With a rapid recovery in international travel after the COVID-19 pandemic, improving vaccination uptake among travelers is critical to preventing the cross-border spread of pathogens. We examined the associations between vaccine-related beliefs and vaccination behavior among Japanese travelers staying at a budget guesthouse in New Delhi, India.
Methods
Japanese travelers aged 16–75 years who stayed at a budget guesthouse in Paharganj, New Delhi were targeted (n = 1493). Cross-sectional surveys were conducted from December 14, 2022, to March 28, 2024, and from August 1 to October 7, 2024, using a web-based questionnaire. Vaccination behavior was defined as the primary outcome from whether individuals had gotten any vaccines for their travel. We examined the associations of four vaccine-related belief items (each on a 5-point scale for confidence, barriers, trust, and natural immunity) with vaccination behavior.
Results
In total (n = 853), 447 participants (52.4 %) had not received any vaccines for international travel. After adjusting for all potential confounders, 1-point increases in vaccine confidence and medical trust were positively associated with vaccination behavior, i.e., ORs (95 % CIs) of 1.60 (1.34, 1.92) and 1.52 (1.35, 1.73), respectively. In contrast, a 1-point increase in belief in natural immunity was negatively associated with vaccination behavior.
Conclusions
Addressing vaccine confidence, medical trust, and beliefs in natural immunity would be beneficial to promoting travel vaccinations among Japanese travelers staying at a budget guesthouse in New Delhi, India.
{"title":"Vaccine-related beliefs and preventive behavior among Japanese travelers staying at a budget guesthouse in New Delhi, India: travel vaccinations after the COVID-19 pandemic","authors":"Michiyo Yamakawa , Yuko Tanaka , Akiko Tokinobu , Toshihide Tsuda","doi":"10.1016/j.jiac.2025.102894","DOIUrl":"10.1016/j.jiac.2025.102894","url":null,"abstract":"<div><h3>Background</h3><div>With a rapid recovery in international travel after the COVID-19 pandemic, improving vaccination uptake among travelers is critical to preventing the cross-border spread of pathogens. We examined the associations between vaccine-related beliefs and vaccination behavior among Japanese travelers staying at a budget guesthouse in New Delhi, India.</div></div><div><h3>Methods</h3><div>Japanese travelers aged 16–75 years who stayed at a budget guesthouse in Paharganj, New Delhi were targeted (n = 1493). Cross-sectional surveys were conducted from December 14, 2022, to March 28, 2024, and from August 1 to October 7, 2024, using a web-based questionnaire. Vaccination behavior was defined as the primary outcome from whether individuals had gotten any vaccines for their travel. We examined the associations of four vaccine-related belief items (each on a 5-point scale for confidence, barriers, trust, and natural immunity) with vaccination behavior.</div></div><div><h3>Results</h3><div>In total (n = 853), 447 participants (52.4 %) had not received any vaccines for international travel. After adjusting for all potential confounders, 1-point increases in vaccine confidence and medical trust were positively associated with vaccination behavior, i.e., ORs (95 % CIs) of 1.60 (1.34, 1.92) and 1.52 (1.35, 1.73), respectively. In contrast, a 1-point increase in belief in natural immunity was negatively associated with vaccination behavior.</div></div><div><h3>Conclusions</h3><div>Addressing vaccine confidence, medical trust, and beliefs in natural immunity would be beneficial to promoting travel vaccinations among Japanese travelers staying at a budget guesthouse in New Delhi, India.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 1","pages":"Article 102894"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145756974","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}
Cefiderocol, a novel β-lactam antibiotic, exhibits potent activity against carbapenemase-producing Enterobacterales (CPE). While its clinical efficacy has been reported for infections caused by KPC-type CPE and Stenotrophomonas maltophilia, evidence regarding its effectiveness against IMP-type CPE remains primarily derived from in vitro studies, with limited clinical data available. This is the first pediatric case successfully treated with cefiderocol for IMP-type CPE bacteremia. He was a 6-year-old boy with inherited glycosylphosphatidylinositol deficiency and acute lymphoblastic leukemia undergoing chemotherapy. He developed bacteremia that blood culture multiplex PCR identified Klebsiella pneumoniae with IMP gene. The combination therapy of cefiderocol 60mg/kg/dose every 8 hours and gentamicin 5mg/kg/dose once daily sterilized blood culture, and subsequent monotherapy with cefiderocol was continued for a total of 14 days. Additional molecular test in the strain detected IMP-1 carbapenemase, SHV extended spectrum β-lactamase and EBC-type AmpC β-lactamase. Cefiderocol was susceptible at minimum inhibitory concentration 0.5μg/mL. Further study is needed for cefiderocol treatment for IMP-type CPE infection in children.
