European Journal of Clinical Microbiology & Infectious Diseases最新文献

{"title":"Streptococcus pneumoniae keratitis: epidemiology and outcomes over 6 years in a French eye care center.","authors":"Thibaud Garcin, Gautier Hoarau, Valentin Leger, Lilia Merabet, Françoise Brignole-Baudouin, Vincent Borderie, Nacim Bouheraoua","doi":"10.1007/s10096-025-05057-0","DOIUrl":"10.1007/s10096-025-05057-0","url":null,"abstract":"<p><strong>Purpose: </strong>We evaluated the epidemiology, clinical features, microbiology, management and visual outcome of Streptococcus pneumoniae keratitis.</p><p><strong>Methods: </strong>We retrospectively reviewed the medical charts of patients diagnosed with culture-proven Streptococcus pneumoniae keratitis in a French tertiary center between January 2015 and December 2020.</p><p><strong>Results: </strong>We analyzed data from 51 eyes of 51 patients with Streptococcus pneumoniae keratitis followed for 64 (19-105) days, out of a total of 1222 eyes with documented bacterial keratitis (4.17%). Most cases (55%) occurred in winter or spring (p = 0.037). A local or systemic risk factor was identified in 39 (76%) and 32 (63%) eyes respectively: previous ocular surgery (55%) followed by glaucoma (24%), and diabetes (18%). Forty-one patients (80%) with severe keratitis remained in hospital for 7 (1-60) days. Polymicrobial infection was detected in 6 eyes (12%) and multidrug resistant strain in 9 eyes (18%). Medical treatment lasted 36 (21-60) days. Adjuvant surgery was required in 13 eyes (25%) mainly for delayed ulcer healing (n = 10), with amniotic membrane transplantation (n = 12) or tectonic keratoplasty (n = 1). In multivariate analysis, endothelial plaque (OR 65.87, p = 0.028), hypopyon (OR 17.8, p = 0.040), and infiltrate > 5mm² (OR 2.49, p = 0.012) were significantly associated with the need for adjuvant surgery. Baseline visual acuity (VA) 2.00(1.33-2.00) logMAR did not improve significantly at final visit (p = 0.121). Eyes requiring adjuvant surgery had worse final VA (p = 0.009).</p><p><strong>Conclusion: </strong>Streptococcus pneumoniae keratitis are rare in France but may be sight-threatening. Overall VA is poor, most of patients require hospitalization, and some local factors at presentation predict the need for adjuvant surgery.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"963-972"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic tests performance in detecting Pneumocystis jirovecii: A systematic review and meta-analysis.","authors":"Ling Zhang, Caopei Zheng, Yuqing Sun, Xue Chen, Yu Wang, Hanxue Xiang, Ying Liang, Feili Wei, Yulin Zhang","doi":"10.1007/s10096-025-05051-6","DOIUrl":"10.1007/s10096-025-05051-6","url":null,"abstract":"<p><strong>Background and objective: </strong>Pneumocystis jirovecii (Pj) pneumonia (PJP) is a life-threatening opportunistic infection primarily affecting immunocompromised individuals. Detecting Pj is challenging, particularly in distinguishing between Pj colonization (PJC) and infection. We aimed to systematically evaluate the diagnostic accuracy of various tests in differentiating Pj colonization from infection.</p><p><strong>Methods: </strong>Systematic reviews and meta-analyses were performed. Searches were conducted in PubMed, Embase, and Web of Science. Original clinical studies reporting sensitivity and specificity data for diagnostic tests such as quantitative polymerase chain reaction (qPCR), nested PCR, (1,3)-Beta-D glucan (BDG), metagenomic next-generation sequencing (mNGS), and digital PCR (ddPCR) to differentiate PJC from PJP were included. Quality assessment was performed using QUADAS-2 tool, and data processing followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Diagnostic performance was evaluated using either a random-effects or fixed-effects model.</p><p><strong>Results: </strong>Twenty-eight studies (2,550 patients, 1,445 with PJP) were included, with moderate methodological quality. The pooled sensitivity of these diagnostic tests was 0.80 (95% CI 0.77-0.82) and specificity was 0.83 (95% CI 0.81-0.85), with a diagnostic odds ratio (DOR) of 23.12. Among the individual tests, BDG (5 studies) showed high pooled sensitivity (0.83, 95% CI 0.77-0.88) but lower specificity (0.78, 95% CI 0.69-0.85). mNGS (3 studies) had the highest performance, with pooled sensitivity and specificity both at 0.87 (95% CI 0.80-0.92 and 95% CI 0.77-0.94, respectively), and the highest DOR of 41.57. qPCR (19 studies) demonstrated adequate pooled sensitivity (0.78, 95% CI 0.76-0.81) and high specificity (0.83, 95% CI 0.81-0.86), with a DOR of 20.44.