International Journal of Antimicrobial Agents最新文献

{"title":"Title Page & Editorial Board","authors":"","doi":"10.1016/S0924-8579(25)00146-3","DOIUrl":"10.1016/S0924-8579(25)00146-3","url":null,"abstract":"","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":"66 4","pages":"Article 107591"},"PeriodicalIF":4.6,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144867465","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":"Microbiome and antibiotic resistance profile of milk and faeces from cattle in an organized dairy production system","authors":"Monica Rose Amarlapudi ,&nbsp;Chandrasekhar Balasubramaniam ,&nbsp;Akash ,&nbsp;Hemlata Singh ,&nbsp;Amit Yadav ,&nbsp;Raghu Hirikyathanahalli Vishweswaraiah ,&nbsp;Diwas Pradhan ,&nbsp;Nishant Kumar ,&nbsp;Dhiraj Dhotre ,&nbsp;Atul P. Kolte ,&nbsp;Rashmi Hogarehalli Mallappa","doi":"10.1016/j.ijantimicag.2025.107590","DOIUrl":"10.1016/j.ijantimicag.2025.107590","url":null,"abstract":"<div><div>Antimicrobial resistance (AMR) represents a critical public health challenge, responsible for over one million fatalities each year. Livestock, particularly dairy cattle, significantly contribute to the AMR crisis due to the extensive use of antibiotics in the animal health sector. This study aimed to characterize the antibiotic resistome of dairy cattle by analyzing their fecal and milk metagenomes. We collected 36 milk and 36 fecal samples from three different organized dairy farms and extracted metagenomic DNA, yielding 2.58 and 2.81 billion total reads contributing 200.4 and 206.5 GB data, respectively. The majority of these reads mapped to bacterial genomes, revealing 37 bacterial phyla within the dairy production system, with greater phylum-level diversity observed in feces compared to milk. The predominant phyla identified were Bacillota (53.3%), Pseudomonadota (24.7%), Bacteroidota (11.0%), and Actinomycetota (8.4%). The most abundant genera found were <em>Clostridium</em> in milk and <em>Bifidobacterium</em> in feces. In total, we identified 290 distinct antibiotic-resistant genes spanning 27 diverse drug classes and 12 resistance mechanisms. The abundance of antibiotic-resistant genes was higher in feces than in milk, with 229 distinct antibiotic-resistant genes found in milk. Overall, aminoglycoside-resistant genes were the most prevalent and abundant in both fecal and milk metagenomes of cattle from organized dairy production systems.</div></div>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":"66 6","pages":"Article 107590"},"PeriodicalIF":4.6,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859147","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":"International Society of Antimicrobial Chemotherapy (ISAC) News and Information Page","authors":"","doi":"10.1016/j.ijantimicag.2025.107588","DOIUrl":"10.1016/j.ijantimicag.2025.107588","url":null,"abstract":"","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":"66 4","pages":"Article 107588"},"PeriodicalIF":4.6,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144810197","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":"Emergence of carbapenem-resistant XDR Salmonella enterica in paediatric patients in South China: A genomic perspective study","authors":"Xueqin Feng ,&nbsp;Shengkai Li ,&nbsp;Dingjie Huang ,&nbsp;Nan Tan ,&nbsp;Xueer Li ,&nbsp;Shuting Xia ,&nbsp;Lulu Hu ,&nbsp;Rui Cai ,&nbsp;Yinghui Li ,&nbsp;Juan Wang ,&nbsp;Miaomiao Luo ,&nbsp;Huimin Li ,&nbsp;Xiaolang Ye ,&nbsp;Ziquan Lv ,&nbsp;Xiaolu Shi ,&nbsp;Shuang Wu ,&nbsp;Nigel Dyer ,&nbsp;Heng Li ,&nbsp;Qinghua Hu ,&nbsp;Zhemin Zhou","doi":"10.1016/j.ijantimicag.2025.107589","DOIUrl":"10.1016/j.ijantimicag.2025.107589","url":null,"abstract":"<div><h3>Background and Aim</h3><div>Carbapenem-resistant <em>Salmonella enterica</em> (CRSE), mostly driven by plasmids, poses a growing public health threat, especially in paediatric populations. This study investigates a cluster of paediatric CRSE infections in paediatric populations, characterizes genomic features of CRSE isolates, assesses global CRSE prevalence, and explores plasmid-mediated horizontal gene transfer.