Infection最新文献

{"title":"Tuberculosis outbreak in a German daycare center.","authors":"Cornelia Feiterna-Sperling, Julia von Hake, Birgit Lala, Mirjam Völler, Lujin Zaidan-Braun, Luise Martin, Annette Günther, Dinah von Schöning, Renate Krüger","doi":"10.1007/s15010-025-02655-0","DOIUrl":"https://doi.org/10.1007/s15010-025-02655-0","url":null,"abstract":"<p><strong>Purpose: </strong>Young children who are exposed to people with infectious tuberculosis (TB) have an increased risk of developing TB disease following infection. The risk of infection and disease progression can be minimized by prompt identification of TB-exposed individuals and initiation of prophylactic or preventive treatment.</p><p><strong>Methods: </strong>We report on a TB outbreak in a daycare center in Berlin, Germany following a delayed diagnosis of cavitary pulmonary TB in a childhood educator. We describe contact investigation, diagnostic, prophylactic, preventive and therapeutic measures in 62 TB-exposed children (median age 3.9 years), including 30 with prolonged TB exposure.</p><p><strong>Results: </strong>The initial examination took place 5-16 days after the index patient was diagnosed with TB. Ten of the 30 children with intensive contact became infected, six (median age 2.7 years) developed pulmonary TB. Three of these children had a concurrent influenza infection, which may have contributed to disease progression. No child without prolonged exposure to the index patient developed disease.</p><p><strong>Conclusion: </strong>Early diagnosis of TB in adult patients, especially those with persistent cough, is crucial to prevent TB in vulnerable infants. Close collaboration between public health departments and specialized facilities is essential for the effective control of TB outbreaks.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225288","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":"Long-term outcomes after intensive care unit-treated COVID-19, influenza and respiratory sepsis in 2020 - a comparative, population-based cohort study.","authors":"Franka E A Joost, Norman Rose, Aurelia Kimmig, Thomas Ruhnke, Patrik Dröge, Antje Freytag, Christian Günster, Mathias W Pletz, Martin Roesler, Philipp A Reuken, Peter Schlattmann, Konrad F R Schmidt, Andreas Stallmach, Josephine Storch, Konrad Reinhart, Lisa Wedekind, Carolin Fleischmann-Struzek","doi":"10.1007/s15010-025-02644-3","DOIUrl":"https://doi.org/10.1007/s15010-025-02644-3","url":null,"abstract":"<p><strong>Background: </strong>Sepsis survivors are affected by a broad spectrum of long-term impairments, which overlap with Long-Covid and sequelae after influenza in their clinical presentation. However, we lack comparative assessments on the burden of long-term outcomes, particularly with patients being recruited from the same, contemporary patient population. Therefore we compared long-term outcomes after respiratory sepsis (RS), SARS-CoV-2-associated sepsis (SS) and influenza-associated sepsis (IS).</p><p><strong>Methods: </strong>Retrospective, population-based cohort study. We included patients > 15 years hospitalized with RS, SS and IS between 01/2020 and 12/2020 in Germany, who received intensive care unit treatment. We compared mortality, readmissions, prevalence of diagnoses in the cognitive, psychological or medical domain, and the number of impaired domains in the 12 months post-discharge between the three survivor cohorts, adjusting for between-group differences in relevant covariates by inverse propensity score weighting based on generalized propensity scores.</p><p><strong>Results: </strong>Our study included 12,854 patients, of which 8,201 were RS, 3,964 SS and 689 IS survivors. RS survivors had a considerably higher risk for 12-month mortality compared to SS and IS survivors (relative risk, 1.77 [95% CI, 1.54-2.03]; P < 0.001 and relative risk, 1.37 [95% CI, 1.14-1.65]; P = 0.001, respectively). They were more often rehospitalized, affected by multiple domain impairments, cognitive decline and impairments related to the severity of acute disease, e.g. complications of the tracheostoma, compared to survivors after SS and IS. RS survivors had a lower risk for being affected by medical diagnoses compared to SS. Risks for psychological diagnoses did not differ between RS and the other survivor groups.</p><p><strong>Conclusions: </strong>Although respiratory sepsis survivors seem to be affected by more severe long-term impairments, the overall burden of post-acute sequelae among all survivor groups is high. This warrants efforts to provide targeted aftercare for all survivor populations after life-threatening infections.