Infection and Drug Resistance最新文献

{"title":"Pan-Genome-Wide Association Study Identifies Genetic Factors Associated with the Pathogenicity of Invasive Serotype 19F Streptococcus Pneumoniae.","authors":"Xing Shi, Sandip Patil, Qiuwei Yi, Zihao Liu, Heping Wang, Chunqing Zhu, Yunsheng Chen, Yuejie Zheng, Shaowei Dong, Yanmin Bao","doi":"10.2147/IDR.S519795","DOIUrl":"10.2147/IDR.S519795","url":null,"abstract":"<p><strong>Background: </strong><i>Streptococcus pneumoniae</i> is a common respiratory pathogen that poses significant health concerns in children, particularly serotype 19F strains that demonstrate high level of invasiveness in China. To investigate the genetic variations associated with high invasiveness of serotype 19F <i>S. pneumoniae</i> strains isolated from children in Shenzhen.</p><p><strong>Methods: </strong>We compared the genomic profiles of 42 invasive and 162 noninvasive strains from children's respiratory tracts and employed pan-genome-wide association methods to elucidate the origins of genetic variation.</p><p><strong>Results: </strong>Significant gene presence variability was observed between invasive and noninvasive strains, suggesting a genetic basis for their pathogenicity differences. Invasive 19F strains demonstrated enhanced adhesion in co-culture experiments with human epithelial cells, with adhesion abilities correlating with the presence of specific genes. Despite high non-susceptibility to common antibiotics across all strains, no significant differences in antimicrobial susceptibility patterns were found between invasive and noninvasive groups.</p><p><strong>Conclusion: </strong>Although genomic differences within serotype 19F were relatively minor, invasive and noninvasive strains exhibited significant differences in adherence and invasiveness in the host microenvironment. While the underlying regulatory mechanisms remain uncertain, genetic differences play a crucial role in determining the invasiveness of <i>S. pneumoniae</i> serotype 19F strains in children.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"2963-2975"},"PeriodicalIF":2.9,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316837","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":"The Negative Regulatory Role of Transcriptional Regulator H-NS on the Type VI Secretion System in <i>Acinetobacter baumannii</i>.","authors":"Yi Zhang, Huijing Zhou, Jingchun Kong, Panjie Hu, Yichi Zhang, Jianming Cao, Beibei Zhou","doi":"10.2147/IDR.S512650","DOIUrl":"10.2147/IDR.S512650","url":null,"abstract":"<p><strong>Introduction: </strong>This study investigates the negative regulatory role of the global transcriptional regulator H-NS (Histone-like Nucleoid Structuring Protein) on the Type VI secretion system (T6SS) in <i>Acinetobacter baumannii</i> (<i>A. baumannii</i>). We explored potential targets of H-NS mediated silencing or activation within the regulation of <i>A. baumannii</i> T6SS, along with the specific regulatory mechanisms involved, thereby providing a theoretical foundation for further research on <i>A. baumannii</i> invasive infections stemming from mixed infections and the development of therapeutic target.</p><p><strong>Methods: </strong>Using the plasmids pAT04 and pYMAb2-hyg, we constructed <i>A. baumannii</i> ATCC19606 strains with the <i>hns</i> gene knocked out (ABΔ<i>hns</i>) and overexpressed (AB<i>hns</i>+). We measured the expression of the T6SS-related gene <i>hcp</i> in wild-type (AB WT), ABΔ<i>hns</i>, and AB<i>hns</i>+ strains using RT-qPCR, combined with a mouse sepsis model featuring mixed infections. We assessed their serum resistance, competitive ability against <i>Escherichia coli</i> (<i>E. coli</i>), and blood invasion capability. Proteomic analysis identified differentially expressed proteins, and we further investigated the regulatory role of H-NS on <i>A. baumannii</i> T6SS using electrophoretic mobility shift assays (EMSA).</p><p><strong>Results: </strong>We successfully constructed both ABΔ<i>hns</i> and AB<i>hns</i>+ strains of <i>A. baumannii</i> ATCC19606. RT-qPCR results indicated that H-NS functions as a negative regulator of the T6SS-related gene <i>hcp</i> in <i>A. baumannii</i>. Phenotypic assays for extracellular virulence revealed that the loss of <i>hns</i> enhanced both the competitive ability and serum resistance of ATCC19606. Results from the mouse sepsis infection model demonstrated that knockout of <i>hns</i> significantly increased the bacterium's blood invasion capability. Bioinformatics analysis of differentially expressed proteins identified elevated levels of T6SS-related proteins in the knockout strain. Furthermore, EMSAs confirmed that H-NS directly binds to multiple sites in the upstream region of <i>hcp</i>.