Pub Date : 2026-01-01DOI: 10.1016/j.eimce.2025.503027
Mario Fernández-Ruiz , Rafael San-Juan , María Milagro Montero , José Ramón Paño-Pardo , Jordi Carratalà , Jesús Fortún , Miguel Salavert , Julián Torre-Cisneros , José María Aguado , representing the members of the OPENIN
Due to its high incidence, urinary tract infection (UTI) is a common cause of health resources utilization and antibiotic prescription in both outpatient and inpatient settings. The OPENIN (“Optimización de procesos clínicos para el diagnóstico y tratamiento de infecciones”) Group is composed of Infectious Diseases specialists and Microbiologists and aims at generating recommendations that can contribute to improve the approach to processes with high impact on the health system based on a review of the best available evidence. The second Group meeting (held in October 2024) sought to answer the following questions: Can we optimize the syndromic and microbiological diagnosis of UTI? Is it possible to improve antibiotic treatment practices? And finally, are the different interventions (non-pharmacological measures, antibiotic prophylaxis, bacterial vaccines or probiotics, among others) effective in reducing the risk of recurrences? The present review summarizes the literature reviewed for that meeting and offers a series of expert recommendations.
尿路感染（UTI）由于其高发病率，是门诊和住院卫生资源利用和抗生素处方的常见原因。OPENIN（“Optimización de procesos clínicos para el diagnóstico y tratamiento de infeciones”）小组由传染病专家和微生物学家组成，旨在根据对现有最佳证据的审查，提出有助于改进对卫生系统有重大影响的过程的方法的建议。第二次小组会议（于2024年10月举行）旨在回答以下问题：我们能否优化尿路感染的综合征和微生物诊断？是否有可能改进抗生素治疗方法？最后，不同的干预措施（非药物措施、抗生素预防、细菌疫苗或益生菌等）是否能有效降低复发风险？本综述总结了为该会议审查的文献，并提出了一系列专家建议。
{"title":"How can we optimize the diagnostic and therapeutic approach of urinary tract infection? Expert opinion-based recommendations","authors":"Mario Fernández-Ruiz , Rafael San-Juan , María Milagro Montero , José Ramón Paño-Pardo , Jordi Carratalà , Jesús Fortún , Miguel Salavert , Julián Torre-Cisneros , José María Aguado , representing the members of the OPENIN","doi":"10.1016/j.eimce.2025.503027","DOIUrl":"10.1016/j.eimce.2025.503027","url":null,"abstract":"<div><div>Due to its high incidence, urinary tract infection (UTI) is a common cause of health resources utilization and antibiotic prescription in both outpatient and inpatient settings. The OPENIN <em>(“Optimización de procesos clínicos para el diagnóstico y tratamiento de infecciones”)</em> Group is composed of Infectious Diseases specialists and Microbiologists and aims at generating recommendations that can contribute to improve the approach to processes with high impact on the health system based on a review of the best available evidence. The second Group meeting (held in October 2024) sought to answer the following questions: Can we optimize the syndromic and microbiological diagnosis of UTI? Is it possible to improve antibiotic treatment practices? And finally, are the different interventions (non-pharmacological measures, antibiotic prophylaxis, bacterial vaccines or probiotics, among others) effective in reducing the risk of recurrences? The present review summarizes the literature reviewed for that meeting and offers a series of expert recommendations.</div></div>","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"44 1","pages":"Article 503027"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145897134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.eimce.2025.503047
Miaoni Kong, Wen Zhou
Objective
To characterize the clinical manifestations of Rickettsia japonica (R. japonica) infection and to generate evidence facilitating early diagnosis and targeted treatment.
Methods
We retrospectively reviewed the clinical data of five patients with R. japonica infection who were treated in the Emergency Department, Xiling Campus, Yichang Central People's Hospital, between January 2023 and December 2024.
Results
All patients were residents of Yichang City, Hubei Province, aged 58–70 years, and 80% (4/5) were farmers. The onset of illness occurred exclusively between May and September, and all patients reported a definite history of outdoor exposure. The predominant clinical manifestations were fever, rash, and eschar. Laboratory findings revealed thrombocytopenia, elevated aspartate aminotransferase (AST) and creatine kinase (CK), as well as increased inflammatory markers including C-reactive protein (CRP), procalcitonin (PCT), and interleukin-6 (IL-6). R. japonica nucleic acid was detected in all patients by metagenomic next-generation sequencing (mNGS) of blood samples. Three patients initially received empirical doxycycline therapy, which was subsequently adjusted to a standard regimen after diagnostic confirmation. Defervescence occurred at a median of two days (range, 1–7 days), followed by gradual resolution of rash and alleviation of systemic symptoms. All patients achieved complete clinical recovery and were discharged without complications.
Conclusion
This study highlights the importance of heightened clinical awareness of R. japonica infection, emphasizing the integration of epidemiological context with hallmark clinical features – particularly fever, rash, and eschar – during peak transmission seasons in endemic areas. Early recognition allows the timely initiation of doxycycline therapy, which is essential for achieving favorable outcomes. Moreover, metagenomic next-generation sequencing (mNGS) provides the definitive identification of pathogens and guides targeted antimicrobial therapy.
{"title":"Clinical characteristics and outcomes of Rickettsia japonica infection: A retrospective case series of five patients","authors":"Miaoni Kong, Wen Zhou","doi":"10.1016/j.eimce.2025.503047","DOIUrl":"10.1016/j.eimce.2025.503047","url":null,"abstract":"<div><h3>Objective</h3><div>To characterize the clinical manifestations of <em>Rickettsia japonica</em> (<em>R. japonica</em>) infection and to generate evidence facilitating early diagnosis and targeted treatment.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed the clinical data of five patients with <em>R. japonica</em> infection who were treated in the Emergency Department, Xiling Campus, Yichang Central People's Hospital, between January 2023 and December 2024.</div></div><div><h3>Results</h3><div>All patients were residents of Yichang City, Hubei Province, aged 58–70 years, and 80% (4/5) were farmers. The onset of illness occurred exclusively between May and September, and all patients reported a definite history of outdoor exposure. The predominant clinical manifestations were fever, rash, and eschar. Laboratory findings revealed thrombocytopenia, elevated aspartate aminotransferase (AST) and creatine kinase (CK), as well as increased inflammatory markers including C-reactive protein (CRP), procalcitonin (PCT), and interleukin-6 (IL-6). <em>R. japonica</em> nucleic acid was detected in all patients by metagenomic next-generation sequencing (mNGS) of blood samples. Three patients initially received empirical doxycycline therapy, which was subsequently adjusted to a standard regimen after diagnostic confirmation. Defervescence occurred at a median of two days (range, 1–7 days), followed by gradual resolution of rash and alleviation of systemic symptoms. All patients achieved complete clinical recovery and were discharged without complications.</div></div><div><h3>Conclusion</h3><div>This study highlights the importance of heightened clinical awareness of <em>R. japonica</em> infection, emphasizing the integration of epidemiological context with hallmark clinical features – particularly fever, rash, and eschar – during peak transmission seasons in endemic areas. Early recognition allows the timely initiation of doxycycline therapy, which is essential for achieving favorable outcomes. Moreover, metagenomic next-generation sequencing (mNGS) provides the definitive identification of pathogens and guides targeted antimicrobial therapy.</div></div>","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"44 1","pages":"Article 503047"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145957887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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