Infection最新文献

{"title":"Letter to the editor: serum copper, zinc and selenium and their ratios as predictors of pneumonia death risk in men: the Kuopio ischaemic heart disease risk factor study.","authors":"Manisha Chamanlal, Karan Chaman Lal, Pirthvi Raj, Puja -","doi":"10.1007/s15010-025-02615-8","DOIUrl":"10.1007/s15010-025-02615-8","url":null,"abstract":"","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873016","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":"Predictors of therapeutic exposure and pharmacokinetic variability of second-line anti-TB drugs in MDR-TB patients: a retrospective study.","authors":"Chilie Quncuo, Wei Dan Ye, Jing Yang, Jian-Qing He","doi":"10.1007/s15010-025-02620-x","DOIUrl":"https://doi.org/10.1007/s15010-025-02620-x","url":null,"abstract":"<p><strong>Background: </strong>Therapeutic drug monitoring (TDM) is increasingly recommended for managing multidrug-resistant tuberculosis (MDR-TB) due to significant interindividual pharmacokinetic variability. However, data on plasma concentration variability and associated patient factors for second-line anti-TB drugs remain limited.</p><p><strong>Methods: </strong>We conducted a retrospective observational study including 74 patients with MDR-TB at West China Hospital, Sichuan University, from January 2022 to December 2024. Plasma concentrations of second-line drugs (levofloxacin, cycloserine, clofazimine, bedaquiline, and linezolid) were measured at steady-state. We analyzed therapeutic target attainment rates, evaluated correlations between drug concentrations and patient baseline characteristics, and explored predictors of drug exposure using multivariable linear regression.</p><p><strong>Results: </strong>Significant interindividual variability in drug exposure was observed across the studied second-line anti-TB drugs. Clofazimine demonstrated the highest therapeutic target attainment (72.7%), while bedaquiline had the lowest (21.1%). For levofloxacin, 29.8% of patients achieved therapeutic concentrations, whereas cycloserine reached target levels in 43.2% of cases. Age was positively correlated with cycloserine concentrations (ρ = 0.328, p = 0.030). Multivariable regression identified age and liver enzymes (ALT and AST) as independent predictors of levofloxacin exposure. Specifically, elevated ALT was associated with lower levofloxacin levels (B = -0.191, 95% CI: -0.337 to -0.045), while elevated AST was linked to higher levels (B = 0.292, 95% CI: 0.080 to 0.503). Linezolid trough concentrations showed a negative correlation with RBC count, and peak concentrations were positively associated with ESR. Additionally, bedaquiline concentrations correlated positively with CRP levels.</p><p><strong>Conclusion: </strong>Our findings highlight substantial pharmacokinetic variability among second-line anti-TB drugs, influenced by patient age, liver function, and systemic inflammation. These results underscore the potential importance of individualized dosing and routine TDM in optimizing drug exposure and minimizing toxicity in patients with MDR-TB.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834968","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 of ICU-acquired infections with a focus on bloodstream infections: a single-center retrospective registry study.","authors":"Tero I Ala-Kokko, Jaana M Karhu, Pasi Lehto, Sinikka Sälkiö, Pasi Ohtonen, Hannu Syrjälä","doi":"10.1007/s15010-025-02621-w","DOIUrl":"https://doi.org/10.1007/s15010-025-02621-w","url":null,"abstract":"<p><strong>Objectives: </strong>Intensive care unit (ICU) patients have an increased risk of bacteremia. We aimed to investigate the 5-year outcome of ICU-acquired infections comparing them with ICU patients without new infections. Our second aim was to compare the outcome of Gram-positive, Gram-negative and fungal ICU-acquired bloodstream infections (BSIs).</p><p><strong>Methods: </strong>This single-center retrospective registry study occurred in an academic teaching hospital during 2000-2017 in a mixed adult ICU consisting of patients who stayed longer than 48 h in the ICU. Data was retrieved from the ICU and hospital electronic data management systems. Three groups were included: no infection and no new antimicrobial treatment, a new ICU-acquired infection with negative blood cultures (BCs), and a new ICU-acquired BSI. A multivariable-adjusted Cox proportional hazards model was used to determine the impact of ICU-acquired infection on 5-year mortality.