Journal of Infection and Chemotherapy最新文献

{"title":"Antimicrobial susceptibility of commensal Neisseria species in the Japanese population","authors":"Izumo Kanesaka ,&nbsp;Sheeba Santhini Manoharan-Basil ,&nbsp;Tessa De Block ,&nbsp;Chris Kenyon ,&nbsp;Masahiro Morita ,&nbsp;Takamitsu Ito ,&nbsp;Natsue Yamane ,&nbsp;Akiko Katsuse Kanayama ,&nbsp;Intetsu Kobayashi","doi":"10.1016/j.jiac.2025.102670","DOIUrl":"10.1016/j.jiac.2025.102670","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to, for the first time, characterize the antimicrobial susceptibilities of commensal <em>Neisseria</em> species in the general population in Japan. In particular, we assessed if the tetracycline minimum inhibitory concentrations (MICs) of these isolates were changing over time and, given the recent interest in doxycycline post exposure prophylaxis (PEP), if the tetracycline MICs were associated with those of the other antimicrobials.</div></div><div><h3>Methods</h3><div><em>Neisseria</em> spp. were isolated from 1679 patients visiting dental clinics in Japan between 2018 and 2023. The MICs of tetracycline, ceftriaxone, cefixime, penicillin, azithromycin and ciprofloxacin against <em>Neisseria</em> spp. were determined using agar dilution. Linear regression was used to assess if there was an association between MIC and the year the isolate was obtained from, controlling for species identity.</div></div><div><h3>Results</h3><div><em>Neisseria</em> spp. were detected in 424 of 1679 individuals sampled. Of these, 417 (98.3 %) isolates were identified as <em>Neisseria subflava</em>, and the remaining 7 (1.7 %) as <em>Neisseria mucosa</em>. The median tetracycline MIC was 0.5 mg/L (IQR 0.5–1 mg/L). The MICs of penicillin, cefixime, ceftriaxone and ciprofloxacin were lower in <em>N. mucosa</em> than in <em>N. subflava</em>. The tetracycline MICs of <em>Neisseria</em> spp. were positively correlated with penicillin, azithromycin and ciprofloxacin. No significant correlations were found with cefixime or ceftriaxone.</div></div><div><h3>Conclusions</h3><div>Our results suggest that despite the overall decline in antimicrobial use in Japan, MICs for several antimicrobials have increased over time. In particular, the MIC of tetracycline tends to be high in Japan. These results suggest the need to include surveillance of tetracycline MICs of commensal <em>Neisseria</em> spp. in doxycycline PEP implementation studies.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 4","pages":"Article 102670"},"PeriodicalIF":1.9,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143527557","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":"Mycobacterium goodii pulmonary disease in an immunocompetent patient: A case report and literature review","authors":"Toshihiro Shiratori ,&nbsp;Yasuhito Nunomura ,&nbsp;Masamichi Itoga ,&nbsp;Tomonori Makiguchi ,&nbsp;Hisashi Tanaka ,&nbsp;Kageaki Taima ,&nbsp;Kinuyo Chikamatsu ,&nbsp;Akira Kurose ,&nbsp;Satoshi Mitarai ,&nbsp;Sadatomo Tasaka","doi":"10.1016/j.jiac.2025.102665","DOIUrl":"10.1016/j.jiac.2025.102665","url":null,"abstract":"<div><div><em>Mycobacterium goodii</em> is a rapidly growing non-tuberculosis mycobacterium, which is known to cause skin, bone and soft tissue infections, but there are a few reports of respiratory infections due to <em>M. goodii</em>. A 67-year-old man had suffered from productive cough, shortness of breath and weight loss for 6 months. He had a history of total gastrectomy for gastric ulcer perforation. Computed tomography (CT) showed dense consolidation in the right lower lobe and nodular lesions in both lungs. Transbronchial cryobiopsy was performed on a lesion in the right lower lobe and granulomatous lesions were observed pathologically. Because <em>M. goodii</em> was identified from two sputum samples using matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS), we made a diagnosis of <em>M. goodii</em> pulmonary disease. To confirm the diagnosis, whole genome sequencing analysis was performed, which showed average nucleotide identity of 99.18 %. The patient was responded well to the initial therapy with amikacin, imipenem/cilastatin, doxycycline, sulfamethoxazole/trimethoprim, and clarithromycin, followed by 18 months of ambulatory treatment with doxycycline, sulfamethoxazole/trimethoprim, clarithromycin, and sitafloxacin. The sputum culture remained negative and CT findings also significantly improved 6 months after the introduction of treatment. In this case, the development of <em>M. goodii</em> pulmonary disease is might be associated with the history of gastrectomy. For identifying the pathogen, MALDI-TOF MS and whole genome sequencing analysis were useful and the intensive initial treatment in accordance with the drug susceptibility testing was successful.