Xiang Huo, Zhongming Tan, Huimin Qian, Yuanfang Qin, Chen Dong, Chuchu Li, Xiaoxiao Kong, Jie Hong
Background:Streptococcus pneumoniae is a significant etiological agent of infection and commonly inhabits the human nasopharynx, alongside other potentially pathogenic bacteria. In this study, S. pneumoniae strains were obtained from a community population and subjected to investigation of their phenotypes, genotypes, and vaccine coverage. Methods:S. pneumoniae was isolated from nasopharyngeal swab samples of a healthy population in the Guangfu Community. Capsular serotypes and genotypes were identified using Quellung reaction and multilocus sequence typing (MLST), respectively. The antimicrobial susceptibility was tested using minimum inhibitory concentrations. Results: In total, 500 unvaccinated people were sampled. Ninety-four S. pneumoniae strains were identified. Common serotypes were 19F, 6A, and 9V. The strain coverages of PCV13 and PPV23 were 61.7% and 58.5%, respectively. About 27.6% isolates were non-susceptible to penicillin, and over 80% were resistant to erythromycin and doxycycline. Among 27 novel sequence types (STs) identified in all strains, the most common STs were ST236 (6/94, 6.4%) and ST12669 (6/94, 6.4%). Nearly half of the strains were grouped into four clone complexes (CC12665, CC271, CC6011, and CC180), of which CC271 showed the highest resistance to PEN. Conclusion: In our study, various drug-resistant clone complexes of Streptococcus pneumoniae were found in the healthy population, the elderly, and children. Consequently, pneumococcal vaccines should be included in the national immunization schedule to prevent disease spread.
{"title":"Serotypes and Genotypes of Streptococcus pneumoniae in an Unvaccinated Population in Suzhou, China","authors":"Xiang Huo, Zhongming Tan, Huimin Qian, Yuanfang Qin, Chen Dong, Chuchu Li, Xiaoxiao Kong, Jie Hong","doi":"10.2147/idr.s454042","DOIUrl":"https://doi.org/10.2147/idr.s454042","url":null,"abstract":"<strong>Background:</strong> <em>Streptococcus pneumoniae</em> is a significant etiological agent of infection and commonly inhabits the human nasopharynx, alongside other potentially pathogenic bacteria. In this study, <em>S. pneumoniae</em> strains were obtained from a community population and subjected to investigation of their phenotypes, genotypes, and vaccine coverage.<br/><strong>Methods:</strong> <em>S. pneumoniae</em> was isolated from nasopharyngeal swab samples of a healthy population in the Guangfu Community. Capsular serotypes and genotypes were identified using Quellung reaction and multilocus sequence typing (MLST), respectively. The antimicrobial susceptibility was tested using minimum inhibitory concentrations.<br/><strong>Results:</strong> In total, 500 unvaccinated people were sampled. Ninety-four <em>S. pneumoniae</em> strains were identified. Common serotypes were 19F, 6A, and 9V. The strain coverages of PCV13 and PPV23 were 61.7% and 58.5%, respectively. About 27.6% isolates were non-susceptible to penicillin, and over 80% were resistant to erythromycin and doxycycline. Among 27 novel sequence types (STs) identified in all strains, the most common STs were ST236 (6/94, 6.4%) and ST12669 (6/94, 6.4%). Nearly half of the strains were grouped into four clone complexes (CC12665, CC271, CC6011, and CC180), of which CC271 showed the highest resistance to PEN.<br/><strong>Conclusion:</strong> In our study, various drug-resistant clone complexes of <em>Streptococcus pneumoniae</em> were found in the healthy population, the elderly, and children. Consequently, pneumococcal vaccines should be included in the national immunization schedule to prevent disease spread.<br/><br/>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142247811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: This study aims to investigate the association between antimicrobial resistance genes and virulence factors in ST11 and non-ST11 types of CR-KP in bloodstream infections in the intensive care unit, providing a theoretical basis for infection control and clinical diagnosis and treatment. Methods: From January 2021 to June 2023, samples of Klebsiella pneumoniae from bloodstream infections were collected at our hospital, focusing on those resistant to carbapenems. The resistance genes, housekeeping genes, and virulence genes were identified through PCR and analyzed using the GrapeTree software to perform MLST-based minimum spanning tree typing. Results: Among the 85 CR-KP cases, 61.18% were of the ST11 type, predominantly of the KL64 capsular type; non-ST11 types were mainly ST15, accounting for 25.88%, predominantly of the KL5 capsular type. The carriage rates of virulence genes such as rmpA2, entB, silS, kpn, iucA, peg-344, and terB were significantly higher in the ST11 group than in the non-ST11 group. The primary carbapenemase identified was class A enzyme blaKPC-2, with a higher carriage rate in the ST11 group. Drug susceptibility tests showed that the resistance rates for cefepime, ertapenem, nitrofurantoin, amikacin, and gentamicin were also higher in the ST11 group, consistent with the resistance genotype findings. Conclusion: The study reveals that ST11 type CR-KP in intensive care unit bloodstream infections exhibits stronger resistance and higher virulence compared to non-ST11 types, posing significant challenges to clinical treatment. Thus, strict control over the use of carbapenem antibiotics is essential to prevent the spread of resistant plasmids.
