European Journal of Clinical Microbiology & Infectious Diseases最新文献

Purpose: Infective endocarditis (IE) requires prolonged intravenous antibiotic therapy, leading to extended hospitalization and increased morbidity. Dalbavancin, a long-acting antibiotic with excellent tissue penetration and a favorable safety profile, can be a promising alternative. This systematic review aimed to investigate the current literature regarding the use of dalbavancin for infective endocarditis.

Methods: A systematic search of PubMed and Scopus was conducted according to PRISMA guidelines. Eligible studies included adult patients (≥ 18 years) with IE diagnosed by the modified Duke criteria, treated with dalbavancin as monotherapy or sequential/consolidation therapy. Data extraction included demographics, type of IE, causative pathogen, dosing regimen, surgical intervention, adverse events, and outcomes. Descriptive analyses were performed.

Results: Thirty-eight studies including 565 patients were analyzed. The overall cure rate was 88.0%, with a similar success rate across native valve (90.1%), prosthetic valve (90.0%), and cardiac device-related IE (86.0%). Staphylococcus aureus, Coagulase-negative staphylococci (CNS), Streptococcus spp., and Enterococcus faecalis were the most common pathogens. Cure rates were comparable among most pathogens, though a lower cure rate was evident in infections due to Enterococcus faecalis compared to Streptococcus spp. (80.7% vs. 96.6%, p = 0.008). An effective antimicrobial exposure of 2 weeks had similar success rate compared to a longer period of effective antimicrobial exposure (p = 0.31). Adverse events were rare (2.9%), with mild rash being the most common.

Conclusions: Dalbavancin demonstrates high cure rates and excellent tolerability in IE, and could offer an attractive alternative to conventional prolonged intravenous therapy. Further randomized controlled trials are warranted to define standardized protocols.

Purpose: In June 2024, a genomic cluster of seven Salmonella Typhimurium - sequence type 19, and cluster type 21092 - was detected in Norway, triggering a national outbreak investigation.

Methods: Information about new cases was collected from the Norwegian Surveillance System for Communicable Diseases and the database at the National Reference Laboratory for Enteropathogenic Bacteria (NRL) at the Norwegian Institute of Public Health (NIPH). Microbiological analyses were conducted by NRL at NIPH for human samples and at the Norwegian Veterinary Institute for animal samples. Epidemiological data was collected through interviews. International notification was sent via EpiPulse.

Results: Eleven cases in total, sampled between March 6 and July 11, 2024, were identified across Norway. The median age of affected individuals was three years. Notably, 73% of the cases reported prior contact with cats or passerine birds. The outbreak strain was also detected in a faecal sample from a cat belonging to one of the affected households, suggesting an animal source. Concurrently, Finland and Sweden reported five and six cases, respectively, involving the same outbreak strain. Several of these individuals also reported contact with cats or birds.

Conclusions: Passerine birds are a well-documented reservoir for S. Typhimurium in the Nordic region, often leading to transmission to both cats and humans. This outbreak highlights the role of animal exposure in the spread of S. Typhimurium and emphasize the need for timely, targeted public health communication on infection prevention measures.

Introduction: Pneumococcal conjugate vaccines (PCVs) were implemented in the childhood vaccination program of the Community of Madrid (CM) in 2007, but despite very high vaccination coverage since then, increasing trends in invasive pneumococcal disease (IPD) have been observed in recent years.

Methods: Epidemiological, clinical, and microbiological data from the Notifiable Disease Surveillance System on IPD cases in children aged 0-17 years in the CM during the period 2007-2024 were analysed. A descriptive analysis was conducted by sex, age-group, clinical presentation, laboratory results, prior vaccination, and antibiotic resistance. Incidence rates (IRs) and IR ratios (IRRs) were calculated overall and by serotypes (STs) covered by each vaccine and the most relevant STs using 2015-2019 as reference period.

Results: Between 2007 and 2024, 1,856 cases of IPD were notified: 1,052 (56.7%) in boys and 804 (43.3%) in girls. By age-group, there were 431 cases (23.2%) in < 1 year, 994 (53.6%) in those aged 1-4 years, and 431 (23.2%) in those aged 5-17 years. PCV7, PCV13, PCV15, and PCV20 vaccine included STs IRs increased 7.0, 2.9, 2.3, and 1.5 times, respectively (all P < 0.05), in 2024. STs 24A, 14, 15A, 10A, and 3 IRs also increased (IRRs: 30.5, 17.8, 2.8, 2.7, and 2.6, respectively; all P < 0.05). No strains of the STs 1, 5, or 7F were detected in 2024, and STs 19A decreased to 2.2%.

