The Journal of Infectious Diseases最新文献

{"title":"Addition of macrolide antibiotics for hospital treatment of community-acquired pneumonia","authors":"Jia Wei, A Sarah Walker, David W Eyre","doi":"10.1093/infdis/jiae639","DOIUrl":"https://doi.org/10.1093/infdis/jiae639","url":null,"abstract":"Background Current guidelines recommend combining a macrolide with a β-lactam antibiotic for the empirical treatment of moderate-to-high severity community-acquired pneumonia (CAP); however macrolide use is associated with potential adverse events and antimicrobial resistance. Methods We analysed electronic health data from 8,872 adults in Oxfordshire, UK, hospitalised with CAP between 01-January-2016 and 19-March-2024, who received either amoxicillin or co-amoxiclav as initial treatment. We examined the effects of adjunctive macrolides on 30-day all-cause mortality, time to hospital discharge, and changes in Sequential Organ Failure Assessment (SOFA) score, using inverse probability treatment weighting to address confounding by baseline severity. Subgroup analyses by severity and sensitivity analyses with missing covariates imputed were performed. Results There was no evidence of an association between the use of additional macrolides and 30-day mortality, with marginal odds ratios of 1.05 (95%CI 0.75-1.47) for amoxicillin with vs. without macrolide, and 1.12 (0.93-1.34) for co-amoxiclav with vs. without macrolide. No evidence of difference was found in time to discharge from additional macrolides to amoxicillin (restricted mean days lost +1.76 [-1.66,+5.19]), or co-amoxiclav (+0.44 [-1.63,+2.51]). There was also no evidence that macrolide use was associated with SOFA score decreases. Results were consistent across stratified analyses by pneumonia severity, and remained broadly similar in sensitivity analyses with missing data imputed. Conclusions At a population level, the addition of macrolides was not associated with improved clinical outcomes for CAP patients. The potential advantages of combining macrolides with a β-lactam antibiotic in CAP treatment should be balanced against the risks of adverse effects and antimicrobial resistance.","PeriodicalId":501010,"journal":{"name":"The Journal of Infectious Diseases","volume":"59 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142884141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socio-Economic Inequities in the Age-Specific Burden of Severe Respiratory Syncytial Virus (RSV) in Canada, 2016-2019","authors":"Jenna Alessandrini, Brendan T Smith, Tiffany Fitzpatrick, Sarah A Buchan","doi":"10.1093/infdis/jiae635","DOIUrl":"https://doi.org/10.1093/infdis/jiae635","url":null,"abstract":"Background Socio-economic status (SES) is an important determinant of severe respiratory infections. Despite being a leading cause of hospitalization, limited attention has been given to social inequities in respiratory syncytial virus (RSV), particularly outside of childhood and beyond neighbourhood-level measures. This study aimed to quantify the burden of severe RSV disease across the age continuum by individual-level SES indicators. Methods We conducted a longitudinal descriptive study of Canadians (excluding Québec) ≥6 months of age using linked socio-demographic and hospitalization data from the 2016 Canadian Census Health and Environment Cohort (2016-2019). Crude and age-stratified International Classification of Diseases, 10th Revision, Canada (ICD-10-CA) coded RSV-related hospitalization rates, rate ratios (RRs), and rate differences (RDs) per 100,000 person-years were estimated across SES indicators using Poisson regression. Results Rates of RSV-related hospitalization were greatest among Canadians with lower compared to higher SES, as indicated through multiple measures including income (RD: 11.7 [95% confidence interval, 10.1-13.3]; RR: 2.8 [2.4-3.2]), education (RD: 18.7 [16.6-20.9]; RR: 3.3 [2.9-3.7]), and various indicators of poorer housing conditions including unaffordable housing and apartment-living. Inequities in RSV-related hospitalization varied by SES measure and age group; while rates were highest among 6-59-month- and ≥80-year-olds overall, some of the greatest relative SES inequities were among other age groups. Conclusions This work highlights novel individual-level social determinants influencing the burden of severe RSV disease. In addition to clinical characteristics, understanding SES factors role in age-specific RSV-related hospitalization risk is necessary to inform equitable prevention efforts, including delivery of emerging RSV immunizations.","PeriodicalId":501010,"journal":{"name":"The Journal of Infectious Diseases","volume":"86 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142884143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Staphylococcus aureus Tetracycline Resistance and Co-resistance in a Doxy-PEP-Eligible