Infection and Chemotherapy最新文献

{"title":"The Feasibility and Applicability of Pediatric Inpatient Beta Lactam De-Labeling: From Bedside Challenge to Long-Term Follow Up.","authors":"Michal Paret, Rinat Komargodski, Bella London, Hadas Paz, Naama Epstein Rigbi","doi":"10.3947/ic.2025.0077","DOIUrl":"10.3947/ic.2025.0077","url":null,"abstract":"<p><strong>Background: </strong>Beta-lactam allergy (BLA) labels are common in pediatric patients but are often inaccurate, leading to unnecessary use of second-line antibiotics. While direct oral challenge tests (OCTs) are effective for de-labeling, their implementation in inpatient pediatric settings remains underexplored. This study aimed to evaluate the feasibility and barriers of an inpatient pediatric BLA de-labeling program, from bedside OCT to long-term follow-up and integration into electronic medical records (EMRs).</p><p><strong>Materials and methods: </strong>We conducted a prospective interventional study in the pediatric ward between 2019 and 2024. Hospitalized children with a documented BLA were screened and eligible patients underwent a 2-step graded OCT. In-house pediatricians completed surveys to assess beliefs and barriers regarding inpatient OCT implementation. Long term follow-up included caregiver surveys and review of hospital and Health Maintenance Organization (HMO) EMRs to evaluate de-labeling documentation and subsequent beta-lactam use.</p><p><strong>Results: </strong>Of 192 eligible BLA-labeled patients, 32 (16.6%) were recruited, 93.8% carrying an amoxicillin allergy label and the vast majority without other drug allergy labels. All patients had a history of a mild reaction, 100% presented with a benign rash. 30/32 (93.4%) had a negative OCT. Pediatricians faced challenges such as workload pressures, staff shortages and overestimation of severe reaction risks, all serving as barriers for patient recruitment. At follow-up (median 37 months), 35.7% of caregivers reported de-labeling, while EMRs documented higher rates (HMO: 80%; hospital: 70%). Despite successful OCTs, discrepancies between caregiver understanding, physician attitudes, and EMR documentation persisted.</p><p><strong>Conclusion: </strong>While direct OCTs are proved to be effective in de-labeling BLA, significant challenges persist in implementing inpatient de-labeling and ensuring their long-term success. These include low recruitment rates, pediatricians' misconceptions and incomplete integration into EMRs. Addressing these barriers requires targeted education, improved communication, and streamlined processes to improve de-labeling outcomes and support antibiotic stewardship.</p>","PeriodicalId":51616,"journal":{"name":"Infection and Chemotherapy","volume":" ","pages":"29-38"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13053898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145656384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Effectiveness of Biktarvy^® (bictegravir/emtricitabine/tenofovir alafenamide) in Patients with HIV-1 Infection: Interim Report of a Post-Marketing Surveillance Study in Korea.","authors":"Shin-Woo Kim, Jami Peters, Markus G Lang, Jeong-A Lee, Jinhye Cha, Yeon-Sook Kim","doi":"10.3947/ic.2025.0140","DOIUrl":"10.3947/ic.2025.0140","url":null,"abstract":"<p><p>We present the results of the 4^th year surveillance period of a prospective, multicenter, observational, post-marketing surveillance study that evaluates the safety and effectiveness of Biktarvy in routine clinical practice in Korea. A total of 1,157 patients were included in the safety analysis set. Most patients were male (93.3%) and ART experienced (treatment-experienced [89.3%]). Adverse events occurred in 425 patients (36.7%) and of those 63 patients reported adverse drug reactions (ADRs [5.5%]). No serious ADRs were reported. The virological success rate (HIV-1 RNA <50 copies/mL) of Biktarvy treatment at last visit was 96.7%.</p>","PeriodicalId":51616,"journal":{"name":"Infection and Chemotherapy","volume":" ","pages":"122-127"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13053886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147379505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Stepwise Household Transmission of Vaccine-Strain Varicella-Zoster Virus Resulting in Neonatal Varicella.","authors":"Tae-Yang Choi, Yun-Kyung Kim, Youngkyu Shim, Minsoo Shin","doi":"10.3947/ic.2025.0133","DOIUrl":"10.3947/ic.2025.0133","url":null,"abstract":"<p><p>We describe a rare case of neonatal varicella from sequential household transmission of varicella-zoster virus. A vaccinated sibling developed herpes zoster before delivery, followed by maternal varicella and neonatal infection at 20 days of life. The infant showed generalized vesiculopustular eruptions with mild respiratory symptoms. Polymerase chain reaction confirmed infection presumed to be caused by the vaccine strain because the sibling had no history of natural varicella and there were no other exposure sources. Intravenous acyclovir was administered with good response. The patient recovered fully. This case reminds clinicians to consider vaccine-strain transmission in families with a non-immune mother.