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Biomedical subjects

V K Lim

Publications and source records attributed to V K Lim.

At least 37 records · Page 2Linked to original sources
PubMed1997

Prevention of infection in the immunocompromised.

Infection is an important cause of morbidity and mortality in immunocompromised patients. The high risk of infection is not only the consequence of the underlying disease but also the result of the diagnostic, monitoring and therapeutic procedures performed on these patients. Infections may be exogenous or endogenous in origin. The prevention of exogenous infections requires a high standard of hygiene. As many infections are acquired in hospitals, an effective control of nosocomial infection programme is crucial in preventing infections in the immunocompromised. Prevention of endogenous infections involves suppression of the aerobic bacterial flora (selective decontamination) and measures to maintain gastrointestinal epithelial integrity to reduce risk of translocation of intestinal flora. Boosting the host immunity through passive and active immunisation should also be considered. Prevention of infection in the immunocompromised is no easy task and requires a multidisciplinary approach.

Antibiotic Prophylaxis↗
PubMed1996

Necrotizing fasciitis.

A 31-year-old Pakistani man was admitted to hospital after sustaining a Grade I compound fracture of the mid-shaft of the left tibia and fibula following a motor vehicle accident. He developed septicaemic shock, acute renal failure and Group A streptococcal necrotizing fasciitis of the left leg. The patient underwent an above knee amputation followed by disarticulation of the left hip with extensive debridement. He was treated with benzylpenicillin, vancomycin, inotropes and continuous haemodialysis and survived without further sequelae. Subsequently, skin grafting was done over the wound site. This case highlights the role of Group A streptococcus as a cause of this rare and life-threatening infection.

Adult↗
PubMed1996

Sepsis.

Explore the source record for details and available documents.

Decontamination↗
PubMed1996

Pyomyositis revisited.

Pyomyositis, purportedly a common tropical infection affecting mainly healthy adults and children, appears to be most uncommon in this region. We report a case of pyomyositis caused by a Methicillin-resistant Staphylococcus aureus (MRSA) in a previously healthy army officer. This case serves to illustrate the difficulty in recognising this disease entity, which is why many cases may have been missed. With the increasing incidence of MRSA nosocomial infections, the emergence of MRSA in a hitherto community-acquired infection poses a major concern especially since intravenous drug abuse and acquired immune deficiency syndrome (AIDS) are on the rise in our country. We hope to inculcate greater awareness of this infection.

Adult↗
PubMed1995

In-vitro activity of cefoperazone-sulbactam combination against cefoperazone resistant clinical isolates in a Malaysian general hospital.

Beta-lactamase production is one of the major mechanisms of resistance amongst bacteria especially the enteric bacilli. The purpose of this study is to assess the in-vitro activity of Sulperazon, a combination of cefoperazone and an irreversible beta-lactamase inhibitor, sulbactam, against the cefoperazone resistant isolates of aerobic gram-negative bacilli. A total of 92 such strains were tested. It was found that at a concentration of < or = 8 mg/l of sulbactam added to cefoperazone 82% of Klebsiella spp, 100% of E. coli, 100% of Enterobacter spp, 33% of Pseudomonas aeruginosa, 67% of Pseudomonas spp and 62% of Acinetobacter spp that were resistant to cefoperazone alone were susceptible to the combination. Hence it is concluded that the addition of sulbactam to cefoperazone does expand the spectrum of the in-vitro activity of cefoperazone.

Cefoperazone↗
PubMed1994

The use of surgical antibiotic prophylaxis in seven Malaysian hospitals.

A survey on the use of antibiotics in surgical prophylaxis was carried out in seven Malaysian hospitals. Details of antibiotic prescriptions were obtained through questionnaires completed by the prescriber. A total of 430 such prescriptions was analysed. A large number of different antibiotic regimens were used for a variety of surgical procedures. The majority of prescriptions (70%) were issued for procedures where such prophylaxis was probably not necessary. Antibiotics were also often prescribed for durations that were longer than necessary. There is an urgent need to educate surgeons and standardize surgical prophylactic regimens in order to reduce cost and combat the emergence of antibiotic resistance.

