European Journal of Clinical Microbiology & Infectious Diseases最新文献

{"title":"Epidemiological characteristics of Helicobacter pylori infection and antibiotic resistance in urban areas of Guangdong Province, China: a multi-center, cross-sectional surveillance.","authors":"Luhua Xian, Yuting Si, Luan Luan, Jinxin Lai, Jiawei Tang, Liang Wang","doi":"10.1007/s10096-025-05105-9","DOIUrl":"10.1007/s10096-025-05105-9","url":null,"abstract":"<p><strong>Purpose: </strong>Helicobacter pylori (H. pylori) infection is widespread globally and can cause serious gastrointestinal complications, including gastric cancer. This study assesses the prevalence and antibiotic resistance of H. pylori in Guangdong, one of China's most developed provinces.</p><p><strong>Methods: </strong>A multi-center, cross-sectional study was conducted across six cities in Guangdong provinces, that is, Guangzhou, Shenzhen, Heyuan, Foshan, Yunfu, and Zhaoqing. Non-invasive gastric fluid samples were collected via the string test, and H. pylori infection and antibiotic resistance were detected using quantitative PCR. Risk factors for infection were analyzed.</p><p><strong>Results: </strong>Of 1,764 participants, 444 (25.17%) tested positive for H. pylori, with the highest infection rate in Foshan (29.81%). Antibiotic resistance testing of these 444 infected individuals revealed that, except for levofloxacin resistance in Yunfu (14.29%), clarithromycin resistance in Yunfu and resistance to other antibiotics in all cities exceeded the 15% threshold. Infection rates were significantly higher in males (OR 1.29, 95% CI 1.03-1.60, p = 0.03) and obese individuals (OR 2.04, 95% CI 1.04-3.91, p = 0.03), with obesity identified as an independent risk factor.</p><p><strong>Conclusion: </strong>This study provides a comprehensive update on the prevalence, antibiotic resistance, and risk factors of H. pylori infection in Guangdong, offering valuable insights for public health strategies aimed at improving diagnosis and treatment.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"1305-1312"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interpretation of pathogenicity and clinical features of multiple pathogens in pediatric lower respiratory tract infections by tNGS RPTM analysis.","authors":"Yujia Xiao, Dekyi, Xia Wang, Shuwen Feng, Yiyu Yang, Junwen Zheng, Dongchi Zhao","doi":"10.1007/s10096-025-05094-9","DOIUrl":"10.1007/s10096-025-05094-9","url":null,"abstract":"<p><strong>Background: </strong>To characterize the epidemiology of pathogens in children with lower respiratory tract infections (LRTI) using targeted next-generation sequencing (tNGS), assess the correlation between reads per ten million (RPTM) of co-detected pathogens, identify common co-detection patterns, and explore their clinical significance.</p><p><strong>Methods: </strong>Children aged 29 days to 14 years hospitalized for LRTI at the Department of Pediatrics, Zhongnan Hospital of Wuhan University, from April 2023 to August 2024 were included. Bronchoalveolar lavage fluid (BALF) or nasopharyngeal swab (NS) samples were tested for pathogens using tNGS, and clinical data were collected. The data and RPTM were statistically analyzed based on lung X-ray and CT scan results, classifying cases as pneumonia or lung consolidation/pulmonary atelectasis (LC/PA).</p><p><strong>Results: </strong>Among 1118 children, the highest pathogen detection rate was Mycoplasma pneumoniae (MP) at 60.20%, followed by Haemophilus influenzae (HI) at 42.40% and Streptococcus pneumoniae (SP) at 35.42%. In children under 4 years old, common pathogens were HI, Rhinovirus (RhV), and Respiratory syncytial virus (RSV). For those over 4 years old, MP and HI were predominant. In common pneumonia cases, MP, HI, and RhV were frequent, with MP being the primary pathogen in LC/PA. 80.70% of respiratory samples detected two or more pathogens, and viruses were more frequently detected in NS than in BALF. Correlation analysis showed that MP RPTM was negatively correlated with other co-detected pathogens' RPTM, SP was negatively correlated with RSV but positively correlated with Influenza virus (flu virus), HI was positively correlated with Adenovirus (ADV) and flu virus, RhV was negatively correlated with flu virus. Clinical characteristics of co-detected pathogens showed no significant differences in acute LRTI symptoms among different combinations.