Infection最新文献

{"title":"Emerging antimalarial drug targets to combat drug-resistant malaria parasites.","authors":"Rohit Nehra, Urvashi Yadav, Ritesh Ranjha, Mradul Mohan, Himmat Singh, Praveen Kumar Bharti, Kuldeep Singh, Suman Dhanda","doi":"10.1007/s15010-026-03000-9","DOIUrl":"https://doi.org/10.1007/s15010-026-03000-9","url":null,"abstract":"<p><p>The emergence and rapid spread of multidrug resistance in Plasmodium parasites, particularly in the Greater Mekong region and increasingly in Sub-Saharan Africa. Resistance has led to an urgent need to develop novel anti-malaria therapies with an effective mechanism. Several non-classical targets, including Na⁺⁺ pump PfATP4 (Plasmodium falciparum ATPase 4), PI4K (Phosphatidylinositol 4-kinase) and PfNCR1(Plasmodium falciparum Niemann-Pick Type C1-Related protein), are highly active against the asexual stage of Plasmodium. We summarise the progress achieved on key emerging targets over past decade and emerging pipeline of artemisinin-combination therapies (ACTs). Other targets, such as dihydroorotate dehydrogenase (PfDHODH) for pyrimidine biosynthesis, ion transporters, mitochondrial electron transport chain, and apicoplast metabolic pathways, have demonstrated significant therapeutic potential due to their essential roles in parasite physiology and minimal homology to human counterparts. Combating drug-resistant malaria parasites and strengthening the global antimalarial drug pipeline for long-term disease control can be achieved by developing new ways to target parasites. This comprehensive review discusses the current status of novel antimalarial drug targets, recent discoveries and future of novel therapies in the following innovation areas: Protein synthesis machinery as drug targets, hemoglobin metabolism targets, transport proteins therapeutic targets, Kinase targets, Organelles and cell targets, and mitochondrial targets, which fill critical gaps in the existing therapeutic arsenal.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early monotherapy for Enterococcus faecalis endocarditis: do the NIDUS relapse data establish similar outcomes?","authors":"Alejandro Díez-Vidal","doi":"10.1007/s15010-026-03026-z","DOIUrl":"https://doi.org/10.1007/s15010-026-03026-z","url":null,"abstract":"","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increasing contribution of dental antibiotic prescribing to community-acquired Clostridioides difficile infection: a 9-year retrospective cohort study.","authors":"Božana Miklaušić Pavić, Josip Begovac, Irina Pristaš, Tomislava Skuhala","doi":"10.1007/s15010-026-03028-x","DOIUrl":"https://doi.org/10.1007/s15010-026-03028-x","url":null,"abstract":"<p><strong>Purpose: </strong>Community-acquired Clostridioides difficile infection (CA-CDI) is increasingly recognized outside healthcare settings, yet the contribution of dental antibiotic prescribing remains poorly characterized. This study compared patients with CA-CDI following antibiotics prescribed by dental practitioners versus family physicians.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study at the University Hospital for Infectious Diseases \"Dr. Fran Mihaljević\", Zagreb, Croatia, including adults with a first episode of confirmed CA-CDI following outpatient antibiotic exposure between 2011 and 2019. Characteristics were compared by prescriber.</p><p><strong>Results: </strong>Among 666 patients with CA-CDI, 190 (28.5%) had received antibiotics from dental practitioners and 476 (71.5%) from family physicians. Dental-associated CA-CDI increased significantly over time (13.1% in 2011 to 31.1% in 2019; p = 0.003). Dental patients had a lower comorbidity burden, with less frequent diabetes, chronic obstructive pulmonary disease, and proton pump inhibitor use. Amoxicillin-clavulanate was the most frequently prescribed antibiotic overall; clindamycin was more common among dental patients (39.9% vs. 11.9%), 79.7% of whom had no penicillin allergy. Severity and treatment duration were similar between groups.