Infection and Drug Resistance最新文献

{"title":"Appendiceal Perforation and Abdominal Wall Infection Caused by Invasive Mucormycosis in a Child with Acute Leukemia.","authors":"Chuanxin Li, Yonghan Luo, Yanchun Wang, Qiang Bai","doi":"10.2147/IDR.S504206","DOIUrl":"10.2147/IDR.S504206","url":null,"abstract":"<p><p>Gastrointestinal mucormycosis is one of the most difficult forms of the disease to diagnose due to its lack of specific clinical features. It is extremely rare to observe gastrointestinal mucormycosis in pediatric acute leukemia patients undergoing chemotherapy. In this report, we describe a case of a child with acute leukemia who developed invasive mucormycosis, leading to appendiceal perforation and abdominal wall infection. Initially, surgical intervention was delayed due to concerns over exacerbating bone marrow suppression, which ultimately resulted in the progression of the intra-abdominal infection. However, after thorough debridement of the abdominal wall infection and treatment with liposomal amphotericin B, the patient gradually recovered. This case highlights the importance of early and complete debridement of abdominal wall infections and intra-abdominal abscesses to prevent the further spread of mucormycosis, shorten the course of the disease, and improve outcomes.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"495-498"},"PeriodicalIF":2.9,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079649","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":"Azithromycin in the Management of Upper Respiratory Tract Infections (URTIs): Indian Real-Life Experience.","authors":"Mathew Dominic, Rakesh Srivastava, Kshitij Shah, Sudhir M Naik, Khageswar Rout, Bidhan Ray, Dinesh Patil, Darshan Rana, Onkar C Swami","doi":"10.2147/IDR.S488479","DOIUrl":"10.2147/IDR.S488479","url":null,"abstract":"<p><strong>Objective: </strong>Upper Respiratory Tract Infections (URTIs) pose a significant public health challenge worldwide. Azithromycin has been approved for its management due to broad-spectrum antibacterial properties and favorable pharmacokinetics. This study aims to evaluate the effectiveness and safety of Azithromycin in treatment of URTIs in a real-world setting.</p><p><strong>Methods: </strong>This multicenter, retrospective, observational study was conducted across 184 Ear, Nose, and Throat (ENT) clinics in India. Medical records of adults (≥18 years) who received Azithromycin 500 mg for 5 days to treat URTIs and provided consent were retrieved. Sore throat, fever, and interference with daily activities were assessed alongside clinical signs (pharyngeal erythema, tonsillar erythema, and exudates/plugs on tonsils). Clinical global impression of change was evaluated using a 7-point rating scale. Statistical analyses included paired <i>t</i>-tests for mean score changes and the McNemar-Bowker test to evaluate symptom improvement from baseline to day 5.</p><p><strong>Results: </strong>Data from 884 patients were analyzed. With 5 days of Azithromycin therapy, significant reduction in proportion of patients reporting URTI symptoms and signs was noted. Proportion of patients reporting sore throat was reduced from 95.8% to 10.4%; work absenteeism dropped from 47.9% to 1%; and fever subsided in 97.4% of patients. Clinical signs also improved notably, with moderate-to-severe pharyngeal erythema (90.9% of patients at baseline to 13.6% at day 5), tonsillar erythema (84% of patients at baseline to 9.6%), and tonsillar exudates (58.3% patients at baseline to 4.4%). Also, 97.2% of patients showed considerable improvement in their Clinical Global Impression score with Azithromycin. Adverse events were reported by 2.37% of patients.</p><p><strong>Conclusion: </strong>Azithromycin demonstrates a significant improvement in clinical manifestations of URTIs, with a low incidence of adverse events.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"523-531"},"PeriodicalIF":2.9,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079720","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 and Transmission Characteristics of <i>Mycobacterium Tuberculosis</i> Strains Among College Students in Beijing, China.","authors":"Xiaolong Cao, Xinyue Li, Zexuan Song, Ping He, Ruiqing Zhang, Chong Teng, Qian Sun, Xue Wang, Bing Zhao, Zhiguo Zhang, Yanlin Zhao","doi":"10.2147/IDR.S503797","DOIUrl":"10.2147/IDR.S503797","url":null,"abstract":"<p><strong>Background: </strong>College students are a crucial link in curbing the epidemic. The aim of this study is to analyze the genetic diversity and drug resistance of <i>Mycobacterium tuberculosis</i> strains in college students with tuberculosis in Beijing, revealing the lineage structure and transmission patterns specific to this group.