Clinical Infectious Diseases最新文献

{"title":"Performance of a novel P. falciparum rapid diagnostic test in areas of widespread hrp2/3 gene deletion","authors":"Aynalem Mandefro, Xavier C Ding, Jocelyn Farge, Gezahegn Solomon Alemayehu, Geletta Tadele, Bacha Mekonen, Yirgalem Gebrehiwot, Nega Berhe, Berhanu Erko, Hannah C Slater, Greg T Bizilj, Rebecca Barney, Allison Golden, Gonzalo J Domingo, Lemu Golassa","doi":"10.1093/cid/ciaf212","DOIUrl":"https://doi.org/10.1093/cid/ciaf212","url":null,"abstract":"Background Rapid diagnostic tests (RDTs) have improved malaria diagnosis, however the emergence of hrp2/3 gene deletions threatens the reliability of HRP2-based RDTs. This study evaluated the diagnostic performance of a novel RDT detecting both HRP2 and PfLDH in a single test line. Method A cross-sectional study was conducted at two health centers in Ethiopia, recruiting 1004 study participants. Blood samples were tested using the novel and comparator RDTs, using microscopy and nested PCR as the reference standards. P. falciparum hrp2 and hrp3 genotyping and HRP2 and PfLDH antigen quantification were also conducted. Results In this study settings, characterized by 80% of P. falciparum infections showing hrp2 or hrp3 deletion, the novel RDT showed a sensitivity of 77.4% and a specificity of 96%, surpassing the HRP2-only comparators Bioline™ Malaria Ag Pf (55.9%) and Bioline™ Malaria Ag Pf/Pv (56.8%). Its performance was comparable to the three-line Bioline™ Malaria Ag Pf/Pf/Pv RDT, which detects HRP2, PfLDH, and PvLDH, at 77.7% sensitivity. Additionally, the novel RDT exhibited the ability to detect P. falciparum cases across a broader range of HRP2 and PfLDH antigen concentrations compared to the comparator RDTs. Conclusions The single-line, easy-to-interpret index malaria RDT outperforms conventional HRP2-only RDTs, making it a promising tool for enhancing malaria diagnosis in regions with high hrp2/3 deletion prevalence. The study is registered on ClinicalTrials.gov ID NCT05286359.","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":"15 1","pages":""},"PeriodicalIF":11.8,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143872690","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":"Untangling the Sources of HIV-related Cardiovascular Risk.","authors":"Sonya Krishnan,Eileen P Scully","doi":"10.1093/cid/ciaf211","DOIUrl":"https://doi.org/10.1093/cid/ciaf211","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":"49 1","pages":""},"PeriodicalIF":11.8,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143880206","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":"Cryptococcal Meningitis Treatment Beyond HIV: Recognizing the need for Individualized Immune-Based Strategies","authors":"Hyunah Yoon, Liise-anne Pirofski, David R Boulware","doi":"10.1093/cid/ciaf218","DOIUrl":"https://doi.org/10.1093/cid/ciaf218","url":null,"abstract":"The promising results of the Ambition-CM trial in persons with HIV have sparked interest in treating non-HIV-associated cryptococcal meningitis with single 10mg/kg liposomal amphotericin B, combined with oral flucytosine and fluconazole. However, caution is warranted when applying this approach to non-HIV organ transplant recipients, whose immune status may vary due to the effects of immunosuppressive drugs. In these patients, cryptococcal disease, which generally occurs after initial immunosuppressant doses are reduced, may be driven by fungal growth, an immune response to cryptococcal antigens, or both. The latter is particularly relevant as potent antimicrobial therapy can lyse Cryptococcus, releasing antigens that trigger inflammation and cause host-mediated damage. Reducing iatrogenic immunosuppression may enhance host immune responses, which, in the context of neuro-infections, may be fatal. This highlights the importance of understanding the immune status of non-HIV organ transplant recipients within the context of the Damage-Response Framework to guide personalized treatment strategies.","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":"15 1","pages":""},"PeriodicalIF":11.8,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143875866","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":"Case series of patients with laboratory confirmed Marburg virus disease, 2023 Equatorial Guinea","authors":"Florentino Abaga Ondo Ndoho, Luca Fontana, Candido Ondo Ondo Avomo, Ladislao Ekiri Ngomo Mikue, Domitila Ñadang Fuga Eyemam, Micaela Ayang Nguere, Ilda Elobe Mometolo, Rosalia Nazang Bibang Nzang, Damaso Mitogo Nguema Maye, Yosbanis Hernandez Suarez, Salvador Eduardo Esono, José Antonio Miko Ayang, Ruggero Giuliani, Frédérique Jacquerioz, Hans-Joerg Lang, Richard Kojan, Antoine Chaillon, Stephanie Ngai, Olivier le Polain de Waroux, Anna Silenzi, Michele Di Marco, Anaïs Legand, Pierre Formenty, Maria E Negron, John D Klena, Mary J Choi, Oren Mayer, Florine E M Scholte, Stephen R Welch, Emily Zielinski Gutierrez, Janet Diaz","doi":"10.1093/cid/ciaf208","DOIUrl":"https://doi.org/10.1093/cid/ciaf208","url":null,"abstract":"Background Marburg virus disease (MVD) is a severe viral infection caused by the Marburg marburgvirus species. In February 2023, Equatorial Guinea declared its first outbreak. This case series describes the natural history of MVD in five laboratory confirmed patients. Methods Patients with confirmed MVD admitted to the national treatment center in Bata, Equatorial Guinea, were monitored for vital signs and symptoms. Comprehensive clinical data was