Infection and Drug Resistance最新文献

{"title":"Nasal Carriage Rate and Antimicrobial Susceptibility Profile of <i>Staphylococcus aureus</i> Among Healthcare Workers and Inpatients at Shahid Beheshti Hospital, Kashan, Iran (2023-2024): A Cross-Sectional Study.","authors":"Maryam Jamalan, Mehdi Nazeri, Mohamad Sadegh Sayahi, Mohammad Javad Azadchehr, Zahra Sadat Fateminasab, Hossein Sedaghat","doi":"10.2147/IDR.S639173","DOIUrl":"https://doi.org/10.2147/IDR.S639173","url":null,"abstract":"<p><strong>Objective: </strong><i>Staphylococcus aureus</i> is an opportunistic bacterial pathogen that affects humans. The objective of this study was to ascertain the prevalence of nasal carriage and antibiotic resistance profiles of isolated <i>S. aureus</i> strains among healthcare workers and patients admitted to Shahid Beheshti Hospital in Kashan, Iran.</p><p><strong>Methods: </strong>In this study, 165 and 130 nasal swabs were collected from inpatients and staff, respectively, at Shahid Beheshti Hospital from October 2023 to May 2024 in Kashan, Iran. Antibiotic sensitivity was tested using the standard disk diffusion method. The presence of <i>mecA</i> in MRSA (methicillin-resistant <i>Staphylococcus aureus</i>) isolates was confirmed by PCR.</p><p><strong>Results: </strong>The prevalence of <i>S. aureus</i> carriers among healthcare staff and hospitalized patients was 29 (22.3%) and 19 (11.5%), respectively. Among the 48 identified <i>S. aureus</i> carriers, four (13.8%) and one (5.3%) were classified as carriers of MRSA within the staff and inpatient populations, respectively. The antibiotic susceptibility profile showed the highest sensitivity to linezolid and cefoxitin, whereas erythromycin exhibited the lowest sensitivity. The <i>mecA</i> gene was detected in all MRSA isolates.</p><p><strong>Conclusion: </strong>The nasal carriage rate of <i>S. aureus</i> among healthcare workers and inpatients in our study was consistent with previous reports. Given the considerable resistance to erythromycin and clindamycin, alongside confirmation of the <i>mecA</i> gene in all MRSA isolates, we recommend implementing routine active surveillance and stringent infection control policies to limit the transmission of these potentially life-threatening strains in hospital settings.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"639173"},"PeriodicalIF":3.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038389","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":"Analysis of Plasma Biomarkers and Potential Pathogenesis in Children with <i>Mycoplasma pneumoniae</i> Pneumonia Based on Metabolomic Technology.","authors":"Qiuyan Xu, Li Shen, Lei Hong, Xiang Li, Min Lu, Shuangqin Ran","doi":"10.2147/IDR.S622829","DOIUrl":"10.2147/IDR.S622829","url":null,"abstract":"<p><strong>Background: </strong>Mycoplasma pneumoniae pneumonia (MPP) is a common cause of community-acquired pneumonia in children, yet its metabolic alterations and pathogenic mechanisms remain incompletely understood. This study aimed to characterize the plasma metabolomic profile of children with MPP and explore associated metabolic pathways.</p><p><strong>Methods: </strong>This retrospective case-control study involved 42 children including 14 MPP patients, 14 non-MPP (MPN) patients, and 14 healthy controls (HC). Clinical and laboratory data were compared across groups. Plasma metabolomic profiling was performed using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Multivariate statistical analyses, including principal component analysis (PCA), partial least squares-discriminant analysis (PLS-DA), and orthogonal partial least squares-discriminant analysis (OPLS-DA), were employed to identify metabolic differences among groups. Pathway enrichment analysis used the KEGG and Reactome databases.</p><p><strong>Results: </strong>Clinically, the MPP group exhibited significantly higher C-reactive protein (CRP) levels and neutrophil percentages, and lower lymphocyte percentages (all P<0.05), indicating enhanced inflammatory response. Distinct plasma metabolic profiles were observed in the MPP group compared with the MPN and HC groups. A total of 127 differential metabolites were identified in MPP vs MPN, and 749 in MPP vs HC. Pathway enrichment analysis revealed that downregulated metabolites in MPP vs MPN were significantly enriched in the PPAR signaling pathway, linoleic acid metabolism, and vitamin digestion/absorption pathways. In MPP vs HC, downregulated metabolites were mainly enriched in amino acid metabolism (arginine biosynthesis, alanine-aspartate-glutamate metabolism), GABAergic synapse, and glycerophospholipid metabolism. These perturbations aligned with the enhanced inflammatory responses observed in MPP.