JAC-Antimicrobial Resistance最新文献

{"title":"Antimicrobial resistance trends of methicillin-resistant <i>Staphylococcus aureus</i> in Norway from 2008 to 2017.","authors":"Torunn Gresdal Rønning, Hege Enger, Jan Egil Afset, Christina Gabrielsen Ås","doi":"10.1093/jacamr/dlaf094","DOIUrl":"10.1093/jacamr/dlaf094","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of this study was to analyse nationwide trends in antimicrobial susceptibility and molecular epidemiology of all MRSA strains in Norway over a 10-year period.</p><p><strong>Materials and methods: </strong>All cases of MRSA in Norway from 2008 to 2017 were included, limited to the first case per year per individual (<i>n</i> = 15 200). Strains were confirmed as MRSA with PCR and genotyped using <i>spa</i>-typing. Antimicrobial susceptibility data and epidemiological data were collected from the Norwegian MRSA reference laboratory and the Norwegian Surveillance System for Communicable Diseases, respectively.</p><p><strong>Results: </strong>Despite an increase in MRSA cases, antimicrobial resistance rates remained stable throughout the study period. The most common susceptibility profile of the MRSA strains was resistance to cefoxitin alone (41.4%), while co-resistance (58.6%) was observed most commonly for erythromycin (31.0%), tetracycline (25.3%) and ciprofloxacin/norfloxacin (21.6%). Notably, associations were identified between specific resistance patterns and clinical variables, including higher resistance rates among healthcare-associated MRSA, particularly in older adults and nursing home residents. Geographic associations were also observed, linking specific resistance profiles to strains acquired in North America, Africa and Asia.</p><p><strong>Conclusions: </strong>The findings highlight a complex landscape of MRSA resistance in a low-prevalence country, characterized by a diverse genotypic population and stable longitudinal trends in resistance rates. However, the prevalence of co-resistance to one or more antibiotics among Norwegian MRSA strains was high and increasing. This study thus underscores the importance of continuous surveillance and adherence to antimicrobial guidelines.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"7 3","pages":"dlaf094"},"PeriodicalIF":3.7,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12141746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resistance mechanisms and tedizolid susceptibility in clinical isolates of linezolid-resistant bacteria in Japan.","authors":"Ryosuke Shoji, Masayuki Maeda, Kozue Yamaguchi, Takahiro Takuma, Rintaro On, Kazuhisa Ugajin, Daisuke Okatomi, Kunihiko Fukuchi, Issei Tokimatsu, Keiko Ishino","doi":"10.1093/jacamr/dlaf097","DOIUrl":"10.1093/jacamr/dlaf097","url":null,"abstract":"<p><strong>Objectives: </strong>Studies combining linezolid resistance mechanisms and tedizolid susceptibility in linezolid-resistant clinical isolates are scarce. This study investigated the linezolid resistance mechanisms and tedizolid susceptibility of linezolid-resistant strains isolated clinically in Japan.</p><p><strong>Methods: </strong>We analysed 25 linezolid-resistant strains of <i>Enterococcus faecium</i> and <i>Enterococcus faecalis</i> isolated from Japanese hospitals between 2015 and 2021. MICs of linezolid and tedizolid were determined using the agar plate dilution method. Each 23S rRNA copy was amplified by PCR, sequenced and analysed for mutations. The linezolid resistance genes <i>cfr</i>, <i>poxtA</i>, <i>optrA</i>, <i>fexA</i> and <i>fexB</i> were also detected by PCR.</p><p><strong>Results: </strong>Drug susceptibility tests revealed that five linezolid-resistant <i>E. faecium</i> isolates had low (≤1 mg/L) tedizolid MICs. Resistance mechanisms included the G2576T mutation in 23S rRNA, the T2504A mutation and the resistance genes <i>optrA</i>, <i>fexA</i> and <i>fexB</i>. The T2504A mutation was identified in one <i>E. faecium</i> isolate, which exhibited linezolid and tedizolid MICs of 64 and 32 mg/L, respectively.</p><p><strong>Conclusions: </strong>Some linezolid-resistant isolates demonstrated low (≤1 mg/L) tedizolid MICs. To determine whether tedizolid susceptibility testing should be performed on linezolid-resistant isolates, more linezolid-resistant isolates should be collected and tested for tedizolid MICs. Tedizolid MICs were 2-3 doubling dilutions lower than linezolid MICs. The results of this study suggest that future research should investigate whether the T2504A mutation contributes to tedizolid resistance. To our knowledge, this is the first study to report tedizolid susceptibility in <i>E. faecium</i> with the T2504A mutation and in isolate harbouring this mutation.