Infection最新文献

{"title":"Clinical outcomes of patients hospitalized in internal medicine wards adequately treated for bloodstream infections caused by NDM-producing Klebsiella pneumoniae. Results from a real-life retrospective multi-center study in an endemic area.","authors":"Simone Meini, Roberta Del Cesta, Francesco Sbrana, Javier Rosada, Davide Carrara, Maddalena Mura, Benedetta Longo, Roberto Andreini, Giuseppe Linsalata, Alessandro Fedele, Francesco Filidei, Andrea Ripoli, Elisabetta Andreoli, Enrico Tagliaferri, Spartaco Sani","doi":"10.1007/s15010-025-02488-x","DOIUrl":"10.1007/s15010-025-02488-x","url":null,"abstract":"<p><strong>Background: </strong>New Delhi metallo-beta-lactamase (NDM)-producing Klebsiella pneumoniae (NDM-Kp) represents a growing challenge for modern medicine.</p><p><strong>Objectives: </strong>To assess real-life clinical outcomes in patients adequately treated in Internal medicine units (IMUs) for bloodstream infections (BSI) caused by NDM-Kp.</p><p><strong>Methods: </strong>A two-years retrospective study was conducted recruiting 30 consecutive adult patients with NDM-Kp BSI treated with an adequate definitive antibiotic therapy (27 aztreonam plus ceftazidime/avibactam; 3 cefiderocol) in three Italian IMUs located in a highly endemic area.</p><p><strong>Results: </strong>Mean age of patients was 75.3 years, mean Charlson Comorbidity Index (CCI) 7.5. All the patients had rectal colonization. Thirty-day mortality rate was 46.7%; 78.6% of patients who died received an adequate empiric therapy. Non-survivors had mean age, CCI and SOFA score significantly higher compared to survivors (80.1 vs. 71.2, p = 0.036; 8.6 vs. 6.6, p = 0.047; 5.9 vs. 4, p = 0.043, respectively). The percentage of survivors was significantly higher among the 13 cases with community-acquired than in the 17 with hospital-acquired BSI (76.9% vs. 35.3%, p = 0.024). In the multivariate penalized logistic regression analysis, age, CCI, SOFA score and hospital-acquired BSI onset were identified as independent predictors of mortality.</p><p><strong>Conclusion: </strong>This study provides real-life data on clinical outcomes regarding old and highly multimorbid patients hospitalized in IMU for BSI caused by NDM-Kp, showing a very high 30-day mortality even in case of adequate treatment.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"1737-1744"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572878","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":"Genomic perspectives on NDM Salmonella Typhi, and a case report from India.","authors":"Shruthi Vasanthaiah, Pritibala Takey, Prasanna Kumar Selvam, Supraja Mohan, Ravi Kiran, Shabnam Roohi, Karthick Vasudevan","doi":"10.1007/s15010-025-02546-4","DOIUrl":"10.1007/s15010-025-02546-4","url":null,"abstract":"<p><strong>Background: </strong>Carbapenem resistance in Enterobacterales is a growing public health concern, primarily driven by carbapenemase enzymes such as OXA-48, VIM, NDM, and IMP. Among these, New Delhi Metallo-β-lactamase (NDM) has disseminated widely across various Enterobacterales species, including Salmonella Typhi, though reports remain rare.</p><p><strong>Case presentation: </strong>We report an 11-year-old boy from Bangalore with a 10-day history of high-grade fever, chills, rigors, and cough. Laboratory investigations revealed elevated CRP, normal CBC, and microcytic hypochromic anemia. A respiratory panel detected Human Rhinovirus/ Enterovirus. Blood cultures grew non-lactose fermenting gram-negative bacilli, identified as Salmonella spp. via Vitek ID/AST. The isolate exhibited resistance to ampicillin, ciprofloxacin, ceftriaxone, tetracycline, and meropenem but remained susceptible to azithromycin, chloramphenicol, and Co-trimoxazole. Serotyping confirmed the serotype as Salmonella Typhi. Whole-genome sequencing (Illumina) revealed blaNDM-5 and aac(6')-Ia, InCX3 plasmid, and the fluoroquinolone resistance-associated gyrAS83Y mutation. Phylogenetic analysis placed the isolate (IOB-SWH-01) within a cluster of recently sequenced S. Typhi strains from India belonging to the H58 haplotype.</p><p><strong>Discussion and conclusion: </strong>To date, NDM-producing S. Typhi has been reported only once, from Pakistan. This is the first documented case in India. The presence of blaNDM-5 in S. Typhi poses a serious clinical and public health threat, given its multidrug-resistant nature and potential for interspecies transmission. Continued genomic surveillance is crucial to monitor its spread and guide treatment strategies.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"2053-2059"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020422","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":"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":"1677-1684"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460534/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful cure of multiple large, inoperable liver abscesses by antibiotic therapy.","authors":"Sarah Niederreiter, Andreas Voelkerer, Christian Datz, Guenter Weiss","doi":"10.1007/s15010-025-02480-5","DOIUrl":"10.1007/s15010-025-02480-5","url":null,"abstract":"<p><strong>Purpose: </strong>Pyogenic liver abscesses are challenging due to their diverse etiology and the risk of severe complications. In many cases, surgical interventions are initiated. However, these are only applicable in selected scenarios. We report the case of a 63-year-old woman with multiple large liver abscesses of up to 6.7 cm spread across both liver lobes, which could not be managed surgically.