Journal of Infection and Chemotherapy最新文献_第9页

Disinfection and monitoring of Mycobacterium avium complex in the environment: A novel approach to the management of hot tub lung. 消毒和监测环境中的复合分枝杆菌：管理热浴盆肺的新方法。

IF 1.9 4区医学

Journal of Infection and Chemotherapy Pub Date : 2025-01-01 Epub Date: 2024-06-12 DOI: 10.1016/j.jiac.2024.06.005

Kento Kono, Takashi Yanagawa, Keita Kawakado, Tomohiro Fujita, Yuki Matsuoka, Makoto Nagasaki

{"title":"Disinfection and monitoring of Mycobacterium avium complex in the environment: A novel approach to the management of hot tub lung.","authors":"Kento Kono, Takashi Yanagawa, Keita Kawakado, Tomohiro Fujita, Yuki Matsuoka, Makoto Nagasaki","doi":"10.1016/j.jiac.2024.06.005","DOIUrl":"10.1016/j.jiac.2024.06.005","url":null,"abstract":"A 45-year-old man visited our hospital with a chronic cough and breathing difficulties. Chest computed tomography revealed diffuse granular shadows. Mycobacterium avium (M. avium) was cultured from bronchoalveolar lavage fluid (BALF). Surgical lung biopsy revealed non-necrotizing granulomas, and M. avium-specific PCR was positive in the tissue. M. avium was also cultured in a sample from the inlet of the patient's bathtub. Mycobacterium avium tandem repeat variable-number tandem-repeat loci (MATR-VNTR) analysis confirmed that the M. avium cultured from BALF and the bathtub inlet had identical allele profiles. The patient's symptoms and oxygenation improved while the patient was in hospital, presumably because of lack of ongoing exposure to M. avium. He was diagnosed with hot tub lung. We advised the patient to avoid bathing to avoid re-exposure. However, the patient was unwilling to follow this advice. Therefore, his bathtub and pipework were disinfected by heating them to over 70 °C. We confirmed that the disinfection has been successful by repeated culture of environmental samples. Three months after resuming bathtub use, the patient's symptoms resolved, and the pulmonary shadows seen on the initial radiography did not recur. For the treatment of hot tub lung, disinfection of M. avium complex in the environment should be considered and the environment should be monitored to confirm eradication.","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":" ","pages":"102442"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141321025","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

Severe mpox requiring colostomy in a patient with advanced HIV disease: A case report and literature review. 一名晚期艾滋病患者因严重便秘而需要进行结肠造口术：病例报告和文献综述。

IF 1.9 4区医学

Journal of Infection and Chemotherapy Pub Date : 2025-01-01 Epub Date: 2024-06-25 DOI: 10.1016/j.jiac.2024.06.017

So Yun Lim, Hong Soon Yim, Eun Jung Ahn, Euijin Chang, Jonghee Yoon, Ja-Hee Suh, Jihye Um, Hyang Su Kim, Min-Kyung Kim, Yeonjae Kim, Gayeon Kim, Jaehyun Jeon, Jun-Sun Park, BumSik Chin

引用次数: 0

Genetic characteristics of invasive pneumococcal disease-derived Streptococcus pneumoniae of serogroup 24 isolated in Tokyo, Japan. 在日本东京分离到的侵袭性肺炎链球菌疾病衍生的血清 24 型肺炎链球菌的遗传特征。

IF 1.9 4区医学

Journal of Infection and Chemotherapy Pub Date : 2025-01-01 Epub Date: 2024-07-31 DOI: 10.1016/j.jiac.2024.07.024

Yumi Uchitani, Rumi Okuno, Tsukasa Ariyoshi, Hiroaki Kubota, Jun Suzuki, Kenji Sadamasu

