Infectious diseases now最新文献

{"title":"Indications for corticosteroids in the treatment of Community-Acquired pneumonia","authors":"Mathieu Blot ,&nbsp;Damien Basille ,&nbsp;Aurélien Dinh ,&nbsp;François Barbier ,&nbsp;Pierre Fillatre","doi":"10.1016/j.idnow.2025.105127","DOIUrl":"10.1016/j.idnow.2025.105127","url":null,"abstract":"<div><div>Preceding guidelines on treatment and management of community-acquired pneumonia (CAP) do not endorse systematic use of corticosteroids. The data in the literature show contradictory results; while some have suggested clinical improvement in cases of severe CAP, others have reported no significant benefit.</div><div>The recent CAPE-COD trial demonstrated a marked reduction of mortality and intubation through early hydrocortisone treatment (200 mg/d). Consequently, the 2025 French guidelines recommend its being used in cases of severe CAP requiring critical care (excluding influenza, myelosuppression, and aspiration pneumonia, which are not considered in the trial), with progressive de-escalation over the course of eight to fourteen days. Since no benefit has seen shown for non-severe CAP, corticosteroid therapy is not recommended in these cases.</div></div>","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":"55 6","pages":"Article 105127"},"PeriodicalIF":2.2,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144756912","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":"Value of molecular biology tests in community-acquired acute pneumonia","authors":"V. Cattoir ,&nbsp;A. Dinh ,&nbsp;S. Jarraud ,&nbsp;A.Le Monnier ,&nbsp;P. Loubet","doi":"10.1016/j.idnow.2025.105128","DOIUrl":"10.1016/j.idnow.2025.105128","url":null,"abstract":"<div><div>For patients hospitalized with community-acquired acute pneumonia (CAP), molecular tools (especially multiplex PCR syndromic panels) are associated with a significant improvement of microbiological diagnosis yield, compared with conventional methods. Two main families of tests are currently available: targeted viral PCR tests (influenza, SARS-CoV-2, RSV) performed on nasopharyngeal swabs and adapted to epidemic situations; and “upper respiratory tract” (nasopharyngeal) or “lower respiratory tract” (deep swabs) syndromic panels to detect a broad spectrum of viral and bacterial agents, sometimes including resistance genes.</div><div>These tests are not recommended for routine use in CAP patients treated in ambulatory settings. In hospitalized CAP patients, their use must be guided by severity, epidemic context, and therapeutic implications. “Upper respiratory tract” panels can be useful when an atypical agent or a virus undetected by targeted PCR tests is suspected. “Lower respiratory tract” panels must only be used in case of severe forms or complex situations.</div><div>Clinical trials showed real diagnostic value but variable clinical impact, which is often limited in the absence of an optimization strategy for the antibiotic therapy.</div><div>Multiplex PCR syndromic panels represent a promising step forward in the management of patients hospitalized with CAP, but their clinical value still depends on several factors: type of panel and swab, quick results, presence of mobile teams of infectious diseases specialists, and capacity to correctly interpret results to guide treatment decisions.</div></div>","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":"55 6","pages":"Article 105128"},"PeriodicalIF":2.2,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144757105","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":"Duration of antibiotic treatment for community-acquired pneumonia","authors":"Aurélien Dinh ,&nbsp;David Lebeaux","doi":"10.1016/j.idnow.2025.105125","DOIUrl":"10.1016/j.idnow.2025.105125","url":null,"abstract":"<div><div>Previous guidelines have recommended 5-day antibiotic treatment for community-acquired pneumonia (CAP) patients manifesting clinical improvement after 48–72 h, and seven-day treatment for other, uncomplicated forms of CAP.</div><div>Three <em>meta</em>-analyses and two randomized double-blind trials have confirmed the non-inferiority of short (3–7 days) as compared to long treatments (&gt;7 days). A trial involving young patients with few comorbidities demonstrated the efficacy of 3-day treatment by amoxicillin in the event of clinical improvement at D3. A second trial, which involved older patients with more comorbidities, validated three-day antibiotic treatment by injectable beta-lactams for patients stabilized at D3.</div><div>The 2025 guidelines adopt a personalized approach premised on attainment of clinical stability: three days of antibiotic treatment for non-severe or moderate CAP stabilized at D3, five days when stability is achieved by D5, and seven days for other, uncomplicated forms of community-acquired pneumonia. Only when complications occur is prolonged duration indicated.