Infection最新文献

{"title":"Postoperative CT-derived spleen volumetry for recurrence risk stratification after curative-intent surgery for hepatic alveolar echinococcosis.","authors":"Lukas Endrös, Jochen Schneider, Marc Martignoni, Christian Brückner, Markus Mergen, Daniel Spitzl, Felianty Teresa, Manuel Nickel, Mara Goetz, Daniel Martinez Heinemann, Christian Maegerlein, Jan S Kirschke, Rickmer Braren, Lisa Steinhelfer","doi":"10.1007/s15010-026-02957-x","DOIUrl":"https://doi.org/10.1007/s15010-026-02957-x","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate automated CT-derived spleen volumetry as an opportunistic imaging biomarker for postoperative risk stratification in patients with surgically treated hepatic alveolar echinococcosis (AE) and to compare its prognostic performance with clinical and laboratory parameters.</p><p><strong>Methods: </strong>This retrospective single-center cohort study included consecutive patients undergoing curative-intent R0 resection for hepatic AE. Baseline was defined as the immediate postoperative CT. Automated spleen segmentation was performed on baseline and 12-month CT using TotalSegmentator, and relative spleen volume change was calculated. The primary endpoint was imaging-defined disease recurrence within 24 months. Clinical, laboratory, serological (indirect hemagglutination assay [IHA], total IgE), and imaging variables were analyzed using univariate logistic regression; significant predictors entered multivariate analysis. ROC analysis assessed discriminatory performance.</p><p><strong>Results: </strong>62 patients were included; 21 developed recurrence within 24 months. In univariate analysis, 4 features were significant, with relative spleen volume change showing the strongest association with recurrence (OR 1.158; 95% CI 1.082-1.239; p < 0.001). In multivariate analysis, only relative spleen volume change remained independently associated with recurrence (OR 1.152; 95% CI 1.056-1.255; p = 0.001). Relative spleen volume change showed excellent discrimination (AUC 0.926; 95% CI 0.851-0.978); a 24.3% increase yielded sensitivity of 0.81 and specificity of 0.90. Total IgE and IHA titers, including longitudinal changes, were not associated with recurrence.</p><p><strong>Conclusions: </strong>Automated postoperative CT-derived spleen volumetry may provide an objective imaging biomarker for postoperative risk stratification after curative-intent surgery for hepatic AE, independently predicting recurrence, whereas routinely available clinical, serological and laboratory markers showed no significant association in this cohort.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840355","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 persistent challenge of meningitis in the vaccine era: a three-decade longitudinal analysis of residual burden in the United States.","authors":"Ruyu Liu, Liang Hao","doi":"10.1007/s15010-026-02945-1","DOIUrl":"https://doi.org/10.1007/s15010-026-02945-1","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluates evolutionary trajectories, structural pathogen shifts, and geographical efficiency of the 1990-2021 United States (US) meningitis burden to identify vulnerable populations and drivers in the post-vaccine era.</p><p><strong>Methods: </strong>Integrating Global Burden of Disease (GBD) 2021 and American Community Survey (ACS) data, we employed Joinpoint regression, decomposition, and frontier analyses to assess trends and efficiency. Multivariable regression and interrupted time series (ITS) analysis assessed socioeconomic associations and vaccine-related trend discontinuities.</p><p><strong>Results: </strong>Age-standardized incidence (ASIR), mortality (ASMR), and years lived with disability (YLDs) rates fell by 72.15%, 68.57%, and 80.25%, respectively, between 1990 and 2021, while age-standardized disability-adjusted life years (DALYs) rates fell by 75.53%. Pathogen patterns underwent structural shifts; the share of years of life lost (YLLs) attributable to Neisseria meningitidis fell from 20.81% to 8.02%, while Klebsiella pneumoniae became the leading contributor to pathogen-attributable YLLs (15.58%). Inter-state DALYs rates varied 2.72-fold, with efficiency gaps notable even in high socio-demographic index (SDI) regions. Poverty was associated with mortality-related burdens (ASMR aRR = 1.057, 95% CI: 1.043-1.071; DALYs 1.057, 1.041-1.073; YLLs 1.060, 1.044-1.077; all P < 0.001) but not incidence; the American Indian and Alaska Native population proportion was independently associated with all six indicators. After PCV7, Streptococcus pneumoniae DALYs showed a level change of -0.553 and a trend change of -0.241 (both P < 0.001); no MenACWY or MenB parameter reached significance (all P > 0.24). Since 2012, the rate of decline has slowed.