Journal of Infection and Chemotherapy最新文献

{"title":"Isavuconazole in chronic pulmonary aspergillosis: What is the evidence?","authors":"Vitor Falcão de Oliveira ,&nbsp;Mariane Taborda ,&nbsp;Jéssica Toshie Katayose ,&nbsp;Bruno Victor dos Santos Prates ,&nbsp;Isadora Cristina de Souza Ritter ,&nbsp;Adriana Satie Gonçalves Kono Magri ,&nbsp;Edson Abdala ,&nbsp;Marcello Mihailenko Chaves Magri","doi":"10.1016/j.jiac.2025.102704","DOIUrl":"10.1016/j.jiac.2025.102704","url":null,"abstract":"<div><h3>Background</h3><div>Newer drugs like isavuconazole have been more widely used for invasive aspergillosis, where they are included as first-line treatments in major guidelines, whereas their use in chronic pulmonary aspergillosis (CPA) remains limited. Therefore, the aim of this study is to conduct a systematic review of the literature on the use of isavuconazole in CPA.</div></div><div><h3>Methods</h3><div>We searched PubMed/MEDLINE and Embase on August 9th, 2024. Our inclusion criteria included patients with CPA who were treated with isavuconazole. We summarized binary variables with counts and percentages, and continuous variables with mean and SD.</div></div><div><h3>Results</h3><div>We found 15 articles on CPA using isavuconazole. These studies were published after 2017, with a high predominance in high-income countries, especially US (40 %, n = 6) and UK (33.3 %, n = 5). There were 10 case reports, the majority of which used isavuconazole as salvage therapy. Two articles compared isavuconazole with voriconazole. The overall response rates at the end of treatment for CPA patients were similar, and the incidence of adverse drug reactions was numerically lower in the isavuconazole group compared to voriconazole. We found five articles on blood levels of isavuconazole. The mean isavuconazole serum level was &gt;1 mg/L in all studies, even at a 100-mg daily dose. In the retrospective studies, the rate of isavuconazole discontinuation ranged from 17 % to 36 %.</div></div><div><h3>Conclusion</h3><div>There is limited experience with isavuconazole in treating CPA. This study consolidates existing evidence on its use in CPA, highlighting its potential as a therapeutic option beyond invasive aspergillosis, though further research is needed.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 6","pages":"Article 102704"},"PeriodicalIF":1.9,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143828478","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":"Role of continuous infusion in Bayesian-assisted vancomycin dosing guided by area under the concentration-time curve in adults: A scoping review with case series","authors":"Kazutaka Oda ,&nbsp;Tomomi Katanoda ,&nbsp;Shoji Kondo ,&nbsp;Hirofumi Jono ,&nbsp;Hideyuki Saito","doi":"10.1016/j.jiac.2025.102703","DOIUrl":"10.1016/j.jiac.2025.102703","url":null,"abstract":"<div><h3>Introduction</h3><div>Continuous infusion (CI) of vancomycin offers potential benefits in achieving therapeutic drug levels and reducing nephrotoxicity compared to intermittent infusion (IntI). However, no studies from Japan have evaluated CI in detail. This study presents a scoping review with the relevant case series to assess the role of CI in Bayesian-assisted AUC-guided vancomycin dosing.</div></div><div><h3>Methods</h3><div>The scoping review was performed using PubMed, Web of Science, and Cochrane Library to identify studies published between 2018 and 2024. Data included study design, dosing methods, AUC estimation techniques, outcomes of nephrotoxicity, and therapeutic target achievement. The retrospective analysis was conducted on 15 cases treated with CI at Kumamoto University Hospital. Demographics, nephrotoxicity, and mortality outcomes were analyzed.</div></div><div><h3>Results</h3><div>The scoping review identified 10 studies, including one randomized controlled trial. Most studies relied on trough concentrations as surrogates for AUC in IntI groups, despite guidelines recommending against this approach. Target exposures for CI varied, with few studies aligning with AUC-guided dosing ranges of 400–600 μg h/mL. Of 15 cases included, four required increased dosing due to high creatinine clearance (CCr), achieving therapeutic targets without nephrotoxicity or mortality. The remaining 11 cases demonstrated variable outcomes, with only 45.5 % achieving therapeutic targets and 54.5 % developing nephrotoxicity.