Expert Review of Anti-infective Therapy最新文献

{"title":"Pan-TB regimens: too good to be true?","authors":"Stephen J Aston, Geraint R Davies","doi":"10.1080/14787210.2026.2719692","DOIUrl":"10.1080/14787210.2026.2719692","url":null,"abstract":"","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"1-3"},"PeriodicalIF":4.6,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A 12-year trend of antimicrobial resistance among ESKAPEEc organisms isolated from blood cultures in a large private medical diagnostic laboratory network in Malaysia (2013-2024).","authors":"Omotayo Fatokun, Ali Haider Mohammed, Chuan Sheng Yap, Ariza Adnan, Si Wei Fong, Bassam Abdul Rasool Hassan","doi":"10.1080/14787210.2026.2729403","DOIUrl":"https://doi.org/10.1080/14787210.2026.2729403","url":null,"abstract":"<p><strong>Background: </strong>ESKAPEEc blood culture isolates are important indicators of invasive bacterial disease and antimicrobial resistance (AMR). This study examined 12-year AMR trends in Malaysia.</p><p><strong>Research design and methods: </strong>This retrospective laboratory-based study analyzed de-identified blood culture records from a large private diagnostic laboratory network between January 2013 and December 2024. An Antimicrobial Resistance Index (ARI) was calculated for each deduplicated patient-year isolate, and multivariable logistic regression identified factors associated with high ARI (≥0.5).</p><p><strong>Results: </strong>Among 10,274 eligible isolates, <i>Escherichia coli</i> was most common (44.5%), followed by <i>Klebsiella pneumoniae</i> (20.7%) and <i>Staphylococcus aureus</i> (19.6%). Mean ARI increased from 0.22 in 2013 to 0.28 in 2024 (<i>p</i> < 0.001), while high-ARI isolates rose from 12.1% in 2020 to 22.8% in 2024. Significant increases occurred in <i>E. coli</i>, <i>K. pneumoniae</i>, and <i>Enterobacter</i> spp./complex. Male sex, Indian or other ethnicity, <i>Acinetobacter baumannii</i>, <i>Enterococcus</i> spp. and year 2024 were associated with high ARI.</p><p><strong>Conclusions: </strong>AMR burden increased, particularly in 2024, supporting stronger stewardship, surveillance, and updated empiric treatment guidance. Findings should be interpreted cautiously because changes in AST methods, breakpoints, test panels, referral patterns, and case mix could not be fully adjusted.</p>","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"1-11"},"PeriodicalIF":4.6,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Four-year surveillance of major Gram-negative pathogens in a Saudi tertiary hospital: clinical distribution, comorbidity profiles, and antimicrobial resistance.","authors":"Kamaleldin B Said, Khalid F Alshammari, Ruba M Elsaid Ahmed, Hamad Alshetaiwi, Naif K Binsaleh, Ahmed N Alshammari, Ibrahim Alshaghdali, Ahmed A Alsolami, Somaia Ibrahim, Nahlah F Alreshidi, Amel B Elhag, Sara A Yousef, Layan Z Alhamashi, Muath B Alghubayni, Rahaf S Alazmi","doi":"10.1080/14787210.2026.2729396","DOIUrl":"10.1080/14787210.2026.2729396","url":null,"abstract":"<p><strong>Purpose: </strong>To describe four-year diagnostic-distribution, burden, and antimicrobial-resistances of major Enterobacterales and <i>Pseudomonas aeruginosa</i> in a tertiary-care surveillance framework.</p><p><strong>Patients and methods: </strong>We retrospectively studied first non-duplicate-isolate per/patient/organism between 2022-2025 at a Saudi tertiary-care. Diagnostics used automated-platforms with GeneXpert-Carba-R employed parallel to cultures. Susceptibility interpretations used CLSI-breakpoints relevant to test-year. Annual-trends were assessed with grouped-binomial logistic-regression, and Benjamini-Hochberg false-discovery-rate correction was applied within prespecified analysis.</p><p><strong>Results: </strong>Among 1,857 isolates, <i>Klebsiella pneumoniae</i> was most frequent (36.2%), followed by <i>P. aeruginosa</i> (33.4%), <i>Escherichia coli</i> (17.9%), and <i>Enterobacter cloacae</i> (12.3%). Mean patient age was 64.8 years, 51.3% isolates were from intensive-care, 37.4% from urine, and 80.8% records had comorbidity. <i>K. pneumoniae</i> showed overall ESBL (76.6%), CRE (59.9%), MDR (69.3%), panel-defined XDR (64.7%), and panel-defined PDR (15.2%) frequencies. Enterobacterales ESBL-positivity increased (58.1% to 76.8%;q <0.001), whereas meropenem non-susceptibility decreased (52.6% to 33.2%;q <0.001). In <i>P. aeruginosa</i>, ceftazidime non-susceptibility increased (55.2% to 78.6%;q <0.001), meropenem decreased (46.8% to 32.9%;q = 0.031), and tobramycin increased (22.2% to 45.7%;q = 0.030). Crude-comorbidity differences remained insignificant after false-discovery-rate correction.</p><p><strong>Conclusion: </strong>We show a persistent species-specific Gram-negative resistance burden, led by <i>K. pneumoniae</i> and accompanied by substantial <i>P. aeruginosa</i> non-susceptibility. This supports organism-specific detections, antibiograms and continued multicenter-surveillance linked to antimicrobial exposure, genomic-data, and patient outcomes.