Journal of Infection and Chemotherapy最新文献

{"title":"In vitro activity of cefiderocol against carbapenem-resistant Gram-negative pathogens in Japan","authors":"Kenjiro Matsui ,&nbsp;Aki Sakurai ,&nbsp;Yasufumi Matsumura ,&nbsp;Takuya Hosoda ,&nbsp;Masahiro Suzuki ,&nbsp;Sho Saito ,&nbsp;Ryota Hase ,&nbsp;Hideaki Kato ,&nbsp;Takehiro Hashimoto ,&nbsp;Takashi Matono ,&nbsp;Naoya Itoh ,&nbsp;Momoko Mawatari ,&nbsp;Kohei Uemura ,&nbsp;Kayoko Hayakawa ,&nbsp;Hiroyasu Ito ,&nbsp;Yohei Doi","doi":"10.1016/j.jiac.2026.102905","DOIUrl":"10.1016/j.jiac.2026.102905","url":null,"abstract":"<div><h3>Introduction</h3><div>Carbapenem-resistant Gram-negative bacteria (CRGNB) pose a major clinical threat. This study evaluated the <em>in vitro</em> activity of cefiderocol and other recently approved β-lactam/β-lactamase inhibitor combinations against major CRGNB.</div></div><div><h3>Materials and methods</h3><div>A total of 292 CRGNB clinical isolates were analyzed, comprising 146 Enterobacterales, 106 <em>Pseudomonas aeruginosa</em>, and 40 <em>Stenotrophomonas maltophilia</em>, all collected from hospitals across Japan. Antimicrobial susceptibility testing was performed by broth microdilution (BMD). Disk diffusion testing was also conducted for cefiderocol, and categorical agreement with BMD was assessed. Whole-genome sequencing (WGS) was used for species confirmation and characterization of resistance determinants.</div></div><div><h3>Results</h3><div>Carbapenemase producers accounted for 64.4 % of Enterobacterales (94/146) and 8.5 % of <em>P. aeruginosa</em> (9/106), with metallo-β-lactamase (MBL) producers comprising 92.6 % (87/94) and 77.8 % (7/9), respectively. Based on CLSI breakpoints, 94.5 % (276/292) of isolates were susceptible to cefiderocol, including 91.8 % of Enterobacterales, 99.1 % of <em>P. aeruginosa</em>, and 92.5 % of <em>S. maltophilia</em>. Ceftolozane-tazobactam, ceftazidime-avibactam, and imipenem-relebactam were active against 12.3 %, 44.5 % and 45.9 % of Enterobacterales, and 89.6 %, 86.8 % and 72.6 % of <em>P. aeruginosa</em>, respectively. Categorical agreement between cefiderocol disk diffusion and BMD exceeded 92 % across all groups, although very major errors occurred in Enterobacterales (n = 2) and <em>S. maltophilia</em> (n = 3). Cefiderocol-non-susceptible Enterobacterales isolates frequently harbored carbapenemase and extended-spectrum β-lactamase (ESBL) genes, together with mutations in <em>ftsI</em> (encoding PBP3), <em>ompK35</em>, or siderophore receptor genes (<em>cirA, tonB</em>).</div></div><div><h3>Discussion</h3><div>Cefiderocol showed potent <em>in vitro</em> activity against CRGNB in Japan, including MBL producers. Disk diffusion correlated well with BMD results; however, confirmatory BMD testing should be considered when resistance is clinically suspected.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 2","pages":"Article 102905"},"PeriodicalIF":1.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145933602","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}

{"title":"Orbital cellulitis with emm1-type M1UK sublineage group A Streptococcus detected in a blood culture: a case report","authors":"Aya Tateishi ,&nbsp;Takeru Kanazawa ,&nbsp;Kazuhiko Matsuhashi ,&nbsp;Ryo Karato ,&nbsp;Yoshifusa Abe ,&nbsp;Ayumi Tada ,&nbsp;Yuho Horikoshi","doi":"10.1016/j.jiac.2026.102913","DOIUrl":"10.1016/j.jiac.2026.102913","url":null,"abstract":"<div><div>Invasive group A streptococcal infection (iGAS) increases in Europe and it causes skin and soft-tissue infection, including orbital cellulitis. In this study, we report a case of a 7-year-old girl with orbital cellulitis and invasive <em>emm</em>1-type M1_UK sublineage group A <em>Streptococcus</em> (GAS) detected in a blood culture. The patient was initially treated with a combination of cefotaxime (CTX) and clindamycin (CLDM). We changed antibiotics from CTX to ampicillin after susceptibility results were known. After discharge, oral clavulanic acid/amoxicillin was continued as an oral medication, and antibiotics were administered for a total of 21 days. The bacterium was isolated from a blood culture and identified as an <em>emm</em>1-type M1_UK sublineage GAS. This case is unusual in that it involved bloodstream infection in a pediatric orbital cellulitis, and M1_UK's highly toxin-producing and highly transmissible may have been implicated. In rapidly exacerbating orbital cellulitis, iGAS infection should be considered.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 2","pages":"Article 102913"},"PeriodicalIF":1.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146044175","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}

