Journal Of Infection In Developing Countries[JOURNAL]
Sun
200 papers
Ceftolozane-tazobactam and ceftazidime-avibactam efficacy against K. pneumoniae: first NDM-5 and OXA-232 report from Türkiye.
Altun B, Hazırolan G, Gür D
J Infect Dev Ctries · 2026 Jan · PMID 41662426 · Publisher ↗
INTRODUCTION: Ceftolozane-tazobactam (CLZ-TAZ) and ceftazidime-avibactam (CAZ-AVB) are recently developed β-lactam/β-lactamase inhibitor combinations active against resistant Gram-negative bacteria. This study compared t...
INTRODUCTION: Ceftolozane-tazobactam (CLZ-TAZ) and ceftazidime-avibactam (CAZ-AVB) are recently developed β-lactam/β-lactamase inhibitor combinations active against resistant Gram-negative bacteria. This study compared the in vitro activities of ceftazidime, meropenem, piperacillin-tazobactam (PIP-TAZ), CLZ-TAZ, and CAZ-AVB in Klebsiella pneumoniae isolates from Hacettepe University hospitals and investigated the carbapenemase types detected over the past five years. METHODOLOGY: A total of 550 K. pneumoniae isolates were collected consecutively from invasive clinical samples between 2015 and 2022 according to the SENTRY protocol. Identification was performed using matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). Susceptibility testing for ceftazidime, meropenem, PIP-TAZ, CLZ-TAZ, and CAZ-AVB was carried out by broth microdilution and interpreted according to EUCAST standards. Carbapenemase genes were determined by whole-genome sequencing. RESULTS: Isolates were obtained from blood (n = 191), skin/soft tissue (n = 130), urine (n = 102), respiratory (n = 86), and intra-abdominal (n = 41) samples. Resistance rates were 62.3% for ceftazidime, 29.7% for meropenem, 60.4% for PIP-TAZ, 43.1% for CLZ-TAZ, and 8.7% for CAZ-AVB. The predominant carbapenemases were OXA-48, OXA-232, NDM-1, OXA-181, and KPC-2. Multiple carbapenemases coexisted in 10% of carbapenem-resistant isolates. CONCLUSIONS: CAZ-AVB demonstrated superior activity compared to CLZ-TAZ in this high-resistance setting, While OXA-48 and NDM-1 remain the most frequent carbapenemases, emerging enzymes including OXA-181, OXA-232, KPC-3, and NDM-5 were also detected. The coexistence of multiple enzymes in single isolates highlights a growing therapeutic challenge, emphasizing the need for continued surveillance and effective antimicrobial stewardship.
Analysis of chromosomal genes and proteins of gyrA and gyrB from Indonesian Local-Strain Salmonella enterica serovar Typhi.
Wijaya A, Nainggolan IM, Nathania I … +2 more , Thantry ADK, Moehario LH
J Infect Dev Ctries · 2026 Jan · PMID 41662425 · Publisher ↗
INTRODUCTION: Typhoid fever is an infection of the gastrointestinal tract caused by Salmonella Typhi. Ciprofloxacin is the most widely used second-line therapy; it provides good results in therapy. Indonesia has a unique...
INTRODUCTION: Typhoid fever is an infection of the gastrointestinal tract caused by Salmonella Typhi. Ciprofloxacin is the most widely used second-line therapy; it provides good results in therapy. Indonesia has a unique resistance pattern of fluoroquinolones. Earlier studies of the gyrA and gyrB from local S. Typhi strains showed no mutation, and amino acid replacement was identified in all reported codons. In this study, we explored the whole sequence of the gyrA and gyrB further to understand the association of the unique characteristics of our local strains with fluoroquinolone resistance. METHODOLOGY: This was an analytical study with a cross-sectional approach. Isolates collection, identification, antibiotic sensitivity test, DNA extraction, gene amplification, purification, and sequencing were carried out. Bioedit was used for the analysis of sequencing data. RESULTS: Four isolates were identified as S. Typhi. Three isolates were sensitive to nalidixic acid, ciprofloxacin, levofloxacin, and moxifloxacin. One isolate was intermediate to nalidixic acid, ciprofloxacin, levofloxacin, and resistant to moxifloxacin. The gyrA and gyrB genes were aligned with S. Typhi Ty2 reference sequence (NCBI GenBank AE014613.1). Three amino acid changes (Gly133Glu, Asn538Asp, and Thr856Ala) and one amino acid change (Ala416Ser) were found in gyrA and gyrB, respectively. Protein secondary structures of these isolates showed some changes in alpha helices, beta sheets, random coils, and beta turns, which could result in alterations of the properties of proteins. CONCLUSIONS: Some variations and protein secondary structure alterations were found in the gyrA and gyrB among local strains of S. Typhi, which might be associated with fluoroquinolone susceptibility.
Assessing human brucellosis infection rates in high-risk occupational groups.
Almashhadany DA, Mohammed HI, Omer BZ … +1 more , Taher ZM
J Infect Dev Ctries · 2026 Jan · PMID 41662424 · Publisher ↗
INTRODUCTION: Human brucellosis is a significant zoonotic disease with a substantial public health impact, particularly among individuals in high-risk occupations such as veterinarians, farmers, and laboratory workers. D...
