Journal of Infection and Chemotherapy最新文献

{"title":"Molecular versus conventional assay for diagnosis of hospital-acquired pneumonia in critically ill patients: a single center experience","authors":"Angela Quirino ,&nbsp;Claudia Cicino ,&nbsp;Nadia Marascio ,&nbsp;Giorgio Settimo Barreca ,&nbsp;Luigia Gallo ,&nbsp;Brunella Brescia ,&nbsp;Francesca Trimboli ,&nbsp;Marta Pantanella ,&nbsp;Francesca Serapide ,&nbsp;Alessandro Russo ,&nbsp;Giovanni Matera ,&nbsp;Enrico Maria Trecarichi","doi":"10.1016/j.jiac.2025.102754","DOIUrl":"10.1016/j.jiac.2025.102754","url":null,"abstract":"<div><h3>Purpose</h3><div>Lower respiratory tract infections are reported as one of top five causes of mortality and morbidity in the world. A bacterial etiology is often involved in HAP, most frequently from multidrug resistant gram-negative bacteria, and fast accurate diagnosis of etiologic agent(s) of LRTI is essential for an appropriate management. The aim of this retrospective study was to evaluate the analytical performance of Biofire Filmarray Pneumonia Plus for bacteria detection in bronchoalveolar lavage samples and the concordance of bacterial loads between BFPP and cultural gold standard methods.</div></div><div><h3>Methods</h3><div>A total of 111 BAL samples were obtained from 111 consecutive patients admitted to Intensive Care Unit of “Renato Dulbecco” Teaching Hospital of Catanzaro, from March 2023 to March 2024.</div></div><div><h3>Results</h3><div>Compared to conventional methods, BFPP showed a sensitivity of 99 % and a specificity of 64 %. The agreement between the two methods was assessed by calculating PPA and NPA, being 89 % and 95 %, respectively. The most common bacterial species identified at BFPP was <em>Klebsiella pneumoniae</em>, followed by <em>Acinetobacter calcaceuticus-baumanii complex</em>, <em>Staphylococcus aureus</em> and <em>Pseudomonas aeruginosa</em>. Bacterial load (CFU/ml) in relation to copy number detected by molecular analysis showed the best performance for value ≥10⁶ copie/mL. About molecular mechanisms of resistance in comparison to phenotypic profiles, the highest level of performance was observed for presence of KPC genes, all isolates showing resistance to carbapenems, followed by OXA-48 like and NDM.</div></div><div><h3>Conclusion</h3><div>The high concordance reported in this study between the identification of resistance genes and phenotypic indication can lead to an appropriate, fast and tailored antibiotic therapy.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 8","pages":"Article 102754"},"PeriodicalIF":1.9,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144280400","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":"Diagnosis of Tropheryma whipplei pneumonia in an immunocompromised lymphoma patient using metagenomic next generation sequencing: A case report","authors":"Qingming Guo ,&nbsp;Le Wang ,&nbsp;Bin Han ,&nbsp;Xiaofeng Mu ,&nbsp;Weiwei Wu ,&nbsp;Qingqing Bi ,&nbsp;Juan Chen","doi":"10.1016/j.jiac.2025.102752","DOIUrl":"10.1016/j.jiac.2025.102752","url":null,"abstract":"<div><div>Whipple's disease (WD) is a rare chronic infectious illness caused by <em>Tropheryma whipplei</em> (<em>T.whipplei</em>), primarily affecting the gastrointestinal tract and joints, with rare lung involvement. Diagnosis can be challenging due to nonspecific symptoms and the difficulty in isolating the bacterium. This report describes a patient with pneumonia resulting from <em>T.whipplei</em> and <em>Streptococcus pneumoniae</em> infections during lymphoma treatment with chemotherapy and glucocorticoids. Imaging revealed pulmonary infections characterized by diffuse ground glass opacities and small nodules. Metagenomic sequencing of bronchoalveolar lavage fluid confirmed the mixed infection. The patient was treated with moxifloxacin and ceftriaxone, leading to improved inflammation within eight days. After completing chemotherapy, the patient was discharged with significant remission. This case highlights the susceptibility of immunocompromised patients to <em>T.whipplei</em> infection, emphasizing the need for early diagnosis and treatment.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 8","pages":"Article 102752"},"PeriodicalIF":1.9,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144262677","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":"Risk factors for mpox infection among MSM with STIs in northern Taiwan, 2022–2024","authors":"Wei-Yen Chen ,&nbsp;Shu-Hsing Cheng ,&nbsp;Cheng-Pin Chen ,&nbsp;Shu-Yuan Lee ,&nbsp;Shin-Yen Ku ,&nbsp;Shu-Ting Gan ,&nbsp;Chen-En Hsieh ,&nbsp;Chien-Yu Cheng","doi":"10.1016/j.jiac.2025.102750","DOIUrl":"10.1016/j.jiac.2025.102750","url":null,"abstract":"<div><h3>Introduction</h3><div>Since 2022, Mpox has emerged among men who have sex with men (MSM) in Taiwan. Data on local risk factors remain limited, particularly the role of sexual behavior and STI history.