Journal of Infection and Chemotherapy最新文献

{"title":"Missed opportunities: HIV testing deficits among syphilis-tested patients in Japan","authors":"Toshibumi Taniguchi,&nbsp;Kazutaka Yamagishi,&nbsp;Misuzu Yahaba,&nbsp;Hiroshi Yoshikawa,&nbsp;Hidetoshi Igari","doi":"10.1016/j.jiac.2025.102816","DOIUrl":"10.1016/j.jiac.2025.102816","url":null,"abstract":"<div><div>Japan faces dual challenges of rising syphilis incidence and persistent late HIV diagnoses, with approximately 30 % of new HIV cases identified at AIDS stage. This study analyzed HIV testing practices among syphilis-tested patients using National Database of Health Insurance Claims sampling data (2011–2020). Among 253,865 patients tested for syphilis, only 13,485 (5.31 %) underwent HIV testing. HIV testing rates showed a concerning age-related decline from 8.27 % in patients under 20 years to 4.67 % in those over 70 years (Cochran-Armitage trend test, p &lt; 0.0001). This age-based disparity persisted across both sexes and showed no improvement over the study period (p = 0.24). Among 22,961 patients who received antibiotic treatment for any sexually transmitted infection (STI), only 905 (3.94 %) underwent HIV testing. The inverse relationship between testing rates and age is particularly alarming given that older patients have the highest risk of late HIV diagnosis, with 56.9 % of those over 70 diagnosed at AIDS stage compared to 10.0 % of those under 20. These findings reveal critical implementation gaps in HIV testing despite international guidelines recommending routine testing for all STI patients. The persistent low testing rates across all age groups, combined with systematic age-based disparities, indicate entrenched system failures requiring urgent policy intervention. Implementing opt-out HIV testing for all STI evaluations could substantially reduce missed opportunities for early HIV detection and improve public health outcomes.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 10","pages":"Article 102816"},"PeriodicalIF":1.5,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145118511","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":"A rare case of anthrax zoonosis from an infected cow to butchers and meat handlers","authors":"Tara Sankar Pan ,&nbsp;Parimal Roy ,&nbsp;Prasanta Biswas ,&nbsp;Ajijul Laskar ,&nbsp;Samir Patra","doi":"10.1016/j.jiac.2025.102814","DOIUrl":"10.1016/j.jiac.2025.102814","url":null,"abstract":"<div><h3>Background</h3><div>Anthrax is a fatal disease of domestic and wild herbivores, caused by <em>Bacillus anthracis</em>, a Gram positive spore forming bacterium. Humans pick up infection from affected animals or their products but occupational exposures are rare. Human anthrax is often fatal except cutaneous form, but some untreated cases progress to fatal septicaemia and occasionally death.</div></div><div><h3>Case</h3><div>A rare cutaneous anthrax outbreak in Murshidabad was traced back to exposure of sick cow or its meats. Anthrax infection both in the cow and humans were confirmed by laboratory tests. Susceptible livestock were vaccinated and the affected people were treated orally with Doxycycline and topically with Neosporin for 7 days. Cutaneous lesions healed completely in 7 days time.</div></div><div><h3>Conclusion</h3><div>Prompt diagnosis of anthrax and successful treatment with Doxycycline and Neosporin, was highlighted to cure cutaneous anthrax. Vaccination was advocated to prevent the disease in livestock. Farmers were advised to avoid sick animal consumption and commerce.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 10","pages":"Article 102814"},"PeriodicalIF":1.5,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145118513","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":"Nationwide surveillance of bacterial pathogens isolated from children by the surveillance committee of the Japanese society of chemotherapy, Japanese association for infectious diseases, and Japanese society for clinical microbiology between April 2021 and March 2024: General overview of pathogenic antimicrobial susceptibility","authors":"Naruhiko Ishiwada ,&nbsp;Junichiro Nishi ,&nbsp;Kazuo Fujimaki ,&nbsp;Satoshi Takahashi ,&nbsp;Tetsuya Matsumoto ,&nbsp;Junko Sato ,&nbsp;Masaharu Watanabe ,&nbsp;Fujio Kakuya ,&nbsp;Junko Oikawa ,&nbsp;Toshihiko Mori ,&nbsp;Reiko Takayanagi ,&nbsp;Yoshio Yamaguchi ,&nbsp;Tadashi Hoshino ,&nbsp;Masayoshi Shinjoh ,&nbsp;Hideaki Miyashita ,&nbsp;Takeshi Tajima ,&nbsp;Hanako Funakoshi ,&nbsp;Atsushi Narabayashi ,&nbsp;Tomohiro Oishi ,&nbsp;Rika Okano ,&nbsp;Tsuyoshi