Infection最新文献

{"title":"Transurethral resection of the prostate (TUR-P) and associated risk of infective endocarditis.","authors":"Emil Loldrup Fosbøl, Anna Stahl, Andreas Røder, Cecilie Bagi Nordsten, Lauge Østergaard, Thomas S G Sehested, Anders Dahl, Nikolaj Ihlemann, Henning Bundgaard, Kasper Iversen, Nana Valeur, Gunnar Gislason, Christian Torp-Pedersen, Marianne Voldstedlund, Per Bagi, Lars Køber","doi":"10.1007/s15010-024-02450-3","DOIUrl":"https://doi.org/10.1007/s15010-024-02450-3","url":null,"abstract":"<p><strong>Purpose: </strong>Bacteremia is a well-known complication to surgery and may result in infective endocarditis (IE). Transurethral resection of the prostate (TUR-P) may give rise to bacteremia, but the associated risk of IE is not well described. We aimed to examine risk of infective endocarditis following TUR-P.</p><p><strong>Methods: </strong>We examined risk of IE following TUR-P between 2010 and 2020 in comparison with an age-matched (match-ratio 1:1) cohort from the background population. Patients were considered exposed to TUR-P related IE 6 months after TUR-P. Comparisons were estimated using cumulative incidences and multivariable time-dependent Cox regression models.</p><p><strong>Results: </strong>A total of 25,781 males underwent TUR-P (11.4% diagnosed with prostate cancer). Median age was 70.7 years (25-75 percentiles, 64.9-76.3 years). In the TUR-P group, 901 (3.5%) patients had bacteremia and 44 (0.2%) patients developed IE within 6 months following index. The most common microorganism in IE-cases was Enterococcus faecalis (72.7%). The incidence of IE was higher < 6 months after TUR-P (34.64 (25.78-46.55)) IEs per 10,000 person years) than 6-12 months after TUR-P (8.37 (5.46-12.84) IEs per 10,000 person years). TUR-P was associated with a higher hazard ratio of IE within 6 months (age-adjusted HR 8.16, 95% CI 3.06-21.79), but not 6-12 months after TUR-P (adj. HR 2.15 (0.91-5.07)).</p><p><strong>Conclusions: </strong>TUR-P was associated with an eight-fold higher risk of IE compared with age-matched controls within 6 months after surgery. Although the absolute risk was low, TUR-P seems to be a significant risk factor for IE and this warrant consideration for development of better prophylactic interventions.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142870836","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 and outcome of Pseudomonas aeruginosa bloodstream infections (PABSI) in hematological patients: a single center retrospective cohort study.","authors":"Johanna Kessel, Gesine Bug, Björn Steffen, Uta Brunnberg, Maria J G T Vehreschild, Sarah Weber, Sebastian Scheich, Fabian Lang, Hubert Serve, Eva Herrmann, Michael Hogardt","doi":"10.1007/s15010-024-02453-0","DOIUrl":"https://doi.org/10.1007/s15010-024-02453-0","url":null,"abstract":"<p><strong>Purpose: </strong>Bloodstream infections caused by Pseudomonas aeruginosa (PABSI) in hematological patients are associated with high morbidity and mortality. We investigated the epidemiology, risk factors, and outcomes of PABSI at our center.</p><p><strong>Methods: </strong>All adult hematological patients with PABSI between January 2013 and July 2023 were included. Demographic and clinical characteristics, antimicrobial susceptibilities, antibiotic therapy, fluoroquinolone-prophylaxis, source of infection, and 30-day outcome were recorded. Descriptive statistics, tests for difference, and logistic regression models were performed.</p><p><strong>Results: </strong>Fifty patients with PABSI were identified with a median age of 58.5 years (range 24-78). 37 patients (74%) had severe neutropenia, 20 (40%) received allogeneic HSCT, and 29 (58%) had acute leukemia. A total of 34 (68%) had received timely appropriate anti-pseudomonal antibiotic therapy. The most common presumed cause of PABSI was mucositis (n = 16, 32%), followed by pneumonia (8, 16%) and skin and soft tissue infections (n = 6, 12%). Empirical combination therapy was used in 16 (32%) patients, while targeted combination therapies were used in 27 (54%) patients. P. aeruginosa detection led to treatment change in 31 (62%) cases. The overall 30-day survival rate was 78% (n = 39). Carbapenem-resistance occurred in 34% (n = 17), and multidrug-resistance (MDR) in 20% (n = 10). Prior antibiotic exposure was associated with resistance. Appropriate antibiotic therapy was associated with survival, whereas antibiotic resistance and organ infection were associated with a fatal outcome.