Infection and Drug Resistance最新文献

{"title":"Clinical and Economic Outcomes Associated with Rapid Antimicrobial Susceptibility Reporting and Dual-Card Testing in ICU Bloodstream Infections.","authors":"Ya Xu, Yue Feng, Chunlei Shi, Panpan Ma, Xiu Cai, Ling Huang, Xinyu Liu, Keke Shao, Linlin Xu","doi":"10.2147/IDR.S632364","DOIUrl":"https://doi.org/10.2147/IDR.S632364","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the clinical and economic outcomes associated with implementation of an optimized blood culture workflow in intensive care unit (ICU) patients with bloodstream infections.</p><p><strong>Patients and methods: </strong>From March 2022 to June 2023, the laboratory implemented a multi-modal workflow optimization including satellite blood culture incubation in the emergency department, upgraded blood culture bottles, rapid MALDI-TOF MS identification, automated rapid antimicrobial susceptibility testing (AST) reporting, and dual AST cards for Gram-negative bacteria. The pre-optimization group included 107 adult ICU patients with positive blood cultures (March 2021 - February 2022). The post-optimization group included 153 patients (September 2023 - August 2024).</p><p><strong>Results: </strong>Compared to the final AST report in the pre-optimization group, the rapid AST report in the post-optimization group was 19.6 hours faster (<i>P</i> < 0.001). Total antibiotic use duration was 1.5 days shorter (<i>P</i> = 0.055). Use of two broad-spectrum antibiotics, meropenem (<i>P</i> < 0.001) and tigecycline (<i>P</i> = 0.045), decreased significantly. Hospital length of stay was 5 days shorter (<i>P</i> = 0.006). In unadjusted comparisons, antibiotic and hospitalization costs were reduced by 4871 CNY ([US$ 684], <i>P</i> < 0.001) and 13,336 CNY ([US$ 1873], <i>P</i> = 0.073), respectively.</p><p><strong>Conclusion: </strong>This multimodal workflow optimization for ICU patients with BSIs, incorporating automated rapid AST reporting and dual-AST-card-enabled expanded antimicrobial panels, shortened laboratory turnaround time. It was associated with earlier opportunities for targeted antimicrobial therapy and suggests potential clinical-economic benefits, alongside possible mitigation of antimicrobial-resistance risk.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"632364"},"PeriodicalIF":3.2,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166948","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":"Immunoglobulin-Y in Infectious Disease Diagnostics: The Ethical, Sustainability and Conditions Does It Outperform Conventional Antibodies.","authors":"Meti Kusmiati, Shabarni Gaffar, Sri Agung Fitri Kusuma","doi":"10.2147/IDR.S644269","DOIUrl":"https://doi.org/10.2147/IDR.S644269","url":null,"abstract":"<p><p>Infectious diseases remain a major global health challenge, and effective control depends on early and accurate diagnosis. However, conventional immunodiagnostic platforms rely heavily on mammalian antibodies, which may present limitations related to animal welfare, production, and nonspecific immunological interactions. Immunoglobulin Y (IgY), isolated from the yolk of eggs collected non-invasively from immunized hens, has emerged as a potential alternative, although its advantages over conventional mammalian antibodies appear to be context-dependent rather than universal. This narrative review synthesizes current evidence on IgY production, diagnostic performance, comparative advantages and limitations, and ethical and sustainability considerations. A structured literature search of PubMed and Scopus covering January 2016 to February 2026 identified 66 records. Of these, 25 articles underwent full-text eligibility assessment, and 17 studies met the inclusion criteria and were included in the qualitative synthesis. Additional supporting literature identified through hand-searching was used for mechanistic and contextual interpretation but was not counted among the 17 included studies. Across the diagnostic studies, IgY demonstrated favorable performance in selected immunoassay platforms, particularly where reduced interaction with mammalian Fc receptors, rheumatoid factor, or complement may decrease nonspecific interference. High diagnostic performance was reported for applications including bovine coronavirus detection (97.7% sensitivity and 98.2% specificity) and SARS-CoV-2 detection (>90% sensitivity and specificity). However, IgY did not consistently outperform mammalian antibodies across all applications, with limitations observed in free-solution turbidimetric assays, selected in vivo models, and certain engineered antibody formats. Two included studies addressed ethical and sustainability considerations, with quantitative sustainability assessment indicating advantages for IgY-based approaches, although the evidence remains limited. Overall, IgY represents a promising but context-dependent alternative to conventional antibodies. Further head-to-head comparative studies, standardized production and validation protocols, and larger-scale clinical evaluation are required to define the diagnostic settings in which IgY provides a meaningful advantage.