BackgroundLeptospirosis is a zoonotic disease caused by Leptospira species and is distributed globally. Microscopic agglutination test (MAT) is the serological ‘gold standard’ for diagnosis of leptospirosis but it is time-consuming and labour-intensive. An alternative serological method that is rapid, sensitive and specific is important for early treatment to reduce morbidity and mortality. The use of local Leptospira isolation may improve the sensitivity and specificity of the test because it may varies from one geographical region to another region. The objective of this study was to determine the sensitivity, specificity and cut-off points for an in-house Immunoglobulin M (IgM) enzyme-linked immunosorbent assay (ELISA) using a locally isolated Leptospiral strain IMR/175 as the antigen for the detection of anti-Leptospiral IgM.MethodsSerum samples from 270 patients with clinical symptoms of leptospirosis were subjected to the in-house IgM ELISA, MAT and Leptospirosis rapid test. The optimal cut-off values for positivity and negativity of the IgM ELISA were determined by Receiver Operating Characteristic curves and mean ± 2 standard deviation (SD) analyses of the ELISA values.ResultsThe area under the curve (AUC) which indicates the diagnostic performance of the in-house IgM ELISA was 0.953 (95% Confidence Interval, CI: 0.928, 0.978). The sensitivity and specificity of 90.38% and 87.72% respectively were obtained with the cut-off point of 0.55. A higher sensitivity (96.15%) was obtained when the cut-off point was set at 0.45.ConclusionsThe in-house IgM ELISA assay using local Leptospira isolation was shown to be sensitive and may be suitable to use for the serological diagnosis of leptospirosis for our local hospital setting.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-014-0563-7) contains supplementary material, which is available to authorized users.

Background: Sporotrichosis is a subacute or chronic mycosis caused by a dimorphic fungus of the genus Sporothrix. Zoonotic-transmitted sporotrichosis has become a major public health concern and is characterised by a different clinical pattern from the traditional epidemiology of sporotrichosis. Case presentation: We present the details of four patients with mucosal sporotrichosis with regional lymphadenopathy (three cases of granulomatous conjunctivitis and one case of nasal sporotrichosis). The patients’ age range was between 23 to 46 years old and their gender was three female and one male patient. All four patients shared the same ethnicity, Malay, and they had a common history of owning domestic cats as pets. Sporothrix schenckii were isolated from all the culture samples and its antifungal susceptibility patterns were compared in the mycelial and yeast phases. All four patients recovered with oral itraconazole treatment, but the treatment duration was variable among patients. Conclusions: People who have a history of contact with domestic cats should be aware of the possibility of sporotrichosis infection. It can present in cutaneous, lymphocutaneous, disseminated, or systemic forms. Early treatment and the prevention of disease progression are more beneficial to patients. The published data concludes that antifungal treatment is highly efficacious, although the reported treatment duration is variable.

Leptospirosis is an emerging zoonotic infectious disease in Malaysia. The symptoms of leptospirosis vary from mild nonspecific flu-like illness to a severe condition which is usually associated with serious complication and fatality. To study the protein expression profile of mild and severe leptospirosis, 15 paired sera were collected from the patients who were mildly infected and following that progressed to severe stage. The proteome profiles of mild and severe cases were studied using 2DE analysis in combination with LC-MS/MS. The expression of proteins that were significantly different and had a fold difference of at least 2 had been identified and then validated using Western blot. Our study demonstrated apolipoprotein A-I (APOA-I), serum amyloid A (SAA), transferrin (TF), haptoglobin (HP) and transthyretin (TTR) have significantly different expression between mild and severe leptospirosis. The Ingenuity Pathway Analysis software suggested the expression of these five proteins were modulated by acute phase response signaling pathway. Besides that, a functional network of lipid metabolism, molecular transport and small molecule biochemistry that interconnects these five proteins with interactomes also had been predicted by this software. In conclusion, this finding supports the potential of these five proteins to be the biomarkers for mild and severe human leptospirosis.

Background: Voriconazole is a trizaole antifungal to treat fungal infection. In this study, the susceptibility pattern of voriconazole against filamentous fungi was studied using Sensititre® YeastOne and Clinical & Laboratory Standards Institute (CLSI) M38 broth microdilution method. Methods: The suspected cultures of Aspergillus niger, A. flavus, A. fumigatus, A. versicolor, A. sydowii, A. calidoutus, A. creber, A. ochraceopetaliformis, A. tamarii, Fusarium solani, F. longipes, F. falciferus, F. keratoplasticum, Rhizopus oryzae, R. delemar, R. arrhizus, Mucor sp., Poitrasia circinans, Syncephalastrum racemosum and Sporothrix schenckii were received from hospitals. Their identification had been confirmed in our lab and susceptibility tests were performed using Sensititre® YeastOne and CLSI M38 broth microdilution method. The significant differences between two methods were calculated using Wilcoxon Sign Rank test.Results: Mean of the minimum inhibitory concentrations (MIC) for Aspergillus spp. and Fusarium were within 0.25 μg/mL-2.00 μg/mL by two methods except A. calidoutus, F. solani and F. keratoplasticum. Moreover, mean of MIC for S. schenkii were around 3.00 μg/mL by two methods. In contrast, mean of MIC for Rhizopus spp., Mucor sp., P. circinans and S. racemosum were ≥6.00 μg/mL by two methods. Generally, the MIC obtained by Sensititre YeastOne was one two-fold increase or decrease compared with the results obtained by CLSI method. The overall agreement between Sensititre YeastOne and CLSI methods to test susceptibility testing of voricaonazole was more than 70% except A. sydowii. The significant differences between two methods were significant when tested on A. niger, A. flavus, A. fumigatus, A. versicolor, A. sydowii, F. solani and S. schenkii. Conclusions: In conclusion, Sensititre YeastOne method appears to be an alternative procedure for antifungal susceptibility testing for some Malaysian moulds.