Infectious Diseases and Therapy最新文献

{"title":"Clinical and Virologic Outcomes of Baloxavir Compared with Oseltamivir in Pediatric Patients with Influenza in Japan.","authors":"Nobuhisa Ishiguro, Ichiro Morioka, Takashi Nakano, Atsushi Manabe, Keiko Kawaguchi, Shintaro Tanaka, Masahiro Kinoshita","doi":"10.1007/s40121-025-01131-4","DOIUrl":"https://doi.org/10.1007/s40121-025-01131-4","url":null,"abstract":"<p><strong>Introduction: </strong>Baloxavir marboxil, a cap-dependent endonuclease inhibitor, has proven efficacy against influenza. There are limited comparative data between baloxavir and oseltamivir in Japanese pediatric patients with influenza. We evaluated the clinical and virologic outcomes and assessed safety of baloxavir compared with oseltamivir for treating influenza in Japanese patients aged 6 to < 12 years.</p><p><strong>Methods: </strong>In this open-label, randomized (2:1) trial, patients received oral administration of either a single dose of baloxavir or a twice-daily 5-day course of oseltamivir. The primary efficacy endpoint was time to illness alleviation (TTIA). Other efficacy and safety endpoints were also assessed.</p><p><strong>Results: </strong>Of 199 enrolled patients (mean age: 9 years), 195 were randomized (baloxavir, n = 128; oseltamivir, n = 67). Of these, 50.8% had influenza A/H3N2, 37.4% influenza B, and 10.3% influenza A/H1N1pdm. Median (95% confidence interval) TTIA was 44.8 (41.5, 69.7) h and 72.2 (50.9, 96.9) h in the baloxavir group and the oseltamivir group, respectively. The median time to first cessation of virus shedding was shorter in the baloxavir vs. oseltamivir group (48.0 vs. 192.0 h). Before treatment, one patient had PA/I38X virus infection at baseline. After treatment, PA/I38X viruses were observed in 12 patients (11 A/H3N2 and 1 A/H1N1pdm). No serious adverse events, including death, were observed in either group.</p><p><strong>Conclusion: </strong>In this study, baloxavir showed the potential for shortening of symptom duration compared with oseltamivir, which suggests baloxavir as an important treatment option for patients with influenza aged 6 to < 12 years.</p><p><strong>Trial registration: </strong>The study was registered at the Japan Registry of Clinical Trial (jRCT) on November 11, 2020 (registration no. jRCTs011200011).</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742601","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":"Cost-Effectiveness and Public Health Impact of Universal Prophylaxis with Nirsevimab Against Respiratory Syncytial Virus (RSV) Infections in all Infants in Japan.","authors":"Shinichi Noto, Alexia Kieffer, Samira Soudani, Takeshi Arashiro, Chiho Tadera, Sebastien Eymere, Tobiasz Lemański, Xinyu Wang","doi":"10.1007/s40121-025-01134-1","DOIUrl":"https://doi.org/10.1007/s40121-025-01134-1","url":null,"abstract":"<p><strong>Introduction: </strong>Respiratory syncytial virus (RSV) is a common cause of lower respiratory tract disease, and the standard prevention strategy in Japan is limited to high-risk infants. Nirsevimab provides protection against medically attended (MA) RSV infection in healthy late-preterm and term infants and was approved in Japan in 2024. This study estimates the cost-effectiveness of universal immunization with nirsevimab in an all-infant population from the Japanese public healthcare payer perspective.</p><p><strong>Methods: </strong>A static decision analytic model, able to track costs and health outcomes in a cohort of infants, was adapted to the Japanese setting. The standard of care, palivizumab, administered to high-risk infants, was compared with nirsevimab administrated to all infants in the first year, and an additional increased dose of nirsevimab (200 mg) in the second season for high-risk infants. Differences in costs and quality-adjusted life years (QALYs) were captured considering RSV-related MA health events requiring inpatient hospitalizations, emergency room visits, and primary care visits, as well as RSV-related complications. Sensitivity and scenario analyses were conducted to explore the robustness and uncertainty of the study.</p><p><strong>Results: </strong>Assuming a price of ¥45,000 for nirsevimab, universal immunization with nirsevimab was found to be cost-effective with an incremental cost-effectiveness ratio (ICER) of ¥4,537,256/QALY. At the Japanese willingness-to-pay threshold of ¥5,000,000, the economically justifiable price was ¥45,496. Using the societal perspective, the ICER decreased to ¥1,695,635/QALY. Nirsevimab has a substantial public health impact on RSV disease burden, reducing approximately 50% of RSV-associated health events in an all-infant population.