</div></div><div><h3>Methods</h3><div>We conducted a retrospective case–control study at a regional hospital in Taoyuan from 2022 to 2024. MSM aged ≥18 years with at least one STI were included. Mpox cases were compared to STI-only controls. Data on demographics, HIV status, and behaviors were analyzed using Firth logistic regression.</div></div><div><h3>Results</h3><div>Among 729 MSM, 42 had confirmed Mpox. Having more than two prior STIs was strongly associated with Mpox (aOR = 17.32; 95 % CI: 5.64–53.17). In contrast, HIV viral load &gt;1000 copies/mL (aOR = 0.02) and multiple sexual partners (aOR = 0.22) were linked to lower odds of infection.</div></div><div><h3>Conclusions</h3><div>Multiple STIs were a strong predictor of Mpox. Lower infection rates among viremic or sexually active individuals may reflect behavior change or healthcare engagement. STI history may help guide targeted Mpox prevention.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 8","pages":"Article 102750"},"PeriodicalIF":1.9,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144270631","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":"Global impact of antimicrobial stewardship programs in Healthcare: An umbrella review of effectiveness, cost-efficiency, and implementation strategies","authors":"Yuvaraj Krishnamoorthy ,&nbsp;Dhanajayan Govindan ,&nbsp;Monica Karunakaran ,&nbsp;Muneera Parveen ,&nbsp;Anaswara Manohar ,&nbsp;Jaffar A. Al-Tawfiq","doi":"10.1016/j.jiac.2025.102753","DOIUrl":"10.1016/j.jiac.2025.102753","url":null,"abstract":"<div><h3>Background</h3><div>Antimicrobial Stewardship Programs (ASPs) are vital in mitigating global threat of antimicrobial resistance (AMR) by optimizing antibiotic use and improving patient outcomes. Despite available evidence from high-income countries, challenges remain in low- and middle-income countries (LMIC) due to resource constraints and heterogeneous implementation. This umbrella review synthesizes evidence from systematic reviews to assess the effectiveness, cost-effectiveness, and implementation barriers and facilitators of ASPs across diverse healthcare settings.</div></div><div><h3>Methods</h3><div>Following PRIOR guidelines and PROSPERO registration (ID: CRD42024541821), we conducted comprehensive search of PubMed, Scopus, Cochrane Library, Epistemonikos, Google Scholar, and ScienceDirect up to July 2024. Data were extracted using standardized form and methodological quality of reviews was assessed with AMSTAR-2 tool. Given heterogeneity in study designs, outcomes, and ASP interventions, narrative synthesis was employed.</div></div><div><h3>Results</h3><div>The included 55 reviews demonstrated that ASPs consistently reduce antibiotic consumption—achieving reductions up to 91 %—and improve adherence to prescribing guidelines. Significant declines in resistance rates for key pathogens, such as MRSA and ESBL-producing organisms, were reported. Although effects on mortality and hospital length of stay were variable, most studies confirmed substantial cost-savings (up to 82 % reduction in antibiotic expenditures). Implementation barriers primarily included limited resources, insufficient data infrastructure, and prescriber resistance, while strong organizational support and multidisciplinary collaboration emerged as key facilitators.</div></div><div><h3>Conclusion</h3><div>ASPs are both clinically effective and economically advantageous in diverse healthcare settings. Tailored strategies that address local barriers and leverage existing infrastructure are essential for sustainable implementation. Future research should focus on standardized evaluation methods and long-term impacts to further optimize ASP adoption globally.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 8","pages":"Article 102753"},"PeriodicalIF":1.9,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144280399","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":"Refractory invasive pulmonary aspergillosis caused by two Aspergillus species in an allogeneic hematopoietic stem cell transplantation recipient","authors":"Mizuki Haraguchi ,&nbsp;Otoya Watanabe ,&nbsp;Muneyoshi Kimura ,&nbsp;Sho Ogura ,&nbsp;Takashi Umeyama ,&nbsp;Yasunori Muraosa ,&nbsp;Ami Koizumi ,&nbsp;Takayuki Shinohara ,&nbsp;Yoshitsugu Miyazaki ,&nbsp;Go Yamamoto ,&nbsp;Hideki Araoka ,&nbsp;Naoyuki Uchida","doi":"10.1016/j.jiac.2025.102751","DOIUrl":"10.1016/j.jiac.2025.102751","url":null,"abstract":"<div><div>Invasive