Infectious diseases now最新文献

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Toward an optimization of empirical antibiotic therapy in acute graft pyelonephritis: A retrospective multicenter study 优化急性移植肾盂肾炎的经验性抗生素治疗：一项回顾性多中心研究。

IF 3.5 4区医学 Q2 Medicine

Infectious diseases now

Pub Date : 2024-05-14 DOI: 10.1016/j.idnow.2024.104922

Pauline Martinet , Luca Lanfranco , Anne Coste , Didier Tandé , Pierre Danneels , Léa Picard , Clément Danthu , Simon Jamard , Benjamin Gaborit , Jean-François Faucher , Jean-Philippe Talarmin , Yannick Le Meur , Truong An Nguyen , Christophe Masset , Clarisse Kerleau , Séverine Ansart , Schéhérazade Rezig , on behalf of the EPAGGO study group

Objective

Acute graft pyelonephritis (AGPN) is the most frequent infectious complication in kidney transplant recipients (KTR). The treatment of acute community-acquired (CA) pyelonephritis is based on third-generation cephalosporins (3GC) and fluoroquinolones. Cefepime or a piperacillin-tazobactam combination are more often used in healthcare-associated (HCA) infections. However, these recommendations do not consider the resistance observed in KTRs. The objective of our study was to define the most appropriate empirical antibiotherapy for AGPN in KTRs according to the CA and HCA settings. To answer this question, we assessed the prevalence of resistance to different antibiotics usually recommended for urinary tract infections (UTIs) in the general population.

Methods

Observational, retrospective, multicenter study covering all episodes of AGPN occurring in hospitalized KTRs in 2019.

Results

A total of 210 patients were included in 7 centers and 244 episodes of AGPN were analyzed (158 CA-AGPN and 86 HCA-AGPN). The prevalence of 3GC and fluoroquinolone resistance was 23 % (n = 36) and 30 % (n = 50) in CA infections (n = 158), and 47 % (n = 40) and 31 % (n = 27) in HCA infections (n = 86), respectively. Cefepime resistance rate was 19 % (n = 30) in CA-AGPN and 29 % (n = 25) in HCA-AGPN. Piperacillin-tazobactam combination had resistance rates > 15 % in both CA and HCA infections. The only antimicrobials with resistance rates < 10 % were aminoglycosides and carbapenems.

Conclusion

None of the antibiotics recommended in empirical treatment in UTIs has shown a resistance rate of less than 10% with regard to AGPN. Therefore, none of them should be used as monotherapy. A combination therapy including amikacin could be an appropriate strategy in this setting.

目的：急性移植物肾盂肾炎（AGPN）是肾移植受者（KTR）最常见的感染性并发症。急性社区获得性（CA）肾盂肾炎的治疗以第三代头孢菌素（3GC）和氟喹诺酮类药物为主。头孢吡肟或哌拉西林-他唑巴坦复方制剂更常用于医护人员相关性（HCA）感染。然而，这些建议并未考虑在 KTR 中观察到的耐药性。我们研究的目的是根据 CA 和 HCA 环境，确定最适合 KTR AGPN 的经验性抗生素疗法。为了回答这个问题，我们评估了普通人群中对通常推荐用于尿路感染（UTI）的不同抗生素的耐药性发生率：观察性、回顾性、多中心研究，涵盖 2019 年 KTR 住院患者中发生的所有 AGPN 病例：7个中心共纳入210名患者，分析了244例AGPN（158例CA-AGPN和86例HCA-AGPN）。在CA感染（158例）中，3GC和氟喹诺酮耐药率分别为23%（36例）和30%（50例）；在HCA感染（86例）中，3GC和氟喹诺酮耐药率分别为47%（40例）和31%（27例）。头孢吡肟耐药率在 CA-AGPN 中为 19%（n = 30），在 HCA-AGPN 中为 29%（n = 25）。在 CA 和 HCA 感染中，哌拉西林-他唑巴坦联合用药的耐药率均大于 15%。耐药率高于 15% 的抗菌药物只有哌拉西林-他唑巴坦：推荐用于UTI 经验性治疗的抗生素中，没有一种对 AGPN 的耐药率低于 10%。因此，任何一种抗生素都不应作为单一疗法使用。在这种情况下，包括阿米卡星在内的联合疗法可能是一种合适的策略。

