Clinical Microbiology and Infection最新文献

{"title":"Efficacy of influenza vaccines and its relationship with immunological surrogate endpoints: a systematic review and meta-analysis of RCT.","authors":"Handa Ge, Hong Cao, Jiaxin Lv, Xiao Li, Andrew Lee, Jian Zou, Minghuan Jiang, Lilong Xiao, Yong Gan, Mingwang Shen, Da Feng","doi":"10.1016/j.cmi.2025.09.005","DOIUrl":"https://doi.org/10.1016/j.cmi.2025.09.005","url":null,"abstract":"<p><strong>Background: </strong>Vaccine efficacy may vary due to influenza strain types, their similarity, and vaccine type. The relationship between immunological surrogate endpoints and vaccine efficacy remains unclear, requiring further investigation to optimize vaccination strategies.</p><p><strong>Objective: </strong>This systematic review aims to address two key issues. First, to evaluate the vaccine efficacy stratified by vaccine types and virus strains; Second, to explore the quantitative relationship between immunological surrogate endpoints and vaccine efficacy.</p><p><strong>Data sources: </strong>We searched PubMed, Embase, and ClinicalTrials.gov databases.</p><p><strong>Study eligibility criteria, patients, interventions: </strong>We included randomized controlled trials (RCTs) published by July 16, 2024, that evaluated the efficacy of influenza vaccines against laboratory-confirmed influenza. Phase I/II clinical trials, abstracts, reviews, unregistered trials, duplicate studies, and studies lacking original data or efficacy results were excluded.</p><p><strong>Methods: </strong>This systematic review evaluates influenza vaccine efficacy and immunogenicity, including RCTs with outcomes like Geometric Mean Titer (GMT), seroprotection and seroconversion rates. Data were extracted from multiple databases and assessed using Cochrane and GRADE frameworks.</p><p><strong>Results: </strong>Twenty-six RCTs (104,931 participants) were included. Pooled vaccine efficacy against laboratory-confirmed influenza was 48.48% (95% CI: 41.9-54.29), with significant heterogeneity (I² =70.1%, p < 0.0001). IIVs had the highest vaccine efficacy (54.70%). Among different strains, the vaccine efficacy against H1N1 was the highest, reaching 59.38% (95% CI: 24.60-78.12). We found a significant non-linear relationship between Standardized Mean Difference (SMD) in Hemagglutination Antibody Titer(HAI) concentration and vaccine efficacy against symptomatic infections, but with low explanatory power, and seroconversion rates, seroprotection rates and fold increase in GMT were strongly associated with viral attack rates with Medium explanatory power (p < 0.05 for all), with explanatory values of 0.5038, 0.464, and 0.286, respectively.</p><p><strong>Conclusions: </strong>This systematic review highlights that Influenza vaccines provide moderate protection while Inactivated Influenza Vaccine demonstrate higher efficacy. Seroconversion, seroprotection rates and fold increase in GMT offer limited but valuable insights into vaccine performance. Annual vaccination is crucial for controlling both similar and dissimilar influenza strains.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058435","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":"Defining epidemiological cutoff values for Brucella melitensis: an European multicentre study.","authors":"Flavia Dematheis, Joseph Papaparaskevas, Erika Matuschek, Tara Wahab, Inga Fröding, Marcella Mori, Tiziano Fancello, Veronica Klausmark Jensen, Tone B Johansen, Margrete Solheim, Falk Melzer, Mandy C Elschner, Viviana Manzulli, Domenico Galante, Enrico Mantel, Roland Grunow, Gunnar Kahlmeter, Daniela Jacob, Sabine Zange","doi":"10.1016/j.cmi.2025.09.001","DOIUrl":"10.1016/j.cmi.2025.09.001","url":null,"abstract":"<p><strong>Objectives: </strong>Brucellosis in humans is mainly caused by Brucella melitensis and is associated with a risk of chronic infections and relapses. For appropriate patient treatment decisions and outcomes, clinical breakpoints as well as standard antimicrobial susceptibility testing (AST) procedures, are needed. In this study, a Europe-wide network of Brucella reference laboratories aimed, in close collaboration with the European Committee on Antimicrobial Susceptibility Testing (EUCAST), at establishing standardized AST methods, wild-type (WT) minimum inhibitory concentrations (MICs), and zone diameter distributions, and to set epidemiological cutoff (ECOFF) values for nine therapeutically relevant antimicrobial agents.</p><p><strong>Methods: </strong>A total of 499 B. melitensis strains were tested at six study centres by broth microdilution (BMD) and disc diffusion (DD). MICs and inhibition zone diameters were curated according to EUCAST standard operating procedure (SOP) 10.2, and the results were submitted to EUCAST for ECOFFs and clinical breakpoint determination.</p><p><strong>Results: </strong>BMD and DD data distributions revealed putative wild-type distributions for the tested antimicrobial agents. MIC ECOFFs were determined for all agents based on five to six distributions, encompassing 249 to 499 observations. Six isolates showed MIC values slightly above the ECOFFs, indicating the presence of a potential resistance mechanism to rifampicin, streptomycin, and trimethoprim-sulfamethoxazole. Zone diameter ECOFFs were established for rifampicin and ceftriaxone, whereas tentative (t)ECOFFs were determined for ciprofloxacin, levofloxacin, gentamicin, and streptomycin.