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Article ; Online: Interrupting transmission of COVID-19: lessons from containment efforts in Singapore.

Lee, Vernon J / Chiew, Calvin J / Khong, Wei Xin

2020 Volume 27, Issue 3

MeSH term(s)	Betacoronavirus ; COVID-19 ; Communicable Disease Control/methods ; Coronavirus Infections/epidemiology ; Coronavirus Infections/prevention & control ; Humans ; Pandemics/prevention & control ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/prevention & control ; Quarantine ; SARS-CoV-2 ; Singapore/epidemiology
Keywords	covid19
Language	English
Publishing date	2020-01-20
Publishing country	England
Document type	Journal Article
ZDB-ID	1212504-0
ISSN	1708-8305 ; 1195-1982
ISSN (online)	1708-8305
ISSN	1195-1982
DOI	10.1093/jtm/taaa039
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Article: Interrupting transmission of COVID-19: lessons from containment efforts in Singapore

Lee, Vernon J / Chiew, Calvin J / Khong, Wei Xin

J. travel med

Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #8423
Database	COVID19

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Article ; Online: Interrupting transmission of COVID-19

Lee, Vernon J / Chiew, Calvin J / Khong, Wei Xin

Journal of Travel Medicine

lessons from containment efforts in Singapore

2020 Volume 27, Issue 3

Abstract: Despite multiple importations resulting in local chains of transmission, Singapore has been able to control the COVID-19 outbreak without major disruption to daily living. In this article, we describe the combination of measures taken by Singapore to ... ...

Abstract	Despite multiple importations resulting in local chains of transmission, Singapore has been able to control the COVID-19 outbreak without major disruption to daily living. In this article, we describe the combination of measures taken by Singapore to contain COVID-19 and share some early lessons learnt from the experience.
Keywords	General Medicine ; covid19
Language	English
Publisher	Oxford University Press (OUP)
Publishing country	uk
Document type	Article ; Online
ZDB-ID	1212504-0
ISSN	1708-8305 ; 1195-1982
ISSN (online)	1708-8305
ISSN	1195-1982
DOI	10.1093/jtm/taaa039
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Genomic surveillance uncovers ongoing transmission of carbapenem-resistant

Ong, Sean Wei Xiang / Rao, Pooja / Khong, Wei Xin / Ong, Victor Yi Fa / Sridatta, Prakki Sai Rama / Thevasagayam, Natascha May / Ho, Benjamin Choon Heng / Ang, Brenda Sze Peng / De, Partha Pratim / Ng, Oon Tek / Marimuthu, Kalisvar

Infection control and hospital epidemiology

2022 Volume 44, Issue 3, Page(s) 460–466

Abstract: Objective: In our center, previous infection prevention and control (IPC) resources were concentrated on multidrug-resistant organisms other than CRAB because the rate of CRAB was stable with no evidence of outbreaks. Triggered by an increase in the ... ...

