Journal of Infectious Diseases最新文献

{"title":"Pandemic preparedness: analyzing national plans for respiratory pathogen pandemics in the Americas region.","authors":"Andrea Patricia Villalobos, Iyanna Wellington, Shoa Moosavi, Ana de la Garza, Ángel Rodríguez, Britney McMurren, Juliana Almeida Leite, Jairo Andrés Méndez-Rico, Lidia Redondo, Miriam Esther Blanco, Olaya Astudillo, Paula Couto, Priscila Born, Sara Hess, Shoshanna Goldin, Hannah Lewis, Tamara Mancero, Andrea Vicari, Marc Rondy","doi":"10.1093/infdis/jiaf047","DOIUrl":"https://doi.org/10.1093/infdis/jiaf047","url":null,"abstract":"<p><strong>Background: </strong>The International Health Regulations (2005) (IHR), requires that States Parties develop their capacities to detect, assess, and respond to public health threats and report to the World Health Assembly through the States Parties Annual Report (SPAR). The National Pandemic Preparedness and Response Plans (PPRP) contribute to countries capacities however there are some discrepancies between both tools. To identify gaps and define priority actions to strengthen pandemic plans, we assessed the concordance between national pandemic preparedness and response plans for respiratory pathogens against the pandemic checklist published in 2023 and the SPAR.</p><p><strong>Methods: </strong>In this retrospective, semi-quantitative study, conducted in August 2024, we reviewed the most recent respiratory pandemic plans for 35 PAHO member states and assessed their concordance with (1) actionable guidelines in the World Health Organization pandemic checklist and (2) IHR (2005) core capacities using the latest SPAR tool. We developed 25 tracking questions to identify gaps, strengths, and opportunities for improvement in the pandemic plans, using the pandemic checklist built on the capacities and capabilities described in the WHO's Preparedness and Resilience for Emerging Threats (PRET) Module 1. We used a five-point scale (from 1, when the subcomponent was not mentioned, to 5, when the subcomponent was described at all levels), and we calculated the average pandemic plans score (PP score) for each component. Data from pandemic plans (2005-2024) were compiled, selected, analyzed, and scored. We compared the average SPAR score and the PP score to assess areas of convergence and variance between preparedness and capacities. The analysis was carried out using R and Excel.</p><p><strong>Results: </strong>We analyzed 35 respiratory pandemic plans: 29 were influenza-specific, five were COVID-19-specific, and one was not pathogen-specific. Most current national plans showed limited alignment with the content recommended in the PRET pandemic checklist. At regional level, the lowest concordance between plans and pandemic checklist was in the following subcomponents Public Health and Social Measures (80% of the plans had a score of 1); Emergency, Logistics and Supply Chain Management (74%); and Research and Development (71%). Conversely, the strongest subcomponents (≥40% of plans with a score of 4 or 5) were: Policy, Legal, and Normative Instruments (45%); Coordination (46%); and Surveillance: early detection and assessment (43%). In most countries, the SPAR scores tended to be higher than PP scores, except for Argentina (the newest plan reviewed) for which the pattern was reversed, and the PP scores exceeded the SPAR scores.</p><p><strong>Conclusion: </strong>Given the gaps identified between current plans and the global standards espoused by the PRET Module 1 initiative, it is recommended that countries build on the strengths of their national","PeriodicalId":50179,"journal":{"name":"Journal of Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076250","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":"Strengthening the Surveillance and Response to Public Health Events with a One Health approach: a perspective from 12 countries in Latin America and the Caribbean.","authors":"Angel Rodriguez, Paula Couto, Alejandra Acevedo, Belsy Acosta Herrera, Olaya Astudillo, Martín Avaro, Gisela Barrera Badillo, Alfredo Bruno Caicedo, Patricia