20 September 2025, Volume 25 Issue 5

  

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Original Article
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  Monitoring of voriconazole blood concentration in elderly patients and analysis of influencing factors

  LI Ge, QIAN Lei, WANG Lei, WANG Ranran, WEI Can, FANG Ling

  2025, 25(5): 487-492. https://doi.org/10.16718/j.1009-7708.2025.05.001

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  Objective To explore the factors influencing the blood concentration of voriconazole in elderly hospitalized patients and inform the probability of attaining the target concentration in clinical practice. Methods Patients aged ≥65 years who were hospitalized in the First Affiliated Hospital of Anhui Medical University from January 2022 to December 2023 and underwent voriconazole blood concentration monitoring were enrolled. Their voriconazole blood concentrations and clinical data were collected. The patients were grouped according to the target effective concentration 0.5-5.0 mg/L of voriconazole recommended by the Chinese Pharmacological Society guidelines. Multivariate logistic regression analysis was used to determine the factors affecting the rate of achieving the target concentration. Results The 202 enrolled patients included 139 males and 63 females. A total of 244 voriconazole blood concentrations were available. The median age of the patients was 74 (range: 65-95) years. Voriconazole blood concentration ranged from 0.08 to 13.38 mg/L. The average concentration was (4.10 ± 2.45) mg/L. The target effective blood concentration of voriconazole was achieved in 65.35% (132/202) of the patients. Logistic regression results showed that the dosage regimen, body weight, and hypoproteinemia (albumin < 25 g/L) were the main factors affecting voriconazole blood concentration. Conclusions The dosing regimen, body weight, and hypoproteinemia are the main influencing factors of voriconazole blood concentration. Relevant factors should be fully considered in clinical medication to ensure the safety and effectiveness of voriconazole.
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  Utility of tuberculosis antibody, adenosine deaminase, carbohydrate antigen 125 alone or in combination for diagnosis of tuberculous pleurisy

  CHEN Suting, YANG Jian, YAO Qi, LIU Dongming

  2025, 25(5): 493-497. https://doi.org/10.16718/j.1009-7708.2025.05.002

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  Objective To evaluate the utility of tuberculosis antibody (TB-Ab), adenosine deaminase (ADA), and carbohydrate antigen 125 (CA125) alone or in combination for differentiating tuberculous from non-tuberculous pleural effusion. Methods This retrospective study included 75 patients initially diagnosed with tuberculous pleural effusion (observation group) and 75 patients hospitalized with non-tuberculous pleural effusion (control group) between January 2020 and June 2024. Receiver operating characteristic (ROC) curve analysis was used to compare the diagnostic performance of TB-Ab, ADA, CA125 alone or in combination for diagnosing tuberculous pleurisy. Results The patients with tuberculous pleural effusion showed significantly higher TB-Ab positive rate than the patients with non-tuberculous pleural effusion (control group) (60.00% vs 9.33%, P < 0.001). Tuberculous pleural effusion was associated with significantly higher levels of ADA [(43.44 ± 15.51) U/L] and CA125 [(175.57 ± 64.66) U/mL] compared to the control group [(27.81 ± 3.42) U/L] and (122.35 ± 41.22) U/mL, respectively (P < 0.001). Taking 34 U/L as cutoff value, ADA showed good diagnostic performance with an AUC of 0.856, sensitivity of 98.67%, and specificity of 78.67%. Taking 180 U/mL as cutoff value, CA125 demonstrated high sensitivity (89.94%) but low specificity (52.33%) with an AUC of 0.739. CA125 alone was not so specific for detecting tuberculous pleurisy. TB-Ab had an AUC of 0.753 in detecting tuberculous pleurisy, with a sensitivity of 90.67% and specificity of 61.22%. These three markers in combination significantly improved diagnostic performance, with an AUC of 0.926, sensitivity of 90.67%, and specificity of 86.67%. Conclusions TB-Ab, ADA, and CA125 in combination performed better than these biomarkers alone in diagnosing tuberculous pleurisy.
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  An observational study on efficacy and safety of regimens containing delamanid and linezolid in the treatment of rifampicin resistant tuberculosis for 24 weeks

