Journal of Infection and Chemotherapy最新文献_第2页

The effect of pharmacist-led antimicrobial stewardship on antimicrobial use in an intensive care unit: a single-center, retrospective, observational study 药师主导的抗菌药物管理对重症监护病房抗菌药物使用的影响：一项单中心、回顾性、观察性研究

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2025-12-18 DOI: 10.1016/j.jiac.2025.102898

Yoshihiro Nishita , Natsuko Ishida , Masatoshi Taga , Ryoji Takata , Yoshitsugu Iinuma , Togen Masauji , Junko Ishizaki

Purpose

We investigated the long-term impact of an antimicrobial stewardship program (ASP) led by a dedicated intensive care unit (ICU) pharmacist belonging to an antimicrobial stewardship team (AST) on trends in antimicrobial use and patient outcomes.

Methods

This was a single-center, retrospective study of patients admitted in an open ICU. Days of therapy (DOT) and number of patients receiving antimicrobial drug (NAD) of carbapenems, anti-pseudomonal β-lactams and non-anti-pseudomonal β-lactams, and all-cause mortality at 28 days were compared between the pre-ASP period (April 2012 to March 2016) and post-ASP period (April 2016 to March 2024). We divided patients into the sepsis, non-sepsis, and non-infection groups and compared outcomes. De-escalation rates and number of days until de-escalation of carbapenems and anti-pseudomonal β-lactams were investigated in sepsis and non-sepsis cases.

Results

DOT decreased significantly for carbapenems, anti-pseudomonal and non-anti-pseudomonal β-lactams post-ASP. In sepsis cases, the number of days until de-escalation of carbapenems and anti-pseudomonal β-lactams significantly decreased post-ASP; the ICU pharmacist intervened in all cases for sepsis and non-sepsis post-ASP. DOT of carbapenems and anti-pseudomonal β-lactams decreased significantly in non-sepsis and non-infection cases post-ASP. NAD significantly decreased in patients treated with carbapenems, anti-pseudomonal β-lactams and non-anti-pseudomonal β-lactams post-ASP. In non-infection cases, NAD significantly decreased in patients treated with carbapenems, anti-pseudomonal β-lactams post-ASP. No significant difference occurred in all-cause mortality rate between groups.

Conclusion

ASP led by a pharmacist belonging to an AST in the open ICU contributed to long-term appropriate antimicrobial use of carbapenems and anti-pseudomonal β-lactams, and DOT for non-pseudomonal β-lactams.

目的：研究由隶属于抗菌药物管理团队（AST）的重症监护病房（ICU）专职药剂师领导的抗菌药物管理项目（ASP）对抗菌药物使用趋势和患者预后的长期影响。方法：本研究为单中心、回顾性研究，纳入开放ICU患者。比较asp前（2012年4月~ 2016年3月）和asp后（2016年4月~ 2024年3月）的碳青霉烯类、抗假单胞菌β-内酰胺类和非抗假单胞菌β-内酰胺类药物的治疗天数（DOT）、抗菌药物使用人数（NAD）和28天全因死亡率。我们将患者分为败血症组、非败血症组和非感染组，并比较结果。研究脓毒症和非脓毒症患者碳青霉烯类和抗假单胞菌β-内酰胺类药物的降压率和降压天数。结果asp后碳青霉烯类、抗假单胞菌和非抗假单胞菌β-内酰胺类dot明显降低。在脓毒症病例中，碳青霉烯类和抗假单胞菌β-内酰胺类药物减少的天数在asp后显著减少；ICU药剂师介入所有脓毒症和非脓毒症后asp。asp后，非脓毒症和非感染患者的碳青霉烯类和抗假单胞菌β-内酰胺类DOT明显降低。asp后给予碳青霉烯类、抗假单胞菌β-内酰胺类和非抗假单胞菌β-内酰胺类治疗的患者NAD显著降低。在非感染病例中，asp后给予碳青霉烯类、抗假单胞菌β-内酰胺类治疗的患者NAD显著降低。两组间全因死亡率无显著差异。结论开放ICU由AST药师主导的asp有助于长期合理使用碳青霉烯类和抗假单胞菌β-内酰胺类抗菌药物，而非假单胞菌β-内酰胺类抗菌药物则采用DOT。

