Infection and Drug Resistance最新文献

{"title":"Epidemiology, Risk Factors, and External Validation of Predictive Models for Multidrug-Resistant Bacterial Infections in Diabetic Foot Ulcers.","authors":"Xiangheng Dai, Fuzhou Xu, Weiqi Lu, Guiping Zhang, Yuyue Li, Xinying Hu, Lijing Deng, Kun Zhao, Wenlian Zheng, Beidi Zhou, Guobao Deng, Qiang Wu","doi":"10.2147/IDR.S537142","DOIUrl":"10.2147/IDR.S537142","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the epidemiological characteristics and risk factors of multidrug-resistant bacterial (MDRB) infections in diabetic foot ulcer (DFU) and externally validate existing predictive models for MDRB, <i>Pseudomonas aeruginosa</i> (<i>PSA</i>), and <i>methicillin-resistant Staphylococcus aureus</i> (<i>MRSA</i>) infections.</p><p><strong>Methods: </strong>A retrospective analysis of 344 patients diagnosed with DFU identified key clinical and laboratory variables associated with outcomes. Univariate and multivariate logistic regression identified risk factors, while receiver operating characteristic (ROC) curves and calibration analyses assessed model validity.</p><p><strong>Results: </strong>MDRB infections were linked to longer hospitalization, lower hemoglobin, higher hs-CRP, and higher osteoporosis prevalence. Significant risk factors included prolonged hospitalization, osteomyelitis, osteoporosis, prior antimicrobial use, and respiratory rate. <i>PSA</i> infections correlated with myocardial infarction and peripheral vascular disease, while no significant risk factors were identified for <i>MRSA</i>. External validation showed poor discriminatory ability (AUC: 0.501 for MDRB, 0.505 for <i>PSA</i>, 0.569 for <i>MRSA</i>) and calibration performance, indicating poor generalizability of existing models in our cohort.</p><p><strong>Conclusion: </strong>MDRB infections in DFUs are associated with specific clinical characteristics and risk factors. However, existing predictive models demonstrated limited utility in our dataset, emphasizing the need for model refinement and inclusion of additional risk factors. Future research should focus on improving predictive models and developing targeted antimicrobial strategies to enhance clinical outcomes in diabetic foot infections.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"4471-4483"},"PeriodicalIF":2.9,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12402424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992384","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":"Palivizumab for Severe Respiratory Syncytial Virus Infection in Immunocompetent Adults: A Case Series.","authors":"Jun-Yu Zhong, Ting-Kuang Yeh, Hsien-Po Huang, Chun-Mei Ho, Po-Yu Liu, Yun-Ching Fu","doi":"10.2147/IDR.S528785","DOIUrl":"10.2147/IDR.S528785","url":null,"abstract":"<p><strong>Background: </strong>Respiratory syncytial virus (RSV) is a significant cause of lower respiratory tract infections in adults, particularly the elderly, and can lead to severe outcomes, including respiratory failure. Current treatment options for RSV in immunocompetent adults are limited to supportive care.</p><p><strong>Objective: </strong>This case series aims to describe the clinical course and outcomes of two immunocompetent adults with severe RSV infection treated with Palivizumab, a monoclonal antibody against RSV.</p><p><strong>Methods: </strong>We report two cases: a 92-year-old female with a history of hypertension and a previous meningioma resection, and a 42-year-old female with no significant past medical history. Both presented with severe respiratory symptoms, were diagnosed with RSV infection via PCR, and received a single dose of intramuscular Palivizumab (approximately 12-13 mg/kg) after initial clinical deterioration despite supportive care and empiric antibiotic therapy.</p><p><strong>Results: </strong>Following Palivizumab administration, both patients exhibited clinical improvement, including resolution of fever and improvement in oxygenation and radiographic findings. Both patients were discharged in stable condition without the need for supplemental oxygen.</p><p><strong>Conclusion: </strong>These cases suggest that Palivizumab may be a potential therapeutic option for severe RSV infection in immunocompetent adults. Further research, including randomized controlled trials, is needed to confirm these preliminary findings and establish optimal dosing and treatment protocols.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"4455-4460"},"PeriodicalIF":2.9,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12402706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992415","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":"Shifts in Epidemiology and Antibiotic Resistance of Haemophilus Influenzae in Children From Chongqing (2019-2024): Pre-, During, and Post-COVID-19.","authors":"Jing Wang, Renyan Wang, Chunmei Jing, Yupei Xiang, Zhongzheng Xiong, Fang Liu","doi":"10.2147/IDR.S535755","DOIUrl":"10.2147/IDR.S535755","url":null,"abstract":"<p><strong>Objective: </strong>To comprehensively investigate the epidemiology and analyze the antimicrobial resistance of Haemophilus influenzae isolated from children in Chongqing before, during, and after the COVID-19 pandemic.