Awareness, knowledge, disease prevention practices, and immunization attitude of hepatitis E virus among food handlers in Klang Valley, Malaysia.

Concern about the zoonotic Hepatitis E virus (HEV) is rising. Since, food handlers are at greater risk in contracting HEV, the present study aims to determine awareness, knowledge, prevention practices against HEV, and immunization attitudes. A cross sectional study was conducted among 400 food handlers in Klang Valley, Malaysia from December 2021 to March 2022. A structured questionnaire was employed for data collection and analysis with Statistical Package for Social Science (SPSS) version 29. Approximately 4.5% of the respondents (18) reported having heard of HEV, while the median scores for the knowledge and practice domains were 0/10 and 1/5, respectively. A total of 316 (79%) respondents expressed willingness to obtain vaccination if made available. This study also found that those respondents who completed their tertiary education were significantly possessed better knowledge of the disease [odd ratio (OR) = 8.95, and 95% confidence interval (CI) 4.98-16.10]. Respondents with HEV awareness reported considerably better practices (OR = 8.24, 95% CI 1.72-39.63). Food handlers with one to five years of experience in the industry expressed notable willingness to take vaccination (OR = 7.71, 95% CI 1.79-33.18). Addressing poor HEV awareness and knowledge and poor practices against the disease is crucial in enlightening the policy makers about awareness among food handlers and general population. Nonetheless, a good immunization attitude, significant acceptance toward vaccination even with the vaccine being unavailable in Malaysia, and limited awareness of HEV highlight a promising development.

Multidrug-Resistant Salmonella Species and Their Mobile Genetic Elements from Poultry Farm Environments in Malaysia.

The prevalence and persistent outbreaks of multidrug-resistant (MDR) Salmonella in low-income countries have received growing attention among the public and scientific community. Notably, the excessive use of antibiotics in chicken feed for the purpose of treatment or as prophylaxis in the poultry industry have led to a rising rate of antimicrobial resistance. Therefore, this study aimed to determine the presence of antimicrobial-resistant Salmonella species and its mobile genetic elements from soil and effluent samples of 33 randomly selected poultry farms in Selangor, Malaysia. Salmonella species were isolated on selective media (CHROMagar™ Salmonella). VITEK® 2 system was used to identify the isolates and their antimicrobial susceptibility. Subsequently, eight isolates were subjected to the whole genome sequencing (WGS). Based on the results, Salmonella spp. was detected in 38.1% (24/63) of samples, with the highest resistance to ampicillin (62.5%), followed by ampicillin/sulbactam (50.0%) and ciprofloxacin (45.8%). Meanwhile, the identified serovars were Salmonella enterica subspecies enterica serovar Weltevreden (S. Weltevreden), S. Jedburgh, and S. Brancaster. The most prevalent resistance genes detected include qnrS1, blaTEM-176, dfrA14, and tet(A). The IncX1 plasmid, with encoded resistance genes, was also detected in four isolates. Furthermore, mutations in the quinolone resistant-determining regions (QRDR) were discovered, specifically in the gyrA, gyrB, and parC genes. In short, surveillance such as continuous monitoring of antimicrobial resistance and emerging trends in resistance patterns through farm environmental samples could provide information to formulate public health interventions for effective infection prevention and disease control.

Occurrence of endocrine disruptors in Malaysia's water systems: A scoping review.

Contamination of water systems with endocrine disrupting chemicals (EDCs) is becoming a major public health concern due to their toxicity and ubiquity. The intrusion of EDCs into water sources and drinking water has been associated with various adverse health effects on humans. However, there is no comprehensive overview of the occurrence of EDCs in Malaysia's water systems. This report aims to describe the occurrence of EDCs and their locations. Literature search was conducted electronically in two databases (PubMed and Scopus). A total of 41 peer-reviewed articles published between January 2000 and May 2021 were selected. Most of the articles dealt with pharmaceuticals (16), followed by pesticides (7), hormones (7), mixed compounds (7), and plasticisers (4). Most studies (40/41) were conducted in Peninsular Malaysia, with 60.9% in the central region and almost half (48.8%) in the Selangor State. Only one study was conducted in the northern region and East Malaysia. The Langat River, the Klang River, and the Selangor River were among the most frequently studied EDC-contaminated surface waters, while the Pahang River and the Skudai River had the highest concentrations of some of the listed compounds. Most of the risk assessments resulted in a hazard quotient (HQ) and a risk quotient (RQ) < 1, indicating negligible health risk, except for ciprofloxacin and dexamethasone, which had a potential human health risk (HQHH) > 1 in the Selangor River. An RQ > 1 for combined pharmaceuticals was found in Putrajaya tap water. Overall, this work provides a comprehensive overview of the occurrence of EDCs in Malaysia's water systems. The findings from this review can be used to mitigate risks and strengthen legislation and policies for safer drinking water.