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 4","pages":"Article 102665"},"PeriodicalIF":1.9,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523362","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":"Assignments of antibiotic spectrum coverage scores of antibiotic agents approved in Japan: Utilization of the days of antibiotic spectrum coverage","authors":"Masayuki Maeda ,&nbsp;Satoshi Kakiuchi ,&nbsp;Yuichi Muraki","doi":"10.1016/j.jiac.2025.102667","DOIUrl":"10.1016/j.jiac.2025.102667","url":null,"abstract":"<div><div>Integrating the automated collection of antimicrobial use metrics into national surveillance systems is vital for antimicrobial stewardship evaluation. The days of antibiotic spectrum coverage (DASC) serves as a quantitative metric for assessing de-escalation strategies. A major challenge is that DASC has not yet been integrated into the national surveillance system, partly owing to the omission of commonly used antibiotics in Japan in the initially developed antibiotic spectrum coverage (ASC) scores. This study aimed to establish ASC scores for antibiotics approved in Japan and generate data supporting their integration into the national surveillance system. Antibiotics approved in Japan that had not been assigned ASC scores in the prior study were identified. Their antimicrobial activity was assessed against 16 organism categories using the same methodology as the original study. We analyzed the correlation between the Access, Watch, Reserve (AWaRe) classification and ASC scores for antibiotics approved in Japan. The ASC scores had a range of 3–16, with a median of seven. The AWaRe classification was slightly correlated with ASC scores (Spearman's ρ = 0.234). Our findings highlight the significance of employing diverse antimicrobial use metrics for comprehensively evaluating antimicrobial stewardship. The results of this study will support stakeholders in implementing ASC scores into the national surveillance system.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 4","pages":"Article 102667"},"PeriodicalIF":1.9,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523409","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":"Impact of BD BACTEC blood culture bottle shortage on performance metrics: An interrupted time-series analysis at a Japanese university-affiliated hospital","authors":"Naoya Itoh ,&nbsp;Nana Akazawa-Kai ,&nbsp;Nobumasa Okumura ,&nbsp;Shunsuke Kuriki ,&nbsp;Chiharu Wachino ,&nbsp;Takanori Kawabata","doi":"10.1016/j.jiac.2025.102664","DOIUrl":"10.1016/j.jiac.2025.102664","url":null,"abstract":"<div><h3>Background</h3><div>In 2024, a global shortage of BD BACTEC blood culture bottles disrupted clinical practices worldwide. This study assessed the impact of the shortage on blood culture performance metrics and evaluated the effectiveness of management strategies implemented at a Japanese university-affiliated hospital.</div></div><div><h3>Methods</h3><div>This single-center, retrospective observational study was conducted between June 29, 2024, and September 25, 2024, and analyzed two phases: the pre-shortage period and the shortage period. During the shortage, clinicians were instructed to collect only one blood culture set per patient, with exceptions allowed for specific conditions. Interrupted time-series analysis was performed to examine changes in blood culture performance indicators.</div></div><div><h3>Results</h3><div>A total of 4490 blood cultures were collected during the study period. The proportion of cases with two or more sets collected and the contamination rate of blood cultures significantly decreased during the shortage period. Additionally, the positivity rate of blood cultures also significantly declined compared to the pre-shortage period. <em>Candida</em> species were isolated more frequently during the shortage period, while no significant changes were observed for other organisms.</div></div><div><h3>Conclusions</h3><div>The adoption of simplified instructions enabled a rapid transition to single-set blood culture collection during the supply shortage. However, this approach reduced the blood culture positivity rate and hindered contamination rate assessment. These findings highlight the critical need for a stable supply of blood culture bottles and the importance of continued education on optimal blood culture collection practices.