Infection最新文献

{"title":"Hemophagocytic lymphohistiocytosis in people living with HIV-a single centre experience.","authors":"Pascal Migaud, Daniela Drauz, Alessia Dalla Pria, Kai Hosmann, Markus Müller, Leyli Ghaeni, Hartmut Stocker","doi":"10.1007/s15010-025-02573-1","DOIUrl":"10.1007/s15010-025-02573-1","url":null,"abstract":"<p><strong>Background: </strong>Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening hyperinflammatory syndrome that clinically resembles sepsis thus obscuring the underlying condition and delaying its diagnosis and therapy. Among the most common triggers are lymphomas and infectious diseases. Lymphoma-associated HLH appears to be more common in People living with HIV (PLWH).</p><p><strong>Methods: </strong>Retrospective cohort study comprising all adult HIV-infected patients with HLH treated at St. Joseph Hospital Berlin-Tempelhof, Germany, defined by HLH 2004-criteria and the HScore, between April 2020 and November 2024.</p><p><strong>Results: </strong>22 patients were included with at least 5/8 positive HLH criteria and a median HScore of 222 points. Median age was 44 [29-66] years. The median CD4-count at HLH-diagnosis was 100/µL [14-936]. In 8 (36%) patients the HIV-viral load was undetectable. HLH led to the diagnosis of HIV in 6 (27%) patients. In 20/22 patients an LPD was the HLH trigger. Hodgkin's lymphoma, HHV8-positive multicentric Castleman disease and HHV8-positive primary effusion lymphoma accounted for 8 (36%), 5 (23%) and 3 (14%) cases respectively. Kaposi sarcoma inflammatory cytokine syndrome (KICS) HHV8-positive plasmablastic lymphoma, HHV8-positive diffuse large B-cell lymphoma, DLBCL and invasive Aspergillosis were each found in 1 (4%) patient. All patients with Hodgkin's lymphoma had bone marrow involvement. In 1 patient simultaneous malaria and multiple myeloma were diagnosed. 11/22 (50%) patients had HHV8-associated conditions. 5 (23%) patients died within 30 days of the HLH-diagnosis.</p><p><strong>Conclusion: </strong>Lymphomas and HHV8-associated diseases are common triggers of HLH in PLWH and are linked to a high mortality rate.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"2203-2207"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208466","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":"Epidemiology of hospital-acquired bloodstream infections in haemato-oncology patients in Geneva, Switzerland.","authors":"Aleece MacPhail, Marie-Noëlle Chraïti, Aude Nguyen, Gaud Catho, Loic Fortchantre, Marie-Céline Zanella, Véronique Camus, Stavroula Masouridi-Levrat, Dionysios Neofytos, Zoe McQuilten, Stephan Harbarth, Niccolò Buetti","doi":"10.1007/s15010-025-02524-w","DOIUrl":"10.1007/s15010-025-02524-w","url":null,"abstract":"<p><strong>Background: </strong>Hospital-acquired bloodstream infections (HA-BSI), including catheter-associated bloodstream infections (CABSI), cause preventable harm in haemato-oncology patients but surveillance data are limited.</p><p><strong>Methods: </strong>We performed a retrospective cohort study using prospectively collected data in a large hospital network in Switzerland from 2017-2022. Incidence, source, and microbiology of HA-BSI were compared between (1) haematology patients with acute leukaemia or allogeneic stem cell transplantation (2) oncology patients with solid tumour or lymphoma, and (3) general medical patients. No routine quinolone prophylaxis was prescribed.</p><p><strong>Results: </strong>We included 320,058 patient-days and 201,081 catheter-days across two haematology, two oncology and nine non-COVID-19 general medical wards. 669 HA-BSI occurred in 547 individual patients. In haematology patients, HA-BSI incidence was 9.1/1000 patient-days (95% CI 8.2-10.3). 224/299 (75%) of episodes were \"unknown/other\" source. Low virulence Gram-positive organisms (coagulase-negative staphylococci, viridans Streptococci, enterococci) accounted for 232/378 (61%) HA-BSI organisms and 46/52 (88%) CABSI organisms. Compared to oncology and general medical patients, haematology patients had higher HA-BSI incidence, but a smaller proportion of infections caused by virulent organisms (Gram-negative bacteria, Staphylococcus aureus, p < 0.01).</p><p><strong>Conclusions: </strong>In haematology patients, HA-BSI are less commonly caused by virulent Gram-negative organisms or Staphylococcus aureus compared to solid tumour and general medical patients, in the absence of quinolone prophylaxis.