Metallo-β-lactamase (MBL)-producing Enterobacter cloacae complex (ECC) is an emerging threat associated with limited treatment options and increased mortality. This study aimed to describe the clinical and molecular characteristics, risk factors, and outcomes of MBL-producing ECC infections in Taiwan. We conducted a retrospective cohort study at a tertiary hospital in central Taiwan from July 2022 to December 2023. Hospitalised patients with ECC infections were included. MBL production was determined using multiplex PCR for bla_IMP-1, bla_IMP-2, bla_VIM, and bla_NDM genes. We compared clinical characteristics, antibiotic susceptibility profiles, and outcomes between MBL-producing and non-MBL-producing ECC infections. Among 239 patients with ECC infections, 9.2% (22/239) were MBL-producing. bla_NDM was the predominant MBL gene (72.7%, 16/22). MBL-producing ECC showed significantly lower antibiotic susceptibility compared to non-MBL-producing ECC, except for amikacin and tigecycline. Patients with MBL-producing ECC infections had higher rates of ICU admission (50.0% vs. 11.1%, p < 0.001), prolonged hospitalisation exceeding four weeks (54.5% vs. 29.5%, p = 0.030), and 30-day all-cause mortality (22.7% vs. 5.1%, adjusted HR: 2.95, 95% CI: 1.02-8.52, p = 0.035). MBL production was an independent risk factor for mortality in bloodstream infections. MBL-producing ECC infections are associated with high antibiotic resistance, increased healthcare resource utilisation, and significantly higher mortality, particularly in bloodstream infections. The predominance of bla_NDM among MBL genes aligns with recent regional trends. These findings underscore the urgent need for enhanced surveillance, rapid diagnostics, and targeted management strategies to address this emerging threat.

Purpose: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes post-acute sequelae of coronavirus disease 2019 (COVID-19), including pulmonary vasculopathy, increasing thrombotic risk. Screening and treating survivors are essential to reduce associated disabilities. We aim to investigate the clinical characteristics of patients with post-COVID-19 condition and pulmonary embolism, as well as their health-related quality of life one year after COVID-19 diagnosis. Patients and Methods: In our study, we analyzed nine cases of post-COVID-19 condition and pulmonary embolism in a tertiary hospital in Taiwan. Patient characteristics, including age, sex, symptoms, and outcomes, were recorded. One year post-diagnosis, patients underwent follow-up with lab tests, chest X-rays, electrocardiograms, and health-related quality of life (HRQOL) assessments using the EuroQoL 5-Dimension 5-Level (EQ-5D-5L) tool. Results: Post-COVID-19 condition with pulmonary embolism predominantly affects females. Common symptoms include breathlessness and chest pain, and a lung perfusion scan may be useful for diagnosis. The one-year follow-up of five patients mainly showed normal lab results and no active lung lesions. The mean EQ-5D score was 0.928 ± 0.119, and the EQ visual analogue scale (EQ-VAS) was 85.00 ± 11.18. Pain/discomfort was the most reported issue. Conclusion: This research reveals that post-COVID-19 condition with pulmonary embolism affects a significant number of women and those with preexisting conditions like cancer or diabetes. Symptoms overlap also complicates diagnosis. Although many lab results were normal, the elevated risk of pulmonary embolism persists. Lower utility scores and increased anxiety highlight the need for targeted interventions and mental health support. Our study underscores the importance of monitoring pulmonary embolism in patients after COVID-19 infection, given the significant impact on post-COVID-19 condition and overall health outcomes.

Seasonal influenza remains a major threat to healthcare facilities, where introduction of the virus can cause disproportionate morbidity and mortality among high-risk inpatients. This narrative review synthesizes current evidence and practice-oriented guidance on the prevention of hospital-acquired influenza. We conducted a targeted literature search using PubMed, guideline repositories for English-language publications from 2000 to 2025, prioritizing systematic reviews, clinical trials, and authoritative guidelines. A multifaceted strategy is emphasized: annual vaccination of healthcare personnel and eligible patients; consistent implementation of standard and transmission-based precautions; attention to environmental cleaning and disinfection; and occupational-health policies that limit presenteeism and workplace exposure. Evidence demonstrates that higher healthcare personnel (HCP) vaccination coverage is associated with lower patient influenza rates and improved survival. Reliable hand hygiene, respiratory source control, early initiation of droplet precautions, and cohorting when single rooms are limited all contribute to interrupting in-facility transmission. Ensuring that ill HCP can remain off duty without penalty further reduces the likelihood of staff-to-patient spread. Collectively, these coordinated measures provide a protective framework and underscore the central role of clinicians and infection-prevention teams in sustaining influenza control within acute-care settings.