</div></div><div><h3>Conclusions</h3><div>Although the scoping review highlighted the need for further studies to optimize dosing strategies and clarify the comparative benefits of CI versus Bayesian-assisted IntI, CI may offer potential advantages in achieving therapeutic targets, particularly for adults requiring higher doses, such as those exceeding 3–4 g/day.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 5","pages":"Article 102703"},"PeriodicalIF":1.9,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143823819","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":"Can enterobacterales bacteremia with pyelonephritis be treated with ceftriaxone?","authors":"Yuichi Shibata ,&nbsp;Marisa Hirose ,&nbsp;Shiori Kondo ,&nbsp;Nobuhiro Asai ,&nbsp;Mao Hagihara ,&nbsp;Hiroshige Mikamo","doi":"10.1016/j.jiac.2025.102696","DOIUrl":"10.1016/j.jiac.2025.102696","url":null,"abstract":"<div><h3>Background</h3><div>Ceftriaxone (CTRX) is the antibiotic of choice for treating urinary tract infections (UTIs). However, CTRX has a lower urinary excretion rate than other β-lactam antibiotics. In 2023, Japan had a shortage of cefotiam (CTM), increasing the demand for CTRX for patients with UTIs. This study compared the efficacy of CTRX and other β-lactam antibiotics for Enterobacterales bacteremia and pyelonephritis.</div></div><div><h3>Methods</h3><div>Patients with <em>Escherichia coli</em>, <em>Klebsiella</em> spp, or <em>Proteus</em> spp in blood and urine cultures treated with β-lactam antibiotics at Aichi Medical University Hospital between July 2014 and February 2024 were retrospectively recruited. Overall, 123 patients were included in the study and divided into two groups based on the type of antibiotic treatment: CTRX main group (CTRX for ≥5 days) and other β-lactam main group (ampicillin, cefazoline, CTM, or cefotaxime for ≥5 days). Patients were propensity score-matched by age, Charlson comorbidity index, duration of intravenous antibiotic treatment, number of patients who switched to oral antibiotics, albumin levels, white blood cell count, C-reactive protein, body temperature, and need for intensive care unit admission. The primary outcomes were treatment side effects, outcomes, and mortality at 30 and 90 days.</div></div><div><h3>Results</h3><div>After propensity score matching, 26 patients were selected from each group. The all-cause 30-day mortality rate was 3.8 % in both groups. None of our patients experienced reinfections or rehospitalization for pyelonephritis.</div></div><div><h3>Conclusions</h3><div>CTRX treatment did not affect the prognosis of patients with Enterobacterales bacteremia and pyelonephritis. Therefore, avoiding using CTRX for UTIs because of lower urinary excretion rates may be unnecessary.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 6","pages":"Article 102696"},"PeriodicalIF":1.9,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143882315","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 primary meningococcal conjunctivitis in an older patient","authors":"Yu Matsuo ,&nbsp;Yu Monden ,&nbsp;Hiroshi Watanabe ,&nbsp;Hideyuki Takahashi ,&nbsp;Yukihiro Akeda ,&nbsp;Hodaka Akune ,&nbsp;Kensuke Sasaki ,&nbsp;Daiki Ishio ,&nbsp;Kohei Yamazaki ,&nbsp;Naotaka Tashiro ,&nbsp;Shigeo Yoshida","doi":"10.1016/j.jiac.2025.102702","DOIUrl":"10.1016/j.jiac.2025.102702","url":null,"abstract":"<div><div>Primary meningococcal conjunctivitis (PMC) is rare, and it is particularly rare in older patients. Patients with PMC may develop invasive meningococcal disease (IMD), which has an overall mortality rate of 8 %–14 %. An 81-year-old man presented to us with complaints of decreased vision and persistent pain in his right eye after ocular trauma. He had copious purulent discharge, conjunctival injection, corneal edema and Descemet's membrane folds in the right eye. The best-corrected visual acuity (BCVA) was 0.02. Levofloxacin 1.5 % eye drops and fluorometholone 0.1 % eye drops, each four times daily, were initiated before the results of conjunctival culture were available. <em>Neisseria meningitidis</em> was isolated 2 days after the patient's first visit. Cefmenoxime hydrochloride 0.5 % eye drops eight times daily were added and a single dose of oral levofloxacin 500 mg was administered to prevent IMD. After treatment, his symptoms resolved and BCVA increased to 0.8. The frequency of instillation of eye drops was reduced, and all medications were stopped 21 days after the first visit. The patient did not develop IMD. Later, the serogroup and sequence type of our isolate was revealed to be non-groupable and 11026, which is unique to Japan. All ST-11026 isolates have been found to lack the ability to synthesize capsular polysaccharide, which is one of the meningococcal pathogenicity. If a patient presents with conjunctivitis with copious ocular purulent discharge, conjunctival culture should be performed promptly for early diagnosis of PMC regardless of the patient's age.