Abstract	Objective: In our center, previous infection prevention and control (IPC) resources were concentrated on multidrug-resistant organisms other than CRAB because the rate of CRAB was stable with no evidence of outbreaks. Triggered by an increase in the baseline rate of CRAB isolated in clinical cultures, we investigated horizontal transmission of CRAB to guide targeted IPC actions. Methods: We prospectively collected clinical data of patients with positive CRAB cultures. We identified genetic relatedness of CRAB isolates using whole-genome sequencing. Findings were regularly presented to the IPC committee, and follow-up actions were documented. Results: During the study period, 66 CRAB isolates were available for WGS. Including 12 clinical isolates and 10 environmental isolates from a previous study, a total of 88 samples were subjected to WGS, of which 83 were successfully sequenced and included in the phylogenetic analysis. We identified 5 clusters involving 44 patients. Genomic transmissions were explained by spatiotemporal overlap in 12 patients and by spatial overlap only in 12 patients. The focus of transmission was deduced to be the intensive care units. One cluster was related to a retrospective environmental isolate, suggesting the environment as a possible route of transmission. Discussion of these findings at multidisciplinary IPC meetings led to implementation of measures focusing on environmental hygiene, including hydrogen peroxide vapor disinfection in addition to terminal cleaning for rooms occupied by CRAB patients. Conclusions: We showed that WGS could be utilized as a "tool of persuasion" by demonstrating the presence of ongoing transmission of CRAB in an endemic setting, and by identifying actionable routes of transmission for directed IPC interventions.
MeSH term(s)	Humans ; Acinetobacter baumannii/genetics ; Retrospective Studies ; Phylogeny ; Cross Infection/epidemiology ; Cross Infection/prevention & control ; Acinetobacter Infections/epidemiology ; Microbial Sensitivity Tests ; Carbapenems/pharmacology ; Genomics
Chemical Substances	Carbapenems
Language	English
Publishing date	2022-05-23
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	639378-0
ISSN	1559-6834 ; 0195-9417 ; 0899-823X
ISSN (online)	1559-6834
ISSN	0195-9417 ; 0899-823X
DOI	10.1017/ice.2022.115
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Interrupting transmission of COVID-19: lessons from containment efforts in Singapore ;Journal of Travel Medicine ;Oxford Academic

Vernon J Lee, Calvin J. Chiew Wei Xin Khong

Journal of Travel Medicine

Abstract: Despite multiple importations resulting in local chains of transmission, Singapore has been able to control the COVID-19 outbreak without major disruption to daily living In this article, we describe the combination of measures taken by Singapore to ... ...

Abstract	Despite multiple importations resulting in local chains of transmission, Singapore has been able to control the COVID-19 outbreak without major disruption to daily living In this article, we describe the combination of measures taken by Singapore to contain COVID-19 and share some early lessons learnt from the experience
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #8509
Database	COVID19

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Article ; Online: Primary cardiac lymphoma: the management and outcome of a single-centre cohort of 22 patients.

Wei, Xiao-Juan / Yuan, Hui / Khong, Pek-Lan / Zhang, Fen / Liao, Peng-Jun / Jiang, Xin-Miao / Huang, Ling / Guo, Han-Guo / Chen, Fei-Li / Liu, Si-Chu / Huang, Yan-Ying / Wang, Shu-Xia / Li, Wen-Yu

Acta oncologica (Stockholm, Sweden)

2021 Volume 60, Issue 9, Page(s) 1122–1129

Abstract: Background: The incidence of primary cardiac lymphoma (PCL) is increasing, but the optimal management approach remains unclear. We assessed the clinical characteristics of a single-centre cohort with the goal of determining the optimal management ... ...

Abstract	Background: The incidence of primary cardiac lymphoma (PCL) is increasing, but the optimal management approach remains unclear. We assessed the clinical characteristics of a single-centre cohort with the goal of determining the optimal management approach. The treatment outcomes and prognostic factors are reported. Material and methods: All PCL patients were diagnosed via biopsy guided by whole-body imaging (positron emission tomography/computed tomography [PET/CT] and/or contrast-enhanced CT]. Curative therapy involved either surgery or prephase steroids followed by definitive immunochemotherapy, depending on the histological type. The primary outcomes were overall survival (OS) and progression-free survival (PFS); the secondary outcome was the treatment response. Results: Twenty-two PCL patients (14 males, 8 females; age: 59.5 ± 14.7 years [mean ± S.D.]) were histologically confirmed to have diffuse large B-cell lymphoma (DLBCL; Conclusions: Whole-body imaging is essential for diagnosis and prognosis. Curative therapy provided reasonable outcomes and survival; extrapericardial lesions were associated with a poorer treatment response.
MeSH term(s)	Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Female ; Fluorodeoxyglucose F18 ; Humans ; Lymphoma, Large B-Cell, Diffuse/drug therapy ; Male ; Middle Aged ; Positron Emission Tomography Computed Tomography ; Prognosis ; Progression-Free Survival ; Retrospective Studies
Chemical Substances	Fluorodeoxyglucose F18 (0Z5B2CJX4D)
Language	English
Publishing date	2021-08-17
Publishing country	England
Document type	Journal Article
ZDB-ID	896449-x
ISSN	1651-226X ; 0349-652X ; 0284-186X ; 1100-1704
ISSN (online)	1651-226X
ISSN	0349-652X ; 0284-186X ; 1100-1704
DOI	10.1080/0284186X.2021.1950923
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Article ; Online: Environmental colonization and onward clonal transmission of carbapenem-resistant

