Journal of global antimicrobial resistance最新文献_第8页

Emergence and inter-hospital circulation of capsule K2- and OXA-48-producing Klebsiella pneumoniae ST395 in north-eastern Italy 意大利东北部产生K2-和oxa -48胶囊的肺炎克雷伯菌ST395的出现和医院间循环

IF 3.2 3区医学 Q2 INFECTIOUS DISEASES

Journal of global antimicrobial resistance

Pub Date : 2026-01-01 Epub Date: 2025-11-20 DOI: 10.1016/j.jgar.2025.11.007

Vittoria Mattioni Marchetti , Francesca Piscopiello , Assunta Girardi , Stefano Grandesso , Roberta Migliavacca

Objective

Klebsiella pneumoniae ST395 is an internationally disseminated, high-risk clone implicated in OXA-48-producing K. pneumoniae (OXA-48 Kp) outbreaks. In Italy, K. pneumoniae ST395 is sporadically detected and mainly associated with the bla_KPC-3 determinant. Here we aimed to explain the increase in cases of OXA-48 Kp ST395 in north-eastern Italy.

Methods

In the period May–July 2024, 57 OXA-48 Kp samples were collected from three different hospitals and related communities within the province of Venice, Italy. Species identification, antimicrobial susceptibility, carbapenemase production, and clonal relatedness were ascertained using MALDI-TOF MS, the Vitek-2 System, CARBA PLUS (MASTGroup), and pulsed-field gel electrophoresis, respectively. Whole-genome sequencing was carried out on seven representative strains using an Illumina (San Diego, CA, USA) NovaSeq.

Results

All 57 OXA-48 Kp strains retained susceptibility to aminoglycosides only, with three pulsotypes (A–C) detected by pulsed-field gel electrophoresis. Pulsotype A included 13 subtypes (A–A12). Subtypes A3 and A9 (n = 8, respectively) had the highest pattern similarity, followed by A12 (n = 4), A5 (n = 3), and A11 (n = 2). ST395 and the K2 capsule were highlighted by whole-genome sequencing. The shared resistome consisted of aminoglycoside (aac(3)-IIa, aac(6′)-Ib-cr), chloramphenicol (catA1, catB4), beta-lactam (bla_CTX−M-15), and carbapenem (bla_OXA-48) genes. SNP-based phylogeny showed relevant genomic relatedness, although clonal identity was obtained in only two cases.

Conclusions

Here we have highlighted the alarming inter-hospital circulation of OXA-48 Kp ST395 in north-eastern Italy.

背景：肺炎克雷伯菌ST395是一种与产生OXA-48的肺炎克雷伯菌（OXA-48 Kp）暴发有关的国际高风险克隆。在意大利，偶尔检测到肺炎克雷伯菌ST395，主要与blaKPC-3决定因子相关。我们的目的是描述意大利东北部OXA-48 Kp ST395病例的增加情况。方法：于2024年5 - 7月在威尼斯省3家不同医院及相关社区采集OXA-48-Kp共57份。采用MALDI-TOF MS、vitvek -2 System、CARBA PLUS （MASTGroup）和PFGE分别鉴定菌株的种类、抗菌敏感性、碳青霉烯酶产量和克隆亲缘关系。利用NovaSeq Illumina对7株代表性菌株进行全基因组测序（WGS）。结果：57株OXA-48-Kp菌株仅对氨基糖苷类药物敏感。PFGE检测三种脉冲型（A-C）。脉冲型A包括13个亚型（A-A12），其中以A3和A9 （n= 8）为主导型，其次为A12 （n=4）、A5 （n=3）和A11 （n=2）。ST395和K2胶囊被WGS突出显示。共享抗性组由氨基糖苷(aac(3)-IIa, aac（6’）- ibr -cr)，氯霉素（catA1, catB4）， β -内酰胺（blaCTX-M-15）和碳青霉烯类（blaOXA-48）基因组成。基于单核苷酸多态性的系统发育显示了相关的基因组相关性，尽管克隆同源性仅在两例中获得。结论：总之，我们记录了意大利东北部OXA-48 Kp ST395令人担忧的医院间循环。

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引用次数: 0

Treatment of asymptomatic bacteriuria during pregnancy: A risk-factor-based approach 妊娠期无症状细菌性尿症的治疗：基于危险因素的方法。

