Lancet Infectious Diseases最新文献

{"title":"Real-world effectiveness of RSVpreF vaccination during pregnancy against RSV-associated lower respiratory tract disease leading to hospitalisation in infants during the 2024 RSV season in Argentina (BERNI study): a multicentre, retrospective, test-negative, case–control study","authors":"Gonzalo Pérez Marc, Carla Vizzotti, Deshayne B Fell, Lucila Di Nunzio, Santiago Olszevicki, Shauna Wolf Mankiewicz, Virginia Braem, Ramiro Rearte, Jessica E Atwell, Alejandra Bianchi, Nora Fuentes, Romina Zadoff, Gabriela Vecchio, María Gabriela Abalos, Rong Fan, Graciela del Carmen Morales, Bradford D Gessner, Luis Jodar, Romina Libster, Analía Rearte","doi":"10.1016/s1473-3099(25)00156-2","DOIUrl":"https://doi.org/10.1016/s1473-3099(25)00156-2","url":null,"abstract":"<h3>Background</h3>In March, 2024, Argentina became the first country to implement a national maternal immunisation programme with bivalent respiratory syncytial virus (RSV) prefusion F vaccine (RSVpreF) as the primary strategy to prevent RSV disease among infants. We aimed to evaluate vaccine effectiveness against RSV-associated lower respiratory tract disease (LRTD) and severe LRTD leading to hospitalisation among infants during the first season after implementation.<h3>Methods</h3>A multicentre, retrospective, test-negative, case-control study was done during the 2024 RSV season in 12 hospitals across Argentina (BERNI study). We included infants aged 6 months or younger who were hospitalised with LRTD between April 1 and Sept 30, 2024, and tested for RSV using PCR or indirect immunofluorescence; cases were infants with any positive RSV test and controls were PCR-confirmed negative for RSV. Infants were considered born to an RSVpreF-vaccinated pregnant woman if RSVpreF was received between 32^+0/7 weeks and 36^+6/7 weeks of gestation and 14 days or more before delivery. We estimated vaccine effectiveness against RSV-associated LRTD requiring hospitalisation (primary outcome) and RSV-associated severe LRTD requiring hospitalisation (key secondary outcome) by comparing the odds of RSVpreF vaccination during pregnancy among infant cases versus controls using multilevel logistic regression adjusted for potential confounders.<h3>Findings</h3>Of 633 infants hospitalised for LRTD between April 1 and Sept 30, 2024, 505 (286 cases and 219 controls) met full eligibility criteria for inclusion in the primary vaccine effectiveness analysis; 51 (18%) cases and 109 (50%) controls were born to individuals who received RSVpreF during pregnancy. Vaccine effectiveness against RSV-associated LRTD leading to infant hospitalisation was 78·6% (95% CI 62·1–87·9) from birth to age 3 months and 71·3% (53·3–82·3) from birth to age 6 months. Effectiveness against RSV-associated severe LRTD leading to hospitalisation was 76·9% (45·0–90·3) from birth to age 6 months. Three RSV-associated in-hospital deaths occurred, all among infants whose mothers did not receive RSVpreF during pregnancy.<h3>Interpretation</h3>These real-world estimates for the 2024 RSV season in Argentina show high RSVpreF effectiveness against RSV-associated LRTD and severe LRTD leading to hospitalisation from birth to age 3 months and sustained to age 6 months.<h3>Funding</h3>Pfizer.<h3>Translation</h3>For the Spanish translation of the abstract see Supplementary Materials section.","PeriodicalId":49923,"journal":{"name":"Lancet Infectious Diseases","volume":"18 1","pages":""},"PeriodicalIF":56.3,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143910684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal vaccination to prevent severe RSV disease in infants","authors":"Heather J Zar, Renato T Stein","doi":"10.1016/s1473-3099(25)00231-2","DOIUrl":"https://doi.org/10.1016/s1473-3099(25)00231-2","url":null,"abstract":"No Abstract","PeriodicalId":49923,"journal":{"name":"Lancet Infectious Diseases","volume":"56 1","pages":""},"PeriodicalIF":56.3,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143910685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Underimmunisation during the 2025 Texas measles outbreak","authors":"Erin N Hulland, Marie-Laure