  ZOU Liping, CHEN Qing, SHI Zhengyu, TANG Xianzhen, LIANG Li, CHEN Lei, WU Guihui

  2025, 25(5): 498-504. https://doi.org/10.16718/j.1009-7708.2025.05.003

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  Objective To evaluate the early efficacy and safety of the regimens containing delamanid and linezolid in the treatment of rifampicin resistant tuberculosis (RR-TB). Methods A total of 47 patients diagnosed with RR-TB at Public Health Clinical Center of Chengdu from August 2020 to December 2021 were enrolled, including 22 cases (46.8%) of multidrug-resistant tuberculosis (MDR-TB), 8 cases (17.0%) of RR-TB, and 17 cases (36.2%) of pre-extensively drug-resistant tuberculosis (pre-XDR-TB). All patients were treated with a regimen based on delamanid and linezolid. The efficacy and safety were evaluated at 24 weeks of treatment. Results Among the 47 patients, 46 (97.9%) completed 24 weeks of treatment and 1 (2.1%) was lost to follow-up. At 24 weeks, the sputum culture conversion rate was 100% in the 43 patients with positive baseline sputum culture. The median conversion time was 2 (2, 8) weeks. Imaging examination showed absorption in 46 patients (97.9%). Overall, 40 patients (85.1%) experienced varying degrees of adverse events (AEs) within 24 weeks. Eleven patients (23.4%) experienced AEs possibly related to delamanid, mainly including QTcF interval prolongation (12.8%), gastrointestinal reactions (8.5%), dizziness (2.1%), headache (2.1%), and allergy (2.1%). Six patients permanently discontinued delamanid due to AEs including gastrointestinal reactions (6.4%), prolonged QTcF interval (2.1%), severe dizziness (2.1%), and drug allergy (2.1%). Patients with low baseline CD4⁺ T lymphocyte counts (OR = 0.991, 95% CI: 0.984-0.999) were more likely to experience delamanid-related AEs. Thirty patients (63.8%) experienced AEs possibly related to linezolid, including myelosuppression (55.3%),peripheral neuropathy (6.4%),optic neuritis occurred (2.1%), and allergy(2.1%). Three patients (6.4%) discontinued linezolid permanently due to severe anemia, peripheral neuropathy, and allergy. Conclusions The treatment regimens containing delamanid and linezolid for RR-TB showed a high sputum culture conversion rate and good tolerance at 24 weeks. Attention should be paid to gastrointestinal reactions and cellular immunity during treatment.
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  Clinical characteristics of patients with community-acquired pneumonia caused by methicillin-sensitive Staphylococcus aureus versus Streptococcus pneumoniae

  CHEN Lu, SHANG Xin

  2025, 25(5): 505-510. https://doi.org/10.16718/j.1009-7708.2025.05.004

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  Objective To compare and analyze the clinical characteristics and outcomes of community-acquired pneumonia (CAP) caused by methicillin-sensitive Staphylococcus aureus (MSSA) and CAP caused by Streptococcus pneumoniae. Methods A prospective observational study was conducted on 870 patients with CAP diagnosis who were hospitalized during the period from February 2019 to January 2023. The patients were assigned to MSSA or S. pneumoniae group according to the primary pathogen of CAP. The clinical characteristics and outcomes of patients were compared between groups. Results Overall, 51 patients with MSSA CAP and 819 patients with S. pneumoniae CAP were included in this study. Fever was reported in 62.75% (32/51) of patients with MSSA-CAP and 79.49% (651/819) of patients with S. pneumoniae CAP. Compared to S. pneumoniae, MSSA was associated with longer hospital stay (OR = 2.016, P = 0.016), longer ICU stay (OR = 1.829, P = 0.004), more ICU admission (OR = 3.024, P < 0.001), more mechanical ventilation (OR = 2.243, P = 0.002), higher mortality within 30 days of admission (OR = 2.623, P < 0.001), and higher mortality within 1 year after onset (OR = 2.779, P = 0.033). Conclusions The clinical symptoms of patients with MSSA CAP are relatively mild, but the outcome is worse than the patients with S. pneumoniae CAP.
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  Value of procalcitonin-to-albumin ratio for predicting the mortality risk in elderly patients with sepsis

