Infection最新文献

{"title":"SeptAsTERS- SeptiCyte® RAPID as assessment tool for early recognition of sepsis - a prospective observational study.","authors":"M von der Forst, L Back, K M Tourelle, D Gruneberg, M A Weigand, F C F Schmitt, Maximilian Dietrich","doi":"10.1007/s15010-024-02409-4","DOIUrl":"https://doi.org/10.1007/s15010-024-02409-4","url":null,"abstract":"<p><strong>Purpose: </strong>Early recognition of sepsis is critical to patient outcome, with mortality increasing with every hour of delay in treatment. The aim of this study was to investigate the use of a point-of-care molecular host response assay to differentiate sepsis from inflammation after surgery.</p><p><strong>Methods: </strong>Three molecular host response assays (SeptiCyte® RAPID) were performed in 61 patients after major abdominal surgery with admission to the intensive care unit and drawn blood cultures. The first (T0) was taken ± 3 h around the time of obtaining blood cultures, the second 24 h later (T24) and the third at discharge from the intensive care unit (Tex). The primary endpoint was the agreement of SeptiCyte® RAPID results with the diagnosis of sepsis. SeptiScore® indicates sepsis probability (low risk 0 - high risk 15). Patients were retrospectively classified into sepsis and inflammation by three blinded experts.</p><p><strong>Results: </strong>25 (42.4%) patients were categorized as \"inflammation\" and 34 (57.6%) patients as \"sepsis\". At T0 and T24 septic patients showed significantly higher mean SeptiScores® of 8.0 (± 2.2 SD) vs. 6.3 (± 2.1 SD) and 8.5 (± 2.1 SD) vs. 6.2 (± 1.8 SD), respectively. The Receiver Operating Curves (ROC) for the ability to discriminate between sepsis and inflammation had an Area Under the Curve (AUC) of 0.71 (T0) and 0.80 (T24).</p><p><strong>Conclusion: </strong>Embedded in a comprehensive diagnostic algorithm molecular host response analysis could broaden the possibilities for infection diagnostics to differentiate between sepsis and inflammatory response after surgery. But validation in larger cohorts is needed.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687006","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":"Prophylactic vs preemptive strategy for the prevention of CMV disease in solid organ transplant recipients: systematic review and meta-analysis of randomized controlled trials.","authors":"Niv Reiss-Gindi, Tomer Hoffman, Tanya Ruderman, Alaa Atamna, Ili Margalit, Dafna Yahav","doi":"10.1007/s15010-024-02441-4","DOIUrl":"https://doi.org/10.1007/s15010-024-02441-4","url":null,"abstract":"<p><strong>Purpose: </strong>Cytomegalovirus (CMV) is associated with significant morbidity and mortality among solid organ transplant (SOT) recipients. Strategies for CMV prevention include universal prophylaxis or preemptive approach. We aimed to evaluate the optimal approach.</p><p><strong>Methods: </strong>We performed a systematic review and meta-analysis of randomized controlled trials comparing prophylaxis versus preemptive therapy for CMV in SOT. The primary outcome was CMV disease. Subgroup analysis of outcomes in D+ R- patients was performed.</p><p><strong>Results: </strong>Nine trials have met inclusion criteria, five of them included kidney transplant recipients, all compared val/ganciclovir universal prophylaxis versus preemptive approach. Universal prophylaxis resulted in lower probability of CMV infection (relative risk [RR] 0.44, 95% confidence interval [CI] 0.33-0.58), yet the impact on CMV disease was insignificant (RR 0.54, 95% CI 0.24-1.23), in neither SOT recipients in general nor among D+R- subgroup (RR 0.93, 95% CI 0.37-2.32). Late-onset CMV disease rates were lower with preemptive approach. Sensitivity analysis according to allocation concealment and blinding showed similar results for CMV disease. No significant differences were demonstrated for the outcomes of mortality, bacterial or fungal infection or graft related outcomes. Acute kidney injury was significantly more common with prophylaxis (RR 1.79, 95% CI 1.12-2.89).</p><p><strong>Conclusion: </strong>Preemptive approach is a reasonable approach for CMV prevention in SOT recipients, if feasible. Strategies for combining the preemptive with prophylaxis strategies, as well as immune monitoring, should be investigated.