IF 3.2 3区医学 Q2 INFECTIOUS DISEASES

Journal of global antimicrobial resistance

Pub Date : 2026-01-01 Epub Date: 2025-11-20 DOI: 10.1016/j.jgar.2025.11.010

George Zhanel , Patricia de Rossi , Cosimo Oliva , Truls E. Bjerklund Johansen

During pregnancy, there is increased risk of ascending urinary tract infection (UTI) resulting in pyelonephritis and associated preterm delivery and low birth weight. It is therefore important that pregnant women who are at high risk of pyelonephritis because of the presence of asymptomatic bacteriuria (ASB) or cystitis receive appropriate antibiotic therapy. The aim of this position paper is to propose a risk-factor-based approach for the treatment of ASB and cystitis in pregnancy to help ensure that antibiotic treatment is prescribed only when necessary, and that the benefits of antibiotic treatment outweigh potential harms for pregnant women and neonates. Rather than advocating ASB screen-and-treat for all pregnant women who have ready access to healthcare, this risk-factor-based approach involves selective screening for ASB in pregnant women with other risk factors for UTI (previous UTI, diabetes mellitus, urinary tract abnormalities, or immunosuppression) and/or a history of preterm birth. Antibiotic treatment is indicated for persistent ASB confirmed with two urine cultures during selective high-risk screening, and for all pregnant women with cystitis confirmed by urine culture, with empiric treatment considered for symptoms of dysuria and urinary frequency. Evidence suggests that such a risk-factor-based approach will prevent progression to pyelonephritis in pregnant women with ASB and cystitis while complying with the principles of antimicrobial stewardship.

在怀孕期间，上行尿路感染（UTI）导致肾盂肾炎和相关的早产和低出生体重的风险增加。因此，由于无症状性细菌尿（ASB）或膀胱炎的存在而有肾盂肾炎高风险的孕妇接受适当的抗生素治疗是很重要的。本立场文件的目的是提出一种基于风险因素的方法来治疗妊娠期ASB和膀胱炎，以帮助确保仅在必要时才开抗生素治疗，并且抗生素治疗的益处大于对孕妇和新生儿的潜在危害。这种基于风险因素的方法不是提倡对所有有条件获得医疗保健的孕妇进行ASB筛查和治疗，而是对有其他尿路感染风险因素（既往尿路感染、糖尿病、尿路异常或免疫抑制）和/或有早产史的孕妇进行ASB选择性筛查。在选择性高风险筛查中，对于经两次尿培养证实的持续性ASB，以及所有经尿培养证实的膀胱炎孕妇，应采用抗生素治疗，并考虑排尿困难和尿频症状。有证据表明，这种基于风险因素的方法可以预防ASB和膀胱炎孕妇肾盂肾炎的进展，同时遵守抗菌药物管理原则。

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引用次数: 0

The resistance trends in Mycobacterium kansasii pulmonary isolates and identification of risk factors for drug resistance in Taiwan 台湾地区结核分枝杆菌肺分离株耐药趋势及耐药危险因素分析。

IF 3.2 3区医学 Q2 INFECTIOUS DISEASES

Journal of global antimicrobial resistance

Pub Date : 2026-01-01 Epub Date: 2025-11-07 DOI: 10.1016/j.jgar.2025.11.001

Sheng-Bin Fan , Hung-Ling Huang , Hung-Pin Tu , Benjamin Sobkowiak , Meng-Hsuan Cheng , Wei-Chang Huang , Yi-Wen Huang , Shang-Yi Lin , Inn-Wen Chong , Po-Liang Lu

Objectives

Mycobacterium kansasii (M. kansasii) pulmonary disease is an emerging global health concern, and the pathogen's resistance to antimicrobial agents is challenging. Understanding the epidemiology of drug resistance rates and the associated risk factors is useful for guiding antimicrobial agent selection for M. kansasii treatment.

Methods

This retrospective cohort study analysed 361 pathogenic M. kansasii isolates collected from patients with M. kansasii pulmonary disease in two tertiary medical centres in Taiwan between 2011 and 2022. Antimicrobial susceptibility testing was performed using Sensititre™ SLOMYCO1 or SLOMYCO2, and MIC breakpoints were according to CLSI 2018. We applied multivariate logistic regression and Cochran–Mantel–Haenszel test to assess the factors associated with drug resistance.

Results

Most M. kansasii isolates in Taiwan remained susceptible to the first-line agents, including rifampin (92.2%) and clarithromycin (98.6%). High resistance rates were observed in ciprofloxacin (42.7%), doxycycline (56.2%), and trimethoprim/sulfamethoxazole (87.8%). The drug resistance rates of tested antibiotics for M. kansasii increased notably in 2018–2022 compared to those between 2015–2017. M. kansasii isolates from central Taiwan exhibited significantly higher resistance rates in all drugs compared to those in southern Taiwan. Pulmonary fibrocavitary lesion was an independent risk factor for resistance to rifampin and ciprofloxacin.

Conclusions

The study reveals increasing resistance to the first- and second-line agents in M. kansasii isolates across Taiwan. Resistance epidemiology differed between regions. Fibrocavitary lung lesion was significantly associated with drug resistance. These findings underscore the importance of region-specific surveillance to undergo individualized treatment strategies for M. kansasii pulmonary disease.

