Journal of Infection and Chemotherapy最新文献

{"title":"Ban of colistin livestock feed supplementation decreased the prevalence of colistin-resistant Escherichia coli in Ecuador","authors":"Hoa Thi Thanh Hoang ,&nbsp;Mayumi Yamamoto ,&nbsp;Manuel Calvopina ,&nbsp;Carlos Bastidas-Caldes ,&nbsp;Diep Thi Khong ,&nbsp;Thang Nam Nguyen ,&nbsp;Yoshimasa Yamamoto","doi":"10.1016/j.jiac.2025.102682","DOIUrl":"10.1016/j.jiac.2025.102682","url":null,"abstract":"<div><h3>Objectives</h3><div>In 2019, Ecuador implemented a ban on colistin feed supplementation owing to the increasing prevalence of colistin-resistant bacteria; however, the impact of this ban remains unclear.</div></div><div><h3>Methods</h3><div>In this study, we aimed to elucidate the effects of the 2019 colistin ban by comparing the prevalence of colistin-resistant <em>Escherichia coli</em> in Ecuador with that in Vietnam, where colistin use is still permitted. We isolated colistin-resistant <em>E. coli</em> from the fecal samples of residents and detected mobile colistin resistance (<em>mcr</em>) genes in both the fecal samples and isolates.</div></div><div><h3>Results</h3><div>Prevalence of colistin-resistant <em>E. coli</em> significantly decreased from 80.6 % in 2019 (n = 139) to 4.7 % in 2022 (n = 106) in Ecuador. Meanwhile, colistin-resistant <em>E. coli</em> prevalence only decreased from 84.7 % in 2017 (n = 98) to 62 % in 2024 (n = 50) in Vietnam. Notably, 96.8 % of the colistin-resistant <em>E. coli</em> isolates in Vietnam carried the <em>mcr</em> genes in 2024, whereas only 4.7 % of the isolates in Ecuadorian fecal samples harbored these genes in 2023.</div></div><div><h3>Conclusions</h3><div>Overall, our findings highlight the significant impact of colistin use regulations on the decreased prevalence of colistin-resistant <em>E. coli</em> among Ecuadorian residents.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 4","pages":"Article 102682"},"PeriodicalIF":1.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669983","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":"The contribution of metagenomic next-generation sequencing to a diagnosis of gas-producing Fusobacterium-induced septic hip arthritis: A case report","authors":"Shiori Kitaya ,&nbsp;Kazuhiro Horiba ,&nbsp;Tamon Kabata ,&nbsp;Takahiro Iyobe ,&nbsp;Masanori Hashino ,&nbsp;Hiroka Yamazaki ,&nbsp;Yoshinori Takahashi ,&nbsp;Yoshitaka Zaimoku ,&nbsp;Megumi Oshima ,&nbsp;Hajime Kanamori","doi":"10.1016/j.jiac.2025.102681","DOIUrl":"10.1016/j.jiac.2025.102681","url":null,"abstract":"<div><div>Pyogenic arthritis with gas gangrene triggered by intra-articular steroid injections can occasionally result in fatal complications. <em>Clostridium perfringens</em> is typically the causative pathogen, with infections caused by <em>Fusobacterium</em> species being relatively rare. <em>Fusobacterium</em> species are known to cause pyogenic infections, but due to their extreme sensitivity to oxygen, they can be difficult to detect with traditional culture methods. Recently, metagenomic next-generation sequencing (mNGS) has gained attention as an alternative diagnostic tool to traditional culture, enabling rapid identification of causative pathogens in infectious diseases, including pyogenic arthritis. Its use is illustrated in the following case report, which demonstrates the diagnostic utility of mNGS in pyogenic arthritis with gas gangrene triggered by an intra-articular steroid injection. Using mNGS as a complement to conventional culture testing allows for a more precise narrowing-down of causative pathogens, enabling targeted therapy and improving patient outcomes. This approach may also help reduce the use of broad-spectrum antibiotics and prevent the emergence of antibiotic-resistant bacteria.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 4","pages":"Article 102681"},"PeriodicalIF":1.