An infected aneurysm in the carotid artery is a rare but life-threatening condition. The most common cause of such infections is Staphylococcus aureus; however, Salmonella 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 Salmonella enterica subsp. Enterica 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 Salmonella 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.
{"title":"An infected aneurysm in the internal carotid artery caused by Salmonella enterica subsp. enterica serovar Enteritidis","authors":"Kazuki Maegawa , Hikari Tomita , Ami Masaoka , 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}
This study aimed to examine outpatient perceptions of voluntary, routine coronavirus disease (COVID-19) vaccinations scheduled for fall and winter of 2024.
Methods
A questionnaire was administered to the patients of five Japanese general medicine clinics.
Results
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, >90 % preferred a vaccination fee of <3000 JPY.
Conclusion
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.
{"title":"Promoting COVID-19 vaccination: Results of a 2024 Japanese survey of outpatient intention to vaccinate","authors":"Takuma Bando, Hideyuki Ikematsu, Kazuya Hamada, Masako Negami, Hiroyuki Fujii, Ken-ichi Doniwa, 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, >90 % preferred a vaccination fee of <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}
This study aims to assess the impact of metagenomic next-generation sequencing (mNGS) on optimizing diagnostic-therapeutic pathways for lower respiratory tract infections (LRTIs).
Methods
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.
Results
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.
Conclusion
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.
{"title":"Structured framework for the application of metagenomic next-generation sequencing in the whole-process management of lower respiratory tract infections","authors":"Meihua Zhao , Xisheng Yu , Meizeng Zhao , 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}
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.
{"title":"Oligella urethralis bacteremia associated with urinary tract obstruction: A case report and literature review","authors":"Emiri Muranaka , Mutsuka Kurihara , Naoki Okawa , Yuji Nishihara , Haruki Mito , Natsuki Fujiwara , Yuichi Oshimoto , Yasunobu Endo , 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}
Pub Date : 2026-01-13DOI: 10.1016/j.jiac.2026.102908
Ho Won Kim , Hoe Sun Yoon , Jake Whang , Jong-Seok Kim
Nontuberculous mycobacteria (NTM), particularly Mycobacterium avium complex (MAC) and Mycobacterium abscessus 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.
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.
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.
{"title":"Adjunctive and supportive strategies to mitigate drug toxicities in the treatment of nontuberculous mycobacterial disease with future directions","authors":"Ho Won Kim , Hoe Sun Yoon , Jake Whang , 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}
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.
Methods
A total of 452 MDR-GNB isolates, including 272 Enterobacterales and 180 non-fermenters (Pseudomonas aeruginosa, Acinetobacter baumannii, Stenotrophomonas maltophilia), 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.
Results
BMD demonstrated >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.
Conclusions
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.
{"title":"Evaluation of Japan-specific cefiderocol susceptibility testing methods in multidrug-resistant gram-negative isolates from Japan and Bangladesh","authors":"Takashi Okanda , Niinyo Nakajima , Takuro Koshikawa , Tadatomo Oyanagi , Tomonori Takano , Tetsuo Yamaguchi , Hiroyuki Kunishima , Mitsuo Kaku , 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 >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}
Amid a large-scale resurgence of pertussis in Japan in 2025, concern is growing about the spread of macrolide-resistant Bordetella pertussis (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.
{"title":"Microbiologic clearance in macrolide-resistant Bordetella pertussis: An infant treated with sulfamethoxazole-trimethoprim — A case timeline","authors":"Yu Kuramochi , Meiwa Shibata , Mikako Morinaga , Tomoyuki Tame , Kazue Kinoshita , Osamu Saito , 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}
Non-O1 and non-O139 Vibrio cholerae (NOVC) strains rarely harbor the cholera toxin gene and are typically associated with mild, self-limiting gastroenteritis. However, an increasing number of reports in recent years have described severe gastroenteritis or extraintestinal infections with fatal outcomes, particularly in immunocompromised individuals, such as those with underlying conditions including cirrhosis. Here, we describe a case of severe gastroenteritis caused by V. cholerae serogroup O24, following the consumption of seafood during prolong prednisolone treatment for systemic lupus erythematosus. Stool culture upon admission yielded yellow colonies on thiosulfate-citrate-bile salt-sucrose agar, and Gram staining of the colonies revealed Gram-negative, curved, comma-shaped rods, suggestive of Vibrio species. Although matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) yielded low-confidence identifications, suggesting either Vibrio mimicus or Vibrio albensis, the isolate was ultimately identified as NOVC based on its biochemical characteristics and salt tolerance. Subsequent genetic analysis confirmed the isolate as V. cholerae serogroup O24, a strain not included in the MALDI-TOF MS identification database. This case underscores the diagnostic value of conventional methods, such as biochemical profiling, in identifying V. cholerae strains not detectable by current mass spectrometry-based systems.
