Infection and Drug Resistance最新文献

{"title":"Genetic Analysis of Molecular Mechanisms of Drug Resistance in <i>Mycobacterium tuberculosis</i> Against Four Major First-Line Anti-Tuberculosis Drugs (Isoniazid, Rifampin, Ethambutol, and Pyrazinamide).","authors":"Mehdi Roshdi Maleki","doi":"10.2147/IDR.S542287","DOIUrl":"10.2147/IDR.S542287","url":null,"abstract":"<p><p>Tuberculosis (TB) is a highly contagious and devastating disease that claims millions of lives annually. According to the World Health Organization (WHO), approximately 10.8 million people worldwide will be affected by TB in 2023, highlighting that TB remains the deadliest infectious disease globally. It is the second leading cause of death due to infectious disease. Additionally, the emergence of drug-resistant strains has created a significant challenge for the treatment of this disease. Approximately 25% of TB-related deaths are attributed to antimicrobial drug resistance. Various mechanisms contribute to the development of drug resistance in <i>Mycobacterium tuberculosis</i>; however, this resistance is primarily due to mutations in the target genes of antibiotics, which reduce the efficacy of anti-TB drugs. This study aimed to provide up-to-date and valuable information on the genetic mechanisms of <i>M. tuberculosis</i> resistance to major first-line anti-TB drugs. Understanding these mechanisms can open new avenues for researchers to treat TB and to overcome drug resistance.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"4901-4915"},"PeriodicalIF":2.9,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12449273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113095","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":"Comorbidity Clusters and Immune Profiles in Hospitalized People with HIV: A Retrospective Analysis at a Tertiary Care Center in Eastern China.","authors":"Zhikai Wan, Kun Wang, Lingling He, Xueling Zhu, Ying Huang, Biao Zhu","doi":"10.2147/IDR.S538627","DOIUrl":"10.2147/IDR.S538627","url":null,"abstract":"<p><strong>Background: </strong>Antiretroviral therapy (ART) has shifted hospitalization causes in people with HIV (PWH) from AIDS-related to non-AIDS-related events. Data on comorbidity profiles and clinical characteristics of hospitalized PWH remain limited. Therefore, this study analyzes comorbidities and clinical characteristics of PWH in eastern China to understand the regional burden of comorbidities and inform clinical practice and regional hospital management.</p><p><strong>Methods: </strong>This retrospective study included 593 hospitalized PWH. Demographic, clinical, and laboratory data, along with HIV-related medical history, were extracted from medical records. Diagnoses of comorbidities were based on established criteria. Clinical characteristics were compared across comorbidity groups.</p><p><strong>Results: </strong>Among 593 participants, comorbidities were categorized into three groups: Non-AIDS-Defining Diseases (NADs, n=241), Opportunistic Infections (OI, n=204), and Malignancies (n=111). PWH with malignancies were significantly older (median age 58 years) than those with OI (43 years, <i>p</i>=0.001) or NADs (42 years, <i>p</i>=0.001). Patients with OIs had a significantly shorter duration since HIV diagnosis and ART initiation compared with the NADs and malignancy groups. Immunological analysis showed that the NADs group had higher median CD4+ T cell counts [413.5 (234-584) cells/μL] and CD4/CD8 ratios [0.75 (0.41-1.18)] compared with the OI and malignancy groups. AIDS-Defining Malignancies (ADMs) cases had significantly lower CD4+ T cell counts than Non-AIDS-Defining Malignancies (NADMs) cases [134.5 (97-313.75) vs 306 (200.25-503.00) cells/μL, <i>p</i>=0.002]. Multivariate logistic regression analysis established that a CD4/CD8 ratio below 0.5 independently associated with ADMs [adjusted OR 3.47 (95% CI 1.37-8.77), P=0.004].</p><p><strong>Conclusion: </strong>NADs have emerged as the leading cause of hospitalization among PWH. For PWH who receive stable ART, remain at risk for NADs, warranting regular screening to prevent advanced disease. Routine monitoring of CD4+ T cell counts and CD4:CD8 ratios may facilitate improved cancer and OI screening strategies for individuals with persistently low ratios of CD4/CD8 or ART-naïve.