</p><p><strong>Conclusion: </strong>The analysis demonstrated that universal prophylaxis strategy with nirsevimab would significantly reduce the health and economic burden associated with RSV among infants in Japan. At the assumed price, nirsevimab can provide a cost-effective prophylaxis option against RSV infection in an all-infant population not limited to infants born prematurely or with high risk.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735803","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":"Economic Evaluation of Adolescent Vaccination with Serogroup ACWY and C Meningococcal Vaccines in Germany.","authors":"Sebastian Gruhn, Manuel Batram, Moritz Wick, Edith Langevin, Stefan Scholz, Wolfgang Greiner, Oliver Damm","doi":"10.1007/s40121-025-01132-3","DOIUrl":"https://doi.org/10.1007/s40121-025-01132-3","url":null,"abstract":"<p><strong>Introduction: </strong>Invasive meningococcal disease (IMD) is a rare but serious condition caused by Neisseria meningitidis, with rising cases of serogroups W and Y in Germany. Currently, routine vaccination in Germany includes MenC vaccination in toddlers, and as of early 2024, MenB vaccination has been recommended in infancy. MenACWY vaccination, however, is currently only recommended for high-risk individuals. This study evaluates the potential public health impact and cost-effectiveness of introducing routine adolescent MenACWY or MenC vaccination in Germany.</p><p><strong>Methods: </strong>This study presents a health economic evaluation based on a previously published dynamic transmission model, which simulates the introduction of MenACWY vaccination in adolescents in Germany. The evaluation incorporates costs and quality-adjusted life years (QALYs), and is conducted from a societal perspective. Deterministic and probabilistic sensitivity analyses were performed to assess the robustness of the findings and to account for parameter uncertainty.</p><p><strong>Results: </strong>The introduction of adolescent MenACWY vaccination was estimated to prevent 1467 IMD cases and 156 deaths by 2060, leading to a total gain of 2333 QALYs. The MenACWY vaccination strategy was associated with incremental costs of approximately €306 million, resulting in an incremental cost-effectiveness ratio (ICER) of €131,150 per QALY gained. Scenarios assuming higher levels of carriage protection reduced the ICER to as low as €76,000 per QALY. In contrast, adolescent MenC vaccination had a comparatively minor impact on IMD incidence and mortality, with ICERs exceeding €1 million per QALY. Sensitivity analyses highlighted the significant influence of assumed vaccine carriage protection and duration of protection on the ICER.</p><p><strong>Conclusions: </strong>Adolescent MenACWY vaccination in Germany has the potential to reduce the incidence and mortality of IMD, particularly from serogroups W and Y. Although the cost-effectiveness of the strategy depends on several assumptions, particularly the extent of carriage protection, the ICER for MenACWY introduction appears favorable.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735751","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":"Xpert MTB/XDR Assay for Detection of Resistance to Isoniazid, Fluoroquinolone, Aminoglycoside, and Ethionamide Among Patients with Pulmonary Tuberculosis in Bangladesh.","authors":"S M Mazidur Rahman, Noshin Nawer Ruhee, Amiyo Haider, Md Jahid Hasan, Rumana Nasrin, Ahammad Shafiq Sikder Adel, Mohammad Khaja Mafij Uddin, Shahriar Ahmed, Aung Kya Jai Maug, Sayera Banu","doi":"10.1007/s40121-025-01127-0","DOIUrl":"https://doi.org/10.1007/s40121-025-01127-0","url":null,"abstract":"<p><strong>Introduction: </strong>Early detection of drug resistance in patients with tuberculosis (TB) is crucial for prompt and effective treatment. This study evaluated the performance of Xpert MTB/XDR assay (Xpert XDR) for detecting resistance to isoniazid (INH), fluoroquinolones (FLQ), aminoglycosides (AMG), and ethionamide (ETH) in patients with pulmonary TB (PTB) in Bangladesh.