  WANG Na, LIU Bo, WANG Jiaping, HU Ming, SUN Zhaodong, HUANG Tingting, WU Huiyi, SUN Runfeng

  2025, 25(5): 511-516. https://doi.org/10.16718/j.1009-7708.2025.05.005

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  Objective To investigate the value of procalcitonin-to-albumin ratio (PAR) for predicting 28-day mortality risk in elderly patients with sepsis for optimizing the diagnosis and treatment strategies. Methods The clinical data of 112 elderly patients diagnosed with sepsis in the intensive care unit were retrospectively reviewed and analyzed. Patients were assigned to survivors group or deaths group based on 28-day outcomes. Clinical characteristics and the results of laboratory tests were collected, including procalcitonin (PCT), albumin, and C-reactive protein (CRP). The normally distributed data were compared between groups using t-test. Mann-Whitney U test was adopted for comparing non-normally distributed data. Cox proportional hazards regression model was used to analyze the effects of multiple variables on survival time. Receiver operating characteristic (ROC) curve analysis was performed to determine the sensitivity and specificity of various variables in predicting mortality risk. Results Mechanical ventilation, APACHE II scores, and length of hospital stay (all P < 0.05) were significantly different between survivors group and deaths group. Blood culture results showed that Gram-negative bacteria were predominant pathogen (75.9%), especially Escherichia coli (45.5%). Albumin level was significantly lower (P = 0.026), while PCT, CRP, and PAR levels were significantly higher (P <0.05) in the deaths group compared to those in the survivors group. Multivariate Cox regression analysis revealed that PAR was an independent predictor of 28-day mortality (HR = 3.72, 95% CI: 1.98-4.42, P < 0.001). ROC curve analysis showed that the area under the curve (AUC) of PAR was 0.852 in predicting mortality, with a sensitivity of 81.25% and specificity of 87.82%. Conclusions PAR outperformed PCT or albumin alone in predicting 28-day mortality risk in elderly patient with sepsis. For every 0.1 increase in PAR, the risk of mortality increased by 272%. Early monitoring of PAR can assist clinicians in rapidly identifying high-risk patients and optimizing treatment strategies.
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  Survival analysis of HIV-infected patients complicated with progressive multifocal leukoencephalopathy

  YANG Honghong, YUAN Jing, LI Mei, ZENG Qin, WU Yushan, LIU Min

  2025, 25(5): 517-522. https://doi.org/10.16718/j.1009-7708.2025.05.006

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  Objective To investigate the mortality and risk factors of HIV-infected patients complicated with progressive multifocal leukoencephalopathy (PML) to inform the outcomes of these patients. Methods The clinical data of people living with HIV related PML who were treated at Chongqing Public Health Medical Treatment Center from January 1, 2019 to December 31, 2023 were retrospectively analyzed. Kaplan-Meier method was used for survival analysis. Log-rank test was performed. Cox regression model was used for multivariate analysis. Results A total of 42 people living with HIV related PML were enrolled, including 34 males (81.0 %). The median age was 44.5 (36.3, 51.0) years. PML was confirmed in 76.2% (32/42) of patients, and possible PML was diagnosed in 23.8% (10/42) of patients. The median time to diagnosis was 32.5 (14.8, 58.3) days. The median CD4⁺ T cell count was 69.0 (39.8, 112.0) cells/μL. The median HIV viral load was 5.05 (2.62, 5.77) log₁₀ copies/mL. The overall mortality rate was 54.8% (23/42) for patients with HIV related PML. CD4⁺ T cell count ≤50 cells/μL and initial modified Rankin scale (mRS) score ≥4 points were independent risk factors for the overall mortality of people living with HIV related PML (P < 0.05). Conclusions People living with HIV related PML have a high mortality rate. Low CD4⁺ T cell count and high initial mRS score were independent risk factors for the mortality of patients with HIV related PML. Currently, no definitive and effective drug treatment is available for PML. Early detection, diagnosis and initiation of antiretroviral therapy may improve the outcomes of patients.
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  Safety profile of linezolid in patients with bone marrow suppression after chemotherapy for acute myeloid leukemia

