International Journal of Infectious Diseases最新文献

Objectives: Sexual transmission of extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) is suspected. We aimed to identify clusters of sexual behavior associated with ESBL-E carriage among individuals at risk of sexually transmitted infections (STI).

Methods: In this cross-sectional study, patients attending an STI-screening center and HIV outpatient clinic in Paris, France between 2018-2019 were asked questions on the following sexual activities in the last 6 months: receptive/insertive anal intercourse, passive/active rimming, receptive/insertive fellatio, receptive/insertive fisting, receptive/insertive fingering, active/passive cunnilingus. ESBL-E carriage was determined from rectal swabs. Bayesian latent class analysis was used to identify clusters of sexual activity, which were then associated with ESBL-E carriage using logistic regression.

Results: Among 1211 men who have sex with men (MSM), those belonging to two latent classes with higher prevalence of insertive fingering and active rimming (ESBL-E prevalence=15.3%, N=124 and 16.0%, N=100) and one class with higher proportions of all behaviors (24.3%, N=70) had a higher risk of ESBL-E carriage compared to those in a class with few sexual behaviors (7.3%, N=259) after adjustment. Among 439 other men and 479 women, no clear associations between sexual clusters and ESBL-E carriage were observed.

Conclusions: Sexual behaviors are associated with varying degrees of ESBL-E carriage, particularly among MSM.

Bartonella spp. infections are increasingly recognized as causes of zoonotic diseases. One of the most severe infections caused by Bartonella spp. is infective endocarditis, predominantly affecting individuals with underlying valvular heart disease, immunosuppression and homelessness. The microbiological diagnosis of these endocarditis cases is highly challenging due to the fastidious nature of Bartonella spp., requiring specialized serologic and molecular tests in addition to blood cultures, which are usually negative. While B. henselae and B. quintana are the main species associated with these infections, other rarer Bartonella species are increasingly being identified in such cases. Herein, we report the first case of infective endocarditis on prosthetic heart valves caused by Bartonella vinsonii subsp. berkhofii in a 74 year-old shepherd, also being the fourth reported human endocarditis case due to this pathogen. This Bartonella subspecies has been associated with canid exposure, as these animals are believed to be its main reservoir. Interestingly, in our case the bacteria grew in heart-valve culture, allowing for species identification by whole-genome sequencing. Our patient, whose risk factors included canid exposure, cardiac anomalies and immunosuppression, is a clear example of the importance of considering this pathogen in such high-risk populations.

Objectives: Currently recognized risk factors for sexually transmitted enteric infections (STEIs) among men who have sex with men (MSM) include oroanal sex, multiple sexual partners, and chemsex. This study aimed to investigate the prevalence of the asymptomatic carriage of enteric pathogens in men who have sex with men (MSM) and to identify the associated risk factors.

Methods: Questionnaires were completed by 375 MSM in Taiwan from December 2019 to November 2022. Fecal samples were analyzed by multiplex PCR to determine whether seven enteric pathogens, including Entamoeba histolytica, Giardia duodenalis, Shiga toxin-producing Escherichia coli, Cryptosporidium, Campylobacter, Salmonella, and Shigella species, were present.

Results: Among 375 fecal samples from asymptomatic MSM, 27 (7.2%) fecal samples tested positive for at least one enteric pathogen. The recent use of proton pump inhibitors (PPIs) was significantly associated with asymptomatic fecal carriage (22.2% vs. 2.0%, P < 0.001). G. duodenalis (2.1%, 8 cases), E. histolytica (1.6%, 6 cases), and Shigella species (1.3%, 5 cases) were commonly detected. Oroanal sex and PPI use were associated with the asymptomatic carriage of enteric pathogens. Specifically, Shigella, Salmonella, or Campylobacter carriage was significantly correlated with PPI use. In contrast, rectal gonorrhea was associated with multiple sexual partners and prior syphilis.

Conclusions: Recent use of PPIs was associated with the asymptomatic carriage of enteric pathogens. Therefore, targeted education about the appropriate use of PPIs is necessary to mitigate the risk of STEIs among MSM.

The perspective explores the emergence of autochthonous tropical diseases in Europe, driven by climate change and the associated increase in vector-borne diseases. Rising temperatures, along with changes in humidity and rainfall patterns, have altered the activity, distribution, and diversity of vectors such as mosquitoes and ticks. Species like Aedes albopictus and Aedes aegypti, which are primary vectors of dengue, have established self-sustaining populations across Europe. This spread has led to a surge in cases of dengue fever, West Nile virus, and tick-borne encephalitis in temperate regions. The complexity of predicting these outbreaks is compounded by factors like vector diapause, serological cross-reactivity, and land-use changes. The perspective calls for the implementation of enhanced surveillance, weather-linked predictive models, and robust vector control strategies to mitigate the public health risks posed by the spread of these diseases. As climate change accelerates, Europe faces increasing health threats previously confined to tropical regions, emphasizing the need for proactive public health measures to protect populations from this growing threat.

Objectives: The prevalence and risk factors of SARS-CoV-2 infection among unvaccinated people living with HIV (PWH) are not well understood, and the protective role of tenofovir remains controversial. This study aimed to assess the SARS-CoV-2 prevalence and associated risk factors among unvaccinated PWH, and to evaluate the impact of tenofovir.

Methods: We conducted as a cross-sectional study between November 2020 and May 2021. Plasma samples from 4,400 of 5,476 PWH were tested for total antibodies, IgG, IgM, and IgA.

