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Nonbacterial thrombotic endocarditis mimics acute infective endocarditis in a woman with endometrial cancer 一名子宫内膜癌妇女的非细菌性血栓性心内膜炎模仿急性感染性心内膜炎。
IF 4.5 2区 医学 Q2 IMMUNOLOGY Pub Date : 2024-08-01 DOI: 10.1016/j.jmii.2024.02.006
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引用次数: 0
Efficacy of short- versus prolonged-courses of antimicrobial therapy for carbapenem-resistant Klebsiella pneumoniae bloodstream infections: A propensity score-matched cohort study 耐碳青霉烯类肺炎克雷伯氏菌血流感染短期与长期抗菌治疗的疗效:倾向评分匹配队列研究
IF 4.5 2区 医学 Q2 IMMUNOLOGY Pub Date : 2024-08-01 DOI: 10.1016/j.jmii.2024.05.010

Background

As limited antibiotic options are available for the treatment of carbapenem-resistant Klebsiella pneumoniae (CRKP) bloodstream infections (BSIs), the optimal treatment duration for CRKP BSIs is unclear. Our objective was to investigate whether short courses (6–10 days) are as effective as prolonged courses (≥11 days) of active antibiotic therapy for CRKP BSIs.

Methods

A retrospective cohort study comprising adults with monomicrobial CRKP BSI receiving a short or prolonged course of in vitro active therapy at a medical center was conducted between 2010 and 2021. Comparisons of two therapeutic strategies were assessed by the logistic regression model and propensity score analysis. The primary endpoint was 30-day crude mortality. Secondary outcomes included recurrent BSIs, the emergence of multidrug-resistant organisms and candidemia during hospitalization after completing antibiotic therapy for CRKP BSIs.

Results

Of 263 eligible adults, 160 (60.8%) were male, and the median (interquartile range) age was 69.0 (53.0–76.0) years. Common comorbidities included diabetes (143 patients, 54.4%), malignancy (75, 28.5%), cerebrovascular accident (58, 22.1%), and hemodialysis (49, 18.6%). The 30-day mortality rate was 8.4% (22 patients). Of 84 propensity score well-balanced matched pairs, the 30-day mortality was similar in the short-course and prolonged-course group (6.0% and 7.1%, respectively; P = 1.00). However, there were less episodes candidemia in the short-course group (1.2% versus 13.1%; odds ratio, 0.08; 95% confidence interval, 0.01–0.63; P = 0.005).

Conclusion

Short courses of active therapy for CRKP BSIs demonstrate comparable clinical outcomes to prolonged courses and are associated with a lower risk of subsequent candidemia.

由于可用于治疗耐碳青霉烯类(CRKP)血流感染(BSI)的抗生素种类有限,CRKP BSI 的最佳治疗时间尚不明确。我们的目的是研究短疗程(6-10 天)与长疗程(≥11 天)积极抗生素治疗 CRKP BSI 是否同样有效。我们在 2010 年至 2021 年期间开展了一项回顾性队列研究,研究对象包括在一家医疗中心接受短期或长期积极治疗的单微生物 CRKP BSI 成人患者。通过逻辑回归模型和倾向评分分析对两种治疗策略进行了评估比较。主要终点是 30 天粗死亡率。次要结局包括复发性BSI、多重耐药菌的出现以及CRKP BSI抗生素治疗结束后住院期间的念珠菌血症。在263名符合条件的成人中,160人(60.8%)为男性,年龄中位数(四分位数间距)为69.0(53.0-76.0)岁。常见合并症包括糖尿病(143 名患者,54.4%)、恶性肿瘤(75 名患者,28.5%)、脑血管意外(58 名患者,22.1%)和血液透析(49 名患者,18.6%)。30 天死亡率为 8.4%(22 名患者)。在 84 对倾向评分平衡良好的配对患者中,短疗程组和长疗程组的 30 天死亡率相似(分别为 6.0% 和 7.1%;= 1.00)。不过,短疗程组的念珠菌血症发病率较低(1.2% 对 13.1%;几率比 0.08;95% 置信区间 0.01-0.63; = 0.005)。短疗程积极治疗 CRKP BSI 的临床效果与长疗程相当,且随后发生念珠菌血症的风险较低。
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引用次数: 0
The multicenter real-world report of the efficacies of 14-day esomeprazole-based and rabeprazole-based high-dose dual therapy in first-line Helicobacter pylori eradication in Taiwan 台湾多中心真实世界报告:基于埃索美拉唑和雷贝拉唑的 14 天大剂量双重疗法在一线根除幽门螺杆菌中的疗效。
IF 4.5 2区 医学 Q2 IMMUNOLOGY Pub Date : 2024-08-01 DOI: 10.1016/j.jmii.2024.02.009

Background

High-dose dual therapy (HDDT) using proton-pump inhibitors (PPI) and amoxicillin attracted attention for its simplicity and lower adverse event profile. Besides, vonoprazan is not available worldwide. This real-world study aims to compare the efficacy of esomeprazole-based and rabeprazole-based HDDT regimens and to identify clinical factors influencing outcomes.

Methods

A retrospective study enrolled 346 Helicobacter pylori-infected naïve patients from January 2016 to August 2023. Patients were assigned to either a 14-day esomeprazole-based HDDT (EA-14; esomeprazole 40 mg t.i.d. and amoxicillin 750 mg q.i.d. for 14 days, n = 173) or a 14-day rabeprazole-based HDDT (RA-14; rabeprazole 20 mg and amoxicillin 750 mg q.i.d. for 14 days, n = 173).