</p>","PeriodicalId":51616,"journal":{"name":"Infection and Chemotherapy","volume":"58 1","pages":"112-116"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13053883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic Insights into Colistin Resistance in Carbapenem-Resistant <i>Klebsiella pneumoniae</i> from Southern Thailand.","authors":"Sutanya Thanudaksorn, Arnon Chukamnerd, Sarunyou Chusri, Komwit Surachat, Rattanaruji Pomwised","doi":"10.3947/ic.2025.0098","DOIUrl":"10.3947/ic.2025.0098","url":null,"abstract":"<p><strong>Background: </strong>Colistin is a last-resort antibiotic for treating carbapenem-resistant <i>Klebsiella pneumoniae</i> (CRKP). The emergence of colistin resistance threatens public health by further limiting therapeutic options. This study aimed to molecularly characterize colistin resistance in 17 CRKP isolates obtained from seven hospitals in lower Southern Thailand between March and August 2019.</p><p><strong>Materials and methods: </strong>Antimicrobial susceptibility testing was performed using broth microdilution, and whole-genome sequencing was employed to identify acquired antimicrobial resistance genes, mutations associated with colistin resistance, virulence-associated genes (VAGs), and plasmid replicons.</p><p><strong>Results: </strong>All isolates were multidrug-resistant but remained susceptible to amikacin and, in 80% of cases, tigecycline. Multilocus sequence typing revealed 6 distinct sequence types with ST16 predominating. Average nucleotide identity and core genome single-nucleotide polymorphism analysis suggested clonal relatedness. While no <i>mcr</i> gene was detected, mutations were identified in genes implicated in lipid A modification, including <i>mgrB</i>, <i>lpxM</i>, <i>arnB</i>, <i>arnT</i>, and <i>eptA</i>. Several isolates harbored VAGs encoding for yersiniabactin and aerobactin siderophore.</p><p><strong>Conclusion: </strong>Our findings highlight the convergence of resistance and virulence in clonally related CRKP strains, emphasizing the need for continued genomic surveillance and antimicrobial stewardship.</p>","PeriodicalId":51616,"journal":{"name":"Infection and Chemotherapy","volume":"58 1","pages":"59-72"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13053899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"NDM-producing Multidrug-resistant <i>Pseudomonas aeruginosa</i> in Korea: A Growing Threat Requiring National Attention.","authors":"Bongyoung Kim","doi":"10.3947/ic.2025.0145","DOIUrl":"10.3947/ic.2025.0145","url":null,"abstract":"","PeriodicalId":51616,"journal":{"name":"Infection and Chemotherapy","volume":"58 1","pages":"131-132"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13053896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147629061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Pneumococcal Eye Infection and Changes in Antibiotic Susceptibility: A Retrospective Study.","authors":"Ui Yoon Choi, Soo-Han Choi, Doo Ri Kim, Kil Sung Bae, Areum Shin, Yae-Jean Kim","doi":"10.3947/ic.2025.0135","DOIUrl":"10.3947/ic.2025.0135","url":null,"abstract":"<p><p>This retrospective study analyzed the antimicrobial susceptibility of pneumococcus isolated from eye discharge of pediatric patients. It included 65 patients, stratified by age (<2 years <i>vs.</i> ≥2 years) and date of isolation of pneumococcus (earlier period, 1994-2013 <i>vs.</i> later period, 2014-2024). There were no differences between the age groups in antimicrobial susceptibility. Between the periods, antibiotic susceptibility showed no significant difference for cefotaxime (83.3% <i>vs.</i> 63.8%) and levofloxacin (100% <i>vs.</i> 95.5%), but there was a significant difference for penicillin susceptibility (48.5% <i>vs</i>. 16.7%, <i>P</i>=0.035). The results suggest an increase in non-susceptibility to penicillin in the later period.</p>","PeriodicalId":51616,"journal":{"name":"Infection and Chemotherapy","volume":" ","pages":"117-121"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13053893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147379400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Memory of Professor Hee Young Chung, A Pioneer and Visionary of Infectious Diseases in Korea.","authors":"","doi":"10.3947/ic.2026.0004","DOIUrl":"10.3947/ic.2026.0004","url":null,"abstract":"","PeriodicalId":51616,"journal":{"name":"Infection and Chemotherapy","volume":"58 1","pages":"135"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13053882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147629040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"St. Sebastian and the Epidemic Imagination: Why a Third-Century Martyr Still Matters in the Age of COVID-19.","authors":"Kun Hwang","doi":"10.3947/ic.2025.0150","DOIUrl":"10.3947/ic.2025.0150","url":null,"abstract":"","PeriodicalId":51616,"journal":{"name":"Infection