Infectious Diseases and Therapy最新文献

{"title":"Burden of Invasive Meningococcal Disease: Evolving Epidemiology and Implications for Prevention Policy.","authors":"Mary Bausch-Jurken, Sean Leng, Jana Shaw, Stephen Pelton","doi":"10.1007/s40121-026-01434-0","DOIUrl":"10.1007/s40121-026-01434-0","url":null,"abstract":"<p><p>Invasive meningococcal disease (IMD), caused by Neisseria meningitidis, remains a rare but devastating condition characterized by rapid clinical progression, high case fatality, and long-term morbidity. Despite effective conjugate (or alternative) vaccine availability, sporadic cases and outbreaks persist across the age spectrum in the USA and globally. Contemporary surveillance data reveal a dynamic epidemiologic landscape, shifting serogroup dominance, evolving outbreak patterns involving community-based and socially connected groups, and growing recognition of disease burden among adults. Adolescents serve as key reservoirs of nasopharyngeal carriage; however, despite IMD incidence and case-fatality rates being highest among infants and older adults, respectively, both populations lack routine age-based vaccination recommendations. Prevention strategies in the USA remain anchored to historical incidence peaks and narrowly defined risk groups, leaving substantial gaps in protection, as highlighted by the sharp contrast between high adolescent quadrivalent meningococcal conjugate vaccine coverage and low serogroup B vaccine uptake under shared clinical decision-making. This narrative review synthesizes contemporary evidence on age-specific IMD burden, serogroup dynamics, and long-term sequelae, and critically examines how existing vaccination policies align with infection risk across the lifespan, with emphasis on US vaccination policy. Additional country-specific studies were included to contextualize age-specific epidemiology and provide policy comparators. A life-course-based prevention framework integrating age-related vulnerability, severity, and evolving transmission dynamics is needed to mitigate the burden of IMD.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":"2839-2864"},"PeriodicalIF":5.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bivalent RSVpreF Effectiveness Against Respiratory Syncytial Virus (RSV)-Related Respiratory Disease Hospitalization and Emergency Department Visits Across Three RSV Seasons.","authors":"Sara Y Tartof, Evan J Zasowski, Negar Aliabadi, Gabriella Goodwin, Jeff Slezak, Vennis Hong, Timothy B Frankland, Bradley Ackerson, Qing Liu, Sally Shaw, Sabrina Welsh, Banshri Kapadia, Brigitte C Spence, Gregg S Davis, Joseph A Lewnard, Hina Chowdhry, Michael Dutro, Erica Chilson, Alejandro Cane, Kyla Hayford, Elizabeth Begier","doi":"10.1007/s40121-026-01438-w","DOIUrl":"10.1007/s40121-026-01438-w","url":null,"abstract":"<p><strong>Introduction: </strong>Respiratory syncytial virus (RSV) protein subunit vaccines reduce the risk of severe outcomes such as hospitalization and emergency department (ED) visits for at least two RSV seasons following vaccination. No data have been published on real-world RSV vaccine effectiveness (VE) beyond the second season after vaccination. This study evaluates bivalent RSVpreF VE against RSV-related respiratory disease hospitalizations/ED visits throughout three seasons after vaccination.</p><p><strong>Methods: </strong>This retrospective test-negative case-control study evaluates bivalent RSVpreF VE among adults aged ≥60 years at Kaiser Permanente Southern California, USA, with lower respiratory tract disease (LRTD) or acute respiratory illness (ARI) over three RSV seasons (11/24/2023-4/18/2026). Cases were RSV-positive without coinfection. Controls were negative for RSV, hMPV, influenza, SARS-CoV-2, and positive for a non-vaccine preventable disease pathogen. Exposure was bivalent RSVpreF (Abrysvo) receipt ≥ 21 days before LRTD/ARI. Adjusted VE was estimated using odds ratios from multivariable logistic regression or generalized estimating equations.</p><p><strong>Results: </strong>Overall adjusted VE against RSV-related LRTD hospitalization/ED visits was 80% (95% CI 68-87), 70% (95% CI 53-81), and 51% (95% CI -12-78) in the first, second, and third season after vaccination, respectively. Overall adjusted VE against RSV-related ARI hospitalization/ED visits was 81% (71-87), 64% (48-75), and 60% (15-81), respectively. Adjusted VE among non-immunocompromised individuals trended 4-7% higher than corresponding overall estimates. Overall adjusted VE across the three combined seasons was 73% (95% CI 64-80) and 73% (95% CI 65-79) against RSV-related LRTD and ARI, respectively.