Infection最新文献

{"title":"Beyond granulomatous amoebic encephalitis: changing epidemiology and an expanding spectrum of non-flagellated amoebic CNS infection in India.","authors":"Nitin Gupta, Aravind Reghukumar, Tirlangi Praveen Kumar","doi":"10.1007/s15010-026-02986-6","DOIUrl":"https://doi.org/10.1007/s15010-026-02986-6","url":null,"abstract":"<p><strong>Purpose: </strong>Granulomatous amoebic encephalitis (GAE) is the conventional label for central nervous system (CNS) infection caused principally by Acanthamoeba spp. and Balamuthia mandrillaris, but contemporary disease encompasses meningitic, focal, vascular, brainstem, and spinal phenotypes that extend beyond the classical description. This narrative review examines the changing epidemiology, clinical spectrum, diagnosis, and management of non-flagellated amoebic CNS infection in India.</p><p><strong>Methods: </strong>We narratively synthesised published Indian case reports, case series, molecular studies, surveillance investigations, and relevant environmental and epidemiological evidence on CNS infections caused by Acanthamoeba, Balamuthia, Vermamoeba, and Sappinia.</p><p><strong>Results: </strong>Historically, disease in India was recognised mainly through sporadic reports of Acanthamoeba GAE, with occasional confirmed Balamuthia infection. More recent reports from several regions, particularly Karnataka and West Bengal, together with systematic surveillance in Kerala, suggest a substantial expansion in recognised disease. Contemporary Indian experience increasingly includes apparently immunocompetent patients and a broader neurological spectrum, including chronic meningitis mimicking CNS tuberculosis, focal abscess, parkinsonism, myelopathy, and rhombencephalomyelitis; relapse after apparent recovery has also been documented. Water-related exposures and use of nonchlorinated domestic water have emerged as potentially important epidemiological associations. Molecular studies confirm that Acanthamoeba is the dominant contemporary organism, whereas Balamuthia remains rare; reported Vermamoeba infections warrant cautious interpretation, and no Indian Sappinia CNS infection was identified. Treatment remains empirical, multidrug, and poorly standardised.</p><p><strong>Conclusion: </strong>The recent Indian experience probably reflects substantial diagnostic discovery superimposed on a possible true increase in environmentally acquired Acanthamoeba CNS infection. Organism-specific surveillance, improved molecular diagnosis, and prospective treatment data are needed to define the true burden, transmission pathways, and optimal management of these infections.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108932","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":"Oral tebipenem pivoxil for complicated urinary tract infections: evidence, potential role in IV-to-oral transition, and antimicrobial stewardship.","authors":"Mohammed Alkhanafsa, Jamil Wafi, Soud Deek","doi":"10.1007/s15010-026-02991-9","DOIUrl":"https://doi.org/10.1007/s15010-026-02991-9","url":null,"abstract":"<p><strong>Purpose: </strong>Complicated urinary tract infections (cUTIs), including pyelonephritis, are increasingly challenging when resistant Enterobacterales eliminate conventional oral treatment options. Tebipenem pivoxil (UTEBZI), approved by the US Food and Drug Administration in June 2026, is the first oral carbapenem approved in the United States for selected adults with cUTI. This review evaluates its pharmacology, microbiological activity, efficacy, safety, and potential role in intravenous (IV)-to-oral treatment and antimicrobial stewardship METHODS: A structured narrative review of PubMed/MEDLINE, regulatory documents, clinical-trial reports, guidelines, pharmacokinetic/pharmacodynamic studies, microbiological studies, and relevant oral step-down literature was conducted through 12 August 2026. Priority was given to randomized phase 3 trials, FDA prescribing information, and IDSA guidance RESULTS: ADAPT-PO and PIVOT-PO demonstrated noninferiority of complete oral tebipenem regimens to IV ertapenem and IV imipenem-cilastatin, respectively, with high clinical cure rates. Tebipenem retains activity against many ESBL- and AmpC-producing Enterobacterales but lacks reliable activity against major carbapenemases. Neither phase 3 trial randomized clinically improving patients after initial IV therapy; therefore, direct randomized evidence for a formal tebipenem step-down strategy is lacking. Important uncertainties include limited bacteremia data, every-six-hour adherence, optimal post-IV duration, cost-effectiveness, microbiome effects, and resistance selection CONCLUSION: Tebipenem is an important culture-directed oral option for selected adults with cUTI when narrower effective oral agents are unavailable. Its most defensible early role is replacement of otherwise necessary continued IV carbapenem therapy in carefully selected patients, with source control, susceptibility confirmation, renal doseadjustment, safety screening, duration planning, and stewardship oversight. Dedicated switch, bacteremia, implementation, and resistance-surveillance studies remain needed.