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Biomedical subjects

J M Ling

Publications and source records attributed to J M Ling.

At least 37 records · Page 2Linked to original sources
PubMed1996

Investigation of the epidemiology of hospital isolates of Acinetobacter anitratus by two molecular methods.

Two hundred and two isolates of Acinetobacter anitratus from 126 patients in 36 wards belonging to 11 specialties of a university teaching hospital were compared by ribotyping and restriction enzyme digest analysis (REA) of total DNA. Forty-six groups were defined by both techniques and there was 96 center dot 5% agreement between the methods for the designation of isolates into groups. Only two groups were endemic and circulating in the whole hospital while others were less common. Burns and intensive therapy units had the highest number of isolates and these were mainly of the two endemic groups while renal dialysis and neonatal units had isolates belonging to the less common groups. Of the 32 patients with multiple isolates, 17 were infected or colonized at different sites by two and up to four groups of A. anitratus. Both ribotyping and REA of total DNA are discriminatory methods for typing A. anitratus, however, the latter is a simpler and more rapid method and it can be used in a routine clinical laboratory.

Acinetobacter↗
PubMed1996

Presence of strA-strB gene within a streptomycin-resistance operon in a clinical isolate of Shigella flexneri.

Three aminoglycoside-modifying enzymes (AMEs) were produced by a clinical isolate of Shigella flexneri which was resistant to gentamicin, tobramycin, netilmicin, kanamycin, sisomicin and streptomycin: acetyltransferase (AAC) (3)-II-type, and phosphotransferase (APH) (3")- and (6)-type enzymes. The aminoglycoside-resistance genes were located on a 75-Kb plasmid. Two genes, strA-HK and strB-HK, in a transcriptional unit were found to code for streptomycin-resistance. The genetic organization and sequence of this transcriptional unit were identical to those of strA and strB in plasmid RSF1010. strA-HK and strB-HK when expressed separately produced functional enzymes. Our substrate profile study on the crude extracts of StrA-HK and StrB-HK proteins confirmed that StrA-HK was an APH(3")-type and showed that StrB-HK was a member of the APH(6) family.

Drug Resistance, Microbial↗
PubMed1996

Susceptibilities to 23 antimicrobial agents and beta-lactamase production of blood culture isolates of Acinetobacter sp in Hong Kong.

The susceptibility of 140 Acinetobacter spp. isolated from blood cultures of patients from the Prince of Wales Hospital, Hong Kong, from 1990 to 1994 to 23 antimicrobial agents was studied by an agar dilution method. Resistance to most of the beta-lactams, aminoglycosides and fluoroquinolones tested was high, being 11%-92%. Only amikacin, imipenem and meropenem were reliably active against this organism. Most of the isolates produced cephalosporinases with very high pIs while 33% produced beta-lactamases with pI ranges of 5.2-8.7.

Acinetobacter↗
PubMed1996

A retrospective study of clinical characteristics of acinetobacter bacteremia.

High rates of acinetobacter bacteremia were observed in a large teaching hospital in Hong Kong. A retrospective study of 94 acinetobacter bacteremic episodes in patients in 1993-94 revealed 70 episodes of significant bacteremia. 53% of the patients were over 60 years with a male to female ratio of 1.5:1. Cases were most rare during the fourth quarter. The intensive care unit was the commonest location of acquisition of bacteremia. Most infections were hospital acquired. Intravascular catheters, urinary catheters, antibiotic therapy and respiratory tract manipulations were common risk factors. Lower respiratory tract infections and catheter-related sepsis were predominant foci of bacteremia. One-third of the patients received appropriate antibiotics within 48 hours after bacteremia onset. Mortality attributable to acinetobacter infection was 27%. Prognosis of underlying diseases, location in intensive care unit, lower respiratory tract infection as foci of infection as well as diabetes mellitus were associated with mortality.

Acinetobacter Infections↗
PubMed1995

Carriage of Haemophilus influenzae and Streptococcus pneumoniae in healthy Chinese and Vietnamese children in Hong Kong.

Nasopharyngeal carriage of Haemophilus influenzae and Streptococcus pneumoniae was studied in 621 healthy Chinese children and 300 healthy Vietnamese children aged from 2 months to 5 years in Hong Kong. The carriage rate of H. influenzae type b in Vietnamese children was 1.3% (CI 0.04-2.63); it was zero in Chinese. The carriage rate of non-typable H. influenzae was 5.8% (CI 1.4-7.6%) in Chinese and 65.4% (CI 58.9-69.8%) in Vietnamese. The carriage rates of S. pneumoniae were 10.8% (CI 8.3-13.2%) and 55.7% (CI 50.1-61.3%) in Chinese and Vietnamese children, respectively. Univariate and multivariate logistic regression analyses were performed to search for factors associated with differences in carriage rates of both H. influenzae and S. pneumoniae between Chinese and Vetnamese children. Although older age, smaller living area and parental smoking were associated with higher carriage rates, these could not explain the remarkably low carriage rates of both bacteria in Chinese children.