</p><p><strong>Conclusion: </strong>Bivalent RSVpreF provides protection against RSV-related respiratory hospitalization/ED visits for at least three seasons after vaccination in this population of older adults with a high prevalence of comorbidities. Estimates in the third season for ARI were more definitive, while those for LRTD were imprecise due to limited event numbers. This suggests bivalent RSVpreF vaccination results in substantial individual and public health benefit.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov ID: NCT06077968.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":"3181-3190"},"PeriodicalIF":5.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simplifying Adult Pneumococcal Vaccination in India: A Cost-Effectiveness Analysis of the 20-Valent Conjugate Vaccine.","authors":"Santosh Taur, Namrata Kulkarni, Sachin Choudhari, Ahuva Averin, Anu Suokas, Mary MacKinnon, Mark Atwood, Liping Huang","doi":"10.1007/s40121-026-01464-8","DOIUrl":"https://doi.org/10.1007/s40121-026-01464-8","url":null,"abstract":"<p><strong>Introduction: </strong>In India, adult pneumococcal disease prevention relies on the 23‑valent pneumococcal polysaccharide vaccine (PPSV23) and the 13‑ and 20‑valent pneumococcal conjugate vaccines (PCV13, PCV20). Before PCV20 introduction, adults at older age or high risk typically received PCV13 followed by PPSV23, although no national recommendation exists and uptake has been low. This study evaluated the cost‑effectiveness of a single‑dose PCV20 strategy compared with the sequential PCV13→PPSV23 regimen from private and public perspectives.</p><p><strong>Methods: </strong>Incremental cost‑effectiveness ratios (ICERs) per quality‑adjusted life‑year (QALY) gained were estimated for PCV20 versus PCV13→PPSV23. Analyses were conducted from the private perspective for high‑risk adults aged 18-49 years and all adults aged ≥ 50 years, and from the government perspective for high‑risk adults aged 18-59 years and all adults aged ≥ 60 years.</p><p><strong>Results: </strong>Compared with PCV13→PPSV23, PCV20 was projected to reduce pneumococcal disease cases and deaths and was cost‑effective under the 3× GDP per capita threshold. PCV20 generated 18,186 and 44,659 additional QALYs from the private and public perspectives, with incremental costs of ₹2.0 billion (Indian Rupees; medical: -₹17.4B; vaccine: ₹19.4B) and ₹25.5B (medical: -₹3.6B; vaccine: ₹29.1B), yielding ICERs of ₹110,790 and ₹570,327 per QALY, respectively. PCV20 was cost‑effective in 92.4% and 75.0% of probabilistic simulations from the private and government perspectives. Extending vaccination to at‑risk adults aged 18-49 years remained cost‑effective from the private perspective (ICER: ₹292,531/QALY).</p><p><strong>Conclusions: </strong>A single‑dose PCV20 strategy for high‑risk and older adults in India is cost‑effective compared with the current sequential regimen and may simplify pneumococcal vaccination and potentially improve uptake.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223992","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":"Correction: Burden of Invasive Meningococcal Disease: Evolving Epidemiology and Implications for Prevention Policy.","authors":"Mary Bausch-Jurken, Sean Leng, Jana Shaw, Stephen Pelton","doi":"10.1007/s40121-026-01461-x","DOIUrl":"https://doi.org/10.1007/s40121-026-01461-x","url":null,"abstract":"","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216166","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":"Postpandemic Social Contact Patterns: A Cross-Sectional Survey in Japan, South Korea, Thailand, and Vietnam.","authors":"June Young Chun, Yunseop Shin, Yongdai Kim, Shinya Tsuzuki","doi":"10.1007/s40121-026-01467-5","DOIUrl":"https://doi.org/10.1007/s40121-026-01467-5","url":null,"abstract":"<p><strong>Introduction: </strong>Social contact patterns are one of the key determinants of infectious disease transmission, but post-coronavirus disease 2019 (COVID-19)-pandemic evidence from East and Southeast Asia remains limited. We examined age-specific contact patterns in Japan, South Korea, Thailand, and Vietnam and assessed whether contact frequencies had returned to prepandemic levels.</p><p><strong>Methods: </strong>We conducted online, single-day contact surveys in 2025 using quota sampling by age and sex. Participants reported contacts on the preceding day, defined as physical contact or direct conversations of at least three sentences held within 2 m. Age-specific contact matrices were constructed for weekdays and weekends and combined using a 5:2 weighting. Factors associated with daily contact counts were examined using negative binomial regression.