</div><div>The ensuing recommendations are aimed at reducing antibiotic exposure while maintaining optimal efficacy of treatment for community-acquired pneumonia.</div></div>","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":"55 6","pages":"Article 105125"},"PeriodicalIF":2.2,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144756913","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":"Bacterial epidemiology and antibiotic resistance rates in male urinary tract infections in France, 2019–2023","authors":"Sophie Reissier ,&nbsp;Malo Penven ,&nbsp;Marlène Amara ,&nbsp;Laurent Dortet ,&nbsp;Emeline Riverain ,&nbsp;Yvan Caspar ,&nbsp;Nicolas Degand ,&nbsp;Eric Farfour ,&nbsp;Stéphane Corvec ,&nbsp;Olivier Barraud ,&nbsp;Cécile Le Brun ,&nbsp;Christophe Isnard ,&nbsp;Hervé Jacquier ,&nbsp;Assaf Mizrahi ,&nbsp;Anaïs Potron ,&nbsp;Sébastien Larréché ,&nbsp;Audrey Mérens ,&nbsp;Vincent Cattoir ,&nbsp;on behalf of the GMC study group","doi":"10.1016/j.idnow.2025.105123","DOIUrl":"10.1016/j.idnow.2025.105123","url":null,"abstract":"<div><h3>Aim</h3><div>The aim of this study was to describe the bacterial epidemiology and antibiotic resistance rates of bacterial isolates collected from urine specimens in male patients with suspected urinary tract infection (UTI).</div></div><div><h3>Methods</h3><div>This retrospective multicenter study included routine data from midstream urine cultures of adult male patients with suspected UTI admitted to the emergency departments of 15 hospitals from 2019 to 2023. Urinalysis was performed according to the recommendations of the French Society for Microbiology and bacterial identification was carried out using MALDI-TOF mass spectrometry. Antimicrobial susceptibility testing was performed by disk diffusion or semi-automated methods and interpreted according to the CA-SFM/EUCAST guidelines.</div></div><div><h3>Results</h3><div>Overall, 38,279 bacterial isolates were detected among 33,113 male patients (mean age = 70.7 years). The most frequently encountered pathogen was <em>E. coli</em> (40.0 %) followed by <em>E. faecalis</em> (13.2 %), <em>K. pneumoniae</em> (7.8 %) and <em>P. mirabilis</em> (5.8 %). Overall prevalence of ESBL-E was 9.0 %, represented mainly by <em>K. pneumoniae</em> (22.8 %), <em>E. cloacae</em> complex (19.3 %) and <em>E. coli</em> (8.4 %). Prevalence of resistance to fluoroquinolones and cotrimoxazole was high (usually &gt; 15–20 %). The resistance rates in <em>E. coli</em> were very low (around 1 %) for fosfomycin and nitrofurantoin, as was the overall prevalence of carbapenemase-producing Enterobacterales (0.1 %). In <em>S. aureus</em>, 20.4 % of isolates were resistant to methicillin, and only three vancomycin-resistant enterococci (&lt;0.01 %) were detected.</div></div><div><h3>Conclusion</h3><div>This original study provides recent, nationwide and helpful data on bacterial epidemiology and antibiotic resistance rates of isolates recovered from urines in male patients with suspected UTIs.</div></div>","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":"55 7","pages":"Article 105123"},"PeriodicalIF":2.2,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730103","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":"Amoxicillin/clavulanate activity against bacteria isolated in severe community-acquired pneumonia: a retrospective study (sCAP)","authors":"A. Sarr ,&nbsp;M.A. Matta ,&nbsp;F. Kayembe ,&nbsp;A. Depontfarcy ,&nbsp;M. Monchi ,&nbsp;S. Diamantis","doi":"10.1016/j.idnow.2025.105122","DOIUrl":"10.1016/j.idnow.2025.105122","url":null,"abstract":"<div><h3>Background</h3><div>Severe community-acquired pneumonia (sCAP) requires prompt empirical antibiotic therapy. Amoxicillin-clavulanate (AMC), an “Access” antibiotic per WHO AWaRe classification, could possibly constitute an ecologically preferable alternative to third-generation cephalosporins (3GCs).</div></div><div><h3>Objectives</h3><div>To assess AMC susceptibility in bacterial isolates from sCAP patients and to identify factors associated with AMC resistance.</div></div><div><h3>Methods</h3><div>A retrospective single-center study was conducted between 2019 and 2021 in a single ICU. Patients with sCAP and positive respiratory cultures within 48 h were included.</div></div><div><h3>Results</h3><div>In 185 patients, 212 isolates were identified. AMC susceptibility was 83.5 % overall, with the highest rates for <em>S. pneumoniae</em> (97.9 %), <em>H. influenzae</em> (84.6 %), and <em>S. aureus</em> (96.1 %). Prior antibiotic use within three months was the only independent factor associated with AMC resistance (p &lt; 0.00001). Susceptibility reached 90.9 % in patients without prior antibiotic use.</div></div><div><h3>Conclusion</h3><div>AMC is a viable empirical option for sCAP treatment in patients without recent antibiotic exposure, offering more pronounced ecological benefits than 3GCs.