Clinical Microbiology and Infection最新文献

{"title":"Reassessing host genetic susceptibility to tick-borne encephalitis: evidence from a systematic review and meta-analysis.","authors":"Piyush Gampawar, Daniel Ruzek, Benno Kohlmaier, Markus Seidel, Werner Zenz","doi":"10.1016/j.cmi.2026.10.004","DOIUrl":"https://doi.org/10.1016/j.cmi.2026.10.004","url":null,"abstract":"<p><strong>Background: </strong>Host genetic factors have been proposed to influence susceptibility to tick-borne encephalitis (TBE), but findings from candidate-gene association studies have been inconsistent.</p><p><strong>Objective: </strong>To evaluate evidence for common genetic variants associated with TBE susceptibility and severity by synthesising candidate-gene and genome-wide association study (GWAS) data.</p><p><strong>Methods: </strong>Data source: PubMed and Web of Science were searched for studies published between January 2005 and December 2025 following PRISMA 2020 guidelines.</p><p><strong>Study eligibility criteria: </strong>Case-control studies of laboratory-confirmed TBE reporting genotype or allele frequencies sufficient to estimate effect sizes.</p><p><strong>Participants: </strong>The review included 16 candidate-gene studies and one European consortium GWAS, comprising 3,759 patients with TBE (1,521 mild; 1,454 severe) and 11,771 controls from nine countries. Assessment of risk of bias: Methodological quality was assessed using the Q-Genie tool.</p><p><strong>Methods: </strong>of data synthesis: Random-effects meta-analyses were performed for variants investigated in ≥4 datasets. Heterogeneity, publication bias, subgroup analyses, and minimum detectable odds ratios (MDORs) were assessed.</p><p><strong>Results: </strong>Four variants met the criteria for quantitative synthesis. No significant associations with TBE susceptibility were observed for CCR5 rs333 (OR = 1.12, 95% CI = 0.98-1.29), TLR3 rs3775291 (OR = 0.87, 95% CI = 0.68-1.10), IL10 rs1800872 (OR = 0.97, 95% CI = 0.88-1.08), or CD209 rs2287886 (OR = 0.96, 95% CI = 0.80-1.15). Analyses of severe disease yielded similarly null results. MDOR analyses indicated adequate power to detect moderate genetic effects (OR≈1.12-1.18), indicating that any true effects are likely to be small.</p><p><strong>Conclusions: </strong>This study provides the most comprehensive synthesis of TBE genetic association studies to date and demonstrates that the most extensively investigated genetic variants are unlikely to serve as clinically useful predictors of TBE susceptibility or severity, supporting genome-wide discovery, rare variant analyses, and integrative approaches to identify biologically relevant host determinants of TBE.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166909","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: 'Pharmacokinetics, target attainment and outcomes of piperacillin/tazobactam in critically ill patients receiving continuous infusion with therapeutic drug monitoring: a retrospective analysis' by Chiriac et al.","authors":"Pier Giorgio Cojutti, Federico Pea","doi":"10.1016/j.cmi.2026.09.036","DOIUrl":"https://doi.org/10.1016/j.cmi.2026.09.036","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165443","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":"Integrating Infectious Disease Experts into Primary Care Antibiotic Stewardship: A Multicentre, Cluster-Randomised, Outcome-Assessor-Blinded Trial.","authors":"Mar Ronda, Ariadna Padullés, Jordi Carratalà, Cinta Estrada, Ana Lérida, Fe Tubau, Gemma Rodríguez, Pere Simonet, Lluïsa Gardeñes, Rosa Freixedas, Montserrat López, Sara Cobo-Sacristán, Judith Peñafiel, Mireia Puig-Asensio, Evelyn Shaw","doi":"10.1016/j.cmi.2026.09.034","DOIUrl":"https://doi.org/10.1016/j.cmi.2026.09.034","url":null,"abstract":"<p><strong>Objective: </strong>To assess the impact of integrating infectious disease (ID) experts into primary care antimicrobial stewardship (AMS) programmes on antibiotic consumption and prescribing adequacy for upper respiratory tract infections (URTIs) and urinary tract infections (UTIs).