</p><p><strong>Conclusion: </strong>Co-detection of pathogens in children's LRTI using tNGS was common, with MP and bacterial infections being predominant. There were synergistic and competitive relationships between the RPTM of co-detected pathogens.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"1313-1324"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological and clinical profiles of respiratory syncytial virus infections in hospitalized children: a retrospective cohort study utilizing targeted next-generation sequencing.","authors":"Chunyun Fu, Jialing Ruan, Lishai Mo, Jiangyang Zhao, Junming Lu, Ya Huang, Xuehua Hu, Qiang Huang, Yanhua Feng, Wenting Tang, Ning Zhu, Cuihong Lu, Xiangjun Lu, Ruting Chen, Guangbing Liu, Huiping Huang, Qifei Li, Jie Tan","doi":"10.1007/s10096-025-05112-w","DOIUrl":"10.1007/s10096-025-05112-w","url":null,"abstract":"<p><strong>Background: </strong>Respiratory syncytial virus (RSV) is a significant cause of respiratory infections in children. Currently, there is limited literature on the clinical use of pathogen-targeted sequencing technologies and the systematic analysis of RSV infections in hospitalized children. The primary objective of this research was to evaluate the infection status and clinical manifestations associated with RSV in these pediatric patients.</p><p><strong>Methods: </strong>Between July 2021 and November 2023, 5,021 children hospitalized due to respiratory infections or associated complications were enrolled at the Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region. Targeted next-generation sequencing (tNGS) was used to detect pathogens in their respiratory samples. Subsequently, the clinical data of children infected with RSV were systematically evaluated.</p><p><strong>Results: </strong>Of the 5,021 children hospitalized with respiratory infections, RSV was detected in 1,080, yielding a detection rate of 21.5%. Among RSV-positive patients, only 8.6% (93/1080) experienced single infections, while the majority, 91.4% (987/1080), had co-infections with other pathogens. Among the observed infection patterns, RSV-viral-bacterial co-infection was the most prevalent, occurring in 524 cases (48.5%), followed by RSV-viral co-infection in 141 cases (13.1%). Among children with RSV co-infections, 43 additional microorganisms were detected, with cytomegalovirus, Haemophilus influenzae, and Streptococcus pneumoniae being the most prevalent. Of the 1,080 children diagnosed with RSV, 172 (15.9%) required ICU admission for monitoring. The median duration of hospitalization for the 1080 children diagnosed with RSV infection was 8 days. Of these, 1025 (94.9%) patients recovered and were discharged following treatment, while 54 (5.0%) of the patients' family members requested voluntary discharge due to unsatisfactory outcomes or other reasons. Unfortunately, one child (0.1%) died despite receiving intensive medical treatment.</p><p><strong>Conclusion: </strong>Due to the high incidence of RSV infections and associated ICU admissions, there is a critical need for effective vaccine development to protect infants and children. This study presents a comprehensive analysis of hospitalized pediatric patients with RSV, examining infection patterns, clinical manifestations, laboratory findings, imaging characteristics, complications, and prognosis.