Infection and Drug Resistance最新文献

{"title":"From Phenotype to Genotype: A Clonal Perspective on Virulence and Biofilm Formation in Bloodstream-Derived <i>Escherichia coli</i>.","authors":"Amirreza Shalipour, Niloofar Kiaheyrati, Hamseh Ali Hossien, Fatemeh Fardsanei, Mohammadmahdi Bahari, Farhad Nikkhahi","doi":"10.2147/IDR.S627946","DOIUrl":"10.2147/IDR.S627946","url":null,"abstract":"<p><strong>Background: </strong>Bloodstream infections, BSIs caused by <i>Escherichia coli</i> are a major healthcare concern due to the increasing emergence of multidrug-resistant and virulent strains. This study aimed to investigate the phenotypic and genotypic characteristics of bloodstream-derived <i>E. coli</i> isolates, with a focus on antimicrobial resistance, biofilm formation, virulence-associated genes, phylogenetic distribution, and clonal diversity.</p><p><strong>Methods: </strong>A total of 150 blood culture samples were collected from patients with suspected BSIs, of which 60 (40%) <i>E. coli</i> isolates were recovered and confirmed using conventional microbiological methods. Antimicrobial susceptibility testing was performed according to the CLSI2026 guidelines, whereas biofilm formation was assessed using a microtiter plate assay. Virulence genes, phylogenetic groups, and clonal relationships were evaluated using polymerase chain reaction-based, PCR methods.</p><p><strong>Results: </strong>High susceptibility rates were observed for colistin (96.7%) and meropenem (93.3%), whereas the highest rates of resistance were detected against ciprofloxacin (93.3%) and co-trimoxazole (61.7%). Multidrug resistance, MDR was detected in 41.7% of the isolates, while 31.7% were phenotypically characterized as Extended-Spectrum Beta-Lactamase, ESBL producers. Biofilm analysis revealed that 75% of the isolates were capable of biofilm formation. Among the investigated virulence genes, <i>fimH</i> (88.3%), <i>ompT</i> (73.3%), and <i>irp2</i> (58.3%) were most prevalent. Phylogenetic analysis revealed a predominance of groups B2 (26.7%), B1 (23.3%), and D (23.3%). The ERIC-PCR analysis classified the isolates into 26 distinct ERIC types, indicating substantial genetic diversity.</p><p><strong>Conclusion: </strong>The coexistence of virulence-associated genes, biofilm-forming ability, antimicrobial resistance, and genetic diversity among bloodstream-derived <i>E. coli</i> isolates highlights the circulation of potentially high-risk lineages in healthcare environments. These observations underscore the necessity for ongoing molecular epidemiological monitoring and the implementation of effective infection control strategies.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"627946"},"PeriodicalIF":3.2,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887458","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":"Fatal Tension Pneumocephalus Associated with Central Nervous System Infection Caused by an Extended-Spectrum β-Lactamase-Producing <i>Klebsiella pneumoniae</i> Harboring Hypervirulence-Associated Genes.","authors":"Xianyu Zhu, Ying Gao, Jiayan Zhang, Lifeng Sun, Min Peng, Yan Cui, Keliang Xie","doi":"10.2147/IDR.S631108","DOIUrl":"10.2147/IDR.S631108","url":null,"abstract":"<p><strong>Background: </strong>Central nervous system (CNS) infections caused by <i>Klebsiella pneumoniae</i> harboring hypervirulence-associated genes usually arise from metastatic dissemination from an extracranial focus. Cases lacking an overt extracranial source remain uncommon. Furthermore, the spontaneous development of tension pneumocephalus in this context is exceptionally rare.</p><p><strong>Case presentation: </strong>We report a fatal case of a 49-year-old female with a 40-year history of polycystic liver and kidney disease who presented with fulminant meningoencephalitis. Despite aggressive systemic meropenem therapy and neuroprotective measures, she developed refractory intracranial hypertension (780 mmH₂O) and rapidly progressive tension pneumocephalus without evidence of neurotrauma or external anatomical breach. Blood and cerebrospinal fluid (CSF) cultures, alongside CSF metagenomic next-generation sequencing (mNGS), identified an extended-spectrum β-lactamase (ESBL)-producing <i>K. pneumoniae</i>. The isolate exhibited a hypermucoviscous phenotype and harbored multiple hypervirulence-associated genes (eg, rmpA, iucA, and iroB) alongside resistance determinants (CTX-M-15-like and AAC(6')-Ib-cr), supporting a probable convergent phenotype. The patient ultimately died from irreversible multiple organ dysfunction syndrome on day 7.