fungal infections are critical complications in patients with hematological malignancies. Herein, we report a case of refractory invasive pulmonary aspergillosis (IPA) caused by two <em>Aspergillus</em> species in a recipient of hematopoietic stem cell transplantation. Repeated sputum cultures revealed causative pathogens, which were identified as <em>Aspergillus terreus</em> and <em>Aspergillus flavus</em>. The antifungal susceptibility testing showed that these <em>Aspergillus</em> species had a high minimal inhibitory concentration against amphotericin B, suggesting that they caused the refractory infection in this patient. Although the patient was treated with a combination of isavuconazole and micafungin, the IPA worsened, and the patient died due to multiple organ failure. The findings from this case highlight the complexity of refractory invasive fungal infections, wherein multiple fungal species can simultaneously affect patients, particularly those with severely compromised immune function. Further investigation is urgently required to improve the management strategies for refractory IPA, including early pathogen identification and novel antifungal agent development.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 8","pages":"Article 102751"},"PeriodicalIF":1.9,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275107","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 case of infectious endocarditis and vertebral discitis caused by Streptococcus pneumoniae serotype 23A","authors":"Mayuko Kawamura ,&nbsp;Daisuke Ono ,&nbsp;Takayuki Kawamura ,&nbsp;Kazuyuki Mimura ,&nbsp;Eiyu Ebata ,&nbsp;Bin Chang ,&nbsp;Yukihiro Akeda ,&nbsp;Akihiro Yoshitake ,&nbsp;Kotaro Mitsutake ,&nbsp;Hideaki Oka","doi":"10.1016/j.jiac.2025.102749","DOIUrl":"10.1016/j.jiac.2025.102749","url":null,"abstract":"<div><div><em>Streptococcus pneumoniae</em>, is a Gram-positive diplococcus, causes various community-acquired infections. Although pneumococcal vaccination has reduced the incidence of invasive pneumococcal disease, relative incidence of non-vaccine serotype-associated infections has increased. Herein, we report a case of pneumococcal infectious endocarditis and vertebral discitis diagnosed concurrently. A 73-year-old man presented with a 1-week history of fever and back pain (day 0). Laboratory tests revealed elevated inflammatory markers and magnetic resonance imaging confirmed vertebral osteomyelitis. Empirical intravenous cefazolin and vancomycin were initiated, considering appropriate coverage for common causative organisms of vertebral osteomyelitis. On day 1, blood cultures yielded <em>S. pneumoniae</em>— later identified as penicillin G susceptible serotype 23A belonging to sequence type 5242 —and antibiotics were switched to ceftriaxone and vancomycin. On the same day, the patient developed worsening oxygenation and a systolic murmur. Echocardiography revealed a mitral valve vegetation with severe regurgitation. Cefepime and vancomycin were initiated on day 2, followed by meropenem and vancomycin on day 4 for potential nosocomial pneumonia. On day 6, cefepime monotherapy was continued after methicillin-resistant <em>Staphylococcus aureus</em> was not detected in sputum culture. To address persistent respiratory failure, mitral valve replacement was performed on day 7. Cultures of tissue removed from the mitral valve were negative; 16S rRNA sequencing using the excised valve confirmed <em>S. pneumoniae</em> infection. Postoperatively, ceftriaxone was resumed, followed by oral levofloxacin, and a 42-day antimicrobial course was completed. The patient recovered without any recurrence. Continued surveillance of pneumococcal serotypes and antimicrobial resistance is warranted.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 8","pages":"Article 102749"},"PeriodicalIF":1.9,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144254121","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":"Candida auris clade I isolates from ear discharge in Japan demonstrated comparable virulence to invasive clade I isolates against Galleria mellonella","authors":"Sayoko Oiki ,&nbsp;Masahiro Abe ,&nbsp;Sota Sadamoto ,&nbsp;Kazuki Amemiya ,&nbsp;Takayuki Shinohara ,&nbsp;Amato Otani ,&nbsp;Ami Koizumi ,&nbsp;Takashi Umeyama ,&nbsp;Koichi Makimura ,&nbsp;Yoshitsugu Miyazaki","doi":"10.1016/j.jiac.2025.102747","DOIUrl":"10.1016/j.jiac.2025.102747","url":null,"abstract":"<div><h3>Introduction</h3><div><em>Candida auris</em> is one of the most serious fungal pathogens in the world due to its characteristics of multidrug resistance and causing outbreaks in hospitals. Based on genetic analysis through whole-genome sequencing, <em>C. auris</em> has been classified into four major clades. In Japan, most strains were isolated from noninvasive ear discharge and classified into clade II, whereas clades I, III, and IV are typically detected in patients with invasive candidiasis worldwide. However, three strains, NIIDFCaurisB0004, LSEM 3732, and LSEM 4020, were isolated from ear discharge in Japan and classified into clade I, and their virulence remains unknown. Here, we demonstrate the virulence of these ear discharge-derived clade I strain using the <em>Galleria mellonella</em> infection model.