Infection and Drug Resistance最新文献

{"title":"Antimicrobial Decision-Making in Culture-Negative Bacterial Meningitis with mNGS-Detected <i>Prevotella</i>-Dominant Anaerobic Signals: Two Case Reports and a Literature Review.","authors":"Yan Li, Yuyuan Hu, Yuhang Yang, Wen Yuan Li, Minghua Fan, Wei Zhang, Yanhong Wang","doi":"10.2147/IDR.S635205","DOIUrl":"10.2147/IDR.S635205","url":null,"abstract":"<p><p>Anaerobic meningitis is uncommon and may be underrecognized when cerebrospinal fluid (CSF) culture is non-diagnostic, particularly after antimicrobial exposure or when anaerobic collection, transport, and incubation conditions are suboptimal. Metagenomic next-generation sequencing (mNGS) can provide complementary microbiological evidence in selected culture-negative central nervous system (CNS) infections, but low-biomass CSF results require explicit quality-control reporting and careful assessment of contamination and clinical plausibility. We report two culture-negative bacterial meningitis cases in which CSF mNGS showed a <i>Prevotella</i>-dominant anaerobic signal. <i>Prevotella oris</i> was the predominant species-level detection in both cases, accompanied by lower-abundance anaerobic co-detections. Because <i>P. oris</i> was not recovered by culture or independently confirmed by species-specific PCR, the results were classified as mNGS-supported <i>Prevotella-</i>dominant signals rather than confirmed monomicrobial <i>P. oris</i> meningitis. Both patients received case-specific antimicrobial therapy adjusted according to clinical status, serial CSF findings, neuroimaging evolution, and adverse-event monitoring. Case 1 required meropenem re-escalation after radiological progression and recurrent intracranial hypertension, whereas Case 2 improved after escalation to meropenem followed by the documented de-escalation to metronidazole. Both patients achieved favorable functional outcomes. These cases illustrate how CSF mNGS may be used as an adjunct when conventional microbiology is non-diagnostic, while emphasizing that sequencing signals, serial CSF changes, imaging, and treatment response must be interpreted together. The two observations do not establish <i>P. oris</i> causality or a standardized escalation/de-escalation regimen.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"635205"},"PeriodicalIF":3.2,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919255","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":"Gut-Lung Axis Microbiome Dysbiosis and Cross-Domain Network Analysis in Bronchiectasis Complicated by Invasive Pulmonary Aspergillosis.","authors":"Wei Zhao, Chunlai Feng, Yilei Zhang, Linlin Wang","doi":"10.2147/IDR.S612147","DOIUrl":"10.2147/IDR.S612147","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the clinical significance of pulmonary and gut microbiota in patients with bronchiectasis (BE) with invasive pulmonary aspergillosis (BE-IPA). By analyzing cross-domain microbial networks, we aimed to elucidate the bidirectional interaction mechanisms of the gut-lung axis, provide a theoretical basis for clinical diagnosis, and to identify potential candidate biomarkers and inform future mechanistic studies from a microbiomic perspective.</p><p><strong>Patients and methods: </strong>We retrospectively examined 78 patients with BE, divided into BE without IPA (n = 37) and BE-IPA (n = 41) groups. Bronchoalveolar lavage fluid and anal swabs were collected. Metagenomic next-generation sequencing was used to analyze microbiota diversity, species composition, and metabolic pathways between the groups. Clinical data were evaluated for correlations with specific taxa, and a cross-domain microbial co-occurrence network was constructed.</p><p><strong>Results: </strong>Compared to the BE group, the BE-IPA group exhibited significant differences in pulmonary microbiota β-diversity (<i>P</i> < 0.05) and increased gut microbiota evenness (Shannon and Simpson indices, <i>P</i> < 0.05). <i>Aspergillus</i> and species-level <i>Aspergillus fumigatus</i> were significantly enriched in the BE-IPA group lungs, whereas <i>Parabacteroides</i> and <i>Hoylesella</i> were enriched in the gut. The relative abundance of core gut commensals such as <i>Bacteroides dorei</i> was negatively correlated with Acute Physiology and Chronic Health Evaluation II score. The BE-IPA group showed 17 upregulated gut metabolic pathways (<i>P</i> < 0.05), primarily involving lipopolysaccharide biosynthesis and carbohydrate metabolism. Pulmonary <i>A. fumigatus</i> exhibited negative correlations with gut <i>B. dorei</i> and pulmonary <i>Rothia mucilaginosa</i>.