Clinical Microbiology and Infection最新文献

{"title":"Recurrent brain abscess after 18 years in an adult with undiagnosed congenital sinus venosus atrial septal defect.","authors":"Sigrid Bergmann, Morten Eneberg Nielsen, Hans Linde Nielsen, Jacob Bodilsen","doi":"10.1016/j.cmi.2025.07.024","DOIUrl":"10.1016/j.cmi.2025.07.024","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144768512","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":"Platelets and mortality in bloodstream infection: a multicenter cohort study","authors":"Max W. Adelman ,&nbsp;Stefano Casarin ,&nbsp;James Kurian ,&nbsp;William R. Miller ,&nbsp;Ashton Connor ,&nbsp;Enshuo Hsu ,&nbsp;Aarjav A. Sanghvi ,&nbsp;Jiaqiong Xu ,&nbsp;Sara C. Auld ,&nbsp;Stephen L. Jones ,&nbsp;David B. Corry ,&nbsp;Cesar A. Arias ,&nbsp;Masayuki Nigo","doi":"10.1016/j.cmi.2025.07.021","DOIUrl":"10.1016/j.cmi.2025.07.021","url":null,"abstract":"<div><h3>Objective</h3><div>The objective of this study was to determine whether thrombocytopenia is independently associated with mortality in patients with bloodstream infections (BSIs) and compare the impact of platelets on mortality with that of white blood cells and neutrophils.</div></div><div><h3>Methods</h3><div>This retrospective cohort study used the following two U.S. cohorts of patients with BSIs: (1) patients at a multihospital network in the metropolitan Houston, Texas, area between July 01, 2016 and June 17, 2023, and (2) patients in the publicly available Medical Information Mart for Intensive Care (MIMIC)-IV database (2008–2022). We included patients who had their platelets checked in the 48 hours before positive blood culture collection. We created multivariable logistic regression models to determine whether 30-day in-hospital mortality was impacted by the degree of thrombocytopenia (severe [platelets &lt;50 k/μL], moderate [50–99 k/μL], mild [100–149 k/μL], and none [≥150 k/μL]).</div></div><div><h3>Results</h3><div>We included 21105 patients in the Houston cohort and 2710 in the MIMIC-IV cohort, and 30-day mortality in the Houston cohort was 12.0% (2524/21105) and was significantly associated with the platelet count. After controlling for confounders, the adjusted odds ratio (aOR) for 30-day mortality with severe thrombocytopenia was 4.66 (95% CI, 3.91–5.55); aOR for moderate thrombocytopenia was 2.61 (95% CI, 2.25–3.02); and aOR for mild thrombocytopenia was 1.55 (95% CI, 1.37–1.76), all compared with normal platelet counts (≥150 k/μL). The adjusted odds of death with severe thrombocytopenia were greater than those with neutropenia, leukopenia, or leukocytosis. Results were similar in multiple sensitivity analyses and in the MIMIC-IV cohort.</div></div><div><h3>Discussion</h3><div>Thrombocytopenia was independently associated with mortality among patients with BSIs. Platelet counts can provide clinicians a readily available way to risk-stratify patients with BSI, and future research should examine the mechanisms by which platelets are protective in BSI.</div></div>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":"31 10","pages":"Pages 1733-1736"},"PeriodicalIF":8.5,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759337","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":"Treatment and follow-up of vascular graft and endograft infection: Delphi consensus document.","authors":"Ilse J E Kouijzer, Marta Hernández-Meneses, Erik H J G Aarntzen, Jonas Ahl, Larry M Baddour, Daniel C DeSimone, Emanuele Durante Mangoni, Nuria Fernández-Hidalgo, Guillaume S C Geuzebroek, Efthymia Giannitsioti, Andor W J M Glaudemans, Lars Husmann, Marco Merli, Carlos A Mestres, Flaminia Olearo, Matthaios Papadimitriou-Olivgeris, Nis Pedersen Jørgensen, Andrés Perissinotti, Annibale Raglio, Zoran Rancic, Akshatha Ravindra, Benedikt Reutersberg, Leonardo Francesco Rezzonico, Marco Ripa, Petar Risteski, Alessandro Russo, Ben R Saleem, Karl Sörelius, Dolores Sousa, Pierre Tattevin, Marjan Wouthuyzen-Bakker, Thomas R Wyss, Xavier Yugueros, Alexander Zimmermann, Barbara Hasse","doi":"10.1016/j.cmi.2025.07.020","DOIUrl":"10.1016/j.cmi.2025.07.020","url":null,"abstract":"<p><strong>Scope: </strong>Vascular graft or endograft infection (VGEI) is a severe complication requiring a multidisciplinary approach combining surgery and antimicrobial therapy. This study aimed to develop expert consensus on the management and follow-up of VGEI, with a focus on antimicrobial strategies.