BMC Infectious Diseases[JOURNAL]
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200 papers
Machine learning-based prediction of ICU admission and mortality in Crimean-Congo hemorrhagic fever by using wide-range targeted metabolomics.
Cephe A, Büyüktuna SA, Koçhan N … +10 more , Zararsız GE, Yerlitaş Sİ, Doğan K, Kablan D, Bağcı G, Özer S, Baysal C, Kıymaz YÇ, Doğan HO, Zararsız G
BMC Infect Dis · 2026 Jun · PMID 42380783 · Full text
PURPOSE: This study aimed to evaluate the potential of amino-acid profiles to predict disease progression in patients with Crimean-Congo Hemorrhagic Fever (CCHF) and to identify metabolic biomarkers associated with clini...
PURPOSE: This study aimed to evaluate the potential of amino-acid profiles to predict disease progression in patients with Crimean-Congo Hemorrhagic Fever (CCHF) and to identify metabolic biomarkers associated with clinical outcomes and survival. METHODS: Of the 115 confirmed CCHF patients, 18 required intensive care unit (ICU) admission and 16 died. Notably, 15 of the deaths occurred among ICU patients, whereas only one death occurred outside the ICU. For each patient, 32 amino acid concentrations were used as input for machine-learning (ML) models. RESULTS: Among the classification models evaluated for predicting ICU admission, XGBOOST and LASSO achieved the highest performance, each with an AUC of 0.958. Arginine and glutamic acid consistently emerged as the most predictive features across all models, followed by 1-methyl-L-histidine, tryptophan, and tyrosine, which appeared among the top variables in four of the five best-performing models. In survival analysis, the mean concordance index (and integrated Brier score) was 0.973 (0.10) for Survival LASSO, 0.971 (0.11) for RFSRC, and 0.942 (0.12) for Survival XGBOOST. In survival models, the top five amino acids contributing to predictions were ornithine, gamma-aminobutyric acid, ethanolamine, arginine, and histidine. CONCLUSION: ML models based on amino-acid profiles can accurately predict disease progression in CCHF, supporting early risk stratification and providing insights into the metabolic mechanisms underlying disease severity.
A case of peritoneal dialysis-associated peritonitis caused by Rhodococcus pyridinivorans.
Lei W, Yang C, Yang Z … +2 more , Cai X, Zhou J
BMC Infect Dis · 2026 Jun · PMID 42374321 · Full text
BACKGROUND: Rhodococcus infections are exceedingly rare and largely reported in immunocompromised hosts, with no consensus on optimal therapy due to limited evidence. CASE PRESENTATION: This article reports for the first...
BACKGROUND: Rhodococcus infections are exceedingly rare and largely reported in immunocompromised hosts, with no consensus on optimal therapy due to limited evidence. CASE PRESENTATION: This article reports for the first time a case of peritoneal dialysis-associated peritonitis caused by Rhodococcus pyridinivorans in a patient with diabetic nephropathy. The dialysate leukocyte count declined substantially with combination antimicrobial therapy, but complete normalization occurred only after replacing icodextrin with a glucose-based dialysate. CONCLUSIONS: These findings support the use of combination regimens and emphasize the need to consider icodextrin-associated sterile peritonitis when dialysate abnormalities persist despite appropriate antimicrobial treatment.
A real-world study of the efficacy of a simplified pill count-based strategy for treating HCV/HIV coinfection patients.
Cao B, Peng Y, Liu M … +8 more , Ding P, Tang L, Guo M, Liu L, Deng C, Wu G, Zhong L, Zou Y
BMC Infect Dis · 2026 Jun · PMID 42374261 · Full text
BACKGROUND: Hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infections are major public health issues throughout the world. In resource-limited areas, successful treatment of HCV/HIV coinfection frequently...
BACKGROUND: Hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infections are major public health issues throughout the world. In resource-limited areas, successful treatment of HCV/HIV coinfection frequently faces challenges, particularly restricted access to drugs and poor treatment compliance. However, data comparing single-tablet regimen (STR) versus multi-tablet regimen (MTR) direct-acting antiviral (DAA) strategies, specifically focusing on pill burden, remain scarce in such settings. METHODS: This single-center, retrospective cohort study enrolled patients with HCV/HIV coinfection between April 2023 and October 2025. All patients received DAA therapy in addition to the antiretroviral therapy (ART). Participants were divided into DAA STR (one pill daily) and DAA MTR (multiple pills daily) groups. The primary endpoint was sustained virologic response at least 12 weeks after completion of treatment (SVR). RESULTS: A total of 105 patients with HCV/HIV coinfection were enrolled. The overall SVR rate was 96.2% (101/105). The DAA STR group had a numerically higher SVR rate than the DAA MTR group (98.8% vs. 88.0%, P = 0.041); however, this comparison was confounded by genotype. In a sensitivity analysis limited to non-genotype 3b patients (n = 87), SVR rate was 98.8% in the DAA STR group and 85.7% in the DAA MTR group (P = 0.155). The DAA STR demonstrated a numerical advantage in achieving SVR in all subgroups stratified by sex, age, HCV infection route, baseline HCV RNA level, HCV genotype, and ART regimen. Univariate logistic regression identified DAA regimen was the only factor associated with SVR (OR 10.773, 95% CI 1.067-108.743); however, because only 4 participants failed to achieve SVR, this analysis was exploratory and the estimate was statistically unstable. CONCLUSIONS: In this real-world study, both DAA STR and DAA MTR achieved high overall SVR rates in HCV/HIV coinfection in a resource-limited setting. The simplified DAA STR was associated with a numerically higher SVR, but the comparison was confounded by the selective allocation of genotype 3b patients to DAA MTR. The observed difference between DAA STR and DAA MTR may reflect treatment selection practices and genotype distribution rather than an independent effect of regimen simplification. The simplified pill count-based strategy remains a practical option, but its advantage over MTR was confounded by genotype selection in this cohort. Our findings support the feasibility of both approaches and highlight the need for large, prospective, genotype-balanced comparative studies with integrated adherence monitoring.