Population","authors":"Rachel Mittelstaedt, Sanjat Kanjilal, David Helekal, Gregory K Robbins, Yonatan H Grad","doi":"10.1093/infdis/jiae634","DOIUrl":"https://doi.org/10.1093/infdis/jiae634","url":null,"abstract":"Among doxycycline post-exposure prophylaxis (doxy-PEP) eligible men, Staphylococcus aureus tetracycline non-susceptibility is more prevalent than in the overall population and is associated with resistance to trimethoprim-sulfamethoxazole and clindamycin. Doxy-PEP may select for multi-drug-resistant S. aureus, underscoring the importance of surveillance.","PeriodicalId":501010,"journal":{"name":"The Journal of Infectious Diseases","volume":"630 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142884142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns and cofactors of polyfunctional mycobacteria-specific T cell response restoration following 6-month antiretroviral treatment in children living with HIV","authors":"Cheryl L Day, Irene N Njuguna, Lisa Marie Cranmer, Wendy E Whatney, Rachel A Pearson, Cecilia S Lindestam Arlehamn, Alessandro Sette, Sylvia M LaCourse, Jaclyn N Escudero, Loren E Sasser, Cyrus Mugo, Hellen Moraa Okinyi, Elizabeth Maleche-Obimbo, Dalton C Wamalwa, Grace C John-Stewart","doi":"10.1093/infdis/jiae630","DOIUrl":"https://doi.org/10.1093/infdis/jiae630","url":null,"abstract":"Background Despite immune restoration after initiation of antiretroviral treatment (ART), the risk of tuberculosis (TB) persists in children living with HIV (CLHIV). We determined patterns of immune restoration of mycobacteria-specific T cells following ART in CLHIV. Methods CD4 and CD8 T cell activation and memory phenotype and functional profiles before and 6 months after ART were evaluated in peripheral blood mononuclear cells (PBMCs) from CLHIV enrolled in the PUSH study (NCT02063880) in Nairobi, Kenya. T cell expression of cytokines and activation induced markers (AIM) were measured following stimulation of PBMCs with a pool of 300 peptides from TB (MTB300) or staphylococcal enterotoxin B (SEB). Results Among 47 CLHIV of median age 1.5 years, SEB-induced Th1 cytokine+ and AIM+ CD4 cell frequencies increased significantly after 6 months ART. Although MTB300-specific CD4 and CD8 cell frequency did not increase after ART, polyfunctional capacity of MTB300-specific CD4 cells expressing combinations of Th1 cytokines with CD40L increased significantly after ART. Baseline age, immune activation, and effector memory CD4 levels were associated with less restoration of MTB300-specific polyfunctional CD4 cells, whereas CD4% and levels of naïve CD4 cells following ART were associated with improved MTB300-specific polyfunctional capacity. Conclusions Despite increases in Th1 cytokine production, deficits in mycobacteria-specific CD4 cells persisted 6 months after ART, with higher deficits in older CLHIV with more immunosuppression, higher immune activation, and lower proportion of naïve CD4 cells. These findings may explain persistent TB risk during early ART among CLHIV and identify those at highest risk.","PeriodicalId":501010,"journal":{"name":"The Journal of Infectious Diseases","volume":"60 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diversity in Naturally Acquired Immunity to Group B Streptococcus: A Comparative Study of Women from Bangladesh, Malawi, and the United Kingdom","authors":"Shadia Khandaker, Shilpee Sharma, Tom Hall, Suzanna Lim, Janne Lehtonen, Stephanie Leung, Zabed Bin Ahmed, Andrew Gorringe, Samir K Saha, Arnaud Marchant, Kirsty Le Doare, Aras Kadioglu, Neil French","doi":"10.1093/infdis/jiae607","DOIUrl":"https://doi.org/10.1093/infdis/jiae607","url":null,"abstract":"Background Significant disparities in Group B Streptococcus (GBS) colonisation and neonatal disease rates have been documented across different geographical regions. For example, Bangladesh reports notably lower rates compared to the United Kingdom (UK) and Malawi. This study investigates whether this epidemiological variability correlates with the immune response to GBS in these regions. Methods Qualitative and quantitative analyses of naturally acquired immunoglobulin G (IgG) antibodies against GBS capsular polysaccharides (CPS) and the Alp protein family were conducted in serum samples from women of childbearing age in the UK, Bangladesh, and Malawi. The efficacy of these antibodies in clearing vaginal colonisation or protecting newborns from GBS infection was assessed using humanised mouse models. Results Bangladeshi women displayed the highest diversity in serotype distribution, with elevated immunoglobulin G (IgG) levels in the serum against GBS capsular polysaccharides (CPS)- Ia, Ib, II, III, IV, and V, as well as Alp family proteins. In contrast, Malawian sera demonstrated the weakest antibody response. Bangladeshi sera also showed heightened IgG-mediated complement deposition, opsonophagocytic