{"title":"Genetic characteristics of invasive pneumococcal disease-derived Streptococcus pneumoniae of serogroup 24 isolated in Tokyo, Japan.","authors":"Yumi Uchitani, Rumi Okuno, Tsukasa Ariyoshi, Hiroaki Kubota, Jun Suzuki, Kenji Sadamasu","doi":"10.1016/j.jiac.2024.07.024","DOIUrl":"10.1016/j.jiac.2024.07.024","url":null,"abstract":"Background: Since the introduction of the national routine vaccination program against Streptococcus pneumoniae in Japan from the early 2010s, the incidence of invasive pneumococcal disease (IPD) caused by non-vaccine serotypes has increased. This study focused on non-vaccine serogroup 24 strains derived from IPD and aimed to clarify their genetic characteristics.Methods: Between 2013 and 2022, 121 strains identified as serogroup 24 in patients with IPD were collected and applied to multilocus sequence typing and next-generation sequencing. Whole-genome data were used to delineate phylogenetic relationships and to identify virulence and antimicrobial resistance-associated genes.Results: Recent trends in sequence types (STs) were characterized by an increase in the proportion of ST162 and ST2754 for 24F and 24B, respectively, after 2018. Whole-genome phylogenetic analysis demonstrated that serogroup 24 strains were organized into three clades, closely related to STs but not with serotypes. All ST162 strains were classified as Global Pneumococcal Sequence Cluster (GPSC) 6 and harbored the virulence-associated rlrA islet, with co-trimoxazole-resistance mutations in folA and folP genes. Two ST162 strains with different serotypes 24F and 24B from the same patient were phylogenetically indistinguishable, showing that these strains were derived by serotype conversion during infection.Conclusion: The recent changes in predominant STs were similar to those previously reported throughout Japan, except Tokyo. Little correlation between whole-genome phylogeny and serotypes and the observed serotype conversion in one patient indicate potentially variable immunogenicity of this serogroup.","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":" ","pages":"102484"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141878855","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

Facility wastewater monitoring as an effective tool for pandemic infection control: An experience in COVID-19 pandemic with long-term monitoring. 将设施废水监测作为大流行病感染控制的有效工具：在 COVID-19 大流行中进行长期监测的经验。

IF 1.9 4区医学

Journal of Infection and Chemotherapy Pub Date : 2025-01-01 Epub Date: 2024-08-21 DOI: 10.1016/j.jiac.2024.08.014

Shoko Tateishi, Kensuke Hamada, Noriko Emoto, Kazumi Abe, Koichi Abe, Yuki Kawasaki, Mitsuhiro Sunohara, Kyoji Moriya, Hiroyuki Katayama, Takeya Tsutsumi, Yoshinori Murakami, Yutaka Suzuki, Hiroshi Yotsuyanagi, Shintaro Yanagimoto

{"title":"Facility wastewater monitoring as an effective tool for pandemic infection control: An experience in COVID-19 pandemic with long-term monitoring.","authors":"Shoko Tateishi, Kensuke Hamada, Noriko Emoto, Kazumi Abe, Koichi Abe, Yuki Kawasaki, Mitsuhiro Sunohara, Kyoji Moriya, Hiroyuki Katayama, Takeya Tsutsumi, Yoshinori Murakami, Yutaka Suzuki, Hiroshi Yotsuyanagi, Shintaro Yanagimoto","doi":"10.1016/j.jiac.2024.08.014","DOIUrl":"10.1016/j.jiac.2024.08.014","url":null,"abstract":"Introduction: Since the first report of a novel coronavirus infection caused by SARS-CoV-2 in late 2019, the infection has spread rapidly and had a significant impact on our lives. In the early stages of the COVID-19 pandemic, there was no adequate testing system in place, despite an urgent need for infection control measures in student dormitories.Methods: We have been monitoring SARS-CoV-2 in wastewater as part of our infection control efforts in the university facilities since fall 2020. In the four dormitories, absorbent cotton was placed in the drains that the facility wastewater passed through, and samples were collected twice a week and processed by RT-PCR for SARS-CoV-2. The dormitory residents were informed of the monitoring results the next morning.Results: The positivity of residents in the dormitories was highly consistent with the positivity of wastewater. Wastewater was positive in 89 % of cases before any residents were tested and found positive. Facility wastewater monitoring showed sensitivities of 80.4 % and specificities of 87.6 %. No traceable resident-to-resident transmission of infection within the facility was confirmed during the study period.Conclusion: Sampling a single wastewater outlet in a building for SARS-CoV-2 PCR can effectively indicate the presence or absence of COVID-19 cases and be very useful for infection control of a facility. This simple and effective monitoring is applicable to future outbreaks of both emerging and re-emerging infectious diseases.","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":" ","pages":"102499"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142036037","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

