Infection and Drug Resistance最新文献

{"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}

{"title":"Pathogenesis and Triazole Resistance in <i>Aspergillus fumigatus</i>: A Narrative Review Across the Host Immune Spectrum and One Health Context.","authors":"Tianfang Chen, Yelu Yao, Jianwu Chen, Huoyang Lv, Peng Nan","doi":"10.2147/IDR.S629247","DOIUrl":"10.2147/IDR.S629247","url":null,"abstract":"<p><p>This narrative review explores triazole resistance and pathogenesis of <i>Aspergillus fumigatus (A. fumigatus)</i> under a unified One Health framework, integrating evidence across host immune spectrums, agricultural environmental selection pressures, veterinary aspergillosis and clinical antifungal management. We illustrate layered host-fungus immune interactions underlying distinct clinical aspergillosis phenotypes, and delineate core resistance mechanisms including <i>cyp51</i>-related target alterations, enhanced efflux pump activity, biofilm-mediated tolerance and adaptive stress response rewiring. Special emphasis is placed on cross-sector transmission pathways of azole-resistant <i>A. fumigatus</i> (ARAF) originating from agricultural ecosystems, as well as surveillance deficits and public health risks linked to animal intermediate hosts. Novel antifungal agents, such as olorofim, fosmanogepix, rezafungin, ibrexafungerp, and T-2307, along with targeted delivery and immunomodulatory adjunct therapies for resistant aspergillosis, are also summarized. Literature published 2020-2026 was retrieved from PubMed via Boolean search strategies, with supplementary manual screening of landmark reference lists to include pivotal earlier studies. Only peer-reviewed original studies, epidemiological surveillance reports, and review articles with complete clinical or experimental datasets were incorporated following rigorous screening. Most studies discuss clinical or agricultural resistance separately, lacking integrated analyses covering human, animal, and environmental dimensions. Major knowledge gaps persist regarding horizontal gene transfer of resistance mutations, cross-species transmission chains, and translational applications of environmental monitoring data. This review summarizes existing research bottlenecks and proposes integrated multi-sector prevention and control strategies from a One Health perspective to curb the growing threat of triazole-resistant aspergillosis.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"629247"},"PeriodicalIF":3.2,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963139","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":"Shapiro Decision Rule, Systemic Inflammatory Response Index, and Systemic Immune-Inflammation Index as Rapid Predictors of Bacteremia in Emergency Department Patients.","authors":"Dewi Kartika Turbawaty, Levina Felicia, Ratu Purwanti","doi":"10.2147/IDR.S619432","DOIUrl":"10.2147/IDR.S619432","url":null,"abstract":"<p><strong>Purpose: </strong>Bacteremia is a serious condition that can progress to sepsis, septic shock, and multiple organ dysfunction syndrome (MODS) if not promptly treated. Blood culture is the gold standard for diagnosis but has a long turnaround time, low positivity, and risk of false positives, often leading to excessive culture sampling in the emergency department (ED). The Shapiro Decision Rule (SDR), Systemic Inflammatory Response Index (SIRI), and Systemic Immune-Inflammation Index (SII) offer rapid, low-cost alternatives. This study compared their accuracy for predicting bacteremia in ED patients undergoing blood culture.</p><p><strong>Patients and methods: </strong>This retrospective, single-center cross-sectional study included adult ED patients at Dr. Hasan Sadikin General Hospital, Bandung (May 2023-July 2025) who underwent blood culture and complete hematology testing. Patients with prior antibiotics (within 48 h), immunosuppression, active hematological disorders, or contaminated cultures were excluded. Sensitivity, specificity, predictive values, Youden index, ROC-AUC, the DeLong test, and multivariable logistic regression were computed in SPSS v25.