Charpignon, Thomas Berkane, Maimuna S Majumder","doi":"10.1016/s1473-3099(25)00254-3","DOIUrl":"https://doi.org/10.1016/s1473-3099(25)00254-3","url":null,"abstract":"No Abstract","PeriodicalId":49923,"journal":{"name":"Lancet Infectious Diseases","volume":"1 1","pages":""},"PeriodicalIF":56.3,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143910686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimated undertreatment of carbapenem-resistant Gram-negative bacterial infections in eight low-income and middle-income countries: a modelling study","authors":"Anant Mishra, Rahul Dwivedi, Kim Faure, Daniel J Morgan, Jennifer Cohn","doi":"10.1016/s1473-3099(25)00108-2","DOIUrl":"https://doi.org/10.1016/s1473-3099(25)00108-2","url":null,"abstract":"&lt;h3&gt;Background&lt;/h3&gt;Carbapenem-resistant Gram-negative (CRGN) bacterial infections are an urgent health threat, especially in low-income and middle-income countries (LMICs), where they are rarely detected and might not be treated appropriately given inadequate health system capacity. To understand this treatment gap, we estimated the total number of CRGN bacterial infections requiring an active agent and the number of individuals potentially initiated on appropriate treatment in eight large LMICs.&lt;h3&gt;Methods&lt;/h3&gt;For eight selected countries (Bangladesh, Brazil, Egypt, India, Kenya, Mexico, Pakistan, and South Africa), we estimated deaths associated with CRGN bacterial infections (that were not susceptible to other antibiotics) in 2019 using data from the Global Burden of Disease 2021 study on antimicrobial resistance. We used estimates from the literature to establish infection type-specific case fatality rates and an overall case fatality rate for CRGN bacterial infections. The total number of CRGN bacterial infections requiring an active agent could then be calculated by dividing the total number of CRGN bacterial infection-related deaths by the overall case fatality rate. We estimated the treatment gap (ie, the number of individuals with CRGN bacterial infections who were not appropriately treated) by subtracting from the total number of infections the number of individuals who initiated appropriate treatment, which was estimated using 2019 IQVIA sales data for six antibiotics active against CRGN bacteria, corrected to account for IQVIA's partial data coverage for each country and dose-adjusted by age.&lt;h3&gt;Findings&lt;/h3&gt;In 2019, in the eight selected countries, we estimated that there were 1 496 219 CRGN bacterial infections (95% CI 1 365 392–1 627 047) but that only 103 647 treatment courses were procured. The resulting treatment gap (1 392 572 cases [95% CI 1 261 745–1 523 400]) meant that only 6·9% of patients were treated appropriately. The treatment gap persisted even when we used more restrictive assumptions. The most-procured antibiotic was tigecycline (intravenous; 47 531 [45·9%] of 103 647 courses). India procured most of the treatment courses (83 468 [80·5%] courses), with 7·8% of infections treated appropriately (treatment gap 982 848 cases [95% CI 909 291–1 056 405]). The rates of appropriate treatment coverage were highest in Mexico (5634 [5·4%] courses procured; treatment gap 32 141 cases [30 416–33 867]) and Egypt (7572 [7·3%] courses procured; treatment gap 43 258 cases [38 742–47 774]), both with 14·9% of infections treated appropriately.&lt;h3&gt;Interpretation&lt;/h3&gt;Infections caused by CRGN bacteria are likely to be significantly undertreated in LMICs. To close this treatment gap, improved access to diagnostics and antibiotics, strengthening of health systems, and research to identify gaps in the treatment pathway are needed.