Journal of Infection and Chemotherapy最新文献

{"title":"Gastrointestinal anaerobes and Enterococcus faecalis promote Candida glabrata gastrointestinal colonization and organ dissemination","authors":"Masahiro Abe ,&nbsp;Tsuyoshi Sekizuka ,&nbsp;Yoshitsugu Miyazaki","doi":"10.1016/j.jiac.2025.102658","DOIUrl":"10.1016/j.jiac.2025.102658","url":null,"abstract":"<div><h3>Background</h3><div><em>Candida glabrata</em> is a common causative pathogen of endogenous candidiasis. It is assumed that the gastrointestinal flora affects <em>C. glabrata</em> gastrointestinal colonization and organ dissemination in the gastrointestinal tract (GIT). However, no reports have yet described the relationships between <em>C. glabrata</em> and bacteria in the GIT. This study aimed to clarify these relationships using a mouse endogenous candidiasis model with cortisone acetate immunosuppression.</div></div><div><h3>Methods</h3><div>Dysbiosis was induced in the GIT by several antibiotic combinations, and then <em>C. glabrata</em> gastrointestinal colonization and organ dissemination were evaluated. Next, metagenomic sequencing analysis of the gastrointestinal flora was performed to identify bacteria associated with <em>C. glabrata</em> organ dissemination. Finally, coinfection experiments were performed using bacteria isolated from the mouse GIT.</div></div><div><h3>Results</h3><div><em>C. glabrata</em> organ dissemination was significantly promoted using specific antibiotics regardless of the amount of colonization in the GIT. Metagenomic sequencing analysis of the gastrointestinal flora showed that <em>Enterococcus</em> species and anaerobes were significantly associated with enhanced organ dissemination, whereas <em>Enterobacterales</em>, such as <em>Escherichia</em> species and <em>Klebsiella</em> species, were associated with the suppression of organ dissemination. In coinfection experiments, <em>Enterococcus faecalis</em> and <em>Faecalibaculum rodentium</em> inoculation, but not either of them, increased <em>C. glabrata</em> organ dissemination without affecting gastrointestinal colonization.</div></div><div><h3>Conclusions</h3><div>Coinfection with gastrointestinal bacteria promoted <em>C. glabrata</em> organ dissemination, which would indicate that gastrointestinal flora could affect <em>C. glabrata</em> dissemination. Therefore, the gastrointestinal flora could be a target for intervention or treatment in clinical settings. Insights from this study would lead to better control of endogenous candidiasis focusing on the gastrointestinal flora.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 4","pages":"Article 102658"},"PeriodicalIF":1.9,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433167","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 manifestations of COVID-19 Omicron variants in medical healthcare workers: Focusing on the cough","authors":"Naoyuki Miyashita ,&nbsp;Yasushi Nakamori ,&nbsp;Makoto Ogata ,&nbsp;Naoki Fukuda ,&nbsp;Akihisa Yamura ,&nbsp;Tomoki Ito","doi":"10.1016/j.jiac.2025.102659","DOIUrl":"10.1016/j.jiac.2025.102659","url":null,"abstract":"<div><h3>Introduction</h3><div>Important points in cough management are that it is necessary to be familiar with the characteristic medical history for each disease, such as infection and cough variant asthma. To clarify whether cough due to SARS-CoV-2 has any characteristics or not, we investigated the clinical manifestations of COVID-19 Omicron variant focused especially on infectious cough.</div></div><div><h3>Methods</h3><div>We enrolled adult patients consecutively diagnosed with mild COVID-19 who were medical healthcare workers in our five hospitals. A total of 2449 patients were analyzed: 300 patients with BA.1 subvariant, 202 patients with BA.2 subvariant, 1030 patients with BA.5 subvariant, 413 patients with XBB lineage, 103 patients with BA.2.86, and 401 patients with JN.1 subvariant.