Clinical Microbiology and Infection最新文献

{"title":"Patterns of outpatient antibiotic prescribing in older adults by social determinants of healthcare access: a population-based retrospective cohort study.","authors":"Mia E Sapin, Colleen J Maxwell, Anna E Clarke, Curtis Cooper, Miranda So, Kevin L Schwartz, Nick Daneman, Sharmistha Mishra, Derek R MacFadden","doi":"10.1016/j.cmi.2025.02.025","DOIUrl":"10.1016/j.cmi.2025.02.025","url":null,"abstract":"<p><strong>Objectives: </strong>Strategies to improve antibiotic use may exacerbate health inequities if they do not consider existing barriers to healthcare access. We examined associations between social determinants of healthcare access (SDOH) and antibiotic prescribing and variations in these associations pre- and post-COVID-19 emergence.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of community-dwelling adults aged ≥66 years in Ontario, Canada, between March 2018 and March 2020 (pre-pandemic period) and March 2020 and March 2022 (pandemic period). Multivariable Fine-Gray subdistribution hazard models were used to examine associations between three SDOH variables (neighbourhood-level income and proportion racialized, and individual-level recent immigration) and incident antibiotic prescriptions, accounting for mortality as a competing risk. We assessed for potential effect modification by the pandemic period.</p><p><strong>Results: </strong>The pre-pandemic (n = 2 567 382) and pandemic (n = 2 744 337) cohorts were similar in average age (75 years). Antibiotic prescribing was slightly higher among residents in the highest income neighbourhoods in pre-pandemic (subdistribution hazard ratio [sHR], 1.03 [95% CI, 1.02-1.04], compared with lowest income) and pandemic (sHR, 1.02 [1.01-1.03]) periods. Prescribing was higher among recent immigrants (vs. long-term residents) in both periods, with a more pronounced difference observed during the pandemic (sHR, 1.21 [1.18-1.25]) than pre-pandemic (sHR, 1.12 [1.09-1.16]) period. Prescribing was lower among residents living in the most diverse neighbourhoods (vs. least diverse) in both periods, with a more pronounced difference during the pandemic (sHR, 0.81 [0.80-0.82]) than pre-pandemic (sHR, 0.92 [0.91-0.93]) period.</p><p><strong>Discussion: </strong>SDOH variables are associated with antibiotic prescribing patterns over time among older outpatients, and the COVID-19 pandemic further modified some of these associations.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540459","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":"Revisiting diagnostics: practical application of next-generation sequencing technologies for infectious diseases.","authors":"Lucía Henríquez, Ander Uribarri, Maria Eugenia Portillo","doi":"10.1016/j.cmi.2025.02.032","DOIUrl":"10.1016/j.cmi.2025.02.032","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536881","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: Long-term outcomes of patients with central nervous system tuberculosis in a high-income country: a retrospective study.","authors":"Lucas Khellaf, Adrien Cottu, Nathan Peiffer-Smadja, Laurence Armand-Lefevre, Romain Sonneville, Michael Thy","doi":"10.1016/j.cmi.2025.02.028","DOIUrl":"10.1016/j.cmi.2025.02.028","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536875","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":"Investigator-initiated randomized clinical trials in infectious diseases: the BALANCE experience.","authors":"Nick Daneman, Asgar H Rishu, Ruxandra Pinto, Yaseen M Arabi, Deborah J Cook, Richard Hall, John Muscedere, Rachael Parke, Steven Reynolds, Benjamin Rogers, Yahya Shehabi, Robert A Fowler","doi":"10.1016/j.cmi.2025.02.033","DOIUrl":"10.1016/j.cmi.2025.02.033","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536874","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 relationship between diagnostic and antimicrobial stewardship: trusting blood cultures alone in diagnosis of cholangitis.","authors":"Lauro Damonti, Angela Huttner, Niccolò Buetti","doi":"10.1016/j.cmi.2025.02.034","DOIUrl":"10.1016/j.cmi.2025.02.034","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536885","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":"Revisiting diagnostics: introduction of new technologies.","authors":"Jordi Vila, Arturo Martínez-Trejo, Elisa Rubio, Laura Horvath, Mariana Fernández-Pittol, Climent Casals-Pascual","doi":"10.1016/j.cmi.2025.02.035","DOIUrl":"10.1016/j.cmi.2025.02.035","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536879","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":"Safety and immunogenicity of hepatitis E vaccine in compensated liver cirrhosis with chronic hepatitis B.","authors":"Xuejiao Liao, Dapeng Li, Yingying Su, Xinwu Wang, Shuting Wu, Yanling Chen, Zhiyu Li, Qiyuan Tang, Zhenghua Ma, Xiaobin Wan, Jingke Dong, Liping Zhang, Changxiang Lai, Haiyan Wang, Qing He, Jun Zhang, Fang Wang, Zheng Zhang","doi":"10.1016/j.cmi.2025.02.027","DOIUrl":"10.1016/j.cmi.2025.02.027","url":null,"abstract":"<p><strong>Objectives: </strong>Hepatitis E virus (HEV) is a global health concern that causes acute hepatitis with severe consequences, particularly in patients with chronic liver disease. Despite the availability of a recombinant hepatitis E vaccine (Hecolin), its safety and immunogenicity in patients with pre-existing liver cirrhosis remain uncertain. This study aimed to assess the safety and immunogenicity of Hecolin in individuals with compensated liver cirrhosis who have chronic hepatitis B (CHB).