Infection and Drug Resistance最新文献

{"title":"Assessment of Non-Adherence to Anti-TB Drugs and Associated Factors Among Patients Attending TB Treatment Centers During COVID-19 Pandemic in Mogadishu, Somalia: A Cross-Sectional Study","authors":"Abdullahi Abdirahman Omar, Jamal Hassan Mohamoud, Mohamed Hussein Adam, Bashiru Garba, Mariam Abdi Hassan, Ibrahim Abdullahi Mohamed, Zakaria Mohamed Adam","doi":"10.2147/idr.s468985","DOIUrl":"https://doi.org/10.2147/idr.s468985","url":null,"abstract":"<strong>Background:</strong> The COVID-19 pandemic’s first wave and subsequent lockdowns disrupted global healthcare systems, significantly impacting essential services including tuberculosis (TB) care. Non-adherence to anti-TB drugs is a critical concern, leading to treatment failure, drug resistance, and increased morbidity and mortality. This study assessed the rate and determinants of non-adherence to TB treatment among patients at TB centers during the first wave of the pandemic.<br/><strong>Material and Methods:</strong> A cross-sectional study was conducted from June 15 to July 30, 2020, involving 255 TB patients at three centers in Mogadishu. Data were gathered using the Morisky Medication Adherence Scale-8 (MMAS-8) through structured interviews and analyzed using descriptive statistics and binary logistic regression.<br/><strong>Results:</strong> The study found a 34.5% non-adherence rate during the pandemic. Key reasons for non-adherence included forgetting to take medication (33%), feeling well (29%), experiencing side effects (18%), and fear of contracting COVID-19 (16%). Significant factors associated with non-adherence were age groups 25– 34 years (OR = 2.96, p = 0.024) and 35– 44 years (OR = 4.55, p = 0.005), unemployment (OR = 2.57, p = 0.037), smoking (OR = 3.49, p = 0.029), tobacco use (OR = 4.15, p = 0.034), proximity to a health facility (OR = 0.44, p = 0.033), perception of healthcare providers as very friendly (OR = 0.24, p = 0.031) or friendly (OR = 0.45, p = 0.023), being in the continuous treatment phase (OR = 3.2, p &lt; 0.001), and experiencing adverse treatment effects (OR = 2.42, p = 0.003).<br/><strong>Conclusion:</strong> Non-adherence to anti-tuberculosis treatment was notably high in Mogadishu during the first wave of the pandemic, necessitating targeted interventions to improve adherence.<br/><br/>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142197158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Machine Learning Model Based on CT Imaging Metrics and Clinical Features to Predict the Risk of Hospital-Acquired Pneumonia After Traumatic Brain Injury","authors":"Shaojie Li, Qiangqiang Feng, Jiayin Wang, Baofang Wu, Weizhi Qiu, Yiming Zhuang, Yong Wang, Hongzhi Gao","doi":"10.2147/idr.s473825","DOIUrl":"https://doi.org/10.2147/idr.s473825","url":null,"abstract":"<strong>Objective:</strong> To develop a validated machine learning (ML) algorithm for predicting the risk of hospital-acquired pneumonia (HAP) in patients with traumatic brain injury (TBI).<br/><strong>Materials and Methods:</strong> We employed the Least Absolute Shrinkage and Selection Operator (LASSO) to identify critical features related to pneumonia. Five ML models—Logistic Regression (LR), Extreme Gradient Boosting (XGB), Random Forest (RF), Naive Bayes Classifier (NB), and Support Vector Machine (SVC)—were developed and assessed using the training and validation datasets. The optimal model was selected based on its performance metrics and used to create a dynamic web-based nomogram.<br/><strong>Results:</strong> In a cohort of 858 TBI patients, the HAP incidence was 41.02%. LR was determined to be the optimal model with superior performance metrics including AUC, accuracy, and F1-score. Key predictive factors included Age, Glasgow Coma Score, Rotterdam Score, D-dimer, and the Systemic Immune Response to Inflammation Index (SIRI). The nomogram developed based on these predictors demonstrated high predictive accuracy, with AUCs of 0.818 and 0.819 for the training and validation datasets, respectively. Decision curve analysis (DCA) and calibration curves validated the model’s clinical utility and accuracy.