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":"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":"2026-02-01","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":"2026-02-01","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}

{"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":"Xpert MTB/RIF probe reactivity to non-tuberculosis mycobacteria cultured in MGIT broth samples","authors":"Tatsuya Hioki ,&nbsp;Yoshikazu Mutoh ,&nbsp;Takumi Umemura ,&nbsp;Yoshimi Ishihara ,&nbsp;Masayoshi Ajioka ,&nbsp;Akiko Takaki ,&nbsp;Kinuyo Chikamatsu ,&nbsp;Satoshi Mitarai","doi":"10.1016/j.jiac.2025.102891","DOIUrl":"10.1016/j.jiac.2025.102891","url":null,"abstract":"<div><div>The Xpert MTB/RIF assay can simultaneously detect <em>Mycobacterium tuberculosis</em> (MTB) and rifampicin resistance (RR), though the culture-positive Mycobacteria Growth Indicator Tube (MGIT) broth is not a specified sample type. In clinical settings the assay is sometimes used as an ancillary test to identify MTB and RR in MGIT broth samples, however, limited information is available on the reactivity of the probes to non-tuberculosis mycobacteria (NTM) species. The aim of this study was to assess the results of the Xpert MTB/RIF assay using MGIT broth samples positive for NTM. Of 65 NTM samples tested, 48 (74 %) showed probe signals. Probe reactivity and cycle threshold value differed according to the <em>Mycobacterium</em> species. Ten of 11 (91 %) of <em>Mycobacterium intracellulare</em> samples showed positive Probe A signals, and 23 of 29 (79 %) <em>Mycobacterium avium</em> samples showed positive Probe C signals. Additionally, a sample with <em>M</em>. <em>avium</em> and <em>M</em>. <em>intracellulare</em> co-infection tested false-positive for RR MTB. The proportion of NTM samples that tested positive was higher than that reported previously. These findings could help prevent misinterpretation of Xpert MTB/RIF results.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 1","pages":"Article 102891"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145734028","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":"Oral gepotidacin for the treatment of uncomplicated urinary tract infection in Japanese female patients: a randomized, active reference, double-blind, double-dummy, Phase 3 trial (EAGLE-J)","authors":"Shingo Yamamoto ,&nbsp;Kenji Fujii ,&nbsp;Yoko Kayama ,&nbsp;Akinori Nimura ,&nbsp;Takao Maenaka ,&nbsp;Marcela Ramirez ,&nbsp;Rudrani Banerjee ,&nbsp;Nicole E. Scangarella-Oman ,&nbsp;Susan Mozzicato ,&nbsp;Shintaro Ura","doi":"10.1016/j.jiac.2025.102829","DOIUrl":"10.1016/j.jiac.2025.102829","url":null,"abstract":"<div><h3>Background</h3><div>Two global Phase 3 trials, EAGLE-2 and EAGLE-3, found gepotidacin non-inferior (and superior in EAGLE-3) to nitrofurantoin for the treatment of uUTI in female participants, with an acceptable safety profile; however, these studies did not include Japanese centers.</div></div><div><h3>Methods</h3><div>EAGLE-J (NCT05630833; jRCT2031220467) was a Phase 3, randomized, double-blind, active reference study evaluating the efficacy and safety of gepotidacin for the treatment of uUTI in Japan. Eligible participants were females aged ≥12 years with ≥2 uUTI symptoms and urinary nitrite or pyuria. Participants were randomly assigned (3:1) oral gepotidacin (1500 mg) or nitrofurantoin (100 mg) twice daily for 5 days. To bridge data, consistency of therapeutic response at test-of-cure (day 10–13) in the gepotidacin arm of EAGLE-J with EAGLE-2/EAGLE-3 was assessed in participants with qualifying nitrofurantoin-susceptible uropathogens (≥10⁵ colony-forming units/mL). Therapeutic success comprised clinical (symptom resolution) and microbiological success (eradication). Consistency was claimed if the therapeutic success rate in EAGLE-J was greater than the consistency threshold predicted from EAGLE-2/EAGLE-3.