Pub Date : 2025-02-14DOI: 10.1016/j.jinf.2025.106444
David Chadwick , Hannah Williams , Catriona Lane , Jane Knowles , Jim Woods , Sarah Bircham , Leanne Waters , Sandra Gittins , Buddhika Perera , Priyantha Batagalla , Kirsty Foster
Objectives
The incidence of syphilis in several areas of England has risen substantially. National programmes for blood-borne viruses (BBV) screening in emergency departments (ED) have been ongoing for several years however have not included syphilis. We hypothesised that screening for syphilis in an ED in a region of high prevalence might identify significant numbers of cases.
Methods
Universal opt-out syphilis screening was included with BBVs in a Northeast England ED, where a regional outbreak is ongoing. Those with reactive tests were invited to sexual health service (SHS) for further evaluation.
Results
Of 3312 ED attenders having blood drawn, 38 (1.2%) were confirmed T. pallidum EIA positive (45% RPR-positive). Compared to ED attenders testing negative, those with positive tests were younger and lived in more deprived areas, however had similar gender and ethnicity. 71% of those identified as needing assessment were seen in the SHS and 59% treated.
Conclusions
Universal screening for syphilis appears effective in identifying people with syphilis who traditionally don’t access SHS. This population has different demographics to people with syphilis attending SHS in England, being predominantly heterosexual and equal proportions of women. Routine ED screening for syphilis along with BBVs may be warranted in areas of high transmission.
{"title":"Universal opt-out syphilis screening in a UK emergency department","authors":"David Chadwick , Hannah Williams , Catriona Lane , Jane Knowles , Jim Woods , Sarah Bircham , Leanne Waters , Sandra Gittins , Buddhika Perera , Priyantha Batagalla , Kirsty Foster","doi":"10.1016/j.jinf.2025.106444","DOIUrl":"10.1016/j.jinf.2025.106444","url":null,"abstract":"<div><h3>Objectives</h3><div>The incidence of syphilis in several areas of England has risen substantially. National programmes for blood-borne viruses (BBV) screening in emergency departments (ED) have been ongoing for several years however have not included syphilis. We hypothesised that screening for syphilis in an ED in a region of high prevalence might identify significant numbers of cases.</div></div><div><h3>Methods</h3><div>Universal opt-out syphilis screening was included with BBVs in a Northeast England ED, where a regional outbreak is ongoing. Those with reactive tests were invited to sexual health service (SHS) for further evaluation.</div></div><div><h3>Results</h3><div>Of 3312 ED attenders having blood drawn, 38 (1.2%) were confirmed <em>T. pallidum</em> EIA positive (45% RPR-positive). Compared to ED attenders testing negative, those with positive tests were younger and lived in more deprived areas, however had similar gender and ethnicity. 71% of those identified as needing assessment were seen in the SHS and 59% treated.</div></div><div><h3>Conclusions</h3><div>Universal screening for syphilis appears effective in identifying people with syphilis who traditionally don’t access SHS. This population has different demographics to people with syphilis attending SHS in England, being predominantly heterosexual and equal proportions of women. Routine ED screening for syphilis along with BBVs may be warranted in areas of high transmission.</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"90 3","pages":"Article 106444"},"PeriodicalIF":14.3,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-12DOI: 10.1016/j.jinf.2025.106443
Katherine V. Williams , Mary G. Krauland , Mary Patricia Nowalk , Lee H. Harrison , John V. Williams , Mark S. Roberts , Richard K. Zimmerman
Objectives
Availability of caregiver-administered nasal spray live attenuated influenza vaccine (LAIV) raises the potential for increased influenza vaccine uptake. Direct and indirect benefits (decreased influenza cases and hospitalizations) of increased uptake among school-age children may be realized across the age spectrum. We used an agent-based model to determine the extent to which increased vaccination of children might affect overall influenza epidemiology.
