Infection and Drug Resistance最新文献

{"title":"The Outcome of Tuberculosis Treatment in the Presence of SARS-CoV-2 Anti-RBD Antibody.","authors":"Heni Muflihah, Fajar Awalia Yulianto, Winni Maharani, Anis Rapiq Hanipan","doi":"10.2147/IDR.S579272","DOIUrl":"10.2147/IDR.S579272","url":null,"abstract":"<p><strong>Background: </strong>Vaccination or infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can induce specific antibodies. The level of anti-spike receptor-binding (RBD) antibody may last long and interact with the immune response to tuberculosis (TB). We aimed to investigate the impact of the anti-RBD antibody level at baseline on the outcome of the intensive phase of TB treatment.</p><p><strong>Patients and methods: </strong>This cohort study recruited newly diagnosed TB patients from September 2022 to May 2023. Observation was conducted at baseline and after two months of TB treatment. Interviews and physical examinations were performed for patients with a history of Coronavirus Disease 2019 (COVID-19) vaccination or infection and anthropometric data, respectively. Peripheral blood was collected for baseline assessment of anti-RBD antibodies, an interferon gamma release assay (IGRA), and complete blood count. The clinical outcomes of TB treatment include sputum conversion, hematology parameters and body mass index (BMI).</p><p><strong>Results: </strong>Among the 63 participants, the majority were vaccinated for COVID-19 (73,02%), underweight (58.73%), and IGRA positive (79,03%), increased median ESR (71.5 (IQR 18-111) mm/hour), and slightly low median lymphocyte proportion (19.5 (IQR 7-33) %) at baseline. The median titer of anti-RBD antibodies at baseline was 1,584.2 (IQR 95.6-34,379.3) AU/mL/. At two months of TB treatment, all the returned participants had sputum conversion and improved BMI and normal hematology parameters. The anti-RBD antibody level was associated with the baseline BMI (β <b>=</b>0.00019, 95% CI: 0.0001-0.0003, p=0.00) and post treatment lymphocyte count (β=0.0003 (95% CI: 0.0001-0.001, p=0.02).</p><p><strong>Conclusion: </strong>Our study revealed that susceptible TB patients had favorable outcomes after 2 months of TB treatment when baseline anti-RBD antibody was high at baseline. We suggest that larger studies are needed to confirm the relationship.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"579272"},"PeriodicalIF":3.2,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13401388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148591377","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":"Admission D-Dimer-to-Albumin Ratio as a Predictor of Poor Prognosis in Patients with Severe Fever with Thrombocytopenia Syndrome: A Retrospective Cohort Study.","authors":"Jiankang Zhang, Yu Yu, Nannan Feng, Jianguo Rao, Xiangjun Deng, Hongjuan Yin, Liangchen Wei, Xiaobo Ding, Lifen Hu, Ying Ye","doi":"10.2147/IDR.S620018","DOIUrl":"10.2147/IDR.S620018","url":null,"abstract":"<p><strong>Purpose: </strong>Severe fever with thrombocytopenia syndrome (SFTS) is a severe viral infection associated with rapid clinical deterioration and high mortality. This study evaluated the prognostic value of the D-dimer-to-albumin ratio (DAR) in hospitalized patients with SFTS.</p><p><strong>Patients and methods: </strong>A total of 387 patients with SFTS were retrospectively included. Correlations between biomarkers and SFTSV RNA levels were evaluated by Spearman analysis. The prognostic performance of DAR and other candidate biomarkers was assessed using ROC analysis and DeLong's test. Multivariable Cox regression and Kaplan-Meier survival analyses were performed to determine the independent prognostic value of DAR.</p><p><strong>Results: </strong>Of the 387 included patients, 314 (81.1%) survived and 73 (18.9%) died within 28 days after admission. Among the evaluated biomarkers, DAR showed the strongest correlation with SFTSV RNA level (r = 0.438, <i>P</i> < 0.001). DAR also demonstrated the best discriminative ability for predicting 28-day mortality (AUC=0.810, 95% CI, 0.745-0.874). Its prognostic performance was significantly better than that of PLR, CRP, ALB/PLT, LDH/ALB, FAR, and SII, and was comparable to that of NLR and PCT. The optimal cutoff value for DAR was 0.087, with a sensitivity of 73.8% and a specificity of 79.4%, and the highest Youden index. In univariate Cox regression analysis, patients with DAR >0.087 had a significantly increased risk of 28-day mortality (HR = 7.026, 95% CI: 4.228-11.677; <i>P</i> < 0.001). In multivariable Cox regression analysis adjusted for age, sex, cardiovascular comorbidity, neurologic symptoms, bleeding manifestations, SFTSV RNA viral load, onset-to-admission interval, and year of disease onset, DAR remained independently associated with poor outcome (adjusted HR, 4.475; 95% CI, 2.635-7.600; <i>P</i> < 0.001). This association remained significant when DAR was analyzed as a continuous variable. Kaplan-Meier analysis further showed significantly lower survival probability in patients with DAR >0.087.