Journal of Infection and Chemotherapy最新文献

{"title":"Epstein–Barr virus-associated infectious mononucleosis exhibits substantially higher non-treponemal test titers in biological false-positive reactions","authors":"Naoki Matsuura ,&nbsp;Takashi Matono ,&nbsp;Miho Kuroki ,&nbsp;Kenta Saitou","doi":"10.1016/j.jiac.2025.102738","DOIUrl":"10.1016/j.jiac.2025.102738","url":null,"abstract":"<div><h3>Objectives</h3><div>Biological false-positive (BFP) reactions in rapid plasma reagin (RPR) tests can complicate syphilis screening interpretation. Although Epstein–Barr virus-associated infectious mononucleosis (EBV-IM) is a known cause of BFP reactions, the characteristics of RPR titers in such cases remain unclear. This study aimed to compare the RPR titers in BFP reactions between patients with EBV-IM and those with other underlying conditions.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed the RPR and <em>Treponema pallidum</em> hemagglutination assay (TPLA) results of all tests performed at a community hospital in Japan between April 2016 and March 2024. BFP reactions were defined as positive RPR and negative TPLA results. Clinical characteristics and RPR titers were compared between EBV-IM and other causes of BFP reactions.</div></div><div><h3>Results</h3><div>Among 154 confirmed BFP cases, EBV-IM cases (n = 7) showed significantly higher RPR titers than other underlying conditions (n = 147) (median 28.5 relative units [RU], interquartile range [IQR]: 11.2–31.2 vs. 1.9 RU, IQR: 1.2–4.3, <em>p</em> &lt; 0.001), despite a significantly younger age (median age 18 years, IQR: 17.4–25 vs. 72 years, IQR, 44.5–82, <em>p</em> &lt; 0.001). Among all BFP cases, neoplasms were the most common underlying condition (22.1 %), followed by digestive diseases (8.4 %) and infectious diseases (7.8 %).</div></div><div><h3>Conclusions</h3><div>EBV-IM is associated with distinctively high RPR titers in BFP reactions, in contrast to the typically low titers observed under other conditions. Clinicians should be aware that high RPR titers can occur during BFP reactions, particularly in young patients with suspected EBV infection.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 7","pages":"Article 102738"},"PeriodicalIF":1.9,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144123180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of antibiotic adverse events","authors":"Toshiharu Urakami,&nbsp;Takashi Matono","doi":"10.1016/j.jiac.2025.102735","DOIUrl":"10.1016/j.jiac.2025.102735","url":null,"abstract":"<div><h3>Purpose</h3><div>Antibiotic-associated adverse drug events (ADEs) are common and diverse in clinical practice, yet healthcare professionals often lack sufficient understanding of them. An ill-considered change to an alternative agent whent symptoms of suspected ADEs appear can lead to excessive overuse and misuse of antibiotics. Proper management of ADEs is part of antimicrobial stewardship.</div></div><div><h3>Areas covered</h3><div>This review describes clinical characteristics, diagnosis and management of ADEs, featuring drug fever, rash, nephrotoxicity, liver injury, interstitial pneumonitis, rhabdomyolysis, encephalopathy, QT prolongation, thrombocytopenia and neutropenia.</div></div><div><h3>Summary</h3><div>Healthcare professionals should be familiar with the typical symptoms, time course and likely causative agent for each adverse reaction. Early detection and proper judgement are important. In sever case, early discontinuation of the causative agent and proper treatment are required. If it is not fatal, continuing the suspected agent and careful monitoring may help identify the causative agent. Especially in penicillin allergies, it is important to remember that most patients labeled as allergic are, in fact, misclassified.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 7","pages":"Article 102735"},"PeriodicalIF":1.