Therapeutic Advances in Infectious Disease最新文献

{"title":"Clinical outcomes, environmental exposure factors, and antibiotic resistance patterns of extensively drug-resistant (XDR) typhoid fever in Pakistan: A prospective observational study.","authors":"Hamna Khalid, Abdul Rehman Shahid, Eman Ahmad, Noshaba Razaq, Fatima Binte Muhammad, Laiba Irfan Ghauri, Sehrish Khan, Muhammad Dawood Nazir, Noof K Binashikhbubkr","doi":"10.1177/20499361261474659","DOIUrl":"https://doi.org/10.1177/20499361261474659","url":null,"abstract":"<p><strong>Background: </strong>Extensively drug-resistant (XDR) typhoid fever is a major public health concern in Pakistan, with limited treatment options and rising morbidity. There is a limited amount of evidence available on the role of the environmental factors that may impact the severity of the disease in adults.</p><p><strong>Objectives: </strong>To evaluate clinical outcomes, antimicrobial resistance patterns, and environmental factors associated with disease severity among adults with XDR typhoid fever in Northern Punjab, Pakistan.</p><p><strong>Design: </strong>Prospective observational study.</p><p><strong>Methods: </strong>A prospective observational study was conducted from January 2024 to January 2025 at a tertiary care hospital in Northern Punjab. The enrollment occurred among adult patients (18- 60 years) with blood culture-confirmed XDR <i>Salmonella enterica</i> serovar Typhi infection using consecutive sampling. Clinical characteristics, susceptibility to antimicrobials, and environmental exposure were recorded. Severity of the disease was defined based on clinically significant complications and adverse outcomes. The chi-square test and Fisher exact test were used to analyze the associations, followed by multivariable logistic regression analysis to adjust for potential confounders.</p><p><strong>Results: </strong>Among 110 patients, meropenem (98.2%) and azithromycin (96.4%) showed the highest antimicrobial susceptibility. Contaminated drinking water, poor sanitation, street food and season of diagnosis were also significantly associated with severe disease (p<0.05).</p><p><strong>Conclusion: </strong>XDR typhoid fever in Northern Punjab was characterized by extensive antimicrobial resistance, while poor sanitation, contaminated drinking water, street food consumption, and season of diagnosis were significantly associated with severe disease. There is an immediate need to strengthen water, sanitation, antibiotic stewardship, and vaccination strategies.</p><p><strong>Registration: </strong>Not applicable.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261474659"},"PeriodicalIF":3.8,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13473778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763288","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":"Antiviral strategies against human norovirus: Molecular targets, therapeutics, and vaccine development.","authors":"Sadia Islam, Sabbir Alam Zia, Simonto Mirza, Md Moshiur Rahman, Md Abdullah All Shafi, Md Hamed Hasan, Abdullah Al Mamun","doi":"10.1177/20499361261473798","DOIUrl":"https://doi.org/10.1177/20499361261473798","url":null,"abstract":"<p><p>Human norovirus (HuNoV) is a leading cause of acute viral gastroenteritis worldwide and represents a major unmet challenge in antiviral drug and vaccine development. HuNoV is a non-enveloped, positive-sense RNA virus characterized by extensive genetic diversity and rapid evolution, which contribute to recurrent outbreaks in the absence of effective licensed therapeutics. Despite substantial progress in understanding HuNoV molecular biology, effective antiviral strategies remain limited, in part due to historical limitations in experimental model systems and the virus's ability to evade host antiviral responses. Recent advances in HuNoV in vitro culture systems, particularly human intestinal enteroids, and inhibitor screening platforms have improved the identification of antiviral candidates, while parallel efforts in vaccine development have yielded immunogenicity data in preclinical and early-stage clinical studies. However, significant challenges persist, including antigenic diversity, strain-specific immunity, and limited correlates of protection. This review provides a critical analysis of the molecular mechanisms governing HuNoV infection, immune evasion, and replication, with a focused emphasis on key antiviral targets, inhibitory strategies, and therapeutic development. Moreover, this review outlines key limitations and future directions for the development of effective therapeutic and preventive measures against HuNoV infection.