Clinical Microbiology and Infection最新文献

{"title":"Which trial do we need? A randomized controlled trial comparing 7 vs. 14 days of antibiotic therapy for the treatment of urinary tract infection with systemic signs and symptoms in male patients.","authors":"Johan Van Laethem, Marco Moretti, Ineke Aerts, Pieter-Jan Cortoos","doi":"10.1016/j.cmi.2025.05.025","DOIUrl":"10.1016/j.cmi.2025.05.025","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181070","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":"Diagnosis and management of Candida endophthalmitis and chorioretinitis.","authors":"Nitipong Permpalung, Sarah Sedik, Peter G Pappas, Martin Hoenigl, Luis Ostrosky-Zeichner","doi":"10.1016/j.cmi.2025.05.028","DOIUrl":"10.1016/j.cmi.2025.05.028","url":null,"abstract":"<p><strong>Background: </strong>Candida endophthalmitis (CE) and chorioretinitis are uncommon but potentially devastating complications of candidemia, associated with significant risks of vision loss and long-term morbidity. Effective management relies on timely diagnosis and targeted antifungal therapy. However, diagnostic and therapeutic approaches are hindered by inconsistent guidelines, limited evidence, and variations in clinical practice.</p><p><strong>Objectives: </strong>This review synthesizes current knowledge on CE and chorioretinitis to provide a comprehensive framework for clinicians. It addresses diagnostic challenges, including ophthalmoscopy, imaging, and microbiological diagnostics, and therapeutic strategies such as systemic and intravitreal antifungal therapies, surgical interventions, and serial ophthalmic evaluations.</p><p><strong>Sources: </strong>An extensive literature search was conducted using PubMed, Embase, and Scopus, with a focus on epidemiology, pathogenesis, diagnostics, treatment, and outcomes. Guidelines from the Infectious Diseases Society of America, European Confederation for Medical Mycology, and American Academy of Ophthalmology were reviewed.</p><p><strong>Content: </strong>The prevalence of CE among patients with candidemia has increased from 1.8% in the pre-echinocandin era to 2.1% after the introduction of echinocandins. Diagnosis relies primarily on indirect ophthalmoscopy, the reference standard for retinal visualization. In selected cases, optical coherence tomography or fundus photography may support lesion assessment. Microbiological confirmation via vitreous sampling remains definitive but is often limited by low organism burden. Emerging diagnostics-such as clustered regularly interspaced short palindromic repeats-based fungal DNA assays-have shown promise. Although artificial intelligence-assisted imaging tools are established in other retinal diseases, they have not yet been validated for Candida ocular infections. Fluconazole and voriconazole remain first-line systemic therapies, with intravitreal injections and vitrectomy reserved for severe cases.</p><p><strong>Implications: </strong>Improving outcomes in CE requires harmonized screening protocols, timely access to ophthalmologic care, and multidisciplinary collaboration. Future research should aim to refine diagnostic algorithms, define optimal treatment durations, clarify the role of emerging diagnostics, and leverage telemedicine and imaging technologies to improve early detection and longitudinal monitoring.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180696","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":"Antibiotic resistance in Türkiye: what has been done and what needs to be done urgently?","authors":"Özlem Alhan, Hasan Selçuk Özger, Onur Karatuna, Özlem Kurt Azap, Bahar Madran, Şiran Keske, Güle Çınar, İrem Akdemir, Önder Ergönül","doi":"10.1016/j.cmi.2025.05.019","DOIUrl":"10.1016/j.cmi.2025.05.019","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180863","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":"Incidence, microbiology, and mortality of ventilation-associated pneumonia in a large Italian cohort of critically ill patients: results from the PROSAFE project.","authors":"Marta Colaneri, Giorgia Montrucchio, Giovanni Scaglione, Gianpaola Monti, Giovanni Tricella, Camilla Genovese, Fulvio Agostini, Francesca Dore, Bruno Viaggi, Luca Brazzi, Valentina Sanna, Andrea Gori, Emanuele Palomba, Martina Offer, Stefano Finazzi","doi":"10.1016/j.cmi.2025.05.026","DOIUrl":"10.1016/j.cmi.2025.05.026","url":null,"abstract":"<p><strong>Objectives: </strong>Despite preventive measures, ventilator-associated pneumonia (VAP) remains the most common healthcare-associated infection in the intensive care unit (ICU). VAP's striking incidence and impact are a leading cause of morbidity and prolonged ICU stay. This study focused on the characteristics and outcomes of patients diagnosed with ICU-acquired VAPs in Italian ICUs.