</div></div><div><h3>Results</h3><div>Among the clinical symptoms, cough was most frequent symptom in all Omicron subvariants groups and all age groups. The most frequent pattern of symptoms was cough appearing after pharyngeal symptoms in 38 % of patients, with cough appearing after fever observed in 25.1 % of patients. The pattern in which cough and pharyngeal symptoms were the initial symptoms was observed in 19.6 % of cases, and where cough and fever were the initial symptoms was observed in 14.9 % of cases.</div></div><div><h3>Conclusions</h3><div>Cough was the most frequent symptom in patients with COVID-19 Omicron variant and cough was the initial symptom in 1/3 of cases, and 2/3 of cases were preceded by symptoms other than cough. There were few cases of cough only or paroxysmal cough. However, it is considered difficult to differentiate between sources of infectious cough based on symptoms alone.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 4","pages":"Article 102659"},"PeriodicalIF":1.9,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425492","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":"Association of doses based on body constitutional parameters with the efficacy of micafungin in candidemia","authors":"Masaya Nagamizu ,&nbsp;Yuji Hotta ,&nbsp;Masato Noda ,&nbsp;Daigaku Nakamura ,&nbsp;Masayuki Hori ,&nbsp;Yuto Otsuka ,&nbsp;Ryuhei Takemoto ,&nbsp;Yasuhiro Horita ,&nbsp;Eri Wakita ,&nbsp;Nobuyuki Morishita ,&nbsp;Masahiro Kondo ,&nbsp;Yoko Furukawa–Hibi ,&nbsp;Kazunori Kimura","doi":"10.1016/j.jiac.2025.102654","DOIUrl":"10.1016/j.jiac.2025.102654","url":null,"abstract":"<div><h3>Background</h3><div>Invasive candidiasis is a life-threatening infection associated with high mortality, necessitating early and effective treatment. Micafungin, an echinocandin, is recommended as initial therapy for invasive candidiasis. However, the optimal micafungin dose relative to patients’ body constitutional parameters (BCPs) remains unclear. This study aimed to evaluate the relationship between the dose of micafungin per BCPs (Dose/BCPs) and treatment outcomes.</div></div><div><h3>Methods</h3><div>This two-center retrospective study included patients treated with micafungin who had confirmed positive blood cultures for Candida species between January 1, 2010, and December 31, 2020. We assessed the association between Dose/BCP and treatment success, as well as time to recovery following micafungin therapy.</div></div><div><h3>Results</h3><div>Eighty-three patients were included in the analysis, with a median age of 78 years. The primary isolated <em>Candida</em> species were <em>Candida albicans</em> (n = 34), <em>Candida parapsilosis</em> (n = 19), and <em>Candida glabrata</em> (n = 16). The treatment success rate was 44.6 % and was significantly associated with age ≥75 years. Although no significant differences in Dose/BCP were observed between the success and failure groups, patients with a Dose/BSA ≥100 mg/m² experienced a significantly shorter time to recovery with micafungin therapy.</div></div><div><h3>Conclusion</h3><div>Our study identified an association between Dose/BSA and the time to recovery with micafungin therapy. While some missing data, including APACHE-II scores, limit the robustness of the findings because of the retrospective design, dose adjustment to achieve Dose/BSA ≥100 mg/m² may be beneficial in antifungal stewardship. This adjustment could reduce treatment duration with this broad-spectrum antifungal agent.