Methods
The Framework for Reproducing Epidemiological Dynamics (FRED) uses a population based on the US census and accounts for individual characteristics to estimate the effect of changes in parameters including vaccine uptake, on outcomes. We modeled increases in vaccine uptake among school-age children 5–17 years old on influenza cases and hospitalizations by age group.
Results
Increasing vaccination rates in school-aged children by 5%−15% decreased their symptomatic influenza cases by 3.2%−10.9%, and among all age groups by 3.3%−11.6%, corresponding to an estimated annual reduction in cases of 522,867–1,810,170 among school-age children and of 1,394,687–4,945,952 overall. Annual U.S. hospitalizations could decrease by as much as 49,977, with the greatest impact (23,258) in those ages 65 years and over.
Conclusions
The opportunity to increase vaccination coverage in school-age children using LAIV can have a positive impact across all ages.
{"title":"Increasing child vaccination coverage can reduce influenza cases across age groups: An agent-based modeling study","authors":"Katherine V. Williams , Mary G. Krauland , Mary Patricia Nowalk , Lee H. Harrison , John V. Williams , Mark S. Roberts , Richard K. Zimmerman","doi":"10.1016/j.jinf.2025.106443","DOIUrl":"10.1016/j.jinf.2025.106443","url":null,"abstract":"<div><h3>Objectives</h3><div>Availability of caregiver-administered nasal spray live attenuated influenza vaccine (LAIV) raises the potential for increased influenza vaccine uptake. Direct and indirect benefits (decreased influenza cases and hospitalizations) of increased uptake among school-age children may be realized across the age spectrum. We used an agent-based model to determine the extent to which increased vaccination of children might affect overall influenza epidemiology.</div></div><div><h3>Methods</h3><div>The Framework for Reproducing Epidemiological Dynamics (FRED) uses a population based on the US census and accounts for individual characteristics to estimate the effect of changes in parameters including vaccine uptake, on outcomes. We modeled increases in vaccine uptake among school-age children 5–17 years old on influenza cases and hospitalizations by age group.</div></div><div><h3>Results</h3><div>Increasing vaccination rates in school-aged children by 5%−15% decreased their symptomatic influenza cases by 3.2%−10.9%, and among all age groups by 3.3%−11.6%, corresponding to an estimated annual reduction in cases of 522,867–1,810,170 among school-age children and of 1,394,687–4,945,952 overall. Annual U.S. hospitalizations could decrease by as much as 49,977, with the greatest impact (23,258) in those ages 65 years and over.</div></div><div><h3>Conclusions</h3><div>The opportunity to increase vaccination coverage in school-age children using LAIV can have a positive impact across all ages.</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"90 3","pages":"Article 106443"},"PeriodicalIF":14.3,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-12DOI: 10.1016/j.jinf.2025.106441
Catherine Isitt , Helen Campbell , Catherine A. Cosgrove , Mary E. Ramsay , Paul T. Heath , Ray Borrow , Shamez N. Ladhani
Background
Asplenia and splenic dysfunction is associated with an increased risk of severe and fatal infections, especially due to encapsulated bacteria including Streptococcus pneumoniae, Haemophilus influenzae serotype b (Hib) and Neisseria meningitidis. People with sickle cell disease (SCD) develop recurrent splenic infarcts rendering them functionally asplenic. Consequently, additional vaccination against these three pathogens is recommended. There is robust evidence of an increased risk for invasive pneumococcal (IPD) and Hib disease, in people with SCD, but for not invasive meningococcal disease (IMD).
Methods
We conducted a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) recommendations. Studies published in any language before June 2024 and including people with SCD of all ages and from all geographical locations were included. Studies were included if they documented bacterial culture and/or PCR in patients with SCD with suspected infection. The primary outcome was to estimate IMD risk in people with SCD. Secondary outcomes included estimating the risk of IMD and Hib disease in people with SCD.
