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Clinical and patient-reported outcomes of self-administered outpatient parenteral antimicrobial treatment (S-OPAT): a scoping review. 门诊患者自行给予肠外抗菌药物治疗(S-OPAT)的临床和患者报告结果:一项范围审查。
IF 5.4 2区 医学
Infection Pub Date : 2025-05-12 DOI: 10.1007/s15010-025-02549-1
Jolanda M Maaskant, Tessa de Vries, Laura Volle, Faridi S Jamaludin, Suzanne E Geerlings, Kim C E Sigaloff
{"title":"Clinical and patient-reported outcomes of self-administered outpatient parenteral antimicrobial treatment (S-OPAT): a scoping review.","authors":"Jolanda M Maaskant, Tessa de Vries, Laura Volle, Faridi S Jamaludin, Suzanne E Geerlings, Kim C E Sigaloff","doi":"10.1007/s15010-025-02549-1","DOIUrl":"https://doi.org/10.1007/s15010-025-02549-1","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to provide a comprehensive overview of the existing literature on Self-administered Outpatient Parenteral Antimicrobial Therapy (S-OPAT), focusing on safety and clinical outcomes, factors influencing these outcomes, and the experiences of patients and caregivers.</p><p><strong>Methods: </strong>We searched the databases MEDLINE, CINAHL, Embase and Cochrane library. Publications were included if they reported on the clinical outcomes, safety, and/or experiences of patients and caregivers with S-OPAT. Study selection and data extraction were performed independently by two reviewers. Quantitative and qualitative data were summarized in data charting forms.</p><p><strong>Results: </strong>Forty-four studies were included: 41 primary studies, 2 systematic reviews and 1 clinical guideline. Clinical outcomes were reported in 17 and safety in 23 primary studies. Eleven studies compared S-OPAT to other OPAT delivery models. These studies showed that all models were generally comparable regarding clinical outcomes, but two studies reported an increased number of adverse events with S-OPAT. Nine studies, exploring a total of 7 potential risk factors, identified older age, comorbidities and Staphylococcus aureus infections as contributors to adverse events. The results of 14 studies on patient-centred outcomes showed that patients and caregivers considered S-OPAT a suitable alternative to other OPAT delivery models.</p><p><strong>Conclusion: </strong>We conclude that S-OPAT is a viable model of care, demonstrating favourable clinical outcomes, although some safety concerns have been reported. The growing care demand now and in the future urges further development of S-OPAT care. Gaps of knowledge still exist, and we provide recommendations for future research.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963441","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}
引用次数: 0
Genomic perspectives on NDM Salmonella Typhi, and a case report from India. NDM伤寒沙门氏菌的基因组观点,以及来自印度的病例报告。
IF 5.4 2区 医学
Infection Pub Date : 2025-05-12 DOI: 10.1007/s15010-025-02546-4
Shruthi Vasanthaiah, Pritibala Takey, Prasanna Kumar Selvam, Supraja Mohan, Ravi Kiran, Shabnam Roohi, Karthick Vasudevan
{"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":"https://doi.org/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":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-12","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}
引用次数: 0
Prevalence and outcomes of Urinary tract infections caused by Enterobacterales resistant to third-generation cephalosporins in the Emergency Department: results from UTILY cohort, a prospective multicentre study. 急诊科对第三代头孢菌素耐药肠杆菌引起的尿路感染的患病率和结局:来自UTILY队列的结果,一项前瞻性多中心研究
IF 5.4 2区 医学
Infection Pub Date : 2025-05-09 DOI: 10.1007/s15010-025-02547-3
Caterina Monari, Lorenzo Onorato, Alessandro Cornelli, Margherita Macera, Enrico Allegorico, Andrea Ferraro, Carmine Nasta, Maria Teresa Florio, Kim Russo, Piero Bianco, Vita Dora Iula, Fabio Giuliano Numis, Giovanna Guiotto, Mauro Giordano, Rosa Raucci, Ferdinando Dello Vicario, Rodolfo Nasti, Evaluna Perez Guillen, Nicola Coppola
