Pub Date : 2024-09-06DOI: 10.1016/j.jmii.2024.09.001
Jing-Yi Ren, Hong-Qiang Yu, Sheng Xu, Wen-Juan Zhou, Zhong-Hao Liu
, belonging to the viridans group streptococci (VGS), has been considered a component of the normal flora predominantly inhabiting the oral cavity. In recent years, a growing body of literature has revealed that dental procedures or daily tooth brushing activities can cause the spread of from the oral cavity into various body sites leading to life-threatening opportunistic infections such as infective endocarditis (IE) and meningitis. However, very little is currently known about the pathogenicity of . Thus, the aim of this review is to update the current understanding of the pathogenic potential of to pave the way for the prevention and treatment of opportunistic infections.
{"title":"Putative pathogenic factors underlying Streptococcus oralis opportunistic infections","authors":"Jing-Yi Ren, Hong-Qiang Yu, Sheng Xu, Wen-Juan Zhou, Zhong-Hao Liu","doi":"10.1016/j.jmii.2024.09.001","DOIUrl":"https://doi.org/10.1016/j.jmii.2024.09.001","url":null,"abstract":", belonging to the viridans group streptococci (VGS), has been considered a component of the normal flora predominantly inhabiting the oral cavity. In recent years, a growing body of literature has revealed that dental procedures or daily tooth brushing activities can cause the spread of from the oral cavity into various body sites leading to life-threatening opportunistic infections such as infective endocarditis (IE) and meningitis. However, very little is currently known about the pathogenicity of . Thus, the aim of this review is to update the current understanding of the pathogenic potential of to pave the way for the prevention and treatment of opportunistic infections.","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":"251 1","pages":""},"PeriodicalIF":7.4,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142207777","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}
Pub Date : 2024-09-06DOI: 10.1016/j.jmii.2024.07.011
Andrea López-Suárez, Mar Santos-Sebastián, Alicia Hernanz-Lobo, Elena Rincón-López, David Aguilera-Alonso, Jesús Saavedra-Lozano, María Jesús Ruiz Serrano, Ángel Hernández-Bartolomé, Luz María Medrano de Dios, José Luis Jiménez Fuentes, María Luisa Navarro, Marc Tebruegge, Begoña Santiago-García
Immune-based diagnostic tests for tuberculosis (TB) have suboptimal sensitivity in children and cannot differentiate between latent infection (LTBI) and active disease. This study evaluated the diagnostic potential of a broad range of biomarkers of tissue damage and inflammation in unstimulated plasma in children.
{"title":"Diagnostic potential of combining plasma biomarkers of tissue damage and inflammation in pediatric TB","authors":"Andrea López-Suárez, Mar Santos-Sebastián, Alicia Hernanz-Lobo, Elena Rincón-López, David Aguilera-Alonso, Jesús Saavedra-Lozano, María Jesús Ruiz Serrano, Ángel Hernández-Bartolomé, Luz María Medrano de Dios, José Luis Jiménez Fuentes, María Luisa Navarro, Marc Tebruegge, Begoña Santiago-García","doi":"10.1016/j.jmii.2024.07.011","DOIUrl":"https://doi.org/10.1016/j.jmii.2024.07.011","url":null,"abstract":"Immune-based diagnostic tests for tuberculosis (TB) have suboptimal sensitivity in children and cannot differentiate between latent infection (LTBI) and active disease. This study evaluated the diagnostic potential of a broad range of biomarkers of tissue damage and inflammation in unstimulated plasma in children.","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":"22 1","pages":""},"PeriodicalIF":7.4,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142251591","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}
Pub Date : 2024-09-04DOI: 10.1016/j.jmii.2024.08.013
Ya-Chun Huang, Nan-Yao Lee, Meng-Yu Weng
The prevalence of Pneumocystis jirovecii (PJ) pneumonia among rheumatic patients is rising. PJ colonization serves as a reservoir for transmission and precedes the development of PJ pneumonia. We aim to clarify the association of PJ colonization in patients of rheumatoid arthritis (RA) treated with biologics or Janus kinase inhibitors (JAKi).
