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A 2.5D transfer deep learning model based on artificial intelligence for differentiating lymphoma and tuberculous lymphadenitis in HIV/AIDS patients 基于人工智能的2.5D转移深度学习模型在HIV/AIDS患者淋巴瘤与结核性淋巴结炎鉴别中的应用
IF 14.3 1区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-02-06 DOI: 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
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引用次数: 0
Rezafungin in special populations with candidaemia and/or invasive candidiasis Rezafungin适用于念珠菌血症和/或侵袭性念珠菌病的特殊人群。
IF 14.3 1区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-02-05 DOI: 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.
由于剂量-暴露关系和潜在的药物-药物相互作用,在特殊患者群体中,如有器官功能障碍(肝或肾)或肥胖的患者,或老年患者,实现和维持抗真菌药物的治疗性药物暴露可能具有挑战性。在这些人群中可能需要调整剂量以维持治疗效果和/或防止毒性。我们回顾了在患有念珠菌血症和/或侵袭性念珠菌病的特殊人群中抗真菌药物的具体剂量考虑,重点是与棘白菌素有关的抗真菌药物(基于处方信息),然后探讨了第二代棘白菌素rezafungin在治疗这些人群中的效用(基于PubMed和国会摘要检索中目前可用的数据)。现有数据显示,对于患有念珠菌血症/侵袭性念珠菌病的特殊人群,棘珠菌素有时可能需要调整剂量,主要是由于药代动力学暴露减少。根据现有数据,Rezafungin似乎适用于各种特殊人群,不需要调整剂量,包括器官功能障碍或肥胖患者、老年人和危重患者。需要在没有rezafungin数据的人群中进行进一步研究,包括儿童、艾滋病毒感染者、接受ECMO的患者和有潜在神经系统疾病的患者。
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引用次数: 0
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 6个月大时接种麻疹-腮腺炎-风疹疫苗和出生后第一年患特应性疾病的风险:来自丹麦安慰剂对照随机试验的结果
IF 14.3 1区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-02-02 DOI: 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.
背景:在观察性研究中,儿童接种疫苗与特应性疾病有关。然而,结果是相互矛盾的,缺乏随机试验的证据。方法:干预性麻疹-腮腺炎-风疹(MMR)疫苗接种后的特应性疾病是MMR试验的一个预先计划的次要结局,该试验是一项随机、双盲、安慰剂对照试验,在丹麦高收入环境下的6540名丹麦婴儿中进行。在两家医院,5-7个月大的婴儿按1:1的比例随机分配,接受肌肉注射M-M-R VaxPro或安慰剂(仅溶剂)。随机分组按地点、性别和早产(< 37周妊娠)分层。在丹麦健康登记处对婴儿进行随访,以检测湿疹、哮喘样疾病和过敏性鼻结膜炎,这三种疾病的综合结局是本研究的主要终点。该试验已在EU临床试验注册中心(2016-001901-18)和ClinicalTrials.gov (NTC03780179)注册。研究结果:在2019年4月至2021年10月期间,6540名婴儿被随机分组(3266名MMR和3274名安慰剂)。MMR组和安慰剂组12月龄前的特应性疾病发生率没有差异(MMR组76例,安慰剂组77例),导致风险比为0.98(95%可信区间为0.72 ~ 1.35)。随访至24个月的二次分析得出了基本相同的结果。解释:基于6540名丹麦婴儿在5-7个月时随机接受MMR或安慰剂治疗的试验数据,未观察到MMR与幼儿期特应性疾病之间的关联。资助:本试验由丹麦创新基金(VACOP 8089-00019B)资助。
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引用次数: 0
COVID-19 reinfection in pregnancy: Assessment of severity and pregnancy outcomes in England 妊娠期 COVID-19 再感染:英格兰的严重程度和妊娠结局评估。
IF 14.3 1区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-02-01 DOI: 10.1016/j.jinf.2024.106392
Anna A. Mensah , Julia Stowe , Kevin Brown , Jamie LopezBernal , Shamez Ladhani , Nick Andrews , Helen Campbell

Background

Disease severity and pregnancy outcomes following SARS-CoV-2 reinfections in pregnancy are not well understood.