</p><p><strong>Methods: </strong>A modified Delphi method was conducted to reach consensus on key aspects of VGEI care, including antimicrobial treatment, surgical management, and follow-up. An expert panel representing infectious diseases, vascular and cardiothoracic surgery, microbiology, and nuclear medicine participated in four rounds of surveys. Ten general and 35 specific statements were rated using a five-point Likert scale. Statements with ≥75% agreement (agree/strongly agree) were considered to have achieved consensus. Internal consistency across rounds was assessed using Cronbach's alpha (>0.80).</p><p><strong>Questions addressed by the delphi method and recommendations: </strong>The panel agreed that empirical antimicrobial therapy should be initiated only in patients with complications (e.g. sepsis and bleeding) or when diagnostic intervention is delayed. Empirical therapy must be individualized based on graft location and risk factors. For abdominal VGEI without aorto-enteric fistula and unknown pathogens, initial coverage should target gram-positive cocci, gram-negative bacilli, and anaerobes, with consideration for Methicillin-Resistant Staphylococcus aureus (MRSA)/Methicillin-Resistant Staphylococcus epidermidis (MRSE) based on risk. For thoracic VGEI without fistula, gram-positive coverage is prioritized, with optional MRSA coverage. Postoperative treatment duration should be individualized. In cases of complete graft removal and replacement with autologous veins, a 6-week antibiotic course is recommended, with early oral switch if bioavailable options are available. If prosthetic material remains, at least 4 to 6 weeks of intravenous therapy followed by oral treatment for a total of 12 weeks is advised. Prolonged therapy should be considered in cases with virulent pathogens, incomplete source control, or persistent inflammatory markers. The study provides practical, expert-based antimicrobial guidance for VGEI management and emphasizes the importance of individualized, microbiologically informed therapy within a multidisciplinary care framework.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759338","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":"Nonantimicrobial therapies for recurrent urinary tract infection in women: is there a place for faecal microbiota transfer?","authors":"Nadim Cassir, Rohma Ghani, Lena M Biehl, Tiscar Graells, Ed J Kuijper, Benjamin H Mullish, Julian R Marchesi, Nicolas Benech","doi":"10.1016/j.cmi.2025.07.022","DOIUrl":"10.1016/j.cmi.2025.07.022","url":null,"abstract":"<p><strong>Background: </strong>Recurrent urinary tract infection (rUTI) is a common condition, affecting approximately one-third of women after an initial UTI. It significantly impacts health care costs and patients' quality of life. The relationship between the pathophysiology of UTI and the gut and vaginal microbiota is recognized as a contributing factor to rUTI in women. As antibiotic resistance among uropathogens continues to increase, there is a clear need to develop novel therapeutic interventions. Faecal microbiota transfer (FMT) is a potent nonantimicrobial strategy for modulating the gut microbiota; however, its clinical relevance in the context of rUTI is unclear.</p><p><strong>Objectives: </strong>This narrative review aimed to summarize the current evidence on the use of FMT for the treatment of rUTI, focusing on women, excluding those with mechanical dysfunctions such as urinary incontinence, neurogenic bladder, and bladder cancer, compared with other nonantimicrobial interventions. We also discussed the pathophysiology and epidemiology of rUTI to identify patients for whom microbiota-targeting therapies may be the most effective.</p><p><strong>Content: </strong>Periurethral colonization and migration to the bladder of uropathogens that inhabit the gut and vagina have been linked to the aetiology of UTI in women, particularly in patients with multidrug-resistant organisms. FMT appears to be a promising approach for preventing the clinical development of rUTI, although prospective data remain limited. In contrast, other reported nonantimicrobial strategies targeting the gut and urogenital microbiota have shown variable significant clinical efficacy. Prospective randomized controlled clinical trials are then needed to further confirm a potential therapeutic benefit, optimize the FMT procedure, and better assess its cost-effectiveness.