</p><p><strong>Conclusion: </strong>Poverty was the state-level factor most strongly associated with inequalities in US meningitis mortality, although the American Indian and Alaska Native and Black population proportions were also independently associated with mortality-related outcomes. Neonates and the elderly represent critical structural gaps in the post-vaccine era. Maternal GBS immunization is a prospective strategy contingent on licensure, and attention to the material conditions associated with poverty may help address the residual burden.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840338","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":"Active screening for asymptomatic versus symptomatic tuberculosis in high-risk groups in a low-prevalence country: a retrospective study.","authors":"Margherita S Silani, Serena Piccirillo, Jacopo Civello, Niccolò Riccardi, Giovanni Fumagalli, Maurizio Ferrarese, Lucia Allavena, Alice Claudia Repossi, Chiara La Sala, Giovanni Rossi, Antonio Voza, Paolo Tarsia, Francesco Blasi, Pavilio Piccioni, Luigi Ruffo Codecasa","doi":"10.1007/s15010-026-02921-9","DOIUrl":"https://doi.org/10.1007/s15010-026-02921-9","url":null,"abstract":"<p><strong>Introduction: </strong>Asymptomatic Tuberculosis (TB) represents up to 60% of cases in endemic countries, remains largely underdiagnosed and sustains transmission. Several European low-TB prevalence countries have implemented active screening in at-risk populations for identification of such cases. This study aims to describe clinical characteristics and possible risk factors of asymptomatic vs. symptomatic pulmonary TB cases in this setting.</p><p><strong>Methods: </strong>This retrospective cohort study included pulmonary TB cases detected through active screening of at-risk populations at two Italian regional reference centers between 2015 and 2024. Asymptomatic and symptomatic cases were identified and compared.</p><p><strong>Results: </strong>Among 372 TB cases included, 56.5% belonged to the asymptomatic and 43.5% to the symptomatic group. Individuals from the first group required more often radiologic investigation with chest CT scan (145 [69%] vs. 78 [48.1%], p < 0.001). Cavitations were observed in both groups (75 [20%]); microbiologic confirmation by sputum culture, molecular methods or smear microscopy was more common in symptomatic patients (101 [75.9%] vs. 94 [63.1%], p = 0.02). Non-native individuals were more often symptomatic, younger, had history of previous TB and were more often screened due to exposure to congregate settings. Bivariate models showed that patient origin, previous TB disease history, chest CT scan and negative microbiology were associated with asymptomatic presentation, which was partly confirmed in multivariate models.</p><p><strong>Discussion: </strong>Active screening in at-risk populations is essential to identify asymptomatic TB cases, which may display markers of infectiousness and therefore drive transmission. Epidemiologic risk profiling and advanced diagnostic strategies are necessary to improve early TB detection both in high and low prevalence countries.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148827863","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":"Effectiveness and safety of ceftazidime-avibactam plus aztreonam vs. cefiderocol for infections due to ceftazidime-avibactam-resistant Enterobacterales and Pseudomonas aeruginosa: a single-center cohort study.","authors":"Shahd Mohammad, Haneen Ghazal, Emadeldin El Daly, Fadi Alkhateeb, Tasnim Dawoud, Zaid Al Hassani, Aqeel Saleem, Ali Al Hassani, Thamer A Almangour","doi":"10.1007/s15010-026-02932-6","DOIUrl":"https://doi.org/10.1007/s15010-026-02932-6","url":null,"abstract":"<p><strong>Purpose: </strong>Resistance to ceftazidime-avibactam (C/A) among Enterobacterales and Pseudomonas aeruginosa limits treatment options. This study compared the effectiveness and safety of C/A plus aztreonam versus cefiderocol for C/A-resistant infections.</p><p><strong>Methods: </strong>This retrospective, single-center cohort study was conducted at a tertiary care hospital in the United Arab Emirates between April 1, 2022, and November 30, 2025. Eligible patients were hospitalized adults with microbiologically confirmed infections caused by C/A-resistant Enterobacterales or P. aeruginosa who received C/A plus aztreonam or cefiderocol for ≥ 48 h. The main outcomes were in-hospital mortality, 30-day mortality, and clinical cure. Additional microbiological and safety outcomes were also assessed.