Clinical Microbiology and Infection最新文献

{"title":"Revisiting diagnostics: Immune markers to diagnose invasive pulmonary aspergillosis.","authors":"Simon Feys, Emmanuel Dudoignon, Louise Chantelot, Agostinho Carvalho, Joost Wauters, Vishukumar Aimanianda, Sarah Dellière","doi":"10.1016/j.cmi.2024.11.017","DOIUrl":"https://doi.org/10.1016/j.cmi.2024.11.017","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142646933","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":"Case-fatality rate of invasive pneumococcal disease caused by various serotypes - an analysis of nationwide surveillance data from Israel, 2009-2018.","authors":"Anat Wieder-Finesod, Dafna Yahav, Carmit Rubin, Shirley Hashkor, Jo Southern, Gabriel Mircus, Christian Theilacker, Ron Dagan, Gili Regev-Yochay","doi":"10.1016/j.cmi.2024.11.018","DOIUrl":"https://doi.org/10.1016/j.cmi.2024.11.018","url":null,"abstract":"<p><strong>Objectives: </strong>The 20-valent pneumococcal conjugate vaccine (PCV20) has been introduced in Israel. Its public health benefit depends on its effect on mortality caused by PCV20 serotypes not present in PCV13 (PCV20non13). We aimed to describe invasive pneumococcal disease (IPD) characteristics and case fatality rate among adults by serotypes.</p><p><strong>Methods: </strong>We analysed data from the Israeli nationwide surveillance database of IPD in adults, 2009-2018. The primary outcome was in-hospital case fatality rate (CFR) within 30 days, focusing on specific serotypes. Adjusted odds ratios (aORs) for association between PCV20non13 serotypes and mortality were calculated using logistic regression.</p><p><strong>Results: </strong>Overall, 3864 IPD episodes were reported, 3733 (96.6%) with known serotype, 54% (1705/3123) were in men; 54% (1997/3733) were aged ≥65 years. PCV13-IPD cases constituted 40% of all IPD and decreased during study years. PCV20non13 and nonPCV20 serotypes constituted 26% and 34% of cases, respectively, and increased over time. The most frequent non-PCV13 serotypes detected were PCV20non13 serotypes 8 (8%), 12F (7.2%), 22F (3%); and nonPCV20 serotype 16F (5%). In-hospital CFR was 22% (698/3140). CFR for PCV13 serotype was 21.1% (265/1255); for PCV20non13 - 16.2% (124/766); and for nonPCV20 CFR - 28.5% (289/1014). Among PCV20non13 serotypes compared to PCV13 serotypes, 11A was associated with higher CFR (41%, aOR 3.1, 95% CI 1.64-5.83), while serotype 8 was associated with lower CFR (8%, aOR 0.5, 95% CI 0.3-0.8).</p><p><strong>Conclusions: </strong>PCV20non13 serotypes constituted 26% of all adult IPD in the post-PCV13 era. CFR from PCV20non13 serotype IPD was comparable to that from PCV13 serotypes. These data support the potential added benefit of PCV20 in reducing mortality from IPD, though mortality remains substantial from nonPCV20 serotypes. Future IPD-related mortality will depend on the evolution of serotype distribution over time.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142646929","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":"Global vaccination against hepatitis E virus: position paper from the ESGVH-ESCMID.","authors":"Susanne Dudman, Arjana Zerja, İmran Hasanoğlu, Simona Ruta, Berend van Welzen, Laura Ambra Nicolini, Paul Yonga, Joakim Øverbø, Sumit Rawat, Selma Habibovic, Tan Bou Kim, Antonio Rivero-Juarez","doi":"10.1016/j.cmi.2024.11.016","DOIUrl":"https://doi.org/10.1016/j.cmi.2024.11.016","url":null,"abstract":"<p><strong>Scope: </strong>Hepatitis E Virus (HEV) is a significant global health issue, impacting both low- and middle-income countries (LMICs) and industrialized nations. HEV genotypes 1 and 2, primarily transmitted through contaminated water, are endemic in LMICs, while genotypes 3 and 4 are zoonotically transmitted in industrialized regions. Acute HEV infection poses severe risks, particularly to pregnant women and immunocompromised individuals, while chronic HEV infection leads to serious complications in those with pre-existing liver disease and transplant recipients. The development of an HEV vaccine offers new prevention opportunities, though its availability and integration into global immunization programs remain limited.