Infectious diseases now最新文献

{"title":"The pragmatic management of rabies risk in Operation DAMAN 50 (Lebanon, October 2024-February 2025): A case study for evidence-based military medicine in the field","authors":"T. Gasc ,&nbsp;Y. Santinelli ,&nbsp;J. Marti","doi":"10.1016/j.idnow.2025.105136","DOIUrl":"10.1016/j.idnow.2025.105136","url":null,"abstract":"<div><div>The French Armed Forces are regularly deployed in areas of endemic rabies, a virus responsible for 59,000 deaths worldwide every year. During Operation DAMAN 50 at the end of year 2024, a rapid conflict intensification in southern Lebanon significantly increased rabies exposure of French servicemen and decreased access to laboratory analyses. Exposures of military personnel to scratches from cats of unknown rabies status multiplied, putting extreme strain on post-exposure prophylaxis (PEP) stocks. To minimize the risk of a PEP shortage and its consequences, medical personnel deployed in Operation DAMAN 50 adopted a pragmatic strategy that adapted existing recommendations to the situation. At the individual level, the watch-and-see PEP occurred only if veterinarian cat observation was possible. It relied on pathophysiological, epidemiological, environmental and operational data and despite the lack of reliable laboratory at that time. On the wider scale, the strategy involved controlling the feline population. Based on clinical field skills and global appreciation of original situations of military practitioners, it maintained operational capacity while reserving limited vaccine supplies to patients with greatest need.</div></div>","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":"55 7","pages":"Article 105136"},"PeriodicalIF":2.2,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144902160","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":"Beta-lactam underdosing is not more frequent in COVID-19 than in non-COVID-19 critically ill patients","authors":"Maeva Palayer ,&nbsp;Juliette Bernier ,&nbsp;Emmanuel Pardo ,&nbsp;Franck Verdonk ,&nbsp;Tomas Urbina ,&nbsp;Emmanuel Bourgogne","doi":"10.1016/j.idnow.2025.105137","DOIUrl":"10.1016/j.idnow.2025.105137","url":null,"abstract":"<div><h3>Objectives</h3><div>COVID-19 has been associated with high rates of ventilator-associated pneumonia relapse. Antibiotic underdosing due to augmented renal clearance (ARC) has been suggested as a possible contributing factor. This retrospective study compared plasmatic beta-lactam concentrations between critically-ill COVID-19 and non-COVID-19 patients.</div></div><div><h3>Patients and methods</h3><div>We included measurements for cefotaxime, ceftazidime, cefepime and piperacillin. A multivariable logistic regression model was used to identify variables associated with underdosing.</div></div><div><h3>Results</h3><div>All in all, 361 samples were included from 126 patients. Median concentrations did not differ between COVID-19 and non-COVID-19 patients for any molecule, nor did the rate of underdosing (38 % <em>vs</em> 42 %, p = 0.68). In a logistic regression model adjusting for age, gender, BMI, creatinine clearance and type of beta-lactam molecule, COVID-19 status was not associated with underdosing (OR = 0.83 [0.38–1.83], p = 0.997).</div></div><div><h3>Conclusions</h3><div>Although underdosing of most commonly prescribed beta-lactams occurred in more than one third of cases in critically-ill COVID-19 patients, this rate did not differ from non-COVID-19 patients.</div></div>","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":"55 8","pages":"Article 105137"},"PeriodicalIF":2.2,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952670","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":"The infected optimist: Tracing contagion in Voltaire’s Candide","authors":"Francesco Brigo","doi":"10.1016/j.idnow.2025.105134","DOIUrl":"10.1016/j.idnow.2025.105134","url":null,"abstract":"","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":"55 7","pages":"Article 105134"},"PeriodicalIF":2.2,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144890740","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":"Rapid-sequence clinical research before and during a pandemic: Lessons learned and the way forward","authors":"","doi":"10.1016/j.idnow.2025.105135","DOIUrl":"10.1016/j.idnow.2025.105135","url":null,"abstract":"<div><div>In the aftermath of the COVID-19 pandemic, the structuring of a nationwide research network for preparation and response to emerging infectious diseases (EID) with epidemic or pandemic potential has become increasingly essential.</div><div>A nationwide EID operational research network (OPEN-ReMIE),is funded for five years through the <em>France 2030</em> program and run by the French national research agency (ANR). Its primary missions are to accelerate hospital-based clinical research under epidemic or pandemic conditions with academic or industrial sponsors, and to pursue this effort in international research networks. OPEN-ReMIE governance is geared to steering this network and to guaranteeing its operability in inter- as well as crisis modes. It will be the point of entry for key international trial platforms, academic and private sponsors, regulatory agencies, associations of citizens and patients, and think tanks committed to promoting scientific integrity.