目的：堪萨斯分枝杆菌（M. kansasii）肺部疾病是一个新兴的全球健康问题，病原体对抗微生物药物的耐药性具有挑战性。了解耐药率的流行病学及相关危险因素，有助于指导堪萨斯分枝杆菌治疗的抗菌药物选择。方法：本回顾性队列研究分析了2011年至2022年在台湾两家三级医疗中心收集的361株致病性堪萨斯分枝杆菌肺部疾病患者。使用Sensititre™SLOMYCO1或SLOMYCO2进行抗菌药敏试验，MIC断点符合CLSI 2018。我们采用多元logistic回归和Cochran-Mantel-Haenszel检验对耐药相关因素进行评估。结果：台湾地区大部分堪萨斯分枝杆菌对一线药物敏感，包括利福平（92.2%）和克拉霉素（98.6%）；环丙沙星（42.7%）、强力霉素（56.2%）、甲氧苄啶/磺胺甲恶唑（87.8%）耐药率较高。与2015-2017年相比，2018-2022年堪萨斯分枝杆菌的抗生素耐药率显著上升。台湾中部地区的堪萨斯分枝杆菌对所有药物的耐药率明显高于台湾南部地区。肺纤维腔病变是利福平和环丙沙星耐药的独立危险因素。结论：本研究显示台湾各地的肯萨西结核分枝杆菌对一线和二线药物的耐药性增加。不同地区的耐药流行病学存在差异。肺纤维腔病变与耐药显著相关。这些发现强调了区域特异性监测对堪萨斯分枝杆菌肺病个体化治疗策略的重要性。

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引用次数: 0

Emergence of blaKPC-71 variant and loss of aerobactin-encoding genes (iucABCD-iutA) in ST11-K64 carbapenem-resistant Klebsiella pneumoniae during ceftazidime–avibactam treatment 在头孢他啶-阿维巴坦治疗期间，ST11-K64耐碳青霉烯肺炎克雷伯菌中出现blaKPC-71变异和易动蛋白编码基因（iucABCD-iutA）的丢失

IF 3.2 3区医学 Q2 INFECTIOUS DISEASES

Journal of global antimicrobial resistance

Pub Date : 2026-01-01 Epub Date: 2025-12-16 DOI: 10.1016/j.jgar.2025.11.020

Fang-ling Du , Dan-dan Wei , Yong-qing Guo , Peng Liu , Yan-fang Mei , Shan-shan Huang , Qi-sen Huang , Lin-Ping Fan , Yang Liu

Objective

To investigate the within-host evolutionary dynamics of resistance and virulence in carbapenem-resistant Klebsiella pneumoniae during ceftazidime-avibactam treatment.

Methods

Three K. pneumoniae strains were isolated from the sputum of the same patient. Broth microdilution method, whole-genome sequencing and genetic analysis were employed to clarify the dynamics and mechanisms of antibiotic resistance. Galleria mellonella infection models were used to investigate the changes in virulence.

Results

The study described the changes of three strains of ST11-K64 carbapenem-resistant K. pneumoniae associated with pulmonary infection in vivo. The transition from a ceftazidime-avibactam-susceptible but imipenem-resistant isolate (JXZRKP1) to a ceftazidime-avibactam-resistant but imipenem-susceptible isolate (JXZRKP2) was attributed to the transformation of the bla_KPC gene from bla_KPC-2 to bla_KPC-71 and upregulation of bla_KPC gene expression. Notably, the bla_KPC-71 enzyme exhibited a Ser182 duplication compared to the wild-type bla_KPC-2 carbapenemase. The bla_KPC gene of three strains was carried by the IS26-mediated tandem core structure ISKpn27-bla_KPC-IS1182 on an IncFII-type plasmid. Furthermore, in comparison with JXZRKP2, the virulence plasmid of JXZRKP3 lost the aerobactin-encoding genes (iucABCD-iutA), resulting in diminished virulence in G. mellonella infection models, but there was no significant difference(P > .05).

Conclusions

We first discovered that the mutation from bla_KPC-2 to bla_KPC-71 leads to resistance to ceftazidime-avibactam, followed by the loss of the aerobactin-encoding gene (iucABCD-iutA) on the virulence plasmid in vivo. This study underscores the complexity of addressing carbapenem-resistant K. pneumoniae infections.