and Chemotherapy","volume":"58 1","pages":"128-130"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13053888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147629114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bone Health in People Living with HIV: From Pathophysiology to Practical Management.","authors":"Eun-Jeong Joo","doi":"10.3947/ic.2025.0124","DOIUrl":"10.3947/ic.2025.0124","url":null,"abstract":"<p><p>As the life expectancy of people living with HIV (PLWH) continues to rise with the success of antiretroviral therapy (ART), long-term complications such as reduced bone mineral density (BMD) and osteoporosis have become increasingly prevalent. PLWH exhibit a higher risk of bone loss and fractures compared to the general population, driven by multiple factors including chronic immune activation, systemic inflammation, and ART-related toxicity. Tenofovir disoproxil fumarate is known to induce proximal renal tubular dysfunction and hypophosphatemia, contributing to reduced BMD. Tenofovir alafenamide is associated with improved renal and bone safety profiles. Recent data on integrase inhibitor-based or tenofovir-sparing regimens such as dolutegravir/lamivudine and long-acting cabotegravir plus rilpivirine suggest favorable effects on bon health. However, bone loss may still occur following ART initiation, regardless of regimen, and long-term skeletal outcomes remain under investigation. Given the increasing burden of bone disease in aging PLWH, timely assessment using dual-energy X-ray absorptiometry and fracture risk tools such as FRAX is essential. Management strategies should include lifestyle modification, calcium and vitamin D supplementation, and pharmacologic interventions including bisphosphonates or denosumab. Optimizing ART selection to minimize bone toxicity is also an important consideration. As PLWH age, bone health must be integrated into comprehensive HIV care.</p>","PeriodicalId":51616,"journal":{"name":"Infection and Chemotherapy","volume":" ","pages":"1-7"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13053889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147379191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Nationwide Investigation on the Distribution and Antimicrobial Susceptibility Profiling of <i>Chlamydia trachomatis</i> Collected from Patients in Korea.","authors":"Taeuk Kang, Yeon-Joo Choi, Won-Jong Jang","doi":"10.3947/ic.2025.0081","DOIUrl":"10.3947/ic.2025.0081","url":null,"abstract":"<p><strong>Background: </strong>In Korea, data on circulating <i>Chlamydia trachomatis</i> strains and their antimicrobial susceptibility profiles remain limited despite its significance in terms of public health. To date, their antimicrobial susceptibility or related genes are not fully characterized yet. This study aimed to determine the distribution of <i>C. trachomatis</i> genotypes and antimicrobial susceptibility profiles, and the presence of antimicrobial susceptibility related genes in Korea from 2016 to 2019.</p><p><strong>Materials and methods: </strong>A total number of 118 clinical <i>C. trachomatis</i> isolates were obtained from 1,011 samples for analysis. We characterized patient demographics and performed <i>ompA</i> genotyping and multilocus sequence typing (MLST) on the isolates, determined their <i>in vitro</i> susceptibilities to tetracycline, levofloxacin, azithromycin, and rifampicin, and screened for susceptibility-associated genes in both isolates and clinical samples.</p><p><strong>Results: </strong>The genotype D/Ep6, which is rarely reported globally, was the predominant strain (82, 69.5%), followed by genotypes F (14, 11.9%), Ja (12, 10.2%), E (9, 7.6%), and J (1, 0.9%) out of 118 <i>C. trachomatis</i> isolates. The MLST revealed eight sequence types (STs), including two novel STs. Of clinically isolated <i>C. trachomatis</i> (n=118), many isolates were susceptible to tetracycline at 125 ng/mL (52, 44.1%), levofloxacin at 250 ng/mL (81, 68.6%), azithromycin at 62.5 ng/mL (50, 42.4%), and rifampicin at 7.81 ng/mL (50, 42.4%). In antimicrobial susceptibility profiling. One isolate was susceptible to both azithromycin at 256 µg/mL and rifampicin at 8 µg/mL. Also, several single nucleotide polymorphisms (SNPs) on <i>rpoB</i> genes and <i>tet(C)</i> gene of <i>C. trachomatis</i> L2/tet9 were detected.</p><p><strong>Conclusion: </strong>A rarely reported genotype, D/Ep6, was the dominant <i>C. trachomatis</i> variant in Korea during 2016 to 2019. The detection of SNPs and novel <i>rpoB</i> mutations may suggest unique <i>C. trachomatis</i> landscape in Korea. Our findings provide meaningful distribution landscape and antimicrobial susceptibility profiling of <i>C. trachomatis</i> in Korea.</p>","PeriodicalId":51616,"journal":{"name":"Infection and Chemotherapy","volume":" ","pages":"39-48"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13053900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147379194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}