</p><p><strong>Conclusion: </strong>DAR was significantly associated with poor prognosis in hospitalized patients with SFTS. As a simple and readily available admission-based biomarker, DAR may be useful for early risk stratification and clinical monitoring.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"620018"},"PeriodicalIF":3.2,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13390671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148561845","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":"Admission D-Dimer for Early Risk Stratification of in-Hospital Mortality in Adults with Non-HIV Cryptococcal Meningitis: A Retrospective Cohort Study.","authors":"Qiong Wu, Xiangzhi Xiao, Huashan Zhou, Sufen Chen, Jue Hu, Zhen Wang, Wengao Zeng","doi":"10.2147/IDR.S625174","DOIUrl":"10.2147/IDR.S625174","url":null,"abstract":"<p><strong>Background: </strong>Cryptococcal meningitis (CM) is a life-threatening central nervous system fungal infection. In adults without human immunodeficiency virus (HIV) infection, early prognostic indicators remain limited. D-dimer reflects activation of coagulation and fibrinolysis and may provide prognostic information in severe infections, but its significance in non-HIV CM is unclear.</p><p><strong>Methods: </strong>We retrospectively included consecutive adults with microbiologically confirmed non-HIV CM admitted to a tertiary teaching hospital from January 2012 to December 2023. The primary outcome was all-cause in-hospital mortality. Missing data were handled using multiple imputation. Candidate predictors were selected using least absolute shrinkage and selection operator regression across five imputed datasets. Multivariable analysis used Firth's penalized logistic regression, and coefficients were pooled according to Rubin's rules. Model performance was assessed using receiver operating characteristic analysis, calibration plots, decision curve analysis, and bootstrap internal validation.</p><p><strong>Results: </strong>Among 104 patients, 22 (21.2%) died during hospitalization. Admission D-dimer was independently associated with in-hospital mortality (odds ratio [OR] 1.41, 95% confidence interval [CI] 1.03-1.94, P = 0.033). Cerebral infarction, cerebrospinal fluid (CSF) adenosine deaminase (ADA), and CSF cryptococcal antigen positivity were retained in the exploratory model but were not statistically significant. The model showed acceptable apparent discrimination (area under the receiver operating characteristic curve [AUC] 0.793, 95% CI 0.675-0.911). Bootstrap internal validation yielded an optimism-corrected AUC of 0.753 and calibration slope of 0.790. Log-transformed D-dimer showed directionally consistent results.</p><p><strong>Conclusion: </strong>Elevated admission D-dimer was independently associated with in-hospital mortality in adults with non-HIV CM. D-dimer may help early risk stratification, but the exploratory model requires external validation before clinical implementation.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"625174"},"PeriodicalIF":3.2,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148548928","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":"High-Resolution Melting Curve Analysis (HRMA) for the Identification of Class D β-Lactamases (CHDLs) in <i>Pseudomonas aeruginosa</i> Lung Infection.","authors":"Hamed Tahmasebi, Sanaz Dehbashi, Mohammad Reza Arabestani","doi":"10.2147/IDR.S620945","DOIUrl":"10.2147/IDR.S620945","url":null,"abstract":"<p><strong>Objective: </strong>Conventional approaches for laboratory detection of Carbapenem-hydrolyzing class D β-lactamases (CHDLs) from clinical isolates of <i>Pseudomonas aeruginosa</i> are laborious, slow, and have limited sensitivity. This study presents a novel high-resolution melting curve analysis (HRMA) assay for the rapid molecular characterization of CHDLs in <i>P. aeruginosa</i> lung infections.