Infection and Drug Resistance最新文献

{"title":"Interpretable SVM Model for Predicting CMV Infection in Seropositive Kidney Transplant Recipients: A Single-Center Retrospective Study.","authors":"Guangli Zhong, Yujie Tang, Runtao Feng, Xujun Xu, Ya Zhang, Junpeng Wang, Song Zhou, Ming Zhao","doi":"10.2147/IDR.S577857","DOIUrl":"https://doi.org/10.2147/IDR.S577857","url":null,"abstract":"<p><strong>Background: </strong>Cytomegalovirus (CMV) infection is a serious complication after kidney transplantation. Although most recipients are CMV-seropositive (R+), preventive strategies for this group remain controversial, whereas they are relatively well established for CMV-seronegative recipients (R-). Conventional serostatus-based classification alone is insufficient to accurately assess infection risk in R+ individuals. Therefore, we aimed to develop machine learning models that integrate clinical and immune variables to provide a precise risk prediction tool for CMV infection in R+ recipients.</p><p><strong>Methods: </strong>This study included patients from June 2023 to December 2024, and were randomly divided into training and validation cohorts in a 7:3 ratio. Feature selection was performed in the training cohort using the Boruta algorithm. Six machine learning models were applied to identify the best model for predicting CMV infection risk in R+ patients, and model interpretability was assessed using SHAP.</p><p><strong>Results: </strong>Of 162 R+ patients, 51.2% developed CMV DNAemia. Seven key predictors were identified, including T-cell subsets (CD8+, CD4+, CD4+CD27-), recipient age, cold ischemia time, donor type, and prevention strategy. Among these, CD4+ and CD8+ T-cell subset counts were the most influential predictors, with lower counts associated with a higher risk of CMV infection. The support vector machine (SVM) achieved the best discrimination in the validation cohort (AUC, 0.821; 95% CI, 0.692-0.932).</p><p><strong>Conclusion: </strong>The interpretable SVM model showed promising performance for identifying R+ recipients at high risk of CMV infection and potentially individualized prophylactic and monitoring strategies. External validation in prospective cohorts is warranted.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"577857"},"PeriodicalIF":2.9,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13129268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814617","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 High-Risk Factors for Tuberculosis Retreatment Based on Machine Learning and Latent Class Analysis.","authors":"Xilong Du, Maiwulajiang Yimamu, Yan Na, Xiaoxue Li, Ziyu Wang, Zulimire Z Nuermaihaimaiti, Yuxin Wang, Liping Zhang, Yanling Zheng","doi":"10.2147/IDR.S594300","DOIUrl":"https://doi.org/10.2147/IDR.S594300","url":null,"abstract":"<p><strong>Object: </strong>To identify high-risk factors for tuberculosis retreatment and to provide a scientific basis for developing targeted prevention and control strategies by integrating machine learning with latent class analysis.</p><p><strong>Methods: </strong>This study retrospectively collected baseline and treatment-related data from 6,821 tuberculosis patients, employing machine learning and latent class analysis (LCA) to investigate the key influencing factors associated with high-risk populations for retreatment.</p><p><strong>Results: </strong>The XGBoost model achieved an overall accuracy of 84% and an area under the ROC curve (AUC) of 0.938. The analysis identified sputum examination results at month 6 or 8 of treatment, treatment regimen, and diagnostic classification as the most influential factors associated with retreatment. SHAP analysis further revealed that a sputum examination status of \"not performed\" was strongly linked to increased retreatment risk. Logistic regression confirmed this finding, with \"not performed\" (<i>OR</i> = 123.47, <i>P</i> < 0.001) and a \"positive\" result (<i>OR</i> = 14.89, <i>P</i> = 0.02) at month 6 or 8 identified as significant risk factors. Latent class analysis stratified patients into four distinct subgroups, among which those characterized by comorbid diabetes or prior treatment failure constituted the highest-risk populations for retreatment.</p><p><strong>Conclusion: </strong>It is recommended to improve treatment adherence and efficacy monitoring for newly diagnosed patients, strengthen whole-course supervision, and optimize management for elderly patients and those on long-term regimens.