Clinical Microbiology and Infection最新文献

{"title":"Re: 'Safety and immunogenicity of hepatitis E vaccine in compensated liver cirrhosis with chronic hepatitis B' by Liao et al.","authors":"Yuwen Yang, Rui Lai","doi":"10.1016/j.cmi.2025.06.004","DOIUrl":"10.1016/j.cmi.2025.06.004","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257422","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":"Candida Endocarditis: current perspectives on diagnosis and therapy.","authors":"Ben-Ami Ronen, Bassetti Matteo, Bouza Emilio, Kosman Alex, Vena Antonio","doi":"10.1016/j.cmi.2025.05.035","DOIUrl":"https://doi.org/10.1016/j.cmi.2025.05.035","url":null,"abstract":"<p><strong>Background: </strong>Candida infective endocarditis (CIE) is a rare but potentially devastating condition. Although it accounts for only 1-1.5% of infective endocarditis cases, CIE carries a high mortality rate (36-49%) and a substantial risk of relapse. Despite advances in diagnostic and therapeutic strategies, significant uncertainties persist regarding the role and selection of imaging modalities and the most effective medical and surgical management. Furthermore, the best follow-up strategy to promptly detect recurrences in patients with a confirmed diagnosis remains inadequately defined.</p><p><strong>Objectives: </strong>This review explores the diagnosis and management of CIE with a particular focus on: i) optimal use of cardiac imaging studies; ii) challenges associated with antifungal therapy iii) the limitations and real-world impact of surgical intervention, and (iv) strategies for long-term follow-up.</p><p><strong>Sources: </strong>A comprehensive literature search was conducted in PubMed using the terms Candida endocarditis, fungal biomarkers, echocardiography, antifungal therapy, and surgical management. Additional studies were identified through reference screening. Only clinically relevant articles, as judged by the authors, were included.</p><p><strong>Content: </strong>Diagnosis remains difficult due to intermittently negative blood cultures and limitations of standard endocarditis criteria. Echocardiography is the mainstay diagnostic modality for patients with candidemia, and risk-stratification to guide its use remains exploratory. Novel diagnostic methods, including fungal biomarkers (1,3-β-D-glucan), molecular assays, and PET/CT, may improve detection, but robust clinical data are lacking. Management requires a multimodal approach, combining prolonged antifungal therapy and, when feasible, surgical intervention. Echinocandins or liposomal amphotericin B plus flucytosine are first-line treatments, with fluconazole as a step-down option. Prosthetic valve infections often require lifelong suppressive therapy due to high relapse rates.</p><p><strong>Implications: </strong>Given the high mortality and recurrence rates, early multidisciplinary involvement is crucial. With emerging antifungal resistance, anti-biofilm strategies and next-generation antifungals are needed to improve outcomes.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257420","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: 'Scope and aims of ESCMID guidelines' by Scudeller et al.","authors":"Hilary Humphreys","doi":"10.1016/j.cmi.2025.05.034","DOIUrl":"10.1016/j.cmi.2025.05.034","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246690","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":"Commentary: Standing on the shoulders of giants - virtue and vulnerability in science.","authors":"Sibylle C Mellinghoff, Agnese Grossi Alessandra, Yannick Assion, Oliver A Cornely, Marylyn M Addo, Claudia Bloeser","doi":"10.1016/j.cmi.2025.05.030","DOIUrl":"https://doi.org/10.1016/j.cmi.2025.05.030","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246689","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":"Rectal colonization by multidrug-resistant Gram-negative bacteria and subsequent bacteraemia in haematological patients.","authors":"Antonio Gallardo-Pizarro, Carlos Lopera, Olivier Peyrony, Patricia Monzo-Gallo, Tommaso Francesco Aiello, Ana Martinez-Urrea, Sabina Herrera, Ana Del Río, Christian Teijon-Lumbreras, Mariana Chumbita, Carlos Jimenez-Vicente, Albert Cortés, Marta Bodro, Cristina Pitart, Elisa Rubio, Josep Mensa, Alex Soriano, Jose Antonio Martínez, Carolina Garcia-Vidal","doi":"10.1016/j.cmi.2025.05.033","DOIUrl":"10.1016/j.cmi.2025.05.033","url":null,"abstract":"<p><strong>Objectives: </strong>This study assessed the prevalence of multidrug-resistant Gram-negative bacilli (MDR-GNB) colonization in rectal swabs from haematological patients with malignancies undergoing routine surveillance and explored the relationship between MDR-GNB colonization and subsequent development of bloodstream infections (BSIs).