IJID regions最新文献

{"title":"Effectiveness and safety of tenofovir alafenamide/emtricitabine/bictegravir as a first-line regimen in people with HIV: A retrospective observational study","authors":"Andrea Giacomelli ,&nbsp;Maria Vittoria Cossu ,&nbsp;Davide Moschese ,&nbsp;Giorgia Carrozzo ,&nbsp;Serena Reato ,&nbsp;Federico Sabaini ,&nbsp;Giacomo Pozza ,&nbsp;Martina Laura Colombo ,&nbsp;Chiara Fusetti ,&nbsp;Anna Lisa Ridolfo ,&nbsp;Cristina Gervasoni ,&nbsp;Spinello Antinori ,&nbsp;Andrea Gori","doi":"10.1016/j.ijregi.2025.100622","DOIUrl":"10.1016/j.ijregi.2025.100622","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess the effectiveness and safety of tenofovir alafenamide/emtricitabine/bictegravir (TAF/FTC/BIC) in patients newly diagnosed with HIV (PWH) in a non-experimental setting.</div></div><div><h3>Methods</h3><div>We conducted a single-center, retrospective observational study that included all newly diagnosed PWH treated with TAF/FTC/BIC at our institution. Virological failure was defined as two consecutive HIV-RNA values of &gt;50 cp/ml after 48 weeks of treatment. Reasons for TAF/FTC/BIC interruption were also collected. The durability of TAF/FTC/BIC was estimated using Kaplan-Meier curves.</div></div><div><h3>Results</h3><div>A total of 236 PWH started TAF/FTC/BIC, with a median follow-up time of 13 months (interquartile range [IQR] 4-27 months). Most PWH were cisgender men (178/236, 75.4%) with a median age at diagnosis of 37 years (IQR 29-48) and a median cluster of differentiation 4 cell counts of 302 cells/mm³ (IQR 117-467). One protocol-defined virological failure was observed, without the development of drug resistance, resulting in an incidence of 3.1 per 1000 person-years of follow-up (95% confidence interval [CI] 0.8-17.3). Six (2.5%) PWH discontinued TAF/FTC/BIC because of toxicity. The estimated durabilities of TAF/FTC/BIC at 12 and 24 months were 84.8% (95% CI 78.6-89.3%) and 75.5% (95% CI 67.6-82.6%), respectively.</div></div><div><h3>Conclusions</h3><div>In our cohort of newly diagnosed PWH treated with TAF/FTC/BIC, the low occurrence of virological failure and discontinuation related to drug toxicities underscores the effectiveness and tolerability of the regimen.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"15 ","pages":"Article 100622"},"PeriodicalIF":1.5,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143644862","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":"Operationalizing SARS-CoV-2 wastewater monitoring to assess traveler health in Las Vegas, Nevada, USA","authors":"Casey A. Barber ,&nbsp;Ching-Lan Chang ,&nbsp;Michael A. Moshi ,&nbsp;Shahraiz Akbar ,&nbsp;Van Vo ,&nbsp;Edwin C. Oh ,&nbsp;Daniel Gerrity","doi":"10.1016/j.ijregi.2025.100619","DOIUrl":"10.1016/j.ijregi.2025.100619","url":null,"abstract":"<div><h3>Objectives</h3><div>This study explored expanded traveler- and tourism-focused wastewater monitoring in Las Vegas, Nevada, USA to complement community SARS-CoV-2 surveillance.</div></div><div><h3>Methods</h3><div>Wastewater samples were collected November 2023 to July 2024 from the largest community-scale wastewater treatment plant in Southern Nevada, USA (N = 112 samples) and two upstream utility access holes (i.e. manholes), isolating an international airport (N = 68 samples) and a commercial area with high-density bars and nightclubs (N = 30-33 samples). Polymerase chain reaction-based methods quantified RNA concentrations of SARS-CoV-2 and pepper mild mottle virus; whole genome sequencing characterized SARS-CoV-2 variants (N = 83 qualifying samples).</div></div><div><h3>Results</h3><div>SARS-CoV-2 concentrations exhibited concordance between liquids- and solids-based approaches. Similar trends were observed between methods and sampling locations; however, select manhole-level findings suggested potentially divergent COVID-19 infection profiles relative to residents. Whole genome sequencing also demonstrated similarities across sampling locations, although airport samples facilitated the identification of SARS-CoV-2 variants that either failed to spread locally (EG.6, JN.1.11) or preceded detection at the wastewater treatment plant (JN.1.7, KP.3).</div></div><div><h3>Conclusions</h3><div>These findings offer new insight into the operationalization of broader traveler- and tourism-focused wastewater monitoring, which may capture SARS-CoV-2 concentration spikes and genomic profiles in high-tourism/nightlife areas that community-scale sampling might otherwise miss.