International Journal of Antimicrobial Agents最新文献

{"title":"Effectiveness of short treatment duration for carbapenemase-producing Enterobacterales in bloodstream-infections: A retrospective cohort study","authors":"Sofía De la Villa ,&nbsp;Celia Sánchez-Martínez ,&nbsp;Emilia Cercenado ,&nbsp;Belén Padilla ,&nbsp;Teresa Vicente ,&nbsp;Julia Serrano ,&nbsp;Luciana Urbina ,&nbsp;Patricia Muñoz","doi":"10.1016/j.ijantimicag.2024.107318","DOIUrl":"10.1016/j.ijantimicag.2024.107318","url":null,"abstract":"<div><h3>Objective</h3><div>We analyse the effectiveness of short courses of adequate treatment in patients with episodes of carbapenemase-producing Enterobacterales bloodstream-infections (CPE-BSI).</div></div><div><h3>Methods</h3><div>Patients with first monomicrobial CPE-BSI episodes who received ≥72 h of appropriate treatment from 2014–2022 were selected. Detection of CPE was established on the basis of phenotypic antibiogram and confirmation by PCR and/or immunochromatographic methods. Patients were classified in short treatment group (STG) those who received 3–10 days of appropriate treatment, and long treatment (LTG) those receiving &gt;10 days. Unfavourable outcome consisted in a composite of global 30-day mortality and/or persistent bacteremia and/or recurrent bacteremia. Inverse probability of treatment weighting (IPTW) analysis was performed to compare the outcome between the two study groups.</div></div><div><h3>Results</h3><div>We included 105 CPE-BSI episodes: 99 were caused by OXA-48-like, 4 VIM and 2 KPC carbapenemases. Thirty-nine patients (37.1%) were included in the STG and 66 (62.9%) in LTG. The STG group presented frequent treatment with ceftazidime-avibactam (43.6% vs. 24.2%, <em>P</em> = 0.03) and lower in-hospital stay (21 days vs. 32 days, <em>P</em> = 0.02). Overall, 28 patients (26.7%) presented unfavourable outcome: IPTW analysis showed no differences in the outcome between STG to LTG groups (24.2% vs. 30.8%, weighted-risk difference 6.6%, <em>P</em> = 0.44). Patients with unfavourable outcome presented more frequently source other than urinary-biliary (46.4% vs. 23.4%, <em>P</em> = 0.02), received less frequently ceftazidime-avibactam (14.3% vs. 37.7%, <em>P</em> = 0.02) and presented frequently with absence of source control when indicated (28.6% vs. 13.0%, <em>P</em> = 0.06).</div></div><div><h3>Conclusions</h3><div>Short treatment durations for CPE-BSI episodes may be effective, as long as they are appropriate and source control is performed.</div></div>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":"64 5","pages":"Article 107318"},"PeriodicalIF":4.9,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132647","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 emergence of transposon-driven multidrug resistance in invasive nontypeable Haemophilus influenzae over the last decade","authors":"Tsai-Wen Wan ,&nbsp;Yu-Tsung Huang ,&nbsp;Jian-Hong Lai ,&nbsp;Qiao-Ting Chao ,&nbsp;Hui-Hui Yeo ,&nbsp;Tai-Fen Lee ,&nbsp;Yung-Chi Chang ,&nbsp;Hao-Chieh Chiu","doi":"10.1016/j.ijantimicag.2024.107319","DOIUrl":"10.1016/j.ijantimicag.2024.107319","url":null,"abstract":"<div><div>Nontypeable <em>Haemophilus influenzae</em> (NTHi), once considered a harmless commensal, has emerged as a significant concern due to the increased prevalence of multidrug-resistant (MDR) strains and their association with invasive infections. This study aimed to explore the epidemiology and molecular resistance mechanisms of 51 NTHi isolates collected from patients with invasive infections in northern Taiwan between 2011 and 2020. This investigation revealed substantial genetic diversity, encompassing 29 distinct sequence types and 18 clonal complexes. Notably, 68.6% of the isolates exhibited ampicillin resistance, with 28 categorised as MDR and four isolates were even resistant to up to six antibiotic classes. Among the MDR isolates, 18 pulsotypes were identified, indicating diverse genetic lineages. Elucidation of their resistance mechanisms revealed 18 β-lactamase-producing amoxicillin–clavulanate-resistant (BLPACR) isolates, 12 β-lactamase-producing ampicillin-resistant (BLPAR) isolates, and 5 β-lactamase-nonproducing ampicillin-resistant (BLNAR) isolates. PBP3 analysis revealed 22 unique substitutions in BLPACR and BLNAR, potentially contributing to cephem resistance. Notably, novel transposons, Tn<em>7736</em>-Tn<em>7739</em>, which contain critical resistance genes, were discovered. Three strains harboured Tn<em>7739</em>, containing seven resistance genes [<em>aph(3′)-Ia, bla</em>_TEM-1, <em>catA, sul2, strA, strB</em>, and <em>tet</em>(B)], while four other strains carried Tn<em>7736</em>, Tn<em>7737</em>, and Tn<em>7738</em>, each containing three resistance genes [<em>bla</em>_TEM-1, <em>catA</em>, and <em>tet</em>(B)]. The emergence of these novel transposons underscores the alarming threat posed by highly resistant NTHi strains. Our findings indicated that robust surveillance and comprehensive genomic studies are needed to address this growing public health challenge.</div></div>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":"64 4","pages":"Article 107319"},"PeriodicalIF":4.9,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132648","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":"Can clinical microbiology laboratories rely on disk diffusion for accurate susceptibility assessment of cefiderocol?","authors":"Patricia Orlandi Barth ,&nbsp;Camila Mörschbächer Wilhelm ,&nbsp;Dariane Castro Pereira ,&nbsp;Afonso Luís Barth","doi":"10.1016/j.ijantimicag.2024.107316","DOIUrl":"10.1016/j.ijantimicag.2024.107316","url":null,"abstract":"","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":"64 5","pages":"Article 107316"},"PeriodicalIF":4.9,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132645","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":"Early Antibiotic De-escalation in Patients With Severe Infections Due to Bloodstream Infection by Enterobacterales: A Post Hoc Analysis of a Prospective Multicentre Cohort","authors":"Francesc Escrihuela-Vidal ,&nbsp;Zaira R. Palacios-Baena ,&nbsp;Josune Goikoetxea Agirre ,&nbsp;María Teresa Pérez-Rodríguez ,&nbsp;José María Reguera Iglesias ,&nbsp;Jordi Cuquet Pedragosa ,&nbsp;Leticia Sánchez Gómez ,&nbsp;Lucía Boix-Palop ,&nbsp;Alberto Bahamonde Carrasco ,&nbsp;Clara Natera-Kindelán ,&nbsp;Jonathan Fernández-Suárez ,&nbsp;Alfredo Jover-Sáenz ,&nbsp;Alejandro Smithson Amat ,&nbsp;Alfonso del Arco Jiménez ,&nbsp;Juan Manuel Sánchez Calvo ,&nbsp;Andrés Martín-Aspas ,&nbsp;Pedro María Martínez Pérez-Crespo ,&nbsp;Inmaculada López-Hernández ,&nbsp;Jesús Rodríguez-Baño ,&nbsp;Luis Eduardo López-Cortés ,&nbsp;Isabel Reche","doi":"10.1016/j.ijantimicag.2024.107317","DOIUrl":"10.1016/j.ijantimicag.2024.107317","url":null,"abstract":"<div><h3>Background</h3><div>Data about antibiotic de-escalation in sepsis associated with the bloodstream and caused by Enterobacterales are scarce. The objectives of this study are to identify factors associated with early de-escalation and to analyse the impact of de-escalation on mortality in patients with Enterobacterales bloodstream infection (BSI) with a Sequential Organ Failure Assessment (SOFA) score ≥ 2.</div></div><div><h3>Methods</h3><div>A prospective, multicentre cohort study was performed including episodes of BSI due to Enterobacterales and a SOFA score ≥ 2 who were receiving an active antipseudomonal β-lactam; the isolate should be susceptible to at least 1 narrower-spectrum antibiotic. Variables associated with de-escalation were identified using logistic binary regression. The association of de-escalation with 30-day mortality was investigated. Confounding was controlled by calculating a propensity score used as covariate, as matching variable, and for inverse probability treatment weighting.