Infection最新文献

{"title":"Månsson et al. conclusion that Piperacillin/tazobactam(PTZ) is non inferior for ESBL-producing enterobacterales bloodstream infections, should be viewed with caution.","authors":"Oren Zimhony, Victoria Yakovenko","doi":"10.1007/s15010-025-02595-9","DOIUrl":"https://doi.org/10.1007/s15010-025-02595-9","url":null,"abstract":"","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475088","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":"Congenital syphilis: adverse pregnancy outcomes and neonatal disorders.","authors":"Baihuan Duan, Yuefang Zhou, Xinyi Wang, Huiqiao Wang, Yan Li, Xiang Zhou, Yujun Tang, Chenbin Zhu, Peng Liu, Jiaofeng Peng","doi":"10.1007/s15010-025-02591-z","DOIUrl":"https://doi.org/10.1007/s15010-025-02591-z","url":null,"abstract":"<p><p>Treponema pallidum (T. pallidum) poses a significant hazard to the health of both expectant mothers and neonates. The bacterium can be transmitted via the placenta from an infected mother to the fetus during pregnancy. Congenital syphilis may occur if the infant is exposed to the infection through contact with the mother's body fluids after delivery. The symptoms of congenital syphilis can severely compromise a newborn's health. In addition to various pathological anomalies, affected children may face skin, bone, internal organ, and nervous system issues. These complications can lead to long-term developmental delays, cognitive impairments, and increased risk of infections. Early detection and treatment are crucial to mitigate these risks and promote healthier outcomes for both the infant and the mother. The worldwide prevalence of congenital syphilis is escalating, rising from 203 cases per 100,000 in 2015 to 295 cases per 100,000 in 2021. The primary treatment for syphilis is currently penicillin G therapy, which produces reliable clinical efficacy. This review offers a thorough analysis of adverse pregnancy outcomes, including preterm birth, miscarriage, stillbirth, and neonatal disorders such as skin lesions and skeletal malformations. The aim is to foster the development of innovative preventive and early diagnostic strategies through a thorough analysis of diagnostic data. These initiatives are expected to reduce the number of affected children significantly, hence enhancing societal stability and safeguarding the health of mothers and infants.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475086","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":"Syphilitic uveitis masquerading as behçet's disease: a case of bilateral macular edema with fern-like fluorescein leakage.","authors":"Ken Fukuda, Kenji Yamashiro","doi":"10.1007/s15010-025-02592-y","DOIUrl":"https://doi.org/10.1007/s15010-025-02592-y","url":null,"abstract":"","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475089","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 impact of age, sex, and comorbidities on COVID-19 mortality of hospitalized patients during the SARS-CoV-2 pandemic: data from the multicentric prospective cohort study of the Lean European Open Survey on SARS-CoV-2 (LEOSS).","authors":"Julian Triebelhorn, Maria M Rüthrich, Susana M Nunes de Miranda, Jochen Schneider, Timm Westhoff, Margarete Scherer, Christoph D Spinner, Maria J G T Vehreschild, Florian Voit, Julia Lanznaster, Johanna Erber, Kerstin Hellwig, Bjoern-Erik Ole Jensen, Laura Wagner","doi":"10.1007/s15010-025-02583-z","DOIUrl":"https://doi.org/10.1007/s15010-025-02583-z","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to analyse COVID-19-related mortality during the pandemic, stratified by groups at risk of severe COVID-19.</p><p><strong>Methods: </strong>Patients with COVID-19 between March 2020 and February 2023 were enrolled using the international multicentric Lean European Open Survey on SARS-CoV-2-Infected Patients (LEOSS). The COVID-19 in-hospital mortality was calculated using a multivariable logistic regression model adjusted for age and sex.</p><p><strong>Results: </strong>A total of 11,765 patients were included, with an overall mortality rate of 13.1% (N = 1541). Mortality decreased from 14.4% during the wildtype (wt) period to 10.6%, 9.5%, and 6.3% in the alpha (α), delta (δ), and omicron (Ω) periods, respectively. Patients aged 66-75, 76-85, and > 85 years had 11.4-, 19.3-, and 34.7-fold higher mortality odds than patients aged 26-35 years (p < 0.001 in all comparisons). This increase in mortality between younger and older patients decreased with the shift from wt (increase of 39.4%) to Ω (15.5%). The overall adjusted mortality rate in males (18.4%) was higher than in females (10.6%); however, this sex-specific difference levelled off with the shift from wt (m: 18.9%, f: 10.1%) to Ω (m: 5.9%, f: 5.3%). Referring to comorbidities, adjusted mortality increased significantly with the number of comorbidities in patients during the wt but remained stable in patients with Ω-period. Among severely immunosuppressed patients, mortality declined markedly throughout the pandemic (wt vs. Ω: p < 0.001).