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

Clinical utility of the MN severity criteria in predicting recurrent Clostridioides difficile infection MN严重程度标准预测难辨梭菌感染复发的临床应用

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2026-03-01 Epub Date: 2026-02-12 DOI: 10.1016/j.jiac.2026.102930

Jun Hirai , Yuki Hanai

Background

Clostridioides difficile infection (CDI) frequently recurs and remains a major clinical challenge. The MN severity criteria, a Japanese scoring system for assessing acute CDI severity, have not previously been evaluated for predicting recurrence.

Methods

We conducted a single-center retrospective cohort study between January 2011 and July 2025. The MN severity score was calculated at diagnosis. CDI recurrence was defined as symptomatic infection with a positive stool toxin test within 8 weeks after initial clinical response. Multivariable logistic regression and receiver operating characteristic (ROC) analyses were performed to evaluate predictors of recurrence.

Results

Among 558 eligible patients, 139 (24.9%) experienced CDI recurrence. Patients with recurrence had significantly higher MN severity scores at diagnosis (median 9 vs. 8, p < 0.001). An MN score ≥9 predicted recurrence with an area under the ROC curve of 0.70 (sensitivity 69.1%, specificity 63.3%). In multivariable analysis, an MN score ≥9 was independently associated with recurrence (adjusted odds ratio [aOR] 4.76, 95% confidence interval [CI] 2.97–7.61). Hematologic malignancy (2.28, 1.21–4.28) was also independently associated with recurrence, whereas use of potassium-competitive acid blockers was protective (0.33, 0.12–0.90). Higher MN severity scores were additionally associated with a shorter time to recurrence and a lower clinical cure rate.

Conclusion

The MN severity score, originally developed to assess acute CDI severity, also independently predicts 8-week recurrence. Incorporating the MN criteria into routine clinical practice may facilitate early identification of patients at high risk for recurrence and support individualized post-treatment strategies, including enhanced monitoring and recurrence-prevention interventions.

艰难梭菌感染（CDI）经常复发，仍然是一个主要的临床挑战。MN严重程度标准是一种评估急性CDI严重程度的日本评分系统，以前未对预测复发进行过评估。方法2011年1月至2025年7月进行单中心回顾性队列研究。诊断时计算MN严重程度评分。CDI复发定义为首次临床反应后8周内大便毒素试验阳性的症状性感染。采用多变量logistic回归和受试者工作特征（ROC）分析来评估复发的预测因素。结果558例符合条件的患者中，139例（24.9%）出现CDI复发。复发患者在诊断时MN严重程度评分明显较高（中位数为9比8，p < 0.001）。MN评分≥9预测复发，ROC曲线下面积为0.70（敏感性69.1%，特异性63.3%）。在多变量分析中，MN评分≥9与复发独立相关（调整优势比[aOR] 4.76, 95%可信区间[CI] 2.97-7.61）。血液恶性肿瘤（2.28,1.21-4.28）也与复发独立相关，而使用钾竞争酸阻滞剂具有保护作用（0.33,0.12-0.90）。MN严重程度评分越高，复发时间越短，临床治愈率越低。MN严重程度评分最初用于评估急性CDI严重程度，也可独立预测8周复发。将MN标准纳入常规临床实践可能有助于早期识别复发高风险患者，并支持个性化的治疗后策略，包括加强监测和预防复发干预。

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引用次数: 0

Evaluation of an in-house rapid antimicrobial susceptibility testing (RAST) using the direct disk-diffusion method for gram-negative bacilli from positive blood cultures in a Japanese tertiary hospital jiche - d - 25 - 01188。R1：日本一家三级医院采用直接圆盘扩散法对阳性血培养的革兰氏阴性杆菌进行内部快速抗菌药物敏感性试验（RAST）的评价。

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2026-03-01 Epub Date: 2026-02-10 DOI: 10.1016/j.jiac.2026.102927

Moeko Ohara , Mitsutaka Iguchi , Teruko Ohkura , Yukari Osada , Jun Taguchi , Kohei Kanda , Toshihiko Okumura , Hiroshi Morioka , Keisuke Oka , Tetsuya Yagi

Background

Rapid antimicrobial susceptibility testing (RAST) by direct disk-diffusion (DD) on positive blood cultures can shorten the time to optimize therapy for bloodstream infections. Since 2014, we have implemented an in-house RAST-DD protocol for gram-negative bacilli based on CLSI M100-S23.