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"7 3","pages":"dlaf097"},"PeriodicalIF":3.7,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12130435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clonal dissemination and persistence of Carbapenem-resistant <i>bla</i> _KPC-2 harbouring <i>Klebsiella pneumoniae</i> ST307 in a Tertiary Hospital in the Republic of Korea.","authors":"Eunkyung Shin, Dong-Yeop Lee, Min Kyeong Kim, Jaeil Yoo, Ji-Yeon Hyeon, Junyoung Kim","doi":"10.1093/jacamr/dlaf090","DOIUrl":"10.1093/jacamr/dlaf090","url":null,"abstract":"<p><strong>Objectives: </strong>We investigated the epidemiological patterns of carbapenem-resistant, <i>bla</i> _KPC-2 harbouring <i>Klebsiella pneumoniae</i> (<i>K. pneumoniae</i>) ST 307 isolates in a tertiary hospital in South Korea between 2019 and 2021 and compared them to isolates collected from 25 hospitals through a nationwide survey, using whole genome sequencing and phylogenetic analysis.</p><p><strong>Methods: </strong>Whole genome sequences of 25 isolates from hospital GB2 and 45 isolates from 25 other hospitals were analysed for antibiotic resistance gene profiles, virulence gene profiles, plasmid replicons, and phylogenetic relationships.</p><p><strong>Results: </strong>Core genome single nucleotide polymorphism (cgSNP)-based phylogenetic analysis categorized the 70 isolates into three distinct groups and 13 subgroups, supported by high bootstrap values and low SNP differences. Subgroup 1 comprised the 18 isolates from GB2 collected over 3 years, suggesting long-term persistence and repeated outbreaks within GB2. Region-specific dissemination was indicated by several subgroups containing isolates from different hospitals within the same province. Subgroup 7 comprised isolates from multiple provinces and years, suggesting potential long-distance transmission via patient transfers or community reservoirs. All isolates carried multiple β-lactam resistance genes; <i>bla</i> _CTX-M-15 was observed in 67 isolates (89.3%) and the OXA variants in 70 isolates (93.3%). None of the isolates carried the <i>rmpA/rmpA2</i> or <i>magA</i> genes, while 58 of the 70 (82.9%) harboured yersiniabactin-encoding genes.</p><p><strong>Conclusions: </strong>Our findings reveal both clonal persistence within a tertiary hospital and region-specific dissemination of <i>bla</i> _KPC-2 producing <i>K. pneumoniae</i> ST307 across South Korea. These results highlight the importance of continuous nationwide surveillance and genomic analysis to implement effective infection control measures to mitigate further dissemination.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"7 3","pages":"dlaf090"},"PeriodicalIF":3.7,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge, practices, educational needs and hospital engagement in Infection Prevention and Control (IPC) among Italian healthcare workers and students: results from a national multicentre survey.","authors":"Francesco Di Gennaro, Francesco Vladimiro Segala, Roberta Papagni, Elda De Vita, Giacomo Guido, Luisa Frallonardo, Alessandra Vigna, Monica Fiorella, Davide Capruzzi, Marinella Cibelli, Annunziata Ilenia Ritacco, Luigi Pisani, Francesca De Palo, Pietro Locantore, Alessandra Tolin, Federica Penco, Marianna Meschiari, Rita Murri, Massimo Fantoni, Cristina Mussini, Annalisa Saracino","doi":"10.1093/jacamr/dlaf081","DOIUrl":"10.1093/jacamr/dlaf081","url":null,"abstract":"<p><strong>Objective: </strong>This study assesses the knowledge, practices, educational needs and hospital engagement in IPC among healthcare workers (HCWs) and students in Italy.</p><p><strong>Methods: </strong>A national cross-sectional observational study was conducted from April to July 2024. Participants completed a validated questionnaire based on WHO and CDC guidelines. Four outcomes were evaluated: (i) knowledge of IPC, (ii) self-reported compliance, (iii) satisfaction with education and (iv) hospital engagement in IPC.</p><p><strong>Results: </strong>Among respondents (<i>n</i> = 1063, 67.75% female) significant gaps in IPC knowledge were noted, with only 66.1% correctly identifying key hand hygiene moments. Compliance was low, with only 43.3% always adhering to hand hygiene rules. Satisfaction with IPC education was also low (28%). While alcohol-based hand gel was widely available (84.2%), only 36.6% received formal hand hygiene training before onboarding.Multivariate analysis revealed that female HCWs had higher IPC knowledge [adjusted odds ratio (aOR) 1.55, 95% CI: 1.04-2.31] and better compliance (aOR 1.72, 95% CI: 1.01-2.92). Younger HCWs demonstrated greater knowledge and satisfaction. Surgical ward staff, despite greater education satisfaction, exhibited lower IPC knowledge (aOR 0.53, 95% CI: 0.32-0.87). Nurses and health assistants received more hospital IPC training (aOR 1.59, 95% CI: 1.04-2.46; aOR 5.83, 95% CI: 1.94-18.89, respectively). Finally, the presence of a hospital IPC team positively correlated with all outcomes, including higher IPC knowledge (aOR 2.68, 95% CI: 1.79-4.05) and adherence (aOR 3.4, 95% CI: 1.92-6.3).