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212707","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":"Letter to the editor regarding: \"Ceftazidime-avibactam versus polymyxins in treating patients with carbapenem‑resistant Enterobacteriaceae infections: a systematic review and meta‑analysis\".","authors":"Tanya Babich, Leonard Leibovici, Vered Daitch","doi":"10.1007/s15010-025-02563-3","DOIUrl":"10.1007/s15010-025-02563-3","url":null,"abstract":"","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"2241-2242"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110668","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":"Evaluation of systemic inflammatory response following transcatheter aortic valve replacement: a pathway to rational antibiotic use.","authors":"Henning Guthoff, Valerie Lohner, Ute Mons, Julia Götz, Hendrik Wienemann, Jan Wrobel, Stephan Nienaber, Sascha Macherey-Meyer, Philipp von Stein, Stephan Baldus, Matti Adam, Maria Isabel Körber, Norma Jung, Victor Mauri","doi":"10.1007/s15010-025-02485-0","DOIUrl":"10.1007/s15010-025-02485-0","url":null,"abstract":"<p><strong>Purpose: </strong>Elevations in inflammatory markers after transcatheter aortic valve replacement (TAVR) often lead to preemptive antibiotic therapy (ABT). Distinguishing between physiological inflammatory reaction and true infection is crucial for rational ABT use.</p><p><strong>Methods: </strong>This retrospective study included 1275 consecutive TAVR patients from January 2020 to July 2022. Infectious foci, ABT administration, and inflammatory markers over seven days post-procedure were evaluated. Using multivariable logistic regression, predictors for infection were identified and integrated into the Risk of Infection After TAVR (RIAT) score.</p><p><strong>Results: </strong>An infectious focus was retrospectively identified in 2.6% of patients, while 11.4% received ABT. Distinct trends in body temperature (BT), white blood cells (WBC), and C-reactive protein (CRP) were noted, with BT and WBC peaking on day 1 and CRP on day 3. Significant predictors of infection included a rise in BT of ≥ 0.2 °C between day 1 and 3 (odds ratio [OR] 3.08, 95% confidence interval [CI] 1.38-6.88, p = 0.006), elevated WBC counts ≥ 12 × 10⁹/L (OR 3.77, 95% CI 1.67-8.48, p = 0.001), and CRP levels ≥ 80 mg/L (OR 5.72, 95% CI 2.59-12.64, p < 0.001) within three days after TAVR. Integrating these into the RIAT score revealed an infection probability of 1.5% for scores 0-3 points, 9.2% for scores 4-6 points, and 54.5% for scores 7-8 points.</p><p><strong>Conclusion: </strong>Our findings indicate significant ABT overuse among TAVR recipients, likely due to misinterpretation of postoperative physiological reactions. Incorporating specific changes and thresholds of BT, WBC, and CRP post-TAVR into the RIAT score improved risk prediction for infection, underscoring its utility in enhancing antibiotic stewardship in this growing patient population.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"1725-1735"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergence and characterization of mixed Candida auris strain infections in China.","authors":"Han Du, Yanfeng Huang, Penghao Guo, Weihong Liang, Tianhong Zheng, Zhangyue Guan, Jian Bing, Haiqing Chu, Guanghua Huang","doi":"10.1007/s15010-025-02536-6","DOIUrl":"10.1007/s15010-025-02536-6","url":null,"abstract":"<p><strong>Purpose: </strong>The multidrug-resistant fungal pathogen Candida auris poses an increasing global health threat due to its high transmissibility and persistence in healthcare environments. We aimed to explore the potential cases of mixed C. auris-strain colonizations or infections in China and to investigate the genetic and biological diversity of the associated isolates.</p><p><strong>Methods: </strong>C. auris isolates from 5 colonization or infection cases were distinguished by colony morphology and verified by D1/D2-ITS alignment. Phylogenetic and genomic diversity analysis of all isolates were conducted using whole genome sequences. Comparative biological analysis of all isolates, including cellular and colony morphology, antifungal susceptibility, biofilm formation, SAP activity, and both in vitro and in vivo survival capabilities were performed.