European Journal of Clinical Microbiology & Infectious Diseases最新文献

{"title":"The feasibility of antimicrobial lead time as process and quality indicator for hospitals.","authors":"R I Helou, H van der Sijs, D Rizopoulos, M Vogel, N J Verkaik, A Verbon","doi":"10.1007/s10096-025-05085-w","DOIUrl":"10.1007/s10096-025-05085-w","url":null,"abstract":"<p><strong>Purpose: </strong>Antimicrobial lead time (ALT) is the time from antimicrobial order to administration, an understudied parameter. This study aims to determine feasibility of retrieving ALT, differences in ALT for different infectious diseases and the association of ALT with length of stay (LoS) in order to establish the value of this parameter as potential new process or quality indicator (QI).</p><p><strong>Methods: </strong>In a retrospective study in a tertiary care hospital in the Netherlands, adult hospitalized patients treated for an infection were included over a 20-month period. ALT was calculated with data from the electronic health record system with computerized provider order entry.</p><p><strong>Results: </strong>Thousand patients (56.1% men, median age 61 years) were included. The median ALT was 1.05 h and significantly shorter in septic patients (n = 65) than in patients with other infections (n = 935; 0.27 h, interquartile range (IQR) 0.07-0.67 vs. 1.18 h, IQR 0.37-3.15; p < 0.001). If blood cultures were obtained median ALT was shorter (0.85 h vs. 1.77 h; p < 0.001). ALT was not shorter in patients with positive compared to negative blood cultures (0.63 h vs. 0.94 h; p = 0.053). Antimicrobials ordered in the emergency room had a shorter median ALT than in medical wards (0.43 h vs. 1.57 h; p < 0.001). After correcting for indication, we found no association between ALT and LoS (p = 0.34).</p><p><strong>Conclusions: </strong>ALT is an easily measurable QI for sepsis. More studies are needed to establish whether ALT is a feasible QI for meningitis and community-acquired pneumonia. For all infections, ALT can be used as process indicator for drug administration.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"1177-1183"},"PeriodicalIF":3.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572543","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":"Improving effective antimicrobial resistance (AMR) prevention in ambulatory care: lessons from secondary appraisal of Belgian anti-infectious treatment care guidelines.","authors":"Johan Van Laethem, Simon Planken, Pieter-Jan Cortoos, Marie-Angélique De Scheerder, Maja Kiselinova, Anne Tilmanne, Erlangga Yusuf, Johan Vansintejan, Nicolas Dauby","doi":"10.1007/s10096-025-05075-y","DOIUrl":"10.1007/s10096-025-05075-y","url":null,"abstract":"<p><p>The emergence of antimicrobial resistance (AMR) has been designated as a global threat by the World Health Organization. To combat AMR in Belgium, the Belgian Antibiotic Policy Coordination Committee (BAPCOC) has, among others, developed guidelines for the appropriate use of antimicrobials in the ambulatory practice. We aim to assess the current guidelines from an antimicrobial stewardship perspective and procide suggestions for improving the ambulatory antibiotic guidelines for first-line healthcare providers. The 2022 BAPCOC guidelines were independently evaluated by 7 antimicrobial stewardship experts based on the five \"Ds\" of antimicrobial stewardship. The results were aggregated, summarized, and consensus was sought. Recommendations improving the guidelines were formulated. A total of 52 recommendations were made, covering 16 different (sub)chapters. The most frequently covered topics were urinary tract infections, followed by skin and soft tissue infections. Among the top five recommendations deemed to have the greatest impact on antimicrobial stewardship outcomes, three were related to the diagnosis or treatment duration of urinary tract infections. Tailoring infectious disease and antibiotic treatment guidelines to antimicrobial stewardship principles and the latest literature is essential in combating antimicrobial resistance. Implementing our proposed recommendations in the Belgian ambulatory treatment guidelines could significantly enhance rational and judicious antibiotic use while minimizing the risk of 'antibiotic undertreatment. The proposed 'Choosing Wisely' recommendations have the potential to be applied to a broader (European) context.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"1251-1263"},"PeriodicalIF":3.