Clinical Microbiology and Infection最新文献

{"title":"Effectiveness of influenza vaccination to prevent severe disease: a systematic review and meta-analysis of test-negative design studies.","authors":"Sergey Yegorov, Om D Patel, Harsh Sharma, Taha Khan, Ribhav Gupta, Michael Yao, Ashwin Sritharan, Noam Silverman, Eleanor Pullenayegum, Matthew S Miller, Mark Loeb","doi":"10.1016/j.cmi.2025.09.023","DOIUrl":"https://doi.org/10.1016/j.cmi.2025.09.023","url":null,"abstract":"<p><strong>Background: </strong>Seasonal influenza vaccination may be effective against severe influenza disease.</p><p><strong>Objectives: </strong>To assess evidence on the real-world effectiveness of influenza vaccination in preventing severe influenza-related outcomes.</p><p><strong>Data sources: </strong>PubMed, Ovid, and Cochrane CENTRAL from inception to September 24, 2024.</p><p><strong>Study eligibility criteria: </strong>Observational test-negative design studies reporting influenza vaccine effectiveness (IVE) against influenza-associated hospitalisation, death, pneumonia, intensive care unit (ICU) admission, or ventilatory support (VS).</p><p><strong>Participants: </strong>Hospitalized adults and children with laboratory-confirmed influenza and inpatient controls who tested negative for influenza infection.</p><p><strong>Interventions: </strong>Influenza vaccination.</p><p><strong>Assessment of risk of bias: </strong>Newcastle-Ottawa Scale (NOS) and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) were used to assess study quality and evidence certainty.</p><p><strong>Methods of data synthesis: </strong>We extracted study characteristics and odds ratio (OR) or IVE estimates and corresponding 95% confidence intervals (95% CI). Both crude and adjusted estimates were considered and analysed using a random-effects model. We calculated pooled IVE overall and by season, age group, circulating strains, vaccine type and match between vaccine and circulating strains.</p><p><strong>Results: </strong>Overall, 7727 publications were identified, 461 reviewed, 165 included. Pooled IVE was 42% (95% CI 39-44) against influenza-associated hospitalisation (very low certainty), 36% (95% CI 24-46) against death (no certainty), 51% (95% CI 36-63) against pneumonia (low certainty), 52% (95% CI 38-63) against ICU admission (very low certainty), and 55% (95% CI 44-64) against VS (low certainty). IVE varied by age and was generally higher (up to 2-fold) in children compared to adults. Higher IVE was observed against influenza A(H1N1) compared to A(H3N2) and in seasons with good vaccine match. Hospitalisation IVE was slightly higher for quadrivalent (45% (95% CI, 32-56) compared to trivalent (36% (95% CI, 27-43) vaccine.</p><p><strong>Conclusions: </strong>Seasonal influenza vaccination moderately reduces severe influenza-related outcomes, particularly in children, against A(H1N1), and with good vaccine-strain match.</p><p><strong>Prospero registration: </strong>CRD42023476003.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298946","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":"Immune reconstitution in very advanced HIV patients treated with Dolutegravir vs Darunavir-based triple antiretroviral therapy. The Advanz-4 randomized clinical trial.","authors":"Jose M Miro, Ferran Torres, Christian Manzardo, Eva Bonfill, Adrià Curran, Pere Domingo, Daniel Podzamczer, Roger Paredes, Lluis Force, Vicenç Falco, Mar Gutierrez, Maria Saumoy, Anna Castelli, Alexis Inciarte, Cristina Rovira, Anna Cruceta, Carmen Hurtado, Núria Climent, Francisco Lozano, Montserrat Plana","doi":"10.1016/j.cmi.2025.09.026","DOIUrl":"https://doi.org/10.1016/j.cmi.2025.09.026","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this trial was to compare the immune reconstitution, virologic response, and safety of dolutegravir (DTG)- vs. darunavir (DRV) boosted-based antiretroviral (ART) regimens in very advanced HIV patients.</p><p><strong>Methods: </strong>Phase IV, randomized (1:1 ratio), open-label trial, including adult (≥18 years) ART-naïve HIV-1+ patients with CD4⁺ cell counts <100 cells/ L from nine hospitals in Spain. Participants were randomized to Lamivudine (3TC)/Abacavir (ABC)/DTG (DTG arm) and 3TC/ABC/DRV + Ritonavir (DRV/r arm).</p><p><strong>Primary endpoint: </strong>change in the absolute CD4⁺-cells number at 48 weeks. by modified intention-to-treat population.</p><p><strong>Trial registration: </strong>NCT02337322.