</p><p><strong>Methods: </strong>This study used the hospital's electronic management system to screen for tuberculosis among college students in Changping District, Beijing, from January 2004 to December 2023. Socio-demographic and clinical data were collected, and whole-genome sequencing was performed on culture-positive isolates. Isolates with a genetic distance of less than 12 SNPs were grouped into the same genomic cluster. The TB Profiler software predicted drug resistance mutations, and categorical data were analyzed using Chi-square or Fisher's exact tests.</p><p><strong>Results: </strong>Among the 1436 college students with tuberculosis, a total of 153 isolates successfully underwent whole-genome sequencing. The results showed that about one-third (49/153) of the isolates carried one or more drug resistance genes, with more than half (26/49) associated with first-line anti-tuberculosis drugs. However, encouragingly, the incidence of drug-resistant tuberculosis showed a significant downward trend, with statistical significance (<i>p</i><0.05). Lineage 2 (86.3%, 132/153) was the predominant genotype, with the Beijing genotype (90.1%, 120/153) being the most common, while the isolation of Lineage 3 in a student from Xinjiang. Sixteen college student isolates clustered, and all of which were Beijing genotype. Transmission within the same campus showed characteristics of short clustering time.</p><p><strong>Conclusion: </strong>The drug resistance rate among college students is relatively high, however it shows a declining trend. School tuberculosis infections could stem not only from within-campus transmission but also necessitate consideration of spatial and cross-regional spread possibilities.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"499-509"},"PeriodicalIF":2.9,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079722","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":"Advances in the Diagnosis of Latent Tuberculosis Infection.","authors":"Haiying Zhang, Weiwei Guan, Jikun Zhou","doi":"10.2147/IDR.S504632","DOIUrl":"10.2147/IDR.S504632","url":null,"abstract":"<p><p>Latent tuberculosis infection (LTBI) is a critical stage of tuberculosis infection in which Mycobacterium tuberculosis (MTB) is dormant and does not cause active disease. Traditionally, the most commonly used clinical methods for diagnosing LTBI have been the tuberculin skin test (TST) and the interferon-gamma release assay (IGRA). Recently, however, novel skin tests, molecular biology techniques, and cytokine biomarkers have been developed. This review summarizes the latest research on the diagnosis of LTBI, highlighting new tools and methods to improve detection and differentiation from active tuberculosis(ATB).</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"483-493"},"PeriodicalIF":2.9,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11776534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065440","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":"Epidemiology, Clinical Characteristics and Treatment Outcomes of <i>Acinetobacter baumannii</i> Infection at a Regional Hospital in Thailand.","authors":"Parichart Sakulkonkij, Jackrapong Bruminhent","doi":"10.2147/IDR.S494712","DOIUrl":"https://doi.org/10.2147/IDR.S494712","url":null,"abstract":"<p><strong>Objective: </strong>This retrospective cohort study evaluated the treatment outcome of <i>Acinetobacter baumannii</i> infection.</p><p><strong>Methods: </strong>In this retrospective cohort study, 476 patients with <i>Acinetobacter baumannii</i> (<i>A. baumannii</i>) infection who were admitted to the internal medicine ward at Lampang Hospital, Lampang, Thailand, from 1 January 2020 to 31 December 2020 were enrolled. Medical records were reviewed.