id-journal - Bluesky Statics

Trends in population structure, antimicrobial susceptibility and resistance determinants of Neisseria gonorrhoeae isolates from surveillance in the Kanto region, Japan, 2017–2023 AbstractObjectivesThe spread of antimicrobial-resistant Neisseria gonorrhoeae has limited treatment options. To monitor trends in population structure, antimicrobial susceptibility rates and resistant determinants of gonococcus isolated from patients, we collected longitudinal isolates and performed AST and molecular analyses.MethodsOf 985 gonococcus isolates obtained from clinical specimens submitted by health care institutions in the Kanto region of Japan between 2017 and 2023, one isolate per patient per year was eligible, and up to 50 isolates per year were randomly selected. A total of 349 isolates were analysed. MICs were determined by the agar dilution method. Multilocus sequence typing and N. gonorrhoeae sequence typing for antimicrobial resistance (NG-STAR) were performed using a high-throughput typing method based on multiplex PCR amplicon sequencing on the MiSeq (Illumina) platform.ResultsOver this study period, 29 sequence types (STs) were identified. Only one ceftriaxone non-susceptible strain—harbouring mosaic penA 60.001 and belonging to ST1903—was found in 2017. A ciprofloxacin-susceptible lineage belonging to ST9362, lacking quinolone resistance-determining region mutations, was sporadically predominant in 2018 and 2023. The susceptibility rate to azithromycin remained ≥86% throughout the study period. There was a clear association between lineage and carriage of antimicrobial resistance determinants.ConclusionsCeftriaxone remains a reliable first-line treatment option for gonorrhoea. Ongoing surveillance is essential to detect emerging fluoroquinolone-susceptible lineages that may inform future treatment strategies.

From 985 isolates, 349 analyzed showed 29 STs; 1 ceftriaxone-resistant strain in 2017. Azithromycin susceptibility ≥86%. Ceftriaxone stays effective; ongoing surveillance needed.🦠💊

03.03.2026 12:30 — 👍 0 🔁 0 💬 0 📌 0

Outpatient parenteral antimicrobial therapy delivery, readmission rates, and multidisciplinary teams: a scoping review of the impact of published quality indicators View abstract Background:Outpatient parenteral antimicrobial therapy (OPAT) reduces hospitalization, yet poor standardization and implementation contribute to readmission rates near 25%. The Infectious Diseases Society of America recommends structured and multidisciplinary OPAT programs. Twelve quality indicators, spanning organization, initiation, continuation, and outcome domains, have been proposed to improve OPAT delivery. Our scoping review assessed associations between reported OPAT quality indicators and patient readmission.Methods:We searched PubMed, Embase, Cochrane CENTRAL, Web of Science, and Google Scholar from database inception through May 1, 2025, for studies of adults discharged on OPAT, managed by multidisciplinary teams, and reporting readmission rates. Data included presence of each quality indicator, team composition, and readmission rates. Readmission was categorized as low (<10%) or high (≥10%).Results:Of 2,610 studies screened, 18 (5,027 patients) met criteria. The median readmission rate was 11.3 (IQR 8–20). All studies reported a structured OPAT program and formal OPAT team. Initial patient assessment by a competent team member was more common in studies with lower readmissions. Reporting more indicators (range 4–11) did not significantly correlate with fewer readmissions. Organization and initiation indicators were reported more frequently than continuation and outcome indicators. All programs included an infectious diseases physician; 94% included nurses, 55% pharmacists, 28% social workers, and 11% hospitalists.Conclusions:Higher quantity of reported indicators did not predict fewer readmissions. Future research should explore team engagement, including potential roles of hospitalists and social workers to strengthen care transitions, and the impact of continuation and outcome indicators on readmissions.

OPAT cuts hospital stays but readmission ~11.3%📉. All had structured teams; lower readmissions linked to initial competent assessment. More QIs (4-11) ≠ fewer readmissions.👩‍⚕️👨‍⚕️

03.03.2026 12:00 — 👍 0 🔁 0 💬 0 📌 0

Comparing Efficacy and Safety of Itraconazole Solution versus Posaconazole for Antifungal Prophylaxis after Heart Transplant Posaconazole and itraconazole are two oral agents that are commonly prescribed for heart transplant recipients requiring aspergillus prophylaxis; however, there is limited data comparing their efficacy and tolerability.MethodsThis was a single-center, retrospective cohort study comparing itraconazole and posaconazole for the prevention of invasive fungal infections in heart transplant recipients between January 2015 and May 2022. The primary efficacy outcome was incidence of fungal infection. The primary safety outcome was incidence of hepatic dysfunction after initiation of therapy. Standard duration of prophylaxis therapy was 3 months for both cohorts.Results134 patients received itraconazole prophylaxis and 98 received posaconazole prophylaxis. Patients receiving itraconazole were more likely to have received induction immunosuppression (p<0.001) and more likely to have received a heart-kidney transplant, but other baseline characteristics were similar. Patients receiving itraconazole prophylaxis had a higher rate of fungal infection (7.4% vs. 0% p=0.0065) and were more likely to have therapy changed to an alternative antifungal (20.9% vs. 10.2% p=0.03). Adverse events were similar between cohorts.ConclusionPosaconazole prophylaxis after heart transplant was associated with a lower rate of fungal infections and reduced need to change to alternative therapy when compared to itraconazole.

Heart transplant pts: Posaconazole ↓fungal infections 0% vs 7.4% itraconazole; less therapy change 10.2% vs 20.9%. Adverse events similar. 📉🍄

03.03.2026 11:30 — 👍 0 🔁 0 💬 0 📌 0

Ribosomal protection as a linezolid resistance mechanism in Mycobacterium abscessus ABSTRACTMycobacterium abscessus has emerged as a significant pulmonary pathogen characterized by its resistance to most first-line antimycobacterial drugs. Recent investigations have highlighted the clinical efficacy of including the oxazolidinone antibiotic linezolid in M. abscessus combination therapies, despite moderate resistance frequently being observed in patient isolates. Even with the potential usefulness of linezolid, the mechanisms that drive linezolid resistance in M. abscessus remain poorly understood. In several bacterial pathogens, including Mycobacterium tuberculosis, ATP-binding cassette (ABC) family proteins of the F subtype (ABC-F) have been found to confer antibiotic resistance to ribosome-targeting antibiotics, including linezolid. Here, we identified an M. abscessus ABC-F protein, MAB_2736c, that causes specific resistance to antibiotics that bind the 50S ribosomal subunit, including linezolid, macrolides, and chloramphenicol. These results demonstrate that targeting ABC-F proteins could help combat intrinsic resistance to several ribosome-targeting antibiotics in mycobacteria.