</p><p><strong>Conclusion: </strong>The pulmonary microbiota in the BE-IPA group showed a fungal-bacterial symbiotic network centered on <i>A. fumigatus</i>, whereas gut microbiota presented a bacterial co-occurrence network enriched with <i>Parabacteroides</i>. In patients with BE-IPA, pulmonary and gut microbes were associated with multiple clinical indicators and metabolic pathways. These microbiota signatures may aid in the assessment of disease severity in BE-IPA, with the gut commensal <i>B. dorei </i>emerging as a candidate biomarker and a potential subject for future interventional studies.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"612147"},"PeriodicalIF":3.2,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919246","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":"Mechanistic Insights into Maxing Shigan Decoction in Community-Acquired Pneumonia Based on Bioinformatics and Experimental Validation.","authors":"Chenhao Wei, Rui Wang, Xiuying Zhang, Mengfei Yang, Shiyao Zhang, Hangyu Zhao, Lai Zhang","doi":"10.2147/IDR.S637858","DOIUrl":"10.2147/IDR.S637858","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the mechanisms of Maxing Shigan Decoction (MXSGD) in community-acquired pneumonia (CAP) via network pharmacology, machine learning, molecular docking, and experimental validation.</p><p><strong>Methods: </strong>MXSGD active compounds and targets were collected from TCMSP and TCM-ID; CAP-related genes were obtained from GEO datasets, and integrated with targets from GeneCards, OMIM, DisGeNET, and TTD. Overlapping targets were subjected to PPI, GO, and KEGG analyses. LASSO and SVM-RFE were used to select feature genes, and six core targets with robust diagnostic performance (AUC > 0.8 in both training and validation sets) were identified after ROC evaluation. Immune infiltration, GSEA, molecular docking, and 100 ns molecular dynamics simulations were performed. In vivo, the efficacy of MXSGD was assessed in a clinically relevant influenza A virus-<i>Streptococcus pneumoniae</i> co-infection mouse model by measuring lung index, histopathology, serum IL-6 and TNF-α levels by ELISA, and mRNA expression by qRT-PCR.</p><p><strong>Results: </strong>We obtained 139 active compounds, 867 MXSGD targets, and 4,444 CAP genes, yielding 262 shared targets enriched in immune-inflammation pathways. Six core targets with high diagnostic accuracy were identified: ABCB1 (AUC = 0.9072), KIT (AUC = 0.8072), PLA2G7 (AUC = 0.8391), SLC2A3 (AUC = 0.9372), PRF1 (AUC = 0.8082), and GPR18 (AUC = 0.8414). Immune infiltration revealed eight differentially abundant immune cell types. Molecular docking and molecular dynamics supported the stable binding of glabridin to KIT and SLC2A3. In vivo, MXSGD significantly ameliorated lung pathological injury, reduced lung index and serum IL-6 and TNF-α levels (FDR-adjusted <i>P</i> < 0.001), and partially reversed mRNA expression changes of KIT, GPR18, and SLC2A3 (FDR-adjusted <i>P</i> < 0.05), while changes in ABCB1, PLA2G7, and PRF1 showed a trend without statistical significance.</p><p><strong>Conclusion: </strong>These results suggest that MXSGD may exert immunomodulatory and anti-inflammatory effects in CAP, potentially by regulating ABCB1, KIT, PLA2G7, SLC2A3, PRF1, and GPR18; however, only three of these (KIT, GPR18, and SLC2A3) showed statistically significant mRNA changes. These findings provide a multi-component, multi-target rationale requiring further experimental and clinical confirmation.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"637858"},"PeriodicalIF":3.2,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919259","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":"Giant Abdominal Haematoma and Rapid Multidrug-Resistant Infection After Low-Molecular-Weight Heparin in a Patient With COVID-19 and Rheumatoid Arthritis.","authors":"Chuan Sun, Xiao Zheng, Hui Wang, Shaoling Xu","doi":"10.2147/IDR.S618431","DOIUrl":"10.2147/IDR.S618431","url":null,"abstract":"<p><strong>Background: </strong>Low-Molecular-Weight Heparin (LMWH) is a widely used anticoagulant in clinical practice during the COVID-19 pandemic. However, the risk of adverse reactions increases significantly in patients with multiple underlying diseases and immune dysfunction. This article reports a case of a patient with COVID-19 complicated with rheumatoid arthritis who had long-term oral prednisone (5 mg/d) for rheumatoid arthritis, who developed a rare giant hematoma (15cm×15cm) after LMWH administration, which rapidly progressed to sequential infections caused by multidrug-resistant organisms, including extended-spectrum β-lactamase (ESBL)-producing <i>Escherichia coli</i> and carbapenem-resistant <i>Acinetobacter baumannii</i> (CRAB), within one day. This case describes the complexity and severity of adverse drug reactions under the superposition of multiple factors, and offers clinical insights for diagnosis and management.