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639728","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":"Emergence of high-level penicillin-resistant Neisseria meningitidis harboring ROB-1-type β-lactamase gene in Japan","authors":"Hideyuki Takahashi ,&nbsp;Yuki Ohama ,&nbsp;Kazuhiro Horiba ,&nbsp;Munehisa Fukusumi ,&nbsp;Tomimasa Sunagawa ,&nbsp;Tsukasa Ariyoshi ,&nbsp;Mayako Koide ,&nbsp;Ken Shimuta ,&nbsp;Ryoichi Saito ,&nbsp;Yukihiro Akeda","doi":"10.1016/j.jiac.2025.102679","DOIUrl":"10.1016/j.jiac.2025.102679","url":null,"abstract":"<div><div>While antimicrobial resistance in <em>Neisseria meningitidis</em>, the causative agent for invasive meningococcal disease (IMD), is rare, some meningococcal isolates in Japan were resistant to ciprofloxacin and penicillin (PCG). Among 290 meningococci isolated from 2003 to 2020 in Japan, four PCG resistant (PCG^R) meningococci were found but showed the minimum inhibitory concentration (MIC) with 0.5 μg/mL at a maximum due to mutation in <em>penA</em> gene that encodes penicillin-binding protein 2. However, we herein report that PCG^R meningococci harboring the ROB-1-type β-lactamase gene (<em>bla</em>_ROB-1) with PCG MIC of 32 μg/mL were isolated in Japan from 2 independent IMD patients at Tokyo in June, and at Shiga in December in 2024. The both isolates were also resistant to another β-lactams, ampicillin and amoxicillin. The PCG^R meningococci with <em>bla</em>_ROB-1, which was genetically classified in sequence type (ST)-3587, was firstly identified in France in 2018 and isolated only in European and American countries until 2024. Phylogenetic analysis with whole genome sequencing revealed that the two Japanese <em>N. meningitidis</em> isolates were not genetically identical and that they were not identical to other ST-3057 meningococci isolated in western countries. The emergence of the <em>bla</em>_ROB-1 positive meningococci in Japan would warn medical risk that β-lactams such as PCG and amoxicillin are not always applicable to IMD treatment and prevention in Japan.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 4","pages":"Article 102679"},"PeriodicalIF":1.9,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624966","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 evaluation of the modified carbapenem inactivation method (mCIM) in conjunction with EDTA or sodium mercaptoacetate, for detecting metallo β-lactamase production for Aeromonas species harboring blaCphA","authors":"Kohei Uechi ,&nbsp;Naoya Nishiyama ,&nbsp;Wakako Arakaki ,&nbsp;Ami Nakano ,&nbsp;Ayumi Uechi ,&nbsp;Tatsuya Nakamura ,&nbsp;Kazuko Yamamoto ,&nbsp;Shiro Maeda","doi":"10.1016/j.jiac.2025.102678","DOIUrl":"10.1016/j.jiac.2025.102678","url":null,"abstract":"<div><div>Several <em>Aeromonas</em> species, including <em>Aeromonas hydrophila</em>, have been known to produce CphA, a chromosomal metallo β-lactamase (MBL). We aimed to evaluate the clinical usefulness of modified carbapenem inactivation method (mCIM) in conjunction with EDTA (eCIM) or sodium mercaptoacetate (SMA-mCIM) for MBL-producing <em>Aeromonas</em> species.</div><div>Fifty-six clinical isolates of <em>Aeromonas</em> species stored at the University of the Ryukyus Hospital were used in this study. The antimicrobial susceptibility testing was performed using a VITEK®2 AST-N404 card (bioMerieux, Marcy-l'Etoile, France) and the results were interpreted according to the CLSI guideline M45 3rd edition. The carbapenemase genes, namely <em>bla</em>_GES, <em>bla</em>_IMP, <em>bla</em>_KPC, <em>bla</em>_NDM, <em>bla</em>_OXA-48-like, <em>bla</em>_VIM, and <em>bla</em>_CphA, were detected by PCR. The production of carbapenemase was evaluated using the mCIM and the differentiation of MBL was eCIM and SMA-mCIM.</div><div>The resistance rates to imipenem and meropenem were 21.4 % (12/56) and 32.1 % (18/56), respectively. The mCIM showed a sensitivity of 100 % (33/33 <em>bla</em>_CphA positive isolates) and a specificity of 95.7 % (22/23 <em>bla</em>_CphA negative isolates) for the tested isolates. Among the 33 mCIM-positive isolates, 29 (87.9 %) for eCIM, and 6 (18.2 %) for SMA-mCIM were judged as MBL positive, respectively.</div><div>It is suggested that the mCIM in conjunction with EDTA is useful for detecting MBL production in <em>Aeromonas</em> species harboring <em>bla</em>_CphA.