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"1391-1403"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alkalihalobacillus clausii bacteremia after probiotic use for acute diarrhea: a case report.","authors":"Paola Andrea Gallego Aristizabal, Sebastián Peláez García, Javier Eduardo Caicedo Espinosa, Susana Montoya-Jaramillo, Isabel González-Tapias","doi":"10.1007/s10096-025-05115-7","DOIUrl":"10.1007/s10096-025-05115-7","url":null,"abstract":"<p><p>Alkalihalobacillus clausii (previously known as Bacillus clausii) is a spore-forming bacterium used as a probiotic due to its resistance to gastric acidity and intestinal conditions. It is marketed for managing acute diarrhea, though evidence of its efficacy and safety is limited. We present the case of an 87-year-old man with acute viral diarrhea treated with Alkalihalobacillus clausii, who developed septic shock with blood cultures confirming Alkalihalobacillus clausii bacteremia. Intensive care and daptomycin therapy led to clinical resolution.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"1527-1529"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early appropriate therapy with polymyxin B reduces the mortality in burn sepsis caused by carbapenem-resistant gram-negative bacteria: a retrospective analysis.","authors":"Nanhong Jiang, Weiguo Xie, Deyun Wang, Wei Wang","doi":"10.1007/s10096-025-05119-3","DOIUrl":"10.1007/s10096-025-05119-3","url":null,"abstract":"<p><strong>Objective: </strong>The prevalence of Carbapenem-Resistant Gram-Negative Bacteria (CR-GNB) is rapidly escalating, presenting a significant global public health concern. This study aims to evaluate the survival rate of early appropriate therapy with polymyxin B (PMB), and adverse drug reactions of PMB in treating severe burn sepsis caused by CR-GNB infections.</p><p><strong>Methods: </strong>We retrospectively analyzed 72 patients with severe burn sepsis caused by CR-GNB infections from January 1, 2018, to December 30, 2023. These patients received a treatment regimen based on PMB for at least three days. We collected data on the patient's clinical characteristics, microbiological results, details of PMB treatment, adverse drug reactions with PMB, and mortality. We compared the 30-day mortality rates between patients who received early appropriate therapy (the timely administration of an active antimicrobial agent within 48 h after the onset of infection) and those who underwent non-early appropriate therapy, multivariate Cox regression analysis was employed to evaluate factors impacting the 30-day survival rate of patients, and the adverse drug reactions caused by PMB were also analyzed.</p><p><strong>Results: </strong>Among the 72 patients with severe burn sepsis, the clinical effective rate was 69.4% (50/72), the 30-day all-cause mortality rate was 31.9% (23/72) and the 30-day sepsis-associated mortality rate was 27.8% (20/72). The adverse drug reactions of PMB included nephrotoxicity and skin pigmentation, with an incidence of 19.4% (14/72) and 15.3% (11/72), respectively. The patients who received early appropriate therapy had a lower mortality rate, lower SOFA scores and more wound infections compared to those who underwent non-early appropriate therapy (all P < 0.05). The univariate Cox regression analysis showed that age, hypertension, SOFA score at the time of sepsis diagnosis, and early appropriate therapy with PMB were associated with both 30-day all-cause mortality and sepsis-associated mortality in severely burned patients (all P < 0.05). Additionally, In the multivariate Cox regression analysis, early appropriate therapy with PMB was identified as an independent protective factor for both 30-day all-cause mortality (HR = 0.183 [95% CI 0.071-0.468], P < 0.001) and sepsis-associated mortality (HR = 0.150 [95% CI 0.054-0.414], P < 0.001) in severely burned patients.</p><p><strong>Conclusions: </strong>Polymyxin B is an effective option for burn sepsis patients in treating CR-GNB infections. Early appropriate therapy with PMB significantly improved the survival rate of severe burn sepsis patients infected with CR-GNB.