</p><p><strong>Conclusion: </strong>Prior antibiotic exposure in hematological patients is associated with resistance in PABSI, which is a major risk factor for a fatal outcome. Antibiotic stewardship efforts should be intensified and fluoroquinolone prophylaxis needs to be reconsidered.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854128","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":"Considerations regarding a meta-analysis of ceftazidime-avibactam versus other antimicrobial agents for treatment of multidrug-resistant pseudomonas aeruginosa.","authors":"Feng Li, Huayang Pang, Chunxue Li","doi":"10.1007/s15010-024-02458-9","DOIUrl":"https://doi.org/10.1007/s15010-024-02458-9","url":null,"abstract":"","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846352","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":"Respiratory syncytial virus infection in patients with haematological diseases: a retrospective multicentre study.","authors":"Sebastian Herrmann, Stephanie Graefe, Maximilian Christopeit, Piet Sonnemann, Tessa Hattenhauer, Rebekka Mispelbaum, Malte B Monin, Hans Martin Orth, Charlotte Flasshove, Henning Gruell, Florian Klein, Uwe Klein, Clara Lehmann, Jan-Hendrik Naendrup, Jannik Stemler, Jon Salmanton-Garcia, Theresa Markus, Oliver A Cornely, Sibylle C Mellinghoff","doi":"10.1007/s15010-024-02449-w","DOIUrl":"https://doi.org/10.1007/s15010-024-02449-w","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to evaluate the burden of respiratory syncytial virus (RSV) infections in patients with haematological diseases. It seeks to analyse the relevance of prevention, diagnosis and treatment of RSV infections.</p><p><strong>Methods: </strong>A multi-centre, retrospective study was conducted across University Hospitals in Cologne, Düsseldorf, Bonn, and the University Medical Centre Hamburg-Eppendorf between Jan 2016 and Aug 2023. All haematological patients with diagnosed RSV infection were included. The study focused on the incidence of RSV, underlying conditions, comorbidities, coinfections and clinical outcomes such as hospitalization, intensive care unit (ICU) admission and mortality.</p><p><strong>Results: </strong>Of 166 patients, 89 (53.6%) had signs of pneumonia and 37 (22.3%) were admitted to ICU due to RSV infection, while 20 (54%) of those were mechanically ventilated with median duration of 11 days (1,33; IQR:18). Mean age was 60 years (range 14-88). Sixteen patients (9.6%) were treated as outpatients, while 52 (31.3%) were hospitalized due to RSV infection; the median hospital stay was 16 days (IQR 25.25, range 0-97). 79 (47.6%) of patients presented with leukopenia and 57 (34.3%) with neutropenia. In total, 22 patients (13.3%) died within 30 days and 29 (17.5%) died within 90 days. Highest mortality rates were seen in patients with aggressive lymphoma (23.5%) and acute leukaemia (18%).</p><p><strong>Conclusion: </strong>RSV significantly impacts patients with haematological diseases, leading to high rates of hospitalization, ICU admission, and mortality. Preventive measures, such as vaccination, alongside early diagnosis and individualized management, are essential to reduce RSV-associated morbidity and mortality in this high-risk population.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142835616","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":"Anidulafungin exposure and population pharmacokinetics in critically ill patients with invasive candidiasis.","authors":"Omar Elkayal, Yannick Hoffert, Beatrijs Mertens, Ruth Van Daele, Katrien Lagrou, Joost Wauters, Isabel Spriet, Erwin Dreesen","doi":"10.1007/s15010-024-02448-x","DOIUrl":"https://doi.org/10.1007/s15010-024-02448-x","url":null,"abstract":"<p><strong>Purpose: </strong>Anidulafungin is recommended as a first-line treatment for invasive Candida infections in critically ill patients. Pharmacokinetic (PK) variability is large in critically ill patients, potentially compromising pharmacokinetic-pharmacodynamic (PKPD) target attainment under standard dosing. We aimed to assess anidulafungin exposure, PKPD target attainment, and population (pop)PK in critically ill patients.</p><p><strong>Methods: </strong>Adult ICU patients receiving standard anidulafungin dosing [200 mg on day 1, then 100 mg daily] were included (NCT04045366). We performed rich blood sampling on an early (day 2 ± 1) and/or late (day 5 ± 1) treatment day. Using total anidulafungin plasma concentrations, we developed a popPK model (NONMEM7.5) and conducted Monte Carlo simulations (n = 1,000 per virtual patient) to evaluate the impact of patient factors on PKPD target attainment (AUC_24h target 83.5 mg×h/L).