Mohamad Norfazlina, Yahaya Maitasha Alia Meor, Muthanna AbdulRahman, Desa Mohd Nasir Mohd, Ismail Elysha Nur, Dapari Rahmat, Rahman Anita Abd, Hasan Ahmad Najib, Taib Niazlin Mohd, Masri Siti Norbaya, Chee Hui Yee, Rengasamy Sithra, Othman Norlijah
Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia.
Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia.
J Glob Antimicrob Resist. 2025 May 26;44:64-68. doi: 10.1016/j.jgar.2025.05.017.
Implementation of pneumococcal conjugate vaccines (PCV) targeting selected serotypes has led to a decrease in invasive pneumococcal diseases. In Malaysia, PCV10 was recently included in the national immunisation programme. Therefore, monitoring serotype distribution and antimicrobial resistance of pneumococci in high-density areas is crucial. This study investigated the serotype distribution, antimicrobial resistance pattern, and genotype of pneumococci in healthy children below 5 years old attending daycare centres in Klang Valley, Malaysia, while indirectly assessing transmission dynamics through nasopharyngeal carriage.
168 children across 25 daycare centres provided parental consent. Nasopharyngeal swabs collected between January 2023 and May 2024, were analysed for pneumococcal carriage, and serotyped by PCR. Antimicrobial susceptibility was determined using E-test assay. Multilocus sequence typing was performed on isolates with reduced susceptibility.
The pneumococcal carriage rate was 22.6%. Serotype 15C was the most prevalent (15.8%), followed by 23A and 11A. In the E-test assay, 47.4% isolates were resistant to erythromycin, 28.9% to tetracycline, and 5.3% to penicillin. One isolate was resistant to ceftriaxone, whereas none demonstrated resistance to cefotaxime; reduced susceptibility to the two antibiotics was observed in one isolate, while two others had intermediate susceptibility to either ceftriaxone or cefotaxime alone. Sequence type distribution was diverse, with ST338 being the most common (n = 3).
The predominance of nonvaccine serotypes, particularly 15C and 23A, alongside antibiotic resistance, indicates a potential epidemiological shift in the post-PCV era. These results emphasise the need for continuous surveillance to monitor serotype dynamics and antimicrobial resistance pattern in the community.
针对特定血清型的肺炎球菌结合疫苗（PCV）的实施已导致侵袭性肺炎球菌疾病的减少。在马来西亚，PCV10最近被纳入国家免疫规划。因此，监测高密度地区肺炎球菌的血清型分布和抗菌药物耐药性至关重要。本研究调查了马来西亚巴生谷地区日托中心5岁以下健康儿童肺炎球菌的血清型分布、抗菌药物耐药模式和基因型，同时通过鼻咽部携带情况间接评估传播动态。
25个日托中心的168名儿童获得了家长同意。收集2023年1月至2024年5月期间的鼻咽拭子，分析肺炎球菌携带情况，并通过PCR进行血清分型。使用E-test法测定抗菌药物敏感性。对敏感性降低的分离株进行多位点序列分型。
肺炎球菌携带率为22.6%。血清型15C最为常见（15.8%），其次是23A和11A。在E-test法中，47.4%的分离株对红霉素耐药，28.9%对四环素耐药，5.3%对青霉素耐药。一株分离株对头孢曲松耐药，而对头孢噻肟均无耐药；一株分离株对这两种抗生素敏感性降低，另外两株分别对头孢曲松或头孢噻肟有中介敏感性。序列型分布多样，ST338最为常见（n = 3）。
非疫苗血清型，特别是15C和23A的优势，以及抗生素耐药性，表明在PCV时代后可能出现了流行病学转变。这些结果强调需要持续监测，以监测社区中的血清型动态和抗菌药物耐药模式。
