{"title":"Outcomes of low-dose trimethoprim-sulfamethoxazole treatment in patients with non-HIV pneumocystis pneumonia: A nationwide Japanese retrospective cohort study","authors":"Jumpei Taniguchi , Shotaro Aso , Taisuke Jo , Hiroki Matsui , Kiyohide Fushimi , Hideo Yasunaga","doi":"10.1016/j.idnow.2024.104992","DOIUrl":"10.1016/j.idnow.2024.104992","url":null,"abstract":"<div><h3>Objectives</h3><div>Low-dose trimethoprim-sulfamethoxazole (TMP-SMX) may be a treatment option for patients with <em>Pneumocystis jirovecii</em> pneumonia (PCP). However, its effectiveness in patients without human immunodeficiency virus (HIV) infection has yet to be thoroughly investigated.</div></div><div><h3>Methods</h3><div>This retrospective cohort study used data extracted from the Japanese Diagnosis Procedure Combination inpatient database. We included immunocompromised patients without HIV having been diagnosed with PCP and had started TMP-SMX treatment between July 2010 and March 2022. We divided eligible patients into conventional-dose (15.0–20.0 mg/kg/d) and low-dose (7.5–15.0 mg/kg/d) groups and performed propensity-score overlap-weighting analysis. The primary outcome was in-hospital mortality rate. Secondary outcomes were completion of the initial treatment and use of alternatives to TMP-SMX for PCP treatment during hospitalization.</div></div><div><h3>Results</h3><div>Among 4449 eligible patients, 1682 (37.8 %) and 2767 (62.2 %) received conventional- and low-dose TMP-SMX treatments, respectively. No significant difference was observed in in-hospital mortality (risk difference, −1.4 %; 95 % CI, −4.5–1.7 %; <em>P</em> = 0.388). Low-dose TMP-SMX was associated with increased completion of initial treatment (risk difference, 4.6 %; 95 % CI, 2.3–6.9 %; <em>P</em> < 0.001), and reduced use of alternative agents (risk difference, −4.0 %; 95 % CI, −7.4 to −0.6 %; <em>P</em> = 0.020).</div></div><div><h3>Conclusion</h3><div>Low-dose TMP-SMX may be a treatment option for patients with non-HIV PCP.</div></div>","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":"54 8","pages":"Article 104992"},"PeriodicalIF":2.9,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142377864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sébastien Briol , Olivier Gheysens , François Jamar , Halil Yildiz , Julien De Greef , Jean Cyr Yombi , Alexia Verroken , Leïla Belkhir
{"title":"Impact of [18F] FDG PET/CT on outcomes in patients with Staphylococcus aureus bacteremia: A retrospective single-center experience","authors":"Sébastien Briol , Olivier Gheysens , François Jamar , Halil Yildiz , Julien De Greef , Jean Cyr Yombi , Alexia Verroken , Leïla Belkhir","doi":"10.1016/j.idnow.2024.104977","DOIUrl":"10.1016/j.idnow.2024.104977","url":null,"abstract":"<div><h3>Objective</h3><div><em>Staphylococcus aureus</em> bacteremia (SAB) is a leading cause of community and hospital-acquired bacteremia with significant morbidity and mortality. Effective management depends on accurate diagnosis, source control and assessment of metastatic infections. [<sup>18</sup>F] FDG PET/CT has been shown to reduce mortality in high-risk SAB patients. This study aims to evaluate the impact of [<sup>18</sup>F] FDG PET/CT on outcomes in patients with SAB.</div></div><div><h3>Methods</h3><div><em>S</em>ingle-center, retrospective, real-life setting study including all consecutive SAB cases from 2017 to 2019. Medical records were analyzed to collect information.</div></div><div><h3>Results</h3><div>Out of the 315 included patients, 132 underwent [<sup>18</sup>F] FDG PET/CT. In those patients, a clear focus of infection was more frequently identified, leading to better adapted treatments and extended hospital stays. Overall mortality rates at 30 days, 90 days and one year were 25.1 %, 36.8 % and 44.8 % respectively. Mortality was significantly lower in the [<sup>18</sup>F] FDG PET/CT group (p < 0.0001) and persisted (p < 0.05) after adjusting for imbalances between groups regarding oncologic patients and deaths within 7 days. The difference in mortality remained significant irrespective of prolonged bacteremia but was not significant with regard to hospital-acquired SAB. Supplementary analysis using the Cox proportional hazards model confirmed that [<sup>18</sup>F] FDG PET/CT was significantly associated with reduced mortality (p < 0.05).</div></div><div><h3>Conclusion</h3><div>In this real-life cohort, patients with SAB having undergone [<sup>18</sup>F] FDG PET/CT experienced lower mortality rates, highlighting the additional value of [<sup>18</sup>F] FDG PET/CT in SAB management. Further research is needed to identify the subpopulations that would benefit most from the integration of [<sup>18</sup>F] FDG PET/CT in their work-up.