Clinical Microbiology and Infection最新文献

{"title":"Real-world effectiveness of nirmatrelvir-ritonavir and molnupiravir in non-hospitalised adults with Covid-19: a population-based, retrospective cohort study cohort study.","authors":"Anselm Jorda, Dominik Ensle, Hubert Eser, Florentin Glötzl, Benjamin Riedl, Marton Szell, Arschang Valipour, Alexander Zoufaly, Christoph Wenisch, Doris Haider, Heinz Burgmann, Florian Thalhammer, Florian Götzinger, Bernd Jilma, Robin Ristl, Ursula Karnthaler, Markus Zeitlinger","doi":"10.1016/j.cmi.2024.10.026","DOIUrl":"https://doi.org/10.1016/j.cmi.2024.10.026","url":null,"abstract":"<p><strong>Objectives: </strong>The real-world effectiveness of the oral antivirals nirmatrelvir-ritonavir and molnupiravir against the SARS-CoV-2 Omicron variant remains uncertain. We aimed to estimate their effectiveness in non-hospitalised adults with Covid-19.</p><p><strong>Methods: </strong>This retrospective cohort study used data from the Municipal Department for Public Health Services of Vienna, Austria, to identify non-hospitalised adults with confirmed SARS-CoV-2 infection between Jan-2022-May-2023. Nirmatrelvir-ritonavir users were compared with untreated controls and molnupiravir users with untreated controls by calculating adjusted risk differences (aRDs) using a covariate-adjusted logistic regression model with inverse probability weighting. Outcomes were hospitalisation and all-cause death within 28 days.</p><p><strong>Results: </strong>We identified 113,399 eligible cases (90,481 untreated controls, 12,166 nirmatrelvir-ritonavir users, and 10,752 molnupiravir users). Over 96% of the patients were immunised by previous infection or vaccination. In the nirmatrelvir-ritonavir analysis, the estimated risk of hospitalisation was 0.57% (95%CI, 0.35-0.78) in nirmatrelvir-ritonavir users and 1.09% (95%CI, 0.86-1.32) in untreated controls (aRD -0.53%; 95%CI, -0.77--0.28). The estimated risk of death was 0.0% (95%CI, 0.0-0.0) in nirmatrelvir-ritonavir users and 0.13% (95%CI, 0.08-0.18) in untreated controls (aRD -0.13%, 95%CI, -0.18--0.08). The number needed to treat to prevent hospitalisation and death was 190 (95%CI, 130-356) and 792 (95%CI, 571-1289), respectively. These statistically significant aRDs were restricted to the subgroup of patients ≥60 years. In the molnupiravir analysis, the estimated risk of hospitalisation was 1.36% (95%CI, 0.95-1.77) in molnupiravir users and 1.16% (95%CI, 0.93-1.39) in untreated controls (aRD 0.2%; 95%CI, -0.08-0.49). The estimated risk of death was 0.12% (95%CI, 0.01-0.23) in molnupiravir users and 0.14% (95%CI, 0.06-0.21) in untreated controls (aRD, -0.01%; 95%CI, -0.08--0.06).</p><p><strong>Conclusions: </strong>Among outpatients aged ≥60 years with Covid-19 in an Omicron-dominated era, treatment with nirmatrelvir-ritonavir was associated with a lower risk of hospitalisation and all-cause death within 28 days, albeit with wide confidence intervals and high numbers needed to treat. This finding was not observed in molnupiravir users and younger nirmatrelvir-ritonavir users.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":null,"pages":null},"PeriodicalIF":10.9,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A phase 3 randomized trial of sulopenem vs. ertapenem in patients with complicated intraabdominal infections.","authors":"Michael W Dunne, Steven I Aronin, Anita F Das, Karthik Akinapelli, Jeanne Breen, Michael T Zelasky, Sailaja Puttagunta","doi":"10.1016/j.cmi.2024.10.025","DOIUrl":"https://doi.org/10.1016/j.cmi.2024.10.025","url":null,"abstract":"<p><strong>Objective: </strong>To demonstrate the noninferiority of intravenous (IV) sulopenem to IV ertapenem, each followed by an oral regimen, in adults with complicated intraabdominal infections (cIAI).