</p><p><strong>Conclusion: </strong>H-NS inhibits the expression of T6SS-related proteins in <i>A. baumannii</i> by regulating relevant targets associated with the T6SS. This regulation influences the bacterium's pathogenicity, interspecies competitive ability, and serum resistance.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"2997-3011"},"PeriodicalIF":2.9,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316839","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":"Retrospective Analysis of Factors Influencing Clinical Outcomes of Revision Surgery for Periprosthetic Infection After Unicondylar Knee Arthroplasty.","authors":"Xuyang Cao, Zizi Zhao, Cheng Zhang, Bo Gao, Ruifang Dong, Lijie Ma","doi":"10.2147/IDR.S517567","DOIUrl":"10.2147/IDR.S517567","url":null,"abstract":"<p><strong>Objective: </strong>To identify factors influencing clinical outcomes of revision surgery for periprosthetic joint infection (PJI) after unicondylar knee arthroplasty (UKA).</p><p><strong>Methods: </strong>This retrospective study included 40 patients who underwent UKA revision for PJI (May 2009-May 2023). Patients were divided into responders (n=27, favorable outcomes: no infection, KSS ≥80, HSS ≥85 at 6 months) and non-responders (n=13, suboptimal outcomes: persistent infection or KSS <80/HSS <85). Inflammatory markers (CRP, WBC), Knee Society Score (KSS), and Hospital for Special Surgery (HSS) score were assessed. Multivariate logistic regression identified predictors of success.</p><p><strong>Results: </strong>Non-responders had higher rates of diabetes (46.2% vs 14.8%), smoking (30.8% vs 18.5%), alcohol use (23.1% vs 14.8%), Gram-positive infections (30.8% vs 11.1%), and deep infections (84.6% vs 22.2%, all P<0.05). Key predictors of success included optimal antibiotic management (OR=1.33, 95% CI=1.02-1.74), patient compliance (OR=1.44, 95% CI=1.08-1.92), and absence of diabetes (OR=1.54, 95% CI=1.24-1.98), smoking (OR=1.60, 95% CI=1.08-2.37), or Gram-positive infections (OR=1.46, 95% CI=1.12-1.90, all P<0.05).</p><p><strong>Conclusion: </strong>Diabetes, smoking, alcohol use, Gram-positive infections, deep infection, antibiotic management, and compliance significantly impact UKA revision outcomes. Smoking showed the strongest association (OR=1.60). Clinicians should prioritize preoperative optimization (glycemic control, smoking cessation) and protocol-driven antibiotic use. Findings are exploratory due to small sample size and require validation in larger cohorts.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"2977-2986"},"PeriodicalIF":2.9,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316838","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":"Molecular Characteristics and Antimicrobial Resistance of Linezolid-Resistant <i>Staphylococcus aureus</i> in Osteoarticular Infections: A 11-Year Study From a Hospital in Xi'an.","authors":"Shan Zhou, Ke Zhou, Peihong Yang, Meijuan Kong, Hao Liu, Rui Zhang, Zheng Hou, Jiayun Liu","doi":"10.2147/IDR.S508027","DOIUrl":"10.2147/IDR.S508027","url":null,"abstract":"<p><strong>Purpose: </strong>This study examines the distribution of pathogens and the characteristics of linezolid-resistant <i>Staphylococcus aureus</i> (LRSA) in osteoarticular infections (OAIs) over an 11-year period.</p><p><strong>Methods: </strong>Identification and initial antimicrobial susceptibility testing were conducted using the VITEK2 compact system. Broth microdilution method (BMD) to confirm linezolid-resistant isolates. The results were interpreted according to the Clinical and Laboratory Standards Institute (CLSI) guideline. Polymerase chain reaction (PCR) screening identified linezolid-resistance-related genes and molecular typing loci.</p><p><strong>Results: </strong>From 2012 to 2022, 2049 clinical isolates were collected, with <i>S. aureus</i> identified as the leading pathogen, constituting 38.90% (797/2049) of cases. Among the 797 <i>S. aureus</i> isolates, eight strains were initially identified as LRSA through VITEK2; however, only one isolate was confirmed as LRSA by BMD. For the eight strains, molecular typing revealed four spa types (t030, t037, t002, t437) and three MLST types, with ST239-t030 as the dominant clone. No transferable resistance genes (<i>cfr, optrA, poxtA</i>) were detected, but a G2576T mutation, associated with reduced linezolid sensitivity, was identified in two isolates (included the isolate confirmed as LRSA by BMD) subjected to extended linezolid therapy.