Infection and Drug Resistance最新文献

{"title":"Impact of Acid Suppressants on the Development of <i>Clostridioides difficile</i> Infection and Possible Preventive Effects of Probiotic Formulations.","authors":"Chihiro Shiraishi, Hideo Kato, Takuya Iwamoto","doi":"10.2147/IDR.S543864","DOIUrl":"10.2147/IDR.S543864","url":null,"abstract":"<p><strong>Background: </strong>The comparative effectiveness and potential impact of individual proton pump inhibitors (PPIs) on the development of <i>Clostridioides difficile</i> infection (CDI) remain unclear. Additionally, there is insufficient evidence to support the use of probiotics for CDI prevention outside clinical trials. This study aimed to identify the PPIs that are most associated with CDI development and to determine whether probiotic co-administration can reduce this risk.</p><p><strong>Methods: </strong>We retrospectively analyzed the data of 3287 patients tested for CDI at Mie University Hospital between January 2014 and June 2024, excluding 1917 patients who had received antibiotics within the prior 3 months. The PPIs studied included esomeprazole, omeprazole, rabeprazole, and lansoprazole.</p><p><strong>Results: </strong>Univariate logistic regression analysis revealed age and esomeprazole use as potential risk factors for CDI (<i>p</i> = 0.009). Although not significant, the co-administration of probiotics tended to reduce the incidence of CDI in patients receiving esomeprazole (3.8% vs 10.4%, <i>p</i> = 0.060). Patients prescribed vonoprazan had a significantly higher rate of concomitant probiotic use than did those prescribed esomeprazole (<i>p</i> = 0.025).</p><p><strong>Conclusion: </strong>Our findings suggest that esomeprazole use and advanced age may increase the risk of CDI. Additionally, probiotics may help prevent CDI during PPI therapy. Selecting PPIs based on individual bleeding profiles and considering probiotics could be beneficial to mitigate the risk of CDI.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"4593-4602"},"PeriodicalIF":2.9,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12410385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015122","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":"Comparative Case Series of Herpes Zoster in Older Immunocompromised Chinese Adults: Clinical, Immunological, and Treatment Profiles in Four Cases Over 60.","authors":"Xuemin Wang, Huan Shi, Suwei Tang, Yang Yang, Qi Zheng, Wencheng Jiang","doi":"10.2147/IDR.S531066","DOIUrl":"10.2147/IDR.S531066","url":null,"abstract":"<p><strong>Purpose: </strong>Herpes zoster poses severe complications in elderly immunocompromised patients, particularly those with altered drug metabolism and renal impairment, impacting quality of life.</p><p><strong>Patients and methods: </strong>To evaluate brivudine's efficacy and safety in such cases, we conducted a retrospective case series at Shanghai Skin Disease Hospital, analyzing four Chinese patients (aged 64-84 years) with complex herpes zoster, including systemic lupus erythematosus, diabetes nephropathy, multiple comorbidities, and trigeminal nerve involvement. Selected for their immunocompromised status and prior antiviral failure or renal concerns, patients received oral brivudine (125 mg once daily) with or without intravenous acyclovir, with outcomes assessed via clinical examination, pain scores, and laboratory monitoring over 7-14 days.</p><p><strong>Results: </strong>All patients experienced rapid symptom relief, lesion resolution, and pain reduction with minimal side effects. Compared to previous use of other antivirals, brivudine was better tolerated and did not require renal dose adjustment.</p><p><strong>Conclusion: </strong>In summary, brivudine appears to be a promising option for elderly immunocompromised patients with herpes zoster, offering effective viral control, favorable safety, and improved clinical outcomes.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"4513-4525"},"PeriodicalIF":2.9,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015118","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":"Postoperative Disseminated <i>Mycoplasma hominis</i> Infection with False-Negative Blood Cultures: A Case Report.","authors":"Yefu Yu, Yanan Wang, Weifang Mao, Huiyu Wang, Faxiang Jin, Wenfang Xu","doi":"10.2147/IDR.S548195","DOIUrl":"10.2147/IDR.S548195","url":null,"abstract":"<p><strong>Background: </strong><i>Mycoplasma hominis</i> commonly colonizes the genitourinary tract and primarily affects immunocompromised individuals. It is mostly confined to localized infections, with bloodstream dissemination being rare. Because of its fastidious nutritional requirements, the organism is seldom recovered by routine blood culture, and the absence of a cell wall renders it intrinsically resistant to many first-line antimicrobials. Consequently, the diagnosis and treatment of <i>M. hominis</i> bloodstream infections remain challenging.