Pak Leung Ho

..5; P = 0.001). In period 2, high rates of dual penicillin/erythromycin nonsusceptibility were found in serotypes 6B (77.3%), 14 (100%), 19F (100%), 23F (78%), 19A (75%), 6A (87.8%), 6C (59.3%), and 23A (78.9%)...

..After renovation of the adult intensive care unit (ICU) with installation of ten single rooms, an enhanced infection control program was conducted to control the spread of methicillin-resistant Staphylococcus aureus (MRSA) in our hospital...

..To determine the use of antibiotics by primary care doctors...

..Nonetheless, results from the molecular studies indicated that the evolution of the capsular genes have involved complex pathways...

..To discuss the implementation of an 'antimicrobial stewardship programme' as a means to improve the quality of antimicrobial use in a hospital setting in Hong Kong...

..9-23.3) for children aged <or=2 years, 15.6 (95% CI, 12.8-18.6) for children aged <or=5 years and 1 (95% CI, 0.52-1.7) for children aged 6-14 years. The findings indicate a significant disease burden...

..This review discusses their recent epidemiology, microbiology, clinical features, and treatment of CAP caused by these antimicrobial-resistant pathogens...

..To determine the prevalence and molecular epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) strains among residents in residential care homes for the elderly in Hong Kong...

..3 (95% CI, 16.7-21.9) for IPD, 58.5 (95% CI, 57.3-59.6) for clinical pneumonia and 40.6 (95% CI, 59-82.2) for radiological pneumonia...

..1% to 64.2% (P=0.01). The types that often had dual penicillin/erythromycin resistance were 6B, 14, 19F, 23F, 6A and 19A. The emergence of serotype 19A was associated with expansion of sequence type 320...

..Stored cytological materials prepared from the pleural fluid were retrieved for molecular analysis. The result indicates the presence of a Panton-Valentine leucocidin-positive, spa type 019 MRSA...

..The present study shows fecal carriage of organisms producing bla(CTX-M) determinants and underscores the role that commensals could play as a reservoir for their dissemination...

..4-5.7; P = 0.003) and ciprofloxacin resistance (OR, 2.5; 95% CI, 1.1-5.8; P = 0.03). Knowledge of the resistance data and risk factors could inform better use of antibiotics for empiric therapy for acute uncomplicated cystitis...

..Since they mediate resistance to virtually all ?-lactam antibiotics and there is often co-resistance to other antibiotic classes, the therapeutic options for infections caused by these organisms are very limited...

..To compare the distribution of integrons and trimethoprim-sulfamethoxazole resistance genes among Escherichia coli isolates from humans and food-producing animals...

..To assess whether vancomycin MIC creeps among blood methicillin-resistant Staphylococcus aureus (MRSA) isolates recovered from 5 hospitals in Hong Kong from 1997 to 2008...

..An IncFII plasmid of 140 kb in size was shared by one human and three animal isolates. In summary, this study showed that human and animal isolates share the same pool of resistance genes...

..1. Community-associated methicillin-resistant Staphylococcus aureus (MRSA) strains with diverse genetic backgrounds are emerging in Hong Kong. 2. Intra-familial spread of community-associated MRSA is common...

..Community-associated methicillin resistant Staphylococcus aureus is an emerging cause of skin and soft tissue infections in Hong Kong, especially among certain ethnic minorities...

..To assess the occurrence of faecal carriage of Escherichia coli with resistance to 'critically important' antibiotics in various animals...

..A study was conducted to evaluate the occurrence and characterization of extended-spectrum beta-lactamases (ESBLs) among blood isolates of Proteus mirabilis collected over a 4 year period in Hong Kong...

..coli and K. pneumoniae isolates, with potential for incorporation into routine clinical laboratory service...

..Minor emm gene sequence alterations were noted for 31 isolates, and for 13 of these isolates, deletion, insertion, or point mutations were seen in the hypervariable 50 N-terminal residues...

..Among clinical isolates of S. pneumoniae, accumulation of target site mutations in strains with an efflux mechanism was associated with increasing MICs of fluoroquinolones...

..A total of 139 consecutive and non-duplicate bloodstream isolates of Enterobacter spp. collected from inpatients in Hong Kong during 2000-2002 were studied for production of extended-spectrum beta-lactamases (ESBLs)...

..9%) had decreased susceptibility to quinolones. The five strains had a Ser-84-Lys or Asp-88-Asn substitution in GyrA. Pulsed-field gel electrophoresis showed that the isolates are genetically diverse...

..coli conferred resistance to ceftazidime (MIC >or= 32 mg/L). The amino acid sequence of BPS-1m differed from that of BPS-1 by a Pro-to-Ser change at position 167 in the omega loop...

..5% from children < or = 5 years of age and 93% from persons of all ages were of serotypes that are included in the 23-valent polysaccharide vaccine...

..7 and 66.1% of the invasive and carriage isolates, respectively. The same seven serotypes comprised 87.5% invasive isolates and 82.8% carriage isolates with resistance to penicillin, erythromycin and/or cefotaxime...

..pneumoniae was found in Hong Kong. Typing analysis suggests that this is due to the pan-regional dissemination of a fluoroquinolone-resistant variant (designated Hong Kong(23F)-1) of the globally distributed Spain(23)F-1 clone...

..These strains exhibited capsular switching and were highly similar to the Spanish 23F clone...

..1. Extended-spectrum beta-lactamase(ESBL) resistance in Enterobacter spp may be under-recognised. 2. Detection methods for ESBL resistance in Enterobacter spp may need to be modified...

