Journal of Infection and Chemotherapy最新文献_第5页

Increase in the age of onset of pediatric acute otitis media after the Covid-19 pandemic: A study at a primary emergency medical center COVID-19大流行后儿童急性中耳炎发病年龄的增加：一项在初级急诊医疗中心的研究

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2025-11-21 DOI: 10.1016/j.jiac.2025.102875

Shingo Ishimori , Akihiro Nishimura , Akihiro Tamura , Kazumichi Fujioka , Kandai Nozu , Masaaki Kugo

Background

During the coronavirus disease 2019 (Covid-19) pandemic, rigorous infection control measures led to a decrease in the incidence of various infectious diseases. In this study, we investigated the clinical characteristics of acute otitis media (AOM) children during the post-Covid-19 period at a primary emergency medical center.

Methods

We retrospectively reviewed children with AOM who visited Kobe Children's Primary Emergency Medical Center between April 2017 and March 2024. Patients with AOM or suppurative otitis media were included. We defined each fiscal year (FY) as the period from April to the following March. We defined the “pre-Covid-19 period” as FY2017–2019, the “Covid-19 period” as FY2020–2022, and “post-Covid-19 period” as FY2023.

Results

A total of 2078 AOM cases were included. The mean age at presentation was 3.5 years. A significant difference in age was present across the three FY time periods. The age during the post-Covid-19 period was significantly higher than that during the pre-Covid-19 period using the pairwise comparisons (p < 0.05). In a multivariate analysis between the pre-Covid-19 and post-Covid-19 periods, age at onset (95 % confidence intervals: 1.02–1.11) was the only independent factor associated with the post-Covid-19 period. Between the Covid-19 and post-Covid-19 periods, age at onset (95 % confidence intervals: 1.02–1.15) and body temperature (95 % confidence intervals: 1.05–1.40) were significantly associated with the post-Covid-19 period.

Conclusions

A multifactorial effect may have contributed to the increase in age at the onset of AOM during the post-Covid-19 period compared with the other study periods.

背景：在2019冠状病毒病（COVID-19）大流行期间，严格的感染控制措施导致各种传染病的发病率下降。在本研究中，我们调查了一家初级急诊医疗中心covid -19后时期急性中耳炎（AOM）儿童的临床特征。方法：回顾性分析2017年4月至2024年3月在神户儿童初级急救医疗中心就诊的急性中耳炎患儿。包括急性中耳炎或化脓性中耳炎患者。我们将每个财政年度（FY）定义为从4月到次年3月的期间。我们将“新冠肺炎前期”定义为2017-2019财年，“新冠肺炎期”定义为2020-2022财年，“后新冠肺炎期”定义为2023财年。结果：共纳入AOM 2078例。发病时平均年龄为3.5岁。在三个财政年度期间，年龄存在显著差异。结论：与其他研究时期相比，包括疫苗接种覆盖率降低在内的多因素影响可能导致了covid -19后时期AOM发病年龄的增加。

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引用次数: 0

Clinical outcomes of Baloxavir marboxil versus oseltamivir in outpatients aged 1 to under 5 years in China: a multicenter, retrospective cohort study 巴洛韦与奥司他韦在中国1至5岁以下门诊患者中的临床结果：一项多中心、回顾性队列研究

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2025-11-20 DOI: 10.1016/j.jiac.2025.102874

Chengyu Li , Yanwu Zhang , Ming Yang , Xiao Liu , Shuhui Tian , Zoe Fu , Alastair Mah , Hongjie Yu , Qianli Wang , Helen Zhang

Objectives

Baloxavir marboxil (BXM) is a novel single-dose antiviral agent. The benefit and risk assessment of BXM use in children under 5 years of age remains scarce in China. We aimed to investigate the real-world effectiveness of BXM in this vulnerable population in China.

Study design

This retrospective study analyzed real-world outpatient data from 13 United Family Healthcare hospitals and clinics in China (Oct 2023–Apr 2024), identifying 1-<5 years old lab-confirmed influenza patients treated with BXM or Oseltamivir (OSV). Patients admitted within 14 days post-initial visit for the same condition were evaluated. Influenza-related return visits, symptoms and signs and complications were compared between BXM and OSV groups at 3, 7, and 14 days post-initial visit. Propensity score matching (PSM) was used to reduce bias and balance groups for analysis.