Yamatou","doi":"10.1016/j.jiac.2025.102812","DOIUrl":"10.1016/j.jiac.2025.102812","url":null,"abstract":"<div><div>A nationwide surveillance program was conducted in Japan between April 2021 and March 2024 to assess the antimicrobial susceptibilities of <em>Streptococcus pneumoniae</em>, <em>Haemophilus influenzae</em>, and <em>Moraxella catarrhalis</em> in pediatric patients aged &lt;15 years with respiratory tract infections. A total of 1498 clinical isolates were collected from 18 medical institutions. Among 384 <em>S. pneumoniae</em> isolates, vaccine serotype coverage was 4.4 % for the 13-valent pneumococcal conjugate vaccine, 9.1 % for the 15-valent pneumococcal conjugate vaccine, and 30.2 % for the 20-valent pneumococcal conjugate vaccine. Serotype 35B was the most frequently isolated serotype. The proportion of <em>S. pneumoniae</em> isolates with penicillin G minimum inhibitory concentration ≥0.125 μg/mL increased compared with the 2017 survey, with serotypes 23A and 15A being the most common among less susceptible penicillin strains. Among 530 <em>H. influenzae</em> isolates, 9.2 % were β-lactamase-producing and 35.3 % were β-lactamase-non-producing ampicillin-resistant (BLNAR) strains, indicating a rise in BLNAR prevalence compared with the 2017 survey. Almost all of the <em>H. influenzae</em> isolates (98.3 % [521/530]) were non-encapsulated, and no capsular type b strain was detected. All 584 <em>M. catarrhalis</em> isolates were β-lactamase-producing strains, and one macrolide-resistant strain was identified for the first time in our surveillance program. These findings underscore the ongoing shifts in antimicrobial resistance and serotype distribution and provide information that will inform future treatment and prevention strategies.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 10","pages":"Article 102812"},"PeriodicalIF":1.5,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145118514","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":"Dibothriocephalus nihonkaiensis infection accompanied with vitamin B12 deficiency: A case report","authors":"Kyoko Yoshida ,&nbsp;Masahiko Saito ,&nbsp;Akiko Sumiyoshi ,&nbsp;Hiroki Makino ,&nbsp;Michiyo Tashiro ,&nbsp;Madoka Ichikawa-Seki","doi":"10.1016/j.jiac.2025.102815","DOIUrl":"10.1016/j.jiac.2025.102815","url":null,"abstract":"<div><div>Diphyllobothriosis is a tapeworm infection and is associated with the consumption of raw or undercooked fish. Among causative pathogens of human tapeworm infection, <em>Dibothriocephalus nihonkaiensis</em> is the second most prevalent species, contributing to over 2000 cases of human infection annually. Although <em>D. nihonkaiensis</em> is primarily distributed in the northern Pacific region, several cases have recently been reported from other parts of the world, including the United States. As there is a concern regarding the further spread of <em>D. nihonkaiensis</em> infection, accurate diagnosis and understanding related complications is essential. Although <em>Dibothriocephalus latus</em>, one of the major species involved in human diphyllobothriasis, is widely recognized to occasionally accompany vitamin B₁₂ deficiency, to the best of our knowledge, a case of <em>D. nihonkaiensis</em> with decreased vitamin B₁₂ level has not been previously reported. However, the issue of vitamin B12 deficiency caused by tapeworms should be discussed carefully because the two species were not separated before 1986.</div><div>We herein report the first case of molecularly proven <em>D. nihonkaiensis</em> infection in Japan associated with vitamin B₁₂ deficiency. The case was a 19-year-old male without any significant past history. The patient presented with tapeworm excretion at 2 months following raw trout fish consumption. At the initial visit, his laboratory data showed a slightly decreased vitamin B₁₂ level; however, anemia was not noted. Two months later, his vitamin B₁₂ level further decreased; however, it spontaneously resolved following anthelmintic treatment. This case provides valuable insights into the clinical picture of <em>D. nihonkaiensis</em> infection.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 10","pages":"Article 102815"},"PeriodicalIF":1.5,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145118512","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":"Cellulitis with bacteremia caused by Pseudomonas mosselii in a Japanese patient: A case report","authors":"Kento Furuya ,&nbsp;Nobumasa Okumura ,&nbsp;Yu Kaku ,&nbsp;Naoya Itoh","doi":"10.1016/j.jiac.2025.102813","DOIUrl":"10.1016/j.jiac.2025.102813","url":null,"abstract":"<div><div><em>Pseudomonas mosselii</em> is a glucose-nonfermenting, rod-shaped, Gram-negative bacterium commonly found in soil and water. There are only a few cases of <em>P. mosselii</em> infection<em>.