</p><p><strong>Conclusion: </strong>Childhood MPP is characterized by extensive metabolic disturbances involving amino acid, lipid, vitamin, and neurotransmitter metabolism. These metabolic disturbances may be associated with altered antioxidant defense, inflammatory signaling and neuroimmune crosstalk in MPP. The identified metabolites and dysregulated pathways may represent preliminary exploratory candidate signatures that require further validation to establish their relevance to childhood MPP.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"622829"},"PeriodicalIF":3.2,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149060432","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":"Discriminative Utility of Peripheral Blood Immune-Inflammatory Indices for Chronic Osteomyelitis: A Single-Center Retrospective Case-Control Study.","authors":"Lekai Zhu, Jiutai Chen, Changhuan Liu, Haodong Jiang, Zheng Wang, Xin Wang","doi":"10.2147/IDR.S618270","DOIUrl":"10.2147/IDR.S618270","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to assess the clinical utility of composite immune-inflammatory indices formed from differential peripheral blood cell counts (NLR, PLR, SIRI, SII, PIV) for the early identification and risk stratification of chronic osteomyelitis, and to investigate potential clinical applications.</p><p><strong>Methods: </strong>A retrospective unmatched case-control study was conducted at Zhongnan Hospital of Wuhan University. A total of 212 patients with confirmed chronic osteomyelitis and 440 non-infected trauma controls during the same period were enrolled using convenience sampling. Routine complete blood count data and main clinical information at admission were collected. The five composite indices were calculated and compared between groups. Receiver operating characteristic (ROC) curves and area under the curve (AUC) with 95% confidence intervals (CI) were used to evaluate diagnostic performance, with pairwise AUC comparisons by DeLong's test. Multivariate logistic regression was performed to adjust for potential confounders (age, sex, diabetes, drinking history) and assess independent diagnostic value.</p><p><strong>Results: </strong>Although total white blood cell count did not differ significantly between groups, NLR, PLR, SIRI, SII, and PIV were all significantly elevated in the osteomyelitis group (all <i>P</i> < 0.001). SII and PIV showed higher AUC, sensitivity, and specificity (SII AUC = 0.800, 95% CI: 0.764-0.835; PIV AUC = 0.781, 95% CI: 0.744-0.818). After adjustment for confounders, SII (OR = 1.002, 95% CI: 1.001-1.002) and PIV (OR = 1.002, 95% CI: 1.002-1.003) remained independent predictors. DeLong's test indicated that SII had significantly better diagnostic utility than NLR, PLR, and SIRI, but not significantly different from PIV.</p><p><strong>Conclusion: </strong>Composite immune‑inflammatory indices based on peripheral blood counts are clinically accessible and cost‑effective. SII and PIV may serve as potential auxiliary tools for chronic osteomyelitis diagnosis, complementing the limitations of traditional WBC, pending further prospective validation.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"618270"},"PeriodicalIF":3.2,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149060510","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 NGS Technology in Osteomyelitis Caused by Human Bites.","authors":"Qingfang Zhao, Xiaodi Zou, Ahmad Alhaskawi, Mengmeng Luo, Kun Li, Jinghong Xu, Hui Lu","doi":"10.2147/IDR.S631065","DOIUrl":"10.2147/IDR.S631065","url":null,"abstract":"<p><p>Osteomyelitis caused by human bites is a severe and complex polymicrobial infection that is often complicated by delayed diagnosis and the high false-negative rate of conventional cultures. This case series retrospectively analyzed four cases of human bite-induced osteomyelitis to evaluate the clinical utility of next-generation sequencing (NGS) for the diagnosis of complex infections. Conventional intraoperative bacterial cultures were negative in two of the four cases, limiting pathogen-directed antimicrobial therapy. In contrast, NGS identified microbial organisms in all four patients and revealed polymicrobial profiles in several cases, including fastidious oral flora and obligate anaerobes that were not detected by conventional culture, such as <i>Prevotella, Bacteroides</i>, and <i>Porphyromonas</i> species, as well as <i>Treponema denticola</i>. All four patients achieved satisfactory wound healing without radiological evidence of recurrence, regained full range of motion, and returned to normal daily activities during follow-up. These findings support the potential value of NGS as an adjunctive diagnostic tool for identifying difficult-to-culture pathogens and providing additional microbiological information to support clinical decision-making in complex osteomyelitis.