Infection and Drug Resistance最新文献

{"title":"Impact of HIV Pretreatment Drug Resistance on Secondary Transmission Through Treatment Dropout: A Prospective Population-Based Study in Southwestern China.","authors":"Yi Chen, Xiaoshan Xu, Huanhuan Chen, Xiangjun Zhang, Qiuying Zhu, Shujia Liang, Hui Xing, Lingjie Liao, Yi Feng, Yiming Shao, Yuhua Ruan, Guanghua Lan, Jianjun Li","doi":"10.2147/IDR.S516513","DOIUrl":"https://doi.org/10.2147/IDR.S516513","url":null,"abstract":"<p><strong>Objective: </strong>Discontinuation of antiretroviral treatment (ART) raised drug resistance and failure of Human Immunodeficiency Virus (HIV) virological suppression. The study aimed to assess the relationship between pretreatment drug resistance (PDR) and ART dropout, as well as the relationship between HIV treatment dropout and HIV secondary transmission.</p><p><strong>Methods: </strong>This study included all eligible participants from a local surveillance database in southwestern China between 2014 and 2021. The PDR prevalence trend was assessed using trend Chi-square tests within a consecutive cross-sectional design (N = 3060). Cox proportional hazards model was used to investigate the relationship between PDR and the risk of treatment dropout within a cohort design. Generalized Estimating Equations model was applied to explore the association between treatment dropout and HIV secondary transmission within a longitudinal genetic network study design. (N = 5094).</p><p><strong>Results: </strong>The overall PDR prevalence was 6.2%, analyzing a study sample of 3060 individuals with HIV/AIDS. Specifically, the prevalence of PDR to non-nucleoside reverse transcriptase inhibitors (NNRTIs), nucleoside reverse transcriptase inhibitors (NRTIs), and protease inhibitors (PIs) was 3.6%, 1.4%, and 1.1%, respectively. Yearly difference in prevalence was not identified. The independent association between PDR to NNRTIs and treatment dropout was significant (adjusted hazard ratio: 2.55, 95% CI 1.52-4.29). Among 5094 newly diagnosed HIV cases, participants who dropped out did not show a significant difference in HIV secondary transmission compared to those not on ART (adjusted odds ratio: 1.15, 95% CI 0.74-1.79).</p><p><strong>Conclusion: </strong>PDR to NNRTIs may contribute to HIV secondary transmission through treatment dropout. It is imperative to offer comprehensive and advanced HIV care for all individuals with HIV, enhance treatment and medication adherence, and closely monitor PDR prevalence.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"2311-2327"},"PeriodicalIF":2.9,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977858","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":"Cutaneous Nontuberculous Mycobacteria Infections Following Cosmetic Procedures: A Retrospective Study.","authors":"Rui Zeng, Jingshu Xiong, Wei Gao, Jiayi Peng, Ying Shi, Wenyue Zhang, Haiqin Jiang, Chaojiang Cheng, Gai Ge, Zhenzhen Wang, Youming Mei, Zhiming Chen, Hongsheng Wang","doi":"10.2147/IDR.S517138","DOIUrl":"https://doi.org/10.2147/IDR.S517138","url":null,"abstract":"<p><strong>Background: </strong>Reports of skin infections associated with nontuberculous mycobacteria (NTM) following cosmetic procedures are increasing. The diagnosis and treatment of these infections remain a significant challenge for clinicians.</p><p><strong>Objective: </strong>We examined the clinical characteristics, microbiology, histopathology, and treatment strategies of NTM infections following cosmetic procedures, including botulinum toxin injection, lipolysis injection, hyaluronic acid injection, mesotherapy, autologous fat grafting, and other related procedures.</p><p><strong>Methods: </strong>This retrospective study of cosmetology-related cutaneous NTM infections diagnosed based on culture or molecular identification was conducted at a tertiary dermatology hospital in China. Demographic, clinical, microbiological, pathological biopsy, management, and outcome data were also collected.</p><p><strong>Results: </strong>The series enrolled 28 patients, four diagnosed by molecular identification and histology, and 24 by positive culture. All 24 NTM cultures were rapid-growing mycobacteria, mainly <i>Mycobacterium abscessus</i> complex (75%), with a mean time to positive culture of 11.8 days. The mean incubation period for the lesions was three weeks, while the mean time to diagnosis was 9.8 weeks. Treatment typically requires long-term, multi-drug therapy. Surgical intervention may shorten the disease course.