{"title":"Zinc: An oft-forgotten component in the management of diarrhea.","authors":"Indi Trehan","doi":"10.1093/cid/ciag111","DOIUrl":"https://doi.org/10.1093/cid/ciag111","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2026-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146218586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Simon Herbel, Olivier Paccoud, Étienne de Montmollin, Baptiste Grenier, Muriel Picard, Clara Vigneron, David Osman, Aëlle Le Gall, Juliette Guitard, Jérémie Joffre, Thomas Frapard, Valentin Coirier, Adrien Joseph, Julien Schmidt, Laurent Argaud, Maxens Decavèle, Guillaume Lacave, Guillaume Voirot, Mathieu Bellal, Mathilde Neuville, Anne-Sophie Moreau, Vincent Das, Maïté Agbakou, Claire Pichereau, Jean-Pierre Quenot, Fabrice Uhel, Marc Le Pape, Sylvie Meireles, Achille Kouatchet, Damien Contou, Romain Persichini, Nahema Issa, Djamel Mokart, Olivier Lortholary, Elie Azoulay, Fanny Lanternier, Naïke Bigé
Background: Cryptococcus causes life-threatening opportunistic infections in immunocompromised hosts. Data on the most severe cases requiring ICU admission remain limited.
Methods: We conducted a retrospective, multicenter study of patients admitted to 30 French ICUs for severe cryptococcosis between 2000 and 2022.
Results: Among 151 patients included, 56.9% were patients with HIV. Cases in patients without HIV became increasingly prevalent over time (51.3% in 2012-2022 vs. 32.4% before 2012); 82.5% were receiving immunosuppressive therapy. Central nervous system infection was predominant (91.1%), followed by lung infection (39.7%). Fungemia occurred in 59.8% patients, and 75.2% had disseminated infection. Neurological failure was the leading organ impairment at admission (75.5%) followed by respiratory failure (47.7%), acute kiney injury (41.7%) and shock (24.5%). The median SOFA score was 4 [2-7]. Invasive mechanical ventilation, vasopressors and renal replacement therapy were required in 54.9%, 34.4% and 18.5% of patients, respectively. At day 90, 94% of patients requiring mechanical ventilation and vasopressors were deceased, compared to 38.7% with invasive ventilation alone and 17.2% without any organ support (p<0.001). Overall, 90-day mortality reached 49.6%. SOFA score (HR 1.04 [1.02-1.06]), admission between 2000 and 2012 (HR 2.30 [1.36-3.89]), disseminated infection (HR 2.32 [1.15-4.67]) and initiation of antifungal therapy before ICU admission (HR 0.38 [0.22-0.63]) were independently associated with 90-day mortality, whereas HIV serostatus was not (HR 0.93 [0.47-1.84]).
Conclusion: Severe cryptococcosis requiring ICU admission affects an increasing number of patients without HIV and is associated with high, though declining, mortality. Early diagnosis and treatment are mandatory to improve prognosis.
