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Clinical and Economic Outcomes Associated with Complicated Urinary Tract Infections Caused by Carbapenem-resistant Enterobacterales in Patients Admitted to a Referral Center in Lima, Peru. 秘鲁利马一家转诊中心收治的患者中碳青霉烯耐药肠杆菌引起的复杂尿路感染的临床和经济结果
IF 2.9 Q2 INFECTIOUS DISEASES Pub Date : 2025-09-01 Epub Date: 2025-09-15 DOI: 10.3947/ic.2025.0022
Annel Rojas-Alvarado, Karim Dioses-Diaz, Roxana Sandoval-Ahumada, Giancarlo Pérez-Lazo
<p><strong>Background: </strong>Urinary tract infections (UTIs) affect 150 million people annually, with increased incidence among individuals over 60 years of age. Complicated UTIs (cUTIs), frequently caused by multidrug-resistant pathogens such as <i>Escherichia coli</i> and <i>Klebsiella pneumoniae</i>, present therapeutic challenges due to host factors and anatomical abnormalities. Carbapenem-resistant <i>Enterobacterales</i> (CRE) infections are of particular concern as they are associated with higher mortality and healthcare costs. This study aimed to compare the clinical and economic outcomes of cUTIs caused by CRE and carbapenem-susceptible <i>Enterobacterales</i> (CSE) at a referral hospital in Lima, Peru.</p><p><strong>Materials and methods: </strong>This retrospective cohort study included 200 patients with cUTI admitted to the emergency department. Patients were categorized into two groups: those with CRE-cUTI and those with CSE-cUTI. Data were collected from electronic medical records, including demographics, comorbidities, antimicrobial treatments, and clinical outcomes, with a primary focus on the 30-day mortality. Kaplan-Meier survival curves, log-rank tests, and generalized linear models were used to assess mortality risk factors. Adjusted relative risks (aRRs) were reported with 95% confidence intervals (CI). The final multivariate model was adjusted for three variables selected based on epidemiological relevance: carbapenem resistance, septic shock on admission, and Charlson comorbidity index. Hospitalization costs were calculated based on the hospital's fee schedule, whereas antibiotic costs were estimated by multiplying the unit cost of each antimicrobial by the total number of vials used for cUTI treatment.</p><p><strong>Results: </strong>Twenty-one patients with CRE-cUTI and 179 with CSE-cUTI were enrolled. Third-generation cephalosporins and carbapenems were the most frequently used empirical antibiotics. Inappropriate empirical therapy was higher in the CRE group (76.2% <i>vs.