European Journal of Clinical Microbiology & Infectious Diseases最新文献

We evaluated in vitro activity of sulbactam/durlobactam in combination with different antimicrobials against Carbapenem-Resistant Acinetobacter baumannii (CRAB) clinical isolates with different susceptibility profiles, including sulbactam/durlobactam-resistant strains. The genomes of 13 CRAB clinical isolates were characterized by whole-genome sequencing and synergy testing was performed with MIC Test Strips. Sulbactam/durlobactam, when combined with piperacillin/tazobactam or ceftazidime/avibactam, showed synergistic activity against 53.8% (7/13) of CRAB isolates and restored meropenem MIC values below the clinical breakpoint in 46.2% (6/13) of them. Our results demonstrate that sulbactam-durlobactam in combination with β-lactams exhibited high in vitro synergistic activity against CRAB strains.

Purpose: This study aims to investigate the effect of seasonal influenza vaccination on hospitalization rates among patients presenting to the emergency department with influenza-like illness.

Methods: A retrospective, single-center observational study was conducted, involving adult patients with influenza (ICD-10 codes J10 and J11) diagnosed in the emergency department between May 2024 and April 2025. Clinical and demographic information was collected from electronic records, and vaccination status was confirmed through follow-up phone calls. To tackle the "zero event" problem-no hospitalizations among vaccinated individuals-advanced statistical modeling was employed, including standard logistic regression, and Bayesian logistic regression using Markov Chain Monte Carlo (MCMC) simulations. Odds ratios (OR) and 95% Highest Density Intervals (HDI) were calculated to assess the effectiveness of vaccination.

Results: A total of 878 patients were enrolled: 3.3% (n = 29) received vaccinations, while 2.7% (n = 24) required hospitalization. None of the vaccine recipients were hospitalized. Standard logistic regression indicated that age was a significant indicator of hospitalization. Furthermore, Bayesian logistic regression followed, which confirmed vaccination's statistically significant protective effect. The OR for vaccination was 0.526 (95% HDI: 0.336-0.739), indicating a 47% reduction in hospitalization risk among vaccinated individuals.

Conclusion: Seasonal influenza vaccination was significantly associated with a lower risk of hospitalization in patients presenting with influenza-like illness to the emergency department. These findings support public health initiatives to enhance influenza vaccine coverage, particularly for the elderly.

Purpose: Systematic collection and analysis of antimicrobial resistance data from key bacterial pathogens is essential to contribute to control antimicrobial resistance (AMR). The aim of this work was to survey the drug resistance on clinically relevant organisms stratified according to age, gender, clinical specimens and facilities.

Methods: Microbiological data were collected from 55 centers across 24 states in Mexico between January 1 and March 31, 2025. Bacterial identification and antimicrobial susceptibility testing were performed at each participating center using locally available methods. Data was processed using WHONET 2025. Isolates obtained from lower respiratory specimens, urine, blood, biopsies and abscesses were analyzed. Carbapenem non-susceptible isolates were further analyzed by PCR for common carbapenemase-encoding genes. Resistance frequencies were compared using the chi-square test.

Results: A total of 11,290 clinical isolates were analyzed, mostly from urine (n = 7,149; 63.3%), followed by blood (n = 1,370; 12.1%). The most prevalent was Escherichia coli (n = 6,185; 54.8%), followed by Klebsiella pneumoniae (n = 1,365; 12.1%) and Pseudomonas aeruginosa (n = 1,110; 9.8%). Resistance to carbapenems in E. coli was higher in respiratory isolates (imipenem: 5.8%, p = 0.016; meropenem: 5.3%, p < 0.001), with 75.9% producing extended-spectrum ß-lactamases (ESBLs). K. pneumoniae had the highest resistance to ampicillin/sulbactam (52.5%, p = 0.028) and sulfamethoxazole/trimethoprim (62.1%, p = 0.014) in blood isolates, and 63.2% were ESBL-producers (p = 0.001). In P. aeruginosa, urine isolates showed significantly higher resistance to ceftolozane-tazobactam (24.7%, p = 0.008), ceftazidime-avibactam (36.6%, p < 0.001), and meropenem (34.5%, p = 0.009) compared to other clinical specimens included. For A. baumannii, respiratory isolates had 73.6% resistance to meropenem (p < 0.001). S. aureus from blood showed 25.7% resistance to oxacillin (p < 0.004). The most frequent carbapenemase genes were bla_OXA-48-like in E. coli (26/56, 46.4%), bla_NDM for K. pneumoniae (7/17, 41.2%), bla_OXA-24 in A. baumannii (79/108, 73.1%) and bla_IMP for P. aeruginosa (18/108, 16.7%).

