Longitudinal molecular epidemiology of ceftriaxone-resistant enterobacterales in intra-abdominal and urinary tract infections: A decade-long SMART surveillance study in Taiwan (2009-2019).

Background: Third-generation cephalosporin-resistant Enterobacterales is a recognized global concern. This study investigated the molecular epidemiology of β-lactamase genes and antimicrobial susceptibility patterns among ceftriaxone-resistant Enterobacterales causing intra-abdominal and urinary tract infections in Taiwan between 2009 and 2019.

Methods: Data from the SMART surveillance program were analyzed, including Enterobacterales isolates with ceftriaxone minimum inhibitory concentrations ≥4 μg/mL.

Evaluation of the Roche cobas MTB and MTB-RIF/INH for detecting Mycobacterium tuberculosis complex and resistance to isoniazid and rifampicin: A prospective, multicenter diagnostic accuracy study.

Objectives: To evaluate the diagnostic performance of Roche cobas MTB and MTB-RIF/INH assays for detecting Mycobacterium tuberculosis complex (MTBC) and resistance to isoniazid (INH) and rifampicin (RIF).

Methods: This multicenter study was conducted in Taiwan between September 2023 and June 2024. Clinical specimens were collected from adult patients with presumptive tuberculosis (TB).

Deciphering the impact of contaminating microbiota in DNA extraction reagents on metagenomic next-generation sequencing workflows.

Unlabelled: The widespread adoption of metagenomic next-generation sequencing has revolutionized microbial detection, yet contaminating DNA in laboratory reagents poses significant challenges for result interpretation. This study investigated microbial contamination profiles across four commercial DNA extraction reagent brands (M, Q, R, and Z) and assessed batch-to-batch variability. Extraction blanks were generated using molecular-grade water or ZymoBIOMICS Spike-in Control I as input materials.

Evolving risk factors and predisposing conditions of Pneumocystis pneumonia in non-HIV patients: A seven-year multicenter study.

Objectives: As Pneumocystis pneumonia (PCP) increasingly develops in non-HIV patients without established immunocompromising factors, the study examined the evolving predisposing factors and at-risk medications.

Methods: This multicenter retrospective study included non-HIV PCP at seven clinical centers from 2016-2023. Patients were categorized by exposed medications and underlying predisposing diseases.

High prevalence but low clinical impact of acyclovir-resistant herpes simplex virus type 1 infections in patients with hematologic disorders.

Background/purpose: Herpes simplex virus type 1 (HSV-1) is highly prevalent in immunocompromised patients. Due to the recurrent nature of HSV-1 infection, frequent exposure to antiviral agents raises concerns about drug resistance. This study aimed to investigate antiviral-resistant profiles of HSV-1 and discuss the clinical impact of acyclovir-resistant (ACV-R) compared to acyclovir-susceptible (ACV-S) HSV-1 infected patients.

Prediction of methicillin-resistant Staphylococcus aureus and carbapenem-resistant Klebsiella pneumoniae from Raman spectra by Artificial Intelligent Raman Detection and Identification System (AIRDIS) with machine learning.

Objectives: Methicillin-resistant Staphylococcus aureus (MRSA) and carbapenem-resistant Klebsiella pneumoniae (CRKP) are two of the most important antibiotic-resistant bacteria. Early use of the correct treatment strategy can not only reduce patient mortality but also prevent the development of resistance. Although some rapid but costly techniques are available, routine workflows in clinical microbiology laboratories can sometimes take several days to deliver bacterial identification and resistance profiles.

Machine Learning for Detecting Iron Deficiency through Comprehensive Blood Analysis.

Background: Iron deficiency (ID) is a prevalent global health issue with a major impact on well-being. Early detection of ID is crucial but challenging due to its nonspecific symptoms and the limitations of traditional diagnostic tests, which are impractical for large-scale screening. This study proposes a machine learning (ML) approach using complete blood count (CBC) data and cell population data (CPD) for detecting ID in the general population.

Safety, immunogenicity, and breakthrough infection of nine homologous or heterologous COVID-19 vaccination booster regimens in healthy adults: A prospective study in Taiwan.

