Journal of Infection and Chemotherapy最新文献_第9页

Analysis of vancomycin administration to patients with one kidney 万古霉素在单肾患者中的应用分析

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2025-10-31 DOI: 10.1016/j.jiac.2025.102848

Hitomi Motomura , Masashi Uchida , Shingo Yamazaki , Itsuko Ishii

Introduction

When one kidney is lost, the other works to compensate. The renally excreted antibiotic vancomycin (VCM) requires therapeutic drug monitoring to avoid renal injury and ensure efficacy. However, no studies have clarified whether the dosing regimen for patients with two kidneys can be used in patients with one kidney. We investigated whether patients with one kidney are able to receive VCM with the same dosing regimen as patients with two kidneys.

Methods

This retrospective case series included patients with one kidney who were treated with VCM at Chiba University Hospital. Changes in serum creatinine (Scr) values and VCM trough concentrations were assessed. To evaluate individual VCM pharmacokinetic (PK) parameters in patients with one kidney, we performed Bayesian estimation using two population PK models for Japanese patients with two kidneys.

Results

Six patients with one kidney were included in this study. The median loading dose and maintenance dose were 20.6 mg/kg and 28.3 mg/kg/day, respectively. Scr showed little change from before to after VCM administration (before, median 0.93 [0.72–1.32] mg/dL; after, 0.85 [0.69–1.22] mg/dL), and no patients developed VCM-associated nephrotoxicity. The trough concentration of VCM remained within the effective blood range of 10–20 μg/mL in almost all patients. There was a significant and strong correlation between the observed and Bayesian-estimated VCM trough concentrations for both population PK models.

Conclusion

Patients with one kidney may be able to receive VCM with the same dosing regimen as patients with two kidneys.

当一个肾脏失去时，另一个会起补偿作用。肾脏排泄抗生素万古霉素（VCM）需要监测治疗药物，以避免肾脏损伤和保证疗效。然而，尚无研究明确双肾患者的给药方案是否可用于单肾患者。我们调查了单肾患者是否能够接受与双肾患者相同给药方案的VCM。方法回顾性分析千叶大学附属医院单侧肾脏VCM患者。评估血清肌酐（Scr）值和VCM谷浓度的变化。为了评估单肾患者的个体VCM药代动力学（PK）参数，我们使用日本双肾患者的两种群体PK模型进行了贝叶斯估计。结果本研究共纳入6例单肾患者。中位负荷剂量和维持剂量分别为20.6 mg/kg和28.3 mg/kg/天。给药前后Scr变化不大（给药前中位数为0.93 [0.72-1.32]mg/dL，给药后中位数为0.85 [0.69-1.22]mg/dL），无患者发生VCM相关肾毒性。几乎所有患者VCM谷浓度均保持在10 ~ 20 μg/mL的有效血药范围内。在两种种群PK模型中，观察到的VCM槽浓度与贝叶斯估计的VCM槽浓度之间存在显著且强的相关性。结论单肾患者可以采用与双肾患者相同的给药方案接受VCM治疗。

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引用次数: 0

EQUAL candida score can predict the prognosis of candidemia at a single center study 在单中心研究中，EQUAL念珠菌评分可以预测念珠菌病的预后

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2025-10-30 DOI: 10.1016/j.jiac.2025.102849

Nobuhiro Asai , Wataru Ohashi , Yuichi Shibata , Daisuke Sakanashi , Hideo Kato , Mao Hagihara , Hiroshige Mikamo

Introduction

Despite the advance in diagnostic testing and antifungal therapy, candidemia remains still a life-threatening infectious disease. While the European Confederation of Medical Mycology proposed the European Confederation of Medical Mycology Quality of Clinical Candidemia Management (EQUAL) Candida score in 2018, its efficacy and validity are still discussing.

Patients and methods

We reviewed all patients with candidemia during 2018–2023 to analyze the efficacy and validity of the EQUAL Candida score for predicting the outcome of candidemia.

