Antibiotics-Basel最新文献

{"title":"Impact of the COVID-19 Pandemic on Carbapenem-Resistant <i>Klebsiella pneumoniae</i> in Northern Region, Brazil: A Shift Towards NDM Producers.","authors":"Thalyta Braga Cazuza Barros, Yan Corrêa Rodrigues, Amália Raiana Fonseca Lobato, Lívia Maria Guimarães Dutra, Herald Souza Dos Reis, Ana Judith Pires Garcia, Fernanda do Espírito Santo Sagica, Cintya de Oliveira Souza, Danielle Murici Brasiliense","doi":"10.3390/antibiotics14090866","DOIUrl":"10.3390/antibiotics14090866","url":null,"abstract":"<p><p><b>Background:</b> The global impact of the SARS-CoV-2 pandemic on antimicrobial resistance (AMR) patterns has been significant. In northern Brazil, Carbapenem-resistant <i>Klebsiella pneumoniae</i> (CRKP) are a major concern, with an observed shift from <i>Klebsiella pneumoniae</i> carbapenemase (KPC) to New Delhi metallo-β-lactamase (NDM) during the pandemic. <b>Methods:</b> This cross-sectional study analyzed 775 carbapenem-resistant <i>K. pneumoniae</i> isolates collected from 25 hospitals in the Brazilian Amazon Region (states of Pará and Acre) between 2018 and 2021. The isolates were tested for the presence of carbapenemase genes (<i>bla</i>_KPC, <i>bla</i>_NDM, <i>bla</i>_OXA-48, <i>bla</i>_IMP, <i>bla</i>_VIM, <i>bla</i>_AIM, <i>bla</i>_DIM, <i>bla</i>_GIM and <i>bla</i>_SIM). <b>Results:</b> Of the isolates analyzed, n = 653/775 (84%) were carbapenemase producers, with the most prevalent being <i>bla</i>_KPC n = 446/775 (57.5%) and <i>bla</i>_NDM n = 243/775 (31.4%). A significant increase in NDM producers was observed during the pandemic, rising from n = 1/250 (8.4%) pre-pandemic to n = 222/525 (42.3%) during the pandemic, while KPC producers declined from n = 172/250 (68.8%) to n = 274/525 (52.2%) (<i>p</i> < 0.001). Adult intensive care units (ICUs) were the primary source of isolates n = 357/775 (46%), with a notable increase in tracheal secretion and surveillance swab samples during the pandemic. Regression analysis confirmed a strong upward trend in the prevalence of <i>bla</i>_NDM (R² = 0.778). <b>Conclusions:</b> The shift from KPC to NDM producers in northern Brazil highlights an evolving AMR landscape, partly driven by the pandemic. Strengthened infection control measures, antimicrobial stewardship and continuous surveillance are essential to mitigate the spread of NDM-producing <i>K. pneumoniae</i> in settings with limited resources.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 9","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Human Antimicrobial Use in Bangladesh: Five-Year Trend Analysis Including COVID-19 Pandemic Era.","authors":"S M Sabrina Yesmin, Paritosh Chakma, Umme Habiba, Anders Rhod Larsen, Terence Tino Fusire, Sangay Wangmo, Shila Sarkar, Majda Attauabi","doi":"10.3390/antibiotics14090868","DOIUrl":"10.3390/antibiotics14090868","url":null,"abstract":"<p><p><b>Background:</b> This paper provides the first national analysis of antimicrobial use (AMU) of oral and parenteral dosages in Bangladesh, as well as biannual trends for the years from 2019 to 2023. It also analyzes the effect of the COVID-19 pandemic on AMU. <b>Methods:</b> AMU was analyzed in accordance with the WHO Anatomical Therapeutic Chemical classification and defined daily doses per 1000 inhabitants per day methodology. Data on antimicrobial medicine dispatched from manufacturers' central warehouse was collected and categorized based on the WHO's Access, Watch, and Reserve (AWaRe) classification. <b>Findings:</b> This AMU surveillance demonstrates an increase in the use of antimicrobial medicines from 2021 to 2022, and in 2023, it decreased, with our national AMU surveillance data indicating that cefixime and azithromycin were the most consumed antibiotics during this period. Most antibiotics used in Bangladesh are broad-spectrum 'Watch'-category antibiotics. Among oral antibiotics, 50 to 67% are from the 'Watch'-category. When considering only parenteral antibiotics, 70 to 91 % fall under the 'Watch'-category. Third-generation cephalosporin consumption has been found to be higher than second- and first-generation cephalosporins. The oral antimicrobials are more commonly used than parenteral ones. AMU notably increased during the COVID-19 pandemic, especially in the case of systemic antibacterial use. <b>Conclusions:</b> To achieve the global target of 70% use of Access category antibiotics by 2030, the use of Watch-group antibiotics, like cefixime, azithromycin, ciprofloxacin, levofloxacin, and ceftibuten, needs to be reduced through investing in and strengthening stewardship programs and eliminating self-medication in Bangladesh. The findings of this study provide useful information to policymakers to tackle AMR in Bangladesh.