Clinical Infectious Diseases最新文献

{"title":"Atypical HBV Serological Patterns After Switching to CAB/RPV: Interpretation Within Current Definitions.","authors":"Alberto Foncillas, Juan Ambrosioni, Lorena de la Mora, Josep Mallolas, Ana González-Cordón, Montserrat Laguno","doi":"10.1093/cid/ciag303","DOIUrl":"https://doi.org/10.1093/cid/ciag303","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834567","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":"Influenza A and B Viral Shedding in Adults Immunized with Live Attenuated Influenza Vaccine.","authors":"Brandon M Tower, Cindy M Liu, David J Diemert, Sydney G Nelson, Chelsea E Ware, Juan E Salazar, Tony Pham, Reed M Leventis, Katherine E Rose, Annie L S Roberts, Nathan O Weber, Edward H Sung, Maliha Aziz, Ryan M Troyer, Daniel E Park","doi":"10.1093/cid/ciag294","DOIUrl":"https://doi.org/10.1093/cid/ciag294","url":null,"abstract":"<p><strong>Background: </strong>Live attenuated influenza vaccine (LAIV) induces mucosal immunity through limited viral replication in the upper respiratory tract, but post-vaccination viral shedding dynamics and their clinical correlates remain incompletely characterized.</p><p><strong>Methods: </strong>We evaluated 283 healthy adults (108 in 2023-2024, 175 during the 2024-2025 influenza seasons) following intranasal LAIV administration. Nasal swabs were collected on post-LAIV days 1, 2-4, and 5-7 to quantify influenza A and B RNA by RT-PCR. Viral detection, shedding duration and burden, clearance kinetics, and probability of detection were compared across seasons, vaccine strain compositions (quadrivalent vs. trivalent), and host factors. Respiratory symptoms were assessed.</p><p><strong>Results: </strong>Early viral shedding was frequent: influenza A or B RNA was detected in 86.9% of participants on day 1, with co-detection in 52.7%. Probability of detection declined from 92% on day 1 to 9% on day 7. Influenza B had longer shedding duration (median, 2.0 vs. 1.0 days; p<0.001) and higher shedding burden (4.2 vs. 4.0 log₁₀ RNA copies/mL; p<0.001). Three clearance profiles - rapid (clearance ≤4 days), moderate (5-7 days), and slow (≥7 days) - were identified. Profiles were consistent across seasons but influenza B was disproportionately represented in slower-clearance groups (p<0.001). Total viral burden (p<0.01) and shedding duration (p=0.01) were associated with total symptom burden.</p><p><strong>Conclusions: </strong>LAIV replication begins within 24 hours and declines over the first week, with persistent shedding uncommon after day 7. Influenza B replicates more extensively and persists longer than influenza A. Symptom burden correlates with shedding duration and viral burden.</p>","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834599","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":"Anti-HBs Seroconversion Following Withdrawal of Anti-HBV-Active Agents: An Underrecognized Form of HBV Reactivation?","authors":"Eisuke Adachi, Hiroshi Yotsuyanagi","doi":"10.1093/cid/ciag305","DOIUrl":"https://doi.org/10.1093/cid/ciag305","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834606","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":"Challenges in defining severe influenza with implications for measuring and communicating influenza vaccine effects.","authors":"Catherine H Bozio, Manish Patel, Carrie Reed, Shikha Garg","doi":"10.1093/cid/ciag304","DOIUrl":"https://doi.org/10.1093/cid/ciag304","url":null,"abstract":"<p><p>With declining influenza vaccine coverage since the COVID-19 pandemic, it is more critical than ever to provide a strong evidence base to support the benefits of influenza vaccination. Influenza vaccination can reduce the risk of influenza-associated outpatient visits and hospitalizations, but some studies have also shown that influenza vaccination can decrease the severity of disease among those who develop influenza illness despite vaccination. Yet, using observational real-world data to demonstrate these benefits is challenging. In this commentary, we outline some of the challenges and issues to consider when designing observational studies to demonstrate the benefits of influenza vaccination among patients hospitalized with influenza. We further provide suggestions for how to create more standardized definitions for severe and critical influenza outcomes against which vaccine benefits may be measured, using lessons learned from the COVID-19 pandemic.</p>","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834624","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":"Transfusion-transmitted Severe Dengue: Implications for Blood Supply Safety.","authors":"Davidson H Hamer, Ralph Huits","doi":"10.1093/cid/ciag293","DOIUrl":"https://doi.org/10.1093/cid/ciag293","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834565","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":"Fatal transfusion-transmitted severe dengue in an immunocompromised host: case report and systematic literature review.","authors":"Alexandre Mestre Tejo, Amaro Nunes Duarte-Neto, Jacqueline Alves Rena, Wdson Luis Lima Kruschewsky, Camila Malta Romano, Caio Santos de Souza, Raquel Gomes Catozo, Mariene Ribeiro Amorim, Cinthya Dos Santos Cirqueira Borges, Hermes Ryoiti Higashino, Bruno Garcia Pires, Ester Cerdeira Sabino, Alfredo Mendrone-Junior, Vanderson Rocha, Silvia Figueiredo Costa","doi":"10.1093/cid/ciag292","DOIUrl":"https://doi.org/10.1093/cid/ciag292","url":null,"abstract":"<p><p>Transfusion-transmitted dengue remains a relevant risk during outbreaks. We report a transfusion-transmitted severe dengue case in a stem cell transplant recipient during the 2024 epidemic in Brazil, supported by phylogenetic linkage, evolving to a fatal outcome. This sentinel case highlights the potential severity of transfusion-transmitted dengue, particularly in immunocompromised hosts.