Methods

We linked women aged 18 to 50 years testing positive in the community for COVID-19 between April 2021 and March 2022 to hospital, vaccine and maternal services databases. We compared hospital and intensive care unit (ICU) admission rates following infection and reinfection in pregnant and non-pregnant women, and low birthweight, prematurity and stillbirth in women infected and reinfected during pregnancy.

Results

We identified 68,842 pregnant and 3,915,069 infected non-pregnant women. Hospital admission after SARS-CoV-2 reinfection was more common in pregnancy, especially during the third trimester (aOR= 18.56; 95% CI: 9.46 - 36.42) and was similar following reinfection or primary infection in pregnancy (aOR= 0.82; 95% CI: 0.50 - 1.33). All ICU admissions (n=49) in pregnancy occurred after primary infection with delta. There was no notable difference in adverse pregnancy outcomes after primary infection or reinfection with SARS-CoV-2 during pregnancy.

Conclusion

Pregnant women remain at higher risk of more severe disease during reinfection compared to non-pregnant women yet; hospitalisation and ICU admissions risk were low during the omicron period. The virulence of circulating variants needs to be assessed to guide maternal COVID-19 vaccination programmes against.
背景:妊娠期SARS-CoV-2再感染后的疾病严重程度和妊娠结局尚不清楚。方法:我们将2021年4月至2022年3月期间社区COVID-19检测呈阳性的18至50岁女性与医院、疫苗和孕产妇服务数据库联系起来。我们比较了孕妇和非孕妇感染和再感染后的住院率和重症监护病房(ICU)住院率,以及妊娠期感染和再感染妇女的低出生体重、早产和死胎率。结果:我们确定了68,842名孕妇和3,915,069名感染的非孕妇。SARS-CoV-2再感染后住院在妊娠期更为常见,尤其是在妊娠晚期(aOR= 18.56;95% CI: 9.46 ~ 36.42),妊娠期再感染或原发感染后相似(aOR= 0.82;95% ci: 0.50 - 1.33)。所有妊娠期ICU住院病例(n=49)均发生在原发性感染delta后。妊娠期首次感染和再次感染SARS-CoV-2后的不良妊娠结局无显著差异。结论:与未怀孕妇女相比,孕妇在再感染期间仍有更高的严重疾病风险;住院和ICU入院风险低。需要评估流行变体的毒力,以指导孕产妇预防COVID-19疫苗接种规划。
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引用次数: 0
Early circulating biomarkers to predict plasma leakage in dengue fever 预测登革热血浆渗漏的早期循环生物标志物。
IF 14.3 1区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-02-01 DOI: 10.1016/j.jinf.2024.106401
Samaneh Moallemi , Nicodemus Tedla , Chathurani Sigera , Praveen Weeratunga , Deepika Fernando , Senaka Rajapakse , Andrew R. Lloyd , Chaturaka Rodrigo

Background

Dengue, a mosquito-borne viral infection, poses a rapidly growing burden, particularly in low- and middle-income countries. Without early identification of patients at risk of severe outcomes (dengue haemorrhagic fever, severe dengue, and plasma leakage- the latter typically occurring on days 5–7 of illness), untriaged admissions lead to hospital overcrowding and suboptimal care.

Methods

This nested case-control study compared early-stage plasma samples (within the first 96 hours of fever) from dengue patients with and without plasma leakage. Thirty-four potential biomarkers, selected through systematic review, were tested on a multiplex bead-based immunoassay platform. Subgroup analysis stratified patients by primary or secondary dengue infection.