</p><p><strong>Methods: </strong>Data were drawn from the PROSAFE network, a prospective multicentric observational project conducted across 192 Italian ICUs (2014-2023). Clinical data were recorded following the European Centre for Disease Prevention and Control VAP definitions. The incidence rate was estimated, and multivariable logistic regression identified ICU mortality risk factors.</p><p><strong>Results: </strong>The patients admitted to the included ICUs were 402 085. Among 122 430 classified at risk for VAP because of invasive mechanical ventilation (IMV) ≥48 hours, a total of 11 978 VAP cases were identified, corresponding to a prevalence of 9.8%. The incidence rate of VAP was 10.47 cases per 1 000 ventilator days (95% CI: 10.28-10.66). Patients with VAP exhibited prolonged ICU stays (median: 23 days, Q1-Q3: 15-36) and high mortality (30.0%). Microbiological profiling of VAP identified Pseudomonas spp. (21.0%), Staphylococcus aureus (20.2%), and Klebsiella spp. (20.1%) as the predominant pathogens. The logistic regression showed that older age, chronic liver and kidney diseases, multidrug-resistant organisms, and Acinetobacter spp. aetiology and duration of ICU stay before VAP were significantly associated with higher mortality.</p><p><strong>Discussion: </strong>While confirming the overall high mortality of patients undergoing IMV, our findings highlight the significantly prolonged ICU stay in VAP patients, and the influence of multidrug-resistant organisms on VAP-related mortality. These insights emphasize the necessity for effective and timely preventive strategies, as well as the early identification of VAP aetiology.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180674","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: Humans as a potential reservoir for the emerging ST301 Shiga toxin-producing Escherichia coli clones of serotype O80:H2?","authors":"Frédéric Auvray, Federica Gigliucci, Valeria Michelacci, Gaia Scavia, Laurent Cavalié, Aurélie Cointe, Florence Crombé, Flemming Scheutz, Claire Jenkins, Stefano Morabito, Stéphane Bonacorsi, Eric Oswald","doi":"10.1016/j.cmi.2025.05.018","DOIUrl":"10.1016/j.cmi.2025.05.018","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173047","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":"Delayed accurate diagnosis of emerging disease outbreaks, the example of nodding syndrome.","authors":"Robert Colebunders, Amber Hadermann, Charlotte Lubbers, Joseph Siewe Fodjo","doi":"10.1016/j.cmi.2025.05.024","DOIUrl":"10.1016/j.cmi.2025.05.024","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173032","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: 'Learning from post COVID-19 condition for epidemic preparedness' by Górska et al.","authors":"Hugh R Watson","doi":"10.1016/j.cmi.2025.05.020","DOIUrl":"10.1016/j.cmi.2025.05.020","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149352","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: 'Mortality due to carbapenem-resistant Acinetobacter baumannii bacteraemia' by Kritsotakis et al.","authors":"Shouhui Yi","doi":"10.1016/j.cmi.2025.04.043","DOIUrl":"10.1016/j.cmi.2025.04.043","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957178","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: 'Safety of pertussis vaccination in pregnancy and effectiveness in infants' by Kildegaard et al.","authors":"Qinhan Liu, Jun Li, Yaling Li","doi":"10.1016/j.cmi.2025.04.044","DOIUrl":"10.1016/j.cmi.2025.04.044","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980902","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":"Prosthetic joint infection-a complex disease with rising challenges.","authors":"Flaminia Olearo, Parham Sendi","doi":"10.1016/j.cmi.2025.04.039","DOIUrl":"10.1016/j.cmi.2025.04.039","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":10.9,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970095","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}