Results

We identified 1473 influenza infected outpatients for analysis, 359 patients received BXM treatment, while 1114 were treated with OSV. The proportion of hospitalization within 14 days were comparable between the BXM group (0.8 %, 3/359) and the OSV (1.0 %, 11/1114). Return visit were consistently higher in the OSV group across all time points, while fewer persistent symptoms and signs (within 3, 7, and 14 days) were observed in the BXM group; after PSM, the BXM group demonstrated consistently slightly fewer return visit for the same illness across all time points compared to the OSV group, none of these differences reached statistical significance.

Conclusion

BXM, the single-dose oral regimen, has demonstrated comparable effectiveness to OSV in terms of influenza-related return visits and hospitalization rates.

目的：Baloxavir marboxil （BXM）是一种新型单剂量抗病毒药物。在中国，5岁以下儿童使用BXM的获益和风险评估仍然很少。我们的目的是调查BXM在中国这一弱势群体中的实际有效性。研究设计：本回顾性研究分析了来自中国13家和睦家医院和诊所的真实门诊数据（2023年10月至2024年4月），确定了1-结果：我们确定了1473名流感感染门诊患者进行分析，359名患者接受BXM治疗，1114名患者接受OSV治疗。14天内住院比例BXM组（0.8%,3/359）与OSV组（1.0%,11/1114）具有可比性。在所有时间点上，OSV组的回访率始终较高，而BXM组观察到的持续症状和体征（3、7和14天内）较少；PSM后，与OSV组相比，BXM组在所有时间点上对同一疾病的回访次数始终略少，这些差异均无统计学意义。结论：单剂量口服BXM在流感相关的回访和住院率方面显示出与OSV相当的有效性。

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引用次数: 0

Impact of hypoalbuminemia severity on total teicoplanin concentrations after 3 days loading dose: a retrospective observational study 低白蛋白血症严重程度对3天负荷剂量后总替柯蛋白浓度的影响：一项回顾性观察研究。

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2025-11-19 DOI: 10.1016/j.jiac.2025.102871

Yuki Shimizu , Kazuhiko Hanada , Takeaki Watanabe , Mari Araki , Keisuke Aoyama , Tomoya Sakai , Keiko Kadota

Background

Hypoalbuminemia is known to decrease total teicoplanin (TEIC) concentration; however, whether total TEIC concentration varies depending on hypoalbuminemia severity remains unclear. This study investigated the correlation between hypoalbuminemia severity and total TEIC concentrations after 3 days loading dose.

Methods

The study included patients (≥18 years old) administered TEIC between January 2017 and January 2025. Factors influencing total TEIC trough concentrations after 3 days loading dose (C_trough) were determined using multiple linear regression. Serum albumin (Alb) levels were stratified into three groups. The total and predicted free TEIC C_trough of patients administered standard and high loading dose regimens were compared among the groups.

Results

The total TEIC C_trough was negatively correlated with age (p = 0.04), and the estimated glomerular filtration rate (p < 0.01) and positively correlated with body weight (p < 0.01), serum Alb (p < 0.01), and TEIC loading dose for within 3 days (p < 0.01). The median total TEIC C_trough for the three groups differed significantly in both dosing regimens: standard, 10.5 [interquartile range, 9.2−13.0], 15.8 [12.1−18.6], and 17.1 [15.4−20.6] μg/mL; high, 12.5 [9.4−16.8], 17.2 [15.7−18.4], and 20.7 [17.4−22.8] μg/mL for Alb <2.0 g/dL, 2.0 ≤ Alb <3.0 g/dL, and Alb ≥3.0 g/dL, respectively. However, the predicted free TEIC C_trough was not significantly different among the Alb groups for either regimen.

Conclusion

The more severe the hypoalbuminemia, the lower the total TEIC C_trough; however, predicted free TEIC C_trough might not be affected. Overall, setting lower target total TEIC concentrations may be beneficial in case of hypoalbuminemia.