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687005","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":"JYNNEOS vaccine safety surveillance in the vaccine safety datalink during the 2022 mpox outbreak in the United States.","authors":"Jonathan Duffy, W Katherine Yih, Kimp Walton, Malini B DeSilva, Jason M Glanz, Simon J Hambidge, Lisa A Jackson, Nicola P Klein, Bruno J Lewin, Allison L Naleway, Maria E Sundaram, Judith C Maro, Eric Weintraub","doi":"10.1007/s15010-024-02428-1","DOIUrl":"https://doi.org/10.1007/s15010-024-02428-1","url":null,"abstract":"<p><strong>Background: </strong>The JYNNEOS vaccine (two doses given 28 days apart) was recommended in the United States for people at high risk of exposure to monkeypox virus during the 2022 mpox outbreak. Our objective was to assess the safety of JYNNEOS using two complementary epidemiologic methods.</p><p><strong>Methods: </strong>This observational cohort included patients of eight large integrated healthcare organizations who received JYNNEOS. Adverse events were identified using ICD-10 coded diagnoses assigned to medical visits. The first analysis used standardized incidence ratios (SIR) to compare the observed incidence of ten prespecified adverse events of special interest (AESI) during the 28 days after receipt of each dose of JYNNEOS to the expected incidence adjusted for several risk factors. The second analysis used tree-based data mining to identify temporal clustering of cases for more than 60,000 diagnoses and diagnosis groups within 70-days after JYNNEOS dose 1 administration.</p><p><strong>Results: </strong>The SIR analysis included 53,583 adults who received JYNNEOS dose 1 and 38,206 who received dose 2. Males received 92% of the doses. There were no statistically significant elevated SIRs for any of the ten AESI. The tree-based data mining analysis included 36,912 vaccinees. Analysis of diagnoses in inpatient, emergency department, and outpatient settings identified statistically significant clusters of visits for rash and unspecified adverse effects.</p><p><strong>Conclusions: </strong>No new or unexpected safety concerns were identified. AESI did not occur more frequently than expected by chance alone. Non-serious medically attended adverse events, such as rash, have been previously reported and occurred infrequently.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675698","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":"Rare and risky: a unique case of concurrent chronic pulmonary aspergillosis and lemierre syndrome.","authors":"Peter Weber, H Rohn, J Jäger, S Dolff, O Witzke, P-M Rath, M Zettler","doi":"10.1007/s15010-024-02440-5","DOIUrl":"https://doi.org/10.1007/s15010-024-02440-5","url":null,"abstract":"<p><p>Lemierre Syndrome is a condition that appears to have been overlooked in recent decades in clinical practice, often resulting in death or long-lasting sequelae when left undetected and untreated. Typically, it occurs following an upper respiratory tract infection, often stemming from tonsillitis, leading to thrombosis of the internal jugular vein and subsequent multiple septic emboli. Here, we present a case a 46-year-old patient with the clinical presentation of pneumogenic sepsis. Remarkably, we were able to diagnose the simultaneous presence of chronic pulmonary aspergillosis and Lemierre syndrome.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647885","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":"Post-COVID recovery is faster after an infection with the SARS-CoV-2 Omicron variant: a population-based cohort study.","authors":"Laura Rebecca Pfrommer, Sophie Diexer, Bianca Klee, Janka Massag, Cornelia Gottschick, Oliver Purschke, Mascha Binder, Thomas Frese, Matthias Girndt, Daniel Sedding, Jonas Rosendahl, Jessica I Hoell, Irene Moor, Michael Gekle, Christine Allwang, Florian Junne, Rafael Mikolajczyk","doi":"10.1007/s15010-024-02438-z","DOIUrl":"https://doi.org/10.1007/s15010-024-02438-z","url":null,"abstract":"<p><strong>Purpose: </strong>Post-COVID-19 condition (PCC) poses a substantial burden to affected individuals, health care systems, and society as a whole. We examined factors associated with recovery from PCC, focusing on the vaccination status prior to infection and the virus variant.