Journal of Infection and Chemotherapy最新文献

{"title":"The effect of baricitinib and corticosteroid compared to that of corticosteroid monotherapy in severely and critically ill patients with COVID-19: A Japanese multicenter inpatient database study","authors":"Tomoki Mizuno ,&nbsp;Jun Suzuki ,&nbsp;Shota Takahashi ,&nbsp;Haruka Imai ,&nbsp;Hideya Itagaki ,&nbsp;Makiko Yoshida ,&nbsp;Shiro Endo","doi":"10.1016/j.jiac.2024.09.020","DOIUrl":"10.1016/j.jiac.2024.09.020","url":null,"abstract":"<div><h3>Background</h3><div>Systemic baricitinib and corticosteroids play important roles in treating severely and critically ill patients with coronavirus disease 2019 (COVID-19). However, the efficacy of the combination of baricitinib and corticosteroids compared to that of corticosteroid monotherapy in severely and critically ill hospitalized patients with COVID-19 remains unclear.</div></div><div><h3>Methods</h3><div>We analyzed severely and critically ill hospitalized patients with COVID-19 aged &gt;18 years between January 1, 2020 and May 31, 2023, using a Japanese multicenter inpatient database. We performed propensity score matching to analyze the effect of the combination of baricitinib and corticosteroids within 2 days of hospital admission (combination group) on the 28-day and in-hospital mortality rates compared with those of corticosteroid monotherapy within 2 days of hospital admission (control group). Sensitivity analysis was performed using inverse probability weighting analysis and the generalized estimating equation method.</div></div><div><h3>Results</h3><div>The eligible patients (n = 7433) were divided into a combination (n = 679) and a control group (n = 6754). One-to-four propensity score matching analyses included 566 combination and 2264 control group patients. There was no significant difference in 28-day (8.5 % vs. 8.8 %; risk difference, −0.3 % [95 % confidence interval, −2.9 to 2.3]) or in-hospital (11 % vs. 10 %; risk difference, 1.0 [−1.9 to 3.9]) mortality rates between 2 groups. The sensitivity analysis showed similar outcomes.</div></div><div><h3>Conclusion</h3><div>This observational study, using a Japanese multicenter inpatient database, found that the combination of baricitinib and corticosteroid therapy did not improve the 28-day or in-hospital mortality rates in severely and critically ill patients with COVID-19 compared to corticosteroid monotherapy.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 2","pages":"Article 102531"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348238","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":"Carbon dioxide-dependent, extended-spectrum β-lactamase producing Escherichia coli bacteremia associated with pyelonephritis: A case-report","authors":"Shinya Yamamoto ,&nbsp;Tatsuya Kobayashi ,&nbsp;Mahoko Ikeda ,&nbsp;Yusuke Nomura ,&nbsp;Takeru Morishige ,&nbsp;Katsuhiro Makino ,&nbsp;Hiroshi Ito ,&nbsp;Marie Yamashita ,&nbsp;Daisuke Jubishi ,&nbsp;Yoshiaki Kanno ,&nbsp;Koh Okamoto ,&nbsp;Yoshimi Higurashi ,&nbsp;Shu Okugawa ,&nbsp;Kyoji Moriya ,&nbsp;Haruki Kume ,&nbsp;Takeya Tsutsumi","doi":"10.1016/j.jiac.2024.10.010","DOIUrl":"10.1016/j.jiac.2024.10.010","url":null,"abstract":"<div><div><em>Escherichia coli</em> is a facultative anaerobic bacterium that causes urinary tract and bloodstream infections. Generally, <em>E. coli</em> is easily identified in routine clinical microbiology laboratories. Herein, we report a case of pyelonephritis with bacteremia due to extended-spectrum β-lactamase (ESBL) producing <em>E. coli</em>, which delayed the identification of the isolate as it exhibited carbon dioxide (CO₂)-dependent growth. The patient was a 62-year-old man who presented with nausea and an altered mental status. Contrast-enhanced computed tomography revealed multiple abscesses in the left kidney. The anaerobic bottles of the two sets of blood cultures were positive, but growth on a routine aerobic culture was weak. Identification of the isolate was delayed because it grew only on agar plates incubated in a 5 % CO₂ atmosphere. The isolate was suspected to be an ESBL-producing strain based on antimicrobial susceptibility testing, which was confirmed by polymerase chain reaction analysis. The patient was successfully treated with administering meropenem and nephrectomy. To the best-of-our-knowledge, this is the first reported case of a human infection caused by ESBL-producing carbon-dioxide-dependent <em>E. coli</em>.