</em> Here, we present a case of cellulitis with bacteremia caused by P. <em>mosselii.</em></div><div>A 63-year-old Japanese woman with a history of stasis dermatitis, lower extremity ulcers, and poorly controlled diabetes presented to the emergency department with fever and left lower leg pain. She was diagnosed with cellulitis. Gram-negative rods were detected in one aerobic blood culture bottle and subsequently identified as <em>P. mosselii</em> using matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) and 16S ribosomal RNA (16S rRNA) gene sequencing. She was initially treated with cefepime. Based on the antibiotic susceptibility of <em>P. mosselii</em>, treatment was switched to ceftazidime. Antibiotics were administered for 14 days. However, due to cellulitis recurrence, antibiotic therapy was resumed for an additional 14 days. She was subsequently discharged from the hospital with no further recurrence.</div><div>Accurate identification of <em>P. mosselii</em> using MALDI-TOF MS and 16S rRNA gene sequencing facilitated appropriate clinical management. Furthermore, this case suggests that <em>P. mosselii</em> may inhabit human environments and can cause community-acquired infections.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 10","pages":"Article 102813"},"PeriodicalIF":1.5,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145105105","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":"Nosocomial outbreak of multidrug-resistant Streptococcus pneumoniae serotype 15A (non-vaccine serotype) in a community hospital","authors":"Junya Takahashi ,&nbsp;Tomomi Yajima ,&nbsp;Mitsuyo Kawaguchiya ,&nbsp;Noriyuki Hashimoto ,&nbsp;Momoko Furuya ,&nbsp;Nobumichi Kobayashi ,&nbsp;Noriyuki Sato ,&nbsp;Fumitake Hata","doi":"10.1016/j.jiac.2025.102811","DOIUrl":"10.1016/j.jiac.2025.102811","url":null,"abstract":"<div><div>Multidrug-resistant <em>Streptococcus pneumoniae</em> (MDRSP) showing resistance to β-lactams, macrolides, and fluoroquinolones poses a significant clinical challenge, with increasing prevalence of non-vaccine serotypes (NVT) such as 15A and 35B following the introduction of pneumococcal conjugate vaccines. Here, we report an outbreak of serotype 15A MDRSP isolated from four patients at a community hospital. A nosocomial outbreak occurred in an acute care ward and affected four unvaccinated elderly patients (aged 62–91 years). All isolates were identified as serotype 15A and showed resistance to β-lactams, fluoroquinolones, and macrolides. The isolates belonged to a single-locus variant of sequence type (ST) 292 and showed amino acid alterations in the transpeptidase domains of penicillin-binding proteins (PBPs; PBP1a, 2b, and 2x), and mutations causing amino acid changes in the quinolone resistance–determining regions of <em>gyrA</em>, <em>parC</em>, and <em>parE</em>. Additionally, they harbored both <em>ermB</em> and <em>mefA/E</em> genes. These findings indicate a clonal outbreak. A retrospective analysis suggests possible associations with frequent sputum suctioning, tube feeding, low body mass index, and prolonged hospitalization. MDRSP likely spread via healthcare workers working within the vicinity of the patients. The outbreak was contained within 24 days by the implementation of contact precautions, cohorting, and the use of closed suction systems. This report describes the first documented nosocomial outbreak of MDRSP ST292 lineage in Japan, highlighting several important points: the emergence of multidrug-resistant NVT in healthcare settings, the effectiveness of basic infection control measures in prevention, and the importance of serotyping in understanding pathogenicity and resistance patterns.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 10","pages":"Article 102811"},"PeriodicalIF":1.5,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102999","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":"Evaluation of outpatient antibiotic use using AWaRe and DDD/DOT indicators: A community pharmacy-based study in Nayoro City, Japan","authors":"Yuki Kishino ,&nbsp;Takahiro Suzuki ,&nbsp;Kaoru Kigasawa ,&nbsp;Koji Yamahata ,&nbsp;Yasukuni Fukai ,&nbsp;Shinya Kiyokawa ,&nbsp;Kaei Hiroi","doi":"10.1016/j.jiac.2025.102810","DOIUrl":"10.1016/j.jiac.2025.102810","url":null,"abstract":"<div><h3>Objective</h3><div>This study evaluated outpatient antibiotic use in Nayoro City using the WHO AWaRe.