Journal of Infection and Chemotherapy最新文献_第4页

Clinical and molecular characteristics of urinary catheter-associated Pseudomonas aeruginosa prostatic infection: A case series of four postoperative nosocomial infections 导尿管相关性铜绿假单胞菌前列腺感染的临床和分子特征：4例术后医院感染病例系列

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2025-11-10 DOI: 10.1016/j.jiac.2025.102853

Shinnosuke Fukushima , Takayuki Sano , Takashige Kashimoto , Hideharu Hagiya

Pseudomonas aeruginosa is a causative pathogen of nosocomial catheter-associated urinary tract infections (CAUTI), but prostate involvement, including prostatitis and prostatic abscess, is rare. The clinical characteristics of P. aeruginosa-associated CAUTI with prostatic lesions, as well as the contribution of genetic backgrounds remain unclear. We describe four cases of urinary catheter-associated prostatic infection caused by P. aeruginosa following postoperative catheterization. All patients developed fever within 10 days after surgery, and three of the four patients developed bacteremia. Three patients were diagnosed with prostatic abscess by contrast-enhanced computed tomography or magnetic resonance imaging, while one case presented with prostatitis without abscess formation. Prostate-specific antigen levels were elevated over 20 ng/mL in all three measured cases. All patients were treated successfully with prolonged antibiotic therapy (28–39 days) without surgical drainage. Notably, all three abscess cases were successfully managed with fluoroquinolone-based combination therapy, highlighting its potential role in the management of prostatic abscesses. Three of four isolates were submitted for molecular investigations. All isolates harbored exoT and exoY, whereas exoU was absent. Biofilm-associated genes were detected in two cases, but not in the remaining case. Our findings suggested that P. aeruginosa strains carrying T3SS genes (exoT and exoY) potentially develop prostatic infections, independent of biofilm-associated genes. Host and iatrogenic factors, such as catheter manipulation, may play more critical roles in the development of prostatic pathology than strain-specific determinants. Assessment of prostate-specific antigen levels and early imaging may facilitate appropriate diagnosis and effective management when P. aeruginosa is detected as a cause of CAUTI.

铜绿假单胞菌是院内导尿管相关性尿路感染（CAUTI）的致病病原体，但前列腺受累，包括前列腺炎和前列腺脓肿，是罕见的。铜绿假单胞菌相关CAUTI与前列腺病变的临床特征以及遗传背景的贡献尚不清楚。我们描述了4例尿导管相关性前列腺感染引起铜绿假单胞菌术后导尿。所有患者术后10天内出现发热，4例患者中有3例出现菌血症。3例患者经增强计算机断层扫描或磁共振成像诊断为前列腺脓肿，1例患者表现为前列腺炎，但未形成脓肿。在所有三个测量病例中，前列腺特异性抗原水平均高于20 ng/mL。所有患者均经延长抗生素治疗（28-39天）成功治疗，无手术引流。值得注意的是，所有三个脓肿病例都成功地通过氟喹诺酮类药物联合治疗，突出了其在前列腺脓肿治疗中的潜在作用。4个分离株中有3个进行了分子研究。所有分离株均含有exoT和exy，而exoU不存在。在两例中检测到生物膜相关基因，但在其余病例中未检测到。我们的研究结果表明，携带T3SS基因（exoT和exoY）的铜绿假单胞菌菌株可能发生前列腺感染，而不依赖于生物膜相关基因。宿主和医源性因素，如导管操作，可能在前列腺病理的发展中发挥比菌株特异性决定因素更关键的作用。当铜绿假单胞菌被诊断为CAUTI的病因时，评估前列腺特异性抗原水平和早期成像可能有助于适当的诊断和有效的管理。

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引用次数: 0

Impact of continuous hemodiafiltration on serum acyclovir concentrations in a patient with encephalopathy 持续血液滤过对脑病患者血清无环鸟苷浓度的影响。

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2025-11-10 DOI: 10.1016/j.jiac.2025.102859

Takahiro Ito , Kotaro Itohara , Sachi Hirata , Takeshi Kimura , Yumi Kitahiro , Tomohiro Omura , Joji Kotani , Ikuko Yano