INTRODUCTION: Human brucellosis is a significant zoonotic disease with a substantial public health impact, particularly among individuals in high-risk occupations such as veterinarians, farmers, and laboratory workers. Despite its global prevalence, data on the occupational risk of brucellosis, particularly in specific regions like the Kurdistan region, remains limited. This study aimed to investigate the prevalence of Brucella infections among different occupational groups in Erbil, Kurdistan. METHODOLOGY: A cross-sectional study was conducted from July to December 2023, involving 350 human blood samples collected from participants with various occupations in Erbil. Brucella infection was assessed using the Rose Bengal Test (RBT) and bacterial culture method. The results were analyzed with a focus on the association between occupation, gender, residence, and age; with the prevalence of Brucella infection. RESULTS: The overall prevalence of Brucella infection was 10.9% by RBT and 8.9% by bacterial culture. Veterinarians and veterinary assistants had the highest infection rates (16.0% RBT, 14.0% culture). Gender and residence had no significant impact on infection rates, although rural residents exhibited slightly higher prevalence. The age group 31-40 years showed the highest positivity rates, but differences across age groups were not statistically significant. CONCLUSIONS: The prevalence of brucellosis in Erbil has remained stable over the past decade. High-risk occupations, particularly veterinarians and laboratory workers, require targeted preventive measures, including the use of personal protective equipment. This study emphasizes the need for enhanced occupational health strategies to reduce the risk of brucellosis in vulnerable groups.
Changing trends of vector-borne diseases after the COVID-19 pandemic in India.
Mayilsamy M, Parthasarathy R, Veeramanoharan R … +1 more , Rajaiah P
J Infect Dev Ctries · 2026 Jan · PMID 41662423 · Publisher ↗
INTRODUCTION: Although the unprecedented outbreak of coronavirus disease 2019 (COVID-19) and its deep-rooted consequences are visible in many areas, their impact on vector-borne diseases (VBDs) is only poorly understood....
INTRODUCTION: Although the unprecedented outbreak of coronavirus disease 2019 (COVID-19) and its deep-rooted consequences are visible in many areas, their impact on vector-borne diseases (VBDs) is only poorly understood. Therefore, the temporal trends of major VBDs such as malaria, dengue, chikungunya, Japanese encephalitis, and kala-azar in India were analyzed before and after the COVID-19 pandemic. METHODOLOGY: Data of annually reported VBD cases, such as malaria, dengue, chikungunya, Japanese encephalitis, and kala-azar, in India from 2014 to 2024 were collected and plotted on a bar graph using Microsoft Excel. Trend lines were drawn separately for all VBDs before and after 2020 and the R2 value was calculated. The Pearson correlation coefficient (r value) for each trend was calculated using Microsoft Excel to determine the strength of the trend before and after 2020 for each VBD. RESULTS: The trend line of each VBD; including malaria, dengue, chikungunya, Japanese encephalitis, and kala-azar; showed a different pattern before and after 2020. The r value of the trend indicated that the COVID-19 pandemic has transformed the declining trend of malaria into a strongly increasing trend. The other trends affected by the pandemic were Japanese encephalitis, dengue, chikungunya, and kala-azar. CONCLUSIONS: This study demonstrates a clear influence of the COVID-19 pandemic over the trend of VBDs ranging from mild changes to a total reversal of the trend.
Analysis of the Type VI secretion system and microbiological characteristics of hypervirulent Klebsiella pneumoniae causing urinary tract infections.
Li FF, Li JJ, Zhang Y … +2 more , Wu ZY, Xu YH
J Infect Dev Ctries · 2026 Jan · PMID 41662422 · Publisher ↗
INTRODUCTION: This study aimed to evaluate the Type VI secretion system (T6SS) and microbiological features in hypervirulent Klebsiella pneumoniae (hvKP) causing urinary tract infections (UTIs) in hospitalized adults. ME...
INTRODUCTION: This study aimed to evaluate the Type VI secretion system (T6SS) and microbiological features in hypervirulent Klebsiella pneumoniae (hvKP) causing urinary tract infections (UTIs) in hospitalized adults. METHODOLOGY: This retrospective, observational analysis encompassed 167 inpatients with UTIs caused by KP. The study investigated disease prevalence, antimicrobial susceptibility, gene carriage rates, and competition indices. Strains were classified as classic KP (cKP), T6SS-positive hvKP, or T6SS-negative hvKP, and compared for clinical traits, antimicrobial susceptibilities, and virulence gene carriage. Furthermore, the bacterial competition index of T6SS-positive hvKP strains was assessed through in vitro cultivation. RESULTS: Of 167 patients, 82 had hvKP and 85 had cKP. hvKP had higher rates of thrombosis, immunotherapy, hypoproteinemia, and longer hospital stays (p < 0.05). The 30-day mortality was 29.26% for hvKP vs. 12.94% for cKP (p = 0.045). hvKP showed highest resistance to cefuroxime (81.70%) and cKP to ampicillin/sulbactam (56.47%), with low resistance to tigecycline. The resistance to carbapenems (carbapenem-resistant KP, CR-KP) was significantly higher in hvKP compared to cKP (30.48% vs 16.47%, p = 0.032). Aerobactin and iroB differed between hvKP and cKP. T6SS-positive hvKP had higher rates of thrombosis and immunotherapy (p < 0.05). The 30-day mortality was 9.52% for T6SS-positive vs. 36.06% for T6SS-negative (p = 0.043). T6SS-positive hvKP strains exhibited lower resistance to carbapenems compared to T6SS-negative strains (9.52% vs 37.70%, p = 0.015). T6SS-positive strains had higher aerobactin and iroB positivity. CONCLUSIONS: T6SS-positive hvKP exhibits lower antimicrobial resistance but stronger virulence, playing a major role in bacterial competition.