</p><p><strong>Conclusion: </strong>While BDG has low specificity and mNGS is costly with no standardized interpretation, along with the limited number of relevant studies in BDG and mNGS, this meta-analysis concluded that qPCR remains valuable for distinguishing P. jirovecii infection from colonization. A well-designed randomized clinical trial that standardizes the technical aspects of the qPCR protocol is needed to assess its effectiveness and provide a solid basis for clinical diagnosis.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"789-805"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Whether to continue combining carbapenems to treat carbapenem-resistant Acinetobacter baumannii nosocomial pneumonia in critically ill patients: a retrospective efficacy and safety analysis.","authors":"Cheng Shiqi, Wang Chuhui, Zhang Yijing, Qiu Yulan, Chen Jiaojiao, Chen Keyu, Shi Qindong, Zeng Xiaoyan, Dong Yalin","doi":"10.1007/s10096-025-05063-2","DOIUrl":"10.1007/s10096-025-05063-2","url":null,"abstract":"<p><p>To explore the efficacy and safety of non-carbapenem-containing (NCC) regimens and carbapenem-containing regimens (CC) regimens, along with the factors influencing the outcomes in critically ill patients with carbapenem-resistant Acinetobacter baumannii (CRAB) pneumonia. This study retrospectively enrolled critically ill patients with CRAB pneumonia who were treated with NCC and CC regimens in a teaching hospital. The primary efficacy outcome was the 28-day clinical efficacy rate, and the safety outcome was the incidence of nephrotoxicity. After the propensity score matching analysis removed the differences between the two groups, the differences in outcomes were statistically analyzed. Cox regression and logistic regression models were used to analyze the factors influencing the outcomes of critically ill patients with CRAB pneumonia. Data from 168 critically ill patients with CRAB pneumonia were eventually included in this study for analysis (NCC = 84, CC = 84). The 28-day clinical efficacy rate was significantly lower in the CC group compared to the NCC group (40.5% vs. 57.1%, P = 0.031), and the incidence of nephrotoxicity was not significantly different in the two groups (P > 0.05). Logistic analysis showed that the prescription of carbapenems was the risk factor of decreased clinical efficacy (aOR = 0.494, 95%CI = 0.262-0.932, P = 0.029) and reduced microbiological eradication (aOR = 0.397, 95%CI = 0.201-0.783, P = 0.008) in patients. CC regimen may not contribute to the 28-day clinical efficacy of CRAB pneumonia and further studies are necessary to elucidate the CC regimen when treating CRAB pneumonia in critically ill patients.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"973-983"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Multicenter evaluation of leprosy rapid test Fast ML Flow Hanseníase in Brazil.","authors":"Djairo Pastor Saavedra, Maurício Lisboa Nobre, Rafael Alves Guimarães, Matheus Bernardes Torres Fogaça, Isabela Maria Bernardes Goulart, Jaison Antônio Barreto, Vânia Nieto Brito de Souza, Selma Maria Bezerra Jeronimo, Francianne Medeiros Amorim, Tatiana Pereira da Silva, Roberta Olmo Pinheiro, Mariane Martins de Araújo Stefani, Samira Bührer-Sékula","doi":"10.1007/s10096-025-05071-2","DOIUrl":"10.1007/s10096-025-05071-2","url":null,"abstract":"<p><strong>Purpose: </strong>Leprosy represents a public health concern; its diagnosis remains clinical. Recently, the Brazilian public health system/SUS incorporated the leprosy-specific IgM anti-PGL-I rapid test Fast ML Flow Hanseníase (MLFH/Bioclin, Brazil; originally ML Flow) to aid leprosy contacts surveillance and diagnosis. Anti-PGL-I antibody levels correlate with bacterial load. This multicenter study evaluated MLFH performance in confirmed leprosy cases from four Brazilian reference centers.