</p><p><strong>Methods: </strong>A multicentre, cluster-randomised trial across six primary care centres in Catalonia, Spain. All centres implemented a standard AMS programme, with three randomised to an advanced AMS (receiving ID expert support via a telephone helpline and biweekly meetings). The primary endpoint was total antibiotic consumption (defined daily doses per 1,000 inhabitants per day [DID]). Secondary endpoints included unnecessary and inadequate prescriptions, and 30-day reconsultations or hospitalisations, evaluated through point-prevalence surveys in patients aged over 14 years with URTI or UTI.</p><p><strong>Results: </strong>Between October 2021 and March 2023, overall antibiotic consumption increased from 7.08 (SD 1.29) to 7.79 (SD 1.65) DID (mean difference +0.71 [95% CI 0.13;1.28]). This rise was lower under advanced AMS, from 7.16 (SD 1.33) to 7.56 (SD 1.44) DID (+0.40 [95% CI -0.40;1.20]) than standard AMS, from 7.00 (SD 1.29) to 8.01 (SD 1.82) DID (+1.01 [95% CI 0.15;1.88]). During the intervention, Poisson regression showed a 4% monthly DID increase (IRR 1.04 [95% CI 1.01;1.06]), without intergroup differences (IRR 0.95 [95% CI 0.19;4.74]). Across 1,389 URTI/UTI episodes, 25.0% of prescriptions were unnecessary and 50.3% of indicated treatments were inadequate. By intervention end, advanced AMS reduced unnecessary (21.2% vs 28.3%; OR 0.68 [95% CI 0.51;0.91]) and inadequate prescriptions (38.8% vs 52.9%; OR 0.54 [95% CI 0.36;0.81]) compared with standard AMS. Reconsultations or hospitalisations showed no significant differences.</p><p><strong>Conclusion: </strong>Integrating ID experts into primary care AMS did not demonstrate a statistically significant reduction in total antibiotic use. However, the data suggest a positive impact on prescribing quality without compromising patient safety. Health policymakers should consider embedding ID expertise within primary care AMS frameworks.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135282","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":"Caspofungin tolerance driving treatment failure in persistent Candida tropicalis bloodstream infection: a case report.","authors":"Yongqin Wu","doi":"10.1016/j.cmi.2026.09.033","DOIUrl":"10.1016/j.cmi.2026.09.033","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127016","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":"Group B Streptococcus serotype-specific IgG immunity in mother-newborn dyads in South Asian and African countries: a multicountry study, 2016-2018.","authors":"Gaurav Kwatra, Alane Izu, Christian Mukendi, Nisha Dhar, Musa Mohammed Ali, Godwin Akaba, Zabed Ahmed, Manisha Madhai Beck, Hellen Cherono Barsosio, James A Berkley, Tolossa Eticha Chaka, Anélsio Cossa, Sowmitra Ranjan Chakraborty, Clare L Cutland, Phurb Dorji, Maksuda Islam, Adama Mamby Keita, Stella Mwakio, Salim Mwarumba, Nubwa Medugu, Feleke Belachew Lema, Stephen Obaro, Eyinade K Olateju, Betuel Sigaúque, Samba O Sow, Samir K Saha, Sridhar Santhanam, Ragunath Sharma, Eric A F Simões, Rani Diana Sahni, Milagritos D Tapia, Balaji Veeraraghavan, Shabir A Madhi","doi":"10.1016/j.cmi.2026.09.032","DOIUrl":"10.1016/j.cmi.2026.09.032","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate sero-epidemiology of maternal and cord blood Group B Streptococcus (GBS) serotype-specific capsular polysaccharide (CPS) IgG concentrations and transplacental antibody transfer across diverse low middle-income country populations.</p><p><strong>Methods: </strong>We conducted a multicountry, cross-sectional study among pregnant women without human immunodeficiency virus (HIV) infection and their newborns across six African (South Africa, Kenya, Mozambique, Ethiopia, Mali and Nigeria) and three South Asian countries (Bhutan, Bangladesh and India). Maternal and cord blood samples were collected at delivery and analysed using a multiplex immunoassay for serotype-specific CPS GBS IgG.