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"1929-1939"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811298","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":"Prevalence and outcomes of Urinary tract infections caused by Enterobacterales resistant to third-generation cephalosporins in the Emergency Department: results from UTILY cohort, a prospective multicentre study.","authors":"Caterina Monari, Lorenzo Onorato, Alessandro Cornelli, Margherita Macera, Enrico Allegorico, Andrea Ferraro, Carmine Nasta, Maria Teresa Florio, Kim Russo, Piero Bianco, Vita Dora Iula, Fabio Giuliano Numis, Giovanna Guiotto, Mauro Giordano, Rosa Raucci, Ferdinando Dello Vicario, Rodolfo Nasti, Evaluna Perez Guillen, Nicola Coppola","doi":"10.1007/s15010-025-02547-3","DOIUrl":"10.1007/s15010-025-02547-3","url":null,"abstract":"<p><strong>Introduction: </strong>In accordance with the spread of drug-resistant bacteria worldwide, an increase in the prevalence of Antimicrobial Resistance (AMR) among pathogens causing urinary tract infections (UTIs) has been described globally. The aim of this study was to describe the prevalence and outcome of UTIs caused by third-generation cephalosporin-resistant (3GC-R) Enterobacterales in a prospective cohort of patients admitted to Emergency Department (ED).</p><p><strong>Materials and methods: </strong>We conducted an observational prospective multicentre study, involving 7 healthcare facilities, enrolling all consecutive adult patients admitted to ED with a microbiologically confirmed diagnosis of UTIs caused by Enterobacterales. The primary outcomes were the prevalence of UTIs caused by 3GC-R Enterobacterales, and 30-day mortality.</p><p><strong>Results: </strong>During the study period, we included 288 patients with urinary tract infection: 41.7% of subjects were males, median age was 72 years (IQR 56-81). The most frequently isolated pathogen was Escherichia coli (70.5%); 35.9% of all pathogens isolated were non-susceptible to 3GC. At multivariate logistic regression analysis, admission to a hospital (OR 3.31, 95% CI 1.41-7.75, p = 0.006) or a long-term care facility (OR 4.87, 95% CI 1.16-20.36, p = 0.03) in the previous three months was independently associated with isolation of a 3GC-R pathogen. Regarding the clinical outcomes, 22 out of 217 (10.1%) patients completing follow-up died at 30 days. At multivariate analysis 7-day clinical response was the only variable associated with 30-day mortality (OR 0.11, 95% CI 0.04-0.36, p < 0.001).</p><p><strong>Conclusions: </strong>In our study, 35.9% of pathogens isolated in urine cultures of patients with community-acquired UTIs were non-susceptible to 3GC. In the ED, the knowledge of local epidemiology and of risk factors for antimicrobial resistance is of paramount importance for choosing the right empiric therapy and setting up local guidelines.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"2061-2072"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978656","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":"Panoramic quantitative and visualization-based bibliometric analysis of Mycoplasma pneumoniae.","authors":"Jun Wang, Mo Wu, Mei Liu, Wenbin Tuo, Yu Shang, Yuxuan Tao, Tian Chen, Cong Yao, Zhen Xie, Yun Xiang, Qinzhen Cai, Chunhui Yuan","doi":"10.1007/s15010-025-02482-3","DOIUrl":"10.1007/s15010-025-02482-3","url":null,"abstract":"<p><strong>Purpose: </strong>Severe pneumonia, refractory pneumonia and extrapulmonary complications caused by mycoplasma pneumoniae infection were increasing, posing a serious threat to health. This study aimed to explore a breakthrough for further investigations in further.</p><p><strong>Methods: </strong>The Web of Science Core Collection was queried using the search term TS = \"mycoplasma pneumoniae\" for articles from January 1, 2009, to September 24, 2024. Bibliometric indicators were analyzed using VOSviewer, Pajek, and Scimago Graphica, while CiteSpace was utilized for visual analyses, including the contributions of different countries/regions, institutions, authorship patterns, journals, co-citations, keywords, and genes.</p><p><strong>Results: </strong>3,093 articles were collected and showed an increase interest in MPP research. China was the most prolific contributor, and the USA demonstrated the strongest collaboration willingness. The USA and China had the highest cooperation frequency and closest research relationship. The UK had the highest single-article citation count. Fudan University had the greatest total link strength. The top keywords were \"Mycoplasma Pneumoniae\" and \"community-acquired pneumonia\", with \"children\" being particularly prominent throughout the literatures. \"risk factors\" and \"plastic bronchitis\" may represent emerging hotspots in MPP research. Antibiotic therapy, herpes simplex virus infections, and serology detection were the high interest surrounding topics over past decade. mNGS, severe community-acquired pneumonia, co-infections of adenovirus or RSV may become focal points in future. CRP and IL-17 A represented significant genes among MP infection. Positive regulation of cytokine production played a critical role in MP infection.