Clinical Infectious Diseases最新文献

{"title":"Revisiting Cost-Effectiveness of Commercial or Traditional Fecal Microbiota Transplantation to Prevent Clostridioides difficile Recurrence.","authors":"Nirja Mehta, Christian Lodberg Hvas","doi":"10.1093/cid/ciag264","DOIUrl":"10.1093/cid/ciag264","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":"399-400"},"PeriodicalIF":8.3,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148204383","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":"Real-World Application of Recommended Practices in Nocardiosis.","authors":"Giulia Lenzi, Ivana Palucci, Barbara Fiori, Simone De Giorgi, Giancarlo Scoppettuolo, Antonella Cingolani, Rita Murri, Francesco Taccari, Gianmaria Baldin, Francesca Raffaelli, Giuseppe Puma, Brunella Posteraro, Maurizio Sanguinetti, Carlo Torti","doi":"10.1093/cid/ciag248","DOIUrl":"10.1093/cid/ciag248","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":"e671-e672"},"PeriodicalIF":8.3,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147866882","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":"Interpreting Outcomes of Intrathecal Therapy for Tuberculous Meningitis: Treatment Timing, Patient Selection, and Residual Uncertainty.","authors":"Rui Chen, Feng Li","doi":"10.1093/cid/ciag637","DOIUrl":"https://doi.org/10.1093/cid/ciag637","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":8.3,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126996","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":"An Unusual Appearance of Pruritus in the Elderly.","authors":"Shufen Yang, Changxian Wang, Xin Li","doi":"10.1093/cid/ciag286","DOIUrl":"https://doi.org/10.1093/cid/ciag286","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":"83 3","pages":"495-497"},"PeriodicalIF":8.3,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127006","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":"Changes in Epidemiology of Candidemia in the United States With a Focus on Candida auris.","authors":"María Alejandra Pérez, Khush A Patel, Laila Rasmy, Hisato Yoshida, Cesar A Arias, Masayuki Nigo, Max W Adelman","doi":"10.1093/cid/ciag312","DOIUrl":"10.1093/cid/ciag312","url":null,"abstract":"<p><strong>Background: </strong>Candidemia is a common complication in hospitalized and critically ill patients. Nationwide US data on candidemia risk factors, species, antifungal resistance, and outcomes remain limited. Our objective was to describe candidemia trends from 2015 to 2024 and identify risk factors for Candida auris candidemia.</p><p><strong>Methods: </strong>Retrospective study using the Epic Cosmos database. We analyzed trends in candidemia risk factors and outcomes. Thirty-day mortality was evaluated using multivariable logistic regression adjusted for age, Elixhauser comorbidity index, COVID-19-related hospitalization, ICU-acquired candidemia, and calendar year. We compared characteristics of patients with C. auris vs. non-C. auris candidemia.</p><p><strong>Results: </strong>A total of 29 454 candidemia cases were identified among 27 926 unique patients; candidemia incidence increased over time (P = .02). Overall 30-day mortality was 31.5% and increased significantly over the study period (from 24.7% to 31.8%; P = .02). There were similar trends in in-hospital mortality (P = .01) and intensive care unit-acquired candidemia (P = .03). The proportion of cases involving C. albicans decreased (P = .05) while C. auris cases increased (P = .008). Patients with C. auris candidemia were more likely to be Black, have renal failure, and have a higher social vulnerability index (P < .001 for all comparisons). Fluconazole resistance increased in C. parapsilosis (from 2.5% to 10.8%, P = .02) and C. tropicalis (from 6.2% to 18.1%, P = .03).</p><p><strong>Conclusions: </strong>Candidemia-associated 30-day mortality increased over the past decade, aligning with a trend toward older, more acutely ill patients developing candidemia. Candida auris candidemia was associated with Black race, higher social vulnerability, and renal failure. Overall, our findings highlight concerning nationwide US candidemia trends.