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 6","pages":"Article 102702"},"PeriodicalIF":1.9,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143829380","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":"Longitudinal impact of a pharmacist-led stepwise antimicrobial stewardship program on intravenous antimicrobial use at a small resource-limited Japanese hospital","authors":"Yasuhiro Sasaki ,&nbsp;Hiroshi Horiuchi ,&nbsp;Ayumi Umehara ,&nbsp;Masataka Yano ,&nbsp;Yasuaki Tagashira","doi":"10.1016/j.jiac.2025.102697","DOIUrl":"10.1016/j.jiac.2025.102697","url":null,"abstract":"<div><h3>Background</h3><div>Clinical pharmacists play a central role in the implementation of antimicrobial stewardship programs (ASP). However, personnel shortages, the lack of a system for career development, and other challenges impede the active contribution of clinical pharmacists to ASPs in Japan.</div></div><div><h3>Aim</h3><div>To conduct a long-term evaluation of a pharmacist-led antimicrobial stewardship program.</div></div><div><h3>Methods</h3><div>The present, retrospective study used segmented time-series analysis to examine antimicrobial consumption, blood culture practices, and the rate of resistance in pathogens to the antimicrobials prescribed.</div></div><div><h3>Findings</h3><div>After the ASP was introduced, days of therapy (DOT) with anti-pseudomonal agents demonstrated a downward trend (−0.31; 95 % confidence interval [CI]: −0.43 to −0.19; p &lt; 0.01). Moreover, the trend in the number of blood cultures after the intervention significantly increased (0.20; 95 % CI: 0.05 to 0.35; p = 0.01), and the rate of resistance of <em>Pseudomonas aeruginosa</em> to cefepime and piperacillin decreased. No significant change was observed in the DOT trend for total intravenous antimicrobial use before or after the intervention (−1.07; 95 % CI: −2.44 to 0.29; p = 0.12).</div></div><div><h3>Conclusion</h3><div>Although the role of pharmacists in an ASP should continue to be examined, the present, longitudinal study found that stepwise introduction of an ASP reduced broad-spectrum antimicrobial use and was associated with a decrease in the antimicrobial resistance rate of <em>Pseudomonas aeruginosa</em> but not of third-generation cephalosporin-resistant <em>Escherichia coli</em> or MRSA.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 6","pages":"Article 102697"},"PeriodicalIF":1.9,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143851726","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":"Short-course treatment for community-acquired pneumonia in adults aged less than 65 years in Japan: A descriptive study using large healthcare claims database","authors":"Mikiyasu Sakai ,&nbsp;Takamasa Sakai ,&nbsp;Fumiko Ohtsu","doi":"10.1016/j.jiac.2025.102698","DOIUrl":"10.1016/j.jiac.2025.102698","url":null,"abstract":"<div><h3>Introduction</h3><div>In community-acquired pneumonia (CAP), short-course treatment is not inferior in effectiveness compared to conventional treatment durations, and clinical guidelines recommend 5–7-day-long treatments. However, it remains unclear how widely this practice is adopted in Japan. This study aimed to clarify the treatment duration of CAP in Japan using a large healthcare claims database.</div></div><div><h3>Methods</h3><div>We used health insurance claims data provided by JMDC Inc. (Tokyo, Japan) and included patients aged 18–64 years diagnosed with CAP who began antibiotic treatment between January 1, 2013, and December 31, 2022. Short-course treatment was defined as ≤ 7 d. Analyses were conducted separately for inpatient and outpatient cases, and the annual trends were also investigated.</div></div><div><h3>Results</h3><div>Overall, 25,572 patients (3367 inpatients and 22,205 outpatients) were included in the analysis. Short-course treatment was administered to 1087 (32 %) inpatients and 15,614 (70 %) outpatients. The proportion of short-course treatments during the 10-year study period was 31–35 % for inpatient cases and 67–72 % for outpatient cases, with no marked changes over the years.