20 November 2025, Volume 25 Issue 6

  

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Editorial
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  Heritage and development of China Antimicrobial Surveillance Network in 20 years

  HU Fupin, ZHU Demei

  2025, 25(6): 593-596. https://doi.org/10.16718/j.1009-7708.2025.06.001

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Original Article
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  Antimicrobial resistance profile of clinical isolates in hospitals across China: report from the CHINET Antimicrobial Resistance Surveillance Program, 2024

  GUO Yan, DING Li, HU Fupin, ZHU Demei, WANG Fu, TIAN Yueru, XU Yingchun, ZHANG Xiaojiang, ZHANG Fengbo, JI Ping, XIE Yi, XIAO Yuling, WANG Chuanqing, FU Pan, XU Yuanhong, HUANG Ying, SUN Ziyong, CHEN Zhongju, SUN Jingyong, CHEN Qing, CHU Yunzhuo, TIAN Sufei, HU Zhidong, LI Jin, YU Yunsong, FU Ying, SHAN Bin, XU Yunmin, GUO Sufang, WANG Yanyan, WEI Lianhua, LI Keke, ZHANG Hong, PAN Fen, HU Yunjian, AI Xiaoman, ZHUO Chao, GUAN Jing, GUO Dawen, ZHAO Jinying, YU Hua, HUANG Xiangning, LIU Wen'en, LI Yanming, JIN Yan, SHAO Chunhong, XU Xuesong, LI Wei, WANG Shanmei, MA Bing, 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, SUN Qian, DUAN Jinju, KANG Jianbang, MA Xiaobo, ZHENG Yanqing, GUO Ruyi, ZHU Yan, CHEN Yunsheng, MENG Qing, WANG Shifu, HU Xuefei, FANG Hua, ZHANG Penghui, YU Bixia, GONG Ping, SHI Haixia, WEN Kaizhen, ZHAO Hongdong, YANG Xiuli, ZHAO Yiqin, LIAO Longfeng, WU Jinhua, GU Hongqin, JIANG Lin, HU Meifang, BAI Fangdong, FENG Jiao, YOU Lingling, WANG Dongmei, WANG Dong'e, LIU Yanyan, AN Yong, HUANG Wenhui, LI Juan, SHI Quangui, YANG Juan, Reziwaguli Abulimiti, HUANG Lili, SHAO Xuejun, REN Xiaoyan, LI Dong, ZHANG Qun, CHEN Xue, LI Rihai, XU Jieli, GAO Kaijie, XU Lu, LIN Lin, ZHANG Zhuo, LIU Jianlong, FU Min, GUO Yinghui, ZHANG Wenchao, WANG Zengguo, JIA Kai, XIA Yun, SUN Shan, YANG Huimin, MIAO Yan, WANG Jianping, ZHOU Mingming, ZHANG Shihai, LIU Hongjuan, CHEN Nan, LI Chan, KOU Cunshan, XUE Shunhong, SHEN Jilu, MEN Wanqi, WANG Peng, ZHANG Xiaowei, ZENG Xiaoyan, LI Wen, GENG Yan, LIU Zeshi, WU Xiaoyan, LI Xiaosi