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144115536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of switching to long-acting cabotegravir + rilpivirine versus continuing bictegravir/emtricitabine/tenofovir alafenamide in Japanese participants: 12-month results from the phase 3b randomized SOLAR trial","authors":"Eisuke Adachi ,&nbsp;Yoshiyuki Yokomaku ,&nbsp;Dai Watanabe ,&nbsp;Hiroyuki Gatanaga ,&nbsp;Shinichi Oka ,&nbsp;Takuma Shirasaka ,&nbsp;Rumi Wakatabe ,&nbsp;Nadine Chamay ,&nbsp;Kenneth Sutton ,&nbsp;Denise Sutherland-Phillips ,&nbsp;Rimgaile Urbaityte ,&nbsp;Ronald D'Amico ,&nbsp;Jean van Wyk","doi":"10.1016/j.jiac.2025.102734","DOIUrl":"10.1016/j.jiac.2025.102734","url":null,"abstract":"<div><div>In the phase 3b SOLAR study, switching to long-acting cabotegravir + rilpivirine (CAB+RPV LA) administered every 2 months (Q2M) was non-inferior to continuing daily oral bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF). We present a post hoc analysis of Japanese participants. SOLAR is a randomized (2:1), open-label, multicenter, non-inferiority study of virologically suppressed participants switching to CAB+RPV LA Q2M (with or without oral lead-in) versus continuing BIC/FTC/TAF. The primary endpoint was HIV-1 RNA ≥50 copies/mL at Month 12 (Snapshot algorithm). Of 670 participants (modified intention-to-treat–exposed population), 20 were from Japan (LA, n = 14; BIC/FTC/TAF, n = 6). At Month 12, no participants in either Japanese group had HIV-1 RNA ≥50 copies/mL; 86 % (12/14; 2 participants withdrew) versus 100 % (6/6) had HIV-1 RNA &lt;50 copies/mL in the LA versus BIC/FTC/TAF groups; none had confirmed virologic failure. Withdrawals were due to a non–drug-related adverse event (AE; acute hepatitis B) and a physician decision. Excluding injection site reactions, drug-related AE rates were higher in the LA group (36 % vs 17 %; all grade 1 or 2). No drug-related serious AEs were reported. Injection site reactions were common (100 % [13/13] of LA participants); all were grade 1 or 2; none led to withdrawal; median duration was 4 days. Mean treatment satisfaction scores improved from baseline to Month 12 in the LA versus BIC/FTC/TAF Japanese groups (+6.25 vs + 0.33 on a 66-point scale). Though limited, these data suggest switching to CAB+RPV LA from BIC/FTC/TAF was well tolerated in Japanese participants, with comparable efficacy and improved treatment satisfaction.</div><div>ClinicalTrials.gov; NCT04542070 (<span><span>https://www.clinicaltrials.gov/study/NCT04542070</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 7","pages":"Article 102734"},"PeriodicalIF":1.9,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antimicrobial susceptibility surveillance of bacterial isolates recovered in Japan from odontogenic infections in 2018","authors":"Akihiro Kaneko ,&nbsp;Hiroshi Iwabuchi ,&nbsp;Junko Sato ,&nbsp;Tetsuya Matsumoto ,&nbsp;Hiroshi Kiyota ,&nbsp;Naoki Hasegawa ,&nbsp;Hideaki Hanaki ,&nbsp;Hiroyuki Naito ,&nbsp;Tomohiro Hamada ,&nbsp;Hiroshi Yamazaki ,&nbsp;Kazuto Hoshi ,&nbsp;Masanobu Abe ,&nbsp;Yasunobu Busujima ,&nbsp;Takatsugu Suzuki ,&nbsp;Dai Nakashima ,&nbsp;Kazumi Izawa ,&nbsp;Tohru Akashiba ,&nbsp;Masataka Uematsu ,&nbsp;Fumitaka Terasawa ,&nbsp;Takefumi Morihana ,&nbsp;Yumiko Obayashi","doi":"10.1016/j.jiac.2025.102731","DOIUrl":"10.1016/j.jiac.2025.102731","url":null,"abstract":"<div><h3>Background</h3><div>This study reports the findings of the second antimicrobial susceptibility surveillance study of isolates recovered from odontogenic infections in Japan.</div></div><div><h3>Methods</h3><div>A total of 164 odontogenic infections samples including periodontitis (group 1, n = 33), pericoronitis (group 2, n = 7), jaw inflammation (group 3, n = 83), and phlegmon in the jawbone area (group 4, n = 42) from 21 facilities were included in the study.</div></div><div><h3>Results</h3><div>Antimicrobial susceptibility testing was performed on 515 isolates, consisting of 120, 115, 173, 38, and 69 <em>Streptococcus</em> spp., anaerobic gram-positive cocci, <em>Prevotella</em> spp., <em>Porphyromonas</em> spp., and <em>Fusobacterium</em> spp. isolates, respectively. The ratio of susceptible bacteria to causative agents of odontogenic infections was determined in accordance with the guidelines of the Clinical and Laboratory Standards Institute. The susceptibility rates of <em>Streptococcus anginosus</em> were as follows: ampicillin, 98.6 %; cefcapene, ceftriaxone, meropenem, and doripenem, 100 %; clarithromycin and azithromycin, 71.2 %; and clindamycin, 87.7 %. The MIC90 value for ampicillin for <em>Prevotella</em> spp. was 32 μg/mL, with a susceptibility rate of 65.3 %. The MIC90 value for sulbactam/ampicillin was 2 μg/mL, with a susceptibility rate of 100 %.</div></div><div><h3>Conclusions</h3><div>The findings of the present study indicate that the resistance to the combination of penicillins and β-lactamase inhibitors, the first-line antimicrobial agents for odontogenic infections and oral infections caused by anaerobic flora, are low.