Reports on serum acyclovir (ACV) concentrations in patients undergoing continuous hemodiafiltration (CHDF) remain limited. We present a case describing the impact of CHDF on serum ACV levels in a patient with encephalopathy. A Japanese woman in her 70s was prescribed oral valacyclovir (VACV) at a dose of 1000 mg three times daily for herpes zoster ophthalmicus. After 7 days of treatment, she was admitted to a local hospital with fever, dysarthria, altered consciousness, hallucinations, and headache. Her serum creatinine level was elevated at 4.02 mg/dL. Intravenous ACV was initiated under the clinical suspicion of varicella zoster virus (VZV) encephalitis. However, after 3 days of treatment without improvement in consciousness, she was transferred to our hospital. Her serum ACV concentration upon admission was 14.1 μg/mL. Suspecting ACV-induced encephalopathy and renal dysfunction, CHDF was promptly initiated. Following CHDF therapy, serum ACV levels declined rapidly, accompanied by a gradual improvement in consciousness. This case suggests that CHDF may be an effective therapeutic option for managing ACV-associated nephropathy and encephalopathy.

关于持续血液滤过（CHDF）患者血清无环鸟苷（ACV）浓度的报道仍然有限。我们提出一个病例，描述CHDF对脑病患者血清ACV水平的影响。一名70多岁的日本妇女每天三次口服1000毫克的伐昔洛韦（VACV）治疗带状疱疹。治疗7天后，患者因发热、构音障碍、意识改变、幻觉和头痛入住当地医院。血清肌酐升高至4.02 mg/dL。临床怀疑为水痘带状疱疹病毒（VZV）脑炎，开始静脉注射ACV。治疗3天后，患者意识未见好转，转至我院。入院时血清ACV浓度为14.1 μg/mL。怀疑acv引起的脑病和肾功能障碍，CHDF立即开始。CHDF治疗后，血清ACV水平迅速下降，并伴有意识逐渐改善。本病例提示CHDF可能是治疗acv相关肾病和脑病的有效选择。

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引用次数: 0

Lelliottia amnigena bacteremia in a patient with sigmoid colon cancer and schizophrenia: a case report 乙状结肠结肠癌合并精神分裂症患者羊水菌血症1例。

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2025-11-10 DOI: 10.1016/j.jiac.2025.102858

Hiroshi Umemura , Yumiko Tanimichi , Ayami Karita , Hirokazu Kobayashi , Masaki Nakajima , Sachio Tsuchida , Fumitaka Ihara , Yuta Kojima , Suguru Nakajima , Kou Nagai , Tadashi Kanamori , Masahiro Suzuki , Kiyofumi Ohkusu , Tomohiro Nakayama

Lelliottia amnigena is a facultative anaerobe that is generally considered to show low pathogenicity, and few reports have described human infection. We describe herein a case of bacteremia due to L. amnigena in a patient with sigmoid colon cancer and schizophrenia. A 64-year-old Japanese man with schizophrenia was transferred to our hospital from a psychiatric hospital after experiencing several weeks of bloody bowel discharge and fever. He presented with hypotension, an elevated white blood cell count, raised levels of C-reactive protein, and decreased hemoglobin levels. Blood culture on transfer to our hospital detected Gram-negative rods, identified as L. amnigena by matrix-assisted laser desorption/ionization mass spectrometry and 16S rRNA gene sequencing. Antimicrobial therapy was initiated with piperacillin/tazobactam, which was later de-escalated to ampicillin/sulbactam according to the results of antimicrobial susceptibility testing, resulting in a total of 14 days of antimicrobial treatment. Computed tomography and colonoscopy revealed that the patient had sigmoid colon cancer, which was subsequently surgically resected. The sigmoid colon cancer was considered to represent the gateway for L. amnigena entry into the bloodstream. The course of treatment was favorable and the patient was transferred back to the original hospital 98 days after admission. L. amnigena bacteremia has rarely been reported, and the present case appears to represent the first detailed description. L. amnigena can cause bacteremia and sometimes lead to serious conditions in patients.

羊膜小叶菌是一种兼性厌氧菌，一般认为致病性较低，很少有关于人感染的报道。我们在此报告一例乙状结肠结肠癌和精神分裂症患者因羊水乳杆菌引起的菌血症。一名患有精神分裂症的64岁日本男子在经历数周的血性肠排出物和发烧后从精神病院转至我院。他表现为低血压，白细胞计数升高，c反应蛋白水平升高，血红蛋白水平降低。转至我院的血液培养检测到革兰氏阴性棒，经基质辅助激光解吸/电离质谱和16S rRNA基因测序鉴定为羊膜乳杆菌。开始使用哌拉西林/他唑巴坦进行抗菌治疗，随后根据抗菌药敏试验结果降级为氨苄西林/舒巴坦，总共进行了14天的抗菌治疗。计算机断层扫描和结肠镜检查显示患者患有乙状结肠癌，随后手术切除。乙状结肠被认为是羊膜乳杆菌进入血流的入口。治疗过程良好，患者于入院后98天转回原医院。羊水乳杆菌菌血症很少报道，本病例似乎是第一次详细描述。羊膜乳杆菌可引起菌血症，有时会导致患者出现严重的疾病。

