Infection and Drug Resistance最新文献

{"title":"Contezolid Harbored Equivalent Efficacy to Linezolid in Tuberculosis Treatment in a Prospective and Randomized Early Bactericidal Activity Study.","authors":"Guanglu Jiang, Rongmei Liu, Yi Xue, Qiping Ge, Lihui Nie, Zizheng Lv, Zhongshun Kong, Jin Shi, Hongmei Chen, Hua Li, Xiaoguang Wu, Li Xie, Yanhua Song, Hairong Huang, Mengqiu Gao","doi":"10.2147/IDR.S499816","DOIUrl":"10.2147/IDR.S499816","url":null,"abstract":"<p><strong>Background: </strong>Contezolid (CZD) is an analog of Linezolid (LZD) that has demonstrated potent in vitro and in vivo activity against tuberculosis (TB) while presenting a safer side-effect profile. In this study, we evaluated the early bactericidal activity (EBA) of CZD compared to LZD, with LZD serving as a control.</p><p><strong>Methods: </strong>Naive, smear-positive pulmonary TB patients were enrolled and randomly assigned to receive either a 14-day monotherapy regimen of 600 mg LZD once daily (QD) or 800 mg CZD twice daily (BID). Sputum samples were collected daily starting one day before treatment initiation and continuing throughout the treatment period. Each sample was processed for the enumeration of acid-fast bacilli (AFB) colonies, and time-to-positivity (TTP) during MGIT960 liquid culture was recorded.</p><p><strong>Results: </strong>A total of 10 eligible patients were enrolled in each treatment group, although one patient in the CZD group was later excluded from the analysis. The early bactericidal activity (EBA0-14) was 0.08 ± 0.12 log CFU/mL/day (95% CI: -0.02 to 0.18 CFU/mL/day) in the CZD group, compared to 0.03 ± 0.10 log CFU/mL/day (95% CI: -0.05 to 0.10 CFU/mL/day) in the LZD group. The increase in time-to-positivity (TTP0-14) was 38.6 ± 43.69 hours (95% CI: -1.85 to 79 hours) in the CZD group and 27.7 ± 78.21 hours (95% CI: -28.15 to 83.75 hours) in the LZD group. LZD showed rapid bacterial reduction in sputum during the first two days of treatment, whereas CZD demonstrated superior efficacy after a few days of treatment.</p><p><strong>Conclusion: </strong>800 mg BID contezolid exhibited comparable efficacy to 600 mg QD LZD in treating pulmonary TB in this EBA study. While CZD showed slower initial bactericidal action compared to LZD, its efficacy surpassed that of LZD after a few days of treatment. Given its similar efficacy and superior safety profile, contezolid may serve as an alternative to linezolid for the treatment of tuberculosis.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"261-268"},"PeriodicalIF":2.9,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11742132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004504","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 Antibacterial Effect of Reduning Combined with Polymyxin on Carbapenem Resistant <i>Klebsiella pneumoniae</i>.","authors":"Zui-Fei Shangguan, Hong-Lei Chen, Yi-Fan Li, Na Shi, Qi-Fen Mao","doi":"10.2147/IDR.S490029","DOIUrl":"10.2147/IDR.S490029","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the status of carbapenem-resistant strains of <i>Klebsiella pneumoniae</i> isolated from the Department of Microbiology, Zhejiang Tongde Hospital between September 2023 and February 2024, and to examine the in vitro antibacterial effect of Reduning combined with polymyxin on carbapenem-resistant <i>Klebsiella pneumoniae</i> (CRKP), which may provide evidence on the application of Reduning in the clinical anti-infective therapy.</p><p><strong>Methods: </strong>A total of 50 different isolates of CRKP were collected, and the minimum inhibitory concentrations (MIC) of polymyxin, Reduning and polymyxin plus Reduning were measured with microbroth dilution method. Then, the fractional inhibition concentration index (FICI) was calculated.</p><p><strong>Results: </strong>A total of 50 strains of CRKP were isolated, sputum and clean urine were the most common source of CRKP, and intensive care unit was the most common source department. More than 90% of CRKP strains were resistant to cefepime, ceftazidime, piperacillin/tazobactam, and cefoperazone/sulbactam. The rate of resistance to levofloxacin was high, but that to tobramycin, tigecycline, and compound sulfamethoxazole was low. In addition, MIC of Reduning plus polymyxin for CRKP was lower than that of Reduning or polymyxin alone. Among 50 strains of CRKP, FICI ≤0.5 was noted in 7 strains, 0.5 < FICI ≤ 1.0 in 43 strains, and none had FICI >1.0. The results showed Reduning combined with polymyxin B exerted additive effect on CRKP and conferred synergistic effect on several strains of CRKP.