Infection and Drug Resistance最新文献

{"title":"Synergy and Mechanism of the Action of the Combination of Essential Oils and Antibiotics Against Antibiotic-Resistant Food Borne Disease Bacteria in Burkina Faso.","authors":"Paul Sodéré, Marius K Somda, Luc Zongo, Henriette B Mihin, Iliassou Mogmenga, Agbémébia Y Akakpo, Mamoudou H Dicko","doi":"10.2147/IDR.S518717","DOIUrl":"10.2147/IDR.S518717","url":null,"abstract":"<p><strong>Background: </strong>Bacterial resistance to antibiotics is an important developing threat for human health. Therefore, searching for alternatives through the synergistic combination of essential oils with conventional antibiotics is one of the relevant approaches. This study aims to investigate the mechanism of action of essential oils isolated from local common medicinal plants of Burkina Faso (<i>Hyptis suaveolens</i> and <i>Laggera aurita</i>) combined with three antibiotics (ciprofloxacin, amoxicillin + clavulanic acid and colistin) against resistant-bacterial strains (08) involved in toxi-intoxic effects (<i>Staphylococcus aureus</i> ATCC 2523, <i>Escherichia coli</i> ATCC 25922, <i>Pseudomonas aeruginosa</i> ATCC 9027, <i>Enterococcus faecalis</i> 0366 V, <i>Salmonella typhi</i> SKN 1152, <i>Bacillus cereus</i> 0998 V, <i>Bacillus subtilis</i> 0486 V, <i>Yersinia enterocolitica</i> 0938 V).</p><p><strong>Methods: </strong>The methodological approach consisted of evaluating the antibacterial activity followed by investigating antibacterial mechanism.</p><p><strong>Results: </strong>The MICs (minimum inhibitory concentration) of <i>Laggera aurita</i> and <i>Hyptis suaveolens</i> ranged from 4.05 mg/mL to 64.92 mg/mL and from 9.57 mg/mL to 38.28 mg/mL, respectively. Checkerboard assays revealed synergistic effects resulting in reductions of 93.69% and 87.73%, respectively, in amoxicillin+ clavulanic acid and colistin MICs. Protein and nucleic acid leakage assays demonstrated that peptidoglycan and cytoplasmic membrane damage induced by the synergistic combination were significantly greater than those in the control. The viable count of bacteria for this combination showed a complete killing profile after 12 hours and further.</p><p><strong>Conclusion: </strong>It appears from this study that the combinations (essential oil-antibiotic) reduced the MICs of the antibiotics and eradicated antibiotic-resistant bacteria completely. This combination could constitute an excellent means against bacterial resistance to antibiotics.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"2743-2763"},"PeriodicalIF":2.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12132064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215719","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":"An Approach to, and Tool for, Predicting the Time Course of an Infectious Disease Outbreak as a Function of Behavioral Interventions.","authors":"Haftom Temesgen Abebe, Amir Siraj, Kiros Berhane, Dawd Siraj, Gerard J P Van Breukelen","doi":"10.2147/IDR.S501934","DOIUrl":"10.2147/IDR.S501934","url":null,"abstract":"<p><strong>Introduction: </strong>In the early twenty-first century, humanity faced life-threatening infectious diseases, primarily caused by zoonotic pathogens, such as Ebola, Influenza, Middle East Respiratory Syndrome Coronavirus and Severe Acute Respiratory Syndrome Coronavirus. Early warnings based on epidemic models are crucial for preventing and controlling outbreaks. However, most decisions rely on expert opinions rather than robust epidemic model outputs. Implementing epidemic models can be challenging without a strong background in statistical modeling.</p><p><strong>Methods: </strong>This paper presents a simple, user-friendly tool in MATLAB to predict the time course of an infectious disease outbreak using various modified epidemic models. These models incorporate key non-pharmaceutical interventions to limit transmission within communities. Additionally, we introduce improved epidemiological model structures for outbreak control and prevention. To demonstrate the application of our interactive program and discuss user decision-making, we provide an example using key parameters from recent studies. The simulation model was run with varying scenarios, adjusting the effectiveness and coverage of social distancing, hand washing, and face mask usage.