[This corrects the article DOI: 10.3389/fcimb.2026.1796479.].

PURPOSE:The increasing prevalence of Klebsiella pneumoniae (KP) infections underscores an urgent need for novel therapeutic agents. This study aimed to comprehensively evaluate the antibacterial efficacy, in vivo therapeutic potential, preliminary safety profile, and mechanism of action of the compound MTEBT-3 against clinical isolates of KP. METHODS:The minimum inhibitory concentration (MIC) of MTEBT-3 against 30 clinical isolates of KP was determined using the broth microdilution method. The membrane-disrupting effect of MTEBT-3 was investigated by measuring the permeability of both the inner and outer membranes. A murine skin infection model was established to assess in vivo treatment efficacy over a 14-day observation period. Systemic safety was evaluated via complete blood count analysis and histopathological examination. Transcriptomic profiling of MTEBT-3 treated bacteria was performed, followed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses to identify affected biological processes and signaling pathways. RESULTS:MTEBT-3 exhibited potent antibacterial activity against all 30 clinical isolates, with MIC values ranging from 1 to 8 μg/mL. The results indicated that the permeability of both the inner and outer bacterial membranes increased significantly after treatment with MTEBT-3 (P < 0.05), demonstrating its membrane-disrupting effect on bacterial cell structure. In the murine infection model, the treatment group showed significantly enhanced wound healing compared with the model control group (P < 0.001). Blood routine tests and histopathological assessment revealed no significant signs of systemic toxicity, indicating favorable preliminary safety and biocompatibility. CONCLUSION:MTEBT-3 demonstrates strong in vitro and in vivo antibacterial effects against clinical K. pneumoniae isolates, along with a promising safety profile. Its mechanism may involve disruption of bacterial membrane integrity, impairment of energy metabolism, and interference with essential biological processes, supporting its potential as a candidate for anti-infective therapy.

IntroductionCarbapenem-resistant Klebsiella pneumoniae (CRKP) skin infections represent a critical therapeutic challenge due to biofilm formation and poor drug penetration. Reactive oxygen species (ROS)-mediated strategies, such as advanced photodynamic therapy, offer promising multi-target approaches against such resistant pathogens.MethodsWe developed a light-tunable conjugated polymer, P3, designed to penetrate CRKP biofilms and achieve spatiotemporally controlled activation. Its efficacy was evaluated against established CRKP biofilms in both dark and visible light conditions, assessing biofilm biomass elimination and bacterial viability.ResultsP3 leveraged its intrinsic optical properties and ROS production to eliminate 50% of the CRKP biofilm in darkness. Upon visible light irradiation, its efficacy was dramatically enhanced via a triggered compensatory self-destruction (CSD) mechanism. This self-amplifying reaction catastrophically disrupted bacterial membrane integrity and oxidative balance, resulting in the internal destruction of over 80% of the biofilm and bacterial death. This action combines physical matrix breakdown with ROS-mediated biomolecular damage, leading to near-complete biofilm eradication.DiscussionOur study demonstrates that P3 functions as a "metabolic time bomb," providing a targeted, antibiotic-free strategy against structured bacterial communities. These findings highlight the significant potential of this light-controlled platform for treating resistant biofilm-associated infections.

Following China’s 2021 national policy canceling routine cephalosporin skin testing (CST), substantial implementation barriers persist in some hospitals due to traditional clinical practices and fears about liability. For example, prescribers often order CST out of habit, citing concerns about potential allergic reactions and the risk of adverse events being attributed to them without a documented skin test. A similar challenge exists in the nephrology department of our hospital. Three months following the release of the national policy, the rate of routine CST remained persistently high. This highlights an urgent need for clinical pharmacists to implement targeted interventions to facilitate policy adoption and improve practice adherence. This study compares two different strategies: pharmacist-led Collaborative Learning in Practice(CLiP)-aligned “point education” (concentrated, personalized training) vs. “rotation communication” (without pharmacist-led point education, indirect knowledge diffusion through physician rotations and informal information sharing). We analyze their differential effectiveness in reducing skin test rates in a real-world clinical setting. A retrospective observational study collected data on hospitalized nephrology patients planned for cephalosporin use between January 2021 and April 2023. Using the April 2022 pharmacist intervention in one treatment team as the node, interrupted time series analysis compared pre-/post-level and trend changes of skin test rates among wards (first nephrology group, second nephrology group, Nephrology Intensive Care Unit (NICU)) and physicians. The overall skin test rate decreased dramatically from 96.02

