Infection最新文献

{"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":"https://doi.org/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":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suspected Buruli ulcer cases in Tonkolili District, Sierra Leone- a prospective cohort study.","authors":"Jonathan Vas Nunes, Lars Wassill, Giulia Mönnink, Abdul-Mac Falama, Hanna Mathéron, Amara Conteh, Maxwell Sesay, Aminata Sesay, Håkon Bolkan, Martin P Grobusch, Frieder Schaumburg","doi":"10.1007/s15010-025-02548-2","DOIUrl":"https://doi.org/10.1007/s15010-025-02548-2","url":null,"abstract":"<p><strong>Purpose: </strong>There is a high burden of chronic ulcers in Sierra Leone. However, (early) diagnosis and treatment are challenging. Data on endemicity of Mycobacterium ulcerans is limited to WHO reports from 2008 to 2011.</p><p><strong>Methods: </strong>Patients presenting with wounds at Masanga Teaching Hospital were included in a prospective cohort study and scored following the WHO clinical list for Buruli ulcer (BU). Wounds were screened for M. ulcerans by selective culture on solid and liquid media and loop-mediated isothermal amplification (LAMP) of the M. ulcerans specific IS2404.</p><p><strong>Results: </strong>Between July 2019 and November 2020, 159 patients were included. The median age was 41 years (range: 2-92), 34% (54/159) were female and 56% (89/159) were literate. The median duration of a wound before admission was 12 months (range: 0-720 months), 87% (137/159) of lesions were below the knee. Wounds of 37% (58/159) of the patients were clinically scored as '(very) likely to be Buruli ulcer'. Seven out of 72 patients tested by LAMP were positive for IS2404, two showed specific melting curves. None of the wound swabs yielded a positive culture for M. ulcerans. Ninety-eight (62%) patients had a wound-related surgery during this study, 101 (63%) of patients were improving or healed at the time of discharge.</p><p><strong>Conclusions: </strong>The prevalence of BU based on the WHO scoring system is high in Sierra Leone. National and international awareness, training of healthcare workers, development of in-country bacteriology as well as the furthering of robust molecular and immunological assays could reduce the burden of this neglected tropical disease.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110751","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":"Diagnosis, management and prevention of loiasis: guideline of the German Society for Tropical Medicine, Travel Medicine, and Global Health (DTG).","authors":"Michael Ramharter, Stefan Schlabe, Marc P Hübner, Pia Michelitsch, Florian Kurth, Sabine Bélard, Tamara Nordmann, Saskia Dede Davi","doi":"10.1007/s15010-024-02443-2","DOIUrl":"https://doi.org/10.1007/s15010-024-02443-2","url":null,"abstract":"<p><p>Loiasis is a complex filarial infection endemic in Central Africa and parts of West Africa. Loa loa is transmitted by the deer fly Chrysops dimidiata and C. silacea. The clinical manifestation of the disease is highly variable ranging from asymptomatic infection, symptomatic disease, to life-threatening complications. The diagnosis of L. loa infection is challenging due to a significant proportion of occult infections and a lack of reliable point of care tests. While diethylcarbamazine is the gold standard for curative treatment in many non-endemic countries, its use is limited in endemic regions due to its propensity for severe adverse drug reactions that may occasionally lead to life threatening complications. Alternative treatment regimens have specific indications and limitations in the treatment of loiasis. In this guideline, issued by the German Society for Tropical Medicine, Travel Medicine, and Global Health, recommendations for the diagnosis, management, treatment, and prevention of loiasis are provided based on the currently available best evidence, and gaps in our understanding are highlighted.