Infection and Drug Resistance最新文献

{"title":"Investigation into the Efficacy of Formic Acid Fumigation for Inactivating Clinically Isolated Filamentous Fungi.","authors":"Kaixuan Yuan, Benshun Tian, Annan Zhan, Zhuoxi Chen, Long Ye, Yong Ling, Suiling Liu, Xuejiao Bai, Yunhu Zhao","doi":"10.2147/IDR.S519486","DOIUrl":"https://doi.org/10.2147/IDR.S519486","url":null,"abstract":"<p><strong>Purpose: </strong>Inactivating filamentous fungi (molds) reduce toxin production and transmission. This study evaluated the efficacy of formic acid (FA) fumigation to identify optimal conditions and its effects on fungal morphology. We aim to develop an efficient inactivation protocol for molds and provide valuable insights into laboratory techniques for fungal inactivation.</p><p><strong>Methods: </strong>Initially, 238 clinical isolates from 23 species of molds were evaluated for the inactivation efficacy of formic acid, formaldehyde, and peracetic acid. After identifying the optimal sterilizing agent, 188 isolates from 16 clinically significant species were tested. Four concentrations (30%, 50%, 70%, and 100%) and six-time intervals (4 to 14 hours) were tested to optimize fumigation conditions. Morphological changes were analyzed using <i>Aspergillus fumigatus</i> ATCC MYA-3626 as the standard strain.</p><p><strong>Results: </strong>The inactivation rates of 238 molds fumigated with formic acid, formaldehyde, and peracetic acid for 24 hours were 99.16%, 89.08%, and 90.35% (<i>P</i> < 0.05), indicating that formic acid was more effective than formaldehyde and peracetic acid. Subsequently, 188 isolates from 16 species were fumigated with formic acid at concentrations of 30%, 50%, 70%, and 100% for 24 hours, resulting in inactivation rate of 73.9%, 98.4%, 100%, and 100% (<i>P</i> < 0.05). Inactivation rate increased significantly with longer exposure times: 51.1% at 4 hours, 80.9% at 6 hours, 89.4% at 8 hours, 94.7% at 10 hours, 100% at 12 hours, and 100% after 14 hours (<i>P</i> < 0.05). After fumigation, <i>A. fumigatus</i> ATCC MYA-3626 growth ceased. Electron microscopy revealed irregular folds and roughness on spore surfaces, as well as collapsed or dead spores.</p><p><strong>Conclusion: </strong>Formic acid demonstrated superior inactivation efficacy compared to formaldehyde and peracetic acid. At a concentration of 70% and a fumigation duration of 12 hours, the inactivation of molds was most effective.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"3709-3721"},"PeriodicalIF":2.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful Treatment of Mucormycosis and Azole-Resistant <i>Aspergillus</i> Coinfection in a Diabetic Patient: A Case Report.","authors":"Tingting Zhao, Yuan Fang, Qiuhui Wu, Minke Shi, Yueyan Ni, Ruyi Zou, Mengying Liu, Weiwei Wu, Xin Su","doi":"10.2147/IDR.S530615","DOIUrl":"https://doi.org/10.2147/IDR.S530615","url":null,"abstract":"<p><strong>Objective: </strong>To report a case of coinfection with mucormycosis and azole-resistant <i>Aspergillus fumigatus</i> in a patient with poorly controlled type 2 diabetes, highlighting successfully treated with high-dose posaconazole combined with liposomal amphotericin B and lobectomy.</p><p><strong>Methods: </strong>A 52-year-old man who presented to our hospital with a 1-month history of fever accompanied by productive cough and sputum. He had type 2 diabetes with poor control of glucose level. Chest computed tomography (CT) showed rapidly progressive multiple cavities and consolidation in the lungs. Sputum culture showed azole-resistant <i>Aspergillus fumigatus</i>, confirmed by whole genome sequencing, which revealed mutations in non-azole target genes (eg, <i>CYP51A</i> was wild-type). Targeted next-generation sequencing (tNGS) of bronchoalveolar lavage fluid (BALF) at admission detected <i>Aspergillus fumigatus</i> and <i>Rhizopus microsporus</i>, while histopathology of right upper lobe necrotic material on day 18 confirmed mucormycosis. The patients had previously received intravenous voriconazole (400 mg/d) combined with inhaled amphotericin B (10 mg twice daily) for 2 weeks without improvement. Upon admission, initial treatment with isavuconazole, liposomal amphotericin B, and caspofungin was also ineffective. Subsequently, high-dose posaconazole (600 mg/d) combined with liposomal amphotericin B was administered.</p><p><strong>Results: </strong>Following the initiation of high-dose posaconazole and liposomal amphotericin B, the patient's temperature normalized, and pulmonary exudates significantly improved. Therapeutic drug monitoring (TDM) showed that posaconazole trough concentrations were maintained at 3-4 mg/L without significant hepatic or renal toxicity. The main adverse effects observed were hypokalemia and anorexia. After 102 days of antifungal therapy, the patient underwent successful lobectomy, leading to complete resolution of symptoms.