Methods

Positive blood cultures processed between April and September 2024 were tested using our in-house RAST-DD method (12-antimicrobial panel including cefmetazole [CMZ]) and compared with broth microdilution interpreted according to CLSI M100-ED29. Categorical agreement (CA) and error rates—very major (VME), major (ME), and minor (mE)—were calculated. We also assessed the effects of applying updated CLSI criteria and rapid species identification, and evaluated the clinical utility of CMZ for extended-spectrum β-lactamase (ESBL)-producing Enterobacterales.

Results

Among 234 g-negative isolates (206 Enterobacterales, 28 glucose non-fermenters), most agents showed high CA, but VMEs occurred for cefepime and ceftriaxone, and MEs for cefazolin and tazobactam/piperacillin among Enterobacterales. Applying CLSI M100-ED29 susceptible dose-dependent criteria and rapid identification reduced VMEs and mEs (CA 93.8%, VME 0.1%, ME 5.4%, mE 0.6%). CMZ achieved 100% CA for Enterobacterales excluding chromosomal AmpC producers and supported carbapenem-sparing treatment in several ESBL-producing Escherichia coli bacteremia cases with favorable outcomes.

Conclusions

The in-house RAST-DD method demonstrated reliable performance for gram-negative bacilli. Updating interpretive criteria and incorporating rapid identification reduced interpretive errors. Inclusion of a CMZ disk in the RAST panel may support carbapenem-sparing therapy for ESBL-producing Enterobacterales.

背景：采用直接圆盘扩散法（DD）对阳性血培养物进行快速药敏试验（RAST）可以缩短优化血流感染治疗的时间。自2014年以来，我们已经实施了基于CLSI M100-S23的革兰氏阴性杆菌的内部RAST-DD方案。方法：对2024年4月至9月处理的阳性血培养采用我们的内部RAST-DD方法（包括头孢美唑[CMZ]在内的12种抗菌素组）进行检测，并与根据CLSI M100-ED29解释的肉汤微量稀释进行比较。计算了绝对一致性（CA）和错误率——非常严重（VME）、严重（ME）和轻微（ME）。我们还评估了应用更新的CLSI标准和快速物种鉴定的效果，并评估了CMZ在广谱β-内酰胺酶（ESBL）产生肠杆菌中的临床应用。结果：234株革兰氏阴性分离菌（206株肠杆菌，28株葡萄糖非发酵菌）中，大多数药物的CA值较高，但肠杆菌中头孢吡肟和头孢曲松的CA值较高，头孢唑林和他唑巴坦/哌拉西林的CA值较高。应用CLSI M100-ED29敏感剂量依赖标准和快速鉴定可降低VME和mEs （CA 93.8%, VME 0.1%, ME 5.4%, ME 0.6%）。CMZ在肠杆菌（不包括染色体AmpC生产者）中实现了100%的CA，并支持在几个产生esbl的大肠杆菌血症病例中使用碳青霉烯节约治疗，并取得了良好的结果。结论：本方法对革兰氏阴性杆菌具有可靠的检测效果。更新解释标准和结合快速识别减少了解释错误。在RAST组中加入CMZ盘可能支持对产生esbl的肠杆菌进行碳青霉烯保留治疗。

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引用次数: 0

The usefulness of cytomegalovirus IgG avidity tests for predicting congenital cytomegalovirus infection: A comparison between chemiluminescent microparticle immunoassay and enzyme-linked immunosorbent assay 巨细胞病毒IgG抗体检测预测先天性巨细胞病毒感染的有效性：化学发光微粒免疫分析法与酶联免疫吸附法的比较

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2026-03-01 Epub Date: 2026-02-09 DOI: 10.1016/j.jiac.2026.102929

Kenji Tanimura , Akiko Uchida , Takumi Kido , Kazumichi Fujioka , Ichiro Morioka , Toshio Minematsu , Hideto Yamada

Introduction

This study evaluated the correlation between cytomegalovirus (CMV) IgG avidity measured by chemiluminescent microparticle immunoassay (CMIA) and enzyme-linked immunosorbent assay (ELISA), and assessed the usefulness of CMIA for predicting congenital CMV (cCMV) infection, compared with ELISA.