</p><p><strong>Results: </strong>Fifty-six patients were included, of whom 36 received C/A plus aztreonam and 20 received cefiderocol. The median age was 65 years, and 51.8% were admitted to the intensive care unit. P. aeruginosa and Klebsiella spp. were the most common targeted pathogens. No statistically significant differences were observed between treatment groups in rates of in-hospital mortality (38.9% vs. 30.0%; OR, 0.67; 95% CI, 0.21-2.17), 30-day mortality (22.2% vs. 25.0%; OR, 1.17; 95% CI, 0.32-4.20), or clinical cure (61.1% vs. 60.0%; OR, 0.95; 95% CI, 0.31-2.92). Pathogen-stratified analyses were consistent with the overall findings, with no significant between-group differences within either pathogen group. Microbiological and safety outcomes were also comparable.</p><p><strong>Conclusions: </strong>No significant differences in clinical outcomes were observed between C/A plus aztreonam and cefiderocol for C/A-resistant Enterobacterales and P. aeruginosa infections, but wide confidence intervals limited certainty. Larger molecularly characterized studies are needed to guide treatment selection.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817722","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":"Point prevalence assessments of five respiratory viruses in adults ≥ 50 years of age in Germany by multi-pathogen rapid antigen testing on June 1, 2024, and December 15, 2024.","authors":"Miranda Anggitakirana, Julia A Nacov, Jon Salmanton-García, Julia Jakobs, Sarah Grimm, Janina Leckler, Katharina Köbe, Louise M Cremer, Pauline Wipfler, Jannik Stemler, Heinz-Josef Schmitt, Ullrich Bethe, Oliver A Cornely","doi":"10.1007/s15010-026-02917-5","DOIUrl":"https://doi.org/10.1007/s15010-026-02917-5","url":null,"abstract":"<p><strong>Purpose: </strong>Acute respiratory infections (ARI) impose a significant burden on healthcare systems and society. This study aimed to investigate the circulation of respiratory viruses in community-dwelling older adults in Germany.</p><p><strong>Methods: </strong>Participants aged ≥ 50 years in Germany performed multi-pathogen rapid antigen self-tests (MAK5) detecting adenovirus (AdV), severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2), influenza A and B, and respiratory syncytial virus (RSV) on June 1 and December 15, 2024. Participants reported test results, ARI symptoms and duration, medical consultations, work absenteeism, comorbidities, vaccination history, and prior infections.</p><p><strong>Results: </strong>2,654 participants enrolled in the point prevalence assessment on June 1, 2024 and 2,385 on December 15, 2024. Most tests were negative (n = 4,807; 93.9%), with an overall detection rate of 5.7%. In June, 153 pathogens were detected, compared to 138 in December. AdV was the most frequently detected pathogen in both June (59/153; 38.6%) and December (44/138; 31.9%), followed by SARS-CoV-2 and influenza A. Among participants with a positive test, at least one ARI symptom was reported by 47.7% in June and 58.7% in December. SARS-CoV-2 was associated with the highest clinical burden, resulting in healthcare utilization in 10.0% and 19.4% of cases and work absenteeism in 10.0% and 13.9% of cases in June and December, respectively.</p><p><strong>Conclusion: </strong>Point prevalence testing revealed substantial AdV circulation, underrepresented in routine surveillance. Its frequent co-detection with other viruses suggests a role as a co-infecting agent. Community-based screening can help identify asymptomatic reservoirs and underreported viral circulation, linking viral detection to clinical and economic impact.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817952","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":"Comparable treatment response rates with benzathine penicillin and doxycycline in early syphilis: evidence from a large German cohort.","authors":"Michael Sabranski, Guido Schäfer, Stefan Fenske, Axel Adam, Stefan Hansen, Carl Knud Schewe, Thomas Buhk, Malena Hinrichs, Christian Hoffmann","doi":"10.1007/s15010-026-02950-4","DOIUrl":"https://doi.org/10.1007/s15010-026-02950-4","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to identify predictors of serological nonresponse, defined as a less than fourfold decline in VDRL titers at 12 months, and factors associated with higher minimum titers during months 13-24 after treatment, and to assess whether either outcome was associated with the antibiotic regimen.