</p><p><strong>Results: </strong>Without any intervention, 99.6% of the population could be infected within 100 days. Combining social distancing with 80% coverage of face masks and hand washing reduced transmission and death by 99.96% and 99.98%, respectively, compared to no preventive measures.</p><p><strong>Conclusion: </strong>This interactive computer program aids epidemiologists, public health experts, and decision-makers in understanding and predicting infectious transmission. It is also valuable for generating rapid reports on infectious diseases and outbreak responses where time is a critical. Furthermore, it enhances collaboration between public health stakeholders and modeling professionals, aiming to optimize disease prevention and control strategies during outbreaks or epidemics.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"2717-2729"},"PeriodicalIF":2.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12132073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215718","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":"Metabolic Health Consequences of Switching to the Bictegravir/Emtricitabine/Tenofovir Alafenamide and Dolutegravir Plus Lamivudine Regimens in Virologically Suppressed People Living with HIV Aged > 40 Years: A Retrospective Real-World Study.","authors":"Jinchuan Shi, Wenhui Zhang, Jie Han, Zhongdong Zhang, Dingyan Yan, Rongrong Zheng, Feng Li, Yi Wang","doi":"10.2147/IDR.S516775","DOIUrl":"10.2147/IDR.S516775","url":null,"abstract":"<p><strong>Objective: </strong>Both B/F/TAF and DTG/3TC are recommended in treatment guidelines for switch therapy in PLWH. This study aimed to evaluate the safety and metabolic health consequences of two switched regimens in a real-world setting among virologically suppressed PLWH previously treated with EFV/TDF/3TC.</p><p><strong>Methods: </strong>This retrospective real-world study in Hangzhou included 220 virologically suppressed PLWH who switched from EFV/TDF/3TC to DTG/3TC or B/F/TAF between January 1, 2020 and October 30, 2023. All participants were examined the changes in weight, BMI, GLU levels, lipid parameters (TC, LDL-C, HDL-C, and TG), and eGFR at post-12-month.</p><p><strong>Results: </strong>The mean age of included participants was 50.8 years (SD: 11.3). After 12 months of switching, the HIV RNA level was below the limit of detection (< 20 copies/mL) among all participants. The switch to DTG/3TC or B/F/TAF therapy was associated with significant improvement in LDL-C, GLU levels, and eGFR values (all <i>P</i> < 0.05), while other metabolic indexes did not change significantly. Furthermore, there was a significant difference in the incidence of hyperglycemia (5.7% vs 19.35%; <i>P</i> = 0.004) between the B/F/TAF and DTG/3TC groups, but not included the mean changes of weight, BMI, lipid profiles, GLU levels, and eGFR and incidence of high TC and high TG. For the aged 40-59 years and aged ≥ 60 years PLWH, the differences in metabolic indicators were minimal between DTG/3TC and B/F/TAF groups post-12-month, with no significant differences between the arms in mean change from baseline in TC, TG, HDL-C, LDL-C, GLU, BMI, weight, and eGFR.</p><p><strong>Conclusion: </strong>In this study, the B/F/TAF or DTG/3TC regimens are safe for virologically suppressed PLWH aged > 40 years. The transition to B/F/TAF demonstrated dual clinical benefits, significantly reducing hyperglycemia incidence while preserving renal function.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"2703-2716"},"PeriodicalIF":2.9,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208464","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":"β-Lactam/β-Lactamase Inhibitor Combinations Non-Susceptible ESBL-Producing <i>Enterobacteriaceae</i> Bloodstream Infections: An Underestimated Clinical Entity.","authors":"Yan Zhang, Shuangling Ni, Hangbin Hu, Sheng Zhang, Haiting Feng, Lingmei Ni, Hongchao Chen, Qing Yang, Meihong Yu, Tingting Qu","doi":"10.2147/IDR.S514373","DOIUrl":"10.2147/IDR.S514373","url":null,"abstract":"<p><strong>Background: </strong>To describe the clinical and molecular characteristics of β-lactam/β-lactamase inhibitor combinations (BLBLIs) non-susceptible ESBL-producing Enterobacteriaceae (BnESBL-E) bloodstream infections (BSIs).