Infection最新文献

{"title":"Efficacy and safety of colistin plus beta-lactams for bone and joint infection caused by fluoroquinolone-resistant gram-negative bacilli: a prospective multicenter study.","authors":"Mikel Mancheño-Losa, Oscar Murillo, Eva Benavent, Luisa Sorlí, Melchor Riera, Javier Cobo, Natividad Benito, Laura Morata, Alba Ribera, Beatriz Sobrino, Marta Fernández-Sampedro, Elena Múñez, Alberto Bahamonde, José María Barbero, Mª Dolores Del Toro, Jenifer Villa, Raül Rigo-Bonnin, Sonia Luque, Isabel García-Luque, Antonio Oliver, Jaime Esteban, Jaime Lora-Tamayo","doi":"10.1007/s15010-024-02379-7","DOIUrl":"10.1007/s15010-024-02379-7","url":null,"abstract":"<p><strong>Objectives: </strong>The prognosis of bone and joint infections (BJI) caused by Gram-negative bacilli (GNB) worsens significantly in the face of fluoroquinolone-resistance. In this setting, scarce pre-clinical and clinical reports suggest that intravenous beta-lactams plus colistin may improve outcome. Our aim was to assess the efficacy and safety of this treatment in a well-characterized prospective cohort.</p><p><strong>Methods: </strong>Observational, prospective, non-comparative, multicenter (14 hospitals) study of adults with BJI caused by fluoroquinolone-resistant GNB treated with surgery and intravenous beta-lactams plus colistin for ≥ 21 days. The primary endpoint was the cure rate.</p><p><strong>Results: </strong>Of the 44 cases included (median age 72 years [IQR 50-81], 22 [50%] women), 32 (73%) had an orthopedic device-related infection, including 17 (39%) prosthetic joints. Enterobacterales were responsible for 27 (61%) episodes, and Pseudomonas spp for 17 (39%), with an overall rate of MDR/XDR GNB infections of 27/44 (61%). Patients were treated with colistin plus intravenous beta-lactam for 28 days (IQR 22-37), followed by intravenous beta-lactam alone for 19 days (IQR 5-35). The cure rate (intention-to-treat analysis; median follow-up = 24 months, IQR 19-30) was 82% (95% CI 68%-90%) and particularly, 80% (95% CI 55%-93%) among patients managed with implant retention. Adverse events (AEs) leading to antimicrobial withdrawal occurred in 10 (23%) cases, all of which were reversible. Colistin AEs were associated with higher plasma drug concentrations (2.8 mg/L vs. 0.9 mg/L, p = 0.0001).</p><p><strong>Conclusions: </strong>Combination therapy with intravenous beta-lactams plus colistin is an effective regimen for BJI caused by fluoroquinolone-resistant GNB. AEs were reversible and potentially preventable by close therapeutic drug monitoring.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"359-372"},"PeriodicalIF":5.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153934","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 association between COVID-19 vaccine/infection and new-onset asthma in children - based on the global TriNetX database.","authors":"Chiao-Yu Yang, Yu-Hsiang Shih, Chia-Chi Lung","doi":"10.1007/s15010-024-02329-3","DOIUrl":"10.1007/s15010-024-02329-3","url":null,"abstract":"<p><strong>Introduction: </strong>The COVID-19 pandemic has underscored the importance of its potential long-term health effects, including its link to new-onset asthma in children. Asthma significantly impacts children's health, causing adverse outcomes and increased absenteeism. Emerging evidence suggests a potential association between COVID-19 infection and higher rates of new-onset asthma in adults, raising concerns about its impact on children's respiratory health.</p><p><strong>Methods: </strong>A retrospective cohort study design was employed, using electronic medical records from the TriNetX database, covering January 1, 2021, to December 31, 2022. Two cohorts of children aged 5 to 18 who underwent SARS-CoV-2 RT-PCR testing were analyzed: unvaccinated children with and without COVID-19 infection, and vaccinated children with and without infection. Propensity score matching was used to mitigate selection bias, and hazard ratio (HR) and 95% CI were calculated to assess the risk of new-onset asthma.</p><p><strong>Results: </strong>Our study found a significantly higher incidence of new-onset asthma in COVID-19 infected children compared to uninfected children, regardless of vaccination status. In Cohort 1, 4.7% of COVID-19 infected children without vaccination developed new-onset asthma, versus 2.0% in their non-COVID-19 counterparts within a year (HR = 2.26; 95% CI = 2.158-2.367). For Cohort 2, COVID-19 infected children with vaccination showed an 8.3% incidence of new-onset asthma, higher than the 3.1% in those not infected (HR = 2.745; 95% CI = 2.521-2.99). Subgroup analyses further identified higher risks in males, children aged 5-12 years, and Black or African American children. Sensitivity analyses confirmed the reliability of these findings.