Infection and Drug Resistance最新文献

{"title":"Clinical Characteristics and Treatment Outcomes of Fungal Endophthalmitis Caused by <i>Neoscytalidium dimidiatum</i>.","authors":"Chunxia Qi, Biyun Mo, Changhong Jiang, Jiali Li, Xuguang Bo, Xuhui Xiao, Hao Zhou, Jun Long","doi":"10.2147/IDR.S517505","DOIUrl":"10.2147/IDR.S517505","url":null,"abstract":"<p><p><i>Neoscytalidium dimidiatum</i> (<i>N. dimidiatum</i>) is a common fungal pathogen that primarily affects plants but can also cause rare infections in humans. In recent years, sporadic cases have been reported worldwide. Here, we report the first case of endophthalmitis in China resulting from a corneal scratch caused by an infected dragon fruit. Exogenous fungal endophthalmitis can be classified into three categories: postoperative, post-traumatic, and keratitis-associated. Currently, there is no standardized antifungal regimen for <i>N. dimidiatum</i> infections, especially for endophthalmitis, where systemic antibiotics have poor intraocular penetration. Successful management often requires surgical interventions such as amputation or drainage. Our case highlights the diagnostic and therapeutic challenges, as well as the poor outcomes associated with <i>N. dimidiatum</i> infections in humans.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"3671-3675"},"PeriodicalIF":2.9,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12297007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730174","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":"Successful Treatment of Lomentospora Prolificans Infection Following Allogeneic Hematopoietic Stem Cell Transplantation: A Case Report and Literature Review.","authors":"Yi-Han Yang, Chun Di, Hao Zheng, Ya Luo, Ao-Ran Zhang, Tong Su, Xiao-Dong Mo, Yu-Qian Sun, Yu Wang, Meng Lv","doi":"10.2147/IDR.S529984","DOIUrl":"10.2147/IDR.S529984","url":null,"abstract":"<p><p>Lomentospora prolificans is an opportunistic fungal pathogen known for its intrinsic multidrug resistance. This pathogen poses a significant challenge in immunocompromised individuals, particularly patients with hematologic malignancies. We present a case of a 27-year-old male diagnosed with adverse-risk acute myeloid leukemia (AML) who developed pulmonary Lomentospora prolificans infection following therapy for positive measurable residual disease (MRD) and severe chronic graft-versus-host disease (cGVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Despite the pathogen's multidrug resistance and the typically poor prognosis associated with invasive infections in immunocompromised hosts, the patient achieved sustained remission and favorable outcome. This study systematically reviews Lomentospora prolificans infections following HSCT by analyzing 37 reported cases from 24 studies identified through a PubMed search. The majority of cases had acute myeloid leukemia as the most common underlying disease. Disseminated infections were predominant (83.8%), with frequent pulmonary and central nervous system involvement. Antifungal treatment strategies largely involved combination therapy, yet outcomes remained poor, with an overall survival rate of only 13.5%. These findings highlight the critical need for novel therapeutic approaches and early intervention strategies to improve patient outcomes.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"3617-3628"},"PeriodicalIF":2.9,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12297014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730181","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":"Pharmacokinetic Profile of Isoniazid and Acetylator Status in Patients with Systemic Lupus Erythematosus: Implications for Tuberculosis Prevention Therapy in Indonesia.","authors":"Yane Lis Cintawati, Vycke Yunivita, Laniyati Hamijoyo, Edhyana Sahiratmadja","doi":"10.2147/IDR.S513294","DOIUrl":"10.2147/IDR.S513294","url":null,"abstract":"<p><strong>Introduction: </strong>Systemic Lupus Erythematosus (SLE) is a chronic autoimmune inflammatory disease with a high risk of tuberculosis (TB) infection, especially in those living in TB-endemic areas. Isoniazid (INH), an anti-tuberculosis drug, is recommended as preventive therapy in TB susceptible groups, however, its use in SLE is still controversial. SLE patients are more likely to have compromised liver function which can influence the kinetic of INH. The aim of the study was to explore the pharmacokinetic profile of INH and acetylator status in SLE patients.