</p><p><strong>Conclusion: </strong>Our findings highlight the importance of accurate susceptibility testing and proactive monitoring of LRSA in the treatment of chronic OAIs to mitigate potential therapeutic challenges.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"2987-2996"},"PeriodicalIF":2.9,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316836","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":"The Association of Latent Tuberculosis Infection with Air Pollutant Exposure, Meteorological and Other Factors: A Retrospective Study in Eastern China of College Students.","authors":"Beibei Qiu, Zhengyuan Xu, Ruifen Miao","doi":"10.2147/IDR.S523064","DOIUrl":"10.2147/IDR.S523064","url":null,"abstract":"<p><strong>Objective: </strong>The associations between meteorological factors, air pollutant indicators, and latent tuberculosis infection (LTBI) have not yet been confirmed. This study aimed to assess the association of meteorological factors, air pollutant indicators, and other factors with LTBI among college students.</p><p><strong>Methods: </strong>We selected 5,193 freshmen randomly who originated from key tuberculosis areas in nine colleges in Nanjing. We ranked the importance of independent variables using Least Absolute Shrinkage and Selection Operator (LASSO) regression and random forest models. We then conducted a multi-model analysis after incorporating them into the prediction model. In addition, we adopted a calibration curve to determine the quality of the model. A nomogram was used to evaluate the possibility of using multiple models to predict LTBI risk.</p><p><strong>Results: </strong>We found that higher outdoor PM₁₀ concentrations (OR: 1.35; 95% CI: 1.10-1.65) was associated with LTBI. A history of allergies (OR: 1.37; 95% CI: 1.16-1.62) and coal-based fuels (OR: 1.44; 95% CI: 1.11-1.87) had a positive correlation with the occurrence of LTBI. Taking vitamin D supplements (OR: 0.82; 95% CI: 0.69-0.98) could reduce the risk of LTBI. Besides, age (OR: 1.11; 95% CI: 1.00-1.22) were significantly associated with strong positive populations.</p><p><strong>Conclusion: </strong>Higher outdoor PM₁₀ concentration, history of allergies, and use of coal-based fuels were positively correlated with the occurrence of LTBI. Vitamin D supplementation might reduce the risk of LTBI. Besides, older people were more likely to contribute to strong positive results.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"2951-2961"},"PeriodicalIF":2.9,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309825","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":"Bacterial Infectious Scleritis: A Case Report.","authors":"Qianqian Liang, Yuerong Wang, Xiubin Ma","doi":"10.2147/IDR.S514745","DOIUrl":"10.2147/IDR.S514745","url":null,"abstract":"<p><strong>Purpose: </strong>To report the outcomes of a case of bacterial infectious scleritis managed with thorough debridement and antibiotic irrigation therapy.</p><p><strong>Observations: </strong>A patient presented with severe infectious scleritis secondary to <i>Pseudomonas aeruginosa</i> subsequent to cataract surgery. The scleral abscess was cleaned completely and rinsed with ciprofloxacin every day in the treatment room. Over the next week, the conjunctival and scleral wounds healed. The patient's condition was observed to be stable over the next 3 months, and the uncorrected vision acuity in the treated eye improved to 0.22 logMAR.</p><p><strong>Conclusions and importance: </strong>This case highlights the utilization of thorough debridement and antibiotic irrigation to preserve the globe and good vision while treating severe infectious scleritis.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"2923-2927"},"PeriodicalIF":2.9,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12164874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301989","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":"HIV Transmission Misconceptions and Their Associated Factors Among Reproductive-Age Women in Somalia: Findings from a Nationwide Study.","authors":"Liban Ali Mohamud, Mohamed Abdulkadir Hassan-Kadle, Hamza Mohamed Abdullahi, Ahmed Ali Ahmed","doi":"10.2147/IDR.S514775","DOIUrl":"10.2147/IDR.S514775","url":null,"abstract":"<p><strong>Background: </strong>Human Immunodeficiency Virus (HIV) remains a significant public health challenge, particularly in low-resource settings, where limited knowledge contributes to its spread, especially among women facing socio-economic and educational barriers. This study examines the associations between misconceptions about HIV transmission and sociodemographic factors among Somali women. Identifying regions and groups with limited awareness will help prioritize targeted education and healthcare interventions, aligning with the National Strategic Plan (NSP).