</p><p><strong>Conclusion: </strong>Dental antibiotic prescribing emerged as an increasingly important contributor to CA-CDI, associated with higher clindamycin use despite a lower burden of traditional risk factors, highlighting the need to strengthen antimicrobial stewardship in dental practice.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An impaired T-cell-mediated mitogen response as a potential biomarker to aid in clinical diagnosis of pulmonary tuberculosis.","authors":"Difery Minadzi, Augustine Yeboah, Millicent Lamptey, Monika M Vivekanandan, Joseph F Arthur, Hubert S Ahor, Wilfred Aniagyei, Samuel A Sakyi, Anthony A A Awuah, Rejoice A Arthur, Victoria A Ofori, Albert D Kegya, Linda A Amoakoa, Ernest Adankwah, Dorcas O Owusu, Ijeoma C Anyitey-Kokor, Mohammed K Abass, Fredrick G Apraku, Nana K Ayisi-Boateng, Seth Adane, Salisu Zakaria, Ertan Mayatepek, Julia Seyfarth, Richard O Phillips, Marc Jacobsen","doi":"10.1007/s15010-026-03021-4","DOIUrl":"https://doi.org/10.1007/s15010-026-03021-4","url":null,"abstract":"<p><strong>Purpose: </strong>A considerable proportion of suspected pulmonary tuberculosis (pTB) cases are identified and treated on the basis of clinical diagnoses, as it is often not possible to confirm Mycobacterium tuberculosis (Mtb) infection. In the absence of pathogen detection, supplementary indicators, such as immunological biomarkers, would facilitate TB diagnostic decision-making.</p><p><strong>Methods: </strong>In this prospective case-control study conducted in Ghana, patients with suspected pTB (n = 83) were divided into three subgroups: confirmed cases with high (pTB_high) or low (pTB_low) Mtb sputum load, and clinically diagnosed patients without Mtb confirmation (pTB_clin). pTB patient subgroups were then compared with healthy contacts (controls; n = 49) for their immune responses to Mtb antigens (i.e. PPD_Mtb, ESAT6/CFP10), the mitogen phytohemagglutinin, and a superantigen.</p><p><strong>Results: </strong>About half of the pTB patients were pTB_clin (n = 41; 49.4%), while pTB_high accounted for only about one-third (n = 26; 31.3%) and pTB_low for about one-fifth (n = 16; 19.3%). Antigen-specific CD4⁺ T-cell responses varied among the pTB subgroups, and only the pTB_high group had higher IFNγ⁺/TNFα⁺ T-cell proportions as compared to controls (PPD_Mtb, p = 0.0003; ESAT6/CFP10, p < 0.0001). In contrast, phytohemagglutinin induced significantly lower proportions of CD4⁺ T cells in all TB subgroups (pTB_high, p < 0.0001; pTB_low, p = 0.0039; pTB_clin, p = 0.0012 for IFNγ⁺/TNFα⁺) and this measurement distinguished patient subgroups effectively from controls (pTB_high, p < 0.0001; pTB_low, p = 0.0132; pTB_clin, p = 0.0006 for TNFα⁺/CD40L⁺). Finally, TNFα⁺/CD40L⁺ T-cell responses to phytohemagglutinine had the highest efficiency to distinguish pTB_clin with severe lung manifestation from controls (AUC = 0.9; p < 0.0001; 95%CI:0.82-0.98).</p><p><strong>Conclusion: </strong>This study underscores the importance of clinical pTB diagnosis and identifies a reduced T-cell cytokine response to phytohemagglutinin as a potential biomarker.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-course versus long-course antibiotics in bone infections: a meta-analysis of randomised controlled trials.","authors":"Yang Sun, Yu Sun, Zhaolun Feng, Bo Hakert, Jiantong Ma, Jillian Cornish","doi":"10.1007/s15010-026-03024-1","DOIUrl":"https://doi.org/10.1007/s15010-026-03024-1","url":null,"abstract":"<p><strong>Purpose: </strong>The optimal duration of antibiotic therapy for bone infections remains controversial. We therefore conducted a meta-analysis of randomised controlled trials (RCTs) comparing short- versus long-course antibiotic therapy for bone infections.</p><p><strong>Methods: </strong>PubMed, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov were searched through February 2026 for RCTs comparing short- and long-course antibiotic therapy in bone infections, including periprosthetic joint infection, diabetic foot osteomyelitis, vertebral osteomyelitis, and paediatric acute haematogenous osteomyelitis. Treatment failure and antibiotic-related adverse events were analysed using both intention-to-treat (ITT) and per-protocol (PP) data. Risk of bias and certainty of evidence were assessed using ROB 1 and GRADE.