Journal of Infection and Chemotherapy最新文献

{"title":"Current management and awareness of hepatitis coinfection in HIV care: A single-center retrospective study in Japan.","authors":"Keiji Konishi, Hiroo Matsuo, Michinori Shirano","doi":"10.1016/j.jiac.2024.11.007","DOIUrl":"10.1016/j.jiac.2024.11.007","url":null,"abstract":"<p><strong>Background: </strong>Liver disease remains a significant concern for people living with HIV (PLWH), especially in those with hepatitis B virus (HBV) and hepatitis C virus (HCV) coinfection. This study assessed the prevalence of viral hepatitis coinfections and evaluated the current state of hepatitis management by HIV care providers in Japan.</p><p><strong>Methods: </strong>This single-center, retrospective, observational study analyzed data from PLWH treated with antiretroviral therapy between April 1, 2023 and March 31, 2024. Data included demographics, ART regimen, hepatitis status, and screening practices of 811 PLWH treated with antiretroviral therapy.</p><p><strong>Results: </strong>The median age of the study population was 48 years, and 97.8 % were men. The HBV status was as follows: chronic HBV, 6.5 %; clinical remission, 34.0 %; uninfected, 30.9 %; unknown, 14.2 %. The HCV antibody positivity rate was 3.2 %. Substantial gaps in hepatitis screening and monitoring were identified. Specifically, we found inadequate rates of abdominal ultrasound examinations and HCC screening among patients with HIV and viral hepatitis coinfection. Moreover, only 71.7 % of patients chronically infected with HBV and 61.5 % with HCV underwent abdominal ultrasound examinations in the preceding 12 months-only 5.7 % and 3.8 % of the participants in these groups had had received tumor marker testing in the previous 12 months.</p><p><strong>Conclusion: </strong>There are challenges in hepatitis and HCC screening and monitoring among patients with HIV and viral hepatitis coinfection in Japan. These findings underscore the need to improve adherence to clinical practice guidelines and implement integrated care models to enhance hepatitis management in PLWH.</p>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622052","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":"Triple artemisinin-based combination therapy (TACT): Efficacy of dihydroartemisinin-piperaquine plus chloroquine against Plasmodium berghei ANKA strains with different drug sensitivities in a murine malaria model.","authors":"Olugbenga Akinola, Oluwapelumi O Afolabi, Gbemisola O Adebisi-Jose, Abiodun I Amusan, Hidayah A Olumoh-Adbul, Olawale Olabanji, Olayinka Teslim, Grace O Gbotosho","doi":"10.1016/j.jiac.2024.11.006","DOIUrl":"10.1016/j.jiac.2024.11.006","url":null,"abstract":"<p><strong>Background: </strong>Evident detection of artemisinin resistance markers in patient isolates of Plasmodium falciparum from East Africa threatens the efficacy of artemisinin-based combination therapies (ACTs) as first-line treatment of malaria in sub-Saharan Africa. Repositioning previously used antimalarials as complementary addition to ACTs has been suggested as a viable option to mitigating this threat. This study evaluated the potential benefit of chloroquine (CQ) as a complementary partner to dihydroartemisinin/piperaquine (DHA/PQ) in the treatment of malaria in a mice model.</p><p><strong>Methods: </strong>The comparative efficacy of the combination of DHA/PQ/CQ and DHA/PQ against two strains of Plasmodium berghei ANKA (MRA 311 and 671) with different levels of sensitivities to chloroquine was evaluated in separate experiments. Parasitological activities including; parasite suppression time, parasite clearance time, recrudescence time, and parasite reduction ratio were evaluated in vivo. The mean survival time was also monitored throughout the duration of the study.</p><p><strong>Results: </strong>In both parasite lines, 99.99 % chemo-suppression was observed on day 4 in the drug treatment groups (CQ alone, DHA/PQ and DHA/PQ/CQ). In the curative test, there were significant differences between DHA/PQ/CQ and DHQ/PQ treatment, highlighted by reduced parasite clearance time (4.75 ± 0.3 Vs 5.5 ± 0.3 days, P < 0.05), significantly delayed recrudescence time (28.5 ± 1.04 Vs 13.3 ± 0.48 days, P < 0.01), a 1.5-fold change in parasite reduction ratio, and a prolonged mean survival time (34.5 ± 1.04 Vs 26.7 ± 0.48 days, P < 0.05).</p><p><strong>Conclusion: </strong>The addition of chloroquine to dihydroartemisinin-piperaquine may be beneficial in the treatment of malaria, especially in areas where malaria parasite sensitivity to chloroquine is predominant.