背景：已知低白蛋白血症可降低总teicoplanin （TEIC）浓度；然而，TEIC总浓度是否随低白蛋白血症的严重程度而变化仍不清楚。本研究探讨了负荷3天后低白蛋白血症严重程度与总TEIC浓度的相关性。方法：研究纳入2017年1月至2025年1月期间接受TEIC治疗的患者（≥18岁）。采用多元线性回归确定3 d负荷剂量后总TEIC谷浓度的影响因素。血清白蛋白（Alb）水平分为三组。比较标准剂量组和高负荷剂量组患者的总游离TEIC流通量和预测游离TEIC流通量。结果：TEIC总穿透率与年龄呈负相关（p = 0.04），三组的肾小球滤过率（p谷）在两种给药方案中均有显著差异：标准，10.5[四分位数区间，9.2-13.0],15.8 [12.1-18.6],17.1 [15.4-20.6]μg/mL；高，12.5 [9.4-16.8],17.2 [15.7-18.4],20.7 [17.4-22.8]μg/mL在两种给药方案中均无显著差异。结论：低白蛋白血症越严重，总TEIC通度越低；然而，预计的自由TEIC通道可能不会受到影响。总的来说，在低白蛋白血症的情况下，设定较低的TEIC目标浓度可能是有益的。

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引用次数: 0

A case of pneumonia caused by Corynebacterium durum mimicking Nocardia pneumonia in a patient with dermatomyositis 皮肌炎患者由模拟诺卡菌肺炎的硬棒状杆菌引起的肺炎1例。

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2025-11-17 DOI: 10.1016/j.jiac.2025.102869

Natsuko Hara , Tomoaki Higuchi , Mayuko Fujisaki , Ryo Motoyama , Risa Yamada , Rei Yamaguchi , Akiko Tochimoto , Eiichi Tanaka , Ken Kikuchi , Aoi Ito , Masayoshi Harigai

Nocardia can cause severe pneumonia primarily in patients with impaired cell-mediated immunity, such as those taking immunosuppressants. A delayed diagnosis is associated with a poor prognosis. However, early diagnosis is difficult, and conventional identification methods can sometimes misidentify Nocardia as other bacterial pathogens because of its morphological similarity. We report a case of pneumonia caused by Corynebacterium durum primarily misidentified as Nocardia pneumonia in a patient with dermatomyositis who was undergoing intensified immunosuppressive treatment. A 67-year-old woman with dermatomyositis who had received long-term prednisolone and tacrolimus therapy experienced worsening interstitial lung disease and skin and muscle lesions, and the prednisolone dose was increased to 40 mg/day (1 mg/kg/day). During treatment, she developed a productive cough. Nocardia pneumonia was initially suspected on the basis of symptoms, cavitary, infiltrative, and nodular shadows in the dorsal right lobe on computed tomography of the chest, and a sputum smear. Empirical therapy with sulfamethoxazole/trimethoprim 3200 mg/640 mg/day was started, and her symptoms improved quickly. The clinical course and antimicrobial susceptibility test profile were atypical. Therefore, 16S ribosomal ribonucleic acid gene analysis and matrix-assisted laser desorption ionization-time of flight mass spectrometry were performed. Based on this analysis, the pathogen was re-identified as C. durum. Sulfamethoxazole/trimethoprim was continued, leading to improvement of the symptoms and the pulmonary lesions on computed tomography. The findings from this case indicate that C. durum can be misidentified as Nocardia by conventional identification methods and highlight the importance of incorporating more precise identification approaches.