{"title":"The first pediatric case successfully treated with cefiderocol for IMP-type carbapenemase-producing Enterobacterales bacteremia","authors":"Haruna Mori , Yuto Otsubo , Meiwa Shibata , Kyogo Suzuki , Yuho Horikoshi","doi":"10.1016/j.jiac.2025.102899","DOIUrl":"10.1016/j.jiac.2025.102899","url":null,"abstract":"<div><div>Cefiderocol, a novel β-lactam antibiotic, exhibits potent activity against carbapenemase-producing Enterobacterales (CPE). While its clinical efficacy has been reported for infections caused by KPC-type CPE and <em>Stenotrophomonas maltophilia</em>, evidence regarding its effectiveness against IMP-type CPE remains primarily derived from in vitro studies, with limited clinical data available. This is the first pediatric case successfully treated with cefiderocol for IMP-type CPE bacteremia. He was a 6-year-old boy with inherited glycosylphosphatidylinositol deficiency and acute lymphoblastic leukemia undergoing chemotherapy. He developed bacteremia that blood culture multiplex PCR identified <em>Klebsiella pneumoniae</em> with IMP gene. The combination therapy of cefiderocol 60mg/kg/dose every 8 hours and gentamicin 5mg/kg/dose once daily sterilized blood culture, and subsequent monotherapy with cefiderocol was continued for a total of 14 days. Additional molecular test in the strain detected IMP-1 carbapenemase, SHV extended spectrum β-lactamase and EBC-type AmpC β-lactamase. Cefiderocol was susceptible at minimum inhibitory concentration 0.5μg/mL. Further study is needed for cefiderocol treatment for IMP-type CPE infection in children.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 1","pages":"Article 102899"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145781415","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}
Peripheral parenteral nutrition (PPN), administered via a peripheral intravenous catheter (PVC), can occasionally lead to bloodstream infections (BSIs). We previously reported that a prolonged daily infusion time of PPN and all intravenous fluids were risk factors for BSI development. In response, our institution implemented a recommendation to limit the average daily infusion time of PPN to <12 h and that of all intravenous fluids to <18 h. The aim of this study was to investigate whether the incidence of BSI in patients receiving PPN decreased following the implementation of these recommendations.
Methods
We retrospectively collected data from 714 patients who underwent PPN therapy via PVC at Fukujuji Hospital from August 2022 to July 2025. We compared the incidence of BSI during PPN therapy between the preintervention and postintervention periods.
Results
Among the 714 patients, 507 were in the preintervention group, and 207 were in the postintervention group. The proportion of patients who developed BSIs was significantly lower in the postintervention group than in the preintervention group (n = 2 [1.0 %] vs. n = 27 [5.3 %], p = 0.006). The crude BSI incidence rate decreased from 3.59 to 0.73 per 1000 infusion days. A multivariable Poisson regression model revealed that the postintervention period was associated with a significantly lower BSI incidence rate (adjusted incidence rate ratio: 0.190; 95 % confidence interval: 0.045–0.804; p = 0.024), corresponding to an approximately 81 % reduction in BSI incidence.
Conclusion
Shortening the average daily infusion time of PPN and all intravenous fluids may help prevent the development of BSIs.