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引用次数: 0

Zoonotic aortic graft infection by Streptococcus equi 马链球菌感染主动脉瓣人畜共患。

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2025-12-16 DOI: 10.1016/j.jiac.2025.102900

Haruka Karaushi , Akihiro Yoshitake , Yuta Kanazawa , Noriyuki Watanabe , Mieko Tokano , Masafumi Seki , Kotaro Mitsutake

A 69-year-old woman with hypertension had undergone total arch replacement with an open stent graft 7 years prior. She was referred to our hospital for evaluation after experiencing fever (>38 °C) and cough. Chest radiography revealed a prominent aortic arch, and contrast-enhanced computed tomography demonstrated aortic arch enlargement and peri-graft fluid collection containing air. These findings indicated graft infection and prompted immediate intervention. Blood cultures grew Streptococcus equi subspecies zooepidemicus, a zoonotic pathogen associated with horses. Notably, the patient worked as a horse trainer. On hospital day 6, she developed severe hemoptysis due to an aortobronchial fistula caused by stent graft infection and underwent emergency re-replacement of the aortic arch. Intraoperative specimens also yielded the same pathogen. Consequently, she was treated with ampicillin, and her postoperative course was uneventful. Although rare, zoonotic pathogens can cause vascular graft infections.

一位69岁的高血压女性在7年前接受了全弓置换术和开放式支架移植。在出现发热（bbb38°C）和咳嗽后，她被转介到我们医院进行评估。胸片显示主动脉弓突出，增强ct显示主动脉弓增大，移植物周围积液含气。这些发现提示移植物感染，需要立即干预。血液培养培养出马链球菌亚种动物流行病，一种与马有关的人畜共患病原体。值得注意的是，这位病人是一名驯马师。住院第6天，由于支架感染导致主动脉支气管瘘，患者出现严重咯血，并接受了主动脉弓的紧急再置换术。术中标本也产生了相同的病原体。因此，她接受氨苄西林治疗，术后过程顺利。虽然罕见，人畜共患病原体可引起血管移植物感染。

引用次数: 0

Characteristics of invasive group B streptococcal infections in adults and older individuals in a super-aging society in Japan, 2016–2023 2016-2023年日本超老龄化社会成人和老年人侵袭性B群链球菌感染特征

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2025-12-16 DOI: 10.1016/j.jiac.2025.102897

Hideaki Takahashi , Haruko Miyazaki , Yuki Watanabe , Daisuke Kawahata , Yutaka Nasu , Misako Takata , Hidemasa Nakaminami , Hidehiro Watanabe , Yuji Hirai , Kimiko Ubukata , Shigeki Nakamura

Background

Group B Streptococcus (GBS), a commensal bacterium in the gastrointestinal tract, can cause invasive GBS (iGBS) infections, particularly in older adults with underlying comorbidities. We determined the relationship between mortality and host-related or virulence factors in older adults with iGBS infections.

Methods

We retrospectively analyzed 105 cases of iGBS infection treated between January 2016 and October 2023 at Tokyo Medical University Hospital and two affiliated hospitals. The association between patient outcomes and demographics, underlying diseases, clinical manifestations, medical treatment, biomarkers, antimicrobial agents used at admission, and capsular type of GBS isolates was examined.

Results

The median age of the patients was 78 years (interquartile range, 64–85 years), and 89.5 % had underlying comorbidities, such as diabetes, chronic kidney disease, and malignancies. Common clinical manifestations include skin and soft tissue infections, bacteremia, and urosepsis. The overall mortality rate was 11.4 %. White blood cell (WBC) counts (breakpoint,10 × 10³/μL) on admission were significantly lower in fatal cases (P < 0.001; odds ratio, 9.6), but no significant differences were observed for other biomarkers. The Kaplan–Meier estimate of 28-day survival was associated with WBC count (P < 0.001). The most common capsular type was Ib, followed by type V. Levofloxacin resistance was predominantly identified in type Ib. No significant association was found between capsular type and mortality rates.

