Infection and Drug Resistance最新文献

{"title":"Correlation Between Xpert MTB/RIF Results and <i>rpoB</i> Mutations within Probe-Targeted Regions in <i>Mycobacterium tuberculosis</i> Isolates from Sichuan Basin.","authors":"Kun Li, Long Li","doi":"10.2147/IDR.S541544","DOIUrl":"10.2147/IDR.S541544","url":null,"abstract":"<p><strong>Purpose: </strong>This study characterized mutation patterns within the rifampicin resistance-determining region (RRDR) of the <i>rpoB</i>gene (codons 507-533), targeted by Xpert MTB/RIF probes, in <i>Mycobacterium tuberculosis</i> isolates from Southwest China. Regional molecular profiles were and compared regional profiles against global datasets to elucidate implications for rifampicin resistance surveillance.</p><p><strong>Methods: </strong>We conducted a retrospective study of 197 rifampicin-resistant tuberculosis cases involving 197 cases of rifampicin-resistant tuberculosis (comprising 194 pulmonary and 3 extrapulmonary cases) confirmed through the GeneXpert MTB/RIF assay at Suining Central Hospital during 2023-2024. Mutation characteristics across five RRDR probes (labeled A-E) were assessed, along with the semi-quantitative classification of bacterial loads.</p><p><strong>Results: </strong>Single-probe mutations predominated (82.7%; 163/197), with hotspots at Probe E (S531L, 55.8%) and Probe A (Q510H/V511D, 12.2%). Dual-probe mutations (16.8%, 33/197) were primarily A+B combinations (13.7%, 27/197), showing significantly elevated prevalence in patients aged 46-60 years (OR = 2.31, 95% CI: 1.12-4.79, P< 0.05). Bacterial load stratification revealed strong diagnostic accuracy associations: smear positivity rates were 79.4% (high load) and 44.4% (medium), while culture positivity rates were 67.6% and 57.8%, respectively.</p><p><strong>Conclusion: </strong>A unique double-peak mutation pattern (primarily involving probes E and A) was identified in Sichuan Province, which contrasts sharply with the single hotspot pattern observed in Europe and the epidemiological pattern in Beijing, China, where probe E predominates. The elevated Probe A mutation rate (12.2%) potentially reflects regional rifabutin usage in second-line regimens. These findings provide molecular epidemiological insights for optimizing diagnosis and drug resistance monitoring in southwestern China.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"5161-5171"},"PeriodicalIF":2.9,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12493105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232457","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":"BK Polyomavirus Prevalence in Renal Diseases: Associations with Immunosuppressants and Lymphocyte Subsets.","authors":"Ziran Wang, Jiawei Zhao, Lingjun Kong, Cun Liu, Zhou Lv, Yanhong Wang, Yaling Dou, Xin You","doi":"10.2147/IDR.S548434","DOIUrl":"10.2147/IDR.S548434","url":null,"abstract":"<p><strong>Background: </strong>BK polyomavirus (BKV), a latent pathogen in immunocompromised individuals, poses significant risks in renal-associated diseases (RD).</p><p><strong>Methods: </strong>This study recruited 88 healthy control (HC) individuals and 271 patients with RD, including 96 connective tissue diseases with renal involvement (CTD-RI), 90 chronic kidney disease (CKD), 66 urological tumors (UT), 19 kidney transplantation (KT), at Peking Union Medical College Hospital from January 2020 to September 2021. The BKV-DNA qPCR detection kit was evaluated in terms of lowest detection limit, linear range, accuracy, precision, analytical specificity. Urine, serum, and plasma specimens from 17 UT patients were detected simultaneously to evaluate the detection sensitivity of various sample types. The positive rates and loads of BKV-DNA were compared among the various groups. The difference in immunosuppressants use between BKV-DNA positive and negative groups was compared in patients with CTD-RI. Furthermore, the correlations between BKV-DNA loads and the counts of lymphocyte subsets were explored in the CTD-RI group.