</div></div><div><h3>Methods</h3><div>An epidemiological investigation of 18 paediatric CRSE cases was conducted. Genomic analysis included resistome profiling, plasmid typing, and phylogenetic clustering to assess genetic diversity. A global analysis of 530 113 <em>Salmonella</em> genomes identified carbapenemase-carrying isolates. Plasmid transfer experiments between <em>S. enterica</em> and <em>Escherichia coli</em> were performed to evaluate horizontal gene transmission.</div></div><div><h3>Results</h3><div>Respiratory co-infections (67% of cases, primarily respiratory syncytial virus and human parainfluenza viruses) were associated with severe clinical outcomes. Genomic analysis revealed multiple genetically distinct CRSE clones carrying <em>bla</em>_NDM-5, predominantly on IncI-gamma/K1 and IncHI2A plasmids. Plasmid-mediated transfer of carbapenem resistance genes between <em>S. enterica</em> and <em>E. coli</em> was confirmed. Global surveillance identified 228 carbapenemase-positive <em>Salmonella</em> isolates (2000–2023) across 35 genetically diverse populations and 24 countries, demonstrating widespread dissemination.</div></div><div><h3>Conclusions</h3><div>Respiratory co-infections may exacerbate CRSE severity in children, while plasmid circulation drives carbapenem resistance transmission. The high genetic diversity and global distribution of CRSE highlight urgent needs for integrated surveillance, antimicrobial stewardship, and interventions targeting co-infections and environmental reservoirs.</div></div>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":"66 5","pages":"Article 107589"},"PeriodicalIF":4.6,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804048","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":"Piperacillin/tazobactam clearance predicted by non-creatinine based estimates of GFR in critically ill adults","authors":"Erin F. Barreto ,&nbsp;Jack Chang ,&nbsp;Andrew D. Rule ,&nbsp;Kristin C. Cole ,&nbsp;Lindsay Fogelson ,&nbsp;Johar Paul ,&nbsp;Paul J. Jannetto ,&nbsp;Arjun P. Athreya ,&nbsp;Marc H. Scheetz","doi":"10.1016/j.ijantimicag.2025.107586","DOIUrl":"10.1016/j.ijantimicag.2025.107586","url":null,"abstract":"<div><h3>Background and objective</h3><div>As a renally-eliminated beta-lactam antibiotic, estimated glomerular filtration rate (eGFR) is a central component of piperacillin/tazobactam pharmacokinetics. This study aimed to determine the optimal eGFR equation for inclusion in population pharmacokinetic models for piperacillin and tazobactam among critically ill adults.</div></div><div><h3>Methods</h3><div>The study included critically ill adults treated with piperacillin/tazobactam at a single academic medical center between 2018 and 2022. Excluded individuals had acute kidney injury, received kidney replacement therapy, or had extracorporeal membrane oxygenation at piperacillin/tazobactam initiation. Non-linear mixed effects population pharmacokinetic models using eGFR equations with creatinine, cystatin C, or both were developed and compared.</div></div><div><h3>Results</h3><div>Using 377 samples from 120 critically ill patients, we found that a two-compartment model with first-order elimination best fit the piperacillin data and a one-compartment model with first-order elimination best fit the tazobactam data. For piperacillin, the final population mean parameters (standard error) were 8.36 (0.55) L/h for CL and 12.96 (1.17) L for V1. The values for Q and V2 were fixed at 0.98 L/h and 18 L, respectively, due to low interindividual variation in these parameters. For tazobactam, the final population mean parameters were 8.12 (0.52) L/h for CL and 16.87 (1.44) L for V. Both final models identified eGFR_cystatinC expressed in mL/min as the eGFR equation that best predicted drug clearance as a covariate.</div></div><div><h3>Conclusions</h3><div>An eGFR equation that includes cystatin C improves the predictive performance of pharmacokinetic models for piperacillin/tazobactam in critically ill adults.