Chuan Hun Ding

Hospital Universiti Kebangsaan Malaysia (HUKM) | HUKM · Department of Microbiology and Immunology

Multilocus sequence typing (MLST) has been used to characterise methicillin-resistant Staphylococcus aureus (MRSA) isolates into sequence types (STs) and together with SCCmec typing, form the clonal nomenclature for MRSA. MLST was conducted as per the standard protocol on ten out of 236 isolates collected previously from January to December 2009 re...

Background: New Delhi metallo-β-lactamase-1 (NDM-1) is a relatively recent carbapenemase enzyme that inactivates all b-lactam antibiotics with the exception of aztreonam. This study aims to ascertain the baseline prevalence and antibiotic susceptibility patterns of NDM-1-producing Enterobacteriaceae in a tertiary medical center in Malaysia. Methods...

Candida auris is an emerging pathogenic yeast responsible for nosocomial infections with high mortality, on a global scale. A 65-year-old woman with hypovolemic shock and severe metabolic acidosis was intubated and admitted to the intensive care unit (ICU). Shortly after admission, she developed ventilator-associated pneumonia caused by multidrug-r...

Cryptococcus is a basidiomycetous yeast responsible for considerable HIV-related morbidity and mortality. A cachectic 26-year-old HIV-positive man with a CD4 count of 103 cells/μl presented with fever, breathlessness, and bilateral lower limb weakness. A brain computed tomography scan could not elucidate the neurological deficit. His blood was sent...

Mycotic aneurysm is one of the extra-intestinal manifestations of Salmonella Enteritidis infection. The diagnosis of this condition is challenging owed to its variation in clinical presentations. We presented a case of a 54-year-old man with underlying diabetes mellitus and chronic smokers presented with acute right flank pain and fever associated...

Parengyodontium album is a very rarely encountered opportunistic fungal pathogen. A severely neutropenic 11-year-old boy with acute T-cell lymphoblastic leukemia/lymphoma was febrile and lethargic during his admission for elective chemotherapy. No cutaneous lesion or obvious source of infection was noted, and clinical examination was otherwise unre...

Sporotrichosis is an infection caused by a thermally dimorphic fungus, Sporothrix schenckii which is commonly reported in the tropics and subtropics. Infection usually occurs as a consequence of traumatic inoculation into the skin. A previously healthy 33-year-old Malay woman presented with a scratch wound over the lateral aspect of her left thigh...

Background: Pseudomonas aeruginosa is a notorious gram-negative bacterium that has become a globalpublic health concern owing to the emergence of multi- and pandrug-resistant strains. This study sought todetermine the antibiotic susceptibility profile of P. aeruginosa in a tertiary medical center from Malaysia. Materials and Methods: Each isolate’s...

The second wave of the COVID-19 pandemic in India had brought with it a surge of ‘black fungus’ co-infection, which is a misnomer for mucormycosis. The present case illustrates the ‘real black fungus’ infection in a 50-year old male patient with COVID-19 pneumonia, who otherwise had no significant previous medical history. He was admitted on day 8...

Salmonella intracranial infection is infrequently encountered in clinical practice. However, with prompt intervention and appropriate antimicrobial therapy, the outcome is usually favourable. A 56-year-old gentleman who worked as an organic fertilizer production supervisor underwent tumour resection for meningioma located at the left frontal tempor...

Nasopharyngeal diphtheria is an acute infectious upper respiratory tract disease caused by toxigenic strains of Corynebacterium diphtheriae. We report a case of a young adult who presented to us with a short history of fever, sore throat, hoarseness of voice and neck swelling. He claimed to have received all his childhood vaccinations and had no kn...

Bullous systemic lupus erythematosus (BSLE) is a rare autoimmune blistering condition. A 10-year-old boy presented with generalized vesiculobullous skin eruptions and was initially diagnosed with bullous disease of childhood. Indirect immunofluorescence testing for antinuclear antibodies (ANA) was positive, with a homogeneous pattern and a titre of...

Histoplasmosis is a common fungal infection in endemic countries including Malaysia. Although it is commonly diagnosed in immunosuppressed individuals, there is a preponderance of immunocompetent individuals among individuals with disseminated disease involving adrenal gland. There is a diagnostic dilemma in most patients as the clinical presentati...

