International Journal of Infectious Diseases最新文献

{"title":"Influenza epidemiology and vaccine effectiveness during the 2023/2024 season in Italy: A test-negative case-control study","authors":"","doi":"10.1016/j.ijid.2024.107202","DOIUrl":"10.1016/j.ijid.2024.107202","url":null,"abstract":"<div><h3>Objectives</h3><p>In order to support policymakers in allocating resources, we aimed to assess vaccine effectiveness (VE) of inactivated influenza vaccines (IIVs) available for Italian adults in the 2023/2024 season.</p></div><div><h3>Methods</h3><p>A hospital-based test-negative case-control study was conducted in Genoa between mid-October 2023 and mid-April 2024. Adult (≥18 years) inpatients with prescription of a polymerase chain reaction test for influenza were eligible.</p></div><div><h3>Results</h3><p>Of 1,664 adults analyzed, most (82%) of which were ≥65 years, 114 (6.9%) tested positive for influenza A. Most (92%) cases were caused by subclades 6B.1A.5a.2a and 6B.1A.5a.2a.1 of the A(H1N1)pdm09 subtype. In older adults aged ≥65 years vaccination was effective at 51% (95% CI: 8%, 74%) against any influenza A and 49% (95% CI: 2%, 73%) against A(H1N1)pdm09. Compared with non-vaccinated older adults, VE point estimates for the adjuvanted and, especially, high-dose IIVs were higher than those for the standard-dose non-adjuvanted IIV.</p></div><div><h3>Conclusion</h3><p>The 2023/2024 seasonal influenza vaccination proved moderately effective in preventing hospitalization for laboratory-confirmed influenza. Being more appropriate for older adults, local policymakers and vaccinating physicians should maximize adoption of the enhanced IIVs.</p></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S120197122400273X/pdfft?md5=00459b2d74e8075a2457682c5182317e&pid=1-s2.0-S120197122400273X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141912542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Doxycycline prophylaxis for the prevention of sexually transmitted infections: A systematic review and meta-analysis of randomized controlled trials","authors":"","doi":"10.1016/j.ijid.2024.107186","DOIUrl":"10.1016/j.ijid.2024.107186","url":null,"abstract":"<div><h3>Objectives</h3><p>To investigate the effects of doxycycline pre- and post-exposure prophylaxis (doxy-PrEP/PEP) on bacterial sexually transmitted infections (STIs) by conducting a systematic review and meta-analysis.</p></div><div><h3>Methods</h3><p>PubMed, Embase, and CENTRAL were searched for randomized controlled trials (RCTs), including ongoing studies published until November 7, 2023. Our primary endpoint was the incidence of bacterial STIs measured as the number of visits with an STI per total number of visits. Random-effects model was used to estimate pooled effect sizes. The study was registered with PROSPERO, CRD42023478486.</p></div><div><h3>Results</h3><p>We identified six eligible studies containing data from seven articles and four conference abstracts, enrolling men who have sex with men (MSM), transgender women (TGW), and cisgender women (CGW). The pooled analysis of 1,766 participants with 602 newly diagnosed STIs showed a 56% decrease in the overall STI incidence using doxy-PrEP/PEP (RR = 0.44; 95% CI: 0.30-0.65; I² = 73%). For doxy-PEP, including MSM and TGW only, the RR observed for overall STI incidence was 0.40 (95% CI: 0.28-0.57; I² = 37%), 0.19 (95% CI: 0.08-0.44; I² = 39%) for chlamydia, 0.23 (0.14-0.36; I² = 0%) for syphilis and 0.55 (95% CI: 0.34-0.87; I² = 41%) for gonorrhea. No serious adverse events were reported in the studies. The certainty of evidence regarding the efficacy of doxy-PEP among MSM and TGW was graded as high.</p></div><div><h3>Conclusion</h3><p>Doxy-PEP significantly reduces the number of new cases of chlamydia and syphilis and is potentially effective against gonorrhea, influenced by local resistance patterns. Thus, it is a promising tool in the prevention of bacterial STIs among MSM and TGW.</p></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1201971224002571/pdfft?md5=cd782b4c096ef62c7d2d56845897d396&pid=1-s2.0-S1201971224002571-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141912541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Finite immune imprinting on neutralizing antibody responses to Omicron subvariants by repeated vaccinations","authors":"","doi":"10.1016/j.ijid.2024.107198","DOIUrl":"10.1016/j.ijid.2024.107198","url":null,"abstract":"<div><h3>Objective</h3><p>To investigate the effects of repeated vaccination with ancestral SARS-CoV-2 (Wuhan-hu-1)-based inactivated, recombinant protein subunit or vector-based vaccines on the neutralizing antibody response to Omicron subvariants.