Pub Date : 2026-02-01Epub Date: 2026-01-14DOI: 10.1016/j.jinf.2026.106691
Vera Bain, Isabela Silva-Avelar, Simone Correa-Silva, Olivia M. Matsuo, Yingying Zheng, Andreia Rangel-Santos, Guilherme Souza Gonçalves, Thais de Toledo Fink, Priscila Suguita, Juliana Caires O.A. Ferreira, Arthur Eduardo Fernandes Ferreira, Camila Sanson Yoshino de Paula, Camilla Astley, Fernanda Martins, Magda Carneiro-Sampaio, Heloisa Helena de Sousa Marques, Clovis A. Silva, Patricia Palmeira , Maria Fernanda Bádue Pereira
{"title":"Immune profile of T-lymphocytes in pediatric patients recovered of COVID-19: A longitudinal report","authors":"Vera Bain, Isabela Silva-Avelar, Simone Correa-Silva, Olivia M. Matsuo, Yingying Zheng, Andreia Rangel-Santos, Guilherme Souza Gonçalves, Thais de Toledo Fink, Priscila Suguita, Juliana Caires O.A. Ferreira, Arthur Eduardo Fernandes Ferreira, Camila Sanson Yoshino de Paula, Camilla Astley, Fernanda Martins, Magda Carneiro-Sampaio, Heloisa Helena de Sousa Marques, Clovis A. Silva, Patricia Palmeira , Maria Fernanda Bádue Pereira","doi":"10.1016/j.jinf.2026.106691","DOIUrl":"10.1016/j.jinf.2026.106691","url":null,"abstract":"","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"92 2","pages":"Article 106691"},"PeriodicalIF":11.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145991376","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 : 2026-02-01Epub 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":"2026-02-01","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 : 2026-02-01Epub 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":"2026-02-01","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 : 2026-02-01Epub 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":"2026-02-01","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 : 2026-01-01Epub Date: 2025-12-09DOI: 10.1016/j.jinf.2025.106665
Murielle Baltazar , Laura C. Jacques , Teerawit Audshasai , Marie O'Brien , Aras Kadioglu
Objectives
Streptococcus pneumoniae serotype 1 (S1) is a major cause of invasive pneumococcal disease. Despite its high attack rate, S1 exhibits a low carriage prevalence within the population, which raises questions about the relationship between nasopharyngeal carriage and transmission of hypervirulent strains between individuals. We compared the transmission dynamics of S1 to serotypes 2 (S2) and 3 (S3) using a novel model of transmission in adolescent mice.
Methods
Donor “index” mice were intranasally infected with S1, S2, S3 or isogenic pneumolysin-deficient mutants and co-housed with naïve recipient “contact” mice. Three days later, all mice were infected with influenza A virus (IAV). Pneumococcal transmission was analysed during colonisation alone and co-infection with IAV by quantification of the nasal shedding and nasopharyngeal bacterial density in both index and contact mice. The role of the polysaccharide capsule and toxin pneumolysin, as well as biofilm production in shedding and transmission, and the host nasopharyngeal immune response, were investigated.
Results
We show that S1 was shed at significantly greater levels than S2 and S3 in index mice, which led to significantly higher shedding and transmission rates in contact mice. S1 produced less biofilm and a thick capsule that promoted its increased shedding and transmission. Interestingly, pneumococcal acquisition led to pneumolysin-dependant macrophage recruitment in the nasopharynx of contact mice.
Conclusion
Our results show that rapid and high transmission rate of serotype 1 is a key factor for its success in disseminating quickly within the population and causing outbreaks.