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引用次数: 0

External validation of two clinical prediction models for mortality in COVID-19 patients (4C and NEWS2), in three centers in Medellín, Colombia: Assessing the impact of vaccination over time 在哥伦比亚麦德林的三个中心，对 COVID-19 患者死亡率的两个临床预测模型（4C 和 NEWS2）进行外部验证：评估疫苗接种的长期影响

IF 3.5 4区医学 Q2 Medicine

Infectious diseases now

Pub Date : 2024-05-03 DOI: 10.1016/j.idnow.2024.104921

Paola Andrea Gallego Aristizabal , Tania Paola Lujan Chavarría , Sara Isabel Vergara Hernández , Federico Rincón Acosta , María Paula Sánchez Carmona , Paula Andrea Salazar Ospina , Carlos Jose Atencia Florez , Carlos Mario Barros Liñán , Fabián Jaimes

Objectives

External validation of the 4C and NEWS2 scores for the prediction of in-hospital mortality in COVID-19 patients, and evaluation of its operational performance in two time periods: before and after the start of the vaccination program in Colombia.

Methods

Retrospective cohort in three high complexity hospitals in the city of Medellín, Colombia, between June 2020 and April 2022.

Results

The areas under the ROC curve (AUC) for the 4C mortality risk score and the NEWS2 were 0.75 (95% CI 0.73–0.78) and 0.68 (95% CI 0.66–0.71), respectively. For the 4C score, the AUC for the first and second periods was 0.77 (95% CI 0.74–0.80) and 0.75 (95% CI 0.71–0.78); whilst for the NEWS2 score, it was 0.68 (95% CI 0.65–0.71) and 0.69 (95% CI 0.64–0.73). The calibration for both scores was adequate, albeit with reduced performance during the second period.

Conclusions

The 4C mortality risk score proved to be the more adequate predictor of in-hospital mortality in COVID-19 patients in this Latin American population. The operational performance during both time periods remained similar, which shows its utility notwithstanding major changes, including vaccination, as the pandemic evolved.

目的对预测 COVID-19 患者院内死亡率的 4C 和 NEWS2 评分进行外部验证，并评估其在哥伦比亚疫苗接种计划开始之前和之后两个时间段的操作性能。结果 4C死亡率风险评分和NEWS2的ROC曲线下面积（AUC）分别为0.75（95% CI 0.73-0.78）和0.68（95% CI 0.66-0.71）。对于 4C 评分，第一和第二阶段的 AUC 分别为 0.77（95% CI 0.74-0.80）和 0.75（95% CI 0.71-0.78）；而对于 NEWS2 评分，AUC 分别为 0.68（95% CI 0.65-0.71）和 0.69（95% CI 0.64-0.73）。结论在拉丁美洲人群中，4C 死亡率风险评分被证明是预测 COVID-19 患者院内死亡率的更有效指标。两个时间段内的操作性能保持相似，这表明尽管随着大流行病的发展发生了包括疫苗接种在内的重大变化，该评分仍具有实用性。

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引用次数: 0

The increasing healthcare burden of enteric fever in a low-incidence setting 低发病率地区肠热病的医疗负担日益加重。

IF 3.5 4区医学 Q2 Medicine

Infectious diseases now

Pub Date : 2024-04-21 DOI: 10.1016/j.idnow.2024.104919

Seung Y Lee , Annaleise R Howard-Jones , Venkata LN Lavu , Sophie Norton , Vitali Sintchenko , Philip N Britton , Shopna Bag , Ameneh Khatami

Objectives

Enteric fever carries appreciable morbidity in non-endemic settings, particularly in returned travelers. This study aimed to characterize the healthcare burden of enteric fever in a low-incidence setting and to identify risk factors and opportunities for preventative interventions.

Methods

Analysis of a retrospective case series from a tertiary pediatric center (2015–2019), augmented by public health notification and microbiological laboratory data (2018–2019), from Western Sydney, Australia, a region with frequent travel links to South Asia.

Results

Eighty-nine (89) patients were diagnosed with enteric fever, including 43 children with complete demographic and travel data. Enteric fever cases increased over time (by 4.9 % per year) and incidence was three times higher in the pediatric population (<15 years old) compared to adults. Travel to India and visiting friends and relatives (VFR) travel were risk factors. Few children received enteric fever vaccination prior to travel, as pre-travel advice most commonly was not sought.

Conclusions

Children visiting relatives in high-incidence countries are increasingly at risk for enteric fever, particularly when travelling to South Asia. Targeted health advice to travelers visiting friends and relatives is warranted to mitigate the healthcare burden of enteric fever in low-incidence settings.