</p><p><strong>Results: </strong>1857 had no infection and 768 developed an ICU-acquired infection with positive BCs in 195 cases (25.4%). The adjusted HR was 2.03 (95% CI from 1.76-2.35, p < 0.001) for the impact of ICU-acquired infection on 5-year mortality. The highest median sequential organ failure assessment (SOFA) was 7.0 (5.0-8.0) for the no-infection group, 9.0 (7.0-10.0) for the BC-negative ICU-acquired infection group, and 12.0 (9.0-15.0) for the ICU-acquired BSI patients (p < 0.001). The crude 30-day mortalities in the no-infection, the BC-negative, and the BSI groups were 98 (5.5%), 58 (10.1%), and 51 (26.0%), respectively (p < 0.001). The highest median SOFA for Gram-positive BSIs was 11.0 (8.0-13.0), for Gram-negative BSIs 13.0 (11.0-16.0), and for fungal BSIs 12.5 (10.0-16.0) (p = 0.01). The need for RRT was 23.2% (19) in Gram-positive, 29.8% (14) in Gram-negative, and 48.1% (25) in fungal BSIs (p = 0.01). The crude ICU-mortalities were 12.2% (10) in Gram-positive BSIs, 31.9% (15) in Gram-negative BSIs, and 11.5% (6) in fungal BSIs (p = 0.008). Patients with fungal BSI had the worst 5-year outcome, whereas the long-term outcome did not differ between Gram-positive and Gram-negative BSIs.</p><p><strong>Conclusions: </strong>Patients with ICU-acquired infections had three times higher 5-year mortality than non-infected ICU patients. ICU-acquired Gram-negative BSIs had the highest ICU mortality, whereas the long-term outcome did not differ between Gram-negative and Gram-positive ICU-acquired BSIs. Fungal BSI showed the worst long-term outcome.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144845882","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":"Human metapneumovirus (hMPV): the virus who came with the common cold.","authors":"Varun Pandey, Preeti Shahi, George Kolios, Muhammad Ikhtear Uddin, Michail Spathakis, Alexandra R Collins, Vasilis Paspaliaris, Ambak Kumar Rai","doi":"10.1007/s15010-025-02626-5","DOIUrl":"https://doi.org/10.1007/s15010-025-02626-5","url":null,"abstract":"<p><p>Human metapneumovirus (hMPV) is a significant cause of respiratory infections worldwide, particularly in young children, the elderly, and immunocompromised individuals. Since its discovery in 2001, hMPV has been recognized as a major contributor to acute respiratory tract infections, along with respiratory syncytial virus (RSV) and influenza. This review explores the virology, epidemiology, pathogenesis, clinical manifestations, diagnostic methods, and recent advances in therapeutic and preventive strategies for hMPV infection. By consolidating current knowledge, we aim to highlight the importance of hMPV in public health and the need for continued research to address its clinical and economic burdens.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144821307","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":"Tick-borne encephalitis in Latvia: an epidemiological and clinical comparison of European and Siberian subtype infections.","authors":"Zane Freimane, Gerhard Dobler, Guntis Karelis, Sanita Kuzmane, Oksana Savicka, Lidia Chitimia-Dobler, Maksims Zolovs, Dace Zavadska","doi":"10.1007/s15010-025-02616-7","DOIUrl":"https://doi.org/10.1007/s15010-025-02616-7","url":null,"abstract":"","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144821308","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":"Blood transcriptomic for the diagnosis of nosocomial infections in critically ill patients: an observational proof-of-concept study.","authors":"Ruben Martín-Latorre, Kaya Haener, Hugo Arrando, Juan Frasquet, Mónica Gordón, Amparo Martinez, Carlos Folgado, Álvaro Castellanos-Ortega, Paula Ramirez","doi":"10.1007/s15010-025-02602-z","DOIUrl":"https://doi.org/10.1007/s15010-025-02602-z","url":null,"abstract":"<p><strong>Purpose: </strong>The assessment of genetic activation has shown good diagnostic capacity in identifying sepsis in patients at the emergency department or upon admission to the intensive care unit. This study evaluates a gene expression diagnostic test for identifying nosocomial infections in critically ill patients and compares it with well-established tests used in routine clinical practice.