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CMS was preheated at 37\u201360\u00a0\u00b0C for 5\u2009~\u200930\u00a0min. The antibacterial effects of preheated CMS were evaluated against five MDR\/XDR strains: carbapenem-resistant\n                    <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                    (CRPA),\n                    <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                    (CRKP),\n                    <jats:italic>Escherichia coli<\/jats:italic>\n                    (CREC),\n                    <jats:italic>Acinetobacter baumannii<\/jats:italic>\n                    (CRAB), and methicillin-resistant\n                    <jats:italic>Staphylococcus aureus<\/jats:italic>\n                    (MRSA). Bacterial counts were assessed after 3\u00a0h of SCS, and the average inhibition rate (AIR) was calculated. The safety experiment was performed to evaluate the nephrotoxicity of preheated CMS under hypothermic condition. Preheating CMS at 60\u00a0\u00b0C for 15\u2009~\u200930\u00a0min significantly reduced bacterial loads of CRPA, CRKP, CREC, and CRAB, with average inhibition rates (AIR) up to 100%, 96.91%, 98.36%, and 85.06%, respectively. At 37\u00a0\u00b0C, extended heating (30\u00a0min) was required for partial efficacy against CRKP and CRAB, while CREC remained largely unaffected. MRSA showed no susceptibility to preheated CMS. Preheated CMS did not cause significant morphological alterations or reduction in HK-2 cell viability within 3\u2009~\u20096\u00a0h of SCS. Thermal pretreatment of CMS at 60\u00a0\u00b0C represents a novel, practical, and safe strategy for PF decontamination, providing rapid bactericidal activity against frequently encountered MDR\/XDR Gram-negative bacilli during the SCS process.\n                  <\/jats:p>","DOI":"10.1038\/s41598-026-38748-5","type":"journal-article","created":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T16:16:58Z","timestamp":1770308218000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Preheating colistimethate sodium enhances its efficacy against multi\/extensively drug-resistant Gram-negative bacilli in preservation fluid"],"prefix":"10.1038","volume":"16","author":[{"given":"Daqian","family":"Tang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lijie","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yazhe","family":"Duan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanhua","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuhong","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pei","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuxiang","family":"Wan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kang","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenyu","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junhao","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Zeng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingxing","family":"Sui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,5]]},"reference":[{"key":"38748_CR1","doi-asserted-by":"publisher","first-page":"856","DOI":"10.1111\/ajt.14208","volume":"17","author":"JA Fishman","year":"2017","unstructured":"Fishman, J. 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