Data on the association between same-day reporting of carbapenemase testing results using lateral flow immunochromatographic assays (LFA) and antimicrobial treatment decisions remain limited. This study aimed to evaluate the agreement between an LFA and commercial qPCR for carbapenemase detection and to compare the LFA with the Carba NP-direct test (CNPtd) and modified carbapenem inactivation method (mCIM). We also assessed the association between LFA results and same-day antimicrobial treatment decisions. The study included 110 retrospective (80 carbapenemase-producing and 30 non-carbapenemase-producing) and 95 prospective Enterobacterales isolates. Agreement between the Carbapenem Resistant Enterobacteriaceae Test-Kit (Dynamiker Biotechnology, Tianjin, China), CNPtd, mCIM, and the Biospeedy Carbapenem Resistance qPCR Kit (Bioeksen, Türkiye) was evaluated using positive percent agreement (PPA) and negative percent agreement (NPA). The association between LFA positivity and treatment escalation was evaluated using multivariable logistic regression. In the retrospective cohort, the LFA showed 100
Tuberculosis (TB) recurrence after successful treatment remains an important challenge for TB control. We characterized recurrence timing and associated factors among successfully treated pulmonary TB patients in Nanjing, China. We conducted a retrospective cohort study using the Tuberculosis Management Information System. A total of 23,423 newly diagnosed pulmonary TB patients registered during 2011–2022 who achieved cure or treatment completion were followed from successful treatment until first recorded recurrence or 31 December 2022. Kaplan–Meier methods and log-rank tests were used to assess recurrence patterns and subgroup differences. Multivariable associations were evaluated using Cox regression; proportional hazards were assessed with scaled Schoenfeld residuals, and a time-varying coefficient was used for bacteriological positivity. During 144,259.81 person-years of follow-up, 660 patients developed recurrent TB, giving a recurrence proportion of 2.82
The role of artificial intelligence in managing complex infectious diseases (ID) remains poorly understood. This study assessed the quality and safety of the management plan recommended by ChatGPT-4o in patients with infective endocarditis (IE). Prospective, single-center study enrolling adults with IE over an 8-months period. Clinical data for each patient, using ESC guidelines and Duke-ISCVID criteria as external knowledge or fine-tuning data, were provided to ChatGPT-4o asking for a management plan (diagnosis, diagnostic work-up, antimicrobial therapy, follow-up). The recommendations provided by local ID specialists (IDSs) and ChatGPT-4o were rated by three independent IDSs using a standardized scoring system. Evaluations were compared using McNemar-Bowker test and the inter-grader agreement was assessed. Fifty patients with IE were included, mostly with definite IE (86
Current blood-based diagnostic modalities for LNB have significant limitations. Using Next Generation Sequencing, we investigated blood samples from patients with LNB and non-LNB controls for Borrelia burgdorferi-specific cfDNA (Bb-cfDNA). Blood-samples from 61 adults suspected for LNB were analysed with amplification-free Nanopore metagenomic sequencing and detected cfDNA was cross-referenced with human and Bb-genome databases to identify Bb-specific-cfDNA. Bb-cfDNA was detected in 3 of 45 patients with LNB (6.7
Adults with type 2 diabetes mellitus (T2DM) are at increased risk of pneumococcal disease because of impaired immune function. Although pneumococcal vaccination is recommended for this high-risk population, evidence describing functional antibody responses following sequential pneumococcal vaccination remains limited. We evaluated naturally acquired and vaccine-induced functional antibody responses against 24 pneumococcal vaccine serotypes in adults with T2DM following sequential PCV13-PPSV23 vaccination. In this prospective cohort study, 132 pneumococcal vaccine-naïve adults with T2DM received PCV13 followed by PPSV23 eight weeks later. Functional antibody responses were assessed in 123 paired serum samples collected before and four weeks after PPSV23 administration using the WHO-standardized multiplex opsonophagocytic assay (MOPA). Serotype-specific geometric mean titres (GMTs), geometric mean fold rises (GMFRs), proportions achieving ≥ 4-fold increases, and protective OPA thresholds (≥ 8 and ≥ 64) were evaluated. Baseline functional immunity varied considerably across serotypes, indicating heterogeneous naturally acquired protection. More than 30