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"631065"},"PeriodicalIF":3.2,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149060381","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":"Severe Fever with Thrombocytopenia Syndrome Complicated by Mixed Pulmonary Aspergillus and Mucorales Infection and Isavuconazole-Associated Liver Injury: A Case Report.","authors":"Shuting Liu, Haobo Kong, Yun Wang, Jingjing Pan, Hua Niu, Dahai Zhao","doi":"10.2147/IDR.S633745","DOIUrl":"10.2147/IDR.S633745","url":null,"abstract":"<p><strong>Background: </strong>Severe fever with thrombocytopenia syndrome (SFTS) is a tick-borne viral disease characterized by severe immune dysregulation and high mortality, predisposing patients to opportunistic infections.</p><p><strong>Case presentation: </strong>We report a 76-year-old male patient diagnosed with SFTS complicated by chronic hepatitis B with low-level viral replication, liver injury, and myocardial injury. After initial treatment with intravenous immunoglobulin, hepatoprotective therapy, and antiviral therapy, the patient stabilized. During hospitalization, he developed pulmonary infection. Sputum culture was positive for Aspergillus fumigatus and serum galactomannan (GM) test was positive. Initial treatment with voriconazole led to radiological improvement in the right lung lesion; however, progression of the left lung lesion was observed. Bronchoalveolar lavage fluid metagenomic next-generation sequencing (mNGS) identified Rhizopus microsporus, leading to the diagnosis of invasive pulmonary Aspergillus-Mucorales coinfection. Oral isavuconazole combined with nebulized amphotericin B was administered, resulting in significant clinical and radiological improvement. Approximately one month after isavuconazole therapy, the patient developed jaundice and coagulation dysfunction. After exclusion of hepatitis B virus reactivation and other potential causes, isavuconazole-associated drug-induced liver injury was considered probable based on the clinical course and a RUCAM score of 8.</p><p><strong>Conclusion: </strong>SFTS patients are highly susceptible to invasive fungal infections due to immune dysregulation, thrombocytopenia, and endothelial injury. Clinicians should consider mucormycosis in patients with poor response to voriconazole and progressive pulmonary lesions, and early bronchoscopy with mNGS is recommended. Although isavuconazole is considered relatively safe, liver function monitoring is essential, especially in patients with underlying liver disease.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"633745"},"PeriodicalIF":3.2,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149037763","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":"Prediction of Meropenem Target Attainment in Critically Ill Patients Using Routine Clinical Data from a Single Center: A Machine Learning Approach.","authors":"Qingliu Lu, Yinglian Wang, Ke Huang, Long Gan, Xiaoyu Chen, Zhongwen Feng","doi":"10.2147/IDR.S642373","DOIUrl":"https://doi.org/10.2147/IDR.S642373","url":null,"abstract":"<p><strong>Objective: </strong>Meropenem pharmacokinetics vary considerably among critically ill patients, resulting in uncertainty in target concentration attainment. This study aimed to develop a predictive model using real-world therapeutic drug monitoring (TDM) data to assess target attainment and provide a reference for individualized meropenem management.</p><p><strong>Methods: </strong>This single-center retrospective study included critically ill patients administered meropenem treatment and subjected to trough concentration monitoring from August 2023 to January 2026. Meropenem target attainment was defined as a trough concentration (Cmin) exceeding 8.0 mg/L. The analysis included 399 TDM samples from 333 patients, which were partitioned into training and test sets at an 8:2 ratio using a patient-level splitting approach. Following feature selection, eight machine learning algorithms were applied to build prediction models. Predictive performance was assessed primarily by the area under the receiver operating characteristic curve (AUC), with accuracy, sensitivity, specificity, F1 score, and calibration curves used as additional evaluation measures. SHapley Additive exPlanations (SHAP) analysis was then used to interpret the final model.