Results

A total of 159 patients were enrolled in the study. The EQUAL Candida scores were higher in survival group than death group for 30-day mortality (13.4 vs. 10.6, p < 0.001). As for cases with central venous catheter (CVC), the score was higher in survival group than in death group (14.3 vs. 11.2, p < 0.001). In terms of cases without CVC, survival group showed higher EQUAL Candida scores than death group (11.6 vs. 9.1, p < 0.001). The appropriate cut-off for predicting the 30-day mortality was 10 and was chosen based on the Youden Index.

We found that higher SOFA score (≥5), higher CCI score (≥3), higher EQUAL Candida score (≥10), and catheter related blood stream infection were prognostic factors for 30-day mortality among patients with candidemia. Of these 4, Cox hazard model showed that higher SOFA score (≥5), higher CCI score (≥3) and higher EQUAL Candida score (≥10) were independent prognostic factors for 30-day mortality among them.

Conclusion

The EQUAL Candida score can predict the outcome of candidemia with and without CVC.

尽管在诊断测试和抗真菌治疗方面取得了进展，念珠菌病仍然是一种危及生命的传染病。虽然欧洲医学真菌学联合会于2018年提出了欧洲医学真菌学临床念珠菌管理质量（EQUAL）念珠菌评分，但其有效性和有效性仍在讨论中。患者和方法我们回顾了2018-2023年所有念珠菌感染患者，分析EQUAL念珠菌评分预测念珠菌感染结局的有效性和有效性。结果共纳入159例患者。生存组的30天死亡率的EQUAL念珠菌评分高于死亡组（13.4比10.6,p < 0.001）。中心静脉置管（CVC）患者，生存组评分高于死亡组（14.3比11.2,p < 0.001）。在无CVC的病例中，生存组的EQUAL念珠菌评分高于死亡组（11.6比9.1,p < 0.001）。预测30天死亡率的适当截止值为10，并根据约登指数选择。我们发现较高的SOFA评分（≥5）、较高的CCI评分（≥3）、较高的EQUAL念珠菌评分（≥10）和导管相关血流感染是念珠菌病患者30天死亡率的预后因素。其中，Cox风险模型显示较高的SOFA评分（≥5）、较高的CCI评分（≥3）和较高的EQUAL念珠菌评分（≥10）是其中30天死亡率的独立预后因素。结论EQUAL念珠菌评分可预测伴有和不伴有CVC的念珠菌血症的预后。

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引用次数: 0

Corrigendum to "The origin of sequence type 72 community-associated methicillin-resistant Staphylococcus aureus (MRSA) and fusidic acid (FA) resistant sequence type 5 MRSA: Analysis of FA resistance and spa type in a single center in South Korea" [J Infect Chemother 30 (2024) 2280]. “72型社区相关耐甲氧西林金黄色葡萄球菌（MRSA）和耐夫西地酸（FA）序列5型MRSA的起源：韩国单一中心FA耐药和spa型分析”的更正[Journal of Infection and Chemotherapy 30(2024)/2280]。

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2025-10-30 DOI: 10.1016/j.jiac.2025.102847

Jiwon Jung, Yong Kyun Kim, Euijin Chang, Seongman Bae, Min Jae Kim, Yong Pil Chong, Sung-Han Kim, Sang-Ho Choi, Sang-Oh Lee, Yang Soo Kim

引用次数: 0

Development of two methods for detecting Streptococcus mitis/oralis-related species with meropenem-non-susceptibility 两种美罗培宁不敏感的口腔相关链球菌检测方法的建立。

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2025-10-27 DOI: 10.1016/j.jiac.2025.102846

Kazuto Kuri , Ryo Kinoshita-Daitoku , Yoshichika Arakawa , Keigo Shibayama , Kouji Kimura