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 9","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Ceftaroline Use in Pediatric Patients: A Retrospective Case Series.","authors":"Amy Miller, Madison Grizzle, Halee Van Poppel, Gustavo R Alvira-Arill, Richard Lueking, Stephen A Thacker, Krutika Mediwala Hornback, Taylor Morrisette","doi":"10.3390/antibiotics14090864","DOIUrl":"10.3390/antibiotics14090864","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Ceftaroline (CPT) is a broad-spectrum, fifth-generation cephalosporin with in vitro activity against methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) and drug-resistant <i>Streptococcus pneumoniae</i>. Real-world data on its use in pediatric patients remain limited. This study aimed to the describe clinical characteristics and outcomes associated with CPT use in pediatric patients at a pediatric academic medical center. <b>Methods</b>: This retrospective case series evaluated patients under 18 years of age who received CPT between November 2016 and August 2023. The primary outcome was clinical success, defined as a composite of 30-day survival, absence of microbiological recurrence within 30 days, and/or resolution of acute infection signs and symptoms without therapy modification due to clinical failure. The secondary outcomes included adverse effects potentially attributable to CPT and the clinical rationale guiding its use. <b>Results</b>: Among 25 patients, most were male (68%) with a median (IQR) age of 3.4 (1.4-14.3) years. The indications for use commonly included respiratory infections (48%), bacteremia (16%), and/or skin and soft tissue (12%) infections. The frequently used dosing regimens included 12 mg/kg (36%) and 8 mg/kg (28%) q8hr, with a median (IQR) duration of therapy of 4.6 (1.7-10.0) days. Clinical success was achieved in 96% of patients. No adverse effects attributable to CPT were observed and CPT was commonly used for escalation (40%) and/or issues with alternative therapies (36%). <b>Conclusions</b>: CPT use was associated with high clinical success rates and no observed adverse effects in this pediatric report. These findings support its use as a therapeutic option when the alternatives are limited. Larger multicenter studies are needed to further evaluate the clinical outcomes and safety of CPT use in pediatric patients.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 9","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unexplained High Prevalence of ESBL-<i>Escherichia coli</i> Among Cattle and Pigs in Peru.","authors":"Marília Salgado-Caxito, Daphne Léon, Olga Bardales, Luis M Jara, Patricia Medrano, Clara Murga, Veronica Pérez, Brenda Aylas-Jurado, Roberto Su-Tello, Juana Najarro, Elías Salvador-Tasayco, Jonas Farrugia-Audri, Carlos Shiva, Julio A Benavides","doi":"10.3390/antibiotics14090867","DOIUrl":"10.3390/antibiotics14090867","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Extended-Spectrum Beta-Lactamase-producing <i>Escherichia coli</i> (ESBL-<i>E. coli</i>) are widely circulating in livestock of low- and middle-income countries. However, the drivers of their circulation remain largely unknown. Small-scale farms in Peru exhibit an unusually high prevalence of fecal carriage of ESBL-<i>E. coli</i> in their livestock. The objective of this study was to compare the prevalence of ESBL-<i>E. coli</i> fecal carriage in dairy cows, pigs, and poultry in the Lima and Ica regions of Peru and to identify the drivers associated with the observed prevalence at the farm level. <b>Methods</b>: We compared the prevalence of fecal carriage of ESBL-<i>E. coli</i> isolated from dairy cattle (N = 244 animals; 25 farms), pigs (N = 261; 25), and laying hens (N = 255; 10). We also administrated questionnaires to 59 farmers regarding their socioeconomic status, husbandry practices, animal diseases, and antibiotic use. <b>Results</b>: All but one of the 60 farms sampled had at least one animal carrying ESBL-<i>E. coli</i>. A statistically higher prevalence of ESBL-<i>E. coli</i> was estimated in dairy cows (75%) and pigs (61%) from Lima compared to laying hens from Ica (34%). Our statistical analyses (Poisson generalized linear models) using two variable selection approaches revealed that the prevalence of ESBL-<i>E. coli</i> was lower in farms raising laying hens, when farmers oversaw both animal husbandry and healthcare, and in farms with a lower number of gastrointestinal outbreaks in the last semester. Socio-economic features of farmers and