</div></div>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":"66 5","pages":"Article 107586"},"PeriodicalIF":4.6,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775297","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":"Prediction of methicillin-resistant Staphylococcus aureus and carbapenem-resistant Klebsiella pneumoniae from Raman spectra by Artificial Intelligent Raman Detection and Identification System (AIRDIS) with machine learning","authors":"Hsiu-Hsien Lin ,&nbsp;Yu-Tzu Lin ,&nbsp;Chih-Hao Chen ,&nbsp;Kun-Hao Tseng ,&nbsp;Pang-Chien Hsu ,&nbsp;Ya-Lun Wu ,&nbsp;Wei-Cheng Chang ,&nbsp;Nai-Shun Liao ,&nbsp;Yi-Fan Chou ,&nbsp;Chun-Yi Hsu ,&nbsp;Yu-Hui Liao ,&nbsp;Mao-Wang Ho ,&nbsp;Shih-Sheng Chang ,&nbsp;Po-Ren Hsueh ,&nbsp;Der-Yang Cho","doi":"10.1016/j.ijantimicag.2025.107587","DOIUrl":"10.1016/j.ijantimicag.2025.107587","url":null,"abstract":"<div><h3>Objectives</h3><div>Methicillin-resistant <em>Staphylococcus aureus</em> (MRSA) and carbapenem-resistant <em>Klebsiella pneumoniae</em> (CRKP) are two of the most important antibiotic-resistant bacteria. Early use of the correct treatment strategy can not only reduce patient mortality but also prevent the development of resistance. Although some rapid but costly techniques are available, routine workflows in clinical microbiology laboratories can sometimes take several days to deliver bacterial identification and resistance profiles. In this study, we developed a bacterial identification and resistance prediction system that combines Raman spectroscopy and machine learning to predict the MRSA and CRKP.</div></div><div><h3>Methods</h3><div>A total of 988 <em>S. aureus</em> isolates (including 513 MRSA) and 1053 <em>K. pneumoniae</em> isolates (including 517 CRKP) were collected. Of these, 266 <em>S. aureus</em> isolates and 285 <em>K. pneumoniae</em> isolates were used for training, while the remainder were used for validation.</div></div><div><h3>Results</h3><div>The system demonstrated high predictive performance, with accuracy and area under receiver operating characteristic (AUROC) values of 88% and 0.92 for MRSA prediction and 87% and 0.96 for CRKP prediction, respectively.</div></div><div><h3>Conclusions</h3><div>As a result, we confirmed the ability of machine learning to interpret Raman spectra for predicting resistant bacteria in clinical microbiology laboratories. This is the first and novel system validated with a large number of clinical isolates and may be incorporated into existing workflows.</div></div>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":"66 5","pages":"Article 107587"},"PeriodicalIF":4.6,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764795","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":"Exploring the therapeutic potential of bacteriophage-mediated modulation of gut microbiota towards colorectal cancer","authors":"Mutebi John Kenneth ,&nbsp;Jung-Sheng Chen ,&nbsp;Chuan-Yin Fang ,&nbsp;Hsin-Chi Tsai ,&nbsp;Chin-Chia Wu ,&nbsp;Tsui-Kang Hsu ,&nbsp;Chien-Chin Chen ,&nbsp;Bing-Mu Hsu","doi":"10.1016/j.ijantimicag.2025.107585","DOIUrl":"10.1016/j.ijantimicag.2025.107585","url":null,"abstract":"<div><h3>Objectives</h3><div>Given a strong association between gut dysbiosis and colorectal cancer (CRC), this review aims to explore the potential of phage therapy as a targeted intervention that can selectively eliminate CRC-associated bacteria and restore a healthy gut microbiota.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was conducted in Web of Science, PubMed, and Google Scholar to identify studies published within the last decade relevant to gut microbiota, phage therapy, and colorectal cancer (CRC). The search strategy employed the following keywords and Boolean combinations: <em>“gut microbiota” AND “colorectal cancer”; “gut microbiota” AND “phage therapy”; “phage therapy”; “phage therapy” AND “colorectal cancer”; “gut dysbiosis” AND “colorectal cancer”</em>; and <em>“gut microbial modulation” AND “colorectal cancer.”</em></div></div><div><h3>Results</h3><div>Tailored phage-based strategies, such as phage cocktails and Fecal Microbial Transplantation (FMT), have demonstrated therapeutic potential in modulating disease-associated microbiota. However, the clinical application of FMT is limited by safety concerns, particularly the risk of transferring intact bacteria with pathogenic potential. In this review, we highlight Fecal Viral Transplantation (FVT) as a promising and safer alternative, where filtered fecal samples containing phages are transferred, eliminating intact bacteria that could otherwise cause adverse effects.