Journal of Infection and Chemotherapy最新文献_第7页

The application value of targeted next-generation sequencing using bronchoalveolar lavage fluid samples in community-acquired pneumonia in children. 支气管肺泡灌洗液靶向新一代测序在儿童社区获得性肺炎中的应用价值

IF 1.9 4区医学

Journal of Infection and Chemotherapy Pub Date : 2025-01-10 DOI: 10.1016/j.jiac.2025.102610

Shiyi He, Weishi Xue, Xiaoning Wu, Zhengyi Liang, Jinwei Gao, Weijuan Qin, Huanhuan Wei, Liyan Zhou, Haining Yuan, Li Xie

{"title":"The application value of targeted next-generation sequencing using bronchoalveolar lavage fluid samples in community-acquired pneumonia in children.","authors":"Shiyi He, Weishi Xue, Xiaoning Wu, Zhengyi Liang, Jinwei Gao, Weijuan Qin, Huanhuan Wei, Liyan Zhou, Haining Yuan, Li Xie","doi":"10.1016/j.jiac.2025.102610","DOIUrl":"10.1016/j.jiac.2025.102610","url":null,"abstract":"Background: The precise identification of pathogens responsible for community-acquired pneumonia (CAP) in children is essential for effective treatment. However, the performance of targeted next-generation sequencing (tNGS) in the detection of pathogens associated with CAP in children remains unclear.Methods: In this study, 216 children diagnosed with CAP were enrolled, and bronchoalveolar lavage fluid (BALF) samples underwent detection through tNGS, culture, and multiplex quantitative polymerase chain reaction (qPCR).Results: In 208 children, tNGS identified a total of 389 strains of microorganisms, including 111 Mycoplasma pneumoniae, 123 bacteria, 127 viruses, and 28 fungi. Among the cases, 89 presented as single-pathogen detection, while 119 exhibited multiple pathogens co-detection. The positive detection rates of bacteria and fungi through tNGS were significantly higher than those achieved through the traditional culture method, with rates of 56.9 % vs 8.3 % for bacteria and 13.0 % vs 4.2 % for fungi, respectively. The overall agreement between tNGS and multiplex qPCR ranged from 89.4 % to 99.1 %, with Kappa values ranging from 0.541 to 0.912 (P = 0.000).Conclusions: The tNGS technique demonstrates rapid and effective capabilities in identifying a wide array of pathogens with a detection sensitivity that surpasses traditional culture methodologies while exhibiting a high degree of consistency with multiplex qPCR in detecting respiratory viruses. The tNGS detection method can serve as an important complement to traditional diagnostic approaches; however, caution must be exercised when interpreting tNGS findings due to its heightened sensitivity which may lead to identification of pathogens that are not necessarily responsible for causing disease.","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":" ","pages":"102610"},"PeriodicalIF":1.9,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971181","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}

引用次数: 0

Home visit survey on outpatient antibiotic use: Assessing leftover medications and factors influencing appropriate use by community Pharmacists. 门诊抗生素使用家访调查：评估剩余药物及影响社区药师合理使用的因素[j]。

IF 1.9 4区医学

Journal of Infection and Chemotherapy Pub Date : 2025-01-10 DOI: 10.1016/j.jiac.2025.102623

Keisuke Sawada, Yuichi Muraki, Ryo Inose, Shuji Kono, Mitsuru Tanaka, Toshiaki Ueba, Eiji Kawakami

