Journal of Microbiology Immunology and Infection最新文献

{"title":"Exploring the role of the CCAAT-binding complex in cell wall maintenance and biofilm formation in Candida albicans.","authors":"Dinh-Dong Le, Wen-Han Wang, Chung-Yu Lan","doi":"10.1016/j.jmii.2025.08.008","DOIUrl":"https://doi.org/10.1016/j.jmii.2025.08.008","url":null,"abstract":"<p><strong>Background: </strong>The conserved CCAAT-binding complex (CBC) specifically recognizes and binds to the CCAAT motif present in eukaryotic promoters, thereby controlling gene transcription. In Candida albicans, the CBC cooperates with another transcription factor, Hap43, to regulate iron homeostasis. Moreover, several Hap43-independent functions have also been uncovered. However, the functions of CBC have not been extensively characterized.</p><p><strong>Methods: </strong>Deletion mutants lacking each component of the CBC were independently compared to the wild-type strain with regard to cell wall properties, composition, and structure. The effects of CBC deletion on biofilm formation were also investigated. Finally, RNA-seq analysis was performed to reveal functional divergence between the two Hap3 paralogs, Hap31 and Hap32.</p><p><strong>Results: </strong>CBC deletion significantly impacts cell wall properties, composition, exposure of glucan and chitin, as well as cell wall remodeling. These effects appear to be associated with the small GTPase Rhb1 and the Mkc1 signaling pathway. Moreover, we showed that CBC deletion affects biofilm formation, which appears to be independent of Rhb1. RNA-seq analysis further revealed the broad roles of the Hap3 paralogs within the CBC.</p><p><strong>Conclusion: </strong>Notably, this work provides new insights into the relationship among CBC, cell wall maintenance, and biofilm formation in C. albicans.</p>","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876973","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":"Dexamethasone treatment is associated with a higher HBsAg sero-clearance rate in HBeAg-positive patients with hepatitis B flares.","authors":"Dongqing Gu, Haoliang Wang, Xing Wan, Xiaomei Xiang, Zhaoxia Tan, Yi Zhou, Yan Gao, Jianmei Xiao, Wenting Tan, Qing Mao, Guohong Deng","doi":"10.1016/j.jmii.2025.08.009","DOIUrl":"https://doi.org/10.1016/j.jmii.2025.08.009","url":null,"abstract":"<p><strong>Purpose: </strong>Short-term dexamethasone has been used in patients with chronic hepatitis B flares to reduce inflammation in the liver. We aim to identify the potential population that may benefit from dexamethasone treatment.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted involving 856 hospitalized hepatitis B e antigen-positive patients with chronic hepatitis B flares. The primary endpoint was the 1-year incidence of hepatitis B surface antigen (HBsAg) sero-clearance after the hospital admission. The hazard ratio (HR) and 95 % confidence interval (CI) were calculated using the Cox proportional hazards regression model.</p><p><strong>Results: </strong>Dexamethasone treatment was associated with a higher incidence of HBsAg sero-clearance (adjusted HR: 3.561, 95 % CI: 1.281-9.902, P = 0.015). These results were further confirmed using the propensity score matching method (HR: 13.115, 95 % CI: 1.705-100.886, P = 0.013). In addition, a faster total bilirubin decrease was observed under dexamethasone treatment (0.57 × upper limit of normal [ULN] per day vs. 0.11 × ULN per day, P < 0.001). Importantly, patients with alanine aminotransferase (ALT) ≥ 30 × ULN and platelet counts ≥ 110 × 10⁹/L were identified as the beneficial population for dexamethasone treatment. These patients showed a higher incidence of HBsAg sero-clearance (39.3 % vs. 11.3 %, P < 0.001; HR: 5.524, 95 % CI: 1.192-25.607, P = 0.029), and faster total bilirubin decline.