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"4931-4940"},"PeriodicalIF":2.9,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12447969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113060","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>Klebsiella pneumoniae</i> with Two Carbapenemases: Where Molecular Research Stands Now.","authors":"Qian Yu, Gaosha Li, Qianqian Xu, Yijun Zhu","doi":"10.2147/IDR.S537638","DOIUrl":"10.2147/IDR.S537638","url":null,"abstract":"<p><p><i>Klebsiella pneumoniae</i> is a significant pathogen causing various infections. Since the 1990s, carbapenem-resistant <i>Klebsiella pneumoniae</i> (CRKP) has threatened global health. Its main resistance mechanism is producing carbapenemases like KPC, NDM, OXA, IMP and VIM, which have different prevalent isoforms and resistance features. In China, KPC is the most common carbapenemase in CRKP, followed by metallo-β-lactamase (MBL). Alarmingly, an increasing number of <i>K. pneumoniae</i> strains carry two or more types of enzymes, making resistance more complex. This review summarizes the major carbapenemases carried by <i>K. pneumoniae</i>, their global spread, and plasmids of CRKP enzyme type combinations reported in existing studies. Common combinations such as KPC + metalloenzyme, bimetallic enzyme, and metalloenzyme + OXA-48 are discussed in detail, including their genetic environments and transfer characteristics. Whole genome sequencing technology plays a crucial role in studying drug resistance genes of <i>K. pneumoniae</i>, facilitating in - depth identification and analysis of bacteria, and being useful for outbreak investigation and epidemiological surveillance. In conclusion, resistance genes in <i>K. pneumoniae</i> are often located on mobile elements. Different resistance genes tend to be carried by specific plasmids, which have high transformation rates and little impact on host growth. In order to prevent the emergence of Klebsiella pneumoniae carrying multiple drug-resistant genes, several measures such as the rational use of antibiotics, earlier monitoring of the transmission trajectory of strains, and the prediction of the development direction of drug resistance as much as possible are particularly important in the world today.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"4917-4929"},"PeriodicalIF":2.9,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113080","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":"Surveillance of Antibiotic Resistance and Molecular Epidemiology of <i>Staphylococcus aureus</i> in Baotou, Inner Mongolia, China.","authors":"Wenlan Zhang, Fangxin Liu, Jing Li, Lixia Zhang, Tongping Hu","doi":"10.2147/IDR.S540702","DOIUrl":"10.2147/IDR.S540702","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the distribution, drug resistance patterns, multi-locus sequence typing (MLST), and virulence gene carriage of <i>Staphylococcus aureus</i> in the Baotou region of Inner Mongolia, China.</p><p><strong>Methods: </strong>From January 2018 to December 2020, clinical isolates of <i>S. aureus</i> were collected from 11 hospitals in Baotou participating in the China Antimicrobial Resistance Surveillance System (CARSS). Data were analyzed using WHONET 5.6 and SPSS 26.0. Ninety methicillin-resistant <i>S. aureus</i> (MRSA) strains from 2020 were typed by MLST, with results analyzed via the eBURST program. Ninety randomly selected methicillin-sensitive <i>S. aureus</i> (MSSA) strains from 2020, along with the 90 MRSA strains, underwent polymerase chain reaction to detect 20 virulence genes, including <i>clfa, clfb, fnbB, scn, chp, sak, coa, nuc, ebps, eno, cna</i>, and <i>bbp</i>.</p><p><strong>Results: </strong>A total of 2453 <i>S. aureus</i> strains, including 309 MRSA, were isolated. Secretions were the main source for <i>S. aureus</i> (38.0%), and sputum for MRSA (16.7%). MRSA showed higher resistance to most antimicrobials than MSSA. Among eight identified sequence types, ST59 dominated (60%), mainly linked to hospital-acquired surgical infections (66.7%, 36/54). All strains carried <i>hla, hld, nuc, clfa</i>, and <i>clfb</i> genes, and over 90% carried <i>sak, scn</i>, and <i>coa</i> genes. The <i>fnb</i>B gene detection rate was significantly higher in MSSA (83%) than in MRSA (15%). Detection rates of <i>chp, pvl</i>, and <i>Luk</i>ED genes varied significantly among sequence types. The detection rate of the <i>pvl</i> gene was 67% in ST22 strains, which was higher than that observed in the ST59, ST398, and ST25 strains.</p><p><strong>Conclusion: </strong>The isolation rates of <i>S. aureus</i> and MRSA in Baotou are lower than the national averages, with no strains resistant to vancomycin, linezolid, or teicoplanin. The predominant MRSA strain in this region is ST59. The <i>S. aureus</i> strains in this region carry a large number of virulence genes, indicating high virulence.