M. abscessus resists many drugs; linezolid shows promise but faces moderate resistance. MAB_2736c ABC-F protein causes resistance to linezolid, macrolides, chloramphenicol. 🦠💊

03.03.2026 01:00 — 👍 0 🔁 0 💬 0 📌 0

Single-ascending and multiple-ascending dose study of the pharmacokinetics, safety, and tolerability of BV100 (rifabutin for infusion) in healthy volunteers ABSTRACTBV100 (rifabutin for infusion) is being developed as an intravenous formulation for treating serious or life-threatening infections due to carbapenem-resistant Acinetobacter baumannii in patients with limited treatment options. Phase 1 studies were conducted to characterize the pharmacokinetics (PK), safety, and tolerability of BV100 in healthy volunteers after single and multiple doses. Single-ascending and multiple-ascending dose studies were conducted in healthy subjects to establish the PK profile of BV100. Blood samples were assayed to determine plasma concentrations of rifabutin and the major metabolite 25-O-desacetyl-rifabutin and to determine PK parameters. Subjects were assessed for safety and tolerability. The PK profile of BV100 was generally dose-proportional in the single-ascending dose studies with a t1/2 of 7.9–56.1 h, and Tmax of 1.0–1.75 h and increasing exposure with dose. A q12h versus q24h dosing interval resulted in approximately a 1.5-fold to 2-fold greater exposure of rifabutin. The 25-O-desacetyl-rifabutin metabolite represented <5% of rifabutin activity. Adverse events were more common at higher doses with q24h versus q12h dosing, and with a 60 min infusion time. The most common adverse events were infusion site events, with systemic treatment-emergent adverse events as expected for the known safety profile of rifabutin. No other treatment-related safety issues were identified. BV100 demonstrated a dose-proportional PK profile and was generally safe and well tolerated. Based on these results, BV100 doses of 200–300 mg q12h are undergoing evaluation in a Phase 2 study for treating carbapenem-resistant A. baumannii infections.CLINICAL TRIALSThis study is registered with ClinicalTrials.gov as NCT04636983 and NCT05087069.

BV100 (IV rifabutin) showed dose-proportional PK; t1/2 7.9–56.1h, Tmax 1–1.75h. q12h dosing gave 1.5–2× exposure. Common AEs were infusion site events; safe & well-tolerated.

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Designing novel bisquinoline antimalarials from historical 4-aminoquinolines to combat drug-resistant malaria ABSTRACTPlasmodium falciparum, the deadliest causative agent of malaria, continues to evade eradication efforts through widespread drug resistance. The recent development of ADC-028, a 4-aminoquinoline antimalarial with excellent activity and pharmacokinetic properties, prompted the investigation of bisquinoline analogs featuring similar structural motifs. Here, we describe a structure-activity relationship study that guided the optimization of compounds with key features, including the 4-anilinoquinoline core and diverse bridging linkers. Several analogs exhibited potent in vitro activity (IC50 < 20 nM) against both drug-sensitive and multidrug-resistant P. falciparum strains, while maintaining favorable cytotoxicity profiles. Among them, 25 demonstrated improved intrinsic metabolic stability (t1/2 = 121 min) and potent in vivo efficacy (ED50 = 0.32 mg/kg/day), achieving complete curative protection at a reduced dose compared to ADC-028. While 25 showed moderately reduced oral bioavailability (F = 43%) and a shorter half-life (T1/2 = 27.2 h) relative to ADC-028, its enhanced in vivo efficacy underscores its therapeutic potential. This work highlights a promising path forward in developing antimalarials that retain the efficacy of legacy compounds while overcoming modern resistance mechanisms.

Study of bisquinoline analogs showed 25 had IC50 <20nM vs. resistant P. falciparum, t1/2=121min, ED50=0.32 mg/kg/day, F=43%, T1/2=27.2h, improved efficacy vs. ADC-028⚡️

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Population pharmacokinetics of pyrazinamide and ethambutol in children with tuberculosis with or without HIV ABSTRACTTuberculosis (TB) is a major cause of morbidity and mortality in children globally. This study developed models to describe population pharmacokinetics (PK) of pyrazinamide (PZA) and ethambutol (EMB) in children with TB with or without human immunodeficiency virus (HIV) coinfection. Ghanaian children with TB with or without HIV coinfection receiving first-line antituberculosis therapy for at least 4 weeks had blood samples collected at time 0 (pre-dose), 1-, 2-, 4-, 8-, and 12-h post-dose. PZA and EMB concentrations were quantified using liquid chromatography tandem mass spectrometry. Nonlinear mixed-effects models were applied to describe the population PK using Monolix2024R1. Maximum concentrations (Cmax) and 24-h area under the time concentration curve (AUC0–24) were compared to published values in adults. A total of 85 children (41 TB, 44 TB/HIV) were included. The median (range) age was 5 years (0.3–14.5), and 61.2% were male. Median (range) doses for PZA and EMB were 31.6 (21.4–49.7) and 21.4 mg/kg (14.3–34.2), respectively. PZA was best described using a one-compartment model and EMB by a two-compartment model. Allometric scaling improved both model fits. Children with TB/HIV coinfection had approximately 18.5% faster PZA clearance and 25% faster EMB clearance. Optimized dosing to achieve adult-equivalent exposures required higher-than-currently recommended doses, particularly among children in the lowest weight bands and those with HIV. The population PK of PZA and EMB was well described by the final models, but the higher-than-currently recommended doses needed to achieve adult-equivalent exposures raise concerns regarding risks for drug-associated toxicities and will require further evaluation.

Study of 85 Ghanaian kids (5y median, 61%♂) with TB±HIV found TB/HIV ↑PZA clearance by 18.5%, EMB by 25%. Higher doses💊 needed for adult-like levels; toxicity risk⚠️ needs review.

02.03.2026 23:30 — 👍 0 🔁 0 💬 0 📌 0

Tracking Plasmodium knowlesi through faecal DNA for monitoring zoonotic transmission in wild macaques across Southeast and South Asia AbstractWe conducted the non-invasive surveillance of Plasmodium knowlesi in wild macaques using 4,752 faecal samples collected across nine endemic countries. Parasite DNA was detected in 390 samples (8.2%), with positivity rates ranging from 1.4% to 18.4%. This provides the first field-based evidence that P. knowlesi DNA in faeces shed by macaques and present under natural conditions can be detected. These findings validate faecal sampling as a practical and scalable tool for tracking zoonotic-malaria. The results support integration into forest-runoff and rural wastewater surveillance systems, offering new opportunities for early detection of pathogens and environmental monitoring at the human–wildlife interface.