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 4","pages":"Article 102678"},"PeriodicalIF":1.9,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624952","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":"Incidence and risk factors of COVID-19-associated pulmonary aspergillosis in severe cases: A single-center study from Japan","authors":"Kengo Kawamoto ,&nbsp;Waki Imoto ,&nbsp;Yoshihiro Kimura ,&nbsp;Shigeki Kakuno ,&nbsp;Wataru Shibata ,&nbsp;Yuka Myodo ,&nbsp;Tetsuro Nishimura ,&nbsp;Shoichi Ehara ,&nbsp;Hiromichi Fujii ,&nbsp;Yasumitsu Mizobata ,&nbsp;Toshihiko Shibata ,&nbsp;Hiroshi Kakeya","doi":"10.1016/j.jiac.2025.102676","DOIUrl":"10.1016/j.jiac.2025.102676","url":null,"abstract":"<div><h3>Objective</h3><div>Coronavirus disease 2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) is a serious complication in patients with severe COVID-19. This study investigated the incidence and risk factors for CAPA in patients with severe COVID-19 at Osaka Public University Hospital from April 2020 to November 2021.</div></div><div><h3>Methods</h3><div>This retrospective study involved patients with CAPA patients requiring invasive ventilation who were diagnosed according to the European Confederation of Medical Mycology and the International Society of Human and Animal Mycology criteria. Patients were classified into the CAPA and non-CAPA groups. Data collected included age, sex, body mass index, smoking history, underlying disease, length of hospital stay, steroid and other drug use, extracorporeal membrane oxygenation use, and outcome. Univariate analysis was used to identify risk factors associated with CAPA.</div></div><div><h3>Results</h3><div>Of the 256 COVID-19 patients, 187 required invasive ventilation, and eight were diagnosed with CAPA. The incidence of CAPA among COVID-19 patients requiring ventilator management was 4.28 %. Tracheostomy was performed in seven patients, and <em>Aspergillus</em> spp. was detected in six, of whom four were confirmed to have <em>A. fumigatus</em>. CAPA mortality was high, with six of eight patients dying. Univariate analysis showed COPD (P = 0.04) and chronic liver disease (P = 0.04) as common comorbidities. β-D-glucan positivity, tracheostomy, prolonged hospitalization, prolonged steroid use, and death (P &lt; 0.01) were more prevalent in the CAPA group.</div></div><div><h3>Conclusions</h3><div>When bronchoscopy is unfeasible, early diagnosis using serum <em>Aspergillus</em> antigen measurement and imaging is essential, particularly for patients with COPD, liver disease, or risk factors like prolonged hospitalization or steroid use post-COVID-19 treatment.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 4","pages":"Article 102676"},"PeriodicalIF":1.9,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586056","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":"Central venous access Port–Related blood stream infection caused by Cyberlindnera fabianii: A case report and literature review","authors":"Koichi Kawasaki ,&nbsp;Toyomitsu Sawai ,&nbsp;Yudai Inadomi ,&nbsp;Shun Morimitsu ,&nbsp;Tomonari Ikeda ,&nbsp;Sumako Yoshioka ,&nbsp;Nobuko Matsuo ,&nbsp;Junichi Kadota ,&nbsp;Katsunori Yanagihara ,&nbsp;Hiroshi Mukae","doi":"10.1016/j.jiac.2025.102662","DOIUrl":"10.1016/j.jiac.2025.102662","url":null,"abstract":"<div><div><em>Cyberlindnera fabianii</em>, an ascomycetous yeast, is a rare human pathogen. Here, we describe the first reported case of central venous (CV) access port–related blood-stream infection caused by <em>C. fabianii</em>. An 80-year-old Asian man presented to our department with a mass in the pancreas. A diagnosis of pancreatic cancer (cT4N0M0, cStage III) was made. A catheter with CV access port was inserted, and anticancer chemotherapy and radiotherapy was initiated. One year after the first visit, he was urgently admitted to our hospital due to recurrent hematemesis. On day 37, organism cultures of the blood and catheter tip were positive for <em>Candida pelliculosa</em> by the BD PHOENIX™ 100 system. On the basis of these findings, CV port–related blood-stream infection caused by <em>C</em>. <em>pelliculosa</em> was diagnosed, and treatment with micafungin (MCFG) was initiated. On day 51, the blood culture converted to negative. On day 65, MCFG was stopped. The cultured strain was sent to reference laboratory where <em>Cyberlindnera fabianii</em> was identified by MALDI-TOF mass spectrometry and direct sequencing of the internally transcribed spacer region. The present case report describes the first known case of CV access port–related blood-stream infection caused by <em>C. fabianii</em>. MCFG was successfully used to treat the fungemia caused by <em>C. fabianii</em>. Although the incidence of uncommon yeast species causing human infections has gradually increased in recent years, conventional biochemical methods may offer limited usefulness for identifying these rare organisms. Accordingly, MALDI-TOF mass spectrometry or molecular assays may be required to identify these uncommon fungal species.