Journal of global antimicrobial resistance最新文献

{"title":"Progress and challenges in the implementation of Antimicrobial Stewardship Programs in 50 hospitals in Mexico.","authors":"Anahí Dreser, Jennifer Hegewisch-Taylor, María Alejandra Cortés-Ortiz, Gabriel Levy Hara","doi":"10.1016/j.jgar.2025.02.018","DOIUrl":"https://doi.org/10.1016/j.jgar.2025.02.018","url":null,"abstract":"<p><strong>Objectives: </strong>;Antimicrobial stewardship programs (ASP) aim to improve the quality of medical prescribing and contain antimicrobial resistance (AMR). There is little information on the implementation of ASP in hospitals in Mexico. This study aimed to characterize ASP in a sample of hospitals in Mexico and to identify the facilitators and barriers perceived in their implementation, including the COVID-19 pandemic.</p><p><strong>Methods: </strong>;A self-assessment electronic survey was adapted from the CDC and WHO ASP's core elements, considering ASP organization, structure, education, guidelines, interventions, surveillance, monitoring, and reporting processes. The survey was addressed to ASP team leaders in a sample of public and private hospitals carrying out regular antimicrobial stewardship activities in Mexico in 2021 and 2022.</p><p><strong>Results: </strong>;Fifty hospitals participated: 32 (64%) public and 18 (36%) private. Fifty-two percent of hospitals had an official ASP document, 12% allocated protected time for ASP professionals, and 34% had an annual plan. Most hospitals had an ASP committee (68%); only 14% allocated funding. Most interventions were restrictive (68%). 61% percent of hospitals prepared cumulative antibiograms periodically, 54% monitored antimicrobial consumption (DDD/DOT), 44% monitored adherence to guidelines, and 24% monitored the implementation of interventions. The main barriers identified were work overload, insufficient human resources, and hospital reconversion due to COVID-19 (particularly in public hospitals), while the support of hospital authorities was the most important facilitator.</p><p><strong>Conclusions: </strong>;This diagnosis provides a baseline for strengthening ASP implementation in the country's hospitals. National and institutional policies should prioritize targeting ASP planning, monitoring, and human resources allocation.</p>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615634","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":"Epidemiology, phylogeny and genetic characterization of carbapenem-resistant Citrobacter spp. from 5 hospitals in China","authors":"Qiang Zhao ,&nbsp;Ling Guo ,&nbsp;Kun Ye,&nbsp;Lifeng Wang,&nbsp;Jiyong Yang,&nbsp;Liyan Ye","doi":"10.1016/j.jgar.2025.03.003","DOIUrl":"10.1016/j.jgar.2025.03.003","url":null,"abstract":"<div><h3>Objectives</h3><div>Carbapenem-resistant <em>Citrobacter</em> spp. (CRC) are increasingly recognized as healthcare-associated pathogens, while systematic studies on clinical epidemiology, genetic diversity, and resistant mechanisms of CRC are relatively scarce. The present study provides comprehensive and systematic research on CRC.</div></div><div><h3>Methods</h3><div>Clinical isolates of <em>Citrobacter</em> spp. resistant to carbapenems were collected from 5 hospitals across China between October 2014 and December 2017. All the isolates were identified by MALDI-TOF MS and FastANI. Whole-genome sequencing and phylogenetic analyses were performed. Sequencing data were analyzed using MLST, PlasmidFinder, ResFinder, and ISFinder tools.</div></div><div><h3>Results</h3><div>Thirty-one CRC isolates were isolated from 5 hospitals in different provinces. These strains exhibited significant phylogenetic divergence. ST85 (12.90%) and ST116 (12.90%) were the predominant STs. NDM (41.94%), KPC-2 (25.81%), and IMP (19.35%) were the most frequent carbapenemases of CRC. Interestingly, KPC is frequently associated with <em>C. freundii</em>, while NDM is predominantly observed in <em>C. portucalensis</em>. All the IncX3 and IncN-type plasmids carrying <em>bla</em>_NDM and most non-typeplasmids carrying <em>bla</em>_KPC were transferrable by conjugation. The genes <em>bla</em>_NDM and <em>bla</em>_KPC were primarily located within relatively conserved genomic environments, including “IS<em>Aba125</em>-<em>bla</em>_NDM-<em>ble</em>_MBL-<em>trp</em>F-<em>dsb</em>D-<em>cut</em>A1-<em>gro</em>ES-<em>gro</em>EL-IS<em>CR27</em>” and “Tn3 transposase-IS<em>Kpn27</em>-<em>bla</em>_KPC-2-△IS<em>Kpn6</em>-<em>kor</em>C-<em>kc</em>lA-hp-hp-△repB-Tn<em>AS1</em>”.