{"title":"Prevalence and outcomes of Urinary tract infections caused by Enterobacterales resistant to third-generation cephalosporins in the Emergency Department: results from UTILY cohort, a prospective multicentre study.","authors":"Caterina Monari, Lorenzo Onorato, Alessandro Cornelli, Margherita Macera, Enrico Allegorico, Andrea Ferraro, Carmine Nasta, Maria Teresa Florio, Kim Russo, Piero Bianco, Vita Dora Iula, Fabio Giuliano Numis, Giovanna Guiotto, Mauro Giordano, Rosa Raucci, Ferdinando Dello Vicario, Rodolfo Nasti, Evaluna Perez Guillen, Nicola Coppola","doi":"10.1007/s15010-025-02547-3","DOIUrl":"https://doi.org/10.1007/s15010-025-02547-3","url":null,"abstract":"<p><strong>Introduction: </strong>In accordance with the spread of drug-resistant bacteria worldwide, an increase in the prevalence of Antimicrobial Resistance (AMR) among pathogens causing urinary tract infections (UTIs) has been described globally. The aim of this study was to describe the prevalence and outcome of UTIs caused by third-generation cephalosporin-resistant (3GC-R) Enterobacterales in a prospective cohort of patients admitted to Emergency Department (ED).</p><p><strong>Materials and methods: </strong>We conducted an observational prospective multicentre study, involving 7 healthcare facilities, enrolling all consecutive adult patients admitted to ED with a microbiologically confirmed diagnosis of UTIs caused by Enterobacterales. The primary outcomes were the prevalence of UTIs caused by 3GC-R Enterobacterales, and 30-day mortality.</p><p><strong>Results: </strong>During the study period, we included 288 patients with urinary tract infection: 41.7% of subjects were males, median age was 72 years (IQR 56-81). The most frequently isolated pathogen was Escherichia coli (70.5%); 35.9% of all pathogens isolated were non-susceptible to 3GC. At multivariate logistic regression analysis, admission to a hospital (OR 3.31, 95% CI 1.41-7.75, p = 0.006) or a long-term care facility (OR 4.87, 95% CI 1.16-20.36, p = 0.03) in the previous three months was independently associated with isolation of a 3GC-R pathogen. Regarding the clinical outcomes, 22 out of 217 (10.1%) patients completing follow-up died at 30 days. At multivariate analysis 7-day clinical response was the only variable associated with 30-day mortality (OR 0.11, 95% CI 0.04-0.36, p < 0.001).</p><p><strong>Conclusions: </strong>In our study, 35.9% of pathogens isolated in urine cultures of patients with community-acquired UTIs were non-susceptible to 3GC. In the ED, the knowledge of local epidemiology and of risk factors for antimicrobial resistance is of paramount importance for choosing the right empiric therapy and setting up local guidelines.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978656","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}
引用次数: 0
Early and late mortality in vertebral osteomyelitis: who dies within the first year after diagnosis. 椎体骨髓炎的早期和晚期死亡率:诊断后一年内死亡。
IF 5.4 2区 医学
Infection Pub Date : 2025-05-09 DOI: 10.1007/s15010-025-02541-9
Nikolaus Kernich, Arian Abi-Chokami, Norma Jung, Dorothee Jochimsen, Krishnan Sircar, Ada Marie Hoffmann, Stefan Meuser, Peer Eysel, Carolyn Weber, Juan Manuel Vinas-Rios, Ayla Yagdiran, Norma Jung, Ayla Yagdiran, Nikolaus Kernich, Krishnan Sircar, Julia Fischer, Dorothee Jochimsen, Carolyn Weber, Charlotte Meyer-Schwickerath
{"title":"Early and late mortality in vertebral osteomyelitis: who dies within the first year after diagnosis.","authors":"Nikolaus Kernich, Arian Abi-Chokami, Norma Jung, Dorothee Jochimsen, Krishnan Sircar, Ada Marie Hoffmann, Stefan Meuser, Peer Eysel, Carolyn Weber, Juan Manuel Vinas-Rios, Ayla Yagdiran, Norma Jung, Ayla Yagdiran, Nikolaus Kernich, Krishnan Sircar, Julia Fischer, Dorothee Jochimsen, Carolyn Weber, Charlotte Meyer-Schwickerath","doi":"10.1007/s15010-025-02541-9","DOIUrl":"https://doi.org/10.1007/s15010-025-02541-9","url":null,"abstract":"<p><strong>Objective: </strong>Vertebral osteomyelitis (VO) is a severe clinical entity associated with high mortality rates, especially within the first year after diagnosis. The aim of this single-center prospective cohort study was to identify and compare predictive factors influencing early and late mortality in patients with conservatively and surgically treated VO.</p><p><strong>Methods: </strong>We conducted a single-center prospective cohort study including patients treated for VO between 2008 and 2020 in a tertiary center in Germany to determine early (death within 30 days after diagnosis) and late mortality (death between day 31 and 365 after diagnosis). Additionally, multivariable analyses were performed to analyze predictive risk factors for early and late mortality.</p><p><strong>Results: </strong>A total of 323 patients were included. 