</p><p><strong>Methods: </strong>This position paper was developed by the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Viral Hepatitis Study Group (ESGVH) through an extensive review of clinical data, safety profiles, efficacy, and immunogenicity of HEV vaccines. The study group focused particularly on high-risk and special populations, synthesizing global health insights and incorporating recommendations from the Strategic Advisory Group of Experts (SAGE) to formulate strategies for wider HEV vaccination use.</p><p><strong>Questions addressed in the position paper: </strong>The position paper evaluates the efficacy and safety of HEV vaccines in both general and special populations. It identifies key barriers to the integration of HEV vaccines into routine immunization programs, including infrastructure limitations, costs, and vaccine accessibility. The paper also proposes strategies to overcome these challenges and improve vaccine distribution. Furthermore, it addresses ways to enhance public awareness and international cooperation to promote HEV vaccination efforts globally.</p><p><strong>Implications: </strong>ESGVH-ESCMID recommends HEV vaccination for high-risk groups, including women of childbearing age, patients with chronic liver diseases, and immunosuppressed individuals. Prioritizing investments in vaccine logistics, integrating diagnostics, and educational outreach can enhance uptake.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643892","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":"Revisiting diagnostics: Microbial cell free DNA-sequencing: addressing unmet challenges in implant-related cardiovascular Infections.","authors":"Flaminia Olearo, Martin Christner, Marc Lütgehetmann, Martin Aepfelbacher, Nicole Fischer, Holger Rohde","doi":"10.1016/j.cmi.2024.11.019","DOIUrl":"https://doi.org/10.1016/j.cmi.2024.11.019","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643893","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":"Whatever Happened to Ticarcillin-clavulanate? We need to Resurrect it in the Era of Multidrug-resistant Gram-negative Bacteria.","authors":"Maroun M Sfeir","doi":"10.1016/j.cmi.2024.11.020","DOIUrl":"https://doi.org/10.1016/j.cmi.2024.11.020","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643894","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":"Patient scoring of outcomes for clinical trials that compare treatment options for bloodstream infections: a survey among adult inpatients.","authors":"Judith Olchowski, Hagar Dallasheh, Maria Postnikov, Yosuf Laham, Hanan Egbaria, Mical Paul","doi":"10.1016/j.cmi.2024.11.014","DOIUrl":"https://doi.org/10.1016/j.cmi.2024.11.014","url":null,"abstract":"<p><strong>Objectives: </strong>Patients' perspectives on outcomes of clinical trials is critical to the design of meaningful trials. As they are the primary recipients of treatment, it is important to focus on outcomes that are of value to the patients. We planned a study involving patients in defining and prioritizing endpoints for intervention trials for bloodstream infections (BSI).</p><p><strong>Methods: </strong>A survey was conducted at Rambam Health Care Campus, targeting hospitalized patients over 18 years old. Participants were asked to score the importance of various outcomes on a scale of 1 to 10, 10 being most important. We calculated the mean and median and dispersion measures per outcome.</p><p><strong>Results: </strong>732 randomly selected patients were approached; 378 were not available due to technical reasons. Of the remaining 354 approached to take the survey, 300 consented and participated in the study. The median age was 51.9 years, with 55.3% female. Death was scored as the most important outcome, while the length of hospital stay was the least important.</p><p><strong>Conclusions: </strong>Eliciting patient views on outcome importance was challenging but revealed key insights. Patients prioritized death, functional decline, and the development of secondary infections. Non-clinical outcomes, such as microbiological failure, were less clearly understood. Future studies should focus on clinical outcomes and include larger, more diverse patient populations to enhance the relevance of BSI trials.