</div></div><div><h3>Results</h3><div>Of the 582 patients included, de-escalation was performed in 311 (53.4%). Neutropenia (adjusted odds ratio [aOR] = 0.37; 95% confidence interval [95% CI] = 0.18–0.75), central venous catheter (aOR = 0.52; 95% CI = 0.32–0.83), and extended-spectrum β-lactamase (ESBL)–producing isolate (aOR = 0.28; 95% CI = 0.17–0.48) were negatively associated with de-escalation, and urinary tract source was positively associated (aOR = 2.27; 95% CI = 1.56–3.33). The 30-day mortality was 6.8% (21 patients) in de-escalated patients and 14.4% (39) in not de-escalated patients (relative risk, 0.63; 95% CI = 0.44–0.89). In multivariate analysis including the propensity score, de-escalation was not associated with mortality (AOR = 0.98; 95% CI = 0.39–2.47) and was protective in the case of urinary or biliary tract source (AOR = 0.31, 95% CI = 0.09–1.06). Matched and inverse probability treatment weighting analysis showed similar results.</div></div><div><h3>Conclusions</h3><div>These results suggest that early de-escalation from antipseudomonal β-lactams is safe in patients with Enterobacterales bacteremia and SOFA ≥ 2.</div></div>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":"64 5","pages":"Article 107317"},"PeriodicalIF":4.9,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132646","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(24)00229-2","DOIUrl":"10.1016/S0924-8579(24)00229-2","url":null,"abstract":"","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":"64 3","pages":"Article 107313"},"PeriodicalIF":4.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0924857924002292/pdfft?md5=e847c8e42e743d5156dfca39c82dca40&pid=1-s2.0-S0924857924002292-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142096088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improvement in high-density lipoprotein cholesterol in people with HIV who switched from a tenofovir alafenamide-containing regimen to cabotegravir plus rilpivirine","authors":"Camilla Muccini ,&nbsp;Sara Diotallevi ,&nbsp;Riccardo Lolatto ,&nbsp;Girolamo Piromalli ,&nbsp;Vincenzo Spagnuolo ,&nbsp;Antonella Castagna","doi":"10.1016/j.ijantimicag.2024.107312","DOIUrl":"10.1016/j.ijantimicag.2024.107312","url":null,"abstract":"","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":"64 4","pages":"Article 107312"},"PeriodicalIF":4.9,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107120","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 impact of extracorporeal support on antimicrobial pharmacokinetics in critically ill neonatal and paediatric patients: A systematic review","authors":"Michele L. Cree ,&nbsp;Mohd Hafiz Abdul-Aziz ,&nbsp;Luregn J. Schlapbach ,&nbsp;Jason A. Roberts ,&nbsp;Suzanne L. Parker","doi":"10.1016/j.ijantimicag.2024.107311","DOIUrl":"10.1016/j.ijantimicag.2024.107311","url":null,"abstract":"<div><h3>Objectives</h3><p>Infections represent a major risk for critically ill neonatal and paediatric patients requiring extracorporeal life-saving support such as extracorporeal membrane oxygenation (ECMO) and/or continuous renal replacement therapies (CRRT). Patient outcomes rely on achieving target antimicrobial concentrations. In critically ill adults on extracorporeal support, suboptimal antimicrobial concentrations have been shown to be common. Our objective was to systematically review antimicrobial pharmacokinetic studies in critically ill term neonatal and paediatric patients receiving ECMO and/or CRRT and compare them to similar cohorts of patients not receiving ECMO or CRRT.</p></div><div><h3>Methods</h3><p>Studies published between 1990 and 2022 were identified through systematic searches in PUBMED, Embase, Web of Science, Medline, Google Scholar and CINAHL. Studies were included which provided antimicrobial pharmacokinetic parameters (volume of distribution and clearance) in the neonatal and paediatric patients receiving ECMO and/or CRRT. Studies were excluded if no antimicrobial pharmacokinetic parameters were described or could be calculated.</p></div><div><h3>Results</h3><p>Forty-four pharmacokinetic studies were identified describing 737 patients, with neonatal patients recruited in 70% of the ECMO studies and &lt;1% of the CRRT studies. Of all the studies, 50% were case reports or case series. The pharmacokinetics were altered for gentamicin, daptomycin, ceftolozane, micafungin, voriconazole, cefepime, fluconazole, piperacillin, and vancomycin, although considerable patient variability was described.</p></div><div><h3>Conclusion</h3><p>Significant gaps remain in our understanding of the pharmacokinetic alterations in neonatal and paediatric patients receiving ECMO and CRRT support.