Clinical Microbiology and Infection最新文献

{"title":"Corrigendum to \"Transforming ESCMID in a time of climate change: a call for sustainable conferencing\" [Clin Microbiol Infect 30 (2024) 1347-1350].","authors":"Teun Bousema, Suzanne A V van Asten, Jordache Ramjith, Michael E J Buhl, Bieke Tack, Kate E Whitfield, Alexander W Friedrich, Anu Kantele","doi":"10.1016/j.cmi.2025.02.023","DOIUrl":"https://doi.org/10.1016/j.cmi.2025.02.023","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482379","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":"Taking the patient pulse: Gauging outcomes important to patients for bloodstream infection trials.","authors":"Sarah B Doernberg, Heather A King","doi":"10.1016/j.cmi.2025.02.019","DOIUrl":"https://doi.org/10.1016/j.cmi.2025.02.019","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476340","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":"Mortality due to carbapenem-resistant Acinetobacter baumannii bacteraemia: a five-year cohort study in intensive care patients.","authors":"Stamatis Karakonstantis, Evangelos I Kritsotakis, Renatos-Nikolaos Tziolos, Loukia Vassilopoulou, Maria Loukaki, Despoina Kypraiou, Emmanouil C Petrakis, Alberto Tovil, Sophia Kokkini, Kyriaki Tryfinopoulou, Petros Ioannou, Εumorfia Kondili, Diamantis P Kofteridis","doi":"10.1016/j.cmi.2025.02.018","DOIUrl":"https://doi.org/10.1016/j.cmi.2025.02.018","url":null,"abstract":"<p><strong>Objectives: </strong>Carbapenem-resistant Acinetobacter baumannii (CRAB) has emerged as a major and difficult-to-treat nosocomial pathogen. This study estimated the mortality associated with CRAB bacteraemia in patients receiving treatment in the intensive care unit. A susceptible-infection counterfactual framework was applied to reflect the potential benefit of improved antimicrobial therapy.</p><p><strong>Methods: </strong>A five-year (2019-2023) cohort study was conducted in a tertiary-care referral hospital in Greece. Competing risks survival analysis methods were applied to estimate excess in-hospital mortality due to CRAB bacteraemia by comparing patients infected by CRAB to those infected by other more susceptible Gram-negative bacteria (GNB).</p><p><strong>Results: </strong>The cohort comprised 400 intensive care patients with GNB bacteraemia (median age 70 years, 65% male). CRAB was the most common pathogen (43%), followed by K. pneumoniae (12%), E. coli (11%), and P. aeruginosa (10%). Patients with CRAB bacteraemia experienced significantly higher in-hospital mortality at 14 days (35% vs. 21%), 28 days (53% vs. 30%) and overall (74% vs. 52%) compared to patients with other GNB bacteraemia. Multivariable competing-risks regression confirmed that CRAB bacteraemia was independently associated with increased risk of 28-day inpatient death (cause-specific hazard ratio [csHR] 1.80, 95% CI 1.28-2.54; sub-distribution hazard ratio [sHR] 1.84, 95% CI 1.28-2.62), simultaneously lowering the probability of discharge alive (csHR 0.68, 95% CI 0.38-1.21; sHR 0.52, 95% CI 0.30-0.91). Estimation of the attributable fraction suggested that effective antimicrobial management may result in a relative decrease in the risk of in-hospital mortality by 44% (95% CI 22%-61%) in CRAB bacteraemia patients.</p><p><strong>Conclusions: </strong>CRAB's detrimental role as a leading cause of increased inpatient mortality and prolongation of hospitalisation in intensive-care patients was demonstrated. These outcomes could improve substantially if more effective antimicrobial treatment becomes available. Nevertheless, considering CRAB is predominantly a hospital-acquired pathogen, efforts should always be directed towards preventing nosocomial transmission.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466630","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":"Detection of Treponema pallidum DNA for diagnosis, resistance identification, and treatment outcome prediction in early syphilis among men who have sex with men.","authors":"Tzong-Yow Wu, Kuan-Yin Lin, Hsin-Yun Sun, Yu-Shan Huang, Wang-Da Liu, Li-Hsin Su, Wen-Chun Liu, Yi-Ching Su, Sui-Yuan Chang, Chien-Ching Hung","doi":"10.1016/j.cmi.2025.02.017","DOIUrl":"https://doi.org/10.1016/j.cmi.2025.02.017","url":null,"abstract":"<p><strong>Objectives: </strong>We investigated the use of Treponema pallidum DNA (TP-DNA) for diagnosis, resistance identification, and treatment outcome prediction in early syphilis among men who have sex with men (MSM).