Journal of global antimicrobial resistance最新文献

{"title":"Drug-resistance patterns and associated mutations of Mycobacterium tuberculosis strains isolated from chronic kidney disease and diabetes mellitus patients in Ethiopia","authors":"Ayinalem Alemu ,&nbsp;Getu Diriba ,&nbsp;Getachew Seid ,&nbsp;Solomon H. Mariam ,&nbsp;Nega Berhe ,&nbsp;Balako Gumi","doi":"10.1016/j.jgar.2025.04.026","DOIUrl":"10.1016/j.jgar.2025.04.026","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the drug-resistance (DR) patterns, mutations, and associated factors among tuberculosis (TB) cases identified from diabetes mellitus (DM) and chronic kidney disease patients.</div></div><div><h3>Methods</h3><div>The DR patterns of 77 <em>Mycobacterial</em> isolates were assessed using phenotypic drug-susceptibility testing, the Xpert MTB/rifampicin (RIF) assay, the Xpert MTB/XDR assay, and line probe assays. Data were analysed using SPSS version 27. Descriptive statistics, a chi-squared test, and logistic regression were conducted. The 95% CI was determined, and a <em>P</em>-value &lt;0.05 was considered a statistically significant difference.</div></div><div><h3>Results</h3><div>Resistance pattern was determined for 76 <em>Mycobacterial</em> isolates, and one isolate had an invalid result. Any DR and multi-DR were detected among 25.0% (19), and 7.9% (6) isolates, respectively. Resistance to streptomycin, isoniazid (INH), RIF, ethambutol, and pyrazinamide was 11.8% (9), 13.2% (10), 10.5% (8), 6.6% (5), and 11.8%(9), respectively. Mono-DR was detected for streptomycin 3.9% (3), INH 2.6% (2), RIF 2.6% (2), and pyrazinamide 4.5% (4). One isolate was resistant to fluoroquinolones. Phenotypic and genotypic methods had concordant results in determining RIF and fluoroquinolones resistance. The common RIF and INH-resistant conferring mutations were observed at the <em>S531L</em> and <em>S315T</em> regions, respectively. Previous TB treatment and TB contact history were associated with DR-TB.</div></div><div><h3>Conclusions</h3><div>A quarter of TB cases identified had DR-TB, with a higher risk among patients with previous TB treatment history and had contact with TB patients, necessitating programmatic interventions, including applying infection prevention, contact tracing, and access to drug-susceptibility testing using rapid molecular methods.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"43 ","pages":"Pages 293-300"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness and safety of ceftazidime-avibactam in Chinese patients with hospital-acquired pneumonia, including ventilator-associated pneumonia: A Phase 4, multi-centre, open-label study","authors":"Jinyi Yuan ,&nbsp;Haihui Huang ,&nbsp;Fei Guo ,&nbsp;Aimin Li ,&nbsp;NanYan Xu ,&nbsp;Xiaoyue Chang ,&nbsp;Zuke Xiao ,&nbsp;Huiqing Zeng ,&nbsp;Hua Qiao ,&nbsp;Liangfa Tang ,&nbsp;Yunsong Yu ,&nbsp;Bin Liu ,&nbsp;Panpan Wang ,&nbsp;Paurus Irani ,&nbsp;Rienk Pypstra ,&nbsp;Junchao Lu ,&nbsp;Fanglei Liu ,&nbsp;Yuting Mu ,&nbsp;Yingyuan Zhang","doi":"10.1016/j.jgar.2025.03.001","DOIUrl":"10.1016/j.jgar.2025.03.001","url":null,"abstract":"<div><h3>Background</h3><div>Ceftazidime-avibactam was approved in patients with hospital-acquired pneumonia (HAP), including ventilator-associated pneumonia (VAP), based on the multinational Phase 3 REPROVE study. This study assessed efficacy and safety of ceftazidime-avibactam in Chinese adults with HAP/VAP.</div></div><div><h3>Methods</h3><div>This was a Phase 4, prospective, multi-centre, open-label study, conducted at 42 sites in China. Patients with HAP/VAP received ceftazidime-avibactam 2.5 g by 2-h IV infusion every 8 h for 7–14 d. Primary efficacy endpoint was clinical response at the test-of-cure (TOC) visit in the clinical modified intent-to-treat (cMITT) analysis set. Secondary endpoints included microbiological response at TOC (microbiological modified intent-to-treat analysis set) and all-cause mortality at TOC and D 28. Results were summarized descriptively.