</p>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622057","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":"Multiple arterial aneurysms in a patient with spondylitis following intravesical Bacillus Calmette-Guérin administration for bladder cancer: A case report.","authors":"Shun Yonezaki, Masumi Suzuki Shimizu, Tomomi Ota, Soichiro Ozasa, Shogo Akabame, Shotaro Ide, Kosuke Kosai, Katsunori Yanagihara, Koya Ariyoshi, Akitsugu Furumoto","doi":"10.1016/j.jiac.2024.10.017","DOIUrl":"10.1016/j.jiac.2024.10.017","url":null,"abstract":"<p><p>Mycobacterium bovis is one of the species belonging to the Mycobacterium tuberculosis complex; its attenuated form-Bacillus Calmette-Guérin (BCG)-is used as a live vaccine against tuberculosis. Besides its use as a vaccine, BCG is widely used for treating bladder cancer. However, complications related to its use can lead to disseminated infection with M. bovis, known as BCGosis. BCGosis has multiple manifestations, and its culture requires a long time and complex polymerase chain reaction (PCR), posing challenges to its diagnosis. Herein, we report a case of a 74-year-old man with bladder cancer in whom multiple new arterial aneurysms developed during spondylitis treatment following intravesical BCG administration. The patient presented with syncope and left neck swelling. His medical history included transurethral bladder tumor resection and intravesical BCG therapy for bladder cancer. Sixteen months before he visited our institution, he developed spondylitis (L5/S1), an epidural abscess (L5/S1), and an abscess on the right thigh. Biopsy cultures and PCR confirmed M. tuberculosis complex, leading to antituberculosis drug therapy. Upon admission, multiple aneurysms were identified, and drug therapy was continued. However, new multiple aneurysms developed with the rupture of the right femoral aneurysm, leading to surgical interventions and arterial biopsy. The biopsy showed no signs of mycobacterial infection. Other aneurysm etiologies were ruled out and M. bovis was confirmed by PCR in the specimen from the initial intervertebral disc biopsy; thus, a diagnosis of BCGosis was made. This case highlights the importance of a thorough follow-up to detect new complications, even during treatment.</p>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142605034","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":"Selection and evaluation of suitable quality control strains for meropenem antimicrobial susceptibility testing through preliminary external quality assessment.","authors":"Junichi Hirayama, Kotaro Aoki, Kohji Komori, Yo Sugawara, Chika Arai, Yoshikazu Ishii, Motoyuki Sugai, Kazuhiro Tateda","doi":"10.1016/j.jiac.2024.11.003","DOIUrl":"https://doi.org/10.1016/j.jiac.2024.11.003","url":null,"abstract":"<p><strong>Background: </strong>Quality control (QC) of carbapenem susceptibility testing for Gram-negative bacteria faces challenges due to limited measuring ranges and the lack of suitable QC strains. This study aimed to select and evaluate QC strains for meropenem antimicrobial susceptibility testing (AST) through a pilot external quality assessment (EQA).</p><p><strong>Methods: </strong>Candidate QC strains for meropenem AST were selected based on primary AST data and genomic information from the Japan Antimicrobial Resistant Bacterial Bank. Phenotype stability was verified through serial passaging and MIC comparison with original strains. The validated broth microdilution method was used to determine the target MIC value in a pilot EQA involving 47 clinical laboratories in Japan using ten different AST methods.</p><p><strong>Results: </strong>Two strains, Citrobacter freundii JBBDAJB-19-0032 (Strain-A) and Enterobacter hormaechei subsp. steigerwaltii JBEBAAB-19-0102 (Strain-B), both carrying bla_IMP-1, were selected as candidate QC strains. The meropenem MICs for Strain-A and Strain-B were 4 mg/L and 2 mg/L, respectively. In the pilot EQA, 43 laboratories reported appropriate results for Strain-A and 40 laboratories reported appropriate results for Strain-B. The MIC range was 2-8 mg/L for Strain-A and 1-4 mg/L for Strain-B. However, 19 and 12 laboratories, respectively, reported out-of-range MICs using AST plates on the MicroScan WalkAway. Inappropriate results were reported by four and seven laboratories, respectively, using common methods for Strain-A and Strain-B, respectively.