Keywords: intensive care unit, bloodstream infections, ST11 CR-KP, Non-ST11 CR-KP, resistance genes, virulence genes
{"title":"Analysis of the Association Between Antimicrobial Resistance Genes and Virulence Factors in ST11 and Non-ST11 CR-KP Bloodstream Infections in the Intensive Care Unit","authors":"Yanye Tu, Hui Gao, Rongqing Zhao, Jiliang Yan, Diyu Wu","doi":"10.2147/idr.s478156","DOIUrl":"https://doi.org/10.2147/idr.s478156","url":null,"abstract":"<strong>Objective:</strong> This study aims to investigate the association between antimicrobial resistance genes and virulence factors in ST11 and non-ST11 types of CR-KP in bloodstream infections in the intensive care unit, providing a theoretical basis for infection control and clinical diagnosis and treatment.<br/><strong>Methods:</strong> From January 2021 to June 2023, samples of <em>Klebsiella pneumoniae</em> from bloodstream infections were collected at our hospital, focusing on those resistant to carbapenems. The resistance genes, housekeeping genes, and virulence genes were identified through PCR and analyzed using the GrapeTree software to perform MLST-based minimum spanning tree typing.<br/><strong>Results:</strong> Among the 85 CR-KP cases, 61.18% were of the ST11 type, predominantly of the KL64 capsular type; non-ST11 types were mainly ST15, accounting for 25.88%, predominantly of the KL5 capsular type. The carriage rates of virulence genes such as <em>rmpA2, entB, silS, kpn, iucA, peg-344</em>, and <em>terB</em> were significantly higher in the ST11 group than in the non-ST11 group. The primary carbapenemase identified was class A enzyme <em>bla</em><sub>KPC-2</sub>, with a higher carriage rate in the ST11 group. Drug susceptibility tests showed that the resistance rates for cefepime, ertapenem, nitrofurantoin, amikacin, and gentamicin were also higher in the ST11 group, consistent with the resistance genotype findings.<br/><strong>Conclusion:</strong> The study reveals that ST11 type CR-KP in intensive care unit bloodstream infections exhibits stronger resistance and higher virulence compared to non-ST11 types, posing significant challenges to clinical treatment. Thus, strict control over the use of carbapenem antibiotics is essential to prevent the spread of resistant plasmids.<br/><br/><strong>Keywords:</strong> intensive care unit, bloodstream infections, ST11 CR-KP, Non-ST11 CR-KP, resistance genes, virulence genes<br/>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142247845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yuanzhong Fang, Juan Jin, Minfei Peng, Lidong Xu, Linyuan Gu, Danni Bao, Qiuying Zhang, Kainan Jin
Background: Hypervirulent carbapenem-resistant K. pneumoniae (hv-CRKP) has been spreading rapidly worldwide. Here, we investigated the genomic characteristics of ST11 K. pneumoniae isolate SM117 with capsular serotype KL25, co-carrying blaNDM-5, two copies of blaKPC-2 and multiple plasmid-borne virulence genes from a county level hospital in China. Methods: Antimicrobial susceptibility of K. pneumoniae SM117 was evaluated. The Illumina NovaSeq 6000 and Oxford Nanopore MinION platforms were applied to sequence the genome and then de novo assembled. The genome sequence was annotated using the NCBI Prokaryotic Genome Annotation Pipeline and further subjected to identify the sequence type (ST), capsular type, antibiotic resistance genes, plasmid replicon types and virulence genes. The phylogenetic analysis was performed based on the core genome single nucleotide polymorphisms (cgSNPs) using CSI Phylogeny 1.4, and further visualized by Interactive Tree of Life (iTOL) V5 web server. Results: The whole-genome sequence of K. pneumoniae SM117 is made up of eight contigs totaling 6,104,486 bp, contain a 5,612,620 bp single chromosome and seven plasmids. The isolate was assigned to ST11 with capsular serotype KL25, co-carrying including blaNDM-5, blaKPC-2 and multiple plasmid-borne virulence genes including rmpA2 and aerobactin genes iucABCD-iutA. The coexistence of blaKPC and blaNDM in K. pneumoniae strains exhibit a high degree of resistance to β-lactam antibiotics. The strain SM117 also carries multiple antibiotic resistance genes, making it resistant to all antibiotics except polymyxin. The closest relative of K. pneumoniae C793 was identified in 2023 from a hospital surface sample in Zhejiang, China, with just 52 SNPs difference. Conclusion: This study reported the genomic characteristics of a multidrug-resistant ST11 K. pneumoniae with capsular serotype KL25, co-carrying blaNDM-5, two copies of blaKPC-2 genes and multiple plasmid-borne virulence genes in China. These findings will provide important knowledge of the antibiotic resistance mechanisms, genomic epidemiological characteristics and transmission dynamics of multidrug-resistant K. pneumoniae.