</p><p><strong>Conclusion: </strong>Overall mortality decreased during the pandemic, even among severely immunosuppressed patients. Age, sex, and the number of comorbidities were key mortality risk factors, although their impact lessened as the pandemic progressed.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316840","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":"Carbapenemase type and mortality in blood-stream infections caused by carbapenemase-producing enterobacterales: a multicenter retrospective cohort study.","authors":"Yaakov Dickstein, Dafna Yahav, Giusy Tiseo, Cristina Mussini, Erica Franceschini, Antonella Santoro, Galia Rahav, Hila Elinav, Assaf Potruch, Amir Nutman, Mical Paul, Marco Falcone","doi":"10.1007/s15010-025-02584-y","DOIUrl":"https://doi.org/10.1007/s15010-025-02584-y","url":null,"abstract":"<p><strong>Background: </strong>Previous studies analyzing differences in mortality associated with carbapenemase type in patients with a variety of infections caused by carbapenemase-producing Enterobacterales (CPE) have produced conflicting results.</p><p><strong>Methods: </strong>We performed a multinational multicenter retrospective cohort study. Adult patients with blood-stream infections (BSI) caused by CPE between 2015 and 2020 were included. The primary outcome was 14-day mortality; 28-day mortality and microbiological failure were secondary outcomes. Clinical and microbiological data were collected and analyzed using conditional logistic regression.</p><p><strong>Results: </strong>A total of 360 patients were identified of whom 226 had infections caused by KPC-producing isolates, 109 by NDM-producing isolates and 25 by other carbapenemases. Definitive therapy was colistin-based in 35.1% of patients, ceftazidime/avibactam ± aztreonam (CAZ/AVI ± A) in 28.2% and other in 23.4%. Overall 14-day mortality was 28.1%; carbapenemase type was unassociated with mortality in univariate or multivariate analyses. Antimicrobial therapy was significantly associated with 14-day mortality: patients treated with CAZ/AVI ± A had an adjusted hazard ratio of 0.172 (95% confidence interval 0.063-0.473) for death as compared to patients treated with colistin-based therapy. At 28 days, overall mortality was 35.3%; no association was observed between carbapenemase type and 28-day mortality or microbiological failure.</p><p><strong>Conclusion: </strong>After controlling for antimicrobial therapy, we did not find evidence of an association between carbapenemase type and mortality. Ceftazidime/avibactam was associated with a greater than 80% reduction in mortality as compared with colistin.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301994","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":"Cost-effectiveness analysis of HPV vaccination of men who have sex with men in Germany.","authors":"Cody Palmer, Cornelia Wähner, Regine Wölle, Alexander Kreuter, Jens Peter Klussmann, Julian Witte, Agnes Luzak, Miriam Reuschenbach","doi":"10.1007/s15010-025-02567-z","DOIUrl":"https://doi.org/10.1007/s15010-025-02567-z","url":null,"abstract":"<p><strong>Introduction: </strong>Men who have sex with men (MSM) have a high risk of human papillomavirus (HPV) infection and HPV-related diseases. While gender neutral HPV vaccination between the ages of 9-14 years (with the option for catch-up between 15- and 17-years-of-age) has been recommended in Germany since 2018, adult MSM are currently not included and thus do not benefit from its advantages. This analysis aims to quantify the reduction in public health and health economic burden of including 18-26-year-old or 18-45-year-old MSM in the national HPV vaccination recommendation, compared to the status quo of vaccinating adolescent boys only.</p><p><strong>Methods: </strong>We developed a dynamic transmission model of HPV, with an integrated HIV model, to analyze the potential impact of the 9-valent HPV vaccination on HPV infections and HPV-related diseases (anal, penile, and oropharyngeal cancers, and anogenital warts). By including economic outcomes, the model provides estimates of the cost-effectiveness of HPV vaccination among adult MSM in Germany.</p><p><strong>Results: </strong>Vaccinating MSM aged 18-26 years could prevent an additional 2,583 anal, penile and oropharyngeal cancers, 709 deaths and 81,372 anogenital warts. Expanding vaccination to MSM aged 18-45 years, 4,091 cancers, 1,516 deaths and 114,117 anogenital warts could be averted. The highest reductions were found in anal cancers and anogenital warts; significant incidence reductions in cancers were seen within about 20 years. Vaccinating 18-26 and 18-45-year-old MSM resulted in Incremental Cost-Effectiveness Ratios (ICERs) of 35,300.09€/QALY and 42,088.06€/QALY, respectively, when compared to the vaccination of adolescent boys only.