Infection最新文献

{"title":"Cardiac structure and function 1.5 years after COVID-19: results from the EPILOC study.","authors":"Jana Schellenberg, Lynn Matits, Daniel A Bizjak, Peter Deibert, Birgit Friedmann-Bette, Siri Göpel, Uta Merle, Andreas Niess, Norbert Frey, Oliver Morath, Gunnar Erz, Raphael S Peter, Alexandra Nieters, Dietrich Rothenbacher, Winfried V Kern, Jürgen M Steinacker","doi":"10.1007/s15010-025-02481-4","DOIUrl":"https://doi.org/10.1007/s15010-025-02481-4","url":null,"abstract":"<p><strong>Purpose: </strong>Impaired left and right ventricular (LV/RV) function during acute SARS-CoV-2 infection has been predominantly reported in hospitalized patients, but long-term cardiac sequelae in large, well-characterized cohorts remain inconclusive. This study evaluated cardiac structure and function in individuals with post-Coronavirus disease (COVID) syndrome (PCS) compared to recovered controls (CON), focusing on associations with cardiopulmonary symptoms and rapid physical exhaustion (RPE).</p><p><strong>Methods: </strong>This multicenter, population-based study included 1154 participants (679 PCS, 475 age- and sex matched CON; mean age 49 ± 12 years; 760 women) 1.5 years post-infection. Transthoracic echocardiography assessed LV global longitudinal strain (GLS), RV GLS and RV free wall strain (FWS), and other measures. Cardiopulmonary exercise testing (CPET) measured maximum respiratory oxygen uptake (VO₂max) as a marker of cardiopulmonary fitness.</p><p><strong>Results: </strong>PCS participants exhibited significantly lower LV GLS (-20.25% [-21.28 - -19.22] vs. -20.73% [-21.74 - -19.72], p = 0.003), reduced diastolic function (E/A 1.16 [1.04-1.27] vs. 1.21 [1.1-1.32], p = 0.022) and decreased TAPSE (24.45 mm [22.14-26.77] vs. 25.05 mm [22.78-27.32], p = 0.022) compared to CON, even after adjusting for confounders. RV strain values were similar between groups. LV GLS correlated inversely with VO₂max (p = 0.004) and positively with RPE (p = 0.050), though no associations were observed with other cardiopulmonary symptoms.</p><p><strong>Conclusions: </strong>This study demonstrates subtle yet consistent reductions in LV function, specifically LV GLS and diastolic function, and exercise capacity in PCS compared to CON. While these changes are within reference ranges, their potential impact on clinical outcomes warrants further investigation. These findings highlight the need for cardiac assessments and long-term follow-up in symptomatic PCS patients.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483036","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":"Correction: Successful therapy of a newborn with Stenotrophomonas maltophilia nosocomial pneumonia with cefiderocol.","authors":"Janina Trauth, Rahel Schuler, Markus Waitz, Harald Ehrhardt, Moritz Fritzenwanker, Susanne Herold","doi":"10.1007/s15010-025-02487-y","DOIUrl":"https://doi.org/10.1007/s15010-025-02487-y","url":null,"abstract":"","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491926","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 nonabsorbable antibiotics for prevention of recurrent cholangitis; a brief report study.","authors":"Jesús Fortún, Miguel Angel Rodríguez-Gandía, Vicente Pintado, Pilar Martín-Dávila, Miguel García-González, Javier Graus, Rosa Martín-Mateos, Javier Sáez de la Fuente, Alfonso Muriel, Santiago Moreno","doi":"10.1007/s15010-025-02491-2","DOIUrl":"https://doi.org/10.1007/s15010-025-02491-2","url":null,"abstract":"<p><strong>Background: </strong>Patients with recurrent cholangitis are at risk of developing life-threatening sepsis. Selective decontamination of the digestive tract (SDD) involving oral nonabsorbable antibiotics has been primarily applied to children undergoing Kasai portoenterostomy surgery.</p><p><strong>Methods: </strong>In this study, SDD containing colistin, tobramycin, and nystatin was administered to eight patients with recurrent cholangitis, and the incidence density before and after SDD administration was analyzed.</p><p><strong>Results: </strong>The overall incidence density of cholangitis requiring hospital admission was 0.37 per 100 patient days during the SDD period and was significantly lower than observed before SDD administration (1.05 per 100 patient days) [RR: 0.35 (95% CI: 0.21-0.59); p: <0.001, two-sided]. This was not associated with an increased risk of resistance during SDD administration.</p><p><strong>Conclusion: </strong>In this study SDD reduced by 65% the frequency and severity of recurrent cholangitis. In addition, this procedure is patient-friendly and microbiologically safe.