Infection and Drug Resistance最新文献

{"title":"In-Utero Maternal-to-Fetal Transmission of COVID-19: An Immunological and Virological Study in the Eastern Province of Saudi Arabia.","authors":"Hibah A Alzayer, Basavaraja C Hunasemarada, Arwa Alumran, Shaikha Aldossary, Reem A Al Dossary","doi":"10.2147/IDR.S501533","DOIUrl":"https://doi.org/10.2147/IDR.S501533","url":null,"abstract":"<p><strong>Background: </strong>Coronavirus disease 2019 (COVID-19) is a respiratory illness caused by SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2). The pandemic potential of the virus along with its severity posed a threat to all individuals particularly pregnant women. Multiple studies suggested the possibility of vertical transmission of COVID-19 with variable findings.</p><p><strong>Aim: </strong>This study aims to assess the frequency of COVID-19 vertical transmission and identify maternal and neonatal complications.</p><p><strong>Materials and methods: </strong>A retrospective study of 17 months for all pregnant women attending for delivery who tested positive using SARS-CoV-2 polymerase chain reaction (PCR) (n = 80) and their neonates (n = 81) who were tested by both SARS-CoV2 PCR and viral IgG and IgM antibodies detection using immunochromatography. A matched control group of PCR negative mothers (n = 51) was included. All testing was done within 24-48 hours, and the neonates of positive mothers were immediately and completely separated from their mothers as per the hospital policy.</p><p><strong>Results: </strong>A total of 263 individuals were included in the study. Out of 80 SARS-CoV2 PCR positive mothers, 4 (5%) had PCR positive neonates and one (1.3%) had SARS-CoV2 IgM positive neonates. The commonest presentation of COVID-19 in mothers were cough (11.4%) and dyspnea (10%). In addition, the need for ICU admission and antibiotics usage was significantly higher in SARS-CoV2 PCR positive mothers (p value 0.042, 0.003 respectively). On the other hand, neonates of SARS-CoV2 PCR positive mothers had a higher risk of low birth weight and NICU admission (p value < 0.001).</p><p><strong>Conclusion: </strong>This study, with its unique infection control protocol for managing SARS-CoV2 PCR-positive mothers and the use of immunological testing for neonates, provides evidence for in-utero SARS-CoV2 transmission, and interpretation of the results should be in conjunction with the WHO categorization of the timing of mother-to-fetal transmission. Further studies are needed to assess the impact of viral genetic evolution on the risk of maternal-fetal transmission.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"1393-1403"},"PeriodicalIF":2.9,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11910909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648331","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":"Biomarkers for Early Predicting In-Hospital Mortality in Severe Fever with Thrombocytopenia Syndrome and Differentiating It from Hemorrhagic Fever with Renal Syndrome.","authors":"Chaochao Chen, Yuwei Zheng, Xuefen Li, Bo Shen, Xiaojie Bi","doi":"10.2147/IDR.S492942","DOIUrl":"https://doi.org/10.2147/IDR.S492942","url":null,"abstract":"<p><strong>Purpose: </strong>Severe fever with thrombocytopenia syndrome (SFTS) has a high mortality rate and is easily misdiagnosed as hemorrhagic fever with renal syndrome (HFRS), particularly in resource-limited rural areas where early diagnosis remains challenging. This study used routine laboratory parameters, epidemiology and clinical manifestations to develop a model for the early diagnosis of SFTS and identify fatal risk factors, ultimately reducing mortality of SFTS.</p><p><strong>Patients and methods: </strong>This retrospective cohort study included 141 SFTS and 141 HFRS patients. Of these, 94 patients with SFTS were allocated to the model cohort for mortality risk identification by using multivariable Cox regression analysis. Sensitivity, specificity, and predictive values were calculated from validation cohort to assess the clinical values. Then, we analyzed 62 SFTS and 113 HFRS using multivariable logistic regression to identify SFTS. Receiver operating characteristic (ROC) curve analysis was used to evaluate their diagnostic value.</p><p><strong>Results: </strong>Multivariate Cox regression analysis showed that blood urea nitrogen (BUN) ≥10.22mmol/L activated partial thromboplastin time (APTT) ≥58.05s and D-dimer ≥4.68mg/L were the risk factors for death in SFTS. This combined indicators had an area under the curve (AUC) of 0.91 (95% CI: 0.847-0.973), with a sensitivity and specificity of 86%, respectively. Any indicator was achieved the cutoff, and sensitivity and specificity in the validation group were 93% and 54%. Multivariable logistic regression showed that age (OR: 1.10) and initial laboratory indicators including WBC (OR: 0.48), Cr (OR: 0.86), CK (OR: 1.01), and APTT (OR: 1.09) can be used to identify SFTS from HFRS. This model achieved an AUC value of 0.97 (95% CI: 0.977-0.999) and 0.98 (95% CI: 0.958-1.000) in validation cohort.