</p><p><strong>Results: </strong>Five cases of potential mixed C. auris-strain colonization or infections in China were identified. Comparative genomic analysis revealed these cases involved strains from two distinct genetic clades (I and III) or strains from the same clade but with genetic alterations. Comparative biological analysis demonstrated the strains from mixed colonization or infections exhibit differences in several key aspects, including colony morphology, biofilm formation, SAP activity, and both in vitro and in vivo survival capabilities.</p><p><strong>Conclusion: </strong>Comparative analyses revealed notable differences in biofilm formation, environmental survival, and secretion of virulence factors between the co-colonizing or co-infecting strains of C. auris. These biological and genetic disparities may present significant challenges for the diagnosis and treatment of C. auris infections, as strains with different genetic backgrounds may exhibit varying abilities to colonize host or environmental niches.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"2005-2014"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology and outcomes of Candida spp. bloodstream infections in cancer patients: a comparative retrospective study from a German tertiary cancer center.","authors":"Sebastian Wolf, Sarah Weber, Aaron Janetta, Friederike Klein, Julius C Enssle, Michael Hogardt, Volkhard A J Kempf, Johanna Kessel, Maria J G T Vehreschild, Björn Steffen, Thomas Oellerich, Hubert Serve, Sebastian Scheich","doi":"10.1007/s15010-025-02513-z","DOIUrl":"10.1007/s15010-025-02513-z","url":null,"abstract":"<p><strong>Background: </strong>Bloodstream infections (BSI) due to Candida spp. significantly contribute to morbidity and mortality among cancer patients. Understanding their clinical course, risk factors, and outcomes compared to bacterial BSI is essential.</p><p><strong>Aim: </strong>We aim to elucidate the epidemiology and risk factors associated with Candida BSI compared to bacterial BSI in cancer patients.</p><p><strong>Methods: </strong>We analyzed epidemiological data of Candida BSI versus bacterial BSI among cancer patients, primarily with hematological malignancies. Blood cultures were obtained upon clinical suspicion, with species identification by VITEK 2 and MALDI-TOF. Susceptibility testing utilized VITEK 2 or antibiotic gradient tests.</p><p><strong>Results: </strong>Candida BSI was associated with higher 30-day mortality compared to bacterial BSI (Hazard ratio (HR) 4.5, 95% CI 2.5-8.1, p < 0.001) occurring predominantly in patients with relapsed/refractory disease. Univariate analysis identified risk factors for Candida BSI: hypoalbuminemia (Odds ratio (OR) 9.13, 95% CI 2.7-57, p = 0.003), prior ICU/MC stay (OR 3.91, 95% CI 1.38-9.65, p = 0.005), palliative treatment (OR 3.42, 95% CI 1.52-7.4, p = 0.002), parenteral nutrition (OR 2.44, 95% CI 0.9-5.5, p = 0.039) and prior allogeneic HSCT (OR 2.28, 95% CI 0.92-5.13, p = 0.056). Risk factors identified by multivariate analysis were palliative therapy (OR 5.23, 95% CI 3.14-8.71, p = 0.001), hypoalbuminemia (OR 9.02, 95% CI 4.23-19.2, p = 0.004), and prior ICU/IMC stay (OR 4, 95% CI 2.31-6.92, p = 0.011). In patients with confirmed Candida BSI, delayed initiation of antifungal was associated with worse outcomes.</p><p><strong>Conclusion: </strong>Compared to bacterial BSI events, Candida BSI are associated with significantly higher 30-day mortality, primarily affecting heavily pretreated patients with relapsed or refractory disease.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"1875-1885"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibiotic resistance of urinary pathogens after kidney transplantation: a 10-year single-center survey in Germany.","authors":"P Weber, P Braß, J Jäger, L Jacquet, S Jansen, A Gäckler, C Jürgens, J Reinold, U Eisenberger, P-M Rath, A Kribben, O Witzke, H Rohn","doi":"10.1007/s15010-025-02493-0","DOIUrl":"10.1007/s15010-025-02493-0","url":null,"abstract":"<p><strong>Purpose: </strong>Urinary tract infections (UTIs) are common complications after kidney transplantation (KT), often resulting in severe outcomes like acute graft failure and sepsis. Factors such as diabetes, age, sex, and type of transplantation significantly influence disease progression. Rising antibiotic resistance complicates treatment, emphasizing the importance of Antimicrobial Stewardship (AMS), particularly during the post-transplant immunosuppression phase. Recent changes in treatment protocols, including a shift away from treating asymptomatic bacteriuria and modifications in antibiotic prescribing, highlight the need for updated resistance trend analyses.