</p><p><strong>Methods: </strong>We conducted a retrospective longitudinal cohort study of individuals with early syphilis treated with benzathine penicillin G or doxycycline and followed for 24 months. Predictors of 12-month serological response were assessed using multivariable logistic regression. Factors associated with the lowest log₂-transformed VDRL titer recorded during months 13-24 were evaluated using multivariable linear regression.</p><p><strong>Results: </strong>Among the 633 eligible cases, 106 (16.7%) did not achieve a fourfold decline within 12 months after treatment. In addition, 127 cases (20.1%) showed incomplete seroreversion, defined as a minimum VDRL titer of ≥ 1:2 during months 13-24. The antibiotic regimen was not associated with either outcome. Higher baseline VDRL titers were associated with greater odds of achieving a fourfold decline by 12 months, but also with higher minimum VDRL titers during months 13-24. In contrast, age > 65 years and PrEP use were associated with lower odds of achieving a fourfold decline. Several clinical and immunological characteristics were associated with the magnitude of late VDRL seroreactivity during the late follow-up period.</p><p><strong>Conclusions: </strong>Serological outcomes were associated primarily with baseline and host characteristics rather than the antibiotic regimen. Doxycycline may be an effective alternative to benzathine penicillin G for early syphilis, although the observational design does not establish equivalence.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817486","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":"Characteristics of late HIV diagnosis in Germany in 2019 and 2020 - A regional analysis.","authors":"Carlotta Helbig, Susanne Mohr, Mathias W Pletz, Juliane Ankert, Jens Forthmann, Markus Bickel, Christoph Stephan, Olaf Degen, Sebastian Noe, Hans Wesselmann, Daniela Tominski, Stefanie Holm, Christoph Spinner, Neel Petersen, Christoph Boesecke, Axel Baumgarten, Wolfgang Schmidt, Sven Becker, Hartmut Stocker, Christoph Lübbert, Thomas Heuchel, Christoph Wyen, Wilfried Obst, Ines Ruck, Steve Rößler, Heribert Knechten, Michael Waizmann, Thomas Seidel, Benjamin T Schleenvoigt","doi":"10.1007/s15010-026-02935-3","DOIUrl":"https://doi.org/10.1007/s15010-026-02935-3","url":null,"abstract":"<p><strong>Purpose: </strong>A large proportion of HIV diagnoses are made at an advanced stage of infection and different patient characteristics have been associated with late diagnosis of HIV. This study aims to assess the prevalence of late HIV diagnosis, to characterize individuals diagnosed at a late stage of infection and to evaluate regional differences in Germany.</p><p><strong>Methods: </strong>This retrospective, cross-sectional analysis included 1,169 individuals newly diagnosed with HIV in 2019 and 2020. Data on patient demographics, information on the HIV diagnosis and laboratory parameters were collected. Late diagnosis and advanced HIV disease were defined according to established consensus criteria. Regional comparison was made between eastern and western Germany.</p><p><strong>Results: </strong>In our cohort, 82.6% of the individuals were male and 16.9% female, with a median age of 39 years (IQR: 31-50). The prevalence of late diagnosis was 61.6% and advanced HIV disease, as a subgroup of late diagnosis, was present in 41.7%. Individuals with late diagnosis were significantly older than those diagnosed at an earlier stage (p < 0.001). Patients in eastern Germany were diagnosed at more advanced stages of infection with significantly higher rates of late diagnosis (p < 0.01), advanced HIV disease (p < 0.001), and AIDS-defining conditions (p < 0.001), as well as significantly lower CD4 cell counts (p < 0.001).</p><p><strong>Conclusion: </strong>Our data demonstrate that a high proportion of HIV diagnoses in Germany are made at a late stage of infection. Late diagnosis was more frequent in older individuals and in those living in eastern Germany. These findings highlight the need for strengthened HIV testing strategies, particularly in underserved populations and regions.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817380","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":"Emerging epidemiology of invasive group a Streptococcus in tropical Australia: a 21-year population-based data linkage study.","authors":"Himali Erandathie Ratnayake, Damon Eisen, Oyelola Adegboye, Anton Pak, Emma McBryde","doi":"10.1007/s15010-026-02904-w","DOIUrl":"https://doi.org/10.1007/s15010-026-02904-w","url":null,"abstract":"<p><strong>Purpose: </strong>Invasive Group A Streptococcus (iGAS) is an important cause of severe bacterial infection with increasing incidence and substantial socioeconomic disparities. This study quantified long-term trends, spatial distribution, and determinants of iGAS incidence in Northern Queensland, Australia.