self-reporting antibiotic use varied across farms (i.e., highest antibiotic use over the last semester was reported among pig farmers (96%), followed by laying hen (70%) and dairy cattle farmers (50%)), but these factors were not associated with the prevalence of ESBL-<i>E. coli</i>. <b>Conclusions</b>: Despite a relatively low number of farms sampled, our findings suggest that the widespread circulation of ESBL-<i>E. coli</i> among livestock in Peru could be mainly associated with unknown species-specific drivers, independently of the socioeconomic status of farmers and antibiotic use. Therefore, our study calls for future research to identify the specific drivers promoting the high prevalence of ESBL-<i>E. coli</i> among cattle and pigs in Peru.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 9","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leveraging Implementation Science for Effective Antimicrobial Resistance Education and Awareness in the WHO AFRO Region.","authors":"Walter Fuller, Otridah Kapona, Yahaya Ali Ahmed","doi":"10.3390/antibiotics14090861","DOIUrl":"10.3390/antibiotics14090861","url":null,"abstract":"<p><p>Inappropriate antimicrobial use (misuse, overuse, underuse, and abuse), often due to a lack of knowledge, is a major factor driving antimicrobial resistance (AMR). Effective education and awareness programs are crucial for addressing this issue. This paper examines how implementation science can improve AMR education and awareness in the World Health Organization (WHO) African Region. This paper discusses the relevance of implementation science frameworks and practical strategies for adapting AMR initiatives to local contexts. By reviewing the literature and case studies, this paper underscores the need for tailored approaches that reflect the region's unique socio-cultural and healthcare settings. Integrating implementation science into AMR education can promote sustainable behavior change with regard to antimicrobial use, improve healthcare practices, and help combat AMR.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 9","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparative Study of Ceftazidime-Avibactam and Meropenem-Based Regimens in the Treatment of Carbapenem-Resistant Gram-Negative Bacterial Infections in Intensive Care Units.","authors":"Murat Aydın, Nurten Nur Aydın, Mehtap Hülya Aslan, Mithat Kahramanoğlu","doi":"10.3390/antibiotics14090863","DOIUrl":"10.3390/antibiotics14090863","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to compare mortality rates and treatment efficacy between ceftazidime-avibactam (CAZ/AVI) and meropenem-based combination regimens in critically ill patients with carbapenem-resistant Gram-negative bacteria (CRGNB) infections.</p><p><strong>Methods: </strong>This retrospective study included 135 intensive care unit (ICU) patients diagnosed with CRGNB infections between 2020 and 2024. Patients were categorized on the basis of treatment: CAZ/AVI or alternative combinations that included meropenem with either amikacin or polymyxin. The primary outcomes were 14-day, 30-day, and 90-day all-cause mortality rates. The secondary outcomes included the clinical response on day 14 and the total duration of ICU hospitalization.</p><p><strong>Results: </strong>Among the patients, 74 received CAZ/AVI, whereas 61 were treated with meropenem-based regimens. No significant differences were observed in the baseline characteristics between the groups. There were no statistically significant differences in 14-day (27.0% vs. 31.1%), 30-day (41.9% vs. 47.5%), or 90-day mortality rates (62.2% vs. 65.6%) between the two groups (<i>p</i> = 0.738, 0.511, and 0.818, respectively), including within the pneumonia and bloodstream infection subgroups. Clinical success was observed in 64.9% of the CAZ/AVI group and 65.6% of the other group (<i>p</i> = 0.931), with comparable ICU lengths of stay (44.0 ± 29.1 vs. 41.5 ± 26.4 days, <i>p</i> = 0.974). Multivariate analysis revealed that advanced age, higher Sequential Organ Failure Assessment (SOFA) scores, elevated procalcitonin levels, and prolonged time from culture collection to the initiation of appropriate antibiotic therapy were independent predictors of increased 30-day mortality.</p><p><strong>Conclusions: </strong>CAZ/AVI demonstrated efficacy and mortality outcomes comparable to those of meropenem-based regimens in ICU patients with CRGNB infections. Prompt initiation of appropriate antimicrobial therapy remains critical.