  CUI Yi, LIAO Ru, ZHAO Peixi, DONG Haiyan

  2025, 25(5): 523-529. https://doi.org/10.16718/j.1009-7708.2025.05.007

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  Objective To investigate the effect of linezolid on platelets in patients with acute myeloid leukemia (AML) and analyze the safety profile of linezolid by comparing the platelet count and bleeding risk of linezolid during bone marrow suppression in patients after chemotherapy for AML. Methods A retrospective study was conducted on patients who underwent chemotherapy for AML in a tertiary hospital from January 2020 to November 2024. The patients treated with linezolid and those not receiving linezolid were matched in a 1:2 ratio. The safety of linezolid during bone marrow suppression after chemotherapy for AML was analyzed in terms of platelet count <20×10⁹/L, <50×10⁹/L, minimum platelet count, total platelet transfusion volume, and clinical bleeding events. Results A total of 126 patients were enrolled, including 42 patients receiving linezolid and 84 patients not receiving linezolid. There was no significant difference between linezolid group and control group in the days for platelet count <20×10⁹/L and <50×10⁹/L. No life-threatening severe bleeding events were reported in either group. The time to platelet recovery and time to platelet count increase prolonged significantly in patients who received linezolid treatment for more than 7 days during bone marrow suppression. Albumin <35 g/L may prolong the time to platelet count increase. Conclusions This study suggests that short-term use of linezolid for not more than 7 days is safe during bone marrow suppression in patients after chemotherapy for AML. When linezolid is used for more than 7 days, the time required for platelet recovery and platelet count increase will be significantly prolonged. In cases of albumin <35 g/L, the time required for platelet count increase may be prolonged. These findings can inform clinical decision-making and help optimize infection management strategies for AML patients.
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  Pulmonary abscess caused by Slackia exigua: a case report and literature review

  XIANG Yupei, FAN Bing, LI Jinling, LI Xiaohong, WANG Jianhong

  2025, 25(5): 530-534. https://doi.org/10.16718/j.1009-7708.2025.05.008

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  Objective To review the clinical characteristics of Slackia exigua infections for improving the diagnosis and treatment. Methods We reviewed the clinical characteristics of a case of pulmonary abscess caused by Slackia exigua. The infection cases caused by Slackia exigua were searched and retrieved from PubMed, CNKI, and Wanfang databases, for the articles published during the period from January 1, 2011 to December 31, 2023. Results Among the 15 cases of Slackia exigua infection, 84.6% (11/13) had underlying diseases. Hypertension was the most common underlying disease, reported in 54.5% (6/11) of patients. Fever was present in 73.3% (11/15) of patients. Oral diseases and abscess caused by Slackia exigua were found in 63.6% (7/11) and 60.0% (9/15) of patients, respectively. Mixed infection was identified in 33.3% (5/15) of patients. The bacterium was susceptible to penicillin, ampicillin-sulbactam, ceftriaxone, levofloxacin and clindamycin, but mostly (2/3) resistant to metronidazole. Conclusions Slackia exigua infection often originates from oral aspiration and can cause abscess. Beta-lactam antibiotics are preferred for treatment of Slackia exigua infections. More data are required to confirm whether metronidazole is effective.
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  Pneumonia caused by Rhizopus microsporus: a case report and literature review