</div></div><div><h3>Results</h3><div>Of 257 screened individuals, 235 were treated with ceftazidime-avibactam (safety analysis set); 71% were male; median age was 67 y. <em>Klebsiella pneumoniae</em> (<em>n</em> = 49 [61.3%]) and <em>Pseudomonas aeruginosa</em> (<em>n</em> = 16 [20.0%]) were the most frequently isolated baseline pathogens. Clinical cure at TOC was achieved in 62.7% patients (131/209, 95% confidence interval [CI]: [56.0, 69.0]) in the cMITT analysis set. Favourable microbiological responses at TOC occurred in 51.3% (41/80, 95% CI: [40.4, 62.0]) patients (microbiological modified intent-to-treat analysis set). All-cause mortality was 5.7% (12/209; 95% CI: 3.2, 9.6) at TOC and D 28 (cMITT analysis set). No new safety signals were identified.</div></div><div><h3>Conclusions</h3><div>Ceftazidime-avibactam was effective in Chinese patients with HAP/VAP, and results were consistent with the Phase 3 REPROVE study. These findings support the use of ceftazidime-avibactam as a potential treatment option in Chinese adults with HAP/VAP.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"43 ","pages":"Pages 248-255"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In vitro activity of omadacycline against bacterial isolates from bone/joint infections and rare pathogens in the SENTRY antimicrobial surveillance program (2015–2023)","authors":"Michael D. Huband ,&nbsp;Paul R. Rhomberg ,&nbsp;Kelley A. Fedler ,&nbsp;Christopher Blankers ,&nbsp;Diane Anastasiou ,&nbsp;Alisa W. Serio ,&nbsp;Mariana Castanheira","doi":"10.1016/j.jgar.2025.04.027","DOIUrl":"10.1016/j.jgar.2025.04.027","url":null,"abstract":"<div><h3>Objectives</h3><div>Omadacycline is an aminomethylcycline (tetracycline class) antibacterial approved by the United States Food and Drug Administration (2018) for treatment of adults with acute bacterial skin and skin structure infection (ABSSSI) and community acquired bacterial pneumonia (CABP) caused by indicated organisms (oral and iv formulations). Omadacycline has activity against bacterial isolates expressing common tetracycline resistance mechanisms (ribosomal protection proteins and efflux pumps), which render older generation tetracyclines inactive. Omadacycline <em>in vitro</em> activity was assessed against 919 bacterial isolates collected from patients with bone/joint infections in the United States and Europe (2015–2023) and 3945 rarely encountered bacterial pathogens from patients (multiple infection sites) in the United States (2015–2023) as part of the SENTRY Antimicrobial Surveillance Program. program.</div></div><div><h3>Methods</h3><div>Broth microdilution susceptibility testing followed Clinical and Laboratory Standards Institute M07 (2024) and M100 (2024) guidelines.</div></div><div><h3>Results</h3><div>Omadacycline demonstrated susceptibilities of ≥90.0% (FDA breakpoints) against <em>Staphylococcus aureus</em> (including MRSA), <em>Staphylococcus lugdunensis, Enterococcus faecalis</em> (including vancomycin-resistant), and streptococci including <em>Streptococcus anginosus, Streptococcus pneumoniae</em>, and <em>Streptococcus pyogenes</em> from patient with bone/joint infections. Omadacycline demonstrated potent <em>in vitro</em> activity against rare Gram-positive pathogens (multiple infection sites), inhibiting 97.3%, 91.3%, and 99.4% of uncommon staphylococci, streptococci, and enterococci isolates at or below current FDA approved ABSSSI breakpoints for <em>S. aureus, S. pyogenes</em>, and <em>E. faecalis</em>.</div></div><div><h3>Conclusions</h3><div>The potent omadacycline activity observed in this study suggests potential clinical utility for treatment of bone/joint infections and rarely encountered Gram-positive infections caused by various staphylococci, streptococci, and enterococci isolates and supports ongoing clinical trials for these disease indications.