</p><p><strong>Results: </strong>We analysed 2293 mother-newborn dyads. Maternal serotype-specific CPS-IgG concentrations varied significantly by country and serotype. Most women had detectable serotype-specific IgG antibodies, with >95% of participants having detectable antibodies against serotypes II, III, and IV across most countries, whereas lower proportions were observed for serotypes Ib and V. Serotype II demonstrated the most efficient transplacental transfer ratios with geometric mean ratios (GMRs) ranging from 0.80 (95% CI 0.74-0.85) in South Africa to 1.16 (95% CI 1.07-1.27) in Bhutan. Transfer was generally lower for other serotypes, particularly in Kenya, where GMRs ranged from 0.51 (95% CI 0.46-0.58) for serotype IV to 0.81 (95% CI 0.73-0.91) for serotype II. The proportions of newborns above the serotype-specific serological thresholds of risk reduction varied widely across countries ranging from 10.0% to 56.8% for serotype Ia and 13.5% to 68.0% for serotype III. Bangladesh consistently had the highest maternal and cord blood antibody concentrations, whereas Bhutan and Ethiopia had the lowest.</p><p><strong>Conclusions: </strong>Marked geographic and serotype-specific variability in maternal and neonatal GBS IgG concentration was observed across South Asian and African countries. These findings provide important information on baseline naturally acquired immunity and transplacental antibody transfer, which may inform the evaluation and implementation of maternal GBS vaccines in diverse populations.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104862","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":"Clinical significance of Dientamoeba fragilis and Blastocystis: Lessons from clinical trials, cohort studies, and faecal microbiota transplantation - a narrative review.","authors":"Ludovico Cobuccio, Keyvan Moser, Damien Jacot, Nathalie Kapel, Anastasios D Tsaousis, Tatiana Galperine","doi":"10.1016/j.cmi.2026.09.031","DOIUrl":"https://doi.org/10.1016/j.cmi.2026.09.031","url":null,"abstract":"<p><strong>Background: </strong>The adoption of highly sensitive syndromic multiplex PCR panels led to an increase in Blastocystis and Dientamoeba fragilis detection, two of the most commonly identified intestinal protists worldwide. With positivity rates of 15-25% on syndromic gastrointestinal panels, a positive result frequently triggers antimicrobial treatment despite uncertain clinical significance.</p><p><strong>Objectives: </strong>To synthesise multi-dimensional evidence on the pathogenicity of Blastocystis and D. fragilis from multiple lines of investigation and to propose a pragmatic clinical decision framework for interpreting positive test results.</p><p><strong>Sources: </strong>A systematic search of PubMed/MEDLINE (inception to January 2026) was conducted using structured queries for Blastocystis and D. fragilis across thematic blocks: epidemiology, molecular diagnosis, pathogenicity mechanisms, clinical trials, faecal microbiota transplantation (FMT), and microbiome associations. No language restriction was applied. Study selection prioritised randomised controlled trials, prospective FMT cohorts, large-scale metagenomic analyses, and systematic reviews. Reference lists of retrieved articles were manually screened.</p><p><strong>Content: </strong>Current evidence suggests asymptomatic carriage is the biological norm for both organisms, and no specific subtypes, genotypes, or parasite load thresholds have been consistently linked to disease. Three placebo-controlled randomised controlled trials (RCTs) showed no treatment benefit: two conducted in paediatric populations and one an adult pilot study. FMT cohort studies demonstrate safe transmission without adverse events. Metagenomic analyses of nearly 57,000 individuals have identified an association between Blastocystis carriage, greater microbial diversity, and more favourable cardiometabolic profiles, although the direction and causality of these relationships remain unclear.</p><p><strong>Implications: </strong>In immunocompetent hosts, detection of Blastocystis or D. fragilis does not indicate disease; for Blastocystis in particular, carriage should be regarded as an ecological marker of the intestinal microbiota. A clinical decision algorithm is proposed in which reassurance is the default, treatment is reserved for exceptional circumstances (severe immunosuppression or chronic unexplained symptoms after thorough exclusion of alternative diagnoses), and clinical response, not PCR clearance, serves as the only meaningful endpoint.