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Other specific DSP article suggested by Editorial Board
Anti-inflammatory and antimicrobial efficacy of coconut oil for periodontal pathogens: a triple-blind randomized clinical trial
Citation:- 10.1007/s00784-025-06267-8
Authors: Simón Pardiñas López
Abstract
Objectives: To evaluate the effect of coconut oil on the oral bacteriome and inflammatory response in patients with periodontitis by integrating next-generation sequencing analyses of pathogenic bacterial shifts and quantification of inflammatory markers, thereby assessing its potential as a natural adjunct to standard nonsurgical periodontal therapy.
Materials and methods: A triple-blind clinical trial was conducted with 30 participants diagnosed with periodontitis, randomized into 3 groups: (1) coconut oil, (2) chlorhexidine and (3) placebo. Saliva and gingival crevicular fluid (GCF) samples were collected before treatment, one month after treatment, and one month post-non-surgical periodontal therapy. Bacterial DNA was extracted, and the V3-V4 region of the 16 S rRNA gene was PCR-amplified and sequenced using Illumina MiSeq technologies. Inflammatory biomarkers, including Interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α), were quantified from GCF samples.
Results: Coconut oil treatment significantly reduced pathogenic bacterial families such as Spirochaetaceae and Tannerellaceae while promoting beneficial bacteria such as Streptococcaceae. At the genus and species levels, coconut oil reduced pathogens such as Tannerella forsythia and Treponema denticola along with increase in beneficial bacteria such as Streptococcus. The subgingival microbial dysbiosis index improved significantly in both coconut oil and chlorhexidine groups. Furthermore, the coconut oil demonstrated a reduction in IL-6 and TNF-α levels, indicating decreased local inflammation.
Conclusions: Coconut oil treatment significantly modulated the oral microbiome and reduced inflammatory markers in patients with periodontitis, suggesting its potential as a natural and effective adjunct in periodontal therapy.
Clinical relevance: This study highlights coconut oil’s potential as a natural adjunct in periodontal therapy, effectively reducing pathogenic bacteria and inflammatory markers (IL-6, TNF-α). It offers a safe alternative to chlorhexidine, promoting microbiome balance and improved periodontal health.
© 2025. The Author(s).
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Evaluating the efficacy of N-acetylcysteine in diminishing the duration and frequency of rotavirus-induced gastroenteritis: a preliminary randomized, placebo-controlled, double-blind clinical trial
Citation:- 10.1007/s00784-025-06267-8
Authors: Behrooz Heydari
Abstract
Background: Globally, gastroenteritis stands as a primary contributor to child mortality, annually taking the lives of 3 million children under the age of 5 years. Rotavirus, a major factor in viral diarrhea among children aged 6 months to 2 years, presents with severe symptoms such as watery diarrhea and vomiting. Although mortality rates have decreased due to supportive care and vaccines, promising alternatives like N-acetylcysteine (NAC) show potential benefits in laboratory studies, indicating a possible supplementary strategy for managing rotavirus infections by reducing the duration and antigen excretion in feces.
Methods: During this double-blind clinical trial, 71 patients, confirmed to have gastroenteritis resulting from rotavirus using a rapid diagnostic strip, were randomly allocated to two groups. One group was prescribed NAC at a dosage of 60 mg/kg/day, while the other received a placebo. The patient’s progress was monitored daily until their gastroenteritis improved, and details regarding the duration of diarrhea and the frequency of bowel movements were recorded for each participant.
Results: The average duration of diarrhea in the NAC group and the placebo group was 2 and 3 days, respectively, with a level of p = 0.121. During the diarrhea period, the number of bowel movements in the NAC group was recorded at 28.1 ± 21.6 times, whereas in the placebo group, it was 35.3 ± 33.1 times, yielding a p-value of 0.409.
Conclusions: Even though the effects of NAC were observed in lowering the duration of the period and decreasing the frequency of bowel movements in gastroenteritis, these results did not reach statistical significance. Hence, the data from this study suggest that NAC may not effectively reduce the duration of diarrhea and the frequency of bowel movements linked to gastroenteritis caused by rotavirus.
Trial registration: IRCT20181208041882N13, 14-10-2023 ( https://irct.behdasht.gov.ir/trial/68259 ).
Keywords: Children; Clinical trial; Diarrhea; Gastroenteritis; N-acetylcysteine; Rotavirus.
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Impact of mass drug administration with ivermectin, diethylcarbamazine, and albendazole for lymphatic filariasis on hookworm and Strongyloides stercoralis infections in Papua New Guinea
Citation:- 10.1007/s00784-025-06267-8
Authors: Jannet A Tobon Ramos
Abstract
Background: Persons with lymphatic filariasis (LF) are often co-infected with soil-transmitted helminths. A single co-administered dose of ivermectin/diethylcarbamazine/albendazole (IDA) is recommended by WHO for mass drug administration (MDA) for LF instead of diethylcarbamazine/albendazole (DA) in Papua New Guinea (PNG). We compared the effectiveness of a single round of MDA with IDA or DA on hookworm and strongyloidiasis in PNG.
