Therapeutic Advances in Infectious Disease最新文献

{"title":"Microbiological characterization of bacteremia in patients with chemotherapy-induced febrile neutropenia: systematic review and meta-analysis.","authors":"Alvarez Franklin Correa, Paola Guasti, Luis Fuenmayor-González, Harold Alexander-León, Yunqi Yu Liu, Johana Elizabeth Salgado-Apunte, Jorge González Grijalva, Hernan Sánchez, Nayely García-Méndez, María Fernanda García-Aguilera","doi":"10.1177/20499361251376123","DOIUrl":"https://doi.org/10.1177/20499361251376123","url":null,"abstract":"<p><strong>Background: </strong>Febrile neutropenia (FN) is the most common and serious adverse event of chemotherapy for solid and hematological neoplasms, with infection as a major complication. FN occurs in 10%-50% of patients with solid tumors and over 80% with hematological malignancies, with mortality rates up to 11%.</p><p><strong>Objective: </strong>To characterize bloodstream pathogens in post-chemotherapy FN through a systematic review and meta-analysis of studies published from 2013 to February 13, 2024.</p><p><strong>Design: </strong>Systematic review and meta-analysis.</p><p><strong>Data sources and methods: </strong>PubMed, Web of Science, Scopus, and Embase were searched using MeSH, Emtree, and keywords. Risk of bias was assessed using the JBI checklist. Random-effects proportions meta-analysis was performed.</p><p><strong>Results: </strong>Twenty-two studies (<i>n</i> = 23,319) reported 8665 positive blood cultures: 59% Gram-negative (95% CI: 46.8-67.5), 39.7% Gram-positive (95% CI: 31.3-48.2), and 2.5% fungi (95% CI: 0.9-4.1). Random-effects meta-analysis showed high heterogeneity (<i>I</i> ² = 98.92%, <i>p</i> < 0.01). Meta-regression by sample size, economic development, and risk of bias did not explain this variability.</p><p><strong>Conclusion: </strong>Gram-negative pathogens slightly predominate over Gram-positives in bloodstream infections among post-chemotherapy FN patients.</p><p><strong>Trial registration: </strong>PROSPERO (CRD42023472191).</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"12 ","pages":"20499361251376123"},"PeriodicalIF":3.4,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12515338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mpox: transmission dynamics, treatment, and innovations.","authors":"Prakasini Satapathy, Beema T Yoosuf, Abhay M Gaidhane, Nasir Vadia, Soumya V Menon, Kattela Chennakesavulu, Rajashree Panigrahi, Manpreet Kaur, Ganesh Bushi, Muhammed Favas K T, Muhammed Shabil, Mayank Goyal, Harish Kumar, Anju Rani, Sabah Ansar, Sanjit Sah, Diptismita Jena, Mahalaqua Nazli Khatib, Ahmad Neyazi, Khang Wen Goh","doi":"10.1177/20499361251357521","DOIUrl":"10.1177/20499361251357521","url":null,"abstract":"<p><p>The resurgence of monkeypox (mpox), driven by Clade IIb of the monkeypox virus (MPXV), has intensified global concerns about its transmission, treatment, and prevention. Mpox, a zoonotic orthopoxvirus and is primarily transmitted through close contact with infected individuals, contaminated surfaces, or respiratory droplets. Historically, the virus has been divided into two clades: Clade I, endemic to Central Africa and characterized by higher fatality rates, and Clade II, linked to milder disease in West Africa. The unprecedented global spread of Clade IIb Mpox in 2022, affecting over 99,000 individuals across 118 countries, underscored the potential for widespread transmission beyond endemic regions. This review provides a detailed examination of the transmission dynamics of mpox, current treatments, innovations, and global health challenges. Current treatment strategies primarily involve supportive care, with advanced therapeutics such as tecovirimat, cidofovir, and brincidofovir reserved for severe cases. While these antivirals show promise, their clinical efficacy and safety remain inadequately substantiated, creating a pressing need for rigorous trials. Preventive measures, including vaccination and postexposure prophylaxis, remain pivotal in mitigating disease spread, yet face barriers such as limited supply, accessibility, and vaccine hesitancy. Emerging therapeutic innovations, such as monoclonal antibodies, gene-editing technologies, and RNA-based therapies, offer hope for addressing these gaps. These novel approaches aim to enhance treatment specificity, minimize off-target effects, and reduce the risk of resistance. However, their successful integration into clinical practice demands robust validation through preclinical and clinical research. In addressing the challenges ahead, this review underscores the critical importance of global collaboration to strengthen epidemiological surveillance, accelerate drug development, and optimize prevention strategies. The emergence of drug-resistant strains, the persistence of mpox in vulnerable populations, and the potential for future outbreaks necessitate sustained investment in research and public health infrastructure. By integrating innovative therapeutic approaches, effective preventive measures, and comprehensive outbreak management strategies, the global health community can better address the ongoing threat of mpox and prepare for future public health challenges.