Journal of global antimicrobial resistance最新文献

{"title":"Ceftolozane/tazobactam in action: Prescribing patterns, effectiveness, and healthcare utilisation across seven countries","authors":"Emre Yucel ,&nbsp;Alex Soriano ,&nbsp;David L. Paterson ,&nbsp;Florian Thalhalmmer ,&nbsp;Stefan Kluge ,&nbsp;Pierluigi Viale ,&nbsp;Mike Allen ,&nbsp;Brune Akrich ,&nbsp;Jessica Levy ,&nbsp;Huina Yang ,&nbsp;Sunny Kaul","doi":"10.1016/j.jgar.2025.10.013","DOIUrl":"10.1016/j.jgar.2025.10.013","url":null,"abstract":"<div><h3>Objectives</h3><div>Infections by antimicrobial-resistant, Gram-negative bacteria present significant global challenge, resulting in difficult treatment scenarios and poor clinical outcomes. Although ceftolozane/tazobactam (C/T) has been approved for the treatment of hospital-acquired HABP/VABP, cUTI, and cIAI, data on real-world use remains limited. This study presents real-world use of C/T across various countries.</div></div><div><h3>Methods</h3><div>The Study of Prescribing patterns and Effectiveness of Ceftolozane/Tazobactam: Real-world Analysis (SPECTRA) was a retrospective, observational study involving 617 adult inpatients across seven countries who were treated with C/T for at least 48 hours between 2016 and 2020. The primary objective was to describe real-world utilisation of C/T, focusing on sociodemographic and clinical characteristics, treatment patterns, clinical outcomes, and resource utilisation.</div></div><div><h3>Results</h3><div>617 patients from seven countries were included. Prevalence of at least one comorbidity ranged from 55.9% (Mexico) to 91.7% (Austria), with mean number of comorbidities from 1.0 (Mexico) to 2.7 (UK). Culture results from 72.7% patients identified MDR <em>Pseudomonas aeruginosa</em>, ranging from 55.9% (Italy) to 80.6% (Spain). Median hospital length of stay ranged from 23 (Mexico) to 53.5 (Austria) days. Clinical success rate for treating the index infection with C/T was 64.8%, with 51.1% of cases treated within the ICU.</div></div><div><h3>Conclusions</h3><div>This multi-national, retrospective, observational study demonstrates the real-world use and healthcare resource utilisation (HCRU) of C/T in patients with Gram-negative infections across seven countries. These findings provide valuable insights into prescribing patterns and resource implications of C/T treatment, underscoring the importance of real-world data to inform clinical practice and optimise antimicrobial therapy in diverse healthcare settings.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"46 ","pages":"Pages 14-21"},"PeriodicalIF":3.2,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145623450","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}

{"title":"Rapid clonal replacement by ST773 with NDM-1 among carbapenem-resistant Pseudomonas aeruginosa in South Korea","authors":"Yonggeun Cho ,&nbsp;Kyung-Wook Hong ,&nbsp;Min-Kyoung Shin ,&nbsp;Sunjoo Kim ,&nbsp;Jung-Hyun Byun","doi":"10.1016/j.jgar.2025.10.010","DOIUrl":"10.1016/j.jgar.2025.10.010","url":null,"abstract":"","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"45 ","pages":"Pages 287-289"},"PeriodicalIF":3.2,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145370278","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}