</p><p><strong>Results: </strong>Twenty patients contributed 188 anidulafungin concentrations. PKPD target attainment was 45% and 65% on early and late sampling days, respectively. A two-compartment popPK model with first-order elimination described the data. Anidulafungin clearance increased with bodyweight and central volume of distribution increased as serum albumin decreased. Both bodyweight and serum albumin had a clinically relevant impact on PKPD target attainment at day 1 (area under the ROC curve; AUROC 0.82 and 0.62, respectively), and bodyweight on PKPD target attainment at day 14 (AUROC 0.94). Standard anidulafungin dosing regimen fails to achieve adequate target attainment throughout the treatment period.</p><p><strong>Conclusion: </strong>Standard anidulafungin dosing is insufficient for achieving adequate exposure in critically ill patients. An interactive simulation tool is provided to aid dose-finding research and explore different dosing strategies and targets.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785420","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":"Bacteremic nosocomial pneumonia caused by Gram-negative bacilli: results from the nationwide ALARICO study in Italy.","authors":"Giusy Tiseo, Valentina Galfo, Sergio Carbonara, Andrea Marino, Giovanni Di Caprio, Anna Carretta, Alessandra Mularoni, Michele Fabiano Mariani, Alberto Enrico Maraolo, Riccardo Scotto, Lidia Dalfino, Lorenzo Corbo, Margherita Macera, Alice Annalisa Medaglia, Maria Luca d'Errico, Claudia Gioè, Christian Sgroi, Rosa Fontana Del Vecchio, Giancarlo Ceccarelli, Antonio Albanese, Calogero Buscemi, Simona Talamanca, Giuseppe Foti, Giulio De Stefano, Antonina Franco, Carmelo Iacobello, Salvatore Corrao, Domenico Morana, Filippo Pieralli, Ivan Gentile, Teresa Santantonio, Antonio Cascio, Nicola Coppola, Bruno Cacopardo, Mario Venditti, Francesco Menichetti, Marco Falcone","doi":"10.1007/s15010-024-02423-6","DOIUrl":"https://doi.org/10.1007/s15010-024-02423-6","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the clinical characteristics and outcomes of patients with nosocomial pneumonia (NP) caused by carbapenem-resistant Gram-negative bacilli (CR-GNB) and to compare them to patients with NP caused by carbapenem-susceptible (CS)-GNB.</p><p><strong>Methods: </strong>Prospective observational multicenter study including patients with bacteremic NP caused by GNB from the ALARICO Network (June 2018-January 2020). The primary outcome measure was 30-day mortality. A Cox regression analysis was performed to identify factors independently associated with 30-day mortality. Hazard ratio (HR) and 95% confidence intervals (CI) were calculated.</p><p><strong>Results: </strong>Overall, 167 patients with GNB NP were included: 101 with bacteremic NP caused by CR-GNB (n = 39 by KPC-producing Klebsiella pneumoniae, n = 29 by carbapenem-resistant Acinetobacter baumannii, n = 28 by carbapenem-resistant Pseudomonas aeruginosa, n = 5 by MBL-producing Klebsiella pneumoniae) and 66 cases of bacteremic CS-GNB NP. Thirty-day mortality rate was higher in patients with NP caused by CR-GNB compared to those with NPcaused by CS-GNB (46.5% vs 30.3%, p = 0.036). On multivariable analysis, age (HR 1.044, 95% CI 1.021-1.067, p < 0.001), hematological malignancy (HR 4.307, 95% CI 1.924-9.643, p < 0.001) and septic shock (HR 3.668, 95% CI 2.001-6.724, p < 0.001) were factors independently associated with 30-day mortality, while the receipt of adequate antibiotic therapy within 24 h from infection onset (HR 0.495, 95% CI 0.252-0.969, p = 0.04) was a protective factor. Carbapenem resistance was not associated with increased risk of mortality (HR 1.075, 95% CI 0.539-2.142, p = 0.837).</p><p><strong>Conclusions: </strong>Patients with bacteremic NP caused by CR-GNB have high mortality rate. Strategies to reduce the time from infection to the administration of adequate antibiotic therapy should be implemented in patients with NP.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142790668","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":"Piperacillin/tazobactam vs. cefepime or carbapenems for the treatment of bloodstream infections due to bacteria producing chromosomal AmpC beta-lactamase: a systematic review and meta-analysis.","authors":"Lorenzo Onorato, Ilaria de Luca, Annabella Salvati, Caterina Monari, Nicola Coppola","doi":"10.1007/s15010-024-02447-y","DOIUrl":"https://doi.org/10.1007/s15010-024-02447-y","url":null,"abstract":"<p><strong>Background: </strong>The best treatment for bloodstream infections (BSI) due to chromosomal AmpC (c-AmpC) producing Enterobacterales is not clearly defined.