</p><p><strong>Case summary: </strong>A 61-year-old female patient was admitted to the hospital for treatment of \"viral pneumonia and COVID-19\". Her underlying diseases included rheumatoid arthritis (long-term oral prednisone 5mg/d), hypertension, and type 2 diabetes mellitus. After admission, the patient was given subcutaneous injection of LMWH (2500 IU, qd) for anticoagulation, combined with Simnotrelvir/Ritonavir for antiviral treatment. On the 9th day of medication, a giant hematoma of about 15cm×15cm appeared at the LMWH injection site; on the 10th day of medication, the hematoma rapidly developed into severe soft tissue infection, and the infection further spread to both waists. Etiological examination successively detected extended-spectrum β-lactamase (ESBL)-producing <i>Escherichia coli</i> and carbapenem-resistant <i>Acinetobacter baumannii</i> (CRAB). The total length of hospital stay was 84 days (excluding 2 days of outpatient observation during inter-hospital transfers). During this period, the patient received multiple rounds of anti-infective treatment with meropenem, linezolid, minocycline, etc. and underwent 5 debridements, Vacuum Sealing Drainage (VSD), and skin grafting. After active treatment, the patient's infection was finally effectively controlled, and she was discharged smoothly after wound healing.</p><p><strong>Conclusion: </strong>Under the superposition of multiple immunosuppressive factors such as COVID-19, long-term prednisone use and additional in-hospital glucocorticoid therapy, conventional-dose LMWH can induce an unusually large hematoma (15cm×15cm), with rapid disease progression (secondary infection within 1 day), which is prone to refractory MDROs infection. For such high-risk patients, clinical practice should formulate highly individualized anticoagulant treatment plans and further strengthen the monitoring of adverse reactions.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"618431"},"PeriodicalIF":3.2,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919186","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":"Complementary Utility of Metagenomic Next-Generation Sequencing and Blood Culture for Bloodstream Infections: Insights into Pathogen-Specific Inflammatory and Coagulation Profiles.","authors":"Yuchong Chen, Xiaofen Zou, Yingyu Zhong, Weiwen Luo, Xinhui Zou, Huanghui Zeng, Xianhui Liu","doi":"10.2147/IDR.S637436","DOIUrl":"10.2147/IDR.S637436","url":null,"abstract":"<p><strong>Background: </strong>Bloodstream infections (BSIs) are a major cause of sepsis and mortality in critically ill patients, yet accurate pathogen identification remains challenging because blood culture has limited sensitivity and delayed turnaround time. This study aimed to evaluate the complementary diagnostic value of blood culture and mNGS for BSIs patients, and to identify distinct inflammatory and coagulation signatures across bacterial, viral, fungal and polymicrobial infections to facilitate rapid early pathogen discrimination.</p><p><strong>Methods: </strong>In this retrospective study, 18,803 patients with suspected BSI admitted between December 2017 and December 2024 were included. Baseline clinical characteristics and blood culture results were collected. Blood culture was performed as first-line testing, whereas mNGS was selectively applied to patients with negative blood cultures or persistent clinically suspected infection to assess its incremental pathogen detection. Differences in pathogen distribution and inflammatory/coagulation biomarkers across pathogen types were analyzed. Receiver operating characteristic (ROC) curve analysis was conducted to evaluate the predictive performance of these biomarkers for viral and fungal infections.