Journal of Infection最新文献

{"title":"Dental plaque disclosing gel: An effective detecting agent for guiding debridement of bacterial biofilms in periprosthetic joint infection","authors":"Wushi Cui ,&nbsp;Tao Zhang ,&nbsp;Shicheng Wang ,&nbsp;Liwen Guo ,&nbsp;Jiarong Hu ,&nbsp;Jian Xiao ,&nbsp;Jiaxuan Zou ,&nbsp;Congsun Li ,&nbsp;Weinan Yang ,&nbsp;Tao Sun ,&nbsp;Songyu Hu ,&nbsp;Haobo Wu ,&nbsp;An Liu","doi":"10.1016/j.jinf.2025.106581","DOIUrl":"10.1016/j.jinf.2025.106581","url":null,"abstract":"<div><h3>Objectives</h3><div>The presence and invisibility of biofilms are critical factors contributing to incomplete debridement in periprosthetic joint infection (PJI), often leading to infection relapse and failure of debridement, antibiotics, and implant retention (DAIR) procedures or subsequent revision surgeries. GC Tri Plaque ID Gel™ (GC gel), a three-tone disclosing gel, is widely used in dentistry to assess plaque presence, maturation and acidity by different colors. However, its potential in PJI remains unvalidated. This study aimed to assess GC gel’s feasibility in visualizing implant surface biofilm, distinguishing maturity and guiding DAIR procedures.</div></div><div><h3>Methods</h3><div>Murine subcutaneous biofilm infection models with fluorescence-labeled Methicillin-resistant Staphylococcus aureus (MRSA) and Escherichia coli (E. coli) were used to simulate biofilm formation. Infected implants collected at different time points were observed under fluorescence microscopy, followed by GC gel staining. Staining accuracy, sensitivity, the Dice and the Jaccard scores were calculated by comparing fluorescence and stained images. Bacterial load and inflammatory responses were evaluated via bacterial counting and routine blood tests. A murine PJI model was used to assess the debridement effectiveness of GC gel-guided DAIR through microbiological, hematological, and histological analysis. Clinical PJI prostheses were stained to evaluate GC gel’s clinical applicability.</div></div><div><h3>Results</h3><div>GC gel demonstrated over 70% accuracy in visualizing MRSA biofilms, and the sensitivity reached 88.67 ± 4.54%. The Dice and the Jaccard scores were 0.81 ± 0.04 and 0.68 ± 0.06, respectively. Infected implants, including clinical PJI prostheses, exhibited distinct red, blue, and purple staining, indicating biofilm maturity and stage. In contrast, sterile implants and non-infected clinical prostheses could not be stained. With prolonged infection, bacterial load and systemic inflammation increased, reflected by changes in staining intensity and area. GC gel-guided DAIR resulted in lower bacterial load and inflammation in the animal model. Staining of clinical prostheses showed biofilm aggregation in static regions of the joint cavity, with low density on the articulating surface.</div></div><div><h3>Conclusions</h3><div>GC gel can effectively visualize biofilms and assesses biofilm maturity, revealing biofilm distribution patterns on prosthetic surfaces. GC gel-guided DAIR exhibited superior debridement outcome in animal model, supporting its potential in further PJI treatment.</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"91 3","pages":"Article 106581"},"PeriodicalIF":11.9,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856850","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":"Risk factors for invasive mould infections in adult patients with hematological malignancies and/or stem cell transplant: A systematic literature review and meta-analysis","authors":"Emmanuelle Gras ,&nbsp;Loris Azoyan ,&nbsp;Patricia Monzo-Gallo ,&nbsp;Carolina Garcia-Vidal ,&nbsp;Fanny Lanternier ,&nbsp;Eolia Brissot ,&nbsp;Juliette Guitard ,&nbsp;Karine Lacombe ,&nbsp;Agnès Dechartres ,&nbsp;Laure Surgers","doi":"10.1016/j.jinf.2025.106574","DOIUrl":"10.1016/j.jinf.2025.106574","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate risk factors for invasive mould infections (IMI) in adult patients with hematological malignancies and/or hematopoietic stem cell transplantation (HSCT).