</p><p><strong>Methods: </strong>Xpert XDR was performed on sputum samples from 793 Xpert MTB/RIF positive patients with PTB enrolled between April 2021 and March 2023. Results were compared with phenotypic drug susceptibility test (pDST) performed on Lowenstein-Jensen (L-J) media for the detection of resistance to INH, FLQ, AMG, and ETH. The performance of the assay was also compared between newly diagnosed or rifampicin (RIF)-sensitive versus re-treated or RIF-resistant patients with PTB.</p><p><strong>Results: </strong>Of 793 samples tested by Xpert XDR, indeterminate results for INH, FLQ, AMG, and ETH were observed for 3 (0.4%), 5 (0.6%), 33 (4.2%), and 0 (0%) isolates, respectively. The assay's sensitivity and specificity compared to pDST was 94.0% (95% CI 90.5-96.4; 264/281) and 97.3% (95% CI 95.4-98.5; 495/509), respectively for INH; 86.0% (95% CI 78.2-91.8; 98/114) and 99.3% (95% CI 98.3-99.3; 669/674), respectively for FLQ; 85.7% (95% CI 42.1-99.6; 6/7) and 99.9% (95% CI 99.3-100.0; 752/753), respectively for AMG; and 25.0% (95% CI 19.0-31.7; 48/192) and 96.7% (95% CI 94.9-98.0; 581/601), respectively for ETH. Agreement of Xpert XDR with pDST was almost perfect for detecting resistance to INH, FLQ, and AMG (kappa: 0.91, 0.89, and 0.86, respectively), but fair for ETH (kappa: 0.28). Xpert XDR performed significantly better among re-treated or RIF-resistant patients with TB compared to newly diagnosed or RIF-sensitive cases.</p><p><strong>Conclusions: </strong>Given the high performance, Xpert XDR assay can be programmatically implemented nationwide for rapid and accurate detection of resistance to INH, FLQ, and AMG in patients with PTB, aiding clinicians in selecting appropriate regimens for the treatment of drug-resistant TB.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700381","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":"Characteristics and Real-World Outcomes of Patients Treated with Fecal Microbiota, Live-jslm (RBL) for the Prevention of Recurrent Clostridioides difficile Infection.","authors":"Sahil Khanna, Sanghyuk Seo, Min Yang, Viviana Garcia-Horton, Yipeng Gao, Hannah H Kim, Loren Ormenaj, Amy Guo","doi":"10.1007/s40121-025-01130-5","DOIUrl":"https://doi.org/10.1007/s40121-025-01130-5","url":null,"abstract":"<p><strong>Introduction: </strong>Recurrent Clostridioides difficile infection (rCDI) is common, with symptoms ranging from diarrhea to life-threatening sepsis. This study aimed to assess the real-world outcomes of patients with rCDI in the United States (US) who received fecal microbiota, live-jslm (RBL), the first US Food and Drug Administration-approved microbiota-based therapy for the prevention of rCDI after antibiotic treatment.</p><p><strong>Methods: </strong>Adults with rCDI who received RBL between July 2023 and August 2024 at home or in a clinic and had ≥ 8 weeks of follow-up or experienced CDI recurrence at any time after RBL administration were included. Treatment success, defined as no CDI recurrence within 8 weeks of RBL, was assessed overall and in subgroups stratified by age, number of prior CDI recurrences, duration of the antibiotic washout period, prior bezlotoxumab use, and RBL administration setting.</p><p><strong>Results: </strong>Among 196 patients who received RBL, 176 had either ≥ 8 weeks of follow-up or had < 8 weeks of follow-up but experienced CDI recurrence during that period. The treatment success rate at 8 weeks was 83.0%. No significant differences were observed in treatment success rates among subgroups based on age (< 65 years old vs. ≥ 65 years old: 85.9% vs. 80.2%, p = 0.20), duration of the antibiotic washout period (24 h: 80.0%, 48 h: 84.5%, 72 h: 85.0%, p = 0.68), number of prior CDI recurrences (< 3 vs. ≥ 3: 82.5% vs. 83.1%, p = 0.60), or prior bezlotoxumab use (86.4% vs. 83.7%, p = 1.00). Patients receiving RBL at home had a higher treatment success rate compared to those receiving RBL in a clinic (87.3% vs. 62.5%, p < 0.01).</p><p><strong>Conclusions: </strong>RBL was highly effective in preventing rCDI in a real-world setting, including at-home administration. The effectiveness was also observed among high-risk subgroups, such as patients ≥ 65 years old and those with ≥ 3 prior CDI recurrences.