Journal of Infection and Chemotherapy最新文献_第7页

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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引用次数: 0

A case of KSHV/HHV8-positive large B-cell lymphoma in a background of HIV-negative KSHV/HHV8-positive Multicentric Castleman disease hiv阴性KSHV/ hhv8阳性多中心Castleman病背景下KSHV/ hhv8阳性大b细胞淋巴瘤1例

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2025-11-12 DOI: 10.1016/j.jiac.2025.102861

Takafumi Tsushima , Shiho Konno , Akihiro Shoji , Chiharu Kimeda , Kosuke Matsuo , Rena Matsumoto , Sonoko Shimoji , Yoshikazu Utsu , Shin-Ichi Masuda , Kengo Takeuchi , Nobuyuki Aotsuka

Lymphoproliferative disorders associated with human herpes virus 8 (HHV8) include Kaposi's sarcoma-associated herpesvirus (KSHV)/HHV8-positive multicentric Castleman disease (MCD), primary effusion lymphoma (PEL)/extracavitary PEL (EC-PEL), and KSHV/HHV8-positive diffuse large B-cell lymphoma (DLBCL). These lymphoproliferative disorders occur primarily in patients with HIV infection and immunodeficiency. HIV-negative KSHV/HHV8-positive MCD is extremely rare in Japan. We encountered a patient with KSHV/HHV8-positive large B-cell lymphoma with a history of HIV-negative, KSHV/HHV8-positive MCD. Although the KSHV/HHV8-positive MCD was in long-term remission with rituximab treatment, the patient developed refractory KSHV/HHV8-positive large B-cell lymphoma four years after the onset of MCD. The KSHV/HHV8-positive large B-cell lymphoma was refractory to chemotherapy, and the patient died. The course of this case suggests that HIV-negative KSHV/HHV-8-positive MCD may eventually lead to refractory KSHV/HHV8-positive large B-cell lymphoma, even after long-term remission with rituximab therapy.

与人类疱疹病毒8 （HHV8）相关的淋巴增生性疾病包括卡波西肉瘤相关疱疹病毒(KSHV)/HHV8阳性多中心Castleman病（MCD）、原发性积液性淋巴瘤(PEL)/腔外淋巴瘤（EC-PEL）和KSHV/HHV8阳性弥漫性大b细胞淋巴瘤（DLBCL）。这些淋巴细胞增生性疾病主要发生在HIV感染和免疫缺陷患者中。hiv阴性KSHV/ hhv8阳性MCD在日本极为罕见。我们遇到了一例KSHV/ hhv8阳性大b细胞淋巴瘤患者，同时伴有hiv阴性、KSHV/ hhv8阳性MCD病史。尽管KSHV/ hhv8阳性MCD在接受利妥昔单抗治疗后长期缓解，但患者在MCD发病4年后出现难治性KSHV/ hhv8阳性大b细胞淋巴瘤。KSHV/ hhv8阳性大b细胞淋巴瘤对化疗难治，患者死亡。该病例的病程提示hiv阴性KSHV/ hhv -8阳性MCD可能最终导致难治性KSHV/ hhv -8阳性大b细胞淋巴瘤，即使在美罗华治疗长期缓解后也是如此。

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引用次数: 0

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