Several studies have reported clinical isolates of Streptococcus mitis, Streptococcus oralis, and their related species (S. mitis/oralis group) with reduced carbapenem susceptibility. However, to date, no simple and accurate methods of detecting S. mitis/oralis group isolates with reduced carbapenem susceptibility have been reported. The meropenem ETEST misinterpreted 3 of 25 (12 %) meropenem-non-susceptible S. mitis/oralis group isolates as susceptible to meropenem. Therefore, we screened 38 disks containing 38 different β-lactams to detect S. mitis/oralis group strains with reduced carbapenem susceptibility using the disk-diffusion method. Additionally, using the agar dilution method to determine susceptibility, we identified the optimal antibiotic concentrations in agar medium to enable selective culture of meropenem-non-susceptible S. mitis/oralis group by culturing 25 meropenem-non-susceptible (meropenem minimum inhibitory concentration [MIC] >0.5 μg/mL) and 24 meropenem-susceptible (meropenem MIC ≤0.5 μg/mL) S. mitis/oralis group isolates on agar containing different concentrations of six β-lactams. Meropenem-susceptible and non-susceptible S. mitis/oralis group isolates were successfully differentiated using oxacillin- and cefoxitin-containing disks. Moreover, cefdinir-, flomoxef-, meropenem-, and doripenem-containing disks showed clear differences in the growth inhibitory zone diameter between the meropenem-susceptible and meropenem-non-susceptible S. mitis/oralis group isolates. Media containing 2 μg/mL oxacillin, 4–16 μg/mL cefoxitin, 2 μg/mL cefdinir, 2–4 μg/mL flomoxef, 0.06–0.25 μg/mL meropenem, and 0.06–0.12 μg/mL doripenem allowed selective culture of meropenem-non-susceptible S. mitis/oralis group strains. The disk-diffusion method using six β-lactam-containing disks and selective culture agar medium are the first-reported simple and accurate methods of detecting meropenem-non-susceptible S. mitis/oralis group suitable for use in clinical microbiology laboratories.

一些研究报道了临床分离的miptococcus mitis， oral alis及其相关物种（S. mitis/oral group）对碳青霉烯敏感性降低。然而，到目前为止，还没有简单、准确的方法检测出碳青霉烯类敏感性降低的S. mitis/oral组分离株。美罗培南测试将25株美罗培南不敏感的S. mitis/oral组分离株中的3株（12%）误诊为对美罗培南敏感。因此，我们筛选了38个含有38种不同β-内酰胺的圆盘，采用圆盘扩散法检测碳青霉烯类敏感性降低的S. mitis/oral组菌株。此外，采用琼脂稀释法测定药敏性，在琼脂培养基中培养25株美罗培南不敏感（美罗培南最低抑制浓度[MIC] 0.5 μg/mL）和24株美罗培南敏感（美罗培南MIC≤0.5 μg/mL）的美罗培南不敏感S. mitis/oral组菌株，在含有不同浓度的6种β-内酰胺的琼脂培养基上进行选择性培养，确定最佳抗生素浓度。用含氧苄西林和头孢西林圆盘成功区分美罗培宁敏感和非敏感S. mitis/oral组分离株。此外，含头孢地尼、氟莫昔夫、美罗培南和多利培南的圆盘在美罗培南敏感和美罗培南不敏感的S. mitis/oral组分离株的生长抑制带直径有明显差异。含2 μg/mL奥西林、4-16 μg/mL头孢西丁、2 μg/mL头孢地尼、2-4 μg/mL氟莫西夫、0.06-0.25 μg/mL美罗培南、0.06-0.12 μg/mL多利培南的培养基可选择性培养美罗培南不敏感S. mitis/oral组菌株。6个含β-内酰胺的圆盘扩散法和选择性培养琼脂培养基是首次报道的简便、准确的检测美罗培尼非敏感口腔链球菌群的方法，适用于临床微生物学实验室。

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引用次数: 0

Whole-genome sequencing and in vitro characterization of a disseminated ST398 Staphylococcus aureus infection: A case report 全基因组测序和体外鉴定弥散性ST398金黄色葡萄球菌感染：1例报告。

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2025-10-27 DOI: 10.1016/j.jiac.2025.102845

Yosuke Sazumi , Shinnosuke Fukushima , Hideharu Hagiya , Atsushi Kato , Atsuhito Suyama , Kohei Oguni , Kazuyoshi Gotoh , Shoko Kutsuno , Junzo Hisatsune , Motoyuki Sugai , Shuma Tsuji , Koji Iio , Fumio Otsuka