  2025, 25(6): 597-607. https://doi.org/10.16718/j.1009-7708.2025.06.002

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  Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in healthcare facilities in major regions of China in 2024. Methods Clinical isolates from 74 hospitals in China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems. Results were interpreted using the 2024 Clinical & Laboratory Standards Institute (CLSI) breakpoints. Results A total of 458 271 clinical isolates were collected in 2024, of which 28.3% were gram-positive and 71.7% were gram-negative. The prevalence of methicillin-resistant strains in Staphylococcus aureus, Staphylococcus epidermidis and other coagulase-negative Staphylococcus species (excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi) (MRSA, MRSE and MRCNS) were 28.4%, 76.5%, and 70.2%, respectively. No vancomycin-resistant strains were found. The resistance rates of Enterococcus faecalis and Enterococcus faecium to high-concentration gentamicin were 36.6% and 39.7%, respectively. A few vancomycin-resistant strains were identified in both E. faecalis and E. faecium. E. faecium showed higher resistance rates to most antimicrobials compared to E. faecalis. The prevalence of penicillin-nonsusceptible strains (PISP and PRSP) among non-meningitis Streptococcus pneumoniae isolated from children and adults was 0.1% and 1.0%, respectively. The resistance rate to carbapenems was lower than 15.0% for most Enterobacterales species except for Klebsiella, 21.3%, and 22.1% of which were resistant to imipenem and meropenem, respectively. Most Enterobacterales isolates were highly susceptible to tigecycline (≤3.1% resistant) and colistin (≤4.2% resistant). The resistance rates to imipenem and meropenem were 21.3% and 17.3% for Pseudomonas aeruginosa, respectively, 64.5% and 64.7% for Acinetobacter baumannii, respectively. Conclusions In 2024, the antimicrobial resistance of clinical bacterial isolates was still serious. Clinicians should rationally select antimicrobial agents based on the results of antimicrobial resistance surveillance to effectively control the development of bacterial resistance.
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  Analysis of the factors influencing the rational use of antibiotics and the implementation of relevant policies among the general population in Northeast China

  ZHANG Xiaoyu, ZHANG Deng, ZHANG Xifan, ZHANG Jingping, CHEN Baiyi, ZHANG Xin

  2025, 25(6): 608-618. https://doi.org/10.16718/j.1009-7708.2025.06.003

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  Objective To assess the public's knowledge level regarding basic antibiotic-related concepts, their adherence to proper antibiotic usage, and their attitudes toward discontinuing skin testing of β-lactam (penicillin) allergy. The study aims to provide guidance for improving the current state of antibiotic usage and reducing the healthcare burden. Methods A questionnaire survey was conducted via online questionnaire "Wenjuanxing" among patients in the Department of Infectious Diseases at the First Affiliated Hospital of China Medical University, as well as their family members and the hospital's healthcare workers between May 1, 2023, and April 30, 2024. The study analyzed the public's knowledge level of antibiotics, their adherence to appropriate antibiotic usage, and the factors influencing the formulation of policies on discontinuing skin testing of β-lactams. Results A total of 533 valid questionnaires were collected from patients and their family members, and 194 valid questionnaires were collected from healthcare workers at the hospital. Overall, the public's knowledge level regarding antibiotics was low and moderate, which was significantly associated with gender (OR = 1.484, 95% CI: 1.023-2.154), different income level (OR = 2.548, 95% CI: 1.433-4.531; OR = 1.981, 95% CI: 1.063-3.694), and family medical background (OR = 0.130, 95% CI: 0.036-0.465). Approximately 22.33% of individuals had antibiotic misuse. Multiple medical visits (OR = 1.990, 95% CI: 1.284-3.082) and the habit of purchasing health supplements (OR = 1.786, 95% CI: 1.045-3.053) significantly affect the standardization of public antibiotic use behavior. Regarding the policy of discontinuing β-lactam skin tests, approximately 81.24% of the public showed low levels of acceptance, particularly among urban residents (OR = 1.951, 95% CI: 1.109-3.433), low-income groups (OR = 2.441, 95% CI: 1.300-4.585), and 45-69 years individuals (OR = 4.094, 95% CI: 2.384-7.032). Analysis of the questionnaires from the healthcare workers of our hospital revealed that although nearly all respondents (92.78%) had a high level of knowledge about antibiotics, only 35.57% could use them in a very standardized manner. For the policy of discontinuing β-lactam skin tests, only 32.47% held a positive attitude, while 67.53% expressed opposition. Conclusions Currently, more efforts are needed to improve public knowledge about antibiotics, adherence to appropriate usage behaviors, and acceptance of the policy to abolish skin tests for beta-lactam drugs. Females, high-income individuals, and those from families with a medical background demonstrate higher levels of awareness, but improper use of antibiotics remains prevalent, particularly among individuals who frequently seek medical care or have a habit of purchasing health supplements. As for the policy to cancel skin tests, acceptance is lower among 45-69-year-old people, low-income groups, and urban residents. Although healthcare workers possess higher levels of knowledge about antibiotics, there is still room for improvement in their practice adherence and acceptance of the policy.
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  Antifungal resistance in fungal strains isolated from bloodstream infections and multilocus sequence typing of Candida tropicalis