Methods

A total of 130 serum samples, previously tested for CMV IgG avidity using ELISA, were selected. Thirty samples were obtained from pregnant women positive for both CMV-specific IgG (CMV IgG) and IgM, and 100 samples were obtained from pregnant women positive for CMV IgG but negative for CMV IgM. CMV IgG avidities in these stored sera were measured by CMIA and compared with the ELISA results.

Results

A strong positive correlation was observed between CMV IgG avidities measured by ELISA and CMIA among the 30 pregnant women positive for both CMV IgG and IgM (Spearman's ρ = 0.78, p = 3.8 × 10⁻⁷). Additionally, in 121 women (93.1%), the CMIA classifications of low and high avidities (low: <50%Avi, high: ≥60%Avi) were consistent with those from ELISA (low: <35%, high: >40%). Among the 18 pregnant women whose newborns had cCMV infection, eight and six were classified as having low avidities by ELISA and CMIA, respectively.

Conclusions

The high concordance rate in classifying CMV IgG avidities as low or high between ELISA and CMIA suggests that both methods exhibit similar clinical usefulness in predicting cCMV infection resulting from primary maternal CMV infection.

简介：本研究评估了化学发光微粒免疫分析法（CMIA）和酶联免疫吸附法（ELISA）测定巨细胞病毒（CMV） IgG亲和力的相关性，并比较了CMIA与ELISA预测先天性巨细胞病毒（cCMV）感染的有效性。方法：选取既往用ELISA法检测巨细胞病毒IgG抗体的血清130份。从CMV特异性IgG （CMV IgG）和IgM均阳性的孕妇中获得30份样本，从CMV IgG阳性但CMV IgM阴性的孕妇中获得100份样本。用CMIA法检测血清中CMV IgG的活性，并与ELISA结果进行比较。结果：在30例CMV IgG和IgM均阳性的孕妇中，ELISA检测的CMV IgG与CMIA呈显著正相关（Spearman ρ = 0.78, p = 3.8 × 10-7）。此外，在121名妇女（93.1%）中，CMIA分类为低和高发病率（低：40%）。在18例新生儿感染cCMV的孕妇中，ELISA和CMIA分别为8例和6例低胆固醇。结论：ELISA和CMIA在CMV IgG活性高低分类上的一致性较高，提示两种方法在预测母体原发CMV感染引起的cCMV感染方面具有相似的临床应用价值。

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引用次数: 0

Maternal RSV vaccination in Japan: Beyond financial barriers toward the 2026 routine immunization transition 日本母亲RSV疫苗接种：克服财政障碍，向2026年常规免疫过渡

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2026-03-01 Epub Date: 2026-02-02 DOI: 10.1016/j.jiac.2026.102920

Masaki Machida

引用次数: 0

Clinical characteristics of Parvimonas micra bacteremia in Japan: A single-center case series and literature review 日本微小细小单胞菌菌血症的临床特征：单中心病例系列和文献回顾。

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2026-03-01 Epub Date: 2026-02-09 DOI: 10.1016/j.jiac.2026.102928

Shugo Inada , Hiroki Kitagawa , Keitaro Omori , Kayoko Tadera , Toshinori Hara , Yuta Kuhara , Takuji Omoto , Toshihito Nomura , Norifumi Shigemoto , Noboru Hattori , Hiroki Ohge

Objectives

Gram-positive anaerobic cocci (GPAC) account for 11–15% of anaerobic bacteremia. Parvimonas micra is one of the most commonly identified microorganisms in GPAC bacteremia. This study reviewed the clinical characteristics of P. micra bacteremia.