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261473798"},"PeriodicalIF":3.8,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13473764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765796","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":"Community awareness, perception, and preventive practices towards rabies in Ethiopia: A systematic review and meta-analysis.","authors":"Gebremeskel Kibret Abebe, Wagaw Abebe","doi":"10.1177/20499361261473789","DOIUrl":"https://doi.org/10.1177/20499361261473789","url":null,"abstract":"<p><strong>Background: </strong>Rabies is a major global public health problem, with case fatality rate approaching 100% once clinical symptoms appear, causing severe neurological complications and significant social and economic burdens. Ethiopia bears a high burden of rabies, with the disease remaining endemic and contributing to considerable vaccine-preventable deaths, largely due to low community awareness, inadequate preventive practices, and limited access to timely post-exposure prophylaxis. Although studies have examined community knowledge, attitudes, and preventive practices regarding rabies in Ethiopia; however, the reported findings vary across studies.</p><p><strong>Objectives: </strong>This review was conducted to estimate the pooled prevalence and identify associated factors of community knowledge, attitudes, and preventive practices related to rabies prevention in Ethiopia.</p><p><strong>Design: </strong>Systematic review and meta-analysis.</p><p><strong>Data sources and methods: </strong>A comprehensive and systematic literature search was conducted in PubMed/MEDLINE, EMBASE, ScienceDirect, Semantic Scholar, Google Scholar, the Cochrane Library, and the National Institute for Health and Care Excellence (NICE), together with relevant grey literature to identify studies reporting on community knowledge, attitudes, and preventive practices regarding rabies in Ethiopia. Data on prevalence estimates and associated determinants were extracted using Microsoft Excel and subsequently analyzed using Stata version 17.0. A random-effects model was applied to estimate the pooled prevalence, and subgroup analyses were performed to explore potential sources of heterogeneity among the included studies. Publication bias was assessed through visual inspection of funnel plots and Egger's regression test. The methodological quality of the included studies was evaluated using the Joanna Briggs Institute (JBI) critical appraisal checklist.</p><p><strong>Results: </strong>A total of 27 studies involving 11,964 participants were included in the final analysis. The pooled estimates of good knowledge, favorable attitudes, and good preventive practices toward rabies were 60.36%, 58.56%, and 54.62%, respectively. Individuals living in urban areas, formal education and previous exposure to rabies were positively associated with good knowledge of rabies prevention.</p><p><strong>Conclusions: </strong>Community awareness, attitudes, and preventive behaviors toward rabies in Ethiopia remain suboptimal, with disparities among rural populations and individuals with lower educational status. The findings highlight the need for focused education intervention, improved availability of vaccination and post-exposure services, and enhanced collaboration through the One Health approach. Future efforts should focus on scaling up community awareness and preventive behaviors to support rabies control.</p><p><strong>Registration: </strong>Not registered.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261473789"},"PeriodicalIF":3.8,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13473797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148766396","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":"Diabetic immune dysfunction and severe influenza: A comprehensive narrative review with clinical implications.","authors":"Alejandro Chapa-Rodriguez, Elizabeth Onyeaso, Purnachander Vangala","doi":"10.1177/20499361261476159","DOIUrl":"https://doi.org/10.1177/20499361261476159","url":null,"abstract":"<p><p>Diabetes mellitus is among the strongest independent risk factors for severe influenza, hospitalization, and influenza-associated acute respiratory distress syndrome (ARDS). The mechanistic basis of this association, and its clinical implications for immunomodulatory therapy, has been examined extensively in basic immunology and virology but is rarely synthesized for the practicing intensivist. This narrative review synthesizes the mechanistic basis by which diabetes predisposes to severe influenza and to translate the established pathogen-driven versus host-driven lung injury framework into a bedside-relevant heuristic for immunomodulatory decision-making. PubMed/MEDLINE and the Cochrane Library were searched from inception through April 2026, integrating evidence across innate and adaptive immunology, viral pathogenesis, and clinical trial data. The review was guided by the SANRA framework. Diabetes plausibly impairs early antiviral containment through disruption of type I interferon signaling, alveolar macrophage function, neutrophil-mediated barrier defense, and CD8⁺ T-cell responses, predominantly demonstrated in vitro and in murine models with