Journal of global antimicrobial resistance最新文献

{"title":"Full genome of Paenimyroides ceti strain MC-ZM-24 producing a new subclass B1 metallo-β-lactamase","authors":"Chahrazed Belhout ,&nbsp;Claudia Aldeia ,&nbsp;Vincent Perreten ,&nbsp;Andrea Endimiani","doi":"10.1016/j.jgar.2025.11.013","DOIUrl":"10.1016/j.jgar.2025.11.013","url":null,"abstract":"<div><h3>Objectives</h3><div><em>Paenimyroides ceti</em> is a newly defined species belonging to the <em>Flavobacteriaceae</em> family. It was originally isolated from the lung and liver of two beaked whales. Here, we report the first complete circular genome of a <em>P. ceti</em> and provide insights into its antimicrobial resistance determinants.</div></div><div><h3>Methods</h3><div><em>P. ceti</em> strain MC-ZM-24 was isolated from homogenized tissues of <em>Zophobas morio</em> larvae. Antimicrobial susceptibility tests were determined by broth microdilution and carbapenemase production was assessed by Blue-Carba test. Whole-genome sequencing (WGS) was obtained using both the Illumina short and Oxford Nanopore long-read technologies. A hybrid genome assembly was generated with Unicycler and subsequently annotated using the NCBI Prokaryotic Genome Annotation Pipeline. Antimicrobial resistance genes were identified using AMRFinder and ResFinder. Known metallo-β-lactamase (MBL) protein sequences deposited in NCBI GenBank and UniProt databases were compared with that of strain MC-ZM-24.</div></div><div><h3>Results</h3><div>The genome comprised a single circular chromosome of 3,274,043-bp, with 3,053 genes, and exhibited a GC content of 35.56%. Phenotypically, the strain was multidrug-resistant, non-susceptible to carbapenems and produced a carbapenemase. WGS analysis identified a unique chromosomal <em>bla</em> gene encoding a MBL that harbors the conserved subclass B1 motifs, but shares low sequence identity with previously described MBL enzymes.</div></div><div><h3>Conclusions</h3><div>The complete genome of <em>P. ceti</em> MC-ZM-24 expands our understanding of <em>Paenimyroides</em> ecology and evolution. It also highlights an intrinsic subclass B1 β-lactamase, extending the repertoire of chromosomal MBLs in <em>Flavobacteriaceae</em>. This new MBL will require further detailed characterization.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"46 ","pages":"Pages 109-111"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145581683","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":"ISAC News and Updates","authors":"","doi":"10.1016/j.jgar.2026.01.009","DOIUrl":"10.1016/j.jgar.2026.01.009","url":null,"abstract":"","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"46 ","pages":"Pages ii-iii"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147394328","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":"Adapting international evidence-based guidelines to local challenges: A Lebanese perspective on the latest American Thoracic Society and Infectious Diseases Society of America (ATS/IDSA) community-acquired pneumonia antibacterial therapy recommendations","authors":"Rana Attieh ,&nbsp;Joe Nahal ,&nbsp;Rola Husni ,&nbsp;Jacques E. Mokhbat ,&nbsp;Jamil Barhoun ,&nbsp;Joumana Kmeid ,&nbsp;Mona Youssef ,&nbsp;Zahi Helou ,&nbsp;Wael Zorkot ,&nbsp;Nassab Fakhreddine ,&nbsp;Fatima Baalbaki ,&nbsp;Nazih Bizri ,&nbsp;Hanine Mansour ,&nbsp;Dania Abdallah ,&nbsp;Rima Moghnieh","doi":"10.1016/j.jgar.2025.11.005","DOIUrl":"10.1016/j.jgar.2025.11.005","url":null,"abstract":"<div><div>Community-acquired pneumonia (CAP) remains a major global health concern, particularly in regions with rising antimicrobial resistance (AMR). In Lebanon, increasing resistance among respiratory pathogens complicates management, limiting treatment options and worsening clinical and economic outcomes. This expert panel