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Article ; Online: In vitro

Huang, Yu-Shan / Chuang, Yu-Chung / Chen, Pao-Yu / Chou, Pei-Chun / Wang, Jann-Tay

JAC-antimicrobial resistance

2024 Volume 6, Issue 1, Page(s) dlae006

Abstract: Background: This study evaluated the : Methods: Bacteraemic isolates of 126 multidrug-resistant : Results: The MIC: Conclusion: Cefiderocol may serve as an alternative treatment for multidrug- ... ...

Abstract	Background: This study evaluated the Methods: Bacteraemic isolates of 126 multidrug-resistant Results: The MIC Conclusion: Cefiderocol may serve as an alternative treatment for multidrug-resistant
Language	English
Publishing date	2024-02-01
Publishing country	England
Document type	Journal Article
ISSN	2632-1823
ISSN (online)	2632-1823
DOI	10.1093/jacamr/dlae006
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Article ; Online: Concerns About the Association Between Poor Clinical Outcomes and the Minimum Inhibitory Concentrations Determined by Etest.

Cheng, Aristine / Chuang, Yu-Chung

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

2019 Volume 69, Issue 5, Page(s) 902–903

MeSH term(s)	Bacteremia ; Daptomycin ; Disk Diffusion Antimicrobial Tests ; Humans ; Microbial Sensitivity Tests ; Vancomycin
Chemical Substances	Vancomycin (6Q205EH1VU) ; Daptomycin (NWQ5N31VKK)
Language	English
Publishing date	2019-02-04
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	1099781-7
ISSN	1537-6591 ; 1058-4838
ISSN (online)	1537-6591
ISSN	1058-4838
DOI	10.1093/cid/ciz079
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Article ; Online: Evaluation of the synergistic effect of eravacycline and tigecycline against carbapenemase-producing carbapenem-resistant Klebsiella pneumoniae.

Huang, Yu-Shan / Yang, Jia-Ling / Wang, Jann-Tay / Sheng, Wang-Huei / Yang, Chia-Jui / Chuang, Yu-Chung / Chang, Shan-Chwen

Journal of infection and public health

2024 Volume 17, Issue 5, Page(s) 929–937

Abstract: Background: Carbapenem-resistant Klebsiella pneumoniae (CRKP) poses a substantial healthcare challenge. This study assessed the in vitro efficacy of selected antibiotic combinations against CRKP infections.: Methods: Our research involved the ... ...

Abstract	Background: Carbapenem-resistant Klebsiella pneumoniae (CRKP) poses a substantial healthcare challenge. This study assessed the in vitro efficacy of selected antibiotic combinations against CRKP infections. Methods: Our research involved the evaluation of 40 clinical isolates of CRKP, with half expressing Klebsiella pneumoniae carbapenemase (KPC) and half producing Metallo-β-lactamase (MBL), two key enzymes contributing to carbapenem resistance. We determined the minimum inhibitory concentrations (MICs) of four antibiotics: eravacycline, tigecycline, polymyxin-B, and ceftazidime/avibactam. Synergistic interactions between these antibiotic combinations were examined using checkerboard and time-kill analyses. Results: We noted significant differences in the MICs of ceftazidime/avibactam between KPC and MBL isolates. Checkerboard analysis revealed appreciable synergy between combinations of tigecycline (35%) or eravacycline (40%) with polymyxin-B. The synergy rates for the combination of tigecycline or eravacycline with polymyxin-B were similar among the KPC and MBL isolates. These combinations maintained a synergy rate of 70.6% even against polymyxin-B resistant isolates. In contrast, combinations of tigecycline (5%) or eravacycline (10%) with ceftazidime/avibactam showed significantly lower synergy than combinations with polymyxin-B (P < 0.001 and P = 0.002, respectively). Among the MBL CRKP isolates, only one exhibited synergy with eravacycline or tigecycline and ceftazidime/avibactam combinations, and no synergistic activity was identified in the time-kill analysis for these combinations. The combination of eravacycline and polymyxin-B demonstrated the most promising synergy in the time-kill analysis. Conclusion: This study provides substantial evidence of a significant synergy when combining tigecycline or eravacycline with polymyxin-B against CRKP strains, including those producing MBL. These results highlight potential therapeutic strategies against CRKP infections.
MeSH term(s)	Humans ; Ceftazidime/therapeutic use ; Tigecycline/pharmacology ; Carbapenems/pharmacology ; Carbapenems/therapeutic use ; Klebsiella pneumoniae ; Klebsiella Infections/drug therapy ; Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; beta-Lactamases/pharmacology ; Carbapenem-Resistant Enterobacteriaceae ; Polymyxins/pharmacology ; Polymyxins/therapeutic use ; Microbial Sensitivity Tests ; Bacterial Proteins ; Tetracyclines ; Azabicyclo Compounds
Chemical Substances	Ceftazidime (9M416Z9QNR) ; Tigecycline (70JE2N95KR) ; carbapenemase (EC 3.5.2.6) ; avibactam (7352665165) ; Carbapenems ; eravacycline (07896928ZC) ; Anti-Bacterial Agents ; beta-Lactamases (EC 3.5.2.6) ; Polymyxins ; Bacterial Proteins ; Tetracyclines ; Azabicyclo Compounds
Language	English
Publishing date	2024-03-27
Publishing country	England
Document type	Journal Article
ZDB-ID	2467587-8
ISSN	1876-035X ; 1876-0341
ISSN (online)	1876-035X
ISSN	1876-0341
DOI	10.1016/j.jiph.2024.03.027
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Article ; Online: Clinical characteristics and outcomes of non-cystic fibrosis patients with Burkholderia cepacia complex bacteremia at a medical center in Taiwan.