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 4","pages":"Article 102654"},"PeriodicalIF":1.9,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374152","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":"Clinical and microbiological characteristics of skin and soft tissue infections of the extremities with bacteremia in patients with malignancy","authors":"Taisuke Enokida ,&nbsp;Sohei Harada ,&nbsp;Koh Okamoto ,&nbsp;Daisuke Ohkushi ,&nbsp;Koichi Takeda ,&nbsp;Kosuke Hoashi ,&nbsp;Toshiharu Sasaki ,&nbsp;Kazumi Takehana ,&nbsp;Yohei Doi ,&nbsp;Masahiro Suzuki ,&nbsp;Brian Hayama","doi":"10.1016/j.jiac.2025.102656","DOIUrl":"10.1016/j.jiac.2025.102656","url":null,"abstract":"<div><h3>Introduction</h3><div>Although skin and soft tissue infections (SSTIs) of the extremities are primarily caused by Gram-positive cocci (GPC), some cases are caused by Gram-negative rod (GNR). In addition, malignancy is a recognized risk factor for GNR infection. Nevertheless, information on the clinical and microbiologic characteristics of SSTIs of the extremities caused by GNR in patients with malignancy is limited.</div></div><div><h3>Methods</h3><div>Clinical and microbiological characteristics of patients with malignancy who developed bacteremic SSTIs of the extremities at a single cancer center over eight years were reviewed. In addition, whole-genome sequencing of the GNR isolates causing necrotizing fasciitis was conducted.</div></div><div><h3>Results</h3><div>Of 42 cases identified, 32 cases (76.2 %) and 10 cases (23.8 %) were caused by GPC and GNR, respectively. Four cases in the GNR group were due to <em>Escherichia coli</em>, and the remaining cases were caused by diverse species. The majority of cases in the GNR group were hospital-onset and the lesions were limited to a single extremity. Chronic liver disease, cellular immunodeficiency, or anatomic abnormalities of the gastrointestinal, biliary, or urinary tract underlay seven GNR cases (70 %). Inappropriate empiric therapy was numerically more common in the GNR group compared to the GPC group (33.3 % vs. 9.4 %, p = 0.107). Whole-genome sequencing analysis revealed that two cases of GNR necrotizing fasciitis were caused by <em>E. coli</em> ST1193-<em>fimH</em>64 and <em>Klebsiella pneumoniae</em> K2-ST86.</div></div><div><h3>Conclusions</h3><div>GNR organisms are a significant cause of SSTIs of the extremities in patients with malignancy and may be associated with inappropriate empiric therapy.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 4","pages":"Article 102656"},"PeriodicalIF":1.9,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382388","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":"Transmission of a plasmid harboring NDM-1 gene between Salmonella Typhimurium and Escherichia coli strains in an infant","authors":"Xiangjin Zhu ,&nbsp;Tinghua Ye ,&nbsp;Yingqian Sun ,&nbsp;Sipei Wang ,&nbsp;Shanshan Jin ,&nbsp;Xinling Pan","doi":"10.1016/j.jiac.2025.102655","DOIUrl":"10.1016/j.jiac.2025.102655","url":null,"abstract":"<div><h3>Background</h3><div><em>NDM-1</em> has been frequently identified in <em>Enterobacteriaceae</em> strains from clinical samples, but its occurrence in <em>Salmonella Typhimurium</em> (<em>S. Typhimurium</em>) is uncommon. Moreover, reports on the transmission of a plasmid harboring <em>NDM-1</em> between different species in clinical samples are rare.</div></div><div><h3>Methods</h3><div>Two <em>S. Typhimurium</em> strains and an <em>Escherichia coli</em> (<em>E. coli</em>) strain were isolated from a 14-month-old infant presenting with diarrhea. The resistance phenotypes were determined using the VITEK 2 Compact System. Genomic DNA was extracted from the isolated strains and whole genome sequencing was performed. The transmissibility of plasmids was validated by a conjugation experiment.</div></div><div><h3>Results</h3><div>The subsequently isolated <em>S. Typhimurium</em> and <em>E. coli</em> strains exhibited resistance to imipenem, and whole genomic analysis revealed that each strain harbored a plasmid harboring <em>NDM-1</em> and <em>Qnrs1</em> genes. The two plasmids were nearly identical based on their sequences and could transfer to recipient strains. A genomic region containing several genes encoding phosphoribosylanthranilate isomerase, bleomycin binding protein, subclass B1 metallo-beta-lactamase, and IS30-like element ISAba125 family transposase was surrounded by the two flanking <em>IS26</em> elements.