Infection and Drug Resistance最新文献

{"title":"AI-2 Signaling: A Potential Driver of Bacteremia in Non-Typhoidal <i>Salmonella</i> Infections.","authors":"Yu Li, Bing Lu, Xinhua Qiang, Yibin Lin, Jie He, Yunxiang Cai","doi":"10.2147/IDR.S507908","DOIUrl":"10.2147/IDR.S507908","url":null,"abstract":"<p><strong>Introduction: </strong>Non-typhoidal <i>Salmonella</i> (NTS) infections typically present as localized inflammation near the intestinal mucosal epithelium. However, some NTS strains can breach the intestinal barrier and enter the bloodstream, leading to bacteremia and severe systemic infections. The mechanisms by which NTS invades the bloodstream remain unclear.</p><p><strong>Methods: </strong>In this study, we isolated 36 NTS strains from patients with diarrhea and bacteremia at First Affiliated Hospital of Huzhou University. Strains represented two distinct clinical manifestations, and were subjected to whole-genome sequencing, comparative genomics, and genetic differentiation analysis to identify genes potentially involved in bloodstream invasion. Additionally, we conducted inhibition assays using quercetin, a chemical inhibitor of the identified gene pathways, to validate our findings.</p><p><strong>Results: </strong>Our analysis revealed that genes distinguishing the bloodstream <i>Salmonella</i> isolates from the fecal <i>Salmonella</i> isolates were primarily involved in the AI-2 quorum sensing pathway and biofilm-associated protein transport. Subsequent biofilm formation assays demonstrated that the bloodstream isolates exhibited significantly higher biofilm formation capacity compared to the fecal isolates. Upon the addition of quercetin, biofilm formation was equally inhibited in both groups. Collectively, these findings suggest that genes involved in the AI-2 pathway and biofilm-associated protein transport may be key factors contributing to the development of bacteremia in NTS infections.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"1521-1537"},"PeriodicalIF":2.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692040","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":"Cross-District Transmission of Tuberculosis in a High-Mobility City in China: Implications for Regional Collaboration in Infectious Disease Control.","authors":"Chuangyue Hong, Jinjin Ge, Jing Gui, Xiaoling Che, Yilin Li, Zhipeng Zhuo, Mingzhen Li, Feng Wang, Weiguo Tan, Zhiguang Zhao","doi":"10.2147/IDR.S516162","DOIUrl":"10.2147/IDR.S516162","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to elucidate the transmission dynamics of tuberculosis in a Chinese city with high population mobility and to identify the associated risk factors.</p><p><strong>Methods: </strong>We included the data from ten city-level surveillance sites in Shenzhen between 2018 and 2023. Genomic clusters were defined as having a genomic distance of 12 single nucleotide polymorphisms based on whole-genome sequencing. Cross-district clusters were characterized as clusters containing patients from at least two districts, indicating cross-district transmission. Risk factors for clustering were identified using logistic regression.</p><p><strong>Results: </strong>Of the 2,519 enrolled patients, 263 (10.4%) were grouped into 119 genomic clusters. Notably, 52.1% (62/119) of these clusters were cross-district clusters. We analyzed the data from Shenzhen's 10 districts separately and compared the results with a citywide combined analysis, finding that the combined analysis revealed significantly higher clustering rates across all districts (P<0.001). Furthermore, the risk of cross-district transmission was 3.41 times higher (95% CI: 1.49-7.80) among internal migrants than among residents. Multivariable logistic regression analysis identified significant risk factors for TB transmission, including age under 25 years (OR=3.07, 95% CI: 1.17-8.03), age 25-44 years (OR=2.86, 95% CI: 1.13-7.23), and drug-resistant TB (OR=1.57, 95% CI: 1.15-2.13).</p><p><strong>Conclusion: </strong>Cross-district transmission is a key factor in the spread of tuberculosis in cities with high population mobility. TB control institutions at all levels must transcend regional boundaries and enhance collaboration to achieve more effective tuberculosis control.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"1551-1560"},"PeriodicalIF":2.