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"4887-4900"},"PeriodicalIF":2.9,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113093","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":"Single-Cell Multi-Omics Deciphers Core Gene Networks and Immune Interaction Collapse in Sepsis-Associated T Cell Dysfunction.","authors":"Xiang Li, Zhibin Chen, Yandong Yao, Muhu Chen, Yingchun Hu","doi":"10.2147/IDR.S538883","DOIUrl":"10.2147/IDR.S538883","url":null,"abstract":"<p><strong>Introduction: </strong>Sepsis is a life-threatening condition characterized by immune dysregulation, yet the mechanisms underlying T cell dysfunction remain poorly understood.</p><p><strong>Methods: </strong>We integrated multi-omics data from public GEO datasets and prospective cohorts. Single-cell transcriptomic analysis was applied to identify core genes, followed by diagnostic and prognostic validation. Cell-cell interaction networks were constructed to investigate signaling alterations, and cross-platform validation was conducted.</p><p><strong>Results: </strong>Seven core genes (<i>LTB, CD3D, TRAF3IP3, CD3G, GZMM, HLA-DPB1, CD3E</i>) were identified, showing strong diagnostic value (AUC ≥ 0.86) and prognostic significance (HR=4.50 for <i>CD3E</i>). Network analysis revealed collapse of critical signaling axes (HLA-DRA-MHCII, ITGB2-CD226) and aberrant activation of inhibitory pathways (LGALS9-CD45), leading to a \"co-stimulation inhibition-checkpoint activation\" imbalance. Cross-platform validation confirmed conserved downregulation of these genes in sepsis, which contributed to immune exhaustion via disrupted T cell differentiation trajectories and impaired intercellular communication.</p><p><strong>Conclusion: </strong>Our findings highlight novel biomarkers and potential therapeutic targets for sepsis immunotherapy by systematically deciphering core gene networks and immune interaction collapse in T cell dysfunction.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"4863-4885"},"PeriodicalIF":2.9,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12442820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086034","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 Significance of Hematological Parameters and Ratios in the Context of <i>Mycobacterium</i> Avium Complex Pulmonary Disease Across Various Age Groups.","authors":"Xuejuan Long, Qian Li, Han Wang, Shizheng Wang, Zhe Ren, Xin Wang, Yanjun Gao","doi":"10.2147/IDR.S543622","DOIUrl":"10.2147/IDR.S543622","url":null,"abstract":"<p><strong>Objective: </strong>This investigation intends to clarify the disparities in hematological parameters and ratios among different age groups,providing new insights for the diagnostic of <i>Mycobacterium</i> Avium Complex Pulmonary Disease (MAC-PD).</p><p><strong>Patients and methods: </strong>A retrospective investigation was undertaken to examine the hematological parameters of elderly (n=88) and non-elderly (n=44) patients diagnosed with MAC-PD at Hebei Chest Hospital between 2020 and 2024. The study involved the calculation of the neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), hemoglobin-to-lymphocyte ratio (HLR),hemoglobin-to-platelet ratio (HPR),systemic inflammatory response index (SIRI) and systemic immune-inflammation index (SII). Statistical analyses were executed utilizing SPSS 27.0 and R (4.2.1) software.</p><p><strong>Results: </strong>The levels of absolute lymphocyte count (ALC),hemoglobin (Hb) and LMR were lower in Elderly MAC group compared to Non-elderly MAC group. Conversely,the levels of NLR, PLR,HLR,SIRI and SII were higher in Elderly MAC group than in Non-elderly MAC group. There was a certain correlation between the Ct value of MAC nucleic acid and NLR, LMR, SIRI and SII (<i>P</i><0.05) in Elderly MAC group. In Non-elderly MAC group, the Ct value of MAC nucleic acid was correlated with absolute neutrophil count (ANC), LMR, SIRI and SII (<i>P</i><0.05). Receiver operating characteristic curve (ROC) analysis indicated that NLR, LMR, SIRI and SII exhibited high diagnostic value in Elderly MAC group,while LMR, SIRI and SII demonstrated high diagnostic value in Non-elderly MAC group. The combined diagnostic value was even more prominent. Nevertheless,no significant diagnostic indicators were identified between Elderly MAC group and Non-elderly MAC group.