</div></div><div><h3>Methods</h3><div>Systematic review from PubMed, Embase, CENTRAL, and grey literature (01/01/2002–23/01/2025). Eligible studies were cohort or case-control studies. Selection, data extraction, and bias assessment were performed in duplicate. Adjusted measure effects were pooled using random-effects models.</div></div><div><h3>Results</h3><div>From 13,372 references, 45 studies were included; 17 focused on any type of IMI (n=846), 26 specifically on invasive aspergillosis (IA, n=2086) and 2 on mucormycosis (n=53). Twenty-eight studies (10 on IMI, 18 on IA) were eligible for meta-analysis. Relapsed/refractory hemopathies were significantly associated with a higher risk of IMI (HR 3.43 [95%CI 1.58–7.46]) whereas prolonged neutropenia was associated with IA (OR 4.85 [95%CI 2.15–10.97]). Specifically in the allo-HSCT population, both acute and chronic graft vs host disease (GvHD) (acute GvHD HR 3.23 [95%CI 2.20–4.74]; chronic GvHD HR 2.95 [95%CI 1.25–6.96]) were associated with IMI and CMV disease (HR 3.23 [95%CI 1.00–10.43]), and corticosteroid use (HR 4.67 [95% CI 2.79–7.82]) were associated with IA.</div></div><div><h3>Conclusion</h3><div>Recognizing risk factors for IMI in patients with hematological malignancy or HSCT is essential to improve prevention and management strategies.</div></div><div><h3>Registration</h3><div>PROSPERO, CRD42023429103.</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"91 3","pages":"Article 106574"},"PeriodicalIF":11.9,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849543","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":"Characterization of neutralizing antibodies against emerging XDV, XEC, and LP.8.1 variants across heterogeneous hybrid immunity backgrounds","authors":"Xin-Jing Zhao ,&nbsp;Yu-Min Liang ,&nbsp;Xiao-Lin Liu,&nbsp;Qing-Jie Wang,&nbsp;Wang-Qian Wei,&nbsp;Jing Jia,&nbsp;Sheng Zhang,&nbsp;Li-Bo Li,&nbsp;Wen-Guo Jiang,&nbsp;Qiang Xu,&nbsp;Chen-Long Lv,&nbsp;Ti Liu,&nbsp;Guo-Lin Wang,&nbsp;Li-Qun Fang","doi":"10.1016/j.jinf.2025.106584","DOIUrl":"10.1016/j.jinf.2025.106584","url":null,"abstract":"","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"91 3","pages":"Article 106584"},"PeriodicalIF":11.9,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818065","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":"Nowcasting cases and trends during the measles 2023/24 outbreak in England","authors":"Maria L. Tang ,&nbsp;Ian S. McFarlane ,&nbsp;Christopher E. Overton ,&nbsp;Erjola Hani ,&nbsp;Vanessa Saliba ,&nbsp;Gareth J. Hughes ,&nbsp;Paul Crook ,&nbsp;Thomas Ward ,&nbsp;Jonathon Mellor","doi":"10.1016/j.jinf.2025.106569","DOIUrl":"10.1016/j.jinf.2025.106569","url":null,"abstract":"<div><h3>Objectives</h3><div>In 2023/24, England had its largest measles outbreak in a decade. Lags from symptom onset to test results made laboratory-confirmed case data inherently retrospective rather than real-time. Reporting lags varied by measles prevalence and testing purpose. Nowcasting models can predict future backfilling of reported cases and estimate recent trends.</div></div><div><h3>Methods</h3><div>We developed a generalised additive model accounting for reporting delays, location, and day-of-week effects in line-list data by symptom onset date. The model was re-fit weekly providing real-time nowcasts and directional trends for national and regional users. Retrospectively, we tested alternative specifications to optimise structure and confirm predictive performance, evaluating with log weighted interval score (WIS) and ranked probability score (RPS).</div></div><div><h3>Results</h3><div>For national case estimates, the operational and retrospective models outperformed the baseline model, reducing daily log WIS by 42% and 41%, respectively. For four-week trends, the operational and retrospective models provided better national estimates than the baseline, reducing RPS by 69% and 6%, respectively. An alternative model indexed by report date sometimes outperformed others for trend direction but lagged trend changes.