Journal of Infection and Chemotherapy最新文献

{"title":"Evaluation of an automated rapid plasma reagin test of serum and cerebrospinal fluid for monitoring neurosyphilis treatment: A case report","authors":"Yudai Tanaka ,&nbsp;Miho Mitsui ,&nbsp;Nanae Asahi ,&nbsp;Hiromichi Iwasaki ,&nbsp;Ippei Sakamaki","doi":"10.1016/j.jiac.2024.09.007","DOIUrl":"10.1016/j.jiac.2024.09.007","url":null,"abstract":"<div><div>This case report explores the utility of monitoring automated rapid plasma reagin (RPR) test results in both serum and cerebrospinal fluid (CSF) samples from a patient undergoing treatment for neurosyphilis. Syphilis treatment is based on the rapid plasma reagin (RPR) and syphilis treponema antibody levels, and in the case of RPR-positive syphilis, a 1/4 reduction in the RPR value by the manual card test is considered curative. However, it should be noted that when RPR is followed by the manual card test, there may seem to be no reduction when the automated method shows a steady reduction. In the present case, initially under surveillance for an unrelated condition, was found to have symptoms; imaging and serological findings suggestive of syphilis infection including syphilitic aortitis and neurosyphilis. After two weeks of high-dose intravenous Penicillin G, the patient was treated with oral amoxicillin as an indicator of RPR titers in both the serum and cerebrospinal fluid (CSF) by automated latex agglutination. RPR in serum automated latex agglutination decreased to 1/4 at 14 weeks and treatment was terminated, with a subsequent downward trend. The RPR using the manual card test was 1/2 at 14 weeks. If only the manual card method was used, the patient might require a longer treatment. In conclusion, the automated latex agglutination method for monitoring the treatment response may be useful, especially in patients with high RPR titers.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 2","pages":"Article 102518"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142262405","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":"Dilated common bile duct diameter as an indicator of bacteremia in patients with symptomatic common bile duct stones","authors":"Kazuharu Kawano ,&nbsp;Takayuki Otani ,&nbsp;Toshikazu Abe ,&nbsp;Toshihisa Ichiba ,&nbsp;Keisuke Maeda ,&nbsp;Yuji Okazaki ,&nbsp;Hiroshi Naito","doi":"10.1016/j.jiac.2024.12.001","DOIUrl":"10.1016/j.jiac.2024.12.001","url":null,"abstract":"<div><h3>Background</h3><div>The optimal timing and selection for blood culture collection in patients with acute cholangitis remains unclear. The relationship between common bile duct (CBD) diameter and the incidence of bacteremia in patients with CBD stones was elucidated.</div></div><div><h3>Methods</h3><div>This single-center retrospective observational study included patients with symptomatic CBD stones who presented to the emergency department between January 2019 and December 2021. The primary endpoint was the incidence of bacteremia. The patients were divided into two groups based on bacteremia complications. The patient characteristics and CBD diameters were compared between the two groups to identify factors associated with bacteremia.</div></div><div><h3>Results</h3><div>In total, 270 patients were analyzed, with bacteremia identified in 134 patients (50 %), and the median CBD diameter was 10.7 mm (IQR, 8.7–13.7). The CBD diameter was significantly larger in patients with bacteremia (median 12.4 mm [IQR, 9.9–15.7] vs. 9.7 mm [IQR, 8.2–11.7], <em>P</em> &lt; 0.001) in univariate analysis. Multivariable analysis revealed that the CBD diameter was significantly associated with bacteremia (OR: 1.25, 95 % CI: 1.14–1.38, <em>P</em> &lt; 0.010). The area under the ROC curves, representing the diagnostic accuracy of CBD diameter for indicating bacteremia, was 0.72 (95 % CI, 0.66–0.78) with a cut-off value of 11.2 mm.</div></div><div><h3>Conclusion</h3><div>CBD dilation in patients with symptomatic CBD stones is significantly correlated with bacteremia. The CBD diameter cannot be assessed as the sole tool for detecting bacteremia; however, CBD dilation could be an indicator of bacteremia, assisting in the treatment strategy, regardless of the initial severity of cholangitis.