Guillaume Favre , Rebecca L. Bromley , Matthew Bluett-Duncan , Emeline Maisonneuve , Léo Pomar , Charlotte Daire , Anda-Petronela Radan , Luigi Raio , Daniel Surbek , Carolin Blume , Stylianos Kalimeris , Yoann Madec , Juliane Schneider , Myriam Bickle Graz , Ursula Winterfeld , Alice Panchaud , David Baud
{"title":"Neurodevelopmental outcomes of infants after in utero exposure to SARS-CoV-2 or mRNA-COVID-19 vaccine compared with unexposed infants: a COVI-PREG prospective cohort study","authors":"Guillaume Favre , Rebecca L. Bromley , Matthew Bluett-Duncan , Emeline Maisonneuve , Léo Pomar , Charlotte Daire , Anda-Petronela Radan , Luigi Raio , Daniel Surbek , Carolin Blume , Stylianos Kalimeris , Yoann Madec , Juliane Schneider , Myriam Bickle Graz , Ursula Winterfeld , Alice Panchaud , David Baud","doi":"10.1016/j.cmi.2024.10.019","DOIUrl":"10.1016/j.cmi.2024.10.019","url":null,"abstract":"<div><h3>Objectives</h3><div>Data are lacking regarding the long-term consequences of SARS-CoV-2 and COVID-19 mRNA vaccine on infants exposed <em>in utero</em>. We aimed to evaluate the neurodevelopment of infants exposed prenatally to SARS-CoV-2 or mRNA-COVID-19 vaccine during pregnancy at 12 months after birth.</div></div><div><h3>Methods</h3><div>Infants born to mothers exposed to SARS-CoV-2 or mRNA-COVID-19 vaccine during pregnancy, or unexposed to either the virus or the vaccine were enrolled from 2021 to 2023. Infants with prenatal exposure to the virus or vaccine were compared with infants without prenatal exposure to the virus and/or vaccine. Parents received a neurodevelopmental questionnaire (ages and stages questionnaire third edition) at 12 months after birth assessing five subdomains: communication, gross motor, fine motor, problem-solving, and personal social development. A low score was defined as <2 standard deviations below the normative mean in at least one of the subdomains.</div></div><div><h3>Results</h3><div>A total of 330 infants were included (76 in the SARS-CoV-2 group, 153 in the mRNA-COVID-19 vaccine group, and 101 in the reference group). <em>In utero</em> exposure to the SARS-CoV-2 or mRNA-COVID-19 vaccine was not associated with an increased risk of a low score for at least one subdomain compared with the reference group. The crude ORs were 1.16 (95% CI, 0.59–2.28) and 1.04 (95% CI, 0.58–1.86), respectively. Results remained consistent in the multivariate analysis, showing no increased risk of a low score for at least one subdomain for infants exposed to the SARS-CoV-2 or mRNA-COVID-19 vaccine, compared with the reference group. The adjusted ORs were 1.74 (95% CI, 0.76–3.99) and 0.76 (95% CI, 0.39–1.49), respectively.</div></div><div><h3>Discussion</h3><div><em>In utero</em> exposure to SARS-CoV-2 or mRNA-COVID-19 vaccine was not associated with an increased risk of a low score for at least one ages and stages questionnaire third edition subdomain at 12 months after birth. Additional studies are needed to confirm our results, especially longer-term evaluation of infant development.</div></div>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":"31 2","pages":"Pages 266-273"},"PeriodicalIF":10.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Re: 'Marburg virus disease outbreak in Rwanda 2024' by Grobusch et al.","authors":"Christina Frank, Hendrik Wilking, Raskit Lachmann","doi":"10.1016/j.cmi.2025.01.032","DOIUrl":"10.1016/j.cmi.2025.01.032","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074074","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":"Procalcitonin in acute exacerbation of chronic obstructive pulmonary disease: can fresh evidence tip the scales?","authors":"Markus Fally, Jens-Ulrik Stæhr Jensen","doi":"10.1016/j.cmi.2025.01.030","DOIUrl":"10.1016/j.cmi.2025.01.030","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074072","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}
Anura David, Lyndel Singh, Keneilwe Peloakgosi-Shikwambani, Zanele Nsingwane, Violet Molepo, Gerard Cangelosi, Pedro da Silva, Wendy Stevens, Lesley Scott
