Infection最新文献

{"title":"In vivo divergent evolution of cross-resistance to new β-lactam/β-lactamase inhibitor combinations in Pseudomonas aeruginosa following ceftazidime/avibactam treatment.","authors":"Heng Cai, Minhua Chen, Yue Li, Nanfei Wang, Hanming Ni, Piaopiao Zhang, Xiaoting Hua, Yunsong Yu","doi":"10.1007/s15010-024-02432-5","DOIUrl":"10.1007/s15010-024-02432-5","url":null,"abstract":"<p><strong>Purpose: </strong>To describe and characterize the evolutionary process of cross-resistance to ceftazidime/avibactam, ceftolozane/tazobactam and imipenem/relebactam of a carbapenem-resistant Pseudomonas aeruginosa (CRPA) lineage isolated from a patient receiving two courses of ceftazidime/avibactam treatment.</p><p><strong>Methods: </strong>The minimum inhibitory concentrations (MICs) of strains were determined by broth microdilution methods. The mutant genes were identified by the whole genome sequencing results. Cloning, knockout and complementation experiments were used to evaluate the impact of the resistance relative genes on the MICs. Reverse transcription-quantitative PCR was used to evaluate the relative expression of ampC and mexA. The fitness cost was measured by growth curve tests.</p><p><strong>Results: </strong>A total of 24 CRPA strains were isolated encompassing the whole ceftazidime/avibactam treatment. The CRPA strains developed high-level resistance to ceftazidime/avibactam and cross-resistance to ceftolozane/tazobactam or imipenem/relebactam, clustering into clade A and clade B, respectively. In both clades, the overexpression of AmpC was crucial to ceftazidime/avibactam resistance, which was driven by AmpD deficiency in clade A and dacB mutation in clade B, respectively. In clade A, mraY mutation and a new allele of AmpC (bla_PDC-575) elevated resistance to ceftazidime/avibactam, with bla_PDC-575 also conferring resistance to ceftolozane/tazobactam. In clade B, mexB mutation was associated with the resistance to both ceftazidime/avibactam and imipenem/relebactam. Moreover, the fitness costs of P. aeruginosa strains typically increased with the higher MICs of ceftazidime/avibactam.</p><p><strong>Conclusion: </strong>Divergent resistance evolution resulted in a complex phenotype in the CRPA lineage, posing significant challenge to clinical treatment. The resistance surveillance needs to be prioritized, and new therapeutic strategies are urgently required.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"635-647"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604357","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":"Kerion of the pubis.","authors":"Elisabeth Gomez-Moyano, Fatima Moreno-Suarez, Leandro Martinez-Pilar","doi":"10.1007/s15010-025-02518-8","DOIUrl":"https://doi.org/10.1007/s15010-025-02518-8","url":null,"abstract":"<p><strong>Purpose: </strong>Kerion of the pubis is a deep dermatophyte infection with systemic symptoms, rarely affecting the genital area. We present three new cases of kerion of the pubis secondary to Microsporum canis infection.</p><p><strong>Methods and results: </strong>Direct examination with potassium hydroxide solution showed hyaline septate hyphae and chains of arthroconidia around the hair shaft. Microsporum canis was isolated in culture in all of the cases, with yellow to orange colonies on Sabouraud agar. Identification by mass spectrometry was made using MALDI-TOF. Patients were treated with griseofulvin.</p><p><strong>Conclusion: </strong>Clinicians should have a high index of clinical suspicion for deep fungal infection when patients present with suppurative infections or folliculitis-like lesions on the mons pubis area.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752573","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":"Pathophysiology and clinical outcomes of pancytopenia in disseminated histoplasmosis: a scoping review.","authors":"Bassey E Ekeng, David E Elem, Anthony N Kokelu, Asukwo Onukak, Walter O Egbara, Ofonime O Benjamin, Aje N Ogar, Stella T Chukwuma, Love E Okafor, Kingsley A Essien, Deborah U Ekpenyong, Felix Bongomin","doi":"10.1007/s15010-024-02431-6","DOIUrl":"10.1007/s15010-024-02431-6","url":null,"abstract":"<p><strong>Purpose: </strong>Pancytopenia in the setting of disseminated histoplasmosis is sparsely described in the literature. We investigated the underlying mechanisms of pancytopenia in disseminated histoplasmosis and highlighted clinical outcomes.</p><p><strong>Methods: </strong>We conducted a scoping review of cases and series on disseminated histoplasmosis presenting with pancytopenia published between 2001 and 2024. PubMed database was used for the search. The search terms were (disseminated histoplasmosis) AND (pancytopenia OR haemophagocytic syndrome OR lymphohistiocytosis).