</p><p><strong>Conclusion: </strong>Our study confirmed the beneficial role of low-dose and short-term dexamethasone treatment in flare patients, particularly in patients with ALT ≥ 30 × ULN and platelet counts ≥ 110 × 10⁹/L.</p>","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979997","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":"A retrospective cohort study of Mycobacterium kansasii complex pulmonary infections at a tertiary teaching hospital.","authors":"Yi-Chi Lin, Hsiu-Hui Lee, Chong Kei Lao, Jeng-How Yang, Nan-Yu Chen, Chun-Fu Yeh, Po-Yen Huang, Shian-Sen Shie, Wen-Chi Huang, Chang-Wei Lin, Shih-Hong Li, Chih-Liang Wang, Shih-Wei Lin, Chung-Chi Huang, Jang-Jih Lu, Cheng-Hsun Chiu, Hsin-Chih Lai, Ting-Shu Wu","doi":"10.1016/j.jmii.2025.08.006","DOIUrl":"https://doi.org/10.1016/j.jmii.2025.08.006","url":null,"abstract":"<p><strong>Background: </strong>Mycobacterium kansasii complex (MKC) is the second common slowly growing mycobacterium associated with pulmonary diseases, typically presenting as chronic, progressive respiratory symptoms with structural lung damage. This study aimed to identify the prognostic factors, genotypes, antimicrobial susceptibility, and treatment outcomes in patients with MKC pulmonary disease (MKC-PD).</p><p><strong>Methods: </strong>This retrospective cohort study of patients with MKC-PD from January 2016 to August 2021 was conducted at Linkou Chang Gung Memorial Hospital in Taiwan. Diagnosis was based on the 2020 American Thoracic Society/European Respiratory Society/European Society of Clinical Microbiology and Infectious Diseases/and Infectious Diseases Society of America criteria. Medical records were reviewed for demographic data, antimycobacterial agents, and treatment outcomes. Speciation was based on heat-shock protein 65 (hsp65) or Tu elongation factor (tuf) gene sequencing for MKC. Antimicrobial susceptibility was determined using Sensititre RAPMYCO2 broth microdilution.</p><p><strong>Results: </strong>A total of 202 isolates, one from each patient, were included in the analysis. Sixty-six patients did not meet the diagnostic criteria for MKC-PD, and 71 underwent clinical monitoring without antimycobacterial therapy. Of 65 treated patients, 30 (46.2 %) achieved treatment success, whereas 35 (53.8 %) were categorized as treatment failure. Logistic regression analysis identified age, body mass index (BMI), and treatment duration as significant predictors of treatment outcomes. Of 33 rifampin-resistant strains, 21(63 %) were identified as Mycobacterium persicum.</p><p><strong>Conclusions: </strong>In this cohort of patients with MKC-PD, treatment outcomes were significantly associated with age, BMI, and treatment duration. These findings underscored the importance of early individualized risk stratification to improve treatment outcomes in MKC-PD.</p>","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979959","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":"Application of antimicrobial stewardship interventions improves outcomes in adults with bloodstream infection caused by multidrug-resistant Enterobacteriaceae.","authors":"Bo-Ming Huang, Ching-Lung Lo, Wen-Liang Lin, Ming-Chi Li, Tzu-Ping Weng, Hao-En Jan, Po-Hsuan Tseng, Sheng-Jie Yeh, Wen-Chien Ko, Nan-Yao Lee","doi":"10.1016/j.jmii.2025.08.007","DOIUrl":"https://doi.org/10.1016/j.jmii.2025.08.007","url":null,"abstract":"<p><strong>Background: </strong>The increasing incidence of multidrug-resistant Enterobacteriaceae (MDRE) presents a significant challenge in clinical settings. We aimed to evaluate the impact of antimicrobial stewardship interventions (ASIs) on clinical outcomes in patients with MDRE bloodstream infections (BSI).</p><p><strong>Materials and methods: </strong>A single-center, pre-post quasi-experimental study was conducted on patients with BSIs caused by MDRE from March 1, 2014 to February 29, 2016. Infectious disease specialists actively reviewed all positive blood culture notifications and provided evidence-based recommendations for antibiotic therapy. The primary outcomes were 30-day mortality and time to appropriate antibiotics. Secondary outcomes included the hospital length of stay (LOS) after BSIs and duration of antibiotic therapy among survivors.