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616079","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":"The multifaceted nature of lack of access to antibiotics: types of shortage and specific causes, consequences, and solutions.","authors":"Enrico Baraldi, Christine Årdal, Emil Aho, Gabriel-Adrian Popescu, Tsegaye Melaku","doi":"10.1016/j.cmi.2024.11.012","DOIUrl":"https://doi.org/10.1016/j.cmi.2024.11.012","url":null,"abstract":"<p><strong>Background: </strong>Maintaining access to a broad range of old and new antibiotics is increasingly difficult due to supply, market and demand issues. Next to immediate negative consequences for individual patients and healthcare systems, antibiotic unavailability can accelerate resistance development due to unmotivated use of suboptimal broad-spectrum antibiotics.</p><p><strong>Objectives: </strong>While academics and policymakers agree that lack of access to antibiotics is a major public challenge, there are widely different situations of lack of access which are not always clearly identified. Therefore, this paper aims to clarify potential confusion by delving into four different types of lack of access, their specific causes, consequences and potential solutions.</p><p><strong>Sources: </strong>The paper builds on a narrative review of academic and policy literature about lack of access to antibiotics and potential solutions to address it.</p><p><strong>Content: </strong>We discuss causes as well as economic and clinical consequences of four different types of antibiotic unavailability: short-term shortages, long-term shortages, deregistrations and lack of registration. The discussion is supported by examples from Norway, Romania and Ethiopia, three countries characterized by clearly different market sizes and ability to pay. Common causes for all types of lack access include unattractive markets, dependence on few suppliers and insufficient communication, whereas other causes are specific to one type (e.g., insufficient inventories cause short-term shortages or regulatory complexity hinders registration). Longer lack of access entails more serious clinical consequences and higher risk of resistance development, but may not correspondingly increase costs in the long-term if alternatives are identified.</p><p><strong>Implications: </strong>It is essential to understand the type of unavailability at hand because no single solution can address all types. For instance, stockpiling addresses short-term shortages, but not long-term ones or deregistrations. However, supply chain transparency and pooled procurement are remedies that support other solutions and can cope with several types of lack of access.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616086","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":"'Heightened incidence of adverse events associated with a live attenuated varicella vaccine strain that lacks critical genetic polymorphisms in ORF62' - Author's reply.","authors":"Daechan Park, Hyun Mi Kang","doi":"10.1016/j.cmi.2024.11.013","DOIUrl":"https://doi.org/10.1016/j.cmi.2024.11.013","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616070","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":"Diagnostic Test Accuracy of the Fungitell Serum (1→3)-β-D-Glucan Assay for the Diagnosis of Pneumocystis jirovecii Pneumonia: A Systematic Review and Meta-Analysis.","authors":"Connor Prosty, Owen Dan Luo, Roy Khalaf, Olivier Del Corpo, Emily G McDonald, Todd C Lee","doi":"10.1016/j.cmi.2024.11.004","DOIUrl":"https://doi.org/10.1016/j.cmi.2024.11.004","url":null,"abstract":"<p><strong>Background: </strong>The diagnosis of Pneumocystis jirovecii pneumonia (PCP) can be challenging because of diagnostic tests that are imperfect and/or invasive. The Fungitell serum (1→3)-β-D-glucan (BDG) assay is a non-invasive blood test studied for PCP; however, the manufacturer-recommended cut-off of 80pg/mL is not well validated for this disease.</p><p><strong>Objectives: </strong>We conducted a systematic review and meta-analysis to determine the diagnostic test accuracy of the Fungitell BDG assay for the diagnosis of PCP.