</p><p><strong>Conclusion: </strong>In resource-limited rural hospitals, the integration of routine laboratory parameters with epidemiology and clinical manifestations demonstrates enhanced sensitivity for early SFTS identification and mortality risk stratification to reduce mortality rate.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"1355-1366"},"PeriodicalIF":2.9,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11910929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648203","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":"Predicting Healthcare-Associated Infection in Patients with Pneumonia via QuantiFERON^®-Monitoring.","authors":"Taehwa Kim, Eunjeong Son, Min Wook So, Doosoo Jeon, Hye Ju Yeo, Seung Eun Lee, Yun Seong Kim","doi":"10.2147/IDR.S499765","DOIUrl":"10.2147/IDR.S499765","url":null,"abstract":"<p><strong>Objective: </strong>A functional immune system is essential for recovery from pneumonia; hence, measuring and monitoring immune-status indicators is clinically important. This study aimed to determine whether QuantiFERON monitoring (QMF) could predict healthcare-associated infection (HCAI) according to the immune-status of patients with pneumonia.</p><p><strong>Methods: </strong>Prospective, observational, single-center study, patients ≥19 years hospitalized for pneumonia between October 2020 and November 2021. QFM was performed at hospital admission (D1) and seven days after (D2). Data from 90 patients in the D1 QFM group were analyzed, which was further divided into the non-healthcare-associated infection (non-HCAI, n = 41, 45.6%) and HCAI (n = 49, 54.4%) groups.</p><p><strong>Results: </strong>The D1 and D2 QFM levels were both significantly higher in the non-HCAI group than in the HCAI group (D1 hCAI vs non-HCAI: 4.40 vs 5.75 IU/mL, D2 hCAI vs non-HCAI: 4.38 vs 6.10 IU/mL). Analysis of the change in D1 and D2 QFM levels by each group showed that D2 QFM levels increased over D1 QFM levels in the non-HCAI group (5.75 vs 6.10 IU/mL), while D2 QFM levels decreased over D1 QFM levels in the HCAI group (4.40 vs 4.38 IU/mL). D1 QFM was consistently negatively correlated with TNF-α and CRP. The integrated analysis of D1 QFM and CCI and D1 QFM and CURB-65 had fair to predict the occurrence of HCAI.</p><p><strong>Conclusion: </strong>QFM can be used to predict the immune-status of patients in the context of healthcare-associated infections. These findings provide important insights into the current understanding of pneumonia treatment and recovery.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"1381-1391"},"PeriodicalIF":2.9,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11911649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648266","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":"Rebound of Antibiotic Use and Respiratory Infections After Resumption of Normalcy From COVID-19 in Hong Kong.","authors":"Edmond Siu-Keung Ma, Enoch Hsu, Vincent Chow, Tracy Chow, K H Kung, Albert Au, Hong Chen","doi":"10.2147/IDR.S502126","DOIUrl":"https://doi.org/10.2147/IDR.S502126","url":null,"abstract":"<p><strong>Purpose: </strong>During COVID-19 pandemic, use of antimicrobial has been shown to be reduced coupled with various respiratory infections. We investigated whether this effect on reduction of antibiotic prescription can be sustained after resumption of normalcy and lifting of public health measures.</p><p><strong>Methods: </strong>We compared the wholesale supply of antimicrobials using mean annual Daily Defined Dose/1000 inhabitants (DID) in different sectors in pre-COVID-19 (2014-2019), COVID-19 (2020-2022) and post-COVID-19 (2023) periods. We grouped the data according to AWaRe categorisation namely Access, Watch and Reserve defined by WHO, and analysed the trends of the top 10 antibiotics and broad-spectrum antimicrobials. The trends in statutory notifiable diseases including scarlet fever, pneumococcal infections, chickenpox, tuberculosis, and pertussis and influenza-like-illness detected by sentinel surveillance system was analysed by negative-binominal regression.</p><p><strong>Results: </strong>Compared to baseline level, an overall reduction of 27.2% of antimicrobial utilization was observed during the pandemic years, with a rebound recorded in 2023, up to 89.5% of the pre-pandemic level. The access group of antimicrobials accounted for 57.9% in 2014 gradually increased to 60.2% in 2023 across the pandemic years. Concurrently, reduction in incidence of scarlet fever, pneumococcal infections, chickenpox, tuberculosis, pertussis and influenza-like-illness was observed during COVID-19 pandemic with statistical decreasing trend, p<0.05 for scarlet fever, pneumococcal infections and chickenpox. Rebound in all these infections was reported in 2023, except for chickenpox which showed continued decrease in incidence.