{"title":"Increased risk of Pneumocystis jirovecii colonization in rheumatoid arthritis patients on biologics and Janus kinase inhibitor","authors":"Ya-Chun Huang, Nan-Yao Lee, Meng-Yu Weng","doi":"10.1016/j.jmii.2024.08.013","DOIUrl":"https://doi.org/10.1016/j.jmii.2024.08.013","url":null,"abstract":"The prevalence of <ce:italic>Pneumocystis jirovecii</ce:italic> (PJ) pneumonia among rheumatic patients is rising. PJ colonization serves as a reservoir for transmission and precedes the development of PJ pneumonia. We aim to clarify the association of PJ colonization in patients of rheumatoid arthritis (RA) treated with biologics or Janus kinase inhibitors (JAKi).","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":"116 1","pages":""},"PeriodicalIF":7.4,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142251592","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}
A predominate azole-resistant clade 4 genotype causing candidemia has been detected in not only Taiwan but also China, Singapore, and Australia. It can also be detected on fruit surfaces. In addition to determining distribution and drug susceptibilities of pathogenic yeasts in environments of intensive care units of 25 hospitals in Taiwan, we would also like to investigate whether the azole-resistant exists in Taiwan's hospital environment. The swabs of hospital environments were collected from August to November in 2020 and were cultured for yeasts. The yeasts were identified by rDNA sequence and the antifungal susceptibilities of those isolates were determined by the broth microdilution method. The average yeast-culture rate of hospitals was 9.4% (217/2299). Sinks had the highest yeast-positive culture rate (32.7%), followed by bedside tables (28.9%), floors (26.0%), water-dispenser buttons (23.8%), and TV controller/touch panels (19.0%). Of 262 identified isolates, was the most common species, accounting for 22.1%, followed by (18.3%), (9.5%), (8.0%), () (6.9%), and 30 other species (35.1%). Of the 21 isolates from 11 units in 9 hospitals, 15 diploid sequence types (DSTs) were identified. The two DST506 fluconazole-resistant ones belonged to clade 4. We detected not only various pathogenic yeast species but also the predominant clade 4 genotype of azole-resistant . . Our findings highlight and re-emphasize the importance of regular cleaning and disinfection practices.
{"title":"Surveillance of pathogenic yeasts in hospital environments in Taiwan in 2020","authors":"De-Jiun Tsai, Li-Yun Hsieh, Pei-Jung Chung, Yin-Zhi Chen, Yi-Jyun Jhou, Kuo-Yun Tseng, Chia-Jui Yang, Yen-Cheng Yeh, Seng-Yi Lin, Susan Shin-Jung Lee, Ting-I Wu, Tsung-Ta Chiang, Chien-Hsuan Chou, Wei-Chieh Miu, Po-Yu Liu, Chin-Te Lu, Yuan-Ti Lee, Yu-Ling Syu, Gwo-Jong Hsu, Yee-Chun Chen, Nan-Yao Lee, Chang-Hua Chen, Ching-Cheng Yang, Lih-Shinn Wang, Jien-Wei Liu, Chin-Chuan Kao, Ya-Ting Chang, Keh-Sen Liu, Bor-Shen Hu, Che-Han Hsu, Yi-Ching Huang, Hsiu-Jung Lo","doi":"10.1016/j.jmii.2024.08.011","DOIUrl":"https://doi.org/10.1016/j.jmii.2024.08.011","url":null,"abstract":"A predominate azole-resistant clade 4 genotype causing candidemia has been detected in not only Taiwan but also China, Singapore, and Australia. It can also be detected on fruit surfaces. In addition to determining distribution and drug susceptibilities of pathogenic yeasts in environments of intensive care units of 25 hospitals in Taiwan, we would also like to investigate whether the azole-resistant exists in Taiwan's hospital environment. The swabs of hospital environments were collected from August to November in 2020 and were cultured for yeasts. The yeasts were identified by rDNA sequence and the antifungal susceptibilities of those isolates were determined by the broth microdilution method. The average yeast-culture rate of hospitals was 9.4% (217/2299). Sinks had the highest yeast-positive culture rate (32.7%), followed by bedside tables (28.9%), floors (26.0%), water-dispenser buttons (23.8%), and TV controller/touch panels (19.0%). Of 262 identified isolates, was the most common species, accounting for 22.1%, followed by (18.3%), (9.5%), (8.0%), () (6.9%), and 30 other species (35.1%). Of the 21 isolates from 11 units in 9 hospitals, 15 diploid sequence types (DSTs) were identified. The two DST506 fluconazole-resistant ones belonged to clade 4. We detected not only various pathogenic yeast species but also the predominant clade 4 genotype of azole-resistant . . Our findings highlight and re-emphasize the importance of regular cleaning and disinfection practices.","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":"24 1","pages":""},"PeriodicalIF":7.4,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142207779","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}