Blood culture bottles for culturing cerebrospinal fluid in cases of bacterial meningitis caused by Enterococcus faecalis: A case report. 粪肠球菌引起的细菌性脑膜炎病例中用于脑脊液培养的血培养瓶：病例报告°。

IF 1.9 4区医学

Journal of Infection and Chemotherapy Pub Date : 2025-01-01 Epub Date: 2024-05-20 DOI: 10.1016/j.jiac.2024.05.005

Shugo Inada, Keitaro Omori, Hiroki Kitagawa, Yumiko Koba, Toshihito Nomura, Norifumi Shigemoto, Akira Taguchi, Yasuyuki Kinoshita, Noboru Hattori, Hiroki Ohge

{"title":"Blood culture bottles for culturing cerebrospinal fluid in cases of bacterial meningitis caused by Enterococcus faecalis: A case report.","authors":"Shugo Inada, Keitaro Omori, Hiroki Kitagawa, Yumiko Koba, Toshihito Nomura, Norifumi Shigemoto, Akira Taguchi, Yasuyuki Kinoshita, Noboru Hattori, Hiroki Ohge","doi":"10.1016/j.jiac.2024.05.005","DOIUrl":"10.1016/j.jiac.2024.05.005","url":null,"abstract":"Pathogen identification is essential for the treatment of bacterial meningitis. However, cerebrospinal fluid (CSF) culture tests are often negative when antimicrobial agents are administered before CSF is collected. Therefore, it is necessary to improve the culturing process for such samples. Here, we report a case of bacterial meningitis where the causative bacteria were detected by inoculating that patient's CSF samples into blood culture bottles. A 52-year-old man developed a fever and headache after undergoing transnasal transsphenoidal surgery for a nonfunctioning pituitary neuroendocrine tumor. He was suspected of having a wound infection, for which he was treated with cefozopran and vancomycin. A CSF test was also performed, owing to persistent fever, and bacterial meningitis was suspected. Although conventional CSF culture tests were negative, CSF cultures using blood culture bottles detected Enterococcus faecalis. The antimicrobial agents were therefore changed to ampicillin and gentamicin, after which the patient's meningitis improved. The blood culture bottles used contained adsorbed polymer beads with antimicrobial neutralizing properties, which likely contributed to the isolation of the bacteria. In addition to conventional cultures, ones done in blood culture bottles may be useful for diagnosing bacterial meningitis via CSF samples-particularly in cases where antimicrobial agents have already been administered.","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":" ","pages":"102425"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141079954","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

Investigating the WHO's AWaRe classification for assessing antimicrobial stewardship programs: A single-center study. 调查世界卫生组织用于评估抗菌药物管理计划的 AWaRe 分类：单中心研究。

IF 1.9 4区医学

Journal of Infection and Chemotherapy Pub Date : 2025-01-01 Epub Date: 2024-09-02 DOI: 10.1016/j.jiac.2024.08.025