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 9","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Dusting Off the Cobwebs\": Rethinking How We Use New Antibiotics.","authors":"Jacob Myles Keck, Jacob Schultz, Alina Viteri","doi":"10.3390/antibiotics14090862","DOIUrl":"10.3390/antibiotics14090862","url":null,"abstract":"<p><p>Antimicrobial resistance continues to escalate worldwide, threatening effective medical care, patient safety, and global health security. Traditional antibiotics are increasingly unreliable against multidrug-resistant pathogens, resulting in delayed appropriate therapy, prolonged illness, higher healthcare costs, and increased mortality. In this context, antimicrobial stewardship must evolve beyond the preservation of older drugs to include the judicious, evidence-based use of newer antibiotics. When used empirically in high-risk scenarios, novel agents can improve clinical outcomes by ensuring timely, effective coverage against MDR organisms while reducing the need for broad-spectrum combinations that drive collateral resistance and adverse effects. A major challenge, however, is the underutilization of these agents, which not only limits patient benefit but also undermines incentives for continued pharmaceutical innovation. To address this gap, stewardship programs must incorporate strategies for appropriate empiric deployment of new antibiotics, guided by local epidemiology, risk stratification, rapid diagnostics, and multidisciplinary decision-making. A coordinated global effort, linking stewardship, innovation, and policy reform, will be critical to optimize the role of novel antimicrobials in clinical practice moving forward.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 9","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Genomics of DH5α-Inhibiting <i>Escherichia coli</i> Isolates from Feces of Healthy Individuals Reveals Common Co-Occurrence of Bacteriocin Genes with Virulence Factors and Antibiotic Resistance Genes.","authors":"Shuan Er, Yichen Ding, Linda Wei Lin Tan, Yik Ying Teo, Niranjan Nagarajan, Henning Seedorf","doi":"10.3390/antibiotics14090860","DOIUrl":"10.3390/antibiotics14090860","url":null,"abstract":"<p><p><b>Background/Objectives</b>: The presence of multi-drug-resistant (MDR) bacteria in healthy individuals poses a significant public health concern, as these strains may contribute to or even facilitate the dissemination of antibiotic resistance genes (ARGs) and virulence factors. In this study, we investigated the genomic features of antimicrobial-producing <i>Escherichia coli</i> strains from the gut microbiota of healthy individuals in Singapore. <b>Methods</b>: Using a large-scale screening approach, we analyzed 3107 <i>E. coli</i> isolates from 109 fecal samples for inhibitory activity against <i>E. coli</i> DH5α and performed whole-genome sequencing on 37 representative isolates. <b>Results</b>: Our findings reveal genetically diverse strains, with isolates belonging to five phylogroups (A, B1, B2, D, and F) and 23 unique sequence types (STs). Bacteriocin gene clusters were widespread (92% of isolates carried one or more bacteriocin gene clusters), with colicins and microcins dominating the profiles. Notably, we identified an <i>hcp-et3-4</i> gene cluster encoding an effector linked to a Type VI secretion system. Approximately 40% of the sequenced isolates were MDR, with resistance for up to eight antibiotic classes in one strain (strain D96). Plasmids were the primary vehicles for ARG dissemination, but chromosomal resistance determinants were also detected. Additionally, over 55% of isolates were classified as potential extraintestinal pathogenic <i>E. coli</i> (ExPEC), raising concerns about their potential pathogenicity outside the intestinal tract. <b>Conclusions</b>: Our study highlights the co-occurrence of bacteriocin genes, ARGs, and virulence genes in gut-residing <i>E. coli</i>, underscoring their potential role in shaping microbial dynamics and antibiotic resistance. While bacteriocin-producing strains show potential as probiotic alternatives, careful assessment of their safety and genetic stability is necessary for therapeutic applications.