{"title":"Diagnostic accuracy of self-collected tongue swabs for Mycobacterium tuberculosis complex detection in individuals being assessed for tuberculosis in South Africa using the Xpert MTB/RIF Ultra assay.","authors":"Anura David, Lyndel Singh, Keneilwe Peloakgosi-Shikwambani, Zanele Nsingwane, Violet Molepo, Gerard Cangelosi, Pedro da Silva, Wendy Stevens, Lesley Scott","doi":"10.1016/j.cmi.2025.01.029","DOIUrl":"10.1016/j.cmi.2025.01.029","url":null,"abstract":"<p><strong>Objectives: </strong>Tongue swabs (TS) have shown potential for detecting Mycobacterium tuberculosis complex (MTBC) through downstream molecular testing. Analytical performance varies, depending on the processing protocol and the molecular test used. This study aimed to first investigate the ease of use of TS collection in addition to acceptability by individuals being assessed for tuberculosis and second to determine the performance of self-collected TS on the Xpert MTB/rifampicin (RIF) Ultra (Ultra) assay (Cepheid, Sunnyvale, CA, USA) for MTBC and RIF resistance detection.</p><p><strong>Methods: </strong>The ease of use of TS collection and acceptability by study participants was assessed through completion of a survey questionnaire. Analytical performance of self-collected TS on the Ultra assay was determined by comparing results with a liquid culture reference result and with Ultra on sputum. Results were additionally stratified by HIV and smear status.</p><p><strong>Results: </strong>Of the 399 survey respondents, all were happy with the TS collection procedure with minimal discomfort reported. Data analysis was performed on 321 specimens. The sensitivity of the Ultra TS assay for MTBC detection was 78.1% (95% CI, 66.0-87.5%), whereas the specificity was 100% (95% CI, 98.6-100%). Test performance was better in individuals with a higher bacillary load, with some variability. On HIV-positive individuals, TS performance is ∼30% lower than that on sputum but also slightly better than smear microscopy, whereas the performance of TS among HIV-negative individuals is similar to sputum (93% vs. 97%). For RIF resistance profiling, the Ultra TS assay showed 41/41 (100%) concordance with phenotypic drug-susceptibility testing.</p><p><strong>Discussion: </strong>Although self-collected TS have lower sensitivity compared with sputum, their ease of use and high acceptability make them a valuable additional specimen type for molecular tuberculosis testing. Self-collection can reduce the burden on healthcare workers and increase access to testing, particularly for individuals who are too busy to visit healthcare facilities or fear stigma.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064092","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}
Yuting Yan, Lianhan Shang, Jiuyang Xu, Xiaoying Gu, Guohui Fan, Yeming Wang, Bin Cao
{"title":"The prevalence and outcomes of viremia in patients with acute respiratory viral infection: a systematic review and meta-analysis.","authors":"Yuting Yan, Lianhan Shang, Jiuyang Xu, Xiaoying Gu, Guohui Fan, Yeming Wang, Bin Cao","doi":"10.1016/j.cmi.2025.01.027","DOIUrl":"10.1016/j.cmi.2025.01.027","url":null,"abstract":"<p><strong>Background: </strong>Viremia has been detected in a significant proportion of patients with acute respiratory viral infection, yet its clinical value remains underappreciated.</p><p><strong>Objectives: </strong>This study synthesized available evidence to comprehensively assess the prevalence of viremia and its impact on clinical outcomes.</p><p><strong>Methods: </strong>Data sources: Data were retrieved from Medline (via Ovid), Embase, and the WHO COVID-19 database.</p><p><strong>Study eligibility criteria: </strong>This review included original clinical studies analysing the prevalence of viremia in patients with acute respiratory viral infection or its association with clinical outcomes, while excluding non-original research, insufficiently detailed studies, inconsistent pathogen observations, or those with inadequate sample sizes.</p><p><strong>Participants: </strong>Patients with acute respiratory viral infection.