Methicillin-resistant (MRSA) sequence type (ST) 45 was first reported in Taiwan in 2006. Since then, the prevalence of ST45 MRSA in clinical isolates has increased. This study was carried out to understand the changes in the proportions, evolutionary relationships, and infection advantages of ST45 and its related clones. : including MRSA and MSSA (methicillin-sensitive ), and clonal complex (CC) 45 blood isolates were collected in 2000, 2005, and from January 2010 to August 2014. Molecular typing, multiple-locus variable-number tandem repeat analysis (MLVA) and single nucleotide polymorphism (SNP)-based phylogenetic analysis were performed. Fitness and virulence analyses were used to understand the infection advantages of the isolates. Among the 67 CC45 isolates, only MSSA ST508 isolates were found in 2000 and 2005. Since 2010, the prevalence of MRSA has increased, t1081/ST45 has become dominant, and MRSA ST508 has been found. Phylogenetic analysis indicated that most of the ST45 isolates were located in a cluster distinct from those of ST508 and ST929. However, the t026 isolates clustered with the ST508 isolates rather than with the other ST45 isolates. Moreover, fitness and virulence analyses revealed that the t1081 isolates had higher hemolytic activity than the t026 and ST508 isolates did. Our findings indicated that the increased prevalence of ST45 MRSA isolates from blood cultures in Taiwan was due to the t1081 isolates, and their high hemolytic activity may provide an infection advantage.
{"title":"High hemolytic activity of the Staphylococcus aureus spa t1081 among clonal complex 45 in Taiwan","authors":"Yu-Tzu Lin, Chun-Li Lee, Chin-Yun Lin, Tai-Fen Lee, Po-Ren Hsueh","doi":"10.1016/j.jmii.2024.08.012","DOIUrl":"https://doi.org/10.1016/j.jmii.2024.08.012","url":null,"abstract":"Methicillin-resistant (MRSA) sequence type (ST) 45 was first reported in Taiwan in 2006. Since then, the prevalence of ST45 MRSA in clinical isolates has increased. This study was carried out to understand the changes in the proportions, evolutionary relationships, and infection advantages of ST45 and its related clones. : including MRSA and MSSA (methicillin-sensitive ), and clonal complex (CC) 45 blood isolates were collected in 2000, 2005, and from January 2010 to August 2014. Molecular typing, multiple-locus variable-number tandem repeat analysis (MLVA) and single nucleotide polymorphism (SNP)-based phylogenetic analysis were performed. Fitness and virulence analyses were used to understand the infection advantages of the isolates. Among the 67 CC45 isolates, only MSSA ST508 isolates were found in 2000 and 2005. Since 2010, the prevalence of MRSA has increased, t1081/ST45 has become dominant, and MRSA ST508 has been found. Phylogenetic analysis indicated that most of the ST45 isolates were located in a cluster distinct from those of ST508 and ST929. However, the t026 isolates clustered with the ST508 isolates rather than with the other ST45 isolates. Moreover, fitness and virulence analyses revealed that the t1081 isolates had higher hemolytic activity than the t026 and ST508 isolates did. Our findings indicated that the increased prevalence of ST45 MRSA isolates from blood cultures in Taiwan was due to the t1081 isolates, and their high hemolytic activity may provide an infection advantage.","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":"52 1","pages":""},"PeriodicalIF":7.4,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142207782","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}
Pub Date : 2024-08-28DOI: 10.1016/j.jmii.2024.08.010
Keng-Chin Yang, Wan-Yu Tien, Ming-Fang Cheng
Antimicrobial resistance, particularly in third-generation cephalosporin–resistant (3GC-R) (), poses major global health challenges and has various clinical implications. Researchers have explored the relationship between extended-spectrum β-lactamase–producing and gut microbiota composition, which influence host health and disease susceptibility, in adults. In this study, we analyzed gut microbiota composition in Taiwanese children by the colonization status of 3GC-R . This cross-sectional study included children (age, 0–6 years) from Kaohsiung, Taiwan. Fecal samples were subjected to microbiological and gut microbiome (full-length 16S rRNA sequencing) analyses. The antimicrobial susceptibility of colonies isolated from the samples was tested. Furthermore, gut microbiota compositions and diversity indices were compared between 3GC-R carriers and noncarriers. Approximately 46% of all children aged <6 years carried 3GC-R . The abundances of , , and (genus level) were higher in carriers than in noncarriers. By contrast, the abundances of (family level) and (genus level) were higher in noncarriers than in carriers. No significant between-group difference was observed in alpha diversity. However, a significant between-group difference was noted in beta diversity (unweighted UniFrac analysis). This is the first study that investigated differences in the gut microbiota between healthy 3GC-R carriers and noncarriers in children, suggesting potential mechanisms involving altered utilization of short-chain fatty acids and elevated succinate levels contributing to increased colonization of 3GC-R . The other taxa identified in this study may contribute to colonization resistance in the pediatric population.