</p><p><strong>Conclusion: </strong>We demonstrated a substantial reduction of antibiotic use during the COVID-19 pandemic, which rebounded in 2023, likely due to increased incidence of respiratory diseases after lifting of public health and social measures. We urged for close monitoring of the antimicrobial resistance pattern of different bacteria due to the inter-connectiveness and global impact of these two pandemics.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"1325-1337"},"PeriodicalIF":2.9,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11910044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648408","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":"Mechanisms of Antimicrobial Resistance in <i>Klebsiella</i>: Advances in Detection Methods and Clinical Implications.","authors":"Jian Li, Yuwen Shi, Xuanli Song, Xiaoyu Yin, Hui Liu","doi":"10.2147/IDR.S509016","DOIUrl":"https://doi.org/10.2147/IDR.S509016","url":null,"abstract":"<p><p><i>Klebsiella spp</i>. are ubiquitous gram-negative bacteria, commonly present in natural environments and as part of the human microbiota. <i>Klebsiella</i> is involved in the occurrence and development of many diseases, and effective antibiotics for it have attracted the attention of researchers. In recent years, its multi-drug resistance, particularly to carbapenems and β-lactam antibiotics, has posed significant challenges to clinical treatment. Therefore, a comprehensive understanding of the resistance mechanisms of <i>Klebsiella</i>, along with the enhancement of detection methods, is crucial for effectively controlling the spread of drug-resistant strains and guiding individualized clinical treatment. This paper systematically reviews the epidemiological characteristics, resistance mechanisms, detection methods, and treatment strategies of <i>Klebsiella</i>, aiming to provide new insights for the clinical management of this pathogen.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"1339-1354"},"PeriodicalIF":2.9,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11910031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648262","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":"Temporal Shifts in Etiological Agents and Trends in Antimicrobial Resistance of Bloodstream Infection in Southwest China from 2016 to 2023.","authors":"Shanshan Long, Min Zhong, Xiangning Huang, Jie Zhang, Xin Liu, Hua Yu","doi":"10.2147/IDR.S514966","DOIUrl":"https://doi.org/10.2147/IDR.S514966","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to assess the frequency distribution of bacterial pathogens causing bloodstream infections (BSIs) as well as the characteristics of antibiotic susceptibility and resistance to gain a deeper understanding of the drug resistance situation in the southwest China.</p><p><strong>Methods: </strong>Non-duplicate pathogenic bacteria according to the American Clinical and Laboratory Standards Institute (CLSI) M100 and analyzed using WHONET 5.6 software.</p><p><strong>Results: </strong>A total of 170,246 non-duplicated pathogenic bacteria were isolated from blood from 2016 to 2023. Gram-negative bacteria accounted for 59.5% and Gram-positive bacteria accounted for 40.5%. The top five detection rates were <i>Escherichia coli</i> (33.9%), coagulase-negative <i>staphylococci</i> (21.7%), <i>Klebsiella pneumoniae</i> (11.5%), <i>Staphylococcus aureus</i> (7.0%), and <i>Enterococcus</i> spp (5.4%). <i>Streptococcus pneumoniae, Salmonella</i> spp and β-Hemolytic <i>Streptococcus</i> were significantly more frequently isolated in pediatric patients than in adult patients. The rate of resistance to carbapenems was less than 1.2% in the <i>Escherichia coli</i> over the 8-year period, with a significant upward trend in the <i>Klebsiella pneumoniae</i>. The overall resistance rate of <i>Pseudomonas aeruginosa</i> to imipenem and meropenem had a slow decreasing trend. The resistance rate of <i>Acinetobacter baumannii</i> to imipenem and meropenem has been maintained at a high level, which is greater than 50%. The detection rate of MRSA was 27.70% and vancomycin- and linezolid-resistant strains were not found. The resistance rates of <i>Enterococcus faecium</i> and <i>Enterococcus faecalis</i> to vancomycin, linezolid and teicoplanin were less than 2.1%.</p><p><strong>Conclusion: </strong>The pathogenic bacteria of bloodstream infection in southwest China were diversified, and the multi-drug resistant bacteria, especially Carbapenem-resistant Klebsiella pneumoniae (CRKP), had increased significantly, posing a serious challenge to clinical treatment. Additionally, the situation of Methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) and Vancomycin-resistant Enterococcus (VRE) also required close attention.