</div></div><div><h3>Conclusion</h3><div>The transfer of plasmid harboring <em>NDM-1</em> between <em>S. Typhimurium</em> and <em>E</em>. <em>coli</em> strains within patients highlights the potential for widespread transmission between different species. Continuous monitoring these strains may be important for preventing extensive transmission of resistance genes.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 4","pages":"Article 102655"},"PeriodicalIF":1.9,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382406","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":"Infective native aortic and iliac artery aneurysms: Clinical profiles and short-term outcomes from a single-center cohort","authors":"Natsuki Shinya ,&nbsp;Masafumi Seki ,&nbsp;Haruka Karaushi ,&nbsp;Toshihisa Asakura ,&nbsp;Akihiro Yoshitake ,&nbsp;Kotaro Mitsutake","doi":"10.1016/j.jiac.2025.102644","DOIUrl":"10.1016/j.jiac.2025.102644","url":null,"abstract":"<div><h3>Introduction</h3><div>Infective native aortic and iliac artery aneurysms, although rare, have high mortality rates of 21%–44 %. Diagnosis is often delayed owing to nonspecific symptoms. Treatment includes surgical intervention and antimicrobial therapy. This study aimed to describe the clinical characteristics and short-term outcomes of 32 patients with infective aneurysms at a single center.</div></div><div><h3>Methods</h3><div>This retrospective study, conducted at the Saitama International Medical Center from January 2011 to December 2020, included patients diagnosed with infective native aortic and iliac artery aneurysms. The patients’ clinical data, microbiological and radiological findings, treatment methods, and outcomes were collected and analyzed.</div></div><div><h3>Results</h3><div>Of the 32 patients, 56.3 % presented with fever (≥37.5 °C) and 87.5 % exhibited nonspecific symptoms, such as pain and loss of appetite. Blood cultures were positive in 18 patients (58.1 %), with <em>Staphylococcus aureus</em> being the predominant pathogen, isolated in 11 patients. Pathogens in 5 of the 11 cases (45 %) were resistant to methicillin. Surgery was performed in 75 % of patients, with 20 undergoing open surgical repair (OSR) and 4 undergoing endovascular treatment (EVT). The 1-year mortality rates of the patients who underwent OSR and EVT were 23.5 % (4/17) and 0 % (0/4), respectively. Postoperative infection-related complications occurred in 25 % of patients who underwent OSR. For nonsurgical patients, the 30-day and 1-year mortality rates were 25 % (2/8) and 85.7 % (6/7), respectively.</div></div><div><h3>Conclusion</h3><div>The findings of this study highlight the high mortality rates associated with infective aneurysms. <em>S. aureus</em> was the predominant pathogen, differing from trends observed in other Asian regions.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 4","pages":"Article 102644"},"PeriodicalIF":1.9,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374155","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":"Invasive pneumococcal disease caused by CO2-dependent Streptococcus pneumoniae serotype 24F sequence type 162: A case report","authors":"Takahiko Niwa ,&nbsp;Takehisa Matsumoto ,&nbsp;Misako Ohkusu ,&nbsp;Naruhiko Ishiwada ,&nbsp;Kazunori Fukushima ,&nbsp;Suguru Hiramoto ,&nbsp;Azusa Uchida ,&nbsp;Katsuhiko Tsunekawa ,&nbsp;Kiyohiro Oshima ,&nbsp;Takao Kimura","doi":"10.1016/j.jiac.2025.102653","DOIUrl":"10.1016/j.jiac.2025.102653","url":null,"abstract":"<div><div>We report the case of a man in his 70s who developed invasive pneumococcal disease (IPD) caused by CO₂-dependent <em>Streptococcus pneumoniae</em>. He was admitted with suspected pneumonia based on chest X-ray and computed tomography imaging findings. Ceftriaxone treatment was initiated following the collection of sputum samples and two sets of blood cultures. The antimicrobial treatment was then changed to sulbactam/ampicillin (SBT/ABPC) because urine pneumococcal antigen testing performed on admission was positive. The following