</p><p><strong>Results: </strong>The BKV-DNA qPCR detection kit has satisfactory sensitivity, linear range, reproducibility, accuracy, and specificity to detect the presence and loads of BKV-DNA. Urine specimens are more sensitive for BKV-DNA detection than serum and plasma. The CTD-RI and UT groups had higher BKV-DNA positive rates (49.0% and 31.8%, respectively) and loads (median: 5.69 log10 copies/mL and 6.03 log10 copies/mL, respectively) compared to the HC group (positive rate 12.5%, load median 3.96 log10 copies/mL). Multivariate logistic regression analysis indicated that the use of mycophenolate mofetil (MMF) was associated with a reduced risk of BKV (odds ratio and 95% confidence interval: 0.27 (0.09-0.78), <i>P</i>=0.015). The trends toward negative correlations between the BKV-DNA loads and the counts of CD19+ B cells, CD4+CD28+ T cells, CD45RA+CD4+ T cells, and naive CD4+ T cells were observed.</p><p><strong>Conclusion: </strong>These findings support monitoring BKV-DNA in high-risk RD patients to guide immunosuppressant use and mitigate renal injury. Future long-term follow-up and multicenter large-scale cohort studies are necessary to further clarify the role of BKV in RD.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"5149-5160"},"PeriodicalIF":2.9,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12493924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232454","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 Mortality Prediction Nomogram for <i>Stenotrophomonas maltophilia</i> Bloodstream Infection.","authors":"Siting Yi, Mengmin Ye, Pingjuan Liu, Kainan Chen, Ying Yuan, Liubing Li","doi":"10.2147/IDR.S536417","DOIUrl":"10.2147/IDR.S536417","url":null,"abstract":"<p><strong>Background: </strong>The World Health Organization classifies <i>Stenotrophomonas maltophilia</i> (<i>S. maltophilia</i>) as one of the most overlooked and difficult-to-treat multidrug-resistant pathogens. It mainly causes pneumonia and bloodstream infections (BSIs). Therefore, the aim of this study was to investigate the risk factors for mortality in patients with <i>S. maltophilia</i> BSIs and to construct a predictive nomogram model.</p><p><strong>Methods: </strong>Clinical data were collected from patients with <i>S. maltophilia</i> BSIs who were admitted to the First Affiliated Hospital of Sun Yat-sen University from January 2013 to December 2023. Prognostic risk factors were identified using Cox regression and LASSO analysis. A nomogram was developed based on a multivariate analysis and validated using bootstrap resampling, receiver operating characteristic curve analysis, and calibration plots.</p><p><strong>Results: </strong>The mortality rate was 20.0% among 85 patients with <i>S. maltophilia</i> BSIs. Multivariable analysis identified septic shock (hazard ratio [HR] = 7.859, 95% confidence interval (CI): 1.569-79.607; <i>P</i> = 0.009) and respiratory diseases (HR = 7.602, 95% CI: 2.269-39.202; <i>P</i> < 0.001) as independent risk factors for mortality. A predictive nomogram model incorporating these factors demonstrated excellent discrimination, with a C-index of 0.872 and high area under the curve values for 14-day (0.922) and 28-day (0.882) mortality. Calibration analysis showed precise agreement between predicted and observed outcomes.</p><p><strong>Conclusion: </strong>Septic shock and respiratory diseases were independent risk factors for mortality in patients with <i>S. maltophilia</i> BSIs. The nomogram model developed in this study showed good predictive value for the survival rates of patients with <i>S. maltophilia</i> BSIs, thus facilitating clinical prevention and treatment.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"5129-5137"},"PeriodicalIF":2.9,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12484109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212619","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":"<i>Burkholderia pseudomallei</i>: A Multifaceted Threat and the Path Forward in Treatment and Prevention.","authors":"Karem Ibrahem, Bandar Hasan Saleh, Nabeel Hussain Alhussainy, Abdulaziz Alsaedi, Hatoon A Niyazi, Hanouf A Niyazi, Noha A Juma, Mona A Alqarni, Abdelbagi Alfadil, Asim T Sharif, Bayan Redwan, Malaz Gazzaz, Ohood S Alharbi, Khulud A Alhazmi, Rawan Altalhi, Waiel S Halabi, Sarah Almuhayya, Faye A Aldehalan, Hala Altarawneh, Mohammed Abu Lubad, Sulaiman Bani Abdel-Rahman, Hamed Alzoubi, Wafaa Alhazmi, Hadeel A Alsufyani","doi":"10.2147/IDR.S535624","DOIUrl":"10.2147/IDR.S535624","url":null,"abstract":"<p><p><i>Burkholderia pseudomallei</i>, a gram-negative facultative intracellular bacterium, is the