Infection and Drug Resistance最新文献

{"title":"Clinical Characteristics and Treatment Outcomes of Pediatric Fungal Keratitis.","authors":"Jing Zhang, Huabo Chen, Vishal Jhanji, Bining Zhang, Lixin Xie, Yanling Dong","doi":"10.2147/IDR.S507178","DOIUrl":"10.2147/IDR.S507178","url":null,"abstract":"<p><strong>Background: </strong>Fungal keratitis is relatively rare in children. This study aimed to analyze the clinical characteristics and treatment outcomes of pediatric fungal keratitis.</p><p><strong>Methods: </strong>A retrospective review of medical records was conducted for children (aged <18 years) diagnosed with fungal keratitis from 1996 to 2021. Demographic features, etiology, clinical characteristics, and treatment outcomes were collected.</p><p><strong>Results: </strong>Forty-seven children (48 eyes) were included (31 males, 16 females). The mean age of onset was 11.8±4.1 (range: 1-17) years. The leading cause of fungal keratitis was trauma including dust or ocular foreign body (29.2%) and vegetative matter (25.0%). <i>Fusarium</i> (41.7%) and <i>Aspergillus</i> (20.8%) were the main causative organisms. 16.7% (8/48) of the infected eyes were treated successfully with medications. Voriconazole had the highest drug sensitivity rate (70.0%). 66.7% (32/48) of the eyes required therapeutic keratoplasty (21 eyes penetrating keratoplasty, 11 eyes lamellar keratoplasty). The diameter of the corneal ulcer was significantly associated with keratoplasty (OR 3.556, <i>p</i> = 0.014). The peripheral blood neutrophil/lymphocyte ratio (NLR) showed positive correlation with the age of onset (<i>r</i> = 0.437, <i>p</i> = 0.002) and the diameter of corneal ulcer (<i>r</i> = 0.298, <i>p</i> = 0.04). Logistic regression analysis revealed a significant association between NLR and the need for surgical treatment (odds ratio = 117.926, <i>p</i> = 0.019).</p><p><strong>Conclusion: </strong>In the current study, ocular trauma was the leading cause of fungal keratitis in the pediatric age group. <i>Fusarium</i> was the most common organism. Voriconazole was the preferred antifungal drug. Surgical treatment was necessary in two-thirds of the eyes.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"1271-1278"},"PeriodicalIF":2.9,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585462","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":"Rare Emphysematous Osteomyelitis of the Femoral Head: A Case Report and Literature Review.","authors":"Yuanyuan Xu, Guangrong Wu, Guomin Zhang, Dongxue Li, Lunyou Zhang, Wei Yang","doi":"10.2147/IDR.S479261","DOIUrl":"10.2147/IDR.S479261","url":null,"abstract":"<p><p>Emphysematous osteomyelitis (EO) is a perilous infection of the femoral head. In this case, we present a 66-year-old male patient of Han ethnicity, who had lumbar disc herniation and type 2 diabetes mellitus. The patient reported severe pain in his lower back and right lower limb, which had worsened over the past 20 days. Despite undergoing invasive procedures such as regional anesthetic blocks and other traditional Chinese medical methods such as acupuncture and acupotomy, his condition deteriorated. Pain in the lumbar region was not relieved, and there was a new onset of pain in the right hip, groin, and thighs. Preliminary medical evaluation revealed normal body temperature but elevated levels of the inflammatory marker high-sensitivity C-reactive protein (hsCRP). In the imaging tests, computed tomography revealed air bubbles within the right femoral head, corresponding to the EO. Diabetes mellitus and malignant neoplasms have been well-established as predominant risk factors for EO, while iatrogenic interventions may serve as potential precipitating factors in disease pathogenesis. Our report underlines the critical role of radiologists in identifying EO through distinctive imaging features, such as the \"pumice stone\" sign. This highlights the need for further research to enhance our understanding, diagnosis, and management of EO.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"1279-1285"},"PeriodicalIF":2.9,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585581","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":"AIDS-Associated <i>Talaromyces marneffei</i> Infection with Thoracic Spinal Cord Involvement Leading to Paraplegia: A Case Report and Literature Review.","authors":"Yongzheng Guo, Ying Song, Xiaorong Peng, Xiaotang Zhou, Hengjun Zhou, Lijun Xu, Biao Zhu","doi":"10.2147/IDR.S495568","DOIUrl":"10.2147/IDR.S495568","url":null,"abstract":"<p><strong>Background: </strong><i>Talaromyces marneffei</i> is a common opportunistic infection in patients with acquired immune deficiency syndrome (AIDS) in South China. Spinal cord abscesses caused by <i>T. marneffei</i> are exceptionally rare and present with non-specific symptoms, which may result in delayed diagnosis and heightened adverse prognoses.