Infection and Drug Resistance最新文献

{"title":"Strengthening One Health AMR Surveillance in Africa: From Cross-Sectoral Data to Policy Action.","authors":"Yusuf Hared Abdi, Sharmake Gaiye Bashir, Zakaria Ibrahim Issack","doi":"10.2147/IDR.S640711","DOIUrl":"10.2147/IDR.S640711","url":null,"abstract":"<p><p>Antimicrobial resistance (AMR) has emerged as one of the greatest threats to global health, with Africa bearing a disproportionate burden: an estimated 1.05 million deaths were associated with bacterial AMR and approximately 250,000 deaths were directly attributable to AMR in the WHO African Region in 2019 alone. This burden reflects high infectious disease prevalence, limited diagnostic capacity, weak antimicrobial stewardship, and fragmented surveillance systems. Given that resistant pathogens and resistance genes circulate across humans, animals, and the environment, effective surveillance requires a coordinated One Health approach. This narrative review synthesizes published literature (2015-2026) identified through PubMed, Scopus, Web of Science, and Google Scholar to assess the status of One Health AMR surveillance in Africa, examine progress across the human, animal, and environmental sectors, identify major implementation barriers, and propose strategic priorities for strengthening integrated surveillance systems. The evidence reviewed shows that participation in surveillance initiatives such as GLASS has expanded and laboratory capacity has improved in several countries; however, substantial gaps remain in veterinary and environmental surveillance, laboratory infrastructure, data interoperability, governance, workforce capacity, and sustainable financing. Fragmented information systems and limited cross-sectoral collaboration continue to impede timely detection of emerging resistance and evidence-informed policy action. Based on these findings, we recommend prioritizing integrated governance structures, strengthened laboratory networks, interoperable digital surveillance platforms, and sustainable domestic financing as foundational steps, with genomic technologies, wastewater surveillance, and regional collaboration serving as complementary priorities as feasibility and resources allow. Strengthening One Health surveillance will be critical for improving early detection of resistant pathogens, informing antimicrobial stewardship, supporting outbreak preparedness, and reducing the growing health and economic burden of AMR across Africa.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"640711"},"PeriodicalIF":3.2,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13592423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016640","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":"Cross-Reactivity of GeneXpert MTB/RIF Probe C with <i>Nocardia</i> Species as a Suggestive Ancillary Indicator.","authors":"Yanyan Fan, Rongrong Song, Jingyi Feng, Jiankang Zhao","doi":"10.2147/IDR.S633640","DOIUrl":"10.2147/IDR.S633640","url":null,"abstract":"<p><strong>Background: </strong>The slow-growing, fastidious nature of <i>Nocardia</i> species makes rapid molecular tools essential for diagnosis. Although the GeneXpert MTB/RIF assay targets <i>Mycobacterium tuberculosis</i> (MTB), the cross-reactivity of its Probe C with <i>Nocardia</i> has not previously been characterized.</p><p><strong>Methods: </strong>We retrospectively analyzed 14,141 non-duplicate clinical samples from February 2020 to June 2023. Probe C reactivity was first assessed against <i>Nocardia</i> culture results. To investigate the molecular basis, we subsequently compared the <i>rpoB</i> target region of Probe C with the genomes of 1082 <i>Nocardia</i> strains from the NCBI database.</p><p><strong>Results: </strong>Probe C showed species-specific reactivity, failing to detect many clinically prevalent species. Among culture-positive <i>Nocardia</i> isolates, Probe C detected 10 of 17 <i>N. cyriacigeorgica</i> (Ct range: 32.8-39.2), 1 of 2 <i>N. asiatica</i> (Ct: 39), and 2 of 8 <i>N. abscessus</i> (Ct range: 30.5-38.7). Notably, the most frequently isolated species, <i>N. farcinica</i> (59 isolates), showed no Probe C reactivity. The overall sensitivity of Probe C among all culture-confirmed nocardiosis cases was only 13.4% (13/97); even among the subset of cross-reacting species, it reached only 48.1% (13/27), highlighting its inadequacy as a standalone diagnostic test. In the full MTB-negative cohort, the Probe C-positive rate was just 0.27% (38/14,141), with 25 of those 38 signals lacking culture confirmation. Genome alignment confirmed 100% identity between the <i>rpoB</i> sequences of reactive <i>Nocardia</i> strains and the Probe C target region.