Journal of Infection and Chemotherapy最新文献_第6页

Transplacental transfer of antibodies against pertussis and respiratory syncytial virus and follow-up after birth 经胎盘转移抗百日咳和呼吸道合胞病毒抗体及出生后随访。

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2026-01-01 Epub Date: 2025-11-21 DOI: 10.1016/j.jiac.2025.102877

Yukako Kosaka , Takashi Ito , Kyoko Hattori , Ayumi Saito , Yusuke Okuda , Daigo Ochiai , Kenji Ishikura , Kazuhiko Katayama , Tetsuo Nakayama

Objectives

Maternal immunization is recommended through transplacental antibody transfer to protect newborn babies against respiratory syncytial virus (RSV) and pertussis. The objective of the study is to realize the current situation of maternal transfer of antibodies against RSV and pertussis before introduction of RSV maternal vaccine.

Methods

Maternal serum samples were taken from 421 pregnant women before delivery, and 366 paired umbilical cord blood samples were obtained. Pertussis toxin (PT) antibodies and neutralizing test (NT) antibodies against RSV were examined. Follow-up serum samples were obtained from 22 infants at 2 and 6 months, and one and 1.5 years after birth.

Results

RSV NT antibody was positive in all maternal sera and showed higher levels in umbilical cord blood, with a 1.31-fold increase. It decreased to 1/3 levels at 2 months and 1/8–9 levels at 6 months after birth in comparison with umbilical blood. Three subjects were considered RSV infection between 2 and 6 months after birth. The positive rate of PT antibody was approximately 30 % in pregnant women with extremely low levels, which decreased to undetectable at 2 months, increased at 6 months with routine immunization, decreased at one year, and increased at 1.5 years with a booster dose of pertussis-containing vaccine.

Conclusion

The transplacental transfer ratio was 1.31 for both RSV and pertussis antibodies. Transferred RSV NT decreased to 1/3 levels at 2 months and 1/8–9 levels at 6 months. PT antibody levels were undetectable until 2 months. The data suggests the critical role of maternal immunization.

目的：建议孕妇通过经胎盘抗体转移免疫，以保护新生儿免受呼吸道合胞病毒（RSV）和百日咳的侵害。本研究的目的是在引入RSV母源疫苗前了解抗RSV和百日咳抗体的母源转移现状。方法：抽取421例孕妇产前血清和366例配对脐带血。检测百日咳毒素（PT）抗体和抗RSV的中和试验（NT）抗体。22名婴儿在出生后2个月和6个月，1岁和1.5岁时获得随访血清样本。结果：RSV NT抗体在所有母体血清中均呈阳性，脐带血中RSV NT抗体水平较高，升高1.31倍。与脐血相比，2个月时降至1/3,6个月时降至1/8-9。三名受试者在出生后2至6个月被认为感染了呼吸道合胞病毒。在极低水平的孕妇中，PT抗体的阳性率约为30%，在2个月时降至检测不到，在6个月时常规免疫增加，在1年时下降，在1.5岁时加强剂量的百日咳疫苗增加。结论：RSV抗体和百日咳抗体经胎盘转移率均为1.31。转移的RSV NT在2个月时降至1/3，在6个月时降至1/8-9。直到2个月后才检测到PT抗体水平。这些数据表明，孕产妇免疫发挥了关键作用。

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引用次数: 0

Lumbar-peritoneal shunt-associated meningitis and peritoneal abscess due to Corynebacterium striatum: A case report and literature review 纹状棒状杆菌所致腰腹膜分流相关脑膜炎及腹膜脓肿1例报告及文献复习。

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2026-01-01 Epub Date: 2025-12-12 DOI: 10.1016/j.jiac.2025.102895

Akiho Maeda , Koji Hayashi , Rina Izumi , Yusuke Tsujigiwa , Yuka Nakaya , Yoshitomo Fukuoka , Kohei Ueda , Norichika Hashimoto

We describe the first case of both a peritoneal abscess and a lumbar-peritoneal (LP) shunt infection related to Corynebacterium striatum (C. striatum). An 85-year-old Japanese male with a history of diabetes, hyperlipidemia, and a pulmonary vein isolation procedure for atrial fibrillation presented with urinary incontinence, gait disturbance, and cognitive decline. He was diagnosed with normal-pressure hydrocephalus (NPH) and underwent LP shunt surgery. Postoperatively, he developed pneumonia followed by an intra-abdominal abscess and bacterial meningitis. C. striatum was isolated from both cerebrospinal fluid (CSF) and intraperitoneal abscess. Despite antibiotic treatment including vancomycin, he developed septic shock and ultimately resulted in his death.