</div><div>classification and DDD/DOT indicators. It assessed: (1) overall antibiotic use, (2) differences in Access group proportions by prescription duration, and (3) regional prescribing patterns in response to a confirmed drug shortage.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 32,632 outpatient prescriptions from July 2022 to March 2025. Short-term prescriptions (≤14 days) were extracted per national guidelines. Antibiotics were classified using the AWaRe framework, and DDDs were calculated. Cosine similarity assessed consistency across pharmacies. Following a cefaclor shortage in May 2024, changes in faropenem use were analyzed using Pearson's correlation, cross-correlation (CCF), vector autoregression (VAR), Welch's <em>t</em>-test, and interrupted time series (ITS) analysis.</div></div><div><h3>Results</h3><div>Short-term prescriptions comprised 81.1 % of all prescriptions. Access to antibiotics accounted for 33.2 % of all prescriptions and 27.2 % of short-term ones, considerably lower than the WHO's target of 60 %. Watch group antibiotics, especially second- and third-generation cephalosporins and fluoroquinolones, were predominantly prescribed for short-term use. Cefaclor alone represented 22.5 % of all prescriptions. After its shortage, the use of faropenem (Reserve group) significantly increased. Cosine similarity (≥0.85) confirmed consistent prescription patterns across pharmacies—antibiotic selection varied by prescription duration.</div></div><div><h3>Conclusion</h3><div>This study identified regional overuse of Watch antibiotics and a shift toward Reserve agents during drug shortages. Hospital formulary restrictions likely influenced citywide prescribing trends. These findings highlight the need for stable antibiotic supply chains, formulary review, and locally adapted antimicrobial stewardship strategies.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 10","pages":"Article 102810"},"PeriodicalIF":1.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145060385","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":"Development and validation of a simple 11-item long COVID burden index (LCBI).","authors":"Gen Yamada, Takahiro Itaya, Noriko Iwamoto, Yoshie Yamada, Yusuke Ogawa, Michiyo Suzuki, Shinichiro Morioka, Kentaro Tochitani, Daisuke Miyamori, Jun Miyashita, Norio Ohmagari, Yosuke Yamamoto","doi":"10.1016/j.jiac.2025.102809","DOIUrl":"10.1016/j.jiac.2025.102809","url":null,"abstract":"<p><strong>Background: </strong>Existing patient-reported outcome measures for long COVID are comprehensive; however, they are time-consuming and burdensome for some patients in daily practice.</p><p><strong>Objectives: </strong>This study aimed to develop and validate a simple patient-reported outcome measure to assess the burden associated with frequently occurring symptoms in patients with long COVID.</p><p><strong>Methods: </strong>Following an extensive literature review, a questionnaire consisting of 11 items was developed based on the modified Delphi method with an expert panel. Its face validity was assessed in three individuals with COVID-19 history. The study subjects were Japanese residents who responded to the online QoLCoVE (Quality of Life in the COVID-19 Era) study between March 8 and April 1, 2024. The known-groups and concurrent validity were assessed after exploratory factor analysis. The internal consistency was evaluated using Cronbach's alpha.</p><p><strong>Results: </strong>A total of 1014 participants were included in the analysis, all at least two months after their last COVID-19 infection. The factor analysis results showed unidimensionality. Internal consistency reliability assessed using Cronbach's alpha was 0.89. For known-groups validity, the total score decreased with time since the acute COVID-19 infection, as well as with more frequent vaccinations, and increased with an increasing previous history of COVID-19. A dose-dependent relationship was observed between EQ-5D-5L and the scale's total score, categorized according to quartiles.</p><p><strong>Conclusion: </strong>We successfully developed the Long COVID Burden Index, a simple 11-item scale to easily quantify symptoms frequently experienced by patients with long COVID, which may interfere with their daily lives.