</p><p><strong>Conclusion: </strong>The rapid evolution of tension pneumocephalus in this case highlights the potential for abrupt neurological deterioration in CNS infections associated with convergent <i>K. pneumoniae</i> phenotypes. While the exact etiology of intracranial gas is likely multifactorial, this case underscores the critical need to integrate phenotypic assays with molecular diagnostics to identify hypervirulence, while maintaining rigorous differential diagnoses for spontaneous pneumocephalus in the neurocritical care setting.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"631108"},"PeriodicalIF":3.2,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887387","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":"Pediatric Bloodstream Infections in Eastern Democratic Republic of the Congo: Epidemiology, Antimicrobial Resistance Patterns, and Predictors of Mortality.","authors":"Isia Nanci Francisca, Joe Bwija Kasengi, Joseph Ntagerwa Ntaganzibwa, Germain Mudumbi Zabaday, Oreste Battisti, Dimitri Van der Linden, David Lupande Mwenebitu, Richard Mbusa Kambale","doi":"10.2147/IDR.S622068","DOIUrl":"10.2147/IDR.S622068","url":null,"abstract":"<p><strong>Background: </strong>Bloodstream infections (BSI) are a major cause of pediatric morbidity and mortality in low- and middle-income countries, yet microbiological surveillance data remain limited in Central Africa. We aimed to characterize the epidemiology, microbiological spectrum, antimicrobial resistance (AMR) patterns, and predictors of mortality among children with culture-confirmed BSI in eastern Democratic Republic of the Congo (DRC).</p><p><strong>Methods: </strong>We conducted a retrospective cohort study at Hôpital Provincial Général de Référence de Bukavu, a tertiary referral hospital in eastern DRC. Children aged 29 days to 18 years admitted with clinically suspected sepsis between June 2020 and December 2024 were eligible. Blood cultures classified as contaminants according to predefined microbiological criteria were excluded. Clinical, microbiological, and antimicrobial susceptibility data were extracted from hospital and laboratory records. Multivariable logistic regression was used to identify independent predictors of in-hospital mortality.</p><p><strong>Results: </strong>Among 123 children with culture-confirmed bacteremia, 123 clinically significant bacterial isolates were identified and in-hospital mortality was 9.8% (12/123). Gram-negative bacteria predominated (84/123; 68.3%), with <i>Salmonella</i> spp. (27/123; 22.0%) and <i>Enterococcus</i> spp. (25/123; 20.3%) being the most frequently isolated pathogens. Among the main Gram-negative pathogens, resistance to amoxicillin-clavulanate was 100.0% in <i>Salmonella</i> spp. (24/24), <i>K. pneumoniae</i> (11/11), and <i>E. coli</i> (10/10), whereas amikacin resistance ranged from 0.0% (0/24) in <i>Salmonella</i> spp. to 23.1% (3/13) in <i>K. pneumoniae</i>; no meropenem resistance was detected among isolates tested. In multivariable analysis, altered level of consciousness was associated with higher odds of in-hospital mortality (aOR 12.83; 95% CI 1.54-107.09). Model discrimination was acceptable (AUROC 0.71; 95% CI 0.55-0.87).</p><p><strong>Conclusion: </strong>Pediatric BSI in eastern DRC were predominantly caused by Gram-negative pathogens and showed substantial resistance to commonly used antibiotics. Altered level of consciousness was associated with higher odds of in-hospital mortality. Strengthening microbiological surveillance, diagnostic stewardship, and antimicrobial stewardship is essential to optimize empiric therapy and improve pediatric sepsis outcomes.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"622068"},"PeriodicalIF":3.2,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880024","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":"Tibetan Medicine Liuwei Dingxiang Pills Decoction Inhibits <i>Pseudomonas aeruginosa</i> via Fatty Acid Metabolic Reprogramming and Lipid Peroxidation Revealed by Untargeted Metabolomics.","authors":"Ping He, Ling Yi, Shuyao Ren, Zhen Ci, Cuomu Yixi, Xiaokang Hao, Yanli Zhang, Xiaoxing Liu, Xiaoli Zhu, Datao Lin, Jehangir Khan, Caixia Wu","doi":"10.2147/IDR.S625113","DOIUrl":"10.2147/IDR.S625113","url":null,"abstract":"<p><strong>Background: </strong><i>Pseudomonas aeruginosa</i> is a major opportunistic pathogen and poses threat to public health. Traditional medicines are a valuable source of novel antibacterial agents. Liuwei Dingxiang Pills, a classical Tibetan formulation, have demonstrated clinical efficacy, but the antibacterial mechanisms remain unclear. This study evaluated the antibacterial effect and mechanism against <i>P. aeruginosa</i> via untargeted metabolomics.