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"1433-1442"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cefiderocol treatment for patients infected by Stenotrophomonas maltophilia, Burkholderia cepacia complex and Achromobacter spp.: subgroup analysis from the PERSEUS study.","authors":"Julian Torre-Cisneros, Ricard Ferrer, Carmen De La Fuente Martos, Jessica Sarda, A Javier Gonzalez Calvo, Stefano Verardi, Andreas Karas, Alex Soriano","doi":"10.1007/s10096-025-05109-5","DOIUrl":"10.1007/s10096-025-05109-5","url":null,"abstract":"<p><strong>Purpose: </strong>This subgroup analysis of the PERSEUS study aimed to describe the effectiveness of cefiderocol treatment in the early access programme in Spain in patients infected by Stenotrophomonas maltophilia, Burkholderia cepacia complex (Bcc) or Achromobacter species.</p><p><strong>Methods: </strong>In the retrospective, observational, multicentre PERSEUS study in Spain, the effectiveness and safety of cefiderocol treatment administered for at least 72 h up to 28 days in patients infected by Gram-negative bacteria, except Acinetobacter spp., in the early access programme was investigated. Patient demographics and baseline clinical characteristics, cefiderocol use, clinical cure at end of treatment, all-cause mortality at Day 28 were the main outcomes.</p><p><strong>Results: </strong>A total of 20 patients had S. maltophilia infections, and 14 patients had other rare glucose non-fermenters (Bcc 8, Achromobacter spp. 5, Ralstonia mannitolilytica 1). The median (interquartile range [IQR]) age was 60.5 (48.0-65.5) years and 49.5 (33.0-59.0) years for patients with S. maltophilia and other rare non-fermenters, respectively. The majority of patients had respiratory tract infections (S. maltophilia 55%; other rare non-fermenters 71.4%), and median (IQR) duration of cefiderocol treatment was 10.0 (6.5-13.5) days and 8.0 (6-14) days, respectively. Clinical cure rates were 70%, 62.5% and 80.0% for patients with S. maltophilia, Bcc and Achromobacter spp., respectively. Corresponding 28-day all-cause mortality rates were 30.0%, 37.5% and 40.0%, respectively. One patient with R. mannitolilytica had clinical cure and survived to Day 28.</p><p><strong>Conclusions: </strong>Cefiderocol is an important addition to the limited treatment options for patients infected by these rare glucose non-fermenting Gram-negative bacteria.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov: NCT05789199 (Registration date: 16 February 2023).</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"1367-1374"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel comparative evaluation of multiplex PCR panels for gastrointestinal pathogen detection: Seegene Allplex™ vs. Luminex NxTAG^® in clinical stool samples.","authors":"Laura Seijas-Pereda, Ana Martín, Raquel Menchero, Carlos Rescalvo-Casas, Marcos Hernando-Gozalo, Juan Cuadros-González, Ramón Pérez-Tanoira","doi":"10.1007/s10096-025-05098-5","DOIUrl":"10.1007/s10096-025-05098-5","url":null,"abstract":"<p><strong>Purpose: </strong>Accurate and rapid diagnosis of gastrointestinal infections is essential for effective patient management. This study compared the diagnostic performance of two multiplex PCR panels- the Seegene Allplex™ Gastrointestinal Panels (Seegene, Seoul, Korea) and the Luminex NxTAG^® Gastrointestinal Pathogen Panel (Luminex Corporation, Austin, Texas, a Diasorin Company)-in detecting gastrointestinal pathogens from clinical stool samples.</p><p><strong>Methods: </strong>A total of 196 stool samples, collected from patients at a Spanish hospital during 2023, were analyzed using both assays through prospective and retrospective approaches. The performance of each test was assessed based on Positive Percentage Agreement (PPA), Negative Percentage Agreement (NPA), and overall agreement. Discrepancies between methods were resolved with a third confirmatory technique when available.</p><p><strong>Results: </strong>Both assays demonstrated high overall concordance, with NPA values consistently above 95% and overall Kappa values exceeding 0.8 for most pathogens. The average PPA was greater than 89% for nearly all targets; however, lower agreement was observed for Cryptosporidium spp. (86.6%). Notably, discrepancies were primarily observed for certain pathogens, such as Salmonella spp. and Cryptosporidium spp., highlighting the diagnostic challenges associated with these targets.