</div></div><div><h3>Conclusions</h3><div>Our work highlights the value of real-time nowcasting during outbreaks to inform fast-evolving trends, and early access to accurate reporting delay data for effective modelling.</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"91 3","pages":"Article 106569"},"PeriodicalIF":11.9,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812623","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":"Heterologous COVID-19 vaccine schedule with protein-based prime (NVX-CoV2373) and mRNA boost (BNT162b2) induces strong humoral responses: Results from COV-BOOST trial","authors":"Leila Janani ,&nbsp;Alasdair P.S. Munro ,&nbsp;Annie Wright ,&nbsp;Parvinder K. Aley ,&nbsp;Gavin Babbage ,&nbsp;David Baxter ,&nbsp;Tanveer Bawa ,&nbsp;Sagida Bibi ,&nbsp;Marcin Bula ,&nbsp;Katrina Cathie ,&nbsp;Krishna Chatterjee ,&nbsp;Catherine Cosgrove ,&nbsp;Yvanne Enever ,&nbsp;Eva Galiza ,&nbsp;Anna L. Goodman ,&nbsp;Christopher A. Green ,&nbsp;Mae Harris ,&nbsp;Alexander Hicks ,&nbsp;Christine E. Jones ,&nbsp;Nasir Kanji ,&nbsp;Saul N. Faust","doi":"10.1016/j.jinf.2025.106576","DOIUrl":"10.1016/j.jinf.2025.106576","url":null,"abstract":"<div><h3>Background</h3><div>Heterologous schedules of booster vaccines for COVID-19 following initial doses of mRNA or adenoviral vector vaccines have been shown to be safe and immunogenic. There are few data on booster doses following initial doses of protein nanoparticle vaccines.</div></div><div><h3>Methods</h3><div>Participants of the phase 3 clinical trial of the COVID-19 vaccine NVX-CoV2373 (EudraCT 2020–004123-16) enroled between September 28 and November 28, 2020, who received 2 doses of NVX-CoV2373 administered 21 days apart were invited to receive a third dose booster vaccine of BNT162b2 (wild type mRNA vaccine) as a sub-study of the COV-BOOST clinical trial, and were followed up for assessment of safety, reactogenicity and immunogenicity to day 242 post-booster.</div></div><div><h3>Results</h3><div>The BNT162b2 booster following two doses of NVX-COV2373 was well-tolerated. Most adverse events were mild to moderate, with no serious vaccine-related adverse events reported. Immunogenicity analysis showed a significant increase in spike IgG titres and T-cell responses post-third dose booster. Specifically, IgG levels peaked at day 14 with a geometric mean concentration (GMC) of 216,255 ELISA laboratory units (ELU)/mL (95% CI 191,083–244,743). The geometric mean fold increase from baseline to day 28 post-boost was 168.6 (95% CI 117.5–241.8). Spike IgG titres were sustained above baseline levels at day 242 with a GMC of 58,686 ELU/mL (95% CI 48,954–74,652), with significant decay between days 28 and 84 (geometric mean ratio 0.58, 95% CI 0.53–0.63). T-cell responses also demonstrated enhancement post-booster, with a geometric mean fold increase of 5.1 (95% CI 2.9–9.0) at day 14 in fresh samples and 3.0 (95% CI 1.8–4.9) in frozen samples as measured by ELISpot. In an exploratory analysis, participants who received BNT162b2 after two doses of NVX-COV2373 exhibited higher anti-spike IgG at Day 28 than those who received homologous three doses of BNT162b2, with a GMR of 5.02 (95% CI: 3.17–7.94). This trend remained consistent across all time points, indicating a similar decay rate between the two schedules.</div></div><div><h3>Conclusions</h3><div>A BNT162b2 third dose booster dose in individuals primed with two doses of NVX-COV2373 is safe and induces strong and durable immunogenic responses, higher than seen in other comparable studies. These findings support the use and investigation of heterologous booster strategies and early investigation of heterologous vaccine technology schedules should be a priority in the development of vaccines against new pathogens.