Infectious diseases & clinical microbiology最新文献

{"title":"A Case of Severe Cutaneous Anthrax: Malignant Edema Leading to Laryngeal Involvement.","authors":"Özge Atik, Yusuf Özkaraman, Nurdan Çobaner","doi":"10.36519/idcm.2025.473","DOIUrl":"10.36519/idcm.2025.473","url":null,"abstract":"<p><p><i>Bacillus anthracis</i>, the causative agent of anthrax, primarily affects herbivorous animals but can also infect humans. This disease is prevalent in livestock, particularly in rural regions. Cutaneous anthrax, the most common form, is usually benign; however, it can cause significant edema, particularly on the face, which may spread to the neck and chest. This swelling may compress the trachea, leading to respiratory distress. This report presented a severe and rare case of cutaneous anthrax in which facial edema extended, resulting in laryngeal edema.</p>","PeriodicalId":519881,"journal":{"name":"Infectious diseases & clinical microbiology","volume":"7 2","pages":"226-231"},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628809","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":"Quantitative Immunoglobulin G and Interferon-Gamma Responses After Different Booster Strategies of CoronaVac and BNT162b2 Vaccines in Türkiye.","authors":"Aylin İrem Ocaklı, Şeyma Aybüke Özyar-Kurtçu, Mertcan Uzun, Merve Kaşıkçı-Çavdar, Gülçin Telli-Dizman, Gökhan Metan, Murat Akova, Zeynep Sarıbaş, Burçin Şener","doi":"10.36519/idcm.2025.546","DOIUrl":"10.36519/idcm.2025.546","url":null,"abstract":"<p><strong>Objective: </strong>The global effort to combat the COVID-19 pandemic requires a comprehensive assessment of vaccine efficacy, including both humoral and cellular immune responses. This study aimed to determine the effects of CoronaVac and BNT162b2 booster doses on quantitative immunoglobulin G (IgG) and interferon-gamma (IFN-γ) responses of individuals primed with two doses of CoronaVac in Türkiye.</p><p><strong>Materials and methods: </strong>This prospective cohort study included participants aged 18-59 years, without comorbidities, who were not under drug therapy and had no clinical history of COVID-19 and primed with CoronaVac. Participants were divided into three groups: Group 1 received a single CoronaVac booster, Group 2 received a single BNT162b2 booster, and Group 3 received two BNT162b2 boosters. Humoral immunity was assessed by the determination of IgG levels against the spike receptor-binding domain (RBD) protein of SARS-CoV-2, and cellular immunity was assessed by the IFN-γ release assay.</p><p><strong>Results: </strong>The study included 48 participants. When the 6-12-month post-vaccination period was considered, the lowest quantitative IgG levels were detected in Group 1. Higher IgG levels were detected in Group 2 and Group 3, with Group 3 revealing the highest levels for both IgG and IFN-γ responses. Although the differences between the IFN-γ levels among the three groups were not statistically significant, the individuals boosted with the BNT162b2 demonstrated two- and three-fold higher levels compared to the homologous boosted individuals. The median IgG and IFN-γ values were significantly higher in the younger participants compared to the older participants in Group 3.</p><p><strong>Conclusion: </strong>Our findings revealed that although homologous and heterologous boosting in inactivated vaccine-primed individuals provided effective humoral and cellular immunity, boosting with two doses of BNT162b2 should be prioritized since it exhibited a positive impact on both humoral and cellular immunity.</p>","PeriodicalId":519881,"journal":{"name":"Infectious diseases & clinical microbiology","volume":"7 2","pages":"156-165"},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628818","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":"Risk Factors for Cytomegalovirus Reactivation and Its Impact on Clinical Outcomes in Immunocompetent Seropositive Patients Admitted to the Intensive Care Unit: A Single-Center Prospective Observational Study.","authors":"Hacer Ceylan Çimendağ, Arzu Sayıner, Ali Necati Gökmen, Vildan Avkan-Oğuz","doi":"10.36519/idcm.2025.480","DOIUrl":"10.36519/idcm.2025.480","url":null,"abstract":"<p><strong>Objective: </strong>Monitoring cytomegalovirus (CMV) plasma DNAemia is not used in routine clinical practice for immunocompetent patients. However, immunocompetent patients in the intensive care unit (ICU) may develop transient immunosuppression due to severe illness and its treatment, potentially leading to CMV reactivation. This study aimed to investigate the incidence, risk factors, and clinical outcomes of CMV reactivation in non-immunocompromised patients in the intensive care unit (ICU).