IntroductionIntravenous (IV) infusion is overused in Chinese hospitals, and a tool to appraise its appropriateness quantitatively and qualitatively is lacking. This study aimed to develop a multidimensional evaluation framework for assessing the appropriateness of IV infusion use in general hospitals using factor and cluster analyses.MethodsWe conducted a multicentre retrospective study using data from 25 hospitals and a total of 2,064 cases were analyzed. Stratified proportional random sampling was used to select medical records, and a dedicated intravenous infusion survey form was completed for each patient. Factor analysis and cluster analysis were employed to comprehensively assess the ranking and classification of standardized intravenous infusion use among these hospitals. The Kruskal-Wallis test was used to compare disparities in performance characteristics across clusters. Nine IV infusion-related indicators were selected based on national quality control guidelines. Principal component factor analysis was used to extract common factors, and K-means cluster analysis was applied to categorize hospitals into performance tiers. Statistical comparisons were performed to validate inter-group differences.ResultsThe number of prescription items was classified according to ATC codes, with the top three being anti-infectives (J01), nutritional preparations (V06), and vitamins (A11). Two factors explained 81.9% of variance: “intensity” (high loadings on DOT, LOT, volume, bottles) and “penetration” (utilization and bed-day coverage). K-means clustering classified the 25 hospitals into four categories. “Excellent” (24.00%), “good” (20.00%), “Middle” (2.00%), and “Inferior” (48.00%). Inter-group comparisons showed no statistically significant difference in the proportion of intravenous infusion orders (P = 0.131), while the other eight indicators differed significantly (P < 0.01). These results objectively reflect the distinct characteristics of intravenous infusion practices among hospitals in Shanxi Province.DiscussionThe factor analysis incorporating nine evaluation indicators can serve as a method to assess the standardization of intravenous infusion in hospitals. The cluster analysis reveals a discernible pattern in the combination of intravenous-infusion -related indicators across hospitals. This study presents a practical and scalable tool for evaluating IV infusion appropriateness in hospitals. The proposed framework supports targeted quality improvement interventions and aligns with national goals for rational drug use. Future efforts should expand the scope of evaluation and link infusion patterns to clinical outcomes.

IntroductionCentral nervous system infection (CNSI) following neurosurgery is challenging to treat and carries a high risk of recurrence, morbidity, and mortality. Low CNS penetration of antibiotics may contribute to poor clinical outcomes from CNS infections. Different drug regimens also suggested variable impacts on clinical outcomes. This study aims to measure the cerebrospinal fluid (CSF) concentration of meropenem, vancomycin and tigecycline in patients with CNSI following neurosurgery and thus evaluate the differential therapeutic efficacy of different drug regimens.MethodsPatients who received meropenem, vancomycin and/or tigecycline for highly suspected or confirmed bacterial CNSI following neurosurgery were recruited from a tertiary hospital in Shanxi from January 2021 through December 2022. The concentrations of these three antibiotics in CSF and/or plasma were determined by high-performance liquid chromatography (HPLC) or enzyme immunoassay. Relevant pharmacokinetic/pharmacodynamic (PK/PD) parameters were assessed using DAS 2.0 software. Body temperature, biochemical examination and bacterial culture results were collected to evaluate efficacy.ResultsIn total, 55 CSF and ten plasma samples obtained from ten patients were included in this study. In particular, of five patients who had a positive CSF culture, four achieved culture conversion to negative. Nine individuals successfully achieved CSF, blood tests, or body temperature improvement. Only one patient showed no improvement at discharge.ConclusionThe CSF concentration and PK/PD parameters of meropenem, vancomycin, and tigecycline in patients with CNSI following neurosurgery featured large inter-individual variation. Different drug regimens can partially improved the outcomes of such patients, but monitoring of potential adverse reactions is required.