</p><p><strong>Results: </strong>A total of 476 patients with <i>A. baumannii</i> infection were enrolled. Of these, 204 (43%) survived, while 272 (57%) died. Extensively drug-resistant (XDR) <i>A. baumannii</i> with hospital-acquired pneumonia was the most common presentation. Risk factors for acquiring multidrug-resistant (MDR) pathogens included previous hospitalization or antibiotic use and the presence of an indwelling urinary catheter, which was common in both survived and deceased groups. The survival group was significantly more likely to have received appropriate antibiotic therapy compared to the deceased group (71% vs 51%; <i>p</i><0.001), particularly with colistin monotherapy (34% vs 18%; <i>p</i><0.001). Additionally, multivariate analysis showed that predictors of unfavorable outcomes, such as multiorgan failure, hypoalbuminemia, hematologic malignancy, and healthcare-associated pneumonia. The survival group had a significantly longer hospital stay compared to the deceased group (15 days vs 7 days; <i>p</i><0.001) and also showed an increased microbiological cure rate (49% vs 26%; <i>p</i><0.001).</p><p><strong>Conclusion: </strong>XDR <i>A. baumannii</i> leads to serious nosocomial infections. Understanding the risk factors for XDR <i>A. baumannii</i> infections could enhance colistin prescription prior to the antimicrobial susceptibility testing results.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"473-482"},"PeriodicalIF":2.9,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11776409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065443","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":"Five-Year Prospective Follow-Up of Patients with Hepatitis C Virus Infection Treated with Direct-Acting Antiviral Agents.","authors":"Yaping Zhang, Huan Xia, Luchang Fan, Lu Jiang, Bin Yang, Fengmei Wang","doi":"10.2147/IDR.S487414","DOIUrl":"10.2147/IDR.S487414","url":null,"abstract":"<p><strong>Purpose: </strong>The research intended to present prospective data on the long-term prognosis of individuals with hepatitis C virus (HCV) infection who received direct-acting antiviral agent (DAA) treatment.</p><p><strong>Patients and methods: </strong>Patients who received DAA treatment at Tianjin Third Central Hospital and Tianjin Second People's Hospital were prospectively enrolled and subsequently underwent a longitudinal follow-up. This research monitored occurrences of virological relapse, hepatocellular carcinoma (HCC), mortality, and liver disease progression. The annualized incidence rates (AIRs), cumulative incidence rates of adverse events and risk factors were investigated. Changes in liver stiffness measurement (LSM), aspartate aminotransferase-to-platelet ratio index (APRI) score, fibrosis-4 (FIB-4) index, as well as the albumin-bilirubin (ALBI) scores were also documented.</p><p><strong>Results: </strong>A total of 862 individuals were followed up for 4.86 (P₂₅, P₇₅; 4.48, 5.48) years. The proportion of all participants with undetectable HCV-RNA exceeded 98% at all follow-up time points. Patients experienced virological relapse, HCC, death and disease progression with a cumulative AIRs of 1.03% (95% confidence interval [CI] 0.6-1.5), 1.76% (95% CI 1.2-2.3), 1.51% (95% CI 1.0-2.0), and 5.81% (95% CI 4.8-6.8), respectively. Cirrhotic patients were at a heightened risk of virological relapse (adjusted hazard ratio [aHR] 3.20, 95% CI 1.59-9.75; p = 0.016), HCC (aHR 6.57, 95% CI 2.66-16.28; p < 0.0001), and unfavorable prognosis (aHR 6.93, 95% CI 2.56-18.74; p < 0.0001). Additionally, patients with diabetes faced an elevated risk of HCC (aHR 2.33, 95% CI 1.05-5.15; p = 0.038) and poor prognosis (aHR 2.72, 95% CI 1.13-6.55; p = 0.026). Furthermore, liver stiffness measurement (LSM) exhibited a significant decrease compared to baseline. Additionally, patients in the cirrhosis group showed reductions in APRI score, FIB-4 index and ALBI score to different degrees.</p><p><strong>Conclusion: </strong>Cirrhotic patients exhibited increased susceptibility to virological relapse, HCC, unfavorable prognosis, and liver disease progression following DAA treatment. Consequently, it is imperative to implement a rigorous monitoring protocol for all cirrhotic patients after DAA treatment.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"455-471"},"PeriodicalIF":2.9,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059034","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":"A Predictive Model for Pulmonary Aspergillosis in ICU Patients: A Multicenter Retrospective Cohort Study.","authors":"Yujing Li, Xindie Ren, Qianqian Wang, Songying Shen, Yihao Li, Xinling Qian, Yufei Tang, Jinguang Jia, Hao Zhang, Junjie Ding, Yinsen Song, Sisen Zhang, Shengfeng Wang, Yinghe Xu, Yongpo Jiang, Xuwei He, Muhua Dai, Lin Zhong, Yonghui Xiong, Yujie Pan, Mingqiang Wang, Huanzhang Shao, Hongliu Cai, Lingtong Huang, Hongyu Wang","doi":"10.2147/IDR.S493019","DOIUrl":"10.2147/IDR.S493019","url":null,"abstract":"<p><strong>Background: </strong>Several predictive models for invasive pulmonary aspergillosis (IPA) based on clinical characteristics have been reported. Nevertheless, the significance of other concurrently detected microorganisms in IPA patients is equally noteworthy. This study aimed to develop a risk prediction model for IPA by integrating clinical and microbiological characteristics.