Infection and Drug Resistance最新文献

{"title":"Risk Factors for Development and Mortality of Bloodstream Infections Caused by Carbapenem-Resistant <i>Acinetobacter baumannii</i>.","authors":"Liubing Li, Dubo Chen, Pingjuan Liu, Luqi Dai, Zhaoxia Tang, Siting Yi, Mengmin Ye","doi":"10.2147/IDR.S484546","DOIUrl":"10.2147/IDR.S484546","url":null,"abstract":"<p><strong>Background: </strong>Bloodstream infections (BSIs) caused by <i>Acinetobacter baumannii</i> (AB), especially carbapenem-resistant <i>Acinetobacter baumannii</i> (CRAB), can lead to a high patient mortality rate.</p><p><strong>Methods: </strong>This study aimed to analyze the clinical data and prognosis of 191 patients with AB-BSI hospitalized in Southern China from January 2017 to December 2023.</p><p><strong>Results: </strong>CRAB was diagnosed in 128 (67.0%) of the 191 patients with AB-BSI. Endotracheal intubation (OR = 23.957, 95% CI: 5.123-112.022, P < 0.001), carbapenem treatment (OR = 6.422, 95% CI: 1.554-26.542, P = 0.010) and ≥2 antimicrobial drugs therapy (OR = 6.131, 95% CI: 1.763-21.324, P = 0.004) prior to the onset of BSI were independent risk factors for the development of CRAB-BSI, as revealed by the binary logistic regression analysis. The overall mortality rate of patients with AB-BSI was 27.7%, while that of patients with CRAB was significantly higher than that of patients with carbapenem-sensitive <i>Acinetobacter baumannii</i> (CSAB) (39.1% vs 4.8%, P < 0.001). Multivariate Cox regression analysis revealed septic shock (HR = 3.664, 95% CI: 1.537-8.736, P = 0.003) as an independent risk factor for mortality in CRAB-BSI patients. Kaplan-Meier survival analysis showed a significantly lower 28-day survival rate for CRAB-BSI patients who developed septic shock compared to those who did not (58.4% vs 87.1%, P = 0.001).</p><p><strong>Conclusion: </strong>Clinicians should closely monitor patients at high risk for CRAB-BSI, focusing on invasive procedure management and antimicrobial stewardship. Timely supportive care is crucial for CRAB-BSI patients at risk of septic shock to improve survival outcomes.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"17 ","pages":"5699-5706"},"PeriodicalIF":2.9,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885827","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 Growth Hormone Treatment on COVID-19 Susceptibility and Severity in Children with Short Stature: A Survey Study with Mendelian Randomization Analysis.","authors":"Wenjuan Qiu, Ruifang Wang, Lili Liang, Yuning Sun, Rong Zhou, Xiaoli Wang, Wen Sun, Xuefan Gu","doi":"10.2147/IDR.S483477","DOIUrl":"10.2147/IDR.S483477","url":null,"abstract":"<p><strong>Introduction: </strong>Growth hormone (GH) is crucial for immune system development and regulation, potentially benefiting COVID-19 outcomes. However, there are limited studies on the role of GH treatment in COVID-19 in children with short stature.</p><p><strong>Methods: </strong>We conducted a survey study to evaluate the association between GH treatment and COVID-19 risk in short stature children aged 7 to 18 years. Two groups were defined: GH Treated and GH Untreated. The primary endpoint was the proportion of children with COVID-19 histories. Secondary endpoints included the presence, severity, and duration of COVID-19 symptoms. Exploratory endpoints included the frequency of common colds after GH treatment. We further performed two-sample Mendelian randomization (MR) analyses to explore the causal relationship between GH levels and COVID-19 susceptibility, hospitalization, and severity using genome-wide association study summary-level data.</p><p><strong>Results: </strong>Of the 201 children, 113 (56.2%) reported COVID-19 history, and 149 (74.1%) used GH. The mean age was 11.02 ± 2.10 years. GH treatment was associated with a somewhat lower proportion of COVID-19 history (-9.77%, 95% confidence interval [CI] -26.41% to 6.87%; P = 0.289), and the odds ratio (OR) is 0.58 (95% CI 0.29 to 1.14, P = 0.120) after adjusting for confounders. Among the 113 children with COVID-19 histories, the highest body temperature was significantly lower in the GH Treated group (P = 0.040). In the MR analyses, for one unit increase in GH level, the OR was 0.95 (95% CI 0.92 to 0.99, P = 0.022) for COVID-19 susceptibility, 0.86 (95% CI 0.77 to 0.96, P = 0.007) for COVID-19 hospitalization, and 0.95 (95% CI 0.84 to 1.07, P = 0.392) for COVID-19 severity.