</p><p><strong>Results: </strong>Compared with blood culture, mNGS provided additional pathogen detection, with newly identified pathogens comprising viruses (33.5%, 184/550), polymicrobial infections (34.9%, 192/550), and fungal pathogens, whereas single bacterial infections accounted for only 14.5% (80/550). Compared with bacterial infections (n=80), viral infections (n=184) were associated with significantly lower procalcitonin (PCT), C-reactive protein (CRP), and fibrinogen (FIB), but higher prognostic nutritional index (PNI) (all <i>p</i><0.05). Fungal infections (n=57) showed significantly lower PNI and FIB levels (<i>p</i><0.05) than bacterial infections (n=1098). ROC analysis demonstrated moderate discriminatory performance of PCT, CRP, and FIB for viral infections, while PNI and FIB showed comparable predictive value for fungal infections.</p><p><strong>Conclusion: </strong>mNGS complements conventional blood culture by expanding pathogen detection in clinically selected patients, while inflammatory and coagulation biomarkers may assist early etiological assessment and support clinical assessment and antimicrobial decision-making.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"637436"},"PeriodicalIF":3.2,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919212","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 and Microbiological Characteristics of Pulmonary Aspergillosis in Elderly vs Non-Elderly Patients: A tNGS-Based Retrospective Study.","authors":"Miao Yu, Qianqian Zhao, Jingwen Huang, Jiaxin Tian, Xuefei Liu, Simin Xie, Chao Sun, Yijie Li, Wanjie Xu, Fengfei Qian, Xiaohua Zhong, Chuanhua Nie, Xiaoli Zhao, Wenxin Wu, Min Zhou","doi":"10.2147/IDR.S613333","DOIUrl":"10.2147/IDR.S613333","url":null,"abstract":"<p><strong>Background: </strong>Elderly patients are more susceptible to pulmonary aspergillosis(PA) and exhibit worse clinical outcomes. This study aims to compare the clinical characteristics, pathogen distribution, co-infection patterns, and outcomes of elderly and non-elderly patients with PA diagnosed via targeted next-generation sequencing (tNGS).</p><p><strong>Methods: </strong>This retrospective study included 107 patients with tNGS-confirmed pulmonary aspergillosis admitted to Ruijin Hospital between March 2023 and January 2025. Demographic, clinical, radiological, and laboratory data were extracted from electronic medical records to compare the clinical and microbiological profiles between the elderly (≥65 years) and non-elderly (<65 years) cohorts.</p><p><strong>Results: </strong>A total of 107 patients including elderly (n=64) and non-elderly (n=43) were included retrospectively. The prevalence of invasive pulmonary aspergillosis was significantly higher in the elderly group compared to the non-elderly group (93.8% vs 74.4%). Similarly, the elderly group had significantly higher proportions of overall co-infection (79.7% vs 51.2%), bacterial co-infection (68.8% vs 39.5%), and atypical imaging features such as patchy infiltrates/consolidation (89.1% vs 62.8%) (all <i>P</i> < 0.05). Furthermore, the elderly exhibited significantly lower lymphocyte and albumin levels, and higher D-dimer levels (<i>P</i> < 0.05). Mortality was also significantly higher among elderly patients (18.8% vs 4.7%; <i>P</i> = 0.042).</p><p><strong>Conclusion: </strong>Within our study scope, pulmonary aspergillosis in the elderly is characterized by higher mortality, atypical imaging, prevalent bacterial co-infections, and specific laboratory deviations-most notably, diminished lymphocytes and albumin alongside elevated D-dimer and LDH levels. Furthermore, tNGS serves as a valuable adjunctive tool to identify complex mixed pathogens and assist in clinical management.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"613333"},"PeriodicalIF":3.2,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13552398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911371","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":"Yellow Fever, an Arboviral Disease with Public Health Impacts: General Aspects and the Use of the One Health Approach in the Context of This Zoonosis.","authors":"Larissa de Souza Araújo, Igor Rosa Meurer","doi":"10.2147/IDR.S629847","DOIUrl":"10.2147/IDR.S629847","url":null,"abstract":"<p><p>Yellow fever is a long-standing zoonotic arboviral disease that affects hundreds of thousands of people annually in different regions of the world, even though the vaccine has been available since the 1930s. Thus, studies that synthesize general and current information on yellow fever are relevant, aiming to disseminate knowledge that can contribute to mitigating its impacts. This narrative review