causative agent of melioidosis, a life-threatening infectious disease endemic to tropical and subtropical regions, particularly Southeast Asia and Northern Australia. Key risk factors such as diabetes, alcoholism, and socioeconomic challenges were identified as major contributors to disease susceptibility and treatment outcomes in melioidosis. Globally, melioidosis accounts for approximately 89,000 deaths annually and poses a significant public health concern, particularly in resource-limited settings. <i>B. pseudomallei</i> exhibits remarkable environmental resilience, thrives in soil and water, and is intrinsically resistant to various antibiotics. Its pathogenicity is mediated by diverse virulence factors, including type III and VI secretion systems, a protective capsule, lipopolysaccharide (LPS), and BimA-mediated actin-based motility, which facilitate intracellular survival, immune evasion, and systemic dissemination. This bacterium can cause a wide spectrum of clinical manifestations ranging from localized skin infections to severe septicemia, pneumonia, and neurological involvement. In certain cases, <i>B. pseudomallei</i> may persist in a latent state for years and reactivation is often triggered by immunosuppression. The treatment of melioidosis is challenging because of its intrinsic antibiotic resistance, necessitating a two-phase approach: an intensive phase with intravenous antibiotics, such as ceftazidime or meropenem, followed by a prolonged eradication phase using trimethoprim-sulfamethoxazole. However, relapse remains a concern, particularly in patients with poor adherence to the therapy. Preventive strategies, particularly in endemic regions, focus on minimizing environmental exposure through protective measures and safe water practices. Despite advancements in therapeutic approaches, there is an urgent need for novel treatment strategies, including bacteriophage therapy and vaccine development, to enhance melioidosis prevention and control. Understanding the complex pathogenic mechanisms of <i>B. pseudomallei</i> is essential to improve its clinical management and reduce its global burden.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"5115-5127"},"PeriodicalIF":2.9,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12478206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199246","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":"Establishment of a Machine Learning-Based Predictive Model for <i>Klebsiella pneumoniae</i> Liver Abscess.","authors":"Haoran Li, Yan Yu, Xi Chen, Qingqing Sun, Xiumin Li, Qiujing Shang, Minghua Ying, Xiulin Liu, Jing Meng, Lele Bian, Shanshan Wu, Yuejuan Gao","doi":"10.2147/IDR.S545440","DOIUrl":"10.2147/IDR.S545440","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the clinical and ultrasonographic characteristics of pyogenic liver abscess (PLA) caused by <i>Klebsiella pneumoniae</i> (K-PLA) and <i>non-Klebsiella pneumoniae</i> pathogens, and to develop machine learning models for the differential diagnosis of K-PLA.</p><p><strong>Materials and methods: </strong>In this retrospective study, patients clinically diagnosed with PLA and confirmed by ultrasound-guided puncture at the Fifth Medical Center of PLA General Hospital between April 2013 and December 2020 were enrolled. Based on the causative pathogens, patients were categorized into K-PLA and non-K-PLA groups. Baseline data, including ultrasonographic features, clinical characteristics, and laboratory findings, were collected. The Boruta algorithm was employed for feature selection, and four machine learning models-Deep Learning-Fully Connected Neural Network (deeplearning), Distributed Random Forest (drf), Gradient Boosting Machine (gbm), and Generalized Linear Model (glm)-were developed to diagnose K-PLA. The models were validated using 5-fold cross-validation.</p><p><strong>Results: </strong>A total of 201 patients with bacterial liver abscess were included (median age: 57 years; range: 49-66; 136 males), comprising 134 K-PLA cases and 67 non-K-PLA cases. The Boruta algorithm identified seven significant predictive variables: history of diabetes, history of hepatocellular carcinoma, history of biliary tract disease, history of infectious diseases, duration of fever, body temperature, and alanine aminotransferase (ALT) levels. Using these variables, the four machine learning models were constructed. In the training set, the area under the receiver operating characteristic curve (AUC) for predicting K-PLA was 0.716 (deeplearning), 0.999 (drf), 0.922 (gbm), and 0.718 (glm). In the validation set, the corresponding AUC values were 0.799, 0.763, 0.848, and 0.805, respectively.