Ng, Deborah H L / Marimuthu, Kalisvar / Lee, Jia Jun / Khong, Wei Xin / Ng, Oon Tek / Zhang, Wei / Poh, Bee Fong / Rao, Pooja / Raj, Maya Devi Rajinder / Ang, Brenda / De, Partha Pratim

Antimicrobial resistance and infection control

2018 Volume 7, Page(s) 51

Abstract: Background: In May 2015, we noticed an increase in carbapenem-resistant : Methods: We conducted a one-day point prevalence screening (PPS) of the patients and environment in the MICU. We screened patients using endotracheal tube aspirates and swabs ... ...

Abstract	Background: In May 2015, we noticed an increase in carbapenem-resistant Methods: We conducted a one-day point prevalence screening (PPS) of the patients and environment in the MICU. We screened patients using endotracheal tube aspirates and swabs from nares, axillae, groin, rectum, wounds, and exit sites of drains. We collected environmental samples from patients' rooms and environment outside the patients' rooms. CRAB isolates from the PPS and clinical samples over the subsequent one month were studied for genetic relatedness by whole genome sequencing (WGS). Results: We collected 34 samples from seven patients and 244 samples from the environment. On the day of PPS, we identified 8 CRAB carriers: 3 who screened positive and 5 previously known clinical infections. We detected environmental contamination in nearly two-thirds of the rooms housing patients with CRAB. WGS demonstrated genetic clustering of isolates within rooms but not across rooms. We analysed 4 CRAB isolates from clinical samples following the PPS. One genetically-related CRAB was identified in the respiratory sample of a patient with nosocomial pneumonia, who was admitted to the MICU five days after the PPS. Conclusion: The extensive environmental colonization of CRAB by patients highlights the importance of environmental hygiene. The transmission dynamics of CRAB needs further investigation.
MeSH term(s)	Acinetobacter Infections/epidemiology ; Acinetobacter Infections/microbiology ; Acinetobacter Infections/transmission ; Acinetobacter baumannii/classification ; Acinetobacter baumannii/drug effects ; Acinetobacter baumannii/isolation & purification ; Anti-Bacterial Agents/pharmacology ; Carbapenems/pharmacology ; Cross Infection/epidemiology ; Drug Resistance, Multiple, Bacterial/physiology ; Female ; Humans ; Hygiene ; Intensive Care Units/statistics & numerical data ; Intubation/adverse effects ; Male ; Mass Screening ; Microbial Sensitivity Tests
Chemical Substances	Anti-Bacterial Agents ; Carbapenems
Language	English
Publishing date	2018-04-10
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2666706-X
ISSN	2047-2994 ; 2047-2994
ISSN (online)	2047-2994
ISSN	2047-2994
DOI	10.1186/s13756-018-0343-z
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Identification of HIV Mutation as Diagnostic Biomarker through Next Generation Sequencing.

Shaw, Wen Hui / Lin, Qianqian / Muhammad, Zikry Zhiwei Bin Roslee / Lee, Jia Jun / Khong, Wei Xin / Ng, Oon Tek / Tan, Eng Lee / Li, Peng

Journal of clinical and diagnostic research : JCDR

2016 Volume 10, Issue 7, Page(s) DC04–8

Abstract: Introduction: Current clinical detection of Human immunodeficiency virus 1 (HIV-1) is used to target viral genes and proteins. However, the immunoassay, such as viral culture or Polymerase Chain Reaction (PCR), lacks accuracy in the diagnosis, as these ... ...

