Journal of Microbiology Immunology and Infection最新文献

{"title":"A fungal-induced immune response that mediates resistance against COVID-19.","authors":"Rafaela Lúcia Lopes de Souza, Luciana Benevides, Thaís da Silva Rigoni, Rodrigo Paolo Flores Abuna, Bruna Amanda da Cruz Rattis, Osvaldo Campos Dos Santos Nonato, Anamélia Lorenzetti Bocca, Ricardo Tostes Gazzinelli, João Santana Silva","doi":"10.1016/j.jmii.2026.06.007","DOIUrl":"https://doi.org/10.1016/j.jmii.2026.06.007","url":null,"abstract":"<p><strong>Background: </strong>Here, we aim to determine the effect of previous infection with Paracoccidioides brasiliensis (Pb18), a primary human pathogenic fungus, associated with high mortality and morbidity rates, on the outcome of SARS-CoV-2 infection.</p><p><strong>Methods: </strong>The K18hACE2 transgenic mice were infected with 1 × 10⁶ yeasts of the Pb18 fungus followed by the infection with 5 × 10⁴ Plaque-Forming Unit (PFU) of the SARS-CoV-2 virus.</p><p><strong>Results: </strong>The coinfected mice exhibit lower weight loss and mortality compared to mice infected with the virus alone. Moreover, the inflammatory infiltrate and the viral load of lung, heart, spleen, and brain were lower, suggesting that prior infection with the Pb18 leads to increased resistance against the virus infection. In addition, after SARS-CoV-2 infection, a lower frequency of inflammatory monocytes in the lung tissue of mice previously infected with Pb18 was found. We also observed that mice infected only with SARS-CoV-2 had higher expression of pro-inflammatory cytokines and lower frequency of dendritic cells, alveolar and interstitial macrophages and T lymphocytes in lung tissue compared to mice coinfected or infected only with the fungus. The fungus-induced resistance is dependent on the IFN-I signaling pathway, since treatment with antibody against IFNAR impaired animal survival and viral load.</p><p><strong>Conclusion: </strong>This study reveals a distinct outcome compared to what is typically observed in opportunistic fungal coinfections, highlighting the pathways necessary to induce resistance against viral infections.</p>","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148383313","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":"First identification of Holosporales endosymbionts in Acanthamoeba spp. isolated from keratitis patients in Taiwan.","authors":"Jie Yu Lau, Kumiko Nakada-Tsukui, Nai-Wen Fan, Silvere D Zaongo, Bing-Mu Hsu, Dar-Der Ji","doi":"10.1016/j.jmii.2026.05.007","DOIUrl":"https://doi.org/10.1016/j.jmii.2026.05.007","url":null,"abstract":"<p><strong>Background: </strong>Acanthamoeba spp. are free-living amoebas commonly found in various environmental settings and are recognized as opportunistic pathogens in humans. Endosymbiosis within Acanthamoeba, particularly involving bacteria, can enhance the pathogenic potential of both the host and symbiont, influencing human health risks. This study aims to characterize the clinical Acanthamoeba isolate and to identify and localize the Acanthamoeba endosymbiont.</p><p><strong>Methods: </strong>Environmental and clinical Acanthamoeba isolates were collected and identified through morphological analysis and 18S rRNA gene sequencing. The presence of bacterial endosymbionts was determined using PCR amplification targeting 16S rRNA and gltA genes. Phylogenetic analysis characterized Acanthamoeba and the bacterial endosymbiont.</p><p><strong>Results: </strong>PCR and cultivation methods identified Acanthamoeba in 40% of clinical samples, with phylogenetic analysis revealing that all isolated clinical strains belonged to the T4 genotype, while environmental strains were classified as T3, T4, and T5. Phylogenetic analysis of the DF3 region in Acanthamoeba 18S rDNA classified clinical and environmental isolates into six T4 sub-genotypes. Two clinical isolates harbored bacterial endosymbionts from the order Holosporales, as supported by 16S rRNA and gltA gene analyses. Fluorescence microscopy revealed the intracellular DNA-containing structures consistent with endosymbiont localization.</p><p><strong>Conclusion: </strong>Our study reveals the genetic diversity of Acanthamoeba isolates from clinical and environmental sources and highlights the widespread presence of bacterial endosymbionts. These findings underscore the need for continued surveillance and advanced genomic studies to understand endosymbiont-Acanthamoeba interactions and their potential impact on public health.