Distribution and antibiotic resistance of Gram-negative bacteria from blood cultures before and during the COVID-19 pandemic.
Etiz P, Ekenoğlu Merdan Y, Avci P
J Infect Dev Ctries · 2026 Jan · PMID 41662421 · Publisher ↗
INTRODUCTION: Antimicrobial resistance in bloodstream infections is an important clinical challenge. The impact of the coronavirus disease 2019 (COVID-19) pandemic on antimicrobial resistance remains a subject of ongoing...
INTRODUCTION: Antimicrobial resistance in bloodstream infections is an important clinical challenge. The impact of the coronavirus disease 2019 (COVID-19) pandemic on antimicrobial resistance remains a subject of ongoing debate. This single-center study aimed to analyze Gram-negative bacteria (GNB) isolated from blood cultures and evaluate changes in antimicrobial resistance between the pre-pandemic (March 2018-February 2020) and pandemic (March 2020-February 2022) periods. METHODOLOGY: Blood culture data collected over 4 years were retrospectively analyzed using the BACT/ALERT 3D system. Bacterial identification was conducted with the VITEK® 2 compact system, and antimicrobial susceptibility testing was performed according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) criteria. RESULTS: Of 1,668 positive blood cultures, 38.3% yielded GNB. There was an increase in Gram-negative isolates during the pandemic, compared to the pre-pandemic period (55.9% vs. 44.1%). Resistance changes were detected in extensive antibiogram analyses in which 18 different antibiotics were studied for the 4 most frequently isolated species, Acinetobacter baumannii, Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa. During the pandemic period, resistance to amoxicillin/clavulanic acid, ampicillin, ampicillin-sulbactam, ceftriaxone, and cefuroxime decreased; while resistance to amikacin, levofloxacin, and cefepime increased; except in Escherichia coli. CONCLUSIONS: K. pneumoniae remained the most frequently isolated bacterium in both periods, while A. baumannii showed a significant increase during the pandemic. The 2.6-fold increase in A. baumannii may have been caused by the increased use of broad-spectrum antibiotics during the pandemic. These findings reflect data from a single hospital and should be validated by further multicenter studies.
The role of syndromic testing in pneumonia diagnosis: a comparison with culture methods.
Dharmawan A, Pusparini
J Infect Dev Ctries · 2026 Jan · PMID 41662420 · Publisher ↗
INTRODUCTION: Pneumonia is an infection in the pulmonary tissue that is caused by bacteria, viruses, fungi, or parasites. Based on Indonesian Health Survey data for 2023, the prevalence of pneumonia was 10.8%. The rapid...
INTRODUCTION: Pneumonia is an infection in the pulmonary tissue that is caused by bacteria, viruses, fungi, or parasites. Based on Indonesian Health Survey data for 2023, the prevalence of pneumonia was 10.8%. The rapid detection of pathogens accompanied by their antibiotic sensitivity pattern is crucial to obtain relevant outcomes. The gold standard test by bacterial culture needs approximately 72 hours. In order to speed this up, the PCR-based test was developed, such as syndromic testing. METHODOLOGY: The present study was a retrospective study conducted from May 2021 to July 2024, using total sampling, on BAL and sputum specimens, with as inclusion criteria of patients aged ≥ 18 years diagnosed with pneumonia on the basis of bacterial culture and the pneumonia panel test. RESULTS: A total of 147 specimens were collected, with a 66.7% predominance of males and a mean age of 67.24 ± 18.23 years. There was 72.11% correspondence between the two tests, with the proportion of pathogens being 67.35% from the pneumonia panel test and 55.1% from culture. The distribution of pathogens in both tests was dominated by K. pneumoniae, whereas the most frequent antibiotic resistance genes were CTX-M and IMP. The antibiotics that may still be of choice for the therapy of Gram-negative bacteria are tigecycline and amikacin, while for P. aeruginosa, the antibiotic of choice is piperacillin-tazobactam. CONCLUSIONS: The pneumonia panel test provides higher positivity rates, faster results, and detects resistance genes, but lacks coverage for fungi and S. maltophilia.
Unraveling the rarity: p16-positive and p53-positive locally advanced anal cancer in a person living with HIV.
Stanic JD, Jovanovic LD, Jankovic RM … +2 more , Arsenijevic TJ, Nikitovic MR
J Infect Dev Ctries · 2026 Jan · PMID 41662419 · Publisher ↗
INTRODUCTION: Anal squamous cell carcinoma (ASCC) is rare in the general population but is associated with significant morbidity and mortality, particularly among people living with HIV (PLWH). Patient outcomes are influ...
