Pub Date : 2026-01-12DOI: 10.1016/j.jinf.2026.106689
Andreas Widmer , Nadine Imhasly , Christian Brand , Vilijam Zdravkovi , Adrian Spoerri , Kurt Schmidlin , Melanie Wicki , Martin Beck , Rami Sommerstein , for SIRIS and SWISSNOSO
Objective
Evaluate long-term mortality and the role of causative pathogens in periprosthetic joint infection (PJI) following total hip arthroplasty (THA).
Methods
Retrospective nationwide cohort study of adults undergoing THA (2012–2022) using data from the Swiss Joint Registry, Center for Infection Prevention and civil registry. Primary outcome was up to 10-year survival with or without PJI. Adjusted hazard ratios (aHR) were estimated via Gompertz regression, controlling for sex, age, BMI, and ASA. Pathogen-specific mortality hazard was analyzed.
Results
Of 215,678 patients, 89,709 met inclusion criteria (51.3% women; median age 69 years). PJI occurred in 745 (0.8%) patients, 2 752 (3.1%) underwent aseptic revision. PJI was associated with increased mortality (aHR 2.15; 95% CI, 1.79–2.57; p<0.001) compared to no PJI/revision, aseptic revisions were not (aHR 0.92; 95% CI, 0.80–1.06; p=0.27). Pathogens associated with increased mortality included Enterobacterales (aHR 3.17; 95% CI, 2.09–4.83, p<0.001), Staphylococcus aureus (aHR 2.32; 95% CI, 1.65–3.27; p<0.001), Cutibacterium acnes (aHR 2.31; 95% CI, 1.20–4.45; p=0.01), and coagulase-negative staphylococci (aHR 1.65; 95% CI, 1.16–2.35; p=0.006). Streptococcal infections showed no significant association (aHR 1.24; 95% CI, 0.62–2.49; p=0.54).
Conclusion
PJI following THA was associated with an approximately twofold increase in long-term mortality hazard. C. acnes presented an unexpectedly high mortality hazard.
{"title":"Increased long-term mortality of patients with prosthetic joint infection after primary total hip arthroplasty – A large observational cohort study","authors":"Andreas Widmer , Nadine Imhasly , Christian Brand , Vilijam Zdravkovi , Adrian Spoerri , Kurt Schmidlin , Melanie Wicki , Martin Beck , Rami Sommerstein , for SIRIS and SWISSNOSO","doi":"10.1016/j.jinf.2026.106689","DOIUrl":"10.1016/j.jinf.2026.106689","url":null,"abstract":"<div><h3>Objective</h3><div>Evaluate long-term mortality and the role of causative pathogens in periprosthetic joint infection (PJI) following total hip arthroplasty (THA).</div></div><div><h3>Methods</h3><div>Retrospective nationwide cohort study of adults undergoing THA (2012–2022) using data from the Swiss Joint Registry, Center for Infection Prevention and civil registry. Primary outcome was up to 10-year survival with or without PJI. Adjusted hazard ratios (aHR) were estimated via Gompertz regression, controlling for sex, age, BMI, and ASA. Pathogen-specific mortality hazard was analyzed.</div></div><div><h3>Results</h3><div>Of 215,678 patients, 89,709 met inclusion criteria (51.3% women; median age 69 years). PJI occurred in 745 (0.8%) patients, 2 752 (3.1%) underwent aseptic revision. PJI was associated with increased mortality (aHR 2.15; 95% CI, 1.79–2.57; p<0.001) compared to no PJI/revision, aseptic revisions were not (aHR 0.92; 95% CI, 0.80–1.06; p=0.27). Pathogens associated with increased mortality included Enterobacterales (aHR 3.17; 95% CI, 2.09–4.83, p<0.001), <em>Staphylococcus aureus</em> (aHR 2.32; 95% CI, 1.65–3.27; p<0.001), <em>Cutibacterium acnes</em> (aHR 2.31; 95% CI, 1.20–4.45; p=0.01), and coagulase-negative staphylococci (aHR 1.65; 95% CI, 1.16–2.35; p=0.006). Streptococcal infections showed no significant association (aHR 1.24; 95% CI, 0.62–2.49; p=0.54).</div></div><div><h3>Conclusion</h3><div>PJI following THA was associated with an approximately twofold increase in long-term mortality hazard. <em>C. acnes</em> presented an unexpectedly high mortality hazard.</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"92 2","pages":"Article 106689"},"PeriodicalIF":11.9,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-12DOI: 10.1016/j.jinf.2026.106683
Estela Giménez , María Ángeles Clari , Eliseo Albert , Nieves Carbonell , David Navarro
