Infection最新文献

{"title":"Unmasking the mimic: vertebral alveolar echinococcosis diagnosed by metagenomic next-generation sequencing.","authors":"Tassilo Kruis, Marion Wassermann, Barbara Graf, Katharina Lührig, Peter Menzel, Rolf Schwarzer, Johannes Ziegler, Caroline Isner","doi":"10.1007/s15010-025-02717-3","DOIUrl":"10.1007/s15010-025-02717-3","url":null,"abstract":"<p><p>A Siberian woman in her forties presented to a public hospital in northeastern Germany with chronic back pain and a paravertebral mass, initially misdiagnosed as spinal tuberculosis. Repeated biopsies and metagenomic next-generation sequencing (mNGS) ultimately confirmed vertebral alveolar echinococcosis. Haplotype analysis revealed a novel Asian-cluster variant, supporting the presumed origin of infection.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"1001-1009"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13021751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145804341","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":"Evaluating Seqstant LiveGene Analysis in real-time assessment of metagenomic next-generation sequencing (mNGS) data from respiratory samples.","authors":"Sébastien Boutin, Sabrina Klein, Gerold Untergasser, Tobias P Loka, Suzan Jakob, Yasemin Caf, Elham Khatamzas, Ludwig Knabl, Georg Wrettos, Henri Knobloch, Dennis Nurjadi","doi":"10.1007/s15010-025-02665-y","DOIUrl":"10.1007/s15010-025-02665-y","url":null,"abstract":"<p><strong>Background: </strong>The detection of pathogens causing infections by conventional diagnostic methods can be challenging and next-generation sequencing (NGS) technology offers a promising alternative method. In this study, we evaluated the performance of real-time metagenomic next-generation sequencing (rt-mNGS) for the detection of pathogens in respiratory samples.</p><p><strong>Method: </strong>We used rt-mNGS, using the Seqstant LiveGene Analysis platform, on 335 respiratory samples in comparison to conventional culture results.</p><p><strong>Results: </strong>We observed an overall good concordance in 71.64% (240/335) of the methods. The rt-mNGS outperformed the gold standard culture in 16.12% (54/335) of the samples, while the culture was superior in detecting the clinically relevant pathogen in 12.24% (41/335) of the samples. The non-inferiority of rt-mNGS was statistically significant (δ = 10, α = 0.05, 1 - β = 0.8). We also observed that the real-time analysis of NGS data is beneficial in obtaining reliable, timely results, as the initial report at cycle 46 exhibits a Positive Predictive Value (PPV) of 93.75% at the species-level with a sensitivity of 32.09%.</p><p><strong>Conclusion: </strong>Overall, our study showed the non-inferiority of rt-mNGS compared to the standard-of-care microbiology for respiratory samples with statistical significance. Moreover, the rt-mNGS method exhibited superior sensitivity and superior overall performance. It also uniquely detected certain organisms that are typically hard to culture. However, rt-mNGS reported a higher number of false positives and faced limitations in detecting Aspergillus spp. In conclusion, the study highlights the potential of rt-mNGS as a powerful tool in clinical diagnostics of respiratory infections and beyond.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"707-715"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13021706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145488453","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":"Uropathogens and prognosis among patients with hospital-diagnosed acute pyelonephritis: insights from a 19-year population-based cohort study.","authors":"Lise Skovgaard Svingel, Mette Nørgaard, Christian Fynbo Christiansen, Henrik Birn, Hans Linde Nielsen, Kirstine Kobberøe Søgaard","doi":"10.1007/s15010-026-02729-7","DOIUrl":"10.1007/s15010-026-02729-7","url":null,"abstract":"<p><strong>Purpose: </strong>The microbial aetiologies of acute pyelonephritis (APN) may change over time. We aimed to describe long-term trends in microbiological diagnostics and pathogen distribution in patients with hospital-diagnosed APN, and to characterise clinical outcomes by pathogens.</p><p><strong>Methods: </strong>We conducted a population-based, serial cross-sectional and cohort study of patients with hospital-diagnosed APN in North Denmark across three periods covering 2000-2018. National health registries were linked with microbiological data to describe temporal trends in microbiological diagnostics and pathogen distribution, and to provide a descriptive comparison of median length of stay (LOS) with interquartile range (IQR) and 30-day cumulative mortality with 95% confidence interval (CI) between Escherichia coli and non-E. coli APN.