</p><p><strong>Methods: </strong>This retrospective study was conducted in adult intensive care units (ICUs) of 17 medical centers in China. Clinical data were collected from patients with severe pneumonia who underwent clinical metagenomics of bronchoalveolar lavage fluid between January 1, 2019, and June 30, 2023. Subsequently, patients were randomly assigned to training and validation cohorts in a 7:3 ratio. In the training cohort, potential influencing factors were identified through univariate analysis, clinical practice, and existing literature, and a risk prediction model was constructed using multivariate logistic regression analysis. The performance of this model was then assessed and validated in the validation cohort.</p><p><strong>Results: </strong>Out of 1737 patients initially included in the study, 898 were ultimately analyzed, of which 100 (11%) were diagnosed with IPA. The risk prediction model for IPA, incorporating microbiological characteristics, identified six independent risk factors, namely age, immunosuppression, chronic kidney disease, connective tissue disease, liver failure, and cytomegalovirus positivity. The model demonstrated a superior discriminative ability, with area under the curve (AUC) values of 0.791 and 0.792 in the training and validation cohorts, respectively. Sensitivity and specificity reached 73.1% and 74.9%, respectively, and the model demonstrated good calibration.</p><p><strong>Conclusion: </strong>This study developed a novel risk prediction model for IPA incorporating microbiological characteristics based on clinical metagenomics. The model exhibited good discriminative ability and calibration.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"441-454"},"PeriodicalIF":2.9,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052548","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 Risk Factors for Multidrug-Resistant <i>Enterobacter cloacae</i> Complex Bacteremia in a Chinese Tertiary Hospital: A Decade Review (2013-2022).","authors":"Mei Han, Miaomiao Hua, Hui Xie, Jia Li, Yijun Wang, Han Shen, Xiaoli Cao","doi":"10.2147/IDR.S502509","DOIUrl":"10.2147/IDR.S502509","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to analyze the antimicrobial resistance profiles, clinical characteristics and risk factors of bacteremia caused by <i>Enterobacter cloacae</i> complex (ECC) strains.</p><p><strong>Methods: </strong>We retrospectively collected clinical data from patients diagnosed with ECC bacteremia between 2013 and 2022 in a tertiary hospital in Jiangsu. Subgroup analyses were performed based on multidrug resistance (MDR), nosocomial acquisition, polymicrobial bacteremia, and mortality.</p><p><strong>Results: </strong>Among 188 ECC strains, the highest resistance was to ceftriaxone (39.9%), followed by ceftazidime (36.7%) and aztreonam (31.2%), with low resistance to carbapenems (<8.6%) and amikacin (1.6%). MDR ECC accounted for 30.9% (58/188). Previous antibiotic therapy was an independent risk factor for MDR ECC (OR = 3.193, <i>P</i> < 0.020), while appropriate antibiotic therapy significantly reduced the risk (OR = 0.279, <i>P</i> < 0.001). ICU admission was an independent risk factor for polymicrobial bacteremia, both endoscopy and blood transfusion were associated with mortality.</p><p><strong>Conclusion: </strong>Carbapenems and amikacin are the most effective treatments for ECC bacteremia. Previous antibiotic therapy increases the risk of MDR ECC, while appropriate antibiotic therapy reduces it. ICU admission is an independent risk factor for polymicrobial bacteremia, both endoscopy and blood transfusion are linked to higher mortality. Effective control of MDR ECC bacteremia requires comprehensive strategies, including resistance detection, risk factor identification, and infection prevention.