</i> 51.4%, <i>P</i>=0.031). Among the CRE isolates, <i>bla</i><sub>NDM</sub>, <i>bla</i><sub>KPC</sub>, and <i>bla</i><sub>OXA-48</sub> were identified. The targeted therapies included amikacin and colistin. The 30-day mortality rate was significantly higher in the CRE group than in the CSE group (38.1% <i>vs.</i> 11.7%, <i>P</i>=0.004). Multivariate analysis revealed that an increased Charlson comorbidity index (aRR 1.18; 95% CI, 1.08-1.30; <i>P</i><0.001), septic shock on admission (aRR 3.57, 95% CI, 1.85-6.88; <i>P</i><0.001), and CRE infection (aRR 2.19, 95% CI, 1.16-4.16; <i>P</i>=0.015) were significant predictors of mortality. Hospital stay costs were also higher in the CRE group ($4691.6 <i>vs.</i> $2920.9; <i>P</i>=0.032).</p><p><strong>Conclusion: </strong>Patients with cUTI caused by CRE experienced significantly higher 30-day mortality and hospital costs than those with cUTI caused by CSE. Effective prevention and management strategies a
背景:尿路感染(uti)每年影响1.5亿人,60岁以上人群的发病率增加。复杂性尿路感染(cUTIs)通常由多重耐药病原体如大肠杆菌和肺炎克雷伯菌引起,由于宿主因素和解剖异常,给治疗带来了挑战。碳青霉烯耐药肠杆菌(CRE)感染尤其令人担忧,因为它们与较高的死亡率和医疗费用相关。本研究旨在比较秘鲁利马一家转诊医院由CRE和碳青霉烯敏感肠杆菌(CSE)引起的cUTIs的临床和经济结果。材料和方法:本回顾性队列研究纳入急诊科收治的200例cUTI患者。患者分为两组:CRE-cUTI组和CSE-cUTI组。从电子病历中收集数据,包括人口统计数据、合并症、抗菌治疗和临床结果,主要关注30天死亡率。Kaplan-Meier生存曲线、log-rank检验和广义线性模型用于评估死亡危险因素。校正相对危险度(arr)以95%置信区间(CI)报告。根据流行病学相关性选择三个变量:碳青霉烯类耐药性、入院时感染性休克和Charlson合并症指数,对最终的多变量模型进行调整。住院费用是根据医院的收费表计算的,而抗生素费用是通过将每种抗菌素的单位成本乘以用于cUTI治疗的小瓶总数来估计的。结果:CRE-cUTI患者21例,CSE-cUTI患者179例。第三代头孢菌素和碳青霉烯类是最常用的经验性抗生素。CRE组经验治疗不当发生率较高(76.2%比51.4%,P=0.031)。CRE分离株中鉴定出blaNDM、blaKPC和blaOXA-48。靶向治疗包括阿米卡星和粘菌素。CRE组的30天死亡率显著高于CSE组(38.1%比11.7%,P=0.004)。多变量分析显示,Charlson合病指数升高(aRR 1.18; 95% CI, 1.08-1.30; PPP=0.015)是死亡率的重要预测因子。CRE组住院费用也较高(4691.6美元vs 2920.9美元;P=0.032)。结论:CRE所致cUTI患者的30天死亡率和住院费用明显高于CSE所致cUTI患者。有效的预防和管理策略对于改善CRE-cUTIs的预后和减轻经济负担至关重要。
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引用次数: 0
Response to Skin Abscesses by Community-Associated Methicillin-Resistant Staphylococcus aureus: Cases to Raise Awareness. 社区相关耐甲氧西林金黄色葡萄球菌对皮肤脓肿的反应:病例提高认识。
IF 2.9 Q2 INFECTIOUS DISEASES Pub Date : 2025-09-01 Epub Date: 2025-05-30 DOI: 10.3947/ic.2025.0037
Sudip Bhattacharya
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引用次数: 0
Pneumococcal Vaccination in Korean Adults: 2025 Recommendations by the Korean Society of Infectious Diseases. 韩国成人肺炎球菌疫苗接种:韩国传染病学会2025建议
IF 2.9 Q2 INFECTIOUS DISEASES Pub Date : 2025-09-01 Epub Date: 2025-09-04 DOI: 10.3947/ic.2025.0042
Joon Young Song, Ki Tae Kwon, Wan Beom Park, Ji Yun Noh, Sun Hee Park, Eun Ju Choo, Min Joo Choi, Jun Yong Choi, Jung Yeon Heo, Won Suk Choi