</p><p><strong>Objectives: </strong>To describe the clinical and microbiological outcomes of patients treated with piperacillin/tazobactam, cefepime or carbapenems for bloodstream infections (BSIs) due to c-AmpC beta-lactamase-producing strains.</p><p><strong>Data sources: </strong>We searched MEDLINE, the Cochrane Library and EMBASE to screen original reports published up to January 2024.</p><p><strong>Study eligibility criteria: </strong>RCTs and observational studies investigating all-cause mortality, clinical failure, microbiological failure or rate of ADRs of patients treated with piperacillin/tazobactam, cefepime or carbapenems.</p><p><strong>Participants: </strong>Patients with bloodstream infections due to c-AmpC producing bacteria.</p><p><strong>Interventions: </strong>Piperacillin/tazobactam, cefepime or carbapenems as targeted treatment.</p><p><strong>Assessment of risk of bias: </strong>We used the Cochrane Risk of Bias Tool for RCTs, and the Newcastle Ottawa scale for observational studies.</p><p><strong>Methods of data synthesis: </strong>We conducted a meta-analysis pooling Risk ratios (RRs) through random effect models.</p><p><strong>Results: </strong>We screened 1,720 original reports, and 20 studies (1 RCTs, 1 case-control study, 18 cohort studies) were included in the analysis, for a total of 2,834 patients. When comparing piperacillin/tazobactam with alternative treatments (cefepime or carbapenems), no significant difference in mortality rate was observed between the treatment groups (RR: 1.1; 95% CI: 0.76-1.58, p = 0.61), while an higher rate of microbiological failure (RR: 1.80; 95% CI: 1.15-2.82, p = 0.01) and clinical failure (RR: 1.54; 95% CI: 1.00-2.40, p = 0.05) was observed among patients receiving piperacillin/tazobactam. No difference was observed in microbiological and clinical failure rate among patients treated with cefepime or carbapenems, with a lower mortality rate in those receiving cefepime (RR: 0.74; 95% CI: 0.59-0.94, p = 0.014).</p><p><strong>Conclusions: </strong>Cefepime represents an excellent alternative to carbapenems for BSI due to AmpC-producing strains, whereas piperacillin/tazobactam is associated with a higher rate of clinical and microbiological failure. There is an urgent need for randomized clinical trials that aim to define the best carbapenem-sparing strategy in these infections.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768382","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":"Embolic complications in a large contemporary cohort of infective endocarditis: do we need score model?","authors":"Lorenzo Bertolino, Ahsanullah Unar, Fabian Patauner, Raffaella Gallo, Anna Maria Carolina Peluso, Augusto Delle Femine, Oriana Infante, Silvia Mercadante, Fabio Luciano, Sabrina Manduca, Roberto Andini, Rosa Zampino, Emanuele Durante-Mangoni","doi":"10.1007/s15010-024-02444-1","DOIUrl":"https://doi.org/10.1007/s15010-024-02444-1","url":null,"abstract":"<p><strong>Purpose: </strong>Infective endocarditis (IE) is a heterogeneous disease undergoing epidemiological changes. Whether those changes have an impact on the correlates of embolic events (EE) remains unclear. We analyzed the correlates of EE and proposed a diagnostic score model in a large contemporary cohort.</p><p><strong>Methods: </strong>This is a retrospective observational study including patients with definite valve IE admitted between 2000 and 2023. EE were defined as acute complications causing overt clinical manifestations. The study primary aim was to identify independent correlates of EE.</p><p><strong>Results: </strong>715 valve-IE cases were included. EE occurred in 41.4% (n = 296) of patients. S. aureus etiology (OR 2.708[1.268-5.786]; p = 0.010), C-reactive protein > 6.7 mg/dL (OR 2.415[1.371-4.252]; p = 0.002), and splenomegaly (OR 2.858[1.620-5.403]; p < 0.001) were independently associated with EE. VS ≥ 14 mm (OR 1.575[0.925-2.682]; p = 0.061) and D-dimers > 747 ng/mL (OR 1.677[0.976-2.881]; p = 0.061) showed a trend for independent association. These variables were included in a diagnostic score model. A stepwise increase of EE occurrence was found stratifying patients into 3 categories (score 0-2-22%; score 3-5-53%; score 6-8-78%;p < 0.001). A cut-off of 2 (< 2 vs. ≥ 2) showed a sensitivity of 83% and a specificity of 50% (AUROC 0.732; p < 0.001).