ObjectiveTo investigate the current patterns of antimicrobial use among nonsurgical inpatients across 25 general hospitals in Shanxi Province and to evaluate the antimicrobial use rate, antimicrobial use density (AUD), days of therapy (DOT), length of therapy (LOT), and the application of cluster analysis in monitoring antimicrobial prescribing practices.MethodsThis study included 25 general hospitals covering 11 cities in Shanxi Province. In total, 2064 hospitalized nonsurgical patients were evaluated for antimicrobial use between December 1, 2022, and January 31, 2023. Data collected included the proportion of antimicrobial prescriptions, antimicrobial use rate, AUD, DOT, and LOT. Statistical analyses were conducted using IBM SPSS version 21.0. Cluster analysis was employed to categorize the 25 hospitals systematically.ResultsAmong the hospitals, the antimicrobial utilization rate ranged from 43.00 to 83.33%. The intensity of antimicrobial use ranged from 40DDDs/ 100pd to 98.99DDDs/100pd. DOT values ranged from 380/1000pd to 713/1000pd, while LOT ranged from 425/1000pd to 1,014/1000pd. The top three antimicrobial classes by AUD were third-generation cephalosporins (15.38 DDDs/100pd), quinolones (13.60 DDDs/100pd), and cephalosporins (11.54 DDDs/100pd). The ICU had the highest antimicrobial use rate and AUD—91.67% and 133.28 DDDs/100pd, respectively —and the longest DOT (1,230/1000 pd). The infection department recorded the highest LOT (988/1000pd). In pediatrics, the AUD and DOT were 53.77DDDs/ 100pd and 1,106/1000pd, respectively. The 25 hospitals were grouped into three distinct clusters via cluster analysis. Statistically significant differences in some antimicrobial indicators were observed among the groups (p < 0.05).ConclusionAcross the 25 hospitals, the rate and intensity of antimicrobial use were relatively high in institutions and departments. During the study period, the use of cefoperazone/sulbactam and fluoroquinolones increased. Concurrently, the combined use of AUD and DOT provided complementary perspectives for evaluating antimicrobial consumption, allowing for a more comprehensive understanding of exposure levels across hospitals and departments. Cluster analysis provides valuable insights for identifying patterns into antimicrobial management and usage.

During the coronavirus disease 2019 (COVID-19) pandemic, widespread empirical antimicrobial use was reported globally, often without confirmed bacterial infection. This study aimed to assess antimicrobial prescribing patterns, bacterial coinfection rates, and clinical outcomes among inpatients during the Omicron surge in Shanxi Province, China. We conducted a multicentre retrospective study using data from 25 hospitals. Non-surgical inpatients discharged between December 1, 2022, and January 31, 2023, were included. Patients were categorized by COVID-19 status and antimicrobial use. Antimicrobial consumption was measured using defined daily doses (DDDs), days of therapy (DOT), and antimicrobial use density (AUD). Clinical outcomes, microbiological data, and adverse events were analyzed. Among the 2064 inpatients included, 701 (34.0

BACKGROUND:The spread of carbapenem-resistant Klebsiella pneumoniae (CRKP) that produces K. pneumoniae carbapenemase-2 has garnered significant attention due to its increasing prevalence. In China, the dissemination of K. pneumoniae carbapenemase-2-producing CRKP is predominantly linked to sequence type 11 (ST11), with capsular serotypes KL47 and KL64 being the primary capsular identified. METHODS:A total of 64 CRKP-ST11 strains were collected from 2020 to 2023 and whole-genome sequencing was performed on all isolated ST11-CRKP strains. Antibiotic susceptibility was tested using the VITEK 2 system. Growth curve tests and in vitro competition experiments were used to assess the growth adaptability of different capsular type isolates. Moreover, the biofilm assessment and phagocytosis assays were performed to evaluate CRKP isolate virulence. RESULTS:During the observed period, a notable subclonal shift was perceived within the prevailing ST11-CRKP clone, wherein the previously dominant KL64 and KL47 serotypes have been largely supplanted by the KL25 serotype since 2022. The ST11-KL25-CRKP strain significantly outgrew both ST11-KL64-CRKP and ST11-KL47-CRKP. Additionally, ST11-KL25-CRKP displayed a greater enhanced capacity to form biofilms than ST11-KL64-CRKP and ST11-KL47-CRKP. Furthermore, ST11-KL25-CRKP demonstrated enhanced resistance to phagocytosis than both of its counterparts. CONCLUSIONS:ST11-KL25-CRKP possesses a remarkable level of adaptability and has the potential to regionally replace ST11-KL64-CRKP as the predominant strain in the region. Additionally, this novel and high-risk ST11-KL25-CRKP strain may indicate stronger virulence.

