Journal of global antimicrobial resistance最新文献_第9页

Surveillance and characteristics of vancomycin-resistant Enterococcus isolates in a Chinese tertiary hospital in Shenzhen, 2018 to 2024 2018年至2024年深圳一家中国三级甲等医院耐万古霉素肠球菌菌株的监测和特征。

IF 3.7 3区医学 Q2 INFECTIOUS DISEASES

Journal of global antimicrobial resistance

Pub Date : 2025-01-01 DOI: 10.1016/j.jgar.2024.11.002

Hongwei Shen , Qiaomin Zhang , Shaobo Li , Tingting Huang , Wen Ma , Daming Wang , Peng Li

Objective

To investigate the prevalence and characteristics of vancomycin-resistant Enterococcus (VRE) isolates in a Chinese tertiary hospital in Shenzhen.

Methods

A hospital-based retrospective epidemiological survey of Enterococcus was conducted over a 6.5-y period, from January 2018 to June 2024. The VRE isolates were identified and subjected to screening for the six van genes and multi-locus sequence typing (MLST) genotyping. The clinical characteristics, antimicrobial susceptibility profiles and molecular features were subjected to analysis.

Results

A total of 34 non-duplicate VRE isolates were identified, comprising 32 vancomycin-resistant Enterococcus faecium (VREfm) and 2 vancomycin-resistant Enterococcus faecalis (VREfa) strains. Since its initial isolation in 2022, there has been an observable increase in the detection rate of VRE. The detection rate of VRE between 2022 and 2024 (until June) was 0.3%, 4.8%, and 8.6%, respectively. The majority of the VRE strains were isolated from urine (25/34, 73.5%), and the highest detection rate (9.1%) of VRE infections was observed in the patients aged ≥75 y. In excess of 90% of VRE isolates exhibited resistance to ciprofloxacin (97.1%) and levofloxacin (97.1%), followed by ampicillin (94.1%) and penicillin (94.1%). The non-susceptible rate was observed to be low for linezolid (2.9%) and tigecycline (5.9%). Of the 29 VREfm isolates preserved and tested, 28 were found to harbour the vanA gene. A total of six STs were identified among the 29 VREfm isolates, with ST80 (16/29, 55.2%) being the predominant. The ST80 remained the most prevalent clone until the introduction of ST78 in May 2023, at which point these two clones became the most prevalent.

Conclusion

There has been an observable increase in the prevalence of VRE in our hospital since 2022. Furthermore, an ongoing outbreak of ST80 and ST78 VREfm with vanA-harboring plasmid was identified. It is imperative that continuous surveillance be conducted in order to inform public health interventions.

目的：调查深圳中国三级甲等医院耐万古霉素肠球菌（VRE）分离株的流行率和特征：调查深圳一家中国三级甲等医院耐万古霉素肠球菌（VRE）分离株的流行率和特征：方法：在 2018 年 1 月至 2024 年 6 月的 6.5 年期间，对医院进行了肠球菌流行病学回顾性调查。对分离出的 VRE 进行了鉴定，并筛查了 6 个 van 基因和多焦点序列分型（MLST）基因分型。对临床特征、抗菌药敏感性谱和分子特征进行了分析：结果：共鉴定出 34 株不重复的 VRE 分离物，包括 32 株耐万古霉素粪肠球菌（VREfm）和 2 株耐万古霉素粪肠球菌（VREfa）。自 2022 年首次分离出 VRE 以来，VRE 的检出率明显上升。2022 年至 2024 年（截至 6 月）的弧菌检出率分别为 0.3%、4.8% 和 8.6%。大多数 VRE 菌株是从尿液中分离出来的（25/34，73.5%），年龄≥75 岁患者的 VRE 感染检出率最高（9.1%）。超过 90% 的 VRE 分离物对环丙沙星（97.1%）和左氧氟沙星（97.1%）具有耐药性，其次是氨苄西林（94.1%）和青霉素（94.1%）。据观察，利奈唑胺（2.9%）和替加环素（5.9%）的非敏感率较低。在保存和检测的 29 个 VREfm 分离物中，发现 28 个含有 vanA 基因。在 29 个 VREfm 分离物中共鉴定出 6 种 ST，其中以 ST80（16/29，55.2%）为主。ST80 仍是最常见的克隆，直到 2023 年 5 月引入 ST78，这两个克隆才成为最常见的克隆：结论：自 2022 年以来，我们医院的 VRE 感染率明显上升。结论：自 2022 年以来，我们医院的弧菌感染率明显上升，而且还发现了 ST80 和 ST78 VREfm 与 vanA 包载质粒的持续爆发。当务之急是进行持续监测，以便为公共卫生干预措施提供信息。

