Journal of Microbiology Immunology and Infection最新文献_第2页

Levofloxacin is as effective as trimethoprim-sulfamethoxazole for the treatment of pertussis: A prospective observational study 左氧氟沙星与甲氧苄啶-磺胺甲恶唑治疗百日咳同样有效：一项前瞻性观察研究。

IF 3.7 2区医学 Q2 IMMUNOLOGY

Journal of Microbiology Immunology and Infection

Pub Date : 2026-02-01 DOI: 10.1016/j.jmii.2025.08.023

Chuning Wang , Jingjing Li , Hailing Chang , He Tian , Jiehao Cai , Mingliang Chen , Zhongqiu Wei , Mei Zeng

Purpose

To evaluate the effectiveness and safety of oral levofloxacin verse trimethoprim-sulfamethoxazole (TMP-SMX) for the treatment of macrolides-resistant pertussis in pediatric outpatients.

Methods

A prospective observational study was conducted at a pediatric pertussis outpatient clinic during the pertussis outbreak in 2024. For eligible children with PCR-confirmed pertussis, administration of either levofloxacin (8–10 mg/kg/dose, once or twice daily) or TMP-SMX (4–20 mg/kg/dose, twice daily) depended on parents’ preference. Effectiveness and safety were evaluated for the 5–14 days duration of levofloxacin and TMP-SMX treatment in terms of alleviation of cough symptoms, bacteriologic clearance of Bordetella pertussis and adverse effects.

Results

Among 193 enrolled pertussis cases, eighty-four (43.53 %) received levofloxacin and 109 (56.48 %) received TMP-SMX. After completing treatment, paroxysmal cough resolved or improved in 96.43 % of levofloxacin group and 94.50 % (103/109) of TMP-SMX group (p = 0.554). Nocturnal cough resolved or improved in 98.81 % of levofloxacin group and in 98.17 % of TMP-SMX group (p = 0.057). There was no significant difference in bacteriologic clearance rate between levofloxacin group and TMP-SMX group determined by PCR (92.00 % vs 87.06 %, p = 0.378) and culture (100 % vs 100 %, p > 0.378). Symptom resolution rate did not differ significantly among patients treated for 5 or 7 days with either levofloxacin or TMP-SMX. Adverse events were reported in 9.2 % of TMP-SMX-treated patients and 2.4 % of levofloxacin-treated patients (p < 0.05). Drug rash was reported in nine (8.26 %) TMP-SMX-treated patients.

Conclusions

Oral levofloxacin showed a comparable clinical effectiveness and a favorable safety profile to TMP-SMX for the treatment of non-severe pertussis with a 5–7 days course in children.

目的：评价口服左氧氟沙星与甲氧苄啶-磺胺甲恶唑（TMP-SMX）治疗儿科门诊大环内酯耐药百日咳的有效性和安全性。方法：在2024年百日咳爆发期间在儿科百日咳门诊进行前瞻性观察研究。对于经pcr证实的符合条件的百日咳患儿，根据家长的喜好，给予左氧氟沙星（8- 10mg /kg/剂，每日1次或2次）或TMP-SMX （4- 20mg /kg/剂，每日2次）。从缓解咳嗽症状、百日咳杆菌的细菌清除率和不良反应方面评估左氧氟沙星和TMP-SMX治疗5-14天的有效性和安全性。结果：193例百日咳患者中，84例（43.53%）接受左氧氟沙星治疗，109例（56.48%）接受TMP-SMX治疗。治疗结束后，左氧氟沙星组止咳率为96.43%，TMP-SMX组止咳率为94.50% (103/109)（p = 0.554）。左氧氟沙星组和TMP-SMX组夜间咳嗽缓解或改善率分别为98.81%和98.17% （p = 0.057）。PCR检测左氧氟沙星组与TMP-SMX组的细菌清除率（92.00 % vs 87.06%, p = 0.378）和培养组（100% vs 100%, p = 0.378）差异无统计学意义。在左氧氟沙星或TMP-SMX治疗5天或7天的患者中，症状缓解率无显著差异。结果表明：口服左氧氟沙星治疗儿童非重度百日咳的临床疗效和安全性与TMP-SMX相当，疗程为5-7天。

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引用次数: 0

Taiwan guideline for the diagnosis and management of juvenile idiopathic arthritis: Consensus statement of the Taiwan Academy of Pediatric Allergy, Asthma and Immunology 台湾青少年特发性关节炎诊断与治疗指南：台湾儿科过敏、哮喘与免疫学会共识声明。