The 20-valent pneumococcal conjugate vaccine (PCV20) was approved by the Korean Ministry of Food and Drug Safety in October 2024. Despite the ongoing national immunization programs that include pneumococcal conjugate vaccines for children and 23-valent pneumococcal polysaccharide vaccine (PPSV23) for adults, the burden of invasive pneumococcal disease and pneumococcal community-acquired pneumonia remains high among the elderly and high-risk adults. Serotypes 3 and 19A, both included in 13-valent pneumococcal conjugate vaccine (PCV13), continue to be the most prevalent serotypes, and infections caused by non-PCV13 serotypes have increased. Given the need to broaden serotype coverage and simplify vaccination strategies, the Korean Society of Infectious Diseases recommends either a single dose of PCV20 or sequential vaccination with 15-valent pneumococcal conjugate vaccine followed by PPSV23 for adults aged 65 years and older, and for high-risk adults aged 19-64 years. These recommendations are based on immunogenicity, safety, and cost-effectiveness data from recent clinical trials. Vaccine selection, dosing intervals, and schedules should be determined according to individual underlying medical conditions and previous vaccination history to optimize protection against pneumococcal disease in the adult population.

20价肺炎球菌结合疫苗(PCV20)于2024年10月获得食品医药品安全处的批准。尽管正在进行的国家免疫规划包括儿童肺炎球菌结合疫苗和成人23价肺炎球菌多糖疫苗(PPSV23),但在老年人和高危成年人中,侵袭性肺炎球菌疾病和肺炎球菌社区获得性肺炎的负担仍然很高。包括在PCV13中的血清型3和19A仍然是最普遍的血清型,由非PCV13血清型引起的感染有所增加。考虑到扩大血清型覆盖范围和简化疫苗接种策略的需要,韩国传染病学会建议65岁及以上的成年人和19-64岁的高危成年人接种单剂PCV20或连续接种PCV15后再接种PPSV23。这些建议是基于最近临床试验的免疫原性、安全性和成本效益数据。疫苗的选择、剂量间隔和时间表应根据个人潜在的医疗条件和以前的疫苗接种史来确定,以优化对成人肺炎球菌疾病的保护。
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引用次数: 0
Clinical Burden of Pediatric Influenza A and B in Malaysia: Outcomes and Resource Utilization in A Tropical Setting. 马来西亚儿童甲型和乙型流感的临床负担:热带环境下的结果和资源利用。
IF 2.9 Q2 INFECTIOUS DISEASES Pub Date : 2025-09-01 Epub Date: 2025-09-11 DOI: 10.3947/ic.2025.0069
Vishnu Arvindran Chandra Mohan, Chuin-Hen Liew, Kah Kee Tan, Naveen Nair Gangadaran, Pon Ling Lau, Syaniza Shaharudin, Yasothai Chandran, Asuwani Maran, Farah Nuruliayana A Nazri, Hui Yi Lim, Xiang Lin Cheng, Muhammad Ihsan Roslan, Joanne Pereira, Nur Ainaa Najwa Razali, Marlindawati Mohd Ali, David Chun-Ern Ng

Background: Influenza is a leading cause of pediatric respiratory illness globally, yet comparative data on influenza A and B in tropical regions remain scarce. This study aimed to compare clinical features, healthcare utilization, and outcomes in children hospitalized with laboratory-confirmed influenza A and B.

Materials and methods: We conducted a retrospective cross-sectional study of children aged ≤12 years hospitalized with laboratory-confirmed influenza at a tertiary referral centre from May 2022 to December 2023. Influenza diagnosis was established using antigen-based detection via direct fluorescent antibody testing. Demographics, clinical features, laboratory results, interventions received, and patient outcomes were analyzed.

Results: Among 177 hospitalized children, 116 (65.5%) had influenza A and 61 (34.5%) had influenza B. Seizures were significantly more common in influenza A (27.6% vs. 3.3%, P<0.001). Influenza B was associated with higher rates of diarrhea (31.1% vs. 14.7%, P=0.010) and signs of respiratory distress (tachypnea: 42.6% vs. 26.7%, P=0.031; chest recessions: 41.0% vs. 25.0%, P=0.028; adventitious breath sounds: 45.9% vs. 29.3%, P=0.028). Children with influenza B more frequently required non-invasive ventilation (13.1% vs. 3.4%, P=0.015), and intravenous fluids (70.5% vs. 55.2%, P=0.048). Median hospital stay was longer in influenza B (3 vs. 2 days, P=0.008).

Conclusion: Influenza A was more frequently associated with neurologic manifestations, whereas influenza B showed a higher prevalence of lower respiratory and gastrointestinal symptoms and required greater supportive care. These findings highlight the distinct clinical profiles of influenza A and B and their implications for healthcare resource utilization.