This study aimed to assess the association between bacterial loads as quantified by the BIOFIRE® Filmarray Pneumonia Plus Panel (FA-PP) and clinically significant bacterial cultures in different clinical settings, taking into account the type of sample processed and the bacterial targets detected. A comprehensive search was conducted of the PubMed, EMBASE, and Web of Science databases up to November 2024. Pooled odds ratios (ORs) for binned values in genome copies/ml (gc/ml)(104, 105, 106, and ≥107) and their respective 95% confidence intervals (95% CI) are reported throughout the study. Heterogeneity across studies was assessed using the I2 statistic. Twenty-three observational studies comprising a total of 4581 patients and 5147 respiratory samples were finally included in the meta-analysis. Overall, pooled ORs for clinically significant culture results were 4.30 (95% CI, 2.53–7.31; P < 0.001) for ≥107 gc/ml, 1.33 (95% CI, 0.70–2.56; P=0.39) for 106, 0.42 (95% CI, 0.20–0.90; P=0.03) for 105, and 0.15 (95% CI, 0.07–0.37; P < 0.001) for 104 gc/ml. Subgroup analyses conducted according to the type of respiratory sample, bacterial target, and hospital admission ward yielded rather similar conclusions. The heterogeneity across studies was very high (I2 >80%). Our analyses suggested that values ≥107 gc/ml may be considered reliable indicators of clinically significant bacterial infection. Conversely, 104 gc/ml values likely reflect colonization. Intermediate values (105–106 gc/ml) pose a greater interpretative challenge.
Importance
The FA-PP assay has emerged as an ancillary tool for diagnosing lower respiratory tract infections and adjusting empirical antimicrobial therapies; consequently, it is being increasingly requested by clinicians. The current study fills a critical gap in the interpretation of quantitative data returned by the FA-PP for nosocomial bacterial targets. Assessment of the clinical relevance of FA-PP binned gc/ml values seems mandatory for clinical and therapeutic decision-making processes in patients with severe community-acquired or nosocomial pneumonia. Our analyses showed that values ≥107 gc/ml are consistently associated with a high probability of culture positivity, regardless of the respiratory sample type and the bacterial target considered. In contrast, values of 104 gc/ml likely reflect colonization. Our study emphasizes the need for well-designed and homogeneous studies to gauge the clinical relevance of intermediate FA-PP binned values (105 and 106 gc/ml).
{"title":"Performance of the BIOFIRE® Filmarray Pneumonia Plus Panel for quantifiable bacterial targets compared to semiquantitative culture methods: A systematic review and meta-analysis","authors":"Estela Giménez , María Ángeles Clari , Eliseo Albert , Nieves Carbonell , David Navarro","doi":"10.1016/j.jinf.2026.106683","DOIUrl":"10.1016/j.jinf.2026.106683","url":null,"abstract":"<div><div>This study aimed to assess the association between bacterial loads as quantified by the BIOFIRE® Filmarray Pneumonia Plus Panel (FA-PP) and clinically significant bacterial cultures in different clinical settings, taking into account the type of sample processed and the bacterial targets detected. A comprehensive search was conducted of the PubMed, EMBASE, and Web of Science databases up to November 2024. Pooled odds ratios (ORs) for binned values in genome copies/ml (gc/ml)(10<sup>4</sup>, 10<sup>5</sup>, 10<sup>6</sup>, and ≥10<sup>7</sup>) and their respective 95% confidence intervals (95% CI) are reported throughout the study. Heterogeneity across studies was assessed using the I<sup>2</sup> statistic. Twenty-three observational studies comprising a total of 4581 patients and 5147 respiratory samples were finally included in the meta-analysis. Overall, pooled ORs for clinically significant culture results were 4.30 (95% CI, 2.53–7.31; <em>P</em> < 0.001) for ≥10<sup>7</sup> gc/ml, 1.33 (95% CI, 0.70–2.56; <em>P</em>=0.39) for 10<sup>6</sup>, 0.42 (95% CI, 0.20–0.90; <em>P</em>=0.03) for 10<sup>5</sup>, and 0.1<sup>5</sup> (95% CI, 0.07–0.37; <em>P</em> < 0.001) for 10<sup>4</sup> gc/ml. Subgroup analyses conducted according to the type of respiratory sample, bacterial target, and hospital admission ward yielded rather similar conclusions. The heterogeneity across studies was very high (I<sup>2</sup> >80%). Our analyses suggested that values ≥10<sup>7</sup> gc/ml may be considered reliable indicators of clinically significant bacterial infection. Conversely, 10<sup>4</sup> gc/ml values likely reflect colonization. Intermediate values (10<sup>5</sup>–10<sup>6</sup> gc/ml) pose a greater interpretative challenge.