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 2","pages":"Article 102542"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142467555","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":"Triple artemisinin-based combination therapy (TACT): Efficacy of dihydroartemisinin-piperaquine plus chloroquine against Plasmodium berghei ANKA strains with different drug sensitivities in a murine malaria model","authors":"Olugbenga Akinola ,&nbsp;Oluwapelumi O. Afolabi ,&nbsp;Gbemisola O. Adebisi-Jose ,&nbsp;Abiodun I. Amusan ,&nbsp;Hidayah A. Olumoh-Adbul ,&nbsp;Olawale Olabanji ,&nbsp;Olayinka Teslim ,&nbsp;Grace O. Gbotosho","doi":"10.1016/j.jiac.2024.11.006","DOIUrl":"10.1016/j.jiac.2024.11.006","url":null,"abstract":"<div><h3>Background</h3><div>Evident detection of artemisinin resistance markers in patient isolates of <em>Plasmodium falciparum</em> from East Africa threatens the efficacy of artemisinin-based combination therapies (ACTs) as first-line treatment of malaria in sub-Saharan Africa. Repositioning previously used antimalarials as complementary addition to ACTs has been suggested as a viable option to mitigating this threat. This study evaluated the potential benefit of chloroquine (CQ) as a complementary partner to dihydroartemisinin/piperaquine (DHA/PQ) in the treatment of malaria in a mice model.</div></div><div><h3>Methods</h3><div>The comparative efficacy of the combination of DHA/PQ/CQ and DHA/PQ against two strains of <em>Plasmodium berghei</em> ANKA (MRA 311 and 671) with different levels of sensitivities to chloroquine was evaluated in separate experiments. Parasitological activities including; parasite suppression time, parasite clearance time, recrudescence time, and parasite reduction ratio were evaluated <em>in vivo</em>. The mean survival time was also monitored throughout the duration of the study.</div></div><div><h3>Results</h3><div>In both parasite lines, 99.99 % chemo-suppression was observed on day 4 in the drug treatment groups (CQ alone, DHA/PQ and DHA/PQ/CQ). In the curative test, there were significant differences between DHA/PQ/CQ and DHQ/PQ treatment, highlighted by reduced parasite clearance time (4.75 ± 0.3 Vs 5.5 ± 0.3 days, P &lt; 0.05), significantly delayed recrudescence time (28.5 ± 1.04 Vs 13.3 ± 0.48 days, P &lt; 0.01), a 1.5-fold change in parasite reduction ratio, and a prolonged mean survival time (34.5 ± 1.04 Vs 26.7 ± 0.48 days, P &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>The addition of chloroquine to dihydroartemisinin-piperaquine may be beneficial in the treatment of malaria, especially in areas where malaria parasite sensitivity to chloroquine is predominant.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 2","pages":"Article 102556"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622057","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":"Evaluation of the clinical characteristics, laboratory parameters, and antibiotic treatment in patients diagnosed with tularemia","authors":"Yasemin Çakır Kıymaz ,&nbsp;Serkan Bolat ,&nbsp;Bilge Katırcı ,&nbsp;Özlem Aldemir ,&nbsp;Işık Altınkaya ,&nbsp;Merdan Mustafa Özcan ,&nbsp;Serhat Murat Hopoğlu ,&nbsp;Murtaza Öz ,&nbsp;Ertuğrul Keskin ,&nbsp;Caner Öksüz ,&nbsp;Kübra Fırtına Topçu ,&nbsp;Mürşit Hasbek ,&nbsp;Halef Okan Doğan ,&nbsp;Seyit Ali Büyüktuna ,&nbsp;Nazif Elaldı","doi":"10.1016/j.jiac.2024.10.014","DOIUrl":"10.1016/j.jiac.2024.10.014","url":null,"abstract":"<div><h3>Introduction</h3><div>This retrospective, cross-sectional, multi-center study aimed to evaluate the impact of laboratory results and treatments on the treatment response in patients diagnosed with tularemia.</div></div><div><h3>Methods</h3><div>The study included 190 adult patients diagnosed with tularemia between November 2023 and June 2024.</div></div><div><h3>Results</h3><div>67.9 % were female, mean age was 45.8 ± 14.9 years. The most frequently detected symptoms were sore throat (74.2 %), fatigue (71.6 %), and neck swelling (56.3 %). The most common form of tularemia was oropharyngeal (82.6 %) and glandular (14.2 %). The most used monotherapy was ciprofloxacin (80.5 %, n = 136), and combination therapy was streptomycin-ciprofloxacin (81.0 %, n = 17). Treatment failure was observed in 29 patients (15.2 %). No difference was found between patients who responded and didn't respond to treatment regarding laboratory parameters. Lymph node drainage or excision was performed in 47 patients (23 %). Suppurative lymphadenitis, abscess, necrosis, and conglomerate lymphadenopathy were more common in the lymph node drainage group. Reactive lymph nodes were more common in the group without lymph node drainage. There was no difference between the two groups regarding laboratory parameters of patients with and without lymph node drainage. The duration of antibiotic treatment was longer in patients who underwent lymph node drainage than in those who didn't.