European Journal of Clinical Microbiology & Infectious Diseases最新文献

Oritavancin is a long-acting lipoglycopeptide with excellent bone penetration and activity against biofilm-embedded bacteria, making it a promising candidate for the treatment of bone and joint infections (BJIs). To explore its potential in this clinical context, we assessed the in vitro activity of oritavancin in comparison with other glyco-, lipo- and glycolipo-peptides against a panel of 148 multidrug-resistant staphylococcal clinical isolates, mainly collected from BJI cases. Although oritavancin showed lower overall activity than dalbavancin, resistance to oritavancin could not be reliably inferred from the activity of related antibiotics. This lack of cross-resistance highlights the need for dedicated phenotypic susceptibility testing prior to clinical use.

Background: The escalating prevalence of macrolide-resistant Mycoplasma pneumoniae (MRMP) in China has posed substantial challenges for pediatricians managing mycoplasma pneumoniae pneumonia (MPP). This study aimed to compare the clinical efficacy and prognostic outcomes between two treatment strategies for pediatric patients with macrolide-unresponsive mycoplasma pneumoniae pneumonia (MUMPP) following initial 72-hour intravenous azithromycin therapy: (1) continuation of intravenous azithromycin combined with methylprednisolone, versus (2) switch to oral doxycycline monotherapy.

Methods: We performed a retrospective analysis of children hospitalized for MPP at our institution between November 2023 and October 2024. Children with MPP who showed no clinical response to an initial 72-hour course of intravenous azithromycin were assigned to two groups: (1) intravenous azithromycin combined with methylprednisolone (AZM + methylprednisolone group), and (2) doxycycline monotherapy (DXC group). Clinical efficacy and prognosis were compared between groups using 1:1 propensity score matching (PSM) to adjust for baseline confounding, followed by calculation of statistical power for the primary outcomes.

Results: A total of 1,112 children with MPP were screened, of whom 493 (44.33%) met the criteria for MUMPP, and 382 were included in the final analysis. The DXC group showed a significantly higher rate of pulmonary imaging improvement at discharge compared to the AZM + methylprednisolone group (94.29%vs.77.14%, P < 0.05). No significant intergroup differences were observed in the time to fever resolution or cough relief (P > 0.05). The AZM + methylprednisolone group had a significantly longer hospital stay than the DXC group [8 (7, 9) days vs. 6 (5, 7) days, P < 0.05]. Additionally, the refractory rate was higher in the AZM + methylprednisolone group (14.29% vs. 4.29%, P < 0.05). At 3-month follow-up, the incidence of new infections or diseases was significantly higher in the AZM + methylprednisolone group (32.86% vs. 4.29%, P < 0.05), whereas no significant difference was found in the complete imaging absorption rate between groups within 3 months (98.57% vs. 94.29%,P > 0.05). Notably, no cases of tooth discoloration-related adverse reactions were observed in the DXC group.

Conclusion: For pediatric cases of MUMPP, doxycycline yields superior efficacy over the combination regimen of azithromycin plus methylprednisolone in improving radiological findings at discharge, shortening hospital stays, reducing the rate of refractory disease, and lowering the incidence of post-discharge recurrent infection or disease exacerbation.

Non-typhoidal Salmonella (NTS) usually causes self-limiting gastroenteritis, but can lead to severe invasive infections, such as mycotic pseudoaneurysms, in immunocompromised patients. Here, we present the case of a 62-year-old male with NTS bacteraemia, which was complicated by an iliac artery mycotic pseudoaneurysm. The patient underwent successful endovascular management with a balloon-expandable graft stent, followed by targeted antimicrobial therapy against Salmonella enterica serotype Enteritidis. The patient achieved favourable clinical and radiological outcomes. This case highlights the importance of early recognition and demonstrates the effectiveness of endovascular stent-grafting as an alternative to open surgery for treating infected vascular lesions caused by NTS.

Objective: Severe Fever with Thrombocytopenia Syndrome (SFTS), an emerging infectious disease of essential public health concern, currently lacks specific antiviral treatments, This study evaluated the efficacy of the broad-spectrum antiviral drug T-705 (Favipiravir).

Methods: Using propensity score matching (PSM) to minimize confounding factors between T-705 and Non-T-705 groups, Absolute Shrinkage and Selection Operator (LASSO) regression and multivariate logistic regression were used to screen the factors affecting the efficacy of T-705.