{"title":"Home visit survey on outpatient antibiotic use: Assessing leftover medications and factors influencing appropriate use by community Pharmacists.","authors":"Keisuke Sawada, Yuichi Muraki, Ryo Inose, Shuji Kono, Mitsuru Tanaka, Toshiaki Ueba, Eiji Kawakami","doi":"10.1016/j.jiac.2025.102623","DOIUrl":"10.1016/j.jiac.2025.102623","url":null,"abstract":"This cross-sectional study investigated the prevalence and factors associated with leftover antibiotics in Japanese households through pharmacist home visits. The research, conducted in collaboration with pharmaceutical associations in Kyoto and Hirakata, included 37 cases analyzed from October 2023 to March 2024. Participants had a median age of 81 years and received a median of two antibiotic prescriptions in the past year. Leftover antibiotics were found in 18.9 % of cases, with 5 out of 7 cases resulting from prophylactic prescriptions. Levofloxacin was the most common leftover antibiotic. Notably, 27.0 % of participants reported a history of reusing leftover antibiotics. Logistic regression analysis revealed that frequent pharmacist visits (≥2/month) were significantly associated with decreased leftover antibiotics (adjusted OR: 0.02, 95 % CI: 0.00-0.48, p = 0.015), whereas a history of antibiotic reuse increased the likelihood of leftovers (adjusted OR: 20.32, 95 % CI: 1.78-231.33, p = 0.015). Other factors, including the number of antibiotic prescriptions and the presence of medication support, did not show statistically significant associations. This study highlights the potential role of community pharmacists in promoting appropriate antibiotic use and managing leftover medications through home healthcare engagement. The findings suggest that regular pharmacist interventions could significantly improve medication management and contribute to antimicrobial stewardship efforts. Future research should replicate these findings in larger, more diverse populations to enhance generalizability and further explore the long-term impact of pharmacist interventions on antibiotic use patterns.","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":" ","pages":"102623"},"PeriodicalIF":1.9,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971179","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}

引用次数: 0

Spontaneous remission of Pneumocystis jirovecii pneumonia followed by severe pulmonary nocardiosis in a patient with HIV infection: A case report. 艾滋病毒感染患者急性肺孢子虫肺炎自发性缓解并发严重肺诺卡菌病1例。

IF 1.9 4区医学

Journal of Infection and Chemotherapy Pub Date : 2025-01-08 DOI: 10.1016/j.jiac.2025.102609

Yuki Hiraoka, Takashi Ogasawara, Yasuhisa Tajima, Takashi Yaguchi, Akira Watanabe, Katsuji Teruya, Kimihiko Nagasaki, Wataru Matsuyama, Mitsuru Niwa, Yuichi Ozawa, Jun Sato

{"title":"Spontaneous remission of Pneumocystis jirovecii pneumonia followed by severe pulmonary nocardiosis in a patient with HIV infection: A case report.","authors":"Yuki Hiraoka, Takashi Ogasawara, Yasuhisa Tajima, Takashi Yaguchi, Akira Watanabe, Katsuji Teruya, Kimihiko Nagasaki, Wataru Matsuyama, Mitsuru Niwa, Yuichi Ozawa, Jun Sato","doi":"10.1016/j.jiac.2025.102609","DOIUrl":"10.1016/j.jiac.2025.102609","url":null,"abstract":"We describe a rare case of spontaneous remission of Pneumocystis jirovecii pneumonia (PCP) in a 42-year-old patient with human immunodeficiency virus (HIV) infection, followed by severe pulmonary nocardiosis. To our knowledge, this is the first report of spontaneous remission of PCP in a completely untreated patient with HIV infection. The patient, a bisexual Japanese man, presented with fever and anorexia and had a history of non-compliance with antiretroviral therapy (ART) for 13 years. PCP was initially suspected on the basis of imaging and laboratory findings, but the patient refused further evaluation and treatment. Surprisingly, the evidence of PCP infection disappeared without intervention. Four months later, the patient was diagnosed with severe pulmonary nocardiosis caused by Nocardia beijingensis, which was confirmed by bronchoscopy and culture. Antibiotic therapy and ART resulted in significant clinical improvement. Based on this case, we propose that N. beijingensis infection may contribute to spontaneous remission of PCP, possibly through production of antimicrobial substances and induction of granulocyte-macrophage colony-stimulating factor. On the other hand, fluctuations in immune function, particularly variability in CD4+ T lymphocytes, may also contribute. This report highlights the complex interplay between opportunistic infections in immunocompromised patients. These findings may provide valuable insights into the management of PCP.","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":" ","pages":"102609"},"PeriodicalIF":1.9,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142965577","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}

引用次数: 0

Polymicrobial bacteremia including Ignatzschineria indica caused by myiasis in a female patient with carcinoma of unknown primary. 1例原发不明癌女性患者因蝇蛆病引起的多微生物菌血症，包括印度伊格纳茨氏菌。

IF 1.9 4区医学

Journal of Infection and Chemotherapy Pub Date : 2025-01-07 DOI: 10.1016/j.jiac.2025.102607