</p>","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"1-10"},"PeriodicalIF":4.6,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148896866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in therapeutics and vaccines for Marburg virus disease: challenges and future directions.","authors":"Venkataramana Kandi, Francesco Branda, Mohammed Alissa, Gurudutta Pattnaik, Alaa S Alhegaili, Mohammed A Alshehri, Alok Ranjan Sahu, Ranjan K Mohapatra","doi":"10.1080/14787210.2026.2723576","DOIUrl":"10.1080/14787210.2026.2723576","url":null,"abstract":"<p><strong>Introduction: </strong>Marburg virus disease (MVD) is a highly lethal filovirus infection with case fatality rates of up to 88%. Although no virus-specific interventions have yet been approved, recent laboratory breakthroughs have markedly accelerated translational progress in vaccine and therapeutic development.</p><p><strong>Areas covered: </strong>A hybrid methodological design was employed, combining macro-level bibliometric analysis with a targeted qualitative narrative review. As per the findings, the human monoclonal antibody MR191N provides complete post-exposure protection in non-human primates. Advanced RNA-targeted siRNAs, antisense oligonucleotides, and small-molecule nucleoside analogues (e.g. galidesivir) demonstrate robust preclinical efficacy in suppressing viral replication. Prophylactic platforms - including adenovirus-vectored (ChAd3-MARV), rVSV-MARV, and mRNA-based vaccines - are progressing through early-phase clinical and preclinical evaluation. Bibliometric analysis, however, reveals pronounced geographic disparities: high-income nations dominate scientific output (United States: 31.7%), while endemic African countries remain severely underrepresented in global collaboration networks.</p><p><strong>Expert opinion: </strong>Addressing MVD requires a coordinated transition from experimental research to licensed, field-ready interventions. This necessitates adaptive trial designs, expanded diagnostic models, and synergistic combination therapies. Ultimately, correcting global research inequities and embedding robust, cross-border One Health surveillance infrastructure are essential to transforming scientific advances into equitable, rapid-response solutions for endemic regions.</p>","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"1-27"},"PeriodicalIF":4.6,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148812516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Pneumocystis</i> pneumonia in non-HIV immunocompromised patients in 2026: evolving therapeutic standards.","authors":"Hélène Kemp, Virginie Lemiale, Elie Azoulay","doi":"10.1080/14787210.2026.2695974","DOIUrl":"10.1080/14787210.2026.2695974","url":null,"abstract":"<p><strong>Introduction: </strong><i>Pneumocystis jirovecii</i> pneumonia (PJP) remains a life-threatening lower respiratory tract infection associated with respiratory failure in patients with impaired T-cell immunity. Its incidence is increasing in non-HIV patients, who typically experience a more severe disease course and poorer outcomes than HIV patients. Keeping a high level of suspicion for PJP when confronted to an immunocompromised patient presenting with an acute respiratory failure (ARF) is essential to start promptly the treatment and thereby reduce associated morbidity and mortality.</p><p><strong>Areas covered: </strong>The mechanism of <i>Pneumocystis jirovecii</i> infestation and the immune cells implicated in the host response are discussed. The clinical and patterns on imaging are reported. The need for prompt treatment initiation, even before diagnostic confirmation is emphasized. The prophylactic and therapeutic arsenal is listed and discussed, as well as adverse events and additional measures.</p><p><strong>Expert opinion: </strong>The research field for PJP in non-HIV patients in the next years should focus on: individualize the risk prediction of PJP, define an international quantitative PCR threshold, improve diagnostic criterion, optimize the treatment.</p>","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"813-825"},"PeriodicalIF":4.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148351416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study of prescription-indication of antivirals for herpesviruses in a Colombian population: a cross-sectional study.","authors":"Luis Fernando Valladales-Restrepo, Mariana Velásquez-Echeverry, Mariana Castañeda-Orozco, Sahian Camila Trejos-Gonzáles, Zayra Daniela Tapasco-Hernández, María Paula Cedeño-Ospina, Jorge Enrique Machado-Alba","doi":"10.1080/14787210.2026.2699182","DOIUrl":"10.1080/14787210.2026.2699182","url":null,"abstract":"<p><strong>Background: </strong>To describe the utilization patterns and therapeutic indications of antivirals used for herpesvirus infections in Colombian patients.