Background There is a major public health challenge threatening the world with the rapid spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which emerged in December 2019 from Wuhan, China. Objective The aim of this study was to assess the knowledge, attitude and practice regarding COVID-19 and its transmission, causes and prevention among people living in Malaysia. Methods A cross-sectional study was conducted among people living in Malaysia by using an online survey in March and April 2020. Results Out of 520 respondents, the mean age was 36.9 ± 14.9, between 19 and 67 years with the majority being female. Most respondents had good knowledge, attitude and practice towards COVID-19 with mean ± sd 18.2 ± 1.7, 5.2 ± 1.1 and 4.1 ± 1.4, respectively. In addition, the majority had good knowledge regarding cause, mode of transmission, signs and symptoms, prevention and treatment and quarantine measures after answering 21 questions. Conclusion To date, there is no specific treatment or vaccine for COVID-19, thus staying at home is the best preventive measure to curb the further growth of positive cases in the country. These findings could provide an insight in designing effective preparedness for future pandemic outbreaks.

Enterococci possess a high propensity to spread their resistance genes between intra-and inter-species via mobile genetic elements. Potential reservoirs for acquiring antibiotic resistance genes by commensal and environmental bacteria, including enterococci, have raised significant public health concerns over recent decades. This concern is further complicated by the rampant use of tetracyclines in aquaculture and animals for therapeutic and chemoprophylactic purposes. This systematic review was conducted to elucidate the occurrence of tetracycline-resistant enterococcal species, their resistomes and virulence determinants in faecal samples of aquatic and overland animals. The PubMed, Web of Science, ScienceDirect and Scopus databases were searched to retrieve relevant studies that matched the specific keywords. A total of 19 low-bias studies were included. It was found that several tetracycline resistance genes such as tet(M), tet(L), and tet(M + L) genes encode for the ribosomal protection protein or for the efflux mechanism of tetracyclines in E. faecium, E. faecalis, E. hirae, E. durans, E. gallinarium and E. casseliflavus. Additionally, tet(M) and tet(M + L) or tet(M) genes were associated with transposons Tn916 and/or Tn5397 or Tn1545 plus Tn916, respectively. The acquisition of tet(M) and tet(M + L) genes may be assisted by transposons Tn916 and/or Tn5397 or Tn1545 plus Tn916. In conclusion, tetracycline-resistant enterococci recovered from aquatic and overland animals could further complicate the management of antibiotic-resistant bacteria in both humans and animals. Thus, a concerted, multisectoral and transdisciplinary approach (One Health) is needed for active surveillance to be exacted and for better public health measures to be initiated in the future.

Pathogenic microorganisms from hospitals, communities, and the environment remain great threats to human health. The increasing concern about antibiotic resistance has also necessitated the search for robust alternatives. Therefore, this study aims to isolate, screen and evaluate the antibiotic susceptibility of Pseudomonas aeruginosa isolated from a soil sample taken from northern, western and eastern parts of Kelana Jaya Lake against four antibiotics (gentamycin, tetracycline, ampicillin, and penicillin) on a Mueller-Hinton Agar media plate. Pseudomonas identification was done by using API 20 kit. Disc diffusion was employed as well as the oxidase test. From the positive oxidase result, the isolated bacteria were identified as Burkholderia cepacia (97.6% ID), Pseudomonas aeruginosa (99.5-99.9% ID), and Pseudomonas fluorescent (75.9% ID). Only Pseudomonas aeruginosa isolates were further evaluated for antibiotic susceptibility tests. The result showed that P. aeruginosa was susceptible to only three antibiotics (gentamycin, tetracycline, and penicillin) showing a clear zone of inhibition while it was resistant to only ampicillin with no zone of inhibition. Soil isolates are potential sources for the development of effective antibiotics against resistant bacteria.

Scrub typhus, caused by mite-borne Orientia tsutsugamushi (O. tsutsugamushi), is a major febrile disease in the Asia-Pacific region. The DNA load of O. tsutsugamushi in the blood was previously found to be significantly higher in patients with fatal disease than those with non-fatal disease and correlated with the duration of illness, presence of eschar, and hepatic enzyme levels. In this prospective observation study, we analyzed the association of bacterial DNA load with clinical features, disease severity, and genotype using real-time PCR targeting the 56 kDa TSA gene of O. tsutsugamushi in the blood samples of 117 surviving patients with scrub typhus who had not received appropriate antibiotic treatment. The median O. tsutsugamushi DNA load was 3.11×103 copies/mL (range, 44 to 3.3×106 copies/mL). The severity of patients was categorized as mild, moderate, and severe based on the number of dysfunctional organs, and no significant difference in O. tsutsugamushi DNA load was found among these groups. Patients infected with the Karp group showed a significantly higher O. tsutsugamushi DNA load than those in the Gilliam (P < 0.05) and TA763 (P < 0.01) groups. Patients belonging to the Li ethnic group showed a significantly higher DNA load than those in the Han ethnic groups. The blood bacterial DNA load of patients showed no significant difference between groups divided by gender, age, with or without eschar, or the season of disease onset. The highest body temperature recorded during fever onset was positively correlated with O. tsutsugamushi DNA load (ρ  =  0.272, P  =  0.022). Correlation analyses indicated that the serum total bilirubin level was positively correlated with O. tsutsugamushi DNA load. In conclusion, the findings in this study demonstrated the association of DNA load of O. tsutsugamushi with the severity and genotype in patients with scrub typhus in Hainan, China.

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