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"644269"},"PeriodicalIF":3.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166745","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":"Admission-Based Prediction of Macrolide Resistance in Children Aged >28 Days and ≤8 Years with <i>Mycoplasma pneumoniae</i> Pneumonia: A Retrospective Prediction Model Study.","authors":"Weiwei Zhang, Kelei Deng, Zhiyue Deng, Ying Nie, Yue Wu, Shuhe Yang, Xuewei Wang, Mei Mei, Jing Nie","doi":"10.2147/IDR.S640851","DOIUrl":"https://doi.org/10.2147/IDR.S640851","url":null,"abstract":"<p><strong>Purpose: </strong>Macrolide-resistant <i>Mycoplasma pneumoniae</i> pneumonia (MRMP) complicates the management of pediatric <i>Mycoplasma pneumoniae</i> pneumonia (MPP), especially around the 8-year treatment threshold, where second-line antimicrobial choices require careful risk-benefit assessment. This study aimed to develop and internally validate an admission-based model for predicting macrolide resistance in children aged >28 days and ≤8 years with MPP.</p><p><strong>Patients and methods: </strong>This single-center retrospective prediction model study included hospitalized children with confirmed MPP at the First Affiliated Hospital of Jiamusi University from October 2023 to October 2024. Candidate predictors were restricted to demographic and laboratory variables available at admission or during early hospitalization. Univariable analyses were followed by multivariable logistic regression with stepwise selection. Model performance was assessed by receiver operating characteristic (ROC) analysis, calibration plots, decision curve analysis (DCA), and bootstrap internal validation.</p><p><strong>Results: </strong>A total of 724 children were included, of whom 146 (20.2%) were classified as having macrolide resistance. The final model included height, C-reactive protein (CRP), lactate dehydrogenase (LDH), and creatine kinase-MB (CK-MB). The model showed an apparent area under the ROC curve (AUC) of 0.752 (95% CI, 0.711-0.793), and the optimism-corrected AUC after internal validation was 0.746. At the selected cutoff, sensitivity was 0.719, specificity was 0.680, and the negative predictive value was 0.906. Calibration and DCA suggested acceptable agreement and potential clinical usefulness within the observed sample.</p><p><strong>Conclusion: </strong>An admission-based model using height, CRP, LDH, and CK-MB showed moderate discrimination for predicting macrolide resistance in children aged >28 days and ≤8 years with MPP. The model showed a high negative predictive value and may help identify children at lower risk of molecularly confirmed macrolide resistance; molecular testing remains necessary to confirm resistance in children at higher predicted risk, and external validation is required before routine clinical use.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"640851"},"PeriodicalIF":3.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165515","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 Distribution Characteristics and Antimicrobial Resistance Trends of <i>Klebsiella pneumoniae</i> in a Chinese Tertiary Hospital (2021-2025).","authors":"Kang Liu, Zhi Zheng, Lili Liu, Wanjun Wang, Xiaoyue Li","doi":"10.2147/IDR.S633846","DOIUrl":"10.2147/IDR.S633846","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the distribution and antimicrobial susceptibility of <i>Klebsiella pneumoniae</i> from Anqing First People's Hospital of Anhui Medical University from 2021 to 2025 and to provide rational regimens for clinical anti-infection.</p><p><strong>Methods: </strong>The non-repetitive bacterial strains were detected and collected in this hospital, Pathogen identification was performed using a mass spectrometer. Susceptibility testing was performed using an automated system or disk diffusion. The 2025 CLSI clinical standards were applied to determine susceptibility. Experimental susceptibility data were statistically analyzed using WHONET 5.6 software and SPSS26.0. Chi-square tests and trend tests were used for the statistical analyses.