</p><p><strong>Results: </strong>104 patients (86·5% male, median [IQR] age 41·0 [31·5, 47·0] years) were recruited and randomized to DTG (n=52) and DRV/r arms (n=52). Baseline median (IQR) CD4⁺ cell counts were 41·0 (18·5, 67·5) and 30·0 (11·0, 57·5) cells/ L in the DTG and DRV/r arms. They significantly increased by median (IQR) 172·5 (118·0, 255·3) and 157·0 (66·0, 276·9) cells/ L, respectively (p=0·4299); 29 (55·8%) and 21 (42·9%) (p=0·2343), respectively, reached >200 cells/ L. 41 (78·8%) and 31 (63·3%) patients (p=0·1229) in the DTG and DRV/r arms, respectively, achieved undetectable viral loads at 48 weeks; differences were significant at weeks 4 (p<0·0001) and 12 (p=0·0190). Inflammation (TNF-alpha) and bacterial translocation (sCD14) markers decreased more in the DTG arm, a median (IQR]) -8 (-11, -4) vs -5 (-9, -3) pg/mL (p=0·0357) and -972 [-1334, -508] vs -544 [-1128, -292] μg/mL (p=0·0565), respectively, at 48 weeks. Discontinuation rates were higher in the DRV/r arm (3/52 [5.8%] vs. 9/51 [18,4%]; p=0·0526).</p><p><strong>Conclusions: </strong>DTG/3TC/ABC is safe and efficacious in very advanced ART-naïve HIV+ patients, induced a faster virological response, and was superior to the DRV/r regimen in reducing inflammation and bacterial translocation markers at 48 weeks.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285760","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":"Enhancing SARS-CoV-2 Response Capacity in Africa and Other CREID Centers through a Collaborative Training Program.","authors":"Ambroise Ahouidi, Abdou Padane, Alioune Gaye, Anavaj Sakuntabha, Awa Deme, Badara Cisse, Carla de Oliveira, Caroline Weldon, Cyrille Diedhiou, Daouda Ndiaye, Geoffrey S Gottlieb, Helene McOwen, Ibrahima Dia, Joilson Xavier, Katherine J Siddle, Kristian Andersen, Lynn Barrett, Mariétou Faye Paye, Mawlouth Diallo, Sasha Tilles, Scott C Weaver, Shirlee Wohl, Tulio de Oliveira, Luiz Carlos Junior Alcantara, Wesley C Van Voorhis, Souleymane Mboup, Eduan Wilkinson, Marta Giovanetti","doi":"10.1016/j.cmi.2025.10.002","DOIUrl":"https://doi.org/10.1016/j.cmi.2025.10.002","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285765","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":"Can we rely on using penicillin as the first-line treatment of pneumonia in outpatient care?","authors":"Carl Llor, Niels Frimodt-Møller","doi":"10.1016/j.cmi.2025.09.025","DOIUrl":"https://doi.org/10.1016/j.cmi.2025.09.025","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274126","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":"Which trial do we need? Combination regimen for individuals exposed to multi-drug resistant Mycobacterium tuberculosis.","authors":"Divya Shah, Giovanni Fumagalli, Niccolo Riccardi, Andrea Calcagno, Giovanni Ferrara, Luigi Ruffo Codecasa","doi":"10.1016/j.cmi.2025.09.024","DOIUrl":"https://doi.org/10.1016/j.cmi.2025.09.024","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274107","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":"An open call to join the CMI editorial team: editor in infectious diseases.","authors":"Leonard Leibovici","doi":"10.1016/j.cmi.2025.10.004","DOIUrl":"https://doi.org/10.1016/j.cmi.2025.10.004","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274130","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":"Corrigendum to Candidate anti-tuberculosis medicines and regimens under clinical evaluation.","authors":"Michael Hoelscher, David Barros-Aguirre, Masoud Dara, Norbert Heinrich, Eugene Sun, Christoph Lange, Simon Tiberi, Charles Wells","doi":"10.1016/j.cmi.2025.10.001","DOIUrl":"https://doi.org/10.1016/j.cmi.2025.10.001","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257538","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":"On retiring from the role of CMI Editor-in-Chief.","authors":"Leonard Leibovici","doi":"10.1016/j.cmi.2025.10.003","DOIUrl":"https://doi.org/10.1016/j.cmi.2025.10.003","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257566","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":"An introduction to Network Meta-analyses in clinical microbiology and infectious diseases.","authors":"Georgios Seitidis, Ourania Koutsiouroumpa, Roland van Rensburg, Michael McCaul, Isabelle Boutron, Dimitris Mavridis","doi":"10.1016/j.cmi.2025.09.022","DOIUrl":"https://doi.org/10.1016/j.cmi.2025.09.022","url":null,"abstract":"<p><strong>Background: </strong>Network Meta-Analysis (NMA) allows synthesizing results from studies comparing all available interventions. It uses direct evidence from studies comparing directly two interventions (say B and C) but also indirect evidence if there are studies comparing each of B and C to a common comparator (say A). By synthesizing both direct and indirect evidence, NMA allows for the comparison of multiple interventions within a single framework. Additionally, NMA enables comparing interventions that have not been directly compared, provides more precise estimates compared to pairwise meta-analysis and creates a ranking hierarchy based on any specific outcome.