4,752 macaque fecal samples tested for Plasmodium knowlesi; 8.2% positive (1.4%-18.4%). Validates non-invasive fecal sampling for zoonotic malaria monitoring.🦧🦠📊

02.03.2026 13:30 — 👍 0 🔁 0 💬 0 📌 0

2024-2025 COVID-19 mRNA Vaccine Effectiveness against Severe Disease This study evaluated the effectiveness of the 2024–2025 coronavirus disease 2019 (COVID-19) messenger RNA (mRNA) vaccine against COVID-19 emergency department (ED) and hospital admissions.MethodsWe used electronic health records in a large South Carolina health system to emulate a target trial comparing individuals aged 18 and older who received versus did not receive the 2024–2025 COVID-19 mRNA vaccine. Individuals who received the vaccine during the study period (9/1/2024-3/15/2025) were risk-set matched with unvaccinated individuals based on demographic and clinical covariates using propensity score matching (1:2). The primary outcomes were time to ED or hospitalization admission between September 01, 2024, to April 16, 2025, analyzed with Cox proportional hazards models.ResultsThe participation criteria resulted in 157,988 individuals, of whom 10,041 (6.4%) received the updated 2024-2025 COVID-19 vaccine. The final matched sample included 30,080 individuals, with 10,029 receiving the vaccine. mRNA vaccine protection was 41.3% (95% CI: 17.2-58.4) against ED or more severe care and 46.1% (95% CI: 13.6-66.3) against hospitalization.ConclusionThese findings demonstrate that the 2024–2025 mRNA COVID-19 vaccine had moderate protection against hospitalization and ED or more severe care, even in a southern US state with a significant rural population and high levels of prior exposure through infection and/or previous vaccination. Given the low vaccine uptake in this population, our results underscore the need for sustained public health efforts to increase vaccination coverage and address the challenges posed by emerging variants, particularly among older adults and those with medical comorbidities.

2024-25 mRNA COVID vaccine gave 41.3%🛡️against ED visits & 46.1%🛡️against hospitalization in SC (n=30,080; 6.4% vaccinated). Low uptake needs more public health⚕️ efforts.

02.03.2026 13:00 — 👍 0 🔁 0 💬 0 📌 0

In vitro activity of cefepime/zidebactam against Klebsiella pneumoniae carrying blaKPC variants conferring resistance to ceftazidime/avibactam AbstractObjectivesResistance to ceftazidime/avibactam among KPC-producing Klebsiella pneumoniae (KPC-Kp) is often due to mutations within the blaKPC gene, determining a widespread occurrence of novel variants. Against KPC-Kp carrying novel blaKPC variants, further therapeutic agents are needed.MethodsWe evaluated the in vitro activity of cefepime/zidebactam against 21 KPC-Kp clinical isolates carrying different blaKPC variants showing different antimicrobial susceptibility patterns to ceftazidime/avibactam, and compared it with the in vitro activity of cefepime/enmetazobactam. WGS was performed to identify antimicrobial resistance genes associated with ceftazidime/avibactam resistance. Analysis of porins and PBP-2 sequences was performed by manual alignment. Antimicrobial susceptibility testing to cefepime, cefepime/enmetazobactam and cefepime/zidebactam was performed by MIC test strips.ResultsWe selected a total of 21 ceftazidime/avibactam susceptible (n = 9) or resistant (n = 12) strains. Genomic analysis revealed that all ceftazidime/avibactam-resistant KPC-Kp carried mutations within blaKPC variants (blaKPC-31, blaKPC-14, blaKPC-33, blaKPC-93, blaKPC-203, blaKPC-205, blaKPC-49 and blaKPC-167), whereas susceptible strains carried blaKPC-3 and blaKPC-2 alleles. Overall, 42.85% (9/21) and 4.76% (1/21) of KPC-Kp harboured, respectively, a truncated OmpK35 or OmpK36 porin. PBP-2 analysis showed that all KPC-Kp carried WT enzymes, whereas one isolate carried a V521M substitution (valine→methionine). Cefepime/zidebactam (median 0.38 mg/L, IQR 0.222–0.5 mg/L) exhibited greater antibacterial activity (P < 0.0001) than cefepime alone and cefepime/enmetazobactam against ceftazidime/avibactam-susceptible KPC-Kp, whereas it exhibited no statistically significant difference (P = 0.4621) in antibacterial activity compared with cefepime/enmetazobactam against ceftazidime/avibactam-resistant strains carrying blaKPC variants. Also, we observed that cefepime/zidebactam exhibited greater antibacterial activity (P < 0.001) against KPC-Kp strains carrying the mutated blaKPC gene than against isolates harbouring the WT blaKPC gene.ConclusionsCefepime/zidebactam provided potent in vitro results against KPC-Kp due to blaKPC variants, supporting its clinical utility for the treatment of infections due to ceftazidime/avibactam-resistant strains. Also, we demonstrated that zidebactam was not influenced by different blaKPC variants.

21 KPC-Kp strains: 12 resistant with blaKPC variants, 9 susceptible. Cefepime/zidebactam showed superior activity (median MIC 0.38 mg/L, P<0.0001) vs cefepime/enmetazobactam.🚫💊

02.03.2026 12:30 — 👍 0 🔁 0 💬 0 📌 0

IDSA 2025 Guidelines on the use of vaccines for the prevention of seasonal RSV infections in immunocompromised patients AbstractImmunocompromised individuals experience disproportionately severe outcomes from Respiratory Syncytial Virus (RSV) infection, yet direct evidence to guide vaccination in this population remains limited. To support clinical and shared decision-making for the 2025–2026 respiratory virus season, the Infectious Diseases Society of America (IDSA) convened a multidisciplinary expert panel to develop rapid, evidence-based recommendations on RSV vaccination among immunocompromised adults and children. The panel conducted a systematic review of comparative effectiveness and harms data published between August 2024 and July 2025, supplemented by additional evidence from the Vaccine Integrity Project. Certainty of evidence and recommendation strength were assessed using the GRADE approach.Two test-negative case–control studies in immunocompromised adults demonstrated that RSV vaccination reduced RSV-associated hospitalization by 70% (95% CI: 66–73%). Furthermore, indirect evidence from older adult populations showed 81% effectiveness (95% CI: 52–92%) against critical illness. Serious adverse events were comparable between vaccinated and unvaccinated groups across three randomized trials, while Guillain–Barré syndrome was rare, with an estimated 11 excess cases per million doses.Given the substantial reduction in severe disease and low likelihood of serious harm, the panel issued a strong recommendation for age-appropriate RSV vaccination in adults and adolescents with compromised immunity. For immunocompromised patients <18 years, shared decision-making is advised. Timing should be individualized across immunocompromised subgroups, considering treatment cycles, transplant status, and B-cell–depleting therapies. Household members should remain up to date with RSV vaccination when eligible, and coadministration with influenza and COVID-19 vaccines is acceptable.Key research priorities include correlates of protection, durability of immunity, safety in specific immunosuppressed groups, and the role of booster doses.