</p><p><strong>Methods: </strong>MLFH results were compared to anti-PGL-I ELISA, bacilloscopy/BI and analyzed in indeterminate/I, pure neuritic/PN and in Ridley Jopling/RJ categories (tuberculoid/TT, borderline-tuberculoid/BT, borderline/BB, borderline-lepromatous/BL, lepromatous/LL). Leprosy patients' serum samples (N = 158; 95 multibacillary/MB, 63 paucibacillary/PB) were evaluated. Additionally, 20 previously tested leprosy samples were distributed to each center to assess MLFH repeatability, inter-center and inter-operator reproducibility.</p><p><strong>Results: </strong>Higher MLFH seropositivity (84.8%) compared to ELISA (60.8%; p < 0.001) and bacilloscopy (50.6%; p < 0.001), indicated moderate and fair agreement, respectively. Visual intensity readings (0 to 4 + range) from 20 samples showed excellent agreement (ICC: 0.954); test repeatability was 95.57%. Compared to ELISA and bacilloscopy, positivity difference was statistically significant (p < 0.05) in TT, BT, and I forms. Lower MLFH positivity was observed in indeterminate, BT and PN forms.</p><p><strong>Conclusion: </strong>The change in MLFH result criteria adopted by Bioclin/SUS considering faint test line (0.5) as positive (originally negative in ML Flow), increased MLFH sensitivity leading to higher seropositivity in MB and especially in PB, known as weak antibody producers. However, when screening asymptomatic leprosy contacts, this modified criterion may lead to reduced specificity since in endemic areas, anti-PGL-I positivity alone does not necessarily indicate active disease.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"985-995"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of reporting rapid susceptibility results in Gram negative bloodstream infections: a real world prospective study.","authors":"Anne-Sophie Messiaen, Stien Vandendriessche, Emilie De Muynck, Gregory Strubbe, Liesbet De Bus, Petra Schelstraete, Kristen Decommer, Sanne De Smet, Alexander Soetens, Leslie Naesens, Katrien Timmermans, Jan J De Waele, Diana Huis In 't Veld, Jerina Boelens","doi":"10.1007/s10096-025-05046-3","DOIUrl":"10.1007/s10096-025-05046-3","url":null,"abstract":"<p><strong>Purpose: </strong>Mortality and morbidity of patients with bloodstream infection (BSI) remain high despite advances in diagnostic methods and efforts to speed up reporting. This study investigated the impact of reporting rapid Minimum Inhibitory Concentration (MIC)-results in Gram negative BSIs with the ASTar system (Q-linea, Uppsala, Sweden) on the adaptation of empirically started antimicrobial therapy. We performed a real-world study during which antimicrobial susceptibility testing (AST) results were instantly reported to the treating physician in an established multidisciplinary antimicrobial stewardship setting.</p><p><strong>Methods: </strong>Consecutive patients with Gram negative bacteremia were included in the study (monomicrobial Gram stain, life expectancy of at least 48 h and flagging positive before 2 PM). Rapid AST (RAST) reporting with ASTar was added on top of the standard workflow. Technical performance of the system was evaluated as well as the impact on antimicrobial treatment and timelines of achieving effective and optimal antimicrobial therapy.</p><p><strong>Results: </strong>A total of 79 analyses were performed in 77 patients, of which 68 episodes were eligible for analysis. A categorical agreement was observed in 97,5% of 1160 MIC results without false susceptible results. All patients on ineffective empirical therapy (12/68) were switched after a median time of approximately one hour (5 min - 15 h) after communication of the result. Furthermore, 20/55 non-optimal therapies were adapted within a median period of 3 h after communication.</p><p><strong>Conclusion: </strong>The implementation of rapid MICs, measured by the ASTar system, in our low antimicrobial resistance setting with elaborate antimicrobial guidelines, was easy and led to early adaptation of empirical treatment in 32/55 instances (12 ineffective and 20 non-optimal therapy).</p><p><strong>Trial registration number: </strong>NCT06218277 (date of registration: 18-12-2023).