</p><p><strong>Case description: </strong>A 72-year-old man developed persistent fever and marked systemic inflammation after lumbar spine surgery. Despite empirical broad-spectrum antibiotics, he progressed to severe incisional infection, pulmonary infection, and effusions in multiple serous cavities-including the left interlobar fissure, pleural space, and pericardium. Routine blood and urine cultures remained negative until two weeks after surgery, when <i>M. hominis</i> was first isolated from incisional exudate and definitively identified by MALDI-TOF MS. The patient ultimately recovered after surgical debridement and combination therapy with doxycycline plus moxifloxacin. During this period, we used Mycoplasma-specific liquid media combined with Columbia blood agar and subsequently recovered <i>M. hominis</i> from the patient's sputum, urethral swabs, and initially culture-negative blood samples. MALDI-TOF MS cluster analysis confirmed that all isolates belonged to a single clonal group responsible for disseminated infection.</p><p><strong>Conclusion: </strong>Immunocompromised patients with postoperative indwelling catheters constitute a high-risk population for hematogenous dissemination of <i>M. hominis</i>. In patients with persistent fever and negative routine cultures, <i>M. hominis</i> infection should be actively suspected. Timely targeted mycoplasma culture and MALDI-TOF MS confirmation are essential.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"4549-4556"},"PeriodicalIF":2.9,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12410094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015175","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":"Risk Factors of Surgical Site Infection After Adult Closed Tibial Plateau Fractures Treated by Open Reduction and Internal Fixation.","authors":"Qing Zhang, Lin Li, Fulin Tao, Dawei Wang, Jinlei Dong, Dongsheng Zhou, Wenhao Song","doi":"10.2147/IDR.S531307","DOIUrl":"10.2147/IDR.S531307","url":null,"abstract":"<p><strong>Background: </strong>Surgical site infection (SSI) after surgery can cause serious sequelae in patients with tibial plateau fractures. This study aims to report the incidence and characteristics of SSI and to investigate the risk factors of SSI in adult patients with closed tibial plateau fracture, especially the relationship between SSI and preoperative hypoalbuminemia.</p><p><strong>Methods: </strong>We retrospectively reviewed the records of adult patients with closed tibial plateau fracture who were treated at our institution from January 2016 to December 2022. From the medical records, demographic data, surgical data, preoperative results of laboratory examination and postoperative complications extracted. Univariable and multivariable analyses were performed to determine the association between risk factors and SSI after surgery.</p><p><strong>Results: </strong>In total, 460 patients met inclusion criteria, and 23 patients were diagnosed with SSI, the postoperative infection rate was 5%, with eleven cases (2.4%) were deep SSI and twelve cases (2.6%) were superficial SSI. According to the univariable analysis, current smoking, alcoholism, fracture type (IV-VI), osteofascial compartment syndrome, operative time ≥3 hours, intraoperative blood loss ≥400 mL, double incisions, more plates, preoperative hypoalbuminemia were investigated to the significant risk factors for SSI. According to the multivariable analysis, fracture type and hypoalbuminemia were independently risk factors for SSI.</p><p><strong>Conclusion: </strong>Fracture type and preoperative hypoalbuminemia could be predictors of SSI in adult patients with closed tibial plateau fractures. Shorten operation time, reduce intraoperative blood loss, stop smoking and drinking and correct hypoalbuminemia could reduce the risk of postoperative infection.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"4569-4578"},"PeriodicalIF":2.9,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12409926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015190","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":"Positive Metagenomic Next-Generation Sequencing of Renal Lavage Fluid Associates with Delayed Graft Function in Kidney Transplants from Donors After Circulatory Death: A Retrospective Study.","authors":"Dongsheng Li, Jiashan Pan, Mo Yang, Jinbiao Zhong, Handong Ding, Wei Chen, Ji Zhang, Guiyi Liao","doi":"10.2147/IDR.S541861","DOIUrl":"10.2147/IDR.S541861","url":null,"abstract":"<p><strong>Background: </strong>Delayed graft function (DGF) is a major complication in kidney transplants from donation after circulatory death (DCD). This study assessed the association between metagenomic next-generation sequencing (mNGS) results and the occurrence of DGF during the perioperative period in DCD kidney transplant recipients.