European Journal of Inflammation,
Journal Year:
2024,
Volume and Issue:
22
Published: Jan. 1, 2024
The
safety
of
vancomycin
in
children
requires
special
attention.
evidence
from
active
pharmacovigilance
systems
about
vancomycin-related
adverse
drug
reactions
(ADRs)
was
rare.
We
aimed
to
investigate
the
association
between
doses
and
ADRs
among
children.
This
retrospective
cohort
study
included
a
total
643
inpatient
Children
who
received
were
regarded
as
exposed
groups
classified
into
low-dose,
normal-dose,
high-dose
groups.
Those
did
not
receive
had
similar
severity
infection
unexposed
group.
ADR
signal
detection
performed
by
China
Hospital
Pharmacovigilance
System.
Logistic
regression
analyses
conducted
explore
effect
intravenous
on
ADRs.
156
patients
(178
cases)
group
487
(364
top
three
reported
eosinophilia
(
n
=
75,
48.1%),
hemoglobin
decreased
72,
46.2%),
blood
bilirubin
increased
13,
8.3%)
Patients
showed
higher
risk
when
compared
with
those
group,
fully
adjusted
ORs
(95%
CIs)
6.91
(3.61,
13.20),
7.80
(3.87,
15.76),
8.80
(4.08,
19.01),
respectively.
Besides,
normal-dose
show
significantly
increased,
It
is
important
monitor
eosinophilia,
decreased,
pediatrics
receiving
vancomycin,
especially
vancomycin.
Journal of Global Antimicrobial Resistance,
Journal Year:
2025,
Volume and Issue:
unknown
Published: April 1, 2025
This
study
aimed
to
investigate
the
effects
of
polymyxin
B
(PMB)
in
combination
with
other
antibiotics
on
delaying
resistance
Klebsiella
pneumoniae
and
explore
mechanisms
underlying
PMB-induced
resistance.
In
vitro
continuous
induction
experiments
were
performed
observe
changes
drug
susceptibility
PMB
alone
versus
combination.
RNA-seq,
qRT-PCR,
proteomic
analyses
utilized
evaluate
differential
gene
protein
expression
between
induced-resistant
strains
those
exhibiting
delayed
Then,
knockout
validate
functional
roles
relevant
genes.
These
findings
indicated
that
could
induce
within
1-2
days,
whereas
amikacin
or
tigecycline
onset
by
6
days.
revealed
significant
upregulation
nlpE,
two-component
systems
AcrAB-TolC
efflux
pump-associated
genes
resistant
strains,
these
downregulated
combined
amikacin.
Deletion
complementation
demonstrated
levels
pump-related
nlpE
strains.
Furthermore,
a
PmrA,
PhoP,
PhoQ,
PagP,
AcrB
proteins
associated
cationic
antimicrobial
peptide
pathways
wild-type
complemented
no
change
was
observed
strain.
contributes
modulating
pump
PhoP/Q
PmrA/B
systems.
The
use
effectively
delays
development
K.
through
regulation
its
signaling
pathways.
Infectious Diseases Now,
Journal Year:
2025,
Volume and Issue:
unknown, P. 105080 - 105080
Published: May 1, 2025
Carbapenem-resistant
Enterobacteriaceae
(CRE)
infections
are
associated
with
increased
mortality
and
higher
healthcare
costs
in
hospitalized
patients,
making
it
reasonable
to
explore
the
effectiveness
of
strategies
for
decolonization
intestinal
carriage.
To
evaluate
safety
oral
and/or
intravenous
antibiotics
adults
colonized
by
CRE.
We
conducted
a
systematic
review
randomized
clinical
trials
nonrandomized
studies
comparing
antibiotic
therapy
versus
no
treatment
or
placebo
Outcomes
assessed
included
eradication,
infection
rate,
mortality,
length
hospital
stay,
adverse
events.
Searches
were
performed
Embase,
MEDLINE
(PubMed),
Cochrane
Library.