Kazutaka Oda, Shinichiro Okamoto, Eisaku Iwanaga, Hirotomo Nakata

{"title":"Investigating the WHO's AWaRe classification for assessing antimicrobial stewardship programs: A single-center study.","authors":"Kazutaka Oda, Shinichiro Okamoto, Eisaku Iwanaga, Hirotomo Nakata","doi":"10.1016/j.jiac.2024.08.025","DOIUrl":"10.1016/j.jiac.2024.08.025","url":null,"abstract":"Background: AWaRe (Access, Watch, Reserve) classification proposed by the World Health Organization (WHO) holds potential for assessing antimicrobial stewardship programs (ASPs). However, increase in antibiotics for non-infectious treatment might undermine the effectiveness of using the AWaRe classification for assessing ASPs. The study aimed to evaluate the antimicrobial usage by AWaRe classification and specify issues for assessing ASPs.Methods: The retrospective study was conducted in a single center within an 845-bed hospital. Antimicrobial usage data for outpatients were obtained from medical records used for billing purposes. Antimicrobials for non-infectious treatment were defined by smaller dose of macrolides, tetracyclines with pemphigoid, rifaximin, and prophylactic sulfamethoxazole-trimethoprim (ST) agent.Results: The usage of antimicrobials for non-infectious treatment increased from 25.3 % to 50.1 % for the ratio of the amount to defined daily doses (DDDs) and from 46.3 % to 65.9 % for prescription days between January 2015 and March 2024. The usage of prophylactic sulfamethoxazole-trimethoprim (ST) agents increased by 2.4 times, and the usage of rifaximin increased by more than 100 times. Macrolides for non-infectious treatment was stable or fluctuated while that for infection treatment decreased to that amount for non-infectious treatment. The ratios for Access increased from 31.9 % to 58 % and 42 % to 78 % by excluding the antimicrobials for non-infectious treatment.Conclusions: The findings suggested that the AWaRe classification might not be appropriate for assessing ASPs and comparing them among hospitals.","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":" ","pages":"102511"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132967","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

Tocilizumab in combination with standard of care in patients with severe COVID-19 pneumonia: Efficacy and safety from a phase 3 clinical trial in Japan. COVID-19重症肺炎患者使用托昔单抗联合标准疗法：日本 3 期临床试验的疗效和安全性。

IF 1.9 4区医学

Journal of Infection and Chemotherapy Pub Date : 2025-01-01 Epub Date: 2024-09-24 DOI: 10.1016/j.jiac.2024.09.013

Nobuyoshi Mori, Toshihiro Nanki, Akihiro Hirakawa, Masaya Yamato, Yuko Kaneko, Rie Shiokawa, Ryoto Ozaki, Norihiro Kawabata, Norio Ohmagari

{"title":"Tocilizumab in combination with standard of care in patients with severe COVID-19 pneumonia: Efficacy and safety from a phase 3 clinical trial in Japan.","authors":"Nobuyoshi Mori, Toshihiro Nanki, Akihiro Hirakawa, Masaya Yamato, Yuko Kaneko, Rie Shiokawa, Ryoto Ozaki, Norihiro Kawabata, Norio Ohmagari","doi":"10.1016/j.jiac.2024.09.013","DOIUrl":"10.1016/j.jiac.2024.09.013","url":null,"abstract":"Background: Coronavirus disease 2019 (COVID-19) is characterized by high interleukin-6 levels. Clinical data supporting tocilizumab, a monoclonal antibody that targets interleukin-6 receptor-alpha, for treating Japanese patients with severe COVID-19 pneumonia are needed.Methods: This single-arm phase 3 study investigated tocilizumab (8 mg/kg) plus standard of care (SOC) in Japanese patients hospitalized with severe COVID-19 pneumonia. Clinical status was assessed using a 7-category ordinal scale on day 28 (primary endpoint) and day 14 (secondary endpoint). Other secondary endpoints were time to improvement (≥2 category improvement) and time to hospital discharge. Safety was assessed as the incidence of adverse events (AEs).Results: Among 48 patients enrolled, 44 (91.7 %) scored ≥3 on the 7-category ordinal scale at baseline. At day 28, 35 patients (72.9 %) scored 1 and 5 (10.4 %) scored 7 on the 7-category ordinal scale; 36 (75.0 %, 95 % confidence interval [CI]: 60.40 %-86.36 %) and 39 (81.3 %, 95 % CI: 67.37 %-91.05 %) patients achieved ≥2- and ≥1-category improvement, respectively; 6 patients (12.5 %, 95 % CI: 4.73 %-25.25 %) demonstrated ≥1-category worsening. At day 14, 25 (52.1 %, 95 % CI: 37.19 %-66.71 %) and 33 patients (68.8 %, 95 % CI: 53.75 %-81.34 %) achieved ≥2- and ≥1-category improvement, respectively; 5 patients (10.4 %, 95 % CI: 3.47 %-22.66 %) demonstrated ≥1-category worsening. Median times (95 % CI) to improvement and hospital discharge were 11 (9-15) and 15 (11-18) days, respectively. Forty patients (83.3 %) experienced AEs; the incidence of ≥grade 3 AEs was 25 %.Conclusion: Tocilizumab plus SOC may provide improved clinical status in Japanese patients with severe COVID-19 pneumonia; no new safety signals were identified.","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":" ","pages":"102524"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348239","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