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"15 ","pages":"Article 100619"},"PeriodicalIF":1.5,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143644861","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 Global Fund's Bangladesh program","authors":"Md Ferdous Rahman ,&nbsp;Md Sharful Islam Khan ,&nbsp;M Mamun Huda ,&nbsp;Utpal K. Mondal ,&nbsp;Muhammad J.A. Shiddiky ,&nbsp;Allen G. Ross","doi":"10.1016/j.ijregi.2025.100618","DOIUrl":"10.1016/j.ijregi.2025.100618","url":null,"abstract":"<div><div>The Global Fund program, launched in 2002, focuses on combating HIV/AIDS, tuberculosis (TB), and malaria. To date, it has mobilized over US$ 65 billion across 120 countries, contributing to saving more than 65 million lives. In Bangladesh, the Global Fund has played a pivotal role in expanding treatment coverage, enhancing case detection, and strengthening prevention efforts. Despite notable progress, significant challenges persist, particularly among high-risk populations such as people who inject drugs, sex workers, and transgender individuals. These groups face stigma and limited access to healthcare, both of which hinder disease control. Additionally, drug resistance presents a growing threat to the control of malaria and TB. Looking ahead, continued support from the Global Fund will be critical, particularly in scaling up diagnostic infrastructure, promoting community-led interventions, and enhancing cross-border collaboration. These efforts are essential to ensuring sustained progress and achieving the long-term goal of eliminating HIV, TB, and malaria in Bangladesh. Effective coordination among government agencies, non-governmental organizations, and international donors will be essential to ensure the success of these initiatives.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"15 ","pages":"Article 100618"},"PeriodicalIF":1.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143644859","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":"Prevalence of intestinal parasites, Salmonella, Shigella and antimicrobial resistance of bacterial isolates among food handlers in Wachemo University Students’ food service facility, Southcentral Ethiopia: A cross-sectional study","authors":"Samuel Desalegn ,&nbsp;Galana Abaya ,&nbsp;Tarekegn G'Yesus ,&nbsp;Dawit Admasu ,&nbsp;Abdulhakim Mussema","doi":"10.1016/j.ijregi.2025.100617","DOIUrl":"10.1016/j.ijregi.2025.100617","url":null,"abstract":"<div><h3>Objectives</h3><div>Intestinal parasites, along with <em>Salmonella</em> and <em>Shigella</em>, are significant causes of acute diarrhea in resource-limited countries, posing challenges for health authorities. This study aimed to assess the prevalence and risk factors for these pathogens among food handlers at Wachemo University students’ food service facility.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted from June to November 2022, involving 390 food handlers selected through random sampling. Data were collected via a semi-structured questionnaire, and stool samples were analyzed for <em>Salmonella, Shigella</em>, and intestinal parasites using microscopic examination and selective culture media. <em>Salmonella and Shigella</em> species were subsequently identified using standard bacteriological protocols. Antimicrobial susceptibility was evaluated using the Kirby-Bauer disk diffusion method and data were analyzed by using SPSS version 20.</div></div><div><h3>Results</h3><div>Prevalence rates were 4.6% for <em>Salmonella</em> spp. and 2.1% for <em>Shigella</em> spp. Bacterial isolates showed high sensitivity to gentamicin (92.3%) and ciprofloxacin (88.5%), but 100% and 61.5% resistance to ampicillin and ceftriaxone, respectively. Additionally, 32.3% of samples tested positive for intestinal parasites, with <em>Entamoeba histolytica</em>/<em>dispar</em> being the most common (17.7%). Poor hygiene practices such as untrimmed nails and inadequate handwashing, were linked to these infections.</div></div><div><h3>Conclusions</h3><div>This study highlights the health risks posed by these pathogens among food handlers. It highlights the need for health education, regular check-ups, and rational antibiotic use at Wachemo University students’ food service facility.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"15 ","pages":"Article 100617"},"PeriodicalIF":1.