Quality
assessment
was
using
ROB1
ROBINS-I
tool.
Meta-analysis
random
effects
model
Review
Manager,
certainty
evidence
evaluated
GRADE
methodology.
Seven
comprising
728
participants
included.
Decolonization
significantly
carriage
eradication
(OR:
2.66;
95%
CI:
1.55-4.55;
I2:
0%).
There
trend
toward
reduced
rate
0.66;
0.26-1.65;
4%).
Data
on
events
limited
insufficient
draw
conclusions
about
differences
between
groups.
The
ranged
from
moderate
very
low.
This
study
suggests
that
may
be
effective
eradicating
CRE
state,
but
current
is
determine
its
impact
rates,
Larger,
high-quality
necessary
generate
robust
supporting
use.
Carbapenem-resistant
Klebsiella
pneumoniae
(CRKP)
poses
a
significant
global
health
challenge
due
to
its
limited
treatment
options
and
high
mortality
rates.
Meanwhile,
the
prevalence
of
non-carbapenemase-producing
CRKP
(NC-CRKP)
strains
is
increasing,
but
their
resistance
mechanisms
remain
less
understood
compared
those
carbapenemase-producing
(CP-CRKP).
In
this
study,
KP-469,
an
NC-CRKP
strain,
was
found
lack
major
porins
OmpK35
Ompk36
possessed
OmpK37,
coexisting
with
ESBL
genes
CTX-M
SHV.
Membrane
porin
coding
sequence
alignment
revealed
minor
deletion
in
Ompk35
768
bp
insertion
promoter
region
(IS-PR)
Ompk36,
located
between
-10
ribosome
binding
site
(RBS).
KO-469
strain
scarless
excision
IS-PR
constructed
pHSG396-promoter-Ompk36
that
incorporated
wild-type
into
transcription
levels
were
significantly
higher
than
KP-469
His-tag
antibody
quantification
further
confirmed
regular
expression
KO-469.
These
results
demonstrated
markedly
reduced
transcriptional
translational
efficiency
leading
decreased
permeability
meropenem.
Moreover,
restored
susceptibility
meropenem
validated
by
vitro
antimicrobial
tests
vivo
intraperitoneal
infection
model
neutrophil-depleted
mice.
The
novel
carbapenem
mechanism
caused
OmpK36
will
facilitate
development
antibacterial
regimens
for
treating
infections.
Infectious Diseases and Therapy,
Journal Year:
2025,
Volume and Issue:
unknown
Published: May 17, 2025
Treatment
options
for
carbapenem-resistant
Enterobacteriaceae
(CRE)
infections
are
limited,
with
polymyxin
B
(PMB)
and
ceftazidime-avibactam
(CZA)
being
among
the
available
choices.
However,
research
on
these
is
scarce
significantly
heterogeneous.
This
study
aims
to
analyze
efficacy,
safety,
cost-effectiveness
of
PMB
CZA
within
a
standardized
target
trial
emulation
(TTE)
framework.
retrospective
emulated
evaluate
versus
treating
CRE
infections.
Conducted
at
Nanjing
Drum
Tower
Hospital,
this
included
adult
patients
treated
or
from
July
2020
December
2022.
Data
demographics,
treatment
outcomes,
costs
were
collected.
The
primary
outcomes
clinical
cure,
incidence
adverse
drug
reactions
(ADRs),
cost-effectiveness.
Secondary
assessed
28-day
all-cause
mortality,
microbiological
eradication
rates,
acute
kidney
injury
(AKI),
gastrointestinal
events.
using
modified
intention-to-treat
(mITT)
effects,
per-protocol
propensity
score
overlap
weighting
(PSOW)
methods.
Between
1,
2020,
31,
2022,
492
hospitalized
screened
Hospital.