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引用次数: 0

Prevalence and antimicrobial resistance of three clones (ST1223, ST2198, ST2250) of Staphylococcus argenteus clinical isolates in northern Japan 日本北部金黄色葡萄球菌临床分离株三个克隆（ST1223、ST2198 和 ST2250）的流行率和抗菌药耐药性。

IF 3.7 3区医学 Q2 INFECTIOUS DISEASES

Journal of global antimicrobial resistance

Pub Date : 2025-01-01 DOI: 10.1016/j.jgar.2024.11.004

Meiji Soe Aung , Noriko Urushibara , Mitsuyo Kawaguchiya , Nobuhide Ohashi , Mina Hirose , Kenji Kudo , Masahiko Ito , Nobumichi Kobayashi

Objectives

Staphylococcus argenteus, a newly described species of coagulase-positive Staphylococcus, was first identified in clinical isolates in northern Japan in 2019. The aim of the present study was to clarify the trends in the epidemiological features and antimicrobial resistance traits of S. argenteus in the recent years.

Methods

S. argenteus isolates from various clinical specimens were screened using MALDI-TOF and genotyped using the multilocus sequence typing scheme. Antimicrobial susceptibility was determined using broth microdilution test and resistance genes were detected by multiplex/uniplex PCR. Nucleotide sequences of haemolysin genes (hla, hlb, hld, and hlg) were determined and analysed in some isolates.

Results

From August 2020 to December 2023, 210 isolates were identified as S. argenteus. The ratio of S. argenteus to Staphylococcus aureus clinical isolates was 0.0045, showing a slightly decreasing trend compared to what was previously reported (2019.8–2020.7). Three genotypes, ST1223-coa-XV, ST2198-coa-XIV, and ST2250-coa-XId were identified, with ST2250 being dominant (49%) and exhibiting an increasing trend. S. argenteus isolates were almost susceptible to antimicrobials examined, while ST2198 isolates showed higher resistance rates to ampicillin, macrolides, and aminoglycosides than other clones, harbouring blaZ, msrA, and aac(6′)-Ie-aph(2″)-Ia. Only eight isolates (4-ST2250, 3-ST1223, and 1-ST2198) did not show haemolysis on blood agar plates. These isolates had intact haemolysin genes and promoter regions; however, a novel deletion mutation in hlg-component A was detected in some haemolytic and non-haemolytic isolates.

Conclusions

The present study revealed the epidemiological trend of S. argenteus clones in northern Japan, along with the occurrence of non-haemolytic isolates with intact haemolysin genes.

目的：阿根廷葡萄球菌是一种新描述的凝固酶阳性葡萄球菌，于2019年首次在日本北部的临床分离物中发现。本研究旨在阐明近年来阿根廷葡萄球菌的流行病学特征和抗菌药耐药性特征的变化趋势：方法：使用 MALDI-TOF 对来自各种临床标本的银环蛇分离株进行筛选，并使用 MLST 方案进行基因分型。采用肉汤微稀释试验测定抗菌药敏感性，并通过多重/单工 PCR 检测耐药基因。对部分分离物的溶血素基因（hla、hlb、hld和hlg）的核苷酸序列进行了测定和分析：结果：从 2020 年 8 月至 2023 年 12 月，210 株分离物被鉴定为 S. argenteus。金黄色葡萄球菌与金黄色葡萄球菌临床分离株的比例为 0.0045，与之前报告的比例（2019.8-2020.7）相比略有下降趋势。鉴定出了三种基因型：ST1223-coa-XV、ST2198-coa-XIV 和 ST2250-coa-XId，其中 ST2250 占主导地位（49%），并呈上升趋势。阿根廷鹅膏菌分离株对所检测的抗菌药物几乎都敏感，而 ST2198 分离株对氨苄西林、大环内酯类和氨基糖苷类药物的耐药率高于其他携带 blaZ、msrA 和 aac(6')-Ie-aph(2")-Ia 的克隆。只有 8 个分离株（4-ST2250、3-ST1223 和 1-ST2198）在血琼脂平板上没有溶血现象。这些分离物的溶血素基因和启动子区域完好无损；但在一些溶血和不溶血的分离物中检测到 hlg 成分 A 发生了新的缺失突变：本研究揭示了日本北部银环蛇克隆的流行趋势，以及具有完整溶血素基因的非溶血性分离株的出现。