Long-term survival probability and predictors of mortality among adult patients living with HIV initiating combination antiretroviral therapy in Oman: an ambidirectional cohort study, 1992-2024.
Al-Zadjali ZM, Khamis F, Malehi A … +7 more , Jaju S, AlSabei SD, Al-Maskari IK, Aimaq R, Al-Naamani J, Al-Alawi K, Al-Farsi YM
BMC Infect Dis · 2026 Jun · PMID 42374250 · Full text
BACKGROUND: Acquired immunodeficiency syndrome (AIDS) remains a major global public health challenge despite substantial advances in combination antiretroviral therapy (cART). Evidence on long-term survival and mortality...
BACKGROUND: Acquired immunodeficiency syndrome (AIDS) remains a major global public health challenge despite substantial advances in combination antiretroviral therapy (cART). Evidence on long-term survival and mortality predictors among adult patients living with HIV in Oman remains limited. This study evaluated long-term survival probability and predictors of mortality among adults living with HIV initiating cART in Oman over 32 years. METHODS: An ambidirectional cohort study was conducted using data from the HIV/AIDS registry at the national tertiary referral hospital, the Royal Hospital in Oman, covering the period from January 1992 to December 2024. A total of 549 adult patients living with HIV who initiated cART were included in the study. Clinical and laboratory data were extracted from electronic medical records and analyzed using descriptive statistics, Kaplan-Meier survival analysis, and multivariable Cox proportional hazards regression. RESULTS: Among 549 adult patients living with HIV, 99 deaths occurred during follow-up, including 83 AIDS-related and 16 non-AIDS-related deaths. The overall mortality incidence rate was 1.5 deaths per 1,000 person-months (95% CI: 1.21-1.80). Median survival was not reached during follow-up because the cumulative survival probability remained above 50%. In the adjusted Cox model, participants aged 18-27 years (AHR = 0.36, 95% CI: 0.20-0.67) and 28-37 years (AHR = 0.36, 95% CI: 0.21-0.64) had significantly lower mortality hazards compared with those aged > 47 years. Patients diagnosed at WHO clinical stage 1 (AHR = 0.15, 95% CI: 0.07-0.32), stage 2 (AHR = 0.24, 95% CI: 0.07-0.78), and stage 3 (AHR = 0.42, 95% CI: 0.27-0.67) had lower mortality risk than those diagnosed at stage 4. Hemoglobin ≤ 10 g/dL was independently associated with increased mortality (AHR = 1.75, 95% CI: 1.09-2.81). Although crude analyses showed higher mortality among males, gender was not independently associated with mortality after adjustment for confounders. Timing of cART initiation was also not independently associated with mortality after adjustment. CONCLUSION: Long-term survival probability among adult patients living with HIV in Oman was favorable, with a median survival of over 32 years of follow-up. Younger age at diagnosis, earlier WHO clinical stage, and higher hemoglobin levels were independently associated with lower mortality risk. These findings highlight the importance of early HIV diagnosis and sustained clinical monitoring to improve long-term outcomes.
Co-occurrence of triple ESBL-associated genes (bla, bla and bla) in Gram-negative bacteria from clinical specimens at a provincial hospital in Far-Western Nepal.
Bohara MS, Sharma S, Bhatta DR
BMC Infect Dis · 2026 Jun · PMID 42374219 · Full text
BACKGROUND: Antimicrobial resistance (AMR) among Gram-negative bacteria, particularly those producing extended-spectrum β-lactamase (ESBLs), represents a significant global healthcare challenge. CTX-M enzymes have achiev...
BACKGROUND: Antimicrobial resistance (AMR) among Gram-negative bacteria, particularly those producing extended-spectrum β-lactamase (ESBLs), represents a significant global healthcare challenge. CTX-M enzymes have achieved global dominance, often disseminated through plasmid-mediated horizontal gene transfer, complicating treatment in resource-limited settings. This study aimed to determine prevalence, antimicrobial resistance patterns and ESBL-associated gene profiles in clinical Gram-negative isolates. METHODS: A hospital-based cross-sectional study was conducted at Mahakali Provincial Hospital from November 2024 to February 2026. Using a consecutive sampling technique, 1485 clinical specimens (including urine, pus, blood, wound swabs, throat swabs and tissues) were processed for bacterial culture, identification, antimicrobial susceptibility testing and ESBL detection following CLSI 2024 guidelines. ESBL-associated genes (bla, bla and bla) were detected by PCR. RESULTS: Of 1485 specimens, 478 (32.3%) were culture-positive, yielding 411 (86.0%) Gram-negative bacteria. Urine samples accounted for 88.3% of isolates. E. coli (71.8%) and K. pneumoniae (15.6%) were the most common pathogens. Overall, 54.7% of isolates were multidrug-resistant (MDR). Among ESBL-screened Enterobacterales (n = 385), 108 (28.1%) were confirmed ESBL producers. Molecular analysis of 108 ESBL- producing MDR isolates revealed bla (56.5%) as the most prevalent gene followed by bla (44.4%) and bla (32.4%). Co-occurrence of multiple genes was observed in 56 (51.9%) isolates, with 6 (5.6%) harboring all three genes. CONCLUSIONS: To the best of our knowledge, this is the first report from Far-Western Nepal documenting the co-carriage of triple ESBL-associated genes in clinical Enterobacterales. These findings highlight a high regional burden of community-level resistance and emphasize the urgent need for continuous molecular surveillance, targeted antimicrobial stewardship and region-specific treatment guidelines.
Correction: A COVID-19 prediction Model based on symptomatology google trends and its optimization.