collected to understand the progression and outcome of the disease. Results Five patients were confirmed to have MVD. Three male healthcare workers were diagnosed early in their disease and subsequently survived. The other two patients, both females, were admitted later in their disease progression and died within 24 hours of admission. Four patients received remdesivir under a protocol for the Monitored Emergency Use of Unregistered and Experimental Interventions. The early symptoms were non-specific, with rapid progression to more severe conditions in the later stages of the disease. Early treatment with remdesivir showed the drug to be well tolerated. Conclusions Contrary to some reports and the recommended case definition for MVD, our patients presented with a rash but did not exhibit vomiting or diarrhea. Hemorrhagic signs were solely observed in the terminal stage, preceding demise. Despite the limited sample size, these findings emphasize the importance of tailoring the case definition to the specific outbreak. Further evidence on the efficacy and safety of therapeutics for MVD, including remdesivir, should be gathered through well-designed trials during future epidemic responses.","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":"8 1","pages":""},"PeriodicalIF":11.8,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143872693","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":"Too Much Coffee: A Rare Cause of Sore Throat.","authors":"Sebastian Sanchez-Lopez,María Susana Cerino-Peñaloza,John M Scott,Jacob Hodges,Suzuki Hiroyuki","doi":"10.1093/cid/ciaf123","DOIUrl":"https://doi.org/10.1093/cid/ciaf123","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":"4 1","pages":""},"PeriodicalIF":11.8,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143866825","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 Burnout: The Power of Purpose, Partnership, and Serving Others.","authors":"Mary Lou Manning,Elizabeth Monsees,Elaine Larson","doi":"10.1093/cid/ciaf133","DOIUrl":"https://doi.org/10.1093/cid/ciaf133","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":"2 1","pages":""},"PeriodicalIF":11.8,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143862042","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":"Clostridioides difficile: Treating Sustained Antibiotic Responders With Fecal Microbiota Transplantation Does Not Improve Efficacy.","authors":"Sara Ellegaard Paaske,Simon Mark Dahl Baunwall,Gianluca Ianiro,Tariq Iqbal,Josbert Keller,Jouzas Kupciskas,Alexander Link,Benjamin H Mullish,Maria J G T Vehreshild,Jens Frederik Dahlerup,Christian Lodberg Hvas","doi":"10.1093/cid/ciaf141","DOIUrl":"https://doi.org/10.1093/cid/ciaf141","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":"7 1","pages":""},"PeriodicalIF":11.8,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143862044","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":"Antimicrobial Stewardship and Beyond: The Many Essential Roles of Infectious Diseases Pharmacists","authors":"Wesley D Kufel, Conan MacDougall, Samuel L Aitken, Kathryn Dzintars, Matthew R Davis, Monica V Mahoney, Jason C Gallagher","doi":"10.1093/cid/ciaf106","DOIUrl":"https://doi.org/10.1093/cid/ciaf106","url":null,"abstract":"Infectious diseases (ID) pharmacists are experts in antimicrobial pharmacology and pharmacotherapy and have the training and expertise for collaborative patient care with ID providers. Although ID pharmacists are recognized as key members of antimicrobial stewardship (AS) programs, this is not where the specialty began, and ID pharmacists fill multiple other roles beyond AS. The specialty of ID pharmacy initially arose as a form of consultancy for complex antimicrobial use cases. The rising complexity of ID pharmacotherapy among other reasons necessitates the growth of roles for ID pharmacists outside of positions primarily in AS, which we refer to as ID consultant pharmacists. They may be part of inpatient consultation teams, transitions of care, outpatient ID, and/or pharmaceutical industry/drug development. Various funding mechanisms exist, and additional opportunities should be explored including hybrid AS and ID consultant pharmacist positions. These roles should continue to be supported and increased to optimize collaborative ID patient care.","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":"225 1","pages":""},"PeriodicalIF":11.8,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143863030","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":"Diagnostic Uncertainties and Delayed Treatment Protocols Impact Efficacy of FMT for C. Difficile Infection.","authors":"Jessica R Allegretti,Monika Fischer,Colleen R Kelly","doi":"10.1093/cid/ciaf140","DOIUrl":"https://doi.org/10.1093/cid/ciaf140","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":"273 1","pages":""},"PeriodicalIF":11.8,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143862006","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":"Efficacy and Safety of Fecal Microbiota Transplant for Prevention of Recurrent Clostridioides difficile Infection.","authors":"Aasma Shaukat,Dimitri M Drekonja,Yuan Huang,Jane H Zhang,Anne Davis-Karim,Tassos C Kyriakides","doi":"10.1093/cid/ciaf142","DOIUrl":"https://doi.org/10.1093/cid/ciaf142","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":"234 1","pages":""},"PeriodicalIF":11.8,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143862040","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}