</p><p><strong>Methods: </strong>Detection of <i>bla</i>OXA genes in CHDLs was performed using an HRMA assay. ABI Step One-Plus Manager Software version 3.2 and Precision Melt Analysis Software version 3.02 (Applied Biosystems) were used to analyze a wide range of HRMA data.</p><p><strong>Results: </strong>Out of the 47 <i>P. aeruginosa</i> MBL-producing strains, 18 (38.2%) were <i>bla</i>OXA145 positive, 24 (51.0%) were <i>bla</i>OXA-161 positive, 20 (42.5%) were <i>bla</i>OXA-224 positive, 29 (61.7%) were <i>bla</i>OXA-539 positive, 7 (14.8%) were <i>bla</i>OXA-675 positive, and 19 (40.4%) were <i>bla</i>OXA848 positive. Distinct, non-overlapping melting peaks (eg, 81.70°C for <i>blaOXA-145</i>, 87.35°C for <i>blaOXA-848</i>) were achieved with an accuracy of ±0.1-0.5°C, enabling unambiguous genotype identification. Clinically, multi-locus sequence typing (MLST) of 100 isolates revealed that the dominant sequence types-ST09, ST15, ST111, and ST235-were significantly associated with MDR/XDR phenotypes, biofilm formation, and CHDL carriage (p < 0.05). ST235 and ST09 predominated among CHDL producers, and 57% of isolates were new or singleton sequence types, highlighting regional genetic diversity.</p><p><strong>Conclusion: </strong>Novelty lies in the precise differentiation of six clinically relevant OXA alleles exclusively through unique melting temperature (Tm) shifts and melt curve morphologies, eliminating the need for fluorescent probes. In practice, HRMA offers significant advantages over conventional methods, such as the modified Hodge test or Sanger sequencing. As a closed-tube, single-step assay, it eliminates post-amplification handling, reduces cross-contamination risks, and provides actionable results within two hours. This marked reduction in turnaround time and reagent costs makes HRMA a highly scalable, user-friendly tool, ideally suited for routine clinical microbiology laboratories to expedite antimicrobial stewardship and epidemiological surveillance in <i>P. aeruginosa</i> pulmonary infections.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"620945"},"PeriodicalIF":3.2,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148548899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Ambroxol Hydrochloride and Clenbuterol Hydrochloride Oral Solution with Respiratory Symptom Improvement and Safety in Chinese Children with Pneumonia: A Real-World Propensity Score-Matched Study.","authors":"Ying Liang, Yesheng Ling, Bing Hu, Yingxue Zou, Enmei Liu, Jinhai Ma, Changshan Liu, Quan Lu, Xiaoyan Dong, Huifen Zi, Chuangli Hao, Rongjun Lin, Xiangrong Zheng, Bingfei Li, Lingping Zhu, Mei Fang, Weimin Tian, Zhiqiang Zhuo, Deyu Zhao, Zhimin Chen, Yuejie Zheng, Jingyang Zheng, Yong Yin, Qiuyu Tang, Liqun Wu, Li Gu, Jinzhun Wu, Liyi He, Tao Ai, Ning Wang, Minjun Zhang, Hailin Zhang, Hanmin Liu, Youxiang Zhang, Jianguo Hong, Zhiying Han, Yunbo Mo, Hongmei Qiao, Zhiliang Tian, Lixia Li, Pingping Zhang","doi":"10.2147/IDR.S559221","DOIUrl":"10.2147/IDR.S559221","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the association of ambroxol hydrochloride and clenbuterol hydrochloride oral solution (AHCHOS) with respiratory symptom improvement and safety in Chinese children with pneumonia using real-world data.</p><p><strong>Methods: </strong>A propensity score-matched (PSM) cohort study was conducted. Children patients (≤14 years) with a diagnosis of pneumonia between May, 2018 and July, 2019 were considered as the study population. The main outcome of interest was the overall rate of improvement of respiratory symptoms in treatment groups with or without AHCHOS at day 7 using respiratory symptom scores (QS) and Visual Analog Scale (VAS) score of severity of respiratory signs. Secondary end points include medication adherence assessment and safety assessment.</p><p><strong>Results: </strong>A total of 3103 children with a diagnosis of pneumonia were included. After propensity score matching, a sample of 1428 patients was analyzed. AHCHOS use was associated with greater improvement in cough score (p=0.01) and day 7 clinical sign improvement rate (p=0.03) compared with no AHCHOS use. Exploratory subgroup analyses suggested larger differences in children aged 3-6 years and in selected severity strata. Medication adherence assessmentdid not differ significantly between groups at days 4, 7, 14, and 28. Adverse events were similar between groups.