Methodology/principal findings: This study was conducted as part of a cluster randomized trial of MDA with IDA versus DA for LF in individuals willing to provide stool and blood samples at baseline and 12 months after MDA. Participants from 23 villages were included in the clinical trial. Primary outcomes were changes in hookworm prevalence and infection intensity assessed by Kato Katz and Strongyloides prevalence by serology. Hookworm prevalence at baseline was 78% (91/117) and 80% (119/149) in villages assigned to DA and IDA treatment, respectively. Twelve months post-MDA, hookworm prevalence decreased to 56.5% in DA- and 34.4% in IDA-treated villages, respectively (p<0.001, both comparisons). The proportion of individuals with moderate to heavy infection (>2000 egg per gram (EPG)) similarly decreased from 8.7% to 1.5% after DA (p = 0.001) and from 5.7% to 1.0% after IDA (p = 0.002). Using a logistic regression model adjusting for age, gender, baseline hookworm prevalence, and village drug coverage, IDA resulted in a 45% greater reduction in hookworm prevalence than DA (Odds ratio 0.55, 95% CI [0.31,0.99], p = 0.049). MDA also reduced hookworm transmission. Strongyloides seroprevalence at baseline was 68% (192/283) and 62% (180/290) in IDA and DA villages, respectively, with 49% becoming seronegative in the IDA versus 23% in DA villages at 12 months (p = 0.0001).
Conclusions/significance: MDA with IDA was more effective than DA for reducing hookworm and Strongyloides infections in PNG, extending the benefit of MDA with IDA beyond its effect on LF.
Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.
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Other specific DSP article suggested by Editorial Board
Effect of N-acetylcysteine on antimicrobials induced nephrotoxicity: a meta-analysis
Citation:- 10.1007/s00784-025-06267-8
Authors: Xianming Qiu
Abstract
Objective: N-acetylcysteine (NAC) has antioxidant effects in reducing acute kidney injury. This study systematically reviewed and assessed the efficacy of NAC in preventing antimicrobials induced nephrotoxicity.
Methods: Pubmed, Embase, Web of Science, and the Cochrane Library were searched extensively for relevant studies that evaluating NAC on antimicrobials induced nephrotoxicity until June 1, 2024. Eligible records were screened according to the inclusion and exclusion criteria. The odds ratio (OR) was selected to evaluate the effect of NAC on nephrotoxicity. We pooled the extracted data using a random effects model.
Results: Three randomized controlled trials were included in the analysis. The pooled results showed that NAC could reduce the incidence of antimicrobials induced nephrotoxicity (OR = 0.487, 95% CI = 0.258, 0.918, P = 0.03, I2 = 0%). Serum creatine (Scr) on Day 2 was significantly decreased in the NAC group compared to the placebo group (SMD, – 0.298; 95%CI, – 0.585 to – 0.010; I2 = 23%; P = 0.04). No difference was observed in blood urea nitrogen (BUN), and creatinine clearance (CrCl).
Conclusion: In this meta-analysis, NAC was associated with a benefit in the prevention of antimicrobials induced nephrotoxicity. However, large-scaled and well-designed RCTs are required in the future.
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Male-Partner Treatment to Prevent Recurrence of Bacterial Vaginosis
Citation:- 10.1056/NEJMoa2405404
Authors: Lenka A Vodstrcil
Abstract
Background: Bacterial vaginosis affects one third of reproductive-aged women, and recurrence is common. Evidence of sexual exchange of bacterial vaginosis-associated organisms between partners suggests that male-partner treatment may increase the likelihood of cure.
Methods: This open-label, randomized, controlled trial involved couples in which a woman had bacterial vaginosis and was in a monogamous relationship with a male partner. In the partner-treatment group, the woman received first-line recommended antimicrobial agents and the male partner received oral and topical antimicrobial treatment (metronidazole 400-mg tablets and 2% clindamycin cream applied to penile skin, both twice daily for 7 days). In the control group, the woman received first-line treatment and the male partner received no treatment (standard care). The primary outcome was recurrence of bacterial vaginosis within 12 weeks.
Results: A total of 81 couples were assigned to the partner-treatment group, and 83 couples were assigned to the control group. The trial was stopped by the data and safety monitoring board after 150 couples had completed the 12-week follow-up period because treatment of the woman only was inferior to treatment of both the woman and her male partner. In the modified intention-to-treat population, recurrence occurred in 24 of 69 women (35%) in the partner-treatment group (recurrence rate, 1.6 per person-year; 95% confidence interval [CI], 1.1 to 2.4) and in 43 of 68 women (63%) in the control group (recurrence rate, 4.2 per person-year; 95% CI, 3.2 to 5.7), which corresponded to an absolute risk difference of -2.6 recurrences per person-year (95% CI, -4.0 to -1.2; P<0.001). Adverse events in treated men included nausea, headache, and metallic taste.
