Journal of Infection and Chemotherapy最新文献

{"title":"Clinical characteristics of Parvimonas micra bacteremia in Japan: A single-center case series and literature review","authors":"Shugo Inada ,&nbsp;Hiroki Kitagawa ,&nbsp;Keitaro Omori ,&nbsp;Kayoko Tadera ,&nbsp;Toshinori Hara ,&nbsp;Yuta Kuhara ,&nbsp;Takuji Omoto ,&nbsp;Toshihito Nomura ,&nbsp;Norifumi Shigemoto ,&nbsp;Noboru Hattori ,&nbsp;Hiroki Ohge","doi":"10.1016/j.jiac.2026.102928","DOIUrl":"10.1016/j.jiac.2026.102928","url":null,"abstract":"<div><h3>Objectives</h3><div>Gram-positive anaerobic cocci (GPAC) account for 11–15% of anaerobic bacteremia. <em>Parvimonas micra</em> is one of the most commonly identified microorganisms in GPAC bacteremia. This study reviewed the clinical characteristics of <em>P. micra</em> bacteremia.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of the records of 35 patients diagnosed with <em>P. micra</em> bacteremia at Hiroshima University Hospital between January 2011 and July 2024 and conducted a literature review, comparing our cases with previous reports.</div></div><div><h3>Results</h3><div>The median patient age was 70 years, and 74% (26/35) were male. All had immunosuppressive conditions such as solid organ malignancy (49%, 17/35) and diabetes mellitus (34%, 12/35). Of the patients evaluated by a dentist, 96% (22/23) had periodontitis. The most common source of <em>P. micra</em> bacteremia was intra-abdominal infections (31%, 11/35), followed by dental (20%, 7/35), lower respiratory tract (20%, 7/35), and skin and soft tissue infections (14%, 5/35). The prevalence of dental infections was higher than that reported previously, but the distribution of other sources of infection was comparable. Of the patients with <em>P. micra</em> bacteremia, 57% (20/35) had polymicrobial infections, with members of the <em>Streptococcus anginosus</em> group being the most frequently identified co-pathogens (45%, 9/20). The 30-day mortality rate was 26% (9/35). All <em>P. micra</em> isolates showed low minimum inhibitory concentrations for β-lactam antibiotics.</div></div><div><h3>Conclusion</h3><div>Dental infection represented the second most frequent source of <em>P. micra</em> bacteremia, following intra-abdominal infection. In patients with <em>P. micra</em> bacteremia, clinicians should check for periodontitis and investigate the presence polymicrobial infections.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 3","pages":"Article 102928"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146165488","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":"Tick-borne pathogens in ticks collected from Humans: A prospective clinical pilot study","authors":"Shinnosuke Fukushima ,&nbsp;Takaomi Sumida ,&nbsp;Osamu Kawamata ,&nbsp;Yoshimi Hidani ,&nbsp;Hideharu Hagiya","doi":"10.1016/j.jiac.2026.102931","DOIUrl":"10.1016/j.jiac.2026.102931","url":null,"abstract":"<div><div>Tick-borne diseases (TBDs), particularly Japanese spotted fever, are an increasing public health concern in Japan. Data on pathogens carried by ticks removed directly from patients and their associated clinical outcomes remain limited. This prospective study investigated pathogen carriage in patient-derived ticks and evaluated the clinical risk of TBDs. Between April and October 2025, ticks were collected from patients presenting with tick bites at two medical institutions in Western Japan. Ticks were morphologically identified and spotted fever group rickettsiae (SFGR) was detected by nested PCR targeting the 17-kDa antigen gene, followed by sequence analysis. Clinical data, including patient background, antibiotic prescriptions, and outcomes, were reviewed. Clinical information was available for 70 patients (median age; 75 years), of whom 88.6% were prescribed prophylactic antibiotics. Ticks were collected from 60 patients (85.7%), and seven adults without antibiotic prophylaxis were followed for disease onset. Sixty-two ticks, predominantly <em>Amblyomma testudinarium</em> (88.7%), were analyzed. SFGR was detected in eight ticks (12.9%), including seven <em>A. testudinarium</em> and one <em>Ixodes nipponensis,</em> collected from seven patients. Two patients bitten by <em>Rickettsia tamurae</em>–carrying ticks were observed for one month without antibiotics and remained asymptomatic. In this prospective analysis, no clinically apparent rickettsiosis was observed following bites from <em>R. tamurae</em>–positive ticks without antibiotic prophylaxis; however, subclinical infection could not be excluded. Despite the small sample size, our findings suggest that the clinical risk associated with <em>R. tamurae</em> infection may be low. Direct analysis of removed ticks from patients may help characterize pathogen reservoirs and inform targeted approaches to TBDs.