Ma Y, Lyu K, Xu H … +9 more , Jiao C, Ren L, Lyu H, Zhang A, Yang Y, Li Z, Zhu K, Ren X, Chen J
BMC Infect Dis · 2026 Jun · PMID 42374216 · Full text
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First reported mortality from XDR Acinetobacter Baumannii Meningitis following posterior lumbar interbody fusion in Iran: a case report.
Nabiuni M, Zarghami F
BMC Infect Dis · 2026 Jun · PMID 42374209 · Full text
BACKGROUND: Bacterial meningitis is a rare but serious complication following neurosurgical procedures. Acinetobacter baumannii (A. baumannii) has emerged as an opportunistic pathogen, causing serious infections worldwid...
BACKGROUND: Bacterial meningitis is a rare but serious complication following neurosurgical procedures. Acinetobacter baumannii (A. baumannii) has emerged as an opportunistic pathogen, causing serious infections worldwide. The increasing prevalence of multidrug-resistant strains presents growing challenge in healthcare settings. The occurrence of multidrug-resistant A. baumannii meningitis after Posterior Lumbar Interbody Fusion (PLIF) surgery is exceptionally uncommon. CASE PRESENTATION: We report a 59-year-old osteoporotic female who developed A. baumannii meningitis resistant to our available antibiotics following PLIF for L5/S1 spondylolisthesis. Although a minor durotomy occurred during surgery due to sever adhesion in the inflamed tissue and no cerebrospinal fluid (CSF) leakage was observed postoperatively. The patient experienced fever and headache on first day after discharge which was managed with ondansetron, and then gradual loss of consciousness six days after discharge occurred, leading to her readmission. Despite administration of intravenous antibiotics and two courses of intrathecal antibiotic therapy via an External Ventricular Drain (EVD), her condition progressively deteriorated, and she ultimately succumbed to the infection. CONCLUSION: This case highlights the critical importance of maintaining dura integrity and adhering to strict operating room sterilization protocols. As resistant organisms become increasingly prevalent, healthcare providers must exercise heightened vigilance in the early recognition and management of infections following neurosurgical procedures.
Serum Interleukin-6 and Interleukin-10 levels in people living with HIV on short-term and long-term antiretroviral therapy: a comparative cross-sectional study with HIV-negative controls.
Adegoke AA, Onyeaghala C, Olojede AO … +2 more , Omitola OG, Nwauche CA
BMC Infect Dis · 2026 Jun · PMID 42365282 · Full text
BACKGROUND: Antiretroviral therapy (ART) suppresses HIV replication and partially restores immune function, but immune recovery is often incomplete. Interleukin-6 (IL-6) and Interleukin-10 (IL-10) reflect opposing sides...
BACKGROUND: Antiretroviral therapy (ART) suppresses HIV replication and partially restores immune function, but immune recovery is often incomplete. Interleukin-6 (IL-6) and Interleukin-10 (IL-10) reflect opposing sides of the immune response, pro-inflammatory and regulatory, respectively. They may provide insight into the degree of residual immune dysregulation in people living with HIV (PLHIV) on treatment. This study aims to determine serum IL-6 and IL-10 levels in PLHIV on ART compared to HIV-negative controls. METHODS: A comparative cross-sectional study was conducted at the HIV Care and Treatment Clinic of the University of Port Harcourt Teaching Hospital (UPTH), Nigeria. Eighty-one participants were enrolled: 63 were living with HIV (27 on short-term ART [less than six months], 36 on long-term ART [two years or more]), and 18 HIV-negative controls. Serum IL-6 and IL-10 were quantified by enzyme-linked immunosorbent assay (ELISA). Group differences were assessed using one-way analysis of variance (ANOVA), Tukey HSD post hoc tests, and independent samples t-tests. The influence of age and sex on cytokine levels was examined by analysis of covariance (ANCOVA). RESULTS: IL-6 was 7.35 ± 0.17 pg/ml in the short-term ART group, 6.38 ± 0.12 pg/ml in the long-term ART group, and 5.65 ± 0.15 pg/ml in controls. All three pairwise comparisons were statistically significant (p < 0.05). IL-10 was 6.42 ± 0.15 pg/ml, 6.21 ± 0.11 pg/ml, and 5.81 ± 0.22 pg/ml across the same groups respectively. Only the comparison between the short-term ART group and controls was significant for IL-10. Age and sex had no statistically significant effect on either cytokine. CONCLUSION: IL-6 declines with longer ART but remains elevated above control levels even after years of treatment, indicating persistent residual inflammation. Interleukin 10 is elevated in treated individuals compared with controls but does not track ART duration. These findings support the value of cytokine profiling as a supplementary tool for monitoring immune status in ART-treated PLHIV in a Nigerian clinical setting.
Development and external validation of a machine learning prediction model for Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis in children using routine blood parameters: a retrospective cohort study.
Xiao L, Liao M, Meng Y … +6 more , Yu J, Cui Y, Liu H, Liu W, Wang R, Li Z
BMC Infect Dis · 2026 Jun · PMID 42365248 · Full text
BACKGROUND: Epstein-Barr virus (EBV) infection is a common pediatric infectious disease. Infectious mononucleosis (IM) and hemophagocytic lymphohistiocytosis (HLH), two major complications of EBV infection, share similar...