外周静脉营养（PPN）通过外周静脉导管（PVC）给予，偶尔会导致血流感染（bsi）。我们之前报道过PPN每日输注时间延长和所有静脉输液是BSI发展的危险因素。作为回应，我们的机构实施了一项建议，将PPN的平均每日输注时间限制在12小时，所有静脉输液的平均每日输注时间限制在18小时。本研究的目的是调查在实施这些建议后，接受PPN的患者BSI的发生率是否降低。方法回顾性收集2022年8月至2025年7月在福大医院经PVC行PPN治疗的714例患者的资料。我们比较了干预前和干预后PPN治疗期间BSI的发生率。结果714例患者中干预前组507例，干预后组207例。干预后组发生脑梗死的患者比例显著低于干预前组（n = 2 [1.0%] vs. n = 27 [5.3%], p = 0.006）。粗BSI发生率从每1000天3.59下降到0.73。多变量泊松回归模型显示，干预后期间BSI发病率显著降低（调整后的发病率比：0.190；95%可信区间：0.045-0.804;p = 0.024），相当于BSI发病率降低了约81%。结论缩短PPN及所有静脉输液的平均每日输注时间有助于预防脑梗死的发生。
{"title":"Reducing the daily infusion time of peripheral parenteral nutrition to prevent bloodstream infection in hospitalized patients","authors":"Masafumi Shimoda, Yoshiaki Tanaka, Hiroyuki Kokutou, Takashi Yoshiyama, Kozo Morimoto, Kozo Yoshimori, Shoji Kudoh","doi":"10.1016/j.jiac.2025.102884","DOIUrl":"10.1016/j.jiac.2025.102884","url":null,"abstract":"<div><h3>Introduction</h3><div>Peripheral parenteral nutrition (PPN), administered via a peripheral intravenous catheter (PVC), can occasionally lead to bloodstream infections (BSIs). We previously reported that a prolonged daily infusion time of PPN and all intravenous fluids were risk factors for BSI development. In response, our institution implemented a recommendation to limit the average daily infusion time of PPN to <12 h and that of all intravenous fluids to <18 h. The aim of this study was to investigate whether the incidence of BSI in patients receiving PPN decreased following the implementation of these recommendations.</div></div><div><h3>Methods</h3><div>We retrospectively collected data from 714 patients who underwent PPN therapy via PVC at Fukujuji Hospital from August 2022 to July 2025. We compared the incidence of BSI during PPN therapy between the preintervention and postintervention periods.</div></div><div><h3>Results</h3><div>Among the 714 patients, 507 were in the preintervention group, and 207 were in the postintervention group. The proportion of patients who developed BSIs was significantly lower in the postintervention group than in the preintervention group (n = 2 [1.0 %] vs. n = 27 [5.3 %], <em>p</em> = 0.006). The crude BSI incidence rate decreased from 3.59 to 0.73 per 1000 infusion days. A multivariable Poisson regression model revealed that the postintervention period was associated with a significantly lower BSI incidence rate (adjusted incidence rate ratio: 0.190; 95 % confidence interval: 0.045–0.804; <em>p</em> = 0.024), corresponding to an approximately 81 % reduction in BSI incidence.</div></div><div><h3>Conclusion</h3><div>Shortening the average daily infusion time of PPN and all intravenous fluids may help prevent the development of BSIs.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 1","pages":"Article 102884"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145682332","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}
Understanding factors influencing vaccine-induced immunity in adolescents is important for optimizing COVID-19 vaccination strategies. Allergic diseases have been hypothesized to alter immune responses through Th2-dominant inflammation, but data regarding their impact on SARS-CoV-2 mRNA vaccine antibody production remain limited in real-world adolescent populations. The purpose of this study is to identify factors affecting SARS-CoV-2 antibody titers after mRNA vaccination in a general population of 16- to 17-year-olds.
Methods
This study analyzed data from 233 participants in the T-CHILD Study, a Japanese general birth cohort, who received their 17-year medical checkup between July 2021 and October 2023. Individuals with a history of COVID-19 or serological evidence of prior infection (positive for both S- and N-antibodies) were excluded. Associations between SARS-CoV-2 S-antibody titers and vaccination history, allergic diseases, and other variables were examined.
Results
Multivariate analysis revealed that only a higher number of vaccine doses was independently associated with higher SARS-CoV-2 antibody titers. No significant associations were found between antibody titers and vaccine type, the interval since the last vaccination, allergic diseases such as asthma, atopic dermatitis (AD), or food allergy, or with total serum IgE levels.