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引用次数: 0

Increasing trend of antimicrobial resistance among methicillin-resistant Staphylococcus aureus strains in Southwest Finland, 2007–2016: An analysis of shifting strain dynamics and emerging risk factors 2007-2016年芬兰西南部耐甲氧西林金黄色葡萄球菌耐药性上升趋势：菌株动态变化及新出现的危险因素分析

IF 3.7 3区医学 Q2 INFECTIOUS DISEASES

Journal of global antimicrobial resistance

Pub Date : 2025-01-01 DOI: 10.1016/j.jgar.2024.11.015

Jaakko Silvola , Kirsi Gröndahl-Yli-Hannuksela , Tiina Hirvioja , Kaisu Rantakokko-Jalava , Mari Kanerva , Kari Auranen , Harri Marttila , Jenna Junnila , Jaana Vuopio

Objective

Substantial rise in the annual incidence of methicillin-resistant Staphylococcus aureus (MRSA) was reported in Southwest Finland (12.4–24.9/100,000 people) between 2007 and 2016. To understand the implications of these changes to the management of MRSA, we sought to analyse the antimicrobial resistance (AMR) trends of MRSA in relation with patient characteristics.

Methods

Antimicrobial susceptibility was determined for 10 clinically relevant antimicrobials. Strains with resistance to ≥2 antimicrobials were defined multi-resistant. The isolates were spa-typed and clustered. AMR trends and risk factors were identified by associating resistant phenotypes with patient demographics.

Results

A total of 983 new MRSA cases were identified between 2007 and 2016. After 2011, significant increasing trends were observed in the proportion of isolates resistant to clindamycin (13.9%–31.5%, P < 0.001), erythromycin (19.4%–35.4%, P < 0.001) and tetracycline (16.7%–32%, P < 0.001). The proportion of multi-resistant isolates more than doubled from 14.8% to 39.2%. The increasing AMR trend was reflected in the increase of new strain types and the decrease of previously dominant, non-multi-resistant strains. Patient risk factors associated with (P < 0.001) the acquisition of multi-resistant strains included community acquisition, livestock contact, hospital care abroad and immigrant status.

Conclusions

Notable increasing AMR trends among MRSA isolates were observed in Southwest Finland, 2007–2016. The shift in patient demographics to younger age groups and community acquisition contributed to the increase in multi-resistant strains. Immigration, contact with hospital environment abroad and contact with livestock were identified as essential risk factors of multi-resistance. The increased level of co-resistance has persisted after 2016.

目的：2007-2016年间，芬兰西南部耐甲氧西林金黄色葡萄球菌（MRSA）的年发病率大幅上升（12.4至24.9/10万人）。为了了解这些变化对MRSA管理的影响，我们试图分析MRSA的抗微生物药物耐药性（AMR）趋势与患者特征的关系。方法：对10种临床相关抗菌药物进行药敏试验。对≥2种抗菌素耐药的菌株为多重耐药菌株。分离株为spa型和聚类。通过将耐药表型与患者人口统计学相关联，确定了AMR趋势和危险因素。结果：2007-2016年共发现新发MRSA病例983例。结论：2007-2016年芬兰西南部地区MRSA分离株AMR呈显著上升趋势，耐药比例从13.9%上升至31.5%。患者人口统计数据向年轻年龄组的转变和社区获得促成了多重耐药菌株的增加。移民、接触国外医院环境和接触家畜是多重耐药的主要危险因素。自2016年以来，共同耐药性的增加一直持续下去。

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引用次数: 0

Pseudomonas aeruginosa ST1971 clinical strain carrying the blaNDM-1 gene on ICETn43716385 in Greece 希腊ICETn43716385携带blaNDM-1基因铜绿假单胞菌ST1971临床菌株

IF 3.7 3区医学 Q2 INFECTIOUS DISEASES

Journal of global antimicrobial resistance

Pub Date : 2025-01-01 DOI: 10.1016/j.jgar.2024.12.003

Christos-Georgios Gkountinoudis, Efthymia Petinaki

引用次数: 0

Draft genome sequence of a co-harbouring blaNDM-5 and mcr-1.1 Escherichia coli phylogroup A isolate associated with patient colonisation in Ireland 绘制与爱尔兰患者定植相关的共藏blaNDM-5和mcr-1.1大肠杆菌系统群a分离物的基因组序列。

IF 3.7 3区医学 Q2 INFECTIOUS DISEASES

Journal of global antimicrobial resistance

Pub Date : 2025-01-01 DOI: 10.1016/j.jgar.2024.11.018

Anna Tumeo , Francesca McDonagh , Aneta Kovarova , Kate Ryan , Christina Clarke , Georgios Miliotis

Objectives

While Escherichia coli phylogroup-A is typically associated with commensal strains, some isolates can harbour virulence and exhibit multidrug-resistant (MDR) phenotypes. We report the draft genome of a rare instance of carbapenem, fosfomycin and colistin resistant E. coli phylogroup-A, isolated as part of routine screening of a human patient in a clinical setting in Ireland.