</p><p><strong>Methods: </strong>This was a prospective, observational, non-interventional study conducted in a single intensive care unit of a tertiary university hospital. Adult critically ill patients were enrolled if their attending physician suspected a nosocomial ICU-acquired infection, and a comprehensive microbiological study was performed. The genetic host response was assessed using the SeptiCyte RAPID assay at study inclusion, alongside microbiological, analytical, and radiological evaluations.</p><p><strong>Results: </strong>Sixty-nine patients were enrolled, of whom 78.3% (n 54) received empirical antimicrobial treatment. ICU-acquired infection was confirmed in 35 patients (50.7%). A bacterial etiology was established in 32 cases (91.4%), and viral reactivation was diagnosed in 2 cases (5.7%). Diagnostic capacity was measured as follows: procalcitonin AUC 0.600 (95% CI 0.454-0.745), C-reactive protein AUC 0.703 (95% CI 0.564-0.839) and Septi-Cyte RAPID AUC 0.995 (95% CI 0.930-1.003). The optimal cut-off point for Septi-cyte score was 6.35, yielding a sensitivity of 91.4%, specificity of 73.5%, and positive and negative predictive values of 78% and 89.3%, respectively.</p><p><strong>Conclusions: </strong>Genetic activation analysis in patients with suspected ICU-acquired nosocomial sepsis demonstrated good diagnostic capability, even surpassing traditional inflammatory biomarkers.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816457","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":"Diagnostic performance of adenosine deaminase for extrapulmonary tuberculosis in a higher-prevalence area of mainland France: a 10-year retrospective study.","authors":"Quiterie Boscals de Réals, Ugo Françoise, Nicolas Vignier, Hervé Delacour, Frédéric Méchaï","doi":"10.1007/s15010-025-02579-9","DOIUrl":"https://doi.org/10.1007/s15010-025-02579-9","url":null,"abstract":"<p><strong>Purpose: </strong>Diagnosing extrapulmonary tuberculosis (EPTB) - including pleural, peritoneal, pericardial, meningeal forms - remains challenging due to the insufficient sensitivity of smear microscopy (SM), mycobacteriological culture, and nucleic acid amplification test (NAAT). The Adenosine Deaminase (ADA) assay has potential as a diagnostic tool for EPTB, but its performance in high-income countries is poorly documented. This study aimed to evaluate the diagnostic performance of ADA for microbiologically confirmed EPTB in such a setting.</p><p><strong>Methods: </strong>We retrospectively analyzed data from all patients undergoing ADA testing in our hospital network in Paris area between May 2014 and April 2024. Microbiological confirmation (positive SM, culture, or NAAT) from the same sample site served as the reference standard.</p><p><strong>Results: </strong>Among 363 ADA assays (352 patients), 69% were pleural fluid, 18% peritoneal, < 1% pericardial, 11% CSF. For pleural fluid, ADA at a threshold of 30 U/L demonstrated 92% sensitivity (CI 80-98%), 75% specificity (CI 68-81%), 47% PPV (CI 37-57%), and 97% NPV (CI 94-99%). For peritoneal fluid, sensitivity, specificity, PPV, and NPV were 77% (CI 46-95%), 81% (CI 69-91%), 50% (CI 27-73%), and 94% (CI 82-99%), respectively. Raising the ADA threshold to 60 U/L improved specificity to 92% in pleural fluid (CI 87-95%) and 85% in peritoneal fluid (CI 73-93%). Combining ADA with other biomarkers showed no added diagnostic value.</p><p><strong>Conclusion: </strong>ADA testing is a rapid and practical tool for EPTB diagnosis. In pleural and peritoneal fluids, a threshold < 30 U/L effectively excludes EPTB, while a threshold > 60 U/L supports initiating treatment pending culture results.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144798900","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":"Immunogenicity and safety of the accelerated 2-dose intradermal rabies pre exposure prophylaxis regimen in immunocompetent and immunocompromised pediatric populations: a comparative study.","authors":"Anurag Agarwal, Charu Singh, Surendra Bahadur Mathur, Vikas Manchanda, Kashvi Agarwal, Mukta Mantan, Amir Maroof Khan","doi":"10.1007/s15010-025-02623-8","DOIUrl":"https://doi.org/10.1007/s15010-025-02623-8","url":null,"abstract":"<p><strong>Purpose: </strong>Rabies is a fatal zoonotic disease, and India accounts for 35% of global rabies-related deaths. In 2018, the World Health Organization (WHO) revised its guidelines for pre-exposure prophylaxis (PrEP) from a 3-dose to a cost-saving 2-dose intradermal (ID) regimen. This study evaluates the immunogenicity and safety of this regimen in pediatric populations, including children exposed to immunosuppressant therapy.