supportive observational human data. The resulting prolonged viral replication, superimposed on baseline endothelial vulnerability, may contribute to rapid, severe lung injury. The framework applies most directly to type 2 diabetes; mechanistic differences between type 1 and type 2, and between acute glucose-driven and chronic structural mechanisms, are addressed. Available observational and meta-analytic evidence consistently associates corticosteroids with worse outcomes in influenza pneumonia. Selective adjunctive strategies, most notably mTOR inhibition with sirolimus and combination clarithromycin-naproxen-oseltamivir, show early hypothesis-generating signals but require confirmatory trials. This synthesis is intended as hypothesis-generating, not definitive.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261476159"},"PeriodicalIF":3.8,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13473762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762765","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":"Rare manifestation of melioidosis with suppurative pericarditis: A case report and mini review.","authors":"Ssu-Han Pan, Chien-Feng Li, Wei-Yao Wang","doi":"10.1177/20499361261475457","DOIUrl":"https://doi.org/10.1177/20499361261475457","url":null,"abstract":"<p><p>Melioidosis is a serious infectious disease caused by <i>Burkholderia pseudomallei</i>, a bacterium endemic to tropical regions, including Taiwan. The disease can involve multiple organs; however, cardiac involvement, particularly cardiac tamponade, is rare. To date, only four cases of melioidosis presenting with cardiac tamponade have been reported in the literature. Here, we report an extremely rare case of melioidosis complicated by pericardial effusion and cardiac tamponade, which was successfully treated with pericardiocentesis and appropriate antimicrobial therapy.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261475457"},"PeriodicalIF":3.8,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13473761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762132","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 on: Precision geospatial targeting for cost-effective tuberculosis case finding in Eastern Uganda: A quasi-experimental study.","authors":"Nicky McCreesh, Palwasha Y Khan","doi":"10.1177/20499361261477179","DOIUrl":"https://doi.org/10.1177/20499361261477179","url":null,"abstract":"","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261477179"},"PeriodicalIF":3.8,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13473769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762257","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":"Ensitrelvir in hospitalized patients with COVID-19 who were moderately to severely immunocompromised: a single-center cohort study.","authors":"Masaya Yamato, Masahiro Kinoshita, Yuki Yoshida, Yudai Yamamoto, Rie Izuhara, Takuhiro Sonoyama","doi":"10.1177/20499361261464359","DOIUrl":"10.1177/20499361261464359","url":null,"abstract":"<p><strong>Background: </strong>Immunocompromised patients have a risk of severe COVID-19.</p><p><strong>Objectives: </strong>To describe the outcomes of ensitrelvir in hospitalized immunocompromised patients with COVID-19, with remdesivir as a reference.</p><p><strong>Design: </strong>Single-center retrospective cohort study.</p><p><strong>Methods: </strong>We analyzed patients with moderate/severe immunodeficiency who received ensitrelvir or remdesivir as initial therapy. The primary outcome was 28-day all-cause mortality; secondary outcomes were time to discharge and viral clearance. Exploratory analyses used inverse probability of treatment weighting (IPTW) based on propensity scores and Cox proportional-hazards models.</p><p><strong>Results: </strong>Among 56 patients (22 ensitrelvir; 34 remdesivir), 28-day mortality was 4.5% versus 8.8%, respectively. Time to discharge and viral clearance were similar. IPTW-adjusted 28-day mortality was 4.2% with ensitrelvir and 10.7% with remdesivir (hazard ratio 0.39; 95% CI 0.04-3.64).</p><p><strong>Conclusion: </strong>In this small, single-center exploratory cohort, ensitrelvir was associated with low mortality, although comparison with remdesivir should be interpreted cautiously given treatment selection, treatment switching, and limited sample size.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261464359"},"PeriodicalIF":3.8,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13438334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680310","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":"Adjunctive corticosteroids in non-HIV immunocompromised patients with <i>Pneumocystis jirovecii</i> pneumonia: a systematic review and meta-analysis.","authors":"Gustavo Rosales-Chavez, Pedro Martínez-Ayala, Mauricio Alfredo Ambriz-Alarcón, Brian Rafael Rubio-Mora, Judith Carolina De Arcos-Jiménez, Ana María López-Yáñez, Alejandro Marín-Castañeda-Barón, Andrés Alejandro Briseño-Hernández, José Rafael Villafán-Bernal, Jaime Alejandro Sánchez-Gutiérrez, Jaime Briseno-Ramirez","doi":"10.1177/20499361261468451","DOIUrl":"10.1177/20499361261468451","url":null,"abstract":"<p><strong>Background: </strong><i>Pneumocystis jirovecii</i> pneumonia (PJP) in non-HIV immunocompromised adults carries 30%-60% mortality. Adjunctive corticosteroids are standard in HIV-PJP but remain contested in non-HIV PJP.