Infectious Diseases and Therapy最新文献

{"title":"Antibiotics and Artificial Intelligence: Clinical Considerations on a Rapidly Evolving Landscape.","authors":"Daniele Roberto Giacobbe, Sabrina Guastavino, Cristina Marelli, Ylenia Murgia, Sara Mora, Alessio Signori, Nicola Rosso, Mauro Giacomini, Cristina Campi, Michele Piana, Matteo Bassetti","doi":"10.1007/s40121-025-01114-5","DOIUrl":"10.1007/s40121-025-01114-5","url":null,"abstract":"<p><p>The growing interest in leveraging artificial intelligence (AI) tools for healthcare decision-making extends to improving antibiotic prescribing. Large language models (LLMs), a type of AI trained on extensive datasets from diverse sources, can process and generate contextually relevant text. While their potential to enhance patient outcomes is significant, implementing LLM-based support for antibiotic prescribing is complex. Here, we specifically expand the discussion on this crucial topic by introducing three interconnected perspectives: (1) the distinctive commonalities, but also the crucial conceptual differences, between the use of LLMs as assistants in scientific writing and in supporting antibiotic prescribing in real-world practice; (2) the possibility and nuances of the expertise paradox; and (3) the peculiarities of the risk of error when considering LLMs to support complex tasks such as antibiotic prescribing.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":"493-500"},"PeriodicalIF":4.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425264","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":"Delayed Transition to 20-Valent Pneumococcal Conjugate Vaccine in Pediatric National Immunization Programs: Forgone Public Health and Economic Benefit.","authors":"Johnna Perdrizet, An Ta, Liping Huang, Warisa Wannaadisai, Aleksandar Ilic, Kyla Hayford, Ayman Sabra","doi":"10.1007/s40121-025-01108-3","DOIUrl":"10.1007/s40121-025-01108-3","url":null,"abstract":"<p><strong>Introduction: </strong>Despite the approval of a 20-valent pneumococcal conjugate vaccine (PCV20) for pediatric use in many regions globally, integration of PCV20 into national immunization programs (NIPs) is delayed in some countries. We explored the public health and economic benefits forfeited by postponing transitions from lower-valent pneumococcal conjugate vaccines (PCVs) to PCV20.</p><p><strong>Methods: </strong>A targeted literature review (TLR) identified modeling studies comparing the public health and economic impact of PCV20 versus 13-valent PCV (PCV13) or 15-valent PCV (PCV15) in pediatric NIPs. Only studies with accessible models underwent data extraction and analysis. Foregone public health (pneumococcal disease cases/disease-related deaths) and economic (medical/non-medical costs) outcomes, defined as the projected incremental differences between the outcomes associated with PCV20 and lower-valent PCVs, were calculated over 2 years following PCV20 implementation (per year and month). Discount rates for all outcomes were adjusted to 0% given the short time horizon and for consistency across analyses.</p><p><strong>Results: </strong>The TLR identified models from 13 countries globally. The monthly health benefits forgone due to delayed transitions from PCV13 to PCV20 ranged between 40 (Slovakia) and 1740 (Canada) pneumococcal disease cases averted in the first year of delay across populations, increasing by between 1.5 (Sweden) and 15-16 times (Germany and Mexico) in the second year. Forgone cumulative disease-related deaths averted ranged from 18 (Spain) to 2657 (Germany) and forgone cumulative direct medical cost-savings ranged from 930 thousand Euros (Portugal) to 146 million Euros (Germany) due to delayed transitions from PCV13 to PCV20 over 2 years. Similar, but slightly reduced, benefits were forfeited with delayed transitions from PCV15 to PCV20.</p><p><strong>Conclusion: </strong>Delays in implementing PCV20 into pediatric NIPs were projected to have substantial negative public health and economic consequences. These results underscore the necessity for national immunization technical advisory groups, policymakers, health organizations, and manufacturers to accelerate replacement of lower-valent standard-of-care PCVs with PCV20.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":"501-525"},"PeriodicalIF":4.