</p><p><strong>Methods: </strong>This was a descriptive observational study with a purposive sampling technique, including adult female SLE at Dr. Hasan Sadikin Hospital Bandung, conducted in January - August 2023. Inclusion criteria were SLE patients in remission with no TB infection; whereas the exclusion criteria were INH allergy, liver or kidney disorders, pregnant or lactating patients, and malignancy. Pharmacokinetic data was collected from six blood collection time points (0, 1, 2, 3, 4, and 8 hours) after 10 days of daily INH 300 mg administration on an empty stomach.</p><p><strong>Results: </strong>In total, 20 female SLE patients were included. The C_max value was 8.73 (2.55-18.27) mg/L and AUC_0-24 was 28.01 (8.82-79.40) mg.h/L.</p><p><strong>Conclusion: </strong>In terms of pharmacokinetic features, preventive isoniazid (INH) daily use of 300mg in SLE is sufficient to provide the prospect of protection from TB. These findings suggest that INH prophylaxis may be a viable strategy for TB prevention in SLE patients, warranting further investigation into long-term safety and efficacy.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"3637-3646"},"PeriodicalIF":2.9,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12301248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730180","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":"Diagnostic Utility of Nanopore Sequencing for Tuberculous Serous Effusions.","authors":"Yu Chen, Yuyang Ling, Xudong Xu, Yanqin Shen, Kan Xu, Guocan Yu","doi":"10.2147/IDR.S524986","DOIUrl":"10.2147/IDR.S524986","url":null,"abstract":"<p><strong>Objective: </strong>Early and precise diagnosis of tuberculous serous effusions is a huge challenge. Nanopore sequencing is a potentially efficient assay. The objective of the current study was to evaluate the diagnostic accuracy of nanopore sequencing for tuberculous serous effusions using clinical specimens directly, and to provide a new pathway for the early and precise diagnosis of tuberculous serous effusions.</p><p><strong>Methods: </strong>This was a retrospective analysis of the effectiveness of nanopore sequencing as a diagnostic method for tuberculous serous effusions using clinical specimens (pleural fluid, pericardial effusion, and ascitic fluid). Using clinical diagnosis as reference standard, the diagnostic accuracy indicators such as sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC) for the tests in question were evaluated.</p><p><strong>Results: </strong>In total, 132 patients were eligible for inclusion. Nanopore sequencing showed sensitivity of 93.3%, specificity of 85.2%, PPV of 96.1%, NPV of 76.7%, and AUC of 0.89 for tuberculous serous effusions. The diagnostic accuracy of nanopore sequencing was significantly superior than that of Xpert MTB/RIF and culture. Similar results were observed in different types of tuberculous serous effusions (pleural tuberculosis, pericardial tuberculosis, and peritoneal tuberculosis).</p><p><strong>Conclusion: </strong>Nanopore sequencing was efficient for the rapid diagnosis of tuberculous serous effusions and had a very positive effect. For paucibacillary tuberculous serous effusions, nanopore sequencing might become an effective method for detecting pathogenic bacteria.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"3661-3670"},"PeriodicalIF":2.9,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730176","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 EUCAST Rapid Antimicrobial Susceptibility Testing for Gram-Negative Bacteria Directly from Positive Blood Cultures.","authors":"Peng-Peng Tian, Hui Yang, Tian Wang, Li Wang, Meng-Yao Du, Shan-Shan Su, Li-Sha Zhu, Xian-Mo Wang, Liang-Cai Xie, Wen Fan, Tian Tian, Hua-Wei Yi","doi":"10.2147/IDR.S514981","DOIUrl":"10.2147/IDR.S514981","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to evaluate the accuracy of EUCAST rapid antimicrobial susceptibility testing (RAST) for Gram-negative bacteria directly from positive blood cultures, comparing it with short-term incubation (5-7 hours) and conventional broth microdilution methods.</p><p><strong>Methods: </strong>A total of 139 Gram-negative isolates were tested. RAST results were assessed at 4 h, 6 h against minimal inhibitory concentration results using the short-term incubation (5-7 h) method, while at 16-20 h, the RAST results were compared to conventional method. For those with interpretable results, CLSI M52 was used to define cutoffs for equivalence in antimicrobial susceptibility testing.