Findings
We identified 3804 publications and included 86 in the final analyses. Among 74 cohort studies published during 1971–2023, there were three IMD cases among 26,404 persons with SCD compared with 570 IPD and 113 Hib cases. Eight case-control studies published during 1983–2022 reported one IMD case among 932 people with SCD (0.1%) compared to 118 IMD cases among 7143 people without SCD (1.65%). In contrast, there were 126 IPD cases (126/932, 13.5%) in people with SCD compared to 588 (588/7143, 8.2%) in those without SCD. For Hib, the rates were 32/932 (3.4%) and 316/7143 (4.4%), respectively. After including all published studies, we identified five IMD cases in people with SCD across studies published worldwide during 1965–1995 and all five survived their infection.
Interpretation
We found no evidence of any increased risk of IMD in people with SCD. This has important implications for policymakers in countries and organisations that currently recommend meningococcal vaccination for people with SCD.
{"title":"Risk of invasive meningococcal disease in people with sickle cell disease: A systematic review","authors":"Catherine Isitt , Helen Campbell , Catherine A. Cosgrove , Mary E. Ramsay , Paul T. Heath , Ray Borrow , Shamez N. Ladhani","doi":"10.1016/j.jinf.2025.106441","DOIUrl":"10.1016/j.jinf.2025.106441","url":null,"abstract":"<div><h3>Background</h3><div>Asplenia and splenic dysfunction is associated with an increased risk of severe and fatal infections, especially due to encapsulated bacteria including <em>Streptococcus pneumoniae</em>, <em>Haemophilus influenzae</em> serotype b (Hib) and <em>Neisseria meningitidis</em>. People with sickle cell disease (SCD) develop recurrent splenic infarcts rendering them functionally asplenic. Consequently, additional vaccination against these three pathogens is recommended. There is robust evidence of an increased risk for invasive pneumococcal (IPD) and Hib disease, in people with SCD, but for not invasive meningococcal disease (IMD).</div></div><div><h3>Methods</h3><div>We conducted a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) recommendations. Studies published in any language before June 2024 and including people with SCD of all ages and from all geographical locations were included. Studies were included if they documented bacterial culture and/or PCR in patients with SCD with suspected infection. The primary outcome was to estimate IMD risk in people with SCD. Secondary outcomes included estimating the risk of IMD and Hib disease in people with SCD.</div></div><div><h3>Findings</h3><div>We identified 3804 publications and included 86 in the final analyses. Among 74 cohort studies published during 1971–2023, there were three IMD cases among 26,404 persons with SCD compared with 570 IPD and 113 Hib cases. Eight case-control studies published during 1983–2022 reported one IMD case among 932 people with SCD (0.1%) compared to 118 IMD cases among 7143 people without SCD (1.65%). In contrast, there were 126 IPD cases (126/932, 13.5%) in people with SCD compared to 588 (588/7143, 8.2%) in those without SCD. For Hib, the rates were 32/932 (3.4%) and 316/7143 (4.4%), respectively. After including all published studies, we identified five IMD cases in people with SCD across studies published worldwide during 1965–1995 and all five survived their infection.</div></div><div><h3>Interpretation</h3><div>We found no evidence of any increased risk of IMD in people with SCD. This has important implications for policymakers in countries and organisations that currently recommend meningococcal vaccination for people with SCD.</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"90 3","pages":"Article 106441"},"PeriodicalIF":14.3,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-12DOI: 10.1016/j.jinf.2025.106440
Caihua Liang , Elizabeth Begier , Stefan Hagel , Juliane Ankert , Liz Wang , Claudia Schwarz , Lea J. Bayer , Christof von Eiff , Qing Liu , Jo Southern , Jeffrey Vietri , Sonal Uppal , Bradford D. Gessner , Christian Theilacker , Mathias W. Pletz
Background
RSV is a leading cause of ARI, including CAP, in older adults. Data available often underestimate RSV-related ARI incidence. We estimated RSV-related ARI hospitalization incidence from a prospective CAP study, adjusting for undiagnosed RSV infections due to nasopharyngeal/nasal swab testing only.