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引用次数: 0

Primary pyogenic ventriculitis due to Streptococcus dysgalactiae treated with intralumbar vancomycin administration: A case report 万古霉素静脉注射治疗原发性化脓性脑室炎1例。

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2025-11-08 DOI: 10.1016/j.jiac.2025.102854

Yayoi Miyamatsu, Ryutaro Tanizaki

Intrathecal antibiotics are occasionally employed in the management of central nervous system infections; however, standard treatment regimens have not been clearly established, particularly for primary pyogenic ventriculitis in patients without an intraventricular drain. We report the first documented case of successful intralumbar administration of vancomycin, in combination with systemic antibiotics, for the treatment of primary pyogenic ventriculitis caused by Streptococcus dysgalactiae in a 65-year-old Japaneses woman. Despite receiving appropriate systemic antibiotic therapy, her level of consciousness showed no significant improvement, indicating that systemic therapy alone was insufficient to control the infection. Due to her advanced breast cancer, poor general condition, and limited prognosis, the neurosurgical team deemed intraventricular drainage inappropriate. As an alternative, intralumbar vancomycin therapy was initiated. Serial intrathecal vancomycin concentrations were measured during intralumbar vancomycin therapy, providing valuable pharmacokinetic data. This case highlights that intralumbar vancomycin may represent a feasible therapeutic alternative when systemic antibiotic therapy alone is insufficient. Further studies are warranted to elucidate the pharmacokinetics, efficacy, and safety of this therapeutic approach.

鞘内抗生素偶尔用于中枢神经系统感染的治疗；然而，标准的治疗方案尚未明确建立，特别是对于没有脑室内引流的原发性化脓性脑室炎。我们报告了第一个成功的记录案例，万古霉素联合全身抗生素，用于治疗65岁的日本妇女，由无乳链球菌引起的原发性化脓性脑室炎。尽管接受了适当的全身抗生素治疗，但患者的意识水平没有明显改善，表明单靠全身治疗不足以控制感染。由于她的乳腺癌晚期，一般情况不佳，预后有限，神经外科团队认为脑室内引流不合适。作为一种替代方法，开始了静脉万古霉素治疗。在静脉注射万古霉素治疗期间，连续测量鞘内万古霉素浓度，提供有价值的药代动力学数据。本病例强调，当全身抗生素治疗不足时，静脉注射万古霉素可能是一种可行的治疗选择。需要进一步的研究来阐明这种治疗方法的药代动力学、有效性和安全性。

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引用次数: 0

Echinocandin-resistant Candida albicans: A case report from Japan 棘白菌素耐药白色念珠菌：日本一例报告。

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2025-11-07 DOI: 10.1016/j.jiac.2025.102856

Sayaka Hikida , Yutaro Akiyama , Masahiro Ishikane , Hiroshi Shimazu , Ryo Nasu , Takayuki Shinohara , Minoru Nagi , Rei Shirai , Makiko Onakado , Nobuko Nakayama , Yoshitsugu Miyazaki , Akira Hangaishi , Norio Ohmagari

Echinocandin-resistant Candida albicans (C. albicans) is a rare but increasing global concern. In Japan, at least three cases had been confirmed by the end of 2015. Mutations in FKS cause echinocandin resistance in Candida species, which is primarily driven by previous echinocandin antifungal use. C. albicans resistance to echinocandins is raising clinicians' concerns globally and could pose a threat to Japan in the near future. The fungus is also an antimicrobial-resistant pathogen, raising awareness of the risk of resistance to prophylactic antifungals. Herein, we report a case of echinocandin-resistant C. albicans at our hospital. Mutations in the FKS gene that cause echinocandin resistance in Candida species have been detected.