</p><p><strong>Methods: </strong>Minimum inhibitory concentration (MIC) were determined using agar diffusion and broth microdilution methods. Bacterial growth curves were plotted for different concentrations. Chemical constituents of the decoction and the bacterial metabolic profiles during the logarithmic phase were analyzed using high-performance liquid chromatography-mass spectrometry (HPLC-MS/MS). Differential metabolites were annotated and assessed through KEGG (Kyoto Encyclopedia of Genes and Genomes) enrichment analysis.</p><p><strong>Results: </strong>The decoction contained multiple bioactive compounds including gallic acid, homoorientin, corilagine, isovitexin, swertiamarin, isoalantolactone, coumarin, etc. It significantly inhibited all nine tested <i>P. aeruginosa</i> strains, with inhibition zones positively correlated with drug concentration. The MIC was 50 mg/mL. Untargeted metabolomics after sub-MIC treatment identified 346 differential metabolites (<i>p</i> < 0.05), 281 were upregulated and 65 were downregulated. Notably, the oxidation products of linoleic acid (8-HPODE, 9/13-HODE, 9/13-OxoODE) and other derivatives 9,10-DHOME, 12,13-DHOME and γ-linolenic acid were significantly increased. Additionally, alpha-linolenic acid and traumatin in the α-linolenic acid pathway were also elevated. KEGG analysis indicated the activation of linolenic acid and α-linolenic acid metabolic pathways, suggesting that unsaturated fatty acid metabolism is the primary target of antibacterial action.</p><p><strong>Conclusion: </strong>Metabolomics analysis indicated that Liuwei Dingxiang Pills exert antibacterial effects through a mechanism involving multiple components and targets, synergistically inducing membrane disruption and endogenous oxidative stress, thereby triggering extensive linoleic acid-centered lipid peroxidation and metabolic reprogramming in <i>P. aeruginosa</i>. This novel mechanism provides theoretical basis for development of new antibacterial strategies targeting bacterial lipid metabolism.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"625113"},"PeriodicalIF":3.2,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13526912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864832","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":"<i>Stenotrophomonas maltophilia</i> in the Antimicrobial Resistance Era: Species-Complex Taxonomy, Pathogenesis, Evolving Therapeutic Priorities, and Genomic Surveillance.","authors":"Rong Sun, Xiaoli Cao, Qianjin Sun","doi":"10.2147/IDR.S627852","DOIUrl":"10.2147/IDR.S627852","url":null,"abstract":"<p><p><i>Stenotrophomonas maltophilia</i> is a globally distributed, aerobic, non-fermenting Gram-negative bacillus increasingly recognized as an opportunistic pathogen in hospitalized and immunocompromised patients. Clinical interpretation is challenging because respiratory and device-associated isolates may represent colonization, polymicrobial infection, or true invasive disease. Recent genomic studies further suggest that organisms historically identified as <i>S. maltophilia</i> comprise a genetically diverse species complex, with implications for epidemiology, virulence, resistance surveillance, and susceptibility testing. Treatment is difficult because of biofilm formation, persistence in water-associated healthcare reservoirs, and intrinsic or acquired resistance mediated by L1 and L2 β-lactamases, multidrug efflux pumps, reduced permeability, mobile resistance determinants, and biofilm-associated tolerance. Current IDSA guidance identifies cefiderocol monotherapy as the preferred treatment for invasive <i>S. maltophilia</i> infection, whereas aztreonam-avibactam and agents such as trimethoprim-sulfamethoxazole, levofloxacin, and minocycline occupy alternative or combination-based roles. Nevertheless, the therapeutic evidence base remains uneven, and clinical decisions should integrate infection severity, source control, susceptibility findings, pharmacokinetic/pharmacodynamic (PK/PD) exposure, toxicity, infection site, and host-related factors. This review summarizes advances in taxonomy, epidemiology, pathogenesis, diagnostics, resistance, treatment, infection prevention, and genomic surveillance, and highlights the need for standardized identification, validated breakpoints, prospective comparative-effectiveness studies, and pragmatic or adaptive trial designs.