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 7","pages":"Article 102731"},"PeriodicalIF":1.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disseminated cat-scratch disease during abatacept therapy for rheumatoid arthritis in an older patient: A case report and review of the literature","authors":"Hiroaki Saito ,&nbsp;Yoshinori Takahashi ,&nbsp;Shunsuke Tsuge ,&nbsp;Ryo Nishioka ,&nbsp;Takeshi Zoshima ,&nbsp;Kiyoaki Ito ,&nbsp;Ichiro Mizushima ,&nbsp;Mitsuhiro Kawano ,&nbsp;Hiroko Ikeda ,&nbsp;Tomoyoshi Komiya ,&nbsp;Yasunori Iwata","doi":"10.1016/j.jiac.2025.102732","DOIUrl":"10.1016/j.jiac.2025.102732","url":null,"abstract":"<div><div>Cat-scratch disease (CSD) is a zoonotic infection primarily caused by <em>Bartonella henselae</em> following cat scratches. It typically presents with localized skin symptoms and self-limiting lymphadenopathy; however, in some cases, it can progress to disseminated lesions, leading to severe complications. We report a case of CSD with multiorgan involvement in a 79-year-old woman undergoing abatacept treatment for rheumatoid arthritis. She presented with persistent fever and painful right axillary lymphadenopathy, accompanied by induration on the right hand caused by a cat scratch. Imaging studies revealed multiple enlarged lymph nodes as well as hepatosplenic and cervical spine lesions. Initially, the patient was clinically diagnosed with CSD and initiated on azithromycin monotherapy; however, her symptoms persisted. A right axillary lymph node biopsy was performed to re-evaluate the diagnosis. Histopathological analysis showed numerous necrotizing granulomas with multinucleated giant cells, and a polymerase chain reaction assay confirmed the presence of <em>B. henselae</em> in the lymph node, establishing the diagnosis of CSD with multiorgan involvement. Treatment was adjusted to an azithromycin and rifampicin combination, resulting in a gradual improvement in symptoms. CSD may present as a fever of unknown origin with extranodal involvement affecting organs, such as the liver, spleen, bones, and central nervous system, or causing infective endocarditis, complicating the diagnosis. In immunosuppressed patients receiving biological agents for rheumatic diseases, a comprehensive evaluation is crucial. This should include a detailed medical history, physical examination, and comprehensive histological and microbiological assessments to differentiate CSD from conditions such as tuberculosis and malignant lymphoma.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 7","pages":"Article 102732"},"PeriodicalIF":1.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144071548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of Prevotella species in anaerobic culture-negative multiple abscesses using next-generation sequencing","authors":"Maki Goto ,&nbsp;Kei Yamamoto ,&nbsp;Kazuhiro Horiba ,&nbsp;Masanori Hashino ,&nbsp;Yuta Kubono ,&nbsp;Norio Ohmagari","doi":"10.1016/j.jiac.2025.102733","DOIUrl":"10.1016/j.jiac.2025.102733","url":null,"abstract":"<div><div>Next-generation metagenomic sequencing (mNGS) provides a comprehensive analysis of DNA and RNA in samples. In this case report, pus specimens were collected from an 86-year-old male with multiple muscle, periarticular, and bone abscesses, and osteomyelitis, without prior antimicrobial therapy. Results of bacterial culture tests, including anaerobic and intensified cultures, were negative. Despite this, mNGS using shotgun sequencing revealed a significant number of DNA and RNA nucleic acid reads from <em>Prevotella</em> spp. Although the subspecies could not be identified, mNGS allowed the selection of an appropriate antimicrobial agent and suggested significant oral contamination as the portal of entry. In summary, mNGS helped identify the causative organism in a case without prior antimicrobial therapy wherein culture test results were negative.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 7","pages":"Article 102733"},"PeriodicalIF":1.