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109227","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":"Contact behavior and serological evidence of influenza reinfection across three post-COVID-19 pandemic seasons in a nationwide German cohort.","authors":"Heiko Hampel, Manuela Harries, Carolina J Klett-Tammen, Patrick Marsall, Johanna Griesbaum, Madeleine Fandrich, Alex Dulovic, Jana Prokein, André Karch, Veronika K Jaeger, Berit Lange","doi":"10.1007/s15010-026-02947-z","DOIUrl":"https://doi.org/10.1007/s15010-026-02947-z","url":null,"abstract":"<p><strong>Background: </strong>Influenza remains a global public health burden. While interpersonal contacts drive transmission, their association with individual-level reinfection risk is not well quantified, particularly in the post-COVID-19 period. We assessed the relationship between contact frequency and serological evidence of influenza reinfection across three consecutive seasons.</p><p><strong>Methods: </strong>In this multicentre, population-based panel study conducted between 2020 and 2024, binding antibody titers against hemagglutinin antigens of three influenza subtypes (A(H1N1), A(H3N2), and B) were measured by a bead-based multiplex immunoassay. Serological evidence of influenza reinfection was defined by fold-changes relative to the preceding season; with adjustments to minimize misclassification due to influenza vaccination. Logistic regression models were designed to estimate crude odds ratios (ORs) and DAG-informed adjusted odds ratios (aORs) for reinfection associated with total, household, and non-household contacts.</p><p><strong>Results: </strong>Serological reinfection was detected in 14% (2021/22), 17% (2022/23), and 12% (2023/24) of participants. Among self-reported unvaccinated participants, reinfection was detected in 6%, 13% and 17% across the respective seasons. Non-household contacts were associated with increased odds of reinfection in one season (2022/23: aOR 1.008, 95% CI 1.002-1.014), while household contacts were associated with higher odds of reinfection in two seasons (2022/23: aOR 1.285, 95% CI 0.905-1.823; 2023/24: aOR 1.267, 95% CI 0.685-2.343).</p><p><strong>Conclusions: </strong>Serological evidence of reinfection among unvaccinated participants in comparison with all participants aligned more closely with surveillance data in 2021/22. Residual misclassification of vaccination or preceding infections may partly explain the absence of an association in 2021/22. Associations between contact behavior and reinfection were season-specific, with household contacts showing the strongest and most consistent effects.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109064","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":"Knowledge, attitudes and educational exposure regarding neglected tropical diseases among medical students and residents in Italy: a nationwide multicenter survey from the Italian Society for Tropical Medicine and Global Health (SIMET ETS).","authors":"Giacomo Guido, Rosa Buonamassa, Benedetta Rossi, Anna Barbiero, Claudia Mangiapelo, Federica Perego, Eleonora Perugini, Ilenia Annunziata Ritacco, Andrea De Vito, Giordano Madeddu, Francesca Serapide, Alessandro Russo, Giuseppina De Iaco, Mariantonietta Pisaturo, Nicola Coppola, Emanuele Nicastri, Federico Gobbi, Salvatore Scarso, Rosalia Marrone, Serafino Maria Kai Poli, Emanuele Rollo, Claudia Zella, Alessandra D'Abramo, Annalisa Saracino, Roberta Iatta, Guido Calleri, Angela Corpolongo, Francesco Di Gennaro","doi":"10.1007/s15010-026-02987-5","DOIUrl":"https://doi.org/10.1007/s15010-026-02987-5","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Neglected tropical diseases (NTDs) represent a major cause of preventable morbidity and are increasingly relevant in high-income settings because of migration, international travel, climate-sensitive vector expansion and persistent health inequities. However, NTDs-related knowledge and educational exposure among future and early-career physicians in Europe remain poorly documented. This study assessed NTDs-related knowledge, attitudes and practice-related experiences among medical students and residents in Italy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a national multicenter cross-sectional survey through a structured and previously validated REDCap questionnaire distributed across 40 Italian universities covering all 20 Italian regions. The survey included demographic and academic variables, exposure to NTDs-related teaching, six clinical vignettes, ten theoretical knowledge questions, Likert-scale attitude items and practice-related experience questions. The questionnaire had undergone a multi-step validation process, including a two-round Delphi assessment with a multidisciplinary expert panel, external expert evaluation and psychometric testing. A basic knowledge threshold of ≥ 50% correct responses was defined a priori by consensus within the SIMET working group as an operational criterion for basic knowledge. A more stringent high-knowledge threshold was defined as ≥ 12 correct answers out of 16.