Journal of Infection and Chemotherapy最新文献

{"title":"Efficacy of oral antivirals and combination therapy with remdesivir in hematological patients with COVID-19","authors":"Kaito Takikawa,&nbsp;Mana Sota,&nbsp;Yui Imai,&nbsp;Hirofumi Nakano,&nbsp;Tomoyuki Uchida,&nbsp;Morihiro Inoue,&nbsp;Masao Hagihara","doi":"10.1016/j.jiac.2025.102805","DOIUrl":"10.1016/j.jiac.2025.102805","url":null,"abstract":"<div><h3>Introduction</h3><div>Patients with hematological malignancies are at a high risk of contracting COVID-19, developing severe disease, and experiencing antiviral treatment failure. The present study examined the effectiveness of oral antivirals, and assessed the efficacy of combination therapy with remdesivir (RDV) and oral antivirals.</div></div><div><h3>Methods</h3><div>All patients with hematological disorders in our institution between May 20, 2023 and October 31, 2024 who developed COVID-19 during this period were included. Patients were treated with RDV, nirmatrelvir/ritonavir (Nir/Rit), ensitrelvir (Ens), or combinations of these drugs. Antiviral combination therapy was selected for patients receiving chemotherapy, those with infections occurring prior to treatment for their underlying disease, and cases in which initial antiviral treatment was ineffective.</div></div><div><h3>Results</h3><div>Forty-six patients were included in this study. When used as 1st-line treatments, viral load reductions by the oral antivirals Nir/Rit or Ens (a significant reduction in the viral load was defined as achieving a Ct value ≥ 30; 50 or 44 %, respectively) were superior to that by intravenous RDV (0 %). Combination therapy with Rit/Nir or Ens plus RDV was effective in 12 out of 13 cases (92 %) when used as a 1st-line treatment, and in all 9 cases when used as 2nd⁻ or 3rd-line treatment.</div></div><div><h3>Conclusions</h3><div>Nir/Rit and Ens may exhibit superior antiviral efficacy compared to RDV in COVID-19 patients with underlying hematological malignancies. Combination therapy needs to be considered for patients with high risk of severe disease or persistent infection, and in cases where a rapid therapeutic response is urgently required for the management of the underlying malignancy.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 10","pages":"Article 102805"},"PeriodicalIF":1.5,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957221","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":"Antiviral combination therapy in severely immunocompromised patients with persistent or recurrent COVID-19","authors":"Keitaro Omori ,&nbsp;Hiroki Kitagawa ,&nbsp;Ayako Takamori ,&nbsp;Tetsumi Yoshida ,&nbsp;Takuji Omoto ,&nbsp;Toshihito Nomura ,&nbsp;Yuko Kubo ,&nbsp;Norifumi Shigemoto ,&nbsp;Tomoyuki Akita ,&nbsp;Yasushi Orihashi ,&nbsp;Tatsuo Ichinohe ,&nbsp;Noboru Hattori ,&nbsp;Hiroki Ohge","doi":"10.1016/j.jiac.2025.102802","DOIUrl":"10.1016/j.jiac.2025.102802","url":null,"abstract":"<div><h3>Background</h3><div>Antiviral agents are the primary treatment for coronavirus disease 2019 (COVID-19). Severely immunocompromised patients may experience persistent illnesses or multiple recurrences despite antiviral therapy, and optimal management remains unclear. We evaluated the efficacy of conventional monotherapy versus combination antiviral therapy in this population.</div></div><div><h3>Methods</h3><div>This single-center, retrospective cohort study enrolled severely immunocompromised patients with COVID-19 in whom initial therapy failed post-diagnosis. The success rates of conventional monotherapy and combination therapy in the second and later courses were evaluated. Combination therapy was defined as the sequential or concurrent use of ≥2 antiviral agents. Factors associated with treatment success were evaluated using a generalized linear mixed model.</div></div><div><h3>Results</h3><div>Of the 23 enrolled patients, 87.0 % had hematologic malignancies and 69.6 % were receiving B-cell-depleting therapy. After initial treatment failure, patients received between two and six additional courses. Of the 34 courses, 22 were conventional monotherapy and 12 were combination therapy; overall success rates were 50.0 % and 91.7 %, respectively. Considering only the second course, success rates were 56.3 % for monotherapy and 100 % for combination therapy. The median (range) treatment durations were 5 days (3–10) for monotherapy and 10 days (10–25) for combination therapy. Each agent was administered consecutively for its approved duration. Combination therapy was associated with treatment success (p = 0.036).