contributing factors of the environment and climatic influences towards the bacterium. The objective of this study was to review the literatures on the influencing factors towards the distribution of B.pseudomallei in the environment. Five-stage methodological framework developed by Arksey and O'Malley, 2005 was used as a guideline. The search for literature was done through various on-line bibliographic databases (Springer link, Ovid, Ebsco, Science Direct, PubMed, Scopus, Highwire, Wiley and Google Scholar) using pertinent keywords. Reports, proceedings, books and journal articles published in English between the year of 2000 until 2016 focusing on environmental elements within Asia and Australia were designated for this review. A data extraction form to record the methodology was used to detect B. pseudomallei related with environmental issues and study findings was developed and piloted with a beginning total of more than 7000 papers, subset to 95 eligible studies and final selection of 53 articles for the review based on the inclusion criteria. Data extracted related to geographical location, type of samples taken (soil, water or air), methods used and findings related to environment and climate. The findings showed that there were multiple factors which influenced the presence of B.pseudomallei in the environment. The environmental conditions, natural disaster and the ignorance of human on safety measures increase prevalence of melioidosis and existence of B. pseudomallei.


48

PP1-03

Effectiveness of Sulfadoxine and Pyrimethamine in Prevention of Malaria in Pregnancy: In Silico Pharmacological Model Htay, Mila Nu Nu1,Hastings, Ian M2; Hodel, Eva Maria2; Kay, Katherine3

1Melaka Manipal Medical College, Malaysia 2Liverpool School of Tropical Medicine, United Kingdom 3State University of New York at Buffalo, United States of America

Intermittent preventive treatment of malaria in pregnancy (IPTp) with sulfadoxine and pyrimethamine (SP) is recommended by the World Health Organization (WHO) in sub-Saharan African countries to reduce the complications. In silico pharmacokinetic-pharmacodynamics (PK/PD) models are powerful tools that can potentially predict the efficacy and effectiveness of antimalarial drugs at a far lower cost, over shorter time periods than clinical trials. This project aimed to investigate the effectiveness of the recommended three-dose and four-, six- and eight-weekly SP-IPTp regimens, with specific focus on the impact of various non-adherence patterns in multiple transmission settings. The effectiveness of SP-IPTp given according to the WHO recommended dose (1500mg of Sulfadoxine, 75mg of Pyrimethamine) was simulated using an extended version of the pre-existing PK/PD model, accounting for synergistic effects of SP. Using the PK/PD model, IPTp was simulated in 1,000 pregnant women; fully sensitive parasites to SP and the effects of transmission intensity on the prophylactic ability were assessed. The model was implemented in R software package (version 3.1.0). The results were investigated by using the Kaplan-Meier (KM) analysis and Log rank test. The WHO recommended three-dose regimen was effective at preventing malaria in pregnancy, i.e., >99%, 98% and 92% of pregnant women were protected in low, moderate and high transmission intensities respectively. Simulations of full adherence to four-, six- and eight-weekly regimens, found the former two regimens provided protection to >99% in all transmission regions. However, the protection dropped following eight-weekly regimen to 71% in high transmission and 86% to 99% in moderate to low transmission intensities respectively. Investigation into non-adherence patterns showed that missing doses in the second trimester had a much greater impact on the protective ability of IPTp than missing doses in the third trimester.


49

PP1-04

Preliminary Analysis on the Effect of Prolonged Incubation Period in Blood on the Gene Expression of Burkholderia pseudomallei Hii SYF, Ahmad N, Amran F. Institute for Medical Research, Kuala Lumpur, Malaysia

Burkholderia pseudomallei (B.pseudomallei) is the agent that causes melioidosis, a life-threatening disease if not treated promptly. Melioidosis is endemic in Malaysia, northern Australia and other Southeast Asia regions. B.pseudomallei consists of two chromosomes totaling to ≈7.3mb. To compare the differential genes expressed during prolonged period of incubation in blood. B.pseudomallei was inoculated and cultured in blood for 5 days and 1 month. The Rrna was removed from the total RNA extracted prior to RNA sequencing. A total of 1524 genes were differentially expressed comprising of 718 genes up-regulated and 806 genes down-regulated genes. Among the down-regulated genes, 67.8% was of chromosome 2. According to DAVID gene functional classification, the main differentially expressed gene clusters involved in metabolism; bacterial secretion system and transporters. Prolonged incubation in blood incurs stress in B.pseudomallei as most of the differentially down-regulated genes are from chromosome 2. There were significantly expressed antibiotic (polyketide synthase & non-ribosomal peptide synthase) genes, type 3 and type 6 secretion systems which could be an adaptation in adverse environment or quorum sensing. However, this observation was different from B.pseudomallei grown under oxidative stress whereby the most required process is cell wall/cell membrane biosynthesis and the least in intracellular trafficking/secretion. Furthermore, the rpoE gene which is related to stress response was found to be reduced after one month incubation. The type 6 secretion system shown in our analysis are of cluster 2, 3 and 5 which was previously described as non-virulent. Despite that, flagellar –related protein were observed to be significantly increased upon one month incubation. Prolonged incubation period of B.pseudomallei in blood showed slightly differed gene expression compared to growth in other medium as previously reported.


50

PP1-05

Molecular Characterization of Methicillin-Resistant Staphylococcus aureus Clinical Isolates Collected from a Tertiary Teaching Hospital in Kuala Lumpur over Two Year Period Niek, W.K.1,Teh, S.J.1, Kamarulzaman, A.1, Sam, I.C.1, Syed Omar, S.F.1, Sulaiman, H.1, Thong, K.L.2, Ponnampalavanar, S.1

1Dept of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia 2Institute of Biological Sciences, Faculty of Science, University of Malaya, Kuala Lumpur, Malaysia

Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most common nosocomial pathogens, which may cause mild to severe infections. Emergence of community-acquired MRSA since 1990s is gaining clinical importance as there has been crossover between hospital-acquired and community-acquired MRSA. The objective of this study was to determine the molecular characteristics of clinical isolates collected from a teaching hospital in Kuala Lumpur. Clinical isolates collected from 2014-2015 were genotyped by multilocus sequence typing (MLST), staphylococcal cassette chromosome mec (SCCmec) typing and Panton-Valentine leukocidin (PVL) gene detection. The most prevalent sequence type was ST22, which differed from previous findings, reporting ST239 as the most prevalent sequence type in the same hospital. One novel sequence type, ST3547, was identified from an isolate from 2015. Three SCCmec types (III in 26.53%, IV in 70.41% and V in 3.06%) were detected. The most prevalent SCCmec type was SCCmec type IV which belonged to ST22. 71.01% of the SCCmec IV isolates were HA-MRSA. The remaining isolates were CA-MRSA (18.84%) and HC-MRSA (10.14%), respectively. SCCmec types IVa and IVc were detected in 10 (10.2%) and 5 (5.1%) of the MRSA isolates, respectively. Panton-Valentine leukocidin (PVL) gene was detected in 2.3% and 9.1% of clinical isolates in both 2014 and 2015. In conclusion, emergence and circulation of CA-MRSA variants were observed in our hospital.


51

PP1-06

Serotype Distribution and Antibiotic Resistance among Invasive Pneumococcal Isolated from Children Less than 5 Years Old Revathy Arushothy, Norazah Ahmad, Rohaidah Hashim, Nazirah Samsudin, Sakina Zainal Institute for Medical Research, Kuala Lumpur, Malaysia

Pneumococcal disease, caused by Streptococcus pneumoniae, is a major burden to global health. World Health Organization (WHO) strongly recommends pneumococcal conjugate vaccines in national immunization programmes (NIP's) worldwide to reduce the morbidity and mortality levels, especially among young children. In this study we describe the pneumococcal surveillance program in Malaysia as baseline to introduce the pneumococcal vaccines in our NIP program.A total of 242 Streptococcus pneumoniae isolates were received from pediatric patients less than 5 years old, admitted for various prognosis. Capsular serotypes were identified by the Quellung reaction test (SSI, Copenhagen, Denmark). Drug susceptibility and resistance was determined by minimum inhibitory concentrations (E-test; AB Biodisk, Solna, Sweden). The data shows that the most common serotype for S.pneumoniae were serotype 6B (16.1%), 14 (14.5%), 19F (14.5%), 19A (9.1%), 23F (7.4%) 6A (7.4%), 23A (4.5%), 11A (3.3%), 15C (2.1% and 19B (2.1%). The serotype 23A and 11A is an emerging non vaccine serotype, compared from the year 2014, the number of these isolates are higher. WHO reported that the penicillin resistance for S.pneumoniae is in rise, however it is relatively low in Malaysia. The resistance to erythromycin was (45.3%), followed by tetracycline (40.1%), trimethoprim/sulfamethoxazole (39.7%), cefotaxime (13.9%) and ceftriaxone (11.3%).The 13 valent pneumococcal polysaccharide conjugate vaccine (PCV-13) covered the majority of the serotypes identified in this study. The results from this study shows important data on S.pneumoniae serotype distribution and immunization coverage that could influence vaccination strategies in Malaysia.