Methods
Active surveillance of adult CAP hospitalizations in Germany was conducted between 2021–2023. Nasopharyngeal/nasal swabs were RSV-tested, and age-group specific proportions were applied to calculate RSV-related CAP incidence. This was divided by the CAP proportions among RSV-related ARI hospitalizations (from multispecimen study) to extrapolate RSV-related ARI rates.
Results
Among 1040 radiologically confirmed CAP cases, 3.7% tested RSV-positive via nasopharyngeal/nasal swab, corresponding to 7.8% after adjusting for underdetection. For 18–59 and ≥60 years, adjusted RSV-related CAP hospitalization rates (95% CI) were 4.9 (1.8–10.9) and 115.6 (78.8–163.6); adjusted RSV-related ARI hospitalization rates were 19.8 (6.8–50.1) and 401.6 (260.7–609.3) per 100,000, respectively. Within 30 days of an RSV-related CAP admission, 18.2% of those ≥65 years died, and 11.1% and 36.4% had cardiovascular events among those 18–64 and ≥65 years, respectively.
Conclusions
Older adults in Germany experience a high burden of RSV-related ARI hospitalizations, including CAP, underscoring RSV vaccination’s potential utility for this population.
{"title":"Incidence of RSV-related hospitalizations for ARIs, including CAP: Data from the German prospective ThEpiCAP study","authors":"Caihua Liang , Elizabeth Begier , Stefan Hagel , Juliane Ankert , Liz Wang , Claudia Schwarz , Lea J. Bayer , Christof von Eiff , Qing Liu , Jo Southern , Jeffrey Vietri , Sonal Uppal , Bradford D. Gessner , Christian Theilacker , Mathias W. Pletz","doi":"10.1016/j.jinf.2025.106440","DOIUrl":"10.1016/j.jinf.2025.106440","url":null,"abstract":"<div><h3>Background</h3><div>RSV is a leading cause of ARI, including CAP, in older adults. Data available often underestimate RSV-related ARI incidence. We estimated RSV-related ARI hospitalization incidence from a prospective CAP study, adjusting for undiagnosed RSV infections due to nasopharyngeal/nasal swab testing only.</div></div><div><h3>Methods</h3><div>Active surveillance of adult CAP hospitalizations in Germany was conducted between 2021–2023. Nasopharyngeal/nasal swabs were RSV-tested, and age-group specific proportions were applied to calculate RSV-related CAP incidence. This was divided by the CAP proportions among RSV-related ARI hospitalizations (from multispecimen study) to extrapolate RSV-related ARI rates.</div></div><div><h3>Results</h3><div>Among 1040 radiologically confirmed CAP cases, 3.7% tested RSV-positive via nasopharyngeal/nasal swab, corresponding to 7.8% after adjusting for underdetection. For 18–59 and ≥60 years, adjusted RSV-related CAP hospitalization rates (95% CI) were 4.9 (1.8–10.9) and 115.6 (78.8–163.6); adjusted RSV-related ARI hospitalization rates were 19.8 (6.8–50.1) and 401.6 (260.7–609.3) per 100,000, respectively. Within 30 days of an RSV-related CAP admission, 18.2% of those ≥65 years died, and 11.1% and 36.4% had cardiovascular events among those 18–64 and ≥65 years, respectively.</div></div><div><h3>Conclusions</h3><div>Older adults in Germany experience a high burden of RSV-related ARI hospitalizations, including CAP, underscoring RSV vaccination’s potential utility for this population.</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"90 3","pages":"Article 106440"},"PeriodicalIF":14.3,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-12DOI: 10.1016/j.jinf.2025.106442
Guangyu Ao , Toni Li , Yushu Wang, Nathan Balzer, Jie Luo, Min Chen
{"title":"The effect of amubarvimab-romlusevimab on clinical outcomes in patients with COVID-19: A meta-analysis","authors":"Guangyu Ao , Toni Li , Yushu Wang, Nathan Balzer, Jie Luo, Min Chen","doi":"10.1016/j.jinf.2025.106442","DOIUrl":"10.1016/j.jinf.2025.106442","url":null,"abstract":"","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"90 3","pages":"Article 106442"},"PeriodicalIF":14.3,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-06DOI: 10.1016/j.jinf.2025.106437
Virginia Dos Santos , Sebastian Meller , Carsten Perka , Andrej Trampuz , Nora Renz
Objectives
Antimicrobial suppression improves short-term outcome of streptococcal periprosthetic joint infection (PJI) compared to standard treatment. This study assesses the long-term effectiveness of suppression.