</p><p><strong>Methods: </strong>This study was conducted in Shenzhen City, China, from November 2019 to June 2022. The adult participants were stratified into untreated CHB, CHB treatment, CHB cirrhosis, and control groups based on their disease status. Safety assessment included adverse events and liver function tests. Serological samples were collected before vaccination and 1 month after both the first and third doses of vaccination to assess anti-HEV IgG antibodies.</p><p><strong>Results: </strong>A total of 162 eligible participants, including 43 with CHB cirrhosis, 50 with treated CHB, 50 with untreated CHB, and 19 controls were included in the study. A total of 157 (96.9%) participants received three doses of the vaccine. Safety analysis revealed 7-day local adverse events in 13.95.0%, 24.0%, 12.0%, and 5.26% and systemic adverse events in 6.98%, 12.0%, 4.0%, and 0% across the cirrhosis, treated, untreated, and control groups, respectively. No serious adverse events were deemed to be causally related to vaccination. In the per-protocol set for immunogenicity, all vaccinated participants with cirrhosis (95% CI, 88.1-100%) were seroconverted, and 82.8% (24/29) had anti-HEV IgG levels higher than 1.0 WU/mL at 1 month after the final dose (median, 38 days; interquartile range, 31-44).</p><p><strong>Discussion: </strong>This study suggests that Hecolin is safe and immunogenic in patients with CHB with compensated liver cirrhosis, supporting its use in preventing HEV superinfection in this high-risk population.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536883","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: Decoding community-acquired pneumonia by Fally et al.","authors":"Josselin Le Bel, Clara Flateau, Sarah Tubiana, Yann-Erick Claessens, Xavier Duval","doi":"10.1016/j.cmi.2025.02.031","DOIUrl":"10.1016/j.cmi.2025.02.031","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536877","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":"Enhancing antimicrobial stewardship: recommendations to support implementation of the 2024 UN General Assembly political declaration on antimicrobial resistance.","authors":"Filippo Medioli, Nathan Peiffer-Smadja, Lucy Catteau, Rita Murri, Jeroen A Schouten, Karin Thursky, Mark G J de Boer, Diane Ashiru-Oredope","doi":"10.1016/j.cmi.2025.02.024","DOIUrl":"10.1016/j.cmi.2025.02.024","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536873","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":"Diagnostic accuracy of 16S rDNA PCR, multiplex PCR and metagenomic next-generation sequencing in periprosthetic joint infections: a systematic review and meta-analysis.","authors":"Flaminia Olearo, Said El Zein, Maria Eugenia Portillo, Antonia Zapf, Holger Rohde, Elie F Berbari, Marjan Wouthuyzen-Bakker","doi":"10.1016/j.cmi.2025.02.022","DOIUrl":"10.1016/j.cmi.2025.02.022","url":null,"abstract":"<p><strong>Background: </strong>The diagnostic accuracy of 16S rDNA PCR, multiplex PCR (mPCR), and metagenomic next-generation sequencing (mNGS) in periprosthetic joint infections (PJIs) remains unclear.</p><p><strong>Objectives: </strong>This study aims to evaluate the diagnostic accuracy of 16S rDNA PCR, mPCR, and mNGS in PJI.</p><p><strong>Methods: </strong>Data sources: Data sources included PubMed and Embase (January 1, 2000-March 1, 2024), with no language restrictions.</p><p><strong>Study eligibility criteria: </strong>Studies containing sufficient data to construct a 2 × 2 contingency table allowing for sensitivity and specificity calculation were considered.</p><p><strong>Participants: </strong>Participants included adults (≥18 years) with PJI and appropriate control groups.</p><p><strong>Tests: </strong>Tests included 16S rDNA PCR, mPCR, and mNGS.</p><p><strong>Reference standard: </strong>Diagnosis required adherence to Musculoskeletal Infection Society, Infectious Diseases Society of America, International Consensus Meeting, European Bone and Joint Infection Society criteria. Studies employing alternative author-defined criteria were included only if they did not rely solely on positive cultures to define PJI.</p><p><strong>Assessment of risk of bias: </strong>Quality Assessment of Diagnostic Accuracy Studies 2 was used.</p><p><strong>Methods of data synthesis: </strong>A bivariate model calculated pooled diagnostic odds ratios (DORs), sensitivities, and specificities, each with 95% CIs.</p><p><strong>Results: </strong>Seventy-nine studies were included, comprising 3940 PJI cases and 4700 uninfected controls. Pooled sensitivity/specificity were 80.0% (95% CI, 75.4-84.3%)/94.0% (95% CI, 91-96%) for 16S rDNA PCR; 62.2% (52.5-70.9%)/96.2% (93.2-97.9%) for mPCR; and 88.6% (83.3-92.4%)/93.2% (89.5-95.6%) for mNGS. Notably, mNGS had the highest DOR (105.9; 95% CI, 60-186.9). A sensitivity analysis excluding lower-quality studies resulted in increased DORs for all methods.</p><p><strong>Discussion: </strong>These molecular techniques display strong diagnostic accuracy for identifying PJI. Although mNGS yielded the highest DOR, numerous technical and practical challenges preclude its routine use for PJI diagnosis. Significant heterogeneity across studies warrants cautious interpretation and underscores the need for future comparative research.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536871","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}