synthesizes the general aspects of yellow fever, discusses its impacts on public health, and presents information on the use of the One Health approach in the context of this zoonosis. The databases used to select the articles were PubMed, Scopus, LILACS, and SciELO, using various descriptors related to the study's theme and objectives. It is important to highlight that yellow fever remains a significant public health challenge due to its high mortality rate in severe cases and the continued circulation of the yellow fever virus in tropical areas, especially in South America and Africa. Although many patients recover spontaneously, recurrent outbreaks continue in endemic regions. The initial clinical similarity to other zoonoses makes timely diagnosis difficult, and management remains restricted to clinical support, as there is no specific antiviral treatment. Vaccination and epidemiological surveillance stand out as the main preventive measures. Additionally, considering that the management of yellow fever involves human, animal, and environmental health aspects, the One Health approach stands out as a modern, robust, and effective alternative for addressing this zoonosis. However, the lack of knowledge regarding this approach among public managers and health professionals results in its non-use and, consequently, impacts the fight against yellow fever. Therefore, it is important to widely disseminate knowledge about the One Health approach, aiming at carrying out holistic actions in the human-animal-environmental interface sectors in the context of yellow fever, allowing for coordinated and sustainable responses at different levels and instances.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"629847"},"PeriodicalIF":3.2,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13549303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906103","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":"Best Evidence Summary for the Prevention of Ventilator-Associated Pneumonia.","authors":"Wenjuan Wu, Yuanxin Pan, Xiang An, Jiamin Lyu","doi":"10.2147/IDR.S637541","DOIUrl":"10.2147/IDR.S637541","url":null,"abstract":"<p><strong>Objective: </strong>To retrieve, appraise, and synthesize the best available evidence on the prevention of ventilator-associated pneumonia (VAP) from Chinese and international sources, and to provide evidence-based guidance for clinical nursing practice.</p><p><strong>Methods: </strong>Guided by the 6S evidence pyramid model, a comprehensive electronic search was conducted in BMJ Best Practice, UpToDate, the Guidelines International Network, the National Institute for Health and Care Excellence, the Scottish Intercollegiate Guidelines Network, the Registered Nurses' Association of Ontario, the American Association for Respiratory Care, the American Thoracic Society, CHEST, the Cochrane Library, the IBI Evidence-Based Health Care Center database, Embase, PubMed, Medlive, the Chinese Thoracic Society, the Chinese Biomedical Literature Database, China National Knowledge Infrastructure, and Wanfang Database. The search period ranged from January 1, 2016, to January 1, 2026. Evidence summaries, clinical practice guidelines, systematic reviews, and other evidence-based resources related to VAP prevention were retrieved. After quality appraisal and evidence synthesis, the best evidence was summarized.</p><p><strong>Results: </strong>A total of 24 publications were included, comprising 2 clinical decision support resources, 10 systematic reviews, 5 guidelines, and 7 evidence summaries. Thirty-three recommendations were synthesized into eight practical domains covering organizational strategies, prevention bundles, airway management, positioning, nutrition, device management, pharmacologic approaches, and non-recommended interventions.</p><p><strong>Conclusion: </strong>This evidence summary systematically synthesizes the best available evidence regarding VAP prevention and provides evidence-based guidance for standardized clinical management. These findings may support clinical decision-making and the development of nursing practice strategies for VAP prevention; however, further studies are needed to evaluate the effectiveness of implementing these recommendations in specific clinical settings.