</p><p><strong>Materials and methods: </strong>Patients admitted to the Internal Medicine and Anesthesia ICUs were included. CMV-seropositive patients who met inclusion criteria were monitored daily. Quantitative real-time polymerase chain reaction (qPCR) was performed on days 0, 3, 7, 14, 21, and 28 to determine CMV plasma DNAemia. Patients' data was recorded and analyzed by dividing them into reactivation and non-reactivation groups.</p><p><strong>Results: </strong>CMV reactivation occurred in 26 of 146 patients (17.8%), with a mean onset of 10 ± 4.72 days after ICU admission (range: 3-21 days). The reactivation rates in different ICU populations were found to be 31.5% in patients with septic shock, 25% in those with COVID-19, 23.8% in those with sepsis, 18.4% in mechanically ventilated patients, and 11.4% following trauma or surgery. In multivariate analysis, sepsis at ICU admission (odds ratio [OR] 2.88, 95% confidence interval [CI]: 1.017-8.157), Acute Physiology and Chronic Health Evaluation II (APACHE II) score at ICU admission (OR 1.062, 95% CI: 1.003-1.126), and duration of illness before admission (OR 1.048, 95% CI: 1.001-1.097) were independently associated with CMV reactivation. The incidence of fungemia after ICU admission was significantly higher in the group with CMV reactivation. Mortality rates, ICU duration, and hospital stay were comparable between the two groups.</p><p><strong>Conclusion: </strong>Consistent with previous studies, our findings suggested that the presence of infection, especially sepsis, during ICU admission is the most significant risk factor for CMV reactivation. The identification of sepsis and high APACHE II score as independent risk factors supported the association between severe sepsis-related illness and CMV reactivation. In patients with risk factors, CMV reactivation may serve as a marker of disease severity and the level of immunosuppression.</p>","PeriodicalId":519881,"journal":{"name":"Infectious diseases & clinical microbiology","volume":"7 2","pages":"174-184"},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628819","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":"Prognostic Factors in COVID-19 Patients with Ventilator-Associated Pneumonia: A Single-Centre Experience.","authors":"Hilal Ekici, Seda Zor-Çakıllı, Emine Arman-Fırat, Esma Eryılmaz-Eren, İlhami Çelik","doi":"10.36519/idcm.2025.522","DOIUrl":"10.36519/idcm.2025.522","url":null,"abstract":"<p><strong>Objective: </strong>Coronavirus disease 2019 (COVID-19) presents with a broad range of symptoms, varying from mild or moderate illness to severe cases such as acute respiratory distress syndrome (ARDS) and death.  This study aimed to identify risk factors associated with the development of ventilator-associated pneumonia (VAP) and its impact on 14-day mortality in mechanically ventilated COVID-19 patients.</p><p><strong>Materials and methods: </strong>This study was conducted in our hospital's intensive care units (ICUs) between July 2020 and July 2021. It included patients aged 18 years and older who tested positive for SARS-CoV-2 by PCR. Demographic data, comorbidities, immunosuppressive treatments, antimicrobial therapies, and laboratory values were evaluated, along with pathogen identification and antimicrobial resistance rates.</p><p><strong>Results: </strong>A total of 311 patients were included in the study. The mean age was 72.6 ± 11.9 years. Hypertension (48.6%) was the most frequent comorbidity. Among patients who survived on day 14, higher rates of methylprednisolone (MP) use were observed (<i>p</i>=0.019), along with longer duration (<i>p</i><0.001) and greater total dose (<i>p</i><0.001). Pulse steroid therapy was more common in survivors (28%, <i>p</i>=0.007). Among patients who developed VAP, the duration and total dose of MP were higher (<i>p</i><0.001 for both). Antibiotic therapy on day 14 showed macrolides (59.6%) and third-generation cephalosporins (36.5%) as the most frequently used. <i>Acinetobacter baumannii</i> was the most commonly isolated pathogen (62.5%), with 100% resistance to third-generation cephalosporins in <i>Acinetobacter</i> strains and 83.3% in <i>Klebsiella pneumoniae</i>. All strains of <i>A. baumannii</i>, <i>K. pneumoniae</i>, and <i>Escherichia coli</i> were resistant to carbapenems.