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  1. Ngoi ST, Muhamad AN, Teh CSJ, Chong CW, Abdul Jabar K, Chai LC, et al.
    Pathogens, 2021 Dec 09;10(12).
    PMID: 34959557 DOI: 10.3390/pathogens10121602
    The rise of antimicrobial resistance (AMR) among clinically important bacteria, including respiratory pathogens, is a growing concern for public health worldwide. Common causative bacteria for upper respiratory tract infections (URTIs) include Streptococcus pneumoniae and Haemophilus influenzae, and sometimes Staphylococcus aureus. We assessed the β-lactam resistant trends and mechanisms of 150 URTI strains isolated in a tertiary care hospital in Kuala Lumpur Malaysia. High rates of non-susceptibility to penicillin G (38%), amoxicillin-clavulanate (48%), imipenem (60%), and meropenem (56%) were observed in S. pneumoniae. Frequent mutations at STMK and SRNVP motifs in PBP1a (41%), SSNT motif in PBP2b (32%), and STMK and LKSG motifs in PBP2x (41%) were observed in S. pneumoniae. H. influenzae remained highly susceptible to most β-lactams, except for ampicillin. Approximately half of the ampicillin non-susceptible H. influenzae harboured PBP3 mutations (56%) and only blaTEM was detected in the ampicillin-resistant strains (47%). Methicillin-susceptible S. aureus (MSSA) strains were mostly resistant to penicillin G (92%), with at least two-fold higher median minimum inhibitory concentrations (MIC) for all penicillin antibiotics (except ticarcillin) compared to S. pneumoniae and H. influenzae. Almost all URTI strains (88-100%) were susceptible to cefcapene and flomoxef. Overall, β-lactam antibiotics except penicillins remained largely effective against URTI pathogens in this region.
  2. Binti Md Bahar AN, Muhamad AN, Teh CSJ, Adnan MS, Adam S, Hng SY, et al.
    Pathog Glob Health, 2024;118(7-8):582-586.
    PMID: 39244781 DOI: 10.1080/20477724.2024.2400412
    INTRODUCTION AND AIM: In Malaysia, pertussis in children beyond infancy is underreported. This study aimed to determine the prevalence of Bordetella pertussis and the prevalence of pertussis-susceptible children aged ≥4 years who presented with acute respiratory infections.

    METHODS: This single-center, cross-sectional study conducted at the Paediatric Emergency Department from 1 October 2022, to 31 January 2023, included children aged 4 years and older with ARTIs symptoms and excluded those who were COVID-19 positive. B. pertussis was detected via quantitative Polymerase Chain Reaction on nasopharyngeal swabs and pertussis toxin (PT) IgG enzyme-linked immunosorbent assay.

    RESULTS: Children (n = 298) with a median (Interquartile range, [IQR]) age of 6.0 (5.0, 8.0) years old were recruited, and 98% were vaccinated adequately. Two cases of B. pertussis (n = 2/298, 0.67%) were detected. Both children were also co-infected with Bordetella spp. The majority of the patients (n = 246/296, 83.1%) had low protective antibodies against pertussis (anti-PT IgG <5 IU/ml), and children 5 years and older were more likely to have lower anti-PT Ig G levels of <5 IU/ml (odds ratio 2.02 [95% CI 1.04,3.90]) compared to children 4 years old.

    CONCLUSION: The prevalence of pertussis was low. However, there is significant waning immunity. Booster doses of pertussis vaccine should be given to all school-aged children.

  3. Muhamad AN, Teh CSJ, Draman MR, Adnan YK, Abbas AA, Khong TL, et al.
    Antimicrob Resist Infect Control, 2025 Mar 13;14(1):22.
    PMID: 40082971 DOI: 10.1186/s13756-025-01537-2
    BACKGROUND: Surgical site infections (SSIs) are a persistent challenge in healthcare, contributing significantly to patient morbidity, mortality, and healthcare costs. Despite advancements in preventive measures, SSIs remain prevalent, especially in countries like Malaysia where rates are higher than in high-income nations.

    METHODS: A prospective, cohort study was conducted at the University Malaya Medical Center (UMMC), Malaysia, from November 2020 to May 2023. Clinical and microbiological data were collected, and logistic regression were performed to identify risk factors associated with SSIs.

    RESULTS: A total of 1,815 patients undergoing orthopedic, neurosurgical, and general surgical procedures were monitored for SSIs. The incidence rate of SSIs was 3.23 per 100 procedures (n = 71) with significant associations observed between SSI occurrence and prolonged surgical duration > 100 min, extended hospitalization > 5 days, trauma-to-surgery interval > 8 days, and presence of implants. Common pathogens isolated included Staphylococcus aureus, Klebsiella pneumoniae, and Pseudomonas aeruginosa. Multidrug-resistant organisms (MDROs) were identified in 42.1% of the total isolates.

    CONCLUSIONS: In this study, a high rate of MDRO and risk factors for SSI were identified. It emphasises the need for ongoing surveillance to guide infection prevention strategies and antimicrobial stewardship programs. Future research should prioritize evaluating the impact of targeted interventions tailored to identified risk factors to optimize surgical patient outcomes.

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