Tatsuki Mura, Yutaka Takahara, Masaharu Iguchi, Nobuhiko Ueda, Yoshitsugu Iinuma

{"title":"Polymicrobial bacteremia including Ignatzschineria indica caused by myiasis in a female patient with carcinoma of unknown primary.","authors":"Tatsuki Mura, Yutaka Takahara, Masaharu Iguchi, Nobuhiko Ueda, Yoshitsugu Iinuma","doi":"10.1016/j.jiac.2025.102607","DOIUrl":"https://doi.org/10.1016/j.jiac.2025.102607","url":null,"abstract":"A 70-year-old woman with a 6-month history of poor hygiene presented with a right occipital mass, ulceration, and neck swelling. The right occipital region was infested with approximately 100 fly maggots, and the mass contained a foul-smelling abscess. Maggots were removed, and the mass was drained, irrigated, and dressed with padding. Ceftriaxone 1 g/day was administered for 6 days. The patient was transferred on hospital day 32. Blood cultures obtained at admission were positive at 17.3 hours. Gram stain revealed both Gram-positive cocci and Gram-negative rods. However, only Providencia stuartii, Ignatzschineria indica, and Desulfovibrio desulfuricans were subsequently identified. Aerobic reculture of the initial blood culture bottle was performed for 4 days, followed by repeated incubation under 5% CO2 and anaerobic conditions. A 1 mm colony adjacent to I. indica growth was isolated after CO2 incubation and identified as Fastidiosipila sanguinis by 16S rRNA analysis. Myiasis, a parasitic disease caused by dipteran larvae, can lead to the detection of maggot-associated bacteria in blood cultures. Ignatzschineria species, particularly I. indica, are most commonly isolated in myiasis patients. These organisms are typically associated with blood cultures from unhygienic male patients, although cases in females with adenocarcinoma have been reported. Fastidiosipila sanguinis has only been documented in three cases since its description in 2005, with its origin remaining unknown. In this case, the origin of F. sanguinis was presumed to be the myiasis.","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":" ","pages":"102607"},"PeriodicalIF":1.9,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950193","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}

引用次数: 0

Incidence of severe illness in pediatric influenza outpatients treated with baloxavir or neuraminidase inhibitors. 小儿流感门诊患者接受巴洛韦或神经氨酸酶抑制剂治疗的严重疾病发生率

IF 1.9 4区医学

Journal of Infection and Chemotherapy Pub Date : 2025-01-07 DOI: 10.1016/j.jiac.2025.102606

Isao Miyairi, Shogo Miyazawa, Yusaku Takahashi, Satoshi Kojima, Yoshitake Kitanishi, Eriko Ogura

{"title":"Incidence of severe illness in pediatric influenza outpatients treated with baloxavir or neuraminidase inhibitors.","authors":"Isao Miyairi, Shogo Miyazawa, Yusaku Takahashi, Satoshi Kojima, Yoshitake Kitanishi, Eriko Ogura","doi":"10.1016/j.jiac.2025.102606","DOIUrl":"10.1016/j.jiac.2025.102606","url":null,"abstract":"Introduction: A single oral dose of baloxavir marboxil, a cap-dependent endonuclease inhibitor, is approved for patients with influenza A or B infection; however, real-world evidence is limited. We evaluated the effectiveness of baloxavir vs neuraminidase inhibitors in reducing the incidence of severe illness in influenza outpatients aged 5-11 years.Methods: In this retrospective cohort study, we analyzed individual-level data from patients treated with these antivirals, using a large, Japanese health insurance claims database (JMDC). Patients were included at the first date of diagnosis of the influenza virus infection (Day 1) in two influenza seasons. The primary outcome was the incidence of hospitalization from Day 2-14.Results: Of 196,749 included patients (Season 2018/2019, n = 103,709; Season 2019/2020, n = 93,040), 20.9 % received baloxavir, 38.8 % received oseltamivir, 28.7 % received laninamivir, and 11.6 % received zanamivir. In each treatment group, 61-70 % patients had influenza A. The incidence of hospitalization from Day 2-14 was significantly lower for baloxavir than for oseltamivir, laninamivir, and zanamivir. The adjusted risk ratio (95 % CI) for oseltamivir, laninamivir, and zanamivir were 1.86 (1.30-2.68), 2.11 (1.37-3.25), and 1.90 (1.31-2.77), respectively, compared with baloxavir. Comparative incidence of hospitalizations between agents were unaffected by season or virus type.Conclusion: Using a large, Japanese health insurance claims database, a lower rate of hospitalization was demonstrated in children aged 5-11 years with an influenza virus infection when treated with baloxavir vs neuraminidase inhibitors. Thus, single dose, oral baloxavir may reduce the incidence of severe illness in these patients.","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":" ","pages":"102606"},"PeriodicalIF":1.9,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950191","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}