{"title":"Severe gastroenteritis caused by Vibrio cholerae serogroup O24 in an immunocompromised patient: A case report","authors":"Tomoko Azuma , Yoshinori Takahashi , Megumi Oshima , Megumi Ikeda , Daiki Hayasi , Hatsumi Otani , Akiko Maekawa , Hiroyasu Oe , Aya Noguchi , Mika Mori , Hajime Kanamori","doi":"10.1016/j.jiac.2026.102906","DOIUrl":"10.1016/j.jiac.2026.102906","url":null,"abstract":"<div><div>Non-O1 and non-O139 <em>Vibrio cholerae</em> (NOVC) strains rarely harbor the cholera toxin gene and are typically associated with mild, self-limiting gastroenteritis. However, an increasing number of reports in recent years have described severe gastroenteritis or extraintestinal infections with fatal outcomes, particularly in immunocompromised individuals, such as those with underlying conditions including cirrhosis. Here, we describe a case of severe gastroenteritis caused by <em>V. cholerae</em> serogroup O24, following the consumption of seafood during prolong prednisolone treatment for systemic lupus erythematosus. Stool culture upon admission yielded yellow colonies on thiosulfate-citrate-bile salt-sucrose agar, and Gram staining of the colonies revealed Gram-negative, curved, comma-shaped rods, suggestive of <em>Vibrio</em> species. Although matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) yielded low-confidence identifications, suggesting either <em>Vibrio mimicus</em> or <em>Vibrio albensis</em>, the isolate was ultimately identified as NOVC based on its biochemical characteristics and salt tolerance. Subsequent genetic analysis confirmed the isolate as <em>V. cholerae</em> serogroup O24, a strain not included in the MALDI-TOF MS identification database. This case underscores the diagnostic value of conventional methods, such as biochemical profiling, in identifying <em>V. cholerae</em> strains not detectable by current mass spectrometry-based systems.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 2","pages":"Article 102906"},"PeriodicalIF":1.5,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145928990","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}
Pub Date : 2026-01-05DOI: 10.1016/j.jiac.2026.102904
Fatih Çubuk , Caner Öksüz , Murtaza Öz
Objective
A substantial proportion of urine cultures in patients with suspected urinary tract infections (UTIs) yield negative results. This study aimed to evaluate whether parameters from automated urinalysis could predict the likelihood of significant bacterial growth, thereby aiding in reducing unnecessary cultures.
Methods
A total of 696 patients (402 females, 294 males) undergoing urinalysis with the FUS-200 automated analyzer were evaluated. Urine cultures were processed using the BD Phoenix 100 system. Demographic data and urinalysis parameters were compared according to culture results.
Results
Among culture-negative patients, females were younger (median age: 45 vs. 58 years, p = 0.000) and had significantly higher leukocyte, erythrocyte, and bacterial counts (p = 0.000). In culture-positive cases, females were younger than males (55 vs. 72.5 years, p = 0.000), though they had lower leukocyte counts (p = 0.029). Gram-negative infections were associated with significantly higher leukocyte and bacterial counts compared to gram-positive infections (p < 0.05), along with increased nitrite and leukocyte esterase positivity. ROC analysis identified optimal cut-off values for predicting significant culture growth: leukocyte count ≥16.5 (sensitivity, 79.5 %; specificity, 79.9 %) and bacterial count ≥2.5 (sensitivity, 77.6 %; specificity, 79.3 %). Cut-off values were higher in females (leukocytes: 23.5, bacteria: 5.5) than in males (leukocytes: 11.5, bacteria: 0.5).
Conclusion
The practical utility of the defined normal range values for urinary leukocyte count is limited. The predictive power of urinalysis parameters for culture results is affected by patient gender. For predicting significant bacterial growth in males, we recommend leukocyte and bacteria cut-off values of 11.5/HPF and 0.5/HPF, respectively (with >85 % sensitivity and specificity). In females, leukocyte and bacterial counts in urine provide poor predictive value for culture positivity.
{"title":"Diagnostic utility of urinalysis parameters in predicting urine culture positivity: A gender-stratified evaluation","authors":"Fatih Çubuk , Caner Öksüz , Murtaza Öz","doi":"10.1016/j.jiac.2026.102904","DOIUrl":"10.1016/j.jiac.2026.102904","url":null,"abstract":"<div><h3>Objective</h3><div>A substantial proportion of urine cultures in patients with suspected urinary tract infections (UTIs) yield negative results. This study aimed to evaluate whether parameters from automated urinalysis could predict the likelihood of significant bacterial growth, thereby aiding in reducing unnecessary cultures.</div></div><div><h3>Methods</h3><div>A total of 696 patients (402 females, 294 males) undergoing urinalysis with the FUS-200 automated analyzer were evaluated. Urine cultures were processed using the BD Phoenix 100 system. Demographic data and urinalysis parameters were compared according to culture results.</div></div><div><h3>Results</h3><div>Among culture-negative patients, females were younger (median age: 45 vs. 58 years, p = 0.000) and had significantly higher leukocyte, erythrocyte, and bacterial counts (p = 0.000). In culture-positive cases, females were younger than males (55 vs. 72.5 years, p = 0.000), though they had lower leukocyte counts (p = 0.029). Gram-negative infections were associated with significantly higher leukocyte and bacterial counts compared to gram-positive infections (p < 0.05), along with increased nitrite and leukocyte esterase positivity. ROC analysis identified optimal cut-off values for predicting significant culture growth: leukocyte count ≥16.5 (sensitivity, 79.5 %; specificity, 79.9 %) and bacterial count ≥2.5 (sensitivity, 77.6 %; specificity, 79.3 %). Cut-off values were higher in females (leukocytes: 23.5, bacteria: 5.5) than in males (leukocytes: 11.5, bacteria: 0.5).</div></div><div><h3>Conclusion</h3><div>The practical utility of the defined normal range values for urinary leukocyte count is limited. The predictive power of urinalysis parameters for culture results is affected by patient gender. For predicting significant bacterial growth in males, we recommend leukocyte and bacteria cut-off values of 11.5/HPF and 0.5/HPF, respectively (with >85 % sensitivity and specificity). In females, leukocyte and bacterial counts in urine provide poor predictive value for culture positivity.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 2","pages":"Article 102904"},"PeriodicalIF":1.5,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145903896","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}
Pub Date : 2026-01-01DOI: 10.1016/j.jiac.2025.102902
Nesrin Türker , Ozge Eren Korkmaz , Figen Kaptan Aydogmus , Nur Miray Ayhan Geniş , Tuba Müderris , Murat Aksun
Background
Carbapenem-resistant Gram-negative bloodstream infections (CR-GNB BSIs) are increasingly prevalent in intensive care units (ICUs) and associated with high mortality. Accurate early risk stratification tools are lacking.