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 9","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temocillin: A Narrative Review of Its Clinical Reappraisal.","authors":"Lavinia Cosimi, Verena Zerbato, Nina Grasselli Kmet, Alessandra Oliva, Francesco Cogliati Dezza, Nicholas Geremia, Dario Cattaneo, Kristina Nadrah, Mateja Pirs, Rajko Saletinger, Alessio Nunnari, Filippo Mearelli, Filippo Giorgio Di Girolamo, Graziana Avena, Roberta Russo, Carolina Fabiani, Sergio Venturini, Luigi Principe, Giovanna Maria Nicolò, Stefano Di Bella","doi":"10.3390/antibiotics14090859","DOIUrl":"10.3390/antibiotics14090859","url":null,"abstract":"<p><p><b>Background:</b> The emergence of multidrug-resistant Gram-negative bacteria, particularly extended-spectrum β-lactamase (ESBL) and AmpC-producing <i>Enterobacterales</i>, has brought renewed interest in temocillin, a narrow-spectrum β-lactam antibiotic first introduced in the 1980s. <b>Objectives:</b> We aimed to provide a comprehensive overview of the microbiological, pharmacological, and clinical profile of temocillin. <b>Methods:</b> We conducted a narrative review of the literature using the PubMed database to identify relevant studies concerning the microbiology, pharmacokinetics, pharmacodynamics, clinical applications, and safety of temocillin. <b>Results</b>: Temocillin shows strong in vitro activity against ESBL- and AmpC-producing organisms, and partial efficacy against certain <i>Klebsiella pneumoniae</i> carbapenemase (KPC)-producing strains. Its pharmacokinetic and pharmacodynamic characteristics, including β-lactamase stability and low ecological impact, support its use in urinary tract infections, bloodstream infections, intra-abdominal infections, pneumonia, and central nervous system infections. Additionally, evidence supports its utility in outpatient parenteral antimicrobial therapy (OPAT), including subcutaneous administration, and in vulnerable populations such as pediatric, elderly, and immunocompromised patients. Temocillin demonstrates a favorable safety profile, minimal disruption of gut microbiota, and cost-effectiveness. It also exhibits synergistic activity with agents like fosfomycin, further enhancing its clinical value. Most of the current evidence is derived from retrospective and observational studies. <b>Conclusions:</b> Temocillin emerges as a promising carbapenem-sparing option for the treatment of challenging infections caused by multidrug-resistant Gram-negative bacteria.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 9","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genomic Epidemiology of Vancomycin-Resistant <i>Enterococcus faecium</i> Isolates with Full and Truncated <i>vanA</i> Operons from Russian Hospitals.","authors":"Anna Slavokhotova, Andrey Shelenkov, Yulia Mikhaylova, Lyudmila Petrova, Vitaly Gusarov, Mikhail Zamyatin, Vasiliy Akimkin","doi":"10.3390/antibiotics14090858","DOIUrl":"10.3390/antibiotics14090858","url":null,"abstract":"<p><p><b>Background</b>: Vancomycin-resistant <i>Enterococcus faecium</i> (VREfm), particularly <i>vanA</i>-positive strains, represents a growing threat in hospital settings worldwide. These bacteria are able to survive under severe environmental conditions, including high temperatures and saline concentrations. High genome plasticity and advanced ability of inheriting antimicrobial resistance determinants defined the success of <i>E. faecium</i> as a hospital pathogen. <b>Methods</b>: This study presents the whole genomic characterization of <i>vanA</i>-positive VREfm isolates, analyzing 10 clinical isolates collected from three tertiary care hospitals in Moscow, Russia. Several typing approaches, including two MLST schemes and cgMLST profiles, were used to elucidate the relationship between the isolates. Phylogenetic analysis placed the isolates in context with global VREfm populations, demonstrating both local clonal expansion and possible international connections. Phenotypic and genomic antimicrobial resistance profiles were obtained, as well as data regarding the repertoire of virulence factors and plasmid content. <b>Results</b>: Whole genome sequencing revealed that all isolates belonged to the clinically significant CC17 lineage, specifically sequence types ST80 and ST552. Notably, two isolates possessed truncated Tn1546-type transposons lacking <i>vanY</i> and <i>vanZ</i> genes, representing a potentially emerging variant of the <i>vanA</i> operon in Russian clinical settings. A plasmid carrying a truncated <i>vanA</i> operon was reconstructed using long-read sequencing. <b>Conclusions</b>: The study highlights the utility of genomic investigation for tracking resistance mechanisms and strain dissemination, providing crucial baseline data for epidemiological surveillance of infections caused by VREfm in Russia. These findings emphasize the need for continued genomic monitoring to understand the evolution and spread of antimicrobial resistance in clinically important enterococcal lineages.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 9","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12466474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}