Conclusions: The addition of combined oral and topical antimicrobial therapy for male partners to treatment of women for bacterial vaginosis resulted in a lower rate of recurrence of bacterial vaginosis within 12 weeks than standard care. (Funded by the National Health and Medical Research Council of Australia; StepUp Australian New Zealand Clinical Trials Registry number, ACTRN12619000196145.).
Copyright © 2025 Massachusetts Medical Society
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Safety of combined long-acting injectable cabotegravir and long-acting injectable rilpivirine in virologically suppressed adolescents with HIV (IMPAACT 2017/MOCHA): a phase 1/2, multicentre, open-label, non-comparative, dose-finding study
Citation:- 10.1016/S2352-3018(24)00344-8
Authors: Carolyn Bolton Moore
Abstract
Background: Long-acting cabotegravir and long-acting rilpivirine constitute a completely intramuscular antiretroviral therapy (ART) regimen for adults with HIV. We aimed to assess the safety, antiviral activity, and pharmacokinetics of oral cabotegravir and rilpivirine followed by a combination of long-acting cabotegravir and long-acting rilpivirine in virologically suppressed adolescents with HIV.
Methods: The IMPAACT 2017/MOCHA study is a phase 1/2, multicentre, open-label, non-comparative, dose-finding trial being conducted at 18 sites across Botswana, South Africa, Thailand, Uganda, and the USA. In cohort 2 of this study, adolescents (aged 12-18 years; weight ≥35 kg) with HIV and no serious comorbidities who were receiving stable combination ART with confirmed virological suppression and had either previously enrolled in the first cohort or had not previously participated in the study were eligible for inclusion. Participants stopped their background combination ART and received oral cabotegravir 30 mg once daily and oral rilpivirine 25 mg once daily orally for 4-6 weeks, followed by long-acting injectable cabotegravir 600 mg (3 mL) and long-acting injectable rilpivirine 900 mg (3 mL) intramuscularly at weeks 4 and 8, and every 8 weeks thereafter. The primary outcome was safety, including all adverse events, at week 24. Primary safety outcome measures were summarised as frequencies, percentages, and exact Clopper-Pearson 95% CIs in the evaluable analysis population, which included participants who were treated exclusively with the regimen and either completed all scheduled treatments or experienced severe adverse events, permanently discontinued the treatment, or died, whichever occurred first; and in the all-treated analysis population, which included all participants who received at least one dose of any study product. This study is registered with ClinicalTrials.gov (NCT3497676) and is ongoing.
Findings: Between July 26, 2021, and Aug 27, 2022, 44 (80·0%) of 55 adolescents who participated in cohort 1 and 100 (87·0%) of 115 screened study-naive adolescents were enrolled in cohort 2. 74 (51·4%) participants were female and 70 (48·6%) were male. Overall, 15 (10·8% [95% CI 6·2-17·2]) of all 139 participants in the evaluable analysis population had at least one adverse event of grade 3 or above by week 24. Among 142 participants who received at least one injection, 43 (30%) experienced at least one injection site reaction (ISR). All 106 ISRs were either grade 1 (98 [92·5%]) or grade 2 (eight [7·5%]), and 97 (91·5%) resolved within 7 days. No participant experienced a drug-related serious adverse event or prematurely discontinued treatment due to a drug-related adverse event.
Interpretation: Long-acting injectable cabotegravir and long-acting injectable rilpivirine, administered to adolescents at recommended adult dosages every 8 weeks, showed no unanticipated safety concerns in the 24 weeks following administration.
Funding: National Institutes of Health, ViiV Healthcare, and Johnson & Johnson.
Trial registration: ClinicalTrials.gov NCT03497676.
Copyright © 2025 Elsevier Ltd. All rights reserved, including those for text and data mining, AI training, and similar technologies.
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Efficacy and safety of Saccharomyces boulardii as an adjuvant therapy for the eradication of Helicobacter pylori: a meta-analysis
Citation:- 10.3389/fcimb.2025.1441185
Authors: Manning Li
Abstract
Background: Helicobacter pylori (H. pylori) is highly prevalent worldwide and is closely associated with many gastric conditions. Current methods for eradicating H. pylori include triple or quadruple therapy, including antibiotics, proton pump inhibitors, and bismuth agents; however, with antibiotic abuse and increased drug resistance rates, the effectiveness of traditional methods is gradually decreasing, with many adverse effects such as abdominal pain, diarrhea, and intolerance. In recent years, there has been controversy regarding whether adding Saccharomyces boulardii (S. boulardii) to traditional therapies is beneficial for eradicating H. pylori.