RSV vax cuts hospitalization by 70% (66–73%) in immunocompromised adults; 81% vs critical illness in older adults. Serious AEs rare, Guillain-Barré ~11/million doses. Strong IDSA rec.🦠💉

02.03.2026 12:00 — 👍 0 🔁 0 💬 0 📌 0

IDSA 2025 Guidelines on the use of vaccines for the prevention of seasonal COVID-19, Influenza, and RSV infections in immunocompromised patients AbstractRespiratory viruses—including SARS-CoV-2 (COVID-19), Respiratory Syncytial Virus (RSV), and Influenza—pose significant risks to immunocompromised patients, who experience attenuated vaccine responses and higher morbidity. To address evolving vaccine recommendations for the 2025–2026 season, the Infectious Diseases Society of America (IDSA), in collaboration with the Vaccine Integrity Project (VIP) and partner organizations, developed rapid guidelines for U.S.-licensed vaccines targeting these viruses. The guideline applies to adults and children with compromised immunity due to hematologic malignancy, solid organ or hematopoietic cell transplantation, autoimmune disease on immunosuppressants, HIV with severe immunosuppression, and similar conditions. Strong recommendations, supported by moderate-certainty evidence, endorse timely administration of age-appropriate COVID-19, RSV, and Influenza vaccines, with guidance on optimal timing relative to immunosuppressive therapy and transplantation. Co-administration of these vaccines is considered appropriate. Research gaps remain in immunogenicity, durability, and clinical effectiveness, particularly for patients receiving B-cell–depleting therapies or early post-transplant. Priority areas include defining correlates of protection, optimizing vaccine schedules, evaluating high-dose or adjuvanted formulations, and improving real-world effectiveness and safety data. Equity and access strategies are essential to ensure uptake among vulnerable populations. These guidelines aim to support evidence-based decision-making and highlight the need for harmonized, multi-virus research to inform tailored vaccination strategies for immunocompromised individuals.

Respiratory viruses risk immunocompromised patients🤒. IDSA urges timely COVID-19, RSV, Flu vaccines🛡️, co-admin OK✅. Research gaps in effectiveness remain🔬. Equity needed⚖️.

02.03.2026 11:30 — 👍 0 🔁 0 💬 0 📌 0

Immunogenicity of HPV Vaccine in a High-Risk and Understudied Group: Female Sex Workers Female sex workers (FSW) have multiple sexual partners and are at higher risk of HPV infection. They could be a target group for HPV vaccination, but their expected immune response to the HPV vaccine is unclear due to potential exposure to the virus.MethodsWe conducted a pilot study (NCT04590521) in Hai Phong, Vietnam to evaluate HPV vaccine immunogenicity among FSW aged 18–26 years. All participants received the standard three-dose schedule (0, 2 and 6 months) of the quadrivalent Gardasil® vaccine (4vHPV). Cervical swabs were collected at time of vaccination to detect high-risk HPV DNA and cervical abnormalities. Blood samples were collected at baseline and at 2, 3, 6 and 7 months post-first dose to determine neutralising antibody (NAb) responses to HPV16 and 18, as well as related HPV52 and HPV58.ResultsA total of 63 FSW with a median age of 23.4 years (IQR 21.6-25.4) were recruited. Prevalence of any high-risk HPV type and HPV16/18 infection at baseline was 28.6% (18/63) and 9.5% (6/63), respectively. Following first dose, 90% and 55% of individuals were seropositive for HPV16 and HPV18, respectively. By Month 7, all participants were seropositive to both HPV16 and HPV18. Higher NAb responses were observed among HPV-DNA negative participants at baseline compared with HPV-DNA positive participants after 2 and 3 doses (HPV16: GMR: 2.97 and 1.63, p<0.05; HPV18: 2.83 and 1.49, p=0.06).ConclusionThree doses of 4vHPV elicited robust NAb to HPV16 and HPV18 among FSW. Further studies are needed to evaluate the effectiveness of HPV vaccination in FSW.

63 FSW (median age 23.4) in Vietnam had 28.6% hrHPV⚠️; post-1st dose: 90% HPV16🛡️, 55% HPV18🛡️; 100% seropositive by month 7; stronger response if HPV-DNA–.

01.03.2026 23:30 — 👍 0 🔁 0 💬 0 📌 0

IDSA 2025 Guidelines on the use of vaccines for the prevention of seasonal Influenza infections in immunocompromised patients AbstractImmunocompromised individuals are at heightened risk for severe influenza-related complications, yet vaccine responses may be attenuated due to underlying disease or immunosuppressive therapies. To inform clinical decision-making for the 2025–2026 respiratory virus season, the Infectious Diseases Society of America (IDSA) convened an expert panel to develop rapid evidence-based guidelines on influenza vaccination for immunocompromised adults and children. The panel conducted a systematic review of literature published between August 2023 and July 2025, supplemented by analyses from the Vaccine Integrity Project. Only comparative effectiveness and harm data were included. Certainty of evidence and strength of recommendations were assessed using the GRADE approach.Direct evidence in immunocompromised populations was limited but demonstrated that influenza vaccination reduced influenza-associated hospitalization by 32%. Indirect evidence from older adult populations showed consistent reductions in hospitalization, intensive care admission, and all-cause mortality, supporting applicability to immunocompromised groups. No increased risk of Guillain–Barré syndrome or serious adverse events was detected, and studies evaluating autoimmune or immunocompromising disease exacerbation showed no significant safety concerns.Given moderate certainty of benefit and low likelihood of serious harm, IDSA strongly recommends that all immunocompromised individuals aged ≥6 months receive an age-appropriate 2025–2026 influenza vaccine. Vaccination should be individualized based on underlying conditions, timing of immunosuppressive therapy, and community influenza activity. High-dose or adjuvanted vaccines may offer enhanced immunogenicity. Household contacts should also be vaccinated to reduce transmission risk.Ongoing research is needed to define correlates of protection, optimize vaccine timing, improve real-world effectiveness data, and enhance strategies for patients with blunted immune responses.

IDSA says flu vax cuts hospitalization by 32% in immunocompromised pts🛡️. No serious risks found⚠️. Recommends vax for 6mo+ in 2025-26 season, incl. contacts👨‍👩‍👧.

01.03.2026 01:00 — 👍 0 🔁 0 💬 0 📌 0

Toxoplasmosis acquired in French Guiana in immunocompetent adults: case series from 2002 to 2019, with a focus on outpatients Amazonian toxoplasmosis is classically associated with severe disease in hospitalised adults. However, little is known about milder outpatient forms in French Guiana.MethodsWe retrospectively analysed 174 immunocompetent adults diagnosed with acute toxoplasmosis in French Guiana (2002-2019), comparing clinical and laboratory features between hospitalised (HPs) and outpatient (OPs) cases.ResultsSeventy-four patients (43%) were OPs. Fever (93%), lymphadenopathy (62%), and digestive symptoms (56%) predominated among OPs, while respiratory symptoms, anaemia, and hyponatremia predicted hospitalisation (aOR 9.8, 3.9, and 5.4, respectively). Parasitaemia was detected in 27% of OPs but genotyping succeeded only in HPs, all infected by Toxoplasma gondii strains of the Amazonian population.ConclusionsMild parasitaemic forms of toxoplasmosis occur in immunocompetent adults in French Guiana. The clinical spectrum of toxoplasmosis in French Guiana appears broader than previously described, extending beyond the severe forms typically associated with strains of the Amazonian population.