  WANG Ying, ZHOU Xin, XU Liangfei, JIN Peipei

  2025, 25(6): 619-625. https://doi.org/10.16718/j.1009-7708.2025.06.004

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  Objective To investigate the pathogen distribution and antifungal susceptibility of the strains isolated from invasive fungal bloodstream infections, and conduct epidemiological analysis of Candida tropicalis for improving clinical antifungal treatment. Methods Fungal isolates from blood were collected at the clinical laboratories. Microbial identification and antifungal susceptibility testing were conducted by matrix assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF) and VITEK2 AST-YS08 kit, respectively. Genotyping of C. tropicalis were conducted using multilocus sequence typing (MLST) system to explore the molecular epidemiology. The MLST clonal clusters (CCs) were analyzed by goeBURST software. Results A total of 47 fungal strains isolated from 46 patients were collected from August 2022 to January 2025. The patients are mainly in intensive care units (65.22%), including 36.96% in internal medicine intensive care unit, 19.57% in cardiac and vascular surgery intensive care unit, and 8.70% in neurological intensive care unit. The top three strains are C. albicans (n=15), C. tropicalis (n=13) and C. parapsilosis complex (n=11). Antifungal susceptibility testing showed that fluconazole-non-susceptible rate was 22.22% in C. parapsilosis and 76.92% in C. tropicalis. However, echinocandin drugs showed low minimum inhibitory concentration (MIC) against most fungal isolates. The concatenated sequences of the 13 strains of C. tropicalis were classified into 9 diploid sequence types (DSTs), 3 of which were newly identified DSTs. Phylogenetic analysis found clonal aggregation between azole-resistant C. tropicalis isolates. The strains resistant to both fluconazole and voriconazole are classified into the same clone cluster. Conclusions Candida are still the most common pathogens causing fungal bloodstream infections. C. albicans showed low resistance to azole drugs. C. parapsilosis showed certain degree of azole-non-susceptibility. Significantly, C. tropicalis strains were highly resistant to azoles. Azole drugs are apparently not suitable for first-line treatment of C. tropicalis candidemia. The clonal aggregation phenomenon of azole-resistant isolates calls for more epidemiological researches on C. tropicalis in future clinical practice.
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  A prediction model based on age-adjusted Charlson Comorbidity Index score, C-reactive protein and serum lactate levels for estimating the risk of deterioration of methicillin-resistant Staphylococcus aureus pneumonia

  HUANG Heqing, LU Hong, ZHU Qiongfang, REN Yalu, XU Jie, CHEN Zutao

  2025, 25(6): 626-630. https://doi.org/10.16718/j.1009-7708.2025.06.005

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  Objective To analyze the clinical characteristics and risk factors associated with the development of severe pneumonia caused by methicillin-resistant Staphylococcus aureus (MRSA). Methods Seventy patients with MRSA-associated pneumonia who were hospitalized in the First Affiliated Hospital of Soochow University from June 2023 to August 2024 were enrolled. They were assigned to severe pneumonia (SP group, n=28) or non-severe pneumonia (nSP group, n=57) based on the diagnostic criteria for severe pneumonia. The clinical data, underlying conditions, and laboratory test results were analyzed retrospectively to identify the risk factors for severe pneumonia. Results There was no statistically significant difference between the SP group and the nSP group in patient gender, age, common underlying diseases, clinical manifestations, white blood cell count, lymphocytes, neutrophils, or platelet count (P > 0.05). Healthcare-associated MRSA (HA-MRSA) was the most common pathogen in both groups without significant difference between groups (P > 0.05). However, the age-adjusted Charlson Comorbidity Index score (aCCI score), C-reactive protein, and serum lactate levels were significantly higher in the SP group compared to the nSP group(P < 0.05). Multivariate logistic regression analysis indicated that aCCI score, C-reactive protein, and serum lactate levels were risk factors for predicting the deterioration of MRSA pneumonia. The three variables combined performed better in predictive efficacy (AUC = 0.893, P < 0.001, 95% CI: 0.815 to 0.972). Conclusions The clinical manifestations of MRSA pneumonia are nonspecific. An aCCI score greater than 7, along with elevated levels of C-reactive protein, and serum lactate at early stage indicates that MRSA pneumonia may progress to a severe form.
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  Status and influencing factors of drug resistance of active pulmonary tuberculosis patients in Lanzhou city, 2015-2022