Conclusions: IRs for children and adolescents increased between 2022 and 2024 in the CM, associated to the rise of some PCVs STs, as ST14, while the still persistent ST3 started to decline after 2022.

Purpose: Furazidin is a nitrofuran derivative used in Eastern Europe (e.g., Latvia, Lithuania and Poland) and Russia for treating uncomplicated urinary tract infections (UTI), while nitrofurantoin, another nitrofuran, is a widely used for this indication. This study (23-ADA-01) evaluated the activity of furazidin, nitrofurantoin, and fosfomycin against bacterial isolates collected between 2020 and 2022 from female UTI patients in 19 European and the Mediterranean countries.

Methods: A total of 3,111 isolates were tested for susceptibility to furazidin, nitrofurantoin and fosfomycin using broth microdilution or agar dilution at a monitoring laboratory (JMI Laboratories, North Liberty, Iowa, USA). Minimum inhibitory concentration (MIC) results for antimicrobial agents commonly used to treat UTI, that were previously evaluated as part of the SENTRY Antimicrobial Surveillance Program, were added to the study for evaluation of cross-resistance. Additionally, minimum bactericidal concentration (MBC) testing was performed for 212 isolates.

Results: Furazidin demonstrated high in vitro activity, especially against Escherichia coli (n = 1,758; MIC_50/90, 4/8 mg/L; 99.0% inhibited at ≤ 32 mg/L), Staphylococcus saprophyticus (n = 168; MIC_50/90, 2/2 mg/L; highest MIC 2 mg/L) and Enterococcus faecalis (n = 156; MIC_50/90, 1/2 mg/L; highest MIC 16 mg/L). It was also effective against other pathogens such as Klebsiella pneumoniae, Citrobacter freundii, Citrobacter koseri, Enterobacter cloacae, Staphylococcus aureus, Streptococcus agalactiae and Entercococcus faecium. Furazidin was fourfold more potent than nitrofurantoin against Enterobacterales and four- to eightfold more active against Gram-positive organisms. The MBC: MIC ratio for furazidin was ≤ 8 for all isolates tested, with 85.8% showing this ratio ≤ 2. Furazidin's activity against E. coli was consistent across the European countries, with MIC₅₀ and MIC mode values of 4 mg/L. Isolates with higher furazidin MIC values also exhibited higher nitrofurantoin MIC values. Furazidin retained good activity against E. coli isolates resistant to fosfomycin or trimethoprim-sulfamethoxazole.

Conclusion: Our study demonstrates that furazidin exhibits potent in vitro activity against a broad spectrum of organisms responsible for UTIs. These data support furazidin as an effective alternative for treatment of UTIs.

We report a never seen before upsurge of Chlamydia pneumoniae (Cp) respiratory tract infections in 2024/25 in southern Germany. Regarding 43,558 Cp PCR tests analyzed, the positivity rate increased from 0.3% in 2015-2020 to 2.6% in 2024, and 2.4% in 2025 until August 2025, peaking at ≥ 6.0% with > 100 monthly cases in October and November 2024. Children aged 6-14 years were predominantly affected, and co-infections with other pathogens were frequently detected. We aim at raising awareness concerning Cp infections.

Stenotrophomonas maltophilia (S. maltophilia), is a low virulence opportunistic pathogen intrinsically resistant to a wide range of antibiotics with several virulence factors and is increasingly found in hospital and community settings, the organism is increasingly associated with biofilm infections in diabetic foot ulcers. With limited options, a novel treatment strategy is required, and the use of lytic phages presents a promising alternative. In this study, lytic phage vB_SmaS_BCU-1 was isolated from soil and propagated with a clinical S. maltophilia strain, isolated from a diabetic foot ulcer. Morphology characterisation and genomic analysis revealed it is a siphophage belonging to the family Casjenviridae, genus Sanovirus. Phage vB_SmaS_BCU-1 is a dsDNA virus consisting of 57,752 bp containing 75 open reading frames, with no virulence or antibiotic resistance genes found. vB_SmaS_BCU-1 was stable at a range of temperatures (4-55 °C) & pH values (4-12), has a short latent period (30 min), a large burst size (150 PFU/cell) and efficient adsorption. The phage demonstrated lysis of planktonic cells and can significantly reduce biofilm biomass. In a human fibroblast co-culture model, the phage exhibited no cytotoxicity, protected cells from bacterial-induced damage and significantly reduced the bacterial load.