</p><p><strong>Objectives: </strong>To determine whether adjunctive corticosteroids reduce mortality and invasive mechanical ventilation (IMV) in non-HIV PJP, and whether effect estimates differ between randomized and observational study designs.</p><p><strong>Design: </strong>Systematic review and meta-analysis.</p><p><strong>Data sources and methods: </strong>Six databases and two trial registers were searched from inception to February 7, 2026. Randomized and observational studies comparing adjunctive corticosteroids versus no corticosteroids or placebo in non-HIV adults with PJP were eligible. Random-effects meta-analyses (restricted maximum likelihood) of two co-primary outcomes included subgroup, sensitivity, <i>E</i>-value, and Grading of Recommendations Assessment analyses.</p><p><strong>Results: </strong>Twenty-eight studies were included (one randomized controlled trial (RCT), 27 observational; <math><mrow><mi>∼</mi></mrow> </math> 5300 patients): 22 contributed corticosteroid-versus-no-corticosteroid comparisons and six contributed dose-comparison data only. Evidence was discordant by design (interaction <math><mrow><mi>p</mi> <mo>=</mo> <mn>0</mn> <mo>.</mo> <mn>006</mn></mrow> </math> ): the RCT showed lower IMV (hazard ratio (HR) 0.36, 95% CI 0.14-0.90) and lower 90-day mortality (HR 0.59, 0.37-0.93); regression-adjusted observational studies suggested harm (odds ratio (OR) 1.56, 1.10-2.22); propensity-based estimates were null-compatible. Pre-specified mortality pools were non-significant short-term (OR 1.22, 0.88-1.70) and intermediate-term (OR 1.39, 0.85-2.29). Secondary infections ( <math><mrow><mi>k</mi> <mo>=</mo> <mn>4</mn></mrow> </math> ): OR 1.04 (0.63-1.72); RCT 0.59 (0.32-1.06). <i>E</i>-values for RCT effects (3.44 IMV; 2.24 mortality) exceeded the 1.81 <i>E</i>-value of the adjusted observational mortality pool. Certainty was very low for pooled mortality and moderate for RCT outcomes.</p><p><strong>Conclusion: </strong>Reliable inference rests on the single RCT rather than the pooled observational estimate, which is discordant by design and most consistent with confounding by indication. In the RCT, corticosteroids did not significantly reduce 28-day mortality but lowered IMV and 90-day mortality and sped respiratory recovery, without clear excess secondary infections (low certainty). Corticosteroids may be considered for severe respiratory failure using the PIC (ClinicalTrials.gov NCT02944045) protocol; adequately powered confirmatory trials are needed. <b><i>Trial registration</i>:</b> PROSPERO CRD420261304396.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261468451"},"PeriodicalIF":3.8,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13438341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680148","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 and determinants of dolutegravir resistance among people living with HIV with virologic failure in North-Eastern Uganda: a retrospective cross-sectional study (2022-2024).","authors":"Saadick Mugerwa Ssentongo, Hamidah Kakooza Mulungi, Ronald Opito, William Okello, Connie Nait, Ivan Katende, Baker Bakashaba, Bonniface Oryokot","doi":"10.1177/20499361261467152","DOIUrl":"10.1177/20499361261467152","url":null,"abstract":"<p><strong>Background: </strong>In 2016, Uganda adopted the WHO HIV drug resistance (HIVDR) monitoring strategy to track treatment outcomes following the introduction of a dolutegravir (DTG) based regimen as first line among people living with HIV (PLHIV). However, despite widespread transition to DTG-based regimens, evidence on acquired DTG resistance and its determinants remains limited.</p><p><strong>Objectives: </strong>To determine the prevalence of acquired DTG resistance among PLHIV with virologic failure and identify associated factors in North-Eastern Uganda.</p><p><strong>Design: </strong>We conducted a retrospective cross-sectional study from 24 accredited antiretroviral therapy health facilities in North-Eastern Uganda by 28th February 2025.