Infectious diseases (London, England)最新文献

{"title":"Comparison of HANDOC and Chamat-Hedemand's risk stratification systems for predicting infective endocarditis among patients with non-beta-hemolytic streptococci blood stream infections.","authors":"Gustav Pernow, Frida Eriksson, Torgny Sunnerhagen, Magnus Rasmussen","doi":"10.1080/23744235.2025.2513537","DOIUrl":"https://doi.org/10.1080/23744235.2025.2513537","url":null,"abstract":"<p><strong>Background: </strong>Non-β-hemolytic streptococci (NBHS) cause blood stream infections (BSI) which can be complicated by infective endocarditis (IE). To stratify the risk for IE in NBHS BSI and to guide the use of echocardiography in this condition, two risk stratification systems (RSSs), the HANDOC score (HANDOC), and the Chamat-Hedemand algorithm (CH-A) have been developed.</p><p><strong>Objectives: </strong>To compare the sensitivity and the specificity of HANDOC and CH-A and to describe how the utilization of transesophageal echocardiography (TEE) would be affected using either HANDOC or CH-A.</p><p><strong>Methods: </strong>A retrospective, population-based cohort study of patients with blood cultures positive for NBHS during 2018 was performed. Medical records of the included patients were studied for classification of the episodes according to HANDOC, CH-A, and the Duke-ISCVID criteria.</p><p><strong>Results: </strong>Three hundred and twenty-five episodes of NBHS BSIs involving 308 patients were included. Twenty-one episodes (6.5%) met the Duke-ISCVID criteria for definite IE. TEE was performed in 26% of episodes. HANDOC had a sensitivity of 95% and a specificity of 73% for definite IE whereas CH-A had a sensitivity of 90% and a specificity of 63%. The CH-A outcome 'any echocardiography' had a sensitivity of 100% for definite IE, but the specificity was only 24%. In this cohort, implementation of the RSSs would lead to an increase in the utilization of TEE compared to the real-life use, both when using HANDOC (+22%) and CH-A (+60%).</p><p><strong>Conclusion: </strong>HANDOC had the highest combined sensitivity and sensitivity for IE. The utilization of TEE would increase using these RSSs, especially the CH-A.</p>","PeriodicalId":73372,"journal":{"name":"Infectious diseases (London, England)","volume":" ","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251175","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":"Outcomes of a paediatric antimicrobial stewardship program in the Emergency Department observation unit of a hospital in Spain.","authors":"Paloma Suárez-Casillas, Germán Peñalva, Ana Belén Guisado-Gil, Blanca González de Boado, Ángela Hurtado-Mingo, Jose Molina, Marta Mejías-Trueba, José Antonio Lepe, José Miguel Cisneros, María Jesús Sánchez-Álvarez","doi":"10.1080/23744235.2025.2512388","DOIUrl":"https://doi.org/10.1080/23744235.2025.2512388","url":null,"abstract":"<p><strong>Background: </strong>In paediatric emergency departments the use of empirical antimicrobials is very common, even though most infections are caused by viruses, resulting in misuse of antimicrobials. We aimed to assess the impact of a comprehensive antimicrobial stewardship program (ASP) on the optimisation of antimicrobial prescribing and clinical outcomes in a paediatric Emergency Department Observation Unit (EDOU).</p><p><strong>Methods: </strong>A quasi-experimental before-and-after longitudinal study was conducted at the EDOU of a paediatric hospital, over 24 quarters from January 2017 to December 2023, excluding 2020 due to the pandemic and the phase-in period. The ASP intervention included the development and implementation of clinical guidelines, rapid diagnostic tests (RDTs), and staff stabilisation. Data on antimicrobial use and clinical outcomes, such as revisits within 72 h and hospital admissions, were collected and analysed using Bayesian structural time series models.</p><p><strong>Results: </strong>The study included 33,799 patients transferred to the EDOU. Mean antimicrobial consumption significantly decreased from 46.5 ± 12.9 pre-intervention defined daily doses (DDDs) per 100 patients transferred to the Observation Unit (TOs) to 20.1 ± 3.0 DDDs per 100 TOs in the intervention period (<i>p</i> < 0.0001). Significant reductions were observed for amoxicillin-clavulanic acid, amoxicillin, and azithromycin. The percentage of revisits and hospital admissions remained stable for the whole period.</p><p><strong>Conclusion: </strong>The implementation of ASP measures improved antimicrobial prescribing in the paediatric EDOU. These findings support the need for continued efforts in ASP, emphasising the development and implementation of guidelines, RDTs, and staff stabilisation.