The LP shunt likely facilitated the entry of C. striatum into the CSF, resulting in meningitis and subsequent abscess formation. Despite appropriate antibiotic treatment including vancomycin, C. striatum infections can be resistant and lead to severe outcomes. This case highlights a new complication associated with C. striatum: bacterial meningitis and intraperitoneal abscesses via an LP shunt, expanding its clinical spectrum.

我们描述了第一例腹膜脓肿和腰-腹膜（LP）分流感染与纹状棒状杆菌（C.纹状体）。一名85岁日本男性，有糖尿病、高脂血症病史，因房颤而行肺静脉隔离手术，表现为尿失禁、步态障碍和认知能力下降。他被诊断为常压脑积水（NPH）并接受了LP分流手术。术后，患者出现肺炎，并发腹腔脓肿和细菌性脑膜炎。纹状体c从脑脊液和腹腔脓肿中分离。尽管接受了包括万古霉素在内的抗生素治疗，他还是患上了感染性休克，最终导致了他的死亡。LP分流可能促进纹状体梭状体进入脑脊液，导致脑膜炎和随后的脓肿形成。尽管适当的抗生素治疗包括万古霉素，纹状体梭状体感染可耐药并导致严重的后果。本病例突出了纹状体梭状体的新并发症：细菌性脑膜炎和经LP分流的腹膜内脓肿，扩大了其临床范围。

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引用次数: 0

Characteristics of invasive group B streptococcal infections in adults and older individuals in a super-aging society in Japan, 2016–2023 2016-2023年日本超老龄化社会成人和老年人侵袭性B群链球菌感染特征

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2026-01-01 Epub Date: 2025-12-16 DOI: 10.1016/j.jiac.2025.102897

Hideaki Takahashi , Haruko Miyazaki , Yuki Watanabe , Daisuke Kawahata , Yutaka Nasu , Misako Takata , Hidemasa Nakaminami , Hidehiro Watanabe , Yuji Hirai , Kimiko Ubukata , Shigeki Nakamura

Background

Group B Streptococcus (GBS), a commensal bacterium in the gastrointestinal tract, can cause invasive GBS (iGBS) infections, particularly in older adults with underlying comorbidities. We determined the relationship between mortality and host-related or virulence factors in older adults with iGBS infections.

Methods

We retrospectively analyzed 105 cases of iGBS infection treated between January 2016 and October 2023 at Tokyo Medical University Hospital and two affiliated hospitals. The association between patient outcomes and demographics, underlying diseases, clinical manifestations, medical treatment, biomarkers, antimicrobial agents used at admission, and capsular type of GBS isolates was examined.

Results

The median age of the patients was 78 years (interquartile range, 64–85 years), and 89.5 % had underlying comorbidities, such as diabetes, chronic kidney disease, and malignancies. Common clinical manifestations include skin and soft tissue infections, bacteremia, and urosepsis. The overall mortality rate was 11.4 %. White blood cell (WBC) counts (breakpoint,10 × 10³/μL) on admission were significantly lower in fatal cases (P < 0.001; odds ratio, 9.6), but no significant differences were observed for other biomarkers. The Kaplan–Meier estimate of 28-day survival was associated with WBC count (P < 0.001). The most common capsular type was Ib, followed by type V. Levofloxacin resistance was predominantly identified in type Ib. No significant association was found between capsular type and mortality rates.

Conclusion

Effective prevention of iGBS infections in older individuals requires large-scale surveillance, including environmental factors, and the development of comprehensive and multifaceted prevention strategies for high-risk older populations.

背景：B群链球菌（GBS）是胃肠道中的一种共生细菌，可引起侵袭性GBS （iGBS）感染，特别是在有潜在合并症的老年人中。我们确定了iGBS感染老年人的死亡率与宿主相关或毒力因素之间的关系。方法：回顾性分析2016年1月至2023年10月在东京医科大学附属医院及两家附属医院治疗的105例iGBS感染病例。研究了患者结局与人口统计学、基础疾病、临床表现、药物治疗、生物标志物、入院时使用的抗菌药物和GBS分离株荚膜类型之间的关系。结果：患者的中位年龄为78岁（四分位数范围为64-85岁），89.5%有潜在的合并症，如糖尿病、慢性肾脏疾病和恶性肿瘤。常见的临床表现包括皮肤和软组织感染、菌血症和尿毒症。总死亡率为11.4%。死亡病例入院时白细胞（WBC）计数（断点，10 × 103/μL）显著降低（P < 0.001；优势比，9.6），但其他生物标志物无显著差异。Kaplan-Meier估计28天生存率与白细胞计数相关（P < 0.001）。最常见的荚膜类型是Ib型，其次是v型。Ib型主要发现左氧氟沙星耐药。荚膜类型与死亡率之间未发现显著相关性。结论：有效预防老年人iGBS感染需要包括环境因素在内的大规模监测，并针对老年高危人群制定全面、多方面的预防策略。