</div></div><div><h3>Conclusion</h3><div>Radiological evaluation of lymph nodes upon hospital admission, in addition to antibiotic therapy during treatment, may help predict which patients are more likely to require surgical drainage. Laboratory parameters may not provide significant benefits in predicting the need for lymph node drainage and long-term treatment did not affect the treatment response.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 2","pages":"Article 102546"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558064","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":"Factors associated with the change of antimicrobial prescription before and after the national action plan on antimicrobial resistance: Additional analysis of a nationwide survey conducted by the Japanese Society of Chemotherapy and the Japanese Association for Infectious Diseases","authors":"Shinichiro Morioka ,&nbsp;Shinya Tsuzuki ,&nbsp;Yoshiaki Gu ,&nbsp;Yumiko Fujitomo ,&nbsp;Hiroshi Soeda ,&nbsp;Chikara Nakahama ,&nbsp;Naoki Hasegawa ,&nbsp;Shigefumi Maesaki ,&nbsp;Masayuki Maeda ,&nbsp;Tetsuya Matsumoto ,&nbsp;Isao Miyairi ,&nbsp;Norio Ohmagari","doi":"10.1016/j.jiac.2024.09.021","DOIUrl":"10.1016/j.jiac.2024.09.021","url":null,"abstract":"<div><h3>Background</h3><div>A nationwide survey conducted by the Japanese Society of Chemotherapy and the Japanese Association for Infectious Diseases in 2020 provided insights into antimicrobial prescription practices among clinic doctors. This study aimed to investigate factors influencing changes in antimicrobial prescriptions post-implementation of the National Action Plan on Antimicrobial Resistance (NAPAR) and doctors' inclination to prescribe antimicrobials for common cold cases.</div></div><div><h3>Methods</h3><div>In September 2020, randomly selected questionnaires were distributed to 3000 community-based medical clinics in Japan. The primary objective was to assess the reduction in antimicrobial prescriptions post-NAPAR implementation. Multivariate linear regression analysis was employed to identify associated factors.</div></div><div><h3>Results</h3><div>Analysis of 632 responses (response rate: 21.1 %) revealed determinants of decreased antimicrobial prescriptions, including familiarity with the Guide to Antimicrobial Stewardship (β = .482, t = 3.177, p = 0.002) and awareness of NAPAR (β = .270, t = 2.301, p = 0.022).</div></div><div><h3>Conclusion</h3><div>Interventions such as the Guide to Antimicrobial Stewardship may have contributed to the reduction in antimicrobial prescriptions among Japanese physicians. However, targeted strategies are needed to address high-prescription groups. Enhancing awareness and education on appropriate antimicrobial use should be integral components of future initiatives to combat antimicrobial resistance effectively.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 2","pages":"Article 102532"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142375561","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":"Cryptococcus neoformans fungemia in a liver transplant patient: Case report and literature review","authors":"Kübra Evren ,&nbsp;Fatma Mutlu-Sarıgüzel ,&nbsp;Ayşe Nedret Koç","doi":"10.1016/j.jiac.2024.08.011","DOIUrl":"10.1016/j.jiac.2024.08.011","url":null,"abstract":"<div><div><em>Cryptococcus neoformans</em> is an environmental fungus that can frequently cause life-threatening meningitis and fungemia in acquired immunodeficiency syndrome patients. In recent years, cases of these fungal infections are increasingly identified in HIV-negative patients especially in solid organ transplantation (SOT) patients. Cryptococcal fungemia can often clinically present as life-threatening disseminated disease from subclinical colonization. This is a factor that affects survival, especially in patients with decompensated liver cirrhosis and SOT recipients. Early diagnosis and appropriate treatment are important for the course of the disease. This report describes the cryptococcal fungemia that developed in an HIV-negative patient after SOT due to alcohol-related liver cirrhosis.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 2","pages":"Article 102496"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141995858","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 clinical characteristics and severity of COVID-19 with or without viral co-infection in hospitalized children","authors":"Kensuke Shoji ,&nbsp;Yusuke Asai ,&nbsp;Shinya Tsuzuki ,&nbsp;Nobuaki Matsunaga ,&nbsp;Setsuko Suzuki ,&nbsp;Noriko Iwamoto ,&nbsp;Takanori Funaki ,&nbsp;Isao Miyairi ,&nbsp;Norio Ohmagari","doi":"10.1016/j.jiac.2024.09.009","DOIUrl":"10.1016/j.jiac.2024.09.009","url":null,"abstract":"<div><h3>Background</h3><div>Co-infection with other pathogens can alter the severity and clinical outcomes of viral infections. However, the information regarding viral co-infections in pediatric coronavirus disease 2019 (COVID-19) cases is still limited.