</div></div><div><h3>Conclusions</h3><div>Subsequent conventional monotherapy failed in approximately half of severely immunocompromised patients who experienced treatment failure on the initial COVID-19 treatment. Antiviral combination therapy has a high clinical success rate and may be useful.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 10","pages":"Article 102802"},"PeriodicalIF":1.5,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144916465","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 associated with respiratory syncytial virus-neutralizing antibody titers in adults","authors":"Kensuke Shoji ,&nbsp;Masaki Yamada ,&nbsp;Michi Hisano ,&nbsp;Yusuke Okubo ,&nbsp;Erika Obikane ,&nbsp;Koushi Yamaguchi","doi":"10.1016/j.jiac.2025.102801","DOIUrl":"10.1016/j.jiac.2025.102801","url":null,"abstract":"<div><h3>Background</h3><div>Respiratory syncytial virus (RSV) is associated with high morbidity in children. Despite recent advances in vaccine development for adults and maternal vaccination strategies to protect newborns, data on RSV seroprevalence and neutralizing antibody titers in adults remain limited. This study aimed to measure RSV-neutralizing antibody titers in adults and explore associated background characteristics.</div></div><div><h3>Methods</h3><div>This cross-sectional study was conducted from July 10 to July 18, 2024, among healthcare and non-healthcare workers at a pediatric medical facility in Japan. Blood samples collected during routine health checkups were analyzed for RSV-neutralizing antibody titers. Multivariable modified Poisson regression was used to examine associations between antibody titers and background characteristics collected using a structured questionnaire. A restricted cubic spline model was applied to assess age-related trends in antibody titers.</div></div><div><h3>Results</h3><div>Among 1226 participants, 4.5 % were seronegative and 63.5 % had RSV-neutralizing antibody titers ≥8-fold. The spline model showed that titers were highest in the early 20s, declined in the 30s, modestly increased in the early 40s, and declined thereafter. Higher titers (≥8-fold) were associated with age 30–39 years (prevalence ratio [PR], 0.85; 95 % confidence interval [CI], 0.74–0.97), presence of chronic disease (PR, 1.11; 95 %CI, 1.01–1.22), and having children &lt;9 years in the household (PR, 1.17; 95 %CI, 1.03–1.33).</div></div><div><h3>Conclusions</h3><div>RSV-neutralizing antibody titers showed age-dependent variation, with notably lower levels among individuals in their 30s. Higher titers were associated with chronic conditions and living with younger children, highlighting the role of exposure history in shaping immunity.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 10","pages":"Article 102801"},"PeriodicalIF":1.5,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144921387","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":"Corrigendum to \"Comparison of Clinical Characteristics of Hospitalized Pediatric Patients with Respiratory Syncytial Virus Infections before and during/after the Coronavirus Disease 2019 Pandemic in Japan -Importance of Universal Prevention using Maternal Vaccination and Nirsevimab\" [J Infect Chemother 31 (2025) 102779].","authors":"Yusuke Karahashi, Takayuki Yamanaka, Yuta Aizawa, Rie Habuka, Shinya Tsukano, Akihiko Saitoh","doi":"10.1016/j.jiac.2025.102800","DOIUrl":"10.1016/j.jiac.2025.102800","url":null,"abstract":"","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":" ","pages":"102800"},"PeriodicalIF":1.5,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957248","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 endogenous and collateral reactivation caused by two Mycobacterium tuberculosis subclones","authors":"Junji Seto ,&nbsp;Sumito Inoue ,&nbsp;Shuichi Abe ,&nbsp;Kyoko Terashita ,&nbsp;Yuko Endo ,&nbsp;Shunji Fujii ,&nbsp;Yusuke Sasaki ,&nbsp;Yuichi Kato ,&nbsp;Hidetoshi Yamashita ,&nbsp;Yoshiro Murase ,&nbsp;Satoshi Mitarai ,&nbsp;Tatsuya Ikeda ,&nbsp;Katsumi Mizuta ,&nbsp;Tadayuki Ahiko ,&nbsp;Takayuki Wada","doi":"10.1016/j.jiac.2025.102795","DOIUrl":"10.1016/j.jiac.2025.102795","url":null,"abstract":"<div><div>Endogenous reactivation of tuberculosis (TB) has been considered a process