</p><p><strong>Conclusion: </strong>This study successfully established four machine learning models for predicting the risk of K-PLA, with the gbm-based model demonstrating the highest diagnostic performance. These models may facilitate early clinical diagnosis and treatment of K-PLA, thereby reducing antibiotic misuse.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"5097-5108"},"PeriodicalIF":2.9,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199243","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":"Incidence, Clinical Characteristics and Outcomes of Persistent <i>Staphylococcus aureus</i> Bacteremia in a Chinese Tertiary Care Hospital: A Single-Center Retrospective Study.","authors":"Dandan Wu, Jiongfei Jin, Jiachang Cai","doi":"10.2147/IDR.S540374","DOIUrl":"10.2147/IDR.S540374","url":null,"abstract":"<p><strong>Purpose: </strong>Persistent <i>Staphylococcus aureus</i> bacteremia (pSAB) poses significant clinical challenges because of its association with poor outcomes, including relapse and mortality. Despite its clinical importance, data on pSAB in the mainland Chinese population remain limited. This study aimed to investigate the prevalence, clinical characteristics, and predictors of pSAB in a tertiary hospital in China.</p><p><strong>Patients and methods: </strong>We conducted a retrospective case-control study at a large tertiary-care hospital in China from 2020 to 2024. Patients with <i>Staphylococcus aureus</i> bacteremia (SAB) were categorized into persistent and nonpersistent groups on the basis of the duration of bacteremia (>48 hours). Clinical characteristics, management, and outcomes were compared. Multivariate logistic regression was used to identify independent risk factors for pSAB.</p><p><strong>Results: </strong>Among 499 patients with SAB, 48 (9.6%) met the criteria for pSAB, with the incidence peaking at 13.9% in 2024. Compared with the non-pSAB group, the pSAB group had higher rates of infective endocarditis (p=0.002), a CCI ≥7 (p=0.036), metastatic infection (p=0.007), and preadmission fever ≥7 days (p=0.026). They more frequently underwent surgical intervention (p=0.041), received dual anti-MRSA therapy (p<0.001), and less often received β-lactam monotherapy (p=0.001). pSAB was associated with prolonged fever (p=0.014), a hospital stay ≥7 days after SAB onset (p=0.002), increased 30-day mortality (p=0.036), and increased 3-month relapse (p=0.001). Multivariate analysis revealed a CCI ≥7 (OR=4.09; 95% CI: 1.19-14.00; p=0.025), infective endocarditis (OR=8.66; 95% CI: 1.52-49.03; p=0.015), and preadmission fever ≥7 days (OR=5.06; 95% CI: 1.61-15.90; p=0.006) as independent predictors of pSAB.</p><p><strong>Conclusion: </strong>The incidence of pSAB is increasing in China and is associated with complex clinical features and adverse outcomes. Severe comorbidities, infective endocarditis, and prolonged fever before admission are significant predictors of pSAB. Early identification and aggressive source control are critical for improving the outcomes of high-risk patients.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"5087-5095"},"PeriodicalIF":2.9,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191492","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 Chelerythrine Chloride as a Potential Treatment for Multidrug-Resistant Gonorrhea.","authors":"Ran Zhang, Yuqiu Qi, Hui Peng, Chenlong Tao, Songwei Lu, Qiankun Ke, Shangzhu Shen, Zhuo Wang, Xiaomian Lin","doi":"10.2147/IDR.S538954","DOIUrl":"10.2147/IDR.S538954","url":null,"abstract":"<p><strong>Objective: </strong><i>Neisseria gonorrhoeae</i> (<i>N</i>. <i>gonorrhoeae)</i> is responsible for the sexually transmitted infection (STI) gonorrhea, which has an estimated global annual incidence of 82.4 million cases among adults. The recommended first-line treatment typically involves a single-dose systemic therapy, comprising injectable ceftriaxone and oral azithromycin. Nonetheless, the first-line treatment failures caused by antimicrobial resistance represent a major global public health concern, threatening the efficacy of current gonorrhea treatments and highlighting the urgent need for the development of alternative therapeutic approaches.