Aim: To evaluate the efficacy and safety of S. boulardii as an adjuvant therapy for the eradication of H. pylori.
Methods: We systematically searched the PubMed and Web of Science databases from January 2002 to January 2023. The primary outcome was the H. pylori eradication rate. The secondary outcomes included total adverse effects, abdominal pain, diarrhea, bloating, constipation, nausea, vomiting, taste disorders, and other adverse reactions. We evaluated the included studies for publication bias and heterogeneity. Fixed- and random-effects models were used for studies without and with heterogeneity, respectively, to calculate the risk ratios (RRs) and conduct sensitivity and subgroup analyses.
Results: Nineteen studies comprising 5,036 cases of H. pylori infection were included in this meta-analysis. The addition of S. boulardii to traditional therapy significantly improved the H. pylori eradication rate [RR=1.11, 95% confidence interval (CI): 1.08-1.15] and reduced the incidence of total adverse effects (RR=0.49, 95% CI: 0.37-0.66), diarrhea (RR=0.36, 95% CI: 0.26-0.48), abdominal distension (RR=0.49, 95% CI: 0.33-0.72), constipation (RR=0.38, 95% CI: 0.26-0.57), and nausea (RR=0.50, 95% CI: 0.37-0.68). However, it did not reduce the occurrence of abdominal pain, vomiting, or taste disorders.
Conclusions: S. boulardii supplementation in traditional eradication therapy significantly improves the H. pylori eradication rate and reduces the total adverse effects and incidence of diarrhea, bloating, constipation, and nausea.
Systematic review registration: Prospero, identifier CRD42024549780.
Keywords: Helicobacter pylori; Saccharomyces boulardii; adverse effects; eradication rate; meta-analysis.
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Building upon the core elements of antifungal stewardship: practical recommendations for effective antifungal stewardship in resource-limited settings.
Citation:- 10.1080/14787210.2025.2479011
Authors: Chakrabarti A et al
Abstract
Introduction: Despite the crucial importance of effective AFS in resource-limited settings, such settings remain comparatively underserved and underrepresented in terms of resource-setting-specific guidance and research. Further practical contextualization and application of current AFS best practices is thus necessary.
Areas covered: A panel of leading experts from diverse countries (India, Nigeria, Spain, and the US) was brought together to provide recommendations for practical and effective implementation of AFS in resource-limited settings. We have adapted and contextualized the Centers for Disease Control and Prevention’s (CDC) seven core elements and the Mycoses Study Group Education and Research Consortium’s (MSGERC) recommendations for facilities in resource-limited settings through a resource-stratified approach. Where relevant to facilities based on their context and respective resources across multiple dimensions, facilities may choose to prioritize certain recommendations that may be more immediately actionable before implementing others.
Expert opinion: The authors recommend future studies to examine the efficacy, cost-effectiveness, and practicality of our recommendationsin resource-limited settings to enable them to effectively prioritize, channel or gradually increase resource capacity at hand. AFS interventions should be integrated within a larger systemic framework (e.g. city, state, national, regional, international) with collaboration among institutional leader
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The Paediatric European Confederation of Medical Mycology (ECMM) Quality (Paed-EQUAL) Candida Score for the Management of Candidaemia in Children and Neonates.
Citation:- 10.1111/myc.70041
Authors: Bal AM et al
Abstract
Candidaemia in children is associated with high mortality. The epidemiology of Candida bloodstream infection is changing with rising rates of fluconazole resistance worldwide and the emergence of novel multidrug-resistant species such as Candida auris, which is associated with outbreaks. Guidelines on the management of candidaemia emphasise identification of species and determination of antifungal susceptibility to guide appropriate treatment, performing relevant investigations to rule out deep-seated infection, and removal of central venous catheters. However, it is difficult to apply guidelines in routine practice. The European Confederation of Medical Mycology candidaemia scoring tool (the EQUAL score) has facilitated adherence to guidelines by using a point-based system. A point-based paediatric EQUAL (paed-EQUAL) score tool has been designed for the management of candidaemia in neonates and children. The paed-EQUAL scoring tool can be applied to improve guideline adherence and facilitate antifungal stewardship.
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Exploring the role of gut microbiota in antibiotic resistance and prevention.
Citation:- 10.1080/07853890.2025.2478317
Authors: Dongre DS et al
Abstract
Background/introduction: Antimicrobial resistance (AMR) and the evolution of multiple drug-resistant (MDR) bacteria is of grave public health concern. To combat the pandemic of AMR, it is necessary to focus on novel alternatives for drug development. Within the host, the interaction of the pathogen with the microbiome plays a pivotal role in determining the outcome of pathogenesis. Therefore, microbiome-pathogen interaction is one of the potential targets to be explored for novel antimicrobials.