</p><p><strong>Conclusions: </strong>The candidate QC strains selected for this study are suitable for meropenem AST EQA, except when the measuring range of certain methods does not match their QC range.</p>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142605041","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 Combinations as Novel Indicators for Clostridioides difficile infection development: Population-Based, Nested Case-Controlled Study in Japan-The Shizuoka Kokuho Database Study.","authors":"Takashi Saito, Yoko Sato, Seiichiro Yamamoto","doi":"10.1016/j.jiac.2024.11.002","DOIUrl":"https://doi.org/10.1016/j.jiac.2024.11.002","url":null,"abstract":"<p><strong>Background: </strong>Clostridioides difficile is a major cause of antimicrobial-associated colitis. While antimicrobial stewardship has reduced the incidence of C. difficile infection (CDI), managing CDI is challenging because knowledge about preventing it is limited among healthcare professionals. To address this, we examined associations between antimicrobial use and CDI development.</p><p><strong>Methods: </strong>This observational, nested case-controlled study was conducted using the Shizuoka Kokuho Database (SKDB). Individuals with no record of CDI or antimicrobial-associated enterocolitis within 1 year after SKDB enrolment, but who subsequently developed CDI, were included as the Case group. The Control group comprised individuals selected via 1:4 matching sampling without replacement for sex, age, and month of CDI onset. Conditional logistic regression analysis was performed to assess associations between antimicrobial use (number and combination) and CDI development, controlling for matched variables, background factors, and underlying conditions.</p><p><strong>Results: </strong>Of the 2,398,393 individuals, 4917 were assigned to the Case group and 19,668 to the Control group. The adjusted odds ratios (ORs) for CDI were 3.65 for one antimicrobial and 8.58, 17.3, and 38.9 for combinations of two, three, or four or more agents (all p < 0.001). Penicillins, fourth-generation cephems, and carbapenems exhibited high ORs. Similar results were observed in certain demographic and comorbidity-free subgroups. Several combinations (penicillins + carbapenems, penicillins + cephems + carbapenems, cephems + fluoroquinolones, and penicillins + cephems + carbapenems) were notably associated with CDI development.</p><p><strong>Conclusion: </strong>CDI prevalence increased with the number of antimicrobial classes used in combination. Certain types or combinations of antimicrobials may increase the OR for CDI.</p>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604984","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":"Real-world study on disease burden and current clinical practice of hospital-acquired pneumonia in Japan.","authors":"Masahiro Kimata, Yosuke Aoki, Takeshi Akiyama, Akiko Harada","doi":"10.1016/j.jiac.2024.11.001","DOIUrl":"10.1016/j.jiac.2024.11.001","url":null,"abstract":"<p><strong>Background: </strong>Hospital-acquired pneumonia (HAP) is a common nosocomial infection and is associated with high mortality. Despite advances in the understanding of the causes and prevention of HAP, it continues to be a frequent complication associated with hospital care. Presently, there are no large retrospective cohort studies on HAP in Japan.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted using the Medical Data Vision Co. Ltd. database for the study period (April 1, 2015 to May 31, 2018). The study population was defined based on ICD-10 codes for bacterial pneumonia, characteristics of hospitalization, and prescription of injection-only antibiotics. The study included patients ≥18 years of age with at least one episode of HAP during the identification period, where the episode was defined as hospitalization with HAP within the study identification period.</p><p><strong>Results: </strong>A total of 2968 patients were included in this study contributing to 2979 HAP episodes. Patients with HAP were more likely to be male (64.9 %) and older than age 65 (86.5 %). The top three frequently prescribed antibiotics were sulbactam-ampicillin (39.7 %; 1183 episodes), tazobactam-piperacillin (28.4 %; 846 episodes) and ceftriaxone (23.2 %; 690 episodes). The mean (±SD) length of hospital stay during overall hospitalization and the HAP period were 49.9 (±34.2) days and 11.3 ± 7.3 days respectively. The HAP patient mortality at discharge was 22.0 %.