Chang, Tien-Hao / Chuang, Yu-Chung / Wang, Jann-Tay / Sheng, Wang-Huei

Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi

2021

Abstract: Background: Burkholderia cepacia complex (BCC) represents a group of multidrug-resistant gram-negative bacteria that cause infections among immunocompromised hosts. Bacteremia occurs in patients who are chronically ill and is associated with substantial ...

Abstract	Background: Burkholderia cepacia complex (BCC) represents a group of multidrug-resistant gram-negative bacteria that cause infections among immunocompromised hosts. Bacteremia occurs in patients who are chronically ill and is associated with substantial morbidity and mortality. The aim of this study was to investigate the clinical characteristics and outcomes of BCC bacteremic patients without cystic fibrosis. Methods: We conducted a retrospective study at the National Taiwan University Hospital. Adults with BCC bacteremia from January 2015 to May 2019 were enrolled. The primary outcome was 14-day mortality. Multivariable logistic regression was performed for outcome analysis. Results: One-hundred and ninety-five patients were analyzed and their mean age was 67 years. Over 95% of the BCC isolates were susceptible to trimethoprim/sulfomethoxazole (TMP/SXT). Levofloxacin resistance rates were high, with only 25.1% of isolates being susceptible. Pairwise comparisons were made between different definitive regimens including meropenem-monotherapy, ceftazidime-monotherapy, levofloxacin-monotherapy, TMP/SXT-monotherapy, tigecycline-monotherapy as well as combination versus monotherapy. No regimen was significantly associated with survival in our study. Multivariable logistic regression showed that the Pitt bacteremia score (adjust odds ratio [aOR],1.46; 95% confidence interval [CI],1.19-1.79; p < 0.001), underlying metastatic cancer (aOR, 2.73; 95% CI, 1.01-7.39; p = 0.047), inappropriate definitive treatment independently predicted greater 14-day mortality (aOR, 8.21; 95% CI, 2.49-27.08; p < 0.001). Conclusions: No single regimen is associated with improved mortality. After adjusting for other potential confounders, our data suggest selection of an appropriate antibiotic provide better clinical outcomes among patients with BCC bacteremia.
Language	English
Publishing date	2021-10-08
Publishing country	England
Document type	Journal Article
ZDB-ID	1497590-7
ISSN	1995-9133 ; 1684-1182 ; 0253-2662
ISSN (online)	1995-9133
ISSN	1684-1182 ; 0253-2662
DOI	10.1016/j.jmii.2021.09.009
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Article ; Online: In vitro susceptibility of common Enterobacterales to eravacycline in Taiwan.