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"594300"},"PeriodicalIF":2.9,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814534","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":"Predictive Value of Nutritional Status in Sputum Culture Conversion Among Patients with Nontuberculous Mycobacterial Pulmonary Disease: A Retrospective Cohort Study.","authors":"Bo Zhang, Xiangyu Yin, Jinxing Li, Jifei Cai","doi":"10.2147/IDR.S598545","DOIUrl":"https://doi.org/10.2147/IDR.S598545","url":null,"abstract":"<p><strong>Background: </strong>Nutritional status has been increasingly recognized as an important determinant of outcomes in nontuberculous mycobacterial pulmonary disease (NTM-PD), but its predictive value for sputum culture conversion remains unclear.</p><p><strong>Methods: </strong>This retrospective cohort study included 416 patients with NTM-PD between January 2016 and September 2024. Patients were categorized based on nutritional status and sputum culture conversion. Logistic regression was used to identify independent predictors, and a combined predictive model was evaluated using ROC curves. Kaplan-Meier analysis assessed time to culture conversion. Internal validation was performed using bootstrap resampling.</p><p><strong>Results: </strong>Among 416 patients, 109 (26.2%) achieved sputum culture conversion. Malnourished patients had significantly lower conversion rates. Multivariable analysis showed age (OR=1.048, 95% CI: 1.012-1.085), BMI (OR=0.746, 95% CI: 0.668-0.835), hemoglobin (OR=0.936, 95% CI: 0.906-0.967), and total protein (OR=0.920, 95% CI: 0.853-0.992) were independent predictors. The combined model demonstrated strong predictive performance (AUC=0.925, sensitivity=89.3%, specificity=78.0%).</p><p><strong>Conclusion: </strong>Nutritional status is significantly associated with sputum culture conversion in NTM-PD. A combined model incorporating nutritional indicators may assist in risk stratification, although further validation is required.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"598545"},"PeriodicalIF":2.9,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814684","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":"Antimicrobial Resistance in Refugee Camps and Prisons: A Global Scoping Review of Primary Studies on Burden, Risk Factors, Surveillance, and Mitigation Strategies.","authors":"Egide Ndayambaje, Olivier Sibomana, Marvellous Asika, Grace Marie Uwizeyimana, Gabriel Oke, Leonard Ighodalo Uzairue, Darius Benimana","doi":"10.2147/IDR.S566267","DOIUrl":"https://doi.org/10.2147/IDR.S566267","url":null,"abstract":"<p><strong>Background: </strong>AMR is a global health threat, and prisons and refugee camps are high-risk environments for the acquisition and spread of multidrug-resistant organisms (MDROs). This scoping review aims to map the existing evidence on antimicrobial resistance (AMR) in prisons and refugee camps, focusing on burden, risk factors, surveillance, resistance patterns, and mitigation strategies.</p><p><strong>Methods: </strong>The scoping review followed the Arksey and O'Malley methodology and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) checklist. Using predefined search terms related to AMR, literature was identified through searches of SCOPUS, PubMed/MEDLINE, Google Scholar, the Directory of Open Access Journals (DOAJ), and grey literature sources, including reports from the World Health Organization (WHO) and the United Nations High Commissioner for Refugees (UNHCR). The literature was screened based on inclusion and exclusion criteria to select relevant studies. Studies were screened based on predefined inclusion and exclusion criteria, and data were extracted into Microsoft Excel for descriptive and thematic analysis.</p><p><strong>Results: </strong>From 3659 records identified at the initial search, 26 primary studies from 18 countries met the inclusion criteria. Most studies addressed AMR burden (65.4%), followed by risk factors (26.9%), while surveillance and mitigation strategies were each addressed in 3.8% of studies. Key themes were categorized as primary focus, while additional themes were recorded as secondary focus areas. Overall, the studies reported a high prevalence of multidrug-resistant organisms. MRSA colonization reached 15.7% in Swiss refugee canters and 21.3% in Finnish cohorts, while ESBL carriage was as high as 32.9%. Additionally, multidrug-resistant tuberculosis (MDR-TB) prevalence reached 9.5% in Ethiopian prisons. Risk factors included prior hospitalization, self-medication, prolonged antibiotic exposure, treatment interruptions, overcrowding, and poor hygiene Surveillance efforts were limited, and evidence on mitigation strategies was scarce, with only two studies describing antimicrobial stewardship program (ASP) implementation in prison settings in Italy and the United States.</p><p><strong>Conclusion: </strong>The review shows that overcrowding, inadequate sanitation, interrupted healthcare, and poor stewardship are the main causes of the high incidence of AMR in prison and refugee camps. To protect these susceptible groups and stop the spread of AMR worldwide, it is critically necessary to improve surveillance, infection control, and context-specific mitigation techniques.