</p><p><strong>Methods: </strong>A total of 54 clinical strains of <i>N. gonorrhoeae</i> were collected in Nanchang City, 2021. To assess the efficacy of antibiotics and chelerythrine chloride, we determined the minimum inhibitory concentrations (MICs) using agar dilution and broth microdilution methods, respectively. To explicitly evaluate the potential for resistance induction, the ATCC49226 strain was subjected to continuous passaging for 30 days in sub-MIC concentrations of chelerythrine chloride, with MIC assessments every 5 days.</p><p><strong>Results: </strong>In clinical samples, antimicrobial resistance was observed for penicillin (67.27%), tetracycline (81.82%), ciprofloxacin (98.18%), azithromycin (5.45%), and spectinomycin (0%), with decreased susceptibility for ceftriaxone (16.36%) and cefixime (20.00%). High-throughput screening of a natural product library identified chelerythrine chloride as exhibiting significant inhibitory activity against <i>N. gonorrhoeae</i>, including strains with decreased susceptibility to cephalosporins. The MIC range was 0.002-8 mg/L, with both the MIC₅₀ and MIC₉₀ values at 8 mg/L. Furthermore, <i>N. gonorrhoeae</i> did not develop resistance, maintaining a stable MIC of 4 mg/L over a 30-day treatment period.</p><p><strong>Conclusion: </strong>In this study, we have established a novel association between chelerythrine chloride and <i>N. gonorrhoeae</i>, demonstrating for the first time its preliminary efficacy in eradicating multidrug-resistant strains of <i>N. gonorrhoeae</i>. Considering the significant resistance challenges posed by <i>N. gonorrhoeae</i>. chelerythrine chloride emerges as a promising antibacterial agent with substantial potential for clinical development.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"5109-5114"},"PeriodicalIF":2.9,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191480","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":"Distribution of Pathogenic Bacteria in Health Care Associated Sepsis in Preterm Infants and Ten Years Variation in Their Drug Resistance.","authors":"Shen-Wang Ni, Li Wang, Yang Wang, Ji-Lu Shen","doi":"10.2147/IDR.S536773","DOIUrl":"10.2147/IDR.S536773","url":null,"abstract":"<p><strong>Aim: </strong>To identify the causative bacteria of healthcare-associated sepsis in preterm infants and analyze their antibiotic resistance trends over ten years, providing evidence for infection prevention strategies.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed blood culture data from preterm infants (<37 weeks) with healthcare-associated sepsis (onset >72 hours after birth) admitted between January 2014 and December 2023. Pathogen distribution and antibiotic resistance patterns were compared between two periods (2014-2018 vs 2019-2023).</p><p><strong>Results: </strong>Among 9928 preterm infants, 3.3% (332 cases) had positive blood cultures, with incidence increasing from 1.4% (2014-2018) to 2.7% (2019-2023). Gram-negative bacteria remained predominant (48.00% to 61.07%), led by <i>Klebsiella pneumoniae</i>. Gram-positive bacteria increased significantly (5.33% to 31.30%), primarily <i>coagulase-negative staphylococci</i>, while fungal infections decreased (46.67% to 7.63%). Resistance to third-generation cephalosporins persisted in <i>K. pneumoniae</i> (~80%) and increased in <i>Enterobacter cloacae</i> (60% to 90%). Emerging carbapenem resistance was observed in <i>E. coli</i> (0% to 33.33%) and <i>K. pneumoniae</i> (5.25% to 4.08%), with <i>Enterobacter cloacae</i> showing a significant rise (0% to 60%). ESBL-producing strains rose from 13.33% to 30.53%. All Gram-positive isolates remained susceptible to linezolid, except one vancomycin-resistant <i>Staphylococcus capsulatus</i>.</p><p><strong>Conclusion: </strong>The incidence of healthcare-associated sepsis in preterm infants increased significantly, with rising carbapenem resistance in Gram-negative bacteria and a marked increase in coagulase-negative staphylococci. These trends underscore the need for enhanced infection control and judicious antibiotic use guided by blood culture results.