Bustos, Mauricio Cerpa, Hector Chiparelli, Dulce Curon, Rodrigo Fasce, Axel Galo, Elías Guilarte, Irma López Martínez, Mariela G Martínez, Jairo Mendez-Rico, María Fernanda Olivares Barraza, Elena Penayo, María Paz Rojas Mena, Paula Rodríguez Ferrari, Marc Rondy, Viviana Sotomayor Proschle, Priscila S Born, Lidia Redondo, Juliana A Leite, Natalia Vergara Mallegas, Marta von Horoch, Andrea Patricia Villalobos, Andrea Vicari","doi":"10.1093/infdis/jiae629","DOIUrl":"https://doi.org/10.1093/infdis/jiae629","url":null,"abstract":"","PeriodicalId":50179,"journal":{"name":"Journal of Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076255","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":"From Epidemics to Pandemics: Over a Decade of SARInet Strengthening and Laboratory Surveillance and Response for Respiratory Viruses in the Americas.","authors":"Juliana A Leite, Priscila S Born, Angel Rodriguez, Paula Couto, Mauricio Cerpa, Jean-Marc Gabastou, Lionel Gresh, Leticia Franco, Mariela G Martínez, Madelaine Sugasti, Jorge Jara, Lidia Redondo Bravo, Iyanna W Perkins, Andrea Patricia Villalobos, Rosa Ramirez, Ximena Terrazas, Juliana Barbosa, Marc Rondy, Andrea Vicari, Sylvain Aldighieri, Richard Webby, Wenqing Zhang, Dimitry Pereyaslov, Magdi Samaan, Jairo Mendez-Rico","doi":"10.1093/infdis/jiaf046","DOIUrl":"https://doi.org/10.1093/infdis/jiaf046","url":null,"abstract":"","PeriodicalId":50179,"journal":{"name":"Journal of Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076244","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":"Correction to: Review: Current Laboratory and Point-of-Care Pharyngitis Diagnostic Testing and Knowledge Gaps.","authors":"","doi":"10.1093/infdis/jiaf024","DOIUrl":"https://doi.org/10.1093/infdis/jiaf024","url":null,"abstract":"","PeriodicalId":50179,"journal":{"name":"Journal of Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069307","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":"Resistance Analyses in Heavily Treatment-Experienced People with HIV Treated with the Novel HIV Capsid Inhibitor Lenacapavir After 2 years.","authors":"Nicolas A Margot, Vamshi Jogiraju, Nina Pennetzdorfer, Vidula Naik, Laurie A VanderVeen, John Ling, Renu Singh, Hadas Dvory-Sobol, Onyema Ogbuagu, Sorana Segal-Maurer, Jean-Michel Molina, Martin S Rhee, Christian Callebaut","doi":"10.1093/infdis/jiaf050","DOIUrl":"https://doi.org/10.1093/infdis/jiaf050","url":null,"abstract":"<p><strong>Background: </strong>Lenacapavir is a highly potent first-in-class inhibitor of HIV-1 capsid approved for the treatment of heavily treatment-experienced (HTE) people with HIV-1 (PWH) harboring multidrug resistant (MDR) virus, in combination with an optimized background regimen (OBR). Resistance analyses conducted after 2 years of lenacapavir treatment in the phase 2/3 CAPELLA study are described.</p><p><strong>Methods: </strong>CAPELLA enrolled viremic HTE PWH with resistance to 2 or more drugs per class in at least 3 of the 4 main drug classes. Post-baseline resistance was evaluated in participants experiencing virologic failure using resistance assays (HIV-1 capsid, protease, reverse transcriptase, and integrase genotypic/phenotypic tests). Adherence to OBR was assessed by plasma drug measurement using tandem liquid chromatography/mass spectrometry.</p><p><strong>Results: </strong>After 2 years, lenacapavir plus OBR treatment led to HIV-1 RNA suppression in 82% of participants (missing=excluded). Treatment-emergent capsid resistance occurred in 19% (14/72) of participants, including capsid mutations M66I, Q67H/K/N, K70H/N/R/S, and/or N74D/H/K, which were all associated with functional lenacapavir monotherapy. Seven participants with lenacapavir resistance reattained HIV-1 RNA <50 copies/mL upon OBR resumption or change, while remaining on lenacapavir.</p><p><strong>Conclusions: </strong>Emergence of lenacapavir resistance after 2 years in CAPELLA was a consequence of functional lenacapavir monotherapy. In half of participants with lenacapavir resistance, continued treatment with lenacapavir + active OBR led to HIV-1 RNA resuppression.