</p>","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254601","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":"Beyond the stomach: Repurposing bismuth tripotassium dicitrate as a novel strategy against multidrug-resistant Mycobacterium abscessus.","authors":"Min-Hsuan Kuo, Chin-Chung Shu, Hui-Hui Yeo, Tsai-Wen Wan, Kuan-Chen Chen, Ming-Chen Chiang, Hao-Chieh Chiu","doi":"10.1016/j.jmii.2026.05.006","DOIUrl":"https://doi.org/10.1016/j.jmii.2026.05.006","url":null,"abstract":"<p><strong>Background/purpose: </strong>Mycobacterium abscessus is a rapidly growing nontuberculous mycobacterium characterized by extensive antibiotic resistance, presenting substantial challenges in clinical management. This study aimed to identify potential antimicrobial agents repurposed from an FDA-approved drug library to combat M. abscessus infection.</p><p><strong>Methods: </strong>An initial high-throughput screen of 2680 FDA-approved drugs was conducted to identify compounds with antimicrobial activity against M. abscessus. Promising hits were further assessed through resazurin-based minimum inhibitory concentration (MIC) assays and MTT cytotoxicity assays using multidrug-resistant (MDR)-M. abscessus clinical isolates and various human cells, respectively. Moreover, the interactions of hit compounds with conventional antibiotics were assessed using the checkerboard assay.</p><p><strong>Results: </strong>The primary screen identified 39 nonantibiotic compounds with antibacterial activity against M. abscessus. Of these, eight exhibited favourable therapeutic indices on the basis of the MIC and cytotoxicity profiles. Among them, bismuth tripotassium dicitrate (BTD) emerged as the most promising candidate, demonstrating potent activity against multidrug-resistant clinical isolates, minimal cytotoxicity to multiple human cell lines, and significant synergy with clarithromycin and erythromycin.</p><p><strong>Conclusion: </strong>BTD has strong efficacy against M. abscessus and favourable safety and synergy profiles. These findings support its potential for repurposing as a novel therapeutic for M. abscessus infections.</p>","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148267154","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":"Cefoperazone-sulbactam versus cefepime and piperacillin-tazobactam for initial empiric treatment of febrile neutropenia in patients with hematologic malignancies: A retrospective matched-cohort study.","authors":"Ming-Tao Tsai, Yu-Chung Chuang","doi":"10.1016/j.jmii.2026.06.001","DOIUrl":"https://doi.org/10.1016/j.jmii.2026.06.001","url":null,"abstract":"<p><strong>Objectives: </strong>Empiric antipseudomonal β-lactams are the standard of care for febrile neutropenia (FN), but comparative data for cefoperazone-sulbactam are limited. We compared cefoperazone-sulbactam with cefepime and piperacillin-tazobactam as initial empiric therapies for FN in adults with hematologic malignancies.</p><p><strong>Methods: </strong>We conducted a retrospective matched-cohort study at a tertiary center in Taiwan (2021-2023). Adults with hematologic malignancies who received cefoperazone-sulbactam, cefepime, or piperacillin-tazobactam as the initial empiric therapy for FN were included (53 episodes/regimen). The episodes were matched by calendar time to reduce confounding factors related to changes in empiric antibiotic use. The primary outcome was treatment success, defined as defervescence without modification of the initial empiric β-lactam regimen and day 5 survival.</p><p><strong>Results: </strong>Among the 159 included episodes, treatment success occurred in 120/159 (75.5%) episodes and did not differ across regimens (cefoperazone-sulbactam, 79.2%; cefepime, 71.7%; piperacillin-tazobactam, 75.5%; P = 0.70). Neutrophil recovery by day 5 independently predicted treatment success (adjusted odds ratio, 3.32; 95% confidence interval, 1.15-9.63; P = 0.027), but empiric β-lactam selection did not. The median duration of empiric β-lactam therapy was similar across regimens. Bleeding (3/159, 1.9%) and prothrombin time/international normalized ratio prolongation (2/46, 4.3%) were uncommon and similar across regimens.</p><p><strong>Conclusions: </strong>No significant differences in early clinical effectiveness or overall safety were observed among the three regimens. Neutrophil recovery, rather than empiric regimen, independently predicts treatment success. These retrospective findings should be interpreted cautiously given potential residual confounding by indication and warrant confirmation in larger studies.