</div></div><div><h3>Conclusions</h3><div>The clonal transmission of CRC and the conjugative antibiotic resistance plasmids were the key mechanisms driving the spread of multidrug resistance. It highlights the need to strengthen molecular surveillance, with a focus on high-prevalence clones such as ST85 and ST116 carrying mobile resistance elements.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"42 ","pages":"Pages 207-213"},"PeriodicalIF":3.7,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of Klebsiella pneumoniae carbapenemase (KPC)-14, a KPC variant conferring resistance to ceftazidime-avibactam in the extensively drug-resistant ST463 Pseudomonas aeruginosa clinical isolate","authors":"Yanyan Xiao ,&nbsp;Le Wang ,&nbsp;Huiqiong Jia ,&nbsp;Yan Jiang ,&nbsp;Yue Li ,&nbsp;Jiamin Han ,&nbsp;Shengchao Li ,&nbsp;Yaxi Gu ,&nbsp;Qing Yang","doi":"10.1016/j.jgar.2025.03.004","DOIUrl":"10.1016/j.jgar.2025.03.004","url":null,"abstract":"<div><h3>Objective</h3><div>We studied two <em>Klebsiella pneumoniae</em> carbapenemase (KPC)-14 variants from clinical <em>Pseudomonas aeruginosa</em> isolates (C137 and C159) to better understand the genomic diversity, mechanisms, and genes that confer antibiotic resistance and pathogenicity.</div></div><div><h3>Methods</h3><div>Genomic DNA from C137/159 was subjected to Illumina and Oxford Nanopore sequencing. Horizontal transmission of the plasmid was evaluated using cloning experiments. The expression of efflux pumps, the outer membrane protein OprD, and the enzyme AmpC was quantified using qRT-PCR. The detectability of KPC-14 was evaluated using different methods, and biofilm formation assays and growth curves were assessed.</div></div><div><h3>Results</h3><div>C137 and C159, sequence type 463 ExoU-positive multidrug-resistant strains, were concurrently resistant to carbapenems and ceftazidime-avibactam. Both strains possessed five intrinsic antimicrobial resistance genes (<em>fosA, catB7, crpP, bla</em>_PAO, and a <em>bla</em>_OXA-486 variant) as well as <em>bla</em>_KPC-14. In strain C137, <em>bla</em>_KPC-14 was located on a plasmid (pC137). Both strains expressed the <em>bla</em>_KPC-14 gene, concurrent inactivation of OprD, overexpression of the MexX efflux pump, and a pronounced capacity for biofilm formation. The genomic environment of KPC-14 consisted of IS<em>26</em>/IS<em>26</em>/TnpR_<em>Tn3</em>/IS<em>Kpn27</em>/IS<em>Kpn6</em>/IS<em>26</em>, which classified it as pseudo-compound transposon (PCT). IS<em>26</em>-mediated PCTs may store a variety of resistance genes, including <em>bla</em>_KPC-2 and KPC variants, which are currently disseminating in this region.</div></div><div><h3>Conclusions</h3><div>The KPC-14 variant presents significant challenges for clinical treatment. The <em>bla</em>_KPC-14 gene carried by PCTs was integrated into the chromosome and exhibited stability throughout bacterial inheritance. Our research highlights the need for improved clinical surveillance of KPC-producing <em>P. aeruginosa</em>.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"42 ","pages":"Pages 234-242"},"PeriodicalIF":3.7,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615669","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":"Plasmidome analyses of Klebsiella pneumoniae co-producing blaKPC-2 and blaNDM-1 in Southern Brazil: characterisation of mobile genetic elements","authors":"Mayana Kieling Hernandez Berdichevski ,&nbsp;Rafaela R. Guerra ,&nbsp;Dariane C. Pereira ,&nbsp;Camila M. Wilhelm ,&nbsp;Patricia O. Barth ,&nbsp;Melise C. Silveira ,&nbsp;Fabiana C.Z. Volpato ,&nbsp;Claudio Rocha-de-Souza ,&nbsp;Richard M. Carrassai ,&nbsp;Ana Paula Carvalho-Assef ,&nbsp;Andreza F. Martins ,&nbsp;Afonso Luís Barth","doi":"10.1016/j.jgar.2025.02.020","DOIUrl":"10.1016/j.jgar.2025.02.020","url":null,"abstract":"<div><h3>Objective</h3><div>Infections due to carbapenemase-producing Enterobacterales harbouring more than one carbapenemase-encoding gene spread mainly by plasmid and transposon mobilisation. The objective of this study was to analyse the mobile genetic elements carrying <em>bla</em>_KPC and <em>bla</em>_NDM of <em>Klebsiella pneumoniae</em> carbapenemase co-producers (KpKN).