Infectious diseases (London, England)最新文献

{"title":"Evaluating the role and clinical impact of extended respiratory viral PCR testing in adult inpatients.","authors":"Jake Fletcher, Yvonne Hersusianto, Saliya Hewagama","doi":"10.1080/23744235.2026.2639743","DOIUrl":"10.1080/23744235.2026.2639743","url":null,"abstract":"<p><strong>Introduction: </strong>Low value diagnostic testing is an increasingly significant issue in the context of rising healthcare costs. The additional benefit of extended respiratory viral polymerase chain reaction (PCR) testing (influenza A/B, RSV, parainfluenza, human metapneumovirus, adenovirus, rhinovirus) over a standard of care Flu/RSV/SARS-CoV-2 PCR is unclear at our institution.</p><p><strong>Objective: </strong>To investigate whether the additional information provided by extended respiratory viral PCR testing reduces adult patient length of stay, duration of intravenous (IV) or oral antibiotics at our institution.</p><p><strong>Methods: </strong>A retrospective audit of extended respiratory viral PCR tests was performed in adult inpatients and emergency department patients at the Northern Hospital (Melbourne, Australia) between April 1^st - August 31^st 2024. In the subgroup of patients discharged with a diagnosis of respiratory tract infection or exacerbation, inpatient length of stay, IV, oral and total antibiotic usage were compared based on respiratory viral PCR result, adjusting for clinically appropriate covariables.</p><p><strong>Results/discussion: </strong>Only 330 of 941 tested patients met the criteria for inclusion in the respiratory tract infection or exacerbation subgroup. Length of stay, IV, oral and total antibiotic usage were not significantly reduced in patients with a positive extended respiratory viral PCR result. In contrast, patients with a positive Flu/RSV/SARS-CoV-2 PCR were significantly less likely to receive oral antibiotics (OR 0.31, <i>p</i> < 0.01) or any antibiotics (OR 0.30, <i>p</i> < 0.01), with no significant difference in IV antibiotic usage.</p><p><strong>Conclusion: </strong>No objective benefit of extended respiratory viral PCR testing was detected in adult inpatients with regards to antibiotic usage or inpatient length of stay.</p>","PeriodicalId":73372,"journal":{"name":"Infectious diseases (London, England)","volume":" ","pages":"727-737"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147438196","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":"Overdiagnosis of necrotizing fasciitis: clinical-radiological suspicion <i>versus</i> intraoperative findings in 62 fasciotomy patients.","authors":"Andrea Bedini, Anna Spadoni, Giovanni Manzini, Giacomo Franceschi, Valentina Menozzi, Mattia Simion, Federico Romani, Marianna Meschiari, Erica Franceschini, Mario Sarti, Cristina Mussini","doi":"10.1080/23744235.2026.2639004","DOIUrl":"10.1080/23744235.2026.2639004","url":null,"abstract":"<p><strong>Introduction: </strong>Necrotising fasciitis (NF) is a rare but life-threatening soft tissue infection, whose diagnosis remains challenging due to non-specific early clinical signs. This retrospective single-center study aimed to compare the clinical, radiological, and microbiological characteristics, as well as outcomes, of patients undergoing fasciotomy for suspected NF, distinguishing between those with surgically confirmed necrosis and those without.</p><p><strong>Methods: </strong>Data from 62 adults who underwent fasciotomy for suspected NF between 2013 and 2023 were retrospectively analyzed. Patients were stratified into two groups according to intra-operative confirmation of necrosis (<i>n</i> = 29) or its absence (<i>n</i> = 33). Demographic characteristics, clinical presentation, laboratory parameters, timing of surgery, and 30-, 90-, and 180-day mortality rates were compared.</p><p><strong>Results: </strong>Patients with confirmed necrosis showed significantly higher LRINEC scores (7.5 vs 5.6; <i>p</i> = 0.004), blood glucose (223.6 vs 154.9 mg/dL; <i>p</i> = 0.031), and urea levels (75.4 vs 50.4 mg/dL; <i>p</i> = 0.019) at admission. Advanced clinical signs, including bullae or crepitus, were strongly associated with necrosis (OR = 4.82; <i>p</i> = 0.007). These patients were more frequently admitted to the ICU (82.8% vs 42.4%; <i>p</i> = 0.002) and underwent earlier surgery (<24 h; OR = 0.19; <i>p</i> = 0.002). No significant differences were observed in infection site, microbiology, hospital stay, or mortality (6.9% vs 12.2%; <i>p</i> = 0.676).