Publications by authors named "Ng Oon Tek"
Antimicrobial resistance (AMR) is an emerging threat to global public health. Specifically, Acinetobacter baumannii (A. baumannii), one of the main pathogens driving the rise of nosocomial infections, is a Gram-negative bacillus that displays intrinsic resistance mechanisms and can also develop resistance by acquiring AMR genes from other bacteria.
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- - Patients with severe COVID-19 often experience rapid worsening of symptoms, particularly dyspnea, necessitating early involvement of specialist palliative care (SPC) for effective symptom management and end-of-life care.
- - A study at the National Centre for Infectious Diseases in Singapore analyzed nonventilated COVID-19 patients between January 2021 and July 2022 to identify risk factors for high use of opioids and benzodiazepines in managing dyspnea.
- - Findings revealed that patients with higher dyspnea scores and lower ISARIC-4C mortality scores were more likely to be high users of these medications, indicating they have increased oxygen needs and higher mortality rates, thus highlighting the need for timely
Article Synopsis
- - The study examines how cephalosporin-resistant E. coli spreads in tropical waters of Singapore by analyzing samples from various sources between 2016 and 2020.
- - Researchers found strong genetic similarities between E. coli from the environment and hospitals, particularly the concerning pandemic strain ST131, indicating high resistance due to mutations and mobile genetic elements.
- - Pathogenic strains linked to public health threats were discovered in community sewage and aquaculture areas, highlighting the important connection between human activities and environmental health issues related to antibiotic resistance.
Background: The spread of Carbapenemase-producing Organisms (CPO) remains a major threat globally. Within clinical settings, the existing method of determining gene load involves traditional culture to determine bacterial load and polymerase-chain-reaction-based Xpert Carba-R Assay to determine carbapenemase gene type. However, there is a need for a fast and accurate method of quantifying CPO colonisation to study the risk of persistent CPO carriage.
View Article and Find Full Text PDFIntroduction: Toxoplasma gondii can cause symptomatic toxoplasmosis in immunodeficient hosts, including in people living with human immunodeficiency virus (PLWH), mainly because of the reactivation of latent infection. We assessed the prevalence of toxoplasmosis and its associated risk factors in PLWH in the Asia-Pacific region using data from the TREAT Asia Human Immunodeficiency Virus (HIV) Observational Database (TAHOD) of the International Epidemiology Databases to Evaluate AIDS (IeDEA) Asia-Pacific.
Methods: This study included both retrospective and prospective cases of toxoplasmosis reported between 1997 and 2020.
Impact of COVID-19 pandemic on carbapenem-resistant Enterobacterales incidence in the South-East Asia region: an observational study.
Antimicrob Steward Healthc Epidemiol
November 2023
The COVID-19 pandemic led to an initial increase in the incidence of carbapenem-resistant Enterobacterales (CRE) from clinical cultures in South-East Asia hospitals, which was unsustained as the pandemic progressed. Conversely, there was a decrease in CRE incidence from surveillance cultures and overall combined incidence. Further studies are needed for future pandemic preparedness.
View Article and Find Full Text PDFThe Omicron variant has been reported to present with milder disease compared with Delta, although this may be due to immunity from vaccination and prior exposure. Predictors of severity with recent strains have not been well characterized. We retrospectively examined consecutive cases of moderate-to-severe COVID-19 (defined as requiring supplemental oxygenation, intensive care or mortality) admitted to seven tertiary hospitals across Singapore in April 2023.
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- Antimicrobial resistance surveillance is crucial for informed antibiotic prescribing and infection control, yet many systems lack comprehensive patient data, especially in low- and middle-income countries (LMICs).
- The ACORN II initiative builds on the WHO's surveillance framework to focus on healthcare-related infections, aiming to create effective, routine surveillance systems that capture critical patient information.
- The project emphasizes improving local antibiotic practices through streamlined data collection and the use of an R Shiny application for analytics, enhancing overall clinical decision-making and infection control policies.
NG-Test CARBA 5 (NG-Biotech) is a rapid multiplex immunoassay for the phenotypic detection and differentiation of the "big five" carbapenemase families (KPC, OXA-48-like, VIM, IMP, and NDM). Version 2 of this assay was evaluated alongside the Xpert Carba-R assay (Cepheid, Inc.), the modified carbapenem inactivation method (mCIM), and the CIMTris assay, with a collection of carbapenem-resistant non-fermenting Gram-negative bacilli comprising 138 and 97 isolates.
View Article and Find Full Text PDFIntroduction: Widespread mask use is an important intervention for control of the coronavirus disease 2019 pandemic. However, data on the factors affecting mask use are lacking. In this observational study, we evaluated the proportion of and factors influencing face mask use and related hygiene practices.
View Article and Find Full Text PDFPseudomonas aeruginosa ST308 clone has been reported to carry carbapenemase genes such as and but has been rarely associated with . A total of 199 P. aeruginosa ST308 clinical and environmental isolates obtained between April 2019 and November 2020 from a tertiary-care hospital in Singapore were characterized using whole-genome sequencing.
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- The article DOI: 10.1016/j.lanwpc.2021.100299 has been corrected.
- The correction addresses specific errors or updates in the original publication.
- This ensures that readers have access to the most accurate and reliable information.
