International Journal of Antimicrobial Agents最新文献

{"title":"In reply to the Letter to Editor regarding \"Enhancing meropenem therapy in critical care: A retrospective study of PK/PD target attainment and therapeutic drug monitoring\".","authors":"Jingli Liao, Chao Li, Jingxian Liu, Wei Wu, Xiaohui Huang, Yanfei Mao, Lixia Li","doi":"10.1016/j.ijantimicag.2026.107830","DOIUrl":"https://doi.org/10.1016/j.ijantimicag.2026.107830","url":null,"abstract":"","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":" ","pages":"107830"},"PeriodicalIF":4.6,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Environmental surveillance in Chile reveals a multidrug-resistant Salmonella Amager from an emerging bla_CTX-M-65/pESI-positive lineage.","authors":"Josefina Miranda-Riveros, Daniel Tichy-Navarro, María José Navarrete, Angélica Reyes-Jara, Magaly Toro, Juan A Ugalde, Andrea I Moreno-Switt, Alejandro Piña-Iturbe","doi":"10.1016/j.ijantimicag.2026.107831","DOIUrl":"https://doi.org/10.1016/j.ijantimicag.2026.107831","url":null,"abstract":"<p><p>The spread of extended-spectrum β-lactamase (ESBL)-producing and fluoroquinolone-resistant Salmonella pose a global public health challenge in addition to the high burden of infections associated with this foodborne pathogen. In this study we aimed to characterize a multidrug-resistant strain of Salmonella serovar Amager isolated from a Chilean river in October 2023. Antimicrobial susceptibility testing revealed a resistance phenotype against multiple antibiotic families, including fluoroquinolones and β-lactams, showing ESBL production. Hybrid genome sequencing allowed the identification of a 311,303 bp plasmid carrying the aadA1, aph(4)-Ia, aac(3)-IVa, floR, sul1, tet(A), and bla_CTX-M-65 genes, sharing 99.98% sequence identity with the Salmonella Infantis pESI-like megaplasmid. In addition, the qnrB19 gene was found in a ≈2.7 kbp plasmid of widespread distribution. Population structure and temporal phylogenetic analysis at the global scale revealed the emergence of a Salmonella Amager lineage from the HC20_35565 cluster, carrying the Salmonella Infantis bla_CTX-M-65-positive pESI-like megaplasmid and causing human infections in the United States and the United Kingdom. Our work describes the environmental detection and characterization of a Salmonella lineage with resistance against first-line antibiotics used for treating severe infections, underscoring the relevance of environmental surveillance as a means for detecting emergent pathogens and anticipating human infections.</p>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":" ","pages":"107831"},"PeriodicalIF":4.6,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on: New-generation antibiotics and nonantibiotic strategies against carbapenemase-producing Enterobacterales: More focus on metallo-β-lactamase producers.","authors":"Xiaopei Yang, Wen Zhou, Xisong Ke","doi":"10.1016/j.ijantimicag.2026.107833","DOIUrl":"https://doi.org/10.1016/j.ijantimicag.2026.107833","url":null,"abstract":"","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":" ","pages":"107833"},"PeriodicalIF":4.6,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Title Page & Editorial Board","authors":"","doi":"10.1016/S0924-8579(26)00108-1","DOIUrl":"10.1016/S0924-8579(26)00108-1","url":null,"abstract":"","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":"67 5","pages":"Article 107819"},"PeriodicalIF":4.