</p><p><strong>Results: </strong>8992 pathogenic strains were isolated during 2021-2025, including 1135 KPN, and the total detection rate was 12.6%. The annual detection rates from 2021 to 2025 were 12.8% (225/1,756), 11.7% (203/1,733), 14.5% (261/1,804), 12.6% (234/1,863), and 11.5% (212/1,836), respectively. The overall detection rate of Carbapenem-resistant <i>Klebsiella pneumoniae</i> (CRKP) was 13.8% (157/1135). Over the five-year period, the predominant specimen sources of the isolates were sputum (35.5%), midstream urine (27.8%), and secretions (17.3%). The top three departments by isolation rate were ICU, Neurosurgery, and Urology. The drug sensitivity results showed that the resistance of <i>K. pneumoniae</i> to most common antibiotics were different during 2021 to 2025 (<i>P</i> < 0.05), and it had certain resistance to common antibiotics. The resistance rate of <i>K. pneumoniae</i> to imipenem detected in the ICU was significantly higher than that in the neurosurgery and urology departments.</p><p><strong>Conclusion: </strong>During the five-year period from 2021 to 2025, the isolated <i>K. pneumoniae</i> showed varying levels of resistance to common antibacterial drugs in our hospital. The resistance rates varied among different departments. The situation of drug resistance remains severe. Therefore, The hospital must strengthen daily infection control measures and drug resistance monitoring to reduce the spread of drug-resistant bacteria.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"633846"},"PeriodicalIF":3.2,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13648167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136489","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":"Metagenomic Next-Generation Sequencing in Brucellar Spondylitis with Discordant Serologic Findings in a Non-Endemic Region: A Case Report and Literature Review.","authors":"Danlei Chen, Weijiang Ye, Xinyi Li, Jiawei Zhang","doi":"10.2147/IDR.S627757","DOIUrl":"10.2147/IDR.S627757","url":null,"abstract":"<p><strong>Background: </strong>Brucellar spondylitis (BS) is a focal osteoarticular manifestation of brucellosis with nonspecific clinical and imaging features. Diagnosis may be difficult in areas where brucellosis is not traditionally considered endemic, particularly when epidemiologic exposure is not identified and serologic tests yield discordant results. We report a case in which metagenomic next-generation sequencing (mNGS) of vertebral lesion tissue provided additional microbiologic evidence for the diagnosis.</p><p><strong>Case presentation: </strong>A 71-year-old man presented with a 2-month history of fatigue, anorexia, night sweats, and worsening back pain without an identifiable epidemiologic exposure. Imaging showed destructive T8-T9 spondylitis with intervertebral disc involvement, paravertebral soft-tissue swelling, and small abscess formation. CT-guided biopsy demonstrated inflammatory changes, while routine bacterial culture, lesion-based MTBC DNA/RNA testing, and mycobacterial culture were negative. <i>Brucella</i>-specific immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies were positive, whereas the standard tube agglutination test (SAT) titer was <1:25 and the Rose Bengal test (RBT) was negative. mNGS of vertebral lesion tissue detected <i>Brucella</i> spp. DNA. Serial serologic testing subsequently showed SAT titers of 1:200 and 1:400, with later conversion of the RBT to positive, providing further support for brucellar spondylitis. The patient received combination anti-brucellar therapy and underwent posterior thoracic fixation, spinal canal decompression, lesion debridement, and bone graft fusion because of extensive vertebral destruction and concern for spinal instability. At approximately 10 weeks after treatment initiation, while anti-brucellar therapy was ongoing, back pain had markedly improved.</p><p><strong>Literature review: </strong>Published studies suggest that mNGS may improve pathogen detection in selected spinal infections when conventional microbiologic testing is unrevealing. Reports of focal brucellosis also show that lesion-derived specimens may provide microbiologic evidence that complements peripheral serologic findings.</p><p><strong>Conclusion: </strong>In this case, mNGS did not identify a previously unsuspected pathogen but added microbiologic evidence from the affected vertebral lesion to an otherwise discordant serologic profile. Tissue-based mNGS may be useful in selected patients with suspected BS when conventional serologic findings are discordant and culture is negative.