Purpose: The DANFLU-1 trial suggested lower incidence of hospitalizations for pneumonia and influenza, respiratory disease and all-cause mortality among older adults receiving high-dose (HD-IV) versus standard-dose (SD-IV) influenza vaccine. This study assessed the relative effectiveness of HD-IV versus SD-IV according to comorbidity in elderly individuals.

Methods: This was a post-hoc analysis of the DANFLU-1 randomized controlled feasibility trial of HD-IV versus SD-IV conducted during the 2021-2022 influenza season in adults aged 65-79 years. Outcomes assessed included influenza-related, respiratory, and cardiovascular hospitalizations, and mortality. We tested for effect modification by level of the Charlson Comorbidity Index (CCI) using ICD-10 codes up to 10 years prior to randomization.

Results: Of the 12,477 randomly assigned participants (mean age 71.7 ± 3.9 years, 47.1% female), 8,020 (64.3%) had CCI = 0, 3,560 (28.5%) had CCI = 1-2 and 893 (7.2%) had CCI ≥ 3. When comparing HD-IV with SD-IV, hazard ratios of hospitalizations for pneumonia and influenza were similar across CCI groups (HR [95%CI]: 0.15 [0.03-0.68] for CCI = 0, 0.36 [0.11-1.15] for CCI = 1-2, 1.00 [0.25-4.00] for CCI ≥ 3). Comparable patterns were found for hospitalizations for respiratory disease (0.46 [0.17-1.20] for CCI = 0, 0.67 [0.32-1.39] for CCI = 1-2, 0.66 [0.24-1.87] for CCI ≥ 3) and all-cause mortality (0.28 [0.09-0.86] for CCI = 0, 0.70 [0.30-1.63] for CCI = 1-2, 0.57 [0.24-1.36] for CCI ≥ 3). There was no statistical evidence of effect modification by CCI for any outcome.

Conclusions: The lower incidences of clinical outcomes for HD-IV compared to SD-IV were not significantly modified by CCI. The potential benefit of HD-IV versus SD-IV may therefore be applicable regardless of comorbidity burden. Further research is required to confirm these findings.

Purpose: This study characterized Salmonella bacteriophage SGP007 to assess its potential as a safe and effective biocontrol or therapeutic agent against pathogenic Salmonella.

Results: Transmission electron microscopy revealed Podoviridae family traits, including an icosahedral head and short, non-contractile tail. Whole-genome sequencing identified a 43,156-base-pair, double-stranded DNA genome with 50.2% G + C content, consistent with Jerseyviruses targeting Salmonella enterica subsp. enterica serovar Gallinarum. Bioinformatic analysis annotated 58 open reading frames, encompassing DNA replication (helicase, methyltransferase), structural assembly (portal, capsid, tail), and host lysis (holin, spanin, endolysin) modules. A single tRNA-Ser-UGA gene was detected, with codon bias compatible with Salmonella's translational system. Critically, the genome lacked lysogenic, virulence, antimicrobial resistance, or toxin-related sequences, confirming its safety. Computational tools (PHASTER, PHACTS, PhageAI) verified an obligately lytic lifecycle. Phylogenetic analysis of the large terminase subunit and genome-wide comparisons (VICTOR, VIPTree) positioned SGP007 within a distinct Jerseyvirus subclade, closely related to Salmonella-specific phages SETP7 and BPS11Q3. VIRFAM classification assigned it to Neck Type 1 - Cluster 3, reflecting its streamlined morphology. The infection cycle follows a typical lytic pathway: receptor binding, DNA ejection, gene expression, replication, virion assembly, and lytic release.

Conclusion: This genomic evidence showed that SGP007 was virulent lytic phage, optimized for rapid replication and host lysis without genomic integration.