</p><p><strong>Methods: </strong>A cohort study was performed with ESBL-E-BSI cases from 2017 to 2019 in East China. Clinical characteristics, risk factors, and all-course mortality were evaluated. Whole-genome sequencing and antibiotic susceptibility testing were performed.</p><p><strong>Results: </strong>Among the 187 patients with ESBL-E-BSI, 39.57% (74/187) had BnESBL-E-BSI. Nosocomial infections constituted 63.51% of BnESBL-E-BSIs, and 39.19% of cases originated from intra-abdominal sources. Risk factors for BnESBL-E-BSI included BLBLIs exposure within the preceding 3 months, ICU admission within the last 3 months, and the duration of hospital stay prior to BSI. Notably, a urinary source of bacteremia emerged as a protective factor against BnESBL-E-BSI(OR, 0.177; 95% CI, 0.049-0.647; <i>p</i>=0.009). BnESBL-E-BSIs were associated with a higher 28-day mortality compared to BLBLIs-susceptible cases (31.08%vs.16.81%; <i>p</i>=0.031). Multivariate analysis identified the Pitt bacteremia score, CRP level, and hospitalization within the preceding 3 months as risk factors for BnESBL-E-BSI-related mortality, while receipt of carbapenems within 72 hours of symptom onset improved survival(OR, 0.128; 95% CI, 0.018-0.912; <i>p</i> = 0.04). BnESBL-E isolates demonstrated no clonal transmission and remained highly susceptible to amikacin, carbapenems and tigecycline. Coexistence of multiple ESBL types was frequently observed, occurring in 40.6% of BnESBL-<i>Ec</i> and 72.7% of BnESBL-<i>Kp</i> isolates.</p><p><strong>Conclusion: </strong>Given the high prevalence and mortality of BnESBL-E-BSI, carbapenems may be preferable treatment option for non-urinary ESBL-E-BSIs. BnESBL-E represents an underestimated clinical threat, warranting timely identification of risk factors and the consideration of appropriate empirical therapy.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"2687-2701"},"PeriodicalIF":2.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198974","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":"Evaluating the Clinical Benefit of Carbapenem-Resistant <i>Enterobacteriaceae</i> Screening in a Tertiary Care Center in Saudi Arabia.","authors":"Ebrahim Mahmoud, Abrar Fahad Alhameed, Afrah Almukhtar, Sameer Desai","doi":"10.2147/IDR.S518397","DOIUrl":"10.2147/IDR.S518397","url":null,"abstract":"<p><strong>Background: </strong>Limited data exist regarding the risk of infection in patients who test positive during Carbapenem-resistant <i>Enterobacteriaceae</i> (CRE) screening. This study evaluates the clinical impact of CRE screening on infection risk and outcomes in patients with positive screening results.</p><p><strong>Objective: </strong>Compare CRE infection rates between patients with positive and negative CRE screening results.</p><p><strong>Design: </strong>Retrospective, non-experimental descriptive cohort study.</p><p><strong>Study setting: </strong>Conducted at King Faisal Specialist Hospital and Research Center (KFSHRC), a tertiary care center in Madinah, Saudi Arabia.</p><p><strong>Subjects and methods: </strong>Over one year, 1070 admitted patients were screened for CRE. Propensity score matching was used to create comparable cohorts of positive and negative screening patients. The study compared the subsequent CRE infection risk, 90-day mortality, total days of hospitalization, ICU admissions, and duration of antibiotic treatment in patients who tested positive for CRE.</p><p><strong>Main outcome measures: </strong>CRE infection rates among patients with positive and negative screening results.</p><p><strong>Results: </strong>Propensity score matching resulted in 66 patients with positive CRE screens matched to 133 negative-screen patients. Of those who screened positive, 35% developed a confirmed CRE infection during their hospital stay, compared to 4.6% in the negative group. CRE-positive patients experienced longer hospital stays (mean 21.2 vs 14.7 days, p < 0.001), higher readmission rates (38% vs 19%, p = 0.004), and increased mortality (24% vs 11%, p = 0.019). No significant differences were noted in ICU admission rates.