Results

Five patients from the EA-14 group and 10 from the RA-14 group were lost to follow-up, resulting in 168 and 163 patients for the per-protocol (PP) analysis, respectively. Eradication rates for the EA-14 and RA-14 groups were 90.2% and 80.9% (P = 0.014) in intention-to-treat (ITT) analysis; and 92.9% and 85.9% (P = 0.039) in PP analysis. Adverse event rates were similar between the two groups (11.9% vs 11.7%, P = 0.944). In multiple logistic regression analysis, age≧60 was associated with eradication failure (P = 0.046) and a trend of significance for smoking (P = 0.060) in the EA-14 group but not in the RA-14 group. A trend of significance was also observed for eradication regimens (EA-14 vs RA-14) (P = 0.071).

The antibiotic resistance rates were amoxicillin (2.3%), clarithromycin (14.7%), metronidazole (40.3%), and dual resistance to clarithromycin and metronidazole (7.0%).

Conclusions

Esomeprazole-based HDDT achieved over 90% eradication rates but rabeprazole-based HDDT, which failed.

背景:使用质子泵抑制剂(PPI)和阿莫西林的大剂量双重疗法(HDDT)因其简便、不良反应少而备受关注。此外,Vonoprazan 并非全球通用。这项真实世界研究旨在比较以埃索美拉唑为基础的 HDDT 方案和以雷贝拉唑为基础的 HDDT 方案的疗效,并确定影响疗效的临床因素:一项回顾性研究在2016年1月至2023年8月期间招募了346名幽门螺杆菌感染的新患者。患者被分配接受为期14天的基于埃索美拉唑的HDDT(EA-14;埃索美拉唑40 mg t.i.d.和阿莫西林750 mg q.i.d.,共14天,n = 173)或为期14天的基于雷贝拉唑的HDDT(RA-14;雷贝拉唑20 mg和阿莫西林750 mg q.i.d.,共14天,n = 173):EA-14组和RA-14组分别有5名和10名患者失去随访,因此按方案(PP)分析的患者分别为168名和163名。在意向治疗(ITT)分析中,EA-14组和RA-14组的根除率分别为90.2%和80.9%(P = 0.014);在PP分析中,EA-14组和RA-14组的根除率分别为92.9%和85.9%(P = 0.039)。两组的不良事件发生率相似(11.9% vs 11.7%,P = 0.944)。在多重逻辑回归分析中,EA-14 组年龄≧60 与根除失败相关(P = 0.046),吸烟与根除失败呈显著性趋势(P = 0.060),而 RA-14 组与吸烟无关。根除方案(EA-14 与 RA-14)也有显著性趋势(P = 0.071)。抗生素耐药率为阿莫西林(2.3%)、克拉霉素(14.7%)、甲硝唑(40.3%)以及克拉霉素和甲硝唑双重耐药(7.0%):结论:以埃索美拉唑为基础的HDDT的根除率超过90%,但以雷贝拉唑为基础的HDDT却失败了。
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引用次数: 0
Changing epidemic patterns of infectious diseases during and after COVID-19 pandemic in Taiwan 台湾 COVID-19 大流行期间和之后传染病流行模式的变化。
IF 4.5 2区 医学 Q2 IMMUNOLOGY Pub Date : 2024-07-19 DOI: 10.1016/j.jmii.2024.07.002
Ping-Ing Lee , Po-Ren Hsueh , Jen-Hsiang Chuang , Ming-Tsan Liu

Mitigation measures aimed at curbing the transmission of the severe acute respiratory syndrome coronavirus 2 effectively suppressed the occurrence of many respiratory infections other than coronavirus disease 2019. Several infections experienced a resurgence following the relaxation of non-pharmaceutical interventions, surpassing pre-pandemic levels in Taiwan. This phenomenon, known as immune debt, primarily affected respiratory infections in young children, including respiratory syncytial virus (RSV) infection. Infections transmitted by means other than droplets or contact did not exhibit significant changes in their epidemic patterns, such as varicella and Japanese encephalitis. Alterations in seasonality were noted for RSV infection and influenza, and these changes are also linked to immune debt. The recent emergence of severe pediatric pneumonia in northern China may be associated with immune debt and the rise of macrolide-resistant Mycoplasma pneumoniae associated with severe illness.

旨在遏制严重急性呼吸系统综合征冠状病毒 2 传播的缓解措施有效抑制了 2019 年冠状病毒病以外的许多呼吸道感染的发生。在放松非药物干预措施后,一些感染再次出现,超过了台湾大流行前的水平。这种现象被称为免疫债务,主要影响幼儿呼吸道感染,包括呼吸道合胞病毒(RSV)感染。通过飞沫或接触以外的方式传播的传染病,如水痘和日本脑炎,其流行模式没有发生显著变化。RSV 感染和流感的季节性发生了变化,这些变化也与免疫债务有关。最近在中国北方出现的小儿重症肺炎可能与免疫债务以及与重症肺炎有关的耐大环内酯肺炎支原体的增加有关。
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引用次数: 0
Twelve-month effectiveness and safety of bictegravir/emtricitabine/tenofovir alafenamide in treatment-naïve and treatment-experienced people with HIV: Findings from the Asia cohort of the BICSTaR study 比特拉韦/恩曲他滨/替诺福韦-阿拉非那酰胺治疗艾滋病病毒感染者的十二个月有效性和安全性:BICSTaR 研究亚洲队列的结果
IF 4.5 2区 医学 Q2 IMMUNOLOGY Pub Date : 2024-07-14 DOI: 10.1016/j.jmii.2024.07.003
Yu-Ting Tseng , Chia-Jui Yang , Yeon-Sook Kim , Jun Yong Choi , Chen Seong Wong , Kuan-Yeh Lee , Jeong-a Lee , Jack Chang , Rebecca Harrison , Andrea Marongiu , Sun Hee Lee , Chien-Ching Hung

Background

The ongoing, observational BICSTaR (BICtegravir Single Tablet Regimen) cohort study is evaluating real-world effectiveness and safety of bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) in people with HIV across 14 countries over 24 months. We present 12-month data from the BICSTaR Asia cohort.