</p>","PeriodicalId":73372,"journal":{"name":"Infectious diseases (London, England)","volume":" ","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217724","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":"Changing risky food habits in controlling zoonoses in Nepal: a missing link?","authors":"Krishna Prasad Acharya, Sarita Phuyal","doi":"10.1080/23744235.2025.2511076","DOIUrl":"https://doi.org/10.1080/23744235.2025.2511076","url":null,"abstract":"","PeriodicalId":73372,"journal":{"name":"Infectious diseases (London, England)","volume":" ","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200994","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":"Infection type and short-term mortality in patients with infection-associated disseminated intravascular coagulation: a cohort study.","authors":"Simon Flæng, Asger Granfeldt, Kasper Adelborg, Henrik Toft Sørensen","doi":"10.1080/23744235.2025.2453591","DOIUrl":"10.1080/23744235.2025.2453591","url":null,"abstract":"<p><strong>Background: </strong>Severe infection is the most frequent disease underlying disseminated intravascular coagulation (DIC). To improve understanding of the clinical course, we examined the association between infection type and short-term mortality in patients with infection-associated DIC.</p><p><strong>Methods: </strong>Patients with infection-associated DIC registered in the Danish Disseminated Intravascular Coagulation (DANDIC) cohort were categorised by infection type: pulmonary, intra-abdominal, urogenital, others, multiple infection sites and unknown foci. The Kaplan-Meier method was used to create survival curves and compute 30-day and 90-day mortality; logistic regression was used to compute odds ratios, as a measure of relative risk, with corresponding 95% confidence intervals. Regression models were adjusted for age, sex, comorbidities and surgery within one week before DIC diagnosis. Pulmonary infection, the most frequent infection type, was used as the reference group.</p><p><strong>Results: </strong>In total, 1,853 patients had infection-associated DIC. The most common types of infection were pulmonary (35.1%), intra-abdominal (25.6%) and urogenital (12.6%). Thirty-day mortality ranged from 19.7% in patients with urogenital infections to 55.1% in patients with unknown foci. The 30-day mortality odds ratio with respect to pulmonary infection was 0.22 (95% CI, 0.15-0.32) for urogenital infection, 0.57 (95% CI, 0.39-0.82) for other infection types, 0.60 (95% CI, 0.36-1.00) for multiple infection sites, 0.73 (95% CI, 0.56-0.97) for intra-abdominal infections and 1.41 (95% CI, 1.02-1.95) for unknown foci.</p><p><strong>Conclusion: </strong>Infection-associated DIC had a high short-term mortality, which varied among infection types, thus suggesting that infection type is an important predictor of the clinical course of DIC.</p>","PeriodicalId":73372,"journal":{"name":"Infectious diseases (London, England)","volume":" ","pages":"526-534"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025809","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":"How likely is it that a virus or bacteria is causing a patient's symptoms? A new approach to interpret the outcome from multi-pathogen PCR.","authors":"Cassie Hulme, Ronny Gunnarsson, Dan Merenstein, Bruce Barrett, Margareta Ieven, Mark H Ebell","doi":"10.1080/23744235.2025.2456902","DOIUrl":"10.1080/23744235.2025.2456902","url":null,"abstract":"<p><strong>Background: </strong>Whether a detected virus or bacteria is a pathogen that may require treatment, or is merely a commensal 'passenger', remains confusing for many infections. This confusion is likely to increase with the wider use of multi-pathogen PCR.</p><p><strong>Objectives: </strong>To propose a new statistical procedure to analyse and present data from case-control studies clarifying the probability of causality.</p><p><strong>Methods: </strong>We conducted a case-control study in US outpatient settings that enrolled patients aged 18 to 75 years with acute lower respiratory tract infection and controls without respiratory symptoms. Patients underwent multi-pathogen PCR testing. The positive etiologic predictive value was calculated to estimate the probability that each potential pathogen was the cause of symptoms. The outcome was illustrated using a modified forest plot and by classifying pathogens into five categories clarifying the probability for causality.