</p><p><strong>Conclusion: </strong>EE were independently associated to Staphylococcus aureus, C-reactive protein and splenomegaly and less strongly linked to vegetation size in our cohort. These results may be explained by a change in embolic complications correlates linked to the epidemiological shift. The discriminative ability of our score was only fair. At present, clinicians should rely upon clinical and imaging data to diagnose EE.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768356","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":"Syncopes, paresis and loss of vision after COVID-19 mRNA-based vaccination and SARS-CoV-2 infection.","authors":"Tobias Weirauch, Gundolf Schüttfort, Maria J G T Vehreschild","doi":"10.1007/s15010-024-02439-y","DOIUrl":"https://doi.org/10.1007/s15010-024-02439-y","url":null,"abstract":"<p><p>mRNA-based vaccines played a key role in fighting the global COVID-19 pandemic by saving millions of lives. In rare cases, however, the BNT162b2 vaccine has been associated with severe adverse reactions e.g. myocarditis (OE ratio 2.78; 95% CI 2.61; 2.95) [Faksova in Vaccine 42(9):2200-2211, 2024, https://doi.org/10.1016/j.vaccine.2024.01.100 , Schwab in Clin Res Cardiol 112(3):431-440, 2022, https://doi.org/10.1007/s00392-022-02129-5 ]. Here, we describe the case of a 38-year-old man who developed a wide variety of long-term symptoms (fatigue, dizziness, palpitations with recurrent syncopes, paresthesia, paresis and fasciculations) following his first mRNA-based BNT162b2 COVID-19 vaccination. 143 days after vaccination, a subsequent COVID-19 infection was associated with exacerbation of paresis and a temporary loss of vision. After ruling out other causes and due to the immediate temporal association, an adverse reaction to vaccination appears likely. The fact that these symptoms worsened after a subsequent acute COVID 19 infection hints at the possibility of a common underlying pathophysiology. This case combines two clinical phenomena that have emerged during the COVID 19 pandemic, side effects associated with novel vaccines and Post-COVID Syndrome.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768393","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":"Results of a monocentric field study: value of histology compared to sonication method and conventional tissue culture in the diagnosis of periprosthetic joint infection (PJI).","authors":"Alexander Röhrl, Frank Klawonn, Bernd Füchtmeier, Christian Wulbrand, Andre Gessner, Jozef Zustin, Andreas Ambrosch","doi":"10.1007/s15010-024-02278-x","DOIUrl":"10.1007/s15010-024-02278-x","url":null,"abstract":"<p><strong>Background: </strong>To confirm the diagnosis of periprosthetic joint infection (PJI), the Infectious Diseases Society of America (IDSA) and the International Consensus Meeting (ICM) have defined criteria that include histology as a minor criterion and the sonication method only as an additional criterion. The aim of this monocentric, retrospective study was to investigate the value of histology and whether sonication leads to a more accurate diagnosis.</p><p><strong>Materials and methods: </strong>All revision surgeries for knee and hip arthroplasty between 2017 and 2020 were included. With regard to microbiological diagnostic, conventional culture of periprosthetic biopsies and sonication of explant material were performed. In addition, histology and non-specific inflammatory markers (CRP, leukocytes) were recorded.</p><p><strong>Results: </strong>A total of 78 patients with PJI and 62 aseptic controls were included. From both microbiological methods (conventional culture / sonication), Staphyloccus (S.) epidermidis and S. aureus were detected most frequently. However, compared to the conventional microbiology, a higher sensitivity was calculated for sonication, albeit with a lower specificity in relation to a PJI. In two logistic regression models for the significance of all diagnostic parameters in PJI, the AUC was 0.92 and 0.96 with histology in particular making the decisive contribution in both models (p < 0. 001, both models).</p><p><strong>Conclusion: </strong>Since histology showed the highest accuracy in the current study, its importance in the PJI criteria should be reevaluated. Sonication shows a high sensitivity for germ detection with a lower specificity and should only be used in combination with the conventional culture for microbiolgical diagnostics.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":"2287-2296"},"PeriodicalIF":5.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140904124","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}