Results: Among the participants (median age 48 years, 84% male), 92% had undetectable HIV viral loads and 5% had syphilis. The prevalence of SARS-CoV-2 infection was 18% (95% CI 17-19), with 1,180 individuals showing antibodies (IgG 13%, IgA 10%, IgM 11%). Of those seropositive for SARS-CoV-2, 67.5% were asymptomatic, 29% had mild disease, and 3.5% had severe/critical conditions. Risk factors included younger age, being female, men who have sex with men (MSM) status, non-European origin, and a history of syphilis. Neither antiretrovirals nor tenofovir provided protection against SARS-CoV-2 infection or COVID-19 disease.

Conclusion: Ongoing surveillance and tailored interventions are crucial for at-risk PWH amid evolving SARS-CoV-2 variants. Tenofovir did not prevent SARS-CoV-2 infection or COVID-19.

Background: We examined the added value of serologic testing for estimating influenza virus infection incidence based on illness surveillance with molecular testing versus periodic serologic testing.

Methods: Pregnant persons unvaccinated against influenza at <28 weeks gestation were enrolled before the 2017 and 2018 influenza seasons in Peru and Thailand. Blood specimens were collected at enrollment and ≤14 days postpartum for testing by hemagglutination inhibition assay for antibodies against influenza reference viruses. Seroconversion was defined as a ≥4-fold rise in antibody titers from enrollment to postpartum with the second specimen's titer of ≥40. Throughout pregnancy, participants responded to twice weekly surveillance contacts asking about influenza vaccination and influenza-like symptoms (ILS). A mid-turbinate swab was collected with each ILS episode for influenza real-time reverse transcription polymerase chain reaction (rRT-PCR).

Results: Of 1,466 participants without evidence of influenza vaccination during pregnancy, 296 (20.2%) had evidence of influenza virus infections. Fifteen (5.1%) were detected by rRT-PCR only, 250 (84.4%) by serologic testing only, and 31 (10.5%) by both methods.

Conclusions: Influenza virus infections during pregnancy occurred in 20% of cohort participants; >80% were not detected by a broad illness case definition coupled with rRT-PCR.

Objectives: As the SARS-CoV-2 virus evolves more rapidly than vaccines are updated, T cell immunity potentially confers protection against disease progression and death from new variants. In this study, we aimed to assess whether the current boosting vaccination schemes offer sufficient T cell protection against new SARS-CoV-2 variants.

Methods: . 292 adults who had received the second booster of either monovalent wild type vaccines (inactivated virus or mRNA) (cohort 1) or the second/third booster of bivalent WT/BA.4-5 mRNA vaccine (cohort 2) were recruited in Hong Kong. All participants showed no serological evidence of recent infection of SARS-CoV-2. Blood samples of each participant were collected before and one-month after receiving the booster. T cell and antibody responses were determined by flow cytometry and neutralization test respectively.

Results: . Among all vaccination strategies, only the adults who had received the bivalent vaccine as the third booster dose significantly elicited T cell responses to the XBB variant. Either monovalent or bivalent mRNA but not inactivated virus vaccine as the second/third booster induced antibody against different XBB variants.

Conclusions: . Receiving bivalent mRNA vaccine as the third booster is preferrable to induce both T cell and antibody responses against XBB.

Purpose: Yellow fever (YF) is a major public health concern particularly in Africa and South America. This study aimed to detect YF in human and mosquito samples to understand transmission dynamics in the Tanzania-Uganda and Tanzania-Kenya cross-border areas.

Methods: Blood samples were collected from 9 months and older individuals for serological testing while mosquitoes were captured and tested for YF virus RNA. Logistic regression models were used to predict seroprevalence and associated risk factors.

Results: The overall YF seroprevalence was 12.5% with higher rates in older individuals (7.0%) and females (IgG 4.4%, IgM 6.0%). Notably, YF virus RNA was detected in three out of 46 pools of 192 mosquitoes. The odds of testing positive for YF IgG were lower among those with primary education compared with college education (AOR = 0.27, CI: 0.08-0.88) and increased with being female (AOR = 4.7, CI: 1.5-14.7), traveling to YF endemic areas (AOR = 5.2, CI: 1.35-44.75), exposure to Aedes mosquitoes (AOR = 3.7, CI: 1.27-10.84), experiencing muscle pain (AOR = 4.5, CI: 1.08-18.78), and exhibiting bruising (AOR = 13.5, CI: 1.23-145.72).

Conclusion: Despite not experiencing YF outbreaks, Tanzania shows evidence of YF exposure in studied borders highlighting the need to strengthen cross border-surveillance, vector control, vaccination and further research to evaluate country overall YF risks.

Background: The current treatment recommendation involves administering a high dose of sulbactam alongside at least one additional agent. However, there remains a lack of data regarding the optimal dosage of sulbactam. We investigated whether administering sulbactam at a dosage of 12 g/day decreases the mortality rate among patients with CRAB pneumonia compared to 9 g/day.

Methods: The study was an open-label, superiority, randomized controlled trial conducted at Phramongkutklao Hospital between September 2019 and September 2023 in patients diagnosed with CRAB. Participants were randomly assigned to receive a combination of colistin with either 9 or 12 g/day of sulbactam. The primary endpoint was the all-cause mortality rate at 28 days postrandomization.

Results: Among the 138 participants, there was a trend towards a lower mortality rate in the 12 g/day group (59.4% vs. 47.8%; P = 0.158). After adjusting for factors associated with mortality, a lower mortality was observed in the 12 g/day group (adjusted HR 0.54 [95% CI 0.33-0.87]; P = 0.0110). The microbiological cure rate at day 7 was higher in the 12 g/day group (73.2% vs. 89.4%; P = 0.02).

Conclusions: Colistin in combination with sulbactam at a dosage of 12 g/day may improve mortality compared to 9 g/day.