</p><p><strong>Methods: </strong>MSM seeking care for sexually transmitted infections were prospectively enrolled from September 2021 to August 2024. Oral rinse, rectal swab, and urethral swab samples were tested for TP-DNA. Resistance-associated mutations (RAMs) to macrolides and tetracyclines were identified. Treatment responses were compared between syphilis cases with detected TP-DNA and those without.</p><p><strong>Results: </strong>Of 656 MSM enrolled, TP-DNA was most frequently detected in oral rinse samples (37.8% [193/510]), followed by rectal swab (20.2% [103/510]) and urethral swab samples (11.6%, 59/510) in clinic visits for early syphilis. TP-DNA was detected in 45.7% (233/510) of early syphilis cases and 0.7% (1/141) of cases without syphilis, resulting in a specificity of 99.3% (95%CI, 96.1-100%) and sensitivity 45.7% (95%CI, 41.3-50.1%). Secondary syphilis cases had the highest yield of TP-DNA detection (67.6% [117/173]), followed by primary (48.7% [19/39]) and early latent syphilis cases (32.6% [97/298]). The Ct values of TP-PCR in oral rinse samples were significantly lower in cases of higher rapid plasma reagin (RPR) titers (P<0.001). The rate of T. pallidum harbouring RAMs to macrolides was 58.9% (139/236), increasing over six-month intervals, from 32.4% (12/37) in 2021 to 77.8% (21/27) in 2023. Cases of detected TP-DNA had greater serologic responses to treatments than those without: 80.3% (159/198) vs 67.0% (156/233) at month 6 (P=0.002) and 84.1% (143/170) vs 70.3% (137/195) at month 12 (P=0.002).</p><p><strong>Conclusions: </strong>TP-PCR showed high specificity for the diagnosis of early syphilis, which correlated with RPR titers and treatment response, and lower Ct values in oral rinse samples correlated with higher RPR titers. The high prevalence of T. pallidum strains with RAMs to macrolides argues against using azithromycin to treat syphilis in Taiwan.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467278","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":"Metagenomic analysis of microbial cell-free DNA from plasma of patients with suspected infections: performance and therapeutic impact in clinical routine.","authors":"Jan Esse, Johannes Träger, Philipp Steininger, Karl Bihlmaier, Julia Fürst, Zsofia Bardonicsek-Depnering, Nora Naumann-Bartsch, Patrick Morhart, Ixchel Castellanos, Stefan W Krause, Larissa Herbst, Richard Strauß, Martin Chada, Klaus Korn, Giuseppe Valenza, Daniel Teschner, Christian Bogdan, Jürgen Held","doi":"10.1016/j.cmi.2025.02.016","DOIUrl":"https://doi.org/10.1016/j.cmi.2025.02.016","url":null,"abstract":"<p><strong>Objectives: </strong>The sensitivity of blood cultures (BC) is limited, especially when antimicrobial therapy already has been administered or when non-culturable pathogens are causing the disease. Metagenomic next-generation sequencing (mNGS) of cell-free DNA (cfDNA) from plasma has the potential to compensate for the disadvantages of BC diagnostics.</p><p><strong>Methods: </strong>We conducted a retrospective study in patients with suspected infections over a period of 3 months. cfDNA from plasma was analysed by mNGS (Illumina NextSeq, 25 million reads per sample, read length 75 base pairs) and sequences were analysed with DISQVER®, a CE-IVDD-labelled software algorithm and curated database. The data were compared to findings obtained with simultaneously taken BC and other microbiological results (+/- 7 days).</p><p><strong>Results: </strong>DISQVER® analysis was performed on 190 samples from 147 patients (124 adult, 23 pediatric). The median time-to-result including transport was two days (IQR 2-3; range 2-8). DISQVER® detected 158 pathogens (103 bacteria, 49 viruses, four fungi, one parasite) in 80 plasma samples (positivity rate 42.1%). The median number of pathogens per positive sample was one (IQR 1-2; range 1-10). The most common bacteria were Enterobacterales (30.1%; 31/103), anaerobic bacteria (18.4%; 19/103) and Enterococcus spp. (15.5%; 16/103), the most frequent viruses were Epstein-Barr virus (28.6%; 14/49), human herpesvirus 6B (18.4%; 9/49) and human cytomegalovirus (18.4%; 9/49). Mycobacterium avium, Legionella pneumophila, Tropheryma whipplei, Rhizomucor pusillus and Leishmania infantum were detected in one sample each. Simultaneous BC were positive in only 10.2% (18/176) of the samples, but were mostly (68.2%; 120/176) collected under antibiotic therapy. DISQVER® analysis resulted in 24 treatment changes in 20 patients (13.6%; 20/147; 9 start/escalation, 10 stop/de-escalation, 2 catheter replacements, 3 other).