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 4","pages":"Article 102664"},"PeriodicalIF":1.9,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520702","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":"Real-world data on combination treatment with bedaquiline in patients with multidrug-resistant pulmonary tuberculosis in Japan: An interim analysis of post-marketing surveillance","authors":"Mako Nakaya ,&nbsp;Manami Kamishima ,&nbsp;Toshio Yamaoka ,&nbsp;Hiroaki Tsuchiya ,&nbsp;Tokiko Touma ,&nbsp;Atsushi Saito ,&nbsp;Yuki Saito ,&nbsp;Hideaki Nagai","doi":"10.1016/j.jiac.2025.102661","DOIUrl":"10.1016/j.jiac.2025.102661","url":null,"abstract":"<div><h3>Background</h3><div>An observational post-marketing surveillance (PMS) is being conducted to evaluate the long-term safety and effectiveness of bedaquiline as part of combination therapies in treating pulmonary multidrug-resistant tuberculosis (MDR-TB) in Japan.</div></div><div><h3>Methods</h3><div>This interim analysis includes patients with MDR-TB who started bedaquiline-containing anti-tuberculosis (TB) drugs in Japan between January 2018 and September 2022. Outcomes include the incidence of adverse drug reactions (ADRs) and negative sputum cultures.</div></div><div><h3>Results</h3><div>In total, 112 patients were included in the safety analysis. All patients were receiving anti-TB drugs in addition to bedaquiline at baseline; 96.4 % were receiving ≥3 drugs. The most commonly used concomitant anti-TB drugs were delamanid, cycloserine, linezolid, and levofloxacin hydrate. At 24 weeks after bedaquiline initiation, in the effectiveness analysis set, 19/20 (95.0 %) had negative sputum mycobacteria growth indicator tube cultures and 9/12 (75.0 %) have negative solid medium cultures. Patients received bedaquiline for a median of 186.0 days, during which 85 ADRs occurred in 45 patients (40.2 %). The top three ADRs were electrocardiogram QT prolonged (9.8 %), nausea (7.1 %), and hepatic function abnormal (4.5 %).</div></div><div><h3>Conclusions</h3><div>This interim analysis of a PMS supports the long-term safety and effectiveness of bedaquiline for MDR-TB in Japan. ADRs were consistent with previous reports and no new safety signals were detected. The final analysis of this ongoing PMS will be expected to confirm these findings.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 4","pages":"Article 102661"},"PeriodicalIF":1.9,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458104","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":"Intention and potential determinants of COVID-19 vaccination among healthcare workers at a single university hospital in Japan, 2024–2025 pre-season","authors":"Hideharu Hagiya ,&nbsp;Yasushi Fujita ,&nbsp;Takashi Kiguchi ,&nbsp;Yohei Manabe","doi":"10.1016/j.jiac.2025.102660","DOIUrl":"10.1016/j.jiac.2025.102660","url":null,"abstract":"<div><h3>Background</h3><div>Financial accessibility has emerged as a significant barrier to vaccine uptake following the cessation of universal public funding for coronavirus disease 2019 (COVID-19) vaccination programs. This investigation assessed the intention and determinant factors of COVID-19 vaccination among healthcare workers in Japan in the 2024–2025 pre-season.</div></div><div><h3>Methods</h3><div>A retrospective survey was conducted utilizing data collected from hospital staff at Okayama University Hospital, Japan, to inform the COVID-19 vaccination strategy in October 2024. The analysis evaluated demographic characteristics, vaccine intention, perceived barriers to vaccination, and maximum acceptable out-of-pocket expenditure.</div></div><div><h3>Results</h3><div>The study population of 3417 respondents comprised 843 medical doctors (24.7 %), 1131 nurses (33.1 %), 320 other medical staff (9.4 %), 286 dental doctors (8.4 %), and 627 administrative officers (18.3 %). At full cost, 2109 (61.7 %) indicated no intention to receive vaccination, while only 4.4 % expressed willingness to be vaccinated and 33.9 % remained undecided. With total self-payment, the vaccination acceptance rates were the highest and lowest among medical doctors (11.4 %) and nurses (1.0 %), respectively. Cost (38.1 %), followed by safety issues (29.5 %) and concerns regarding efficacy or medical necessity (20.3 %), emerged as the primary barrier. The projected vaccination intention increased to 43.9 % and 54.9 % at reduced self-pay costs of 3000 JPY and 5000 JPY, respectively.</div></div><div><h3>Conclusions</h3><div>Addressing financial constraints through policy interventions could be effective strategies in increasing overall vaccination coverage among healthcare workers. In addition, providing tailored education on vaccine safety, efficacy, and necessity may further facilitate increased vaccine uptake within this critical population.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 3","pages":"Article 102660"},"PeriodicalIF":1.9,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143428798","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":"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}