INTRODUCTION: Anal squamous cell carcinoma (ASCC) is rare in the general population but is associated with significant morbidity and mortality, particularly among people living with HIV (PLWH). Patient outcomes are influenced by human papillomavirus (HPV) status, immune function, and tumor biology. CASE REPORT: We report a case of a 56-year-old man with long-standing HIV infection on stable antiretroviral therapy (ART), diagnosed with locally advanced ASCC (T4N1cM0). He received standard concurrent chemoradiotherapy (CRT) with mitomycin C and 5-fluorouracil (5-FU). Treatment was complicated by Grade 3 febrile leukopenia, Grade 2 radiodermatitis, and scrotal lymphedema. An institutional COVID-19 outbreak caused an unplanned treatment interruption, extending the overall CRT duration to 70 days; the patient did not contract COVID-19. Therapy was resumed without dose modification. Six months post-treatment, imaging and endoscopic evaluation revealed fibrotic changes without evidence of active disease. At twelve months, however, the patient developed rapid locoregional recurrence and pulmonary metastases, with fistula and abscess formation, necessitating palliative care. Retrospective immunohistochemical analysis of the original tumor revealed strong p16 expression (indicative of transcriptionally active high-risk HPV), aberrant p53 expression, and a markedly elevated Ki-67 index (99%), reflecting aggressive tumor biology. CONCLUSIONS: This case illustrates the challenges of managing ASCC in PLWH and underscores the need for optimized CRT protocols for this population. Reliable molecular biomarkers, including p16, p53, and Ki-67, may guide personalized therapy and improve prognostic stratification.
Patients with SARS-CoV-2 Omicron variant infection complicated with myocardial injury: a retrospective cohort study.
Zheng J, Liu L, Zou J … +6 more , Liang C, Zhang Y, Peng H, Wang W, Zhou Y, Wang WE
J Infect Dev Ctries · 2026 Jan · PMID 41662418 · Publisher ↗
INTRODUCTION: The SARS-CoV-2 virus and its variants affect not only the respiratory system but also the heart. The impact of SARS-CoV-2 on the heart during the Omicron pandemic is not yet fully elucidated. METHODOLOGY: W...
INTRODUCTION: The SARS-CoV-2 virus and its variants affect not only the respiratory system but also the heart. The impact of SARS-CoV-2 on the heart during the Omicron pandemic is not yet fully elucidated. METHODOLOGY: We conducted a retrospective cohort study of 1,026 hospitalized patients with the Omicron variant at Southwest Hospital (December 2022 to March 2023). Adverse events were defined as a composite of all-cause mortality, intensive care unit admission, mechanical ventilation use, and discharge against medical advice. The risk factors were analyzed by Logistic regression and the Cox regression model. RESULTS: Median age was 69 years (IQR 56-79), myocardial injury occurred in 54.7% (n = 561); adverse events occurred in 25.5% (n = 262). The risk factors of myocardial injury included older age (OR 1.04 [1.03, 1.05], p < 0.001), body temperature at admission (OR 1.64 [1.19, 2.29], p = 0.003), critical COVID-19 (OR 4.96 [2.34, 11.54], p < 0.001), severe valvular heart disease (OR 2.46 [1.06, 6.12], p = 0.042), renal insufficiency (OR 4.04 [2.75, 6.01], p < 0.001), anemia (OR 3.10 [2.12, 4.58], p < 0.001), type II respiratory failure (OR 5.54 [1.79, 24.39], p = 0.008) and higher white blood cell (OR 1.09 [1.05, 1.14], p < 0.001). After adjustment, myocardial injury (HR 1.79 [1.28, 2.48], p = 0.001) was significantly associated with adverse events in patients with Omicron variant infection. CONCLUSIONS: Myocardial injury, the most common extrapulmonary complication of COVID-19 caused by the SARS-CoV-2 Omicron variant, requires timely attention to prevent adverse events in hospitalized patients.
Intensive care units-acquired urinary tract infections: a 5-year multicenter retrospective study in Istanbul.
Kucukates E, Karatas A, Alacam S
J Infect Dev Ctries · 2026 Jan · PMID 41662417 · Publisher ↗
INTRODUCTION: Urinary tract infection (UTI) is the most common hospital-acquired infection worldwide. Nosocomial UTI develops due to swelling of the urinary catheter. This study was conducted to determine the pathogens a...
INTRODUCTION: Urinary tract infection (UTI) is the most common hospital-acquired infection worldwide. Nosocomial UTI develops due to swelling of the urinary catheter. This study was conducted to determine the pathogens associated with catheter-associated urinary tract infection (CAUTI), identify these microorganisms, and investigate antimicrobial resistance patterns in intensive care units-acquired CAUTIs of two hospitals during 5 years. METHODOLOGY: Semiquantitative culture of urine samples was done in both hospitals. Identification and sensitivity of microorganisms were made using conventional methods and automated systems. Susceptibility testing was performed according to Clinical and Laboratory Standards Institute (CLSI) standards and European Committee on Antimicrobial Susceptibility Testing (EUCAST). All 24,882 patients were admitted to the intensive care units (ICUs) at both hospitals. RESULTS: A total of 677 microorganisms were isolated from 580 patients. The CAUTI rate observed in patients was 580/24,882 (2.33%). The most common microorganisms isolated were E. coli (184; 27.18%), K. pneumoniae (128; 18.9%), and enterococci (104; 15.36%). Vancomycin resistance was noted in 10.6% of all enterococci. Staphylococci were not resistant to vancomycin. The most effective antibiotics for Gram-negative bacteria were colistin (90.5%), followed by amikacin (77.4%), meropenem (66.6%), and imipenem (66.4%). High rates of extended-spectrum beta lactamase (ESBL) was noted in 54.3% and 69.5% of E. coli and K. pneumoniae, respectively. CONCLUSIONS: Universal recommendations on the use of catheters should be carefully applied to prevent the development of the infection. Patients who are infected by multidrug resistant (MDR) microorganisms should be followed carefully. Both centers should develop their own policies on this issue.