</p><p><strong>Conclusion: </strong>Elevated LRINEC scores and advanced clinical signs predict confirmed necrosis but not mortality. The timely decision to perform fasciotomy, regardless of confirmed necrosis, appears to be critical for improving outcomes. This suggests that relying on clinical judgement and early surgical exploration is critical for a timely and effective response to highly suspected cases of NF.</p>","PeriodicalId":73372,"journal":{"name":"Infectious diseases (London, England)","volume":" ","pages":"718-726"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147357850","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":"Temporal changes of hospital contacts due to Herpes zoster during three decades in Denmark.","authors":"Mads Frederik Eiberg, Omid Rezahosseini, Mikkel Porsborg Andersen, Christian Torp-Pedersen, Casper Roed, Cæcilie Stilling Denholt, Casper Møller Frederiksen, Thea K Fischer, Christian Søborg, Christina Ekenberg, Klaus Rostgaard, Henrik Hjalgrim, Zitta Barrella Harboe","doi":"10.1080/23744235.2026.2625355","DOIUrl":"10.1080/23744235.2026.2625355","url":null,"abstract":"<p><strong>Background: </strong>Herpes Zoster (HZ) is a common disease associated with morbidity, including cardiovascular complications, particularly in older adults and immunocompromised individuals.</p><p><strong>Objective: </strong>To explore temporal changes in the incidence of hospital contacts due to HZ and estimate the risk of stroke and myocardial infarction (MI) following a hospital contact due to HZ.</p><p><strong>Methods: </strong>This nationwide register-based cohort study from 1994 to 2022, included all adults (≥ 18 years) living in Denmark with a hospital contact due to a first-time event of HZ registered in the national patient register as an ICD-10 code. The incidences of hospital contact due to HZ were estimated by Poisson regression and reported per 100,000 person-years (PY). Furthermore, we estimated the hazard ratio (HR) of MI or stroke up to 90 days following a hospital contact with HZ using a Cox proportional hazard model.</p><p><strong>Results: </strong>We included 23,433 individuals with a hospital contact due to HZ. The incidence of HZ increased in all age groups during the period, with the highest increase in the 60-64 age group from 10 (95% CI: 8-13) to 30 (95% CI: 26-33) per 100,000 PY. The HR of a stroke or MI after a hospital contact with an HZ diagnosis was 2.65 (95% CI: 2.06-3.42, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>We found that the incidence of hospital contacts with an HZ diagnosis increased during the past three decades. Also, the relative rate of cardiovascular events was higher after a hospital contact with an HZ diagnosis than in individuals without such an event.</p>","PeriodicalId":73372,"journal":{"name":"Infectious diseases (London, England)","volume":" ","pages":"680-689"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146144539","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":"Expression of concern.","authors":"","doi":"10.1080/23744235.2026.2668278","DOIUrl":"10.1080/23744235.2026.2668278","url":null,"abstract":"","PeriodicalId":73372,"journal":{"name":"Infectious diseases (London, England)","volume":" ","pages":"773"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846974","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":"Evaluation of anti diphtheria immunity among Nigerian children aged 6-59 months.","authors":"A E Sadoh, E Ayinbuomwan, I I Osaigbovo","doi":"10.1080/23744235.2026.2629940","DOIUrl":"10.1080/23744235.2026.2629940","url":null,"abstract":"<p><strong>Introduction: </strong>The recent outbreak of diphtheria in Nigeria affected mostly unvaccinated children; but a significant proportion of fully vaccinated children were affected prompting questions on level of immunity post vaccination.</p><p><strong>Aim: </strong>To determine the seroprevalence of anti-diphtheria antibodies in children aged 6 months to 59 months.