{"title":"Elucidating artemisinin (ART)-heme as a biomarker for ART resistance and ATP-dependent transport of ART in Plasmodium falciparum","authors":"Hui Liu ,&nbsp;Hongchang Zhou ,&nbsp;Yuan Cai ,&nbsp;Shanshan Du ,&nbsp;Zhenghui Huang ,&nbsp;Kun Xu ,&nbsp;Jie Xing","doi":"10.1016/j.jgar.2025.10.017","DOIUrl":"10.1016/j.jgar.2025.10.017","url":null,"abstract":"<div><h3>Objectives</h3><div>Artemisinin (ART) resistance is widespread in Southeast Asia and emerging in Africa. In this study, the potential biomarker for ART resistance was first characterised in <em>P. falciparum</em>, and the roles of several molecular pathways (e.g., Hb endocytosis) in ART resistance were then evaluated.</div></div><div><h3>Methods</h3><div>The metabolic profiles of ART and its pharmacokinetics were studied in <em>Plasmodium falciparum (P. falciparum)</em> incubated <em>in vitro.</em> Several strains of <em>P. falciparum</em> (ART-sensitive strains <em>Pf</em>3D7/<em>Pf</em>Dd2, and ART-resistance strain <em>Pf</em>6320 carrying K13 mutation C580Y) synchronised at different stages (ring and trophozoite) were used. The antimalarial activity of ART-heme adduct was evaluated. Several molecular pathways (i.e., Hb endocytosis) were evaluated for their roles in ART resistance using (non)selective inhibitors.</div></div><div><h3>Results</h3><div>ART-heme adduct was identified as a major metabolite for ART in <em>P. falciparum</em>, and it exhibited weak antimalarial activity (µM level). In ART-sensitive parasites, the formation of ART-heme was rapid, and both time- and concentration-dependent (50–450 nM). In contrast, ART-heme formation in ART-resistant parasites was independent of ART concentration. ART-heme formation was susceptible to orthovanadate (an inhibitor of P-type ATPase). Hb endocytosis/degradation, SERCA and the efflux transporter played roles in ART-heme formation to some extent. Synergistic antiplasmodial effect existed between ART and verapamil (an inhibitor of the efflux transporter).</div></div><div><h3>Conclusions</h3><div>ART-heme adduct displayed weak antiplasmodial activity but may still serve as a biomarker for both the antiplasmodial efficacy of ART and its resistance. ART transport in <em>P. falciparum</em> was ATP-dependent, and inhibition of efflux transporter may be a strategy to enhance ART potency.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"45 ","pages":"Pages 260-267"},"PeriodicalIF":3.2,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145370315","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}

{"title":"Efficacy and safety of novel β-lactam/β-lactamase inhibitor combinations for the treatment of complicated urinary tract infections or acute pyelonephritis: A systematic review and meta-analysis","authors":"Sirui Tang ,&nbsp;Yuxuan Song ,&nbsp;Caipeng Qin ,&nbsp;Tao Xu","doi":"10.1016/j.jgar.2025.10.011","DOIUrl":"10.1016/j.jgar.2025.10.011","url":null,"abstract":"<div><h3>Objectives</h3><div>The increasing resistance of gram-negative bacteria in complicated urinary tract infections (cUTI) and acute pyelonephritis (APN) poses major treatment challenges. This study aimed to evaluated the efficacy and safety of novel β-Lactam/β-Lactamase inhibitor combinations compared with conventional antibiotics.</div></div><div><h3>Methods</h3><div>We systematically searched PubMed, Embase, Cochrane Library, Web of Science, ClinicalTrials.gov, and FDA.gov for randomized controlled trials (RCTs) published up to July 15, 2025. Eligible studied included patients with cUTI or APN. Primary outcomes were clinical and microbiological response rates at the test-of-cure (TOC) or the end-of-treatment visit. Secondary outcomes included adverse events (AEs), serious AEs (SAEs), and treatment discontinuations due to AEs. Risk of bias was assessed using the Cochran tool.</div></div><div><h3>Results</h3><div>Eleven RCTs with a total of 4986 patients (2719 in the experimental group and 2267 in the control group) were included. Novel β-Lactam/β-Lactamase inhibitors significantly improved clinical response in the microbiological modified intent-to-treat population (OR = 1.64, 95% CI [1.43–1.88], <em>P</em> &lt; 0.001). The incidence of overall AEs and SAEs was similar between groups, though drug-related AEs were more common in the experimental group (OR = 1.38, 95% CI [1.11–1.72], <em>P</em> = 0.003).</div></div><div><h3>Conclusions</h3><div>Novel β-Lactam/β-Lactamase inhibitor combinations demonstrated superior efficacy and comparable safety to conventional antibiotics in treating cUTI and APN, particularly at the TOC stage.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"45 ","pages":"Pages 268-281"},"PeriodicalIF":3.2,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145368125","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}