白念珠菌（C. albicans）是一种罕见但日益引起全球关注的疾病。在日本，截至2015年底，至少有三例确诊病例。FKS突变导致念珠菌对棘白菌素产生耐药性，这主要是由于以前使用棘白菌素抗真菌所致。白念珠菌对棘白菌素的耐药性引起了全球临床医生的关注，并可能在不久的将来对日本构成威胁。这种真菌也是一种具有抗菌素耐药性的病原体，这提高了人们对预防性抗真菌药物耐药性风险的认识。在此，我们报告一例在我们医院的棘白酵素耐药白色念珠菌。在念珠菌中发现了引起棘珠菌素抗性的FKS基因突变。

引用次数: 0

Cytomegalovirus reactivation with severe lymphopenia during elranatamab treatment: a case series in patients with triple-class refractory multiple myeloma 埃尔那他单抗治疗期间巨细胞病毒再激活伴严重淋巴细胞减少：三级难治性多发性骨髓瘤患者的病例系列

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2025-11-06 DOI: 10.1016/j.jiac.2025.102851

Aika Kitamura , Shinya Fujita , Yuki Isono , Tomoka Nakano , Takumi Morino , Kiho Tozuka , Himari Kudo , Ryohei Abe , Sumiko Kohashi , Takaaki Toyama

Elranatamab (ELRA), a bispecific antibody targeting B-cell maturation antigen (BCMA) and CD3, is effective in patients with triple-class refractory multiple myeloma (TCRMM). However, its T cell–engaging mechanism can induce profound immunosuppression. We retrospectively evaluated infectious complications, including cytomegalovirus (CMV) reactivation, in five TCRMM patients treated with ELRA at our institution. The median age was 77 years, and all patients experienced grade ≥3 lymphopenia. Four (80 %) developed CMV reactivation within 50 days of treatment initiation—markedly higher than the 1.8–5.7 % reported in clinical trials. All reactivation cases were detected by PCR (>500 IU/mL) and managed pre-emptively with valganciclovir; no CMV disease occurred. Absolute lymphocyte counts declined rapidly by day 8 (mean 287/μL) and remained suppressed for over two months in most patients. CD4⁺ T-cell counts were persistently low (22–75/μL) in four of five patients. Neutropenia was transient and inconsistent; bacterial infections occurred in two patients, and no fungal infections were observed. These real-world data suggest that treatment with ELRA in older, transplant-ineligible patients may be associated with a high risk of CMV reactivation than previously appreciated, likely driven by prolonged lymphopenia with a potential contribution from hypogammaglobulinemia. Our results underscore the importance of routine CMV monitoring and lymphocyte profiling during ELRA therapy. Further prospective studies are warranted to optimize infection surveillance and prophylactic strategies in this population. To our knowledge, this is the first case series from Japan to describe infectious complications of ELRA in routine practice, providing important real-world evidence for clinicians.

Elranatamab （ELRA）是一种靶向b细胞成熟抗原（BCMA）和CD3的双特异性抗体，对三级难治性多发性骨髓瘤（TCRMM）患者有效。然而，它的T细胞参与机制可以诱导深刻的免疫抑制。我们回顾性评估了在我院接受ELRA治疗的5例TCRMM患者的感染性并发症，包括巨细胞病毒（CMV）再激活。中位年龄为77岁，所有患者均出现≥3级淋巴细胞减少症。4例（80%）在治疗开始的50天内发生巨细胞病毒再激活，明显高于临床试验中报道的1.8-5.7%。所有再激活病例均采用PCR检测（> ~ 500 IU/mL），并用缬更昔洛韦进行预防性处理；未发生巨细胞病毒疾病。绝对淋巴细胞计数在第8天迅速下降（平均287/μL），并且在大多数患者中保持抑制超过两个月。5例患者中有4例CD4+ t细胞计数持续偏低（22 ~ 75/μL）。中性粒细胞减少是短暂的和不一致的；2例患者发生细菌感染，未见真菌感染。这些真实数据表明，ELRA治疗年龄较大、不适合移植的患者可能与CMV再激活的高风险相关，这可能是由低丙种球蛋白血症引起的长期淋巴细胞减少所致。我们的研究结果强调了常规巨细胞病毒监测和淋巴细胞分析在ELRA治疗中的重要性。需要进一步的前瞻性研究来优化这一人群的感染监测和预防策略。据我们所知，这是日本首次在常规实践中描述ELRA感染并发症的病例系列，为临床医生提供了重要的现实证据。

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引用次数: 0

Assessment of cellular and humoral immunity against varicella-zoster virus in adult allogeneic hematopoietic cell transplant recipients: a cross-sectional study assessing cellular immunity after administration of an adjuvanted recombinant zoster vaccine 评估成人同种异体造血细胞移植受者对水痘带状疱疹病毒的细胞和体液免疫：一项评估接种佐剂重组带状疱疹疫苗后细胞免疫的横断面研究