</p><p><strong>Methods: </strong>A population-based retrospective cohort study was conducted using linked hospital data linkage from 2000-2020. Incidence rates were calculated per 100,000 person-years and temporal trends were assessed. Spatial clustering was evaluated using Moran's I statistic for spatial autocorrelation. Determinants of incidence were examined using a negative binomial generalized additive model (GAM).</p><p><strong>Results: </strong>A total of 933 iGAS events were identified among 870 individuals. Incidence increased substantially over time, with the highest rates observed among older adults and a secondary peak among infants. Age-standardised incidence was approximately nine-fold higher among Indigenous compared with non-Indigenous populations for both males and females. Spatial analysis demonstrated significant clustering of incidence (Moran's I = 0.19, p < 0.001), with the greatest burden occurring in remote and very remote regions. In multivariable analysis, Indigenous status (IRR = 8.97, p < 0.001) and male sex (IRR = 1.28, p < 0.001) were independently associated with higher incidence. Smooth terms showed significant nonlinear effects of age (edf = 7.45, p < 0.001) and calendar year (edf = 8.04, p < 0.001), indicating heterogeneous age patterns and temporal acceleration in incidence.</p><p><strong>Conclusion: </strong>iGAS incidence in Northern Queensland increased markedly over two decades and was characterised by pronounced geographic and Indigenous health inequities, highlighting the need for targeted prevention strategies in high-risk populations and regions.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817794","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":"Pembrolizumab in people with HIV-associated progressive multifocal leukoencephalopathy: a retrospective case series.","authors":"Leyli Ghaeni, Hartmut Stocker, Daniela Drauz, Pascal Migaud","doi":"10.1007/s15010-026-02939-z","DOIUrl":"https://doi.org/10.1007/s15010-026-02939-z","url":null,"abstract":"<p><p>Progressive multifocal leukoencephalopathy (PML) in people with HIV (PWH) carries high mortality, and no specific antiviral treatment is available. In this retrospective single-centre case series of six patients treated with pembrolizumab, four showed clinical improvement or stabilisation. Pembrolizumab might represent a salvage option in this population.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817998","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":"Q fever outbreak in a slaughterhouse in Brazil: description and decade-later investigation.","authors":"Danilo A França, Igor S Silito, Matheus Pasini-Martins, Leila C Saad, Tais B Carvalho, Milenne U S Dias, Rodrigo N Angerami, Fabiana C P Santos, Silvia Colombo, Marcelo B Labruna","doi":"10.1007/s15010-026-02922-8","DOIUrl":"https://doi.org/10.1007/s15010-026-02922-8","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the first Q fever outbreak in Brazil and the long-term clinical and serological outcomes of affected individuals ten years after the outbreak.</p><p><strong>Methods: </strong>A follow-up investigation was conducted among patients involved in a Q fever outbreak that occurred in 2015 in a slaughterhouse in Barbosa, São Paulo State, Brazil. Clinical records from the acute phase were reviewed, and patients were reevaluated ten years later through clinical assessment, review of medical history, serological testing, and molecular analysis.</p><p><strong>Results: </strong>The outbreak affected 17 of 40 slaughterhouse workers (attack rate = 42.5%) and was likely associated with the inhalation of Coxiella burnetii during the slaughter of pregnant cows. Patients presented with prolonged fever, headache, myalgia, pneumonia, hepatitis, and hematuria; six required hospitalization. Ten years later, 14 patients were reevaluated. Of these, 10 developed complications compatible with chronic Q fever, including cardiac and respiratory disorders, as well as persistent fatigue. One woman experienced a premature birth after becoming pregnant following the outbreak. In 2025, one patient presented a phase I antibody endpoint titer of 1:1024 and a history of endocarditis, suggesting persistent infection.</p><p><strong>Conclusion: </strong>This study provides a unique description of the long-term clinical and serological outcomes of workers involved in the first documented Q fever outbreak in Brazil and emphasizes the importance of post-outbreak surveillance and prolonged clinical follow-up.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148812901","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}