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 3","pages":"Article 102931"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146257535","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":"Definitive cefepime versus carbapenems for bacteremia caused by Enterobacterales with a risk of chromosomal AmpC production in children","authors":"Takashi Shoji ,&nbsp;Yuto Otsubo ,&nbsp;Yuho Horikoshi","doi":"10.1016/j.jiac.2026.102923","DOIUrl":"10.1016/j.jiac.2026.102923","url":null,"abstract":"<div><h3>Background</h3><div>In adults, cefepime is proposed as a treatment option for infections associated with a risk of AmpC β-lactamase overproduction; however, data in pediatric populations are limited. We aimed to compare clinical outcomes between cefepime versus carbapenem as definitive therapy for bacteremia caused by Enterobacterales with a relatively high risk of chromosomal AmpC production (AmpC-E) in children.</div></div><div><h3>Methods</h3><div>This retrospective cohort study was conducted at a tertiary children's hospital between 2010 and 2024. Eligible patients were &lt;21 years old with blood cultures positive for AmpC-E. The primary outcome was 30-day mortality. Secondary outcomes included 30-day recurrence, time to negative blood culture and treatment-related toxicity.</div></div><div><h3>Results</h3><div>51 children met the inclusion criteria. The median age was 11 months (IQR: 3–63), with 54.9% male patients. Cefepime and meropenem were administered as definitive therapy in 38 (74.5%) and 13 (25.5%) cases. Baseline characteristics of the patients were comparable. Isolated organisms included <em>Enterobacter cloacae</em> complex (47.1%), <em>Serratia marcescens</em> (29.4%) and <em>Klebsiella aerogenes</em> (19.6%). The cefepime group had a higher prevalence of <em>Klebsiella aerogenes</em> (26.3%, p = 0.048) and <em>Serratia marcescens</em> (39.5%, p = 0.006). The 30-day mortality was 2.6% (1/38) in the cefepime group and 15.4% (2/13) in the meropenem group (p = 0.156). No recurrence of bacteremia or treatment-related toxicity were observed. The median time to negative blood cultures was 2 days (IQR: 1–3) in the cefepime group and 1 day (IQR: 1–5) in the meropenem group (p = 0.949).</div></div><div><h3>Conclusion</h3><div>Cefepime and meropenem as definitive therapy demonstrated comparable outcomes for AmpC-E bacteremia. Further prospective studies are warranted.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 3","pages":"Article 102923"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146131602","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":"Characterization of thermostable antimicrobial and anti-inflammatory protein from marine Bacillus sp.","authors":"Chinnarajan Ravindran ,&nbsp;Eshana Mukhopadhyay ,&nbsp;Lawrance Irudayarajan","doi":"10.1016/j.jiac.2026.102919","DOIUrl":"10.1016/j.jiac.2026.102919","url":null,"abstract":"<div><h3>Introduction</h3><div>Marine microorganisms are rich in bioactive compounds having biotechnological significance. Hydrothermal vents are specifically home to unique microbial communities that have the ability to produce diverse compounds with therapeutic potential. This study aimed to isolate and characterize bioactive proteins from marine <em>Bacillus</em> sp. with antibacterial and anti-inflammatory properties and to evaluate their efficacy.</div></div><div><h3>Methods</h3><div><em>Bacillus</em> sp. isolated from hydrothermal vents, have been grown optimally, with the partially purified extracellular protein fraction separated by ammonium sulfate precipitation and Sephadex G-10 gel filtration. The antimicrobial property was determined against the Methicillin-resistant <em>Staphylococcus aureus</em> (MRSA) and <em>Vibrio vulnificus</em>, with temperature stability studies conducted on the proteins. Zebrafish infection assays, together with lipopolysaccharide (LPS) challenges, served to determine the biological activity.</div></div><div><h3>Results</h3><div>A thermostable protein with a molecular weight of ⁓ 55 kDa showed strong inhibitory effects against MRSA and <em>V. vulnificus</em>. In the infection models using zebrafish, administration of the protein extract led to a substantial increase in survival rates (P &lt; 0.01). Besides, a reduction in mRNA expression of pro-inflammatory cytokines (<em>IL-1β</em>, <em>IL-6</em>, <em>TNF-α</em>) was observed using RT-PCR analysis.</div></div><div><h3>Conclusion</h3><div>The thermostable <em>Bacillus</em> sp. protein exhibited both antibacterial and anti-inflammatory properties, indicating its potential for scale-up and biotherapeutic use.