Methods
This prospective study included consecutive patients with streptococcal PJI. Infection-free survival was analyzed using the Kaplan-Meier method and compared between patients receiving standard therapy (12 weeks) and those with suppression therapy (>6 months) with the log-rank test.
Results
A total of 63 PJI episodes were analyzed. Standard treatment was administered to 33 patients, while 30 patients received suppression therapy (10 had ongoing and 20 had discontinued suppression at time of follow-up). Predominant pathogens included Streptococcus agalactiae (n=20) and Streptococcus dysgalactiae (n=18). The main surgical procedures used were two-stage exchange (n=35) and prosthesis retention (n=21). At 7.5 years, infection-free survival was significantly higher in the suppression group (62%) compared to the standard therapy group (38%) (p=0.038). Streptococci accounted for 14 of 27 failures (52%). Suppression effectively prevented streptococcal infection during treatment; however, relapses or new streptococcal infections occurred in 5 of 20 patients (25%) after discontinuation. Failures during ongoing suppression were exclusively caused by gram-negative rods.
Conclusions
Suppression therapy significantly improves long-term outcome in streptococcal PJI. While suppression effectively prevents streptococcal reinfections during treatment, the risk of recurrence reemerges after discontinuation.
{"title":"Ongoing suppression prevents relapse in streptococcal periprosthetic joint infection: A prospective long-term cohort study","authors":"Virginia Dos Santos , Sebastian Meller , Carsten Perka , Andrej Trampuz , Nora Renz","doi":"10.1016/j.jinf.2025.106437","DOIUrl":"10.1016/j.jinf.2025.106437","url":null,"abstract":"<div><h3>Objectives</h3><div>Antimicrobial suppression improves short-term outcome of streptococcal periprosthetic joint infection (PJI) compared to standard treatment. This study assesses the long-term effectiveness of suppression.</div></div><div><h3>Methods</h3><div>This prospective study included consecutive patients with streptococcal PJI. Infection-free survival was analyzed using the Kaplan-Meier method and compared between patients receiving standard therapy (12 weeks) and those with suppression therapy (>6 months) with the log-rank test.</div></div><div><h3>Results</h3><div>A total of 63 PJI episodes were analyzed. Standard treatment was administered to 33 patients, while 30 patients received suppression therapy (10 had ongoing and 20 had discontinued suppression at time of follow-up). Predominant pathogens included <u>Streptococcus agalactiae</u> (n=20) and <u>Streptococcus dysgalactiae</u> (n=18). The main surgical procedures used were two-stage exchange (n=35) and prosthesis retention (n=21). At 7.5 years, infection-free survival was significantly higher in the suppression group (62%) compared to the standard therapy group (38%) (p=0.038). Streptococci accounted for 14 of 27 failures (52%). Suppression effectively prevented streptococcal infection during treatment; however, relapses or new streptococcal infections occurred in 5 of 20 patients (25%) after discontinuation. Failures during ongoing suppression were exclusively caused by gram-negative rods.</div></div><div><h3>Conclusions</h3><div>Suppression therapy significantly improves long-term outcome in streptococcal PJI. While suppression effectively prevents streptococcal reinfections during treatment, the risk of recurrence reemerges after discontinuation.</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"90 3","pages":"Article 106437"},"PeriodicalIF":14.3,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-06DOI: 10.1016/j.jinf.2025.106438
Bethany Hillier , Tim Waterboer , Jill Brooks , Paul Nankivell , Ridhi Agarwal , Ahmad K. Abou-Foul , Tessa Fulton-Lieuw , Caroline Kristunas , Alex Vorsters , Joanna Parish , Hisham Mehanna
Objectives
Human papillomavirus (HPV) mediated oropharyngeal cancer (OPC) incidence has increased dramatically. Accurate oral HPV prevalence data are essential for assessing population epidemiology, vaccination and screening programmes. As oral rinse is the most commonly used primary outcome measure for estimating oral HPV prevalence, we aimed to compare the efficacy of oral rinse against other detection methods.