</p><p><strong>Conclusion: </strong>Cosmetology-related cutaneous NTM infections are frequently underrecognized and challenging to diagnose, leading to delayed treatment. We aimed to enhance clinician awareness of NTM infections to facilitate early detection and prompt treatment. Empirical therapy with clarithromycin and moxifloxacin may be considered in the absence of susceptibility results, but treatment decisions should be carefully guided by susceptibility testing results. Surgical intervention may be beneficial, and tigecycline is a viable option when resistant to clarithromycin.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"2301-2309"},"PeriodicalIF":2.9,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004114","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":"In vitro Antifungal Susceptibility Profile of Clinical <i>Cladophialophora boppii</i> in Malaysia.","authors":"Xue Ting Tan, Nurin Nazirah Mokhtar, Murnihayati Hassan, Min Moon Tang","doi":"10.2147/IDR.S513536","DOIUrl":"https://doi.org/10.2147/IDR.S513536","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to determine the antifungal susceptibility pattern of clinical <i>Cladophialophora boppii</i> isolates in Malaysia.</p><p><strong>Patients and methods: </strong>Eight clinical strains of the <i>C. boppii</i> were received from various Malaysian hospitals from the year 2020 until 2024. The isolates were obtained from patients with clinical presentations suggestive of cutaneous fungal infection. Their identities were determined using microscopic, macroscopic and molecular methods, specifically internal transcribed spacer (ITS) sequencing. Next, the antifungal susceptibility of amphotericin B, itraconazole, fluconazole, voriconazole, ravuconazole, posaconazole, ketoconazole, isavuconazole, flucytosine and terbinafine against the <i>C. boppii</i> were determined using broth microdilution method as outlined in the Clinical and Laboratory Standards Institute (CLSI) M38 guideline. The geometric means (GM) of minimum inhibitory concentration (MIC), MIC₅₀, and MIC₉₀ were determined for each antifungal. Subsequently, the Kruskal-Wallis test was performed to determine the significant difference observed in the median MIC values between the different antifungal groups (azole, polyene, pyrimidine and allylamine) against the isolate. The significance value was set at <i>p</i><0.05.</p><p><strong>Results: </strong>The GM MIC, MIC₅₀ and MIC₉₀ of all tested antifungals except amphotericin B and fluconazole against the <i>C. boppii</i> were ≤0.25 μg/mL. In contrast, amphotericin B and fluconazole exhibited higher MICs ranging from 2 to 16 μg/mL. Furthermore, the Kruskal-Wallis test revealed a significant difference in the median MIC values across all antifungals, with a <i>p</i>-value of 4.94 × 10⁻⁵.</p><p><strong>Conclusion: </strong>In conclusion, all the <i>C. boppii</i> isolates in this study were susceptible to pyrimidine, allylamine, and azoles, while showing intermediate susceptibility to fluconazole and notable resistance to amphotericin B. Additionally, itraconazole and terbinafine could be recommended as the first-line therapy option, which was supported by their demonstrated efficacy (MIC ≤0.03 μg/mL) and clinical improvement observed in this study.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"2291-2299"},"PeriodicalIF":2.9,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995552","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 Features, Outcomes, and Antifungal Susceptibility Profiles of Invasive <i>Candida</i> Infections in a Tertiary Care Hospital in China.","authors":"Dongting Yao, Jia Chen, Guanyi Zhang","doi":"10.2147/IDR.S510389","DOIUrl":"https://doi.org/10.2147/IDR.S510389","url":null,"abstract":"<p><strong>Purpose: </strong>Given the increasing incidence of invasive <i>Candida</i> infection worldwide, particularly among immunocompromised and critically ill patients, we aimed to assess the distribution of <i>Candida</i> species as well as their clinical features and responses to common antifungal agents through a retrospective analysis of patient data in a Chinese traditional medicine hospital.