</div></div><div><h3>Methods</h3><div>Survival analysis, histopathological analysis, and colony count measurements of <em>G. mellonella</em> larvae infected with <em>C. auris</em> were conducted to compare the virulence of ear discharge-derived clade I strains, ear discharge-derived clade II strains, and non-ear discharge-derived clade I strains.</div></div><div><h3>Results</h3><div>Ear discharge-derived clade I strains exhibited higher mortality rates than ear discharge-derived clade II strains, comparable to those of invasive clade I strains. Histopathological analysis and colony count measurements revealed that the ear discharge-derived clade I strain, NIIDFCaurisB0004, exhibited significantly more growth than clade II strains in <em>G. mellonella</em>.</div></div><div><h3>Conclusion</h3><div>Even if <em>C. auris</em> is isolated from ear discharge in Japan, there exists a possibility that it can be classified into clade I with high virulence. Therefore, detailed identification of the clade is essential.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 8","pages":"Article 102747"},"PeriodicalIF":1.9,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248264","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":"Vancomycin-associated acute kidney injury and its clinical and economic impact: a retrospective cohort study using two Japanese healthcare databases","authors":"Shutaro Murakami ,&nbsp;Azusa Ishiyama ,&nbsp;Sayuri Otogawa ,&nbsp;Ryoko Sakai ,&nbsp;Manabu Akazawa","doi":"10.1016/j.jiac.2025.102744","DOIUrl":"10.1016/j.jiac.2025.102744","url":null,"abstract":"<div><h3>Background</h3><div>Previous studies examining vancomycin-associated acute kidney injury (AKI) were methodologically limited. We herein investigated the AKI incidence, clinical outcomes, and economic impact of this condition on Japan's aging population using a robust, methodological approach to analyze information from two, large-scale, Japanese, healthcare databases.</div></div><div><h3>Methods</h3><div>This retrospective cohort study analyzed data on 2007 and 2607 patients aged ≥18 years and registered with the Medical Data Vision (MDV) database and the JMDC, Inc. database, respectively, who received vancomycin ≥4 days. Target trial emulation was employed with 1:1 propensity score matching to compare the outcomes of patients with and without AKI. The primary outcomes included 30-day in-hospital mortality, length of hospital stay (LOS), and direct medical costs. The KDIGO guidelines’ definition of AKI was used.</div></div><div><h3>Results</h3><div>AKI occurred in 19.4 % (MDV) and 14.9 % (JMDC) of the cohorts with the median onset being five days. After propensity score matching (386 and 387 pairs for MDV and JMDC, respectively), the AKI group demonstrated significantly higher 30-day in-hospital mortality (odds ratio: 3.82 [95 % confidence interval (CI): 2.52–5.79] for MDV; 4.36 [95 % CI: 2.89–6.57] for JMDC; both P &lt; .001), prolonged LOS (hazard ratio: 1.45 [95 % CI: 1.22–1.72] for MDV; 1.79 [95 % CI: 1.35–2.37] for JMDC; both P &lt; .001), and higher daily direct medical costs per patient (cost ratio: 1.39 [95 % CI: 1.19–1.62] for MDV; 1.33 [95 % CI: 1.18–1.50] for JMDC; both P &lt; .001).</div></div><div><h3>Conclusions</h3><div>Vancomycin-associated AKI significantly increased mortality, prolonged hospitalization, and elevated healthcare costs. These findings can provide further impetus to effective vancomycin stewardship.