</p><p><strong>Objectives: </strong>We aim to provide a thorough introduction to NMA tailored for clinicians and scientists working in the fields of clinical microbiology and infectious diseases.</p><p><strong>Sources: </strong>We illustrated all steps of NMA using a published example from the field of clinical microbiology and infectious diseases. We considered cases and use examples of published NMAs.</p><p><strong>Content: </strong>We outlined the key concepts and assumptions of NMA using illustrative examples from common infectious diseases. We presented some common pitfalls and misconceptions that are frequently encountered in real-world practice. To reduce the gap between theory and practice, we applied the broad steps for conducting and interpretating an NMA to a published NMA evaluating the efficacy of different monotherapies for chronic hepatitis B infection.</p><p><strong>Implications: </strong>By clarifying methodological challenges and providing practical guidance, this paper aims to enhance infectious disease practitioners' understanding of NMA, assuring its proper application and interpretation.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250009","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":"Estimating the potential economic and health impact of integrated genomic surveillance in a hospital setting.","authors":"Frederik Boetius Hertz, Karen Leth Nielsen, Dmytro Strunin, Jelena Erdmann, Martin Lucas Jørgensen, Theiss Bendixen, Roshkan Srinathan, Rasmus L Marvig, Steen Christian Rasmussen, Asger Nellemann Rasmussen, Christian Salgaard Jensen, Jenny Dahl Knudsen, Susanne Häussler","doi":"10.1016/j.cmi.2025.09.021","DOIUrl":"https://doi.org/10.1016/j.cmi.2025.09.021","url":null,"abstract":"<p><strong>Objectives: </strong>Integrated genomic surveillance, combining whole genome sequencing (WGS) of bacterial isolates with patient movement data, promises improved detection and prevention of pathogen transmission. However, evidence on its cost-effectiveness and clinical utility remains limited, not least because the full extent of transmission in hospital settings is difficult to capture.</p><p><strong>Methods: </strong>We conducted a 28-month observational study at Rigshospitalet, Copenhagen, collecting patient movement data and sequencing 18,438 bacterial isolates from 7,398 patients across diverse species, infection sites, and resistance profiles. We estimated the hypothetical benefits of implementing integrative WGS surveillance, assuming that continued transmission could be prevented when WGS information was acted upon immediately.</p><p><strong>Results: </strong>We found that 1,975 of 7,398 of culture-positive hospitalized patients (26.7 %) harboured a pathogen genetically related to another patient´s isolate. 1359 of those (68.8 %) had an epidemiological link in the hospital, with Enterococcus faecium by far being the most prevalent involved in transmissions. WGS-informed prevention could hypothetically generate net savings of €1.35 million annually if transmission was stopped once a clonal isolate was detected in a second patient. Furthermore, this approach could potentially have prevented an estimated 1,284 hospital-acquired infections over the 28-month study period, including 94 cases characterized by the recovery of bloodstream isolates.</p><p><strong>Conclusions: </strong>Our integrated genomic surveillance approach reveals previously unexplored transmission landscapes. We discovered that transmission is widespread, varies between species, and is not limited to resistant isolates. Our results emphasise the potential of integrated genomic surveillance, the identification of local transmission hotspots, potential greater savings by including susceptible isolates, and an incremental cost-effectiveness ratio classification by pathogen species.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250050","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}