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引用次数: 0

RSV epidemiology in Italian adults over 60: a multicenter cross-sectional study 意大利60岁以上成年人RSV流行病学：一项多中心横断面研究。

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2026-01-01 Epub Date: 2025-12-02 DOI: 10.1016/j.jiac.2025.102881

Federica Novazzi , Laura Pellegrinelli , Federica A.M. Giardina , Carla Acciarri , Stefano Menzo , Elisa Vian , Valeria Biscaro , Giulia Piccirilli , Tiziana Lazzarotto , Sara Uceda Renteria , Annapaola Callegaro , Guglielmo Ferrari , Elisabetta Pagani , Elisa Masi , Cristina Galli , Claudia Tiberio , Martina Esposito , Alessandra Pierangeli , Guido Antonelli , Eleonora Lalle , Matteo Fracella

Objective

Respiratory syncytial virus (RSV) infections have a significant impact on public health, particularly among children and the elderly. However, the burden on older adults in Italy is underestimated due to a lack of comprehensive data.

Methods

Data on the molecular detection of RSV in respiratory samples from laboratories across Italy, from north to south, between September 2021 and May 2023 were collected and analyzed.

Results

A total of 138,783 tests were provided by 13 laboratories, with an overall RSV positivity rate of 6.4 %. Among adults aged ≥60 years (35.4 % of the total), the RSV positivity rate was 3.5 %. Two epidemic waves were observed, peaking in December 2021 and January 2023, with the second wave showing a higher number of cases. RSV subtyping revealed that RSV-B was the predominant subtype in both epidemic seasons, compared to RSV-A.

Conclusion

Analyses of RSV circulation in older adults highlight seasonal variability and underscore the importance of testing in this population. These findings may inform surveillance, clinical management, and the development of future preventive strategies, including vaccination.

目的：呼吸道合胞病毒（RSV）感染对公众健康有重大影响，特别是在儿童和老年人中。然而，由于缺乏全面的数据，意大利老年人的负担被低估了。方法：收集和分析2021年9月至2023年5月期间意大利各地实验室呼吸样本中RSV分子检测数据，从北到南。结果：13个实验室共提供138,783份检测报告，RSV总阳性率为6.4%。60岁以上成人（35.4%）RSV阳性率为3.5%；观察到两次流行波，分别于2021年12月和2023年1月达到高峰，第二波病例数更高。RSV亚型分型结果显示，与RSV- a相比，RSV- b是两个流行季节的主要亚型。结论：对老年人RSV循环的分析强调了季节性变异，并强调了在该人群中进行检测的重要性。这些发现可为监测、临床管理和制定包括疫苗接种在内的未来预防策略提供信息。

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引用次数: 0

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 : 2026-01-01 Epub 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

The current status of neonatal echovirus 11 infections in Japan: A comparison to the global situation 日本新生儿埃可病毒11型感染现状：与全球比较

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2026-01-01 Epub Date: 2025-12-01 DOI: 10.1016/j.jiac.2025.102879

Takanori Funaki , Kensuke Shoji

Enteroviruses (EVs) are one of the most common causes of severe neonatal infections. The spectrum of diseases varies with age, sex, and immune status. As molecular methods have evolved, several new EVs have been identified, bringing the total number of serotypes to over 100. Since 2022, the World Health Organization has published Disease Outbreak News on echovirus 11 (E11) infections due to an increase in severe neonatal E11 infections in several European countries. In Japan, several life-threatening neonatal cases were also reported in the summer of 2024. Clinical characteristics of severe cases include rapid clinical deterioration with multiorgan failure, hemophagocytic lymphohistiocytosis-like inflammatory features, and a high mortality rate. Male infants are likely to experience severe outcomes, specifically in neonates, onset soon after birth, and possible maternal peripartum infection. Meanwhile, older infants with aseptic meningitis often show mild, self-limited disease. Genomic characteristics indicate that a new recombinant genotype D5 is the predominant circulating E11 lineage worldwide. Recent severe neonatal cases linked to a closely related genetic variant that may have increased pathogenicity. This evidence suggests both viral evolution and immature neonatal immunity may contribute to the disease severity. Given the newly initiated nationwide surveillance in Japan, enhanced EV surveillance and rapid genomic characterization are crucial for early identification of severe E11 infection in neonates.