Findings

A total of 228 patient samples (114 had plasma leakage) were tested. Elevated Vascular cell adhesion molecule-1 (OR:3.289, 95% CI: 1.090–9.926, p<0.05), and Interleukin 33 receptor levels (OR: 2.677, 95% CI: 1.244–5.856, p<0.05) were associated with an increased risk of plasma leakage while eotaxin-1 was associated with a decreased risk (OR: 0.166, 95% CI: 0.057–0.483, p<0.05). When adjusted for prior dengue exposure, additional biomarkers (C-X-C motif chemokine 11, serum amyloid A) were also associated with plasma leakage.

Interpretation

Plasma leakage in dengue, being more objectively measurable than other severe outcomes, offers a reliable endpoint for biomarker studies. Identifying biomarkers that predict plasma leakage strengthens the evidence base in dengue research. These biomarkers could improve clinical assessment and patient care in dengue cases.
背景:登革热是一种蚊媒病毒感染,造成的负担迅速增加,特别是在低收入和中等收入国家。如果不能及早发现有严重后果风险的患者(登革出血热、重症登革热和血浆泄漏——后者通常发生在发病后的第5-7天),未经分类的入院会导致医院过度拥挤和护理欠佳。方法:本巢式病例对照研究比较了伴有和不伴有血浆渗漏的登革热患者的早期血浆样本(发热最初96小时内)。通过系统评价选择34种潜在的生物标志物,在多重头部免疫分析平台上进行测试。亚组分析按原发性或继发性登革热感染对患者进行分层。结果:共检测了228例患者样本(114例有血浆泄漏)。血管细胞黏附分子-1升高(OR:3.289, 95% CI: 1.090-9.926)解释:登革热患者血浆渗漏比其他严重结局更客观可测量,为生物标志物研究提供了可靠的终点。识别预测血浆泄漏的生物标志物加强了登革热研究的证据基础。这些生物标志物可以改善登革热病例的临床评估和患者护理。资助:澳大利亚国家卫生和医学研究委员会(资助号:1173666),斯里兰卡科伦坡大学[资助号:AP /3/2/2017/ CG /25]。
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引用次数: 0
Immunogenicity, safety, and reactogenicity of concomitant administration of the novavax vaccine against Omicron XBB.1.5 (NVX-CoV2601) and a 20-valent pneumococcal conjugate vaccine in adults aged ≥60 years: A randomised, double-blind, placebo-controlled, non-inferiority trial ≥60岁成人同时使用Novavax抗Omicron XBB.1.5 (NVX-CoV2601)疫苗和一种20价肺炎球菌结合疫苗的免疫原性、安全性和反应原性:一项随机、双盲、安慰剂对照、非效性试验
IF 14.3 1区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-02-01 DOI: 10.1016/j.jinf.2024.106405
Anselm Jorda , Marlene Prager , Lena Pracher , Patrick Haselwanter , Matthias Jackwerth , Valentin al Jalali , Erdem Yildiz , Amelie Leutzendorff , Maria Weber , Schermin Yourieva , Paula Kammerer , Theresa Pecho , Alice Decaminada , Lena Ederer , Ursula Wiedermann , Lukas Weseslindtner , Monika Redlberger-Fritz , Felix Bergmann , Markus Zeitlinger

Objectives

There is conflicting evidence as to whether the combined administration of two vaccines can lead to poorer immunogenicity and reactogenicity. The co-administration of the Omicron-adapted COVID-19 vaccine from Novavax (NVX-CoV2601) and a 20-valent pneumococcal conjugate vaccine (PCV20) has not been previously investigated.

Methods

In this randomised, double-blind, placebo-controlled, non-inferiority trial, immunocompetent participants aged ≥60 years were randomised in a 1:1:1:1 ratio to four groups: NVX-CoV2601 plus PCV20 (combination group); NVX-CoV2601 plus placebo (NVX-only group); PCV20 plus placebo (PCV20-only group); or placebo plus placebo (placebo group). The primary outcome was Omicron-specific anti-spike protein IgG ELISA units at day 28 in the combination group compared with the NVX-only group. Non-inferiority was established if the lower limit of the two-sided 95% CI of the geometric mean titre ratio was above the non-inferiority margin of 0.67. Secondary outcomes included anti-pneumococcal capsular polysaccharide (PCP) IgG ELISA units. Solicited local and systemic adverse events were collected for 7 days after vaccination. This study was registered with ClinicalTrials.gov, number NCT05767606, and the EU Clinical Trials Register, EudraCT number 2022–004118-12.