</p><p><strong>Conclusion: </strong>This case demonstrated the good efficacy and safety of high-dose posaconazole combined with liposomal amphotericin B in the treatment of azole-resistant <i>Aspergillus</i> and mucormycosis.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"3689-3694"},"PeriodicalIF":2.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors for Postoperative Neurologic Dysfunction in Patients with Spinal Tuberculosis: A Retrospective Study.","authors":"Pengfei Shao, Yushan Wang, Mingjie Dong, Hao Fan, Yingjie Gao, Yu Gao, Zhaoyang Hao, Jia Lv, Junjun Bai, Zhuangzhuang Wu, Yi Feng","doi":"10.2147/IDR.S528677","DOIUrl":"https://doi.org/10.2147/IDR.S528677","url":null,"abstract":"<p><strong>Purpose: </strong>Unexplained neurological dysfunction often occurs in patients after spinal tuberculosis(STB) surgery; therefore, this study aimed to analyze the causes of this dysfunction from the perspectives of the patient's preoperative inflammatory state, carrier bacterial state, and increased degree of autoimmunity.</p><p><strong>Patients and methods: </strong>We collected 247 patients with STB and 270 patients with degenerative diseases of the spine admitted from May 2015 to December 2024 at the Second Hospital of Shanxi Medical University. According to the exclusion criteria, 132 patients for each disease were included in this study. All patients with spinal STB underwent one-stage posterior lesion removal. We used the ASIA score to assess patients' neurological function and pain levels before and after surgery. We also compared the patients' pre- and postoperative changes in relevant inflammatory indicators, such as the ESR and PCT.</p><p><strong>Results: </strong>Postoperatively, one patient developed paraplegia with an ASIA grade of A; 29 patients developed incomplete paraplegia with an ASIA score of grade B in 5 patients, grade C in 7 patients, and grade D in 17 patients. In the damaged group, LYM% decreased from 35.52 ± 10.44 preoperatively to 14.36 ± 7.27 postoperatively. NEU% increased from 54.72 ± 11.85 preoperatively to 77.72 ±7.16 postoperatively. The WBC count increased from 5.97±1.65 preoperatively to 8.34 ± 2.71 postoperatively. The LNR decreased from 0.72 ± 0.31 preoperatively to 0.18 ± 0.11 postoperatively. Neurological dysfunction was somewhat recovered in the postoperative period (6 months to 2 years) in all patients.</p><p><strong>Conclusion: </strong>In summary, this clinical study successfully established a predictive model with significant prognostic value for postoperative neurological dysfunction in patients with spinal tuberculosis. Notably, based on the ranking of variable contributions, the use of antituberculosis drugs may play a pivotal role in the development of postoperative neurological dysfunction in spinal tuberculosis patients. A well-validated nomogram incorporating acid-fast staining and piezosurgery use may facilitate preoperative risk stratification. Prolonged exposure of the spinal cord to a highly inflammatory environment may serve as a risk factor for intraoperative spinal cord injury in these patients. Furthermore, identical or similar surgical procedures may yield differential clinical outcomes across different disease subtypes and individual patients.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"3695-3707"},"PeriodicalIF":2.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Characteristics and Treatment Outcomes of Fungal Endophthalmitis Caused by <i>Neoscytalidium dimidiatum</i>.","authors":"Chunxia Qi, Biyun Mo, Changhong Jiang, Jiali Li, Xuguang Bo, Xuhui Xiao, Hao Zhou, Jun Long","doi":"10.2147/IDR.S517505","DOIUrl":"10.2147/IDR.S517505","url":null,"abstract":"<p><p><i>Neoscytalidium dimidiatum</i> (<i>N. dimidiatum</i>) is a common fungal pathogen that primarily affects plants but can also cause rare infections in humans. In recent years, sporadic cases have been reported worldwide. Here, we report the first case of endophthalmitis in China resulting from a corneal scratch caused by an infected dragon fruit. Exogenous fungal endophthalmitis can be classified into three categories: postoperative, post-traumatic, and keratitis-associated. Currently, there is no standardized antifungal regimen for <i>N. dimidiatum</i> infections, especially for endophthalmitis, where systemic antibiotics have poor intraocular penetration. Successful management often requires surgical interventions such as amputation or drainage. Our case highlights the diagnostic and therapeutic challenges, as well as the poor outcomes associated with <i>N. dimidiatum</i> infections in humans.