Clinical Microbiology and Infection最新文献

{"title":"Pathogen and host determinants of extrapulmonary tuberculosis among 1035 patients in Frankfurt am Main, Germany, 2008-2023.","authors":"Natalia Rachwal, Raja Idris, Viola Dreyer, Elvira Richter, Thomas A Wichelhaus, Stefan Niemann, Nils Wetzstein, Udo Götsch","doi":"10.1016/j.cmi.2024.11.009","DOIUrl":"https://doi.org/10.1016/j.cmi.2024.11.009","url":null,"abstract":"<p><strong>Objectives: </strong>Extrapulmonary tuberculosis (EPTB) presents with nonspecific symptoms which can pose a significant diagnostic challenge. Various factors, including age, sex, and HIV status, have been associated with an increased risk of developing EPTB. However, the influence of the lineage of the infecting Mycobacterium tuberculosis complex (Mtbc) strain remains controversial.</p><p><strong>Methods: </strong>Between 2008 and 2023, comprehensive clinical data from 1035 cases, along with whole genome sequencing (WGS) data of the respective Mtbc strains have been collected. To examine the association between Mtbc lineage and EPTB, we calculated crude and adjusted odds ratios (OR) using logistic regression and performed propensity score matching with a subset of the cohort.</p><p><strong>Results: </strong>Of the 1035 patients, 272 had exclusively extrapulmonary disease and 138 had both pulmonary and extrapulmonary disease. Patients infected with a lineage 1 strain had the highest odds of developing EPTB in the univariate analysis (OR: 3.30, 95% CI: 1.97-5.49). However, Mtbc lineage was not a significant predictor in the multivariable model, while the odds of developing extrapulmonary disease were higher among patients born in the South-East Asian region (adjusted OR: 6.00, 95% CI: 3.41-10.69) and the Eastern Mediterranean Region (adjusted OR: 5.95, 95% CI: 3.61-9.96) compared to those born in the European region. Further, female sex and age were significant positive predictors for EPTB.</p><p><strong>Conclusions: </strong>Our results demonstrate that host factors, such as geographic origin, age and sex are stronger predictors for EPTB than infection with a Mtbc strain of a particular lineage. Further investigation of this host-pathogen interaction is needed.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616076","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":"Aztreonam and Avibactam Combination Therapy for Metallo-β-Lactamase-Producing Gram-Negative Bacteria: A Comprehensive Review.","authors":"Giuseppe Sangiorgio, Maddalena Calvo, Stefania Stefani","doi":"10.1016/j.cmi.2024.11.006","DOIUrl":"https://doi.org/10.1016/j.cmi.2024.11.006","url":null,"abstract":"<p><strong>Background: </strong>Carbapenem-resistant Gram-negative bacteria represent a challenging healthcare threat, accounting for metallo-β-lactamases (MBL) production increase across the world. MBL-producing Enterobacterales and P. aeruginosa represent the main target for ultimate antibiotics combinations due to the difficulty to include carbapenems within the antimicrobial treatment.</p><p><strong>Objectives: </strong>To provide a comprehensive review of the current knowledge about the aztreonam/avibactam (ATM-AVI) combination, which has emerged as a promising option for treating MBL-producing bacteria. Sources Relevant in vitro and in vivo studies on ATM-AVI effectiveness.</p><p><strong>Content: </strong>The review summarizes ATM-AVI characteristics and targets, examining how avibactam restores aztreonam effectiveness against MBLs while protecting it from other β-lactamases. Key in vitro and in vivo studies on ATM-AVI efficacy are presented.</p><p><strong>Implications: </strong>This review provides insights into the potential clinical management implications of ATM-AVI for treating carbapenem-resistant Gram-negative infections, particularly those caused by MBL-producing organisms.