</p><p><strong>Conclusion: </strong>The study highlights a strong link between COVID-19 infection and an increased risk of new-onset asthma in children, which is even more marked in those vaccinated. This emphasizes the critical need for ongoing monitoring and customized healthcare strategies to mitigate the long-term respiratory impacts of COVID-19 in children, advocating for thorough strategies to manage and prevent asthma amidst the pandemic.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"125-137"},"PeriodicalIF":5.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141431866","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":"Disseminated, fatal reactivation of bovine tuberculosis in a patient treated with adalimumab: a case report and review of the literature.","authors":"Gioele Capoferri, Giovanni Ghielmetti, Bettina Glatz, Markus R Mutke, Alexandar Tzankov, Roger Stephan, Peter M Keller, Niklaus D Labhardt","doi":"10.1007/s15010-024-02364-0","DOIUrl":"10.1007/s15010-024-02364-0","url":null,"abstract":"<p><strong>Purpose: </strong>Tumor necrosis factor inhibitors (TNFi) are known to increase the risk of tuberculosis (TB) reactivation, though cases involving Mycobacterium bovis are rarely reported.</p><p><strong>Case presentation/results: </strong>We describe a case of disseminated TB with M. bovis in a 78-year-old woman with a negative Interferon-Gamma-Release Assay (IGRA), taking adalimumab due to rheumatoid polyarthritis, which resulted in a fatal outcome. The atypical clinical and histopathological features were initially interpreted as sarcoidosis. The case occurred in Switzerland, an officially bovine tuberculosis-free country. The whole genome sequence of the patient's cultured M. bovis isolate was identified as belonging to the animal lineage La1.2, the main genotype in continental Europe, but showed significant genetic distance from previously sequenced Swiss cattle strains. In a literature review, four cases of bovine tuberculosis reactivation under TNFi treatment were identified, with pulmonal, oral and intestinal manifestations. Similar to our patient, two cases presented a negative IGRA before TNFi initiation, which later converted to positive upon symptomatic presentation of M. bovis infection.</p><p><strong>Conclusion: </strong>This case highlights the diagnostic challenges of TB in immunosuppressed patients, the limited sensitivity of IGRA, and the importance of considering TB reactivation even in regions declared free of bovine tuberculosis. Detailed patient histories, including potential exposure to unpasteurized dairy products, are essential for guiding preventive TB treatment before TNFi initiation.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"481-487"},"PeriodicalIF":5.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141982237","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":"25 years of experience on the management of enterococcal infective endocarditis an observational study.","authors":"Lorenz Schubert, Rui-Yang Chen, Matthias Weiss-Tessbach, Richard Kriz, Markus Obermüller, Matthias Jackwerth, Wolfgang Barousch, Heinz Burgmann, Manuel Kussmann, Ludwig Traby","doi":"10.1007/s15010-024-02407-6","DOIUrl":"10.1007/s15010-024-02407-6","url":null,"abstract":"<p><strong>Purpose: </strong>As they are effective and well tolerated, aminopenicillins are still the cornerstone for the treatment of enterococcal infections. Current treatment guidelines for infective endocarditis (IE) recommend combination treatments, which carry a higher risk of adverse effects and are based on limited in vitro and experimental data. The aim of this study was therefore to evaluate the treatments of enterococcal IE in real-life practice.</p><p><strong>Methods: </strong>A total of 4121 episodes of enterococcal bloodstream infections, occurring between 1994 and 2019, were screened for the evidence of IE. Baseline characteristics, risk factors for complicated infections and treatment information were assessed and analyzed using Cox regression analysis.</p><p><strong>Results: </strong>Overall, 80 (3.9%) IE episodes were identified of which 78 were included in the final analysis. Treatment regimens in our cohort comprised aminopenicillin-monotherapy (n = 20), teicoplanin-monotherapy (n = 26), other monotherapies (OMT) (n = 8), as well as combinations of ampicillin plus daptomycin (n = 8), ampicillin plus gentamicin (n = 4) or other combinations (n = 9). Overall mortality at 28-days was low (9 of 75) and increased to (19 of 75) after 6-months. Frequency of moderate to severe valve regurgitation (p = 0.89), or signs of uncontrolled infection (p = 0.5) and vegetation size ≥ 10 mm (p = 0.11) were similar in the treatment groups. None of the treatment groups was associated with increased hazard for IE-related mortality.