背景:流感是全球儿童呼吸道疾病的主要原因,但热带地区甲型和乙型流感的比较数据仍然很少。本研究旨在比较甲型和乙型实验室确诊流感住院儿童的临床特征、医疗保健利用和结局。材料和方法:我们对2022年5月至2023年12月在三级转诊中心实验室确诊流感住院的≤12岁儿童进行了回顾性横断面研究。通过直接荧光抗体检测,建立基于抗原的流感诊断方法。分析了人口统计学、临床特征、实验室结果、接受的干预措施和患者结果。结果:177例住院患儿中,甲型流感患儿116例(65.5%),乙型流感患儿61例(34.5%)。甲型流感患儿癫痫发作(27.6%比3.3%,P比14.7%,P=0.010)和呼吸窘迫症状(呼吸急促:42.6%比26.7%,P=0.031;胸部衰退:41.0%比25.0%,P=0.028;呼吸音:45.9%比29.3%,P=0.028)更为常见。乙型流感患儿更频繁地需要无创通气(13.1%比3.4%,P=0.015)和静脉输液(70.5%比55.2%,P=0.048)。乙型流感患者的中位住院时间更长(3天对2天,P=0.008)。结论:甲型流感更常与神经系统症状相关,而乙型流感则表现出更高的下呼吸道和胃肠道症状,需要更多的支持治疗。这些发现突出了甲型和乙型流感的不同临床特征及其对医疗资源利用的影响。
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引用次数: 0
Albumin Continues to Engender Debate. 白蛋白继续引发争论。
IF 2.9 Q2 INFECTIOUS DISEASES Pub Date : 2025-09-01 DOI: 10.3947/ic.2025.0110
Dae Won Park
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引用次数: 0
Migration and the Necessity of Real-Time Locating Systems in Infection Control. 迁移和实时定位系统在感染控制中的必要性。
IF 2.9 Q2 INFECTIOUS DISEASES Pub Date : 2025-09-01 Epub Date: 2025-07-23 DOI: 10.3947/ic.2025.0023
Dalmacito A Cordero
{"title":"Migration and the Necessity of Real-Time Locating Systems in Infection Control.","authors":"Dalmacito A Cordero","doi":"10.3947/ic.2025.0023","DOIUrl":"10.3947/ic.2025.0023","url":null,"abstract":"","PeriodicalId":51616,"journal":{"name":"Infection and Chemotherapy","volume":" ","pages":"438-439"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12511756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Response to Use of a Real-Time Locating System in Infection Control. 对感染控制中使用实时定位系统的反应。
IF 2.9 Q2 INFECTIOUS DISEASES Pub Date : 2025-09-01 Epub Date: 2025-07-23 DOI: 10.3947/ic.2024.0147
Sudip Bhattacharya
{"title":"Response to Use of a Real-Time Locating System in Infection Control.","authors":"Sudip Bhattacharya","doi":"10.3947/ic.2024.0147","DOIUrl":"10.3947/ic.2024.0147","url":null,"abstract":"","PeriodicalId":51616,"journal":{"name":"Infection and Chemotherapy","volume":" ","pages":"436-437"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12511752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Touch Me Not! Exploring the Devastating Stigma on People Living with HIV. 别碰我!探索艾滋病毒感染者的毁灭性耻辱。
IF 2.9 Q2 INFECTIOUS DISEASES Pub Date : 2025-09-01 Epub Date: 2025-07-23 DOI: 10.3947/ic.2025.0055
Dalmacito A Cordero
{"title":"Touch Me Not! Exploring the Devastating Stigma on People Living with HIV.","authors":"Dalmacito A Cordero","doi":"10.3947/ic.2025.0055","DOIUrl":"10.3947/ic.2025.0055","url":null,"abstract":"","PeriodicalId":51616,"journal":{"name":"Infection and Chemotherapy","volume":" ","pages":"444-445"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12511751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Post-marketing Surveillance of a Live Attenuated Herpes Zoster Vaccine (SKYZoster®) in Adults Aged ≥50 Years in Korea. 韩国≥50岁成人减毒带状疱疹活疫苗(SKYZoster®)上市后监测
IF 2.9 Q2 INFECTIOUS DISEASES Pub Date : 2025-09-01 Epub Date: 2025-08-13 DOI: 10.3947/ic.2025.0036
Sun Heom Baik, Hyeeun Lee, Hyunjeong Kim, Hye Young Kim

Background: Herpes zoster (HZ; shingles) results from the reactivation of the varicella-zoster virus following a primary infection with varicella (chickenpox) in earlier life. Vaccination against HZ has been effective in preventing the disease. SKYZoster, a live attenuated zoster vaccine developed in Korea, was first licensed in Korea on September 29, 2017, and subsequently approved in Thailand (May 20, 2020) and Malaysia (December 13, 2022). This post-marketing surveillance (PMS) study aimed to assess and evaluate the safety profile of SKYZoster in adults who received the vaccine during a 4-year period in Korea.

Materials and methods: This PMS study was an open, non-comparative, multi-center study conducted from September 29, 2017, to September 28, 2021. Adults aged ≥50 years who were vaccinated with SKYZoster in Korea were enrolled in this study. Adverse events (AEs) that occurred during the first 42 days after vaccination were recorded and classified using the System Organ Class and Preferred Term using MedDRA 24.1.

Results: A total of 651 participants were included in the safety evaluation. Participants had a mean age of 62.15±8.59 years, with 55.30% of the participants being female and 1.69% (11 participants) had an allergy history. Overall, 121 AEs were reported in 76 participants (11.67%), including 51 adverse drug reactions (ADRs) in 37 participants (5.68%). Most AEs (120/121; 99.17%) were mild in severity and no serious AEs were reported. The most frequently reported ADRs were injection site reactions including vaccination site pain (2.92%), erythema (1.08%), and pruritus (0.46%). Multiple logistic regression analysis identified that allergy history (P=0.0001), concomitant medication use (P=0.0179) and current medical history (P=0.0351) were significantly associated with an increased AE incidence.