</p><p><strong>Methods: </strong>The study included eligible PLHIV on DTG-based regimens with at least 2 viral loads >1000 copies/mL and a documented HIV genotypic resistance testing result between April 2022 and July 2024. Clinical data were extracted from the national drug resistance dashboard and verified against facility electronic medical records. Logistic regression via generalised estimating equations (GEE) was used to identify factors associated with DTG resistance. A <i>p</i>-value < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Of 225 participants, the median age was 19 years (interquartile range: 15-39), and 55.1% (<i>n</i> = 124) were male. The prevalence of high-level to intermediate DTG resistance was 18.7% (<i>n</i> = 42), with 14.2% (<i>n</i> = 32) having high-level resistance to DTG and 4.4% (<i>n</i> = 10) intermediate resistance. Most participants were unemployed (60.0%, <i>n</i> = 135) and had not disclosed their HIV status (74.2%, <i>n</i> = 167). DTG resistance was associated with presence of nucleoside reverse transcriptase inhibitor (NRTI) drug resistance mutations (DRMs) (adjusted odds ratio (aOR); 12.14, 95% confidence interval (CI): 4.14-35.65, <i>p</i> < 0.001), poor adherence (aOR; 6.19, 95% CI: 2.54-15.11, <i>p</i> = 0.001), DTG use ⩾ 3 years (aOR; 9.19, 95% CI: 1.60-52.74, <i>p</i> = 0.013), and alcohol/substance abuse (aOR; 3.94, 95% CI: 1.74-8.91, <i>p</i> = 0.001).</p><p><strong>Conclusion: </strong>Nearly one in five PLHIV with virologic failure exhibited DTG resistance, predominantly high-level. Key associated factors included poor adherence, being on DTG for ⩾3 years, alcohol/substance abuse, and the presence of relevant NRTI DRM. Strengthening family and peer support, integrating substance abuse screening and management in HIV care, and improving adherence may help reduce the risk of DTG resistance. These findings highlight the urgent need for enhanced HIVDR monitoring and tailored interventions to sustain progress toward HIV epidemic control by 2030.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261467152"},"PeriodicalIF":3.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13428828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664576","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":"European Society of Clinical Microbiology and Infectious Diseases Study Group for Artificial Intelligence and Digitalisation consensus statements on key aspects in the interaction of clinical microbiologists and infectious disease specialists with general-purpose large language model-based systems: project protocol.","authors":"Daniele Roberto Giacobbe, Riccardo Lucis, Suryabrata Banerjee, Giorgia Carra, Eric Dexter, Benjamin McFadden, Alberto Rizzo","doi":"10.1177/20499361261467605","DOIUrl":"10.1177/20499361261467605","url":null,"abstract":"<p><strong>Background: </strong>General-purpose large language model (LLM)-based systems are increasingly accessible to clinicians and are being explored for applications in clinical microbiology and infectious diseases (ID). However, rapid adoption has outpaced the development of specialty-specific guidance, raising concerns related to safety, reliability, accountability, and antimicrobial stewardship.</p><p><strong>Objectives: </strong>The project aims to develop consensus-based statements, endorsed by Study Group for Artificial Intelligence and Digitalisation of the European Society of Clinical Microbiology and Infectious Diseases (ESGAID), that describe principles, opportunities, and limitations in the interactions of clinical microbiologists and ID specialists with general-purpose LLM-based systems. Secondary objectives are to quantify expert agreement and identify areas of uncertainty and disagreement.</p><p><strong>Design: </strong>The project follows a structured expert consensus design using the RAND/UCLA Appropriateness Method.</p><p><strong>Methods and analysis: </strong>A multidisciplinary panel of 15 experts will be selected through ESGAID using predefined criteria to ensure balanced expertise across clinical microbiology, infectious diseases, ethics, legal aspects, and patient safety. Ten draft statements, each supported by a structured literature review, will be developed by project coordinators. Statements will be evaluated through iterative rounds of anonymous rating on a 1-9 scale, combined with moderated remote discussions. Median scores will classify statements as supported, uncertain, or unsupported. Consensus will be defined as ⩾70% agreement with <15% disagreement during final anonymous voting.</p><p><strong>Discussion: </strong>This protocol provides a transparent and reproducible framework to generate interim, specialty-specific statements on principles, opportunities, and limitations in the interactions of clinical microbiologists and ID specialists with general-purpose LLM-based systems. By combining structured evidence review with expert judgment, the resulting statements aim to delineate guidance on principles for interacting with these systems, highlight the nature of both existing risks and excessive skepticism, and identify research priorities in a rapidly evolving technological and regulatory landscape.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261467605"},"PeriodicalIF":3.8,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13396570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585494","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}