</p><p><strong>Methods: </strong>A total of 21,723 Haemophilus influenzae strains from four Chongqing hospitals during 2019-2024 were included. Antimicrobial susceptibility testing was conducted according to Clinical and Laboratory Standards Institute 2024 breakpoints using Kirby-Bauer method or automated systems. β-lactamase was detected by the cefinase disc method. Specimen types, age-and season-specific distributions, and antibiotic susceptibility results were analyzed.</p><p><strong>Results: </strong>Among the isolates, 91.43% of infected children were under 6 years old and 57.30% were male. Sputum was the main source (94.22%). Detection rates were higher in spring and winter (p < 0.001). β-lactamase-positive strains accounted for 71.82% and BLNAR strains accounted for 4.99%. High resistance was found for ampicillin (79.05%), cefuroxime (58.95%), ampicillin-sulbactam (59.82%), sulfamethoxazole-trimethoprim (68.51%), azithromycin (49.67%), and cefixime (37.78%), while meropenem (0.48%), levofloxacin (0.11%), chloramphenicol (4.85%), ceftriaxone (0.62%), rifampicin (0.15%), tetracycline (5.55%), and cefepime (6.11%) showed low resistance. The COVID-19 pandemic affected resistance patterns: resistance to ampicillin, aztreonam, cefuroxime, amoxycillin-clavulanic, and ampicillin-sulbactam were higher before and after the COVID-19 pandemic than during it (p< 0.001). Throughout the pre-pandemic, pandemic, and post-pandemic periods, the resistance rates of sulfamethoxazole-trimethoprim cefixime and cefepime showed a downward trend, while the resistance rate of azithromycin showed an upward trend.</p><p><strong>Conclusion: </strong>Haemophilus influenzae infections mainly occur in children under 6 years old, with seasonal peaks in spring and winter. The COVID-19 pandemic influenced infection patterns of specific age groups and resistance trends. Caution is required for commonly resistant antibiotics, and continuous resistance monitoring is necessary.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"4461-4470"},"PeriodicalIF":2.9,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12402710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992387","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":"HIV Low-Level Viremia is Not Related to Subsequent Virological Failure Under NNRTI-Based Regimens: A Multicenter Retrospective Study in China.","authors":"Xinmin Duan, Xiaojing Song, Wei Lyu, Yanling Li, Jing Tang, Wei Cao, Yang Han, Taisheng Li","doi":"10.2147/IDR.S533871","DOIUrl":"10.2147/IDR.S533871","url":null,"abstract":"<p><strong>Background: </strong>The long-term impact of low-level viremia (LLV), defined as two consecutive viral loads (VL) of <200 copies/mL, on virological failure remains unclear. This study aimed to investigate the association between viremia patterns and virological failure in people living with HIV (PLWH) in China who predominantly received non-nucleoside reverse transcriptase inhibitor (NNRTI)-based therapies.</p><p><strong>Methods: </strong>Data from six HIV-infected cohorts in China were analyzed. Adult antiretroviral therapy (ART)-naïve patients were included. Patients were excluded if they received less than 24 weeks of ART, had fewer than two documented VL and CD4+ T cell count, initiated ART during the acute infection stage, or had a follow-up duration of less than 48 weeks. All patients were stratified according to virological suppression (VS), virological blips (VB), or LLV. Cox regression analysis was used to evaluate the association between virological failure and patterns of viremia. Genotypic drug resistance mutations were compared at baseline and during LLV.</p><p><strong>Results: </strong>Among the 1532 patients, 374 (24.4%) had blips and 166 (10.8%) had LLV. The LLV group had a higher baseline viral load and lower CD4⁺ T cell count. Approximately 90% of patients received NNRTI-based regimens. In the adjusted Cox regression, neither the blip nor LLV groups demonstrated a significantly increased risk of virological failure compared to the VS group (Blip, adjusted HR = 0.5 [95% CI: 0.2-1.2], <i>p</i> = 0.116; LLV, aHR = 0.7 [95% CI: 0.3-1.9], <i>p</i> = 0.474). Among the 17 patients who successfully underwent sequencing, three (17.6%) developed new drug resistance mutations, but none experienced virological failure.