Background: The COVID-19 pandemic necessitated diverse vaccination strategies to enhance immune protection. This study aimed to evaluate the immunogenicity, reactogenicity, and breakthrough infection of nine distinct vaccination regimens involving homologous or heterologous second booster doses in a SARS-CoV-2-naïve population in Taiwan.

Methods: From December 2021 to May 2022, 784 healthy adults who had completed either homologous or heterologous prime and first booster vaccinations received a second booster dose, resulting in nine vaccination combinations.

Resurgence of human metapneumovirus in the post-COVID-19 era: pathogenesis, epidemiological shifts, clinical impact, and future challenges.

Human metapneumovirus (hMPV), a respiratory pathogen identified in 2001, is a substantial cause of community-acquired respiratory infections across all age groups. This Review explores the impact of hMPV after the COVID-19 pandemic, emphasising its resurgence as a public health concern. Epidemiological shifts, as well as unusual seasonal patterns, increased co-infection rates, and altered age distributions, have been observed globally.

High sensitivity and enhanced antibiotic stewardship of the BioFire Joint Infection Panel in acute, but not chronic, prosthetic joint infection of the knee.

The BioFire Joint Infection (JI) Panel is a multiplex polymerase chain reaction assay developed for rapid pathogen detection in synovial fluid, particularly for suspected prosthetic joint infections (PJI). However, its diagnostic sensitivity varies by clinical context and pathogen, and the impact of prior antibiotic exposure on sample quality and PJI stewardship remains unclear. This prospective study evaluated the diagnostic performance of the Investigational Use Only JI Panel versus conventional synovial fluid culture, using Musculoskeletal Infection Society criteria and symptom onset within 3 weeks to define acute PJI.

Rising threat of metallo-β-lactamase-producing Klebsiella oxytoca complex in Taiwan, 2013-2022.

Objectives: The emergence of metallo-beta-lactamases (MBLs) within the Klebsiella oxytoca complex (CRKO) poses a significant challenge in Taiwan, with so far incomplete characterization of species distribution and carbapenemase variants. This study aimed to elucidate the diversity, variants, and clinical presentations of CRKO isolates collected from 2013 to 2022.

Methods: We analyzed production of carbapenemases by the modified carbapenem inhibitory method (mCIM) and the NG test CARBA-5.

Beyond the blood-brain barrier: feasibility and technical validation of dual-compartment circulating tumor cells detection in high-grade glioma patients.

The elusive nature of brain tumor progression, hidden behind the blood-brain barrier, presents significant challenges for treatment monitoring in high-grade gliomas. In this feasibility study, we evaluate a novel approach to tracking glioblastoma through liquid biopsy, assessing whether tumor cells leave detectable molecular footprints in both blood and cerebrospinal fluid (CSF). Using the MiSelect R II System with specialized microfluidic technology, we analyzed paired blood and CSF samples from six glioblastoma patients, revealing a striking presence of circulating tumor cells (CTCs)- with higher abundance in CSF, where detection rates reached 100% compared to 83.

Geographic variations in distributions of carbapenemase-encoding genes, susceptibilities, and minimum inhibitory concentrations of inpatient meropenem-resistant Enterobacterales to ceftazidime-avibactam, meropenem-vaborbactam, and aztreonam-avibactam across four global regions: 2020-2022 data from the Antimicrobial Testing Leadership and Surveillance.

Purpose: To evaluate the susceptibility profiles of regional inpatient meropenem-resistant (MEM-R) carbapenemase-producing Enterobacterales (CPE) isolates and their MIC values to ceftazidime-avibactam (CZA), meropenem-vaborbactam (MVB), and aztreonam-avibactam (ATM-AVI) METHODS: The 2020-2022 Antimicrobial Testing Leadership and Surveillance database were analyzed. Carbapenemase-encoding genes in CPE isolates were identified using multiplex PCR and Sanger sequencing. Susceptibility breakpoints for CZA and MVB recommended by CLSI 2024 and EUCAST 2025 against Enterobacterales were applied.