IF 3.7 2区医学 Q2 IMMUNOLOGY

Journal of Microbiology Immunology and Infection

Pub Date : 2026-02-01 DOI: 10.1016/j.jmii.2025.05.011

Hai-Lun Sun , Yu-Hsuan Kao , Hsin-Hui Yu , Li-Chieh Wang , Chao-Yi Wu , Tsung-Chieh Yao , for the Committee of the Taiwan Academy of Pediatric Allergy, Asthma and Immunology

Juvenile idiopathic arthritis (JIA) is one of the most common types of arthritis to affect children, with onset occurring under the age of 16. Primarily characterized by chronic inflammation of the synovium, JIA is actually a heterogenous disease, comprising several subtypes. It is therefore important to accurately identify the disease subtype, and subsequently prescribe treatments that can target the corresponding disease mechanisms. Regular monitoring during and after treatment is also necessary to mitigate related risks and adverse effects. In Taiwan, epidemiological research has shown that enthesitis-related arthritis (ERA) is the predominant JIA subtype (38.6% of all cases), which differs from the epidemiological features in other countries. The Taiwan Academy of Pediatric Allergy, Asthma and Immunology (TAPAAI) therefore developed this guideline with these epidemiological characteristics in mind, and further draws upon the latest clinical evidence regarding JIA diagnosis, monitoring, and newly approved treatments, as well as recently published JIA guidelines from the United States and Germany. It is hoped that this guideline can serve as a practical and up-to-date reference for healthcare professionals, and support daily clinical practice for the enhancement of patient outcomes.

青少年特发性关节炎（JIA）是儿童最常见的关节炎类型之一，发病年龄在16岁以下。JIA主要以滑膜慢性炎症为特征，实际上是一种异质性疾病，包括几个亚型。因此，重要的是准确识别疾病亚型，并随后开出针对相应疾病机制的治疗方案。治疗期间和治疗后的定期监测也是必要的，以减轻相关风险和不良反应。在台湾，流行病学研究表明，关节炎相关性关节炎（ERA）是JIA的主要亚型（占所有病例的38.6%），这与其他国家的流行病学特征不同。因此，考虑到这些流行病学特征，台湾儿科过敏、哮喘和免疫学会（TAPAAI）制定了本指南，并进一步借鉴了有关JIA诊断、监测和新批准治疗的最新临床证据，以及美国和德国最近发布的JIA指南。希望本指南可以作为医疗保健专业人员的实用和最新参考，并支持日常临床实践，以提高患者的预后。

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引用次数: 0

Personalized serum proteome profiles of COVID-19-associated acute respiratory distress syndrome in response to mesenchymal stem cell therapy covid -19相关急性呼吸窘迫综合征对间充质干细胞治疗的个性化血清蛋白质组谱

IF 3.7 2区医学 Q2 IMMUNOLOGY

Journal of Microbiology Immunology and Infection

Pub Date : 2026-02-01 DOI: 10.1016/j.jmii.2025.07.004

Denise Utami Putri , Mei-Chuan Chen , Chih-Ming Weng , Han-Pin Kuo , Chih-Hsin Lee , Chia-Li Han

Background

Mesenchymal stem cell (MSC) therapy is one of the therapeutic options for COVID-19-related acute respiratory distress syndrome (ARDS). However, not all patients benefit equally and the mechanism of action of the treatment remains unknown. Herein, we aimed to elucidate the molecular response to MSC treatment in COVID-19-related ARDS, and proposed protein signature to advocate for patient selection to maximize the benefit.

Method

Five COVID-19-related ARDS patients who consented to compassionate placenta-derived (pc)-MSC treatment were followed for clinical response and disease progression. Serum samples were collected before and after pc-MSC infusion for quantitative proteomics analysis.

Results

Following treatment, lung injury was significantly improved. Patients with invasive mechanical ventilation exhibited activation of inflammation, coagulation, and glucose metabolism, while it was inhibited in patients with high-flow oxygenation maintenance. Upregulations of complement system and HIF1α signaling may suggest a correlation to lung fibrosis. We proposed CD44, MMP2, MMP9, and CRP as a distinction panel to advise the response to pc-MSC treatment.

Conclusion

We exploited molecular regulations in response to pc-MSC treatment for COVID-19-related ARDS and proposed protein signatures to assist treatment decisions. Large cohort study to observe the long-term impact should be implemented in the future.