</div></div><div><h3>Conclusions</h3><div>Phage therapy represents a promising strategy to modulate gut microbiota and improve CRC treatment by selectively targeting CRC-associated bacteria. However, its clinical translation in the context of CRC remains dependent on further experimental and clinical studies to establish its safety and efficacy to patients.</div></div>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":"66 5","pages":"Article 107585"},"PeriodicalIF":4.6,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764793","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":"Understanding the role of drug efflux pumps in biofilms and virulence properties: Multiple potential strategies controlling bacterial infections","authors":"Du-Min Jo ,&nbsp;Do Kyung Oh ,&nbsp;Kyung-Jin Cho ,&nbsp;Nazia Tabassum ,&nbsp;Seok-Chun Ko ,&nbsp;Kyung Woo Kim ,&nbsp;Dongwoo Yang ,&nbsp;Ji-Yul Kim ,&nbsp;Gun-Woo Oh ,&nbsp;Grace Choi ,&nbsp;Dae-Sung Lee ,&nbsp;Seul-Ki Park ,&nbsp;Young-Mog Kim ,&nbsp;Fazlurrahman Khan","doi":"10.1016/j.ijantimicag.2025.107584","DOIUrl":"10.1016/j.ijantimicag.2025.107584","url":null,"abstract":"<div><h3>Objectives</h3><div>This study highlights the role of efflux pumps in the resilience of bacterial biofilms and explores strategies to overcome efflux-mediated resistance in order to improve the treatment of biofilm-associated infections.</div></div><div><h3>Methods</h3><div>A literature-based analysis was conducted to examine the mechanisms by which efflux pumps contribute to biofilm resistance and persistence, and to evaluate natural, synthetic, and nanomaterial-based inhibitors as potential therapeutic approaches.</div></div><div><h3>Results</h3><div>Efflux pumps were identified as critical determinants of biofilm resilience, actively expelling antibiotics, biocides, and signaling molecules, thereby reducing antimicrobial efficacy. Overexpression of efflux pumps in biofilm-forming bacteria was linked to enhanced survival and chronic infection. Several natural compounds, synthetic molecules, and nanomaterials demonstrated inhibitory effects on efflux pumps, disruption of biofilm integrity, and restoration of antibiotic susceptibility. Combination therapies using efflux pump inhibitors with conventional antibiotics showed synergistic effects.</div></div><div><h3>Conclusions</h3><div>Targeting efflux pumps provides a promising strategy to mitigate biofilm-associated resistance and virulence. Incorporating efflux pump inhibitors into therapeutic regimens may enhance patient outcomes and improve management of persistent biofilm-related infections.</div></div>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":"66 5","pages":"Article 107584"},"PeriodicalIF":4.6,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764796","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":"Genome-wide analysis and longitudinal study of Klebsiella pneumoniae in Portugal: Tracing the evolution and spread of carbapenem resistance","authors":"Rita Elias ,&nbsp;Jody E. Phelan ,&nbsp;Luís Lito ,&nbsp;Cátia Caneiras ,&nbsp;Cátia Marques ,&nbsp;Margarida Pinto ,&nbsp;Patrícia Cavaco‑Silva ,&nbsp;Helena Ferreira ,&nbsp;Constança Pomba ,&nbsp;Gabriela J. Da Silva ,&nbsp;Maria José Saavedra ,&nbsp;Rosário Coelho ,&nbsp;Rita Lourinho ,&nbsp;Luísa Gonçalves ,&nbsp;Woranich Hinthong ,&nbsp;Maria João Rosa ,&nbsp;José Melo‑Cristino ,&nbsp;Susana Campino ,&nbsp;Isabel Portugal ,&nbsp;Aida Duarte ,&nbsp;João Perdigão","doi":"10.1016/j.ijantimicag.2025.107583","DOIUrl":"10.1016/j.ijantimicag.2025.107583","url":null,"abstract":"<div><h3>Background</h3><div>Carbapenem-resistant <em>Klebsiella pneumoniae</em> (CRKP) has high incidence in Portugal, causing severe and often fatal infections.</div></div><div><h3>Objectives</h3><div>Characterize the evolutionary history and epidemiology of CRKP in Portugal over a 40-year period.