</p><p><strong>Case presentation: </strong>We report a case of a spinal cord abscess in a 30-year-old patient with AIDS that was caused by <i>T. marneffei</i> infection. The patient initially presented with <i>T. marneffei</i> septicemia and pleurisy. After initial antifungal treatment and combined antiretroviral therapy (cART), the patient's condition temporarily improved. However, he discontinued the antifungal treatment against medical advice and subsequently developed paraplegia, <i>T. marneffei</i> meningitis, and related intracranial and thoracic spinal cord lesions. Neurosurgical resection of the spinal cord lesion, combined with continued cART and antifungal treatment, resulted in the intracranial mass in the cerebellum resolving on MRI, but the patient remained non-ambulatory and incontinent during the last follow-up in August 2024.</p><p><strong>Conclusion: </strong>In patients with spinal cord abscesses and a history of disseminated <i>T. marneffei</i> infection, especially those with AIDS, talaromycosis should be considered as a potential differential diagnosis. Comprehensive management, encompassing adherence to treatment plans and effective follow-up, is crucial for improving prognosis.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"1263-1269"},"PeriodicalIF":2.9,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585302","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":"Capsular Polysaccharide as a Potential Target in Hypervirulent and Drug-Resistant <i>Klebsiella pneumoniae</i> Treatment.","authors":"Yiying Ke, Zhangrui Zeng, Jinbo Liu, Caihong Ye","doi":"10.2147/IDR.S493635","DOIUrl":"10.2147/IDR.S493635","url":null,"abstract":"<p><p><i>Klebsiella pneumoniae</i> is a common cause of antimicrobial-resistant opportunistic infections in hospitalized patients. Hypervirulent <i>Klebsiella pneumoniae</i> (hvKP) acquiring exogenous resistance-encoding and hypervirulence-encoding genetic elements tend to develop both high virulence and resistance. The management of hvKP has also been made more difficult. Capsular polysaccharide (CPS) is the most important virulent factor of hvKP. The high degree of heterogeneity of the CPS and its hindering function adds difficulties in finding a general therapeutic approach. Thus, it is imperative to develop effective ways to target the CPS. The development of CPS-targeting phage treatment has spurred scientific interest. CPS relative vaccines show great potential as therapeutic alternatives to the currently ineffective antibiotics. To find out new ideas for clinical practice, we reviewed the molecular pathogenesis of <i>K. pneumoniae</i>, discussed the biological functions and regulatory factors of CPS. We studied the roles of CPS in virulence, drug resistance, and treatment of <i>K. pneumoniae</i>, and preliminarily investigated the viability of CPS as a target for prevention and therapy of <i>K. pneumoniae</i> infection.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"1253-1262"},"PeriodicalIF":2.9,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585380","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":"Microbiological Diagnostic Performance and Clinical Effect of Metagenomic Next-Generation Sequencing for the Detection of Immunocompromised Patients With Community-Acquired Pneumonia.","authors":"Hongfei Zheng, Pei Peng, Shaofei Wang, Bo Zhang, Linying Yang, Yaoyao Wang, Lejun Li, Guifen Pang","doi":"10.2147/IDR.S462358","DOIUrl":"10.2147/IDR.S462358","url":null,"abstract":"<p><strong>Objective: </strong>Community-acquired pneumonia (CAP) presents a significant public health concern, necessitating timely and precise diagnosis. Metagenomic next-generation sequencing (mNGS) has shown promise as a powerful tool for pathogen identification in infectious diseases. This study aimed to evaluate the diagnostic efficacy and clinical applicability of mNGS for immunocompromised patients with CAP compared to the culture method.</p><p><strong>Methods: </strong>This study included 168 patients. We used both mNGS and conventional culture methods to identify the pathogen spectrum and evaluate diagnostic performance. Treatment regimens and clinical outcomes were meticulously documented.