</div></div><div><h3>Conclusions</h3><div>The proportion of inpatients receiving short-course treatments for CAP was low. In Japan, especially for inpatient cases, further efforts are required to optimize the duration of CAP treatment.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 5","pages":"Article 102698"},"PeriodicalIF":1.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143823817","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":"External validation of a flowchart related to achieving the target area under the concentration-time curve for vancomycin: A retrospective multicenter study","authors":"Tomoyuki Ishigo ,&nbsp;Ayako Suzuki ,&nbsp;Yuta Ibe ,&nbsp;Satoshi Fujii ,&nbsp;Masahide Fukudo ,&nbsp;Hiroaki Yoshida ,&nbsp;Hiroaki Tanaka ,&nbsp;Hisato Fujihara ,&nbsp;Fumihiro Yamaguchi ,&nbsp;Fumiya Ebihara ,&nbsp;Takumi Maruyama ,&nbsp;Yusuke Yagi ,&nbsp;Yukihiro Hamada ,&nbsp;Masaru Samura ,&nbsp;Fumio Nagumo ,&nbsp;Toshiaki Komatsu ,&nbsp;Atsushi Tomizawa ,&nbsp;Akitoshi Takuma ,&nbsp;Hiroaki Chiba ,&nbsp;Yoshifumi Nishi ,&nbsp;Kazuaki Matsumoto","doi":"10.1016/j.jiac.2025.102701","DOIUrl":"10.1016/j.jiac.2025.102701","url":null,"abstract":"<div><div>During therapeutic drug monitoring (TDM) for vancomycin (VCM), the area under the concentration-time curve (AUC) is important for balancing efficacy versus toxicity. In a previous study, we developed a decision tree (DT) model to achieve the target AUC during TDM over the follow-up period (AUC_follow-up). This study aimed to validate the DT model for achieving the target AUC_follow-up. Patients who received VCM for at least 72 h and had an initial TDM within four doses between January 2023 and December 2023 were analyzed. The AUC of the initial TDM was calculated over 2-point (peak/trough) concentrations via Bayesian estimation. The target AUC_follow-up was defined as 400–600 μg h/mL.</div><div>Among 188 patients (median age [interquartile range], 66 [56, 79] years; 50 % female), the target AUC_follow-up was achieved in 70 % (132/188). When the predicted AUC was 400–600 μg h/mL, 84 % (102/121) achieved the target AUC_follow-up. In a 12 h dosing interval subgroup, 86 % (88/102) achieved the target AUC_follow-up. Conversely, when the predicted AUC was &lt;400 or &gt;600 μg h/mL, the proportion who achieved the target AUC_follow-up dropped to 44 % (30/67). Only 30 % (3/10) of those with creatinine clearance rates of &gt;130 mL/min/1.73 m² achieved the target. The area under the receiver operating characteristics curve was 0.74, and the R² value was 0.15.</div><div>Our findings confirmed the external validity of the DT model and supported its use for optimizing VCM dosing. Overall, the DT model offers a reliable framework for achieving target AUC values during follow-up for TDM, aiding safe and effective treatment.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 5","pages":"Article 102701"},"PeriodicalIF":1.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143817437","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":"Successful detection of an unrecognized outbreak of Mycobacterium tuberculosis in the modern Beijing subfamily through combined molecular epidemiological and population genetic analyses","authors":"Shinichiro Hirai ,&nbsp;Masaki Nakamura ,&nbsp;Satoshi Kawato ,&nbsp;Yushi Hachisu ,&nbsp;Takashi Kikuchi ,&nbsp;Naoshi Ando ,&nbsp;Hiroaki Shigemura ,&nbsp;Nobuhiro Takemae ,&nbsp;Eiji Yokoyama","doi":"10.1016/j.jiac.2025.102700","DOIUrl":"10.1016/j.jiac.2025.102700","url":null,"abstract":"<div><h3>Introduction</h3><div>While multi-locus variable number tandem repeat analysis (MLVA) as molecular epidemiological analysis has been used to detect <em>Mycobacterium tuberculosis</em> outbreaks, its discriminatory power for identifying strains is limited. Whole-genome sequencing (WGS) offers high discriminatory power but is expensive. This study was established to develop a strategy to overcome these limitations of molecular epidemiological analysis by combining it with population genetic analysis.</div></div><div><h3>Methods</h3><div>MLVA data from 2732 <em>M.