Infection and Drug Resistance最新文献

{"title":"The First Case of <i>Candida auris</i> Detection and Infection Control in a Pediatric Bone Marrow Transplant Child Patient in Guangxi, China.","authors":"Liu Yang, Kaiting Hong, Jiajia Luo, Lili Wang, Lei Zhang, Lijun Jiang, Qiliu Peng, Jian Guo","doi":"10.2147/IDR.S490696","DOIUrl":"10.2147/IDR.S490696","url":null,"abstract":"<p><p><i>Candida auris</i> is an emerging yeast species and an opportunistic pathogen. Due to its multi-drug resistance and ability to colonize and transmit, it poses a significant risk for outbreaks in medical institutions. In this study, we report the first case of <i>C. auris</i> detected in a pediatric bone marrow transplant child patient in Guangxi, China. <i>C. auris</i> was isolated from urine and identified using matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry, and the isolate belonged to clade I using sequencing. We have implemented stringent infection control measures including personal protective equipment and treatment in a single room, and conducted regular surveillance screening of patients' body surfaces, as well as those of related medical and logistics personnel, medical equipment, and surrounding environmental surfaces. These measures aim to effectively control the colonization of <i>C. auris</i> in patients, prevent its spread within hospitals, and ensure the quality of diagnosis and treatment for patients.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"127-133"},"PeriodicalIF":2.9,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11720992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970605","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":"Aggressive Infection by K1/ST1265 <i>Klebsiella pneumoniae</i> Leading to Multiple Abscesses: Case Report and Literature Review.","authors":"Lina Chen, Canhu Qiu, Ye Lu, Jianqing Lin, Liping Xu","doi":"10.2147/IDR.S489161","DOIUrl":"https://doi.org/10.2147/IDR.S489161","url":null,"abstract":"<p><p>Hypervirulent <i>Klebsiella pneumoniae</i> (hvKp) has attracted increasing attention in recent years. Diabetes and serotype K1 or K2 are risk factors for invasive liver abscess syndrome including liver abscesses and the metastatic complications such as bacteremia, meningitis, endophthalmitis, and necrotizing fasciitis. Simultaneous infections of the liver, lungs, prostate, brain, and eyes are exceedingly rare. In this paper, a 41-year-old male patient who presented with a 4-day history of fever with polydipsia and polyuria and untreated diabetes deteriorated dramatically with sepsis, prostate abscess, lung abscess, liver abscess and intracranial infection as well as endophthalmitis. He was diagnosed with infection by K1/ST1265 hypervirulent <i>Klebsiella pneumoniae</i> and after treatment with antibiotics and abscess drainage, while the patient still passed away. K1/ST1265 hvKp exhibits exceptionally high virulence and invasiveness, necessitating broad awareness and vigilant monitoring.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"43-49"},"PeriodicalIF":2.9,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142948133","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":"Etiology, Risk Factors, and Antimicrobial Resistance in Recurrent Pyogenic Liver Abscesses: A Six-Year Analysis.","authors":"JinHua Cui, YaMan Liu, Hua Fu, MiaoHang Cui, JiZhong Li, ZiYu Bai, Jian Li","doi":"10.2147/IDR.S492544","DOIUrl":"https://doi.org/10.2147/IDR.S492544","url":null,"abstract":"<p><strong>Aim: </strong>To perform a comparative analysis of the clinical data of patients with and without recurrent pyogenic liver abscess and explore the influencing factors, clinical characteristics, and pathogenic bacteria associated with the recurrence of liver abscesses.</p><p><strong>Patients and methods: </strong>A retrospective analysis was conducted on 436 recently diagnosed patients with pyogenic liver abscess admitted to the Affiliated Hospital of Chengde Medical College between June 2017 and June 2023. Patients with recurrence comprised the observation group, whereas those without recurrence comprised the control group.This analysis included the examination of clinical characteristics, pathogens, drug resistance patterns, and treatment modalities. Additionally, regression analysis was employed to investigate the factors influencing liver abscess recurrence.