</p>","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834550","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 Duration after Debridement and Implant Retention for Early Postoperative Spinal Implant Infections: A Multicenter Cohort Study.","authors":"Don Bambino Geno Tai, Emily Poehlein, Jessica C O'Neil, Sandra B Nelson, Aaron J Tande, Daniela De Lima Corvino, Alaina S Ritter, Jenny Aronson, Laura Certain, Daisuke Furukawa, Alexander M Tatara, Cynthia L Green, Tarek Abdalla, Molly E Fleece, Daniel G Tobert, Melissa Erickson, Jessica Seidelman","doi":"10.1093/cid/ciag300","DOIUrl":"https://doi.org/10.1093/cid/ciag300","url":null,"abstract":"<p><strong>Background: </strong>Postoperative spinal implant infections (PSII) are a serious complication of instrumented spinal fusion. Although debridement with implant retention is standard for early infection, the optimal duration of antimicrobial therapy remains uncertain.</p><p><strong>Methods: </strong>We conducted a multicenter retrospective cohort study across ten U.S. academic centers, including adults with early PSII (≤90 days after fusion surgery) from 2017 to 2021. We excluded patients who experienced treatment failure within 6 weeks of debridement. The primary outcome was treatment failure. Antibiotic therapy effect was analyzed as a time-varying exposure using adjusted Cox proportional hazards models. Secondary analyses included 12-week landmark and clone-censor-weighted models to compare durations ≤12 weeks versus >12 weeks.</p><p><strong>Results: </strong>116 patients out of 499 (23.2%) experienced treatment failure during a median follow-up of 3.2 years. Among patients who remain failure-free six weeks from debridement, being on antibiotics was not associated with treatment failure (adjusted hazard ratio [aHR] 0.71, 95% confidence interval [CI] 0.48-1.07; p = 0.10). In a 12-week landmark analysis limited to 359 patients who were not on indefinite suppressive antibiotic therapy, treatment durations >12 weeks did not significantly reduce the risk of failure (aHR 1.01, 95% CI 0.62-1.64; p = 0.99). Results were consistent in the clone-censor-weight sensitivity analysis (aHR 0.85, 95% CI 0.62-1.16; p = 0.30).</p><p><strong>Conclusions: </strong>Prolonged antibiotic therapy was not associated with improved outcomes in early PSII managed with debridement and implant retention. These results support shorter, individualized antibiotic courses in patients with adequate surgical source control.</p>","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834560","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 Road Not Yet Taken: Cell-Free DNA PCR Testing For Coccidioidomycosis.","authors":"Fariba M Donovan","doi":"10.1093/cid/ciag288","DOIUrl":"https://doi.org/10.1093/cid/ciag288","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834546","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":"Accuracy of Plasma Cell-Free DNA PCR for Diagnosis of Coccidioidomycosis.","authors":"Annalyse Lalljie, Indre Budvytiene, Joseph L Wheat, Elitza S Theel, Niaz Banaei","doi":"10.1093/cid/ciag287","DOIUrl":"https://doi.org/10.1093/cid/ciag287","url":null,"abstract":"<p><strong>Background: </strong>Coccidioidomycosis is the most prevalent endemic mycosis in the United States. Diagnosis of coccidioidomycosis can be challenging due to limitations of conventional diagnostics. Detection of fungal plasma cell-free DNA (cfDNA) is a novel non-invasive testing modality for the diagnosis of invasive fungal disease. In this study, we characterized the performance of Coccidioides plasma cfDNA PCR.</p><p><strong>Methods: </strong>A retrospective study was conducted in patients with suspected coccidioidomycosis who underwent plasma cfDNA PCR testing and conventional fungal testing for C. immitis and C. posadasii. Patients were categorized per the EORTC/MSGERC case definitions as proven or probable for sensitivity analyses and no coccidioidomycosis for specificity analyses.</p><p><strong>Results: </strong>Overall, 362 plasma samples from unique patients were included in this study. The overall sensitivity, specificity, and positive and negative predictive values of Coccidioides plasma cfDNA PCR at 0.04% prevalence were 57.5% (27/47; 95% CI, 42.2-71.7), 100% (315/315; 95% CI, 98.8-100), 100% (95% CI, 87.2-100), and 99.9% (95% CI, 100-100), respectively. The sensitivity was 33.3% (2/6; 95% CI, 4.3-77.7) in patients with pulmonary focal disease, 66.7% (14/21; 95% CI, 43.0-85.4; P≥0.05) in patients with pulmonary multifocal disease, and 52.6% (10/19; 95% CI, 39.6-77.9; P≥0.05) in patients with disseminated coccidioidomycosis. In patients with concurrent antigen results, the sensitivity of cfDNA PCR was 58.3% (14/24; 95% CI, 39.6-77.9) compared with 37.5% (9/24; 95% CI, 18.8-59.4; P≥0.05) for antigen.</p><p><strong>Conclusions: </strong>Coccidioides plasma cfDNA PCR is modestly sensitive but highly specific which can be useful for rapid and non-invasive diagnosis of coccidioidomycosis.</p>","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834523","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":"Rising Antifungal Resistance in Candidozyma auris: Signals, Gaps, and the Path Forward.","authors":"Rosanne Sprute, Oliver A Cornely","doi":"10.1093/cid/ciag258","DOIUrl":"https://doi.org/10.1093/cid/ciag258","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811701","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}