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"627852"},"PeriodicalIF":3.2,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13532890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873870","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":"High Prevalence of ESBL-Producing Enterobacteriaceae and Antimicrobial Resistance Patterns in a Tertiary Care Hospital in Mogadishu, Somalia: A Retrospective Cross-Sectional Study.","authors":"Liban Abdi Nor, Ahmed Hassan Ibrahim, Serpil Doğan, Hanan Hassan Hirei, Said Mohamed Mohamud, Abdulrahman Nor Abdi, Yahye Sheikh Abdulle Hassan","doi":"10.2147/IDR.S630945","DOIUrl":"10.2147/IDR.S630945","url":null,"abstract":"<p><strong>Background: </strong>Extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae are a major global public health threat because of resistance to third-generation cephalosporins and frequent multidrug resistance. Data from Somalia remain limited. This study determined the prevalence of ESBL production, antimicrobial resistance patterns, and associated clinical and demographic factors.</p><p><strong>Methods: </strong>A retrospective cross-sectional study was conducted on 369 non-duplicate clinical Enterobacteriaceae isolates collected from inpatient and outpatient departments of a tertiary care hospital in Mogadishu, Somalia, between April and December 2025. ESBL production was detected using the combination disc test according to Clinical Laboratory Standards Institute (CLSI) guidelines. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion method and E-test. Multidrug resistance (MDR) was defined as resistance to at least one agent in three or more antimicrobial classes. Associations were assessed using Pearson's chi-square test.</p><p><strong>Results: </strong>Overall, 71.27% (263/369) of isolates were ESBL producers and 48.78% (180/369) were MDR. <i>Escherichia coli</i> (59.35%) was the predominant isolate, followed by <i>Klebsiella</i> spp. (30.62%) and <i>Enterobacter</i> spp. (5.15%). High resistance (>68%) to third- and fourth-generation cephalosporins was observed across major species. Meropenem resistance was highest in <i>Enterobacter</i> spp. (63.16%). Hospital department was significantly associated with ESBL production (p = 0.003) and MDR (p = 0.004), with the highest burden in the intensive care unit. Gender was associated with ESBL production (p = 0.034), while organism type was associated with MDR (p = 0.044).</p><p><strong>Conclusion: </strong>The high prevalence of ESBL-producing and multidrug-resistant Enterobacteriaceae, particularly in intensive care settings, highlights the need for strengthened antimicrobial stewardship, enhanced infection prevention and control, and continuous antimicrobial resistance surveillance.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"630945"},"PeriodicalIF":3.2,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13532642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873897","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":"Safety and Virological Outcomes of a Modified Albuvirtide Intensification Regimen with Standard ART in People with HIV.","authors":"Caiqin Hu, Xiaotang Zhou, Lingling He, Xueling Zhu, Qing Cao, Bohao Dai, Junwei Su, Huiting Liu, Jiaying Qin, Jingjing Wang, Biao Zhu","doi":"10.2147/IDR.S617345","DOIUrl":"10.2147/IDR.S617345","url":null,"abstract":"<p><strong>Background: </strong>To control HIV-1 viral load and maintain optimal immune function, albuvirtide (ABT) combined with antiretroviral therapy (ART) is used in designated AIDS hospitals in China. However, the standard weekly 320-mg ABT injection regimen poses adherence-related challenges. This study explored the safety and virological outcomes of a modified ABT intensification regimen in people with HIV.