{"title":"Impact of preoperative urine culture on postoperative febrile urinary tract infection after ureterorenoscopic lithotripsy","authors":"Junya Hara ,&nbsp;Katsuki Muramoto ,&nbsp;Sumire Santo ,&nbsp;Takuya Hagiwara ,&nbsp;Kazuaki Yamaga ,&nbsp;Hakaru Masumoto ,&nbsp;Yuji Yata ,&nbsp;Tomohiro Hongo ,&nbsp;Tomoya Yamasaki ,&nbsp;Rei Kato ,&nbsp;Kei Fujio ,&nbsp;Shinya Uehara ,&nbsp;Mitsuru Oshiro ,&nbsp;Hideo Otsuki","doi":"10.1016/j.jiac.2026.102918","DOIUrl":"10.1016/j.jiac.2026.102918","url":null,"abstract":"<div><h3>Introduction</h3><div>Ureterorenoscopic lithotripsy (URSL) has become the first-line treatment for upper urinary tract calculi smaller than 20 mm in Japan. However, postoperative febrile urinary tract infection (f-UTI) sometimes leads to fatal outcomes. Few studies have evaluated the impact of bacterial strains and counts from preoperative urine cultures on f-UTI risk. This study investigated these associations and discussed potential preventive strategies.</div></div><div><h3>Materials and methods</h3><div>We retrospectively analyzed 1514 URSL cases performed between October 2018 and September 2023. Positive urine culture was defined as ≥10⁴ CFU/mL. Cases were divided into a low-count group (&lt;10⁶ CFU/mL) and a high-count group (≥10⁶ CFU/mL). F-UTI incidence was assessed according to demographics, bacterial strains, and counts. Statistical analyses included chi-square test, Student's t-test, and multivariate logistic regression.</div></div><div><h3>Results</h3><div>Postoperative f-UTI occurred in 127 cases (8.4%). Multivariate analysis identified preoperative f-UTI and positive urine culture as independent predictors. F-UTI incidence was 5.3% in culture-negative versus 12.1% in culture-positive cases. High-count cases showed a significantly higher f-UTI rate than low-count cases (17.9% vs. 11.2%, p &lt; 0.01). <em>Escherichia coli</em> was associated with f-UTI even at low counts, while <em>Enterococcus faecalis</em> increased risk only at high counts. Multidrug-resistant strains such as <em>Corynebacterium</em> and <em>Enterococcus faecium</em> were also high-risk strains.</div></div><div><h3>Discussion</h3><div>Preoperative positive urine culture was an independent risk factor for f-UTI after URSL. Both bacterial strain and count influenced infection risk. When high-risk strains or high bacterial counts are present, careful antibiotic selection, shorter operative time, and intrarenal pressure control may help reduce postoperative f-UTI.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 3","pages":"Article 102918"},"PeriodicalIF":1.5,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146098608","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}

{"title":"An infected aneurysm in the internal carotid artery caused by Salmonella enterica subsp. enterica serovar Enteritidis","authors":"Kazuki Maegawa ,&nbsp;Hikari Tomita ,&nbsp;Ami Masaoka ,&nbsp;Hiroaki Nishioka","doi":"10.1016/j.jiac.2026.102912","DOIUrl":"10.1016/j.jiac.2026.102912","url":null,"abstract":"<div><div>An infected aneurysm in the carotid artery is a rare but life-threatening condition. The most common cause of such infections is <em>Staphylococcus aureus</em>; however, <em>Salmonella</em> is a possible but uncommon cause. We report the case of an elderly man with an infected aneurysm in the left internal carotid artery caused by <em>Salmonella enterica</em> subsp. <em>Enterica</em> serovar Enteritidis despite the absence of gastrointestinal symptoms. Following confirming the absence of neurological symptoms after blood flow disruption through balloon test occlusion (BTO), the patient underwent coil embolization of the aneurysm and aneurysmectomy without neurological complications. Antibiotics were administered for 8 weeks and full recovery was achieved. Non-typhoidal <em>Salmonella</em> spp. can cause infected aneurysms in the carotid artery, even in the absence of gastrointestinal symptoms. Additionally, BTO may be beneficial for determining the treatment strategy for infected aneurysms in the carotid artery.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 2","pages":"Article 102912"},"PeriodicalIF":1.5,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023983","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}