</div></div>","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":"54 7","pages":"Article 104977"},"PeriodicalIF":2.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142286097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Quality of life and therapeutic adherence in patients treated for an orthopedic hardware infection: A prospective observational study","authors":"Baptiste Derosais , Agathe Couturaud , Elise Fiaux , Abdeljalil Zeggay , Thibaut Sabatier , Annaelle Soubieux , Franck Dujardin , Jonathan Curado","doi":"10.1016/j.idnow.2024.104976","DOIUrl":"10.1016/j.idnow.2024.104976","url":null,"abstract":"<div><h3>Objectives</h3><div>In France, hardware infections occur in 1% of patients following orthopedic surgery. The study aimed to evaluate the quality of life (QoL) and adherence to antibiotic therapy of patients with an orthopedic hardware infection in the postoperative period.</div></div><div><h3>Patients and methods</h3><div>A prospective observational study was conducted at Rouen University Hospital from May 2022 to May 2023. QoL was evaluated using the Short Form Health Survey (SF-36) and therapeutic adherence using the Girerd questionnaire. These forms were filled out by patients during routine follow-up visits at 6- and 12-week follow-up. A cohort of patients with a non-hardware infection was constituted to compare cases and controls. They were paired according to age, sex, and site of index surgery.</div></div><div><h3>Results</h3><div>Seventy-nine patients were enrolled as cases and 158 patients as controls. At six weeks and at 12 weeks, significant decreases were observed in 8/8 and 4/8 sub scores of SF-36, respectively (p < 0.05).</div><div>Among patients discharged to their homes, at 12 weeks, 30.4 % of patients reported high therapeutic adherence compared to 66.7 % of patients discharged to postoperative care.</div></div><div><h3>Conclusion</h3><div>Patients treated for postoperative hardware infections following orthopedic surgery reported a significant decrease in QoL and lower therapeutic adherence, particularly when discharged to their homes.</div></div>","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":"54 7","pages":"Article 104976"},"PeriodicalIF":2.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142260297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Seang , P. Detruchis , E. Todesco , M-A. Valantin , L. Schneider , R. Palich , G. Peytavin , V. Pourcher , A-G. Marcelin , C. Katlama
{"title":"A case series of intermittent nucleoside analogue-based (NA) regimen to maintain HBV virological suppression in coinfected HBV/HIV patients with suppressed viremia","authors":"S. Seang , P. Detruchis , E. Todesco , M-A. Valantin , L. Schneider , R. Palich , G. Peytavin , V. Pourcher , A-G. Marcelin , C. Katlama","doi":"10.1016/j.idnow.2024.104980","DOIUrl":"10.1016/j.idnow.2024.104980","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the efficacy of intermittent nucleoside analogue-based (NA) regimen to maintain HBV virological suppression in HBV/HIV-1 patients.</div></div><div><h3>Methods</h3><div>Conducted between 2014 and 2023, this observational retrospective study included all HBV (positive AgHbs)/HIV-1 coinfected patients with HIV RNA ≤ 50 cp/mL and HBV DNA ≤ 25 UI/mL who were switched to an intermittent (<7/7 days(D)) TDF or TAF-containing antiretroviral (ART) regimen. The primary outcome was the HBV virological success rate (SR) (proportion of patients with HBV pVL < 25 UI/mL) at W48.</div></div><div><h3>Results</h3><div>Among 501 HBV/HIV-1 patients, 19(3.7 %) had switched to an intermittent NA-containing regimen that included TDF/FTC or TDF/3TC or TAF/FTC or TDF alone administered 5D-a-week(n = 7), 4D-a-week(n = 7) or 3D-a-week(n = 5). HBV virological success rates were 100 % [95 %CI 82.3–100] and 100 %[95 %CI 80.5–100] at W48 and W96(n = 17), respectively; with no viral HBV or HIV rebound (61.8 months (32.4–70.3) of follow-up).</div></div><div><h3>Conclusion</h3><div>This case series shows the potential for intermittent NA-containing regimens to maintain long-term control of HBV replication among suppressed HBV/HIV-1 patients.</div></div>","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":"54 7","pages":"Article 104980"},"PeriodicalIF":2.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ellen Iileka , Maryke Geldenhuys , Juliet Charity Yauka Nyasulu