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 2,088 questionnaires were received; 267 (12.8%) were excluded because of incomplete or insufficient data, leaving 1,821 analyzable responses (87.2%), including 1,366 medical students (75.0%) and 455 residents (25.0%). Median age was 25 years (IQR 22-29) and 60.1% were female. Regarding formal curricular teaching, 40.7% of participants reported no hours of NTDs-related teaching, whereas only 8.5% reported more than 10 h. Only 38.6% reached the basic knowledge threshold and 32.7% correctly answered at least four out of six clinical vignettes. A much smaller proportion (8.7%) reached the high-knowledge threshold of ≥ 12/16 correct answers, with markedly higher attainment among residents than medical students (32.3% vs. 0.8%; p &lt; 0.001). Nevertheless, attitudes were highly favorable: 92.4% supported mandatory inclusion of NTDs in educational curricula, 90.8% were willing to attend dedicated courses and 93.8% considered workshops useful. In multivariable analysis, increasing hours of formal NTDs-related teaching were associated with progressively higher odds of achieving the basic knowledge threshold (&lt; 5 h: aOR 1.25, 95% CI 1.00-1.56; 5-10 h: aOR 1.63, 95% CI 1.24-2.13; &gt;10 h: aOR 2.42, 95% CI 1.74-3.37), with a significant linear trend across categories (p for trend = 0.002). Participation in dedicated educational activities (aOR 1.84, 95% CI 1.49-2.27) and previous suspicion or diagnosis of an NTD case (aOR 1.52, 95% CI 1.18-1.96) were also independently associated with t","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109289","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":"Bacteriophage therapy for multidrug- and extensively drug-resistant Acinetobacter baumannii: isolation, characterization, and therapeutic applications.","authors":"Hafiz Anas Saeed, Arslan Ullah Khan, Mahnoor Jan, Umer Farooq, Muhammad Usama Nadeem, Rabia Arooj, Hafiz Muhammad Husnain Azam, Nazim Hussain","doi":"10.1007/s15010-026-02980-y","DOIUrl":"https://doi.org/10.1007/s15010-026-02980-y","url":null,"abstract":"<p><strong>Background: </strong>Acinetobacter baumannii is a WHO critical-priority pathogen that causes life-threatening healthcare-associated infections, particularly in intensive care units (ICUs). In South Asia and the Middle East, multidrug-resistant (MDR) and extensively drug-resistant (XDR) strains are common and resistance to cephalosporins is 87-100% and to carbapenems 78-90%, leaving only a few remaining therapeutic options like colistin, tigecycline, and polymyxin B.</p><p><strong>Objectives: </strong>This review aimed to provide an overview of the current knowledge regarding the epidemiology, virulence factors, and resistance mechanisms of MDR/XDR A. baumannii globally and within Pakistan, with particular emphasis on therapeutic approach using bacteriophages as potential alternative to conventional antimicrobial therapy. This review is distinguished from prior publications on A. baumannii phage therapy by its integration of Pakistan-specific epidemiological and phage-isolation data with a critical, comparative synthesis of phage-antibiotic synergy evidence and emerging (2024-2026) clinical and preclinical literature.</p><p><strong>Content: </strong>This review synthesizes current isolation, purification, and genomic/proteomic characterization methods for A. baumannii-targeting bacteriophages, and critically evaluates phage-antibiotic synergy (PAS), in vivo and compassionate-use clinical evidence, and translational and regulatory barriers, alongside emerging alternative antimicrobial strategies and surveillance gaps in resource-limited settings such as Pakistan.</p><p><strong>Conclusions: </strong>In conclusion, combination therapy of phage and antibiotics, especially sequential phage-colistin therapy, is a promising strategy against MDR/XDR A. baumannii infections. There are several key priorities for the future to consider, such as the establishment of national phage banks, development of standardized phage susceptibility testing (phagograms), and the integration of phage therapy into antimicrobial stewardship and surveillance frameworks, especially in high-burden, resource-limited settings such as Pakistan.