</p><p><strong>Methods: </strong>Data Sources A search strategy of MEDLINE and Embase from a previous meta-analysis on BDG was updated to January 31, 2024. Test Fungitell BDG assay. Reference Standard One or more of: lung biopsy, bronchoalveolar lavage, induced sputum, or nasopharyngeal swab specimens tested for PCP by histopathology, microscopy using immunofluorescence or staining, or polymerase chain reaction. Assessment of Risk of Bias The QUADAS-2 tool. Methods of Data Synthesis Diagnostic test accuracy data of the Fungitell serum BDG assay across all reported cut-offs were pooled by meta-analysis. We then evaluated a categorical approach using <80pg/mL as a rule-out threshold and ≥400pg/mL as a rule-in threshold.</p><p><strong>Results: </strong>26 articles were included comprising 5111 patients and 1150 PCP cases. At the conventional cut-off of 80pg/mL, the overall pooled sensitivity and specificity were 83.5% (95% Confidence Interval [95%CI]=72.8-90.6) and 75.5% (95%CI=66.0-83.0), respectively. At a pre-test probability of <20% and a BDG <80pg/mL, the post-test probability would be <5% (negative predictive value >95%). At 400pg/mL, sensitivity was reduced to 63.5% (95%CI=45.8-78.1) with specificity increased to 93.6% (95%CI=88.6-96.5). At a pre-test probability of 47.5%, a BDG >400pg/mL would have a post-test probability of >90%.</p><p><strong>Discussion: </strong>A categorical approach using <80pg/mL to rule-out and >400pg/mL to rule-in PCP may allow for a more nuanced interpretation based on pre-test probability. More accurate estimates of pre-test probability and further external validation is required.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616026","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":"Impact of Pseudomonas aeruginosa carriage on ICU-acquired pneumonia: a European multicentre prospective cohort study.","authors":"Claudia Recanatini, Cornelis H van Werkhoven, Thomas E van der Schalk, Fleur Paling, Derek Hazard, Leen Timbermont, Gabriel Torrens, Antonio DiGiandomenico, Mark T Esser, Martin Wolkewitz, Frangiscos Sifakis, Herman Goossens, Marc Bonten, Antonio Oliver, Surbhi Malhotra-Kumar, Jan Kluytmans","doi":"10.1016/j.cmi.2024.11.007","DOIUrl":"https://doi.org/10.1016/j.cmi.2024.11.007","url":null,"abstract":"<p><strong>Objectives: </strong>Pseudomonas aeruginosa (PA) is a common causative pathogen of pneumonia acquired in the ICU. The aim of this study was to determine the incidence of PA ICU pneumonia (PAIP) and to quantify its independent association with PA colonisation at different body sites.</p><p><strong>Methods: </strong>Adult patients on mechanical ventilation at ICU admission were prospectively enrolled across 30 European ICUs. PA colonisation in the perianal area and in the lower respiratory tract were assessed within 72 hours after ICU admission and twice weekly until ICU discharge. PAIP development was evaluated daily. Competing risk models with colonisation as a time-varying exposure and ICU death and discharge as competing events were fitted and adjusted for confounders to investigate the association between PA carriage and PAIP.</p><p><strong>Results: </strong>1971 subjects were enrolled. The colonisation prevalence with P. aeruginosa in the first 72 hours of ICU admission was 10.4% (179 perianal, 51 respiratory), while the acquisition incidence during the ICU stay was 7.0% (158 perianal, 47 respiratory). Of the 43 (1.8%) patients who developed PAIP, 11 (25.6%) were PA colonised on admission and 9 (20.9%) acquired colonisation prior to PAIP onset. Both perianal (adjusted sub distribution hazard ratio [aSHR] 4.4, 95%CI 1.7-11.6) and respiratory colonisation (aSHR 4.6, 95%CI 1.9-11.1) were independently associated with PAIP development.</p><p><strong>Conclusions: </strong>PAIP incidence was higher in PA colonised vs non-colonised patients. Both colonisation of the rectum and of the respiratory tract were associated with development of PAIP. The increased risk of P. aeruginosa colonisation for subsequent infection provides an opportunity for targeted preventive interventions.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616073","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}