Infectious Disease Frontier

With the escalating issue of antimicrobial resistance globally, newly emerged resistant strains pose a serious threat to public health. At the 34th European Congress of Clinical Microbiology and Infectious Diseases (ESCMID Global 2024), a study by Professor Ning Shen 's team from Peking University Third Hospital (Abstract No.: E0451) focused on the resistance issues of cefiderocol, a drug not yet marketed in China. The study discovered that cefiderocol can induce resistance in vitro and amplify the blaSHV-12 gene. Long-read sequencing technology demonstrated its potential in the rapid and accurate detection of resistance gene amplification, offering a new tool for future resistance research.

Non-tuberculous mycobacteria (NTM) refers to all mycobacteria other than Mycobacterium tuberculosis and Mycobacterium leprae. NTM most commonly affect the lungs, causing NTM pulmonary disease (NTM-PD), which can even lead to disseminated disease in immunocompromised individuals. In recent years, with changes in the environment, updates in detection technology, and increased awareness among physicians, the incidence of NTM-PD has been steadily increasing, with Mycobacterium avium complex (MAC) pulmonary disease being the most common worldwide. At the recent Fourth National Conference of the Chinese Medical Association on Bacterial and Fungal Infections (BISC 2024), Professor Hongfei Duan from the Department of Tuberculosis, Beijing Chest Hospital, Capital Medical University, delivered a fascinating presentation titled "Advances in Diagnosis and Treatment of Mycobacterium avium Complex Pulmonary Disease," elucidating and analyzing the current status, challenges, and progress in the diagnosis and treatment of MAC pulmonary disease.

Patients with hematological disorders are often immunocompromised due to their primary disease or treatment, making them susceptible to infections. These infections often present atypically and can be caused by a wide variety of pathogens. Traditional diagnostic methods have low positivity rates and are time-consuming. Pathogen diagnosis is crucial for optimizing anti-infection treatment and improving patient outcomes. Metagenomic Next-Generation Sequencing (mNGS) is a high-throughput, broad-coverage diagnostic technique that has been widely applied in clinical infection settings. In diagnosing infections in hematological patients, mNGS offers high positivity rates, minimal interference from antimicrobial drugs, and broad pathogen coverage. To standardize the application of mNGS in hematological patients and optimize report interpretation, the Infectious Diseases Group of the Chinese Society of Hematology has invited experts in the field to develop a consensus.

Neonatal sepsis refers to the systemic inflammatory response syndrome caused by various pathogens in newborns, ranking as the third leading cause of neonatal mortality globally. Meropenem is one of the most widely used broad-spectrum antibiotics in the treatment of neonatal sepsis. However, its irrational use has led to an increasingly serious problem of bacterial multidrug resistance. The Clinical Practice Guidelines for the Use of Meropenem in Treating Neonatal Sepsis (2024 Edition) provide 12 recommendations addressing 9 clinical issues, covering the timing of meropenem use, recommended dosage, prolonged infusion, monitoring and assessment, antibiotic adjustment strategies, treatment duration, and therapeutic strategies for carbapenem-resistant Enterobacteriaceae infections. These guidelines aim to provide evidence-based recommendations for the rational use of meropenem in neonatal sepsis patients. Professor Xiaomei Tong from the Department of Pediatrics at Peking University Third Hospital presented a detailed interpretation of the guidelines at the recent Fourth National Congress of the Chinese Medical Association for Bacterial and Fungal Infections (BISC 2024).

Urinary tract infections (UTIs) are commonly encountered in clinical practice, yet their treatment is not as straightforward as many assume. Professor Wenjie Yang  from the Department of Infectious Diseases at Tianjin City First Central Hospital begins with epidemiology, etiology, and resistance trends of UTIs, and emphasizes the principles and precautions of treating UTIs with oral antimicrobial agents. This discussion is highly beneficial for guiding clinical practice, and we share the insights below.

In recent years, the detection rate of carbapenem-resistant Gram-negative bacteria (CRO) in China has remained high, posing serious challenges to clinical treatments and patient outcomes. The limited therapeutic options have left many clinical needs unmet. At the recent Fourth National Conference on Bacterial and Fungal Infections organized by the Chinese Medical Association (BISC 2024), Professor Yunsong Yu from Zhejiang Provincial People's Hospital delivered a presentation titled "The Current Epidemic Situation and Challenges of Carbapenem-Resistant Organisms (CRO) Infections in China." Professor Yu detailed the prevalence and treatment status of CRO in China and explored the clinical challenges and strategies in depth.

Solid Organ Transplantation (SOT) is a crucial procedure for saving the lives of patients with end-stage organ failure. In recent years, the field of SOT has flourished in China, with significant improvements in the number of transplants and treatment outcomes. However, infections remain a critical factor affecting the survival and quality of life of SOT recipients. Among these, the incidence and mortality rates of invasive fungal diseases (IFD) are particularly high, especially among lung transplant recipients. At the recent 4th National Conference on Bacterial and Fungal Infections organized by the Chinese Medical Association (BISC 2024), the journal "Infection Medicine Today" had the opportunity to interview Professor Chunrong Ju from The First Affiliated Hospital of Guangzhou Medical University. Professor Ju shared her expert insights on the prevalence, current treatment landscape, and diagnostic challenges of IFD in SOT recipients, as well as discussed strategies for improving treatment outcomes through precision medicine.

As the incidence of syphilis continues to rise, clinicians are faced with an increasing number of patients with complex clinical presentations, posing significant challenges in patient management. At the 31st Conference on Retroviruses and Opportunistic Infections (CROI), Dr. Khalil Ghanem from the Johns Hopkins University School of Medicine delivered a keynote on the diagnosis and treatment of syphilis. In this issue of Infectious Disease Frontier, we are fortunate to have Dr. Ghanem discuss the diagnostic challenges of neurosyphilis, the value of the DoxyPEP prevention strategy, and the future outlook for syphilis management.