{"title":"Gut microbiota compositions in the carriers and noncarriers of third-generation cephalosporin–resistant Escherichia coli: A study among children in southern Taiwan","authors":"Keng-Chin Yang, Wan-Yu Tien, Ming-Fang Cheng","doi":"10.1016/j.jmii.2024.08.010","DOIUrl":"https://doi.org/10.1016/j.jmii.2024.08.010","url":null,"abstract":"Antimicrobial resistance, particularly in third-generation cephalosporin–resistant (3GC-R) (), poses major global health challenges and has various clinical implications. Researchers have explored the relationship between extended-spectrum β-lactamase–producing and gut microbiota composition, which influence host health and disease susceptibility, in adults. In this study, we analyzed gut microbiota composition in Taiwanese children by the colonization status of 3GC-R . This cross-sectional study included children (age, 0–6 years) from Kaohsiung, Taiwan. Fecal samples were subjected to microbiological and gut microbiome (full-length 16S rRNA sequencing) analyses. The antimicrobial susceptibility of colonies isolated from the samples was tested. Furthermore, gut microbiota compositions and diversity indices were compared between 3GC-R carriers and noncarriers. Approximately 46% of all children aged <6 years carried 3GC-R . The abundances of , , and (genus level) were higher in carriers than in noncarriers. By contrast, the abundances of (family level) and (genus level) were higher in noncarriers than in carriers. No significant between-group difference was observed in alpha diversity. However, a significant between-group difference was noted in beta diversity (unweighted UniFrac analysis). This is the first study that investigated differences in the gut microbiota between healthy 3GC-R carriers and noncarriers in children, suggesting potential mechanisms involving altered utilization of short-chain fatty acids and elevated succinate levels contributing to increased colonization of 3GC-R . The other taxa identified in this study may contribute to colonization resistance in the pediatric population.","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":"58 1","pages":""},"PeriodicalIF":7.4,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142207780","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}
Liver cirrhosis compromises immunity against cryptococcosis, and liver transplant recipients tend to develop the disease earlier after transplantation, possibly due to unrecognized pretransplant infection. We assessed the prevalence and characteristics of cryptococcosis among liver transplant candidates and whether pre-transplant cryptococcal antigen (CrAg) can detect the disease before transplantation. We retrospectively included liver transplant candidates in a tertiary hospital during 2017–2022. Serum CrAg and pulmonary computed tomography were incorporated in routine transplant evaluation. Other investigations were done if indicated. Cryptococcosis was diagnosed by positive culture or CrAg. Risk factors for cryptococcosis were also assessed. Of the 377 candidates with a median MELD-Na score of 18, 84.4% had hepatitis B virus (HBV) infection. Cryptococcosis was diagnosed in 10 (2.6%) candidates, by CrAg in 6, culture in 2, or both in 2. Only 3 had fever, and 3 were asymptomatic; 7 had pulmonary cryptococcosis. Of the 10 candidates with cryptococcosis, one underwent transplantation after 143-day antifungals. Of the 87 candidates undergoing liver transplantation, one (1.2%) recipient developed cryptococcosis 14 days post-transplant with negative CrAg three weeks before transplantation. HBsAg-positive chronic HBV infection with HBV DNA loads <2000 IU/mL was significantly associated with cryptococcosis (odds ratio 4.4, 95% confidence interval 1.2–16.5, p = 0.03) after the adjustment of MELD-Na score. The prevalence of cryptococcosis was 2.6% among our liver transplant candidates and CrAg detected 80% of the cases. Disease presentation was mild and pulmonary disease predominated. HBsAg-positive chronic HBV infection with HBV DNA loads <2000 IU/mL was significantly associated with cryptococcosis.
