Journal of Infection最新文献

{"title":"Rapid impedance-based Antimicrobial Susceptibility Testing (iFAST) of Enterobacterales in urinary tract infections","authors":"Lucy J. Bock ,&nbsp;Daniel C. Spencer ,&nbsp;Bethany K. Martin ,&nbsp;Caitlin N. Daniels ,&nbsp;Xena Dyball ,&nbsp;Charlotte K. Hind ,&nbsp;Matthew E. Wand ,&nbsp;Collette E. Allen ,&nbsp;Robert C. Read ,&nbsp;H. Morgan ,&nbsp;J. Mark Sutton","doi":"10.1016/j.jinf.2025.106549","DOIUrl":"10.1016/j.jinf.2025.106549","url":null,"abstract":"<div><h3>Objectives</h3><div>Evidence-based antibiotic prescribing for urinary tract infections (UTIs) would increase treatment success and improve antibiotic stewardship. Current antimicrobial susceptibility tests (AST) are time-consuming. A novel phenotypic impedance-based Fast AST (iFAST) measures changes in the electrical phenotype of single bacteria in response to antibiotic exposure. Suitability of this technology for UTI causing bacteria was investigated.</div></div><div><h3>Methods</h3><div>Fifty-eight strains of <em>Escherichia coli</em> and <em>Klebsiella pneumoniae</em> were exposed to EUCAST breakpoint concentrations of UTI antibiotics. Following a two-hour exposure, the % cell count compared to unexposed control populations were compared and susceptibility deduced. Results were compared to gold standard broth microdilution (BMD) AST results. Susceptibility thresholds were clinically evaluated. Strain-antibiotic combinations with a minimum inhibitory concentration (MIC) on or one doubling dilution above the breakpoint were exposed to doubling dilutions of antibiotics and measured on iFAST to determine an electrical MIC.</div></div><div><h3>Results</h3><div>100% correlation was obtained for all eight antibiotics against laboratory strains, when allowing for the inherent 2-fold variability of the BMD MIC measurement, within a five-hour test. Clinical evaluation showed concordance in at least 74 out of 80 tests. Electrical MICs showed broad equivalence with classical MICs.</div></div><div><h3>Conclusions</h3><div>iFAST has potential as an accurate and rapid AST for UTI causing <em>Enterobacterales</em>.</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"91 2","pages":"Article 106549"},"PeriodicalIF":14.3,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585515","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":"Impact of climate change and extreme temperature on the incidence of infectious disease among children and adolescents in China: A nationwide case-crossover study with over 8.7 million cases between 2008 and 2019","authors":"Li Chen ,&nbsp;Duanke Liu ,&nbsp;Yuchen Guo ,&nbsp;Bo Wen ,&nbsp;Yao Wu ,&nbsp;Yi Xing ,&nbsp;Yi Zhang ,&nbsp;Xinli Song ,&nbsp;RuoLin Wang ,&nbsp;Jianuo Jiang ,&nbsp;Yang Qin ,&nbsp;Jun Ma ,&nbsp;Mengjie Geng ,&nbsp;Yanhui Dong ,&nbsp;Yi Song ,&nbsp;Daniel Prieto-Alhambra ,&nbsp;Junqing Xie","doi":"10.1016/j.jinf.2025.106547","DOIUrl":"10.1016/j.jinf.2025.106547","url":null,"abstract":"<div><h3>Background</h3><div>The relationship between ambient temperature and infectious disease incidence lacks comprehensive documentation. Our study, therefore, sought to systematically determine the national association between temperature and the incidence of infectious diseases, categorized into respiratory, gastrointestinal and enterovirus, and vector-borne categories. We aimed to study the association between extreme cold and heat extreme temperature on infectious disease occurrence among children and teenagers, and to evaluate the secular trends in these diseases in relation to temperature extremes.