诺卡菌可引起严重肺炎，主要发生在细胞介导免疫受损的患者中，例如服用免疫抑制剂的患者。延迟诊断与预后不良有关。然而，早期诊断是困难的，传统的鉴定方法有时会将诺卡菌误认为其他细菌病原体，因为其形态相似。我们报告一例由硬棒状杆菌引起的肺炎，主要误诊为诺卡菌肺炎在皮肌炎患者谁正在接受强化免疫抑制治疗。一名长期接受强的松龙和他克莫司治疗的67岁皮肌炎妇女，肺间质性疾病和皮肤及肌肉病变加重，强的松龙剂量增加到40mg /天（1mg /kg/天）。在治疗期间，她出现咳嗽。诺卡菌肺炎最初是根据症状、胸部计算机断层扫描右肺背叶空洞、浸润和结节影以及痰涂片怀疑。开始磺胺甲恶唑/甲氧苄啶3200mg / 640mg /天的经验治疗，症状迅速好转。临床病程及药敏试验不典型。因此，进行了16S核糖体核糖核酸基因分析和基质辅助激光解吸电离飞行时间质谱分析。在此基础上，重新鉴定病原菌为硬膜梭菌。继续使用磺胺甲恶唑/甲氧苄啶，导致症状和计算机断层扫描肺部病变的改善。该病例的研究结果表明，常规鉴定方法可能将硬膜梭菌误认为诺卡菌，并强调采用更精确的鉴定方法的重要性。

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引用次数: 0

A case of asymptomatic paragonimiasis with mobile pulmonary lesions and concomitant liver fluke infection 无症状肺吸虫病伴肺移动性病变及肝吸虫感染1例。

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2025-11-17 DOI: 10.1016/j.jiac.2025.102865

Kenji Ohnishi , Kana Sugimoto , Hideki Wakabayashi , Kohei Sasamoto , Yuichiro Imai

We report here an asymptomatic patient showing the location of lung lesions that differ between the first and subsequent chest CT scans. This raised suspicion of paragonimiasis, which ultimately led to its diagnosis. For physicians with limited or no experience with paragonimiasis, the observation that the location of lung lesions differs over time on imaging tests is an important clue in suspecting paragonimiasis. Moreover, this patient was co-infected with liver fluke. Even when one kind of parasitic infection is identified, it is important to be aware of other parasitic infections.

我们在此报告一位无症状的患者，在首次和随后的胸部CT扫描中显示肺部病变的位置不同。这引起了对吸虫病的怀疑，并最终导致其诊断。对于有有限或没有吸虫病经验的医生来说，观察到肺部病变的位置随时间的变化在影像学检查中是怀疑吸虫病的重要线索。此外，该患者同时感染肝吸虫。即使确定了一种寄生虫感染，重要的是要了解其他寄生虫感染。

引用次数: 0

When malaria hides: a case report of sudden coma without prior fever in cerebral malaria 当疟疾隐藏：脑型疟疾患者无发热突然昏迷1例报告。

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2025-11-17 DOI: 10.1016/j.jiac.2025.102866

Fiona Valerie Muskananfola, Asep Purnama

Malaria is a major global health burden. Severe malaria, including cerebral malaria (CM), significantly increases mortality and requires immediate treatment. CM often manifests as loss of consciousness and behavioural changes. In this case, a 19-year-old woman presented with sudden unconsciousness and rigor. Fever before admission was denied, but later developed during hospitalization. Given the patient's residence in a malaria-endemic area, a rapid diagnostic test (RDT) was performed and was positive. Microscopic examination was delayed but later confirmed Plasmodium falciparum infection. The patient was treated with intravenous artesunate, followed by primaquine and dihydroartemisinin-piperaquine (DHP). The patient improved following treatment; follow-up microscopy confirmed parasite clearance.

疟疾是一个主要的全球卫生负担。严重疟疾，包括脑型疟疾，会显著增加死亡率，需要立即治疗。多发性硬化症通常表现为意识丧失和行为改变。在这个案例中，一名19岁的女性表现为突然失去意识和僵硬。入院前未发烧，但后来在住院期间出现。鉴于患者居住在疟疾流行地区，进行了快速诊断试验（RDT），结果呈阳性。显微镜检查延迟，但后来确诊为恶性疟原虫感染。患者先静脉滴注青蒿琥酯，再用伯氨喹和双氢青蒿素-哌喹（DHP）治疗。经治疗后病情好转；随访显微镜检查证实寄生虫清除。

引用次数: 0

Relationship between blood posaconazole concentration and serum potassium levels 泊沙康唑血药浓度与血钾水平的关系。

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2025-11-17 DOI: 10.1016/j.jiac.2025.102868

Yuichi Shibata , Nobuhiro Asai , Mao Hagihara , Hiroshige Mikamo

Background

Some studies have suggested a correlation between posaconazole (PSCZ) concentration and efficacy in preventing fungal infections; the international guidelines recommend therapeutic drug monitoring. However, few studies have investigated the association between PSCZ concentration and its representative adverse effect of hypokalemia. This study aimed to measure serum PSCZ concentrations and investigate the relationship between this parameter and hypokalemia.