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of full-time equivalent allocation on the effectiveness of antimicrobial stewardship activities: A multicenter study in Okayama, Japan","authors":"Shiho Kajita ,&nbsp;Hideharu Hagiya ,&nbsp;Atsushi Okita ,&nbsp;Yuto Haruki ,&nbsp;Haruto Yamada ,&nbsp;Yasurou Inoue ,&nbsp;Tsukasa Higashionna ,&nbsp;Kana Satou ,&nbsp;Fumihiro Torigoe ,&nbsp;Shinobu Iwamoto ,&nbsp;Mika Yoshida ,&nbsp;Yumiko Yamane ,&nbsp;Hiroki Kenmotsu ,&nbsp;Satoru Sugimura ,&nbsp;Yutaka Fujiwara ,&nbsp;Fusao Ikeda ,&nbsp;Toshihiro Koyama ,&nbsp;Chikamasa Yoshida ,&nbsp;Shinichirou Andou ,&nbsp;Toshimitsu Suwaki","doi":"10.1016/j.jiac.2025.102730","DOIUrl":"10.1016/j.jiac.2025.102730","url":null,"abstract":"<div><h3>Background</h3><div>Optimized administration of antimicrobial agents is critical for mitigating the emergence of antimicrobial resistance. This study aimed to elucidate the relationship between antimicrobial stewardship (AS) activities and antimicrobial prescription trends and patterns.</div></div><div><h3>Methods</h3><div>This retrospective, multicenter, longitudinal study was conducted between April 2014 and March 2023 (9-year fiscal period). A structured, questionnaire survey, regarding institutional infrastructure and environmental parameters, service modalities provided by AS activities, resource allocation and systemic support, and data on the use of broad-spectrum antimicrobial agents, was distributed to co-investigators working at seven hospitals in Okayama, Japan. Full-time equivalent (FTE) allocation for each healthcare facility were calculated and subsequently compared among the hospitals. Temporal variations in the proportional distribution of broad-spectrum antimicrobial agents were statistically evaluated using joinpoint regression analysis.</div></div><div><h3>Results</h3><div>Two hospitals where pharmacists were exclusively dedicated to AS activities and met the recommended FTE allocation showed a statistically significant reduction in the proportion of broad-spectrum antibiotic administration, with average annual percentage changes of −8.0 % (95 % confidence interval [CI]: −10.5 to −5.8) and −3.1 % (95 % CI: −5.5 to −0.7), respectively. In contrast, two other hospitals with full-time AS members but insufficient FTE allocation exhibited inconsistent and statistically nonuniform trends. The remaining three healthcare institutions with poorly resourced AS teams demonstrated no statistically significant trends in their broad-spectrum antimicrobial prescriptions.</div></div><div><h3>Conclusion</h3><div>Our findings uncovered that hospitals with adequate FTE staffing metrics for AS activities exhibited statistically significant downward trends in the consumption of broad-spectrum antimicrobial agents.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 7","pages":"Article 102730"},"PeriodicalIF":1.9,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does the use of pulsed-xenon ultraviolet light reduce the risk of healthcare-associated infections?: An updated systematic review and meta-analysis","authors":"Lejuan Ma ,&nbsp;Chungen Yan ,&nbsp;Yan Huang ,&nbsp;Jvmei Lv ,&nbsp;Siyan Liu","doi":"10.1016/j.jiac.2025.102729","DOIUrl":"10.1016/j.jiac.2025.102729","url":null,"abstract":"<div><h3>Objective</h3><div>The present review was conducted to assess the ability of the pulsed-xenon ultra-violet system (PX-UVL) to reduce healthcare-associated infections (HAI).</div></div><div><h3>Methods</h3><div>All types of studies available on PubMed, Embase, Scopus, and Web of Science databases assessing the risk of any HAI with the use of PX-UVL and published up to 25 February 2025 were included. Data on <em>C. difficile</em> infection (CDI), Methicillin-resistant <em>Staphylococcus aureus</em> (MRSA) infection, Vancomycin-resistant <em>enterococci</em> (VRE) infections, and <em>Acinetobacter baumannii</em> infections (ABI) was pooled.</div></div><div><h3>Results</h3><div>Fourteen studies were included. Most studies had a pre-post study design while two were controlled trials. Meta-analysis showed a statistically significant reduction in the risk of CDI with PX-UVL (RR: 0.76 95 % CI: 0.59, 0.97 I² = 72 %). However, results were significant only for pre-post studies (RR: 0.75 95 % CI: 0.57, 0.98 I² = 73 %) but not for controlled trials (RR: 0.70 95 % CI: 0.25, 1.96 I² = 72 %). The results were also not stable on sensitivity analysis. Meta-analysis also showed a tendency of reduction of MRSA infections but the effect size was statistically non-significant (RR: 0.80 95 % CI: 0.62, 1.02 I² = 65 %). Pooled analysis demonstrated no significant impact of PX-UVL in reducing the risk of VRE infections (RR: 0.83 95 % CI: 0.66, 1.04 I² = 54 %) or ABI (RR: 0.64 95 % CI: 0.21, 1.90 I² = 96 %). Subgroup analysis based on study design showed that the risk of VRE infection did not change in both pre-post studies and controlled trials.