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692097","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":"Hemophagocytic Lymphohistiocytosis Secondary to Melioidosis in Paediatric Patients: A Case Series.","authors":"Kecheng Wan, Yingjie Liu, Yuwen Chen, Song Sun, Hong Liang","doi":"10.2147/IDR.S505259","DOIUrl":"10.2147/IDR.S505259","url":null,"abstract":"<p><strong>Background: </strong>Melioidosis caused by <i>Burkholderia pseudomallei</i> manifests as a variety of infectious symptoms. However, hemophagocytic lymphohistiocytosis (HLH) secondary to bacteraemic melioidosis is rarely documented in the literature. We report a series of fatal cases of melioidosis combined with HLH in one Chinese family.</p><p><strong>Case presentation: </strong>Three cases of melioidosis with HLH were reported in a family with three children, two boys aged 4 and 6 years and a 12-year-old girl. The most common clinical presentation was fever. A blood culture confirmed <i>B. pseudomallei</i>, and bone marrow aspiration revealed hemophagocytosis. Despite the administration of antibiotics, glucocorticoids and other treatments, all the patients died, and their deaths were attributed to HLH.</p><p><strong>Conclusion: </strong>Melioidosis complicating HLH is rare in occurrence, but the mortality rate is high. Clinicians should be aware of the risk of a <i>B. pseudomallei</i> bloodstream infection in children.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"1561-1566"},"PeriodicalIF":2.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700380","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 Case of Severe Community-Acquired Pneumonia Caused by Coinfection of Five Pathogens.","authors":"Sha Min, Qingqing Lu, Yiling Zhang","doi":"10.2147/IDR.S483156","DOIUrl":"10.2147/IDR.S483156","url":null,"abstract":"<p><strong>Introduction: </strong>Severe pneumonia is a serious pulmonary infection, and its high morbidity and mortality are associated with underlying diseases, treatment-induced immunodeficiency, co-infection of multiple pathogens, and increase of multi-resistant pathogens; For severe community-acquired pneumonia (SCAP) in immunocompromised patients, most of which are infected with rare atypical pathogens, mNGS as an unbiased and hypothesis-free approach to rapidly detect potential infectious agents in pulmonary mixed infections. The cases of simultaneous co-infection of five non-respiratory core pathogens represented by Nocardia farcinica have not been reported.</p><p><strong>Case presentation: </strong>This article will elaborate on a case of immunocompromised patient with nephrotic syndrome after corticosteroid treatment, who was diagnosed as SCAP after hospital admission and relevant laboratory examination. Bronchoalveolar lavage fluid (BALF) metagenome next-generation sequencing (mNGS) method identified as Nocardia farcinica, Aspergillus fumigatus, Pneumocystis jirovecii, cytomegalovirus and human coronavirus OC43 five pathogens co-infection, the patient improved and he was discharged after receiving the combination treatment of imipenem, ganciclovir, compound sulfamethoxazole, and fluconazole.</p><p><strong>Conclusion: </strong>For SCAP patients with immunocompromised, there may be possible co-infection of multiple rare pathogens, low positive rate of conventional laboratory tests, mNGS can quickly and accurately identify pathogens, which can be used for targeted drug treatment, promote the early recovery of patients and reduce the abuse of broad-spectrum antibiotics.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"1515-1519"},"PeriodicalIF":2.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692084","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":"Amorphous Roxithromycin Loaded in-situ Gel for the Treatment of <i>Staphylococcus aureus</i> Induced Upper Respiratory Tract Infection.","authors":"Li Ji, He Bai, Ning Tao, Yanpeng Lei, Anyin Li, Cheng Wang, Pengfei Cui, Xiaofeng Gu","doi":"10.2147/IDR.S502389","DOIUrl":"10.2147/IDR.S502389","url":null,"abstract":"<p><strong>Objective: </strong>Upper respiratory tract infections are among the most prevalent respiratory diseases, imposing both financial and physical burdens on affected individuals. Roxithromycin (ROX), a primary drug for treating bacterial-induced respiratory tract infections, is typically administered orally due to its hydrophobic nature. However, the non-specific distribution resulting from oral administration reduces bioavailability and can cause side effects such as diarrhea.