review assessed recent national AMR data to adapt CAP treatment recommendations to the Lebanese context. The 2019 ATS/IDSA guidelines and their 2025 update were reviewed; while most recommendations were retained, empiric antibiotic choices were adjusted for key pathogens based on local resistance patterns. The proposed management algorithm stratifies patients by disease severity, care setting, and AMR risk, integrating pathogen-specific risk factors into clinical decisions. By contextualizing international guidance to local epidemiology and healthcare infrastructure, these recommendations aim to optimize targeted therapy, support antimicrobial stewardship, and preserve antibiotic efficacy in Lebanon’s evolving resistance landscape.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"46 ","pages":"Pages 98-108"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145557031","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":"Integrative machine learning approaches with genomic data for predicting antitubercular drug resistance: A systematic review and meta-analysis","authors":"Rohan Shrivastava ,&nbsp;Kashmi Sharma ,&nbsp;Somesh Mishra ,&nbsp;Poonam Parihar ,&nbsp;Gobardhan Das ,&nbsp;Khushhali Menaria Pandey ,&nbsp;Anand Kumar Maurya ,&nbsp;Vineet Kumar Sharma ,&nbsp;Anamika Mishra ,&nbsp;Sandeep Kushwaha ,&nbsp;Rekha Khandia ,&nbsp;Kuldeep Singh Yadav ,&nbsp;Anvita Gupta Malhotra ,&nbsp;Amit Agrawal ,&nbsp;Jitendra Singh ,&nbsp;Megha Katare Pandey","doi":"10.1016/j.jgar.2025.11.021","DOIUrl":"10.1016/j.jgar.2025.11.021","url":null,"abstract":"<div><h3>Objectives</h3><div>Tuberculosis (TB) remains a leading infectious cause of death, with drug-resistant TB threatening control gains worldwide Rapid, accurate prediction of resistance to first-line agents is essential to guide therapy.</div><div>The objective of this meta-analysis is to evaluate the diagnostic performance of machine learning (ML) algorithms trained on genomic data for predicting phenotypic resistance to the antitubercular drugs.</div></div><div><h3>Methods</h3><div>We searched 4 databases for original studies applying ML to whole-genome or targeted sequencing for resistance prediction against rifampicin (RIF), isoniazid (INH), ethambutol (EMB), streptomycin (STM), and other routinely tested drugs. Random-effects meta-analyses (REML) pooled sensitivity and specificity; Area Under Curve (AUC) was meta-analysed after logit transformation. Publication bias was examined via funnel plots plus Egger’s and Begg’s tests with trim-and-fill adjustment.</div></div><div><h3>Results</h3><div>Seven eligible studies were included. Pooled performance was strongest for RIF and INH (RIF: sensitivity 0.90, specificity 0.95; INH: sensitivity 0.88, specificity 0.93). EMB and STM showed lower sensitivities despite reasonable AUCs. Forest plots for AUC (including logit scale), sensitivity, and specificity demonstrated drug-wise variation. Across studies, specificity (mean ≈ 0.92) exceeded sensitivity (mean ≈ 0.75). Bias diagnostics revealed marked funnel plot asymmetry; trim-and-fill imputation added 22, 29, and 23 studies for AUC, sensitivity, and specificity, respectively, yielding adjusted pooled estimates of ∼0.89 (AUC), 0.70 (sensitivity), and 0.93 (specificity).</div></div><div><h3>Conclusions</h3><div>ML models trained on genomic data demonstrate high diagnostic accuracy and robust discriminative ability for predicting first-line drug resistance—particularly for RIF and INH—although sensitivity remains variable across drugs and model types. Standardized external validation and calibration are needed before broad clinical deployment.