目的肠热病在非流行病环境中发病率很高，尤其是在回国旅行者中。本研究旨在描述肠热病在低发病率环境中的医疗负担，并确定风险因素和预防干预的机会。方法分析来自澳大利亚西悉尼的一个三级儿科中心的回顾性系列病例（2015-2019 年），并通过公共卫生通知和微生物实验室数据（2018-2019 年）进行补充，西悉尼是一个与南亚有频繁旅行联系的地区。肠热病例随着时间的推移而增加（每年增加 4.9%），儿童（15 岁以下）的发病率是成人的三倍。前往印度和探亲访友（VFR）是风险因素。很少有儿童在旅行前接种肠热病疫苗，因为他们通常没有寻求旅行前建议。结论到高发国家探亲的儿童患肠热病的风险越来越高，尤其是到南亚旅行时。有必要向探亲访友的旅行者提供有针对性的健康建议，以减轻低发病率地区肠热病的医疗负担。

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引用次数: 0

Is there an interest in systematic serum screening for aspergillosis in COVID-19 patients in a medical ward? 在内科病房对 COVID-19 患者进行系统的曲霉菌病血清筛查是否有意义？

IF 3.5 4区医学 Q2 Medicine

Infectious diseases now

Pub Date : 2024-04-16 DOI: 10.1016/j.idnow.2024.104918

Victor Gerber , Louis Boehn , Marcela Sabou , Antoine Studer , Axel Ursenbach , Yves Hansmann , Raoul Herbrecht , Nicolas Lefebvre , Valérie Letscher-Bru , François Danion

Purpose

We evaluated the interest of systematic screening of serum fungal markers in patients hospitalized in a medical ward.

Methods

We retrospectively analyzed all patients hospitalized in our infectious disease department from October 1st to October 31st, 2020 for COVID-19 without prior ICU admission, and for whom systematic screening of serum fungal markers was performed.

Results

Thirty patients were included. The majority of patients received corticosteroids (96.7%). The galactomannan antigen assay was positive for 1/30 patients at D0, and 0/24, 0/16, 0/13 and 0/2 at D4, D7, D10 and D14 respectively. 1,3-ß-D-glucan was positive for 0/30, 1/24, 1/12, 0/12, 0/2 at D0, D4, D7, D10 and D14 respectively. No Aspergillus fumigatus PCR was positive. No cases of aspergillosis were retained.

Conclusion

Our study does not support the interest of systematic screening of fungal markers in immunocompetent patients with COVID-19 in a conventional unit.

方法我们回顾性分析了 2020 年 10 月 1 日至 10 月 31 日期间因 COVID-19 在我院感染性疾病科住院的所有患者，这些患者事先未入住 ICU，并对其进行了血清真菌标志物系统筛查。大多数患者接受了皮质类固醇治疗（96.7%）。半乳甘露聚糖抗原检测在 D0 时有 1/30 患者呈阳性，在 D4、D7、D10 和 D14 时分别为 0/24、0/16、0/13 和 0/2。1,3-ß-D-葡聚糖在 D0、D4、D7、D10 和 D14 时分别有 0/30、1/24、1/12、0/12 和 0/2 呈阳性。没有曲霉菌 PCR 呈阳性。结论：我们的研究并不支持在常规病房对免疫功能正常的 COVID-19 患者进行系统的真菌标记物筛查。

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引用次数: 0

Impact of Open Access status on journal metrics in infectious diseases and clinical microbiology – A cross-sectional study 开放获取状态对传染病学和临床微生物学期刊指标的影响--一项横断面研究

IF 3.5 4区医学 Q2 Medicine

Infectious diseases now

Pub Date : 2024-04-13 DOI: 10.1016/j.idnow.2024.104909

Noam Tau , Marin Moutel , Maiwenn Petithomme-Nanrocki , Maxime Hentzien , Dafna Yahav

Introduction

While Open Access (OA) journals provide free access to articles, they entail high article processing charges (APC), limiting opportunities for young researchers and those from low-middle income countries to publish OA.

Methods

Cross-sectional study, evaluating APC and academic impact of full OA (FOA) journals in infectious diseases (ID) and clinical microbiology (CM) compared to hybrid journals. Data were collected from Journal Citation Reports and journals’ websites.

Results

Among 255 journals, median APC was 2850 (interquartile range [IQR] 1325–3654$). Median APC for 120 FOA journals was significantly lower than for 119 hybrid journals (2000, IQR 648–2767$ versus 3550, IQR 2948–4120$, p < 0.001). FOA journals had lower citation numbers and impact metrics compared to hybrid journals.

