Publications by authors named "Huangdu Hu"

Polymyxin B, a last resort for carbapenem-resistant gram-negative bacteria (CRGNB) infections, has infection site-specific pharmacokinetic/pharmacodynamic (PK/PD) properties. However, there is little clinical evidence to support optimal exposures of polymyxin B for different site infections. We performed a prospective, observational, multicenter study to evaluate the clinical outcomes and PK/PD of intravenous polymyxin B treatment for various site CRGNB infections.

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Objective: To investigate clinical characteristics of hematological malignancy (HM) patients with carbapenem-resistant gram-negative organism (CRO) bloodstream infections (BSI) in China, and to elucidate the prognostic risk factors of CRO BSI.

Methods: We conducted a multicenter case-control study of 201 HM patients with CRO BSI between 2018-2020. Antimicrobial susceptibility testing and whole genome sequencing were performed for CRO isolates.

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Article Synopsis
  • - The study investigated carbapenem resistance in the carbapenem-resistant complex (CRECC) over ten years in a Zhejiang hospital, revealing an overall rise from 5.5% to 18.3% resistance rates.
  • - Among the 82 detected CRECC isolates, NDM-1 was the most common carbapenemase, suggesting specific genetic factors contribute to resistance, along with overactive efflux pumps and disrupted outer membrane proteins.
  • - The findings emphasize the urgent need for improved infection control measures in hospitals due to the increasing prevalence of carbapenem-resistant strains.
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  • - The study examined 271 non-duplicate Salmonella enterica strains from a tertiary hospital in Hangzhou, revealing 46 serotypes and 54 sequence types, with S. Enteritidis and S. Typhimurium being the most common among adults and children.
  • - Approximately 12.55% of the strains were identified as multi-drug resistant, with notable resistance to antibiotics like cefepime and ciprofloxacin, especially among pediatric cases where resistance rates for ceftriaxone reached 30.65%.
  • - The research highlighted specific resistance mechanisms, including the presence of extended-spectrum β-lactamase (ESBL) genes, and identified mutations contributing to antibiotic resistance, providing valuable insights for potential infection
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Hypervirulent Klebsiella pneumoniae (hvKP) typically causes severe invasive infections affecting multiple sites in healthy individuals. In the past, hvKP was characterized by a hypermucoviscosity phenotype, susceptibility to antimicrobial agents, and its tendency to cause invasive infections in healthy individuals within the community. However, there has been an alarming increase in reports of multidrug-resistant hvKP, particularly carbapenem-resistant strains, causing nosocomial infections in critically ill or immunocompromised patients.

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Article Synopsis
  • Carbapenem-resistant Klebsiella pneumoniae (CRKP) is a rising concern in healthcare settings, with a notable increase in its prevalence across China.
  • A study analyzed 3,415 K. pneumoniae strains from 28 hospitals, revealing that 20.7% were CRKP, primarily identified as the ST11 clone with KPC-2 as the leading carbapenemase.
  • The findings indicated a geographic variation in clone prevalence and showed that specific types, like KL64, are becoming more dominant, warranting further research into their virulence and resistance mechanisms.
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  • Patients with hematological diseases in China have a notable 10.8% rate of intestinal colonization by carbapenem-resistant Gram-negative bacteria (CR-GNB), highlighting a serious health concern.
  • Key risk factors for this colonization include male gender, acute leukemia, recent stem cell transplants, use of β-lactam antibiotics, and non-perianal infections.
  • The study identified that carbapenem-resistant Enterobacteriaceae (CRE) is the most common type of CR-GNB, with many CRE strains producing metallo-β-lactamases, which complicates treatment options.
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As a widely spread Gram-negative bacteria, Klebsiella pneumoniae (KP) mainly causes acquired infections in hospitals, such as lung infections, urinary tract infections, and bloodstream infections. In recent years, the number of multidrug-resistant KP strains has increased dramatically, posing a great threat to human health. Carbapenem-resistant KP (CRKP) can be colonized in human body, especially in gastrointestinal tract, and some colonized patients can be infected during hospitalization, among which invasive operation, underlying disease, admission to intensive care unit, antibiotic use, severity of the primary disease, advanced age, operation, coma, and renal failure are common risk factors for secondary infection.

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To investigate the epidemiology of ST20 carbapenem-resistant (CRKP) in China, and further explore the genomic characteristics of and coharboring isolates and plasmid contributions to resistance and fitness. Seven ST20 CRKP isolates were collected nationwide, and antimicrobial susceptibility testing was performed. Antimicrobial resistance genes, virulence genes, and plasmid replicons were identified via whole-genome sequencing, and clonality assessed via core-genome multilocus sequence typing.

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Carbapenem-resistant Enterobacterales (CRE), specifically those resistant to only ertapenem among carbapenems (ETP-mono-resistant), are increasingly reported, while the optimal therapy options remain uncertain. To investigate the prevalence and characteristics of ETP-mono-resistant CRE, CRE strains were systematically collected from 102 hospitals across China between 2018 and 2021. A 1:1 randomized matching study was conducted with ETP-mono-resistant strains to meropenem- and/or imipenem-resistant (MEM/IPM-resistant) strains.