Main body: This review focuses on how the gut microbiome has evolved as a significant component of the resistome as a source of antibiotic resistance genes (ARGs). Antibiotics alter the composition of the native microbiota of the host by favouring resistant bacteria that can manifest as opportunistic infections. Furthermore, gut dysbiosis has also been linked to low-dosage antibiotic ingestion or subtherapeutic antibiotic treatment (STAT) from food and the environment.
Discussion: Colonization by MDR bacteria is potentially acquired and maintained in the gut microbiota. Therefore, it is pivotal to understand microbial diversity and its role in adapting pathogens to AMR. Implementing several strategies to prevent or treat dysbiosis is necessary, including faecal microbiota transplantation, probiotics and prebiotics, phage therapy, drug delivery models, and antimicrobial stewardship regulation.
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Infection prevention and control measures for multidrug-resistant organisms: a systematic review and network meta-analysis.
Citation:- 10.1007/s15010-025-02498-9
Authors: Geng YS et al
Abstract
Background: The effectiveness of infection prevention and control measures combating multidrug-resistant organisms (MDROs) in healthcare settings remains controversial.
Methods: PubMed, Embase, MEDLINE, Cochrane Library, and CINAHL were searched from inception to June 1, 2024. The interventions encompassed standard precautions (SP), contact precautions (CP), hand hygiene (HH), environmental cleaning (ENV), antimicrobial stewardship programs (ASP), decolonization (DCL), and chlorhexidine baths (CHG). The primary outcome were the acquisition, infection, and colonization of MDROs. Secondary outcomes were all-cause mortality and MDROs-associated bacteraemia. Effect indicators were expressed as rate ratios (RRs) with 95% confidence intervals (CIs).
Results: The study included a total of 97 articles, comprising 19 RCTs and 78 non-RCTs. The results showed that the most effective combination interventions for the acquisition, infection, and colonization of MDROs compared to SP varied as follows: CP + CHG (RR, 0.38 [0.18, 0.79]), SP + CP + ENV (RR, 0.04 [0.02, 0.08]), and SP + CHG (RR, 0.28 [0.14, 0.56]). In subgroup analyses, CP + CHG (RR, 0.36 [0.20,0.64]) was the most effective intervention for the acquisition of MDROs in the ICU setting, whereas SP + CP + ASP (RR, 0.35 [0.14,0.92]) was the most effective hospital-wide. Across subgroups, SP + CP + ENV (RR, 0.04 to 0.09 [95% CI, 0.01 to 0.99]) was identified as the most effective intervention for MDROs infections. In the ICU setting, SP + CHG (RR, 0.28 [0.14,0.56]) demonstrated the highest effectiveness in reducing the colonization of MDROs, whereas SP + CP + ENV + CHG (RR, 0.15 [0.06,0.38]) was the most effective on a hospital-wide scale. SP + CP + DCL (RR, 0.28 [0.24, 0.32]) was associated with reduced CRE colonization. The results of this study were robust according to the sensitivity analysis. None of the analyses related to secondary outcomes were statistically significant. In terms of article quality assessment, 94.7% of the RCTs were medium to high risk, while 92.31% of the non-RCTs. The primary limitation of the RCTs were related to the randomization process, whereas the non-RCTs were primarily affected by confounding bias.
Conclusions: Effective interventions differ based on carriage status, intervention setting, and the resistant strain. Additionally, contact precautions is a crucial component of these combinations. Consequently, healthcare organizations can select appropriate interventions based on their unique resistance profiles to optimize precision and resource efficiency.
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Patterns of antibiotic resistance in urinary tract infections before and during the COVID-19 pandemic in Uganda and Tanzania.
Citation:- 10.1007/s15010-025-02498-9
Authors: Silago V et al
Abstract
Background: Increased antimicrobial use during the COVID-19 pandemic has driven antimicrobial resistance (AMR) globally, particularly in resource-limited settings. This study assessed AMR patterns in urinary tract infections (UTIs) in Uganda and Tanzania before and during the pandemic.
Methods: A cross-sectional study was conducted among UTI patients at healthcare facilities in Mbarara (Uganda) and Mwanza (Tanzania) between March 2019-September 2020 and January-December 2021. Mid-stream urine samples were collected and analysed following standard procedures. AMR patterns were compared across the two periods.