BACKGROUND: Epstein-Barr virus (EBV) infection is a common pediatric infectious disease. Infectious mononucleosis (IM) and hemophagocytic lymphohistiocytosis (HLH), two major complications of EBV infection, share similar clinical manifestations in the early stage. While IM is typically self-limiting, HLH is life-threatening and requires immediate intervention. Early differentiation between these two conditions is crucial for clinical decision-making; however, reliable prediction models based on readily available laboratory parameters remain scarce. This study aimed to develop and validate a machine learning prediction model using routine blood parameters obtained within 24 h of hospital admission in children with confirmed acute EBV infection to distinguish EBV-associated IM (EBV-IM) from EBV-associated HLH (EBV-HLH). METHODS: This retrospective cohort study included 4,871 pediatric patients diagnosed with either EBV-IM or EBV-HLH from two campuses of Children's Hospital of Chongqing Medical University. Demographic information and initial complete blood count (CBC) parameters within 24 h of admission were collected. The cohort was divided into a model development group (Yuzhong Campus, n = 2,848; 70% for training, 30% for internal testing) and an external validation group (Liangjiang Campus, n = 2,023). Thirteen machine learning algorithms were evaluated using random search with 5-fold cross-validation for hyperparameter tuning. Shapley Additive exPlanations (SHAP) analysis was performed to interpret model predictions. RESULTS: EBV-HLH accounted for 12.46% (607/4,871) of the total cohort, with significantly different prevalence between the development and validation cohorts (18.29% vs. 4.25%, p < 0.001). Significant differences were observed between cohorts in age and all CBC parameters except gender (p < 0.05). The Random Forest (RF) model demonstrated optimal performance in the internal validation set (AUC = 0.993, 95% CI: 0.990-0.996). In the external validation cohort, the RF model maintained robust discriminative ability (AUC = 0.971, 95% CI: 0.949-0.992). Calibration curves indicated excellent agreement between predicted probabilities and actual risks. SHAP analysis identified WBC, PLT, LAC, and Hb as the most critical predictors of EBV-HLH. DCA demonstrated substantial clinical net benefit. A free online decision-support tool (https://wangrj1988.shinyapps.io/EBV-HLH-IM/) was developed based on the RF model to facilitate real-time risk assessment. CONCLUSIONS: The RF-based model using routine CBC parameters enables admission-based risk assessment of pediatric EBV-HLH with excellent generalizability, offering a cost-effective tool for diverse healthcare settings. TRIAL REGISTRATION: Clinical trial number: not applicable.
Utilizing RT-PCR for infectious disease diagnosis with emphasis on non-tuberculous mycobacteria in Bangladesh, 2019-2024.
Sayem MA, Hossain MA, Salam MA … +5 more , Khan AA, Nath S, Hossain MA, Adham MI, Haque MA
BMC Infect Dis · 2026 Jun · PMID 42365240 · Full text
BACKGROUND: Advanced diagnostics like reverse transcription polymerase chain reaction (RT-PCR) improve accuracy, limit infectious disease transmission and decrease mortality. This study evaluated the utility of RT-PCR fo...
BACKGROUND: Advanced diagnostics like reverse transcription polymerase chain reaction (RT-PCR) improve accuracy, limit infectious disease transmission and decrease mortality. This study evaluated the utility of RT-PCR for detecting infectious agents, including Nontuberculous mycobacteria (NTM), to guide clinical decision-making. METHODS: This retrospective study analyzed infectious disease data from Apollo Imperial Hospitals Ltd., Chattogram, Bangladesh from June 2019 to July 2024. Of 810 anonymized records extracted from the molecular biology laboratory, 786 samples with complete diagnostic information undergoing RT-PCR testing were included. Associations between positivity and socio-demographic/clinical factors (e.g., gender, sample type, pathogen tested) were analyzed using chi-square tests and binary logistic regression. RESULTS: Among 786 patients, the mean age and SD was 38.8 ± 19.3 years with 87.1% adults or elderly (> 60 years old), and 53.7% were female. Samples comprised blood (31.6%), tissue (27.2%), body fluids (19.3%), swabs (8.1%), sputum (6.1%), pus (4.8%), and urine (2.8%). Overall, 100 (12.7%) specimens were positive by RT-PCR. Mycobacteria were detected in 6.4%, including Mycobacterium tuberculosis (MTB; 2.9%) and nontuberculous mycobacteria (NTM; 3.5%). The gender and clinical samples had significant difference with unadjusted OR, while pathogens were significantly associated with tests results (adjusted OR: 0.16, 95% CI: 0.03-0.87; P < 0.05) respectively. Male patients and specimens tested for respiratory pathogen panel (RPP) had higher odds of positivity, while body fluid, tissue, HPV/HSV, and Mycobacterial samples had lower odds of positivity. CONCLUSIONS: RT-PCR is a reliable diagnostic tool with higher sensitivity (up to 95%) and specificity (up to 100%) for infectious diseases, with potential for greater optimization in Bangladesh, especially for NTM detection. Improved specimen selection and clinical practices can enhance positivity rates and reduce costs. The NTP should prioritize better NTM detection to prevent misdiagnosis and improper treatment. WHO global report on tuberculosis should highlight NTM to guide policy and management strategies. CLINICAL TRIAL NUMBER: Not applicable.
Lessons in the Wake of a Lassa fever case in the Midwest U.S: epidemiology, management and preparedness gaps.
Sebastian SL, Maria Susana CP, Huber Said PZ … +1 more , Karen B
BMC Infect Dis · 2026 Jun · PMID 42365235 · Full text
BACKGROUND: Lassa fever (LF) is a zoonotic viral hemorrhagic disease endemic to West Africa that remains persistently neglected despite substantial morbidity, mortality, and outbreak potential. A fixed burden estimate is...
