Annals of Clinical Microbiology and Antimicrobials最新文献

{"title":"Peritonsillar abscess in children: age-stratified incidence rates, microbiology, and evaluation of penicillin as drug of choice.","authors":"Andrea Lund, Pelle Hanberg, Tejs Ehlers Klug","doi":"10.1186/s12941-025-00842-3","DOIUrl":"10.1186/s12941-025-00842-3","url":null,"abstract":"<p><strong>Introduction: </strong>Peritonsillar abscess is the most frequent complication of acute tonsillitis. Although adult epidemiology and microbiology are well characterized, age-specific pediatric data remain limited. We investigated the incidence, microbiology, and suitability of penicillin monotherapy for pediatric peritonsillar abscess.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of patients aged 0-17 years admitted with peritonsillar abscess to Aarhus University Hospital, Denmark (2012-2024). Age-stratified incidence rates were calculated using national population data. Bacterial findings and treatment outcomes were analysed across age groups.</p><p><strong>Results: </strong>A total of 395 patients (mean age 13.9 ± 3.5 years) were included; 88% (349/395) had cultures performed, of which 81% (281/349) were positive. Fusobacterium necrophorum and Streptococcus pyogenes predominated, with marked age variation: Streptococcus pyogenes prevailed in children ≤ 11 years (61%), while Fusobacterium necrophorum dominated in adolescents aged 16-17 years (57%) (p < 0.001). Peritonsillar abscess incidence increased steadily with age, peaking at 78.4/100,000 in the oldest group. Most patients were treated with penicillin, either intravenously (158/395, 40%) or orally (130/395, 33%). Twelve patients (3%) received broader-spectrum antibiotics, and 95 (24%) patients underwent acute tonsillectomy without antibiotic treatment. Complications were rare (3/395, 1%), all of which involved postoperative pneumonia following tonsillectomy.</p><p><strong>Conclusion: </strong>Peritonsillar abscess incidence increases with age, accompanied by a microbiological shift from Streptococcus pyogenes in younger children to Fusobacterium necrophorum among adolescents. Given the high susceptibility of both pathogens to penicillin and the low complication rate, penicillin monotherapy appears to be a safe and adequate empirical treatment across all pediatric age groups.</p><p><strong>Key points: </strong>Peritonsillar abscess incidence in children increases with age, with Streptococcus pyogenes predominating in young children and Fusobacterium necrophorum in adolescents. Penicillin monotherapy yielded excellent outcomes, supporting stewardship-conscious empiric therapy tailored to pediatric patients.</p>","PeriodicalId":8052,"journal":{"name":"Annals of Clinical Microbiology and Antimicrobials","volume":" ","pages":"6"},"PeriodicalIF":3.6,"publicationDate":"2026-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12866488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145896043","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":"Cross-sectional hospital-based investigation on clinical characteristics of pediatric Group A Streptococcus isolates in a Beijing hospital from 2014 to 2023.","authors":"Luwei Wang, Zhiyong Lyu","doi":"10.1186/s12941-025-00845-0","DOIUrl":"10.1186/s12941-025-00845-0","url":null,"abstract":"<p><strong>Background: </strong>Group A Streptococcus (GAS) is a major bacterial pathogen associated with diverse clinical diseases. Despite its general susceptibility to β-lactam antibiotics, GAS outbreaks remain a significant global health and economic concern. In this study, we retrospectively analyzed the clinical features and antimicrobial resistance patterns of GAS infections in pediatric patients in Beijing over the past decade.</p><p><strong>Methods: </strong>Data on all GAS infections from 2014 to 2023 were collected from the microbiology department of Beijing Children's Hospital. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disc diffusion method and interpreted according to the Clinical and Laboratory Standards Institute (CLSI) guidelines.