目的：研究头孢他啶-阿维巴坦治疗期间耐碳青霉烯肺炎克雷伯菌在宿主内的耐药性和毒力进化动力学。方法：从同一患者的痰液中分离出3株肺炎克雷伯菌。采用微量肉汤稀释法、全基因组测序（WGS）和遗传分析阐明了抗生素耐药的动态和机制。采用大孔线虫感染模型研究其毒力变化。结果：本研究描述了3株ST11-K64耐碳青霉烯类肺炎克雷伯菌体内相关肺部感染的变化。从头孢他啶-阿维巴坦敏感但亚胺培南耐药的分离株（JXZRKP1）到头孢他啶-阿维巴坦耐药但亚胺培南敏感的分离株（JXZRKP2）的转变归因于blaKPC基因从blaKPC-2转化为blaKPC-71，并上调了blaKPC基因的表达。值得注意的是，与野生型blaKPC-2碳青霉烯酶相比，blaKPC-71酶表现出Ser182重复。三个菌株的blaKPC基因由is26介导的串联核心结构ISKpn27-blaKPC-IS1182在incfii型质粒上携带。此外，与JXZRKP2相比，JXZRKP3的毒力质粒丢失了需氧肌动蛋白编码基因（iucABCD-iutA），导致在mellonella感染模型中的毒力降低，但差异无统计学意义（P < 0.05）。结论：我们首先发现从blaKPC-2到blaKPC-71突变导致对头孢他啶-阿维巴坦耐药，随后在体内发现毒质粒上的好氧肌动蛋白编码基因（iucABCD-iutA）缺失。这项研究强调了解决耐碳青霉烯肺炎克雷伯菌感染的复杂性。

{"title":"Emergence of blaKPC-71 variant and loss of aerobactin-encoding genes (iucABCD-iutA) in ST11-K64 carbapenem-resistant Klebsiella pneumoniae during ceftazidime–avibactam treatment","authors":"Fang-ling Du , Dan-dan Wei , Yong-qing Guo , Peng Liu , Yan-fang Mei , Shan-shan Huang , Qi-sen Huang , Lin-Ping Fan , Yang Liu","doi":"10.1016/j.jgar.2025.11.020","DOIUrl":"10.1016/j.jgar.2025.11.020","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the within-host evolutionary dynamics of resistance and virulence in carbapenem-resistant <em>Klebsiella pneumoniae</em> during ceftazidime-avibactam treatment.</div></div><div><h3>Methods</h3><div>Three <em>K. pneumoniae</em> strains were isolated from the sputum of the same patient. Broth microdilution method, whole-genome sequencing and genetic analysis were employed to clarify the dynamics and mechanisms of antibiotic resistance. <em>Galleria mellonella</em> infection models were used to investigate the changes in virulence.</div></div><div><h3>Results</h3><div>The study described the changes of three strains of ST11-K64 carbapenem-resistant <em>K. pneumoniae</em> associated with pulmonary infection in vivo. The transition from a ceftazidime-avibactam-susceptible but imipenem-resistant isolate (JXZRKP1) to a ceftazidime-avibactam-resistant but imipenem-susceptible isolate (JXZRKP2) was attributed to the transformation of the <em>bla</em><sub>KPC</sub> gene from <em>bla</em><sub>KPC-2</sub> to <em>bla</em><sub>KPC-71</sub> and upregulation of <em>bla</em><sub>KPC</sub> gene expression. Notably, the <em>bla</em><sub>KPC-71</sub> enzyme exhibited a Ser182 duplication compared to the wild-type <em>bla</em><sub>KPC-2</sub> carbapenemase. The <em>bla</em><sub>KPC</sub> gene of three strains was carried by the IS<em>26</em>-mediated tandem core structure IS<em>Kpn27</em>-<em>bla</em><sub>KPC</sub>-IS<em>1182</em> on an IncFII-type plasmid. Furthermore, in comparison with JXZRKP2, the virulence plasmid of JXZRKP3 lost the aerobactin-encoding genes (<em>iucABCD-iutA</em>), resulting in diminished virulence in <em>G. mellonella</em> infection models, but there was no significant difference(<em>P</em> > .05).</div></div><div><h3>Conclusions</h3><div>We first discovered that the mutation from <em>bla</em><sub>KPC-2</sub> to <em>bla</em><sub>KPC-71</sub> leads to resistance to ceftazidime-avibactam, followed by the loss of the aerobactin-encoding gene (<em>iucABCD-iutA</em>) on the virulence plasmid in vivo. This study underscores the complexity of addressing carbapenem-resistant <em>K. pneumoniae</em> infections.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":"46 ","pages":"Pages 166-170"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145781127","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}

引用次数: 0

Multicentric evaluation of the MTS™ Synergy Application System for reliable antibiotic synergy testing in clinical laboratories 多中心评价MTS-SAS®在临床实验室可靠的抗生素协同试验。

IF 3.2 3区医学 Q2 INFECTIOUS DISEASES

Journal of global antimicrobial resistance

Pub Date : 2026-01-01 Epub Date: 2025-12-19 DOI: 10.1016/j.jgar.2025.12.010

Edoardo Carretto , Stefano Andreoni , Richard Aschbacher , Daniela Barbarini , Simone Bramati , Flavia Brovarone , Claudio Farina , Angela Papa , Andrea Rocchetti , Giuseppe Russello , Vittorio Sambri , Assunta Sartor , Paolo Gaibani