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"566267"},"PeriodicalIF":2.9,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814542","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":"Antifungal Stewardship in the Pediatric Intensive Care Unit: Time is of the Essence.","authors":"Elisavet Chorafa, Elias Iosifidis, Christina Tzika, Anastasia-Izampella Papathanasiou, Emmanuel Roilides","doi":"10.2147/IDR.S541588","DOIUrl":"https://doi.org/10.2147/IDR.S541588","url":null,"abstract":"<p><p>Invasive fungal infections (IFIs) represent a significant cause of morbidity and mortality in critically ill children admitted to pediatric intensive care units (PICUs). Despite the variation of the incidence of candidemia and invasive candidiasis (IC) and <i>Candida</i> species distribution between different PICU settings, increasing rates of non-<i>albicans Candida</i> species and emerging antifungal resistant strains are observed. Antifungals are prescribed in PICUs mainly for empiric treatment, with limited use of diagnostic-driven strategies despite availability of fungal biomarkers in many settings. Data on antifungal prophylaxis in PICU outside traditional high-risk populations are scarce with no official guidance on administration of prophylaxis and to which patients. Diagnostic challenges, heterogeneity and complexity of PICU patients, and the absence of specific guidelines on prophylaxis contribute to increased and/or inappropriate antifungal use. Although antifungals are frequently used in PICU, antifungal stewardship (AFS) activities reported particularly in this population remain limited. Shift from empiric to pre-emptive treatment, systematic use of therapeutic drug monitoring, new diagnostic tests and fungal biomarkers and limiting the group of patients outside the high-risk groups on prophylaxis are the key targets for AFS in critically ill children. Only nine AFS interventions including PICU patients were found in the English literature; seven were part of hospital-wide stewardship programs and only three were targeted to antifungals. Audit with feedback was mainly used as a strategy, while various designs and outcomes were observed. Antifungal stewardship programs are essential to optimize antifungal use in PICUs; however, standardized frameworks tailored to these settings should be developed. This review describes the epidemiology of IFIs in PICUs, current antifungal prescribing practices, and summarizes AFS interventions implemented in PICUs up to now in order to propose recommendations for future antifungal stewardship initiatives in these patients.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"541588"},"PeriodicalIF":2.9,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13123547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770364","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":"Use of the Proportion of Neutrophils in Bronchoalveolar Lavage Fluid for Rapid Diagnosis of Bacterial Pneumonia in Children.","authors":"Chuanghong Ke, Xiangxiang Zhai, Dang Ao, Xiaohua Liu, Xiaohuan Mo, Huanqin Han","doi":"10.2147/IDR.S604517","DOIUrl":"https://doi.org/10.2147/IDR.S604517","url":null,"abstract":"<p><strong>Background: </strong>Currently-available conventional diagnostic tests to identify the causative pathogen of community-acquired pneumonia in children have several limitations. However, the lack of timely and accurate etiological diagnosis could substantially affect childhood pneumonia outcomes. Therefore, this study assessed the efficacy of cytological analysis of bronchoalveolar lavage fluid (BALF) in rapidly distinguishing between bacterial and non-bacterial pneumonia in paediatric patients.</p><p><strong>Patients: </strong>We enrolled patients with community-acquired pneumonia who underwent bronchoalveolar lavage at the Affiliated Hospital of Guangdong Medical University. Pathogens were detected in the BALF, and BALF cytological analysis was performed.</p><p><strong>Results: </strong>Overall, 154 patients were enrolled, among whom 141 had pneumonia (68 severe cases), with 116 cases of bacterial pneumonia and 25 cases of viral pneumonia. The bacterial pneumonia group exhibited a significantly higher neutrophil percentage in the BALF (BALF-NE%) than the viral pneumonia group (p<0.001). Additionally, 100% (13/13), 96.0% (24/25), and 89.7% (104/116) of cases in the control, viral pneumonia, and bacterial pneumonia groups had a BALF-NE% ≤10%, ≤30%, and >30%, respectively. The area under the receiver operating characteristics curve for diagnosing bacterial pneumonia using BALF-NE% was 0.986 (95% confidence interval: 0.963-1.000, standard error: 0.012) (p<0.0001), surpassing that of the white blood cell count, NE%, C-reactive protein level, and procalcitonin level. When setting the threshold to BALF-NE% >28%, the sensitivity and specificity for diagnosing bacterial pneumonia were 98.8% and 94.1%, respectively. Among patients with pneumonia caused by <i>Chlamydia pneumoniae, Mycoplasma pneumoniae</i>, and <i>Bordetella pertussis</i>, the proportions with a BALF-NE% >70% were 92.3% (12/13), 100% (16/16), and 80.0% (8/10), respectively.