Methods
The Oromouth study enrolled 945 participants, aged 0–65 years (63% female), undergoing tonsillectomy for non-malignant indications, without OPC diagnoses. Samples from oral rinse, pharyngeal wall, tongue base, tonsil tissue and blood were collected. HPV DNA in oral samples was centrally tested via polymerase chain reaction, and serology samples for HPV antibodies. Statistical analyses assessed prevalence, detection rates and ratios.
Results
Combining all four oral collection sites, high-risk (HR)-HPV and any HPV prevalence were 4·3% and 18%, respectively. HR-HPV prevalence was similar between males (4·1%) and females (4·5%). Oral rinse had the highest HR-HPV (4·0%) and any HPV detection rates (16%), but still missed 73% (11/15) identified as HR-HPV-positive by other oral sites. Compared to oral rinse alone, an additional 38% (11/29) HR-HPV infections were picked up by the other three oral collection methods. Addition of serology testing did not result in substantial improvement.
Conclusions
Of the four oral sites, oral rinse demonstrates the highest detection rates by far but has important limitations. These findings should be taken into consideration when estimating oral HPV infection rates, especially for vaccination studies and screening programmes.
{"title":"Efficacy of oral rinse and other detection methods in detecting oral human papillomavirus infections: The Oromouth cohort study","authors":"Bethany Hillier , Tim Waterboer , Jill Brooks , Paul Nankivell , Ridhi Agarwal , Ahmad K. Abou-Foul , Tessa Fulton-Lieuw , Caroline Kristunas , Alex Vorsters , Joanna Parish , Hisham Mehanna","doi":"10.1016/j.jinf.2025.106438","DOIUrl":"10.1016/j.jinf.2025.106438","url":null,"abstract":"<div><h3>Objectives</h3><div>Human papillomavirus (HPV) mediated oropharyngeal cancer (OPC) incidence has increased dramatically. Accurate oral HPV prevalence data are essential for assessing population epidemiology, vaccination and screening programmes. As oral rinse is the most commonly used primary outcome measure for estimating oral HPV prevalence, we aimed to compare the efficacy of oral rinse against other detection methods.</div></div><div><h3>Methods</h3><div>The Oromouth study enrolled 945 participants, aged 0–65 years (63% female), undergoing tonsillectomy for non-malignant indications, without OPC diagnoses. Samples from oral rinse, pharyngeal wall, tongue base, tonsil tissue and blood were collected. HPV DNA in oral samples was centrally tested via polymerase chain reaction, and serology samples for HPV antibodies. Statistical analyses assessed prevalence, detection rates and ratios.</div></div><div><h3>Results</h3><div>Combining all four oral collection sites, high-risk (HR)-HPV and any HPV prevalence were 4·3% and 18%, respectively. HR-HPV prevalence was similar between males (4·1%) and females (4·5%). Oral rinse had the highest HR-HPV (4·0%) and any HPV detection rates (16%), but still missed 73% (11/15) identified as HR-HPV-positive by other oral sites. Compared to oral rinse alone, an additional 38% (11/29) HR-HPV infections were picked up by the other three oral collection methods. Addition of serology testing did not result in substantial improvement.</div></div><div><h3>Conclusions</h3><div>Of the four oral sites, oral rinse demonstrates the highest detection rates by far but has important limitations. These findings should be taken into consideration when estimating oral HPV infection rates, especially for vaccination studies and screening programmes.</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"90 3","pages":"Article 106438"},"PeriodicalIF":14.3,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-06DOI: 10.1016/j.jinf.2025.106439
Chang Song , Chun-Yan Zhao , Kai Li , Yan-Rong Lin, Shu-Lin Song, Chao-Yan Xu, Hang-Biao Qiang, Zhou-Hua Xie, Qing-Dong Zhu
{"title":"A 2.5D transfer deep learning model based on artificial intelligence for differentiating lymphoma and tuberculous lymphadenitis in HIV/AIDS patients","authors":"Chang Song , Chun-Yan Zhao , Kai Li , Yan-Rong Lin, Shu-Lin Song, Chao-Yan Xu, Hang-Biao Qiang, Zhou-Hua Xie, Qing-Dong Zhu","doi":"10.1016/j.jinf.2025.106439","DOIUrl":"10.1016/j.jinf.2025.106439","url":null,"abstract":"","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"90 3","pages":"Article 106439"},"PeriodicalIF":14.3,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-05DOI: 10.1016/j.jinf.2025.106435