Methods

Data were pooled from retrospective and prospective cohorts of antiretroviral therapy (ART)-naïve (hereafter, TN) and ART-experienced (hereafter, TE) people with HIV (aged ≥21 years) receiving B/F/TAF in routine clinical care in the Republic of Korea, Singapore, and Taiwan. Analyses included effectiveness (primary endpoint: HIV-1 RNA <50 copies/ml, missing = excluded analysis), CD4 count, CD4/CD8 ratio, safety, treatment persistence, and patient-reported outcomes (prospective group).

Results

The analysis population included 328 participants (80 retrospective, 248 prospective; 65 TN, 263 TE). Participants were predominantly male (96.9% TN, 93.2% TE) with ≥1 comorbidity (52.3% TN, 57.8% TE); median age (years) was 31 (TN) and 42 (TE). Following 12 months of B/F/TAF, HIV-1 RNA was <50 copies/ml in 98.2% (54/55) of TN and 97.0% (227/234) of TE participants. Median (Q1, Q3) CD4 cell count increased by +187 (119, 291) cells/μl in the TN group (p < 0.001) and remained stable (+8 [–91, 110] cells/μl) in the TE group. B/F/TAF persistence was high in the prospective group, with 1/34 (2.9%) TN and 5/214 (2.3%) TE participants discontinuing treatment within 12 months. Drug-related adverse events occurred in 5.8% (19/328) of participants, leading to treatment discontinuation in 0.6% (2/328).

Conclusions

Real-world evidence from BICSTaR supports the effectiveness, safety and tolerability of B/F/TAF in people with HIV in Asia.

背景正在进行的观察性 BICSTaR(BICtegravir Single Tablet Regimen,比特拉韦单片疗法)队列研究正在评估比特拉韦/恩曲他滨/替诺福韦-阿拉非那胺(B/F/TAF)在 14 个国家艾滋病毒感染者中 24 个月的实际有效性和安全性。我们展示了 BICSTaR 亚洲队列的 12 个月数据。方法数据来自大韩民国、新加坡和台湾地区在常规临床护理中接受 B/F/TAF 治疗的抗逆转录病毒疗法(ART)无效(以下简称 TN)和有抗逆转录病毒疗法经验(以下简称 TE)的 HIV 感染者(年龄≥21 岁)的回顾性和前瞻性队列。分析包括有效性(主要终点:HIV-1 RNA 50拷贝/毫升,缺失 = 排除分析)、CD4计数、CD4/CD8比值、安全性、治疗持续性和患者报告结果(前瞻性组)。结果分析人群包括328名参与者(80名回顾性参与者,248名前瞻性参与者;65名TN,263名TE)。参与者主要为男性(96.9% TN,93.2% TE),合并症≥1 种(52.3% TN,57.8% TE);中位年龄(岁)为 31(TN)和 42(TE)。经过 12 个月的 B/F/TAF 治疗后,98.2% 的 TN 参与者(54/55)和 97.0%的 TE 参与者(227/234)的 HIV-1 RNA 为 50 copies/ml。TN 组 CD4 细胞计数中位数(Q1,Q3)增加了 +187(119,291)个/μl(p <0.001),TE 组保持稳定(+8 [-91,110] 个/μl)。前瞻性治疗组的B/F/TAF持续率较高,1/34(2.9%)名TN参与者和5/214(2.3%)名TE参与者在12个月内中断了治疗。5.8%(19/328)的参与者发生了与药物相关的不良事件,0.6%(2/328)的参与者因此中断治疗。结论BICSTaR的实际证据支持B/F/TAF在亚洲艾滋病感染者中的有效性、安全性和耐受性。
{"title":"Twelve-month effectiveness and safety of bictegravir/emtricitabine/tenofovir alafenamide in treatment-naïve and treatment-experienced people with HIV: Findings from the Asia cohort of the BICSTaR study","authors":"Yu-Ting Tseng ,&nbsp;Chia-Jui Yang ,&nbsp;Yeon-Sook Kim ,&nbsp;Jun Yong Choi ,&nbsp;Chen Seong Wong ,&nbsp;Kuan-Yeh Lee ,&nbsp;Jeong-a Lee ,&nbsp;Jack Chang ,&nbsp;Rebecca Harrison ,&nbsp;Andrea Marongiu ,&nbsp;Sun Hee Lee ,&nbsp;Chien-Ching Hung","doi":"10.1016/j.jmii.2024.07.003","DOIUrl":"10.1016/j.jmii.2024.07.003","url":null,"abstract":"<div><h3>Background</h3><p>The ongoing, observational BICSTaR (BICtegravir Single Tablet Regimen) cohort study is evaluating real-world effectiveness and safety of bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) in people with HIV across 14 countries over 24 months. We present 12-month data from the BICSTaR Asia cohort.</p></div><div><h3>Methods</h3><p>Data were pooled from retrospective and prospective cohorts of antiretroviral therapy (ART)-naïve (hereafter, TN) and ART-experienced (hereafter, TE) people with HIV (aged ≥21 years) receiving B/F/TAF in routine clinical care in the Republic of Korea, Singapore, and Taiwan. Analyses included effectiveness (primary endpoint: HIV-1 RNA &lt;50 copies/ml, missing = excluded analysis), CD4 count, CD4/CD8 ratio, safety, treatment persistence, and patient-reported outcomes (prospective group).</p></div><div><h3>Results</h3><p>The analysis population included 328 participants (80 retrospective, 248 prospective; 65 TN, 263 TE). Participants were predominantly male (96.9% TN, 93.2% TE) with ≥1 comorbidity (52.3% TN, 57.8% TE); median age (years) was 31 (TN) and 42 (TE). Following 12 months of B/F/TAF, HIV-1 RNA was &lt;50 copies/ml in 98.2% (54/55) of TN and 97.0% (227/234) of TE participants. Median (Q1, Q3) CD4 cell count increased by +187 (119, 291) cells/μl in the TN group (p &lt; 0.001) and remained stable (+8 [–91, 110] cells/μl) in the TE group. B/F/TAF persistence was high in the prospective group, with 1/34 (2.9%) TN and 5/214 (2.3%) TE participants discontinuing treatment within 12 months. Drug-related adverse events occurred in 5.8% (19/328) of participants, leading to treatment discontinuation in 0.6% (2/328).</p></div><div><h3>Conclusions</h3><p>Real-world evidence from BICSTaR supports the effectiveness, safety and tolerability of B/F/TAF in people with HIV in Asia.</p></div>","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":"57 5","pages":"Pages 760-770"},"PeriodicalIF":4.5,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1684118224001142/pdfft?md5=81f8de64e84ca34d88fa8240c4e57522&pid=1-s2.0-S1684118224001142-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141696209","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}
引用次数: 0
A sbiT-sbiRS-gloIo regulatory circuit is involved in oxidative stress tolerance of Stenotrophomonas maltophilia sbiT-sbiRS-gloIo调控回路参与了嗜麦芽霉菌的氧化应激耐受性
IF 4.5 2区 医学 Q2 IMMUNOLOGY Pub Date : 2024-07-14 DOI: 10.1016/j.jmii.2024.07.005
Cheng-Mu Wu , Yi-Tzu Lee , Hsu-Feng Lu , Yen-Ling Lin , Tsuey-Ching Yang