</p><p><strong>Results: </strong>We identified 5338 APN episodes among 4773 patients. The proportion with urine culture increased from 75.1% in 2000-2006 to 92.9% in 2013-2018, with a concomitant increase in the proportion with a positive urine culture from 44.4% to 56.7%. The median LOS declined by 2 days across calendar periods. E. coli remained the predominant pathogen with a prevalence in the range 77.3%-81.9%. Non-E. coli APN was more common in male, older, and comorbid patients, and was characterised by longer LOS (median 5 days [IQR: 3-8] vs. 4 days [IQR: 2-6]) and higher 30-day mortality (3.7% [95% CI 2.3%-5.2%] vs. 1.0% [95% CI 0.6%-1.5%]) compared with E. coli.</p><p><strong>Conclusion: </strong>Microbiological testing increased during the study period, and the pathogen distribution remained largely stable with E. coli as the predominant uropathogen. Non-E. coli infections were associated with slightly less favourable short-term outcomes.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"917-929"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13021717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146040852","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":"Effectiveness of antibiotic prophylaxis for ventilator-associated pneumonia in acute brain injury: a systematic review and meta-analysis.","authors":"Marcelo Costa, Aurelia Incristi, Justin Lindsay, Filipe Virgilio Ribeiro, Kristen Paradine, Tate Barney, Rahul Manne, Gustavo de Oliveira Almeida, Amelia Liu, Raphael Bertani, Wellingson Silva Paiva","doi":"10.1007/s15010-025-02709-3","DOIUrl":"10.1007/s15010-025-02709-3","url":null,"abstract":"<p><strong>Background: </strong>Ventilator-associated pneumonia (VAP) affects 30-50% of mechanically ventilated patients with acute brain injury (ABI), exceeding general ICU rates (10-20%) due to aspiration risks and immunosuppression, prolonging ICU stays and morbidity. Although short-course antibiotic prophylaxis (AP; e.g., ceftriaxone) targets early VAP, efficacy in ABI remains debated amid mixed evidence, resistance concerns, and non-endorsement by IDSA/ATS guidelines.</p><p><strong>Methods: </strong>We searched PubMed, Cochrane Library, and Web of Science (inception to October 2024) for RCTs and non-RCTs on systemic AP (short-course beta-lactams) for VAP prevention in ABI (TBI, SAH, stroke, post-arrest coma) requiring ventilation ≥ 48 h.</p><p><strong>Primary outcomes: </strong>early-onset VAP (≤ 96 h), late-onset VAP (> 96 h), overall VAP, ICU mortality. Secondaries: mechanical ventilation duration, ICU/hospital length of stay (LOS), time to first VAP. Random-effects meta-analysis; heterogeneity via I²; risk of bias (RoB 2.0/ROBINS-I).</p><p><strong>Results: </strong>Ten studies (5 RCTs [n = 586], 5 non-RCTs [n = 1,087]; total n = 1,673) were included. AP reduced overall VAP (RR = 0.65, 95% CI: 0.48-0.90, P < 0.001; I² = 75.9%) and early-onset VAP (RR = 0.41, 95% CI: 0.33-0.52, P < 0.001; I² = 0%; events: 88/754 AP vs. 240/832 control). No effect on late-onset VAP (RR = 1.13, 95% CI: 0.72-1.78, P = 0.07; I² = 64.8%) or ICU mortality (RR = 0.91, 95% CI: 0.76-1.08, P = 0.27; I² = 0%). Secondaries: Reduced ICU LOS (MD = - 2.05 days, 95% CI: - 3.73 to - 0.37, P = 0.01; I² = 46%) and hospital LOS (MD = - 5.02 days, 95% CI: - 9.20 to - 0.85, P = 0.02; I² = 70.8%); no difference in ventilation duration (MD = - 1.36 days, 95% CI: - 2.91 to 0.19, P = 0.09) or time to VAP (MD = 1.04 days, 95% CI: - 0.87 to 2.95, P = 0.29). RCTs showed low-moderate bias; non-RCTs moderate-serious (confounding).</p><p><strong>Conclusion: </strong>Short-course AP reduces early/overall VAP and LOS in ABI without impacting late VAP or mortality, supporting targeted use in high-risk cases (e.g., GCS < 8) per stewardship principles. However, heterogeneity, resistance gaps, and guideline caution warrant larger RCTs with non-ABI comparatives to mitigate selection bias and confirm specificity.