Severe hemolytic and emphysematous liver abscess in patient with sepsis due to Edwardsiella tarda.
Ton SQ, Nguyen HQ, Vu MK
J Infect Dev Ctries · 2026 Jan · PMID 41662416 · Publisher ↗
INTRODUCTION: Edwardsiella tarda is a Gram-negative facultative anaerobe commonly isolated from fish and reptiles. This bacterium infrequently causes disease in humans, but the mortality rate is very high when associated...
INTRODUCTION: Edwardsiella tarda is a Gram-negative facultative anaerobe commonly isolated from fish and reptiles. This bacterium infrequently causes disease in humans, but the mortality rate is very high when associated with sepsis. CASE PRESENTATION: This case report describes an 80-year-old female patient with Edwardsiella tarda infection who rapidly deteriorated, ultimately succumbing to infection within 9 hours after presenting to the emergency department. This patient was diagnosed with sepsis, hemolytic, emphysematous liver abscess. CONCLUSIONS: This report underscores the potential fatality and rapid progression of Edwardsiella tarda infection, highlighting the importance of early recognition and intervention.
Antibiotic resistance in East Asia: current status, risks, and response strategies.
Zhang J, Fan J, Li D … +10 more , Yang C, Cheng Z, Cheng Z, Qu H, Li G, Yuan N, Song T, Zhou K, Zhao Y, Wang X
J Infect Dev Ctries · 2026 Jan · PMID 41662415 · Publisher ↗
INTRODUCTION: This study investigates the current status and regional disparities of resistance to novel antibiotics in East Asia, exploring links to socioeconomic factors and identifying high-risk resistance determinant...
INTRODUCTION: This study investigates the current status and regional disparities of resistance to novel antibiotics in East Asia, exploring links to socioeconomic factors and identifying high-risk resistance determinants. METHODOLOGY: Metagenomic sequencing was performed on 1024 human fecal samples (25 local, 999 public) from 12 regions across China and Japan. Antibiotic resistance genes (ARGs) were identified by aligning sequences against a comprehensive antibiotic resistance database, focusing on 8 novel antibiotic classes. The relationship between regional per capita GDP and resistance rates for clinically relevant novel antibiotics was statistically analyzed. RESULTS: Significant regional variation in resistance rates was observed for clinically used novel antibiotics (aminocoumarins, glycylcyclines, oxacephems, oxazolidinones, pleuromutilins). A significant inverse correlation was found between per capita GDP and resistance rates for aminocoumarins, glycylcyclines, and oxacephems, particularly pronounced within inland regions. Oxacephem resistance was alarmingly high (> 55% in all regions, > 90% in some). Oxazolidinone resistance remained low (< 28%). Pleuromutilin resistance showed a strong negative GDP correlation only inland. Analysis revealed 24 high-frequency ARGs (5 exceeding 45% coverage: CfxA, IsaB, MexB, abeS, IsaE). Minimal shared resistance determinants existed among novel antibiotic classes, except between oxazolidinones and pleuromutilins. CONCLUSIONS: Resistance to novel antibiotics in East Asia exhibits significant regional heterogeneity, strongly influenced by local economic development levels. Resistance rates for specific agents (e.g., oxacephems) critically limit their clinical utility, necessitating mandatory susceptibility testing. High-frequency ARGs linked to traditional antibiotic misuse pose cross-resistance risks. Surveillance and stewardship strategies must be regionally tailored, prioritizing vulnerable areas and tracking critical resistance loci for novel agents.
Detection of mcr-1 harbouring multidrug-resistant Escherichia coli from hospitalized patients and aquatic environments.
Xue L, Lu H, Liu Z
J Infect Dev Ctries · 2026 Jan · PMID 41662414 · Publisher ↗
INTRODUCTION: The global dissemination of colistin resistance poses a critical challenge to antimicrobial therapy amid increasing multidrug resistance. The objective of this study was to characterize the epidemiology and...
INTRODUCTION: The global dissemination of colistin resistance poses a critical challenge to antimicrobial therapy amid increasing multidrug resistance. The objective of this study was to characterize the epidemiology and transmission of colistin resistance mediated by the mcr-1 gene in multidrug-resistant (MDR) Enterobacteriaceae isolated from hospitalized patients with bloodstream infections and adjacent aquatic environments. METHODOLOGY: A three-year study was conducted to collect MDR Enterobacteriaceae isolates from two distinct sources: blood samples and environmental water samples from five distinct aquatic environments adjacent to the hospital. A systematic analysis was conducted on patient demographic data, bacterial identification, antimicrobial susceptibility profiles, mcr-1 gene screening, and conjugation assays. RESULTS: A total of 159 MDR Enterobacteriaceae were isolated from blood samples, demonstrating an overall colistin resistance rate of 4.4%. Three mcr-1-harbouring Escherichia coli (E. coli) strains were identified: one from an inpatient without colistin exposure, and two from aquatic environmental sources, classified into sequence types (STs) ST10, ST131, and ST155. Conjugation experiments revealed higher transfer frequencies for environmental mcr-1-positive E. coli strains within and across genera. A comparative analysis under varying nutrient conditions identified delayed transfer kinetics in aquatic isolates. Moreover, most transconjugants exhibited levels of colistin resistance that were comparable to or surpassing donor strains, with minimum inhibitory concentrations (MICs) ranging from 4 to 16 mg/L. CONCLUSIONS: This study documents the epidemiological patterns of mcr-1-mediated colistin resistance in clinical and aquatic MDR Enterobacteriaceae. The present findings indicate the dissemination of resistance traits within aquatic environments, where persistence and amplification were observed.