</p><p><strong>Methods: </strong>A multivariable Bayesian logistic regression model was used to analyze data from the 2018-2019 Somali Demographic and Health Survey (SDHS). This modeling approach was chosen for its ability to handle uncertainty and incorporate prior knowledge into the analysis. Bayesian adjusted odds ratios (BAORs) with 95% highest posterior density intervals (HPDIs) were calculated to determine significant associations between misconceptions and sociodemographic factors.</p><p><strong>Results: </strong>The study found that 67.18% of women had misconceptions about HIV transmission. Significant factors associated with misconceptions included age, education, wealth, and internet usage. Women aged 30-34 (BAOR = 0.94, 95% HPDI: 0.90-0.98), 35-39 (BAOR = 0.94, 95% HPDI: 0.90-0.98), and 40-44 (BAOR = 0.93, 95% HPDI: 0.89-0.98), women with secondary education (BAOR = 0.92, 95% HPDI: 0.88-0.95), women with higher education (BAOR = 0.84, 95% HPDI: 0.79-0.88), women in the highest wealth quintile (BAOR = 0.90, 95% HPDI: 0.86-0.95), and women who had never used the internet (BAOR = 1.06, 95% HPDI: 1.03-1.09).</p><p><strong>Conclusion: </strong>This study highlights the critical need for targeted interventions to reduce misconceptions about HIV transmission among Somali women. Policies should focus on educating younger women, promoting female education, implementing region-specific health interventions, and enhancing internet access and digital literacy, particularly in rural areas, to improve HIV knowledge and support public health efforts.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"2929-2942"},"PeriodicalIF":2.9,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12164838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301990","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":"The Effectiveness of Antiretroviral Therapy in Mitigating New HIV Infections in Southwest China: An Ecological Study.","authors":"Xiwei Sun, Hang Chen, Shu Liang, Ticheng Xiao, Yali Zeng, Hong Liu, Liao Feng, Dinglun Zhou","doi":"10.2147/IDR.S505706","DOIUrl":"10.2147/IDR.S505706","url":null,"abstract":"<p><strong>Background: </strong>Antiretroviral therapy (ART) has been shown to reduce the number of local HIV (Human Immunodeficiency Virus) reported cases; however, there is insufficient research on the relationship between new HIV infections and ART. This study utilized real-world data to evaluate the community-level effectiveness of ART in reducing new HIV infections.</p><p><strong>Methods: </strong>Ecological study was designed to establish the relationship between ART quality and new HIV infections. New HIV infections were identified through an expanded testing system in 2018-2023; ART quality was evaluated based on ART-treated clients in 2016-2023, and non-probabilistic sampling was performed. Generalized linear models was employed to assess associations between metrics of ART effectiveness and new HIV infections. Statistical significance was set at <i>α</i> = 0.05 with 95% confidence intervals.</p><p><strong>Results: </strong>A total of 3836 new HIV infections were identified, yielding an overall incidence of 2.1%. Treatment coverage for the entire population was 80.8%, and the proportion of clients with an increased CD4 count was 61.0% of the entire population. In the generalized linear modeling, four key factors were associated with reduced new HIV infections: a greater number of clients undergoing treatment, a higher proportion of clients demonstrated CD4 count improvement, higher level of CD4 in baseline, and a reduction in reported cases (<i>β</i> = -0.04, -0.03, -0.01, 0.17 respectively).</p><p><strong>Conclusion: </strong>This ecological study verified that expanding treatment coverage, optimizing the effectiveness of antiretroviral treatment and elevating baseline CD4 counts could curb community-level new HIV infections. Early detection, prompt treatment, and effective ART are crucial for curbing HIV transmission in regions mainly driven by sexual transmission and with high cumulative incidence rates.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"2943-2950"},"PeriodicalIF":2.9,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12165698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301991","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":"Real-World Effectiveness of Nirmatrelvir/Ritonavir in Hospitalized Older Adults with Severe Omicron COVID-19: A Retrospective Cohort Study from China.","authors":"Yangxi Chen, Lika Liu, Yu Liu, Fang Huang, Lei Guo, Wenhui Wan, Haiyang Jiang","doi":"10.2147/IDR.S518205","DOIUrl":"10.2147/IDR.S518205","url":null,"abstract":"<p><strong>Background: </strong>The real-world effectiveness of Nirmatrelvir/ritonavir (NMV/RTV) against the SARS-CoV-2 Omicron variant in older patients remains uncertain. We aimed to estimate the effectiveness in older patients aged 80 and above with severe COVID-19.