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, whereas resistance was highest to tetracycline, erythromycin, and co-trimoxazole. Among children aged \(\:\le\:\)5 years with IPD, serotype distribution shifted after PCV10 introduction, with declining PCV10 serotype isolates and a proportional increase in serotypes 19A, 3, 19F, and non-vaccine serotypes (NVTs). Conclusion These findings provide baseline evidence to support integrated surveillance of pneumococcal disease burden, antimicrobial resistance, serotype replacement, and PCV impact in Malaysia.
Background: Scrub typhus, a potentially fatal infection spread by chiggers’ bites carrying Orientia tsutsugamushi , is under-reported in Malaysia. Methods: This retrospective, descriptive study analyzed 28 PCR-confirmed Orientia tsutsugamushi cases presented in Hospital Tuanku Ja’afar Seremban between 2023–2025, focusing data on socio-demographic data, clinical spectrum and outcome, and molecular analysis of the cohort. Results: The study found most patients were male (82%), Malaysian (68%), and from the Seremban area (71%). A significant portion (43%) worked in plantations, and 46% had rodent exposure. Initial diagnoses often missed scrub typhus, with common symptoms including acute fever (93%). About 21% of subjects had detectable eschars on physical examinations. Common laboratory abnormalities include elevated transaminases (89%), and renal impairment (36%). Severe complications like the need for mechanical ventilation (25%) were observed, with a mortality rate of 11%. PCR analysis showed Karp genotype formed the largest cluster of the cohort. Conclusions: The findings highlight the need for more local data and increased awareness among healthcare professionals and the public to better manage this neglected tropical disease. Delayed recognition of the disease likely contributes to severe complications as illustrated from the study.
Metabolic syndrome (MetS) definitions may perform differently in indigenous populations with distinct genetic and lifestyle exposures. The Negrito community remains under-represented in cardiometabolic research despite emerging risk. Building on earlier observations of atypical biomarker patterns in this population, potentially linked to CDH13-related vascular mechanisms, this study aimed to determine MetS prevalence using the International Diabetes Federation (IDF) and Harmonized Joint Interim Statement (JIS) definitions, evaluate agreement between these definitions and their concordance with cardiovascular risk scores (CRS), and examine relationships between inflammatory and vascular biomarkers in the context of MetS. A cross-sectional study was conducted among Negrito adults. MetS was categorized using the IDF and JIS definitions. CRS included the Framingham risk score (FRS), Castelli risk index (CRI)-I, CRI-II and the atherogenic index of plasma (AIP). High-sensitivity C-reactive protein, lipoprotein(a), soluble intercellular adhesion molecule-1 (sICAM-1), and T-cadherin were quantified. Agreement statistics, correlations, logistic and linear regression models were applied. Among 153 adults, MetS prevalence was 11.8% (IDF) and 16.3% (JIS) with near-perfect agreement (κ = 0.81), although McNemar testing indicated slight asymmetry between definitions. Concordance between MetS and CRS was generally weak, with AIP showing the highest agreement (IDF κ = 0.17; JIS κ = 0.30), followed by CRI-II (IDF κ = 0.05; JIS κ = 0.20). CRI-I showed slight agreement with both definitions (IDF κ = 0.07; JIS κ = 0.15), while FRS showed no meaningful alignment (IDF κ = -0.07; JIS κ = -0.01). sICAM-1 showed weak but consistent positive correlations with all CRS (r = 0.20-0.26, P = .017-.002). T-cadherin did not correlate with CRS but was inversely associated with sICAM-1 (r = -0.28, P = .001). In multivariable logistic models, CRI-I (OR = 3.20), CRI-II (OR = 2.32) and AIP (OR = 2.15) remained independently associated with MetS. In linear models, sICAM-1 showed consistent associations with each CRS (FRS R2 = 0.03; CRI-I R2 = 0.06; CRI-II R2 = 0.06; AIP R2 = 0.03). IDF and JIS definitions classified MetS similarly but showed limited concordance with CRS. AIP and CRI demonstrated stronger cross-sectional associations with MetS than FRS. Biomarker analyses indicated that sICAM-1 correlated with CRS. The inverse relationship between T-cadherin and sICAM-1 raises the possibility of compensatory vascular-protective mechanisms. Collectively, these findings suggest a distinct lipid-inflammatory cardiometabolic phenotype in the Negrito population, where endothelial activation markers may capture early vascular stress beyond traditional risk scores.
