Journal of Infection and Chemotherapy最新文献

{"title":"Limitations of the AWaRe antibiotic classification during the 2024 Mycoplasma pneumoniae epidemic in Tokyo","authors":"Yuto Otsubo ,&nbsp;Rentaro Oda ,&nbsp;Yo Murata ,&nbsp;Funato Sato ,&nbsp;Shogo Akahoshi ,&nbsp;Hiroshi Sakiyama ,&nbsp;Yuho Horikoshi","doi":"10.1016/j.jiac.2025.102885","DOIUrl":"10.1016/j.jiac.2025.102885","url":null,"abstract":"<div><h3>Background</h3><div>The utility of AWaRe antibiotic classification for evaluating antimicrobial stewardship in clinics during epidemics of specific, infectious diseases remains unknown. This study aimed to examine antibiotic prescribing patterns using the AWaRe classification during a <em>Mycoplasma pneumoniae</em> epidemic in Tokyo.</div></div><div><h3>Methods</h3><div>Oral antibiotic prescription data from January 2024 to June 2025 were obtained from the prescription surveillance system of 11 clinics in the Tama regional network (Tama cohort), a subset of all registered clinics in Tokyo (Tokyo cohort). For analysis, the pre-epidemic period, epidemic period, and post-epidemic period were defined as January–June 2024, July–December 2024, and January–June 2025, respectively. The primary outcome was the change in Access antibiotic proportions across the three periods. The secondary outcome was the difference in this change between cohorts.</div></div><div><h3>Results</h3><div>In total, 8,420 and 526,822 antibiotic prescriptions were issued by the Tama cohort and the Tokyo cohort, respectively. In the Tama cohort, Access antibiotic proportions were 64 %, 48 %, and 75 % during the pre-epidemic, epidemic, and post-epidemic periods, respectively; the corresponding values in the Tokyo cohort were 37 %, 32 %, and 40 %. Compared with the Tokyo cohort, estimated changes in Access proportions in the Tama cohort were −11.7 % (95 % CI: −14.2 to −9.2) from pre-epidemic to epidemic period, and +19.0 % (95 % CI: 16.6 to 21.5) from epidemic to post-epidemic period.</div></div><div><h3>Conclusions</h3><div>Access proportions temporarily decreased during the 2024 <em>M. pneumoniae</em> epidemic, particularly in the Tama cohort, where the baseline Access proportion was high, indicating potential limitation of AWaRe indicators under epidemic conditions.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 1","pages":"Article 102885"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145682336","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":"Letermovir prophylaxis and risk of bacterial or fungal infection after allogeneic hematopoietic cell transplantation","authors":"Shun-ichi Kimura ,&nbsp;Shunto Kawamura ,&nbsp;Takashi Toya ,&nbsp;Keiji Okinaka ,&nbsp;Hiroki Hosoi ,&nbsp;Naoyuki Uchida ,&nbsp;Noriko Doki ,&nbsp;Tetsuya Nishida ,&nbsp;Masatsugu Tanaka ,&nbsp;Yuta Hasegawa ,&nbsp;Yoshinobu Kanda ,&nbsp;Noboru Asada ,&nbsp;Naoki Kurita ,&nbsp;Hirohisa Nakamae ,&nbsp;Tetsuya Eto ,&nbsp;Makoto Yoshimitsu ,&nbsp;Makoto Onizuka ,&nbsp;Takahiro Fukuda ,&nbsp;Marie Ohbiki ,&nbsp;Yoshiko Atsuta ,&nbsp;Kimikazu Yakushijin","doi":"10.1016/j.jiac.2025.102888","DOIUrl":"10.1016/j.jiac.2025.102888","url":null,"abstract":"<div><h3>Background</h3><div>Previous reports have suggested an association between cytomegalovirus (CMV) infection and bacterial or fungal infections after allogeneic hematopoietic cell transplantation (HCT). This study aimed to examine the relationship between letermovir (LTV) prophylaxis and the incidence of bacteremia and invasive fungal infections.</div></div><div><h3>Methods</h3><div>Using a Japanese transplant registry database, we analyzed 19,531 patients who underwent their first allogeneic HCT from 2011 to 2022. Patients who initiated LTV prophylaxis within the first week post-transplantation were classified as the LTV group.</div></div><div><h3>Results</h3><div>A total of 4915 patients in the LTV group and 14,616 in the No LTV group were analyzed. The incidence of bacteremia by day 100 was significantly lower in the LTV group compared to the No LTV group (17.4 % vs. 21.7 %, <em>P</em> &lt; 0.001). In the multivariate analysis, LTV prophylaxis (HR 0.75, 95 %CI: 0.69–0.81) was found to be significantly associated with a reduced risk of bacteremia, along with neutrophil engraftment. Age &gt;50 years, male, non-remission status, alternative donors, higher values of the hematopoietic cell transplantation-comorbidity index, poor performance status, and grade II–IV acute graft-versus-host disease were associated with an increased risk of bacteremia. LTV was associated with a reduced risk of bacteremia both within 30 days (HR 0.74, 95 %CI: 0.68–0.81) and beyond 30 days (HR 0.76, 95 %CI: 0.66–0.89) after HCT. Conversely, it was not associated with the risk of invasive aspergillosis or candidemia.