Conclusion

Effective prevention of iGBS infections in older individuals requires large-scale surveillance, including environmental factors, and the development of comprehensive and multifaceted prevention strategies for high-risk older populations.

背景：B群链球菌（GBS）是胃肠道中的一种共生细菌，可引起侵袭性GBS （iGBS）感染，特别是在有潜在合并症的老年人中。我们确定了iGBS感染老年人的死亡率与宿主相关或毒力因素之间的关系。方法：回顾性分析2016年1月至2023年10月在东京医科大学附属医院及两家附属医院治疗的105例iGBS感染病例。研究了患者结局与人口统计学、基础疾病、临床表现、药物治疗、生物标志物、入院时使用的抗菌药物和GBS分离株荚膜类型之间的关系。结果：患者的中位年龄为78岁（四分位数范围为64-85岁），89.5%有潜在的合并症，如糖尿病、慢性肾脏疾病和恶性肿瘤。常见的临床表现包括皮肤和软组织感染、菌血症和尿毒症。总死亡率为11.4%。死亡病例入院时白细胞（WBC）计数（断点，10 × 103/μL）显著降低（P < 0.001；优势比，9.6），但其他生物标志物无显著差异。Kaplan-Meier估计28天生存率与白细胞计数相关（P < 0.001）。最常见的荚膜类型是Ib型，其次是v型。Ib型主要发现左氧氟沙星耐药。荚膜类型与死亡率之间未发现显著相关性。结论：有效预防老年人iGBS感染需要包括环境因素在内的大规模监测，并针对老年高危人群制定全面、多方面的预防策略。

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引用次数: 0

The first pediatric case successfully treated with cefiderocol for IMP-type carbapenemase-producing Enterobacterales bacteremia 首例头孢地罗成功治疗imp型产碳青霉烯酶肠杆菌菌血症的儿童病例。

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2025-12-16 DOI: 10.1016/j.jiac.2025.102899

Haruna Mori , Yuto Otsubo , Meiwa Shibata , Kyogo Suzuki , Yuho Horikoshi

Cefiderocol, a novel β-lactam antibiotic, exhibits potent activity against carbapenemase-producing Enterobacterales (CPE). While its clinical efficacy has been reported for infections caused by KPC-type CPE and Stenotrophomonas maltophilia, evidence regarding its effectiveness against IMP-type CPE remains primarily derived from in vitro studies, with limited clinical data available. This is the first pediatric case successfully treated with cefiderocol for IMP-type CPE bacteremia. He was a 6-year-old boy with inherited glycosylphosphatidylinositol deficiency and acute lymphoblastic leukemia undergoing chemotherapy. He developed bacteremia that blood culture multiplex PCR identified Klebsiella pneumoniae with IMP gene. The combination therapy of cefiderocol 60mg/kg/dose every 8 hours and gentamicin 5mg/kg/dose once daily sterilized blood culture, and subsequent monotherapy with cefiderocol was continued for a total of 14 days. Additional molecular test in the strain detected IMP-1 carbapenemase, SHV extended spectrum β-lactamase and EBC-type AmpC β-lactamase. Cefiderocol was susceptible at minimum inhibitory concentration 0.5μg/mL. Further study is needed for cefiderocol treatment for IMP-type CPE infection in children.

Cefiderocol是一种新型β-内酰胺类抗生素，具有抗产碳青霉烯酶肠杆菌（CPE）的活性。虽然其对kpc型CPE和嗜麦芽窄养单胞菌引起的感染的临床疗效已有报道，但其对imp型CPE有效性的证据主要来自体外研究，临床数据有限。这是首例成功使用头孢地罗治疗imp型CPE菌血症的儿童病例。他是一名6岁男孩，患有遗传性糖基磷脂酰肌醇缺乏症和急性淋巴细胞白血病，正在接受化疗。他患了菌血症，血培养多重PCR鉴定出带有IMP基因的肺炎克雷伯菌。头孢地洛尔60mg/kg/剂/ 8 h联合用药，庆大霉素5mg/kg/剂/剂/日1次消毒血培养，随后头孢地洛尔单药治疗共持续14天。另外在菌株中检测到IMP-1型碳青霉烯酶、SHV型延伸谱β-内酰胺酶和ebc型AmpC型β-内酰胺酶。头孢地洛尔最低抑菌浓度为0.5μg/mL。头孢地罗治疗儿童imp型CPE感染的疗效有待进一步研究。