</p><p><strong>Conclusion: </strong>GH treatment was associated with somewhat decreased COVID-19 susceptibility but was not statistically significant. Higher GH levels were causally associated with a significantly lower rate of COVID-19 susceptibility and hospitalization.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"17 ","pages":"5675-5684"},"PeriodicalIF":2.9,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885829","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":"Application of Metagenomics Next-Generation Sequencing on Diagnosis of Disseminated Infection Caused by <i>Rhizomucor pusillus</i> in an Acute Lymphoblastic Leukemia Patient.","authors":"Hengxin Chen, Mingjin Qiu, Hongxu Xu, Penghao Guo, Yaqin Peng","doi":"10.2147/IDR.S499419","DOIUrl":"10.2147/IDR.S499419","url":null,"abstract":"<p><strong>Background: </strong><i>Rhizomucor pusillus</i> is one of the major pathogens in mucormycosis. Infection due to <i>R. pusillus</i> is rare and has a high mortality rate, especially disseminated mucormycosis infections. Rapid and accurate pathogen identification is important for the development of targeted antifungal therapies.</p><p><strong>Case presentation: </strong>We presented a case of disseminated <i>R. pusillus</i> infection, identified through metagenomics next-generation sequencing (mNGS), in a 4-year-old patient with acute lymphoblastic leukemia. On days 22, 23, and 28, <i>R. pusillus</i> was detected in bronchoalveolar lavage fluid, blood, and hydrothorax, respectively, through mNGS. The patient developed lung, pleural, and blood disseminated lesions caused by <i>R. pusillus</i> infection. Subsequently, the patient was treated with antifungal therapy, including posaconazole, amphotericin B, and isacconazole, with supportive treatment. However, with the continuous deterioration of symptoms, the patient's family decided to give up treatment. The patient eventually died of multiple-organ failure on day 34.</p><p><strong>Conclusion: </strong>mNGS facilitates prompt diagnosis of disseminated <i>R. pusillus</i> infections. The successful application of mNGS provided a new perspective for the clinician, underscoring the technique's potential for rapid diagnostic etiology. mNGS has the capability to identify pathogens at the species level, which is a significant asset in guiding clinical medication decisions.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"17 ","pages":"5707-5713"},"PeriodicalIF":2.9,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885822","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 Application of Metagenomic Next-Generation Sequencing (mNGS) in Patients with Early Pulmonary Infection After Liver Transplantation.","authors":"Hua-Bin Peng, Ying Liu, Fei Hou, Shuang Zhao, Yi-Zhi Zhang, Zhi-Ying He, Jing-Yi Liu, Hao-Feng Xiong, Li-Ying Sun","doi":"10.2147/IDR.S483684","DOIUrl":"10.2147/IDR.S483684","url":null,"abstract":"<p><strong>Purpose: </strong>To examine the clinical utility of metagenomic next-generation sequencing (mNGS) in individuals with early pulmonary infection following liver transplantation.</p><p><strong>Patients and methods: </strong>mNGS and traditional detection results were retrospectively collected from 99 patients with pulmonary infection within one week following liver transplantation. These patients were admitted to the Department of Critical Liver Diseases at Beijing Friendship Hospital from February 2022 to February 2024, along with their general clinical data.