{"title":"The effects of the SARS-CoV-2 pandemic on the delivery of maternal and child health services in South Africa","authors":"Ellen Iileka , Maryke Geldenhuys , Juliet Charity Yauka Nyasulu","doi":"10.1016/j.idnow.2024.104978","DOIUrl":"10.1016/j.idnow.2024.104978","url":null,"abstract":"<div><h3>Objective</h3><div>The COVID-19 pandemic severely interrupted the functioning of healthcare systems, negatively affecting the global provision of maternal and child health (MCH) services. This study aims to specify the effects of COVID-19 on these services in the Gauteng province (South Africa) and to put forward context-specific recommendations aimed at augmenting them and ensuring ongoing uninterrupted coverage, even and especially during pandemics.</div></div><div><h3>Methods</h3><div>In this quantitative study, a retrospective review of District Health Information System data routinely collected between February 2019 and March 2021 was conducted, comparing performance of the relevant indicators across the two-year span. The data were analyzed using Stata 16 statistical software (StataCorp). The two sample <em>t</em>-test with equal variance and the Mann-Whitney test were applied to evaluate the equality of the indicators.</div></div><div><h3>Results</h3><div>Routine MCH services were negatively impacted, with marked declines in all relevant indicators from the onset of the pandemic. There was a statistically significant decline in cervical cancer coverage and maternal postnatal visits within six days of delivery. While declines in the other critical indicators were likewise observed, they were not statistically significant.</div></div><div><h3>Conclusion</h3><div>The South African response to the pandemic had negative repercussions on all MCH services in the Gauteng province. The lessons to be drawn from the pandemic experience should help to strengthen health system capacities, boost service provision, and mitigate future damage to the healthcare system.</div></div>","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":"54 7","pages":"Article 104978"},"PeriodicalIF":2.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142286098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Doutchi Mahamadou , Adamou Bara Abdoul-Aziz , Lamine Mahaman Moustapha , Diongolé Hassane , Souleymane Adoum Fils , Bagnou Hamsatou , George Thomas Abraham , Moussa Sahada , Hamadou Idrissa , Sani Ousmane , Ali Zaratou , Garba Abdoul Aziz , Ousmane Abdoulaye , Adehossi Eric , Serge Paul Eholié
{"title":"The resurgence of diphtheria in Zinder, Niger","authors":"Doutchi Mahamadou , Adamou Bara Abdoul-Aziz , Lamine Mahaman Moustapha , Diongolé Hassane , Souleymane Adoum Fils , Bagnou Hamsatou , George Thomas Abraham , Moussa Sahada , Hamadou Idrissa , Sani Ousmane , Ali Zaratou , Garba Abdoul Aziz , Ousmane Abdoulaye , Adehossi Eric , Serge Paul Eholié","doi":"10.1016/j.idnow.2024.104979","DOIUrl":"10.1016/j.idnow.2024.104979","url":null,"abstract":"<div><h3>Background</h3><div>Diphtheria is a re-emerging bacterial disease in developing countries with low vaccination coverage.</div></div><div><h3>Objectives</h3><div>This is a descriptive cross-sectional study of diphtheria cases reported to the DRSP/Zinder from March 14, 2022 through June 26, 2023.</div></div><div><h3>Methods</h3><div>It includes cases reported through epidemiological surveillance and data on patients hospitalized in the infectious and tropical diseases department of the Zinder National Hospital (SMIT).</div></div><div><h3>Results</h3><div>A total of 32 patients were included in this study. The median age was 12 years [4–22 years]. Key symptoms included dysphagia and odynophagia (100 %), false membranes (84.4 %), fever (46.9 %), thrombocytopenia (39.3 %), cervical lymphadenopathy (37 %), respiratory distress (15.6 %), epistaxis (12.5 %), gingival bleeding (9.4 %), agitation (6.2 %) and paresis (3.1 %). Renal function was altered in 74 % of cases. Diagnostic confirmation was procured through culture on oropharyngeal swabs. <em>Corynebacterium diphtheriae</em> was isolated in 26.31 % (5/19) of cases. Patients were treated with macrolides and diphtheria antitoxin. The case fatality rate was 31.2 %. Poor prognostic factors included gingival bleeding (p = 0.0262), respiratory distress (p = 0.0374), and thrombocytopenia below 50,000 platelets/mm<sup>3</sup> (p = 0.0020).</div></div><div><h3>Conclusion</h3><div>Diphtheria is a deadly re-emerging disease. The fight against this condition necessitates improved vaccination coverage.</div></div>","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":"54 8","pages":"Article 104979"},"PeriodicalIF":2.9,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Vo-Quang , N. Vignier , A. Adenis , L. Adriouch , A. Lucarelli , B Guarmit , M. Nacher