引用次数: 0

Electrocautery ablation therapy for anal intraepithelial carcinoma with high-resolution anoscopy. 高分辨率肛门镜下电灼消融治疗肛门上皮内癌。

IF 1.9 4区医学

Journal of Infection and Chemotherapy Pub Date : 2025-01-06 DOI: 10.1016/j.jiac.2025.102608

Hiroshi Kitamura, Naokatsu Ando, Daisuke Mizushima, Daisuke Shiojiri, Takato Nakamoto, Misao Takano, Hiroyuki Gatanaga

{"title":"Electrocautery ablation therapy for anal intraepithelial carcinoma with high-resolution anoscopy.","authors":"Hiroshi Kitamura, Naokatsu Ando, Daisuke Mizushima, Daisuke Shiojiri, Takato Nakamoto, Misao Takano, Hiroyuki Gatanaga","doi":"10.1016/j.jiac.2025.102608","DOIUrl":"10.1016/j.jiac.2025.102608","url":null,"abstract":"Objective: This study investigated the efficacy and safety of electrocautery ablation for high-grade squamous intraepithelial lesions (HSILs) in men who have sex with men (MSM) including people with human immunodeficiency virus, using comprehensive biopsy with high-resolution anoscopy (HRA).Methods: This single-arm, open-label pilot study included 20 MSM with HSIL who were treated with electrocautery ablation. The participants were recruited from the National Center for Global Health and Medicine and followed up using HRA with a comprehensive biopsy approach at 3- and 6-months post-ablation. A comprehensive biopsy was defined as at least 1 biopsy taken from each of the 6 segments of the anal canal regardless of any abnormal findings. The primary endpoint was the local HSIL cure rate at 6 months. Secondary endpoints included the total cure rate, recurrence rates, and adverse events.Results: The median age of the 20 participants was 45 years, and 90 % were HIV-positive. The local cure rates were 40 % at 3 months and 50 % at 6 months. The total cure rates were 35 % and 40 % at 3 and 6 months, respectively. Ectopic recurrence occurred in 27.8 % of the participants. Most adverse events were mild and self-limiting.Conclusion: Electrocautery ablation was a moderately effective and safe treatment for HSIL among MSM in Japan. However, the recurrence rates were high, indicating that conducting biopsies on normal-appearing lesions did not sufficiently prevent ectopic recurrence. Further research with larger sample sizes and longer follow-up periods is warranted to improve outcomes. This trial was registered in the Japan Registry of Clinical Trials: Clinical Trial Plan Number: jRCTs032210649.","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":" ","pages":"102608"},"PeriodicalIF":1.9,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950189","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}

引用次数: 0

Clinical and microbiological characteristics of granulomatous mastitis caused by Corynebacterium species: A case series. 棒状杆菌引起肉芽肿性乳腺炎的临床和微生物学特征：一个病例系列。

IF 1.9 4区医学

Journal of Infection and Chemotherapy Pub Date : 2025-01-03 DOI: 10.1016/j.jiac.2025.102605

Toshinori Hara, Hiroki Kitagawa, Kayoko Tadera, Rie Nagaoka, Yumiko Koba, Seiya Kashiyama, Yuta Kuhara, Takuji Omoto, Toshihito Nomura, Keitaro Omori, Norifumi Shigemoto, Sho Mokuda, Hiroki Ohge