{"title":"Antimicrobial susceptibility patterns and genotypic characteristics of Mycobacterium marinum and Mycobacterium abscessus isolated from cutaneous infections: A retrospective study","authors":"Jiayi Peng ,&nbsp;Wenyue Zhang ,&nbsp;Ying Shi ,&nbsp;Haiqin Jiang ,&nbsp;Jingshu Xiong ,&nbsp;Youming Mei ,&nbsp;Tian Gan ,&nbsp;Hongsheng Wang","doi":"10.1016/j.jgar.2025.10.001","DOIUrl":"10.1016/j.jgar.2025.10.001","url":null,"abstract":"<div><h3>Objectives</h3><div>Antimicrobial susceptibility data for cutaneous mycobacteria remain limited. This study investigated the antimicrobial susceptibility patterns and molecular resistance mechanisms of <em>Mycobacterium marinum</em> and <em>Mycobacterium abscessus</em> isolates from a dermatology specialized hospital in China.</div></div><div><h3>Methods</h3><div>Antimicrobial susceptibility testing was performed on 200 <em>M. marinum</em> and 50 <em>M. abscessus</em> clinical isolates using broth microdilution method. <em>M. abscessus</em> subspecies were identified through <em>hsp65, erm (41),</em> and <em>rpoB</em> gene sequencing. For <em>M. abscessus</em> isolates, resistance-associated mutations for clarithromycin, amikacin, and fluoroquinolones were analysed by sequencing <em>erm (41), rrl, rrs, gyrA, and gyrB</em> genes.</div></div><div><h3>Results</h3><div><em>M. marinum</em> demonstrated high susceptibility (82.5%–100%) to clarithromycin, rifampin, rifabutin, moxifloxacin, linezolid, trimethoprim-sulfamethoxazole, with moderate susceptibility to tetracyclines and ciprofloxacin. Ethambutol showed favourable activity against <em>M. marinum</em> with MIC₉₀ of 2 µg/mL. Among <em>M. abscessus</em> isolates (23 <em>M. abscessus subsp. abscessus</em>, 26 <em>M. abscessus subsp. massiliense</em>, 1 <em>M. abscessus subsp. bolletii</em>), overall susceptibility to clarithromycin and amikacin was 78% and 82%, respectively. Tigecycline and clofazimine were effective against <em>M. abscessus</em> with MIC₉₀ 1 and 0.5 µg/mL, respectively. In contrast, <em>M. abscessus</em> isolates demonstrated high-level of resistance to multiple antibiotics, including linezolid, fluoroquinolones, and tetracyclines. <em>M. abscessus subsp. massiliense</em> exhibited higher clarithromycin susceptibility (100%) compared to <em>M. abscessus subsp. abscessus</em> (56.5%). Clarithromycin resistance of <em>M. abscessus</em> isolates correlated with functional T28 sequevar in the <em>erm (41)</em> gene.</div></div><div><h3>Conclusions</h3><div>Our findings elucidate distinct antimicrobial susceptibility profiles of <em>M. marinum</em> and <em>M. abscessus</em> isolated from cutaneous infection in China, providing critical guidance for clinical treatment. Cutaneous <em>M. abscessus</em> isolates exhibit extensive drug resistance patterns. Subtyping and <em>erm (41)</em> polymorphism detection serve as reliable predictors of clarithromycin resistance in <em>M. abscessus</em>.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"45 ","pages":"Pages 240-247"},"PeriodicalIF":3.2,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145368143","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}

{"title":"blaNDM-5 is the predominant variant of blaNDM gene in Klebsiella species detected in Mississippi, USA","authors":"Srimadhav Nallani ,&nbsp;Saihou Ceesay ,&nbsp;Abiye Iyo,&nbsp;Lucersia Nichols,&nbsp;Daphne Ware,&nbsp;Beata Karolewicz","doi":"10.1016/j.jgar.2025.10.014","DOIUrl":"10.1016/j.jgar.2025.10.014","url":null,"abstract":"<div><h3>Objectives</h3><div>The Mississippi Public Health Laboratory conducts active surveillance of carbapenem-resistant <em>Enterobacterales</em> (CRE) infections as part of the Antimicrobial Resistance Laboratory Network (ARLN) program implemented by the United States Centers for Disease Control and Prevention (CDC). Here, we describe the prevalence of New Delhi Metallo-β-lactamase (<em>bla</em>_NDM) genes in <em>Klebsiella</em>, a major pathogen of the <em>Enterobacterales</em> order linked to nosocomial infections, between January 2022 and June 2025.</div></div><div><h3>Methods</h3><div>Carbapenemase activity was confirmed using the Modified Carbapenem Inactivation Method (mCIM). PCR was then performed on carbapenemase-positive isolates to detect <em>bla</em>_NDM genes. Whole-genome sequencing (WGS) was performed on 35 <em>bla</em>_NDM-positive isolates to identify <em>bla</em>_NDM gene variants, other antimicrobial resistance (AMR) determinants, virulence factors, and plasmids. Antibiotic susceptibility testing (AST) was determined by the Kirby-Bauer disk diffusion assay.</div></div><div><h3>Results</h3><div>Among the 35 NDM-positive <em>Klebsiella</em> species, the <em>bla</em>_NDM-5 variant was identified in 23 (65.7%) isolates, followed by <em>bla</em>_NDM-1 and <em>bla</em>_NDM-7 genes which were identified in 6/35 (17%) and 6/35 (17%) cases, respectively. A significant proportion of <em>bla</em>_NDM-5 cases also harbored additional β-lactamase genes such as <em>bla</em>_SHV family (18/23; 78%) and <em>bla</em>_TEM-1 (9/23; 39%) indicating multi-drug resistance. All 23 <em>bla</em>_NDM-5-positive isolates were resistant to carbapenems and broad-spectrum cephalosporins, but 13/23 (56.5%) remained susceptible to aztreonam. PlasmidFinder analysis identified IncX3 (20/23) and IncFIB(K) (19/23) as the predominant plasmid replicons among these isolates.</div></div><div><h3>Conclusion</h3><div>The emergence and spread of bacteria carrying <em>bla</em>_NDM-5 gene poses a significant threat to public health in Mississippi. Our dataset warrants further study to investigate the potential role of plasmids in <em>bla</em>_NDM-5 dissemination.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"45 ","pages":"Pages 282-286"},"PeriodicalIF":3.2,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145354938","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}