  YAN Ruqing, SU Guoqing, YANG Binfa, WANG Chenjin, GAO Wenlong, SONG Yanjun, LI Chao, ZHAO Xinjie, YANG Fan, ZHOU Yingquan

  2025, 25(6): 631-640. https://doi.org/10.16718/j.1009-7708.2025.06.006

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  Objective To analyze the current status and influencing factors of drug resistance among active pulmonary tuberculosis (TB) patients in Lanzhou city from 2015 to 2022 to inform better prevention and control of drug-resistant TB. Methods A retrospective case-control study was conducted using the data of 5 966 active TB patients in Lanzhou. Univariate and multivariate logistic regression analyses were performed to identify risk factors for drug resistance. A risk prediction nomogram model was constructed. The model performance was validated by the receiver operating characteristics (ROC) curves, calibration curves, and decision curve analysis. Results The overall drug resistance rate was 4.16% among active TB patients in Lanzhou. Multivariate analysis revealed that retreated patients (OR=2.903, 95% CI: 1.591-5.298), intercity migration (OR=12.424, 95% CI: 5.114-30.185), unemployment or temporary employment (OR=3.532, 95% CI: 1.199-10.404), non-use of fixed-dose combination (FDC) regimens (OR=2.532, 95% CI: 1.617-3.965), secondary TB (OR=2.035, 95% CI: 1.425-2.907), and referral-based patient origin (OR=3.409, 95% CI: 1.066-10.902) significantly increased drug resistance risk. Protective factors included Center for Disease Control and Prevention (CDC) management (OR=0.044, 95% CI: 0.026-0.075), intensive-phase supervision (OR=0.034, 95% CI: 0.011-0.104), contact tracing patient origin (OR=0.037, 95% CI: 0.010-0.147), absence of diabetes mellitus (OR=0.274, 95% CI: 0.152-0.493), no prior anti-TB treatment history (OR=0.033, 95% CI: 0.018-0.060), and non-comorbidity with other TB types (OR=0.093, 95% CI: 0.015-0.585). The nomogram demonstrated excellent predictive performance, with an area under the curve (AUC) of 0.977 (95% CI: 0.969-0.986). Calibration and decision curves confirmed the robust clinical utility of the nomogram model. Conclusions Drug-resistant active TB remains a critical challenge in Lanzhou, influenced by multidimensional factors. The constructed nomogram model provides a reliable tool for precise risk assessment and personalized intervention optimization, offering actionable insights for clinical practice and public health strategies.
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  Correlation between serum LC3B, neuron specific enolase, acetylcholinesterase and DNA load of varicella zoster virus and the value of the biomarkers for predicting the outcomes of varicella-zoster virus encephalitis

