Antibiotics-Basel最新文献

{"title":"Multiplex Real-Time Polymerase Chain Reaction and Recombinase Polymerase Amplification: Methods for Quick and Cost-Effective Detection of Vancomycin-Resistant Enterococci (VRE).","authors":"Ibukun Elizabeth Osadare, Abdinasir Abdilahi, Martin Reinicke, Celia Diezel, Maximilian Collatz, Annett Reissig, Stefan Monecke, Ralf Ehricht","doi":"10.3390/antibiotics14030295","DOIUrl":"10.3390/antibiotics14030295","url":null,"abstract":"<p><p><b>Background</b>/<b>Objectives</b>: Vancomycin-resistant enterococci (VRE) are one of the leading causes of antibiotic-resistant infections in the hospital setting worldwide, and this has become a major issue, because most patients infected with this strain are difficult to treat. Multiplex real-time polymerase chain reaction (RT PCR) is an advantageous technique that can amplify multiple targets in a single reaction, and can be used to quickly detect specific targets in VRE within two hours, starting from suspected colonies of bacterial cultures, without sample preparation. <b>Methods</b>: In this study, we selected the glycopeptide/vancomycin resistance genes that are most common in clinical settings, <i>vanA</i> and <i>vanB</i>, in combination with the species markers <i>ddl_faecium</i> and <i>ddl_faecalis</i> for the most common VRE species-<i>Enterococcus faecium</i> and <i>Enterococcus faecalis</i>. <b>Results</b>: DNA from forty clinical VRE strains was prepared using a fast and economic heat lysis method, and a multiplex real-time PCR assay was optimized and carried out subsequently. The results were in concordance with the results from recombinase polymerase amplification (RPA) of the same VRE samples. <b>Conclusions</b>: Multiplex RT PCR and RPA for VRE detection proffers a second method for the confirmation of vancomycin resistance, and it can be developed as a fast screening assay for patients before admission into high-risk settings.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 3","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11939700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733081","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":"Whole-Genome Sequencing Analysis Revealed High Genomic Variability, Recombination Events and Mobile Genetic Elements in <i>Streptococcus uberis</i> Strains Isolated from Bovine Mastitis in Colombian Dairy Herds.","authors":"Paola A Rios Agudelo, Julián Reyes Vélez, Martha Olivera Angel, Adam M Blanchard, Yesid Cuesta Astroz, Arley Caraballo Guzmán, Giovanny Torres Lindarte","doi":"10.3390/antibiotics14030297","DOIUrl":"10.3390/antibiotics14030297","url":null,"abstract":"<p><p><b>Introduction:</b><i>Streptococcus uberis</i> is a poorly controlled cause of bovine intramammary infections and a common motivation for the use antibiotics in dairy farms worldwide. Therefore, studying the genomic characteristics of this pathogen is fundamental to understand its complex epidemiology and behavior against antimicrobials. <b>Methods:</b> A comparative genomic analysis of 10 <i>S. uberis</i> strains was performed and their antimicrobial susceptibility was assessed. <b>Results:</b> Ten different novel sequence types were found, and genes (<i>tetM, tetO</i>, <i>patB</i>, <i>lnuC</i>, <i>lnuA</i>, <i>lsaE</i>, <i>ermB</i>, <i>ANT</i>(6)-la) and mobile genetic elements previously associated with antimicrobial resistance (repUS43, IS<i>Sag</i>2, and IS<i>Enfa</i>4) and virulence (315.2 phage) were detected. Additionally, our strains had the highest relative rate of recombination to mutation (8.3) compared to other <i>S. uberis</i> strains isolated from different continents (America: 7.7, Asia: 2.9, Europe: 5.4, and Oceania: 6.6). Most of the strains (80%) tested showed phenotypic resistance to clindamycin and 70% exhibited intermediate susceptibility to penicillin. <b>Conclusions:</b> The high heterogeneity of strains observed and the presence of genetic factors linked to antimicrobial resistance represent a challenge for the implementation and surveillance of measures focused on the control and elimination of this pathogen.