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482537","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":"Successful treatment of carbapenem-resistant Acinetobacter baumannii meningitis and purulent ventriculitis using cefiderocol combination therapy: a case report and literature review.","authors":"Xuan Wang, Qihui Liu, Biwu Wu, Huaiyin Zhao, Jin Hu, Ning Li","doi":"10.1007/s10096-025-05077-w","DOIUrl":"10.1007/s10096-025-05077-w","url":null,"abstract":"<p><p>The application of cefiderocol in treating carbapenem-resistant Acinetobacter baumannii (CRAB) central nervous system (CNS) infections is rarely reported. Here we presented the case of a 66-year-old man with CRAB meningitis and purulent ventriculitis successfully treated with a combination antibiotic therapy including cefiderocol. Cerebrospinal fluid (CSF) analysis revealed normalization of glucose, chloride, protein, and lactate levels. CRAB cultures turned negative by Day 7, and metagenomics next generation sequencing (mNGS) results were negative by Day 25. The cefiderocol-contained regimen was continued for 41 days, with no recurrence of CRAB infection and no cefiderocol-associated adverse effects were observed. This case highlighted the potential of cefiderocol as a promising therapeutic option in treating CRAB CNS infections.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"1245-1250"},"PeriodicalIF":3.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466636","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":"Extensively drug-resistant Haemophilus influenzae isolated in Geneva, Switzerland.","authors":"Abdessalam Cherkaoui, Patrice Francois, Nadia Gaia, Gesuele Renzi, Adrien Fischer, Jacques Schrenzel","doi":"10.1007/s10096-025-05093-w","DOIUrl":"10.1007/s10096-025-05093-w","url":null,"abstract":"<p><p>The emergence of multi-drug resistant (MDR) and even extensively drug-resistant (XDR) strains among H. influenzae was observed in some Asian countries. Herein, we reported the first XDR H. influenzae isolated in Geneva, Switzerland. This strain was isolated in a good-quality sputum sample from a 63 year-old male patient. There was no respiratory infection diagnosed at that time. The strain was non-typeable and pan-β-lactam resistant. According to whole genome sequencing analysis it belongs to sequence type 159 and the ST-107 clonal complex. It was classified into group III + regarding the amino acid substitutions identified in the transpeptidase domain of PBP3.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"1273-1277"},"PeriodicalIF":3.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565990","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":"Determinants of time to positivity in bloodstream infections: an analysis of a population-based cohort in Queensland, Australia.","authors":"Felicity Edwards, Michael Waller, Kevin B Laupland","doi":"10.1007/s10096-025-05096-7","DOIUrl":"10.1007/s10096-025-05096-7","url":null,"abstract":"<p><strong>Purpose: </strong>Time to Positivity (TTP) measures the interval from incubation to bacterial growth detection in blood cultures. Although shorter TTP is associated with higher mortality, factors associated with TTP remain uncertain.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted among Queensland residents with positive blood cultures between 2000-2019. Incident bloodstream infections (BSIs) were identified using Pathology Queensland data, with demographic, clinical, and outcome data linked to state-wide databases.</p><p><strong>Results: </strong>The study analysed 84,341 patients with monomicrobial BSI with a median patient age of 65.6 years (IQR 45.4-78.1), and most infections being community-associated (77.0%). Age showed a non-linear relationship with TTP, and male sex was linked with slightly higher TTP (Incidence Rate Ratio (IRR) 1.01; 95% Confidence Intervals (CI) 1.00-1.02; p = 0.011), reflecting a small but measurable association. Liver disease and malignancy were associated with lower TTP (IRR 0.93; 95% CI 0.91-0.95; p < 0.0001 and IRR 0.95; 95% CI 0.94-0.97; p < 0.0001 respectively), whilst diabetes showed no significant difference (IRR 1.01; 95% CI 1.00-1.02; p = 0.0840). Hospital onset infections exhibited longer TTPs (IRR 1.09; 95% CI 1.08-1.10; p < 0.0001).</p><p><strong>Conclusions: </strong>There are several host characteristics associated with TTP that may in part explain the complex relationship between this variable and mortality. Beyond microbiological factors such as isolate type, TTP is also influenced by clinical variables including patient demographics and infection characteristics highlighting its potential as a prognostic marker. Further evaluation is needed to clarify its role in predicting patient outcomes and guiding tailored treatment strategies.