</p><p><strong>Conclusion: </strong>To our knowledge, this is the first study to compare the novel Luminex NxTAG^® panels from Diasorin with the Seegene Allplex™. Both multiplex assays provide rapid and reliable detection of gastrointestinal pathogens, making them valuable tools in clinical diagnostics. Future research should focus on improving detection accuracy for challenging pathogens and expanding target panels to further enhance patient management and reduce disease burden.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"1341-1348"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolving patterns of healthcare-associated infections in NICU: a five-year retrospective analysis from a tertiary children's hospital in China.","authors":"Zhen Wang, Jiali Wang, Kouzhu Zhu, Yan-Jun Kang","doi":"10.1007/s10096-025-05103-x","DOIUrl":"10.1007/s10096-025-05103-x","url":null,"abstract":"<p><strong>Background: </strong>Neonates in the NICU, particularly those born with very low birth weights, are at heightened risk for healthcare-associated infections (HAIs). Such infections can prolong hospitalization, increase medical costs, and potentially lead to adverse long-term outcomes. Recognizing evolving infection patterns and targeted prevention measures is essential to improving patient care.</p><p><strong>Methods: </strong>We retrospectively collected data on neonates admitted to the NICU of our hospital between January 2019 and December 2023. Information regarding HAI incidence, site of infection, device utilization, pathogen distribution, and antibiotic use was extracted and statistically analyzed. Comparisons regarding infection rates and clinical variables were performed using chi-square or Fisher's exact tests for categorical variables and Wilcoxon rank-sum tests for continuous variables.</p><p><strong>Results: </strong>Among 9786 neonates (70,509 patient-days), 86 HAI cases were identified (0.88%), corresponding to 1.22‰ infections per 1000 patient-days. Neonates with extremely low birth weight had significantly higher infection rates (13.04%) than other birth weight groups (p < 0.01). Bloodstream infections (35.87%) were the most common site, followed by respiratory and gastrointestinal infections (both 18.48%). Central line-associated bloodstream infection occurred at 0.75 infections per 1000 catheter-days, while ventilator-associated pneumonia decreased from 2.76‰ to 0.73‰ over the study period. Staphylococcus epidermidis was the predominant isolate among the pathogens identified. Neonates with HAIs had significantly longer antibiotic courses and higher rates of combination antibiotic therapy (p < 0.001).</p><p><strong>Conclusions: </strong>Although the overall incidence of NICU HAIs declined from 2019 to 2023, infection patterns continued to evolve, particularly regarding bloodstream infections. Prevention strategies must focus on high-risk neonates, rigorous device management, punctual surveillance of pathogen resistance, and prudent antibiotic use to further reduce infection morbidity and mortality in the NICU setting.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"1357-1365"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness and safety of cefiderocol treatment in patients with Gram-negative bacterial infections in Spain in the early access programme: results of the PERSEUS study.","authors":"Julian Torre-Cisneros, Benito Almirante, Carmen De La Fuente Martos, Pedro Rascado, Miguel Salavert Lletí, Miguel Sánchez-García, Alex Soriano, Maria Cruz Soriano-Cuesta, A Javier Gonzalez Calvo, Andreas Karas, Jessica Sarda, Stefano Verardi, Ricard Ferrer","doi":"10.1007/s10096-025-05108-6","DOIUrl":"10.1007/s10096-025-05108-6","url":null,"abstract":"<p><strong>Purpose: </strong>We assessed the effectiveness and safety of cefiderocol in patients with Gram-negative bacterial infections, excluding Acinetobacter spp., in the early access programme (EAP) in Spain.