</p><p><strong>Methods: </strong>In this study, we prepared a thermo-sensitive in-situ gel using a facile and highly reproducible method by simply mixing two types of poloxamers with ROX.</p><p><strong>Results: </strong>The ROX can be well dissolved in the poloxamer matrix in amorphous state to give solution. Upon intranasal administration, the ROX solution undergoes a phase transition to form in-situ gel under body temperature. This gel remains in the nasal cavity for an extended period, releasing the drug directly to the site of infection and minimizing non-specific distribution. Pharmacokinetic experiments revealed that, compared to oral administration, the bioavailability of local nasal administration increased by 1.5 times, and the drug concentration in the local nasal cavity increased by 8 times. In contrast, concentrations in the liver and small intestine did not significantly differ from those following oral administration. In vivo antibacterial experiments also showed that the ROX in-situ gel has superior antibacterial efficacy and excellent biocompatibility.</p><p><strong>Conclusion: </strong>These results suggest that the thermo-sensitive ROX in-situ gel is a promising formulation for treating bacterial upper respiratory tract infections.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"1471-1483"},"PeriodicalIF":2.9,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692044","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":"The Conservative Treatment of a Rare Postoperative Complication of DBS-Brain Abscess: Case Series.","authors":"Guanghan Lu, Jingxuan Liu, Xiang Wei, Jiuqi Yan, Jian Sun, Wenwen Dong, Liang Zhao, Chang Qiu, Bei Luo, Wenbin Zhang","doi":"10.2147/IDR.S497124","DOIUrl":"10.2147/IDR.S497124","url":null,"abstract":"<p><strong>Background: </strong>Deep Brain Stimulation (DBS) is an established treatment option for movement disorders such as Parkinson's disease and dystonia, so more and more patients (over 160,000 patients till 2019) worldwide have undergone DBS for a variety of neurological and non-neurological conditions, with numbers increasing each year. This case series primarily discusses a very rare complication following DBS surgery -- brain abscess.</p><p><strong>Case presentation: </strong>We administered vancomycin and metronidazole to patients who developed brain abscesses after undergoing DBS surgery based on previous literature. After treatment, the abscess lesions and infection symptoms completely resolved, resulting in a good therapeutic outcome without the removal of the DBS system.</p><p><strong>Conclusion: </strong>In previous studies, similar cases always involved surgical intervention to drain the pus while also removing the DBS system; however, in our cases, the patient did not have the DBS system removed and achieved a good prognosis. To our knowledge, our two cases are among the few where a conservative treatment approach has been used for brain abscesses after DBS surgery.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"1485-1490"},"PeriodicalIF":2.9,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692122","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 the Distribution Characteristics and Changes of Drug Resistance of Pathogens in Patients with Urinary Tract Infection Across Southwest China From 2019 to 2023.","authors":"Min Zhong, Xiangning Huang, Xin Liu, Hua Yu, Shanshan Long","doi":"10.2147/IDR.S512409","DOIUrl":"10.2147/IDR.S512409","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the changes in the distribution and drug resistance of pathogenic bacteria causing urinary tract infections in Southwest China from 2019 to 2023, and to provide an accurate scientific basis for empirical clinical use.</p><p><strong>Methods: </strong>The identification results and drug susceptibility tests of non-duplicate pathogens isolated from urine samples of patients in Sichuan region from 2019 to 2023 were retrospectively analyzed. The results obtained were interpreted with reference to CLSI M100-33th and analyzed with WHONET 5.6 software.