Methods

We conducted a retrospective analysis of the records of 35 patients diagnosed with P. micra bacteremia at Hiroshima University Hospital between January 2011 and July 2024 and conducted a literature review, comparing our cases with previous reports.

Results

The median patient age was 70 years, and 74% (26/35) were male. All had immunosuppressive conditions such as solid organ malignancy (49%, 17/35) and diabetes mellitus (34%, 12/35). Of the patients evaluated by a dentist, 96% (22/23) had periodontitis. The most common source of P. micra bacteremia was intra-abdominal infections (31%, 11/35), followed by dental (20%, 7/35), lower respiratory tract (20%, 7/35), and skin and soft tissue infections (14%, 5/35). The prevalence of dental infections was higher than that reported previously, but the distribution of other sources of infection was comparable. Of the patients with P. micra bacteremia, 57% (20/35) had polymicrobial infections, with members of the Streptococcus anginosus group being the most frequently identified co-pathogens (45%, 9/20). The 30-day mortality rate was 26% (9/35). All P. micra isolates showed low minimum inhibitory concentrations for β-lactam antibiotics.

Conclusion

Dental infection represented the second most frequent source of P. micra bacteremia, following intra-abdominal infection. In patients with P. micra bacteremia, clinicians should check for periodontitis and investigate the presence polymicrobial infections.

目的：革兰氏阳性厌氧球菌（GPAC）占厌氧菌血症的11-15%。微细小单胞菌是GPAC菌血症中最常见的微生物之一。本文综述了微假单胞菌血症的临床特点。方法：回顾性分析2011年1月至2024年7月在广岛大学医院诊断为微假单胞菌血症的35例患者的记录，并进行文献复习，将我们的病例与以往的报道进行比较。结果：患者中位年龄为70岁，男性占74%（26/35）。所有患者均有免疫抑制情况，如实体器官恶性肿瘤（49%,17/35）和糖尿病（34%,12/35）。在接受牙医评估的患者中，96%（22/23）患有牙周炎。微微p.m icra菌血症最常见的来源是腹腔感染（31%,11/35），其次是口腔感染（20%,7/35）、下呼吸道感染（20%,7/35）和皮肤和软组织感染（14%,5/35）。牙齿感染的流行率比以前报道的要高，但其他感染源的分布是相似的。在微假单胞菌血症患者中，57%（20/35）存在多微生物感染，其中最常见的共病原菌是血管链球菌（Streptococcus anginosus）（45%, 9/20）。30天死亡率为26%（9/35）。所有微微假单胞菌对β-内酰胺类抗生素的最低抑菌浓度均较低。结论：口腔感染是微假杆菌菌血症的第二大常见来源，仅次于腹腔感染。在微假杆菌菌血症患者中，临床医生应检查牙周炎并调查是否存在多种微生物感染。