</p><p><strong>Conclusion: </strong>The BALF-NE% outperforms conventional diagnostic indicators and allows reliable, rapid differentiation between bacterial and viral pneumonia in children.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"604517"},"PeriodicalIF":2.9,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13121782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770424","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":"Necrotizing Fasciitis Caused by <i>Aspergillus flavus</i> in an Immunocompetent Young Patient: A Case Report and Literature Review.","authors":"Wenwu Sun, Yuzhuo Han, Daohong Zhou, Huayu Liu, Qiu Zhong","doi":"10.2147/IDR.S587862","DOIUrl":"https://doi.org/10.2147/IDR.S587862","url":null,"abstract":"<p><strong>Background: </strong>Necrotizing fasciitis caused by <i>Aspergillus flavus</i> is extraordinarily rare, with most cases observed in immunocompromised patients. We report a case in an immunocompetent young patient and review the literature.</p><p><strong>Methods: </strong>We present a case of limb-necrotizing fasciitis caused by <i>Aspergillus flavus</i> and conducted a systematic PubMed search using keywords related to \"Aspergillus flavus\", \"soft tissue infection\" and \"necrotizing fasciitis\" to identify previously reported cases.</p><p><strong>Results: </strong>A 26-year-old man presented with progressive swelling and numbness of the right forearm originating from a minor abrasion. Surgical debridement and fungal cultures confirmed <i>Aspergillus flavus</i> infection. The patient was successfully treated with voriconazole. Notably, severe local signs contrasted with nearly normal systemic inflammatory indices throughout the disease course. Literature review identified 8 reports encompassing 10 patients; 7 were immunocompromised. Non-facial <i>Aspergillus flavus</i> soft tissue infections were exceedingly rare, with only two cases in immunocompromised hosts and one in an immunocompetent patient following trauma.</p><p><strong>Conclusion: </strong>We report the youngest immunocompetent patient with limb necrotizing fasciitis caused by <i>Aspergillus flavus</i>. This case highlights the discrepancy between local signs and systemic response. Timely intervention is crucial for favorable prognosis.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"587862"},"PeriodicalIF":2.9,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770408","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":"Efficacy, Safety, and in vitro Sensitivity of Omadacycline in the Treatment of Brucellosis: A Case Series Study.","authors":"Zhu Zeng, Hongdong Tan, Beibei Wu, Qiuting Jiang, Ying Ye, Yanping Zhang, Yiyi Wu, Yunsong Yu, Hua Zhou","doi":"10.2147/IDR.S574932","DOIUrl":"https://doi.org/10.2147/IDR.S574932","url":null,"abstract":"<p><strong>Purpose: </strong>Treatment options for brucellosis are limited. Omadacycline demonstrates strong antibacterial activity against a broad spectrum of bacteria. However, the efficacy of omadacycline against <i>Brucella</i> spp. remains unclear.</p><p><strong>Patients and methods: </strong>We screened brucellosis patients who received omadacycline from April to July 2023 across five hospitals in China and conducted in vitro experiments to evaluate the activity of omadacycline against different <i>Brucella</i> species.</p><p><strong>Results: </strong>A total of 13 patients were included, all of whom received omadacycline as part of a combination regimen. Within this cohort, 11 were diagnosed with Brucella spondylitis, and 8 of these underwent surgical intervention. Omadacycline was administered as second-line therapy in 10 (76.9%) patients due to uncontrolled symptoms and as empirically in the remaining 3. Following the initiation of an omadacycline-containing regimen, symptoms of fever and/or back pain improved rapidly, regardless of whether it was used as empirical or second-line therapy. The median time from omadacycline initiation to defervescence was 3 days, and to relief of back pain was 7 days. The median duration of omadacycline treatment was 32 days, and it was administered in combination with other agents, including rifampicin and cephalosporins. The regimen was well tolerated, with only one patient experiencing mild nausea. In vitro, omadacycline demonstrated consistent activity against all tested <i>Brucella</i> species.</p><p><strong>Conclusion: </strong>In this case series, omadacycline-containing regimens were well tolerated and associated with rapid symptomatic improvement. These findings support further evaluation in prospective comparative studies.