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"3671-3675"},"PeriodicalIF":2.9,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12297007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful Treatment of Lomentospora Prolificans Infection Following Allogeneic Hematopoietic Stem Cell Transplantation: A Case Report and Literature Review.","authors":"Yi-Han Yang, Chun Di, Hao Zheng, Ya Luo, Ao-Ran Zhang, Tong Su, Xiao-Dong Mo, Yu-Qian Sun, Yu Wang, Meng Lv","doi":"10.2147/IDR.S529984","DOIUrl":"10.2147/IDR.S529984","url":null,"abstract":"<p><p>Lomentospora prolificans is an opportunistic fungal pathogen known for its intrinsic multidrug resistance. This pathogen poses a significant challenge in immunocompromised individuals, particularly patients with hematologic malignancies. We present a case of a 27-year-old male diagnosed with adverse-risk acute myeloid leukemia (AML) who developed pulmonary Lomentospora prolificans infection following therapy for positive measurable residual disease (MRD) and severe chronic graft-versus-host disease (cGVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Despite the pathogen's multidrug resistance and the typically poor prognosis associated with invasive infections in immunocompromised hosts, the patient achieved sustained remission and favorable outcome. This study systematically reviews Lomentospora prolificans infections following HSCT by analyzing 37 reported cases from 24 studies identified through a PubMed search. The majority of cases had acute myeloid leukemia as the most common underlying disease. Disseminated infections were predominant (83.8%), with frequent pulmonary and central nervous system involvement. Antifungal treatment strategies largely involved combination therapy, yet outcomes remained poor, with an overall survival rate of only 13.5%. These findings highlight the critical need for novel therapeutic approaches and early intervention strategies to improve patient outcomes.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"3617-3628"},"PeriodicalIF":2.9,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12297014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacokinetic Profile of Isoniazid and Acetylator Status in Patients with Systemic Lupus Erythematosus: Implications for Tuberculosis Prevention Therapy in Indonesia.","authors":"Yane Lis Cintawati, Vycke Yunivita, Laniyati Hamijoyo, Edhyana Sahiratmadja","doi":"10.2147/IDR.S513294","DOIUrl":"10.2147/IDR.S513294","url":null,"abstract":"<p><strong>Introduction: </strong>Systemic Lupus Erythematosus (SLE) is a chronic autoimmune inflammatory disease with a high risk of tuberculosis (TB) infection, especially in those living in TB-endemic areas. Isoniazid (INH), an anti-tuberculosis drug, is recommended as preventive therapy in TB susceptible groups, however, its use in SLE is still controversial. SLE patients are more likely to have compromised liver function which can influence the kinetic of INH. The aim of the study was to explore the pharmacokinetic profile of INH and acetylator status in SLE patients.</p><p><strong>Methods: </strong>This was a descriptive observational study with a purposive sampling technique, including adult female SLE at Dr. Hasan Sadikin Hospital Bandung, conducted in January - August 2023. Inclusion criteria were SLE patients in remission with no TB infection; whereas the exclusion criteria were INH allergy, liver or kidney disorders, pregnant or lactating patients, and malignancy. Pharmacokinetic data was collected from six blood collection time points (0, 1, 2, 3, 4, and 8 hours) after 10 days of daily INH 300 mg administration on an empty stomach.</p><p><strong>Results: </strong>In total, 20 female SLE patients were included. The C_max value was 8.73 (2.55-18.27) mg/L and AUC_0-24 was 28.01 (8.82-79.40) mg.h/L.</p><p><strong>Conclusion: </strong>In terms of pharmacokinetic features, preventive isoniazid (INH) daily use of 300mg in SLE is sufficient to provide the prospect of protection from TB. These findings suggest that INH prophylaxis may be a viable strategy for TB prevention in SLE patients, warranting further investigation into long-term safety and efficacy.