Candida dubliniensis is a pathogenic yeast which is rarely encountered in clinical practice. An 83-year-old HIV-negative woman with numerous medical co-morbidities presented with a dental abscess which was preceded by a long-standing toothache. The right side of her face was swollen from the preauricular to the malar and submandibular regions. A co...

Introduction: Rifampicin is a key first-line antimycobacterial agent employed for the treatment of pulmonary tuberculosis (PTB). This study sought to obtain prevalence data on rifampicin-resistant Mycobacterium tuberculosis among smear-positive PTB patients in the Klang District of Malaysia. Materials and methods: A total of 103 patients from th...

Septic arthritis usually represents a direct invasion of joint space by various microorganisms, most commonly caused by bacteria. Most of the time, it is caused by Staphylococci spp. or Streptococci spp. This is a case of a 70-year-old Chinese man with underlying end stage renal failure on regular hemodialysis who presented with recurrent right sho...

Primary prostatic melioidosis is a rare presentation of melioidosis even in melioidosis endemic areas. We report a case of a 58-year-old man with underlying diabetes mellitus who presented with a 5-day history of high-grade fever associated with lower urinary tract symptoms. Suprapubic tenderness and tender prostatomegaly were noted on examination....

Trichosporon asahii is a yeast-like fungus that is emerging as an important cause of invasive infections in tertiary medical centres. A 58-year-old Chinese man with no known medical illnesses presented with liver lacerations and multiple fractures following an alleged 12-foot fall at a construction site. The gravity of his injuries and poor haemody...

Introduction: Fresh frozen plasma (FFP) is a blood component containing functional quantities of all coagulation factors stored at -18°C or below. FFP has to be thawed and transfused as soon as possible to prevent the loss of certain coagulation factor activities and to minimise microbial contamination. Materials and methods: Thirty units of FFP...

Primary biliary cholangitis (PBC) is an autoimmune disease that is increasingly recognized as an important cause of chronic liver disease. Incidental diagnoses are not uncommon. We report a case of a middle-aged female with persistently elevated ALP activity. During the investigation of cholestasis, anti-mitochondrial antibodies (AMA) were detected...

Sporotrichosis is a globally prevalent subcutaneous mycosis commonly acquired through traumatic inoculation. A 66-year-old woman with underlying systemic lupus erythematosus (SLE) presented initially with a painful non-healing nodule on her right thumb. There was no history of traumatic contact with soil, plants or animals. She was started on an an...

Shewanella spp. are infrequently implicated in human infections but they are emerging pathogens with particular significance in regions with warm climates, such as Southeast Asia. This is a case of a middle-aged diabetic and hypertensive man who presented with worsening congestive heart failure symptoms associated with fever and a painful right leg...

Objective: To determine the laboratory detection rates and epidemiology of Aspergillus spp. in Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Design: Retrospective cross-sectional study. Materials and methods: Mycology laboratory data on Aspergillus cultures, galactomannan antigen and Aspergillus antibody detection tests from 2013 to 2016 w...

Tuberculosis is a public health problem that can cause extrapulmonary infections, including urogenital infections. We report here the case of a 29-year old female with a 2-year history of dysuria and hematuria treated with multiple courses of antibiotics with urine cultures all negative. She was then diagnosed with IgA nephropathy based on a renal...

Thawed fresh frozen plasma (FFP) if not used within 6 h, may have to be discarded due to the risk of contamination and uncertainty about its quality. The main objective of this study was to evaluate the levels of coagulation Factor II (FII), Factor VIII (FVIII), fibrinogen and bacterial growth in thawed refrozen FFP. Thirty FFP samples were collect...

Hypertensive crises can be life-threatening if undiagnosed due to the risk of acute target organ damage. This is a case of a middle-aged woman with poorly controlled hypertension who presented with a 3-day history of dyspnea, orthopnea, and cough productive of frothy sputum. Repeated attempts to measure her blood pressure (BP) using both a mercury...

Cryptococcemia attributed to non-neoformans cryptococci has not received much attention due to the relative scarcity of reported cases. The primary aim of this case report is to highlight several notable characteristics of Cryptococcus laurentii. A 35-year-old woman presented with a right supraclavicular mass and a history of low-grade fever. A yea...