</p><p><strong>Methods: </strong>In this cross-sectional analytic study conducted in Edo state, Nigeria, 257 apparently healthy children were studied. Following written informed consent, 3mls of blood was drawn. The blood was spun, separated and serum stored at -20 °C until analysis for anti-diphtheria antibodies by ELISA method. Anti-diphtheria IgG antibody levels were log-transformed and categorised as <0.01 IU/mL no protection, 0.01-0.09 IU/mL minimal protection, 0.1-0.9 IU/mL full protection and >1 IU/mL long term protection. Data analysis was done using SPSS with Statistical significance set at <i>p</i> < 0.05. Geometric mean titres (GMT) were calculated. Difference in mean titres was tested using student t test and ANOVA as appropriate.</p><p><strong>Results: </strong>There were 158(61.5%) males and 99(38.5%) females. Overall GMT was 0.08 IU/mL. GMT of children younger than 12 months was 0.25 IU/mL and was higher than those of all other age groups <i>p</i> < 0.001. There were 54(21.0%) children with no immunity while only 10(3.89%) children had long term immunity. The age group 36-47 months had the highest proportion 14(51.4%) with inadequate immunity followed by the age group 48-59 months with 14(50%).</p><p><strong>Conclusion: </strong>Significant proportions of Nigerian children have inadequate immunity despite having received 3 primary doses of diphtheria containing vaccine. We recommend booster doses in the second year of life.</p>","PeriodicalId":73372,"journal":{"name":"Infectious diseases (London, England)","volume":" ","pages":"690-696"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146215037","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":"Strengthening pandemic preparedness for H5N1 threats in Southeast Asia: a national pandemic toolbox for Nepal.","authors":"Dipti Shrestha, Kalyan Subedi, Yogendra Shah, Shyam Prakash Dumre, Pramod Joshi, Sher Bahadur Pun, Krishna Prasad Acharya, Giancarlo Ceccarelli, Fabio Scarpa, Massimo Ciccozzi, Francesco Branda","doi":"10.1080/23744235.2026.2671236","DOIUrl":"10.1080/23744235.2026.2671236","url":null,"abstract":"","PeriodicalId":73372,"journal":{"name":"Infectious diseases (London, England)","volume":" ","pages":"745-758"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977459","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":"Procalcitonin compared to C-reactive protein and leukocyte count. A comparative analysis of baseline markers of bacterial co-infection in patients admitted with a viral respiratory tract infection. A retrospective observational cohort study.","authors":"Bo Langhoff Hønge, Jacob Rudjord Therkilsen, Jacob Redder, Thomas Greve, Lars Skov Dalgaard, Anita Rath Sørensen, Lotte Ebdrup, Rajesh Mohey, Britta Tarp, Mette Holm, Lars Østergaard, Merete Storgaard","doi":"10.1080/23744235.2026.2636718","DOIUrl":"10.1080/23744235.2026.2636718","url":null,"abstract":"<p><strong>Background: </strong>Patients admitted with viral respiratory tract infections are at risk of bacterial co-infections, often requiring antibiotics. Standard bacterial cultures may take days to yield results, making early indicators of bacterial co-infection a potential asset.</p><p><strong>Methods: </strong>In a retrospective regionwide cohort study, we included all patients admitted to a hospital in the Central Denmark Region with COVID-19, influenza, or respiratory syncytial virus (RSV) in the period February 2019 to February 2024. Further inclusion criteria were having a blood sample taken for procalcitonin measurement and blood cultures within 72 h of admission. We evaluated the diagnostic value of procalcitonin compared to other inflammatory markers.</p><p><strong>Results: </strong>There were 1,670 patients fulfilling the inclusion criteria. The majority 1,556 (92.2%) were infected with SARS-CoV-2, 51 (3.7%) with influenza A, 1 (0.1%) with influenza B, 45 (2.7%) with RSV, and 17 (1.0%) with multiple viruses. Blood cultures were positive in 43 (2.6%) of the patients after a median of 67.4 h from time of admission. Median procalcitonin levels were higher in patients with bacteraemia (1.7 µg/L) than in patients without bacteraemia (0.2 µg/L. Overall, procalcitonin cut-off at >0.25 µg/L and >0.50 µg/L tended to have higher sensitivity, specificity, positive and negative predictive values than C-reactive protein (CRP) > 100 mg/L and total leukocyte count >10 × 10⁹ cells/L, although the numerical differences were small. Overall diagnostic performance for bacterial pneumonia was lower.