</p><p><strong>Methods: </strong>This single-arm, uncontrolled prospective cohort enrolled 20 people with HIV who received intravenous ABT 320 mg for three consecutive days every four weeks while continuing their baseline ART regimens. Peripheral blood samples were collected to measure alanine aminotransferase (ALT), aspartate aminotransferase (AST), triglyceride (TAG), cholesterol, CD4⁺ T-cell counts, HIV-RNA levels, and plasma ABT concentrations.</p><p><strong>Results: </strong>No adverse events considered related to ABT were observed in this cohort. Pharmacokinetic analysis demonstrated sustained therapeutic exposure, with mean trough concentrations of 4.71 mg/L, 3.83 mg/L, and 4.53 mg/L at Weeks 4, 8, and 12, respectively, each exceeding 50-fold the IC₉ ₀. During follow-up, mean HIV-RNA decreased from 1.65 log₁₀ copies/mL at baseline to 0.59 log₁₀ copies/mL at Week 12 (mean reduction: 1.06 log₁ ₀ copies/mL; <i>P</i> = 0.0007). Among patients with baseline HIV-RNA above 20 copies/mL, the viral load decreased from 2.55 to 1.43 log₁₀ copies/mL.</p><p><strong>Conclusion: </strong>Preliminary results demonstrate that 4-week ABT antiviral intensification regimen is feasible and exhibits potential antiviral activity.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"617345"},"PeriodicalIF":3.2,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864839","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":"Investigation of Antimicrobial Resistance Genes and Clonal Relatedness of Outbreak-Associated <i>Salmonella</i> Enteritidis Isolates Using PFGE.","authors":"Farhad Nikkhahi, Fatemeh Zeynali Kelishomi, Mohammad Mehdi Soltan Dallal, Anita Fardsanei, Fatemeh Fardsanei","doi":"10.2147/IDR.S635566","DOIUrl":"10.2147/IDR.S635566","url":null,"abstract":"<p><strong>Purpose: </strong><i>Salmonella</i> Enteritidis is one of the most common causes of gastroenteritis outbreaks. Detailed characterization of outbreak-associated isolates is essential for understanding local epidemiology, antimicrobial resistance patterns, and transmission dynamics. Epidemiological investigations of these strains can help to control the spread of this bacterium.</p><p><strong>Methods: </strong>In the current study, 27 strains of <i>S</i>. Enteritidis were isolated from patients with gastroenteritis. Antibiotic resistance of these strains was determined using phenotypic and genotypic methods. Biofilm formation ability was evaluated using the microtiter method. The strains were clustered using pulsed-field gel electrophoresis (PFGE) with <i>Avr</i>II.</p><p><strong>Results: </strong>The highest rate of antibiotic resistance was associated with cefuroxime (74.1%). Five antibiotic-resistance genes were detected, and all of them were <i>bla</i> _TEM. Of 27 strains, 96.3% were biofilm producers. According to PFGE results, the studied strains were all included in one clone.</p><p><strong>Conclusion: </strong>This study provides data on the antimicrobial susceptibility and high biofilm-forming capacity of outbreak-associated <i>S</i>. Enteritidis isolates in Iran. The limited genetic diversity observed by PFGE highlights the clonal nature of these strains and suggests that combining PFGE with additional DNA-based methods is beneficial for an accurate diagnosis.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"635566"},"PeriodicalIF":3.2,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13526381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864820","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":"Antimicrobial Resistance Profiles of Bacterial Isolates from Purulent Specimens in Women and Children: A Six-Year Retrospective Study in Central China.","authors":"Sijing Liu, Meng Ye, Lei Xi, Bangxian Ding, Yijian Zhou","doi":"10.2147/IDR.S632047","DOIUrl":"10.2147/IDR.S632047","url":null,"abstract":"<p><strong>Objective: </strong>To analyze pathogenic distribution, temporal trends, age-specific differences, and antimicrobial resistance (AMR) profiles of purulent specimens from a Central China women-and-children hospital, to guide empirical antimicrobial therapy and stewardship.</p><p><strong>Methods: </strong>This single-center, retrospective study included 6767 purulent specimens (including wound exudates, abscess pus and surgical site secretions, among others) collected between 2019 and 2024 at a tertiary hospital in Central China. Bacterial identification and AMR testing followed CLSI standards; data were analyzed <i>via</i> WHONET 5.6 and GraphPad Prism.