{"title":"Presentation and prognosis of cryptococcosis requiring intensive care unit admission in France: the CRYPTO-ICU study.","authors":"Simon Herbel, Olivier Paccoud, Étienne de Montmollin, Baptiste Grenier, Muriel Picard, Clara Vigneron, David Osman, Aëlle Le Gall, Juliette Guitard, Jérémie Joffre, Thomas Frapard, Valentin Coirier, Adrien Joseph, Julien Schmidt, Laurent Argaud, Maxens Decavèle, Guillaume Lacave, Guillaume Voirot, Mathieu Bellal, Mathilde Neuville, Anne-Sophie Moreau, Vincent Das, Maïté Agbakou, Claire Pichereau, Jean-Pierre Quenot, Fabrice Uhel, Marc Le Pape, Sylvie Meireles, Achille Kouatchet, Damien Contou, Romain Persichini, Nahema Issa, Djamel Mokart, Olivier Lortholary, Elie Azoulay, Fanny Lanternier, Naïke Bigé","doi":"10.1093/cid/ciag091","DOIUrl":"https://doi.org/10.1093/cid/ciag091","url":null,"abstract":"<p><strong>Background: </strong>Cryptococcus causes life-threatening opportunistic infections in immunocompromised hosts. Data on the most severe cases requiring ICU admission remain limited.</p><p><strong>Methods: </strong>We conducted a retrospective, multicenter study of patients admitted to 30 French ICUs for severe cryptococcosis between 2000 and 2022.</p><p><strong>Results: </strong>Among 151 patients included, 56.9% were patients with HIV. Cases in patients without HIV became increasingly prevalent over time (51.3% in 2012-2022 vs. 32.4% before 2012); 82.5% were receiving immunosuppressive therapy. Central nervous system infection was predominant (91.1%), followed by lung infection (39.7%). Fungemia occurred in 59.8% patients, and 75.2% had disseminated infection. Neurological failure was the leading organ impairment at admission (75.5%) followed by respiratory failure (47.7%), acute kiney injury (41.7%) and shock (24.5%). The median SOFA score was 4 [2-7]. Invasive mechanical ventilation, vasopressors and renal replacement therapy were required in 54.9%, 34.4% and 18.5% of patients, respectively. At day 90, 94% of patients requiring mechanical ventilation and vasopressors were deceased, compared to 38.7% with invasive ventilation alone and 17.2% without any organ support (p<0.001). Overall, 90-day mortality reached 49.6%. SOFA score (HR 1.04 [1.02-1.06]), admission between 2000 and 2012 (HR 2.30 [1.36-3.89]), disseminated infection (HR 2.32 [1.15-4.67]) and initiation of antifungal therapy before ICU admission (HR 0.38 [0.22-0.63]) were independently associated with 90-day mortality, whereas HIV serostatus was not (HR 0.93 [0.47-1.84]).</p><p><strong>Conclusion: </strong>Severe cryptococcosis requiring ICU admission affects an increasing number of patients without HIV and is associated with high, though declining, mortality. Early diagnosis and treatment are mandatory to improve prognosis.</p>","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2026-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146225735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Additional Details on the COPAT Trial.","authors":"Joy J Juskowich, Arif R Sarwari","doi":"10.1093/cid/ciag103","DOIUrl":"https://doi.org/10.1093/cid/ciag103","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2026-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146218653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Andi L Shane, Mark D Gonzalez, Amanda M Roy, Geoffrey A Preidis, Michael H Woodworth
{"title":"I Zinc, Therefore I Am: Context is Key.","authors":"Andi L Shane, Mark D Gonzalez, Amanda M Roy, Geoffrey A Preidis, Michael H Woodworth","doi":"10.1093/cid/ciag112","DOIUrl":"https://doi.org/10.1093/cid/ciag112","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2026-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146212315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Request for Additional Details on the COPAT Trial.","authors":"Brad Spellberg, Bassam Ghanem","doi":"10.1093/cid/ciag100","DOIUrl":"https://doi.org/10.1093/cid/ciag100","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2026-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146212318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"New French Guidelines on Subcutaneous Antibiotic Therapy: A Response to Di Bella et al.","authors":"Emmanuel Forestier, Gaëtan Gavazzi, Sylvain Diamantis, Sylvain Goutelle, Claire Roubaud-Baudron","doi":"10.1093/cid/ciag088","DOIUrl":"https://doi.org/10.1093/cid/ciag088","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2026-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146218639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shari Sapuan, Ngee Keong Tan, David Carrington, Vanessa Greening, Christine E Jones, Asma Khalil, Cassie F Pope, Blair L Strang, Sarah White, Paul T Heath