背景：间充质干细胞（MSC）治疗是covid -19相关急性呼吸窘迫综合征（ARDS）的治疗选择之一。然而，并不是所有的患者都同样受益，治疗的作用机制仍然未知。在此，我们旨在阐明MSC治疗在covid -19相关ARDS中的分子反应，并提出蛋白质标记以倡导患者选择以最大化获益。方法：对5例同意体恤性胎盘来源(pc)-MSC治疗的covid -19相关ARDS患者进行临床反应和疾病进展随访。采集pc-MSC输注前后血清样本进行定量蛋白质组学分析。结果：经治疗后肺损伤明显改善。有创机械通气患者表现出炎症、凝血和糖代谢的激活，而高流量氧合维持患者表现出抑制。补体系统和HIF1α信号的上调可能与肺纤维化有关。我们建议将CD44、MMP2、MMP9和CRP作为区分小组，以建议对pc-MSC治疗的反应。结论：我们利用了pc-MSC治疗covid -19相关ARDS的分子调控，并提出了蛋白质特征来辅助治疗决策。未来应实施大规模队列研究以观察其长期影响。

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引用次数: 0

Plasma calprotectin as a severity biomarker in pediatric invasive Streptococcus pyogenes infections: insights from a multicenter immune profiling study during an outbreak 血浆钙保护蛋白作为儿童侵袭性化脓性链球菌感染的严重程度生物标志物：来自疫情期间多中心免疫分析研究的见解

IF 3.7 2区医学 Q2 IMMUNOLOGY

Journal of Microbiology Immunology and Infection

Pub Date : 2026-02-01 DOI: 10.1016/j.jmii.2025.07.008

José Avendaño-Ortiz , David Aguilera-Alonso , Concepción M. Rodríguez , Jesús Oteo-Iglesias , Roberto Lozano-Rodríguez , Eduardo López-Collazo , Andrea López-Suárez , Victoria Rello-Saltor , Ana Belén Jimenez , Beatriz Jiménez , Rosa del Campo , Rafael Cantón , Cristina Calvo , Jesús Saavedra-Lozano

Purpose

To characterize the immune signature of pediatric invasive Streptococcus pyogenes infections (iGAS) and identify host biomarkers associated with disease severity.

Methods

Plasma samples (n = 32) were collected during an iGAS outbreak from a multicentric Spanish pediatric cohort, including patients with iGAS (n = 19), S. pyogenes acute tonsillitis (n = 3), and healthy children/controls (n = 10). Patients were monitored and stratified based on the need of pediatric intensive-care unit (PICU). A panel of 56 soluble markers –including cytokines, chemokines, immune-checkpoints, antimicrobial peptides, growth factors, and vascular inflammation, myeloid and thrombosis markers— were quantified in plasma.

Results

Regardless of disease severity, children with S. pyogenes infection exhibited a systemic inflammatory profile characterized by an upregulation of vascular inflammation markers. Patients with iGAS requiring PICU admission were mostly infected by emm1 S. pyogenes harboring speA and speJ genes and exhibited an immune profile characterized by alterations in CXCL10, IL-6, IL-10, IL-17A, sCD14, sCD40L, calprotectin, angiopoietin 2 and HGF. Area under the ROC curve analysis revealed that calprotectin and IL-6 exhibited the best classificatory performance for PICU admission (p < 0.01; AUC = 0.90 and AUC = 0.91, respectively), with an optimal Youden cut-off for calprotectin of 2753 ng/mL. A logistic regression model integrating both biomarkers and routine clinical parameters revealed an independent association between calprotectin levels and PICU admission.

Conclusion

Pediatric iGAS is characterized by a complex immune landscape involving a combination of vascular and immune response mediators. Plasma calprotectin levels emerge as a promising severity biomarker, potentially aiding in the early identification of high-risk patients.