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108855","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":"Early antimicrobial therapy and clinical outcomes of left-sided Enterococcus faecalis endocarditis: a NIDUS registry study.","authors":"Anna Stahl, Lauge Østergaard, Katra Hadji-Turdeghal, Peter L Graversen, Ida Holm Jessen Knudsen, Louise Marqvard Sørensen, Anders Dahl, Jacob Eifer Møller, Niels Eske Bruun, Jonas Agerlund Povlsen, Claus Moser, Morten Smerup, Peter Godsk Jørgensen, Søren Fanø, Jannik Helweg-Larsen, Daniel Faurholt-Jepsen, Henning Bundgaard, Kasper Iversen, Lars Køber, Emil L Fosbøl","doi":"10.1007/s15010-026-02974-w","DOIUrl":"https://doi.org/10.1007/s15010-026-02974-w","url":null,"abstract":"<p><strong>Purpose: </strong>Antimicrobial therapy of Enterococcus faecalis endocarditis treatment is challenged by high intrinsic resistance and relapse rates. Knowledge on practice patterns is warranted. We aimed to describe early-phase monotherapy and combination therapy use in E. faecalis endocarditis treatment.</p><p><strong>Methods: </strong>This retrospective, nationwide cohort study was conducted in Denmark between 2016 and 2021. All patients with left-sided E. faecalis endocarditis were derived from the NatIonal Danish endocarditis stUdieS registry (NIDUS). Antimicrobial therapy during the first 10 days was compared between monotherapy and combination therapy. The groups were compared by in-hospital mortality, acute kidney injury and surgery with logistic regression and 6-month relapse and recurrence rate and 6-month mortality rate with Kaplan-Meier estimates and multivariable cox regression.</p><p><strong>Results: </strong>We included 392 patients, 59(15.1%) received monotherapy and 333 (84.9%) combination therapy. Patients in monotherapy were older (median 79.3 versus 76.0 years) and had more comorbidities. Monotherapy comprised ampicillin (74.6%), vancomycin (16.9%) and penicillin (6.8%). Among combination regimens the most frequent were ampicillin +gentamicin (65.4%), ampicillin + linezolid (6.6%) and ampicillin + ceftriaxone (5.1%). Surgical rates were comparable. Acute kidney injury during admission occurred in 20.7% versus 16.6% patients. No significant difference in relapse (5.9% versus 8.5%) or recurrence rates (5.4% versus 6.8%) was found. Similar in-hospital mortality (13.8% vs. 11.9%) and 6-month mortality rates were seen in the monotherapy and combination therapy groups.</p><p><strong>Conclusion: </strong>The most common treatment of E. faecalis endocarditis was combination therapy, however certain selected patients were treated with monotherapy with similar outcomes. Use of monotherapy remains controversial and would need testing in a controlled randomized setting.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109036","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":"Prevalence and clinical impact of dento-alveolar foci in periprosthetic joint infections: a retrospective cohort study of 213 cases.","authors":"Christina Pempe, Gerhard Schmalz, Dirk Ziebolz, Andreas Roth","doi":"10.1007/s15010-026-02814-x","DOIUrl":"https://doi.org/10.1007/s15010-026-02814-x","url":null,"abstract":"<p><strong>Purpose: </strong>Periprosthetic joint infection (PJI) is a serious complication after total joint arthroplasty, leading to repeated revisions, substantial costs, and increased morbidity. Oral pathologies have been suggested as possible sources of hematogenous infection, however their prevalence and impact on PJI outcomes remain unclear. This study aimed to determine the prevalence of dento-alveolar foci in hip or knee PJI patients and explore differences in outcomes.</p><p><strong>Methods: </strong>Patients with hip or knee periprosthetic joint infection (PJI) were retrospectively screened at a single center between 2020 and 2023. Inclusion required a confirmed diagnosis according to the 2018 International Consensus Meeting (ICM) criteria and a clinical and radiological dental assessment to identify dento-alveolar foci. Dento-alveolar foci were defined as pathological findings requiring therapeutic intervention. The primary outcome was the presence of a dental focus. Secondary outcomes included differences in outcomes, especially DAIR-failure and revision surgery rates between groups.</p><p><strong>Results: </strong>Among 213 PJI cases (mean 71.9 ± 10.4 years; 52% male), dento-alveolar foci were identified in 59/213 patients (27.7%). Prevalence was similar across infection type. DAIR failure occured in 6/22 patients (27.3%) vs. 26/61 patients (42.6%; p = 0.205) and revision surgery rates were 25/59 (42.4%) vs. 79/144 (54.9%; p = 0.106). No significant differences were observed between patients with and without dental foci. Baseline characteristics and infection patterns were comparable.</p><p><strong>Conclusion: </strong>Dento-alveolar foci were frequently detected in PJI patients but were not descriptively associated with differences in treatment outcomes. Immediate preemptive dental interventions may not be required during acute PJI management. Prospective studies are needed to clarify the clinical relevance of dental foci in PJI.