Conclusions
These findings suggest that adolescents with mild allergic diseases can mount sufficient immune responses to SARS-CoV-2 mRNA vaccines, supporting the safety and efficacy of vaccination in this population. (230 words)
{"title":"Does having allergic diseases affect SARS-CoV-2 antibody responses to mRNA vaccination in adolescents?","authors":"Mayako Saito-Abe , Kiwako Yamamoto-Hanada , Tatsuki Fukuie , Kensuke Shoji , Yukihiro Ohya","doi":"10.1016/j.jiac.2025.102893","DOIUrl":"10.1016/j.jiac.2025.102893","url":null,"abstract":"<div><h3>Background</h3><div>Understanding factors influencing vaccine-induced immunity in adolescents is important for optimizing COVID-19 vaccination strategies. Allergic diseases have been hypothesized to alter immune responses through Th2-dominant inflammation, but data regarding their impact on SARS-CoV-2 mRNA vaccine antibody production remain limited in real-world adolescent populations. The purpose of this study is to identify factors affecting SARS-CoV-2 antibody titers after mRNA vaccination in a general population of 16- to 17-year-olds.</div></div><div><h3>Methods</h3><div>This study analyzed data from 233 participants in the T-CHILD Study, a Japanese general birth cohort, who received their 17-year medical checkup between July 2021 and October 2023. Individuals with a history of COVID-19 or serological evidence of prior infection (positive for both S- and N-antibodies) were excluded. Associations between SARS-CoV-2 S-antibody titers and vaccination history, allergic diseases, and other variables were examined.</div></div><div><h3>Results</h3><div>Multivariate analysis revealed that only a higher number of vaccine doses was independently associated with higher SARS-CoV-2 antibody titers. No significant associations were found between antibody titers and vaccine type, the interval since the last vaccination, allergic diseases such as asthma, atopic dermatitis (AD), or food allergy, or with total serum IgE levels.</div></div><div><h3>Conclusions</h3><div>These findings suggest that adolescents with mild allergic diseases can mount sufficient immune responses to SARS-CoV-2 mRNA vaccines, supporting the safety and efficacy of vaccination in this population. (230 words)</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 1","pages":"Article 102893"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145751757","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}
Pub Date : 2026-01-01Epub Date: 2025-12-04DOI: 10.1016/j.jiac.2025.102885
Yuto Otsubo , Rentaro Oda , Yo Murata , Funato Sato , Shogo Akahoshi , Hiroshi Sakiyama , Yuho Horikoshi
Background
The utility of AWaRe antibiotic classification for evaluating antimicrobial stewardship in clinics during epidemics of specific, infectious diseases remains unknown. This study aimed to examine antibiotic prescribing patterns using the AWaRe classification during a Mycoplasma pneumoniae epidemic in Tokyo.
Methods
Oral antibiotic prescription data from January 2024 to June 2025 were obtained from the prescription surveillance system of 11 clinics in the Tama regional network (Tama cohort), a subset of all registered clinics in Tokyo (Tokyo cohort). For analysis, the pre-epidemic period, epidemic period, and post-epidemic period were defined as January–June 2024, July–December 2024, and January–June 2025, respectively. The primary outcome was the change in Access antibiotic proportions across the three periods. The secondary outcome was the difference in this change between cohorts.
Results
In total, 8,420 and 526,822 antibiotic prescriptions were issued by the Tama cohort and the Tokyo cohort, respectively. In the Tama cohort, Access antibiotic proportions were 64 %, 48 %, and 75 % during the pre-epidemic, epidemic, and post-epidemic periods, respectively; the corresponding values in the Tokyo cohort were 37 %, 32 %, and 40 %. Compared with the Tokyo cohort, estimated changes in Access proportions in the Tama cohort were −11.7 % (95 % CI: −14.2 to −9.2) from pre-epidemic to epidemic period, and +19.0 % (95 % CI: 16.6 to 21.5) from epidemic to post-epidemic period.
Conclusions
Access proportions temporarily decreased during the 2024 M. pneumoniae epidemic, particularly in the Tama cohort, where the baseline Access proportion was high, indicating potential limitation of AWaRe indicators under epidemic conditions.