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457825","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":"Toxigenic Corynebacterium ulcerans in raw milk of a cow with acute mastitis: case report and historical review on milk-transmitted diphtheria.","authors":"Andreas Sing, Laura Macias Luaces, Alexandra Dangel, Stefano Deramo, Katja Bengs, Vyacheslav G Melnikov, Anja Berger","doi":"10.1007/s15010-025-02477-0","DOIUrl":"https://doi.org/10.1007/s15010-025-02477-0","url":null,"abstract":"<p><strong>Purpose: </strong>Historically, a considerable number of diphtheria outbreaks, mainly in the UK and the USA, have been epidemiologically or bacteriologically linked to the consumption of milk and dairy products. However, with the introduction of milk pasteurization and hygienic improvements in livestock farming and animal welfare, no cases of milk-linked human diphtheria outbreaks or bovine mastitis due to toxigenic corynebacterial have been reported in the recent decades. Here we report the first isolation of a toxigenic Corynebacterium ulcerans strain from the milk of a cow with acute mastitis within nearly 40 years and outside of UK or Finland.</p><p><strong>Methods: </strong>The isolated strain was analysed by state-of-the-art bacteriological methods including toxigenicity testing by a novel Lateral Flow Immunoassay and Elek test, molecular typing was done by whole genome sequencing and MLST/cgMLST analysis. Due to the rarity of our finding, an extensive historical review of milk-associated diphtheria outbreaks was performed.</p><p><strong>Results: </strong>The obtained sequence type ST-331 is also found in human isolates of cutaneous diphtheria. cgMLST analysis, however, found no close relationship to 43 human ST-331 isolates from our German strain collection or to two animal samples from a zoonic cluster of this ST.</p><p><strong>Conclusion: </strong>The risk of milk-associated diphtheria due to C. ulcerans, although today extremely rare, should be avoided by milk pasteurization and the respective hygienic standards.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457829","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":"RSV is the main cause of severe respiratory infections in infants and young children in Germany - data from the prospective, multicenter PAPI study 2021-2023.","authors":"Martin Wetzke, Matthias Lange, Cordula Koerner-Rettberg, Alexander Kiefer, Michael Kabesch, Sven Armbrust, Kerim Abdelkhalek, Christiane Lex, Markus Hufnagel, Sebastian Bode, Michael Dördelmann, Michael Lorenz, Stefan Arens, Markus Panning, Holger Köster, Rolf Kramer, Mathieu Bangert, Frank Eberhardt, Grit Barten-Neiner, Christine Happle","doi":"10.1007/s15010-025-02484-1","DOIUrl":"https://doi.org/10.1007/s15010-025-02484-1","url":null,"abstract":"<p><strong>Background: </strong>Respiratory syncytial virus (RSV) is one of the main causes of morbidity in infants and young children worldwide. Current data on RSV-associated disease burden in Germany before the introduction of new immunization strategies is lacking.</p><p><strong>Methods: </strong>The PAPI study is a multicenter, prospective surveillance study of lower respiratory tract infections (LRTI) in children aged ≤ 24 months in Germany.</p><p><strong>Results: </strong>Data from 1607 children with LRTI hospitalized in twelve German hospitals between September 2021 and May 2023 were analyzed. Among these children, RSV was the most frequently detected pathogen (57.1%), followed by rhino/entero-, metapneumo- and parainfluenza virus. Children with RSV were significantly younger than those with LRTI of other causes (mean of 5.6 ± SD 6.1 vs. mean of 10.1 ± SD 7.3 months, p < 0.001) and more frequently affected in their first six months of life. RSV positive children were significantly more likely to develop hypoxemia (61.9% vs. 44.3%, p < 0.001) and need for intravenous or enteral fluid supplementation (48.1% vs. 43.1%, p = 0.009; 13.2% vs. 5.9%, p < 0.001) than those without RSV.</p><p><strong>Conclusion: </strong>RSV is the dominant pathogen for LRTI-associated hospitalizations in children ≤ 24 months in Germany and associated with a particularly high need for treatment. The ongoing implemented use of RSV immunization according to current recommendations could lead to significant reduction in early childhood morbidity in Germany.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457898","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":"Primary HIV-1 infection presenting with nephrotic-range proteinuria and severe acute kidney injury mimicking imported Lassa fever.","authors":"Frieder Pfäfflin, Ralf Schindler, Miriam Songa Stegemann, Wolfgang Schneider, Leif Erik Sander, Philipp Enghard, Stephan Achterberg, Dirk Schürmann","doi":"10.1007/s15010-024-02466-9","DOIUrl":"https://doi.org/10.1007/s15010-024-02466-9","url":null,"abstract":"<p><strong>Purpose: </strong>Primary HIV-1 infection (PHI) can present with protean clinical manifestations. We report a rare presentation of PHI that underscores that a high index of suspicion is required for diagnosis of PHI.