目的：研究儿童侵袭性化脓性链球菌感染（iGAS）的免疫特征，并确定与疾病严重程度相关的宿主生物标志物。方法：在iGAS爆发期间从西班牙多中心儿童队列中收集血浆样本（n = 32），包括iGAS患者（n = 19），化脓性链球菌急性扁桃体炎患者（n = 3）和健康儿童/对照组（n = 10）。根据儿童重症监护病房（PICU）的需要对患者进行监测和分层。一组56可溶性标记物——包括细胞因子、趋化因子、免疫检查点、抗菌肽、生长因子、血管炎症、骨髓和血栓形成标记物——在血浆中被量化。结果：无论疾病严重程度如何，化脓性链球菌感染的儿童都表现出系统性炎症特征，其特征是血管炎症标志物上调。需要PICU入院的iGAS患者主要感染携带speA和speJ基因的emm1化脓性链球菌，并表现出以CXCL10、IL-6、IL-10、IL-17A、sCD14、sCD40L、钙保护素、血管生成素2和HGF改变为特征的免疫谱。ROC曲线下面积分析显示，钙保护蛋白和IL-6在PICU入院时表现出最佳的分类表现(p结论：儿童iGAS具有复杂的免疫景观，涉及血管和免疫反应介质的组合。血浆钙保护蛋白水平作为一种有前景的严重程度生物标志物，可能有助于早期识别高危患者。

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引用次数: 0

Javanicin inhibits the secretion of hepatitis B virus particles thorough the proteasome-dependent degradation of core protein 爪哇霉素通过蛋白酶体依赖的核心蛋白降解抑制乙型肝炎病毒颗粒的分泌。

IF 3.7 2区医学 Q2 IMMUNOLOGY

Journal of Microbiology Immunology and Infection

Pub Date : 2026-02-01 DOI: 10.1016/j.jmii.2025.06.004

Nayeon Park , Gwang-Hoon Ko , Yun Seo Park , Jung-Ah Kang , Sang Hee Shim , Sung-Gyoo Park

Background

Hepatitis B virus (HBV) is the primary cause of liver disease. Nucleot(s)ide analogues such as Entecavir are commonly used to treat HBV infection; however, although these drugs attenuate the virus, they are not a cure. Therefore, it is important to find a novel anti-HBV compounds that enable complete remission of chronic hepatitis B (CHB) infection.

Methods

We screened 190 natural product libraries using the HepG2.2.15 cell line. Additionally, anti-HBV activities were assessed across genotypes C and D. The mechanism underlying the inhibition of HBV replication by the identified compound was elucidated through cell-based assays.

Results

We identified a hit compound called Javanicin, which is derived from the endophytic fungus JS169. The IC₅₀ of Javanicin is < 500 nM, and the selectivity index (SI = CC₅₀/IC₅₀) is > 10. Javanicin induced proteasome-mediated degradation of the HBV core protein, and reduced the amount of HBV capsid protein. Javanicin and Entecavir acted synergistically, and were more effective than either drug alone. Additionally, structural analysis showed that Javanicin carries several modifiable moieties, which may lead to development of derivatives.

Conclusions

Javanicin is a novel class of HBV capsid assembly inhibitors, functioning by inducing proteasome-mediated degradation. Furthermore, when paired with Entecavir, Javanicin holds potential as a curative treatment for CHB.

背景：乙型肝炎病毒（HBV）是肝脏疾病的主要原因。核苷类似物如恩替卡韦通常用于治疗HBV感染；然而，尽管这些药物能减弱病毒，但它们并不能治愈病毒。因此，寻找一种能够完全缓解慢性乙型肝炎（CHB）感染的新型抗hbv化合物是很重要的。方法：利用HepG2.2.15细胞系筛选190个天然产物文库。此外，还评估了C和d基因型的抗HBV活性。通过基于细胞的实验阐明了所鉴定化合物抑制HBV复制的机制。结果：鉴定出一种从内生真菌JS169中分离得到的有效化合物Javanicin。Javanicin的IC50为50/IC50为bb10。Javanicin诱导蛋白酶体介导的HBV核心蛋白降解，并减少HBV衣壳蛋白的数量。Javanicin和恩替卡韦协同作用，比单独用药更有效。此外，结构分析表明，爪哇霉素含有几个可修饰的片段，这可能导致衍生物的开发。结论：Javanicin是一类新型HBV衣壳组装抑制剂，通过诱导蛋白酶体介导的降解起作用。此外，当与恩替卡韦配对时，Javanicin具有治疗慢性乙型肝炎的潜力。