The sbiT-sbiR-sbiS operon of Stenotrophomonas maltophilia encodes an inner-membrane protein SbiT and a SbiS-SbiR two-component regulatory system. A sbiT mutant displayed a growth defect in LB agar. Mechanism studies revealed that sbiT deletion resulted in SbiSR activation and gloIo upregulation, which increased intracellular ROS level and caused growth defect.

嗜麦芽气单胞菌的 sbiT-sbiR-sbiS 操作子编码内膜蛋白 SbiT 和 SbiS-SbiR 双组分调控系统。sbiT 突变体在 LB 琼脂中显示出生长缺陷。机理研究发现,sbiT缺失导致SbiSR激活和gloIo上调,从而增加了细胞内ROS水平,造成生长缺陷。
{"title":"A sbiT-sbiRS-gloIo regulatory circuit is involved in oxidative stress tolerance of Stenotrophomonas maltophilia","authors":"Cheng-Mu Wu ,&nbsp;Yi-Tzu Lee ,&nbsp;Hsu-Feng Lu ,&nbsp;Yen-Ling Lin ,&nbsp;Tsuey-Ching Yang","doi":"10.1016/j.jmii.2024.07.005","DOIUrl":"10.1016/j.jmii.2024.07.005","url":null,"abstract":"<div><p>The <em>sbiT</em>-<em>sbiR</em>-<em>sbiS</em> operon of <em>Stenotrophomonas maltophilia</em> encodes an inner-membrane protein SbiT and a SbiS-SbiR two-component regulatory system. A <em>sbiT</em> mutant displayed a growth defect in LB agar. Mechanism studies revealed that <em>sbiT</em> deletion resulted in SbiSR activation and <em>gloIo</em> upregulation, which increased intracellular ROS level and caused growth defect.</p></div>","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":"57 5","pages":"Pages 827-831"},"PeriodicalIF":4.5,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1684118224001154/pdfft?md5=c9eae1eba1b4d76d478d661a2ba2c616&pid=1-s2.0-S1684118224001154-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141691979","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}
引用次数: 0
Respiratory viral infections and Kawasaki disease: A molecular epidemiological analysis 呼吸道病毒感染与川崎病:分子流行病学分析
IF 4.5 2区 医学 Q2 IMMUNOLOGY Pub Date : 2024-07-14 DOI: 10.1016/j.jmii.2024.07.001
Kentaro Marutani , Kenji Murata , Yumi Mizuno , Sagano Onoyama , Takayuki Hoshina , Kenichiro Yamamura , Kenji Furuno , Yasunari Sakai , Junji Kishimoto , Koichi Kusuhura , Toshiro Hara

Background/Purpose

Recent large-scale epidemiological studies have revealed significant temporal associations between certain viral infections and the subsequent development of Kawasaki disease (KD). Despite these associations, definitive laboratory evidence linking acute or recent viral infections to KD cases remains elusive. The objective of this study is to employ a molecular epidemiological approach to investigate the temporal association between viral infections and the development of KD.

Methods

We analyzed 2460 patients who underwent the FilmArray® Respiratory Panel test between April 2020 and September 2021.