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引用次数: 0

Impact of timing in prospective audit and feedback on broad-spectrum antibiotic use: a comparison between third-day and seventh-day interventions 前瞻性审核和反馈时间对广谱抗生素使用的影响：第三天和第七天干预措施的比较

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2025-12-15 DOI: 10.1016/j.jiac.2025.102896

Hisako Machida , Yoshiki Kusama , Daisuke Onozuka , Atsuko Sunada , Satoshi Kutsuna

Prospective audit and feedback (PAF) is a key component of antimicrobial stewardship (AS) programs and has been shown to reduce the use of broad-spectrum antibiotics. However, the optimal timing of PAF intervention remains unclear.

This quasi-experimental, single-center study investigated the impact of changing PAF timing from day 3 to day 7 after initiating empirical broad-spectrum antibiotics. Monthly days of therapy (DOT) for carbapenems (CAR), piperacillin-tazobactam (PIP/TAZ), and cefepime (PEF) were extracted from 2016 to 2024. Annual susceptibility rates of Pseudomonas aeruginosa and the time from blood culture submission to susceptibility results were also evaluated. Interrupted time series analysis assessed changes in DOT, while other data were descriptively analyzed.

DOT for CAR and PIP/TAZ decreased significantly post-intervention (CAR: −0.68, P < 0.001; PIP/TAZ: −0.29, P = 0.031), despite no significant change in trend slopes. PEF showed no significant changes. Susceptibility rates of P. aeruginosa remained stable. Notably, 28.3 % of blood culture results exceeded 4 days to report, and 95 % were available by day 7.

As causality cannot be inferred from this observational design, the mechanism underlying the observed reduction in DOT remains uncertain. Nevertheless, adjusting PAF timing may be feasible in settings with limited stewardship resources. Further studies are needed to determine the most effective timing of PAF interventions and to assess generalizability to other institutions.

前瞻性审核和反馈（PAF）是抗菌药物管理（AS）计划的关键组成部分，已被证明可以减少广谱抗生素的使用。然而，PAF干预的最佳时机仍不清楚。这项准实验、单中心研究调查了在使用经验性广谱抗生素后第3天至第7天改变PAF时间的影响。提取2016 - 2024年碳青霉烯类药物（CAR）、哌拉西林-他唑巴坦（PIP/TAZ）和头孢吡肟（CEF）的月治疗天数（DOT）。同时对铜绿假单胞菌的年敏感性和血培养提交至药敏结果的时间进行了评价。中断时间序列分析评估DOT的变化，而其他数据进行描述性分析。干预后，尽管趋势斜率没有显著变化，但CAR和PIP/TAZ的DOT显著下降（CAR: -0.68, P < 0.001; PIP/TAZ: -0.29, P = 0.031）。CEF无明显变化。铜绿假单胞菌的敏感率保持稳定。值得注意的是，28.3%的血培养结果超过4天报告，95%的血培养结果在第7天报告。由于因果关系不能从这种观察设计中推断出来，因此观察到的DOT减少的机制仍然不确定。然而，在管理资源有限的情况下，调整PAF时间可能是可行的。需要进一步的研究来确定PAF干预的最有效时机，并评估对其他机构的推广。