</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"91 3","pages":"Article 106576"},"PeriodicalIF":11.9,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812621","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":"The United Kingdom meningococcal vaccine (4CMenB) programme against gonorrhoea: A review of the evidence and knowledge gaps","authors":"Shamez N. Ladhani ,&nbsp;Sema Mandal ,&nbsp;Hamish Mohammed ,&nbsp;John Saunders ,&nbsp;Nick Andrews ,&nbsp;Mary E. Ramsay ,&nbsp;Helen Fifer","doi":"10.1016/j.jinf.2025.106582","DOIUrl":"10.1016/j.jinf.2025.106582","url":null,"abstract":"<div><div>On 01 August 2025, the United Kingdom became the first country in the world to implement a targeted immunisation programme using a meningococcal vaccine (4CMenB) for protection against gonorrhoea. 4CMenB is a recombinant, protein-based vaccine licensed for prevention of serogroup B meningococcal disease but, because <em>Neisseria meningitidis</em> is genetically closely related to <em>Neisseria gonorrhoeae</em>, observational studies estimate that the vaccine also provides some (30–41%) protection against gonorrhoea. Given the rising incidence of gonorrhoea and increasing antimicrobial resistance, the UK programme will offer 4CMenB through specialist sexual health services clinics primarily to gay, bisexual and other men who have sex with men (GBMSM) who are at high risk of infection. A comprehensive national surveillance programme is in place to assess vaccine uptake as well as effectiveness and impact of vaccination on symptomatic disease, asymptomatic infection, recurrent infections, co-infections with other sexually transmitted infections and duration of protection. Microbiological surveillance will monitor trends in antimicrobial resistance and help elucidate mechanisms of vaccine protection, including identification of potential antigenic targets for next-generation vaccines. It is hoped that the data collected will provide an evidence base for other countries considering implementing a similar immunisation programme for their populations at high risk of gonorrhoea.</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"91 3","pages":"Article 106582"},"PeriodicalIF":11.9,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812641","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":"HIV status and the risk of typhoid fever and iNTS: A systematic review and meta-analysis","authors":"Peter I. Johnston ,&nbsp;Wankumbu Chisala ,&nbsp;Adam Hinchcliffe ,&nbsp;Chipiliro Mhango ,&nbsp;Ndaru Jambo ,&nbsp;Matthew R. Cooper ,&nbsp;Farah Shahi ,&nbsp;Melita A. Gordon ,&nbsp;Thomas C. Darton","doi":"10.1016/j.jinf.2025.106572","DOIUrl":"10.1016/j.jinf.2025.106572","url":null,"abstract":"<div><h3>Objectives</h3><div>The WHO recommends prioritising people living with HIV (PLHIV) for typhoid vaccination, but evidence for increased typhoid fever risk is inconsistent. We aimed to evaluate whether HIV infection alters the risk of blood culture-confirmed typhoid fever.</div></div><div><h3>Methods</h3><div>We systematically searched four databases from inception to 30 November 2023 for studies reporting <em>Salmonella</em> Typhi bacteraemia with documented HIV status. Where available, we also extracted data on invasive non-typhoidal <em>Salmonella</em> (iNTS) bacteraemia. We used random-effects meta-analysis to pool odds ratios (ORs) and assessed effect modification by ART era, age, and CD4 count.</div></div><div><h3>Results</h3><div>Seventeen studies met inclusion criteria, comprising 10,117 PLHIV and 53,289 HIV-negative individuals from Africa and Asia. PLHIV had lower odds of typhoid fever (OR 0.53, 95% CI 0.30–0.92), but higher odds of iNTS disease (OR 4.06, 2.23–7.39). Apparent protection against typhoid was most evident in adults with CD4 counts &lt;200 cells/µl and was not significant after ART rollout.</div></div><div><h3>Conclusions</h3><div>Advanced HIV infection may reduce the risk of typhoid fever. While altered clinical presentations or healthcare-seeking behaviours could contribute, the contrasting increase in iNTS risk within the same populations suggests a genuine difference in susceptibility. These findings support re-evaluating WHO guidance that prioritises PLHIV for typhoid vaccination.