</div></div><div><h3>Importance</h3><div>The FA-PP assay has emerged as an ancillary tool for diagnosing lower respiratory tract infections and adjusting empirical antimicrobial therapies; consequently, it is being increasingly requested by clinicians. The current study fills a critical gap in the interpretation of quantitative data returned by the FA-PP for nosocomial bacterial targets. Assessment of the clinical relevance of FA-PP binned gc/ml values seems mandatory for clinical and therapeutic decision-making processes in patients with severe community-acquired or nosocomial pneumonia. Our analyses showed that values ≥10<sup>7</sup> gc/ml are consistently associated with a high probability of culture positivity, regardless of the respiratory sample type and the bacterial target considered. In contrast, values of 10<sup>4</sup> gc/ml likely reflect colonization. Our study emphasizes the need for well-designed and homogeneous studies to gauge the clinical relevance of intermediate FA-PP binned values (10<sup>5</sup> and 10<sup>6</sup> gc/ml).</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"92 2","pages":"Article 106683"},"PeriodicalIF":11.9,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-10DOI: 10.1016/j.jinf.2025.106675
Umaporn Limothai , Nattachai Srisawat , David A. Haake
Leptospirosis is a globally prevalent zoonotic infection causing more than one million cases and nearly 60,000 deaths annually yet is often diagnosed late after organ dysfunction and other complications have arisen. Delayed diagnosis leads to late initiation of antibiotics and other therapeutic interventions, at which point complications such as renal failure, jaundice, or pulmonary hemorrhage are more common and therapy is less effective. This review highlights the critical importance of early recognition and intervention, emphasizing the therapeutic window during the leptospiremic phase when antibiotics are most effective. We examine the limitations of current clinical and laboratory diagnostic methods, the evolving role of molecular and biomarker-based platforms, and the potential of integrated scoring systems for frontline triage. Evidence supporting early antibiotic therapy, supportive care strategies, and severity prediction tools is summarized. We propose a paradigm shift toward field-adaptable, point-of-care diagnostics and integrated care pathways to ensure earlier treatment, improved outcomes, and reduced global disease burden.
{"title":"Early diagnosis and treatment of leptospirosis: Optimizing clinical outcomes","authors":"Umaporn Limothai , Nattachai Srisawat , David A. Haake","doi":"10.1016/j.jinf.2025.106675","DOIUrl":"10.1016/j.jinf.2025.106675","url":null,"abstract":"<div><div>Leptospirosis is a globally prevalent zoonotic infection causing more than one million cases and nearly 60,000 deaths annually yet is often diagnosed late after organ dysfunction and other complications have arisen. Delayed diagnosis leads to late initiation of antibiotics and other therapeutic interventions, at which point complications such as renal failure, jaundice, or pulmonary hemorrhage are more common and therapy is less effective. This review highlights the critical importance of early recognition and intervention, emphasizing the therapeutic window during the leptospiremic phase when antibiotics are most effective. We examine the limitations of current clinical and laboratory diagnostic methods, the evolving role of molecular and biomarker-based platforms, and the potential of integrated scoring systems for frontline triage. Evidence supporting early antibiotic therapy, supportive care strategies, and severity prediction tools is summarized. We propose a paradigm shift toward field-adaptable, point-of-care diagnostics and integrated care pathways to ensure earlier treatment, improved outcomes, and reduced global disease burden.</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"92 2","pages":"Article 106675"},"PeriodicalIF":11.9,"publicationDate":"2026-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-09DOI: 10.1016/j.jinf.2026.106680