19% died within the first year after diagnosis. Early mortality occurred in 5% and late mortality in 14% of cases. Multivariable analysis revealed chronic kidney disease (CKD) (OR: 13.2, 95% CI 5.7-30.3; p < 0.001) and MSSA (OR: 4.0, 95% CI 1.4-11.1; p = 0.008) as independent risk factors for early mortality, whereas ASA score > 2 (HR: 5.2, 95% CI 2.6-10.6; p < 0.001), age > 70 years (HR: 2.4, 95% CI 1.6-3.7; p < 0.001), CKD (HR: 1.9, 95% CI 1.3-3.0; p = 0.003) and bacteremia (HR: 1.8, 95% CI 1.2-2.7; p = 0.002) were identified as independent risk factors for late mortality.</p><p><strong>Conclusion: </strong>One out of five VO patients dies within the first year after diagnosis. Risk factors for mortality within the first year include CKD and bacteremia. As a consequence in particular those patients should be closely monitored within the first year after.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006944","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}
引用次数: 0
Delayed but successful development of immune memory against SARS-COV-2 after B cell-depleting monotherapy. B细胞消耗单一疗法后针对SARS-COV-2的延迟但成功的免疫记忆发展
IF 5.4 2区 医学
Infection Pub Date : 2025-05-07 DOI: 10.1007/s15010-025-02544-6
Nicolas Graf, Joseph Bayerl, Barbara Schmidt
{"title":"Delayed but successful development of immune memory against SARS-COV-2 after B cell-depleting monotherapy.","authors":"Nicolas Graf, Joseph Bayerl, Barbara Schmidt","doi":"10.1007/s15010-025-02544-6","DOIUrl":"https://doi.org/10.1007/s15010-025-02544-6","url":null,"abstract":"<p><strong>Purpose: </strong>Patients receiving CD20-directed therapies are known to insufficiently develop neutralizing antibody titers against SARS-COV-2 after two vaccinations. We investigated the impact of a third and fourth vaccination, possibly deriving predictive factors.</p><p><strong>Methods: </strong>In a monocentric, prospective, non-interventional observational study patients who had received at least one administration of a monoclonal CD20 antibody (mCD20Ab) within 9 months prior to vaccination were included to receive mRNA-based third vaccination. SARS-COV-2 IgG titer was determined before and four weeks after immunisation. Patients without adequate humoral immune response proceeded to a fourth vaccination. Furthermore, tolerability and prespecified potentially influencing factors such as age, baseline lymphocyte counts and others were analysed.</p><p><strong>Results: </strong>Twenty-four patients were included and vaccination was well tolerated. Quantitative analysis of humoral response four weeks after third vaccination revealed a significant increase which, however, did not translate into a clinically relevant seroconversion rate. In the subgroup analysis, patients older than 65 years and mCD20Ab therapy longer than 6 months ago benefited. All evaluable patients on mCD20Ab monotherapy (n = 7) showed an immediate or delayed immune response after third vaccination, while all non-responders (n = 7) were on combination therapy. Clinical parameters such as lymphocyte count, immunoglobulin status and others did not appear to have any influence.</p><p><strong>Conclusion: </strong>An interval of at least 6 months after the last mCD20Ab administration and mCD20Ab monotherapy appears to be favorable for humoral immune response to third vaccination. Furthermore, patients can be reassured that delayed immune responses are possible. Future studies should therefore also investigate seroconversion at later time points.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998381","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}
引用次数: 0
Raising awareness of Demodex mites: a neglected cause of skin disease. 提高对蠕形螨的认识:一种被忽视的皮肤病病因。
IF 5.4 2区 医学
Infection Pub Date : 2025-05-03 DOI: 10.1007/s15010-025-02521-z
Amal El-Moamly, Omar El-Swify