Objectives
To develop and internally validate a nomogram-based model predicting 30-day mortality in ICU patients with CR-GNB BSIs.
Methods
We conducted a retrospective cohort study of adult ICU patients with CR-GNB BSIs at a tertiary hospital in western Turkey (January 2020–October 2024). Demographic, clinical, laboratory, and microbiological data were collected. Patients were randomly split into training (70 %) and validation (30 %) cohorts. Univariable and multivariable logistic regression analyses identified independent mortality predictors, which were incorporated into a nomogram. Model discrimination, calibration, and decision-curve utility were evaluated.
Results
A total of 281 patients were included (median age 66 years; 60.9 % male); 30-day mortality was 58 %. Acinetobacter spp. predominated (51.6 %), followed by Klebsiella spp. (42.3 %) and Pseudomonas spp. (6.1 %). Independent predictors of 30-day mortality included older age, immunosuppression, hypoalbuminemia, elevated white blood cell count, and absence of microbiological cure. The nomogram demonstrated excellent discrimination (AUC 0.895 training; 0.854 validation), good calibration (mean absolute error 0.022–0.059), and meaningful clinical net benefit across intermediate risk thresholds.
Conclusions
We developed and internally validated a nomogram using routine clinical and laboratory variables to predict 30-day mortality in ICU patients with CR-GNB BSIs. This tool may support early prognostic assessment at bedside and guide individualized management. Prospective multicenter validation is warranted.
{"title":"Carbapenem resistant gram negative bacteremia in intensive care unit patients: Development and validation of a nomogram-based 30-day mortality risk prediction model","authors":"Nesrin Türker , Ozge Eren Korkmaz , Figen Kaptan Aydogmus , Nur Miray Ayhan Geniş , Tuba Müderris , Murat Aksun","doi":"10.1016/j.jiac.2025.102902","DOIUrl":"10.1016/j.jiac.2025.102902","url":null,"abstract":"<div><h3>Background</h3><div>Carbapenem-resistant Gram-negative bloodstream infections (CR-GNB BSIs) are increasingly prevalent in intensive care units (ICUs) and associated with high mortality. Accurate early risk stratification tools are lacking.</div></div><div><h3>Objectives</h3><div>To develop and internally validate a nomogram-based model predicting 30-day mortality in ICU patients with CR-GNB BSIs.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of adult ICU patients with CR-GNB BSIs at a tertiary hospital in western Turkey (January 2020–October 2024). Demographic, clinical, laboratory, and microbiological data were collected. Patients were randomly split into training (70 %) and validation (30 %) cohorts. Univariable and multivariable logistic regression analyses identified independent mortality predictors, which were incorporated into a nomogram. Model discrimination, calibration, and decision-curve utility were evaluated.</div></div><div><h3>Results</h3><div>A total of 281 patients were included (median age 66 years; 60.9 % male); 30-day mortality was 58 %. <em>Acinetobacter spp</em>. predominated (51.6 %), followed by <em>Klebsiella spp</em>. (42.3 %) and <em>Pseudomonas spp</em>. (6.1 %). Independent predictors of 30-day mortality included older age, immunosuppression, hypoalbuminemia, elevated white blood cell count, and absence of microbiological cure. The nomogram demonstrated excellent discrimination (AUC 0.895 training; 0.854 validation), good calibration (mean absolute error 0.022–0.059), and meaningful clinical net benefit across intermediate risk thresholds.</div></div><div><h3>Conclusions</h3><div>We developed and internally validated a nomogram using routine clinical and laboratory variables to predict 30-day mortality in ICU patients with CR-GNB BSIs. This tool may support early prognostic assessment at bedside and guide individualized management. Prospective multicenter validation is warranted.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 1","pages":"Article 102902"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145856988","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}
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