  YANG Jinmei, YANG Ruifang, WANG Ailing, SUN Jipeng, YI Wenting, YU Qiaoli, FENG Jiankai

  2025, 25(5): 535-539. https://doi.org/10.16718/j.1009-7708.2025.05.009

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  Objective To review the characteristics of Rhizopus microsporus infection for better awareness of the disease. Methods One case of pneumonia caused by R. microsporus was reported in a 66-year-old male patient. Similar reports on infections caused by R. microsporus were retrieved in PubMed and CNKI databases since 2013. The characteristics of patients with R. microsporus infection were reviewed. Results This case involves a 66-year-old male patient presenting with a 10-day history of cough, sputum production, and hemoptysis. The patient had a previous history of diabetes mellitus. Pulmonary CT scan revealed an irregular soft tissue density mass in the right lower lobe and pneumonia. The clinical presentation and laboratory findings were consistent with pulmonary mucormycosis caused by R. microsporus. R. microsporus was isolated from bronchoalveolar lavage fluid culture. The patient was treated with intravenous liposomal amphotericin B followed by oral posaconazole for antifungal therapy, and achieved a favorable prognosis. A total of 24 cases (18 males, 5 females, 1 unknown) of R. microsporus infection were reviewed (including this one). The specific site of infection included pulmonary infection (n=10), ocular infection (n=1), skin tuberculosis (n=1), splenic abscess (n=1), oral mucositis (n=1), gouty arthritis (n=1), esophageal ulceration (n=1), abdominal infection (n=1), and others (n=7). The clinical symptoms varied with the organs involved. Majority of the patients (n=11) were cured by surgery combined with antimicrobial therapy. Overall, 13 patients died. Conclusions Clinicians should be aware of the possibility of R. microsporus infection in case of pulmonary infection, especially those with diabetes mellitus.
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  Wound infection caused by Mycobacterium senegalense: one case report and literature review

  WANG Xiaohui, MA Xuzhu, LEI Dan, LIN Minggui

  2025, 25(5): 540-543. https://doi.org/10.16718/j.1009-7708.2025.05.010

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  Objective To explore the clinical features, diagnosis, and treatment of Mycobacterium senegalense infection. Methods We reported a case of postoperative wound infection caused by M. senegalense in a patient who underwent spinal intradural tumor surgery at Beijing Tsinghua Changgung Hospital. CNKI, Wanfang, VIP, and PubMed databases were searched from inception to April 1, 2024 using keywords Mycobacterium senegalense both in Chinese and English to identify relevant reports. Thirteen eligible articles were retrieved, including 1 in Chinese and 12 in English. The clinical data of the 13 cases of M. senegalense infection were reviewed and analyzed. Results A case of postoperative wound infection caused by M. senegalense was reported in a patient who underwent spinal intradural tumor surgery. The patient was a 53-year-old male. He was previously healthy. The patient was initially treated for schwannoma by resection of an intraspinal space-occupying lesion at another hospital. Two weeks after the operation, the skin surrounding the surgical incision became redness, swelling, and pain. The patient did not have fever. M. senegalense was identified from pus culture. The patient was treated with doxycycline, moxifloxacin, and clarithromycin combination therapy, as well as wound disinfection and dressing changes. The infected wound subsequently healed. Among the 13 patients with M. senegalense infection, 30.8% (4/13) were males and 69.2% (9/13) were females. The average age of patients was (51.6 ± 17.7) years. The reported cases included skin and soft tissue infection (7 cases), bloodstream infection (2 cases), artificial joint infection (2 cases), and one case each of osteomyelitis and prosthetic infection. About half (46.2%, 6/13) of the patients were immunosuppressed. Most (76.9%, 10/13) of the patients were infected after surgery and trauma. Antimicrobial susceptibility test showed that all of the M. senegalense isolates were susceptible to amikacin, ciprofloxacin, clarithromycin and doxycycline. Conclusions M. senegalense infection is rarely reported. It primarily occurs following surgical procedures or trauma. Appropriate and adequate antibiotic combination therapy based on antimicrobial susceptibility testing generally results in favorable outcomes.
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  Fungal keratitis caused by Diaporthe phaseolorum: one case report and literature review

