Infections in Malaysia: A Review of Antimicrobial Resistance and Characteristics of the Clinical Isolates, 1990-2017.

is an important nosocomial pathogen and its multidrug resistant strains, particularly methicillin-resistant (MRSA), poses a serious threat to public health due to its limited therapeutic options. The increasing MRSA resistance towards vancomycin, which is the current drug of last resort, gives a great challenge to the treatment and management of MRSA infections. While vancomycin resistance among Malaysian MRSA isolates has yet to be documented, a case of vancomycin resistant has been reported in our neighboring country, Indonesia. In this review, we present the antimicrobial resistance profiles of clinical isolates in Malaysia with data obtained from the Malaysian National Surveillance on Antimicrobial Resistance (NSAR) reports as well as various peer-reviewed published records spanning a period of nearly three decades (1990-2017). We also review the clonal types and characteristics of Malaysian isolates, where hospital-associated (HA) MRSA isolates tend to carry staphylococcal cassette chromosome (SCC) type III and were of sequence type (ST)239, whereas community-associated (CA) isolates are mostly SCC type IV/V and ST30. More comprehensive surveillance data that include molecular epidemiological data would enable further in-depth understanding of Malaysian isolates.