{"title":"Limitations of the AWaRe antibiotic classification during the 2024 Mycoplasma pneumoniae epidemic in Tokyo","authors":"Yuto Otsubo , Rentaro Oda , Yo Murata , Funato Sato , Shogo Akahoshi , Hiroshi Sakiyama , Yuho Horikoshi","doi":"10.1016/j.jiac.2025.102885","DOIUrl":"10.1016/j.jiac.2025.102885","url":null,"abstract":"<div><h3>Background</h3><div>The utility of AWaRe antibiotic classification for evaluating antimicrobial stewardship in clinics during epidemics of specific, infectious diseases remains unknown. This study aimed to examine antibiotic prescribing patterns using the AWaRe classification during a <em>Mycoplasma pneumoniae</em> epidemic in Tokyo.</div></div><div><h3>Methods</h3><div>Oral antibiotic prescription data from January 2024 to June 2025 were obtained from the prescription surveillance system of 11 clinics in the Tama regional network (Tama cohort), a subset of all registered clinics in Tokyo (Tokyo cohort). For analysis, the pre-epidemic period, epidemic period, and post-epidemic period were defined as January–June 2024, July–December 2024, and January–June 2025, respectively. The primary outcome was the change in Access antibiotic proportions across the three periods. The secondary outcome was the difference in this change between cohorts.</div></div><div><h3>Results</h3><div>In total, 8,420 and 526,822 antibiotic prescriptions were issued by the Tama cohort and the Tokyo cohort, respectively. In the Tama cohort, Access antibiotic proportions were 64 %, 48 %, and 75 % during the pre-epidemic, epidemic, and post-epidemic periods, respectively; the corresponding values in the Tokyo cohort were 37 %, 32 %, and 40 %. Compared with the Tokyo cohort, estimated changes in Access proportions in the Tama cohort were −11.7 % (95 % CI: −14.2 to −9.2) from pre-epidemic to epidemic period, and +19.0 % (95 % CI: 16.6 to 21.5) from epidemic to post-epidemic period.</div></div><div><h3>Conclusions</h3><div>Access proportions temporarily decreased during the 2024 <em>M. pneumoniae</em> epidemic, particularly in the Tama cohort, where the baseline Access proportion was high, indicating potential limitation of AWaRe indicators under epidemic conditions.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 1","pages":"Article 102885"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145682336","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}
Previous reports have suggested an association between cytomegalovirus (CMV) infection and bacterial or fungal infections after allogeneic hematopoietic cell transplantation (HCT). This study aimed to examine the relationship between letermovir (LTV) prophylaxis and the incidence of bacteremia and invasive fungal infections.
Methods
Using a Japanese transplant registry database, we analyzed 19,531 patients who underwent their first allogeneic HCT from 2011 to 2022. Patients who initiated LTV prophylaxis within the first week post-transplantation were classified as the LTV group.
Results
A total of 4915 patients in the LTV group and 14,616 in the No LTV group were analyzed. The incidence of bacteremia by day 100 was significantly lower in the LTV group compared to the No LTV group (17.4 % vs. 21.7 %, P < 0.001). In the multivariate analysis, LTV prophylaxis (HR 0.75, 95 %CI: 0.69–0.81) was found to be significantly associated with a reduced risk of bacteremia, along with neutrophil engraftment. Age >50 years, male, non-remission status, alternative donors, higher values of the hematopoietic cell transplantation-comorbidity index, poor performance status, and grade II–IV acute graft-versus-host disease were associated with an increased risk of bacteremia. LTV was associated with a reduced risk of bacteremia both within 30 days (HR 0.74, 95 %CI: 0.68–0.81) and beyond 30 days (HR 0.76, 95 %CI: 0.66–0.89) after HCT. Conversely, it was not associated with the risk of invasive aspergillosis or candidemia.
Conclusions
LTV prophylaxis significantly reduced the risk of bacteremia. However, it was not associated with the risk of invasive fungal infections.
{"title":"Letermovir prophylaxis and risk of bacterial or fungal infection after allogeneic hematopoietic cell transplantation","authors":"Shun-ichi Kimura , Shunto Kawamura , Takashi Toya , Keiji Okinaka , Hiroki Hosoi , Naoyuki Uchida , Noriko Doki , Tetsuya Nishida , Masatsugu Tanaka , Yuta Hasegawa , Yoshinobu Kanda , Noboru Asada , Naoki Kurita , Hirohisa Nakamae , Tetsuya Eto , Makoto Yoshimitsu , Makoto Onizuka , Takahiro Fukuda , Marie Ohbiki , Yoshiko Atsuta , Kimikazu Yakushijin","doi":"10.1016/j.jiac.2025.102888","DOIUrl":"10.1016/j.jiac.2025.102888","url":null,"abstract":"<div><h3>Background</h3><div>Previous reports have suggested an association between cytomegalovirus (CMV) infection and bacterial or fungal infections after allogeneic hematopoietic cell transplantation (HCT). This study aimed to examine the relationship between letermovir (LTV) prophylaxis and the incidence of bacteremia and invasive fungal infections.</div></div><div><h3>Methods</h3><div>Using a Japanese transplant registry database, we analyzed 19,531 patients who underwent their first allogeneic HCT from 2011 to 2022. Patients who initiated LTV prophylaxis within the first week post-transplantation were classified as the LTV group.</div></div><div><h3>Results</h3><div>A total of 4915 patients in the LTV group and 14,616 in the No LTV group were analyzed. The incidence of bacteremia by day 100 was significantly lower in the LTV group compared to the No LTV group (17.4 % vs. 21.7 %, <em>P</em> < 0.001). In the multivariate analysis, LTV prophylaxis (HR 0.75, 95 %CI: 0.69–0.81) was found to be significantly associated with a reduced risk of bacteremia, along with neutrophil engraftment. Age >50 years, male, non-remission status, alternative donors, higher values of the hematopoietic cell transplantation-comorbidity index, poor performance status, and grade II–IV acute graft-versus-host disease were associated with an increased risk of bacteremia. LTV was associated with a reduced risk of bacteremia both within 30 days (HR 0.74, 95 %CI: 0.68–0.81) and beyond 30 days (HR 0.76, 95 %CI: 0.66–0.89) after HCT. Conversely, it was not associated with the risk of invasive aspergillosis or candidemia.</div></div><div><h3>Conclusions</h3><div>LTV prophylaxis significantly reduced the risk of bacteremia. However, it was not associated with the risk of invasive fungal infections.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 1","pages":"Article 102888"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145723056","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}
Listeria monocytogenes infection, known as listeriosis, is relatively uncommon. However, in elderly or immunocompromised patients, it can lead to severe manifestations such as meningitis and bacteremia, making it a clinically important disease. The primary route of transmission is through ingestion of contaminated food, and since a wide range of food items may be involved, close collaboration with public health authorities is essential for effective source identification.
