Clinical Microbiology and Infection最新文献

{"title":"Methenamine hippurate for the prevention of urinary tract infections in older women: does it impress you?","authors":"Amelia Joseph","doi":"10.1016/j.cmi.2025.08.011","DOIUrl":"10.1016/j.cmi.2025.08.011","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945293","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":"Comparative epidemiology of diarrhoeal organisms in high-risk adults using multiplex PCR gastrointestinal panel testing: a multicentre observational study.","authors":"Jeffrey Shu, Hannah Wang, Anisha Misra, Daniel D Rhoads, Amy S Nowacki, Jarrod E Dalton, Abhishek Deshpande","doi":"10.1016/j.cmi.2025.08.008","DOIUrl":"10.1016/j.cmi.2025.08.008","url":null,"abstract":"<p><strong>Objectives: </strong>Infectious diarrhoea remains a significant cause of morbidity and mortality in immunocompromised and high-risk populations. However, pathogen-specific epidemiology and diagnostic utility of molecular gastrointestinal panels (GIPs) in these groups remain poorly defined. Our objective was to describe diarrhoeal pathogen distribution across 10 high-risk conditions and evaluate the diagnostic yield of GIPs in these populations to inform the development of improved diagnostic algorithms.</p><p><strong>Methods: </strong>We conducted a retrospective observational study analysing all adults (age ≥18 years) tested with a BioFire FilmArray GIP at 12 U.S. hospitals from 2019-2024. We reported observed organism detection rates overall, risk status, and by each of 10 high-risk conditions identified by International Classification of Diseases 10 (ICD-10) codes. Mixed-effects multivariable logistic regression estimated the independent effect of each high-risk condition on organism detection, controlling for sex, location, setting, year, season, and 10 high-risk conditions.</p><p><strong>Results: </strong>Among 16 570 patients, (median age 66 years; 65% [10 752/16 570] with ≥1 high-risk condition), pathogens were detected in 22% [3591/16 570]. Enteropathogenic Escherichia coli (EPEC) and norovirus were the most common organisms detected (6.4% [1059/16 570] and 6.1% [1006/16 570], respectively). The third most common organism varied based on high-risk comorbidity, typically Salmonella or Campylobacter. High-risk patients had significantly lower odds of detecting any pathogen compared with low-risk patients (19% [1996/10 752] vs. 27% [1595/5818]) (OR 0.60; 95% CI, 0.56-0.65). Patients with HIV had higher bacterial (adjusted OR 1.61; 95% CI, 1.05-2.38) and parasitic detection (2.94; 95% CI, 1.11-6.46), while transplant recipients had higher viral detection (adjusted OR 1.50; 95% CI, 1.08-2.07). Codetections most commonly involved EPEC with other organisms.</p><p><strong>Discussion: </strong>Most GIP testing in high-risk patients did not identify a causative pathogen. When the GIP did detect an organism, EPEC and norovirus were the most common, with distinct pathogen profiles by comorbidity. Our findings support risk-stratified testing and highlight GIP limitations, including potential false positives.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945312","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":"Peginterferon λ for the treatment of patients admitted to hospital with COVID-19: a phase 2, placebo-controlled randomized trial.","authors":"Christopher Kandel, Mia J Biondi, Mark Gillrie, Maureen Taylor, Bethany Barber, Leila Amiri, Traci Robinson, Jeff Powis, Neill Kj Adhikari, Robert A Kozak, Muhammad Atif Zahoor, David Smookler, Joshua Booth, Shinthuka Jeganathan, Evaldo Stanislau, Adam J Gehring, Grishma Hirode, Seham Noureldin, Camelia Capraru, Bettina Hansen, Jordan J Feld","doi":"10.1016/j.cmi.2025.08.003","DOIUrl":"10.1016/j.cmi.2025.08.003","url":null,"abstract":"<p><strong>Objectives: </strong>SARS-CoV-2 continues to circulate widely, and there is a need to find effective treatments for individuals admitted to hospital. Peginterferon λ has been shown to be effective for outpatients with COVID-19; the purpose of this randomized trial was to evaluate the efficacy among inpatients.</p><p><strong>Methods: </strong>Individuals admitted to hospital with COVID-19 who were within 10 days of symptom onset and receiving <6 L/min of supplemental oxygen were recruited from seven sites in Canada and Brazil from November 23, 2020 until December 6, 2022. Participants were randomized to receive two doses of 180 mcg of subcutaneous peginterferon λ or placebo (at enrolment and day 5). The primary outcome was clinical status according to the WHO COVID severity scale at day 14 with the main secondary analysis being the probability of hospital discharge over time until day 28. The trial was stopped prematurely due to the changing conditions of the pandemic.