Staphylococcus aureus potentially causes systemic infections such as disseminated abscesses and bloodstream infections, leading to high mortality rates. We herein describe a case of disseminated muscle abscesses caused by sequence type (ST) 398 methicillin-sensitive S. aureus (MSSA), along with in vitro investigation results for potential pathogenic factors. A 67-year-old healthy woman was admitted to our hospital with complaints of systemic body pain. Blood cultures identified MSSA and contrast-enhanced computed tomography revealed multiple muscle abscesses extending from her neck to her soles. She received antibiotic treatment with intravenous cephazolin and underwent repeated surgical drainage, and was finally discharged. Notably, the MSSA strain exclusively affected her muscle tissues, prompting us to perform genetic analysis to uncover the underlying reason. Short-read genome analysis revealed the isolate to be ST398, harboring chp and scn genes known for immune evasion from human immunity. However, no other known pathogenic factors were identified despite rigorous assays for biofilm formation, surface and cell wall proteins, protease production, and hyaluronidase activity. ST398 S. aureus is commonly isolated from livestock, and her prior experience of being flooded could be related to the disease onset. The present case underscores the possibility of severe ST398 MSSA infections in humans, even in the absence of direct animal exposure.

金黄色葡萄球菌可能引起全身感染，如弥散性脓肿和血流感染，导致高死亡率。我们在此报告一例由序列型（ST） 398甲氧西林敏感金黄色葡萄球菌（MSSA）引起的弥散性肌肉脓肿，并提供潜在致病因素的体外调查结果。一名67岁健康女性因全身疼痛入住我院。血培养鉴定为MSSA，对比增强计算机断层扫描显示多发性肌肉脓肿，从颈部延伸到脚底。患者接受头孢唑啉静脉注射抗生素治疗，反复手术引流，最终出院。值得注意的是，MSSA菌株只影响她的肌肉组织，这促使我们进行基因分析以找出潜在的原因。短读基因组分析显示，该分离物为ST398，含有chp和scn基因，已知可逃避人类免疫。然而，尽管对生物膜形成、表面和细胞壁蛋白、蛋白酶产生和透明质酸酶活性进行了严格的测定，但没有发现其他已知的致病因素。ST398金黄色葡萄球菌通常从牲畜中分离出来，她以前被水淹的经历可能与疾病发病有关。本病例强调了即使在没有动物直接接触的情况下，人类也有可能严重感染ST398 MSSA。

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引用次数: 0

Screening and detection of IgG antibodies against severe fever with thrombocytopenia syndrome virus among blood donors in southwestern part of Japan 日本西南地区献血者发热伴血小板减少综合征病毒IgG抗体的筛查和检测

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2025-10-27 DOI: 10.1016/j.jiac.2025.102844

Hitomi Nakamura , Yasuko Sagara , Midori Yamamoto , Kayoko Fujimura , Koji Matsuzaki

Introduction

Severe fever with thrombocytopenia syndrome (SFTS) is a tick-borne infectious disease caused by SFTS virus (SFTSV). No large-scale evaluation of the seroprevalence of SFTSV infection in the general population of Kyushu-Okinawa, where it is endemic, had ever been conducted. This study aimed to detect the antibody for SFTSV in blood donors and estimate the prevalence of anti-SFTSV IgG antibodies in Kyushu-Okinawa.

Materials and methods

Serum samples derived from 9987 blood donations were collected from December 2020 to January 2023. Anti-SFTSV antibodies was examined using the luciferase immunoprecipitation system (LIPS) with a recombinant nucleocapsid protein (rNP). LIPS-positive samples were further tested using indirect immunofluorescence assay (IFA) with rNP-expressed cells and enzyme-linked immunosorbent assay (ELISA) with SFTSV-infected cell lysate.