</p><p><strong>Patients and methods: </strong>In this retrospective single-center study, we analyzed data from 301 patients with invasive <i>Candida</i> infection at our hospital between 2020 and 2022, We report the clinical characteristics, species distribution, and in-vitro susceptibility profiles of <i>Candida</i> isolates to eight antifungal agents. Logistic regression analysis was employed for multivariate assessments to analysis the correlation between clinical symptoms and prognosis. Kaplan-Meier survival analysis was used for survival analysis.</p><p><strong>Results: </strong><i>Candida albicans</i> was the most prevalent species (38.9%, 117/301), followed by <i>C. tropicalis</i> (28.2%, 85/301) and <i>C. glabrata</i> (22.9%, 69/301). Age, department of admission, underlying disease, and presence of risk factors differed significantly among patients with different <i>Candida</i> infections. Kaplan-Meier survival analysis showed that <i>C. krusei</i> infection was associated with a higher seven-day mortality than other <i>Candida</i> spp. infections. Multivariate logistic regression analyses showed that age, presence of sepsis, insertion of the central venous catheter, and administration of total parenteral nutrition were independent predictors of mortality. <i>C. tropicalis</i> was most resistant to azoles, with 36.26% of the strains being fluconazole-resistant, 35.16% being non-wild type to itraconazole, and 34.52% being non-wild type to voriconazole. Non-susceptibility to echinocandins was found in 11 <i>C. glabrata</i> strains (10.39%, 3.90%, and 1.30% of isolates for caspofungin, micafungin, and anidulafungin, respectively).</p><p><strong>Conclusion: </strong>Our findings underscore the need for close monitoring of azole resistance in <i>C. tropicalis</i> and echinocandin resistance in <i>C. glabrata</i>, and highlight age, sepsis, CVC insertion, and parenteral nutrition as key predictors of mortality in invasive <i>Candida</i> infections.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"2271-2282"},"PeriodicalIF":2.9,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003720","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 First Case of Antimicrobial-Resistant <i>Salmonella</i> Stanley ST29 Diagnosed Secondary to Acute Cholecystitis.","authors":"Wenqing Wang, Shufen Liu, Minlan Zhang, Yan Chen, Yanru Liang, Shuqi You, Peijun Lv, Xuebin Xu, Fenghua Zhang","doi":"10.2147/IDR.S507875","DOIUrl":"https://doi.org/10.2147/IDR.S507875","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the phenotypic and genomic characteristics of a non-typhoidal <i>Salmonella</i> bile isolate from a patient with chronic diarrhoea secondary to acute cholecystitis.</p><p><strong>Methods: </strong>The patient presented with chronic diarrhoea lasting for two weeks, which was secondary to acute cholecystitis. The non-typhoidal <i>Salmonella</i> bile isolate was identified using biochemical tests, mass spectrometry, serum agglutination tests, and antimicrobial susceptibility testing. Subsequently, whole-genome sequencing (WGS) was performed to predict and annotate the serotype, multilocus sequence typing (MLST), antimicrobial resistance genes (AMR), mobile genetic elements (MGEs), and virulence genes of the isolate.</p><p><strong>Results: </strong>The isolate was identified as <i>Salmonella</i> spp. by biochemical tests and mass spectrometry. The serotype of the isolate identified by serum agglutination tests was consistent with WGS prediction and was identified as <i>Salmonella</i> Stanley (1,4,5,12: d:1,2, ST29). It was resistant to six antimicrobial agents, including ampicillin, ciprofloxacin, cefotaxime, azithromycin, trimethoprim/sulfamethoxazole, and chloramphenicol. Five major classes of antimicrobial agents, comprising a total of 14 resistance genes were screened, including β-lactam resistance genes: <i>bla</i> _TEM-1B, <i>bla</i> _OXA-1, and <i>bla</i> _DHA-1; quinolone resistance gene: <i>qnrB4</i> and <i>aac(6</i>'<i>)-Ib-cr</i>; macrolide resistance genes: <i>mph(A), mph(E)</i>, and <i>msr(E)</i>, and folate pathway inhibitor resistance genes: <i>sul1, sul2</i>, and <i>dfrA14</i>; chloramphenicol resistance genes: <i>floR, catA2</i> and <i>catB3</i>. T57S mutation in the <i>parC</i> gene was detected in the quinolone resistance-determining region (QRDR). Three plasmid replicons (<i>IncHI2/IncHI2A, IncR, IncN</i>) and three insertion MGEs were predicted. Forty-two virulence genes were predicted, of which 25 were secretion and transporter genes, and ten were fimbrial adherence genes. Only one invasive protein-regulated gene(<i>inv</i>) was found in <i>Salmonella</i> Pathogenicity Islands 1(SPI-1), and no Typhoid toxin genes were predicted.