</p><p><strong>Methods: </strong>The retrospective, multicentre PERSEUS study (2018-2022) enrolled hospitalised patients with serious Gram-negative infections, except Acinetobacter spp., who received first-time cefiderocol for ≥ 72 h following requests through the EAP. Clinical cure at end of treatment, all-cause mortality at Day 28, cefiderocol use, and adverse drug reactions (ADRs) were the key outcomes.</p><p><strong>Results: </strong>Overall, 261 patients were eligible for analysis. Median (interquartile range) age was 61 (49-68) years, 202 (77.4%) were male and 165 (63.2%) were in the intensive care unit. The most frequent diagnoses were respiratory tract infection (47.9%), intra-abdominal infection (14.6%), and urinary tract infection (14.6%). The median (IQR) duration of cefiderocol treatment was 10 (7-14) days. Overall, the clinical cure rate was 80.5% (210/261) and the 28-day mortality rate was 21.5% (56/261). In patients with Pseudomonas aeruginosa infection (66.7% [n = 174], including 73 [42%] with metallo-β-lactamases), the clinical cure rate was 84.5% (147/174) and the 28-day mortality was 17.2% (30/174). Logistic regression analysis showed that prior antibiotic treatment for > 7 days (OR 0.19, 95% CI 0.05-0.56) and mechanical ventilation (OR 0.32, 95% CI 0.15-0.67) were independent negative predictive factors for clinical cure. ADRs occurred in seven patients, six events resolved, and one was fatal (toxic epidermal necrolysis).</p><p><strong>Conclusions: </strong>Cefiderocol is a valuable option in the treatment of serious Gram-negative bacterial infections, particularly for those caused by P. aeruginosa.</p><p><strong>Clinicaltrials: </strong>GOV: NCT05789199 (Registration date: 16 February 2023).</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"1375-1390"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of MALDI-TOF VITEK MS for rapid and efficient identification of KPC-type carbapenemases in Enterobacterales carrying the Tn4401a transposon.","authors":"Aleyda M Montaño, Carlos Robledo, Julián C Galvis-Ayala, J Natalia Jimenez, Romain Brunel, Jaime Robledo","doi":"10.1007/s10096-025-05097-6","DOIUrl":"10.1007/s10096-025-05097-6","url":null,"abstract":"<p><strong>Purpose: </strong>To determine diagnostic validity of MALDI-TOF MS (VITEK MS) system for detecting Klebsiella pneumoniae carbapenemases (KPC)-type carbapenemases by identifying the 11,109 Da peak in the mass spectrum generated for species identification as compared to RAPIDEC^® CARBA NP, and the modified carbapenemase inactivation method (mCIM) and the EDTA-modified carbapenem inactivation method (eCIM) in a collection of isolates previously characterized as KPC positive or negative.</p><p><strong>Methods: </strong>210 Enterobacterales clinical strains previously characterized having bla_KPC gene, the pKpQIL plasmid and the Tn4401a transposon were evaluated, including 34 positive controls carbapenemase-producing Klebsiella pneumoniae associated with Tn4401a, 30 Enterobacterales bla_KPC positive of unknown plasmid background, and 146 negative controls. Accuracy and agreement were established for Vitek MS, RAPIDEC^® CARBA NP, and mCIM/eCIM) tests; ROC curves were compared among these tests.</p><p><strong>Results: </strong>The 11,109 Da peak was detected in 100% of KPC Tn4401a positive isolates using Vitek MS, sensitivity of 100% (95% CI 98.53-100), specificity of 95.5% (95% CI 91.7-99.4), positive predictive value (PPV) of 85.0 (95% CI 72.7-97.3), negative predictive value (NPV) of 100% (95% CI 99.6-100) and positive Likelihood Ratio (PLR) of 22.3 (10.2-48.8). Agreement between the three tests was 93.3% Kappa index of 0.90 (95% CI 0.83-0.97, p ≤ 0.05). ROC curves showed areas under the curve (AUCs) of 0.95, 0.96 and 0.96 for the VITEK MS, RAPIDEC CARBA NP and the mCIM/eCIM tests, respectively.</p><p><strong>Conclusion: </strong>Detection of the 11,109 Da peak by Vitek MS confirms the presence of KPC-type carbapenemase, allowing rapid and simultaneous detection with species identification; a negative result does not rule out the presence of the enzyme and may require additional tests.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"1443-1453"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}