52

PP1-07

Serological Cross-Reactions between Bartonella henselae, Bartonella quintana, Coxiella burnetii and Chlamydia species: Implications for Diagnosis Tay B.Y., Mohamed Zahidi J., Yee C. Y., Dolhan NQ, Arushothy R., Amran F. Bacteriology Unit, Institute for Medical Research, Kuala Lumpur, Malaysia

Bartonella henselae is responsible for cat scratch disease (CSD) which is a bacterial infection affecting lymph nodes. Immunofluorescent antibody assay (IFA) using acute serum is the most convenient and sensitive serological procedure to identify CSD. The study aimed to demonstrate possible cross-reactivities of antibody detections between B. henselae with B. quintana, Coxiella burneti and the three Chlamydia spp. (C. pneumoniae, C.psittaci and C.trachomatis) using their respective serological assays. IFA to detect immunoglobulin G (IgG) antibody against B. quintana and C. burnetii were performed on 36 samples that were positive for B. henselae antibody and diagnosed as CSD. Results and discussion: Thirty-three of the serum samples positive for CSD were also positive for B. quintana IgG and 24 were positive for C. burnetii IgG giving rise to 91.7% and 66.7% cross-reactivities respectively. When the same 36 samples were tested for the presence of Chlamydia IgM antibodies, C. psittaci IgM showed highest cross-reactivities with 31/36 (86.1%) tested positive. Although serological testing for diagnosis of CSD is rapid and convenient, it has several limitations. Cross-reacting antibodies with other diseases as observed in the present study, may lead to a significant diagnostic dilemma unless clinical features are very suggestive of the diagnosis of CSD. Therefore other supportive diagnostic methods need to be done to confirm the diagnosis. Molecular detection of specific B.henselae DNA would provide more accurate laboratory diagnosis of CSD and should be employed whenever such dilemma arises.


53

PP1-08

Sexually Transmitted Infection Awareness and Information Seeking Online among Young People Shakir, S. M. M., Wong, L. P., Abdullah, K. L., Adam, P. University of Malaya, Kuala Lumpur, Malaysia

Information about sexually transmitted infections (STI) can be found on the Internet and is an important resource for young people. Little is known of the factors associated with online STI information seeking. This study aimed to identify the factors associated with STI information seeking online among young people. A cross sectional online survey was conducted among young people aged 18 to 25 years old who were recruited through Facebook. Multivariate logistic regression was used to determine the factors associated with STI information seeking online. In total, 57.1% of the respondents seek STI information online. Young people who were in a relationship (OR=1.31, 95% CI=1.02-1.68, P=0.003), had higher knowledge scores (score 11-25) (OR=1.73, 95% CI=1.34-2.22, P=0.000), use the Internet to search for health-related information (OR=8.01, 95% CI=1.52-42.32, P=0.000), aware of STIs (OR=2.39, 95% CI=1.81-3.15, P=0.000), think about STIs (OR=4.74, 95% CI=3.70-6.07, P=0.000), seen or heard media coverage on STIs (OR=1.56, 95% CI=1.10-2.21, P=0.000), and seen or heard of sexual health promotion campaign (OR=1.67, 95% CI=1.26-2.21, P=0.000) were more likely to seek STI information online. Findings suggest that STI information seeking online is associated with awareness of STIs. STI information seeking online should be encouraged among young people who are not in a relationship, have low STI knowledge, do not search for health information online, are unaware of STIs, as well as unaware of media coverage on STIs and sexual health promotion campaigns. This is because STI information online is beneficial for STI prevention education and STI awareness among young people. More media coverage on STIs and sexual health promotion campaigns should be carried out to create awareness on STIs which should be synchronous with online STI prevention intervention efforts aimed at young people.


54

PP1-09

Characterization, Distribution and Genetic Diversity of Salmonella typhi in Malaysia Abd Hazis, N.H.,Hashim, R., Ahmad, N., Amran, F. Bacteriology Unit, Infectious Diseases Research Centre, Institute for Medical Research, Kuala Lumpur, Malaysia

Salmonella enterica serovar Typhi (Salmonella typhi) is the etiological agent of typhoid fever, a systemic febrile illness in humans. The disease remains as an important public health problem in developing countries especially in South Central and Southeast Asia. The objectives of this study were to study the characteristic, distribution and determine the genetic relationships between the strains of S.typhi circulating in Malaysia in the year of 2015.A total of 344 isolates from various government and teaching hospitals throughout Malaysia were processed. Antibiogram of the isolates were determined for ampilicillin (10 µg), chloramphenicol (30 µg), cotrimoxazole (25 µg), nalidixic acid (30µg), ceftriaxone (30 µg) and ciprofloxacin (5 µg) using Kirby-Bauer disk diffusion method. 87 isolates were selected and analyzed using Pulsed-Field Gel Electrophoresis (PFGE) using XbaI restriction enzyme and results were interpreted by fingerprinting software (Bio-Rad Laboratories). Cases of S.typhi was found to be highest in Kelantan (45.3%, n=156). Four point seven percent isolates were resistant to at least 3 of the 6 antibiotics tested with highest resistance rate was observed for nalidixic acid (25.9%, n=89). PFGE analysis generated 65 unique profiles and the number of DNA fragments ranged from 12 to 20. Thirty eight PFGE patterns were identified either identical or closely related based on Dice coefficient of similarity, F=0.9-1.0. This findings suggested a genetically heterogenous and diverse population of S.typhi in Malaysia. Sharing of similar PFGE pattern between isolates of typhoid outbreak in Kuala Lumpur and sporadic cases in other states suggested that the strain was not restricted to a particular state and widely distributed throughout Malaysia.


55

PP1-10

Community Mobilization in Sustainable Dengue Control by Using Social media via „WhatsApp‟ in Kinta District “Preliminary Study” Devarajah N1,Loges V2

1Pejabat Kesihatan Daerah Kinta, Batu Gajah, Perak, Malaysia

Dengue is one of the major challenges in most Tropical countries. Now, it has been an issue in Kinta District too. The Kinta Health Department found that there is no proper mechanism to report Dengue related issues in the community to the relevant authorities. A new approach was formed to curb it. The powerful waves of social media was introduced. „WhatsApp‟ groups were created at various localities to encourage community participation. The group consists of both health and local authorities, counselors, members of the community and nongovernmental organization personnel which served as a mean of two way communication. The community issued their relevant grouses and environmental issues via „WhatsApp‟ group by uploading pictures and locations of those problematic spots so that immediate action will be taken. Effective sustainable prevention and control measures were then channeled to the community for further actions. Various other effective strategies were also taken. Dengue committee was set up in each locality. The localities were than subdivided into different zones in which the Community Dengue Patrol Team will combat dengue by identifying risk areas. ‟10 minutes Checklist‟ tool were used to create awareness in the community. Management of construction sites and factories within each zone is required to participate in this program. „Single Case Approach‟ method was implied. Three (3) days „Gotong Royong‟ method was introduced and school children participations were also targeted. Continuous teamwork among the community with health authorities in implementing these strategies has created sustainable preventive and control measures. The community will be alerted immediately by the Kinta Health Department if their locality has „single case‟ detected. The two way communication created between community and relevant Health Authority by using „WhatsApp‟ group is indeed a powerful sustainable mechanism in combating Dengue and clean environment.