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 4","pages":"Article 102662"},"PeriodicalIF":1.9,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergence of a methicillin-resistant Staphylococcus aureus strains with an unusual susceptibility antibiotic pattern in Tunisia","authors":"Sana Ferjani ,&nbsp;Zaineb Hamzaoui ,&nbsp;Lamia Kanzari ,&nbsp;Ahmed Fakhfekh ,&nbsp;Asma Ferjani ,&nbsp;Ilhem Boutiba Ben Boubaker","doi":"10.1016/j.jiac.2025.102677","DOIUrl":"10.1016/j.jiac.2025.102677","url":null,"abstract":"<div><div>Typically, methicillin-resistant <em>Staphylococcus aureus</em> (MRSA) strains exhibit concurrent resistance to numerous commonly used antibiotics. Between June and December 2023, five MRSA strains with an unusual antibiotic susceptibility pattern (susceptible to all antibiotics tested, except cefoxitin) were isolated at Charles Nicolle Hospital of Tunis. Isolates were characterized by whole genome sequencing using the Illumina DNA Prep kit. All isolates carried the <em>mec</em>A gene [SCC<em>mec</em> types IVa (2B) (n = 4) and V (n = 1)]. Virulence genes, including leukocidin genes (<em>luk</em>D, <em>luk</em>E), enterotoxin genes (<em>sea</em>, <em>seg</em>, <em>sei</em>, <em>sem</em>, <em>sen</em>, <em>seo</em>, <em>seu</em>), and immune evasion genes (<em>sak</em>, <em>scn</em>). They were identified as ST97/CC97 (n = 2), ST149/CC5 (n = 2), and ST5/CC4 (n = 1). This study highlights the emergence of MRSA clones with an unusual susceptible antibiotic pattern, emphasizing the importance of continued molecular surveillance to monitor both antimicrobial resistance and virulence traits and track the spread of newly introduced clones, thereby improving infection control strategies.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 4","pages":"Article 102677"},"PeriodicalIF":1.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143580252","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":"Current status and challenges of health economic evaluations related to antimicrobial stewardship in Japan: A scoping review up to 2023","authors":"Ryota Goto ,&nbsp;Ryo Inose ,&nbsp;Tomokazu Shoji ,&nbsp;Manabu Akazawa ,&nbsp;Yuichi Muraki","doi":"10.1016/j.jiac.2025.102657","DOIUrl":"10.1016/j.jiac.2025.102657","url":null,"abstract":"<div><h3>Background</h3><div>Antimicrobial resistance is a major global threat, and the promotion of antimicrobial stewardship (AS) is critical. Although AS is recognized for its economic benefits, the situation in Japan has not yet been thoroughly summarized. This scoping review summarizes the current landscape of health economic evaluations related to AS in Japan, considering challenges and prospects for the future.</div></div><div><h3>Methods</h3><div>Articles related to AS and economic evaluations were extracted from PubMed, Scopus, and Ichushi-Web using search formulas. After performing primary screening based on titles and abstracts, secondary screening of full texts was conducted to identify suitable studies.</div></div><div><h3>Results</h3><div>This review identified 41 single-institution studies, primarily from special functioning hospitals, regional medical care support hospitals, and hospitals with more than 500 beds. The most frequently reported AS activities were prospective audits and feedback (48.8 %, 20 of 41 articles). Among the economic evaluations, 39 articles demonstrated reductions in drug costs, ranging from 3.74 % to 100 % for the evaluated drugs. Furthermore, no worsening trends were observed in the outcome measures, including mortality, which was evaluated along with drug and healthcare costs. However, few studies have considered the costs associated with AS operations.</div></div><div><h3>Conclusion</h3><div>This scoping review indicates that AS may offer economic benefits in terms of drug and healthcare costs in Japan. In the future, promoting research on the economic impact of AS in small- or medium-sized hospitals, along with broader economic evaluations that consider the operational costs of AS, will be necessary to facilitate comparisons with data from other countries.