{"title":"Hypervirulent serotype 1 pneumococci display high levels of nasal shedding and rapid onward transmission","authors":"Murielle Baltazar , Laura C. Jacques , Teerawit Audshasai , Marie O'Brien , Aras Kadioglu","doi":"10.1016/j.jinf.2025.106665","DOIUrl":"10.1016/j.jinf.2025.106665","url":null,"abstract":"<div><h3>Objectives</h3><div><em>Streptococcus pneumoniae</em> serotype 1 (S1) is a major cause of invasive pneumococcal disease. Despite its high attack rate, S1 exhibits a low carriage prevalence within the population, which raises questions about the relationship between nasopharyngeal carriage and transmission of hypervirulent strains between individuals. We compared the transmission dynamics of S1 to serotypes 2 (S2) and 3 (S3) using a novel model of transmission in adolescent mice.</div></div><div><h3>Methods</h3><div>Donor “index” mice were intranasally infected with S1, S2, S3 or isogenic pneumolysin-deficient mutants and co-housed with naïve recipient “contact” mice. Three days later, all mice were infected with influenza A virus (IAV). Pneumococcal transmission was analysed during colonisation alone and co-infection with IAV by quantification of the nasal shedding and nasopharyngeal bacterial density in both index and contact mice. The role of the polysaccharide capsule and toxin pneumolysin, as well as biofilm production in shedding and transmission, and the host nasopharyngeal immune response, were investigated.</div></div><div><h3>Results</h3><div>We show that S1 was shed at significantly greater levels than S2 and S3 in index mice, which led to significantly higher shedding and transmission rates in contact mice. S1 produced less biofilm and a thick capsule that promoted its increased shedding and transmission. Interestingly, pneumococcal acquisition led to pneumolysin-dependant macrophage recruitment in the nasopharynx of contact mice.</div></div><div><h3>Conclusion</h3><div>Our results show that rapid and high transmission rate of serotype 1 is a key factor for its success in disseminating quickly within the population and causing outbreaks.</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"92 1","pages":"Article 106665"},"PeriodicalIF":11.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745509","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 : 2026-01-01Epub Date: 2025-12-20DOI: 10.1016/j.jinf.2025.106668
Berit Lange , Thomas Theo Brehm , Sandra M. Arend , Miguel Arias-Guillén , Marleen Bakker , Cristina Berastegui , Maaz Babiker , Rawya Charif , Raquel Duarte , Holger Flick , Regina W. Hofland , Joanna Ismail , Daniela Kniepeiss , Jessica Krepel , Nithya Krishnan , Dora L. Kuijpers , Heinke Kunst , Frank van Leth , Visnja Lezaic , Ibai Los-Arcos , Martina Sester
Background
Solid organ transplant (SOT) recipients face elevated tuberculosis risk, yet optimal prevention strategies in low- to medium-incidence regions remain unclear.
Methods
We conducted a multicenter retrospective cohort study of adult SOT recipients transplanted between 2007 and 2012 at 15 European centers, with follow-up through 2018. The primary outcome was microbiologically confirmed post-transplant tuberculosis. Incidence rates were calculated per 100,000 person-years; standardized incidence ratios (SIRs) used World Health Organization country-specific background rates. Cox models assessed risk factors.
Results
Among 5805 patients (median age 51; 62.7% male; 73.9% renal transplants), 33.8% were tested for tuberculosis infection and 10.3% received tuberculosis preventive therapy (TPT). Over 33,785 person-years, 23 patients (0.4%) developed tuberculosis (68.0/100,000 person-years). Highest incidence occurred in patients with positive screening but no TPT (233.8/100,000). Incidence was higher in Southern vs. Central Europe (251.9 vs. 28.7/100,000), with pooled SIRs of 12.8 and 3.1, respectively. Tuberculosis risk was elevated among Southern European recipients (HR 22.9) and those with migration history (HR 2.7).
Conclusion
Tuberculosis risk is increased in European SOT recipients. Regionally adapted prevention strategies, including targeted screening in low-incidence areas and universal screening in higher-incidence regions, are warranted.