</p><p><strong>Conclusion: </strong>Neither blip nor LLV were significantly associated with an increased risk of virological failure in China. Emerging drug resistance mutations in LLV are rare and do not correlate with subsequent virological failures. Further research is needed to understand the clinical significance of these patterns of viremia.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"4373-4384"},"PeriodicalIF":2.9,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12399107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952476","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":"Antimicrobial Peptides: Mechanisms, Applications, and Therapeutic Potential.","authors":"Mohammed Alzain, Hussam Daghistani, Taghreed Shamrani, Yousef Almoghrabi, Yassir Daghistani, Ohood S Alharbi, Ahmad M Sait, Mohammed Mufrrih, Wafaa Alhazmi, Mona Abdulrahman Alqarni, Bandar Hasan Saleh, Manal A Zubair, Noha A Juma, Hatoon A Niyazi, Hanouf A Niyazi, Waiel S Halabi, Rawan Altalhi, Imran Kazmi, Hisham N Altayb, Karem Ibrahem, Abdelbagi Alfadil","doi":"10.2147/IDR.S514825","DOIUrl":"10.2147/IDR.S514825","url":null,"abstract":"<p><p>Antimicrobial peptides (AMPs) are short protein fragments that function as an innate immune response across diverse life forms. Structurally, AMPs exhibit diverse configurations, including α-helical, β-sheet, mixed, and random-coil forms, enabling a variety of mechanisms to combat pathogens. The mechanisms of action of AMPs encompass membrane disruption and inhibition of critical cellular processes, highlighting their broad-spectrum activity against bacteria, fungi, viruses, and parasites. AMP activity extends to anti-tumor and anti-HIV activities, further emphasizing their therapeutic potential. Purifying AMPs from natural sources can be challenging due to posttranslational processing. Fortunately, chemical synthesis has the advantage of producing high yield and pure AMPs, but the reaction efficiency diminishes as the molecular weight of peptides increases. Advances in computational tools and curated databases have further accelerated AMP discovery and engineering. While commercially available AMP-based antibiotics and in vivo efficacy against multidrug-resistant bacteria demonstrate their clinical relevance, several limitations still hinder the widespread use of AMPs such as low stability and toxicity to human cells. This review provides a comprehensive overview of AMP origins, characteristics, mechanisms, applications, and future prospects in combating infectious diseases with a particular focus on the clinical applicability of AMPs and their prospects as potent alternative to traditional antibiotics.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"4385-4426"},"PeriodicalIF":2.9,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12399857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992423","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":"Viral-Induced Erythema Multiforme Complicated by Secondary Bacterial Infection with Hyperpyrexia Following Cervical Spine Surgery: A Rare Case of Dual Infection.","authors":"Junhong He, Yang Wang, Qiong Yang","doi":"10.2147/IDR.S541026","DOIUrl":"10.2147/IDR.S541026","url":null,"abstract":"<p><p>Erythema multiforme, an inflammatory skin and mucosal condition, is mainly caused by a viral infection and presents as plaques of various morphologies. We present the case of a 59-year-old man who developed a pruritic rash all over his body seven days after posterior cervical single-open-door spinal decompression surgery. He had no history of a viral rash. He received antibiotics and anti-allergic treatment without relief of symptoms. Suspecting a viral infection, antivirals were started. While the rash subsided, the inflammatory markers continued to increase, accompanied by hyperpyrexia, leading to the suspicion of secondary bacterial infection. Meropenem was started, and the patient's vital signs returned to normal. This is a rare case of erythema multiforme and secondary bacterial infection following cervical spine surgery. Based on our findings, antimicrobial therapy is recommended for patients with viral infection after cervical spine surgery in the following situations: bacterial infection was not confirmed by the blood cultures obtained, and was suspected by the patients' course and elevated infection indices.