</p>","PeriodicalId":50179,"journal":{"name":"Journal of Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054075","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":"Global Impact of Mass Vaccination Campaigns on Circulating Type 2 Vaccine-Derived Poliovirus Outbreaks: An Interrupted Time-Series Analysis.","authors":"Laura V Cooper, Ananda S Bandyopadhyay, Nicholas C Grassly, Elizabeth J Gray, Arie Voorman, Simona Zipursky, Isobel M Blake","doi":"10.1093/infdis/jiae614","DOIUrl":"https://doi.org/10.1093/infdis/jiae614","url":null,"abstract":"<p><strong>Background: </strong>Between 2016 and 2023, 3248 cases of circulating vaccine-derived type 2 poliomyelitis (cVDPV2) were reported globally and supplementary immunization activities (SIAs) with monovalent type 2 oral poliovirus vaccine (mOPV2) and novel type 2 oral poliovirus vaccine (nOPV2) targeted an estimated 356 and 525 million children, respectively. This analysis estimates the community-level impact of nOPV2 relative to mOPV2 SIAs.</p><p><strong>Methods: </strong>We fitted interrupted time-series regressions to surveillance data between January 2016 and November 2023 to estimate the impact of nOPV2 and mOPV2 SIAs on cVDPV2 poliomyelitis incidence and prevalence in environmental surveillance across 37 countries, directly comparing the impact of SIAs in 13 countries where both vaccines were used.</p><p><strong>Results: </strong>We did not find any statistically significant differences between nOPV2 and mOPV2 SIA impact except for in the Democratic Republic of Congo (DRC), where nOPV2 SIAs had lower impact (adjusted relative risk [aRR] for cVDPV2 poliomyelitis incidence per nOPV2 SIA, 0.505; 95% confidence interval [CI], .409-.623) compared to mOPV2 (aRR, 0.193; 95% CI, .137-.272); P value for difference in RRs = 3e-6.</p><p><strong>Conclusions: </strong>We find variation in OPV2 SIA impacts globally, with greater certainty about Nigeria and DRC, where large outbreaks provided an opportunity to assess impact at scale. In most countries, we find no significant difference between nOPV2 and mOPV2 SIA impact. We are unable to identify the reason for the significant difference in DRC, which could include differential SIA coverage, timing, vaccine effectiveness, or outbreak dynamics.</p>","PeriodicalId":50179,"journal":{"name":"Journal of Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054072","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":"Associations between the gut microbiome, inflammation and cardiovascular profiles in people with HIV.","authors":"Rachel MacCann, Junhui Li, Alejandro Abner Garcia Leon, Riya Negi, Dana Alalwan, Willard Tinago, Padraig McGettrick, Aoife G Cotter, Alan Landay, Caroline Sabin, Paul W O'Toole, Patrick W Mallon","doi":"10.1093/infdis/jiaf043","DOIUrl":"https://doi.org/10.1093/infdis/jiaf043","url":null,"abstract":"<p><strong>Background: </strong>Inflammation and innate immune activation are associated with chronic HIV infection, despite effective treatment. Although gut microbiota alterations are linked to systemic inflammation, the relationships between the gut microbiome, inflammation and HIV remain unclear.</p><p><strong>Methods: </strong>The UPBEAT-CAD sub-study, examining cardiovascular disease (CVD) risk in HIV, enrolled participants matched on HIV status and traditional CVD risk factors. Subclinical CVD was assessed using coronary computed tomography angiography (CCTA). 34 biomarkers were measured using quantitative immunoassays. Microbiota composition was analysed by 16S rRNA sequencing of stool samples, with taxonomic assignment via the SPINGO pipeline. Differentially abundant species were identified by Analysis of Compositions of Microbiomes with Bias Correction (ANCOM-BC) and correlated to biomarkers, diet and CCTA outcomes using Spearman correlation.