</p><p><strong>Conclusions: </strong>DISQVER® significantly increased the detection rate of pathogens, led to the diagnosis of serious infections that otherwise would have been missed, and possibly improved the treatment of more than 10% of patients.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467280","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":"Mortality and sequelae associated with regional use of intracranial devices among patients with pneumococcal meningitis; a nationwide, population-based cohort study.","authors":"Isabella L Platz, Malte M Tetens, Nanna S Andersen, Jacob Bodilsen, Ram B Dessau, Svend Ellermann-Eriksen, Jens K Møller, Lene Nielsen, Alex Christian Yde Nielsen, Kirstine K Søgaard, Christian Østergaard, Anne-Mette Lebech, Lars Haukali Omland, Niels Obel","doi":"10.1016/j.cmi.2025.02.015","DOIUrl":"https://doi.org/10.1016/j.cmi.2025.02.015","url":null,"abstract":"<p><strong>Objectives: </strong>Intracranial devices may be used to treat or guide treatment of increased intracranial pressure in patients with pneumococcal meningitis. European guidelines do not recommend the routine use of intracranial devices in management of pneumococcal meningitis. However, in some countries, intracranial devices are used routinely, but the effect remains unknown. We aimed to examine whether mortality and sequelae were lower in patients with pneumococcal meningitis admitted to hospitals in regions in which intracranial devices were routinely used compared to regions not utilizing intracranial devices routinely in pneumococcal meningitis management.</p><p><strong>Methods: </strong>In a registry-based, nationwide, population-based cohort study we examined patients with pneumococcal meningitis (Denmark, 2004-2021). Patients were categorized according to whether the individual was admitted to hospitals in regions where intracranial devices were routinely (exposed patients, n=305 of whom 66 (22%) had an intracranial device) or not routinely used (non-exposed patients, n=333 of whom 4 (1%) had an intracranial devices). We used Cox-regression to calculate adjusted mortality rate ratios (aMRR) and hazard ratios of sequelae for the short-term and long-term periods (<6 or ≥6 months after study inclusion).</p><p><strong>Results: </strong>The short-term cumulative incidence of death was 22% among exposed patients and 22% among non-exposed patients. We found no association between mortality and routine use of intracranial devices in the region in which patients with pneumococcal meningitis were admitted (short-term aMRR (95% confidence interval [95%CI]): 0.9 [0.6-1.3], long-term aMRR [95%CI]: 1.0 [0.7-1.6]). Furthermore, our study did not demonstrate lower risks of diagnosis of epilepsy, hearing loss, diagnoses suggestive of brain damage, disability pension, or shorter length of stay in exposed compared with non-exposed patients with pneumococcal meningitis.</p><p><strong>Conclusions: </strong>The routine use of intracranial devices is not associated with lower mortality or morbidity among patients with pneumococcal meningitis.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425162","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: 'In vitro activity of cefepime-enmetazobactam on carbapenem resistant Gram negatives' by Bonnin et al.","authors":"Christophe Le Terrier, Stuart Shapiro, Patrice Nordmann, Laurent Poirel","doi":"10.1016/j.cmi.2025.02.013","DOIUrl":"https://doi.org/10.1016/j.cmi.2025.02.013","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424472","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":"Disseminated Saccharomyces cerevisiae infection in advanced HIV: literature review.","authors":"Lucy X Li, Amita Gupta, Matthew M Hamill, Sean X Zhang, Yukari C Manabe","doi":"10.1016/j.cmi.2025.02.009","DOIUrl":"https://doi.org/10.1016/j.cmi.2025.02.009","url":null,"abstract":"<p><strong>Background: </strong>Saccharomyces cerevisiae is a common environmental fungus and an uncommon, but increasingly recognized, cause of invasive fungal infection. The clinical manifestations of this infection can often be mistaken for histoplasmosis, a major cause of mortality in patients with advanced HIV.