Stewards TTSH

27/04/2026

🔬 New Research Findings: 𝐑𝐢𝐬𝐤 𝐟𝐚𝐜𝐭𝐨𝐫𝐬 𝐟𝐨𝐫 𝐦𝐞𝐭𝐡𝐢𝐜𝐢𝐥𝐥𝐢𝐧-𝐫𝐞𝐬𝐢𝐬𝐭𝐚𝐧𝐭 𝐒𝐭𝐚𝐩𝐡𝐲𝐥𝐨𝐜𝐨𝐜𝐜𝐮𝐬 𝐚𝐮𝐫𝐞𝐮𝐬 (𝐌𝐑𝐒𝐀) 𝐛𝐚𝐜𝐭𝐞𝐫𝐚𝐞𝐦𝐢𝐚 𝐢𝐧 𝐩𝐚𝐭𝐢𝐞𝐧𝐭𝐬 𝐰𝐢𝐭𝐡 𝐨𝐫 𝐰𝐢𝐭𝐡𝐨𝐮𝐭 𝐩𝐫𝐢𝐨𝐫 𝐌𝐑𝐒𝐀 𝐜𝐨𝐥𝐨𝐧𝐢𝐬𝐚𝐭𝐢𝐨𝐧.

This matched case–control study evaluated risk factors for hospital‑onset (HO) MRSA bacteraemia among patients with and without prior MRSA colonisation at two tertiary hospitals between 2016 and 2022. Stratified analyses identified common and colonisation status‑specific risk factors, highlighting heterogeneity in patient risk profiles relevant to infection prevention.

𝐊𝐞𝐲 𝐟𝐢𝐧𝐝𝐢𝐧𝐠𝐬:
• Risk factors differed by MRSA colonisation status, with PICC presence unique to colonised patients, and prolonged hospital stay and chronic haemodialysis unique to non‑colonised patients.
• Several major risk factors were common to both groups, including immunosuppressive therapy, fluoroquinolone and glycopeptide exposure, and thrombophlebitis.
• Non‑colonised patients contributed substantially to HO‑MRSA bacteraemia, challenging prevention strategies focused solely on known carriers.

𝐒𝐭𝐮𝐝𝐲 𝐢𝐦𝐩𝐥𝐢𝐜𝐚𝐭𝐢𝐨𝐧𝐬:
HO‑MRSA bacteraemia risk is not uniform and varies by colonisation status, indicating that prevention strategies should extend beyond previously colonised patients. Tailored approaches, including strengthened catheter care and enhanced surveillance for high‑risk non‑colonised patients such as those with prolonged hospitalisation or haemodialysis exposure, enhance the prevention of HO‑MRSA bacteraemia.

𝐑𝐞𝐚𝐝 𝐦𝐨𝐫𝐞 𝐡𝐞𝐫𝐞: https://doi.org/10.1016/j.jhin.2026.03.009

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05/04/2026

Hoppy Easter! Wishing everyone a day filled with blessings, happiness and joyful moments with your loved ones ✨️🐰

21/03/2026

Selamat Hari Raya Aidilfitri! May this festive season bring happiness, health and countless blessings to you and your loved ones ✨💚🌙

16/02/2026

Gong Xi Fa Cai! Wishing everyone prosperity, health, and happiness in the Year of the Horse ✨️🐴

11/02/2026

🔬 New Research Findings: 𝐍𝐨𝐦𝐨𝐠𝐫𝐚𝐦-𝐛𝐚𝐬𝐞𝐝 𝐚𝐧𝐚𝐥𝐲𝐬𝐢𝐬 𝐨𝐟 𝐩𝐥𝐚𝐬𝐦𝐚 𝐚𝐥𝐛𝐮𝐦𝐢𝐧 𝐚𝐧𝐝 𝐂-𝐫𝐞𝐚𝐜𝐭𝐢𝐯𝐞 𝐩𝐫𝐨𝐭𝐞𝐢𝐧 30 𝐝𝐚𝐲𝐬 𝐛𝐞𝐟𝐨𝐫𝐞 𝐛𝐥𝐨𝐨𝐝𝐬𝐭𝐫𝐞𝐚𝐦 𝐢𝐧𝐟𝐞𝐜𝐭𝐢𝐨𝐧 𝐟𝐨𝐫 30-𝐝𝐚𝐲 𝐦𝐨𝐫𝐭𝐚𝐥𝐢𝐭𝐲 𝐢𝐧 𝐒𝐢𝐧𝐠𝐚𝐩𝐨𝐫𝐞 𝐚𝐧𝐝 𝐃𝐞𝐧𝐦𝐚𝐫𝐤