Objectives

The rise of antimicrobial resistance poses a major challenge for both clinicians and clinical microbiologists. There is an increasing need for user-friendly and reliable methods to assess the activity of antibiotics against multidrug-resistant (MDR) strains. Although synergy testing provides valuable insights, conventional methods such as checkerboard assays and time-kill studies are labour-intensive, technically demanding, and difficult to standardize. This study evaluated the MTS™ SAS (MIC Test Strip – Synergy Application System, Liofilchem, Italy), a commercial gradient diffusion assay developed for antibiotic synergy testing.

Methods

The performance of MTS™ SAS was evaluated in comparison with the checkerboard microdilution method, used as the reference standard. Nine antibiotic combinations were tested against ten different bacterial strains across 11 Italian hospitals. Inter-laboratory reproducibility and agreement with the reference method were analysed.

Results

The concordance between MIC test strips and the broth microdilution (BMD) method was 98.4%, with 1.6% showing discordant results – all within a 3-dilution range. Among 996 synergy determinations, MTS™ SAS demonstrated high reproducibility across all centers (96.7%), while only 3.3% of tests showed discordant synergy classifications (e.g., synergy vs. indifference). Comparison with the checkerboard method demonstrated an overall concordance of 96.2%, despite the absence of specific operator training at each site.

Conclusion

These findings support MTS™ SAS as a practical and reliable alternative to conventional synergy testing methods, particularly suitable for routine clinical settings and laboratories lacking advanced microbiological expertise.

目的：抗菌素耐药性的上升对临床医生和临床微生物学家提出了重大挑战。越来越需要用户友好和可靠的方法来评估抗生素对多药耐药菌株的活性。尽管协同测试提供了有价值的见解，但诸如棋盘分析和耗时研究之类的传统方法是劳动密集型的，技术要求高，并且难以标准化。本研究评估了MTS-SAS®（MIC试纸-协同应用系统，Liofilchem®，意大利），这是一种用于抗生素协同测试的商业梯度扩散试验。方法：将MTS-SAS®与棋盘格微量稀释法进行比较，并作为对照标准。在意大利11家医院对9种抗生素组合进行了针对10种不同菌株的测试。分析了该方法的实验室间重复性及与参考方法的一致性。结果：MIC试纸与微量肉汤稀释法（BMD）的一致性为98.4%，结果不一致的为1.6%，均在3倍稀释范围内。在996个协同作用测定中，MTS-SAS®在所有中心显示出高重复性（96.7%），而只有3.3%的试验显示出不一致的协同作用分类（例如，协同作用与无差异）。与棋盘法相比，尽管在每个站点缺乏具体的操作人员培训，但总体一致性为96.2%。结论：这些发现支持MTS-SAS®作为传统协同检测方法的实用可靠的替代方法，特别适用于常规临床环境和缺乏先进微生物专业知识的实验室。

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引用次数: 0

Isolation and in vitro evaluation of bacteriophages against Pseudomonas aeruginosa isolated from burn wounds of human patients and hospital environment 人体烧伤患者创面及医院环境中铜绿假单胞菌噬菌体的分离及体外评价。

IF 3.2 3区医学 Q2 INFECTIOUS DISEASES

Journal of global antimicrobial resistance

Pub Date : 2026-01-01 Epub Date: 2025-10-31 DOI: 10.1016/j.jgar.2025.10.012

Rabia Kanwar , Muhammad Aamir Aslam , Sajjad Ur Rahman , Muhammad Saqib

Objective

Multidrug resistance Pseudomonas aeruginosa is a global public health issue, and bacteriophages are an effective alternative therapy over antibiotics to combat antibiotic resistance. This study was designed to isolate bacteriophages and determine their antimicrobial potential against P. aeruginosa isolated from burn wounds and the environment of the burn ward.

Methods

A total of 100 random swab samples were collected from the burn ward, including 50 from the burn wounds and 50 from the environment and proceeded for further investigations at the University of Agriculture Faisalabad. P. aeruginosa was confirmed by genomic detection of OprL gene. Bacteriophages were isolated from sewage water through the agar overlay method, and their lytic spectrum was determined. Genome sequencing and analysis was performed. Phage stability and synergism between phage and antibiotics were analysed.

Results

Overall, 50 samples were positive for P. aeruginosa, in which 35 of 50 were positive from wounds of patients with burns, and 15 of 50 were positive from the hospital environment. OprL-positive strains were selected for bacteriophage isolation. Two phages, PhPa-6 and PhPa-4, with lytic spectra of 88 % and 60 %, respectively, were selected. The genome sizes of PhPa-6 and PhPa-4 were 186.978 kb and 73.3 kb, respectively. A cocktail of these phages has shown an active in vitro synergistic effect with ciprofloxacin (0.125 µg/mL).