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 3","pages":"Article 102919"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137331","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 preoperative urine culture on postoperative febrile urinary tract infection after ureterorenoscopic lithotripsy","authors":"Junya Hara ,&nbsp;Katsuki Muramoto ,&nbsp;Sumire Santo ,&nbsp;Takuya Hagiwara ,&nbsp;Kazuaki Yamaga ,&nbsp;Hakaru Masumoto ,&nbsp;Yuji Yata ,&nbsp;Tomohiro Hongo ,&nbsp;Tomoya Yamasaki ,&nbsp;Rei Kato ,&nbsp;Kei Fujio ,&nbsp;Shinya Uehara ,&nbsp;Mitsuru Oshiro ,&nbsp;Hideo Otsuki","doi":"10.1016/j.jiac.2026.102918","DOIUrl":"10.1016/j.jiac.2026.102918","url":null,"abstract":"<div><h3>Introduction</h3><div>Ureterorenoscopic lithotripsy (URSL) has become the first-line treatment for upper urinary tract calculi smaller than 20 mm in Japan. However, postoperative febrile urinary tract infection (f-UTI) sometimes leads to fatal outcomes. Few studies have evaluated the impact of bacterial strains and counts from preoperative urine cultures on f-UTI risk. This study investigated these associations and discussed potential preventive strategies.</div></div><div><h3>Materials and methods</h3><div>We retrospectively analyzed 1514 URSL cases performed between October 2018 and September 2023. Positive urine culture was defined as ≥10⁴ CFU/mL. Cases were divided into a low-count group (&lt;10⁶ CFU/mL) and a high-count group (≥10⁶ CFU/mL). F-UTI incidence was assessed according to demographics, bacterial strains, and counts. Statistical analyses included chi-square test, Student's t-test, and multivariate logistic regression.</div></div><div><h3>Results</h3><div>Postoperative f-UTI occurred in 127 cases (8.4%). Multivariate analysis identified preoperative f-UTI and positive urine culture as independent predictors. F-UTI incidence was 5.3% in culture-negative versus 12.1% in culture-positive cases. High-count cases showed a significantly higher f-UTI rate than low-count cases (17.9% vs. 11.2%, p &lt; 0.01). <em>Escherichia coli</em> was associated with f-UTI even at low counts, while <em>Enterococcus faecalis</em> increased risk only at high counts. Multidrug-resistant strains such as <em>Corynebacterium</em> and <em>Enterococcus faecium</em> were also high-risk strains.</div></div><div><h3>Discussion</h3><div>Preoperative positive urine culture was an independent risk factor for f-UTI after URSL. Both bacterial strain and count influenced infection risk. When high-risk strains or high bacterial counts are present, careful antibiotic selection, shorter operative time, and intrarenal pressure control may help reduce postoperative f-UTI.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 3","pages":"Article 102918"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146098608","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":"Oligella urethralis bacteremia associated with urinary tract obstruction: A case report and literature review","authors":"Emiri Muranaka ,&nbsp;Mutsuka Kurihara ,&nbsp;Naoki Okawa ,&nbsp;Yuji Nishihara ,&nbsp;Haruki Mito ,&nbsp;Natsuki Fujiwara ,&nbsp;Yuichi Oshimoto ,&nbsp;Yasunobu Endo ,&nbsp;Ryota Hase","doi":"10.1016/j.jiac.2026.102909","DOIUrl":"10.1016/j.jiac.2026.102909","url":null,"abstract":"<div><div><em>Oligella urethralis</em> is a gram-negative, non-fermentative coccobacillus that is considered part of the normal urogenital flora but can cause opportunistic infections in immunocompromised patients or those with underlying conditions. Coccobacilli such as <em>O. urethralis</em> are rarely encountered as urinary pathogens compared to typical rod-shaped bacteria, making their identification clinically significant. We report a case of <em>O. urethralis</em> bacteremia in a 74-year-old male long-term care facility resident with ureteral stones who presented with acute pyelonephritis and bacteremia. Blood and urine cultures both yielded small gram-negative bacilli, which were identified as <em>O. urethralis</em> using MALDI-TOF mass spectrometry, and the patient was successfully treated with antibiotics. A literature search for reports published between 1987 and May 2025 identified six previously reported cases of <em>O. urethralis</em> bacteremia with English abstracts. Including our case, a total of seven cases were analyzed. All cases occurred in elderly patients (median age 79 years) with predisposing conditions, particularly obstructive uropathy. The prognosis was favorable; only one death occurred among the seven patients (1/7), and it was attributed to causes other than the <em>O. urethralis</em> infection. <em>O. urethralis</em> should be considered a potential pathogen in elderly patients with obstructive uropathy presenting with bacteremia, especially when gram-negative coccobacilli are identified on blood cultures. Fluoroquinolone resistance is frequently reported in <em>O. urethralis</em>, and awareness of this organism is important for appropriate antimicrobial selection, particularly given the challenges in antimicrobial susceptibility interpretation due to lack of species-specific breakpoints.