Huang, Chun-Fu / Wang, Jann-Tay / Chuang, Yu-Chung / Sheng, Wang-Huei / Chen, Yee-Chun

Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi

2022 Volume 56, Issue 2, Page(s) 358–366

Abstract: Background: New tetracycline derivatives exhibit broad-spectrum antimicrobial activities. This study aimed to assess the in vitro activity of eravacycline against common Enterobacterales.: Methods: Clinical Enterobacterales isolates were collected ... ...

Abstract	Background: New tetracycline derivatives exhibit broad-spectrum antimicrobial activities. This study aimed to assess the in vitro activity of eravacycline against common Enterobacterales. Methods: Clinical Enterobacterales isolates were collected between 2017 and 2021. The minimum inhibitory concentration (MIC) was determined using a broth microdilution test. Results: We identified Klebsiella pneumoniae (n = 300), Escherichia coli (n = 300), Klebsiella oxytoca (n = 100), Enterobacter cloacae complex (n = 100), Citrobacter freundii (n = 100), and Proteus mirabilis (n = 100). All P. mirabilis strains were resistant to eravacycline. Excluding P. mirabilis, the susceptibility rates to eravacycline, omadacycline, and tigecycline were 75.2%, 66.9%, and 73%, respectively. The MIC Conclusion: This study provides the MIC and susceptibility rate of eravacycline for common Enterobacterales. Eravacycline could be a therapeutic choice for cefotaxime non-susceptible or meropenem non-susceptible Enterobacterales, especially K. oxytoca, C. freundii, and E. coli.
MeSH term(s)	Humans ; Meropenem ; Tigecycline/pharmacology ; Escherichia coli ; Taiwan ; Anti-Bacterial Agents/pharmacology ; Klebsiella pneumoniae ; Klebsiella oxytoca ; Cefotaxime ; Microbial Sensitivity Tests
Chemical Substances	omadacycline (090IP5RV8F) ; Meropenem (FV9J3JU8B1) ; Tigecycline (70JE2N95KR) ; eravacycline (07896928ZC) ; Anti-Bacterial Agents ; Cefotaxime (N2GI8B1GK7)
Language	English
Publishing date	2022-10-02
Publishing country	England
Document type	Journal Article
ZDB-ID	1497590-7
ISSN	1995-9133 ; 1684-1182 ; 0253-2662
ISSN (online)	1995-9133
ISSN	1684-1182 ; 0253-2662
DOI	10.1016/j.jmii.2022.09.009
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Article: The Combination of Daptomycin with Fosfomycin is More Effective than Daptomycin Alone in Reducing Mortality of Vancomycin-Resistant Enterococcal Bloodstream Infections: A Retrospective, Comparative Cohort Study.

Tseng, Tai-Chung / Chuang, Yu-Chung / Yang, Jia-Ling / Lin, Chi-Ying / Huang, Sung-Hsi / Wang, Jann-Tay / Chen, Yee-Chun / Chang, Shan-Chwen

Infectious diseases and therapy

2023 Volume 12, Issue 2, Page(s) 589–606

Abstract: Introduction: High-dose daptomycin-based combinations are recommended for vancomycin-resistant Enterococcus (VRE) bloodstream infection (BSI). Preclinical data have shown a synergistic effect of daptomycin/fosfomycin combinations against VRE. However, ... ...