</p><p><strong>Results: </strong>From 2014 to 2023, a total of 1,445 strains of GAS were isolated. School-age children (6-18 years) had the highest isolation rate (77.7%) among all age groups. Among the isolates, 53.6% were from outpatients (except pediatric gynecology). The top 3 wards with the highest GAS isolation rates were the rheumatology and immunology, pulmonology and dermatology wards. Most GAS infections were superficial (95.8%). Invasive infections were primarily due to bacteremia, which accounted for 40.0% of invasive cases. The isolation rate of GAS peaked in 2017 and remained at a lower level during the SARS-CoV-2 pandemic, specifically from 2019 to 2022. GAS infections also showed seasonal variation, with the highest prevalence in winter. No GAS strains were resistant to penicillin, cephalosporins, vancomycin, or linezolid. The resistance rates to erythromycin and clindamycin were generally above 90%.</p><p><strong>Conclusion: </strong>In the post-SARS-CoV-2 period, the isolation rate of GAS has increased. GAS infections are more common in winter and summer, so children, especially school-age children, should be cautious. Given the high resistance of GAS to erythromycin and clindamycin, clinicians should limit the use of these two drugs to avoid treatment failure.</p>","PeriodicalId":8052,"journal":{"name":"Annals of Clinical Microbiology and Antimicrobials","volume":" ","pages":"5"},"PeriodicalIF":3.6,"publicationDate":"2026-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12857052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145896097","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":"Carbapenem resistance and multidrug resistance in Morganellaceae: a 12-year retrospective cross-sectional study from southern Saudi Arabia.","authors":"Yahya Shabi, Ghaday Hadi, Abdullah Algarni, Ali Al Bshabshe, Tarik Alazraqi, Safia Abdullah, Sara Habbash, Khalifa Binkhamis, Ali Somily, Ayidh Alsalem, Mohammed K Almaghrabi, Abdulah J Alqahtani, Saeed Ms Alhamhhum, Abdulah Os Bawazeer","doi":"10.1186/s12941-025-00844-1","DOIUrl":"10.1186/s12941-025-00844-1","url":null,"abstract":"<p><strong>Background: </strong>Morganellaceae (including Proteus, Providencia, and Morganella) are opportunistic pathogens increasingly associated with antimicrobial resistance (AMR). Long-term trend data, particularly from the Middle East, remain scarce. This study aimed to characterize the epidemiology, demographic and clinical characteristics, and antimicrobial resistance dynamics of Morganellaceae isolates in southern Saudi Arabia over a 12-year period, with a specific focus on carbapenem resistance (CRE), multidrug resistance (MDR), and difficult-to-treat resistance (DTR), as well as their genus-level variability and unique resistance phenotypes.</p><p><strong>Methods: </strong>A 12-year retrospective cross-sectional study (2012-2024) was conducted at Aseer Central Hospital, southern Saudi Arabia. Non-duplicate clinical isolates from patients ≥ 12 years were identified using VITEK^® 2, with susceptibility interpreted according to CLSI guidelines. CRE, MDR, and DTR were defined by standardized criteria. Logistic regression was applied to model annual non-susceptibility trends, reported as odds ratios (ORs) and annual percent change (APC). Subgroup analyses explored genus-level differences, ICU versus non-ICU settings, and intra-genus variability.</p><p><strong>Results: </strong>A total of 3,338 isolates were recovered, predominantly Proteus spp. (72.4%), followed by Providencia (18.6%) and Morganella (9.0%). Overall prevalence of CRE, MDR, and DTR was 25.7%, 44.8%, and 13.2%, respectively. Providencia showed the highest resistance burdens (CRE 33.6%, MDR 68.1%, DTR 23.2%), significantly exceeding Proteus (CRE 23.3%, MDR 39.1%, DTR 10.0%) and Morganella (CRE 29.3%, MDR 42.3%, DTR 9.2%) (all p < 0.001). Within CRE, 32.8% of isolates were non-susceptible to imipenem yet remained susceptible to meropenem and ertapenem. Compared with non-ICU isolates, ICU isolates exhibited higher MDR (49.6% vs. 41.5%, p < 0.001) but lower CRE (23.1% vs. 27.5%, p = 0.006), while DTR prevalence was comparable. Temporal analysis demonstrated significant declines in resistance to cephalosporins, fluoroquinolones, aminoglycosides, and Trimethoprim-Sulfamethoxazole, whereas imipenem resistance rose sharply (APC + 48.6%; OR 1.49, 95% CI 1.43-1.54, p < 0.001); meropenem and ertapenem remained stable.