</p><p><strong>Results: </strong>In the ITT analysis, no significant difference in treatment failure was observed between short- and long-course therapy (RR = 1.12, 95% CI 0.77-1.62, P = 0.55). The PP analysis suggested a potential increase in treatment failure with short-course therapy (RR = 1.47, 95% CI 1.00-2.16, P = 0.05). Short-course therapy was associated with a significantly lower risk of antibiotic-related adverse events (RR = 0.81, 95% CI 0.69-0.94, P = 0.006). Certainty of evidence was moderate for treatment failure outcomes and high for adverse events.</p><p><strong>Conclusion: </strong>No statistically significant difference in treatment failure was observed between short- and long-course antibiotic therapy in the ITT analysis, whereas short-course therapy was associated with significantly fewer antibiotic-related adverse events. However, the PP analysis suggested a possible increase in treatment failure with short-course therapy. The included bone infections were clinically heterogeneous, which may limit generalisability.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological and sociodemographic profile of Mpox in Brazilian Amazon: a cross-sectional study.","authors":"Gabriel Palheta Beltrão, Marcos Vinicius Neves Dos Santos, Leonardo Miranda Dos Santos, Victor Augusto de Alencar Menezes, Silvio Augusto Fernandes de Menezes, Ricardo Roberto de Souza Fonseca, Luiz Fernando Almeida Machado","doi":"10.1007/s15010-026-03022-3","DOIUrl":"https://doi.org/10.1007/s15010-026-03022-3","url":null,"abstract":"<p><strong>Background: </strong>The Mpox outbreak was characterized by viral transmission within sexual networks and atypical clinical presentations, requiring regional epidemiological evaluations. This study aimed to describe the sociodemographic profile, temporal notification trends, and clinical characteristics of suspected and confirmed Mpox cases in Pará, Brazilian Amazon (2022-2025).</p><p><strong>Materials and methods: </strong>Observational, cross-sectional, and analytical study based on the Notifiable Diseases Information System (SINAN) between March 2022 and December 2025, adhering to STROBE guidelines. The sample (N = 296) was stratified into confirmed Mpox cases (G1; n = 86) and ruled-out cases (G2; n = 210). Associations were evaluated using Pearson's Chi-square test (for expected cell counts ≥ 5) or Fisher's exact test (for expected counts < 5), with significance set at p < 0.05 in SPSS v.26.0.</p><p><strong>Results: </strong>In G1, infection was concentrated among men (97.7%), cisgender men (96.5%), adults aged 19 to 59 years (98.8%), residents of Belém (76.7%), individuals with tertiary education (53.5%), and those reporting homosexual (73.3%) or bisexual (12.8%) orientation (p < 0.001). Clinically, fever (81.4%; p < 0.001) and localized genital lesions (43.0% in G1 vs. 6.2% in G2; p < 0.001) were the primary presentations. Intimate sexual contact was the primary probable exposure pathway (65.1%; p < 0.001). A high proportion of HIV coinfection was observed in G1 (54.7%), with complete reporting overlap with immunosuppression status, alongside 23.3% presenting an active STI at notification (p < 0.001), predominantly active syphilis (16.3%). Clinical management was predominantly outpatient (7.0% hospitalization rate; p = 0.261), with a 96.5% cure rate among valid confirmed cases. No Mpox-attributed deaths occurred among confirmed cases, though all-cause mortality in G1 was 2.3% (n = 2).</p><p><strong>Conclusion: </strong>Mpox cases in Pará were concentrated in the state capital, associated with intimate sexual contact networks among young adults, and characterized by high coinfection frequencies with HIV and syphilis.