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"781-793"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145722681","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":"Melioidosis imported to Northern Germany: a case report series.","authors":"Dorothea Ekoka Mbassi, Aiman Gamal Abdelrahim, Ilka Grewe, Pia M Michelitsch, Annette Hennigs, Flaminia Olearo, Marylyn M Addo, Michael Ramharter, Sabine Jordan, Stefan Schmiedel","doi":"10.1007/s15010-025-02692-9","DOIUrl":"10.1007/s15010-025-02692-9","url":null,"abstract":"<p><strong>Purpose: </strong>Melioidosis is a serious infection caused by Burkholderia pseudomallei, a bacterium found in soil, water, and plants in tropical and subtropical regions. The infection can present with a range of clinical symptoms and may be fatal without appropriate treatment.</p><p><strong>Case presentation: </strong>We present four confirmed cases of melioidosis in patients with a history as tourists travelling to endemic areas. These cases illustrate the diverse clinical manifestations of the infection, ranging from respiratory tract involvement to multiple organ abscesses, as well as the therapeutic approaches employed.</p><p><strong>Conclusion: </strong>Melioidosis is a severe infection with variable clinical presentations, including fever, night sweats, weight loss, dyspnoea, and abscess formation at different sites. The broad spectrum of symptoms complicates diagnosis. Therefore, melioidosis should be considered in returning travellers from endemic regions presenting with compatible clinical features. Prolonged antibiotic treatment is essential for effective infection control.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"991-1000"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145632957","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":"Structural mimics of SARS-CoV-2.","authors":"Natasha Killassy, Patrick Arbuthnot, Mohube Betty Maepa","doi":"10.1007/s15010-025-02682-x","DOIUrl":"10.1007/s15010-025-02682-x","url":null,"abstract":"<p><p>Since its first detection in 2019, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has infected approximately 778 million people and claimed 7.1 million lives globally. A deeper understanding of the biology of SARS-CoV-2 was instrumental in facilitating the development of protective vaccines and new therapeutics, as well as evaluating the impact of drug re-purposing to limit the pandemic. To date, approximately 13.64 billion vaccine doses have been administered; with approximately 67% of the global population having completed their primary series of COVID-19 vaccinations. The FDA has authorised the use of several repurposed drugs to combat the disease and while these developments have been instrumental in curbing the pandemic, the approved therapies have shown poor efficacy in cases of severe disease. Furthermore, several vaccine candidates received FDA approval following clinical trials where they proved to be both safe and efficacious. These vaccines were sanctioned for emergency roll-out to the global population, conferring herd immunity and reducing both infections and related mortalities. However, these vaccines are not without flaws and are limited by short term immune responses and poor efficacy against emerging variants, which has resulted in slip-through infections. Hence, efforts to develop potent drugs and vaccines are continuing. In these efforts, physiologically relevant models of SARS-CoV-2 infection are critical. This review describes available SARS-CoV-2 particle mimics, their contribution to COVID-19 research and the development of new vaccines and therapies.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"575-588"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13021691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146018405","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":"Impact of HDV infection on post-transplant outcomes in patients transplanted for HBV-related liver disease: results from a multicenter cohort study in Southern Italy.","authors":"Gianfranca Stornaiuolo, Mariantonietta Pisaturo, Lorenzo Salmoni, Antonio Russo, Debora Angrisani, Giovanni Valente, Francesco Longobardi, Antonella Santonicola, Filomena Morisco, Maria Stanzione, Alfonso Galeota Lanza, Rosaria Focareta, Caterina Sagnelli, Carmine Coppola, Nicola Coppola","doi":"10.1007/s15010-025-02707-5","DOIUrl":"10.1007/s15010-025-02707-5","url":null,"abstract":"<p><strong>Aims: </strong>Patients with HBV and HBV/HDV infection were compared in terms of clinical outcomes after liver transplantation in a long-term follow-up.