</p><p><strong>Results: </strong>Total 193 patients were included: 73 patients in the pre-intervention period and 120 patients in the intervention period. The 30-day mortality was lower in the intervention group (12.5% vs. 28.8%, P = 0.007). Species identification of BSI pathogens was more rapidly completed (median 70 h vs. 76 h, P = 0.001), and the time to appropriate antibiotics (median 9 h vs. 33 h, P < 0.001) and duration of antibiotic therapy (10 days vs. 12.5 days, P < 0.001) were shorter in the intervention group. Cox regression analysis revealed that ASIs were associated with a better prognosis among adults with MDRE BSIs (hazard ratio: 0.40; 95 % CI: 0.20-0.77; P = 0.006).</p><p><strong>Conclusion: </strong>ASIs can reduce the time to appropriate antimicrobial therapy, shorten antibiotic therapy duration, and improve clinical outcomes in patients with BSIs caused by MDRE.</p>","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979966","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":"High-dose daptomycin versus linezolid for the treatment of vancomycin-resistant Enterococcus faecium bloodstream infections: Role of pharmacodynamic target attainment.","authors":"Liang-En Hwang, Jia-Ling Yang, Chi-Ying Lin, Sung-Hsi Huang, Yu-Chung Chuang, Jann-Tay Wang, Yee-Chun Chen, Shan-Chwen Chang","doi":"10.1016/j.jmii.2025.08.005","DOIUrl":"https://doi.org/10.1016/j.jmii.2025.08.005","url":null,"abstract":"<p><strong>Background: </strong>Although high-dose daptomycin (≥8 mg/kg) and linezolid are recommended treatments for vancomycin-resistant Enterococci (VRE) bloodstream infection (BSI), direct comparisons and the impact of achieving prespecified pharmacokinetic/pharmacodynamic (PK/PD) target on outcomes remain unclear.</p><p><strong>Methods: </strong>We conducted a retrospective observational study in a single health system (January 2010-December 2021). Patients receiving daptomycin ≥8 mg/kg or linezolid for VRE BSI were included. The primary outcome was in-hospital mortality. The free area under the concentration-time curve to minimum inhibitory concentration ratio (fAUC/MIC) was estimated to assess its association with outcomes.</p><p><strong>Results: </strong>Overall, 795 patients met the inclusion criteria. The overall mortality was 59.2 %. The linezolid group (n = 170) had a mortality of 44 %, and the daptomycin group (n = 625) mortality was 63 % (P < 0.001). Among daptomycin-treated patients, 528 had fAUC/MIC data and 114 achieved the PK/PD target. Mortality was 66 % for fAUC/MIC ≤75.07 (P < 0.001) and 49 % for fAUC/MIC >75.07 (P = 0.41), compared with linezolid group. In multivariable analysis, daptomycin was associated with higher mortality than linezolid (adjusted odds ratio [aOR], 2.00; P < 0.001). However, failing to achieve PK/PD target conferred significantly higher mortality than linezolid (aOR, 2.51; P < 0.001), whereas achieving the PK/PD target showed no difference (aOR, 0.97; P = 0.91).</p><p><strong>Conclusions: </strong>Even at doses ≥8 mg/kg, the efficacy for daptomycin is comparable to linezolid only when the PK/PD target is reached. Failing to achieve PK/PD target leads to worse outcomes, underscoring the importance of dose optimization and therapeutic drug monitoring.