</div></div><div><h3>Conclusions</h3><div>LTV prophylaxis significantly reduced the risk of bacteremia. However, it was not associated with the risk of invasive fungal infections.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 1","pages":"Article 102888"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145723056","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 cluster of 11 cases of Listeria monocytogenes bacteremia in Kyoto, Japan","authors":"Hajime Tsuboi ,&nbsp;Shin Matsubara ,&nbsp;Yoshiyuki Kawahara ,&nbsp;Kenji Konaka ,&nbsp;Kaori Tamai ,&nbsp;Daisuke Yokoi ,&nbsp;Yoshihiro Tanabe ,&nbsp;Naohisa Fujita ,&nbsp;Satoru Shikata","doi":"10.1016/j.jiac.2025.102887","DOIUrl":"10.1016/j.jiac.2025.102887","url":null,"abstract":"<div><h3>Background</h3><div><em>Listeria monocytogenes</em> infection, known as listeriosis, is relatively uncommon. However, in elderly or immunocompromised patients, it can lead to severe manifestations such as meningitis and bacteremia, making it a clinically important disease. The primary route of transmission is through ingestion of contaminated food, and since a wide range of food items may be involved, close collaboration with public health authorities is essential for effective source identification.</div></div><div><h3>Case report</h3><div>We encountered 11 cases of <em>Listeria monocytogenes</em> bacteremia within a limited region over the course of one month. Whole-genome sequencing revealed that the isolates were highly genetically related. Notably, the patients resided in different municipalities, suggesting exposure to a widely distributed food source. However, under the current Japanese legal framework, bacteremia is not a notifiable condition, which hindered timely identification of the infection source.</div></div><div><h3>Conclusion</h3><div>This case series underscores challenges in both clinical practice and the public health system in Japan, highlighting how such rare, genetically related clusters of bacteremia, occurring within a short period and across multiple municipalities, can easily be overlooked under the current surveillance framework.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 1","pages":"Article 102887"},"PeriodicalIF":1.5,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145682333","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 infective endocarditis following urinary tract infection by Proteus mirabilis","authors":"Kohei Maruyama ,&nbsp;Naoya Harada ,&nbsp;Hiroki Katsumata ,&nbsp;Yumi Hosoi ,&nbsp;Minato Kawaguchi ,&nbsp;Haruna Nishikori ,&nbsp;Shuhei Yasuda ,&nbsp;Kiyoshi Sekiya","doi":"10.1016/j.jiac.2025.102839","DOIUrl":"10.1016/j.jiac.2025.102839","url":null,"abstract":"<div><div>Infective endocarditis (IE) is most commonly caused by gram-positive cocci, whereas that caused by gram-negative rods, particularly Enterobacteriaceae, is uncommon. In particular, only a few dozen cases of IE caused by <em>Proteus mirabilis</em> have been reported globally. This report describes a 93-year-old woman who developed calculous pyelonephritis, renal impairment, and <em>P. mirabilis</em> bacteremia. She presented with multiple cerebral infarcts on cranial imaging after her consciousness was impaired. Transthoracic echocardiography revealed mobile vegetation on the mitral valve, leading to a diagnosis of possible IE according to the modified Duke criteria. <em>P. mirabilis</em> was detected in blood and urine cultures. Based on the antimicrobial susceptibility testing and the clinical course, the antibiotics were changed stepwise, including switching to oral agents when intravenous therapy became difficult. Owing to the patient's advanced age and overall condition, surgery was not performed. However, vegetation enlargement and a new cerebral infarction occurred, indicating treatment failure. This rare case of IE developed following a urinary tract infection and <em>P. mirabilis</em> bacteremia and was incidentally diagnosed by echocardiography. The case underscores the importance of considering echocardiographic evaluation in patients with <em>P. mirabilis</em> bacteremia accompanied by cerebrovascular events, as IE might be an underlying complication.