</p><p><strong>Conclusion: </strong>Fourteen-day survival was associated with higher corticosteroid use, including dexamethasone and MP, along with pulse steroid therapy. The use of immunosuppressive agents was more common in patients who developed VAP. Given the potential link between immunosuppressive therapy and VAP development, tailored treatment strategies should be considered for these patients.</p>","PeriodicalId":519881,"journal":{"name":"Infectious diseases & clinical microbiology","volume":"7 2","pages":"143-155"},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628817","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 Hypervirulent ST-17 Clone Among Clinical Group B Streptococcus Isolates Using MALDI-TOF MS and PCR.","authors":"Gülşah Malkoçoğlu, Mehmet Emin Bulut, Banu Bayraktar, Barış Otlu, Elif Aktaş","doi":"10.36519/idcm.2025.455","DOIUrl":"10.36519/idcm.2025.455","url":null,"abstract":"<p><strong>Objective: </strong>Group B streptococcus (GBS) is the leading causative agent of neonatal morbidity and mortality. Sequence type 17 (ST-17) in GBS causes neonatal invasive disease more frequently than other STs. This study aimed to investigate the presence of hypervirulent ST-17 in a collection of clinical GBS isolates.</p><p><strong>Materials and methods: </strong>GBS isolates obtained from patients with invasive and non-invasive infections were included in the study. For the detection of ST-17 GBS, matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS) and polymerase chain reaction (PCR) methods were performed. Multilocus sequence typing (MLST) was also performed in a subset of some representative GBS strains.</p><p><strong>Results: </strong>Among 108 GBS isolates included in the study, 6 (5.5%) were identified as ST-17 by MALDI-TOF MS. Discriminatory peaks were detected at 7620 Da for ST-17 and 7638 Da for non-ST-17 isolates. In addition to six isolates that were positive for ST-17 by MALDI-TOF MS, one more isolate (GBS2) was found to be positive for ST-17 by PCR test. MLST revealed that those six isolates were ST-17 or single-locus variants of ST-17, while the isolate GBS2 was ST-1. Among the remaining 20 representative GBS isolates, 14 STs were identified by MLST, and all of them were non-ST-17 in accordance with MALDI-TOF MS and PCR results.</p><p><strong>Conclusion: </strong>In this study, the presence of a circulating hypervirulent ST-17 clone in Türkiye was demonstrated for the first time. MALDI-TOF MS successfully and rapidly detected ST-17 and non-ST-17 GBS isolates. This practical method may contribute to efficiently managing neonatal infections caused by ST-17 GBS.</p>","PeriodicalId":519881,"journal":{"name":"Infectious diseases & clinical microbiology","volume":"7 2","pages":"166-173"},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628811","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":"Potential Predictors of the Outcome of Tocilizumab Treatment in Patients with COVID-19-Associated Hyperinflammation.","authors":"Shirkhan Amikishiyev, Murat Bektaş, Mehmet Güven Günver, Burak İnce, Sarvan Aghamuradov, Nevzat Koca, Naci Şenkal, Görkem Durak, Murat Köse, Mustafa Erelel, Arif Atahan Çağatay, Serap Şimşek-Yavuz, Sevgi Kalayoğlu-Beşışık, Figen Esen, Ahmet Gül","doi":"10.36519/idcm.2025.475","DOIUrl":"10.36519/idcm.2025.475","url":null,"abstract":"<p><strong>Objective: </strong>During the COVID-19 pandemic, a subset of patients developed COVID-19-associated hyperinflammation (HIC), which resulted in increased mortality. While early and effective anti-inflammatory therapies, such as glucocorticoids and tocilizumab, improved survival, tools to predict treatment response remained lacking. This study aimed to identify predictors of clinical outcomes in patients who received tocilizumab for HIC.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed the records of hospitalized adult patients with COVID-19 treated between March and December 2020. Patients who received tocilizumab for HIC constituted the study cohort. Dynamic changes in the laboratory parameters were analyzed, and the HIC scores (≥35) were calculated to assess disease severity and treatment response.