</p><p><strong>Conclusion: </strong>Reduning has antibacterial effect on CRKP in vitro, and the addition of Reduning can reduce the dose of polymyxin in the treatment of CRKP.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"227-237"},"PeriodicalIF":2.9,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Site-Specific <i>Mycoplasma genitalium</i> Infection and Macrolide and Fluoroquinolone-Associated Mutations in Men Who Have Sex with Men in Shenzhen, China.","authors":"Xinying Leng, Rui Zhu, Xian Ao, Ying Zhou, Kechun Zhang, Tian Hu, Jiaxin Wu, Zhaoqi Chen, Lixia Huang, Nanxuan Huang, Xinyuan Li, Ruaa Ahmed Alnour, Zhantu Xue, Xiangcai Zhang, Han Liu, Tuerhongjiang Axirejiang, Wujian Ke, Huachun Zou","doi":"10.2147/IDR.S489403","DOIUrl":"10.2147/IDR.S489403","url":null,"abstract":"<p><strong>Background: </strong><i>Mycoplasma genitalium</i> (MG) poses a growing public health concern due to the escalating antimicrobial resistance. We aimed to assess site-specific MG infection and its correlates and macrolide and fluoroquinolones mutations among men who have sex with men (MSM) in Shenzhen, China.</p><p><strong>Methods: </strong>Samples were obtained from different anatomic sites of MSM based on their sexual behavior. MG infection was detected using nested polymerase chain reaction (nested PCR). Identifying macrolide and fluoroquinolone resistance involved targeting the V region of the 23S rRNA, topoisomerase IV and DNA gyrase genes. Logistic regression was used to evaluate correlates of MG infection.</p><p><strong>Results: </strong>We collected 124 pharynx swabs, 132 urethral swabs, and 89 rectal swabs from 162 MSM participants based on their sexual behavior. MG was detected in 13.0% (21/162) of MSM. The prevalence of MG in the pharynx, urethra, and rectum was 9.7% (12/124), 6.1% (8/132), and 7.9% (7/89), respectively. Among the 21 MG-positive participants, 4.8% (1/21) were infected at all three sites, and 19.0% (4/21) were infected at two sites. Of the 27 MG-positive specimens, 22.2% (2/9) exhibited mutations at position A2071G, with A2071T being the predominant mutation in the 23S rRNA gene, accounting for 77.8% (7/9) of cases. Mutations in the <i>parC</i> and <i>gyrA</i> genes were detected in 33.3% (1/3) and 33.3% (2/6) of specimens, respectively.</p><p><strong>Conclusion: </strong>We observed a high prevalence of MG infections at different anatomic sites among the MSM population in Shenzhen, China. The high prevalence of macrolide and fluoroquinolone-resistant MG underscores the importance of implementing resistance-guided therapy, establishing surveillance networks, and exploring new antibiotics against MG.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"239-252"},"PeriodicalIF":2.9,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11742131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004636","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":"Characterization of Pancreatic Infections in Patients with Severe Acute Pancreatitis: A Retrospective Study from 2019 to 2023.","authors":"Yong Chen, Qichao Cui, Jin Cao, Qiuyue Wu, Peixuan Lu, Gang Li, Ning Sun","doi":"10.2147/IDR.S500916","DOIUrl":"10.2147/IDR.S500916","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated the distribution and changes in pancreatic infections among patients with acute pancreatitis (AP) from 2019 to 2023, while exploring the impact of multidrug-resistant bacterial infections on the prognosis of patients with poor outcomes.</p><p><strong>Methods: </strong>This study included patients diagnosed with SAP between 2019 and 2023 and collected the demographic and clinical characteristics of all participants. Based on routine clinical microbiological culture results, the distribution and drug resistance of pathogens associated with pancreatic infections were analyzed. Multivariable logistic regression was used to evaluate the association between multidrug-resistant organism (MDRO) infection and poor prognosis.