</div></div><div><h3>Methods</h3><div><em>K. pneumoniae</em> isolates with reduced susceptibility to carbapenems were obtained between 2016 and 2023. To evaluate the genetic environment of KpKN, 22 isolates were selected for antimicrobial susceptibility testing and whole-genome sequencing.</div></div><div><h3>Results</h3><div>The <em>bla</em>_KPC-2 gene was carried mainly by IncN/IncFIB, a novel co-integrated plasmid in the Tn<em>4401b</em> transposon. <em>bla</em>_NDM-1 was disseminated in the only two KpKN isolates recovered prior to 2020 by the IncHI1B/IncFIB plasmid type within the Tn<em>3000</em> transposon. Significantly, isolates obtained since 2020 showed the <em>bla</em>_NDM-1 gene carried by IncA/C in an IS<em>26</em>-flanked pseudo-composite transposon containing IS<em>CR1</em>, which also had genes that conferred resistance to sulfonamides, aminoglycosides, macrolides, quinolones, amphenicols, tetracyclines, rifampicin, sulfonamide, and trimethoprim. The isolates belonged mainly to ST11 and ST16.</div></div><div><h3>Conclusions</h3><div>Plasmid and transposon changes during different periods could be related to higher dissemination of <em>bla</em>_NDM-1, and the large number of resistance genes present in the IS<em>26</em>-flanked transposon may have increased co-selection of this plasmid through the wide use of antimicrobials during the pandemic.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"42 ","pages":"Pages 214-221"},"PeriodicalIF":3.7,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","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, Fei Guo, Aimin Li, NanYan Xu, Xiaoyue Chang, Zuke Xiao, Huiqing Zeng, Hua Qiao, Liangfa Tang, Yunsong Yu, Bin Liu, Panpan Wang, Paurus Irani, Rienk Pypstra, Junchao Lu, Fanglei Liu, Yuting Mu, Haihui Huang, Yingyuan Zhang","doi":"10.1016/j.jgar.2025.03.001","DOIUrl":"https://doi.org/10.1016/j.jgar.2025.03.001","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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-hour IV infusion every 8 hours for 7-14 days. 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; [mMITT] analysis set) and all-cause mortality at TOC and Day 28. Results were summarized descriptively.</p><p><strong>Results: </strong>Of 257 screened individuals, 235 were treated with ceftazidime-avibactam (safety analysis set); 71% were male; median age was 67 years. Klebsiella pneumoniae (n = 49 [61.3%]) and Pseudomonas aeruginosa (n = 16 [20.0%]) were the most frequently isolated baseline pathogens. Clinical cure at TOC was achieved in 62.7% patients (131/209, 95% 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 (mMITT analysis set). All-cause mortality was 5.7% (12/209; 95% CI: 3.2, 9.6) at TOC and Day 28 (cMITT analysis set). No new safety signals were identified.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-08","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":"Therapeutic effects of zinc nanoparticles green synthesized by Ferula macercolea extract against chronic toxoplasmosis in mice","authors":"Abdullah D. Alanazi ,&nbsp;Areej Jameel Alghabban","doi":"10.1016/j.jgar.2025.03.002","DOIUrl":"10.1016/j.jgar.2025.03.002","url":null,"abstract":"<div><h3>Objectives</h3><div>The present study aimed to green synthesize and characterize the zinc nanoparticles (ZNP) and evaluate its potency to control <em>Toxoplasma gondii</em> infection in mice by stimulating the immune system, antioxidant activity, and anti-inflammatory effects.</div></div><div><h3>Methods</h3><div>By in vivo, <em>T. gondii</em> infected mice were orally treated by ZNP (5–20 mg/kg) for 14 d. The number and size of tissue cysts, oxidant-antioxidant enzymes, the expression of inflammatory cytokines, apoptotic, and pathogenicity-related factors were evaluated by real-time polymerase chain reaction.