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"46 ","pages":"Pages 148-157"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145756841","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 analysis of a novel high-risk ST5217/ExoU+/O11 clone of carbapenem-resistant OXA-181- and VIM-2-producing Pseudomonas aeruginosa in India","authors":"Subhasree Roy ,&nbsp;Souvik Nandy ,&nbsp;Daichi Morita ,&nbsp;Ranjan Kumar Nandy ,&nbsp;Balaji Veeraraghavan ,&nbsp;Kamini Walia ,&nbsp;Santasabuj Das ,&nbsp;Sulagna Basu","doi":"10.1016/j.jgar.2025.12.002","DOIUrl":"10.1016/j.jgar.2025.12.002","url":null,"abstract":"<div><h3>Objectives</h3><div>Studies of carbapenem-resistant <em>Pseudomonas aeruginosa</em> (CRPA)-harbouring OXA-48-like carbapenemases are rare. The study aimed to report the emergence and characterization of a novel high-risk clone of CRPA-harbouring OXA-48-like from India.</div></div><div><h3>Methods</h3><div>Identification, AST, phenotypic detection of carbapenemases and WGS using Ion-Torrent-S5 platform were carried out. Analyses included ResFinder, VFDB, MLST, PAst, Phastest and CRISPR/Cas. SNP-based phylogenetic analysis with global OXA-48-like-harbouring CRPA genomes was carried out by CSI Phylogeny and iTOL for visualization.</div></div><div><h3>Results</h3><div>The clinical MDR strain of CRPA AMRIR00655 belonged to a novel sequence type ST5217 and serotype O11. Phenotypic tests followed by WGS revealed the presence of dual carbapenemases, OXA-181 (serine-carbapenemase) and VIM-2 (zinc-carbapenemase), both located on chromosome. <em>bla</em>_OXA-181 resides between chromosomal genes encoding RodZ and PAP2 in <em>P. aeruginosa</em>, confirming chromosomal integration<em>.</em>4,261 bp of <em>bla</em>_OXA-181-bearing contig-DNA showed 100% homology to <em>K. pneumoniae</em> plasmid pKP3-A. IS<em>Ecp1</em> was present on upstream and on downstream, △<em>lysR,</em> △<em>ereA</em> and <em>repA</em> genes were detected. <em>bla</em>_VIM-2 was located within class 1 integron along with <em>aacC6-II, dfrB5, aac(3)-Id, tniC</em> in surrounding regions and 13,242 bp showing 100% identity to <em>P. aeruginosa</em> chromosome. Presence of other ARGs (<em>bla</em>_PAO, <em>bla</em>_OXA-488, <em>aph(3′')-Ib, aph(6)-Id, crpP, catB7, fosA, sul2</em>) and efflux-pump genes might explain its MDR phenotype. Virulence factors including T3SS (PscF, PopB, PopD, PcrV) and its effectors (ExoT, ExoU, ExoY) indicated the pathogenic potential of ST5217. Core genome analysis showed that ST5217 was closest with other high-risk clones ST1339 and ST773-harbouring <em>bla</em>_OXA-48-like.</div></div><div><h3>Conclusions</h3><div>To the best of our knowledge, this is the first report of <em>bla</em>_OXA-181-harbouring novel high-risk clone of CRPA ST5217/ExoU+/O11 in India which emphasises the spread of OXA-181 among bacteria other than Enterobacteriaceae-family and warrant close monitoring.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"46 ","pages":"Pages 158-161"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145742985","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":"Emergence and inter-hospital circulation of capsule K2- and OXA-48-producing Klebsiella pneumoniae ST395 in north-eastern Italy","authors":"Vittoria Mattioni Marchetti ,&nbsp;Francesca Piscopiello ,&nbsp;Assunta Girardi ,&nbsp;Stefano Grandesso ,&nbsp;Roberta Migliavacca","doi":"10.1016/j.jgar.2025.11.007","DOIUrl":"10.1016/j.jgar.2025.11.007","url":null,"abstract":"<div><h3>Objective</h3><div><em>Klebsiella pneumoniae</em> ST395 is an internationally disseminated, high-risk clone implicated in OXA-48-producing <em>K. pneumoniae</em> (OXA-48 Kp) outbreaks. In Italy, <em>K. pneumoniae</em> ST395 is sporadically detected and mainly associated with the <em>bla</em>_KPC-3 determinant. Here we aimed to explain the increase in cases of OXA-48 Kp ST395 in north-eastern Italy.