Publications by authors named "Chee Lan Lau"

Article Synopsis
  • Antimicrobial resistance (AMR) poses serious health risks, particularly in bacteria carrying Extended-Spectrum β-Lactamases (ESBL), which can lead to ineffective treatments and increased spread of resistance.
  • A study analyzing 137 blood cultures from patients in a Malaysian hospital found that while many bacteria had genotypes linked to ESBL, over half remained susceptible to certain antibiotics, indicating complexities in treating infections.
  • Results showed that even though the prediction for ESBL phenotypes was reasonably accurate, there were no significant differences in clinical outcomes, such as severity of infection or mortality, between patients with ESBL-positive and those without.
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Molecular surveillance of methicillin-resistant Staphylococcus aureus (MRSA) isolated from Hospital Canselor Tuanku Muhriz (HCTM), a Malaysian teaching hospital revealed clonal replacement events of SCCmec type III-SCCmercury to SCCmec type IV strains before the year 2017; however, the reasons behind this phenomenon are still unclear. This study aimed to identify factors associated with the clonal replacement using genomic sequencing and phenotypic investigations (antibiogram profiling, growth rate and desiccation tolerance determination, survival in vancomycin sub-minimum inhibitory concentration (MIC) determination) of representative HCTM MRSA strains isolated in four-year intervals from 2005 - 2017 (n = 16). HCTM Antimicrobial Stewardship (AMS) and Infection Prevention and Control (IPC) policies were also reviewed.

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Article Synopsis
  • * Out of 566 surgical inpatients, 44.2% received antimicrobial treatment, with significant issues including non-compliance and inappropriate prescribing identified, particularly with incorrect duration and unnecessary broad-spectrum use.
  • * The findings suggest a need for improved antimicrobial stewardship focused on enhancing surgical prophylaxis practices, promoting proper documentation, and raising awareness among healthcare providers.
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Introduction: Malaysia is an upper-middle-income country with national antimicrobial stewardship programs in place. However, hospitals in this country are faced with a high incidence of multidrug-resistant organisms and high usage of broad-spectrum antibiotics. Therefore, this study aimed to use a standardized audit tool to assess clinical appropriateness, guideline compliance, and prescribing patterns of antimicrobial use among medical patients in two tertiary hospitals in Malaysia to benchmark practice.

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Methicillin-resistant (MRSA) is a successful pathogen that has achieved global dissemination, with high prevalence rates in Southeast Asia. A huge diversity of clones has been reported in this region, with MRSA ST239 being the most successful lineage. Nonetheless, description of MRSA genotypes circulating in the Southeast Asia region has, until now, remained poorly compiled.

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Excessive antibiotic consumption is still common among critically ill patients admitted to intensive care units (ICU), especially during the coronavirus disease 2019 (COVID-19) period. Moreover, information regarding antimicrobial consumption among ICUs in South-East Asia remains scarce and limited. This study aims to determine antibiotics utilization in ICUs by measuring antibiotics consumption over the past six years (2016−2021) and specifically evaluating carbapenems prescribed in a COVID-19 ICU and a general intensive care unit (GICU) during the second year of the COVID-19 pandemic.

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Background: There is a paucity of data on pharmacists' competency and learning needs in antimicrobial stewardship (AMS).

Objectives: To identify and prioritize learning needs based on self-perceived competence of ward pharmacists in AMS, to identify predictors of self-perceived competence, learning methods in AMS and perceived barriers to learning.

Methods: A cross-sectional survey involving ward pharmacists from Hospital Canselor Tuanku Muhriz (HCTM) and hospitals under the Ministry of Health was conducted from May to July 2018.

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Antimicrobial resistance remains a significant public health issue, and to a greater extent, caused by the misuse of antimicrobials. Monitoring and benchmarking antimicrobial use is critical for the antimicrobial stewardship team to enhance prudent use of antimicrobial and curb antimicrobial resistance in healthcare settings. Employing a comprehensive and established tool, this study investigated the trends and compliance of antimicrobial prescribing in a tertiary care teaching hospital in Malaysia to identify potential target areas for quality improvement.

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Article Synopsis
  • The study examines the effectiveness of vancomycin in treating methicillin-resistant Staphylococcus aureus (MRSA) bacteremia in critically ill patients, highlighting the role of pharmacokinetic measures in treatment outcomes.
  • Out of 28 patients, 46% responded positively to vancomycin; however, non-responders had higher vancomycin minimum inhibitory concentration (MIC) levels and lower ratios of vancomycin concentration to MIC.
  • The study concludes that ratios of vancomycin trough concentration/MIC and area under the curve (AUC)/MIC are more reliable indicators of treatment success compared to trough concentration or AUC alone.
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Background: Hypertrophic scarring caused by sternotomy is prevalent among Asians. The effectiveness of silicone gel in scar prevention may influence the decision of surgeons and patients regarding its routine use during the postoperative period.

Methods: The authors conducted a randomized, placebo-controlled, double-blind, prospective clinical trial.

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