Methods

E. coli E230738 was identified using MALDI-ToF/MS. Antibiotic susceptibility testing was performed using the Sensititre-EUMDRXXF plate. Whole-genome-sequencing was conducted with NextSeq1000, and genomic analysis identified antibiotic-resistance-genes (ARGs) and virulence-factors (VFs). Phylogenetic analysis was performed using whole-genome-multilocus-sequence-typing (wgMLST).

Results

E. coli E230738 genome was identified to belong to phylogroup-A/ST10 complex and to harbour 63 ARGs, 17 of which acquired. Resistance to beta-lactams, including carbapenems and cephalosporins was likely due to chromosomally identified bla_NDM-5. Colistin resistance appeared associated with acquired mcr-1.1. Despite lacking fosfomycin-inactivating-enzymes, fosfomycin resistance was observed, possibly due to efflux pumps. Forty-seven chromosomal VFs were identified, involved in adhesion and iron acquisition amongst other properties. Plasmid replicons associated with the spread of MDR genes such as IncHI2/HI2A were detected. wgMLST analysis showed the closest relative being a strain from the UK, exhibiting differences in the sequences of 851 genes.

Conclusion

This is a first detected instance of a bla_NDM-5 and mcr-1.1 co-occurring in E. coli in Ireland. The MDR profile of E. coli E230738 highlights the growing public health concern posed by the dissemination of MDR E. coli lineages with limited treatment options and underscores the need for clinical screening coupled with genomic surveillance to better understand evolving MDR patterns in E. coli.

目的：虽然大肠杆菌系统群a通常与共生菌株相关，但一些分离株可能具有毒力并表现出多重耐药（MDR）表型。我们报告了碳青霉烯、磷霉素和粘菌素耐药大肠杆菌系统群a的罕见实例的基因组草案，作为爱尔兰临床环境中人类患者常规筛查的一部分分离出来。方法：采用MALDI-ToF/MS对大肠杆菌E230738进行鉴定。采用sensiire - eumdrxxf平板进行药敏试验。使用NextSeq1000进行全基因组测序，基因组分析鉴定出抗生素耐药基因（ARGs）和毒力因子（VFs）。采用全基因组-多位点序列分型（wgMLST）进行系统发育分析。结果：大肠杆菌E230738基因组属于系统群a /ST10复合体，包含63个ARGs（17个获得性）。对-内酰胺类，包括碳青霉烯类和头孢菌素的耐药性可能是由于预测的染色体blaNDM-5。粘菌素耐药性与获得性mcr-1.1相关。尽管缺乏磷霉素灭活酶，但仍观察到磷霉素耐药，可能是由于外排泵。鉴定出47个染色体VFs，涉及粘附和铁获取等。检测到与IncHI2/HI2A等MDR基因传播相关的质粒复制子。系统发育分析显示，最近的亲戚是来自英国的一个菌株，有851个基因不同。结论：这是爱尔兰首次在大肠杆菌中检测到blaNDM-5和mcr-1.1共存的病例。大肠杆菌E230738的耐多药谱突出了耐多药大肠杆菌谱系的传播所造成的日益严重的公共卫生威胁，而治疗选择有限，并强调了临床筛查与基因组监测相结合的必要性，以更好地了解大肠杆菌耐多药模式的演变。

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引用次数: 0

Clonal dissemination of methicillin-resistant Staphylococcaceae between Algerian sheep farms 耐甲氧西林葡萄球菌科在阿尔及利亚绵羊养殖场间的克隆传播。

IF 3.7 3区医学 Q2 INFECTIOUS DISEASES

Journal of global antimicrobial resistance

Pub Date : 2024-12-30 DOI: 10.1016/j.jgar.2024.12.017

Chahrazed Belhout , Javier E. Fernandez , Patrick Butaye , Vincent Perreten

Objectives

Sheep farming represents an important economic sector in Algeria, and the potential dissemination of methicillin-resistant Staphylococcaceae (MRS) is a critical veterinary and public health concern. This study aimed to determine the prevalence and types of MRS in ovine in Algeria and characterize them using whole-genome sequencing (WGS) analysis.