</p><p><strong>Results: </strong>Total of 97 participants were enrolled with 94 contributing outcome information. The global odds ratio of peginterferon λ leading to improved outcomes according to the WHO severity scale was 0.76 (95% CI, 0.35-1.66; p = 0.49). Clinical trajectories were similar between the peginterferon λ and placebo groups. The probability that peginterferon λ, as compared with placebo, led to a >1-day reduction in duration of hospitalization was 0.04. No safety concerns were identified.</p><p><strong>Discussion: </strong>In this phase II, prematurely stopped randomized placebo-controlled trial of peginterferon λ for individuals hospitalized with COVID-19 infection, no apparent benefit was identified.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862180","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":"How can health care professionals address vaccine hesitancy in practice?","authors":"Monia Chemais, Noni MacDonald, Eve Dubé, Bolette Søborg, Muge Cevik, Zitta Barrella Harboe, Petar Velikov","doi":"10.1016/j.cmi.2025.08.002","DOIUrl":"10.1016/j.cmi.2025.08.002","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859027","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":"Screening and targeted prophylaxis for Clostridioides difficile infection.","authors":"Mathew J Ziegler, Judith Anesi, Pam Tolomeo, Laurel Glaser, Laura Cowden, Leigh Cressman, Elizabeth Huang, Alexa Patel, Ebbing Lautenbach, David A Pegues, Brendan J Kelly","doi":"10.1016/j.cmi.2025.08.004","DOIUrl":"10.1016/j.cmi.2025.08.004","url":null,"abstract":"<p><strong>Objective: </strong>Patients receiving immunosuppression for oncology treatment and solid organ transplantation are at high risk for developing hospital-onset Clostridioides difficile infection (HO-CDI). We studied the impact of a prophylactic enteral vancomycin intervention on the reduction of HO-CDI during high-risk inpatient admissions among immunocompromised patients.</p><p><strong>Methods: </strong>The screening and targeted prophylaxis (STOP) intervention was implemented over a 2-year period. Patients admitted for solid organ transplant, autologous stem cell transplant, chimeric antigen receptor T-cell, or treatment for leukaemia were screened for colonization with C. difficile. Colonized patients were placed in contact isolation and were advised to start anti-C.difficile antibiotic prophylaxis. To assess the effect of this intervention on both C.difficile testing and incident HO-CDI, comparison was made to historical controls in the 2 years before implementation of the STOP intervention, both unweighted and weighted by treatment category and separately by treatment category and severity of illness.</p><p><strong>Results: </strong>From November 2021 to December 2023, 696 patients were screened for C difficile, among whom 11.1% (77/696) were found to be colonized and received the prophylactic intervention. Compared with treatment-weighted controls, the odds of HO-CDI were significantly lower in the intervention group (6/696 [0.88%] vs. 81/1450 [5.6%]; odds ratio [OR], 0.15; 95% Credible Interval [CrI], 0.06-0.30). Significant reductions in 90-day CDI (OR 0.40, 95% CrI 0.25-0.64), stool output (incidence rate ratio, 0.84; 95% CrI, 0.77-0.92), and length of stay (-2.5 days; 95% CrI, -3.4 to -1.5) were also observed in the intervention group. There was no detected difference in vancomycin-resistant Enterococci infection (OR, 0.77; 95% CrI, 0.33-1.75) or mortality (OR, 0.44; 95% CrI, 0.11-1.49).</p><p><strong>Discussion: </strong>The STOP intervention was effective at reducing HO-CDI, length of stay, and symptoms of C difficile in this high-risk cohort.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859028","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":"Henrik Carl Schønheyder.","authors":"Henrik Nielsen, Michael Dalager-Pedersen, Jacob Bodilsen, Reimar Wernich Thomsen","doi":"10.1016/j.cmi.2025.08.005","DOIUrl":"https://doi.org/10.1016/j.cmi.2025.08.005","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859026","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":"Survival and quality-of-life in mucormycosis.","authors":"Jesús Fortún, Miguel Suárez","doi":"10.1016/j.cmi.2025.07.034","DOIUrl":"10.1016/j.cmi.2025.07.034","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854791","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: Comparing large language models for antibiotic prescribing in different clinical scenarios: which performs better?","authors":"Thomas Hänscheid, João Carrasco, Martin P Grobusch","doi":"10.1016/j.cmi.2025.08.006","DOIUrl":"10.1016/j.cmi.2025.08.006","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854790","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":"Systematic