Abstract	Introduction: Current clinical detection of Human immunodeficiency virus 1 (HIV-1) is used to target viral genes and proteins. However, the immunoassay, such as viral culture or Polymerase Chain Reaction (PCR), lacks accuracy in the diagnosis, as these conventional assays rely on the stable genome and HIV-1 is a highly-mutated virus. Next generation sequencing (NGS) promises to be transformative for the practice of infectious disease, and the rapidly reducing cost and processing time mean that this will become a feasible technology in diagnostic and research laboratories in the near future. The technology offers the superior sensitivity to detect the pathogenic viruses, including unknown and unexpected strains. Aim: To leverage the NGS technology in order to improve current HIV-1 diagnosis and genotyping methods. Materials and methods: Ten blood samples were collected from HIV-1 infected patients which were diagnosed by RT PCR at Singapore Communicable Disease Centre, Tan Tock Seng Hospital from October 2014 to March 2015. Viral RNAs were extracted from blood plasma and reversed into cDNA. The HIV-1 cDNA samples were cleaned up using a PCR purification kit and the sequencing library was prepared and identified through MiSeq. Results: Two common mutations were observed in all ten samples. The common mutations were identified at genome locations 1908 and 2104 as missense and silent mutations respectively, conferring S37N and S3S found on aspartic protease and reverse transcriptase subunits. Conclusion: The common mutations identified in this study were not previously reported, therefore suggesting the potential for them to be used for identification of viral infection, disease transmission and drug resistance. This was especially the case for, missense mutation S37N which could cause an amino acid change in viral proteases thus reducing the binding affinity of some protease inhibitors. Thus, the unique common mutations identified in this study could be used as diagnostic biomarkers to indicate the origin of infection as being from Singapore.
Language	English
Publishing date	2016-07-01
Publishing country	India
Document type	Journal Article
ZDB-ID	2775283-5
ISSN	0973-709X ; 2249-782X
ISSN (online)	0973-709X
ISSN	2249-782X
DOI	10.7860/JCDR/2016/19760.8140
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Assessment of the risk posed to Singapore by the emergence of artemisinin-resistant malaria in the Greater Mekong Subregion.

Zhang, Emma Xuxiao / Chavatte, Jean-Marc / Yi, Cherie See Xin / Tow, Charlene / Ying, Wong Jia / Khan, Kamran / Oh, Olivia Seen Huey / Chin, Sarah Ngeet Mei / Xin, Khong Wei / Said, Zubaidah / James, Lyn / Cutter, Jeffery / Ho, Marc / Tey, Jeannie Su Hui

Western Pacific surveillance and response journal : WPSAR

2019 Volume 10, Issue 2, Page(s) 6–13

Abstract: Objective: To assess the public health risk to Singapore posed by the emergence of artemisinin-resistant (ART-R) malaria in the Greater Mekong Subregion (GMS).: Methods: We assessed the likelihood of importation of drug-resistant malaria into ... ...