OBJECTIVE:With the increasing prevalence of antimicrobial resistance (AMR), the rational use of antibiotics is crucial. This study aimed to evaluate the antibiotic use patterns and influencing factors of compliance in Shanxi Province Hospitals between 2015 and 2021 and provide data support for the management of antibiotics. DESIGN:This was a retrospective observational study of trends in antibiotic use and data reporting trends in the context of antimicrobial stewardship (AMS). DATA SOURCES:The analysis involved annual antibiotic data from hospitals covered by China's National Clinical Improvement System (NCIS). We obtained information on hospital characteristics (eg, city, a deidentified hospital code and hospital level) from Shanxi Provincial Pharmaceutical Quality Control Centre. ELIGIBILITY CRITERIA:Our study included Shanxi hospitals that reported annual antibiotic data to the NCIS system in any year between 2015 and 2021. RESULTS:The number of hospitals reporting antibiotic data has increased annually. Between 2015 and 2021, a total of 221 hospitals in 11 cities were analysed. The proportion of patients undergoing clean surgical procedures with prophylactic antibiotic prescriptions decreased from 45.08% to 40.0% between 2019 and 2021, with a compound annual growth rate (CAGR) of -5.80 (p=0.103). The intensity of antibiotic treatment among inpatients was from 42.00 to 39.70 daily defined dose between 2017 and 2021, with a CAGR of -1.40 (p=0.015). The proportion of inpatients with antibiotic prescriptions decreased from 51.42% to 47.14% between 2015 and 2021, with a CAGR of -1.44 (p<0.001), and the proportion of inpatients with special-grade antibiotic prescriptions decreased from 0.74% to 0.49% between 2016 and 2021, with a CAGR of -2.56 (p=0.998). The multivariable logistic regression analysis showed that public hospitals, hospitals with prescription automatic screening system (PASS), hospitals with AMS, City A, City G and City I were independently associated with the proportion of patients who used prophylactic antibiotics for patients undergoing clean surgical procedures. Hospitals with PASS and AMS, and hospitals in City A, City D, City E and City I were independently associated with the antibiotic use density. Tertiary hospitals and City C were independently significantly associated with the proportion of inpatients with antibiotic prescriptions. Hospitals with AMS and City D were independently significantly associated with the proportion of inpatients with special-grade antibiotic prescriptions (all p<0.05). CONCLUSIONS:Antibiotic consumption in inpatients decreased during the study period. However, we need to take more measures to reduce patients undergoing clean surgical procedures with prophylactic antibiotic prescriptions and inpatients with special-grade antibiotic prescriptions. Antibiotic use was associated with various hospital characteristics and geographic locations. While the provincial efforts in controlling antibiotic use show some efficacy, further enhancement of surveillance programmes and targeted interventions at the hospital level are necessary to mitigate the escalation of AMR and ensure adequate antibiotic supply for emerging infectious diseases.