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 2","pages":"Article 102571"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780399","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":"Selection and evaluation of suitable quality control strains for meropenem antimicrobial susceptibility testing through preliminary external quality assessment","authors":"Junichi Hirayama ,&nbsp;Kotaro Aoki ,&nbsp;Kohji Komori ,&nbsp;Yo Sugawara ,&nbsp;Chika Arai ,&nbsp;Yoshikazu Ishii ,&nbsp;Motoyuki Sugai ,&nbsp;Kazuhiro Tateda","doi":"10.1016/j.jiac.2024.11.003","DOIUrl":"10.1016/j.jiac.2024.11.003","url":null,"abstract":"<div><h3>Background</h3><div>Quality control (QC) of carbapenem susceptibility testing for Gram-negative bacteria faces challenges due to limited measuring ranges and the lack of suitable QC strains. This study aimed to select and evaluate QC strains for meropenem antimicrobial susceptibility testing (AST) through a pilot external quality assessment (EQA).</div></div><div><h3>Methods</h3><div>Candidate QC strains for meropenem AST were selected based on primary AST data and genomic information from the Japan Antimicrobial Resistant Bacterial Bank. Phenotype stability was verified through serial passaging and MIC comparison with original strains. The validated broth microdilution method was used to determine the target MIC value in a pilot EQA involving 47 clinical laboratories in Japan using ten different AST methods.</div></div><div><h3>Results</h3><div>Two strains, <em>Citrobacter freundii</em> JBBDAJB-19-0032 (Strain-A) and <em>Enterobacter hormaechei</em> subsp<em>. steigerwaltii</em> JBEBAAB-19-0102 (Strain-B), both carrying <em>bla</em>_IMP-1, were selected as candidate QC strains. The meropenem MICs for Strain-A and Strain-B were 4 mg/L and 2 mg/L, respectively. In the pilot EQA, 43 laboratories reported appropriate results for Strain-A and 40 laboratories reported appropriate results for Strain-B. The MIC range was 2–8 mg/L for Strain-A and 1–4 mg/L for Strain-B. However, 19 and 12 laboratories, respectively, reported out-of-range MICs using AST plates on the MicroScan WalkAway. Inappropriate results were reported by four and seven laboratories, respectively, using common methods for Strain-A and Strain-B, respectively.</div></div><div><h3>Conclusions</h3><div>The candidate QC strains selected for this study are suitable for meropenem AST EQA, except when the measuring range of certain methods does not match their QC range.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 2","pages":"Article 102553"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142605041","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 experience of tixagevimab/cilgavimab prophylaxis in Japanese patients with immunodeficiency","authors":"Kento Inoue ,&nbsp;Dan Tomomasa ,&nbsp;Yu Nakagama ,&nbsp;Hiroaki Takeuchi ,&nbsp;Yukie Tanaka ,&nbsp;Kousuke Tanimoto ,&nbsp;Takahiro Kamiya ,&nbsp;Takeshi Isoda ,&nbsp;Masatoshi Takagi ,&nbsp;Keisuke Tanaka ,&nbsp;Kota Yoshifuji ,&nbsp;Yuki Miwa ,&nbsp;Hidenori Ohnishi ,&nbsp;Satoshi Okada ,&nbsp;Takehiko Mori ,&nbsp;Shinsuke Yasuda ,&nbsp;Yasutoshi Kido ,&nbsp;Tomohiro Morio ,&nbsp;Hirokazu Kanegane","doi":"10.1016/j.jiac.2024.12.006","DOIUrl":"10.1016/j.jiac.2024.12.006","url":null,"abstract":"<div><h3>Background</h3><div>Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes severe illness and mortality in patients with immunodeficiency. Although vaccination has been recommended, the induction of protective antibodies by immunization, and thus the disease-preventive effect, has proven insufficient in immunodeficient patients, especially in those with predominantly antibody deficiency. A monoclonal antibody combination of tixagevimab and cilgavimab (TIX/CIL) was developed as a pre-exposure prophylaxis (PrEP). In this study, we investigated the post-PrEP increase in antiviral antibody titers and detailed the breakthrough infections that occurred despite PrEP in Japanese immunodeficient patients who had received TIX/CIL.</div></div><div><h3>Methods</h3><div>Blood samples were collected before and after TIX/CIL administration between November 2022 and August 2023. Antibody titers against the S-protein of SARS-CoV-2 were measured to evaluate TIX/CIL-induced protection. Information regarding breakthrough infection, as evidenced by positive antigen and/or PCR tests, was collected.</div></div><div><h3>Results</h3><div>A significant increase in the anti-S antibody titer was observed in all 89 immunodeficient patients who had received TIX/CIL. However, 14 (16 %) patients experienced breakthrough SARS-CoV-2 infections, of which one died of respiratory failure.