INTRODUCTION: Infant hepatitis B vaccination was introduced into the Expanded Programme on Immunisation (EPI) in Malaysia in 1989. This study aimed to investigate seroprevalence of hepatitis B among UKM pre-clinical medical students, born between 1991 and 1995, and had their infant vaccination more than 20 years ago. MATERIALS AND METHODS: A prospe...

The increasing use of invasive medical devices and broad-spectrum antimicrobial agents has resulted in rising candidemia rates throughout the world. A 70-year-old diabetic and schizophrenic woman was admitted initially for staphylococcal sepsis secondary to an infected sacral sore but developed a catheter-related bloodstream infection caused by ext...

Catheter-related bloodstream infections caused by Kodamaea ohmeri are generally not considered due to the relative scarcity of reported cases. This is a case of an 85-year-old man with poorly controlled diabetes mellitus who was initially admitted to our hospital for diabetic ketoacidosis. An internal jugular catheter was inserted as part of the in...

Pneumocystis pneumonia is an important human immunodeficiency virus (HIV)-associated opportunistic infection, and especially so in pregnant HIV-positive patients. We report a case of a 40-year-old woman in her first trimester of pregnancy who initially presented with acute gastroenteritis symptoms but due to a history of high-risk behaviour and the...

p> Objective: Onychomycosis can be caused by numerous fungi, with geographical and temporal factors influencing the prevalence of the various aetiological agents. We set out to identify and classify the various fungi cultured from the nail clippings of patients diagnosed with onychomycosis in UKM Medical Centre, Malaysia. Methods: This retrospecti...

Background: Chlamydia trachomatis and Neisseria gonorrhoeae are important bacterial pathogens of sexually transmitted infections (STIs) worldwide. This study sought to compare the analytical sensitivity and specificity of conventional methods against a rapid molecular method in detecting STIs caused by these bacteria. Methods: Ninety five first-...

Objectives: The aims of this study were to determine the seroprevalence of acute dengue in Universiti Kebangsaan Malaysia (UKM) Medical Centre and its correlation with selected haematological and biochemical parameters. Methods: This cross-sectional study was conducted from January to June 2015. A patient was serologically diagnosed with acute den...

Objective: The New Delhi metallo-β-lactamase-1 (NDM-1) enzyme is a plasmid-encoded enzyme that inactivates carbapenem antibiotics. This study aims to ascertain if the modified Hodge test (MHT) has a role in screening for NDM-1 in Enterobacteriaceae with reduced carbapenem susceptibility. Methods: Over a period of one year, all Enterobacteriaceae...

Primary biliary cirrhosis in combination with autoimmune hepatitis has been termed “overlap syndrome”, but its diagnosis is challenging. We report a case of a 43-year-old lady who presented with a six-month history of jaundice and pruritus. She subsequently developed gum bleeds. Laboratory investigations revealed hypochromic microcytic anemia, abno...

To determine the proportion of albicans and non-albicans candiduria in a hospital setting and to ascertain if fluconazole is still suitable as empirical antifungal therapy based on antifungal susceptibility patterns of Candida species. The cross-sectional study was conducted between December 2010 and December 2011 at UKM Medical Centre, Kuala Lumpu...

Fungaemia due to Paecilomyces lilacinus is generally not considered in AIDS patients because this condition is not categorised as an AIDS-indicator illness. We report a case of a 25-year-old lady who presented to our hospital with Guillain-Barré Syndrome, with the subsequent development of refractory fungaemia, multi-organ failure and disseminated...

Scedosporium apiospermum is a cosmopolitan mycotic agent with unique characteristics. This is a case of a 65-year-old immunocompetent patient who presented with shortness of breath and fever. Consolidation was observed in both lung fields on chest X-ray. A diagnosis of aspiration pneumonia was made. Extended spectrum β-lactamase (ESBL)-producing Kl...

Burkholderia pseudomallei is an free-living gram-negative bacterium causing melioidosis and is endemic in Southeast Asia. A 56-year-old diabetic construction worker with a 1-month history of abdominal pain and 1-day history of high-grade fever was found to have a left non-dissecting infrarenal mycotic aortic aneurysm by abdominal computerized tomog...