ObjectiveTo optimize the use of tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs) for cancer patients, we characterized and evaluated ONJ related to TKIs and ICIs by analyzing a public database and reviewing the relevant literature. TKIs and ICIs are limited to drugs that treat renal cancer recommended by the National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology for Kidney Cancer.MethodsWe described a case series of patients experiencing ONJ while on TKIs or ICIs. We also analyzed spontaneous reports submitted to the FAERS in an observational and retrospective manner between January 2004 and December 2022. Selecting ONJ’ adverse events to TKIs and ICIs. Associations between TKIs, ICIs and ONJ were assessed using reporting odds ratios (ROR), drug interaction signals based on the Ω shrinkage measure.Results29 patients with ONJ events while on TKIs and ICIs were included in our case series. 240 were related to ONJ AEs. Specifically, 32.1% ICSRs were linked to sunitinib, 16.7% to lenvatinib, 12.9% to pazopanib, 12.5% to nivolumab, 10.0% to axitinib, 5.4% to sorafenib, 5.0% to pembrolizumab, 4.2% to cabozantinib, and 1.3% to ipilimumab. More ICSRs were generally seen in male and reported in Europe. The median age was 63 years. Renal cancer and lung cancer was the most common indication for TKIs and ICIs, respectively. Excluding missing data, the prevalence of mortality was highest for sunitinib-related ONJ ICSRs (18.5%), followed by sorafenib-related ONJ ICSRs (15.4%). With the criteria of ROR, sunitinib and lenvatinib were significantly associated with ONJ AEs. With the criteria of Ω, nivolumab + cabozantinib was significantly associated with ONJ AEs.ConclusionTKIs and ICIs have been reported to have significant ONJ side effects. Patients and physicians need to recognize and monitor these potentially fatal adverse events.

Flavonoid compounds exhibit remarkable antioxidant and anti-inflammatory properties in DCM and various other diseases. However, the specific mechanisms by which Tricin, 4’,5,7-trihydroxy-3‘,5’-dimethoxyflavone, exerts its effects in the context of DCM remain to be elucidated. Rat H9C2 cells were cultured and subjected to high glucose conditions to establish a DCM cell model. Tricin was administered in varying concentrations to evaluate its effects on cellular oxidative stress markers, including ROS, LDH, and SOD. Additionally, the levels of inflammatory cytokines TNF-α, IL-1β, and IL-6, as well as the expression of TLR4, MYD88, and p-NF-κB, were assessed through ELISA and Western blotting. Tricin treatment significantly ameliorated high glucose-induced oxidative stress in H9C2 cells, evidenced by reduced ROS and LDH levels and increased SOD levels in a dose-dependent manner. Furthermore, Tricin effectively suppressed the elevation of pro-inflammatory cytokines TNF-α, IL-1β, and IL-6. Tricin also inhibited the overactivation of the TLR4-MYD88-NF-κB signaling pathway, suggesting its role in modulating key inflammatory processes in DCM. Tricin exhibits a protective role against high glucose-induced cardiac damage in a DCM cell model. By reducing oxidative stress and inflammation, and inhibiting the TLR4-MYD88-NF-κB pathway, Tricin shows significant therapeutic potential for DCM treatment. This study underscores the value of Tricin as a novel therapeutic approach for managing diabetic cardiomyopathy, warranting further research and clinical investigation. Not applicable.

Purpose The rise of carbapenem-resistant Klebsiella pneumoniae (CRKP) has led to increased morbidity and mortality in clinical patients, highlighting the urgent need for effective antibacterial agents. Methods We obtained a synthetic compound, MTEBT-3, using hydrophobic triphenylamine as the skeleton and hydrophilic ammonium salts. We determined the MIC of MTEBT-3 using the macro-broth susceptibility testing method. We isolated a clinical CRKP strain ST3984 and performed synergistic antibiotic sensitivity tests, time-kill assays, and resistance evolution studies. Biofilm formation under sub-MIC conditions was evaluated using crystal violet staining and CLSM. Additionally, biofilm proteins and polysaccharides were quantified. We assessed the bactericidal mechanism of MTEBT-3 by examining the integrity of CRKP bacterial cell membranes and analyzing the transcription of virulence-regulating genes via quantitative real-time PCR. Results MTEBT-3 exhibited broad-spectrum antibacterial activity with a low resistance rate, achieving the MIC of 8 μg/mL. The compound displayed additive effects with meropenem and imipenem and synergistic effects with tigecycline. It maintained its efficacy over multiple bacterial generations, with no significant increase in resistance observed. Under sub-MIC conditions, the biomass of biofilms was significantly reduced, and the levels of proteins and polysaccharides within the biofilms were markedly lowered in a concentration-dependent manner. The bactericidal mechanism of MTEBT-3 involved disrupting the integrity of CRKP bacterial cell membranes, leading to increased permeability. Quantitative real-time PCR results showed that MTEBT-3 effectively suppressed the expression of key virulence genes, including fimH, wbbM, rmpA, and rmpA2, which are associated with biofilm formation and bacterial adhesion. Conclusion The significant antimicrobial activity of MTEBT-3 against clinically isolated CRKP, along with its synergistic or additive effects with commonly used antibiotics, positions it as a promising candidate for treatment. Its ability to disrupt biofilm formation and reduce virulence factor expression further underscores its potential in managing CRKP infections.