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676662","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":"Real-World Use, Effectiveness, and Safety of Intravenous Fosfomycin: The FORTRESS Study.","authors":"Klaus-Friedrich Bodmann, Stefan Hagel, Alessandra Oliva, Stefan Kluge, Alessandra Mularoni, Valentina Galfo, Marco Falcone, Mathias W Pletz, Simone Lindau, Nadja Käding, Jan T Kielstein, Michael Zoller, Carlo Tascini, Sebastian Kintrup, Dirk Schädler, Claudia Spies, Francesco G De Rosa, Szilvia Radnoti, Alessandra Bandera, Roberto Luzzati, Sam Allen, Loredana Sarmati, Antonio Cascio, Nikolaos Kapravelos, Chinari P K Subudhi, George Dimopoulos, Matthias G Vossen, Abhijit M Bal, Mario Venditti, Claudio M Mastroianni, Thomas Borrmann, Christian Mayer","doi":"10.1007/s40121-025-01125-2","DOIUrl":"https://doi.org/10.1007/s40121-025-01125-2","url":null,"abstract":"<p><strong>Introduction: </strong>Intravenous fosfomycin (FOS) is a broad-spectrum antibiotic primarily used in combination therapy to treat severe infections caused by both Gram-positive (GP) and Gram-negative (GN) pathogens, including multi-drug resistant (MDR) bacteria. The aim of this study, the largest to date, was to evaluate the effectiveness, safety, usage patterns, and patient characteristics of FOS in a real-world setting.</p><p><strong>Methods: </strong>Interim analysis of an ongoing, prospective, non-interventional, multicentre study in five European countries, involving centres in Germany, Italy, the United Kingdom, Greece, and Austria.</p><p><strong>Results: </strong>A total of 716 patients were enrolled between January 2017 and November 2023 (mean age: 62.8 years, APACHE II: 18.3, SOFA: 6.7). Main indications for FOS were bacteraemia/sepsis (23.6%), complicated urinary tract infections (18.0%), and bone and joint infections (17.4%). Other indications included hospital-acquired/ventilator-associated pneumonia (11.0%), complicated skin and soft tissue infections (9.1%), bacterial meningitis/central nervous system (CNS) infections (7.8%), and infective endocarditis (6.4%). Most common pathogens identified were Staphylococcus aureus (31.4%, including methicillin-resistant S. aureus), Klebsiella spp. (including K. pneumoniae) (17.2%), Escherichia coli (14.2%), coagulase-negative staphylococci (12.9%), other Enterobacterales (10.9%), and Pseudomonas aeruginosa (8.4%). In 34.6% of patients, an MDR pathogen was involved. Carbapenem resistance (CR) was high in Klebsiella spp. infections (59/123, 48.0%). In most patients, FOS was used in combination therapy (90.2%). The median dose was 15 g/day. Overall, clinical success and clinical response were favourable with 75.3% and 83.4% at the end of FOS treatment. Clinical success rates in infections caused by MDR or CR pathogens were 78.0% and 81.8%, respectively. Microbiological cure was achieved in 82.4% of all patients. Electrolyte imbalances were the most frequently observed adverse drug reactions, while gastrointestinal disorders were rare.</p><p><strong>Conclusion: </strong>The results from this study suggest that FOS is a safe and effective option as combination partner in the treatment of patients with severe infections caused by both GP and GN pathogens, including deep-seated infections and/or involvement of MDR bacteria.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier, NCT02979951.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663219","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":"PCV13-Serotype Breakthrough Pneumococcal Disease in Infants Receiving High-Valency Conjugate Vaccines: Population-Level Modeling in France.","authors":"Kevin M Bakker, Rachel J Oidtman, Natalie Banniettis, Kristen Feemster, Priscilla Velentgas, Tufail M Malik, Giulio Meleleo, Jessica Weaver","doi":"10.1007/s40121-025-01123-4","DOIUrl":"https://doi.org/10.1007/s40121-025-01123-4","url":null,"abstract":"<p><strong>Introduction: </strong>Pneumococcal conjugate vaccines (PCVs) have been increasing in valency to protect against a larger number of serotypes; however, the addition of serotypes has come at the cost of reduced immunogenicity, which may lead to breakthrough disease.</p><p><strong>Methods: </strong>This study used a mathematical model to evaluate the impact of introducing routine vaccination with either PCV15 or PCV20 on breakthrough invasive pneumococcal disease (bIPD) incidence associated with PCV13 serotypes in infants aged 0-12 months in France. The model incorporated historical PCV introductions and calibrated age- and serotype-specific IPD data spanning 2000-2019. Serotype-specific vaccine effectiveness for PCV15 and PCV20 was predicted based on previously published analyses. The incidence of bIPD was evaluated across three serotype classes: PCV7 (serotypes 4, 6B, 9V, 14, 18C, 19F, and 23F), PCV13-nonPCV7-nonST3 (serotypes 1, 5, 6A, 7F, and 19A), and ST3 (serotype 3). Results were compared to IPD incidence in 2019.