{"title":"Promoting COVID-19 vaccination: Results of a 2024 Japanese survey of outpatient intention to vaccinate","authors":"Takuma Bando,&nbsp;Hideyuki Ikematsu,&nbsp;Kazuya Hamada,&nbsp;Masako Negami,&nbsp;Hiroyuki Fujii,&nbsp;Ken-ichi Doniwa,&nbsp;Naoki Kawai","doi":"10.1016/j.jiac.2026.102911","DOIUrl":"10.1016/j.jiac.2026.102911","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to examine outpatient perceptions of voluntary, routine coronavirus disease (COVID-19) vaccinations scheduled for fall and winter of 2024.</div></div><div><h3>Methods</h3><div>A questionnaire was administered to the patients of five Japanese general medicine clinics.</div></div><div><h3>Results</h3><div>A total of 692 questionnaires were returned. Of the respondents, 38.5 % intended to receive vaccination. The intention to be vaccinated was significantly higher among respondents aged ≥60 years and those with high-risk underlying conditions, and was lower among those with a history of COVID-19. Intention increased as the number of past vaccinations increased. Multivariable logistic regression analysis revealed a significantly lower intention for women than for men. A higher number of past vaccinations was significantly associated with greater intention. The most frequently cited reason for hesitancy was concerns about adverse reactions, particularly among women (44.3 %). Of the respondents, &gt;90 % preferred a vaccination fee of &lt;3000 JPY.</div></div><div><h3>Conclusion</h3><div>To encourage COVID-19 vaccination, it is essential to provide clear information on adverse effects, particularly for women and individuals with fewer prior vaccinations. Reducing the out-of-pocket cost of vaccination to 3000 to 5000 JPY or less through public subsidies would likely improve coverage.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 2","pages":"Article 102911"},"PeriodicalIF":1.5,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146018758","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}

{"title":"Structured framework for the application of metagenomic next-generation sequencing in the whole-process management of lower respiratory tract infections","authors":"Meihua Zhao ,&nbsp;Xisheng Yu ,&nbsp;Meizeng Zhao ,&nbsp;Guoqing Zhang","doi":"10.1016/j.jiac.2026.102910","DOIUrl":"10.1016/j.jiac.2026.102910","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aims to assess the impact of metagenomic next-generation sequencing (mNGS) on optimizing diagnostic-therapeutic pathways for lower respiratory tract infections (LRTIs).</div></div><div><h3>Methods</h3><div>This retrospective observational study analyzed 42 consecutive LRTI patients at Jiading Branch of Shanghai General Hospital (June 2023–October 2024). Comprehensive clinical data were evaluated including demographic features, laboratory result, radiological findings, mNGS interpretation, treatment modifications, and outcomes.</div></div><div><h3>Results</h3><div>The mNGS detected pathogens in 37/42 patients (88.1 %), despite the fact that 38 patients (90.5 %) had received ineffective empirical antibiotic therapy prior to mNGS testing. More than half the patients (22/42, 52.4 %) had comorbidities and about half the cases were within the normal range in the level of inflammatory biomarker. Pathognomonic CT features suggesting specific pathogens were observed in 33.3 % (14/42) of cases. With regard to the interpretation of mNGS reports combaining the clinical characteristics, the results were consistent with the final diagnosis in 30 (30/42, 71.4 %) patients. Crucially, 92.9 % (39/42) underwent treatment modifications: 66.7 % (28/42) transitioned to targeted/narrower-spectrum antibiotics and 26.2 % (11/42) discontinued antimicrobial therapy following infection exclusion. Patients receiving targeted regimens demonstrated universal clinical improvement with radiological resolution, particularly in complex infections.</div></div><div><h3>Conclusion</h3><div>While mNGS provides robust pathogen detection, its clinical application requires integration with multidimensional patient data. The standardized protocol proposed in this study has the potential to enhances diagnostic efficiency and resource utilization in LRTI management.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 2","pages":"Article 102910"},"PeriodicalIF":1.5,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145998288","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}