</p><p><strong>Results: </strong>A total of 1586 pancreatic fluid specimens were analyzed and collected from 843 patients diagnosed with AP. The positive rate of the culture results was 81% (1280/1586), with the predominant pathogens identified as <i>Klebsiella pneumoniae, Pseudomonas aeruginosa, Enterococcus faecium</i>, and <i>Acinetobacter baumannii</i> complex. Of the 843 patients, 756 met the criteria, and the proportion of MDROs in pancreatic infections was 87.57% (662/756). Multivariate logistic regression analysis revealed that septic shock, acute kidney injury, and tracheostomy were associated with a poor prognosis, whereas ICU length of stay, infected pancreatic necrosis, and tracheostomy were associated with multidrug-resistant bacterial infections in patients with severe or critical AP.</p><p><strong>Conclusion: </strong>The proportion of MDRO infections in patients with severe or critical AP was notably high, primarily involving multidrug-resistant <i>Klebsiella pneumoniae, Pseudomonas aeruginosa</i>, and <i>Acinetobacter baumannii</i>. Septic shock, acute kidney injury, and tracheostomy have been identified as independent risk factors of poor prognosis in patients with severe or critical AP.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"199-207"},"PeriodicalIF":2.9,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004780","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":"Bacterial Isolates and Their Antimicrobial Susceptibility Patterns Among Pediatric Patients with Urinary Tract Infections: A Retrospective Cross-Sectional Study at Tertiary Level in Afghanistan.","authors":"Esmatullah Esmat, Ramin Saadaat, Noor Hassan Saedi, Ahmadullah Hakimi, Abdul Tawab Baryali, Abdul Jamil Rasooli, Sahar Noor, Maryam Ahmad, Ahmed Maseh Haidary","doi":"10.2147/IDR.S499017","DOIUrl":"10.2147/IDR.S499017","url":null,"abstract":"<p><strong>Introduction: </strong>The widespread use of antibiotics is a serious and alarming situation in terms of the development of antimicrobial resistance. The current study was conducted to demonstrate the types of organism isolated from the urine of patients presenting with UTI symptoms as well as their antimicrobial sensitivity spectrum.</p><p><strong>Methodology: </strong>A descriptive cross-sectional study was conducted, and 272 positive urine cultures from children under 5 years of age with signs and symptoms of a UTI were included in the study. The types of organisms isolated from the urine cultures and their susceptibility to antibiotics were identified. The data collection form was designed as an Excel spreadsheet that included both dependent and independent variables, such as patient age, gender, WBC, red blood cell (RBC) count, nitrite, organism isolated, and antiprogram results.</p><p><strong>Results: </strong>Of the patients included, 64% were female. The majority were under one year of age, followed by children aged one to three. Among these children, 63% had pyuria and hematuria, and 64% had nitrite-positive urine samples. The most commonly isolated organisms included <i>Escherichia coli, Klebsiella species, Candida species, Candida albicans</i>, and <i>Enterococcus species</i>. In this study, 62% of gram-negative organisms were ESBL positive, among which the <i>Proteus species</i> demonstrated the highest ESBL positivity, followed by the <i>Klebsiella species</i> and <i>E. coli</i>. The majority of <i>Enterobacteriaceae</i> isolates in this study showed resistance to Augmentin and Ampicillin. Similarly, <i>E. coli</i> was highly resistant to third-generation cephalosporins, ceftazidime, and ceftriaxone.</p><p><strong>Conclusion: </strong>Due to the high prevalence of UTIs in pediatric patients and their nonspecific signs and symptoms, particularly in infants or young children, diagnosing and treating them, whilst difficult, is crucial. Urine samples should be analyzed for all pediatric patients with fever and, if pyuria is present, a urine culture is necessary.