Results: A total of 5563 patients were enrolled from Mwanza (55.0%, n = 3061) and Mbarara (45.0%, n = 2502). The overall prevalence of microbiologically confirmed UTIs in Mwanza was 32.5% (999/3060; 95% CI: 30.9%-34.3%), raised from 30.1% (655/2180; 95% CI: 28.1%-32.0%) before to 39.1% (344/880; 95% CI: 35.8%-42.4%) during the pandemic. Whereby, the overall prevalence of microbiologically confirmed UTIs in Mbarara was 24.8% (620/2502; 95% CI: 23.1%-26.5%), decreasing from 27.5% (502/1824; 95% CI: 25.5%-29.6%) before to 17.4% (118/678; 95% CI: 14.6%-20.5%) during the pandemic. The proportion of multidrug-resistant Gram-negative bacteria (MDR-GNB) rose significantly (74% versus 83.4%, P = 0.01) while MDR Gram-positive bacteria (MDR-GPB) increased slightly (55.5% versus 56.7%, P = 0.45) in Mwanza. Conversely, MDR-GPB increased substantially (31.4% versus 51.6%, P = 0.09) while MDR-GNB decreased (67.3% versus 61.9%, P = 0.22) in Mbarara.
Conclusions: This study provides critical insights into AMR trends in UTI pathogens in Tanzania and Uganda, emphasizing the need for stringent antimicrobial stewardship, requiring ongoing surveillance and targeted interventions.
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Bacterial, Clinical, and Antimicrobial Profile of Gram-Negative Community-Acquired Infections in a Rural Tertiary Care Hospital in India.
Citation:- 10.7759/cureus.79003
Authors: Dole PP et al
Abstract
Background: Gram-negative bacilli, such as Escherichia coli, Pseudomonas aeruginosa, Klebsiella species (spp.), and Proteus species (spp.), are major causes of community-acquired infections (CAI). The rise in antibiotic use, especially in low- and middle-income countries, has led to increased antimicrobial resistance, with multidrug-resistant Gram-negative bacilli (MDR-GNB) becoming a global concern. This resistance contributes to longer hospital stays, increased mortality rates, and higher healthcare costs. The study aims to evaluate the bacterial, clinical, and antimicrobial profile of Gram-negative community-acquired infections (CAI) in a hospital setting to understand the prevalence better and inform strategies to tackle antibiotic resistance.
Material and methods: This study at Krishna Hospital and Medical Research Centre, Karad, focused on outpatient department (OPD) patients with suspected clinical infections. Non-repetitive Gram-negative bacilli isolates were included. After obtaining ethical approval and patient consent, clinical specimens were obtained aseptically first. The specimens were Gram-stained, cultured on various agars, and further confirmed. Species identification and testing for antimicrobial susceptibility were performed using the VITEK® 2 (bioMérieux, Marcy-l’Étoile, France) COMPACT Automated System to determine susceptibility profiles.
Result: A total of 518 specimens were processed, resulting in 102 Gram-negative bacilli isolates. The study revealed that community-acquired infections were most common in individuals aged 51-60 years (22, 21.57%). Men were more affected (62, 60.78%) than female patients (40, 39.22%). The most frequent pathogen was Pseudomonas aeruginosa (33, 32.35%), followed by Escherichia coli (29, 28.43%) and Klebsiella species (27, 26.47%). Discharge/pus was a frequent specimen source (66, 64.71%), followed by urine (30, 29.41%). These findings highlight age, gender, bacterial distribution, and the importance of pus and urine samples in diagnosis. The most sensitive drugs found in the study were fosfomycin (n = 54, 79.41%) and amikacin (n = 61, 67.03%); also, the most resistant drugs were cefuroxime (n = 43, 84.31%) and ciprofloxacin (n = 78, 76.47%).
Conclusion: Community-acquired infections represent a major public health challenge, shaped by factors such as age, gender, and pathogen diversity. These are more common in the 51-60 age group and show a male predominance due to behavioral and exposure factors in the study. Frequent pathogens include Pseudomonas aeruginosa, Escherichia coli, and Klebsiella spp., often involving skin and soft tissue infections (SSTI) and urinary tract infections (UTI). The study emphasizes the importance of understanding epidemiological trends, microbiological profiles, and trends of antibiotic resistance to improve treatment and prevention.
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Exploring the Intricacies of Antimicrobial Resistance: Understanding Mechanisms, Overcoming Challenges, and Pioneering Innovative Solutions.
Citation:- 10.1016/j.ejphar.2025.177511
Authors: Haq SU et al
Abstract
Antimicrobial resistance (AMR) poses a growing global threat. This review examines AMR from diverse angles, tracing the story of antibiotic resistance from its origins to today’s crisis. It explores the rise of AMR, from its historical roots to the urgent need to counter this escalating menace. The review explores antibiotic classes, mechanisms, resistance profiles, and genetics. It details bacterial resistance mechanisms with illustrative examples. Multidrug-resistant bacteria spotlight AMR’s resilience. Modern AMR control offers hope through precision medicine, stewardship, combination therapy, surveillance, and international cooperation. Converging traditional and innovative treatments presents an exciting frontier as novel compounds seek to enhance antibiotic efficacy. This review calls for global unity and proactive engagement to address AMR collectively, emphasizing the quest for innovative solutions and responsible antibiotic use. It underscores the interconnectedness of science, responsibility, and action in combatting AMR. Humanity faces a choice between antibiotic efficacy and obsolescence. The call is clear: unite, innovate, and prevail against AMR.