</p><p><strong>Methods & results: </strong>Streptococcus intermedius was isolated in blood culture and PCR positivity for this pathogen was obtained in liver puncture specimen. Following a two-weeks course of intravenous therapy with cefuroxime, metronidazole and fosfomycin, the patients received a consecutive, combined oral antibiotic treatment with clindamycin and cephalexin for four months. This resulted in complete resolution of the abscesses, with no evidence of relapse at follow-up.</p><p><strong>Conclusion: </strong>This case illustrates the complex therapeutic challenges in the management of multiple, large hepatic abscesses, highlighting the potential of antibiotic therapy to cure even inoperable patients.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"2235-2239"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079732","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":"Antimicrobial treatment for 7 versus 14 days in patients with bacteremia: a meta-analysis of randomized controlled trials.","authors":"Marlene Prager, Felix Bergmann, Lena Pracher, Dragan Copic, Jasmin Zessner-Spitzenberg, Georg Gelbenegger, Heimo Lagler, Nicole Harrison, Heinz Burgmann, Markus Zeitlinger, Anselm Jorda","doi":"10.1007/s15010-025-02562-4","DOIUrl":"10.1007/s15010-025-02562-4","url":null,"abstract":"<p><strong>Purpose: </strong>The optimal duration of antibiotic treatment in patients with bacteremia is a matter of ongoing debate.</p><p><strong>Methods: </strong>We conducted a meta-analysis of randomized controlled trials that compared 7 days with 14 days of antimicrobial treatment in adults with bacteremia. The systematic search included trials published until December 2024. Efficacy outcomes included 90-day all-cause mortality, recurrence of bacteremia and mean length of hospital stay. Safety outcomes included the total number of adverse events, Clostridioides difficile infections, diarrhea, acute kidney injury, rash or emergence of antibiotic resistance.</p><p><strong>Results: </strong>The final analysis included four randomized controlled trials with a total of 4790 participants. Death by day 90 occurred in 321 (13.3%) of 2406 patients receiving antibiotic treatment for 7 days and 342 (14.3%) of 2384 patients receiving antibiotic treatment for 14 days (RR 0.93 [95% CI, 0.81 to 1.07)]; p = 0.30; prediction interval 0.74 to 1.17). The mean hospital stay did not differ significantly (mean difference - 0.18 days [95% CI, -1.03 to 0.67]; p = 0.69; prediction interval - 2.57 to 2.22). Recurrence of bacteremia was similar between antibiotic treatment for 7 days (64 [2.7%] of 2406) and antibiotic treatment for 14 days (56 [2.3%] of 2384) (RR 1.14 [95% CI, 0.80 to 1.63)]; p = 0.47; prediction interval 0.64 to 2.03). Safety outcomes, including the total number of adverse events, Clostridioides difficile infections, diarrhea, acute kidney injury, rash, and antibiotic resistance, were similar between groups.</p><p><strong>Conclusions: </strong>This meta-analysis suggests that 7-day and 14-day antimicrobial treatment is associated with a similar efficacy and safety profile in patients with bacteremia.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"2159-2168"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247727","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":"External ophthalmomyiasis misdiagnosed as periorbital cellulitis.","authors":"Ana-Lee Gerdes, Alexander Kreuter, Milan Vidakovic, Frank Oellig, Valentina Laura Müller","doi":"10.1007/s15010-025-02656-z","DOIUrl":"https://doi.org/10.1007/s15010-025-02656-z","url":null,"abstract":"","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199229","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":"Outreach information campaigns for awareness and screening of strongyloidiasis and Chagas disease among Latin American migrants: uncovering a hidden public health burden in a non-endemic country.","authors":"Rosalia Marrone, Miriam Castaldo, Cristina Mazzi, Francesca Perandin, Maria Letizia Giancola, Zeno Bisoffi, Christian Napoli","doi":"10.1007/s15010-025-02634-5","DOIUrl":"https://doi.org/10.1007/s15010-025-02634-5","url":null,"abstract":"<p><strong>Background: </strong>Chagas disease and strongyloidiasis are endemic in Latin America, but both infections have become diseases of global concern due to migration flows. During the last fifteen years, these infections have become emerging infections in Italy as a consequence of the huge immigration from Latin American countries. The aim of this study is to assess the prevalence of Chagas disease, strongyloidiasis, and their co-infection in a cohort of Latin American migrants living in Rome. Additionally, it seeks to evaluate whether informational outreach campaigns-offered directly within communities and supported by local leaders-could represent a possible approach to reveal the hidden public health burden of these neglected infections among migrant populations.</p><p><strong>Methods: </strong>Six community-based information campaigns on Chagas disease and strongyloidiasis were performed in Rome (Italy) in public events or in homes occupied by migrants from Latin America, inviting people to carry out screening tests at the National Institute for Health, Migration and Poverty clinic.