</p><p><strong>Results: </strong>Among 81 participants (median age 51 years, 73% male), people with HIV (n=44 , 54%) had a higher prevalence of hypercholesterolaemia (p <0.025) and statin use (p <0.001). A significant separation in gut microbiome β-diversity was observed between people with and without HIV. ANCOM-BC analysis identified 42 differentially abundant species and 10 genera in those with HIV. Enrichment of Bifidobacterium pseudocatenulatum, Megamonas hypermegale and Selenomonas ruminantium and depletion of Fusicatenenibacter correlated with lower plaque burden. Depletion of SCFA-producing Ruminococcus bromii correlated with higher plaque burden and fat intake, while depletion of Bacteroides spp and Alistepes spp correlated with elevated inflammatory biomarkers (D-dimer, CD40-ligand, CRP and IFN-γ).</p><p><strong>Conclusion: </strong>Significant gut microbiota differences in people with HIV were linked to subclinical CVD, diet, and inflammation, suggesting a role for the microbiome in cardiovascular risk in HIV infection.</p>","PeriodicalId":50179,"journal":{"name":"Journal of Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034024","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":"Population-based age-period-cohort analysis of declining Human Papillomavirus prevalence.","authors":"Penelope Gray, Jiangrong Wang, Sara Nordqvist Kleppe, K Miriam Elfström, Joakim Dillner","doi":"10.1093/infdis/jiaf032","DOIUrl":"https://doi.org/10.1093/infdis/jiaf032","url":null,"abstract":"<p><strong>Background: </strong>Most countries in the world have launched human papillomavirus (HPV) vaccination programmes and declining prevalences of HPV are reported. We aimed to disentangle the influences of calendar time, birth cohort and age by analysing HPV prevalences in the population-based cervical screening programme using age-period-cohort modelling.</p><p><strong>Methods: </strong>All 836,314 primary HPV-based cervical screening tests from women aged 23-64 between 2014-2023 in the capital region of Sweden were identified in the Swedish National Cervical Screening Registry. The odds ratio of HPV16/18 infection was estimated comparing each birth cohort to the unvaccinated 1984-born using an age-period-cohort model. The impact of changing HPV prevalences on the numbers needed to screen (NNS) to detect and prevent 1 cervical cancer case were calculated.</p><p><strong>Results: </strong>HPV vaccination coverage was 82-83% among women born in 1999-2000. Before 2019 the HPV16/18 prevalence was highest among the youngest women in the screening program. During 2020-2023 the prevalence consistently decreased among the birth cohorts offered organised school-based vaccination. There was a 98% decline in HPV16 prevalence (odds ratio=0.02 [95% CI 0.01-0.04]) and a 99% decline in HPV18 prevalence (odds ratio=0.01 [0.00-0.04]) among the 2000-born compared to the HPV unvaccinated 1984-born. The declining HPV16/18 prevalences resulted in major increases in the NNS to detect and to prevent 1 case of cervical cancer.</p><p><strong>Conclusions: </strong>The declines of HPV16/18 were considerably larger than the vaccination coverage, suggesting herd immunity effects. The changing epidemiology of HPV types impacts screening needs, necessitating updated screening programs.</p>","PeriodicalId":50179,"journal":{"name":"Journal of Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015026","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":"Healthy Aging and the Gut Microbiome in People With and Without HIV.","authors":"Brandilyn A Peters, Xiaonan Xue, David B Hanna, Yi Wang, Zheng Wang, Anjali Sharma, Michelle Floris-Moore, Deborah Konkle-Parker, Maria L Alcaide, Anandi N Sheth, Elizabeth F Topper, Kathleen M Weber, Phyllis C Tien, Daniel Merenstein, Elizabeth Vásquez, Yue Chen, Matthew J Mimiaga, Valentina Stosor, Todd T Brown, Kristine M Erlandson, Stephanie M Dillon, Noha S Elsayed, Mykhaylo Usyk, Christopher C Sollecito, Robert C Kaplan, Robert D Burk, Qibin Qi","doi":"10.1093/infdis/jiae644","DOIUrl":"10.1093/infdis/jiae644","url":null,"abstract":"<p><strong>Background: </strong>Aging-related comorbidities are more common in people with human immunodeficiency virus (HIV) compared to people without HIV. The gut microbiome may play a role in healthy aging; however, this relationship remains unexplored in the context of HIV.