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 12","pages":"Article 102839"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145419801","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 pneumonia caused by Corynebacterium durum mimicking Nocardia pneumonia in a patient with dermatomyositis","authors":"Natsuko Hara ,&nbsp;Tomoaki Higuchi ,&nbsp;Mayuko Fujisaki ,&nbsp;Ryo Motoyama ,&nbsp;Risa Yamada ,&nbsp;Rei Yamaguchi ,&nbsp;Akiko Tochimoto ,&nbsp;Eiichi Tanaka ,&nbsp;Ken Kikuchi ,&nbsp;Aoi Ito ,&nbsp;Masayoshi Harigai","doi":"10.1016/j.jiac.2025.102869","DOIUrl":"10.1016/j.jiac.2025.102869","url":null,"abstract":"<div><div><em>Nocardia</em> can cause severe pneumonia primarily in patients with impaired cell-mediated immunity, such as those taking immunosuppressants. A delayed diagnosis is associated with a poor prognosis. However, early diagnosis is difficult, and conventional identification methods can sometimes misidentify <em>Nocardia</em> as other bacterial pathogens because of its morphological similarity. We report a case of pneumonia caused by <em>Corynebacterium durum</em> primarily misidentified as <em>Nocardia</em> pneumonia in a patient with dermatomyositis who was undergoing intensified immunosuppressive treatment. A 67-year-old woman with dermatomyositis who had received long-term prednisolone and tacrolimus therapy experienced worsening interstitial lung disease and skin and muscle lesions, and the prednisolone dose was increased to 40 mg/day (1 mg/kg/day). During treatment, she developed a productive cough. <em>Nocardia</em> pneumonia was initially suspected on the basis of symptoms, cavitary, infiltrative, and nodular shadows in the dorsal right lobe on computed tomography of the chest, and a sputum smear. Empirical therapy with sulfamethoxazole/trimethoprim 3200 mg/640 mg/day was started, and her symptoms improved quickly. The clinical course and antimicrobial susceptibility test profile were atypical. Therefore, 16S ribosomal ribonucleic acid gene analysis and matrix-assisted laser desorption ionization-time of flight mass spectrometry were performed. Based on this analysis, the pathogen was re-identified as <em>C</em>. <em>durum</em>. Sulfamethoxazole/trimethoprim was continued, leading to improvement of the symptoms and the pulmonary lesions on computed tomography. The findings from this case indicate that <em>C</em>. <em>durum</em> can be misidentified as <em>Nocardia</em> by conventional identification methods and highlight the importance of incorporating more precise identification approaches.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 12","pages":"Article 102869"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145557066","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 comparative study of out-of-pocket expenditure and quality of life in chronic pulmonary aspergillosis and post-tuberculosis lung disease patients","authors":"Renuka Titiyal ,&nbsp;Sanjukta Sarkar ,&nbsp;Megha Priyadarshi ,&nbsp;Ved Prakash Meena ,&nbsp;Prayas Sethi ,&nbsp;G. Rahul Krishnan ,&nbsp;Bindu Prakash ,&nbsp;Gagandeep Singh ,&nbsp;Immaculata Xess ,&nbsp;Surabhi Vyas ,&nbsp;Neeraj Nischal ,&nbsp;Manish Soneja ,&nbsp;Sanjeev Sinha ,&nbsp;Naveet Wig ,&nbsp;Animesh Ray","doi":"10.1016/j.jiac.2025.102873","DOIUrl":"10.1016/j.jiac.2025.102873","url":null,"abstract":"<div><h3>Background</h3><div>Chronic pulmonary aspergillosis (CPA) comprises a spectrum of conditions that frequently affect individuals with chronic lung diseases, particularly post-tuberculosis lung disease (PTLD). Both disorders contribute to significant morbidity and impaired quality of life (QoL). In addition, they impose financial burden, much of which is borne directly by patients in low- and middle-income countries. However, data on out-of-pocket expenditure (OOPE) and its relationship with QoL in these groups remain limited.</div></div><div><h3>Methods</h3><div>This cross-sectional study, conducted at a tertiary referral centre in India, aimed to estimate OOPE (direct and indirect costs) in patients with CPA and PTLD, identify determinants of expenditure, and assess associations with QoL. Data on OOPE, borrowing, and catastrophic health expenditure during the preceding year were collected through structured interviews. QoL was evaluated using the St. George's Respiratory Questionnaire (SGRQ). <u>Results</u>: Both the direct ($406.42 ± 543.95 vs $251.81 ± 245.42, p value: 0.0038) and indirect costs ($49.93 ± 72.07 vs $39.81 ± 123.32, p value: 0.001) were significantly higher in the CPA group compared with the PTLD group. Subgroup analyses revealed higher diagnostic, transport, and food-related expenses in CPA individuals. Catastrophic expenditure was comparable in both groups (CPA: 60.5 %; PTLD: 67.9 %; p:0.325). Hemoptysis independently predicted poorer QoL across groups. QoL was significantly worse in CPA than PTLD (SGRQ total: 37.32 vs 31.16, p: 0.0125) and significant correlation between OOPE and QoL.