</p><p><strong>Methods: </strong>This retrospective study at the University Hospital Essen analyzed urine samples from kidney transplant outpatients from 2013 to 2022. Pathogen identification and resistance testing focused on common UTI pathogens, including Escherichia coli, Klebsiella spp., Pseudomonas aeruginosa, Enterococcus faecium, and Enterococcus faecalis. Data on antibiotic prescriptions were sourced from the North Rhine Association of Statutory Health Insurance since 2017.</p><p><strong>Results: </strong>Out of 10,508 urine samples collected from 6962 patients, bacterial growth was detected in 4126 samples (39%). Escherichia (E.) coli was the most frequent pathogen (41%). Klebsiella spp., which accounted for 11.7% of all pathogens, showed increasing resistance to piperacillin/tazobactam and ceftazidime. Resistance rates Enterococcus faecalis showing a significant decline in levofloxacin (100% resistance in 2014 in all isolates, compared to 2% in 2022). An increasing concern in our cohort is the prevalence of Extended Spectrum Beta-Lactamase (ESBL)-producing Gram-negative pathogens, particularly Klebsiella spp., which are being detected with greater frequency. In our center, we have observed a significant increase in the use of oral antibiotics recommended for first-line therapy. This shift is attributed to updated guidelines and therapeutic recommendations. Consequently, oral cephalosporins are now rarely used due to their low bioavailability.</p><p><strong>Conclusion: </strong>The study highlights the importance of ongoing surveillance to address antibiotic resistance in KT recipients. Increasing resistance in pathogens like Klebsiella spp. necessitates new antimicrobial strategies. Findings should inform future guidelines to preserve antibiotic effectiveness and improve therapeutic outcomes in this vulnerable patient population.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"1755-1768"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of treatment of COVID-19 with sotrovimab on post-acute sequelae of COVID-19 (PASC): an analysis of National COVID Cohort Collaborative (N3C) data.","authors":"Myriam Drysdale, Rose Chang, Tracy Guo, Mei Sheng Duh, Jennifer Han, Helen Birch, Catherine Sharpe, Daisy Liu, Sarah Kalia, Melissa Van Dyke, Maral DerSarkissian, Iain A Gillespie","doi":"10.1007/s15010-025-02505-z","DOIUrl":"10.1007/s15010-025-02505-z","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the impact of early sotrovimab treatment versus no treatment on the risk of developing post-acute sequelae of COVID-19 (PASC; long COVID) in patients (age ≥ 12 years) with COVID-19 at high risk for progression to severe disease.</p><p><strong>Methods: </strong>Retrospective cohort study using the US National COVID Cohort Collaborative (N3C) data. Phase 1 identified and assessed multiple definitions of PASC; Phase 2 evaluated the effectiveness of sotrovimab for reducing the risk of PASC, utilizing definitions from Phase 1. Average treatment effect in the treated (ATT)-weighted Cox proportional hazards regression models were used to compare time to event for PASC between high-risk patients who received sotrovimab treatment between May 26, 2021 and April 5, 2022, and high-risk patients with COVID-19 diagnosed between May 26, 2021 and March 26, 2022 who did not receive any treatment for COVID-19 during the acute phase or any pre-exposure prophylaxis against SARS-CoV-2.</p><p><strong>Results: </strong>A total of 9,504 sotrovimab-treated and 619,668 untreated patients were included in the main analysis. Most baseline characteristics were balanced between the two cohorts after ATT weighting. The doubly robust ATT-weighted hazard ratio (95% confidence interval) was 0.92 (0.89-0.96) (p < 0.001), indicating that sotrovimab use was associated with a significantly lower risk of PASC. Results remained consistent in sensitivity analyses.</p><p><strong>Conclusion: </strong>In patients at high risk for severe COVID-19, the benefits of early sotrovimab treatment may extend beyond the acute phase of COVID-19 and contribute to the prevention of PASC symptoms.