</p>","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859888","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":"NADPH Oxidase 4 Deficiency Enhances Dendritic Cell-mediated IL-12 Production and Th1 Responses in Mycobacterium tuberculosis Infection.","authors":"Seunghyun Lee, Hongmin Kim, Yura Ha, Hong-Hee Choi, Lee-Han Kim, Sangwon Choi, Kyungmin Kim, Ji-Hwan Ryu, Sung Jae Shin, Ju Mi Lee","doi":"10.1016/j.jmii.2025.08.004","DOIUrl":"https://doi.org/10.1016/j.jmii.2025.08.004","url":null,"abstract":"<p><strong>Background: </strong>Mycobacterium tuberculosis (Mtb) infection triggers oxidative stress, necessitating host mechanisms to maintain redox balance. The NADPH oxidase (NOX) family, which produces reactive oxygen species, plays an integral part in this process. While the protective role of NOX2 in Mtb infection is well-studied, the function of NOX4 remains unclear.</p><p><strong>Methods: </strong>To investigate the impact of NOX4, we infected C57BL/6 wild-type (WT) and NOX4-deficient (Nox4^-/-) mice with the Mtb K strain, assessing bacterial burdens, lung pathology, and immune responses. Then, we analyzed cytokine production and signaling pathways to explore the interaction between dendritic cells (DCs) and T cells.</p><p><strong>Results: </strong>Nox4^-/- mice exhibited reduced bacterial burden and milder lung pathology compared to WT mice, accompanied by increased DC infiltration and a higher frequency of CD4⁺ T cells of the Th1 subset that secrete interferon-gamma (IFN-γ) in the lungs. Interestingly, ex vivo experiments showed no significant difference in IFN-γ production by T cells from WT and Nox4^-/- mice when activated using antibody-coated beads. However, Mtb-infected bone marrow-derived DCs (BMDCs) from Nox4^-/- mice markedly enhanced IFN-γ production in WT T cells. Further investigation into the role of NOX4 in DCs revealed that BMDCs from Nox4^-/- mice infected with Mtb produced significantly higher levels of IL-12. This elevation was attributed to enhanced activation of IRF1, mediated by the AKT/GSK-3β signaling pathway.</p><p><strong>Conclusion: </strong>NOX4 negatively regulates IL-12 production in Mtb-infected DCs, suppressing Th1-mediated immunity. Its absence enhances Th1 responses, improves immune control of Mtb. Targeting NOX4 may improve tuberculosis outcomes by strengthening host immunity.</p>","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857131","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":"Genomic analysis of Mycobacterium abscessus isolates from non-cystic fibrosis patients in Thailand: phylogeny, subspecies distribution, and antimicrobial resistance profiles.","authors":"Ajala Prommi, Vorthon Sawaswong, Suthidee Petsong, Kanphai Wongjarit, Ubonwan Somsukpiroh, Sunchai Payungporn, Suwatchareeporn Rotcheewaphan","doi":"10.1016/j.jmii.2025.08.003","DOIUrl":"https://doi.org/10.1016/j.jmii.2025.08.003","url":null,"abstract":"<p><strong>Background: </strong>Mycobacterium abscessus (MABS) is a clinically significant nontuberculous mycobacterium, and its drug resistance poses substantial therapeutic challenges. Comprehensive genomic and phenotypic analyses are essential for elucidating the mechanisms underlying this resistance and enhancing understanding of its epidemiology.</p><p><strong>Methods: </strong>Whole-genome sequencing (WGS) using the Illumina platform was conducted on 61 clinical MABS isolates obtained from patients in Thailand. MABS subspecies classification was performed using FastANI, TYGS, and NTM-Profiler. Phenotypic drug susceptibility testing (pDST) was determined using a broth microdilution method. Resistance mutations were identified through NTM-Profiler and Snippy pipelines.</p><p><strong>Results: </strong>The analysis classified MABS isolates into three subspecies: subsp. abscessus (40/61, 65.57 %), subsp. massiliense (15/61, 24.59 %), and subsp. bolletii (6/61, 9.83 %). Phylogenetic analysis revealed genetic diversity among the majority of the MABS clinical isolates. These isolates clustered into distinct clades, separate from globally recognized clinical strains and dominant circulating clones. Inducible clarithromycin resistance was detected in 60.66 % of MABS isolates, associated with the T28 variant in erm(41). The Ile80Val mutation in erm(41) was significantly associated with inducible clarithromycin resistance (χ² = 12.61, p < 0.001). Acquired clarithromycin resistance associated with rrl mutations (A2270C, A2270G, A2271C) and amikacin resistance linked to the rrs mutation A1375G were detected in 11.48 % and 4.92 % of isolates, respectively. The categorical agreement between WGS-based DST and pDST was 95.08 %, 88.33 %, and 96.43 % for inducible clarithromycin, clarithromycin, and amikacin, respectively.