Clinical Microbiology and Infection最新文献

{"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}

{"title":"Real-world effectiveness of nirmatrelvir-ritonavir and molnupiravir in non-hospitalised adults with Covid-19: a population-based, retrospective cohort study cohort study.","authors":"Anselm Jorda, Dominik Ensle, Hubert Eser, Florentin Glötzl, Benjamin Riedl, Marton Szell, Arschang Valipour, Alexander Zoufaly, Christoph Wenisch, Doris Haider, Heinz Burgmann, Florian Thalhammer, Florian Götzinger, Bernd Jilma, Robin Ristl, Ursula Karnthaler, Markus Zeitlinger","doi":"10.1016/j.cmi.2024.10.026","DOIUrl":"https://doi.org/10.1016/j.cmi.2024.10.026","url":null,"abstract":"<p><strong>Objectives: </strong>The real-world effectiveness of the oral antivirals nirmatrelvir-ritonavir and molnupiravir against the SARS-CoV-2 Omicron variant remains uncertain. We aimed to estimate their effectiveness in non-hospitalised adults with Covid-19.</p><p><strong>Methods: </strong>This retrospective cohort study used data from the Municipal Department for Public Health Services of Vienna, Austria, to identify non-hospitalised adults with confirmed SARS-CoV-2 infection between Jan-2022-May-2023. Nirmatrelvir-ritonavir users were compared with untreated controls and molnupiravir users with untreated controls by calculating adjusted risk differences (aRDs) using a covariate-adjusted logistic regression model with inverse probability weighting. Outcomes were hospitalisation and all-cause death within 28 days.</p><p><strong>Results: </strong>We identified 113,399 eligible cases (90,481 untreated controls, 12,166 nirmatrelvir-ritonavir users, and 10,752 molnupiravir users). Over 96% of the patients were immunised by previous infection or vaccination. In the nirmatrelvir-ritonavir analysis, the estimated risk of hospitalisation was 0.57% (95%CI, 0.35-0.78) in nirmatrelvir-ritonavir users and 1.09% (95%CI, 0.86-1.32) in untreated controls (aRD -0.53%; 95%CI, -0.77--0.28). The estimated risk of death was 0.0% (95%CI, 0.0-0.0) in nirmatrelvir-ritonavir users and 0.13% (95%CI, 0.08-0.18) in untreated controls (aRD -0.13%, 95%CI, -0.18--0.08). The number needed to treat to prevent hospitalisation and death was 190 (95%CI, 130-356) and 792 (95%CI, 571-1289), respectively. These statistically significant aRDs were restricted to the subgroup of patients ≥60 years. In the molnupiravir analysis, the estimated risk of hospitalisation was 1.36% (95%CI, 0.95-1.77) in molnupiravir users and 1.16% (95%CI, 0.93-1.39) in untreated controls (aRD 0.2%; 95%CI, -0.08-0.49). The estimated risk of death was 0.12% (95%CI, 0.01-0.23) in molnupiravir users and 0.14% (95%CI, 0.06-0.21) in untreated controls (aRD, -0.01%; 95%CI, -0.08--0.06).</p><p><strong>Conclusions: </strong>Among outpatients aged ≥60 years with Covid-19 in an Omicron-dominated era, treatment with nirmatrelvir-ritonavir was associated with a lower risk of hospitalisation and all-cause death within 28 days, albeit with wide confidence intervals and high numbers needed to treat. This finding was not observed in molnupiravir users and younger nirmatrelvir-ritonavir users.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589885","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":"A phase 3 randomized trial of sulopenem vs. ertapenem in patients with complicated intraabdominal infections.","authors":"Michael W Dunne, Steven I Aronin, Anita F Das, Karthik Akinapelli, Jeanne Breen, Michael T Zelasky, Sailaja Puttagunta","doi":"10.1016/j.cmi.2024.10.025","DOIUrl":"https://doi.org/10.1016/j.cmi.2024.10.025","url":null,"abstract":"<p><strong>Objective: </strong>To demonstrate the noninferiority of intravenous (IV) sulopenem to IV ertapenem, each followed by an oral regimen, in adults with complicated intraabdominal infections (cIAI).</p><p><strong>Methods: </strong>Hospitalized adults with cIAI were randomized to 5 days of IV sulopenem followed by oral sulopenem etzadroxil/probenecid twice daily or 5 days of IV ertapenem followed by oral ciprofloxacin/metronidazole or amoxicillin-clavulanate depending on baseline pathogen susceptibility. The target treatment duration was 7-10 days. The primary (FDA-specified) endpoint was clinical response at Day 28 [Test-of-Cure (TOC)] in the micro-Modified Intent to Treat (micro-MITT) population.</p><p><strong>Results: </strong>674 patients were randomized. The two treatment arms were well-balanced. E. coli (395 patients) and B. fragilis (111 patients) were the most frequently isolated pathogens. Clinical success rates in the micro-MITT population were 81.9% (204/249) for sulopenem-treated patients and 87.9% (233/265) for ertapenem-treated patients. The lower bound of the confidence interval (CI) for the treatment difference of the primary endpoint was below the prespecified non-inferiority margin of -10.0 [treatment difference -6.0%, 95% CI [-12.2, 0.2]. In all other analysis populations, the lower limit of the 95% CI was above -10.0. Treatment emergent adverse events (all, 26.0% [87/335] vs 23.4% [78/333]; related, 6.0% [20/335] vs 5.1% [17/333]) were similar for sulopenem and ertapenem, respectively. Most events were mild to moderate in severity. There were more serious adverse events in the sulopenem arm (7.5% [25/335] vs 3.6% [12/333]), only two of which were considered possibly drug-related.</p><p><strong>Conclusions: </strong>Sulopenem IV followed by oral sulopenem etzadroxil/probenecid was not noninferior to ertapenem followed by oral step-down in treating cIAI in the micro-MITT population. This finding should be interpreted in the context of country regulations, as endpoint timing, primary analysis population and noninferiority margin may vary regionally. Both IV and oral sulopenem were well-tolerated; the oral formulation allowed patients with resistant pathogens to step down from IV therapy.</p><p><strong>Clinical trial registration: </strong>NCT03358576.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567534","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: 'Heightened incidence of adverse events associated with a live attenuated varicella vaccine strain that lacks critical genetic polymorphisms in ORF62' by Kang et al.","authors":"Young Woo Han, Seung Hye Hong, Seung Gu Kang, Seong-Beom Park, Hye Young Kim","doi":"10.1016/j.cmi.2024.10.024","DOIUrl":"https://doi.org/10.1016/j.cmi.2024.10.024","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567555","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":"'Measurement of circulating viral antigens post-SARS-CoV-2 infection in a multicohort study' - Author's reply.","authors":"Zoe Swank, Elizabeth W Karlson, David R Walt","doi":"10.1016/j.cmi.2024.10.028","DOIUrl":"https://doi.org/10.1016/j.cmi.2024.10.028","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567549","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":"Questioning the existence of Baggio-Yoshinari syndrome in Brazil.","authors":"Rodrigo Nunes Rodrigues-da-Silva, Laura Sant'anna Ataides, Rodrigo Nogueira Angerami, Marcos Vinícius da Silva, Elba Regina Sampaio de Lemos","doi":"10.1016/j.cmi.2024.10.027","DOIUrl":"https://doi.org/10.1016/j.cmi.2024.10.027","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567552","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}