</div><div>OPEN-ReMIE encompasses six work packages: <em>(i)</em> regulatory affairs, sponsoring, fast-track procedures and contracts; <em>(ii)</em> clinical site network management; <em>(iii)</em> methodology and management centers to provide methodological expertise (generic master protocols, sets of core and extended variable catalogs, electronic case reports form templates, data management and interoperability, monitoring…); <em>(iv)</em> laboratory and biological resource center management; <em>(v)</em> drug supply and pharmacovigilance supervisory board; <em>(vi)</em> training programs and communication plans for various stakeholders: research teams, healthcare professionals, students, associations of citizens and patients and, increasingly, civil society actors.</div><div>All in all, OPEN-ReMIE is a nationwide “preparedness task force” embedded in a large-scale European consortium for EID clinical research and working with other international EID clinical research platforms.</div></div>","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":"55 7","pages":"Article 105135"},"PeriodicalIF":2.2,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952668","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":"Antibiotic susceptibility according to age of clinical strains from hospital respiratory samples: A nationwide study","authors":"Alain Putot ,&nbsp;Elodie Couve-Deacon ,&nbsp;Marie-Cécile Ploy ,&nbsp;Thibaut Fraisse ,&nbsp;Jean-Philippe Lanoix ,&nbsp;Virginie Prendki ,&nbsp;Sylvain Diamantis","doi":"10.1016/j.idnow.2025.105133","DOIUrl":"10.1016/j.idnow.2025.105133","url":null,"abstract":"<div><h3>Objectives</h3><div>This study evaluated the microbiological distribution and sensitivity of clinical strains from respiratory samples of inpatients to the antibiotics usually recommended for treatment of lower respiratory tract infection (LRTI).</div></div><div><h3>Methods</h3><div>Using the French SPARES (<em>Surveillance et Prévention de l’AntibioRésistance en Etablissement de Santé</em>) database, we recorded all respiratory microbiological samples collected in 2022 in 409 hospitals located in all regions of France. The distribution of main bacterial species and their resistance to the most frequently prescribed antibiotics for LRTI were compared by age group (18–64 years, 65–79 years, ≥ 80 years).</div></div><div><h3>Results</h3><div>Among 48,721 strains, 47.7 % were isolated from patients aged 18–64 years, 37.9 % aged 65–79 years, and 14.4 % aged ≥ 80 years. <em>Enterobacteriaceae</em> (30.1 %, 36.0 % and 35.1 %, respectively) and <em>Pseudomonas aeruginosa</em> (19.0 %, 25.0 % and 27.1 %) were the most prevalent pathogens, especially in older patients. Conversely, <em>Haemophilus influenzae</em> (14.5 %, 10.7 % and 8.7 %) and <em>Streptococcus pneumoniae</em> (8.3 %, 5.6 % and 3.4 %) were rare in older age. Overall antibiotic resistance increased with age across all classes: in increasing order of resistance, levofloxacin (9.2 %, 11.1 % and 13.2 %), piperacillin-tazobactam (14.5 %, 16.8 % and 17.4 %), cefotaxime (27.4 %, 34.3 % and 39.5 %), doxycycline (28.2 %, 37.4 % and 39.5 %), cotrimoxazole (32.1 %, 38.5 % and 40.2 %), and amoxicillin-clavulanate (37.2 %, 46.0 % and 51.4 %, p &lt; 0.05 for all comparisons). More than half of the strains were resistant to amoxicillin and erythromycin.</div></div><div><h3>Conclusions</h3><div>In this large nationwide database of respiratory samples, older age was associated with a high prevalence of <em>Enterobacteriaceae</em> and <em>P. aeruginosa</em> and beta-lactam resistance, a finding challenging current LRTI probabilistic treatment. Conversely, <em>H. influenzae</em> and <em>S. pneumoniae</em> were rarely observed in patients over 80 years of age.</div></div>","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":"55 7","pages":"Article 105133"},"PeriodicalIF":2.2,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144829643","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":"West Nile virus in Italy: A rising public health concern calling for reinforced surveillance and preventive measures.","authors":"Pietro Ferrara","doi":"10.1016/j.idnow.2025.105132","DOIUrl":"10.1016/j.idnow.2025.105132","url":null,"abstract":"","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":" ","pages":"105132"},"PeriodicalIF":2.2,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812001","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":"Artificial intelligence and infectious diseases: Scope and perspectives.","authors":"S Abbara, Y Crabol, J Goupil de Bouillé, A Dinh, D Morquin","doi":"10.1016/j.idnow.2025.105131","DOIUrl":"10.1016/j.idnow.2025.105131","url":null,"abstract":"<p><p>Artificial intelligence (AI) is set to permeate every facet of infectious disease practice-from prevention and public health surveillance to epidemic management and bedside care. Routine care data (laboratory results, medication orders, progress notes) and research-generated datasets now fuel state-of-the-art machine-learning (ML) pipelines that sharpen diagnosis, prognosis, antimicrobial stewardship, and, by combining both sources, accelerate drug discovery. In diagnostics, deep networks that now flag pneumonia or tuberculosis on chest images are increasingly able to identify-and localize-virtually more infectious processes throughout the body, while simultaneously predicting pathogen identity and antimicrobial resistance from routine microbiology. Prognostic models trained on Electronic Health Records surpass traditional scores in anticipating clinical deterioration or postoperative sepsis, enabling earlier targeted interventions. Predictive analytics can also personalize antimicrobial dosing by fusing real-time drug-monitoring data. Large language models (LLMs) build upon these advances by transforming unstructured clinical narratives into structured phenotypes