  LIN Xue, LIU Ruqian

  2025, 25(6): 641-646. https://doi.org/10.16718/j.1009-7708.2025.06.007

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  Objective To investigate the correlation between serum microtubule-associated protein 1 light chain 3B (LC3B), neuron-specific enolase (NSE), acetylcholinesterase (AChE) and DNA load of varicella zoster virus and the performance of the biomarkers combined for predicting the outcomes of varicella-zoster virus encephalitis. Methods The patients with varicella zoster encephalitis (n=100) admitted to Hengshui People’s Hospital from January 2022 to June 2024 were selected as the disease group, and assigned to one of the two groups according to the outcomes. Meanwhile, 93 healthy subjects were included as control group. The serum levels of LC3B, NSE and AChE were compared between the disease group and control group. Varicella zoster virus DNA load was detected in the disease group. The correlation between serum LC3B, NSE, AChE and varicella zoster virus DNA load was analyzed by Pearson correlation method. Receiver operating characteristic (ROC) curve was used to analyze the predictive efficacy of the biomarkers in improving the outcomes of patients. Results The gender, age, body mass index, smoking history and drinking history did not show significant difference between disease group and control group (P > 0.05). Serum LC3B, NSE and AChE levels were significantly higher in disease group than those in control group (P < 0.05). Serum LC3B, NSE, AChE levels and viral DNA load were lower in the patients with improved outcomes compared to those without improved outcomes (P < 0.05). Pearson correlation analysis showed that serum LC3B, NSE and AChE were positively correlated with viral DNA load (r=0.311, 0.268, 0.202, P = 0.002, 0.007, 0.044). ROC curve analysis showed that the area under the curve (AUC) of serum LC3B, NSE, AChE levels and viral DNA load was 0.798, 0.811, 0.773 and 0.839, respectively in predicting disease outcome. The corresponding sensitivity was 78.8%, 81.8%, 90.9% and 81.8%, and the specificity was 76.5%, 70.6%, 58.8% and 79.4%, respectively. The AUC of the biomarkers combined was 0.932, which was higher than that of any biomarker alone (Z=2.554, P=0.011; Z=2.823, P=0.005; Z=3.303, P=0.001; Z=2.820, P=0.005), and the sensitivity and specificity were 97.0% and 79.4%, respectively. Conclusions Serum LC3B, NSE and AChE were positively correlated with varicella zoster viral DNA load. All the four biomarkers had certain predictive value for the outcomes of patients. These biomarkers combined can achieve better performance in predicting the outcomes of patients, which may be useful for predicting improved outcomes of patients with varicella zoster encephalitis.
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  Development and validation of a physiologically based pharmacokinetic model of vancomycin for extrapolating the pharmacokinetic data from adult patients with Gram-positive bacterial infection to pediatric population

  ZHOU Delong, SHEN Kai, CHEN Yuancheng, FAN Yaxin, WU Jufang, XU Yuhong, WU Xiaojie, WU Hailan, ZHANG Jing

  2025, 25(6): 647-653. https://doi.org/10.16718/j.1009-7708.2025.06.008

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  Objective To establish a physiologically based pharmacokinetic (PBPK) model of vancomycin in Chinese adult patients with gram-positive bacterial infection for extrapolation to children to support the clinical use of vancomycin in pediatric patients. Methods A PBPK model was established based on vancomycin concentration data during therapeutic drug monitoring in prospective multicenter clinical studies in adults and pediatric patients with gram-positive bacterial infection. Simcyp^® software was used to establish a vancomycin PBPK model based on the concentration data from 18 organs of Chinese adults. Steady-state volume of distribution was predicted according to the Rogers and Rowland method. The tissue-plasma partition coefficient was predicted by the default value of the software. A vancomycin PBPK model was established for children aged 0-17 years by changing the physiological parameters of the population and extrapolating them to children. Clinical concentration data of vancomycin were used for internal and external validation. When the fold error of prediction was in the range of 05-2, the prediction effect of the model was considered to be good. Results In this study, 380 adult patients and 108 pediatric patients were included. A PBPK model was established for adult and pediatric patients, respectively. The external verification of the measured data of 23 children confirmed that following administration of vancomycin 40 mg·kg^-1·d^-1 every 6 hours, the measured and predicted mean values of steady-state peak concentration (C_max,ss) were 22.28 mg/L and 30.27 mg/L, respectively, with a fold error of 1.36. The measured and predicted mean values of steady-state trough concentration (C_min,ss) were 4.84 mg/L and 5.12 mg/L, respectively, with a fold error of 1.06. For the dosing regimen of vancomycin 60 mg·kg^-1·d^-1 every 6 hours, the measured and predicted mean values of C_max,ss were 28.60 mg/L and 45.56 mg/L, respectively, with a fold error of 1.59. The measured and predicted mean values of C_min,ss were 5.03 mg/L and 7.74 mg/L, respectively, with a fold error of 1.54. Conclusions The PBPK model of vancomycin established for adults in this study can be extrapolated to children, which is helpful for individualized treatment of vancomycin in children.
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  The utility of 7 inflammatory biomarkers in differentiating bacterial infections from viral infections