</p><p><strong>Conclusion: </strong>This bibliometric analysis provides insights into its status, frontiers, and hotspots, offering essential guidance to address challenges in MP.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"1699-1713"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399093","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":"Global, regional, and national burden of lower respiratory infections and chronic obstructive pulmonary disease, 1990-2021: a systematic analysis from the global burden of disease study 2021.","authors":"Yi-Yuan Wang, Jing Wang, Zhang-Wei Lu, Qian-Qian Zhou, Yang-Guang Cao, Yu-Jie Du, Xue Jin, Bao-Zhu Li","doi":"10.1007/s15010-025-02566-0","DOIUrl":"10.1007/s15010-025-02566-0","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluates the global burden of lower respiratory infections (LRIs) and chronic obstructive pulmonary disease (COPD), focusing on their combined impact across age groups and regions.</p><p><strong>Methods: </strong>Data from 204 countries were analyzed using spatiotemporal Gaussian process regression to estimate LRI and COPD incidence, prevalence, and disability-adjusted life years (DALYs). Age-standardized ratios (ASR) and the Socio-Demographic Index (SDI) were used to compare disease burdens, with trends assessed via linear regression and restricted cubic spline models.</p><p><strong>Results: </strong>In 2021, COPD and LRI caused 360 million cases and 5.9 million deaths, with the highest burden in low-SDI regions. COPD remained the fourth leading cause of death, while LRI dropped to seventh.</p><p><strong>Conclusion: </strong>The bidirectional link between LRI and COPD exacerbates disease progression, disproportionately affecting low-income regions and aging populations. Addressing disparities in healthcare access, improving vaccines, and strengthening public health infrastructure are critical to reducing the global burden of these diseases.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"2191-2202"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198987","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":"Cardiac structure and function 1.5 years after COVID-19: results from the EPILOC study.","authors":"Jana Schellenberg, Lynn Matits, Daniel A Bizjak, Peter Deibert, Birgit Friedmann-Bette, Siri Göpel, Uta Merle, Andreas Niess, Norbert Frey, Oliver Morath, Gunnar Erz, Raphael S Peter, Alexandra Nieters, Dietrich Rothenbacher, Winfried V Kern, Jürgen M Steinacker","doi":"10.1007/s15010-025-02481-4","DOIUrl":"10.1007/s15010-025-02481-4","url":null,"abstract":"<p><strong>Purpose: </strong>Impaired left and right ventricular (LV/RV) function during acute SARS-CoV-2 infection has been predominantly reported in hospitalized patients, but long-term cardiac sequelae in large, well-characterized cohorts remain inconclusive. This study evaluated cardiac structure and function in individuals with post-Coronavirus disease (COVID) syndrome (PCS) compared to recovered controls (CON), focusing on associations with cardiopulmonary symptoms and rapid physical exhaustion (RPE).</p><p><strong>Methods: </strong>This multicenter, population-based study included 1154 participants (679 PCS, 475 age- and sex matched CON; mean age 49 ± 12 years; 760 women) 1.5 years post-infection. Transthoracic echocardiography assessed LV global longitudinal strain (GLS), RV GLS and RV free wall strain (FWS), and other measures. Cardiopulmonary exercise testing (CPET) measured maximum respiratory oxygen uptake (VO₂max) as a marker of cardiopulmonary fitness.</p><p><strong>Results: </strong>PCS participants exhibited significantly lower LV GLS (-20.25% [-21.28 - -19.22] vs. -20.73% [-21.74 - -19.72], p = 0.003), reduced diastolic function (E/A 1.16 [1.04-1.27] vs. 1.21 [1.1-1.32], p = 0.022) and decreased TAPSE (24.45 mm [22.14-26.77] vs. 25.05 mm [22.78-27.32], p = 0.022) compared to CON, even after adjusting for confounders. RV strain values were similar between groups. LV GLS correlated inversely with VO₂max (p = 0.004) and positively with RPE (p = 0.050), though no associations were observed with other cardiopulmonary symptoms.