{"title":"Genomic Characteristics of a Carbapenem-Resistant Klebsiella pneumoniae Co-Carrying blaNDM-5 and blaKPC-2 Capsular Type KL25 Recovered from a County Level Hospital in China","authors":"Yuanzhong Fang, Juan Jin, Minfei Peng, Lidong Xu, Linyuan Gu, Danni Bao, Qiuying Zhang, Kainan Jin","doi":"10.2147/idr.s479560","DOIUrl":"https://doi.org/10.2147/idr.s479560","url":null,"abstract":"<strong>Background:</strong> Hypervirulent carbapenem-resistant <em>K. pneumoniae</em> (hv-CRKP) has been spreading rapidly worldwide. Here, we investigated the genomic characteristics of ST11 <em>K. pneumoniae</em> isolate SM117 with capsular serotype KL25, co-carrying <em>bla</em><sub>NDM-5</sub>, two copies of <em>bla</em><sub>KPC-2</sub> and multiple plasmid-borne virulence genes from a county level hospital in China.<br/><strong>Methods:</strong> Antimicrobial susceptibility of <em>K. pneumoniae</em> SM117 was evaluated. The Illumina NovaSeq 6000 and Oxford Nanopore MinION platforms were applied to sequence the genome and then <em>de novo</em> assembled. The genome sequence was annotated using the NCBI Prokaryotic Genome Annotation Pipeline and further subjected to identify the sequence type (ST), capsular type, antibiotic resistance genes, plasmid replicon types and virulence genes. The phylogenetic analysis was performed based on the core genome single nucleotide polymorphisms (cgSNPs) using CSI Phylogeny 1.4, and further visualized by Interactive Tree of Life (iTOL) V5 web server.<br/><strong>Results:</strong> The whole-genome sequence of <em>K. pneumoniae</em> SM117 is made up of eight contigs totaling 6,104,486 bp, contain a 5,612,620 bp single chromosome and seven plasmids. The isolate was assigned to ST11 with capsular serotype KL25, co-carrying including <em>bla</em><sub>NDM-5</sub>, <em>bla</em><sub>KPC-2</sub> and multiple plasmid-borne virulence genes including <em>rmpA2</em> and aerobactin genes <em>iucABCD-iutA</em>. The coexistence of <em>bla</em><sub>KPC</sub> and <em>bla</em><sub>NDM</sub> in <em>K. pneumoniae</em> strains exhibit a high degree of resistance to β-lactam antibiotics. The strain SM117 also carries multiple antibiotic resistance genes, making it resistant to all antibiotics except polymyxin. The closest relative of <em>K. pneumoniae</em> C793 was identified in 2023 from a hospital surface sample in Zhejiang, China, with just 52 SNPs difference.<br/><strong>Conclusion:</strong> This study reported the genomic characteristics of a multidrug-resistant ST11 <em>K. pneumoniae</em> with capsular serotype KL25, co-carrying <em>bla</em><sub>NDM-5</sub>, two copies of <em>bla</em><sub>KPC-2</sub> genes and multiple plasmid-borne virulence genes in China. These findings will provide important knowledge of the antibiotic resistance mechanisms, genomic epidemiological characteristics and transmission dynamics of multidrug-resistant <em>K. pneumoniae</em>.<br/><br/>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142247563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ximiao Yu, Ruiqi Luo, Guijuan Xie, Jiali Ji, Jiehong Wang, Xiyue Li, Xiaojun Qian, Xun Wang
Purpose: This retrospective study aims to compare the effectiveness and safety of four oral antiviral drugs including Simnotrelvir/Ritonavir, Nirmatrelvir/Ritonavir, Azvudine and Molnupiravir in hospitalized patients with Coronavirus Disease 2019 (COVID-19) in a real-world setting, providing evidence to guide clinical practice against COVID-19. Patients and Methods: Patients with mild or moderate COVID-19 hospitalized at Wuxi City’s Second People’s Hospital during December 2022 to June 2023 were included in this study. Patients were grouped by the antiviral drug received. The primary endpoint was the length of hospital stay. Patients were further divided into subgroups for stratified analysis, considering age, timing of medication, and drug mechanisms, to explore whether these factors could influence the treatment efficacy. Results: Of the enrolled 195 patients receiving any treatment, 42 received Nirmatrelvir/Ritonavir, 33 received Molnupiravir, 81 received Simnotrelvir/Ritonavir, and 39 received Azvudine. Patients in Nirmatrelvir/Ritonavir and Simnotrelvir/Ritonavir groups had significantly shorter hospital stays compared to those in Azvudine group (P < 0.05). No significant difference was observed in hospital stays between those initiating antiviral therapy within or more than five days after symptom onset (P = 0.1109). Among patients with comorbidities, the Nirmatrelvir/Ritonavir and Simnotrelvir/Ritonavir group showed shorter hospital stays than the Azvudine group (P < 0.05). No serious treatment-related adverse events were observed across the groups. Conclusion: In this retrospective study, Nirmatrelvir/Ritonavir and Simnotrelvir/Ritonavir exerts stronger potency on reducing duration of hospital stays in hospitalized patient with COVID-19, suggestive of a better choice for antiviral therapy. Patients who fail to take antiviral drugs in time after symptom onset would still benefit from these antiviral regimens. Additional well-designed clinical trials with large sample size are still needed to further confirm the effectiveness of these antivirals.