</p><p><strong>Conclusion: </strong>The combination of NLR, LMR, SIRI and SII may serve as diagnostic markers for Elderly MAC-PD and the combination of LMR, SIRI and SII may serve as diagnostic markers for Non-lderly MAC-PD. But there were no significant diagnostic indicators differentiating Elderly MAC group from Non-elderly MAC group.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"4847-4862"},"PeriodicalIF":2.9,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12442926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085993","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 of Lefamulin for Community-Acquired Bacterial Pneumonia (CABP) Patients: Pooled Analysis of the Lefamulin Evaluation Against Pneumonia (LEAP) 1, LEAP 2 and LEAP China Trials.","authors":"Shuo Liang, Yu-Hua Wen, Zhen-Hua Zhang, Yi Shi, Jin-Fu Xu","doi":"10.2147/IDR.S540124","DOIUrl":"10.2147/IDR.S540124","url":null,"abstract":"<p><strong>Purpose: </strong>Lefamulin represents a newly developed pleuromutilin antibiotic utilized for treating Community-Acquired Bacterial Pneumonia (CABP). Two pivotal Phase 3 studies, the Lefamulin Evaluation Against Pneumonia (LEAP) 1 and LEAP 2 trials, along with the bridging LEAP China trial, each confirmed that Lefamulin has proven efficacy and is non-inferior to active control treatments. This study conducted a post-hoc pooled analysis of these trials to assess Lefamulin's overall efficacy and its effects on specific patient groups, particularly the elderly and those at high risk of drug resistance.</p><p><strong>Methods: </strong>Trials compared lefamulin to moxifloxacin in adults with CABP. The primary outcome was early clinical response (ECR). Secondary outcomes included investigator assessment of clinical response (IACR), and these responses in subgroups, such as severe patients, elderly patients, and those with prior antibiotic treatment. The pooled analysis was conducted post hoc, using noninferiority margin of 10% and 95% confidence intervals.</p><p><strong>Results: </strong>Lefamulin (n=728) can provide sustained high efficacy, which was noninferior to moxifloxacin (n=683). ECR and IACR success rates demonstrated similar elevation (≥ 84.0%). Comparable and elevated ECR and IACR rates across subgroup of PORT risk class III to V(84.1-88.6%) and subgroup of prior antibiotic treatment (81.8-85.6%) were observed. In the subgroup of age over 65 years old, higher ECR of lefamulin vs moxifloxacin in each ten years-stratification (65-74 years old: 87.2% vs 86.5%; 75-84 years old: 86.8 vs 85.4%; ≥85 years old: 88.5 vs 82.4%). The older the age over 65 years old, the more favorable lefamulin.</p><p><strong>Conclusion: </strong>Lefamulin, non-inferior to moxifloxacin, showed high effectiveness in CABP patients, especially in patients over 65 years old, those with PORT III-V or prior antibiotic treatment.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"4833-4845"},"PeriodicalIF":2.9,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12439686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080599","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 High-Throughput Gene Chip Array for Enhanced Diagnosis of Bone and Joint Infections: A Comparative Analysis with mNGS and Conventional Culture Methods.","authors":"Yunjiao Zhang, Qingxin Guo, Jinmei Chen, Hao Shen, Yuan Fang, Yi Zhang, Pei Han, Xiaohua Chen","doi":"10.2147/IDR.S523306","DOIUrl":"10.2147/IDR.S523306","url":null,"abstract":"<p><strong>Background: </strong>While conventional culture-based diagnosis of bone and joint infections (BJI) requires prolonged incubation periods and metagenomic next-generation sequencing (mNGS) remains cost-prohibitive for routine clinical use, there is an urgent need for diagnostic strategies that balance timeliness with economic feasibility. This study investigates the clinical utility of a high-throughput (HT) gene chip array as a novel solution, offering significantly shorter turnaround time while maintaining cost-effectiveness than mNGS expenses.</p><p><strong>Methods: </strong>Thirty-six patients of the BJI group (28 positives and 8 negatives diagnosed by clinician) and 20 patients of respiratory tract infection (RTI) group (14 positives and 6 negatives diagnosed by clinician) were included in this study. Synovial fluid and ultrasound fluid samples of BJI group and alveolar lavage fluid samples of RTI group were collected and subjected to microbiological analysis performed by HT gene chip array, metagenomic next-generation sequencing (mNGS) and conventional culture. Sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) were calculated. Positive and negative percent agreement and Cohen`s kappa coefficient were calculated.