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078948","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":"Management of Recurrent Clostridioides difficile Infection (rCDI): A Systematic Literature Review to Assess the Feasibility of Indirect Treatment Comparison (ITC).","authors":"Johanna Eliasson Vinterberg, Julia Oddsdottir, Maria Nye, Philippe Pinton","doi":"10.1007/s40121-024-01105-y","DOIUrl":"10.1007/s40121-024-01105-y","url":null,"abstract":"<p><p>Recurrent Clostridioides difficile infection (rCDI) is a major cause of increased morbidity, mortality, and healthcare costs. Fecal-microbiota-based therapies are recommended for rCDI on completion of standard-of-care (SoC) antibiotics to prevent further recurrence: these therapies include conventional fecal-microbiota transplantation and the US Food and Drug Administration-approved therapies REBYOTA® (RBL) and VOWST Oral Spores™ (VOS). As an alternative to microbiota-based therapies, bezlotoxumab, a monoclonal antibody, is used as adjuvant to SoC antibiotics to prevent rCDI. There are no head-to-head clinical trials comparing different microbiota-based therapies or bezlotoxumab for rCDI. To address this gap, we conducted a systematic literature review to identify clinical trials on rCDI treatments and assess the feasibility of using them to conduct an indirect treatment comparison (ITC). The feasibility analysis determined that trial heterogeneity, particularly relating to inclusion criteria, may significantly compromise ITC and prevent cross-trial comparisons. Our analysis underlines the need to adopt standardized protocols to ensure comparability across trials.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":"327-355"},"PeriodicalIF":4.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004572","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":"Predictors of COVID-19 Readmission Among Patients Previously Hospitalized for SARS-CoV-2.","authors":"Marta Colaneri, Marta Canuti, Ginevra Torrigiani, Lucia Dall'Olio, Chiara Bobbio, Sante L Baldi, Alessandro Nobili, Massimo Puoti, Giulia Marchetti, Simone Piva, Pierluigi Plebani, Mario Raviglione, Andrea Gori, Danilo Cereda, Olivia Leoni, Ida Fortino, Maria Luisa Ojeda-Fernandez, Marta Baviera, Mauro Tettamanti, Alessandra Bandera","doi":"10.1007/s40121-024-01107-w","DOIUrl":"10.1007/s40121-024-01107-w","url":null,"abstract":"<p><strong>Introduction: </strong>Predictors of coronavirus disease 2019 (COVID-19)-related rehospitalization remain underexplored. This study aims to identify the main risk factors associated with rehospitalizations due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfections among residents of Lombardy, northern Italy.</p><p><strong>Methods: </strong>A retrospective observational study was conducted using two linked administrative databases covering demographic data, comorbidities, hospital records, and COVID-19 data of Lombardy residents. The study population included patients hospitalized for COVID-19 between February 2020 and August 2021. Rehospitalization was defined as a second COVID-19-related hospitalization occurring at least 90 days after the first admission. The Fine-Gray subdistribution hazard model was used to identify risk factors, accounting for death as a competing risk.</p><p><strong>Results: </strong>Out of 98,369 patients hospitalized for COVID-19 between February 1, 2020 and August 31, 2021, 72,593 were alive 90 days after admission and 610 of these (0.8%) were rehospitalized. A higher rehospitalization risk was observed in older male patients with multiple comorbidities. Renal failure, liver disease, and use of diuretics were significantly associated with rehospitalization risk, while female biological sex and the use of lipid-lowering drugs were associated with a lower risk.</p><p><strong>Conclusions: </strong>This is the first study conducted on regional administrative databases to investigate COVID-19 rehospitalizations. Through the availability of a huge cohort, it provides a groundwork for optimizing care for individuals at higher risk for COVID-19-related rehospitalizations. It underlines the need for patient-management approaches that extend beyond the initial recovery. This stresses the importance of ongoing monitoring and personalized interventions for those at heightened risk not only of SARS-CoV-2 reinfection but also related rehospitalizations.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":"447-461"},"PeriodicalIF":4.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004578","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":"Risk Factors for Mortality Among Older Adults with Hospital-Acquired Bloodstream Infections in the Intensive Care Unit: A Multicenter Cohort Study.","authors":"Tomer Hoffman, Ili Margalit, Alexis Tabah, Stéphane Ruckly, François Barbier, Pierre Singer, Jean-François Timsit, Virginie Prendki, Nasreen Hassoun-Kheir, Niccolò Buetti, Dafna Yahav","doi":"10.1007/s40121-024-01104-z","DOIUrl":"10.1007/s40121-024-01104-z","url":null,"abstract":"<p><strong>Introduction: </strong>We aimed to investigate risk factors for mortality among older adults (≥ 75 years) with hospital-acquired bloodstream infections (HA-BSI) in the intensive care unit (ICU).