Methicillin-Resistant Staphylococcus aureus forming into biofilms can trigger chronic inflammation and disrupt skin wound healing processes. Prolonged and excessive use of antibiotics can expedite the development of resistance, primarily because of their limited ability to penetrate microbial membranes and biofilms, especially antibiotics with intracellular drug targets. Herein, we devise a strategy in which virus-inspired nanoparticles control the release of antibiotics through rapid penetration into both bacterial cells and biofilms, thereby combating antimicrobial-resistant infections and promoting skin wound healing. Lipid-based nanoparticles based on stearamine and cholesterol were designed to mimic viral highly ordered nanostructures. To mimic the arginine-rich fragments in viral protein transduction domains, the primary amines on the surface of the lipid-based nanoparticles were exchanged by guanidine segments. Levofloxacin, an antibiotic that inhibits DNA replication, was chosen as the model drug to be incorporated into nanoparticles. Hyaluronic acid was coated on the surface of nanoparticles acting as a capping agent to achieve bacterial-specific degradation and guanidine explosion in the bacterial microenvironment. Our virus-inspired nanoparticles displayed long-acting antibacterial effects and powerful biofilm elimination to overcome antimicrobial-resistant infections and promote skin wound healing. This work demonstrates the ability of virus-inspired nanoparticles to achieve a dual penetration of microbial cell membranes and biofilm structures to address antimicrobial-resistant infections and trigger skin wound healing.

目的 调查并分析山西地区抗菌药物使用、耐药和院感情况,以期为细化抗菌药物管理和耐药控制制定相关干预策略提供依据.方法 调查对象为山西省11个地市共15家三级甲等综合医院,采用全球-断面时点流行病学调查(pointprevalence survey,PPS)方法收集各医院患者抗菌药物使用、医院获得性感染(hospital acquired infection,HAI)和细菌分离及耐药情况,采用logistics多因素回归模型分析HAI的危险因素.结果 被调查的15家医院共6664名患者计入.抗菌药物使用率为30.06％,单一用药占比为67.20％,联合用药占比为32.80％,其中呼吸科抗菌药物使用率及联合用药占比最高,分别为72.97％和44.27％,均高于ICU的66.54％和40.22％.感染类型以社区感染(community acquired infection,CAI)为主,占91.59％;治疗CAI经验性用药的比例为89.96％,高于HAI的67.17％.肺炎或下呼吸道感染比率最高37.46％,其次是胃肠感染11.54％.调查当日,抗菌药物医嘱应用前3位分别为左氧氟沙星、头孢他啶和依替米星.1259例手术患者,手术类型以Ⅱ类切口最多占51.72％,第二代头孢菌素头孢呋辛钠为手术预防用药的主要药物;术后预防用药疗程大于1 d的比例为67.43％.发生医院获得性感染的多因素分析结果显示,疾病类型、入院前住院史、入住重症医学科为HAI的独立危险因素(P＜0.05).微生物种类前5位为革兰阴性菌,肠杆科细菌耐碳青霉烯类的比率为10％.结论 被调查各医院之间抗菌药物使用存在差别,整体呼吸系统抗菌药物使用率及联合用药率较高,手术预防用抗菌药物术后疗程偏长,需制定相应的管理措施进行干预.