{"title":"Cryptococcosis in wait-listed liver transplant candidates: Prevalence, manifestations, and risk factors","authors":"Wan-Ting Tsai, Aristine Cheng, Yu-Chung Chuang, Cheng-Maw Ho, Yao-Ming Wu, Ming-Chih Ho, Hsin-Yun Sun, Ray-Hung Hu, Yee-Chun Chen","doi":"10.1016/j.jmii.2024.08.001","DOIUrl":"https://doi.org/10.1016/j.jmii.2024.08.001","url":null,"abstract":"Liver cirrhosis compromises immunity against cryptococcosis, and liver transplant recipients tend to develop the disease earlier after transplantation, possibly due to unrecognized pretransplant infection. We assessed the prevalence and characteristics of cryptococcosis among liver transplant candidates and whether pre-transplant cryptococcal antigen (CrAg) can detect the disease before transplantation. We retrospectively included liver transplant candidates in a tertiary hospital during 2017–2022. Serum CrAg and pulmonary computed tomography were incorporated in routine transplant evaluation. Other investigations were done if indicated. Cryptococcosis was diagnosed by positive culture or CrAg. Risk factors for cryptococcosis were also assessed. Of the 377 candidates with a median MELD-Na score of 18, 84.4% had hepatitis B virus (HBV) infection. Cryptococcosis was diagnosed in 10 (2.6%) candidates, by CrAg in 6, culture in 2, or both in 2. Only 3 had fever, and 3 were asymptomatic; 7 had pulmonary cryptococcosis. Of the 10 candidates with cryptococcosis, one underwent transplantation after 143-day antifungals. Of the 87 candidates undergoing liver transplantation, one (1.2%) recipient developed cryptococcosis 14 days post-transplant with negative CrAg three weeks before transplantation. HBsAg-positive chronic HBV infection with HBV DNA loads <2000 IU/mL was significantly associated with cryptococcosis (odds ratio 4.4, 95% confidence interval 1.2–16.5, p = 0.03) after the adjustment of MELD-Na score. The prevalence of cryptococcosis was 2.6% among our liver transplant candidates and CrAg detected 80% of the cases. Disease presentation was mild and pulmonary disease predominated. HBsAg-positive chronic HBV infection with HBV DNA loads <2000 IU/mL was significantly associated with cryptococcosis.","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":"29 1","pages":""},"PeriodicalIF":7.4,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142207781","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}
Pub Date : 2024-08-08DOI: 10.1016/j.jmii.2024.08.002
Chou-Jui Lin , Jin-Hua Chen , Shun-Tien Chien , Yi-Wen Huang , Chih-Bin Lin , Jen-Jyh Lee , Chih-Hsin Lee , Ming-Chih Yu , Chen-Yuan Chiang
Background
Bedaquiline, delamanid and fluoroquinolones are associated with increased QTcF. Whether clofazimine is associated with QTcF prolongation is less clear.
Methods
All patients with rifampicin-resistant TB enrolled between May 2017 and Dec 2019 were included. ECGs were performed at baseline, month 1, month 3 and month 6 for patients treated with conventional regimens, and at additional timepoint for patients treated with bedaquiline, delamanid and short regimen. We estimated the maximum increase of QTcF and constructed cox proportional hazards models to assess factors associated with QTcF≥501ms.
Results
Among 321 patients, 59 (18.4%) patients had QTcF≥501ms during a mean follow-up of 242 days (median 189, range 4–1091). The median maximum increase of QTcF was 43.4 ms (IQR 31.3–65.9) in patients treated with clofazimine. Treatment with clofazimine was significantly associated with QTcF≥501ms as compared to without clofazimine (adjusted hazards ratio (adjHR) 4.35, 95% confidence interval (CI) 2.01–9.44). Among patients not treated with bedaquiline and delamanid, those treated with clofazimine and a fluoroquinolone (adjHR 3.43, 95% CI 1.61–7.34) and those treated with clofazimine and high dose moxifloxacin (adjHR 6.54, 95% CI 2.43–17.60) had a significantly higher risk of QTcF≥501ms as compared to those treated with a fluoroquinolone without other QTcF prolonging agents. Four (1.6%) patients had documented ventricular tachycardia, in which one was Torsade de pointes. One patient was found to have sudden death during hospitalization.
Conclusions
Clofazimine was significantly associated with an increased risk of QTcF prolongation. QTcF≥501ms was potentially associated with fatal event and needed to be managed cautiously.