</p><p><strong>Results: </strong>Ten features were ultimately selected, including age, CRRT, ECMO, Scr, ALP, PLT, P-LCR, APACHE II score, CrCl, and dose per body weight. In the independent test set, the random forest showed the best performance, with an AUC of 0.873 (95% CI: 0.779-0.946), followed by extreme gradient boosting with an AUC of 0.867 (95% CI: 0.763-0.942) and support vector machine with an AUC of 0.863 (95% CI: 0.771-0.935). SHAP analysis showed that CrCl, APACHE II score, and Scr were the most important predictors.</p><p><strong>Conclusion: </strong>Machine learning models developed using routine clinical variables showed good performance in predicting meropenem target attainment in critically ill patients and may help identify patients at high risk of target non-attainment, providing a reference for individualized meropenem management.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"642373"},"PeriodicalIF":3.2,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149037355","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":"Formulation and Evaluation of a <i>Nigella sativa</i> Oil-Based Emulsion as a Potential Hand Sanitizer Against Methicillin-Susceptible and Methicillin-Resistant <i>Staphylococcus aureus</i>.","authors":"Tamba Buffa, Abdulai Kanu, Sahr E Gbomor, Amidu G Torto","doi":"10.2147/IDR.S632120","DOIUrl":"10.2147/IDR.S632120","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Hand hygiene is key to controlling healthcare-associated infections. &lt;i&gt;Staphylococcus aureus&lt;/i&gt; is a critical pathogen in wound infections and infection prevention is compromised by methicillin-resistant &lt;i&gt;S. aureus&lt;/i&gt; (MRSA) because of the ability of this pathogen to resist antimicrobial agents. In this study, the efficacy of &lt;i&gt;Nigella sativa&lt;/i&gt; oil-based emulsion against clinical &lt;i&gt;S. aureus&lt;/i&gt; strains separated from wound samples, including methicillin-resistant strains, was studied.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This in vitro experimental study examined the properties of crude &lt;i&gt;N. sativa&lt;/i&gt; oil, its preliminary oil emulsions, and the final emulsions made by mixing with either distilled water or carbomer 940 gel. The identification of wound strains was performed using culturing and different tests like Gram staining, catalase, coagulase, and performance of the phenotypic test for methicillin-resistant strains using cefoxitin disk diffusion. The results of antibacterial activity testing were obtained by using agar well diffusion. The obtained results were compared to those of broth-dilution MIC. The characterization included physicochemical parameters such as quality of oil, size of droplets in emulsion, viscosity of gel, and pH. All results were analyzed statistically and no duplicates were included in the analyses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The tested 13 &lt;i&gt;S. aureus&lt;/i&gt; strains are listed in the table containing the results of the antibacterial efficacy comparison. Undiluted &lt;i&gt;N. sativa&lt;/i&gt; oil is suggested to have shown antibacterial activity against 11 (84.6%) of the &lt;i&gt;S. aureus&lt;/i&gt; isolates, with the measured inhibition zones ranging from 24 to 38 mm. On the basis of the susceptibility data presented in the paper and CLSI interpretation standard, three strains from the total number of tested strains belong to MRSA. Of these three strains, two strains are susceptible to undiluted &lt;i&gt;N. sativa&lt;/i&gt; oil. The average inhibition zone when using &lt;i&gt;N. sativa&lt;/i&gt; oil was recorded at 27.5 ± 13.0 mm, although the inhibition ring average in the case of cefoxitin usage made 21.5 ± 8.1 mm, although the statistical difference in results was insignificant (paired &lt;i&gt;t&lt;/i&gt; test, P = 0.100). The active solution of the emulsion at the concentration of 50% produced inhibition effects on seven studied &lt;i&gt;S. aureus&lt;/i&gt; strains. As for other concentrations, the lowest one producing measurable effects on all studied &lt;i&gt;S. aureus&lt;/i&gt; strains made 10% w/w with water, or 5% w/w with carbomer gel. As for the carbomer gel S1 studied in terms of viscosity, it was shown that its viscosity amounted to 2050 poise and the pH level was 7.6. The initial studies of the emulsion based on &lt;i&gt;N. sativa&lt;/i&gt; showed droplet diameters equal to 0.25-0.29 µm.