BACKGROUND: Lassa fever (LF) is a zoonotic viral hemorrhagic disease endemic to West Africa that remains persistently neglected despite substantial morbidity, mortality, and outbreak potential. A fixed burden estimate is not available due to the absence of systematic surveillance across endemic regions; passive case detection, limited laboratory capacity, and significant underreporting make precise quantification impossible. Contemporary modeling now projects approximately 2.7 million Lassa virus infections each year across West Africa, with an estimated 3,900 deaths and 2.0 million disability-adjusted life years (DALYs) over a decade - figures that likely still underestimate the true burden (6,86). While most infections are mild or asymptomatic, severe disease is associated with high case-fatality rates, nosocomial transmission, and long-term sequelae. The most recent travel-associated case in the Midwest U.S highlights the ongoing risk of international spread and exposes critical gaps in recognizing and responding to rare but high-consequence pathogens, even in high-resource settings. METHODS: This narrative review synthesizes epidemiologic data, clinical studies, surveillance reports, and outbreak investigations to examine Lassa fever through the lens of outbreak detection, response, and preparedness. RESULTS: Early clinical recognition remains difficult due to non-specific presentations and, in non-endemic countries, ignoring travel and exposure history. Non-specific presentation and limited diagnostic tools access contributes to delayed diagnosis and extensive contact investigations. Molecular diagnostics, particularly RT-PCR, remain central to early diagnosis but are influenced by viral genetic diversity and sampling timing. Ribavirin continues to be widely used for treatment and post-exposure prophylaxis despite limited and heterogeneous evidence. Emerging antivirals, monoclonal antibodies, and vaccine candidates show promise but are not yet available for routine use. Outbreak control is further complicated by the complex ecology of Lassa virus, including rodent reservoirs, environmental drivers, and potential involvement of additional host species. CONCLUSIONS: Lassa fever remains a high-threat pathogen at the intersection of endemic disease and global outbreak preparedness. Travel-associated cases, like the most recent one in Iowa, consistently reveal gaps in infection prevention and control, exposure-risk assessment, and post-exposure management. Early suspicion, followed by immediate isolation, rapid engagement of public health authorities, and timely initiation of infection control and clinical measures is central to limiting downstream consequences. Addressing these gaps will require strengthened laboratory capacity, harmonized surveillance and response frameworks, accelerated development of medical countermeasures, and sustained investment in preparedness strategies applicable to both endemic and non-endemic settings. CLINICAL TRIAL NUMBER: Not applicable.
Computed tomography findings and severity scores in Chlamydia psittaci pneumonia: a retrospective study of 69 cases with clinical correlation.
Li Y, Zhu H, Li G … +5 more , Cao Y, Zhan Z, Zhou Q, Zheng C, Huang F
BMC Infect Dis · 2026 Jun · PMID 42365231 · Full text
BACKGROUND: Chlamydia psittaci pneumonia (CPP) is a rare but potentially severe zoonotic disease.This study aimed to characterize the computed tomography(CT)findings of CPP and evaluate the utility of CT severity scores...
BACKGROUND: Chlamydia psittaci pneumonia (CPP) is a rare but potentially severe zoonotic disease.This study aimed to characterize the computed tomography(CT)findings of CPP and evaluate the utility of CT severity scores for predicting intensive care unit(ICU) admission. METHODS: We retrospectively analyzed patients diagnosed with CPP between January 2022 and September 2025.Patients were divided into ICU and non-ICU groups based on disease severity and ICU admission.Demographic, clinical, laboratory, and radiological data were collected.Two radiologists independently reviewed CT images to record imaging features and calculate two scores: the chest CT score(CTS, range 0-25 based on lobar involvement)and the chest CT severity score(CTSS, range 0-40 based on 20 lung segments).Multivariable logistic regression and receiver operating characteristic(ROC)curve analyses were performed to identify predictors of ICU admission.We further compared the predictive performance of CTS with that of the CURB - 65 (confusion, urea, respiratory rate, blood pressure, age ≥ 65 years) score, a widely - utilized clinical severity assessment tool for community - acquired pneumonia. The CURB - 65 score was calculated for each patient upon admission. RESULTS: A total of 69 patients were included(45 male,24 female; mean age 61.6 ± 12.5years).A history of poultry or bird exposure was reported in 65 patients(94.2%).The ICU group comprised 22 patients(31.9%).Among survivors(n = 65),follow-up showed complete clinical recovery, and repeat CT imaging demonstrated complete resolution or marked improvement of interstitial abnormalities in those with available follow-up scans, supporting the reversible acute nature of these changes.In the ICU group, both the CTS (9.9 ± 6.4 vs. 5.9 ± 3.4, P = 0.011) and CTSS (13.5 ± 9.0 vs. 9.0 ± 4.8, P = 0.035) were significantly elevated. ROC analysis indicated that the area under the curve was 0.710 for CTS (cut - off 7.5; sensitivity 63.6%; specificity 76.6%) and 0.657 for CTSS. The CURB - 65 score yielded an area under the curve (AUC) of 0.633 (95% confidence interval [CI]: 0.476-0.790, P = 0.076). The DeLong test showed no statistically significant difference between the AUCs of the CTS and CURB - 65 (P = 0.452). Notably, only the CTS reached statistical significance in predicting intensive care unit (ICU) admission, implying that computed tomography (CT) - based severity assessment might offer prognostic information that cannot be captured solely by clinical score. CONCLUSION: This study provides a detailed imaging characterization of CPP.CT severity scores, particularly the CTS, are independently associated with ICU admission and may serve as adjunctive tools for early risk stratification.The reversible nature of interstitial changes on follow-up supports their acute inflammatory origin.Compared with CURB-65,the CTS offered a numerically higher AUC and provided significant prognostic information where clinical scoring alone did not.
Leptospirosis and its co-infections in India: prevalence, geographic distribution, and clinical implications.
Joseph G, Kulavalli S, Bélard S … +1 more , Saravu K
BMC Infect Dis · 2026 Jun · PMID 42363130 · Full text
BACKGROUND: Leptospirosis is a zoonotic disease prevalent in low and middle-income countries and tropical regions. It can be mimicked by endemic infectious diseases that present simultaneously, like dengue, malaria, meli...