{"title":"Impact of timing in prospective audit and feedback on broad-spectrum antibiotic use: a comparison between third-day and seventh-day interventions","authors":"Hisako Machida , Yoshiki Kusama , Daisuke Onozuka , Atsuko Sunada , Satoshi Kutsuna","doi":"10.1016/j.jiac.2025.102896","DOIUrl":"10.1016/j.jiac.2025.102896","url":null,"abstract":"<div><div>Prospective audit and feedback (PAF) is a key component of antimicrobial stewardship (AS) programs and has been shown to reduce the use of broad-spectrum antibiotics. However, the optimal timing of PAF intervention remains unclear.</div><div>This quasi-experimental, single-center study investigated the impact of changing PAF timing from day 3 to day 7 after initiating empirical broad-spectrum antibiotics. Monthly days of therapy (DOT) for carbapenems (CAR), piperacillin-tazobactam (PIP/TAZ), and cefepime (PEF) were extracted from 2016 to 2024. Annual susceptibility rates of <em>Pseudomonas aeruginosa</em> and the time from blood culture submission to susceptibility results were also evaluated. Interrupted time series analysis assessed changes in DOT, while other data were descriptively analyzed.</div><div>DOT for CAR and PIP/TAZ decreased significantly post-intervention (CAR: −0.68, P < 0.001; PIP/TAZ: −0.29, P = 0.031), despite no significant change in trend slopes. PEF showed no significant changes. Susceptibility rates of <em>P. aeruginosa</em> remained stable. Notably, 28.3 % of blood culture results exceeded 4 days to report, and 95 % were available by day 7.</div><div>As causality cannot be inferred from this observational design, the mechanism underlying the observed reduction in DOT remains uncertain. Nevertheless, adjusting PAF timing may be feasible in settings with limited stewardship resources. Further studies are needed to determine the most effective timing of PAF interventions and to assess generalizability to other institutions.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 1","pages":"Article 102896"},"PeriodicalIF":1.5,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145774669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Lumbar-peritoneal shunt-associated meningitis and peritoneal abscess due to Corynebacterium striatum: A case report and literature review 纹状棒状杆菌所致腰腹膜分流相关脑膜炎及腹膜脓肿1例报告及文献复习。

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2025-12-12 DOI: 10.1016/j.jiac.2025.102895

Akiho Maeda , Koji Hayashi , Rina Izumi , Yusuke Tsujigiwa , Yuka Nakaya , Yoshitomo Fukuoka , Kohei Ueda , Norichika Hashimoto

We describe the first case of both a peritoneal abscess and a lumbar-peritoneal (LP) shunt infection related to Corynebacterium striatum (C. striatum). An 85-year-old Japanese male with a history of diabetes, hyperlipidemia, and a pulmonary vein isolation procedure for atrial fibrillation presented with urinary incontinence, gait disturbance, and cognitive decline. He was diagnosed with normal-pressure hydrocephalus (NPH) and underwent LP shunt surgery. Postoperatively, he developed pneumonia followed by an intra-abdominal abscess and bacterial meningitis. C. striatum was isolated from both cerebrospinal fluid (CSF) and intraperitoneal abscess. Despite antibiotic treatment including vancomycin, he developed septic shock and ultimately resulted in his death.

The LP shunt likely facilitated the entry of C. striatum into the CSF, resulting in meningitis and subsequent abscess formation. Despite appropriate antibiotic treatment including vancomycin, C. striatum infections can be resistant and lead to severe outcomes. This case highlights a new complication associated with C. striatum: bacterial meningitis and intraperitoneal abscesses via an LP shunt, expanding its clinical spectrum.

我们描述了第一例腹膜脓肿和腰-腹膜（LP）分流感染与纹状棒状杆菌（C.纹状体）。一名85岁日本男性，有糖尿病、高脂血症病史，因房颤而行肺静脉隔离手术，表现为尿失禁、步态障碍和认知能力下降。他被诊断为常压脑积水（NPH）并接受了LP分流手术。术后，患者出现肺炎，并发腹腔脓肿和细菌性脑膜炎。纹状体c从脑脊液和腹腔脓肿中分离。尽管接受了包括万古霉素在内的抗生素治疗，他还是患上了感染性休克，最终导致了他的死亡。LP分流可能促进纹状体梭状体进入脑脊液，导致脑膜炎和随后的脓肿形成。尽管适当的抗生素治疗包括万古霉素，纹状体梭状体感染可耐药并导致严重的后果。本病例突出了纹状体梭状体的新并发症：细菌性脑膜炎和经LP分流的腹膜内脓肿，扩大了其临床范围。

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引用次数: 0

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2025-12-12 DOI: 10.1016/j.jiac.2025.102894

Michiyo Yamakawa , Yuko Tanaka , Akiko Tokinobu , Toshihide Tsuda

Background

With a rapid recovery in international travel after the COVID-19 pandemic, improving vaccination uptake among travelers is critical to preventing the cross-border spread of pathogens. We examined the associations between vaccine-related beliefs and vaccination behavior among Japanese travelers staying at a budget guesthouse in New Delhi, India.