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681220","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":"Human Papillomavirus in Jordan—A selective study of 650 cases","authors":"Abeer W. Annab ,&nbsp;Isam M. Lataifeh ,&nbsp;Yahia F. Dajani","doi":"10.1016/j.ijregi.2025.100620","DOIUrl":"10.1016/j.ijregi.2025.100620","url":null,"abstract":"<div><h3>Objectives</h3><div>To study the occurrence of Human Papillomavirus (HPV) in the community of Amman, Jordan through analyzing 650 samples randomly referred from community-based gynecology clinics during the years 2011-2023. Findings, including follow-up cases, were compared with those reported from within and outside this region.</div></div><div><h3>Methods</h3><div>This study used a liquid-based cytology technique. Samples from gynecology clinics underwent HPV genotyping by reverse transcription-polymerase chain reaction machine; next, a consultant pathologist reported on corresponding ThinPrep slides. Positive cases were stratified into high- or low-risk (HR-HPV or LR-HPV) genotypes, if the infection was single, multiple, or mixed HR-HPV with LR-HPV. Numbers, age distribution, and peak incidence of HPV in an Amman community were analyzed.</div></div><div><h3>Results</h3><div>A total of 644 women and six men (husbands) resident in Amman, all from gynecology clinics, showed HPV infection in 152 of 591 natives group I (25.7%), and 19 of 59 expatriates group II (23.2%). Group I showed 106 single, 38 double, seven triple, and one quadruple infection; 114 of 152 (75%) were HR-HPV; and 15 (9.9%) had mixed HR and LR-HPV. Group II showed 15 single, three double, and one triple infection; 15 of 59 (79%) in group II were HR-HPV, three (15.8%) mixed, and one LR-HPV. The most frequently found genotypes were 16 and 11 for HR-HPV and LR-HPV, respectively. Incidence of HPV occurred during ages 30-44 years in Jordanians and 25-49 years in expatriates. Abnormal cervical smear results with high- and low-grade neoplasia were seen in association with HR-HPV genotypes. HPV converted to negative in 22 of 61 (36%), average follow-up (FU) 2.8 years, and to positive in four (6.6%), 1.2-year average FU.</div></div><div><h3>Conclusions</h3><div>A selective study limited to Amman, Jordan indicates that cervical HPV, particularly HR-HPV infection, affects residents of Amman, Jordan, in whom cervical cancer ranks 10^th in women 15-44 years old. Any extrapolation on incidence rates awaits extension into other cities and rural zones of Jordan. Occurrence of HR-HPV genotypes and FU data justify promoting HPV vaccination programs to curb cervical cancer.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"15 ","pages":"Article 100620"},"PeriodicalIF":1.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681221","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":"Molecular epidemiology of circulating dengue serotypes in Dhaka, Bangladesh: 2023 outbreak","authors":"Sultana Shahana Banu ,&nbsp;Kamrun Nahar ,&nbsp;Nusrat Sultana ,&nbsp;Selim Reza Tony ,&nbsp;Shaheen Alam ,&nbsp;Afsana Rashed ,&nbsp;Yeasir Karim ,&nbsp;Sumaiya Binte Hannan ,&nbsp;Asish Kumar Ghosh ,&nbsp;Amirul Huda Bhuiyan ,&nbsp;Mst. Noorjahan Begum ,&nbsp;Mustafizur Rahman","doi":"10.1016/j.ijregi.2025.100597","DOIUrl":"10.1016/j.ijregi.2025.100597","url":null,"abstract":"<div><h3>Objectives</h3><div>Dengue fever is a significant global health concern, especially in tropical regions, including Bangladesh, which reported 316,773 cases and 1652 deaths in 2023. This study intends to explore the circulating serotypes of the dengue virus (DENV) and their clinical associations across Bangladesh.</div></div><div><h3>Methods</h3><div>The study enrolled 1317 febrile patients presenting with at least two symptoms (nausea or vomiting, rash, aches and pains, positive tourniquet test, and leukopenia) at Dhaka Medical College and Hospital (DMCH) between July and August 2023. They provided demographic data, clinical features, and blood samples. DENV was tested using a rapid detection test and real-time reverse transcription-polymerase chain reaction.</div></div><div><h3>Results</h3><div>Of 1317 patients, 300 (23%) tested positive by rapid detection test and 775 (59%) by real-time reverse transcription-polymerase chain reaction. The median age of participants was 20 years, with 61% of confirmed cases being male. The DENV-2 serotype was found in 88%, DENV-3 in 12%, and only one was found positive for DENV-4. Overall, 80 percent of dengue-positive cases showed warning signs (abdominal tenderness, persistent vomiting, rash, and bleeding). The severity of cases was significantly higher with DENV-2.