</p><p><strong>Results: </strong>The analysis used data from 10,279 individuals: 8,080 in Japan, 1,102 in South Korea, 589 in Thailand, and 508 in Vietnam. Mean daily contact counts were 8.1, 6.2, 6.4, and 8.8, respectively; medians were 4, 4, 4, and 6, respectively. All four countries showed age-assortative mixing, although assortativity was less pronounced in Thailand and Vietnam. In Japan and South Korea, younger age and larger household size were associated with more contacts, whereas greater mask-wearing tendency was associated with more contacts in Japan and fewer contacts in South Korea. Compared with available historical estimates, contact frequencies in Japan and South Korea remained below prepandemic levels. Sparse baseline data and methodological differences precluded firm conclusions being made for Thailand and Vietnam.</p><p><strong>Conclusions: </strong>Contact frequencies in Japan and South Korea remained below prepandemic levels in 2025, suggesting persistent postpandemic changes in mixing behavior. Evidence for comparable changes in Thailand and Vietnam was inconclusive. Future surveys should collect setting-specific information, in addition to contact frequency and age, to clarify how changes in work, education, and household interaction shape postpandemic social mixing patterns.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216220","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":"A Phase 1/2 Trial Evaluating the Safety and Immunogenicity of an mRNA-based Seasonal Influenza Vaccine Candidate Encoding Hemagglutinin and Neuraminidase.","authors":"Ilse De Coster, Jose F Cardona, Murdo Ferguson, Isabel Leroux-Roels, Haylene Nell, Stefano Berrè, Sonia Schoonbroodt, Clarisse Lorin, Leroy Jide Ovbude, Brian Moldt","doi":"10.1007/s40121-026-01463-9","DOIUrl":"https://doi.org/10.1007/s40121-026-01463-9","url":null,"abstract":"<p><strong>Introduction: </strong>Hemagglutinin (HA) is the principal immunologic target of most licensed seasonal influenza vaccines. Targeting both HA and neuraminidase (NA) might improve vaccine effectiveness. This randomized phase 1/2 study evaluated an investigational mRNA-based quadrivalent seasonal influenza vaccine, encoding HA and NA of A/H1N1, A/H3N2, B/Victoria, and B/Yamagata (FLUm4HA-4NA).</p><p><strong>Methods: </strong>In phase 1, adults aged 18-50 years received either one of twelve mRNA vaccine formulations of varying HA-only or HA and NA mRNA doses, or a licensed quadrivalent seasonal influenza comparator. In phase 2, participants aged 18-64 years (younger adults) and 65-85 years (older adults) received FLUm4HA-4NA (three groups per age category, with different HA/NA mRNA doses) or age-appropriate licensed quadrivalent comparator. Primary endpoints were safety/reactogenicity, and hemagglutination inhibition [HI] and NA inhibition [NI] responses against the four seasonal strains at day 29. Cross-reactive HI/NI responses against drifted strains, virus neutralization, and HA-/NA-specific cell-mediated immunity were evaluated in phase 2 as tertiary objectives.</p><p><strong>Results: </strong>A total of 293 participants (21-25 per group) were vaccinated in phase 1, 480 younger (108-137 per group) and 483 older adults (117-125 per group) in phase 2. Solicited events were more frequent with FLUm4HA-4NA than comparators and were mostly short-lived and mild or moderate. No deaths or vaccine-related serious adverse events were reported. Post-vaccination HI and neutralizing titers in the FLUm4HA-4NA groups were similar or higher for the A strains and lower for the B strains versus comparators. NI responses exceeded those of comparators for all four strains. HI and NI titers against evaluated drifted A strains were similar or higher after FLUm4HA-4NA than after comparator vaccination. HA-specific CD4+ and CD8+ T-cell responses were generally higher after FLUm4HA-4NA than comparator vaccination.</p><p><strong>Conclusions: </strong>FLUm4HA-4NA showed an acceptable safety profile and humoral and cellular immunogenicity in the study population, supporting further development and formulation optimization to improve influenza B HI responses.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov: NCT05823974; euclinicaltrials.eu: 2022-502308-66-00.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181709","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":"A Phase 2 Trial Evaluating the Immunogenicity and Safety of an mRNA-Based Seasonal Influenza Vaccine Candidate Encoding Hemagglutinin and Neuraminidase.","authors":"Brian Moldt, Rafael A Ubeda, Alexander V Murray, Giresse Tima, Sophie Germain, Clarisse Lorin, Leroy Jide Ovbude, Danaé Steinbrecher, Marcus Nordgren","doi":"10.1007/s40121-026-01462-w","DOIUrl":"https://doi.org/10.1007/s40121-026-01462-w","url":null,"abstract":"<p><strong>Introduction: </strong>Influenza vaccines targeting both hemagglutinin (HA) and neuraminidase (NA) might offer broader protection than current vaccines, which primarily target HA. This randomized phase 2 study evaluated the immunogenicity and safety of an investigational mRNA-based trivalent seasonal influenza vaccine encoding HA and NA from A/H1N1, A/H3N2, and B/Victoria (FLUm3HA-3NA).