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2025-11-06 DOI: 10.1016/j.jiac.2025.102857

Takaaki Konuma , Megumi Hamatani-Asakura , Etsuko Nagai , Seiko Kato , Shohei Andoh , Eisuke Adachi , Maki Monna-Oiwa , Satoshi Takahashi , Hiroshi Yotsuyanagi , Yasuhito Nannya

Background

Allogeneic hematopoietic cell transplantation (HCT) recipients have a high risk of developing the reactivation of latent varicella-zoster virus (VZV), which is partly due to an attenuated cellular immunity. Recently, the adjuvanted recombinant zoster vaccine (RZV) has been demonstrated to be safe in allogeneic HCT recipients. However, evaluations of cellular and humoral immune responses to vaccination and reactivation in these populations remain limited.

Methods

We performed a cross-sectional, comprehensive analysis of cellular immunity using a dual-color enzyme-linked immunosorbent spot (ELISpot) assay capable of detecting both interferon-gamma (IFN-γ) and interleukin-2 (IL-2)-secreting T cells in response to VZV glycoprotein E (gE) antigens in 44 allogeneic HCT recipients.

Results

The median interval from HCT to sample collection was 43 months (range, 9–220 months). Prior to sample collection, 16 patients received the RZV, whereas 20 patients experienced zoster reactivation after allogeneic HCT. The median anti-VZV IgG antibody level was 347.5 mIU/mL (range, 50–13,650 mIU/mL). ELISpot assays revealed that gE-specific IFN-γ- and IL-2-producing T cells were present in 60.0 % and 18.2 % of patients, respectively. Antibody levels did not correlate with the frequency of IFN-γ-producing T cells (r = 0.152, P = 0.324) or IL-2-producing T cells (r = 0.216, P = 0.157). Patients who experienced zoster reactivation and received vaccination had higher antibody levels and more frequent gE-specific IFN-γ-producing T cells compared to those without either.

Conclusion

Both zoster reactivation and vaccination were associated with enhanced cellular and humoral immunity against VZV in adult allogeneic HCT recipients.

背景：同种异体造血细胞移植（HCT）受者发生潜伏水痘-带状疱疹病毒（VZV）再激活的风险很高，部分原因是细胞免疫减弱。最近，佐剂重组带状疱疹疫苗（RZV）已被证明对同种异体HCT受体是安全的。然而，在这些人群中，对疫苗接种和再激活的细胞和体液免疫反应的评估仍然有限。方法：我们使用双色酶联免疫吸附斑点（ELISpot）法对44例异体HCT受体对VZV糖蛋白E （gE）抗原反应的干扰素γ (IFN-γ)和白细胞介素-2 （IL-2）分泌T细胞进行了横断、全面的细胞免疫分析。结果：从HCT到样本采集的中位时间间隔为43个月（范围9-220个月）。在采集样本之前，16名患者接受了RZV，而20名患者在异体HCT后经历了带状疱疹再激活。抗vzv IgG抗体水平中位数为347.5 mIU/mL（范围50 ~ 13650 mIU/mL）。ELISpot检测显示，60.0%和18.2%的患者中分别存在ge特异性IFN-γ-和il -2产生T细胞。抗体水平与产生IFN-γ的T细胞（r = 0.152, P = 0.324）或产生il -2的T细胞（r = 0.216, P = 0.157）的频率无关。与没有接种疫苗的患者相比，经历带状疱疹再激活并接种疫苗的患者具有更高的抗体水平和更频繁的ge特异性IFN-γ产生T细胞。结论：带状疱疹再激活和疫苗接种均可增强成人同种异体HCT受者对VZV的细胞和体液免疫。

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引用次数: 0

Distribution and antifungal susceptibility of Candida species in pelvic inflammatory disease patients from Hail, Saudi Arabia: A retrospective study 沙特阿拉伯Hail地区盆腔炎患者念珠菌的分布和抗真菌敏感性：一项回顾性研究

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2025-11-05 DOI: 10.1016/j.jiac.2025.102855

Mohd Saleem , Azharuddin Sajid Syed Khaja , Soha Moursi , Ghorashy Eltayeb Yousif Mohammed , Syed Monowar Alam Shahid , Sahar Hammam , Nuzhat Parveen , Sheeba Afreen

Background and aim

Pelvic inflammatory disease (PID) is a common gynecological condition caused primarily by bacterial pathogens. However, recent evidence suggests that fungal organisms, particularly Candida species, may also contribute, especially in immunocompromised individuals. This study aimed to investigate the ward-wise distribution of PID cases, determine the prevalence of Candida species, and assess their antifungal susceptibility patterns in Hail, Saudi Arabia.