Anti-Bacterial Agents↗
PubMed1994

Antimicrobial resistance in 6 Malaysian general hospitals.

Knowledge of local antimicrobial resistance patterns of bacteria is a valuable guide to empirical antimicrobial therapy. This paper reports the resistance patterns of more than 36,000 bacteria isolated between August 1991 and July 1992 in six Malaysian hospitals and discusses the implications of the results. A customized menu driven software programme was developed to analyse the results. Generally, resistance to the commonly used antibiotics like ampicillin, cloxacillin, cephalosporins, gentamicin, cotrimoxazole and tetracycline was high. Some differences in resistance rate amongst the six hospitals were also noted. Continuous surveillance of antimicrobial resistance in hospitals is encouraged for the effective control of the emergence of antimicrobial resistance.

Drug Resistance, Microbial↗
PubMed1993

Pattern of antibiotic usage in hospitals in Malaysia.

A prospective survey of antibiotic prescribing patterns in six Ministry of Health general hospitals in Malaysia was undertaken. Information on antibiotic prescriptions including the types of antibiotics used and the purposes for prescription was obtained through the use of questionnaires. A total of 1,918 antibiotic prescriptions were available for analysis. About two-thirds of prescriptions were for therapeutic purposes. The most common infections treated were lower respiratory infection (31%), followed by skin and soft tissue infection (17%), and urinary tract infection (8%). Only 20% of the therapeutic prescriptions were based on microbiological test results. Prophylactic prescriptions were issued for a variety of indications, the most common being toilet and suture of wounds. Only 5% of prophylactic prescriptions were of less than 3 days duration. There was great diversity in antibiotics and antibiotic regimens employed. It was evident that there was a lack of compliance with guidelines on antibiotic use issued by the Ministry of Health.

Anti-Bacterial Agents↗
PubMed1993

A comparative study of the in-vitro activity of cefepime and other cephalosporins.

Cefepime is a new cephalosporin antibiotic which is highly active against both Gram-positive and Gram-negative organisms. The purpose of this study was to establish the in-vitro activity of cefepime and three other cephalosporins against recent clinical isolates from patients at the General Hospital Kuala Lumpur. A total of 334 strains comprising Enterobacteriaceae, non-fermentative Gram-negative bacilli and Staphylococcus aureus were tested for their sensitivity to cefepime, cefotaxime, ceftriaxone and ceftazidime. Minimum inhibitory concentrations of the antibiotics were established using an agar dilution method. With the exception of some strains of Flavobacterium meningosepticum, Xanthomonas maltophilia and other non-fermentative Gram-negative bacilli, cefepime was found to be active against a wide range of Gram-negative organisms. Cefepime was as or more active than the other cephalosporins against Acinetobacter, Enterobacteriaceae and methicillin-sensitive Staphylococcus aureus. Strains of Klebsiella and Salmonella that were resistant to the third generation cephalosporins were sensitive to cefepime. Cefepime could be a valuable alternative for the treatment of nosocomial infections due to multiply resistant organisms.

Cefepime↗
PubMed1992

Bacteriology turnaround time in seven Malaysian general hospitals.

A turnaround time study was conducted for bacteriological culture tests in seven Malaysian general hospitals. The turnaround times were determined using a specially designed form that was completed by the ward staff. Doctors at these hospitals were also polled to find out whether they were satisfied with the promptness of bacteriological test reporting in their hospitals. The turnaround times obtained from this survey were found to be satisfactory taking into account the constraints of laboratory methods employed. Nevertheless only about a third of doctors expressed satisfaction with the timeliness of the bacteriological test reporting. Doctors and microbiologists should get together and agree on acceptable standards of turnaround times that are practical and reasonable.

Bacteriological Techniques↗