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759336","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":"Beyond guidelines: what do I need to know when dealing with fungal diagnostics?","authors":"Cornelia Lass-Flörl","doi":"10.1016/j.cmi.2025.07.016","DOIUrl":"10.1016/j.cmi.2025.07.016","url":null,"abstract":"<p><strong>Background: </strong>Diagnosing invasive fungal infections (IFIs) is notoriously challenging. Test sensitivity and specificity vary with fungal burden, overlapping microscopic fungal appearances, lack of quantitative culture thresholds and, above all, the patient's immune status, specimen quality and prior antifungal exposure. These variables can mask or mimic disease, leading to delayed or erroneous treatment decisions.</p><p><strong>Objectives: </strong>This study aims to distil the practical, 'beyond-guideline' insights that clinicians and laboratorians need for reliable IFI diagnosis, and to outline a context-driven approach that complements existing recommendations.</p><p><strong>Sources: </strong>Narrative synthesis of PubMed-indexed literature on fungal diagnostics published chiefly between 2020 and 2025, augmented by current global guidelines from European Confederation of Medical Mycology (ECMM)/International Society for Human and Animal Mycology (ISHAM)/Americal Society for Microbiology (ASM) and selected landmark papers outside this window when foundational.</p><p><strong>Content: </strong>The review explains how (a) host immune state (neutropenia, AIDS, corticosteroid use) skews antigen-vs.-antibody performance; (b) specimen choice (bronchoalveolar lavage, blood, cerebrospinal fluid, tissue) and site of disease dictate test yield; (c) pre-emptive or empiric antifungals suppress culture and antigen signals yet may leave PCR positive; (d) cross-reactivity (e.g. β-D-glucan with bacteraemia, galactomannan with Fusarium) and mixed infections cloud interpretation; and (e) colonization must be separated from invasion through combined microbiology, and clinical risk assessment. Traditional microscopy/culture, antigen assays, PCR and emerging next-generation sequencing are compared across major pathogen groups, with tables summarizing sensitivities, specificities and pitfalls.</p><p><strong>Implications: </strong>Applying an approach that layers multiple modalities according to patient risk and specimen type can shorten time-to-diagnosis, reduce false negatives/positives and enable earlier targeted therapy. Integrating these context-aware steps into routine practice and future guideline updates is likely to improve IFI outcomes and optimize antifungal stewardship.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728430","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: 'Microbes know no borders: importation of macrolide-resistant Bordetella pertussis into France in 2024' by Bouchez et al.","authors":"Siyu Chen, Leran He, Kaihu Yao","doi":"10.1016/j.cmi.2025.07.017","DOIUrl":"10.1016/j.cmi.2025.07.017","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728432","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: Diagnostic accuracy of self-collected tongue swabs for Mycobacterium tuberculosis complex detection in individuals being assessed for tuberculosis in South Africa using the Xpert MTB/RIF Ultra assay.","authors":"Salvatore Rotundo, Francesca Serapide, Alessandro Russo","doi":"10.1016/j.cmi.2025.07.018","DOIUrl":"10.1016/j.cmi.2025.07.018","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728431","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":"Disseminated Mycobacterium avium intracellulare complex infection.","authors":"Ke Xiao","doi":"10.1016/j.cmi.2025.07.014","DOIUrl":"10.1016/j.cmi.2025.07.014","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717679","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 diversity of carbapenemases in Pseudomonas aeruginosa: a global genomic epidemiology investigation.","authors":"Jiayang Li, Jiajie Wang, Wenqi Wu, Ze Li, Xiuwen Wu, Jianan Ren","doi":"10.1016/j.cmi.2025.07.015","DOIUrl":"10.1016/j.cmi.2025.07.015","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717680","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 tolerability of linezolid use in 186 children: a single centre observational study.","authors":"Neal Russell, Lucy Jefferson, Orlagh McGarrity, James Hatcher, Seilesh Kadambari, Hanna Schmid","doi":"10.1016/j.cmi.2025.07.013","DOIUrl":"10.1016/j.cmi.2025.07.013","url":null,"abstract":"","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706586","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}