</p><p><strong>Conclusion: </strong>Nearly one-third of patients with positive CRE screening results were at risk of developing subsequent CRE infections. Additionally, positive CRE screening was associated with higher mortality.</p><p><strong>Limitations: </strong>Small sample size and potential selection bias due to screening being performed only in ICU-required patients, potentially skewing results toward poorer outcomes. Findings apply only to hospitalized patients.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"2679-2686"},"PeriodicalIF":2.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198973","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":"Case Report: A Case of Visceral Leishmaniasis Misdiagnosed as Brucellosis.","authors":"Jianping Xu, Yaqing Li, Xiaoqing Wang, Yusen Mu","doi":"10.2147/IDR.S508319","DOIUrl":"10.2147/IDR.S508319","url":null,"abstract":"<p><p>Visceral leishmaniasis (VL) is an infectious disease caused by protozoan parasites of the genus <i>Leishmania</i> and transmitted through the bites of infected female sandflies. Due to its nonspecific clinical presentation, VL is prone to misdiagnosis and underdiagnosis. Though rare, VL is endemic in regions of Africa, South America, Asia, and parts of Europe, including the Mediterranean. This report describes a case of VL initially misdiagnosed as brucellosis due to a history of close contact with sheep. The patient tested negative for brucellosis via serum agglutination, blood culture, and bone marrow smear, and showed no improvement with a combination of omadacycline and rifampin therapy. Definitive diagnosis was achieved through metagenomic next-generation sequencing (mNGS) and confirmation with the rk39 antigen test. The patient was successfully treated with amphotericin B cholesterol sulfate complex and recovered fully. This case highlights the need to consider rare pathogens when epidemiological history and clinical response to treatment are incongruent and emphasizes the value of mNGS in timely diagnosis of VL.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"2673-2677"},"PeriodicalIF":2.9,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198972","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":"Whole-Genome Analysis of <i>Paenibacillus campinasensis</i> from Blood of a Hand-Foot-Mouth Patient.","authors":"Xiaoling Yu, Jun Lin, Wenqian Jiang, Tianzhu Zhu, Xiao Lin, Xiaolong Liu, Yongyi Zeng","doi":"10.2147/IDR.S501740","DOIUrl":"10.2147/IDR.S501740","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to investigate the antibiotic resistance and virulence factors of <i>Paenibacillus campinasensis</i>, an understudied opportunistic pathogen, through whole-genome sequencing and resistance genes. The findings will contribute to the development of effective clinical strategies for infection control.</p><p><strong>Patients and methods: </strong>A 1-year and 3-month-old boy presenting with fever and rash was admitted to the hospital and clinically diagnosed with hand-foot-mouth disease. A blood culture was obtained, and the pathogen was preliminarily identified as belonging to the genus <i>Paenibacillus</i> using MALDI-TOF-MS. Subsequent 16S rDNA PCR product Sanger sequencing confirmed the isolate as <i>Paenibacillus campinasensis</i>. Whole-genome sequencing and bioinformatics analysis were performed to evaluate the antibiotic resistance and virulence factors of the strain.</p><p><strong>Results: </strong>Whole-genome sequencing and bioinformatics analysis identified 18 resistance genes in the <i>Paenibacillus campinasensis</i> strain, spanning multiple antibiotic categories. These findings suggest the potential for multidrug resistance in this bacterium, despite its isolation from blood without associated clinical infection in the patient.