Resistance towards Critically Important Antimicrobials among Enterococcus faecalis and E. faecium in Poultry Farm Environments in Selangor, Malaysia.

Multidrug resistant (MDR) enterococci pose significant public health challenges. However, the extent of resistance in the environment is less explored. This study aimed to determine the antibiotic resistance in a poultry farm environment. Eighty enterococcal isolates recovered from the soil and effluent water of 28 poultry farms in Selangor state were included in the study for further bacterial identification and antibiotic susceptibility testing using a VITEK 2 system. Data were analyzed using Statistical Package for Social Science (SPSS) version 27. The resistance rate and MDR of enterococcal isolates were reported. Out of 80 isolates recovered, 72 (90%) exhibited resistance to at least one antibiotic, with 50 isolates (62.5%) being found to be MDR. All linezolid-resistant enterococci (LRE) exhibit MDR, which constituted 40% of resistance among all the isolates recovered from poultry environment. Since linezolid is listed as critically important antibiotics for clinical use by the World Health Organization (WHO), the higher resistance towards it and other critically important antibiotic for human use is a serious concern. Hence, relevant agencies need to investigate the use of clinically important antimicrobials in poultry farms paying special attention towards linezolid or any other antibiotics that can facilitate the development of LRE.

Multidrug-Resistant Gram-Negative Bacteria and Extended-Spectrum ß-Lactamase-Producing Klebsiella pneumoniae from the Poultry Farm Environment.

The indiscriminate use and overuse of various antibiotics have caused the rapid emergence of antibiotic-resistant bacteria (ARB) in poultry products and the surrounding environment, giving rise to global public health issues. This study aimed to determine the prevalence of multidrug-resistant (MDR) Gram-negative bacteria (GNB) found in the environment of poultry farms and to evaluate the risk of contamination in these farms based on multiple antibiotic resistance (MAR) index values. Soil and effluent samples were collected from 13 poultry farms. The VITEK 2 system was used for bacterial identification and susceptibility testing of the isolates. The identified Gram-negative isolates were Acinetobacter spp., Aeromonas spp., Enterobacter spp., Klebsiella pneumoniae, Proteus spp., Providencia spp., Pseudomonas spp., and Sphingomonas paucimobilis. The results showed that Enterobacter spp., Aeromonas spp., and Providencia spp. exhibited the highest MDR rates and MAR indices; 14% of K. pneumoniae isolates (3/21 isolates) were resistant to 13 antibiotics and found to be extended-spectrum ß-lactamase (ESBL)-producing bacteria. As for the tested antibiotics, 96.6% of the isolates (28/29 isolates) demonstrated resistance to ampicillin, followed by ampicillin-sulbactam (55.9% [33/59 isolates]) and cefazolin (54.8% [57/104 isolates]). The high percentage of MDR bacteria and the presence of ESBL-producing K. pneumoniae strains suggested the presence of MDR genes from the poultry farm environment, which poses an alarming threat to the effectiveness of the available antibiotic medicines to treat infectious diseases. Therefore, the use of antibiotics should be regulated and controlled, while studies addressing One Health issues are vital for combating and preventing the development and spread of ARB. IMPORTANCE The occurrence and spread of ARB due to high demand in poultry industries are of great public health concern. The widespread emergence of antibiotic resistance, particularly MDR among bacterial pathogens, poses challenges in clinical treatment. Some pathogens are now virtually untreatable with current antibiotics. However, those pathogens were rarely explored in the environment. In alignment with the concept of One Health, it is imperative to study the rate of resistance in the environment, because this domain plays an important role in the dissemination of bacteria to humans, animals, and other environmental areas. Reliable data on the prevalence of MDR bacteria are crucial to curb the spread of bacterial pathogens that can cause antimicrobial-resistant infections.