</p><p><strong>Methods: </strong>Our analyses are based on the population-based cohort study for digital health research in Germany (DigiHero). Respondents who reported a SARS-CoV-2 infection and COVID-related symptoms ≥ 12 weeks post-infection were classified as having PCC. Those with ongoing PCC were followed-up in six-month intervals based on their date of infection. We used a Cox model for interval-censored data to analyze PCC recovery.</p><p><strong>Results: </strong>Among the 4,529 respondents with PCC included in our analyses, about 26%, 19%, 36%, and 44% of those infected during dominance of the SARS-CoV-2 wildtype, Alpha, Delta, and Omicron variant had recovered one year after infection, respectively. When stratifying by virus variant, vaccination was not associated with a faster recovery. Conversely, those infected with Omicron (HR = 2.20; 95%CI: 1.96-2.48) or Delta (HR = 1.69; 95%CI: 1.43-2.01) recovered faster than those infected with the SARS-CoV-2 wildtype or Alpha strain.</p><p><strong>Conclusion: </strong>Although the recovery from PCC is faster for the newer virus variants, still a substantial fraction of those who developed PCC after an infection with the Omicron variant report prolonged persistence of symptoms.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647879","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":"In vitro activity of ceftazidime-avibactam/aztreonam combination against MBL-producing Pseudomonas aeruginosa strains.","authors":"Niklas Klein, Jonathan Jantsch, Michaela Simon, Jürgen Rödel, Sören L Becker, Annerose Serr, Joerg Steinmann, Stefan F Ehrentraut, Ernst Mollitor, Gunnar T R Hischebeth","doi":"10.1007/s15010-024-02425-4","DOIUrl":"https://doi.org/10.1007/s15010-024-02425-4","url":null,"abstract":"<p><strong>Purpose: </strong>The emergence of multidrug-resistant P. aeruginosa isolates poses a challenge to healthcare systems worldwide. Rising numbers in deaths, duration of hospitalization as well as failing treatments prove the hazards posed by these pathogens. This and the lack of promising therapeutic options highlight the urgency of antibiotic drug development. As interim solution or alternative to the development of new antibiotic drugs, investigation of novel combinations of existing antibiotic drugs can be an economic and swift approach. Therefore, this study addresses the evaluation of in vitro activity of the antibiotic combination of ceftazidime-avibactam/aztreonam against MBL-producing P. aeruginosa strains.</p><p><strong>Methods: </strong>We tested 153 isolates from six university hospitals via microdilution against their susceptibility to meropenem, aztreonam, ceftazime-avibactam and the minimal inhibitory concentration of the combination of ceftazidime-avibactam/aztreonam. 64 isolates produced carbapenemases of which 61 were VIM-, 2 NDM- and 1 OXA-producer.</p><p><strong>Results: </strong>We were able to show that the synergetic effects of this regimen with an avibactam concentration of 4 mg/l and an aztreonam concentration of 16 mg/l could successfully lower the number of MBL-producing isolates that showed a high minimal inhibitory concentration compared to a carbapenemase-negative control group in vitro.</p><p><strong>Conclusion: </strong>The antibiotic combination consisting of ceftazidime-avibactam/aztreonam represents a possible approach to the treatment of patients infected with multidrug-resistant P. aeruginosa isolates.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647946","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":"Pre-hospital time delays in imported malaria diagnosis in hospitalized sub-Saharan travelers and migrants: not only on the patient's shoulders.","authors":"Nerea Castillo-Fernández, Manuel Jesús Soriano-Pérez, Ana Belén Lozano-Serrano, José Vázquez-Villegas, María Pilar Luzón-García, María Isabel Cabeza-Barrera, Cristina Ocaña-Losada, Rosario Pérez-Moyano, Joaquín Salas-Coronas","doi":"10.1007/s15010-024-02436-1","DOIUrl":"10.1007/s15010-024-02436-1","url":null,"abstract":"<p><strong>Purpose: </strong>To analyze the diagnostic delay in malaria related to misdiagnosis at first medical visit and its association with the risk of severe malaria in non-endemic areas.