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"12 ","pages":"20499361251357521"},"PeriodicalIF":3.4,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12497981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in virus-related exacerbations of chronic respiratory diseases before and after the relaxation of COVID-19 infection control measures: a single-centre retrospective study in Japan.","authors":"Tsuyoshi Sasada, Ryota Kishi, Chigusa Shirakawa, Ryosuke Hirabayashi, Yuki Sato, Kazuma Nagata, Atsushi Nakagawa, Keisuke Tomii, Koichi Ariyoshi, Ryo Tachikawa","doi":"10.1177/20499361251379981","DOIUrl":"10.1177/20499361251379981","url":null,"abstract":"<p><strong>Background: </strong>Infection prevention and control (IPC) measures during the coronavirus disease 2019 (COVID-19) pandemic have led to a reduction in respiratory viral infections. However, these infections showed a resurgence in the post-COVID-19 era. Respiratory viral infections often exacerbate respiratory diseases.</p><p><strong>Objectives: </strong>This study aimed to determine how the relaxation of IPC measures affects the incidence of virus-related acute exacerbations in various respiratory diseases.</p><p><strong>Design: </strong>A retrospective study conducted at a tertiary care facility.</p><p><strong>Methods: </strong>This study retrospectively assessed data from adult patients aged 18 years and older who visited the emergency department (ED) of a tertiary medical centre in Kobe, Japan, from 1 October 2020 to 12 March 2024. We identified patients who visited because of chronic obstructive pulmonary disease (COPD) exacerbation, asthma exacerbation or acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) and classified them into two groups based on the pre-relaxation and post-relaxation of IPC measures. The detection rates and respiratory viruses identified using multiplex polymerase chain reaction were compared between the groups.</p><p><strong>Results: </strong>The total number of ED visits was 84,183 involving 129 cases of COPD exacerbation, 156 cases of asthma exacerbation and 68 cases of AE-IPF. Virus-related COPD exacerbations were significantly more frequent after the relaxation of IPC measures than before (7.7% vs 52.5%, <i>p</i> < 0.001). Similarly, virus-related asthma exacerbations occurred significantly more frequently after relaxation than before (39.7% vs 66.7%, <i>p</i> = 0.009). In contrast, no significant difference in the virus-associated AE-IPF was observed before and after relaxation (2.5% vs 5.0%, <i>p</i> = 0.61).</p><p><strong>Conclusion: </strong>Relaxation of IPC measures may increase virus-related exacerbations in COPD and asthma.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"12 ","pages":"20499361251379981"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating harm reduction and addiction care in HIV prevention among persons who inject drugs in the United States-a narrative review.","authors":"Wei-Teng Yang","doi":"10.1177/20499361251380642","DOIUrl":"10.1177/20499361251380642","url":null,"abstract":"<p><p>New human immunodeficiency virus (HIV) cases related to injection drug use (IDU) in the United States increased between 2016 and 2022. The uptake of preexposure prophylaxis (PrEP) is exceedingly low in persons who inject drugs (PWID) despite its efficacy to prevent HIV. There are multilevel barriers in the PrEP care cascade for PWID. We need a combination of effective HIV prevention strategies, including PrEP, treatment for substance use disorder, and syringe services programs (SSP) to reverse the trend. A major challenge is the lack of knowledge and skills in harm reduction practices and addiction care in the infectious disease (ID) workforce. ID clinicians could benefit from education in harm reduction and addiction, including taking on the responsibility of prescribing buprenorphine or navigating the resources for it. Addiction clinicians could benefit from education on PrEP and related program implementation knowledge. Both specialties need to comprehensively evaluate and address the risks for HIV acquisition in PWID. We should create integrated clinical programs between ID and addiction. We should improve HIV screening for hospitalized PWID. We should expand low-barrier integrated clinics with flexible hours, walk-in appointments, same-day PrEP starts, and collocated laboratory and pharmacy services. Other entities that could provide integrated care include substance detoxification and rehabilitation programs, SSPs, opioid treatment programs (OTP), community pharmacies, and mobile health clinics. Long-acting injectable PrEP for PWID is an attractive option for HIV prevention, but robust implementation programs are necessary for roll-out. We still need to address upstream barriers to care for PWID, including stigma and health disparities. We need to continue to advocate for policy changes and funding for SSPs and OTPs to provide comprehensive HIV prevention.