</p><p><strong>Conclusions: </strong>This retrospective study complements previous evidence, demonstrating that monotherapy regimens may be a suitable and effective option for the treatment of IE and supports the need for a prospective evaluation of aminopenicillin-monotherapy for initial and subsequent therapy in these patients.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"467-474"},"PeriodicalIF":5.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464320","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":"Predictors of mortality of Pseudomonas aeruginosa bacteraemia and the role of infectious diseases consultation and source control; a retrospective cohort study.","authors":"Matthaios Papadimitriou-Olivgeris, Laurence Senn, Damien Jacot, Benoit Guery","doi":"10.1007/s15010-024-02326-6","DOIUrl":"10.1007/s15010-024-02326-6","url":null,"abstract":"<p><strong>Purpose: </strong>To determine predictors of mortality among patients with Pseudomonas aeruginosa bacteraemia.</p><p><strong>Methods: </strong>Retrospective study.</p><p><strong>Setting: </strong>This study conducted at the Lausanne University Hospital, Switzerland included adult patients with P. aeruginosa bacteraemia from 2015 to 2021.</p><p><strong>Results: </strong>During the study period, 278 episodes of P. aeruginosa bacteraemia were included. Twenty (7%) isolates were multidrug-resistant. The most common type of infection was low respiratory tract infection (58 episodes; 21%). Sepsis was present in the majority of episodes (152; 55%). Infectious diseases consultation within 48 h of bacteraemia onset was performed in 203 (73%) episodes. Appropriate antimicrobial treatment was administered within 48 h in 257 (92%) episodes. For most episodes (145; 52%), source control was considered necessary, with 93 (64%) of them undergoing such interventions within 48 h. The 14-day mortality was 15% (42 episodes). The Cox multivariable regression model showed that 14-day mortality was associated with sepsis (P 0.002; aHR 6.58, CI 1.95-22.16), and lower respiratory tract infection (P < 0.001; aHR 4.63, CI 1.78-12.06). Conversely, interventions performed within 48 h of bacteraemia onset, such as infectious diseases consultation (P 0.036; HR 0.51, CI 0.27-0.96), and source control (P 0.009; aHR 0.17, CI 0.47-0.64) were associated with improved outcome.</p><p><strong>Conclusion: </strong>Our findings underscore the pivotal role of early infectious diseases consultation in recommending source control interventions and guiding antimicrobial treatment for patients with P. aeruginosa bacteraemia.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"117-124"},"PeriodicalIF":5.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141426708","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":"Detection of Mycoplasma pneumoniae in hospitalized pediatric patients presenting with acute lower respiratory tract infections utilizing targeted next-generation sequencing.","authors":"Chunyun Fu, Lishai Mo, Yanhua Feng, Ning Zhu, Huiping Huang, Ziyin Huang, Cuihong Lu, Yubing Wei, Jiangyang Zhao, Xiangjun Lu, Ruting Chen, RenYe Yao, Li Wu, Guangbing Liu, Mengjun Li, Jialing Ruan, Jielin Chen, Silin Jiang, Ya Huang, Qifei Li, Jie Tan","doi":"10.1007/s15010-024-02467-8","DOIUrl":"https://doi.org/10.1007/s15010-024-02467-8","url":null,"abstract":"<p><strong>Background: </strong>Mycoplasma pneumoniae is a prevalent pathogen in pediatric community-acquired pneumonia. Currently, limited literature exists on the clinical utilization of pathogen-targeted sequencing technologies.</p><p><strong>Methods: </strong>Targeted next-generation sequencing (tNGS) technology was employed to analyze bronchoalveolar lavage fluid (BALF) from 1,070 hospitalized pediatric patients with acute lower respiratory tract infections. Subsequently, the clinical data of children diagnosed with Mycoplasma pneumoniae pneumonia were systematically evaluated.</p><p><strong>Results: </strong>tNGS identified pathogenic infections in 1,064 (99.4%) of these patients, with M. pneumoniae infections representing 56.9% of the cases. Of these with M. pneumoniae cases, 169 patients (27.75%, 169/609) had infections solely due to with M. pneumoniae, while 440 patients (72.25%, 440/609) presented with co-infections involving M. pneumoniae and additional microorganisms. Among the co-infections, Rhinovirus was the most frequent co-infecting pathogen (120/609), followed by Streptococcus pneumoniae (91/609), human respiratory syncytial virus (78/609) and human parainfluenza virus (74/609). Among the 609 children identified M. pneumoniae infection, 274 were found to harbor macrolide-resistant M. pneumoniae (MRMP), yielding a resistance rate of 45.0% (274/609). In children with M. pneumoniae infection, pleural effusion and respiratory failure emerged as the most prevalent respiratory complications, while hepatic impairment and myocardial impairment were the predominant complications of other systems. The median duration of hospitalization for the children diagnosed with M. pneumoniae infection was 7 days. Out of 609 children with M. pneumoniae infection, 10 cases required intensive care unit (ICU) admission, accounting for 1.64% of the total.