</p><p><strong>Conclusion: </strong>The study reveals substantial gaps in IPC knowledge, practices and education among Italian HCWs, emphasizing the urgent need for effective targeted interventions that require robust institutional support.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"7 3","pages":"dlaf081"},"PeriodicalIF":3.7,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12117534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phenotypic susceptibility profiles of AmpC- and/or extended-spectrum beta-lactamase-(co)producing <i>Escherichia coli</i> strains.","authors":"Joan E Totté, Chantal Quiblier, Oliver Nolte, Vladimira Hinic, Herman F Wunderink, Adrian Egli, Stefano Mancini","doi":"10.1093/jacamr/dlaf091","DOIUrl":"10.1093/jacamr/dlaf091","url":null,"abstract":"","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"7 3","pages":"dlaf091"},"PeriodicalIF":3.7,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144158838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current practices in outpatient parenteral antimicrobial therapy programmes: an international multi-centre survey.","authors":"Zenaw T Wolie, Jason A Roberts, Luis Eduardo López-Cortés, Manuel Mirón-Rubio, James Pollard, Afra Nahdia Marizan Nor, Mohd H Abdul-Aziz, Conor Jamieson, R Andrew Seaton, Mark Gilchrist, Fekade B Sime","doi":"10.1093/jacamr/dlaf075","DOIUrl":"10.1093/jacamr/dlaf075","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to assess the current international practices of outpatient parenteral antimicrobial therapy (OPAT).</p><p><strong>Methods: </strong>A multi-site cross-sectional study was conducted, using REDCap platform for survey distribution and data collection. Data analysis was performed in SPSS version 29.</p><p><strong>Results: </strong>Of the 146 OPAT responding centres serving adults, paediatrics or both, 82% have been operating for over 10 years. OPAT teams were multidisciplinary, with nurses comprising the largest proportion in 89% of centres, followed by infectious disease (ID) pharmacists (83%) and ID physicians (80%). Service activity varied widely, with 92% centres treating fewer than 100-5000 patients annually (median = 300). Home-based models of care were used by more than 85% of facilities in Australia, the UK and Spain, while 82% of Malaysian and 75% of UK centres used infusion centres. Common OPAT indications include skin and soft tissue, bone and joint, urinary tract and respiratory tract infections, with ceftriaxone and ertapenem used by over 80% of the centres. Peripherally inserted central and midline catheters were common except in Malaysia. Among enrolled centres, complex oral antimicrobial therapy supervision was higher in the UK (82%) than in Spain (77%), Australia (42%) and Malaysia (24%). Inconsistencies in guidelines supporting antimicrobial stability and dosing information were noted, with a call for more stability data on certain antimicrobials.</p><p><strong>Conclusions: </strong>This study revealed significant variation in OPAT practice. Further study is needed to understand the reasons for these differences and whether better alignment of practice could improve patient outcomes, antimicrobial stewardship practice and resource utilization.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"7 3","pages":"dlaf075"},"PeriodicalIF":3.7,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144158710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnitude, predictors, and trends of multidrug-resistant tuberculosis among tuberculosis patients at Debre Markos, Northwest, Ethiopia: a five-year retrospective study.","authors":"Aytenew Atnaf, Mekuanenit Kibret, Bekele Tesfaye, Desalegn Abebaw","doi":"10.1093/jacamr/dlaf086","DOIUrl":"10.1093/jacamr/dlaf086","url":null,"abstract":"<p><strong>Background: </strong>The emergence of multidrug-resistant tuberculosis (MDR-TB) is a threat to the people of resource-limited countries, such as Ethiopia. This study aimed to assess the magnitude, predictors and trends of multidrug-resistant tuberculosis among patients with pulmonary tuberculosis (TB) at Debre Markos Comprehensive and Specialized Hospital (DMCSH), Northwest Ethiopia.