</div></div><div><h3>Methods</h3><div>We accessed the dataset encompassing 8,731,930 cases of 27 distinct infectious diseases, spanning respiratory, gastrointestinal and enterovirus infections, and vector-borne categories, across 507 Chinese cities from 2008 to 2019. Employing a time-stratified case-crossover design, we quantified the association between temperature exposure and the risk of infectious diseases specific to each city. The attributable fractions for temperature-related risks were determined by identifying extreme temperatures exceeding the 90th percentile and falling below the 10th percentile of the respective city-specific temperature distributions, indicative of heat and cold effects. A comparative analysis of these attributable fractions between the periods 2008–2010 and 2017–2019 was conducted to evaluate the secular changes of infectious diseases associated with cold and heat.</div></div><div><h3>Findings</h3><div>Our analysis revealed significant non-linear associations between temperature and the incidence of specific infectious diseases. Cold temperatures were found to be responsible for 1.35% (95% CI: 1.18 to 1.51%) of respiratory infectious disease cases. In contrast, heat was attributed to a lower proportion, with 0.29% (95% CI: 0.25 to 0.33%) of such cases. Among gastrointestinal and enterovirus diseases, a more substantial 4.93% (95% CI: 4.82 to 5.04%) of cases were linked to heat exposure. Notably, vector-borne diseases demonstrated the highest attributable fraction to heat, with 22.12% (95% CI: 21.82 to 22.41%) of cases affected. Specifically, five diseases—scarlet fever, tuberculosis, mumps, leprosy, and typhus—exhibited an increased incidence associated with cold temperatures. Notably, for scarlet fever, leprosy, and typhus, the attributable fraction escalated from the period 2008–2010 to 2017–2019. However, findings for leprosy should be interpreted with caution due to its low incidence. As for heat-related diseases, thirteen were identified, with the attributable fraction for nine diseases—tuberculosis, pertussis, hand, foot, and mouth disease, infectious diarrhea, dysentery, hepatitis A, typhoid and paratyphoid, dengue, and Japanese encephalitis—showing a marked increase over the same comparative timeframes.</div></div><div><h3>Interpretation</h3><div>The temperature increase observed from 2008–2010 to 2017–20","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"91 2","pages":"Article 106547"},"PeriodicalIF":14.3,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576823","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":"Evaluating clinical decision rules and rapid diagnostic tests for the diagnosis of Streptococcus pyogenes pharyngitis in Gambian children: A diagnostic accuracy study","authors":"Edwin P. Armitage ,&nbsp;Elina Senghore ,&nbsp;Fatoumata E. Camara ,&nbsp;Sheikh Jarju ,&nbsp;Sukai Jagne ,&nbsp;Ebrima Ceesay ,&nbsp;Fatoumata Fornah Darboe ,&nbsp;Gabrielle de Crombrugghe ,&nbsp;Alexander J. Keeley ,&nbsp;Jennifer N. Hall ,&nbsp;Adrienn Angyal ,&nbsp;Musukoi Jammeh ,&nbsp;Saffiatou Darboe ,&nbsp;Adam Kucharski ,&nbsp;Pierre R. Smeesters ,&nbsp;Thushan I. de Silva ,&nbsp;Michael Marks ,&nbsp;on behalf of the MRCG StrepA Study Group","doi":"10.1016/j.jinf.2025.106546","DOIUrl":"10.1016/j.jinf.2025.106546","url":null,"abstract":"<div><h3>Objectives</h3><div>Accurate diagnosis of <em>Streptococcus pyogenes</em> (<em>S. pyogenes</em>) pharyngitis is imperative in high rheumatic heart disease-burden countries. We aimed to assess the diagnostic accuracy of two rapid diagnostic tests and five clinical decision rules (CDRs) in The Gambia.</div></div><div><h3>Methods</h3><div>Children under 16 years presenting with signs and symptoms of pharyngitis were recruited at Sukuta Health Centre, The Gambia. A rapid antigen detection test (SD Bioline; LFT) and a rapid gene-amplification test (ID NOW™ STREP A2) were assessed for diagnostic accuracy alongside five CDRs against culture and qPCR for <em>S. pyogenes</em>. Logistic regression was used to determine risk factors for <em>S. pyogenes</em> pharyngitis.