Conclusion: This surveillance study underscores the elevated levels of antimicrobial resistance, ESBL production, and carbapenemase activity among priority pathogens, including some Enterobacterales, P. aeruginosa, and A. baumannii. These findings emphasize the urgent need to strengthen epidemiologic surveillance programs in Mexican healthcare settings.

Purpose: Escherichia coli (E.coli) represents the predominant Gram-negative bacterial causing bloodstream infection (BSI) in patients with acute leukemia (AL). This study sought to determine the risk factors for antibiotic-resistant E.coli strains and for 30-day mortality in this specific patient cohort.

Methods: This retrospective study enrolled adult patients with AL and E.coli BSI hospitalized between January 2017 and December 2023 at Fujian Medical University Union Hospital. Risk factors for antibiotic-resistant E.coli and for 30-day mortality were identified using multivariate logistic regression and Cox proportional hazards regression, respectively, while the Kaplan-Meier method was employed to plot survival curves.

Results: This study included 127 patients with AL and E.coli BSI. The rates of ESBL-producing E.coli (ESBL-E.coli) and carbapenem-resistant (CR) E.coli were 7.9% and 54.3%, respectively. Multivariate analysis identified prior cephalosporins use as an independent predictor for ESBL-E.coli BSI. The 30-day mortality rate of patients with AL and E.coli BSI was 17.3%. Age, pulmonary infections, CR E.coli, ESBL-E.coli, and inappropriate empirical therapy exhibited higher 30-day mortality rates. Nevertheless, only pulmonary infection and inappropriate empirical therapy were independent risk factors. Consequently, patients with pulmonary infection or receiving inappropriate empirical therapy had a worse prognosis.

Conclusions: Prior cephalosporins use independently increased the risk of developing ESBL-E.coli. 30-day mortality was independently associated with pulmonary infections and inappropriate empirical therapy. Thus, prompt initiation of appropriate antimicrobial therapy and prevention of pulmonary infection are essential in patients with AL and E.coli BSI.

Oritavancin is a long-acting lipoglycopeptide with excellent bone penetration and activity against biofilm-embedded bacteria, making it a promising candidate for the treatment of bone and joint infections (BJIs). To explore its potential in this clinical context, we assessed the in vitro activity of oritavancin in comparison with other glyco-, lipo- and glycolipo-peptides against a panel of 148 multidrug-resistant staphylococcal clinical isolates, mainly collected from BJI cases. Although oritavancin showed lower overall activity than dalbavancin, resistance to oritavancin could not be reliably inferred from the activity of related antibiotics. This lack of cross-resistance highlights the need for dedicated phenotypic susceptibility testing prior to clinical use.

Background: The escalating prevalence of macrolide-resistant Mycoplasma pneumoniae (MRMP) in China has posed substantial challenges for pediatricians managing mycoplasma pneumoniae pneumonia (MPP). This study aimed to compare the clinical efficacy and prognostic outcomes between two treatment strategies for pediatric patients with macrolide-unresponsive mycoplasma pneumoniae pneumonia (MUMPP) following initial 72-hour intravenous azithromycin therapy: (1) continuation of intravenous azithromycin combined with methylprednisolone, versus (2) switch to oral doxycycline monotherapy.

Methods: We performed a retrospective analysis of children hospitalized for MPP at our institution between November 2023 and October 2024. Children with MPP who showed no clinical response to an initial 72-hour course of intravenous azithromycin were assigned to two groups: (1) intravenous azithromycin combined with methylprednisolone (AZM + methylprednisolone group), and (2) doxycycline monotherapy (DXC group). Clinical efficacy and prognosis were compared between groups using 1:1 propensity score matching (PSM) to adjust for baseline confounding, followed by calculation of statistical power for the primary outcomes.