</p><p><strong>Conclusion: </strong>Probe C is the first MTB-targeted tool demonstrated to cross-react with <i>Nocardia</i> via <i>rpoB</i> homology, with genomic evidence ruling out other genetic sources. However, given the low overall sensitivity of Probe C among all culture-confirmed nocardiosis cases, the restricted species spectrum, and the lack of molecular confirmation for most positive signals at high Ct values, an isolated Probe C-positive result in an MTB-negative sample should be regarded as a suggestive, non-diagnostic ancillary hint that warrants <i>Nocardia</i>-specific confirmatory testing rather than as a diagnostic finding.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"633640"},"PeriodicalIF":3.2,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13590008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012189","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":"Blood Host-Response mRNA Assays in Adult Acute Care: Diagnostic Performance, Translational Evidence, and the Clinical Implementation Gap.","authors":"Xinzhuo Li, Xinyue Tu, Zihao Yan, Yi Gong","doi":"10.2147/IDR.S648424","DOIUrl":"10.2147/IDR.S648424","url":null,"abstract":"<p><p>Blood host-response messenger RNA (mRNA) assays provide a complementary approach to evaluating suspected acute infection by measuring the patient's transcriptional response. Fixed multigene assays can distinguish infection from noninfectious inflammation and estimate bacterial or viral likelihood, and several rapid platforms have demonstrated clinically relevant diagnostic performance in emergency and critical-care populations. This critical narrative review synthesizes representative evidence from fixed blood host-response mRNA assays in adult acute care. Structured searches of PubMed/MEDLINE, Embase, and Web of Science Core Collection were completed through August 12, 2026, and were supplemented by citation tracking and assay-specific update searches through September 2, 2026. We examine evidence by assay generation, patient-source independence, prespecified operating points, and workflow characteristics, with particular attention to the distinction between diagnostic performance and clinical utility. Current evidence is strongest for clinical validity and implementation feasibility, whereas evidence that test-guided use safely improves antimicrobial management or patient outcomes remains limited. We therefore propose a staged conceptual framework linking fixed-assay validation and prespecified operating points to representative recruitment, end-to-end workflow, clinician-visible reporting, test-guided clinical evaluation, and prospectively measured safety, patient, and resource outcomes. This framework is intended to organize translational evidence and identify the steps still required before routine clinical utility can be established.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"648424"},"PeriodicalIF":3.2,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008463","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":"Blood mNGS-Detected Epstein-Barr Virus in ICU Patients with Pneumonia: Associations with Disease Severity Markers and Inflammatory Burden.","authors":"Xia Wang, Wei-Ping Hu, Yi-Xing Wu, Jian-Lan Hua, Zi-Xuan Cheng, Xiao Wang, Li Liu, Jing Zhang","doi":"10.2147/IDR.S596241","DOIUrl":"10.2147/IDR.S596241","url":null,"abstract":"<p><strong>Background: </strong>Epstein-Barr virus (EBV) is frequently detected in critically ill patients, but the clinical meaning of EBV reported by blood metagenomic next-generation sequencing (mNGS) in ICU patients with pneumonia remains unclear.</p><p><strong>Methods: </strong>This retrospective secondary analysis used data from a prospective multicenter cohort of patients with suspected sepsis. Data included demographics, clinical variables, radiological findings, blood culture and mNGS results, cytokine levels, and 30-day mortality.</p><p><strong>Results: </strong>A total of 184 ICU patients with pneumonia were included and classified as EBV-positive (n=34) or EBV-negative (n=150) according to blood mNGS. EBV-positive patients had lower serum albumin and systolic blood pressure, higher qSOFA score distribution, more frequent sepsis at enrollment, higher C-reactive protein and procalcitonin levels, higher PaCO₂, and lower serum calcium. <i>Pneumocystis jirovecii</i> was numerically more frequent in EBV-positive patients but was not independently associated with EBV positivity after adjustment. In exploratory cytokine analysis, EBV-positive patients showed higher TRAIL levels and more frequent IL-17 detection. In an exploratory multivariable model, lower serum albumin and sepsis at enrollment remained associated with EBV positivity. 30-day mortality did not differ significantly between groups.</p><p><strong>Conclusion: </strong>In ICU patients with pneumonia, blood mNGS-detected EBV was associated with markers of disease severity and inflammatory burden. However, these associations do not establish clinically significant EBV reactivation, and no statistically significant difference in 30-day mortality was observed between groups.