</p><p><strong>Results: </strong>344 adults were tested for Chagas disease and strongyloidiasis. The overall prevalence of Trypanosoma cruzi infection was 7.8% (27/344). Of the positive results, 77.8% (21/27) were observed in persons originating from Bolivia. The prevalence of strongyloidiasis was 10.5% (36/344). Of the positive results, 69.4% (25/36)were among persons originating from Bolivia, out 27(22.2%) individuals tested positive for both Trypanosoma cruzi and Strongyloides stercoralis.</p><p><strong>Conclusions: </strong>Our findings indicate that targeted informational outreach campaigns-particularly those embedded within cultural, recreational, and sporting events-can be an effective strategy for promoting systematic and combined screening for Chagas disease and strongyloidiasis. Such initiatives not only raise public health awareness among Latin American migrants in non-endemic settings but also help to uncover a largely overlooked public health issue.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137373","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":"Letter to the editor: The added value of metagenomic next-generation sequencing in central nervous system infections: a systematic review of case reports.","authors":"Abdullah Waheed, Huma Wazir, Meva Ram, Noor Un Nisa Irshad","doi":"10.1007/s15010-025-02653-2","DOIUrl":"https://doi.org/10.1007/s15010-025-02653-2","url":null,"abstract":"","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137336","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":"Candida auris candidemia, septic arthritis, and vertebral osteomyelitis requiring dual antifungal therapy: a case report.","authors":"Lizis Rodriguez, Laura Brizuela Grabosky, Jeremy Cypen","doi":"10.1007/s15010-025-02643-4","DOIUrl":"https://doi.org/10.1007/s15010-025-02643-4","url":null,"abstract":"<p><strong>Background: </strong>Candida auris is a significant cause of severe infections in immunocompromised patients, contributing to its frequent occurrence in healthcare settings. Although Candida species are typically linked to candidemia, deep-seated infections like osteomyelitis have also been observed, though they are rarely documented in literature. A 72-year-old man with Guillain-Barré syndrome (GBS) and quadriplegia, status-post tracheostomy and gastrostomy tube placement, presented with new right facial droop and aphasia. A brain CT was unremarkable. Labs were significant for leukocytosis, anemia, and elevated lactic acid consistent with septic shock. A CT scan of the abdomen and pelvis revealed fluid in both hip joints, concerning for source of infection. Fluid cultures from his left hip grew Candida auris. He was subsequently also diagnosed with Candida auris osteomyelitis and discitis of the thoracic spine, confirmed by PET scan and follow-up fine-needle aspiration. The patient had persistent infection despite treatment with Amphotericin B and micafungin for nine months but has shown clinical and radiographic signs of improvement. A full 12-month course of antifungal therapy is to be completed.</p><p><strong>Conclusion: </strong>This case underscores the importance of thorough tissue, joint, and vertebral sampling for accurate diagnosis, and highlights the urgent need for standardized treatment protocols for Candida auris osteomyelitis to improve patient outcomes.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137341","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":"Post-tuberculosis lung disease: a guide for clinicians.","authors":"Giovanni Fumagalli, Jessica Mencarini, Irene Sini, Lucia Allavena, Marina Tadolini, Marco Mantero, Francesco Blasi, Niccolò Riccardi, Agostina Pontarelli, Pavilio Piccioni, Andrea Calcagno, Giovanni Sotgiu, Divya Shah, Luigi Ruffo Codecasa, Roberto Parrella","doi":"10.1007/s15010-025-02645-2","DOIUrl":"https://doi.org/10.1007/s15010-025-02645-2","url":null,"abstract":"<p><p>Post-tuberculosis lung disease (PTLD) is an increasingly recognized condition that significantly affects survivors' quality of life, creating disability and incrementing the risk of mortality. PTLD includes a spectrum of structural and functional lung impairments such as obstructive, restrictive, and mixed patterns, bronchiectasis, and pulmonary fibrosis that persist beyond microbiological cure. Global prevalence data highlight a heavy burden of PTLD, especially in high-incidence regions, driven by late diagnosis and suboptimal treatment. Functional and radiological evaluation remains critical for timely diagnosis, with spirometry and imaging revealing lasting abnormalities in a large proportion of TB survivors. Multidisciplinary care is essential and includes bronchodilator therapy, infections/complications management and prevention, pulmonary rehabilitation, and, in selected cases, surgical intervention. Despite increasing recognition, standardized diagnostic and therapeutic pathways for PTLD are still lacking, and data on optimal follow-up, rehabilitation strategies, and preventive measures remain limited. Prospective studies, better stratification tools, and patient education initiatives are urgently needed to reduce PTLD morbidity and mortality. This narrative review synthesizes current evidence on PTLD epidemiology, clinical evaluation and management while offering practical suggestions for clinicians taking care of people with TB and addressing research needs.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137368","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}