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics and outcomes of localized versus disseminated nontuberculous mycobacterial disease in people living with HIV, 2004-2025.","authors":"Johannes Zielke, Alexander Killer, Clara de Angelis, Colin R Mackenzie, Tom Luedde, Björn-Erik Ole Jensen, Smaranda Gliga","doi":"10.1007/s15010-026-02999-1","DOIUrl":"https://doi.org/10.1007/s15010-026-02999-1","url":null,"abstract":"<p><strong>Purpose: </strong>Advanced or untreated HIV remains an important risk factor for opportunistic infections, including nontuberculous mycobacteria (NTM). We assessed disease extent, recurrence, and mortality in adults with HIV and NTM disease over 21 years at University Hospital Düsseldorf.</p><p><strong>Methods: </strong>We conducted a retrospective study at University Hospital Düsseldorf of adults with HIV and microbiologically confirmed or clinically diagnosed NTM disease between April 2004 and April 2025. Dissemination was defined as NTM detection at a normally sterile site, involvement of at least two non-contiguous sites, or clinically diagnosed multifocal or systemic disease. Survival was assessed using Kaplan-Meier analysis and Cox regression.</p><p><strong>Results: </strong>Fifty patients were included; median age was 42 years, 68% were male, median CD4 count was 27 cells/µL and 52% were receiving ART at the time of NTM diagnosis. The most frequent pathogens were Mycobacterium avium complex (54%), M. genavense (14%) and M. kansasii (8%). Disseminated disease occurred in 31/50 patients (62%) and was associated with lower CD4 counts than localized disease (median 12 vs. 51 cells/µL; p = 0.002). The crude proportion of deaths was higher in disseminated than localized disease (32.3% vs. 5.3%; Fisher's exact p = 0.035), whereas the survival comparison did not reach statistical significance (log-rank p = 0.052); 5/11 deaths occurred within 3 months of NTM diagnosis. Recurrence occurred only after disseminated disease (25.8% vs. 0%; Fisher's exact p = 0.018).</p><p><strong>Conclusion: </strong>NTM disease was largely a complication of late-diagnosed or untreated HIV. Disseminated disease was associated with higher crude mortality and recurrence, and nearly half of deaths occurred within three months of diagnosis. These findings indicate the need for prospective evaluation of interventions to facilitate earlier HIV diagnosis, rapid ART initiation, adherence support, and close follow-up after NTM diagnosis.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109100","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":"β-Lactam-Induced Encephalopathy: An Underrecognized Complication Of Commonly Used Antibiotics-A Case Report.","authors":"Bronz Gabriel, Ciobanu Georgiana, Ogna Adam, Utebay Didar","doi":"10.1007/s15010-026-02956-y","DOIUrl":"10.1007/s15010-026-02956-y","url":null,"abstract":"<p><strong>Background: </strong>β-lactam-induced encephalopathy is an underrecognized cause of altered mental status, particularly in hospitalized patients. Despite being described decades ago, its diagnosis remains challenging.</p><p><strong>Case presentation: </strong>We report the case of a 67-year-old man with septic shock secondary to Streptococcus pyogenes - mediastinitis who developed a minimally state of consciousness, psychomotor agitation, myoclonus, and dyskinesia, during treatment with different β-lactam antibiotics (ceftriaxone, amoxicillin, meropenem). Extensive neurological workup, including brain magnetic resonance imaging, cerebrospinal fluid analysis, and autoimmune testing, was unremarkable, while electroencephalography showed diffuse, non-specific slowing. A drug-induced encephalopathy was suspected. Discontinuation of β-lactam antibiotics led to rapid clinical improvement. Subsequent re-exposure resulted in recurrence of symptoms, which again rapidly resolved after drug withdrawal. This reproducible pattern strongly supported a causal relationship.</p><p><strong>Discussion: </strong>This case illustrates key features of β-lactam-induced encephalopathy. Importantly, the recurrence of symptoms following exposure to structurally distinct β-lactam agents provides compelling evidence of a class effect. The condition may occur even in the absence of severe renal failure such as our patient, highlighting the role of individual susceptibility.</p><p><strong>Conclusion: </strong>β-lactam-induced encephalopathy is an underrecognized but clinically significant adverse drug reaction. Increased awareness of this condition may facilitate earlier diagnosis and prompt discontinuation of the offending agent.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149080792","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":"Publisher Correction: Syphilis and neurosyphilis in people living with HIV: analysis of cerebrospinal fluid findings.","authors":"Tobias Weirauch, Sarah Plano, Markus Bickel, Pavel Khaykin, Anette Haberl, Gundolf Schüttfort, Timo Wolf, Benjamin Marx, Silke Besier, Thomas A Wichelhaus, Christoph Stephan","doi":"10.1007/s15010-026-02949-x","DOIUrl":"https://doi.org/10.1007/s15010-026-02949-x","url":null,"abstract":"","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149080794","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}