</p><p><strong>Conclusions: </strong>Morganellaceae infections in southern Saudi Arabia carry substantial MDR and CRE burdens with pronounced genus-level variability,with Providencia posing the greatest therapeutic challenge. While several antibiotic classes showed declining resistance, the sharp rise in imipenem non-susceptibility is concerning. Strengthening species-level AST reporting and integrating Morganellaceae resistance data into healthcare-associated infection (HAI) surveillance frameworks are essential, particularly in ICU settings where outbreak risk is greatest.</p>","PeriodicalId":8052,"journal":{"name":"Annals of Clinical Microbiology and Antimicrobials","volume":" ","pages":"10"},"PeriodicalIF":3.6,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12895696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145861855","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":"Synergistic effect of lactoferrin combined with fluconazole to overcome antifungal resistance in Candida species.","authors":"Iñigo de-la-Fuente, Juan Daniel Carton, Andrea Guridi, Nerea Jauregizar, Guillermo Quindós, Elena Eraso, Elena Sevillano","doi":"10.1186/s12941-025-00836-1","DOIUrl":"10.1186/s12941-025-00836-1","url":null,"abstract":"<p><strong>Background: </strong>The incidence of drug-resistant candidiasis has increased in recent decades, leading to significant treatment challenges and high morbidity and mortality rates. The development of new therapeutic options is crucial, but it is a complex and time-consuming process; an interesting strategy to face this problem is to combine existing antifungal drugs with synergistic agents to enhance treatment efficacy, reduce dosage and prevent resistance development.</p><p><strong>Methods: </strong>We analyzed the activity of lactoferrin against 80 isolates of 14 Candida species, including Candida auris according to both EUCAST and CLSI guidelines. Moreover, interaction between fluconazole and lactoferrin was assessed by checkerboard method against a selection of 38 isolates of eight Candida species, and by time-kill curves against six isolates of two Candida species, including fluconazole susceptible and resistant isolates.</p><p><strong>Results: </strong>Synergistic and additive effects were demonstrated, with effective inhibition of Candida growth. Furthermore, combination therapy significantly reduced fluconazole minimum inhibitory concentrations (MICs) and showed synergistic effect against fluconazole-resistant isolates.</p><p><strong>Conclusions: </strong>Lactoferrin has significant potential value in the treatment of candidiasis and further exploration of its potential clinical applications is of great importance. The ability of lactoferrin to enhance the efficacy of existing antifungal drugs while potentially reducing the development of antifungal resistance makes it an intriguing candidate for future research and development efforts.</p>","PeriodicalId":8052,"journal":{"name":"Annals of Clinical Microbiology and Antimicrobials","volume":" ","pages":"3"},"PeriodicalIF":3.6,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12821989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145767109","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":"Five-year surveillance of antimicrobial resistance patterns among blood culture isolates at the University Teaching Hospital, Kigali, Rwanda.","authors":"Jean Bosco Munyemana, Gilbert Uwizeyimana, Marie Claire Ndayisaba, Angelique Dusabe, Masceline Jenipher Mutsaka-Makuvaza, Jean Paul Sinumvayo, Evelyne Kantarama, Nicolas Rubambana, Louise Mwiseneza, Innocent Hahirwa, Belson Rugwizangoga, Florence Masaisa, Martin Nyundo, Tharcisse Mpunga","doi":"10.1186/s12941-025-00837-0","DOIUrl":"10.1186/s12941-025-00837-0","url":null,"abstract":"<p><strong>Background: </strong>Bloodstream infections remain a major cause of morbidity and mortality worldwide, with the increasing threat of antimicrobial resistance (AMR) complicating treatment options. This study aimed to describe the frequency, distribution, and patterns of AMR among blood culture isolates over 5 years at the University Teaching Hospital of Kigali, in Rwanda.