Results

Following the application of inclusion criteria, 2402 patients were categorized into KD (n = 148), respiratory tract infection (n = 1524), and control groups (n = 730). The KD group exhibited higher positive rates for respiratory syncytial virus (RSV), human rhinovirus/enterovirus (hRV/EV), parainfluenza virus (PIV) 3, and adenovirus (AdV) compared to the control group. Additionally, coinfections involving two or more viruses were significantly more prevalent in the KD group. Notably, RSV-positive, hRV/EV-positive, and PIV3-positive KD patients exhibited a one-month delay in peak occurrence compared to non-KD patients positive for corresponding viruses. In contrast, AdV-positive KD cases did not show a one-month delay in peak occurrence. Moreover, anti-RSV, anti-PIV3, and anti-AdV antibody-positive rates or antibody titers were higher in RSV-, PIV3-, and AdV-positive KD cases, respectively, compared to non-KD cases with the same viral infections.

Conclusion

Recent infection with RSV, PIV3, or AdV, occasionally in conjunction with other viruses, may contribute to the pathogenesis of KD as infrequent complications.

背景/目的最近的大规模流行病学研究显示,某些病毒感染与随后的川崎病(KD)发病之间存在明显的时间关联。尽管存在这些关联,但将急性或近期病毒感染与川崎病病例联系起来的确切实验室证据仍然难以找到。方法我们分析了在 2020 年 4 月至 2021 年 9 月期间接受 FilmArray® 呼吸道样本检测的 2460 名患者。结果根据纳入标准,2402 名患者被分为 KD 组(n = 148)、呼吸道感染组(n = 1524)和对照组(n = 730)。与对照组相比,KD 组的呼吸道合胞病毒 (RSV)、人鼻病毒/肠道病毒 (hRV/EV)、副流感病毒 (PIV) 3 和腺病毒 (AdV) 阳性率更高。此外,KD 组合并感染两种或两种以上病毒的比例明显更高。值得注意的是,与相应病毒阳性的非 KD 患者相比,RSV 阳性、hRV/EV 阳性和 PIV3 阳性的 KD 患者的发病高峰推迟了一个月。相比之下,AdV 阳性的 KD 病例的发病高峰并没有延迟一个月。此外,在 RSV、PIV3 和 AdV 阳性的 KD 病例中,抗 RSV、抗 PIV3 和抗 AdV 抗体阳性率或抗体滴度分别高于感染相同病毒的非 KD 病例。
{"title":"Respiratory viral infections and Kawasaki disease: A molecular epidemiological analysis","authors":"Kentaro Marutani ,&nbsp;Kenji Murata ,&nbsp;Yumi Mizuno ,&nbsp;Sagano Onoyama ,&nbsp;Takayuki Hoshina ,&nbsp;Kenichiro Yamamura ,&nbsp;Kenji Furuno ,&nbsp;Yasunari Sakai ,&nbsp;Junji Kishimoto ,&nbsp;Koichi Kusuhura ,&nbsp;Toshiro Hara","doi":"10.1016/j.jmii.2024.07.001","DOIUrl":"10.1016/j.jmii.2024.07.001","url":null,"abstract":"<div><h3>Background/Purpose</h3><p>Recent large-scale epidemiological studies have revealed significant temporal associations between certain viral infections and the subsequent development of Kawasaki disease (KD). Despite these associations, definitive laboratory evidence linking acute or recent viral infections to KD cases remains elusive. The objective of this study is to employ a molecular epidemiological approach to investigate the temporal association between viral infections and the development of KD.</p></div><div><h3>Methods</h3><p>We analyzed 2460 patients who underwent the FilmArray® Respiratory Panel test between April 2020 and September 2021.</p></div><div><h3>Results</h3><p>Following the application of inclusion criteria, 2402 patients were categorized into KD (n = 148), respiratory tract infection (n = 1524), and control groups (n = 730). The KD group exhibited higher positive rates for respiratory syncytial virus (RSV), human rhinovirus/enterovirus (hRV/EV), parainfluenza virus (PIV) 3, and adenovirus (AdV) compared to the control group. Additionally, coinfections involving two or more viruses were significantly more prevalent in the KD group. Notably, RSV-positive, hRV/EV-positive, and PIV3-positive KD patients exhibited a one-month delay in peak occurrence compared to non-KD patients positive for corresponding viruses. In contrast, AdV-positive KD cases did not show a one-month delay in peak occurrence. Moreover, anti-RSV, anti-PIV3, and anti-AdV antibody-positive rates or antibody titers were higher in RSV-, PIV3-, and AdV-positive KD cases, respectively, compared to non-KD cases with the same viral infections.</p></div><div><h3>Conclusion</h3><p>Recent infection with RSV, PIV3, or AdV, occasionally in conjunction with other viruses, may contribute to the pathogenesis of KD as infrequent complications.</p></div>","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":"57 5","pages":"Pages 691-699"},"PeriodicalIF":4.5,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1684118224001129/pdfft?md5=fe77a6df805b421c26b7bce8ad6e5685&pid=1-s2.0-S1684118224001129-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141689508","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}
引用次数: 0
Risk of severe dengue during secondary infection: A population-based cohort study in Taiwan 二次感染严重登革热的风险:台湾一项基于人群的队列研究。
IF 4.5 2区 医学 Q2 IMMUNOLOGY Pub Date : 2024-07-11 DOI: 10.1016/j.jmii.2024.07.004
Hsin-I Shih , Yu-Ching Wang , Yu-Ping Wang , Chia-Yu Chi , Yu-Wen Chien

Background

Dengue poses a significant public health concern. Secondary dengue infections with different dengue virus (DENV) serotypes have been linked to an increased risk of severe dengue. This study aimed to assess the risk of severe dengue during secondary infection in Taiwan.