Case report
We encountered 11 cases of Listeria monocytogenes bacteremia within a limited region over the course of one month. Whole-genome sequencing revealed that the isolates were highly genetically related. Notably, the patients resided in different municipalities, suggesting exposure to a widely distributed food source. However, under the current Japanese legal framework, bacteremia is not a notifiable condition, which hindered timely identification of the infection source.
Conclusion
This case series underscores challenges in both clinical practice and the public health system in Japan, highlighting how such rare, genetically related clusters of bacteremia, occurring within a short period and across multiple municipalities, can easily be overlooked under the current surveillance framework.
{"title":"A cluster of 11 cases of Listeria monocytogenes bacteremia in Kyoto, Japan","authors":"Hajime Tsuboi , Shin Matsubara , Yoshiyuki Kawahara , Kenji Konaka , Kaori Tamai , Daisuke Yokoi , Yoshihiro Tanabe , Naohisa Fujita , Satoru Shikata","doi":"10.1016/j.jiac.2025.102887","DOIUrl":"10.1016/j.jiac.2025.102887","url":null,"abstract":"<div><h3>Background</h3><div><em>Listeria monocytogenes</em> infection, known as listeriosis, is relatively uncommon. However, in elderly or immunocompromised patients, it can lead to severe manifestations such as meningitis and bacteremia, making it a clinically important disease. The primary route of transmission is through ingestion of contaminated food, and since a wide range of food items may be involved, close collaboration with public health authorities is essential for effective source identification.</div></div><div><h3>Case report</h3><div>We encountered 11 cases of <em>Listeria monocytogenes</em> bacteremia within a limited region over the course of one month. Whole-genome sequencing revealed that the isolates were highly genetically related. Notably, the patients resided in different municipalities, suggesting exposure to a widely distributed food source. However, under the current Japanese legal framework, bacteremia is not a notifiable condition, which hindered timely identification of the infection source.</div></div><div><h3>Conclusion</h3><div>This case series underscores challenges in both clinical practice and the public health system in Japan, highlighting how such rare, genetically related clusters of bacteremia, occurring within a short period and across multiple municipalities, can easily be overlooked under the current surveillance framework.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"32 1","pages":"Article 102887"},"PeriodicalIF":1.5,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145682333","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}
Infective endocarditis (IE) is most commonly caused by gram-positive cocci, whereas that caused by gram-negative rods, particularly Enterobacteriaceae, is uncommon. In particular, only a few dozen cases of IE caused by Proteus mirabilis have been reported globally. This report describes a 93-year-old woman who developed calculous pyelonephritis, renal impairment, and P. mirabilis bacteremia. She presented with multiple cerebral infarcts on cranial imaging after her consciousness was impaired. Transthoracic echocardiography revealed mobile vegetation on the mitral valve, leading to a diagnosis of possible IE according to the modified Duke criteria. P. mirabilis was detected in blood and urine cultures. Based on the antimicrobial susceptibility testing and the clinical course, the antibiotics were changed stepwise, including switching to oral agents when intravenous therapy became difficult. Owing to the patient's advanced age and overall condition, surgery was not performed. However, vegetation enlargement and a new cerebral infarction occurred, indicating treatment failure. This rare case of IE developed following a urinary tract infection and P. mirabilis bacteremia and was incidentally diagnosed by echocardiography. The case underscores the importance of considering echocardiographic evaluation in patients with P. mirabilis bacteremia accompanied by cerebrovascular events, as IE might be an underlying complication.