</div></div><div><h3>Conclusions</h3><div>This study generates insights into the distribution of dengue serotypes and their association with disease severity. The DENV-2 was found as the dominant serotype in the 2023 outbreak.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"14 ","pages":"Article 100597"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519677","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":"Demographic characteristics and clinical and laboratory features of patients with Clostridiodes difficile infection: A retrospective study in Qatar","authors":"Vamanjore A. Naushad ,&nbsp;Nishan K. Purayil ,&nbsp;Irfan Varikkodan ,&nbsp;Ahmed M. Badi ,&nbsp;Mohamed A. Baghi ,&nbsp;Prem Chandra ,&nbsp;Khaled M.S. Alarbi ,&nbsp;Maryam K. Althani ,&nbsp;Ahmed T. Aboughalia ,&nbsp;Amer Farooqi ,&nbsp;Anand B. Kartha ,&nbsp;Abdelnaser Elzouki","doi":"10.1016/j.ijregi.2025.100592","DOIUrl":"10.1016/j.ijregi.2025.100592","url":null,"abstract":"<div><h3>Objectives</h3><div><em>Clostridioides difficile</em> infection (CDI) is one of the most common causes of diarrhea in healthcare facilities, imposing a significant burden on health-related budgets and resources worldwide. We aimed to study the demographic features, laboratory findings, and outcomes of CDI in Qatar.</div></div><div><h3>Methods</h3><div>A retrospective study involving adult patients with a confirmed diagnosis of CDI was conducted.</div></div><div><h3>Results</h3><div>Of the 595 patients, 308 (51.8%) were men with a mean age of 58 ± 19.9 years. The median duration of symptoms was 2 days, with an interquartile range values of 2-4 days. The most common symptoms reported were diarrhea (90.6%) and abdominal pain (41.5%). A total of 426 (71.6%) and 422 (70.9%) patients had a history of exposure to antibiotics and proton pump inhibitors, respectively, while 461 (77.7%) patients had a history of contact with a healthcare facility in the prior 3 months. Respiratory tract infections (33.9%) and urinary tract infections (22.4%) were the most common indications for antibiotic use in the study population. Increased C-reactive protein levels were the most frequently observed laboratory findings. Sepsis was identified as the most common complication (10.4 %). Reinfection was observed in 75 (12.6%) patients. Vancomycin monotherapy was the most commonly prescribed treatment.</div></div><div><h3>Conclusions</h3><div>In Qatar, CDI remains a significant health concern, primarily affecting elderly men, especially those who have had hospital admissions or used proton pump inhibitors or antibiotics. Preventive measures and increased knowledge of contact precautions and hand hygiene, particularly among healthcare workers, will help to reduce transmission. Raising physician awareness regarding the prudent use of antibiotics and antibiotic stewardship will serve as an adjunct to reduce the incidence of CDIs.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"14 ","pages":"Article 100592"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143551913","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":"Changes in the lipid profile in people with HIV after one year of antiretroviral therapy – the significance of immune parameters","authors":"Agnieszka Lembas ,&nbsp;Andrzej Załęski ,&nbsp;Tomasz Mikuła ,&nbsp;Joanna Kozłowska ,&nbsp;Alicja Wiercińska-Drapało","doi":"10.1016/j.ijregi.2025.100602","DOIUrl":"10.1016/j.ijregi.2025.100602","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to analyze lipid profiles among people with HIV and observe changes in lipid parameters during 1 year of antiretroviral therapy (ART), with particular reference to immune parameters.</div></div><div><h3>Methods</h3><div>We analyzed adult newly diagnosed people with HIV (PWH) who started ART, continued uninterruptedly for 1 year and achieved complete viral suppression. Patients were not receiving lipid-lowering therapy. The cluster of differentiation (CD4) count, CD4:CD8 ratio, HIV type 1 viral load, and lipid profile were examined at HIV diagnosis and after 12 months of ART.