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"427-440"},"PeriodicalIF":2.9,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11766150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046467","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":"Coexistence of Asymptomatic Allergic Bronchopulmonary Aspergillosis and Active Pulmonary Tuberculosis: Case Report.","authors":"Qingqing Jia, Lian Wang, Xiang Tong, Jibo Sun, Hong Fan","doi":"10.2147/IDR.S499569","DOIUrl":"10.2147/IDR.S499569","url":null,"abstract":"<p><p>We present a rare case of asymptomatic allergic bronchopulmonary aspergillosis (ABPA) concurrent with active pulmonary tuberculosis. Allergic bronchopulmonary aspergillosis is an immunological pulmonary disorder characterized by hypersensitivity to Aspergillus fumigatus, while pulmonary tuberculosis (PTB) is a complex infection caused by Mycobacterium tuberculosis (MTB). The association between pulmonary tuberculosis infections and Aspergillus infections remains a fascinating area of inquiry. A 26-year-old female patient exhibited no symptoms. However, her initial chest computed tomography revealed bronchiectasis with high-attenuation mucus plugs in the upper lobes, peripheral lung atelectasis, and a tree-in-bud pattern. To obtain a clear diagnosis, she visited multiple hospitals and incurred substantial time and financial costs. Active tuberculosis was initially confirmed using specialized detection methods, including metagenomic next-generation sequencing and Xpert MTB/RIF analysis of bronchoalveolar lavage fluid. Subsequent pathological biopsy and Aspergillus-specific antibody tests further confirmed the diagnosis of allergic bronchopulmonary aspergillosis combined with active tuberculosis. Following twelve months of antituberculosis therapy, an avoidable surgery, and three months of oral glucocorticoid treatment, the patient's lung lesions showed significant resolution. This case provides valuable insights into the clinical diagnosis and management of these two distinct infectious diseases.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"401-405"},"PeriodicalIF":2.9,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11769722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052549","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":"Targeted Next-Generation Sequencing in Pneumonia: Applications in the Detection of Responsible Pathogens, Antimicrobial Resistance, and Virulence.","authors":"Bing Liu, Zhiyao Bao, Wei Chen, Xiaotong Xi, Xiao Ge, Jun Zhou, Xiaoyan Zheng, Peipei Zhang, Wanglong Deng, Ran Ding, Min Zhou, Jie Fang","doi":"10.2147/IDR.S504392","DOIUrl":"10.2147/IDR.S504392","url":null,"abstract":"<p><strong>Background: </strong>Targeted next-generation sequencing (tNGS) is a high-throughput and cost-effective diagnostic alternative for pneumonia, with the ability to simultaneously detect pathogens, antimicrobial resistance genes, and virulence genes. We aimed to explore the applicability of tNGS in the co-detection of the responsible pathogens, antimicrobial resistance (AMR) genes, and virulence genes in patients with pneumonia.</p><p><strong>Methods: </strong>A prospective study was conducted among patients with suspected pneumonia at Ruijin Hospital from March 1 to May 31, 2023. Bronchoalveolar lavage fluid (BALF) or sputum samples were collected and sent for tNGS, metagenomic next-generation sequencing (mNGS), and conventional microbiological tests (CMTs).</p><p><strong>Results: </strong>In total, 67 BALF and 11 sputum samples from 78 patients were included in the analyses. According to the composite reference standards, the accuracy of tNGS in the detection of responsible pathogens was 0.852 (95% confidence interval 0.786-0.918), which resembled that of mNGS and remarkably exceeded that of CMTs. In addition, 81 AMR genes associated with responsible pathogens were reported, and 75.8% (25/33) priority drug-resistant pathogens could be directly identified. A total of 144 virulence genes were detected for four common pathogens. And patients with virulence genes detected were of higher proportions of severe pneumonia (95.0% vs 42.9%, P = 0.009), acute respiratory distress syndrome (55.0% vs 0%, P = 0.022), and neutrophils (82.3% vs 62.2%, P = 0.026) than those not.</p><p><strong>Conclusion: </strong>In patients with pneumonia, tNGS could detect the responsible pathogens, AMR genes, and virulence genes simultaneously, serving as an efficient and cost-effective tool for the diagnosis, treatment, and severity indication of pneumonia.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"407-418"},"PeriodicalIF":2.9,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11769725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052550","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}