</p><p><strong>Results: </strong>Out of 961 hospitalized COVID-19 patients, 150 who received tocilizumab were identified. Among them, 124 were treated with only tocilizumab in the first phase of the pandemic (from March to September 2020). After this period, 26 patients also received glucocorticoids, typically initiated 2-3 days prior to tocilizumab administration. Anakinra treatment was given to 22 patients whose inflammatory parameters did not resolve with tocilizumab. Findings of HIC were treated in 122 patients (84%), with a significant reduction in C-reactive protein (CRP) levels (from 121.8 ± 8.2 to 9.8 ± 2.8 mg/L). Despite tocilizumab treatment, no effective resolution of the CRP response was observed (from 172 ± 22.8 to 53 ± 8 mg/L by Day 5) among non-survivors, alongside increasing trends in neutrophil count, D-dimer, lactate dehydrogenase (LDH), troponin, and creatine kinase. The composite HIC scores progressively decreased in survivors until the last day of hospitalization but increased in non-survivors (33.8 ± 0.14 vs. 72.3 ± 0.13).</p><p><strong>Conclusion: </strong>Analysis of this cohort indicated that neutrophil count, CRP, D-dimer, LDH, troponin, and creatine kinase levels may serve as predictors of tocilizumab efficacy on Day 5. The score developed to diagnose HIC can also be used for monitoring treatment response.</p>","PeriodicalId":519881,"journal":{"name":"Infectious diseases & clinical microbiology","volume":"7 2","pages":"185-194"},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628816","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 Definition, Prevalence, and Risk Factors of Augmented Renal Clearance in Adult Patients on Antimicrobial Therapy: A Scoping Review.","authors":"Hasan Memiş, Ahmet Çakır, Aysel Pehlivanlı, Bilgen Başgut","doi":"10.36519/idcm.2025.504","DOIUrl":"10.36519/idcm.2025.504","url":null,"abstract":"<p><strong>Objective: </strong>Augmented renal clearance (ARC), defined as rapid drug clearance, can lead to subtherapeutic antimicrobial concentrations in specific patient populations. This scoping review aimed to synthesize current evidence on ARC in adult patients receiving antimicrobial treatment, focusing on its prevalence, risk factors, and influence on attaining therapeutic drug levels. It also identified gaps for future research and provided dosage recommendations.</p><p><strong>Materials and methods: </strong>This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement for Scoping Reviews (PRISMA-ScR) reporting guidelines. The titles, abstracts, and keywords of the studies indexed in Web of Science, PubMed, or Scopus between 2019 and 2023 were extensively analyzed for relevance to ARC and antimicrobial therapy. Non-English articles, reviews, and non-human studies were excluded. Data extracted included article type, study details, patient population, ARC definition, ARC prevalence, methods of renal function assessment, and study results.</p><p><strong>Results: </strong>Of 492 articles identified, 47 met the inclusion criteria, covering a total of 6193 patients. ARC prevalence in the studies ranged from 3.3% to 100%. The Cockcroft-Gault equation was the most commonly used method for calculating creatinine clearance (66%). Risk factors for ARC were reported in 8.5% of the studies, and glycopeptides were the most frequently examined drug class (31.9%). In 26 (55.3%) studies, high doses or prolonged infusions were recommended to achieve therapeutic drug levels.</p><p><strong>Conclusion: </strong>β-lactams and linezolid may require prolonged infusion or higher doses in ARC patients, while glycopeptides and aminoglycosides may also require higher doses. Further research is needed to clarify how ARC affects clinical outcomes and dosing strategies.</p>","PeriodicalId":519881,"journal":{"name":"Infectious diseases & clinical microbiology","volume":"7 2","pages":"123-132"},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628820","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":"A Case of Leukocytoclastic Vasculitis Related to Acute Parvovirus B19 Infection.","authors":"Eren Öztürk, Serpil Erol, Fügen Vardar-Aker, Şirin Yaşar","doi":"10.36519/idcm.2025.452","DOIUrl":"10.36519/idcm.2025.452","url":null,"abstract":"<p><p>Parvovirus B19 (PVB19) infection can cause various clinical presentations. While mostly erythema infectiosum, transient aplastic crisis, and fetal hydrops are seen, it rarely causes myocarditis, hepatitis, or vasculitis. We report a patient admitted with fever, fatigue, arthralgia, and rash. Although there was no aetiological clue in the first-line studies, the tests were repeated because of clinical suspicion. Therefore, >4-fold increase in PVB19 IgM titer, IgG seroconversion, and pathological findings led to the diagnosis of leukocytoclastic vasculitis (LCV) related to PVB19. We aimed to emphasize the importance of testing repetition in high clinical suspicion.