</p><p><strong>Methods: </strong>A retrospective cross-sectional surveillance analysis was performed on 1352 bacterial isolates from 8301 blood cultures conducted between January 1, 2020, and December 31, 2024. The distribution of pathogens, antimicrobial resistance profiles, and comparisons of resistance patterns between isolates from outpatient and hospitalized patients were analyzed using SPSS version 28. A p-value less than 0.05 was considered statistically significant.</p><p><strong>Results: </strong>The most common isolates were Staphylococcus aureus (37.2%), Klebsiella pneumoniae (22.4%), Escherichia coli (13%), and Acinetobacter baumannii (11.6%). Nearly all isolates originated from inpatients (98.6%), with the pediatric unit accounting for 40.7%. Alarmingly high resistance rates were observed for ampicillin (94.2%), amoxicillin-clavulanic acid (92.5%), third-generation cephalosporins (79-86%), and ciprofloxacin (58.7%). Notably, vancomycin (1%) for Gram-positive bacteria, and polymyxin B (27.1%), imipenem (25.5%), and amikacin (15.6%) for Gram-negative bacteria generally exhibited lower resistance rates. Additionally, AMR was significantly more prevalent in isolates from hospitalized patients compared to ambulatory patients (p < 0.0001).</p><p><strong>Conclusion: </strong>This study reveals a substantial burden of AMR in blood culture isolates, particularly affecting hospitalized and pediatric patients. The high resistance rates to commonly used antibiotics highlight an urgent need for strengthened antimicrobial stewardship programs, improved infection prevention measures, and enhanced diagnostic laboratory capacity to guide therapy.</p>","PeriodicalId":8052,"journal":{"name":"Annals of Clinical Microbiology and Antimicrobials","volume":" ","pages":"2"},"PeriodicalIF":3.6,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12777414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145659965","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":"Magnitude of poor multidrug-resistant tuberculosis treatment outcome among multidrug-resistant tuberculous patients at tertiary hospital, South West Ethiopia.","authors":"Gemechu Gelana Ararame, Hailegabreil Nardos","doi":"10.1186/s12941-025-00838-z","DOIUrl":"10.1186/s12941-025-00838-z","url":null,"abstract":"<p><strong>Background: </strong>The persistent spread of multiple drug-resistant tuberculosis (MDR-TB) is one of the most pressing and challenging issues facing the global TB control efforts. Standard first-line treatment for MDR TB is nearly ineffective for patients infected with strains of the disease that are resistant to isoniazid and rifampicin.</p><p><strong>Objective: </strong>To assess the magnitude of poor MDR-TB treatment outcomes among MDR-TB patients at the MDR-TB clinic, tertiary Hospital, Southwest, Ethiopia.</p><p><strong>Methods: </strong>A retrospective cross-sectional study was conducted at the MDR-TB clinic, Mattu Karl Comprehensive Specialized Hospital (MKCSH), from 2018 to 2024. A data collection checklist was used to collect information on sociodemographic, clinical characteristics, medication, and treatment outcomes from the patient's medical cards. The collected data were cleaned, coded, entered, and analyzed using SPSS version 20 computer software. Descriptive data analysis was done to describe variables by percent and frequency. Data were presented in tables and pie charts.</p><p><strong>Result: </strong>A total of 72 (54.2% male and 47.8% female) MDR-TB patients were included in this study analysis. Among a total, 54.2% were men. The mean age of the patients was 31.42 years with a standard deviation of 7.81 years, and 25% were positive for human immunodeficiency virus (HIV). The most common adverse drug reaction was gastric disturbance (45.8%). The majority, 79.2% had a successful outcome: 75% were cured and 4.2% have completed treatment. The magnitude of poor MDR-TB treatment outcome was 20.8%: 12.5% were death and 8.3% defaulted from treatment.</p><p><strong>Conclusion: </strong>The magnitude of poor MDR-TB treatment outcomes among MDR-TB patients was high. Strengthening patient support systems and optimizing treatment protocols are essential strategies to reduce the prevalence of poor outcomes.