..Two other epidemic clones, EMRSA-16 (ST36/SCCmec II) and CC398 (ST1277/SCCmec V), were detected as sporadic isolates for the first time in Hong Kong...

..Both clones were found to have disseminated widely. In conclusion, clonal expansion is playing major roles in the increase of MDR-AB in these hospitals in Hong Kong. The findings highlight the need to enhance infection control measures...

..In contrast, HKU50 strains exhibit both multidrug resistance (MDR) (involving ciprofloxacin, erythromycin, and tetracycline, but not gentamicin) and non-MDR patterns...

..Our results documented the emergence of problematic resistance phenotypes among community urinary E. coli and highlight the need to explore strategies for their containment...

..1, 5.5, or 2.2% of the strains, respectively. These high rates of resistance raise concerns for the future...

..2; p < 0.001). Treatment failed in 4/7 case patients treated with ceftazidime to which the isolate was susceptible in vitro. Our findings have implications for the choice of empirical therapy in nosocomial urinary tract infection...

..2, p<0.001) and discordant therapy (OR 4.3, 95%CI 1.7-10.9, p<0.002) involving agents with poor anti-pneumococcal activity (but not penicillins and broad-spectrum beta-lactam agents) were significantly associated with mortality...

..8%). As a second test for confirming ESBL activity in strains with reduced susceptibility to beta-lactams, the inhibitor-potentiated disc diffusion test is therefore a simple and reliable option...

..To conduct a territory-wide study of extended-spectrum beta-lactamases (ESBLs) among community isolates of urinary Escherichia coli from women in Hong Kong...

..In contrast, HKU200 isolates are characterized by having SCCmec type IV or V, agr4, spa t437, and variable non-beta-lactam susceptibility profiles. The major CA-MRSA spa types were shared by a minority of the MSSA...

..We characterized plasmids encoding CTX-M-14 ?-lactamase originating from Escherichia coli isolates recovered from patients with uncomplicated cystitis or individuals with faecal colonization in Hong Kong from 2002 to 2004...

..In conclusion, CA-MRSA has a propensity to spread within families. Our findings showed that CA-MRSA strains in Hong Kong have diverse genetic backgrounds...

..To investigate the epidemiology of fecal carriage of CTX-M type extended-spectrum beta-lactamases (ESBL)-producing organisms among children and their household contacts...

..Our study aims to identify the mutations outside the RRDR that are associated with rifampicin resistance in M. tuberculosis...

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..A number of gyrA mutations (Glu21Gln, Ser95Thr, and Gly668Asp) were also characterized to be natural polymorphisms not associated with fluoroquinolone resistance...

..The technical simplicity, short turnaround time, and low cost of this molecular strategy should facilitate routine diagnostic services in developing areas with a high prevalence of drug-resistant tuberculosis...

..Novel approaches such as antibiotic-impregnated Tenckhoff catheters, biocompatible dialysis fluid, and peritoneal immuno-augmentation strategies are eagerly awaited...

..The efficacy of dual vaccination remains unknown...

..To investigate the prevalence and molecular epidemiology of Staphylococcus aureus and methicillin-resistant S. aureus (MRSA) nasal carriage in children...

..Dendritic cells are key antigen presenting cells but its role in such co-infection is unclear...

..Unlike previous electronic monitoring systems, MedSense operates in open cubicles with multiple beds and does not disrupt existing workflows...

..Since early empirical treatment with beta-lactam plus fluoroquinolone or macrolides is often initiated before specimen collections, bacterial co-infection in S-OIV may have been under-reported...

..The beta-lactamase characterized from strain HLHK5 was named LHK-5 (gene, bla(LHK-5)) and represents the first example of AmpC beta-lactamase in the beta subdivision of proteobacteria...

..Detailed food history and education on food hygiene is essential in making the diagnosis and preventing recurrence. A prolonged course of antibiotics may be needed to manage these cases...

..CONCLUSIONS: CAP-AB appears to be a unique clinical entity with a high incidence of bacteremia, ARDS, DIC, and death, when compared to HAP-AB. Further studies are needed to investigate the mechanism of the fulminant nature of CAP-AB...

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..This risk seems to be influenced strongly by the proportion of patients with colonization at intensive care unit admission and is associated with severity of illness, length of stay, and exposures to antibiotics and medical devices...

..The risk factors for community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infection were not well understood. The objective of this study was to identify risk factors associated with CA-MRSA infection in Hong Kong...

..Silicosis is a well-recognized risk factor for tuberculosis (TB)...

..Therefore, we suggest that factors other than DFO may account for the increased prevalence of Klebsiella and Aeromonas infection in Asian thalassemic patients...

..The relative lack of background neutralizing antibody against this novel virus provides a unique opportunity for understanding this issue...

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..As SARS might re-emerge, all hospitals should take advantage of the current SARS-free interval to review their infection control programmes, alert mechanisms, response capability and to repair any identified inadequacies...

..The result suggests that combining metal complexation and receptor/ligand interaction offers a useful method to construct multivalent inhibitors...

..The findings support a wider application of annual influenza vaccination in this region...

..RFLP patterns of katG amplicons from respiratory specimens were identical to those of the corresponding MTB cultured colonies. This method has potential application for rapid diagnosis of INH resistance due to katG Ser315Thr mutation...

..Antibiotic hydrogels based on a vancomycin (Van) derivative, formed by self-assembling Van-pyrene (1) in water, using the pi-pi interaction of pyrene moieties and hydrogen bonding of Vans, promise a new way to make novel biomaterials...