56

PP1-11

Knowledge and Practice of Salon Workers on Hepatitis B and Hepatistis C Virus Transmission Azmi NAB, Roslee AHB, Salam NAZB, Nazri NBM, Roy CKR Faculty of Medicine, Universiti Kuala Lumpur Royal College of Medicine Perak, Malaysia

HBV and HCV can be transmitted from infected individuals to others by different parenteral routes. Salon and parlour services related with minor cuts and abrasions in clients and providers may playing role in the transmission of potential hazardous blood borne infections. During a haircut, shave, hair removal and body piercing or pedicure and manicure, barbers may accidentally expose to their clients‟ blood, transmit their own infection to them, or transmit the infection between the clients. Objective: The aims of the presents study were to assess the level of knowledge and observe the attitudes of prevention of blood borne hepatitis virus transmission by professional salon activities. A cross sectional observational study has been conducted to the randomly selected 55 workers of salons in Kinta and Greentown, Ipoh, Perak, Malaysia during 14th December 2016 until 31st December 2016. The pre-designed questionnaires consisting three parts were distributed to salon workers and asked for fill it. Data was collected, analyzed and presented in organized manner. Most of the respondents were educated 5.5%, 50.9% and 38.2% were obtained degree, diploma and SPM respectively. Among the salon workers 43.6% are not aware about the transmission of HBV and HCV. Around 50% of the respondents does not knows that the HBV and HCV infections can be transmitted through contaminated blood and body fluids. Significant number (39/55) of the salon workers have not done blood tests for detection of HBV and HCV infections and, only 10.9% were vaccinated against HBV. The salon workers should have more knowledge about the transmission of those potential life threatening viruses and should be taken preventive initiative to HBV infection by vaccination. Further study may be designed with the aims of sero-surveillance of the salon workers in a large scale.


57

PP1-12

The Attitude and Perception of Young Malay Adults in Ipoh, Perak Regarding Childhood Vaccinations Azizan, Muhammad Hidayat, Mohamad Fakhruddin, Mohamad Nan, Resni, Mona Faculty of Medicine, Universiti Kuala Lumpur Royal College of Medicine Perak, Malaysia

In 2016, a major daily paper in Malaysia reported Perak as one of the four states in Malaysia having the highest non-vaccinated children; and among the three major ethnic groups in Malaysia, the highest rate of vaccination rejection comes from the Malay parents. Therefore, the aim of this study is to gauge the attitude and perception of soon-to-be-married young Malay adult towards vaccination in children in the hope to identify any issues that might affect their willingness to have their children vaccinated in the near future. This is a cross-sectional study involving 153 respondents (44% male and 56% female) who were attending an Islamic Marriage course at a designated centre in Ipoh, Perak. This course is compulsory in Malaysia for those muslim couples who are planning to get married. A small majority of the respondents (69.9%) are in favour of vaccinations and 59% of the respondents doesn‟t think that vaccinations should be given to everyone. While all the respondents agree that the responsibility to have the children vaccinated is on the parents; about 40% of the respondents also agrees that the responsibility can be taken by the health workers and a majority of the respondents (85%) prefers to have a session with their doctor regarding vaccinations. For an issue that concern all Muslim, only half of the respondents think that the vaccines are halal (permissible for Muslim). Where side effects are concerned, the ones that concerned the respondents most are fever and anaphylactic shock, followed by swelling and death. In general, the findings of our study show that the majority of our respondents have a positive perception regarding vaccinations and this is not affected by gender, education level, and the respondents‟ view of their religiosity.


58

PP1-13

Genetic Diversity of Plasmodium knowlesi among Humans and Macaques Population using Microsatellites Markers NoorAzian MY1,Afiqah SH1, Mohd Ridzuan MAR2, Nurhainis OS1, Shamilah H1

1Parasitology Unit, Infectious Disease Research Centre, Institute for Medical Research, Kuala Lumpur, Malaysia 2Bioassai Unit, Herbal Medicine Research Centre, Kuala Lumpur, Malaysia

It was postulated that P. knowlesi could be transmitted from macaques to man. Laboratory studies proved that it was possible in 1965 and a large cluster of human infection was identified in 2004. The aim of this study was to determine the genetic diversity of P. knowlesi in human and macaque samples. Genotyping was performed using 10 neutral microsatellite loci markers. The size of alleles, multiplicity of infection (MOI), mean number of alleles (Na), expected heterozygosity (He), linkage disequilibrium (LD) and genetic differention (FST) were determined. In highly endemic P. knowlesi localities, the microsatellite MOI for human and macaques were 1.08 and 1.26 respectively. The mean number of alleles (Na) for P.knowlesi-infected human isolates was 11.14 and 7.86 for macaque‟s isolates. Based on the allele frequency distribution graph for all loci, no genetic differentiation was seen between human and macaques as no FST value reach more than 0.1. P.knowlesi-infected human isolates at low endemic area mean number of alleles is 6.14 and 2.71 for macaques. There were a fairly high genetic diversity at loci CD05_6, CD08_61, and CD13_61 that gives FSTvalue more than 0.100 (p<0.05). Further molecular analysis on allele frequencies showed that genetic differentiation of human P.knowlesi-isolates have a significant high deviation as compared to macaques isolates, giving a very low fixation index between human and macaques (FST = 0.018, p<0.05). The results showed that humans have mostly single genotype P.knowlesi infection while macaques have polyclonal infections, supporting the assumption that there is a higher rate of transmission among macaques. Understanding the genetic diversity level of isolates in P. knowlesi can provide invaluable information, which may be useful in the intervention strategies to assist the national elimination target.


59

PP1-14

Prevalence of Ectoparasitic Infestations: Head Lice and Scabies among Orang Asli School Soe MM, Ismail S., Sugathan S., Singh D., Sinniah B., and Hassan AKR. Faculty of Medicine, Universiti Kuala Lumpur Royal College of Medicine Perak, Malaysia

Both head lice and scabies are ectoparasitic infestations having worldwide distribution with varying levels of prevalence, with Asia reporting 0.7% to 59% prevalence, and scabies ranging from 0.2 to 71.4% prevalence reported worldwide. However few studies have been done among the Orang Asli population on these two infestations. Our study aims to determine the prevalence of scabies and head lice infestations and their sociodemographic determinants among Orang Asli school children in Perak. A cross sectional survey was conducted among 231 school children aged 7 to 12 years old in selected Orang Asli villages in Perak. The children were interviewed to obtain their sociodemographic information, and examination of skin and head for presence of head lice and scabies were done, and those with infestations were given treatment. The overall prevalence of head licewas 46.3%, with girls having a significantly higher prevalence of 74.7% compared to boys with 13.2% (p=0.00). The prevalence among girls was significantly associated with staying in the hostel with 88.6% compared to 68.9% among the day students (p=0.024). The overall prevalence of scabies was 15.6%, and girls had a higher prevalence with 19.2% compared to boys with 11.3%.; and associated with staying in the hostel with 31.1% compared to day students with 14.4%. The high prevalence of head lice and scabies especially among girls and those staying in the hostel indicate the need for continuous monitoring and treatment of these conditions among school children especially those staying in hostels. Mass treatment at periodic intervals should be considered, along with educational measures for improvement of personal hygiene and environmental conditions.


60

PP1-15

Genetic Relatedness and Antibiotic Resistance Profiling of Salmonella enterica Serovar Albany from Food and Environmental Isolates Obtained from Wet-Markets in Malaysia Abatcha Mustapha Goni, Mohd Esah Effarizah,Gulam Rusul Food Technology Division, School of Industrial Technology, Universiti Sains Malaysia, Penang, Malaysia

Salmonella remains a leading etiological agent in bacterial foodborne diseases, and a leading cause of food poisoning in humans all over the world. A genotypic characterization of foodborne pathogens is important for a routine surveillance studies provide epidemiological data for tracking source of infections. The increasing occurrence of multidrug resistant (MDR) nontyphoidal Salmonella complicates available treatment options. Fifteen isolates of Salmonella enterica serovar Albany isolated from vegetable, chicken and their related environment obtained from different wet-markets were characterised by random amplified polymorphic DNA (RAPD), repetitive extragenic palindromic-PCR(Rep-PCR) and resistance against twelve antimicrobial drugs were examined. RAPD analysis subtyped 15 isolates into 14 profiles (Dice coefficient of similarity, F=0.2-1.0) whereas Rep-PCR produce into 12 profiles (Dice coefficient of similarity, F=0.6-1.0). At 80% similarity of the dendogram, RAPD differentiated the isolates into 3 clusters, while Rep-PCR differentiated into 5 clusters. The Rep-PCR show a high degree of relatedness, isolates from different source and location had unique, indistinguishable profiles and genetically distinct. These probably indicated cross-contamination and poor hygiene in food practices, hence contributing to Salmonella infection. All the chicken (n = 3), environment (n = 8) and vegetables (n = 4) S. Albanywere examined and a high percentage of multidrug resistancewas observed (100% of chicken, 89% of environment and 50% vegetables isolates). This highlights the need to implement stringent control measures to reduce contamination and spread of resistance Salmonella Albany, so as to prevent human infections. The data generated in this finding will contribute towards monitoring, surveillance and investigations of Salmonellosis in Malaysia.

http://www.sciencedirect.com/science/article/pii/S0956713515302528

https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=2&cad=rja&uact=8&ved=0ahUKEwjl947ew9TUAhXENo8KHVf2B7oQFggtMAE&url=http%3A%2F%2Fwww.changbioscience.com%2Fprimo%2Fpcr%2FeRepetitivesextrageni.htm&usg=AFQjCNEYbaOxYv3dlbx3DSxxr9eA5cq14g