</p></div><div><h3>Methods</h3><p>Individuals who received four-dose vaccinations with the Wuhan-hu-1 strain, individuals who were infected with the BA.5 variant alone without prior vaccination, and individuals who experienced a BA.5 breakthrough infection (BTI) following receiving 2-4 doses of the Wuhan-hu-1 vaccine were enrolled. Neutralizing antibodies against D614G, BA.5, XBB.1.5, EG.5.1, and BA.2.86 were detected using a pseudovirus-based neutralization assay. Antigenic cartography was used to analyze cross-reactivity patterns among D614G, BA.5, XBB.1.5, EG.5.1, and BA.2.86 and sera from individuals.</p></div><div><h3>Results</h3><p>The highest neutralizing antibody titers against D614G were observed in individuals who only received four-dose vaccination and those who experienced BA.5 BTI, which was also significantly higher than the antibody titers against XBB.1.5, EG.5.1, and BA.2.86. In contrast, only BA.5 infection elicited comparable neutralizing antibody titers against the tested variants. While neutralizing antibody titers against D614G or BA.5 were similar across the cohorts, the neutralizing capacity of antibodies against XBB.1.5, EG.5.1, and BA.2.86 was significantly reduced. BA.5 BTI following heterologous booster induced significantly higher neutralizing antibody titers against the variants, particularly against XBB.1.5 and EG.5.1, than uninfected vaccinated individuals, only BA.5 infected individuals, or those with BA.5 BTI after primary vaccination.</p></div><div><h3>Conclusions</h3><p>Our findings suggest that repeated vaccination with the Wuhan-hu-1 strain imprinted a neutralizing antibody response toward the Wuhan-hu-1 strain with limited effects on the antibody response to the Omicron subvariants.</p></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1201971224002698/pdfft?md5=82d21d1715e88101d0f2a73f83cb99b8&pid=1-s2.0-S1201971224002698-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141906613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Critical insights from recent outbreaks of Mycoplasma pneumoniae: decoding the challenges and effective interventions strategies","authors":"","doi":"10.1016/j.ijid.2024.107200","DOIUrl":"10.1016/j.ijid.2024.107200","url":null,"abstract":"<div><h3>Objectives</h3><p><em>Mycoplasma pneumoniae</em> (<em>M. pneumoniae</em>) continues to pose a significant disease burden on global public health as a respiratory pathogen. The antimicrobial resistance among <em>M. pneumoniae</em> strains has complicated the outbreak control efforts, emphasizing the need for robust surveillance systems and effective antimicrobial stewardship programs.</p></div><div><h3>Design</h3><p>This review comprehensively investigates studies stemming from previous outbreaks to emphasize the multifaceted nature of <em>M. pneumoniae</em> infections, encompassing epidemiological dynamics, diagnostic innovations, antibiotic resistance, and therapeutic challenges.</p></div><div><h3>Results</h3><p>We explored the spectrum of clinical manifestations associated with <em>M. pneumoniae</em> infections, emphasizing the continuum of disease severity and the challenges in gradating it accurately. Artificial intelligence and machine learning have emerged as promising tools in <em>M. pneumoniae</em> diagnostics, offering enhanced accuracy and efficiency in identifying infections. However, their integration into clinical practice presents hurdles that need to be addressed. Further, we elucidate the pivotal role of pharmacological interventions in controlling and treating <em>M. pneumoniae</em> infections as the efficacy of existing therapies is jeopardized by evolving resistance mechanisms.</p></div><div><h3>Conclusion</h3><p>Lessons learned from previous outbreaks underscore the importance of adaptive treatment strategies and proactive management approaches. Addressing these complexities demands a holistic approach integrating advanced technologies, genomic surveillance, and adaptive clinical strategies to effectively combat this pathogen.