</div></div><div><h3>Conclusions</h3><div>Current evidence from variable study designs suggests that PX-UVL may have limited efficacy in reducing HAI. Further high-quality randomized controlled trials will provide quality evidence.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 7","pages":"Article 102729"},"PeriodicalIF":1.9,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144072439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fatal case of macrolide-resistant Bordetella pertussis infection, Japan, 2024","authors":"Tomoya Iwasaki ,&nbsp;Kentaro Koide ,&nbsp;Takahiro Kido ,&nbsp;Sho Nakagawa ,&nbsp;Masataka Goto ,&nbsp;Tsuyoshi Kenri ,&nbsp;Hiromichi Suzuki ,&nbsp;Nao Otsuka ,&nbsp;Hidetoshi Takada","doi":"10.1016/j.jiac.2025.102727","DOIUrl":"10.1016/j.jiac.2025.102727","url":null,"abstract":"<div><div>Here, we present a fatal case of macrolide-resistant <em>Bordetella pertussis</em> (MRBP) infection in a 1-month-old female infant born prematurely at 34 weeks of gestation. The infant, unvaccinated against pertussis, exhibited respiratory failure, bilateral pneumonia, and hyperleukocytosis (109.8 × 10⁹/L) on day 44 of life. Despite initial treatment with azithromycin and a high-flow nasal cannula, her condition deteriorated rapidly, requiring mechanical ventilation and venoarterial extracorporeal membrane oxygenation. The infant passed away four days after symptom onset. Nasopharyngeal swabs confirmed the presence of <em>B. pertussis</em> carrying an A2047G mutation in the 23S rRNA gene, resulting in significant macrolide resistance. Phylogenetic analysis indicated that the isolate was genetically closer to Chinese MT28-MRBP isolates than to previously identified Japanese isolates. The combination of early infancy and delayed administration of effective antimicrobials likely contributed to the unfavorable outcome in this case. It is imperative to monitor the global dissemination of MRBPs and enhance local diagnostic capabilities.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 7","pages":"Article 102727"},"PeriodicalIF":1.9,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of initial combination therapy with anti-SARS-CoV-2 antivirals targeting viral clearance in COVID-19 patients with B-cell lymphoma treated with anti-CD20 antibodies: A retrospective single-centre study in Japan","authors":"Shuhei Maruyama ,&nbsp;Daiki Wada ,&nbsp;Akira Inoue ,&nbsp;Masami Kashihara ,&nbsp;Junya Shimazaki ,&nbsp;Fukuki Saito ,&nbsp;Kazuyoshi Ishii ,&nbsp;Yasushi Nakamori ,&nbsp;Yasuyuki Kuwagata","doi":"10.1016/j.jiac.2025.102726","DOIUrl":"10.1016/j.jiac.2025.102726","url":null,"abstract":"<div><h3>Objectives</h3><div>There is no clear treatment strategy for persistent COVID-19 infection that enables clinicians to effectively achieve viral clearance, determine the optimal time to discontinue treatment, and prevent virus reactivation. This retrospective, single-centre study aimed to analyse the effectiveness of antiviral therapies in COVID-19 patients with B-cell lymphoma receiving anti-CD20 therapy.</div></div><div><h3>Methods</h3><div>Conducted at Kansai Medical University Medical Center between January 2022 and October 2024, the study examined the impact of various antiviral regimens and factors on time to viral clearance, defined as SARS-CoV-2 viral load &lt;1 copy/μL by nasopharyngeal swab.</div></div><div><h3>Results</h3><div>Sixty-seven cases met the inclusion criteria, with 40 having a history of bendamustine use, and 33 with combination antiviral therapy as the initial treatment. A multivariable Cox proportional hazards model revealed combination antiviral therapy as the initial regimen (HR 0.36, 95 % CI 0.20–0.65, p &lt; 0.001) significantly shortened time to viral clearance, while bendamustine use (HR 2.74, 95 % CI 1.53–4.89, p &lt; 0.001) significantly prolonged time to viral clearance.</div></div><div><h3>Conclusion</h3><div>This study showed the potential of early combination antiviral therapy to shorten the time to viral clearance in this high-risk patient population.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 7","pages":"Article 102726"},"PeriodicalIF":1.9,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143936670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}