Conclusion: Over a 4-year post-marketing safety evaluation period, SKYZoster exhibited an acceptable safety profile in routine clinical practice in Korea. The vaccine was well-tolerated, with no serious adverse event reported, reaffirming its role in preventing HZ in adults.

背景:带状疱疹(HZ;带状疱疹)是由水痘-带状疱疹病毒在早期感染水痘(水痘)后重新激活引起的。针对HZ的疫苗接种在预防该病方面是有效的。SKYZoster是一种由韩国研发的减毒带状疱疹活疫苗,于2017年9月29日首次在韩国获得许可,随后在泰国(2020年5月20日)和马来西亚(2022年12月13日)获得批准。这项上市后监测(PMS)研究旨在评估和评价SKYZoster在韩国4年期间接种该疫苗的成人的安全性。材料和方法:本PMS研究是一项开放、非比较的多中心研究,于2017年9月29日至2021年9月28日进行。在韩国接种SKYZoster疫苗的年龄≥50岁的成年人被纳入本研究。记录接种后前42天发生的不良事件(ae),并使用MedDRA 24.1使用系统器官分类和首选术语进行分类。结果:共有651名参与者被纳入安全性评价。参与者平均年龄为62.15±8.59岁,女性占55.30%,有过敏史的占1.69%(11人)。76例(11.67%)报告了121例不良反应,37例(5.68%)报告了51例药物不良反应(adr)。大多数ae(120/121, 99.17%)为轻度,无严重ae报告。最常见的不良反应是注射部位反应,包括接种部位疼痛(2.92%)、红斑(1.08%)和瘙痒(0.46%)。多元logistic回归分析发现,过敏史(P=0.0001)、合并用药史(P=0.0179)和当前病史(P=0.0351)与AE发病率增加有显著相关性。结论:经过4年的上市后安全性评估期,SKYZoster在韩国的常规临床实践中表现出可接受的安全性。该疫苗耐受性良好,无严重不良事件报告,重申了其在预防成人HZ中的作用。
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引用次数: 0
Effectiveness and Safety of Bictegravir/Emtricitabine/Tenofovir Alafenamide in People with HIV in Korea: 24-Month Data from BICSTaR. BICSTaR的24个月数据显示,比替格拉韦/恩曲他滨/替诺福韦在韩国HIV感染者中的有效性和安全性
IF 2.9 Q2 INFECTIOUS DISEASES Pub Date : 2025-09-01 Epub Date: 2025-09-09 DOI: 10.3947/ic.2025.0061
Yeon-Sook Kim, Jun Yong Choi, Dae Won Park, Shin-Woo Kim, Tae Hyong Kim, Julie Ryu, Rebecca Harrison, Jeong-A Lee, Flora Park, Sun Hee Lee

BICtegravir Single Tablet Regimen is a multi-national observational cohort study evaluating the effectiveness and safety of bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) in people with human immunodeficiency virus. We present 24-month data from participants in Korea. Eighty-eight participants (36 treatment-naïve [TN], 52 treatment-experienced [TE]) were included. At 24 months, 100% (29/29) of TN and 100% (37/37) of TE participants had HIV-1 RNA <50 copies/mL (missing=excluded analysis). BIC/FTC/TAF persistence was 100% (33/33) and 96.1% (49/51) in TN and TE participants, respectively. Drug-related adverse events occurred in 2 TN participants. Improvements in some patient-reported outcomes were observed. BIC/FTC/TAF maintained effectiveness, persistence, and tolerability over 24 months.

BICtegravir单片方案是一项多国观察队列研究,评估了BICtegravir /恩曲他滨/替诺福韦阿拉那胺(BIC/FTC/TAF)治疗人类免疫缺陷病毒感染者的有效性和安全性。我们提供了来自韩国参与者的24个月的数据。共纳入88例受试者(36例treatment-naïve [TN], 52例有治疗经验[TE])。在24个月时,100%(29/29)的TN和100%(37/37)的TE参与者携带HIV-1 RNA
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引用次数: 0
期刊
Infection and Chemotherapy
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