  CHENG Kuo, XU Sanhui, WANG Peixian, LEI Qiuxiang

  2025, 25(6): 654-658. https://doi.org/10.16718/j.1009-7708.2025.06.009

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  Objective To assess the diagnostic utility of white blood cell (WBC) count, neutrophil percentage (N%), C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6), human neutrophil lipocalin (HNL), and heparin-binding protein (HBP) in differentiating bacterial infections from viral infections, and compare the diagnostic efficacy of these biomarkers. Methods Blood samples were collected from 100 patients with bacterial infections, 100 patients with viral infections, and 80 healthy individuals (healthy controls) who underwent health check-ups. Seven inflammatory biomarkers were tested. The diagnostic efficacy of each marker alone and in combinations was analyzed. The receiver operating characteristic (ROC) curve was plotted and the area under the curve (AUC) was calculated. Results The levels of WBC, CRP, PCT and HNL in the bacterial infection group were higher than those in the viral infection group. The levels of 7 inflammatory biomarkers in the bacterial infection group and viral infection group were higher than those in the control group. The levels of N%, IL-6 and HBP did not show significant difference between the bacterial infection group and viral infection group. ROC analysis showed that HNL was the best single biomarker in terms of diagnostic performance, evidenced by AUC of 0.871. The AUC of HNL+CRP +PCT was 0.882, which was better than other combination panels. Conclusions HNL has higher diagnostic utility than other inflammatory biomarkers tested in differentiating bacterial infections from viral infections. HNL+CRP+PCT is the best combination panel with higher diagnostic value than each marker alone. Combination panel test of inflammatory biomarkers is beneficial for successful clinical diagnosis and treatment of infectious diseases.
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  Cutaneous infections caused by Nocardia: report of two cases and literature review

  WANG Wentong, XIONG Xixi, ZONG Yangyongyi, SU Ting, WANG Xinpei, WANG Chaofan, SU Zhonglan

  2025, 25(6): 659-663. https://doi.org/10.16718/j.1009-7708.2025.06.010

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  Objective To explore the clinical manifestations, diagnosis, treatment, and prognosis of patients with cutaneous nocardiosis. Methods Two patients with cutaneous nocardiosis admitted to Department of Dermatology of Jiangsu Province Hospital during the period from 2023 to 2024 were reported. Gene sequencing confirmed Nocardia infection. They were treated with trimethoprim-sulfamethoxazole. The clinical characteristics, treatment process, and disease progression were analyzed. CNKI and Wanfang Databases were searched using the Chinese search terms "cutaneous" and "Nocardia" for the reports from January 1, 2004, to September 25, 2024, yielding 281 articles. PubMed was searched for the reports in English using "cutaneous" and "Nocardia" as search terms, yielding 282 articles. A total of 52 reports in Chinese and 109 in English were included in this review. The detailed data of 180 patients with primary cutaneous nocardiosis were analyzed and summarized to systematically elaborate on cutaneous nocardiosis. Results The cutaneous nocardiosis was caused by Nocardia brasiliensis in one patient, and caused by Nocardia farcinica in the other patient. Both patients were cured after treatment with trimethoprim-sulfamethoxazole. Overall, 60.00% of the 180 cases of cutaneous nocardiosis reported in the literature were in males. The average age of patients was 52.7 ± 19.8 years. Most of the patients were middle-aged and elderly individuals. Nocardia species were identified in 149 cases, of which 69 (69/149, 46.31%) were caused by Nocardia brasiliensis. The site of infection was mainly on the limbs, including 65 cases (36.11%) on the upper limbs and 53 cases (29.44%) on the lower limbs. Most patients (72.22%) were treated with trimethoprim-sulfamethoxazole alone or in combination with other antibacterial drugs. The prognosis was good for patients with primary cutaneous nocardiosis, which was cured in most cases. Conclusions The rashes are diverse and nonspecific for cutaneous nocardiosis. The gold standard for diagnosis is the isolation of Nocardia from clinical samples. Relevant cases are rarely reported. Sulfonamide antimicrobials are currently the first-choice treatment.
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  Renal abscess caused by Brucella infection: report of two cases and literature review

