CMI communications最新文献

{"title":"AdMiRE study: Development and validation of a WHO-aligned tool to assess healthcare access and antibiotic use among migrant populations in Europe-a multicountry Delphi and psychometric study on behalf of ESGITM group.","authors":"Giacomo Guido, Aula Abbara, Muhammad Asaduzzaman, Ferenc Balazs Farkas, Kader Diabate, Alexandre Duvignaud, Ville Holmberg, Sorie Ibrahim Conteh, Sofia Jordão, Roberta Papagni, Laura Jung, Botond Lakatos, Miriam Orcutt, Annalisa Saracino, Ana Requena-Méndez, Elena Romancenco, Marcella Schiavone, Clare Shortall, Christian Napoli, Davide Mosca, Poleta Luga, Jara Llenas-Garcìa, Emanuele Nicastri, Angela Corpolongo, Patrick Bodenmann, Eric Florence, Frode Eick, Lőrinc Závorszky, Santino Severoni, Christian Morberg Wejse, Francesco Di Gennaro","doi":"10.1016/j.cmicom.2026.105184","DOIUrl":"10.1016/j.cmicom.2026.105184","url":null,"abstract":"<p><strong>Objectives: </strong>Migrants and refugees face a high burden of infections caused by multidrug-resistant bacteria but frequently encounter structural barriers to healthcare and appropriate antibiotic treatment. This multicountry study applied a structured Delphi process to develop a standardized survey that systematically assesses healthcare access and barriers to appropriate antibiotic use among migrant and refugee populations in Europe.</p><p><strong>Methods: </strong>A multicountry Delphi consensus study was conducted with two different panels of experts including 64 experts from 12 European countries, from academia, clinical practice, nongovernmental organization, and migrant communities, to design and validate a survey on healthcare access and antibiotic use. Content validity was assessed using Item- and Scale-level Content Validity Indices (I-CVI and S-CVI/Ave) and the interquartile range. The finalized questionnaire was pilot-tested among 183 migrants, evaluating internal consistency (Cronbach's α; KR-20), temporal stability (intraclass correlation coefficient), inter-rater reliability (κ), and construct validity via exploratory factor analysis.</p><p><strong>Results: </strong>Fifteen of 16 experts (94%) completed both Delphi rounds. The S-CVI/Ave improved from 0.94 to 0.95, and the mean interquartile range decreased from 0.38 to 0.02, indicating strengthened content validity and consensus. External validation confirmed excellent agreement (S-CVI/Ave = 0.96). Psychometric testing demonstrated good reliability (Cronbach's α = 0.82-0.91; KR-20 = 0.79), substantial inter-rater agreement (κ = 0.72), and robust construct validity (KMO = 0.84; Bartlett's test p <0.001).</p><p><strong>Conclusions: </strong>The AdMiRE questionnaire is a reliable and methodologically robust tool for assessing healthcare access and antibiotic use among migrants and refugees in Europe. This validated instrument provides a standardized framework for generating comparable data to inform policies, strengthen antimicrobial stewardship, and promote equitable access to care across migrants.</p>","PeriodicalId":521396,"journal":{"name":"CMI communications","volume":"3 2","pages":"None"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13282366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148298676","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":"Human Q fever outbreak investigation and management in six European countries: a One Health compendium of practices and recommendations.","authors":"Ana Hurtado, Elodie Rousset, Aurélie Couesnon, Tara de Haan, Frederika Dijkstra, Silke F Fischer, Pierre-Edouard Fournier, Ana L García-Pérez, Isabel Jado, Elsa Jourdain, Katja Mertens-Scholz, Tom N McNeilly, Susan Neale, Jane C Osborne, Marjan Van Esbroeck, Marcella Mori, René van den Brom","doi":"10.1016/j.cmicom.2026.105195","DOIUrl":"10.1016/j.cmicom.2026.105195","url":null,"abstract":"<p><strong>Background: </strong>Q fever is a zoonotic disease caused by <i>Coxiella burnetii</i>, with domestic ruminants serving as the main reservoir. Infected animals can shed large quantities of the pathogen into the environment after normal parturition or abortion, enabling airborne transmission to humans and potentially triggering outbreaks of variable scale. Effective outbreak management requires the rapid identification of all related cases, tracing of infection source(s), and implementing proportionate control measures that protect human health while considering animal health and ecosystem integrity.</p><p><strong>Objectives: </strong>This report aimed to review and compare human Q fever outbreak management protocols across several European countries, identify areas of convergence, highlight operational challenges, and outline key gaps in diagnostic tools, source investigations, and cross-sector coordination. It also seeks to propose research priorities and recommendations to support more coordinated One Health preparedness and response.