</p><p><strong>Conclusion: </strong>The identification of resistance genes in <i>Paenibacillus campinasensis</i> underscores the challenges in clinical treatment and emphasizes the critical role of whole-genome analysis in pathogen detection and characterization. These findings are vital for informing effective clinical strategies to address infections, particularly given the potential for antibiotic resistance to hinder treatment outcomes, even in the absence of direct disease causation by the bacterium.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"2663-2672"},"PeriodicalIF":2.9,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12120251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181824","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":"Using Machine Learning to Predict Linezolid-Associated Thrombocytopenia.","authors":"Rao Wei, Kexin Li, Huaguang Wang, Xinbo Cai, Nian Liu, Zhuoling An, Hong Zhou","doi":"10.2147/IDR.S479658","DOIUrl":"10.2147/IDR.S479658","url":null,"abstract":"<p><strong>Objective: </strong>Using artificial intelligence and machine learning to predict linezolid-induced thrombocytopenia helps identify related risk factors in patients.</p><p><strong>Methods: </strong>Between January 2020 and December 2023, 284 patients receiving linezolid from Beijing Chaoyang Hospital were enrolled. The data underwent filtering to ensure completeness and quality. The filtered data were then randomly divided into training and validation sets at a 3:1 ratio using stratified sampling. Four machine learning methods-logistic regression, Lasso regression, support vector machine (SVM), and random forest-were employed to develop predictive models on the training set, with optimal hyperparameters determined through grid search. Model performance was assessed via 10 - fold cross - validation on the training set, and the model with the highest AUC was selected. The chosen model was further validated on the independent validation set, with AUC, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) calculated.</p><p><strong>Results: </strong>During treatment with linezolid, 42 (14.8%) of the 284 patients developed thrombocytopenia, with an average onset of 12.0±5.6 days after starting linezolid therapy. The random forest model demonstrated the best performance, with an AUC of 0.902 (95% CI 0.814-0.991) in the validation set. This model achieved a sensitivity of 81.8%, specificity of 86.9%, positive predictive value (PPV) of 52.9%, and negative predictive value (NPV) of 96.4%.</p><p><strong>Conclusion: </strong>We developed a machine learning model to predict linezolid-associated thrombocytopenia, with the random forest model achieving an AUC of 0.902. This model can help clinicians assess patient risk and optimize treatment plans. Future work should validate the model in multicenter studies and explore its integration into clinical decision support systems.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"2653-2661"},"PeriodicalIF":2.9,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12116687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173766","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":"Analysis of Clinical Characteristics and the Effect of Symptomatic Supportive Treatment for Severe Neonatal Enterovirus Infection.","authors":"Zhe Xuan, Ting Wang, Ning Li, Ziqian Tang","doi":"10.2147/IDR.S507842","DOIUrl":"10.2147/IDR.S507842","url":null,"abstract":"<p><strong>Objective: </strong>To retrospectively analyze cases of neonatal enterovirus (EV) infection, identify risk factors for severe infection, pathological characteristics, and prognostic differences, and provide a basis for early identification of high-risk neonates.</p><p><strong>Methods: </strong>Neonates diagnosed with EV infection and admitted to Zhuzhou Central Hospital between January 2020 and December 2023 were included in the study. Based on disease severity, they were divided into a mild infection group (n = 149) and a severe infection group (n = 44). Data on demographic characteristics, clinical manifestations, laboratory findings, treatment methods, and prognosis were collected and statistically analyzed using SPSS 26.0.