</p><p><strong>Results: </strong>Twenty years following introduction into the childhood immunization program, the routine use of PCV15 in a 2 + 1 regimen led to fewer PCV13-nonPCV7-nonST3-associated bIPD cases in infants than the use of PCV20 in either a 2 + 1 or 3 + 1 regimen. PCV15 reduced bIPD incidence in all three serotype classes (- 28% to - 89%) in infants, with the largest impact on ST3. PCV20 in both regimens resulted in more bIPD cases from PCV7 serotypes (+ 65% to + 350%), while PCV13-nonPCV7-nonST3 and ST3 bIPD cases increased in a 2 + 1 regimen (+ 28% and + 6%, respectively) but decreased in a 3 + 1 regimen (- 23% and - 30%, respectively), in infants.</p><p><strong>Conclusions: </strong>Implementation of PCV15 in a 2 + 1 regimen could reduce bIPD incidence due to all PCV13 serotypes in infants, whereas PCV20 in a 2 + 1 regimen may lead to substantial increases in bIPD cases from PCV13 serotypes in infants. PCV20 in a 3 + 1 regimen could potentially lead to a resurgence of bIPD from PCV7 serotypes in infants.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663236","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":"Risk of Severe COVID-19 in Four Immunocompromised Populations: A French Expert Perspective.","authors":"Paul Loubet, Ilies Benotmane, Slim Fourati, Florent Malard, Fanny Vuotto, Elodie Blanchard, François Raffi, Stéphanie Nguyen, Nicolas de Prost, Jérôme Avouac","doi":"10.1007/s40121-025-01124-3","DOIUrl":"https://doi.org/10.1007/s40121-025-01124-3","url":null,"abstract":"<p><p>Immunocompromised patients are disproportionately impacted by severe disease, hospitalization, and mortality associated with coronavirus disease 2019 (COVID-19). To optimize the management of these patients in clinical practice, we convened an expert panel to review current evidence on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine responses and severe COVID-19 in immunocompromised populations. We identified four main immunocompromised groups-solid organ transplant recipients, patients receiving allogeneic hematopoietic stem cell transplantation or chimeric antigen receptor (CAR) T cell therapy, patients treated for hematologic malignancies, and patients treated for inflammatory diseases-who mount suboptimal humoral responses to SARS-CoV-2 vaccination and are at increased risk of severe COVID-19-related outcomes. A wide range of risk factors were associated with reduced vaccine responses and/or poor outcomes, most commonly older age, comorbidities, and the type and number of immunosuppressive therapies. We believe that early identification and close monitoring of these at-risk patients, plus regular booster vaccinations, prophylactic monoclonal antibody therapy, non-pharmacologic prevention measures, prompt antiviral treatment, and other risk mitigation strategies, are critical to protect against SARS-CoV-2 infection and severe COVID-19.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657163","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":"Healthcare Professionals' Knowledge, Attitudes, and Practices Regarding Respiratory Syncytial Virus Disease and Vaccination in Adults Aged 60 Years and Older.","authors":"Elizabeth M La, Carolyn Sweeney, Eric Davenport, Sarah Calhoun, Andrea Harmelink, David Singer","doi":"10.1007/s40121-025-01119-0","DOIUrl":"https://doi.org/10.1007/s40121-025-01119-0","url":null,"abstract":"<p><strong>Introduction: </strong>The burden of respiratory syncytial virus (RSV) disease is substantial among adults aged ≥ 60 years and adults with risk factors for severe RSV. This study assessed the knowledge, attitudes, and practices of healthcare professionals (HCPs) related to RSV disease and vaccination, with a focus on adults aged ≥ 60 years.</p><p><strong>Methods: </strong>During November 14-30, 2023, a cross-sectional, web-based survey was administered to HCPs, targeting a total of 600 primary care physicians (PCPs), specialist physicians, nurse practitioners (NPs)/physician assistants (PAs), and pharmacists. Survey questions evaluated knowledge about RSV disease, vaccines, and vaccination recommendations; RSV-related attitudes and perceptions; and RSV vaccination practices. Responses were analyzed descriptively, overall and by HCP subgroup. Multivariable logistic regression models were used to explore HCP characteristics associated with RSV vaccination knowledge and practices.