</p><p><strong>Conclusions: </strong>This study demonstrates subtle yet consistent reductions in LV function, specifically LV GLS and diastolic function, and exercise capacity in PCS compared to CON. While these changes are within reference ranges, their potential impact on clinical outcomes warrants further investigation. These findings highlight the need for cardiac assessments and long-term follow-up in symptomatic PCS patients.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"1685-1697"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483036","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":"NDM-5 and siderophore receptor mutations drive high-level cefiderocol resistance in Klebsiella pneumoniae: a case series.","authors":"Michelle H Potter, Wajih Askar, Gerardo F Gomez-Abundis, Kent Carpenter, Emir Kobic","doi":"10.1007/s15010-025-02647-0","DOIUrl":"https://doi.org/10.1007/s15010-025-02647-0","url":null,"abstract":"<p><strong>Background: </strong>Infections with Carbapenem-resistant Enterobacterales (CREs) are a serious public health threat. The emergence of distinct New Delhi metallo-beta-lactamase (NDM)-producing K. pneumoniae strains resistant to cefiderocol is a significant concern given the limited armamentarium for these carbapenemases.</p><p><strong>Methods: </strong>A case series of 12 patients was described from a single institution that had cefiderocol-resistant, NDM-producing K. pneumoniae infections between January 2023 and July 2024. Whole genome sequencing with core SNP analysis was performed to identify resistance mechanisms and clonal relatedness for 9 isolates.</p><p><strong>Results: </strong>Patients presented with various infections, including skin and soft tissue infections, pneumonia, and bacteremia. Of concern, cefiderocol resistance was seen among patients with and without prior cefiderocol exposure. Genomic analysis for 9 patients revealed NDM-5 in every isolate, along with additional mutations associated with resistance. A cluster of ST147 identified multiple distinct CirA disruptions, suggestive of convergent evolution with or without cefiderocol exposure. Treatment with either ceftazidime-avibactam plus aztreonam or tigecycline was successful in most instances, although microbiologic recurrence occurred in certain cases.</p><p><strong>Conclusion: </strong>High level cefiderocol resistance among NDM-5 producing K. pneumoniae with siderophore mutations add more challenges to treating CRE infections. Stricter infection control measures along with enhanced surveillance are needed, especially in regions where NDM is endemic to limit additional spread of these variants.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199231","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":"Applications of human lung organoids to human respiratory virus research: advances, limitations and future directions.","authors":"Qi Chen, Huaiqing Qi, Jun Guo","doi":"10.1007/s15010-025-02587-9","DOIUrl":"10.1007/s15010-025-02587-9","url":null,"abstract":"<p><p>Human respiratory viruses (HRVs) can cause a spectrum of respiratory infections, which pose a significant challenge to global public health and are associated with a substantial economic impact. Traditional studies have often relied on in vitro culture systems utilizing transformed cell lines and animal models. However, there has been a shift towards emerging research models. Organoids are three-dimensional cell cultures that self-organize and differentiate into functional cell types, closely mimicking the structure and function of organs in vivo. Increasing evidence suggests that human lung organoids serve as reliable and effective models for studying HRVs. In this review, we compare common research models for HRVs, outline the establishment of human lung organoids, and explore their applications in HRV studies.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"1663-1675"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475085","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 impact of bronchoalveolar lavage fluid metagenomic next-generation sequencing in immunocompromised patients with severe community-acquired pneumonia in ICU: a multicenter retrospective study.","authors":"Junjie Zhao, Runxi Zhuge, Bangchuan Hu, Yesong Wang, Xingxing Wang, Yi Zhang, Lingmin Yuan, Canhu Qiu, Youqin Yan, Xiaojing Zhang, Zhidan Hua, Jing Tang, Kai Guo, Yong Sun, Kaiyu Wang, Liyan Qiu, Jian Luo, Weiwen Zhang, Jiancheng Zhuge, Honglong Fang","doi":"10.1007/s15010-025-02520-0","DOIUrl":"10.1007/s15010-025-02520-0","url":null,"abstract":"<p><strong>Background: </strong>An increasing number of critically ill patients are immunocompromised. These patients are at high risk of intensive care unit (ICU) admission because of numerous complications. Acute respiratory failure due to severe community-acquired pneumonia (SCAP) is one of the leading causes of admission. Early targeted antibiotic therapy is crucial for improving the prognosis of these patients. Metagenomic next-generation sequencing (mNGS) in bronchoalveolar lavage fluid (BALF) has shown significant value in pathogen detection in recent years. However, there are few studies on summarizing pathogen profiles of SCAP in immunocompromised patients.