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"4435-4440"},"PeriodicalIF":2.9,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12399866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992412","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 Case Report of Refractory <i>Mycobacterium wolinskyi</i> Knee Infection in a Metabolic Syndrome Patient: mNGS Diagnosis and Pharmacist-Guided Therapy.","authors":"Min Shao, Lijia Ni, Liang Jiang, Jingyi Hou, Sicheng Xu, Yin Lin, Xiaoying Xie","doi":"10.2147/IDR.S542439","DOIUrl":"10.2147/IDR.S542439","url":null,"abstract":"<p><p><i>Mycobacterium wolinskyi</i> (<i>M. wolinskyi</i>), which is a rare rapidly growing mycobacterium (RGM), and the infections it causes are predominantly linked to surgery or invasive procedures. We detailed a case of refractory surgical site infection (SSI) caused by <i>M. wolinskyi</i>. The causative pathogen was identified by metagenomic next-generation sequencing (mNGS) analysis, 16S rRNA and <i>rpoB</i> gene sequencing. What renders this case particularly remarkable is the complexity introduced by a series of antibiotic-induced adverse effects, which seem to be deeply intertwined with the patient's underlying metabolic syndrome. With the meticulous pharmaceutical guidance provided by the clinical pharmacist, the patient experienced a substantial improvement in his knee joint infection.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"4427-4434"},"PeriodicalIF":2.9,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12399890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992420","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":"Investigation into Antibiotic Resistance Profiles of <i>Staphylococcus aureus</i> Among Chronic Rhinosinusitis Patients and Multifaceted Analysis of Factors Influencing Methicillin-Resistant <i>Staphylococcus aureus</i> Infection.","authors":"Mingqiu Liu, Feng Sun, Yongli Qi, Wenjing Qi, Junyi Li","doi":"10.2147/IDR.S546894","DOIUrl":"10.2147/IDR.S546894","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to comprehensively investigate the antibiotic resistance characteristics of <i>Staphylococcus aureus (S. aureus)</i> in chronic rhinosinusitis (CRS) patients and to identify key determinants influencing the development of methicillin-resistant Staphylococcus aureus (MRSA) infections.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 180 CRS patients admitted to our hospital between February 2022 and July 2024. Nasal secretion samples were collected upon admission for <i>S. aureus</i> strain isolation, and antibiotic susceptibility testing was performed using an automated microbiology system. Patients were categorized into MRSA and methicillin-sensitive Staphylococcus aureus (MSSA) groups based on oxacillin resistance. Univariate analysis was used to screen potential risk factors, followed by multivariate logistic regression to determine independent predictors.</p><p><strong>Results: </strong>Among 180 isolated <i>S. aureus</i> strains, 74 (41.1%) were MRSA and 106 (58.9%) were MSSA. MRSA strains exhibited significantly higher resistance rates to cefoxitin, amikacin, ciprofloxacin, and six other antibiotic classes compared to MSSA strains (all P<0.05), with resistance exceeding 50% for fluoroquinolones and macrolides. Univariate analysis identified 12 clinical factors associated with MRSA infection, including male sex, smoking history, disease duration >5 years, and frequent antibiotic use. Multivariate regression analysis confirmed nine independent risk factors: male sex (OR=2.31), nasal structural abnormalities (OR=1.89), previous nasal surgery (OR=1.76), ≥3 acute infections per year (OR=2.14), excessive antibiotic exposure, and others.</p><p><strong>Conclusion: </strong>MRSA exhibits pronounced resistance to commonly used antibiotics in CRS treatment. Clinicians should prioritize targeted screening for high-risk patients, optimize antibiotic stewardship, and enhance postoperative nasal function management. Implementing a multifaceted approach-including early risk assessment, standardized antibiotic use, and intensified follow-up care-can effectively mitigate MRSA infection risks and improve overall treatment outcomes for CRS patients.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"4363-4371"},"PeriodicalIF":2.9,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12399101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952497","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":"Trends and Characteristics of Pertussis Epidemic in Pediatric Patients During and After the COVID-19 Pandemic in East China.","authors":"Linli Wang, Meiying Gao, Ying Chen, Qing Gu, Lejing Guan, Lidan Sun, Antonita Shereen George, Abdul Rafay, Yang Yang, Guannan Bai","doi":"10.2147/IDR.S527009","DOIUrl":"10.2147/IDR.S527009","url":null,"abstract":"<p><strong>Background: </strong>Pertussis is a highly contagious respiratory disease caused by Bordetella pertussis, posing a significant health threat to children. Despite vaccination efforts, a resurgence of pertussis has been observed globally, especially during and after the COVID-19 pandemic. This study aims to investigate the epidemiological trends and characteristics of pertussis among pediatric patients during and after the COVID-19 pandemic in East China.