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The conducted research shows that it is worthwhile to study different formulations on the basis of &lt;i&gt;N. sativa&lt;/i&gt;. Nonetheless, the resea","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"632120"},"PeriodicalIF":3.2,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13596401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024771","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":"Squamous Cell Carcinoma Arising from Chronic Osteomyelitis: A Single-Center Case Series of Six Patients.","authors":"Hu Li, Jie Chen, Dan Li, Quanhui Tan, Hongjiang Ruan, Pei Han, Xiaohua Chen","doi":"10.2147/IDR.S632466","DOIUrl":"10.2147/IDR.S632466","url":null,"abstract":"<p><strong>Background: </strong>Chronic osteomyelitis (COM) is a persistent bone infection. Long-standing COM may lead to malignant transformation, most commonly squamous cell carcinoma (SCC). However, due to its rarity and nonspecific clinical presentation, early diagnosis remains challenging. This study aimed to characterize the clinical features, microbiological profiles, management strategies, and outcomes of SCC arising from COM.</p><p><strong>Patients and methods: </strong>We retrospectively reviewed six consecutive patients diagnosed with SCC secondary to COM at Shanghai Sixth People's Hospital from January 2021 up to May 2026. Diagnosis was confirmed histopathologically. Demographic data, duration and etiology of osteomyelitis, clinical manifestations, microbiological findings, imaging features, treatment approaches, and follow-up outcomes were systematically analyzed.</p><p><strong>Results: </strong>Six patients (three men and three women) with a median age of 57.5 years (interquartile range, 48.2-61.5) were included. The median duration of osteomyelitis before malignant transformation was 12 years. Lesions were predominantly located in the lower extremities (5/6, 83.3%), and one case involved the thumb (1/6, 16.7%). The most common symptoms included purulent discharge, pain and ulceration. Microbiological analysis revealed a predominance of Gram-negative organisms, including <i>Klebsiella, Escherichia coli</i>, and <i>Pseudomonas aeruginosa</i>, differing from the traditionally reported predominance of <i>Staphylococcus aureus</i>. Imaging revealed aggressive local bone destruction but lacked specific features suggestive of malignancy. Amputation was performed in 5 of 6 patients (83.3%), and one patient developed lymphatic metastasis and received systemic chemotherapy. At a median follow-up of 7.5 months, all patients were alive, with no evidence of local recurrence.</p><p><strong>Conclusion: </strong>SCC should be suspected in patients with long-standing COM with worsening ulceration, increased discharge, or mass formation. Early biopsy is essential for a definitive diagnosis. The observed predominance of Gram-negative pathogens within this cohort generates a hypothesis regarding potential links between microbial characteristics and malignant transformation. Radical surgery, including amputation, achieves effective local disease control. Timely identification of malignant change may offer opportunities for limb-sparing treatment and improved functional outcomes.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"632466"},"PeriodicalIF":3.2,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13596400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024711","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":"Bronchoalveolar Lavage Microbiota in Critically Ill Patients with Aspiration Pneumonia: An Exploratory Comparison with Community-Acquired Pneumonia and Analysis of <i>Gemella</i> Detection and Mortality.","authors":"Runze Wang, Yiru Shao, Lin Zhang, Chen Zhang, Meili Shen, Weichun Mo, Feng Zhang, Jie Shen","doi":"10.2147/IDR.S640842","DOIUrl":"10.2147/IDR.S640842","url":null,"abstract":"<p><strong>Background: </strong>Aspiration pneumonia (AP) is a common and severe infection among critically ill older adults, but its lower respiratory tract microbiota and clinical associations remain incompletely characterized.