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"12 ","pages":"20499361251380642"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A descriptive survey evaluating the implementation and outcomes of a training session highlighting concepts in antimicrobial management and harm reduction for hospital-based clinicians treating persons who use drugs.","authors":"Michael P Madaio, Wendy Y Craig, Amy Eckland, Nichole Moore, Rattanaporn Mahatanan, Colleen M Kershaw, William Bradford, Ellen Eaton, Alison B Rapoport, Monica K Sikka, Hirofumi Yoshida, Kinna Thakarar","doi":"10.1177/20499361251375334","DOIUrl":"10.1177/20499361251375334","url":null,"abstract":"<p><strong>Background: </strong>People who use drugs (PWUD) are at increased risk for severe infections and face many barriers when completing conventional, typically parenteral antimicrobial treatments. Despite evidence supporting various antibiotic options, such as oral antibiotic therapy, there has been limited uptake of these strategies by many clinicians.</p><p><strong>Objectives: </strong>Create a training for hospital-based clinicians detailing harm reduction and various antimicrobial treatment options for the care of PWUD with severe infections. Examine current hospital-based clinician practices regarding the care of PWUD. Compare pre- and post-training clinician knowledge and comfort around various antibiotic treatment options, harm reduction, and substance use stigma.</p><p><strong>Design: </strong>The study design was a pre- and post-intervention descriptive survey. The intervention was the training session. Surveys were completed by participants before and after the training. Surveys were completed by participants before and after the training and asked about participants' practices and attitudes regarding PWUD and treatment options.</p><p><strong>Methods: </strong>The training was provided to hospital-based clinicians across eight different sites in four different states from November 2022 to November 2023. We examined knowledge, attitudes, and practices around treating injection drug use-associated infections, patients with substance use disorders, and comfort with antimicrobial treatment options using pre-and post-training surveys. We also used a modified version of a validated substance use stigma instrument to measure stigma pre- and post-training. For paired pre-post survey data, we used McNemar's test to compare Likert scale responses.</p><p><strong>Results: </strong>Of 167 study participants, 126 (75%) completed the pretraining survey, and 42 (25%) provided paired pre-post survey responses. Among the 126 pre-survey respondents, 64 (51%) were trainees, 75 (60%) frequently treated patients with injection drug use-associated infections, and 61 (50%) reported consistently applying harm reduction strategies to these patients in the hospital. Post-training, participants with paired data were significantly more likely to agree with applying harm reduction principles to the care of PWUD (pre, 23 (55%); post, 39 (95); <i>p</i> < 0.001) and discussing safer drug use practices (pre, 16 (38%); post, 29 (69%); <i>p</i> = 0.004).</p><p><strong>Conclusion: </strong>Our study shows that an interactive training for hospital-based clinicians can significantly improve clinician knowledge and comfort with applying harm reduction strategies and with offering various antibiotic treatment options to PWUD with severe infections.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"12 ","pages":"20499361251375334"},"PeriodicalIF":3.4,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12454946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence, molecular carbapenemase detection, and antibiotic resistance of carbapenem-resistant <i>Enterobacterales</i> in a tertiary care hospital in East Jerusalem (2019-2023): a retrospective study.","authors":"Lilian AbuHadba, Mousa Hindiyeh, Ali Sabateen, Sameh Hallaq, Anton Handal, Hammam Rjoub, Abeer Karmi","doi":"10.1177/20499361251375354","DOIUrl":"10.1177/20499361251375354","url":null,"abstract":"<p><strong>Background: </strong>Carbapenem-resistant <i>Enterobacterales</i> (CRE) are a significant public health threat affecting human health globally. Unfortunately, the incidence of CRE has increased globally, raising the red flag for the need for an urgent plan for this serious and worrisome problem.