</p></div>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":"64 4","pages":"Article 107311"},"PeriodicalIF":4.9,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0924857924002279/pdfft?md5=f2a9986d669051796e197e8a6794f201&pid=1-s2.0-S0924857924002279-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142092853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alexander (Alasdair) McIntosh Geddes: 1934–2024","authors":"Dr Fiona M. MacKenzie","doi":"10.1016/j.ijantimicag.2024.107282","DOIUrl":"10.1016/j.ijantimicag.2024.107282","url":null,"abstract":"","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":"64 3","pages":"Article 107282"},"PeriodicalIF":4.9,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0924857924002000/pdfft?md5=605c68a97c53eac74a68d504cf4278cd&pid=1-s2.0-S0924857924002000-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142048994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","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.2024.107307","DOIUrl":"10.1016/j.ijantimicag.2024.107307","url":null,"abstract":"","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":"64 3","pages":"Article 107307"},"PeriodicalIF":4.9,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0924857924002231/pdfft?md5=807585f03302690ec9120f2eb877d49d&pid=1-s2.0-S0924857924002231-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142040720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reduced mortality with antimicrobial stewardship guided by BioFire FilmArray Blood Culture Identification 2 panel in critically ill patients with bloodstream infection: A retrospective propensity score-matched study","authors":"How‑Yang Tseng ,&nbsp;Chieh-Lung Chen ,&nbsp;Wei‑Cheng Chen ,&nbsp;Yu-Chu Kuo ,&nbsp;Shinn‑Jye Liang ,&nbsp;Chih‑Yen Tu ,&nbsp;Yu‑Chao Lin ,&nbsp;Po-Ren Hsueh","doi":"10.1016/j.ijantimicag.2024.107300","DOIUrl":"10.1016/j.ijantimicag.2024.107300","url":null,"abstract":"<div><h3>Objectives</h3><p>To investigate whether using the BioFire® FilmArray® Blood Culture Identification 2 panel (BCID2) leads to timely antimicrobial therapy and improves patient outcomes in critically ill patients with bloodstream infections (BSIs).</p></div><div><h3>Methods</h3><p>This retrospective observational study included patients with BSIs admitted to the intensive care unit from July 1, 2021, to August 31, 2023. Patients were divided into groups receiving appropriate or inappropriate antimicrobial therapy. Those receiving inappropriate therapy underwent adjustments using standard-of-care (SOC) testing or BCID2. Propensity score matching (PSM) was performed on the original cohort (Model 1) and a time-window bias-adjusted cohort (Model 2). Clinical impact of BCID2-guided antimicrobial adjustment was analysed in both models.</p></div><div><h3>Results</h3><p>A total of 181 patients received inappropriate antimicrobial therapy, with 33 undergoing BCID2 testing and 148 undergoing SOC testing. Following PSM and time-window bias adjustment, 66 patients were analysed in Model 1 and 46 patients in Model 2. BCID2 significantly reduced the median time to appropriate antimicrobial therapy (40.8 vs. 74.0 h in Model 1; 42.8 vs. 68.9 h in Model 2) and the day-28 mortality rate (27.8% vs. 77.1%, <em>P</em> &lt; 0.001 in Model 1; 23.5% vs. 58.6%, <em>P</em> = 0.021 in Model 2). In multivariate regression analysis, BCID2-guided antimicrobial adjustment was an independent prognostic factor for day-28 mortality (adjusted odds ratio [aOR] 0.07 in Model 1 and aOR 0.12 in Model 2).</p></div><div><h3>Conclusion</h3><p>BCID2-guided antimicrobial stewardship was associated with a shorter time to appropriate antimicrobial therapy and reduced day-28 mortality in critically ill patients with BSIs receiving inappropriate antimicrobial therapy.</p></div>","PeriodicalId":13818,"journal":{"name":"International Journal of Antimicrobial Agents","volume":"64 4","pages":"Article 107300"},"PeriodicalIF":4.9,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035807","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}