<br/><strong>Conclusion:</strong> We successfully developed and validated a high-performance ML algorithm to assess the risk of HAP in TBI patients. The dynamic nomogram provides a practical tool for real-time risk assessment, potentially improving clinical outcomes by aiding in early intervention and personalized patient management.<br/><br/><strong>Keywords:</strong> traumatic brain injury, machine learning, hospital-acquired pneumonia, dynamic nomogram, imaging metrics<br/>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142197159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Candidaemia: A 9-Year Retrospective Analysis of Epidemiology and Antimicrobial Susceptibility in Tertiary Care Hospitals in Western China","authors":"Kun Li, Xue Yang, Long Li, Lan Zhi","doi":"10.2147/idr.s477815","DOIUrl":"https://doi.org/10.2147/idr.s477815","url":null,"abstract":"<strong>Purpose:</strong> This investigation endeavors to scrutinize the resistance profiles to antifungal agents, alongside the clinical distribution of <em>Candida</em> isolates that yielded positive results in blood cultures at Suining Central Hospital spanning the years 2015 to 2023. The objective is to provide crucial epidemiological insights that may aid in early clinical intervention and judicious deployment of antifungal therapies.<br/><strong>Methods:</strong> This retrospective analysis analyses data on 182 different <em>Candida</em> strains with positive clinical blood cultures obtained from the Microbiology Laboratory of Suining Central Hospital over a period of nine consecutive years. The study involved identification of Candida species and assessment of resistance patterns to fungal drugs.<br/><strong>Results:</strong> Our analysis revealed that the median age of patients diagnosed with Candidaemia from the 182 strains was 62 years, with a distribution of 63.7% females and 36.3% males. Within the cohort of 182 Candida strains, <em>Candida albicans</em> constituted 32.4%, while <em>non-albicans Candida</em> species comprised 67.6% of the cases. Specifically, <em>Candida tropicalis</em> represented 37.4%, <em>Candida glabrata</em> 12.1%, <em>Candida parapsilosis</em> 11.0%,<em>Candida guilliermondii</em> 3.8%, and both <em>Candida krusei</em> and <em>Candida Dublin</em> accounted for 1.6% each. These Candida species were predominantly identified in intensive care units (ICU), hematology, gastroenterology, neurology centers, and endocrine metabolism units.<br/><strong>Conclusion:</strong> The findings of this investigation suggest a shift in the prevalence of non<em>-Candida albicans</em> species, notably <em>C. tropicalis</em>, as the predominant cause of Candidaemia at Suining Central Hospital, surpassing <em>C. albicans</em>. Although instances of antifungal resistance are infrequent, there has been a notable rise in resistance to azoles. This study provides important insights into the local epidemiology, which will be essential for informing the selection of empirical antifungal therapy and contributing to the global surveillance of antifungal resistance.<br/><br/><strong>Keywords:</strong> candidemia, Candida species, antifungal agents, bloodstream<br/>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142197157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective Analysis of Risk Factors for Cefoperazone/Sulbactam-Induced Thrombocytopenia in Adult Chinese Patients: A Six-Year Real-World Study","authors":"Bolin Zhu, Pengfei Jin, Jianchun Li, Yuanchao Zhu","doi":"10.2147/idr.s475590","DOIUrl":"https://doi.org/10.2147/idr.s475590","url":null,"abstract":"<strong>Background:</strong> Drug-induced thrombocytopenia is a rare adverse reaction of drug therapy and usually underdiagnosed. Cefoperazone/sulbactam is a compound preparation composed of the third generation of cephalosporin and β-lactamase inhibitor, of which thrombocytopenia is an uncommon but serious adverse reaction. However, the existing literature on cefoperazone/sulbactam-induced thrombocytopenia remains limited, and the specific risk factors associated with this adverse effect have not been thoroughly elucidated. Consequently, this study aims to investigate the clinical characteristics and identify the risk factors for thrombocytopenia in adult patients undergoing cefoperazone/sulbactam therapy.