</p><p><strong>Methods: </strong>Retrospective observational study of sub-Saharan migrants with imported malaria from January-2010 to December-2022. Patients were allocated in two groups depending on if malaria was suspected at first medical visit or not. Time delays in seeking healthcare, medical diagnostic delay (time between first attending a medical facility and the diagnosis of malaria) and total diagnostic delay (time between the onset of symptoms and the diagnosis of malaria) were calculated.</p><p><strong>Results: </strong>297 patients were included in the analysis. At first medical visit, malaria was misdiagnosed in 137 patients (46.1%). Medical diagnostic delay and total diagnostic delay were larger for the misdiagnosis group than for those properly diagnosed at first visit (p < 0.001). Although time in seeking healthcare was shorter in the misdiagnosis group, the presence of suggesting symptoms, such as fever, was lower (p < 0.050). Misdiagnosis was more frequent in emergency rooms linked to primary healthcare (p < 0.001). For the overall population (n = 297), total diagnostic delay was mainly due to delay in seeking healthcare. Initial misdiagnosis was associated with a higher risk of severe malaria (adjusted OR 2.23 [1.09-5.10], p = 0.031).</p><p><strong>Conclusion: </strong>In a non-endemic area with a high rate of imported malaria, the percentage of patients misdiagnosed is surprisingly high. Misdiagnosis is associated with longer medical and total diagnostic delays and with a higher risk of severe malaria. It seems necessary to redesign training programs to improve knowledge among healthcare professionals and actions targeted to travelers to promote seeking healthcare advice promptly.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667686","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":"Infants < 90 days of age with late-onset sepsis display disturbances of the microbiome-immunity interplay.","authors":"Simon Graspeuntner, Mariia Lupatsii, Vera van Zandbergen, Marie-Theres Dammann, Julia Pagel, Duc Ninh Nguyen, Alexander Humberg, Wolfgang Göpel, Egbert Herting, Jan Rupp, Christoph Härtel, Ingmar Fortmann","doi":"10.1007/s15010-024-02396-6","DOIUrl":"https://doi.org/10.1007/s15010-024-02396-6","url":null,"abstract":"<p><strong>Objective: </strong>We hypothesized that previously healthy infants < 90 days of age with late-onset sepsis (LOS) have disturbances of the gut microbiome with yet undefined specific immunological patterns.</p><p><strong>Methods: </strong>We performed a prospective single-center convenience sample study between January 2019 and July 2021 in a case-control design. Routine diagnostics included conventional cultures (blood, cerebrospinal fluid, urine), PCRs and inflammatory markers in infants aged < 90 days with clinical LOS. We additionally analyzed blood lymphocyte subsets including CD4 + CD25 + forkhead box protein (FoxP3)⁺ Tregs and performed 16 S rRNA sequencing of stool samples, both compared to age-matched healthy controls. Results were adjusted for potential confounders that may influence microbial composition.</p><p><strong>Results: </strong>51 infants with fever and clinical LOS were enrolled. Bacterial sepsis was diagnosed in n = 24 (47.1%) and viral infection in n = 13 (25.5%) infants, whereas in 14 (27.3%) infants the cause of fever remained undetermined. When compared to healthy controls, the gut microbiome of LOS infants at disease onset was characterized by a shift in community composition, specifically, decreased abundance of B. longum and an increase of Bacteroidia spp. Intriguingly, the abundance of B. longum negatively correlated with the frequency of blood CD4-positive cells in healthy controls but not in infants with LOS. At one year of age, we observed microbiome differences in infants with history of LOS when compared to healthy controls, such as an increased gut microbial diversity.</p><p><strong>Conclusion: </strong>Our data suggest potential signatures of the microbiome-immunity interplay in infants with LOS, which should be investigated further as possible targets for prevention.