</p><p><strong>Results: </strong>Among all isolates, 80.6% (112/139) were successfully interpreted based on EUCAST RAST breakpoints, including <i>Escherichia coli</i> (81), <i>Klebsiella pneumoniae</i> complex (17), <i>Pseudomonas aeruginosa</i> (10) and <i>Acinetobacter baumannii</i> (4). The overall category agreements for all tested antibiotics were 98.9%, 99.5%, and 99.7% at 4, 6, and 16-20 hours, respectively, for <i>E. coli</i>, and 100% for <i>K. pneumoniae, P. aeruginosa</i>, and <i>A. baumannii</i>. The area of technical uncertainty rate significantly decreased over time, from 9.1% at 4 hours to 3.1% at 16-20 hours (<i>p</i> < 0.05). The method effectively identified extended-spectrum beta-lactamase (ESBL)-producing and carbapenem-resistant bacteria, demonstrating performance comparable to the BD system. Additionally, results for other <i>Enterobacterales</i> could be interpreted using the RAST breakpoints for <i>E. coli</i>. The integration of RAST into routine workflows provides rapid and accurate results without incurring additional costs or labor.</p><p><strong>Conclusion: </strong>RAST is a reliable and cost-effective method for testing Gram-negative bacteria directly from blood cultures, significantly reducing turnaround time. Utilizing RAST at various reading times (6 hours and 16-20 hours) optimizes clinical workflows, enhances antimicrobial stewardship, and improves patient outcomes.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"3579-3590"},"PeriodicalIF":2.9,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12297011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730177","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 Characterization, Risk Factors, and Mortality in Patients with Carbapenem-Resistant Hypervirulent <i>Klebsiella pneumoniae</i> Intra-Abdominal Infections.","authors":"Mingjie Qiu, Sai Tian, Liuqing Dou, Jiajie Wang, Li Xu, Meilin Wu, Zhitao Zhou, Jiayang Li, Wenqi Wu, Jianan Ren, Xiuwen Wu","doi":"10.2147/IDR.S529532","DOIUrl":"10.2147/IDR.S529532","url":null,"abstract":"<p><strong>Background: </strong>The outbreak of the highly lethal Carbapenem-resistant <i>Klebsiella pneumoniae</i> (CR-hvKP) strain is increasingly prevalent. The aim of this study was to investigate the epidemiology, molecular characteristics, and mortality rate in intra-abdominal infections (IAIs) caused by CR-hvKP in a tertiary hospital, providing scientific evidence for clinical treatment to reduce mortality and improve patient prognosis.</p><p><strong>Methods: </strong>The study included 160 patients who developed CRKP IAIs from June 2023 to December 2024. Carbapenemase and virulence genes were detected by Polymerase chain reaction assay. Antimicrobial susceptibility test was performed to determine drug resistance. Multivariate logistic regression and multivariate Cox regression were used to determine risk factors of CR-hvKP IAIs and CRKP IAIs mortality, respectively.</p><p><strong>Results: </strong>A total of 160 patients with CRKP IAIs were enrolled: 68 with CR-hvKP IAIs and 92 with CR-non-hvKP IAIs. The mortality rate trended higher in the CR-hvKP group compared with CR-non-hvKP (17.6% vs 10.9%), but the difference was not statistically significant (P=0.218). Multivariate logistic regression identified tracheotomy as a risk factor for infection with CR-hvKP IAIs (OR 2.816, 95% CI 1.120-7.080). Multivariate Cox regression analysis identified four independent risk factors for in-hospital mortality of CRKP IAIs: age (HR 1.066, 95% CI 1.020-1.114), decreased platelet count (HR 0.995, 95% CI 0.990-0.999), septic shock (HR 9.141, 95% CI 2.082-40.133), and tracheotomy (HR 4.322, 95% CI 1.461-12.791).</p><p><strong>Conclusion: </strong>The mortality rate was numerically higher in the CR-hvKP IAIs while the difference was not statistically significant. Our study identified tracheotomy as an independent risk factor for infection with CR-hvKP IAIs. Clinicians need to enhance their awareness and epidemiologic surveillance of this lethal bacterium.