背景：实体器官移植（SOT）受者面临更高的结核病风险，但在中低发病率地区的最佳预防策略仍不清楚。方法：我们在欧洲15个中心进行了一项多中心回顾性队列研究，研究对象为2007-2012年间移植的成人SOT受体，随访至2018年。主要结果为微生物学证实的移植后结核。计算每10万人年的发病率；标准化发病率（SIRs）采用世界卫生组织国家特定背景率。Cox模型评估了危险因素。结果：5805例患者（中位年龄51岁，男性62.7%，肾移植73.9%）中，33.8%的患者接受了结核病感染检测，10.3%的患者接受了结核病预防治疗（TPT）。超过33,785人年，23名患者（0.4%）发展为结核病（68.0/100,000人年）。筛查阳性但未接受TPT的患者发病率最高（233.8/10万）。南欧的发病率高于中欧（251.9 vs 28.7/100,000），合并SIRs分别为12.8和3.1。南欧接受者（风险比22.9）和有移民史者（风险比2.7）的结核病风险升高。结论：欧洲SOT受者结核病风险增加。有必要采取适应区域的预防战略，包括在低发病率地区进行有针对性的筛查，在高发病率地区进行普遍筛查。
{"title":"Tuberculosis incidence in solid organ transplant recipients in Europe: A multicenter TBnet cohort study","authors":"Berit Lange , Thomas Theo Brehm , Sandra M. Arend , Miguel Arias-Guillén , Marleen Bakker , Cristina Berastegui , Maaz Babiker , Rawya Charif , Raquel Duarte , Holger Flick , Regina W. Hofland , Joanna Ismail , Daniela Kniepeiss , Jessica Krepel , Nithya Krishnan , Dora L. Kuijpers , Heinke Kunst , Frank van Leth , Visnja Lezaic , Ibai Los-Arcos , Martina Sester","doi":"10.1016/j.jinf.2025.106668","DOIUrl":"10.1016/j.jinf.2025.106668","url":null,"abstract":"<div><h3>Background</h3><div>Solid organ transplant (SOT) recipients face elevated tuberculosis risk, yet optimal prevention strategies in low- to medium-incidence regions remain unclear.</div></div><div><h3>Methods</h3><div>We conducted a multicenter retrospective cohort study of adult SOT recipients transplanted between 2007 and 2012 at 15 European centers, with follow-up through 2018. The primary outcome was microbiologically confirmed post-transplant tuberculosis. Incidence rates were calculated per 100,000 person-years; standardized incidence ratios (SIRs) used World Health Organization country-specific background rates. Cox models assessed risk factors.</div></div><div><h3>Results</h3><div>Among 5805 patients (median age 51; 62.7% male; 73.9% renal transplants), 33.8% were tested for tuberculosis infection and 10.3% received tuberculosis preventive therapy (TPT). Over 33,785 person-years, 23 patients (0.4%) developed tuberculosis (68.0/100,000 person-years). Highest incidence occurred in patients with positive screening but no TPT (233.8/100,000). Incidence was higher in Southern vs. Central Europe (251.9 vs. 28.7/100,000), with pooled SIRs of 12.8 and 3.1, respectively. Tuberculosis risk was elevated among Southern European recipients (HR 22.9) and those with migration history (HR 2.7).</div></div><div><h3>Conclusion</h3><div>Tuberculosis risk is increased in European SOT recipients. Regionally adapted prevention strategies, including targeted screening in low-incidence areas and universal screening in higher-incidence regions, are warranted.</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"92 1","pages":"Article 106668"},"PeriodicalIF":11.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145812290","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 : 2026-01-01Epub Date: 2025-12-18DOI: 10.1016/j.jinf.2025.106667
Jianwen Situ , Tsz Chung Wong , Shusheng Wu , Zhiyu Li , Estie Hon Kiu Shun , Siu Fung Stanley Ho , Cyril Chik Yan Yip , Kelvin Hon Yin Lo , James Yiu Hung Tsoi , Weihui Ma , Andrew Tsz King Lo , Jayden Yiu , Esmond Yan Tik Ng , Ming Yeung Kwong , Christina Yuen Ling Ip , Hiu Laam Chung , Nicholas Foo Siong Chew , Yonghao Liang , Weiwei Mao , Xiaodan Ma , Siddharth Sridhar
Objectives
Rocahepevirus ratti genotype 1 (rHEV), commonly known as rat hepatitis E virus, is a recently identified cause of viral hepatitis. We compared rHEV infections with conventional hepatitis E and measured rHEV seroprevalence in a large diverse human serum cohort.