</div></div><div><h3>Methods</h3><div>WGS was performed using the Illumina platform. <em>In silico</em> multilocus sequence typing, surface antigen characterization, and resistance gene detection were subsequently carried out. Core and pan-genome analyses were conducted using Roary. Genomic clusters (GCs) were identified based on a 21-SNP threshold. To estimate the divergence times of the most prevalent sequence types (ST) in the dataset, Bayesian evolutionary analysis was performed using BEAST.</div></div><div><h3>Results</h3><div>Nineteen GCs harboring carbapenemases were identified. The <em>bla</em>_KPC-3 gene was the most prevalent carbapenemase, linked to strains circulating in both hospital and community settings, with dissemination patterns at regional, interregional, and international levels. ST15 was the most established sequence type in Portugal, with nine distinct GCs identified in both clinical and environmental samples. Towards the end of 2010s, ST147 and ST13 were responsible for significant outbreaks associated with <em>bla</em>_KPC-3.</div></div><div><h3>Conclusions</h3><div>This study underscores the value of genomic-based surveillance in understanding the evolution of high-risk clones coupled with the spread of AMR determinants. The data obtained highlights a shift in ST predominance across the country from an ST15-dominated period and strongly associated with ESBL dissemination, to the emergence of ST147 and ST13 CRKP clones, the latter associated with international transmission. This work further stresses the importance of cross-border surveillance efforts to monitor the emergence and dissemination of CRKP strains and inform risk assessment and prevention.</div></div>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":"66 5","pages":"Article 107583"},"PeriodicalIF":4.6,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764794","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":"Changes of colistin pharmacokinetics in critically ill patients due to the extracorporeal membrane oxygenation: Results of the COL-ECMO2022 trial","authors":"Pavel Suk ,&nbsp;Jitka Rychlíčková ,&nbsp;Lenka Součková ,&nbsp;Vendula Kubíčková ,&nbsp;Martin Šíma ,&nbsp;Michal Šitina ,&nbsp;Karel Urbánek ,&nbsp;Vladimír Šrámek","doi":"10.1016/j.ijantimicag.2025.107582","DOIUrl":"10.1016/j.ijantimicag.2025.107582","url":null,"abstract":"<div><h3>Introduction</h3><div>Colistin is recognized as the last-resort antibiotic for treating infections caused by multidrug-resistant Gram-negative bacteria, especially in critically ill patients. However, its interference with the extracorporeal membrane oxygenation (ECMO) circuit may affect the achievement of therapeutic targets. The COL-ECMO2022 study aimed to verify the interference of colistin and its prodrug colistimethanesulphonate (CMS) with ECMO.</div></div><div><h3>Methods</h3><div>A prospective pharmacokinetic phase IV study included critically ill adults in whom the parenteral colistin was part of standard medical care. A maximum of three dosing intervals were monitored for each patient. CMS and colistin concentrations were measured by HPLC-MS. ECMO and non-ECMO patients were compared by average steady-state colistin concentration (C_AVG,SS), population pharmacokinetic model (ECMO as a covariate), and linear mixed-effect model (LMEM).</div></div><div><h3>Results</h3><div>Eighteen patients and 40 monitored dosing intervals were analyzed. Median C_AVG,SS was non-significantly lower in 7 patients on ECMO (4.3 [3.5–6.3] mg/L) than in 11 non-ECMO patients (5.2 [4.2–11.5] mg/L) (by 18%; <em>P</em> = 0.551). ECMO was not a significant covariate for any pharmacokinetic parameter in the population PK model. Although LMEM proved significant adsorption of CMS on the ECMO circuit, colistin concentrations were not significantly influenced.</div></div><div><h3>Conclusion</h3><div>No significant differences in colistin plasma concentrations were detected; therefore, CMS dosage adjustment is unnecessary in patients on ECMO.</div></div>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":"66 5","pages":"Article 107582"},"PeriodicalIF":4.6,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760038","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}