</p><p><strong>Results: </strong>A total of 247295 strains of pathogens were detected, including 188551 gram-negative strains (76.2%). The positive rate of female patients (56.8%) was significantly higher than that of male patients (43.2%). The top five most common urinary pathogens were <i>Escherichia coli</i> (50.5%), <i>Enterococcus faecium</i> (11.5%), <i>Klebsiella pneumoniae</i> (8.5%), <i>Enterococcus faecalis</i> (6.5%), and <i>Proteus mirabilis</i> (2.9%). The resistance rate of <i>E.coli</i> to levofloxacin, cefotaxime and ceftriaxone was higher (>50%) and had a certain upward trend. The resistance rates of <i>Klebsiella pneumoniae</i> to imipenem and meropenem increased from 7.8% and 9.6% in 2019 to 11.6% and 13.2% in 2023, respectively, much higher than the resistance rates of <i>E. coli</i> to carbapenem antibiotics (<2%). <i>E. coli, K. pneumoniae</i> and <i>E. cloacae</i> still maintained high activity against tigecycline and polymyxin B. The drug resistance rate of <i>Acinetobacter baumannii</i> to imipenem and meropenem was more than 27.4%. The resistance rates of <i>Enterococcus faecium</i> and <i>Enterococcus faecalis</i> to vancomycin, teicoplanin and linezolid were lower than 3.4%. There was an increasing trend in the detection of CRE-KPN among multidrug-resistant bacteria, and a slight decreasing trend in CRPA and CRAB.</p><p><strong>Conclusion: </strong>The main pathogens of urinary tract infections were <i>E. coli, E. faecium</i> and <i>K. pneumoniae</i>. The drug resistance rates of main clinically isolated bacteria in urine samples showed a diverse trend. Antibiotics should be rationally selected based on the resistance patterns of the pathogens. At the same time, with the continuous detection of multi-drug resistant bacteria VRE and CRE, we have a long way to go in future drug resistance monitoring.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"1491-1502"},"PeriodicalIF":2.9,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692049","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":"Endogenous Fungal Endophthalmitis in a Patient After Fetal Reduction Surgery With a Literature Review: A Case Report.","authors":"Xiaolu Cao, Peipei Jia, Lili Zhao, Xiulian Qiao, Yu Duan, Junxiao Jia, Jiangbo Xin","doi":"10.2147/IDR.S497721","DOIUrl":"10.2147/IDR.S497721","url":null,"abstract":"<p><p>Endogenous fungal endophthalmitis (EFE) is a rare but severe ophthalmic emergency that often results in vision-threatening complications and, in extreme cases, can be life-threatening. This report presents a successfully treated case of fungal endophthalmitis, offering insights into clinical management. A 35-year-old female experienced decreased vision in her right eye following fetal reduction surgery. Her best-corrected visual acuity was limited to 10 cm finger counting in the affected eye. Following systemic antifungal therapy combined with vitrectomy, her vision recovered significantly. Through a detailed case analysis and literature review, this study aims to guide clinical practice. In patients with suspected EFE, obtaining early vitreous samples for pathogen identification and initiating timely treatment is critical. Furthermore, early vitrectomy during disease progression, along with an appropriate dosage and duration of antifungal therapy, is essential for restoring visual function and preventing vision loss.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"1465-1470"},"PeriodicalIF":2.9,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669814","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":"Major Predominant Serotypes and Virulence Genes and Antibiotic Resistance Characteristics of <i>Klebsiella pneumoniae</i> Clinical Isolates in Middle and East China.","authors":"Wang-Kai Pan, Sui-Ning Chen, Mei-Juan Yang, Liang-Ping Tao, Mei-Qi Wang, Xin-Wei Zhang, Yin-Hai Xu, Jie Yan, Jiang-Feng Qin, Ai-Hua Sun","doi":"10.2147/IDR.S502323","DOIUrl":"10.2147/IDR.S502323","url":null,"abstract":"<p><strong>Background: </strong><i>Klebsiella pneumoniae</i> is a common opportunistic pathogen. Predominant serotypes, virulence genes, and resistance characteristics of <i>K. pneumoniae</i> isolates from patients in different regions of China require further investigation.</p><p><strong>Methods: </strong><i>K. pneumoniae</i> isolates from patients and healthy individuals in middle and east China were identified using an auto-bacterial detector. Major serotypes and virulence genes in the isolates were detected by polymerase chain reaction, while drug resistance of the isolates was determined using broth microdilution assays.