{"title":"Tackling a worrisome rate of lost to follow-up among migrants with hepatitis B in French Guiana","authors":"E. Vo-Quang , N. Vignier , A. Adenis , L. Adriouch , A. Lucarelli , B Guarmit , M. Nacher","doi":"10.1016/j.idnow.2024.104974","DOIUrl":"10.1016/j.idnow.2024.104974","url":null,"abstract":"<div><h3>Objectives</h3><p>Management of Hepatitis B virus (HBV)-infected patients, whether they are receiving treatment or not, necessitates long-term follow-up. This study evaluated the rate of lost to follow-up (LTFU) among HBV-infected patients and the feasibility of a callback strategy to re-engage these patients in HBV care.</p></div><div><h3>Patients and methods</h3><p>We conducted a retrospective study involving HBV-infected patients attending the outpatient clinic at Cayenne Hospital, French Guiana. LTFU was defined as patients who had not attended the clinic for more than 18 months. A callback strategy was implemented to re-engage LTFU patients in HBV care.</p></div><div><h3>Results</h3><p>Between 1st January 2015 and 31st December 2018, 203 HBV-infected patients were referred to the outpatient clinic; 95/203 (46.8 %) were LTFU, resulting in a crude LTFU rate of 2.6 (95 % CI, 2.1–3.2) per 100 person-years. At baseline, patients aged 30–40 years (aOR, 0.48; 95 %CI, 0.24–0.95) and those who initiated treatment (aOR, 0.26; 95 %CI, 0.10–0.60) were less likely to be LTFU. Through application of the callback strategy, 55/95 (58 %) patients were successfully contacted, and 46/55 (84 %) attended the outpatient clinic for a liver assessment. The EASL criteria for treatment eligibility were met by 3/46 (4 %) patients. Compared to non-LTFU patients, LTFU patients were more likely to be in informal employment (p = 0.03) and to be receiving state medical assistance (p < 0.01), and had lower levels of knowledge about their condition (p < 0.01).</p></div><div><h3>Conclusions</h3><p>The callback strategy to re-engage LTFU patients in HBV care is feasible and effectively identifies those eligible for antiviral therapy.</p></div>","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":"54 7","pages":"Article 104974"},"PeriodicalIF":2.9,"publicationDate":"2024-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666991924001416/pdfft?md5=359d695d53e94e0b4d94dccd84958693&pid=1-s2.0-S2666991924001416-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142209497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Three versus six weeks of post-amputation antibiotic therapy in diabetic forefoot osteomyelitis with positive culture for residual infected bone","authors":"Maïwenn Petithomme-Nanrocki , Ines Slitine , Saidou Diallo , Martine Crouzet , Malorie Mostaert , Pascale Moysset , Thanh Quang Sang Ly , Maxime Hentzien , Maud Francois , Firouzé Bani-Sadr","doi":"10.1016/j.idnow.2024.104975","DOIUrl":"10.1016/j.idnow.2024.104975","url":null,"abstract":"<div><h3>Objectives</h3><p>In 2021 in our university hospital, it was decided in a multidisciplinary consultation meeting on osteoarticular infection in patients with diabetic foot to reduce the duration of post-amputation antibiotic therapy from six to three weeks in patients with diabetic forefoot osteomyelitis and residual bone infection. This study aimed to compare clinical outcomes in this group of patients, before vs after the change in practice introduced in 2021.</p></div><div><h3>Methods</h3><p>In this before-after study, we included all cases reported between January 2016 and August 2023 in the University Hospital of Reims.</p></div><div><h3>Results</h3><p>We included 113 patients; between 2016 and 2020, 56 (49.5 %) received six weeks of post-amputation antibiotic therapy, and between 2021 and 2023, 57 (50.5 %) received three weeks of therapy. Over six months of follow-up, overall cure rate was 95 %. Treatment failure did not differ between groups.</p></div><div><h3>Conclusion</h3><p>Three weeks of post-amputation antibiotic therapy in diabetic patients with forefoot osteomyelitis and residual bone infection is effective.</p></div>","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":"54 7","pages":"Article 104975"},"PeriodicalIF":2.9,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666991924001428/pdfft?md5=dcadc1b3b16149fd0d495c9819557188&pid=1-s2.0-S2666991924001428-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}