Oliver A. Cornely , Hervé Dupont , Malgorzata Mikulska , Riina Rautemaa-Richardson , Carolina Garcia-Vidal , George R. Thompson III , Martin Hoenigl
Achieving and maintaining therapeutic drug exposures with antifungals can be challenging in special patient populations, such as those with organ dysfunction (liver or kidney) or obesity, or elderly patients, due to dose–exposure relationships and potential drug–drug interactions. Dose adjustments may be needed in these populations to maintain therapeutic efficacy and/or prevent toxicity. We reviewed specific dosing considerations for antifungals in special populations with candidaemia and/or invasive candidiasis, focusing on those relating to echinocandins (based on prescribing information), and then explored the utility of the second-generation echinocandin rezafungin in treating these populations (based on currently available data identified from a PubMed and congress abstract search). Available data showed that echinocandins may sometimes require dosing modifications for special populations with candidaemia/invasive candidiasis, primarily due to decreases in pharmacokinetic exposures. Rezafungin appears to be suitable for use in a variety of special populations without the need for dose modifications based on available data, including patients with organ dysfunction or obesity, and elderly and critically ill patients. Further research is needed in populations where rezafungin data are not available including children, people living with HIV, patients receiving extracorporeal membrane oxygenation and those with underlying neurological conditions.
{"title":"Rezafungin in special populations with candidaemia and/or invasive candidiasis","authors":"Oliver A. Cornely , Hervé Dupont , Malgorzata Mikulska , Riina Rautemaa-Richardson , Carolina Garcia-Vidal , George R. Thompson III , Martin Hoenigl","doi":"10.1016/j.jinf.2025.106435","DOIUrl":"10.1016/j.jinf.2025.106435","url":null,"abstract":"<div><div>Achieving and maintaining therapeutic drug exposures with antifungals can be challenging in special patient populations, such as those with organ dysfunction (liver or kidney) or obesity, or elderly patients, due to dose–exposure relationships and potential drug–drug interactions. Dose adjustments may be needed in these populations to maintain therapeutic efficacy and/or prevent toxicity. We reviewed specific dosing considerations for antifungals in special populations with candidaemia and/or invasive candidiasis, focusing on those relating to echinocandins (based on prescribing information), and then explored the utility of the second-generation echinocandin rezafungin in treating these populations (based on currently available data identified from a PubMed and congress abstract search). Available data showed that echinocandins may sometimes require dosing modifications for special populations with candidaemia/invasive candidiasis, primarily due to decreases in pharmacokinetic exposures. Rezafungin appears to be suitable for use in a variety of special populations without the need for dose modifications based on available data, including patients with organ dysfunction or obesity, and elderly and critically ill patients. Further research is needed in populations where rezafungin data are not available including children, people living with HIV, patients receiving extracorporeal membrane oxygenation and those with underlying neurological conditions.</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"90 3","pages":"Article 106435"},"PeriodicalIF":14.3,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-02DOI: 10.1016/j.jinf.2025.106433
Anne Cathrine Zimakoff , Andreas Jensen , Michelle Malon , Jesper Kiehn Sørensen , Dorthe Maria Vittrup , Signe Kjeldgaard Jensen , Emma Therese Bay , Jannet Svensson , Lone Graff Stensballe
Background
In observational studies, childhood vaccinations have been associated with atopic diseases. However, results are conflicting and evidence from randomised trials is lacking.