Conclusions

A cocktail of PhPa-6 and PhPa-4 in combination with ciprofloxacin displayed significant lytic activity under in vitro conditions and a broad host range against P. aeruginosa isolates from patients with burns.

背景：铜绿假单胞菌多药耐药是一个全球性的公共卫生问题，而噬菌体是对抗抗生素耐药的有效替代疗法。本研究旨在分离噬菌体并确定其对烧伤创面和烧伤病房环境中分离的铜绿假单胞菌的抗菌潜力。方法：从烧伤病房随机抽取100份拭子样本，其中50份来自烧伤创面，50份来自环境，并在费萨拉巴德农业大学进行进一步调查。铜绿假单胞菌经OprL基因基因组检测证实为假单胞菌。采用琼脂覆盖法从污水中分离噬菌体，并测定其裂解谱。进行基因组测序和分析。分析了噬菌体的稳定性及与抗生素的协同作用。结果：50份样本铜绿假单胞菌阳性，其中35/50来自烧伤患者创面，15/50来自医院环境。将oprl阳性菌株进行噬菌体分离。选择了两种噬菌体，分别为PhPa-6和PhPa-4，其裂解谱分别为88%和60%。PhPa-6和PhPa-4的基因组大小分别为186.978 kb和73.3 kb。这些噬菌体的混合物显示出与环丙沙星（0.125µg/ml）的体外协同作用。结论：PhPa-6和PhPa-4与环丙沙星混合对烧伤患者铜绿假单胞菌具有明显的体外溶菌活性和广泛的宿主范围。

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引用次数: 0

in vitro antibacterial activity of nordihydroguaiaretic acid combined with ceftriaxone against carbapenem-resistant Klebsiella pneumoniae 北二氢愈创木酸联合头孢曲松对耐碳青霉烯肺炎克雷伯菌的体外抗菌活性研究。

IF 3.2 3区医学 Q2 INFECTIOUS DISEASES

Journal of global antimicrobial resistance

Pub Date : 2026-01-01 Epub Date: 2025-10-27 DOI: 10.1016/j.jgar.2025.10.007

Chengjiao Luo , Hua Tan , Hang Sun , Xianwei Zhang , Qian Chen

Objective

This study investigated the interplay between biofilm formation and efflux pumps in carbapenem-resistant Klebsiella pneumoniae (CRKP) and evaluated the biofilm inhibition by nordihydroguaiaretic acid (NDGA) along with the efficacy of its combination with ceftriaxone (CRO) against CRKP, to inform the development of novel therapeutic strategies against multidrug-resistant infections.

Methods

Efflux pump genes were detected via PCR. Biofilm formation was quantified by crystal violet staining and categorized by the biofilm formation index (BFI) classification. Strong biofilm producers (BFI > 4 × negative control) were selected for in vitro models. Efflux pump gene expression was compared between biofilm and planktonic states using qRT-PCR. NDGA’s biofilm inhibition and NDGA-CRO synergy were assessed via checkerboard assays.

Results

Among the 86 CRKP isolates, 51.16% (44/86) were classified as strong biofilm producers, followed by moderate (17.44%, 15/86), weak (20.93%, 18/86), and negative (10.47%, 9/86) producers. Efflux pump genes (acrA, acrB, tolC, oqxA, oqxB) were detected in 100%, 100%, 100%, 97.7%, and 98.84% of isolates. Gene expression was significantly upregulated in biofilm versus planktonic state (P < 0.05). NDGA (≥16 µg/mL) inhibited biofilm formation, and its combination with CRO exhibited additive (63.64%) and synergistic (36.36%) effects.

Conclusion

Efflux pumps and biofilms synergistically enhance CRKP resistance. By inhibiting both efflux-mediated antibiotic extrusion and biofilm formation, NDGA resensitizes CRKP to CRO. This in vitro efficacy supports further development, pending in vivo safety studies in animal models.