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Four months daily rifampicin versus three months daily rifampicin/isoniazid for the treatment of tuberculosis infection in asylum seekers: a randomized controlled trial
Citation:- 10.1016/j.cmi.2025.02.037
Authors: Matteelli, Alberto et al.
Abstract
Objectives: Treatment of tuberculosis infection is a core intervention of the TB elimination strategy. The World Health Organization recommends both four months of daily rifampicin (4R) and three months of daily isoniazid/rifampicin (3HR) for preventive therapy, but no trial directly compared the two regimens. We measured completion rate and tolerability of 4R and 3HR for tuberculosis preventive therapy.
Methods: We conducted a prospective, open-label, randomized phase four superiority trial to demonstrate an increase of at least 15% in the completion rate of 4R over 3HR among asylum seekers in Italy. Asylum seekers were tested for tuberculosis infection by the Quantiferon Plus test and offered to participate in the study if infected. The primary outcome was treatment completion, measured by adherence to clinical visits and pill count. Unadjusted Kaplan–Meier curves were used to compare permanent interruptions in the two arms by days of treatment. Generalized linear model for the binomial family and logit link function was performed to determine factors associated with treatment completion.
Results: From June 2021 to July 2023 we randomized 113 individuals to 4R and 112 to 3HR.
Treatment was completed by 88 subjects (77·9; 95% CI: 69·1-85·1) in the 4R arm and 85 (75·9; 95% CI: 66·9-83·5) in the 3HR arm (p=0·7). The risk ratio for completing treatment was 1·03 (95% CI: 0·89-1·18) in the 4R arm compared to the 3HR arm with a risk difference of 0·03 (95% CI: -0·09-0·13).
Dropout rates due to side effects (25/113 in 4R vs 27/112 in 3HR) and the overall rate of adverse events (47/113 in 4R vs 36/112 in 3HR) were not statistically different in the two groups.
Conclusions: Four months of rifampicin was not superior, in term of completion rate, to three months of isoniazid/rifampicin for the treatment of tuberculosis infectiosn among asylum seekers in Italy.
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Effectiveness of metagenomic next-generation sequencing in the diagnosis of infectious diseases: A systematic review and meta-analysis
Citation:- doi: 10.1016/j.ijid.2024.106996
Authors: Liu Y,
Abstract
Objectives: Early diagnosis of infectious diseases remains a challenge. This study assessed the diagnostic value of mNGS in infections and explored the effect of various factors on the accuracy of mNGS.
Methods: An electronic article search of PubMed, Cochrane Library, and Embase was performed. A total of 85 papers were eligible for inclusion and analysis. Stata 12.0 was used for statistical calculation to evaluate the efficacy of mNGS for the diagnosis of infectious diseases.
Results: The AUC of 85 studies was 0.88 (95%CI, 0.85-0.90). The AUC of the clinical comprehensive diagnosis and conventional test groups was 0.92 (95%CI, 0.89-0.94) and 0.82 (95%CI, 0.78-0.85), respectively. The results of subgroup analysis indicated that the PLR and NLR were 12.67 (95%CI, 6.01-26.70) and 0.05 (95%CI, 0.03-0.10), respectively, in arthrosis infections. The PLR was 24.41 (95%CI, 5.70-104.58) in central system infections and the NLR of immunocompromised patients was 0.08 (95%CI, 0.01-0.62).
Conclusion: mNGS demonstrated satisfactory diagnostic performance for infections, especially for bone and joint infections and central system infections. Moreover, mNGS also has a high value in the exclusion of infection in immunocompromised patients.
Keywords: Diagnostic value; Infectious diseases; Meta-analysis; Metagenomic next-generation sequencing (mNGS).
Other specific DSP article suggested by Editorial Board
High incidence of multidrug-resistant organisms and modifiable risk factors associated with surgical site infections: a cohort study in a tertiary medical center in Kuala Lumpur, Malaysia from 2020 to 2023
Citation:- 10.1186/s13756-025-01537-2
Authors: Muhamad, A.N
Abstract
Background: Surgical site infections (SSIs) are a persistent challenge in healthcare, contributing significantly to patient morbidity, mortality, and healthcare costs. Despite advancements in preventive measures, SSIs remain prevalent, especially in countries like Malaysia where rates are higher than in high-income nations.
Methods: A prospective, cohort study was conducted at the University Malaya Medical Center (UMMC), Malaysia, from November 2020 to May 2023. Clinical and microbiological data were collected, and logistic regression were performed to identify risk factors associated with SSIs.