Results

Forty-three (0.43 %) cases showed positive results in LIPS, with relative luminescence units ratios of 1.02–1.82. Three of these cases were regarded IFA-positive, although two of above three showed weak fluorescence reactions with 1:40 serum dilution. One of the two samples with weak-positive IFA results were reactive to both of SFTSV infected and -uninfected cell lysate in ELISA. Therefore, 2 of 9987 samples were confirmed to be with anti-SFTSV IgG antibodies.

Conclusions

In our study, anti-SFTSV-IgG antibodies was detected in 0.02 % of Kyushu-Okinawa blood donors. The antibody assay using SFTSV rNP antigen can be adopted in general laboratories, thus facilitating expanded seroprevalence surveillance. Increasing awareness and popularizing testing would help correct diagnosis of SFTSV infection and provide precise epidemiological data.

重症发热伴血小板减少综合征（SFTS）是一种由SFTS病毒（SFTSV）引起的蜱传传染病。在流行SFTSV的九州-冲绳地区，从未对普通人群中SFTSV感染的血清流行率进行过大规模评估。本研究旨在检测献血者中SFTSV抗体，并估计九州-冲绳地区抗SFTSV IgG抗体的流行情况。材料与方法：收集2020年12月至2023年1月9987份献血者血清样本。采用重组核衣壳蛋白（rNP）荧光素酶免疫沉淀系统（LIPS）检测sftsv抗体。lip阳性样品进一步使用rnp表达细胞的间接免疫荧光法（IFA）和sftsv感染细胞裂解液的酶联免疫吸附法（ELISA）进行检测。结果：LIPS阳性43例（0.43%），相对发光单位比为1.02 ~ 1.82。其中3例被认为是ifa阳性，尽管上述3例中有2例在1:40血清稀释时显示弱荧光反应。其中一份IFA弱阳性的样本在ELISA中对SFTSV感染和未感染的细胞裂解液均有反应。因此，9987份样本中有2份被证实含有抗sftsv IgG抗体。结论：在我们的研究中，在0.02%的九州-冲绳献血者中检测到sftsv - igg抗体。SFTSV rNP抗原抗体检测可在一般实验室采用，便于扩大血清阳性率监测。提高认识和普及检测有助于正确诊断SFTSV感染，提供准确的流行病学数据。

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引用次数: 0

A case of infective endocarditis following urinary tract infection by Proteus mirabilis 奇异变形杆菌引起尿路感染并发感染性心内膜炎1例

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2025-10-25 DOI: 10.1016/j.jiac.2025.102839

Kohei Maruyama , Naoya Harada , Hiroki Katsumata , Yumi Hosoi , Minato Kawaguchi , Haruna Nishikori , Shuhei Yasuda , Kiyoshi Sekiya

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.

感染性心内膜炎（IE）最常由革兰氏阳性球菌引起，而革兰氏阴性杆状菌，特别是肠杆菌科引起的感染性心内膜炎并不常见。特别是，全球仅报道了几十例由奇异变形杆菌引起的IE病例。本报告描述了一位93岁的妇女，她发展为肾盂肾炎、肾功能损害和奇异杆菌菌血症。她在意识受损后表现为多发脑梗死。经胸超声心动图显示二尖瓣上可移动的植被，根据修改的Duke标准诊断可能为IE。在血液和尿液培养中检测到奇异单胞杆菌。根据药敏试验结果和临床病程，逐步更换抗生素，包括在静脉治疗困难时改用口服药物。由于患者年事已高，整体状况不佳，未行手术。然而，出现植被扩大和新的脑梗死，表明治疗失败。这个罕见的IE病例发生在尿路感染和奇异单胞杆菌菌血症之后，偶然通过超声心动图诊断。该病例强调了在伴有脑血管事件的奇异杆菌菌血症患者中考虑超声心动图评估的重要性，因为IE可能是潜在的并发症。

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引用次数: 0

Emphysematous Esophagogastritis: a rare and life-threatening presentation of Streptococcus constellatus infection 气肿性食管胃炎：一种罕见且危及生命的星形链球菌感染

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2025-10-25 DOI: 10.1016/j.jiac.2025.102835

Nguyen Sy Thau , Hong Khanh Vu , Thi Hoai Ngo , Thi Thanh Nhan Pham , Thu Trang Do , Trong The Nguyen