DETECTION OF BURKHOLDERIA PSEUDOMALLEI FROM POST-FLOOD SOIL SAMPLES IN KELANTAN, MALAYSIA.

Burkholderia pseudomallei is an important causative organism of fatal community bacteremia especially in Southeast Asia and northern Australia. Outbreaks of melioidosis have been reported post-floods and -typhoons. A cross sectional study was conducted in January 2015, following a major flood in Kelantan, Malaysia to detect presence of B. pseudomallei from soil. A total of 89 soil samples were cultured for B. pseudomallei on Ashdown agar. Putative colonies underwent further staining and biochemical testing prior to confirmation by PCR. Rate of detection was 1%, although low, it nevertheless indicated a risk for melioidosis among flood victims in Kelantan. Flood affected individuals should be made aware of symptoms of melioidosis and healthcare providers must have a high index of suspicion of patients presenting with fever. Such subjects should be screened for the possibility of melioidosis and given prompt treatment to avoid preventable death.

The mercury levels in crustaceans and cephalopods from Peninsular Malaysia.

This study is to determine total mercury in edible tissues of eight species of cephalopods and 12 species of crustaceans purchased from 11 identified major fish landing ports and wet markets throughout Peninsular Malaysia. The concentration of mercury was measured by cold vapor atomic absorption spectrometry (AAS) technique using the Perkin Elmer Flow Injection Mercury System (FIMS-400). In general, the mercury levels were low with concentrations in cephalopods ranging from 0.099 to 2.715 mg/kg dry weight (or 0.0184-0.505 mg/kg wet weight) and in crustaceans ranging from 0.057 to 1.359 mg/kg dry weight (or 0.0111-0.265 mg/kg wet weight). The mercury levels showed no significant differences (P > 0.05) between species for both cephalopods and crustaceans. There was no significant correlation between mercury concentrations and the body size of individual for both groups as well. Comparisons with mercury levels obtained found from other previous studies and/or species noted that they were of the same magnitude or relatively low compared to various locations reported worldwide.

Mercury levels of marine fish commonly consumed in Peninsular Malaysia.

This study was conducted to determine the concentration of total mercury in the edible portion of 46 species of marine fish (n = 297) collected from selected major fish landing ports and wholesale markets throughout Peninsular Malaysia. Samples were collected in June to December 2009. Prior to analysis, the fish samples were processed which consisted of drying at 65 °C until a constant weight was attained; then, it was grounded and digested by a microwave digestion system. The analytical determination was carried out by using a mercury analysis system. Total mercury concentration among fish species was examined. The results showed that mercury concentrations were found significantly higher (p < 0.001) in demersal fish (the range was from 0.173 to 2.537 mg/kg in dried weight) compared to pelagic fish (which ranged from 0.055 to 2.137 mg/kg in dried weight). The mercury concentrations were also higher in carnivorous fish especially in the species with more predatory feeding habits. Besides, the family group of Latidae (0.537 ± 0.267 mg/kg in dried weight), Dasyatidae (0.492 ± 0.740 mg/kg in dried weight), and Lutjanidae (0.465 ± 0.566 mg/kg in dried weight) showed significantly (p < 0.001) higher mercury levels compared to other groups. Fish collected from Port Klang (0.563 ± 0.509 mg/kg in dry weight), Kuala Besar (0.521 ± 0.415 mg/kg in dry weight), and Pandan (0.380 ± 0.481 mg/kg in dry weight) were significantly higher (p = 0.014) in mercury concentrations when compared to fish from other sampling locations. Total mercury levels were significantly higher (p < 0.002) in bigger fish (body length >20 cm) and were positively related with fish size (length and weight) in all fish samples. Despite the results, the level of mercury in marine fish did not exceed the permitted levels of Malaysian and JECFA guideline values at 0.5 mg/kg methylmercury in fish.