  CHEN Ying, LI Hong, WANG Huiyu, WANG Lihua, WANG Qiongying, LI Xiaofang

  2025, 25(5): 544-548. https://doi.org/10.16718/j.1009-7708.2025.05.011

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  Objective To report a case of fungal keratitis caused by plant pathogens, evidenced by laboratory testing. Methods Specimens were collected by corneal scraping from a 52-year-old male patient for pathogen culture. The patient was treated at Qionghai People’s Hospital for fungal keratitis. The isolates were identified and tested for antimicrobial susceptibility. PubMed, CNKI, Wanfang, and VIP database were searched using keywords Diaporthe or Diaporthe phaseolorum in English and Chinese from the establishment of the database to December 10, 2024. A retrospective literature review was conducted on the cases of human infection caused by Diaporthe. Results The specimens from corneal scraping were directly examined under a microscope. Septate fungal hyphae were observed. The isolate was identified as Diaporthe phaseolorum by targeted DNA sequencing. Antimicrobial susceptibility testing by microdilution method showed that the minimum inhibitory concentrations (MIC) of fluorocytosine, fluconazole, amphotericin B, voriconazole, itraconazole, posaconazole, micafungin, caspofungin, and anidulafungin against this strain were >64, 64, 0.5, 0.12, 2, 0.06, 0.03, <0.03, and 0.12 mg/L, respectively. Clinicians adjusted the antifungal treatment plan timely based on the antimicrobial susceptibility testing results. The patient's vision was restored. Literature review found that of the 12 reported cases of infection worldwide, 6 were localized skin or soft tissue infections, 3 were peritonitis, and the remaining 3 cases were keratitis. Overall, 9 patients were immunocompromised and 3 had normal immune function. Human infections caused by Diaporthe often occur in immunocompromised individuals. Invasive infections often lead to patient mortality. There are no established breakpoints for common antifungal agents against Diaporthe. The MICs against the strain were higher for flucytosine and fluconazole, but lower for azoles, echinocandins, and polyenes. Conclusions Fungal keratitis caused by D. phaseolorum is an emerging infection. The information in this case, including clinical symptoms, the morphology of D. phaseolorum under microscope after corneal scraping, the growth characteristics and antifungal susceptibility testing, targeted DNA sequencing, can inform the microbiology laboratory staff and clinicians of D. phaseolorum infections in the future.
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  Effect of LncRNA NORAD on macrophage apoptosis via sponging miR-20a-5p in Mycobacterium tuberculosis infection