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 3","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11939407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733004","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":"Metagenomics as a Transformative Tool for Antibiotic Resistance Surveillance: Highlighting the Impact of Mobile Genetic Elements with a Focus on the Complex Role of Phages.","authors":"Nikoline S Olsen, Leise Riber","doi":"10.3390/antibiotics14030296","DOIUrl":"10.3390/antibiotics14030296","url":null,"abstract":"<p><p>Extensive use of antibiotics in human healthcare as well as in agricultural and environmental settings has led to the emergence and spread of antibiotic-resistant bacteria, rendering many infections increasingly difficult to treat. Coupled with the limited development of new antibiotics, the rise of antimicrobial resistance (AMR) has caused a major health crisis worldwide, which calls for immediate action. Strengthening AMR surveillance systems is, therefore, crucial to global and national efforts in combating this escalating threat. This review explores the potential of metagenomics, a sequenced-based approach to analyze entire microbial communities without the need for cultivation, as a transformative and rapid tool for improving AMR surveillance strategies as compared to traditional cultivation-based methods. We emphasize the importance of monitoring mobile genetic elements (MGEs), such as integrons, transposons, plasmids, and bacteriophages (phages), in relation to their critical role in facilitating the dissemination of genetic resistance determinants via horizontal gene transfer (HGT) across diverse environments and clinical settings. In this context, the strengths and limitations of current bioinformatic tools designed to detect AMR-associated MGEs in metagenomic datasets, including the emerging potential of predictive machine learning models, are evaluated. Moreover, the controversial role of phages in AMR transmission is discussed alongside the potential of phage therapy as a promising alternative to conventional antibiotic treatment.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 3","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11939754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733043","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":"<i>Aeromonas</i> Species Diversity, Virulence Characteristics, and Antimicrobial Susceptibility Patterns in Village Freshwater Aquaculture Ponds in North India.","authors":"Alka Nokhwal, Rajesh Kumar Vaid, Taruna Anand, Ravikant Verma, Rachna Gulati","doi":"10.3390/antibiotics14030294","DOIUrl":"10.3390/antibiotics14030294","url":null,"abstract":"<p><strong>Background/objectives: </strong>Motile aeromonads are ubiquitous aquatic Gram-negative opportunistic pathogens with environmental, animal, aquatic, and human health implications.</p><p><strong>Methods: </strong>Motile aeromonads were isolated from village pond water samples (<i>n</i> = 100) of the Hisar district of Haryana state in India. Selective isolation and enumeration were followed by biochemical and genotypic identification using <i>gyr</i>B gene; evaluation of seven putative virulence factors and antimicrobial resistance studies and determination of extended spectrum beta lactamase (ESBL) and AmpC beta lactamase (ACBL) enzyme-producing abilities took place.</p><p><strong>Results: </strong>The viable counts of motile aeromonads varied from 1.6 × 10² CFU/mL to 1.2 × 10⁸ CFU/mL. Six species of <i>Aeromonas</i> were identified with high prevalence of <i>A. veronii</i> (74.7%), followed by <i>A. caviae</i> (8.9%), <i>A. hydrophila</i> (7.6), <i>A. jandaei</i> (5%), <i>A. sobria</i> (2.5%), and <i>A. dhakensis</i> (1.3%). PCR amplification of seven genes related to virulence indicated that the majority of the isolates were positive for enolase (<i>eno</i>, 98%), cytotoxic enterotoxin (<i>act</i>, 88%), and hemolysin (<i>asa</i>1, 86%). Many isolates were also positive for type III secretion system inner membrane component (<i>asc</i>V, 53%), ADP-ribosylating toxin (<i>aex</i>T, 47%), and extracellular hemolysin (<i>ahh</i>1, 4%). The antimicrobial resistance (AMR) profile of the isolated <i>Aeromonas</i> isolates indicated the high resistance observed to nalidixic acid (40.2%), cefoxitin (33%), and imipenem (6.2%). In addition, the occurrence of 10.3% ESBL, 32% ACBL, and 29.9% multi-drug resistant (MDR) isolates is alarming. Phylogenetic analysis of <i>gyr</i>B sequences of <i>A. veronii</i> isolates (<i>n</i> = 59) together with GenBank sequences of <i>A. veronii</i> from different geographical regions of the world indicated high genotypic diversity.</p><p><strong>Conclusions: </strong>the village aquaculture ponds in Hisar district have a high occurrence of MDR <i>A. veronii</i>, <i>A. hydrophila</i>, and <i>A. caviae</i>, posing significant animal and public health concern.