killing and neonatal Fc receptor (FcRn)-binding while tested against CPS Ib. In a humanised FcRn mouse model, Bangladeshi sera led to faster clearance of GBS virulent serotype Ib vaginal colonisation. Additionally, offspring from dams passively immunised with Bangladeshi sera demonstrated notably increased survival rates. Conclusions This study demonstrates significant variability in the immune response to GBS across different geographical regions. These findings underscore the importance of understanding GBS-induced immune response in diverse populations, which may significantly impact vaccine efficacy in these regions.","PeriodicalId":501010,"journal":{"name":"The Journal of Infectious Diseases","volume":"91 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142841173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incorporating incubation period distributions to precisely estimate the association between rainfall and Legionella infection","authors":"Kelsie Cassell, Joshua L Warren, Christopher Heneghen, Daniel M Weinberger","doi":"10.1093/infdis/jiae625","DOIUrl":"https://doi.org/10.1093/infdis/jiae625","url":null,"abstract":"Background Multiple studies have shown a positive relationship between weather events and, 1 to 2 weeks later, Legionnaires’ disease (LD) cases. Narrowing this time window of association can help determine whether the mechanism linking rainfall and relative humidity to sporadic LD is direct or indirect. Due to the large number of daily water interactions and low incidence of LD, we propose a new Bayesian modeling approach to disentangle the potential for a direct vs. indirect exposure to precipitation. Methods Incubation period distributions were used to redistribute LD cases to their estimated day of exposure. Then Bayesian distributed lag models were fit to estimate cases per day of exposure with predictor variables for rainfall and absolute humidity. Sensitivity analyses explored the impact of relatively humidity, rainfall post-estimated date of exposure and randomized rainfall to validate our results. Results One standard deviation increase in rainfall 2 and 3 days prior to the date of estimated exposure was associated with an approximately 15% increase in LD risk (per day). When heavy rainfall occurred 0 to 3 days prior to estimated exposure, risk increased by more than 40%, peaking at a 51% increased risk of LD 2 days after heavy rainfall. Discussion Our findings of a 2- and 3-day lag between rainfall and the date of estimated exposure is consistent with an indirect link with rainfall, rather than a same-day exposure. Potential pathways that can indirectly link rainfall to LD cases include rainfall-mediated declines in public water supplies but greater environmental sampling research is needed.","PeriodicalId":501010,"journal":{"name":"The Journal of Infectious Diseases","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142841174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Candida albicans recovered from persistent candidemia exhibit enhanced virulence traits","authors":"Felipe de Camargo Ribeiro, Karoline Kristina Kemmerich, Juliana Caparroz Gonçale, Juliana Campos Junqueira, Mohammad Mannan, Sunna Nabeela, Arnaldo Lopes Colombo, Priya Uppuluri","doi":"10.1093/infdis/jiae631","DOIUrl":"https://doi.org/10.1093/infdis/jiae631","url":null,"abstract":"Candida albicans catheter-related candidemia is largely driven by microbial adhesion and biofilm formation on central venous catheters. Cells that disperse from these biofilms can enter the bloodstream, spread to distant organs, and sustain the cycle of infection. In this study, we investigated the virulence potential of C. albicans isolates obtained from the blood of catheterized patients experiencing persistent candidemia, comparing them to isolates that were cleared from the bloodstream early in the infection. Our results show that isolates persisting in the bloodstream for four days or longer, despite antifungal treatment, exhibited enhanced adherence, filamentation, and biofilm formation in vitro, along with increased expression of key virulence-related genes. Notably, cells dispersed from second-generation biofilms formed by these persistent isolates displayed even more pronounced pathogenic characteristics, including improved immune evasion. Furthermore, in vivo experiments using Galleria mellonella revealed that persistent isolates were significantly more virulent than their non-persistent counterparts.","PeriodicalId":501010,"journal":{"name":"The Journal of Infectious Diseases","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anelloviruses and Cancer","authors":"Jason Y Tang, Trevor B Chen, Valentina L Kouznetsova, Igor F Tsigelny","doi":"10.1093/infdis/jiae626","DOIUrl":"https://doi.org/10.1093/infdis/jiae626","url":null,"abstract":"Anelloviruses are among the most prevalent viruses within the