</p><p><strong>Methods: </strong>We report on a 54-yearold previously healthy woman of African descent who presented with sudden-onset nephrotic-range proteinuria and acute kidney injury (AKI) requiring hemodialysis in the setting of febrile multiple organ dysfunction syndrome. Both the epidemiological and clinical features initially pointed to imported Lassa fever, but this was ruled out. She was eventually diagnosed with PHI. We reviewed the literature for other patients who presented with PHI and AKI requiring hemodialysis.</p><p><strong>Results: </strong>Kidney biopsy evaluation, including conventional and electron microscopy, revealed minimal change disease (MCD) and diffuse tubular damage leading to AKI. To date, MCD has not been reported to be associated with PHI and severe AKI. A literature search revealed six additional cases of severe PHI-associated AKI requiring hemodialysis. In four cases, severe rhabdomyolysis with tubulotoxic myoglobinuria played the primary causative role, while in one case each AKI was associated with HIV-associated nephropathy (HIVAN) and hemolytic uremic syndrome, respectively.</p><p><strong>Conclusions: </strong>Severe AKI requiring hemodialysis is a rare manifestation of PHI and may be associated with several conditions, most commonly PHI-associated rhabdomyolysis with tubulotoxic myoglobinuria. Severe AKI in PHI may also occur as a complication of MCD manifesting with nephrotic-range proteinuria. PHI should be considered in the differential diagnosis in patients presenting with severe proteinuria and AKI in the setting of febrile multiple organ dysfunction syndromes, including hemorrhagic fever diseases.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440680","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":"Viral sepsis - pathophysiology and disease manifestation.","authors":"Lutz G Gürtler, Wolfgang Schramm, Rainer Seitz","doi":"10.1007/s15010-025-02486-z","DOIUrl":"https://doi.org/10.1007/s15010-025-02486-z","url":null,"abstract":"<p><p>Viral infection is found in approximately 30% of all sepsis cases and may be followed by bacterial infection in organs such as the lungs. Sepsis manifests as fever, hemorrhagic lesions and cell death. Organ dysfunction caused by sepsis, such as meningitis and encephalitis, can lead to organ damage. Sepsis is induced by various viral components, host cells and cellular mediators, such as cytokines and chemokines. Cytokines are secreted from stimulated macrophages, monocytes, dendritic cells and T lymphocytes.Further contributors to sepsis are the cleavage products after activation of the complement cascade with anaphylatoxin generation and peptides of the activated clotting cascade, thrombocytopenia and thrombocyte function alteration, intravasal clotting and/or endothelial leakage. The cells involved in viral sepsis are neutrophil granulocytes, monocytes and macrophages, dendritic cells and thrombocytes, and finally, endothelial cells and epithelial cells.Prolonged cytokine release leads to cell damage, immune cell dysfunction and exhaustion, and either impairs or hyperactivates immune cells. The course of viral sepsis may be enhanced by some patient conditions including age, underlying diseases such as diabetes, obesity; and immunodeficiency. Viral sepsis, similar to bacterial sepsis, is an extremely complex disorder, and the involvement of the abovementioned cellular and humoral components can present quite divergent biological and clinical patterns.Examples of viral sepsis discussed in the manuscript include three viruses causing Dengue fever - an emerging infection, COVID-19 - a disease with a prolonged course, Ebola disease - a disease with typically complete viral clearance, while rabies virus - induces a disease that causes coma and death before signs of viral sepsis are apparent.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440682","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":"Comparison of the in vitro activities and resistance mechanisms against imipenem-relebactam and ceftazidime-avibactam in clinical KPC-producing Klebsiella pneumoniae isolated in China.","authors":"Yingyi Guo, Likang Yao, Jiong Wang, Yan Zhang, Chuyue Zhuo, Yijing Wang, Xu Yang, Jiahui Li, Nanhao He, Jiakang Chen, Yexin Lin, Shunian Xiao, Zhiwei Lin, Chao Zhuo","doi":"10.1007/s15010-025-02474-3","DOIUrl":"https://doi.org/10.1007/s15010-025-02474-3","url":null,"abstract":"<p><strong>Background: </strong>Ceftazidime-avibactam (CAZ-AVI) and imipenem-relebactam (IMI-REL) are both antibiotics with promising prospects for treating Klebsiella pneumoniae carbapenemase (KPC)-producing Klebsiella pneumoniae (KPC-Kp) infections. However, differences in the in vitro activities and resistance mechanisms to CAZ-AVI and IMI-REL in clinical KPC-Kps have not been described.