</div></div><div><h3>Methods</h3><div>This is a nationwide, retrospective cohort study using the data from the COVID-19 Registry Japan. The pediatric (&lt;18 years), laboratory confirmed, hospitalized COVID-19 patients in the Omicron variant of concern predominant period (January 2022 to January 2024) were included. Co-infection was investigated by multiplex PCR. We compared clinical characteristics, symptoms, severity, and outcomes between children with and without co-infection.</div></div><div><h3>Results</h3><div>Among 245 hospitalized pediatric COVID-19 patients, 78 (31.8 %) had co-infections. The patient backgrounds of the “co-infection” and “SARS-CoV-2 alone” groups were similar, although age distribution was different, with a lower number of patients over 12 years in the co-infection group (n = 2, 2.6 % vs. n = 29, 17.4 %; <em>P</em> &lt; 0.001). Among the patients with co-infection, the most common pathogen was enterovirus/rhinovirus (51.3 %), followed by parainfluenza virus (23.1 %) and adenovirus (12.8 %). Patients with co-infection more commonly had respiratory symptoms, including SpO₂ &lt; 96 %, shortness of breath, runny nose, and wheezing. Requirement of non-invasive oxygen support was higher in the co-infection group (n = 27, 34.6 % vs. n = 28, 16.8 %, <em>P</em> = 0.006). By multivariable logistic regression analysis, co-infection and presence of any comorbidity were identified as significant risk factors for necessity of oxygen therapy (odds ratio [95 % confidence interval] 2.44 [1.29–4.63] and 3.99 [2.07–7.82], respectively).</div></div><div><h3>Conclusions</h3><div>Viral co-infection may increase the risk of respiratory distress in pediatric COVID-19 patients.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 2","pages":"Article 102520"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142262406","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":"Multiple arterial aneurysms in a patient with spondylitis following intravesical Bacillus Calmette-Guérin administration for bladder cancer: A case report","authors":"Shun Yonezaki ,&nbsp;Masumi Suzuki Shimizu ,&nbsp;Tomomi Ota ,&nbsp;Soichiro Ozasa ,&nbsp;Shogo Akabame ,&nbsp;Shotaro Ide ,&nbsp;Kosuke Kosai ,&nbsp;Katsunori Yanagihara ,&nbsp;Koya Ariyoshi ,&nbsp;Akitsugu Furumoto","doi":"10.1016/j.jiac.2024.10.017","DOIUrl":"10.1016/j.jiac.2024.10.017","url":null,"abstract":"<div><div><em>Mycobacterium bovis</em> is one of the species belonging to the <em>Mycobacterium tuberculosis</em> complex; its attenuated form—Bacillus Calmette-Guérin (BCG)—is used as a live vaccine against tuberculosis. Besides its use as a vaccine, BCG is widely used for treating bladder cancer. However, complications related to its use can lead to disseminated infection with <em>M. bovis</em>, known as BCGosis. BCGosis has multiple manifestations, and its culture requires a long time and complex polymerase chain reaction (PCR), posing challenges to its diagnosis. Herein, we report a case of a 74-year-old man with bladder cancer in whom multiple new arterial aneurysms developed during spondylitis treatment following intravesical BCG administration. The patient presented with syncope and left neck swelling. His medical history included transurethral bladder tumor resection and intravesical BCG therapy for bladder cancer. Sixteen months before he visited our institution, he developed spondylitis (L5/S1), an epidural abscess (L5/S1), and an abscess on the right thigh. Biopsy cultures and PCR confirmed <em>M. tuberculosis</em> complex, leading to antituberculosis drug therapy. Upon admission, multiple aneurysms were identified, and drug therapy was continued. However, new multiple aneurysms developed with the rupture of the right femoral aneurysm, leading to surgical interventions and arterial biopsy. The biopsy showed no signs of mycobacterial infection. Other aneurysm etiologies were ruled out and <em>M. bovis</em> was confirmed by PCR in the specimen from the initial intervertebral disc biopsy; thus, a diagnosis of BCGosis was made. This case highlights the importance of a thorough follow-up to detect new complications, even during treatment.