{"title":"A Real-World Retrospective Study on the Efficacy and Safety of Four Antiviral Drugs for Hospitalized COVID-19 Patients: Nirmatrelvir/Ritonavir, Simnotrelvir/Ritonavir, Molnupiravir and Azvudine","authors":"Ximiao Yu, Ruiqi Luo, Guijuan Xie, Jiali Ji, Jiehong Wang, Xiyue Li, Xiaojun Qian, Xun Wang","doi":"10.2147/idr.s477083","DOIUrl":"https://doi.org/10.2147/idr.s477083","url":null,"abstract":"<strong>Purpose:</strong> This retrospective study aims to compare the effectiveness and safety of four oral antiviral drugs including Simnotrelvir/Ritonavir, Nirmatrelvir/Ritonavir, Azvudine and Molnupiravir in hospitalized patients with Coronavirus Disease 2019 (COVID-19) in a real-world setting, providing evidence to guide clinical practice against COVID-19.<br/><strong>Patients and Methods:</strong> Patients with mild or moderate COVID-19 hospitalized at Wuxi City’s Second People’s Hospital during December 2022 to June 2023 were included in this study. Patients were grouped by the antiviral drug received. The primary endpoint was the length of hospital stay. Patients were further divided into subgroups for stratified analysis, considering age, timing of medication, and drug mechanisms, to explore whether these factors could influence the treatment efficacy.<br/><strong>Results:</strong> Of the enrolled 195 patients receiving any treatment, 42 received Nirmatrelvir/Ritonavir, 33 received Molnupiravir, 81 received Simnotrelvir/Ritonavir, and 39 received Azvudine. Patients in Nirmatrelvir/Ritonavir and Simnotrelvir/Ritonavir groups had significantly shorter hospital stays compared to those in Azvudine group (<em>P</em> < 0.05). No significant difference was observed in hospital stays between those initiating antiviral therapy within or more than five days after symptom onset (<em>P</em> = 0.1109). Among patients with comorbidities, the Nirmatrelvir/Ritonavir and Simnotrelvir/Ritonavir group showed shorter hospital stays than the Azvudine group (<em>P</em> < 0.05). No serious treatment-related adverse events were observed across the groups.<br/><strong>Conclusion:</strong> In this retrospective study, Nirmatrelvir/Ritonavir and Simnotrelvir/Ritonavir exerts stronger potency on reducing duration of hospital stays in hospitalized patient with COVID-19, suggestive of a better choice for antiviral therapy. Patients who fail to take antiviral drugs in time after symptom onset would still benefit from these antiviral regimens. Additional well-designed clinical trials with large sample size are still needed to further confirm the effectiveness of these antivirals.<br/><br/><strong>Keywords:</strong> antivirals, COVID-19, molnupiravir, simnotrelvir/ritonavir, azvudine, nirmatrelvir/ritonavir<br/>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142197129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: We retrospectively review consecutive patients with nontuberculous mycobacterium (NTM) pulmonary disease reported from a designated hospital for infectious diseases in the Fuyang district of China to determine the clinical characteristics of these patients. Methods: This research enrolled 234 patients with NTM pulmonary disease between January 2018 and May 2023 in the Fuyang district of China. Data were collected from the electronic medical records. The NTM strain composition and clinical characteristics of NTM pulmonary disease were retrospectively analyzed. Results: 73 (31.20%) patients had previous tuberculosis (TB) or TB exposure history and bronchiectasis. Mixed NTM infection accounted for 12.39%. Mycobacterium intracellulare strain was detected in 132 patients (49.62%). Women were found to be more affected by Mycobacterium avium infection, and men by Mycobacterium abscessus infection. Mycobacterium avium (34.21%) and Mycobacterium abscessus (33.33%) strains were most common in people with previous TB or TB exposure history. Among respiratory tract-related diseases, patients with bronchiectasis had the highest isolation rate of Mycobacterium avium (55.36%). Women were susceptible to bronchiectasis (P < 0.01). The median of mononuclear-to-lymphocyte ratio (MLR) was higher in men than in women (P < 0.01). The serum albumin (ALB) level was lower in patients with TB or TB exposure history than in those without TB history (P = 0.034). The prognostic nutritional index (PNI) was lower in patients with TB or TB exposure history than in those without tuberculosis history (P = 0.021). Patients with NTM lung disease were poorly treated. Conclusion: Clinical symptoms of the disease were not species-specific. Mycobacterium intracellulare and Mycobacterium avium strains were predominant in the Fuyang district of China. Previous TB or TB exposure history immensely enhanced the risk of NTM disease.
{"title":"Clinical Characteristics of Patients with Nontuberculous Mycobacterium Pulmonary Disease in Fuyang, China: A Retrospective Study","authors":"Xiaowu Wang, Tuantuan Li, Yan Liu, Yilang Zhu, Lichang Chen, Yong Gao","doi":"10.2147/idr.s475652","DOIUrl":"https://doi.org/10.2147/idr.s475652","url":null,"abstract":"<strong>Objective:</strong> We retrospectively review consecutive patients with nontuberculous mycobacterium (NTM) pulmonary disease reported from a designated hospital for infectious diseases in the Fuyang district of China to determine the clinical characteristics of these patients.<br/><strong>Methods:</strong> This research enrolled 234 patients with NTM pulmonary disease between January 2018 and May 2023 in the Fuyang district of China. Data were collected from the electronic medical records. The NTM strain composition and clinical characteristics of NTM pulmonary disease were retrospectively analyzed.<br/><strong>Results:</strong> 73 (31.20%) patients had previous tuberculosis (TB) or TB exposure history and bronchiectasis. Mixed NTM infection accounted for 12.39%. <em>Mycobacterium intracellulare</em> strain was detected in 132 patients (49.62%). Women were found to be more affected by <em>Mycobacterium avium</em> infection, and men by <em>Mycobacterium abscessus</em> infection. <em>Mycobacterium avium</em> (34.21%) and <em>Mycobacterium abscessus</em> (33.33%) strains were most common in people with previous TB or TB exposure history. Among respiratory tract-related diseases, patients with bronchiectasis had the highest isolation rate of <em>Mycobacterium avium</em> (55.36%). Women were susceptible to bronchiectasis (<em>P</em> < 0.01). The median of mononuclear-to-lymphocyte ratio (MLR) was higher in men than in women (P < 0.01). The serum albumin (ALB) level was lower in patients with TB or TB exposure history than in those without TB history (<em>P</em> = 0.034). The prognostic nutritional index (PNI) was lower in patients with TB or TB exposure history than in those without tuberculosis history (<em>P</em> = 0.021). Patients with NTM lung disease were poorly treated.<br/><strong>Conclusion:</strong> Clinical symptoms of the disease were not species-specific. <em>Mycobacterium intracellulare</em> and <em>Mycobacterium avium</em> strains were predominant in the Fuyang district of China. Previous TB or TB exposure history immensely enhanced the risk of NTM disease.<br/><br/><strong>Keywords:</strong> NTM, clinical symptoms, tuberculosis exposure history, bronchiectasis<br/>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142247846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract: Mupirocin, an antibiotic produced by Pseudomonas fluorescens, is mainly used for the topical treatment of various skin and soft tissue infections caused by Staphylococcus (including methicillin-resistant Staphylococcus aureus) and Streptococcus around the world for decades. Nevertheless, the clinical application scope of mupirocin varies in different countries due to differences in their medical policies, prescription types, and drug resistance. According to the experience of Chinese doctors in the past few years, mupirocin presented low drug resistance rates, and could be used as a treatment option for various primary infections and secondary infections, with antibacterial effects in a broad application. In this review, we summarized the experience of mupirocin used in the Chinese population and discussed its clinical value to provide novel insights and inspiration for physicians.
