title: Capsular serotype and antibiotic resistance of Streptococcus pneumoniae isolates in Malaysia.
abstract: BACKGROUND
  Streptococcus pneumoniae is a major causative agent of severe infections, including sepsis, pneumonia, meningitis, and otitis media, that has since become a major public health concern. In this study, the serotypes distribution of pneumococcal isolates was investigated to predict the efficacy of the 7-valent pneumococcal conjugate vaccine (PCV7) among the Malaysian populations.
  
  
  RESULTS
  A total of 151 clinical isolates were serotyped using multiplex PCR assays. Out of them, there were 21.2% penicillin-resistant, 29.1% penicillin-intermediate, and 49.7% penicillin-susceptible S. pneumoniae strains. Serotypes detected among the Malaysian isolates were 1, 3, 10A, 11A/11D, 12F/12A, 14, 15A, 15B/15C, 16F, 18C/18B/18A/18F, 19A, 19F, 23F, 35B, 35F/47F, 6A/6B, 7C/7B/40, 7F/7A, 9V/9A, and 34. Serotype 19F and 23F were the two most prevalent serotypes detected. Serotypes are highly associated with invasiveness of isolates (p = 0.001) and penicillin susceptibility (p<0.001). Serotype 19F was observed to have increased resistance against penicillin while serotype 19A has high invasive tendency. Age of patients was an important factor underlying the pneumococcal serotypes (p = 0.03) and clinical sites of infections (p<0.001). High prevalence of pneumococcal isolates were detected among children <5 years old at nasopharyngeal sites while elderly adults ≥60 years old were at increased risk for pneumococcal bacteremia.
  
  
  CONCLUSIONS
  Current study revealed that a number of serotypes, especially those associated with high penicillin resistance, have been formulated in the PCV7. Therefore, the protections expected from the routine use of PCV7 would be encouraging for the Malaysian. However, it is not possible to predict serotypes that might become predominant in the future and hence continued surveillance of circulating serotypes will be needed.
authors: Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors: Cheng-Foh
authors: CF
authors: Le
authors: Navindra Kumari
authors: NK
authors: Palanisamy
authors: Mohd Yasim
authors: MY
authors: Mohd Yusof
authors: Shamala Devi
authors: SD
authors: Sekaran
references: Southeast Asian J Trop Med Public Health. 1987 Mar;18(1):79-84
references: 3660072
references: Epidemiol Infect. 1999 Feb;122(1):77-82
references: 10098788
references: Infect Immun. 2010 Feb;78(2):704-15
references: 19948837
references: J Clin Microbiol. 2000 Nov;38(11):4137-44
references: 11060081
references: Pediatr Infect Dis J. 1998 Sep;17(9 Suppl):S189-90
references: 9781759
references: J Clin Microbiol. 1992 Jul;30(7):1685-91
references: 1629321
references: J Paediatr Child Health. 2007 May;43(5):366-9
references: 17489826
references: Pediatr Infect Dis J. 1995 Jun;14(6):503-10
references: 7667055
references: J Antimicrob Chemother. 1999 Dec;44(6):852-3
references: 10590295
references: Thorax. 1999 Oct;54(10):929-37
references: 10491458
references: MMWR Recomm Rep. 2000 Oct 6;49(RR-9):1-35
references: 11055835
references: J Clin Microbiol. 2006 Jan;44(1):124-31
references: 16390959
references: J Antimicrob Chemother. 2003 Apr;51(4):887-93
references: 12654736
references: Vaccine. 2009 Dec 9;27(52):7282-91
references: 19393708
references: Antimicrob Agents Chemother. 1999 Aug;43(8):1901-8
references: 10428910
references: J Antimicrob Chemother. 2003 Feb;51(2):443-6
references: 12562720
references: J Trop Pediatr. 1988 Aug;34(4):182-5
references: 3172328
references: Int J Infect Dis. 2003 Sep;7(3):190-7
references: 14563222
references: Microbiol Immunol. 2001;45(2):159-62
references: 11293482
references: Ann Trop Paediatr. 1990 Mar;10(1):89-98
references: 1694651
references: BMJ. 1996 Jun 15;312(7045):1521-5
references: 8646147