</p><p><strong>Assessment of risk of bias: </strong>Newcastle-Ottawa scale and an adapted version were used.</p><p><strong>Exposure: </strong>Respiratory viral infection-related viremia.</p><p><strong>Methods of data synthesis: </strong>Data synthesis utilized random-effects models to pool prevalence and hazard ratio (HR), OR, and adjusted HR/OR for clinical outcomes.</p><p><strong>Results: </strong>In the comprehensive analysis of viremia prevalence, data were pooled from 101 studies, which included a total of 16,388 non-overlapping patients. Viremia was present in 34% (95% CI, 28-41%) of patients with acute respiratory viral infection. A total of 45 studies provided information on the clinical outcomes of 2002 patients with viremia and 3907 patients without viremia. Viremia was associated with increased risks of mortality (OR, 6.83; 95% CI, 4.92-9.48; adjusted HR, 2.91; 95% CI, 1.87-4.53; adjusted OR, 3.68; 95% CI, 2.37-5.71), intensive care unit admission (OR, 4.74; 95% CI, 2.66-8.46; adjusted OR, 4.89; 95% CI, 1.61-14.91), mechanical ventilation (OR, 4.12; 95% CI, 2.25-7.52), and hepatic complications (OR, 3.10; 95% CI, 1.30-7.40).</p><p><strong>Conclusions: </strong>Viremia is prevalent in patients with respiratory viral infection and is associated with elevated risks of adverse clinical outcomes.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064097","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}
Jane Freeman, Ingrid M J G Sanders, Céline Harmanus, Emma V Clark, Andrea M Berry, Wiep Klaas Smits
{"title":"Antimicrobial susceptibility testing of Clostridioides difficile: a dual-site study of three different media and three therapeutic antimicrobials.","authors":"Jane Freeman, Ingrid M J G Sanders, Céline Harmanus, Emma V Clark, Andrea M Berry, Wiep Klaas Smits","doi":"10.1016/j.cmi.2025.01.028","DOIUrl":"10.1016/j.cmi.2025.01.028","url":null,"abstract":"<p><strong>Objectives: </strong>Increasing resistance to antimicrobials used for the treatment of Clostridioides difficile infections necessitates reproducible antimicrobial susceptibility testing. Current guidelines take a one-size-fits-all approach and/or offer limited guidance. We investigated how the choice of medium affects measured MIC values across two sites.</p><p><strong>Methods: </strong>We determined MIC values for the antimicrobials fidaxomicin, metronidazole, and vancomycin for a representative collection of European C. difficile strains (n = 235) using agar dilution on three different media: Brucella Blood Agar (BBA), Fastidious Anaerobe Agar supplemented with horse blood (FAA-HB), and Wilkins-Chalgren (WC) agar. The study was conducted at two sites to compare reproducibility. Usability (ease of preparation of the media as well as read-out of the assay) was assessed through a survey.</p><p><strong>Results: </strong>We found that all media result in highly consistent aggregated MIC data for all antibiotics, with MIC<sub>50</sub> and MIC<sub>90</sub> within two-fold of each other across sites. For fidaxomin, MIC values on WC were lower than on the other media (MIC<sub>90</sub>: WC = 0.125-0.25 mg/L; BBA and FAA-HB = 0.5 mg/L). Metronidazole showed the lowest MIC on BBA and the highest on WC (MIC<sub>90</sub>: WC = 2 mg/L; BBA = 0.5-1 mg/L; FAA-HB: 1-2 mg/L). For vancomycin, MIC values were similar across media (MIC<sub>90</sub>: all media = 1-2 mg/L). Though absolute values for individual isolates differed between sites, identified resistant isolates were similar. Results obtained on FAA-HB were most consistent between sites and results obtained on WC showed the most divergence. FAA-HB was positively evaluated in the usability survey.</p><p><strong>Discussion: </strong>This study shows medium-dependent differences in C. difficile MICs for at least two antimicrobials across two sites. We suggest the use of FAA-HB to align with general European Committee on Antimicrobial Susceptibility Testing (EUCAST) recommendations for susceptibility testing of anaerobic bacteria and deposited reference strains for standard susceptibility testing of C. difficile to increase interlaboratory reproducibility.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064191","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}