61

PP1-16

Common Infections in the Elderly Presenting to Primary Care Chan Sc1, Teoh Lc2,Hussain R. Saadi1

1Universiti Kuala Lumpur Royal College of Medicine Perak, Malaysia 2Klinik Teoh & Chan Sdn Bhd, Batu Gajah, Perak, Malaysia

Infectious diseases account for one third of deaths in the elderly. Contributing factors include comorbidities and increased susceptibility to infections. Besides non communicable diseases, Primary Care Physicians in the frontline providing elderly care must be aware of the continuing health threats of communicable diseases for the elderly. To identify the common infections in the elderly presenting to primary care. Records of all elderly patients aged 60 years and above who presented to a primary care clinic in Perak, Malaysia, from January 2017 to March 2017 were traced. Data entered into SPSS version 17 were analysed for demographic characteristics and presenting problems. Two hundred and eighty six elderly patients (46.5% males, 53.5% female) registered during the study period. Percentage by age groups were: 60-69 years (45%); 70-79 years (37%); 80 years and above (18%). Majority (82%) were Chinese. Thirty six percent (103 patients) presented with infections, accounting for 167 (29%) of the 575 consultations during the study period. The remaining consultations were for chronic diseases and acute non-infectious complaints such as hypertension and minor trauma. Upper respiratory infections accounted for 48% of the consultations, followed by chronic infected diabetic ulcers and skin infections (33%), acute gastroenteritis (4%), herpes zoster infection (3.6%), acute bronchitis (3%) and urinary tract infections (3%). More than one third of the elderly presented with infections in this study. Majority were respiratory and skin infections and related to diabetic complications. Early diagnosis and treatment will prevent progression to more serious consequences in the elderly.


62

PP1-17

Distribution of Eye Diseases in Kasungu District, Malawi, Central Africa Kang, R., Kim, J., Chung, P., Hwang, H., Kim, J.S., Kim, H., Baek, S., and Talama, G Youth with Talents, Fairfax, VA, USA and Kasungu District Hospital, Malawi

Analysis of the distribution of patients and eye diseases in the Kasungu District Hospital of Malawi, a land locked country in South-eastern Africa, was presented. Malawi is one of the poorest countries in the world and the health system faces a lot challenges in terms of resources. The study was, therefore, done to understand the burden and distribution of eye diseases in this resource limited setting. We did a retrospective study by extracting data from data registers in the eye department for the period of May 2015 to June 2016. The statistics of the reported eye diseases were analysed with variables such as patient gender, eye disease type, patient age and times of the year. There was no association between eye diseases and gender nor with times of the year. However, we noted that the commonest type of eye disease was conjunctivitis. And, there was strong association of some disease type with age, for example, conjunctivitis was common in young age group while cataract was common in the elderly. It is shown in this study that many of the eye diseases endemic to Africa do generally occur in this selected district as well. However, the analysis presents the possibility of reducing the incidences of many diseases by preventive measures and access to health facilities on time. This work is the extension of previous efforts to make accurate data available and is placed in the larger context of the diseases affecting the African continent in general.


63

PP1-18

HIV in Kasungu District of Central Malawi - A Descriptive Cross Section Study

Yoon, J., Kim, K. M., Lim, S., Kim, S., Chung, R., Park, S., Kachingwe, J., and Talama, G

Youth with Talents, Fairfax, VA, USA and Kasungu District Hospital, Malawi

More than 70 million people have been infected with the HIV virus and about 35 million people have died of HIV [WHO 2015 report]. Sub-Saharan Africa remains most severely affected, accounting for nearly 70% of the people living with HIV worldwide [WHO fact sheet 2015]. Approximately 8.8% of women and men age 15-49 in Malawi are HIV positive [MDHS 2015-2016]. At present the sociodemographic factors affecting HIV/AIDS epidemic in Kasungu district in Malawi are unknown. We aimed to determine socio - demographic factors affecting HIV/AIDS and its treatment in Kasungu district. We conducted a descriptive cross section study involving1260 adult participants (aged 18+) living with HIV. Data was collected from Kasungu District hospital HIV registry of 2014-2016 and we used face to face interviews to collect similar data from St Andrews Hospital HIV positive clients in the ART clinic. HIV was common among non-pregnant females, (40.9%) compared to pregnant females, (19.3%). HIV was more common among non-pregnant females than men (40.9 vs. 39.6% respectively). The main reason for starting ARV was a low CD4 count seconded by WHO clinical stage 3. HIV was common among farmers, 38.5% and Business people, 24.5%. 9out of 11 patients had negative reactions upon finding out they were HIV positive and 7 out of 11 patients had thoughts related to suicide, or attempted suicide. About 50% of the surveyed patients revealed that they have experienced discrimination due to the fact that they are HIV positive. Stigma and discrimination still exist in Kasungu district despite efforts to mitigate them. Interventions to prevent new infections should be implemented among most of the female population, farmers and business community in Kasungu district.


64

PP2-01

Seasonal Influenza B Virus Strains Circulating in Malaysia from 2005 to 2015 Mohd Zawawi, Z.,Tengku Abdul Rashid, T.R., Yusof, M.A., Thayan, R. Virology Unit, Infectious Disease Research Centre, Institute for Medical Research, Kuala Lumpur, Malaysia

Monitoring the circulating influenza virus strains is important as it can provide a base for the country to prepare for local pandemics planning and vaccine policy. In 1968, Virology Unit of IMR was designated as a National Influenza Center (NIC) and assisted the Ministry of Health (MOH) in monitoring influenza activities for Malaysia. Here, we were monitoring the circulating influenza B virus strains in Malaysia to identify the predominant influenza B strains from 2005 to 2015 and to monitor the vaccine compatibility. Methodology: All respiratory specimens received from patients presenting with Influenza-Like-Illness (ILI) were included in this study. Specimens were inoculated into Madin-Darby Canine Kidney (MDCK) cells and isolates were identified by indirect immunofluorescence antibody technique (IFAT), real-time reverse transcription-polymerase chain reaction (rRT-PCR) and hemagglutination inhibition (HAI) assays. The results were used to observe the predominant circulating influenza B strains in Malaysia. The predominant influenza type B virus strains were B/Hong Kong/330/2001-like in 2005, B/Malaysia/2506/2004-like (new strain isolated in Malaysia) in 2006, B/Florida/4/2006-like in 2007 and 2008 and B/Brisbane/60/2008-like in 2009 to 2012, B/Massachusetts/2/2012-like in 2013 to 2014 and B/Phuket/3073/2013-like virus in 2015. During study period, both B/Victoria lineage and B/Yamagata lineage viruses were found circulating in Malaysia. The predictions on upcoming predominant B lineage for influenza vaccine programme had failed in 2005, 2007 and 2009 since the predominant circulating influenza type B strains were not matched with the vaccine components. For the influenza B type, the B (Victoria) lineage was greater in occurrence compared to B (Yamagata) lineage for the past 11 years. This local surveillance data of the prevalent circulating influenza virus strains is important not only for control strategies but also for selection of virus strains to be used in the annual influenza vaccine formulation.


65

PP2-02

Time Series Analysis of Dengue Incidence in Petaling, Selangor Noraishah, MS, Rafiza, S and Mohd Shahar, AR Environmental Health Research Centre, Institute for Medical Research, Kuala Lumpur, Malaysia

Dengue and climatic conditions has been associated and proved by many studies. Although it is known that weather conditions give a big impact on dengue transmission, the effects of future climate change have been discussed around the world. This study aimed to determine the empirical relationship between climate and dengue incidence and to predict dengue trend in Petaling, Selangor. The longitudinal data of dengue and climate parameters between year 2009 and 2015 were used for model estimation and 2016 for model validation in this study. Box-Jenkins approach was used to fit Auto Regressive Integrated Moving Average (ARIMA) model for the dataset. Petaling was selected as the study area since the district was ranked as the top dengue hotspot area in Malaysia. This study also explore ARIMA models incorporating climate variables as external regressors. The results indicate that temperature and rainfall gives a low negative correlation (r=-0.061 and r= -0.022) with dengue incidence. ARIMA (2, 1, and 2) was chosen as the best model for the dataset and it fits the trends of dengue incidence well. Besides, 75% of the prediction dengue incidence lies within 95% interval range for each month in 2016. Our findings indicate that ARIMA models are useful tools for monitoring dengue incidence in Malaysia. Hence, these models can be applied to surveillance data for predicting trends in dengue incidence.