{"title":"Clofazimine and QT prolongation in the treatment of rifampicin-resistant tuberculosis: Findings of aDSM in Taiwan","authors":"Chou-Jui Lin , Jin-Hua Chen , Shun-Tien Chien , Yi-Wen Huang , Chih-Bin Lin , Jen-Jyh Lee , Chih-Hsin Lee , Ming-Chih Yu , Chen-Yuan Chiang","doi":"10.1016/j.jmii.2024.08.002","DOIUrl":"10.1016/j.jmii.2024.08.002","url":null,"abstract":"<div><h3>Background</h3><p>Bedaquiline, delamanid and fluoroquinolones are associated with increased QTcF. Whether clofazimine is associated with QTcF prolongation is less clear.</p></div><div><h3>Methods</h3><p>All patients with rifampicin-resistant TB enrolled between May 2017 and Dec 2019 were included. ECGs were performed at baseline, month 1, month 3 and month 6 for patients treated with conventional regimens, and at additional timepoint for patients treated with bedaquiline, delamanid and short regimen. We estimated the maximum increase of QTcF and constructed cox proportional hazards models to assess factors associated with QTcF≥501ms.</p></div><div><h3>Results</h3><p>Among 321 patients, 59 (18.4%) patients had QTcF≥501ms during a mean follow-up of 242 days (median 189, range 4–1091). The median maximum increase of QTcF was 43.4 ms (IQR 31.3–65.9) in patients treated with clofazimine. Treatment with clofazimine was significantly associated with QTcF≥501ms as compared to without clofazimine (adjusted hazards ratio (adjHR) 4.35, 95% confidence interval (CI) 2.01–9.44). Among patients not treated with bedaquiline and delamanid, those treated with clofazimine and a fluoroquinolone (adjHR 3.43, 95% CI 1.61–7.34) and those treated with clofazimine and high dose moxifloxacin (adjHR 6.54, 95% CI 2.43–17.60) had a significantly higher risk of QTcF≥501ms as compared to those treated with a fluoroquinolone without other QTcF prolonging agents. Four (1.6%) patients had documented ventricular tachycardia, in which one was Torsade de pointes. One patient was found to have sudden death during hospitalization.</p></div><div><h3>Conclusions</h3><p>Clofazimine was significantly associated with an increased risk of QTcF prolongation. QTcF≥501ms was potentially associated with fatal event and needed to be managed cautiously.</p></div>","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":"57 5","pages":"Pages 791-800"},"PeriodicalIF":4.5,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1684118224001464/pdfft?md5=09591c0da3b02e01c30cbeef369b0c1b&pid=1-s2.0-S1684118224001464-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142006010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-06DOI: 10.1016/j.jmii.2024.07.009
Li-Kuo Kuo , Hou-Tai Chang , Shun-Chung Hsueh , I-Min Liu , Po-Chuen Hsieh , Shio-Shin Jean
Objectives
To understand the microbial profile and investigate the independent predictors for healthcare-associated pneumonia (HCAP) pertinaciously caused by isolates of multidrug-resistant (MDR) Gram-negative bacteria (GNB).
Methods
Multicenter ICU patients who received appropriate antibiotic treatments for preceding pneumonia due to MDR GNB isolates and subsequently developed HCAP caused by either MDR GNB (n = 126) or non-MDR GNB (n = 40) isolates in Taiwan between 2018 and 2023 were enrolled. Between the groups of patients with HCAP due to MDR GNB and non-MDR GNB, the proportions of the following variables, including demographic characteristics, important co-morbidities, nursing home residence, physiological severity, intervals between two hospitalizations, steroid use, the tracheostomy tube use alone, ventilator support, and the predominant GNB species involving HCAP, were analyzed using the chi-square test. Logistic regression was employed to explore the independent predictors for HCAP persistently caused by MDR GNB in the aforementioned variables with a P-value of <0.15 in the univariate analysis.
Results
MDR-Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii complex were the three predominant species causing HCAP. Chronic structural lung disorders, diabetes mellitus, intervals of ≤30 days between two hospitalizations, use of the tracheostomy tube alone, and prior pneumonia caused by MDR A. baumannii complex were shown to independently predict the HCAP tenaciously caused by MDR GNB. Conversely, the preceding pneumonia caused by MDR P. aeruginosa was a negative predictor.
Conclusion
Identifying predictors for HCAP persistently caused by MDR GNB is crucial for prescribing appropriate antibiotics.