</p></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1201971224002716/pdfft?md5=46e42a178529556cf3ab7d0b292a433d&pid=1-s2.0-S1201971224002716-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141906612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Choroid plexitis caused by Burkholderia cepacia complex after COVID-19","authors":"","doi":"10.1016/j.ijid.2024.107201","DOIUrl":"10.1016/j.ijid.2024.107201","url":null,"abstract":"<div><p><em>Burkholderia cepacia</em> complex (BCC) encompasses opportunistic pathogen with various clinical manifestations ranging from no symptoms to severe respiratory infections and septicemia. Central nervous system infections caused by BCC are rare. To the best of our knowledge, we present the first reported case of choroid plexitis caused by BCC after severe COVID-19. A 67-year-old woman who had been previously diagnosed with COVID-19 presented with a mild fever and headache. Gadolinium-enhanced T1-weighted brain magnetic resonance imaging showed contrast effects in the right choroid plexus and encapsulated abscess. Gram staining of cerebrospinal fluid revealed the presence of gram-negative rods. Broad-range polymerase chain reaction amplification of 16S ribosomal RNA from the cerebrospinal fluid, followed by sequence analysis, identified BCC; thus, choroid plexitis caused by BCC was diagnosed. After prolonged antimicrobial treatment with a multiantibiotic regimen, the patient recovered completely. This case highlights the importance of long-term therapy with a carefully selected multiantibiotic regimen to achieve complete recovery after BCC infection.</p></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1201971224002728/pdfft?md5=1291238ac5ca4b4eb01e7a64939e378f&pid=1-s2.0-S1201971224002728-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141893370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunogenicity of Abdala COVID-19 vaccine in Vietnamese people after primary and booster vaccinations: A prospective observational study in Vietnam","authors":"","doi":"10.1016/j.ijid.2024.107173","DOIUrl":"10.1016/j.ijid.2024.107173","url":null,"abstract":"<div><h3>Objectives</h3><p>We studied the immunogenicity after primary and booster vaccinations of the Abdala COVID-19 vaccine, a receptor-binding domain protein subunit vaccine, in Vietnamese people by determining the level of neutralization and cross-neutralization activities against the ancestral SARS-CoV-2 and its variants and SARS-CoV-1.</p></div><div><h3>Methods</h3><p>We performed a prospective observational study, enrolling adults aged 19-59 years in Dong Thap province, southern Vietnam, and collected blood samples from baseline until 4 weeks after the booster dose. We measured anti-nucleocapsid, anti-spike, and neutralizing antibodies against SARS-CoV-2 and assessed the cross-neutralization against 14 SARS-CoV-2 variants and SARS-CoV-1. Complementary antibody data came from Vietnamese health care workers fully vaccinated with ChAdOx1-S.</p></div><div><h3>Results</h3><p>After primary vaccination, anti-spike antibody and neutralizing antibodies were detectable in 98.4% and 87% of 251 study participants, respectively, with neutralizing antibody titers similar to that induced by ChAdOx1-S vaccine. Antibody responses after a homologous (Abdala COVID-19) or heterologous (messenger RNA BNT162b2) booster could neutralize 14 SARS-CoV-2 variants (including Omicron) and SARS-CoV-1.</p></div><div><h3>Conclusions</h3><p>Abdala COVID-19 vaccine is immunogenic in Vietnamese people. Enhanced antibody response after a booster dose could cross-neutralize 14 SARS-CoV-2 variants and SARS-CoV-1. Our results have added to the growing body of knowledge about the contribution of protein subunit vaccine platforms to pandemic control.</p></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1201971224002443/pdfft?md5=608299a5fa3c43d325bd2f6178a6bd8d&pid=1-s2.0-S1201971224002443-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141878691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world effectiveness of the CoronaVac vaccine in a retrospective population-based cohort in four Colombian cities (2021-2022)","authors":"","doi":"10.1016/j.ijid.2024.107156","DOIUrl":"10.1016/j.ijid.2024.107156","url":null,"abstract":"<div><h3>Objectives</h3><p>The National Vaccination Plan against SARS-CoV-2/COVID-19 was launched by the Ministry of Health and Social Protection on 14 February 2021. The main objective of this study was to evaluate the effectiveness of the CoronaVac in preventing the three clinical outcomes of infection, hospitalisation, or death, in a real-world scenario.