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"43 ","pages":"Pages 271-284"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical, microbiological, and laboratory predictors of on- and off-label dalbavancin treatment failure","authors":"Maria Mazzitelli ,&nbsp;Daniele Mengato ,&nbsp;Vincenzo Scaglione ,&nbsp;Elisabetta Maria Vittoria Giunco ,&nbsp;Elena Barzizza ,&nbsp;Luigi Salmaso ,&nbsp;Francesca Venturini ,&nbsp;Annamaria Cattelan","doi":"10.1016/j.jgar.2025.05.014","DOIUrl":"10.1016/j.jgar.2025.05.014","url":null,"abstract":"<div><h3>Objectives</h3><div>Data about risk factors for treatment failure (TF) to dalbavancin are lacking. Our aim was to investigate the clinical, microbiological, and laboratory predictors of TF in both on- and off-label dalbavancin treatments.</div></div><div><h3>Methods</h3><div>We included all patients who received at least one dose of dalbavancin at our centre from January 2018 to June 2024 and with available data on follow-up, collecting all clinical and laboratory parameters. TF was defined as the need for readmission, emergency department access, or death within 90 d after treatment. Factors correlating with TF and mortality rate were assessed using multivariable analyses and Kaplan-Meier curves.</div></div><div><h3>Results</h3><div>Three hundred fifty-one patients were included, mostly men (60.9 %), median age of 64 years (interquartile range [IQR] = 49.5–75.5), 55.3 % receiving dalbavancin in the emergency department/outpatient setting, and 44.7 % for early discharge, in 54.9 % cases as off-label. The main off-label indications were osteomyelitis, prosthetic infections, and endocarditis (17.1 %, 8.3 %, and 7.7 %). In 53.3 % of the cases, a microbiological isolate was available (Methicillin-resistant <em>Staphylococcus aureus</em> [MRSA] in 49.2 % of cases). Overall, the TF rate was 19.4 %. Overall, multivariable analysis showed that intravenous (IV) drug use (hazard ratio [HR] = 7.99, <em>P</em> &lt; 0.001), diabetes (HR = 6.1, <em>P</em> &lt; 0.001), obesity (HR = 4.5, <em>P</em> &lt; 0.001), cancer (HR = 5.3, <em>P</em> &lt; 0.001), HIV (HR = 4.88, <em>P</em> &lt; 0.001), levels of CRP at dalbavancin treatment initiation (HR = 1.01, <em>P</em> &lt; 0.001, and HR = 0.72, <em>P</em> = 0.02) were associated with TF. Additionally, the duration of IV antibiotic therapy before being discharged influenced outcomes in the off-label group (HR = 0.52, <em>P</em> = 0.02).</div></div><div><h3>Conclusions</h3><div>The observed TF rate was high, particularly in off-label uses and among individuals with multiple comorbidities or IV drug use. More evidence is needed to better define the optimal patient profile for effective dalbavancin treatment.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"43 ","pages":"Pages 337-343"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genomic investigation of NDM-1 producing Enterobacterales transmission in a South Korean hospital","authors":"Jeong-Ih Shin ,&nbsp;Sun Hee Park ,&nbsp;Chulmin Park ,&nbsp;Seung-Hyun Jung ,&nbsp;Dong-Gun Lee","doi":"10.1016/j.jgar.2025.05.010","DOIUrl":"10.1016/j.jgar.2025.05.010","url":null,"abstract":"<div><h3>Objective</h3><div>Prolonged detection of multispecies New Delhi metallo-β-lactamase (NDM)-1-producing Enterobacterales was observed in front of a South Korean hospital. This study aimed to investigate the transmission mechanisms of <em>bla</em>_NDM-1 and assess the role of environmental reservoirs in its persistence.</div></div><div><h3>Methods</h3><div>Epidemiological data were collected, and antibiotic susceptibility testing, carbapenemases detection, and whole-genome sequencing were performed on 42 clinical and 13 environmental isolates collected between November 2018 and February 2021, during the pre-outbreak, outbreak (July–September 2019), and post-outbreak periods. Long-read complete-genome sequencing was performed on four clinical and four environmental isolates to characterize plasmids carrying <em>bla</em>_NDM-1 and associated mobile genetic elements. Phylogenetic analyses were also performed.