</p><p><strong>Methods: </strong>A retrospective study analyzed 263 COVID-19 patients aged 80 and above, admitted to the Department of Geriatrics at Jinling Hospital, affiliated with Nanjing University, between December 15, 2022, and January 15, 2023. Among them, 136 cases were non-severe, and 127 were severe. The severe cases were further categorized into a survival group (n=74) and a death group (n=53) based on 28-day mortality. Kaplan-Meier survival curves assessed 28-day survival, and Cox regression models identified factors influencing survival.</p><p><strong>Results: </strong>Among the 127 severe cases, the death group had significantly higher rates of stroke history, renal impairment, endotracheal intubation, renal replacement therapy (RRT), bacterial infection, but significantly lower rates of NMV/RTV use and anticoagulation (p<0.05). Kaplan-Meier analysis indicated that NMV/RTV improved 28-day survival in severe older COVID-19 patients. Multivariate Cox regression identified NMV/RTV as a protective factor (adjusted hazard ratio [HR] 0.307, 95% confidence interval [<i>CI</i>] 0.152-0.620, <i>p</i>=0.001), while COPD (adjusted HR 2.993, 95% <i>CI</i> 1.563-5.731, <i>p</i>=0.001), stroke history (adjusted HR 3.871, 95% <i>CI</i> 1.953-7.671, <i>p</i><0.001), and endotracheal intubation (adjusted HR 5.058, 95% <i>CI</i> 2.809-9.108, <i>p</i><0.001) were significant risk factors for increased 28-day mortality.</p><p><strong>Conclusion: </strong>NMV/RTV may improve the 28-day survival rate of older patients aged 80 and above with severe COVID-19.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"2901-2909"},"PeriodicalIF":2.9,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12159130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144283773","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":"Molecular Characteristics and Phenotypical Analysis of Carbapenem-Resistant <i>K. Pneumoniae</i> in the Lüliang Region, Shanxi Province.","authors":"Huiyuan Wang, Zijiang Jia, Xiaoyan Li, Yan Hao, Jinjing Zhang, Xinyi Zhao, Hui Li, Sifan Jin","doi":"10.2147/IDR.S512203","DOIUrl":"10.2147/IDR.S512203","url":null,"abstract":"<p><strong>Introduction: </strong>To explore the resistance characteristics and molecular features of carbapenem-resistant <i>K. pneumoniae</i> (<i>CRKP</i>) isolates prevalent in the Lüliang region, 81 <i>CRKP</i> isolates were collected from three hospitals in the Lüliang region, Shanxi Province.</p><p><strong>Methods: </strong>The resistance of these <i>CRKP</i> isolates to 11 antibiotics was determined using the disk diffusion method, and antimicrobial resistance encoding genes and virulence genes were detected by PCR. The mucoid phenotype of the <i>CRKP</i> isolates was examined via the string test, and bacterial biofilm formation ability was measured using the crystal violet staining method.</p><p><strong>Results: </strong>The resistance rates of the 81 <i>CRKP</i> isolates to the 11 antibiotics ranged from 62.96% to 100%, with a multidrug resistance rate of 83.95%. The resistance genes <i>bla_SHV, bla_TEM</i> and <i>bla_KPC</i> were the most widely distributed, with a detection rate of 100%. Among the 81 <i>CRKP</i> isolates, 70 had the ability to form biofilms, and 58 presented highly mucoid phenotypes. The virulence genes <i>rmpA2, peg-344</i>, and <i>fimH</i> presented high carriage rates of 92.59%, 91.36%, and 88.89%, respectively. The carriage rate of <i>IroB</i> was low, at 20.99%. Among these genes, <i>fimH, rmpA2</i>, and <i>iucA</i> were associated with biofilm formation, while <i>markD</i> and <i>fimH</i> were associated with a highly mucoid phenotype, and the highly mucoid phenotype was strongly correlated with the biofilm formation ability.</p><p><strong>Conclusion: </strong>This study revealed that the <i>CRKP</i> strains isolated in the Lüliang region of Shanxi Province were strongly resistant and that this resistance was related to virulence characteristics. Therefore, antibiotic management should be strengthened in clinical practice to control the prevalence of <i>CRKP</i> in this region.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"2911-2921"},"PeriodicalIF":2.9,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12153953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274779","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}