Emphysematous esophagogastritis (EEG) is a rare and potentially fatal infection of the upper gastrointestinal tract, marked by gas within the walls of the esophagus and stomach. It is typically associated with gas-forming organisms such as K. pneumoniae, P. aeruginosa, S. aureus, and S. anginosus; however, we report a unique case caused by Streptococcus constellatus, a species known for its aggressive tissue-invasive behavior but rarely implicated in EEG. A previously healthy adult presented with acute epigastric pain, fever, and septic shock. Computed tomography demonstrated diffuse intramural gas and wall thickening of both the esophagus and stomach, consistent with EEG. Blood cultures identified S. constellatus as the causative pathogen. The patient was managed conservatively with intravenous meropenem, proton pump inhibitors, bowel rest, and intensive supportive care. The patient made a complete clinical recovery without requiring surgery in the acute phase. However, a delayed complication, gastric outlet obstruction due to an antral-pyloric stricture, developed during follow-up and necessitated surgical correction. This case underscores the critical importance of early diagnosis, coordinated multidisciplinary care, and prolonged follow-up in managing EEG, and highlights Streptococcus constellatus as a rare but highly invasive pathogen in this life-threatening condition.

肺气肿性食管胃炎（EEG）是一种罕见且可能致命的上消化道感染，以食管和胃壁内气体为特征。它通常与形成气体的生物体有关，如肺炎克雷伯菌、铜绿假单胞菌、金黄色葡萄球菌和血管葡萄球菌；然而，我们报告了一个由星座链球菌引起的独特病例，该物种以其侵袭性组织侵入行为而闻名，但很少涉及脑电图。先前健康的成人表现为急性上腹疼痛、发热和感染性休克。计算机断层扫描显示食管和胃壁弥漫性壁内气体和壁增厚，与脑电图一致。血培养鉴定为病原菌。患者接受静脉注射美罗培南、质子泵抑制剂、肠道休息和强化支持治疗的保守治疗。患者在急性期无需手术即可完全康复。然而，一个延迟的并发症，胃出口梗阻由于幽门狭窄，在随访期间发展和需要手术矫正。该病例强调了早期诊断、协调的多学科护理和长期随访在脑电图管理中的重要性，并强调了星座链球菌作为一种罕见但高度侵袭性的病原体在这种危及生命的疾病中的重要性。

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引用次数: 0

Evaluation of cefazolin <3 g vs. 3 g treatment doses for cellulitis in patients who weigh ≥120 kg within a large, community health system via modified desirability of outcomes ranking (DOOR) methodology 通过改进的结果期望排序（DOOR）方法评估大型社区卫生系统中体重≥120kg的蜂窝织炎患者头孢唑林< 3g与3g治疗剂量的比较

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2025-10-24 DOI: 10.1016/j.jiac.2025.102833

Krista D. Gens , Brandon R. Gagnon , Kimberly C. Claeys , Michael A. Wankum , Elizabeth B. Hirsch

Background

Cefazolin 3 g is recommended for patients ≥120 kg preoperatively; however, there is limited evidence to suggest 3 g for treatment dosing of cefazolin. This study aims to provide data on the efficacy and safety of high-dose cefazolin in obese patients with cellulitis using a modified Desirability of Outcomes Ranking (DOOR) methodology.

Methods

A multi-center, retrospective cohort study including adults weighing ≥120 kg who received ≥48 h of cefazolin for cellulitis in 2021 within a large, community health system was conducted. Patients were placed in a 3:1 ratio in <3 g dosing (standard-dose; SD) and 3 g dosing (high-dose; HD) groups. Exclusion criteria included co-infections, bacteremia, diagnosis of bilateral lower extremity cellulitis, or receipt of >48 h of concomitant antibiotics. The primary endpoint of efficacy and safety as determined by modified DOOR criteria.

Results

A total of 87 patients were included; 70 received SD and 17 received HD cefazolin. There were no differences in age, concomitant antibiotics, or severity of illness. Clinical success was higher in the HD vs SD group resulting in a 63.7% probability of a better outcome for a ≥120 kg patient receiving HD compared to SD (95% CI 50.4%, 75.2%, p = 0.0471).