</div></div><div><h3>Findings</h3><div>Overall, the primary analysis included 108 participants (83 gepotidacin, 25 nitrofurantoin). At test-of-cure, gepotidacin therapeutic success was 83.1 % (69/83), exceeding the consistency threshold (48.2 %). Adverse events were mostly mild-to-moderate; common adverse events were diarrhea (gepotidacin: 60 %, 168/281; nitrofurantoin: 8 %, 7/93) and nausea (gepotidacin: 12 %, 35/281; nitrofurantoin: 2 %, 2/93). No fatalities occurred.</div></div><div><h3>Interpretation</h3><div>Gepotidacin therapeutic success at test-of-cure was consistent between EAGLE-J and EAGLE-2/-3. Gepotidacin has potential as a valuable oral treatment option for uUTI in Japan. No new safety signals were identified.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 1","pages":"Article 102829"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318130","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":"Pharmacokinetics of daptomycin during low-flow continuous renal replacement therapy in critically ill Japanese patients","authors":"Kazuro Ikawa ,&nbsp;Mana Taguchi ,&nbsp;Takeshi Ide ,&nbsp;Norifumi Morikawa ,&nbsp;Kenta Takeda","doi":"10.1016/j.jiac.2025.102883","DOIUrl":"10.1016/j.jiac.2025.102883","url":null,"abstract":"<div><h3>Introduction</h3><div>Daptomycin is used to treat systemic and life-threatening infections caused by methicillin-resistant <em>Staphylococcus aureus</em> in critically ill patients receiving continuous renal replacement therapy (CRRT). However, the pharmacokinetics of daptomycin during low-flow CRRT have not been examined; thus, the appropriate dosing adjustment in Japan remains uncertain.</div></div><div><h3>Methods</h3><div>The daptomycin concentrations in plasma and effluent samples of adult Japanese patients receiving continuous venovenous hemodiafiltration (n = 4) and continuous venovenous hemodialysis (n = 2) were measured by liquid chromatography. The data were analyzed and used to estimate pharmacodynamic exposure and concentrations to profile daptomycin regimens.</div></div><div><h3>Results</h3><div>The pharmacokinetics of daptomycin was described using two-compartment model. In the six CRRT patients (effluent flow rate, 0.825 ± 0.038 L/h), the parameter estimates were: volume of distribution of the central compartment, 8.09 ± 3.76 L; volume of distribution of the peripheral compartment, 6.23 ± 2.58 L; intercompartmental clearance, 4.63 ± 1.98 L/h; total clearance, 0.439 ± 0.172 L/h; sieving coefficient, 0.0995 ± 0.0295; extrinsic clearance by CRRT, 0.0815 ± 0.0223 L/h; intrinsic clearance of the patient, 0.357 ± 0.173 L/h; area under the concentration-time curve (AUC) for 24 h, 597.6 ± 196.1 mg‧h/L. Simulated daptomycin regimen for the exposure target (AUC ≥666 mg‧h/L) was 5.36 ± 2.46 mg/kg every 24 h, achieving the safety target (the minimum concentration ≤24.3 mg/L).</div></div><div><h3>Conclusion</h3><div>These results help to define the pharmacokinetics of daptomycin during low-flow CRRT, while also helping to consider dosing regimens for critically ill Japanese patients receiving CRRT.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 1","pages":"Article 102883"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145687611","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":"Zoonotic aortic graft infection by Streptococcus equi","authors":"Haruka Karaushi ,&nbsp;Akihiro Yoshitake ,&nbsp;Yuta Kanazawa ,&nbsp;Noriyuki Watanabe ,&nbsp;Mieko Tokano ,&nbsp;Masafumi Seki ,&nbsp;Kotaro Mitsutake","doi":"10.1016/j.jiac.2025.102900","DOIUrl":"10.1016/j.jiac.2025.102900","url":null,"abstract":"<div><div>A 69-year-old woman with hypertension had undergone total arch replacement with an open stent graft 7 years prior. She was referred to our hospital for evaluation after experiencing fever (&gt;38 °C) and cough. Chest radiography revealed a prominent aortic arch, and contrast-enhanced computed tomography demonstrated aortic arch enlargement and peri-graft fluid collection containing air. These findings indicated graft infection and prompted immediate intervention. Blood cultures grew <em>Streptococcus equi</em> subspecies <em>zooepidemicus</em>, a zoonotic pathogen associated with horses. Notably, the patient worked as a horse trainer. On hospital day 6, she developed severe hemoptysis due to an aortobronchial fistula caused by stent graft infection and underwent emergency re-replacement of the aortic arch. Intraoperative specimens also yielded the same pathogen. Consequently, she was treated with ampicillin, and her postoperative course was uneventful. Although rare, zoonotic pathogens can cause vascular graft infections.