</div></div><div><h3>Results</h3><div>Among 376 participants, <em>S. pyogenes</em> positivity was 9·8% (37/376) by culture, 32·4% (122/376) by PCR, 31·6% (119/376) by LFT, and 33·3% (122/366) by ID NOW. The ID NOW had sensitivities and specificities of 94·6% and 73·6% against culture, and 93·5% and 87·6% against PCR. The LFT had sensitivities and specificities of 83·8% and 74·0% against culture and 55·7% and 80·0% against PCR. The Smeesters CDR performed best with an area under the curve (AUC) of 0·694 against culture. <em>S. pyogenes</em> pharyngitis risk increased with age. Recent chest infection/cough (aOR 1·89, 1·08–3·28) and concurrent skin infection (aOR 2·11, 1·21–3·69) were associated with increased <em>S. pyogenes</em> pharyngitis.</div></div><div><h3>Conclusions</h3><div>The LFT and the CDRs had poor performance in detecting <em>S. pyogenes</em> pharyngitis compared to PCR and culture. Molecular methods detected a higher proportion of <em>S. pyogenes</em> than culture. Affordable and sensitive diagnostics are urgently needed to improve <em>S. pyogenes</em> management in resource-limited settings.</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"91 2","pages":"Article 106546"},"PeriodicalIF":14.3,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568090","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":"Investigation of the viral causes of febrile jaundice in Burkina Faso through metagenomic sequencing","authors":"Karine Bolloré ,&nbsp;Bachirou Tinto ,&nbsp;Florian Charriat ,&nbsp;Amandine Pisoni ,&nbsp;Anthony Exbrayat ,&nbsp;Serafin Gutierrez ,&nbsp;Yannick Simonin ,&nbsp;Edouard Tuaillon","doi":"10.1016/j.jinf.2025.106541","DOIUrl":"10.1016/j.jinf.2025.106541","url":null,"abstract":"<div><h3>Objectives</h3><div>Yellow fever virus (YFV) is a key concern in West Africa, often associated with febrile jaundice. However, many patients with this syndrome test negative for YFV, raising questions about other potential viral etiologies. This study aimed to characterize the viral landscape in YFV-negative febrile jaundice cases using metagenomic next-generation sequencing (mNGS).</div></div><div><h3>Methods</h3><div>Serum samples were collected in 2019 from 152 febrile jaundice patients in Burkina Faso who tested negative for both YFV and malaria. A random subset of 100 samples was analyzed by mNGS to identify viral sequences. Bioinformatic pipelines were applied to classify viral reads, and findings were validated by quantitative PCR (qPCR) and serological assays. Additional specimens from the same cohort, as well as from febrile patients without jaundice, were tested to assess the prevalence of the key viral findings.</div></div><div><h3>Results</h3><div>mNGS revealed 58 viral species, including four human pathogens: HIV-1 (n=1), YFV (n=1), hepatitis A virus (HAV, n=16), and hepatitis B virus (HBV, n=18). qPCR confirmed 75% of HAV and 67% of HBV cases. Serological testing on additional samples confirmed comparable HAV and HBV prevalence among jaundiced patients, but significantly lower rates among those without jaundice.</div></div><div><h3>Conclusion</h3><div>mNGS uncovered undiagnosed viral infections, demonstrating its value for differential diagnosis and surveillance in resource-limited settings.