</p><p><strong>Results: </strong>We enrolled 618 adult cases and 497 asymptomatic controls. The modified forest plot and the classification of risk for causality aimed to facilitate understanding. Pathogens likely to be causative when present included influenza A and B, SARS-CoV-2, rhinovirus, and parainfluenza viruses, while <i>Staphylococcus aureus</i> is almost always commensal. Broad confidence intervals for the positive etiologic predictive value made it difficult to draw conclusions for potential pathogens with low prevalence.</p><p><strong>Conclusion: </strong>This pilot study shows that the proposed statistical approach is likely to be practical for analysing larger case-control studies or for a meta-analysis of multiple studies. This method may help when interpreting the results from multi-pathogen PCR.</p>","PeriodicalId":73372,"journal":{"name":"Infectious diseases (London, England)","volume":" ","pages":"535-541"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042832","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":"Genetic diversity and impact of vaccination on influenza A (H1N1)pdm09 in Mar del Plata, Argentina: a 2015-2020 molecular epidemiological study.","authors":"Osvaldo Uez, Andrés Culasso, Andrea Lerman, Carlos Cimmino, Rodolfo Campos, Débora Natalia Marcone","doi":"10.1080/23744235.2025.2466118","DOIUrl":"10.1080/23744235.2025.2466118","url":null,"abstract":"<p><strong>Background: </strong>Influenza A viruses are a major cause of viral respiratory infections in humans, leading to a spectrum of diseases ranging from mild to severe, particularly in high-risk groups. Monitoring the frequency and evolution of A (H1N1)pdm09 viruses is essential for guiding vaccine strain selection and maintaining vaccine effectiveness.</p><p><strong>Objectives: </strong>To characterize the evolution of circulating influenza A (H1N1)pdm09 strains in Mar del Plata(MDQ), Argentina, and estimate vaccine efficacy from 2015 to 2020, before the SARS-CoV-2 pandemic.</p><p><strong>Methods: </strong>We analyzed 46 influenza A (H1N1)pdm09 strains detected by RT-PCR from patients with acute respiratory infections in MDQ between 2015 and 2020. Phylogenetic analysis was performed using maximum likelihood, and vaccine efficacy was estimated with the P_epitope model.</p><p><strong>Results: </strong>Seven genetic clades were identified: 6B in 2015, 6B.1 in 2016-2017, 6B.1A, 6B.1A.1, and 6B.1A.3 in 2018, 6B.1A.5A in 2019-2020, and 6B.1A.5a.2 in 2020. Genetic diversity and regional clustering suggested multiple strain introductions from other Argentinian regions or countries. The predicted vaccine efficacy was highest when the frequency of influenza A (H1N1)pmd09 was below 2%, decreasing as viral frequency increased, due to mutations occurring particularly in haemagglutinin epitopes B, C, and E.</p><p><strong>Conclusion: </strong>Our findings highlight the dynamic evolution of influenza A (H1N1)pdm09 in MDQ and emphasize the importance of continuous molecular surveillance and regular vaccine updates. Additionally, the P_epitope model proved useful in estimating vaccine efficacy. The impact of vaccination in reducing viral frequency when circulating and vaccine strains are well-matched further supports annual influenza vaccination recommendations to minimize viral burden in the community.</p>","PeriodicalId":73372,"journal":{"name":"Infectious diseases (London, England)","volume":" ","pages":"574-587"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470069","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":"Towards evidence-based strategies for Staphylococcus aureus Bacteraemia in prosthetic Joint patients.","authors":"Shital Shrikant Ghogale, Ketaki Niranjan Pathak","doi":"10.1080/23744235.2025.2483974","DOIUrl":"10.1080/23744235.2025.2483974","url":null,"abstract":"","PeriodicalId":73372,"journal":{"name":"Infectious diseases (London, England)","volume":" ","pages":"588-589"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060648","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":"Ability to return to work and persistent symptoms six months after viral meningitis - a retrospective single-centre cohort study.","authors":"Albulena Imishti, Mathilde Jepsen Nissen, Anne Øvrehus, Lykke Larsen","doi":"10.1080/23744235.2025.2463960","DOIUrl":"10.1080/23744235.2025.2463960","url":null,"abstract":"<p><strong>Background: </strong>Viral meningitis (VM) is often perceived as mild and self-limiting, but some studies indicate reduced ability to work and cognitive sequelae post-infection.</p><p><strong>Objectives: </strong>To investigate VM patients' self-reported return to work, persistent symptoms, and social limitations up to 6 months post-hospitalisation, assess predictors for full return to work at 6 months, and quantify neuropsychological testing use.