Nomogram models of plasma albumin (PA) and C-reactive protein (CRP), in patient cohorts from Singapore and Denmark with bloodstream infection (BSI), showed that PA level in the pre-infection and infection periods is a strong prognosticator of 30-day mortality risk.

𝐊𝐞𝐲 𝐟𝐢𝐧𝐝𝐢𝐧𝐠𝐬:
• PA levels showed consistent positive correlations with D0 (day of BSI) across all earlier time points, indicating that albumin is a stable prognostic biomarker in the pre-infection period.
• PA levels measured on D0 and days prior to D0, showed strong associations with 30-day mortality risk, while CRP levels did not show significant associations.
• Nomogram models demonstrated that the earliest PA level was the most significant contributing factor to mortality risk, while other variables including CRP were not associated with 30-day mortality risk.

𝐒𝐭𝐮𝐝𝐲 𝐢𝐦𝐩𝐥𝐢𝐜𝐚𝐭𝐢𝐨𝐧𝐬:
Strong associations between PA levels and mortality risk throughout multiple time points, especially during the pre-infection period, potentially allows for early warning for negative outcomes. Nomogram-based analysis also provides a distinguishable graphical representation for clinicians to assess patients’ prognosis and detect a suspected BSI early.

𝐑𝐞𝐚𝐝 𝐦𝐨𝐫𝐞 𝐡𝐞𝐫𝐞: https://doi.org/10.1038/s41598-025-34710-z

This study aimed to assess the prognostic impact of plasma albumin (PA) and C-reactive protein (CRP), measured up to 30 days before a bloodstream infection (BSI), on 30-day mortality risk using nomogram models. Two cohorts comprising 5,221 inpatients from Singapore (SG) and 15,710 from Denmark (DK)....

04/02/2026

🩺 Highlights from Society of Behavioural Health Singapore Annual Scientific Meeting 2026: Advancing Behavioural Health, Caring for Self, Others & Community

Last week, our Senior Consultant and Principal Investigator, Dr Angela Chow, shared findings from our research on increasing flu vaccine uptake through leveraging individuals' health information health information orientation and relationships with a regular doctor and friends in tropical Singapore.

In addition, our research assistants shared their posters on the effect of factors such as personality traits, health activation and technological acceptance on the willingness of COPD and Asthma patients to adopt mHealth tools.

Our team also attended talks by professionals from various fields and gained valuable insights on how our behaviours and choices affect the way we care for ourselves and others. We also learned about how we can bridge across disciplines to empower and motivate ourselves to take charge of our own health and foster meaningful connections with others to improve our collective wellbeing.

01/12/2025

🔍 New Research Alert: 𝐏𝐡𝐲𝐬𝐢𝐜𝐢𝐚𝐧 𝐅𝐞𝐞𝐝𝐛𝐚𝐜𝐤 𝐑𝐞𝐝𝐮𝐜𝐞𝐬 𝐀𝐧𝐭𝐢𝐛𝐢𝐨𝐭𝐢𝐜 𝐏𝐫𝐞𝐬𝐜𝐫𝐢𝐛𝐢𝐧𝐠 𝐟𝐨𝐫 𝐔𝐧𝐜𝐨𝐦𝐩𝐥𝐢𝐜𝐚𝐭𝐞𝐝 𝐔𝐩𝐩𝐞𝐫 𝐑𝐞𝐬𝐩𝐢𝐫𝐚𝐭𝐨𝐫𝐲 𝐓𝐫𝐚𝐜𝐭 𝐈𝐧𝐟𝐞𝐜𝐭𝐢𝐨𝐧 𝐢𝐧 𝐭𝐡𝐞 𝐄𝐦𝐞𝐫𝐠𝐞𝐧𝐜𝐲 𝐃𝐞𝐩𝐚𝐫𝐭𝐦𝐞𝐧𝐭