</p><p><strong>Sources: </strong>The analysis was conducted within the European Union-funded Q‑Net‑Assess project, involving partners from Belgium, France, Germany, Spain, The Netherlands, and the United Kingdom. Information was drawn from national procedures, guideline documents, and operational experiences shared by researchers and experts affiliated with academic, public health, veterinary, and reference laboratories.</p><p><strong>Content: </strong>This report describes practices related to outbreak detection, notification, case investigation, identification of sources, and implementation of control measures across countries. It maps key differences in national protocols, highlighting variability in diagnostic approaches, environmental sampling, molecular typing, and cross-sector coordination. The synthesis identifies both shared methodological elements and structural limitations that affect timely and effective outbreak management.</p><p><strong>Implications: </strong>Findings underscore the need for more harmonized and integrated Q fever outbreak management across Europe. The report outlines research priorities and provides recommendations aimed at strengthening diagnostic capacity, enhancing environmental and molecular investigation tools, and improving One Health collaboration. These insights have potential relevance for other airborne zoonotic diseases.</p>","PeriodicalId":521396,"journal":{"name":"CMI communications","volume":"3 2","pages":"None"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13334506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148440761","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":"Clinical and Genomic Characterization of Serratia Bloodstream Infections.","authors":"Roberta Monardo, Lawrence P Park, Felicia Ruffin, Phillip Cox, An Q Dinh, Rachel E Korn, Parisa Farahani, Marco Ripa, Antonella Castagna, Blake M Hanson, Vance G Fowler, Joshua T Thaden, Stacey A Maskarinec","doi":"10.1016/j.cmicom.2025.105128","DOIUrl":"10.1016/j.cmicom.2025.105128","url":null,"abstract":"<p><strong>Background: </strong>Previously considered a rare opportunistic pathogen, <i>Serratia</i> is now an emerging cause of bacteremia. We compared the risk factors and outcomes of patients with <i>Serratia</i> bacteremia relative to other Enterobacterales in a cohort of hospitalized patients.</p><p><strong>Methods: </strong>Patients were prospectively enrolled from 2002-2021 at Duke University. Characteristics and outcomes were compared among bacteremic patients due to <i>Serratia</i> and other Enterobacterales. Regression models were used to determine features associated with outcomes. Whole genome sequencing (WGS) was performed to characterize the phylogenetic diversity of <i>Serratia</i> isolates associated with device infections.</p><p><strong>Results: </strong>Of 2676 patients, 173 (6.5%) had <i>Serratia</i> bacteremia. Among patients with a medical device (n = 993; 37.1%), <i>Serratia</i> was associated with an increased risk of device infection in an adjusted model (odds ratio (aOR) 2.03; 95% confidence interval (CI), 1.23-3.34). Device infection risk was highest among patients with cardiac devices (OR 3.95, 95% CI 1.45-10.75). <i>Serratia</i> was associated with a greater risk of persistent bacteremia (aOR 1.66, 95% CI 1.08-2.54). WGS of <i>Serratia</i> isolates (n = 93) revealed considerable genetic diversity, with no association between phylogenetic clusters and device infections overall (<i>P</i> = 0.35) or cardiac device infections specifically (<i>P</i> = 0.13).</p><p><strong>Conclusion: </strong>Compared to other Enterobacterales, patients with <i>Serratia</i> bacteremia were more likely to have a device infection in general, a cardiac device-associated infection in particular, and persistent bacteremia. WGS demonstrated genomic diversity of <i>S. marcescens</i> isolates, suggesting the molecular basis for device infection is not clonal. Further studies are needed to elucidate the mechanism underpinning this finding.</p>","PeriodicalId":521396,"journal":{"name":"CMI communications","volume":"2 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849383","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":"Are bactericidal antibiotics necessary to effectively treat bloodstream infections?","authors":"Amy Pulikeyil, Emily G McDonald, Erin K McCreary, Pranita D Tamma, Navaneeth Narayanan","doi":"10.1016/j.cmicom.2025.105077","DOIUrl":"10.1016/j.cmicom.2025.105077","url":null,"abstract":"","PeriodicalId":521396,"journal":{"name":"CMI communications","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13327725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148379540","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}