Conclusion

Cefazolin 3 g was associated with a higher probability of a better outcome in patients ≥120 kg with cellulitis with no difference in adverse effects in this retrospective, cohort study utilizing modified DOOR criteria. Further study is necessary to confirm results.

背景：术前≥120kg的患者推荐头孢唑林3g；然而，有有限的证据表明头孢唑林的治疗剂量为3g。本研究旨在通过改进的预后期望排序（DOOR）方法，提供大剂量头孢唑林治疗肥胖蜂窝织炎患者的疗效和安全性数据。方法：在一个大型社区卫生系统中进行了一项多中心、回顾性队列研究，纳入了2021年体重≥120 kg、接受≥48小时头孢唑林治疗蜂窝织炎的成年人。将患者按3:1的比例分为< 3g给药组（标准剂量，SD）和3g给药组（高剂量，HD）。排除标准包括合并感染，菌血症，诊断为双侧下肢蜂窝织炎，或接受bbbb48小时的联合抗生素治疗。主要疗效和安全性终点由修改后的DOOR标准确定。结果：共纳入87例患者；SD组70例，HD组17例。年龄、伴随抗生素或疾病严重程度没有差异。HD组的临床成功率高于SD组，对于≥120 kg的患者，接受HD治疗获得更好结果的概率为63.7% （95% CI 50.4%, 75.2%, p=0.0471）。结论：在这项采用改进的DOOR标准的回顾性队列研究中，头孢唑林3g与≥120kg蜂窝织炎患者获得更好结果的可能性更高相关，且不良反应没有差异。需要进一步的研究来证实结果。

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引用次数: 0

Strain-specific anti-RBD IgG antibody titers against the WT, XBB.1.5, JN.1, and KP.3 strains consistently correlate with neutralizing activity following SARS-CoV-2 XBB.1.5-adapted mRNA vaccination 针对WT、XBB.1.5、JN.1和KP.3菌株的菌株特异性抗rbd IgG抗体滴度与接种SARS-CoV-2 XBB.1.5适应mRNA后的中和活性一致相关

IF 1.5 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy

Pub Date : 2025-10-24 DOI: 10.1016/j.jiac.2025.102842

Takeyuki Goto , Yong Chong , Tomonori Sato , Naoki Tani , Shouta Saiki , Satoru Ishida , Naoki Kawai , Takuma Bando , Hideyuki Ikematsu

Introduction

Data on the correlation between SARS-CoV-2 neutralizing activity and strain-specific anti-RBD IgG antibody (anti-RBD) titers is limited, particularly in the context of XBB.1.5-adapted vaccination.

Methods

A direct comparison of neutralizing activity, measured as 50 % neutralization (NT₅₀), and anti-RBD titers, measured using an ELISA, was conducted using serum samples collected in Japan before and after XBB.1.5-adapted mRNA vaccination.

Results

A total of 108 serum samples from 54 patients were analyzed. A strong correlation between neutralizing activity and anti-RBD titers was observed for the wild-type (WT), XBB.1.5, JN.1, and KP.3 strains (r = 0.94, 0.87, 0.86, and 0.82, respectively). This correlation persisted when stratifying pre- and post-vaccination samples (r = 0.92, 0.83, 0.85, and 0.82, respectively, for pre-vaccination samples and r = 0.96, 0.85, 0.82, and 0.75, respectively, for post-vaccination samples). Both NT₅₀ and anti-RBD titers significantly increased against all four tested strains after vaccination (p < 0.001), with the highest fold change observed for the XBB.1.5 variant. Additionally, variant specificity, defined as the ratio of variant to WT values, significantly increased for XBB.1.5, JN.1, and KP.3 after vaccination in NT₅₀ and was also observed in anti-RBD titers.

Conclusions

These findings, demonstrating a strong correlation with neutralizing activity not only against the WT strain but also against the XBB.1.5, JN.1, and KP.3 variants, suggest that strain-specific anti-RBD IgG antibody titers would be useful as an indicator of humoral immunity following XBB.1.5-adapted vaccination.

