Clinical Microbiology and Infection最新文献

{"title":"‘Persistent COVID-19 in immunocompromised patients – Israeli society of infectious diseases consensus statement on diagnosis and management’: author's response","authors":"","doi":"10.1016/j.cmi.2024.05.022","DOIUrl":"10.1016/j.cmi.2024.05.022","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":null,"pages":null},"PeriodicalIF":10.9,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141186053","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":"Empiric antibiotic regimens in adults with non-ventilator-associated hospital-acquired pneumonia: a systematic review and network meta-analysis of randomized controlled trials.","authors":"Maryam Ghadimi, Reed A C Siemieniuk, Gordon Guyatt, Mark Loeb, Afeez Abiola Hazzan, Danial Aminaei, Huda Gomaa, Ying Wang, Liang Yao, Arnav Agarwal, John Basmaji, Alexandre Grant, William S H Kim, Giancarlo Alvarado-Gamarra, Valery Likhvantsev, João Pedro Lima, Shahrzad Motaghi, Rachel Couban, Behnam Sadeghirad, Romina Brignardello-Petersen","doi":"10.1016/j.cmi.2024.05.017","DOIUrl":"10.1016/j.cmi.2024.05.017","url":null,"abstract":"<p><strong>Background: </strong>The optimal empiric antibiotic regimen for non-ventilator-associated hospital-acquired pneumonia (HAP) is uncertain.</p><p><strong>Objectives: </strong>To compare the effectiveness and safety of alternative empiric antibiotic regimens in HAP using a network meta-analysis.</p><p><strong>Data sources: </strong>Medline, EMBASE, Cochrane CENTRAL, Web of Science, and CINAHL from database inception to July 06, 2023.</p><p><strong>Study eligibility criteria: </strong>RCTs.</p><p><strong>Participants: </strong>Adults with clinical suspicion of HAP.</p><p><strong>Interventions: </strong>Any empiric antibiotic regimen vs. another, placebo, or no treatment.</p><p><strong>Assessment of risk of bias: </strong>Paired reviewers independently assessed risk of bias using a modified Cochrane tool for assessing risk of bias in randomized trials.</p><p><strong>Methods of data synthesis: </strong>Paired reviewers independently extracted data on trial and patient characteristics, antibiotic regimens, and outcomes of interest. We conducted frequentist random-effects network meta-analyses for treatment failure and all-cause mortality and assessed the certainty of the evidence using the Grading of Recommendations Assessment, Development and Evaluation approach.</p><p><strong>Results: </strong>Thirty-nine RCTs proved eligible. Thirty RCTs involving 4807 participants found low certainty evidence that piperacillin-tazobactam (RR compared to all cephalosporins: 0.65; 95% CI: 0.42, 1.01) and carbapenems (RR compared to all cephalosporins: 0.77; 95% CI: 0.53, 1.11) might be among the most effective in reducing treatment failure. The findings were robust to the secondary analysis comparing piperacillin-tazobactam vs. antipseudomonal cephalosporins or antipseudomonal carbapenems vs. antipseudomonal cephalosporins. Eleven RCTs involving 2531 participants found low certainty evidence that ceftazidime and linezolid combination may not be convincingly different from cephalosporin alone in reducing all-cause mortality. Evidence on other antibiotic regimens is very uncertain. Data on other patient-important outcomes including adverse events was sparse, and we did not perform network or pairwise meta-analysis.</p><p><strong>Conclusions: </strong>For empiric antibiotic therapy of adults with HAP, piperacillin-tazobactam might be among the most effective in reducing treatment failure. Empiric methicillin-resistant Staphylococcus aureus coverage may not exert additional benefit in reducing mortality.</p><p><strong>Registration: </strong>PROSPERO (CRD 42022297224).</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":null,"pages":null},"PeriodicalIF":10.9,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141186059","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":"Long versus short course anti-microbial therapy of uncomplicated Staphylococcus aureus bacteraemia: a systematic review","authors":"","doi":"10.1016/j.cmi.2024.05.015","DOIUrl":"10.1016/j.cmi.2024.05.015","url":null,"abstract":"<div><h3>Background</h3><p>Current guidelines recommend at least 2 weeks duration of antibiotic therapy (DOT) for patients with uncomplicated <em>Staphylococcus aureus</em> bacteraemia (SAB) but the evidence for this recommendation is unclear.</p></div><div><h3>Objectives</h3><p>To perform a systematic literature review assessing current evidence for recommended DOT for patients with SAB.</p></div><div><h3>Methods</h3><p>The following are the methods used for this study.</p></div><div><h3>Data sources</h3><p>We searched MEDLINE, ISI Web of Science, the Cochrane Database and <span><span>clinicaltrials.gov</span><svg><path></path></svg></span> from inception to March 30, 2024. References of eligible studies were screened and experts in the field contacted for additional articles.