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110638","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":"Cellulosimicrobium cellulans endocarditis: a challenge for detection and treatment in interdisciplinary teams.","authors":"Tonina T Mueller, Julius Steffen, Clemens Scherer, Matthias Wa Angstwurm","doi":"10.1007/s15010-025-02551-7","DOIUrl":"https://doi.org/10.1007/s15010-025-02551-7","url":null,"abstract":"<p><p>We present a case of subacute endocarditis with the detection of Cellulosimicrobium cellulans after tricuspid valve replacement and pacemaker extraction without detection in blood cultures before pacemaker extraction despite multiple testing. This atypical pathogen has rarely been reported in cases of subacute endocarditis, particularly in non-immunocompromised patients. Treatment was initiated using fosfomycin and flucloxacillin and switched to vancomycin upon pathogen detection after pacemaker lead removal and tricuspid valve replacement. Interdisciplinary cooperation between cardiologists, cardiothoracic surgeons, and the infectious disease team enabled an accurate diagnosis and optimized antibiotic therapy before surgical intervention.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093526","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":"Fusarium oxysporum infection: a rare case of fusarium oxysporum resistance to amphotericin b following traumatic intracranial injury in an 18-month-old boy.","authors":"Matthias Krause, Arwin Rezai, Matthias Schaffert, Konstanze Pfeiffer, Christoph J Griessenauer, Johann Gradl, Cornelia Lass-Flörl, Jan Marco Kern","doi":"10.1007/s15010-025-02560-6","DOIUrl":"https://doi.org/10.1007/s15010-025-02560-6","url":null,"abstract":"","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093527","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":"A very rare case of osseous involvement of the dens axis in a 52-year-old HIV positive patient as part of secondary syphilis.","authors":"K Lange, C Helbig, N Eckardt, M Baier, J Guse, S Hagel, A Stallmach, B T Schleenvoigt","doi":"10.1007/s15010-025-02552-6","DOIUrl":"https://doi.org/10.1007/s15010-025-02552-6","url":null,"abstract":"","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093525","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":"Vibrio fluvialis cholangitis with bacteremia and refractory septic shock: a case report and review of the literature.","authors":"Roberto Lazzari, María Borja Cano, Alba Rivera Martínez, Marc Rubio Bueno, Marta Castella Rovira, Mireia Puig Campmany","doi":"10.1007/s15010-025-02535-7","DOIUrl":"https://doi.org/10.1007/s15010-025-02535-7","url":null,"abstract":"<p><p>Vibrio fluvialis is an emerging pathogen primarily associated with gastroenteritis, though an increasing number of extraintestinal infections have been reported. We present the first documented case in Europe of V. fluvialis cholangitis with liver abscess and bacteremia. An 85-year-old man with diabetes mellitus and chronic steroid use was admitted with severe epigastric pain but no fever or gastrointestinal symptoms. Initial laboratory tests were unremarkable, yet imaging revealed a hepatic abscess. Despite early antibiotic therapy, the patient rapidly developed refractory septic shock and died within 12 h. Blood cultures confirmed V. fluvialis. This case highlights the potential for severe V. fluvialis infections even in the absence of known seafood or seawater exposure. Given the global rise in raw seafood consumption, physicians should consider V. fluvialis as a potential pathogen in diabetic or immunocompromised patients presenting with hepatobiliary infections and sepsis.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077848","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":"Cervical Mycobacterium genavense infection in a patient with lymphadenitis and previously unknown anti-IFN-γ IgG autoantibodies.","authors":"Ioannis Michaelides, Stilla Bauernfeind, Uwe Kölsch, Florian Hitzenbichler, Christopher Bohr, Constantin A Hintschich","doi":"10.1007/s15010-025-02539-3","DOIUrl":"https://doi.org/10.1007/s15010-025-02539-3","url":null,"abstract":"<p><strong>Background: </strong>Infections with atypical mycobacteria are rare and sometimes difficult to correctly diagnose. In many cases underlying diseases such immune deficiency can promote these infections.</p><p><strong>Case presentation: </strong>A 43-year-old male of Southeast Asian origin presented to our tertiary care hospital with persistent cervical lymphadenopathy non-responsive to antibiotics. Imaging suggested malignancy, but a biopsy did not confirm this suspicion. PCR diagnostics identified Mycobacterium genavense and further immunological testing revealed an acquired adult-onset immunodeficiency due to neutralizing anti-IFN-γ autoantibodies (nAIGA), explaining both the current infection and previous pleural empyema. The patient responded well to triple antimycobacterial therapy, with no recurrence or novel infection after almost two years.