</p><p><strong>Results: </strong>Respiratory <i>K. pneumoniae</i> infection was observed in 70.0% of the patients. Of the <i>K. pneumoniae</i> isolates from patients, 42.3% were hypervirulent K (hvKp) serotypes, of which 30.1% and 37.0% belonged to K1 and K2 serotypes with 78.6-87.8% positive rates of <i>rmpA</i> and <i>rmpA2</i> virulence genes. The isolates from healthy individuals had fewer hvKp serotypes and <i>rmpA/rmpA2</i> genes (7.2% and 22.9%/26.5%). Resistance rates (38.6-79.5%) of the isolates from healthy individuals against 14 antibiotics were higher than those from patients (16.4-40.8%). The isolates from patients were sensitive to amikacin (83.6%) and polymyxin-B (93.9%) but presented 20.3% and 26.6% resistance rates to imipenem and meropenem, respectively. The isolates from patients with urinary infections exhibited higher resistances (42.1-52%) to cefoxitin, cefuroxime, ceftriaxone, ciprofloxacin, and levofloxacin than those from patients with respiratory or blood infections (22.4-39.3%). In the isolates from patients, the K47 and K64 serotypes exhibited multiple drug resistance (65-90%) against 14 antibiotics but all the hvKp serotypes displayed much lower antibiotic resistance (1.9-26.0%).</p><p><strong>Conclusion: </strong>K1/K2 were the major predominant hvKp serotypes with <i>rmpA/rmpA2</i> virulence genes and carbapenem-resistant <i>K. pneumoniae</i> strains were prevalent in patients from middle and east China. The hvKp serotypes have low antibiotic resistance, but <i>K. pneumoniae</i> isolates from patients with urinary infections resist the cephalosporin/quinolone antibiotics for treatment of bacterial urinary infections. Amikacin and polymyxin-B can be used to treat drug-resistant <i>K. pneumoniae</i> infections.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"1451-1464"},"PeriodicalIF":2.9,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648261","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":"The Impact of Non-Thyroidal Illness Syndromes on The Prognosis and Immune Profile in Severe Fever with Thrombocytopenia Syndrome Patients.","authors":"Hongxiao Wu, Yameng Mu, Yuanni Liu, Ruihua Zhang, Yanli Xu, Yuanyuan Zhang, Chenxi Zhao, Wei Zhang, Ling Lin, Zhihai Chen","doi":"10.2147/IDR.S506378","DOIUrl":"10.2147/IDR.S506378","url":null,"abstract":"<p><strong>Background: </strong>Non-thyroidal illness syndrome (NTIS) is the most common endocrine dysfunction in critically ill patients and is often associated with poor prognosis. Thyroid dysfunction and immune cell disturbances are frequently observed in patients with severe fever with thrombocytopenia syndrome (SFTS). This study aims to evaluate the impact of NTIS on the prognosis of SFTS patients and to explore the relationship between thyroid hormones (THs) and immune cell profiles.</p><p><strong>Methods: </strong>Adult patients admitted to Yantai Qishan Hospital for SFTS from January 2023 to December 2023 with no prior history of thyroid disease were retrospectively recruited. Multivariable regressions were used to assess the associations between NTIS and clinical outcomes. Spearman correlation analysis was conducted to evaluate the relationships between immune cells and THs. SFTS patients with NTIS were categorized into four subtypes based on different levels of FT4 and TSH, and the association between NTIS subtypes and mortality was further analyzed.</p><p><strong>Results: </strong>Of the 84 SFTS patients included in the study, 62 (73.8%) were diagnosed with NTIS. Independent risk predictors which may affect prognosis of SFTS patients include NTIS subtype (<i>P</i> =0.002), viral load (<i>P</i> = 0.029), FT3 (<i>P</i> = 0.032), and FT4 (<i>P</i> = 0.041). SFTS patients with NTIS exhibited a higher mortality rate compared to euthyroid patients (<i>P</i> = 0.033). Spearman correlation analysis revealed that LYM, LYM%, MONO, MONO%, BAS, CD3+T, CD3+T%, Th, and Th% were positively correlated with FT3, FT4, or TSH levels. NTIS patients were more likely to present with coagulation abnormalities (APTT, <i>P</i> = 0.005; D-Dimer, <i>P</i> < 0.001), liver enzyme abnormalities (AST, <i>P</i> = 0.001), electrolyte imbalances (Sodium, <i>P</i> = 0.003), elevated LDH (<i>P</i> = 0.001), and increased ɑ-HBDH (<i>P</i> = 0.003).</p><p><strong>Conclusion: </strong>NTIS is common in SFTS patients, and SFTS patients with NTIS have a lower survival rate compared to euthyroid patients. The mortality risk in NTIS type 3 patients is higher than in those with NTIS type 1.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"1439-1449"},"PeriodicalIF":2.9,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11914451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657160","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}