</p><p><strong>Conclusion: </strong>In this real-world propensity score-matched analysis, AHCHOS use was associated with improved respiratory symptom outcomes in children with pneumonia and appeared to have an acceptable safety profile. These findings should be interpreted as observational and hypothesis-generating.</p><p><strong>Trial registration number: </strong>The study was registered at Chinese Clinical Trial Registry (https://www.chictr.org.cn/, ChiCTR1800015818).</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"559221"},"PeriodicalIF":3.2,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148548937","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 of <i>Listeria monocytogenes</i> Meningitis (Complicated) with Hydrocephalus and Occipital Lobe Infarction.","authors":"Meiyan Liu, Yuquan Chen, Pin Xie, Weijie Xu, Shuiwen Huang, Baorong Liu","doi":"10.2147/IDR.S624063","DOIUrl":"10.2147/IDR.S624063","url":null,"abstract":"<p><strong>Background: </strong><i>Listeria monocytogenes (LM)</i> meningitis is a rare but severe infection, particularly in immunocompromised patients, often leading to complications such as hydrocephalus, markedly increasing treatment complexity and the risk of poor outcomes.</p><p><strong>Case presentation: </strong>We report a case of <i>LM</i> meningitis in an immunocompromised patient. The illness began with fever and gastrointestinal symptoms, followed by neck stiffness and altered consciousness. <i>LM</i> was identified via blood culture, cerebrospinal fluid (CSF) culture, and metagenomic next-generation sequencing (mNGS). During hospitalization, the patient developed decompensated hydrocephalus and a right occipital lobe infarction, emergent external ventricular drainage (hospital day 4) and subsequent ventriculoperitoneal shunting (hospital day 44) were performed, which were potentially life-saving. After comprehensive treatment and rehabilitation, the patient was discharged on day 85 without significant neurological deficits.</p><p><strong>Conclusion: </strong>Clinical presentation of <i>LM</i> meningitis may be atypical, especially in immunocompromised patients. In such patients, aggressive management of hydrocephalus-including timely CSF diversion-is potentially life-saving. Early pathogen detection through combined blood culture, CSF culture, and mNGS, together with prompt, targeted antimicrobial therapy and dynamic management of neurological complications such as hydrocephalus, is essential for improving clinical outcomes.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"624063"},"PeriodicalIF":3.2,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13380917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148520326","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":"Fosfomycin Trometamol in the Management of Urinary Tract Infection: A Focus on Antimicrobial Susceptibility and Resistance.","authors":"Stefania Stefani, Carlo Tascini","doi":"10.2147/IDR.S589847","DOIUrl":"10.2147/IDR.S589847","url":null,"abstract":"<p><p>Urinary tract infections (UTIs) are common bacterial infections in women and vulnerable populations, with increasing incidence and prevalence worldwide. Although originally classified as uncomplicated or complicated, UTIs are now classified as localized (ie, cystitis) or systemic based on clinical signs and symptoms. Oral fosfomycin trometamol, a first-line antibiotic for localized UTIs, is active against several Gram-negative and Gram-positive bacteria, including extended-spectrum β-lactamase (ESBL)-producing <i>Enterobacterales</i>; however, susceptibility testing and clinical breakpoints are recommended only for <i>Escherichia coli</i>. Susceptibility testing is also complicated by breakpoint differences of ≤64 mg/L (CLSI) versus <8 mg/L (EUCAST). This narrative review summarizes recent data on trends in fosfomycin susceptibility and resistance across high- and low-resource settings, supporting its role in treating UTIs and informing antibiotic management strategies. Overall, studies show that urinary <i>E. coli</i> isolates, including ESBL-producing isolates, are highly susceptible to fosfomycin, supporting its use in treating localized UTIs. For UTIs caused by <i>E. coli</i>, an overall 96% susceptibility rate was identified across 13 countries, with no significant differences across high-income and lower-middle-income countries (mean fosfomycin susceptibility [min. max.] 96% [95%, 97%] vs 96.75% [85%, 100%], respectively; p=0.432). Similarly, in a European-wide cross-sectional epidemiological