</p>","PeriodicalId":519881,"journal":{"name":"Infectious diseases & clinical microbiology","volume":"7 2","pages":"209-213"},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628808","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":"Diagnostically Challenging Case: Coexistence of Two Zoonoses.","authors":"Melike Törüyenler-Coşkunpınar, İrem Akdemir, Seher Yüksel, Nermin Aras, Meltem Kurt-Yüksel, Alpay Azap","doi":"10.36519/idcm.2025.501","DOIUrl":"10.36519/idcm.2025.501","url":null,"abstract":"<p><p>A male patient presented with fever, cytopenia, and hepatosplenomegaly. The patient's <i>Brucella</i> tube agglutination test was positive at titers 1:640. Due to the lack of response to brucellosis treatment, additional tests were performed. <i>Leishmania</i> amastigotes were seen in the second bone marrow biopsy preparations. <i>Leishmania</i> PCR was positive, and visceral leishmaniasis (VL) was diagnosed. Here, we present a case of VL and brucellosis coinfection that presented with B symptoms (fever, night sweats, and weight loss) and cytopenia and was difficult to diagnose.</p>","PeriodicalId":519881,"journal":{"name":"Infectious diseases & clinical microbiology","volume":"7 2","pages":"214-219"},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628813","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":"Development of a Liquid Chromatography-Tandem Mass Spectrometry Method for Quantifying Teicoplanin and Its Application in Critically Ill Patients.","authors":"Hasan Memiş, Ahmet Çakır, Zeynep Ülkü Gün, Hatice Saraçoğlu, Çiğdem Karakükcü, Aliye Esmaoğlu, Zafer Doğan","doi":"10.36519/idcm.2025.528","DOIUrl":"10.36519/idcm.2025.528","url":null,"abstract":"<p><strong>Objective: </strong>Teicoplanin, a glycopeptide antibiotic, is used to treat infections caused by Gram-positive pathogens. Trough-level monitoring of teicoplanin is recommended in specific -patient populations, including critically ill patients. This study aimed to develop and validate a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method to quantify teicoplanin in human plasma and adapt the method to a critically ill patient sample.</p><p><strong>Materials and methods: </strong>Teicoplanin trough levels were measured using a newly validated LC-MS/MS method. Analysis was conducted using a C18 column with an inner diameter of 2.7 μm (50.0 x 3.0 mm), and vancomycin hydrochloride was used as the internal standard. The method's run time per sample was 5.5 minutes. Non-parametric tests were used for statistical analysis. Univariate and multivariate logistic regression were performed to identify teicoplanin target attainment factors. A <i>p</i>-value of <0.05 was considered statistically significant.</p><p><strong>Results: </strong>The method demonstrated linearity between 1.56-100 mg/L teicoplanin concentration and had a lower limit of detection and quantification of 0.33 mg/L and 1.00 mg/L, respectively. Precision, accuracy, recovery rate, and carry-over effects were all within acceptable limits, according to the U.S. Food and Drug Administration (FDA) guidance. Twenty patients were included in the study. The target teicoplanin trough level (≥10 mg/L) attainment rate was 50%. The patient's laboratory values did not significantly change after teicoplanin treatment (<i>p</i>>0.05), except for erythrocyte count, haemoglobin, and haematocrit values, which decreased significantly (<i>p</i><0.05). Multivariate analysis revealed no significant factors affecting target attainment (<i>p</i>>0.05).</p><p><strong>Conclusion: </strong>The LC-MS/MS assay validated in this study is high-throughput, robust, and quick enough to be implemented in clinical therapeutic drug monitoring (TDM) laboratories. More large-scale studies are needed to understand better the relationship between teicoplanin trough levels and patient-related factors.</p>","PeriodicalId":519881,"journal":{"name":"Infectious diseases & clinical microbiology","volume":"7 2","pages":"195-207"},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628812","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}