BACKGROUND: Leptospirosis is a zoonotic disease prevalent in low and middle-income countries and tropical regions. It can be mimicked by endemic infectious diseases that present simultaneously, like dengue, malaria, melioidosis, or scrub typhus. However, there is a dearth of documented evidence about the frequency of coinfection, as well as related symptoms and mortality. The study aims to determine the frequency and geographical extent of coinfections in leptospirosis patients in India. METHODOLOGY: We systematically searched databases, including Scopus, PubMed, Embase, and Web of Science, for articles published between January 2010 and August 2024 assessing coinfections in leptospirosis patients in India. The eligible articles were evaluated for full text data extraction using a standardized methodology. RESULTS: Of 804 articles screened 39 studies were included; overall these reported on 1565 leptospirosis cases with 236 (15.1%) cases with coinfections. Of these, seven observational studies assessed coinfections in 1318 leptospirosis-positive cases, identifying 113 (8.6%) coinfections: most commonly dengue (79; 69.9%), followed by hepatitis E (15; 13.2%), typhoid (9; 7.9%), and malaria (9; 7.9%). The most coinfection cases were reported from New Delhi (29.6%), followed by Kerala (21.6%), Karnataka (14.4%), Uttar Pradesh (12.2%), and Tamil Nadu (5.5%). Common symptoms included fever, vomiting, icterus, headache, thrombocytopenia, and transaminitis. Cases with coinfection had poorer outcomes with increased mortality compared to cases with isolated infection. CONCLUSION: In India, leptospirosis can present with co-infections such as dengue, hepatitis E, malaria, typhoid, and scrub typhus, complicating diagnosis due to overlapping clinical features. These coinfections are associated with unfavorable outcomes, including multi-organ dysfunction and increased mortality. Early diagnostic testing in febrile patients and timely, appropriate treatment are essential to improve patient outcomes. TRIAL REGISTRATION: Clinical trial number: not applicable. Review protocol registration (Open Science Framework): DOI https://doi.org/10.17605/OSF.IO/AS9W5.
Development and internal validation of a diagnostic prediction model for osteoporosis in elderly people living with HIV receiving antiretroviral therapy: a cross-sectional study.
Qin C, Gu J, Zhang P … +7 more , Chen T, Mo S, Meng X, He W, Kai F, Hu J, Jiang Z
BMC Infect Dis · 2026 Jun · PMID 42363121 · Full text
BACKGROUND: Prolonged antiretroviral therapy (ART) in people living with HIV (PLWH) is associated with progressive bone mineral density (BMD) loss and an elevated risk of osteoporosis and fragility fractures. However, va...
BACKGROUND: Prolonged antiretroviral therapy (ART) in people living with HIV (PLWH) is associated with progressive bone mineral density (BMD) loss and an elevated risk of osteoporosis and fragility fractures. However, validated diagnostic tools for osteoporosis tailored to elderly PLWH remain scarce. This study aimed to develop and internally validate a nomogram-based diagnostic prediction model for osteoporosis in elderly PLWH (postmenopausal women and men aged ≥ 50 years) receiving ART. METHODS: This retrospective cross-sectional study enrolled elderly PLWH who had initiated ART at a single center between September 2010 and July 2022 and had received ART for ≥ 12 months. BMD was assessed by dual-energy X-ray absorptiometry (DXA) during a cross-sectional survey conducted from January to June 2022, and osteoporosis was defined according to the World Health Organization criteria (T-score ≤ - 2.5). Predictor selection was performed using the least absolute shrinkage and selection operator (LASSO) regression. Multivariable logistic regression was subsequently applied to construct a diagnostic prediction nomogram. Model performance was evaluated using the concordance index (C-index), calibration plots, and decision curve analysis (DCA). Internal validation was conducted using bootstrapping with 1,000 resamples. RESULTS: Among 256 eligible patients, 102 (39.8%) were diagnosed with osteoporosis. LASSO regression identified six predictors with nonzero coefficients, and one additional predictor (baseline CD4 count) was incorporated based on clinical evidence, yielding a seven-variable nomogram: Sex, Ratio of Age and BMI, Duration of ART, Baseline CD4 + count, tenofovir disoproxil fumarate (TDF) regimen, β-C-terminal telopeptide of type I collagen (β-CTX), and procollagen type I N-terminal propeptide (PINP). The model achieved a C-index of 0.709 (95% confidence interval [CI]: 0.645-0.773) with good calibration (mean absolute error: 0.014). Internal validation yielded a bias-corrected C-index of 0.695. DCA demonstrated positive net clinical benefit across threshold probabilities ranging from 0.0 to 0.7. CONCLUSION: We developed and internally validated a nomogram incorporating seven clinical and biochemical predictors including Ratio of Age and BMI, Duration of ART, TDF Regimen, β-CTX, PINP, Sex and Baseline CD4 count for the diagnosis of osteoporosis in elderly PLWH receiving ART. The model demonstrated acceptable discrimination, satisfactory calibration and favorable clinical utility. External validation in independent, multi-center cohorts is warranted before clinical implementation.
HIV self-testing practice and associated factors among governmental medical college students in Addis Ababa, Ethiopia, 2024.
Wondie Y, Damtie M, Kebede AG … +6 more , Tadele AE, Yazew A, Haile AG, Kebede LT, Golla EB, Minwuyelet A
BMC Infect Dis · 2026 Jun · PMID 42363114 · Full text
BACKGROUND: Despite global health progress, HIV/AIDS continues to challenge many countries. HIV self-testing is a key strategy to improve testing and early detection. Nevertheless, medical students, who are at risk from...