&lt;h3&gt;Funding&lt;/h3&gt;Global Antibiotic Research and Development Partnership, supported by the Governments of Canada,","PeriodicalId":49923,"journal":{"name":"Lancet Infectious Diseases","volume":"20 1","pages":""},"PeriodicalIF":56.3,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143893415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urachal actinomycosis mimicking a urachal adenocarcinoma: case report and systematic review","authors":"Camilo Medina, Valentina Garcia, Andrés Gutiérrez, Juan Ignacio Caicedo, Camilo Torres, Sebastian Peña, César Alejandro Diaz, Carolina Barrera, Juan Carlos López, Mauricio Palau","doi":"10.1016/s1473-3099(25)00112-4","DOIUrl":"https://doi.org/10.1016/s1473-3099(25)00112-4","url":null,"abstract":"Actinomycosis is a chronic bacterial infection caused by <em>Actinomyces israelii</em>, a Gram-positive anaerobic bacterium typically found in the oral cavity and gastrointestinal tract. This infection can present in various clinical and radiological forms, affecting cervicofacial, thoracic, abdominal, and pelvic regions, often resembling malignancies. This extremely rare disease should be considered in the differential diagnosis of abdominopelvic masses. Accurate identification and appropriate management are challenging and depend on the clinician's suspicion. Most patients undergo surgery, and are treated concomitantly with antimicrobials; however, some studies have proven the potential of a strictly medical approach. Both surgical resection and targeted antibiotic therapy have shown to be successful treatments, with no recurrence rates reported. Therefore, increased clinical awareness and further research are needed to establish standardised diagnostic and treatment protocols that prevent unnecessary invasive treatments. The present Grand Round aims to report a rare case of a urachal mass in a man aged 64 years, with clinical, endoscopic, and radiological findings suggestive of adenocarcinoma. We also conducted a systematic review focused on the main presentations and treatment options.","PeriodicalId":49923,"journal":{"name":"Lancet Infectious Diseases","volume":"50 1","pages":""},"PeriodicalIF":56.3,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143893081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Respiratory syncytial virus vaccine in older adults did not reduce invasive pneumococcal disease incidence in England","authors":"Graeme Rooney, David Litt, Aryan Nikhab, Mary E Ramsay, Shamez N Ladhani","doi":"10.1016/s1473-3099(25)00253-1","DOIUrl":"https://doi.org/10.1016/s1473-3099(25)00253-1","url":null,"abstract":"No Abstract","PeriodicalId":49923,"journal":{"name":"Lancet Infectious Diseases","volume":"35 1","pages":""},"PeriodicalIF":56.3,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143893416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to Lancet Infection 2025; published online April 16. https://doi.org/10.1016/S1473-3099(25)00088-X","authors":"","doi":"10.1016/s1473-3099(25)00290-7","DOIUrl":"https://doi.org/10.1016/s1473-3099(25)00290-7","url":null,"abstract":"<em>Dahmann S, Kueckelhaus M, Wiebringhaus P, et al. Maternal mastitis and streptococcal toxic shock syndrome risk from breastfeeding children with scarlet fever: case report and literature review.</em> Lancet Infect Dis <em>2025; published online April 16. https://doi.org/10·1016/S1473–3099(25)00088-X</em>—In this Grand Round the dosage and regimen of midacolam and ketamine given during ambulance transport, and of piperacillin and tazobactam, have been updated. Details of an additional antibiotic, clindamycin, have been added to the regimen received by the patient on day 2 of their hospital stay. These corrections have been made to the online version as of April 30, 2025, and the printed version is correct.","PeriodicalId":49923,"journal":{"name":"Lancet Infectious Diseases","volume":"91 1","pages":""},"PeriodicalIF":56.3,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143893082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Missing the target for antibiotic access","authors":"Elizabeth A Ashley, Vilada Chansamouth","doi":"10.1016/s1473-3099(25)00166-5","DOIUrl":"https://doi.org/10.1016/s1473-3099(25)00166-5","url":null,"abstract":"No Abstract","PeriodicalId":49923,"journal":{"name":"Lancet Infectious Diseases","volume":"8 1","pages":""},"PeriodicalIF":56.3,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143893413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunogenicity and safety of different immunisation schedules of the VLA15 Lyme borreliosis vaccine candidate