</em> <em>tuberculosis</em> strains isolated in Chiba Prefecture, Japan, in 2008–2016 were subjected to Bayesian population genetic analysis to subdivide the strains into subfamilies and estimate subpopulations within each subfamily. Annual changes in the number of strains within subpopulations exhibiting linkage disequilibrium (LD) in MLVA data were examined. Only strains from subpopulations displaying significant increases were analyzed by WGS.</div></div><div><h3>Results</h3><div>Significant LD was observed in one subpopulation using Bayesian analysis (designated P3) within the modern Beijing subfamily, which exhibited a significant increase in strain number in 2016. WGS analysis of strains belonging to P3 from 2016 revealed that 17 out of 21 of them differed by three or fewer single-nucleotide polymorphisms from their most similar strain, indicating that they had a common origin (i.e., an outbreak). Among these common-origin strains, one exhibited a four-locus variant in the MLVA, which would not be suspected of being an outbreak-related strain based on MLVA alone without Bayesian analysis.</div></div><div><h3>Conclusion</h3><div>The combination of Bayesian population genetic analysis with MLVA successfully detected <em>M. tuberculosis</em> strains from an unrecognized outbreak by performing WGS on only a subset of the strains.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 6","pages":"Article 102700"},"PeriodicalIF":1.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143854428","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":"Comparison of pain between nasopharyngeal swab collection for influenza PCR testing and pharyngeal image capture for AI-based influenza diagnosis","authors":"Kie Kido ,&nbsp;Takaya Hanawa ,&nbsp;Shinji Kido ,&nbsp;Takahiro Mikawa","doi":"10.1016/j.jiac.2025.102699","DOIUrl":"10.1016/j.jiac.2025.102699","url":null,"abstract":"","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 6","pages":"Article 102699"},"PeriodicalIF":1.9,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143843937","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":"Humoral and cellular immune responses to mRNA COVID-19 vaccinations in the elderly: A longitudinal study in Japan","authors":"Kiyoyasu Fukushima ,&nbsp;Toru Kubo ,&nbsp;Yuta Ito ,&nbsp;Yoshie Oda ,&nbsp;Yohsuke Nagayoshi ,&nbsp;Minoru Fukuda ,&nbsp;Takahiro Takazono ,&nbsp;Noriho Sakamoto ,&nbsp;Hiroshi Mukae","doi":"10.1016/j.jiac.2025.102695","DOIUrl":"10.1016/j.jiac.2025.102695","url":null,"abstract":"<div><h3>Objectives</h3><div>This study examined the durability of humoral and cell-mediated immune responses to COVID-19 mRNA vaccines over six months, focusing on age-related changes.</div></div><div><h3>Methods</h3><div>SARS-CoV-2 uninfected Japanese subjects aged 20–99 who received two doses of mRNA COVID-19 vaccine were recruited. SARS-CoV-2 Spike IgG antibody (IgG) level in the serum and the levels of interferon (IFN)-γ in blood stimulated with SARS-CoV-2 specific antigens by QuantiFERON (QFN) SARS-CoV-2 assay were measured.</div></div><div><h3>Results</h3><div>The IgG levels of 138 subjects declined significantly with age and time post-vaccination <em>(p &lt; 0.001).</em> For participants aged 70 and above (n = 80), the IFN-γ levels, an indicator of cell-mediated immunity, also significantly declined over time (p &lt; 0.05). However, in those under 70 (n = 58), the IFN-γ levels were maintained at three- and six months post-vaccination. There was no significant difference in IFN-γ levels between three- and six months post-vaccination for all 138 subjects, including CD4⁺ and CD8⁺ T cell counts. No correlation was observed between IgG antibody levels and secreted IFN-γ values. Multivariate regression analysis revealed a significant correlation between IgG levels and age. In contrast, IFN-γ levels were associated with CD4⁺ T cell counts, CD8⁺ T cell counts, and Performance Status Scores but not with age.</div></div><div><h3>Conclusions</h3><div>The findings suggest that while humoral immunity (IgG levels) decreases with age and time, cell-mediated immunity (IFN-γ levels) is relatively preserved in individuals under 70 up to six months post-vaccination. However, this immune response is significantly attenuated in older adults aged 70 and above, indicating age-related immunosenescence in long-term immunity following COVID-19 vaccination.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 6","pages":"Article 102695"},"PeriodicalIF":1.9,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795628","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}