</p><p><strong>Methods: </strong>We performed a multicenter retrospective analysis of patients with SCAP in the ICU diagnosed between May 2021 to October 2024. Bronchoalveolar lavage fluid (BALF), blood, and sputum samples were collected and subjected to mNGS and conventional microbiological tests (CMTs). The pathogen profiles detected by the two methods were compared.</p><p><strong>Results: </strong>In our study, compared to CMTs, mNGS increased the detection rates of mixed infections in the immunocompromised group (58.82% vs 17.96%, P < 0.05) and immunocompetent group (44.58% vs 18.72%, P < 0.05), while also reducing the rate of no pathogen detected (4.90% vs 38.73%, P < 0.05; 8.37% vs 32.76%, P < 0.05). In both groups, the proportion of positive clinical impacts (diagnosis) resulting from mNGS results exceeded 90% (96.57% vs 93.84%), and the treatment effectiveness rate in the immunocompromised group was higher than in the immunocompetent group (65.69% vs 56.40%, P < 0.05). Further analysis showed that when mNGS-guided treatment was effective, the 28-day mortality rate significantly improved in both the immunocompromised group (31.34% vs 74.29%, P < 0.05) and the immunocompetent group (42.36% vs 40.68%, P < 0.05) compared to when the treatment was ineffective.</p><p><strong>Conclusion: </strong>This study indicates that ICU patients with SCAP, particularly those who are immunocompromised, are more likely to have polymicrobial infections. mNGS in BALF provides rapid and comprehensive pathogen profiling of pulmonary infections, thereby having a positive impact on both the diagnosis, treatment and prognosis of immunocompromised patients with SCAP.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"1911-1927"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003188","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":"The adverse impact of cytomegalovirus infection on intensive care units outcomes in critically ill COVID-19 patients: a single-center prospective observational study.","authors":"Marina López-Olivencia, Raúl de Pablo, Noemí Paredes de Dios, Susana García-Plaza, Sergio Sáez-Noguero, Javier Sáez de la Fuente, Jesús Fortún, María Cruz Soriano Cuesta","doi":"10.1007/s15010-025-02499-8","DOIUrl":"10.1007/s15010-025-02499-8","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the incidence and clinical impact of CMV infection in critically ill COVID-19 patients, examining ICU and hospital mortality, and length of hospital stay.</p><p><strong>Methods: </strong>In this single-center, prospective observational study (March 2020 - September 2022), 431 patients with COVID-19 pneumonia and moderate to severe ARDS were included. An active CMV surveillance protocol was implemented, analyzing CMV DNA in plasma and bronchoalveolar lavage (BAL). Clinical characteristics and outcomes were compared between CMV-COVID co-infected patients and those without CMV reactivation.</p><p><strong>Results: </strong>CMV-COVID co-infection was detected in 14.8% (64/431) of the cohort. Patients with CMV-COVID co-infection exhibited significantly higher ICU mortality (43.8% vs. 13.6%; p < 0.001) and hospital mortality (48.4% vs. 13.6%; p < 0.001) compared to patients without CMV. CMV infection was an independent predictor of hospital mortality (OR 4.91; 95% CI 2.76-8.75; p = 0.019). Earlier CMV reactivation was associated with an increased risk of hospital mortality (HR = 0.94; 95% CI: 0.90-0.98; p = 0.003). Additionally, CMV-COVID patients had a higher incidence of ICU-acquired infections and a prolonged hospital stay.</p><p><strong>Conclusions: </strong>In critically ill patients with SARS-CoV-2 pneumonia, CMV infection was frequently observed, and associated with increased ICU and hospital mortality. CMV co-infection correlated with a higher incidence of ICU-acquired bacterial and fungal infections and prolonged hospital stays. This emphasizes the importance of early CMV monitoring upon ICU admission, as timely detection and intervention could potentially mitigate its impact on patient outcomes.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"1801-1808"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663248","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}