{"title":"A case of infective endocarditis following urinary tract infection by Proteus mirabilis","authors":"Kohei Maruyama , Naoya Harada , Hiroki Katsumata , Yumi Hosoi , Minato Kawaguchi , Haruna Nishikori , Shuhei Yasuda , Kiyoshi Sekiya","doi":"10.1016/j.jiac.2025.102839","DOIUrl":"10.1016/j.jiac.2025.102839","url":null,"abstract":"<div><div>Infective endocarditis (IE) is most commonly caused by gram-positive cocci, whereas that caused by gram-negative rods, particularly Enterobacteriaceae, is uncommon. In particular, only a few dozen cases of IE caused by <em>Proteus mirabilis</em> have been reported globally. This report describes a 93-year-old woman who developed calculous pyelonephritis, renal impairment, and <em>P. mirabilis</em> bacteremia. She presented with multiple cerebral infarcts on cranial imaging after her consciousness was impaired. Transthoracic echocardiography revealed mobile vegetation on the mitral valve, leading to a diagnosis of possible IE according to the modified Duke criteria. <em>P. mirabilis</em> was detected in blood and urine cultures. Based on the antimicrobial susceptibility testing and the clinical course, the antibiotics were changed stepwise, including switching to oral agents when intravenous therapy became difficult. Owing to the patient's advanced age and overall condition, surgery was not performed. However, vegetation enlargement and a new cerebral infarction occurred, indicating treatment failure. This rare case of IE developed following a urinary tract infection and <em>P. mirabilis</em> bacteremia and was incidentally diagnosed by echocardiography. The case underscores the importance of considering echocardiographic evaluation in patients with <em>P. mirabilis</em> bacteremia accompanied by cerebrovascular events, as IE might be an underlying complication.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 12","pages":"Article 102839"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145419801","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}
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.
{"title":"A case of pneumonia caused by Corynebacterium durum mimicking Nocardia pneumonia in a patient with dermatomyositis","authors":"Natsuko Hara , Tomoaki Higuchi , Mayuko Fujisaki , Ryo Motoyama , Risa Yamada , Rei Yamaguchi , Akiko Tochimoto , Eiichi Tanaka , Ken Kikuchi , Aoi Ito , Masayoshi Harigai","doi":"10.1016/j.jiac.2025.102869","DOIUrl":"10.1016/j.jiac.2025.102869","url":null,"abstract":"<div><div><em>Nocardia</em> 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 <em>Nocardia</em> as other bacterial pathogens because of its morphological similarity. We report a case of pneumonia caused by <em>Corynebacterium durum</em> primarily misidentified as <em>Nocardia</em> 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. <em>Nocardia</em> 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 <em>C</em>. <em>durum</em>. Sulfamethoxazole/trimethoprim was continued, leading to improvement of the symptoms and the pulmonary lesions on computed tomography. The findings from this case indicate that <em>C</em>. <em>durum</em> can be misidentified as <em>Nocardia</em> by conventional identification methods and highlight the importance of incorporating more precise identification approaches.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 12","pages":"Article 102869"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145557066","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}
Chronic pulmonary aspergillosis (CPA) comprises a spectrum of conditions that frequently affect individuals with chronic lung diseases, particularly post-tuberculosis lung disease (PTLD). Both disorders contribute to significant morbidity and impaired quality of life (QoL). In addition, they impose financial burden, much of which is borne directly by patients in low- and middle-income countries. However, data on out-of-pocket expenditure (OOPE) and its relationship with QoL in these groups remain limited.
Methods
This cross-sectional study, conducted at a tertiary referral centre in India, aimed to estimate OOPE (direct and indirect costs) in patients with CPA and PTLD, identify determinants of expenditure, and assess associations with QoL. Data on OOPE, borrowing, and catastrophic health expenditure during the preceding year were collected through structured interviews. QoL was evaluated using the St. George's Respiratory Questionnaire (SGRQ). Results: Both the direct ($406.42 ± 543.95 vs $251.81 ± 245.42, p value: 0.0038) and indirect costs ($49.93 ± 72.07 vs $39.81 ± 123.32, p value: 0.001) were significantly higher in the CPA group compared with the PTLD group. Subgroup analyses revealed higher diagnostic, transport, and food-related expenses in CPA individuals. Catastrophic expenditure was comparable in both groups (CPA: 60.5 %; PTLD: 67.9 %; p:0.325). Hemoptysis independently predicted poorer QoL across groups. QoL was significantly worse in CPA than PTLD (SGRQ total: 37.32 vs 31.16, p: 0.0125) and significant correlation between OOPE and QoL.