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"1833-1849"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of tocilizumab for hospitalized patients with COVID-19 pneumonia and high IL-6 levels: A randomized controlled trial.","authors":"Júlia Sellarès-Nadal, Juan Espinosa-Pereiro, Joaquín Burgos, Vicenç Falcó, Alfredo Guillén-Del-Castillo, Salvador Augustin, Juan Bañares-Sánchez, Alba Prio-Ruatg, Ferran Martínez-Valle, Cristina Kirkegaard-Biosca, Adrián Sánchez-Montalvá","doi":"10.1007/s15010-025-02506-y","DOIUrl":"10.1007/s15010-025-02506-y","url":null,"abstract":"<p><strong>Background: </strong>The objective of this clinical trial is to evaluate the efficacy and safety of IL-6 driven personalized treatment strategy with tocilizumab in patients with severe COVID-19 pneumonia.</p><p><strong>Trial design: </strong>Randomized, controlled, open-label, single-center trial of a tocilizumab treatment strategy in adult patients hospitalized with severe COVID-19 pneumonia and IL-6 serum levels > 40 pg/mL.</p><p><strong>Methods: </strong>Patients were randomized 1:1 to receive standard of care (SOC) or SOC plus one dose of tocilizumab. The primary outcome was death or need for invasive mechanical ventilation (IMV) within 28 days after randomization. Secondary outcomes included ICU admission, days on IMV and hospital stay. A meta-analysis of clinical trials to evaluate the effect of tocilizumab on mortality and need of IMV in patients with COVID-19 pneumonia was performed.</p><p><strong>Results: </strong>Sixty-two patients were included: 30 in the SOC arm and 32 in the standard-treatment plus tocilizumab arm. The primary outcome occurred in 12.9% in the tocilizumab arm and 32.3% in the SOC arm(p = 0.068). There was a trend towards fewer days on IMV (7.5 vs 19.5 days, p = 0.073) and a shorter hospital stay (4 vs 8 days, p = 0.134) in the tocilizumab group. No serious adverse events were reported. The meta-analysis revealed a RR for death or IMV of 0.83 (95% CI: 0.77-0.89) in patients receiving tocilizumab, compared to patients receiving SOC.</p><p><strong>Conclusion: </strong>Tocilizumab could be effective to prevent death or IMV in patients with severe COVID-19 pneumonia and high IL-6 serum levels. Safety profile of tocilizumab does not arise major concern in patients with severe COVID19.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"1851-1861"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meropenem plasma concentrations in critically ill patients treated with the novel multi organ replacement therapy ADVOS.","authors":"David Totschnig, Theresa Mader, Thomas Stimpfl, Klaus Breinbauer, Cristina Groza, David Stücklschwaiger, Stephanie Neuhold, Emanuela Friese, Johannes Holbik, Martina Delivuk, Tom Ripplinger, Marcell Leber, Clemens Ott, Wolfgang Hoepler, Aritz Perez Ruiz de Garibay, Christoph Wenisch, Otto Frey, Alexander Zoufaly, Marianna Traugott","doi":"10.1007/s15010-025-02554-4","DOIUrl":"10.1007/s15010-025-02554-4","url":null,"abstract":"<p><strong>Background: </strong>Optimal dosing of antibiotics in critically ill patients treated with the novel multi organ replacement therapy ADVOS (ADVanced Organ Support) based on albumin dialysis is unclear. This study aims to provide real life data on meropenem plasma concentrations after prolonged infusion in patients treated with ADVOS and a critically ill control group with and without continuous veno-venous hemodiafiltration (CVVHDF).</p><p><strong>Methods: </strong>We retrospectively analyzed plasma concentrations of meropenem obtained as part of our standard of care therapeutic drug monitoring in the intensive care unit. Meropenem was administered as a prolonged infusion over 3 h. We measured peak and trough levels, pre-and post-filter levels of meropenem using high performance liquid chromatography. We calculated the meropenem clearance and compared the measured clearance with predicted clearance based on creatinine, calculated by the MeroEasy tool.</p><p><strong>Results: </strong>In total, 159 measurements across 16 patients were analyzed. Meropenem trough concentrations were highest in the CVVHDF group with a median of 23.5 mg/L, followed by the ADVOS (median 9.3 mg/L) and control group (median 7.6 mg/L). No trough levels were below the lower limit of 2 mg/L in the CVVHDF and ADVOS groups. Meropenem machine clearance by CVVHDF was calculated to be 1.8 (± 0.5) L/h and 3.5 (± 1) L/h for ADVOS.</p><p><strong>Conclusion: </strong>Our results suggest that ADVOS treatment in critically ill patients receiving a high dose meropenem regimen (2 g IV q8h) does not lead to underdosing. Some trough values were even within potentially toxic levels, especially in the CVVHDF group, highlighting the importance of therapeutic drug monitoring.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"2103-2110"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}