</div></div><div><h3>Results</h3><div><em>bla</em>_NDM-1 was detected in 15 different species across clinical and environmental isolates. During the 2019 outbreak, clonal spread of <em>Klebsiella pneumoniae</em> and <em>Klebsiella quasipneumoniae</em> in the hospital was the primary mechanism of dissemination. During the post-outbreak period, horizontal gene transfer, mediated by the IncX3 plasmid carrying <em>bla</em>_NDM-1, was the dominant transmission mechanism. This plasmid, detected in both clinical and environmental isolates, showed high genetic conservation with IncX3 plasmids reported worldwide. These plasmids contained conserved mobile genetic elements, including the IS26-<em>dsbD</em>-<em>trpF</em>-<em>ble</em>-<em>bla</em>_NDM-1 structure.</div></div><div><h3>Conclusions</h3><div>This study highlights the dual roles of clonal spread and plasmid-mediated horizontal gene transfer in the dissemination of <em>bla</em>_NDM-1 in hospital settings. The persistence of highly conserved IncX3 plasmids in environmental isolates underscores the complexity of carbapenem resistance control. Comprehensive infection control strategies targeting patient-to-patient transmission and environmental reservoirs are crucial for mitigating the spread of NDM-producing Enterobacterales.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"43 ","pages":"Pages 365-371"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aminoglycoside resistance dynamics and its predictive value for carbapenem resistance in multidrug-resistant Acinetobacter baumannii and Klebsiella pneumoniae","authors":"Bence Sajerli ,&nbsp;Klára Makai ,&nbsp;Lóránt Lakatos ,&nbsp;Ágnes Sarkadi-Nagy ,&nbsp;Katalin Burián ,&nbsp;László Orosz","doi":"10.1016/j.jgar.2025.05.012","DOIUrl":"10.1016/j.jgar.2025.05.012","url":null,"abstract":"<div><h3>Objective</h3><div>The rise of multidrug-resistant bacterial pathogens, including carbapenem-resistant <em>Acinetobacter baumannii</em> (CRAB) and <em>Klebsiella pneumoniae</em> (CRKP), poses a global healthcare challenge. Aminoglycosides remain among the few effective therapeutic options, but increasing resistance threatens their efficacy. This study investigates aminoglycoside consumption and resistance dynamics, focusing on the predictive value of aminoglycoside resistance for future carbapenem resistance.</div></div><div><h3>Methods</h3><div>Data on aminoglycoside use (amikacin, gentamicin, tobramycin) and resistance were retrospectively collected (2010–2024). Resistance patterns were assessed using the antibiotic resistance index and resistance instability index. Correlation analyses examined associations between aminoglycoside consumption and resistance, including delayed effects, and between aminoglycoside and meropenem resistance.</div></div><div><h3>Results</h3><div>We analysed 4582 <em>A. baumannii</em> and 36 049 <em>K. pneumoniae</em> isolates. Among them, 2462 CRAB and 309 CRKP isolates were identified. Amikacin was the most used aminoglycoside, with stable resistance in CRAB and higher variability in CRKP. Gentamicin showed the most unstable resistance. In CRAB, aminoglycoside resistance – especially amikacin (<em>r</em> = 0.73) – was strongly correlated with meropenem resistance, suggesting predictive potential. In CRKP, predictive correlations were weaker; gentamicin showed the highest (<em>r</em> = 0.62).</div></div><div><h3>Conclusions</h3><div>Aminoglycoside resistance trends, particularly for amikacin in CRAB, may serve as early indicators of emerging carbapenem resistance. Integrating such data into surveillance and stewardship frameworks could improve early detection and response to multidrug-resistant threats.