</p><p><strong>Methods: </strong>Hospitalized adults with cIAI were randomized to 5 days of IV sulopenem followed by oral sulopenem etzadroxil/probenecid twice daily or 5 days of IV ertapenem followed by oral ciprofloxacin/metronidazole or amoxicillin-clavulanate depending on baseline pathogen susceptibility. The target treatment duration was 7-10 days. The primary (FDA-specified) endpoint was clinical response at Day 28 [Test-of-Cure (TOC)] in the micro-Modified Intent to Treat (micro-MITT) population.</p><p><strong>Results: </strong>674 patients were randomized. The two treatment arms were well-balanced. E. coli (395 patients) and B. fragilis (111 patients) were the most frequently isolated pathogens. Clinical success rates in the micro-MITT population were 81.9% (204/249) for sulopenem-treated patients and 87.9% (233/265) for ertapenem-treated patients. The lower bound of the confidence interval (CI) for the treatment difference of the primary endpoint was below the prespecified non-inferiority margin of -10.0 [treatment difference -6.0%, 95% CI [-12.2, 0.2]. In all other analysis populations, the lower limit of the 95% CI was above -10.0. Treatment emergent adverse events (all, 26.0% [87/335] vs 23.4% [78/333]; related, 6.0% [20/335] vs 5.1% [17/333]) were similar for sulopenem and ertapenem, respectively. Most events were mild to moderate in severity. There were more serious adverse events in the sulopenem arm (7.5% [25/335] vs 3.6% [12/333]), only two of which were considered possibly drug-related.</p><p><strong>Conclusions: </strong>Sulopenem IV followed by oral sulopenem etzadroxil/probenecid was not noninferior to ertapenem followed by oral step-down in treating cIAI in the micro-MITT population. This finding should be interpreted in the context of country regulations, as endpoint timing, primary analysis population and noninferiority margin may vary regionally. Both IV and oral sulopenem were well-tolerated; the oral formulation allowed patients with resistant pathogens to step down from IV therapy.</p><p><strong>Clinical trial registration: </strong>NCT03358576.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":null,"pages":null},"PeriodicalIF":10.9,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: 'Heightened incidence of adverse events associated with a live attenuated varicella vaccine strain that lacks critical genetic polymorphisms in ORF62' by Kang et al.","authors":"Young Woo Han, Seung Hye Hong, Seung Gu Kang, Seong-Beom Park, Hye Young Kim","doi":"10.1016/j.cmi.2024.10.024","DOIUrl":"https://doi.org/10.1016/j.cmi.2024.10.024","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":null,"pages":null},"PeriodicalIF":10.9,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'Measurement of circulating viral antigens post-SARS-CoV-2 infection in a multicohort study' - Author's reply.","authors":"Zoe Swank, Elizabeth W Karlson, David R Walt","doi":"10.1016/j.cmi.2024.10.028","DOIUrl":"https://doi.org/10.1016/j.cmi.2024.10.028","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":null,"pages":null},"PeriodicalIF":10.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology of human metapneumovirus among children with severe or very severe pneumonia in high pneumonia burden settings: the PERCH study experience.","authors":"Ryo Miyakawa, Haijun Zhang, W Abdullah Brooks, Christine Prosperi, Henry C Baggett, Daniel R Feikin, Laura L Hammitt, Stephen R C Howie, Karen L Kotloff, Orin S Levine, Shabir A Madhi, David R Murdoch, Katherine L O'Brien, J Anthony G Scott, Donald M Thea, Martin Antonio, Juliet O Awori, Charatdao Bunthi, Amanda J Driscoll, Bernard Ebruke, Nicholas S Fancourt, Melissa M Higdon, Ruth A Karron, David P Moore, Susan C Morpeth, Justin M Mulindwa, Daniel E Park, Mohammed Ziaur Rahman, Mustafizur Rahman, Rasheed A Salaudeen, Pongpun Sawatwong, Phil Seidenberg, Samba O Sow, Milagritos D Tapia, Maria Deloria Knoll","doi":"10.1016/j.cmi.2024.10.023","DOIUrl":"https://doi.org/10.1016/j.cmi.2024.10.023","url":null,"abstract":"<p><strong>Objectives: </strong>After respiratory syncytial virus (RSV), human metapneumovirus (hMPV) was the second-ranked pathogen attributed to severe pneumonia in the PERCH study. We sought to characterize hMPV-positive cases in high burden settings, which have limited data, by comparing to RSV-positive and other cases.