</p><p><strong>Conclusions: </strong>Our case highlights the importance of considering underlying immunodeficiencies and the patient's geographic origin in the diagnosis of rare infections.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077844","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":"Impact of sarcopenia and obesity on mortality in older adults with SARS-CoV-2 infection: automated deep learning body composition analysis in the NAPKON-SUEP cohort.","authors":"Sabine Schluessel, Benedikt Mueller, Olivia Tausendfreund, Michaela Rippl, Linda Deissler, Sebastian Martini, Ralf Schmidmaier, Sophia Stoecklein, Michael Ingrisch, Sabine Blaschke, Gunnar Brandhorst, Peter Spieth, Kristin Lehnert, Peter Heuschmann, Susana M Nunes de Miranda, Michael Drey","doi":"10.1007/s15010-025-02555-3","DOIUrl":"https://doi.org/10.1007/s15010-025-02555-3","url":null,"abstract":"<p><strong>Introduction: </strong>Severe respiratory infections pose a major challenge in clinical practice, especially in older adults. Body composition analysis could play a crucial role in risk assessment and therapeutic decision-making. This study investigates whether obesity or sarcopenia has a greater impact on mortality in patients with severe respiratory infections. The study focuses on the National Pandemic Cohort Network (NAPKON-SUEP) cohort, which includes patients over 60 years of age with confirmed severe COVID-19 pneumonia. An innovative approach was adopted, using pre-trained deep learning models for automated analysis of body composition based on routine thoracic CT scans.</p><p><strong>Methods: </strong>The study included 157 hospitalized patients (mean age 70 ± 8 years, 41% women, mortality rate 39%) from the NAPKON-SUEP cohort at 57 study sites. A pre-trained deep learning model was used to analyze body composition (muscle, bone, fat, and intramuscular fat volumes) from thoracic CT images of the NAPKON-SUEP cohort. Binary logistic regression was performed to investigate the association between obesity, sarcopenia, and mortality.</p><p><strong>Results: </strong>Non-survivors exhibited lower muscle volume (p = 0.043), higher intramuscular fat volume (p = 0.041), and a higher BMI (p = 0.031) compared to survivors. Among all body composition parameters, muscle volume adjusted to weight was the strongest predictor of mortality in the logistic regression model, even after adjusting for factors such as sex, age, diabetes, chronic lung disease and chronic kidney disease, (odds ratio = 0.516). In contrast, BMI did not show significant differences after adjustment for comorbidities.</p><p><strong>Conclusion: </strong>This study identifies muscle volume derived from routine CT scans as a major predictor of survival in patients with severe respiratory infections. The results underscore the potential of AI supported CT-based body composition analysis for risk stratification and clinical decision making, not only for COVID-19 patients but also for all patients over 60 years of age with severe acute respiratory infections. The innovative application of pre-trained deep learning models opens up new possibilities for automated and standardized assessment in clinical practice.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077845","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":"Unusual case of non-sexual Mpox transmission in a heterosexual woman.","authors":"Marc Biller, Julia Lais, Stefan Esser, Stefanie Sammet","doi":"10.1007/s15010-025-02550-8","DOIUrl":"https://doi.org/10.1007/s15010-025-02550-8","url":null,"abstract":"<p><p>Monkeypox (MPOX) is becoming an important differential diagnosis in non-endemic regions, particularly in patients with atypical dermatologic lesions and systemic symptoms. Although it is more commonly associated with males, it is important to consider MPOX in females, as its presentation may be misattributed to more common infections. This article describes a 28-year-old heterosexual female with cutaneous lesions and systemic symptoms that were initially thought to be a localized infection. Further evaluation confirmed MPOX with a bacterial superinfection. The patient had no sexual but close contact with a confirmed case of MPOX. Clinicians must remain vigilant to recognize the broad spectrum of MPOX presentations and ensure timely diagnosis, isolation, and preventive measures to limit transmission.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077847","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}