Antimicrobial resistance evolution over time during pre-and post-COVID-19 periods at a major tertiary care center in Lebanon.
Araj GF, Frangieh JG, Sobh GM … +1 more , Ghandour LA
J Infect Dev Ctries · 2026 Jan · PMID 41662413 · Publisher ↗
INTRODUCTION: The increasing rates of AMR have been tolling the healthcare systems globally. This study aims to explore the evolution of AMR patterns against commonly encountered clinical bacterial pathogens at a major t...
INTRODUCTION: The increasing rates of AMR have been tolling the healthcare systems globally. This study aims to explore the evolution of AMR patterns against commonly encountered clinical bacterial pathogens at a major tertiary care center in Lebanon during pre-COVID (2019) and post-COVID (2023) periods. METHODOLOGY: Consecutive non-duplicate isolates of Gram-positive (e.g., Staphylococcus aureus, Streptococcus pneumoniae, Enterococcus spp.) and Gram-negative pathogens (e.g., Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii) were analyzed using MALDI-TOF identification and CLSI-standardized disk diffusion/Etest methods. RESULTS: Key findings revealed persistent methicillin-resistant S. aureus (MRSA) rates (36%), increased vancomycin-resistant Enterococci (VRE; 7% to 10%), and high penicillin susceptibility among S. pneumoniae. Gram-negative isolates exhibited concerning trends: ESBL prevalence rose in E. coli (32% to 36%) but remained stable (35% to 34%) in K. pneumoniae. Carbapenem-resistant Enterobacterales (CRE) rates remained unchanged for E. coli (6% to 5%) but declined for K. pneumoniae (15% to 6%). A. baumannii susceptibility remained critically low (18-55%), while P. aeruginosa showed stable susceptibility (76-92%). CONCLUSIONS: An overall increase in the resistance profiles among different bacterial species is noted in comparison with earlier studies from this institution. These findings align with prior multidrug-resistant strains and underscore the need for robust surveillance, antibiotic stewardship, and infection control measures.
Enhancing serological diagnosis of urogenital schistosomiasis with admixtures of antigens from Schistosoma eggs and worms.
Oyeyemi OT, Irabor PC, Oriade TO … +7 more , Sulaiman KA, Adesida AO, Afolayan FI, Auta T, Odaibo AB, Fatem RG, Grenfell RF
J Infect Dev Ctries · 2025 Dec · PMID 41529015 · Publisher ↗
INTRODUCTION: Timely and effective diagnosis plays a pivotal role in schistosomiasis control efforts. This study aims to assess the utility of combined Schistosoma haematobium soluble egg antigen (Sh SEA) and S. mansoni...
INTRODUCTION: Timely and effective diagnosis plays a pivotal role in schistosomiasis control efforts. This study aims to assess the utility of combined Schistosoma haematobium soluble egg antigen (Sh SEA) and S. mansoni worm antigen (Sm SWA) in serological diagnosis of urogenital schistosomiasis. METHODOLOGY: Admixtures containing 10 µg/mL of both Sm SEA and Sh SEA, as well as Sm SWA and Sh SWA, were employed to detect S. haematobium infection via an indirect enzyme-linked immunosorbent assay (ELISA) using sera and urine from microscopically confirmed positive samples from an endemic population, along with confirmed negative samples from both endemic (NE) and non-endemic (NNE) populations. RESULTS: The diagnostic performance of Schistosoma eggs and worm antigen mixtures varied depending on sample type and negative endemicity. The Sm SEA and Sh SEA mixtures performed poorly with sera and urine from the pair of positive vs negative endemic samples, as well as positive vs non-endemic samples, but excellently with positive vs negative endemic urine samples pair (sensitivity 91.67%; specificity 66.67%). Conversely, SWA mixtures showed superior performance, particularly with the positive vs negative non-endemic sera samples pair (sensitivity 93.75%; specificity 72.92%). Other SWA-based mixtures, except SWA admixture using urine in positive vs NE samples, exhibited acceptable performance. Antibody titers varied significantly, with higher titers generally observed in negative endemic samples for SWA mixtures and in negative non-endemic urine samples for SEA mixtures (p < 0.05). CONCLUSIONS: Combined antigens improve Schistosoma diagnostics: SEA admixtures suit endemic urine samples, while SWA admixtures aid non-endemic sera detection.
Genotyping and phylogenetic analysis of Fasciola species in animals from Iraq using the ITS1 marker.