Conclusion
CPA imposes a greater financial burden and is associated with a poorer QoL compared with PTLD, underscoring the need for financial protection measures to improve outcomes in these patients.
背景：慢性肺曲霉病（CPA）包括一系列经常影响慢性肺病患者的疾病，特别是结核后肺病（PTLD）。这两种疾病都会导致显著的发病率和生活质量（QoL）受损。此外，它们造成经济负担，其中大部分由低收入和中等收入国家的患者直接承担。然而，关于自费支出（OOPE）及其与这些群体生活质量关系的数据仍然有限。方法：这项横断面研究在印度的一家三级转诊中心进行，旨在估计CPA和PTLD患者的OOPE（直接和间接成本），确定支出的决定因素，并评估与生活质量的关系。通过结构化访谈收集了前一年的对外开放、借款和灾难性卫生支出数据。使用圣乔治呼吸问卷（SGRQ）评估生活质量。结果：CPA组的直接成本（$406.42 + 543.95 vs $251.81 + 245.42， p值：0.0038）和间接成本（$49.93 + 72.07 vs $39.81+ 123.32， p值：0.001）均显著高于PTLD组。亚组分析显示，CPA个体的诊断、运输和食品相关费用较高。两组的灾难性支出具有可比性（CPA: 60.5%; PTLD: 67.9%; p:0.325）。咯血独立预测各组较差的生活质量。CPA患者的生活质量明显差于PTLD患者（SGRQ总分：37.32 vs 31.16, p: 0.0125）， OOPE与生活质量之间存在显著相关性。结论：与PTLD相比，CPA患者的经济负担和生活质量负担更大，需要采取经济保护措施来改善这些患者的预后。
{"title":"A comparative study of out-of-pocket expenditure and quality of life in chronic pulmonary aspergillosis and post-tuberculosis lung disease patients","authors":"Renuka Titiyal , Sanjukta Sarkar , Megha Priyadarshi , Ved Prakash Meena , Prayas Sethi , G. Rahul Krishnan , Bindu Prakash , Gagandeep Singh , Immaculata Xess , Surabhi Vyas , Neeraj Nischal , Manish Soneja , Sanjeev Sinha , Naveet Wig , Animesh Ray","doi":"10.1016/j.jiac.2025.102873","DOIUrl":"10.1016/j.jiac.2025.102873","url":null,"abstract":"<div><h3>Background</h3><div>Chronic pulmonary aspergillosis (CPA) comprises a spectrum of conditions that frequently affect individuals with chronic lung diseases, particularly post-tuberculosis lung disease (PTLD). Both disorders contribute to significant morbidity and impaired quality of life (QoL). In addition, they impose financial burden, much of which is borne directly by patients in low- and middle-income countries. However, data on out-of-pocket expenditure (OOPE) and its relationship with QoL in these groups remain limited.</div></div><div><h3>Methods</h3><div>This cross-sectional study, conducted at a tertiary referral centre in India, aimed to estimate OOPE (direct and indirect costs) in patients with CPA and PTLD, identify determinants of expenditure, and assess associations with QoL. Data on OOPE, borrowing, and catastrophic health expenditure during the preceding year were collected through structured interviews. QoL was evaluated using the St. George's Respiratory Questionnaire (SGRQ). <u>Results</u>: Both the direct ($406.42 ± 543.95 vs $251.81 ± 245.42, p value: 0.0038) and indirect costs ($49.93 ± 72.07 vs $39.81 ± 123.32, p value: 0.001) were significantly higher in the CPA group compared with the PTLD group. Subgroup analyses revealed higher diagnostic, transport, and food-related expenses in CPA individuals. Catastrophic expenditure was comparable in both groups (CPA: 60.5 %; PTLD: 67.9 %; p:0.325). Hemoptysis independently predicted poorer QoL across groups. QoL was significantly worse in CPA than PTLD (SGRQ total: 37.32 vs 31.16, p: 0.0125) and significant correlation between OOPE and QoL.</div></div><div><h3>Conclusion</h3><div>CPA imposes a greater financial burden and is associated with a poorer QoL compared with PTLD, underscoring the need for financial protection measures to improve outcomes in these patients.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 12","pages":"Article 102873"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145581936","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}
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