in which <em>Mycobacterium tuberculosis</em> subclones continuously accumulate genome mutations from the initial isolate. However, we encountered a case of endogenous reactivation that <em>M. tuberculosis</em> isolated from the primary disease and recurrence collaterally diverging from an original clone. In a retrospective cohort study, a recurrent TB case was thoroughly investigated in 2012 and 2020 in Yamagata, Japan. This included an evaluation of the clinical course, including computed tomography (CT) findings, retrospective contact tracings, molecular epidemiological investigations, and whole-genome sequencing of <em>M. tuberculosis</em>. CT imaging revealed new lesions in different regions of the right lung in 2012 and 2020. Retrospective contact tracings and a molecular epidemiological surveillance using variable-number tandem repeat typing ruled out exogenous reinfection. A genome comparison of two <em>M. tuberculosis</em> isolates cultured in 2012 and 2020 revealed 14 single nucleotide variants, with each accumulating 7 single nucleotide variants from the original clone. These findings provide evidence that <em>M. tuberculosis</em> subclones in different lung lesions within the same host can accumulate genome mutations collaterally. Our case report indicates that recognizing the potential for collateral reactivation may enhance strategies for tracing transmission routes and deepen our understanding of the evolution of drug resistance. Future research should focus on identifying additional cases of collateral reactivation, supported by both pathophysiological and genome microbiological evidence.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 10","pages":"Article 102795"},"PeriodicalIF":1.5,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908417","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 leptospirosis contracted through occupational exposure in the Tokyo metropolitan area","authors":"Kyoko Yoshida ,&nbsp;Kazuaki Fukushima ,&nbsp;Yukari Nishikawa ,&nbsp;Seowoong Jung ,&nbsp;Masaru Tanaka ,&nbsp;Taiichiro Kobayashi ,&nbsp;Atsushi Ajisawa ,&nbsp;Nobuo Koizumi ,&nbsp;Yukihiro Akeda ,&nbsp;Akifumi Imamura","doi":"10.1016/j.jiac.2025.102799","DOIUrl":"10.1016/j.jiac.2025.102799","url":null,"abstract":"<div><div>Leptospirosis is a zoonotic disease caused by direct or indirect contact with rodent reservoirs. Although it is widely known to be endemic in tropical countries, several cases have been reported even in metropolitan areas of non-tropical countries. Herein, we report a case of leptospirosis caused by occupational exposure in the Tokyo metropolitan area.</div><div>A 24-year-old man presented with fever, headache, and systemic arthralgia. Laboratory tests revealed thrombocytopenia, abnormal liver function, and impaired renal function. Although he denied any direct contact with rats, his workplace was contaminated with them, which was key to the diagnosis. <em>Leptospira interrogans</em> serogroup Icterohaemorrhagiae ST17 was identified as the causative agent based on multilocus sequence typing of the urine sample and the microscopic agglutination test of the paired serum samples. Subsequent epidemiological investigation revealed that <em>L. interrogans</em> serogroup Icterohaemorrhagiae ST17 was isolated from rats captured in the vicinity of the patient's workplace.</div><div>To the best of our knowledge, this is the first case of leptospirosis in Japan in which the same <em>Leptospira</em> genotype was identified in both the patients and the rats trapped around the patient's workplace. Although there is a widespread misconception that leptospirosis is a tropical disease, several cases are reported annually even in non-tropical industrialized cities, such as Tokyo, where rodents play a significant role in human infection. Diagnosis of leptospirosis is sometimes challenging for clinicians, but the first step in diagnosis is to recognize that there is always a risk of infection with <em>Leptospira</em> spp. in any environment potentially contaminated by rats.