Conclusion

While FOA ID/CM journals have lower APCs, they also lower academic impact compared to hybrid journals. These findings highlight the need for reforms in the publication process in view of achieving equitable data dissemination.

方法横断面研究，与混合期刊相比，评估传染病（ID）和临床微生物学（CM）领域完全开放获取（FOA）期刊的APC和学术影响力。结果255种期刊的APC中位数为2850（四分位距[IQR] 1325-3654美元）。120 种 FOA 期刊的 APC 中位数明显低于 119 种混合期刊（2000，IQR 648-2767 美元对 3550，IQR 2948-4120 美元，p <0.001）。结论虽然 FOA ID/CM 期刊的 APC 较低，但其学术影响力也低于混合期刊。这些发现凸显了改革出版流程以实现公平数据传播的必要性。

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引用次数: 0

Providing parents with HPV vaccine information from a male perspective may render them more inclined to have their daughters vaccinated 从男性角度向父母提供 HPV 疫苗信息，可能会让他们更愿意让女儿接种疫苗

IF 3.5 4区医学 Q2 Medicine

Infectious diseases now

Pub Date : 2024-04-09 DOI: 10.1016/j.idnow.2024.104908

Sandra Chyderiotis , Sarah Derhy , Julie Gaillot , Alexandre Cobigo , Laura Zanetti , Clément Piel , Judith E. Mueller

Objectives

Several high-income countries have implemented a gender-neutral vaccination program against human papillomavirus (HPV) infections. The impact of a gender-neutral program (GNP) on parental intention to vaccinate their daughters has not been studied, especially in countries with low HPV vaccine coverage among girls.

Patients and methods

In July 2019, before a GNP was implemented in France (2021), the French National Cancer Institute (INCa) conducted a survey on HPV vaccine acceptance among parents of children aged 11–19 years living in France. In the sample of girls’ parents (n = 1424 parents, 1726 girls), we investigated whether parents who declared no initial intention to have their daughter(s) vaccinated changed their minds after reading information including a male perspective on HPV consisting in description of HPV-related disease among men and in ascertainment of the fact that in some countries, the HPV vaccine is recommended for boys, after which they were once again asked about their intentions “if the vaccine were recommended to boys and girls alike”.

Results

As regards 295 (25.7 %) of the 1147 unvaccinated girls, their parents declared no intention to have them vaccinated, while 509 (44.4 %) were not sure. Among the parents of the 804 girls whose parents had not intended to have them vaccinated, 134 (16.7 %) changed their minds after reading about HPV among men. Fathers were more likely than mothers to change their minds, and finally intend to have their daughters vaccinated (adjusted relative risk, 1.74 [95 % confidence interval, 1.20,2.54]).

Conclusions

These results suggest that parents, and fathers in particular, could be more motivated to have their daughters vaccinated against HPV if the information with which they were provided included a male perspective and a recommendation of vaccination for boys as well as girls.

目标一些高收入国家已经实施了不分性别的人类乳头瘤病毒（HPV）感染疫苗接种计划。患者和方法2019年7月，在法国实施性别中立计划（2021年）之前，法国国家癌症研究所（INCa）对居住在法国的11-19岁儿童的父母进行了一项关于HPV疫苗接受度的调查。在女孩家长样本（n = 1424 名家长，1726 名女孩）中，我们调查了最初无意让女儿接种疫苗的家长在阅读了包括男性视角的 HPV 信息后是否改变了主意，这些信息包括对男性 HPV 相关疾病的描述，以及对某些国家推荐男孩接种 HPV 疫苗这一事实的确认，之后我们再次询问他们 "如果向男孩和女孩都推荐接种疫苗 "的意愿。结果在 1147 名未接种疫苗的女孩中，有 295 人（25.7%）的父母表示不打算让她们接种疫苗，509 人（44.4%）表示不确定。在 804 名不打算接种疫苗的女孩的父母中，有 134 人（16.7%）在了解了男性感染人类乳头瘤病毒的情况后改变了主意。与母亲相比，父亲更有可能改变主意，并最终打算让女儿接种疫苗（调整后的相对风险为 1.74 [95 % 置信区间，1.20,2.54]）。这些结果表明，如果向父母，尤其是父亲提供的信息中包含男性视角，并建议男孩和女孩都接种疫苗，他们会更有动力让女儿接种人乳头瘤病毒疫苗。