</p><p><strong>Conclusion: </strong>tNGS technology exhibits substantial clinical utility in identifying pathogens associated with respiratory tract infections. This study delineates the clinical manifestations and co-infection patterns of M. pneumoniae in Guangxi, China.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064640","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":"Incidence and resistance rates of Pseudomonas aeruginosa bloodstream infections in Switzerland: a nationwide surveillance study (2010-2022).","authors":"Luzia Renggli, Andrea Burri, Simone Ehrhard, Michael Gasser, Andreas Kronenberg","doi":"10.1007/s15010-024-02452-1","DOIUrl":"https://doi.org/10.1007/s15010-024-02452-1","url":null,"abstract":"<p><strong>Purpose: </strong>Bloodstream infections (BSIs) cause significant morbidity and mortality worldwide. Pseudomonas aeruginosa is an important microorganism in BSIs. The aim of this study was to analyze recent trends in the incidence and resistance rates of P. aeruginosa BSIs in Switzerland and its different linguistic regions.</p><p><strong>Methods: </strong>This retrospective, nationwide observational study analyzed the incidence (using Poisson regression models) and antimicrobial resistance (using logistic regression models) of P. aeruginosa BSIs in Switzerland from 2010 to 2022.</p><p><strong>Results: </strong>The annual incidence of P. aeruginosa BSIs in Switzerland increased from 5.5 BSIs per 100,000 inhabitants in 2010 to 7.6 BSIs per 100,000 inhabitants in 2022 (p < 0.001). The incidence was higher in the French-speaking region than in the German-speaking region. The resistance rates increased significantly for cefepime (2.4% in 2010, 8.8% in 2022; p < 0.001), ceftazidime (5.6% in 2010, 9.4% in 2022; p = 0.014), ciprofloxacin (3.3% in 2010, 6.5% in 2022; p = 0.014), and piperacillin-tazobactam (6.4% in 2010, 11.2% in 2022; p = 0.002). No significant trends were observed for carbapenem-, aminoglycoside-, or multidrug-resistant P. aeruginosa. A high incidence was observed in patients ≥ 80 years, whereas resistance rates were high in young patients.</p><p><strong>Conclusion: </strong>The increase in the incidence of P. aeruginosa BSIs emphasizes the importance of monitoring resistant and susceptible P. aeruginosa BSIs. Compared to the population-weighted mean resistance rates in Europe in 2022, those in Switzerland were lower, but an increase was observed for most antibiotics. The high resistance rates in young patients require further investigation.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065269","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":"Outbreak of autochthonous dengue in Fano, Pesaro-Urbino Province - Marche region, Italy, September 2024.","authors":"Luca Santilli, Benedetta Canovari, Maria Balducci, Giovanni Corbelli, Monia Maracci, Antonio Polenta, Ylenia Farinaccio, Francesco Ginevri, Norma Anzalone, Lucia Franca, Lucia Sterza, Francesco Barchiesi","doi":"10.1007/s15010-025-02476-1","DOIUrl":"https://doi.org/10.1007/s15010-025-02476-1","url":null,"abstract":"<p><p>Dengue is the most common arboviral disease globally. It is caused by four distinct but closely related Dengue viruses (DENV-1, -2, -3, and - 4) transmitted through bites of infected Aedes species mosquito vectors. In the last 50 years, incidence has increased 30-fold with increasing geographic expansion to new countries. Here we report the most important autochthonous Dengue epidemic in Italy ever recorded with a total of 86 confirmed cases occurring in September 2024 in Fano. They were caused by DENV-2. They were 61 Dengue fever, 21 Dengue with warning signs and no cases of severe Dengue. Our data underline the importance of considering Dengue not only as imported disease and rapidly testing all those patients with suggestive clinical pictures even if they have no travel history.