</p><p><strong>Methods: </strong>We analyzed 191 DCD kidney transplant recipients in this single-center retrospective cohort study. All recipients underwent routine mNGS testing of renal lavage fluid between July 2021 and July 2024. Demographic, clinical, and microbial data were collected. Associations between mNGS results and DGF were evaluated using logistic regression models adjusted for covariates.</p><p><strong>Results: </strong>The study revealed a strong association between mNGS positivity and DGF development. mNGS-positive recipients (n=97/191) showed significantly higher DGF incidence than mNGS-negative cases (30.9% vs 6.4%, <i>p</i><0.001), highlighting the potential clinical utility of mNGS in predicting DGF. Multivariate analysis confirmed this association after adjusting for confounders (aOR=7.90, 95% CI 1.63-38.24). Bacterial pathogens constituted the majority of detected microorganisms (62.7%), with prevalent isolates including Enterococcus (37 cases) and Staphylococcus (29 cases) that harbored clinically relevant resistance genes.</p><p><strong>Conclusion: </strong>Our findings demonstrate a significant association between mNGS positivity in renal lavage fluid and DGF development in DCD kidney recipients (aOR 7.90, 95% CI 1.63-38.24), These findings support further investigation into mNGS as a tool for early risk stratification and targeted antimicrobial therapy in DCD kidney recipients.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"4579-4592"},"PeriodicalIF":2.9,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12407018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Neisseria sicca</i> Bloodstream Infection in a Patient with Aortic Valve Replacement: Case Report and Genomic Analysis.","authors":"Yizhang Wang","doi":"10.2147/IDR.S552728","DOIUrl":"10.2147/IDR.S552728","url":null,"abstract":"<p><p><i>Neisseria sicca</i> is usually a commensal of the oropharynx but can occasionally cause invasive disease. Herein, we report a rare case of <i>N. sicca</i> bacteremia in a female with a 7-year history of aortic valve replacement (AVR), who presented with persistent fever but no respiratory symptoms or valvular vegetations. Blood cultures yielded <i>N. sicca</i>, identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) and confirmed via 16S rRNA sequencing. Appropriate antibiotic therapy with ticarcillin-clavulanate led to a significant clinical improvement. To gain insight into the pathogenicity and resistome of this strain, whole-genome sequencing of <i>N. sicca</i> junzhu_1 was performed using the Illumina NovaSeq platform. The resistome of the <i>N. sicca</i> strain consists of three antimicrobial resistance genes: <i>macB, macA</i>, and <i>mtrD</i>. Virulence gene analysis revealed that the pathogenicity of <i>N. sicca</i> was associated with <i>mntB, mntC, farA, farB, mtrD, mtrE, msrA</i>/<i>B</i> (<i>pilB), rfaF, rfaC, hpuB, pilT</i>, and <i>recN</i>. This case underscores the potential of <i>N. sicca</i> to act as an opportunistic pathogen in bloodstream infections (BSIs).</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"4557-4567"},"PeriodicalIF":2.9,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12407004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000430","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":"Epidemiology and Antimicrobial Resistance Trends of Bloodstream Infections During and After the Implementation of the National Action Plan on Antimicrobial Resistance in Mwanza, Tanzania: A Comparative Cross-Sectional Study.","authors":"Vitus Silago, Louise Matthews, Katarina Oravcova, Stephen E Mshana, Jeremiah Seni, Heike Claus","doi":"10.2147/IDR.S542495","DOIUrl":"10.2147/IDR.S542495","url":null,"abstract":"<p><strong>Background and purpose: </strong>Bloodstream infections (BSIs) caused by antimicrobial-resistant pathogens, especially WHO-Bacterial-Priority-Pathogens (WHO-BPPs), contribute to significant mortality. The current study determined the prevalence of BSIs, causative bacterial pathogens and their antimicrobial susceptibility profiles, and factors associated with laboratory-confirmed BSIs by WHO-BPPs during and after National Action Plan on Antimicrobial Resistance (NAP-AMR) implementation in Mwanza, Tanzania.</p><p><strong>Patients and methods: </strong>A comparative cross-sectional study was conducted among sepsis patients in District, Regional, and Zonal Referral Hospitals from June 2019 to June 2020 (during NAP-AMR) and March to July 2023 (after NAP-AMR). Blood cultures were processed using conventional methods, while bacterial identification and antimicrobial susceptibility testing were performed using Vitek MS (MALDI-TOF-MS) and Vitek 2, respectively. STATA version 15.0 was used for data analysis.