</p><p><strong>Materials and methods: </strong>A retrospective cross-sectional study was conducted among patients with TB treated at the directly observed treatment short course (DOTS) clinic at DMCSH from 1 June 2016 to 1 June 2020. Data from 1509 patients with TB registered in the clinic were retrieved from medical records. Statistical analysis was performed using SPSS v.24. The frequency of variables is presented via tables and figures. Logistic regression was fitted to predictors of MDR-TB, and a <i>P</i> value < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Overall, data from 1509 patients with pulmonary TB were retrieved during the study. The overall prevalence of MDR-TB was 4.1%. Variables such as sex, human immunodeficiency virus (HIV) status, lesion on chest X-ray, and a history of anti-TB treatment were significantly associated with MDR-TB. The trend of MDR-TB decreased by 40% in 2017, 29% in 2018, and 10% in 2019, but increased by 21% in 2020.</p><p><strong>Conclusions and recommendations: </strong>The prevalence of MDR-TB among patients with pulmonary TB was comparable to the national rate. Key risk factors for MDR-TB included male sex, prior TB treatment, HIV infection, and chest X-ray abnormalities. The increasing trend in 2020 highlights the need for strengthened TB treatment adherence counselling and further prospective studies to explore additional predictors of MDR-TB.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"7 3","pages":"dlaf086"},"PeriodicalIF":3.7,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144158837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of rare β-lactamase <i>bla</i> _SCO-1 from a <i>Klebsiella pneumoniae</i> high-risk clone in Peru.","authors":"Luciano A Palomino-Kobayashi, Rocío Egoávil-Espejo, Gina Salvador-Luján, Pamela Yáñez, Ronnie G Gavilán, Maria J Pons, Joaquim Ruiz","doi":"10.1093/jacamr/dlaf089","DOIUrl":"10.1093/jacamr/dlaf089","url":null,"abstract":"<p><strong>Background: </strong>The <i>bla</i> _SCO-1 gene, which codes for a carbenicillinase, is an uncommon β-lactamase. To the best of our knowledge, we report the first instance of a <i>Klebsiella pneumoniae</i> clinical high-risk isolate carrying <i>bla</i> _SCO-1 in Peru.</p><p><strong>Objectives: </strong>To characterize a <i>K. pneumoniae</i> clinical isolate carrying <i>bla</i> _SCO-1 in Peru, isolated from a tertiary care hospital in Lima, Peru.</p><p><strong>Methods: </strong>Susceptibility to amoxicillin/clavulanic acid, amoxicillin/sulbactam, piperacillin/tazobactam, aztreonam, ceftriaxone, cefotaxime, ceftazidime, ceftazidime/avibactam, cefepime, imipenem, meropenem, ciprofloxacin, trimethoprim/sulfamethoxazole, gentamicin, amikacin and tigecycline was determined using the Kirby-Bauer disc diffusion method. Detection of <i>bla</i> _SCO-1 was established by Illumina WGS and bioinformatic analyses. All the publicly available genomes from <i>K. pneumoniae</i> carrying <i>bla</i> _SCO-1 from the American continent were downloaded from the NCBI Isolates browser for assessment of phylogenetic comparisons.</p><p><strong>Results: </strong>The isolate showed resistance to all the tested antibiotics except for ceftazidime/avibactam, carbapenems and tigecycline. Illumina WGS showed the presence of <i>bla</i> _SCO-1 and <i>bla</i> _OXA-1, <i>bla</i> _SHV-28, <i>bla</i> _TEM-1, <i>bla</i> _CTX-M-15, as well as genes associated with resistance to quinolones, fosfomycin, aminoglycosides, sulphonamides, trimethoprim and phenicols. Moreover, the isolate was ST307, a high-risk clone of <i>K. pneumoniae</i> usually associated with <i>bla</i> _CTX-M-15 and/or carbapenemases. Notwithstanding, the latter were not found on this isolate. Phylogenetic relationships were established by comparisons with 19 <i>K. pneumoniae</i> genomes carrying <i>bla</i> _SCO-1 from other countries in the Americas, revealing at least three different clades.</p><p><strong>Conclusions: </strong>This study highlights the importance of genomic surveillance of uncommon antimicrobial resistance genes such as <i>bla</i> _SCO-1, which might contribute to further antimicrobial resistance levels in this country.