<br/><strong>Methods:</strong> In this retrospective study, we reviewed patients treated with cefoperazone/sulbactam at Beijing Hospital between January 2017 and June 2023. Patients were categorized into two groups based on the presence or absence of thrombocytopenia: the thrombocytopenia group and the non-thrombocytopenia group. We collected data on demographic features, clinical characteristics, laboratory parameters, treatments, and outcomes. Subsequently, univariate and multivariate logistic regression analyses were performed to identify potential risk factors for cefoperazone/sulbactam-induced thrombocytopenia.<br/><strong>Results:</strong> In total, 6489 patients were included in this study, and 2.4% (155/6489) developed thrombocytopenia. The results of multivariate analysis showed that cefoperazone/sulbactam therapy duration (d) &gt; 14, PLT (10⁹/L) &lt; 200, daily dose of cefoperazone/sulbactam (g) ≥ 6, TBil (μmoL/L) &gt; 21, AST (U/L) &gt; 35, and use of non-invasive ventilator were risk factors for cefoperazone/sulbactam-induced thrombocytopenia.<br/><strong>Conclusion:</strong> Despite the low incidence (2.4%), cefoperazone/sulbactam could cause serious thrombocytopenia sometimes accompanied with hemorrhage. In clinical therapy, clinicians should be vigilant in monitoring platelet count, especially for patients with risk factors of cefoperazone/sulbactam-induced thrombocytopenia.<br/><br/>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142197178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cryptococcus Neoformans Osteomyelitis of the Right Ankle Diagnosed by Metagenomic Next-Generation Sequencing in a HIV-Negative Patient with Tuberculous Lymphadenitis and Pulmonary Tuberculosis: A Case Report and Recent Literature Review","authors":"Yao Qin, Xingwu Zou, Yanghui Jin, Jinmeng Li, Qingshan Cai","doi":"10.2147/idr.s476270","DOIUrl":"https://doi.org/10.2147/idr.s476270","url":null,"abstract":"<strong>Aim:</strong> Cryptococcus neoformans osteomyelitis coupled with tuberculosis and tuberculous lymphadenitis, is a rare occurrence in clinical. Diagnostic challenges arise due to the clinical radiological similarity of this condition to other lung infections and the limited and sensitive nature of traditional approaches. Here, we present a case of co-infection diagnosed using Metagenomic Next-Generation Sequencing, highlighting the effectiveness of advanced genomic techniques in such complex scenarios.<br/><strong>Case Presentation:</strong> We present a case of a 67-year-old female infected with cryptococcal osteomyelitis and presented with swelling and pain in the right ankle. Following a biopsy of the right ankle joint, Metagenomic Next-Generation Sequencing (mNGS) of the biopsy tissue revealed Cryptococcus neoformans infection. Positive results for Cryptococcus capsular antigen and pathological findings confirmed the presence of Cryptococcus neoformans. The patient underwent surgical debridement, coupled with oral fluconazole treatment (300mg/day), leading to the resolution of symptoms.<br/><strong>Conclusion:</strong> Cryptococcus neoformans is an uncommon cause of ankle infection. Metagenomic Next-Generation Sequencing (mNGS) serves as a valuable diagnostic tool, aiding clinicians in differentiating cryptococcal osteomyelitis from other atypical infections.<br/><br/><strong>Keywords:</strong> Cryptococcus neoformans, tuberculosis, diagnosis, metagenomic next-generation sequencing, mNGS<br/>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142197160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Characteristics, Serotypes and Antimicrobial Resistance of Invasive <i>Salmonella</i> Infections in HIV-Infected Patients in Hangzhou, China, 2012-2023.","authors":"Jingying Xu, Yuan Chen, Jianhua Yu, Shourong Liu, Ying Meng, Chaodan Li, Qian Huang, Yunlei Xiao","doi":"10.2147/IDR.S465979","DOIUrl":"10.2147/IDR.S465979","url":null,"abstract":"<p><strong>Purpose: </strong>Developing countries, invasive <i>Salmonella</i> infections can cause considerable morbidity and mortality. There is a relative lack of data on coinfection with <i>Salmonella</i> in HIV-infected patients in Hangzhou, China.