</p><p><strong>Conclusions: </strong>All biomarkers had relatively low sensitivity for bacteraemia and bacterial pneumonia in patients with viral respiratory tract infection.</p>","PeriodicalId":73372,"journal":{"name":"Infectious diseases (London, England)","volume":" ","pages":"708-717"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345937","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":"Predicting plasma leakage in adult patients with dengue using clinical and laboratory markers at the time of emergency department presentation.","authors":"Yung Ban Cheng, Aida Bustam, Khadijah Poh, Muhaimin Noor Azhar, Mohd Hafyzuddin Md Yusuf","doi":"10.1080/23744235.2026.2631108","DOIUrl":"10.1080/23744235.2026.2631108","url":null,"abstract":"<p><strong>Background: </strong>Plasma leakage is a key pathophysiological feature of severe dengue and typically precedes clinical deterioration. However, current diagnostic criteria rely on warning signs that often appear after leakage has begun.</p><p><strong>Objectives: </strong>To identify early clinical and laboratory predictors of ultrasound-confirmed plasma leakage in adult dengue patients and evaluate their association with adverse clinical outcomes.</p><p><strong>Methods: </strong>A retrospective cohort study of 507 adult patients with laboratory-confirmed dengue admitted to a tertiary Malaysian hospital between January 2022 and December 2023. Plasma leakage was defined by third-space fluid accumulation detected on point-of-care ultrasound. Multivariate logistic regression identified independent predictors from demographic, clinical, and laboratory variables measured at presentation.</p><p><strong>Results: </strong>Ninety-nine patients (19.5%) developed plasma leakage. Independent predictors included older age (OR 1.042, 95% CI: 1.013-1.071), higher BMI (OR 1.615, 95% CI: 1.255-2.079), smoking (OR 2.955, 95% CI: 1.217-7.176), mucosal bleeding (OR 5.994, 95% CI: 1.152-31.185), elevated haematocrit (OR 1.613, 95% CI: 1.271-2.046), raised AST (OR 1.022, 95% CI: 1.011-1.033), low albumin (OR 0.850, 95% CI: 0.748-0.966), and elevated lactate (OR 29.668, 95% CI: 12.020-73.229). A lactate cut-off of ≥1.45 mmol/L yielded 96.0% sensitivity and 98.3% negative predictive value. These predictors were significantly associated with ICU admission, severe dengue, and prolonged hospital stay.</p><p><strong>Conclusion: </strong>These findings support the use of objective, readily available markers to guide emergency department triage and decision-making where imaging is limited. The association between smoking and plasma leakage is a novel finding warranting further investigation.</p>","PeriodicalId":73372,"journal":{"name":"Infectious diseases (London, England)","volume":" ","pages":"697-707"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146222181","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":"First epidemic of hantavirus on cruise ships: from passenger surveillance to ship ecology.","authors":"Giancarlo Ceccarelli, Francesco Branda, Cecilia Ceccarelli, Fabio Scarpa, Massimo Ciccozzi","doi":"10.1080/23744235.2026.2675432","DOIUrl":"10.1080/23744235.2026.2675432","url":null,"abstract":"","PeriodicalId":73372,"journal":{"name":"Infectious diseases (London, England)","volume":" ","pages":"759-772"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147983962","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":"Letter regarding a herpes zoster outbreak in Korean children: insights from an additional 14 months of data.","authors":"Joowon Lee","doi":"10.1080/23744235.2026.2668004","DOIUrl":"10.1080/23744235.2026.2668004","url":null,"abstract":"","PeriodicalId":73372,"journal":{"name":"Infectious diseases (London, England)","volume":" ","pages":"738-740"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147936058","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}