Outcome evaluation of pharmacist-physician collaborative protocol-based antimicrobial treatment for hospitalized stroke patients with aspiration pneumonia. 对患有吸入性肺炎的住院脑卒中患者进行药剂师-医生合作协议式抗菌治疗的效果评估。

IF 1.9 4区医学

Journal of Infection and Chemotherapy Pub Date : 2025-01-01 Epub Date: 2024-09-21 DOI: 10.1016/j.jiac.2024.09.017

Yusuke Yagi, Narika Yanagisawa, Shinya Higuchi, Moemi Okazaki, Kei Kawada, Tomoaki Ishida, Kohei Jobu, Yu Arakawa, Tomohito Kadota, Yu Kawanishi, Hitoshi Fukuda, Tetsuya Ueba, Yuka Yamagishi, Yukihiro Hamada

{"title":"Outcome evaluation of pharmacist-physician collaborative protocol-based antimicrobial treatment for hospitalized stroke patients with aspiration pneumonia.","authors":"Yusuke Yagi, Narika Yanagisawa, Shinya Higuchi, Moemi Okazaki, Kei Kawada, Tomoaki Ishida, Kohei Jobu, Yu Arakawa, Tomohito Kadota, Yu Kawanishi, Hitoshi Fukuda, Tetsuya Ueba, Yuka Yamagishi, Yukihiro Hamada","doi":"10.1016/j.jiac.2024.09.017","DOIUrl":"10.1016/j.jiac.2024.09.017","url":null,"abstract":"Objectives: To evaluate the efficacy and patient outcomes of pharmacist-physician collaborative protocol-based antimicrobial treatment regimens for antimicrobial stewardship.Methods: Patients treated for aspiration pneumonia due to stroke within 48 h after admission to Kochi Medical School Hospital (January 2019 to December 2022) were included. Primary outcomes were the cumulative number of days of antimicrobial treatment and length of hospital stay. Secondary outcomes included the percentage of patients under-dosed with first-choice antimicrobial agents and inpatient mortality.Results: Group A (66 patients) did not receive the antimicrobial treatment protocol, whereas group B (46 patients) did. There were no differences in the patient backgrounds. Group B had a significantly lower percentage of patients who were undertreated with the first-choice antimicrobial agent (9.1 % vs. 42.9 %). There was no significant difference in inpatient mortality between group A and group B (6.1 % vs. 4.3 %). The cumulative number of days of antimicrobial administration and the length of hospital stay were significantly lower in group B: 7.0 days (95 % CI, 6.0-8.0) vs. 9.0 days (95 % CI, 8.0-11.0) for antimicrobial administration, and 28.5 days (95 % CI, 22.0-35.0) vs. 43.0 days (95 % CI, 28.0-55.0) for hospital stay.Conclusions: Protocol-based antimicrobial treatment for aspiration pneumonia supports appropriate antimicrobial usage and improves patient quality of life. These findings will assist in the effective treatment of aspiration pneumonia in an aging society.","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":" ","pages":"102528"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307927","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

Trimethoprim-sulfamethoxazole combined with echinocandins versus trimethoprim-sulfamethoxazole alone for Pneumocystis pneumonia in patients without human immunodeficiency virus infection: A nationwide retrospective cohort study. 三甲氧苄啶-磺胺甲噁唑联合棘白菌素与单用三甲氧苄啶-磺胺甲噁唑治疗未感染人类免疫缺陷病毒患者的肺孢子虫肺炎：一项全国性回顾性队列研究。

IF 1.9 4区医学

Journal of Infection and Chemotherapy Pub Date : 2025-01-01 Epub Date: 2024-08-06 DOI: 10.1016/j.jiac.2024.08.004