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"1367-1379"},"PeriodicalIF":2.9,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11910178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648428","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":"Maternal-Fetal Listeriosis in China: Clinical and Genomic Characteristics From an ST8 <i>Listeria monocytogenes</i> Case.","authors":"Gang Hu, Wei Yan, Fenfen Dong, Gang Li, Xiaoxing Zhang, Qiongshan Li, Peng Zhang, Lei Ji","doi":"10.2147/IDR.S508470","DOIUrl":"10.2147/IDR.S508470","url":null,"abstract":"<p><strong>Background: </strong>Listeriosis, a severe foodborne infection caused by <i>Listeria monocytogenes</i>, poses significant risks during pregnancy, including maternal-neonatal transmission. This study describes the clinical and genomic characteristics of an sequence type 8 (ST8) <i>L. monocytogenes</i> strain involved in maternal-neonatal transmission during pregnancy.</p><p><strong>Methods: </strong>Clinical presentation, diagnostic process, and treatment outcomes of the case were documented in detail. Whole-genome sequencing (WGS) and subsequent genomic analyses were performed on <i>L. monocytogenes</i> isolates obtained from the maternal and neonatal blood cultures.</p><p><strong>Results: </strong>A 33-week pregnant woman presented with decreased fetal movements and underwent an emergency cesarean delivery. Postpartum, she developed a high fever, and blood cultures from both the mother and the neonate the day after caesarean delivery confirmed <i>L. monocytogenes</i> infection. WGS revealed that the isolates belonged to serotype 1/2a, ST8, clonal complex (CC) 8, and lineage II. Both isolates exhibited susceptibility to first-line antibiotics, including penicillin and ampicillin, and contained virulence and stress adaptation genes such as <i>LIPI-1</i> and SSI-1. Phylogenetic analysis based on cg-SNP linked the clinical isolates to foodborne ST8 strains from Huzhou and Shanghai, suggesting potential contamination routes.</p><p><strong>Conclusion: </strong>This case highlights the importance of timely diagnosis and effective antibiotic management in preventing adverse pregnancy outcomes. It also underscores the need for enhanced food safety surveillance and genomic monitoring of <i>L. monocytogenes</i> to better understand the transmission dynamics and to avoid the extension of a foodborne infection.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"1313-1324"},"PeriodicalIF":2.9,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624384","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 Characteristics, Virulence Profile, and Molecular Epidemiology of <i>Klebsiella pneumoniae</i> Infections in Kidney Transplant Recipients.","authors":"Ruiling Fan, Yan Zuo, Bowei Wang, Debao Shi, Xuanxuan Wang, Zhongxin Wang, Ying Huang","doi":"10.2147/IDR.S506794","DOIUrl":"10.2147/IDR.S506794","url":null,"abstract":"<p><strong>Background: </strong><i>C</i>arbapenem-resistant <i>Klebsiella pneumoniae</i> (CRKP) infections may increase the potential for mortality in kidney transplant (KT) recipients. This study aimed to investigate the clinical features, molecular epidemiology, virulence, and antimicrobial resistance of KP strains from KT patients.</p><p><strong>Methods: </strong>Strains isolated from KT patients were collected, and antimicrobial susceptibility analysis was verified <i>via</i> the Vitek2 compact instrument and the disc diffusion method. In gene expression analysis, carbapenemase genes (KPC-2, OXA-48, IMP, VIM, NDM), capsular genes (K1, K2, K5, K20, K54, K57), and virulence genes (rmpA, rmpA2, aerobactin, peg344) were identified <i>via</i> polymerase chain reaction (PCR). Molecular epidemiology was analyzed using multilocus sequence typing (MLST) and minimal spanning trees (MST).</p><p><strong>Results: </strong>A total of 43 KP isolates were collected from KT patients in this study, and 24 of them were identified as CRKP (55.81%). KPC-2 genes were detected in all of the CRKP strains (100%), and other carbapenemase genes were not detected. Twenty-two strains (91.67%) of CRKP strains were identified as ST11, while 2 (8.33%) were ST15-typing. Finally, two highly virulent <i>K. pneumoniae</i> strains (both K20-ST268 type) were identified. In addition, the group of CRKP showed a higher deceased kidney donor ratio (<i>p</i> = 0.011), a higher proportion of post-transplant transfers to the ICU (<i>p</i> = 0.037), a higher proportion of late-onset infections (3 months post-transplantation acceptance) (p = 0.007), and high positive rates for the virulence gene <i>rmpA2</i> (<i>p</i> = 0.01) when comparing the group of carbapenem-sensitive KP.</p><p><strong>Conclusion: </strong>The resistance rate to carbapenem of KP from KT patients exceeded the regional average with predominant ST typing of ST11. Clinical data were analyzed to derive some high-risk factors for CRKP infection. Therefore, we recommend early prophylactic isolation of transplant patients with high-risk factors for CRKP infection to improve the quality of nosocomial control.