{"title":"Clinical characteristics of Parvimonas micra bacteremia in Japan: A single-center case series and literature review","authors":"Shugo Inada , Hiroki Kitagawa , Keitaro Omori , Kayoko Tadera , Toshinori Hara , Yuta Kuhara , Takuji Omoto , Toshihito Nomura , Norifumi Shigemoto , Noboru Hattori , Hiroki Ohge","doi":"10.1016/j.jiac.2026.102928","DOIUrl":"10.1016/j.jiac.2026.102928","url":null,"abstract":"<div><h3>Objectives</h3><div>Gram-positive anaerobic cocci (GPAC) account for 11–15% of anaerobic bacteremia. <em>Parvimonas micra</em> is one of the most commonly identified microorganisms in GPAC bacteremia. This study reviewed the clinical characteristics of <em>P. micra</em> bacteremia.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of the records of 35 patients diagnosed with <em>P. micra</em> bacteremia at Hiroshima University Hospital between January 2011 and July 2024 and conducted a literature review, comparing our cases with previous reports.</div></div><div><h3>Results</h3><div>The median patient age was 70 years, and 74% (26/35) were male. All had immunosuppressive conditions such as solid organ malignancy (49%, 17/35) and diabetes mellitus (34%, 12/35). Of the patients evaluated by a dentist, 96% (22/23) had periodontitis. The most common source of <em>P. micra</em> bacteremia was intra-abdominal infections (31%, 11/35), followed by dental (20%, 7/35), lower respiratory tract (20%, 7/35), and skin and soft tissue infections (14%, 5/35). The prevalence of dental infections was higher than that reported previously, but the distribution of other sources of infection was comparable. Of the patients with <em>P. micra</em> bacteremia, 57% (20/35) had polymicrobial infections, with members of the <em>Streptococcus anginosus</em> group being the most frequently identified co-pathogens (45%, 9/20). The 30-day mortality rate was 26% (9/35). All <em>P. micra</em> isolates showed low minimum inhibitory concentrations for β-lactam antibiotics.</div></div><div><h3>Conclusion</h3><div>Dental infection represented the second most frequent source of <em>P. micra</em> bacteremia, following intra-abdominal infection. In patients with <em>P. micra</em> bacteremia, clinicians should check for periodontitis and investigate the presence polymicrobial infections.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 3","pages":"Article 102928"},"PeriodicalIF":1.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146165488","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

Tick-borne pathogens in ticks collected from Humans: A prospective clinical pilot study 从人身上收集的蜱传病原体：一项前瞻性临床试验研究。

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2026-03-01 Epub Date: 2026-02-18 DOI: 10.1016/j.jiac.2026.102931

Shinnosuke Fukushima , Takaomi Sumida , Osamu Kawamata , Yoshimi Hidani , Hideharu Hagiya

Tick-borne diseases (TBDs), particularly Japanese spotted fever, are an increasing public health concern in Japan. Data on pathogens carried by ticks removed directly from patients and their associated clinical outcomes remain limited. This prospective study investigated pathogen carriage in patient-derived ticks and evaluated the clinical risk of TBDs. Between April and October 2025, ticks were collected from patients presenting with tick bites at two medical institutions in Western Japan. Ticks were morphologically identified and spotted fever group rickettsiae (SFGR) was detected by nested PCR targeting the 17-kDa antigen gene, followed by sequence analysis. Clinical data, including patient background, antibiotic prescriptions, and outcomes, were reviewed. Clinical information was available for 70 patients (median age; 75 years), of whom 88.6% were prescribed prophylactic antibiotics. Ticks were collected from 60 patients (85.7%), and seven adults without antibiotic prophylaxis were followed for disease onset. Sixty-two ticks, predominantly Amblyomma testudinarium (88.7%), were analyzed. SFGR was detected in eight ticks (12.9%), including seven A. testudinarium and one Ixodes nipponensis, collected from seven patients. Two patients bitten by Rickettsia tamurae–carrying ticks were observed for one month without antibiotics and remained asymptomatic. In this prospective analysis, no clinically apparent rickettsiosis was observed following bites from R. tamurae–positive ticks without antibiotic prophylaxis; however, subclinical infection could not be excluded. Despite the small sample size, our findings suggest that the clinical risk associated with R. tamurae infection may be low. Direct analysis of removed ticks from patients may help characterize pathogen reservoirs and inform targeted approaches to TBDs.

蜱传疾病，特别是日本斑疹热，是日本日益严重的公共卫生问题。直接从患者身上移除的蜱携带的病原体及其相关临床结果的数据仍然有限。本前瞻性研究调查了患者源性蜱的病原体携带情况，并评估了tbd的临床风险。在2025年4月至10月期间，在日本西部的两家医疗机构从蜱虫叮咬的患者身上收集了蜱虫。采用针对17-kDa抗原基因的巢式PCR方法对蜱进行形态鉴定，检测斑点热群立克次体（SFGR），并进行序列分析。临床资料，包括患者背景，抗生素处方和结果进行了回顾。有70例患者（中位年龄75岁）的临床资料，其中88.6%的患者使用了预防性抗生素。采集蜱虫60例（85.7%），对7例未使用抗生素预防的成人进行发病随访。共检获蜱类62只，以鼠眼钝蜱为主，占88.7%。从7例患者采集的蜱中检出SFGR 8只（12.9%），其中雄绒按蚊7只，日本按蚊1只；2例患者被携带tamurera立克次体的蜱叮咬1个月，未使用抗生素，无症状。在这项前瞻性分析中，未观察到未经抗生素预防的tamurae阳性蜱叮咬后临床明显的立克次体病；但不能排除亚临床感染。尽管样本量小，但我们的研究结果表明，与tamurae感染相关的临床风险可能很低。直接分析从患者身上取出的蜱虫可能有助于表征病原体储存库，并为TBDs提供有针对性的方法。