Abstract	Objective: To assess the public health risk to Singapore posed by the emergence of artemisinin-resistant (ART-R) malaria in the Greater Mekong Subregion (GMS). Methods: We assessed the likelihood of importation of drug-resistant malaria into Singapore and the impact on public health of its subsequent secondary spread in Singapore. Literature on the epidemiology and contextual factors associated with ART-R malaria was reviewed. The epidemiology of malaria cases in Singapore was analysed. The vulnerability and receptivity of Singapore were examined, including the connectivity with countries reporting ART-R malaria, as well as the preparedness of Singaporean health authorities. Sources of information include international journals, World Health Organization guidelines, data from the Singapore Ministry of Health and National Public Health Laboratory of the National Centre for Infectious Diseases, and the International Air Transport Association. Results: The importation of ART-R malaria into Singapore is possible given the close proximity and significant travel volume between Singapore and the GMS countries reporting artemisinin resistance. Singapore's vulnerability is further enhanced by the presence of foreign workers from neighbouring endemic countries. Nonetheless, the overall likelihood of such an event is low based on the rarity and decreasing trend of imported malaria incidence. Discussion: This risk assessment highlights the need for a continued high degree of vigilance of ART-R malaria locally and globally to minimize the risk and public health impact of drug-resistant malaria in Singapore.
MeSH term(s)	Animals ; Anopheles/drug effects ; Antimalarials/therapeutic use ; Artemisinins/therapeutic use ; Communicable Diseases, Emerging ; Disease Outbreaks/prevention & control ; Humans ; Malaria, Falciparum/drug therapy ; Malaria, Falciparum/epidemiology ; Plasmodium falciparum/drug effects ; Risk Assessment ; Singapore/epidemiology
Chemical Substances	Antimalarials ; Artemisinins
Language	English
Publishing date	2019-05-16
Publishing country	Philippines
Document type	Journal Article
ZDB-ID	2592503-9
ISSN	2094-7313 ; 2094-7313
ISSN (online)	2094-7313
ISSN	2094-7313
DOI	10.5365/wpsar.2018.9.2.011
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Assessment of the risk posed to Singapore by the emergence of artemisinin-resistant malaria in the Greater Mekong Subregion

Emma Xuxiao Zhang / Jean-Marc Chavatte / Cherie See Xin Yi / Charlene Tow / Wong Jia Ying / Kamran Khan / Olivia Seen Huey Oh / Sarah Ngeet Mei Chin / Khong Wei Xin / Zubaidah Said / Lyn James / Jeffery Cutter / Marc Ho / Jeannie Su Hui Tey

Western Pacific Surveillance and Response, Vol 10, Iss 2, Pp 6-

2019 Volume 13

Abstract: Objective: To assess the public health risk to Singapore posed by the emergence of artemisinin-resistant (ART-R) malaria in the Greater Mekong Subregion (GMS). Methods: We assessed the likelihood of importation of drug-resistant malaria into Singapore ... ...

Abstract	Objective: To assess the public health risk to Singapore posed by the emergence of artemisinin-resistant (ART-R) malaria in the Greater Mekong Subregion (GMS). Methods: We assessed the likelihood of importation of drug-resistant malaria into Singapore and the impact on public health of its subsequent secondary spread in Singapore. Literature on the epidemiology and contextual factors associated with ART-R malaria was reviewed. The epidemiology of malaria cases in Singapore was analysed. The vulnerability and receptivity of Singapore were examined, including the connectivity with countries reporting ART-R malaria, as well as the preparedness of Singaporean health authorities. Sources of information include international journals, World Health Organization guidelines, data from the Singapore Ministry of Health and National Public Health Laboratory of the National Centre for Infectious Diseases, and the International Air Transport Association. Results: The importation of ART-R malaria into Singapore is possible given the close proximity and significant travel volume between Singapore and the GMS countries reporting artemisinin resistance. Singapore’s vulnerability is further enhanced by the presence of foreign workers from neighbouring endemic countries. Nonetheless, the overall likelihood of such an event is low based on the rarity and decreasing trend of imported malaria incidence. With the presence of Anopheles vectors in Singapore, imported cases of drug-resistant malaria could cause secondary transmission. Nevertheless, the risk of sustained spread is likely to be mitigated by the comprehensive surveillance and control system in place for both infected vectors and human cases. Discussion: This risk assessment highlights the need for a continued high degree of vigilance of ART-R malaria locally and globally to minimize the risk and public health impact of drug-resistant malaria in Singapore.
Keywords	Artemisinin resistance ; malaria ; drug-resistant malaria ; risk assessment ; public health ; Medicine ; R ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2019-05-01T00:00:00Z
Publisher	World Health Organization Regional Office for the Western Pacific
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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