</p><p><strong>Discussion: </strong>Standardized BMD and DD methodologies for B. melitensis were validated, and AST results were used by EUCAST to set ECOFFs. Based on these, clinical breakpoints were released in v14.0 of the EUCAST clinical breakpoints table, enabling sensitive detection of resistance mechanisms and monitoring of resistance development. Genetic changes in isolates with slightly elevated MICs remain to be investigated.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058464","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 \"Alternaria infection manifesting as violaceous skin lesions in a solid organ transplant recipient\" [Clin Microbiol Inf (5 August 2025)].","authors":"Auriane Collin, Eleonor Goubeau, Anaïs Gouteron, Marie-Hélène Aubriot-Lorton, Stephane Valot, Sandrine Grosjean, Mathieu Blot, Thibault Sixt","doi":"10.1016/j.cmi.2025.09.007","DOIUrl":"10.1016/j.cmi.2025.09.007","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039275","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":"Towards model-informed precision dosing of intravenous linezolid: a multicentre external evaluation of pharmacokinetic models in critically ill adults.","authors":"Johannes Starp, Antonia Leonhardt, Michael Zoller, Christina Scharf, Johannes Zander, Michael Paal, Sebastian Greppmair, Lea M Schatz, Julian Ermtraud, Alexandra K Kunzelmann, Christina König, Jörn Grensemann, Lana Reiter, Cindy Lau, Deborah Marriott, Sophie L Stocker, Sebastian G Wicha, Uwe Liebchen","doi":"10.1016/j.cmi.2025.08.032","DOIUrl":"https://doi.org/10.1016/j.cmi.2025.08.032","url":null,"abstract":"<p><strong>Objectives: </strong>Linezolid is a frequently utilised antibiotic to treat serious infections caused by resistant pathogens in critically ill patients. Using the currently recommended one-dose-fits-all strategy leads to insufficient target attainment. Model-informed precision dosing (MIPD), an approach combining mathematical models and therapeutic drug monitoring (TDM), can improve target attainment. The underlying population pharmacokinetic (popPK) model must be selected carefully. The aim of this study was to determine which models are applicable for MIPD in critically ill patients treated with intravenous linezolid.</p><p><strong>Methods: </strong>Data for intravenous linezolid administration was obtained from three sites and 166 patients (498 TDM samples). The predictive performance of 30 published popPK models was analysed in three scenarios: considering patients' covariates only (a priori, AP), and including one or two TDM samples (Bayesian forecasting, B1/B2). Metrics used for comparison were median relative prediction error (MDPE) [%], median absolute relative prediction error (MDAPE) [%], and the theoretical target attainment (TTA) [%] for trough concentrations of 2-8 mg/L.</p><p><strong>Results: </strong>The evaluated models were highly heterogeneous in model structure and predictive performance. MDPE, MDAPE and TTA were improved by inclusion of TDM samples. MDPE ranged from -135.9% to 110.9% (AP), -21.1% to 69.7% (B1) and -15.6% to 54.6% (B2). Overall, the lowest MDAPE was demonstrated by the models of Boak, Fang, and Wu. Several models that resulted in similarly good results are also potentially useful for MIPD.</p><p><strong>Conclusion: </strong>Predictive performance varied substantially underlining the importance of model evaluation prior to MIPD implementation for linezolid. Using the aforementioned models promises target attainment rates up to 80% in critically ill patients.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039226","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":"Hybrid and vaccination immunity against severe COVID-19 in the postpandemic era: author's response.","authors":"Ilan Livne, Yair Goldberg, Amit Huppert","doi":"10.1016/j.cmi.2025.08.033","DOIUrl":"10.1016/j.cmi.2025.08.033","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039239","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 \"Rice bodies in Brucellar tenosynovitis: a case report\"[Clin Microbiol Infect (2025)].","authors":"Jiahao Hao, Yumei Guo, Fangyu Qian, Weili Gao, Guangxia Liu, Conghui Cai, Huifen Zuo, Minghui Song, Jiaqing Ye, Chenfeng Zhang, Zhenjun Zhao, Yali Xu, Lijie Zhang","doi":"10.1016/j.cmi.2025.09.006","DOIUrl":"10.1016/j.cmi.2025.09.006","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032759","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 antibiotics for moderate-severe community-acquired pneumonia: we ought to serve patients better!","authors":"Marc Bonten, Valentijn Schweitzer, Henri van Werkhoven","doi":"10.1016/j.cmi.2025.08.029","DOIUrl":"10.1016/j.cmi.2025.08.029","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145005992","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: Platelets and mortality in bloodstream infection: a multicentre cohort study.","authors":"Yuesong Shen, Meiyu Yang, Caihong Zhang, Tiantian Zhang, JianJun Ding","doi":"10.1016/j.cmi.2025.08.031","DOIUrl":"10.1016/j.cmi.2025.08.031","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145005928","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 leukocyte esterase and nitrite tests for diagnosing bacteriuria in older adults: a systematic review and meta-analysis.","authors":"Ana Moragas, Ramon Monfà, Ana García-Sangenís, Carl Llor","doi":"10.1016/j.cmi.2025.08.027","DOIUrl":"10.1016/j.cmi.2025.08.027","url":null,"abstract":"<p><strong>Background: </strong>Urine dipsticks are commonly used for the diagnosis of bacteriuria or urinary tract infections (UTIs).