Abstract
<jats:p>The emergence of resistance in Enterobacterales to commonly used antibiotics, particularly the pandemic spread of Extended Spectrum Beta-Lactamase (ESBL)-producing Escherichia coli (ESBLEC) and Klebsiella pneumoniae (ESBLKP), poses a significant public health challenge. Infections caused by these organisms severely restrict treatment options, yet global data on intestinal carriage of ESBLEC and ESBLKP remain limited. Malaysia, a middle-income country in Southeast Asia, has seen a large influx of economic migrants from Indonesia, Bangladesh, and Nepal since the early 2000s. ESBLEC and ESBLKP prevalence rates in these countries rank among the highest in WHO regions, and Malaysia has reported increasing rates of isolation in parallel with rising migration. This article reviews studies on prevalence of ESBLEC and ESBLKP in Malaysia, Indonesia, Bangladesh, and Nepal from the time of their first reported isolation, together with information on economic migration patterns into Malaysia. We propose potential internal and external modes of intestinal ESBL transmission, and highlight initiatives for intervention to monitor the spread of ESBLs across borders in slowing its pandemic dissemination.</jats:p>