肠病毒（ev）是严重新生儿感染的最常见原因之一。疾病的范围因年龄、性别和免疫状况而异。随着分子方法的发展，已经发现了几种新的ev，使血清型总数超过100种。自2022年以来，世界卫生组织发布了关于埃可病毒11 （E11）感染的疾病暴发新闻，原因是几个欧洲国家新生儿严重感染E11的病例有所增加。在日本，2024年夏天也报告了几例危及生命的新生儿病例。重症病例的临床特点为临床迅速恶化，伴多器官功能衰竭，有噬血细胞淋巴组织细胞病样炎症特征，病死率高。男性婴儿可能会经历严重的后果，特别是新生儿，出生后不久发病，并可能出现母体围产期感染。同时，年龄较大的无菌性脑膜炎患儿通常表现为轻度、自限性疾病。基因组特征表明，新的重组基因型D5是世界范围内主要的循环E11谱系。最近的严重新生儿病例与一种密切相关的基因变异有关，这种变异可能增加了致病性。这一证据表明，病毒进化和不成熟的新生儿免疫都可能导致疾病的严重程度。鉴于日本新启动的全国监测，加强EV监测和快速基因组鉴定对于早期识别新生儿严重E11感染至关重要。

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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 : 2026-01-01 Epub 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

Application of epithelial lining fluid drug concentrations to MICi-Based PK/PD modeling of cefepime/nacubactam in a murine model of CPE pneumonia 上皮内层液药物浓度在CPE肺炎小鼠模型中基于mici的头孢吡肟/纳库巴坦PK/PD模型中的应用

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2026-01-01 Epub Date: 2025-12-08 DOI: 10.1016/j.jiac.2025.102889

Yuki Mizukami , Mishu Takahashi , Kenta Suzuki , Shaoqing Duan , Shintaro Ikegami , Takuma Muraishi , Natsuki Satake , Yuko Okamoto , Yuki Igarashi , Yuki Enoki , Kazuaki Taguchi , Kazuaki Matsumoto

Introduction

Nacubactam is a novel β-lactamase inhibitor with intrinsic antibacterial activity that shows therapeutic potential against carbapenemase-producing Enterobacterales when administered with β-lactam antibiotics. Pharmacokinetics/pharmacodynamics (PK/PD) analyses based on drug concentrations at the site of infection are recommended to better evaluate antibiotic efficacy. A new PD index, the instantaneous minimum inhibitory concentration (MIC_i), which dynamically reflects the changing susceptibility of β-lactams during co-administration with β-lactamase inhibitors, has recently been proposed. This study aimed to assess the efficacy of cefepime combined with nacubactam in a murine model of pneumonia using MIC_i-based PK/PD analysis in the lung epithelial lining fluid (ELF).

Methods

In vitro pharmacodynamic testing using the checkerboard method was conducted with two β-lactamase-producing Klebsiella pneumoniae strains. In vivo PK and PD studies were performed in neutropenic mice using both β-lactamase-producing and non-producing strains. Drug concentrations in plasma and ELF were measured, and MIC_i-based PK/PD analysis was conducted.

Results

In vitro, the MIC of cefepime decreased in a concentration-dependent manner with increasing nacubactam. In the murine model of pneumonia, cefepime monotherapy resulted in bacterial changes of 0.12–4.30 log₁₀ CFU/lung, while the combination therapy reduced bacterial counts by −5.93 to −0.234 log₁₀ CFU/lung. The percentage of time that free cefepime concentrations exceeded MIC_i (T > MIC_i) was highly correlated with bacterial reduction. The target T > MIC_i for maximal effect was estimated to be 29.3 %.

Conclusions

These findings support the utility of MIC_i-based PK/PD analysis for optimizing combination antibiotic therapy in pneumonia.