</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"91 2","pages":"Article 106541"},"PeriodicalIF":14.3,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530778","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":"Epidemiology of Neisseria gonorrhoeae in South-East Asia: Systematic review, meta-analyses, and meta-regressions","authors":"Rwedah A. Ageeb ,&nbsp;Sawsan Almukdad ,&nbsp;Huda Alalami ,&nbsp;Manale Harfouche ,&nbsp;Laith J. Abu-Raddad","doi":"10.1016/j.jinf.2025.106545","DOIUrl":"10.1016/j.jinf.2025.106545","url":null,"abstract":"<div><h3>Objectives</h3><div>The epidemiology of <em>Neisseria gonorrhoeae</em> (NG) infection in South-East Asia remains inadequately understood. This study aimed to systematically review and analyze the available evidence on NG prevalence to provide an understanding of the epidemiology in this region, highlighting prevalence patterns, key populations at risk, and factors influencing transmission.</div></div><div><h3>Methods</h3><div>A systematic review of the literature up to September 3, 2024, was conducted, with findings reported in accordance with PRISMA guidelines. Random-effects meta-analyses were performed to estimate the pooled mean prevalence, while meta-regression analyses were conducted to explore associations, assess time trends, and identify sources of heterogeneity across studies.</div></div><div><h3>Results</h3><div>The review identified 474 relevant publications, encompassing 885 overall and 1136 stratified NG prevalence measures. The pooled mean prevalence of urogenital infection was 0.5% (95% CI: 0.3–0.8%) in general populations, 13.9% (95% CI: 11.9–16.1%) among female sex workers, 16.8% (95% CI: 12.6–21.5%) among sexually transmitted infection clinic attendees, 4.6% (95% CI: 2.9–6.5%) in symptomatic women, and 38.5% (95% CI: 31.8–45.3%) in symptomatic men. Among men who have sex with men, transgender people, and male and transgender sex workers, the pooled mean prevalence was 0.9% (95% CI: 0.4–1.5%) for urogenital infection, 12.0% (95% CI: 8.8–15.7%) for anorectal infection, and 7.1% (95% CI: 4.0–10.9%) for oropharyngeal infection. Multivariable meta-regression analyses explained over 55% of the variation in prevalence, revealing a hierarchical pattern by population type, higher prevalence among men, and a decline in prevalence of 2% per calendar year over the past four decades.</div></div><div><h3>Conclusions</h3><div>NG prevalence in South-East Asia is comparable to the global prevalence. The markedly high prevalence among key populations, coupled with Asia’s substantial burden of gonococcal antimicrobial resistance, underscores the urgent need for targeted interventions focused on these vulnerable groups.</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"91 2","pages":"Article 106545"},"PeriodicalIF":14.3,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530777","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":"Anti-spike IgG4 and Fc effector responses: The impact of SARS-CoV-2 vaccine platform–specific priming and immune imprinting","authors":"Raj Kalkeri ,&nbsp;Mingzhu Zhu ,&nbsp;Shane Cloney-Clark ,&nbsp;Anand Parekh ,&nbsp;Drew Gorinson ,&nbsp;Zhaohui Cai ,&nbsp;Miranda R. Cai ,&nbsp;Soham Mahato ,&nbsp;Gordon Chau ,&nbsp;Tara M. Babu ,&nbsp;Anna Wald ,&nbsp;Pradhipa Ramanathan ,&nbsp;L. Carissa Aurelia ,&nbsp;Kevin John Selva ,&nbsp;Anthony M. Marchese ,&nbsp;Louis Fries ,&nbsp;Lisa M. Dunkle ,&nbsp;Amy W. Chung ,&nbsp;Joyce S. Plested","doi":"10.1016/j.jinf.2025.106543","DOIUrl":"10.1016/j.jinf.2025.106543","url":null,"abstract":"<div><div>Proportional increases in anti-Spike (S) IgG4 associated with decreased Fc effector functions have been reported following repeated mRNA, but not recombinant protein-based (rS) (NVX-CoV2373, Novavax, Inc.), SARS-CoV-2 vaccination. We demonstrate the first evidence of a negative correlation between anti-S IgG4 and neutralizing antibody (nAb), as well as antibody-dependent surrogate Fc effector functions. Priming with two NVX-CoV2373 vaccines followed by a third dose was associated with higher IgG1 and IgG3, lower IgG4, higher nAb titers and surrogate Fc effector functions versus mRNA. Immune imprinting of anti-S IgG4 and nAbs, and Fc effector function imprinting after mRNA priming was observed. This effect was partially overcome by updated XBB.1.5 protein subunit vaccination, but not by ancestral vaccine strains. We establish correlation of anti-S IgG4 responses to reduced nAbs and surrogate Fc effector functions and demonstrate the impact of additional booster vaccination on subsequent immune response and Fc effector functions in the context of ancestral and XBB.1.5 strains.