Methods

Two hundred sheep from 20 different Algerian farms across 3 regions were screened for nasal colonization with MRS. The isolates were identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS), their minimal inhibitory concentration (MIC) was determined by broth microdilution, and the presence of the mec gene was confirmed with polymerase chain reaction (PCR). The mec-positive isolates were sequenced using Illumina technology to build species specific core genome multilocus sequence typing (cgMLST)- and single nucleotide polymorphisms (SNPs)-based phylogenies and perform an in silico screening for antimicrobial resistance genes.

Results

The prevalence of MRS-positive farms was 85% (95% confidence interval [CI] = 69.34%–100%) across the sampled farms. Ten distinct Staphylococcaceae species were identified, with Staphylococcus saprophyticus (S. saprophyticus; n = 29), Mammaliicoccus lentus (M. lentus; n = 24), and Staphylococcus haemolyticus (S. haemolyticus; n = 19) being the predominant species. WGS-based phylogeny and SNP analysis (0 to 126 SNPs) revealed that isolates of these three species were highly related, indicating clonal dissemination within and between farms. MRS exhibited a multi-drug resistance pattern, with detection of resistance genes for β-lactams, tetracyclines, fusidic acid, trimethoprim, aminoglycosides, tiamulin, and macrolides.

Conclusions

Specific clonal lineages of methicillin-resistant S. saprophyticus, S. haemolyticus, and M. lentus are widespread in Algerian sheep farms. Enhancing hygiene practices on farms is recommended to prevent further dissemination of these resistant strains to animals and humans. © 2025 The Author(s). Published by Elsevier Ltd on behalf of International Society for Antimicrobial Chemotherapy.

目的：养羊业是阿尔及利亚的一个重要经济部门，耐甲氧西林葡萄球菌（MRS）的潜在传播是兽医和公共卫生的一个重要问题。本研究旨在确定 MRS 在阿尔及利亚绵羊中的流行率和类型，并利用全基因组测序（WGS）分析确定其特征：方法：对来自阿尔及利亚三个地区 20 个不同农场的 200 只绵羊进行了鼻腔 MRS 定殖筛查。用 MALDI-TOF MS 鉴定分离物，用肉汤微量稀释法测定其最小抑菌浓度 (MIC)，用 PCR 确认是否存在 mec 基因。利用Illumina技术对mec阳性分离物进行测序，以建立基于物种特异性cgMLST和单核苷酸多态性（SNPs）的系统进化，并对抗菌药耐药基因进行体内筛选：在所有采样农场中，MRS 阳性农场的比例为 85%（95% CI，69.34%-100%）。确定了 10 个不同的葡萄球菌科菌种，其中最主要的菌种是溶血性葡萄球菌（29 个）、哺乳球菌（24 个）和溶血性葡萄球菌（19 个）。基于 WGS 的系统发育和 SNP 分析（0 至 126 个 SNP）显示，这三个物种的分离株高度相关，表明在农场内部和农场之间存在克隆传播。MRS表现出多种耐药模式，检测到对β-内酰胺类、四环素类、夫西地酸、三甲氧苄啶、氨基糖苷类、替米考星和大环内酯类的耐药基因：结论：耐甲氧西林溶血性链球菌、溶血性链球菌和扁桃体霉菌的特异性克隆在阿尔及利亚养羊场很普遍。建议加强农场的卫生习惯，以防止这些耐药菌株进一步传播给动物和人类。

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引用次数: 0

Isolation and characterization of Acinetobacter phage vAbaIN10 active against carbapenem-resistant Acinetobacter baumannii (CRAB) isolates from healthcare-associated infections in Dakar, Senegal 塞内加尔达喀尔卫生保健相关感染中抗耐碳青霉烯类鲍曼不动杆菌（CRAB）不动杆菌噬菌体vAbaIN10的分离和鉴定

IF 3.7 3区医学 Q2 INFECTIOUS DISEASES

Journal of global antimicrobial resistance

Pub Date : 2024-12-30 DOI: 10.1016/j.jgar.2024.12.024

Issa Ndiaye , Laurent Debarbieux , Ousmane Sow , Bissoume Sambe Ba , Moussa Moise Diagne , Abdoulaye Cissé , Cheikh Fall , Yakhya Dieye , Ndongo Dia , Guillaume Constantin de Magny , Abdoulaye Seck

Background

Carbapenem-resistant Acinetobacter baumannii (CRAB) is a critical antimicrobial resistance threat and a WHO-prioritized pathogen. With intrinsic resistance to multiple antibiotics and the emergence of pan-resistant isolates, CRAB infections are challenging to treat, often relying on polymyxins, tigecycline, aminoglycosides, or combinations, though co-resistance is rising globally. Phage therapy is considered as a potential treatment for multidrug-resistant A. baumannii. This study focused on isolating and characterizing phages active against CRAB strains from healthcare-associated infections in Dakar, Senegal.