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"3647-3660"},"PeriodicalIF":2.9,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730175","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":"Assessment of Medical Waste Segregation, Disposal Practices for Infectious and Sharps Waste in Healthcare Facilities in Somalia: Implications for Infection Prevention and Control.","authors":"Abdikarim Abdi Adam, Felix Emeka Anyiam, Mukhtar Abdi Shube, Hassan Dahir Mohamed, Hassan Abdi Ahmed, Nor Haji Osman","doi":"10.2147/IDR.S525134","DOIUrl":"10.2147/IDR.S525134","url":null,"abstract":"<p><strong>Background: </strong>Effective handling of healthcare waste is paramount for infection prevention, particularly in fragile environments such as Somalia. When infectious and sharps waste are not appropriately segregated and disposed of, Infectious diseases like HIV, hepatitis B and C, and tuberculosis can spread due to improper waste segregation and disposal, which poses a serious threat to public health. This study aims to assess the infectious and sharps waste management practices and waste segregation in Somalia's healthcare facilities.</p><p><strong>Methodology: </strong>A nationwide cross-sectional study was conducted in 2022/2023 by UNICEF, WHO, and the Federal Ministry of Health in Somalia. Data were collected from 423 healthcare facilities out of 1,410 using the WHO/UNICEF Joint Monitoring Programme (JMP) questionnaire. Simple random sampling ensured an objective and representative assessment.</p><p><strong>Results: </strong>Based on our study, more than 60% of healthcare facilities lacked proper waste segregation systems, and many reported insufficient colour-coded or covered bins. For infectious garbage, incineration was the most common approach (33.57%), whereas for sharps waste, pit burning was the most common option (52.48%). Geographic location and the type of waste management strategies used were significantly correlated (p < 0.001), indicating regional inequalities. These results draw attention to the numerous discrepancies and structural shortcomings in current systems for managing medical waste.</p><p><strong>Conclusion: </strong>Addressing gaps in waste management through policy enforcement, funding, and healthcare worker training is paramount to reducing healthcare-associated infections and improving healthcare safety in Somalia.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"3605-3615"},"PeriodicalIF":2.9,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12301244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730173","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 Activity of the Latex of Jatropha Curcas Against Cutaneous Wound and Burns Infection\".","authors":"Ali Salman Al-Shami, Mokhtar Alzomor","doi":"10.2147/IDR.S531926","DOIUrl":"10.2147/IDR.S531926","url":null,"abstract":"<p><strong>Background: </strong>There is a growing interest in natural materials with antibacterial qualities as alternatives. Jatropha curcas latex has long been used to treat infections.</p><p><strong>Objective: </strong>Compare the antimicrobial activities of both <i>Jatropha curcas latex</i> and the used antibiotics against the isolated microorganisms which cause wound burn infection.</p><p><strong>Methods: </strong>An experimental study was carried out in Sana'a City, Yemen, to assess the antimicrobial properties of J. curcas latex. Infected burn wounds were found to contain pathogenic microorganisms such as Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Candida albicans. Standard antimicrobial strains were subjected to testing as well. We obtained latex from verified J. curcas specimens and subjected it to phytochemical analysis. The assessment of antimicrobial activity involved the use of agar well diffusion, disc diffusion, and broth dilution methods to establish inhibition zones and minimum inhibitory concentrations (MICs).</p><p><strong>Results: </strong>The phytochemical examination of J. curcas latex identified the presence of tannins, flavonoids, alkaloids, glycosides, sterols, saponins, and terpenes. The latex exhibited considerable antibacterial efficacy against all tested species, with inhibition zones measuring from 23 mm (K. pneumoniae) to 31.3 mm (S. aureus). The MIC values varied from 6.25 mg/mL (eg, E. coli, K. pneumoniae, C. albicans) to 25 mg/mL (S. aureus, P. aeruginosa). The comparative research indicated that J. curcas latex surpassed tetracycline and had equivalent or better efficacy to ofloxacin and fluconazole against several isolates.</p><p><strong>Conclusion: </strong>The latex of J. curcas has extensive antibacterial action against major burn wound pathogens. Its efficacy can be linked to the presence of several bioactive substances. These findings point to its potential use as a topical antibacterial agent in burn wound treatment, particularly in countries with significant antibiotic resistance.