</div></div><div><h3>Conclusion</h3><div>CPA imposes a greater financial burden and is associated with a poorer QoL compared with PTLD, underscoring the need for financial protection measures to improve outcomes in these patients.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 12","pages":"Article 102873"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145581936","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":"Recurrent familial furunculosis associated with Panton-Valentine leukocidin-positive methicillin-resistant Staphylococcus aureus sublineage of the USA300 clone in Tokyo","authors":"Ayano Fukushima-Nomura ,&nbsp;Saeko Takamiyagi ,&nbsp;Yoshihiro Ito ,&nbsp;Kaede Sawada ,&nbsp;Hiroshi Kawasaki ,&nbsp;Motoyuki Sugai ,&nbsp;Junzo Hisatsune","doi":"10.1016/j.jiac.2025.102872","DOIUrl":"10.1016/j.jiac.2025.102872","url":null,"abstract":"<div><div>We report a familial case of recurrent furunculosis caused by Panton-Valentine leukocidin (PVL)-positive community-associated methicillin-resistant <em>Staphylococcus aureus</em> (CA-MRSA) in Tokyo. The index case, a 34-year-old female, and her family members (her husband and their 8-month-old son) were also affected, and all recovered after treatment with oral clindamycin, intranasal mupirocin, and hygiene interventions. Whole-genome sequencing revealed that five isolates from skin and nasal swabs belonged to ST8-IVa-t304, carrying ACME type I and PVL genes. All isolates were resistant to levofloxacin but susceptible to other anti-MRSA agents. Genomic analysis showed the absence of the SaPI5 island and the <em>sek/seq</em> genes. Based on phylogenetic analysis, we concluded that these strains represent a unique USA300-like sublineage that diverged from the closest USA300-NAE lineage. The USA300 clone has emerged globally as a dominant CA-MRSA lineage responsible for severe skin and soft tissue infections. In Japan, PVL-positive USA300-related clones have been increasingly identified in recent years, indicating ongoing diversification of community-associated MRSA lineages. This case illustrates the growing presence of USA300-related clones in Japan and the need for genomic surveillance and early intervention to prevent further spread in community settings.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 12","pages":"Article 102872"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145573050","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 KSHV/HHV8-positive large B-cell lymphoma in a background of HIV-negative KSHV/HHV8-positive Multicentric Castleman disease","authors":"Takafumi Tsushima ,&nbsp;Shiho Konno ,&nbsp;Akihiro Shoji ,&nbsp;Chiharu Kimeda ,&nbsp;Kosuke Matsuo ,&nbsp;Rena Matsumoto ,&nbsp;Sonoko Shimoji ,&nbsp;Yoshikazu Utsu ,&nbsp;Shin-Ichi Masuda ,&nbsp;Kengo Takeuchi ,&nbsp;Nobuyuki Aotsuka","doi":"10.1016/j.jiac.2025.102861","DOIUrl":"10.1016/j.jiac.2025.102861","url":null,"abstract":"<div><div>Lymphoproliferative disorders associated with human herpes virus 8 (HHV8) include Kaposi's sarcoma-associated herpesvirus (KSHV)/HHV8-positive multicentric Castleman disease (MCD), primary effusion lymphoma (PEL)/extracavitary PEL (EC-PEL), and KSHV/HHV8-positive diffuse large B-cell lymphoma (DLBCL). These lymphoproliferative disorders occur primarily in patients with HIV infection and immunodeficiency. HIV-negative KSHV/HHV8-positive MCD is extremely rare in Japan. We encountered a patient with KSHV/HHV8-positive large B-cell lymphoma with a history of HIV-negative, KSHV/HHV8-positive MCD. Although the KSHV/HHV8-positive MCD was in long-term remission with rituximab treatment, the patient developed refractory KSHV/HHV8-positive large B-cell lymphoma four years after the onset of MCD. The KSHV/HHV8-positive large B-cell lymphoma was refractory to chemotherapy, and the patient died. The course of this case suggests that HIV-negative KSHV/HHV-8-positive MCD may eventually lead to refractory KSHV/HHV8-positive large B-cell lymphoma, even after long-term remission with rituximab therapy.