  SUN Hongmei, CHENG Huanhuan, KONG Xianglong, XUE Jianchang

  2025, 25(5): 549-556. https://doi.org/10.16718/j.1009-7708.2025.05.012

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  Objective To investigate the effect of long non-coding RNA non-coding RNA-activated by DNA damage (LncRNA NORAD) on macrophage apoptosis induced by Mycobacterium tuberculosis infection via sponging microRNA-20a-5p (miR-20a-5p). Methods Healthy subjects (n=50) who came for health checkup, patients with active tuberculosis (n=50) and individuals with asymptomatic M. tuberculosis infection (n=50) were enrolled from Hebei Chest Hospital from March 2022 to April 2023. Venous blood samples were collected to prepare serum samples. The expression levels of LncRNA NORAD, miR-20a-5p, and inflammatory factors in the serum were measured. Human monocyte line THP-1 was induced to differentiate into macrophages and assigned into Control group, Model group, transfection of NORAD empty vector group (sh-NC group), transfection of sh-NORAD vector group (sh-NORAD group), co-transfection of sh-NORAD and miR-20a-5p inhibitor empty vector group (sh-NORAD+miR-20a-5p inhibitor NC group), co-transfection of sh-NORAD and miR-20a-5p inhibitor vector group (sh-NORAD+miR-20a-5p inhibitor group), transfection of miR-20a-5p empty vector group (miR-NC group), and transfection of miR-20a-5p vector group (miR-20a-5p mimics group). The expression levels of LncRNA NORAD and miR-20a-5p (qRT PCR method), cell proliferation ability (CCK-8 kit method), cell apoptosis (flow cytometry method), inflammatory factor levels (ELISA method), and protein expression levels of BCL2-Associated X (Bax), B-cell lymphoma-2 (Bcl-2), and cleaved caspase 3 in cells were detected. The targeted relationship between LncRNA NORAD and miR-20a-5p was validated. Results Compared with healthy subjects, the patients with active tuberculosis and asymptomatic M. tuberculosis infection had significantly higher serum levels of inflammatory factors and expression of LncRNA NORAD, and significantly lower miR-20a-5p. Compared with Control group, Model group had significantly higher LncRNA NORAD level, cell proliferation ability, Bcl-2 protein expression, and inflammatory factor levels, but significantly lower miR-20a-5p level, apoptosis rate, and Bax and cleaved caspase 3 protein expression (P < 0.05). Compared with the sh-NC group, the sh-NORAD group had significantly lower LncRNA NORAD level, Bcl-2 protein expression, inflammatory factor levels, and cell proliferation ability, but significantly higher miR-20a-5p level, apoptosis rate, and Bax and cleaved caspase 3 protein expression (P < 0.05). Compared with the sh-NORAD+miR-20a-5p inhibitor NC group, the sh-NORAD+miR-20a-5p inhibitor group had significantly higher inflammatory factor levels, Bcl-2 protein expression, and cell proliferation ability, but significantly lower miR-20a-5p level, apoptosis rate, and Bax and cleaved caspase 3 protein expression (P < 0.05). Compared with the miR-NC group, the miR-20a-5p mimics group had significantly increased inflammatory cytokines and proliferation ability, and significantly reduced apoptosis rate (P < 0.05). The targeted relationship between LncRNA NORAD and miR-20a-5p was further confirmed through experiments. Conclusions LncRNA NORAD is overexpressed in macrophages induced by M. tuberculosis. Silencing the expression of LncRNA NORAD can target the downregulation of miR-20a-5p expression, thereby inhibiting the inflammatory response of macrophages induced by M. tuberculosis and promoting cell apoptosis.
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  Changing antimicrobial resistance profiles of Burkholderia cepacia in hospitals across China: results from CHINET Antimicrobial Resistance Surveillance Program, 2015-2021

  GE Chunyue, HU Yunjian, AI Xiaoman, YANG Yang, HU Fupin, ZHU Demei, XU Yingchun, ZHANG Xiaojiang, LI Hui, JI Ping, XIE Yi, KANG Mei, WANG Chuanqing, FU Pan, XU Yuanhong, HUANG Ying, SUN Ziyong, CHEN Zhongju, NI Yuxing, SUN Jingyong, CHU Yunzhuo, TIAN Sufei, HU Zhidong, LI Jin, YU Yunsong, LIN Jie, SHAN Bin, DU Yan, GUO Sufang, WEI Lianhua, ZOU Fengmei, ZHANG Hong, WANG Chun, ZHUO Chao, SU Danhong, GUO Dawen, ZHAO Jinying, YU Hua, HUANG Xiangning, LIU Wen’en, LI Yanming, JIN Yan, SHAO Chunhong, XU Xuesong, YAN Chao, WANG Shanmei, CHU Yafei, ZHANG Lixia, MA Juan, ZHOU Shuping, ZHOU Yan, ZHU Lei, MENG Jinhua, DONG Fang, LÜ Zhiyong, HU Fangfang, SHEN Han, ZHOU Wanqing, JIA Wei, LI Gang, WU Jinsong, LU Yuemei, LI Jihong, DUAN Jinju, KANG Jianbang, MA Xiaobo, ZHENG Yanping, GUO Ruyi, ZHU Yan, CHEN Yunsheng, MENG Qing, WANG Shifu, HU Xuefei, SHEN Jilu, Huang Wenhui, WANG Ruizhong, FANG Hua, YU Bixia, ZHAO Yong, GONG Ping, WENG Kaizhen, ZHANG Yirong, LIU Jiangshan, LIAO Longfeng, GU Hongqin, JIANG Lin, HE Wen, XUE Shunhong, FENG Jiao, YUE Chunlei