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引用次数: 0

Definitive cefepime versus carbapenems for bacteremia caused by Enterobacterales with a risk of chromosomal AmpC production in children 头孢吡肟与碳青霉烯类对儿童染色体AmpC产生风险肠杆菌引起的菌血症的决定性比较

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2026-03-01 Epub Date: 2026-02-04 DOI: 10.1016/j.jiac.2026.102923

Takashi Shoji , Yuto Otsubo , Yuho Horikoshi

Background

In adults, cefepime is proposed as a treatment option for infections associated with a risk of AmpC β-lactamase overproduction; however, data in pediatric populations are limited. We aimed to compare clinical outcomes between cefepime versus carbapenem as definitive therapy for bacteremia caused by Enterobacterales with a relatively high risk of chromosomal AmpC production (AmpC-E) in children.

Methods

This retrospective cohort study was conducted at a tertiary children's hospital between 2010 and 2024. Eligible patients were <21 years old with blood cultures positive for AmpC-E. The primary outcome was 30-day mortality. Secondary outcomes included 30-day recurrence, time to negative blood culture and treatment-related toxicity.

Results

51 children met the inclusion criteria. The median age was 11 months (IQR: 3–63), with 54.9% male patients. Cefepime and meropenem were administered as definitive therapy in 38 (74.5%) and 13 (25.5%) cases. Baseline characteristics of the patients were comparable. Isolated organisms included Enterobacter cloacae complex (47.1%), Serratia marcescens (29.4%) and Klebsiella aerogenes (19.6%). The cefepime group had a higher prevalence of Klebsiella aerogenes (26.3%, p = 0.048) and Serratia marcescens (39.5%, p = 0.006). The 30-day mortality was 2.6% (1/38) in the cefepime group and 15.4% (2/13) in the meropenem group (p = 0.156). No recurrence of bacteremia or treatment-related toxicity were observed. The median time to negative blood cultures was 2 days (IQR: 1–3) in the cefepime group and 1 day (IQR: 1–5) in the meropenem group (p = 0.949).

Conclusion

Cefepime and meropenem as definitive therapy demonstrated comparable outcomes for AmpC-E bacteremia. Further prospective studies are warranted.

背景：在成人中，头孢吡肟被建议作为与AmpC β-内酰胺酶过量产生风险相关的感染的治疗选择；然而，儿科人群的数据是有限的。我们的目的是比较头孢吡肟和碳青霉烯作为儿童染色体AmpC产生（AmpC- e）风险相对较高的肠杆菌引起的菌血症的决定性治疗的临床结果。方法：回顾性队列研究于2010年至2024年在某三级儿童医院进行。结果：51例患儿符合纳入标准。中位年龄为11个月（IQR: 3-63），男性占54.9%。头孢吡肟和美罗培南分别为38例（74.5%）和13例（25.5%）。患者的基线特征具有可比性。分离出的细菌包括阴沟肠杆菌（47.1%）、粘质沙雷菌（29.4%）和产气克雷伯菌（19.6%）。头孢吡肟组产气克雷伯菌（26.3%,p=0.048）和粘质沙雷菌（39.5%,p=0.006）患病率较高。头孢吡肟组30天死亡率为2.6%(1/38)，美罗培南组30天死亡率为15.4% (2/13)（p=0.156）。未观察到菌血症复发或治疗相关毒性。头孢吡肟组中位血培养阴性时间为2 d (IQR: 1 ~ 3)，美罗培南组中位血培养阴性时间为1 d (IQR: 1 ~ 5) （p=0.949）。结论：头孢吡肟和美罗培南作为最终治疗AmpC-E菌血症的效果相当。进一步的前瞻性研究是必要的。