</p><p><strong>Methods: </strong>We included 92,300 patients aged 0-18 years with suspected symptoms of pertussis infection from January 1, 2022, to November 30, 2024, in a tertiary children's hospital in China. Clinical information (eg, detection date, date of birth, gender, type of patients) and pertussis test results were extracted from the laboratory information system. We used two independent sample <i>t</i>-tests and Chi-square tests to compare differences in the above-mentioned variables between the two pandemic phases. Positive detection rates were calculated across age groups, gender, patient types, seasons, and pandemic phases, while nonlinear associations between age and detection rates were assessed using restricted cubic spline regression models.</p><p><strong>Results: </strong>Twenty-two thousand six hundred and forty-two (24.5%) cases were detected as positive cases. Cases surged from November 2023, peaking in April 2024 (n=5363). The highest positive detection rate of pertussis infection was observed in children aged over 6 years (36.2%), particularly among outpatients (37.6%), while the lowest rate was in those aged 18 months to 3 years (12.8%); significant differences were also noted by gender, patient type, season, and COVID-19 pandemic phases (<i>p</i> < 0.05). Nonlinear regression analysis shows a higher risk and wider susceptible age range after the COVID-19 pandemic than those during the pandemic (<i>p</i> _non-linear < 0.001).</p><p><strong>Conclusion: </strong>This study highlights the resurgence of pertussis among children in Eastern China during and after the COVID-19 pandemic, emphasizing significant epidemiological shifts and expanded age susceptibility, underscoring the urgent need for enhanced vaccination strategies and public health interventions.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"4351-4361"},"PeriodicalIF":2.9,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12398290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952583","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":"Multidrug-Resistant <i>Elizabethkingia anophelis</i> Bacteremia in Northern Taiwan: Focusing on Prognostic Factors and Antimicrobial Susceptibility to Minocycline and Rifampin.","authors":"Wei-Lun Chuang, Fu-Chieh Chang, Chien-Feng Kuo, Chih-Chen Lin","doi":"10.2147/IDR.S536057","DOIUrl":"10.2147/IDR.S536057","url":null,"abstract":"<p><strong>Purpose: </strong><i>Elizabethkingia anophelis</i> is an emerging multidrug-resistant pathogen associated with high mortality, particularly in healthcare-associated bacteremia. Treatment is complicated by frequent species misidentification and limited availability of effective antibiotics. This study aimed to investigate the clinical characteristics, predictors of early and late mortality, and antimicrobial resistance profiles, including associated resistance genes.</p><p><strong>Patients and methods: </strong>A retrospective cohort study was conducted from 2018 to 2022 at a center in northern Taiwan, involving patients with <i>E. anophelis</i> bacteremia. Demographic and clinical data, including comorbidities and laboratory parameters, were collected. Clinical severity was assessed using the Pitt bacteremia score. Bacterial isolates were identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and species-specific polymerase chain reaction. Antimicrobial susceptibility was determined using broth microdilution, and resistance genes were detected by PCR.</p><p><strong>Results: </strong>The 14-day and 28-day mortality rates after admission were 35% and 40%, respectively. The 14-day mortality rate was associated with high Pitt bacteremia scores, chronic kidney disease, anemia, and hyperbilirubinemia. Anemia and high Pitt bacteremia scores were consistently associated with 28-day mortality. Most isolates were phenotypically resistant to β-lactams, fluoroquinolones, and trimethoprim-sulfamethoxazole, while susceptibility to minocycline (1.6%) and rifampin (9.5%) was preserved. The detected resistance genes included multiple determinants (<i>bla_B, bla_GOB, bla_CME</i> , and <i>dfrE</i>), with a notable absence of <i>arr-1</i>.</p><p><strong>Conclusion: </strong><i>E. anophelis</i> bacteremia is associated with higher mortality and multidrug resistance. Prognosis is significantly influenced by host factors and specific laboratory findings. Given the high resistance of these bacteria to traditional antibiotics, minocycline and rifampin may serve as key treatment options when susceptibility is confirmed. Further studies are needed to validate their clinical efficacy, dosing, and combination strategies.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"4337-4349"},"PeriodicalIF":2.9,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12399793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992445","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}