Abstract	Introduction: High-dose daptomycin-based combinations are recommended for vancomycin-resistant Enterococcus (VRE) bloodstream infection (BSI). Preclinical data have shown a synergistic effect of daptomycin/fosfomycin combinations against VRE. However, clinical studies comparing daptomycin monotherapy with daptomycin/fosfomycin combinations are unavailable. Methods: An observational study of VRE-BSI was performed between 2010-2021 on patients receiving daptomycin monotherapy (≥ 8 mg/kg) or daptomycin combined with intravenous fosfomycin. Patients treated with concomitant β-lactam combinations were excluded. The primary outcome was in-hospital mortality. Outcomes were analyzed using multivariable logistic regression and augmented inverse probability weighting (AIPW) analyses. Results: Among 224 patients, 176 received daptomycin monotherapy, and 48 received fosfomycin combinations. The median daptomycin and fosfomycin doses were 9.8 mg/kg and 12 g/day, respectively. In-hospital mortality was 77.3% and 47.9% in the daptomycin monotherapy and fosfomycin combination groups (P < 0.001), respectively. Multivariable logistic regression analysis predicted lower mortality with fosfomycin combination treatment (adjusted odds ratio, 0.35; 95% confidence interval (CI), 0.17-0.73; P = 0.005). AIPW demonstrated a 17.8% reduced mortality with fosfomycin combinations (95% CI, - 30.6- - 4.9%; P = 0.007). The survival benefit was significant, especially among patients with a lower Pitt bacteremia score or fosfomycin minimum inhibitory concentration (MIC) ≤ 64 mg/l. Fosfomycin combination resulted in higher hypernatremia (10.4% vs. 2.8%, P = 0.04) and hypokalemia (33.3% vs. 15.3%, P = 0.009) compared to daptomycin monotherapy. Conclusion: The combination of high-dose daptomycin with fosfomycin improved the survival rate of patients with VRE-BSI compared to daptomycin alone. The benefit of the combination was most pronounced for VRE with fosfomycin MIC ≤ 64 mg/l and for patients with a low Pitt bacteremia score.
Language	English
Publishing date	2023-01-11
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2701611-0
ISSN	2193-6382 ; 2193-8229
ISSN (online)	2193-6382
ISSN	2193-8229
DOI	10.1007/s40121-022-00754-1
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Article ; Online: Anti-interferon-γ autoantibody-associated disseminated Mycobacterium abscessus infection mimicking parotid cancer with multiple metastases: A case report.

Chang, Po-Hsiung / Chuang, Yu-Chung

Medicine

2017 Volume 96, Issue 39, Page(s) e8118

Abstract: Rationale: Among the nontuberculous mycobacteria, Mycobacterium abscessus is a common cause of skin, soft tissue, and bone infections. However, disseminated M. abscessus infection that mimics cancer metastasis with an underlying relatively ... ...

Abstract	Rationale: Among the nontuberculous mycobacteria, Mycobacterium abscessus is a common cause of skin, soft tissue, and bone infections. However, disseminated M. abscessus infection that mimics cancer metastasis with an underlying relatively immunocompetent condition has rarely been reported. Patient concerns: A nonsmoking 73-year-old man with an underlying relatively immunocompetent condition reported a 2-month history of a mass in the region of his right parotid gland that had been steadily increasing in size. Diagnoses: The head and neck computed tomography showed an avidly enhancing tumor with central necrosis in the right parotid region and lymphadenopathy bilaterally at neck levels II-V (<6 cm) with a necrotic core. The radiologist and otolaryngologist both suspected a diagnosis of right parotid gland cancer with metastasis. Interventions: The necrotic tissue was removed surgically, and Mycobacterium culture showed M. abscessus. We collected a blood sample and detected anti-interferon-γ autoantibody. Outcomes: After 6 months of anti-M. abscessus treatment, physical examination showed remission of the parotid tumor, and axillary and supraclavicular lymphadenopathy. Lessons: We report a case of disseminated M. abscessus infection, which involved parotid glands with multiple lymphadenopathies in a person with an underlying relatively immunocompetent condition. Possible underlying mechanisms such as anti-interferon-γ autoantibody-associated immunodeficiency should be considered in a patient with disseminated M. abscessus infection without a known immunocompromised condition.
MeSH term(s)	Aged ; Autoantibodies/blood ; Diagnosis, Differential ; Humans ; Interferon-gamma/immunology ; Lymphadenopathy/diagnosis ; Lymphadenopathy/immunology ; Lymphadenopathy/microbiology ; Male ; Mycobacterium Infections, Nontuberculous/diagnosis ; Mycobacterium Infections, Nontuberculous/immunology ; Mycobacterium Infections, Nontuberculous/microbiology ; Nontuberculous Mycobacteria ; Parotid Diseases/diagnosis ; Parotid Diseases/immunology ; Parotid Diseases/microbiology ; Parotid Neoplasms/diagnosis
Chemical Substances	Autoantibodies ; Interferon-gamma (82115-62-6)
Language	English
Publishing date	2017-03-27
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	80184-7
ISSN	1536-5964 ; 0025-7974
ISSN (online)	1536-5964
ISSN	0025-7974
DOI	10.1097/MD.0000000000008118
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Article ; Online: Risk factors for mortality after linezolid treatment of vancomycin-resistant Enterococcus bloodstream infection.