</p><p><strong>Results: </strong>mNGS exhibited a significantly higher detection rate than traditional methods (92.93% vs 54.55%, P < 0.05) and was more effective in identifying mixed infections (67.68% vs 14.81%, P < 0.05). mNGS identified 303 pathogens in 92 patients, with <i>Enterococcus faecium, Pneumocystis jirovecii</i>, and human herpesvirus types 5 and 7 being the most prevalent bacteria, fungi, and viruses. A total of 26 positive cases were identified through traditional culture methods (sputum and bronchoalveolar lavage fluid), with 18 cases consistent with mNGS detection results, representing 69.23% consistency. Among the three drug-resistant bacteria that showed positivity in mNGS and traditional culture, the presence of drug-resistance genes-<i>mecA</i> in <i>Staphylococcus aureus; KPC-2, KPC-9, KPC-18, KPC-26, OXA27, OXA423</i> in <i>Klebsiella pneumoniae</i>; and <i>OXA488</i> and <i>NDM6</i> in <i>Pseudomonas aeruginosa-</i>reliably predicted drug-resistance phenotype. The treatment regimen for 76 of the 92 patients with positive mNGS relied on these results; 74 exhibited significant symptom improvement, yielding a 97.37% recovery rate. The overall prognosis was favorable.</p><p><strong>Conclusion: </strong>mNGS offers rapid detection, a high positivity rate, insensitivity to antibiotics, and a superior ability to detect mixed infections in patients with early post-transplant pulmonary infections. Additionally, mNGS shows good consistency with traditional culture and can predict drug-resistant phenotypes to guide targeted antibiotic therapy for early-stage post-transplant pulmonary infection after liver transplantation. Patients whose antibiotic therapy is based on mNGS results have experienced decreased mortality rates and overall improved prognosis.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"17 ","pages":"5685-5698"},"PeriodicalIF":2.9,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11665138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881723","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":"Whole Genome Sequencing of a Non-O1/O139-Group <i>Vibrio cholerae</i> Isolated from a Patient with a Bloodstream Infection.","authors":"Sipei Wang, Shanshan Jin, Xiangjin Zhu, Yuan Li, Xinling Pan","doi":"10.2147/IDR.S500969","DOIUrl":"10.2147/IDR.S500969","url":null,"abstract":"<p><strong>Background: </strong>Diarrhea caused by non-O1/O139-group <i>V. cholera</i>e (NOVC) tends to be mild and can be readily overlooked. In this report, a NOVC strain designated XXM was isolated from the blood of a 68-year-old male undergoing surgical treatment for a bile duct malignancy in October 2023.</p><p><strong>Methods: </strong>XXM was identified through a matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). Virulence genes were detected using a <i>V. cholerae ctxA/ctxB</i> virulence gene dual real-time fluorescent PCR kit. AST-GN13 and AST-GN334 cards were used to test the resistance against 16 antibiotics with a Vitek2 compact system. The genomic and phylogenetic characteristics of XXM were established through whole genome sequencing (WGS).</p><p><strong>Results: </strong>Serum agglutination tests revealed the isolate to be a non-O1/non-O139 strain. The strain was sensitive to all 16 tested antibiotics and did not carry the <i>ctxA/ctxB</i> gene. MLST analyses identified the XXM strain as ST1538. WGS analyses identified 8 classes of virulence genes with different functions. A total of 3.541 bacterial genes, including 3.482 from <i>V. cholerae</i>, were annoted using the Non-Redundant Protein Sequence (NR) database. Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses annotated 32 genes including 17 key proteins involved in the <i>V. cholerae</i> biofilm pathway. Comparative analyses using the Pathogen Host Interactions Database (PHI) identified the <i>YbeY</i> gene. Evolutionary genealogy of genes: Non-supervised Orthologous Groups (eggNOG) was used to annotate 3280 genes in 21 categories. Phylogenetic analyses revealed that strain XXM was closely related to <i>V. cholerae</i> strain Man9.</p><p><strong>Conclusion: </strong>The XXM carries multiple virulence genes, and this genomic analysis of the XXM in comparison with other NOVC strains provides important information for an improved understanding of the pathogenicity of NOVC in clinical samples.