  XIAO Ke, ZHONG Li

  2025, 25(6): 664-668. https://doi.org/10.16718/j.1009-7708.2025.06.011

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  Objective To understand the clinical characteristics of renal abscess caused by Brucella infection. Methods Two cases of renal abscess caused by Brucella infection were reported, including the diagnosis, treatment of patients and review of relevant literature reports. The Chinese databases of CNKI, Wanfang, and VIP were searched with search terms "Brucella" and "renal abscess" in Chinese. The PubMed database was searched with search terms "brucella/brucellosis" and "renal abscess/renal infection" or "renal brucelloma" in English. The databases were searched from the establishment of the databases to December 2024. The clinical data of patients with renal abscess caused by Brucella infection were screened out and summarized. Results Two patients in the Affiliated Hospital of Southwest Medical University were mainly presented with fever. Abdominal CT showed space-occupying lesions in the kidneys. One patient had Brucella isolated from blood culture. The renal lesion improved after anti-infection treatment. The other patient underwent nephrectomy on the affected side. Brucella was isolated from the postoperative pus culture. A total of 10 patients were included in this review, including 8 males and 2 females, aged 36 to 68 years. Eight patients had relevant epidemiological history of brucellosis. The time from onset to admission ranged from 10 days to 3 months. The main clinical manifestations were fever in 9 cases, lumbar pain/back pain in 5 cases, and weight loss in 3 cases. Brucella was isolated from blood culture or (and) pus culture in 8 patients. Brucella antibody was positive in one patient. Brucella nucleic acid was positive in the pathological tissue of one patient. Four patients underwent surgical resection of the lesion/affected kidney. The postoperative anti-infection treatment ranged from 3 weeks to 2 months. All of the 4 patients were cured. Four patients were treated with anti-infection drugs only. The duration of treatment ranged from 6 weeks to 4 months. Two of the 4 patients were cured. One patient improved but had a recurrence of brucellosis 6 months later, and one was lost to follow-up and died 7 months later. Two patients received drainage combined with anti-infection treatment, one improved and one was cured. Conclusions Renal abscess caused by Brucella infection is rare and easily misdiagnosed or missed in diagnosis. Effective antibacterial drugs combined with appropriate surgical treatment can result in good outcomes for most patients.
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  Good's syndrome complicated with Pneumocystis jirovecii pneumonia: a case report and literature review

  CHENG Ge, WANG Meifang, XIONG Chang, HAN Wenya, WU Xiaofeng, GUO Sijia, ZHANG Qiuyi, TANG Yijun

  2025, 25(6): 669-674. https://doi.org/10.16718/j.1009-7708.2025.06.012

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  Objective To elucidate the clinical manifestations, diagnostic criteria, therapeutic strategies, and pathogenesis of Good's syndrome complicated with Pneumocystis pneumonia so as to improve clinicians' awareness of this rare yet clinically significant disease, and minimize the chance of missed diagnosis or misdiagnosis. Methods The diagnosis and treatment of a patient diagnosed with Good's syndrome complicated with Pneumocystis jirovecii pneumonia (PJP) in Taihe Hospital were reviewed and summarized. The cases of Good's syndrome complicated with PJP reported in Wanfang, China National Knowledge Infrastructure (CNKI), and PubMed database were identified from 1970 to 2024. The relevant clinical data were analyzed retrospectively. Results A 39-year-old female patient was diagnosed with Good's syndrome complicated with PJP in Taihe Hospital. At early stage of treatment, she failed to respond to trimethoprim-sulfamethoxazole monotherapy. The patient experienced disease recurrence. Subsequently, the treatment regimen was adjusted to include gamma globulin therapy. The patient's symptoms were effectively controlled after treatment. A total of 9 cases were identified with Good's syndrome complicated with PJP. These patients included six males and three females. The age of patients ranged from 39 to 74 years old. Type AB thymoma was the most common thymoma subtype. All patients received treatment with intravenous gamma globulin. Conclusions IVIG constitutes a cornerstone in the treatment armamentarium for Good's syndrome complicated with PJP. Prophylactic use of immunoglobulin may be a proactive measure to avert the development of complex infections.
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  Tenosynovitis caused by Mycobacterium arupense: a case report and literature review