</p><p><strong>Conclusion: </strong>The case of <i>Salmonella</i> Stanley ST29 isolated from a patient with diarrhoea lasting 55 days secondary to cholecystitis aligns with the characteristics of high drug resistance and relatively low virulence. This highlights the need for increased vigilance in clinical practice regarding invasive cases and the significant disease burden associated with the intestinal migration of antimicrobial-resistant <i>Salmonella</i> isolates.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"2283-2290"},"PeriodicalIF":2.9,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985161","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":"Aztreonam Acts as a Synergist for Ceftazidime/Avibactam Against Carbapenem-Resistant <i>Enterobacteriaceae</i> (CRE) of Various Carbapenemase Phenotypes in Southwestern China.","authors":"Xuelian Ruan, Zhiyu Gong, Moqiyi Zeng, Ziqing Zhong, Yongling Chen, Fangyi Wei, Chong Lei, Yuanyuan Zhu, Xue Qin, Meng Li","doi":"10.2147/IDR.S523498","DOIUrl":"https://doi.org/10.2147/IDR.S523498","url":null,"abstract":"<p><strong>Background: </strong>Carbapenem-resistant Enterobacteriaceae (CRE) presents a significant challenge due to its role in severe and multidrug-resistant infections.</p><p><strong>Purpose: </strong>This study aims to evaluate aztreonam (ATM) as a synergistic agent with ceftazidime/avibactam (CZA) for treating CRE strains with different carbapenemase phenotypes.</p><p><strong>Methods: </strong>A total of 87 non-repeated clinical CRE strains were collected from various clinical specimens at The First Affiliated Hospital of Guangxi Medical University. Carbapenemase genotypes and phenotypes were identified using polymerase chain reaction (PCR) and NG-Test Carba 5 methods. The synergistic effect of CZA combined with ATM was assessed via the checkerboard MIC and disk stacking methods.</p><p><strong>Results: </strong>The clinical analysis revealed that underlying pulmonary disease, pneumonia, urinary catheter, and central intravenous catheter were associated with poor prognosis in CRE infections (p<0.05). All 87 CRE strains showed high resistance to most antibiotics, especially cefazolin, ceftriaxone, piperacillin/tazobactam, ertapenem, and meropenem, with a rate of 100.00%. For strains with a single carbapenemase gene, NG-Test Carba 5 demonstrated 100.00% accuracy. Notably, The combination of CZA and ATM showed synergy in 95.40% (83/87) of the CRE strains overall, with specific rates of 100.00% (4/4) in strains lacking detectable carbapenemase genes, 94.29% (33/35) in those with _blaNDM, and 100.00% (3/3) in those with <i>bla_NDM</i> plus <i>bla_KPC-2</i> or <i>bla_KPC-2</i> plus _blaIMP-4.</p><p><strong>Conclusion: </strong>In conclusion, ATM significantly enhances CZA's activity against CRE strains in Guangxi, achieving a high synergy rate across diverse isolates, regardless of the carbapenemase genes present.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"2243-2253"},"PeriodicalIF":2.9,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977889","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":"Application of Metagenomic and Targeted Next-Generation Sequencing in Diagnosis of Pulmonary Tuberculosis in Bronchoalveolar Lavage Fluid.","authors":"Zhen Yang, Qian Liu, Yi Hu, Shuang Geng, Ji-Xiang Ni","doi":"10.2147/IDR.S514090","DOIUrl":"https://doi.org/10.2147/IDR.S514090","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the application value of metagenomic next-generation sequencing (mNGS) and targeted next-generation sequencing (tNGS) in the diagnosis of pulmonary tuberculosis (PTB) in bronchoalveolar lavage fluid (BALF).</p><p><strong>Patients and methods: </strong>Data from 202 patients with suspected PTB at Wuhan Central Hospital (Jan 2022 - Jan 2024) were retrospectively analyzed. BALF samples were collected and examined using mNGS and tNGS, comparing their sensitivity to traditional methods like acid-fast staining, TB culture, and TB-DNA. Mixed microbial species were identified from the BALF using mNGS and tNGS, and the pros and cons of tNGS were evaluated against mNGS.