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"7 3","pages":"dlaf089"},"PeriodicalIF":3.7,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between antibiotic consumption intensity and extended-spectrum cephalosporin resistance in nursing homes: a retrospective ecological study.","authors":"Emmanouil Glampedakis, Anne Niquille, Patricia Cuiña Iglesias, Alessandro Cassini, Catherine Plüss-Suard, Andreas Kronenberg, Marie Immaculée Nahimana Tessemo, Tom R Brewer, Thomas Rawson","doi":"10.1093/jacamr/dlaf088","DOIUrl":"10.1093/jacamr/dlaf088","url":null,"abstract":"<p><strong>Background: </strong>Studies relating the usage of antibiotics with extended-spectrum cephalosporin resistance (ESC-R) rates from clinical isolates in nursing homes (NHs) are rare. We investigated associations between the intensity of NH-level antibiotic consumption (ABC) and the frequency of ESC-R expressing urinary <i>Escherichia coli</i>, <i>Klebsiella</i> spp. and <i>Proteus</i> spp. isolates from NH residents.</p><p><strong>Materials and methods: </strong>We used retrospective data on ABC and ESC-R counts aggregated by NH and year between 2017 and 2022 from NHs of canton Vaud in Switzerland. Negative binomial regression was used to relate ABC intensity, expressed as DDDs per 1000 resident days, with counts of ESC-R expressing bacteria.</p><p><strong>Results: </strong>Fifty-four NHs were included cumulatively accounting for 6601 urinary isolates, of which 5028 <i>E. coli</i>, 999 <i>Klebsiella</i> spp. and 574 <i>Proteus</i> spp. Among these, the 6-year ESC-R cumulative incidence was 10.3% (<i>E. coli</i> 12.6%, <i>Klebsiella</i> spp. 3.8% and <i>Proteus</i> spp. 1.2%). Median annual overall ABC varied between 31.3 and 44.2 DDDs per 1000 resident days. There was no association between overall ABC, most antibiotic categories and ESC-R cumulative incidence. The consumption of cephalosporins [adjusted incidence rate ratio (aIRR): 1.023, 95% CI: 1-1.047] and carbapenems (aIRR: 1.542, 95% CI: 1.018-2.336) was independently associated with increased incidence.</p><p><strong>Conclusion: </strong>No association was found between overall ABC and ESC-R rates. Cephalosporin consumption showed a modest association, while for carbapenems this could reflect therapeutic use. These findings highlight the need for enhanced surveillance and resident-level data to better understand antibiotic resistance drivers in this setting.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"7 3","pages":"dlaf088"},"PeriodicalIF":3.7,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12099033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The magnitude of MDR carbapenemase-producing Enterobacteriaceae isolates and associated factors among hospitalized patients of Northeast Ethiopia.","authors":"Assefa Sisay, Chalie Mulugeta","doi":"10.1093/jacamr/dlaf080","DOIUrl":"10.1093/jacamr/dlaf080","url":null,"abstract":"<p><strong>Background: </strong>Currently, carbapenemase-producing Enterobacteriaceae (CPE) are becoming a global public health threat. Infections caused by these bacteria limit treatment options and are associated with high morbidity and mortality. This study aimed to assess the prevalence of CPE and identify associated risk factors.</p><p><strong>Methods: </strong>A hospital-based cross-sectional study was conducted from June to August 2023. Clinical samples were cultured, and species identification was performed using standard biochemical tests. Antimicrobial susceptibility testing was done, and a modified carbapenem inactivation method was employed to confirm carbapenemase production. Data were entered using Epi Data and analysed with SPSS.</p><p><strong>Results: </strong>From a total of 143 isolates, the most commonly identified species were <i>Escherichia coli</i> (62 isolates, 43.4%) and <i>Klebsiella pneumoniae</i> (39 isolates, 27.3%). The highest level of resistance was against ampicillin (138 isolates, 96.5%), whereas the lowest was observed with meropenem (19 isolates, 13.3%). Overall, 123 isolates (86.0%) were classified as MDR. The prevalence of CPE and carbapenem-resistant Enterobacteriaceae (CRE) was 5.7% and 8.1%, respectively. <i>K. pneumoniae</i> and <i>E. coli</i> were the most common carbapenemase producers. Chronic underlying disease, consuming raw vegetables, and lack of regular hand-washing habits before meals showed adjusted odds ratios of 7.9 (95% CI 1.9-31.5), 11 (95% CI 3.4-40) and 8.0 (95% CI 1.7-85), respectively, showing a significant association.</p><p><strong>Conclusions: </strong>The high prevalence of CPE underscores the need for urgent infection control measures. Implementing antimicrobial stewardship, strengthening infection control measures, and further molecular studies are vital to combating this problem.</p>","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"7 3","pages":"dlaf080"},"PeriodicalIF":3.7,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}