{"title":"Mupirocin for Skin Infection: Clinical Experience from China","authors":"Jing Sun, Tracy Lu, Yan Dang, Zigang Xu, Ying Liu","doi":"10.2147/idr.s475611","DOIUrl":"https://doi.org/10.2147/idr.s475611","url":null,"abstract":"<strong>Abstract:</strong> Mupirocin, an antibiotic produced by <em>Pseudomonas fluorescens</em>, is mainly used for the topical treatment of various skin and soft tissue infections caused by <em>Staphylococcus</em> (including methicillin-resistant <em>Staphylococcus aureus</em>) and <em>Streptococcus</em> around the world for decades. Nevertheless, the clinical application scope of mupirocin varies in different countries due to differences in their medical policies, prescription types, and drug resistance. According to the experience of Chinese doctors in the past few years, mupirocin presented low drug resistance rates, and could be used as a treatment option for various primary infections and secondary infections, with antibacterial effects in a broad application. In this review, we summarized the experience of mupirocin used in the Chinese population and discussed its clinical value to provide novel insights and inspiration for physicians.<br/><br/><strong>Keywords:</strong> experience, mupirocin, skin diseases, infectious<br/>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142225169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: Understanding the horizontal transfer of resistance genes, such as blaNDM-5, is pivotal in developing strategies to control the spread of resistance. In this study, we isolated two bacterial strains, Escherichia coli (designated GYB01) and Klebsiella pneumoniae (designated GYB02), from a single patient. The aim of our research is to explore the biological characteristics of these strains and to investigate the interspecies horizontal transfer of blaNDM-5. Materials and Methods: Strain identification and antimicrobial susceptibility testing were conducted using the Vitek 2 system. Both GYB01 and GYB02 were sequenced with the Illumina HiSeq platform. Bioinformatics analysis tools, including multilocus sequence typing, PlasmidFinder, ResFinder, and others, were utilized to analyze the strains. Additionally, conjugation assays and Galleria mellonella infection assays were employed to assess the strains. Results: The isolates exhibited similar antimicrobial resistance profiles and both harbored the blaNDM-5 gene within the IncFIA plasmids (pGYB01-2, 165.8 kb and pGYB02-2, 211.6 kb, respectively). These plasmids (pGYB01-2 and pGYB02-2) shared over 99% homology, suggesting a common ancestral origin. Conjugation experiments confirmed the transferability of the blaNDM-5 carrying IncFIA plasmids among Enterobacteriaceae. GYB02 possessed an iucACD-iutA gene cluster, exhibited high virulence, and tested positive in the string test. Conclusion: Our findings provide direct evidence of potential in vivo interspecies transfer of a multidrug-resistant plasmid, thus enriching our understanding of the mechanisms driving multidrug resistance (MDR) and aiding in the formulation of containment and treatment strategies.