Results: A total of 1,112 children with MPP were screened, of whom 493 (44.33%) met the criteria for MUMPP, and 382 were included in the final analysis. The DXC group showed a significantly higher rate of pulmonary imaging improvement at discharge compared to the AZM + methylprednisolone group (94.29%vs.77.14%, P < 0.05). No significant intergroup differences were observed in the time to fever resolution or cough relief (P > 0.05). The AZM + methylprednisolone group had a significantly longer hospital stay than the DXC group [8 (7, 9) days vs. 6 (5, 7) days, P < 0.05]. Additionally, the refractory rate was higher in the AZM + methylprednisolone group (14.29% vs. 4.29%, P < 0.05). At 3-month follow-up, the incidence of new infections or diseases was significantly higher in the AZM + methylprednisolone group (32.86% vs. 4.29%, P < 0.05), whereas no significant difference was found in the complete imaging absorption rate between groups within 3 months (98.57% vs. 94.29%,P > 0.05). Notably, no cases of tooth discoloration-related adverse reactions were observed in the DXC group.

Conclusion: For pediatric cases of MUMPP, doxycycline yields superior efficacy over the combination regimen of azithromycin plus methylprednisolone in improving radiological findings at discharge, shortening hospital stays, reducing the rate of refractory disease, and lowering the incidence of post-discharge recurrent infection or disease exacerbation.

Non-typhoidal Salmonella (NTS) usually causes self-limiting gastroenteritis, but can lead to severe invasive infections, such as mycotic pseudoaneurysms, in immunocompromised patients. Here, we present the case of a 62-year-old male with NTS bacteraemia, which was complicated by an iliac artery mycotic pseudoaneurysm. The patient underwent successful endovascular management with a balloon-expandable graft stent, followed by targeted antimicrobial therapy against Salmonella enterica serotype Enteritidis. The patient achieved favourable clinical and radiological outcomes. This case highlights the importance of early recognition and demonstrates the effectiveness of endovascular stent-grafting as an alternative to open surgery for treating infected vascular lesions caused by NTS.

Objective: Severe Fever with Thrombocytopenia Syndrome (SFTS), an emerging infectious disease of essential public health concern, currently lacks specific antiviral treatments, This study evaluated the efficacy of the broad-spectrum antiviral drug T-705 (Favipiravir).

Methods: Using propensity score matching (PSM) to minimize confounding factors between T-705 and Non-T-705 groups, Absolute Shrinkage and Selection Operator (LASSO) regression and multivariate logistic regression were used to screen the factors affecting the efficacy of T-705.

Results: Analysis revealed a consistently higher disease improvement rate in the T-705 group (82.3% Pre-PSM, 80.6% Post-PSM) compared to Non-T-705 group (67.3%), with the difference remaining statistically significant (P = 0.032) after PSM. The results demonstrated that Ct values (1.397, 1.168-1.671, P < 0.001), lactate dehydrogenase (LDH) (1.002, 1.001-1.003, P = 0.027) and albumin (ALB) (1.153, 1.001-1.330, P = 0.050) levels were the protective factor for disease improvement, while clinical type (0.146, 0.045-0.477, P = 0.001), age (0.942, 0.893-0.994, P = 0.030), activated partial thromboplastin time (APTT) (0.917, 0.873-0.963, P < 0.001), total bilirubin (TBIL) (0.867, 0.752-0.999, P= 0.048), creatinine (CREA) (0.992, 0.985-0.999, P = 0.038) and uric acid (UA) (0.994, 0.990-0.999, P = 0.017) levels were risk factors for disease improvement.

Conclusions: The study demonstrated that T-705 exhibited significant efficacy and favorable safety in the treatment of SFTS patients. Furthermore, a multivariate logistic regression verified its clinical significance, thereby providing robust evidence to support its inclusion in treatment guidelines.