</p><p><strong>Results: </strong>Of the 202 patients evaluated, 94 were diagnosed with PTB. The BALF mNGS and tNGS exhibited a sensitivity of 77.66% and a specificity of 100%, with positive and negative predictive values of 100% and 83.72%, respectively, outperforming conventional diagnostic methods. It was possible to compare the AUC values of the ROC curves of the BALF mNGS and tNGS with the corresponding values of the other three assay methods (0.89 vs 0.56, p < 0.05), MTB culture (0.89 vs 0.71, p < 0.05), and TB-DNA (0.89 vs 0.68, p < 0.05). Additionally, these techniques identified mixed microbial species in 52.13% of the BALF samples. Although both mNGS and tNGS demonstrated similar diagnostic rates, tNGS proved to be faster, more cost-effective, and incorporated a tuberculosis-specific wall-breaking technology, thereby suggesting greater clinical utility.</p><p><strong>Conclusion: </strong>BALF mNGS and tNGS technologies quickly and accurately detect PTB patients with greater sensitivity and specificity than traditional MTB methods. While both mNGS and tNGS demonstrate enhanced capacity for polymicrobial detection, the clinical significance of co-detected microorganisms requires integration with clinical context to differentiate colonization from active infection. Compared to mNGS, tNGS provides distinct advantages in clinical utility.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"2229-2241"},"PeriodicalIF":2.9,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998803","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":"Comprehensive Analysis of Pathogen Diversity and Diagnostic Biomarkers in Patients with Suspected Pulmonary Tuberculosis Through Metagenomic Next-Generation Sequencing.","authors":"Yuecui Li, Chenghang Li, Yu Fang, LiLi Zhang, Xiaoyan Ying, Ruotong Ren, Yinghui Zang, Dandan Ying, Shengwei Zhu, Jiao Liu, Xuefang Cao","doi":"10.2147/IDR.S504587","DOIUrl":"https://doi.org/10.2147/IDR.S504587","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the co-infecting pathogens and lung microbiomes in patients with clinically confirmed pulmonary tuberculosis (TB) and explore potential diagnostic biomarkers to differentiate between varied infection patterns.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study by analyzing 198 bronchoalveolar lavage fluid (BALF) samples collected from patients with suspected pulmonary TB. All BALF samples were sequenced using metagenomic next-generation sequencing (mNGS).</p><p><strong>Results: </strong>A total of 63 pathogens were detected in all samples. The TB group exhibited a higher diversity of pathogens (n=51) than the Non-TB group (n=37). The analysis revealed that TB patients had significantly higher pathogen counts (<i>P</i>=0.014), and specific microorganisms, such as <i>Mycobacterium tuberculosis</i> complex (MTBC), MTB, <i>Streptococcus infantis</i>, and <i>Campylobacter curvus</i>, were significantly enriched. Furthermore, the abundance of MTBC was negatively correlated with hemoglobin levels (R=-0.17, <i>P</i>=0.015) and positive correlated with C-reactive protein (CRP) levels (R=0.16, <i>P</i>=0.029). The random forest model combined eight differential microbes and five clinical parameters, yielding an area under the curve (AUC) of 0.86 for differentiating TB from Non-TB cohorts, whereas subgroup differentiation yielded an AUC of 0.571, demonstrating the potential for targeted diagnostics in pulmonary infections.</p><p><strong>Conclusion: </strong>Our findings highlight the complexity of co-infection patterns in pulmonary TB and emphasize the potential of integrating microbial and clinical markers to improve diagnostic accuracy. This study provides valuable insights into the role of the lung microbiome in TB and informs future research on targeted therapies for this disease.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"2215-2227"},"PeriodicalIF":2.9,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12056525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990601","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":"Confirmation of Tuberculous Meningitis Using Metagenomic Next-Generation Sequencing: A Case Report.","authors":"Changyu Liu, Yihan Cai, Kaixuan Yuan, Mengdi Lu, Yangxi Deng, Xiaoli Chen, Long Ye, Shanzhao Cui, Jingwen Lyu, Yong Ling","doi":"10.2147/IDR.S519905","DOIUrl":"https://doi.org/10.2147/IDR.S519905","url":null,"abstract":"<p><strong>Background: </strong>Tuberculous meningitis (TBM) remains a significant clinical challenge due to limitations in traditional diagnostic methods, such as cerebrospinal fluid (CSF) analysis and tuberculosis culture, which often have long turnaround times and low sensitivity and specificity. This case report highlights the pivotal role of metagenomic next-generation sequencing (mNGS) in enhancing clinical knowledge for the diagnosis and management of TBM, supplementing insights into its clinical presentation and treatment.