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615937","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":"CMI will recognize excellent research by early-career scientists.","authors":"Katharina Last, Jacob Bodilsen, Inmaculada Lopez Montesinos, Leonard Leibovici","doi":"10.1016/j.cmi.2024.11.015","DOIUrl":"https://doi.org/10.1016/j.cmi.2024.11.015","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616015","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":"Timeline and outcomes of viral and fungal infections after Chimeric Antigen Receptor (CAR) T-cell therapy: A large database analysis.","authors":"Joseph Sassine, Nelson Iván Agudelo Higuita, Emily A Siegrist, Arman Saeedi, Michaele Francesco Corbisiero, Patrick Connelly, Alfonso G Bastias, Rita Wilson Dib, José Henao-Cordero, Daniel B Chastain, Chia-Yu Chiu, Andrés F Henao-Martínez","doi":"10.1016/j.cmi.2024.11.008","DOIUrl":"https://doi.org/10.1016/j.cmi.2024.11.008","url":null,"abstract":"<p><strong>Objectives: </strong>This large database analysis aims to describe the incidence, timeline, and risk factors for viral and fungal infections after chimeric antigen receptor (CAR) T-cell therapy.</p><p><strong>Methods: </strong>We queried a global research network database, TriNetX, for patients who received CAR T-cell therapy, who were identified and followed for the development of viral and fungal infections. Baseline demographic, oncologic history, laboratory data and medication histories were collected. We evaluated risk factors for respiratory viral infections (RVI), herpesvirus, fungal infections and mortality using Cox regression.</p><p><strong>Results: </strong>A total of 2,256 patients who received CAR T-cell therapy were included, 1,867 (82.7%) were CD19-targeted and 400 (17.7%) were BCMA-targeted. Following CAR T-cell infusion, RVI were the most prevalent (23.3%) with a median onset of 160 days (IQR 52-348 days), while herpesvirus and fungal infections were less frequent, occurring in 13.6% and 11.4% of cases with median onsets of 71 (IQR 18-252) and 73 days (IQR 14-236 days), respectively. On multivariable Cox regression, independent predictors of RVI included acute lymphoblastic leukemia (ALL, HR 1.61), prior hematopoietic cell transplant (HCT, HR 1.29), cytokine release syndrome (CRS, HR 1.41), hemophagocytic lymphohistiocytosis (HLH, HR 1.96), and glucocorticoids (HR 3.37). Prior HCT (HR 2.00), hypogammaglobulinemia (HR 1.51), immune-effector cell-associated neurotoxicity syndrome (ICANS, HR 1.52), and HLH (HR 1.99) were associated with a higher risk of herpesviruses. Independent predictors of fungal infections included prior HCT (HR 1.59), CRS (HR 1.58) and hypogammaglobulinemia (HR 1.40). Idecabtagene vicleucel was associated with a lower risk of herpesvirus and fungal infections (HR 0.39 and 0.44, respectively).</p><p><strong>Conclusions: </strong>In a large cohort of CAR T-cell therapy recipients, respiratory viral infections were the most common but occurred later, while herpesvirus and fungal infections were less frequent but occurred earlier. Prospective studies investigating prophylaxis and pre-emptive monitoring strategies are needed in this population.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616090","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":"Editorial: Advances in Infectious Disease Treatments - Innovations and Regulatory Pathways against Emerging Challenges.","authors":"Markus Zeitlinger","doi":"10.1016/j.cmi.2024.11.011","DOIUrl":"https://doi.org/10.1016/j.cmi.2024.11.011","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615947","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":"Accuracy of Xpert and alternative sampling methods to diagnose childhood pulmonary tuberculosis, a prospective cohort