  ZHANG Hongbin, XIAO Binlong, CAI Mingchi, LIANG Shengqiang

  2025, 25(6): 675-680. https://doi.org/10.16718/j.1009-7708.2025.06.013

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  Objective To report the diagnosis and management of a case of tenosynovitis caused by Mycobacterium arupense, and summarize the clinical features by literature review in order to improve the understanding of the disease. Methods The diagnosis and treatment of a case of tenosynovitis caused by M. arupense were described. Similar case reports published during the period from January 2006 to January 2025 were retrieved from PubMed, CNKI, Wanfang and VIP databases using search terms “Mycobacterium arupense” and “tenosynovitis”. The reports were analyzed in terms of underlying disease, exposure history, pathological and etiological analyses, and therapeutic and prognostic characteristics. Results This case was successfully cured by lesion excision and carpal tunnel incision and decompression, dilatation, antimicrobial combinations of rifampicin + clarithromycin + ethambutol and amikacin + cefmetazole. A total of 15 relevant articles were reviewed, including 16 cases. Finally, 17 cases of M.arupense infection were analyzed, including the case in this report. Infections caused by M. arupense included 11 cases of tenosynovitis of the hand, and 6 cases of infections at other sites. Most of the patients with tenosynovitis had a history of foreign body stabbing and corticosteroid injection therapy. Most of the patients with M. arupense infection at other sites had underlying diseases. Pathologic findings were mainly granulomatous inflammation with or without multinucleated giant cells. The primary treatment approach was surgical treatment combined with rifabutin, ethambutol, clarithromycin, and other medications. Overall, 16 of the 17 patients were improved or cured, and 1 patient died due to liver failure. Conclusions Clinical infections caused by M. arupense are rarely reported. In patients with tenosynovitis who have a history of foreign body puncture wounds, negative routine pathogen tests, and a prolonged course of disease, the possibility of M. arupense infections should be considered. Targeted high-throughput sequencing can assist in early diagnosis.
Case Report
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  Bloodstream infection caused by Pseudomonas oleovorans: a case report

  LIU Junbao, XIE Peitao, WANG Xingang, SU Changhai, HAO Duo

  2025, 25(6): 681-683. https://doi.org/10.16718/j.1009-7708.2025.06.014

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  Cutaneous abscess caused by Mycobacterium mageritense infection: one case report

  CHEN Chong, ZHANG Minmin, QI Wen, WAGN Wei

  2025, 25(6): 684-687. https://doi.org/10.16718/j.1009-7708.2025.06.015

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  Severe community-acquired pneumonia caused by Chlamydia psittaci complicated with acute respiratory distress syndrome: one case report

  ZHANG Ping, WANG Dujuan, RUAN Wenjing, ZHANG Hongbo

  2025, 25(6): 688-690. https://doi.org/10.16718/j.1009-7708.2025.06.016

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Translated Article
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  Antimicrobial resistance of clinical bacterial isolates in China: current status and trends

  QIN Xiaohua, DING Li, HAO Min, HU Fupin, WANG Minggui

  2025, 25(6): 691-698. https://doi.org/10.16718/j.1009-7708.2025.06.017

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Information Exchange
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  The formulation of the Expert Consensus on the Performance of Antimicrobial Susceptibility Testing of Bacteria in China

  HU Fupin, ZHU Demei

  2025, 25(6): 699-704. https://doi.org/10.16718/j.1009-7708.2025.06.018

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