{"title":"Javanicin inhibits the secretion of hepatitis B virus particles thorough the proteasome-dependent degradation of core protein","authors":"Nayeon Park , Gwang-Hoon Ko , Yun Seo Park , Jung-Ah Kang , Sang Hee Shim , Sung-Gyoo Park","doi":"10.1016/j.jmii.2025.06.004","DOIUrl":"10.1016/j.jmii.2025.06.004","url":null,"abstract":"<div><h3>Background</h3><div>Hepatitis B virus (HBV) is the primary cause of liver disease. Nucleot(s)ide analogues such as Entecavir are commonly used to treat HBV infection; however, although these drugs attenuate the virus, they are not a cure. Therefore, it is important to find a novel anti-HBV compounds that enable complete remission of chronic hepatitis B (CHB) infection.</div></div><div><h3>Methods</h3><div>We screened 190 natural product libraries using the HepG2.2.15 cell line. Additionally, anti-HBV activities were assessed across genotypes C and D. The mechanism underlying the inhibition of HBV replication by the identified compound was elucidated through cell-based assays.</div></div><div><h3>Results</h3><div>We identified a hit compound called Javanicin, which is derived from the endophytic fungus JS169. The IC<sub>50</sub> of Javanicin is < 500 nM, and the selectivity index (SI = CC<sub>50</sub>/IC<sub>50</sub>) is > 10. Javanicin induced proteasome-mediated degradation of the HBV core protein, and reduced the amount of HBV capsid protein. Javanicin and Entecavir acted synergistically, and were more effective than either drug alone. Additionally, structural analysis showed that Javanicin carries several modifiable moieties, which may lead to development of derivatives.</div></div><div><h3>Conclusions</h3><div>Javanicin is a novel class of HBV capsid assembly inhibitors, functioning by inducing proteasome-mediated degradation. Furthermore, when paired with Entecavir, Javanicin holds potential as a curative treatment for CHB.</div></div>","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":"59 1","pages":"Pages 12-20"},"PeriodicalIF":3.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Maraviroc treatment for hospitalized participants with non-severe COVID-19 at risk of progression: a randomized, proof-of-concept clinical trial 马拉韦洛克治疗有进展风险的非严重COVID-19住院患者：一项随机、概念验证临床试验

IF 3.7 2区医学 Q2 IMMUNOLOGY

Journal of Microbiology Immunology and Infection

Pub Date : 2026-02-01 DOI: 10.1016/j.jmii.2025.07.007

Carmen Gasca-Capote , José Manuel Lomas-Cabezas , Abraham Saborido-Alconchel , Cristina Moral-Turón , María Dolores Navarro , Antonio Ramos , Manuel Poyato-Borrego , Angela María Villalba , Inmaculada Rivas-Jeremías , Monserrat Domínguez , Julia Praena , José Miguel Cisneros , Luis F. López-Cortés , Ezequiel Ruiz-Mateos

Background

Therapeutic options for hospitalized people with COVID-19 remain limited, especially for people with non-severe COVID-19 at risk of progression. The anti-inflammatory role of maraviroc, a CCR5 antagonists, makes it a good candidate for therapeutic strategies for COVID-19.

Methods

This was a proof-of-concept, phase II, parallel, open label clinical trial, to evaluate the safety and efficacy of maraviroc (300 mg, bid), CCR5 antagonist, combined with standard of care (SoC) treatment compared to SoC alone during 14 days, in hospitalized people with mild COVID-19 with pneumonia and ambient air oxygen saturation >94 %. Demographical, clinical, and analytical data were assayed at day 0, 7, 14 and 28.

Results

Thirty-three participants were included, 17 in the control and 16 in the maraviroc group. The proportion of participants who experienced COVID-19 progression was 2.8 times higher in the control group than in the maraviroc group, with three participants admitted in intensive care unit versus none in the maraviroc group. The only variable associated with the time to severe COVID-19 progression was maraviroc treatment. The median time on oxygen therapy was 11 days in the control group, while the two participants in the maraviroc group had oxygen therapy for one and four days. Grade 3–4 events were only present in the control group. Maraviroc treatment was associated with a better neutrophil/lymphocyte ratio and lactate dehydrogenase, IL-6 and TNF-α levels at day 7.

Conclusions

We observed a beneficial role of maraviroc in hospitalized participants with mild COVID-19 at risk of progression at admission.