</p><p><strong>Results: </strong>Of the 603 respondents (148 PCPs, 151 specialist physicians, 150 NPs/PAs, and 154 pharmacists), 63.0% were very familiar with RSV disease in patients aged ≥ 60 years. Although most HCPs recognized the benefits of RSV vaccination within this patient population, many HCPs were not fully knowledgeable about RSV vaccine recommendations, and 33.5% had not recommended, prescribed, or administered any RSV vaccine to patients aged ≥ 60 years in the previous 3 months. In multivariable regression analyses, HCP familiarity with RSV disease (among other factors) was consistently associated with RSV vaccination knowledge and practices.</p><p><strong>Conclusions: </strong>This study characterized RSV disease- and vaccine-related knowledge, attitudes, and practices among HCPs in the United States during the first season of RSV vaccine availability for adults aged ≥ 60 years. These findings can help to inform HCP and patient education efforts to address potential RSV vaccination knowledge gaps and ensure equitable access to RSV vaccines among older adults.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624385","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":"The Impact of the COVID-19 Omicron Variant on Immunocompromised Patients: ICU Admissions and Increased Mortality.","authors":"Jan Pander, Fabian Termorshuizen, Dylan W de Lange, Wendy Beekman-Hendriks, Josien Lanfermeijer, Ferishta Bakhshi-Raiez, Dave A Dongelmans","doi":"10.1007/s40121-025-01122-5","DOIUrl":"https://doi.org/10.1007/s40121-025-01122-5","url":null,"abstract":"<p><strong>Introduction: </strong>The corona virus disease 19 (COVID-19) pandemic has presented a global health challenge, and several consecutive variants of the severe acute respiratory syndrome-corona virus-2 (SARS-CoV-2) virus have been dominant. Previous studies highlighted decreased mortality rates during the predominance of the omicron variant; however, severely immunocompromised individuals remained at high risk due to limited vaccine response. This study aims to compare mortality rates during the omicron period between immunocompromised and non-immunocompromised patients in intensive care units (ICUs) in The Netherlands.</p><p><strong>Methods: </strong>Utilizing data from the Dutch National Intensive Care Evaluation (NICE) registry, this study analyzed ICU admissions due to COVID-19 from February 2022 to December 2023. Patients were categorized as immunocompromised based on recorded immunologic insufficiencies or associated conditions. A historical cohort of viral pneumonia patients from 2017 to 2019 was used for comparison. Logistic regression analyses, adjusted for age, gender, body-mass index (BMI), and acute physiology and chronic health evaluation IV (APACHE-IV) mortality risk, compared in-hospital and ICU mortality and length of stay between groups. A sensitivity analysis excluded early omicron period admissions to assess the consistency of findings.</p><p><strong>Results: </strong>Among 1491 patients admitted to the ICU due to COVID-19, 29.5% were immunocompromised, showing significantly higher in-hospital adjusted odds ratio (OR_adj = 1.56, 95% CI 1.20-2.04) and ICU mortality (OR_adj = 1.64, 95% CI 1.25-2.17) compared to non-immunocompromised patients. The historical cohort exhibited lower mortality rates for immunocompromised individuals compared to the COVID-19 cohort. Sensitivity analysis confirmed these trends, with slight attenuation of odds ratios.</p><p><strong>Conclusion: </strong>Immunocompromised patients admitted to the ICU due to COVID-19 during the omicron period had higher mortality than non-immunocompromised patients. Additionally, immunocompromised patients with COVID-19 had higher mortality than immunocompromised patients with other viral pneumonias. Our results provide additional evidence that COVID-19 is still a significant health concern to immunocompromised individuals, which warrants specific and effective measures to protect this vulnerable group.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630385","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}