目的：通过与群体感应（Quorum Sensing，QS）基因正常菌株对比，探讨喹诺酮信号分子对lasR 缺陷型铜绿假单胞菌绿脓菌素活性的影响。方法：选取2021 年3 月至2022 年10 月山西医科大学第二医院临床分离的10 株铜绿假单胞菌为研究对象，QS 基因正常的非重复菌株为正常组，只有lasR 基因缺失的为缺陷组，观察正常组和缺陷组经不同浓度喹诺酮信号分子（Pseudomonas Quinolone Signal，PQS）（10 μmol/L、40 μmol/L、80 μmol/L）和不同时间（1 d、2 d、3 d、4 d 和5 d）诱导绿脓菌素活性的变化，采用秩和检验和重复测量方差分析进行结果分析。结果：诱导前缺陷组的绿脓菌素活性低于正常组，两组的绿脓菌素活性差异有统计学意义（P ＜ 0.05）。组内比较表明，不考虑诱导浓度间的差异，正常组菌株在不同诱导时间的绿脓菌素活性差异有统计学意义（P ＜ 0.05），缺陷组活性差异没有统计学意义（P ＞ 0.05）；不考虑诱导时间之间的差异，正常组在不同诱导浓度下的绿脓菌素活性差异有统计学意义（P ＜ 0.05），缺陷组活性差异没有统计学意义（P ＞ 0.05）。组间比较表明，两组菌株在不同诱导时间和诱导浓度下绿脓菌素活性差异均有统计学意义（P ＜ 0.05）。结论：外源性喹诺酮信号分子不同诱导方案对正常组和缺陷组绿脓菌素活性影响不同，正常组在不同诱导方案下绿脓菌素活性不同程度地提高，缺陷组在不同诱导方案下绿脓菌素活性变化不明显，缺陷组的绿脓菌素活性均低于正常组。

目的:通过与群体感应(Quorum Sensing,QS)基因正常菌株对比,探讨喹诺酮信号分子对lasR缺陷型铜绿假单胞菌绿脓菌素活性的影响.方法:选取 2021年 3 月至 2022 年10 月山西医科大学第二医院临床分离的10 株铜绿假单胞菌为研究对象,QS基因正常的非重复菌株为正常组,只有lasR基因缺失的为缺陷组,观察正常组和缺陷组经不同浓度喹诺酮信号分子(Pseudomonas Quinolone Signal,PQS)(10 μmol/L、40 μmol/L、80 μmol/L)和不同时间(1 d、2 d、3 d、4 d和 5 d)诱导绿脓菌素活性的变化,采用秩和检验和重复测量方差分析进行结果分析.结果:诱导前缺陷组的绿脓菌素活性低于正常组,两组的绿脓菌素活性差异有统计学意义(P＜0.05).组内比较表明,不考虑诱导浓度间的差异,正常组菌株在不同诱导时间的绿脓菌素活性差异有统计学意义(P＜0.05),缺陷组活性差异没有统计学意义(P＞0.05);不考虑诱导时间之间的差异,正常组在不同诱导浓度下的绿脓菌素活性差异有统计学意义(P＜0.05),缺陷组活性差异没有统计学意义(P＞0.05).组间比较表明,两组菌株在不同诱导时间和诱导浓度下绿脓菌素活性差异均有统计学意义(P＜0.05).结论:外源性喹诺酮信号分子不同诱导方案对正常组和缺陷组绿脓菌素活性影响不同,正常组在不同诱导方案下绿脓菌素活性不同程度地提高,缺陷组在不同诱导方案下绿脓菌素活性变化不明显,缺陷组的绿脓菌素活性均低于正常组.

目的 了解2015-2021年国内主要地区医疗机构临床分离链球菌属细菌对抗菌药物的耐药性.方法 对国内主要地区51所医院临床分离的链球菌属采用纸片扩散法(K-B法)或E试验方法或自动化商业药敏测试系统,按CHINET统一监测方案进行抗菌药物敏感性试验,并按2022年CLSI折点标准统计分析总结.结果 2015-2021年共收集到89 684株链球菌属细菌,包括肺炎链球菌35 254株(39.3％),β溶血链球菌42 563株(47.6％),草绿色链球菌11 767株(13.1％).42 563株β溶血链球菌中A群、B群以及未能鉴定分型的链球菌分别为39.8％、52.8％、7.4％.非脑脊液样本儿童患者分离的25 552株肺炎链球菌中青霉类敏感、中介、耐药(PSSP、PISP、PRSP)菌株的检出率分别为86.2％～97.7％、1.7％～6.5％和0.6％～7.3％,在成人患者7 997株中的检出率分别为92.0％～95.1％、3.8％～5.3％和1.4％～2.7％.脑脊液分离肺炎链球菌PRSP占比81.2％.无论是脑脊液或非脑脊液分离儿童和成人的肺炎链球菌对红霉素和克林霉素高度耐药,耐药率均在90％以上.β溶血链球菌对青霉素和头孢曲松均敏感,未发现耐药菌株;草绿色链球菌对青霉素的耐药率为5.7％～8.5％.46.3％～55.0％的B群β溶血链球菌对左氧氟沙星耐药,其他链球菌对左氧氟沙星仍十分敏感.链球菌属细菌中未发现利奈唑胺和万古霉素的耐药株.结论 青霉素仍是链球菌属非中枢神经系统感染的首选药物.链球菌属持续对红霉素、克林霉素高浓度耐药.