Following
inclusion
exclusion
criteria,
176
in
mITT
analysis,
153
analysis.
cure
rate
was
higher
group
compared
across
all
analyses.
mortality
similar
between
groups,
while
microbial
ADRs
consistent
but
AKI
occurred
more
frequently
patients,
events
common
group.
strategy
demonstrated
28.1%
increase
an
incremental
ratio
71,651.76
yuan.
Sensitivity
analyses
confirmed
robustness
findings.
demonstrates
that
has
standard
TTE
overall
two
treatments.
Pharmacoeconomic
analysis
also
indicated
cost-effective.
https://www.chictr.org.cn
;
identifier,
ChiCTR2300067946.
Frontiers in Cellular and Infection Microbiology,
Journal Year:
2024,
Volume and Issue:
14
Published: May 16, 2024
Introduction
The
increasing
incidence
of
Klebsiella
pneumoniae
and
carbapenem-resistant
(CRKP)
has
posed
great
challenges
for
the
clinical
anti-infective
treatment.
Here,
we
describe
molecular
epidemiology
antimicrobial
resistance
profiles
K.
CRKP
isolates
from
hospitalized
patients
in
different
regions
China.
Methods
A
total
219
26
hospitals
19
provinces
China
were
collected
during
2019–2020.
Antimicrobial
susceptibility
tests,
multilocus
sequence
typing
performed,
genes
detected
by
polymerase
chain
reaction
(PCR).
compared
between
groups.
Results
rates
to
imipenem,
meropenem,
ertapenem
20.1%,
22.4%,
respectively.
45
identified.
There
was
a
significant
difference
174
carbapenem-sensitive
(CSKP)
strains,
characterized
multiple-drug
phenotype.There
regional
differences
among
cefazolin,
chloramphenicol,
sulfamethoxazole,which
lower
northwest
than
those
north
south
China.The
mostcommon
type
(ST)
ST11
(66.7%
strains).
In
addition,
13
other
STs.
non-ST11
rate
amikacin,
gentamicin,
latamoxef,
ciprofloxacin,
levofloxacin,
aztreonam,
nitrofurantoin,
fosfomycin,
ceftazidime/avibactam.
terms
mechanisms,
majority
strains
(71.1%,
32/45)
harbored
blaKPC-2,
followed
blaNDM
(22.2%,
10/45).
Strains
harboring
blaKPC
or
showed
sensitivities
some
antibiotics.
Conclusion
Our
analysis
emphasizes
importance
surveilling
determinants
analyzing
their
characteristics
better
management
agents
use.
European Journal of Inflammation,
Journal Year:
2024,
Volume and Issue:
22
Published: Jan. 1, 2024
The
safety
of
vancomycin
in
children
requires
special
attention.
evidence
from
active
pharmacovigilance
systems
about
vancomycin-related
adverse
drug
reactions
(ADRs)
was
rare.
We
aimed
to
investigate
the
association
between
doses
and
ADRs
among
children.
This
retrospective
cohort
study
included
a
total
643
inpatient
Children
who
received
were
regarded
as
exposed
groups
classified
into
low-dose,
normal-dose,
high-dose
groups.
Those
did
not
receive
had
similar
severity
infection
unexposed
group.
ADR
signal
detection
performed
by
China
Hospital
Pharmacovigilance
System.
Logistic
regression
analyses
conducted
explore
effect
intravenous
on
ADRs.
156
patients
(178
cases)
group
487
(364
top
three
reported
eosinophilia
(
n
=
75,
48.1%),
hemoglobin
decreased
72,
46.2%),
blood
bilirubin
increased
13,
8.3%)
Patients
showed
higher
risk
when
compared
with
those
group,
fully
adjusted
ORs
(95%
CIs)
6.91
(3.61,
13.20),
7.80
(3.87,
15.76),
8.80
(4.08,
19.01),
respectively.
Besides,
normal-dose
show
significantly
increased,
It
is
important
monitor
eosinophilia,
decreased,
pediatrics
receiving
vancomycin,
especially
vancomycin.