Methods

Japanese travelers aged 16–75 years who stayed at a budget guesthouse in Paharganj, New Delhi were targeted (n = 1493). Cross-sectional surveys were conducted from December 14, 2022, to March 28, 2024, and from August 1 to October 7, 2024, using a web-based questionnaire. Vaccination behavior was defined as the primary outcome from whether individuals had gotten any vaccines for their travel. We examined the associations of four vaccine-related belief items (each on a 5-point scale for confidence, barriers, trust, and natural immunity) with vaccination behavior.

Results

In total (n = 853), 447 participants (52.4 %) had not received any vaccines for international travel. After adjusting for all potential confounders, 1-point increases in vaccine confidence and medical trust were positively associated with vaccination behavior, i.e., ORs (95 % CIs) of 1.60 (1.34, 1.92) and 1.52 (1.35, 1.73), respectively. In contrast, a 1-point increase in belief in natural immunity was negatively associated with vaccination behavior.

Conclusions

Addressing vaccine confidence, medical trust, and beliefs in natural immunity would be beneficial to promoting travel vaccinations among Japanese travelers staying at a budget guesthouse in New Delhi, India.

背景：随着2019冠状病毒病大流行后国际旅行的迅速恢复，提高旅行者的疫苗接种率对于预防病原体的跨境传播至关重要。我们研究了在印度新德里一家经济型宾馆住宿的日本游客中与疫苗有关的信念和疫苗接种行为之间的联系。方法：以在新德里Paharganj一家经济型宾馆住宿的16-75岁日本游客为研究对象（n=1493）。横断面调查于2022年12月14日至2024年3月28日和2024年8月1日至10月7日进行，采用基于网络的问卷调查。疫苗接种行为被定义为个人是否在旅行中接种了任何疫苗的主要结果。我们研究了四个与疫苗相关的信念项目（每个项目在信心、障碍、信任和自然免疫的5分制上）与疫苗接种行为的关联。结果：总共（n=853）， 447名参与者（52.4%）未接种任何国际旅行疫苗。在对所有潜在混杂因素进行调整后，疫苗信心和医疗信任增加1点与疫苗接种行为呈正相关，即or （95% ci）分别为1.60（1.34,1.92）和1.52（1.35,1.73）。相比之下，对自然免疫的信心每增加1点，与疫苗接种行为呈负相关。结论：解决疫苗信心、医疗信任和对自然免疫的信念，将有利于在印度新德里一家经济型宾馆住宿的日本游客中推广旅行疫苗接种。

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引用次数: 0

Xpert MTB/RIF probe reactivity to non-tuberculosis mycobacteria cultured in MGIT broth samples MTB/RIF探针对MGIT培养液中培养的非结核分枝杆菌的反应性

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2025-12-11 DOI: 10.1016/j.jiac.2025.102891

Tatsuya Hioki , Yoshikazu Mutoh , Takumi Umemura , Yoshimi Ishihara , Masayoshi Ajioka , Akiko Takaki , Kinuyo Chikamatsu , Satoshi Mitarai

The Xpert MTB/RIF assay can simultaneously detect Mycobacterium tuberculosis (MTB) and rifampicin resistance (RR), though the culture-positive Mycobacteria Growth Indicator Tube (MGIT) broth is not a specified sample type. In clinical settings the assay is sometimes used as an ancillary test to identify MTB and RR in MGIT broth samples, however, limited information is available on the reactivity of the probes to non-tuberculosis mycobacteria (NTM) species. The aim of this study was to assess the results of the Xpert MTB/RIF assay using MGIT broth samples positive for NTM. Of 65 NTM samples tested, 48 (74 %) showed probe signals. Probe reactivity and cycle threshold value differed according to the Mycobacterium species. Ten of 11 (91 %) of Mycobacterium intracellulare samples showed positive Probe A signals, and 23 of 29 (79 %) Mycobacterium avium samples showed positive Probe C signals. Additionally, a sample with M. avium and M. intracellulare co-infection tested false-positive for RR MTB. The proportion of NTM samples that tested positive was higher than that reported previously. These findings could help prevent misinterpretation of Xpert MTB/RIF results.