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"627757"},"PeriodicalIF":3.2,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13640988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109207","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 Novel Erg3 T208Is Substitution Associated with Reduced Fluconazole and Voriconazole Susceptibility in Clinical <i>Talaromyces marneffei</i> Isolates from HIV/AIDS Patients.","authors":"Zheng Yanqing, Pang Xiaofeng, Fang Yinmei, Mo Lida, Luo Xiaolu, Xiao Manqi, Tang Xike","doi":"10.2147/IDR.S629534","DOIUrl":"10.2147/IDR.S629534","url":null,"abstract":"<p><strong>Introduction: </strong><i>Talaromyces marneffei</i> (<i>T. marneffei</i>) is a life-threatening dimorphic fungus endemic to southern China and Southeast Asia. Decreased triazole susceptibility in <i>T. marneffei</i> has emerged as a major clinical challenge for treating immunocompromised patients, particularly those living with HIV/AIDS. This study aimed to explore the mechanisms underlying reduced susceptibility to fluconazole and voriconazole in <i>T. marneffei</i> isolates derived from HIV/AIDS patients in China.</p><p><strong>Methods: </strong>Antifungal susceptibility testing of clinical isolates was performed using the broth microdilution method in accordance with CLSI M27-A4 guidelines. Whole-genome sequencing (WGS) and Sanger sequencing were applied to screen for putative resistance-associated genetic mutations, with a focus on the key ergosterol biosynthesis genes <i>Erg3</i> and <i>cyp51B</i>. Furthermore, sequence conservation analysis was conducted to evaluate the conservation of candidate mutation sites across pathogenic fungi.</p><p><strong>Results: </strong>All four clinical isolates exhibited a putative resistance phenotype to fluconazole and voriconazole, with significantly higher minimum inhibitory concentrations (MICs) compared with the wild-type strain. A novel <i>Erg3</i> c.1195G>A (p.T208I) substitution was identified in three isolates via genomic sequencing. Bioinformatic analysis verified that the T208 residue is highly conserved among <i>T. marneffei</i> and other pathogenic fungi.</p><p><strong>Conclusion: </strong>This is the first study to identify an association between the Erg3 T208I substitution and putative cross-resistance to fluconazole and voriconazole in <i>T. marneffei</i>. The findings of expand the known genetic mechanisms underlying putative antifungal resistance in <i>T. marneffei</i>.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"629534"},"PeriodicalIF":3.2,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109156","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":"Adverse Events Following Immunization: Mechanisms, Clinical Manifestations, Surveillance, and Public Health Management-A Narrative Review.","authors":"Tambwe Patrick, Omari Basombelwa John, Bigabwa Baharanyi Dominique, Raha Zihindula Raoul","doi":"10.2147/IDR.S642114","DOIUrl":"10.2147/IDR.S642114","url":null,"abstract":"<p><p>Immunization is a cornerstone of global public health, preventing substantial morbidity and mortality worldwide. However, the long-term success of immunization programs depends not only on vaccine effectiveness but also on robust systems for monitoring and managing vaccine safety. Adverse Events Following Immunization (AEFIs), defined by the World Health Organization (WHO) as any untoward medical occurrence that follows immunization and does not necessarily have a causal relationship with vaccine use, remain an important challenge for vaccine safety surveillance and public confidence. This narrative review synthesizes evidence on the classification, biological and immunological mechanisms, clinical manifestations, surveillance, causality assessment, and public health management of AEFIs. Literature was identified through searches of PubMed/MEDLINE and Scopus, complemented by relevant grey literature from authoritative organizations, including WHO and the United States Centers for Disease Control and Prevention (CDC). The review considers evidence from both COVID-19 and non-COVID-19 vaccination programs, with emphasis on vaccine safety surveillance, pharmacovigilance, clinical assessment, and public health response. AEFIs were examined according to the WHO classification framework, comprising vaccine product-related, vaccine quality defect-related, immunization error-related, immunization anxiety-related, and coincidental events. Biological and immunological mechanisms range from expected innate inflammatory responses to rare immune-mediated and hypersensitivity reactions. Although most AEFIs are mild and self-limiting, rare serious events require timely recognition, investigation, and appropriate clinical management. Global vaccine safety monitoring capacity remains uneven, with substantial differences in reporting, surveillance infrastructure, diagnostic capacity, and health-system resources across settings. Strengthening pharmacovigilance, active and passive surveillance, healthcare worker training, causality assessment, and transparent risk communication is essential to ensure vaccine safety, sustain public confidence, and support the continued success of immunization programs worldwide.