Amazonian toxoplasmosis in 174 adults (2002-2019): 43% outpatients with fever (93%), lymphadenopathy (62%), digestive symptoms (56%). Hospitalization linked to respiratory issues, anemia, hyponatremia. Parasitaemia in 27% OPs; Amazonian strains only in hospitalized. 🌡️👥

01.03.2026 00:30 — 👍 0 🔁 0 💬 0 📌 0

Intravenous immunoglobulin treatment in patients with streptococcal toxic shock syndrome in southern Sweden – A retrospective population-based study Intravenous immunoglobulins (IVIG) have been suggested as an adjunctive treatment in streptococcal toxic shock syndrome (STSS), but there are no conclusive trials. In southern Sweden, IVIG is routinely used in certain hospitals but not in others. We hypothesized that this would resemble a natural experiment, and aimed to evaluate the effect of IVIG in STSS patients.MethodWe conducted a population-based retrospective cohort study on STSS cases in southern Sweden from 2017 to 2024. The main exposure was any IVIG treatment, and the primary outcome was 30-day mortality. Cox regression, adjusted for lactate, Sequential Organ Failure Assessment score, Charlson Comorbidity Index and concurrent clindamycin treatment, were used. We modelled IVIG as a time-dependent variable to address immortal time bias.ResultsIn total, 106 patients fulfilled STSS criteria, of which 56 (53%) were treated with IVIG. Despite geographical differences, the IVIG group was younger, had fewer comorbidities but higher disease severity at baseline. Crude analysis suggested a lower mortality in the IVIG group (Hazard ratio 0.69, 95% CI: 0.34–1.41). However, after adjusting for covariates and accounting for immortal time bias, the hazard ratio was estimated at 1.69 (95% CI: 0.66–4.30).ConclusionAlthough our study included a large population of STSS patients, our results were inconclusive regarding the effect of IVIG on 30-day mortality. This study highlights the risk of bias in observational studies in rare conditions. Prospective interventional studies are needed to determine the efficacy of IVIG in patients with STSS.

STSS study in Sweden (n=106): 53% got IVIG. Crude HR for death 0.69, adjusted HR 1.69. Results inconclusive for IVIG reducing 30-day mortality.🧪 #STSS #IVIG

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Indirect Influenza Vaccine Effectiveness Under Randomized Conditions: A Systematic Review and Meta-Analysis Indirect vaccine effectiveness (IVE) estimates are vulnerable to bias, and high-quality evidence on influenza IVE remains limited. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) estimating influenza IVE.MethodsWe searched MEDLINE and EMBASE through December 9, 2025, for RCTs conducted in non-institutional settings estimating IVE by comparing RT-PCR-confirmed influenza illness among unvaccinated individuals in vaccinated versus unvaccinated households or communities. Searches were restricted to English-language publications.ResultsEight articles describing twelve RCTs were included, comprising ten cluster-randomized trials designed to estimate IVE and two individual-randomized trials assessing IVE among household contacts. Risk of bias was low. Across trials conducted between 2008 and 2013, estimates of direct vaccine effectiveness (DVE) were moderate, whereas IVE estimates were lower and often centered near no effect, with the confidence intervals (CIs) for 9 of 12 trials including zero. The pooled DVE was 44.1% (95% CI: 29.6%, 55.6%), and the pooled IVE was 13.7% (95% CI: 1.5%, 24.5%). Sensitivity analyses excluding pandemic outcomes yielded minimally higher point estimates and did not materially change the findings. Between-study heterogeneity was moderate. There was no evidence of publication bias. Certainty of evidence was rated as moderate.ConclusionThis review provides a methodologically rigorous benchmark of IVE measurable under randomized conditions. While pooled DVE was moderate, pooled IVE was lower, and most individual trials did not demonstrate statistically significant indirect effects. The findings indicate that individual vaccination is the most reliable means of preventing influenza, rather than depending on indirect or community-level protection.

Meta-analysis of 12 RCTs (2008-13): direct flu vaccine effectiveness (DVE) 44.1%🛡️; indirect vaccine effectiveness (IVE) only 13.7%, often ≈0. Individual vax best.

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Development and Characterization of Candidate Vaccine Viruses against High Pathogenicity Avian Influenza A(H5) Viruses for Rapid Pandemic Response AbstractHigh pathogenicity avian influenza A(H5) viruses pose a pandemic threat. These viruses have rapidly evolved in birds and frequently crossed species barriers, resulting in over 1,000 confirmed human infections, with a case fatality proportion of approximately 50%. In response, the U.S. CDC has developed dozens of A(H5) candidate vaccine viruses (CVVs) over the past two decades, primarily targeting clades known to infect humans. This report summarizes the development and characterization of the CVVs, with a particular focus on their antigenic relationships with clades 2.3.2.1e and 2.3.4.4b A(H5N1) viruses, which have been responsible for the majority of recent human infections.

H5 avian flu caused 1,000+ human cases, 50% fatal. CDC made many vaccines targeting key clades 2.3.2.1e & 2.3.4.4b, main recent human infection sources.🦠💉

28.02.2026 11:30 — 👍 0 🔁 0 💬 0 📌 0

IDSA 2025 Guidelines on the use of vaccines for the prevention of seasonal COVID-19 infections in immunocompromised patients AbstractImmunocompromised individuals face elevated risks of severe COVID-19, yet vaccination guidance for these populations continues to evolve. To support evidence-based decision-making for the 2025–2026 respiratory virus season, the Infectious Diseases Society of America (IDSA) convened a multidisciplinary panel to develop rapid guidelines on the use of U.S.-licensed COVID-19 vaccines in adults and children with hematologic malignancies, primary immunodeficiency, autoimmune disease on immunosuppressive therapy, HIV with severe immunosuppression, solid organ transplantation, hematopoietic cell transplantation (HCT), chimeric antigen receptor T-cell therapy (CAR-T), or solid-tumor chemotherapy.A systematic evidence review of studies published from June 2024 to July 2025 identified comparative data on vaccine effectiveness and safety. Using the GRADE framework, the panel evaluated seven observational effectiveness studies and four safety-focused studies. Across studies, COVID-19 vaccination was associated with reduced hospitalization (33–56% effectiveness), critical illness, mortality, and COVID-19–related outpatient or emergency care visits. Serious adverse events were rare, and available evidence did not show consistent increases in exacerbations of underlying immunocompromising conditions. Most studies had short follow-up durations, likely reflecting higher-end estimates of vaccine effectiveness.Given moderate certainty of benefit and low certainty of harm, the panel strongly recommends the 2025–2026 COVID-19 vaccine for all immunocompromised individuals aged ≥6 months, with timing tailored to immunosuppressive therapy, clinical stability, and community transmission levels. Adjunct strategies—including vaccination of household contacts and early antiviral access—remain essential. Research priorities include defining immunologic correlates of protection, evaluating durability, optimizing vaccine timing, and improving real-world effectiveness and safety data.

IDSA panel found 33–56% vaccine effectiveness in immunocompromised 🛡️; rare serious adverse events⚠️; strong 2025–26 COVID-19 vaccine recommendation for ages ≥6 months👶+.

28.02.2026 04:00 — 👍 0 🔁 0 💬 0 📌 0

Uncomplicated Urinary Tract Infections: From an Invisible Impact to a Visible Change in Complex Care AbstractUncomplicated urinary tract infections can cause significant physical and emotional burden for patients, with high rates of recurrence. The challenges of treating uncomplicated urinary tract infections are exacerbated by rising antimicrobial resistance in key uropathogens, primarily Escherichia coli, on a global scale. Clinicians should consider drug, pathogen, and host-related factors when selecting the most appropriate therapy.