</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"847-853"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolution of ceftazidime/avibactam resistance and plasmid dynamics in OXA-48-producing Klebsiella spp. during long-term patient colonization.","authors":"Salud Rodríguez-Pallares, María Alejandra Mateo-Vargas, Manuel Antonio Rodríguez-Iglesias, Jorge Arca-Suárez, Fátima Galán-Sánchez","doi":"10.1007/s10096-024-05034-z","DOIUrl":"10.1007/s10096-024-05034-z","url":null,"abstract":"<p><strong>Purpose: </strong>To prospectively monitor the evolution of the resistome of OXA-48-producing Klebsiella species in a patient with long-term colonization, with a particular focus into the plasmid dynamics and the evolution of ceftazidime/avibactam resistance.</p><p><strong>Methods: </strong>All OXA-48-producing Klebsiella spp. isolates from a single patient admitted to a hospital during seven months were prospectively collected. MICs were determined through reference broth microdilution. Multilocus sequence types, SNPs analysis, resistance mechanisms, genetic context of β-lactamases and plasmid dynamics were determined by WGS and bioinformatic analysis. The impact of β-lactamase variant obtained after ceftazidime/avibactam exposure was determined via cloning experiments.</p><p><strong>Results: </strong>Four isolates, two before (one OXA-48-producing K. pneumoniae and one CTX-M-15-like-producing K. pneumoniae) and two after treatment with ceftazidime/avibactam (one OXA-48- and CTX-M-15-like-producing K. pneumoniae and one OXA-48- and CTX-M-15-like-producing K. aerogenes) were collected. The plasmid dynamics analysis demonstrated that the IncL and IncFIIK plasmids, in which bla_OXA-48 and bla_{CTX-M-15-like} genes were located, respectively, exhibited a high degree of conservation indicating a potential for both intra- and interspecies transmission. The K. pneumoniae isolate obtained after treatment, which differed from the previous isolate by just six SNPs, exhibited resistance to ceftazidime/avibactam through P167S substitution in CTX-M-15, which is now designated CTX-M-273. Cloning experiments demonstrated enhanced resistance to ceftazidime/avibactam.</p><p><strong>Conclusion: </strong>The transfer of plasmid-borne β-lactamase resistance genes between intra- and interspecies bacterial populations enables the rapid diversification of the bacterial genome. The emergence of ceftazidime/avibactam resistance through the modification of CTX-M-enzymes represents a mechanism by which OXA-48-producing Enterobacterales may evolve toward ceftazidime/avibactam resistance in vivo.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"807-817"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical revenues of selective use of [18F]-FDG-PET/CT scanning in the management of Staphylococcus aureus bacteremia.","authors":"Dewi Verkaik, Annette C Westgeest, Jian Ling Wu, Kim C E Sigaloff, Merel M C Lambregts, Mark G J de Boer","doi":"10.1007/s10096-025-05052-5","DOIUrl":"10.1007/s10096-025-05052-5","url":null,"abstract":"<p><strong>Purpose: </strong>Although [18F]-FDG-PET/CT scanning (PET/CT) is recommended for managing Staphylococcus aureus bacteremia (SAB), its added value remains debated. This study investigated the clinical revenues of selective PET/CT use in SAB by considering three consequence-categories: detection of new infection foci, performance of new interventions, and alterations in antimicrobial therapy.</p><p><strong>Methods: </strong>All adult patients with ≥ 1 blood culture (BC) positive with Staphylococcus aureus admitted in a Dutch academic center between 2017¹¹ and 2023¹¹ were identified. Standard practice was to order PET/CT for patients with community acquired SAB and/or positive BCs after ≥ 48 h of treatment, or if multiple foci, or persistent fever, or endocarditis were present. Clinical- and laboratory data were obtained from electronic health records. Numbers-needed-to-scan (NNT-scan) were calculated for each consequence-category. Regression analyses were performed to identify variables correlated with consequence-bearing PET/CT.</p><p><strong>Results: </strong>Of 397 SAB patients, 143 (36%) underwent PET/CT. This led to detection of new foci in 73/143 patients (NNT-scan ≈ 2), new interventions in 33/143 patients (NNT-scan ≈ 4), and a change in antimicrobial therapy in 44/143 patients (NNT-scan ≈ 3). A CRP > 200 mg/L at presentation and positive follow-up BCs at 48 h were independently associated with interventions following PET/CT (adjusted OR and 95%CI 3.2 (1.2-8.3) and 2.6 (1.0-6.7) respectively). PET/CT results instigated changes in antimicrobial therapy predominantly in patients < 65 years and those with a CRP < 100 at presentation.