</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"91 3","pages":"Article 106572"},"PeriodicalIF":11.9,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812622","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":"Burden of respiratory syncytial virus infection in older adults hospitalised in England during 2023/24","authors":"Rebecca Symes ,&nbsp;Suzanne H Keddie ,&nbsp;Jemma Walker ,&nbsp;Tricia McKeever ,&nbsp;Shazaad Ahmad ,&nbsp;David Arnold ,&nbsp;Cariad M Evans ,&nbsp;Emanuela Pelosi ,&nbsp;Najib M Rahman ,&nbsp;Elizabeth Sapey ,&nbsp;Maria Zambon ,&nbsp;Conall Watson ,&nbsp;Jamie Lopez Bernal ,&nbsp;Wei Shen Lim","doi":"10.1016/j.jinf.2025.106570","DOIUrl":"10.1016/j.jinf.2025.106570","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to describe the incidence, presentation and clinical outcomes of RSV-associated acute respiratory infection (ARI) in older adults using a new national Hospital-based ARI Sentinel Surveillance (HARISS) system in England, prior to RSV vaccine introduction.</div></div><div><h3>Methods</h3><div>Adults aged ≥65 years from seven hospitals admitted for ≥24 hours with symptomatic ARI were included. We estimated the hospitalisation rate of RSV-associated ARI compared to influenza-associated ARI and assessed clinical outcomes using Poisson regression and mortality using Cox regression.</div></div><div><h3>Results</h3><div>This study included 2743 adults. During winter 2023/4 the hospitalisation rate for RSV-associated ARI was 58.3 per 100,000, compared to 114.6 per 100,000 for influenza-associated ARI. Hospitalisations increased with age. Exacerbation of chronic illness (lung disease, heart disease, frailty) was a common admission reason in RSV-associated ARI, with a combined incidence of 33.1 per 100,000. Most adults with RSV-associated ARI had at least one comorbidity (81%); a high proportion with immunosuppression (26%). Symptoms and clinical outcomes including mortality were similar between RSV- and influenza-associated ARI; 30-day mortality 10.6% vs 8.7% (adjusted hazard ratio 0.85, 95% confidence interval 0.6–1.2).</div></div><div><h3>Conclusions</h3><div>In England, RSV infection is a common cause of hospitalisation in older adults. Symptoms and clinical outcomes, including mortality, are comparable to influenza.</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"91 3","pages":"Article 106570"},"PeriodicalIF":11.9,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805178","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":"Improved pathogen identification in sepsis or septic shock by clinical metagenomic sequencing","authors":"Thorsten Brenner ,&nbsp;Sebastian O. Decker ,&nbsp;Yevhen Vainshtein ,&nbsp;Silke Grumaz ,&nbsp;Mehdi Manoochehri ,&nbsp;Manuel Feißt ,&nbsp;Andrea Seidel-Glätzer ,&nbsp;Mathias W. Pletz ,&nbsp;Hendrik Bracht ,&nbsp;Marc M. Berger ,&nbsp;Kristina Fuest ,&nbsp;Manfred Blobner ,&nbsp;Friedhelm Bach ,&nbsp;Onnen Moerer ,&nbsp;Timo Brandenburger ,&nbsp;Thomas Dimski ,&nbsp;Klaudiusz Suchodolski ,&nbsp;Ulrike Jäkel ,&nbsp;Jana Zischkau ,&nbsp;Helene Häberle ,&nbsp;Hans-Jörg Gillmann","doi":"10.1016/j.jinf.2025.106565","DOIUrl":"10.1016/j.jinf.2025.106565","url":null,"abstract":"<div><h3>Objectives</h3><div>Despite limited sensitivity and specificity, blood cultures (BCs) still represent the gold standard of diagnostic care in septic patients. We aimed to overcome current diagnostic limitations by unbiased next-generation sequencing (NGS) of circulating microbial cell-free DNA (mcfDNA) in plasma samples.</div></div><div><h3>Methods</h3><div>We performed a prospective, observational, non-interventional, multicenter study (<em>Next GeneSiS-Trial</em>) to compare positivity rates for NGS-based identification of causative pathogens with BCs in patients suffering from sepsis or septic shock. An independent expert panel (n=3) retrospectively evaluated the plausibility of NGS-based findings and the potential for anti-infective treatment adaptations based on NGS results.