</p><p><strong>Results: </strong>The sensitivity of mNGS was greater than that of the culture method across all samples (79.05% vs 16.03%; <i>p</i> < 0.001). mNGS identified pathogens missed by culture in 59.52% of patients and detected polymicrobial infections that were not detected by culture in 47.62% of patients. <i>Streptococcus pneumoniae, Candida albicans</i>, and <i>Human herpesvirus 4</i> at classification level emerged as the predominant pathogens identified in CAP patients through mNGS. When examining the mNGS results between groups, the proportions of immunocompromised patients with bacterial (<i>p</i> < 0.001), fungal (<i>p</i> < 0.001), viral (<i>p</i> < 0.05), and mixed infections (<i>p</i> < 0.001) were all significantly higher than those in immunocompetent patients. Treatment adjustments guided by mNGS were observed in 73.21% of patients. Specifically, a beneficial clinical effect was observed in 50.60% (85/168) of patients, treatment confirmation in 22.62% (38/168) of patients, and no clinical benefit in 26.80% (45/168) of patients based on mNGS-guided antibiotic treatment adjustments.</p><p><strong>Conclusion: </strong>These findings highlight the diagnostic performance of mNGS for identifying pathogens, particularly in immunocompromised patients vulnerable to infections, offering valuable insights for clinical decision-making.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"1223-1236"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572855","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":"Prognostic Factors and Nomogram for <i>Klebsiella pneumoniae</i> Infections in Intensive Care Unit.","authors":"Chunjing Du, Hua Zhang, Yi Zhang, Hanwen Zhang, Jiajia Zheng, Chao Liu, Fengmin Lu, Ning Shen","doi":"10.2147/IDR.S500523","DOIUrl":"10.2147/IDR.S500523","url":null,"abstract":"<p><strong>Purpose: </strong><i>Klebsiella pneumoniae</i> infections pose a significant threat to public health with high morbidity and mortality rates. The early identification of risk factors for mortality and accurate prognostic evaluation are important. Therefore, we aimed to identify the risk factors for mortality in patients with <i>K. pneumoniae</i> infections and develop a nomogram model for prognosis.</p><p><strong>Methods: </strong>Patients diagnosed with <i>K. pneumoniae</i> infection were recruited from the intensive care unit of Peking University Third Hospital. The enrolled patients were categorized into survivor and non-survivor groups. Univariate and multivariate regression analyses were performed to identify independent risk factors for 30-day mortality, and a nomogram was constructed and validated.</p><p><strong>Results: </strong>A total of 408 patients infected with <i>K. pneumoniae</i> at different sites were included in this study. PO₂, lactate, respiratory failure, urinary tract infection, heart rate, 24h-urineoutput, neutrophil count, alkaline phosphatase, and vasoactive drug use were significant risk factors and were integrated into a nomogram to predict the risk of 7-day, 14-day, 21-day, and 28-day mortality. The nomogram demonstrated superior prognostic ability, achieving higher area under the receiver operating characteristic curve (AUC) (>0.8) and concordance index (C-index) (>0.8) values than the Pitt bacteremia, sequential organ failure assessment (SOFA), and acute physiology and chronic health evaluation (APACHE) II scores (all AUC and C-index < 0.75). Cross-validation of the nomogram confirmed its consistent performance, with both AUC and C-index values exceeding 0.75. The nomogram demonstrated a strong Hosmer-Leme-show goodness-of-fit and good calibration (p > 0.05). Additionally, decision curve analysis revealed that the nomogram provided significant clinical utility for prognostic prediction.</p><p><strong>Conclusion: </strong>The 30-day mortality risk factors for <i>K. pneumoniae</i> infections were identified, and a predictive nomogram model was developed. The nomogram demonstrated good accuracy and predictive efficiency, providing a practical tool for short-term risk assessment and potentially improving clinical outcomes by providing early intervention and personalized patient management.