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 3","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11939274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732926","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":"<i>Thymus syriacus</i> Essential Oil Extract: Potential Antileishmanial Activity Induced by an Apoptotic-like Death.","authors":"Basem Battah, Teresa Chianese, Luigi Rosati, Giacomo Petretto, Chadi Soukkarieh, Marco Ferrari, Vittorio Mazzarello, Aleksandra Barac, Aleksandar Peric, Matthew Gavino Donadu","doi":"10.3390/antibiotics14030293","DOIUrl":"10.3390/antibiotics14030293","url":null,"abstract":"<p><p><b>Background:</b> Chemotherapy continues to be the cornerstone for the management of leishmaniasis. The preferred medications are pricey and have a number of unfavorable side effects. These restrictions make it necessary to produce novel antileishmanial chemicals, and plants have opportunities in this respect. <b>Objectives:</b> This study aimed to evaluate the antileishmanial properties of <i>Thymus syriacus</i> essential oil and its mechanisms of action. <b>Results:</b> Our findings demonstrated that <i>Thymus syriacus</i> essential oil, rich in thymol, exhibited potent antileishmanial activity, with an IC50 value of approximately 1 µg/mL against <i>L. tropica</i> promastigotes. Furthermore, the cell cycle arrest at the sub-G0-G1 phase supported the theory that the leishmanicidal effect was mediated by apoptosis. <b>Methods:</b> The essential oil was characterized using gas chromatography-tandem mass spectrometry. Antileishmanial activity against <i>L. tropica</i> promastigotes was assessed, with mechanisms confirmed via flow cytometry. <b>Conclusions:</b> These results confirm the potential of <i>Thymus syriacus</i> essential oil as a promising therapeutic candidate for the treatment of leishmaniasis.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 3","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11939511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733010","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":"Correction: Osta-Ustarroz et al. Microbial Colonization, Biofilm Formation, and Malodour of Washing Machine Surfaces and Fabrics and the Evolution of Detergents in Response to Consumer Demands and Environmental Concerns. <i>Antibiotics</i> 2024, <i>13</i>, 1227.","authors":"Patricia Osta-Ustarroz, Allister J Theobald, Kathryn A Whitehead","doi":"10.3390/antibiotics14030292","DOIUrl":"10.3390/antibiotics14030292","url":null,"abstract":"<p><p>In the original publication [...].</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 3","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11939160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733042","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":"Silver Nanoparticles: A Versatile Tool Against Infectious and Non-Infectious Diseases.","authors":"Sara González-Fernández, Noelia Blanco-Agudín, David Rodríguez, Iván Fernández-Vega, Jesús Merayo-Lloves, Luis M Quirós","doi":"10.3390/antibiotics14030289","DOIUrl":"10.3390/antibiotics14030289","url":null,"abstract":"<p><p>Silver nanoparticles possess remarkable properties that render them highly beneficial for medical applications in both infectious and non-infectious diseases. Among their most renowned attributes is their antimicrobial activity. They have demonstrated efficacy against a wide range of bacteria, fungi, protozoa, and viruses. Additionally, the antitumor and anti-diabetic properties of silver nanoparticles, along with their ability to promote wound healing and their application as biosensors, underscore their therapeutic potential for various non-infectious conditions. As silver nanoparticles are employed for medical purposes, their potential toxicity must be considered. While silver nanoparticles present a promising alternative in the therapeutic domain, further research is needed to elucidate their precise mechanisms of action, optimize their efficacy, and mitigate any potential health risks associated with their use.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 3","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11939477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733189","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":"The Trade-Off Between Sanitizer Resistance and Virulence Genes: Genomic Insights into <i>E. coli</i> Adaptation.","authors":"Vinicius Silva Castro, Yuri Duarte Porto, Xianqin Yang, Carlos Adam Conte Junior, Eduardo Eustáquio de Souza Figueiredo, Kim Stanford","doi":"10.3390/antibiotics14030291","DOIUrl":"10.3390/antibiotics14030291","url":null,"abstract":"<p><strong>Background: </strong><i>Escherichia coli</i> is one of the most studied bacteria worldwide due to its genetic plasticity. Recently, in addition to characterizing its pathogenic potential, research has focused on understanding its resistance profile to inhibitory agents, whether these be antibiotics or sanitizers.