</p><p><strong>Results: </strong>Of 745 patients meeting inclusion, 216 (29%) had positive cultures; the full eligible cohort was then analyzed, comprising 481 patients (111 with confirmed bacteremia, 370 without; prevalence 23.1%). SDR showed the highest discrimination (sensitivity 87.4%, specificity 51.9%; AUC 0.696, 95% CI 0.653-0.737; p<0.001), outperforming SIRI (79.3%, 41.4%; AUC 0.601, 95% CI 0.556-0.645; p<0.001) and SII (76.6%, 28.9%; AUC 0.508, 95% CI 0.462-0.554; p=0.799). The DeLong test confirmed SDR's AUC significantly exceeded those of SIRI and SII, and SDR remained an independent predictor of bacteremia after adjustment for heart failure and chronic kidney disease (p<0.001).</p><p><strong>Conclusion: </strong>The Shapiro Decision Rule is significantly superior to the simple hematological indices SIRI and SII for predicting bacteremia with an AUC indicating moderate discrimination. It retains value as a practical exclusion tool to help rationalize blood-culture requests in the ED. Given the retrospective, single-center design, external validation is warranted before routine adoption.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"619432"},"PeriodicalIF":3.2,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963080","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":"Multiple Deep Abscesses Caused by Disseminated <i>Nocardia farcinica</i> Infection After Immunosuppressive Treatment for Membranous Nephropathy: A Case Report and Literature Review.","authors":"Chunmei Zhang, Jie Zhu, Juan Luo, Xiang Hu, Hongmei Liu, Jie Liu, Meijuan Shi","doi":"10.2147/IDR.S636193","DOIUrl":"10.2147/IDR.S636193","url":null,"abstract":"<p><p><i>Nocardia farcinica</i> is a highly virulent opportunistic pathogen with a marked propensity to cause disseminated infection in immunocompromised hosts. Its clinical manifestations are often nonspecific, conventional empirical anti-infective therapy may be ineffective, and both misdiagnosis and mortality rates remain high. We report the case of a 20-year-old man with membranous nephropathy who developed multiple cutaneous and deep soft-tissue abscesses, fever, and pulmonary infiltrates after 7 months of dual immunosuppressive therapy with methylprednisolone and tacrolimus. Initial empirical treatment with oxacillin plus moxifloxacin failed to control the infection, and the patient continued to experience high fever with persistently elevated inflammatory markers. Direct smear examination of pus specimens showed weakly acid-fast, branching filamentous organisms, and culture followed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) identified the pathogen as <i>Nocardia farcinica</i>. According to antimicrobial susceptibility testing, therapy was adjusted to trimethoprim-sulfamethoxazole (SMZ-TMP) combined with amoxicillin/clavulanate potassium. The patient subsequently became afebrile, the abscesses gradually decreased in size, and inflammatory markers improved substantially. After clinical stabilization, he was discharged on continued oral anti-infective therapy and showed no evidence of recurrence during 12 months of outpatient follow-up. Together with a review of the literature, this report discusses the clinical features, etiological diagnostic strategies, and susceptibility-guided anti-infective regimens for disseminated <i>Nocardia farcinica</i> infection in immunosuppressed patients, with the aim of providing a practical reference for clinical diagnosis and treatment.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"636193"},"PeriodicalIF":3.2,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963023","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 Simple Scoring System Based on CRP/Alb Ratio, Fasting Glucose, and Surgery Duration for Predicting Postoperative Infection in Older Adult Patients with Intertrochanteric Femoral Fracture: A Retrospective Cohort Study.","authors":"Jinyang Li, Hongmin Yuan, Yanli Niu","doi":"10.2147/IDR.S633705","DOIUrl":"10.2147/IDR.S633705","url":null,"abstract":"<p><strong>Background: </strong>Postoperative infection is a serious complication in older adults undergoing surgery for intertrochanteric femoral fracture (IFF). This study aimed to develop a simple scoring system and nomogram for predicting postoperative infection using routinely available preoperative indicators.