Uncomplicated UTIs cause high recurrence🔁 & burden. Rising antimicrobial resistance in E. coli🌍 complicates treatment. Therapy should consider drug, pathogen & host factors.

28.02.2026 03:30 — 👍 0 🔁 0 💬 0 📌 0

Identification of Aspergillus at section and species levels by artificial intelligence-based microscopic morphology image recognition ABSTRACTRapid and accurate identification of Aspergillus species in clinical microbiology laboratories is crucial for aspergillosis diagnosis and antifungal therapy. However, traditional methods still face challenges in distinguishing phylogenetically related species due to their morphological similarities. This study presents FungalNet, a deep learning model integrating ResNet-50 architecture with Focal Loss algorithm, specifically designed to enhance feature extraction for Aspergillus identification. A total of 12,000 high-resolution images were obtained from lactophenol cotton blue-stained slide preparations under a 100× oil immersion objective, among which 311 images were excluded through a novel quality control approach combining fivefold cross-validation and expert manual review. The performance of four deep learning models (FungalNet and three established models) for identifying Aspergillus species and sections was evaluated using the remaining 11,689 qualified images. FungalNet demonstrated superior classification performance, achieving overall accuracies of 98.45% and 97.85% at the section and species levels, respectively. These results indicate that FungalNet shows significant promise for rapid and accurate identification of Aspergillus species. With further optimization and multicenter validation, this tool could potentially be integrated into routine diagnostic workflows to enhance the efficiency and reliability of fungal identification in clinical settings.IMPORTANCEThis study integrates microscopic morphology identification with deep learning to address the challenge of accurate Aspergillus species identification. Twelve clinically isolated Aspergillus species belonging to eight different sections were included. From touch-tape slide preparations with lactophenol cotton blue staining under a 100× oil immersion objective, 11,689 qualified images were collected and analyzed using FungalNet (our proposed model) along with three established models (GoogLeNet, ResNet-50, and Xception). The results showed that FungalNet demonstrated superior performance in Aspergillus identification, achieving the highest classification accuracy at both section (98.45%) and species (97.85%) levels. Given its rapid turnaround time and cost-effectiveness, this AI-based image analysis approach shows promising potential for the rapid and accurate identification of Aspergillus species in clinical microbiology laboratories.

FungalNet AI identified Aspergillus 🦠 with 98.45% accuracy (section) & 97.85% (species) from 11,689 images, outperforming other models for rapid clinical use.💻🔬

28.02.2026 03:00 — 👍 0 🔁 0 💬 0 📌 0

Frequent Participation in Ryan White Services Improves Time to Human Immunodeficiency Virus (HIV) Viral Suppression Among People With HIV Monoinfection and People With Hepatitis C Virus (HCV) Coinfection in Philadelphia Hepatitis C virus (HCV) coinfection is associated with poor health outcomes for persons with human immunodeficiency virus (HIV). Although higher HIV viral suppression rates have been reported among people with HIV who participate in Ryan White services, studies have not assessed effects on HCV coinfection.MethodsWe used Philadelphia's routine HIV and hepatitis surveillance data to identify new HIV diagnoses during November 2018–October 2021 in a retrospective cohort analysis. We plotted Kaplan-Meier curves and performed Cox regressions to understand effects of HCV coinfection and receipt of Ryan White support services on time to reach HIV viral suppression, adjusting for linkage to HIV care, retention in HIV care, race and ethnicity, gender, age at time of HIV diagnosis, and injection drug use history.ResultsKaplan–Meier plots revealed that median time to HIV viral suppression was shorter among persons with HIV monoinfection, compared with HIV and HCV coinfection (80 days vs 235 days; P < .001). When adjusted for covariates, persons with HCV coinfection remained less likely to reach HIV viral suppression than persons without HCV coinfection for each day of follow-up (hazard ratio, 0.53 [95% confidence interval {CI}, .39–.72]). Compared with persons who received no support services, persons who received ≥1 service weekly and persons who received ≥2 services weekly were 60% (95% CI, 27%–101%) and 117% (95% CI, 36%– 223%) more likely to achieve viral suppression, respectively, for each day of follow-up.ConclusionsAddressing social determinants of health through federally sponsored Ryan White services can improve health for persons with HIV monoinfection and HCV coinfection.

HCV coinfection slows HIV viral suppression (median 235d vs 80d; P<.001). Ryan White services boost suppression odds by 60%-117% daily.📉🦠📈

28.02.2026 02:30 — 👍 0 🔁 0 💬 0 📌 0

Clinical Presentation, Risk Factors and Outcome of Non-Tuberculous Mycobacteria Infection in Hematopoietic Stem-Cell Transplantation: A Multinational Case-Control Study The clinical and microbiological features of infection due to non-tuberculous mycobacteria (NTM) after hematopoietic stem-cell transplantation (HSCT) remain poorly understood.MethodsWe performed a retrospective, multinational case-control study that included HSCT recipients (≥12 years) diagnosed with NTM disease between January 2008 and December 2018. Controls were HSCT recipients with no evidence of NTM disease, matched (1:2 ratio) by participating center and post-transplant survival. Logistic regression on matched pairs was used to investigate risk factors for NTM disease.ResultsWe included 25 cases of NTM disease. The most common HSCT type was allogeneic from unrelated donor (72.0%) after myeloablative conditioning (76.0%). Predominant hematological conditions were acute myelogenous leukemia (28.0%) and myelodysplastic syndrome (24.0%). Most patients (88.0%) had previously received immunosuppressive therapy. The most common species identified were Mycobacterium avium complex (64.0%) and rapidly growing mycobacteria (20.0%). Most patients (68.0%) had pulmonary disease. All but one received antimycobacterial therapy for a median of 267.5 days. Macrolides (83.3%), rifamycins (58.3%) and ethambutol (62.5%) were the most commonly used drugs. Four patients (16.7%) developed adverse events requiring therapy discontinuation. All-cause and attributable mortality rates were 28.0% and 4.0%, respectively. One patient experienced relapse after 464 days. Diagnosis of a non-NTM infection (adjusted odds ratio [aOR]: 3.11; 95% confidence interval [95% CI]: 1.25–7.78) and corticosteroid therapy (aOR: 2.88; 95% CI: 1.16–7.17), both within the previous 90 days, were associated with NTM disease.ConclusionsNTM disease is a serious complication among heavily immunocompromised HSCT recipients associated with prior non-NTM infection and corticosteroid therapy.