Methods

This study was conducted at Aichi Medical University Hospital. All patients in the hematology department who orally received PSCZ were included, wherein their trough serum concentrations (Cmins) of PSCZ were measured using high-performance liquid chromatography. Serum potassium levels were monitored for 60 days following PSCZ initiation. Hypokalemia was defined as serum potassium levels of <3.0 mEq/L and ≥10.0 % decreases from baseline following PSCZ administration.

Results

A total of 24 patients were included. The incidence of hypokalemia was 41.7 %. The median PSCZ concentrations were comparable between patients who developed hypokalemia and those who did not (2.5 μg/mL vs 2.4 μg/mL, p = 0.98). In both groups, approximately 80 % of the patients (80.0 % vs. 78.6 %, p = 0.98) showed PSCZ concentrations below 4.0 μg/mL. No significant correlations were found between PSCZ Cmin and the rate of serum potassium level reduction (γ = −0.21, p = 0.32) or minimum potassium level (γ = −0.03, p = 0.88).

Conclusions

PSCZ might cause hypokalemia regardless of Cmin; clinicians in hematology should remain vigilant.

背景：一些研究表明泊沙康唑（PSCZ）浓度与预防真菌感染的效果相关；国际指南建议对治疗性药物进行监测。然而，很少有研究调查PSCZ浓度与其代表性的低钾血症不良反应之间的关系。本研究旨在测定血清PSCZ浓度，并探讨该参数与低钾血症的关系。方法：本研究在爱知医科大学附属医院进行。纳入血液科所有口服PSCZ的患者，采用高效液相色谱法测定其PSCZ谷血清浓度（Cmins）。在PSCZ开始后的60天内监测血清钾水平。低钾血症定义为血清钾水平。结果：共纳入24例患者。低钾血症发生率为41.7%。低钾血症患者和非低钾血症患者的中位PSCZ浓度相当（2.5μg/mL vs 2.4μg/mL, p = 0.98）。在两组中，约80%的患者（80.0%比78.6%,p = 0.98） PSCZ浓度低于4.0μg/mL。PSCZ Cmin与血清钾水平降低率（γ = -0.21, p = 0.32）或最低钾水平（γ = -0.03, p = 0.88）无显著相关。结论：与Cmin无关，PSCZ可引起低钾血症；血液学临床医生应保持警惕。

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引用次数: 0

N-acetylcysteine is associated with restoration of autophagy-related signaling and reduced intracellular Mycobacterium avium in alveolar type 1 epithelial cells n -乙酰半胱氨酸与自噬相关信号的恢复和肺泡1型上皮细胞内鸟分枝杆菌的减少有关。

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2025-11-14 DOI: 10.1016/j.jiac.2025.102864

Ayako Shiozawa , Chiaki Kajiwara , Yoshikazu Ishii , Kazuhiro Tateda

Purpose

In patients with pulmonary Mycobacterium avium complex disease, the barrier function of the airway epithelium is reduced. In this study, we focused on the host defense responses of alveolar epithelial cells to M. avium.

Methods and results

Clinical isolates of M. avium were used to infect murine alveolar type 1 epithelial cells (AT1s). Administration of N-acetylcysteine suppressed bacterial growth in the infected cells. Expression of the autophagosome marker microtubule-associated protein 1 light chain 3 was decreased in M. avium-infected cells and appeared to be restored by N-acetylcysteine administration. M. avium infection negatively affected the autophagic pathway, specifically mTORC1 signaling and its upstream factor, SLC37A4, which was partially restored by N-acetylcysteine administration. Autophagy inhibition by bafilomycin attenuated the NAC-associated reduction in bacterial load, suggesting involvement of autophagy-related pathways.