</p></div><div><h3>Study eligibility criteria</h3><p>All clinical studies, regardless of design, publication status and language.</p></div><div><h3>Participants</h3><p>Adult patients with uncomplicated SAB.</p></div><div><h3>Interventions</h3><p>Long (&gt;14 days; &gt;18 days; 11–16 days) vs. short (≤14 days; 10–18 days; 6–10 days, respectively) DOT with the DOT being defined as the first until the last day of antibiotic therapy.</p></div><div><h3>Assessment of risk of bias</h3><p>Risk of bias was assessed using the ROBINS-I-tool.</p></div><div><h3>Methods of data synthesis</h3><p>The primary outcome was 90-day all-cause mortality. Only studies presenting results of adjusted analyses for mortality were included. Data synthesis could not be performed.</p></div><div><h3>Results</h3><p>Eleven nonrandomized studies were identified that fulfilled the pre-defined inclusion criteria, of which three studies reported adjusted effect ratios. Only these were included in the final analysis. We did not find any RCT. Two studies with 1230 patients reported the primary endpoint 90-day all-cause mortality. Neither found a statistically significant superiority for longer (&gt;14 days; 11–16 days) or shorter DOT (≤14 days; 6–10 days, respectively) for patients with uncomplicated SAB. Two studies investigated the secondary endpoint 30-day all-cause mortality (&gt;18 days; 11–16 days vs. 10–18 days; 6–10 days, respectively) and did not find a statistically significant difference. All included studies had a moderate risk of bias.</p></div><div><h3>Conclusions</h3><p>Sound evidence that supports any duration of antibiotic treatment for patients with uncomplicated SAB is lacking.</p></div>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":null,"pages":null},"PeriodicalIF":10.9,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1198743X24002520/pdfft?md5=6402721d770d4b012da704165d422475&pid=1-s2.0-S1198743X24002520-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141186048","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":"Revisiting diagnostics: What needs to be discarded and what's next","authors":"","doi":"10.1016/j.cmi.2024.05.021","DOIUrl":"10.1016/j.cmi.2024.05.021","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":null,"pages":null},"PeriodicalIF":10.9,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1198743X24002581/pdfft?md5=f8ee50f6432441ad8b8d4287b694de5a&pid=1-s2.0-S1198743X24002581-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141183735","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":"Gut microbiome and its role in the acquisition of extended-spectrum β-lactamase-producing Enterobacterales","authors":"","doi":"10.1016/j.cmi.2024.05.020","DOIUrl":"10.1016/j.cmi.2024.05.020","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":null,"pages":null},"PeriodicalIF":10.9,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141183741","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 world health organization pandemic agreement draft: considerations by the European Society of Clinical Microbiology and Infectious Diseases Emerging Infections Task Force","authors":"","doi":"10.1016/j.cmi.2024.05.016","DOIUrl":"10.1016/j.cmi.2024.05.016","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":null,"pages":null},"PeriodicalIF":10.9,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141183766","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":"Dialysis-associated infection prevention and surveillance trial: an easy, feasible and effective bundle for infection prevention","authors":"","doi":"10.1016/j.cmi.2024.05.018","DOIUrl":"10.1016/j.cmi.2024.05.018","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":null,"pages":null},"PeriodicalIF":10.9,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141183758","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":"Evaluation of droplet digital polymerase chain reaction by detecting cell-free deoxyribonucleic acid in pleural effusion for the diagnosis of tuberculous pleurisy: a multicentre cohort study","authors":"","doi":"10.1016/j.cmi.2024.05.012","DOIUrl":"10.1016/j.cmi.2024.05.012","url":null,"abstract":"<div><h3>Objectives</h3><p><span>Tuberculous pleurisy<span> is one of the most common types of extra-pulmonary tuberculosis, but the sensitivity of conventional mycobacterial culture (Culture) or Xpert MTB/RIF assay (Xpert) is not satisfying. This multicentre cohort study evaluated the accuracy of a new cell-free DNA </span></span>droplet digital PCR assay (cf-ddPCR) for diagnosing tuberculous pleurisy.</p></div><div><h3>Methods</h3><p>Patients with suspected tuberculosis (≥5 years of age) with pleural effusion were consecutively recruited from nine research sites across six provinces in China between September 2020 to May 2022. Culture, Xpert, Xpert MTB/RIF Ultra assay (Ultra), real-time PCR, and cf-ddPCR were performed simultaneously for all specimens.