</p><p><strong>Objectives: </strong>We aimed to identify the prevalence and genetic characterization of CRE in addition to determining antibiotic resistance profiles and the effect of independent variables on carbapenemase gene types.</p><p><strong>Design: </strong>The study is a retrospective cross-sectional study conducted at a tertiary care hospital in East Jerusalem.</p><p><strong>Methods: </strong>Data were collected from microbiology, molecular, and infectious diseases units from May 2019 till November 2023. Non-repetitive isolates that tested positive for CRE according to the CLSI (M100, S29, 2023) and American Society for Microbiology Diagnostic Microbiology Proceedings manual were included with no age exclusion.</p><p><strong>Results: </strong>A total of 599 CRE non-repetitive isolates were included, carbapenemase detected (C-CRE detected) genes were seen in 421 isolates, while the remaining 178 isolates were carbapenemase not detected (C-CRE not detected). The most common carbapenemase gene was <i>bla</i> NDM (347 isolates, 82.4%), followed by <i>bla</i> OXA-48 (55 isolates, 13.1%). The prevalence of CRE from total cultures (gram-negative, gram-positive, and no growth) during the study period was 2.4%, while the prevalence of CRE from <i>Enterobacterales</i> was 20.6%. The prevalence of CRE increased over the study years with a notable increase between 2020 and 2021, <i>Klebsiella</i> species were the most common carbapenem-resistant bacterial genera, while surveillance anal swab culture was the most dominant culture site from where CRE isolates were isolated. Antibiotic resistance varied according to carbapenemase gene type and bacterial genera.</p><p><strong>Conclusion: </strong>CRE is a growing problematic health issue that spotlights the urgent need for integrated, complete, and appropriate national antimicrobial stewardship and infection prevention and control programs.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"12 ","pages":"20499361251375354"},"PeriodicalIF":3.4,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12434295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment from the field: young people 15-17 years old need PrEP access in Peru.","authors":"Kelika A Konda, Amaya Perez-Brumer, Alfonso Silva-Santisteban","doi":"10.1177/20499361251366124","DOIUrl":"10.1177/20499361251366124","url":null,"abstract":"","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"12 ","pages":"20499361251366124"},"PeriodicalIF":3.4,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12426386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal quantification of serum SARS-CoV-2 neutralising antibodies, pro-inflammatory cytokines, NfL and GFAP before and after breakthrough COVID-19 infection in CNS neuroimmunological diseases: a prospective observational study.","authors":"M Hema Prashaad, Rachel Wan En Siew, Amelia Yun Yi Aw, Janice Hui Yi Tan, Muhammad Yaaseen Gulam Mohamed, Janis Tye Siew Noi, Kalpana Prasad, Kevin Tan, Jens Kuhle, Yinxia Chao, Ivy Ai-Wei Ho, Tianrong Yeo","doi":"10.1177/20499361251370471","DOIUrl":"10.1177/20499361251370471","url":null,"abstract":"<p><strong>Background: </strong>Immunosuppressive treatment can attenuate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine-induced immune responses. Moreover, SARS-CoV-2 has neuroinvasive potential and may induce a persistent pro-inflammatory milieu following infection.</p><p><strong>Objectives: </strong>To investigate if diminished post-vaccine humoral responses can be overcome with additional vaccine doses and/or breakthrough COVID-19 infections, and if COVID-19 infection can lead to a pro-inflammatory state with neuroaxonal/neuroglial injury in the intermediate-term in patients with central nervous system (CNS) neuroimmunological diseases.</p><p><strong>Design: </strong>A prospective observational study conducted at National Neuroscience Institute, Singapore.</p><p><strong>Methods: </strong>Serum levels of SARS-CoV-2 neutralising antibodies (NAbs) were measured in patients with CNS neuroimmunological diseases following their fourth SARS-CoV-2 mRNA vaccine (V4), or after breakthrough COVID-19 infection following three prior SARS-CoV-2 mRNA vaccinations, or both. Serum levels of pro-inflammatory cytokines interleukin-6 (IL-6) and tumour necrosis factor (TNF) were evaluated post-COVID-19 infection and post-V4, compared to baseline within individuals. Serum neurofilament-light chain (NfL) and glial fibrillary acidic protein (GFAP), biomarkers of neuroaxonal and astroglial injury, respectively, were measured at baseline and post-COVID-19 infection within patients with relapsing-remitting multiple sclerosis (RRMS) and neuromyelitis optica spectrum disorder (NMOSD).