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"642114"},"PeriodicalIF":3.2,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13640981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109124","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 Associated with Mortality in Children with Critically Ill Influenza B in the Pediatric Intensive Care Unit.","authors":"Jiapu Hou, Zewen Ding, Ruiyang Sun, Shenyuan Wang, Xinyue Cui, Wanyu Jia, Peng Li, Chunlan Song","doi":"10.2147/IDR.S632937","DOIUrl":"https://doi.org/10.2147/IDR.S632937","url":null,"abstract":"<p><strong>Purpose: </strong>Analysis of the clinical characteristics of critically ill children with influenza B.</p><p><strong>Methods: </strong>This study is a retrospective study. It included 105 critically ill children with influenza B who were admitted to the Pediatric Intensive Care Unit (PICU) at the Children's Hospital Affiliated with Zhengzhou University from January 2018 to December 2024. On the basis of their discharge outcomes, the patients were divided into a mortality group (n=11) and a survival group (n=94). We collected demographic and clinical data from the pediatric patients and compared the differences between the two groups.</p><p><strong>Results: </strong>The mortality rate among 105 critically ill children with influenza B was 10.48%. The incidence of cough was lower in the group of children who died than in the group of children who survived, whereas the incidence of abdominal pain, altered consciousness, seizures, mechanical ventilation, and respiratory failure was higher in the group of children who died than in the group of children who survived. Children in the mortality group had significantly higher levels of D-dimer, aspartate aminotransferase, r-glutamyl transpeptidase, lactate dehydrogenase, procalcitonin, and interleukin-6 than those in the survival group did.</p><p><strong>Conclusion: </strong>Children in the mortality group were older and had a lower incidence of cough than those in the survival group did. In the pediatric intensive care unit (PICU), characteristics associated with mortality in patients with influenza B include abdominal pain, altered consciousness, liver dysfunction, elevated inflammatory markers, or the need for mechanical ventilation. Children with influenza B admitted to the PICU often experience rapid disease progression and are prone to developing respiratory failure. Mechanical ventilation and respiratory failure are important clinical indicators of a severe deterioration in the condition of critically ill pediatric patients with influenza B in the PICU. Respiratory failure and circulatory failure are the direct causes of adverse outcomes in children in the mortality group.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"632937"},"PeriodicalIF":3.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109116","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":"Evaluation of Brucella IgM and IgG ELISA Responses in Relation to Blood Culture Positivity in Pediatric Brucellosis.","authors":"Asuman Akar","doi":"10.2147/IDR.S648045","DOIUrl":"https://doi.org/10.2147/IDR.S648045","url":null,"abstract":"<p><strong>Background: </strong>Class-specific Brucella IgM and IgG enzyme-linked immunosorbent assay (ELISA) responses according to blood culture status are incompletely characterized in children with confirmed brucellosis. We compared IgM and IgG ELISA findings according to contemporaneous blood culture status among children already classified as having confirmed acute brucellosis; diagnostic accuracy was not assessed.</p><p><strong>Methods: </strong>This retrospective, single-center, cross-sectional observational study included 94 children aged 18 years or younger. Rose Bengal testing, standard tube agglutination testing (STAT), Brucella IgM and IgG ELISA, and blood culture were obtained at the same presentation. Serologic findings were compared by culture status, and factors associated with culture positivity were explored using multivariable logistic regression.