Adolescent↗
PubMed1993

Molecular studies of plasmids of multiply-resistant Shigella spp. in Hong Kong.

One hundred and two Shigella spp. isolated in two hospitals in Hong Kong were analysed for antibiotic resistances, resistance plasmids and plasmid profiles. Three quarters of the isolates were S. flexneri. All isolates harboured plasmids, up to a maximum of ten within one strain. Plasmids of 220 kb encoding resistances to tetracycline, chloramphenicol and sulphonamide and probably also associated with invasiveness in the Sereny test were found in 80 strains and were transferable in 18% of cases. Resistance plasmids of 92 and 99 kb were found in 27 and 15 strains respectively and encoded resistances to ampicillin, tetracycline, chloramphenicol, kanamycin, sulphonamide, trimethoprim, cotrimoxazole and gentamicin; these plasmids were usually transferable. Four plasmids of 3.9, 2.8, 2.2 and 1.8 kb were commonly found in S. flexneri strains, but were rare in other species. In contrast, there was no predominant plasmid profile in S. sonnei. S. flexneri is endemic in Hong Kong and these plasmid studies suggest that the strains in circulation are derived from only a few clones.

Animals↗
PubMed1993

Infectious diarrhoea in Hong Kong.

The role of enteric pathogens in diarrhoeal patients presenting at a large general hospital in Hong Kong from May 1984 to December 1990 was assessed. A total of 3267 organisms were isolated. The gastroenteric salmonellae were the most common pathogens (45%), followed by rotavirus (34%) and campylobacters (11%). Shigellae or vibrios constituted 5% or less of the total isolations. Both salmonellae and campylobacters were isolated more often from infants while rotavirus was more common in young children aged 1-4 years. Shigellae commonly affected young adults and vibrios mainly older patients. Rotavirus was most commonly isolated in the winter months while salmonellae and vibrios were more common in the hotter months. There was no seasonal predominance for shigellosis. Multiple infections occurred in 86 patients (3% of total cases); 42 of these patients had concurrent Salmonella and rotavirus infections and 22 had Campylobacter and rotavirus infections. Salmonellae remain a major public health problem in Hong Kong.

Adolescent↗
PubMed1992

Development of trimethoprim-resistance in Salmonella typhi during therapy.

A typhoid patient was infected with a fully-sensitive, plasmidless strain of Salmonella typhi which acquired resistance to kanamycin, sulfamethoxazole and trimethoprim during cotrimoxazole therapy. The resistant post-treatment strain harboured 4 plasmids of 62, 4.1, 3.8 and 3.0 Md in size. Kanamycin-, sulfamethoxazole- and trimethoprim-resistance were borne on a transferable 62 Md plasmid which was compatible with groups FI, FIme, FII, FIV, H1, H2, B, I1, I2, J, K, M, N, T, X, W and P. Sulfamethoxazole-resistance was also borne on the 4.1 Md plasmid. The 3.8 Md plasmid was not transferable; the 3.0 Md plasmid was transferable but did not confer antibiotic resistance. Excluding the strain described here, only 5 out of 35 other S typhi isolates contained plasmids. This is the first report of trimethoprim-resistant S typhi in Hong Kong.

Adult↗
PubMed1991

Antimicrobial susceptibilities and beta-lactamase production of Hong Kong isolates of gastroenteric salmonellae and Salmonella typhi.

We examined the in-vitro antibiotic susceptibility of 760 gastroenteric salmonellae and 36 strains of Salmonella typhi isolated in Hong Kong between 1985 and 1988. S. typhi remained susceptible to all the antibiotics tested except for one isolate resistant to chloramphenicol, another to kanamycin and co-trimoxazole, and a third to nalidixic acid. In contrast, resistance and multiple resistance has increased significantly in gastroenteric salmonellae over the last ten years. Seventeen percent were resistant to ampicillin, 61% to tetracycline, 23% to chloramphenicol and 8% to gentamicin. Many ampicillin-resistant strains remained resistant to ampicillin even in the presence of sulbactam (69%) or clavulanic acid (25%). More than 50% of isolates were resistant to two or more antibiotics and one isolate was resistant to eleven. Ampicillin-resistance was usually due to the production of TEM-1 or OXA-1 beta-lactamases but a few isolates produced AER-1, PSE-1 or PSE-2. Genetic determinants for these enzymes were usually borne on plasmids ranging in size from 2 to 143.7 Md but half of the OXA-1 genes were chromosomally located.