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"596241"},"PeriodicalIF":3.2,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008409","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":"Prevalence and Antibiotic Resistance Pattern of <i>Escherichia coli</i> Isolated from Urine Samples of Pediatric Outpatients with Underlying Medical Conditions from Pakistan.","authors":"Muhammad Nadeem Khan, Atif Haroon, Hazrat Bilal","doi":"10.2147/IDR.S638000","DOIUrl":"10.2147/IDR.S638000","url":null,"abstract":"<p><strong>Background: </strong>Urinary tract infections (UTIs) caused by <i>Escherichia coli</i> pose a significant health burden in children, particularly in those with underlying medical conditions. The emergence of antimicrobial resistance, including extended-spectrum β-lactamase (ESBL) production and multidrug resistance (MDR), complicates treatment strategies. Data on resistance patterns in this vulnerable population remain limited in low-income and middle-income countries.</p><p><strong>Methods: </strong>To determine the prevalence and antibiotic resistance patterns of <i>E. coli</i> isolated from urine samples of pediatric outpatients (1-12 years old) with underlying medical conditions. This hospital-based cross-sectional study was conducted at the Pakistan Institute of Medical Sciences (January 2022-January 2023). Urine samples were collected from 941 pediatric outpatients with documented underlying conditions. <i>E. coli</i> were identified biochemically and molecularly. Antimicrobial susceptibility testing was performed using Kirby-Bauer disc diffusion, with ESBL screening and confirmation.</p><p><strong>Results: </strong><i>E. coli</i> was detected in 30.08% (283/941) of samples, which was significantly higher in females than in males (38.1%, <i>p</i> <0.001). ESBL production was detected in 30.4% (86/283) of the isolates and MDR isolates in 18.7% (53/283). The highest rates of resistance were observed against ampicillin (70.3%), cephalexin (60.1%), and trimethoprim-sulfamethoxazole (59.4%). Low resistance was noted to nitrofurantoin (2.8%) and amikacin (1.8%). Age was a significant predictor, with 1-year old children showing 2.1-fold 95% CI: 1.01-4.55) and 3.6‑fold (95% CI: 1.60-8.15) increased odds of ESBL production and MDR, respectively, compared to children aged 6-12 years.</p><p><strong>Conclusion: </strong>High rates of ESBL-producing and MDR <i>E. coli</i> in Pakistani children with underlying conditions underscore the critical need for antimicrobial stewardship and empirical therapy guided by local susceptibility patterns, particularly in younger children.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"638000"},"PeriodicalIF":3.2,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008466","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 Antimicrobial Resistance and Infection Characteristics of <i>Myroides odoratimimus</i> Harboring the <i>bla</i> _<i>MOC-1</i> Metallo-β-Lactamase Gene.","authors":"Rong Ding, Guiping Xia, Huacheng Tong","doi":"10.2147/IDR.S621054","DOIUrl":"10.2147/IDR.S621054","url":null,"abstract":"<p><p>To investigate the drug resistance genotype and phenotypic characteristics of a clinical isolate of <i>Myroides odoratimimus</i> producing metallo-β-lactamase, so as to provide reference for the diagnosis and treatment of similar severe infections in critical care settings. A Gram-negative bacillus isolated from blood cultures of an elderly patient with severe bloodstream infection was identified using the Vitek 2 Compact system combined with 16S rRNA gene sequencing. Antimicrobial susceptibility testing was performed using the broth microdilution method to determine minimum inhibitory concentrations (MICs). Metallo-β-lactamase phenotype was identified by the modified carbapenem inactivation method (mCIM) combined with the EDTA-modified carbapenem inactivation method (eCIM). The isolate was identified as <i>Myroides odoratimimus</i>. Both mCIM and eCIM tests were positive, confirming the production of metallo-β-lactamase. Whole-genome sequencing and database comparison revealed the presence of the <i>bla_MOC-1</i> gene in this strain, and PCR amplification followed by sequencing of electrophoretic bands yielded a 629-bp <i>bla_MOC-1</i> sequence. Antimicrobial susceptibility testing showed that the isolate exhibited broad-spectrum resistance and was only susceptible to minocycline, doxycycline, levofloxacin, and cefepime. The patient presented with severe septic shock, showed no response to empirical therapy, developed multiple organ injury, and exhibited abnormally elevated biomarkers of inflammation, metabolism, and cardiovascular function. The findings of this study suggest that the bla_MOC-1 gene is carried by this strain and is associated with its broad-spectrum antimicrobial resistance characteristics.