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"3591-3603"},"PeriodicalIF":2.9,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12301237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730171","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":"Management of Invasive Bronchopulmonary Mucormycosis with Low-Dose Antifungal Therapy and Left Lower Lobectomy in a Patient with Renal Insufficiency.","authors":"Chen Zhu, Ying Gu, Qiwu Zhu, Xiuli Liu, Tingshu Jiang","doi":"10.2147/IDR.S529536","DOIUrl":"10.2147/IDR.S529536","url":null,"abstract":"<p><strong>Background: </strong>This case report aims to evaluate the feasibility of medical and surgical management in a patient with invasive bronchopulmonary mucormycosis complicated by renal insufficiency-a critical challenge limiting antifungal dosing and requiring tailored therapeutic strategies, while also reviewing the current literature on the treatment of pulmonary mucormycosis.</p><p><strong>Case presentation: </strong>The patient received low-dose antifungal therapy with posaconazole and amphotericin B cholesterol sulfate complex. Subsequently, the patient underwent a left inferior lobectomy and experienced a successful postoperative recovery. Renal insufficiency complicates drug selection and dosing. A literature review demonstrated that combining antifungal therapy with surgical intervention is an effective approach for treating invasive bronchopulmonary mucormycosis.</p><p><strong>Conclusion: </strong>The combination of antifungal therapy and surgical management proves to be an effective treatment strategy for invasive bronchopulmonary mucormycosis in patients with renal insufficiency.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"3629-3635"},"PeriodicalIF":2.9,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12301116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730179","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 Report of Unusual Diagnosis of Melioidosis in a Non-Traveler: Implications for Transmission and Diagnosis.","authors":"Chenliang Fan, Xiaosi Li, Baizhi Pi, Jiasheng Wu, Heping Shen, Yumiao Guo, Xiaoyan Wu","doi":"10.2147/IDR.S528971","DOIUrl":"10.2147/IDR.S528971","url":null,"abstract":"<p><p>Melioidosis is prevalent in Southeast Asia, acquired via breathing or skin contact with water or soil contaminated by <i>Burkholderia pseudomallei</i>. This article reports a 42-year-old male melioidosis patient without underlying diseases or travel history to epidemic areas, discussing its significance for epidemiology, diagnosis and treatment in non-epidemic areas. The patient's clinical manifestations, disease progression, previous treatment, admission examination, diagnostic process, treatment and follow-up results were retrospectively analyzed. tNGS, microbial culture and WGS were used for sample and pathogen identification and genetic analysis. The patient had recurrent fever with erythema nodosum on the left lower limb. Misdiagnosed and treated ineffectively in other hospitals, he was diagnosed with melioidosis in the Second Affiliated Hospital of Jiaxing University. The strain was identified as <i>Burkholderia pseudomallei</i>, type ST46. Appropriate antibiotic treatment was selected based on drug sensitivity test results. After 6 months of follow-up, most lesions were absorbed, laboratory indicators normalized and the clinical effect was good. Epidemiological investigations suggested ST46 might be transmitted via non-traditional routes related to the fact that 15 days before the onset of the disease, the patient had purchased live turtles and the soil for raising them online which were sourced from Yunnan, indicating the possibility of geographical transmission. This case enriches understanding of melioidosis' non-traditional transmission, strain transmission, clinical diagnosis and treatment, highlighting the importance of considering the disease in non-endemic areas' differential diagnosis and the need for further epidemiological surveillance and research.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"3569-3577"},"PeriodicalIF":2.9,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12301130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730172","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}