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"17 ","pages":"5629-5637"},"PeriodicalIF":2.9,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894170","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":"Diagnosis of Neurological Involvement Caused by <i>Streptococcus dysgalactiae</i>: A Case Report and Review of the Literature.","authors":"Jia Zhou, Xiaoqi Ding, Xinmiao Jia, Hongli Sun","doi":"10.2147/IDR.S493557","DOIUrl":"10.2147/IDR.S493557","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigated the clinical relevance, pathogenic mechanisms, and neurological involvement of <i>Streptococcus dysgalactiae</i> subspecies <i>equisimilis</i> (<i>SDSE</i>) and subspecies <i>dysgalactiae</i> (<i>SDSD</i>), with a focus on a severe case of <i>SDSE</i> meningitis complicated by septic shock.</p><p><strong>Patients and methods: </strong>A systematic review of 19 cases of neurological infections caused by <i>S. dysgalactiae</i> (<i>SDSE</i> or <i>SDSD</i>) from 1971 to 2023 was conducted, supplemented by a detailed case report. Data on patient demographics, predisposing factors, clinical manifestations, diagnostic procedures, treatment, and outcomes were analyzed.</p><p><strong>Results: </strong>The reviewed cases involved 12 patients with <i>SDSE</i> and seven with <i>SDSD</i>. The median age was 53 years, and most patients had underlying conditions such as diabetes, malignancy, or cardiovascular disease. Neurological manifestations were common, with meningitis being diagnosed in 17 patients. Despite prompt antibiotic therapy, six patients (32%) died, highlighting the severe nature of these infections.</p><p><strong>Conclusion: </strong><i>S. dysgalactiae</i> can cause severe neurological infections, particularly in immunocompromised patients. Early recognition and aggressive treatment are essential to improving outcomes. Advanced molecular diagnostic techniques, such as next-generation sequencing (NGS), are crucial in identifying and managing these infections.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"17 ","pages":"5649-5661"},"PeriodicalIF":2.9,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11665141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881727","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":"Changes in Clinical Features and Severity of COVID-19 with the Emergence of Omicron Variants: A Shift Towards a Common Disease.","authors":"Saori Kawamura, Fumihiro Yamaguchi, Rui Kusakado, Yoshihiro Go, Shiho Nohmi, Chinatsu Yoshizaki, Yuki Yoshida, Kensuke Izumizaki, Yuichiro Saito, Hitoshi Kobayashi, Kento Hirata, Kenta Miyo, Chika Kondo, Mamiko Kanzaki, Yize Ding, Takuya Yokoe, Sei Kobayashi, Hiroshi Suzuki","doi":"10.2147/IDR.S492816","DOIUrl":"10.2147/IDR.S492816","url":null,"abstract":"<p><strong>Background: </strong>The emergence of the Omicron variant of severe acute respiratory syndrome coronavirus-2 has significantly altered the clinical features and severity of coronavirus disease 2019 (COVID-19).</p><p><strong>Objective: </strong>This study aims to evaluate whether the clinical factors that previously predicted COVID-19 remain valid following the emergence of the Omicron variant.</p><p><strong>Methods: </strong>This cross-sectional study was conducted at Showa University Fujigaoka Hospital from April 2022 to March 2023. A total of 576 patients with suspected COVID-19 were included, of which 258 (44.8%) were diagnosed with COVID-19 based on real-time reverse-transcription polymerase chain reaction tests. Clinical data were collected retrospectively, and multivariate logistic regression was used to analyze factors associated with a COVID-19 diagnosis.</p><p><strong>Results: </strong>Of the 258 patients diagnosed with COVID-19, 60% had mild disease, and the overall severity was lower than in previous reports prior to the emergence of the Omicron variant. In the multivariate analysis, only C-reactive protein (CRP) levels were significantly associated with COVID-19 (odds ratio, 0.3164; 95% confidence interval, 0.2077-0.4819), while factors such as age, sex, body mass index, lactate dehydrogenase, and comorbidities were not significantly associated. Non-COVID-19 cases were primarily bacterial infections, accounting for 57.2% of the non-COVID-19 diagnoses. Mortality rates did not differ significantly between the COVID-19 and non-COVID-19 groups.</p><p><strong>Conclusion: </strong>The clinical characteristics of COVID-19 have become less distinct since the emergence of the Omicron variant, with CRP being the primary marker associated with a COVID-19 diagnosis. As COVID-19 continues to transition towards a more common infectious disease, distinguishing it will become increasingly challenging.