</div></div>","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":"55 7","pages":"Article 105122"},"PeriodicalIF":2.2,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144720989","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":"CV2 : Editorial board","authors":"","doi":"10.1016/S2666-9919(25)00094-6","DOIUrl":"10.1016/S2666-9919(25)00094-6","url":null,"abstract":"","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":"55 5","pages":"Article 105115"},"PeriodicalIF":2.9,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144686157","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":"What’s new in the diagnosis and treatment of human brucellosis?","authors":"J.-P. Lavigne ,&nbsp;C. Magnan ,&nbsp;P. Loubet ,&nbsp;A. Sotto ,&nbsp;D. O’Callaghan ,&nbsp;A. Keriel","doi":"10.1016/j.idnow.2025.105121","DOIUrl":"10.1016/j.idnow.2025.105121","url":null,"abstract":"<div><div>Brucellosis is a reemerging zoonotic infectious disease caused by <em>Brucella</em> spp. and posing significant global health challenges. Focusing on epidemiology, pathophysiology, diagnostic tools, and therapeutic management, the present review synthesizes recent advances in the diagnosis and treatment of brucellosis. Notwithstanding global control efforts, brucellosis remains endemic in various regions, with emerging species and hosts complicating its epidemiology. The mechanisms of <em>Brucella</em> intracellular survival, including evasion of host immune responses and manipulation of cellular processes, contribute to its persistence and pathogenicity. Diagnostic challenges are addressed through culture-based methods, serological tests, and molecular assays, with recent innovations showing enhanced sensitivity and specificity. Treatment involves prolonged antibiotic therapy, consisting in combination regimens tailored to disease severity and patient-specific factors. However, the emergence of antibiotic-resistant strains necessitates continuous surveillance and application of alternative therapeutic strategies. Prevention programs emphasize surveillance and vaccination of livestock, biosecurity measures, and public education designed to reduce transmission. Laboratory safety protocols are crucial to prevent contamination during the handling of suspected brucellosis samples. Future research should focus on proteomic and transcriptomic analyses in view of identifying resistance mechanisms and improving management strategies. This comprehensive review highlights the need for coordinated efforts to control brucellosis and mitigate its impact on public health.</div></div>","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":"55 7","pages":"Article 105121"},"PeriodicalIF":2.2,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717856","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":"In vitro susceptibility of ciprofloxacin-resistant strains of Pseudomonas aeruginosa to high concentration ciprofloxacin-containing ototopical solution","authors":"Tali Jane Krotter ,&nbsp;Hagai Rechnitzer ,&nbsp;Ohad Ronen","doi":"10.1016/j.idnow.2025.105120","DOIUrl":"10.1016/j.idnow.2025.105120","url":null,"abstract":"<div><h3>Context</h3><div><em>Pseudomonas aeruginosa</em> is the most frequently isolated pathogen in acute otitis externa (AOE), with ototopical antibiotics being the mainstay of treatment. The incidence of ciprofloxacin resistance in <em>P.<!--> <!-->aeruginosa</em> has been steadily increasing. This study aimed to evaluate the in vitro susceptibility of <em>P.<!--> <!-->aeruginosa</em> to a ciprofloxacin-containing ototopical solution.</div></div><div><h3>Methods</h3><div>In this prospective study we examined the in vitro growth of ciprofloxacin-resistant <em>P.<!--> <!-->aeruginosa</em> isolates when exposed to varying concentrations of a ciprofloxacin-containing ototopical solution.</div></div><div><h3>Results</h3><div>Concentration of the ototopical solution was strongly associated with the diameter of inhibition on sensitive strains. Sensitive strains of <em>P.<!--> <!-->aeruginosa</em> showed inhibition of growth with an extrapolated MIC value of 0.0686 <!--> <!-->µg/µL. Resistant strains demonstrated inhibition to all dilutions of the ototopical solution, including undiluted concentration. Ciprofloxacin-sensitive strains demonstrated resistance at higher ototopical concentrations compared with the reported serum concentration after standard systemic administration.</div></div><div><h3>Conclusions</h3><div>The current use of commercially available ciprofloxacin topical ear drops for treating AOE does not appear to hold promise for the fight against resistant strains of <em>P.<!--> <!-->aeruginosa</em> and might be at risk of becoming ineffective in the treatment of sensitive species. Therefore, further investigation is needed to gain a deeper understanding of ototopical solutions, as well as to establish a database of MICs for topical antibiotics.