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引用次数: 0

ChatGPT ability and urinary tract infection-related questions: Comment ChatGPT 能力和尿路感染相关问题：评论

IF 3.5 4区医学 Q2 Medicine

Infectious diseases now

Pub Date : 2024-04-04 DOI: 10.1016/j.idnow.2024.104907

Hinpetch Daungsupawong , Viroj Wiwanitkit

引用次数: 0

Assessment of the impact of telehealth intervention in patients with bone and joint infection 评估远程医疗干预对骨与关节感染患者的影响

IF 3.5 4区医学 Q2 Medicine

Infectious diseases now

Pub Date : 2024-04-03 DOI: 10.1016/j.idnow.2024.104906

Philippine Marque , Julie Leitao , Fréderic-Antoine Dauchy , Olivier Gerbouin , Thierry Fabre , Fabien Xuereb , Marin Lahouati

Objectives

Patients with bone and joint infections (BJI) are involved in a complex care pathway and require prolonged antimicrobial treatment. Some studies have suggested that a pharmacist-led telehealth intervention (TI) could help to ensure better follow-up of chronic diseases. To our knowledge, there are no data on the effects of pharmacist-led TI on patients with BJI. The aim of this study is to assess the impact of a TI on patients treated for BJIs at three weeks after hospital discharge.

Patients and Methods

Patients encountered during hospitalization and receiving standardized care including TI were included in the study. All adverse events (AE) reported by patients during TI were evaluated. Impact of pharmaceutical interventions (PIs) provided by a clinical pharmacist following TI was evaluated by CLEO© (CLinical, Economic and Organizational) scale. Patient satisfaction concerning TI was assessed by an anonymous questionnaire following medical consultation at the end of antimicrobial treatment.

Results

Over a 4-month period, 36 patients received TI. Fifty-two AEs were identified in 21 patients (58%). Two patients were hospitalized due to an AE. Clinical pharmacists provided 34 pharmaceutical interventions (PIs) for 23 patients (64%). According to CLEO scale, 11 PIs had a major clinical impact (32%), 6 PIs (18%) had a favorable impact on the direct cost of treatment and 27 PIs (79%) had positive organizational impact. Concerning TI process, patients were satisfied or very satisfied, with an average score of 9.6/10.

Conclusion

TI led to a high number of pharmaceutical interventions (PIs), with a meaningful clinical, organizational, and economic impact. Patients were also highly satisfied with this intervention.

目的：骨与关节感染（BJI）患者的护理路径复杂，需要长时间的抗菌治疗。一些研究表明，由药剂师主导的远程医疗干预（TI）有助于确保对慢性疾病进行更好的随访。据我们所知，目前还没有关于药剂师主导的远程医疗干预对北京和睦家医院患者的影响的数据。本研究的目的是评估出院后三周内，TI 对接受北京和睦家医院治疗的患者的影响。评估了患者在TI期间报告的所有不良事件（AE）。采用 CLEO©（临床、经济和组织）量表对临床药剂师在 TI 后提供的药物干预（PIs）的影响进行评估。在抗菌药物治疗结束后的医疗咨询中，通过匿名问卷对患者对 TI 的满意度进行了评估。在 21 名患者（58%）中发现了 52 种不良反应。两名患者因AE住院。临床药剂师为 23 名患者（64%）提供了 34 次药物干预 (PI)。根据 CLEO 量表，11 项 PI（32%）对临床产生了重大影响，6 项 PI（18%）对直接治疗成本产生了有利影响，27 项 PI（79%）对组织产生了积极影响。关于 TI 流程，患者表示满意或非常满意，平均得分为 9.6/10.ConclusionTI 带来了大量的药物干预（PIs），对临床、组织和经济产生了有意义的影响。患者对这一干预措施也非常满意。

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引用次数: 0

From imprecise “immune debt” to nuanced “immune shortage”? 从不精确的 "免疫债务 "到细致入微的 "免疫短缺"？

IF 3.5 4区医学 Q2 Medicine

Infectious diseases now

Pub Date : 2024-03-27 DOI: 10.1016/j.idnow.2024.104894

Luwen Zhang

引用次数: 0

Immune debt or immune shortage: The controversy continues – “Season 3 episode 1” 免疫债务还是免疫短缺：争议仍在继续--"第 3 季第 1 集"。

IF 3.5 4区医学 Q2 Medicine

Infectious diseases now

Pub Date : 2024-03-27 DOI: 10.1016/j.idnow.2024.104897

Robert Cohen, Corinne Levy

引用次数: 0

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