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 7","pages":"Article 102744"},"PeriodicalIF":1.9,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144223142","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":"Multifocal pyogenic arthritis and osteomyelitis with bacteremia caused by Streptobacillus notomytis: A case report and comprehensive literature review","authors":"Shun Yonezaki ,&nbsp;Masumi Suzuki Shimizu ,&nbsp;Takashi Sugimoto ,&nbsp;Shotaro Ide ,&nbsp;Yusuke Nakazoe ,&nbsp;Akihiko Yonekura ,&nbsp;Yasuhide Kawamoto ,&nbsp;Norihiko Akamatsu ,&nbsp;Kosuke Kosai ,&nbsp;Katsunori Yanagihara ,&nbsp;Koya Ariyoshi ,&nbsp;Akitsugu Furumoto","doi":"10.1016/j.jiac.2025.102746","DOIUrl":"10.1016/j.jiac.2025.102746","url":null,"abstract":"<div><div><em>Streptobacillus notomytis</em>, recently recognized as a distinct species from <em>Streptobacillus moniliformis—</em>the primary causative agent of rat-bite fever—has been implicated in rare human infections. To date, there are no documented cases of femoral and tibial osteomyelitis attributable to this pathogen. Herein, we report a case of multifocal pyogenic arthritis and osteomyelitis involving the femur and tibia with bacteremia caused by <em>S. notomytis</em>, alongside a review of human infections associated with this organism. A 73-year-old woman initially presented with left knee pain at another hospital, where a filamentous gram-negative bacillus was isolated from joint aspirate and blood cultures. After developing sepsis, she was transferred to our facility. On admission, she had tenderness in both shoulder joints and swelling in the right fingers and wrist. Arthroscopic lavage was performed, and empirical antibiotics were initiated. Further analysis of the original isolates using matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) identified <em>S. moniliformis</em> with a low confidence score of 1.6. Magnetic resonance imaging confirmed osteomyelitis of the femur and tibia. After 9 weeks of targeted therapy, the patient fully recovered ambulatory function. Subsequent 16S rRNA gene sequencing definitively identified the pathogen as <em>S. notomytis</em>. These findings highlighted that in cases of pyogenic arthritis with unclear etiology and potential rodent exposure, <em>Streptobacillus</em> spp., including <em>S. notomytis</em>, should be considered. Comprehensive diagnostics, including 16S rRNA sequencing, are essential for accurate pathogen identification, and careful monitoring for complications like osteomyelitis is crucial during management.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 8","pages":"Article 102746"},"PeriodicalIF":1.9,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234343","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":"Pharmacokinetics of ganciclovir for prevention of cytomegalovirus infection in a lung transplant recipient on veno-arterial extracorporeal membrane oxygenation: A case report and literature review","authors":"Yusuke Kojima ,&nbsp;Yoshiki Katada ,&nbsp;Shunsaku Nakagawa ,&nbsp;Keisuke Umemura ,&nbsp;Yurie Katsube ,&nbsp;Daiki Hira ,&nbsp;Masahiro Tsuda ,&nbsp;Hiroki Ishimura ,&nbsp;Katsuyuki Matsumura ,&nbsp;Machiko Hirai ,&nbsp;Miki Nagao ,&nbsp;Satona Tanaka ,&nbsp;Daisuke Nakajima ,&nbsp;Hiroshi Date ,&nbsp;Tomohiro Terada","doi":"10.1016/j.jiac.2025.102745","DOIUrl":"10.1016/j.jiac.2025.102745","url":null,"abstract":"<div><div>Ganciclovir (GCV) plays an important role in preventing cytomegalovirus (CMV) infection after lung transplantation. Because of the large inter-individual and intra-individual variabilities in GCV pharmacokinetics, it has been suggested that individualized dosages based on blood levels are required. However, GCV pharmacokinetics during veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is unknown. Here, we describe a case in which blood levels of GCV were measured during ECMO after lung transplantation. Additionally, we compared the blood levels of GCV in this case with those of 11 lung transplant recipients who were not on ECMO. A woman in her 40s who underwent deceased-donor bilateral lung transplantation was treated with prolonged VA-ECMO postoperatively. Prophylactic administration of GCV (2.5 mg/kg/12 h) was initiated on postoperative day (POD) 7. The GCV trough concentration during ECMO (PODs 8–28) was 940 ± 854 ng/mL. Thrombocytopenia and renal dysfunction were observed on POD 23. Conversely, 11 adult patients who underwent lung transplantation in the same year as the present patient, but without ECMO, had a GCV trough concentration of 445 ± 263 ng/mL on PODs 8–28. This is the first report of GCV trough concentrations in a patient receiving VA-ECMO after lung transplantation. Compared with lung transplant patients not receiving ECMO, this patient undergoing ECMO exhibited elevated GCV blood trough concentrations, along with acute kidney injury and thrombocytopenia. When GCV is administered during VA-ECMO, therapeutic drug monitoring may be necessary to prevent adverse reactions and account for intra-individual variability.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 8","pages":"Article 102745"},"PeriodicalIF":1.9,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225617","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}