Journal of Infectious Diseases最新文献

{"title":"Buying Time: T cells and Delayed HIV Rebound After Treatment Interruption.","authors":"Charles R Crain, Gaurav D Gaiha, Rajesh T Gandhi","doi":"10.1093/infdis/jiag449","DOIUrl":"https://doi.org/10.1093/infdis/jiag449","url":null,"abstract":"","PeriodicalId":50179,"journal":{"name":"Journal of Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Missed Early Signal of the HIV-Tuberculosis Syndemic in a 1982 MMWR Report.","authors":"Arthur E Pitchenik","doi":"10.1093/infdis/jiag261","DOIUrl":"10.1093/infdis/jiag261","url":null,"abstract":"","PeriodicalId":50179,"journal":{"name":"Journal of Infectious Diseases","volume":" ","pages":"e427"},"PeriodicalIF":4.1,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Accuracy of Commercial Large Language Models for Anogenital Skin Lesion Images: A Comparative Study of Gemini, Claude, and ChatGPT.","authors":"Nyi Nyi Soe, Phyu Mon Latt, David Lee, Ei T Aung, Ryan Horn, Jason J Ong, Christopher K Fairley, Eric P F Chow","doi":"10.1093/infdis/jiag258","DOIUrl":"10.1093/infdis/jiag258","url":null,"abstract":"<p><strong>Background: </strong>Diagnosing anogenital dermatological conditions often requires specialist expertise that is unavailable in many clinical settings. Large language models (LLMs) are increasingly accessible to clinicians, but their diagnostic accuracy for anogenital dermatology has not been evaluated. We evaluated the diagnostic accuracy of 3 LLMs (Gemini 2.5 Pro, Claude Opus 4.1, and ChatGPT 5 Thinking) for anogenital dermatological conditions.</p><p><strong>Methods: </strong>This study was conducted between September and November 2025, using deidentified clinical images of anogenital conditions from the STI Atlas (stiatlas.org) and other publicly available sources. Primary outcomes were correct classification of images identified as sexually transmitted infections (STIs) vs non-STIs and the inclusion of the correct diagnosis among the LLMs' top-ranked (top-1), top-3, or top-5 differential diagnoses.</p><p><strong>Results: </strong>Among 218 images, Gemini achieved the highest accuracy for STI binary classification (76.2% [95% CI, 70.5%-81.9%]) and differential diagnosis (top-1, 39.0% [95% CI, 32.7%-45.7%]; top-3, 54.6% [95% CI, 47.9%-61.1%]; top-5, 60.6% [95% CI, 53.9%-66.9%]), followed by ChatGPT and Claude. In subgroup analysis, all LLMs showed substantially reduced accuracy for diagnostically challenging images (top-5 accuracy range, 29.2%-40.0%). Gemini consistently outperformed Claude across most subgroups (P < .05). None of the LLMs could identify any mpox correctly.</p><p><strong>Conclusions: </strong>LLMs showed limited accuracy for diagnosing anogenital dermatological conditions, particularly for challenging images. The best-performing model (Gemini) achieved only 39.0% for top-1 diagnosis, indicating that current LLMs cannot reliably diagnose anogenital conditions. These tools may support supervised clinical triage but need further validation before routine clinical use. Future studies should compare LLMs with clinicians and explore how they can assist clinical diagnosis.</p>","PeriodicalId":50179,"journal":{"name":"Journal of Infectious Diseases","volume":" ","pages":"e330-e337"},"PeriodicalIF":4.1,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147864748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New Insights Into an Old Vaccine: Potency and Breadth of Neutralizing Antibodies Elicited by Yellow Fever Vaccine 17D Are Boosted by Heterologous Orthoflavivirus Infection.","authors":"Felicity J Coulter, Courtney A Micheletti, Abram E Estrada, Shuhua Luo, Samantha R Osman, Chad D Nix, Sophia Y Hu, Sarah M Sampouw, Bettie W Kareko, Allison L Naleway, William B Messer","doi":"10.1093/infdis/jiag077","DOIUrl":"10.1093/infdis/jiag077","url":null,"abstract":"<p><strong>Background: </strong>Yellow fever vaccine 17D has controlled yellow fever for almost 90 years and is considered highly successful. However, with recent outbreaks in South America and Africa, yellow fever continues to represent a significant threat to public and global health. Despite the long-standing success, few studies have characterized the capacity of 17D-immune sera to neutralize wild type (WT) yellow fever viruses (YFVs).