</p>","PeriodicalId":8052,"journal":{"name":"Annals of Clinical Microbiology and Antimicrobials","volume":" ","pages":"1"},"PeriodicalIF":3.6,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12764050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145627848","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":"Preventive effects of combined live Bifidobacterium, Lactobacillus, Enterococcus, and Bacillus cereus tablets on radiation pneumonitis-associated with cyberknife treatment for pulmonary malignancies.","authors":"Wei Wang, Yingchun Zhao, Ying Guo, Qian Wang, Lichao Hong","doi":"10.1186/s12941-025-00833-4","DOIUrl":"10.1186/s12941-025-00833-4","url":null,"abstract":"<p><strong>Backgroud: </strong>To investigate the preventive effects of combined live Bifidobacterium, Lactobacillus, Enterococcus, and Bacillus cereus tablets (CBLEBTL) on patients with radiation pneumonitis associated with CyberKnife treatment for pulmonary malignancies.</p><p><strong>Methods: </strong>In total, 130 patients who received CyberKnife treatment for pulmonary malignancies at the First Hospital of Hebei Medical University between August 2023 and February 2025 were enrolled. Patients were randomly categorized into the experimental group (n = 65) or control group (n = 65). While both groups received CyberKnife treatment for pulmonary lesions, the experimental group additionally received CBLEBTL (0.5 g/dose, thrice daily). The primary endpoint was to determine the incidence of RP, and secondary endpoints included onset time of RP and Eastern Cooperative Oncology Group performance status (ECOG PS) scores.</p><p><strong>Results: </strong>RP incidence was significantly lower in the experimental group (6/61 [9.8%]) than in the control group (16/62 [25.8%]) (χ² = 5.340, P = 0.021). The mean onset time of RP was significantly delayed in the experimental group than in the control group (176.9 vs. 166.6 days; hazard ratio = 0.34, 95% confidence interval: 0.15-0.80, P < 0.05). ECOG PS of the experimental group was significantly lower than that of the control group at 2, 4 and 6 months post-CyberKnife treatment (P < 0.05).</p><p><strong>Conclusion: </strong>CBLEBTL effectively reduced the incidence of CyberKnife-associated RP among patients with pulmonary malignancies, delayed RP onset, and improved their quality of life.</p><p><strong>Trial registration: </strong>This prospective trial was registered retrospectively (after patient enrollment began) because of delays in institutional approval processes. The retrospective registration was approved by the Ethics Committee of The First Hospital of Hebei Medical University (Approval No. [2025]074). The trial is registered at: WHO-primary registry ChiCTR (No. ChiCTR2500104615; Date: 19-Jun-2025), accessible via WHO ICTRP ( https://trialsearch.who.int/ ); China's National Public Health Security Information Platform (No. MR-13-25-043029; Date: 09-Jun-2025). All study procedures followed the original protocol without modifications.</p>","PeriodicalId":8052,"journal":{"name":"Annals of Clinical Microbiology and Antimicrobials","volume":"24 1","pages":"66"},"PeriodicalIF":3.6,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12628986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145547872","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":"Improving tuberculosis diagnosis: evaluation of tongue swabbing as a complementary method to sputum analysis in Guinea.","authors":"Souleymane Hassane-Harouna, Moussa Condé, Kindy Bah, Sofie Marijke Braet, Magalie Van Dyck-Lippens, Morten Ruhwald, Mary Gaichiri, Margaretha De Vos, Bouke C De Jong, Leen Rigouts","doi":"10.1186/s12941-025-00835-2","DOIUrl":"10.1186/s12941-025-00835-2","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary tuberculosis (PTB) diagnosis primarily relies on sputum examination, which can be challenging for patients unable to produce sputum. Minimally invasive oral sampling methods, such as tongue swabs (TS), have been proposed as alternatives. We assessed the effectiveness of TS for PTB diagnosis using molecular tests.