</p><p><strong>Conclusions: </strong>Selective PET/CT ordering in real-life practice resulted in a relatively low NNT-scan across all consequence-categories. Further research is warranted to optimize patient selection for PET/CT using clinical parameters or profiles.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"895-904"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11946999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Description of an Enterococcus faecium genotype vanB outbreak in a hospitalization ward.","authors":"M Andrés, A Fajardo, M C García, L Grau, Y Angulo, V Marín, V Plasencia, G Santillana, E Jiménez, M Ballestero","doi":"10.1007/s10096-025-05056-1","DOIUrl":"10.1007/s10096-025-05056-1","url":null,"abstract":"<p><strong>Background and objectives: </strong>Vancomycin-resistant Enterococcus faecium (VRE) infections have increased in the last years. Hospital outbreaks have been described with a challenging microbiological diagnosis and control of the transmission.</p><p><strong>Methods: </strong>This is a prospective study of a nosocomial outbreak of VRE in a conventional hospitalization ward. Three clinical samples of VRE genotype vanB (vanB VRE) were detected in two surgical wards. Epidemiological control measures were implemented, including contact isolation, patients from clean surgery ward transferred to other wards, staff training, weekly screening with rectal swab and environmental study.</p><p><strong>Results: </strong>In a 3-month follow-up period, rectal screening was performed on a total of 314 patients, being positive for vanB VRE 51 patients (16.2%). A study of the surface of the common areas with exclusive use by healthcare personnel detected vanB VRE in 28% of the samples. All the strains of VRE analyzed by MLST were ST117, which belongs to clonal complex 17. Hand hygiene observations show proper adherence in 56% of the events monitored. Notwithstanding the large number of colonized patients, just one patient had a relevant infection requiring treatment, with good evolution.</p><p><strong>Conclusions: </strong>The survival of VRE on surfaces and the poor adherence to hand hygiene might have contributed to repetitively infect surfaces, perpetuating the outbreak. After 10 months without positive clinical samples, it was decided to suspend the screening, even though there were still screening positive results. Despite its spread, the clinical impact was low, possibly because the outbreak took place in a ward without severe immunosuppressed patients. The frequent isolation of VRE on surfaces which were exclusive from healthcare personnel areas, indicates how important is the disinfection of these areas.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"915-922"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology of invasive Haemophilus influenzae infections in Belgium: 2018-2022.","authors":"Ricardo El Nouwar, Benoit Prevost, Magali Wautier, Nicolas Yin, Maya Hites, Delphine Martiny","doi":"10.1007/s10096-025-05040-9","DOIUrl":"10.1007/s10096-025-05040-9","url":null,"abstract":"<p><strong>Introduction: </strong>Haemophilus influenzae plays a major role in invasive bacterial infections. Resistant strains are emerging, prompting the WHO to include H. influenzae on its list of priority pathogens for research and development of new antibiotics.</p><p><strong>Purpose: </strong>We aimed to describe the serotypes, demographics and susceptibility profiles of invasive strains collected in Belgium.</p><p><strong>Methods: </strong>Data on invasive strains referred to the Belgian National Reference Center for H. influenzae from 2018 to 2022 were analyzed retrospectively.