</p><p><strong>Results: </strong>Compared to the mild infection group, the severe infection group had lower gestational age (36.61 vs 38.50 weeks, P < 0.001) and higher preterm birth rates (P < 0.05). They presented earlier with higher incidences of rash, respiratory symptoms, and sepsis-like signs (all P < 0.05). Severe cases had significantly higher rates of pneumonia, myocarditis, necrotizing hepatitis, and DIC (all P < 0.001), with a mortality rate of 54.55% (P < 0.001). Laboratory findings showed more thrombocytopenia, coagulation dysfunction, and organ injury markers in the severe group (all P < 0.001). Mild cases required mainly non-invasive treatment, while severe cases had high mortality despite intensive interventions. Among survivors, 50% required long-term neurological rehabilitation.</p><p><strong>Conclusion: </strong>Severe neonatal EV infection is closely associated with preterm birth and perinatal infection, characterized by thrombocytopenia, coagulation dysfunction, and multiple organ damage. Early monitoring of high-risk neonates, especially preterm infants, should be reinforced. For neonates presenting within the first seven days of life with rash or respiratory distress accompanied by a rapid decline in platelet count, intensive care should be promptly initiated. Further research is needed to explore targeted antiviral therapies and immune modulation strategies.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"2629-2636"},"PeriodicalIF":2.9,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Performance of Clinical Metagenomic Next-Generation Sequencing for Suspected Central Nervous System Infections in a Municipal Hospital: A Retrospective Study in China.","authors":"Huimin Wang, Jianting Zhao, Xueyao Wang, Miaomiao Li, Tiantian Hu, Huan Xu, Min Dong, Wenlong He, Zhenyong Che","doi":"10.2147/IDR.S500279","DOIUrl":"10.2147/IDR.S500279","url":null,"abstract":"<p><strong>Purpose: </strong>Cerebrospinal fluid (CSF) metagenomic next-generation sequencing (mNGS) has the potential to identify the majority of pathogens in a single test. Accurate pathogen identification is vital for central nervous system infection (CNSi). However, there are few related studies investigating in a municipal hospital.</p><p><strong>Patients and methods: </strong>A total of 52 suspected CNSi patients were retrospectively recruited in Xinxiang central hospital between July 2019 and April 2023. The diagnostic performance of CSF mNGS, conventional microbiological tests (CMT), and the combination of CSF mNGS and CMT were evaluated by comparing to the final diagnosis.</p><p><strong>Results: </strong>Among 52 suspected CNSi patients, 35 were diagnosed as CNSi. In comparison to the final diagnosis, the area under curves (AUC) for CSF CMT, CSF mNGS, and the combination of CMT and mNGS for the diagnosis of CNSi were 0.56 (95% CI 0.4-0.72), 0.74 (95% CI 0.61-0.84), and 0.76 (95% CI 0.63-0.88), respectively. The sensitivities were 11.43% (95% CI 4.54%-25.95%), 48.57% (95% CI 32.99%-64.43%), and 51.43% (95% CI 35.57%-67.01%), respectively. The accuracy was 40.38 (95% CI 27.01%-54.90%), 65.38% (95% CI 50.91%-78.03%), and 67.31% (95% CI 52.89%-79.67%), respectively. Furthermore, based on CSF mNGS results, seven patients confirmed initial treatment, two escalated, and one de-escalated. Additionally, we identified the optimal cutoff values as 1.75 U/L for CSF adenosine deaminase (ADA), 75.44 U/L for CSF protein, and 185 mmH₂O for CSF pressure, when these values were exceeded, CSF mNGS tended to yield positive results.</p><p><strong>Conclusion: </strong>CSF mNGS showed superior diagnostic performance in CNSi and hence could serve as a complementary tool to CMT and conjunctively guide the precision therapy. Additionally, the values for CSF ADA, protein and pressure could assist in predicting mNGS positive result. With technical improvements for mNGS sample processing to increase throughput and reduce costs, clinicians may use mNGS more widely in municipal hospital laboratories.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"2637-2652"},"PeriodicalIF":2.9,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12106916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144158436","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}