Luise Hänsel , Oliver A. Cornely , Philipp Koehler
{"title":"Integrating pre-test probability and β-D-glucan cut-offs to enhance accuracy in diagnosing pneumocystis pneumonia","authors":"Luise Hänsel , Oliver A. Cornely , Philipp Koehler","doi":"10.1016/j.cmi.2025.01.021","DOIUrl":"10.1016/j.cmi.2025.01.021","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":"31 4","pages":"Pages 497-499"},"PeriodicalIF":10.9,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045757","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}
Tae Seung Lee, Jin Ho Choi, Jae Min Lee, Hankyu Jeon, Woo Hyun Paik, Kwang Bum Cho, Yoon Suk Lee, Joung-Ho Han, Jong Seok Joo, Min Kyu Jung, Jonghyun Lee, Dong-Won Ahn, Jin Myung Park, Jaihwan Kim, Jong-Chan Lee, Eun Ae Cho, Sang Hyub Lee
{"title":"A randomized non-inferiority trial investigating antibiotic adjustments based on blood culture in acute cholangitis.","authors":"Tae Seung Lee, Jin Ho Choi, Jae Min Lee, Hankyu Jeon, Woo Hyun Paik, Kwang Bum Cho, Yoon Suk Lee, Joung-Ho Han, Jong Seok Joo, Min Kyu Jung, Jonghyun Lee, Dong-Won Ahn, Jin Myung Park, Jaihwan Kim, Jong-Chan Lee, Eun Ae Cho, Sang Hyub Lee","doi":"10.1016/j.cmi.2024.12.039","DOIUrl":"10.1016/j.cmi.2024.12.039","url":null,"abstract":"<p><strong>Objectives: </strong>This study evaluated the adequacy of using blood cultures alone for antibiotic therapy in mild-to-moderate acute cholangitis after adequate biliary drainage.</p><p><strong>Methods: </strong>A prospective, multi-centre, non-inferiority, randomized trial was conducted from August 2015 to September 2023 across 12 tertiary hospitals in South Korea. Patients were randomly assigned 1:1 to groups. The control group was administered antibiotics based on blood and bile culture results, whereas the experimental group was treated based on blood culture results alone. The primary outcome was the rate of organ failure, assessed by the presence of shock, acute kidney injury, altered mental status, and acute respiratory distress. The secondary outcomes were all-cause mortality, frequency of re-interventions, antibiotic usage duration, and hospital stay. The non-inferiority margin was 10%.</p><p><strong>Results: </strong>Patients in the control group (n = 215) and experimental group (n = 213) were analysed. Organ failure occurred in 28 (13.0%) in the control and 27 (12.7%) in the experimental group (difference: -0.350% [95% CI, -6.690% to 5.990%], p > 0.999). Mortality rates were 3.3% in the control (seven patients) and 2.3% in the experimental group (five patients) (-0.908% [-4.033% to 2.216%], p 0.782). The reintervention rates were 31 (14.9%) in the control and 26 (12.2%) in the experimental groups (-2.677% [-9.155% to 3.801%], p 0.504). The antibiotic therapy duration was different (-1.500 days [-2.840 to -0.160], p 0.037) between the control (12.8 ± 8.0 days) and the experimental groups (11.3 ± 6.5 days), and the hospital stay was different (-1.900 days [-0.380 to 0.000], p 0.046) between the control (14.1 ± 11.0 days) and the experimental groups (12.2 ± 9.0 days).</p><p><strong>Discussion: </strong>This study confirms that relying on blood culture results alone for managing mild-to-moderate cholangitis is reasonable and may help reduce the unnecessary use of medical resources.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064182","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}
Sebastian M Wingen-Heimann, Oliver A Cornely, Ullrich Bethe, Danila Seidel
{"title":"Revisiting diagnostics: early and accurate diagnosis of invasive fungal infections: a health economic view on investing in innovative diagnostics.","authors":"Sebastian M Wingen-Heimann, Oliver A Cornely, Ullrich Bethe, Danila Seidel","doi":"10.1016/j.cmi.2025.01.023","DOIUrl":"10.1016/j.cmi.2025.01.023","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045759","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}