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104836","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":"Sporothrix brasiliensis infection refractory to antifungal therapy.","authors":"Regielly Caroline Raimundo Cognialli, Bram Spruijtenburg, Carolina Melchior do Prado, Germana Davila Dos Santos, Theun de Groot, Giovanni L Breda, Vânia Aparecida Vicente, Eelco F J Meijer, Flávio de Queiroz-Telles","doi":"10.1016/j.cmi.2026.09.026","DOIUrl":"10.1016/j.cmi.2026.09.026","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104902","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 new antibacterial drugs we need?","authors":"Leonard Leibovici, Dafna Yahav, Mical Paul, Jesus Rodríguez-Baño","doi":"10.1016/j.cmi.2026.09.027","DOIUrl":"10.1016/j.cmi.2026.09.027","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149080001","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":"Retraction notice to \"Prevalence of Coxiella burnetii and Bartonella species as cases of infective endocarditis in Marseilles (1994-2007)\" [CMI 15 (S2) 152-153].","authors":"J-P Casalta, F Gouriet, H Richet, F Thuny, G Habib, D Raoult","doi":"10.1016/j.cmi.2026.09.029","DOIUrl":"10.1016/j.cmi.2026.09.029","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073733","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":"Closing the Surveillance-to-Stewardship Gap in antimicrobial resistance: a narrative review of global lessons from WHO GLASS, UK ESPAUR, and low- and middle-income countries.","authors":"Rasha Abdelsalam Elshenawy, Ada Cernaliu, Omobolanle Margaret Abe, Rishal Dsouza, Shumonto Mowla Chowdhury","doi":"10.1016/j.cmi.2026.09.020","DOIUrl":"10.1016/j.cmi.2026.09.020","url":null,"abstract":"<p><strong>Background: </strong>Antimicrobial resistance surveillance has expanded faster than any other component of the global response, yet resistance continues to rise. In a growing number of settings, the principal constraint is the failure to translate available data into action, a disconnect we describe as the Surveillance-to-Stewardship (S2S) Gap.</p><p><strong>Objectives: </strong>To define the S2S Gap and its component gaps, examine where it binds across health systems of different maturity, analyse why it persists, and propose an operationalizable, testable framework for closing it.</p><p><strong>Sources: </strong>A cross-sectional analysis of WHO Global Antimicrobial Resistance and Use Surveillance System (GLASS) participation across all 55 South Centre member states; the UK English Surveillance Programme for Antimicrobial Utilisation and Resistance programme (2019-2024); published implementation studies from India, Nigeria, and Bangladesh, read alongside three sector-specific systematic syntheses conducted by our group, all now published; and comparative governance analyses and implementation-science frameworks.</p><p><strong>Content: </strong>Adopting the GLASS conception of surveillance (resistance plus antimicrobial use data), the gap recurs but binds at different stages by system maturity: as incomplete surveillance in many low- and middle-income countries (27% [15/55] of the states report both data types), as absent operational stewardship machinery despite near-universal awareness and policy, and as uncertain policy-to-outcome translation in the mature UK system, where a 2% fall in use has not yet been accompanied by falling resistance, for reasons that current data cannot distinguish. Six structural drivers (multilevel governance, diagnostics, workforce, financing, behaviour, and implementation capacity) explain persistence. South Africa illustrates process-level narrowing. The S2S Framework, a five-stage pathway from surveillance to outcomes aligned with Consolidated Framework for Implementation Research, Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM), and a One Health perspective, enables stage diagnosis and targeted intervention.</p><p><strong>Implications: </strong>Closing the gap requires funding translation as deliberately as data generation, with actions for WHO, governments, health systems, and funders, and an explicit agenda for empirically evaluating the framework itself.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073707","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}