NTM post-HSCT affected 25 pts (72% allo), mainly Mycobacterium avium complex (64%), 68% lung disease. Mortality: 28% all-cause, 4% attributable. Risk: prior infection (aOR 3.11), steroids (aOR 2.88). 🦠💉

28.02.2026 02:00 — 👍 0 🔁 0 💬 0 📌 0

Immunogenicity and Safety of the AS01E-adjuvanted Respiratory Syncytial Virus (RSV) Prefusion F Protein Vaccine in Adults Aged 18–49 Years at Increased Risk of RSV Disease Compared with Adults Aged ≥60 Years The AS01E-adjuvanted respiratory syncytial virus (RSV) prefusion F protein-based vaccine (adjuvanted RSVPreF3) is approved for ≥60-year-olds and 50–59-year-olds at increased risk of RSV disease. We evaluated the vaccine's immunogenicity and safety in 18–49-year-olds at increased risk of RSV disease due to certain chronic conditions.MethodsThis open-label, multicountry phase 3b trial included 18–49-year-olds at increased risk (at-risk 18–49 group) and a control group of ≥60-year-olds with or without chronic conditions (≥60 group). Primary objective was to demonstrate immunological noninferiority to adjuvanted RSVPreF3 in the at-risk 18–49 versus ≥60 group, based on group RSV-A/RSV-B geometric mean titer ratios and seroresponse rate differences 1 month postvaccination. Humoral, cell-mediated immunogenicity, and safety were assessed until 6 months postvaccination.ResultsOverall, 1458 adults were vaccinated. Immunological noninferiority was demonstrated in the at-risk 18–49 versus ≥60 group at 1 month postvaccination. Both groups showed increased RSV-A/RSV-B neutralizing titers and RSVPreF3-specific CD4+ T-cell frequencies at 1 month postvaccination that declined but remained above baseline at 6 months. Solicited events were more frequent in the at-risk 18–49 (84.3%) than in the ≥60 group (69.4%); most were mild-to-moderate and transient. Rates and intensity of unsolicited adverse events (AEs) were comparable across groups, with low reporting of serious AEs and AEs of special interest.ConclusionsAdjuvanted RSVPreF3 was immunologically noninferior in 18–49-year-olds with underlying conditions compared with ≥60-year-olds in whom efficacy was previously demonstrated, supporting efficacy inference in this younger population. Up to 6 months postvaccination, the vaccine elicited robust immune responses, and the safety profile was acceptable.Clinical Trial Registration: NCT06389487

RSVPreF3 vaccine was immunologically noninferior in at-risk 18–49 vs ≥60. 84.3% vs 69.4% had mild/moderate events. Immune response stayed high 6 months post-vax. 💉🛡️

28.02.2026 01:30 — 👍 0 🔁 0 💬 0 📌 0

Comparison of CD4 T cell response in Plasmodium falciparum and vivax malaria Plasmodium falciparum and P. vivax are parasites responsible for most malaria cases globally. In areas where these species co-exist, individuals gain protection from P. vivax more rapidly, and important biological differences between species may impact the immune response. CD4 T cells are key drivers of immunity to malaria, both as effector and helper cells, with T-follicular helper (Tfh) cells having key roles in antibody development. Comparative studies on CD4 T cell responses between these species are limited.MethodsWe assessed CD4 T cells in adults with either P. falciparum or P. vivax malaria. Activation and proliferation of CD4 T cells were measured ex vivo, and functional capacity was determined by intracellular cytokine staining using flow cytometry.ResultsThe phenotype, activation and proliferation of CD4 T cells and effector CD4 T cell subsets were comparable between species. However, within the peripheral (p)Tfh cell compartment, there was some evidence for species-dependent activation with relative increased pTfh1 cells in P. falciparum infection. Additionally, in P. falciparum, increased IL-10 production was detected, including within IL-21 producing CD4 T cells.ConclusionWhile activation and function of CD4 T cells in malaria are largely comparable, some species-dependent responses are detected within the pTfh cell compartment that may impact antibody development.

CD4 T cell activation/proliferation similar in P. falciparum & P. vivax malaria. P. falciparum shows ↑pTfh1 cells & IL-10+ CD4 T cells, impacting antibody development.🦠✨

28.02.2026 01:00 — 👍 0 🔁 0 💬 0 📌 0

Diabetes Mellitus is a Risk Factor for Developing CMV Retinitis in Solid Organ Transplant Recipients: A Case-control Study The incidence of cytomegalovirus retinitis (CMVR) in solid organ transplant (SOT) recipients may be increasing due to improved long-term survival post-transplant. However, the epidemiology of CMVR after SOT is not well described. We therefore aimed to determine the incidence of CMVR and identify risk factors for its development post-SOT.MethodCase-control study at a 1:4 ratio between January 1, 2012 and March 31, 2024. Cases were SOT recipients at 1 of 2 British Columbia transplant centres diagnosed with CMVR clinically or through ocular fluid viral PCR. Controls were matched on transplant organ, year, and center. Univariable and multivariable analyses were performed using conditional logistic regression models.ResultsOut of 5877 SOT recipients followed during the study period, there were 16 CMVR cases with an incidence rate of 5.3 per 10 000 person-years. Fourteen eligible cases of CMVR were matched to 56 controls. Cases were older than controls (median age 60.9 vs 42.6 years) and more likely to have diabetes mellitus (DM) (9 [64.3%] vs 9 [16.4%]), chronic heart disease (4 [28.6%] vs 4 [7.3%]), and CMV DNAemia any time post-SOT (12 [85.7%] vs 19 [35.2%]). Most received kidney transplants (50.0%), and the median time to CMVR was 3.4 years. After adjusting for age at transplant, DM, chronic heart disease, CMV DNAemia, and significant lymphopenia, only DM was associated with an increased odds of CMVR (odds ratio 16.5 [95% confidence interval, 1.12–243.8]).ConclusionsCMVR is a rare and late complication post-SOT. DM was independently associated with increased odds of CMVR post-SOT.

CMVR incidence in SOT pts is 5.3/10,000 person-years. DM boosts CMVR risk 16.5x. Median onset: 3.4 yrs post-transplant. Most pts had kidney transplants. 🦠👁️‍🗨️

28.02.2026 00:30 — 👍 0 🔁 0 💬 0 📌 0

Extensive Immunological and Inflammatory Perturbation Underpins the Respiratory Sequelae of Postacute COVID-19 AbstractPostacute sequelae of COVID-19 (PASC), a multisystem disorder with prevalent respiratory manifestations, affecting millions of individuals worldwide, yet the organ-/system-specific PASC pathogenesis and targeted interventions remain largely undefined. In this longitudinal cohort study of individuals followed up at 4 (n = 57) and 7 months (n = 54) after the Omicron BA.5 outbreak in China, we comprehensively analyzed physician-administered PASC symptom assessments, clinical respiratory evaluations (pulmonary function and chest computed tomography), immunological response profiles, and inflammatory markers. Our findings demonstrated that patients with respiratory system–specific PASC (R-PASC) endure long-term pulmonary function impairment (restrictive ventilation and diffusion dysfunction), sustained severe residual lung lesions (predominant fibrosis), and chronic systemic inflammatory responses. Patients with R-PASC exhibited enhanced SARS-CoV-2–specific T-cell responses, whereas in the control group, moderate-magnitude and polyfunctional virus-specific T-cell response correlated with improved lung function and alleviated inflammation. Sustained neutralizing antibody titers were also observed in patients with R-PASC, whereas humoral responses showed minimal association with disease pathophysiology. Moreover, prolonged activation of complement classical and alternative pathway in patients with R-PASC is associated with worsening respiratory parameters, whereas mannose-binding lectin within the lectin pathway exhibits protective correlations with pulmonary tissue function preservation. Overall, our study delineates the extensively perturbed immune–inflammation–organ dysfunction in patients with R-PASC, thereby providing valuable insights into the pathogenesis of this condition and highlighting potential targets for therapeutic intervention.

