{"title":"Risk factors and outcomes of <i>Pneumocystis jiroveciii</i> pneumonia in Christchurch, New Zealand: a retrospective clinical study.","authors":"Maya Wernick, Aileen Harwood, Nicholas M Douglas","doi":"10.1080/23744235.2026.2737798","DOIUrl":"10.1080/23744235.2026.2737798","url":null,"abstract":"<p><p><i>Pneumocystis jirovecii</i> pneumonia (PJP) is an opportunistic fungal infection historically associated with advanced HIV infection but now seen more commonly in recipients of immunomodulatory medications used for the treatment of malignancies and autoimmune conditions. Evidence-based guidance on prophylaxis has not kept pace with the rapidly expanding use of immunomodulatory therapy.</p><p><strong>Methods: </strong>This was a retrospective clinical study of all patients with a positive <i>Pneumocystis jirovecii</i> immunofluorescence or PCR result from a respiratory specimen who were subsequently treated for PJP at Christchurch Hospital, New Zealand, between 18/04/2013 and 12/10/2023. Analysis was undertaken to determine the distribution of risk factors for acquisition of PJP and the outcomes of treatment.</p><p><strong>Results: </strong>After exclusion of patients who did not receive treatment for PJP and children <18 years, 190 patients were analysed. The most prevalent underlying comorbidities associated with acquisition of PJP were chronic respiratory conditions (58 patients, 30.5%), rheumatological conditions (54 patients, 28.4%) and haematological malignancies (53 patients, 27.9%). 114 patients (60.0%) were receiving corticosteroids in the week leading up to diagnosis, 41.2% (<i>n</i> = 47) of whom were receiving additional immunomodulatory treatments. The 30-day mortality in patients with PJP was 23.7%, with case fatality highest amongst those with ANCA-associated vasculitis (42.9%), an underlying respiratory condition (32.8%) or solid organ malignancy (30.3%). Seven (3.7%) patients were receiving chemoprophylaxis at the time of PJP diagnosis.</p><p><strong>Conclusion: </strong>Corticosteroid use is the most common identifiable risk factor for PJP at Christchurch Hospital. Expanded use of chemoprophylaxis in steroid recipients could substantially reduce the incidence of this dangerous disease.</p>","PeriodicalId":73372,"journal":{"name":"Infectious diseases (London, England)","volume":" ","pages":"1-10"},"PeriodicalIF":2.3,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149066593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pontus Naucler, Suzanne Desirée van der Werff, Andreas Winroth, Anders Ternhag, Anders F Johansson
{"title":"Improved sepsis surveillance using a fully automated electronic health record-based algorithm compared to diagnostic coding.","authors":"Pontus Naucler, Suzanne Desirée van der Werff, Andreas Winroth, Anders Ternhag, Anders F Johansson","doi":"10.1080/23744235.2026.2731937","DOIUrl":"https://doi.org/10.1080/23744235.2026.2731937","url":null,"abstract":"<p><strong>Background: </strong>Accurate diagnostic coding of sepsis is essential for surveillance, resource allocation, and health policy planning. Studies assessing the usability of claims-based data (ICD-10 codes) compared to clinical criteria for sepsis surveillance are needed.</p><p><strong>Objectives: </strong>To assess the concordance between ICD-10 diagnostic coding of sepsis and classification using a previously validated fully automated electronic health record (EHR)-based algorithm applying Sepsis-3 criteria.</p><p><strong>Methods: </strong>We conducted an observational study, including adult in-hospital admissions during 2016-2024 at Karolinska University Hospital and 2022-2024 at three hospitals in Region Västerbotten, Sweden. The Sepsis-3 algorithm identified suspected infection combined with an increase in Sequential Organ Failure Assessment (SOFA) score ≥2 points. Sepsis ICD-10 codes were categorised as explicit or specific (R65.1, R57.2). Concordance was evaluated using descriptive and kappa statistics, and time trends were analysed.</p><p><strong>Results: </strong>Among 174,343 admissions during the common study period (2022-2024), the Sepsis-3 algorithm classified sepsis in 11.4% of admissions at Karolinska and 6.2% in Västerbotten, compared to 2.5% and 1.2% with explicit codes and 1.4% and 0.6% with specific codes, respectively. Concordance of diagnostic codes with the Sepsis-3 algorithm was low (kappa 0.21 and 0.14 for explicit and specific codes at Karolinska; 0.15 and 0.09 in Västerbotten). During the study period 2016-24 at Karolinska, introduction of an automated SOFA calculator in the EHR system was associated with increased usage of specific sepsis codes but remained far below algorithm-based classification.</p><p><strong>Conclusion: </strong>Automated EHR-based algorithms allow for data-driven sepsis surveillance and may support more reliable diagnostic coding practices.</p>","PeriodicalId":73372,"journal":{"name":"Infectious diseases (London, England)","volume":" ","pages":"1-6"},"PeriodicalIF":2.3,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Treat, then forget? The persistent challenge of post-treatment follow-up in syphilis.","authors":"Aristos Aristodimou, Zacharias Raptopoulos","doi":"10.1080/23744235.2026.2737279","DOIUrl":"https://doi.org/10.1080/23744235.2026.2737279","url":null,"abstract":"","PeriodicalId":73372,"journal":{"name":"Infectious diseases (London, England)","volume":" ","pages":"1-4"},"PeriodicalIF":2.3,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Beyond containment: making community power the cornerstone of Ebola preparedness in Africa.","authors":"Sharmake Gaiye Bashir, Ilyas Abdullahi Khalif","doi":"10.1080/23744235.2026.2734027","DOIUrl":"https://doi.org/10.1080/23744235.2026.2734027","url":null,"abstract":"","PeriodicalId":73372,"journal":{"name":"Infectious diseases (London, England)","volume":" ","pages":"1-5"},"PeriodicalIF":2.3,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Resurgence of Chandipura virus: a renewed threat of rapidly progressive encephalitis among children in India.","authors":"Ananya Kaul, Rajesh Shetty, Ankita Mathur, Shubham Kumar","doi":"10.1080/23744235.2026.2720189","DOIUrl":"10.1080/23744235.2026.2720189","url":null,"abstract":"","PeriodicalId":73372,"journal":{"name":"Infectious diseases (London, England)","volume":" ","pages":"974-975"},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}