</p><p><strong>Methods: </strong>We included patients aged ≥ 75 years with HA-BSI in ICU from the EUROBACT-2 cohort (2019-2021). Univariable and multivariable analyses were conducted to identify predictors of 28-day mortality.</p><p><strong>Results: </strong>The cohort included 563 patients (median age 80, 39% women). Mortality at 28 day was 50%. Factors associated with mortality in multivariate analysis were admission due to COVID-19, failure to achieve source control, and higher SOFA. Among older adults with Gram-negative BSI, corticosteroid administration for septic shock was an additional factor. Among functionally independent patients, age itself was not associated with mortality.</p><p><strong>Conclusions: </strong>HA-BSI in older adults in ICU are associated with high mortality. Inadequate source control is a significant modifiable risk factor. The use of corticosteroids in ICU management of older adults should be further investigated.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":"483-492"},"PeriodicalIF":4.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142964605","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":"Effectiveness of AZD7442 (Tixagevimab/Cilgavimab) for Pre-Exposure Prophylaxis Against COVID-19 Hospitalization in Israel During the Omicron Sub-Variant Time Period.","authors":"Samah Hayek, Joseph Levy, Galit Shaham, Noa Dagan, Danielle Serby, Hadar Duskin-Bitan, Sabada Dube, Cátia Ferreira, Idit Livnat, Carla Talarico, Sylvia Taylor, Sudhir Venkatesan, Adva Yarden, Ran D Balicer, Doron Netzer, Alon Peretz","doi":"10.1007/s40121-024-01100-3","DOIUrl":"10.1007/s40121-024-01100-3","url":null,"abstract":"<p><strong>Introduction: </strong>The effectiveness of AZD7442 (tixagevimab/cilgavimab) against COVID-19 hospitalizations was determined at 3 and 6 months among immunocompromised individuals in Israel during different variant circulations.</p><p><strong>Methods: </strong>This was a retrospective cohort study using data from Clalit Health Services in Israel. Immunocompromised individuals eligible to receive AZD7442 300 mg between 15 February and 11 December 2022 were identified. Immunocompromised individuals receiving AZD7442 300 mg as pre-exposure prophylaxis (PrEP) were propensity score (PS)-matched 1:1 to unexposed individuals using a \"rolling cohort\" approach. Calendar time Cox proportional hazards regression models were performed with adjustment for post-matched unbalanced covariates to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Overall, 2444 AZD7442-exposed immunocompromised individuals were PS-matched to unexposed individuals. In the matched population, up to 6 months of follow-up, AZD7442 300 mg presented an unadjusted HR (without adjustment for the unbalanced covariates) of 0.68 (95% CI 0.43-1.08) and covariate-adjusted HR of 0.64 (95% CI 0.40-1.03) against COVID-19 hospitalization. Covariate-adjusted instantaneous hazards plots showed that the effectiveness of AZD7442 300 mg waned from Day 90. Up to 3 months of follow-up, the unadjusted HR was 0.43 (95% CI 0.21-0.91) for AZD7442 300 mg against COVID-19 hospitalization in the matched population; there were insufficient events to allow covariate-adjusted analysis.</p><p><strong>Conclusion: </strong>Our results suggest that AZD7442 300 mg reduced COVID-19 hospitalizations among immunocompromised individuals; however, the findings are limited by a lack of sufficient events to produce conclusive results.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":"14 2","pages":"433-445"},"PeriodicalIF":4.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425282","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":"Health-Related Quality of Life Among Patients Who Have Survived an Episode of Sepsis in the United States: A Systematic Review.","authors":"Sanjukta Basu, Ziyan J Wei, Atara Laor, Liga Bennetts, Nina Ahmad, Antoine C El Khoury, Jeroen Geurtsen, Maureen P Neary","doi":"10.1007/s40121-024-01106-x","DOIUrl":"10.1007/s40121-024-01106-x","url":null,"abstract":"<p><strong>Introduction: </strong>Sepsis is a serious condition that may lead to death or profoundly affect the well-being of those who survive. The aim of this systematic review was to identify and summarize evidence on the impact of all-cause sepsis on health-related quality of life (HRQoL), physical, cognitive, and psychological outcomes among sepsis survivors in the USA.