</p><p><strong>Methods: </strong>In a prospective study at two TB clinics, 99 confirmed smear-positive PTB patients provided 11 TS and one additional sputum sample (SS) for GeneXpert-Ultra (Ultra) testing at the National Reference Laboratory for Mycobacteriology. Testing was performed on a single TS (1TS), three pooled TS (3TS), and the additional SS. Additionally, we retrospectively analyzed TS from 120 participants with TB symptoms using an in-house IS6110-qPCR at the Institute of Tropical Medicine, alongside two SSs tested by fluorescence microscopy, GeneXpert-MTB/RIF (Xpert) and Ultra in Guinea.</p><p><strong>Results: </strong>In the prospective study, among 99 smear-positive patients, Ultra detected Mycobacterium tuberculosis (MTB) in 86.9% (1TS) and 91.9% (3TS), compared to 96.9% in SS. The highest positivity grade for sputum was \"MTB detected high\" (n = 31) with no \"Trace\" results, while for any TS the maximum grading was \"Medium\". TS positivity grades were mostly \"MTB Low\", and was not impacted by the sample swab number tested. In the retrospective study, positivity rates for sputum were 35% on microscopy, 44% on Xpert, 38.6% on Ultra, and 38.3% on in-house swab-IS6110-qPCR, with strong agreement between sputum-Xpert/Ultra and swab-IS6110-qPCR (k = 0.91 Xpert, k = 0.86 Ultra).</p><p><strong>Results: </strong>TS demonstrated its ability to detect MTB on molecular tests, providing a minimally invasive complement for PTB diagnosis. Further studies in sputum scarce patients are needed.</p>","PeriodicalId":8052,"journal":{"name":"Annals of Clinical Microbiology and Antimicrobials","volume":"24 1","pages":"65"},"PeriodicalIF":3.6,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12625458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145547867","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 insights into novel ST7947 carbapenem-resistant hypervirulent Klebsiella pneumoniae: a threat from an Indian hospital setting.","authors":"Birasen Behera, Sanghamitra Pati, Bidyutprava Rout, Saubhagini Sahoo, Aishwarya Swain, Rajesh Kumar Sahoo, Rajashree Panigrahy","doi":"10.1186/s12941-025-00834-3","DOIUrl":"10.1186/s12941-025-00834-3","url":null,"abstract":"<p><strong>Background: </strong>The rise of carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-hvKp) strains represents a major clinical threat, particularly in Asia. These strains possess both extensive drug resistance and enhanced virulence traits, leading to high morbidity and mortality. This study aimed to characterize the genomic profile of a CR-hvKp isolate (BB-7) obtained from a clinical case in eastern India and to investigate its resistance and virulence mechanisms.</p><p><strong>Methods: </strong>K. pneumoniae BB-7 was obtained from the urine sample of a 75-year-old male and identified by using the VITEK2 system and ITS-PCR amplification. Hypervirulence was confirmed through the string test and detection of the iucA gene. The antimicrobial susceptibility (AST) was determined by the Kirby-Bauer disk diffusion method, whereas colistin susceptibility was measured using broth microdilution. Whole-genome sequencing was performed using Illumina NovaSeq, followed by de novo assembly, annotation, and resistome/virulome analysis using tools including PROKKA, CARD, ResFinder, and VFAnalyzer. MLST, plasmid typing, capsular serotyping, phage element, and insertion element were analyzed by using an online database. Phylogenetic analysis was performed using cgMLST and core SNP approaches.</p><p><strong>Results: </strong>BB-7 exhibited an extensively drug-resistant (XDR) phenotype, including resistance to β-lactams, fluoroquinolones, aminoglycosides, tetracyclines, and colistin. Resistance genes identified included bla_CTX-M-15, bla_SHV-28, bla_TEM-1, bla_OXA-232, bla_OXA-1, armA, aadA2, and others. The virulence profile revealed genes such as iucABCD, iutA, iroEN, and T6SS clusters. Plasmid analysis identified IncHI1B, ColKP3, and IncFIB(K), contributing to the convergence of resistance and virulence. The Capsular serotype at K-locus and O-locus is K64 and O2α.1, respectively. The isolate was assigned a novel sequence type, ST7947 (gapA-1, infB-6, mdh-1, pgi-1, phoE-749, rpoB-46, tonB-1), differing from ST2096 by one allele phoE. Phylogenetic analysis revealed that BB-7 was closely related to ST2096 MDR K. pneumoniae isolates from an Indian hospital.