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"621054"},"PeriodicalIF":3.2,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Auranofin-Colistin Combination Efficiency Against the Gram-Negative Strains: A Review.","authors":"Mihaela Ileana Ionescu","doi":"10.2147/IDR.S620537","DOIUrl":"10.2147/IDR.S620537","url":null,"abstract":"<p><p>Multidrug-resistant bacteria that possess resistance genes against last-resort antibiotics, such as colistin, are notably prevalent in hospital environments. Therapeutic options for addressing these infections are limited, prompting researchers to explore alternative strategies. One promising approach is drug repurposing, which involves testing combinations of antibiotics with other medications to discover potential synergistic effects against multidrug-resistant (MDR) strains. Auranofin, an antirheumatic drug known for its anti-inflammatory and antineoplastic properties, has recently been investigated in combination with colistin as a potential therapeutic strategy for treating infections caused by multidrug-resistant bacteria. A review of 10 articles retrieved from five public scientific databases indicates that all authors reported synergistic activity of the auranofin-colistin combination against multidrug-resistant (MDR) species, with effectiveness demonstrated in both in vitro and in vivo experiments. However, the minimal inhibitory concentrations (MICs) of this combination vary, and the precise mechanism of action remains unclear. Recent studies examining the crystal structure of metallo-beta-lactamase type 2 (NDM-1) and a probable phosphatidylethanolamine transferase, MCR-1 (which confers mobilized colistin resistance), suggest that activation with glutathione or N-acetylcysteine is necessary for efficacy. Additionally, there is strong evidence indicating that auranofin acts as a dual inhibitor of both MCR and metallo-beta-lactamase (MBL) by displacing the Zn(II) cofactor.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"620537"},"PeriodicalIF":3.2,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008371","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":"Refractory Bacterial Meningitis Associated with an Occult Posterior Fossa Dermal Sinus Tract in an Infant: A Case Report.","authors":"Rong Zhuang, Chao Liang, Jia-Ping Jin, Bo Jin, Ming-Ming Ni","doi":"10.2147/IDR.S629250","DOIUrl":"10.2147/IDR.S629250","url":null,"abstract":"<p><p>Posterior fossa dermal sinus tracts are extremely rare congenital lesions that may extend intracranially and communicate with the dura or brain tissue. This abnormal connection can provide a persistent route for bacterial entry into the central nervous system, predisposing patients to severe infections such as meningitis. We report the case of a 1-year-old boy with refractory bacterial meningitis that remained unresponsive to prolonged broad-spectrum antibiotic treatment. MRI revealed an occult posterior fossa lesion, and cerebrospinal fluid NGS detected multiple microorganisms of uncertain clinical significance, none of which was considered the definitive causative pathogen. Intraoperatively, a sinus tract was found communicating with an intracranial cystic lesion, subsequently confirmed as an infected dermoid cyst on histopathology. After surgical excision and postoperative intraventricular antimicrobial therapy, the patient showed sustained improvement with no recurrence at 6-month follow-up. This case suggests that an occult posterior fossa dermal sinus tract may represent an underrecognized anatomical source of treatment-resistant meningitis and highlights the importance of early structural evaluation when standard antimicrobial therapy fails. Timely surgical intervention may be important for source control and prevention of recurrence.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"629250"},"PeriodicalIF":3.2,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008412","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":"Global Antimicrobial Non-Susceptibility Patterns of <i>Streptococcus pneumoniae</i>: A Systematic Literature Review (2014-2023) Stratified by Age, Region, and Infection Type.","authors":"Mejbah Uddin Bhuiyan, John A Carter, Victoria Abbing-Karahagopian","doi":"10.2147/IDR.S612712","DOIUrl":"10.2147/IDR.S612712","url":null,"abstract":"<p><p>Antimicrobial non-susceptibility of <i>Streptococcus pneumoniae</i> is an important global health challenge. While pneumococcal vaccination has significantly lowered the burden of pneumococcal disease, including that caused by antibiotic-resistant strains, non-susceptible <i>S. pneumoniae</i> isolates are still important contributors to morbidity and mortality, complicating treatment. Empiric antibiotic selection for treating pneumococcal disease should consider the local epidemiology and non-susceptibility profile of isolates. To comprehensively characterize the distribution of non-susceptibility to commonly used antibiotics of <i>S. pneumoniae</i> isolates across different age groups, geographical regions and infection types, we conducted a systematic literature review in accordance with PRISMA guidelines. We