Methods

This retrospective cross-sectional study included 370 PID patients from multiple hospital departments between January 2019 and December 2023. Demographic, clinical, and microbiological data were analyzed. High vaginal swabs were cultured for Candida identification, and antifungal susceptibility testing was performed using the Vitek 2 system. Data were analyzed using SPSS (v.23).

Results

The mean patient age was 34.52 ± 9.73 years, with the highest prevalence among women aged 25–44 years (54.9 %). Most patients were married (60.8 %). Most cases were reported in the gynecology emergency (45.4 %) and the outpatient (31.6 %) wards. Candida albicans was the predominant species (69.8 %), followed by C. glabrata (7.0 %) and other non-albicans species. No significant difference in species distribution was found between the emergency and non-emergency settings (p = 0.263). C. albicans demonstrated high susceptibility to caspofungin (97 %), fluconazole (95 %), and voriconazole (97 %).

Conclusion

Candida species, particularly C. albicans, are prevalent in PID cases in Hail. As a retrospective descriptive study, these findings are preliminary and do not establish causality. Nevertheless, routine fungal diagnostics and antifungal susceptibility testing are recommended, particularly for patients with risk factors or a history of poor response to antibiotic therapy.

背景和目的盆腔炎（PID）是一种常见的妇科疾病，主要由细菌性病原体引起。然而，最近的证据表明，真菌生物，特别是念珠菌，也可能起作用，特别是在免疫功能低下的个体中。本研究旨在调查沙特阿拉伯Hail地区PID病例的ward-wise分布，确定念珠菌种类的流行情况，并评估其抗真菌药敏模式。方法本回顾性横断面研究纳入了2019年1月至2023年12月来自多个医院部门的370例PID患者。对人口统计学、临床和微生物学数据进行分析。培养高剂量阴道拭子进行念珠菌鉴定，并用Vitek 2系统进行抗真菌药敏试验。使用SPSS （v.23）对数据进行分析。结果患者平均年龄为34.52±9.73岁，25 ~ 44岁女性患病率最高（54.9%）。患者以已婚居多（60.8%）。大多数病例报告在妇科急诊科（45.4%）和门诊（31.6%）病房。白色念珠菌为优势菌种（69.8%），其次为光念珠菌（7.0%）和其他非白色念珠菌。在紧急和非紧急情况下，物种分布没有显著差异（p = 0.263）。白色念珠菌对卡泊真菌素（97%）、氟康唑（95%）和伏立康唑（97%）有较高的敏感性。结论冰雹地区PID病例中念珠菌种类较多，以白色念珠菌为主。作为一项回顾性描述性研究，这些发现是初步的，并没有建立因果关系。然而，建议进行常规真菌诊断和抗真菌药敏试验，特别是对于有危险因素或对抗生素治疗反应不佳的患者。

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引用次数: 0

Durations of fever and other symptoms among COVID-19 outpatients administered ensitrelvir during the 2023 Japanese XBB epidemic period 2023年日本XBB流行期间使用恩司他韦门诊患者发热和其他症状持续时间

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2025-11-04 DOI: 10.1016/j.jiac.2025.102852

Naoki Kawai , Takuma Bando , Takeyuki Goto , Shinro Matsuura , Shin Nagao , Osame Tanaka , Takashi Kawashima , Young Chong , Hideyuki Ikematsu

Background

This retrospective study evaluated factors influencing fever and symptom durations and the real-world effectiveness of ensitrelvir in mild to moderate COVID-19 outpatients during Japan's 2023 Omicron XBB epidemic.

Methods

Clinical data were collected via questionnaire. Multiple regression identified factors associated with fever and symptom durations. Durations were compared between patients treated with or without ensitrelvir using stratified analysis and three propensity score matchings (PSM): first (age, sex, vaccination, prior infection), second (fever ≥38 °C, ≥3 symptoms, ≥3 vaccine doses), and third (fatigue, sore throat, gastrointestinal symptoms).

Results

Data from 126 outpatients were analyzed: 85 received ensitrelvir, 41 did not. Ensitrelvir use and ≥3 vaccinations were independently associated with shorter fever duration. Median fever duration was significantly shorter with ensitrelvir (43 vs. 67 h, p = 0.0017). Stratified analysis showed shorter fever duration in patients with ≥38 °C (p = 0.0022) and shorter symptom duration with ≥3 symptoms (p = 0.031). Both durations remained significantly shorter after first (p < 0.001; p = 0.011), second (p = 0.0044; p = 0.025), and third PSM (p = 0.0058; p = 0.015).