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"17 ","pages":"5595-5603"},"PeriodicalIF":2.9,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11663384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876964","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 Levels of Non-Tuberculous Bacteria Isolates from Sputum of TB Patients in Ghana.","authors":"Portia Abena Morgan, Desmond Opoku Ntiamoah, Prince Asare, Ishaque Siam Mintah, Stephen Osei-Wusu, Augustine Asare Boadu, Emelia Konadu Danso, Ivy Naa Koshie Lamptey, Emmanuel Afreh, Amanda Tetteh, Adwoa Asante-Poku, Isaac Darko Otchere, Dorothy Yeboah-Manu","doi":"10.2147/IDR.S483529","DOIUrl":"10.2147/IDR.S483529","url":null,"abstract":"<p><strong>Background: </strong>Patients with tuberculosis (TB) often harbor diverse bacteria in their sputum, including both commensal and opportunistic pathogens. This study aimed to characterize the sputum microbiota of TB patients before and after the intensive phase of anti-TB treatment and assess changes in bacterial diversity and antibiotic resistance profiles.</p><p><strong>Methods: </strong>A total of 162 patients with TB (128 males, 34 females; age range 18-82 years) provided sputum samples at baseline, of which 72 provided follow-up sputum after two months of intensive phase treatment. Sputum samples were cultured on standard agar plates, and distinct colonies were identified by Gram staining and bio-typing using MALDI-TOF mass spectrometry. Antibiotic susceptibility testing of the identified Gram-positive and Gram-negative bacteria was performed using the Kirby-Bauer method according to the CLSI guidelines.</p><p><strong>Results: </strong>At baseline, 209 bacterial isolates were recovered, dominated by Gram-positive bacteria (GPB), particularly <i>Streptococcus oralis</i> (19.6%) and <i>Staphylococcus aureus</i> (13.9%). After treatment, the isolation rate significantly decreased (from 129% to 95.8%; p = 0.000002), with a shift towards Gram-negative bacteria (GNB) dominated by <i>E. coli</i>. High rates of antibiotic resistance were observed for both the GNB and GPB, notably to ampicillin (86.7%), tetracycline (74%), amoxicillin (70.3%), and sulfamethoxazole (63%) for GNP, and PEN (76.9%) for the GPB. 53% of <i>S. aureus</i> isolates were phenotypic Methicillin-resistant <i>S. aureus</i> (MRSA) and 57.7% of suspected extended-spectrum <i>Beta-lactamase</i> (ESBL) producers were confirmed positive, predominantly carrying the <i>blaCTX-M-1</i> gene.</p><p><strong>Conclusion: </strong>The observed antibiotic resistance among the identified isolates, including MRSA and ESBL, underscores the need for routine antibiotic susceptibility testing and judicious antibiotic use in Ghana. Further research is needed to explore the long-term consequences of these microbiome shifts on TB treatment outcomes and risk of secondary infections.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"17 ","pages":"5663-5673"},"PeriodicalIF":2.9,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881539","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":"Comparing the Performance of Two Cryptococcal Antigen Detection Tests: Chemiluminescence vs Colloidal Gold Methods.","authors":"Xiao-Yun Yu, Lei Zhang, Yueyue Hu, Zhongliang Zhu, Yongze Zhu, Xi Li","doi":"10.2147/IDR.S491846","DOIUrl":"10.2147/IDR.S491846","url":null,"abstract":"<p><strong>Objective: </strong>To compare the performance of a new chemiluminescence method with that of the traditional colloidal gold method for cryptococcal antigen (CrAg) detection.</p><p><strong>Methods: </strong>Cryptococcosis is a global invasive mycosis associated with significant morbidity and mortality. Cryptococcal antigen (CrAg) testing from serum and cerebrospinal fluid (CSF) has been regarded as the gold standard for early diagnosis. In this study, a total of 140 samples (92 serum and 48 cerebrospinal fluid samples) from 140 patients with suspected cryptococcosis collected between January 2022 and September 2023 at Zhejiang Provincial People's Hospital were tested via a fully automated chemiluminescent immunoassay analyser (SuperFlex) from Suzhou Xinbo and a cryptococcal antigen detection kit (colloidal gold method) from the IMMY Company of the United States.