Methods
Atopic disease after interventional measles-mumps-rubella (MMR) vaccine was a pre-planned secondary outcome of the MMR trial, a randomised, double-blind, placebo-controlled trial in 6540 Danish infants in the high-income setting of Denmark. At two hospitals, infants 5–7 months of age were randomly assigned 1:1 to receive an intramuscular injection with M-M-R VaxPro or placebo (solvent only). Randomisation was stratified by site, sex, and prematurity (< 37 weeks of gestation). The infants were followed up in the Danish health registries to detect eczema, asthma-like disease, and allergic rhinoconjunctivitis, the composite outcome of the three diseases being the primary endpoint of the present study.
The trial was registered in the EU Clinical Trials Registry (2016-001901-18) and ClinicalTrials.gov (NTC03780179).
Findings
Between April 2019 and October 2021, 6540 infants were randomised (3266 MMR and 3274 placebo). There was no difference in the rate of atopic disease before 12 months of age between the MMR and placebo group (76 events MMR vs. 77 placebo), resulting in a hazard ratio of 0·98 (95% confidence interval 0·72 to 1·35). Secondary analyses with follow-up until 24 months of age yielded essentially identical results.
Interpretation
Based on trial data in 6540 Danish infants randomised to MMR or placebo at 5–7 months, no association between MMR and atopic disease in early childhood was observed.
{"title":"Measles-mumps-rubella vaccination at 6 months of age and the risk of atopic disease in the first year of life: Results from a Danish placebo-controlled randomised trial","authors":"Anne Cathrine Zimakoff , Andreas Jensen , Michelle Malon , Jesper Kiehn Sørensen , Dorthe Maria Vittrup , Signe Kjeldgaard Jensen , Emma Therese Bay , Jannet Svensson , Lone Graff Stensballe","doi":"10.1016/j.jinf.2025.106433","DOIUrl":"10.1016/j.jinf.2025.106433","url":null,"abstract":"<div><h3>Background</h3><div>In observational studies, childhood vaccinations have been associated with atopic diseases. However, results are conflicting and evidence from randomised trials is lacking.</div></div><div><h3>Methods</h3><div>Atopic disease after interventional measles-mumps-rubella (MMR) vaccine was a pre-planned secondary outcome of the MMR trial, a randomised, double-blind, placebo-controlled trial in 6540 Danish infants in the high-income setting of Denmark. At two hospitals, infants 5–7 months of age were randomly assigned 1:1 to receive an intramuscular injection with M-M-R VaxPro or placebo (solvent only). Randomisation was stratified by site, sex, and prematurity (< 37 weeks of gestation). The infants were followed up in the Danish health registries to detect eczema, asthma-like disease, and allergic rhinoconjunctivitis, the composite outcome of the three diseases being the primary endpoint of the present study.</div><div>The trial was registered in the EU Clinical Trials Registry (2016-001901-18) and ClinicalTrials.gov (NTC03780179).</div></div><div><h3>Findings</h3><div>Between April 2019 and October 2021, 6540 infants were randomised (3266 MMR and 3274 placebo). There was no difference in the rate of atopic disease before 12 months of age between the MMR and placebo group (76 events MMR vs. 77 placebo), resulting in a hazard ratio of 0·98 (95% confidence interval 0·72 to 1·35). Secondary analyses with follow-up until 24 months of age yielded essentially identical results.</div></div><div><h3>Interpretation</h3><div>Based on trial data in 6540 Danish infants randomised to MMR or placebo at 5–7 months, no association between MMR and atopic disease in early childhood was observed.</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"90 3","pages":"Article 106433"},"PeriodicalIF":14.3,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号