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"1237-1251"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572862","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 Report of Primary Pyogenic Ventriculitis Caused by <i>Streptococcus Constellatus</i> Diagnosed by Metagenomic Next-Generation Sequencing.","authors":"Dongdong Zhang, Minnan Deng, Fenfen Li, Ruile Shen","doi":"10.2147/IDR.S508937","DOIUrl":"10.2147/IDR.S508937","url":null,"abstract":"<p><strong>Background: </strong>Primary ventriculitis is a rare but serious brain infection characterized by inflammation of the ependyma and purulence within the ventricular system. Due to the challenges in early diagnosis and the potential for suboptimal treatment, this condition carries a significant risk of complications such as recurrence, hydrocephalus, and death. Metagenomic next-generation sequencing (mNGS) enables the rapid and broad-spectrum identification of pathogens, facilitating timely and precise diagnosis.</p><p><strong>Case report: </strong>This study presents the first reported case of primary ventriculitis caused by <i>Streptococcus constellatus</i>. An 81-year-old female patient with hydrocephalus and clinical signs of central nervous system infection was diagnosed with primary ventriculitis based on brain magnetic resonance imaging (MRI) and cerebrospinal fluid (CSF) analysis using mNGS. The patient underwent external ventricular drainage (EVD) and received a five-week course of ceftriaxone and linezolid. Following timely and targeted therapy, she demonstrated significant clinical improvement and was discharged without residual symptoms.</p><p><strong>Conclusion: </strong>Key insights from this case include: 1) mNGS is an invaluable tool for the early and accurate diagnosis of primary ventriculitis; 2) MRI is indispensable for identifying characteristic radiological features of the condition; 3) prompt initiation and completion of appropriate antibiotic regimens significantly improve clinical outcomes.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"1209-1214"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566968","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":"Distribution and Epidemiological Characteristics of Clinical Isolates of <i>A. fumigatus</i> in a Hospital from 2021 to 2023: A Retrospective Study.","authors":"Zhongqiu You, Yunying Yan, Tingting Fu, Xiao Yang, Zhirui Li, Lijun Zhou, Feng Zang","doi":"10.2147/IDR.S507944","DOIUrl":"10.2147/IDR.S507944","url":null,"abstract":"<p><strong>Objective: </strong>The distribution characteristics of clinical isolates of <i>A. fumigatus</i> were analyzed to provide the basis for the prevention and control of <i>A. fumigatus</i> infection.</p><p><strong>Methods: </strong>From January 2021 to December 2023, the First Affiliated Hospital of Nanjing Medical University collected clinical isolates of <i>A. fumigatus</i> from hospitalized patients for study. Duplicate strains from the same patient in the same area were eliminated, and community-, hospital-, and colonization infections were grouped.</p><p><strong>Results: </strong>A total of 561 clinical isolates of <i>A. fumigatus</i> were identified, with 402 (82.35%) originating from male patients and 159 (17.65%) from female patients. The percentage of individuals aged 51 to 90 years was 78.97% (443/561). With the exception of surgery, which predominantly involved colonization, other departments mainly exhibited community-acquired infections (CAI) (<i>P</i>=0.002). The length of hospital stay was less than <15-30 days for most cases in the healthcare-associated infection group (HAI) (<i>P</i><0.001). Lower respiratory tract infection accounted for the main site of infection across all three groups (95.37%), with ventilator-associated pneumonia being most prevalent in the HAI group (<i>P</i><0.001). The detection rates of <i>A. fumigatus</i> from 2021 to 2023 were 3.89‱, 7.15‱, and 12.50‱, respectively. The detection frequencies of <i>A. fumigatus</i> throughout the three groups exhibited a year-on-year increase (P<0.001). Sputum samples constituted the main source of clinical isolates for all three groups, accounting for 61 strains (89.71%), 277 strains (78.69%), and 122 strains (86.52%) respectively, followed by bronchoalveolar lavage fluid samples.</p><p><strong>Conclusion: </strong>The detection rate of <i>A. fumigatus</i> has exhibited a consistent upward trend over the past three years, with varying epidemiological characteristics observed across different infection types. It is recommended that medical institutions develop targeted prevention and control measures for <i>A. fumigatus</i> infections based on these unique characteristics.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"1199-1208"},"PeriodicalIF":2.