</div></div><div><h3>Conclusion</h3><div>The shift in the SARS-CoV-2 circulating strain might have reduced the efficacy of TIX/CIL, leading to an increased number of breakthrough infections.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 2","pages":"Article 102577"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792010","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":"Co-occurrence of hydatid cyst liver with acute myeloid leukaemia: A rare case report","authors":"Anurag Singh ,&nbsp;Anuragani Verma ,&nbsp;Rashmi Kushwaha ,&nbsp;Uma Shankar Singh ,&nbsp;Shailendra Prasad Verma","doi":"10.1016/j.jiac.2024.08.008","DOIUrl":"10.1016/j.jiac.2024.08.008","url":null,"abstract":"<div><div>The term \"hydatid disease\" refers to echinococcosis. Echinococcosis is a zoonotic disease caused by the larval stage of the Echinococcus parasite. The disease is widespread in regions where the parasite is endemic, particularly in developing nations like India. However, there are only a couple of documented case studies of echinococcosis associated with hematological malignancy in the literature. We present an extremely uncommon case of a 36-year-old male who had liver hydatidosis and was diagnosed with acute myeloid leukemia (AML)-M1. The patient received treatment for acute myeloid leukemia (daunomycin, cytarabine, and 5-azacytidine), followed by management of hydatid disease after complete remission of acute leukemia. The patient underwent periodic evaluations for one year and exhibited satisfactory improvement.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 2","pages":"Article 102493"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141995856","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":"Chronic amoxicillin shortage led to alternative broad-spectrum antimicrobial use in pediatric clinics","authors":"Yuto Otsubo ,&nbsp;Nobuaki Matsunaga ,&nbsp;Ai Tsukada ,&nbsp;Tetsuji Kaneko ,&nbsp;Yusuke Isobe ,&nbsp;Yuho Horikoshi","doi":"10.1016/j.jiac.2024.08.023","DOIUrl":"10.1016/j.jiac.2024.08.023","url":null,"abstract":"<div><div>This study aimed to clarify changes in antimicrobial prescribing trends in pediatric clinics before and after the chronic shortage of amoxicillin and amoxicillin-clavulanic acid from 2023 in Japan. Amoxicillin and amoxicillin-clavulanic acid have been in chronic short supply since May 24, 2023 due to increased demand. It is unclear whether this situation has changed the type of oral antimicrobials prescribed by clinics. A retrospective observational study was conducted to analyze antimicrobial prescriptions in pediatric clinics between January and December 2023. The data was collected using information available on a new platform, the Online Monitoring System for Antimicrobial Stewardship at Clinics (OASCIS). The period from March to May was defined as the pre-shortage period, and the period from June to August was defined as the post-shortage period. Antimicrobials were classified using the AWaRe classification proposed by the World Health Organization. The average prescription rate per AWaRe classification in the three months before and after the shortage was compared. A total of 28,888 oral antimicrobial prescriptions were collected. Due to the chronic shortage, the proportion of Access antimicrobials decreased from 53.9 % in the pre-shortage period to 46.8 % in the post-shortage period (<em>p</em> &lt; 0.001). The proportion of Watch antimicrobials increased from 45.9 % to 52.8 % (<em>p</em> &lt; 0.001). Among the Watch antimicrobials, prescriptions for third-generation cephalosporins increased from 18.8 % to 24.7 % (<em>p</em> &lt; 0.001). The chronic shortage of amoxicillin and amoxicillin-clavulanic acid has led to the use of broad-spectrum antimicrobial agents for patients in pediatric clinics.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 2","pages":"Article 102508"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108123","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 between inappropriate empirical antimicrobial therapy and mortality in gram-negative bloodstream infections in patients with febrile neutropenia and hematological malignancy","authors":"Ariel Fernando Flórez Riaño ,&nbsp;Oscar Julián Rojas Castro ,&nbsp;Sigifredo Ospina ,&nbsp;Isabel Cristina Ramírez-Sánchez","doi":"10.1016/j.jiac.2024.10.006","DOIUrl":"10.1016/j.jiac.2024.10.006","url":null,"abstract":"<div><h3>Background and objective</h3><div>Inappropriate initial antimicrobial therapy has been associated with high mortality in patients with gram-negative bacilli bloodstream infections during febrile neutropenia following chemotherapy for hematological malignancies. The aim of this study is to determine this association in our hospital.