</p><p><strong>Results: </strong>Of 436 patients initially diagnosed with pyogenic liver abscess, 58 experienced recurrence. The proportion of <i>Escherichia coli</i> infection was 23.3% in the observation group and 10.3% in the control group, indicating a statistically significant difference. Multivariate analysis identified diabetes mellitus and cerebral infarction as significant risk factors for recurrent pyogenic liver abscess.</p><p><strong>Conclusion: </strong>In comparison with patients without recurrence, those who experienced recurrent pyogenic liver abscess following initial diagnosis exhibited a higher prevalence of <i>E. coli</i> as a pathogenic bacterium. In addition, a history of diabetes mellitus and cerebral infarction are high-risk factors for with pyogenic liver abscess recurrence for the first time.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"15-23"},"PeriodicalIF":2.9,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142948146","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 Rare Q-Fever Infection Diagnosed Using Metagenomic Next-Generation Sequencing in Liver Transplantation Patient: A Case Report and Literature Review.","authors":"Xinxin Niu, Shuang Qiu, Yafeng Zheng, Li Li, Eryun Tian, Jie Liu, Wei Gai, Qing Zhang, Hailong Jin","doi":"10.2147/IDR.S485083","DOIUrl":"https://doi.org/10.2147/IDR.S485083","url":null,"abstract":"<p><p>Q fever is a zoonotic disease caused by the Gram-negative bacterium <i>Coxiella burnetii</i>, typically transmitted through exposure to infected animal secretions. As the clinical signs of Q-fever are largely non-specific in humans, a definitive diagnosis can often be overlooked, particularly when physicians fail to consider <i>C. burnetii</i> on the list of differentials. This case report describes Q-fever in a male patient who had previously undergone orthotopic liver transplantation. The patient had a sudden onset of fever and received the anti-infective moxifloxacin which proved ineffective. Despite the comprehensive laboratory tests and CT imaging that were performed, the etiology remained undetermined. The patient's blood was subjected to metagenomic next-generation sequencing (mNGS), which identified <i>C. burnetii</i>, after which the patient was treated with doxycycline and recovered well. Eight literature articles on Q fever infection in solid organ transplant recipients were reviewed. To our knowledge, this is the first case of Q fever identified by mNGS in an organ transplantation patient. The case underscores the potential of mNGS has in aiding the rapid detection of rare pathogens in immunocompromised patients.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"25-30"},"PeriodicalIF":2.9,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142948128","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":"Deep Learning for Discrimination of Early Spinal Tuberculosis from Acute Osteoporotic Vertebral Fracture on CT.","authors":"Wenjun Liu, Jin Wang, Yiting Lei, Peng Liu, Zhenghan Han, Shichu Wang, Bo Liu","doi":"10.2147/IDR.S482584","DOIUrl":"10.2147/IDR.S482584","url":null,"abstract":"<p><strong>Background: </strong>Early differentiation between spinal tuberculosis (STB) and acute osteoporotic vertebral compression fracture (OVCF) is crucial for determining the appropriate clinical management and treatment pathway, thereby significantly impacting patient outcomes.</p><p><strong>Objective: </strong>To evaluate the efficacy of deep learning (DL) models using reconstructed sagittal CT images in the differentiation of early STB from acute OVCF, with the aim of enhancing diagnostic precision, reducing reliance on MRI and biopsies, and minimizing the risks of misdiagnosis.</p><p><strong>Methods: </strong>Data were collected from 373 patients, with 302 patients recruited from a university-affiliated hospital serving as the training and internal validation sets, and an additional 71 patients from another university-affiliated hospital serving as the external validation set. MVITV2, Efficient-Net-B5, ResNet101, and ResNet50 were used as the backbone networks for DL model development, training, and validation. Model evaluation was based on accuracy, precision, sensitivity, F1 score, and area under the curve (AUC). The performance of the DL models was compared with the diagnostic accuracy of two spine surgeons who performed a blinded review.</p><p><strong>Results: </strong>The MVITV2 model outperformed other architectures in the internal validation set, achieving accuracy of 98.98%, precision of 100%, sensitivity of 97.97%, F1 score of 98.98%, and AUC of 0.997. The performance of the DL models notably exceeded that of the spine surgeons, who achieved accuracy rates of 77.38% and 93.56%. The external validation confirmed the models' robustness and generalizability.