study.","authors":"Lou Macaux, Voahangy Rasolofo, Sara Eyangoh, Kouassi Raymond N'Guessan, Mathurin Cyrille Tejiokem, Niaina Rakotosamimanana, Man-Koumba Soumahoro, Simon Cauchemez, Rindra Vatosoa Randremanana","doi":"10.1016/j.cmi.2024.11.002","DOIUrl":"https://doi.org/10.1016/j.cmi.2024.11.002","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of the study was to estimate sensitivity and specificity of childhood pulmonary tuberculosis (CPTB) diagnostic tests, including Xpert and alternative samples such as nasopharyngeal aspirate and stool. We used latent class analysis to overcome the lack of gold standard.</p><p><strong>Methods: </strong>We included 1165 children suspected of having CPTB in a prospective cohort study conducted in Ivory Coast, Madagascar, and Cameroon. We used Bayesian latent class analysis to evaluate the performance of multiple diagnostic tests for CPTB: smear microscopy, mycobacterial culture, and Xpert MTB/RIF carried out on different types of samples (sputum after 10 years of age, gastric aspirate before 10 of age, nasopharyngeal aspirate, stool), tuberculin skin test (TST), and chest X-ray.</p><p><strong>Results: </strong>Median age was 3.5 years (95% credible interval [1.3-8.2]). Smear microscopy was highly specific in all types of samples but lacked sensitivity (sputum 31% (95% credible interval [18-46]), gastric aspirate 36% [27-45], nasopharyngeal aspirate 24% [17-32], stool 24% [17-32]). Culture sensitivity was slightly higher in gastric (75% [65-83]) than nasopharyngeal aspirate (64% [54-72]). Xpert sensitivity was similar in gastric (69% [59-78]) and nasopharyngeal aspirate (66% [57-74]) but lower in sputum (58% [43-74]) and stools (53% [44-62]). Xpert was highly specific in all respiratory samples (sputum 96% [96-100], gastric aspirate 100% [99-100], nasopharyngeal aspirate 100% [99-100]).</p><p><strong>Conclusions: </strong>Xpert performed on nasopharyngeal aspirate shows similar accuracy than culture. It was also similar to that in gastric aspirate. It highlights it's an interesting CPTB diagnostic combination.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615924","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 a novel non-boric acid-based container for preserving uropathogens in urine samples.","authors":"Julie May Jensen, Charlotte Nielsen Agergaard, Kasper Klein, Flemming Schønning Rosenvinge, Kristian Stærk","doi":"10.1016/j.cmi.2024.11.003","DOIUrl":"https://doi.org/10.1016/j.cmi.2024.11.003","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615951","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":"Persistent vaccine-elicited humoral immune imprinting in Tibetans: a matched cohort study in Tibet.","authors":"Yufang Zhu, Yingying Lu, Aili Lu, Caili Zhou, Kebocuo, Peng Hong","doi":"10.1016/j.cmi.2024.10.029","DOIUrl":"https://doi.org/10.1016/j.cmi.2024.10.029","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616081","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":"Functional outcome after infectious encephalitis: a longitudinal multicenter prospective cohort study.","authors":"Pierre Fillâtre, Alexandra Mailles, Jean Paul Stahl, Ronan Garlantezec, Marion Le Marechal, Pierre Tattevin, Sophie Abgrall, Guillaume Baille, Aurélie Baldolli, Kevin Bertrand, Julien Biberon, Charlotte Biron, Geneviève Blanchet-Fourcade, Mathieu Blot, Anne Bonnetain, Elisabeth Botelho-Nevers, David Boutoille, Hélène Brasme, Cédric Bruel, Rodolphe Buzele, Etienne Canouï, Bernard Castan, Charles Cazanave, Céline Cazorla, Thibault Challan-Belval, Pascal Chavanet, Catherine Chirouze, Tomasz Chroboczek, Johan Courjon, Thomas De Broucker, Arnaud De La Blanchardière, Etienne de Montmollin, Eric Denes, Aurélien Dinh, Olivier Epaulard, Pierre Fillatre, Emmanuel Forestier, Amandine Gagneux-Brunon, Nicolas