</div></div><div><h3>Methods</h3><div>A single center, retrospective, cohort study of bloodstream infection due to gram-negative bacilli and febrile neutropenia was conducted. Clinical characteristics, microbiological etiology, antimicrobial resistance profile, empirical and targeted antibiotic therapy, intensive care unit admission, persistent bacteremia and mortality were analyzed.</div></div><div><h3>Results</h3><div>Of the 171 episodes of bloodstream infection due to gram-negative bacilli, empirical antimicrobial therapy was inappropriate in 43 episodes (25.1 %). There was a significant difference in mortality at 7 and 30 days between patients who received appropriate versus inappropriate empirical treatment (4.6 % versus 13.9 %, p = 0.04; 15.6 % versus 32.5 %, p = 0.016). Inappropriate empirical treatment (RR, 2.97 [95 % CI, 1.01–8.74]), shock at the time of febrile neutropenia diagnosis (RR, 6.5 [95 % CI, 1.83–23.05]) carbapenem-resistant microorganism (RR, 3.73 [95 % CI, 1.14–12.24]) and persistent bacteremia (RR, 84.6 [95 % CI, 11.3–629.4]) were associated with an increased mortality at 7 and 30 days. In the multivariate analysis, shock (RR, 4.85 [95 % CI, 2.10–11.65]) was independently associated with increased 30-day mortality, but inappropriate empirical antimicrobial therapy was not an independent prognostic determinant (RR, 1.66 [0.53–4.82]).</div></div><div><h3>Conclusion</h3><div>Shock at the time of febrile neutropenia diagnosis contributes to mortality in patients with gram-negative bacilli bloodstream infection, in this scenario, appropriate empirical antimicrobial therapy should be encouraged.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 2","pages":"Article 102538"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142467554","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":"Assessment of mumps virus-specific antibodies: Comparison of three different enzyme immunoassays and neutralization test","authors":"Yuka Mihara ,&nbsp;Tetsuo Nakayama ,&nbsp;Fumihiko Hattori ,&nbsp;Midori Yamada ,&nbsp;Tetsushi Yoshikawa","doi":"10.1016/j.jiac.2024.11.021","DOIUrl":"10.1016/j.jiac.2024.11.021","url":null,"abstract":"<div><h3>Introduction</h3><div>We evaluated the application of a newly improved enzyme immunoassay (EIA) kit, Mumps IgG Seiken®, by comparing antibody responses to different EIA kits, and neutralization tests (NTs), using clinical samples.</div></div><div><h3>Methods</h3><div>Serum samples were collected before and 4–6 weeks after vaccination from 128 children who had no history of mumps or mumps vaccination. Using three different EIA kits, Mumps IgG Seiken®, a commercial kit from Enzygnost®, and an in-house kit, mumps-specific IgG antibodies were measured. Anti-mumps antibody responses between each of the EIA kits and NTs were evaluated.</div></div><div><h3>Results</h3><div>Before vaccination, all samples were seronegative, except for three serum samples measured by Mumps IgG Seiken®, which exhibited equivocal. The antibody-positivity rates and equivocal rates of Mumps IgG Seiken® post-vaccination (71.1 % and 23.4 %, respectively) were comparable to those of Enzygnost® (74.2 % and 19.5 %, respectively). However, antibody-positivity and equivocal rates were significantly higher and lower than those of in-house kit (51.6 % and 40.6 %, respectively) (p &lt; 0.05). The concordance rates of the kit (68.7 %) were comparable to those of Enzygnost® (71.1 %) and higher than those of in-house-developed kit (58.6 %) (p &lt; 0.05). The area under curve of the three EIA kits were 0.801, 0.804, and 0.859; however, the differences did not reach significance. Correlations of the values obtained using three EIA kits with NTs were 0.71, 0.61, and 0.78.</div></div><div><h3>Conclusion</h3><div>The newly approved Mumps IgG Seiken® showed good correlation with NTs and had lower equivocal rates compared to in-house kit, comparable to Enzygnost®. This kit may be clinically acceptable for the evaluation of vaccine immunogenicity.