</p><p><strong>Methods: </strong>In a multicenter retrospective study, the patients, who had received liver transplants for HBV chronic liver disease, were enrolled in a long-term follow-up (1-20 years). The primary outcome was overall survival, the secondary outcome occurrence of clinical events.</p><p><strong>Results: </strong>A total of 257 patients were enrolled, 95 with HBV (HBV group) and 162 with HBV/HDV (HBV/HDV group) infection. Overall, 31 patients died in the follow-up, most frequently due to extrahepatic events. Overall mortality was similar between the two groups (15.8% in HBV vs 9.9% in HBV/HDV group), while deaths from hepatic events were more frequent in the first group (7.4 vs. 1.2%, p = 0.014). In multivariable logistic regression analysis only a history of chronic kidney disease (CKD) at the time of transplantation emerged as independent factor associated with death (OR 7.027, 95% CI 2.068-23.876; p = 0.002). Overall, 84 patients experienced at least one clinical event, mainly onset of renal failure (57 cases), cancer (32) and hepatic clinical (19). Compared with HBV/HDV group, clinical events occurred more frequently in HBV group (44.2 vs. 25.9%; p = 0.003), both hepatic and extrahepatic (11.6 vs. 4.9%, p = 0.050; 35.8 vs. 23.5%, p = 0.034, respectively). In multivariable logistic regression analysis, HBV group (OR 2.243, 95% CI 1.172-4.293; p = 0.015) and CKD at the time of transplantation were associated to the occurrence of clinical events (OR 8.890, 95% CI 2.373-33.306; p = 0.001).</p><p><strong>Conclusions: </strong>In this long-term follow-up study, HDV infection was not associated to a worsen post-transplant outcomes, while chronic kidney disease at transplantation emerged as the strongest predictor of mortality and clinical events.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"771-780"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13021802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145756498","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":"Sex and age differences of inflammatory biomarkers around a bloodstream infection: a population-based cohort study.","authors":"Cathrine Sandager Budtz, Line Riis Jølving, Pedro Póvoa, Stig Lønberg Nielsen, Ram Benny Dessau, Jens Kjølseth Møller, John Eugenio Coia, Kim Oren Gradel","doi":"10.1007/s15010-026-02732-y","DOIUrl":"10.1007/s15010-026-02732-y","url":null,"abstract":"<p><strong>Purpose: </strong>Few studies in humans have revealed differences in the inflammatory responses between biological sexes when encountering serious infections. Our study aimed to investigate how those differences were presented among sexes and age groups from 30 days before (D-30) through 30 days after (D30) a bloodstream infection (BSI).</p><p><strong>Methods: </strong>We did a retrospective population-based cohort study, including patients aged > 15 years with their first-time BSI between 2007 and 2016. Based on aggregated data, we computed daily mean levels of C-reactive protein (CRP) and neutrophils in the D-30/D30 period, separately for females and males within the age groups 15-49 and ≥ 50 years. For each age group, we used adjusted multilevel mixed effects linear regression analyses to detect differences in daily mean levels between females and males.</p><p><strong>Results: </strong>A total of 24,074 patients had 268,648 specimens with CRP and 138,482 with neutrophils. CRP and neutrophils peak values were significantly higher in females, reaching their highest values among the ≥ 50 years group. For all age groups, peak values occurred for CRP at D1 and for neutrophils at D0. Neutrophil values were more equal between the sexes, although higher levels were found in the ≥ 50 year age group among females after D-4.</p><p><strong>Conclusion: </strong>Females and males with BSI exhibited different trajectories and different peak values close to the BSI episode, in particular in females in the ≥ 50-year age group. Severe infections, such as BSI, need further investigation regarding sex differences, stratified into age groups for expected female menopause.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"941-950"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13021796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146010272","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":"Epidemiological profile of causative agents in nosocomial pneumonia: a four-year multicenter surveillance study from Georgia (2020-2023).","authors":"Giorgi Mgeladze, Shorena Khetsuriani, Giorgi Maisuradze, Sopio Gachechiladze, Giorgi Akhvlediani, Maia Mikeladze","doi":"10.1007/s15010-025-02702-w","DOIUrl":"10.1007/s15010-025-02702-w","url":null,"abstract":"<p><strong>Background: </strong>Nosocomial pneumonia (NP), including hospital-acquired (HAP) and ventilator-associated pneumonia (VAP), remains a leading cause of morbidity, mortality, and antimicrobial resistance worldwide. Data from Eastern Europe and the Caucasus are scarce, limiting region-specific infection control strategies.