Hama AA
J Infect Dev Ctries · 2025 Dec · PMID 41529014 · Publisher ↗
INTRODUCTION: Fasciola species are trematodes primarily infecting the liver and bile ducts of animals and humans, and causing serious lesions. They have significant medical and economic impacts, leading to chronic illnes...
INTRODUCTION: Fasciola species are trematodes primarily infecting the liver and bile ducts of animals and humans, and causing serious lesions. They have significant medical and economic impacts, leading to chronic illness and reduced productivity in livestock. This study aimed to assess the genetic diversity of liver flukes isolated from domestic ruminants in Sulaimani province in Iraq. METHODOLOGY: A total of 100 fecal samples were collected from animals living in local farms, including sheep (n = 44), goats (n = 36), and cattle (n = 20). Additionally, 42 liver flukes were obtained from 21 slaughtered animals (10 sheep, 6 cattle, and 5 goats) at the Sulaimani abattoir; 2 flukes per host were collected. DNA was extracted from sedimentation-positive fecal samples and from fluke tissue. Molecular characterization was performed by polymerase chain reaction (PCR) of the internal transcribed spacer 1 (ITS1), and subsequent restriction fragment length polymorphism (RFLP) using RsaI and Tsp509I endonucleases. Genetic diversity was assessed through sequence comparison and phylogenetic analysis. RESULTS: RFLP analysis revealed 3 distinct patterns among liver flukes. DNA sequencing and phylogenetic analysis revealed 3 main clusters, primarily consisting of Fasciola hepatica, Fasciola gigantica, and Fasciola intermediate. CONCLUSIONS: The study demonstrates that PCR-RFLP of ITS1 with RsaI is effective for distinguishing F. hepatica from F. intermediate, while Tsp509I is useful for differentiating F. hepatica from F. gigantica. Additionally, PCR-RFLP of the ITS1 is a simple, fast, and reliable method for species identification of liver flukes present in fecal samples of animals, and directly from fluke tissue.
The past, present and future of global malaria and neglected tropical diseases: a disease burden assessment from 1990 to 2030.
Li D, Shi Y, Wang R … +3 more , Hong X, Shi T, Zhu S
J Infect Dev Ctries · 2025 Dec · PMID 41529013 · Publisher ↗
INTRODUCTION: The World Health Organization (WHO) plans to control the epidemics of malaria and neglected tropical diseases (NTDs) by 2030. The aim of this study was to evaluate the realizability of achieving the WHO tar...
INTRODUCTION: The World Health Organization (WHO) plans to control the epidemics of malaria and neglected tropical diseases (NTDs) by 2030. The aim of this study was to evaluate the realizability of achieving the WHO targets by assessing the past, present, and future global disease burden of malaria and NTDs. METHODOLOGY: Joinpoint regression, Spearman's correlation, and the autoregressive integrated moving average model (ARIMA) were used to estimate the trends of malaria and NTDs from 1990 to 2030 based on the Global Burden of Disease (GBD) Study 2019. RESULTS: Western Sub-Saharan Africa had the highest cases of malaria and NTDs in 2019, with one-half of the global cases. The age-standardized incidence rate (ASIR) in high socio-demographic index (SDI) and World Bank high-income regions showed upward trends from 1990 to 2019. The highest burden of NTDs was dengue in 2019, and the ASIR of dengue showed an obvious upward trend from 1990 to 2019. Children (< 5 years) had the most serious disease burden of malaria and NTDs from 1990 to 2019. The predicted results showed that the age-standardized mortality rate of malaria and NTDs worldwide had a slow upward trend from 2020 to 2030. CONCLUSIONS: This analysis emphasizes that the control of malaria and NTDs in western sub-Saharan Africa should be continuously strengthened and the resurgence of malaria and NTDs in high SDI and World Bank high-income regions needs to be highlighted. Dengue and children (< 5 years) are the primary diseases and populations of concern, respectively, for future prevention efforts.
Low adherence of guideline-based monitoring among chronic hepatitis B patients: a mixed quantitative and qualitative study.
Huang CL, Lan CD, Yu Y … +2 more , Gao J, Yang H
J Infect Dev Ctries · 2025 Dec · PMID 41529012 · Publisher ↗
INTRODUCTION: Adherence to guideline-based monitoring (GBM) for chronic hepatitis B (CHB) in China remains understudied. This mixed-methods study assessed GBM adherence and explored patient-reported barriers. METHODOLOGY...
INTRODUCTION: Adherence to guideline-based monitoring (GBM) for chronic hepatitis B (CHB) in China remains understudied. This mixed-methods study assessed GBM adherence and explored patient-reported barriers. METHODOLOGY: A mixed study was conducted at the Zhongshan Hospital (Xiamen), Fudan University, China. Patients visiting the outpatient department of the hospital between January 2018 and December 2018 were included for the quantitative component. Clinical and biochemical data were retrieved from the hospital's electronic medical record system. Adherence to GBM was defined as regular monitoring of alanine aminotransferase (ALT), hepatitis B virus DNA (HBV-DNA), alpha-fetoprotein (AFP), and liver imaging; at least annually during the 2-year follow-up period. The qualitative component involved semi-structured interviews with thematic and content analysis. RESULTS: Among the 402 eligible CHB outpatients, only 103 (25.6%) patients presented good adherence to GBM. Specifically, 171 (42.5%) patients were monitored at least annually for ALT and HBV-DNA, while 107 (26.6%) were monitored for AFP and liver imaging. The factors associated with adherence to GBM included receiving antiviral treatment (OR = 3.54 (1.59-7.86)) and completing initial liver imaging (OR = 4.78 (2.04-9.83)). The reasons for non-adherence included inadequate monitoring tests and health education by healthcare providers, patients' perception of not needing frequent monitoring, forgetfulness, cost concerns, and complex hospital visit procedures. CONCLUSIONS: Adherence to GBM among CHB patients was suboptimal despite guideline recommendations. Enhanced efforts and interventions, such as combining technology-driven tools, targeted education for providers and patients, and primary care integration are essential.