</p><p><strong>Conclusion: </strong>The DL models significantly improved the differentiation between STB and OVCF, surpassing experienced spine surgeons in diagnostic accuracy. These models offer a promising alternative to traditional imaging and invasive procedures, potentially promoting early and accurate diagnosis, reducing healthcare costs, and improving patient outcomes. The findings underscore the potential of artificial intelligence for revolutionizing spinal disease diagnostics, and have substantial clinical implications.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"31-42"},"PeriodicalIF":2.9,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142948145","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":"Molecular Epidemiology and Genetic Characterization of Carbapenem-Resistant <i>Acinetobacter baumannii</i> Isolates from the ICU of a Tertiary Hospital in East China.","authors":"Lili Liu, Yuan Huang, Yaping Wang, Yunlan Jiang, Kang Liu, Zhongxia Pei, Zhiping Li, Yuqiong Zhu, Dan Liu, Xiaoyue Li","doi":"10.2147/IDR.S491858","DOIUrl":"https://doi.org/10.2147/IDR.S491858","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the clinical characteristics, antimicrobial resistance (AMR) phenotypes and genotypes, and homology features of carbapenem-resistant <i>Acinetobacter baumannii</i> (CRAB) in intensive care unit (ICU) and to provide basis for effectively prevention, control and treatment of nosocomial infections caused by CRAB.</p><p><strong>Methods: </strong>A total of 39 CRAB strains isolated from hospitalized patients in the ICU and neurosurgical ICU (NICU) between 2020 and 2023 were subjected to antimicrobial susceptibility testing and whole-genome sequencing (WGS). Virulence factor genes (VFGs), antimicrobial resistance genes (ARGs), multilocus sequencing typing (MLST), complete genome multilocus sequencing typing (cgMLST), average nucleotide identity (ANI), and single nucleotide polymorphism (SNP) analyses were performed using WGS.</p><p><strong>Results: </strong>All CRAB strains were 100% resistant to ciprofloxacin, ceftazidime, piperacillin/tazobactam, and ticarcillin/clavulanic acid. A total of 48 antimicrobial resistance genes (ARGs) were found in the 39 CRAB strains, including <i>bla</i>OXA-66, <i>bla</i>OXA-23, <i>bla</i>ADC-30, <i>bla</i>ADC-73, <i>gyrA, ant(3″)-IIa, aph(3″)-Ib, aph(6)-Id, tetB, tetR, sul1, sul2, LpxC and LpxA</i> which confered resistance to carbapenems, cephalosporins, fluoroquinolones, aminoglycosides, tetracycline and sulfonamides. There were 128 VFGs, including genes encoding the AdeFGH efflux pump, lipopolysaccharide (LpsBLC), outer membrane protein A (OmpA), penicillin-binding protein (PbpG), biofilm-associated proteins (bap, pgaBCD, CsuABCDE), type VI secretion system protein (Tss), quorum sensing protein (AbaI/AbaR). Six clonal lineages were identified by Oxford MLST method, whereas one sequence type (ST2) was identified using the Pasteur MLST method. ANI analysis, heat map of SNP analysis, and phylogenetic tree based on core SNP revealed six clusters, and the strain classification results were consistent with these different methods. Ten clonal lineages were identified by cgMLST.</p><p><strong>Conclusion: </strong>The CRAB strains were ST2 clones accompanied by severe resistance to commonly used antibiotics and abundant ARGs and VFGs in genotype. Strict measures should be implemented to prevent and control transmissions and infections. CgMLST and SNPs analyses showed excellent discriminatory power in homology analysis.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"17 ","pages":"5925-5945"},"PeriodicalIF":2.9,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931749","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 Susceptibility of Pathogenic Enterobacteria Strains from Three Biotopes in the City of Ouagadougou (Burkina Faso).","authors":"Sanhitouo Charlemagne Dabiré, Marius K Somda, Léon W Nitièma, Dinanibè Kambiré, Samiratou Kiemtoré, Serge Théophile Soubeiga, Abdou Azaque Zouré, Konan Kouakou Toussaint Yao, Tegwindé Rebeca Compaoré, Henri Gautier Ouedraogo, Mamoudou H Dicko","doi":"10.2147/IDR.S485200","DOIUrl":"https://doi.org/10.2147/IDR.S485200","url":null,"abstract":"<p><strong>Purpose: </strong>The emergence of antibiotic resistance in pathogenic <i>Enterobacteriaceae</i> is a public health problem in tropical countries such as Burkina Faso. Antibiotic resistance could be identified using a variety of approaches. This study aimed to estimate the prevalence of pathogenic enterobacteria strains from three sources, as well as their antibiotic resistance profile to biotope and climatic season.