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619562","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":"LTT-Validity in diagnosis and therapeutical decision making of neuroborreliosis: a prospective dual-centre study.","authors":"G Summer, V Fingerle, A Spörl, C Lechner, T A Rupprecht","doi":"10.1007/s15010-024-02437-0","DOIUrl":"https://doi.org/10.1007/s15010-024-02437-0","url":null,"abstract":"<p><strong>Objectives: </strong>The key objective of this study was to assess the validity of a commercially available in-house Lymphocyte Transformation Test (LTT) as a diagnostic parameter and indicator of disease activity/therapeutic efficacy in the context of Lyme neuroborreliosis (LNB).</p><p><strong>Methods: </strong>A prospective dual-centre study was conducted from 05/14 - 01/18. With respect to Borrelia-LTT a comparison was made between patients suffering from confirmed acute LNB and patients being affected by inflammatory neurologic diseases, defining the control group: Bell's palsy, viral meningitis, herpes zoster, Guillain-Barré-Syndrome and Encephalomyelitis disseminate. Furthermore, we investigated the LTT within the LNB group at the time of admission and again 12 weeks (+/- one week) later - after appropriate antibiotic treatment.</p><p><strong>Results: </strong>Cases included 15 patients with LNB and 58 participants in the control group. With regard to Borrelia-LTT we calculated a low sensitivity of 40% and a moderate specificity of 91% for LNB. Additionally, LTT-levels three months after adequate antibiotic therapy did not correlate with the therapeutic response of LNB patients.</p><p><strong>Conclusions: </strong>The present study shows that LTT is neither appropriate for LNB detection nor suitable as a follow-up marker.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619577","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":"Sex-dependent variability of isoniazid and rifampicin serum levels in patients with tuberculosis.","authors":"Raja Idris, Alexander Z Dayani, Ana M Groh, André Mohr, Julia Koepsell, Ann-Sophie Zielbauer, Eva Herrmann, Maria J G T Vehreschild, Thomas A Wichelhaus, Nils Wetzstein","doi":"10.1007/s15010-024-02424-5","DOIUrl":"https://doi.org/10.1007/s15010-024-02424-5","url":null,"abstract":"<p><strong>Introduction: </strong>Drug-sensitive TB (DS-TB) is treated with isoniazid, rifampicin, ethambutol, and pyrazinamide. Factors like fast-metabolizing enzymes, malabsorption, and drug interactions can influence serum drug levels. Current TB treatment guidelines recommend weight-adapted dosing without considering sex differences. This study examines drug levels of isoniazid and rifampicin in TB patients treated between 2019 and 2023 at our center focusing on sex-specific aspects.</p><p><strong>Methods: </strong>Patients diagnosed with TB and available serum levels of isoniazid or rifampicin between 2019 and 2023 were retrospectively identified. Serum levels were measured using liquid chromatography-mass spectrometry and high-performance liquid chromatography. Patients were stratified by sex and a linear regression mixed effect model was used to assess predictors for different serum levels.</p><p><strong>Results: </strong>The study included 281 single therapeutic drug monitoring (TDM) measurements from 59 patients (28 women, 47.5%). For isoniazid, no sex-specific differences in serum drug levels were identified. On the other hand, female sex was a significant predictor of higher rifampicin plasma levels (coefficient 4.16, 95% CI 0.74-7.59, p = 0.009). Only 38.2% of rifampicin serum level measurements in male patients were within target range, the majority (40/68, 58.8%) were below range and only 2 (2.9%) TDM-levels were above range. Women displayed higher overall rifampicin serum levels than men (median 13.7 mg/l vs. 7.1 mg/l, p = 0.04), although weight adjusted doses were not significantly different (median 10.0 mg/kg vs. 9.8 mg/kg p = 0.56). Adverse effects were noted in 42.9% (42/98) of measurements in women and 29.5% (54/183) of measurements in men (p = 0.03).</p><p><strong>Discussion: </strong>Rifampicin levels were significantly lower in men compared to women, despite weight-adjusted dosing. Clinicians should consider TDM and potential sex differences when treating patients with TB.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619620","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}