Background Human cytomegalovirus (HCMV) during pregnancy and poor immune control of HCMV are associated with adverse outcomes. Limited data exist on the prevalence, natural history, and risk factors of HCMV shedding and T-cell immune responses during pregnancy and postpartum in HCMV-seropositive women. Methods Samples from 160 HCMV-seropositive women were collected at three timepoints during pregnancy and once postpartum. Shedding was determined by detecting HCMV DNA in saliva, urine, and vaginal secretions by quantitative PCR. HCMV-specific T-cell immune responses were determined by detecting interferon-gamma released in blood by QuantiFERON-CMV and T-SPOT.CMV assays. Information on demographics and contact with children’s bodily fluids was collected. Results The prevalence of HCMV shedding in HCMV-seropositive women in any bodily fluids was 18.8% [95% CI: 13.0-25.7%] during pregnancy and 21.3% [95% CI: 15.2-28.4%] including postpartum. Ethnicity [OR 0.2, 95% CI: 0.05-0.95, p=.043] and gravidity [OR 0.2, 95% CI: 0.05-0.94, p=.042] were associated with detection of shedding. Shedding quantity was associated with contact with children’s saliva [Incidence rate ratio 1.98, 95% CI: 1.69-2.33, p<.001]. The prevalence of T-cell immune responses was ≤75% and almost 100% using QuantiFERON-CMV and T-SPOT.CMV, respectively. T-cell immune responses did not correlate with shedding. Conclusions Around 1 in 5 HCMV-seropositive women shed HCMV during pregnancy and postpartum. Ethnicity and gravidity are associated with shedding, but not T-cell immune responses, and the quantity of shedding is associated with contact with saliva. Further studies investigating HCMV shedding, immune responses and their risk factors in women during pregnancy and postpartum are warranted.
{"title":"Human cytomegalovirus shedding and T-cell immune responses in HCMV-seropositive women during pregnancy and postpartum: prevalence, natural history, and risk factors","authors":"Shari Sapuan, Ngee Keong Tan, David Carrington, Vanessa Greening, Christine E Jones, Asma Khalil, Cassie F Pope, Blair L Strang, Sarah White, Paul T Heath","doi":"10.1093/cid/ciag076","DOIUrl":"https://doi.org/10.1093/cid/ciag076","url":null,"abstract":"Background Human cytomegalovirus (HCMV) during pregnancy and poor immune control of HCMV are associated with adverse outcomes. Limited data exist on the prevalence, natural history, and risk factors of HCMV shedding and T-cell immune responses during pregnancy and postpartum in HCMV-seropositive women. Methods Samples from 160 HCMV-seropositive women were collected at three timepoints during pregnancy and once postpartum. Shedding was determined by detecting HCMV DNA in saliva, urine, and vaginal secretions by quantitative PCR. HCMV-specific T-cell immune responses were determined by detecting interferon-gamma released in blood by QuantiFERON-CMV and T-SPOT.CMV assays. Information on demographics and contact with children’s bodily fluids was collected. Results The prevalence of HCMV shedding in HCMV-seropositive women in any bodily fluids was 18.8% [95% CI: 13.0-25.7%] during pregnancy and 21.3% [95% CI: 15.2-28.4%] including postpartum. Ethnicity [OR 0.2, 95% CI: 0.05-0.95, p=.043] and gravidity [OR 0.2, 95% CI: 0.05-0.94, p=.042] were associated with detection of shedding. Shedding quantity was associated with contact with children’s saliva [Incidence rate ratio 1.98, 95% CI: 1.69-2.33, p&lt;.001]. The prevalence of T-cell immune responses was ≤75% and almost 100% using QuantiFERON-CMV and T-SPOT.CMV, respectively. T-cell immune responses did not correlate with shedding. Conclusions Around 1 in 5 HCMV-seropositive women shed HCMV during pregnancy and postpartum. Ethnicity and gravidity are associated with shedding, but not T-cell immune responses, and the quantity of shedding is associated with contact with saliva. Further studies investigating HCMV shedding, immune responses and their risk factors in women during pregnancy and postpartum are warranted.","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":"9 1","pages":""},"PeriodicalIF":11.8,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146205113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"2025 Content Collections from the IDSA Journals.","authors":"Roger Bedimo, Paul E Sax, Cynthia L Sears","doi":"10.1093/cid/ciag041","DOIUrl":"https://doi.org/10.1093/cid/ciag041","url":null,"abstract":"","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":7.3,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146197434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yann Ruffieux, John Andoh, Andreas D Haas, Chido Chinogurei, Katayoun Taghavi, Cari van Schalkwyk, Matthias Egger, Naomi Folb, Gary Maartens, Eliane Rohner