</p></div><div><h3>Design</h3><p>This was a population-based retrospective dynamic cohort study using a multivariate Cox model to calculate hazard ratios to estimate vaccine effectiveness from 17 February 2021 to 30 June 2022. The data were collected from surveillance systems for 12 months for each individual. Four cities were selected on the basis of the reliability of their data bases.</p></div><div><h3>Results</h3><p>The rates of CoronaVac effectiveness were 32% (95% confidence interval [CI] 31-33) for preventing infection, 55% (95% CI 54-56) for hospitalisation, and 90% (95% CI 89-90) for death, at the end of follow-up. These findings were more consistent during the first 4 months. Compared with the unvaccinated group, homologous booster doses appeared to increase effectiveness in preventing hospitalisation, whereas heterologous booster doses increased protection for both hospitalisation and death. Booster doses did not improve effectiveness among those already vaccinated with CoronaVac, even when they received heterologous boosters.</p></div><div><h3>Conclusions</h3><p>CoronaVac demonstrated effectiveness in preventing death and hospitalisation during the first year of follow-up, but its effectiveness in preventing infection was lower, decreasing rapidly after the first 4 months of follow-up. The effectiveness was higher among children aged between 3 and 12 years, and among adults aged ≥60 years. Booster doses did not improve effectiveness among those already vaccinated with CoronaVac.</p></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1201971224002273/pdfft?md5=7d5b93e0168b3efe044ef1d4f2c9eb25&pid=1-s2.0-S1201971224002273-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relative vaccine effectiveness of ChAdOx1/AZD1222 vaccines as booster dose via intradermal injection with a one-fifth dose compared with the intramuscular injection in the prevention of SAR-CoV-2 infections in Phuket: A retrospective cohort study","authors":"","doi":"10.1016/j.ijid.2024.107179","DOIUrl":"10.1016/j.ijid.2024.107179","url":null,"abstract":"<div><h3>Objectives</h3><p>This study assessed the real-world relative vaccine effectiveness of the ChAdOx1/AZD1222 vaccine given intradermally at one-fifth dose compared to the standard intramuscular injection, following the completion of 2 doses of CoronaVac, due to limited vaccine availability in Thailand during the Coronavirus disease 2019 (COVID-19) pandemic.</p></div><div><h3>Method</h3><p>This retrospective cohort study used 138,264 records from Vachira Phuket Hospital, Phuket, Thailand. The records were divided into 2 groups: 49,387 recipients received one-fifth doses via intradermal injections, and 88,877 recipients received standard-dose intramuscular injections from September 14 to October 3, 2021, with follow-up until December 31, 2021. Relative vaccine effectiveness for the cohorts was estimated using Cox regression, adjusting for demographic and clinical risk factors.</p></div><div><h3>Results</h3><p>The adjusted hazard ratio between the intradermal and intramuscular groups was 0.88 (95% Confidence Interval 0.76-1.02, <em>P</em> = 0.09), indicating a nonsignificant protective factor for the intradermal group. Further stratified analysis revealed no significant difference between the 2 groups. The 21 and 28-day postvaccination periods minimized the possibility of confounding due to differences in the cohorts’ timeframes.</p></div><div><h3>Conclusion</h3><p>A booster dose of ChAdOx1/AZD1222 given intradermally at one-fifth dose did not show a significant difference compared to the standard intramuscular injection.