</p><p><strong>Patients and methods: </strong>In this study, we manually collected case data of patients aged >18 years with HIV combined with invasive <i>Salmonella</i> infections admitted to Xixi Hospital in Hangzhou from January 2012 to August 2023 by logging into the Hospital Information System, and identified 26 strains of invasive <i>Salmonella</i> using a fully automated microbiological identification system and mass spectrometer. Serotypes were determined using <i>Salmonella</i> diagnostic sera based on the White-Kauffmann-Le Minor scheme. Drug sensitivity tests were performed using the automated instrumental method of the MIC method.</p><p><strong>Results: </strong>A total of 26 HIV-infected patients with invasive <i>Salmonella</i> coinfections were identified over 11 years; Twenty-five of the 26 patients (96.2%) were males, with a mean age of 33.5 years (26.75, 46.75). The most common type of infection was bloodstream infection (92.3%). One patient also had concomitant meningitis and osteoarthritis, followed by pneumonia (7.7%). The presence of multiple bacterial infections or even multiple opportunistic pathogens was clearly established in 7 (26.9%) patients. Three (11.6%) patients were automatically discharged from the hospital with deterioration of their condition, and one (3.8%) patient died. <i>Salmonella enteritidis</i> was the most common serotype in 6 patients (23.2%), and <i>Salmonella Dublin</i> was the most common serotype in 6 patients (23.2%). Drug sensitivity results revealed multidrug resistance in a total of 8 (30.8%) patients.</p><p><strong>Conclusion: </strong>The clinical presentation of invasive <i>Salmonella</i> infection in HIV patients is nonspecific and easily masked by other mixed infections. A CD4⁺ count <100 cells/µL and comorbid intestinal lesions may be important susceptibility factors. <i>Salmonella</i> has a high rate of resistance to common antibiotics, and the risk of multidrug resistance should not be ignored.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11380868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153929","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":"In vitro Synergistic and Bactericidal Effects of Aztreonam in Combination with Ceftazidime/ Avibactam, Meropenem/Vaborbactam and Imipenem/Relebactam Against Dual-Carbapenemase-Producing <i>Enterobacterales</i>.","authors":"Ying Fu, Yufeng Zhu, Feng Zhao, Bingyan Yao, Yunsong Yu, Jun Zhang, Qiong Chen","doi":"10.2147/IDR.S474150","DOIUrl":"10.2147/IDR.S474150","url":null,"abstract":"<p><strong>Objective: </strong>Our aim was to elucidate the resistance mechanisms and assess the combined synergistic and bactericidal activities of aztreonam in combination with ceftazidime/avibactam (CZA), meropenem/vaborbactam (MEV), and imipenem/relebactam (IMR) against Enterobacterales strains producing dual carbapenemases.</p><p><strong>Methods: </strong>Species identification, antimicrobial susceptibility testing and determination of carbapenemase type were performed for these strains. Plasmid sizes, plasmid conjugation abilities and the localization of carbapenemase genes were investigated. Whole-genome sequencing was performed for all strains and their molecular characteristics were analyzed. In vitro synergistic and bactericidal activities of the combination of aztreonam with CZA, MEV and IMR against these strains were determined using checkerboard assay and time-kill curve assay.</p><p><strong>Results: </strong>A total of 12 <i>Enterobacterales</i> strains producing dual-carbapenemases were collected, including nine <i>K. pneumoniae</i>, two <i>P. rettgeri</i>, and one <i>E. hormaechei</i>. The most common dual-carbapenemase gene pattern observed was <i>bla</i> _{(KPC-2+NDM-5)} (n=4), followed by <i>bla</i> _KPC-2+IMP-26 (n=3), <i>bla</i> _{(KPC-2+NDM-1)} (n=2), <i>bla</i> _{(KPC-2+IMP-4)} (n=1), <i>bla</i> _{(NDM-1+IMP-4)} (n=1) and <i>bla</i> _{(KPC-2+KPC-2)} (n=1). In each strain, the carbapenemase genes were found to be located on two distinct plasmids which were capable of conjugating from the original strain to the receipt strain <i>E. coli</i> J53. The results of the checkerboard synergy analysis consistently revealed good synergistic effects of the combination of ATM with CZA, MEV and IMR. Except for one strain, all strains exhibited significant synergistic activity and bactericidal activity between 2 and 8 hours.