</p><p><strong>Methods: </strong>Children aged 1-59 months hospitalized with suspected severe pneumonia and age/season-matched community controls in seven African and Asian countries had nasopharyngeal/oropharyngeal swabs tested by multiplex PCR for 32 respiratory pathogens, among other clinical and lab assessments at admission. Odds ratios adjusted for age and site (aOR) were calculated using logistic regression. Etiologic probability was estimated using Bayesian nested partial latent class analysis. Latent class analysis identified syndromic constellations of clinical characteristics.</p><p><strong>Results: </strong>HMPV was detected more frequently among cases (267/3887, 6.9%) than controls (115/4976, 2.3%), among cases with pneumonia chest X-ray findings (8.5%) than without (5.5%), and among controls with respiratory tract illness (3.8%) than without (1.8%; all p≤0.001). HMPV-positive cases were negatively associated with the detection of other viruses (aOR=0.18), especially RSV (aOR=0.11; all p<0.0001), and positively associated with the detection of bacteria (aORs 1.77, p=0.03). No single clinical syndrome distinguished hMPV-positive from other cases. Among hMPV-positive cases, 65.2% were aged <1 year and 27.5% had pneumonia danger signs; positive predictive value was 74.5%; mortality was 3.9%, similar to RSV-positive (2.4%) and lower than other cases (9.6%).</p><p><strong>Conclusions: </strong>HMPV-associated severe pediatric pneumonia in high burden settings was predominantly in young infants and clinically indistinguishable from RSV. HMPV-positives had low case fatality, similar to that in RSV-positives.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":null,"pages":null},"PeriodicalIF":10.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Questioning the existence of Baggio-Yoshinari syndrome in Brazil.","authors":"Rodrigo Nunes Rodrigues-da-Silva, Laura Sant'anna Ataides, Rodrigo Nogueira Angerami, Marcos Vinícius da Silva, Elba Regina Sampaio de Lemos","doi":"10.1016/j.cmi.2024.10.027","DOIUrl":"https://doi.org/10.1016/j.cmi.2024.10.027","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":null,"pages":null},"PeriodicalIF":10.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interventions targeting the nasal microbiome to eradicate MRSA.","authors":"Mary T Bessesen","doi":"10.1016/j.cmi.2024.10.022","DOIUrl":"https://doi.org/10.1016/j.cmi.2024.10.022","url":null,"abstract":"<p><strong>Background: </strong>Staphylococcus aureus is an important pathogen in many sites, including bloodstream, skin and soft tissue, bone and joints. When infection is caused by methicillin resistant S. aureus (MRSA) therapy is more difficult and outcomes are less favorable. Nasal colonization is associated with increased risk for MRSA infections. The nasal microbiome may play a role in risk for nasal colonization and infection.</p><p><strong>Objectives: </strong>To review the role of the microbiome in MRSA nasal colonization and infection.</p><p><strong>Sources: </strong>Peer reviewed literature identified in a Medline search using MRSA, S. aureus, prebiotic and microbiota as search terms.</p><p><strong>Content: </strong>Reduction of S. aureus nasal colonization has been shown to reduce risk of S. aureus infections, but decolonization methods are imperfect. The role of the nasal microbiome in host defense against S. aureus colonization and infection is explored. Numerous organisms have been shown to be negatively associated with S. aureus colonization. Antimicrobial molecules produced by these organisms are an active area of research.