66

PP2-03

First Report of Vancomycin-intermediate Staphylococcus aureus (VISA) in Malaysia Hashim R.1, Baharudin S.2, Zulbadrisham NH.2,Zainal S.1, Hamzah H.1, Dahalan NA.1, Amran F.1 and Ahmad N.1

1Bacteriology Unit, Infectious Disease Research Center, Institute for Medical Research, Kuala Lumpur, Malaysia 2Microbiology Unit, Pathology Department, Hospital Melaka, Melaka, Malaysia

Vancomycin continues to be the drug of choice for treating most methicillin-resistant Staphylococcus aureus (MRSA) infections. As the number of reported MRSA infection increases every year, clinicians have increased reliance on vancomycin. Increased use of vancomycin or history of previous exposure to vancomycin for MRSA treatment in patients has been identified as the predisposing factors to the emergence of vancomycin-intermediate S. aureus (VISA) as well as vancomycin resistant S. aureus (VRSA) which leads to vancomycin treatment failure. To date there is yet any record of VRSA in our country. We are reporting the first case of VISA isolated in a 66 year old patient from one of the major hospitals in Malaysia. RAR has underlying diabetes with end stage renal disease, on renal replacement therapy. She was diagnosed as having MRSA bacteremia in January 2017 following hospital admission for urosepsis, completed vancomycin treatment and was discharged well. In March 2017, the patient presented with fever, chills and rigor. Blood culture grew MRSA with increased minimum inhibitory concentration (MIC) to vancomycin (4µg/mL). She was initially commenced on vancomycin however, treatment was change to linezolid and later daptomycin as clinically she was not responding well. Blood culture finally became negative of VISA. The isolates harboured SCC Mec A but not Panton–Valentine 66eucocidin and VanA genes. Visualization under electron microscope revealed a thicker cell wall compared to the MRSA and Methicillin sensitive Staphylococus aureus which explained the increase in vancomycin MIC reading.


67

PP2-04

Discovery of Novel Antibacterial(s) Noor Akbar, Ruqaiyyah Siddiqui, Naveed Ahmed Khan Department of Biological Sciences, School of Science and Technology, Sunway University, Selangor, Malaysia

Infectious diseases are a leading cause of morbidity and mortality and contribute to more than 14 million deaths annually, worldwide. In developing countries, infectious diseases account for 45 % of all death occur and thus considered as a number one killer diseases. Injudicious and misuse of antibiotics has frequently developed resistance in bacteria that has further worsen the problem. It has been estimated that by 2050, the number of annual deaths from drug resistant infections will reach up to 10 million. If the same situation continues than it seems that we would once again enter into a pre-antibiotic era. Thus there is an urgent need to identify molecules that can target drug-resistant bacteria.Here, we hypothesize that microbial gut flora of animals/pests living in polluted environments produce substances to thwart bacterial infections. Thus the overall aim of this study is to source microbes inhabiting unusual environmental niches and then develop novel antimicrobials. To achieve this, various animals were selected including snakes that feed on germ-infested rodents; cockroaches and rats that thrive in unhygienic conditions. The gut bacteria from these species were isolated and grown in RPMI 1640 and conditioned medium (CM) were prepared. CM was tested against selected gram positive (Methicillin resistant Staphylococcus aureus, Streptococcus pyogenes, Bacillus cereus) and gram negative (E. coli K1, Salmonella enterica, Serratia marcescens, Pseudomonas aeruginosa, Klebsiella pneumoniae).The findings revealed that gut bacteria isolated from cockroaches produce active molecules that showed potent activity against aforementioned bacteria. Studies are in progress to determine the identity of active molecules that could lead to the identification of novel candidates for future antibacterials.


68

PP2-05

Knowledge, Attitude and Practice of Infection Control among Clinical Year Medical Students of a Private Medical School in Malaysia Sandheep Sugathan, Davinder Singh, Myint Myint Soe, Zatul Iffah Binti Mohamad Zabhi, Syafia Nabilah Binti Mohamad Faculty of Medicine, Universiti Kuala Lumpur Royal College of Medicine Perak, Malaysia

The Centers for Disease Control and Prevention (CDC) defines health care associated infections as “infections acquired while in the health care setting with a lack of evidence that the infection was present or incubating at the time of entry into the health care setting” (1). A better knowledge, attitude and practices among clinical medical students can lead to an improved infection control practice among the future doctors. To evaluate the knowledge, attitude and practice of infection control among the clinical year medical students of Universiti Kuala Lumpur, Royal College of Medicine Perak (UniKL RCMP). This was a cross-sectional study carried out among clinical year medical students of UniKL RCMP from October to November 2016. The minimum sample size was calculated, assuming that 73% of medical students would be having a good knowledge on infection control with a precision of 5% as 165.The questions regarding hand washing, anti-sepsis, use of personal protective equipments, hygienic handling of patient care equipments / soiled linen, prevention of needle stick / sharp injuries, spills management, appropriate handling of health care wastes and adherence to standard precautions were enquired. Majority of the respondents had a good knowledge and good attitude (more than 80%) on most of the aspects of infection control. Use of personal protective equipments (49%) and use of hand sanitizer before wearing gloves were less (51%) among the participants. There was a significant association between attitude and practice. There was no difference in different genders or years of study. More emphasis on infection control is needed in the curriculum.


69

PP2-06

Performance of Genexpert MTB/RIF Assay for Rapid Detection of Mycobacterium tuberculosis and Rifampicin Resistance - A Validation Study Ramachandran Vignesh1,2, Chinnambedu R Swathirajan2, Sunil S Solomon2,3, Pachamuthu Balakrishnan2

1Faculty of Medicine, Universiti Kuala Lumpur Royal College of Medicine Perak, Malaysia 2YRG Centre for AIDS Research and Education (YRG CARE), Chennai, India 3Department of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, USA

Lack of a rapid and accurate diagnostic test for detection of active tuberculosis (TB) remains a critical impediment to global TB control. GeneXpert MTB/RIF assay, is an automated real-time PCR based assay for simultaneous detection of Mycobacterium tuberculosis (MTB) complex and resistance to rifampin (RIF) within 2 hours. To evaluate the performance of GeneXpert in detection of MTB and RIF resistance, as against MGIT based liquid culture method.A total of 80 specimens comprising stored sputum specimens and EQAS specimens were included in the study. The diagnostic performance of GeneXpert MTB/RIF assay was validated by calculating sensitivity, specificity, positive and negative predictive values and accuracy, with MGIT results as gold standard. Precision percentages of GeneXpert MTB/RIF assay for detection of MTB and RIF resistance were also measured.Of the specimens tested, 31 were tested positive for MTB by MGIT culture, whereas GeneXpert missed detecting 3 specimens. For detection of MTB, GeneXpert MTB/RIF assay achieved 90.3% sensitivity, 100% specificity and accuracy of 96.3%. The positive predictive value and negative predictive values were 100% and 94.2% respectively. GeneXpert MTB/RIF assay revealed 100% sensitivity, specificity and accuracy for detection of RIF resistance. Precision percentages for detection of MTB and RIF resistance were also 100%.The GeneXpert MTB/RIF assay is observed to be sensitive, specific, easy-to-perform and a rapid method for diagnosing MTB and RIF resistance. Further evaluation studies with more sample size are required to ascertain the applicability, cost-effectiveness and robustness.


70

PP2-07

Knowledge, Attitude and Practice of Dengue and Its Related Factors among Villagers in Kawasan Rukun Tetangga (KRT) Aulong, Selatan, Larut, Matang and Selama, Taiping Perak Hussain R. Saadi, Nur Farah Nabilah Bt. Shuib, Puteri Nurul Syuhadah Bt. Idris, Siti Fatimah Bt. Zainuddin, Muhammad Abdul Azim B. Mustapha, Shanna Asyeqeen Bt. Adzman, Hamizah Bt. Abdullah and Nur Farina Bt. Derahman Faculty of Medicine, Universiti Kuala Lumpur Royal College of Medicine Perak, Malaysia

The incidence of dengue in Malaysia has grown increasingly with 100,000 reported dengue cases in 2016 and 8,033 cases were reported for the first month of January 2017 according to the Ministry of Health. In Perak, 998 cases were reported between January and the first two weeks of February compared to 852 cases in the same period last year. Two hundred and sixty respondents were approached in Kampung Aulong Selatan, Taiping, Perak, and a total of 260 complete responses were obtained with 100% response rate. A cross sectional study design was chosen. The survey was conducted from 6-9 May 2017.All 3 main races were almost equally represented in this study. Out of 260 respondents, 78.1% had good knowledge, whereas 21.9% of them had poor knowledge. When asked about the causes of dengue, 51.5 % of the respondents knew virus was the cause. When it comes to attitude, 90% of respondent had good attitude and only 10% of respondents had poor attitude. In assessing the practice of respondents towards dengue, 71.2% had good practices and 28.8% had poor practices. A significant association was found between level of knowledge and practice (p = 0.005); knowledge and attitude (p = 0.000); and attitude and practice (p = 0.040). Despite having good knowledge about dengue and its cause, good attitude and overall good practices towards dengue prevention, the number of dengue cases is rising and this could be due to the lack of good preventive practices. We recommend more emphasis on the preventive measure to be taken by the Ministry of Health and on the community level, more public cleanup campaign (gotong royong) to be organized regularly.