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 2","pages":"Article 102549"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142605034","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":"Identification of causative and non-causative microorganisms of nephrostomy tube-associated pyelonephritis among patients with malignancy","authors":"Norihiko Terada ,&nbsp;Shigemi Hitomi ,&nbsp;Hanako Kurai","doi":"10.1016/j.jiac.2024.11.013","DOIUrl":"10.1016/j.jiac.2024.11.013","url":null,"abstract":"<div><h3>Background</h3><div>Prolonged installation of a nephrostomy tube causes colonization of various microorganisms within the lumen of the tube, leading to the development of nephrostomy tube-associated pyelonephritis (NTAP). Patients with malignancy, often necessitating long-term installation of a nephrostomy tube, are susceptible to NTAP. However, information regarding the characteristics of NTAP in this population is limited.</div></div><div><h3>Methods</h3><div>We reviewed 43 NTAP cases of patients with malignancy in a cancer center and examined causative and non-causative microorganisms among those detected in urine culture. Causative microorganisms were defined as (1) those detected simultaneously in urine and blood cultures or (2) those detected in monomicrobial urine culture and to which physicians administered active antimicrobials for ≥5 days. Non-causative microorganisms were defined as those to which active antimicrobials were given for a total of &lt;5 days.</div></div><div><h3>Results</h3><div>Patients in 42 of the 43 NTAP cases recovered with antimicrobial therapy for ≥7 days. Causative microorganisms were identified in 25 cases, where <em>Escherichia coli</em> and <em>Klebsiella pneumoniae</em> were most frequent. All enterococci other than <em>Enterococcus faecalis</em>, <em>Corynebacterium</em> species, and <em>Candida</em> species other than <em>Candida albicans</em> and most of <em>Stenotrophomonas maltophilia</em> detected in urine culture were considered non-causative of NTAP.</div></div><div><h3>Conclusion</h3><div><em>E. coli</em> was a common organism causing NTAP of this population. Several microorganisms resistant to cephalosporin were non-causative of NTAP, for which administration of antimicrobials may be unnecessary even if detected in urine culture.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 2","pages":"Article 102563"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681724","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":"Teicoplanin 24-h loading dose regimen using a decision tree model to target serum trough concentration of 15–30 μg/mL: A retrospective study","authors":"Shoji Kondo ,&nbsp;Kazutaka Oda ,&nbsp;Tetsuya Kaneko ,&nbsp;Hirofumi Jono ,&nbsp;Hideyuki Saito","doi":"10.1016/j.jiac.2024.11.014","DOIUrl":"10.1016/j.jiac.2024.11.014","url":null,"abstract":"<div><h3>Introduction</h3><div>Teicoplanin (TEIC) is typically administered as a loading dose over 36–48 h. Achieving an effective concentration quickly is expected to treat severe infections, such as sepsis and methicillin-resistant <em>Staphylococcus aureus</em> infections. We aimed to identify the TEIC loading dose to be completed within 24 h, targeting the concentration of 15–30 μg/mL and factors affecting the loading dose by utilizing the decision tree (DT) model.</div></div><div><h3>Methods</h3><div>Patients treated with TEIC between January 2017 and December 2022 who met the 24-h loading dose regimen were enrolled. A LD_22.5 (corrected TEIC loading dose targeting concentration of 22.5 μg/mL) was determined, factors affecting the concentration were extracted, and a DT model was constructed. The validity of the DT was assessed using the coefficient of determination (R²) in the DT and population pharmacokinetics (PopPK) models for LD_22.5.</div></div><div><h3>Result</h3><div>A total of 149 patients were divided into training (n = 104, 70 %) and test groups (n = 45, 30 %). We indicated an average of 14.5 mg/kg for LD_22.5 and extracted four factors (estimated glomerular filtration rate, age, albumin, and C-reactive protein) from the DT model. The R² values were 0.724, 0.695, 0.681, and 0.653 for the DT models (training and test groups) and two PopPK models, respectively.</div></div><div><h3>Conclusion</h3><div>We established a 24-h loading dose regimen targeting the TEIC concentration of 15–30 μg/mL and identified four factors affecting the loading dose by using DT. By following the indicated DT algorithm flowchat, optimal decisions regarding the loading dose could be made for TEIC therapy.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 2","pages":"Article 102564"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687001","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}