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 10","pages":"Article 102799"},"PeriodicalIF":1.5,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144890789","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":"Dengue virus serotype 4 infection diagnosed not by rapid antigen test, but by real-time reverse transcription-PCR and enzyme-linked immunosorbent assay: A case report","authors":"Ryosaku Oshiro ,&nbsp;Kayoko Hayakawa ,&nbsp;Takahiro Maeki ,&nbsp;Shigeru Tajima ,&nbsp;Satoshi Taniguchi ,&nbsp;Chang-Kweng Lim ,&nbsp;Yutaro Akiyama ,&nbsp;Kei Yamamoto ,&nbsp;Shotaro Ide ,&nbsp;Akitsugu Furumoto ,&nbsp;Norio Ohmagari","doi":"10.1016/j.jiac.2025.102797","DOIUrl":"10.1016/j.jiac.2025.102797","url":null,"abstract":"<div><div>A 39-year-old Japanese male visited our hospital with fever, headache, and joint pain after a 5-day trip to Malaysia. Blood tests revealed decreased white blood cell and platelet counts. Although dengue was suspected, a rapid diagnostic test (RDT) on the 5th day after symptom onset was negative for dengue virus (DENV) nonstructural protein 1 (NS1) antigen, DENV IgM antibody, and DENV IgG antibody. Since dengue could not be ruled out in light of the clinical symptoms, an additional real-time reverse transcription-PCR (RT-PCR) test and enzyme-linked immunosorbent assay (ELISA) were performed. The DENV serotype 4 (DENV-4) genome was detected in the serum using real-time RT-PCR. DENV NS1 antigen, IgM antibody, and IgG antibody were detected in the serum using ELISA. This is a case of dengue diagnosed based not on RDT but on real-time RT-PCR and ELISA. When RDT results are negative, but dengue is suspected, additional real-time RT-PCR or ELISA testing must be performed to correctly diagnose patients with DENV infection.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 10","pages":"Article 102797"},"PeriodicalIF":1.5,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908416","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 mediastinal pyogenic lymphadenitis in a patient with chronic mucocutaneous candidiasis","authors":"Ryohei Watanabe ,&nbsp;Ryosuke Wakatsuki ,&nbsp;Yohei Nishiyama ,&nbsp;Satoshi Miyamoto ,&nbsp;Akihiro Hoshino ,&nbsp;Takahiro Kamiya ,&nbsp;Takeshi Isoda ,&nbsp;Shota Okamoto ,&nbsp;Yoshifumi Ito ,&nbsp;Yuki Mizuno ,&nbsp;Kentaro Okamoto ,&nbsp;Aiko Honda ,&nbsp;Megumi Okawa ,&nbsp;Toshiyuki Takagi ,&nbsp;Kosei Yamashita ,&nbsp;Masatoshi Takagi ,&nbsp;Hirokazu Kanegane","doi":"10.1016/j.jiac.2025.102796","DOIUrl":"10.1016/j.jiac.2025.102796","url":null,"abstract":"<div><div>Chronic mucocutaneous candidiasis disease (CMCD) is an inborn error of immunity characterized by persistent and recurrent mucosal infections caused by <em>Candida</em> spp. <em>STAT1</em> gain-of-function (GOF) is the main causative gene of CMCD and confers resistance to several pathogens including opportunistic ones, such as <em>Candida</em> spp. This report describes the case of a four-year-old boy with CMCD due to <em>STAT1</em> GOF variant complicated by refractory mediastinal pyogenic lymphadenitis. The patient received seven weeks of intravenous therapy and subsequently four weeks of oral antibiotics and was cured with no relapse after completion of therapy. During antibiotic therapy, the patient developed exudative pleural effusion and required thoracentesis to improve respiratory distress. Despite the negative culture test results, the patient responded well to antibiotics and was suspected of having a bacterial infection. The immunodeficiency spectrum of CMCD suggested that the infection might have been caused by <em>Staphylococci</em> or <em>Streptococci</em>. In this patient, finding optimal secondary prophylaxis against bacteria was challenging because of allergic reactions to trimethoprim/sulfamethoxazole and subcutaneous immunoglobulin and drug interactions between azole and macrolide antimicrobial agents. Although Janus kinase inhibitors and allogeneic hematopoietic cell transplantation are options, neither treatment is supported by reliable evidence. Further studies are needed to understand the bacterial infections that occur in patients with CMCD and develop better prophylactic management against microorganisms.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 10","pages":"Article 102796"},"PeriodicalIF":1.5,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144864670","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 effectiveness of repeated vaccination for COVID-19 symptom resolution during the KP.3-dominant epidemic period in Japan: A retrospective multicenter study","authors":"Takuma Bando,&nbsp;Hideyuki Ikematsu,&nbsp;Naoki Kawai,&nbsp;Keigo Shibao,&nbsp;Masayuki Mizuguchi,&nbsp;Tokunao Amemiya,&nbsp;Satoshi Tsuchiya,&nbsp;Yoshitaka Oribe,&nbsp;Woon Joo Lee,&nbsp;Tetsunari Maeda,&nbsp;Takashi Kawashima,&nbsp;Shinro Matsuura,&nbsp;Ken-ichi Doniwa,&nbsp;Hitoshi Asamoto,&nbsp;Masahiro Sugawara","doi":"10.1016/j.jiac.2025.102798","DOIUrl":"10.1016/j.jiac.2025.102798","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effect of repeated vaccination on coronavirus disease (COVID-19) symptoms.