</p><p><strong>Results: </strong>Among 1842 enrolled patients (median age: 5 years, IQR: 0-31), 51.4% were female. The overall prevalence of BSIs was 14.7% (271/1842). A total of 306 bacterial isolates were identified, with Gram-negative bacteria predominating during (92.4%) and after (73.5%) NAP-AMR. <i>Escherichia coli</i> was most common during (31.2%), whereas <i>Klebsiella pneumoniae</i> dominated after (43.4%) NAP-AMR. BSIs caused by WHO-BPPs rose significantly after NAP-AMR (43.5% vs 76.1%, p<0.001), particularly extended-spectrum beta-lactamase producing Enterobacterales. <i>Klebsiella pneumoniae</i> resistance to cefotaxime (65.3% vs 93.2%, p=0.001), gentamicin (63.3% vs 94.9%, p=0.001), and ciprofloxacin (28.6% vs 76.3%, p=0.001) increased significantly. Higher-tier hospitals (OR: 7.01; 95% CI: 1.58-31.05; p=0.010) and after NAP-AMR enrollment (OR: 2.87; 95% CI: 1.33-6.19; p=0.007) were linked to increased BSIs caused by WHO-BPPs.</p><p><strong>Conclusion: </strong>We observed a high prevalence of BSIs with a rising proportion of BSIs caused by WHO-BPPs, particularly in higher-tier hospitals and after the implementation of NAP-AMR. Our findings highlight the need of hospital-specific antibiograms and reinforced infection prevention measures.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"4441-4453"},"PeriodicalIF":2.9,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12404259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992404","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":"Real-World Analysis of Potential Drug-Drug Interactions with Nirmatrelvir/Ritonavir Based on the Hospital Prescription Analysis (HPA) Database in 9 Cities of China.","authors":"Heng Guo, Yang Zhou, Xingang Li, Yingming Zheng, Zhe Li, Yi Liu, Dandan Li","doi":"10.2147/IDR.S536758","DOIUrl":"10.2147/IDR.S536758","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the real-world patterns and extent of potential drug-drug interactions (DDIs) related to nirmatrelvir/ritonavir (NMVr) in China.</p><p><strong>Patients and methods: </strong>Data on NMVr-treated patients from over 160 hospitals across 9 Chinese cities from January 2022 to December 2023 were extracted from the Hospital Prescription Analysis (HPA) database, which was established in Beijing in 1997 to promote rational medication use in China. Grade C, D and X DDIs from the Lexicomp database were defined as clinically significant and analyzed in this study. Statistical analyses included descriptive statistics (continuous variables as mean ± SD; categorical variables as counts and percentages) and multivariate binary logistic regression, which was used to identify factors associated with potential DDIs, with adjustment for confounding variables (sex, age, cities, number of co-administered drugs, comorbidities). Analyses were performed using R software (v4.2.2) with <i>P</i> < 0.05 as statistically significant, and figures were generated via GraphPad Prism (v10.3.1).</p><p><strong>Results: </strong>Of 15,567 patients receiving NMVr, the mean age was 62.4 ±18.2 years, and 53.1% were male. 8542 patients received at least one co-administration, and 5391 patients exhibited at least one potential DDI. A total of 10,694 potential DDIs were identified, with a breakdown of 8310 grade C, 2093 grade D and 291 grade X. Systemic corticosteroids (n=3608) and drugs for obstructive airway diseases (n=2220) had the highest frequencies in grade C DDIs, and the lipid modifying agents (n=601) in grade D DDIs, and cardiac therapy drugs (n=130) in grade X DDIs. Co-administration of drugs significantly increased odds of potential DDIs with the risk escalating markedly as the number of drugs increased, and the comorbidities of hypertension (odds ratio [OR]=1.50), asthma (OR=4.28) and mental disorders (OR=7.02) significantly increased it as well.</p><p><strong>Conclusion: </strong>In this large-scale cross-sectional study in China, approximately one-third of the patients treated with NMVr were at risk of clinically significant potential DDIs, highlighting the importance of making efforts to diminish these risks, such as close monitoring and dose adjustment.