BACKGROUND: Despite global health progress, HIV/AIDS continues to challenge many countries. HIV self-testing is a key strategy to improve testing and early detection. Nevertheless, medical students, who are at risk from both occupational and non-occupational exposure, are often overlooked, leaving many unaware of their HIV status and with limited access to counseling and testing services. OBJECTIVES: This study aimed to assess HIV Self-Testing Practice and Associated Factors among Governmental Medical College Students in Addis Ababa, Ethiopia, 2024. METHODS: An institution-based cross-sectional study was conducted among 375 medical students at a government college in Addis Ababa. Data were collected via a self-administered questionnaire and analyzed using SPSS version 26. Binary logistic regression was performed, and variables with p < 0.25 were included in the multivariable model. Associations with p < 0.05 and 95% confidence intervals were considered statistically significant. RESULT: A total of 375 health science students participated (100% response rate). The prevalence of oral HIV self-testing was 19.2% (n = 72). Factors positively associated with HIVST practice included participation in HIV programs (AOR = 3.27; CI: 1.30-8.21), being male (AOR = 1.74; CI: 1.02-2.82), recent HIV risk exposure (AOR = 2.84; CI: 1.35-5.98), and a history of sexually transmitted infection (AOR = 3.18; CI: 1.42-7.12). CONCLUSION: The prevalence of oral HIV self-testing among students at the governmental medical college was 19.2%. Participation in HIV programs, recent HIV risk exposure, male sex, and a history of sexually transmitted infections were significantly associated with HIVST practice. TRIAL REGISTRATION: Not applicable.
Reconstructing the post-pandemic landscape: a retrospective, hospital-based surveillance of respiratory pathogens in hospitalized children in Chenzhou, China, 2021-2025.
Lei X, Yan X, Li A … +2 more , Tang Z, Tan T
BMC Infect Dis · 2026 Jun · PMID 42363106 · Full text
BACKGROUND & OBJECTIVES: The COVID-19 pandemic significantly altered the global ecology of respiratory pathogens. This study aimed to characterize epidemiological shifts and explore determinants of infection risk among h...
BACKGROUND & OBJECTIVES: The COVID-19 pandemic significantly altered the global ecology of respiratory pathogens. This study aimed to characterize epidemiological shifts and explore determinants of infection risk among hospitalized children at a single center in Chenzhou, China, during the post-pandemic period. METHODS: A retrospective analysis was conducted using hospital-based surveillance data of acute respiratory infections in children from January 1, 2021, to December 31, 2025. Nasopharyngeal swabs from 42,505 cases were tested via multiplex PCR for 13 common respiratory pathogens. Age-stratified positivity rates were calculated, and multivariable logistic regression models were employed to identify independent risk factors, adjusting for year, season, and sex. RESULTS: The data revealed an altered pathogen landscape. Rhinovirus (RV) was consistently detected at a high frequency, becoming a persistently prevalent agent (annual average positivity: 33.65%). The seasonal peak of influenza A virus (FluA) approached pre-pandemic levels, co-circulating with respiratory syncytial virus (RSV) and parainfluenza virus (PIV) in autumn/winter. Mycoplasma pneumoniae (MP) exhibited a notable epidemic surge in 2023 (16.03%), followed by a rapid decline to 0.56% by 2025. Regression analysis, adjusted for multiple covariates, identified age as a significant independent risk factor and revealed three consistent age-related pathogen patterns: (1) RSV/PIV predominance in infants and toddlers; (2) peak incidence of RV, adenovirus (ADV), and human metapneumovirus (HMPV) in preschool children; and (3) increasing risk of MP and Chlamydia pneumoniae with age. Notably, RSV resurged earlier (2021) than reported in Western countries, and the elevated endemicity of RV was more evident.. CONCLUSION: This retrospective analysis of large-scale surveillance data describes changes in respiratory pathogen ecology among hospitalized children in Chenzhou during the post-pandemic period, characterized by age-dependent patterns and region-specific rebound dynamics. These observed season-age risk patterns may help generate hypotheses for informing clinical stratification and could inform local surveillance efforts, though prospective validation is required before clinical implementation.
Epidemiological characteristics and spatiotemporal analysis of scarlet fever in Guangzhou, China: the surveillance of 20 years.
Lin HR, Wang J, Shan J … +8 more , He Q, Dong S, Deng Q, Zhang M, Chen S, Luo L, Li Y, Liu Y
BMC Infect Dis · 2026 Jun · PMID 42363098 · Full text
BACKGROUND: This study investigated the epidemiological and spatiotemporal characteristics of scarlet fever in Guangzhou, China, and provided a scientific basis for the formulation and optimization of prevention and cont...
BACKGROUND: This study investigated the epidemiological and spatiotemporal characteristics of scarlet fever in Guangzhou, China, and provided a scientific basis for the formulation and optimization of prevention and control strategies. METHODS: The epidemiological profile of scarlet fever was systematically reviewed using descriptive analysis. We used the Moran's I, local indicators of spatial association, and the retrospective spatiotemporal scanning statistical analysis to study the spatiotemporal aggregation phenomenon of scarlet fever in Guangzhou. RESULTS: From 2005 to 2024, 9,601 scarlet fever cases were reported within Guangzhou, with an annual average morbidity of 3.16 per 100,000. Joinpoint regression analysis indicated a statistically significant overall upward trend in scarlet fever incidence (AAPC = 17.26%, p < 0.001), characterized by four phases: low-incidence phase, upsurge phase, COVID-19-affected phase and post COVID-19 rebound phase. Seasonal distribution exhibited a dual-modal pattern, and the crest of transmission occurred from April to June and November to the following January. Demographically, cases mainly occurred among males and kindergarten children aged 3-6 years. Notably, during the post COVID-19 rebound phase, the proportion of cases among students, particularly those aged 7-10 years, increased substantially, becoming a major affected group nearly comparable to kindergarten children. Spatially, higher incidence was observed within central urban districts and expanding peri-urban growth centers. Spatiotemporal scanning identified ten statistically significant clusters, characterized by an expansion toward expanding peri-urban growth centers, such as Licheng in Zengcheng, alongside a resurgence in traditional central urban areas like Meihuacun in Yuexiu, Baihedong in Liwan and their surrounding regions. CONCLUSIONS: This study reveals a significant spatial-temporal clustering of scarlet fever in Guangzhou from 2005 to 2024, characterized by an overall upward trend and a notable recent resurgence. The high-risk regions were predominantly localized within the central urban regions and expanding peri-urban growth centers, such as Helong, Licheng, Meihuacun, and their surrounding regions. The outbreak mostly affects kindergarten children aged 3-6 years and students aged 7-10 years, with winter and spring as peaks. Control strategies should target high-risk seasons, populations and regions to reduce scarlet fever cases.