Background Women with HIV (WWH) have a higher cervical cancer risk than women without HIV. The timing and extent to which HIV viremia and immunodeficiency contribute to cervical carcinogenesis remain incompletely understood. Methods We conducted a cohort study using medical claims data from a South African HIV programme (2011–2022) and calculated incidence rates of cervical precancer and cancer. Cox proportional hazards models assessed associations with CD4 cell count and HIV RNA viral load (VL). We tested summary and point-in-time CD4 and VL measures with 6–36 months lag periods. Models were adjusted for age, calendar year, and antiretroviral therapy (ART) initiation; fully adjusted models included both CD4 count and VL. Results Over 66,000 WWH contributed more than 300,000 person-years; 1,202 WWH developed moderate dysplasia (incidence rate: 394/100,000 person-years), 1,237 severe dysplasia (404/100,000 person-years), 211 carcinoma in situ (66/100,000 person-years), and 257 cervical cancer (70/100,000 person-years). Lower CD4 cell counts were strongly associated with higher rates of cervical dysplasia, carcinoma in situ, and cancer, independent of VL. Lowest CD4 count over 30-months was the most informative measure for precancer, while CD4 count lagged by 24 months was most informative for cervical cancer. Higher VL was associated with increased risk of precancer and cancer in models unadjusted for CD4 count, with associations attenuated after adjustment. Conclusions Maintaining high CD4 counts and achieving viral suppression through early ART initiation, along with using CD4 cell count for risk stratification in cervical screening, may help improve cervical cancer prevention among WWH in South Africa.
{"title":"Association of Immunodeficiency and HIV Viremia with Cervical Precancer and Cancer Risk among Women with HIV in South Africa","authors":"Yann Ruffieux, John Andoh, Andreas D Haas, Chido Chinogurei, Katayoun Taghavi, Cari van Schalkwyk, Matthias Egger, Naomi Folb, Gary Maartens, Eliane Rohner","doi":"10.1093/cid/ciag093","DOIUrl":"https://doi.org/10.1093/cid/ciag093","url":null,"abstract":"Background Women with HIV (WWH) have a higher cervical cancer risk than women without HIV. The timing and extent to which HIV viremia and immunodeficiency contribute to cervical carcinogenesis remain incompletely understood. Methods We conducted a cohort study using medical claims data from a South African HIV programme (2011–2022) and calculated incidence rates of cervical precancer and cancer. Cox proportional hazards models assessed associations with CD4 cell count and HIV RNA viral load (VL). We tested summary and point-in-time CD4 and VL measures with 6–36 months lag periods. Models were adjusted for age, calendar year, and antiretroviral therapy (ART) initiation; fully adjusted models included both CD4 count and VL. Results Over 66,000 WWH contributed more than 300,000 person-years; 1,202 WWH developed moderate dysplasia (incidence rate: 394/100,000 person-years), 1,237 severe dysplasia (404/100,000 person-years), 211 carcinoma in situ (66/100,000 person-years), and 257 cervical cancer (70/100,000 person-years). Lower CD4 cell counts were strongly associated with higher rates of cervical dysplasia, carcinoma in situ, and cancer, independent of VL. Lowest CD4 count over 30-months was the most informative measure for precancer, while CD4 count lagged by 24 months was most informative for cervical cancer. Higher VL was associated with increased risk of precancer and cancer in models unadjusted for CD4 count, with associations attenuated after adjustment. Conclusions Maintaining high CD4 counts and achieving viral suppression through early ART initiation, along with using CD4 cell count for risk stratification in cervical screening, may help improve cervical cancer prevention among WWH in South Africa.","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":"201 1","pages":""},"PeriodicalIF":11.8,"publicationDate":"2026-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146184275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dewan Md Sumsuzzman, Congjie Shi, Seyed M Moghadas