Objective To study the epidemiology of mold infectionsin China. Methods Based on the surveillance data of hospitals participating in theChina Hospital Invasive Fungal Surveillance Netfrom Jan 2019 to Jun 2022， the general information of patients and the epidemiological characteristics such as the proportion of strains were analyzed by WHONET software. Results A total of 16285 mold infections were included in the analysis， with the median age of 60 years old， of which 49.3% were patients aged 61 and over. The proportion ofmales was significantly higher than females （62.1% vs 37.9%）. The patients were mainly from the internal medicine and ICU wards. Most strains were isolated fromlowerrespiratory tract， accounting for 81.7%， followed by pus and secretions （7.8%）. About the species distribution， Aspergillus spp. accounted for the highest proportion （84.8%）， with Penicillium spp.， Fusariumspp.，order Mucorales andSedosporium spp. accounting for 5.1%， 3.0%， 1.3% and 0.4%， respectively. For species distribution among different mold infection， 88.7% of lower respiratory tract mold infections were caused by Aspergillus spp.， and Aspergillus fumigatus（47.8%） was the most common species. Theotomycosis was mainly caused by Aspergillus spp. （98.7%）， of which Aspergillus terreus accounted for 39.7%. Fusarium spp.（54.6%） was the most common species among ophthalmomycosis. Conclusion By the retrospective analysis of mold isolation from multicenter in China， it was found that Aspergillus fumigatus， Aspergillus terreus， and Fusarium spp. were the most common species causing pneumonomycosis，otomycosis，and ophthalmomycosis， respectively. It is necessary to pay attention to the difference in the species distribution among different mold infections in clinical empirical treatment of fungal infections.

Abstract Background Global concern surrounds high intensive care unit (ICU) mortality rates from pathogenic microorganism infections, particularly multidrug-resistant (MDR) bacteria. These infections significantly impact patient treatment outcomes and quality of life. This study aims to survey microbial epidemiology in ICU patients, explore death risk factors in severe infections, and establish a mortality risk scoring model. Methods A retrospective cohort study in an ICU analyzed epidemiological characteristics, microbial profiles, antimicrobial susceptibility, and patient mortality risk. Mortality risk factors were classified using univariate and multivariate analyses. The model's calibration was internally validated and its discrimination determined by the Area under the Receiver Operating Characteristic curve (AuROC). Results Between January 1, 2020, and December 31, 2021, a total of 952 patients were enrolled with infections caused by microorganisms. From these patients, 1713 pathogenic microorganisms were isolated in total. The identified microorganisms included 451 gram-positive bacteria, 1140 gram-negative bacteria, 117 funguses, and 5 other protists. Among them are 646 strains of MDR bacteria. A scoring model was developed, which included factors such as infection with MDR bacteria, cardiopulmonary resuscitation (CPR), total bilirubin (TBLT), creatinine clearance (CCr), tumor, Gout & mixed connective tissue disease (MCTD), and disorders of consciousness. The performance of the model was evaluated and showed good discrimination and calibration. Conclusion This study analyzed the prevalence of pathogenic microorganism in the ICU of hospital and explored their risk factors with patient mortality. The Bacteriology profile and antimicrobial susceptibility of MDR bacteria were explored. A simplified predictive scoring tool was established to predict patient mortality with infections in ICU. The study highlights the importance of monitoring and predicting the mortality risk associated with pathogenic microorganism infections in ICUs.