</div></div><div><h3>Methods</h3><div>In the period May–July 2024, 57 OXA-48 Kp samples were collected from three different hospitals and related communities within the province of Venice, Italy. Species identification, antimicrobial susceptibility, carbapenemase production, and clonal relatedness were ascertained using MALDI-TOF MS, the Vitek-2 System, CARBA PLUS (MASTGroup), and pulsed-field gel electrophoresis, respectively. Whole-genome sequencing was carried out on seven representative strains using an Illumina (San Diego, CA, USA) NovaSeq.</div></div><div><h3>Results</h3><div>All 57 OXA-48 Kp strains retained susceptibility to aminoglycosides only, with three pulsotypes (A–C) detected by pulsed-field gel electrophoresis. Pulsotype A included 13 subtypes (A–A12). Subtypes A3 and A9 (<em>n</em> = 8, respectively) had the highest pattern similarity, followed by A12 (<em>n</em> = 4), A5 (<em>n</em> = 3), and A11 (<em>n</em> = 2). ST395 and the K2 capsule were highlighted by whole-genome sequencing. The shared resistome consisted of aminoglycoside (<em>aac(3)-IIa, aac(6′)-Ib-cr</em>), chloramphenicol (<em>catA1, catB4</em>), beta-lactam (<em>bla</em>_CTX−M-15), and carbapenem (<em>bla</em>_OXA-48) genes. SNP-based phylogeny showed relevant genomic relatedness, although clonal identity was obtained in only two cases.</div></div><div><h3>Conclusions</h3><div>Here we have highlighted the alarming inter-hospital circulation of OXA-48 Kp ST395 in north-eastern Italy.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"46 ","pages":"Pages 87-97"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582246","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":"Characterization of tmexCD2-toprJ2-carrying carbapenem-resistant Raoultella ornithinolytica from hospital sewage in Zhejiang Province of China, 2022–2023","authors":"Yonglu Huang ,&nbsp;Yi Sun ,&nbsp;Chang Jiang ,&nbsp;Xiangkun Zeng ,&nbsp;Yuchen Wu ,&nbsp;Zelin Yan ,&nbsp;Jing Wang ,&nbsp;Hongwei Zhou ,&nbsp;Gongxiang Chen ,&nbsp;Yongning Wu ,&nbsp;Ning Dong","doi":"10.1016/j.jgar.2026.01.002","DOIUrl":"10.1016/j.jgar.2026.01.002","url":null,"abstract":"<div><h3>Objective</h3><div>Hospital wastewater serves as a critical source of antimicrobial resistance genes (ARGs), particularly those associated with opportunistic pathogens like <em>Raoultella ornithinolytica</em>. This study aimed to characterize carbapenem-resistant <em>R. ornithinolytica</em> (CR-ROR) isolates carrying the <em>tmexCD2-toprJ2</em> gene cluster from hospital sewage in Zhejiang province, China.</div></div><div><h3>Methods</h3><div>Wastewater samples collected from four hospitals in Zhejiang Province were screened for carbapenem-resistant isolates. Whole-genome sequencing using the Illumina platform, combined with bioinformatic analysis, was performed to investigate phylogenetic relationships, associated ARGs, and the structural features of plasmids in <em>tmexCD2-toprJ2</em>-positive CR-ROR isolates.</div></div><div><h3>Results</h3><div>Five genetically distantly related <em>tmexCD2-toprJ2</em>-positive CR-ROR isolates were identified. All exhibited multidrug-resistant (MDR) phenotypes and carried various ARGs, including carbapenemase genes such as <em>bla</em>_KPC-2, <em>bla</em>_NDM-1, and <em>bla</em>_IMP-4. Genomic analysis revealed that <em>tmexCD2-toprJ2</em> was plasmid-borne and frequently flanked by mobile genetic elements (MGEs), suggesting a high risk of horizontal gene transfer.</div></div><div><h3>Conclusions</h3><div>The presence of <em>tmexCD2-toprJ2</em>-carrying CR-ROR in hospital sewage underscores the role of wastewater as a potential environmental reservoir for clinically resistant genes. Ongoing surveillance of hospital effluents is crucial for tracking the dissemination of high-risk antimicrobial resistance determinants and informing timely public health interventions.