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 3","pages":"Article 102657"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of meningitis treated with intraventricular vancomycin in an infant","authors":"Yuya Uezato ,&nbsp;Wataru Uehara ,&nbsp;Shingo Kurokawa ,&nbsp;Naoya Nishiyama ,&nbsp;Sadao Nakamura ,&nbsp;Masashi Nakamatsu ,&nbsp;Koichi Nakanishi ,&nbsp;Kazuko Yamamoto ,&nbsp;Hideo Shiohira ,&nbsp;Katsunori Nakamura","doi":"10.1016/j.jiac.2025.102674","DOIUrl":"10.1016/j.jiac.2025.102674","url":null,"abstract":"<div><div>There is limited evidence for vancomycin (VCM) ventriculoperitoneal (VP) administration. We report a 3-month-old female with congenital hydrocephalus who developed a fever and was admitted to the hospital with a suspected VP shunt infection; she was being managed as an outpatient following VP shunt placement. Methicillin-resistant <em>Staphylococcus aureus</em> was detected on the removed catheter tip, and VCM treatment was initiated. Intravenous administration was ineffective, so intraventricular administration was initiated. Therapeutic drug monitoring (TDM) of cerebrospinal fluid (CSF) drug concentration showed a high trough level (30.9–50.0 μg/mL) at 2 mg daily dosing. Dose adjustment was implemented considering CSF drainage volume, and administration was changed to every other day. This case suggests that performing TDM and considering the amount of CSF drainage when establishing a detailed dosing regimen are important when administering VCM intraventricularly.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 4","pages":"Article 102674"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143541836","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 prescriptions for older patients in dental medicine: A four-year retrospective study in Japan","authors":"Akira Kurishima ,&nbsp;Yasuhiro Sasaki ,&nbsp;Yusuke Kuwai ,&nbsp;Mari Irie ,&nbsp;Satoshi Miyata ,&nbsp;Yoshiharu Fukuda","doi":"10.1016/j.jiac.2025.102675","DOIUrl":"10.1016/j.jiac.2025.102675","url":null,"abstract":"<div><h3>Background</h3><div>Antimicrobial use (AMU) in Japan is characterized by a high prevalence of oral third-generation cephalosporin prescriptions, especially in dental medicine. However, few studies have examined the time trends and factors influencing AMU in older individuals seeking dental care. Therefore, in this study, we aimed to investigate AMU, particularly third-generation cephalosporin, in a cohort of older adults.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed the dental prescription health insurance claims data of patients aged ≥75 years in one metropolitan area from 2018 to 2021. The antimicrobials were categorized, and the number of defined daily doses (DDDs) per 1000 inhabitants per day (DID) was calculated to assess trends over this period. Multivariate logistic regression analysis was performed to identify factors associated with third-generation cephalosporin prescriptions.</div></div><div><h3>Results</h3><div>This database contains 58,655 patients, of whom 15,038 were prescribed antimicrobials from dentistry. Our findings suggest that third-generation cephalosporins accounted for 44.8 % of all antimicrobial prescriptions, with a noticeable decreasing trend in DID over the study period. Factors significantly associated with third-generation cephalosporin prescriptions included dental association membership (adjusted odds ratio [AOR] 0.72, 95 % confidence interval [CI] 0.63–0.82), fiscal year (AOR 0.86, 95 % CI 0.83–0.89), and their interaction.</div></div><div><h3>Conclusions</h3><div>The findings suggest that the pattern of prescribing third-generation cephalosporins in dental medicine might be shifting owing to heightened awareness of antimicrobial resistance (AMR) and educational initiatives by groups, such as dental associations. Effective educational and policy interventions by professional associations could reduce inappropriate antimicrobial prescriptions, thereby mitigating AMR on a large scale.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 4","pages":"Article 102675"},"PeriodicalIF":1.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}