71

PP2-08

Knowledge, Practice of Preventive Measures and Understanding Health Promotion Related to Dengue among Villagers in Kampong Sri Kinta, Ipoh-Perak Hussain R. Saadi, S Davinder, Rahul Sharma, Ahmad M. Harizan, Aqila M. Noor and Zharif F. Rahim Faculty of Medicine, Universiti Kuala Lumpur Royal College of Medicine Perak, Malaysia

The incidence of dengue has risen dramatically high over the last few decades worldwide. Some three billion people are currently at risk of getting infected with dengue. In Malaysia the total number of dengue cases has been rising annually to reach epidemic proportions. In Perak, the number of cases for both dengue fever and hemorrhagic dengue fever increased dramatically from 421 cases in 2012 to 1024 cases in 2013 accounting for an increasing rate of as much as 143.2%. Furthermore, the incidence rate of every 100 000 populations in 2013 also increased to 120.2 compared to 49.4 incidence rate in 2012. This study aimed to assess the knowledge, practice of preventive measures and benefits from health promotion related to dengue among villagers in Kampong Sri Kinta, Ipoh-Perak. A cross sectional study design was chosen. The study was conducted during the period from 8th June until 24th June 2015. Out of a total of 408 respondent. The results showed that, 61.3% and 74% of participants obtained good scores in knowledge and preventive practice measures respectively. The highest misconceptions occurred on behavior aspects of the Aedes mosquitoes (46.6%) and availability of vaccinations for dengue (40.7%) while 65% of respondents did allow the fogging activities to be conducted at 2pm (noon). Significant associations were shown between types of occupation and knowledge (p=0.017), level of education and practice (p=0.022), previous exposure among family members and practice (p=0.016), and between knowledge and practice (p=0.011).In conclusion, despite having good knowledge about dengue and potential breeding sites of the Aedes mosquito, the number of dengue cases is still rising and this could be due to the lack of good preventive practices.


72

PP2-09

Beta-D-Glucan, a Polysaccharide against Dengue Virus Infection in Vitro Ravindran Jaganathan Faculty of Medicine, Universiti Kuala Lumpur Royal College of Medicine Perak, Malaysia

Malaysia reported in excess of 120,000 dengue fever cases, including 322 dengue related fatalities. Dengue occurs nationally in Malaysia, with increased risk in urban and periurban areas. Although there have been considerable advances in the study of dengue virus, no vaccines or anti-dengue drugs are currently available for humans. Therefore, this study was designed to assess the effect of the polysaccharide, Beta-D-glucan against dengue virus infection and replication in human liver cells (WRL68). To study the effect of Beta-D-glucan against dengue virus infection in vitro. Cytotoxic efficacy was evaluated by quantitative colorimetric MTT. The existence of chemical affinity between DENV-2 for β-D-glucan was evaluated through solid-phase virus-binding assay. Beta-D-Glucan showed viral inhibition in a dose dependent manner with less toxicity on WRL68 cells, as with 600 μg/mL, highest concentration showed 60% viability at 24h, 55% viability at 48h and 50% viability at 72h. Plaque formation test and binding efficiency result of Beta-D-Glucan with viral supernatant conforms activity of Beta-D-Glucan against DENV-2 dengue virus. Study with Beta-D-Glucan, shows significant inhibitory effects against dengue virus replication in the infected cells. The results suggest β-D-glucan inhibit the replication of dengue virus and therefore, further investigation is necessary to develop the polysaccharide Beta-D-Glucan as a new anti-dengue therapeutic.


73

PP2-10

Cutaneous Leishmaniasis in Iraq

Noor Abdulhaleem 1' 2, Hind Younis2, Mohammed Abdullah3, Aliyu Mahmuda1'4, Roslaini Abd Majid1, Leslie Than

Thian Lung1, Wan Omar Abdullate and Zasmy Unyah1

1Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti

Putra Malaysia, Malaysia 2Department of Biology, College of Science, University of Anbar, Anbar, Iraq 3Surgery Department, Ramadi Teaching Hospital, Anbar Province, Iraq 4Department of Parasitology and Entomology, Faculty of Veterinary Medicine, Usmanu Danfodiyo University,

Sokoto, Nigeria 5Department of Medical Sciences, Faculty of Medicine and Health Sciences, Islamic Science University

Malaysia,

Malaysia

Cutaneous leishmaniasis is the most common form of leishmaniasis in Iraq, causing ulcerative skin lesions on the exposed parts of the body, leaving life-long scars and serious disability. This study was done in Anbar Province, one of the affected war zone areas in Iraq for diagnosis of cutaneous leishmaniasis. Staining using common parasitological techniques such as Giemsa and Leishman's stains were used; advance technique such as PCR was unavailable or destroys due to lack of infrastructure during the war. Patients were examined for ulcers or scars and dermal scrapings of skin ulcerations were analyzed by parasitological examination using Giemsa and Leishman-stained smears. Differential diagnosis was essential for the purpose of epidemiological survey and therapeutic purposes due to the similarity in clinical pictures with schistosomiasis and malaria. Iraq is a country with a population of approximately 38 million, the continuing war has caused majority of the population living below the national poverty for more than 25 years. The increase in incidence of cutaneous leishmaniasis was attributed to poor sanitary conditions, lack of proper treatment and medications, migration in endemic areas as well as rise in vector population. Most infections in endemic areas occur in children and were easily diagnosed by its clinical presentation. Diagnostic challenges arise when cases appear in non-endemic areas where any atypical infections resemble cutaneous leishmaniasis. In addition, secondary infection can cause alteration in the clinical presentation making diagnosis even more difficult, hence causing a delay in treatment.


74

PP2-11

Assurance of Safe Food for All with Harmonization of Standards Set through International Efforts Ahmed MK Faculty of Medicine, Universiti Kuala Lumpur Royal College of Medicine Perak, Malaysia

Food safety involves a number of routine works such as preparation, handling, transport and storage that should be followed to avoid potentially severe health hazards. Therefore, Food shall not be deemed to be unsafe or injurious to health and unfit for human consumption. But unhygienic rotten or adulterated foods are being sold by the vendors. Some food consists wholly or in part of filthy, putrid, rotten, decomposed or diseased animal or vegetable substance or is insect-infested or is otherwise unfit for human consumption. Some food may contain poisonous or other ingredient which renders it injurious to health. Some food may be contaminated with poisonous or deleterious substance, unauthorized colors, preservative or chemicals or microbes. Therefore all the countries are becoming aware to assure science based food production, transport and supply. They are enacting acts, rules and regulation to safeguard the wholesome foods accessible to the public. In 1962, to formulate internationally accepted food safety standards for protection of human health and to ensure global fair trade practices, FAO-UN and WHO formed a commission like Codex Alimentarius Commission with a view to protect consumer health and economic interests and to secure fair trade practices in the food industry. It is an intergovernmental body. The members of United Nations are generally the member of Codex and taking part in Codex activities. This commission collaborates with few laboratories in developed countries to determine safest daily intakes of food additives, preservatives, colors and other scientifically allowed chemicals. Presently, most of the countries have a very stringent acts, rules and regulations having well equipped accredited laboratories and trained manpower and are fully capable to contribute in Codex activities. Member countries can easily harmonize the standards set by joint global efforts. Thereby all the countries will come under common scientific and technological standards and non-tariff barriers will be minimized or removed. Food and food products complying with harmonized standards will be easily compete in the international market without compromising health or interests of consumers‟ different nationalities and culture. New economic zones of fair trade will evolve to ensure the standard food and food products to the consumers of those countries involved.