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 12","pages":"Article 102861"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145517684","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":"EQUAL candida score can predict the prognosis of candidemia at a single center study","authors":"Nobuhiro Asai ,&nbsp;Wataru Ohashi ,&nbsp;Yuichi Shibata ,&nbsp;Daisuke Sakanashi ,&nbsp;Hideo Kato ,&nbsp;Mao Hagihara ,&nbsp;Hiroshige Mikamo","doi":"10.1016/j.jiac.2025.102849","DOIUrl":"10.1016/j.jiac.2025.102849","url":null,"abstract":"<div><h3>Introduction</h3><div>Despite the advance in diagnostic testing and antifungal therapy, candidemia remains still a life-threatening infectious disease. While the European Confederation of Medical Mycology proposed the European Confederation of Medical Mycology Quality of Clinical Candidemia Management (EQUAL) Candida score in 2018, its efficacy and validity are still discussing.</div></div><div><h3>Patients and methods</h3><div>We reviewed all patients with candidemia during 2018–2023 to analyze the efficacy and validity of the EQUAL Candida score for predicting the outcome of candidemia.</div></div><div><h3>Results</h3><div>A total of 159 patients were enrolled in the study. The EQUAL Candida scores were higher in survival group than death group for 30-day mortality (13.4 vs. 10.6, <em>p</em> &lt; 0.001). As for cases with central venous catheter (CVC), the score was higher in survival group than in death group (14.3 vs. 11.2, <em>p</em> &lt; 0.001). In terms of cases without CVC, survival group showed higher EQUAL Candida scores than death group (11.6 vs. 9.1, <em>p</em> &lt; 0.001). The appropriate cut-off for predicting the 30-day mortality was 10 and was chosen based on the Youden Index.</div><div>We found that higher SOFA score (≥5), higher CCI score (≥3), higher EQUAL Candida score (≥10), and catheter related blood stream infection were prognostic factors for 30-day mortality among patients with candidemia. Of these 4, Cox hazard model showed that higher SOFA score (≥5), higher CCI score (≥3) and higher EQUAL Candida score (≥10) were independent prognostic factors for 30-day mortality among them.</div></div><div><h3>Conclusion</h3><div>The EQUAL Candida score can predict the outcome of candidemia with and without CVC.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 12","pages":"Article 102849"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145419804","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":"N-acetylcysteine is associated with restoration of autophagy-related signaling and reduced intracellular Mycobacterium avium in alveolar type 1 epithelial cells","authors":"Ayako Shiozawa ,&nbsp;Chiaki Kajiwara ,&nbsp;Yoshikazu Ishii ,&nbsp;Kazuhiro Tateda","doi":"10.1016/j.jiac.2025.102864","DOIUrl":"10.1016/j.jiac.2025.102864","url":null,"abstract":"<div><h3>Purpose</h3><div>In patients with pulmonary <em>Mycobacterium avium</em> complex disease, the barrier function of the airway epithelium is reduced. In this study, we focused on the host defense responses of alveolar epithelial cells to <em>M</em>. <em>avium</em>.</div></div><div><h3>Methods and results</h3><div>Clinical isolates of <em>M. avium</em> were used to infect murine alveolar type 1 epithelial cells (AT1s). Administration of N-acetylcysteine suppressed bacterial growth in the infected cells. Expression of the autophagosome marker microtubule-associated protein 1 light chain 3 was decreased in <em>M. avium</em>-infected cells and appeared to be restored by N-acetylcysteine administration. <em>M. avium</em> infection negatively affected the autophagic pathway, specifically mTORC1 signaling and its upstream factor, SLC37A4, which was partially restored by N-acetylcysteine administration. Autophagy inhibition by bafilomycin attenuated the NAC-associated reduction in bacterial load, suggesting involvement of autophagy-related pathways.</div></div><div><h3>Conclusions</h3><div>Our results suggest that <em>M. avium</em> infection is associated with suppressed autophagy-related responses in AT1s. NAC may function as an immunomodulatory agent by modulating autophagy-associated pathways and reducing intracellular bacterial burden.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 12","pages":"Article 102864"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145534576","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}