Methods

A lytic phage, Acinetobacter vAbaIN10, was isolated from wastewater collected at the Aristide Le Dantec Hospital in Dakar, Senegal. Isolation, host range, efficiency of plating, temperature and pH stability, lysis kinetics, one-step growth test, sequencing, and genomic analysis were performed.

Results

Phage vAbaIN10 belongs to the class Caudoviricetes and the genus Friunavirus. Its genome is 40,279 bp in size. Phage vAbaIN10 is stable across a wide pH range (3–9) and temperature range (25°C–60°C). The phage's lytic activity was evaluated at different multiplicities of infection (MOI): MOI 10, 1, and 10⁻¹. All MOIs significantly reduced the growth of host bacteria. The one-step growth curve showed that vAbaIN10 had a latency period of 25 min and a burst size of approximately 4.78 × 10³ phages per infected bacterial cell. No tRNA, mtRNA, clustered regularly interspaced short palindromic repeat, virulence factors, or antibiotic resistance genes were found in the genome.

Conclusions

The biological and genomic characteristics of vAbaIN10 meet the requirements for its potential use in phage therapy.

背景：鲍曼不动杆菌，特别是碳青霉烯耐药菌株（CRAB），在抗微生物药物耐药性（AMR）的斗争中引起了主要关注，被世界卫生组织（WHO）确定为最优先的病原体。鲍曼不动杆菌对包括青霉素、头孢菌素、氯霉素和磷霉素在内的几种抗生素具有内在耐药性，但抗菌素耐药性的发展导致了极端耐药和泛耐药菌株的出现。螃蟹感染的治疗通常依赖于多粘菌素、替加环素、氨基糖苷及其联合治疗。然而，在世界范围内，对这些抗生素的共同耐药的报道越来越多。噬菌体疗法现在正被重新考虑作为一种有希望的方法来治疗由耐多药鲍曼不动杆菌引起的感染，特别是那些带来治疗挑战的感染。方法：从塞内加尔达喀尔Aristide Le Dantec医院收集的废水中分离出一种裂解噬菌体vAbaIN10不动杆菌。进行了分离、寄主范围、电镀效率（EOP）、温度和pH稳定性、裂解动力学、一步生长试验、测序和基因组分析。结果：噬菌体vAbaIN10属于尾状病毒纲和弗里纳病毒属。其基因组的大小为40279 bp。噬菌体vAbaIN10在很宽的pH范围（3至9）和温度范围（25°C至60°C）内都是稳定的。在不同的感染倍数（MOI）下评估噬菌体的裂解活性：MOI 10、1和10毒血症。所有MOIs均显著降低了宿主细菌的生长。一步生长曲线显示，vAbaIN10的潜伏期为25分钟，每个感染细菌细胞的爆发大小约为4.78 × 10³噬菌体。基因组中未发现tRNA、mtRNA、CRISPR、毒力因子或抗生素耐药基因。结论：vAbaIN10的生物学和基因组学特性满足其在噬菌体治疗中的潜在应用要求。

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引用次数: 0

Efficacy of high doses of intravenous fosfomycin for treatment of urinary tract infection caused by KPC carbapenemase-producing Klebsiella pneumoniae: An observational study 大剂量静脉注射磷霉素治疗由产 KPC 碳青霉烯酶肺炎克雷伯菌引起的尿路感染的疗效。一项观察性研究。

IF 3.7 3区医学 Q2 INFECTIOUS DISEASES

Journal of global antimicrobial resistance

Pub Date : 2024-12-28 DOI: 10.1016/j.jgar.2024.12.013

Jorge Rodríguez-Gómez , Irene Gracia-Ahufinger I , Rosario Carmona-Flores , Julia Guzmán-Puche , Rafael León , Elena Pérez-Nadales , Monserrat Muñoz de la Rosa , Alejandra Mendez Natera , Juan José Castón , Ángela Cano , Juan Jesús Pineda-Capitán , Cristina López , Carmen De la Fuente-Martos , Julián Torre-Cisneros , Luis Martínez-Martínez

Objective

To evaluate the efficacy of high-dose intravenous fosfomycin for the treatment of urinary tract infections (UTI) caused by KPC carbapenemase-producing Klebsiella pneumoniae (KPC-Kp). A secondary objective was to evaluate the impact of the results of fosfomycin susceptibility testing on prognosis.

Methods

This is an observational and retrospective study. Patients hospitalized with UTI caused by KPC-Kp receiving treatment with high-dose intravenous fosfomycin were evaluated from December 2012 to June 2018. The primary outcome variable was clinical cure at d 21.