Matteo RICCO', Claudio COSTANTINO, Paolo MANZONI, Antonio BALDASSARRE, Gianluca Pasquale GIURI, Antonio CASCIO
{"title":"Respiratory syncytial virus and healthcare workers, an unmet need? Insights from SIREN study and systematic review of available evidence","authors":"Matteo RICCO', Claudio COSTANTINO, Paolo MANZONI, Antonio BALDASSARRE, Gianluca Pasquale GIURI, Antonio CASCIO","doi":"10.1016/j.jinf.2026.106680","DOIUrl":"10.1016/j.jinf.2026.106680","url":null,"abstract":"","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"92 2","pages":"Article 106680"},"PeriodicalIF":11.9,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-09DOI: 10.1016/j.jinf.2026.106690
Xichi Tang , Ang Li , Leiliang Zhang
{"title":"EV-A71 virions are identified in retractosomes, indicating a nonlytic egress for enteroviruses","authors":"Xichi Tang , Ang Li , Leiliang Zhang","doi":"10.1016/j.jinf.2026.106690","DOIUrl":"10.1016/j.jinf.2026.106690","url":null,"abstract":"","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"92 2","pages":"Article 106690"},"PeriodicalIF":11.9,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-09DOI: 10.1016/j.jinf.2026.106688
Manon Jaboyedoff , Pierre Alex Crisinel , Zaba Valtuille , Inès Fafi , Margherita Plebani , Yves Fougère , Karim Abawi , Romain Basmaci , Naïm Ouldali , François Angoulvant
Background
Infections remain a leading cause of childhood mortality. Non-pharmaceutical interventions (NPI) implemented during COVID-19 pandemic altered the circulation of communicable pathogens. We aimed to assess how these changes affected paediatric infection-related mortality.
Methods
We conducted a population-based interrupted time-series analysis using national data from France and Switzerland (2015 to 2023), including deaths among individuals <18 years. Monthly infection-related mortality was analysed using quasi-Poisson regression models seasonally adjusted. Mortality rate ratios (MRR) were calculated to compare infection-related mortality among birth cohorts exposed to NPI or post-NPI periods versus pre-NPI cohorts.
Results
Among 32,619 paediatric deaths during the study period, 8272 were related to an infection. During the NPI period, infection-related mortality declined by 16% (95% CI: −23% to −7%), corresponding to an estimated reduction of 221 (95% CI: 90 to 371) deaths. Compared to pre-NPI birth cohorts, 2019 and 2020 cohorts had significantly lower infection-related MRR (0·80, 95% CI 0·66 to 0·98 and 0·80, 95% CI 0·65 to 0·98).
Conclusion
The reduction in paediatric infection-related deaths during the NPI period underscores the ongoing burden of preventable paediatric mortality and suggests that targeted preventive strategies may sustainably reduce infection-related deaths beyond pandemic settings.
背景：感染仍然是儿童死亡的主要原因。在COVID-19大流行期间实施的非药物干预措施改变了传染性病原体的传播。我们的目的是评估这些变化如何影响儿科感染相关死亡率。方法：我们使用法国和瑞士的国家数据（2015年至2023年）进行了基于人群的中断时间序列分析，包括18岁以下个体的死亡。使用准泊松回归模型进行季节性调整，分析每月感染相关死亡率。计算死亡率比率（MRR）以比较暴露于新生儿感染新感染或新生儿感染后与新生儿感染前的出生队列的感染相关死亡率。结果：在研究期间的32,619例儿童死亡中，8272例与感染有关。在新方案实施期间，感染相关死亡率下降了16%(95%置信区间：-23%至-7%)，相当于估计减少221例死亡（95%置信区间：90至371）。与npi前出生队列相比，2019年和2020年队列的感染相关MRR显著降低（0.80,95% CI 0.66至0.98和0.80,95% CI 0.65至0.98）。结论：在新方案实施期间，儿童感染相关死亡的减少强调了可预防的儿童死亡率的持续负担，并表明有针对性的预防战略可以在大流行环境之外持续减少感染相关死亡。