背景：COVID-19住院患者的治疗选择仍然有限，特别是对于有进展风险的非严重COVID-19患者。马拉维洛克是一种CCR5拮抗剂，其抗炎作用使其成为COVID-19治疗策略的良好候选药物。方法：这是一项概念验证、II期、平行、开放标签临床试验，旨在评估CCR5拮抗剂马拉韦洛克（300 mg, bid）联合标准护理（SoC）治疗14天期间对轻度COVID-19合并肺炎住院患者的安全性和有效性，与单独使用SoC相比，环境空气氧饱和度为94%。在第0、7、14和28天分析人口学、临床和分析数据。结果：共纳入33例患者，对照组17例，马拉韦洛克组16例。对照组中出现COVID-19进展的参与者比例是马拉韦洛克组的2.8倍，其中3名参与者住进了重症监护病房，而马拉韦洛克组中没有参与者。与COVID-19严重进展时间相关的唯一变量是马拉维洛克治疗。对照组中位氧疗时间为11天，而马拉韦洛克组2例患者分别为1天和4天。3-4级事件仅在对照组出现。马拉韦洛克治疗与第7天中性粒细胞/淋巴细胞比率和乳酸脱氢酶、IL-6和TNF-α水平的改善有关。结论：我们观察到马拉维洛克对入院时有进展风险的轻度COVID-19住院患者的有益作用。

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引用次数: 0

Application of antimicrobial stewardship interventions improves outcomes in adults with bloodstream infection caused by multidrug-resistant Enterobacteriaceae 抗菌药物管理干预措施的应用改善了由多重耐药肠杆菌科引起的成人血液感染的结果。

IF 3.7 2区医学 Q2 IMMUNOLOGY

Journal of Microbiology Immunology and Infection

Pub Date : 2026-02-01 DOI: 10.1016/j.jmii.2025.08.007

Bo-Ming Huang , Ching-Lung Lo , Wen-Liang Lin , Ming-Chi Li , Tzu-Ping Weng , Hao-En Jan , Po-Hsuan Tseng , Sheng-Jie Yeh , Wen-Chien Ko , Nan-Yao Lee

Background

The increasing incidence of multidrug-resistant Enterobacteriaceae (MDRE) presents a significant challenge in clinical settings. We aimed to evaluate the impact of antimicrobial stewardship interventions (ASIs) on clinical outcomes in patients with MDRE bloodstream infections (BSI).

Materials and methods

A single-center, pre-post quasi-experimental study was conducted on patients with BSIs caused by MDRE from March 1, 2014 to February 29, 2016. Infectious disease specialists actively reviewed all positive blood culture notifications and provided evidence-based recommendations for antibiotic therapy. The primary outcomes were 30-day mortality and time to appropriate antibiotics. Secondary outcomes included the hospital length of stay (LOS) after BSIs and duration of antibiotic therapy among survivors.

Results

Total 193 patients were included: 73 patients in the pre-intervention period and 120 patients in the intervention period. The 30-day mortality was lower in the intervention group (12.5% vs. 28.8%, P = 0.007). Species identification of BSI pathogens was more rapidly completed (median 70 h vs. 76 h, P = 0.001), and the time to appropriate antibiotics (median 9 h vs. 33 h, P < 0.001) and duration of antibiotic therapy (10 days vs. 12.5 days, P < 0.001) were shorter in the intervention group. Cox regression analysis revealed that ASIs were associated with a better prognosis among adults with MDRE BSIs (hazard ratio: 0.40; 95 % CI: 0.20–0.77; P = 0.006).

Conclusion

ASIs can reduce the time to appropriate antimicrobial therapy, shorten antibiotic therapy duration, and improve clinical outcomes in patients with BSIs caused by MDRE.

背景：多药耐药肠杆菌科（MDRE）发病率的增加在临床环境中提出了重大挑战。我们的目的是评估抗菌药物管理干预（ASIs）对MDRE血流感染（BSI）患者临床结果的影响。材料与方法：2014年3月1日至2016年2月29日，对MDRE致脑损伤患者进行单中心、前后准实验研究。传染病专家积极审查所有阳性血培养通知，并提供基于证据的抗生素治疗建议。主要结局是30天死亡率和适当使用抗生素的时间。次要结局包括脑损伤后的住院时间（LOS）和幸存者中抗生素治疗的持续时间。结果：共纳入193例患者，干预前73例，干预期120例。干预组30天死亡率较低（12.5%比28.8%,P = 0.007）。BSI病原菌的种类鉴定完成速度更快（中位数为70 h对76 h， P = 0.001），适用抗生素的时间更短（中位数为9 h对33 h， P = 0.001）。结论：ASIs可缩短MDRE所致BSI患者适用抗菌药物治疗的时间，缩短抗生素治疗时间，改善临床预后。