</p><p><strong>Conclusions: </strong>Vaccination of MSM up to 26 and 45 years of age can profoundly accelerate beneficial public health outcomes while reducing the economic burden of HPV-related cancers and anogenital warts in a cost-effective way compared to vaccinating adolescent boys only.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144283775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of an internet of things device for isothermal molecular detection.","authors":"Manfred Weidmann, Jesus Bueno Alvarez, Steffen Zinn, Ruslan Ibragimov, Mohammed Hasani, Elena Graf, Aiko Weber, Frida Arrey, Marcelina Marta Szczygiel, Zuzanna Kowalewska, Rea Maja Kobialka, Arianna Ceruti, Ahmed Abd El Wahed, Michael Diebold, Christian Wahnes","doi":"10.1007/s15010-025-02581-1","DOIUrl":"https://doi.org/10.1007/s15010-025-02581-1","url":null,"abstract":"<p><p>We describe a low-cost up scalable molecular test platform providing accessibility to frequent testing - the prerequisite to control infectious epidemics. The device uses the Multi-Spectral Digital Sensor AS7341 in a small fluorescence spectrometer which communicates with a Smartphone App via Bluetooth, which passes on the raw data to outsourced computation in the cloud via the internet. This very stable setup allows easy to use on site testing of individual samples and anonymised data analysis while providing the basis for direct result transmission of a rapid isothermal molecular diagnostic test result not only to the user but also to public health bodies. This internet of things (IoT) platform allows to collect real molecular test data from users with usability and industrial up scalability at the heart of the design. The device characteristics are described in detail and the performance for a rapid SARS-CoV-2 Recombinase Polymerase Amplification assay achieved 98.6% sensitivity and 98% specificity testing 148 positive and 501 negative samples.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144283776","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 intestinal spirochetosis presenting as colonic ulceration in an immunocompetent 65-year-old man.","authors":"Sara Zotti, Lisa Fusaro, Stefano Di Bella, Stella Babich","doi":"10.1007/s15010-025-02574-0","DOIUrl":"https://doi.org/10.1007/s15010-025-02574-0","url":null,"abstract":"<p><strong>Purpose: </strong>To report an unusual case of symptomatic human intestinal spirochetosis (HIS) in an immunocompetent individual without known risk factors, and a potential zoonotic source (domestic pig).</p><p><strong>Methods: </strong>A 65-year-old heterosexual man with no gastrointestinal or immunological history presented with acute diarrhea, abdominal pain, vomiting, and rectal bleeding. Colonoscopy revealed two ulcers in the distal transverse colon; biopsies were taken from ulcerated and normal mucosa. Histopathology included Warthin-Starry staining.</p><p><strong>Results: </strong>Histology showed dense spirochetal colonization forming a \"false brush border,\" consistent with HIS. The ileum was unremarkable. The patient was treated with oral metronidazole 500 mg q6h for 10 days, resulting in complete resolution of symptoms. Follow-up colonoscopy at 13 months confirmed full mucosal healing, and the patient remained asymptomatic.</p><p><strong>Conclusion: </strong>This case highlights the possible pathogenic role of HIS in gastrointestinal symptoms and colonic ulceration, even in immunocompetent individuals without traditional risk factors. It underscores the diagnostic value of histology in atypical colonic lesions and suggests zoonotic transmission as a plausible route of infection outside classical risk groups.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of probiotics efficiency for the prevention of Clostridioides difficile infection in hospitalized patients: a systematic review and meta-analysis.","authors":"Yahya A Almutawif, Mustafa A Najim, Najeeb Ullah Khan","doi":"10.1007/s15010-025-02580-2","DOIUrl":"https://doi.org/10.1007/s15010-025-02580-2","url":null,"abstract":"<p><strong>Background: </strong>Clostridioides difficile infection (CDI) poses a significant healthcare challenge, with the most frequent cause being antibiotic-associated diarrhea, affecting hospitalized individuals with substantial cost and mortality concerns. However, there is no information regarding probiotic efficiency for initial CDI treatment, and the modulation of microbiota by probiotics has been suggested as a potential preventive measure against CDI.</p><p><strong>Objective: </strong>To evaluate the efficacy of probiotics in preventing CDI in hospitalized patients.