</p><p><strong>Results: </strong>We identified 72 cases. Forty-four (61.1%) cases were from the Americas, 18 (25.5%) from Asia, 8 (11.1%) from Europe, and 1(1.4%) each from Africa and Australia. Of the 72 cases, five cases (6.9%) were reported in children. The mean age was 41.9 ± 16.7 years with a range of 3 months to 78 years. Seven cases (9.7%) were immunocompetent, 27 (37.5%) had an underlying HIV infection and 45 (62.5%) were complicated with haemophagocytic lymphohistiocytosis syndrome. Histoplasma antigen assay (n = 29, 40.2%) was the major diagnostic method followed by bone marrow biopsy (n = 28, 38.9%). Fifty-three cases (73.6%) recovered, 15 (20.8%) died and outcomes were not stated in 4 cases (5.65%). The relationship between haemophagocytic lymphohistiocytosis and fatal outcomes was not statistically significant (P = 0.5). Likewise, HIV infection was not significantly associated with fatal outcomes (P = 0.6). Fatal outcomes were predominantly due to difficulty or delayed diagnosis of disseminated histoplasmosis and/or haemophagocytic lymphohistiocytosis (n = 5, 6.9%), multiple organ failure (n = 4, 5.6%) and late presentation (n = 2, 2.8%).</p><p><strong>Conclusion: </strong>Pancytopenia in disseminated histoplasmosis is associated with poor outcomes. Such a hematologic finding should arouse the index of suspicion in the attending clinician for an invasive mycosis like disseminated histoplasmosis to avert fatal outcomes. Besides haemophagocytic lymphohistiocytosis, other factors associated with pancytopenia in disseminated histoplasmosis were the cooccurrence of viral and bacterial infections.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"513-522"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921612","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":"Syncopes, paresis and loss of vision after COVID-19 mRNA-based vaccination and SARS-CoV-2 infection.","authors":"Tobias Weirauch, Gundolf Schüttfort, Maria J G T Vehreschild","doi":"10.1007/s15010-024-02439-y","DOIUrl":"10.1007/s15010-024-02439-y","url":null,"abstract":"<p><p>mRNA-based vaccines played a key role in fighting the global COVID-19 pandemic by saving millions of lives. In rare cases, however, the BNT162b2 vaccine has been associated with severe adverse reactions e.g. myocarditis (OE ratio 2.78; 95% CI 2.61; 2.95) [Faksova in Vaccine 42(9):2200-2211, 2024, https://doi.org/10.1016/j.vaccine.2024.01.100 , Schwab in Clin Res Cardiol 112(3):431-440, 2022, https://doi.org/10.1007/s00392-022-02129-5 ]. Here, we describe the case of a 38-year-old man who developed a wide variety of long-term symptoms (fatigue, dizziness, palpitations with recurrent syncopes, paresthesia, paresis and fasciculations) following his first mRNA-based BNT162b2 COVID-19 vaccination. 143 days after vaccination, a subsequent COVID-19 infection was associated with exacerbation of paresis and a temporary loss of vision. After ruling out other causes and due to the immediate temporal association, an adverse reaction to vaccination appears likely. The fact that these symptoms worsened after a subsequent acute COVID 19 infection hints at the possibility of a common underlying pathophysiology. This case combines two clinical phenomena that have emerged during the COVID 19 pandemic, side effects associated with novel vaccines and Post-COVID Syndrome.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"741-746"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768393","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":"Post-COVID recovery is faster after an infection with the SARS-CoV-2 Omicron variant: a population-based cohort study.","authors":"Laura Rebecca Pfrommer, Sophie Diexer, Bianca Klee, Janka Massag, Cornelia Gottschick, Oliver Purschke, Mascha Binder, Thomas Frese, Matthias Girndt, Daniel Sedding, Jonas Rosendahl, Jessica I Hoell, Irene Moor, Michael Gekle, Christine Allwang, Florian Junne, Rafael Mikolajczyk","doi":"10.1007/s15010-024-02438-z","DOIUrl":"10.1007/s15010-024-02438-z","url":null,"abstract":"<p><strong>Purpose: </strong>Post-COVID-19 condition (PCC) poses a substantial burden to affected individuals, health care systems, and society as a whole. We examined factors associated with recovery from PCC, focusing on the vaccination status prior to infection and the virus variant.</p><p><strong>Methods: </strong>Our analyses are based on the population-based cohort study for digital health research in Germany (DigiHero). Respondents who reported a SARS-CoV-2 infection and COVID-related symptoms ≥ 12 weeks post-infection were classified as having PCC. Those with ongoing PCC were followed-up in six-month intervals based on their date of infection. We used a Cox model for interval-censored data to analyze PCC recovery.