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 2","pages":"Article 102909"},"PeriodicalIF":1.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145989625","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":"Comprehensive genomic analysis of ESBL- and carbapenemase-producing Escherichia coli ST131 in Japan: Genetic characteristics of pandemic clade C","authors":"Akihiro Nakamura ,&nbsp;Tatsuya Nakamura ,&nbsp;Makoto Niki ,&nbsp;Tomokazu Kuchibiro ,&nbsp;Katsutoshi Yamasaki ,&nbsp;Masaru Komatsu ,&nbsp;The Study of Bacterial Resistance in the Kinki region of Japan (SBRK) group","doi":"10.1016/j.jiac.2026.102915","DOIUrl":"10.1016/j.jiac.2026.102915","url":null,"abstract":"<div><h3>Introduction</h3><div>The global dissemination of extended-spectrum β-lactamase (ESBL)- and carbapenemase-producing <em>Escherichia coli</em> sequence type 131 (ST131), particularly clade C, represents a major public health concern. However, the clade-specific genomic features underlying the long-term persistence and international spread of this lineage remain incompletely understood.</div></div><div><h3>Methods</h3><div>We performed whole-genome sequencing and comparative genomic analyses of 121 clinical <em>E. coli</em> isolates, including 83 ST131 and 38 non-ST131 strains, collected from 24 healthcare-associated facilities in Japan between 2001 and 2018. Plasmid replicon types, antimicrobial resistance genes, virulence factors, quinolone resistance–determining region (QRDR) mutations, and chromosomal structural variations were analyzed across ST131 clades.</div></div><div><h3>Results</h3><div>ST131 isolates, particularly clade C, showed a significantly higher prevalence of IncF plasmid replicons, QRDR mutations, and uropathogenic virulence genes such as <em>iha</em>, <em>papA</em>, <em>kpsM</em>, and <em>usp</em> compared with non-ST131 isolates. In contrast, <em>dfrA</em> family genes were less frequent in clade C, suggesting potential retained susceptibility to trimethoprim–sulfamethoxazole. Phylogenetic analysis demonstrated long-term persistence of clade C subclades (C1-nM27, C1-M27, and C2) in Japan. A clade-specific chromosomal region, M27PP1, encoding an ATP-binding protein with a conserved AAA + ATPase domain within a clade-specific genomic island, was identified exclusively in C1-M27 isolates.</div></div><div><h3>Conclusions</h3><div>Our findings highlight distinct clade-specific genomic characteristics of ST131 clade C in Japan, particularly in C1-M27. While the biological function of M27PP1 remains to be experimentally determined, its lineage-restricted distribution suggests a potential role in the long-term persistence and dissemination of this subclade. Continued genomic surveillance is essential for understanding and controlling high-risk <em>E. coli</em> lineages.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 2","pages":"Article 102915"},"PeriodicalIF":1.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146046859","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":"Identification of the genetic basis of a CO2-dependent Staphylococcus aureus small-colony variant isolated from pacemaker leads","authors":"Tatsuya Negishi ,&nbsp;Yuuki Higuma ,&nbsp;Aika Takeda ,&nbsp;Ayaka Hachiro ,&nbsp;Tatsuya Natori ,&nbsp;Kazuki Horiuchi ,&nbsp;Nau Ishimine ,&nbsp;Takeshi Uehara ,&nbsp;Takehisa Matsumoto","doi":"10.1016/j.jiac.2026.102917","DOIUrl":"10.1016/j.jiac.2026.102917","url":null,"abstract":"<div><h3>Purpose</h3><div>Small-colony variants (SCVs) are a slow-growing subset of bacteria that exhibit unusual colony morphology and unique biochemical characteristics. They are associated with chronic and persistent infections. CO₂-dependent SCVs of <em>Staphylococcus aureus</em> have been rarely isolated from clinical specimens. This study aimed to characterize the CO₂-dependent phenotype of <em>S. aureus</em> SCV isolated from pacemaker leads and to determine the genetic basis underlying this trait.</div></div><div><h3>Methods</h3><div>CO₂-dependent <em>S. aureus</em> SCV-5700 isolated from pacemaker leads of a patient with a pacemaker infection was used in this study. Phenotypic testing, antimicrobial susceptibility testing, and <em>mecA</em> polymerase chain reaction of the isolate were performed. Moreover, whole-genome sequencing was conducted for multilocus sequence typing and comparative genomic analysis.