</p><p><strong>Methods: </strong>Using 17D and 13 WT YFVs, we conducted focus neutralization tests against sera from a unique cohort of 36 nonendemic vaccinees with diverse Orthoflavivirus histories. By using WT YFVs that represent the known YFV genotypes, we characterized the potency and breadth of 17D-elicited serum neutralizing antibodies against these WT YFVs in the context of heterologous Orthoflavivirus infection.</p><p><strong>Results: </strong>We found significant variability in neutralization test titers and rates of seropositivity of 17D-immune sera across all viruses and specifically against South America genotype I isolates. Vaccinee sera with serologic evidence of heterologous Orthoflavivirus infection had significantly greater potency against South America genotype I strains as compared with sera without evidence of Orthoflavivirus infection, suggesting a boosting effect from heterologous Orthoflavivirus immunity.</p><p><strong>Conclusions: </strong>These results add significantly to what is known regarding the WT YFV antigenic immune landscape, including novel insights into the role of heterologous Orthoflavivirus infection in 17D immunity that have the potential to improve future vaccine design and deployment strategies.</p>","PeriodicalId":50179,"journal":{"name":"Journal of Infectious Diseases","volume":" ","pages":"e232-e242"},"PeriodicalIF":4.1,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13431080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Flotillin 1 Regulation of Enteropathogenic Escherichia coli Pedestal Length.","authors":"Petra A McLeod, Ahmed M H Bshina, Peter L Beach, Julian A Guttman","doi":"10.1093/infdis/jiag314","DOIUrl":"10.1093/infdis/jiag314","url":null,"abstract":"<p><strong>Background: </strong>The attaching and effacing pathogens, enteropathogenic Escherichia coli (EPEC) and enterohemorrhagic E. coli (EHEC), remodel the host actin cytoskeleton to form actin-rich pedestals that anchor the bacteria atop intestinal epithelial cells. Although pedestal formation requires clathrin-endocytic proteins, the role of clathrin-independent proteins like flotillin 1 remain unclear.</p><p><strong>Methods: </strong>Flotillin 1 localization in pedestal formation was analyzed using immunofluorescence microscopy during EPEC and EHEC infections in HeLa cells. This protein's function was then examined using competing peptide interference and small interfering RNA (siRNA)-mediated knockdown approaches.</p><p><strong>Results: </strong>Flotillin 1 localizes to the membranes of EPEC pedestals. Disruption of flotillin 1 membrane association or depletion of flotillin 1 using siRNA resulted in significantly elongated EPEC pedestals. A similar pattern of flotillin 1 localization is seen at EHEC pedestals.</p><p><strong>Conclusions: </strong>Our work expands current models of attaching and effacing host-pathogen interactions by highlighting a role for flotillin 1 in controlling pedestal length.</p>","PeriodicalId":50179,"journal":{"name":"Journal of Infectious Diseases","volume":" ","pages":"256-266"},"PeriodicalIF":4.1,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148279781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Specific Biomarkers Differentiate Cerebral Malaria From Other Causes of Coma in African Children.","authors":"Shaban Mwangi, Claudia Gomes, Abdirahman I Abdi, Ana Rodriguez","doi":"10.1093/infdis/jiag070","DOIUrl":"10.1093/infdis/jiag070","url":null,"abstract":"<p><strong>Background: </strong>Cerebral malaria (CM) is a serious complication of Plasmodium falciparum malaria that causes coma and, frequently, death. In malaria-endemic settings, a large percentage of the population presents with incidental P falciparum malaria parasitemia. In the absence of specific biomarkers for CM, when these individuals suffer from bacterial or viral infections causing coma, they are frequently misdiagnosed with CM.