</p><p><strong>Methods: </strong>16S rRNA gene sequencing was conducted on stool from 1409 women (69% with HIV; 2304 samples) and 990 men (54% with HIV; 1008 samples) in the MACS/WIHS Combined Cohort Study. Associations of age with gut microbiome diversity, uniqueness, and genus-level abundance were examined in women and men separately, followed by examining relationships of aging-related genera with frailty (Fried frailty phenotype) and mortality risk (Veterans Aging Cohort Study [VACS] index).</p><p><strong>Results: </strong>Older age was associated with greater microbiome diversity and uniqueness, greater abundance of Akkermansia and Streptococcus, and lower abundance of Prevotella and Faecalibacterium, among others; findings were generally consistent by sex and HIV status. An aging-related microbiome score, generated via combination of 18 age-related genera, significantly increased with age in both women and men independently of demographic, behavioral, and cardiometabolic factors. In general, age was more strongly related to microbiome features (eg, diversity, microbiome score) in men without compared to with HIV, but age-microbiome associations were similar in women with and without HIV. Some age-related genera associated with healthy/unhealthy aging, such as Faecalibacterium (related to reduced frailty) and Streptococcus (related to higher VACS index).</p><p><strong>Conclusions: </strong>Age is associated with consistent changes in the gut microbiome in both women and men with or without HIV. Some aging-related microbiota are associated with aging-related declines in health.</p>","PeriodicalId":50179,"journal":{"name":"Journal of Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015000","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":"Reduction of vancomycin-associated acute kidney injury with montelukast.","authors":"Nicholas S Teran, Cole S Hudson, Kady Phe, Yunting Wang, Yang Zhang, Hua Chen, Masayuki Nigo, Vincent H Tam","doi":"10.1093/infdis/jiaf027","DOIUrl":"https://doi.org/10.1093/infdis/jiaf027","url":null,"abstract":"<p><strong>Background: </strong>Vancomycin ranks amongst the most utilized antimicrobial agents in the treatment of serious β-lactam-resistant Gram-positive infections, but its use has been associated with nephrotoxicity. Reduction of acute kidney injury (AKI) has been reported in pre-clinical models with adjuvant montelukast. The purpose of the study was to ascertain if montelukast was associated with a reduction in the prevalence of vancomycin-associated AKI.</p><p><strong>Methods: </strong>In this retrospective cohort study, adult patients who received intravenous vancomycin between January 2020 to January 2024 were examined. The RIFLE criteria was employed in identifying cases of AKI. Additionally, a pre-clinical vancomycin-associated nephrotoxicity model was established to provide insights into possible renal protective mechanisms.</p><p><strong>Results: </strong>Patients receiving montelukast (n = 110) were compared to the control (n = 330); of which AKI was observed in 3 of 110 (2.7%) versus 35 of 330 (10.6%), respectively (P=0.01). A multivariate logistic regression analysis revealed that weight (OR: 1.02; 95% CI: 1.006 to 1.03; P-=0.005) and intensive care unit admission (OR: 6.88; 95% CI: 2.96 to 18.8; P<0.001) were independently associated with AKI, while montelukast (OR: 0.26; 95% CI: 0.06 to 0.77; P=0.03) and male gender were protective (OR: 0.41; 95% CI: 0.19 to 0.85; P=0.02). Our in vitro model also revealed that adjuvant montelukast can reduce injury to proximal tubule cells through activation of the p62/KEAP-1/HO-1 antioxidant pathway.</p><p><strong>Conclusion: </strong>Our study suggests that montelukast during vancomycin therapy may be protective against AKI, which may reduce patient harm and hospitalization costs. Further studies are warranted to validate our findings prospectively.</p>","PeriodicalId":50179,"journal":{"name":"Journal of Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985368","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}