</p><p><strong>Conclusion: </strong>Dual-carbapenemase-producing <i>Enterobacterales</i> posed a significant threat to clinical anti-infection treatment. However, the combination of ATM with innovative <i>β</i>-lactam/β-lactamase inhibitor compounds had proven to be an effective treatment option.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11380864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153932","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 Effectiveness and Safety of Colistin Sulphate in Treating Infections Caused by Carbapenem-Resistant Organisms and Analysis of Influencing Factors.","authors":"Ying-Chao Ma, Ya-Qing Sun, Xia Wu, Yong-Jing Wang, Xiu-Ling Yang, Jian-Jun Gu","doi":"10.2147/IDR.S473200","DOIUrl":"10.2147/IDR.S473200","url":null,"abstract":"<p><strong>Objective: </strong>To assess the efficacy and safety of colistin sulfate in treating infections caused by carbapenem-resistant organisms (CRO) and to analyze potential factors impacting its effectiveness.</p><p><strong>Methods: </strong>In this retrospective study, medical records of CRO-infected patients from June 2020 to June 2023 were analyzed, divided into effective and ineffective treatment groups, and compared for clinical outcomes and adverse reactions. Multifactorial logistic regression and ROC curve analysis were used to identify influencing factors.</p><p><strong>Results: </strong>The study included 226 patients, with 124 in the effective treatment group and 102 in the ineffective group. A total of 293 CRO strains were cultured. The clinical efficacy rate of colistin sulfate was 54.87%, the microbiological efficacy rate 46.46%, and the hospital mortality rate 20.80%, with nephrotoxicity observed in 11.50% of patients. Multifactorial analysis identified APACHE II scores and vasoactive drug use as independent predictors of ineffective treatment, while treatment duration and albumin levels predicted effective treatment. ROC analysis indicated that albumin levels >34 g/L, APACHE II scores <13, and treatment duration >10 days correlated with better clinical efficacy.</p><p><strong>Conclusion: </strong>Colistin sulfate is both safe and effective in clinical settings. Factors such as treatment duration, albumin levels, APACHE II scores, and vasoactive drug use independently affect its clinical efficacy, providing valuable guidance for its informed clinical application.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11380488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153930","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":"Prognostic Factors That Affect Mortality Patients with <i>Acinetobacter baumannii</i> Bloodstream Infection.","authors":"Chunrong Huang, Yulian Gao, Hongxia Lin, Qinmei Fan, Ling Chen, Yun Feng","doi":"10.2147/IDR.S475073","DOIUrl":"10.2147/IDR.S475073","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the clinical features of patients with <i>Acinetobacter baumannii</i> bloodstream infection (BSI).</p><p><strong>Methods: </strong>Totally 200 inpatients with <i>Acinetobacter baumannii</i> BSI were included, clinical features of <i>Acinetobacter baumannii</i> BSI inpatients between 90-day survival and 90-day mortality groups, between 30-day survival and 30-day mortality groups, between patients infected with multidrug-resistant (MDR group) and sensitive <i>Acinetobacter baumannii</i> (sensitive group) were analyzed. The prognostic factors of 90-day mortality were analyzed by univariate logistic regression and multivariate logistic regression. The survival curve in bloodstream infectious patients with multidrug-resistant (MDR group) and sensitive <i>Acinetobacter baumannii</i> (sensitive group) was analyzed by Kaplan-Meier analysis.