</p><p><strong>Results: </strong>According to the diagnostic criteria for cryptococcosis, 55 of the 140 suspected patients were diagnosed with cryptococcosis (39.3%), including 47 with pulmonary cryptococcosis (PC) and 8 with cryptococcal meningitis (CM). The degree of agreement between chemiluminescence and the colloidal gold method was analysed via Cohen's kappa coefficient, which was 0.970 (P<0.01). The sensitivities of the chemiluminescence and colloidal gold methods were 98.2% and 96.4%, respectively, and their specificities were 100% and 98.8%, respectively. The area under the receiver operating characteristic (ROC) curve were 0.996 for chemiluminescence and 0.9759 for the colloidal gold method. The area under the curve (AUC) of the two methods did not differ significantly (P=0.086).</p><p><strong>Conclusion: </strong>For the detection of CrAg, the new chemiluminescence method is highly consistent with the traditional colloidal gold method and has higher sensitivity and specificity for the diagnosis of cryptococcosis.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"17 ","pages":"5639-5647"},"PeriodicalIF":2.9,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11663370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876965","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":"Quantifying the Long and Short Axes of the External Iliac Lymph Nodes Using Dual-Energy Computed Tomography: A Potential Diagnostic Approach for Periprosthetic Joint Infection - A Prospective Study.","authors":"Yaji Yang, Haotian Zhou, Runxing Kang, Chen Zhao, Jia Li, Feilong Li, Yidong Shen, Yuelong Chen, Wei Huang, Leilei Qin","doi":"10.2147/IDR.S497736","DOIUrl":"10.2147/IDR.S497736","url":null,"abstract":"<p><strong>Purpose: </strong>Periprosthetic joint infection (PJI) is a severe complication following joint replacement surgery, and there is a current lack of rapid, accurate, and non-invasive diagnostic methods. This study aims to assess the effectiveness of using dual-energy computed tomography (DECT) to quantify the maximum long and short axes of the external iliac lymph nodes (LNs) as a diagnostic tool for PJI.</p><p><strong>Patients and methods: </strong>In this prospective controlled study, 112 patients undergoing total hip or total knee revision surgery were enrolled. All patients underwent preoperative DECT scanning to measure the maximum long and short axes of the external iliac LNs on the affected side. The diagnostic value of lymph node size for PJI was assessed using receiver operating characteristic curves.</p><p><strong>Results: </strong>The AUC (Area Under the Curve) quantifies the diagnostic method's ability to distinguish between positive and negative outcomes in this study. A value closer to 1.0 indicates better discriminatory performance. Compared to erythrocyte sedimentation rate (Area Under the Curve (AUC) = 0.834), percentage of polymorphonuclear leukocytes (AUC = 0.621), and C-reactive protein (AUC = 0.765), the maximum long axis (AUC =0.895) and maximum short axis (AUC = 0.858) of the external iliac LNs better differentiated PJI from aseptic failure. For diagnosing PJI, the threshold for the maximum long axis of the LNs was 20.5 mm, with a sensitivity of 84.21% and a specificity of 87.84%. For the maximum short axis, the threshold was 8.5 mm, with a sensitivity of 89.47% and a specificity of 82.43%. Combining the maximum long and short axes of the external iliac LNs enhanced the diagnostic accuracy for PJI.</p><p><strong>Conclusion: </strong>Measuring the long and short axes of external iliac LNs using DECT is an effective diagnostic approach for PJI, aiding in the differentiation between PJI and aseptic failure following joint replacement surgery.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"17 ","pages":"5605-5617"},"PeriodicalIF":2.9,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11663990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881766","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}