Staying Ahead: Superbugs & Personalized Medicine
7 March 2025
Minor cuts, scrapes, or a simple UTI – things we often shrug off. But what happens when these common infections become life-threatening? The rise of “superbugs,” bacteria resistant to multiple antibiotics, is a growing global crisis, and Malaysia is not immune.
The Superbug Threat
The rise of superbugs, fueled by antimicrobial resistance (AMR), poses a significant threat to global health, including in Malaysia. The overuse and misuse of antibiotics have accelerated this crisis, making even minor infections potentially life-threatening. In this context, pharmacogenomics offers a promising approach to personalize treatment and combat AMR.
Crisis of Antimicrobial Resistance (AMR) in Malaysia
Malaysia faces a critical situation with AMR. Studies have shown that antibiotic prescriptions are often inappropriate, with many being used for viral infections like the common cold, which only accelerates bacterial resistance ¹ ². The economic burden is substantial, with the cost of treating drug-resistant infections being up to three times higher than non-resistant cases ¹.
According to recent news mentioned in The News Straits ³, even minor infections are becoming increasingly difficult to treat due to antibiotic resistance. This means longer hospital stays, higher medical costs, and, in the worst cases, fatalities. Overuse and misuse of antibiotics are major drivers of this resistance. Think about it: do you always finish your antibiotic course, even when you feel better? Have you ever taken antibiotics for a viral infection like the common cold? These habits contribute to the problem.
Methicillin-Resistant Staphylococcus aureus (MRSA)
A key player in AMR MRSA is a prime example of the AMR challenge. It is resistant to almost all β-lactam antibiotics due to the acquisition of a resistant genomic island called the staphylococcal cassette chromosome (SCC) element, which carries the mecA/mecC gene ⁴ ⁵. MRSA can easily spread in hospitals and communities, and its resistance has evolved to include virtually all clinically available antibiotics ⁴ ⁶.
Transmission and Resistance: MRSA strains are highly transmissible and have developed resistance to multiple antibiotics, including beta-lactams like penicillin and cephalosporins ⁵ ⁶.
- Treatment Challenges: While drugs like vancomycin and linezolid have been used to treat MRSA, resistance to these antibiotics is emerging due to mutations and genetic variations ⁵ ⁷.
- Impact on Public Health: MRSA infections are associated with higher morbidity and mortality, especially in cases like infective endocarditis ⁸.
Pharmacogenomics - A Personalized Approach
Pharmacogenomics involves tailoring drug treatments to an individual’s genetic makeup. This can help ensure that the right antibiotics are prescribed at the right dosage, reducing the risk of ineffective treatment and further resistance.
Choosing the Right Antibiotic
Pharmacogenomic testing can predict which antibiotics are most likely to be effective for a patient, minimizing the risk of prescribing ineffective drugs.
Optimizing Dosage
By understanding how an individual’s genes affect drug metabolism, pharmacogenomics can help determine the optimal dosage, reducing side effects and improving outcomes.
Reducing Resistance
By ensuring that antibiotics are used effectively from the start, pharmacogenomics can help reduce the selective pressure that drives resistance.
Malaysian Second Action Plan on Antimicrobial Resistance (MyAP-AMR) 2022–2026
Enhanced Governance: Strengthening the National Antimicrobial Resistance Committee.
Surveillance and Research: Expanding surveillance and promoting research.
Infection Prevention and Control: Implementing stringent IPC measures.
Optimized Use of Antimicrobials: Enforcing regulations and promoting stewardship programs.
Public Education: Conducting nationwide awareness campaigns
*WHO. (2024). Malaysia: Malaysian Second Action Plan on Antimicrobial Resistance (MyAP-AMR) 2022-2026. Retrieved from https://www.who.int/publications/m/item/malaysia--malaysian-second-action-plan-on-antimicrobial-resistance-(myap-amr)
Conclusion
Combating AMR requires a multi-faceted approach that includes pharmacogenomics, responsible antibiotic use, and comprehensive national strategies like the MyAP-AMR. By embracing these measures, Malaysia can mitigate the threat of superbugs and ensure a healthier future for its citizens.
Reference List
BERNAMA. (2024, November 19). Malaysia To Face 87,000 Deaths Due To Antimicrobial Resistance. Bernama. Retrieved from https://www.bernama.com/en/news.php?id=2365212
WHO. (2023, November 6). WHO supports the strengthening of Malaysia’s antimicrobial resistance surveillance and laboratory capacities in hospital settings. WHO Western Pacific Region. Retrieved from https://www.who.int/westernpacific/newsroom/feature-stories/item/who-supports-the-strengthening-of-malaysia-s-antimicrobial-resistance-surveillance-and-laboratory-capacities-in-hospital-settings
- NST. (2025, March 7). Health: Superbugs – When minor infections become untreatable. New Straits Times. Retrieved from https://www.nst.com.my/lifestyle/heal/2025/03/1184303/health-superbugs-when-minor-infections-become-untreatable?sfnsn=wa
Frontiers in Microbiology. (2023). Prevalence, drug resistance, molecular typing and comparative genomic analysis of methicillin-resistant Staphylococcus aureus (MRSA) strains. Frontiers in Microbiology, 14. doi: 10.3389/fmicb.2023.1273397
PMC. (2023). Antimicrobial resistance in methicillin-resistant Staphylococcus aureus. PMC, 10018568.
Microbiology Spectrum. (2019). Antibiotic Resistance and the MRSA Problem. Microbiology Spectrum, 7(2), GPP3-0057-2018. doi: 10.1128/microbiolspec.gpp3-0057-2018
Wikipedia. (n.d.). Methicillin-Resistant Staphylococcus aureus. Retrieved from https://en.wikipedia.org/wiki/Methicillin-resistant_Staphylococcus_aureus
StatPearls. (2024). Methicillin-Resistant Staphylococcus aureus. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK482221/