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"46 ","pages":"Pages 283-287"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145984968","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":"Treatment of asymptomatic bacteriuria during pregnancy: A risk-factor-based approach","authors":"George Zhanel ,&nbsp;Patricia de Rossi ,&nbsp;Cosimo Oliva ,&nbsp;Truls E. Bjerklund Johansen","doi":"10.1016/j.jgar.2025.11.010","DOIUrl":"10.1016/j.jgar.2025.11.010","url":null,"abstract":"<div><div>During pregnancy, there is increased risk of ascending urinary tract infection (UTI) resulting in pyelonephritis and associated preterm delivery and low birth weight. It is therefore important that pregnant women who are at high risk of pyelonephritis because of the presence of asymptomatic bacteriuria (ASB) or cystitis receive appropriate antibiotic therapy. The aim of this position paper is to propose a risk-factor-based approach for the treatment of ASB and cystitis in pregnancy to help ensure that antibiotic treatment is prescribed only when necessary, and that the benefits of antibiotic treatment outweigh potential harms for pregnant women and neonates. Rather than advocating ASB screen-and-treat for all pregnant women who have ready access to healthcare, this risk-factor-based approach involves selective screening for ASB in pregnant women with other risk factors for UTI (previous UTI, diabetes mellitus, urinary tract abnormalities, or immunosuppression) and/or a history of preterm birth. Antibiotic treatment is indicated for persistent ASB confirmed with two urine cultures during selective high-risk screening, and for all pregnant women with cystitis confirmed by urine culture, with empiric treatment considered for symptoms of dysuria and urinary frequency. Evidence suggests that such a risk-factor-based approach will prevent progression to pyelonephritis in pregnant women with ASB and cystitis while complying with the principles of antimicrobial stewardship.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"46 ","pages":"Pages 79-86"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145581633","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":"Emergence of blaKPC-71 variant and loss of aerobactin-encoding genes (iucABCD-iutA) in ST11-K64 carbapenem-resistant Klebsiella pneumoniae during ceftazidime–avibactam treatment","authors":"Fang-ling Du ,&nbsp;Dan-dan Wei ,&nbsp;Yong-qing Guo ,&nbsp;Peng Liu ,&nbsp;Yan-fang Mei ,&nbsp;Shan-shan Huang ,&nbsp;Qi-sen Huang ,&nbsp;Lin-Ping Fan ,&nbsp;Yang Liu","doi":"10.1016/j.jgar.2025.11.020","DOIUrl":"10.1016/j.jgar.2025.11.020","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the within-host evolutionary dynamics of resistance and virulence in carbapenem-resistant <em>Klebsiella pneumoniae</em> during ceftazidime-avibactam treatment.</div></div><div><h3>Methods</h3><div>Three <em>K. pneumoniae</em> strains were isolated from the sputum of the same patient. Broth microdilution method, whole-genome sequencing and genetic analysis were employed to clarify the dynamics and mechanisms of antibiotic resistance. <em>Galleria mellonella</em> infection models were used to investigate the changes in virulence.</div></div><div><h3>Results</h3><div>The study described the changes of three strains of ST11-K64 carbapenem-resistant <em>K. pneumoniae</em> associated with pulmonary infection in vivo. The transition from a ceftazidime-avibactam-susceptible but imipenem-resistant isolate (JXZRKP1) to a ceftazidime-avibactam-resistant but imipenem-susceptible isolate (JXZRKP2) was attributed to the transformation of the <em>bla</em>_KPC gene from <em>bla</em>_KPC-2 to <em>bla</em>_KPC-71 and upregulation of <em>bla</em>_KPC gene expression. Notably, the <em>bla</em>_KPC-71 enzyme exhibited a Ser182 duplication compared to the wild-type <em>bla</em>_KPC-2 carbapenemase. The <em>bla</em>_KPC gene of three strains was carried by the IS<em>26</em>-mediated tandem core structure IS<em>Kpn27</em>-<em>bla</em>_KPC-IS<em>1182</em> on an IncFII-type plasmid. Furthermore, in comparison with JXZRKP2, the virulence plasmid of JXZRKP3 lost the aerobactin-encoding genes (<em>iucABCD-iutA</em>), resulting in diminished virulence in <em>G. mellonella</em> infection models, but there was no significant difference(<em>P</em> &gt; .05).