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"43 ","pages":"Pages 309-318"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the prevalence of CRISPR-Cas system and their association with antibiotic resistance genes and virulence factors in Enterococcus faecalis and Enterococcus faecium strains isolated from hospitalized patients","authors":"Sepideh Soltani ,&nbsp;Tina Fallah ,&nbsp;Morvarid Shafiei ,&nbsp;Abdolrazagh Hashemi Shahraki ,&nbsp;Alireza Iranbakhsh","doi":"10.1016/j.jgar.2025.04.022","DOIUrl":"10.1016/j.jgar.2025.04.022","url":null,"abstract":"<div><h3>Objectives</h3><div><em>Enterococcus faecalis</em> and <em>Enterococcus faecium</em> are Gram-positive opportunistic pathogens that rank among the leading causes of nosocomial infections worldwide. This study investigates the prevalence and role of CRISPR-Cas systems in modulating antimicrobial resistance and virulence factors in clinical isolates of <em>E. faecalis</em> and <em>E. faecium</em> collected from patients in Tehran, Iran.</div></div><div><h3>Methods</h3><div>A total of 75 clinical isolates of <em>E. faecalis</em> and <em>E. faecium</em> were collected from various hospitals in Tehran, Iran, between January and April 2023, from adult patients with urinary tract infections (<em>n</em> = 55), blood infections (<em>n</em> = 12), and wound infections (<em>n</em> = 8). Conventional bacteriology tests and PCR were used to isolate and identify <em>Enterococcus</em> species. Phenotypic antibiotic and genotypic resistance were assessed. CRISPR-Cas repeat-spacer array were screened using PCR, and the relationship between CRISPR-Cas systems and antibiotic resistance and virulence genes was statistically analyzed. Phylogenetic, structural, and conservation analyses were performed to assess the degree of conservation in <em>CRISPR1-Cas csn1</em> and <em>CRISPR3-Cas csn1</em> genes, identify potential mutations, and evaluate their possible impact on Cas9 protein function.</div></div><div><h3>Results</h3><div>86.6% of the isolates harbored CRISPR-Cas repeat-spacer array, with a significantly higher prevalence in <em>E. faecalis</em> than in <em>E. faecium</em> (100% vs. 66.6%, <em>P</em> = 0.0001). CRISPR1-Cas, CRISPR2, and CRISPR3-Cas loci were identified in 76%, 82.6%, and 64% of isolates, respectively. Notably, the prevalence of CRISPR-Cas systems was significantly reduced in extensively drug-resistant (XDR) isolates (32%) compared to multidrug-resistant (MDR) isolates (68%, <em>P</em> = 0.0001). Conservation analyses of <em>CRISPR1-Cas csn1</em> and <em>CRISPR3-Cas csn1</em> genes revealed conserved regions potentially linked to functional activity. Furthermore, CRISPR-Cas repeat-spacer array were correlated with specific antimicrobial resistance phenotypes and genotypes, as well as with virulence factors.</div></div><div><h3>Conclusions</h3><div>These findings suggest that CRISPR-Cas systems may influence the resistance and virulence profiles of clinical <em>Enterococcus</em> isolates, potentially impacting their pathogenicity and adaptability.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"43 ","pages":"Pages 344-357"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vancomycin-resistant Enterococcus faecium and its shifting clonal types","authors":"Ronan F. O’Toole","doi":"10.1016/j.jgar.2025.05.020","DOIUrl":"10.1016/j.jgar.2025.05.020","url":null,"abstract":"","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"43 ","pages":"Pages 390-391"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"External validation of population pharmacokinetic models for meropenem in critically ill adult patients","authors":"Carla Bastida ,&nbsp;Alba Escolà-Rodríguez ,&nbsp;Sara Fernández ,&nbsp;Pedro Castro ,&nbsp;Dolors Soy","doi":"10.1016/j.jgar.2025.05.015","DOIUrl":"10.1016/j.jgar.2025.05.015","url":null,"abstract":"<div><h3>Background</h3><div>While several meropenem population pharmacokinetic (popPK) models have been developed, few have undergone external validation, a crucial step to confirm their robustness and applicability in real-world settings.</div></div><div><h3>Objective</h3><div>This study aimed to conduct an external evaluation of published meropenem popPK models to assess their predictive performance and determine their suitability for implementing Model-Informed Precision Dosing strategies in the intensive care unit (ICU) setting.