Methods

A retrospective cohort study was conducted using Taiwan's National Health Insurance Research Database to identify dengue cases with secondary dengue infection born after 1944 from 2014 to 2015. Ten matched patients with primary infection were selected as controls using propensity score matching for each secondary dengue infection case. The odds ratio (OR) for severe dengue in secondary versus primary infections was calculated using conditional logistic regression.

Results

This study included 357 cases with secondary dengue infection and 3570 matched controls. The risk of severe dengue was found to be 7.8% in individuals with secondary infection, compared to 3.8% in those with primary dengue infection. Secondary infection significantly increased the risk of severe dengue (OR 2.13, 95% CI: 1.40–3.25, P = 0.0004). Notably, a significant association between secondary infection and severe dengue was observed only when the interval between the first and secondary infection was greater than two years (OR 3.19, 95% CI 2.04–5.00, P < 0.0001).

Conclusion

Secondary dengue infection significantly increases the risk of severe disease in Taiwan, particularly when the interval between infections is over two years.

Healthcare professionals should maintain heightened vigilance for individuals with a history of previous dengue infection, particularly if their initial diagnosis was more than two years prior.

背景:登革热是一个重大的公共卫生问题。不同血清型登革热病毒(DENV)的二次登革热感染与严重登革热风险增加有关。本研究旨在评估台湾二次感染严重登革热的风险:方法:利用台湾国民健康保险研究数据库开展了一项回顾性队列研究,以确定2014年至2015年期间1944年后出生的登革热继发感染病例。采用倾向得分匹配法为每个继发性登革热感染病例挑选了10名与之匹配的原发性感染患者作为对照。采用条件逻辑回归法计算了继发性与原发性感染严重登革热的几率比(OR):这项研究包括 357 例继发性登革热感染病例和 3570 例匹配对照。结果发现,继发性感染者发生严重登革热的风险为 7.8%,而原发性感染者为 3.8%。继发感染会大大增加罹患严重登革热的风险(OR 2.13,95% CI:1.40-3.25,P = 0.0004)。值得注意的是,只有当首次感染和二次感染之间的间隔时间超过两年时,才能观察到二次感染与重症登革热之间存在明显的关联(OR 3.19,95% CI 2.04-5.00,P 结论:二次登革热感染会显著增加重症登革热的风险:在台湾,登革热二次感染会大大增加罹患严重疾病的风险,尤其是当感染间隔超过两年时。医护人员应提高对曾有登革热感染史者的警惕,尤其是初次确诊时间超过两年的患者。
{"title":"Risk of severe dengue during secondary infection: A population-based cohort study in Taiwan","authors":"Hsin-I Shih ,&nbsp;Yu-Ching Wang ,&nbsp;Yu-Ping Wang ,&nbsp;Chia-Yu Chi ,&nbsp;Yu-Wen Chien","doi":"10.1016/j.jmii.2024.07.004","DOIUrl":"10.1016/j.jmii.2024.07.004","url":null,"abstract":"<div><h3>Background</h3><p>Dengue poses a significant public health concern. Secondary dengue infections with different dengue virus (DENV) serotypes have been linked to an increased risk of severe dengue. This study aimed to assess the risk of severe dengue during secondary infection in Taiwan.</p></div><div><h3>Methods</h3><p>A retrospective cohort study was conducted using Taiwan's National Health Insurance Research Database to identify dengue cases with secondary dengue infection born after 1944 from 2014 to 2015. Ten matched patients with primary infection were selected as controls using propensity score matching for each secondary dengue infection case. The odds ratio (OR) for severe dengue in secondary versus primary infections was calculated using conditional logistic regression.</p></div><div><h3>Results</h3><p>This study included 357 cases with secondary dengue infection and 3570 matched controls. The risk of severe dengue was found to be 7.8% in individuals with secondary infection, compared to 3.8% in those with primary dengue infection. Secondary infection significantly increased the risk of severe dengue (OR 2.13, 95% CI: 1.40–3.25, P = 0.0004). Notably, a significant association between secondary infection and severe dengue was observed only when the interval between the first and secondary infection was greater than two years (OR 3.19, 95% CI 2.04–5.00, P &lt; 0.0001).</p></div><div><h3>Conclusion</h3><p>Secondary dengue infection significantly increases the risk of severe disease in Taiwan, particularly when the interval between infections is over two years.</p><p>Healthcare professionals should maintain heightened vigilance for individuals with a history of previous dengue infection, particularly if their initial diagnosis was more than two years prior.</p></div>","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":"57 5","pages":"Pages 730-738"},"PeriodicalIF":4.5,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1684118224001166/pdfft?md5=4e156297f003b43f14839f3ea1e1a71d&pid=1-s2.0-S1684118224001166-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141635970","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}
引用次数: 0
Plasma SCUBE2 as a novel biomarker associates with survival outcomes in patients with sepsis-associated acute kidney injury 血浆 SCUBE2 作为一种新型生物标记物与败血症相关急性肾损伤患者的生存结果有关
IF 4.5 2区 医学 Q2 IMMUNOLOGY Pub Date : 2024-07-11 DOI: 10.1016/j.jmii.2024.07.006
Kuo-Hua Lee , Yuh-Charn Lin , Ming-Tsun Tsai , Cheng-Fen Tu , Shuo-Ming Ou , Huan-Yuan Chen , Fu-An Li , Wei-Cheng Tseng , Yao-Ping Lin , Ruey-Bing Yang , Der-Cherng Tarng

Background

The adverse effects of sepsis-associated acute kidney injury (SA-AKI) highlight the need for new biomarkers. Signal Peptide-Complement C1r/C1s, Uegf, Bmp1-Epidermal Growth Factor-like Domain-Containing Protein 2 (SCUBE2), important for angiogenesis and endothelial integrity, has been linked to increased mortality in models of lipopolysaccharide-induced lung injury. This research aimed to assess the utility of plasma SCUBE2 levels as a prognostic indicator for SA-AKI in intensive care unit (ICU) patients.