</p></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1201971224002509/pdfft?md5=e9454ae5011e1f3598e72da1e1bfb4aa&pid=1-s2.0-S1201971224002509-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141878693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of anti-fibrotic medications on post-COVID-19 pulmonary fibrosis: A systematic review and meta-analysis","authors":"","doi":"10.1016/j.ijid.2024.107193","DOIUrl":"10.1016/j.ijid.2024.107193","url":null,"abstract":"<div><h3>Objectives</h3><p>The impact of anti-fibrotic medications on pulmonary fibrosis caused by COVID-19 remains inconclusive and lacks systematic investigation. This study assessed the efficacy of anti-fibrotic drugs in addressing post-COVID-19 lung fibrosis.</p></div><div><h3>Methods</h3><p>We searched PubMed, Web of Science, Embase, and the Cochrane Library until June 15, 2024. The meta-analysis was performed using Review Manager. Heterogeneity was evaluated utilizing I² statistic, and publication bias was assessed via funnel plots.</p></div><div><h3>Results</h3><p>The study (CRD42024552847) included 7 trials with 496 participants. No significant differences were observed in chest CT score (SMD = -0.60, 95% CI: -1.33 to 0.12, <em>P</em> = 0.10), length of hospital stay (MD = -1.34, 95% CI: -4.39 to 1.70, <em>P</em> = 0.39), and mortality (OR = 0.91, 95% CI: 0.50 to 1.64, <em>P</em> = 0.75) between anti-fibrosis and standard treatment groups. Notable improvements in pulmonary function were observed with anti-fibrotic drugs, as indicated by FEV1%pred (MD = 23.95, 95% CI: 12.24 to 35.67, <em>P</em> &lt; 0.0001) and FEV1/FVC (MD = 18.17, 95% CI: 11.96 to 24.38, <em>P</em> &lt; 0.00001).</p></div><div><h3>Conclusions</h3><p>Anti-fibrotic medications may help reduce fibrotic lesions and improve pulmonary function in post-COVID-19 pulmonary fibrosis, but their practical use is currently based more on theory than on solid medical evidence. Currently, in clinical practice, the use of anti-fibrotic drugs in these patients primarily relies on empirical treatment. Further clinical studies are imperative to bolster its credibility for future applications.</p></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1201971224002649/pdfft?md5=e0ad065eb05b665455d8684f0ae586f9&pid=1-s2.0-S1201971224002649-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141878692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current microbiological testing approaches and documented infections at febrile neutropenia onset in patients with hematologic malignancies","authors":"","doi":"10.1016/j.ijid.2024.107183","DOIUrl":"10.1016/j.ijid.2024.107183","url":null,"abstract":"<div><h3>Objectives</h3><p>This study aims to identify infection etiology in febrile neutropenia (FN) is vital. This study explores different microbiological approaches and their impact on diagnosing infections in patients with hematologic malignancies and FN.</p></div><div><h3>Methods</h3><p>This is a retrospective analysis conducted at the Hospital Clinic of Barcelona details microbiological testing strategies used to diagnose infections at FN onset between January 2020 and July 2022.</p></div><div><h3>Results</h3><p>A total of 4520 microbiological tests were ordered in 462 FN episodes, achieving a 10% test positivity rate, with 200 (43.3%) episodes showing microbiological documentation of infection. Blood cultures (40.4%), non-culture blood tests (21.2%), and respiratory tract samples (16.2%) were the most requested. Blood cultures exhibited the highest (16.9%) test positivity rates, whereas non-culture blood tests showed the lowest (3.3%). Bacterial infections were present in 149 of 462 (32.3%) FN episodes. Viral infections (66 of 462, 14.3%)—notably, respiratory viruses—were also frequent. Mortality rate at 60 days was 9.1%; documented infections were associated with a higher risk (15%).</p></div><div><h3>Conclusions</h3><p>In the current landscape of antimicrobial diagnostics, our findings revealed the highest reported rate of microbiologically documented infections at FN onset. Bacterial infections are common; however, our data reiterate the significance of viral infections in causing fever. Optimizing FN management during respiratory viral infections remains a challenge for antimicrobial de-escalation. The low positivity rates observed in certain diagnostic tests emphasize the need for cost-effective diagnostic stewardship.</p></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1201971224002546/pdfft?md5=c99ef4d07e136710417bc2305278403c&pid=1-s2.0-S1201971224002546-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141859726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}