suitable for predictive modeling, automatically summarizing patient encounters, generating synthetic cohorts for rare conditions, and providing real-time conversational decision support at the patient's bedside. Despite rapid progress, real-world deployment faces hurdles: high computational and licensing costs, vendor-specific implementation constraints, limited cross-site model transferability, and fragmented governance of safety, bias, and cybersecurity risks. Rigorous, lifecycle-based evaluation frameworks-covering external validation, cost-effectiveness analysis, and post-deployment monitoring-are required to ensure safe, equitable, and sustainable AI adoption. This review synthesizes current applications, evidential strengths, and unresolved challenges, and proposes a translational roadmap aligning technical innovation with clinical and regulatory realities.</p>","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":" ","pages":"105131"},"PeriodicalIF":2.2,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784247","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":"Modification of reported antibiotic susceptibility testing according to the EUCAST recommendations: Evaluation of the appropriateness of antibiotic prescriptions in a university hospital.","authors":"C About, F Meyer, M Simon, E Jeanbert, B Demore, A Charmillon","doi":"10.1016/j.idnow.2025.105130","DOIUrl":"10.1016/j.idnow.2025.105130","url":null,"abstract":"<p><strong>Objectives: </strong>In January 2022, EUCAST guidelines recommending replacement of the \"intermediate\" category with a \"susceptible, increased exposure\" (SFP) category were implemented in our hospital. We aimed to assess the impact of these changes on antibiotic prescriptions for Pseudomonas aeruginosa and Staphylococcus aureus infections.</p><p><strong>Methods: </strong>This retrospective before-after study included adult inpatients with monobacterial infections between March-August 2021 (BEFORE) and March-August 2022 (AFTER). Antibiotic use and relevance were compared. Meropenem was masked when imipenem was categorized as SFP.</p><p><strong>Results: </strong>We included 240 antibiotic susceptibility tests (195 patients). Infectious disease consultations increased significantly during implementation (53.0 % vs. 28.9 %, p = 0.0005). Meropenem prescriptions for P. aeruginosa declined (13.8 %-6.2 %), while high-dose regimens for SFP antibiotics likewise decreased (50.0 %-35.4 %). Overall, prescription appropriateness remained high (>92 %).</p><p><strong>Conclusion: </strong>The introduction of SFP reporting was associated with increased ID consultation and a trend toward reduced broad-spectrum use, highlighting a need for targeted prescriber education.</p>","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":" ","pages":"105130"},"PeriodicalIF":2.2,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784248","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":"Towards more personalized management of pneumonia: recent progress and outstanding issues","authors":"A. Dinh ,&nbsp;D. Basille ,&nbsp;working group","doi":"10.1016/j.idnow.2025.105124","DOIUrl":"10.1016/j.idnow.2025.105124","url":null,"abstract":"","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":"55 6","pages":"Article 105124"},"PeriodicalIF":2.2,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764887","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":"Antibiotic combination indications for the treatment of community-acquired acute pneumonia","authors":"Pierre Fillatre ,&nbsp;Mathieu Blot ,&nbsp;Damien Basille ,&nbsp;Yacine Tandjaoui-Lambiotte ,&nbsp;François Barbier ,&nbsp;Aurélien Dinh","doi":"10.1016/j.idnow.2025.105126","DOIUrl":"10.1016/j.idnow.2025.105126","url":null,"abstract":"<div><div>Empirical dual combination therapy with beta-lactam and macrolide is often the standard treatment of community-acquired acute pneumonia (CAP) in adults hospitalized in non-intensive care units. However, several recent studies question this standard treatment. The present literature review analyzes available data that compare beta-lactam monotherapy and dual antibiotic therapies in moderate CAP. Macrolides are associated with frequent adverse events (digestive, cardiovascular) as well as with an increase in bacterial resistance, and their clinical benefit in non-severe forms of CAP has yet to be proven. Three randomized trials of good quality did not show any reduction in mortality in patients treated with dual antibiotic therapy, and a large-scale observational real-life study did not show the clinical advantage of dual antibiotic therapy. Only patients with severe CAP could benefit from the addition of a macrolide as it covers atypical bacteria (and potentially because of its immuno-modulatory properties). Considering the current state of knowledge, beta-lactam monotherapy seems to be enough and preferable in moderate CAP, thus allowing to reduce exposure to macrolides and their consequences. The 2025 guidelines confirm the absence of indication for dual antibiotic therapy for mild documented CAP (except for Panton-Valentine leukocidin-producing <em>S.<!--> <!-->aureus</em>). Empirical dual antibiotic therapy is also recommended for patients hospitalized for severe CAP, with rapid de-escalation to monotherapy depending on the clinical evolution and microbiological results.</div></div>","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":"55 6","pages":"Article 105126"},"PeriodicalIF":2.2,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764886","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}