Methods
Patients with hepatitis (n=2018) were tested for rHEV RNA in the context of a real-world clinical service in Hong Kong. rHEV IgG seroprevalence in various risk groups was measured using a validated immunoassay. Commensal rats were tested for rHEV RNA and sequences were compared with human-derived strains.
Results
From 2017 to 2025, 22 human rHEV infections were identified. Of these, 14 (63·6%) were immunocompromised compared to 22/78 (28·2%) conventional HEV patients (p<0.01). Hepatitis was milder in rHEV patients, but most immunocompromised rHEV patients progressed to chronic infection. Rat-derived rHEV belonged to two subtypes, one of which infected humans. Of 8294 individuals, 57 (0·7%) tested positive for rHEV IgG compared to 551 (6·6%) for HEV IgG. Increasing age predicted rHEV seropositivity (OR:1·03; 95% CI:1·01–1·05); persons with bloodborne pathogens did not exhibit higher rHEV seroprevalence.
Conclusions
rHEV is a sporadic cause of hepatitis in humans with disproportionate clinical significance for immunocompromised hosts. Although clearly linked to rat epizootics, routes of rHEV transmission remain enigmatic.
{"title":"Epidemiology and clinical characteristics of rat hepatitis E virus infection in humans","authors":"Jianwen Situ , Tsz Chung Wong , Shusheng Wu , Zhiyu Li , Estie Hon Kiu Shun , Siu Fung Stanley Ho , Cyril Chik Yan Yip , Kelvin Hon Yin Lo , James Yiu Hung Tsoi , Weihui Ma , Andrew Tsz King Lo , Jayden Yiu , Esmond Yan Tik Ng , Ming Yeung Kwong , Christina Yuen Ling Ip , Hiu Laam Chung , Nicholas Foo Siong Chew , Yonghao Liang , Weiwei Mao , Xiaodan Ma , Siddharth Sridhar","doi":"10.1016/j.jinf.2025.106667","DOIUrl":"10.1016/j.jinf.2025.106667","url":null,"abstract":"<div><h3>Objectives</h3><div><em>Rocahepevirus ratti</em> genotype 1 (rHEV), commonly known as rat hepatitis E virus, is a recently identified cause of viral hepatitis. We compared rHEV infections with conventional hepatitis E and measured rHEV seroprevalence in a large diverse human serum cohort.</div></div><div><h3>Methods</h3><div>Patients with hepatitis (n=2018) were tested for rHEV RNA in the context of a real-world clinical service in Hong Kong. rHEV IgG seroprevalence in various risk groups was measured using a validated immunoassay. Commensal rats were tested for rHEV RNA and sequences were compared with human-derived strains.</div></div><div><h3>Results</h3><div>From 2017 to 2025, 22 human rHEV infections were identified. Of these, 14 (63·6%) were immunocompromised compared to 22/78 (28·2%) conventional HEV patients (p<0.01). Hepatitis was milder in rHEV patients, but most immunocompromised rHEV patients progressed to chronic infection. Rat-derived rHEV belonged to two subtypes, one of which infected humans. Of 8294 individuals, 57 (0·7%) tested positive for rHEV IgG compared to 551 (6·6%) for HEV IgG. Increasing age predicted rHEV seropositivity (OR:1·03; 95% CI:1·01–1·05); persons with bloodborne pathogens did not exhibit higher rHEV seroprevalence.</div></div><div><h3>Conclusions</h3><div>rHEV is a sporadic cause of hepatitis in humans with disproportionate clinical significance for immunocompromised hosts. Although clearly linked to rat epizootics, routes of rHEV transmission remain enigmatic.</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"92 1","pages":"Article 106667"},"PeriodicalIF":11.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145791951","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 : 2026-01-01Epub Date: 2025-12-01DOI: 10.1016/j.jinf.2025.106663
E. Kelly , M. Greenland , P. de Whalley , G.C. Macaulay , P.K. Aley , E. Plested , S. Koleva , J. Cotton , J. Kinch , T. Madupuri , R.C. Read , M. Ramsay , C. Cameron , D.P.J. Turner , P. Heath , P. Connor , K. Cathie , S.N. Faust , I. Banerjee , K. Man , X. Liu
Background
The emergence of SARS-CoV2 variants combined with waning vaccine-induced immunity and breakthrough infections has highlighted the need for booster doses to maintain protection against SARS-CoV2 infection and disease.
