Michelle N D Balm

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BACKGROUND Carbapenemase producing Enterobacteriaceae are becoming a major public health concern globally, however, relatively little is known about the molecular and clinical epidemiology of these organisms in many parts of the world. METHODS As part of a laboratory surveillance programme, 96 carbapenem non-susceptible Enterobacteriaceae isolates from(More)
BACKGROUND Meticillin-resistant Staphylococcus aureus (MRSA) has been entrenched in Singapore hospitals since the 1980s, with an excess of 600 non-duplicate cases of infections (120 bacteraemia episodes) each year in our 995-bed university hospital. Approximately 5% of our hospital beds are used as isolation facilities. AIM To study the impact of an MRSA(More)
Zika virus (ZIKV) is a mosquito-borne flavivirus. Infection results in a dengue-like illness with fever, headache, malaise, and a maculopapular rash. Nearly all cases are mild and self-limiting but in 2007, a large outbreak of ZIKV was reported from the island of Yap (in Micronesia, northwest of Indonesia). Singapore is already endemic for dengue, and its(More)
BACKGROUND Elizabethkingia meningoseptica is a nosocomial-adapted Gram-negative bacillus intrinsically resistant to antibiotics commonly used in the intensive care setting. An outbreak investigation commenced when five patients developed E. meningoseptica infection in two intensive care units (ICUs). METHODS Analysis of laboratory data, case reviews, ICU(More)
BACKGROUND A sudden increase in invasive infections caused by Bacillus cereus group organisms prompted an investigation at the National University Hospital in Singapore. AIM To describe the investigation and management and subsequent difficulties controlling the outbreak. METHODS Clinical case reviews were performed on all patients with B. cereus group(More)
The emergence of carbapenemase-producing Enterobacteriaceae is a rapidly evolving threat worldwide. Here, we report the molecular characterization of two Klebsiella pneumoniae isolates carrying both bla(OXA -181) and bla(NDM -1) or bla(NDM -5) isolated from epidemiologically unrelated patients in Singapore. The bla(OXA -181) genes were found existing in(More)
BACKGROUND Patients newly colonised with methicillin-resistant Staphylococcus aureus (MRSA) are at higher risk of clinical MRSA infection. At present, there are limited data on the duration or magnitude of this risk in a hospital population with a known time of MRSA acquisition. METHODS A retrospective cohort study of 909 adult patients known to have(More)
Increasing rates of Clostridium difficile infection (CDI) among those without traditional risk factors have been reported mainly in Europe and North America. Here we describe the epidemiology, clinical features and ribotypes of CDI at National University Hospital (NUH), a 1000-bed tertiary care hospital in Singapore, from December 2011 to May 2012. All(More)
Results B. cereus complex constituted 164 cases (71.3%). Bacteraemia comprised 207 patient episodes (90.0%), of which 124 occurred in immunocompromised patients or those with intravascular devices. Physicians treated the organism in 68 episodes (29.5%). Environmental investigations confirmed heavy air contamination particularly within patient rooms and air(More)
Results Patients 1 and 2 cultured multiresistant P. aeruginosa with identical antibiograms. Patients 3 and 4 cultured multisusceptible P. aeruginosa and Serratia marcescens. Patient 4 also had Stenotrophomonas maltophilia. Bronchoscope cultures taken after manual re-processing grew P. aeruginosa, S. marcescens and S. maltophilia with identical antibiograms(More)