Methods

Between September 2020 and December 2022, our study enrolled ICU patients diagnosed with stage 3 SA-AKI. We collected demographic information, illness severity indices, and laboratory data, including plasma SCUBE2 and sepsis-triggered cytokine levels. We employed receiver operating characteristic curves and DeLong tests to assess the predictive accuracy for survival, Kaplan–Meier curves to evaluate the relative risk of death, and multivariate logistic regression to identify independent mortality predictors.

Results

Among the total of 200 participants, the survivors had significantly higher plasma SCUBE2 levels (115.9 ng/mL) compared to those who died (35.6 ng/mL). SCUBE2 levels showed a positive correlation with the anti-inflammatory cytokine IL-10 and a negative correlation with the APACHE II score, SOFA score, C-reactive protein, and monocyte chemoattractant protein-1. Multivariate analysis revealed that elevated SCUBE2 and IL-10 levels were independently protective against mortality, and associated with the most favorable 30-day survival outcomes.

Conclusions

In ICU patients with stage 3 SA-AKI, lower plasma levels of SCUBE2 were correlated with elevated pro-inflammatory factors, which impacted survival outcomes. This suggests that SCUBE2 could be a potential biomarker for predicting prognosis in patients with SA-AKI.

背景脓毒症相关急性肾损伤(SA-AKI)的不良影响凸显了对新生物标记物的需求。信号肽-补体C1r/C1s、Uegf、Bmp1-表皮生长因子样结构域含蛋白2(SCUBE2)对血管生成和内皮完整性非常重要,在脂多糖诱导的肺损伤模型中与死亡率增加有关。本研究旨在评估血浆 SCUBE2 水平作为重症监护病房(ICU)患者 SA-AKI 预后指标的实用性。我们收集了人口统计学信息、病情严重程度指数和实验室数据,包括血浆 SCUBE2 和脓毒症触发细胞因子水平。我们采用接收器操作特征曲线和 DeLong 检验来评估生存预测的准确性,采用 Kaplan-Meier 曲线来评估死亡的相对风险,并采用多变量逻辑回归来确定独立的死亡预测因素。 结果在总共 200 名参与者中,幸存者的血浆 SCUBE2 水平(115.9 纳克/毫升)明显高于死亡者(35.6 纳克/毫升)。SCUBE2 水平与抗炎细胞因子 IL-10 呈正相关,与 APACHE II 评分、SOFA 评分、C 反应蛋白和单核细胞趋化蛋白-1 呈负相关。多变量分析显示,SCUBE2 和 IL-10 水平的升高对死亡率具有独立的保护作用,并与最有利的 30 天生存结果相关。这表明 SCUBE2 可能是预测 SA-AKI 患者预后的潜在生物标志物。
{"title":"Plasma SCUBE2 as a novel biomarker associates with survival outcomes in patients with sepsis-associated acute kidney injury","authors":"Kuo-Hua Lee ,&nbsp;Yuh-Charn Lin ,&nbsp;Ming-Tsun Tsai ,&nbsp;Cheng-Fen Tu ,&nbsp;Shuo-Ming Ou ,&nbsp;Huan-Yuan Chen ,&nbsp;Fu-An Li ,&nbsp;Wei-Cheng Tseng ,&nbsp;Yao-Ping Lin ,&nbsp;Ruey-Bing Yang ,&nbsp;Der-Cherng Tarng","doi":"10.1016/j.jmii.2024.07.006","DOIUrl":"10.1016/j.jmii.2024.07.006","url":null,"abstract":"<div><h3>Background</h3><p>The adverse effects of sepsis-associated acute kidney injury (SA-AKI) highlight the need for new biomarkers. Signal Peptide-Complement C1r/C1s, Uegf, Bmp1-Epidermal Growth Factor-like Domain-Containing Protein 2 (SCUBE2), important for angiogenesis and endothelial integrity, has been linked to increased mortality in models of lipopolysaccharide-induced lung injury. This research aimed to assess the utility of plasma SCUBE2 levels as a prognostic indicator for SA-AKI in intensive care unit (ICU) patients.</p></div><div><h3>Methods</h3><p>Between September 2020 and December 2022, our study enrolled ICU patients diagnosed with stage 3 SA-AKI. We collected demographic information, illness severity indices, and laboratory data, including plasma SCUBE2 and sepsis-triggered cytokine levels. We employed receiver operating characteristic curves and DeLong tests to assess the predictive accuracy for survival, Kaplan–Meier curves to evaluate the relative risk of death, and multivariate logistic regression to identify independent mortality predictors.</p></div><div><h3>Results</h3><p>Among the total of 200 participants, the survivors had significantly higher plasma SCUBE2 levels (115.9 ng/mL) compared to those who died (35.6 ng/mL). SCUBE2 levels showed a positive correlation with the anti-inflammatory cytokine IL-10 and a negative correlation with the APACHE II score, SOFA score, C-reactive protein, and monocyte chemoattractant protein-1. Multivariate analysis revealed that elevated SCUBE2 and IL-10 levels were independently protective against mortality, and associated with the most favorable 30-day survival outcomes.</p></div><div><h3>Conclusions</h3><p>In ICU patients with stage 3 SA-AKI, lower plasma levels of SCUBE2 were correlated with elevated pro-inflammatory factors, which impacted survival outcomes. This suggests that SCUBE2 could be a potential biomarker for predicting prognosis in patients with SA-AKI.</p></div>","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":"57 5","pages":"Pages 720-729"},"PeriodicalIF":4.5,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1684118224001178/pdfft?md5=13e59f1f53c20f4457220f2b39d279ae&pid=1-s2.0-S1684118224001178-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141716788","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}
引用次数: 0
Recommendations and guidance for herpes zoster vaccination for adults in Taiwan 台湾成人带状疱疹疫苗接种建议和指南
IF 4.5 2区 医学 Q2 IMMUNOLOGY Pub Date : 2024-06-21 DOI: 10.1016/j.jmii.2024.06.001