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 2","pages":"Article 102572"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780396","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":"The efficacy and safety of a quadrivalent live attenuated influenza nasal vaccine in Japanese children: A phase 3, randomized, placebo-controlled study","authors":"Tetsuo Nakayama ,&nbsp;Takuya Hayashi ,&nbsp;Kentaro Makino ,&nbsp;Keiji Oe","doi":"10.1016/j.jiac.2024.06.023","DOIUrl":"10.1016/j.jiac.2024.06.023","url":null,"abstract":"<div><h3>Background</h3><div>Vaccination is the primary method of preventing influenza infection and complications in young children. We evaluated the efficacy and safety of a single dose of MEDI3250 (intranasal, quadrivalent, live attenuated influenza vaccine) in healthy Japanese children during the 2016/17 influenza season.</div></div><div><h3>Methods</h3><div>In this multicenter, randomized, double-blind, phase 3 study (jRCT2080223345), participants aged 2–18 years received MEDI3250 or placebo (2:1), stratified by age (2–6 years, 7–18 years). The primary and secondary endpoints were the incidence of confirmed symptomatic onset of influenza caused by a circulating wild-type strain or by a vaccine-matched strain, respectively. Safety outcomes included the incidence of adverse events (AEs) and vaccine-related AEs.</div></div><div><h3>Results</h3><div>Overall, 910 participants received MEDI3250 (n = 608) or placebo (n = 302). For the primary endpoint (regardless of the influenza subtype), the incidence of influenza onset was 25.5 % (MEDI3250) and 35.9 % (placebo); relative risk reduction, 28.8 % (95 % confidence interval, 12.5 %, 42.0 %). For the secondary endpoint (vaccine-matched strain), the incidence was 10.9 % (MEDI3250) and 17.2 % (placebo); relative risk reduction, 36.6 % (95 % confidence interval, 6.5 %, 56.8 %). Solicited AEs occurred in 67.6 % (MEDI3250) and 63.6 % (placebo). Most events were mild; nasal discharge was most common (59.2 % [MEDI3250] and 52.6 % [placebo]). Unsolicited AEs occurred in 36.0 % (MEDI3250) and 33.1 % (placebo). The most common unsolicited vaccine-related AE was diarrhea (2.3 %, both groups).</div></div><div><h3>Conclusions</h3><div>MEDI3250 had a greater preventive effect against influenza onset in Japanese children than placebo; no new safety signals were observed relative to previous clinical and post-marketing studies of MEDI3250.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 2","pages":"Article 102460"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141498179","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":"A nurse-led multifaceted intervention for the optimal use of indwelling urinary catheters at a tertiary care center: A before-after trial","authors":"Shimpei Harita ,&nbsp;Shutaro Murakami ,&nbsp;Yasuaki Tagashira ,&nbsp;Hitoshi Honda","doi":"10.1016/j.jiac.2024.07.019","DOIUrl":"10.1016/j.jiac.2024.07.019","url":null,"abstract":"<div><h3>Background</h3><div>Few interventional studies of catheter-associated urinary tract infection (CAUTI) have been conducted to optimize indwelling urinary catheter (IUC) use in Japan.</div></div><div><h3>Methods</h3><div>The nurse-led, before-after study was conducted at a tertiary care center from June 2018 through May 2022. The intervention included 1) the provision of appropriate indications for IUC use, 2) prospective feedback to the primary care providers by ward nurses on unnecessary/inappropriate IUC use with two, separate interventional phases, the first involving intensive care units (ICU) only, the second involving ICU and general wards, and 3) proactive feedback by Infectious diseases physicians in the Infection Control department to the primary care providers regarding IUC discontinuation upon discharge from the ICU.</div></div><div><h3>Results</h3><div>During the first phase involving the implementation of the intervention only in the ICU, the indwelling urinary catheter-device utilization ratio (IUC-DUR) trend in the general wards decreased by 1.5 % (P = 0.01). However, the addition of the intervention to the general wards in the second phase led to a 2 % increase in the trend (P = 0.010). The CAUTI incidence in neither the ICU nor the general wards changed significantly.</div></div><div><h3>Conclusions</h3><div>Although providing feedback on IUC removal at discharge from the ICU and appropriate indications for urinary catheter insertion can reduce inappropriate urinary catheter use, the nurse-led intervention alone was inadequate for reducing the CAUTI incidence.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 2","pages":"Article 102479"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141878854","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}