Background Respiratory syncytial virus (RSV) vaccines were first recommended for older adults during the 2023-24 season in countries that authorised their use. Although early observational studies complemented trial findings, real-world evidence on vaccine effectiveness against severe RSV disease remains limited. We assessed the effectiveness of RSVpreF and RSVpreF3 vaccines in preventing RSV-related hospitalisations and emergency department (ED) visits among older adults. Methods We searched MEDLINE, Embase, Web of Science, Scopus, Global Health, and medRxiv for observational studies published between January 1, 2023 and December 30, 2025, reporting real-world effectiveness of RSV vaccines in adults aged 60 years or older. Pooled analyses used inverse-variance random-effects models to estimate effectiveness against RSV-related hospitalisations and ED visits. Subgroup analyses assessed differences in effectiveness by age, immune status, and vaccine type. This study is registered with PROSPERO (CRD420251021777). Results From 4925 records screened, 8 cohort and case-control studies were included. Vaccination was associated with lower odds of RSV-related hospitalisation (odds ratio [OR]: 0.23; 95% Confidence Interval [CI]: 0.20–0.27; I²=6.5%) and ED visits (OR: 0.23; 95% CI: 0.21–0.27; I²=0.0%). Effectiveness against RSV-related hospitalisation was lower in immunocompromised adults (OR: 0.31; 95% CI: 0.27–0.34; I²=0.0%) than in immunocompetent individuals (OR: 0.20; 95% CI: 0.11–0.35; I²=0.0%). Effectiveness did not differ by age group (60–74 vs ≥75 years) or vaccine product. Conclusions Vaccination provided substantial protection against RSV-related healthcare utilisation among older adults. Continued surveillance and real-world evidence are needed to inform immunisation policy and improve protection in immunocompromised individuals.
{"title":"Real-World Effectiveness of RSVpreF and RSVpreF3 Vaccines in Preventing Hospitalisation and Emergency Department Visits Associated with Respiratory Syncytial Virus in Older Adults: A Meta-Analysis","authors":"Dewan Md Sumsuzzman, Congjie Shi, Seyed M Moghadas","doi":"10.1093/cid/ciag107","DOIUrl":"https://doi.org/10.1093/cid/ciag107","url":null,"abstract":"Background Respiratory syncytial virus (RSV) vaccines were first recommended for older adults during the 2023-24 season in countries that authorised their use. Although early observational studies complemented trial findings, real-world evidence on vaccine effectiveness against severe RSV disease remains limited. We assessed the effectiveness of RSVpreF and RSVpreF3 vaccines in preventing RSV-related hospitalisations and emergency department (ED) visits among older adults. Methods We searched MEDLINE, Embase, Web of Science, Scopus, Global Health, and medRxiv for observational studies published between January 1, 2023 and December 30, 2025, reporting real-world effectiveness of RSV vaccines in adults aged 60 years or older. Pooled analyses used inverse-variance random-effects models to estimate effectiveness against RSV-related hospitalisations and ED visits. Subgroup analyses assessed differences in effectiveness by age, immune status, and vaccine type. This study is registered with PROSPERO (CRD420251021777). Results From 4925 records screened, 8 cohort and case-control studies were included. Vaccination was associated with lower odds of RSV-related hospitalisation (odds ratio [OR]: 0.23; 95% Confidence Interval [CI]: 0.20–0.27; I²=6.5%) and ED visits (OR: 0.23; 95% CI: 0.21–0.27; I²=0.0%). Effectiveness against RSV-related hospitalisation was lower in immunocompromised adults (OR: 0.31; 95% CI: 0.27–0.34; I²=0.0%) than in immunocompetent individuals (OR: 0.20; 95% CI: 0.11–0.35; I²=0.0%). Effectiveness did not differ by age group (60–74 vs ≥75 years) or vaccine product. Conclusions Vaccination provided substantial protection against RSV-related healthcare utilisation among older adults. Continued surveillance and real-world evidence are needed to inform immunisation policy and improve protection in immunocompromised individuals.","PeriodicalId":10463,"journal":{"name":"Clinical Infectious Diseases","volume":"199 1","pages":""},"PeriodicalIF":11.8,"publicationDate":"2026-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146209968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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