</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"91 2","pages":"Article 106543"},"PeriodicalIF":14.3,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530807","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":"Reemergence of Oropouche virus infection in Ecuador, 2024: Vectors and cases","authors":"Alfonso J. Rodriguez-Morales ,&nbsp;Juan-Carlos Navarro,&nbsp;Daniel Romero-Alvarez,&nbsp;Alberto Paniz-Mondolfi,&nbsp;David A. Forero-Peña,&nbsp;Laura Naranjo-Lara,&nbsp;Jose A. Suárez","doi":"10.1016/j.jinf.2025.106544","DOIUrl":"10.1016/j.jinf.2025.106544","url":null,"abstract":"","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"91 2","pages":"Article 106544"},"PeriodicalIF":14.3,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512715","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":"Host lncRNA assists the nuclear import of influenza A virus protein PB2 in a species-specific manner","authors":"Jing Wang ,&nbsp;Saisai Guo ,&nbsp;Jianyuan Zhao ,&nbsp;Tingting Sun ,&nbsp;Yilu Ye ,&nbsp;Rui Zhou ,&nbsp;Tao Deng ,&nbsp;Xiaoyu Li ,&nbsp;Jianwei Wang ,&nbsp;Shan Cen","doi":"10.1016/j.jinf.2025.106540","DOIUrl":"10.1016/j.jinf.2025.106540","url":null,"abstract":"<div><div>Long noncoding RNAs (lncRNAs) have been reported to modulate immune responses to viral infections. However, it remains largely unexplored how viruses exploit host lncRNAs to promote viral replication. Here, we found that an lncRNA, called lnc-ALOX12, is upregulated specifically in cells infected by influenza A virus (IAV). Lnc-ALOX12 promotes IAV infection through associating with IAV RNA polymerase subunit PB2, sustaining the interaction between PB2 and importin-α/β, thus warranting PB2 nuclear import and efficient viral RNA synthesis. Importantly, avian influenza A virus needs to mutate its PB2 protein in order to hijack human lnc-ALOX12 for efficient viral RNA synthesis in mammal cells. Therefore, our data support the dependence of IAV replication on host lncRNAs. This dependence is species-specific and acts as a barrier to cross-species transmission of avian influenza viruses.</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"91 2","pages":"Article 106540"},"PeriodicalIF":14.3,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144481768","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":"High-dose versus standard-dose influenza vaccine for immunocompromised patients: A systematic review and meta-analysis of randomised clinical trials","authors":"Mario Rivera-Izquierdo ,&nbsp;Alejandro Verdejo-Iáñez ,&nbsp;Arturo Morales-Portillo ,&nbsp;Manuel González-Alcaide ,&nbsp;Antonio Jesús Láinez-Ramos-Bossini ,&nbsp;Virginia Martínez-Ruiz ,&nbsp;Nicolás Francisco Fernández-Martínez ,&nbsp;Luis Miguel Martín-delosReyes ,&nbsp;Eladio Jiménez-Mejías ,&nbsp;Inmaculada Guerrero-Fernández de Alba ,&nbsp;María del Carmen Valero-Ubierna ,&nbsp;Pablo Lardelli-Claret ,&nbsp;Joan Antoni Schoenenberger-Arnaiz ,&nbsp;José Juan Jiménez-Moleón","doi":"10.1016/j.jinf.2025.106538","DOIUrl":"10.1016/j.jinf.2025.106538","url":null,"abstract":"<div><h3>Background</h3><div>Immunocompromised patients present a higher risk of severe influenza disease and respond worse to vaccination.</div></div><div><h3>Objective</h3><div>We aimed to assess immunogenicity and safety of high-dose vs. standard-dose influenza vaccine in immunocompromised patients.