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 1","pages":"Article 102900"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145781349","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 timing in prospective audit and feedback on broad-spectrum antibiotic use: a comparison between third-day and seventh-day interventions","authors":"Hisako Machida ,&nbsp;Yoshiki Kusama ,&nbsp;Daisuke Onozuka ,&nbsp;Atsuko Sunada ,&nbsp;Satoshi Kutsuna","doi":"10.1016/j.jiac.2025.102896","DOIUrl":"10.1016/j.jiac.2025.102896","url":null,"abstract":"<div><div>Prospective audit and feedback (PAF) is a key component of antimicrobial stewardship (AS) programs and has been shown to reduce the use of broad-spectrum antibiotics. However, the optimal timing of PAF intervention remains unclear.</div><div>This quasi-experimental, single-center study investigated the impact of changing PAF timing from day 3 to day 7 after initiating empirical broad-spectrum antibiotics. Monthly days of therapy (DOT) for carbapenems (CAR), piperacillin-tazobactam (PIP/TAZ), and cefepime (PEF) were extracted from 2016 to 2024. Annual susceptibility rates of <em>Pseudomonas aeruginosa</em> and the time from blood culture submission to susceptibility results were also evaluated. Interrupted time series analysis assessed changes in DOT, while other data were descriptively analyzed.</div><div>DOT for CAR and PIP/TAZ decreased significantly post-intervention (CAR: −0.68, P &lt; 0.001; PIP/TAZ: −0.29, P = 0.031), despite no significant change in trend slopes. PEF showed no significant changes. Susceptibility rates of <em>P. aeruginosa</em> remained stable. Notably, 28.3 % of blood culture results exceeded 4 days to report, and 95 % were available by day 7.</div><div>As causality cannot be inferred from this observational design, the mechanism underlying the observed reduction in DOT remains uncertain. Nevertheless, adjusting PAF timing may be feasible in settings with limited stewardship resources. Further studies are needed to determine the most effective timing of PAF interventions and to assess generalizability to other institutions.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 1","pages":"Article 102896"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145774669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibiotic-associated encephalopathy induced by cefmetazole in a hemodialysis patient: Case report","authors":"Toshiyuki Nakanishi ,&nbsp;Taku Harada ,&nbsp;Satoshi Kutsuna","doi":"10.1016/j.jiac.2025.102882","DOIUrl":"10.1016/j.jiac.2025.102882","url":null,"abstract":"<div><div>Antibiotic-associated encephalopathy (AAE) is a rare but significant neurological complication of β-lactam antibiotics, particularly in patients with renal impairment. While cefepime, ceftazidime, and ceftriaxone are well-documented causes, cefmetazole (CMZ) has not been widely recognized for neurotoxicity. We report an 82-year-old Japanese man with end-stage renal disease on chronic hemodialysis who developed altered mental status and myoclonus five days after starting intravenous CMZ for prostatic abscess. Electroencephalography (EEG) revealed triphasic waves consistent with non-convulsive status epilepticus. Neuroimaging and cerebrospinal fluid analysis showed no evidence of infection or stroke. Symptoms resolved within 48 hours of CMZ discontinuation. A Naranjo score of 5 supported a diagnosis of CMZ-induced AAE. This case underscores the potential neurotoxicity of CMZ and emphasizes the importance of early recognition of AAE in patients with renal dysfunction.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 1","pages":"Article 102882"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145696048","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}