Ampicillin Resistance↗
PubMed1990

Hong Kong strains of methicillin-resistant and methicillin-sensitive Staphylococcus aureus have similar virulence.

While most authorities agree that methicillin-resistant Staphylococcus aureus (MRSA) are as pathogenic as methicillin-sensitive strains (MSSA), some believe that MRSA are relatively avirulent opportunists, and that their importance has been exaggerated. We present evidence that Hong Kong strains of MRSA and MSSA are equally pathogenic: they have similar virulence in animal models; they are isolated in similar proportions from both deep and superficial clinical sites including blood; in patients with hospital-acquired bacteraemias mortality rates are similar when adjusted for clinical factors; and in both animals and patients with systemic MRSA infection, mortality rates are significantly reduced by vancomycin therapy. Efforts to control the spread of MRSA are justified, and in invasive sepsis early treatment with vancomycin may be life-saving.

Animals↗
PubMed1990

Evaluation of Cathra system for identifying gram negative aerobic bacteria.

The Cathra system is a commercial multipoint inoculation method for the identification of aerobic Gram negative bacteria. The system uses a replicator technique in which 21 different agar media can be inoculated simultaneously with 36 organisms. Identifications are made by use of a special computer database. The performance of this system was compared with that of the API 20E for the identification of 372 clinical isolates of Enterobacteriaceae and 133 miscellaneous Gram negative bacteria. For enterobacteria, the Cathra system was in 97% agreement with API 20E at species level and 98% at genus level. For miscellaneous Gram negative strains the two systems were in 59% agreement at species level and 77% at genus level. The Cathra system is suitable for use in diagnostic laboratories, especially those with a heavy workload and a wish to use break-point sensitivity testing. The identification database for miscellaneous Gram negative organisms, however, needs to be expanded.

Bacteriological Techniques↗
PubMed1989

Antimicrobial susceptibilities of Haemophilus species in Hong Kong.

Altogether 403 Haemophilus spp. were isolated in seven hospital laboratories in Hong Kong during June 1986, mostly from sputum. Of these 73% were Haemophilus influenzae and 27% Haemophilus parainfluenzae. All the isolates of H. influenzae were non-capsulated; Haemophilus spp. were not isolated from blood or cerebrospinal fluid (CSF) during the period of the study. Antimicrobial resistance, including multiple resistance, was common. Of all the strains of H. influenzae, 20% were resistant to 1 mg/l ampicillin, (all except one by production of TEM-1 beta-lactamase), 65% were resistant to 0.5 mg/l erythromycin, 25% to 1 mg/l tetracycline, 14% to 1 mg/l chloramphenicol (mediated by the production of a chloramphenicol-destroying enzyme) and less than 1% to 8 mg/l cefaclor and 0.5 mg/l trimethoprim. All isolates were susceptible to cephamandole and cefuroxime. Haemophilus parainfluenzae showed similar susceptibilities, except that a greater proportion of strains was sensitive to erythromycin and chloramphenicol. Only 50% of the ampicillin-resistant strains of H. influenzae and H. parainfluenzae contained detectable plasmids of 2-55 Mdal arranged in six to nine different plasmid profiles. Resistance to ampicillin and chloramphenicol has increased markedly in isolates of H. influenzae in Hong Kong over the last 5 years. This resistance may be associated with transposable genes.

Ampicillin↗
PubMed1989

Microcomputer program in Chinese to manage and analyze antimicrobial susceptibility results.

A chinese microcomputer program which analyzes the minimal inhibitory concentration (MIC) of antimicrobial susceptibility and presents the results in tabular and chart forms is described. This program also computes MIC50, MIC90, and geometric mean MIC and displays these values for a large number of antimicrobials in a summary table. The set of MIC values used for different groups of organisms or antimicrobial agents can be altered without changing the program. A text file of the results is written into the disk to enable editing before final presentation. The program features several major enhancements over previously published ones.

Anti-Bacterial Agents↗
PubMed1988

Evaluation of the Microbact-24E bacterial identification system.

The Microbact 24E (MB24E) system is a commercial microsystem for the identification of common clinical isolates of Enterobacteriaceae and non-fermenting Gram negative bacilli, and consists of dehydrated substrates distributed in the wells of microtitre trays. This system was compared with the API20E for the identification of 386 bacterial isolates, which included 284 clinical and 102 environmental organisms. There was 97% and 91% agreement for the identification of clinical isolates of Enterobacteriaceae and other Gram negative bacilli, respectively. The identification of environmental isolates by both systems was less satisfactory. The API20E has a more extensive database than the MB24E and is thus more reliable for the identification of rare or unusual organisms, but the MB24E is cheaper, is easy and convenient to use, and is suitable for a routine microbiology laboratory.

Bacteriological Techniques↗