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"3637-3646"},"PeriodicalIF":2.9,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12301248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Utility of Nanopore Sequencing for Tuberculous Serous Effusions.","authors":"Yu Chen, Yuyang Ling, Xudong Xu, Yanqin Shen, Kan Xu, Guocan Yu","doi":"10.2147/IDR.S524986","DOIUrl":"10.2147/IDR.S524986","url":null,"abstract":"<p><strong>Objective: </strong>Early and precise diagnosis of tuberculous serous effusions is a huge challenge. Nanopore sequencing is a potentially efficient assay. The objective of the current study was to evaluate the diagnostic accuracy of nanopore sequencing for tuberculous serous effusions using clinical specimens directly, and to provide a new pathway for the early and precise diagnosis of tuberculous serous effusions.</p><p><strong>Methods: </strong>This was a retrospective analysis of the effectiveness of nanopore sequencing as a diagnostic method for tuberculous serous effusions using clinical specimens (pleural fluid, pericardial effusion, and ascitic fluid). Using clinical diagnosis as reference standard, the diagnostic accuracy indicators such as sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC) for the tests in question were evaluated.</p><p><strong>Results: </strong>In total, 132 patients were eligible for inclusion. Nanopore sequencing showed sensitivity of 93.3%, specificity of 85.2%, PPV of 96.1%, NPV of 76.7%, and AUC of 0.89 for tuberculous serous effusions. The diagnostic accuracy of nanopore sequencing was significantly superior than that of Xpert MTB/RIF and culture. Similar results were observed in different types of tuberculous serous effusions (pleural tuberculosis, pericardial tuberculosis, and peritoneal tuberculosis).</p><p><strong>Conclusion: </strong>Nanopore sequencing was efficient for the rapid diagnosis of tuberculous serous effusions and had a very positive effect. For paucibacillary tuberculous serous effusions, nanopore sequencing might become an effective method for detecting pathogenic bacteria.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"3661-3670"},"PeriodicalIF":2.9,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of EUCAST Rapid Antimicrobial Susceptibility Testing for Gram-Negative Bacteria Directly from Positive Blood Cultures.","authors":"Peng-Peng Tian, Hui Yang, Tian Wang, Li Wang, Meng-Yao Du, Shan-Shan Su, Li-Sha Zhu, Xian-Mo Wang, Liang-Cai Xie, Wen Fan, Tian Tian, Hua-Wei Yi","doi":"10.2147/IDR.S514981","DOIUrl":"10.2147/IDR.S514981","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to evaluate the accuracy of EUCAST rapid antimicrobial susceptibility testing (RAST) for Gram-negative bacteria directly from positive blood cultures, comparing it with short-term incubation (5-7 hours) and conventional broth microdilution methods.</p><p><strong>Methods: </strong>A total of 139 Gram-negative isolates were tested. RAST results were assessed at 4 h, 6 h against minimal inhibitory concentration results using the short-term incubation (5-7 h) method, while at 16-20 h, the RAST results were compared to conventional method. For those with interpretable results, CLSI M52 was used to define cutoffs for equivalence in antimicrobial susceptibility testing.</p><p><strong>Results: </strong>Among all isolates, 80.6% (112/139) were successfully interpreted based on EUCAST RAST breakpoints, including <i>Escherichia coli</i> (81), <i>Klebsiella pneumoniae</i> complex (17), <i>Pseudomonas aeruginosa</i> (10) and <i>Acinetobacter baumannii</i> (4). The overall category agreements for all tested antibiotics were 98.9%, 99.5%, and 99.7% at 4, 6, and 16-20 hours, respectively, for <i>E. coli</i>, and 100% for <i>K. pneumoniae, P. aeruginosa</i>, and <i>A. baumannii</i>. The area of technical uncertainty rate significantly decreased over time, from 9.1% at 4 hours to 3.1% at 16-20 hours (<i>p</i> < 0.05). The method effectively identified extended-spectrum beta-lactamase (ESBL)-producing and carbapenem-resistant bacteria, demonstrating performance comparable to the BD system. Additionally, results for other <i>Enterobacterales</i> could be interpreted using the RAST breakpoints for <i>E. coli</i>. The integration of RAST into routine workflows provides rapid and accurate results without incurring additional costs or labor.</p><p><strong>Conclusion: </strong>RAST is a reliable and cost-effective method for testing Gram-negative bacteria directly from blood cultures, significantly reducing turnaround time. Utilizing RAST at various reading times (6 hours and 16-20 hours) optimizes clinical workflows, enhances antimicrobial stewardship, and improves patient outcomes.