Huang, Szu-Ting / Yang, Jia-Ling / Lin, Chi-Ying / Huang, Sung-Hsi / Wang, Jann-Tay / Chuang, Yu-Chung / Chen, Yee-Chun / Chang, Shan-Chwen

International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases

2023 Volume 129, Page(s) 96–102

Abstract: Objectives: We analyzed the risk factors affecting linezolid treatment outcome in vancomycin-resistant Enterococcus (VRE) bloodstream infection (BSI).: Methods: We conducted a multicenter observational study of patients who received linezolid 600 mg ... ...

Abstract	Objectives: We analyzed the risk factors affecting linezolid treatment outcome in vancomycin-resistant Enterococcus (VRE) bloodstream infection (BSI). Methods: We conducted a multicenter observational study of patients who received linezolid 600 mg every 12 hours for VRE BSI. The primary outcome was 28-day mortality. The estimated area under the concentration-time curve and trough concentration were calculated. Multivariable logistic regression was used for the outcome analysis. Results: A total of 170 patients were included: 114 (67.1%) survived and 56 (32.9%) did not. A total of 26 (18.2%) isolates showed a linezolid minimum inhibitory concentration (MIC) of ≤1 mg/l, 113 (79.0%) of 2 mg/l, and 4 (2.8%) of 4 mg/l. The univariable analysis showed that the linezolid MIC and concentration-time curve/MIC were not associated with mortality (P = 0.95 and P = 0.42, respectively). After adjusting for underlying comorbidity and disease severity, the linezolid dose per body weight (LDBW), body height, and interaction between them were independent risks for mortality. Marginal analysis showed that increasing the LDBW was protective in patients with a body height <160 cm. A trough concentration of >12.2 mg/l was a risk factor for thrombocytopenia. Conclusion: The LDBW and body height were interactively associated with clinical outcomes of linezolid treatment for VRE BSI.
MeSH term(s)	Humans ; Linezolid/therapeutic use ; Anti-Bacterial Agents/adverse effects ; Vancomycin/therapeutic use ; Daptomycin/therapeutic use ; Bacteremia/drug therapy ; Vancomycin-Resistant Enterococci ; Gram-Positive Bacterial Infections/drug therapy ; Risk Factors ; Microbial Sensitivity Tests
Chemical Substances	Linezolid (ISQ9I6J12J) ; Anti-Bacterial Agents ; Vancomycin (6Q205EH1VU) ; Daptomycin (NWQ5N31VKK)
Language	English
Publishing date	2023-01-31
Publishing country	Canada
Document type	Multicenter Study ; Observational Study ; Journal Article
ZDB-ID	1331197-9
ISSN	1878-3511 ; 1201-9712
ISSN (online)	1878-3511
ISSN	1201-9712
DOI	10.1016/j.ijid.2023.01.035
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Article: Healthcare-associated carbapenem-resistant Klebsiella pneumoniae bloodstream infections: Risk factors, mortality, and antimicrobial susceptibility, 2017-2019.

Hsu, Jen-Yu / Chuang, Yu-Chung / Wang, Jann-Tay / Chen, Yee-Chun / Hsieh, Szu-Min

Journal of the Formosan Medical Association = Taiwan yi zhi

2021 Volume 120, Issue 11, Page(s) 1994–2002

Abstract: Background: In Taiwan, carbapenem-resistant Klebsiella pneumoniae (CRKP) now became a leading cause of difficult-to-treat healthcare-associated infection, for which there are a lack of recent hospital epidemiological studies on risk factors, mortality, ... ...