{"title":"Oligella urethralis bacteremia associated with urinary tract obstruction: A case report and literature review","authors":"Emiri Muranaka ,&nbsp;Mutsuka Kurihara ,&nbsp;Naoki Okawa ,&nbsp;Yuji Nishihara ,&nbsp;Haruki Mito ,&nbsp;Natsuki Fujiwara ,&nbsp;Yuichi Oshimoto ,&nbsp;Yasunobu Endo ,&nbsp;Ryota Hase","doi":"10.1016/j.jiac.2026.102909","DOIUrl":"10.1016/j.jiac.2026.102909","url":null,"abstract":"<div><div><em>Oligella urethralis</em> is a gram-negative, non-fermentative coccobacillus that is considered part of the normal urogenital flora but can cause opportunistic infections in immunocompromised patients or those with underlying conditions. Coccobacilli such as <em>O. urethralis</em> are rarely encountered as urinary pathogens compared to typical rod-shaped bacteria, making their identification clinically significant. We report a case of <em>O. urethralis</em> bacteremia in a 74-year-old male long-term care facility resident with ureteral stones who presented with acute pyelonephritis and bacteremia. Blood and urine cultures both yielded small gram-negative bacilli, which were identified as <em>O. urethralis</em> using MALDI-TOF mass spectrometry, and the patient was successfully treated with antibiotics. A literature search for reports published between 1987 and May 2025 identified six previously reported cases of <em>O. urethralis</em> bacteremia with English abstracts. Including our case, a total of seven cases were analyzed. All cases occurred in elderly patients (median age 79 years) with predisposing conditions, particularly obstructive uropathy. The prognosis was favorable; only one death occurred among the seven patients (1/7), and it was attributed to causes other than the <em>O. urethralis</em> infection. <em>O. urethralis</em> should be considered a potential pathogen in elderly patients with obstructive uropathy presenting with bacteremia, especially when gram-negative coccobacilli are identified on blood cultures. Fluoroquinolone resistance is frequently reported in <em>O. urethralis</em>, and awareness of this organism is important for appropriate antimicrobial selection, particularly given the challenges in antimicrobial susceptibility interpretation due to lack of species-specific breakpoints.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 2","pages":"Article 102909"},"PeriodicalIF":1.5,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145989625","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}

{"title":"Adjunctive and supportive strategies to mitigate drug toxicities in the treatment of nontuberculous mycobacterial disease with future directions","authors":"Ho Won Kim ,&nbsp;Hoe Sun Yoon ,&nbsp;Jake Whang ,&nbsp;Jong-Seok Kim","doi":"10.1016/j.jiac.2026.102908","DOIUrl":"10.1016/j.jiac.2026.102908","url":null,"abstract":"<div><div>Nontuberculous mycobacteria (NTM), particularly <em>Mycobacterium avium</em> complex (MAC) and <em>Mycobacterium abscessus</em> complex (MABC), are increasingly recognized as major opportunistic pathogens. Standard therapy requires prolonged multidrug regimens, often extending for more than 12 months, yet treatment success remains limited, especially for MABC. One of the greatest barriers to effective therapy is not antimicrobial resistance alone but also the high burden of drug-related toxicities. Hepatotoxicity, ototoxicity, nephrotoxicity, myelosuppression, neuropathy, gastrointestinal intolerance, and dermatologic complications frequently lead to dose reduction, interruption, or discontinuation, undermining therapeutic efficacy and patient adherence.</div><div>This review summarizes current standard regimens for MAC and MABC, details the spectrum of toxicities associated with commonly used agents, and evaluates emerging supportive and adjunctive strategies. Hepatoprotective agents such as ursodeoxycholic acid, silymarin, and N-acetylcysteine, antioxidants and aspirin for aminoglycoside-related ototoxicity, liposomal inhaled amikacin as an alternative to intravenous administration, dose optimization and pyridoxine supplementation for linezolid, and prophylactic antiemetics for tigecycline represent pragmatic approaches with varying levels of evidence. While most supportive measures are extrapolated from tuberculosis cohorts or small pilot studies, they collectively highlight the potential to improve tolerability and adherence.</div><div>Future research should prioritize prospective, NTM-specific trials to validate these interventions and develop structured toxicity management frameworks. By embedding supportive strategies alongside antimicrobial regimens, NTM care can move toward a more holistic paradigm that not only enhances microbiological outcomes but also improves patient quality of life.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 2","pages":"Article 102908"},"PeriodicalIF":1.5,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145979951","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}