study of <i>E. coli</i> urinary isolates, >95% fosfomycin susceptibility was observed in Belgium, Spain, the United Kingdom, and Russia, versus 91.7% in Italy. Fosfomycin also appears to be an appropriate treatment option for localized UTIs in developing countries, with susceptibility rates of 78% to 100% among <i>E. coli</i> isolates and 85.3% to 100% among ESBL-producing <i>E. coli</i> isolates in India. Intracountry variation in fosfomycin susceptibility rates is observed, highlighting the importance of real-world data on local pathogen susceptibility patterns to optimize antibiotic prescribing and reduce antimicrobial resistance. Fosfomycin also shows promise in treating UTIs in vulnerable patient populations, including pediatric patients, pregnant women, men, and patients with catheter-associated UTIs.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"589847"},"PeriodicalIF":3.2,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13381611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148602474","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 Antimicrobial Resistance of Group B <i>Streptococcus</i> in Hainan, China: Genomic Insights from Perinatal and Adult Clinical Isolates.","authors":"Hui-Min Zhao, Xiao-Ding Song, Juan Li, Bei-Bei Miao, Jing-Yi Zhang, Xin-Yi Gong, Yuan He, Ying-Juan Wang, Yong-Shuai Fu, Hua Wu","doi":"10.2147/IDR.S617393","DOIUrl":"10.2147/IDR.S617393","url":null,"abstract":"<p><strong>Background: </strong>Group B <i>Streptococcus</i> (GBS) is a major cause of perinatal infection and increasingly affects non-pregnant adults. However, comprehensive whole-genome sequencing (WGS)-based molecular epidemiological data from Hainan Province remain largely uncharacterized. The objective of this study was to determine the molecular epidemiology and antimicrobial resistance profiles of GBS, alongside their clinical features, in a hospital in Hainan, China.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on patients with GBS isolated from clinical specimens at Hainan General Hospital between June 2020 and September 2023. Antimicrobial susceptibility testing was performed using the Vitek 2 Compact system. Capsular serotyping and multilocus sequence typing (MLST) were conducted via whole-genome sequencing.</p><p><strong>Results: </strong>Among 95 patients with GBS isolated from clinical specimens, 62 (65.3%) were perinatal cases, including 10 confirmed neonatal infections. GBS was isolated from fetal appendageal tissues (placenta, amniotic fluid, and umbilical cord) in 57 perinatal cases. The remaining 33 were non-pregnant adults (mean age 51.8 years), of whom 84.8% had underlying diseases, and urinary tract infection was the most common diagnosis (75.8%). The predominant serotypes were III (36.8%), V (30.5%), and Ib (10.5%). The main sequence types included ST529 (15.8%), ST862 (15.8%), ST1 (13.7%), and ST19 (11.6%). All isolates were susceptible to penicillin and ampicillin, whereas resistance to tetracycline was 96.8%.</p><p><strong>Conclusion: </strong>This single-center retrospective study provides the first WGS-based molecular epidemiological data from Hainan. GBS infections in Hainan predominantly affect perinatal women and non-pregnant adults with comorbidities. Serotypes III, V, and Ib are the most prevalent. Penicillins retain excellent activity and remain the first-line treatment, whereas tetracycline is not recommended due to near-ubiquitous resistance.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"617393"},"PeriodicalIF":3.2,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13380950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148520018","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":"CXCL13 and IL-33 as Immunomodulatory Adjuvants Combined with Respiratory Syncytial Virus Fusion (RSV F) Protein to Enhance Mucosal RSV Vaccination.","authors":"Hadeel Alnajran, Bandar Alosaimi, Maaweya Awadalla, Fahad M Aldakheel, Khalid A Al-Hamad, Ahad Aldhuwayhi, Dalal Alobaid, Joud Almutairi, Zahra Alslaim, Yomna Alkhalifah, Abdulaziz Alshalani, Ayman Mubarak, Wael Alturaiki","doi":"10.2147/IDR.S602692","DOIUrl":"10.2147/IDR.S602692","url":null,"abstract":"<p><p>Respiratory syncytial virus (RSV) is a major pathogen responsible for lower respiratory tract infections, particularly in infants, young children, older adults, and immunocompromised individuals. Although several RSV vaccines and monoclonal antibody therapies have recently been approved, their