</div></div><div><h3>Methods</h3><div>The external validation dataset consisted of data retrospectively collected from a tertiary university hospital. Eight published popPK models were selected from the literature and bias and inaccuracy were calculated. Predictive performance was assessed in two subpopulations: continuous renal replacement therapy (CRRT) and non-CRRT patients, with further stratification by body mass index.</div></div><div><h3>Results</h3><div>Eight popPK models were evaluated with an independent dataset of 30 ICU patients and 48 samples. The Ulldemolins et al. model exhibited the lowest bias for population-level predictions in the overall CRRT cohort. In the overall non-CRRT cohort, the models by Chung et al. and Lan et al. demonstrated excellent population and individual prediction performance. Within the obese subpopulation, the Shekar et al. model showed the lowest bias and inaccuracy in the CRRT cohort, while the models by Li et al., Lan et al., and Chung et al. performed best in the non-CRRT cohort.</div></div><div><h3>Conclusions</h3><div>Published meropenem popPK models exhibit considerable variability in predictive performance when validated in an external dataset of ICU patients failing to generalize across broader patient populations. These findings underscore the need for external validation with independent datasets to ensure reliable performance across diverse populations.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"43 ","pages":"Pages 358-364"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building bridges to operationalize One Health — A longitudinal two years’ AMR study in England using clinical and wastewater-based surveillance approaches","authors":"Like Xu ,&nbsp;Nicola Ceolotto ,&nbsp;Kishore Jagadeesan ,&nbsp;Richard Standerwick ,&nbsp;Megan Robertson ,&nbsp;Ruth Barden ,&nbsp;Helen Lambert ,&nbsp;Barbara Kasprzyk-Hordern","doi":"10.1016/j.jgar.2025.05.005","DOIUrl":"10.1016/j.jgar.2025.05.005","url":null,"abstract":"<div><h3>Objectives</h3><div>The coronavirus disease 2019 (COVID-19) pandemic impacted antimicrobial resistance (AMR) in clinical settings, but evidence is lacking. Considering this, we evaluated community-wide AMR in the shadow of COVID-19, using wastewater-based epidemiology (WBE).</div></div><div><h3>Methods</h3><div>Five hundred ninety wastewater samples were collected from 4 contrasting communities in England between April 2020 and March 2022 to test for antibiotics used, their metabolites, and persistent antibiotic resistance genes (ARGs). Catchment-wide COVID-19 cases and antibiotic prescription data were triangulated with WBE data to evaluate the impact of the COVID-19 pandemic on changes in antibiotic use and resulting AMR at fine spatio-temporal resolution.</div></div><div><h3>Results</h3><div>Observed reduction in antibiotic consumption and AMR prevalence during the COVID-19 pandemic (especially during lockdowns) is likely due to reduced social interactions rather than due to reduced antibiotic prescribing. Population-normalised daily intake and daily prescriptions showed an increase of 17.2% and 5.8%, respectively, in 2021 to 2022, in comparison to the previous pandemic year. Of the 17 antibiotics targeted, amoxicillin and clarithromycin were clearly affected by COVID-19 restrictions during the years 2020 to 2021 with an average of 31.5% (<em>P</em> &lt; 0.01) and 13.5% (<em>P</em> &lt; 0.05) lower usage, respectively, followed by an increase in 2021 to 2022. This has significant implications for practice and policy that currently focus on the reduction of antibiotics as the key risk factor in AMR.</div></div><div><h3>Conclusions</h3><div>Better, more holistic strategies encompassing the One Health philosophy are needed to understand and act upon the AMR challenge.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"43 ","pages":"Pages 256-263"},"PeriodicalIF":3.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}