We conducted a prospective environmental surveillance study to investigate the air, surface, dust, and water contamination of a room occupied by a patient infected with mpox virus (MPXV) at various stages of the illness. The patient tested positive for MPXV from a throat swab and skin lesions. Environmental sampling was conducted in a negative pressure room with 12 unidirectional high efficiency particulate air filter (HEPA) air changes per hour and daily cleaning of the surfaces.
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- Serological testing in Singapore revealed that individuals who received smallpox vaccinations in childhood still have long-term humoral immunity, demonstrated by anti-vaccinia IgG levels and neutralizing activity.
- There is a significant correlation between the levels of IgG and neutralizing titers, suggesting that IgG can serve as a surrogate marker for measuring immunity.
- Following an imported monkeypox case in 2019, it was found that older Singaporeans vaccinated before 1981 retained higher levels of anti-vaccinia IgG, indicating potential protective immunity against orthopoxvirus outbreaks.
Article Synopsis
- Long-term colonization of the gut with carbapenemase-producing Enterobacteriaceae (CPE) raises public health concerns due to potential community transmission and severe infections.
- A study using longitudinal shotgun metagenomics analyzed gut microbiomes of 46 CPE-colonized subjects and their family members, observing changes in microbial diversity and specific ecological shifts in those who decolonized.
- Findings included unstable Enterobacteriaceae populations and strain-level variations in resistant bacterial species, highlighting how multi-drug-resistant bacteria can disrupt gut ecology and spread resistance genes without requiring antibiotic treatments or active infections.
Introduction: Viral load (VL) testing is still challenging to monitor treatment responses of antiretroviral therapy (ART) for HIV treatment programme in Asia. We assessed the association between routine VL testing and virological failure (VF) and determine factors associated with switching to second-line regimen.
Methods: Among 21 sites from the TREAT Asia HIV Observational Database (TAHOD), people living with HIV (PLHIV) aged ≥18 years initiating ART from 2003 to 2021 were included.
Article Synopsis
- The study investigates the effectiveness of booster doses of COVID-19 vaccines (both mRNA and inactivated types) in protecting against severe disease and confirmed infections during the Omicron wave in Singapore.
- It includes Singapore residents aged 30 and older who received either two doses of mRNA vaccines (like Pfizer or Moderna) or inactivated vaccines (like Sinovac and Sinopharm) by March 2022, while excluding those with prior infections.
- Results show that among over 2.4 million individuals, around 13.1% had confirmed SARS-CoV-2 infections, with mRNA boosters showing a protection effectiveness against confirmed infection of approximately 31.7% to 41.3% shortly after receiving the booster
Given the spasmodic increment in antimicrobial resistance (AMR), world is on the verge of "post-antibiotic era". It is anticipated that current SARS-CoV2 pandemic would worsen the situation in future, mainly due to the lack of new/next generation of antimicrobials. In this context, nanoscale materials with antimicrobial potential have a great promise to treat deadly pathogens.
View Article and Find Full Text PDFDissemination of carbapenemase-encoding plasmids by horizontal gene transfer in multidrug-resistant bacteria is the major driver of rising carbapenem-resistance, but the conjugative mechanics and evolution of clinically relevant plasmids are not yet clear. We performed whole-genome sequencing on 1,215 clinical Enterobacterales isolates collected in Singapore during 2010-2015. We identified 1,126 carbapenemase-encoding plasmids and discovered pKPC2 is becoming the dominant plasmid in Singapore, overtaking an earlier dominant plasmid, pNDM1.
View Article and Find Full Text PDFLiver disease is a growing burden among people living with HIV (PLHIV) in resource-limited settings. As an indicator of liver disease, risk factors of high alanine aminotransferase (ALT) and cirrhosis were assessed among PLHIV in the TREAT Asia HIV Observational Database (TAHOD). Patients on combination antiretroviral therapy (cART) with a pre-cART ALT measurement and at least one follow-up ALT measurement were included.
View Article and Find Full Text PDFBackground: Non-Asian body mass index (BMI) classifications are commonly used as a risk factor for high fasting blood glucose (FBG). We investigated the incidence and factors associated with high FBG among people living with HIV in the Asia-Pacific region, using a World Health Organization BMI classification specific to Asian populations.
Methods: This study included people living with HIV enrolled in a longitudinal cohort study from 2003 to 2019, receiving antiretroviral therapy (ART), and without prior tuberculosis.
Article Synopsis
- Carbapenemase-producing Enterobacterales (CPE) infections in hospitals are thought to spread mainly from detected carriers to other patients in the same ward, but there is limited information on how plasmid-mediated transmission occurs at a larger scale.
- A study conducted in Singapore over 4.7 years analyzed 779 patients with CPE, finding that 42% of cases were due to clonal transmission, while 44.8% were linked to plasmid-mediated transmission.
- The results indicated that while direct contact in wards saw a decrease in transmission, indirect contacts (with no overlapping admission periods) remained high, highlighting the need for new strategies to tackle both clonal and plasmid-based infections in hospitals, as the latter
Objective: In our center, previous infection prevention and control (IPC) resources were concentrated on multidrug-resistant organisms other than CRAB because the rate of CRAB was stable with no evidence of outbreaks. Triggered by an increase in the baseline rate of CRAB isolated in clinical cultures, we investigated horizontal transmission of CRAB to guide targeted IPC actions.
Methods: We prospectively collected clinical data of patients with positive CRAB cultures.