Methods
Com-COV3 was a phase II, multicentre, randomised controlled trial, recruiting across 11 UK sites from June 2022 to June 2023, with follow-up visits to February 2024. Healthy 12–15-year-olds who had received a two-30 μg dose BNT162b2 primary regimen at least 90 days previously were randomised 1:1:1:1:1 to receive either BNT162b2 30 μg, BNT162b2 10 μg (adult vaccine formulation), BNT162b2 10 μg (paediatric formulation), NVXCoV2373, or Meningococcal B vaccine (control). The primary objective was to determine if SARS-CoV-2 anti-spike antibody following a 10 μg dose of the adult formulation of BNT162b2 was non-inferior to the paediatric formulation at 28 days post-third vaccination. The last five participants were randomised using a 1:3:3:1:1 ratio to prioritise recruitment to the study groups required for the co-primary endpoint. Although recruitment ceased early, the sample size required to fulfil the primary objective was met.
Findings
281 participants were recruited (mean age 14 years old, 57% female). Adverse reactions were mostly mild-to-moderate. Local reactogenicity was mildest following NVXCoV2373. Frequency of adverse events was similar for both full dose and fractional dose BNT162b2 groups. Four serious adverse events occurred: three in the paediatric and one in the adult 10 μg BNT162b2 group. Immunogenicity of 10 μg BNT162b2 (adult) was both non-inferior and superior to that of 10 μg BNT162b2 (paediatric); adjusted geometric mean ratio (aGMR) anti-spike IgG 1.50 (one-sided 95% CI 1.25 to ∞). Compared with 30 μg BNT162b2, anti-spike IgG at day 28 post-third dose were similar in the 10 μg BNT162b2 (adult) group [aGMR 0.93 (95% CI 0.75–1.14)] and significantly lower in the 10 μg BNT162b2 (paediatric) [aGMR 0.64 (95% CI 0.52–0.78)] and NVXCoV2373 [aGMR 0.77 (95% CI 0.63–0.95)] groups. Compared with 30 μg BNT162b2, levels of neutralising antibodies against Omicron BA.5 and XBB.15 were similar across vaccine groups.
Interpretation
All booster regimens evaluated elicited a robust immune response. 10 μg fractional adult BNT162b2 vaccine demonstrated similar immunogenicity compared with 30 μg BNT162b2 and superior immunogenicity compared with 10 μg paediatric BNT162b2 vaccine. Fractional doses of the adult BNT162b2 vaccine are an alternative to the paediatric formulation for booster campaigns in adolescents.