</p></div><div><h3>Results</h3><p>A total of 321 participants were enrolled, and data from 281 (87.5%) participants were available, including 105 definite tuberculous pleurisy, 113 possible tuberculous pleurisy and 63 non-tuberculous pleurisy according to the composite reference standard. The sensitivity of cf-ddPCR was 90.5% (95/105, 95% CI, 82.8–95.1%) in the definite tuberculous pleurisy group, which was significantly higher than those of Culture (57.1%, 60/105, 95% CI, 47.1–66.6%, p &lt; 0.001), Xpert (46.7%, 49/105, 95% CI, 37.0–56.6%, p &lt; 0.001), Ultra (69.5%, 73/105, 95% CI, 59.7–77.9%, p &lt; 0.001) and real-time PCR (75.2%, 79/105, 95% CI, 65.7–82.9%, p &lt; 0.001). In possible tuberculous pleurisy, whose results of Culture and Xpert were both negative, the sensitivity of cf-ddPCR was 61.1% (69/113, 95% CI, 51.4–70.0%), which was still significantly higher than that of Ultra (27.4%, 31/113, 95% CI, 19.7–36.8%, p &lt; 0.001) and real-time PCR (38.9%, 44/113, 95% CI, 30.0–48.6%, p &lt; 0.001).</p></div><div><h3>Discussion</h3><p>The performance of cf-ddPCR is superior to Culture, Xpert, Ultra, and real-time PCR, indicating that improved diagnostic accuracy can be anticipated by incorporating this new assay.</p></div>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":null,"pages":null},"PeriodicalIF":10.9,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141174695","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":"Cerebrospinal fluid galactomannan detection for the diagnosis of central nervous system aspergillosis: a diagnostic test accuracy systematic review and meta-analysis","authors":"","doi":"10.1016/j.cmi.2024.05.013","DOIUrl":"10.1016/j.cmi.2024.05.013","url":null,"abstract":"<div><h3>Background</h3><p>Cerebrospinal fluid<span> (CSF) galactomannan<span><span> is an adjunctive test for central nervous system (CNS) </span>aspergillosis diagnosis with unclear diagnostic test characteristics.</span></span></p></div><div><h3>Objectives</h3><p><span>To evaluate the diagnostic test characteristics of CSF galactomannan in CNS </span>aspergillosis.</p></div><div><h3>Methods</h3><p>Systematic review and meta-analysis.</p></div><div><h3>Data sources</h3><p><span>MEDLINE, Embase, Web of Science, and </span>Scopus, from inception to 24 February 2023.</p></div><div><h3>Study eligibility criteria</h3><p>Prospective and retrospective studies with 1-group and 2-group designs using any galactomannan<span> assay on CSF to diagnose CNS aspergillosis.</span></p></div><div><h3>Participants</h3><p>Adult and/or paediatric patients with CNS aspergillosis.</p></div><div><h3>Test(s)</h3><p>Galactomannan testing on CSF specimens.</p></div><div><h3>Reference standard</h3><p><span>European Organization for Research and Treatment of Cancer and the </span>Mycoses Study Group Education and Research Consortium (EORTC/MSGERC) diagnostic criteria, or equivalent.</p></div><div><h3>Assessment of risk of bias</h3><p>QUADAS-2 assessment in duplicate.</p></div><div><h3>Methods of data synthesis</h3><p>Bivariate restricted maximum likelihood estimation random-effects meta-analysis, summarized using forest and summary receiver operating characteristic plots; bivariate meta-regression models to investigate heterogeneity; and subgroup and sensitivity analyses to explore subgroup effects and methodologic choices (PROSPERO registration: CRD42022296331; funding: none).</p></div><div><h3>Results</h3><p>We included eight studies (<em>n =</em><span> 342 participants). The summary estimates of CSF galactomannan<span> sensitivity and specificity were 69.0% (95% CI, 57.2–78.7%) and 94.4% (95% CI, 82.8–98.3%), respectively. Using meta-regression, galactomannan cut-off (p = 0.38), EORTC/MSGERC criteria version (p = 0.48), or whether the reference standard was defined as both proven and probable or only proven aspergillosis (p = 0.48) did not explain observed heterogeneity. No subgroup effects were demonstrated by analysing the EORTC/MSGERC criteria reference standard used (e.g. 2002 vs. 2008 definitions) or whether paediatric patients were included. Diagnostic sensitivity was improved using a galactomannan cut-off of 1.0, and by excluding high risk of bias and 1-group design studies.</span></span></p></div><div><h3>Discussion</h3><p>CSF galactomannan is a highly specific but insensitive test for use as a component of CNS aspergillosis diagnosis. Few included studies, no prospective studies, and a high risk of bias are study limitations.</p></div>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":null,"pages":null},"PeriodicalIF":10.9,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141174679","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: lower (1,3)-beta-D-glucan sensitivity and in vitro levels in Candida auris and Candida parapsilosis strains by Mikulska et al.","authors":"Max W Adelman, Truc T Tran, Bhavarth Shukla","doi":"10.1016/j.cmi.2024.05.010","DOIUrl":"10.1016/j.cmi.2024.05.010","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":null,"pages":null},"PeriodicalIF":14.2,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141086793","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}