</div></div><div><h3>Results</h3><div>CO₂-dependent <em>S. aureus</em> SCV-5700 grew poorly under ambient air conditions; however, tiny colonies formed after 48 h incubation. The isolate was sequence type 45 and did not harbor the <em>mecA</em>. The isolate was identified as <em>S. aureus</em> by biochemical characterization in a 5 % CO₂ atmosphere. Comparative genomic analysis revealed that the isolate had a nonsense mutation (c.565C&gt;T) in the <em>mpsB</em>; however, the revertant strain, Rev-5700, had no such mutation.</div></div><div><h3>Conclusion</h3><div>The CO₂-dependent phenotype of clinical <em>S. aureus</em> isolates can be attributed, in part, to loss of MpsB function.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 2","pages":"Article 102917"},"PeriodicalIF":1.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146086020","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":"Adjunctive and supportive strategies to mitigate drug toxicities in the treatment of nontuberculous mycobacterial disease with future directions","authors":"Ho Won Kim ,&nbsp;Hoe Sun Yoon ,&nbsp;Jake Whang ,&nbsp;Jong-Seok Kim","doi":"10.1016/j.jiac.2026.102908","DOIUrl":"10.1016/j.jiac.2026.102908","url":null,"abstract":"<div><div>Nontuberculous mycobacteria (NTM), particularly <em>Mycobacterium avium</em> complex (MAC) and <em>Mycobacterium abscessus</em> complex (MABC), are increasingly recognized as major opportunistic pathogens. Standard therapy requires prolonged multidrug regimens, often extending for more than 12 months, yet treatment success remains limited, especially for MABC. One of the greatest barriers to effective therapy is not antimicrobial resistance alone but also the high burden of drug-related toxicities. Hepatotoxicity, ototoxicity, nephrotoxicity, myelosuppression, neuropathy, gastrointestinal intolerance, and dermatologic complications frequently lead to dose reduction, interruption, or discontinuation, undermining therapeutic efficacy and patient adherence.</div><div>This review summarizes current standard regimens for MAC and MABC, details the spectrum of toxicities associated with commonly used agents, and evaluates emerging supportive and adjunctive strategies. Hepatoprotective agents such as ursodeoxycholic acid, silymarin, and N-acetylcysteine, antioxidants and aspirin for aminoglycoside-related ototoxicity, liposomal inhaled amikacin as an alternative to intravenous administration, dose optimization and pyridoxine supplementation for linezolid, and prophylactic antiemetics for tigecycline represent pragmatic approaches with varying levels of evidence. While most supportive measures are extrapolated from tuberculosis cohorts or small pilot studies, they collectively highlight the potential to improve tolerability and adherence.</div><div>Future research should prioritize prospective, NTM-specific trials to validate these interventions and develop structured toxicity management frameworks. By embedding supportive strategies alongside antimicrobial regimens, NTM care can move toward a more holistic paradigm that not only enhances microbiological outcomes but also improves patient quality of life.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 2","pages":"Article 102908"},"PeriodicalIF":1.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145979951","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":"An infected aneurysm in the internal carotid artery caused by Salmonella enterica subsp. enterica serovar Enteritidis","authors":"Kazuki Maegawa ,&nbsp;Hikari Tomita ,&nbsp;Ami Masaoka ,&nbsp;Hiroaki Nishioka","doi":"10.1016/j.jiac.2026.102912","DOIUrl":"10.1016/j.jiac.2026.102912","url":null,"abstract":"<div><div>An infected aneurysm in the carotid artery is a rare but life-threatening condition. The most common cause of such infections is <em>Staphylococcus aureus</em>; however, <em>Salmonella</em> is a possible but uncommon cause. We report the case of an elderly man with an infected aneurysm in the left internal carotid artery caused by <em>Salmonella enterica</em> subsp. <em>Enterica</em> serovar Enteritidis despite the absence of gastrointestinal symptoms. Following confirming the absence of neurological symptoms after blood flow disruption through balloon test occlusion (BTO), the patient underwent coil embolization of the aneurysm and aneurysmectomy without neurological complications. Antibiotics were administered for 8 weeks and full recovery was achieved. Non-typhoidal <em>Salmonella</em> spp. can cause infected aneurysms in the carotid artery, even in the absence of gastrointestinal symptoms. Additionally, BTO may be beneficial for determining the treatment strategy for infected aneurysms in the carotid artery.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 2","pages":"Article 102912"},"PeriodicalIF":1.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023983","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}