{"title":"Reactogenicity and immunogenicity following heterologous and homologous third dose COVID-19 vaccination in UK adolescents (Com-COV3): A randomised controlled non-inferiority trial","authors":"E. Kelly , M. Greenland , P. de Whalley , G.C. Macaulay , P.K. Aley , E. Plested , S. Koleva , J. Cotton , J. Kinch , T. Madupuri , R.C. Read , M. Ramsay , C. Cameron , D.P.J. Turner , P. Heath , P. Connor , K. Cathie , S.N. Faust , I. Banerjee , K. Man , X. Liu","doi":"10.1016/j.jinf.2025.106663","DOIUrl":"10.1016/j.jinf.2025.106663","url":null,"abstract":"<div><h3>Background</h3><div>The emergence of SARS-CoV2 variants combined with waning vaccine-induced immunity and breakthrough infections has highlighted the need for booster doses to maintain protection against SARS-CoV2 infection and disease.</div></div><div><h3>Methods</h3><div>Com-COV3 was a phase II, multicentre, randomised controlled trial, recruiting across 11 UK sites from June 2022 to June 2023, with follow-up visits to February 2024. Healthy 12–15-year-olds who had received a two-30 μg dose BNT162b2 primary regimen at least 90 days previously were randomised 1:1:1:1:1 to receive either BNT162b2 30 μg, BNT162b2 10 μg (adult vaccine formulation), BNT162b2 10 μg (paediatric formulation), NVXCoV2373, or Meningococcal B vaccine (control). The primary objective was to determine if SARS-CoV-2 anti-spike antibody following a 10 μg dose of the adult formulation of BNT162b2 was non-inferior to the paediatric formulation at 28 days post-third vaccination. The last five participants were randomised using a 1:3:3:1:1 ratio to prioritise recruitment to the study groups required for the co-primary endpoint. Although recruitment ceased early, the sample size required to fulfil the primary objective was met.</div></div><div><h3>Findings</h3><div>281 participants were recruited (mean age 14 years old, 57% female). Adverse reactions were mostly mild-to-moderate. Local reactogenicity was mildest following NVXCoV2373. Frequency of adverse events was similar for both full dose and fractional dose BNT162b2 groups. Four serious adverse events occurred: three in the paediatric and one in the adult 10 μg BNT162b2 group. Immunogenicity of 10 μg BNT162b2 (adult) was both non-inferior and superior to that of 10 μg BNT162b2 (paediatric); adjusted geometric mean ratio (aGMR) anti-spike IgG 1.50 (one-sided 95% CI 1.25 to ∞). Compared with 30 μg BNT162b2, anti-spike IgG at day 28 post-third dose were similar in the 10 μg BNT162b2 (adult) group [aGMR 0.93 (95% CI 0.75–1.14)] and significantly lower in the 10 μg BNT162b2 (paediatric) [aGMR 0.64 (95% CI 0.52–0.78)] and NVXCoV2373 [aGMR 0.77 (95% CI 0.63–0.95)] groups. Compared with 30 μg BNT162b2, levels of neutralising antibodies against Omicron BA.5 and XBB.15 were similar across vaccine groups.</div></div><div><h3>Interpretation</h3><div>All booster regimens evaluated elicited a robust immune response. 10 μg fractional adult BNT162b2 vaccine demonstrated similar immunogenicity compared with 30 μg BNT162b2 and superior immunogenicity compared with 10 μg paediatric BNT162b2 vaccine. Fractional doses of the adult BNT162b2 vaccine are an alternative to the paediatric formulation for booster campaigns in adolescents.</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"92 1","pages":"Article 106663"},"PeriodicalIF":11.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670432","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 : 2026-01-01Epub Date: 2025-12-15DOI: 10.1016/j.jinf.2025.106666
Yi-Yu Lyu , Yu-Shan Zhang , Jie-Hao Tai , Jun-Li Yan , Wen Huang , Wen-Wen Chu , Min Yang , Qiang Zhou , Yi-Le Wu
Objectives
A prospective multicenter study was conducted to elucidate the phenotypic and genotypic characteristics of carbapenem-resistant Enterobacteriaceae (CRE) colonization and infection strains.
Methods
Strains were collected within one year from ten intensive care units (ICUs) in Anhui Province, China. Antimicrobial susceptibility testing and whole-genome sequencing (WGS) were performed.