{"title":"Raising awareness of Demodex mites: a neglected cause of skin disease.","authors":"Amal El-Moamly, Omar El-Swify","doi":"10.1007/s15010-025-02521-z","DOIUrl":"https://doi.org/10.1007/s15010-025-02521-z","url":null,"abstract":"<p><strong>Background: </strong>Demodex mites are among the most prevalent human parasites. While commonly found on healthy individuals, an overpopulation of this arachnid resident of human skin triggers demodicosis, a neglected yet widely prevalent disease with considerable skin and eye morbidity. Despite its health impact, demodicosis remains overshadowed by other common skin diseases. This neglect has significant consequences for individual and public health, which require a paradigm shift in our understanding and management of this ubiquitous ectoparasite. We reviewed the literature to re-evaluate the pathogenicity of the Demodex mite, paying particular attention to the primary risk factors-immune dysregulation, altered microbiota, and concurrent infections-that may contribute to pathogenicity. We discuss the challenges in combating neglect of demodicosis and provide updates on various impediments in achieving this goal. We explore the issues and research gaps in various domains such as those related to parasite biology, pathogenesis, diagnosis, treatment, prevention and control. We present potential solutions and outline future prospects for tackling this important disease. Finally, we hope to catalyze greater attention and investment for this neglected public health issue.</p><p><strong>Conclusion: </strong>Raising awareness of Demodex and demodicosis and its major contribution to human diseases requires a multidisciplinary approach. Efforts to prioritize its place on the global health agenda, invest in research, improve diagnostic tools, and develop new treatment strategies will lead to improved public health outcomes and a higher quality of life for those affected.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022032","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}
引用次数: 0
Letter to the editor: increased incidence of blood culture contaminations during and after the COVID-19 pandemic. 致编辑的信:在COVID-19大流行期间和之后,血液培养污染的发生率增加。
IF 5.4 2区 医学
Infection Pub Date : 2025-04-30 DOI: 10.1007/s15010-025-02545-5
Rabia Nizam, Amna Amir Jalal, Syed Ibad Hussain
{"title":"Letter to the editor: increased incidence of blood culture contaminations during and after the COVID-19 pandemic.","authors":"Rabia Nizam, Amna Amir Jalal, Syed Ibad Hussain","doi":"10.1007/s15010-025-02545-5","DOIUrl":"https://doi.org/10.1007/s15010-025-02545-5","url":null,"abstract":"<p><p>The research conducted by Tolle et al. sheds light on the rising rates of blood culture contaminations (BCC) during and after the COVID-19 pandemic. However, there are several important areas that need more attention to make the study more relevant and impactful. This letter points out some key issues, such as how the training of less experienced staff might affect BCC rates, the risk of misclassification bias even with set classification criteria, the lack of patient-specific risk assessments, and the absence of procedural audits to check for failures in aseptic techniques. It's well-known that having trained personnel can help lower BCC rates, which suggests that simply having staff turnover might not explain the increase we've seen. Moreover, misclassifying contaminants as actual infections-or the other way around-can lead to serious clinical consequences, like unnecessary antibiotic prescriptions and higher healthcare costs. Additionally, certain high-risk groups, such as patients with central venous catheters or chronic conditions, might be more affected by BCC, but the study doesn't take these factors into account. Finally, without observational audits, it's hard to determine if procedural mistakes or other outside factors played a role in the rise of contamination rates. Tackling these issues is essential for improving blood culture practices, boosting diagnostic accuracy, and reducing the unintended effects of BCC in healthcare settings after the pandemic. Future research should focus on thorough assessments of staff training, risk stratification models, and real-time audits of procedures to create targeted strategies aimed at lowering contamination rates and enhancing patient outcomes.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013239","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}
引用次数: 0
Model-informed identification of optimised dosing strategies for meropenem in critically ill patients receiving SLEDD: an observational study. 在接受SLEDD的危重患者中,基于模型的美罗培南最佳给药策略识别:一项观察性研究。
IF 5.4 2区 医学
Infection Pub Date : 2025-04-25 DOI: 10.1007/s15010-025-02504-0
Franz Weber, Christina Scharf, Linda B S Aulin, Ferdinand Weinelt, Michael Paal, Gerd Mikus, Michael Vogeser, Katharina Habler, Wilhelm Huisinga, Michael Zoller, Robin Michelet, Charlotte Kloft, Uwe Liebchen