</div></div><div><h3>Results</h3><div>ZNP ranged in size from 10 to 70 nm with an average size of 45.7 ± 19.4 nm. ZNP treatment resulted in a significant reduction in the number and size of tissue cysts (<em>P</em> &lt; 0.05). The oral administration of infected mice with ZNP caused a considerable decrease in malondialdehyde levels and a marked increase (<em>P</em> &lt; 0.001) in the activity of the antioxidant enzymes glutathione peroxidase and superoxide dismutase. ZNP administration triggered a significant reduction in the expression levels of the genes of interleukin-1β, tumour necrosis factor-α, nuclear factor kappa B, bradyzoite antigen-1, and B-cell lymphoma-2. Conversely, there was an increase in the expression levels of the genes of IL-10, Serpin A3k, caspase-3, and Bcl-2–associated X protein (<em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>In summary, the recent investigation illustrated that ZNP demonstrates promising in vivo effects against <em>T. gondii</em> infection in mice. These effects are ascribed to its antioxidant properties, anti-inflammatory characteristics through the inhibition the specific inflammatory cytokines, and its ability to inhibit pathogenicity in mice without any observable signs of toxicity.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"42 ","pages":"Pages 195-203"},"PeriodicalIF":3.7,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Streptococcus pyogenes M1UK presence in China in 2018","authors":"Dingle Yu ,&nbsp;Yuejie Zheng ,&nbsp;Yunsheng Chen ,&nbsp;Yuanhai You ,&nbsp;Yonghong Yang","doi":"10.1016/j.jgar.2025.02.017","DOIUrl":"10.1016/j.jgar.2025.02.017","url":null,"abstract":"","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"42 ","pages":"Pages 175-176"},"PeriodicalIF":3.7,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of a genetically related carbapenemase-producing Escherichia coli ST167 in clinical and environmental isolates: Evidence for clonal spread of carbapenemase-producing Enterobacteriaceae in humans and the environment in Iowa, United States","authors":"Hanseob Shin ,&nbsp;David M. Cwiertny ,&nbsp;Megan J. Nelson ,&nbsp;Ryan T. Jepson ,&nbsp;Michael A. Pentella ,&nbsp;Darrin A. Thompson","doi":"10.1016/j.jgar.2025.02.021","DOIUrl":"10.1016/j.jgar.2025.02.021","url":null,"abstract":"<div><h3>Background</h3><div>Carbapenemase-producing Enterobacteriaceae (CPE) are listed by the World Health Organization as one of the critical priority pathogens needing urgent attention to address global resistance to antimicrobials. Thus, the transmission and epidemiology of CPEs need to be studied via One Health perspectives.</div></div><div><h3>Methods</h3><div>An environmental CPE, referred to as BO1, was isolated from a creek in Northwest Iowa using a Colilert system (IDEXX, Westbrook, ME, USA). The presence of carbapenemase was examined using the modified carbapenem inactivation test, and then phenotypic resistance was determined using a Sensititre Complete Automated AST System (Thermo Fisher Scientific, Roskilde, Denmark). Whole-genome sequencing was performed and analysed to compare with clinical CPEs.</div></div><div><h3>Results</h3><div>BO1, carrying <em>bla</em>_NDM-5, was isolated from a creek in Northwest Iowa. BO1 exhibited resistance to 15 antimicrobials and was defined as an extensively drug-resistant organism. BO1 was also identified as ST167, which is well known as an emerging high-risk clone, and IncFIA- and IncQ1-type conjugatable plasmids were identified within the BO1 genome. The genetic environment of <em>bla</em>_NDM-5 was highly conserved as <em>bla</em>_NDM-<em>ble</em>_MBL-<em>trpF</em>-<em>dsbD</em> in all strains studied. Interestingly, single-nucleotide polymorphism analysis revealed that BO1 shared only 1, 4 and 12 single-nucleotide polymorphisms with three different clinical strains from patients at Iowa health care facilities.</div></div><div><h3>Conclusions</h3><div>The occurrence of BO1 was temporally and spatially close to that of one clinical strain, IA0018, implying the clonal spread of CPEs among humans and the environment, although the source and directionality of this spread remains unknown. This report illustrates the need for the strict control of CPEs in health care facilities and continuous surveillance within clinical and environmental settings to trace and prevent CPE transmission.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"42 ","pages":"Pages 154-160"},"PeriodicalIF":3.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal trends of enterococcal and vancomycin-resistant Enterococcus faecium bacteraemia in the northern Dutch-German cross-border region: A 10-y multicentre analysis (2013–2022)","authors":"Cansu Cimen ,&nbsp;Andreas Voss ,&nbsp;Josef Hellkamp ,&nbsp;Axel Hamprecht ,&nbsp;Matthijs S. Berends","doi":"10.1016/j.jgar.2025.02.022","DOIUrl":"10.1016/j.jgar.2025.02.022","url":null,"abstract":"<div><h3>Objective</h3><div>To analyse the trends in occurrence of enterococcal and vancomycin-resistant <em>Enterococcus faecium</em> (VREfm) bacteraemia in the northern Dutch-German cross-border region.