</p><p><strong>Methods: </strong>We conducted a prospective multicenter surveillance study across five tertiary hospitals in Georgia from May 2020 to December 2023. A total of 484 respiratory specimens were obtained from 397 adult patients with microbiologically confirmed NP. Pathogen identification was performed using culture and MALDI-TOF MS, with antimicrobial susceptibility testing according to CLSI guidelines. PCR assays detected major resistance genes. Epidemiological, molecular, and clinical outcomes were evaluated, including temporal trends and comparisons between ICU and non-ICU patients.</p><p><strong>Results: </strong>Gram-negative bacteria predominated (71.7%), with Pseudomonas aeruginosa (41.9%) as the leading pathogen, followed by Staphylococcus aureus (21.3%), Acinetobacter baumannii (13.4%), Klebsiella pneumoniae (13.0%), and Streptococcus pneumoniae (9.3%). Multidrug resistance (MDR) was identified in 80% of isolates, extensively drug-resistant (XDR) phenotypes in 18.4%, and pandrug-resistant (PDR) phenotypes in 1.4%. ESBL prevalence increased from 48.3% in 2020 to 79.8% in 2023 (p < 0.001), carbapenemase expression doubled from 15.0% to 30.2% (p < 0.01), and colistin resistance rose from 2.5% to 8.5% (p < 0.05). ICU isolates showed significantly higher MDR and XDR rates than those from non-ICU settings (p < 0.001). Thirty-day mortality correlated with resistance phenotype, ranging from 18.2% in susceptible infections to 71.4% in PDR cases.</p><p><strong>Conclusions: </strong>This four-year study shows high and increasing antimicrobial resistance among NP pathogens in Georgia, especially in ICU settings. The rise in ESBL, carbapenemase, and colistin resistance highlights the need to strengthen antimicrobial stewardship, infection prevention, and genomic surveillance to control the spread of high-risk strains and improve patient outcomes in resource-limited settings.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"749-759"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145707828","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 systematic review and meta-analysis on diagnostic accuracy of point-of-care C-reactive protein devices for acute respiratory tract infections.","authors":"Rakesh Kumar Sahoo, Krushna Chandra Sahoo, Oshima Sachin, Abhinav Sinha, Shubharanjan Jena, Abhisek Jena, Debdutta Bhattacharya, Sanghamitra Pati","doi":"10.1007/s15010-025-02721-7","DOIUrl":"10.1007/s15010-025-02721-7","url":null,"abstract":"<p><p>Acute respiratory tract infections (ARTIs) are among the most common reasons for antibiotic prescriptions globally, despite the majority being viral and self-limiting. Because clinical signs alone are often insufficient, there is a clear need for rapid diagnostic methods to support evidence-based prescribing. We assessed the effectiveness of point-of-care C-reactive protein (POCT-CRP) testing devices for distinguishing between bacterial and viral ARTIs. Our search of five databases produced 413 studies, of which 29 met criteria, and six were included in the meta-analysis. The devices with adequate performance data were QuikRead CRP, NycoCard Reader II, and FebriDx®. Overall pooled sensitivity 70% (95% CI 52-83%) and specificity 86% (95% CI 80-91%). The FebriDx showed a pooled sensitivity of 84% (95% CI 76-90%) and specificity of 87% (95% CI 82-91%). The QuikRead showed a pooled sensitivity of 35% (95% CI 30-40%) and specificity of 86% (95% CI 82-89%). The NycoCard Reader II showed a pooled sensitivity of 54% (95% CI 21-83%) and specificity of 86% (95% CI 59-96%). Although POCT-CRP testing is useful in distinguishing between bacterial and viral ARTIs and is critical for antibiotic prescription, further evidence, including cost-effectiveness analysis, is needed to determine whether the implementation of POCT-CRP improves value or merely raises healthcare expenses.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"683-706"},"PeriodicalIF":3.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145911399","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}