</div></div><div><h3>Results</h3><div>The study included 70 patients. Significant increases in total, high-density lipoprotein (HDL), and low-density lipoprotein (LDL) cholesterol and decreases in triglyceride concentrations after 1 year of ART were observed. A baseline CD4 count &lt;200/µl was associated with higher baseline LDL cholesterol (<em>P</em> = 0.036), and female sex with elevated total, LDL, and non-HDL cholesterol (<em>P</em> = 0.005; <em>P</em> = 0.011; <em>P =</em> 0.008). Patients with baseline CD4 counts &lt;200/µl had significantly higher total, LDL, and non-HDL cholesterol (<em>P</em> = 0.033; <em>P</em> = 0.009; <em>P</em> = 0.009) and triglyceride (<em>P</em> = 0.003) levels after 1 year of ART than patients with CD4 levels ≥200/µl.</div></div><div><h3>Conclusions</h3><div>Lipid parameters should be regularly assessed in all PWH receiving ART, especially in patients with baseline CD4 counts &lt;200/µl.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"14 ","pages":"Article 100602"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143551957","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":"Reviewer Thank you List, 2024","authors":"","doi":"10.1016/S2772-7076(25)00070-0","DOIUrl":"10.1016/S2772-7076(25)00070-0","url":null,"abstract":"","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"14 ","pages":"Article 100635"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683427","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":"Klebsiella pneumoniae urinary tract infection: A multicentric study highlights significant regional variations in antimicrobial susceptibility across India","authors":"Meher Rizvi ,&nbsp;Shalini Malhotra ,&nbsp;Hiba Sami ,&nbsp;Jyotsna Agarwal ,&nbsp;Areena H. Siddiqui ,&nbsp;Sheela Devi ,&nbsp;Aruna Poojary ,&nbsp;Bhaskar Thakuria ,&nbsp;Isabella Princess ,&nbsp;Aarti Gupta ,&nbsp;Amal Al Malehi ,&nbsp;Asfia Sultan ,&nbsp;Ashish Jitendranath ,&nbsp;Balvinder Mohan ,&nbsp;Fatima Khan ,&nbsp;Hatim El Tahir ,&nbsp;Nainaraj Ilanchezhiyan ,&nbsp;Mannu Jain ,&nbsp;Maria Khan ,&nbsp;Narendra Pal Singh ,&nbsp;Neelam Taneja","doi":"10.1016/j.ijregi.2025.100605","DOIUrl":"10.1016/j.ijregi.2025.100605","url":null,"abstract":"<div><h3>Objectives</h3><div>Knowledge of local antibiotic susceptibility rates is essential to strengthen antimicrobial stewardship programs. <em>DASH to Protect Antibiotics</em> (<span><span>https://dashuti.com/</span><svg><path></path></svg></span>), promotes the dissemination of focused local antibiograms in community urinary tract infection (UTI). This study mapped the susceptibility profile of <em>Klebsiella pneumoniae</em> from 18 Indian centers.</div></div><div><h3>Methods</h3><div>The centers spanned nine Indian States and three Union Territories. Urinary <em>K. pneumoniae</em> antibiograms from the outpatient clinic were collated and analyzed. Standardization was achieved through online training. For epidemiological purposes, five centers tested fosfomycin.</div></div><div><h3>Results</h3><div>Overall, low susceptibility (&lt;60%) was observed for the standard oral antibiotics prescribed for cystitis: co-trimoxazole, 54% (36-68%); ciprofloxacin, 52% (29-55%); amoxicillin-clavulanic acid, 46%, (35-82%); nitrofurantoin, 39% (19-78%); and cefuroxime, 30% (15-62%). The rates for third- and fourth-generation cephalosporins were 49% (45-52%) and 60% (36-76%), respectively. Extended-spectrum beta-lactamases ranged from 36-61% in India. Piperacillin-tazobactam 74% (65-87%), amikacin 76% (45-91%), and meropenem 81% (61-87%) exhibited higher activity. Fosfomycin was the most active antimicrobial, with 89% (92-97%) susceptibility. <em>K. pneumoniae</em> susceptibility was directly linked to geographic region, log gross domestic product (<em>P</em> &lt;0.001), and humidity, and low and high temperatures (<em>P</em> &lt;0.05).</div></div><div><h3>Conclusions</h3><div>Oral treatment options for <em>K. pneumoniae</em> cystitis are rapidly decreasing. Northern and southern India showed significant differences in antimicrobial susceptibility, highlighting the importance of local antibiograms for promoting antimicrobial stewardship. For uncomplicated cystitis, co-trimoxazole (54%) may be the empirical choice. Good susceptibility to fosfomycin was observed (89%). The empirical use of fluoroquinolones, cephalosporins, and amoxicillin-clavulanic acid has been discouraged. Piperacillin-tazobactam and aminoglycosides are carbapenem-sparing agents.</div></div>","PeriodicalId":73335,"journal":{"name":"IJID regions","volume":"14 ","pages":"Article 100605"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143601822","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}