Abstract	Background: In Taiwan, carbapenem-resistant Klebsiella pneumoniae (CRKP) now became a leading cause of difficult-to-treat healthcare-associated infection, for which there are a lack of recent hospital epidemiological studies on risk factors, mortality, and antimicrobial susceptibility. Methods: We prospectively enrolled patients with healthcare-associated CRKP monomicrobial bloodstream infection (mBSI) and matched patients with carbapenem susceptible K. pneumoniae (CSKP) mBSI at National Taiwan University Hospital (Taipei, Taiwan) from October 2017 through December 2019 in a 1:2 ratio. Multivariable logistic regression and Kaplan-Meier analyses were applied to identify factors associated with CRKP mBSI and to compare the 14-day survival curves, respectively. We detected the presence of bla Results: A total of 36 CRKP cases and 72 CSKP controls were enrolled. Patients with CRKP mBSI were more likely to have liver cirrhosis (adjusted odds ratio [aOR], 5.61; P = 0.024), length of hospital stay over the previous 14 days (aOR, 1.23; P = 0.001) and prior use of carbapenems in the previous 14 days (aOR, 6.07; P = 0.004) than patients with CSKP mBSI. The 14-day survival was significantly worse for patients with CRKP mBSI than those with CSKP mBSI (all CRKP cases: 50.0% vs. 87.5%; P < 0.001; CRKP cases treated with colistin as an appropriate backbone antibiotic: 58.3% vs. 87.5%; P = 0.007). Compared with the CSKP isolates, CRKP isolates were significantly less susceptible to colistin, amikacin, and tigecycline. Of the 36 CRKP isolates, none harbor bla Conclusion: Prior exposure to carbapenems, longer hospital stay, and the presence of liver cirrhosis predicted CRKP instead of CSKP mBSI. Even with colistin therapy, CRKP mBSIs was still associated with a very high risk of mortality within 14 days. Ceftazidime/avibactam is a potentially useful therapeutic choice for cases caused by in vitro susceptible CRKP strains.
MeSH term(s)	Anti-Bacterial Agents/therapeutic use ; Carbapenems/therapeutic use ; Case-Control Studies ; Delivery of Health Care ; Humans ; Klebsiella Infections/drug therapy ; Klebsiella Infections/epidemiology ; Klebsiella pneumoniae/genetics ; Risk Factors ; Sepsis
Chemical Substances	Anti-Bacterial Agents ; Carbapenems
Language	English
Publishing date	2021-05-05
Publishing country	Singapore
Document type	Journal Article
ZDB-ID	2096659-3
ISSN	1876-0821 ; 0929-6646
ISSN (online)	1876-0821
ISSN	0929-6646
DOI	10.1016/j.jfma.2021.04.014
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Article: Minocycline Susceptibility and

Yang, Jia-Ling / Yang, Chia-Jui / Chuang, Yu-Chung / Sheng, Wang-Huei / Chen, Yee-Chun / Chang, Shan-Chwen

Infection and drug resistance

2022 Volume 15, Page(s) 2401–2408

Abstract: Purpose: In this study, we evaluated the minocycline susceptibility rate in carbapenem-resistant : Patients and methods: A total of 100 genetically unrelated CRAB clinical strains from bloodstream infection were randomly collected from a medical ... ...

Abstract	Purpose: In this study, we evaluated the minocycline susceptibility rate in carbapenem-resistant Patients and methods: A total of 100 genetically unrelated CRAB clinical strains from bloodstream infection were randomly collected from a medical center in Taiwan. An argument for a new minocycline susceptibility breakpoint of 1 mg/L was suggested based on pharmacokinetic (PK) and pharmacodynamic (PD) studies. Strains with minocycline minimum inhibitory concentrations (MICs) of >1 mg/L were classified as PK-PD non-susceptible. Results: Fifty-five (55%) CRAB strains were susceptible to minocycline according to the Clinical and Laboratory Standards Institute (CLSI) criteria, among which 98.2% (54/55) were PK-PD non-susceptible. The minocycline MIC Conclusion: At our institute, most CRAB strains were PK-PD non-susceptible and most carried
Language	English
Publishing date	2022-05-02
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2494856-1
ISSN	1178-6973
ISSN	1178-6973
DOI	10.2147/IDR.S357344
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