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Phage therapy for KPC-producing Klebsiella pneumoniae decolonization in high-risk patients: The KIDNAP Study Protocol - A prospective feasibility and proof of concept study in the Brazilian context” [International Journal of Antimicrobial Agents Volume 67(2026)107673]","authors":"Iris Najjar ,&nbsp;Larissa Simão Gandolpho ,&nbsp;Jôiciglecia Pereira dos Santos ,&nbsp;Camila de Paula Siqueira ,&nbsp;Moses B. Ikechukwu ,&nbsp;Ághata Cardoso da Silva Ribeiro ,&nbsp;Mélanie Roch ,&nbsp;Roberto Sierra ,&nbsp;Diego O. Andrey ,&nbsp;Celso Arrais-Rodrigues ,&nbsp;Ana C. Gales","doi":"10.1016/j.ijantimicag.2026.107766","DOIUrl":"10.1016/j.ijantimicag.2026.107766","url":null,"abstract":"","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":"67 5","pages":"Article 107766"},"PeriodicalIF":4.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147616067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The need for systematic therapeutic drug monitoring of isoniazid in tuberculosis, a real-world study.","authors":"Marine Chancel, Youssef Bennis, Sandra Bodeau, Anne-Sophie Lemaire-Hurtel, Jean-Philippe Lanoix, Claire Andréjak","doi":"10.1016/j.ijantimicag.2026.107827","DOIUrl":"https://doi.org/10.1016/j.ijantimicag.2026.107827","url":null,"abstract":"<p><strong>Objectives: </strong>Isoniazid is a primary first-line antituberculosis agent, exhibiting concentration-dependent bactericidal effect while also posing a risk of hepatotoxicity. Therapeutic drug monitoring (TDM) could optimize exposure but remains underused. This study aimed to assess isoniazid pharmacokinetic variability in real-world settings and the proportion of patients achieving therapeutic concentrations.</p><p><strong>Methods: </strong>We conducted a retrospective, single-center study of adult tuberculosis patients receiving standard first-line therapy (isoniazid, rifampicin, pyrazinamide, ethambutol). Patients underwent fasted-state isoniazid monitoring via a 4-point limited-sampling protocol. We calculated AUC₀₋₂₄ₕ and acetylation status (rapid: half-life <2.2 h; slow: ≥2.2 h). Expected exposure was defined by a Cmax of 3-6 mg/L, while target exposure was defined by an AUC₀₋₂₄ₕ above 10.5 h·mg/L for bactericidal efficacy and below 21.8 h·mg/L to minimize the risk of hepatotoxicity.</p><p><strong>Results: </strong>Among 109 patients (66.1% male, median age 40.7 years, 69.8% pulmonary tuberculosis), AUC₀₋₂₄ₕ showed high interindividual variability (range 3.4-62.8 h·mg/L, coefficient of variation 59.4%), independent of weight-adjusted dosing (Pearson's r=-0.016, p=0.875). Slow acetylators predominated (59%). With a median dose of 4.1 mg/kg, 24 patients (22%) had subtherapeutic AUC₀₋₂₄ₕ (<10.5 h·mg/L), while 52 (47.7%) exceeded the hepatotoxicity risk threshold (>21.8 h·mg/L). Nearly one-third had Cmax within the expected range but AUC₀₋₂₄ₕ above the safety limit.</p><p><strong>Conclusion: </strong>Real-world data reveal substantial isoniazid exposure variability, with frequent deviations from target AUC₀₋₂₄ₕ. These findings advocate for systematic TDM and individualized dosing, prioritizing AUC₀₋₂₄ₕ as a key monitoring parameter.</p>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":" ","pages":"107827"},"PeriodicalIF":4.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multi-target Modulation of the AKT/NF-κB Signaling Axis by Quercetin Attenuates Stenotrophomonas maltophilia-Induced Pneumonia.","authors":"Hanzhao Zhang, Yang Li, Fuming You, Jiang Li, Yuxia Yang, Chelegeri Zhao, Rigetu Zhao, Luomeng Chao","doi":"10.1016/j.ijantimicag.2026.107823","DOIUrl":"https://doi.org/10.1016/j.ijantimicag.2026.107823","url":null,"abstract":"<p><strong>Background: </strong>Multidrug-resistant Stenotrophomonas maltophilia pneumonia lacks effective therapies. Quercetin, a natural flavonoid with anti-inflammatory properties, may offer benefit, but its mechanism remains unclear.</p><p><strong>Methods: </strong>We characterized a clinical S. maltophilia isolate, predicted quercetin targets via network pharmacology, validated interactions through molecular docking and 100 ns dynamics simulations, and evaluated efficacy in a murine pneumonia model using histopathology, western blotting, qPCR, and immunohistochemistry.