Clinical Infectious Diseases最新文献

{"title":"Correction to: Cephalosporins Versus Non-cephalosporin Antibiotics for Perioperative Prophylaxis in Primary Arthroplasty: A Systematic Review and Meta-Analysis.","authors":"","doi":"10.1093/cid/ciag366","DOIUrl":"https://doi.org/10.1093/cid/ciag366","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":8.3,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179821","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":"Low Baseline RPR Titers and Serological Response: Persistent Questions Among People with HIV.","authors":"José L Casado, Alejandro Vallejo","doi":"10.1093/cid/ciag645","DOIUrl":"https://doi.org/10.1093/cid/ciag645","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":8.3,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179854","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":"Does Low Baseline RPR Reflect Treatment Failure or Serologic Response Dynamics in Syphilis Among People With HIV?","authors":"Ercan Yılmaz, Nezihe Koker Özer, Erdem Topal","doi":"10.1093/cid/ciag643","DOIUrl":"https://doi.org/10.1093/cid/ciag643","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":8.3,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179877","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":"Correction to: Comparison of Ceftolozane-Tazobactam and Ceftazidime-Avibactam in the Treatment of Multidrug-Resistant/Difficult-to-Treat Resistant Pseudomonas aeruginosa Infections: A Systematic Review and Meta-analysis.","authors":"","doi":"10.1093/cid/ciag631","DOIUrl":"https://doi.org/10.1093/cid/ciag631","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":8.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166943","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":"Recurrent and Relapsing Catheter-Related Bloodstream Infections in Patients Requiring Long-term Vascular Access.","authors":"Leonard A Mermel, Kevin M Baskin, Niccolò Buetti, Kerry L LaPlante, Jonas Marschall","doi":"10.1093/cid/ciag559","DOIUrl":"https://doi.org/10.1093/cid/ciag559","url":null,"abstract":"<p><p>Patients requiring long-term vascular access are at risk of experiencing recurrent or relapsing infections. Decisions to remove and replace these devices when infected depend on their clinical status, the pathogen involved, options for alternative access sites, the risk of mechanical complications or loss of access with attempted catheter replacement, and interruptions of care plans. This State-of-the-Art Review focuses on a team approach to the management of such complex patients. Management involves empiric and then directed systemic antimicrobial therapy, antimicrobial lock therapy, decisions regarding the use of antibiotic-impregnated catheters, and intentional preservation of central venous access for future device insertion. Meticulous documentation, a team approach to care including shared decision-making with the patient and family, optimization of available prophylactic medications and devices, and individualized adherence to evidence-based best practices and professional standards fill important gaps in care delivery and will improve the prevention and management of these infections in this vulnerable patient population.</p>","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":8.3,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147192","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":"Excess Hospital Use and Years of Life Lost After Cancer Diagnosis among People with HIV: A Nationwide Study in Spain","authors":"Mar Masiá,Ana Gutiérrez-Ortiz de la Tabla,Lidia García,Christian Ledesma,Marta Fernández-González,Melissa Bello-Perez,Paula Mascarell,Ángela Botella,Javier García-Abellán,Sergio Padilla,Félix Gutiérrez","doi":"10.1093/cid/ciag620","DOIUrl":"https://doi.org/10.1093/cid/ciag620","url":null,"abstract":"Abstract Background Cancer is an increasingly important cause of morbidity and mortality among people with HIV (PWH), yet its impact on post-index-admission hospital trajectories remains poorly characterized Methods We conducted a nationwide study using the mandatory Nationwide Hospital Discharge Database of the Spanish National Health System, including all adult hospital admissions from 1997 to 2023. We compared PWH and individuals without HIV for trends in cancer-related hospitalizations, clinical characteristics, post-index-admission hospital trajectories, healthcare use, in-hospital mortality, and years of life lost (YLL). Results Among 115,171,334 admissions, 626,066 occurred in PWH. Cancer-related hospitalizations increased in both groups, but more steeply among PWH, reaching nearly one in five hospitalizations in 2020-2023. At first cancer admission, PWH were younger, had greater comorbidity, and more often had metastatic disease. Following cancer diagnosis, PWH had higher readmission risk, more frequent rehospitalizations, shorter time to readmission, longer cumulative stay, and higher hospitalization costs. A composite measure of complex hospital trajectory was more frequent among PWH (29.6% vs 18.0%; adjusted OR 1.38, 95% CI 1.34–1.41). In-hospital mortality was higher (12.1% vs 8.9%; adjusted OR 1.83, 95% CI 1.79–1.87), and YLL were greater overall (35 vs 18 years) and across major cancer types. Conclusions Cancer has emerged as a major and growing driver of hospitalization among PWH, characterized by sustained excess hospital use, complex post-index-admission hospital trajectories, and significantly greater premature mortality.","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":"52 1","pages":""},"PeriodicalIF":11.8,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149150395","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":"Looking for Something Nobody Is Counting","authors":"Daniel Z Uslan","doi":"10.1093/cid/ciag587","DOIUrl":"https://doi.org/10.1093/cid/ciag587","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":"3 1","pages":""},"PeriodicalIF":11.8,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149150396","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":"Tongue