</p><p><strong>Material and methods: </strong>The methodological approach consisted of identifying <i>Enterobacteriaceae</i> from human (urine, stool), animal (eggs, milk, fish), and environmental (soil, lettuce) samples, followed by assessing their antibiotic susceptibility. Samples were collected from February to December 2023. Bacterial species were isolated and phenotypically identified (morphologically, culturally, biochemically, and antigenically) using standard methods. The prevalence of bacterial susceptibility to ten antibiotics was determined using the agar disk diffusion method. The collected data were analyzed with IBM SPSS Statistics 25 software.</p><p><strong>Results: </strong>A total of 615 <i>Enterobacteriaceae</i> isolates were collected, including 300, 168, and 147 samples from human, animal, and environmental sources respectively. Phenotypic characteristics allowed to partially identify 43 species, among these 29.76% belonged to <i>Escherichia coli</i>, 24.72% <i>to Enterobacter cloacae</i>, 13.<i>82% to Klebsiella pneumoniae, 3.41% to Enterobacter sakazakii</i> and 2.6% to <i>Klebsiella oxytoca</i>. Bacterial resistance rates were: aminopenicillins (54.8%), first-generation cephalosporins (35.3%), sulfonamides (33.3%), third-generation cephalosporins (30.7%), fourth-generation cephalosporins (22.5%), fluoroquinolones (21.8%), phenicols (16.8%), and carbapenems (16.2%). The distribution of antibiotic resistance was 45.3% from human sources, 19.3% from animal sources, and 13.8% from environmental sources.</p><p><strong>Conclusion: </strong>The results indicate that resistant bacteria can come from any of the three biotopes, with human origin being the most frequent. The high prevalence of resistance to the antibiotics tested in isolated bacteria raises interest in investigating the genetic factors responsible.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"17 ","pages":"5909-5924"},"PeriodicalIF":2.9,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931755","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":"Population Pharmacokinetics and Dosing Optimization of Norvancomycin for Chinese Patients with Community-Acquired Pneumonia.","authors":"Yaqian Li, Xiaodan Jiao, Guozhu Sun, Fuxu Wang, Xikun Wu, Weichong Dong, Wenpeng Lu, Zhiyong Zhang, Yadong Yuan, Zhiqing Zhang","doi":"10.2147/IDR.S496776","DOIUrl":"10.2147/IDR.S496776","url":null,"abstract":"<p><strong>Purpose: </strong>Determining the optimal dosage of norvancomycin (NVCM) for Chinese patients with community-acquired pneumonia (CAP) caused by gram-positive cocci remains uncertain. This research aimed to identify influential factors affecting NVCM pharmacokinetics and explore optimal dosage regimens via population pharmacokinetic (PPK) analysis.</p><p><strong>Patients and methods: </strong>A prospective analysis was conducted at the Second Hospital of Hebei Medical University (Shijiazhuang, China). CAP patients aged ≥18 years and receiving intravenous NVCM were enrolled. Each patient underwent the collection of 3-8 blood samples for analysis during the treatment. Nonlinear mixed effect model (NONMEM) software was used to develop PPK models, while Monte Carlo simulations were employed to optimize dose regimens. Pharmacokinetic-pharmacodynamic (PK/PD) breakpoint was defined as daily area under the concentration on the second day of therapy to minimum inhibitory concentration ratio (AUC_24-48h/MIC) ≥361, and a steady-state AUC to MIC radio (AUC_ss,24h/MIC) ≥361.</p><p><strong>Results: </strong>A prospective PPK analysis of 231 NVCM concentrations was performed in 34 patients. A two-compartment model with first-order elimination adequately described the pharmacokinetics. The population typical clearance (CL) of NVCM was 3.15 L/h, and the central volume of distribution was 12.3 L. Notably, CL exhibited significant correlations with age and serum creatinine (Scr) levels. For mild or moderate CAP patients, the recommended doses were 400-800 mg every 12 h to achieve the target exposure with AUC_ss,24h/MIC ≥361. For community-acquired methicillin-resistant <i>Staphylococcus aureus</i> (CA-MRSA) pneumonia, the suggested dosage regimen was 600-800 mg every 8 h, which could achieve the target exposure preferably within the initial 24 to 48 h.