</p><p><strong>Research design/methods: </strong>A cross-sectional study on the use of antivirals for treating outpatients with herpesviruses between November 2023 and January 2024 in a Colombian population database. The Micromedex® database was used to identify Food and Drug Administration (FDA)-approved indications, off-label uses, and potentially inappropriate indications.</p><p><strong>Results: </strong>A total of 14,816 individuals were included (median age:53.0 years [IQR:35.0-65.0]; 60.5% women). Acyclovir was the most frequently prescribed antiviral (oral:77.3%; topical:43.4%). Overall, 56.1% received oral therapy only, 25.2% combined oral and topical therapy, and 18.7% topical therapy only. FDA-approved indications accounted for 29.1% of use (herpes zoster), off-label use for 26.9% (mainly prophylaxis in immunocompromised patients), and potentially inappropriate use for 25.3% (primarily topical treatment of herpes zoster). Acyclovir use (OR:5.93; 95%CI:4.60-7.64) and specialist care (OR:2.17; 95%CI:1.73-2.71) were associated with off-label use.</p><p><strong>Conclusions: </strong>Antiviral prescribing for herpesvirus infections in a group of patients in Colombia is largely driven by acyclovir, with a substantial proportion of off-label and potentially inappropriate use, particularly involving topical therapies for herpes zoster. These findings highlight significant gaps in adherence to evidence-based recommendations and underscore the need for targeted interventions to optimize prescribing practices.</p>","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"867-876"},"PeriodicalIF":4.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148374970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Asymptomatic is not silent: proposal of HTLV-1-associated multiple inflammatory disorder as an early neuroinflammatory state.","authors":"Augusto C Penalva de Oliveira, Tatiane Assone, Michael E Haziot, Jerusa Smid, Rosa M N Marcusso, Victor Folgosi, Maria Rita P Gascon, Felipe Pacheco, Carolina Rosadas, Graham P Taylor, Jorge Casseb","doi":"10.1080/14787210.2026.2695977","DOIUrl":"10.1080/14787210.2026.2695977","url":null,"abstract":"<p><strong>Background: </strong>Human T-lymphotropic virus type 1 (HTLV-1) infection is classically categorized as either asymptomatic or associated with HTLV-1-associated myelopathy (HAM). However, accumulating clinical evidence suggests that a proportion of individuals labeled as asymptomatic present early inflammatory and neurological manifestations that do not fulfill HAM diagnostic criteria.</p><p><strong>Research design and methods: </strong>We conducted an observational study within a large, long-standing Brazilian HTLV-1 cohort. Between January 2015 and December 2025, adults previously classified as asymptomatic were systematically evaluated during follow-up at an outpatient clinic. Standardized clinical and neurological examinations were newly performed by clinicians not previously involved in their care and assessment. These findings were then integrated with neuropsychological, radiological and laboratory assessments.</p><p><strong>Results: </strong>Among individuals previously considered asymptomatic, 24% fulfilled predefined criteria for an intermediate condition termed HTLV-1-associated multiple inflammatory disorder (HAMID). HAMID was associated with older age, female sex, higher proviral load, markers of chronic immune activation, subtle spinal cord abnormalities, and cognitive impairment, particularly affecting episodic memory.</p><p><strong>Conclusions: </strong>HTLV-1 infection encompasses an early, biologically active inflammatory disease stage distinct from both asymptomatic infection and overt HAM. Recognition of HAMID refines the clinical spectrum of HTLV-1 infection and provides a framework for earlier diagnosis, improved risk stratification, and clinical surveillance.</p>","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"891-898"},"PeriodicalIF":4.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148327783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The changing picture of community acquired urinary tract infections in the US: a daunting prospect.","authors":"Teena Chopra, Glenn Tillotson, Angela Donald","doi":"10.1080/14787210.2026.2695445","DOIUrl":"10.1080/14787210.2026.2695445","url":null,"abstract":"<p><strong>Introduction: </strong>Urinary tract infections (UTIs) are among the most common bacterial infections worldwide, yet rising antimicrobial resistance is rapidly eroding the effectiveness of standard oral therapies. Resistance to fluoroquinolones and trimethoprim-sulfamethoxazole exceeding 40% among uropathogenic Escherichia coli, driven by multidrug-resistant and ESBL-producing Enterobacterales strains such as ST131, is fueling increased reliance on parenteral agents and hospitalizations.