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"4539-4548"},"PeriodicalIF":2.9,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12404192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992428","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 Evolution of Virulence of Carbapenem-Resistant <i>Klebsiella pneumoniae</i> from the Same Source Under the Pressure of Omadacycline Treatment.","authors":"Jianhua Fang, Qiong Liu, Huade Chen, Hongyi Lai, Jingyi Huang, Jiayue Li, Yilin Xu, Na Cheng, Tianxin Xiang","doi":"10.2147/IDR.S534712","DOIUrl":"10.2147/IDR.S534712","url":null,"abstract":"<p><strong>Introduction: </strong><i>Klebsiella pneumoniae</i> (KP) is a common Gram-negative bacterium in clinical practice and can cause various infectious diseases, including pneumonia, liver abscess and bloodstream infection. Carbapenem-resistant <i>Klebsiella pneumoniae</i> (CRKP) has become a major threat to global health due to its high incidence and mortality rates, especially the ST11-CRKP strain prevalent in China.</p><p><strong>Methods: </strong>The age, main clinical diagnosis, previous health and immune status of the two patients with ST11-CRKP-related infections during the same period reported in this study were similar.</p><p><strong>Results: </strong>The antibiotic treatment regimens for the two patients were the same in terms of the type and dosage of antibiotics, except for omadacycline. Meanwhile, PFGE, multilocus sequence typing (MLST), and K typing confirmed that the two strains had the same genetic background. Through experiments on serum resistance, biofilm formation, the <i>Galleria mellonella</i> infection model and the hypermucus phenotype, it was found that CRKP1 showed a hypervirulent phenotype, while CRKP15 showed a hopervirulent phenotype. Whole-genome sequencing further revealed the differences in virulence genes between the two strains and further confirmed the virulence phenotypes of the two strains. Single nucleotide polymorphism (SNP) analysis showed that the <i>terw</i> gene was one of the key genes for the virulence difference of the two strains with the same genetic background under the therapeutic difference of omadacycline. In addition, the effect of omadacycline on the expression of the <i>terw</i> gene was evaluated by qRT-PCR technology. The interaction between the <i>terw</i> gene and omadacycline was confirmed through molecular docking.</p><p><strong>Conclusion: </strong>To sum up, these findings suggest that under the therapeutic stress of omadacycline, CRKP may adjust virulence through adaptive evolution, and the <i>terw</i> gene may be the key factor for the differences in virulence within this bacterial population.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"4499-4511"},"PeriodicalIF":2.9,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12405711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000444","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":"Association Between Malnutrition and Multi-Drug Resistant Bacterial Infections in Neurosurgical Intensive Care Unit Patients.","authors":"Wenjing Li, Zixuan Hou, Jinhua Chen, Rong Pi, Hanwenxi Wang, Mengna Dai, Yan Ouyang, Suyun Li","doi":"10.2147/IDR.S538412","DOIUrl":"10.2147/IDR.S538412","url":null,"abstract":"<p><strong>Aim: </strong>Patients in the neurosurgical intensive critical unit (ICU) face high rates of malnutrition and multidrug-resistant (MDR) infections. This study aimed to investigated the correlation between malnutrition and MDR bacterial infections, aiming to offer novel strategies for preventing and controlling MDR infections from the perspective of nutritional management in clinical practice.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed 134 patients with MDR infections and 148 patients with non-MDR infections from November 2023 and May 2024 in neurosurgical ICU. MDR was defined as resistance to at least three antibiotic classes. Univariate, multivariate and correlation analyses were performed to explore the relationship between malnutrition and MDR infections.</p><p><strong>Results: </strong>The incidence of malnutrition risk in the MDR group was significantly higher than in the non-MDR group (<i>P</i> < 0.05). After adjusting for confounding factors, malnutrition was still independently associated with an increased risk of MDR infections (OR = 2.336; 95% CI = 1.361~4.112, <i>P</i> = 0.002). Furthermore, C-reactive protein level was negatively correlated with TP (r = -0.281, <i>P</i> < 0.001), ALB (r = -0.267, <i>P</i> < 0.001), PLB (r = -0.279, <i>P</i> < 0.001), Hb (r = -0.167, <i>P</i> < 0.01) and PNI (r = -0.257, <i>P</i> < 0.001), suggesting that higher infection severity was associated with poorer nutritional status. For bacterial strains, <i>Acinetobacter baumannii</i> accounted for the largest proportion in our study.</p><p><strong>Conclusion: </strong>Malnutrition is an independent risk factor for MDR infection in neurosurgical ICU patients. This finding highlights the need for integrated interventions targeting malnutrition in MDR prevention for neurosurgical ICU patients.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"4485-4498"},"PeriodicalIF":2.9,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992381","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}