</p><p><strong>Conclusion: </strong>This study provides valuable insights into the genomic diversity and antimicrobial resistance of MABS isolates in Thailand, emphasizing regional variations in dominant clones and resistance mechanisms.</p>","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838681","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":"High prevalence but low clinical impact of acyclovir-resistant herpes simplex virus type 1 infections in patients with hematologic disorders.","authors":"Chih-Hao Chen, Ling-Ling Chen, Mei-Chi Su, Hsiu-Hsien Lin, Mao-Wang Ho, Cheng-Wen Lin, Po-Ren Hsueh","doi":"10.1016/j.jmii.2025.08.001","DOIUrl":"https://doi.org/10.1016/j.jmii.2025.08.001","url":null,"abstract":"<p><strong>Background/purpose: </strong>Herpes simplex virus type 1 (HSV-1) is highly prevalent in immunocompromised patients. Due to the recurrent nature of HSV-1 infection, frequent exposure to antiviral agents raises concerns about drug resistance. This study aimed to investigate antiviral-resistant profiles of HSV-1 and discuss the clinical impact of acyclovir-resistant (ACV-R) compared to acyclovir-susceptible (ACV-S) HSV-1 infected patients.</p><p><strong>Methods: </strong>Repeated sampling specimens during 2010-2023 from all age groups were collected and only those with clinical correlations were illegible to be assessed. Plaque reduction assay and Sanger sequencing were used to determine phenotypic and genotypic profiles (UL23/UL30 genes) of ACV-R HSV-1 isolates, respectively.</p><p><strong>Results: </strong>A total of 29 HSV-1 isolates from 18 patients, mainly with hematologic disorders (n = 14, 77.8 %) and the clinical diagnosis of orolabial diseases (n = 14, 77.8 %), were analyzed. The prevalence of ACV-R HSV-1 isolates was 69.0 % (20/29). Most isolates were exposed to antiviral agents before sampling (21/29, 72.4 %). There was no statistical difference in treatment response and duration between patients infected with ACV-S and ACV-R isolates (p = 0.274). No strong correlation could be observed between point mutations, 50 % effective concentration value, and previous antiviral exposure duration. Novel mutations E676K and P355S were detected and probably associated with ACV resistance.</p><p><strong>Conclusions: </strong>The prevalence of ACV-R HSV-1 was higher than reported data from the literature. Several novel mutations were discovered and could enrich the ACV-R HSV-1 database. Further studies are needed to investigate ACV resistance in other potentially related genes, such as UL5 and UL42.</p>","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859887","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":"Bloodstream infections in hospitalized adults with COVID-19: clinical characteristics and outcomes.","authors":"Po-Hsuan Tseng, Ling-Shan Syue, Ching-Chi Lee, Bo-Ming Huang, Sheng-Jie Yeh, Wen-Chien Ko, Nan-Yao Lee","doi":"10.1016/j.jmii.2025.08.002","DOIUrl":"https://doi.org/10.1016/j.jmii.2025.08.002","url":null,"abstract":"<p><strong>Background: </strong>Bloodstream infections (BSIs) are serious complications in hospitalized coronavirus disease 2019 (COVID-19) patients and may have worsened clinical outcomes. We evaluated clinical characteristics and outcomes of COVID-19 patients with BSI and compared them to a matched non-COVID-19 BSI cohort.