</div></div><div><h3>Results</h3><div>The positivity rate of NGS-based diagnostics (NGS+) for 491 septic patients was 70.5% compared to positive BCs (BC+) with 19.4% within the first three days after sepsis onset. NGS+ results were evaluated as plausible in 98.6% of cases by the expert panel. Based on the experts´ recommendations, additional knowledge of NGS-based pathogen findings would have resulted in anti-infective treatment adaptations in 32.6% of all patients. Potentially inadequately treated NGS+/blood culture negative (BC-) patients showed worse outcomes.</div></div><div><h3>Conclusion</h3><div>The integration of NGS-based pathogen diagnostics in sepsis has the potential to improve patients´ outcomes as compared to a treatment strategy based on standard-of-care microbiological diagnostics alone.</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"91 3","pages":"Article 106565"},"PeriodicalIF":11.9,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800831","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":"Clinical phenotype and outcomes in autoimmune encephalitis after herpes simplex virus encephalitis: A systematic review and meta-analysis","authors":"Jonathan Cleaver ,&nbsp;Renetta Chungath ,&nbsp;Amy Gimson ,&nbsp;Christine Strippel ,&nbsp;Bryan Ceronie ,&nbsp;Babak Soleimani ,&nbsp;Thomas Johnson ,&nbsp;Eyal Muscal ,&nbsp;Kristen Fisher ,&nbsp;Yike Jiang ,&nbsp;Timothy A. Erickson ,&nbsp;Kristy O. Murray ,&nbsp;Siv Tonje Faret Hovet ,&nbsp;Charlotte Aaberg Poulsen ,&nbsp;Anna Søgaard Magnussen ,&nbsp;Pauline Dumez ,&nbsp;Shannon Ronca ,&nbsp;Martin Häusler ,&nbsp;Annegret Quade ,&nbsp;Andrew Swayne ,&nbsp;Adam E. Handel","doi":"10.1016/j.jinf.2025.106566","DOIUrl":"10.1016/j.jinf.2025.106566","url":null,"abstract":"<div><h3>Background</h3><div>Autoimmune encephalitis after herpes simplex virus encephalitis (HSVE-AE) represents the intersection of central nervous system infection and autoimmunity. Defining the phenotype and the safety and effectiveness of immunotherapy in HSVE-AE would help identify immunotherapy candidates, optimise therapeutic strategies, and improve patient outcomes.</div></div><div><h3>Methods</h3><div>We systematically searched Embase, Medline, PubMed, and Web of Science (2007–2024) for cases meeting consensus criteria for AE after confirmed HSVE. Demographics, phenotype, treatment and outcome data were extracted. Dimensionality reduction, network analysis, and multivariate logistic regression was used to explore age- and diagnosis-specific patterns and outcome predictors.</div></div><div><h3>Results</h3><div>From 2259 articles screened, 78 studies (225 patients) were included (median age 7.25 years; 52.9% female). Children (0–12 years) experienced more seizures during HSVE (p=0.003) and movement disorders during AE (p&lt;0.001). Older patients (&gt;12 years) had more headaches during HSVE (p=0.003), and speech dysfunction (p=0.02) and neuropsychiatric symptoms (p=0.02) during AE. HSVE-AE (89.3% N-methyl-D-aspartate receptor-antibody encephalitis [NMDAR-AbE]) differed significantly from a canonical NMDAR-AbE cohort (n=1550) in clinical, paraclinical and outcome domains.</div><div>Poor outcomes were linked to infant and older adult age, neuropsychiatric symptoms, and AE-phase mRS &gt;4. Rituximab independently predicted better outcomes. Disability improved over time (p&lt;0.001), with adverse event rates comparable to NMDAR-AbE.</div></div><div><h3>Conclusions and relevance</h3><div>This meta-analysis defines novel age-specific HSVE-AE features, outcome predictors, and confirms the safety and improved outcomes of HSVE-AE after immunotherapy.</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"91 3","pages":"Article 106566"},"PeriodicalIF":11.9,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805199","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}