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Article Synopsis
  • The study explores the worsening threat of carbapenem-resistant Klebsiella pneumoniae (CRKP) in healthcare, focusing on the evolutionary pathways of pKPC-2-bearing plasmids, which are crucial for antibiotic resistance.
  • Researchers collected 237 CRKP strains and performed advanced sequencing and bioinformatics analyses to categorize the plasmids into three subgroups based on their unique evolutionary events and resistance mechanisms.
  • The findings highlight a high incidence of multicopy antibiotic resistance genes, which significantly affect treatment outcomes, especially in reducing sensitivity to ceftazidime/avibactam, ultimately underscoring the complex dynamics of resistance in hospital settings.
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Colistin resistance in carbapenem-resistant Klebsiella pneumoniae (CRKP) poses health challenges. To investigate the prevalence and molecular characteristics of colistin-resistant CRKP, 708 isolates were collected consecutively from 28 tertiary hospitals in China from 2018 to 2019, and 14 colistin-resistant CRKP were identified. Two-component systems (TCSs) related to colistin resistance (PmrA/B, PhoP/Q, and CrrA/B), the negative regulator mgrB gene and mcr genes, were analysed using genomic sequencing.

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The coinfection process producing multiple species of pathogens provides a specific ecological niche for the exchange of genetic materials between pathogens, in which plasmids play a vital role in horizontal gene transfer, especially for drug resistance, but the underlying transfer pathway remains unclear. Interspecies communication of the plasmids associated with the transfer of third-generation cephalosporins, quinolones, and colistin resistance has been observed in simultaneously isolated Escherichia coli and Klebsiella pneumoniae from abdominal drainage following surgery. The MICs of antimicrobial agents were determined by the broth microdilution method.

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In this study, we aimed to clarify the evolutionary trajectory of a Klebsiella pneumoniae carbapenemase (KPC)-producing Klebsiella pneumoniae (KPC-Kp) population during β-lactam antibiotic therapy. Five KPC-Kp isolates were collected from a single patient. Whole-genome sequencing and a comparative genomics analysis were performed on the isolates and all -containing plasmids to predict the population evolution process.

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Aims: To investigate the in vivo evolution of the mucoid-phenotype of ST11-KL64 carbapenem-resistant Klebsiella pneumoniae (CRKP) isolated from the same patients and gain insights into diverse evolution and biology of these strains.

Methods: Whole genome sequencing and bioinformatic analysis were used to determine the mutation involved in the mucoid phenotype of ST11-KL64 CRKP. Gene knockout, bacterial morphology and capsular polysaccharides (CPS) extraction were used to verify the role of wzc and wcaJ in the mucoid phenotypes.

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Carbapenem-resistant (CRKP) is a common nosocomial pathogen causing severe infectious diseases, and ST307 CRKP is an emerging clone. In this study, we collected five ST307 CRKP isolates, evaluated their antimicrobial susceptibility using microbroth dilution, and their clonality and population structure by PFGE, cgMLST, and SNP-based phylogenetic analysis. Then, the genome characteristics, such as antimicrobial resistance genes and plasmid profiles, were studied by subsequent genomic analysis.

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Here, a program was designed to surveil the colonization and associated infection of OXA-232-producing carbapenem-resistant Klebsiella pneumoniae (CRKP) (OXA-232-CRKP) in an intensive care unit (ICU) and to describe the epidemiological characteristics during surveillance. Samples were sourced from patient and environment colonization sites in the ICU from August to December 2019. During the surveillance, 106 OXA-232-CRKP strains were isolated from 8,656 samples of colonization sites, with an average positive rate of 1.

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Objectives: This study aimed to evaluate the in vitro synergy of polymyxin B (PMB) combined with 11 other antibiotics against PMB-resistant gram-negative bacilli (GNBs).

Methods: Thirty-six clinical isolates of PMB-resistant GNBs were used. The MICs of all the antimicrobials tested were determined by the broth microdilution method and the checkerboard assay method.

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Objectives: To elucidate the predictors of carbapenem-resistant Klebsiella pneumoniae (CRKP) infection and help clinicians better identify CRKP infection at an early stage.

Methods: We conducted a multicentre case-control study of 422 patients with CRKP infection and 948 with carbapenem-susceptible K. pneumoniae (CSKP) infection from March to July 2017.

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Carbapenem-resistant (CRKP) is an urgent public health problem worldwide, and its rapid evolution in the clinical environment has been a major concern. A total of 99 CRKP isolates spreading in the intensive care unit (ICU) setting were included and subjected to whole-genome sequencing, and their sequence types (STs), serotype loci, and virulence determinants were screened based on genome data. The phylogenetic structure was reconstructed based on the core genome multilocus sequence typing method.

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