75

PP2-12

Nutritional Status of Orang Asli School Children in Selected Villages of Perak Soe MM,Sugathn S., Sabaridah I, Singh D., Sinniah B., and Hassan AKR Faculty of Medicine, Universiti Kuala Lumpur Royal College of Medicine Perak, Malaysia

Despite tremendous improvements in the health status of the population of Malaysia through the past decades after independence, the Orang Asli indigenous population of Peninsular Malaysia constituting less than 1% of the total population, still lag behind in terms of health and nutritional status improvements of the rest of the country. Our aim is to assess the nutritional status of Orang Asli school children from selected villages in Perak, and to determine the associated sociodemographic factors. A cross sectional survey of 231 school children aged 7 to 12 years old in selected Orang Asli communities in Perak was undertaken during 2015 and 2016. Sociodemographic information was obtained by interview, and height and weight measurements were taken using standard methods. Nutritional status assessment was made using 2007 WHO reference growth curves and Z scores, with recommended cut off points for classification of nutritional status. The overall prevalence of stunting among the Orang Asli children was found to be high at 60.2%; with 30 % being stunted and 28.1% being severely stunted. The prevalence was higher among girls (64.8%) compared to boys (54.7%). Stunting was found to significantly associated with mother‟s education (p=0.002). The prevalence of thin and severely thin was 9.1% by BMI for age. The overall prevalence of underweight was 26.1%, with 20.4% being in underweight category and 5.7% being severely underweight based on weight for age Z scores. The prevalence of malnutrition is still high among Orang Asli school children. Special long term and short term intervention programs focusing on improvement of nutritional status of orang Asli children should be given highest priority to improve the health status of the indigenous population.


76

PP2-13

Anthropometric Parameters of Indigenous Peoples in Various Localities in Northern Peninsular Malaysia in Relation to Blood Pressure, Diet and Lifestyle Nik Asyraf Nik Aziz, Abdul Karim Russ Hassan, Sandheep Sugathan Faculty of Medicine, Universiti Kuala Lumpur Royal College of Medicine Perak, Malaysia

The indigenous people of Peninsular Malaysia are still low in their health status as compared to the other race, the majority of them live in the forest fringes and poverty are still common. The development of roads and electricity supply have reached the villages. The anthropometric study aim to determine the association of the Body Mass Index (BMI), WHR and Blood Pressure of the adults with dietary pattern and lifestyle. A cross-sectional study was carried out in 5 villages in the state Perak, Northern Peninsular Malaysia. A total of 147 respondents were selected using random sampling. A questionnaire was administered and anthropometric measurements was taken. The anthropometric study found that a large portion of those surveyed were either pre-obese (31.29%) or obese (34%). The blood pressure measurement showed 16.4% were hypertensive and 29.9% were normal, while others were either prehypertension, systolic hypertension or diastolic hypertension. Total Household Members has a significant influence on total household income (p<0.05). There was a significant difference between BMI and Gender (p<0.05) where females were more likely to be obese than males. There was a significant difference in smoking and gender (p<0.05) where males were more likely to smoke compared to females. The diet of the indigenous people was largely healthy one and their lifestyle is also a healthy lifestyle that has a lot of exercise. A transition from the conventional agriculture and forest based economy to a more commercialized and services-based economy was evident. There is no starvation or malnutrition in the villages surveyed as the majority of the indigenous people studied were in good health.


77

PP2-14

Antibiotic Susceptibility of Staphylococcus aureus from Suburban Population and Children of Welfare Homes in Perak, Malaysia Nur Amirah R., Cheah T. S. and Davinder B. S. Faculty of Medicine, Universiti Kuala Lumpur Royal College of Medicine Perak, Malaysia

Staphylococcus aureus is one of the potential health threats that can lead to serious infections in both hospital and community. In Malaysia, previous studies on antibiotic resistant S. aureus were conducted mainly on isolates from patients in hospitals. This study was to determine the susceptibility of S. aureus against different type of antibiotics from suburban populations and children of welfare homes. Written consents were obtained from the individuals before the collection of samples. The sterile nasal swabs were placed in both anterior nares of the volunteers and after sampling they were placed in transport medium. The specimens were kept in an ice chest and brought to laboratory for microbiological investigations. A total of 184 samples from suburban population and 95 samples from children of welfare homes were collected. Identification of S. aureus was based on morphology of clumping factor and protein A using rapid slide agglutination test (Remel BactiStaph® kit, USA). Antibiotic Susceptibility Test was conducted using 16 different antibiotics discs diffusion according to method of Clinical Laboratory Standard Institute. They were Cefoxitin, Oxacillin, Erythromycin, Chloramphenicol, Vancomycin, Rifampin, Clindamycin, Tetracycline, Linezolid, Ciprofloxacin, Gentamicin, Fosfomycin, Fusidic Acid, Tigecycline, Trimethoprim-sulfamethoxazole and Quinupristin-dalfopristin. The results were read using Automatic Colony Counter (Scan® 500). Twenty-five (13.5%) samples from suburban population and twenty-two (23.1%) from children of welfare homes were positive for S. aureus. The results of antibiotic resistance of 25 S. aureus isolates from suburban populations were as follows: Tetracycline (12.0%), Chloramphenicol (4.0%) and Erythromycin (4.0%). The antibiotic resistance profile of 22 S. aureus isolates from children of welfare homes were as follows: Tetracycline (27.3%), Tigecycline (18.1%), Cefoxitin (13.6%), Clindamycin (4.5%), Linezolid (4.5%) and Rifampin (4.5%). One isolate from the children of welfare homes was found to be resistant to more than 3 classes of antibiotics and further studies therefore required to elucidate the problem of multi-drug resistant S. aureus in the children of welfare homes.


78

PP2-15

Antibiotic Resistant Staphylococcus aureus from Indigenous and Urban Poor Community in Perak Unwaniah, A. R., Cheah, T. S., and Sabaridah, I.

Faculty of Medicine, Universiti Kuala Lumpur Royal College of Medicine Perak, Malaysia

Staphylococcus aureushas become resistant to most common antibiotics and the treatment can be challenging. The nasal carriage of S. aureushas been widely spread in community and being recognised as an adaptable human pathogen for their potential to acquire antibiotic-resistant mechanisms. The resistant forms are normally known as methicillin resistant-Staphylococcus aureus (MRSA). The present study aimed to investigate antibiotics resistant S.aureus colonisation from 234 indigenous people and 238 urban poor community in Perak. Written consents were obtained from the participants before the collection of samples. Sterile swabs were placed in the anterior nares of the individuals and after swabbing they were placed in a transport medium. The samples were kept in an ice box and brought to the laboratory for microbial investigation.Bacteria isolation and identification of S. aureus were conducted with standard microbiological procedures. S. aureus colonies were confirmed by detection of clumping factor and protein A using rapid slide agglutination test (Bactistaph remel, USA).Of the indigenous people, 24.8% (58 of 234) had the S. aureus colonisation, while 15.1%(36 of 238) of urban poor community had S.aureus. Antibiotic susceptibility testing on the isolates was carried out using disc diffusion method according to the method of Clinical and Laboratory Standard Institute (CLSI). A total of 16 different antibiotic discs were used in the investigation. They were Erythromycin, Rifampin, Clindamycin, Fusidic acid, Chloramphenicol, Ciprofloxacin, Gentamicin, Fosfomycin, Vancomycin, Oxacillin, Tigecycline, Cefoxitin, Tetracycline, Linezolid, Trimethoprim-sulfamethoxazole, and Quinupristin-dalfopristin. The results of antibiotic resistance of 58 S. aureus isolates from the indigenous community were as follows: Chloramphenicol (1.7%), Tigecycline (1.7%), Quinupristin-dalfopristin (5.2%), Rifampin (6.9%), Vancomycin (6.9%), Tetracycline (6.9%), Linezolid (8.6%), Cefoxitin (10.3%), Fusidic acid (10.3%), Erythromycin (10.3%), Oxacillin (10.3%) and Clindamycin (12.1%). The antibiotic resistance profile of 36 S.aureus isolates from the urban poor were as follows: Erythromycin (2.8%), Clindamycin (2.8%), Ciprofloxacin (2.8%), Oxacillin (2.8%), Quinupristin-dalfopristin (2.8%), Fusidic acid (5.6%), Chloramphenicol (5.6%), and Cefoxitin (8.3%). A total of 5S. aureus isolates from indigenous and 1 from urban poor were found to be resistant to more than 3 classes of antibiotics and hence considered as multiple drug resistant (MDR). The findings of the study suggest that multiple drug resistant (MDR) S. aureus are present in the two populations studied. The MDR S. aureus in these two populations merits further studies so as to elucidate this problem of MDR in the two community in Malaysia.