Keywords: CRE, NDM-5 carbapenemase, IncFIA plasmid, interspecies horizontal transfer
{"title":"Dissemination of blaNDM-5 Driven by Horizontal Transfer of IncFIA Plasmid Between Escherichia coli and Klebsiella pneumoniae Co-Isolated from a Patient’s Ascitic Fluid","authors":"Jing Yu, Yanzi Ding, Xue Zhang, Shuhong Tai, Chengwen Zhang, Cailin Liu, Enwu Yuan, Yitao Duan","doi":"10.2147/idr.s478304","DOIUrl":"https://doi.org/10.2147/idr.s478304","url":null,"abstract":"<strong>Purpose:</strong> Understanding the horizontal transfer of resistance genes, such as <em>bla</em><sub>NDM-5</sub>, is pivotal in developing strategies to control the spread of resistance. In this study, we isolated two bacterial strains, <em>Escherichia coli</em> (designated GYB01) and <em>Klebsiella pneumoniae</em> (designated GYB02), from a single patient. The aim of our research is to explore the biological characteristics of these strains and to investigate the interspecies horizontal transfer of <em>bla</em><sub>NDM-5</sub>.<br/><strong>Materials and Methods:</strong> Strain identification and antimicrobial susceptibility testing were conducted using the Vitek 2 system. Both GYB01 and GYB02 were sequenced with the Illumina HiSeq platform. Bioinformatics analysis tools, including multilocus sequence typing, PlasmidFinder, ResFinder, and others, were utilized to analyze the strains. Additionally, conjugation assays and <em>Galleria mellonella</em> infection assays were employed to assess the strains.<br/><strong>Results:</strong> The isolates exhibited similar antimicrobial resistance profiles and both harbored the <em>bla</em><sub>NDM-5</sub> gene within the IncFIA plasmids (pGYB01-2, 165.8 kb and pGYB02-2, 211.6 kb, respectively). These plasmids (pGYB01-2 and pGYB02-2) shared over 99% homology, suggesting a common ancestral origin. Conjugation experiments confirmed the transferability of the <em>bla</em><sub>NDM-5</sub> carrying IncFIA plasmids among <em>Enterobacteriaceae</em>. GYB02 possessed an <em>iucACD-iutA</em> gene cluster, exhibited high virulence, and tested positive in the string test.<br/><strong>Conclusion:</strong> Our findings provide direct evidence of potential in vivo interspecies transfer of a multidrug-resistant plasmid, thus enriching our understanding of the mechanisms driving multidrug resistance (MDR) and aiding in the formulation of containment and treatment strategies.<br/><br/><strong>Keywords:</strong> CRE, NDM-5 carbapenemase, IncFIA plasmid, interspecies horizontal transfer<br/>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142197130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Pregnant women exhibit COVID-19 vaccine hesitancy due to concerns regarding potential risks to their babies, doubts about vaccine efficacy, and limited access to information. Therefore, this study aims to estimate COVID-19 vaccine uptake and factors associated with pregnant women in Mogadishu, Somalia. Methods: A cross-sectional study was conducted on pregnant women using a questionnaire covering socio-demographic information, pregnancy-related characteristics, perceptions about the COVID-19 vaccine, and vaccination status. Univariable and multivariable logistic regression analyses were utilized to identify factors associated with the outcome variable. Results: Among the 400 pregnant women who participated in this study, 26.8% had received a COVID-19 vaccine dose, with only 14.9% receiving it during pregnancy. Reasons for not receiving the vaccine included a lack of information about the vaccine (47.4%), concerns about its adverse effects on personal health (33.8%), misconceptions regarding impacts on fertility or menstrual cycles (14.3%), belief in the vaccine’s inefficacy (3.4%), and fears about adverse effects on their fetus. In multivariable logistic regression, pregnant women with a history of chronic diseases (AOR=3.27, 95% CI=1.992– 6.145), those who perceived themselves at risk of contracting COVID-19 (AOR=3.81, 95% CI=2.11– 5.10), those who believed that the vaccine was accessible to them (AOR=4.34, 95% CI=2.915– 6.165), and those who discussed the COVID-19 vaccine with their healthcare provider (AOR=3.91, 95% CI=2.123– 7.878) were more likely to receive the COVID-19 vaccine compared to their counterparts. Conclusion: Pregnant women in Mogadishu, Somalia, face challenges with sub-optimal covid-19 vaccine uptake. Implementations should improve awareness of COVID-19 risks and facilitate discussions between healthcare providers and pregnant women. In addition, efforts to provide reliable information about the vaccine, alleviate concerns about its adverse effects, and dispel misconceptions about fertility, menstrual cycles, efficacy, and foetal impact are crucial.
{"title":"COVID-19 Vaccine Uptake and Factors Associated Among Pregnant Women in Mogadishu, Somalia","authors":"Najib Isse Dirie, Maryan Abdullahi Sh Nur, Abdirahman Khalif Mohamud, Bashiru Garba, Hassan Abdullahi Dahie, Mohamed Hussein Adam, Jamal Hassan Mohamoud","doi":"10.2147/idr.s471674","DOIUrl":"https://doi.org/10.2147/idr.s471674","url":null,"abstract":"<strong>Background:</strong> Pregnant women exhibit COVID-19 vaccine hesitancy due to concerns regarding potential risks to their babies, doubts about vaccine efficacy, and limited access to information. Therefore, this study aims to estimate COVID-19 vaccine uptake and factors associated with pregnant women in Mogadishu, Somalia.<br/><strong>Methods:</strong> A cross-sectional study was conducted on pregnant women using a questionnaire covering socio-demographic information, pregnancy-related characteristics, perceptions about the COVID-19 vaccine, and vaccination status. Univariable and multivariable logistic regression analyses were utilized to identify factors associated with the outcome variable.