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引用次数: 0

High prevalence but low clinical impact of acyclovir-resistant herpes simplex virus type 1 infections in patients with hematologic disorders 血液系统疾病患者中无环韦耐药1型单纯疱疹病毒感染的高流行率但临床影响低。

IF 3.7 2区医学 Q2 IMMUNOLOGY

Journal of Microbiology Immunology and Infection

Pub Date : 2026-02-01 DOI: 10.1016/j.jmii.2025.08.001

Chih-Hao Chen , Ling-Ling Chen , Mei-Chi Su , Hsiu-Hsien Lin , Mao-Wang Ho , Cheng-Wen Lin , Po-Ren Hsueh

Background/purpose

Herpes simplex virus type 1 (HSV-1) is highly prevalent in immunocompromised patients. Due to the recurrent nature of HSV-1 infection, frequent exposure to antiviral agents raises concerns about drug resistance. This study aimed to investigate antiviral-resistant profiles of HSV-1 and discuss the clinical impact of acyclovir-resistant (ACV-R) compared to acyclovir-susceptible (ACV-S) HSV-1 infected patients.

Methods

Repeated sampling specimens during 2010–2023 from all age groups were collected and only those with clinical correlations were illegible to be assessed. Plaque reduction assay and Sanger sequencing were used to determine phenotypic and genotypic profiles (UL23/UL30 genes) of ACV-R HSV-1 isolates, respectively.

Results

A total of 29 HSV-1 isolates from 18 patients, mainly with hematologic disorders (n = 14, 77.8 %) and the clinical diagnosis of orolabial diseases (n = 14, 77.8 %), were analyzed. The prevalence of ACV-R HSV-1 isolates was 69.0 % (20/29). Most isolates were exposed to antiviral agents before sampling (21/29, 72.4 %). There was no statistical difference in treatment response and duration between patients infected with ACV-S and ACV-R isolates (p = 0.274). No strong correlation could be observed between point mutations, 50 % effective concentration value, and previous antiviral exposure duration. Novel mutations E676K and P355S were detected and probably associated with ACV resistance.

Conclusions

The prevalence of ACV-R HSV-1 was higher than reported data from the literature. Several novel mutations were discovered and could enrich the ACV-R HSV-1 database. Further studies are needed to investigate ACV resistance in other potentially related genes, such as UL5 and UL42.

背景/目的：单纯疱疹病毒1型（HSV-1）在免疫功能低下患者中高度流行。由于1型单纯疱疹病毒感染的复发性，频繁接触抗病毒药物引起对耐药性的担忧。本研究旨在探讨HSV-1的抗病毒耐药谱，并探讨无环韦耐药（ACV-R）与无环韦敏感（ACV-S） HSV-1感染患者的临床影响。方法：收集2010-2023年各年龄组重复取样标本，仅对临床相关性不明显的标本进行评估。采用斑块减少法和Sanger测序分别测定ACV-R HSV-1分离株的表型和基因型（UL23/UL30基因）。结果：从18例患者中分离出29株HSV-1，主要为血液病（n = 14, 77.8%）和口腔疾病（n = 14, 77.8%）。ACV-R HSV-1分离株感染率为69.0%（20/29）。大多数分离株在取样前暴露于抗病毒药物（21/29,72.4%）。感染ACV-S和ACV-R分离株的患者在治疗反应和持续时间方面无统计学差异（p = 0.274）。点突变、50%有效浓度值与既往抗病毒暴露时间无明显相关性。检测到新的突变E676K和P355S，可能与ACV抗性有关。结论：ACV-R HSV-1的流行率高于文献报道的数据。发现了几个新的突变，可以丰富ACV-R HSV-1数据库。需要进一步研究其他潜在相关基因（如UL5和UL42）对ACV的耐药性。

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引用次数: 0

Cardiometabolic multimorbidity in aging adults with HIV: Real-world evidence from a care cohort in Taiwan 老年HIV患者的心脏代谢多病：来自台湾护理队列的真实证据。

IF 3.7 2区医学 Q2 IMMUNOLOGY

Journal of Microbiology Immunology and Infection

Pub Date : 2026-02-01 DOI: 10.1016/j.jmii.2025.06.011

Sheng-Jie Yeh , Chia-Wen Li , Ching-Lung Lo , Po-Lin Chen , Bo-Ming Huang , Po-Hsuan Tseng , Wen-Chien Ko , Ming-Chi Li , Nan-Yao Lee

Background

As the population of people living with HIV (PLWH) ages, the burden of non-cardiometabolic diseases—including diabetes mellitus (DM), hypertension, and hyperlipidemia—has increased. However, data on age-specific cardiometabolic multimorbidity and real-world treatment gaps remain limited.