Results

All 256 randomised participants completed the study. The baseline characteristics were similar in the four groups. Overall, the median age was 64 (IQR 61 to 69) and 105 (41%) of 256 were male. At day 28, the geometric mean anti-spike protein IgG ELISA units were 534 U/mL (95% CI 432–660) in the combination group and 556 U/mL (95% CI 460–672) in the NVX-only group, resulting in a geometric mean titre ratio of 0.96 (95% CI 0.73–1.27), thereby meeting the criteria for non-inferiority.
Anti-PCP IgG ELISA units at day 28 were 507 U/mL (95% CI 416–619) in the combination group and 592 U/mL (95% CI 485–723) in the PCV20-only group. Local and systemic reactogenicity was similar in the three active treatment groups. No safety concerns or serious adverse events were observed.

Conclusions

Immunogenicity following co-administration of NVX-CoV2601 with PCV20 was non-inferior to administration of NVX-CoV2601 alone. Given the similar safety and reactogenicity profile, our findings may help to overcome concerns about concomitant vaccination and pave the way for combination vaccines.

Funding

Novavax.
目的:关于联合接种两种疫苗是否会导致较差的免疫原性和反应原性,目前存在相互矛盾的证据。此前尚未对 Novavax 公司生产的 Omicron 适应型 COVID-19 疫苗(NVX-CoV2601)和 20 价肺炎球菌结合疫苗(PCV20)的联合接种进行过研究:在这项随机、双盲、安慰剂对照、非劣效性试验中,年龄≥60岁的免疫功能正常者按1:1:1:1的比例被随机分为四组:NVX-CoV2601加PCV20(联合组);NVX-CoV2601加安慰剂(仅NVX组);PCV20加安慰剂(仅PCV20组);或安慰剂加安慰剂(安慰剂组)。主要结果是,与纯 NVX 组相比,联合组在第 28 天时的 Omicron 特异性抗尖头蛋白 IgG ELISA 单位。如果几何平均滴度比的双侧 95% CI 的下限高于 0.67 的非劣效边际,则确定为非劣效性。次要结果包括抗肺炎球菌球囊多糖(PCP)IgG ELISA 单位。疫苗接种后 7 天内收集了局部和全身不良反应。该研究已在 ClinicalTrials.gov 注册,注册号为 NCT05767606,并在欧盟临床试验注册中心注册,注册号为 EudraCT 2022-004118-12:所有 256 名随机参与者均完成了研究。四组参与者的基线特征相似。总体而言,中位年龄为 64 岁(IQR 61 至 69),256 名参与者中有 105 名男性(41%)。第28天时,联合组的几何平均抗尖峰蛋白IgG ELISA单位为534U/mL(95% CI 432-660),纯NVX组为556U/mL(95% CI 460-672),几何平均滴度比为0.96(95% CI 0.73-1.27),因此符合非劣效性标准。第28天时,联合组的抗五氯酚钠IgG ELISA单位为507U/mL(95% CI 416-619),纯PCV20组为592U/mL(95% CI 485-723)。三个活性治疗组的局部和全身反应性相似。未发现安全问题或严重不良事件:结论:NVX-CoV2601与PCV20联合用药后的免疫原性并不比单独使用NVX-CoV2601差。考虑到相似的安全性和致病反应,我们的研究结果可能有助于克服对同时接种疫苗的担忧,并为联合疫苗的开发铺平道路:Novavax.
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引用次数: 0
Dasabuvir: An FDA-approved drug inhibiting poxvirus transmission by targeting both migrasome formation and extracellular enveloped virus production 达沙布韦:fda批准的一种药物,通过靶向迁移体形成和细胞外包膜病毒产生抑制痘病毒传播。
IF 14.3 1区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-02-01 DOI: 10.1016/j.jinf.2024.106403
Ting Xu, Daoqun Li, Junwen Luan, Leiliang Zhang
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引用次数: 0
Microbiotoxicity: A call to arms for cross-sector protection of the human microbiome 微生物毒性:呼吁跨部门保护人类微生物群。
IF 14.3 1区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-02-01 DOI: 10.1016/j.jinf.2025.106408
Anastasia A. Theodosiou , Paul-Enguerrand Fady , Natalie Bennett, Robert C. Read, Debby Bogaert, Christine E. Jones
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引用次数: 0
Identifying key weather factors influencing human salmonellosis: A conditional incidence analysis in England, Wales, and the Netherlands 确定影响人类沙门氏菌病的关键天气因素:英格兰、威尔士和荷兰的条件发病率分析。
IF 14.3 1区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-02-01 DOI: 10.1016/j.jinf.2025.106410
Laura C. González Villeta , Linda Chanamé Pinedo , Alasdair J.C. Cook , Eelco Franz , Theo Kanellos , Lapo Mughini-Gras , Gordon Nichols , Roan Pijnacker , Joaquin M. Prada , Christophe Sarran , Matt Spick , Jessica Wu , Giovanni Lo Iacono