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 286 older adult IFF patients (25 with postoperative infection, 261 without) treated at a single tertiary hospital. Optimal cut-off values were determined using the Youden index. Univariate and multivariate logistic regression identified independent risk factors. A nomogram and a simple scoring system (0-3 points) were constructed. Model performance was assessed by AUC, calibration curve, and subgroup analyses. Bootstrap resampling (500 iterations) was used for internal validation.</p><p><strong>Results: </strong>Multivariate analysis confirmed the CRP/albumin ratio (OR = 2582.84, 95% CI: 201.44-67,929.9, <i>p</i> < 0.001), fasting glucose (OR = 2.82, 95% CI: 1.32-6.73, <i>p</i> = 0.011), and surgery duration (OR = 1.06, 95% CI: 1.01-1.12, <i>p</i> = 0.020) as independent predictors. Optimal cut-offs were 1.85 (CRP/albumin), 7.6 mmol/L (glucose), and 89 minutes (surgery). The scoring system showed infection rates of 0%, 5.6%, 40.9%, and 100% for scores 0, 1, 2, and 3, respectively, with an AUC of 0.932. The full model achieved an AUC of 0.951, with Bootstrap-corrected AUC of 0.945 (95% CI: 0.923-0.951). Calibration was satisfactory (Hosmer-Lemeshow, <i>p</i> = 0.327). Subgroup analyses demonstrated robust performance across gender, BMI, and age groups, with AUCs ranging from 0.922 to 0.982.</p><p><strong>Conclusion: </strong>In this single-center retrospective cohort, the CRP/albumin ratio, fasting glucose, and surgery duration were independent predictors of postoperative infection in older adults with IFF. The proposed simple scoring system and nomogram provide practical tools for risk stratification; however, external validation in multicenter prospective cohorts is warranted before widespread clinical implementation.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"633705"},"PeriodicalIF":3.2,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148962895","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":"Determinants of HIV, Hepatitis B, and Hepatitis C Infections Among Preoperative Patients in a Tertiary Hospital in the Eastern Democratic Republic of Congo.","authors":"Tony Akilimali Shindano, Pacifique Mufungizi Cinamula, Fabrice Gulimwentuga Cikomola, David Mwenebitu Lupande","doi":"10.2147/IDR.S621922","DOIUrl":"10.2147/IDR.S621922","url":null,"abstract":"<p><strong>Background: </strong>Human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) are three of the most common occupational infections due to blood-borne infectious diseases. Surgeons are particularly at risk, especially in countries with high endemicity, such as the Democratic Republic of the Congo (DRC). Assessing the burden of these viruses among preoperative patients could help evaluate the level of risk.</p><p><strong>Methods: </strong>This was a retrospective cross-sectional study carried out in the departments of Surgery and Gynecology of a tertiary care hospital in Bukavu, in eastern DRC. Standard enzyme immunoassays were used to determine the serology for HIV (anti-HIV Ab), HBV (HBsAg), and HCV (anti-HCV Ab) as a part of the routine minimum preoperative assessment. The frequency and risk factors of positive tests were evaluated, as well as factors for non-performance of these tests.</p><p><strong>Results: </strong>Of patients who underwent surgery (2092), only 1871 performed at least one serological test (89.4%). A positive HIV serology test was observed in 39/1861 patients (2.1%), while 69/1870 and 43/1871 patients had reactivity to HBsAg (3.37%) and anti-HCV (2.29%), respectively. The female/male ratio showed statistically significant differences for these three viruses, respectively. Among the risk factors studied, age and male gender appear to influence HBsAg and anti-HCV reactivity, whereas a history of transfusion or tattooing was found to be statistically significant in patients with positive HBsAg serology, and previous surgery has been more commonly observed in cases of anti-HCV reactivity.</p><p><strong>Conclusion: </strong>The rate of HIV, HBV, and HCV infection in this patient population was similar to that of the national level, although higher rates are observed among some subgroups. In any case, surgeons should maintain systematic universal protective measures since the cost-effectiveness of screening based on the presence of risk factors has not yet been clearly demonstrated.