Results

Forty-seven patients were included. The results of commercial microdilution panels showed that KPC-Kp isolates from 14 (29.8%) and 33 (70.2%) patients were non-susceptible and susceptible to fosfomycin, respectively. In 28 available isolates, susceptibility was also determined by the reference agar dilution method. In the global cohort, clinical cure was achieved at d 21 for 33 (70.2%) out of the 47 patients, with no statistical differences found between fosfomycin non-susceptible isolates and fosfomycin susceptible isolates as determined by commercial microdilution (78.6 vs. 66.7%; P = 0.50) or by the reference agar dilution (83.3 vs. 72.7%; P = 1). In the logistic regression analysis, the Pitt index was the only variable related to clinical cure at 21 d. No statistically significant differences were found for the variables associated with fosfomycin susceptibility testing or fosfomycin minimum inhibitory concentration.

Conclusions

High-dose intravenous fosfomycin can be considered for treatment of hospitalized patients with KPC-Kp UTI in some scenarios. in vitro fosfomycin susceptibility testing for multiresistant KPC-Kp may be of limited clinical value.

目的：评价静脉注射大剂量磷霉素治疗产碳青霉烯酶肺炎克雷伯菌（KPC- kp）所致尿路感染的疗效。第二个目的是评估磷霉素药敏试验结果对预后的影响。方法：回顾性观察研究。对2012年12月至2018年6月接受大剂量静脉磷霉素治疗的KPC-Kp致尿路感染住院患者进行评估。主要结局变量为第21天的临床治愈。结果：纳入47例患者。商业微量稀释板结果显示，14例（29.8%）患者的KPC-Kp分离株对磷霉素不敏感，33例（70.2%）患者对磷霉素敏感。用对照琼脂稀释法测定了28株菌株的药敏性。在全球队列中，47例患者中有33例（70.2%）在第21天实现临床治愈，经商业微量稀释测定，磷霉素非敏感分离株和磷霉素敏感分离株之间没有统计学差异(78.6 vs 66.7%；P = 0.50)或参考琼脂稀释(83.3 vs. 72.7%； = 1页)。在logistic回归分析中，Pitt指数是唯一与21天临床治愈相关的变量。与磷霉素药敏试验或磷霉素MIC相关的变量无统计学差异。结论：在某些情况下，可考虑大剂量静脉注射磷霉素治疗住院KPC-Kp尿路感染。多耐药KPC-Kp体外磷霉素药敏试验临床应用价值有限。

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引用次数: 0

Potential drug interaction after withdrawal of nirmatrelvir-ritonavir in hospitalized patients with COVID-19 infection COVID-19感染住院患者停用尼马特韦-利托那韦后潜在的药物相互作用

IF 3.7 3区医学 Q2 INFECTIOUS DISEASES

Journal of global antimicrobial resistance

Pub Date : 2024-12-27 DOI: 10.1016/j.jgar.2024.12.014

Yun Han , Yonglan Gou , Jieqiong Liu , Lingyan Yu , Yuhua Zhao , Zhenwei Yu

Background

Nirmatrelvir-ritonavir is effective in the treatment of SARS-CoV-2 infection. It can cause drug‒drug interactions (DDIs), even several days after withdrawal, due to irreversible inhibition of the cytochrome enzyme.

Methods

Hospitalized patients diagnosed with COVID-19 infection and treated with nirmatrelvir-ritonavir were retrospectively included according to preset criteria. Personal information, as well as drug use, were obtained from the hospital information system. Potential DDIs were screened and classified according to three databases (FDA fact sheet, University of Liverpool Drug Interactions resources and Lexicomp).

Results

A total of 332 hospitalized patients with COVID-19 infection who received nirmatrelvir-ritonavir treatment were included in this study. The prevalence of potential DDI risk after withdrawal of nirmatrelvir-ritonavir in hospitalized patients was 57.2 %. Most patients resumed potentially interacting medications on the first day of nirmatrelvir-ritonavir withdrawal, and those drugs with DDI risk at the avoidance level mainly included dexamethasone and rivaroxaban, whereas drugs at the caution level mainly included lidocaine.

Conclusion

The prevalence of potential DDI risk after withdrawal of nirmatlevir-ritonavir was high and should be given more attention.