</p>","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148221084","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 real-world evaluation of a government-led incentive program to improve infection prevention and control in long-term care facilities in Taiwan.","authors":"Yu-Lin Lee, Hsiu-Tzy Chiang, Li-Rong Wang, Jui-Hsing Wang, Hsin-Man Liou, Tzu-Chan Tseng, Wen-Chien Ko, Po-Ren Hsueh","doi":"10.1016/j.jmii.2026.05.005","DOIUrl":"https://doi.org/10.1016/j.jmii.2026.05.005","url":null,"abstract":"<p><strong>Background: </strong>Long-term care facilities (LTCFs) are highly vulnerable to healthcare-associated infections, yet evidence evaluating policy-driven, incentive-based infection prevention and control (IPC) programs in these settings remains limited.</p><p><strong>Methods: </strong>We conducted a retrospective policy evaluation using routinely collected on-site audit and administrative data from 59 LTCFs participating in the \"2025 Taichung City On-site Inspection Program for Incentives to Strengthen Infection Control in Long-term Care Facilities\". Facilities were assessed using standardized IPC indicators, including mandatory core indicators (Indicators 1-3) and voluntary incentive-based indicators (Indicators 4-6). Outcomes included indicator-level compliance, incentive qualification, reward distribution by facility type and bed-capacity category, and the results of post-audit appeals.</p><p><strong>Results: </strong>Compliance with mandatory core IPC indicators was consistently high: all facilities met Indicator 1 (100%), and 58 facilities complied with Indicators 2 and 3 (both 98.3%). In contrast, non-compliance was more frequently observed among incentive-based indicators. Although 34 (57.6%) facilities applied for Indicator 4 and 48 (81.4%) for Indicator 5, non-compliance occurred in 8.8% and 4.2% of applicants, respectively. Indicator 6 demonstrated the greatest implementation gap, with 13 (76.5%) of 17 applicant facilities classified as non-compliant, primarily due to ineligibility of certified personnel. All nine appealed audit items were approved after review. Overall, 58 facilities (98.3%) qualified for incentive payments.</p><p><strong>Conclusions: </strong>A government-led, incentive-based IPC audit program was associated with near-universal compliance with core IPC standards in LTCFs. Linking structured audits, preparedness requirements, and financial incentives represents a feasible approach to strengthening IPC capacity in LTCFs.</p>","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148058591","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":"Molecular and clinical characterization of human adenovirus type 21 (HAdV-21) associated with respiratory tract infections in hospitalized adults in Hangzhou, China, 2022-2024.","authors":"Guoliang Xie, Fei Yu, Linna Zhou, Yuefeng Wang, Xianzhi Yang, Qi Wang, Yifei Shen, Yuejiao Dong, Li Huang, Yun Teng, Shufa Zheng, Weizhen Chen","doi":"10.1016/j.jmii.2026.05.003","DOIUrl":"https://doi.org/10.1016/j.jmii.2026.05.003","url":null,"abstract":"<p><strong>Objectives: </strong>Human adenovirus type 21 (HAdV-21) is linked to severe pneumonia in adults, but adult data from China remain scarce. This study compared the molecular and clinical features of HAdV-21 against other genotypes in hospitalized adults.</p><p><strong>Methods: </strong>We retrospectively analyzed adults with HAdV respiratory infections at a Hangzhou tertiary hospital (January 2022-August 2024). Genotyping utilized hexon gene sequencing. Clinical, laboratory, and etiological data were compared. Multivariable logistic regression identified independent risk factors for severe illness.</p><p><strong>Results: </strong>Among 75 genotyped cases, HAdV-21 was the most prevalent (38.7%; comprising 21a and 21b strains). Compared with other genotypes, HAdV-21 infection was associated with distinctive respiratory findings like dyspnea (62.1% vs. 19.6%). Laboratory abnormalities, like lymphocyte percentage (9.70% vs. 18.55%), PCT (0.48 vs. 0.13 ng/mL), and organ injury markers AST (32.00 vs. 19.00 U/L), were also more frequent in the HAdV-21 group. Severe illness (41.4% vs. 13.0%) and respiratory failure (34.5% vs. 6.5%) were significantly more common in the HAdV-21 group, along with a higher rate of coinfection. Overall multivariable analysis identified HAdV-21 (aOR 5.44, 95% CI 1.32-22.48) and older age (aOR 1.05 per year, 95% CI 1.01-1.09) as independent risk factors for severity. However, this association for HAdV-21 was not significant in the subgroup of patients with adenovirus mono-infection.