</p><p><strong>Case presentation: </strong>A 56-year-old male patient was admitted to the hospital with a chief complaint of \"unconsciousness for 4 days\". Following five days of antimicrobial therapy, the patient showed significant improvement with no fever or headache, but exhibited a suspicious left-sided Babinski sign (+). MRI revealed evidence of cerebral infarction, while spiral CT imaging showed hydrocephalus accompanied by interstitial cerebral edema. A lumbar puncture revealed elevated intracranial pressure, increased protein levels in CSF, reduced glucose and chloride concentrations, and negative results for CSF smear, CSF culture, and blood culture. T-SPOT testing was positive, and mNGS of CSF detected <i>Mycobacterium tuberculosis</i> (<i>M. tuberculosis</i>) Based on clinical and etiological findings, a diagnosis of tuberculous meningitis was confirmed. The patient was treated with quadruple anti-tuberculosis therapy combined with linezolid, resulting in clinical improvement. He was subsequently transferred to a specialized chest hospital for further management.</p><p><strong>Conclusion: </strong>The patient's condition improved after 5 days of treatment. TBM is notoriously challenging to diagnose and treat. Traditional diagnostic methods, such as smear microscopy and tuberculosis culture, often yield low positive rates, delaying timely diagnosis and intervention. Early detection, accurate diagnosis, and prompt treatment are crucial for improving patient outcomes. mNGS of CSF has proven to be a powerful tool in TBM diagnosis, enabling early and precise identification of the pathogen, thereby facilitating timely treatment and reducing TBM-related mortality.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"2209-2214"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12053380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999806","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 Successful Treatment of Carbapenem-Resistant Gram-Negative Bacilli Infections Using Intravenous Colistin Sulfate in China: A Real-World Retrospective Study.","authors":"Weixi Gao, Wei Li, Huali Liu, Dong Xu, Lei Tian, Jinwen Zhang, Dong Liu, Yan He","doi":"10.2147/IDR.S512403","DOIUrl":"https://doi.org/10.2147/IDR.S512403","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy of intravenous colistin sulfate (CS) in the treatment of carbapenem-resistant Gram-negative bacilli (CR-GNB) infections in real-world clinical settings and to identify factors influencing its therapeutic outcomes, with the aim of promoting the rational use of CS.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the clinical characteristics and treatment outcomes of 174 patients diagnosed with CR-GNB infection who received intravenous CS at our center between January 2021 and December 2023. The study evaluated both clinical efficacy and adverse drug reactions (ADRs).</p><p><strong>Results: </strong>Among the 174 patients, 118 cases (67.8%) demonstrated clinical improvement, and the bacterial clearance rate was 53.9%. Multivariate logistic regression analysis identified several factors significantly associated with treatment efficacy: neurological disease (OR [95% CI]: 0.100 [0.019-0.541]; <i>p</i> = 0.006), admission to a surgical ward (OR [95% CI]: 0.136 [0.023-0.801]; <i>p</i> = 0.027), septic shock (OR [95% CI]: 5.147 [1.901-14.096]; <i>p</i> = 0.001), and empirical use of CS (OR [95% CI]: 4.250 [1.109-16.291]; <i>p</i> = 0.035). Additionally, 10 cases (5.8%) of acute kidney injury (AKI) were attributed to nephrotoxicity from CS, with 2 cases recovering after discontinuation of the drug.</p><p><strong>Conclusion: </strong>Our findings suggest that intravenous colistin sulfate may be an effective treatment option for CR-GNB infections when used appropriately. However, further studies are required to better understand its real-world efficacy and safety profile.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"2175-2185"},"PeriodicalIF":2.9,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12050035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965549","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}