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"621922"},"PeriodicalIF":3.2,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148962972","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":"Factors Associated with Active Tuberculosis Disease in Patients with Lung Cancer Following Immune Checkpoint Blockade Therapy: A Retrospective Cohort Study and Case Reports.","authors":"Xiao Wang, Yu-Xiao Wu, Wei-Ping Hu, Yue Ren, Jing Zhang","doi":"10.2147/IDR.S627263","DOIUrl":"10.2147/IDR.S627263","url":null,"abstract":"<p><strong>Background: </strong>Immune checkpoint inhibitors (ICIs) have revolutionized lung cancer treatment by improving survival in patients with advanced disease and expanding treatment options for patients with early-stage disease. However, ICIs may increase the risk of active tuberculosis (TB) disease. Our study investigated potential warning markers for active TB disease in patients with lung cancer receiving ICIs, aiming to inform management strategies.</p><p><strong>Methods: </strong>A retrospective cohort study at Zhongshan Hospital of Fudan University reviewed 4157 solid tumor patients treated with ICIs from January 2021 to February 2023. A total of 118 patients with lung cancer were included, either diagnosed with latent TB infection or non-active TB, or had a confirmed TB history before the start of ICI therapy. The primary outcome was the occurrence of active TB disease, with follow-up extending to February 1, 2024. Propensity score matching (PSM) was applied to account for differences in baseline characteristics.</p><p><strong>Results: </strong>Among the 118 patients, 5 (4.24%) developed active TB. Post-PSM Fisher's exact test suggested that confirmed TB history (RR: 4.00, <i>p</i> = 0.029), high tumor necrosis factor-alpha (RR: 8.64, <i>p</i> = 0.030), high interleukin-2 receptor (RR: 6.00, <i>p</i> = 0.031), low white blood cell count (RR: 8.50, <i>p</i> = 0.009), and low lymphocyte count (RR: 9.33, <i>p</i> = 0.014) were significantly associated with active TB disease. Among patients who developed active TB disease, two had a decrease in T-SPOT.<i>TB</i> spot count after receiving ICI therapy.</p><p><strong>Conclusion: </strong>The identification of significant factors associated with active TB underscores the importance of vigilant monitoring and early intervention. A decrease in the T-SPOT.<i>TB</i> spot count may not necessarily reflect an improvement in TB infection, but may instead indicate potential TB activation.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"627263"},"PeriodicalIF":3.2,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148962998","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":"Genomic Characterization of Antimicrobial Resistance and Virulence in ST11 Carbapenem-Resistant <i>Klebsiella Pneumoniae</i> Colonizing the Intestinal Tract of Elderly Inpatients.","authors":"Jianmei Chen, Liping Liu, Yanhua Zhang, Dong Ling, Feng Wang","doi":"10.2147/IDR.S613182","DOIUrl":"10.2147/IDR.S613182","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to elucidate the molecular epidemiology and virulence characteristics of ST11 carbapenem-resistant <i>Klebsiella pneumoniae</i> (CRKP) colonizing the intestinal tract of elderly inpatients in the Chongzhou region, providing a basis for controlling the transmission of such resistant bacteria in high-risk populations.</p><p><strong>Methods: </strong>CRKP strains isolated from the intestines of elderly inpatients in this region between January 2023 and June 2024 were collected. ST11 strains were identified via multilocus sequence typing (MLST). Whole-genome sequencing, antimicrobial susceptibility testing, and string test, serum killing, biofilm formation, capsular polysaccharide quantification were employed to characterize their resistance genes, virulence genes, and molecular typing profiles.</p><p><strong>Results: </strong>Among 58 CRKP isolates, 17 (29.3%) were ST11. ST11-KL64 was the dominant clone (70.6%). All isolates carried the carbapenemase gene <i>bla</i> _KPC-2 and exhibited extensive drug resistance, with tigecycline retaining the highest susceptibility (64.7%). The yersiniabactin system genes (<i>ybtS, fyuA, entB</i>) were universally present, whereas the aerobactin gene cluster (<i>iuc</i>ABCD-<i>iutA</i>) was detected in only 17.6% of isolates. The virulence regulator <i>rmpA2</i> was incomplete in all carriers. The hypermucoviscosity phenotype was observed in 35.3% of isolates, which correlated with serum resistance in some strains. Biofilm formation was variable. The mortality rate among colonized patients was 35.3%.