This quasi-experimental study conducted in four large adult emergency departments between January 2021 and December 2023 evaluated the effectiveness of physician feedback and patient education in reducing antibiotic prescribing for uncomplicated upper respiratory tract infections (URTIs) that typically do not require antibiotics.

𝐊𝐞𝐲 𝐟𝐢𝐧𝐝𝐢𝐧𝐠𝐬:
• Physician feedback alone showed significant decline in the weekly antibiotic prescribing trend
• The patient education using health professional-developed information leaflets did not reduce antibiotic prescribing
• Weekly antibiotic prescribing trend increased during the post-intervention period indicating that the intervention effect is not sustained

𝐒𝐭𝐮𝐝𝐲 𝐢𝐦𝐩𝐥𝐢𝐜𝐚𝐭𝐢𝐨𝐧𝐬:
Simple, systematic feedback and audit mechanisms can drive meaningful physician behaviour change. Further research into multimodal patient education approaches is warranted.

📙: https://doi.org/10.3390/antibiotics14121196

Objectives: Inappropriate antibiotic prescribing for acute upper respiratory tract infections (URTIs) is a significant problem in emergency departments (EDs) worldwide. In this study, we separately evaluated the effectiveness of physician feedback and patient education in reducing antibiotic prescri...

24/11/2025

As comes to an end, we are reminded that our work as researchers isn’t just about data — it’s about the people, places, and moments that shape our journey.

Check out our LinkedIn article below. 👇

https://www.linkedin.com/pulse/blue-pill-vs-red-my-research-journey-stewardsttsh-9cyrc/?trackingId=33oAjsxFQdafJjLHvUJfEQ%3D%3D

Author: Goh Jedrek A couple of months ago, I was faced with a difficult decision that would redefine my understanding of antibiotic research. I could have stayed in the office to analyse survey data and compile weekly reports about antibiotic resistance – the blue pill of academic comfort that had...

20/11/2025

This year's theme is a powerful reminder that safeguarding our present and protecting future generations begins with strong evidence and collective action against AMR.

On 12 Nov, the Communicable Diseases Agency (CDA) launched Singapore's second National Strategic Action Plan on AMR (NSAPv2). The NSAPv2 was jointly developed by CDA, National Environmental Agency, National Parks Board, Singapore Food Agency and PUB, Singapore's National Water Agency.

We are honoured that our research has provided important insights that guided the development of the national plan. Of the 36 references cited in the plan, 8 were publications from our group. We are heartened to note that the initiatives in NSAPv2's Core Strategy 1 on Communication and Education include:

- Taking a One Health approach to develop educational initiatives that address both personal and pet antibiotic usage

- Exploring innovative channels to deliver educational messages to younger adults

- Engaging the community to co-design and implement solutions to improve appropriate antibiotic usage

(https://www.cda.gov.sg/public/antimicrobial-resistance/singapore-s-national-strategic-action-plans-on-amr)

📚 Explore our publications here: sites.google.com/view/stewards-ttsh-publications/home

Antibiotics are for everyone, our past and our future generations, right? If antibiotics are dead, we will be in big trouble”: Building on community values for public engagement on appropriate use of antibiotics in Singapore.

18/11/2025

🌏 WAAW 2025: Act Now, Protect Our Present, Secure Our Future

AMR is a growing global threat, and the time to act is now. This WAAW, we chose the Red Pill - confronting the reality of AMR by engaging with experts and staying at the forefront of research.