Xpert MTB/RIF试验可以同时检测结核分枝杆菌（MTB）和利福平耐药性（RR），尽管培养阳性分枝杆菌生长指示管（MGIT）肉汤不是指定的样品类型。在临床环境中，该检测有时被用作鉴定MGIT肉汤样品中MTB和RR的辅助检测，然而，关于探针对非结核分枝杆菌（NTM）物种的反应性的信息有限。本研究的目的是使用NTM阳性的MGIT肉汤样品评估Xpert MTB/RIF检测的结果。在65个NTM样本中，48个（74%）显示探针信号。探针反应性和循环阈值因分枝杆菌种类而异。11份分枝杆菌胞内标本中有10份（91%）探针A信号阳性，29份鸟分枝杆菌标本中有23份（79%）探针C信号阳性。此外，一个伴有鸟分枝杆菌和胞内分枝杆菌共感染的样本在抗结核分枝杆菌检测中呈假阳性。NTM样本检测呈阳性的比例高于以前报告的比例。这些发现有助于防止对专家MTB/RIF结果的误解。

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引用次数: 0

Coverage and determinants of maternal RSV vaccination in Japan: A nationwide survey 日本母亲RSV疫苗接种覆盖率和决定因素：一项全国性调查

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2025-12-11 DOI: 10.1016/j.jiac.2025.102892

Yusuke Okubo , Risa Honjo , Shinya Tsuzuki

Background

Respiratory syncytial virus (RSV) is a major cause of pediatric lower respiratory tract infections worldwide, leading to substantial morbidity, hospitalizations, and healthcare costs. Maternal RSV vaccination has recently been introduced in several countries, yet in Japan its uptake remains unclear, particularly given the high out-of-pocket costs and potential socioeconomic disparities.

Methods

We conducted a nationwide survey of women who had given birth between July 2024 and August 2025. The questionnaire assessed maternal RSV vaccination status, its affordability, and related attitudes including the 5C model for vaccine hesitancy together with demographic characteristics. Vaccination coverage was estimated, and factors associated with uptake were analyzed using multivariable modified Poisson regression.

Results

Among 1279 respondents, 11.6 % had received maternal RSV vaccination. Coverage showed a clear income gradient within education strata. Uptake was lower in areas outside Kanto and among multiparous participants, and higher among those with infertility treatment, and vaccination with influenza or diphtheria-pertussis-tetanus during pregnancy. In 5C domains, confidence and collective responsibility aligned with higher uptake, whereas calculation aligned with lower uptake. Among vaccinated people, 87.2 % rated the cost as expensive. Among unvaccinated people, leading barriers were lack of awareness of benefit (28.9 %) and the vaccine itself (27.3 %); 77.5 % would accept vaccination only if no out-of-pocket payment were required.

Conclusions

Maternal RSV vaccination coverage in Japan was low and showed socioeconomic and regional disparities in uptake; limited awareness and high out-of-pocket payment were major barriers. Reducing out-of-pocket payments and standardizing provider recommendations could raise coverage and mitigate inequities.