</p><p><strong>Conclusion: </strong>The present study provided insights regarding the characteristics, treatment patterns of HAP patients in Japan. Further, the study provided noteworthy information regarding antibiotic usage trends in the aging Japanese population.</p>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142605036","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":"Human Papillomavirus vaccination awareness and uptake among healthcare students in Japan.","authors":"Madoka Shimbe, Yuki Otsuka, Hideharu Hagiya, Yoichi Yamada, Fumio Otsuka","doi":"10.1016/j.jiac.2024.11.004","DOIUrl":"https://doi.org/10.1016/j.jiac.2024.11.004","url":null,"abstract":"<p><strong>Background: </strong>The vaccination rate for HPV (Human Papillomavirus) has remained significantly low in Japan because of the administrative suspension of active recommendation. This study investigates the awareness and uptake of the HPV vaccine among healthcare students in Japan following the reinstatement of active recommendation for young women in April 2022.</p><p><strong>Methods: </strong>A web-based survey was administered to 2567 healthcare students from Okayama and Shujitsu Universities in Japan in July 2023. The survey assessed participants' backgrounds, immunization status, awareness of vaccine recommendations, and knowledge of cervical cancer across various demographics, including sex, academic year, and department (Medicine, Health Science, Pharmaceutical, and Dentistry).</p><p><strong>Results: </strong>The response rate was 36.3 % (933 students; 181 male, 739 female, and 13 unspecified gender). The overall immunization rate among female students was 55.6 %, with higher rates observed in medical (73.8 %) and dental (63.0 %) students. Awareness of the government's change in vaccine recommendation was notably high among female and senior male students. Over half of the female students (54.7 %) reported receiving vaccinations based on their parents' advice. Among those unvaccinated but interested in future immunization, concerns about adverse reactions (47.4 %) and challenges in scheduling vaccinations (29.1 %) were predominant.</p><p><strong>Conclusion: </strong>Healthcare students exhibited a higher HPV vaccination rate than the general population. Ongoing education to improve vaccine literacy is crucial for augmenting HPV vaccination rates in Japan.</p>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142605032","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":"Prosthetic stent graft infection caused by Aerococcus urinae: A case report and literature review.","authors":"Shion Maruyama, Toshinori Nishizawa, Kazuhiro Ishikawa, Tomu Sato, Kuniko Sato, Gautam A Deshpande, Hiroko Arioka","doi":"10.1016/j.jiac.2024.10.018","DOIUrl":"10.1016/j.jiac.2024.10.018","url":null,"abstract":"<p><p>Aerococcus urinae, a gram-positive, catalase-negative coccus, has emerged as a notable pathogen in clinical microbiology. It is traditionally associated with urinary tract infections in elderly males with underlying urologic conditions. Recently, A. urinae has been implicated in severe invasive infections outside the genitourinary tract including infective endocarditis, vertebral osteomyelitis, peritonitis, lymphadenitis, and discitis. We present the case of 84-year-old male with a history of aortic graft replacement who presented with five days of fever and fatigue. Blood and urine cultures grew gram-positive cocci, identified as A. urinae. Thoracoabdominal contrast-enhanced CT revealed a slightly increased soft tissue shadowing around the prosthetic stent in the ascending aorta, indicating a possible aortic stent-graft infection. Gallium-67 scintigraphy demonstrated inflammation around the prosthetic stent in the ascending aorta consistent with an aortic stent-graft infection. The patient and family opted for conservative treatment and despite a six-week inpatient course of ampicillin, followed by oral amoxicillin, the patient died one week after discharge. This is the first published case of A. urinae causing an aortic stent-graft infection. Clinicians should remain cognizant of the disseminated source of infection in cases of A. urinae bacteremia.