</p><p><strong>Implications: </strong>Future research should focus on development of safe and effective molecules that can inhibit S. aureus in the nasal vestibule. Damage to the diverse nasal microbiota by unnecessary antibiotics should be avoided.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":null,"pages":null},"PeriodicalIF":10.9,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infectious Diseases Ethics: A Worldwide Survey.","authors":"Elda Righi, Massimo Mirandola, Alessandra Agnese Grossi, Murat Akova, Evelina Tacconelli, Anna Fratucello, Asma Nasim, Aleksandra Barac, Dafna Yahav","doi":"10.1016/j.cmi.2024.10.021","DOIUrl":"https://doi.org/10.1016/j.cmi.2024.10.021","url":null,"abstract":"<p><strong>Objectives: </strong>COVID-19 unravelled new ethical issues in the neglected field of infectious diseases ethics (IDE). We investigated IDE involvement among ID professionals.</p><p><strong>Methods: </strong>A global survey was disseminated during 2021-2022. Responses were stratified by demographics, WHO region, income, and ethics training. A confirmatory factor analysis (CFA) was used to identify two themes representing IDE relevant areas (Theme 1, including stigma, inequity, vulnerability, public health, and global impact) and emerging topics (Theme 2, including inequity and research integrity in COVID-19, increased ethics interest, and gaps in IDE). Quantile and logistic regression analyses investigated determinants of ethics themes and responders' ethics attitude.</p><p><strong>Results: </strong>We included 477 participants from 71 countries. Most were females (282/460, 61%) and clinicians (327/457, 72%). Participants advocated further personal (289/443, 65%) or societies' (374/450, 83%) involvement in bioethics. Only 5% (22/477) of respondents claimed to have received enough bioethics training and 28% (114/412) were dissatisfied with it. Dedicated courses or expert case discussion were the preferred ways for receiving education in bioethics. Theme 1 and 2 median values were above 7 (on a 1-10 scale), showing high interest in IDE. CFA showed optimal and acceptable fit, respectively. Being from the region of Americas was associated with Theme 1, while having received bioethics training was associated with both themes. Females, respondents trained in bioethics, and those from the Americas and Europe regions reported lower involvement in bioethics activities, while those aged between 44-54 years and trained in bioethics were more involved. Age above 55 years and non-clinical role were negatively associated with aspiration for further bioethics involvement.</p><p><strong>Conclusions: </strong>We identified IDE themes that can inform on gaps in bioethics. Ethics training was associated with interest in IDE and bioethics activities and should be offered to integrate this discipline into daily clinical practice across age, gender, and different areas worldwide.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":null,"pages":null},"PeriodicalIF":10.9,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of ZX-7101A, an inhibitor of influenza cap-dependent endonuclease, in adults with uncomplicated influenza: a randomised, double-blind, placebo-controlled phase 2/3 Trial.","authors":"Hongyu Wang, Gang Wang, Yan Gao, Lihong Qu, Hong Wang, Min Deng, Hainv Gao, Yilin Li, Nan Yang, Baogui Wang, Rongge Liu, Xuzhu Ma, Zhen Tao, Guoqiang Zhang, Qian Wang, Weifeng Zhao, Yunsong Yu, Lin Chen, Lianchun Liang, Shengyu Wang, Lei Shao, Tao Yang, JingLei Cao, Yuan Cao, Xiaoli Qin, Jingwen Ai, Huadong Zhu, Wenhong Zhang","doi":"10.1016/j.cmi.2024.10.020","DOIUrl":"https://doi.org/10.1016/j.cmi.2024.10.020","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the efficacy and safety of ZX-7101A: an inhibitor of influenza viral cap-dependent endonuclease, in adults with uncomplicated influenza and explore treatment-emergent resistance.