Infection最新文献

{"title":"Creative illustration for choosing-wisely recommendations on asymptomatic bacteriuria of the Network Young Infection Medicine e.V. - jUNITE.","authors":"Kristin Heenemann, Sarah Kotsias-Konopelska, Jutta Pikalo, Sophie Schneitler, Viktoria Schneitler, Anna Schwabe","doi":"10.1007/s15010-024-02434-3","DOIUrl":"https://doi.org/10.1007/s15010-024-02434-3","url":null,"abstract":"","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663244","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":"Publisher Correction: 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/s15010-025-02511-1","DOIUrl":"https://doi.org/10.1007/s15010-025-02511-1","url":null,"abstract":"","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663247","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":"Publisher Correction: Outcomes for bloodstream infections due to K. pneumoniae NDM+ in Internal Medicine.","authors":"Simone Meini, Roberta Del Cesta, Francesco Sbrana, Javier Rosada, Davide Carrara, Maddalena Mura, Benedetta Longo, Roberto Andreini, Giuseppe Linsalata, Alessandro Fedele, Francesco Filidei, Andrea Ripoli, Elisabetta Andreoli, Enrico Tagliaferri, Spartaco Sani","doi":"10.1007/s15010-025-02509-9","DOIUrl":"https://doi.org/10.1007/s15010-025-02509-9","url":null,"abstract":"","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657165","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":"The blood biomarker combination IL-8/IL-33 and IL-18/IL-33 distinguish between active tuberculosis and latent infection.","authors":"Huimin Zhao, Zhenyan Chen, Douglas B Lowrie, Zhidong Hu, Shuihua Lu, Xiao-Yong Fan","doi":"10.1007/s15010-024-02454-z","DOIUrl":"https://doi.org/10.1007/s15010-024-02454-z","url":null,"abstract":"<p><strong>Purposes: </strong>A leading cause of death from infectious diseases worldwide is tuberculosis (TB), and it often arises from latent infection. New diagnostic tests for latent tuberculosis infection (LTBI) are needed. Therefore, this study aimed to identify novel biomarker signatures in whole human blood to distinguish between active tuberculosis (ATB) and LTBI.</p><p><strong>Methods: </strong>Two LEGENDplex^™ kits were used to evaluate the secretion levels of 20 cytokines triggered by ESAT-6/CFP10 antigen in whole blood of ATB, LTBI, and healthy controls, and to search for cytokine combinations utilized to distinguish between ATB and LTBI.</p><p><strong>Results: </strong>IL-8, IL-18, IL-33, MCP-1, MIG (baseline levels); IL-8, IL-33, IL-1β, MCP-1, MIG, IL-10, I-TAC (ESAT-6/CFP10-stimulated levels); and IL-18, IL-33, IL-1β, IL-10, TNF-α (ESAT-6/CFP10-stimulated minus baseline levels) had the potential to distinguish ATB from LTBI. Our data shows that the sensitivity and specificity of targeted IL-8 and IL-33 distinguishing between ATB and LTBI were 83.3% and 93.75%, and the diagnostic accuracy was 89.28%, and the sensitivity and specificity of targeted IL-18 and IL-33 distinguishing between ATB and LTBI were 91.67% and 81.25%, with the diagnostic accuracy was 85.71%.</p><p><strong>Conclusions: </strong>Our data suggest that IL-8/IL-33 and IL-33/IL-18 together can be utilized as immunological markers to differentiate between LTBI and ATB. A novel TB diagnostic protocol was established, offering novel perspectives to create better tests.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648436","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":"Infection prevention and control measures for multidrug-resistant organisms: a systematic review and network meta-analysis.","authors":"Yuhui Geng, Zhuo Liu, Xiaojuan Ma, Ting Pan, Mingbo Chen, Jingxia Dang, Ping Zhang, Chen Chen, Yuan Zhao, Dongfeng Pan, Peifeng Liang","doi":"10.1007/s15010-025-02498-9","DOIUrl":"https://doi.org/10.1007/s15010-025-02498-9","url":null,"abstract":"<p><strong>Background: </strong>The effectiveness of infection prevention and control measures combating multidrug-resistant organisms (MDROs) in healthcare settings remains controversial.</p><p><strong>Methods: </strong>PubMed, Embase, MEDLINE, Cochrane Library, and CINAHL were searched from inception to June 1, 2024. The interventions encompassed standard precautions (SP), contact precautions (CP), hand hygiene (HH), environmental cleaning (ENV), antimicrobial stewardship programs (ASP), decolonization (DCL), and chlorhexidine baths (CHG). The primary outcome were the acquisition, infection, and colonization of MDROs. Secondary outcomes were all-cause mortality and MDROs-associated bacteraemia. Effect indicators were expressed as rate ratios (RRs) with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>The study included a total of 97 articles, comprising 19 RCTs and 78 non-RCTs. The results showed that the most effective combination interventions for the acquisition, infection, and colonization of MDROs compared to SP varied as follows: CP + CHG (RR, 0.38 [0.18, 0.79]), SP + CP + ENV (RR, 0.04 [0.02, 0.08]), and SP + CHG (RR, 0.28 [0.14, 0.56]). In subgroup analyses, CP + CHG (RR, 0.36 [0.20,0.64]) was the most effective intervention for the acquisition of MDROs in the ICU setting, whereas SP + CP + ASP (RR, 0.35 [0.14,0.92]) was the most effective hospital-wide. Across subgroups, SP + CP + ENV (RR, 0.04 to 0.09 [95% CI, 0.01 to 0.99]) was identified as the most effective intervention for MDROs infections. In the ICU setting, SP + CHG (RR, 0.28 [0.14,0.56]) demonstrated the highest effectiveness in reducing the colonization of MDROs, whereas SP + CP + ENV + CHG (RR, 0.15 [0.06,0.38]) was the most effective on a hospital-wide scale. SP + CP + DCL (RR, 0.28 [0.24, 0.32]) was associated with reduced CRE colonization. The results of this study were robust according to the sensitivity analysis. None of the analyses related to secondary outcomes were statistically significant. In terms of article quality assessment, 94.7% of the RCTs were medium to high risk, while 92.31% of the non-RCTs. The primary limitation of the RCTs were related to the randomization process, whereas the non-RCTs were primarily affected by confounding bias.</p><p><strong>Conclusions: </strong>Effective interventions differ based on carriage status, intervention setting, and the resistant strain. Additionally, contact precautions is a crucial component of these combinations. Consequently, healthcare organizations can select appropriate interventions based on their unique resistance profiles to optimize precision and resource efficiency.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648464","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":"The added value of metagenomic next-generation sequencing in central nervous system infections: a systematic review of case reports.","authors":"Kira Waagner Birkeland, Laurence Mostert, Eric C J Claas, Hege Vangstein Aamot, Thomas Demuyser","doi":"10.1007/s15010-025-02502-2","DOIUrl":"https://doi.org/10.1007/s15010-025-02502-2","url":null,"abstract":"<p><strong>Background: </strong>The diversity of pathogens causing central nervous system (CNS) infections presents a diagnostic challenge. Patient demographics and geographical location affect the likelihood of certain pathogens causing infection. Current diagnostic methods rely on labour-intensive cultivation or targeted detection. Metagenomic next-generation sequencing (mNGS) is a promising tool for detecting pathogens in CNS infections, offering an unbiased approach. To enhance our understanding of patient demographics and the range of pathogens identified through mNGS, we conducted a systematic review of case reports.</p><p><strong>Methods: </strong>The PubMed database was searched in March 2024. Case reports on CNS infections and mNGS published from January 2014 through February 2024 were included based on predefined criteria.</p><p><strong>Results: </strong>The search yielded 649 articles, of which 76 were included, encompassing 104 patients. Most patients were male (75%), the median age was 31,5 years [0-75] and 28% were immunocompromised. The most common diagnosis was encephalitis (36%), followed by meningitis (23%) and meningoencephalitis (22%). 53 unique pathogens were identified, comprising 27 different viruses, 19 bacteria, 5 parasites, and 2 fungi. Syndromic encephalitis/meningitis panels would only have detected four of the viruses and five of the bacteria. Additionally, 14 of the bacterial species are considered slow-growing or fastidious and could be challenging to detect by culture.</p><p><strong>Conclusion: </strong>The application of mNGS in diagnosing CNS infections reveals the diversity of pathogens responsible for these severe infections, thereby improving diagnostics and facilitating targeted treatment. While case reports may be subjected to bias, they provide valuable insights into the use of mNGS in this clinical context.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624386","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 heterogeneity and treatment outcomes of extrapulmonary tuberculosis in a low-incidence setting: insights from a prospective cohort study.","authors":"Angela Klingmüller, Marie Feldmann, Samuel Rohr, Lea Helmhold, Lena Junker, Margarete Scherer, Jörg-Janne Vehreschild, Kirsten Schmidt-Hellerau, Ada Hoffmann, Jonathan Jantsch, Alexander Simonis, Victor Suárez, Dominic Rauschning, Natalie Funke, Jakob J Malin, Lena M Biehl, Philipp Schommers, Gerd Fätkenheuer, Clara Lehmann, Jan Rybniker, Isabelle Suárez","doi":"10.1007/s15010-025-02500-4","DOIUrl":"https://doi.org/10.1007/s15010-025-02500-4","url":null,"abstract":"<p><strong>Purpose: </strong>Tuberculosis (TB) remains a leading cause of morbidity and mortality, with 1.3 million deaths in 2022. Extrapulmonary tuberculosis (EPTB) accounts for approximately 20% of all TB cases. We assessed the clinical presentation and challenges during the course of treatment in EPTB patients in a low-incidence setting.</p><p><strong>Methods: </strong>We conducted a prospective cohort study involving 44 EPTB patients at the University Hospital of Cologne, Germany. Clinical data were collected before and during treatment.