{"title":"Infection-related mortality in children in two European countries, 2015–2023: An interrupted time-series analysis","authors":"Manon Jaboyedoff , Pierre Alex Crisinel , Zaba Valtuille , Inès Fafi , Margherita Plebani , Yves Fougère , Karim Abawi , Romain Basmaci , Naïm Ouldali , François Angoulvant","doi":"10.1016/j.jinf.2026.106688","DOIUrl":"10.1016/j.jinf.2026.106688","url":null,"abstract":"<div><h3>Background</h3><div>Infections remain a leading cause of childhood mortality. Non-pharmaceutical interventions (NPI) implemented during COVID-19 pandemic altered the circulation of communicable pathogens. We aimed to assess how these changes affected paediatric infection-related mortality.</div></div><div><h3>Methods</h3><div>We conducted a population-based interrupted time-series analysis using national data from France and Switzerland (2015 to 2023), including deaths among individuals <18 years. Monthly infection-related mortality was analysed using quasi-Poisson regression models seasonally adjusted. Mortality rate ratios (MRR) were calculated to compare infection-related mortality among birth cohorts exposed to NPI or post-NPI periods versus pre-NPI cohorts.</div></div><div><h3>Results</h3><div>Among 32,619 paediatric deaths during the study period, 8272 were related to an infection. During the NPI period, infection-related mortality declined by 16% (95% CI: −23% to −7%), corresponding to an estimated reduction of 221 (95% CI: 90 to 371) deaths. Compared to pre-NPI birth cohorts, 2019 and 2020 cohorts had significantly lower infection-related MRR (0·80, 95% CI 0·66 to 0·98 and 0·80, 95% CI 0·65 to 0·98).</div></div><div><h3>Conclusion</h3><div>The reduction in paediatric infection-related deaths during the NPI period underscores the ongoing burden of preventable paediatric mortality and suggests that targeted preventive strategies may sustainably reduce infection-related deaths beyond pandemic settings.</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"92 2","pages":"Article 106688"},"PeriodicalIF":11.9,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-08DOI: 10.1016/j.jinf.2026.106682
Sheila F. Lumley , Beatrice Kimono , Joseph Mugisha , Ronald Makanga , Moses Kwizera Mbonye , Kevin Ojambo , Elizabeth Waddilove , Chris Kent , Brian Ssengendo , Richard Ndungutse , Anna L. McNaughton , Florence Nambaziira Muzaale , Janet Seeley , Josh Quick , Ponsiano Ocama , Robert Newton , Philippa C. Matthews
Background
The World Health Organization (WHO) 2024 Hepatitis B virus (HBV) treatment guidelines expand eligibility for nucleos(t)ide analogue treatment in individuals with chronic HBV infection. For countries to implement these guidelines, there is a critical need to understand the population who are treatment eligible. While HBV drug resistance (HBVDR) is uncommon, monitoring for any potential resistance is a relevant public health consideration.
Methods
We studied a population in rural Uganda to describe the proportion of individuals eligible for treatment based on the 2024 WHO treatment guidelines. We determined how this proportion varies according to the eligibility criteria used, comparing the performance of different assessment tools. We calculated Aspartate Aminotransferase-to-Platelet Ratio Index; APRI, Gamma-Glutamyl Transpeptidase-to-Platelet Ratio; GPR and transient elastography; TE and performed HBV sequencing using Oxford Nanopore Technology to determine the prevalence of HBVDR in treatment naive and treatment experienced individuals.
Results
In this cohort, 24/63 (38%) individuals with CHB were eligible for treatment. This fell to 14/63 (22%) in a hypothetical scenario where TE was not available for the assessment of liver fibrosis. We demonstrate a lack of concordance between non-invasive tests (NIT) of liver disease in treatment-naive HBV mono-infected individuals. An APRI cut-off of 0.5 had a sensitivity of 23.0% for predicting a TE score of >7 kPa (F2 fibrosis). Sensitivity for detecting F2 fibrosis was increased to 38.5% using an APRI cut off of 0.36, and to 46.2% using the GPR. We did not identify any HBVDR in the HBV mono-infected treatment-naive population (n=58). 24/210 individuals were living with HIV/HBV coinfection; HBV was sequenced in 5 of these of whom 2 had genomic evidence of nucleos(t)ide analogue resistance (rt180M/204V).
Conclusions
While the WHO 2024 treatment criteria offer an opportunity to expand access to care, there is a need to determine how assessment tools differ in determination of eligibility in different settings. HBVDR remains uncommon but more research is needed to understand its prevalence and clinical impact in African populations.