</p><p><strong>Results: </strong>The sensitivity and accuracy of HT gene chip assay for BJI detection was 71.43% and 77.78%, respectively (<i>p</i> value <0.05). HT gene chip assay exhibited the 100% of specificity and PPV, which is significantly higher than those of mNGS (62.5%, 89.29%) and conventional culture (78.57% and 88.89%). Our results position HT gene chip assay as a clinically actionable solution for accurate and timely bone and joint infection management.</p><p><strong>Conclusion: </strong>HT gene chip assay demonstrates superior diagnostic specificity and cost-effectiveness with rapid turnaround, significantly reducing unnecessary invasive procedures while maintaining high concordance with mNGS, and exhibited higher clinical value of BJI diagnosis compared with mNGS and conventional culture.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"4817-4826"},"PeriodicalIF":2.9,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075195","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":"Recurrent Subcutaneous Abscess from Co-Infection with <i>Prototheca wickerhamii</i> and <i>Mycobacterium haemophilum</i>: mNGS Misdiagnosis as Leprosy.","authors":"Li Jiang, Lili Wei, Xiuying Li, Dongyan Zheng, Cunwei Cao, Meng Li","doi":"10.2147/IDR.S536182","DOIUrl":"10.2147/IDR.S536182","url":null,"abstract":"<p><p><i>Prototheca</i> <i>wickerhamii</i> (<i>P. wickerhamii</i>) and <i>Mycobacterium</i> <i>haemophilum</i> (<i>M. haemophilum</i>) are both opportunistic pathogens that could cause infections in immunocompromised populations. However, these infections rarely occur in individuals with normal immunity. We reported a 39-year-old immunocompetent man presented with recurrent subcutaneous abscess on fingers who developed a co-infection of <i>P. wickerhamii and M. haemophilum</i>. To our knowledge, this is the first reported co-infection involving <i>P. wickerhamii</i> and <i>M. haemophilum</i>. The diagnosis was complicated by mNGS misidentifying <i>M. haemophilum as</i> Mycobacterium leprae (<i>M. leprae)</i> (98% sequence similarity) and overlooking <i>P. wickerhamii</i>. This case underscores the critical need to correlate mNGS results with clinical features and use complementary diagnostic methods to avoid errors. The combination of traditional and molecular methods can improve diagnostic accuracy.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"4827-4831"},"PeriodicalIF":2.9,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069306","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":"Metagenomic Next-Generation Sequencing Reveals <i>Porphyromonas gingivalis</i> in Geriatric Severe Pneumonia Complicated by Empyema: Case Report.","authors":"Na Guo, Guannan Ma, Huimin Liu, Jingxuan Qiu, Yan Yu, Yunlei Gao, Zhong Yi, Zhirong Wan, Lei Zhang, Xiaorui Wu","doi":"10.2147/IDR.S543666","DOIUrl":"10.2147/IDR.S543666","url":null,"abstract":"<p><strong>Background: </strong>Severe pneumonia with empyema in elderly patients presents diagnostic and therapeutic challenges. Traditional culture methods often fail to identify the causative pathogen, leading to delays in targeted treatment. Metagenomic next-generation sequencing (mNGS) has emerged as a powerful tool for detecting rare and fastidious pathogens.</p><p><strong>Case presentation: </strong>We report a 77-year-old male with a history of chronic smoking and alcohol consumption who presented with a two-month history of cough, sputum production, and progressive dyspnea. His condition rapidly deteriorated with high fever and respiratory failure. Initial antibiotic therapy was ineffective, and multiple cultures of blood, sputum, and pleural fluid were negative. However, mNGS of blood and pleural fluid identified <i>Porphyromonas gingivalis</i>, a well-known periodontal pathogen rarely associated with pulmonary infections. The patient's treatment was adjusted to include targeted anaerobic coverage (imipenem plus vancomycin) alongside chest tube drainage, leading to significant clinical improvement.</p><p><strong>Conclusion: </strong>This case highlights the clinical utility of mNGS in diagnosing culture-negative pulmonary infections. <i>Porphyromonas gingivalis</i> should be considered a potential pathogen in patients with severe pneumonia and empyema, particularly in those with poor oral hygiene or periodontal disease.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"4811-4816"},"PeriodicalIF":2.9,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145064502","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}