human virome, detected in over 90% of healthy individuals. Despite their ubiquity, the role of anelloviruses in human health remains elusive. This review examines the potential associations of anelloviruses torque teno virus (TTV), torque teno midi virus (TTMDV), and torque teno mini virus (TTMV) with various cancers, highlighting the mixed conclusions from current epidemiological studies. Anelloviruses may modulate cancer development through abnormal gene fusion, immune response, and toll-like receptor 9 (TLR9) activation. On the other hand, anelloviruses might suppress tumor formation through TTV-derived apoptosis-inducing protein (TAIP) and NF-κB signaling inhibition. The high prevalence of anelloviruses in cancer patients could also be attributed to their immunocompromised status rather than a direct causative role of the viruses. This review underscores the need for more comprehensive studies, including in vitro and in vivo experiments, to clarify the role of anelloviruses in cancer development and progression.","PeriodicalId":501010,"journal":{"name":"The Journal of Infectious Diseases","volume":"51 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142832095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decline of antibodies to major viral and bacterial respiratory pathogens during the COVID-19 pandemic","authors":"Natalie Lorenz, Alex James, Tiaan Van Rooyen, Aimee Paterson, Ciara Ramiah, Lauren Carlton, Prachi Sharma, Michael G Baker, Richard Charlewood, Reuben McGregor, Nicole J Moreland","doi":"10.1093/infdis/jiae611","DOIUrl":"https://doi.org/10.1093/infdis/jiae611","url":null,"abstract":"Surges in infections caused by respiratory pathogens have been documented in multiple settings after relaxation of pandemic restrictions. Antibodies to major antigens from respiratory syncytial virus and Group A Streptococcus waned significantly in a longitudinal adult cohort throughout the pandemic. This waning may have contributed to the pathogen-surges that followed.","PeriodicalId":501010,"journal":{"name":"The Journal of Infectious Diseases","volume":"92 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular epidemiology and clinical characterization of carbapenemase-producing Enterobacter spp. from an international cohort","authors":"Jianping Jiang, Lauren Komarow, Carol Hill, Angelique E Boutzoukas, Blake Hanson, Cesar A Arias, Robert A Bonomo, Scott Evans, Yohei Doi, Michael J Satlin, Gregory Weston, Eric Cober, Sandra Liliana Valderrama-Beltran, Soraya Salcedo Mendoza, Zhengyin Liu, Bettina C Fries, Paul Ananth Tambyah, Henry F Chambers, Vance G Fowler, David van Duin, Barry N Kreiswirth, Liang Chen","doi":"10.1093/infdis/jiae616","DOIUrl":"https://doi.org/10.1093/infdis/jiae616","url":null,"abstract":"Background Despite the global public health threat posed by carbapenem-resistant Enterobacter spp., clinical and molecular epidemiological studies on international isolates remain scarce. Historically, the taxonomy of Enterobacter has been challenging, limiting our understanding of the clinical characteristics and outcomes of carbapenemase-producing Enterobacter spp. infections. Methods Hospitalized patients enrolled in the CRACKLE-2 study (ClinicalTrials.gov, NCT03646227) from 2016-2018 with cultures positive for carbapenemase-producing Enterobacter spp. were included. Clinical and microbiologic data were collected from health records. Whole genome sequencing was performed, and the population structures of selected predominant clones were analyzed. Results We enrolled 136 hospitalized patients with carbapenemase-producing Enterobacter spp. from 30 hospitals in 7 countries. Among the 136 isolates, eleven Enterobacter species were identified, with most isolates belonging to E. xiangfangensis (n=81, 60%) and E. hoffmannii (n=17, 13%), and carrying blaKPC (n=106, 78%) and blaNDM (n=12, 9%). Clinical characteristics and outcomes were similar among patients with E. xiangfangensis, E. hoffmannii or the other Enterobacter spp. 30-day mortality was 20% and older age at enrollment (adjusted odds ratio 1.42, 95% confidence interval 1.08-1.87) was associated with increased mortality. Sequence type (ST)171 E. xiangfangensis, ST78 E. hoffmannii, and ST93 E. xiangfangensis were the predominant clones, and the acquisition of fluoroquinolone resistance-associated mutations and carbapenemase-encoding plasmids contributed to their formation and global dissemination. Conclusions Our findings demonstrated that E. xiangfangensis and E. hoffmannii are common species among international carbapenemase-producing Enterobacter spp., potentially linked to the clonal spread of a few predominant clones that have acquired fluoroquinolone resistance and carbapenemase-encoding plasmids.","PeriodicalId":501010,"journal":{"name":"The Journal of Infectious Diseases","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}