protective efficacy is often short-lived and relies mainly on systemic immunity rather than mucosal immunity. As RSV is a mucosal pathogen, there is a compelling need to develop novel vaccine strategies capable of inducing robust mucosal immune responses. Inducible bronchus-associated lymphoid tissue (iBALT) is an ectopic lymphoid structure that plays a critical role in orchestrating the immune response to respiratory pathogens. iBALT is an important target for vaccine development, as it can support both innate humoral and cellular immune responses and contributes to the establishment of immune memory in the respiratory tract. The formation of iBALT is regulated by airway epithelial cells and the lung microenvironment through release of cytokines and chemokines, including interleukin 33 (IL-33) and C-X-C motif chemokine ligand 13 (CXCL13). In this review, we propose a novel mucosal vaccination strategy against RSV based on the combination of the RSV fusion (F) protein with immunomodulatory molecules, IL-33 and CXCL13, which are involved in the induction and regulation of iBALT. These immunostimulatory molecules may act synergistically to enhance the immune response to RSV infections. IL-33 promotes innate, mucosal, and adaptive immune responses and supports T cell activation, whereas CXCL13 facilitates B cell recruitment and organization within lymphoid structures. Although targeting iBALT represents a promising approach to improving RSV vaccine efficacy, further studies are required to determine the optimal regulation of iBALT in the airways.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"602692"},"PeriodicalIF":3.2,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13381604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148602510","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":"Integrated UHPLC-QTOF-MS, Network Pharmacology, and Experimental Validation Reveal the Antiviral and Anti-Inflammatory Mechanisms of Xiaoer Fengreqing Against COVID-19-Associated Encephalitis.","authors":"Ruihan Chen, Xuanxuan Li, Menglei Wang, Yueyue Xiong, Peifang Xie, Yan Liu, Zhanyu Cui, Yi Ye, Runfeng Li, Chitin Hon, Qinhai Ma","doi":"10.2147/IDR.S610625","DOIUrl":"10.2147/IDR.S610625","url":null,"abstract":"<p><strong>Background: </strong>Xiaoer Fengreqing (XF), a traditional Chinese medicine, is included in pediatric COVID-19 guidelines, but its active components and mechanisms remain unclear. This study aimed to explore XF's bioactive constituents and potential effects against COVID-19-related encephalitis.</p><p><strong>Methods: </strong>UHPLC-QTOF-MS and network pharmacology were used to identify active compounds, targets, and pathways. Antiviral effects against Omicron were assessed by cytopathic inhibition assays. RT-qPCR and Western blot evaluated anti-inflammatory responses, and in vivo experiments tested antiviral and neuroprotective effects against HCoV-OC43 using an intracranial infection model.</p><p><strong>Results: </strong>UHPLC-QTOF-MS identified 220 compounds, with 137 absorbed into plasma, yielding 774 potential targets and 242 KEGG pathways. Core targets included ACE2, EGFR, PARP1, JAK1, and SRC. Molecular docking showed isoalantolactone and isosakuranetin interacted with ACE2. XF exhibited an IC₅₀ of 5.687 mg/mL and selectivity index of 7.06. It significantly reduced TNF-α, IL-6, MCP-1, and IP-10, and downregulated p-STAT1, p-AKT, and p-p38 MAPK. In vivo, XF prolonged survival, reduced HCoV-OC43 titers and brain index, and decreased IFN-γ, TNF-α, IP-10, and IL-6 levels. Pathology confirmed reduced brain necrosis and immune infiltration at high dose.</p><p><strong>Conclusion: </strong>XF may exert antiviral and neuroprotective effects against COVID-19-related encephalitis through TNF-α/IL-6 suppression and modulation of MAPK, JAK/STAT, and PI3K/AKT immune regulatory pathways. Although XF showed potential for further development, its clinical translation remains limited by the complexity of its components, the lack of evaluation of individual active compounds, and its relatively modest in vitro antiviral potency. Therefore, in the absence of clinical trial evidence, XF should be regarded only as a candidate for further investigation.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"610625"},"PeriodicalIF":3.2,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13381628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148602501","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}