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted at a tertiary medical center in southern Taiwan, and included adult patients hospitalized with concurrent COVID-19 and bloodstream infection (BSI) from January 2022 to April 2023. We compared survivors and non-survivors and assessed risk factors for in-hospital mortality. Propensity score matching (1:10) was used to compare COVID-19 BSI patients with non-COVID-19 BSI patients from 2017 to 2019.</p><p><strong>Results: </strong>Among 104 COVID-19 patients with BSI, 26.0 % died during hospitalization. Male sex (adjusted OR (aOR) 5.87, 95 % confidence interval (CI) 1.51-22.83, p = 0.011), diabetes mellitus (aOR 3.89, 95 % CI 1.07-14.21, p = 0.040), Ct value ≤ 20 at diagnosis (aOR 5.15, 95 % CI 1.06-24.98, p = 0.042), Pitt bacteremia score ≥4 (aOR 5.84, 95 % CI 1.48-23.01, p = 0.012), and hospital-onset BSI (aOR 19.45, 95 % CI 3.33-113.54, p < 0.001) were independently associated with mortality. Hospital-onset BSI cases had higher rates of resistant and polymicrobial infections. Compared to non-COVID-19 BSI patients, COVID-19 BSI cases had more primary BSI and higher inappropriate empirical therapy use, though COVID-19 status itself was not independently associated with 30-day mortality after matching.</p><p><strong>Conclusions: </strong>BSIs in COVID-19 patients are linked to high mortality, particularly in hospital-acquired infections. Timely diagnosis, risk stratification, and targeted therapy remain crucial.</p>","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876972","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":"Active drug-safety monitoring and management in the treatment of rifampicin-resistant tuberculosis: a nationwide multicenter prospective study.","authors":"Chou-Jui Lin, Chih-Bin Lin, Shun-Tien Chien, Yi-Wen Huang, Jen-Jyh Lee, Chih-Hsin Lee, Ming-Chih Yu, Chen-Yuan Chiang","doi":"10.1016/j.jmii.2025.07.013","DOIUrl":"https://doi.org/10.1016/j.jmii.2025.07.013","url":null,"abstract":"<p><strong>Background: </strong>Active tuberculosis drug-safety monitoring and management (aDSM) is recommended in the treatment of rifampicin-resistant tuberculosis. We established comprehensive aDSM and conducted a nationwide multicenter prospective study in Taiwan.</p><p><strong>Methods: </strong>We designed a treatment initiation form to capture characteristics of patients at baseline, a treatment review form to monitor symptoms, blood tests, QT intervals, and audiometry during treatment, and an adverse event report form for reporting severe adverse events (grade 3 or more), serious adverse events and adverse events resulting in discontinuation of anti-tuberculosis drugs. Severity of adverse events were categorized by using Common Terminology Criteria for Adverse Events v4.03, and causality was assessed by using the World Health Organization - Uppsala Monitoring Centre system.</p><p><strong>Results: </strong>Of 333 patients with rifampicin-resistant tuberculosis enrolled from May 2017 to February 2020, 329 (98.8 %) had adverse events and 196 (58.9 %) had severe adverse events during treatment. The top three severe adverse events were metabolism disorders (104, 31.2 %), hearing impairment (102, 30.6 %), and hepatotoxicity (64, 19.2 %). Of 403 severe adverse events reported, 284 (70.5 %) were classified as drug-related. The top five drugs associated with severe adverse events were bedaquiline (27.6 %), clofazimine (26.7 %), kanamycin (25.1 %), pyrazinamide (22.4 %) and linezolid (22.2 %). Forty-four (13.2 %) patients were hospitalized and 15 (4.5 %) had prolonged hospitalization due to adverse events. One death was considered drug-related.</p><p><strong>Conclusion: </strong>Severe adverse events in the treatment of rifampicin-resistant tuberculosis were more frequent than previously reported and needed to be closely monitored and timely managed by systematic and comprehensive aDSM.</p>","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144786041","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}