{"title":"Clinical and microbiological characteristics of granulomatous mastitis caused by Corynebacterium species: A case series.","authors":"Toshinori Hara, Hiroki Kitagawa, Kayoko Tadera, Rie Nagaoka, Yumiko Koba, Seiya Kashiyama, Yuta Kuhara, Takuji Omoto, Toshihito Nomura, Keitaro Omori, Norifumi Shigemoto, Sho Mokuda, Hiroki Ohge","doi":"10.1016/j.jiac.2025.102605","DOIUrl":"10.1016/j.jiac.2025.102605","url":null,"abstract":"Corynebacterium species are an important cause of granulomatous mastitis (GM). Although there have been worldwide reports of infections caused by Corynebacterium kroppenstedtii, few cases of C. tuberculostearicum GM have been reported. We conducted a retrospective study to investigate the clinical and microbiological characteristics of GM caused by Corynebacterium spp. between January 1, 2014, and May 31, 2024. During the study period, six patients with GM were identified, including four cases of C. kroppenstedtii GM and two cases of C. tuberculostearicum GM. All patients were female with a median age of 32 years (range: 18-50 years). All patients underwent surgical drainage and were treated with clarithromycin. The minimum inhibitory concentration (MIC) values for various antimicrobial agents, including azithromycin, clarithromycin, ciprofloxacin, clindamycin, and trimethoprim-sulfamethoxazole, were higher for C. tuberculostearicum than for C. kroppenstedtii. Additionally, MALDI-TOF MS and 16s rRNA gene sequencing accurately identified C. kroppenstedtii and C. tuberculostearicum. Accurate identification of lipophilic Corynebacterium spp. is important for antibiotic treatment selection. If clinicians suspect lipophilic Corynebacterium spp. infection, particularly GM, they should ask the microbiology laboratory to test for lipophilic Corynebacterium spp.","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":" ","pages":"102605"},"PeriodicalIF":1.9,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931970","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}

引用次数: 0

Tubo-ovarian abscess caused by Clostridioides difficile after eight months of surgery: Case report and review of extraintestinal abdominal abscess cases. 手术八个月后由艰难梭菌引起的输卵管脓肿：病例报告和腹腔外脓肿病例回顾。

IF 1.9 4区医学

Journal of Infection and Chemotherapy Pub Date : 2025-01-01 Epub Date: 2024-06-01 DOI: 10.1016/j.jiac.2024.05.012

Shin Nakayama, Yoshitaka Wakabayashi, Ai Yamamoto, Takayuki Ichinose, Kazuki Takasaki, Kazunori Nagasaka, Takatoshi Kitazawa

{"title":"Tubo-ovarian abscess caused by Clostridioides difficile after eight months of surgery: Case report and review of extraintestinal abdominal abscess cases.","authors":"Shin Nakayama, Yoshitaka Wakabayashi, Ai Yamamoto, Takayuki Ichinose, Kazuki Takasaki, Kazunori Nagasaka, Takatoshi Kitazawa","doi":"10.1016/j.jiac.2024.05.012","DOIUrl":"10.1016/j.jiac.2024.05.012","url":null,"abstract":"We present a case of tubo-ovarian abscess (TOA) caused by Clostridioides difficile (CD) in a 43-year-old female. Despite lacking a history of sexually transmitted diseases, the patient had undergone paraovarian cystectomy nine months before admission. Transvaginal ultrasonography performed eight months post-surgery revealed left ovarian enlargement, accompanied by subsequent lower abdominal pain and fever exceeding 38 °C. As oral antibiotic treatment was ineffective, the patient was admitted to our hospital. Computed tomography upon admission revealed a massive TOA. Surgical drainage of the abscess was performed, and CD was identified in the culture from the pus. The TOA was treated with a three-month course of metronidazole and oral amoxicillin/clavulanic acid. While CD is commonly associated with colitis, extraintestinal manifestations are exceptionally rare. This case represents the inaugural report of TOA resulting from CD. A literature review on abdominal and pelvic CD abscesses found that patients undergoing surgical drainage had a favorable prognosis. Therefore, surgical intervention plays an important role in the management of CD abscesses.","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":" ","pages":"102432"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141200219","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}

引用次数: 0

Effects of meropenem supply restriction: A multicenter retrospective study. 限制美罗培南供应的影响：一项多中心回顾性研究。

IF 1.9 4区医学

Journal of Infection and Chemotherapy Pub Date : 2025-01-01 Epub Date: 2024-07-18 DOI: 10.1016/j.jiac.2024.07.015

Yoshimichi Koutake, Yoji Nagasaki, Ryosuke Hirata, Keiji Soejima, Hiromi Nishi, Hiroko Tsukada, Shohei Hamasaki, Masashi Hashimoto