in adults, adolescents, and children: a randomised, observer-blind, placebo-controlled, phase 2 trial","authors":"Laura Wagner, Michaela Obersriebnig, Vera Kadlecek, Romana Hochreiter, Santhosh Kumar Ghadge, Julian Larcher-Senn, Lisa Hegele, Jason D Maguire, Ulla Derhaschnig, Juan Carlos Jaramillo, Susanne Eder-Lingelbach, Nicole Bézay","doi":"10.1016/s1473-3099(25)00092-1","DOIUrl":"https://doi.org/10.1016/s1473-3099(25)00092-1","url":null,"abstract":"&lt;h3&gt;Background&lt;/h3&gt;Increasing incidence rates, insufficient effectiveness of exposure prevention strategies, and the potential for serious outcomes despite antibiotic treatment highlight the need for a preventive vaccine against Lyme borreliosis. VLA15, an investigational Lyme borreliosis vaccine based on outer surface protein A (OspA) variants from clinically relevant &lt;em&gt;Borrelia burgdorferi&lt;/em&gt; sensu lato genospecies in North America and Europe, has shown safety and immunogenicity in adults when administered with various three-dose schedules. We aimed to investigate the safety and immunogenicity of two-dose and three-dose schedules of VLA15 within a broader population, including children and adolescents, who are among those at increased risk of Lyme borreliosis.&lt;h3&gt;Methods&lt;/h3&gt;This randomised, observer-blind, placebo-controlled phase 2 trial is taking place at 14 clinical study centres in Lyme borreliosis-endemic areas in the USA. Healthy, eligible participants aged 5–65 years were enrolled in a 2:1:1 ratio to age cohorts of 18–65 years, 12–17 years, and 5–11 years through a staggered age-descending enrolment process. Within each age cohort, participants were randomly assigned with an electronic data capture system in a 1:1:1 ratio to receive intramuscular injections of 180 μg VLA15 at months 0, 2, and 6 (VLA15 M0-2-6 group); 180 μg VLA15 at months 0 and 6, and placebo at month 2 (VLA15 M0-6 group); or placebo at months 0, 2, and 6. Unmasked individuals included site staff and clinical research associates involved in randomisation and handling the investigational product, as well as specific individuals, both internal and external to the sponsor, who regularly reviewed trial safety data (including statisticians preparing relevant tables). All other individuals were masked; unmasking after the database snapshot for month 7 analyses for each age cohort was limited to the trial sponsor, collaboration partner, and statisticians. The primary immunogenicity endpoint was OspA serotype (ST)-specific IgG geometric mean titres (GMTs) assessed by ELISAs at month 7 (ie, 1 month after the third vaccination) and was evaluated in the per-protocol analysis set. The primary safety endpoint was the frequency of solicited local and systemic adverse events occurring within 7 days after each and any vaccination and were assessed in the safety analysis set (ie, all individuals who received at least one vaccination). This report includes safety and immunogenicity data through to month 12. This trial is ongoing but no longer recruiting participants, and is registered with &lt;span&gt;&lt;span&gt;Clinicaltrials.gov&lt;/span&gt;&lt;svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"&gt;&lt;path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt; (&lt;span&gt;&lt;span&gt;NCT04801420&lt;/span&gt;&lt;svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"&gt;&lt;path d=\"M1.12949 2.1072V1H7V6.85795H5.89","PeriodicalId":49923,"journal":{"name":"Lancet Infectious Diseases","volume":"3 1","pages":""},"PeriodicalIF":56.3,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143876000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lyme borreliosis vaccine VLA15 tested safe and immunogenic in children and adolescents","authors":"Ondrej Hajdusek, Jan Perner","doi":"10.1016/s1473-3099(25)00160-4","DOIUrl":"https://doi.org/10.1016/s1473-3099(25)00160-4","url":null,"abstract":"No Abstract","PeriodicalId":49923,"journal":{"name":"Lancet Infectious Diseases","volume":"30 1","pages":""},"PeriodicalIF":56.3,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143876001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}