</p><p><strong>Results: </strong>4,676 (69.1%, N=6,767) strains were isolated. <i>Escherichia coli</i> (33.2%) and <i>Staphylococcus aureus</i> (19.7%) were predominant. Distinct age-specific spectra were observed, along with an apparent increase in the isolation rate of <i>Pseudomonas aeruginosa</i> over the study period. <i>Escherichia coli</i> exhibited the highest resistance rates, particularly to ampicillin (79.9%), and <i>Staphylococcus aureus</i> to penicillin G (95.4%), while carbapenems and amikacin retained high <i>in</i> <i>vitro</i> activity against the major Gram-negative isolates.</p><p><strong>Conclusion: </strong>Purulent infections present age-specific pathogenic spectra. <i>E. coli</i> and <i>S. aureus</i> are core pathogens; the observed increase in <i>P. aeruginosa</i> isolation over the study period warrants continued surveillance. Individualized therapy should be based on age and AMR data.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"632047"},"PeriodicalIF":3.2,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13526390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864786","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":"Lymphopenia is Associated with Altered Pathogen Distribution and Increased Disease Severity in Viral Pneumonia: A Multicenter Retrospective Cohort Study.","authors":"Yanrui Wu, Xiaoqi Zhang, Lan Yang, Nan Su, Lijuan Li","doi":"10.2147/IDR.S604191","DOIUrl":"10.2147/IDR.S604191","url":null,"abstract":"<p><strong>Background: </strong>Lymphopenia is common in viral pneumonia and has been associated with adverse outcomes. However, its relationship with pathogen distribution, mixed infections, and opportunistic infections across different immune statuses remains incompletely characterized.</p><p><strong>Methods: </strong>We conducted a multicenter retrospective cohort study including 2363 adult patients hospitalized with viral pneumonia, of whom 690 were immunocompromised. Patients were stratified into four groups according to immune status and lymphocyte count on admission. Clinical characteristics, laboratory parameters, pathogen profiles, and clinical outcomes were compared across groups. Multivariable logistic regression analyses were performed to identify factors independently associated with in-hospital mortality.</p><p><strong>Results: </strong>Patients with lymphopenia had more severe clinical presentations, higher inflammatory and coagulation markers, and increased severity scores than those without lymphopenia. Across both immune-status strata, patients with lymphopenia had higher observed rates of respiratory failure, invasive mechanical ventilation, ECMO, and in-hospital mortality than those without lymphopenia. Pathogen analyses demonstrated marked differences in pathogen distribution across groups. Immunocompromised patients with lymphopenia showed significantly higher proportions of bacterial co-infections, fungal infections, and mixed infections, particularly involving Aspergillus flavus, Pneumocystis jirovecii, <i>Acinetobacter baumannii</i>, and <i>Pseudomonas aeruginosa</i>. Viral co-infections with human herpesvirus-1 and cytomegalovirus were also more frequent in this group. In multivariable analyses, lymphopenia, advanced age, elevated D-dimer levels, bacterial co-infection, and pre-admission corticosteroid use were independently associated with in-hospital mortality. Overall in-hospital mortality in the cohort was 16.7%, with the highest mortality observed in immunocompromised patients with lymphopenia (27.4%) and the lowest in immunocompetent patients without lymphopenia (7.3%).</p><p><strong>Conclusion: </strong>Lymphopenia is associated with altered pathogen distribution, increased mixed and opportunistic infections, and worse clinical outcomes in viral pneumonia, independent of underlying immune status. Lymphocyte count represents a readily available clinical marker reflecting immune dysfunction and infection complexity, highlighting the need for heightened vigilance and comprehensive pathogen evaluation in patients with viral pneumonia and lymphopenia.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"604191"},"PeriodicalIF":3.2,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13526392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864827","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}