{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T13:16:35Z","timestamp":1773234995752,"version":"3.50.1"},"reference-count":65,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T00:00:00Z","timestamp":1639008000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004386","name":"University of Malaya","doi-asserted-by":"publisher","award":["RU008-2018"],"award-info":[{"award-number":["RU008-2018"]}],"id":[{"id":"10.13039\/501100004386","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>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\u00a0pneumoniae and Haemophilus influenzae, and sometimes Staphylococcus aureus. We assessed the \u03b2-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 \u03b2-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\u2013100%) were susceptible to cefcapene and flomoxef. Overall, \u03b2-lactam antibiotics except penicillins remained largely effective against URTI pathogens in this region.<\/jats:p>","DOI":"10.3390\/pathogens10121602","type":"journal-article","created":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T21:46:58Z","timestamp":1639086418000},"page":"1602","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["\u03b2-Lactam Resistance in Upper Respiratory Tract Pathogens Isolated from a Tertiary Hospital in Malaysia"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8332-4833","authenticated-orcid":false,"given":"Soo Tein","family":"Ngoi","sequence":"first","affiliation":[{"name":"Department of Medical Microbiology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anis Najwa","family":"Muhamad","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cindy Shuan Ju","family":"Teh","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6881-8883","authenticated-orcid":false,"given":"Chun Wie","family":"Chong","sequence":"additional","affiliation":[{"name":"School of Pharmacy, Monash University Malaysia, Bandar Sunway 47500, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8716-4416","authenticated-orcid":false,"given":"Kartini","family":"Abdul Jabar","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8280-3226","authenticated-orcid":false,"given":"Lay Ching","family":"Chai","sequence":"additional","affiliation":[{"name":"Faculty of Science, Institute of Biological Sciences, Universiti Malaya, Kuala Lumpur 50603, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kin Chong","family":"Leong","sequence":"additional","affiliation":[{"name":"Shionogi Singapore Pte Ltd., Anson Road, #34-14 International Plaza, Singapore 079903, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Loong Hua","family":"Tee","sequence":"additional","affiliation":[{"name":"Shionogi Singapore Pte Ltd., Anson Road, #34-14 International Plaza, Singapore 079903, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9267-1420","authenticated-orcid":false,"given":"Sazaly","family":"AbuBakar","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia"},{"name":"Tropical Infectious Diseases Research and Education Centre (TIDREC), Universiti Malaya, Kuala Lumpur 50603, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,12,9]]},"reference":[{"key":"ref_1","unstructured":"Centre for Clinical Practice at NICE (UK) (2008). 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