Multimodal ultrasound in the diagnosis and treatment of caudate lobe Klebsiella pneumoniae liver abscess complicated by rare gas-containing inferior vena cava thrombosis: a case report.
Yang W, Deng Y, Wang Y … +1 more , Li Y
BMC Infect Dis · 2026 Jun · PMID 42363091 · Full text
BACKGROUND: Klebsiella pneumoniae liver abscess (KLA) is an emerging public health concern in Asia. Involvement of the caudate lobe with concurrent inferior vena cava thrombosis is exceedingly rare but life-threatening....
BACKGROUND: Klebsiella pneumoniae liver abscess (KLA) is an emerging public health concern in Asia. Involvement of the caudate lobe with concurrent inferior vena cava thrombosis is exceedingly rare but life-threatening. Timely diagnosis and management are critical but challenging. Multimodal ultrasound can play a pivotal role in both diagnosis and treatment guidance. CASE PRESENTATION: A 66-year-old woman with diabetes presented with 10 days of fever and chills. Imaging revealed a caudate lobe liver abscess containing gas with extension to the inferior vena cava (IVC) and associated septic thrombosis. Contrast-enhanced ultrasound and CT confirmed a Klebsiella pneumoniae liver abscess. Ultrasound-guided percutaneous drainage was performed, and cultures identified an ESBL-producing Klebsiella pneumoniae. The patient was treated with broad-spectrum antibiotics, therapeutic anticoagulation, and catheter drainage. Despite an episode of septic shock during hospitalization, she gradually improved, and follow-up imaging showed near-complete resolution of the abscess and complete disappearance of the IVC thrombus. CONCLUSION: The caudate lobe KLA complicated by IVC thrombosis, particularly gas-containing septic thrombosis, is rare but life-threatening. Multimodal ultrasound plays an important role in the early diagnosis and interventional management of KLA complicated by IVC thrombosis. Timely ultrasound-guided drainage with targeted antimicrobial therapy and individualized anticoagulation can achieve effective source control and favorable outcomes without open surgery.
Modeling the impact of war, interventions, and funding on malaria transmission dynamics in Sudan.
Alhaj MS, Nyabadza F
BMC Infect Dis · 2026 Jun · PMID 42363085 · Full text
Malaria poses a significant public health risk worldwide, and the infection results from the bite of an infected female Anopheles mosquito. Many malaria-endemic regions face instability, often driven by wars, heightening...
Malaria poses a significant public health risk worldwide, and the infection results from the bite of an infected female Anopheles mosquito. Many malaria-endemic regions face instability, often driven by wars, heightening the risk of infectious disease transmission. Malaria funding and targeted prevention are essential for reducing and eventually eradicating transmission. This article focuses on developing a compartmental mathematical model to study malaria infection dynamics, incorporating the effects of malaria prevention, funding, and war on health systems. We evaluate the model's basic reproduction number [Formula: see text] and identify equilibrium points. Our model analysis provides a forward bifurcation, indicating that malaria can be controlled if [Formula: see text], and we show cases of backward bifurcation when the threshold [Formula: see text]. We fit our model to the collected data and perform a sensitivity analysis of [Formula: see text] and numerical simulations. Our results demonstrate that increased funding and effective prevention reduce malaria transmission, whereas war leads to higher transmission rates. We also offer strategies to minimize malaria spread during armed conflict.
Association between hypertension and sepsis-related complications: a retrospective nationwide inpatient sample database cross-sectional study.
Wang J, Huang Y, Xie Z … +7 more , Yu J, Xiao L, Liu X, Wang Z, Zhu J, Shen M, Xiao L
BMC Infect Dis · 2026 Jun · PMID 42363083 · Full text
BACKGROUND: Sepsis remains a significant global health challenge, with high morbidity and mortality rates. The interplay between hypertension, a prevalent comorbidity, and sepsis outcomes has been the subject of ongoing...
BACKGROUND: Sepsis remains a significant global health challenge, with high morbidity and mortality rates. The interplay between hypertension, a prevalent comorbidity, and sepsis outcomes has been the subject of ongoing debate. This study aimed to investigate the incidence of sepsis-related complications in individuals with and without hypertension via a large nationwide inpatient database. METHODS: A retrospective observational analysis was conducted via the National Inpatient Sample (NIS) database from 2010 to 2019. The study population comprised adults (≥ 18 years) diagnosed with sepsis and stratified into hypertension and non-hypertension groups. The outcomes assessed included sepsis-related complications, in-hospital mortality, length of stay (LOS), and total hospitalization costs. RESULTS: The prevalence of hypertension among sepsis patients increased significantly from 53.17% in 2010 to 64.62% in 2019. Patients in the hypertension group were older, with a greater proportion of individuals aged 75 years and above, and presented a greater burden of comorbidities. Interestingly, the hypertension group had lower incidences of septic shock, acute respiratory distress syndrome (ARDS), disseminated intravascular coagulation (DIC), and deep vein thrombosis (DVT), indicating a potential inverse association. However, they experienced higher rates of heart failure, acute kidney injury(AKI), arrhythmias, and acute respiratory failure. Despite these increased risks, the hypertension group had a shorter median LOS and lower median total hospital charges. Notably, the in-hospital mortality rate was lower in the hypertension group (11.93%) than in the nonhypertension group (13.33%). CONCLUSION: This large-scale analysis revealed a complex interplay between hypertension and sepsis outcomes. The observed lower incidence of certain severe sepsis complications among hypertensive patients suggests a potential association that might be partially related to the use of antihypertensive therapies, but this hypothesis requires further investigation into the underlying mechanisms. Our findings should be interpreted as associational, not causal. CLINICAL TRIAL NUMBER: Not applicable.
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