呼吸道合胞病毒（RSV）是全球儿童下呼吸道感染的主要原因，导致大量发病率、住院治疗和医疗费用。最近在一些国家引入了孕产妇呼吸道合胞病毒疫苗接种，但在日本，接种情况仍不明朗，特别是考虑到高昂的自付费用和潜在的社会经济差距。方法对2024年7月至2025年8月期间生育的妇女进行全国范围的调查。问卷评估了母亲的呼吸道合胞病毒疫苗接种状况、可负担性和相关态度，包括疫苗犹豫的5C模型以及人口统计学特征。估计疫苗接种覆盖率，并使用多变量修正泊松回归分析与摄取相关的因素。结果1279名应答者中，11.6%的人接种了母亲RSV疫苗。在教育阶层中，覆盖率显示出明显的收入梯度。在关东以外地区和产多胎的参与者中，摄取率较低，而在接受不孕症治疗和怀孕期间接种流感或白喉-百日咳-破伤风疫苗的参与者中，摄取率较高。在5C领域，信心和集体责任与较高的吸收量一致，而计算与较低的吸收量一致。在接种疫苗的人群中，87.2%的人认为费用昂贵。在未接种疫苗的人群中，主要障碍是缺乏对益处的认识（28.9%）和疫苗本身（27.3%）；77.5%的人只有在不需要自费的情况下才会接受疫苗接种。结论日本母亲RSV疫苗接种率较低，且存在社会经济和地区差异；认识不足和高额自费是主要障碍。减少自付费用和标准化医疗服务提供者的建议可以扩大覆盖面，减轻不公平现象。

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引用次数: 0

Does having allergic diseases affect SARS-CoV-2 antibody responses to mRNA vaccination in adolescents? 过敏性疾病是否会影响青少年对mRNA疫苗接种的SARS-CoV-2抗体反应？

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2025-12-11 DOI: 10.1016/j.jiac.2025.102893

Mayako Saito-Abe , Kiwako Yamamoto-Hanada , Tatsuki Fukuie , Kensuke Shoji , Yukihiro Ohya

Background

Understanding factors influencing vaccine-induced immunity in adolescents is important for optimizing COVID-19 vaccination strategies. Allergic diseases have been hypothesized to alter immune responses through Th2-dominant inflammation, but data regarding their impact on SARS-CoV-2 mRNA vaccine antibody production remain limited in real-world adolescent populations. The purpose of this study is to identify factors affecting SARS-CoV-2 antibody titers after mRNA vaccination in a general population of 16- to 17-year-olds.

Methods

This study analyzed data from 233 participants in the T-CHILD Study, a Japanese general birth cohort, who received their 17-year medical checkup between July 2021 and October 2023. Individuals with a history of COVID-19 or serological evidence of prior infection (positive for both S- and N-antibodies) were excluded. Associations between SARS-CoV-2 S-antibody titers and vaccination history, allergic diseases, and other variables were examined.

Results

Multivariate analysis revealed that only a higher number of vaccine doses was independently associated with higher SARS-CoV-2 antibody titers. No significant associations were found between antibody titers and vaccine type, the interval since the last vaccination, allergic diseases such as asthma, atopic dermatitis (AD), or food allergy, or with total serum IgE levels.

Conclusions

These findings suggest that adolescents with mild allergic diseases can mount sufficient immune responses to SARS-CoV-2 mRNA vaccines, supporting the safety and efficacy of vaccination in this population. (230 words)

背景：了解影响青少年疫苗诱导免疫的因素对优化COVID-19疫苗接种策略具有重要意义。人们假设过敏性疾病可以通过th2显性炎症改变免疫反应，但在现实世界的青少年人群中，关于过敏性疾病对SARS-CoV-2 mRNA疫苗抗体产生影响的数据仍然有限。本研究的目的是确定在16至17岁的普通人群中接种mRNA疫苗后影响SARS-CoV-2抗体滴度的因素。方法：本研究分析了T-CHILD研究中233名参与者的数据，这是一项日本普通出生队列研究，他们在2021年7月至2023年10月期间接受了17年的体检。排除有COVID-19病史或既往感染血清学证据（S抗体和n抗体均阳性）的个体。研究了SARS-CoV-2 s抗体滴度与疫苗接种史、过敏性疾病和其他变量之间的关系。结果：多因素分析显示，较高的疫苗剂量和较短的疫苗接种间隔与较高的SARS-CoV-2抗体滴度独立相关。疫苗类型也显示出显著的相关性，现代疫苗接种者的滴度高于辉瑞疫苗接种者。抗体滴度与过敏性疾病（如哮喘、特应性皮炎（AD）或食物过敏）以及血清总IgE水平之间未发现显著关联。结论：这些研究结果表明，患有轻度过敏性疾病的青少年可以对SARS-CoV-2 mRNA疫苗产生足够的免疫反应，支持疫苗接种在该人群中的安全性和有效性。(230字)。

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