Swab Mycobacterium tuberculosis Quantitative Polymerase Chain Reaction for Community Screening of Asymptomatic Tuberculosis Versus Clinic-Based Triage of Symptomatic Tuberculosis.","authors":"Rachel C Wood, Alaina M Olson, Katherine A Lochner, Rane B Dragovich, Alexey Ball, Amy Steadman, Tahlia Perumal, Simon C Mendelsohn, Humphrey Mulenga, Michele Tameris, Denis Awany, Tumelo Moloantoa, Stephanus T Malherbe, Austin Katona, Fernanda Maruri, Kris M Weigel, Firdows Noor, Ravindre Panchia, Khuthadzo Hlongwane, Kim Stanley, Yuri F van der Heijden, Katie Hadley, Gerhard Walzl, Thomas J Scriba, Neil A Martinson, Keertan Dheda, Al Leslie, Bernard Fourie, Timothy R Sterling, Gerard A Cangelosi, Mark Hatherill","doi":"10.1093/cid/ciag443","DOIUrl":"10.1093/cid/ciag443","url":null,"abstract":"<p><strong>Background: </strong>Diagnostic performance of tongue swab Mycobacterium tuberculosis polymerase chain reaction (PCR) has been evaluated for triage of symptomatic tuberculosis (TB). It is unknown whether performance differs for detection of asymptomatic TB in community-based screening.</p><p><strong>Methods: </strong>Tongue swabs were collected from adult household contacts of persons with TB (HHC cohort), and symptomatic adults presenting with presumptive TB (clinic cohort), at six South African sites. Drug-susceptible pulmonary TB was defined by positive sputum Xpert Ultra (excluding trace) or liquid culture, which were performed in all participants. Tongue swabs from participants with and without TB, matched by propensity score, were tested by high-volume quantitative PCR (qPCR) and, in the clinic cohort, also by sequence-specific magnetic capture (SSMaC) with qPCR.</p><p><strong>Results: </strong>The clinic cohort included 217 participants with TB (100% symptomatic) and 437 participants without TB. The HHC cohort included 44 participants with TB (84.1% asymptomatic) and 136 participants without TB. In the clinic cohort, sensitivity of SSMaC with qPCR was 73.2% (specificity 94.6%), but not significantly higher than high-volume qPCR (63.8%; P = .14) (specificity 94.4%). Sensitivity of high-volume qPCR in the clinic cohort (63.8%) was significantly higher than the HHC cohort (34.1%; P = .0007) (specificity 91.9%). Among HHC, high-volume qPCR sensitivity was 35.1% for asymptomatic TB, 52.2% for TB with abnormal chest radiograph, and 100% for TB with high sputum Xpert Ultra grade.</p><p><strong>Conclusions: </strong>Sensitivity of tongue swab high-volume qPCR in community-based, household screening for asymptomatic TB was low, approximately half that of facility-based triage for symptomatic TB, but increased with radiographic severity and sputum bacillary load.</p>","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":8.3,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149134712","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 exposure and the emergence of multidrug resistant bacteria in patients with liver cirrhosis: A prospective cohort study.","authors":"Myriam W Heilani, Toska Wiedemann, Christopher Best, Philip G Ferstl, Victoria T Mücke, Katharina M Schwarzkopf, Hans-Peter Erasmus, Kai-Henrik Peiffer, Tobias Burbach, Michael Hogardt, André Mohr, Johanna Kessel, Maria J G T Vehreschild, Stefan Zeuzem, Jonel Trebicka, Christoph Welsch, Eva Herrmann, Volkhard A J Kempf, Marcus M Mücke","doi":"10.1093/cid/ciag610","DOIUrl":"https://doi.org/10.1093/cid/ciag610","url":null,"abstract":"<p><strong>Background: </strong>Infections caused by multidrug-resistant organisms (MDROs) are a growing concern in patients with advanced chronic liver disease and acute-on-chronic liver failure, worsening clinical outcomes. Although prior antibiotic exposure is associated with resistance, prospectively defined, clinically actionable exposure thresholds in this population are lacking. We aimed to quantify cumulative-exposure thresholds for de novo MDRO acquisition and assess the prognostic impact of MDRO emergence on survival.</p><p><strong>Methods: </strong>We prospectively enrolled 256 consecutive adults with advanced chronic liver disease at the University Hospital Frankfurt (2020-2023). Antibiotic exposure was quantified using defined daily doses (DDD) and antibiotic use density (AUD); MDRO colonisation and infection were captured by systematic microbiological surveillance. Time-to-death was analysed in a competing-risk framework with liver transplantation as competing event.</p><p><strong>Results: </strong>Among 246 patients without MDRO at the first admission swab, de novo acquisition of vancomycin-resistant enterococci (VRE) or Gram-negative MDR was strongly associated with cumulative antibiotic exposure (p<0.001). The 20% probability threshold for VRE was reached at 9.6 cumulative DDDs of any antibiotic, with substantially lower thresholds for β-lactam/β-lactamase inhibitor combinations, carbapenems, and glycopeptides. De novo MDRO detection during follow-up, but not at baseline, was independently associated with increased 180-day mortality (HR 2.15, 95% CI 1.27-3.64; p=0.004).</p><p><strong>Conclusions: </strong>In advanced cirrhosis, MDRO emergence is associated with cumulative antibiotic exposure beyond distinct, class-specific thresholds and carries excess mortality. These prospective findings identify cumulative antibiotic burden as a modifiable risk factor and support an exposure-aware approach to antimicrobial stewardship in this population.</p>","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":8.3,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149134464","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":"Tipping the Scales: More Reasons to Re-evaluate Antibiotic Use in Patients with Advanced Liver Disease.","authors":"Natalia Medvedeva, Marisa Holubar","doi":"10.1093/cid/ciag612","DOIUrl":"https://doi.org/10.1093/cid/ciag612","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":8.3,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149134691","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}