目的：研究耐碳青霉烯肺炎克雷伯菌（CRKP）生物膜形成与外排泵之间的相互作用，评价去甲二氢愈创木酸（NDGA）对CRKP的生物膜抑制作用及其与头孢曲松（CRO）联合治疗CRKP的效果，为开发抗多重耐药感染的新治疗策略提供依据。方法：采用PCR法检测外排泵基因。采用结晶紫染色定量测定生物膜的形成，并采用生物膜形成指数（BFI）分类。体外模型选用强生物膜产生者（BFI bbb40 × 阴性对照）。采用qRT-PCR方法比较生物膜状态和浮游状态下外排泵基因的表达。通过棋盘法评估NDGA的生物膜抑制作用和NDGA- cro协同作用。结果：86株CRKP菌株中，强生膜菌株占51.16%(44/86)，其次为中等（17.44%,15/86）、弱（20.93%,18/86）和阴性（10.47%,9/86）。外排泵基因acrA、acrB、tolC、oqxA、oqxB的检出率分别为100%、100%、100%、97.7%、98.84%。生物膜状态与浮游状态相比，基因表达显著上调（P < 0.05）。NDGA（≥16 μg/mL）抑制生物膜的形成，与CRO联用表现出加性（63.64%）和增效（36.36%）作用。结论：外排泵和生物膜协同增强CRKP耐药性。NDGA通过抑制外排介导的抗生素挤出和生物膜形成，使CRKP对CRO重新致敏。这种体外功效支持进一步的开发，有待于动物模型的体内安全性研究。

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引用次数: 0

First identification of a multidrug-resistant Pseudomonas kurunegalensis clinical isolate co-carrying blaAFM-1 and blaIMP-1 in China 中国首次发现一株多重耐药库鲁egalensis假单胞菌临床分离株共携带blaAFM-1和blaIMP-1。

IF 3.2 3区医学 Q2 INFECTIOUS DISEASES

Journal of global antimicrobial resistance

Pub Date : 2026-01-01 Epub Date: 2025-12-12 DOI: 10.1016/j.jgar.2025.12.007

Shuwei Fan , Yuzhuo Gong , Chunxiao Chen , Jingchao Shi , Cong Wu

Objectives

The objective of this study was to elucidate the genetic context and characterize chromosome co-carrying bla_AFM-1 and bla_IMP-1 in a multidrug-resistant Pseudomonas kurunegalensis (P. kurunegalensis) isolate obtained from human urine using whole-genome sequencing.

Methods

This P. kurunegalensis isolate JC172 co-harbouring bla_AFM-1 and bla_IMP-1 underwent a comprehensive investigation that included antimicrobial susceptibility testing, conjugation assays, whole-genome sequencing and bioinformatic analyses. To depict the evolutionary dynamics of P. kurunegalensis strains on a global scale, a phylogenetic tree was generated based on single nucleotide polymorphisms of core genomes.

Results

JC172 was classified as P. kurunegalensis based on sequencing results and average nucleotide identity (ANI) assessments. This isolate was designated as ST114 and possesses a chromosome with 5 855 340 base pairs, exhibiting a GC content of 61.9%. Several resistance genes, including bla_AFM-1 and bla_IMP-1, bla_OXA-246 and tmexC3D2-toprJ1 were identified on the chromosome. Genomic analysis revealed that bla_AFM-1 was situated within a core module of the TnAs3-bla_AFM-1 unit, which is bordered by class 1 integrons. This arrangement implies a significant potential for bla_AFM-1 dissemination.

Conclusions

Our study revealed that bla_AFM-1 and bla_IMP-1, bla_OXA-246 and tmexC3D2-toprJ1 were harboured by P. kurunegalensis. We suggested that ST114 P. kurunegalensis may serve as a reservoir for resistance genes.

目的：本研究的目的是利用全基因组测序技术，阐明从人类尿液中获得的多重耐药kurunegalensis假单胞菌（P. kurunegalensis）的遗传背景和染色体共携带blaAFM-1和blaIMP-1的特征。方法：对共携带blaAFM-1和blaIMP-1的kurunegalensis分离株JC172进行药敏试验、偶联试验、全基因组测序和生物信息学分析。为了描述p.k urunegalensis菌株在全球范围内的进化动态，基于核心基因组的单核苷酸多态性构建了系统发育树。结果：根据测序结果和平均核苷酸同源性（ANI）鉴定，JC172属kurunegalensis。该分离物被命名为ST114，具有一条5,855,340对碱基对的染色体，GC含量为61.9%。在染色体上鉴定出blaAFM-1和blaIMP-1、blaOXA-246和tmexc32d - toprj1等抗性基因。基因组分析显示，blaAFM-1位于TnAs3-blaAFM-1单元的核心模块中，该单元与1类整合子相邻。这种安排意味着blaAFM-1传播的巨大潜力。结论：我们的研究表明，blaAFM-1、blaIMP-1、blaOXA-246和tmexc32d - toprj1在库鲁尼加疟原虫中存在。我们认为ST114库鲁egalensis可能是抗性基因的储存库。

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引用次数: 0

Detection of zoonotic Coxiella burnetii causing chronic Q fever endocarditis in a Chinese geriatric patient by mNGS mNGS检测中国老年人慢性Q热心内膜炎的人畜共患伯纳蒂克希菌。

IF 3.2 3区医学 Q2 INFECTIOUS DISEASES

Journal of global antimicrobial resistance

Pub Date : 2025-12-01 Epub Date: 2025-10-06 DOI: 10.1016/j.jgar.2025.09.015

Hui Wang , Jie Sheng , Ying Zhang , Hao Lan , Xiaofeng Lu , Xi Li , Xiaofei Zhao

Objective

Q (query) fever, caused by Coxiella burnetii, is often linked to negative bacterial cultures, with infective endocarditis with negative cultures difficult to diagnose and treat. Our case demonstrates that metagenomic next-generation sequencing (mNGS) is able to provide a rapid and accurate method for pathogenetic diagnosis in infectious diseases.