</p><p><strong>Methods: </strong>Participants aged 18-64 years (younger adults) or 65-85 years (older adults) received one of several mRNA vaccine formulations-each containing different influenza A and B HA mRNA doses-or an age-appropriate licensed seasonal influenza vaccine as a comparator. Four formulations per age cohort were tested in part 1 of the study, and one formulation per age cohort in part 2. Day-29 hemagglutination inhibition (HI) and NA inhibition (NI) responses were assessed as primary and secondary endpoints, respectively, safety/reactogenicity as the secondary, and virus neutralization as the tertiary endpoint.</p><p><strong>Results: </strong>A total of 250 younger and 260 older adults were vaccinated in part 1; 161 and 162, respectively, in part 2. All FLUm3HA-3NA formulations induced HI, NI, and neutralizing responses above baseline. In part 1, HI responses against A/H1N1 and A/H3N2 were similar or higher after FLUm3HA-3NA than after comparator vaccination in both age groups. For B/Victoria, HI responses were lower or similar versus comparator vaccination in younger adults and similar or higher in older adults. In part 2, HI responses were similar or higher with FLUm3HA-3NA versus comparators for A/H1N1 and A/H3N2, and lower for B/Victoria in both age groups. In both study parts and both age groups, NI titers were higher for all three strains with FLUm3HA-3NA versus comparators, and neutralizing titers were similar or higher for A/H1N1 and A/H3N2 and similar for B/Victoria. No safety concerns were identified.</p><p><strong>Conclusions: </strong>FLUm3HA-3NA induced HI, NI, and neutralizing responses, with an acceptable safety profile. The results support further development, including optimization of the influenza B HI response.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov: NCT06431607.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181621","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":"Identification and Characterization of Patient Populations at High Risk for Clostridioides difficile Infection (CDI): A Narrative Review.","authors":"Jessica R Allegretti, Erik R Dubberke, Cátia Ferreira, Christian John Lillis, Mark H Wilcox","doi":"10.1007/s40121-026-01455-9","DOIUrl":"https://doi.org/10.1007/s40121-026-01455-9","url":null,"abstract":"<p><p>Clostridioides difficile infection (CDI) is a major cause of infections worldwide and can lead to life-threatening complications and a severe impact on patients' quality of life (QoL). CDI can affect anyone, but it is generally accepted that those at greatest risk include people receiving antibiotics, of older age, and with a compromised immune system. However, beyond these broad categories, specific populations at high risk for CDI are not clearly defined. We performed a literature search to identify and characterize patients at high risk for CDI. We found that those at high risk for CDI include patients undergoing hematopoietic stem cell transplant, solid organ transplant or chimeric antigen receptor T-cell therapy, or with chronic kidney disease/end-stage kidney disease, hematological malignancies or inflammatory bowel disease, or who are older and frail with comorbidities. In the identified patient populations, CDI was associated with significantly worse clinical outcomes, increased healthcare resource utilization and costs, and generally an increased risk of mortality compared with those without CDI. Patients at high risk for CDI have multiple risk factors for infection that further complicate management of their disease. Apart from older patients, there is a lack of information on the impact on QoL in high-risk populations. Prevention strategies for CDI in high-risk populations are lacking and are based on the general population. As such, there is a need to increase understanding of those at high risk for CDI and the significant impact infection has in these populations, and to identify preventive therapies to alleviate the burden on both patients and healthcare systems.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181687","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":"Immunogenicity and Safety of Single-Dose MenACYW Conjugate Vaccine in Vietnamese Participants Aged ≥ 12 Months: A Phase III, Open-Label Study.","authors":"Vu Dinh Thiem, Stephane Janicot, Olga Syrkina, Vu Hai Ha, Pham Dinh Long, Dao Trung Nguyen, Céline Zocchetti","doi":"10.1007/s40121-026-01458-6","DOIUrl":"https://doi.org/10.1007/s40121-026-01458-6","url":null,"abstract":"<p><strong>Introduction: </strong>Invasive meningococcal disease (IMD) is a progressive condition commonly presenting as septicemia and meningitis, with significant mortality and morbidity. Vietnam reports high incidence rates among military populations and young infants. Despite this burden and unpredictable outbreaks, meningococcal vaccination in Vietnam is offered primarily to high-risk individuals and travelers rather than as routine childhood immunization. MenACYW-TT, a quadrivalent meningococcal polysaccharide tetanus toxoid-conjugate vaccine with licensure in > 80 countries, is approved for toddlers aged ≥ 12 months and for infants aged ≥ 6 weeks. This Phase III, open-label study evaluated the immunogenicity and safety of a single dose of MenACYW-TT in healthy Vietnamese participants aged ≥ 12 months.