Background: Outpatient Parenteral Antimicrobial Therapy (OPAT) has long been established as a safe and cost-effective alternative to inpatient care in Western healthcare systems. In contrast, its implementation across Asia has historically been fragmented and unstructured. A landmark multinational survey in 2017 identified OPAT in Asia as a “missed opportunity,” citing the lack of systematic oversight, standardized protocols, and outcome monitoring systems. Methods: This narrative review examines the evolution of OPAT in Asia over the past decade, synthesizing evidence from regional studies, national policies, and implementation models. Results: The findings demonstrate a clear shift from ad hoc infusion practices toward structured, multidisciplinary OPAT programs in several healthcare systems. These systems increasingly integrate antimicrobial stewardship principles, dedicated care teams, and reimbursement mechanisms. In parallel, innovative models, including hospital-at-home services and elastomeric pump–based continuous infusion, have expanded treatment feasibility while enabling the use of narrower-spectrum antibiotics. Despite these advances, substantial heterogeneity persists. Key barriers include the absence of unified national guidelines, limited monitoring infrastructure, workforce constraints, and regulatory restrictions in certain settings. Resource-limited regions continue to face challenges related to financing, laboratory capacity, and digital health integration. Conclusions: Overall, OPAT in Asia is transitioning from an underrecognized and inconsistently delivered service to an increasingly structured component of infectious disease care. Future priorities include standardized governance, integration with antimicrobial stewardship programs, sustainable reimbursement, digital outcome monitoring, and region-specific evidence on antimicrobial stability and safety.

Background: Respiratory syncytial virus (RSV) is a significant cause of lower respiratory tract infections in adults, particularly the elderly, and can lead to severe outcomes, including respiratory failure. Current treatment options for RSV in immunocompetent adults are limited to supportive care. Objective: This case series aims to describe the clinical course and outcomes of two immunocompetent adults with severe RSV infection treated with Palivizumab, a monoclonal antibody against RSV. Methods: We report two cases: a 92-year-old female with a history of hypertension and a previous meningioma resection, and a 42-year-old female with no significant past medical history. Both presented with severe respiratory symptoms, were diagnosed with RSV infection via PCR, and received a single dose of intramuscular Palivizumab (approximately 12– 13 mg/kg) after initial clinical deterioration despite supportive care and empiric antibiotic therapy. Results: Following Palivizumab administration, both patients exhibited clinical improvement, including resolution of fever and improvement in oxygenation and radiographic findings. Both patients were discharged in stable condition without the need for supplemental oxygen. Conclusion: These cases suggest that Palivizumab may be a potential therapeutic option for severe RSV infection in immunocompetent adults. Further research, including randomized controlled trials, is needed to confirm these preliminary findings and establish optimal dosing and treatment protocols.

Catheter-related bloodstream infections (CRBSIs) caused by Leclercia adecarboxylata are uncommon, and polymicrobial cases are even rarer. We report the first documented case caused by co-infection with Leclercia adecarboxylata and Enterobacter cloacae complex (ECC) in a woman with breast cancer undergoing chemotherapy through an indwelling chemoport. Antimicrobial susceptibility testing revealed that both isolates were susceptible to β-lactams, quinolones, and aminoglycosides. The patient achieved complete clinical recovery following intravenous ciprofloxacin therapy and prompt removal of the chemoport. This case highlights the emerging clinical relevance of Leclercia adecarboxylata and Enterobacter cloacae complex as potential pathogens capable of causing polymicrobial bloodstream infections in immunocompromised hosts and underscores the importance of considering rare environmental Gram-negative organisms as potential causes of catheter-related infections, particularly in patients with malignancy or long-term vascular access.