Gaillard, Julien Gautier, François Goehringer, Simon Gravier, Isabelle Gueit, Thomas Guimard, Carole Henry, Jean-Etienne Herbrecht, Fanny Jomier, Snejana Jurici, Solene Kerneis, Jessica Krause, Manuela Le Cam, Marion Le Maréchal, Gwenael Le Moal, Paul Le Turnier, Raphael Lecomte, Anne-Sophie Lecompte, Romain Lefaucheur, Olivier Lesieur, Philippe Lesprit, Guillaume Louis, Rafael Mahieu, Alain Makinson, Guillaune Marc, Alexandre Maria, Nathalie Marin, Guillaume Martin-Blondel, Martin Martinot, Alexandre Mas, Philippe Mateu, Laurence Maulin, Frédéric Mechai, Eugénie Mutez, Jérémie Orain, Anne Schieber-Pachart, Nathalie Pansu, Solene Patrat-Delon, Patricia Pavese, Hélène Pelerin, Véronique Pelonde-Erimée, Diane Ponscarme, Mathilde Puges, Vincent Roubeau, Yvon Ruch, Isabelle Runge, Romain Sonneville, Pierre Tattevin, Saber Touati, Jean-Marie Turmel, Isabelle Tyvaert, Marc-Olivier Vareil, Virginie Vitrat, Heidi Wille, Mathieu Zuber, Emmanuel Canet, Jean Reignier, Adrien Wang","doi":"10.1016/j.cmi.2024.11.001","DOIUrl":"https://doi.org/10.1016/j.cmi.2024.11.001","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to describe longitudinal functional outcome among survivors after an infectious encephalitis (IE) and to analyze risk factors for poor functional outcome.</p><p><strong>Methods: </strong>Patients included in the prospective ENCEIF cohort (France, 2016-2019) were followed-up at 6 months and one year after hospital discharge for assessment of i) functional outcome using modified Rankin scale (mRS); ii) cognitive function and abilities to perform activities of daily living. Risk factors for poor outcome on the full distribution of mRS were estimated using multivariable mixed ordinal regression analysis with time between hospital discharge and follow-up as a covariate.</p><p><strong>Results: </strong>Our follow-up study included 322 patients with 896 mRS evaluations. Median age was 66 [50-74] years, 197/322 were male (61%) and 35/322 were immunocompromised (11%). Causative agents were herpes simplex virus 1 (HSV-1) in 95/322 cases (30%), varicella zoster virus (VZV) in 46/322 cases (14%), others documented IE in 90/322 cases (28%) and unknown in 91/322 cases (28%). Intensive care unit (ICU) admission was necessary for 117/322 patients (36%). Brain imaging was abnormal in 180/311 (58%) of patients. At 6 months, 95/287 (33%) had fully recovered and 181/287 (63%) had persisting symptoms. At 12 months, 124/253 (49%) had fully recovered and 108/253 (43%) had persisting symptoms. The proportion of patients who improved was 41% (117/287) during the first 6 months, and 24% (52/218) between 6 and 12 months. Factors significantly associated with poor functional outcome were age, immunosuppression, ICU admission, abnormal brain imaging and causative agents, notably HSV-1. Follow-up visit during the first 120 days did not detect significant change in functional outcome, but was strongly associated with better outcome at the subsequent evaluation.</p><p><strong>Conclusions: </strong>After IE, improvement may take several months. Functional outcome is associated with baseline health status (age, immunosuppression), abnormal brain imaging, ICU admission, and causative agent.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615963","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 use viral receptor mapping and particle deposition models to predict the clinical severity of novel airborne pathogens?","authors":"Kineshta Pillay, Linsey C Marr, Andre Henriques, Andrew R Martin, Aaron J Prussin, Luis Aleixo, Marco Andreini, Nicolas Mounet, Warren H Finlay, Julian W Tang","doi":"10.1016/j.cmi.2024.11.005","DOIUrl":"https://doi.org/10.1016/j.cmi.2024.11.005","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616003","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}