Results
Among 310 colonization and 108 infection strains, Klebsiella pneumoniae predominated (74.4%), followed by Escherichia coli (18.4%). Resistance rates were low to tigecycline (2.6%) and colistin (4.2%) and high (>97.9%) to carbapenems, cephalosporins, and β-lactam/β-lactamase inhibitor combinations. Both sequence types (STs) and capsular serotypes showed substantial geographic diversity. ST11 was the predominant ST, while ST15-KL19 (34.4%) was the most frequent combination in colonization and infection strains. Notably, the ST48-KL62 clone was significantly more prevalent in infection strains than in colonization strains. Moreover, 86.6% of strains produced carbapenemases, primarily blaKPC-2 (64.4%), and 1.9% co-produced KPC- and MBL-type enzymes. High-risk E. coli ST167 strains carrying blaNDM-5 were identified. All CRKp carried biosynthetic genes for the siderophore (e.g., fepABCDG, iutA, iroEN). Virulence factors, including iucABCD, irp1/2, ybtAEPQSTUX, and fyuA, were significantly more prevalent in CRKp infection strains. However, ST15-KL19 lacked classic high-virulence factors (e.g., iucABCD, rmpA, rmpA2). Closely related strains were found within and across hospitals, indicating regional spread and intra-hospital transmission.
Conclusions
This study not only characterizes the distinct regional and genomic distribution patterns of CRE but also associates specific clones and virulence determinants with infection risk, thereby providing molecular markers to identify high-risk carriers and facilitate targeted treatment, prevention, and control measures.
{"title":"Phenotypic and genotypic characterization of colonization and infection with carbapenem-resistant Enterobacteriaceae: A prospective cohort study in China","authors":"Yi-Yu Lyu , Yu-Shan Zhang , Jie-Hao Tai , Jun-Li Yan , Wen Huang , Wen-Wen Chu , Min Yang , Qiang Zhou , Yi-Le Wu","doi":"10.1016/j.jinf.2025.106666","DOIUrl":"10.1016/j.jinf.2025.106666","url":null,"abstract":"<div><h3>Objectives</h3><div>A prospective multicenter study was conducted to elucidate the phenotypic and genotypic characteristics of carbapenem-resistant <em>Enterobacteriaceae</em> (CRE) colonization and infection strains.</div></div><div><h3>Methods</h3><div>Strains were collected within one year from ten intensive care units (ICUs) in Anhui Province, China. Antimicrobial susceptibility testing and whole-genome sequencing (WGS) were performed.</div></div><div><h3>Results</h3><div>Among 310 colonization and 108 infection strains, <em>Klebsiella pneumoniae</em> predominated (74.4%), followed by <em>Escherichia coli</em> (18.4%). Resistance rates were low to tigecycline (2.6%) and colistin (4.2%) and high (>97.9%) to carbapenems, cephalosporins, and <em>β</em>-lactam/<em>β-</em>lactamase inhibitor combinations. Both sequence types (STs) and capsular serotypes showed substantial geographic diversity. ST11 was the predominant ST, while ST15-KL19 (34.4%) was the most frequent combination in colonization and infection strains. Notably, the ST48-KL62 clone was significantly more prevalent in infection strains than in colonization strains. Moreover, 86.6% of strains produced carbapenemases, primarily <em>bla</em><sub>KPC-2</sub> (64.4%), and 1.9% co-produced KPC- and MBL-type enzymes. High-risk <em>E. coli</em> ST167 strains carrying <em>bla</em><sub>NDM-5</sub> were identified. All CR<em>Kp</em> carried biosynthetic genes for the siderophore (e.g., <em>fepABCDG</em>, <em>iutA</em>, <em>iroEN</em>). Virulence factors, including <em>iucABCD</em>, <em>irp1/2</em>, <em>ybtAEPQSTUX</em>, and <em>fyuA</em>, were significantly more prevalent in CR<em>Kp</em> infection strains. However, ST15-KL19 lacked classic high-virulence factors (e.g., <em>iucABCD</em>, <em>rmpA</em>, <em>rmpA2</em>). Closely related strains were found within and across hospitals, indicating regional spread and intra-hospital transmission.</div></div><div><h3>Conclusions</h3><div>This study not only characterizes the distinct regional and genomic distribution patterns of CRE but also associates specific clones and virulence determinants with infection risk, thereby providing molecular markers to identify high-risk carriers and facilitate targeted treatment, prevention, and control measures.</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"92 1","pages":"Article 106666"},"PeriodicalIF":11.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145776316","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}
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