</p><p><strong>Conclusion: </strong>HAdV-21 emerged as the predominant genotype among these hospitalized adults, associating with increased severe disease and respiratory failure. Importantly, this severity appears largely mediated by higher coinfection frequencies rather than HAdV-21's inherent viral pathogenicity alone.</p>","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148007475","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":"Radiographic features on baseline and follow-up computed tomography associated with treatment failure in patients with Mycobacterium avium complex lung disease.","authors":"Pin-Yi Chiang, Yu-Sen Huang, Yu-Cheng Huang, Ming-Yann Lee, Chia-Jung Liu, Chin-Chung Shu, Yeun-Chung Chang","doi":"10.1016/j.jmii.2026.05.002","DOIUrl":"https://doi.org/10.1016/j.jmii.2026.05.002","url":null,"abstract":"<p><strong>Objectives: </strong>Nontuberculous mycobacteria, particularly the Mycobacterium avium complex (MAC), have emerged as significant pathogens in chronic pulmonary infections. This study aimed to investigate the association between CT features at baseline and their interval changes during treatment with clinical outcomes in patients with MAC lung disease.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed 149 MAC-LD patients treated between 2006 and 2023 at a single tertiary center with two affiliated sites. CT scores for bronchiectasis, bronchiolitis, consolidation, cavities, and nodules were assessed at baseline and after treatment. Baseline values and interval changes were calculated. Logistic regression identified predictors of sputum culture conversion, and ROC analysis evaluated model performance.</p><p><strong>Results: </strong>Treatment failure (TF) occurred in 63/149 patients (42.2%). The TF group had higher baseline cavitation score and greater interval increases in cavitation, bronchiectasis extension, bronchiolitis, and consolidation, compared to the treatment success group. Bronchiectasis severity worsened in both groups. Baseline cavitation diameter (p = 0.002) and bronchiectasis extension (p = 0.008) were independent predictors of failure; bronchiectasis extension reached significance only in multivariable analysis. Interval changes in cavitation diameter (p = 0.028), bronchiectasis extension (p = 0.013), and consolidation extension (p = 0.007) were also associated with poor outcomes. Receiver operating characteristic analysis showed AUC values of 0.763 for interval change in consolidation extension, 0.748 for interval change in bronchiectasis extension, 0.643 for interval change in cavitation diameter, and 0.663 for baseline cavitation diameter.</p><p><strong>Conclusions: </strong>Baseline and interval CT features might serve as early indicators of poor treatment response in MAC-LD, assisting clinical decision-making.</p>","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148019143","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":"Seroprevalence of SARS-CoV-2 antibodies among blood donors in Taiwan during the initial COVID-19 surge, April-July 2021.","authors":"Cha-Shien Yen, Chia-Ping Su, Ming-Tsan Liu, Wen-Yueh Cheng, Chi-Tai Fang, Jen-Hsiang Chuang","doi":"10.1016/j.jmii.2026.04.002","DOIUrl":"https://doi.org/10.1016/j.jmii.2026.04.002","url":null,"abstract":"<p><p>To understand the extent of SARS-CoV-2 transmission and immunity during Taiwan's first major COVID-19 outbreak in 2021, we conducted a seroepidemiological investigation using blood donor specimens. A total of 5000 residual blood samples were randomly selected from donors aged 17-65 years across six geographic regions during April 25-July 3 (week 17-week 26), 2021. This time period spanned from the beginning of the surge to six weeks after its peak. Serologic testing using Roche Elecsys® assays measured antibodies against nucleocapsid (N) and spike (S) proteins. Infection-induced seropositivity, defined as having both anti-N and anti-S antibodies, was detected in only one individual (0.02%, 95% confidence interval (CI): 0-0.06%). Blood having only anti-S antibody, indicating vaccine-induced immunity, was observed in 5.2% of samples (95% CI: 4.6-5.8%). The findings suggest that SARS-CoV-2 infection prevalence remained low in the community at the time, with seropositivity primarily reflecting early stages of vaccine rollout. This study demonstrates the value of blood donor-based serosurveillance for estimating infection and vaccine-induced immunity, and informs future policy for public health monitoring.