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"574932"},"PeriodicalIF":2.9,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13111158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770413","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":"Risk of Mortality Associated with Rapid versus Delayed ART Initiation and Associated Factors Among Late-Presenting People with HIV: An 8-Year Retrospective Analysis in China.","authors":"Lianfeng Lu, Jiale Xi, Xiang Zhang, Hongjing Guan, Jingli Peng, Rentian Cai, Hongxia Wei","doi":"10.2147/IDR.S593806","DOIUrl":"https://doi.org/10.2147/IDR.S593806","url":null,"abstract":"<p><strong>Objective: </strong>To explore the association between the timing of antiretroviral therapy (ART) initiation and all-causes mortality, as well as related risk factors, for late presenters living with HIV (PWH).</p><p><strong>Methods: </strong>Treatment-naive PWH with CD4+T cell count<350 cells/μL, also called late presenters, who initiated ART at the Nanjing Second Hospital from January 2017 to June 2022 were enrolled in this study and followed for at least 3 year and a maximum of 8 years. Based on the time from diagnosis to ART initiation, subjects were divided into a rapid ART group (ART initiation≤14 days after HIV diagnosis, median 12 days) and a delayed ART group (ART initiation>14 days after HIV diagnosis, median 35 days), with a significant difference in initiation time (p<0.001). The difference in mortality, cause of death and immunological profiles between the two groups were compared, and a Cox proportional hazards model was constructed to analyze death-related risk factors.</p><p><strong>Results: </strong>A total of 1538 PWH were included in the study, and 68 patients died, with the total case mortality rate of 4.42%. There were 459 (29.8%) patients in the rapid ART initiation group, and the mortality rate was 3.92% (18/459), there was no significant difference in case mortality compared to the delayed initiation group (4.63%, 50/1079). The most common cause of death among these patients was non-AIDS-related cancer. Besides, risk factors for death were being single, divorced or widowed, and having a baseline CD4+T cell count <200 cells/μL.</p><p><strong>Conclusion: </strong>The all-cause mortality rate of PWH with CD4+T cell counts <350 cells/μL was 4.42%, and the cause of death in China have shifted over time. Rapid initiation of ART was not significantly associated with reduced mortality in this cohort; however, low CD4+T cell counts at baseline and social factors showed a more significant association with mortality.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"593806"},"PeriodicalIF":2.9,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770416","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":"Emerging Microbiome-Based Therapies for Skin Infections: From Probiotics and Prebiotics to Synthetic Microbiome Engineering.","authors":"Gursahib Singh Brar, Aditi Sharma, Arif Jamal Siddiqui, Lalit Sharma","doi":"10.2147/IDR.S592685","DOIUrl":"https://doi.org/10.2147/IDR.S592685","url":null,"abstract":"<p><p>Skin infections are a major global health burden, made worse by the quick development of antimicrobial resistance (AMR) and the poor effectiveness of traditional antibiotic treatments for chronic and recurring diseases. The importance of the skin microbiome in preserving cutaneous homeostasis, pathogen exclusion, and immunological modulation is becoming more and more clear. Many infectious and inflammatory skin conditions have been linked to dysbiosis of the skin microbiota, which has led to a strategic reorientation from pathogen control to microbiome regulation. Probiotics, prebiotics, postbiotics, bacteriophages, microbiome transplants, and new methods in synthetic microbiome engineering are just a few of the recent advances in microbiome-based therapies in skin diseases that are covered in detail in this review. We go into the clinical effectiveness, safety issues, regulatory obstacles, and molecular underpinnings of various therapies. The promise of microbiome-based treatments to lower AMR, improve long-term effectiveness, and restore microbial balance is highlighted by comparison with traditional antibiotics. Lastly, future possibilities are examined that highlight the translational potential of microbiome-centred techniques in dermatology treatments, such as multi-omics integration, artificial intelligence-guided customisation, or synthetic microbial consortia.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"592685"},"PeriodicalIF":2.9,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13111169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770387","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}