Postacute COVID-19 (PASC) causes long-term lung damage in 57 pts at 4mo & 54 at 7mo post-Omicron. R-PASC 🔥 immune response, fibrosis, impaired lung function persist.

28.02.2026 00:00 — 👍 0 🔁 0 💬 0 📌 0

Symptom Patterns, Recovery, and Impact of Long COVID: Findings From a Longitudinal Survey Long COVID is a predominantly multisystem, often disabling, condition that develops following SARS-CoV-2 infection. We aimed to characterize the pattern, triggers, and impact of Long COVID symptoms.MethodsData from a 1-year follow-up of an online survey originally conducted in November 2020 were used. Surveys were coproduced with people living with Long COVID. Participants were adults with Long COVID following confirmed or probable SARS-CoV-2 infection who were not hospitalized in the first 2 weeks of illness. The baseline survey recruited from social media and online support groups using convenience nonprobability sampling.ResultsOf the 2210 first survey participants invited, 1153 (52%) responded to the follow-up survey. The mean age was 47.7 years (standard deviation 10.6) with 84% females, 83% UK-based, 78% university-qualified, and 90% reporting good to excellent health before SARS-CoV-2 infection. Median duration of illness was 19.8 months (interquartile range, 19.3–20.1) at follow-up. Only 5% of participants reported full recovery, and 45% reported a constant pattern of illness (as opposed to fluctuating or relapsing) compared to 17% at baseline. An equal proportion reported being unable to work at baseline (20.4%) and follow-up (20.6%). However, a higher proportion reported being made redundant or taking early retirement at follow-up (8.9%) than at baseline (2.2%).ConclusionsThis study highlights the prolonged nature of Long COVID as well as the impact on work. This has the potential to widen health inequalities and increase hardship in individuals whose life circumstances and job types may not allow them to make necessary adaptations.

Long COVID study: 1153 respondents, 84%♀, 47.7yrs avg, 19.8mo illness. 5% fully recovered, 45% constant illness; work inability ~20%, redundancy rose 2.2%→8.9%. ⚠️

27.02.2026 23:30 — 👍 2 🔁 1 💬 0 📌 0

<em>Communicable</em> episode 41: Diagnostic stewardship In-hospital mortality rates for patients with methicillin-susceptible Staphylococcus aureus (MSSA) infectious endocarditis (IE) remain very high and approach 40%. Limited data has suggested that combination antibiotic therapy with cefazolin or nafcillin/oxacillin with ertapenem may expedite blood culture clearance and improve clinical outcomes. We evaluated outcomes of patients with MSSA IE receiving combination antimicrobial therapy as directed by a multidisciplinary teamMethodsThis was a single-center retrospective study of patients with definite MSSA IE treated with combination therapy identified from an institutional registry between September 7, 2021, and August 15th, 2025. Clinical and outcomes data were recorded by study investigators.ResultsA total of 52 patients with definite MSSA IE who received combination therapy with cefazolin or nafcillin with ertapenem were identified. Median age was 37 years (33 – 45) and 51.9% were male. Sixty-nine percent had recent injection drug use and 63.2% were admitted to intensive care. Seventy-five percent received cefazolin with ertapenem and 25% received nafcillin and ertapenem. Median duration of bacteremia before combination therapy was 3 days (2 – 5), median total duration of bacteremia was 5 days (4 – 7), and median duration of combination therapy was also 5 days (3 – 6). In-hospital mortality was 5.8% and 90-day mortality was 19.2% with no relapsed infections at 90-days.ConclusionUsing a structured approach, guided by a multidisciplinary endocarditis team, patients with MSSA IE were treated with combination therapy with low in-hospital mortality and short durations of ertapenem utilization. Randomized controlled trial data is needed to determine the efficacy of combination treatment compared to monotherapy.Graphical AbstractDownload: Download high-res image (161KB)Download: Download full-size image

Meth MSSA IE pts (n=52, median age 37, 52%♂) got cefazolin/nafcillin + ertapenem combo. In-hosp death 5.8%⬇️ vs prior ~40%, 90-day death 19.2%, no relapse. Short bact duration.💊 #Endocarditis

27.02.2026 12:00 — 👍 0 🔁 0 💬 0 📌 0

Safety, tolerability, and pharmacokinetics of 6-diazo-5-oxo-L-norleucine (DON) in Malawian adults with and without malaria: a Phase I dose-escalation clinical trial Cerebral malaria (CM) is a common cause of febrile coma among African children. Despite treatment with highly efficacious intravenous artesunate, CM remains associated with high mortality and neurologic sequelae. In a mouse CM model, the glutamine antagonist 6-diazo-5-oxo-L-norleucine (DON) demonstrated robust efficacy as a potential adjuvant therapy. Before testing DON in children with CM, we investigated tolerability in African adults, including individuals with malaria.MethodsWe conducted an open-label, prospective, dose-escalation, Phase I clinical trial of single dose intravenous DON in Blantyre, Malawi. Participants included healthy adults and adults with uncomplicated malaria, enrolled in dose-cohorts of ten and administered DON at 0.1, 1.0, 5.0, or 10 mg/kg. We assessed adverse events (AEs) and plasma pharmacokinetics.ResultsForty healthy adults and 38 adults with uncomplicated malaria received DON. Transient, asymptomatic creatinine elevation occurred 12 hours post-infusion in 18% of all participants. Nausea and vomiting were uncommon at 0.1 and 1.0 mg/kg but occurred more frequently at 5.0 and 10 mg/kg DON. All DON-related AEs resolved rapidly, without sequelae, and did not significantly differ between healthy and uncomplicated malaria participants. In healthy adults, maximum plasma concentrations increased proportional to dose, but adults with malaria had greater than dose-proportional increases. Terminal half-life ranged from 1.7–4.1 hours.ConclusionsDON was well tolerated in healthy adults and adults with uncomplicated malaria. Higher doses were associated with transient gastrointestinal AEs. Pharmacokinetics were minimally influenced by malaria disease. These results provide critical data to guide dosing strategies for adjunctive DON in children with CM.ClinicalTrials.gov: NCT05478720

DON was given IV to 78 adults (40 healthy, 38 malaria). 18% had transient creatinine rise ⬆️; nausea/vomiting ↑ at 5-10 mg/kg. Half-life: 1.7–4.1 hrs. Well tolerated overall.💉

27.02.2026 11:30 — 👍 0 🔁 0 💬 0 📌 0

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