</p><p><strong>Methods: </strong>Studies assessing HRQoL, physical, cognitive, and psychological outcomes in patients who survived an episode of sepsis and published from January 1, 2010, to September 30, 2023, were systematically identified through EMBASE, MEDLINE, and MEDLINE In-Process databases, as well as through gray literature.</p><p><strong>Results: </strong>Of 2885 records identified, 7 studies (7 publications; N = 180,592 participants) met the eligibility criteria for inclusion in this review. Studies examined the effects of sepsis on the following outcomes of interest: HRQoL (4 studies), physical functioning (5 studies), cognitive status (3 studies), and psychological well-being (3 studies). After 12 months, sepsis survivors who developed chronic critical illness (N = 63) had significantly poorer HRQoL as measured by EuroQoL 5-dimensional (EQ-5D) questionnaire mean utility index score and Short Form 36-item (SF-36) physical and mental summary scores compared with patients who rapidly recovered (N = 110). Among patients admitted to a skilled nursing facility post-sepsis (N = 66,540), 34% and 72.5% had severe or very severe cognitive impairment and dependence to perform activities of daily living, respectively. Significant increase in moderate-to-severe cognitive impairment among severe sepsis survivors (N = 623) before and after sepsis was reported (median 0.9 [IQR: 0.4, 1.4] years; 6.1% and 16.7%, respectively [P < 0.001]). Substantial depression and anxiety symptoms were frequently observed post-sepsis, but with limited evidence for increased burden as assessed by specific psychological measures.</p><p><strong>Conclusion: </strong>These findings underscore the profound negative impacts of sepsis on patients' HRQoL, ability to perform activities of daily living, and cognitive abilities.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":"385-400"},"PeriodicalIF":4.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143038280","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":"Optimizing Pyrazinamide Use: A Low-Hanging Fruit in Improving Outcomes with Tuberculous Meningitis? Narrative Review.","authors":"Bella Devaleenal Daniel, Leeberk Raja Inbaraj, Shanmugapriya Kumaravadivelu, Kathirvel Subramanian, Balaji Ramraj, Abi Manesh","doi":"10.1007/s40121-024-01102-1","DOIUrl":"10.1007/s40121-024-01102-1","url":null,"abstract":"<p><p>Tuberculous meningitis (TBM) disables more than a third of its sufferers. Recent research has focused on optimizing the antitubercular regimen, mainly by increasing the dosage of rifampicin. However, pyrazinamide, with higher penetration into the central nervous system, is generally overlooked. We discuss the potential clinical impact of using pyrazinamide throughout antitubercular therapy in TBM, in contrast to only the intensive phase. This approach may improve the treatment outcomes and reduce disability in TBM. We summarize the available data regarding this approach from in vitro studies, clinical cohorts, toxicity data, and baseline resistance rates. Additionally, we discuss the two ongoing clinical trials evaluating this approach.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":"317-325"},"PeriodicalIF":4.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921602","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":"A Phase 3B, Open-Label Study to Evaluate the Immunogenicity and Safety of the Quadrivalent Meningococcal Nimenrix^® Vaccine When Given to Healthy Infants at 3 and 12 Months of Age.","authors":"Susanna Koski, Federico Martinon-Torres, Mika Rämet, Lefteris Zolotas, Ryan Newton, Roger Maansson, Mark Cutler, Paula Peyrani, Jamie Findlow, Paul Balmer, Luis Jodar, William C Gruber, Annaliesa S Anderson, Johannes Beeslaar","doi":"10.1007/s40121-024-01098-8","DOIUrl":"10.1007/s40121-024-01098-8","url":null,"abstract":"<p><strong>Introduction: </strong>Infants and young children typically have the highest age-related risk of invasive meningococcal disease. The immunogenicity and safety of a single primary dose and a booster of a meningococcal A/C/W/Y tetanus toxoid conjugate vaccine (MenACWY-TT; Nimenrix^®) in infants were evaluated.