Conclusions

Ensitrelvir significantly shortened fever and symptom durations in mild to moderate COVID-19 outpatients. Patients with higher fever or more symptoms may benefit, even with repeated COVID-19 vaccination.

背景：本回顾性研究评估了日本2023年Omicron XBB流行期间轻中度COVID-19门诊患者发烧和症状持续时间的影响因素以及恩司他韦的实际疗效。方法：采用问卷调查法收集临床资料。多元回归确定了与发热和症状持续时间相关的因素。使用分层分析和三种倾向评分匹配（PSM）比较使用或不使用恩司替韦治疗的患者的持续时间：第一（年龄、性别、疫苗接种、既往感染），第二（发烧≥38°C，≥3种症状，≥3种疫苗剂量），第三（疲劳、喉咙痛、胃肠道症状）。结果：126例门诊患者的数据分析：85例接受了ensitrelvir治疗，41例未接受。使用恩司替韦和接种≥3次疫苗与发热持续时间缩短独立相关。ensitrelvir组的中位发热持续时间显著缩短（43小时vs. 67小时，p = 0.0017）。分层分析显示，≥38℃患者发热持续时间较短（p = 0.0022），≥3种症状患者发热持续时间较短（p = 0.031）。在第一次PSM （p < 0.001; p = 0.011）、第二次（p = 0.0044; p = 0.025）和第三次PSM （p = 0.0058; p = 0.015）之后，两种持续时间都显著缩短。结论：恩司替韦可显著缩短轻中度COVID-19门诊患者发热和症状持续时间。即使反复接种COVID-19疫苗，高烧或症状较多的患者也可能受益。

{"title":"Durations of fever and other symptoms among COVID-19 outpatients administered ensitrelvir during the 2023 Japanese XBB epidemic period","authors":"Naoki Kawai , Takuma Bando , Takeyuki Goto , Shinro Matsuura , Shin Nagao , Osame Tanaka , Takashi Kawashima , Young Chong , Hideyuki Ikematsu","doi":"10.1016/j.jiac.2025.102852","DOIUrl":"10.1016/j.jiac.2025.102852","url":null,"abstract":"<div><h3>Background</h3><div>This retrospective study evaluated factors influencing fever and symptom durations and the real-world effectiveness of ensitrelvir in mild to moderate COVID-19 outpatients during Japan's 2023 Omicron XBB epidemic.</div></div><div><h3>Methods</h3><div>Clinical data were collected via questionnaire. Multiple regression identified factors associated with fever and symptom durations. Durations were compared between patients treated with or without ensitrelvir using stratified analysis and three propensity score matchings (PSM): first (age, sex, vaccination, prior infection), second (fever ≥38 °C, ≥3 symptoms, ≥3 vaccine doses), and third (fatigue, sore throat, gastrointestinal symptoms).</div></div><div><h3>Results</h3><div>Data from 126 outpatients were analyzed: 85 received ensitrelvir, 41 did not. Ensitrelvir use and ≥3 vaccinations were independently associated with shorter fever duration. Median fever duration was significantly shorter with ensitrelvir (43 vs. 67 h, p = 0.0017). Stratified analysis showed shorter fever duration in patients with ≥38 °C (p = 0.0022) and shorter symptom duration with ≥3 symptoms (p = 0.031). Both durations remained significantly shorter after first (p < 0.001; p = 0.011), second (p = 0.0044; p = 0.025), and third PSM (p = 0.0058; p = 0.015).</div></div><div><h3>Conclusions</h3><div>Ensitrelvir significantly shortened fever and symptom durations in mild to moderate COVID-19 outpatients. Patients with higher fever or more symptoms may benefit, even with repeated COVID-19 vaccination.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 12","pages":"Article 102852"},"PeriodicalIF":1.5,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145459018","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

First case of infective endocarditis caused by Capnocytophaga canis: Confirmed by prolonged blood culture and molecular analysis 犬嗜碳细胞吞噬引起的感染性心内膜炎1例：经长时间血培养和分子分析证实。

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2025-11-04 DOI: 10.1016/j.jiac.2025.102850

Tatsuro Wakizaka , Kenichiro Yokoi , Hiroyuki Ote , Chikao Teramoto , Takenori Yamazaki , Kiyofumi Ohkusu

Capnocytophaga canis is a zoonotic pathogen not previously linked to infective endocarditis (IE). We report the first case of recurrent IE caused by C. canis, initially presumed to be culture-negative. The diagnosis was established through prolonged blood culture and 16S rRNA-based analysis.