<br/><strong>Results:</strong> Among the 400 pregnant women who participated in this study, 26.8% had received a COVID-19 vaccine dose, with only 14.9% receiving it during pregnancy. Reasons for not receiving the vaccine included a lack of information about the vaccine (47.4%), concerns about its adverse effects on personal health (33.8%), misconceptions regarding impacts on fertility or menstrual cycles (14.3%), belief in the vaccine’s inefficacy (3.4%), and fears about adverse effects on their fetus. In multivariable logistic regression, pregnant women with a history of chronic diseases (AOR=3.27, 95% CI=1.992– 6.145), those who perceived themselves at risk of contracting COVID-19 (AOR=3.81, 95% CI=2.11– 5.10), those who believed that the vaccine was accessible to them (AOR=4.34, 95% CI=2.915– 6.165), and those who discussed the COVID-19 vaccine with their healthcare provider (AOR=3.91, 95% CI=2.123– 7.878) were more likely to receive the COVID-19 vaccine compared to their counterparts.<br/><strong>Conclusion:</strong> Pregnant women in Mogadishu, Somalia, face challenges with sub-optimal covid-19 vaccine uptake. Implementations should improve awareness of COVID-19 risks and facilitate discussions between healthcare providers and pregnant women. In addition, efforts to provide reliable information about the vaccine, alleviate concerns about its adverse effects, and dispel misconceptions about fertility, menstrual cycles, efficacy, and foetal impact are crucial.<br/><br/>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142197132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohammad Khaja Mafij Uddin, Ashabul Islam, Maha Sultana Jabin, Tahmina Alam, Salwa Khair, Jannatul Ferdous, Rumana Nasrin, S M Mazidur Rahman, Stephane Pouzol, Jonathan Hoffmann, Sayera Banu
Background: Around one-quarter of the global population has latent tuberculosis infection (LTBI). If left untreated, LTBI has 5– 10% lifetime risk of developing into TB. Interferon-gamma release Assays (IGRAs) are more sensitive than the tuberculin skin test for LTBI detection. However, the high cost and complexity of IGRAs are barriers to adoption in resource-constrained settings. This study evaluated the diagnostic performance of a more affordable IGRA, Standard E TB-Feron (TBE), among different risk groups in Bangladesh. Methods: 532 participants of all age groups were enrolled from the TB Screening and Treatment Centers and Dhaka Hospital of icddr,b between June and September 2023. The participants were categorized into four risk groups: healthy people, healthcare workers/ attendants of TB patients, patients with microbiologically confirmed TB, and people with a history of TB. The diagnostic performance of TBE was compared to QuantiFERON-TB Gold Plus (QFT-Plus) for all groups. GeneXpert, culture, and microscopy were used to confirm TB microbiologically. Results: TBE had an overall agreement of 85.9% (95% CI, 82.5% to 88.7%), positive percent agreement of 86.1% (95% CI, 80.6% to 90.5%), and negative percent agreement of 85.7% (95% CI, 81.3% − 89.4%) with QFT-Plus. Among 81 culture-positive patients, TBE and QFT-Plus were positive for 60 (74.1%) and 62 (76.5%) respectively. Among healthy people, TBE and QFT results were positive for 49 (24.5%) and 59 (29.5%) respectively. Among health workers and contacts, TBE and QFT-Plus were positive for 79 (39.5%) and 73 (35.5%) respectively. Conclusion: We found a substantial agreement (Cohen’s kappa of 0.71) between TBE and QFT-Plus in detecting LTBI across different groups, suggesting its potential as a cost-effective diagnostic tool. Implementation of TBE in routine clinical practice could increase accessibility to LTBI diagnosis, facilitating the timely initiation of preventative therapy, and leading to a reduction of active TB incidence.
{"title":"Comparative Evaluation of Diagnostic Performance: Standard E TB Feron ELISA vs QuantiFERON-TB Gold Plus for Latent Tuberculosis Infection Detection in Diverse Risk Groups in Bangladesh","authors":"Mohammad Khaja Mafij Uddin, Ashabul Islam, Maha Sultana Jabin, Tahmina Alam, Salwa Khair, Jannatul Ferdous, Rumana Nasrin, S M Mazidur Rahman, Stephane Pouzol, Jonathan Hoffmann, Sayera Banu","doi":"10.2147/idr.s475424","DOIUrl":"https://doi.org/10.2147/idr.s475424","url":null,"abstract":"<strong>Background:</strong> Around one-quarter of the global population has latent tuberculosis infection (LTBI). If left untreated, LTBI has 5– 10% lifetime risk of developing into TB. Interferon-gamma release Assays (IGRAs) are more sensitive than the tuberculin skin test for LTBI detection. However, the high cost and complexity of IGRAs are barriers to adoption in resource-constrained settings. This study evaluated the diagnostic performance of a more affordable IGRA, Standard E TB-Feron (TBE), among different risk groups in Bangladesh.<br/><strong>Methods:</strong> 532 participants of all age groups were enrolled from the TB Screening and Treatment Centers and Dhaka Hospital of icddr,b between June and September 2023. The participants were categorized into four risk groups: healthy people, healthcare workers/ attendants of TB patients, patients with microbiologically confirmed TB, and people with a history of TB. The diagnostic performance of TBE was compared to QuantiFERON-TB Gold Plus (QFT-Plus) for all groups. GeneXpert, culture, and microscopy were used to confirm TB microbiologically.<br/><strong>Results:</strong> TBE had an overall agreement of 85.9% (95% CI, 82.5% to 88.7%), positive percent agreement of 86.1% (95% CI, 80.6% to 90.5%), and negative percent agreement of 85.7% (95% CI, 81.3% − 89.4%) with QFT-Plus. Among 81 culture-positive patients, TBE and QFT-Plus were positive for 60 (74.1%) and 62 (76.5%) respectively. Among healthy people, TBE and QFT results were positive for 49 (24.5%) and 59 (29.5%) respectively. Among health workers and contacts, TBE and QFT-Plus were positive for 79 (39.5%) and 73 (35.5%) respectively.<br/><strong>Conclusion:</strong> We found a substantial agreement (Cohen’s kappa of 0.71) between TBE and QFT-Plus in detecting LTBI across different groups, suggesting its potential as a cost-effective diagnostic tool. Implementation of TBE in routine clinical practice could increase accessibility to LTBI diagnosis, facilitating the timely initiation of preventative therapy, and leading to a reduction of active TB incidence.<br/><br/>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142197131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xue Yang, Man Wu, Tangzhiming Li, Jie Yu, Tian Fu, Guoping Li, Huanwen Xiong, Gang Liao, Sensen Zhang, Shaofeng Li, Zhonghua Zeng, Chun Chen, Benhui Liang, Zhiguo Zhou, Ming Lu