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556811","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":"Epidermolysis Bullosa with Esophageal Complications and Co-Infection with <i>Helicobacter pylori</i>: A Case Report.","authors":"Yingmin Lin, Wei Kong, Shuying Li, Min Wang","doi":"10.2147/IDR.S497443","DOIUrl":"10.2147/IDR.S497443","url":null,"abstract":"<p><p>Epidermolysis bullosa (EB) is a group of rare genetic skin disorders that are hereditary and heterogeneous, characterized by skin and mucosal fragility and blister formation, often induced by minimal trauma. Esophageal complications represent a significant extracutaneous manifestation of EB. The lack of standardized diagnostic and therapeutic guidelines of EB with esophageal complications contributes to inconsistent management and a higher susceptibility to recurrence. For patients with EB experiencing digestive tract symptoms, there are few reports that specifically address the follow-up and continuity of mucosal repair treatment. To date, EB with esophageal complications and co-infection with <i>Helicobacter pylori</i> (<i>H. pylori</i>) has been rarely reported. The impact of <i>H. pylori</i> infection on EB remains unclear. Here, we report a case of a 26-year-old man diagnosed with EB and esophageal complications. The patient presented with post-sternal pain, dysphagia, esophageal obstruction, and vomiting. Gastroscopy revealed scattered flake erosions on the esophageal mucosa. The pathological examination revealed inflammatory granulation tissue with necrosis and focal squamous epithelium showing mild atypical hyperplasia. Significant improvement in symptoms was observed after long-term mucosal repair therapy. After being lost to follow-up, the patient developed symptomatic exacerbation and co-infection with <i>H. pylori</i>. The patient's condition improved after the eradication of <i>H. pylori</i>, combined with ongoing treatment for esophageal complications and regular follow-up. Patients with EB who have esophageal complications require long-term mucosal repair treatment and regular follow-up. Co-infection with <i>H. pylori</i> may be an important factor in disease recurrence.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"1215-1222"},"PeriodicalIF":2.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556254","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":"Shifting of Distribution and Changing of Antibiotic Resistance in Gram-Positive Bacteria from Bile of Patients with Acute Cholangitis.","authors":"Yuqi Hao, Lianxin Li, Wenting Du, Jinshuai Lu","doi":"10.2147/IDR.S482375","DOIUrl":"10.2147/IDR.S482375","url":null,"abstract":"<p><strong>Background: </strong>Gram-negative bacteria are the predominant pathogens responsible for biliary infections; however, the prevalence of Gram-positive bacteria is currently increasing. Investigating the bacterial spectrum and evolving antibiotic resistance patterns of Gram-positive bacteria is crucial for optimizing the management of acute cholangitis, particularly in the context of the global rise in antibiotic resistance.</p><p><strong>Methods: </strong>This retrospective analysis focused on Gram-positive bacteria isolated from the bile of patients undergoing biliary drainage with acute cholangitis at our hospital from January 1, 2018, to March 31, 2024. In total, 342 strains of Gram-positive bacteria were examined.</p><p><strong>Results: </strong>The main Gram-positive bacteria detected included Enterococcus (57.23%), Staphylococcus (23.41%), and Streptococcus (13.01%). The most common species detected were <i>Enterococcus faecium</i> (36.42%), <i>Enterococcus faecalis</i> (14.16%), and <i>Staphylococcus epidermidis</i> (7.80%). Trend analysis revealed a decrease in the proportion of Enterococcus and an increase in Streptococcus. Additionally, the detection rate of methicillin-resistant Staphylococcus (MRS) showed a significant rise. Gram-positive bacteria exhibited high resistance to erythromycin and penicillin but remained highly susceptible to linezolid and vancomycin. Further, resistance to quinolones among Gram-positive bacteria was notably elevated.</p><p><strong>Conclusion: </strong>The bacterial spectrum and antibiotic resistance patterns of Gram-positive bacteria in acute cholangitis have undergone significant changes. Penicillin is not recommended for the treatment of Gram-positive bacterial infections. Antibiotic resistance should be closely monitored when using quinolones. Particular attention is warranted regarding the markedly increasing antibiotic resistance of <i>Enterococcus faecium</i>.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"1187-1197"},"PeriodicalIF":2.9,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143541951","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}