</p><p><strong>Methods: </strong>In this phase 3b, open-label, single-arm study, healthy 3-month-old infants received a single Nimenrix dose followed by a booster at age 12 months (1 + 1 series). Functional antibodies before and 1 month after each vaccination were evaluated with serum bactericidal antibody assays using rabbit (rSBA) or human (hSBA) complement for each A/C/W/Y serogroup. Primary endpoints were rSBA seroprotection (titers ≥ 1:8) rates and geometric mean titers (GMTs); supportive secondary endpoints included hSBA seroprotection (titers ≥ 1:4) rates and GMTs. Local reactions and systemic events occurring within 7 days, adverse events (AEs), serious AEs, and newly diagnosed chronic medical conditions following vaccination were assessed.</p><p><strong>Results: </strong>Overall, 147 and 143 participants received the primary and booster Nimenrix doses, respectively. rSBA seroprotection rates across serogroups were 82.3-91.1% at 1 month after the primary dose and increased to 100% at 1 month after the booster. rSBA GMTs were considerably higher after the booster (1299.5‒2714.1) than after the primary dose (54.7‒202.4). In hSBA evaluations performed as supportive to rSBA evaluations, seroprotection rates increased from 38.8 to 95.5% after the primary dose to 100% after the booster, with corresponding GMT increases (8.8‒149.8 to 1208.4‒7299.6). Local reactions and most systemic events were mild to moderate in severity; no new safety concerns were identified.</p><p><strong>Conclusion: </strong>Nimenrix given at ages 3 and 12 months had a favorable safety profile and elicited protective immune responses and robust anamnestic booster responses across A/C/W/Y serogroups. These results provide important support for this alternative Nimenrix 1 + 1 immunization schedule for infants < 6 months, allowing flexibility in infant meningococcal immunization.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov, NCT04819113.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":"463-481"},"PeriodicalIF":4.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065445","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":"Carbapenemase-Producing Enterobacterales from Patients Arriving from Ukraine in Poland, March 2022-February 2023.","authors":"Marta Biedrzycka, Radosław Izdebski, Waleria Hryniewicz, Marek Gniadkowski, Dorota Żabicka","doi":"10.1007/s40121-024-01097-9","DOIUrl":"10.1007/s40121-024-01097-9","url":null,"abstract":"<p><strong>Introduction: </strong>Despite a scarcity of data, before 2022 Ukraine was already considered a high-prevalence country for carbapenemase-producing Enterobacterales (CPE), and the situation has dramatically worsened during the full-scale war with Russia. The aim of this study was to analyse CPEs isolated in Poland from victims of war in Ukraine.</p><p><strong>Methods: </strong>The study included 65 CPE isolates from March 2022 till February 2023, recovered in 36 Polish medical centres from 57 patients arriving from Ukraine, differing largely by age and reason for hospitalisation. All isolates were sequenced by MiSeq and ten Klebsiella pneumoniae isolates also by MinION. Taxonomy, clonality and resistomes were analysed for all CPEs, whereas phylogeny, serotypes, virulomes and plasmids were characterised for K. pneumoniae, and partially for Escherichia coli ST131, using various bioinformatic tools.</p><p><strong>Results: </strong>Multifactorial diversity of the isolates reflected the patients' clinical-epidemiological heterogeneity. The CPEs represented six species. Klebsiella pneumoniae was the most prevalent with 50 isolates and 15 sequence types (STs), mainly ST395, ST307, ST11, ST147 and ST23, producing NDM (-1/-5), OXA-48 (-48/-1242) or KPC (-2/-3)-like carbapenemases. Each of the STs produced groups of loosely related isolates, clusters of close relatives and/or unique isolates, correlating with K serotypes and carbapenemases. Many of these, especially NDM-1- and/or OXA-48-producing ST395 and ST307, were related to Russian organisms. Others, for example, NDM-1-producing ST11, clustered with those from Poland. Numerous K. pneumoniae isolates had specific virulence genes, including aerobactin iuc, largely due to spread of pNDM-MAR plasmids, showing both resistance and virulence. Two E. coli ST131 isolates belonged to clades B or C1 and produced KPC-3 or NDM-1, respectively.</p><p><strong>Conclusions: </strong>Together with similar studies from Germany and The Netherlands, this work has documented broad dissemination of CPE in Ukraine, driven by a number of specific K. pneumoniae lineages circulating over a large territory of Eastern Europe.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":"401-419"},"PeriodicalIF":4.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931668","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}