背景：尼马特利韦-利托那韦治疗SARS-CoV-2感染有效。由于细胞色素酶的不可逆抑制，它可以引起药物-药物相互作用（ddi），甚至在停药后几天。方法：回顾性纳入诊断为COVID-19感染并使用尼马特韦-利托那韦治疗的住院患者。从医院信息系统中获取个人信息和用药情况。根据三个数据库（FDA情况说明书、利物浦大学药物相互作用资源和Lexicomp）筛选和分类潜在的ddi。结果：本研究共纳入332例接受尼马特韦-利托那韦治疗的住院COVID-19感染患者。住院患者停用尼马特韦-利托那韦后潜在DDI风险发生率为57.2%。大多数患者在尼马特利韦-利托那韦停药的第一天恢复了可能相互作用的药物，具有DDI风险的避免级药物主要包括地塞米松和利伐沙班，而具有警告级风险的药物主要包括利多卡因。结论：尼马特韦-利托那韦停药后DDI潜在危险发生率较高，应引起重视。

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引用次数: 0

Next-generation sequencing and drug resistance mutations of HIV-1 subtypes in people living with HIV in Sicily, Italy, 2021–2023 2021-2023年意大利西西里岛HIV-1亚型患者的下一代测序和耐药突变

IF 3.7 3区医学 Q2 INFECTIOUS DISEASES

Journal of global antimicrobial resistance

Pub Date : 2024-12-27 DOI: 10.1016/j.jgar.2024.12.015

Luca Pipitò , Marcello Trizzino , Chiara Mascarella , Sara Cannella , Roberta Gaudiano , Irene Ganci , Gaetano D'Alessandro , Benedetta Romanin , Maria Mercedes Santoro , Giovanni M. Giammanco , Antonio Cascio , Celestino Bonura

Objectives

HIV-1 infection continues to be a significant public health concern, notwithstanding the expanded utilization of antiretroviral treatment (ART), due to the emergence of drug resistance. The prevalence of transmitted drug resistance remains uncertain, particularly concerning integrase inhibitors. This study aimed to assess the extent of HIV resistance in both ART-naïve and experienced individuals living with HIV (PLHIV) at the University Hospital in Palermo, Italy.

Methods

Genotyping and mutation analysis were performed on ART naïve and experienced PLHIV admitted from June 2021 to October 2023 by the NGS method. Mutations were detected by testing different NGS frequency cut-offs: ≥5 %, ≥10 %, and ≥20 %. Demographic, clinical, virological, and immunological data were retrospectively collected.

Results

Of the PLHIV, 85 (70 %) were ART-naïve, while 36 (30 %) were ART-experienced with virological failure. The main HIV-1 subtype was B (54 %), which was significantly associated with Italy-born (P < 0.001) and experienced PLHIV (P = 0.024). In the remaining cases, A1 (6 %), C (3 %), F1 (7 %), G (2 %), and Circulating Recombinant Forms (28 %) were reported. At least one mutation for a drug class was detected in 39.7 %, 45.4 %, and 53.7 % of cases at HIV-1 NGS thresholds of 20 %, 10 %, and 5 %, respectively. Drug resistance was found in 18.2 %, 25.6 %, and 33.0 %, by NGS cut-off of 20 %, 10 %, and 5 % respectively. The lowering of NGS cut-offs mainly increased the rates of integrase strand transfer inhibitor resistance. For overall resistance, no difference was observed between B and non-B subtypes for any NGS cut-offs.

目标：由于出现耐药性，尽管抗逆转录病毒治疗的使用有所扩大，但艾滋病毒-1感染仍然是一个重大的公共卫生问题。传播性耐药的流行程度仍不确定，尤其是整合酶抑制剂。这项研究旨在评估ART-naïve和意大利巴勒莫大学医院的HIV感染者（PLHIV）的HIV耐药性程度。方法：采用NGS方法对ART naïve和2021年6月至2023年10月住院的PLHIV患者进行基因分型和突变分析。通过检测不同的NGS频率截止值来检测突变：≥5%、≥10%和≥20%。回顾性收集人口统计学、临床、病毒学和免疫学资料。结果：在PLHIV中，85例（70%）为ART-naïve， 36例（30%）为art经历的病毒学失败。HIV-1主要亚型为B型（54%），与意大利出生（p < 0.001）和经历过PLHIV （p = 0.024）显著相关。其余病例分别为A1（6%）、C（3%）、F1（7%）、G（2%）和循环重组形式（28%）。在HIV-1 NGS阈值分别为20%、10%和5%时，分别有39.7%、45.4%和53.7%的病例检测到至少一种药物类别的突变。耐药率分别为18.2%、25.6%和33.0%，按NGS截止值分别为20%、10%和5%。NGS切断的降低主要增加了整合酶链转移抑制剂的抗性。对于总体抗性，在任何NGS切断点上，B亚型和非B亚型之间没有观察到差异。

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引用次数: 0