</p><p><strong>Methods: </strong>We have tested the specificity for CM of 2 candidate biomarkers for severe malaria, angiopoietin-like 4 (ANGPTL4) and inhibin-βE (INHBE), which are secreted by endothelial cells in response to P falciparum-infected erythrocytes. The levels of these biomarkers were determined retrospectively in the plasma of a cohort of 379 Kenyan children including cases of severe malaria caused by CM, respiratory distress, or severe anemia, as well as cases of nontraumatic coma of unknown cause.</p><p><strong>Results: </strong>ANGPTL4 and INHBE showed high specificity for severe malaria, including CM (area under the curve [AUC] 0.82), respiratory distress (AUC 0.86), and severe anemia (AUC 0.85), when compared to acute nontraumatic coma of nonmalarial etiology. Specificity was further increased when the biomarkers were used in combination with platelet levels (AUC 0.96). ANGPTL4 and INHBE are also predictors of death by CM (AUC 0.85).</p><p><strong>Conclusions: </strong>ANGPTL4 and INHBE could be developed as a diagnostic tool for the differentiation of comatose patients with CM from other causes of coma.</p>","PeriodicalId":50179,"journal":{"name":"Journal of Infectious Diseases","volume":" ","pages":"288-296"},"PeriodicalIF":4.1,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of Bronchiolitis and Vaccine-induced Enhanced Respiratory Disease in Syrian Hamsters Caused by Respiratory Syncytial Virus Infection.","authors":"Binbin Zhao, Gengxin Zhang, Jing Wu, Wei Zhang, Xiaoyue Ding, Xiaohui Wei, Wanjun Peng, Na Rong, Hekai Yang, Jiangning Liu","doi":"10.1093/infdis/jiag136","DOIUrl":"10.1093/infdis/jiag136","url":null,"abstract":"<p><strong>Background: </strong>Respiratory syncytial virus (RSV) poses a considerable health burden to pediatric and elderly populations, but vaccine development is hindered by the risk of enhanced respiratory disease (ERD) and limitations of current animal models.</p><p><strong>Methods: </strong>Syrian hamsters of different ages were intranasally inoculated with RSV to establish an age-stratified model. Additionally, old hamsters were immunized with heat-inactivated RSV (HI-RSV) for ERD research. Disease pathogenesis was assessed through symptom monitoring, viral load quantification, histopathological examination, and transcriptomic analysis.</p><p><strong>Results: </strong>RSV infection induced coughing-like symptoms in adult and old hamsters. Neonates exhibited significant growth retardation, the most pronounced viral replication and delayed viral clearance, and prolonged bronchiolitis-like lung injury. HI-RSV vaccination in old hamsters resulted in classic ERD, characterized by enhanced lung pathology, eosinophil infiltration, and mucus overproduction. Further transcriptomic profiling revealed upregulation of pathways related to Th1/Th2 cell differentiation, with marked increases in Th2 cytokines (Il4, Il5, and Il13) and associated transcription factors (Jak3, GATA binding protein 3, and Runt-related transcription factor 3), mechanistically linking Th2-biased immunity to ERD.</p><p><strong>Conclusions: </strong>Our findings confirm the relevance of using Syrian hamsters to study age-dependent RSV pathogenesis and to evaluate the safety of RSV vaccines, particularly with regard to the risk of ERD associated with Th2-biased immune responses.