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"51-60"},"PeriodicalIF":2.9,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11730758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983365","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":"Urogenital Manifestations in Mpox (Monkeypox) Infection: A Comprehensive Review of Epidemiology, Pathogenesis, and Therapeutic Approaches.","authors":"Sike He, Jinge Zhao, Junru Chen, Jiayu Liang, Xu Hu, Xingming Zhang, Hao Zeng, Guangxi Sun","doi":"10.2147/IDR.S504280","DOIUrl":"10.2147/IDR.S504280","url":null,"abstract":"<p><p>Monkeypox (mpox), caused by mpox virus (MPXV) infection, reemerged in 2022 and still raises concerns globally. Abundant clinical data indicate that mpox is a sexually transmitted infection and that the urogenital system is the most frequently involved system in mpox, which deserves more attention. Penile lesions are the most common presentation, followed by urethritis. Acute urine retention and acute kidney injury are relatively rare but also highly crucial. Currently, the majority of the urogenital lesions are considered complications secondary to MPXV infection and the common immunosuppression in mpox patients. However, such viewpoints should be treated carefully due to the lack of understanding of the basic mpox pathology. Here, we briefly and comprehensively review the current evidence concerning urogenital lesions caused by mpox, including epidemiology, clinical features, pathogenesis, and therapeutic approaches to provide a preliminary reference for clinicians in future clinical practice.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"209-226"},"PeriodicalIF":2.9,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11733167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004644","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":"Serum Exosomes miR-122-5P Induces Hepatic and Renal Injury in Septic Rats by Regulating TAK1/SIRT1 Pathway.","authors":"Jiaqi Wang, Yujing Jiang, Yamin Yuan, Xin Ma, Tongqin Li, YaTing Lv, Jing Zhang, Liao Chen, Jinquan Zhou, Yanfei Meng, Bei Zhang, Xiaorong Dong, Li Ma","doi":"10.2147/IDR.S499643","DOIUrl":"10.2147/IDR.S499643","url":null,"abstract":"<p><strong>Aim: </strong>Sepsis is a potentially fatal condition characterized by organ failure resulting from an abnormal host response to infection, often leading to liver and kidney damage. Timely recognition and intervention of these dysfunctions have the potential to significantly reduce sepsis mortality rates. Recent studies have emphasized the critical role of serum exosomes and their miRNA content in mediating sepsis-induced organ dysfunction. The objective of this study is to elucidate the mechanism underlying the impact of miR-122-5p on sepsis-associated liver and kidney injury using inhibitors for miR-122-5p as well as GW4869, an inhibitor targeting exosome release.</p><p><strong>Materials and methods: </strong>Exosomes were isolated from serum samples of septic rats, sepsis patients, and control groups, while liver and kidney tissues were collected for subsequent analysis. The levels of miR-122-5p, inflammation indices, and organ damage were assessed using PCR, ELISA, and pathological identification techniques. Immunohistochemistry and Western blotting methods were employed to investigate the activation of inflammatory pathways. Furthermore, big data analysis was utilized to screen potential targets of miR-122-5p in vivo.</p><p><strong>Key findings: </strong>Serum exosomal levels of miR-122-5p were significantly elevated in septic patients as well as in LPS-induced septic rats. Inhibition of miR-122-5p reduced serum pro-inflammatory factors and ameliorated liver and kidney damage in septic rats. Mechanistically, miR-122-5p upregulated TAK1, downregulated SIRT1, and facilitated NF-κB activation.</p><p><strong>Conclusion: </strong>Serum exosomal miR-122-5p promotes inflammation and induces liver/kidney injury in LPS-induced septic rats by modulating the TAK1/SIRT1/NF-κB pathway, highlighting potential therapeutic targets for sepsis management.