</p><p><strong>Results: </strong>The 90-day mortality patients had significantly higher carbapenem-resistant bacterial infection and critical care unit (ICU) admission. The 90-day and 30-day mortality groups showed higher C-reactive protein (CRP) and serum creatinine (Scr) levels and lower red blood cells (RBC) and albumin (ALB) levels than their survival counterparts, respectively. Critical surgery, ICU admission and delayed antibiotic treatment were independently prognostic risk predictors for 90-day mortality in <i>Acinetobacter baumannii</i> BSI patients, while critical surgery and diabetes were independently prognostic risk predictors for 90-day mortality in carbapenem-resistant <i>Acinetobacter baumannii</i> BSI patients. Compared with sensitive group, MDR group showed significantly longer ICU and whole hospital stay, lower levels of lymphocytes, RBC, hemoglobin, lactate dehydrogenase and ALB, higher frequency of infection originating from the skin and skin structure. Moreover, patients in the MDR group had a significantly worse overall survival than the sensitive group.</p><p><strong>Conclusion: </strong>We identified the prognostic factors of <i>Acinetobacter baumannii</i> BSI and carbapenem-resistant <i>Acinetobacter baumannii</i> BSI patients. Critical surgery, ICU admission, delayed antibiotic treatment or diabetes were significantly associated with the mortality of those patients. Moreover, aggressive measures to control MDR <i>Acinetobacter baumannii</i> could lead to improved outcomes.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11380481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153933","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":"ESKAPE Pathogens: Antimicrobial Resistance Patterns, Risk Factors, and Outcomes a Retrospective Cross-Sectional Study of Hospitalized Patients in Palestine.","authors":"Abdallah Damin Abukhalil, Sally Amer Barakat, Aseel Mansour, Ni'meh Al-Shami, Hani Naseef","doi":"10.2147/IDR.S471645","DOIUrl":"10.2147/IDR.S471645","url":null,"abstract":"<p><strong>Background: </strong>Antimicrobial resistance to ESKAPE pathogens (<i>Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter</i> spp). remains a major challenge in hospital settings.</p><p><strong>Objective: </strong>This study aimed to determine the ESKAPE antimicrobial resistance patterns and associated factors with multi-drug resistance strains among hospitalized patients in a single tertiary care medical hospital in Palestine.</p><p><strong>Methods: </strong>A single-center retrospective cross-sectional study was conducted by reviewing patients' electronic medical records and laboratory results from November 1, 2021, to November 30, 2022, at the Palestine Medical Complex in Palestine. The study included patients aged > 18 years who had been infected with ESKAPE pathogens 48 hours after hospital admission.</p><p><strong>Results: </strong>This study included 231 patients, of whom 90.5% had MDR infections. In total, 331 clinical samples of ESKAPE pathogens were identified. <i>A. baumannii</i> was the most prevalent MDR pathogen (95.6%) with Carbapenem-resistant exceeding 95%, followed by <i>K. pneumoniae</i> (83.8%) with extended-spectrum cephalosporin resistance exceeding 90%, <i>S. aureus</i> (68.2) with 85% oxacillin-resistance, <i>E. faecium</i> (40%) with 20% vancomycin resistance, <i>P. aeruginosa</i> (22.6%) with 30% carbapenem resistance. Furthermore, emergent colistin resistance has been observed in <i>A. baumannii, K. pneumoniae</i>, and <i>P. aerogenesis</i>. Risk factors for MDR infection included age (p< 0.035), department (p< 0.001), and invasive procedures such as IUC (p< 0.001), CVC (p< 0.000), and MV (p< 0.008). Patients diagnosed with MDR bacteria had increased 30-day mortality (p< 0.001).</p><p><strong>Conclusion: </strong>The findings of this study show alarming MDR among hospitalized patients infected with ESKAPE pathogens, with resistance to first-line antimicrobial agents and emerging resistance to colistin, minimizing treatment options. Healthcare providers and the Ministry of Health must take steps, adopt policies to prevent antimicrobial resistance, adhere to infection control guidelines, implement antimicrobial stewardship programs to prevent and limit the growing health crisis, and support research to discover new treatment options.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11380491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153931","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}