</p><p><strong>Methods: </strong>Between January 2020 and September 2022, all patients admitted to our haematology ward underwent weekly MDR-GNB colonization screening via rectal swabs. A retrospective analysis was performed. MDR-GNB were defined per 2022 European Society of Clinical Microbiology and Infectious Diseases criteria: (a) third-generation cephalosporin-resistant Enterobacterales (3GCephRE), (b) carbapenem-resistant Enterobacterales (CRE), (c) Pseudomonas aeruginosa with difficult-to-treat resistance (DTR), and (d) carbapenem-resistant Acinetobacter baumannii.</p><p><strong>Results: </strong>Among 3024 rectal swabs from 699 patients, 503 of 3024 (16.6%) tested positive for MDR-GNB in 192 of 699 patients (27.5%). The most prevalent organisms were Escherichia coli (248/503; 49.3%), Klebsiella pneumoniae complex (125/503; 24.9%), and P. aeruginosa (36/503; 7.2%). A total of 59 of 503 (11.7%) colonizations of CRE were identified. Overall, 27 of 192 (14.1%) patients were colonized at admission, primarily by 3GCephRE (27/29; 93.1%). Colonization with CRE and DTR P. aeruginosa was more frequently documented after several days of hospitalization. BSI occurred in 74 of 192 (38.5%) colonized and 61 of 507 (12.0%) non-colonized patients. MDR-GNB caused 57 of 166 BSIs episodes, 50 of 57 (87.7%) of which were in colonized patients. The unadjusted concordance rate between rectal swab isolates and blood cultures was observed in 43 of 90 BSIs (47.8%) occurring in colonized patients, with a positive predictive value (PPV) of 36.4% and a negative predictive value (NPV) of 99.9% for DTR P. aeruginosa; a PPV of 25.0% and an NPV of 99.9% for CRE; and a PPV of 14.6% and an NPV of 99.0% for 3GCephRE.</p><p><strong>Discussion: </strong>Routine weekly surveillance for MDR-GNB in haematological patients enables early identification of colonization, often preceding MDR-GNB BSIs. Further studies using adjusted analyses are needed to establish its independent predictive value.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246691","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":"Bridging the evidence gap: expert consensus on management of SARS-CoV-2 acute infection and post–COVID-19 condition in immunocompromised patients","authors":"Lorenzo M. Canziani ,&nbsp;Antonella d'Arminio Monforte ,&nbsp;Maddalena Giannella ,&nbsp;Jesús Rodríguez-Baño ,&nbsp;Evelina Tacconelli","doi":"10.1016/j.cmi.2025.05.008","DOIUrl":"10.1016/j.cmi.2025.05.008","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":"31 8","pages":"Pages S1-S2"},"PeriodicalIF":10.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076533","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":"ORCHESTRA Delphi consensus: diagnostic and therapeutic management of post-COVID-19 condition in vulnerable populations","authors":"Elisa Gentilotti ,&nbsp;Lorenzo Maria Canziani ,&nbsp;Maria Giulia Caponcello ,&nbsp;Anna Maria Azzini ,&nbsp;Alessia Savoldi ,&nbsp;Pasquale De Nardo ,&nbsp;Zaira R. Palacios-Baena ,&nbsp;Beatrice Tazza ,&nbsp;Natascia Caroccia ,&nbsp;Giulia Carla Marchetti ,&nbsp;Andrea Antinori ,&nbsp;Maddalena Giannella ,&nbsp;Jesús Rodríguez-Baño ,&nbsp;Evelina Tacconelli","doi":"10.1016/j.cmi.2025.04.009","DOIUrl":"10.1016/j.cmi.2025.04.009","url":null,"abstract":"<div><h3>Objectives</h3><div>Post-COVID-19 condition (PCC) remains poorly understood, especially in clinically vulnerable groups. We applied the Delphi approach to drive recommendations for the diagnosis, management, and prevention of PCC in people living with HIV (PWH) and patients affected by rheumatological diseases (RD) and haematological malignancies.</div></div><div><h3>Methods</h3><div>On the basis of literature review, three areas of interest in PCC in PWH, haematological malignancies, and RD were identified: (a) features and risk factors; (b) diagnosis and management; and (c) prevention. A three-round Delphi anonymous survey consisting of 15 questions was conducted including 69 experts. Consensus was measured by the six-point Likert scale categorized into four tiers: strong disagreement, moderate disagreement, moderate agreement, and strong agreement. Statements were generated on questions achieving consensus.