</div></div><div><h3>Methods</h3><div>A retrospective cross-sectional study was conducted using positive blood culture results from two university hospitals, the University Medical Centre Groningen (UMCG) and the Klinikum Oldenburg (KOL) between 1 January 2013 to 31 December 2022.</div></div><div><h3>Results</h3><div>Over the 10-y period, 738 enterococcal bacteraemia episodes were observed at KOL and 1091 at UMCG, involving 685 and 999 patients, respectively. <em>E. faecium</em> was the predominant species in both institutions (60.3% at KOL and 60.8% at UMCG). The median age of patients with enterococcal, <em>E. faecium, E. faecalis</em> and VREfm bacteraemia was consistently higher at KOL than at UMCG (<em>p=</em> <em>.029</em>). In both institutions, over half of the enterococcal bacteraemia cases (53.4% at KOL, 55.8% at UMCG) were observed in intensive care units and haematology/oncology wards. From 2018 to 2022, UMCG had higher overall incidence rates of <em>E. faecium</em>, and <em>E. faecalis</em> bacteraemia, while KOL had a significantly higher incidence of VREfm (0.56 vs. 0.05 per 10,000 patient-d, <em>p&lt;</em> <em>.0001</em>). There was a significant upward trend in VREfm bacteraemia cases (<em>p=</em> <em>.01</em>) and in the proportion of VREfm among bacteraemia caused by <em>E. faecium</em> (<em>p=</em> <em>.027</em>) at KOL, but such a trend was not observed at UMCG during the study period.</div></div><div><h3>Conclusions</h3><div>The results reveal a significant difference in VREfm bacteraemia occurrences between a German and Dutch hospital in a cross-border region, reflecting national trends yet showing regional variation.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"42 ","pages":"Pages 187-194"},"PeriodicalIF":3.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ST11 carbapenem-resistant Klebsiella pneumoniae clone harbouring capsular type KL25 becomes the primarily prevalent capsular serotype in a tertiary teaching hospital in China","authors":"Jing Wang ,&nbsp;Qi Wang ,&nbsp;Ruiqi Wang ,&nbsp;Ruobing Wang ,&nbsp;Jianbang Kang ,&nbsp;Jinju Duan ,&nbsp;Hui Wang","doi":"10.1016/j.jgar.2025.02.019","DOIUrl":"10.1016/j.jgar.2025.02.019","url":null,"abstract":"<div><h3>Background</h3><div>The spread of carbapenem-resistant <em>Klebsiella pneumoniae</em> (CRKP) that produces <em>K. pneumoniae</em> carbapenemase-2 has garnered significant attention due to its increasing prevalence. In China, the dissemination of <em>K. pneumoniae</em> carbapenemase-2-producing CRKP is predominantly linked to sequence type 11 (ST11), with capsular serotypes KL47 and KL64 being the primary capsular identified.</div></div><div><h3>Methods</h3><div>A total of 64 CRKP-ST11 strains were collected from 2020 to 2023 and whole-genome sequencing was performed on all isolated ST11-CRKP strains. Antibiotic susceptibility was tested using the VITEK 2 system. Growth curve tests and in vitro competition experiments were used to assess the growth adaptability of different capsular type isolates. Moreover, the biofilm assessment and phagocytosis assays were performed to evaluate CRKP isolate virulence.</div></div><div><h3>Results</h3><div>During the observed period, a notable subclonal shift was perceived within the prevailing ST11-CRKP clone, wherein the previously dominant KL64 and KL47 serotypes have been largely supplanted by the KL25 serotype since 2022. The ST11-KL25-CRKP strain significantly outgrew both ST11-KL64-CRKP and ST11-KL47-CRKP. Additionally, ST11-KL25-CRKP displayed a greater enhanced capacity to form biofilms than ST11-KL64-CRKP and ST11-KL47-CRKP. Furthermore, ST11-KL25-CRKP demonstrated enhanced resistance to phagocytosis than both of its counterparts.</div></div><div><h3>Conclusions</h3><div>ST11-KL25-CRKP possesses a remarkable level of adaptability and has the potential to regionally replace ST11-KL64-CRKP as the predominant strain in the region. Additionally, this novel and high-risk ST11-KL25-CRKP strain may indicate stronger virulence.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"43 ","pages":"Pages 7-14"},"PeriodicalIF":3.7,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573174","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}