Herpes zoster (HZ) is a painful, vesicular, cutaneous eruption from reactivation of varicella zoster virus (VZV), which can lead to potentially debilitating complications. The lifetime risk of HZ is estimated to be 20%–30% in the general population, with an increased risk in the elderly and immunocompromised populations. The most effective strategy to prevent HZ and its complications is by vaccination. Two types of HZ vaccines, zoster vaccine live and recombinant zoster vaccine, have been approved for use. This guidance offers recommendations and suggestions for HZ vaccination in adults, aiming to reduce the disease burden of HZ and its complications. It is intended as a guide to first-line healthcare providers, but does not supersede clinical judgement when assessing risk and providing recommendations to individuals. The Working Group on Adult Immunization Practice was appointed by the Infectious Diseases Society of Taiwan (IDST) and recommendations were drafted after a full literature review, using the Grading of Recommendation, Assessment, Development and Evaluation (GRADE) system. The recommendations were reviewed and revised by expert review panels during a series of consensus meetings and endorsed by the IDST, Taiwan Association of Family Medicine, the Taiwanese Dermatological Association, the Taiwan Oncology Society, the Taiwan Society of Blood and Marrow Transplantation, the Transplantation Society of Taiwan, the Taiwan AIDS Society, and the Taiwan College of Rheumatology. This guidance describes the epidemiology of HZ and provides recommendations for HZ vaccination in adults with varying levels of risk, differing history of previous VZV infection and past varicella or zoster vaccinations.

带状疱疹(HZ)是水痘带状疱疹病毒(VZV)再活化引起的一种疼痛性水疱性皮肤疹,可导致潜在的衰弱性并发症。据估计,普通人群一生中患 HZ 的风险为 20%-30%,老年人和免疫力低下的人群患 HZ 的风险更高。预防 HZ 及其并发症的最有效策略是接种疫苗。目前已批准使用两种 HZ 疫苗,即带状疱疹活疫苗和重组带状疱疹疫苗。本指南为成人接种 HZ 疫苗提供了建议和意见,旨在减轻 HZ 及其并发症的疾病负担。本指南旨在为一线医疗服务提供者提供指导,但在评估风险和向个人提供建议时并不取代临床判断。成人免疫接种实践工作小组由台湾传染病学会(IDST)任命,在对文献进行全面审查后,采用建议、评估、发展和评价分级(GRADE)系统起草了建议。专家评审小组在一系列共识会议上对建议进行了审查和修订,并获得了 IDST、台湾家庭医学协会、台湾皮肤病学会、台湾肿瘤学会、台湾血液与骨髓移植学会、台湾移植学会、台湾艾滋病学会和台湾风湿病学会的认可。本指南描述了 HZ 的流行病学,并为具有不同风险水平、不同既往 VZV 感染史和既往水痘或带状疱疹疫苗接种史的成人提供了接种 HZ 疫苗的建议。
{"title":"Recommendations and guidance for herpes zoster vaccination for adults in Taiwan","authors":"","doi":"10.1016/j.jmii.2024.06.001","DOIUrl":"10.1016/j.jmii.2024.06.001","url":null,"abstract":"<div><p>Herpes zoster (HZ) is a painful, vesicular, cutaneous eruption from reactivation of varicella zoster virus (VZV), which can lead to potentially debilitating complications. The lifetime risk of HZ is estimated to be 20%–30% in the general population, with an increased risk in the elderly and immunocompromised populations. The most effective strategy to prevent HZ and its complications is by vaccination. Two types of HZ vaccines, zoster vaccine live and recombinant zoster vaccine, have been approved for use. This guidance offers recommendations and suggestions for HZ vaccination in adults, aiming to reduce the disease burden of HZ and its complications. It is intended as a guide to first-line healthcare providers, but does not supersede clinical judgement when assessing risk and providing recommendations to individuals. The Working Group on Adult Immunization Practice was appointed by the Infectious Diseases Society of Taiwan (IDST) and recommendations were drafted after a full literature review, using the Grading of Recommendation, Assessment, Development and Evaluation (GRADE) system. The recommendations were reviewed and revised by expert review panels during a series of consensus meetings and endorsed by the IDST, Taiwan Association of Family Medicine, the Taiwanese Dermatological Association, the Taiwan Oncology Society, the Taiwan Society of Blood and Marrow Transplantation, the Transplantation Society of Taiwan, the Taiwan AIDS Society, and the Taiwan College of Rheumatology. This guidance describes the epidemiology of HZ and provides recommendations for HZ vaccination in adults with varying levels of risk, differing history of previous VZV infection and past varicella or zoster vaccinations.</p></div>","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":"57 5","pages":"Pages 669-684"},"PeriodicalIF":4.5,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1684118224001087/pdfft?md5=1dd4a2238848cb4ff060eace9767d70e&pid=1-s2.0-S1684118224001087-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141528978","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}
引用次数: 0
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Journal of Microbiology Immunology and Infection
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