</div></div><div><h3>Results</h3><div>Eleven statements were generated: six on features and risk factors of PCC in clinically vulnerable populations, two on diagnosis and management, and three on prevention. Chronic fatigue was identified as the most frequent presentation of PCC in PWH and RD populations. A different case definition of PCC is required for RD population, as symptoms of PCC and autoimmune disorders may overlap. Risk factors for PCC include age &gt;65, severity of COVID-19, and female sex; the latter is also associated with increased smell/taste impairment. A clinical assessment or a routine laboratory test performed 3 months after acute infection is not suggested to diagnose PCC in PWH. PWH and RD should be screened to exclude additional autoimmune disorders in case of chronic fatigue/arthralgia of new onset. Full-course vaccination and early treatment for COVID-19 should be promoted to prevent PCC, whereas corticosteroids during acute infection are not recommended.</div></div><div><h3>Discussion</h3><div>Diagnosis, management, and prevention of PCC are still under discussion. This Delphi offers valuable insights on PCC in selected clinically vulnerable populations and suggests a tailored approach in vulnerable populations.</div></div>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":"31 8","pages":"Pages S44-S54"},"PeriodicalIF":10.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977652","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":"ORCHESTRA Delphi consensus: clinical management of SARS-CoV-2 infection in people with HIV","authors":"Alessandro Tavelli ,&nbsp;Alessandra Vergori ,&nbsp;Antonella Cingolani ,&nbsp;Francesca Bai ,&nbsp;Anna Maria Azzini ,&nbsp;Gabriel Levy Hara ,&nbsp;Maria Giulia Caponcello ,&nbsp;Matteo Rinaldi ,&nbsp;Zaira R. Palacios-Baena ,&nbsp;Milo Gatti ,&nbsp;Gaia Maccarrone ,&nbsp;Evelina Tacconelli ,&nbsp;Andrea Antinori ,&nbsp;Antonella d’Arminio Monforte","doi":"10.1016/j.cmi.2025.03.006","DOIUrl":"10.1016/j.cmi.2025.03.006","url":null,"abstract":"<div><h3>Objectives</h3><div>The interaction between HIV and COVID-19 resulted in a syndemic that showed an excess burden of disease for people with HIV (PWH). Four years of the COVID-19 pandemic have raised many unsolved questions about the optimal care of COVID-19 in PWH.</div></div><div><h3>Methods</h3><div>We performed a study using a three-round Delphi methodology involving a panel of physicians with expertise in HIV and COVID-19 infections. The main aim of the study was to provide recommendations on critical clinical issues of COVID-19 among PWH and to inform physicians and policy-makers for improving care and prevention of COVID-19 in PWH. A total of 27 questions were conceived, focusing on four main areas of interest in the management of COVID-19 in PWH; a panel of 34 experts in HIV and COVID-19 care expressed their level of agreement on each item. Questions that received agreement/disagreement ≥79.4% of panellists were identified and statements were generated accordingly.</div></div><div><h3>Results</h3><div>Consensus was reached on 19/27 items, resulting in 18 final statements. These statements addressed: (a) risk of COVID-19 progression to severe disease among PWH; (b) COVID-19 diagnostics and laboratory procedures; (c) early treatments with antivirals and/or monoclonal antibodies; (d) use of corticosteroids; (e) COVID-19 preventive strategies.</div></div><div><h3>Discussion</h3><div>This consensus's study guides infectious diseases physicians in making decisions regarding the care of PWH for COVID-19, where results from the scientific literature are limited or conflicting.</div></div>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":"31 8","pages":"Pages S14-S25"},"PeriodicalIF":10.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691389","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":"ORCHESTRA Delphi consensus: diagnostic and therapeutic management of SARS-CoV-2 infection in solid organ transplant recipients","authors":"Beatrice Tazza ,&nbsp;Natascia Caroccia ,&nbsp;Alice Toschi ,&nbsp;Renato Pascale ,&nbsp;Effrosyni Gkrania-Klotsas ,&nbsp;Paula Olivares Navarro ,&nbsp;Lorenzo Maria Canziani ,&nbsp;Alessandro Tavelli ,&nbsp;Andrea Antinori ,&nbsp;Paolo Antonio Grossi ,&nbsp;Maddalena Peghin ,&nbsp;Evelina Tacconelli ,&nbsp;Zaira Raquel Palacios-Baena ,&nbsp;Pierluigi Viale ,&nbsp;Maddalena Giannella","doi":"10.1016/j.cmi.2025.02.010","DOIUrl":"10.1016/j.cmi.2025.02.010","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to address existing knowledge gaps regarding risk stratification, best use of diagnostic resources, optimal treatment, and general management of SARS-CoV-2 infection in solid organ transplant (SOT) recipients. As high-quality evidence specific to this fragile population is lacking, our final aim was to provide an expert consensus evidence-informed guidance that can aid clinicians in their daily practice.