Therapeutical efficacy of immunobiotics in patients with newly diagnosed rheumatoid arthritis.
Barac B, Lukovic S, Kojic T … +2 more , Radnic TZ, Bibic A
J Infect Dev Ctries · 2025 Dec · PMID 41529011 · Publisher ↗
INTRODUCTION: Rheumatoid arthritis (RA) remission remains a key treatment goal, but remission rates vary. Emerging evidence suggests that gut microbiota modulation via probiotics may influence systemic inflammation and i...
INTRODUCTION: Rheumatoid arthritis (RA) remission remains a key treatment goal, but remission rates vary. Emerging evidence suggests that gut microbiota modulation via probiotics may influence systemic inflammation and improve outcomes in RA. The objective was to evaluate the effects of adjunctive probiotic supplementation on clinical outcomes in patients with newly diagnosed RA receiving conventional disease-modifying antirheumatic drugs (cDMARDs) over 12 months. METHODOLOGY: In this randomized, placebo-controlled trial, 100 patients with newly diagnosed RA were assigned to receive either probiotics containing Lactobacillus casei BLn2401, Lactobacillus salivarius BL2201, and Bifidobacterium breve BL3406 plus cDMARDs (experimental group); or cDMARDs alone (control). Clinical outcomes including disease activity score using 28 joints (DAS28), inflammatory markers (C-reactive protein, CRP; erythrocyte sedimentation rate, ESR), pain (visual analogue scale, VAS), functional disability (health assessment questionnaire, HAQ), and RA quality of life (RAQoL) questionnaire were assessed at baseline and follow-up. Remission rates and corticosteroid use were evaluated. RESULTS: The probiotic group demonstrated faster and more sustained reductions in DAS28, CRP, ESR, pain, and disability scores; compared to controls. The probiotic group achieved near-remission (DAS28 2.3 ± 0.4) by 12 months, while the control group reverted to baseline disease activity. Probiotic use was the independent predictor of remission or low disease activity (HR = 2.703, p < 0.001). Patient-reported quality of life improved significantly, and corticosteroid dependence decreased in the probiotic group. CONCLUSIONS: Adjunctive probiotic supplementation with specific strains may enhance clinical outcomes, reduce inflammation, and increase remission rates in early RA, supporting probiotics as a safe, accessible adjunctive therapy.
Emerging trends and resistance patterns of extended-spectrum beta-lactamases producing Enterobacteriaceae: an epidemiological insight from Ibn Tofail hospital in Marrakesh, Morocco.
Madich FZ, Errahmani MY, Ait Said L … +2 more , Warda K, Zahlane K
J Infect Dev Ctries · 2025 Dec · PMID 41529010 · Publisher ↗
INTRODUCTION: The epidemiology of ESBL infection varies widely from one region to another and rapidly evolves across hospital and community boundaries. Therefore, obtaining an updated local picture of the epidemiology of...
INTRODUCTION: The epidemiology of ESBL infection varies widely from one region to another and rapidly evolves across hospital and community boundaries. Therefore, obtaining an updated local picture of the epidemiology of ESBL-producing microorganisms and analyzing trends in their dissemination is essential. The main aim of this study was to assess the prevalence and the antibiotic resistance profiles of ESBL-producing Enterobacteriaceae (ESBL-E) at Ibn Tofail Hospital in Marrakesh. METHODOLOGY: To our knowledge, the present study is the first to conduct a descriptive analysis from January 1, 2010, to December 31, 2022, including all ESBL-E strains isolated in the microbiology laboratory. Antimicrobial susceptibility testing was determined using the standardized Kirby-Bauer disk diffusion method on Mueller-Hinton agar. The double-disc synergy test confirmed the presence of ESBL. RESULTS: Among 3672 Enterobacteriaceae strains isolated, 20% were ESBL producers. Klebsiella pneumoniae accounted for 45.9% of ESBL-E, followed by Escherichia coli (25.3%) and Enterobacter cloacae (12.8%). The surgical and intensive care units were most affected. Urine samples were the most common source (42.4%). ESBL-E strains exhibited high resistance to tobramycin (80.3%), gentamicin (72.9%), and ciprofloxacin (73.7%), but maintained sensitivity to imipenem (15.6% resistance) and amikacin (21.9%). Significant differences were detected between non-ESBL and ESBL regarding all tested antibiotics. Male patients were significantly more affected by ESBL-E than females. CONCLUSIONS: The increasing incidence of ESBL-E has become a significant concern. Monitoring their epidemiological and resistance profiles is crucial for guiding antibiotic therapy and preventing the development of further resistant strains.
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