{"title":"Effects of meropenem supply restriction: A multicenter retrospective study.","authors":"Yoshimichi Koutake, Yoji Nagasaki, Ryosuke Hirata, Keiji Soejima, Hiromi Nishi, Hiroko Tsukada, Shohei Hamasaki, Masashi Hashimoto","doi":"10.1016/j.jiac.2024.07.015","DOIUrl":"10.1016/j.jiac.2024.07.015","url":null,"abstract":"Background: In Japan, the supply of one generic meropenem product was restricted from August 2022 to March 2023.Objective: To determine the effects of meropenem (MEPM) restriction.Methods: We conducted a multicenter retrospective study comparing antimicrobial use, bacteremia mortality, and drug-resistant bacteria detected before the restriction of MEPM (control period), from September 2021 to February 2022, and after the restriction of MEPM (MEPM supply restriction period), from September 2022 to February 2023, in five institutions.Results: The number of carbapenem days of therapy (DOTs) were decreased in all five institutions. Fourth-generation cephalosporin DOTs increased in all facilities, and piperacillin/tazobactam DOTs increased in four facilities. The 30-day and 90-day mortality rates were significantly higher during the MEPM supply restriction period than those during the control period. Moreover, survival time was significantly shorter during the MEPM supply restriction period than that during the control period. Multivariable analysis revealed that MEPM supply restriction, age >80 years, Pitt Bacteremia Score ≥4, platelet count <10 × 104/μL, serum albumin level <2.5 g/dL, and methicillin-resistant Staphylococcus aureus bloodstream infection were independent risk factors for 30-day mortality. The detection rates of carbapenem-resistant Pseudomonas aeruginosa and Enterobacteriaceae did not differ significantly between the two periods.Conclusions: MEPM supply restriction decreased the use of carbapenems and increased the use of other broad-spectrum antimicrobial agents, which worsened the prognosis of bacteremia. Overall, carbapenems are important drugs for the treatment of infectious diseases and are difficult to replace in unforeseen situations such as drug supply outages.","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":" ","pages":"102475"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141727219","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}

引用次数: 0

Effectiveness of isavuconazole in invasive cerebral aspergillosis during hematopoietic stem cell transplantation in a pediatric patient with myelodysplastic syndrome: A case report. 在骨髓增生异常综合征儿科患者接受造血干细胞移植期间，异武唑对侵袭性脑曲霉菌病的疗效：病例报告。

IF 1.9 4区医学

Journal of Infection and Chemotherapy Pub Date : 2025-01-01 Epub Date: 2024-07-22 DOI: 10.1016/j.jiac.2024.07.018

Hajime Nemoto, Moeko Hino, Takahiro Aoki, Yoshiharu Yamashita, Tomoko Okunushi, Koo Nagasawa, Naruhiko Ishiwada, Akira Watanabe, Shingo Yamazaki, Hiromichi Hamada

{"title":"Effectiveness of isavuconazole in invasive cerebral aspergillosis during hematopoietic stem cell transplantation in a pediatric patient with myelodysplastic syndrome: A case report.","authors":"Hajime Nemoto, Moeko Hino, Takahiro Aoki, Yoshiharu Yamashita, Tomoko Okunushi, Koo Nagasawa, Naruhiko Ishiwada, Akira Watanabe, Shingo Yamazaki, Hiromichi Hamada","doi":"10.1016/j.jiac.2024.07.018","DOIUrl":"10.1016/j.jiac.2024.07.018","url":null,"abstract":"Pediatric myelodysplasia syndrome is often characterized by hypoplastic bone marrow morphology and predisposition to infection. Invasive aspergillosis during hematopoietic stem cell transplantation poses a significant threat and often requires voriconazole (VRCZ) therapy. However, difficulties in achieving appropriate VRCZ blood levels due to drug interactions have prompted the exploration of alternative treatments, such as isavuconazole (ISCZ). We present the case of a 4-year-old boy with myelodysplasia syndrome who developed multiple abscesses, including a brain abscess caused by Aspergillus fumigatus, and was successfully treated with ISCZ. Despite initial treatment with liposomal amphotericin B and VRCZ, the patient's condition deteriorated. Transitioning to ISCZ treatment resulted in significant clinical improvement, resolution of the abscesses, and reduced antigen levels. Although ISCZ induced hepatic enzyme elevation, supportive care improved without discontinuation of treatment. This case highlights the potential of ISCZ in cases of pediatric invasive aspergillosis where traditional therapies fail, underscoring the need for further research and formulation development to optimize its use in this population. As more cases accumulate, ISCZ may become a promising option for treating severe invasive aspergillosis in pediatric patients undergoing hematopoietic stem cell transplantation.","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":" ","pages":"102478"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141759155","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}

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