</p><p><strong>Results: </strong>The cohort comprised 44 patients originating from 21 countries. Two or more invasive procedures were required for microbiological confirmation in 59% (26/44) of the cases. Sputum culture was positive in 18% (8/44) of patients, with 63% (5/8) showing no radiological signs of pulmonary involvement. The median therapy duration was ten months and increased with disease severity. Paradoxical reactions (PR) occurred in 31% (13/42) of the patients. A previously published clinical scoring system assessing EPTB treatment responses showed a favorable treatment outcome in only 68% (21/31) of the patients in this cohort.</p><p><strong>Conclusion: </strong>EPTB exhibits highly variable disease severity and organ involvement. Treatment initiation is often delayed due to diagnostic challenges. Management is complicated by the frequent occurrence of PR, which can lead to treatment durations exceeding standard recommendations. Clinical scores for treatment response assessment may not be reliably applicable, highlighting the need for alternative biomarkers.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604775","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":"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":"https://doi.org/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":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insights into dysregulated innate immunity in the pathogenesis of COVID-19-associated pulmonary aspergillosis.","authors":"Hanxue Xiang, Ling Zhang, Miaotian Cai, Yulin Zhang","doi":"10.1007/s15010-025-02495-y","DOIUrl":"https://doi.org/10.1007/s15010-025-02495-y","url":null,"abstract":"<p><p>Coronavirus disease 2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) is a severe complication arising from the co-infection of viral and fungal pathogens in the lungs, with its incidence notably increasing. Although significant progress has been made in elucidating the pathogenesis of CAPA in recent years, the precise pathophysiological mechanisms underlying this condition remain only partially understood. Current evidence indicates that CAPA primarily results from dysregulation of innate antifungal immune responses. Key contributing factors include epithelial barrier dysfunction, impaired phagocytic activity against fungi, aberrant expression of antimicrobial peptides, immunologic tolerance, and lung dysbiosis, all of which collectively weaken host defense mechanisms. Concurrently, excessive pro-inflammatory responses-driven by cytokine storms and oxidative stress associated with antiviral immunity-further exacerbate lung injury in COVID-19 patients, creating a detrimental feedback loop that impairs immune function and heightens susceptibility to CAPA. In this review, we summarize and discuss recent advances in understanding the role of dysregulated innate immunity in the pathogenesis of CAPA. These insights may inform clinical management strategies and improve outcomes for patients suffering CAPA.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597170","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":"Streptococcus suis endocarditis: prognostic factors and antimicrobial resistance.","authors":"Wilawan Thipmontree, Udomsak Lerssuttipon, Piyapat Chunharas, Rattagan Kajeekul, Atitaya Lewrod, Suganya Yongkiettrakul, Anusak Kerdsin","doi":"10.1007/s15010-025-02497-w","DOIUrl":"https://doi.org/10.1007/s15010-025-02497-w","url":null,"abstract":"<p><strong>Purpose: </strong>Streptococcus suis is an important zoonotic pathogen worldwide. This study aims to identify prognostic factors associated with the development of infective endocarditis (IE) and mortality in patients with S. suis bacteremia.</p><p><strong>Methods: </strong>A retrospective cross-sectional study was conducted by reviewing the medical records of patients with culture-confirmed S. suis infection admitted to a tertiary care hospital in Thailand between 2021 and 2023.</p><p><strong>Results: </strong>Among 200 patients with S. suis bacteremia who underwent echocardiograms, 102 (51%) were diagnosed with IE. Between 2021 and 2023, resistance to penicillin in S. suis increased from 13.0 to 38.7%, while intermediate susceptibility to ceftriaxone rose from 2.2 to 13.3%. Patients with S. suis bacteremia were at higher risk of developing IE if the strains were penicillin-resistant (aPR: 7.94, 95% CI: 1.13-55.80) or if persistent bacteremia was present (aPR: 1.58, 95% CI: 1.27-1.96) in multivariable analysis. Other risk factors included illness duration of more than 14 days (aPR: 2.19, 95% CI: 1.66-2.89) and being under 60 years of age (aPR: 1.42, 95% CI: 1.09-1.83). All-cause in-hospital mortality for patients with S. suis IE was 28.4% (95% CI: 19.9-38.2), higher than that of patients without IE (15.3%, 95% CI: 8.8-24.0). Embolic stroke and acute kidney injury increased the risk of death 3.28-fold (95% CI: 1.82-5.91) and 2.87-fold (95% CI: 1.06-7.79), respectively, after adjusting for confounders.</p><p><strong>Conclusion: </strong>S. suis is a common cause of IE, particularly among antimicrobial-resistant strains, leading to high morbidity and mortality. Echocardiography is recommended for patients with S. suis bacteremia, although managing drug-resistant infections remains challenging.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572882","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}