A 66-year-old man had two hospitalizations within six months for culture-negative IE. No causative pathogen was identified, as all 16 blood culture sets remained negative. Two months after discharge, he presented again with fever and peripheral embolic signs. Echocardiography showed vegetations on both the mitral and aortic valves, consistent with recurrent IE. Prolonged incubation of repeat blood cultures yielded Gram-negative rods on the seventh day. Conventional methods failed to identify the organism. Subsequent 16S rRNA-based analysis at a reference laboratory identified C. canis. The patient had close daily contact with a domestic cat, suggesting a zoonotic source. He underwent double valve replacement and received six weeks of intravenous antibiotics, with a favorable outcome.

This case provides some clinical insights. First, C. canis should be considered as a potential pathogen in culture-negative IE, particularly in patients with animal exposure. Second, C. canis IE may present with a subacute or recurrent course with minimal valvular damage, making early recognition difficult. Careful history-taking, prolonged blood cultures, and molecular diagnostic methods are essential for accurate evaluation of culture-negative IE.

犬嗜糖细胞吞噬是一种人畜共患病原体，以前与感染性心内膜炎（IE）没有联系。我们报告第一例由犬C.引起的复发性IE，最初被认为是培养阴性。通过长时间血培养和基于16S rrna的分析确定诊断。一名66岁男性在6个月内因培养阴性IE住院两次。16组血培养均为阴性，未发现致病菌。出院2个月后再次出现发热和外周栓塞征象。超声心动图显示二尖瓣和主动脉瓣均有赘生物，符合复发性IE。延长重复血培养的孵育时间，在第7天产生革兰氏阴性棒。传统的方法无法识别这种生物。随后在参考实验室进行了基于16S rrna的分析，鉴定出了犬链球菌。患者每天与一只家猫有密切接触，提示有人畜共患源。他接受了双瓣膜置换术，并接受了六周的静脉注射抗生素，结果良好。本病例提供了一些临床见解。首先，在培养阴性的IE中，特别是在与动物接触的患者中，应将犬C. canis视为潜在病原体。其次，犬C. IE可能表现为亚急性或复发病程，瓣膜损伤最小，使早期识别困难。仔细的病史记录，长时间的血液培养和分子诊断方法是准确评估培养阴性IE的必要条件。

{"title":"First case of infective endocarditis caused by Capnocytophaga canis: Confirmed by prolonged blood culture and molecular analysis","authors":"Tatsuro Wakizaka , Kenichiro Yokoi , Hiroyuki Ote , Chikao Teramoto , Takenori Yamazaki , Kiyofumi Ohkusu","doi":"10.1016/j.jiac.2025.102850","DOIUrl":"10.1016/j.jiac.2025.102850","url":null,"abstract":"<div><div><em>Capnocytophaga canis</em> is a zoonotic pathogen not previously linked to infective endocarditis (IE). We report the first case of recurrent IE caused by <em>C. canis</em>, initially presumed to be culture-negative. The diagnosis was established through prolonged blood culture and 16S rRNA-based analysis.</div><div>A 66-year-old man had two hospitalizations within six months for culture-negative IE. No causative pathogen was identified, as all 16 blood culture sets remained negative. Two months after discharge, he presented again with fever and peripheral embolic signs. Echocardiography showed vegetations on both the mitral and aortic valves, consistent with recurrent IE. Prolonged incubation of repeat blood cultures yielded Gram-negative rods on the seventh day. Conventional methods failed to identify the organism. Subsequent 16S rRNA-based analysis at a reference laboratory identified <em>C</em>. <em>canis</em>. The patient had close daily contact with a domestic cat, suggesting a zoonotic source. He underwent double valve replacement and received six weeks of intravenous antibiotics, with a favorable outcome.</div><div>This case provides some clinical insights. First, <em>C. canis</em> should be considered as a potential pathogen in culture-negative IE, particularly in patients with animal exposure. Second, <em>C. canis</em> IE may present with a subacute or recurrent course with minimal valvular damage, making early recognition difficult. Careful history-taking, prolonged blood cultures, and molecular diagnostic methods are essential for accurate evaluation of culture-negative IE.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 12","pages":"Article 102850"},"PeriodicalIF":1.5,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145459103","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