</p><p><strong>Results: </strong>Among the 4,529 respondents with PCC included in our analyses, about 26%, 19%, 36%, and 44% of those infected during dominance of the SARS-CoV-2 wildtype, Alpha, Delta, and Omicron variant had recovered one year after infection, respectively. When stratifying by virus variant, vaccination was not associated with a faster recovery. Conversely, those infected with Omicron (HR = 2.20; 95%CI: 1.96-2.48) or Delta (HR = 1.69; 95%CI: 1.43-2.01) recovered faster than those infected with the SARS-CoV-2 wildtype or Alpha strain.</p><p><strong>Conclusion: </strong>Although the recovery from PCC is faster for the newer virus variants, still a substantial fraction of those who developed PCC after an infection with the Omicron variant report prolonged persistence of symptoms.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"657-665"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647879","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":"Considerations regarding a meta-analysis of ceftazidime-avibactam versus other antimicrobial agents for treatment of multidrug-resistant pseudomonas aeruginosa.","authors":"Feng Li, Huayang Pang, Chunxue Li","doi":"10.1007/s15010-024-02458-9","DOIUrl":"10.1007/s15010-024-02458-9","url":null,"abstract":"","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"757-758"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846352","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 cGAS-STING pathway in HIV-1 and Mycobacterium tuberculosis coinfection.","authors":"Xiaoxu Han, Xiuwen Wang, Fangping Han, Hongxia Yan, Jin Sun, Xin Zhang, Christiane Moog, Conggang Zhang, Bin Su","doi":"10.1007/s15010-024-02429-0","DOIUrl":"10.1007/s15010-024-02429-0","url":null,"abstract":"<p><p>Mycobacterium tuberculosis (M. tuberculosis) infection is the most common opportunistic infection in human immunodeficiency virus-1 (HIV-1)-infected individuals, and the mutual reinforcement of these two pathogens may accelerate disease progression and lead to rapid mortality. Therefore, HIV-1/M. tuberculosis coinfection is one of the major global public health concerns. HIV-1 infection is the greatest risk factor for M. tuberculosis infection and increases the likelihood of endogenous relapse and exogenous reinfection with M. tuberculosis. Moreover, M. tuberculosis further increases HIV-1 replication and the occurrence of chronic immune activation, accelerating the progression of HIV-1 disease. Exploring the pathogenesis of HIV-1/M. tuberculosis coinfections is essential for the development of novel treatments to reduce the global burden of tuberculosis. Innate immunity, which is the first line of host immune defense, plays a critical role in resisting HIV-1 and M. tuberculosis infections. The role of the cyclic guanosine monophosphate-adenosine monophosphate synthase (cGAS)-stimulator of interferon genes (STING) signaling pathway, which is a major DNA-sensing innate immune signaling pathway, in HIV-1 infection and M. tuberculosis infection has been intensively studied. This paper reviews the role of the cGAS-STING signaling pathway in HIV-1 infection and M. tuberculosis infection and discusses the possible role of this pathway in HIV-1/M. tuberculosis coinfection to provide new insight into the pathogenesis of HIV-1/M. tuberculosis coinfection and the development of novel therapeutic strategies.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"495-511"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604359","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":"Correspondence on \"The association between COVID-19 vaccine/infection and new-onset asthma in children - based on the global TriNetX database\".","authors":"An-Ping Huo, Pui-Ying Leong, James Cheng-Chung Wei","doi":"10.1007/s15010-024-02442-3","DOIUrl":"10.1007/s15010-024-02442-3","url":null,"abstract":"","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"755-756"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715833","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":"Comprehensive analysis of the Global Burden and epidemiological trends of meningitis from 1990 to 2021.","authors":"Chao Tang, Rongshou Han, Jiaxin Yang, Ning Wu, Dian He","doi":"10.1007/s15010-025-02483-2","DOIUrl":"10.1007/s15010-025-02483-2","url":null,"abstract":"<p><strong>Background: </strong>Despite significant advances in prevention and treatment strategies, meningitis continues to pose a substantial global health challenge. The disease burden demonstrates marked geographical disparities, with disproportionate impact in resource-limited settings, particularly within the \"meningitis belt\" of Sub-Saharan Africa. The global meningitis burden is influenced by a complex interplay of environmental, behavioral, and socioeconomic determinants.