</p><p><strong>Areas covered: </strong>This commentary reviews the current US epidemiology of UTI, including the growing burden of ESBL-producing Enterobacterales and the pandemic ST131 lineage, and summarizes resistance patterns among key uropathogens. It highlights oral agents approved or under review in the US, specifically pivmecillinam, sulopenem, and gepotidacin for uncomplicated UTI, and tebipenem pivoxil hydrobromide, which if approved would represent the first oral carbapenem for selected complicated UTIs, and discusses stewardship principles for community UTI management. Established first-line agents are referenced in the context of resistance trends but are not reviewed comprehensively.</p><p><strong>Expert opinion: </strong>Recently approved or emerging oral agents offer a meaningful opportunity to reduce intravenous carbapenem dependence and avoid hospitalizations, though uptake may be constrained by cost, limited post-marketing experience, and stewardship concerns. Judiciously deployed, these agents could reduce the burden of multidrug-resistant UTI, contingent on further real-world and pharmacoeconomic evidence.</p>","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"845-853"},"PeriodicalIF":4.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148390134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Misdiagnosis of soft tissue infections: clinical pitfalls and management implications.","authors":"Matteo Bassetti, Claudia Bartalucci, Federica Portunato, Matteo Cerchiaro, Laura Mezzogori","doi":"10.1080/14787210.2026.2722315","DOIUrl":"10.1080/14787210.2026.2722315","url":null,"abstract":"<p><strong>Introduction: </strong>Skin and soft tissue infections (SSTIs) are among the most frequent reasons for medical evaluation worldwide and are associated with significant clinical and healthcare implications. However, their diagnosis remains challenging, with frequent misdiagnosis, including both overdiagnosis of uncomplicated cellulitis and under-recognition of life-threatening necrotizing soft tissue infections.</p><p><strong>Areas covered: </strong>We conducted a narrative review of the literature on diagnostic challenges in SSTIs. A search of PubMed/MEDLINE was performed for studies published up to March 2026, focusing on the misdiagnosis of cellulitis and necrotizing infections. We examined factors contributing to diagnostic errors, as well as the role of clinical assessment, laboratory tests, imaging, and multidisciplinary approaches in improving diagnostic accuracy and patient outcomes.</p><p><strong>Expert opinion: </strong>Improving diagnostic accuracy in SSTIs requires structured clinical pathways based on careful assessment, early reassessment, and the selective use of imaging and specialist consultation. Future advances are more likely to derive from integrated diagnostic frameworks than from single diagnostic tests.</p>","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"1-12"},"PeriodicalIF":4.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148839697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The endocarditis team: a review.","authors":"Aoife Maher, Larry M Baddour, Sami El Dalati, Jose M Miro, Daniel C DeSimone, Arturo J Marti-Carvajal, Martin H Thornhill, Mark J Dayer","doi":"10.1080/14787210.2026.2695437","DOIUrl":"10.1080/14787210.2026.2695437","url":null,"abstract":"<p><strong>Introduction: </strong>Infective endocarditis (IE) is a complex infection of the endocardium, associated with significant morbidity and mortality. Diagnosing IE can be challenging, as shown by the evolution of original diagnostic criteria. Managing IE is difficult, involving decisions about diagnosis, antibiotic therapy, and surgery. Given these challenges, the 2015 European Society of Cardiology (ESC) IE Guidelines recommended establishing an endocarditis team (ET) in centers managing IE. This review evaluates the evidence supporting ETs.</p><p><strong>Areas covered: </strong>We identified 19 before-and-after studies including 5,327 patients (3,069 before and 2,258 after ET introduction) that examined the impact of implementing an ET on the quality of care for patients with IE. No RCTs were found. The studies were reviewed and revealed a significant reduction in in-hospital mortality (20.9-16.3% [RR 0.71, CI 0.54 to 0.93], <i>p</i> = 0.0154)) and the proportion of endocarditis cases in which an organism was not identified (23.8-9.8%; [RR 0.50, 0.39 to 0.64, <i>p</i> < 0.0001]) following ET introduction.</p><p><strong>Expert opinion: </strong>This review provides consistent observational evidence that ETs are effective in saving lives. Despite limitations, the consistency of effect across multiple studies, biological plausibility, and alignment with successful multidisciplinary models in other diseases support the widespread implementation of ETs.</p>","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"801-812"},"PeriodicalIF":4.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148316378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}