</p>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":" ","pages":"102809"},"PeriodicalIF":1.5,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058560","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":"Factors influencing influenza vaccination among childcare and education professionals: A nationwide survey (2023–2024)","authors":"Yusuke Okubo ,&nbsp;Risa Honjo ,&nbsp;Kazuhiro Uda ,&nbsp;Isao Miyairi ,&nbsp;Masahiko Sakamoto","doi":"10.1016/j.jiac.2025.102808","DOIUrl":"10.1016/j.jiac.2025.102808","url":null,"abstract":"<div><h3>Background</h3><div>Influenza remains a major public health issue, leading to millions of severe cases and many deaths annually. Although educational and childcare institutions are key transmission points for the spread of the virus in communities, few studies have comprehensively examined the vaccination rates and their determinants in these settings.</div></div><div><h3>Methods</h3><div>We conducted a nationwide web-based survey to assess influenza knowledge, perceptions, and determinants of vaccine hesitancy based on the 5C model among childcare and educational professionals in Japan. Multivariable modified Poisson regression, machine learning method of classification and regression tree (CART), and network analysis were employed to identify factors influencing vaccination behavior.</div></div><div><h3>Results</h3><div>Influenza vaccination rates were 74.1 % in 2023 and 78.8 % in 2024. Younger age (RR, 1.33; 95 %CI, 1.04–1.70), perceived unnecessity (RR, 1.31; 95 %CI, 1.01–1.70), concerns over adverse reactions (RR, 1.57; 95 %CI, 1.23–2.01) were associated with consistent non-vaccination, while agreement with collective responsibility (RR, 0.02; 95 %CI, 0.01 to 0.06) and recognition of the importance of vaccination for infection prevention (RR, 0.77; 95 %CI, 0.62 to 0.95) served as protective factor. CART and network analyses further highlighted collective responsibility as the key determinant for receiving vaccination consistently among educational and childcare professionals.</div></div><div><h3>Conclusions</h3><div>Our study highlights that collective responsibility (willingness to get vaccinated to protect others) and specific hesitancy factors play a pivotal role in influenza vaccination uptake among childcare and educational professionals. Tailored public health strategies addressing these determinants may enhance vaccine coverage and reduce influenza transmission in high-risk settings.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 10","pages":"Article 102808"},"PeriodicalIF":1.5,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033490","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":"Teicoplanin total trough concentration and adverse effects in patients with hypoalbuminemia","authors":"Hirofumi Oishi ,&nbsp;Yoshimichi Koutake ,&nbsp;Narumi Ebata ,&nbsp;Yoji Nagasaki ,&nbsp;Masashi Hashimoto","doi":"10.1016/j.jiac.2025.102807","DOIUrl":"10.1016/j.jiac.2025.102807","url":null,"abstract":"<div><h3>Background</h3><div>The association between Teicoplanin (TEIC) total trough concentration (C_min) and adverse effects (hepatotoxicity, nephrotoxicity, and thrombocytopenia) in patients with hypoalbuminemia remains poorly understood. We examined this association for patients with hypoalbuminemia from a safety perspective.</div></div><div><h3>Methods</h3><div>This retrospective study included adult patients (≥18 years) who received TEIC at Kyushu Medical Center between April 2013 and March 2024, underwent therapeutic drug monitoring, and had persistent serum albumin &lt;2.5 g/dL. The primary outcome was the occurrence of hepatotoxicity, nephrotoxicity, and thrombocytopenia. Multivariate logistic regression analysis evaluated the association between TEIC C_min and each adverse event.</div></div><div><h3>Results</h3><div>Hepatotoxicity, nephrotoxicity, and thrombocytopenia were reported in 13.5 % (33/245), 19.0 % (42/221), and 14.4 % (22/153) of patients, respectively. TEIC C_min ≥ 21.1 μg/mL, serum albumin &lt;2.0 g/dL, and total parenteral nutrition were associated with hepatotoxicity. Hepatitis/liver cirrhosis and vasopressor use were associated with nephrotoxicity. The factors associated with thrombocytopenia included estimated glomerular filtration rate &lt;30 mL/min/1.73 m², platelet counts ≤150 × 10³/μL, hyperuricemia, and hematologic disorders.</div></div><div><h3>Conclusions</h3><div>Our findings suggest that a TEIC C_min ≥ 21.1 μg/mL may increase the risk of TEIC-induced hepatotoxicity in patients with hypoalbuminemia. These findings may need to be validated in further studies.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 10","pages":"Article 102807"},"PeriodicalIF":1.5,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008374","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}