</p>","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":"e505-e514"},"PeriodicalIF":8.3,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147873596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wanted: A Relevant Correlate of Protection for Dengue Vaccines.","authors":"Anna P Durbin","doi":"10.1093/cid/ciag350","DOIUrl":"10.1093/cid/ciag350","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":"e639-e640"},"PeriodicalIF":8.3,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359912","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 of Short-course Weekly Rifapentine and Isoniazid (3HP) for TB Preventive Treatment at Conception and During First Trimester in Women With HIV: A Secondary Analysis of the WHIP3TB trial.","authors":"Violet Chihota, Zainab Waggie, Vicky Cardenas, Kathy Mngadi, Felex Ndebele, William Brumskine, Modulakgotla Sebe, Neil Martinson, Shu-Hua Wang, Getnet Yimer, Dinis Nguenha, Alberto L Garcia-Basteiro, Susan van den Hof, Alison D Grant, Salome Charalambous, Katherine L Fielding, Richard E Chaisson, Gavin Churchyard","doi":"10.1093/cid/ciag315","DOIUrl":"10.1093/cid/ciag315","url":null,"abstract":"<p><strong>Background: </strong>The safety of a 3-month weekly rifapentine-isoniazid (3HP) for tuberculosis prevention in HIV-positive pregnant women on antiretroviral treatment is unknown. As part of the WHIP3TB trial, 3HP administered once or annually for 2 years was compared to 6 months of isoniazid. We report outcomes among women who became pregnant, with drug exposure in early pregnancy.</p><p><strong>Methods: </strong>Women were classified as exposed if conception occurred while taking study drug, and unexposed if conception occurred after the last dose. Outcomes included live birth, stillbirth, or abortion. A composite adverse pregnancy outcome was defined as any of the following: stillbirth, spontaneous abortion, low birth weight (<2500 g), preterm delivery (<37 weeks' gestation), or major congenital anomalies. Outcomes were compared between exposed and unexposed groups.</p><p><strong>Results: </strong>Among 2207 women aged 15-49 years enrolled between November 2016 and November 2017, 236 pregnancies occurred in 222 participants. Fifty-seven (24%) were exposed to study drug (51 in 3HP arm, 6 in 6 months of isoniazid arm) and 179 were unexposed. Median age was 32 years, median antiretroviral treatment duration 2.9 years (interquartile range; 1.2-4.9 years) and median CD4 count 522 cells/L; [interquartile range, 345-684). Of 219 pregnancies with known outcomes, 162 (74%) were live births, 51 (23%) abortions, and 6 (3%) stillbirths. Spontaneous abortions occurred at similar frequencies among exposed (12% [7/57]) and unexposed (14% [22/162]) groups with comparable rates of composite adverse outcomes (33% [19/57] vs 35% [56/162]).</p><p><strong>Conclusions: </strong>Spontaneous abortion and composite adverse pregnancy outcomes following first-trimester exposure to 3HP were comparable between exposed and unexposed groups, supporting the safety of 3HP in pregnancy.</p>","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":"e550-e558"},"PeriodicalIF":8.3,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147959831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FDG-PET/CT Demonstrates Superior Detection of Multiorgan Involvement in Paracoccidioidomycosis Compared With Conventional Staging.","authors":"Pricila G Cunha, Maria Emilia Seren Takahashi, Raquel S B Stucchi, Mariana Paixão Ribeiro, Thiago F Souza, Carmino Antonio de Souza, Barbara Juarez Amorim, Maria Luiza Moretti, Plinio Trabasso, Celso Dario Ramos","doi":"10.1093/cid/ciag372","DOIUrl":"10.1093/cid/ciag372","url":null,"abstract":"<p><strong>Background: </strong>Paracoccidioidomycosis (PCM) is a neglected systemic mycosis in which accurate staging is critical but challenging with conventional methods. This study evaluated 18F-FDG PET/CT compared with standard evaluation for PCM staging and assessed its impact on disease severity classification.</p><p><strong>Methods: </strong>Thirty-four patients with confirmed PCM (treatment-naïve or with suspected treatment failure) underwent conventional staging and whole-body 18F-FDG PET/CT. Disease severity was classified as mild, moderate, or severe. PET/CT images were analyzed qualitatively and quantitatively (SUVmax, TMLV, TLG).