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"1197-1204"},"PeriodicalIF":3.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143582197","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":"Trends in incidence of neonatal late-onset sepsis in very low birth weight infants: a 15-year Brazilian single center analysis.","authors":"Bárbara Barros Pereira Lobo, Jamil Pedro de Siqueira Caldas","doi":"10.1007/s10096-025-05074-z","DOIUrl":"10.1007/s10096-025-05074-z","url":null,"abstract":"<p><strong>Purpose: </strong>Multiresistant (MR) bacteria neonatal sepsis has been progressively increasing worldwide, raising the risk of death. This study aimed to evaluate the incidence of late-onset neonatal sepsis (LOS) and the incidence of MR agents in very low birth weight (VLBW) infants in a Brazilian tertiary neonatal unit over 15 years.</p><p><strong>Methods: </strong>This was a retrospective temporal trend study. All VLBW infants admitted from 2006 to 2020 diagnosed with LOS caused by Staphylococcus aureus, Enterococcus spp or Gram-negative bacilli were eligible.</p><p><strong>Results: </strong>During the period, 259/1,575 (16.4%) VLBW infants had confirmed LOS, corresponding to 311 episodes of sepsis, 114 of them by agents of interest. There were 20 episodes of MR bacteria LOS (6.4% of the total confirmed LOS), corresponding to 17.5% of the cases of LOS by the studied agents, and to an incidence of 12.7/1,000 admitted VLBW infants. There was a significant trend towards a reduction in the rate of confirmed LOS (P = 0.010), while the trend of incidence of MR agents' sepsis remained stable (1.3 episodes per year - range 0-4/year). The MR incidence corresponded to 18.4% for S. aureus and 19% for Gram-negative bacilli strains. There were no cases of MR Enterococcus or carbapenemase-producing organisms. The rate of sepsis-related in-hospital death was not statistically different between the MR and non-resistant sepsis groups (15.0 versus 19.1%, P = 1,000).</p><p><strong>Conclusion: </strong>The incidence of confirmed LOS in VLBW infants has shown a downward trend, while the rate of LOS due to MR bacteria has remained low and stable over 15 years.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"1107-1118"},"PeriodicalIF":3.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467108","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":"Is the isolation of S. epidermidis from pre-operative synovial fluid culture a predictor of S. epidermidis prosthetic joint infection?","authors":"Flaminia Olearo, Carl Philipp Schoppmeier, Anna Both, Mustafa Citak, Gregor Maschkowitz, Sabine Schubert, Helmut Fickenscher, Thorsten Gehrke, Martin Aepfelbacher, Holger Rohde","doi":"10.1007/s10096-025-05070-3","DOIUrl":"10.1007/s10096-025-05070-3","url":null,"abstract":"<p><p>Pathogen identification is key to the management of periprosthetic joint infection (PJI). Staphylococcus epidermidis is a major cause of PJI. Differentiating between invasive and contaminating S. epidermidis from joint specimens is challenging, and usually S. epidermidis is only considered a true invasive isolate when grown from two or more independent tissue samples. Thus, the detection of S. epidermidis in single synovial fluid (SF) samples from preoperative athrocentesis makes it difficult to draw definitive conclusions about its clinical significance, especially when grown from contamination-prone broth enrichment cultures (BEC). This study evaluates the diagnostic value of S. epidermidis detection in preoperative synovial cultures for the diagnosis of S. epidermidis-related PJI diagnosed by intraoperative tissue culture (TC). A total of 292 patients were included in the study, of whom 271 had prosthetic joint infection (PJI) according to EBJIS criteria. Preoperative synovial fluid (SF) cultures detected Staphylococcus epidermidis in 32.5% cases (SF-epi), other pathogens in 43.2% cases (SF-other), and were negative in 24.3%. Intraoperative tissue cultures TC identified clinically significant S. epidermidis in 30.1% of cases. The overall agreement between SF and tissue cultures was 66.1%, and the presence of S. epidermidis in SF was confirmed by TC in 70.5%. The diagnostic accuracy of SF cultures for S. epidermidis PJI was 83.2%, with sensitivity of 76.1% and specificity of 86.3% to detect S. epidermidis PJI. The positive likelihood-ration (LR+) was 5.5. When S. epidermidis from SF-BEC were excluded from analysis, specificity increased to 94.2%, and LR + was 7, but diagnostic sensitivity dropped to 40.5%. This study highlights the important value of using preoperative SF fluid cultures for the diagnosis of S. epidermidis PJI. The integration of BEC improves diagnostic accuracy and sensitivity in S. epidermidis PJI, and thus providing valuable information to guide clinical practice. For definitive antibiotic treatment decisions intraoperative tissue cultures remain mandatory.