Results: A total of 1,815 patients undergoing orthopedic, neurosurgical, and general surgical procedures were monitored for SSIs. The incidence rate of SSIs was 3.23 per 100 procedures (n = 71) with significant associations observed between SSI occurrence and prolonged surgical duration > 100 min, extended hospitalization > 5 days, trauma-to-surgery interval > 8 days, and presence of implants. Common pathogens isolated included Staphylococcus aureus, Klebsiella pneumoniae, and Pseudomonas aeruginosa. Multidrug-resistant organisms (MDROs) were identified in 42.1% of the total isolates.
Conclusions: In this study, a high rate of MDRO and risk factors for SSI were identified. It emphasises the need for ongoing surveillance to guide infection prevention strategies and antimicrobial stewardship programs. Future research should prioritize evaluating the impact of targeted interventions tailored to identified risk factors to optimize surgical patient outcomes.
Other specific DSP article suggested by Editorial Board
Establishing carbapenem resistant organism surveillance, prevention, and control in a middle-income country: implementation of a hospital-based program in Fiji
Citation:- 10.1186/s13756-025-01534-5
Authors: Getahun Strobel, A
Abstract
Antimicrobial resistance (AMR) is a major public health threat with the highest burden being estimated to be in low- and middle-income countries. Fiji is an upper-middle-income country in Oceania. Recent studies from Fiji highlighted the increasing burden of carbapenem resistant organisms (CRO) such as Acinetobacter baumannii, Pseudomonas aeruginosa and Escherichia coli. A project titled Preparing Fiji for Pathogens with Critical Antimicrobial Resistance was undertaken at the Colonial War Memorial Hospital, Fiji’s main referral hospital, in 2022 and 2023. The overarching goal was to support the hospital’s readiness for prompt detection, management and prevention of infections caused by pathogens with critical AMR including CRO. This paper describes the steps taken to establish CRO surveillance, prevention, and control interventions, outbreak response and healthcare workers’ capacity building initiatives tailored to the hospital’s need and capacity. It also shares the results, lessons learned and challenges in setting up the systems that may inform actions in other low- and middle-income countries in the Pacific Region and globally.
Other specific DSP article suggested by Editorial Board
Antimicrobial activity of new anti-Pseudomonas beta-lactam-beta-lactamase inhibitors against Pseudomonas aeruginosa respiratory isolates recovered dur‐ ing the study for Monitoring Antimicrobial Resistance Trends (SMART) pro‐ gram in France (2016–2022)
Citation:- 10.1016/j.idnow.2025.105056
Authors: C. Zins
Abstract
Objectives: To assess the susceptibility of ceftolozane/tazobactam (C/T) and comparators to Pseudomonas aeruginosa isolates recovered from respiratory-tract-infections (RTI) between 2016-2022 in the French SMART study .
Methods: Antibiotic susceptibility testing and minimum inhibitory concentrations (MICs) of 717 P.aeruginosa isolates collected in five French hospitals were determined and interpreted according to the EUCAST-2022 guidelines. P. aeruginosa isolates resistant (R) to imipenem and/or C/T were screened by PCR for extended-spectrum-β-lactamases (ESBLs), AmpC and carbapenemase genes. The identified genes were sequenced and the variants determined.
Results: All in all, 96.5% of P. aeruginosa isolates were susceptible to C/T, comparable to the susceptibilities of meropenem-vaborbactam (MVB=96.5%), imipenem/relebactam (IMI/REL=96.9%) and ceftazidime-avibactam (C/A=97.0%). MIC50 and MIC90 for C/T were 0.5 and 2mg/L respectively against the 717 isolates. Among the 242 isolates (33.7%) resistant to at least one anti-Pseudomonas -lactam, close to 90% were susceptible to C/T, C/A, MVB and IMI/REL. Among the 80 isolates resistant to piperacillin-tazobactam, cefepime and ceftazidime, 76.3% were susceptible to C/T and only IMI/REL and amikacin reached susceptibility exceeding 80%. Among the 32 isolates resistant to imipenem and meropenem, susceptibility exceeding 60% was observed only for IMI/REL, C/T, and C/A. For these strains, the MIC50 of C/T was 2 mg/L, while that of C/A was at the resistance threshold (8 mg/L). IMI/REL had the strongest activity (72%) against the 25 isolates resistant to C/T. Lastly, 53 imipenem and/or C/T-R isolates harbored a class C -lactam (blaPDC) variant, and one of them also carried the blaPER-1 gene and another, the blaVIM-2 gene.
Conclusion: C/T is a reliable treatment option in RTI caused by P. aeruginosa.
Keywords: Ceftolozane/tazobactam, Pseudomonas aeruginosa