</div></div><div><h3>Methods</h3><div>This study was conducted within the Working Package 4 (fragile population cohorts) of the H2020-funded ORCHESTRA study (<span><span>https://orchestra-cohort.eu</span><svg><path></path></svg></span>). Eight infectious disease and one clinical pharmacology specialists conducted a comprehensive scoping literature review which covered five key areas: the role of SOT as a risk factor for evolution to severe disease; the optimal use of diagnostic resources, considering cost–benefit ratios and appropriateness of active screening; population-specific therapeutic management, including antiviral use and drug–drug interactions and appropriate duration of treatment; the potential need for withdrawal of immunosuppressive agents and management of potential donors and recipients with recent and/or ongoing SARS-CoV-2 infection at the time of transplantation. On the basis of this review, a 28-item questionnaire was developed and administered to a panel of experts through two rounds, following the Delphi methodology.</div></div><div><h3>Results</h3><div>The panel consisted of 21 experts, 13 females and 8 males, from Italy (<em>n</em> = 11), Spain (<em>n</em> = 5), Switzerland (<em>n</em> = 2), Brazil (<em>n</em> = 1), United States (<em>n</em> = 1), and United Kingdom (<em>n</em> = 1). Consensus was achieved for 18 out of 28 items after the first round and for 9 out of 13 items after the second round, according to agreement/disagreement levels obtained for each question and round, ten statements were finally produced.</div></div><div><h3>Discussion</h3><div>The consensus statements derived from this study offer a framework for standardizing care and improving outcomes in SOT recipients affected by SARS-CoV-2 infection in a field where high-quality evidence specific to this high-risk population is currently lacking.</div></div>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":"31 8","pages":"Pages S3-S13"},"PeriodicalIF":10.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424505","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":"ORCHESTRA Delphi consensus: diagnostic and therapeutic management of SARS-CoV-2 infection in haematological patients","authors":"Lorenzo Maria Canziani ,&nbsp;Anna Maria Azzini ,&nbsp;Jon Salmanton-García ,&nbsp;Alessia Savoldi ,&nbsp;Maria Giulia Caponcello ,&nbsp;Zeno Pasquini ,&nbsp;Livio Pagano ,&nbsp;Oliver A. Cornely ,&nbsp;Antonella Cingolani ,&nbsp;Valentina Mazzotta ,&nbsp;Federica Cosentino ,&nbsp;Jesús Rodríguez Baño ,&nbsp;Mauro Krampera ,&nbsp;Evelina Tacconelli","doi":"10.1016/j.cmi.2025.03.004","DOIUrl":"10.1016/j.cmi.2025.03.004","url":null,"abstract":"<div><h3>Objectives</h3><div>COVID-19 poses a significant risk to individuals with haematological malignancies (HM), as they are particularly vulnerable to severe disease progression and hospitalization due to their compromised immune systems. Many clinical decisions regarding the management of COVID-19 in these patients are yet to be fully addressed by existing guidelines, leading to variability in care.</div></div><div><h3>Methods</h3><div>A 28-item Delphi survey was developed to gather expert opinions on key areas of COVID-19 management in patients with HM, including risk stratification for severe COVID-19, diagnostic processes, and treatment decisions.</div></div><div><h3>Results</h3><div>Twenty-one experts with backgrounds in haematology and infectious diseases were enrolled. Of the 28 questions posed to the experts, consensus was reached on 15 statements.</div></div><div><h3>Discussion</h3><div>These Delphi consensus statements offer valuable suggestions with direct implications for clinical practice, addressing critical areas such as risk identification, appropriate diagnostic approaches, and tailored treatment strategies for patients with HM with COVID-19. The findings provide actionable insights that may help fill gaps in current scientific literature, enhancing patient care and decision-making in this high-risk population.</div></div>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":"31 8","pages":"Pages S26-S36"},"PeriodicalIF":10.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691398","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}