{"title":"Evaluation of Japan-specific cefiderocol susceptibility testing methods in multidrug-resistant gram-negative isolates from Japan and Bangladesh","authors":"Takashi Okanda ,&nbsp;Niinyo Nakajima ,&nbsp;Takuro Koshikawa ,&nbsp;Tadatomo Oyanagi ,&nbsp;Tomonori Takano ,&nbsp;Tetsuo Yamaguchi ,&nbsp;Hiroyuki Kunishima ,&nbsp;Mitsuo Kaku ,&nbsp;Hiromu Takemura","doi":"10.1016/j.jiac.2026.102903","DOIUrl":"10.1016/j.jiac.2026.102903","url":null,"abstract":"<div><h3>Background</h3><div>Cefiderocol (CFDC) exhibits potent in vitro activity against multidrug-resistant Gram-negative bacilli (MDR-GNB), yet standardized susceptibility testing remains technically demanding. This study evaluated the reproducibility and categorical agreement (CA) of broth microdilution (BMD), MIC dry plate (DP), and disk diffusion (DD) using MDR-GNB from Japan and Bangladesh. To our knowledge, this is the first systematic assessment of Japan-specific commercial platforms for CFDC testing.</div></div><div><h3>Methods</h3><div>A total of 452 MDR-GNB isolates, including 272 Enterobacterales and 180 non-fermenters (<em>Pseudomonas aeruginosa</em>, <em>Acinetobacter baumannii</em>, <em>Stenotrophomonas maltophilia</em>), were tested using BMD and two commercial platforms. Reproducibility was assessed in triplicate, and essential agreement, CA, and error rates were determined with BMD as the reference.</div></div><div><h3>Results</h3><div>BMD demonstrated &gt;90 % reproducibility across species. DP and DD showed reduced reproducibility and agreement for NDM-producing Enterobacterales, with CA of 54 % for DP and 63 % for DD. Most discrepancies were minor errors. Trailing effects and visual artifacts contributed to elevated MICs, particularly in DP.</div></div><div><h3>Conclusions</h3><div>The performance of simplified CFDC susceptibility methods varies by species and resistance mechanism, with notable limitations for NDM producers. While DP and DD remain practical tools for routine laboratories, their use requires caution. Parallel DP–DD testing does not replace BMD but can help identify discrepant results requiring confirmation, particularly for NDM-producing isolates.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 2","pages":"Article 102903"},"PeriodicalIF":1.5,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145952232","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}

{"title":"Microbiologic clearance in macrolide-resistant Bordetella pertussis: An infant treated with sulfamethoxazole-trimethoprim — A case timeline","authors":"Yu Kuramochi ,&nbsp;Meiwa Shibata ,&nbsp;Mikako Morinaga ,&nbsp;Tomoyuki Tame ,&nbsp;Kazue Kinoshita ,&nbsp;Osamu Saito ,&nbsp;Yuho Horikoshi","doi":"10.1016/j.jiac.2026.102907","DOIUrl":"10.1016/j.jiac.2026.102907","url":null,"abstract":"<div><div>Amid a large-scale resurgence of pertussis in Japan in 2025, concern is growing about the spread of macrolide-resistant <em>Bordetella pertussis</em> (MRBP)—prevalent in China—posing a clinical challenge, particularly in infants. We describe a term 6-week-old unvaccinated infant with life-threatening MRBP. Diagnosis was confirmed by culture and multiplex PCR. The isolate harbored the 23S rRNA A2047G mutation. Daily microbiology (Gram stain, culture, quantitative PCR) was performed on nasopharyngeal swabs and lower-airway aspirates. The infant received empiric azithromycin and a 14-day course of sulfamethoxazole–trimethoprim (SMX-TMP) and recovered without sequelae. Nasopharyngeal cultures became negative by Day 2 of SMX-TMP therapy, and lower-airway aspirate cultures by Day 3. Nasopharyngeal quantitative PCR was below the detection limit by Day 7. Lower-airway quantitative PCR declined through Day 7, and sampling ceased after extubation. These observations suggest that bacteriologic clearance with SMX-TMP may occur on a time frame similar to that used to discontinue precautions for macrolide-susceptible disease, commonly five days after starting effective therapy. During the current resurgence in Japan, transmission appears concentrated among school-aged children, whereas the national vaccination program targets only those under two years of age. Introducing booster doses at 5–6 and 11–12 years may help reduce school-based transmission. In addition, maternal booster vaccination during pregnancy could protect young infants through the transplacental transfer of maternal pertussis antibodies.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 2","pages":"Article 102907"},"PeriodicalIF":1.5,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145952276","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}