</p><p><strong>Objectives: </strong>To perform a systematic review and meta-analysis to evaluate the accuracy of positive leukocyte esterase or nitrite results from dipsticks (index test) for diagnosing bacteriuria in older individuals, using urine culture as the reference standard.</p><p><strong>Data sources: </strong>MEDLINE (PubMed), EMBASE, and Cochrane Database of Systematic Reviews from the inception date up to September 2025. We also searched the reference lists of all the studies identified.</p><p><strong>Study eligibility criteria: </strong>Both prospective observational cohort and case-control diagnostic studies were included. No language restriction was applied.</p><p><strong>Participants: </strong>Individuals aged ≥60 years with or without symptoms of UTI in the community, nursing homes or hospitalized.</p><p><strong>Assessment of risk of bias: </strong>We used the Quality Assessment tool for Diagnostic Accuracy Studies (QUADAS)-2 tool for assessing risk of bias.</p><p><strong>Methods of data synthesis: </strong>A random-effect meta-analysis was performed to determine the pooled sensitivity, specificity and predictive values of leukocyte esterase or nitrites for the detection of bacteriuria. International Prospective Register of Systematic Reviews (PROSPERO) identifier: CRD42024561882.</p><p><strong>Results: </strong>Of 1933 articles screened, 16 met inclusion criteria and had a moderate risk of bias. Ten studies were hospital-based; six were in nursing homes. Pooled urine dipstick sensitivity and specificity for bacteriuria were 90% (95% CI, 84%-94%) and 56% (43%-68%), respectively (diagnostic OR 11.4; 10.2-12.8). In symptomatic older adults, the sensitivity and specificity for predicting UTI were 92% (76%-97%) and 39% (19%-62%), respectively, with a diagnostic OR of 7.4 (3.9-10.9).</p><p><strong>Discussion: </strong>A positive dipstick result is inconclusive and does not confirm bacteriuria or UTI in symptomatic older adults. Because of high asymptomatic bacteriuria prevalence in older individuals, bacteriuria alone lacks diagnostic value. These findings support discontinuing dipstick testing for UTI diagnosis in this population.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145005930","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":"Aspergillus and host-pathogen interaction: focus on treatment-relevant aspects.","authors":"Romain Manchon, Simon Feys, Martin Hoenigl, Frank L van de Veerdonk, Fanny Lanternier, Joost Wauters, Agostinho Carvalho, Alexandra Serris, Sarah Dellière","doi":"10.1016/j.cmi.2025.08.030","DOIUrl":"10.1016/j.cmi.2025.08.030","url":null,"abstract":"<p><strong>Background: </strong>Invasive aspergillosis (IA) remains a major cause of morbidity and mortality in immunocompromised individuals, with an expanding spectrum of at-risk populations, particularly in intensive care settings. Despite advances in antifungal pharmacotherapy, treatment outcomes remain suboptimal, and the rise of antifungal resistance highlights the need for adjunctive therapy that leverages host immune mechanisms. The pathogenesis of IA is primarily driven by impaired or dysregulated immune responses to Aspergillus species, mainly Aspergillus fumigatus. Host defence involves a complex interplay of innate and adaptive, cellular and humoral immune components. However, this response is not only intricate but also heterogenous, challenging the effectiveness of uniform treatment approaches.</p><p><strong>Objectives: </strong>This review aims to examine the diverse roles of immune components in host-Aspergillus interactions and to explore how these insights are currently informing the development of novel immune-targeted therapies.</p><p><strong>Sources: </strong>A thorough analysis of recent and relevant peer-reviewed literature was conducted to synthesize current understanding of Aspergillus-host interactions and the emerging therapeutic strategies derived from these insights.</p><p><strong>Content: </strong>Following a brief overview of the immunopathogenesis of IA, we integrate findings from both preclinical models and clinical studies to evaluate the potential of immune-based therapies as adjuncts to traditional antifungal treatment. Emphasis is placed on the promise of personalized approaches tailored to individual immune profiles. We also address existing knowledge gaps and outline key directions for future research and clinical application.</p><p><strong>Implications: </strong>A deeper understanding of host immunity in IA paves the way for more precise, effective, and personalized therapeutic strategies, with the potential to significantly improve outcomes in vulnerable patient populations. Although still in its early stages, targeted immunotherapy represents an emerging and promising perspective in infectious diseases management. Insights gained from IA may also inform the development of immune-based interventions for other opportunistic infections.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145005987","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}