</p><p><strong>Results: </strong>PET/CT detected more than twice as many lesions as conventional evaluation (150 vs 62; mean 4.4 ± 1.6 vs 1.8 ± 0.9 affected organ systems per patient), with statistically significant superiority for lymph node, pulmonary, and adrenal involvement (McNemar's test, P < .05). PET/CT reclassified 97% of patients as multifocal versus 59% by conventional staging and produced a significant unidirectional shift toward higher severity-the proportion classified as severe increased from 70.6% to 91.2% (P = .016). Patients with suspected treatment failure showed significantly lower TMLV and TLG than treatment-naïve patients (P < .05). Quantitative PET parameters correlated with serological titers and inflammatory markers (P < .05), and PET/CT detected four times as many sites as gallium-67 scintigraphy.</p><p><strong>Conclusions: </strong>18F-FDG PET/CT systematically reveals greater disease burden than conventional evaluation in PCM, reclassifying most patients toward higher severity with direct implications for treatment duration and follow-up. Where available, it should be considered an important complementary modality for initial disease assessment.</p>","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":"e515-e525"},"PeriodicalIF":8.3,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148276489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can Influenza Virus Cause Bacteremia, Sepsis, and Septic Shock?","authors":"Andre C Kalil, Kelly A Cawcutt","doi":"10.1093/cid/ciag243","DOIUrl":"10.1093/cid/ciag243","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":"e650-e651"},"PeriodicalIF":8.3,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980850","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":"Cost-effectiveness of Commercial or Traditional Fecal Microbiota Transplantation for Recurrent Clostridioides difficile Infection.","authors":"William Hirsch, Eva A Enns, Alexander Khoruts, Radha Rajasingham, Byron P Vaughn","doi":"10.1093/cid/ciag263","DOIUrl":"10.1093/cid/ciag263","url":null,"abstract":"<p><strong>Background: </strong>Fecal microbiota transplantation (FMT) is the cost-effective strategy for managing recurrent Clostridioides difficile infection (rCDI). Prior costing models assumed FMT administration via colonoscopy. With the commercialization of microbiota therapeutics for rCDI, this study sought to determine the impact of commercial, Food and Drug Administration (FDA) approved microbiota-based therapeutics relative to traditional FMT on the cost-effectiveness for rCDI.</p><p><strong>Methods: </strong>We used a Markov model to simulate a cohort of patients with rCDI to evaluate the cost-effectiveness of varied methods of FMT administration for rCDI. The model includes estimates of cure, recurrence, and mortality. Data sources were taken from national guidelines and published literature on treatment outcomes. Outcome measures were quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratios (ICERs).</p><p><strong>Results: </strong>FMT by colonoscopy is the cost-effective strategy for preventing second or subsequent rCDI with an incremental cost-effectiveness ratio (ICER) of $44 158. Assuming a willingness-to-pay threshold of $100 000 per quality adjusted life years (QALY) gained, FMT by colonoscopy was optimal in the majority (70%) of simulations. At a willingness-to-pay threshold of $100 000 per quality adjusted life year (QALY), commercial, FDA approved microbiota therapeutics were not cost effective under any circumstance when donor-derived FMT products are available.</p><p><strong>Conclusions: </strong>Traditional FMT administered by colonoscopy is the optimal cost-effective strategy for preventing second or subsequent episodes of rCDI. If FMT is not available, then microbiota therapeutics are not a cost-effective option for rCDI at current pricing.</p>","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":"391-398"},"PeriodicalIF":8.3,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148216311","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}