Conclusions

Our results suggest that M. avium infection is associated with suppressed autophagy-related responses in AT1s. NAC may function as an immunomodulatory agent by modulating autophagy-associated pathways and reducing intracellular bacterial burden.

目的：肺鸟分枝杆菌复合体患者气道上皮屏障功能降低。在本研究中，我们重点研究了肺泡上皮细胞对鸟分枝杆菌的宿主防御反应。方法与结果：采用临床分离的鸟分枝杆菌感染小鼠肺泡1型上皮细胞（AT1s）。n -乙酰半胱氨酸抑制了感染细胞中的细菌生长。自噬体标志物微管相关蛋白1轻链3的表达在鸟分枝杆菌感染的细胞中下降，并在给予n -乙酰半胱氨酸后恢复。M. avium感染对自噬通路产生负面影响，特别是mTORC1信号及其上游因子SLC37A4， n -乙酰半胱氨酸可部分恢复自噬通路。巴非霉素对自噬的抑制减弱了nac相关的细菌负荷的减少，这表明与自噬相关的途径有关。结论：我们的研究结果表明，鸟分枝杆菌感染与at15细胞自噬相关反应的抑制有关。NAC可能作为一种免疫调节剂，通过调节自噬相关途径和减少细胞内细菌负担。

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引用次数: 0

Identification of key risk factors for syphilis among high-risk populations in urban areas of Japan 日本城市高危人群中梅毒关键危险因素的鉴定

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2025-11-14 DOI: 10.1016/j.jiac.2025.102863

Yuka Yamagishi , Marina Minami , Natsuko Nakamura , Yasuhiko Onoe , Yoshitomo Kobori , Ichiro Itoda , Hiroshige Mikamo

Introduction

We aimed to identify high-risk factors for syphilis infection in metropolitan areas, specifically Tokyo, to guide effective strategy development against syphilis epidemics.

Methods

From July 20, 2023, to January 26, 2024, a REDCap survey was administered to individuals tested for syphilis at three Tokyo clinics. Consent was obtained through an agreement option at initiation of the questionnaire permitting individuals to decline participation. By selecting the consent option and completing the survey, individuals agreed to participate in the study. This research was supported by a Ministry of Health, Labor and Welfare research grant (JPMH23HA2011) and approved by the Kochi University School of Medicine Ethics Committee (Approval No. 2023–44).

Results

A total of 215 participants were analyzed after excluding 13 from the initial cohort. Of these, 48.4 % tested positive for syphilis. Positive cases were more frequently individuals with a history of sexually transmitted infections (STIs) undergoing their first syphilis test. Symptoms strongly correlated with syphilis positivity (60.5 % among symptomatic participants). Multivariate analysis identified casual sexual relationships and a history of STIs as significant risk factors for syphilis positivity. The presence of symptoms was also significantly associated with syphilis positivity. Engagement in sex work and anal intercourse trended toward increased risk. Age, men having sex with men, and use of matchmaking apps exhibited no significant association.

Conclusion

This study identified risks related to sexual partners, sex industry involvement, and sexual activities. Promoting preventive measures among sex industry workers and patrons is crucial. Increased syphilis testing opportunities may aid in reducing disease prevalence.

前言：我们旨在确定大都市地区，特别是东京地区梅毒感染的高危因素，以指导有效的梅毒流行策略制定。方法：从2023年7月20日至2024年1月26日，对东京三家诊所的梅毒检测个体进行REDCap调查。在问卷开始时，通过允许个人拒绝参与的协议选项获得同意。通过选择同意选项并完成调查，个人同意参与研究。本研究得到了厚生劳动省研究基金（JPMH23HA2011）的支持，并得到了高知大学医学院伦理委员会的批准（批准号2023-44）。结果：从初始队列中剔除13名参与者后，对215名参与者进行了分析。其中，48.4%的人梅毒检测呈阳性。阳性病例通常是有性传播感染史的个体，他们正在进行第一次梅毒检测。症状与梅毒阳性呈强烈相关（有症状者占60.5%）。多变量分析表明，随意性关系和性传播感染史是梅毒阳性的重要危险因素。出现症状也与梅毒阳性显著相关。从事性工作和肛交有增加风险的趋势。年龄、男男性行为和婚介软件的使用没有明显的关联。结论：本研究确定了与性伴侣、性行业和性活动相关的风险。在性工作者和顾客中推广预防措施至关重要。增加梅毒检测机会可能有助于降低疾病患病率。