</p><p><strong>Results: </strong>Blood cultures yielded <i>Brucella melitensis</i> in 49/94 children (52.1%). IgM ELISA was positive in 93/94 (98.9%). IgG ELISA was positive in 70/94 (74.5%), equivocal in 4/94 (4.3%), and negative in 20/94 (21.3%). IgM values did not differ significantly between culture-positive and culture-negative groups (41.2 ± 15.8 vs 36.2 ± 12.6 NTU; p=0.096). IgG values were lower in culture-positive children (median 18.5 vs 21.0 NTU; Mann-Whitney U=789; p=0.018; rank-biserial correlation=0.284). After excluding equivocal results, IgG negativity was more frequent in culture-positive than culture-negative children (14/47 [29.8%] vs 6/43 [14.0%]), but not significantly (Fisher exact p=0.082). Fever with arthralgia, elevated C-reactive protein, and elevated aspartate aminotransferase remained associated with culture positivity in the exploratory model.</p><p><strong>Conclusion: </strong>Among children with confirmed acute brucellosis, IgM ELISA was positive in nearly all patients, while continuous IgG values were lower in culture-positive children. These findings describe associations with contemporaneous culture status and should not be interpreted as antibody kinetics or diagnostic-performance estimates. ELISA values should not be used alone to predict blood culture positivity or determine whether blood culture should be obtained.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"648045"},"PeriodicalIF":3.2,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13634318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109122","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":"Polymicrobial and ESBL-Producing Bacterial Infections Among Pyogenic Liver Abscess: A 12-Year Study of Risk Factors and Antimicrobial Susceptibility.","authors":"Jinqing Liu, Yao Liu, Chuan Jiang, Lu Yu, Shifang Peng, Lei Fu","doi":"10.2147/IDR.S600399","DOIUrl":"https://doi.org/10.2147/IDR.S600399","url":null,"abstract":"<p><strong>Background: </strong>Pyogenic liver abscess (PLA) is a potentially life-threatening hepatic infection. The increasing prevalence of polymicrobial infections and multidrug-resistant (MDR) pathogens, including extended-spectrum β-lactamase (ESBL)-producing bacteria, poses challenges to treatment and association with higher mortality rates. Identifying risk factors and optimizing clinical management strategies for these infections are essential to improving patient outcomes.</p><p><strong>Methods: </strong>This retrospective study analyzed the clinical data of 643 PLA patients admitted in recent 12 years. Univariate and multivariate analyses were conducted to analyze treatment strategies, disease burden, and clinical outcomes, as well as identify risk factors associated with polymicrobial infections and ESBL-producing bacterial strains.</p><p><strong>Results: </strong>In this study, 255 of 643 PLA patients with positive bacterial identification were enrolled. Among them, 41 had polymicrobial infections. Of the 162 patients who underwent ESBL testing, 128 were infected with ESBL-producing bacteria. Polymicrobial PLA was significantly associated with intra-abdominal trauma or surgery (odds ratio [OR] = 3.06), malignancies or hematological diseases (OR = 3.01). ESBL-producing bacterial PLA was correlated with hepatic tenderness (OR = 3.24), intra-abdominal trauma or surgery (OR = 3.06), and hospitalization within the past three months (OR = 4.32). <i>E. coli</i> was more frequently identified among ESBL-producing bacteria compared to <i>K. pneumoniae</i>. The use of carbapenems for treating ESBL-producing pathogens has been increasing, with carbapenems and β-lactamase inhibitor combinations currently serving as the primary therapeutic options.</p><p><strong>Conclusion: </strong>Patients with PLA who have a history of intra-abdominal trauma or surgery, malignancies or hematological diseases, and recent hospitalization should be closely monitored for polymicrobial and drug-resistant infections. Given the high prevalence of antibiotic-resistant <i>E. coli</i> in PLA cases, judicious use of antibiotics is warranted. Broad-spectrum antibiotics effective against ESBL-producing bacteria should be considered, with carbapenems remaining the first-line treatment option.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"600399"},"PeriodicalIF":3.2,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13634246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109184","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}