</p><p><strong>Objectives: </strong>To review the current epidemiology, diagnostic approaches, and management strategies for S. cerevisiae infection in patients with HIV.</p><p><strong>Sources: </strong>A literature search was conducted using PubMed from January 1980 and May 2024.</p><p><strong>Content: </strong>This review features a case of S. cerevisiae infection in a patient with HIV to highlight the diagnostic challenges and clinical implications of disseminated infection. A summary of published cases in patients with vs. without HIV is provided alongside a review and discussion of both conventional and novel diagnostic methods. The role of current antifungal therapies in managing S. cerevisiae infections is also examined.</p><p><strong>Implications: </strong>S. cerevisiae is a rare but clinically important opportunistic pathogen in patients with advanced HIV who have epidemiologic risk factors. When found in mucocutaneous lesions under the appropriate clinical scenario, S. cerevisiae should not automatically be dismissed as commensal flora.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425152","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":"ORCHESTRA Delphi Consensus: Diagnostic and Therapeutic Management of SARS-CoV-2 Infection in Solid Organ Transplant Recipients.","authors":"Beatrice Tazza, Natascia Caroccia, Alice Toschi, Renato Pascale, Effrosyni Gkrania-Klotsas, Paula Olivares Navarro, Lorenzo Maria Canziani, Alessandro Tavelli, Andrea Antinori, Paolo Antonio Grossi, Maddalena Peghin, Evelina Tacconelli, Zaira Raquel Palacios-Baena, Pierluigi Viale, Maddalena Giannella","doi":"10.1016/j.cmi.2025.02.010","DOIUrl":"https://doi.org/10.1016/j.cmi.2025.02.010","url":null,"abstract":"<p><strong>Objectives: </strong>Our aim was to address existing knowledge gaps regarding risk stratification, best use of diagnostic resources, optimal treatment and general management of SARS-CoV-2 infection in solid organ transplant (SOT) recipients. As high-quality evidence specific to this fragile population is lacking, our final aim was to provide an expert consensus evidence-informed guidance that can aid clinicians in their daily practice.</p><p><strong>Methods: </strong>This study was conducted within the Working Package 4 (WP4 - Fragile population cohorts) of the H2020 funded ORCHESTRA study [https://orchestra-cohort.eu]. Eight infectious disease and one clinical pharmacology specialists conducted a comprehensive scoping literature review which covered five key areas: the role of SOT as a risk factor for evolution to severe disease; the optimal use of diagnostic resources, considering cost-benefit ratios and appropriateness of active screening; a population-specific therapeutic management, including antiviral use and drug-drug interactions and appropriate duration of treatment; the potential need for withdrawal of immunosuppressive agents and management of potential donors and recipients with recent and/or ongoing SARS-CoV-2 infection at the time of transplantation. Based on this review, a 28-item questionnaire was developed and administered to a panel of experts through two rounds, following the Delphi methodology.</p><p><strong>Results: </strong>The panel consisted of 21 experts, 13 females and 8 males, from Italy (n=11), Spain (n=5), Switzerland (n=2), Brazil (n=1), United States (n=1), and United Kingdom (n=1). Consensus was achieved for 18 out of 28 items after the first round and for 9 out of 13 items after the second round, according with agreement/disagreement levels obtained for each question and round, ten statements were finally produced.</p><p><strong>Conclusions: </strong>The consensus statements derived from this study offer a framework for standardizing care and improving outcomes in SOT recipients affected by SARS-CoV-2 infection in field where high-quality evidence specific to this high-risk population is currently lacking.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424505","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":"'Marburg virus disease outbreak in Rwanda, 2024' - Author's reply.","authors":"Martin P Grobusch, Galadriel Pellejero-Sagastizábal, Pikka Jokelainen, F-Xavier Lescure, Marta Mora-Rillo, Nitin Gupta","doi":"10.1016/j.cmi.2025.02.012","DOIUrl":"https://doi.org/10.1016/j.cmi.2025.02.012","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425156","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}