Infection and Drug Resistance最新文献

{"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":"https://doi.org/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":"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":"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":"https://doi.org/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":"https://doi.org/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":"https://doi.org/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":"https://doi.org/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}

{"title":"Case Report: Diagnosis of Hemolytic Anemia from Babesia and Secondary Multi-Pathogen Pneumonia Using a Metagenomic Next-Generation Sequencing Approach.","authors":"Yun Lu, Dan Zhang, Dongsheng Han, Fei Yu, Xingnong Ye, Shufa Zheng","doi":"10.2147/IDR.S472861","DOIUrl":"https://doi.org/10.2147/IDR.S472861","url":null,"abstract":"<p><p>Babesiosis, as a vector-borne infectious disease, remains relatively rare and is prone to being overlooked and misdiagnosed. Therefore, understanding the epidemiological characteristics and clinical manifestations of babesiosis is crucial for the prompt detection and treatment of the disease. We reported a 63-year-old male patient presenting with spontaneous fever and chills. Laboratory investigations revealed erythrocytopenia, reduced hemoglobin levels, and increased reticulocytes and total bilirubin. Bone marrow examination indicated vigorous cell proliferation, a decreased granulocyte to red cell ratio, and predominant erythroid cell proliferation, with a higher prevalence of intermediate and late-stage juvenile granulocyte and erythroid cells. Initial treatment focused on hemophagocytic syndrome triggered by Epstein-Barr virus infection yielded unsatisfactory results, leading to secondary multiple pulmonary infections. Metagenomic next-generation sequencing (mNGS) of sputum samples pointed to hemolytic anemia induced by Babesia infection, which was subsequently confirmed through peripheral blood smear analysis. The patient responded well to prompt administration of atovaquone and azithromycin, with symptoms resolving and laboratory parameters normalizing. Hemolytic anemia resulting from babesiosis should be distinguished from hemophagocytic syndrome caused by Epstein-Barr virus and other hematologic conditions. mNGS represents an efficient technique for Babesia detection.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11378987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153928","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":"Co-Infection with Nocardia Terpene and Pneumocystis Jirovecii in a Patient with Anti-Synthetase Syndrome: A Case Report.","authors":"Yinying Li, Qiuming Li, Haihua Lei, Xiaorong Wei, Tao Feng, Huajiao Qin, Hongchun Huang, Minchao Duan","doi":"10.2147/IDR.S474836","DOIUrl":"10.2147/IDR.S474836","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary infection is a common clinical complication associated with glucocorticoid. There have been no reported cases of mixed infections involving Nocardia and Pneumocystis jirovecii combined with anti-synthetase syndrome (ASS) activity.</p><p><strong>Methods: </strong>This study conducted a retrospective analysis of the clinical data from a patient with active ASS, treated for a pulmonary coinfection.</p><p><strong>Results: </strong>The patient exhibited fever, asthma, and cough as initial symptoms. Chest CT scan revealed multiple infiltration shadows, consolidation shadows, nodules, mass shadows, and internal cavities in both lungs. BALF mNGS detected Nocardia terpene and Pneumocystis jiroveci. Treatment with sulfamethoxazole/trimethoprim and corticosteroids led to an improvement. However, the patient experienced recurrent fever and a new rash with the reduction of the glucocorticoid dosage. Further investigation identified positive anti-Jo-1 and anti-Ro-52 antibodies and myogenic lesions on electromyography, which confirmed the diagnosis of ASS. Following treatment with immunoglobulin, methylprednisolone, and cyclosporine, the patient's condition significantly improved.</p><p><strong>Conclusion: </strong>Immunodeficiency patients are susceptible to opportunistic infections. mNGS is valuable for diagnosis and treatment. Although the image of Nocardia terpene and Pneumocystis jiroveci infections lack specificity, they exhibit distinctive features. Should fever and skin lesions reoccur post-effective anti-infective therapy, it is imperative to explore non-infectious causes and expedite autoantibody testing.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11370755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125632","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":"Bronchoalveolar Lavage Fluid Metagenomic Second-Generation Sequencing Assists in Guiding the Treatment of Visceral Leishmaniasis: A Case Report.","authors":"Jian Li, Li Liu, Zhiyun Gao, Xia Chuai, Xiaokun Liu, Xiaobo Zhang, Xinyu Zhang, Xiaoqing Su, Qian Xu, Zhuojun Deng","doi":"10.2147/IDR.S468684","DOIUrl":"10.2147/IDR.S468684","url":null,"abstract":"<p><strong>Purpose: </strong>The incidence of visceral leishmaniasis (VL), a global infectious disease, has been on the rise in China's Hebei province. When patients achieve clinical cure, they often do not reach an etiological cure, which may lead to recurrence of the disease. Here, we report a case of visceral leishmaniasis with a negative blood smear and bone marrow cytology.</p><p><strong>Patients and methods: </strong>A 65-year-old man and bronchoalveolar lavage fluid mNGS.</p><p><strong>Results: </strong>A 65-year-old man developed a chronic fever, anorexia, splenomegaly, and pancytopenia. The blood metagenomic second-generation sequencing (mNGS) revealed <i>Leishmania</i> sequence readings, which led to the diagnosis of VL. After sodium antimony gluconate treatment, the blood smear and bone marrow cytology revealed no <i>Leishmania</i> bodies. However, pancytopenia and respiratory failure did not fully subside, and cardiotoxic damage emerged. The bronchoalveolar lavage fluid (BALF) mNGS was performed to detect the pathogen. Through BALF mNGS, <i>Leishmania</i> sequence was still detectable. Therefore, after the ECG returned to normal, antimony sodium gluconate was administered as a next course of treatment.</p><p><strong>Conclusion: </strong>BALF mNGS may assist in evaluating the therapeutic efficacy of VL with respiratory failure, especially in patients with negative blood and bone marrow cytology.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11370764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125631","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":"Association Between COVID-19 and Diabetes Management Indices in Japanese Type 2 Diabetes Mellitus Patients: A Single-Center, Retrospective Study.","authors":"Kazuhiro Furumachi, Tatsuki Kagatsume, Akari Higuchi, Mariko Kozaru, Etsuko Kumagai, Keiko Hosohata","doi":"10.2147/IDR.S475917","DOIUrl":"10.2147/IDR.S475917","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of the study was to determine the association between coronavirus disease 2019 (COVID-19) infection and diabetes management indices in patients with type 2 diabetes mellitus.</p><p><strong>Patients and methods: </strong>A single-center, retrospective, observational study of patients with type 2 diabetes mellitus at Kenwakai Hospital (Nagano, Japan) was conducted. Data of 95 patients (mean age, 72 ± 12 years; men, 67.4%) who visited between March 1, 2019 and February 28, 2022 were obtained from the hospital's electronic information system. COVID-19 was diagnosed by a chemiluminescent enzyme immunoassay (CLEIA).</p><p><strong>Results: </strong>There was no association between COVID-19 infection and age, sex, hemodialysis treatment status, or the Charlson Comorbidity Index. After adjustment for possible confounding factors, the incidence of COVID-19 infection was significantly correlated with HbA1c ≥7.0% (odds ratio [OR], 5.51; 95% confidence interval [CI], 1.30-23.26).</p><p><strong>Conclusion: </strong>The results suggest an association between high HbA1c levels and COVID-19 infection in patients with type 2 diabetes mellitus. Appropriate management of diabetes mellitus, focusing on HbA1c levels, may help prevent COVID-19 infection and severe disease after infection.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11368151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142121570","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}