Morris Denise E, McNeil Hannah, Hocknell Rebecca E, Anderson Rebecca, Tuck Andrew C, Tricarico Serena, Norazmi Mohd Nor, Lim Victor, Siang Tan Cheng, Lim Patricia Kim Chooi, Wie Chong Chun, Cleary David W, Yap Ivan Kok Seng, Clarke Stuart C
Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK.
School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
Pneumonia (Nathan). 2021 Apr 25;13(1):6. doi: 10.1186/s41479-021-00084-9.
Pneumonia is a leading cause of death in Malaysia. Whilst many studies have reported the aetiology of pneumonia in Western countries, the epidemiology of pneumonia in Malaysia remains poorly understood. As carriage is a prerequisite for disease, we sought to improve our understanding of the carriage and antimicrobial resistance (AMR) of respiratory tract pathogens in Malaysia. The rural communities of Sarawak are an understudied part of the Malaysian population and were the focus of this study, allowing us to gain a better understanding of bacterial epidemiology in this population.
A population-based survey of bacterial carriage was undertaken in participants of all ages from rural communities in Sarawak, Malaysia. Nasopharyngeal, nasal, mouth and oropharyngeal swabs were taken. Bacteria were isolated from each swab and identified by culture-based methods and antimicrobial susceptibility testing conducted by disk diffusion or E test.
140 participants were recruited from five rural communities. Klebsiella pneumoniae was most commonly isolated from participants (30.0%), followed by Staphylococcus aureus (20.7%), Streptococcus pneumoniae (10.7%), Haemophilus influenzae (9.3%), Moraxella catarrhalis (6.4%), Pseudomonas aeruginosa (6.4%) and Neisseria meningitidis (5.0%). Of the 21 S. pneumoniae isolated, 33.3 and 14.3% were serotypes included in the 13 valent PCV (PCV13) and 10 valent PCV (PCV10) respectively. 33.8% of all species were resistant to at least one antibiotic, however all bacterial species except S. pneumoniae were susceptible to at least one type of antibiotic.
To our knowledge, this is the first bacterial carriage study undertaken in East Malaysia. We provide valuable and timely data regarding the epidemiology and AMR of respiratory pathogens commonly associated with pneumonia. Further surveillance in Malaysia is necessary to monitor changes in the carriage prevalence of upper respiratory tract pathogens and the emergence of AMR, particularly as PCV is added to the National Immunisation Programme (NIP).
肺炎是马来西亚主要的死亡原因之一。虽然许多研究报告了西方国家肺炎的病因，但马来西亚肺炎的流行病学仍知之甚少。由于携带是疾病发生的先决条件，我们试图加深对马来西亚呼吸道病原体携带情况和抗菌药物耐药性（AMR）的了解。砂拉越的农村社区是马来西亚人口中研究较少的一部分，是本研究的重点，使我们能够更好地了解该人群中的细菌流行病学情况。
对马来西亚砂拉越农村社区所有年龄段的参与者进行了一项基于人群的细菌携带情况调查。采集了鼻咽、鼻腔、口腔和口咽拭子。从每个拭子中分离出细菌，并通过基于培养的方法进行鉴定，以及通过纸片扩散法或E试验进行抗菌药物敏感性测试。
从五个农村社区招募了140名参与者。肺炎克雷伯菌是从参与者中最常分离出的细菌（30.0%），其次是金黄色葡萄球菌（20.7%）、肺炎链球菌（10.7%）、流感嗜血杆菌（9.3%）、卡他莫拉菌（6.4%）、铜绿假单胞菌（6.4%）和脑膜炎奈瑟菌（5.0%）。在分离出的21株肺炎链球菌中，分别有33.3%和14.3%的菌株属于13价肺炎球菌结合疫苗（PCV13）和10价肺炎球菌结合疫苗（PCV10）所包含的血清型。所有菌种中有33.8%对至少一种抗生素耐药，然而除肺炎链球菌外的所有细菌菌种对至少一种抗生素敏感。
据我们所知，这是在东马来西亚进行的首次细菌携带情况研究。我们提供了关于通常与肺炎相关的呼吸道病原体的流行病学和AMR的宝贵且及时的数据。在马来西亚有必要进行进一步监测，以监测上呼吸道病原体携带率的变化以及AMR的出现，特别是在国家免疫规划（NIP）中加入PCV之后。