纳库巴坦是一种新型的β-内酰胺酶抑制剂，具有内在的抗菌活性，当与β-内酰胺抗生素一起使用时，对产生碳青霉烯酶的肠杆菌显示出治疗潜力。建议根据感染部位的药物浓度进行药代动力学/药效学（PK/PD）分析，以更好地评估抗生素的疗效。最近提出了一种新的PD指标，即瞬时最小抑制浓度（瞬时最小抑制浓度，MICi），它动态地反映了β-内酰胺酶抑制剂与β-内酰胺酶抑制剂共同给药过程中β-内酰胺类药物敏感性的变化。本研究旨在通过肺上皮衬里液（ELF）基于mici的PK/PD分析，评估头孢吡肟联合纳库巴坦对小鼠肺炎模型的疗效。方法：采用棋盘法对2株产β-内酰胺酶肺炎克雷伯菌进行体外药效学试验。使用产生β-内酰胺酶和不产生β-内酰胺酶的菌株在中性粒细胞减少小鼠体内进行PK和PD研究。测定血浆药物浓度和ELF，并基于mici进行PK/PD分析。结果：体外头孢吡肟的MIC随纳库巴坦的增加呈浓度依赖性降低。在肺炎小鼠模型中，头孢吡肟单药治疗导致细菌数量变化0.12 ~ 4.30 log10 CFU/肺，而联合治疗使细菌数量减少-5.93 ~ -0.234 log10 CFU/肺。游离头孢吡肟浓度超过MICi （t> MICi）的时间百分比与细菌减少高度相关。达到最大效果的目标t> MICi估计为29.3%。结论：这些发现支持基于mici的PK/PD分析在优化肺炎联合抗生素治疗中的应用。

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引用次数: 0

Change of pediatric quality of life following inactivated influenza vaccination using EuroQol-5 dimensions-youth 使用EuroQol-5维度-青少年对灭活流感疫苗接种后儿童生活质量的变化

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2026-01-01 Epub Date: 2025-12-10 DOI: 10.1016/j.jiac.2025.102890

Rika Suzuki, Takahiro Mori, Soshi Hachisuka, Tenshin Okubo, Naohiro Yamamoto, Hiroki Nishikawa, Masayuki Onaka, Sayaka Yoshida, Taito Kitano

Background

Measuring vaccination's impact on health-related quality of life (HRQL) is fundamental for cost-effectiveness analyses and health technology assessments, yet pediatric data remain limited. This study measured HRQL impact from reactogenicity symptoms following inactivated influenza vaccination in Japanese children.

Methods

This prospective study used proxy-reported EuroQol-5 dimension youth (EQ-5D-Y) questionnaires to evaluate HRQL daily from pre-vaccination to 7 d post-vaccination per dose in children aged 4–15 years during the 2024–2025 influenza season. Quality-adjusted life day (QALD) loss per dose for the EQ-5D-Y was calculated to quantify the impact of reactogenicity after receiving the inactivated influenza vaccine. The severity of reactogenicity symptoms was classified using the adverse events following immunization (AEFI) grading scale (grades 0–4).

Results

Overall, 218 children received 381 doses of inactivated influenza vaccination. QALD loss (positive score indicates worse post-vaccination states) was −0.032 (first dose) and 0.012 (second dose). The mean QALD loss for first dose recipients was −0.038 (grade 0–1 AEFI) and −0.009 (grade 2–4 AEFI); second dose values were −0.004 (grade 0–1) and 0.085 (grade 2–4).

Conclusion

QALD loss within 1 week post-vaccination (either first or second dose) was negligible, confirming inactivated influenza vaccine safety in this population.

背景：衡量疫苗接种对健康相关生活质量（HRQL）的影响是成本效益分析和卫生技术评估的基础，但儿科数据仍然有限。本研究测量了日本儿童接种灭活流感疫苗后反应性症状对HRQL的影响。方法：本前瞻性研究采用代理报告的EuroQol-5维度青年（EQ-5D-Y）问卷，评估2024-2025年流感季节4-15岁儿童从接种前至接种每剂疫苗后7天的HRQL。计算每剂量EQ-5D-Y的质量调整生命日（QALD）损失，以量化接种灭活疫苗后反应原性的影响。使用免疫不良事件（AEFI）分级量表（0-4级）对反应性症状的严重程度进行分类。结果：总体而言，218名儿童接种了381剂灭活流感疫苗。QALD损失（阳性评分表明接种后状态更差）为-0.032（第一剂）和0.012（第二剂）。首次给药者的平均QALD损失为-0.038（0-1级AEFI）和-0.009(2-4级AEFI)；第二次剂量值分别为-0.004（0-1级）和0.085（2-4级）。结论：接种疫苗（第一剂或第二剂）后1周内QALD损失可以忽略不计，证实灭活流感疫苗在该人群中的安全性。

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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 : 2026-01-01 Epub 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