</p><p><strong>Methods: </strong>Leveraging the Global Burden of Disease (GBD) 2021 database, we conducted a comprehensive analysis of global meningitis burden from 1990 to 2021. The study employed DisMod-MR 2.1, an advanced Bayesian meta-regression tool, for epidemiological modeling. We implemented age-period-cohort analysis to evaluate mortality trends and utilized the Comparative Risk Assessment framework to assess risk factors. The relationship between socio-demographic index (SDI) and disease burden was examined through Spearman's rank correlation analysis.</p><p><strong>Results: </strong>Our analysis revealed significant geographical and pathogen-specific variations in disease burden. Globally, the age-standardized incidence rate stands at 31.65 per 100,000 with a corresponding mortality rate of 2.95 per 100,000. The disease burden demonstrates a striking gradient across SDI levels, with low SDI regions experiencing the highest burden, approximately 17 times higher than high SDI regions. Neonatal mortality rates remain particularly concerning at 129.69 per 100,000, while under-5 mortality rates stand at 34.50 per 100,000. The Eastern Sub-Saharan African region emerges as an area of particular concern, with disease burden significantly exceeding global averages. Behavioral risks, child and maternal malnutrition, and low birth weight/short gestation emerged as the primary risk factors, each contributing to 0.15 million deaths and 13.41 million DALYs. Strong negative correlations were observed between all risk factors and SDI values (correlation coefficients ranging from - 0.55 to -0.75), indicating higher disease burden in regions with lower socio-demographic development.</p><p><strong>Conclusion: </strong>While substantial progress has been achieved in global meningitis control, particularly in reducing under-5 mortality rates, significant disparities persist between high and low SDI regions. Our findings emphasize the critical need for targeted interventions in resource-limited settings and continued surveillance efforts to address remaining challenges in meningitis control.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"693-709"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143541955","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":"Gas gangrene with Clostridium septicum in a neutropenic patient.","authors":"Tamara Perl, Monique Jacquemai, Nadine Pedrazzi, Rainer Grobholz, Richard Glaab, Anna Conen, Jan A Plock","doi":"10.1007/s15010-024-02401-y","DOIUrl":"10.1007/s15010-024-02401-y","url":null,"abstract":"<p><p>Gas gangrene is a rare presentation of a necrotizing fasciitis, caused by Clostridium perfringens, C. septicum and other clostridial species. With its rapid progression it is a potentially life-threatening infection, that poses as a challenge in the clinical management requiring an interdisciplinary approach.Here we present a 62-year-old woman, who developed neutropenic fever while undergoing chemotherapy for triple negative breast cancer. She presented with a high fever, reporting little pain in her left thigh accompanied by redness and induration locally. Subsequently the patient developed pain and redness of the back of the left hand. The initial findings suggested cellulitis and immediate empiric treatment with intravenous meropenem was started. Despite the antibiotic treatment the patient rapidly developed septic shock along with progression of the local infection. Emergency surgical debridement revealed extensive necrosis of the soft tissues including extensive myonecrosis of the thigh. On the left hand an extensive debridement was performed, the left lower limb could not be preserved and exarticulation of the left hip was required. Microbiologically C. septicum was isolated in different samples, confirming gas gangrene. As there was no local entry portal on the skin, hematogenous seeding from intestinal translocation in this neutropenic patient was suspected. The empiric antibiotic treatment was tailored to intravenous penicillin and complemented with clindamycin for toxin inhibition. Following radical debridement and antibiotic treatment, the patient could be stabilized. After repetitive debridement wound closure was achieved and the patient was discharged for rehabilitation. Antibiotic treatment was continued for four weeks.This rare case of gas gangrene in a neutropenic patient shows the complexity in the diagnostic and therapeutic management of necrotizing soft tissue infections in immunocompromised patients. It particularly highlights the importance of an interdisciplinary management with fast recognition of the disease and rapid, if needed radical, surgical debridement as well as tailored antibiotic treatment for a successful outcome.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"733-739"},"PeriodicalIF":5.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380759","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}