  2025, 25(5): 557-562. https://doi.org/10.16718/j.1009-7708.2025.05.013

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  Objective To examine the changing prevalence and antimicrobial resistance profiles of Burkholderia cepacia in 52 hospitals across China from 2015 to 2021. Methods A total of 9 261 strains of B. cepacia were collected from 52 hospitals between January 1, 2015 and December 31, 2021. Antimicrobial susceptibility of the strains was tested using Kirby-Bauer method or automated antimicrobial susceptibility testing systems according to a unified protocol. The results were interpreted according to the breakpoints released in the Clinical & Laboratory Standards Institute (CLSI) guidelines (2023 edition). Results A total of 9 261 strains of B. cepacia were isolated from all age groups, especially elderly patients. The proportion was 11.1% (1 032 strains) in children, significantly lower than the proportion in adults. About half (46.5%, 4 310/9 261) of the strains were isolated from patients at least 60 years old and 42.3% (3 919/9 261) of the strains were isolated from young adults. Most isolates (71.1%) were isolated from sputum and respiratory secretions, followed by urine (10.7%) and blood samples (8.1%). B. cepacia isolates were highly susceptible to the five antimicrobial agents recommended in the CLSI M100 document (33rd edition, 2023). B. cepacia isolates showed relatively higher resistance rates to meropenem and levofloxacin. However, the resistance rates to ceftazidime, trimethoprim-sulfamethoxazole, and minocycline remained below 8.1%. The percentage of B. cepacia strains resistant to levofloxacin was the highest compared to other antibiotics in any of the three age groups (from 12.4% in the patients < 18 years old to 20.6% in the patients aged 60 years or older). Conclusions B. cepacia is one of the clinically important non-fermenting gram-negative bacteria. Accurate and timely reporting of antimicrobial susceptibility test results and ongoing antimicrobial resistance surveillance are helpful for rational prescription of antimicrobial agents and proper prevention and control of nosocomial infections.
Expert Forum
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  Multidisciplinary expert consensus on the clinical indications and rational application of norvancomycin

  Writing team for “Multidisciplinary expert consensus on the clinical indications, rational application of norvancomycin”

  2025, 25(5): 563-574. https://doi.org/10.16718/j.1009-7708.2025.05.014

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Review
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  Research progress regarding the mechanisms of polymyxin-induced kidney injury

  YE Huijing, WU Xiaojie, YANG Haijing, ZHU Xu, WANG Jingjing, BIAN Xingchen, ZHANG Jing

  2025, 25(5): 575-581. https://doi.org/10.16718/j.1009-7708.2025.05.015

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  Advances in pharmacological and adjunctive therapies for methicillin-resistant Staphylococcus aureus biofilm-associated infections

  CHEN Xiaoqi, XU Shihang, HAN Fuyou, HUANG Chengqiang, ZHANG Xiaoxue

  2025, 25(5): 582-587. https://doi.org/10.16718/j.1009-7708.2025.05.016

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  Advances in clinical research on community-acquired Acinetobacter baumannii pneumonia

  ZHUANG Yuan, WANG Hui

  2025, 25(5): 588-592. https://doi.org/10.16718/j.1009-7708.2025.05.017

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