Jumpei Taniguchi, Shotaro Aso, Hiroki Matsui, Kiyohide Fushimi, Hideo Yasunaga

{"title":"Trimethoprim-sulfamethoxazole combined with echinocandins versus trimethoprim-sulfamethoxazole alone for Pneumocystis pneumonia in patients without human immunodeficiency virus infection: A nationwide retrospective cohort study.","authors":"Jumpei Taniguchi, Shotaro Aso, Hiroki Matsui, Kiyohide Fushimi, Hideo Yasunaga","doi":"10.1016/j.jiac.2024.08.004","DOIUrl":"10.1016/j.jiac.2024.08.004","url":null,"abstract":"Background: Although combination therapy of echinocandins with trimethoprim-sulfamethoxazole (TMP-SMX) has been reported for patients with Pneumocystis jirovecii pneumonia (PCP), the effectiveness of this combination therapy in patients with PCP without human immunodeficiency virus (HIV) infection remains unknown.Methods: Data from the Japanese Diagnosis Procedure Combination inpatient database was used to identify non-HIV patients who underwent their first hospitalisation for PCP between April 2012 and March 2022. The patients were divided into those treated with TMP-SMX alone and those treated with TMP-SMX combined with echinocandins. We performed propensity-score overlap-weighting analysis to estimate in-hospital mortality.Results: Among the 1324 eligible patients, 122 received TMP-SMX plus echinocandins, while 1202 received TMP-SMX alone. The propensity-score overlap-weighting analysis showed that the combination therapy was not associated with reduced in-hospital mortality in comparison with TMP-SMX alone (22.2 % vs. 26.9 %; risk difference, 4.6 %; 95 % confidence interval, -6.1 %-15.3 %; P = 0.398).Conclusions: Echinocandins combined with TMP-SMX may not improve in-hospital mortality due to PCP in patients without HIV infection.","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":" ","pages":"102489"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141906729","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

Cryptococcal prostatitis in an immunocompromised patient with tocilizumab and glucocorticoid therapy: A case report. 一名接受托珠单抗和糖皮质激素治疗的免疫功能低下患者患上了隐球菌性前列腺炎：病例报告。

IF 1.9 4区医学

Journal of Infection and Chemotherapy Pub Date : 2025-01-01 Epub Date: 2024-08-15 DOI: 10.1016/j.jiac.2024.08.009

Kohei Oguni, Shinnosuke Fukushima, Hideharu Hagiya, Atsushi Kato, Atsuhito Suyama, Takehiro Iwata, Yoshia Miyawaki, Sawako Ono, Koji Iio, Fumio Otsuka

{"title":"Cryptococcal prostatitis in an immunocompromised patient with tocilizumab and glucocorticoid therapy: A case report.","authors":"Kohei Oguni, Shinnosuke Fukushima, Hideharu Hagiya, Atsushi Kato, Atsuhito Suyama, Takehiro Iwata, Yoshia Miyawaki, Sawako Ono, Koji Iio, Fumio Otsuka","doi":"10.1016/j.jiac.2024.08.009","DOIUrl":"10.1016/j.jiac.2024.08.009","url":null,"abstract":"Cryptococcus prostatitis is an uncommon manifestation of cryptococcal infection that occurs mostly in immunocompromised patients. Tocilizumab, an anti-interleukin-6 receptor monoclonal antibody, has been associated with an increased risk of cryptococcal infections. However, there have been no documented cases of cryptococcal prostatitis in patients receiving tocilizumab therapy. We report a case of cryptococcal prostatitis in a 72-year-old man treated with glucocorticoids and tocilizumab for giant cell arteritis and granulomatosis with polyangiitis. The patient presented dysuria and his serum level of prostate-specific antigen was elevated. Magnetic resonance imaging revealed a prostate mass, and a prostate biopsy was performed, leading to a pathologic diagnosis of cryptococcal prostatitis. Fungal cultures for blood and urine were negative, while the cryptococcal antigen for both serum and urine showed positive results. There were no particular findings in the pulmonary and central nervous systems. The patient was successfully treated with oral fluconazole (400 mg/day) and was discharged. Although cryptococcal prostatitis is a rare entity, clinicians should note that an immunosuppressed patient may develop such a difficult-to-diagnose disease.","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":" ","pages":"102494"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141995857","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