day, CO₂-dependent <em>S. pneumoniae</em> was isolated from the blood cultures and sputum sample, leading to a diagnosis of IPD. The patient continued SBT/ABPC treatment (6 g/day) but remained febrile and died 4 days after admission. Serotyping and whole-genome sequence analysis of the isolate revealed that it was serotype 24F and sequence type (ST) 162. A c.536C &gt; T mutation was identified in <em>murF</em> of the isolate compared with <em>S. pneumoniae</em> Spain9V-3. The isolation of CO₂-dependent <em>S. pneumoniae</em> serotype 24F ST162 from pediatric patients in Japan was recently reported. However, to the best of our knowledge, this is the first reported IPD case in an elderly patient caused by CO₂-dependent <em>S. pneumoniae</em> serotype 24F ST162. Thus, even in adults with IPD, caution should be exercised going forward.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 4","pages":"Article 102653"},"PeriodicalIF":1.9,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374157","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":"Fatal pneumonia with repeated detection of Talaromyces columbinus two years after haploidentical transplantation","authors":"Yuya Nakata ,&nbsp;Nozomu Yoshino ,&nbsp;Machiko Kusuda ,&nbsp;Shun-ichi Kimura ,&nbsp;Akari Matsuoka ,&nbsp;Tomohiro Meno ,&nbsp;Takuto Ishikawa ,&nbsp;Yuhei Nakamura ,&nbsp;Masakatsu Kawamura ,&nbsp;Junko Takeshita ,&nbsp;Shunto Kawamura ,&nbsp;Yukiko Misaki ,&nbsp;Kazuki Yoshimura ,&nbsp;Ayumi Gomyo ,&nbsp;Masaharu Tamaki ,&nbsp;Yasutaka Hoshino ,&nbsp;Takayuki Shinohara ,&nbsp;Yoshitsugu Miyazaki ,&nbsp;Hideki Nakasone ,&nbsp;Shinichi Kako ,&nbsp;Yoshinobu Kanda","doi":"10.1016/j.jiac.2025.102649","DOIUrl":"10.1016/j.jiac.2025.102649","url":null,"abstract":"<div><div><em>Talaromyces columbinus</em> was previously reported in two patients with lung infections under the name <em>Penicillium piceum</em> and one case of dual infection with <em>Aspergillus calidoustus</em> was recently reported.; currently, no treatment has been established. We identified a 61-year-old woman with fatal pneumonia with repeated detection of <em>T. columbinus</em> that developed two years after haploidentical transplantation using alemtuzumab for chronic myeloid leukemia in the blast phase. Seven months after transplantation, her minimal residual disease (MRD) turned positive. Thus, ponatinib was restarted, which resulted in MRD becoming negative again. Nine months after transplantation, she developed autoimmune hemolytic anemia (AIHA); treatment with prednisone (PSL) 35 mg was started. PSL was discontinued one year ten months after transplantation, but was resumed at 5 mg after relapse one year eleven months after transplantation. Two years after transplantation, she developed cough, and a CT scan showed bilateral pulmonary infiltrates. Initiation of antibiotics, voriconazole (VRCZ), posaconazole (PSCZ) and liposomal amphotericin B (L-AMB) did not improve her condition. Sputum culture detected <em>Penicillium</em> species, which was identified as <em>T. columbinus</em> by polymerase chain reaction (PCR). Since the minimal inhibitory concentration (MIC)/minimal effective concentration (MEC) ratio was lower for echinocandins, micafungin (MCFG) was added to L-AMB. However, the patient died of respiratory failure on day 38 of admission. This is the first reported case of <em>T. columbinus</em> infection in Japan. Managing this infection is challenging due to the lack of established diagnostic methods and treatments. Proactive diagnostic testing and case accumulation are needed.