</p>","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147864656","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":"Vibrio vulnificus MARTX cytotoxin triggers necroptosis-driven macrophage cell death.","authors":"Horng-Ren Lo, Chia-Ming Hsieh, Chun-Ya Chen, Shiao-Ping Huang, Yu-Ting Wang, Yu-Tsen Huang, Ngoc-Niem Bui, Cheng-Hsun Chiu, Chih-Ho Lai","doi":"10.1016/j.jmii.2026.03.001","DOIUrl":"https://doi.org/10.1016/j.jmii.2026.03.001","url":null,"abstract":"<p><strong>Background: </strong>Vibrio vulnificus, a gram-negative bacterium, commonly infects humans via contaminated seafood or wounds and can cause severe sepsis. The multifunctional autoprocessing repeat-in-toxin (MARTX) is one of the most crucial virulence factors in V. vulnificus, associated with host pathogenesis. V. vulnificus MARTX induces serious cell damage, leading to subsequent cell death. However, the specific modalities of cell death are diverse and not fully understood.</p><p><strong>Methods: </strong>Murine macrophage cells were challenged with V. vulnificus wild-type and ΔrtxA1 strains. Necroptotic events were assessed through western blotting, cytokine production assays, and fluorescence-based analyses.</p><p><strong>Results: </strong>In this study, we showed that MARTX is essential for V. vulnificus-induced macrophage necroptosis as it activates receptor-interacting protein kinase 3 (RIPK3)/mixed-lineage kinase domain-like pseudokinase (MLKL) signaling. In contrast, the MARTX-deficient mutant (ΔrtxA1) substantially enhanced phagocytosis by macrophages and abolished necroptosis. We further found that MARTX elicited MLKL mobilization to membrane lipid rafts in response to necroptosis. Disruption of lipid rafts using cholesterol depletion/usurping agents significantly alleviated V. vulnificus-induced cell death.</p><p><strong>Conclusions: </strong>Our findings reveal that V. vulnificus MARTX induces macrophage cell death via the necroptosis pathway, dependent on adequate cholesterol levels and potentially involving other cell death mechanisms.</p>","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790267","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":"Association between epidural labor analgesia and neonatal infection risk in full-term vaginal deliveries: A retrospective study from a tertiary medical center in Northern Taiwan.","authors":"Tzu-Hsiang Tseng, Jhao-Jhuang Ding, Chih-Chien Wang, Chia-Hsiang Yu, Chia-Ning Chang","doi":"10.1016/j.jmii.2026.03.009","DOIUrl":"https://doi.org/10.1016/j.jmii.2026.03.009","url":null,"abstract":"<p><strong>Background: </strong>Epidural analgesia (EA) is widely used during labor and frequently associated with maternal intrapartum fever, often prompting neonatal sepsis evaluations. Data from East Asia is scarce; we evaluated whether EA is associated with increased neonatal infection risk and related complications in a Taiwanese cohort.</p><p><strong>Methods: </strong>This retrospective cohort study included 2375 full-term, singleton vaginal deliveries at a tertiary medical center in Northern Taiwan from 2018 to 2021. Neonatal outcomes were compared between mothers who received EA and those who did not. Neonatal infection was operationalized as admission to the NICU for suspected infection, and prolonged antibiotic therapy (>48 h) was evaluated as a secondary outcome.</p><p><strong>Results: </strong>Neonates in the EA group had a slightly higher rate of NICU admission for suspected infection than non-EA infants (4.04% vs 2.81%; p = 0.157), but this difference was not statistically significant. Maternal intrapartum fever occurred significantly more often with EA (28.3% vs 11.4%; p < 0.001), whereas neonatal fever was rare and similar between groups (1.79% vs 1.58%), and only one infant had culture-confirmed infection. In the NICU subgroup (EA N = 63; non-EA N = 23), low Apgar scores and meconium aspiration occurred only in EA-exposed infants, but these rare events and neonatal fever were not independently associated with EA in exploratory Firth logistic regression. Stratified analyses instead suggested that maternal intrapartum fever, rather than EA exposure, was more closely linked to neonatal fever.</p><p><strong>Conclusions: </strong>In this cohort, EA was associated with frequent precautionary neonatal sepsis evaluation without an increase in culture-confirmed infection. Potential residual confounding suggests that these findings should be interpreted as exploratory rather than causal. These findings highlight the need for cautious evaluation to prevent unnecessary antibiotic use in neonates.</p>","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147618802","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}