</div></div><div><h3>Data source</h3><div>A search was conducted in Medline, Web of Science, Scopus and ClinicalTrials.gov from inception to March 2024 with no other restrictions.</div></div><div><h3>Study eligibility</h3><div>Randomised clinical trials reporting immunogenicity or safety of high-dose versus standard-dose influenza vaccine in immunocompromised patients were included.</div></div><div><h3>Methods</h3><div>The protocol was prospectively registered (PROSPERO ID: CRD42023466202). A meta-analysis was conducted using random-effects models. Heterogeneity was assessed through I² statistic. Subgroup analyses were conducted, and publication bias was assessed through funnel plots and Egger’s tests.</div></div><div><h3>Results</h3><div>A total of 21 analyses from 16 randomised clinical trials were included. Regarding immunogenicity (including 1862 patients), high-dose influenza vaccine showed higher geometric mean titre of hemagglutination inhibition and higher seroconversion rates for all strains (RR=1.30, 95%CI:1.04–1.57, I²=45.0% for H1N1; RR=1.22, 95%CI:1.03–1.41, I²=39.5% for H3N2; RR=1.39, 95%CI:1.15–1.63, I²=18.1% for B). These findings were reinforced in studies with higher methodological quality and higher sample sizes. Regarding safety (including 1403 patients), there were no differences in reported adverse events except for pain, higher in the high-dose influenza vaccine group (RR=1.29, 95%CI:1.04–1.54). Although high-dose influenza vaccine showed less frequency of clinical outcomes, data were not conclusive as few studies analysed clinical effectiveness.</div></div><div><h3>Conclusions</h3><div>High-dose influenza vaccine showed higher immunogenicity and similar safety than standard-dose vaccine and should be recommended for immunocompromised patients. Future larger randomised clinical trials analysing clinical effectiveness are required to provide recommendations for specific immunocompromised populations.</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"91 2","pages":"Article 106538"},"PeriodicalIF":14.3,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144491317","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":"Global spread of H3 subtype avian influenza viruses with an accelerated evolution after interspecies transmission","authors":"Jiaying Yang ,&nbsp;Xiaojing Chen ,&nbsp;Xiyan Li ,&nbsp;Ye Zhang ,&nbsp;Jia Liu ,&nbsp;Min Tan ,&nbsp;Hong Bo ,&nbsp;Wenfei Zhu ,&nbsp;Lei Yang ,&nbsp;Dayan Wang ,&nbsp;Yuelong Shu","doi":"10.1016/j.jinf.2025.106542","DOIUrl":"10.1016/j.jinf.2025.106542","url":null,"abstract":"<div><div>The H3 subtype avian influenza virus (AIV) has been widely spread in birds and is known as a natural source of mammalian influenza viruses. Based on data from public databases and our surveillance data, we analyzed the ecology, evolution, and spread of H3 AIVs. Sublineages of H3 AIVs have been detected worldwide, infecting various birds, at least 90 species in wild birds and poultry. Important areas for large-scale and local dissemination of H3 AIVs were identified, such as Alaska, Central Asia, and Chinese provinces. The H3 viruses have elevated the HA gene substitution rate after introduction from wild birds to domestic poultry, and even faster in domestic chickens. Our results implied an evolutionary mechanism of H3 AIV cross-species transmission, that viruses from wild birds to domestic poultry have accelerated substitution rate by shorter generation time and host selection. Novel chicken H3 viruses, especially H3N8 G25 viruses that have spilled over to humans, require high attention.</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"91 2","pages":"Article 106542"},"PeriodicalIF":14.3,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369483","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}