searched PubMed, Medline, and Embase to retrieve studies published between 2014 and 2023 reporting the proportion of non-susceptible <i>S. pneumoniae</i> isolates detected in patients with pneumococcal disease. Data were analyzed overall and stratified by age groups (pediatric and adult), World Health Organization region, and infection type (any invasive pneumococcal disease, meningitis, bacteremic pneumonia, non-bacteremic pneumonia, bacteremia/septicemia, and acute otitis media). Study quality was assessed using the Newcastle-Ottawa Scale. Due to observed data heterogeneity, meta-analysis was not performed. Of the 1200 publications identified, 128 (113 full-text articles and 15 conference abstracts) were included in the review, comprising antimicrobial susceptibility testing outcomes for >250,000 isolates. Globally, the highest non-susceptibility rates were observed for sulfonamides (52%), macrolides (40%), and lincosamides (30%). Higher rates were reported in the Western Pacific region, with ≥91% of isolates non-susceptible to commonly used antibiotics (lincosamides, tetracyclines, macrolides, and sulfonamides); elevated non-susceptibility to tetracyclines and sulfonamides was also observed in the Southeast Asian region. Non-susceptibility proportions, in general, were higher in the pediatric population than in adults, and they varied markedly by pneumococcal infection type. Up-to-date, stratified information on the non-susceptibility profile of <i>S. pneumoniae</i> isolates causing different types of infection can orient local prescription guidance to use appropriate antibiotics, thereby improving the treatment outcomes and reducing the potential threat of antibiotic resistance.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"612712"},"PeriodicalIF":3.2,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13573865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148968055","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":"Ceftolozane/Tazobactam Susceptibility in ESBL-Producing Enterobacterales: Insights from the SMART Program 2020-2022 in China.","authors":"Yanfei Wang, Yuke Zhang, Jingjing Quan, Ying Fu, Zhihui Zhou, Jiaqi Xia, Yunsong Yu","doi":"10.2147/IDR.S624172","DOIUrl":"10.2147/IDR.S624172","url":null,"abstract":"<p><strong>Purpose: </strong>Surveillance data on ceftolozane/tazobactam (C/T) activity against extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) in China remains limited. This study summarized species- and source-specific C/T susceptibility patterns using isolates collected through the Study for Monitoring Antimicrobial Resistance Trends (SMART) China program (2020-2022).</p><p><strong>Methods: </strong>Non-duplicate Enterobacterales isolates from bloodstream, intra-abdominal, respiratory, and urinary tract infections (BSI, IAI, RTI, UTI) were collected in 18 tertiary hospitals. Minimum inhibitory concentrations (MICs) were determined by broth microdilution and interpreted using CLSI M100 2025. ESBL-E were defined as ceftriaxone-nonsusceptible (i.e, intermediate or resistant) and carbapenem-susceptible Enterobacterales (CSE), with species-specific adjustments for <i>Morganella, Proteus</i>, and <i>Providencia</i>; carbapenem-resistant isolates were analyzed separately. Annual rate was analyzed to reveal the resistance trend from 2020 to 2022.</p><p><strong>Results: </strong>All Enterobacterales isolates meeting inclusion criteria were analyzed; isolation rate is reported by species for the seven most prevalent, which together comprised 93.5% of isolates; the remaining genera contributed to the aggregate totals. Overall susceptibility of Enterobacterales to C/T was high. Among CSE, susceptibility was 92.2%, with 83.1% in ESBL‑E. By infection site, C/T susceptibility among ESBL‑E was 88.3% in UTI, 85.3% in BSI, 79.9% in RTI, and 77.4% in IAI. Susceptibility was highest in ESBL-<i>Escherichia coli</i> (90.6%) and lower in <i>Klebsiella pneumoniae</i> (72.9%) and <i>Enterobacter cloacae</i> (55.3%). Among ESBL-E, the MIC distribution for C/T was centered at ≤0.5-2 mg/L, corresponding to an overall susceptibility of 83.1%; resistant isolates (MIC ≥8 mg/L) were uncommon (12.4%) but clustered in selected species and sources.</p><p><strong>Conclusion: </strong>C/T susceptibility among ESBL-E was high in <i>E. coli</i> but substantially lower and more variable in <i>K. pneumoniae</i> and <i>E. cloacae</i>; the aggregate order-level susceptibility of 83.1% should not be relied upon to guide empiric therapy when <i>Klebsiella</i> or <i>Enterobacter</i> infection is suspected. Continued surveillance and susceptibility testing are essential to support evidence-based antimicrobial use.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"624172"},"PeriodicalIF":3.2,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13573848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148968068","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}