{"title":"A reappraisal of carbapenems dosing in febrile neutropenic patients","authors":"Sun-Ting Qin ,&nbsp;Meng-Yu Kong ,&nbsp;Rui-Yun Ling ,&nbsp;Jing Fu ,&nbsp;Yao-Jie Chen ,&nbsp;Yu-Han Zeng ,&nbsp;Dan-Na Jiang ,&nbsp;Xiu-Hua Zhang ,&nbsp;Xu-Ben Yu ,&nbsp;Hai-Na Zhang","doi":"10.1016/j.jgar.2025.10.006","DOIUrl":"10.1016/j.jgar.2025.10.006","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to optimize carbapenem dosing strategies in febrile neutropenic (FN) patients by evaluating the probability of pharmacokinetic/pharmacodynamic (PK/PD) target attainment (PTA) using Monte Carlo simulations based on published population PK (PopPK) models and real-world covariate data.</div></div><div><h3>Methods</h3><div>A systematic review of published PopPK studies on carbapenems in FN patients was conducted to obtain relevant PK parameters. In parallel, retrospective clinical data from FN patients treated at the First Affiliated Hospital of Wenzhou Medical University between January 2022 and April 2024 were collected to provide covariates for Monte Carlo simulation. Monte Carlo simulations were then performed to evaluate the PTA for various dosing regimens. Dosing regimens were assessed based on achieving a PTA of ≥ 90%.</div></div><div><h3>Results</h3><div>A total of 96 studies were screened, of which 4 met the inclusion criteria. Separately, real-world covariate data were obtained from 163 FN patients to inform the Monte Carlo simulations. The simulation results showed that standard label dosages of carbapenems administered over 0.5-h infusions failed to consistently achieve a PTA ≥ 90% at the current CLSI breakpoint of 1 mg/L for <em>Enterobacterales</em>. Notably, increasing the dose did not consistently improve PTA, whereas extending the infusion duration to 3 h or using continuous infusion strategy markedly enhanced the likelihood of attaining the PK/PD target.</div></div><div><h3>Conclusion</h3><div>Standard carbapenem dosing with 0.5-h infusions may lead to suboptimal exposure in FN patients. Prolonging the infusion duration is an effective strategy to improve PTA and optimize efficacy.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"45 ","pages":"Pages 248-259"},"PeriodicalIF":3.2,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145354974","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}