</p>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568406","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":"Effect of studying abroad on catch-up vaccination in young adults: A study using the Japan Pretravel Consultation Registry.","authors":"Nobumasa Okumura, Kei Yamamoto, Noriko Iwamoto, Shinya Tsuzuki, Kenichi Hayashi, Koh Shinohara, Issaku Nakatani, Hidenori Nakagawa, Natsuko Imakita, Takashi Matono, Akihiro Manabe, Tsuyoshi Kitaura, Takahiro Mikawa, Masaya Yamato, Norio Ohmagari","doi":"10.1016/j.jiac.2024.10.015","DOIUrl":"10.1016/j.jiac.2024.10.015","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the effect of studying abroad on catch-up vaccination coverage for measles, rubella, mumps, varicella, and tetanus during the pretravel consultation among young adult travelers.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed data from the Japan Pretravel Consultation Registry (J-PRECOR) on individuals aged 18-21 years with childhood vaccination records. Propensity score weighting was used to estimate the average treatment effect on the proportion of participants receiving catch-up vaccination.</p><p><strong>Results: </strong>Among 1091 eligible participants, the catch-up vaccination need was highest for mumps (65.7 %) and varicella (49.0 %) and lowest for measles (9.9 %) and rubella (14.0 %). In the unadjusted analysis, the catch-up vaccination rate was 70.6 % for tetanus, 50.9 % for measles, 47.7 % for rubella, 40.0 % for mumps, and 23.9 % for varicella. In the weighted analysis, the study-abroad group had significantly higher catch-up vaccination rates for measles (54.6 % vs. 29.8 %, P = 0.039), rubella (53.0 % vs. 22.1 %, P < 0.001), and varicella (26.8 % vs. 10.9 %, P = 0.002), whereas the non-study-abroad group had a higher catch-up vaccination rate for tetanus (62.4 % vs. 78.4 %, P = 0.024).</p><p><strong>Conclusion: </strong>Compared with other travelers, the catch-up vaccination rate among travelers studying abroad was higher for measles, rubella, and varicella, but lower for tetanus. In clients planning to study abroad, vaccinations required for travel should be recommended in addition to those required by the host institution, and vaccination against highly infectious diseases with potential for complications, such as measles, rubella, mumps, and varicella, should be recommended to clients traveling for reasons other than studying abroad.</p>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564291","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 direct identification of bacteria in blood culture-positive specimens by matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry on physician selection of antimicrobial therapy.","authors":"Hiroshi Umemura, Hiroyuki Nishiyama, Yumiko Tanimichi, Kohgo Seino, Masaki Nakajima, Sachio Tsuchida, Tomohiro Nakayama","doi":"10.1016/j.jiac.2024.10.016","DOIUrl":"10.1016/j.jiac.2024.10.016","url":null,"abstract":"<p><strong>Background: </strong>Rapid identification of the causative organism in blood stream infections is essential for early initiation of appropriate antimicrobial therapy. Direct identification of bacteria in positive blood culture bottles using matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry is a promising application. A variety of direct identification methods have been reported; however, few studies have evaluated the impact of these methods on physician decision making regarding antimicrobial therapy.</p><p><strong>Methods: </strong>We developed a simple method for direct bacterial identification and applied it to daily clinical practice to investigate the impact of direct identification of bacteria in positive blood culture bottles on physicians' choice of antimicrobial agents for treatment.</p><p><strong>Results: </strong>From January 2016 to December 2022, we attempted direct identification in 98 cases and successfully acquired identification results in 88 cases. In three cases, no empiric antimicrobial agents were initiated at the time of venipuncture for blood culture but later initiated based on the direct identification results. In the remaining 85 cases, empiric antimicrobial therapy was initiated at the time blood cultures were performed, and in 29 cases, empiric antimicrobial therapy was changed after direct identification. In 17 of these 29 cases, the antimicrobial therapy was changed based on the direct identification of bacterial genus/species, resulting in a change to an effective antimicrobial therapy before the antimicrobial susceptibility testing results were available.</p><p><strong>Conclusions: </strong>Direct identification of bacteria from positive blood culture bottles could contribute to earlier selection of or changes to antimicrobial therapies by attending physicians.</p>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564295","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}