</p><p><strong>Results: </strong>The isolated H-SMA strain exhibited multidrug resistance (resistant to β-lactams, macrolides, aminoglycosides) but remained susceptible to enrofloxacin. Network pharmacology identified eight core inflammatory/apoptotic targets (TNF, IL6, IL1B, IL10, IFNG, CASP3, BCL2, AKT1). Molecular docking and 100 ns dynamics simulations confirmed stable quercetin binding to all targets, with strongest interactions with AKT1 (-8.4 kcal/mol) and CASP3 (3-5 stable hydrogen bonds). In vivo, quercetin (100 mg/kg/d) significantly ameliorated clinical symptoms, reversed body weight loss, attenuated pulmonary histopathological damage, and restored splenic architecture, achieving efficacy comparable to enrofloxacin. Mechanistically, quercetin inhibited phosphorylation of AKT, IκBα, and NF-κB p65, restored Bcl-2/Bax balance, and reduced cleaved Caspase-3 expression. At the transcriptional level, quercetin downregulated pro-inflammatory (TNF, IL1B, IL6, IFNG) and pro-apoptotic (CASP3) genes while upregulating anti-inflammatory (IL10) and anti-apoptotic (BCL2) genes. Immunohistochemistry confirmed reduced pulmonary NF-κB p65 nuclear translocation and cleaved Caspase-3 positivity.</p><p><strong>Conclusions: </strong>Quercetin alleviates S. maltophilia pneumonia through multi-target modulation of AKT/NF-κB signaling and apoptosis pathways, supporting its potential as host-directed therapy for drug-resistant bacterial infections.</p>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":" ","pages":"107823"},"PeriodicalIF":4.6,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeted Use of Sulopenem in Multidrug-Resistant Uncomplicated Urinary Tract Infections.","authors":"Areej Riaz, Raana Riaz","doi":"10.1016/j.ijantimicag.2026.107828","DOIUrl":"https://doi.org/10.1016/j.ijantimicag.2026.107828","url":null,"abstract":"","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":" ","pages":"107828"},"PeriodicalIF":4.6,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors and serum concentration thresholds associated with tigecycline-induced hepatotoxicity in critically ill patients.","authors":"Mengxue Li, Jie He, Gaoqiu Dong, Hua Shao, Linlin Hu","doi":"10.1016/j.ijantimicag.2026.107822","DOIUrl":"https://doi.org/10.1016/j.ijantimicag.2026.107822","url":null,"abstract":"<p><strong>Background: </strong>Hepatotoxicity is a serious adverse effect associated with tigecycline therapy and may necessitate discontinuation of treatment. Optimal dosing strategies and predictive indicators are urgently needed to improve safety.</p><p><strong>Objectives: </strong>This study aims to identify risk factors associated with tigecycline-induced hepatotoxicity and to determine a serum concentration threshold that can serve as a predictive indicator for this adverse event.</p><p><strong>Methods: </strong>This retrospective and single-center study included patients with severe infections who received tigecycline therapy. Clinical data and serum concentration parameters were extracted from the electronic medical records of these patients. Patients were classified into hepatotoxicity group and normal group to identify the risk factors associated with tigecycline-induced hepatotoxicity. Logistic regression analysis and receiver operating characteristic (ROC) curve analysis were used to determine the risk factors related to tigecycline-induced hepatotoxicity and to establish a serum-concentration-threshold prediction of this adverse effect.