</p><p><strong>Methods: </strong>Retrospective single-centre cohort study of VM patients from 2015 to 2020. Data collected covered hospitalisation, work status at admission, Glasgow Outcome Scale (GOS) score at discharge and neuropsychological testing. Additionally, information on work status and persistent symptoms (headaches, concentration difficulty, social limitations and sound sensitivity) at 1-, 3- and 6-month follow-up appointments.</p><p><strong>Results: </strong>In total, 246 patients were included in the study (median age 33 years, 51.6% female). In all, 26.0% of patients underwent neuropsychological testing. Persistent symptoms could be assessed in 223 patients at follow-up appointments. Headaches were most reported symptom, occurring in 55.6%, 37.7% and 27.8% of patients at 1, 3 and 6 months, respectively. Work status could be assessed in 199 patients. At 6 months, 52.8%patients were fully returned to work, while 24.1% reported a phased or no return. Full return to work was associated with male sex (OR 4.19, <i>p</i> = 0.003) and GOS score 5 at discharge (OR 15.11, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Six months post-VM, approximately 25% of patients had reduced/no work ability and 30% at least one persistent symptom. Women had increased risk of not returning to full work.</p>","PeriodicalId":73372,"journal":{"name":"Infectious diseases (London, England)","volume":" ","pages":"551-560"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411897","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":"Mpox: genomic insights and public health implications.","authors":"Francesco Branda, Massimo Ciccozzi, Fabio Scarpa","doi":"10.1080/23744235.2025.2494053","DOIUrl":"10.1080/23744235.2025.2494053","url":null,"abstract":"","PeriodicalId":73372,"journal":{"name":"Infectious diseases (London, England)","volume":" ","pages":"590-596"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051664","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":"60-day mortality and the role of SARS-CoV-2 in hospital admissions of immunocompromised patients during later Omicron period: a population-based study in Sweden.","authors":"Armin Spreco, Christer Andersson, Rune Sjödahl, Katarina Niward","doi":"10.1080/23744235.2025.2465828","DOIUrl":"10.1080/23744235.2025.2465828","url":null,"abstract":"<p><strong>Background: </strong>Real-world data on hospitalised SARS-CoV-2-positive patients are important for post-pandemic preventive measures.</p><p><strong>Objectives: </strong>This study aims to explore 60-day mortality of immunocompromised patients hospitalised in later Omicron period, accounting for the relevance of COVID-19 for hospital care.</p><p><strong>Methods: </strong>A retrospective population-based cohort study in Östergötland County, Sweden, included all adult patients with a positive SARS-CoV-2 PCR test within 3 weeks of hospital admission. Clinical data including functional level (combined assessment of frailty and performance status), and COVID-19's impact on hospital care were collected from medical records. An adjusted binary logistic regression model was applied for the main outcome of 60-day COVID-19-related mortality, with immunosuppression as the main exposure.</p><p><strong>Results: </strong>1128 hospitalised SARS-CoV-2-positive patients were included in the analysis whereof 12.9% were immunocompromised. Hospital admission due to COVID-19 was significantly more common among immunocompromised than non-immunocompromised (71.9% vs 49.5%), and 60-day COVID-19 mortality was 10.5% and 8.0% (<i>p</i> = 0.41), respectively. The median age of patients hospitalised due to COVID-19 was 78 years, with most having low/very low functional levels and ≥3 comorbidities. Adjusted for possible confounders, immunosuppression showed a significantly increased risk of 60-day COVID-19-related mortality (OR 2.41, 95% CI 1.06-5.47, <i>p</i> = 0.04).</p><p><strong>Conclusion: </strong>A majority of COVID-19-related hospitalisations during later Omicron period in a high immunity population, involved people over 70 years with low/very low functional levels and multiple comorbidities. Immunocompromised patients had a 2.5 times higher risk of 60-day COVID-19-related mortality. These findings underscore the need for targeted preventive measures in vulnerable elderly and immunocompromised populations to mitigate COVID-19-related hospitalisations and deaths.</p>","PeriodicalId":73372,"journal":{"name":"Infectious diseases (London, England)","volume":" ","pages":"561-573"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426757","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}