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Pneumococcal Disease Burden and Pediatric Invasive Pneumococcal Serotype Shifts in Malaysia

Arushothy R, Tan C, Ali MRM, Amdan NAN, Samsudin N, Hashim R

2026

Abstract

Abstract Background Streptococcus pneumoniae remains an important cause of invasive and non-invasive bacterial disease. However, nationwide data describing pneumococcal disease burden, antimicrobial susceptibility, and pediatric invasive pneumococcal disease (IPD) serotype shifts in Malaysia remain limited. Methods This retrospective study analyzed culture-confirmed pneumococcal infections reported to the National Surveillance for Antibiotic Resistance (NSAR) database submitted via WHONET from 2017 to 2023 to evaluate disease burden and antimicrobial susceptibility trends. A separate serotype analysis of invasive pneumococcal isolates from children aged \(\:\le\:\)5 collected between 2018 to 2024 was conducted to describe pre- and post-vaccination serotype distribution and monitor the early impact of pneumococcal vaccines (PCVs) in Malaysia. Results A total of 10,237 culture-confirmed cases were identified, with an average incidence of 4.01 per 100,000 population. Incidence varied geographically, with higher rates in Peninsular Malaysia than in Sabah and Sarawak. Children aged ≤ 15 years represented the largest affected group, followed by adults aged \(\:\ge\:\)66 years, with a male predominance. Blood was the most common specimen source, indicating a substantial IPD contribution, although non-invasive specimens collectively accounted for a larger proportion of cases. Antimicrobial susceptibility was preserved for beta-lactams, levofloxacin, linezolid, and vancomycin,…

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