</p><p><strong>Methods: </strong>We conducted a randomized, double-blind, placebo-controlled, adaptive-design phase 2 and phase 3 studies (ZX-7101A-202) in adults with uncomplicated influenza. Eligible patients were randomised 1:1:1 to receive a single dose of 40 or 80mg ZX-7101A or placebo, stratified by body weight and baseline composite symptom score. The primary efficacy endpoint was time to alleviation of influenza symptoms (TTAS) in intention-to-treat infected (ITTI) population.</p><p><strong>Results: </strong>The phase 2 trial suggested a significantly shorter in TTAS for ZX-7101A compared to placebo: the median TTAS of 40 or 80mg ZX-7101A was 34.7 hours (95% confidence interval [CI], 22.8-43.4; p=0.005) and 45.8 hours (95%CI, 32.0-66.3; p=0.020), compared with 63.6 hours (95%CI, 43.9-93.4) in the placebo group. In the phase 3 trial, the TTAS of both ZX-7101A dose groups was significantly shortened relative to the placebo: the median TTAS was shortened to 48.4 hours (95%CI, 40.5-55.6) for 40mg and 39.4 hours (95%CI, 35.8-49.3) for 80mg, compared with 62.9 hours (95%CI, 56.4-69.3) for placebo (p=0.003 and p<0.001, respectively). In the safety population, ZX-7101A treatment was associated with fewer adverse events (AEs), with 41.8% (100/239) in the 40mg group, 44.2% (106/240) in the 80mg group, and 53.8% (129/240) in the placebo group. The majority of AEs were mild or moderate. Emergence of resistance to ZX-7101A through I38T amino acid substitution was detected in 5/122 (4.1%) patients.</p><p><strong>Conclusions: </strong>ZX-7101A was an effective treatment for influenza with a single dose of either 40mg or 80mg, with more rapid alleviation of influenza symptoms versus placebo. No safety concerns were identified with single-dose treatment of ZX-7101A.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":null,"pages":null},"PeriodicalIF":10.9,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Agreement between Mycobacterium tuberculosis antigen-based skin test and interferon-gamma release assay in elderly individuals aged ≥ 65 years in China.","authors":"Yijun He, Lingyu Shen, Jiang Du, Xuefang Cao, Bin Zhang, Dakuan Wang, Boxuan Feng, Zihan Li, Yuanzhi Di, Juanjuan Huang, Tonglei Guo, Jianguo Liang, Jiaoxia Yan, Zisen Liu, Qi Jin, Weitao Duan, Henan Xin, Lei Gao","doi":"10.1016/j.cmi.2024.10.016","DOIUrl":"https://doi.org/10.1016/j.cmi.2024.10.016","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the agreement of Mycobacterium tuberculosis (MTB) antigen-based skin test (TBST) with interferon-gamma release assay (IGRA) in elderly individuals aged ≥ 65 years beyond instruction for use in China.</p><p><strong>Methods: </strong>Based on the baseline survey of randomized controlled trial with objective to explore suitable regimen for tuberculosis (TB) preventive treatment, MTB infection was tested using TBST and IGRA in parallel in rural residents aged 50-70 years by means of a cross-sectional study design.</p><p><strong>Results: </strong>A total of 21219 participants with both TBST and IGRA results were included in this analysis. The concordance between TBST and IGRA was 89.4% (95%CI: 89.0 - 89.8%) with a kappa coefficient of 0.61 (95%CI: 0.60 - 0.62). In those aged ≥ 65 years, the concordance was 86.5% (95%CI: 85.6 - 87.4%) with a kappa coefficient of 0.55 (95%CI: 0.52 - 0.58). 21.2% (35/165) of the participants with indeterminate IGRA results were TBST positive, and 9 of them aged ≥ 65 years.</p><p><strong>Conclusions: </strong>The consistent agreement between TBST and IGRA in individuals aged ≥ 65 years suggests that TBST has potential to be used in the elderly with age beyond instruction for use in China. The respective diagnostic performance of each test will be analyzed when the longitudinal data on incident TB be obtained in the future.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":null,"pages":null},"PeriodicalIF":10.9,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}