</p><p><strong>Methods: </strong>In this study, KPC-Kp isolates from hospitalized patients in China were collected and subjected to antimicrobial susceptibility testing of IMI-REL and CAZ-AVI using the broth microdilution method. Whole-genome sequencing (WGS) and functional validation of mutations were performed on resistant strains, and RT-qPCR was used to determine the expression levels of bla_KPC.</p><p><strong>Results: </strong>The results showed that 21 (2.7%) of 782 clinical KPC-Kp strains were CAZ-AVI-resistant, 6 (0.8%) of 782 strains were IMI-REL-resistant, and 5 strains among them were resistant to both CAZ-AVI and IMI-REL. Strains resistant to both CAZ-AVI and IMI-REL can be effectively inhibited by tigecycline and polymyxin B. WGS and complementation experiments showed that KPC mutations are linked to high-level resistance to CAZ-AVI; while OmpK36 mutations may be the vital mechanism of IMI-REL resistance, confers resistance to CAZ-AVI simultaneously. Furthermore, RT-qPCR indicated that elevated bla_KPC expression may play an important role in both CAZ-AVI and IMI-REL resistance.</p><p><strong>Conclusions: </strong>In summary, this study suggested that IMI-REL may have superior inhibitory effects in vitro on KPC-Kps than CAZ-AVI, and described the differences in resistance mechanisms between the two antibiotics.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425312","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":"Microbiological diversity among patients with Lemierre syndrome and clinical implications: an individual patient-level analysis.","authors":"Maurus Frehner, Riccardo M Fumagalli, Silvio D Brugger, Silvia Cardi, Filippo Catalani, Alice Trinchero, Alessandro Pecci, Nils Kucher, Luca Valerio, Stefano Barco","doi":"10.1007/s15010-025-02489-w","DOIUrl":"https://doi.org/10.1007/s15010-025-02489-w","url":null,"abstract":"<p><strong>Purpose: </strong>Lemierre syndrome is a rare condition traditionally defined by bacterial infection of the head/neck region, local thrombophlebitis, and septic embolism. Although in most cases Fusobacterium necrophorum is isolated, it is questionable whether the presence of this microbe is mandatory for diagnosis. In this study, we investigated microorganisms isolated in cases of Lemierre syndrome and their association with demographical and clinical features.</p><p><strong>Methods: </strong>We conducted an analysis of individual patient data from 712 patients diagnosed with Lemierre syndrome. Demographics, clinical presentation, treatment strategies, and outcomes according to different pathogens were evaluated.</p><p><strong>Results: </strong>Among a total of 712 patients, in 574 cases bacterial growth was detected. In 415 patients Fusobacterium spp. was isolated, in 108 either Streptococcus spp. or Staphylococcus spp., and in 51 other bacteria. Patients with different bacteria differed markedly in age, site of preceding infections, clinical presentation, and treatment. Fusobacterium spp. was typically isolated in younger patients (69% of patients aged 16 to 30 years) while Streptococcus spp. and Staphylococcus spp. were more prevalent in older subjects (30% of patients aged over 45 years). Of all cases with Fusobacterium spp., 63% had a thrombosis of the internal jugular vein and 91% septic embolism, compared with 94% and 69%, respectively, in cases with Streptococcus spp. or Staphylococcus spp.</p><p><strong>Conclusion: </strong>In contrast to the available literature, our study suggests that Lemierre syndrome may be caused by multiple bacterial species, and that the clinical presentation and course may vary according to the specific bacterial species involved.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425322","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":"Images in infectious diseases: milker's nodule with erythema multiforme after calf bite in a 23-year-old patient.","authors":"Benjamin T Schleenvoigt, Christine Kletta, Christine Zollmann, Stefan Hagel, Stefan Glöckner, Eva Krause, Janine Michel, Carlotta Helbig, Andrea Vanegas-Ramirez","doi":"10.1007/s15010-025-02475-2","DOIUrl":"https://doi.org/10.1007/s15010-025-02475-2","url":null,"abstract":"","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399091","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}