79

PP2-16

Measles: An Insight into Awareness of the Disease and Its Vaccination among Parents in a Residential Area in Ipoh, Perak Davinder S, Sandheep S, Siti Munirah MY, Nuruljannah A, Mohd Fadlin Syafiq MF. Faculty of Medicine, Universiti Kuala Lumpur Royal College of Medicine Perak, Malaysia

Measles, a highly preventable infectious disease is a major public health problem locally and globally. Globally, 134 200 measles death occurred in 2015 with 367 deaths daily. In 2016, Malaysia experienced a rising number of measles cases. The number of cases till June 2016 rose by 340% compared to 2015 during the same period. Outbreaks also rose in the corresponding period. Malaysia intends to eliminate measles by 2018. The anti-vaccine movement which discourages vaccination is gaining exposure hampering Malaysia‟s effort. Insight into the awareness of measles and its vaccination. This cross sectional study was done with distribution of questionnaires to parents in a residential area in Ipoh, Perak. Convenient sampling was done based on accessibility and proximity. The questionnaire consisted of knowledge and attitude on measles and vaccination and practice of vaccination. Of the 200 respondents, 97% knew about measles. Fifty seven percent did not know that measles could cause complications while only 53% knew that measles infection could cause deaths. Only 76% knew that measles was preventable. In regards to attitude, only 1.5% felt they need not vaccinate their child while 4.5% may not complete the full dosage of vaccine requirement. Seventy respondents, 35% agree with the anti-vaccine movement stance while 7.5% felt that their religion prohibits vaccination. Of the respondents, a small proportion, 2.5% will not send their children for vaccination while 9.5% may not complete the full schedule for their children if there are compelling doubts. There are still pockets of people who are misguided on measles and benefits of vaccination. Their concerns have to be addressed since the anti-vaccine movement has convinced parts of the population of the dangers of vaccination. This differential gap between misguided and sound knowledge of individuals has to be overcome by effective and innovative health promotion.


80

PP2-17

Intestinal Parasitic Infections among Orang Asli Children in Relation with Selected Sociodemographic Factors Ismail S, Soe MM, Sinniah B, Hassan AKR, Singh D, Sugathan S. Faculty of Medicine, Universiti Kuala Lumpur Royal College of Medicine Perak, Malaysia

Parasitic infections are common in under previllage communities worldwide resulting in health problems in children. Studies showed that parasitic infections has not improved much over the years despite of socioeconomic development of the country. To determine the prevalence of intestinal parasitic infections among the Orang Asli (aborigine) children and its relation to socioeconomic and type of infections. 183 Orang Asli children of age group 7 to 12 years old were involved in this cross sectional study from selected Orang Asli village in Perak. Sociodemographic data were collected using interview based questionnaires from parents or guardians and stool samples taken and examined in the laboratory. Of 183 Orang Asli children examined, 71.0% were positive for at least one intestinal parasitic infection. Only 0.8% had single infection, 33.1 % 2 infections, 39.2% 3 infections, 22.3% 4 infections and 4.6% had 5 types of parasites infections. There was significant different between stayed in hostel or not which was 91.5% of children who stayed in hostel were infected whereas only 64% were infected among those who did not stay in hostel (p=0.00). Maternal occupation gave significant association with intestinal parasitic infection (p=0.03) where 87.3% of infected children, the mother were housewives. There were no significant different between gender where 72% of males and 69.4 of females were infected. There were also no significant association with age groups, parents‟ education level and number of siblings. The commonest were Trichuris trichiura (68.5%), Ascaris lumbricoides (49.2%), Entaomeba coli (16.2%), Entaomeba histolitica (15.4%) and Blastocystis hominis (15.4%). Intestinal parasitic infections were prevalent among Orang Asli children in school age group who stay in rural areas. The infections were common among who stayed in school hostel and housewife mothers.


81

PP2-18

A Descriptive Study on Prevalence of Opportunistic Infection among HIV/AIDS Individuals in Outpatient Clinic in a Hospital in Ipoh Farah Farzana Binti Ansari, Sharmila Nani and V.Gopalakrishnan Faculty of Medicine, Universiti Kuala Lumpur Royal College of Medicine Perak, Malaysia

This research aimed to determine the prevalence on type of opportunistic infections among HIV infected and AIDS defined individuals at the period of 2009 to 2012 and the median CD4+ count for an opportunistic infection to occur among HIV infected individuals. This is a hospital data based descriptive study. Data collection is based on questionnaire that was prepared. Questionnaire comprised of 5 components which were socio-demography, mode of transmission of HIV infection, type of opportunistic infections, clinical features presented at time of opportunistic infection and CD4+ count. Data interpretation was performed using SPSS version 17.0 and Tally method. The most prevalent opportunistic infection that occurred among HIV infected individuals were Hepatitis C and Toxoplasmosis. Male comprised the highest number of HIV infection which was 70% and among ethnicity, Chinese contributed the highest number which was 39.1%. Among age groups, middle aged individuals with an age range of 31-40 contributed to the largest number HIV infection. The median CD4+ count for an opportunistic infection to occur in this research was 216.HIV infected individuals have 54.9% of higher risk of getting opportunistic infections as compared to a healthy individual. The highest prevalence on types of opportunistic infections was Hepatitis C and Toxoplasmosis among HIV infected individuals. The relative median CD 4+ count for an opportunistic infection to occur among HIV infected individuals are 216/µL. However, these mean CD4+ count showed a significant value for an opportunistic infection to occur with a „p‟ value (0.000) rather than median CD4+ counts.


82

PP2-19

A Retrospective Study of Directed Blood Donations in the Kasungu District of Malawi Chung, D., Shen, F., Lee, S., Ko, J., Kong, T. K., Choe, J. Y., and Talama, G Youth with Talents, Fairfax, VA, USA and Kasungu District Hospital, Malawi

Since the discovery of blood circulation and transfusion, there has been an insatiable demand for voluntary blood donations throughout the world. However, gathering blood donors has never been easy because eligible donors constitute only a fraction of the general population and are often reluctant to donate. This is especially challenging in underprivileged countries of sub-Saharan Africa such as Malawi whose nationally run blood transfusion service struggles to maintain hospital blood banks. As a result, hospitals turn to their local communities for directed donations. A retrospective analysis from January 2014 to June 2016 of directed blood donor data from two hospitals in the Kasungu District of Malawi was conducted. The analysis of 2134 donations was carried out with respect to sex, age, hemoglobin concentration, blood group, and presence of transfusion-transmissible infections. On average, donors were 30 years of age and predominately male. Blood group O+ constituted more than half of all directed blood donations. Ultimately, about one third of donations were unable to be utilized for transfusion.


83

PP2-20

Infections with Methicillin-Resistant Staphylococcus aureus (MRSA) in Patients Attending Tengku Ampuan Afzan Hospital (HTAA) in Kuantan, Pahang, Malaysia Mustafa Mahmud M.I.A. 1, Alarosi M.A.1, Amjad N.M.2 and Saxena A.1

1Department of Basic Medical Sciences, Faculty of Medicine, International Islamic University Malaysia, Malaysia 2Department of Surgery, Faculty of Medicine, International Islamic University Malaysia, Malaysia

The adaptive power of Staphylococcus aureus to antibiotics had lead to the emergence of methicillin-resistant S. aureus (MRSA) in the early 1960s. To look for the presence of the mecA gene situated on the mobile genetic element (SCCmec) and test for the antibiotic susceptibility of MRSA isolates from hospitalized patients in Kuantan. Twenty-eight MRSA isolates were subjected to mecA gene detection by real time PCR. The MRSAs were originally isolated by the Bacteriology Laboratory in Hospital Tengku Ampuan Afzan (HTAA), Kuantan, Pahang, Malaysia. The MRSA isolates were re-identified by known bacteriological methods and Oxoid Brilliance MRSA Agar. The minimal inhibitory concentration (MIC) of oxacillin was determined by E-test. The antibiotic susceptibility was tested by disc diffusion method to 7 different antibiotics. All isolates tested positive for mecA gene. Resistance to oxacillin was 100%, with an MIC >4 μg/mL. Resistance to other antibacterial drugs was erythromycin 82.1%, gentamicin 75%, tetracycline 78.6%, and trimethoprim-sulfamethoxazole 78.6%. None of the isolates was resistant to vancomycin or chloramphenicol. The results confirm observations in several other neighbouring Far Eastern countries and corroborates the endemicity of MRSA in Kuantan, Malaysia. This results from this study are going to be compared with a similar recently planned study in the same hospital looking for both mecA and mecC genes among hospital Staphylococcus aureus isolates.

Date post:	26-Jun-2020
Category:	Documents
Upload:	others
View:	2 times
Download:	0 times

MALAYSIAN JOURNAL OF - Volume 18... · 2018-04-18 · Malaysian Journal of Public Health Medicine,...

Documents