{"title":"Bacterial profile, and independent predictors for healthcare-associated pneumonia persistently caused by multidrug-resistant Gram-negative bacteria for patients with the preceding multidrug-resistant Gram-negative pneumonia in Taiwan","authors":"Li-Kuo Kuo , Hou-Tai Chang , Shun-Chung Hsueh , I-Min Liu , Po-Chuen Hsieh , Shio-Shin Jean","doi":"10.1016/j.jmii.2024.07.009","DOIUrl":"10.1016/j.jmii.2024.07.009","url":null,"abstract":"<div><h3>Objectives</h3><p>To understand the microbial profile and investigate the independent predictors for healthcare-associated pneumonia (HCAP) pertinaciously caused by isolates of multidrug-resistant (MDR) Gram-negative bacteria (GNB).</p></div><div><h3>Methods</h3><p>Multicenter ICU patients who received appropriate antibiotic treatments for preceding pneumonia due to MDR GNB isolates and subsequently developed HCAP caused by either MDR GNB (n = 126) or non-MDR GNB (n = 40) isolates in Taiwan between 2018 and 2023 were enrolled. Between the groups of patients with HCAP due to MDR GNB and non-MDR GNB, the proportions of the following variables, including demographic characteristics, important co-morbidities, nursing home residence, physiological severity, intervals between two hospitalizations, steroid use, the tracheostomy tube use alone, ventilator support, and the predominant GNB species involving HCAP, were analyzed using the chi-square test. Logistic regression was employed to explore the independent predictors for HCAP persistently caused by MDR GNB in the aforementioned variables with a <em>P</em>-value of <0.15 in the univariate analysis.</p></div><div><h3>Results</h3><p>MDR-<em>Klebsiella pneumoniae</em>, <em>Pseudomonas aeruginosa</em>, and <em>Acinetobacter baumannii</em> complex were the three predominant species causing HCAP. Chronic structural lung disorders, diabetes mellitus, intervals of ≤30 days between two hospitalizations, use of the tracheostomy tube alone, and prior pneumonia caused by MDR <em>A. baumannii</em> complex were shown to independently predict the HCAP tenaciously caused by MDR GNB. Conversely, the preceding pneumonia caused by MDR <em>P. aeruginosa</em> was a negative predictor.</p></div><div><h3>Conclusion</h3><p>Identifying predictors for HCAP persistently caused by MDR GNB is crucial for prescribing appropriate antibiotics.</p></div>","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":"57 5","pages":"Pages 801-811"},"PeriodicalIF":4.5,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S168411822400121X/pdfft?md5=1df95c0509fa51081cc6f881e4d055d5&pid=1-s2.0-S168411822400121X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-03DOI: 10.1016/j.jmii.2024.07.010
Ruibing Yang, Meiyining Xu, Lichao zhang, Yao Liao, Yuheng Liu, Xiaoyan Deng, Lifu Wang
is an important soil-transmitted helminth occurring world-wide and affecting 30–100 million people. Because many cases are asymptomatic and sensitive diagnostic methods are lacking, infection is frequently underdiagnosed. The increasing incidence of autoimmune and wasting diseases and increased use of immunosuppressive agents, as well as the increased use of immunosuppressants and cytotoxic drugs, have increased infection and their mortality. This review provides information about epidemiology, life cycle, aetiology, pathology, comorbidities, immunology, vaccines, diagnosis, treatment, prevention, control and makes some recommendations for future prevention and control of this important parasite.
{"title":"Human Strongyloides stercoralis infection","authors":"Ruibing Yang, Meiyining Xu, Lichao zhang, Yao Liao, Yuheng Liu, Xiaoyan Deng, Lifu Wang","doi":"10.1016/j.jmii.2024.07.010","DOIUrl":"https://doi.org/10.1016/j.jmii.2024.07.010","url":null,"abstract":"is an important soil-transmitted helminth occurring world-wide and affecting 30–100 million people. Because many cases are asymptomatic and sensitive diagnostic methods are lacking, infection is frequently underdiagnosed. The increasing incidence of autoimmune and wasting diseases and increased use of immunosuppressive agents, as well as the increased use of immunosuppressants and cytotoxic drugs, have increased infection and their mortality. This review provides information about epidemiology, life cycle, aetiology, pathology, comorbidities, immunology, vaccines, diagnosis, treatment, prevention, control and makes some recommendations for future prevention and control of this important parasite.","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":"40 1","pages":""},"PeriodicalIF":7.4,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141969217","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}
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