</p><p><strong>Conclusion: </strong>Age and Scr levels significantly influenced the pharmacokinetic parameters of NVCM in CAP patients. Our model-informed precision dosing approach may help for early optimization of NVCM exposure. Further prospective studies with larger samples will be needed.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"17 ","pages":"5881-5893"},"PeriodicalIF":2.9,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11687313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914472","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 Lumbar Drug-Resistant Tuberculosis: A Case Report and Review of Literature.","authors":"Tao Li, Shaohua Liu","doi":"10.2147/IDR.S504519","DOIUrl":"10.2147/IDR.S504519","url":null,"abstract":"<p><strong>Introduction: </strong>Tuberculosis is prevalent in high-burden countries. However, spinal multi-drug resistant tuberculosis (MDR-TB) in patients with normal immune function is a disease that is prone to misdiagnosis and even delayed diagnosis. Recently, we successfully treated one such patient.</p><p><strong>Case presentation: </strong>A 46-year-old male patients with lower back pain associated with recurrent fever 2 months before admission. The patient was misdiagnosed as a suppurative spinal infection and failed to respond to treatment for 2 months. The muscle strength of both lower limbs decreased progressively. We performed two operations to clear the lesion and decompress the spinal canal, during which we found a fish-like inflammatory tissue mimicking a suppurative infection. Finally, the patient was diagnosed with lumbar MDR-TB by culture, Xpert MTB/RIF and metagenomic next-generation sequencing (mNGS). The second-line anti-tuberculosis treatment (ATT) is cycloserine + para-aminosalicylic acid + ethambutol + levofloxacin + linezolid. Finally, the patient's symptoms were relieved and the muscle strength of both lower limbs recovered.</p><p><strong>Conclusion: </strong>This case prompt MDR-TB of the spine is not a typical clinical symptoms and imaging examination is the lack of specificity, when for the diagnosis of patients with spinal bone destruction unclear or treatment is invalid, can diagnostic anti-tuberculosis treatment. For patients with spinal instability or spinal canal occupying, early surgical removal of lesions, tissue culture, Xpert MTB/RIF and mNGS to identify pathogens and drug resistance, timely diagnosis and treatment can maximize the prognosis of spinal MDR-TB.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"17 ","pages":"5867-5873"},"PeriodicalIF":2.9,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11687309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914692","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":"Clinical Differences Between Survivors and Non-Survivors of Ventilator-Associated Pneumonia: The Roles of Sulbactam/Ampicillin and Methicillin-Resistant <i>Staphylococcus aureus</i>.","authors":"Masafumi Seki, Anna Takimoto, Manabu Inoue, Kazuya Niiyama, Ayumu Masuoka, Futoshi Kotajima","doi":"10.2147/IDR.S497536","DOIUrl":"10.2147/IDR.S497536","url":null,"abstract":"<p><strong>Background: </strong>Ventilator-associated pneumonia (VAP) is one of the most lethal complications in intensive care unit (ICU) patients. However, critical issues of non-survivors vary and are still unclear in VAP patients.</p><p><strong>Methods: </strong>The clinical differences between survivors and non-survivors of VAP were retrospectively analyzed in patients hospitalized from April 2023 to March 2024.</p><p><strong>Results: </strong>Of a total of 42 VAP patients, 22 (52.4%) survived, and 20 died. Survivors were significantly younger (69.1 vs 71.7 years, p < 0.01) and received sulbactam/ampicillin (SAM) as the initial antibiotics, significantly more (45.5% vs 10%, p = 0.006) than non-survivors. The male/female ratio and wards where they were managed were similar in both groups, but methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) was detected significantly more frequently in non-survivors (4/4 = 100%).</p><p><strong>Conclusion: </strong>These data suggest that VAP patients who survived were younger and received treatment with narrow-spectrum antibiotics, such as SAM. Isolation of MRSA might be critical. These findings could influence antibiotic protocols and ICU management strategies to prevent infection with resistant bacteria to improve the prognosis of patients with VAP.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"17 ","pages":"5875-5879"},"PeriodicalIF":2.9,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921592","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}