{"title":"Eligibility for hepatitis B virus (HBV) treatment and prevalence of drug resistance in a Ugandan population cohort","authors":"Sheila F. Lumley , Beatrice Kimono , Joseph Mugisha , Ronald Makanga , Moses Kwizera Mbonye , Kevin Ojambo , Elizabeth Waddilove , Chris Kent , Brian Ssengendo , Richard Ndungutse , Anna L. McNaughton , Florence Nambaziira Muzaale , Janet Seeley , Josh Quick , Ponsiano Ocama , Robert Newton , Philippa C. Matthews","doi":"10.1016/j.jinf.2026.106682","DOIUrl":"10.1016/j.jinf.2026.106682","url":null,"abstract":"<div><h3>Background</h3><div>The World Health Organization (WHO) 2024 Hepatitis B virus (HBV) treatment guidelines expand eligibility for nucleos(t)ide analogue treatment in individuals with chronic HBV infection. For countries to implement these guidelines, there is a critical need to understand the population who are treatment eligible. While HBV drug resistance (HBVDR) is uncommon, monitoring for any potential resistance is a relevant public health consideration.</div></div><div><h3>Methods</h3><div>We studied a population in rural Uganda to describe the proportion of individuals eligible for treatment based on the 2024 WHO treatment guidelines. We determined how this proportion varies according to the eligibility criteria used, comparing the performance of different assessment tools. We calculated Aspartate Aminotransferase-to-Platelet Ratio Index; APRI, Gamma-Glutamyl Transpeptidase-to-Platelet Ratio; GPR and transient elastography; TE and performed HBV sequencing using Oxford Nanopore Technology to determine the prevalence of HBVDR in treatment naive and treatment experienced individuals.</div></div><div><h3>Results</h3><div>In this cohort, 24/63 (38%) individuals with CHB were eligible for treatment. This fell to 14/63 (22%) in a hypothetical scenario where TE was not available for the assessment of liver fibrosis. We demonstrate a lack of concordance between non-invasive tests (NIT) of liver disease in treatment-naive HBV mono-infected individuals. An APRI cut-off of 0.5 had a sensitivity of 23.0% for predicting a TE score of >7 kPa (F2 fibrosis). Sensitivity for detecting F2 fibrosis was increased to 38.5% using an APRI cut off of 0.36, and to 46.2% using the GPR. We did not identify any HBVDR in the HBV mono-infected treatment-naive population (n=58). 24/210 individuals were living with HIV/HBV coinfection; HBV was sequenced in 5 of these of whom 2 had genomic evidence of nucleos(t)ide analogue resistance (rt180M/204V).</div></div><div><h3>Conclusions</h3><div>While the WHO 2024 treatment criteria offer an opportunity to expand access to care, there is a need to determine how assessment tools differ in determination of eligibility in different settings. HBVDR remains uncommon but more research is needed to understand its prevalence and clinical impact in African populations.</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"92 2","pages":"Article 106682"},"PeriodicalIF":11.9,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145949432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-08DOI: 10.1016/j.jinf.2026.106677
Fasil Wagnew , Jennifer Shield , Suzy J. Birtles , Kefyalew Addis Alene , Catherine Gordon , Richard Bradbury , Stephen Muhi , Deepani D. Fernando , Mary Lorraine Mationg , Wendy Page , Siddhartha Mahanty , Bronwyn Rossingh , Tamara Riley , Jenni Judd , Jessica Hoopes , Madeleine Kelso , John Kaldor , Rogan Lee , Matthew Watts , Beverley-Ann Biggs , Darren J. Gray
Introduction
Strongyloidiasis, caused by the soil-transmitted helminth Strongyloides stercoralis, remains a neglected public health issue in Australia, particularly among remote Aboriginal and Torres Strait Islander communities. This study aimed to map the spatial distribution of strongyloidiasis and investigate associated socioecological factors to identify high-risk areas and guide targeted interventions in Australia.
Methods
We used data from a previous nationwide pathology data survey conducted between 2012 and 2016, which included 81,131 individuals across 332 statistical area level 3 (SA3) regions in Australia. Socio-ecological and environmental variables were extracted from publicly available online sources to explore their relationship with strongyloidiasis. Spatial patterns were analysed using Global Moran's I and Getis-Ord statistic to identify clusters of high and low disease prevalence. Bayesian spatial modelling was applied to investigate whether socio-climatic factors explain the spatial distribution of strongyloidiasis in Australia.