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"3579-3590"},"PeriodicalIF":2.9,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12297011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Characterization, Risk Factors, and Mortality in Patients with Carbapenem-Resistant Hypervirulent <i>Klebsiella pneumoniae</i> Intra-Abdominal Infections.","authors":"Mingjie Qiu, Sai Tian, Liuqing Dou, Jiajie Wang, Li Xu, Meilin Wu, Zhitao Zhou, Jiayang Li, Wenqi Wu, Jianan Ren, Xiuwen Wu","doi":"10.2147/IDR.S529532","DOIUrl":"10.2147/IDR.S529532","url":null,"abstract":"<p><strong>Background: </strong>The outbreak of the highly lethal Carbapenem-resistant <i>Klebsiella pneumoniae</i> (CR-hvKP) strain is increasingly prevalent. The aim of this study was to investigate the epidemiology, molecular characteristics, and mortality rate in intra-abdominal infections (IAIs) caused by CR-hvKP in a tertiary hospital, providing scientific evidence for clinical treatment to reduce mortality and improve patient prognosis.</p><p><strong>Methods: </strong>The study included 160 patients who developed CRKP IAIs from June 2023 to December 2024. Carbapenemase and virulence genes were detected by Polymerase chain reaction assay. Antimicrobial susceptibility test was performed to determine drug resistance. Multivariate logistic regression and multivariate Cox regression were used to determine risk factors of CR-hvKP IAIs and CRKP IAIs mortality, respectively.</p><p><strong>Results: </strong>A total of 160 patients with CRKP IAIs were enrolled: 68 with CR-hvKP IAIs and 92 with CR-non-hvKP IAIs. The mortality rate trended higher in the CR-hvKP group compared with CR-non-hvKP (17.6% vs 10.9%), but the difference was not statistically significant (P=0.218). Multivariate logistic regression identified tracheotomy as a risk factor for infection with CR-hvKP IAIs (OR 2.816, 95% CI 1.120-7.080). Multivariate Cox regression analysis identified four independent risk factors for in-hospital mortality of CRKP IAIs: age (HR 1.066, 95% CI 1.020-1.114), decreased platelet count (HR 0.995, 95% CI 0.990-0.999), septic shock (HR 9.141, 95% CI 2.082-40.133), and tracheotomy (HR 4.322, 95% CI 1.461-12.791).</p><p><strong>Conclusion: </strong>The mortality rate was numerically higher in the CR-hvKP IAIs while the difference was not statistically significant. Our study identified tracheotomy as an independent risk factor for infection with CR-hvKP IAIs. Clinicians need to enhance their awareness and epidemiologic surveillance of this lethal bacterium.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"3647-3660"},"PeriodicalIF":2.9,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Medical Waste Segregation, Disposal Practices for Infectious and Sharps Waste in Healthcare Facilities in Somalia: Implications for Infection Prevention and Control.","authors":"Abdikarim Abdi Adam, Felix Emeka Anyiam, Mukhtar Abdi Shube, Hassan Dahir Mohamed, Hassan Abdi Ahmed, Nor Haji Osman","doi":"10.2147/IDR.S525134","DOIUrl":"10.2147/IDR.S525134","url":null,"abstract":"<p><strong>Background: </strong>Effective handling of healthcare waste is paramount for infection prevention, particularly in fragile environments such as Somalia. When infectious and sharps waste are not appropriately segregated and disposed of, Infectious diseases like HIV, hepatitis B and C, and tuberculosis can spread due to improper waste segregation and disposal, which poses a serious threat to public health. This study aims to assess the infectious and sharps waste management practices and waste segregation in Somalia's healthcare facilities.</p><p><strong>Methodology: </strong>A nationwide cross-sectional study was conducted in 2022/2023 by UNICEF, WHO, and the Federal Ministry of Health in Somalia. Data were collected from 423 healthcare facilities out of 1,410 using the WHO/UNICEF Joint Monitoring Programme (JMP) questionnaire. Simple random sampling ensured an objective and representative assessment.</p><p><strong>Results: </strong>Based on our study, more than 60% of healthcare facilities lacked proper waste segregation systems, and many reported insufficient colour-coded or covered bins. For infectious garbage, incineration was the most common approach (33.57%), whereas for sharps waste, pit burning was the most common option (52.48%). Geographic location and the type of waste management strategies used were significantly correlated (p < 0.001), indicating regional inequalities. These results draw attention to the numerous discrepancies and structural shortcomings in current systems for managing medical waste.</p><p><strong>Conclusion: </strong>Addressing gaps in waste management through policy enforcement, funding, and healthcare worker training is paramount to reducing healthcare-associated infections and improving healthcare safety in Somalia.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"3605-3615"},"PeriodicalIF":2.9,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12301244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}