</div></div><div><h3>Methods</h3><div>This retrospective, multicenter study was conducted across 15 Japanese medical institutions during the 11th wave of the COVID-19 epidemic in Japan. Patients diagnosed with COVID-19 via rapid antigen testing between July 1, 2024, and September 30, 2024, were enrolled. Data were collected using a questionnaire.</div></div><div><h3>Results</h3><div>The data of 408 patients were available for analysis; including 42.6 % were 40–59 years of age, 61.5 % female, and 35.8 % had a history of COVID-19. Seven doses of vaccine were associated with a significantly lower maximum body temperature and shorter fever duration (−0.79 °C, p &lt; 0.001, and −1.50 days, p &lt; 0.001, respectively). Past infection was associated with a significantly lower maximum body temperature and shorter fever duration (−0.35 °C, p &lt; 0.001, and −0.75 days, p &lt; 0.001, respectively). The symptoms in patients with past infection were significantly fewer at days 7, 14, and 30 than were those without past infection. For patients vaccinated seven times, symptoms were fewer after day 14. No significant difference was observed in the interval between onset and the last vaccination.</div></div><div><h3>Conclusion</h3><div>Repeated COVID-19 vaccination, particularly seven doses, was correlated with a lower maximum body temperature and shorter fever and symptom duration for patients during the 11th wave dominated by KP.3 variant. These findings highlight the importance of repeated vaccinations to mitigate the symptoms of COVID-19 with emerging variants.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 10","pages":"Article 102798"},"PeriodicalIF":1.5,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144864669","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":"Clinical characteristics and antibiotic susceptibility of Lactobacillus bacteremia: A retrospective analysis","authors":"Yuichi Shibata ,&nbsp;Nobuhiro Asai ,&nbsp;Mao Hagihara ,&nbsp;Hiroshige Mikamo","doi":"10.1016/j.jiac.2025.102794","DOIUrl":"10.1016/j.jiac.2025.102794","url":null,"abstract":"<div><h3>Background</h3><div><em>Lactobacillus</em> bacteremia (LB) is an uncommon cause of infection in immunocompetent individuals, owing to its low pathogenicity. However, bacteremia has been reported in immunocompromised patients. In Japan, clinical data on the characteristics and antimicrobial susceptibility of LB remain limited. Hence, a retrospective analysis was conducted at our institution to address this gap.</div></div><div><h3>Methods</h3><div>Patients in whom <em>Lactobacillus</em> spp. were identified from blood cultures at the Aichi Medical University Hospital between April 2018 and March 2025 were included in our study. Clinical characteristics and antimicrobial susceptibility profiles of the isolates were retrospectively analyzed.</div></div><div><h3>Results</h3><div>A total of 17 patients (13 men and 4 women) were included in the study and all patients received antibiotic treatment. The most common bacterial species detected was <em>Lacticaseibacillus paracasei</em> (47.1 %). All isolates exhibited 100.0 % susceptibility to ampicillin. Risk factors were present in 82.4 % of patients, and concomitant polymicrobial infections occurred in 70.6 % of the cohort. <em>Candida</em> spp. were the most frequently identified organisms in polymicrobial infections (33.3 %). Six patients (35.3 %) died within 30 days after bacteremia diagnosis, with a median time to death of 26.5 days (range, 2.0–1468.0 days).</div></div><div><h3>Conclusions</h3><div>The detection rate of <em>L. paracasei</em> in this study was higher than that reported in countries outside of Asia. High susceptibility to penicillin was maintained, suggesting that penicillin remains to be an appropriate choice for both empirical and definitive therapy in Japan.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 10","pages":"Article 102794"},"PeriodicalIF":1.5,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873545","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}