</p><p><strong>Methods: </strong>An exhaustive literature search was performed using PubMed to identify controlled/clinical trials investigating the use of probiotics for CDI prevention among hospitalized individuals based on PRISMA guidelines and the PICO framework. Relevant data were extracted from selected studies. Statistical meta-analysis (subgroup or sensitivity analyses) was performed using R Studio to calculate the pooled effect size, odds ratio (OR) with a 95% CI, p-value, and heterogeneity. The risk of bias was assessed using the Cochrane risk-of-bias (RoB) tool to determine publication bias and sensitivity of the included studies.</p><p><strong>Results: </strong>Four studies with a significant number of participants were identified and included in the meta-analysis. The incidence of CDI was reduced in the probiotic group compared to the placebo group, with an overall OR of 0.99 (95% CI [0.56; 1.7]), increased heterogeneity, and a non-significant p-value, using a random effects model in R Studio. Subgroup analysis suggested possible beneficial outcomes regarding the selection of probiotic strain and dose regimen, supporting the effective use of probiotics in preventing CDI. Two of the included studies showed a high risk of bias in the randomization process, while others indicated a significantly low risk of bias.</p><p><strong>Conclusion: </strong>Detailed or systematic information on CDI treatment provides evidence that the direction of the odds ratio suggests a possible protective role of probiotics, although the overall effect was not significant. The OR < 1.0 indicates a neutral efficiency of probiotics, on CDI incidence observed in the probiotics group compared to the placebo group.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257987","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":"Clostridioides difficile evolution in a tertiary German hospital through a retrospective genomic characterization.","authors":"Fabian Lorenzo-Diaz, Tilman E Klassert, Cristina Zubiria-Barrera, Amelya Keles-Slevogt, Mario Gonzalez-Carracedo, Mariano Hernandez, Hortense Slevogt, Thomas Grünewald","doi":"10.1007/s15010-025-02576-y","DOIUrl":"https://doi.org/10.1007/s15010-025-02576-y","url":null,"abstract":"<p><strong>Purpose: </strong>Clostridioides difficile is a major cause of healthcare-associated infections, contributing to significant morbidity and mortality. This study aimed to investigate the genomic characteristics, antimicrobial resistance (AMR) profiles, and temporal dynamics of C. difficile strains isolated from hospitalized patients in a German tertiary hospital over nearly two decades (1997-2015).</p><p><strong>Methods: </strong>Whole-genome sequencing was performed on 46 toxigenic C. difficile isolates to determine sequence types (STs) and phylogenetic relationships and these were compared to national surveillance data on C. dificile. AMR profiling was conducted to identify key resistance determinants at genetic level while epsilometer minimum inhibitory concentration (MIC) analyses were used to correlate genetic resistance markers with phenotypic resistance. Longitudinal antibiotic usage data were analysed to assess potential associations with resistance profiles and strains evolution.</p><p><strong>Results: </strong>Five predominant STs were identified: ST1 (30%), ST54 (24%), ST3 (22%), ST11 (11%), and ST37 (4%). Phylogenetic analysis showed that ST1 (ribotype 027) emerged as the dominant and persistent lineage, replacing ST11 and ST54 over time. AMR profiling detected several resistance genetic markers such as CDD-1/CDD-2 (carbapenem resistance), ErmB (macrolide-lincosamide-streptogramin B resistance/MLS resistance), and mutations in gyrA (fluoroquinolone resistance) and rpoB (rifampicin resistance). MIC analyses confirmed high resistance rates to moxifloxacin (87%) and rifampicin (59%), while susceptibility to fidaxomicin, metronidazole, and vancomycin remained. The tetM gene, associated with doxycycline resistance, declined as ST11 and ST54 frequencies decreased. Longitudinal analysis revealed a reduction in moxifloxacin resistance following its decreased use, whereas increased doxycycline use paradoxically correlated with reduced resistance.</p><p><strong>Conclusion: </strong>This study highlights the dynamic strain evolution of C. difficile, reflecting national trends in strain evolution. The findings emphasize the strong correlation between epsilometer MIC values and molecular resistance markers. This observation reinforces the integration of genetic surveillance with antibiotic stewardship in the clinical routine to effectively mitigate CDI recurrence. Further research is needed to better understand the complex interactions between antibiotic exposure and strain evolution in hospital environments.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247728","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}