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"1303-1311"},"PeriodicalIF":2.9,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597131","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":"Pseudomembranous Aspergillus tracheobronchitis: A Rare Manifestation of Invasive Aspergillosis in a Immunocompetent Patient.","authors":"Xiang-Qin Xu, Chun-Xing Ye, Na Li, Xin Yu, Yan-Fang Liao, Yan Shen","doi":"10.2147/IDR.S495620","DOIUrl":"10.2147/IDR.S495620","url":null,"abstract":"<p><strong>Purpose: </strong>Pseudomembranous Aspergillus tracheobronchitis (PMATB), an uncommon clinical form of invasive aspergillosis, is mainly occurs in patients who are moderate to severely immunocompromised. There are some case reports of immunocompetent individuals developing invasive aspergillosis after occupational exposure (Primarily observed in farmers, sawmill workers, waste collectors, mushroom processing workers, or those who handle grain, hay, or straw), including allergic bronchopulmonary aspergillosis (ABPA), severe asthma with fungal sensitization, hypersensitivity pneumonitis, and invasive pulmonary aspergillosis. To our knowledge, there are no published case reports in the literature with PMATB as the main presentation in construction worker after occupational exposure.</p><p><strong>Case presentation: </strong>We report a case of a 45-year-old construction worker who was previously healthy, presented with cough for one weak and dyspnea and wheezing for two days. Computed tomography (CT) of the chest was normal. He was misdiagnosed with severe asthma, and started on intravenous corticosteroids, together with an inhaled short-acting beta2 agonist and inhaled muscarinic antagonist and empirical anti-infective therapy. However, his symptoms were still progressing. Bronchoscopy revealed cream-colored plaques throughout the trachea and bronchial mucosa. Photomicrograph of tissue and culture of post-bronchoscopy sputum and bronchial aspirate showed aspergillus with branching and septate hyphae.</p><p><strong>Results: </strong>The patient recovered quickly when treated systemically with voriconazole.</p><p><strong>Conclusion: </strong>Our report presents an immunocompetent construction worker with no chronic diseases who developed invasive aspergillosis primarily manifesting as PMATB due to occupational exposure. This presentation is rare and has not been previously documented in the literature. Early diagnosis and prompt initiation of antifungal therapy may improve the outcome and decrease mortality rate.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"1297-1302"},"PeriodicalIF":2.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585602","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":"Are Glucocorticoids Truly Effective in Improving the Clinical Prognosis of HSV-1 Encephalitis?","authors":"Shuhua Xie, Wei Sun, Zhaohui Lai, Xianghong Liu","doi":"10.2147/IDR.S501628","DOIUrl":"10.2147/IDR.S501628","url":null,"abstract":"<p><strong>Background: </strong>Survivors of herpes simplex encephalitis (HSE) commonly experience significant neurological sequelae, imposing a substantial burden on both society and families. The efficacy of glucocorticoids in treating patients with HSE remains controversial. This study aims to evaluate the effectiveness of glucocorticoids in patients with HSE and analyze the clinical characteristics of this patient population.</p><p><strong>Methods: </strong>This retrospective study evaluated the clinical characteristics, auxiliary examinations, and patient prognosis of HSE patients diagnosed with mNGS, and analyzed the prognosis of patients in both Glucocorticoid and Non-glucocorticoid groups. Assess the prognosis based on the improvement of GOS score and MMSE score at 1 and 3 months after discharge.</p><p><strong>Results: </strong>A retrospective analysis was conducted in 29 hSE patients who met the criteria for GOS score improvement 3 months after discharge. The hormone group was better than the non-hormone group (2 (0-2) scores VS 1 (1-2) scores). There was no significant difference between the two groups in GOS score 1 month after discharge. However, no statistical difference was found in improving patient outcomes between the two groups.</p><p><strong>Conclusion: </strong>Despite the hormone group not obtaining the anticipated positive outcomes, potentially due to the relatively limited sample size in this study, previous case series reports have indicated that glucocorticoids, when used as an adjunct to acyclovir therapy, may enhance patient outcomes. Consequently, further extensive clinical studies involving multiple centers and larger sample sizes are warranted to investigate this matter further.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"1287-1296"},"PeriodicalIF":2.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585375","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}