</p><p><strong>Results: </strong>A total of 151 patients were enrolled in this study, of whom 35.10% developed hepatotoxicity. Multivariate regression analysis revealed that trough concentration (C_min), peak concentration (C_max), concentration at 6 hours post-dose (C_6h), 24-hour area under the concentration-time curve (AUC_0-24), and concomitant use of voriconazole or statins were all significantly associated with an increased risk of hepatotoxicity (P < 0.05). Furthermore, C_min and C_6h were identified as the optimal predictors of tigecycline-induced hepatotoxicity in ICU patients, with optimal cut-off values of 0.535 mg/L and 0.690 mg/L, respectively.</p><p><strong>Conclusions: </strong>Tigecycline exposure is significantly associated with tigecycline-induced hepatotoxicity. Therefore, we recommend closely monitoring plasma tigecycline concentrations in patients to ensure both therapeutic efficacy and patient safety.</p>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":" ","pages":"107822"},"PeriodicalIF":4.6,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and tolerability of switching to bictegravir/emtricitabine/tenofovir alafenamide versus continuing dolutegravir/lamivudine in people living with HIV with neuropsychiatric comorbidities: week 24 and 48 results from the Management of INSTI-associated Neuropsychiatric Disorders (MIND) clinical trial.","authors":"Ignacio Perez-Valero, Diana Corona Mata, María Jose Crussells Canales, Maria Velasco Arribas, Rafael Mican Rivera, Pablo Ryan, Miguel Nicolas Navarrete-Lorite, Juan Tiraboschi, Julia Barrado-Cuchillo, Marta Molero Bonilla, Francisca Artigues Serra, Alvaro Mena de Cea, Sara de la Fuente Moral, Xavier Perez Stachowski, Lucio Jesus Garcia Fraile, Mariana Diaz Almidon, Pedro Gil, Claudia Ferreira Tata, Antonio Rivero Juarez, Antonio Rivero","doi":"10.1016/j.ijantimicag.2026.107825","DOIUrl":"https://doi.org/10.1016/j.ijantimicag.2026.107825","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate if switching from dolutegravir/lamivudine (DTG/3TC) to bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) improves neuropsychiatric tolerability in suppressed adults with stable neuropsychiatric comorbidities.</p><p><strong>Methods: </strong>MIND was a phase IV, randomised, double-blind, multicentre trial. Participants were assigned (1:1) to switch to BIC/FTC/TAF or continue DTG/3TC. The primary endpoint was the proportion of grade 2-4 neuropsychiatric adverse events (NP-AEs) at week 24. Secondary endpoints included safety, virological maintenance, and patient-reported outcomes (PROs) through week 48.</p><p><strong>Results: </strong>Eighty participants were randomised (BIC/FTC/TAF, n=41; DTG/3TC, n=39). At week 24, grade 2-4 NP-AEs occurred in 14.6% of the BIC/FTC/TAF arm vs 17.9% in the DTG/3TC group (difference: 3.3% [95%CI -19.5 to 12.9];p=0.688). At week 48, incidences were 21.9% vs 17.9% (difference: 4.0% [95%CI -13.5 to 21.5];p=0.650). NP-AE-related discontinuations were low (7.3% vs 5.1%). At week 24, BIC/FTC/TAF showed less moderate-to-severe nausea/vomiting (3.8% vs 23.2%;p=0.027) and abdominal discomfort (16.8% vs 40.2%;p=0.04). At week 48, BIC/FTC/TAF reported more headache (55.7% vs 26.1%;p=0.03) but fewer skin symptoms (24.9% vs 49.2%;p=0.022). All maintained virological suppression at week 48; four participants on DTG/3TC met failure criteria but achieved re-suppression without emergent resistance. PRO trajectories and treatment satisfaction remained high and stable throughout the study, with no significant between-group differences.</p><p><strong>Conclusions: </strong>In PLWH with stable neuropsychiatric comorbidities, switching to BIC/FTC/TAF did not reduce NP-AEs or improve PROs versus continuing DTG/3TC. Both regimens were safe and highly effective at maintaining virological suppression through 48 weeks.</p>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":" ","pages":"107825"},"PeriodicalIF":4.6,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}