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum hepcidin as a host-derived biomarker of disease severity and risk stratification in tuberculosis.","authors":"Utkarsh Kaushik, Durga Shankar Meena, Sojit Tomo, Gopal Krishana Bohra, Deepak Kumar, Sarika Kombade","doi":"10.1007/s15010-026-03020-5","DOIUrl":"https://doi.org/10.1007/s15010-026-03020-5","url":null,"abstract":"<p><strong>Background: </strong>Hepcidin is a key regulator of systemic iron metabolism. Hepcidin may reflect the inflammatory activity and disease burden in tuberculosis. However, prospective evidence on the prognostic value of serum hepcidin and other host-biomarkers in tuberculosis is limited. We evaluated the association of hepcidin with disease severity and outcomes.</p><p><strong>Methods: </strong>This prospective cohort study enrolled consecutive adults (age ≥ 18 years) with newly diagnosed tuberculosis. Baseline serum hepcidin, adenosine deaminase (ADA), and creatine kinase-MB (CK-MB) levels were measured. Disease severity was assessed using a predefined tuberculosis severity score. The prognostic performance of biomarkers was evaluated using receiver operating characteristic analysis and multivariable logistic regression.</p><p><strong>Results: </strong>Among 140 patients (median age, 48 years; 67.1% male), 25% had pulmonary tuberculosis, 25% extrapulmonary tuberculosis, and 50% disseminated disease; HIV co-infection was present in 16.4%. The 3-month all-cause mortality rate was 22.1%. Serum hepcidin levels were significantly higher in severe than non-severe tuberculosis (201.5 vs. 145.9 ng/mL; p = 0.017), but were not associated with 3-month mortality. Conversely, CK-MB was significantly elevated among non-survivors (24.5 vs. 13.8 U/L; p < 0.001). CK-MB showed good predictive performance for mortality (AUC 0.795), while ADA demonstrated moderate discrimination (AUC 0.647). The ADA/CK-MB combination showed the highest discriminative performance for mortality prediction (AUC 0.82). Triple-marker panel (Hepcidin + ADA+CK-MB) provided the best discrimination for severe disease (AUC 0.717).</p><p><strong>Conclusions: </strong>Serum hepcidin was associated with disease severity in tuberculosis but was not associated with 3-month mortality. Combined biomarker models showed promising prognostic performance, warranting further validation in larger multicentre studies.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149193195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical significance of human rhino-/enterovirus co-detection in pediatric Mycoplasma pneumoniae infections.","authors":"Elena Robinson, Stefanie von Felten, Patrick M Meyer Sauteur","doi":"10.1007/s15010-026-03003-6","DOIUrl":"https://doi.org/10.1007/s15010-026-03003-6","url":null,"abstract":"<p><strong>Purpose: </strong>To determine whether upper respiratory tract co-detection of human rhino-/enterovirus is associated with a distinct clinical phenotype in children with Mycoplasma pneumoniae infection.</p><p><strong>Methods: </strong>We analyzed 236 children with M. pneumoniae infection detected by multiplex polymerase chain reaction (PCR) from 2022 to 2025 at the University Children's Hospital Zurich, comparing those without and with human rhino-/enterovirus co-detection, and performing a secondary analysis after excluding other co-detections.</p><p><strong>Results: </strong>No statistically significant differences were observed in demographic characteristics, clinical presentation, or inflammatory markers between groups.</p><p><strong>Conclusion: </strong>Human rhino-/enterovirus co-detection may represent incidental viral detection rather than clinically relevant co-infection in children with M. pneumoniae infection, supporting cautious interpretation of multiplex PCR results.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From early recognition to precision medicine: advances in the diagnosis and management of adult sepsis and septic shock-a narrative review.","authors":"Hazal Koca, Pinar Ayvat","doi":"10.1007/s15010-026-03019-y","DOIUrl":"https://doi.org/10.1007/s15010-026-03019-y","url":null,"abstract":"<p><strong>Purpose: </strong>Emerging diagnostic, computational, and precision approaches are expanding the ability to detect, classify, and biologically characterise sepsis, but their translation into clinical benefit depends on whether added information changes management and, ultimately, improves patient-centred outcomes. This review evaluates selected advances in adult sepsis and septic shock through a framework of clinical actionability.