</p><p><strong>Conclusion: </strong>The ST11-KL64 clone is dominant among CRKP strains colonizing the intestinal tract of elderly patients in this region. This clone universally carries the <i>bla</i> _KPC-2 gene conferring carbapenem resistance and exhibits a unique virulence gene profile characterized by a low carriage rate of classical hypervirulence markers and an incomplete <i>rmpA2</i> regulator gene. This finding clarifies the local epidemic status of this clone and underscores the importance of implementing active surveillance and targeted prevention strategies for high-risk populations.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"613182"},"PeriodicalIF":3.2,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13564456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148955877","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 the Etiology and Antibiotic Resistance of Bacterial Infections in Newborns in a Chinese Tertiary Hospital: From 2019 to 2024.","authors":"Haoan Sun, Jiangrong Luo","doi":"10.2147/IDR.S599442","DOIUrl":"10.2147/IDR.S599442","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to investigate the pathogen spectrum and antimicrobial resistance trends in hospitalized infants in the neonatal intensive care unit (NICU) of our hospital (a major hospital in China) from 2019 to 2024. The evolving pathogen spectrum highlights the need for precise local diagnostic strategies based on surveillance data. The high prevalence of antimicrobial resistance calls for the optimization of empirical antimicrobial therapy and stringent antimicrobial stewardship. Additionally, this study provides evidence-based recommendations for cost-effective antimicrobial resistance control in resource-limited regions globally.</p><p><strong>Methods: </strong>A retrospective analysis of neonatal infection clinical data from the past five years was performed, focusing on the distribution of major pathogens and the evolution of antimicrobial resistance across the years.</p><p><strong>Results: </strong>A total of 566 distinct pathogens were isolated from 523 neonatal bacterial infection cases. Gram-positive bacteria represented the largest proportion (56.5%), with <i>Staphylococcus aureus</i> being the most common (173 strains, 30.6%). It demonstrated the highest resistance to penicillin (86.1%) and a relatively high resistance to erythromycin (52.6%), while remaining 100% sensitive to vancomycin, linezolid, and tigecycline. <i>Staphylococcus epidermidis</i> exhibited significant resistance to benzathine penicillin (75.3%) and erythromycin (62.3%), with a positive rate of 77.9% in the cefotaxime screening test. The proportion of Gram-negative bacteria was 43.5%. Among the Gram-negative pathogens, <i>Escherichia coli</i> showed high resistance (80.0-86.1%) to cefoperazone-sulbactam and other β-lactams but only 0.9% resistance to carbapenems and full sensitivity to amikacin. <i>Klebsiella pneumoniae</i> exhibited significant resistance, with 34.1% of strains resistant to carbapenems.</p><p><strong>Conclusion: </strong>Over the past five years, Gram-positive bacteria have remained the predominant pathogens in NICU infections, with detection rates increasing annually. In contrast, the detection rate of Gram-negative bacteria has decreased. Gram-positive bacteria show high resistance to penicillin, while Gram-negative bacteria exhibit high resistance to third-generation cephalosporins. Additionally, multidrug-resistant strains have been identified. Temporal trend analysis revealed significant increasing trends for <i>S. aureus</i> (P=0.027) and <i>S. epidermidis</i> (P=0.038), and significant decreasing trends for <i>E. coli</i> (P=0.016).</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"599442"},"PeriodicalIF":3.2,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13564462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148955859","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}