Over the past two weeks, we attended:

1) WAAW
2) Singapore Antimicrobial Resistance Research Symposium 2025
3) One Health- AMR Symposium

Connecting with experts in the field, sharing ideas, and assessing the latest evidence reinforces the urgent need to act now, protect our present and secure our future.

12/11/2025

🔬 Research Findings: 𝐒𝐡𝐚𝐫𝐞𝐝 𝐃𝐞𝐜𝐢𝐬𝐢𝐨𝐧-𝐌𝐚𝐤𝐢𝐧𝐠 𝐢𝐧 𝐕𝐞𝐭𝐞𝐫𝐢𝐧𝐚𝐫𝐲 𝐂𝐥𝐢𝐧𝐢𝐜𝐬: 𝐀 𝐂𝐫𝐨𝐬𝐬-𝐒𝐞𝐜𝐭𝐢𝐨𝐧𝐚𝐥 𝐒𝐭𝐮𝐝𝐲 𝐄𝐱𝐚𝐦𝐢𝐧𝐢𝐧𝐠 𝐄𝐟𝐟𝐞𝐜𝐭𝐬 𝐨𝐧 𝐀𝐩𝐩𝐫𝐨𝐩𝐫𝐢𝐚𝐭𝐞 𝐀𝐧𝐭𝐢𝐛𝐢𝐨𝐭𝐢𝐜 𝐏𝐫𝐞𝐬𝐜𝐫𝐢𝐛𝐢𝐧𝐠 𝐚𝐧𝐝 𝐕𝐚𝐥𝐮𝐞-𝐃𝐫𝐢𝐯𝐞𝐧 𝐅𝐚𝐜𝐭𝐨𝐫𝐬 𝐈𝐧𝐟𝐥𝐮𝐞𝐧𝐜𝐢𝐧𝐠 𝐈𝐭

Our research team recruited 41 veterinarians across Singapore to examine how shared decision-making (SDM) is associated with appropriate antibiotic prescribing for pet cats and dogs, and what are the factors that would promote SDM.

𝐊𝐞𝐲 𝐟𝐢𝐧𝐝𝐢𝐧𝐠𝐬:
- The effectiveness of SDM in promoting appropriate antibiotic prescribing appears to be condition-specific in vet clinics.
- Vets who 1) perceived that their vet clinic values the prioritisation of pet owner satisfaction over appropriate antibiotic prescribing, 2) had the capacity to build relationships and communicate with owners on antibiotic prescribing, and 3) believed in collaborative communication and SDM with owners on antibiotic prescribing, were more likely to engage in SDM.
- Overall, aligning AMR-related values between vet clinics and vets to enable effective communication with pet owners can promote SDM, potentially driving appropriate antibiotic prescribing for pet cats and dogs subsequently.

𝐒𝐭𝐮𝐝𝐲 𝐢𝐦𝐩𝐥𝐢𝐜𝐚𝐭𝐢𝐨𝐧𝐬:
This research sheds light on a unique antibiotic stewardship approach in vet clinics. Encouraging the prioritisation of owner experience and satisfaction could yield an indirect benefit of driving effective communication with owners to promote SDM on antibiotic prescribing.
Better time and resource planning could allow vets to have the capacity to build relationships and communicate with owners on antibiotic prescribing, hence promoting SDM.
In combination with previous research findings, vets could take initiative in investigating owner’s feeding concerns and delivering training and advice to owners on antibiotic administration methods, to better involve pet owners in discussions related to antibiotic prescribing.

📕: https://doi.org/10.3390/antibiotics14111139

Background: Shared decision-making (SDM) can improve appropriate antibiotic prescribing in human primary care clinics, but little is known about it in the veterinary setting. This study examines the association between SDM and antibiotic prescribing for cats and dogs in veterinary clinics, then dete...

31/10/2025

🎉 Heartiest congratulations to Dr Angela Chow, our Principal Investigator and Senior Consultant on this well-deserved recognition.🏆

This achievement reflects the dedication to clinical excellence and innovation that drives our healthcare forward.