关于SARS-CoV-2中和活性与菌株特异性抗rbd IgG抗体（抗rbd）滴度之间相关性的数据有限，特别是在xbb .1.5适应疫苗接种的背景下。方法对日本采集的xbb .1.5 mRNA疫苗接种前后血清样品进行了50%中和活性（NT50）和ELISA检测的抗rbd滴度的直接比较。结果共分析54例患者108份血清样本。野生型（WT）、XBB.1.5、JN.1和KP.3菌株的中和活性与抗rbd滴度有较强的相关性（r分别为0.94、0.87、0.86和0.82）。在对接种前和接种后样本进行分层时，这种相关性仍然存在（接种前样本的r分别为0.92、0.83、0.85和0.82，接种后样本的r分别为0.96、0.85、0.82和0.75）。接种疫苗后，NT50和抗rbd滴度对所有四种测试菌株均显著增加（p < 0.001），其中XBB.1.5变体的滴度变化最大。此外，在NT50接种后，XBB.1.5、JN.1和KP.3的变异特异性（定义为变异值与WT值的比值）显著增加，抗rbd滴度也有所提高。结论这些发现表明，不仅对WT菌株，而且对XBB.1.5、JN.1和KP.3变体的中和活性都有很强的相关性，这表明菌株特异性抗rbd IgG抗体滴度可以作为XBB.1.5适应疫苗接种后体液免疫的一个有用指标。

{"title":"Strain-specific anti-RBD IgG antibody titers against the WT, XBB.1.5, JN.1, and KP.3 strains consistently correlate with neutralizing activity following SARS-CoV-2 XBB.1.5-adapted mRNA vaccination","authors":"Takeyuki Goto , Yong Chong , Tomonori Sato , Naoki Tani , Shouta Saiki , Satoru Ishida , Naoki Kawai , Takuma Bando , Hideyuki Ikematsu","doi":"10.1016/j.jiac.2025.102842","DOIUrl":"10.1016/j.jiac.2025.102842","url":null,"abstract":"<div><h3>Introduction</h3><div>Data on the correlation between SARS-CoV-2 neutralizing activity and strain-specific anti-RBD IgG antibody (anti-RBD) titers is limited, particularly in the context of XBB.1.5-adapted vaccination.</div></div><div><h3>Methods</h3><div>A direct comparison of neutralizing activity, measured as 50 % neutralization (NT<sub>50</sub>), and anti-RBD titers, measured using an ELISA, was conducted using serum samples collected in Japan before and after XBB.1.5-adapted mRNA vaccination.</div></div><div><h3>Results</h3><div>A total of 108 serum samples from 54 patients were analyzed. A strong correlation between neutralizing activity and anti-RBD titers was observed for the wild-type (WT), XBB.1.5, JN.1, and KP.3 strains (r = 0.94, 0.87, 0.86, and 0.82, respectively). This correlation persisted when stratifying pre- and post-vaccination samples (r = 0.92, 0.83, 0.85, and 0.82, respectively, for pre-vaccination samples and r = 0.96, 0.85, 0.82, and 0.75, respectively, for post-vaccination samples). Both NT<sub>50</sub> and anti-RBD titers significantly increased against all four tested strains after vaccination (<em>p</em> < 0.001), with the highest fold change observed for the XBB.1.5 variant. Additionally, variant specificity, defined as the ratio of variant to WT values, significantly increased for XBB.1.5, JN.1, and KP.3 after vaccination in NT<sub>50</sub> and was also observed in anti-RBD titers.</div></div><div><h3>Conclusions</h3><div>These findings, demonstrating a strong correlation with neutralizing activity not only against the WT strain but also against the XBB.1.5, JN.1, and KP.3 variants, suggest that strain-specific anti-RBD IgG antibody titers would be useful as an indicator of humoral immunity following XBB.1.5-adapted vaccination.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 12","pages":"Article 102842"},"PeriodicalIF":1.5,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145365826","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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