</div></div><div><h3>Conclusions</h3><div>We first discovered that the mutation from <em>bla</em>_KPC-2 to <em>bla</em>_KPC-71 leads to resistance to ceftazidime-avibactam, followed by the loss of the aerobactin-encoding gene (<em>iucABCD-iutA</em>) on the virulence plasmid in vivo. This study underscores the complexity of addressing carbapenem-resistant <em>K. pneumoniae</em> infections.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"46 ","pages":"Pages 166-170"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145781127","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":"The resistance trends in Mycobacterium kansasii pulmonary isolates and identification of risk factors for drug resistance in Taiwan","authors":"Sheng-Bin Fan ,&nbsp;Hung-Ling Huang ,&nbsp;Hung-Pin Tu ,&nbsp;Benjamin Sobkowiak ,&nbsp;Meng-Hsuan Cheng ,&nbsp;Wei-Chang Huang ,&nbsp;Yi-Wen Huang ,&nbsp;Shang-Yi Lin ,&nbsp;Inn-Wen Chong ,&nbsp;Po-Liang Lu","doi":"10.1016/j.jgar.2025.11.001","DOIUrl":"10.1016/j.jgar.2025.11.001","url":null,"abstract":"<div><h3>Objectives</h3><div><em>Mycobacterium kansasii</em> (<em>M. kansasii</em>) pulmonary disease is an emerging global health concern, and the pathogen's resistance to antimicrobial agents is challenging. Understanding the epidemiology of drug resistance rates and the associated risk factors is useful for guiding antimicrobial agent selection for <em>M. kansasii</em> treatment.</div></div><div><h3>Methods</h3><div>This retrospective cohort study analysed 361 pathogenic <em>M. kansasii</em> isolates collected from patients with <em>M. kansasii</em> pulmonary disease in two tertiary medical centres in Taiwan between 2011 and 2022. Antimicrobial susceptibility testing was performed using Sensititre™ SLOMYCO1 or SLOMYCO2, and MIC breakpoints were according to CLSI 2018. We applied multivariate logistic regression and Cochran–Mantel–Haenszel test to assess the factors associated with drug resistance.</div></div><div><h3>Results</h3><div>Most <em>M. kansasii</em> isolates in Taiwan remained susceptible to the first-line agents, including rifampin (92.2%) and clarithromycin (98.6%). High resistance rates were observed in ciprofloxacin (42.7%), doxycycline (56.2%), and trimethoprim/sulfamethoxazole (87.8%). The drug resistance rates of tested antibiotics for <em>M. kansasii</em> increased notably in 2018–2022 compared to those between 2015–2017. <em>M. kansasii</em> isolates from central Taiwan exhibited significantly higher resistance rates in all drugs compared to those in southern Taiwan. Pulmonary fibrocavitary lesion was an independent risk factor for resistance to rifampin and ciprofloxacin.</div></div><div><h3>Conclusions</h3><div>The study reveals increasing resistance to the first- and second-line agents in <em>M. kansasii</em> isolates across Taiwan. Resistance epidemiology differed between regions. Fibrocavitary lung lesion was significantly associated with drug resistance. These findings underscore the importance of region-specific surveillance to undergo individualized treatment strategies for <em>M. kansasii</em> pulmonary disease.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"46 ","pages":"Pages 49-56"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145482270","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}