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引用次数: 0

Characterization of thermostable antimicrobial and anti-inflammatory protein from marine Bacillus sp. 海洋芽孢杆菌耐热抗菌抗炎蛋白的研究。

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2026-03-01 Epub Date: 2026-02-05 DOI: 10.1016/j.jiac.2026.102919

Chinnarajan Ravindran , Eshana Mukhopadhyay , Lawrance Irudayarajan

Introduction

Marine microorganisms are rich in bioactive compounds having biotechnological significance. Hydrothermal vents are specifically home to unique microbial communities that have the ability to produce diverse compounds with therapeutic potential. This study aimed to isolate and characterize bioactive proteins from marine Bacillus sp. with antibacterial and anti-inflammatory properties and to evaluate their efficacy.

Methods

Bacillus sp. isolated from hydrothermal vents, have been grown optimally, with the partially purified extracellular protein fraction separated by ammonium sulfate precipitation and Sephadex G-10 gel filtration. The antimicrobial property was determined against the Methicillin-resistant Staphylococcus aureus (MRSA) and Vibrio vulnificus, with temperature stability studies conducted on the proteins. Zebrafish infection assays, together with lipopolysaccharide (LPS) challenges, served to determine the biological activity.

Results

A thermostable protein with a molecular weight of ⁓ 55 kDa showed strong inhibitory effects against MRSA and V. vulnificus. In the infection models using zebrafish, administration of the protein extract led to a substantial increase in survival rates (P < 0.01). Besides, a reduction in mRNA expression of pro-inflammatory cytokines (IL-1β, IL-6, TNF-α) was observed using RT-PCR analysis.

Conclusion

The thermostable Bacillus sp. protein exhibited both antibacterial and anti-inflammatory properties, indicating its potential for scale-up and biotherapeutic use.

海洋微生物富含具有生物技术意义的生物活性化合物。热液喷口是独特的微生物群落的家园，它们有能力产生具有治疗潜力的多种化合物。本研究旨在从海洋芽孢杆菌中分离和鉴定具有抗菌和抗炎特性的生物活性蛋白，并评价其功效。方法：对从热液喷口分离的芽孢杆菌进行最佳培养，用硫酸铵沉淀和Sephadex G-10凝胶过滤分离部分纯化的细胞外蛋白。测定了该蛋白对耐甲氧西林金黄色葡萄球菌（MRSA）和创伤弧菌的抗菌性能，并对其进行了温度稳定性研究。斑马鱼感染试验，连同脂多糖（LPS）挑战，用于确定生物活性。结果：一种分子量为⁓55 kDa的耐热蛋白对MRSA和创伤弧菌具有较强的抑制作用。在斑马鱼感染模型中，给予该蛋白提取物可显著提高斑马鱼的存活率(P)。结论：热稳定性的芽孢杆菌蛋白具有抗菌和抗炎特性，表明其具有扩大规模和生物治疗应用的潜力。

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引用次数: 0

Impact of preoperative urine culture on postoperative febrile urinary tract infection after ureterorenoscopic lithotripsy 术前尿培养对输尿管镜碎石术后发热性尿路感染的影响

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2026-03-01 Epub Date: 2026-01-30 DOI: 10.1016/j.jiac.2026.102918

Junya Hara , Katsuki Muramoto , Sumire Santo , Takuya Hagiwara , Kazuaki Yamaga , Hakaru Masumoto , Yuji Yata , Tomohiro Hongo , Tomoya Yamasaki , Rei Kato , Kei Fujio , Shinya Uehara , Mitsuru Oshiro , Hideo Otsuki

Introduction

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.

Materials and methods

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 (<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.