Introduction: C. psittaci pneumonia has atypical clinical manifestations and is often ignored by clinicians. This study analyzed the clinical characteristics, explored the risk factors for composite outcome and established a prediction model for early prediction of composite outcome among C. psittaci pneumonia patients. Methods: A multicenter, retrospective, observational cohort study was conducted in ten Chinese tertiary hospitals. Patients diagnosed with C. psittaci pneumonia were included, and their clinical data were collected and analyzed. The composite outcome of C. psittaci pneumonia included death during hospitalization, ICU admission, and mechanical ventilation. Univariate and multivariable logistic regression analyses were conducted to determine the significant variables. A ten-fold cross-validation was performed to internally validate the model. The model performance was evaluated using various methods, including receiver operating characteristics (ROC), C-index, sensitivity, specificity, positive/negative predictive value (PPV/NPV), decision curve analysis (DCA), and clinical impact curve analysis (CICA). Results: In total, 83 patients comprised training cohorts and 36 patients comprised validation cohorts. CURB-65 was used to establish predictive Model 1. Multivariate logistic regression analysis identified three independent prognostic factors, including serum albumin, CURB-65, and white blood cells. These factors were employed to construct model 2. Model 2 had acceptable discrimination (AUC of 0.898 and 0.825 for the training and validation sets, respectively) and robust internal validity. The specificity, sensitivity, NPV, and PPV for predicting composite outcome in the nomogram model were 91.7%, 84.5%, 50.0%, and 98.4% in the training sets, and 100.0%, 64.7%, 14.2%, and 100.0% in the validation sets. DCA and CICA showed that the nomogram model was clinically practical. Conclusion: This study constructs a refined nomogram model for predicting the composite outcome in C. psittaci pneumonia patients. This nomogram model enables early and accurate C. psittaci pneumonia patients’ evaluation, which may improve clinical outcomes.
{"title":"Clinical Features and a Prediction Model for Early Prediction of Composite Outcome in Chlamydia psittaci Pneumonia: A Multi-Centre Retrospective Study in China","authors":"Xue Yang, Man Wu, Tangzhiming Li, Jie Yu, Tian Fu, Guoping Li, Huanwen Xiong, Gang Liao, Sensen Zhang, Shaofeng Li, Zhonghua Zeng, Chun Chen, Benhui Liang, Zhiguo Zhou, Ming Lu","doi":"10.2147/idr.s431543","DOIUrl":"https://doi.org/10.2147/idr.s431543","url":null,"abstract":"<strong>Introduction:</strong> C. psittaci pneumonia has atypical clinical manifestations and is often ignored by clinicians. This study analyzed the clinical characteristics, explored the risk factors for composite outcome and established a prediction model for early predictio<u>n</u> of composite outcome among C. psittaci pneumonia patients.<br/><strong>Methods:</strong> A multicenter, retrospective, observational cohort study was conducted in ten Chinese tertiary hospitals. Patients diagnosed with C. psittaci pneumonia were included, and their clinical data were collected and analyzed. The composite outcome of C. psittaci pneumonia included death during hospitalization, ICU admission, and mechanical ventilation. Univariate and multivariable logistic regression analyses were conducted to determine the significant variables. A ten-fold cross-validation was performed to internally validate the model. The model performance was evaluated using various methods, including receiver operating characteristics (ROC), C-index, sensitivity, specificity, positive/negative predictive value (PPV/NPV), decision curve analysis (DCA), and clinical impact curve analysis (CICA).<br/><strong>Results:</strong> In total, 83 patients comprised training cohorts and 36 patients comprised validation cohorts. CURB-65 was used to establish predictive Model 1. Multivariate logistic regression analysis identified three independent prognostic factors, including serum albumin, CURB-65, and white blood cells. These factors were employed to construct model 2. Model 2 had acceptable discrimination (AUC of 0.898 and 0.825 for the training and validation sets, respectively) and robust internal validity. The specificity, sensitivity, NPV, and PPV for predicting composite outcome in the nomogram model were 91.7%, 84.5%, 50.0%, and 98.4% in the training sets, and 100.0%, 64.7%, 14.2%, and 100.0% in the validation sets. DCA and CICA showed that the nomogram model was clinically practical.<br/><strong>Conclusion:</strong> This study constructs a refined nomogram model for predicting the composite outcome in C. psittaci pneumonia patients. This nomogram model enables early and accurate C. psittaci pneumonia patients’ evaluation, which may improve clinical outcomes.<br/><br/><strong>Keywords:</strong> <em>Chlamydia psittaci</em> pneumonia, nomogram, prediction model, composite outcome<br/>","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142197156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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