</p><p><strong>Objectives: </strong>The present study aimed to investigate six of the main serogroups of foodborne infection (O26, O45, O103, O111, O121, and O157) and to understand the dynamics of heterogeneity in resistance to sanitizers derived from quaternary ammonium compounds (QACs) and peracetic acid (PAA) using whole-genome sequencing (WGS).</p><p><strong>Methods: </strong>Twenty-four <i>E. coli</i> strains with varied resistance profiles to QACs and PAA were analyzed by WGS using NovaSeq6000 (150 bp Paired End reads). Bioinformatic analyses included genome assembly (Shovill), annotation via Prokka, antimicrobial resistance gene identification using Abricate, and core-genome analysis using Roary. A multifactorial multiple correspondence analysis (MCA) was conducted to explore gene-sanitizer relationships. In addition, a large-scale analysis utilizing the NCBI Pathogen Detection database involved a 2 × 2 chi-square test to examine associations between the presence of <i>qac</i> and <i>stx</i> genes.</p><p><strong>Results: </strong>The isolates exhibited varying antimicrobial resistance profiles, with O45 and O157 being the most resistant serogroups. In addition, the <i>qac</i> gene was identified in only one strain (S22), while four other strains carried the <i>stx</i> gene. Through multifactorial multiple correspondence analysis, the results obtained indicated that strains harboring genes encoding Shiga toxin (<i>stx</i>) presented profiles that were more likely to be sensitive to QACs. To further confirm these results, we analyzed 393,216 <i>E. coli</i> genomes from the NCBI Pathogen Detection database. Our results revealed a significant association (<i>p</i> < 0.001) between the presence of <i>qac</i> genes and the absence of <i>stx1</i>, <i>stx2</i>, or both toxin genes.</p><p><strong>Conclusion: </strong>Our findings highlight the complexity of bacterial resistance mechanisms and suggest that non-pathogenic strains may exhibit greater tolerance to QAC sanitizer than those carrying pathogenicity genes, particularly Shiga toxin genes.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 3","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11939141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732981","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":"Antibiotic Resistance and Mortality in ICU Patients: A Retrospective Analysis of First Culture Growth Results.","authors":"Metin Kilinc","doi":"10.3390/antibiotics14030290","DOIUrl":"10.3390/antibiotics14030290","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;This study aimed to analyze the antibiotic resistance patterns of microorganisms isolated from intensive care unit (ICU) patients and evaluate their impact on mortality and length of ICU stay. Given the increasing prevalence of multidrug-resistant (MDR) pathogens in critically ill patients, understanding their resistance profiles is crucial for optimizing empirical antibiotic therapy and improving patient outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective study included 237 ICU patients admitted between 1 July 2022, and 1 January 2024. The initial culture growth results from blood and urine samples were analyzed. Microorganism identification was performed using VITEK 2 Compact and conventional bacteriological methods, while antibiotic susceptibility testing followed CLSI 2022 and EUCAST 2022 guidelines.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 237 ICU patients were included in this study. The most frequently isolated microorganisms were &lt;i&gt;Escherichia coli&lt;/i&gt; (&lt;i&gt;E. coli&lt;/i&gt;) (44.3%), &lt;i&gt;Klebsiella pneumoniae&lt;/i&gt; (&lt;i&gt;K. pneumoniae&lt;/i&gt;) (35.0%), and &lt;i&gt;Pseudomonas aeruginosa&lt;/i&gt; (&lt;i&gt;P. aeruginosa&lt;/i&gt;) (25.3%), &lt;i&gt;with Acinetobacter baumannii&lt;/i&gt; (&lt;i&gt;A. baumannii&lt;/i&gt;) (31.2%) being the most resistant pathogen. Among Gram-positive bacteria, &lt;i&gt;methicillin-resistant Staphylococcus aureus&lt;/i&gt; (&lt;i&gt;MRSA&lt;/i&gt;) (12.2%) and vancomycin-resistant enterococci (&lt;i&gt;VRE&lt;/i&gt;) (21.5%) were the most frequently identified multidrug-resistant (MDR) pathogens. Regarding antimicrobial resistance, carbapenem resistance was highest in &lt;i&gt;A. baumannii&lt;/i&gt; (55%), followed by &lt;i&gt;P. aeruginosa&lt;/i&gt; (40%) and &lt;i&gt;K. pneumoniae&lt;/i&gt; (30%). Additionally, ESBL-producing &lt;i&gt;E. coli&lt;/i&gt; (43.2%) and &lt;i&gt;K. pneumoniae&lt;/i&gt; (38.5%), as well as carbapenemase-producing &lt;i&gt;K. pneumoniae&lt;/i&gt; (18.6%) and &lt;i&gt;E. coli&lt;/i&gt; (9.2%), were identified as key resistance mechanisms impacting clinical outcomes. Patients with MDR infections had significantly longer ICU stays (&lt;i&gt;p&lt;/i&gt; &lt; 0.05) and higher mortality rates. The Kaplan-Meier survival analysis revealed that &lt;i&gt;A. baumannii&lt;/i&gt; infections were associated with the highest mortality risk (HR: 4.6, &lt;i&gt;p&lt;/i&gt; &lt; 0.001), followed by &lt;i&gt;MRSA&lt;/i&gt; (HR: 3.5, &lt;i&gt;p&lt;/i&gt; = 0.005) and &lt;i&gt;P. aeruginosa&lt;/i&gt; (HR: 2.8, &lt;i&gt;p&lt;/i&gt; = 0.01). Among laboratory biomarkers, elevated procalcitonin (≥2 ng/mL, OR: 2.8, &lt;i&gt;p&lt;/i&gt; = 0.008) and CRP (≥100 mg/L, OR: 2.2, &lt;i&gt;p&lt;/i&gt; = 0.01) were significantly associated with ICU mortality. Additionally, patients who remained in the ICU for more than seven days had a 1.4-fold increased risk of mortality (&lt;i&gt;p&lt;/i&gt; = 0.02), further emphasizing the impact of prolonged hospitalization on adverse outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;MDR pathogens, particularly &lt;i&gt;A. baumannii&lt;/i&gt;, &lt;i&gt;MRSA&lt;/i&gt;, &lt;i&gt;P. aeruginosa&lt;/i&gt;, and &lt;i&gt;K. pneumoniae&lt;/i&gt;, are associated with longer ICU stays and higher mortality rates. Carbapenem, cephalosporin, fluoroquinolone, and aminoglycoside resistance significantly","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 3","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11939337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733031","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":"Role of Rifaximin in the Prognosis of Critically Ill Patients with Liver Cirrhosis.","authors":"Zhaohui Bai, Congcong Li, Yongjie Lai, Xiaojuan Hu, Luwen Shi, Xiaodong Guan, Yang Xu","doi":"10.3390/antibiotics14030287","DOIUrl":"10.3390/antibiotics14030287","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Critically ill patients with liver cirrhosis impose a substantial health burden on the world. Rifaximin is a potential treatment option for such patients. <b>Methods</b>: We extracted critically ill patients with liver cirrhosis from the Medical Information Mart for Intensive Care (MIMIC) IV database. Based on study outcomes, the current study included prevention and treatment cohorts. A 1:1 propensity score matching (PSM) analysis was performed to match the characteristics of patients. The risk of ICU admission and intensive care unit (ICU), in-hospital, 90-day, and 180-day death were explored. Cox regression analyses were conducted, and hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated. Kaplan-Meier curves were further drawn to demonstrate the cumulative 90-day and 180-day survival rate. <b>Results</b>: Overall, 5381 critically ill patients with liver cirrhosis were included. In the prevention cohort, rifaximin could decrease the risk of ICU admission (HR = 0.427, 95%CI: 0.338-0.539, <i>p</i> < 0.001). In the treatment cohort, rifaximin could decrease the risk of ICU (HR = 0.530, 95%CI: 0.311-0.902, <i>p</i> = 0.019) and in-hospital death (HR = 0.119, 95%CI: 0.033-0.429, <i>p</i> = 0.001) in critically ill patients with liver cirrhosis. However, rifaximin could not decrease the risk of 90-day (HR = 0.905, 95%CI: 0.658-1.245, <i>p</i> = 0.541) and 180-day (HR = 1.043, 95%CI: 0.804-1.353, <i>p</i> = 0.751) death in critically ill patients with liver cirrhosis. Kaplan-Meier curve analyses also showed that rifaximin could not significantly decrease the 90-day (<i>p</i> = 0.570) and 180-day (<i>p</i> = 0.800) cumulative mortality. <b>Conclusions</b>: This study suggests that rifaximin can significantly decrease the risk of ICU admission and improve short-term survival but does not impact long-term survival in critically ill patients with liver cirrhosis.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 3","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11939653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733185","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}