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"185-197"},"PeriodicalIF":2.9,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11727329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142978365","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":"School-Based Epidemiology of <i>Schistosoma haematobium</i> Infection in Kharif District of Amran Governorate, North of Yemen: Need for Chemopreventive Strategy Revisiting.","authors":"Dawla H Z Alansi, Mohammed A K Mahdy, Rashad Abdul-Ghani, Ahmed A Azazy","doi":"10.2147/IDR.S496484","DOIUrl":"10.2147/IDR.S496484","url":null,"abstract":"<p><strong>Background: </strong>Urogenital schistosomiasis is a persistent public health problem in many rural areas of Yemen. Since 2014, <i>Schistosoma haematobium</i> epidemiology has not been assessed in Amran governorate, north of Yemen, where <i>S. haematobium</i> is known to be highly endemic. Therefore, this study determined the prevalence and risk factors associated with <i>S. haematobium</i> infection among schoolchildren in Kharif district of the governorate.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among 529 schoolchildren aged 7 to 15 years in Kharif district. Data on children's demographics, clinical features, behaviors, and infection-related environmental factors were collected using a structured questionnaire. The urine filtration technique was used to detect and count <i>S. haematobium</i> eggs, and chemical reagent strips were used to detect microhematuria. The number of eggs per 10 mL of urine (EP10mL) was used to estimate the intensity of infection, which was classified as light (≤50 EP10mL) or heavy (>50 EP10mL). Multivariable binary logistic regression analysis was used to identify predictors of infection.</p><p><strong>Results: </strong>Light-intensity <i>S. haematobium</i> infection was prevalent among 34.8% of schoolchildren in Kharif district, with a 95% confidence interval (CI) ranging from 30.7 to 38.8. Infection was significantly associated with microhematuria (<i>P</i> <0.001) and self-reported dysuria (<i>P</i> = 0.003). Family ownership of agricultural land was significantly associated with <i>S. haematobium</i> infection among schoolchildren [odds ratio (OR) = 1.8, 95% CI: 1.10-3.17; <i>P</i> = 0.030], which was further identified as an independent predictor of infection (adjusted OR = 2.2, 95% CI: 1.21-3.95; <i>P</i> = 0.010).</p><p><strong>Conclusion: </strong>A considerable proportion of schoolchildren in Kharif district have light-intensity <i>S. haematobium</i> infections, mostly presenting with microhematuria and self-reported dysuria. The district's level of risk should be updated to moderate. Consequently, the chemopreventive strategy needs to be revisited to treat all school-age children biennially, regardless of enrollment status.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"161-170"},"PeriodicalIF":2.9,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970580","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 Epidemiological Characteristics of <i>bla</i> _IMP-4-Carrying <i>Klebsiella pneumoniae</i> ST-11 in Hospitalized Patients.","authors":"Yu E Xue, Dongmei Zhang, Shuaixian Du, Du Chen, Shihan Liu, Tianfeng Peng, Chong Li, Jianchu Zhang, Xiaorong Wang","doi":"10.2147/IDR.S482713","DOIUrl":"10.2147/IDR.S482713","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the molecular epidemiology and risk factors of carbapenem-resistant <i>Klebsiella pneumoniae</i> (CRKP) infection.</p><p><strong>Patients and methods: </strong>Patient's clinical data and CRKP strains were collected from November 2017 to December 2018 at a tertiary hospital in Wuhan, China. The antimicrobial susceptibilities, carbapenem-resistant genes, multi-locus sequence typing (MLST), homologous analysis, and risk factors for CRKP were determined.