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 4","pages":"Article 102649"},"PeriodicalIF":1.9,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374154","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":"Isepamicin alone as antimicrobial prophylaxis for transrectal prostate needle biopsy: “Do we still need levofloxacin? ”","authors":"Hiroki Yamada ,&nbsp;Kojiro Tashiro ,&nbsp;Yusuke Takahashi ,&nbsp;Mariko Honda ,&nbsp;Hajime Ohnuma ,&nbsp;Keiji Yasue ,&nbsp;Mahito Atsuta ,&nbsp;Kei-Ichiro Miyajima ,&nbsp;Mimu Ishikawa ,&nbsp;Yuki Takiguchi ,&nbsp;Hiroshi Kiyota ,&nbsp;Takahiro Kimura","doi":"10.1016/j.jiac.2025.102645","DOIUrl":"10.1016/j.jiac.2025.102645","url":null,"abstract":"<div><div>The purpose of this study was to investigate whether conventional levofloxacin (LVFX) administration is unnecessary for transrectal ultrasound-guided prostate needle biopsy (TRP-Bx) in view of the increase in LVFX-resistant <em>Escherichia coli</em> and appropriate use of antibiotics. The study included 636 cases undergoing TRP-Bx, divided into two groups based on the prophylactic antibiotic regimen. Group 1 (n = 308) received both oral levofloxacin (LVFX) 500 mg and intravenous isepamicin (ISP) 400 mg. Group 2 (n = 328) received only intravenous ISP 400 mg. Biopsies involved sampling 12 cores using an 18G needle. A high-risk subgroup included patients with a large prostate (&gt;75 ml), severe dysuria, diabetes mellitus, or steroid use. Significantly more high-risk cases were in Group 2 than in Group 1 (35.7 % vs. 24.4 %, p = 0.003). Febrile genitourinary tract infections (fGUTIs) occurred in three patients (0.5 %), with no significant difference between the groups (0.3 % in Group 1 vs. 0.6 % in Group 2). No fGUTI complications were noted among high-risk cases in either group. Of the fGUTI cases, one involved LVFX-resistant <em>E. coli;</em> another involved <em>E. coli</em> susceptible to both LVFX and amikacin, isolated from blood. The single- and short-duration intravenous dose of ISP 400 mg would appear to be one of possible options in preventing TRP-Bx-related fGUTIs in both low-risk and high-risk patients.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 4","pages":"Article 102645"},"PeriodicalIF":1.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374158","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":"Days of antibiotic spectrum coverage (DASC) as predictors of recurrent Clostridioides difficile infection: A retrospective cohort study","authors":"Nobuaki Mori ,&nbsp;Yuichi Shibata ,&nbsp;Jun Hirai ,&nbsp;Nobuhiro Asai ,&nbsp;Hiroshige Mikamo","doi":"10.1016/j.jiac.2025.102650","DOIUrl":"10.1016/j.jiac.2025.102650","url":null,"abstract":"<div><h3>Background</h3><div>Broad-spectrum antibiotic use increases the risk of <em>Clostridioides difficile</em> infection (CDI), with recurrence rates varying by antibiotic type, spectrum, and treatment duration. We assessed CDI recurrence risk using the days of antibiotic spectrum coverage (DASC) score, considering antibiotic spectrum and use duration.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed patients with hospital-acquired CDI. A logistic regression analysis was used to evaluate CDI recurrence, incorporating three variables: DASC score prior to CDI diagnosis, type of anti-CDI drugs, or DASC score after CDI diagnosis.</div></div><div><h3>Results</h3><div>Overall, 246 patients were included, with 31 (12.6 %) cases of recurrence. Median DASC scores within 30 days prior to CDI diagnosis were higher in the recurrent group than in the non-recurrent group (128 [interquartile range: 106–217] vs. 80 [interquartile range: 39–142], p &lt; 0.01). Using the lowest quartile of DASC scores as the reference, the analysis indicated higher relative risks of CDI recurrence in the upper quartiles. However, daily DASC scores post-CDI diagnosis did not correlate with recurrence. Compared to metronidazole, fidaxomicin lowered the risk of CDI recurrence (relative risk 0.2, 95 % confidence interval: 0.1–0.8, p = 0.03).</div></div><div><h3>Conclusions</h3><div>The DASC score within 30 days prior to CDI diagnosis appears to be a predictive risk factor for CDI recurrence.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 4","pages":"Article 102650"},"PeriodicalIF":1.9,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365108","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}