Case presentation

A case of infective endocarditis with negative blood cultures is reported in a male patient with a history of sheep farming and previous aortic valve replacement and atrial septal defect atrial septal defect repair. Blood tests showed positive serum immunofluorescent antibodies to Rickettsia, while mNGS of perivalvular abscess tissue suggested C. burnetii. Doxycycline 0.1 g q12h and hydroxychloroquine 0.2 g q12h were used for postoperative antibiotic treatment. The genome of C. burnetii C2245173Z was assembled on the Illumina platform and no known antibiotic resistance genes were detected. Phylogenetic analysis of the C. burnetii genome showed a genetic relationship between animal- and human-derived strains.

Conclusions

mNGS could provide a rapid and accurate assay for clinical diagnosis and play a decisive role in the pathogenetic diagnosis of some infectious diseases. Doxycycline plus hydroxychloroquine remains an effective treatment for chronic Q fever endocarditis. In addition, phylogenetic tree analysis indicates that C. burnetii infection may pose a potential risk to humans working with livestock.

目的：由伯纳氏克希菌引起的发热通常与阴性细菌培养有关。阴性培养的感染性心内膜炎很难诊断和治疗。我们的案例表明，新一代宏基因组测序（mNGS）可以为传染病的病理诊断提供快速准确的方法。病例介绍：我们报告了一例感染性心内膜炎伴阴性血培养的男性患者，有养羊史，有主动脉瓣置换术（AVT）和房间隔缺损（ASD）修复史。血液检查显示血清立克次体免疫荧光抗体阳性，而瓣膜周围脓肿组织的mNGS提示伯氏原体感染。术后应用强力霉素0.1 g q12h、羟氯喹0.2 g q12h给予抗生素治疗。在Illumina平台上组装burnetii C2245173Z基因组，未检测到已知的抗生素耐药基因。伯纳蒂胞杆菌基因组的系统发育分析显示动物源性菌株和人源性菌株之间存在遗传关系。结论：应用mNGS可为临床诊断提供快速、准确的检测方法，在某些感染性疾病的发病诊断中具有决定性作用。强力霉素加羟氯喹仍然是治疗慢性Q热心内膜炎的有效方法。此外，系统发育树分析表明，伯纳蒂胞杆菌感染可能对与牲畜一起工作的人构成潜在风险。

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引用次数: 0

Uncommon pulmonary mycobacterium wolinskyi infection in a hemodialysis patient 血液透析患者罕见的肺沃林斯基分枝杆菌感染。

IF 3.2 3区医学 Q2 INFECTIOUS DISEASES

Journal of global antimicrobial resistance

Pub Date : 2025-12-01 Epub Date: 2025-09-19 DOI: 10.1016/j.jgar.2025.09.006

Lin Zheng , Yanwan Shangguan , Wanru Guo , Zhongkang Ji , Kaijin Xu

In recent years, the detection rate of nontuberculous mycobacteria has increased, drawing attention in clinical settings. Here, we present a case of pulmonary Pseudomonas aeruginosa and Mycobacterium wolinskyi coinfection in a 60-year-old hemodialysis recipient. To the best of our knowledge, this is the first instance of isolating the M. wolinskyi strain from human respiratory samples, including a comprehensive exploration of its susceptibility to clinically available antimicrobials. This discovery deepened our understanding of the infection spectrum of M. wolinskyi, highlighting the need to consider the potential for coinfections with common pathogens and less common atypical pathogens when managing immunocompromised patients. Furthermore, this study also assessed the in vitro antibacterial activity of newly available antibacterial drugs in clinical practice against the M. wolinskyi strain.

近年来，非结核分枝杆菌的检出率有所提高，引起了临床的重视。在这里，我们提出一个病例肺铜绿假单胞菌和沃林斯基分枝杆菌合并感染在一个60岁的血液透析受者。据我们所知，这是首次从人类呼吸道样本中分离出沃林斯基支原体菌株，包括全面探索其对临床可用抗菌药物的敏感性。这一发现加深了我们对沃林斯基支原体感染谱的理解，强调在治疗免疫功能低下患者时需要考虑与常见病原体和不太常见的非典型病原体共感染的可能性。此外，本研究还评估了临床新开发的抗菌药物对沃林斯基支原体的体外抗菌活性。

引用次数: 0