{"title":"Investigating the adjuvant activity of the proline-rich antimicrobial lipopeptide C12-PRP against antimicrobial-resistant veterinary bacterial isolates","authors":"Soumya Deo ,&nbsp;Aimeen Sharoze ,&nbsp;Meerim Esenbekova ,&nbsp;Dawn White ,&nbsp;Frank Schweizer ,&nbsp;Ramesh Kumar Mani ,&nbsp;Bala Kishan Gorityala ,&nbsp;Ayush Kumar","doi":"10.1016/j.jgar.2025.10.015","DOIUrl":"10.1016/j.jgar.2025.10.015","url":null,"abstract":"<div><h3>Objectives</h3><div>Farm animals exposed to excessive amounts of antibiotics are reservoirs for antimicrobial-resistance genes and multidrug-resistant bacteria. The goal of this study was to investigate the adjuvant activity of a previously synthesized, proline-rich lipopeptide called C₁₂-PRP in combination with various antibiotics against multidrug-resistant <em>E. coli</em> isolated from chicken and cattle.</div></div><div><h3>Methods</h3><div>The microbroth dilution method was used to determine the minimum inhibitory concentration of 10 antibiotics against four <em>E. coli</em> isolates. The adjuvant activity of C₁₂-PRP was then tested in combination with the same antibiotics using a checkerboard assay. The best synergistic antibiotic-C₁₂-PRP combinations were tested with the most resistant <em>E. coli</em> isolate using the <em>Galleria mellonella</em> insect infection model. A fluorescence-based membrane permeabilization assay was used to investigate a possible mode of action for C₁₂-PRP.</div></div><div><h3>Results</h3><div>The four <em>E. coli</em> isolates showed varying resistance to the antibiotics (0.008 µg/mL to ≥256 µg/mL), and overall, the addition of C₁₂-PRP lowered the minimum inhibitory concentration. The two most-potent antibiotic-C₁₂-PRP combinations were with novobiocin and erythromycin showing a susceptibility increase of 128-fold and up to 32–fold, respectively. <em>G. mellonella</em> survival was significantly improved when C₁₂-PRP was included with novobiocin or erythromycin during treatment of infected larvae. Membrane permeabilization of an <em>E. coli</em> isolate was markedly higher in the presence of C₁₂-PRP.</div></div><div><h3>Conclusions</h3><div>We demonstrated the synergistic ability of C₁₂-PRP to enhance antibiotic activity and reduce the virulence of the veterinary <em>E. coli</em> isolates, strengthening the potential promise of this adjuvant candidate as a therapeutic agent for multidrug-resistant bacteria.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"45 ","pages":"Pages 305-309"},"PeriodicalIF":3.2,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145354966","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}

{"title":"Mutations in the atpE gene and bedaquiline resistance in Mycobacterium avium","authors":"Yuwei Qiu ,&nbsp;Dan Cao ,&nbsp;Bihan Xu ,&nbsp;Xiuzhi Jiang ,&nbsp;Xu Dong ,&nbsp;Pusheng Xu ,&nbsp;Yanghui Xiang ,&nbsp;Xin Yuan ,&nbsp;Yi Li ,&nbsp;Ying Zhang","doi":"10.1016/j.jgar.2025.10.004","DOIUrl":"10.1016/j.jgar.2025.10.004","url":null,"abstract":"","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"45 ","pages":"Pages 232-233"},"PeriodicalIF":3.2,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145313056","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}

{"title":"Pharmacokinetic/pharmacodynamic targets of ß-lactams associated with bacterial killing and suppression of the resistance emergence in the hollow fiber infection model: A systematic review","authors":"Charles Baulier ,&nbsp;Marion Giry ,&nbsp;Manuel Etienne ,&nbsp;Julien Kallout ,&nbsp;Kévin Alexandre","doi":"10.1016/j.jgar.2025.10.009","DOIUrl":"10.1016/j.jgar.2025.10.009","url":null,"abstract":"<div><h3>Introduction</h3><div>The hollow-fibre infection model (HFIM) is an in vitro model used to study pharmacokinetic/pharmacodynamic (PK/PD) interactions between antibiotics and bacteria. However, its external validity remains poorly assessed. This study aimed to identify PK/PD targets and experimental variables associated with bacterial killing and prevention of resistance emergence during β-lactam treatment in HFIM.</div></div><div><h3>Methods</h3><div>Systematic review of studies using HFIM and β-lactams, with literature search conducted in 4 databases, following PRISMA guidelines. After a quality assessment (modified ToxRtools scale) of the included studies, univariate and multivariate analyses identified factors associated with the prevention of resistance emergence. CART analysis determined values of PK/PD indices best predicting this outcome.</div></div><div><h3>Results</h3><div>Of the 497 screened studies, 41 were included. A total of 367 experiments were analysed, mainly involving <em>Pseudomonas aeruginosa</em> (51%) and carbapenems (46%). Antibiotic exposure through minimal or steady-state free concentrations (<em>f</em>C_min,ss/MIC) (OR 0.78, 95% CI [0.70–0.85], <em>P</em> &lt; 0.001), the initial inoculum size (OR 1.48, 95% CI [1.08–2.06], <em>P</em> = 0.017) and the use of a combination therapy (OR 0.33, CI [0.17–0.64], <em>P</em> = 0.001) remained significantly associated with resistance emergence in multivariate analysis. For carbapenems in monotherapy, the prevention of resistance emergence was likely with <em>f</em>C_min,ss/MIC &gt; 5.7.</div></div><div><h3>Conclusions</h3><div>Stringent PK/PD indices thresholds were necessary to prevent resistance emergence in HFIM experiments.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"45 ","pages":"Pages 220-227"},"PeriodicalIF":3.2,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308259","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}