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"637541"},"PeriodicalIF":3.2,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13549390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905944","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 Re-Emergence of Bundibugyo Ebolavirus in Uganda and the Democratic Republic of Congo: Epidemiological Drivers, Response Strategies, and Implications for Global Health Security.","authors":"Gerald Olwit, Ivy Bochaberi Ombongi, Henon Ataryeba, Andrea Nantongo, Babirye Shamim","doi":"10.2147/IDR.S632723","DOIUrl":"10.2147/IDR.S632723","url":null,"abstract":"<p><p>Bundibugyo ebolavirus (BDBV) is one of the least studied species within the genus Orthoebolavirus (family Filoviridae), despite its capacity to cause severe Ebola virus disease (EVD) with substantial mortality. First identified during a 2007-2008 outbreak in Bundibugyo District, western Uganda (149 reported cases, 37 deaths; case-fatality rate [CFR] approximately 25-36%), BDBV re-emerged in 2012 in Orientale Province, Democratic Republic of the Congo (DRC) (57-59 cases, 29-34 deaths; CFR 34-58%), before resurfacing in Ituri Province, DRC, in April-May 2026. By 11 August 2026, this third outbreak had grown to 4566 laboratory-confirmed cases and 2128 deaths (CFR ≈ 47%) across five DRC provinces and Uganda, becoming the largest, fastest-growing BDBV epidemic on record and the second-largest Ebola-family outbreak overall. This narrative review, not a systematic review or meta-analysis, summarizes peer-reviewed literature, preprints, and official situation reports from WHO, Africa CDC, US CDC, ECDC, and national health ministries, identified through PubMed, Scopus, Web of Science, Google Scholar, and Embase from inception to 12 August 2026, to examine BDBV historical evolution, virology and pathogenesis, drivers of re-emergence, surveillance and response, therapeutic and vaccine gaps, and global health security implications. The 2026 outbreak, unfolding amid conflict and mass displacement in eastern DRC, has been marked by an estimated basic reproduction number of 1.4-2.1 (central estimate 1.71), disproportionate infection among healthcare workers (7.2% of confirmed cases in DRC, 20% in Uganda), and the continued absence of licensed BDBV-specific vaccines or therapeutics. Findings underscore the need for sustained genomic and ecological surveillance, decentralized rapid diagnostics, broadly protective pan-filovirus vaccines, conflict-sensitive response strategies, and strengthened Uganda-DRC collaboration. Because the evidence base for the ongoing outbreak remains preliminary, findings should be interpreted cautiously and revisited as further peer-reviewed data emerge.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"632723"},"PeriodicalIF":3.2,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13549297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906028","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":"Late-Onset Sepsis and Meningitis Caused by <i>Elizabethkingia meningoseptica</i>: A Case Report.","authors":"Shasha Liao, Shaoling Qiu, Na Li, Yunyuan Liu, Xiuneng Tang","doi":"10.2147/IDR.S633763","DOIUrl":"10.2147/IDR.S633763","url":null,"abstract":"<p><p><i>Elizabethkingia meningoseptica</i> is a gram-negative bacillus. Increasing body of literature shows that opportunistic infections may be caused by this Gram negative bacillus in immunocompromised adults and neonates. We describe a case of a preterm neonate born at 33 weeks of gestation who presented with fever and reluctance to feed for two days at one month after birth. Initial laboratory tests of blood and cerebrospinal fluid cultures showed evidence of late-onset sepsis and meningitis caused by <i>E. meningoseptica</i>, which was sensitive to piperacillin/tazobactam, cefoperazone/sulbactam, trimethoprim/sulfamethoxazole, levofloxacin, and minocycline. The neonate underwent sequential anti-infective therapy regimens consisting of: 1) cefoperazone/sulbactam (2:1) in combination with levofloxacin; 2) cefoperazone/sulbactam (2:1) paired with rifampicin; and 3) linezolid administered concomitantly with rifampicin. The neonate exhibited clinical manifestations of ventricular dilatation accompanied by hydrocephalus. The neonate received an 85-day course of anti-infective treatment during hospitalization. Follow-up cranial computed tomography (CT) imaging performed four months post-discharge demonstrated complete resolution of the previously observed complications.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"19 ","pages":"633763"},"PeriodicalIF":3.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900217","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}