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065341","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":"Risk factors for survival after lung transplantation in cystic fibrosis: impact of colonization with multidrug-resistant strains of Pseudomonas aeruginosa.","authors":"Bettina Weingard, Sören L Becker, Sophie Schneitler, Franziska C Trudzinski, Robert Bals, Heinrike Wilkens, Frank Langer","doi":"10.1007/s15010-025-02478-z","DOIUrl":"https://doi.org/10.1007/s15010-025-02478-z","url":null,"abstract":"<p><strong>Background: </strong>Lung transplantation is the ultimate treatment option for patients with advanced cystic fibrosis. Chronic colonization of these recipients with multidrug-resistant (MDR) pathogens may constitute a risk factor for an adverse outcome. We sought to analyze whether colonization with MDR pathogens, as outlined in the German classification of multiresistant Gram-negative bacteria (MRGN), was associated with the success of lung transplantation.</p><p><strong>Methods: </strong>We performed a monocentric retrospective analysis of 361 lung transplantations performed in Homburg, Germany, between 1995 and 2020. All recipients with a main diagnosis of cystic fibrosis (n = 69) were stratified into two groups based on colonization with Pseudomonas aeruginosa in view of MRGN before transplantation: no colonization and colonization without (n = 23) or with (n = 46) resistance to three or four antibiotic groups (3MRGN/4MRGN). Multivariable analyses were performed including various clinical parameters (preoperative data, postoperative data).</p><p><strong>Results: </strong>CF patients colonized with multidrug-resistant pathogens (Pseudomonas aeruginosa) classified as 3MRGN/4MRGN had poorer survival (median survival 16 years (without MRGN) versus 8 years (with MRGN), P = 0.048). Extracorporeal support (P = 0.014, HR = 2.929), re-transplantation (P = 0.023, HR = 2.303), female sex (P = 0.019, HR = 2.244) and 3MRGN/4MRGN (P = 0.036, HR = 2.376) were predictors of poor outcomes in the multivariate analysis. Co-colonization with the mold Aspergillus fumigatus was further associated with mortality risk in the 3MRGN/4MRGN group (P = 0.037, HR = 2.150).</p><p><strong>Conclusion: </strong>Patients with cystic fibrosis and MDR colonization (Pseudomonas aeruginosa) are risk candidates for lung transplantation, targeted diagnostics and tailored anti-infective strategies are essential for survival after surgery. MDR colonization as expressed by MRGN may help to identify patients at increased risk to improve the organ allocation process.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065362","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":"Longterm efficacy of a patient focused intervention in patients with asplenia- a three year follow-up of the PrePPS trial.","authors":"Johannes Camp, Valerie Heine, Marianne Bayrhuber, Natascha Anka, Manuela Glattacker, Erik Farin-Glattacker, Siegbert Rieg","doi":"10.1007/s15010-025-02472-5","DOIUrl":"https://doi.org/10.1007/s15010-025-02472-5","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to reassess the long-term impact of a Health Action Process Approach (HAPA)-informed intervention on guideline adherence among asplenic patients and their physicians, three years post-intervention.</p><p><strong>Methods: </strong>This follow-up study was conducted within the framework of the interventional PrePSS (Prevention of Postsplenectomy Sepsis Score) study. Patients aged 18 or older with anatomical asplenia were in enrolled in a prospective controlled, two-armed historical control group design. The intervention group received tailored educational materials, medical alert cards, and a telephonic HAPA-based intervention. A telephonic follow-up assessment was conducted three years post-intervention, evaluating adherence to preventive measures using the PrePSS-score (range 0-10) and propensity-score based overlap weighting.</p><p><strong>Results: </strong>Out of 106 patients who had received the intervention, 79 (75%) completed the three-year follow-up. The PrePSS-scores further increased compared to six months post-intervention (median of 8.08 points vs 7.60 points), with notable improvements in vaccination coverage and availability of emergency antibiotics. Only four participants reported severe infections requiring hospitalization, none of which were typical of post-splenectomy sepsis. 47/79 (59%) of participants contracted SARS-CoV2 but clinical courses were mild with only one patient needing hospital and ICU treatment.</p><p><strong>Conclusions: </strong>Patients who had received our novel telephonic intervention exhibited significant and sustained improvement in adherence to guideline-based preventive measures at three years post intervention. HAPA-based interventions may yield more sustained effects than traditional nudging strategies.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059036","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}