Efficacy of monocyte distribution width in predicting critical illness in patients with COVID-19 pneumonia: a retrospective cohort study.

Background: Identifying patients at a risk of severe COVID-19 is crucial for prompt intervention and mortality risk mitigation. The monocyte distribution width (MDW) is an effective accurate predictor of sepsis in emergency settings, facilitating timely patient management. However, few reliable laboratory parameters are available for predicting the severity and prognosis of COVID-19.

High bacterial coinfection rates and associated mortality among hospitalized older adults with laboratory-confirmed respiratory syncytial virus infection.

Background: Emerging evidence highlights that respiratory syncytial virus (RSV) poses a significant risk to older adults. However, detailed clinical data on elderly patients hospitalized with RSV remains limited. This study investigates the clinical characteristics and outcomes of older adults (aged ≥50 years) hospitalized with RSV infection.

Utilizing artificial intelligence and cellular population data for timely identification of bacteremia in hospitalized patients.

Background: Bacteremia is a critical condition with high mortality that requires prompt detection to prevent progression to life-threatening sepsis. Traditional diagnostic approaches, such as blood cultures, are time-consuming. This limitation has encouraged the exploration of rapid prediction methodologies.

Recommendation for the use of respiratory syncytial virus vaccines.

Respiratory syncytial virus (RSV) is the most common pathogen for young children hospitalized with bronchiolitis and pneumonia. Most infections occur below 1 year of age. RSV is also a significant viral pathogen for adults with respiratory tract infection.

Identification of Staphylococcus aureus, Enterococcus faecium, Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii from Raman spectra by Artificial Intelligent Raman Detection and Identification System (AIRDIS) with machine learning.

Background: Rapid and accurate identification of bacteria is required in order to develop effective treatment strategies. Traditional culture-based methods are time-consuming, while MALDI-TOF MS is expensive. The Raman spectroscopy, due to its relatively cost-effectiveness, offers a promising alternative for bacterial identification.

Comparison of the BluePoint MoldID oligonucleotide array and Bruker Biotyper MALDI-TOF MS for the identification of filamentous fungi.

Unlabelled: BluePoint MoldID can identify 43 fungal species through nucleic acid array hybridization and matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) can identify 247 filamentous fungi through mass spectrometry. First, 43 standard isolates from the Bioresource Collection and Research Center, Taiwan, and the College of American Pathologists and 41 clinical species isolates confirmed by rDNA-ITS sequencing were analyzed using BluePoint MoldID and Bruker MALDI-TOF MS. BluePoint MoldID accurately identified 79% (34/43) of the standard isolates to the species level but failed to recognize nine isolates absent from its database; additionally, 87.

Geographic differences in susceptibility profiles of potential non-class B carbapenemase-producing Enterobacterales isolates against ceftazidime-avibactam, meropenem-vaborbactam, colistin, amikacin, gentamicin, and tigecycline: Data from the Antimicrobial Testing Leadership and Surveillance, 2018-2022.

To evaluate the susceptibility profiles of regional meropenem-resistant potential non-class B carbapenemase-producing Enterobacterales (CPE) isolates (without confirmation by phenotypic tests) against important antibiotics, we extracted data from the 2018-2022 Antimicrobial Testing Leadership and Surveillance. This data included susceptibility information of meropenem-resistant potential non-class B CPE isolates against indicated antibiotics - amikacin, gentamicin, ceftazidime-avibactam, colistin, meropenem-vaborbactam, and tigecycline - from sepsis patients hospitalized in intensive care units across six major regions. Carbapenemase-encoding genes of the tested CPE isolates, determined by multiplex PCR and Sanger sequencing, were also analyzed.

High hemolytic activity in Staphylococcus aureus t1081/ST45 due to increased hla protein production and potential RNAIII-independent regulation.

Background: α-Hemolysin, encoded by hla, is a major virulence factor of Staphylococcus aureus. Sequence type (ST) 45 is a globally spread clone with increasing clinical prevalence in Taiwan. Our previous study showed that among the CC45 isolates, the spa type t1081 isolates presented greater hemolytic activity.