</p><p><strong>Methods: </strong>This single-center retrospective exploratory study included 72 intensive care unit patients, comprising 49 patients with AP and 23 with community-acquired pneumonia (CAP). Bronchoalveolar lavage fluid (BALF) microbiota were profiled using metagenomic next-generation sequencing (mNGS). Alpha and beta diversity, taxonomic composition, differential abundance, and associations between bacterial taxa and clinical or peripheral immune markers were analyzed. Within the AP cohort, the association between <i>Gemella</i> detection and in-hospital mortality was evaluated using Firth's penalized logistic regression.</p><p><strong>Results: </strong>AP patients had higher Shannon and Simpson diversity than CAP patients. Overall community composition did not differ significantly between the groups based on Bray-Curtis dissimilarity and PERMANOVA (R²=0.022, P=0.066). <i>Streptococcus</i> and <i>Rothia</i> showed nominally higher relative abundances in AP, whereas <i>Acinetobacter</i> and <i>Stenotrophomonas</i> showed nominally lower relative abundances. Only <i>Acinetobacter</i> remained more abundant in CAP after FDR correction (FDR-adjusted P=0.032). Nominal correlations between bacterial taxa and clinical or immune variables were not significant after FDR correction. <i>Gemella</i> was detected in 9 AP patients, including 8 of 26 non-survivors and 1 of 23 survivors (P=0.026). In the unadjusted Firth model, <i>Gemella</i> detection was associated with mortality (OR=6.892, 95% CI 1.360-69.062; P=0.018), but the association was attenuated and non-significant after adjustment for APACHE II score (OR=4.708, 95% CI 0.859-48.395; P=0.076).</p><p><strong>Conclusion: </strong>AP was associated with higher alpha diversity. Selected oral-associated taxonomic patterns and their immune-cell percentages correlations were exploratory and were not confirmed after multiple-testing correction. The association between <i>Gemella</i> detection and mortality was imprecise and sensitive to sparse data and model specification, requiring validation in larger prospective studies.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"640842"},"PeriodicalIF":3.2,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13596457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024660","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":"Knowledge, Attitude and Practice of Dairy Farmers Regarding Antibiotic Use and Resistance in Selected Regions of Eritrea.","authors":"Redie Kidane Ghebrehawariat, Derrick Noah Sentamu, KhairElsid Ali Abdella, Zerai Woldehiwet, Michael Kahsay Ghebremariam, Gabriel Oluga Aboge, Joshua Orungo Onono","doi":"10.2147/IDR.S623296","DOIUrl":"10.2147/IDR.S623296","url":null,"abstract":"<p><strong>Introduction: </strong>Irrational use of antibiotics in livestock and human, especially in low- and middle-income countries poses public health threat. Despite the extensive use of antibiotics in dairy farms in Eritrea, so far there is no published report on use of antibiotics and other related health challenges.</p><p><strong>Methodology: </strong>A cross-sectional survey was undertaken between July to October, 2023 to assess the dairy farmers' knowledge, attitude and practice regarding antibiotic use and antibiotic resistance through face-to-face interviews using semi-structured questionnaires.</p><p><strong>Results: </strong>All dairy farmers 246 (100%) reported using antibiotics, yet 160 (65%) could not identify which infections antibiotics are intended to treat, and 151 (61.4%) had no knowledge of antibiotic resistance. Majority of dairy farmers 207 (84.1%) kept no treatment records, and 144 (58.5%) did not observe withdrawal periods for antibiotics before milk consumption. Overall, 209 (89%), 196 (79.7%) and 200 (81.3%) of the farmers possess inadequate knowledge, unfavorable attitude, and poor practice, respectively. Dairy farmers in Maekel region had favorable attitudes (OR = 3.8, <i>p</i> = 0.037), while farmers in Debub (OR = 13, <i>p</i> = 0.022) and Maekel (OR = 14, <i>p</i> = 0.018) regions showed better practices than Anseba region. And, university educated respondents showed markedly better practices (OR = 35.4, <i>p</i> = 0.002) on antibiotic usage as compared to non-graduates.</p><p><strong>Conclusion: </strong>The low level of farmer's Knowledge, attitude and practice in our study underscore the need for a tailored intervention to improve the awareness of farmers on antibiotic use and resistance in order to mitigate the public health risk.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"623296"},"PeriodicalIF":3.2,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13592332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016655","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}