{"title":"Model-informed identification of optimised dosing strategies for meropenem in critically ill patients receiving SLEDD: an observational study.","authors":"Franz Weber, Christina Scharf, Linda B S Aulin, Ferdinand Weinelt, Michael Paal, Gerd Mikus, Michael Vogeser, Katharina Habler, Wilhelm Huisinga, Michael Zoller, Robin Michelet, Charlotte Kloft, Uwe Liebchen","doi":"10.1007/s15010-025-02504-0","DOIUrl":"https://doi.org/10.1007/s15010-025-02504-0","url":null,"abstract":"<p><strong>Purpose: </strong>An increasing number of critically ill patients receive slow extended daily dialysis (SLEDD) due to their pathophysiology while suffering from sepsis, necessitating effective and safe antibiotic therapy. Although SLEDD reduces meropenem exposure and increases treatment failure risk, effective and safe dosing regimens are unclear. We aimed to identify optimised meropenem dosing strategies for critically ill SLEDD patients through population pharmacokinetic (PK) modelling and PK/pharmacodynamic (PD)-based probability of target attainment (PTA) analysis.</p><p><strong>Methods: </strong>Clinical data from a prospective study involving critically ill SLEDD patients receiving meropenem were monitored through routine therapeutic drug monitoring. A total of 178 blood samples from 13 patients (median 14 samples per patient) were analysed. A PK model was developed and utilised to evaluate 24 clinically relevant dosing regimens during SLEDD therapy (7-h on-SLEDD periods q24h) in PTA analyses. The PK/PD target window of minimum meropenem concentration between 8 mg/L (P. aeruginosa; R-breakpoint) and 44.45 mg/L (toxicity threshold) was used.</p><p><strong>Results: </strong>A one-compartment PK model with linear elimination and total clearance (CL) split into renal (CL<sub>REN</sub>; 45%) and SLEDD-associated (55%) CL well characterised the SLEDD data. Creatinine clearance (urine-collected; CLCR<sub>urine</sub>) was identified as significant factor on CL<sub>REN</sub>. Continuous infusions, specifically 2 g q24h for CLCR<sub>urine</sub> 0-25 mL/min and 3 g q24h for CLCR<sub>urine</sub> 25-40 mL/min, showed the highest PTA being effective and safe during SLEDD therapy. A comprehensive dosing nomogram was developed.</p><p><strong>Conclusion: </strong>Our easy-to-use dosing nomogram presents a promising tool in optimising meropenem dosing regimens for critically ill SLEDD patients considering their kidney function in clinical practice.</p><p><strong>Trial registration: </strong>Clinicaltrials.gov NCT03985605. Registered 14 June 2019. https://classic.</p><p><strong>Clinicaltrials: </strong>gov/ct2/show/study/NCT03985605.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963483","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}
引用次数: 0
Healthcare professionals challenged by 14 distinct carbapenemase-producing micro-organisms in a war-injured Ukrainian patient. 医疗保健专业人员受到14种不同的碳青霉烯酶生产微生物在战争受伤的乌克兰病人。
IF 5.4 2区 医学
Infection Pub Date : 2025-04-24 DOI: 10.1007/s15010-025-02523-x
Nienke L Plantinga, Suzanne A V van Asten, Maarten J Schijffelen, Ralph J de Wit, Sandra Witteveen, Angela de Haan, Fabian Landman, Nashwan Al Naiemi, Daan W Notermans, Antoni P A Hendrickx
{"title":"Healthcare professionals challenged by 14 distinct carbapenemase-producing micro-organisms in a war-injured Ukrainian patient.","authors":"Nienke L Plantinga, Suzanne A V van Asten, Maarten J Schijffelen, Ralph J de Wit, Sandra Witteveen, Angela de Haan, Fabian Landman, Nashwan Al Naiemi, Daan W Notermans, Antoni P A Hendrickx","doi":"10.1007/s15010-025-02523-x","DOIUrl":"https://doi.org/10.1007/s15010-025-02523-x","url":null,"abstract":"<p><p>The Russia-Ukraine war lead to evacuation of patients across Europe. We present an unprecedented case of a severely injured Ukrainian soldier carrying 11 carbapenemase-producing Enterobacterales, two carbapenemase-producing Pseudomonas aeruginosa and one carbapenem-resistant Acinetobacter baumannii, together harboring six different carbapenemase genes and with evidence for in-patient transfer of resistance plasmids.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010637","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}
引用次数: 0
Acral necrosis in a 62-year-old female after travelling to Equatorial Guinea. 一名62岁女性前往赤道几内亚后发生肢端坏死。
IF 5.4 2区 医学
Infection Pub Date : 2025-04-24 DOI: 10.1007/s15010-025-02543-7
Aiman Gamal Abdelrahim, Julian Schulze Zur Wiesch, Michael Ramharter, Stefan Schmiedel
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