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"5067-5077"},"PeriodicalIF":2.9,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199216","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 Serum Ischemia-Modified Albumin And Oxidative Stress Markers in Patients with Sepsis.","authors":"Selçuk Nazik, Selma Ates, Muhammed Seyithanoglu, Hafize Öksüz","doi":"10.2147/IDR.S500446","DOIUrl":"10.2147/IDR.S500446","url":null,"abstract":"<p><strong>Purpose: </strong>The most common causes of mortality and morbidity in patients followed up in intensive care are bacterial infections and sepsis. Rapid and timely intervention is essential for the successful treatment of sepsis. Therefore, this study aimed to reveal the relationships between mortality and patients by examining ıschemia-modified albumin, APACHE II, CRP, PCT, lactate, WBC, NLR, PLR, SII, platelet, and lactate/IMA (LIMA) values in patients with sepsis followed up in intensive care units.</p><p><strong>Material method: </strong>The study was planned as prospective and single-center. 31 patients diagnosed with sepsis were included in the study. The first 24 hours and 5th day values of patients diagnosed with sepsis were examined and recorded. The biomarkers and APACHE-II score of patients diagnosed with sepsis were examined for predictive power of 28-day mortality.</p><p><strong>Results: </strong>Thirty-one patients diagnosed with sepsis from the Anesthesia Intensive Care Unit were included in the study. Of the total patients, 21 (67.7%) were male and 10 (32.3%) were female. The APACHE-II score of patients diagnosed with sepsis in the first 24 hours (AUC:0.891, 95% CI: 77.6-100, p<0.0001) was determined to be the best indicator for predicting 28-day mortality. In addition, neutrophil/lymphocyte ratio on day 5 (AUC:0.765, 95% CI:59.3-93.7, p:0.013), Lactate/IMA on day 1 (AUC:0.628, 95% CI:59.3-83.9, p:0.230) and SII on day 5 (AUC:0.624, 95% CI:42.3-82.5, p:0.246) were also determined as other biomarkers that can be used to predict 28-day mortality.</p><p><strong>Conclusion: </strong>APACHE-II score still maintains its place in predicting mortality in patients with sepsis. No biomarker alone has been able to surpass this score, and markers obtained in combination such as NLR, LIMA and SII may be helpful in predicting mortality. New and large-scale studies are needed on this subject.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"5079-5086"},"PeriodicalIF":2.9,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185902","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 Rare Case of Yersinia Pseudotuberculosis Infection with Septic Shock and Splenic Infarction.","authors":"Yayuan Tan, Xueli Li, Yingchun Xie, Zhaohui Zhang, Jinglan Liu, Gaosheng Zhou, Min Liu","doi":"10.2147/IDR.S548492","DOIUrl":"10.2147/IDR.S548492","url":null,"abstract":"<p><p><i>Yersinia pseudotuberculosis</i> is a Gram-negative bacterium of the family <i>Yersiniaceae</i>, primarily transmitted via the gastrointestinal tract. Progression to sepsis is uncommon, and the combination of septic shock and splenic infarction is exceedingly rare. We report a 40-year-old male who initially presented with fever, abdominal pain, and distension, which rapidly progressed to sepsis and multi-organ dysfunction. Definitive diagnosis of <i>Y. pseudotuberculosis</i> infection was established by blood culture and metagenomic next-generation sequencing, supported by imaging evidence of splenic infarction. The patient was managed with stepwise antimicrobial regimens (including piperacillin-tazobactam, meropenem, levofloxacin, linezolid, and daptomycin), plasma exchange, continuous renal replacement therapy, and organ function support. Following comprehensive treatment, the patient recovered and was discharged in stable condition. This case highlights the importance of considering <i>Y. pseudotuberculosis</i> in atypical sepsis presentations and demonstrates that timely diagnosis and multidisciplinary management are crucial to improving outcomes in such rare and life-threatening infections.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"5057-5065"},"PeriodicalIF":2.9,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12474736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185837","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}