</p><p><strong>Methods: </strong>This single-center, prospective, comparative follow-up study was conducted at a tertiary care hospital. Participants (5-18 years) were enrolled into two groups: (1) children with no known immunodeficiency (n = 31) and (2) children on immunosuppressant therapy (n = 10). All received Vero cell culture rabies vaccine (RABIVAX-S^®) intradermally at two sites on days 0 and 7. Serum anti-rabies virus glycoprotein antibody titres were assessed on days 28, 90, and 180 using an ELISA-based assay. Booster doses were administered to those with insufficient titers (≤ 0.5 EU/ml).</p><p><strong>Results: </strong>By day 28, both groups achieved a 100% seroconversion rate (SCR). Geometric mean titers (GMT) were 2.168 EU/ml and 1.547 EU/ml in the no-known-immunodeficiency and immunosuppressant therapy groups, respectively. At day 90, SCRs were 90% and 70%, with GMTs of 1.358 EU/ml and 0.962 EU/ml, respectively. Booster doses restored titers in all participants with insufficient levels. Pain at the injection site was the only solicited adverse effect.</p><p><strong>Conclusions: </strong>The 2-dose ID PrEP regimen is immunogenic and safe in pediatric populations, including immunosuppressed children. It offers a cost-effective alternative in rabies-endemic regions, enhancing compliance and accessibility.</p><p><strong>Trial registration: </strong>Prospectively registered with the Clinical Trials Registry India with Trial Registration No. CTRI/2022/10/046777.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144798901","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 \"Caseload, clinical spectrum and economic burden of infectious diseases in patients discharged from hospitals in Germany\" Stocker et al., 2025 doi: 10.1007/s15010-025-02507-x.","authors":"Jana Schroeder, Irit Nachtigall, Christian Lanckohr, Hendrik Bracht, Frederike Lund, Alexander Brinkmann, Markus Weigand, Katharina Schüller","doi":"10.1007/s15010-025-02618-5","DOIUrl":"10.1007/s15010-025-02618-5","url":null,"abstract":"","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144798902","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":"Recent updates regarding the management and treatment of pneumonia in pediatric patients: a comprehensive review.","authors":"Yan Ma, Sen Fan, JiaShui Xi","doi":"10.1007/s15010-025-02605-w","DOIUrl":"https://doi.org/10.1007/s15010-025-02605-w","url":null,"abstract":"<p><p>Pneumonia remains one of the leading causes of illness and death among children, particularly in low- and middle-income countries. This review presents a comprehensive update on pediatric pneumonia, covering recent advances in etiology, clinical presentation, diagnostic tools, treatment strategies, and prevention efforts. We explore both traditional and emerging diagnostic methods, including the use of biomarkers like C-reactive protein and procalcitonin, molecular testing, and point-of-care lung ultrasound. Treatment approaches are discussed in detail, with a focus on appropriate antibiotic use, antiviral and antifungal therapies, supportive care such as oxygen therapy and fluid management, and newer interventions like high-flow nasal cannula therapy. Preventive measures, including the introduction and global rollout of pneumococcal, influenza, and RSV vaccines, are also emphasized. In addition, the review highlights ongoing challenges such as antimicrobial resistance, healthcare disparities, and the limited accessibility of advanced diagnostic tools in resource-poor settings. Finally, we outline research gaps and stress the need for strong public health policies, global collaboration, and continued innovation to reduce the burden of pediatric pneumonia and improve outcomes for children worldwide. Highlights Pediatric pneumonia continues to cause high morbidity and mortality, especially in low- and middle-income countries. Advances in diagnostics, including lung ultrasound, procalcitonin testing, and molecular tools, have improved early detection. Rational antibiotic use and stewardship programs are vital to addressing rising antimicrobial resistance. New preventive tools, such as pneumococcal, influenza, and RSV vaccines, play a key role in reducing disease burden. Health disparities and limited access to care remain major challenges, highlighting the need for policy reforms and global health initiatives.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144788890","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}