Results: Analysis revealed a consistently higher disease improvement rate in the T-705 group (82.3% Pre-PSM, 80.6% Post-PSM) compared to Non-T-705 group (67.3%), with the difference remaining statistically significant (P = 0.032) after PSM. The results demonstrated that Ct values (1.397, 1.168-1.671, P < 0.001), lactate dehydrogenase (LDH) (1.002, 1.001-1.003, P = 0.027) and albumin (ALB) (1.153, 1.001-1.330, P = 0.050) levels were the protective factor for disease improvement, while clinical type (0.146, 0.045-0.477, P = 0.001), age (0.942, 0.893-0.994, P = 0.030), activated partial thromboplastin time (APTT) (0.917, 0.873-0.963, P < 0.001), total bilirubin (TBIL) (0.867, 0.752-0.999, P= 0.048), creatinine (CREA) (0.992, 0.985-0.999, P = 0.038) and uric acid (UA) (0.994, 0.990-0.999, P = 0.017) levels were risk factors for disease improvement.

Conclusions: The study demonstrated that T-705 exhibited significant efficacy and favorable safety in the treatment of SFTS patients. Furthermore, a multivariate logistic regression verified its clinical significance, thereby providing robust evidence to support its inclusion in treatment guidelines.

We report a rare case of hospital-acquired meningitis caused by pandrug-resistant Chryseobacterium gleum, which presumed susceptibility to linezolid (inhibition zone, 22 mm). Treatment with ciprofloxacin and piperacillin-tazobactam failed, but adding linezolid led to recovery. This case suggests that linezolid may represent a potential adjunctive option for pandrug-resistant C. gleum meningitis.

Autochthonous human dirofilariasis cases have increased in Europe for the last few decades probably due to climate change, including increased temperature and a greater distribution of the biological vector. Dirofilariasis can present in different ways depending on the species, leading clinicians to incorrect diagnoses. Here we present a case of a 75-year-old man from Italy with no travel history presenting with a of subconjunctival nodule caused by Dirofilaria repens. We review European cases of the last ten years including 17 cases of subconjunctival dirofilariasis. In severe cases, the definitive diagnosis was reached late after initial erroneous hypotheses such as conjunctivitis or scleritis. In almost all cases the responsible agent was D. repens and only in one case D. immitis. We underline the importance of considering dirofilariasis as a possible diagnosis even in temperate regions. The One Health approach is increasingly necessary to manage the spread of dirofilariasis as well as other zoonoses.

Purpose: Artificial Intelligence (AI) and Machine Learning (ML) are innovative technologies, gathering particular interest in all laboratory settings. The aim of this study was to assess the current state of AI and ML adoption in Italian laboratories of clinical microbiology.

Methods: A structured 63-question survey was developed by the AI/ML in Microbiology Study Group and distributed to all members of the Italian Association of Clinical Microbiologists between December 2024 and March 2025. Responses were collected anonymously and analyzed using descriptive statistics analysis.

Results: A total of 163 professionals completed the survey. While 25.4% reported current AI/ML usage-primarily in bacteriology and virology-the majority had limited experience with AI technologies. Only 13.6% of respondents had a good understanding of AI/ML concepts, and 2.5% reported having trained data scientists on staff. Major barriers included lack of trained personnel and insufficient infrastructure. Most participants (99.0%) expressed interest in targeted AI training, and 57.5% showed willingness to collaborate on AI-related initiatives. Large language models (LLMs) were seen as promising, especially for data interpretation, despite low adoption rates.

Conclusion: The survey might provide valuable insights to identify priority areas for intervention, guide future training initiatives and develop targeted strategies to promote the adoption of these technologies through a fruitful dialogue with companies and IT professionals.

Purpose: Although respiratory syncytial virus (RSV) infection in adults is considered as an important health issue, the characteristics and outcomes of hospitalized adults with RSV infection remains limited. We conducted a retrospective study on adult inpatients with RSV infection to explore the clinical characteristics and effects of RSV infection in different age groups, trying to find out the above characteristics of elderly patients, guide the early clinical diagnosis and treatment of RSV infection and improve the clinical outcomes in this population.

Methods: Base on the retrospective enrollment of RSV infection patients hospitalized in Tianjin Chest Hospital, compare the clinical characteristics, treatments and outcomes of different groups according to age. Binary logistic regression model was used to analyze the factors associated with the in-hospital mortality.

Results: Compared with the non-elderly group, the elderly group had a higher proportion of fungal infections, common symptoms of cough, higher rate of receiving steroids and invasive ventilation, higher hospitalization expenses and in-hospital mortality. Over 70 years old (OR 5.555 [95% CI, 1.311-23.542], P = 0.020) and bacterial co-infection (OR 3.789 [95% CI, 1.107-12.971], P = 0.034) were factors affecting the in-hospital mortality of patients with RSV infection.

Conclusion: The morbidity and mortality of RSV infection in adults should not be ignored, especially in elderly patients with high in-hospital mortality. Management and preventive strategies of RSV infection in these vulnerable groups is necessary.