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引用次数: 0

Campylobacter fetus meningitis and bacteremia: A case report in a post–liver transplant and post–splenectomy patient and a restructured literature review 弯曲杆菌性胎儿脑膜炎和菌血症：一例肝移植和脾切除术后患者的报告和重新整理的文献回顾。

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2025-11-13 DOI: 10.1016/j.jiac.2025.102862

Shiori Kitaya , Hatsumi Otani , Masahiro Yanagi , Taketo Kubo , Ryosuke Issiki , Yoshinori Takahashi , Megumi Oshima , Hajime Kanamori

Background

Campylobacter fetus is a rare but serious pathogen, mainly affecting immunocompromised patients. Central nervous system infections, particularly meningitis, are uncommon; only one case has been reported after liver transplantation and none after splenectomy.

Case presentation

We report meningitis and bacteremia caused by C. fetus subsp. fetus (Cff) in a 70-year-old man with liver transplantation and splenectomy for hepatitis C virus-related cirrhosis, on long-term immunosuppression. He presented with intermittent fever; blood cultures grew C. fetus, and cerebrospinal fluid (CSF) cultures confirmed it. Therapy was changed from cefmetazole to meropenem and vancomycin, then de-escalated to high-dose ampicillin. After 23 days of antibiotics, he fully recovered without sequelae.

Literature review

The literature review included 36 adult cases identified through a PubMed search and our own case. Seventy-eight percent were male, with a median age of 49 years. Sixteen percent were immunocompromised, while 41 % were otherwise healthy. Exposure risks were reported in 43 %, though absent in 54 %. Of 38 isolates, 24 were subspeciated: Cff was most frequent (18/24, 75 %), followed by C. fetus subsp. intestinalis and venerealis (2 each), and single isolates of jejuni and Spirillum serpens. Relapse occurred in 22 %, and mortality was 5 %.

Conclusion

C. fetus meningitis is rare and diagnostically challenging but should be considered in immunocompromised patients, including those with post-transplantation or post-splenectomy status. Infection may occur even without clear exposure. Both blood and CSF cultures are essential, with blood cultures often positive earlier. Prompt diagnosis and targeted therapy are crucial for favorable outcomes, and long-term follow-up is recommended due to relapse risk.

背景：胎儿弯曲杆菌是一种罕见但严重的病原体，主要影响免疫功能低下的患者。中枢神经系统（CNS）感染，特别是脑膜炎不常见；肝移植术后仅报道一例，脾切除术后无一例。病例介绍：我们报告由C.胎儿亚种引起的脑膜炎和菌血症。一名70岁男性，因丙型肝炎相关肝硬化接受肝移植和脾切除术，长期免疫抑制。他表现为间歇性发热；血液培养培养出C.胎儿，脑脊液（CSF）培养证实了这一点。治疗由头孢美唑改为美罗培南和万古霉素，然后逐步降至大剂量氨苄西林。经过23天的抗生素治疗，他完全康复，没有后遗症。文献综述：文献综述包括通过PubMed检索确定的36例成人病例和我们自己的病例。78%是男性，平均年龄为49岁。16%的人免疫功能低下，41%的人在其他方面健康。43%的人有暴露风险，54%的人没有暴露风险。38株分离物中有24个亚种，其中以Cff亚种最多（18/ 24,75 %），其次为C.胎儿亚种。肠芽孢菌和性病芽孢菌各2株，空肠芽孢菌和蛇螺旋菌单株。复发率22%，死亡率5%。结论：c型胎儿脑膜炎罕见且诊断困难，但应考虑免疫功能低下患者，包括移植后或脾切除术后的患者。即使没有明确的接触也可能发生感染。血液和脑脊液培养都是必不可少的，早期血液培养通常呈阳性。及时诊断和靶向治疗是获得良好结果的关键，由于复发风险，建议长期随访。

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