Methods

We conducted a retrospective study of 227 PLWH aged ≥50 years at a tertiary HIV center in Taiwan, stratified into premature-old (50–64 years) and old (≥65 years) groups. We assessed prevalence, incidence, and risk factors of cardiometabolic conditions, and applied Taiwan National Health Insurance(TNHI) criteria to evaluate statin eligibility.

Results

Among 227 PLWH, 182 were aged 50–64 (premature-old) and 45 were ≥65 (old). At follow-up, the prevalence of diabetes, hypertension, and hyperlipidemia reached 32.2 %, 48.5 %, and 76.2 %, respectively. Multimorbidity increased from 28.0 % to 46.7 % in premature-old group and 48.9 %–73.3 % in old group. Risk factors for DM included body mass index (BMI) ≥24.0 kg/m² and high-density lipoprotein cholesterol (HDL-C) <40 mg/dL. Risk factors for hypertension included HIV diagnosis >5 years, BMI ≥24.0 kg/m², HDL-C <40 mg/dL, chronic kidney disease (CKD), and specific antiretroviral regimens. BMI ≥24.0 kg/m², HDL-C <40 and CKD increased the risks for hyperlipidemia. Among statin non-users, 33.3 % of premature-old and 40.0 % of old patients met TNHI eligibility criteria.

Conclusion

Cardiometabolic multimorbidity is common among aging PLWH in Taiwan. The premature-old group showed considerable disease burden and treatment gaps, indicating missed prevention opportunities. These findings emphasize the need for age-appropriate, integrated care approaches to address the evolving health challenges in this population.

背景：随着艾滋病毒感染者（PLWH）人口的老龄化，非心脏代谢疾病（包括糖尿病（DM）、高血压和高脂血症）的负担增加。然而，关于年龄特异性心脏代谢多病和现实世界治疗差距的数据仍然有限。方法：我们在台湾某三级HIV中心对227名年龄≥50岁的PLWH进行回顾性研究，分为早老组（50-64岁）和老年组（≥65岁）。结果：227例PLWH中，年龄50 ~ 64岁（早产儿）的有182例，年龄≥65岁（老年人）的有45例。在随访中，糖尿病、高血压和高脂血症的患病率分别达到32.2%、48.5%和76.2%。早产儿多病率从28.0%上升到46.7%，老年人多病率从48.9%上升到73.3%。糖尿病的危险因素包括体重指数(BMI)≥24.0 kg/m2、高密度脂蛋白胆固醇（HDL-C） 5年、BMI≥24.0 kg/m2、HDL-C 2、HDL-C。结论：台湾老年PLWH中心脏代谢多病较为常见。早老组表现出相当大的疾病负担和治疗差距，表明错过了预防机会。这些发现强调需要采用适合年龄的综合护理方法来应对这一人群中不断变化的健康挑战。

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引用次数: 0

A case of avian influenza A (H5N6) presented with secondary infection in Anhui Province, China, 2024. 2024年安徽省报告1例甲型禽流感（H5N6）继发感染病例。

IF 3.7 2区医学 Q2 IMMUNOLOGY

Journal of Microbiology Immunology and Infection

Pub Date : 2026-01-29 DOI: 10.1016/j.jmii.2026.01.002

Wan-Rong Luo, Jun-Ling Yu, Yun Sun, Lei Gong, Sai Hou, Zhong-Hua Lu, Wei-Xi Fang, Hong-Ya Gui, Xue Zhou, Peng Wang, Jun He, Jun Ye, Jia-Bing Wu

A case of H5N6 avian influenza was reported in Anhui Province, China. The viral titers in the patient's lungs and pharynx decreased rapidly after oseltamivir treatment, yet it still fatal. The whole genome sequencing suggested that it derived from four distinct sources and classified within the 2.3.4.4b clade.

中国安徽省报告1例H5N6禽流感病例。在奥司他韦治疗后，患者肺部和咽部的病毒滴度迅速下降，但仍是致命的。全基因组测序表明，它来自四个不同的来源，并被归类为2.3.4.4b进化支。

引用次数: 0