Measles and varicella still occur in the general population despite the widespread vaccination against them, and healthcare workers (HCWs) are still at risk of exposure to these diseases. Here, we evaluated the seroprevalence of measles and varicella-zoster virus (VZV) in HCWs and the trend of seroprevalence according to age, birth year, and occupational group. The serostatuses of measles and VZV of HCWs during new employee medical examinations between October 2015 and October 2021 were included. Thereafter, the trends of seroprevalence according to age, birth year, and occupational groups were evaluated. Overall, 2070 and 1827 HCWs were evaluated for VZV and measles serostatus, respectively. The seroprevalences of VZV and measles were 91% (1884/2070) and 70% (1284/1827), respectively. Younger HCWs had a significantly lower seroprevalence of measles (p = 0.02, age) and VZV (p = 0.003, birth year and p < 0.001, age). The seroprevalence of measles and VZV was significantly higher among doctors and nursing assistants than among nurses and other HCWs (p < 0.001 in both). In conclusion, the seroprevalence of measles and VZV significantly decreased in younger HCWs. Additionally, monitoring the serostatus of measles and VZV and the immunization of susceptible HCWs are required to prepare and control infectious diseases in healthcare facilities.

The incidence of heterogeneous vancomycin-intermediate Staphylococcus aureus (hVISA) infection is increasing and is associated with vancomycin treatment failures. However, studies investigating the risk factors for treatment failure in hVISA infection are limited. Patients with hVISA bacteremia treated with vancomycin over 7 days between August 2008 and June 2020 were enrolled in this study. Clinical and microbiological characteristics were compared between vancomycin treatment failure and success groups to identify the risk factors for vancomycin treatment failure. Among the 180 patients with hVISA bacteremia, 102 patients treated with vancomycin over 7 days were included. Vancomycin treatment failed in 80 (78%) patients. Patients in the vancomycin treatment failure group were older ( P < 0.001) and more frequently had solid cancer ( P = 0.04) than those in the vancomycin treatment success group. Solid organ transplantation (SOT) was more frequent ( P < 0.001) in the vancomycin treatment success group. The Charlson comorbidity index ( P = 0.01) and Acute Physiology and Chronic Health Evaluation II scores ( P < 0.001) were higher in the vancomycin treatment failure group. In multivariate analysis, independent risk factors for vancomycin treatment failure were old age and severity of bacteremia. SOT and vancomycin minimal inhibitory concentration (MIC) ≤ 1.0 mg/L using the broth microdilution (BMD) method were associated with successful vancomycin treatment. Old age and infection severity were independent risk factors for vancomycin treatment failure. Vancomycin MIC using the BMD method is an important risk factor for vancomycin treatment failure, and its use should be considered in hVISA bacteremia. IMPORTANCE: In this study, we assessed the clinical and microbiological characteristics of heterogeneous vancomycin-intermediated Staphylococcus aureus (hVISA) bacteremia and identified risk factors for vancomycin treatment failure. We found that advanced age and severity of infection were independent risk factors for vancomycin treatment failure. On the other hand, solid organ transplantation and a low vancomycin minimal inhibitory concentration were associated with successful vancomycin treatment. This study highlights the importance of vancomycin minimal inhibitory concentration in hVISA bacteremia.

Methods for distinguishing catheter-related candidemia (CRC) from non-CRC before catheter removal remain limited. We thus evaluated the diagnostic performance of differential time to positivity (DTP) to diagnose CRC in neutropenic cancer patients with suspected CRC. Of the 35 patients enrolled, 15 (43%) with CRC (six definite and nine probable) and 17 (49%) with non-CRC were finally analyzed. Based on the receiver operating characteristic curve, the optimal cutoff value of DTP for diagnosing CRC was ≥1.45 hours with the sensitivity 80% (95% confidence interval [CI], 51–95) and specificity 100% (95% CI, 80–100), respectively.

The use of fluoroquinolone (FQ) combination therapy as empirical treatment for severe community-acquired pneumonia (sCAP) remains unclear. In this study, we aimed to evaluate its clinical impact. This retrospective study was conducted in seven large university-affiliated hospitals in Korea. It included adult inpatients (age ≥19 years) diagnosed with sCAP between March 2020 and February 2023, identified through third-ranked pneumonia codes, who received anti-pseudomonal beta-lactam (APBL) and/or FQ within 24 h of admission. Propensity-score matching compared monotherapy and combination therapy outcomes. Of 588 enrolled patients with sCAP, 177 per group were analyzed post-matching. No significant differences were found in all-cause in-hospital mortality (36.7 % vs. 36.2 %, P = 0.917), in-hospital mortality from pneumonia aggravation (29.9 % vs. 30.5 %, P = 1.000), or 30-day mortality (26.6 % vs. 29.4 %, P = 0.251). FQ combination therapy did not affect 30-day mortality significantly (P = 0.489). None of the variables significantly influenced 30-day mortality, pneumonia recurrence within 28 days, total antibiotic duration, or hospital stay. In patients with sCAP, outcomes did not differ significantly between APBL monotherapy and FQ combination therapy. This suggests that even in severe CAP, an individualized treatment strategy based on the causative agent may be more appropriate than indiscriminate combination therapy.