</p><p><strong>Methods: </strong>A focused PubMed search was supplemented by major international guidelines, targeted searches, and reference-list screening through August 2026. Priority was given to randomised trials, systematic reviews and meta-analyses, multicentre studies, and prospective or external validation studies relevant to clinical implementation.</p><p><strong>Results: </strong>We developed a two-gap framework to distinguish gains in information from clinically meaningful translation. The information-to-action gap describes situations in which improved detection, prediction, biological classification, or physiological assessment does not alter management; the decision-to-outcome gap describes management changes without demonstrated patient-centred benefit. Digital alerts, rapid diagnostics, host-response assays, physiology-guided resuscitation, and phenotype- or biomarker-guided strategies show differing degrees of actionability. Across these domains, reproducibility, transportability, workflow integration, timing, temporal stability, and treatment-predictive validity remain key constraints.</p><p><strong>Conclusion: </strong>Most of the emerging diagnostic, computational, and precision approaches reviewed here have not yet established a routine role in sepsis care. Established evidence-based management therefore remains the clinical foundation, while newer strategies should be evaluated prospectively for their ability to close the information-to-action and decision-to-outcome gaps.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of non-tuberculous mycobacterial infection of the bone, joint and soft tissue: a seven-year multicentre retrospective study.","authors":"Angus Lane, Arthur Morris, Nikita Jain, Burcu Isler, Kanthi Vemuri, Holly Sinclair, Earlleen Gunning, Rachel Thomson, Andrew Henderson, Andrew Burke, Peter Simos, Victoria Grey, Magdalena Mausolf, Katherine Garnham, Emma Ballard, Sumudu Britton, Adam Stewart","doi":"10.1007/s15010-026-02988-4","DOIUrl":"https://doi.org/10.1007/s15010-026-02988-4","url":null,"abstract":"<p><strong>Purpose: </strong>Extrapulmonary nontuberculous mycobacterial (EPNTM) infections of bone, joint, and soft tissue are difficult to treat and lack species-specific outcome data. We sought to describe antimicrobial regimens and surgical management by Mycobacterium spp. and to identify predictors of a clinical cure within 12 months in this adult cohort with EPNTM.</p><p><strong>Methods: </strong>We conducted a multicentre retrospective cohort study across five tertiary hospitals in Australia and New Zealand 2014-2020. Adults with culture-confirmed EPNTM infection from sterile or intraoperative specimens were included. Primary outcome was clinical cure at 12 months. Secondary outcomes included relapse, drug toxicity and host factors.</p><p><strong>Results: </strong>Among 107 patients, six species groups were identified, most commonly M. abscessus complex (n = 26, 25%), Mycobacterium marinum (n = 25, 24%), and M. fortuitum complex (n = 24, 23%). Clinical cure within 12 months differed significantly by species, with high cure proportions for M. abscessus complex (n = 22, 92%) in surgically accessible infections and lower cure rates for M. chelonae (n = 6, 60%) and amalgamated slow growing mycobacteria (n = 4, 36%). Younger age (median 47 vs. 60 years, p = 0.006) and Mycobacterium spp. was associated with cure whereas antimicrobial class and surgical intervention were not. Of antibiotic classes used, only macrolide duration was associated with cure. Relapse was uncommon (8%) and occurred predominantly in immunosuppressed patients.</p><p><strong>Conclusions: </strong>This first multicentre Australasian cohort demonstrates substantial species-specific variation in outcomes of EPNTM osteoarticular and soft-tissue infections. This study highlights the need for species-specific management pathways and prospective studies.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}