</p>","PeriodicalId":50179,"journal":{"name":"Journal of Infectious Diseases","volume":" ","pages":"e268-e280"},"PeriodicalIF":4.1,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147349012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Weight Gain on Contemporary Integrase Strand Transfer Inhibitors and Tenofovir Alafenamide in Persons With HIV Starting Antiretroviral Therapy in the United States and Canada.","authors":"","doi":"10.1093/infdis/jiag372","DOIUrl":"10.1093/infdis/jiag372","url":null,"abstract":"","PeriodicalId":50179,"journal":{"name":"Journal of Infectious Diseases","volume":" ","pages":"e435-435"},"PeriodicalIF":4.1,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Conundrum of Shiga Toxin-Producing Escherichia coli O157:H7 Persistence: Evidence for Locally Persistent Lineages.","authors":"Gillian A M Tarr, William Finical, Joshua M Rounds, Anna Panek, Kirk Smith","doi":"10.1093/infdis/jiag223","DOIUrl":"10.1093/infdis/jiag223","url":null,"abstract":"<p><p>Evidence suggests that Shiga toxin-producing Escherichia coli (STEC) strains do not persist at the farm level. We hypothesized that ecosystem-level STEC persistence occurs and contributes significantly to disease burden. We tested this by identifying locally persistent lineages (LPLs) of STEC O157:H7 in Minnesota. We identified 15 distinct LPLs, which were associated with 35.3% of reported cases in Minnesota and persisted for 1.3-8.6 years. Locally persistent lineages were associated with multiple outbreaks with Minnesota sources and no multi-state outbreaks, and LPL cases were spatially clustered. Our findings show long-term persistence in defined geographic areas, suggesting the importance of ecosystem-level persistence.</p>","PeriodicalId":50179,"journal":{"name":"Journal of Infectious Diseases","volume":" ","pages":"e311-e315"},"PeriodicalIF":4.1,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147935132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Small Noncoding RNA, RsaC, Is Essential for Staphylococcus aureus Virulence.","authors":"Suresh Panthee, Atmika Paudel, Suguru Ohgi, Kazuhisa Sekimizu, Hiroshi Hamamoto","doi":"10.1093/infdis/jiag282","DOIUrl":"10.1093/infdis/jiag282","url":null,"abstract":"<p><strong>Background: </strong>Bacterial small noncoding RNAs (sRNAs) play critical roles in virulence, stress adaptation, and host-pathogen interactions. Transcriptomic analyses during infection can help reveal pathogen-derived sRNAs required for pathogenesis, providing valuable insights for the development of novel therapeutic strategies. However, the low abundance of pathogen biomass within the host tissues poses a significant challenge for such analyses.</p><p><strong>Methods: </strong>We employed 2-step cell disruption to enrich Staphylococcus aureus cells from infected mouse organs and conducted RNA sequencing (RNA-seq) analysis to examine staphylococcal sRNAs expressed during infection. qRT-PCR was used to confirm the gene expression. A knockout mutant of highly expressed sRNA, RsaC, was generated, and RNA-seq under in vivo as well as in vitro aerobic and anaerobic conditions were compared between the wild-type and ΔrsaC strains. Virulence of S. aureus was assessed using both mouse and silkworm survival assays.</p><p><strong>Results: </strong>We identified RsaC as one of the most highly expressed sRNAs in mouse organs with consistent increment over time postinfection. Through gene disruption and complementation, we demonstrated that RsaC is an independent virulence determinant required for full pathogenicity of S. aureus in a murine infection model. In addition, RsaC influenced gene expression in response to oxygen availability and host-associated stress. Further analysis revealed that mutation of 2 genes downregulated in ΔrsaC in vivo, NWMN_RS03420 (sodium: proton antiporter) and NWMN_RS12015 (hypothetical protein), reduced S. aureus virulence in a silkworm model.</p><p><strong>Conclusions: </strong>These findings identify RsaC as a novel independent virulence determinant that supports S. aureus adaptation within the host.</p>","PeriodicalId":50179,"journal":{"name":"Journal of Infectious Diseases","volume":" ","pages":"e338-e349"},"PeriodicalIF":4.1,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148266915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}