</div></div>","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":"55 7","pages":"Article 105120"},"PeriodicalIF":2.9,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674688","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":"Management of catheter-related septic thrombosis","authors":"Victor Hémar ,&nbsp;Hélène Chaussade ,&nbsp;Claire Rivoisy ,&nbsp;Anne Contis ,&nbsp;Marie-Anne Vandenhende ,&nbsp;Didier Bronnimann ,&nbsp;Juliette Prola ,&nbsp;Céline Delassasseigne ,&nbsp;Gaël Galli ,&nbsp;Joël Constans ,&nbsp;Fabrice Bonnet","doi":"10.1016/j.idnow.2025.105119","DOIUrl":"10.1016/j.idnow.2025.105119","url":null,"abstract":"<div><h3>Introduction</h3><div>The use of intravascular catheters is associated with a risk of catheter-related septic thrombosis (CRST), which management remains highly variable due to a lack of robust scientific evidence. This study aimed to describe current practices in France through a systematic survey.</div></div><div><h3>Methods</h3><div>A web-based survey was disseminated via 10 French medical societies between June and October 2024.</div></div><div><h3>Results</h3><div>Among 156 respondents, 69 were infectious disease specialists. For catheter-related bloodstream infections, ultrasound imaging is not routinely performed by 60 % of respondents but is typically performed in the presence of local inflammatory signs or antimicrobial therapy (AMT) failure. Over 60 % of respondents reported prescribing AMT for ≤ 21 days. In cases of CRST involving a deep vein (DV), more than 80 % of respondents considered the use of curative anticoagulation. For proximal DV CRST, 126 of 156 (81 %) respondents performed follow-up ultrasound imaging to assess venous repermeabilization. The most frequently cited research priorities included the need for and appropriate use of anticoagulation (n = 71/156; 46 %), as well as AMT optimal duration (n = 47/156; 30 %).</div></div><div><h3>Conclusion</h3><div>Despite the heterogeneity in clinical practice, our findings highlight a prevailing trend toward prescribing AMT for ≤ 21 days and the use of curative anticoagulation in cases of DV thrombosis. However, these approaches require further investigation through well-designed studies to establish their benefit.</div></div>","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":"55 7","pages":"Article 105119"},"PeriodicalIF":2.9,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674689","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":"National survey on aspiration pneumonia in elderly hospitalized or institutionalized patients in France in 2023","authors":"L. Vieilledent ,&nbsp;T. Fraisse ,&nbsp;G. Gavazzi ,&nbsp;C.Roubaud Baudron ,&nbsp;S. Diamantis ,&nbsp;S. Gallien ,&nbsp;JP. Lanoix ,&nbsp;A. Putot ,&nbsp;V. Prendki ,&nbsp;S. Gaujard","doi":"10.1016/j.idnow.2025.105113","DOIUrl":"10.1016/j.idnow.2025.105113","url":null,"abstract":"<div><h3>Background</h3><div>Aspiration pneumonia is not specifically addressed in French guidelines on pneumonia, despite it being a frequent infection affecting specific populations. The French Infectious Diseases Society’s (French acronym SPILF) Recommendations Group and the Infectio-Geriatrics Group (GinGER-SPILF SFGG) have published the first recommendations on this topic in 2025. The objective of this study was to describe practices of French physicians to manage aspiration pneumonia in hospitalized or institutionalized people aged over 75 years.</div></div><div><h3>Methods</h3><div>A nationwide survey conducted from June to November 2023 was distributed to physicians working in hospitals or medico-social facilities to assess their habits from diagnosis to prevention.</div></div><div><h3>Results</h3><div>A total of 452 physicians responded (mainly geriatricians, infectious disease specialists, and family physicians). Diagnostic criteria were consensual: presence of vomiting, swallowing disorders, or a history of inhalation pneumonia. Seventy-eight per cent of physicians reported prescribing complementary examinations. Imaging examinations (74%) were prioritized over bacteriology (19%). Oral amoxicillin-clavulanic acid was the first-line antibiotic (82%). Significant differences were found in the use of metronidazole and of the subcutaneous route, which were more frequently used by geriatricians. Geriatricians referred significantly more patients to speech therapists. The most commonly used swallowing test was the water test (92%). Screening and management of swallowing disorders, secondary prevention, and nutritional management varied according to specialties and practice settings.</div></div><div><h3>Conclusion</h3><div>This survey shows consensus regarding diagnostic criteria and antibiotic therapy. However, the significant variation in prevention and nutritional management across specialties and practice settings highlights the need for specific recommendations.</div></div>","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":"55 7","pages":"Article 105113"},"PeriodicalIF":2.9,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636964","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}