Objectives

This study aimed to improve the understanding of seasonal incidence pattern observed in salmonellosis by identifying the most influential weather factors, characterising the nature of this association, and assessing whether it is geographically restricted or generalisable to other locations.

Methods

A novel statistical model was employed to estimate the incidence of salmonellosis conditional to various combinations of three simultaneous weather factors from 14 available. The analysis utilised daily salmonellosis cases reported from 2000 to 2016 along with detailed spatial and temporal weather data from England and Wales, and the Netherlands.

Results

The incidence simulated from weather data effectively reproduced empirical incidence patterns in both countries. Key weather factors associated with increased salmonellosis cases, regardless of geographical location, included air temperature (>10 ⁰C), relative humidity, reduced precipitation, dewpoint temperature (7–10 ⁰C), and longer day lengths (12–15 h). Other weather factors, such as air pressure, wind speed, temperature amplitude, and sunshine duration, showed limited or no association with the empirical data. The model was suitable for the Netherlands, despite a difference in case ascertainment.

Conclusions

The conditional incidence is a simple and transparent method readily applicable to other countries and weather scenarios that provides a detailed description of salmonellosis cases conditional on local weather factors.
目的:本研究旨在通过确定最具影响力的天气因素,描述这种关联的性质,并评估其是否受地理限制或可推广到其他地点,提高对沙门氏菌病季节性发病率模式的理解。方法:采用一种新的统计模型来估计沙门氏菌病的发病率,该发病率取决于14个可用的三个同时发生的天气因素的不同组合。该分析利用了2000年至2016年每天报告的沙门氏菌病病例,以及来自英格兰、威尔士和荷兰的详细时空天气数据。结果:根据天气数据模拟的发病率有效地再现了两国的经验发病率模式。无论地理位置如何,与沙门氏菌病病例增加相关的关键天气因素包括气温(10摄氏度)、相对湿度、降水减少、露点温度(7-10摄氏度)和日长(12-15小时)。其他天气因子,如气压、风速、温度振幅和日照时数,与经验数据的关联有限或无关联。尽管在病例确定方面存在差异,但该模型适用于荷兰。结论:条件发生率法是一种简单、透明、易于适用于其他国家和天气情景的方法,可根据当地天气因素对沙门氏菌病病例进行详细描述。
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引用次数: 0
The increasing prevalence of Japanese spotted fever in China: A dominant rickettsial threat 日本斑疹热在中国日益流行:立克次体的主要威胁。
IF 14.3 1区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-02-01 DOI: 10.1016/j.jinf.2024.106387
Zhongqiu Teng , Xue Zhang , Na Zhao, Lupeng Dai, Xianxian Zhang, Ling Han, Tian Qin
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引用次数: 0
期刊
Journal of Infection
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