</p><p><strong>Methods: </strong>This study (NCT06228586) was conducted in Vietnam among healthy participants aged ≥ 12 months (five age groups) who received a single dose of MenACYW-TT. Functional antibody activity against all four meningococcal serogroups was measured using serum bactericidal assay with human complement (hSBA) at baseline (Day 1) and after vaccination (Day 31). Safety data were collected up to 30 days (+ 14 days) after vaccination.</p><p><strong>Results: </strong>Among the 447 enrolled participants, seroprotection rates (hSBA titers ≥ 1:8) were high and comparable across all age groups for each serogroup, i.e., 88.8% for serogroup A to 100% for serogroup C. Overall, the seroresponse rates were high for serogroups C: 98.6%, Y: 96.0%, W: 95.0%, and A: 73.6%, with higher seroresponse to serogroup A in the 12- to 23-month group (81.5%) versus the ≥ 24-month group (66.5%). No safety concerns or vaccine-related serious adverse events were observed.</p><p><strong>Conclusions: </strong>A single dose of MenACYW-TT induced robust immunogenicity against all four serogroups and demonstrated an acceptable safety profile across all age groups of Vietnamese participants. Given the high burden of meningococcal disease in Vietnam, these findings support the potential inclusion of MenACYW-TT in Vietnam's National Expanded Program on Immunization.</p><p><strong>Trial registration: </strong>clinicaltrials.gov, NCT06228586.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167096","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":"Complicated Urinary Tract Infections Caused by Fluoroquinolone-Non-Susceptible/Trimethoprim-Sulfamethoxazole-Resistant Extended-Spectrum β-Lactamase-Producing Enterobacterales: Patient Characteristics, Resistance Phenotypes, Treatment Patterns, and Clinical Outcomes.","authors":"Ryan K Shields, A Lenore Ackerman, Myriam Drysdale, Rose Chang, Louise Yu, Maral DerSarkissian, Iain A Gillespie, Megan Pinaire, Zhuo Chen, Mei Sheng Duh, Alanna Farrell-Foster, Fanny S Mitrani-Gold","doi":"10.1007/s40121-026-01460-y","DOIUrl":"https://doi.org/10.1007/s40121-026-01460-y","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with complicated urinary tract infections (cUTIs) caused by extended-spectrum β-lactamase (ESBL)-producing Enterobacterales (ESBL-E) not susceptible (NS) to fluoroquinolones (FQ-NS) or resistant (R) to trimethoprim-sulfamethoxazole (TMP/SMX-R) have few effective oral treatment options.</p><p><strong>Methods: </strong>Data from the Optum de-identified Electronic Health Record data set (Optum EHR) (January 2018-September 2023) were used. The primary objective was to describe cumulative incidence of treatment failure (TF) by care setting (hospital versus non-hospital) within 30 days of the initiation of the latest intravenous antibiotic treatment prescribed ± 7 days from the microbiology results (index).</p><p><strong>Results: </strong>Among 7388 eligible patients, mean (standard deviation) age was 65.6 (17.7) years, and 66.3% were female. Most patients (5211, 70.5%) had a cUTI with a complicating factor; 3415 (46.2%) were diagnosed in hospital. Among the 7902 ESBL-E isolates from eligible patients with cUTIs, Escherichia coli was the predominant pathogen (75.1%), followed by Klebsiella pneumoniae (13.4%). Overall, 6384 (81.7%) isolates were FQ-NS, 5323 (68.0%) TMP/SMX-R, and 170 (2.2%) carbapenem-NS. Kaplan-Meier estimates revealed that the cumulative incidence of TF by day 30 post-index was 27.5% among hospitalized patients and 25.2% among non-hospitalized, with variation by resistance profile, driven primarily by receipt of another antibiotic (both settings). Most patients (5013, 67.9%) were prescribed an intravenous antibiotic at index, often carbapenems (2157, 43.0%), but treatment sequences were heterogeneous. Recurrence occurred in 2116 patients (28.6%), hospitalization (among those not hospitalized at index) in 975 (24.5%), and readmission in 663 (19.4%).</p><p><strong>Conclusions: </strong>These data indicate a substantial burden of cUTIs caused by ESBL-E that were FQ-NS or TMP/SMX-R, characterized by high rates of treatment failures and hospitalization for IV antibiotic treatment.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165536","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}