</p><p><strong>Results: </strong>A total of 203 CRKP strains were isolated, and 98.5% (200/203) of patients were nosocomially infected. The mortality rate was 17.7% (36/203). All 203 strains were confirmed as carbapenemases -producing strains. The most predominant carbapenemase gene was <i>bla</i> _IMP-4 (81.3%, 165/203), followed by <i>bla</i> _KPC-2 (25.1%, 51/203) and <i>bla</i> _NDM-1 (23.2%, 47/205). Of the 203 strains, 28 (13.8%) had both <i>bla</i> _KPC-2 and <i>bla</i> _IMP-4 genes, 23 (11.3%) had both <i>bla</i> _IMP-4 and <i>bla</i> _NDM-1 genes, 20 (9.9%) had <i>bla</i> _KPC-2, <i>bla</i> _IMP-4 and <i>bla</i> _NDM-1 three genes. MLST analysis showed that there were 48 ST typologies (including 7 new STs), of which ST-11 was the most prevalent (59.6%, 121/203). Phylogenetic analysis showed that 203 CRKP isolates came from 7 clusters and exhibited a strong correlation with the isolation source. eBURST analyses indicated that CRKP isolates have undergone different evolutionary processes. Patients with ST-11 CRKP underwent more mechanical ventilation (50% vs 32.9%, <i>P</i>=0.020) and gastric catheterization (15.7% vs 6.1%, <i>P</i>=0.042) within 3 months before sample collection, and also had higher drug-resistance rate than non-ST-11 CRKP. Comparing with CSKP (carbapenem-sensitive <i>Klebsiella pneumoniae</i>), gastrointestinal disease (odds ratio [OR]=6.168, <i>P</i>=0.003), nosocomial infection (OR=5.573, <i>P</i>=0.012), antibiotic exposure (OR=4.131, <i>P</i>=0.004), urinary catheterization (OR=3.960, <i>P</i>=0.031) and venous/arterial catheterization (OR=2.738, <i>P</i>=0.026) within the preceding 3 months were independent risk factors for CRKP infection.</p><p><strong>Conclusion: </strong>The IMP-4 was the most predominant carbapenemase and <i>bla</i> _IMP-4 bearing <i>Klebsiella pneumoniae</i> ST-11 was spreading in the hospital. Nosocomial infections, antibiotic exposure, and urinary and venous/arterial catheterization within 3 months were the risk factors for developing CRKP infection.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"171-184"},"PeriodicalIF":2.9,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970573","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":"Comparison of Clinical Characteristics and Mortality Outcome in Critical COVID-19 Patients Infected with Alpha and Omicron Variants.","authors":"Hsin-I Cheng, Ko-Wei Chang, Bing-Chen Wu, Mei-Yuan Teo, Wei-Syun Hung, Hao-Ming Wu, Allen Chung-Cheng Huang, Chang-Wei Lin, Ting-Yu Lin, Horng-Chyuan Lin, Cheng-Hsun Chiu, Shu-Min Lin","doi":"10.2147/IDR.S479896","DOIUrl":"10.2147/IDR.S479896","url":null,"abstract":"<p><strong>Objective: </strong>Early reports have indicated that the Omicron variant of coronavirus disease 2019 (COVID-19) may be associated with low mortality. However, the mortality rate of critical patients in Taiwan with COVID-19 caused by different variants has not been well described.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted at the Linkou Branch of Chang Gung Memorial Hospital, Taiwan, from April 2020 to September 2022. Critically ill patients who had confirmed SARS-CoV-2 infection and were on mechanical ventilation (MV) were enrolled. Demographic data, laboratory results, and treatment information were collected and analyzed. In addition, clinical outcomes for different SARS-CoV-2 variants were analyzed.</p><p><strong>Results: </strong>This study included 110 critical patients with COVID-19 who required intubation and intensive care unit (ICU) admission. Among these patients, 46 (41.8%) required intensive care during Alpha predominance period and 64 (58.2%) during the Omicron predominance period. The Alpha group had a higher body mass index, had a longer ICU stay, and included more patients with acute respiratory distress syndrome, and the Omicron group included more active smokers, had more comorbidities, had worse initial laboratory data (including higher white blood cell counts, prothrombin time [PT], activated partial prothrombin time, blood urine nitrogen levels, and creatine levels), and had higher in-hospital mortality rates (40.6% vs 15.2%, p = 0.004). The independent risk factors for in-hospital mortality, were Charlson Comorbidity Index (CCI) ≥ 3 and higher PT and creatine levels.</p><p><strong>Conclusion: </strong>Our study discovered that CCI ≥ 3, elevated serum creatine levels, and prolonged PT were independently associated with a high mortality rate in patients with critical COVID-19. Patients with those risk factors may require intensive monitoring during their treatment course.</p>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"151-160"},"PeriodicalIF":2.9,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970538","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}