</p><p><strong>Results: </strong>Sixty-one patients with various CNS neuroimmunological diseases were recruited, including 34 with MS and 19 with NMOSD. All had received at least three doses of the SARS-CoV-2 mRNA vaccine. Patients on anti-CD20/sphingosine-1-phosphate-receptor modulators (S1PRM) showed significantly reduced NAbs levels in both post-V4 and post-COVID-19 infection scenarios, compared to patients on other immunotherapies. No significant differences between baseline and post-COVID-19 infection concentrations of IL-6 and TNF were observed. Within RRMS and NMOSD patients, NfL and GFAP levels remained similar between baseline and post-COVID-19 infection.</p><p><strong>Conclusion: </strong>Anti-CD20/S1PRM treatments are associated with persistently diminished humoral responses post-V4/infection. Patients with CNS neuroimmunological diseases do not show biomarker evidence of intermediate-term pro-inflammatory states and neural injury after COVID-19 infection.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"12 ","pages":"20499361251370471"},"PeriodicalIF":3.4,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12420963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of the clinical features, laboratory findings, and outcomes of human fascioliasis in a global network: a retrospective mutlicenter study.","authors":"Andrés F Henao-Martínez, Juan C Celis-Salinas, Martin Casapia-Morales, Edgar A Ramirez-García, Daniel B Chastain, Alicia Hidron, Carlos Franco-Paredes, Nelson Iván Agudelo Higuita, Luis A Marcos","doi":"10.1177/20499361251365508","DOIUrl":"10.1177/20499361251365508","url":null,"abstract":"<p><strong>Background: </strong>Fascioliasis, caused by <i>Fasciola hepatica</i> and <i>F. gigantica</i>, is a neglected tropical disease that has significant medical and veterinary importance. This foodborne zoonotic trematodiases primarily affects poor rural populations in tropical and subtropical areas, where prevalence can be as high as 21%.</p><p><strong>Objective: </strong>This study aims to characterize the clinical features, laboratory findings, and outcomes of fascioliasis in a real-world cohort.</p><p><strong>Design: </strong>Retrospective study.</p><p><strong>Methods: </strong>Patients ⩾ 18 years old diagnosed with fascioliasis were identified from TriNetX, a global federated research network, on October 26, 2024. We used the International Classification of Diseases results to define fascioliasis (ICD-10 code B66.3) for the period 2021-2024. These data include demographics, diagnoses, comorbidities, procedures, clinical laboratory results, and medications. All variables except outcomes were not time-bound to the diagnosis date.</p><p><strong>Results: </strong>In a cohort of 174 predominantly middle-aged, female, and Caucasian patients, we found high rates of essential hypertension, neoplasms, heart disease, liver disease, and sleep disorders. Key symptoms included upper abdominal pain, skin complaints, dyspnea, and malaise/fatigue. Some outcomes were hepatomegaly, cholelithiasis, and cholangitis in 10% of patients, with hepatic cirrhosis being rare. Among hospitalized patients within 3 months of diagnosis, 63% experienced abdominal pain. Of the 13 patients who developed cholangitis or cholelithiasis, most were men, had abdominal pain, nausea/vomiting, dysphagia, and ascites with a history of liver or intrahepatic bile neoplasia. A total of 90-day mortality was low (less than 6%). Triclabendazole was reported in only 6% of these patients.</p><p><strong>Conclusion: </strong>In a large real-world case series of fascioliasis, we found a high frequency of comorbidities and typical gastrointestinal symptoms. The low use of triclabendazole may be due to limited access to the product in certain countries or its omission from the database if prescribed in the outpatient setting. Mortality was very low, but biliary and liver complications warrant characterization through additional prospective clinical studies.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"12 ","pages":"20499361251365508"},"PeriodicalIF":3.4,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12414119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancements in urinary tract infections: understanding, prevention, diagnosis, and treatment.","authors":"Bhaskar K Somani","doi":"10.1177/20499361251376457","DOIUrl":"10.1177/20499361251376457","url":null,"abstract":"","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"12 ","pages":"20499361251376457"},"PeriodicalIF":3.4,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12409034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145013371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}