Results
The predicted prevalence map showed substantial spatial heterogeneity of strongyloidiasis, with the highest prevalence identified in regions of the Northern Territory, northern Queensland, and northern Western Australia. Bayesian geospatial analysis indicated significant positive associations between strongyloidiasis prevalence and higher temperature (β: 0.080; 95% Credible Interval [CrI]: 0.043, 0.117) and higher soil pH (β: 0.231; 95% CrI: 0.038, 0.425). Conversely, a higher Socio-Economic Indexes for Areas (SEIFA) score, that is, areas with generally higher socio-economic status, was negatively associated with the strongyloidiasis prevalence (β: −0.107; 95% CrI: −0.179, −0.036).
Conclusion
Our findings reveal significant geographical variation in strongyloidiasis prevalence across Australia, with high prevalence observed in northern Queensland, the Northern Territory, and northern Western Australia, where climatic factors, soil characteristics, and socioeconomic conditions can shape the spatial distribution of the disease. Geographically tailored strategies targeting high prevalence areas are essential for effective prevention and control.
{"title":"Spatial distribution of and socio-ecological risk factors for strongyloidiasis in Australia","authors":"Fasil Wagnew , Jennifer Shield , Suzy J. Birtles , Kefyalew Addis Alene , Catherine Gordon , Richard Bradbury , Stephen Muhi , Deepani D. Fernando , Mary Lorraine Mationg , Wendy Page , Siddhartha Mahanty , Bronwyn Rossingh , Tamara Riley , Jenni Judd , Jessica Hoopes , Madeleine Kelso , John Kaldor , Rogan Lee , Matthew Watts , Beverley-Ann Biggs , Darren J. Gray","doi":"10.1016/j.jinf.2026.106677","DOIUrl":"10.1016/j.jinf.2026.106677","url":null,"abstract":"<div><h3>Introduction</h3><div>Strongyloidiasis, caused by the soil-transmitted helminth <em>Strongyloides stercoralis,</em> remains a neglected public health issue in Australia, particularly among remote Aboriginal and Torres Strait Islander communities. This study aimed to map the spatial distribution of strongyloidiasis and investigate associated socioecological factors to identify high-risk areas and guide targeted interventions in Australia.</div></div><div><h3>Methods</h3><div>We used data from a previous nationwide pathology data survey conducted between 2012 and 2016, which included 81,131 individuals across 332 statistical area level 3 (SA3) regions in Australia. Socio-ecological and environmental variables were extracted from publicly available online sources to explore their relationship with strongyloidiasis. Spatial patterns were analysed using Global Moran's I and Getis-Ord statistic to identify clusters of high and low disease prevalence. Bayesian spatial modelling was applied to investigate whether socio-climatic factors explain the spatial distribution of strongyloidiasis in Australia.</div></div><div><h3>Results</h3><div>The predicted prevalence map showed substantial spatial heterogeneity of strongyloidiasis, with the highest prevalence identified in regions of the Northern Territory, northern Queensland, and northern Western Australia. Bayesian geospatial analysis indicated significant positive associations between strongyloidiasis prevalence and higher temperature (β: 0.080; 95% Credible Interval [CrI]: 0.043, 0.117) and higher soil pH (β: 0.231; 95% CrI: 0.038, 0.425). Conversely, a higher Socio-Economic Indexes for Areas (SEIFA) score, that is, areas with generally higher socio-economic status, was negatively associated with the strongyloidiasis prevalence (β: −0.107; 95% CrI: −0.179, −0.036).</div></div><div><h3>Conclusion</h3><div>Our findings reveal significant geographical variation in strongyloidiasis prevalence across Australia, with high prevalence observed in northern Queensland, the Northern Territory, and northern Western Australia, where climatic factors, soil characteristics, and socioeconomic conditions can shape the spatial distribution of the disease. Geographically tailored strategies targeting high prevalence areas are essential for effective prevention and control.</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"92 2","pages":"Article 106677"},"PeriodicalIF":11.9,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145949415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-08DOI: 10.1016/j.jinf.2026.106681
Daryl Geers , Muriel Aguilar-Bretones , Luca M. Zaeck , Paul A. Gill , Cristina Gonzalez-Lopez , Kim Handrejk , Ngoc H. Tan , Yvette den Hartog , Lennert Gommers , Susanne Bogers , Anna Z. Mykytyn , Roos S.G. Sablerolles , Abraham Goorhuis , Douwe F. Postma , Leo G. Visser , Virgil A.S.H. Dalm , Melvin Lafeber , Neeltje A. Kootstra , Debbie van Baarle , Bart L. Haagmans , Rory D. de Vries
Objectives
Ongoing escape from pre-existing antibodies by severe acute respiratory distress syndrome coronavirus-2 (SARS-CoV-2) necessitates yearly coronavirus disease 2019 (COVID-19) vaccine updates. Monovalent variant-specific booster vaccines for at-risk populations aim to re-direct antibody responses towards antigenically distinct variants. However, multiple past exposures to the ancestral SARS-CoV-2 spike (S) protein through vaccination and infection could hinder the de novo induction of variant-specific immune responses.