</p><p><strong>Conclusion: </strong>BB-7 represents a novel CR-hvKp strain with a unique ST7947 genotype, exhibiting co-resistance and hypervirulence, raising concern for public health. The association of high-risk resistance plasmids with virulence factors underscores the urgent need for enhanced genomic surveillance, infection control, and devising specific therapies to restrict the proliferation of such strains.</p>","PeriodicalId":8052,"journal":{"name":"Annals of Clinical Microbiology and Antimicrobials","volume":"24 1","pages":"64"},"PeriodicalIF":3.6,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12625628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145538837","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 insights into ST85 and ST158 belonging to recently emerged global clones of multidrug-resistant Acinetobacter baumannii isolates from Egypt: in vitro assessment of repurposed drug-antibiotic combinations.","authors":"Mona S El Far, Mervat A Kassem, Eva A Edward, Benjamin A Evans, Dave J Baker, Azza S Zakaria","doi":"10.1186/s12941-025-00829-0","DOIUrl":"10.1186/s12941-025-00829-0","url":null,"abstract":"<p><strong>Background: </strong>The strikingly rapid increase in multidrug-resistant Acinetobacter baumannii (MDRAB) incidence rates represents a major challenge in healthcare settings. This is due to the limitation of the currently available treatment options to combat tenacious A. baumannii infections. MDRAB isolates belonging to recently emerged global clones GC9 and GC10 are on the rise, especially in the Middle East and Africa, which warrants a thorough investigation of these global clones.</p><p><strong>Methods: </strong>Thirteen A. baumannii isolates belonging to less well-studied global clones were selected from 46 isolates collected in Alexandria, Egypt, after determining their clone using MLST. Susceptibility to multiple antibiotic classes was determined by the Kirby-Bauer disk diffusion method. Testing of carbapenemase activity and selected virulence phenotypes was done. Whole genome sequencing, phylogenetic analysis, and molecular characterization of the resistance and virulence genotypes were performed. Checkerboard assay was employed for testing the combination of each of ciclopirox and N-acetylcysteine (NAC), as potential repurposed drugs, with each of meropenem and levofloxacin antibiotics against MDRAB isolates.</p><p><strong>Results: </strong>All the isolates displayed multidrug resistance and were carbapenemase-positive. One isolate showed strong biofilm formation, whereas 4 and 8 isolates were moderate and weak biofilm formers, respectively. Twelve out of thirteen isolates were positive twitchers. The isolates showed moderate phospholipase and strong protease activities. However, low phospholipase production was detected in one isolate. The genomic analysis revealed that 3 and 10 isolates belonged to ST85 (GC9) and ST158 (GC10), respectively. All 13 isolates harbored multiple resistance genes including oxa23 and carried an RP-T1 rep type plasmid. Phylogenetic analysis demonstrated that the isolates were clustered together forming subclades with others from Alexandria/Egypt. The AbGRI3-2 resistance island (RI) was detected in ST158 isolates carrying R3-T60 rep type and 9 antibiotic resistance genes. The combination of NAC with each of meropenem or levofloxacin showed a synergistic action against 3 and one isolate(s), respectively, using the checkerboard assay.</p><p><strong>Conclusion: </strong>The current study provides an in-depth characterization of the collected MDRAB isolates from the global clones GC9 and GC10. The endemicity of these clones necessitates strategies to mitigate ongoing MDRAB outbreaks in countries like Egypt. Combination of NAC with meropenem or levofloxacin represents a promising treatment option against the newly emerged global clones that needs further in vivo testing.</p>","PeriodicalId":8052,"journal":{"name":"Annals of Clinical Microbiology and Antimicrobials","volume":"24 1","pages":"63"},"PeriodicalIF":3.6,"publicationDate":"2025-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12619396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145530443","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}