investigation of baseline nosocomial transmission of tuberculosis in the Kyrgyz Republic, Central Asia.","authors":"Harald Hoffmann, Christian Utpatel, Altyn Iskakova, Sevim Ahmedov, Uladzimir Antonenka, Viola Dreyer, Evgeni Sahalchyk, Abdyllaat Kadyrov, Caroline Corbett, Stefan Niemann, Gulmira Kalmambetova","doi":"10.1016/j.cmi.2025.08.001","DOIUrl":"10.1016/j.cmi.2025.08.001","url":null,"abstract":"<p><strong>Objectives: </strong>Controlling tuberculosis (TB) transmission is of paramount importance for combating the TB pandemic. Although TB hospitals are considered hotspots of transmission, systematic longitudinal studies examining the underlying incidence and possible risk factors of nosocomial TB transmission are lacking. The objectives of this study were to detect nosocomial transmission events over a 20-month period using whole genome sequencing (WGS) of Mycobacterium tuberculosis complex (MTBC) isolates collected from 563 patients with pulmonary TB hospitalized in the Kyrgyz Republic.</p><p><strong>Methods: </strong>The WGS was performed on 698 MTBC isolates, including 563 first isolates recovered from participants within 4 weeks of hospitalization and 135 follow-up isolates from treatment control samples collected at least 4 weeks apart. All participants' roommates were recorded over the whole study period.</p><p><strong>Results: </strong>The cohort represented >95% of TB patients hospitalized at the study sites during the follow-up period of 53 372 hospitalization days. Genome-based cluster analysis revealed that 173 of the 563 (30.7%) first isolates fell into 56 clusters (<5 single nucleotide polymorphism [SNPs]). Two nosocomial TB transmissions from index cases to their roommates were proven. And five potential transmissions were observed between patients who shared time, but not a room, in the hospital or where the index case was not identified. Most transmitted strains were more resistant than the previous one.</p><p><strong>Discussion: </strong>Within-community transmission of MTBC is highly active in Kyrgyzstan. With 13.7 per 1000 patient years (95% CI: 1.6-49.5), we observed markedly higher rates of nosocomial transmission than reported in previous WGS-based studies.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834351","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":"Endotracheal aspirate as an alternative to bronchoalveolar lavage fluid for the diagnosis of Pneumocystis pneumonia by real-time polymerase chain reaction.","authors":"Sang-Ho Choi, Sang-Bum Hong, Jin Won Huh, Heungsup Sung, Kyung-Hyun Do, Sang-Oh Lee, Chae-Man Lim, Younsuck Koh","doi":"10.1016/j.cmi.2025.07.031","DOIUrl":"10.1016/j.cmi.2025.07.031","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of this study was to evaluate the diagnostic performance of an endotracheal aspirate (ETA) real-time polymerase chain reaction (RT-PCR) assay for the diagnosis of Pneumocystis jirovecii pneumonia in intensive care unit (ICU) patients with suspected pneumonia.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of a prospective cohort in a 28-bed medical ICU. Adult patients who underwent both ETA and bronchoalveolar lavage (BAL) sampling for P. jirovecii real-time PCR within 48 hours between October 2018 and December 2024 were included. Diagnostic performance metrics of the ETA RT-PCR assay were calculated using BAL RT-PCR results as the reference standard (cycle threshold [Ct] ≤40). The concordance of Ct values between ETA and BAL samples was assessed using Pearson correlation.</p><p><strong>Results: </strong>Among 249 included patients, 69 (27.7%) were positive for P. jirovecii by BAL RT-PCR. The ETA RT-PCR showed a sensitivity of 85.5% (95% confidence interval [CI]: 75.0-92.8%), a specificity of 92.8% (95% CI: 88.0-96.1%), an accuracy of 90.7% (95% CI: 86.4-94.0%), a positive likelihood ratio of 11.84, and a negative likelihood ratio of 0.16. Ct values between ETA and BAL samples were strongly correlated (r = 0.78, p < 0.001). Discordant results were observed in 23 patients (9.2%), with false-positive ETA samples showing significantly higher Ct values (median: 34.6; interquartile range [IQR]: 33.1-35.4) than true positives (median: 26.4; IQR: 24.2-31.0; p < 0.01).</p><p><strong>Discussion: </strong>ETA RT-PCR for P. jirovecii demonstrates high diagnostic concordance with BAL fluid RT-PCR in ICU patients and may serve as a minimally invasive alternative. However, elevated Ct values in ETA samples warrant further confirmatory testing due to possible colonization.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144803763","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}