Methods
Here, we profiled SARS-CoV-2-specific antibody, T- and B-cell responses in healthcare workers up to 6 months after monovalent XBB.1.5 vaccination.
Results
Neutralizing antibodies targeting Omicron subvariants circulating at the time of vaccination were preferentially boosted by vaccination but remained lower than those neutralizing the ancestral strain. Similar responses were observed for antibodies that mediate functionality through antibody-dependent cellular cytotoxicity, although these responses were more promiscuous. Broadly S-reactive B-cells were recalled by vaccination, with limited de novo induction of XBB.1.5-specific B-cell clones. B-cells targeting the receptor binding domain of circulating Omicron subvariants were favored, and T-cell responses cross-reacted with all SARS-CoV-2 variants that were assessed.
Conclusions
Combined, this comprehensive immune profiling demonstrates that despite evidence of imprinted antibody responses targeting ancestral S, monovalent booster vaccination skews the immune response to Omicron lineage recognition.
{"title":"Preferential boosting of SARS-CoV-2 Omicron lineage-specific immune responses by monovalent XBB.1.5 vaccination","authors":"Daryl Geers , Muriel Aguilar-Bretones , Luca M. Zaeck , Paul A. Gill , Cristina Gonzalez-Lopez , Kim Handrejk , Ngoc H. Tan , Yvette den Hartog , Lennert Gommers , Susanne Bogers , Anna Z. Mykytyn , Roos S.G. Sablerolles , Abraham Goorhuis , Douwe F. Postma , Leo G. Visser , Virgil A.S.H. Dalm , Melvin Lafeber , Neeltje A. Kootstra , Debbie van Baarle , Bart L. Haagmans , Rory D. de Vries","doi":"10.1016/j.jinf.2026.106681","DOIUrl":"10.1016/j.jinf.2026.106681","url":null,"abstract":"<div><h3>Objectives</h3><div>Ongoing escape from pre-existing antibodies by severe acute respiratory distress syndrome coronavirus-2 (SARS-CoV-2) necessitates yearly coronavirus disease 2019 (COVID-19) vaccine updates. Monovalent variant-specific booster vaccines for at-risk populations aim to re-direct antibody responses towards antigenically distinct variants. However, multiple past exposures to the ancestral SARS-CoV-2 spike (S) protein through vaccination and infection could hinder the <em>de novo</em> induction of variant-specific immune responses.</div></div><div><h3>Methods</h3><div>Here, we profiled SARS-CoV-2-specific antibody, T- and B-cell responses in healthcare workers up to 6 months after monovalent XBB.1.5 vaccination.</div></div><div><h3>Results</h3><div>Neutralizing antibodies targeting Omicron subvariants circulating at the time of vaccination were preferentially boosted by vaccination but remained lower than those neutralizing the ancestral strain. Similar responses were observed for antibodies that mediate functionality through antibody-dependent cellular cytotoxicity, although these responses were more promiscuous. Broadly S-reactive B-cells were recalled by vaccination, with limited <em>de novo</em> induction of XBB.1.5-specific B-cell clones. B-cells targeting the receptor binding domain of circulating Omicron subvariants were favored, and T-cell responses cross-reacted with all SARS-CoV-2 variants that were assessed.</div></div><div><h3>Conclusions</h3><div>Combined, this comprehensive immune profiling demonstrates that despite evidence of imprinted antibody responses targeting ancestral S, monovalent booster vaccination skews the immune response to Omicron lineage recognition.</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"92 2","pages":"Article 106681"},"PeriodicalIF":11.9,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145949455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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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