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"1147-1154"},"PeriodicalIF":3.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491283","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":"Fulminant parvovirus B19 myocarditis in infants -report of three post-pandemic cases.","authors":"Tatjana Wahjudi, Alex Nitsch, Jan-Peter Sperhake, Peter H Hoeger","doi":"10.1007/s10096-025-05072-1","DOIUrl":"10.1007/s10096-025-05072-1","url":null,"abstract":"<p><p>Lack of immune stimulation (\"immune debt\") in the wake of the COVID-19 pandemic has led to a resurgence of many paediatric infectious diseases, recently including parvovirus B19 (PVB19). We observed three cases of fulminant PVB19 myocarditis in infants. All had experienced a short prodromal illness and succumbed to cardiogenic shock within 2-72 h after admission. The risk of fulminant myocarditis appears to be increased in infants. Further studies are needed to assess the incidence of fulminant myocarditis caused by PVB19, potentially linked to immune debt.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"1239-1243"},"PeriodicalIF":3.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439633","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":"Rapid diagnosis of urinary tract infection with miniaturised point-of-care cultivation on a dipstick.","authors":"Emre Iseri, Gino Jakobsson, Sofia Bertling, Volkan Özenci, Oskar Ekelund, Wouter van der Wijngaart, Alex van Belkum","doi":"10.1007/s10096-025-05088-7","DOIUrl":"10.1007/s10096-025-05088-7","url":null,"abstract":"<p><strong>Purpose: </strong>Urinary Tract InfectionAQ1 (UTI) affects over 400 million people annually and globally and is a major reason for empiric antibiotic prescription by general practitioners (GPs).</p><p><strong>Background: </strong>A problem related to microbiological UTI diagnosis is the current lack of point of care (POC) diagnostics. In addition, remote settings, including low and middle income countries (LMIC), are hard to service. Compliance with requirements posed by the In Vitro Diagnostic Regulation (IVDR) and adherence to guidelines as defined by professional user groups are mandatory to pursue. In addition, the World Health Organisation (WHO) promotes optimization of antimicrobial use and more adequate microbiological diagnostics to cure UTI and combat antimicrobial resistance (AMR).</p><p><strong>Methods: </strong>Miniaturised chromogenic bacterial cultivation including rapid antimicrobial susceptibility testing (RAST) at the POC can be successfully used for the diagnosis of UTI. Using small and cost-effective dipsticks containing chromogenic cultivation media, UTI-causing bacteria can be detected, quantified and identified with good sensitivity and specificity.</p><p><strong>Conclusion: </strong>Access to such trustworthy, easy-to-use and cost-efficient diagnostic tools at the POC would offer more timely results for optimised antibiotic treatment. This will improve UTI therapy and prevent AMR.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"1031-1040"},"PeriodicalIF":3.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596416","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":"Retraction Note: Gastrointestinal symptoms and the acquisition of enteric pathogens in Hajj pilgrims: a 3-year prospective cohort study.","authors":"Van-Thuan Hoang, Thi-Loi Dao, Tran Duc Anh Ly, Doudou Sow, Khadidja Belhouchat, Kamel Larbi Chaht, Laetitia Ninove, Tassadit Drali, Saber Yezli, Badriah Alotaibi, Didier Raoult, Philippe Parola, Vincent Pommier de Santi, Philippe Gautret","doi":"10.1007/s10096-025-05078-9","DOIUrl":"10.1007/s10096-025-05078-9","url":null,"abstract":"","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"1287"},"PeriodicalIF":3.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482539","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}