Results

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 < 0.01). Escherichia coli was associated with f-UTI even at low counts, while Enterococcus faecalis increased risk only at high counts. Multidrug-resistant strains such as Corynebacterium and Enterococcus faecium were also high-risk strains.

Discussion

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.

导读：输尿管镜碎石术（URSL）在日本已成为治疗小于20mm上尿路结石的一线方法。然而，术后发热性尿路感染（f-UTI）有时会导致致命的后果。很少有研究评估术前尿培养细菌菌株和计数对f-UTI风险的影响。本研究调查了这些关联，并讨论了潜在的预防策略。材料与方法回顾性分析2018年10月至2023年9月收治的1514例URSL病例。尿培养阳性定义为≥104 CFU/mL。病例分为低计数组（106 CFU/mL）和高计数组（≥106 CFU/mL）。根据人口统计学、细菌菌株和计数评估F-UTI发病率。统计分析包括卡方检验、学生t检验和多元逻辑回归。结果术后发生f-UTI 127例（8.4%）。多变量分析发现术前f-UTI和尿培养阳性是独立的预测因素。培养阴性的F-UTI发病率为5.3%，而培养阳性的病例为12.1%。高计数病例的f-UTI发生率显著高于低计数病例（17.9%比11.2%,p < 0.01）。即使在低计数时，大肠杆菌也与f-UTI相关，而粪肠球菌仅在高计数时才增加风险。多药耐药菌株如棒状杆菌和屎肠球菌也是高危菌株。术前尿培养阳性是URSL术后f-UTI的独立危险因素。细菌菌株和数量都影响感染风险。当存在高风险菌株或高细菌计数时，谨慎选择抗生素、缩短手术时间和控制肾内压可能有助于减少术后f-UTI。

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引用次数: 0

Oligella urethralis bacteremia associated with urinary tract obstruction: A case report and literature review 尿道少菌血症伴尿路梗阻1例并文献复习。

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2026-02-01 Epub Date: 2026-01-13 DOI: 10.1016/j.jiac.2026.102909

Emiri Muranaka , Mutsuka Kurihara , Naoki Okawa , Yuji Nishihara , Haruki Mito , Natsuki Fujiwara , Yuichi Oshimoto , Yasunobu Endo , Ryota Hase

Oligella urethralis 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 O. urethralis are rarely encountered as urinary pathogens compared to typical rod-shaped bacteria, making their identification clinically significant. We report a case of O. urethralis 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 O. urethralis 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 O. urethralis 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 O. urethralis infection. O. urethralis 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 O. urethralis, 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.

尿道寡杆菌是一种革兰氏阴性、非发酵性球芽孢杆菌，被认为是正常泌尿生殖道菌群的一部分，但在免疫功能低下的患者或有基础疾病的患者中可引起机会性感染。与典型的杆状细菌相比，尿道单胞杆菌等尿道病原体很少遇到，因此其鉴定具有临床意义。我们报告一个病例o尿道菌血症在74岁男性长期护理机构居民输尿管结石谁提出急性肾盂肾炎和菌血症。血液和尿液培养均检出革兰氏阴性杆菌，经MALDI-TOF质谱鉴定为尿道单胞杆菌，并成功给予抗生素治疗。对1987年至2025年5月间发表的报告进行文献检索，确定了6例先前报道的尿道单胞菌血症病例，并附有英文摘要。包括我们的病例，共分析了7例。所有病例均发生于老年患者（中位年龄79岁），伴有易患性疾病，特别是梗阻性尿路病变。预后良好；7例患者中仅有1例死亡（1/7），且死因非尿道O.感染。以菌血症为表现的梗阻性尿病老年患者，特别是在血液培养中发现革兰氏阴性球芽杆菌时，应考虑尿道O.是一种潜在的病原体。尿道O.尿道中经常报道氟喹诺酮类药物耐药，对这种生物的认识对于适当的抗菌药物选择非常重要，特别是考虑到由于缺乏物种特异性断点而在抗菌药物敏感性解释方面存在挑战。

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引用次数: 0