</p><p><strong>Results: </strong>A total of 608 invasive strains were included. The number of notifications per year ranged from 85 to 165, with a marked decrease between 2020 and 2021. The highest incidence rate was observed in Brussels (1.56 per 100,000 inhabitants over the five year 2018-2022). Sex and age distribution were in line with global trends, as was the predominance of the non-typeable H. influenzae (NTHI). Beta-lactam resistance varies between molecules: 18.9% for ampicillin, 5.6% for amoxicillin-clavulanate. Mutations in the ftsI gene associated with decreased susceptibility to beta-lactams increased from 11.5 to 17.7% over the period studied.</p><p><strong>Discussion: </strong>The COVID-19 pandemic significantly influenced the epidemiology of invasive H. influenzae infections in Belgium. Demographic analysis identified a significant male predominance among infants, with a male-to-female ratio of 2.57 in patients under one year of age, a high figure not previously reported in the literature. The continued predominance of NTHI underscores the efficacy of Hib vaccination, although the emergence of Hib in patients younger than five years in 2022 suggests an alarming serotype dynamic. The detection of meropenem resistance also highlights the growing threat of antimicrobial resistance, while the increase in ftsI gene mutations raises concerns about the efficacy of first-line treatment.</p><p><strong>Conclusions: </strong>This study provides a comprehensive overview of the epidemiology of invasive H. influenzae infections in Belgium, focusing on demographic changes, serotype predominance and antimicrobial resistance trends. Vigilant surveillance and research are essential to address emerging challenges and guide future interventions, including potential vaccine development.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"855-865"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Ceftazidime-avibactam in treating Gram-negative infections: a systematic review and meta-analysis.","authors":"Nahal Khoshdel, Melina Noursalehigarakani, Zahra Sadat Seghatoleslami, Fahimeh Hadavand, Elaheh Eghbal, Mohammad Javad Nasiri, Elena Simula, Parnian Ahmed, Leonardo Antonio Sechi","doi":"10.1007/s10096-025-05044-5","DOIUrl":"10.1007/s10096-025-05044-5","url":null,"abstract":"<p><strong>Introduction: </strong>Ceftazidime-avibactam (CAZ-AVI) has emerged as a promising treatment option for Gram-negative infections, particularly those caused by CAZ-Non-Susceptible (NS) pathogens. This systematic review and meta-analysis aim to assess the efficacy and safety of CAZ-AVI in these challenging infections.</p><p><strong>Methods: </strong>We systematically queried EMBASE, Cochrane CENTRAL, and PubMed/Medline for studies published until September 15, 2024. Randomized Controlled Trials (RCTs) evaluating CAZ-AVI against Gram-negative infections were included. A meta-analysis was performed to calculate pooled odds ratios (OR) for both clinical and microbiological success.</p><p><strong>Results: </strong>A total of 146 studies were identified through database searches, leading to the inclusion of 17 studies. Among the efficacy studies for Gram-negative pathogens, there was no significant difference in clinical success rates for CAZ-AVI compared to comparators (pooled OR: 0.90, p = 0.22), and a non-significant increase in microbiological success was observed (pooled OR: 1.20, p = 0.41). In contrast, for CAZ-NS pathogens, six studies reported no significant difference in clinical cure rates (pooled OR: 0.77, p = 0.24), while four studies indicated a non-significant increase in microbiological cure rates (pooled OR: 1.83, p < 0.02).</p><p><strong>Conclusions: </strong>This study suggests that CAZ-AVI is a viable option for treating Gram-negative infections, including CAZ-NS pathogens. While it has shown promising activity against these resistant pathogens, its clinical and microbiological success rates are comparable to other antibiotics in the overall analysis. However, CAZ-AVI may offer an advantage in managing resistant infections. These findings underscore the need to consider CAZ-AVI in treatment guidelines and emphasize the importance of antibiotic stewardship programs to optimize its use and prevent resistance. Ongoing monitoring of resistance patterns and patient outcomes is essential to ensure its long-term efficacy.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"767-778"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11946964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}