BMC Infectious Diseases[JOURNAL]
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200 papers
Trichosporon asahii subcutaneous soft tissue infection after trauma surgery in an immunocompetent patient: a case report.
Zhu H, Ge W, Zhou L … +2 more , Wang Y, Li X
BMC Infect Dis · 2026 Jun · PMID 42363081 · Full text
Trichosporon asahii (T. asahii) is a rare non-Candida basidiomycetous yeast. It commonly causes invasive infections in immunocompromised individuals, while severe subcutaneous soft tissue infections in immunocompetent pa...
Trichosporon asahii (T. asahii) is a rare non-Candida basidiomycetous yeast. It commonly causes invasive infections in immunocompromised individuals, while severe subcutaneous soft tissue infections in immunocompetent patients are extremely uncommon.Here, we report a 67-year-old immunocompetent female who developed secondary T. asahii infection after debridement and suturing for left lower leg trauma, presenting with local skin necrosis, purulent exudation and undermining abscesses, with normal systemic inflammatory markers. The pathogen was confirmed as T. asahii via Vitek Compact system, MALDI-TOF mass spectrometry and next-generation sequencing (NGS). Antifungal susceptibility testing verified susceptibility to voriconazole. The patient achieved marked improvement after 3 weeks of treatment with surgical debridement, vacuum sealing drainage (VSD) and voriconazole. Local infection was controlled and the wound began to heal, and antifungal drugs were then withdrawn. This case highlights that T. asahii infection should be suspected in refractory post-traumatic soft tissue infections in immunocompetent patients. The discordance between severe local lesions and minimal systemic inflammation serves as a key clinical clue. Early etiological diagnosis, surgical intervention combined with susceptible antifungal agents are critical for improving prognosis.
Hepatic, oxidative, and immunological alterations in adults with concomitant Schistosoma mansoni infection and alcohol abuse in an endemic area of Cameroon.
Yimgoua ES, Nkondo ET, Femoe UM … +7 more , Fassi-Kadji JB, Kenfack MC, Feussom NG, Vázquez S, Tchuem Tchuente LA, Sotillo J, Jatsa HB
BMC Infect Dis · 2026 Jun · PMID 42363080 · Full text
BACKGROUND: Schistosoma mansoni infection and chronic alcohol consumption are major public health concerns that predominantly affect the liver, yet their combined hepatic effects remain insufficiently understood. This st...
BACKGROUND: Schistosoma mansoni infection and chronic alcohol consumption are major public health concerns that predominantly affect the liver, yet their combined hepatic effects remain insufficiently understood. This study aimed to investigate the pathophysiological mechanisms associated with this co-exposure in an endemic setting in Cameroon. METHODS: A cross-sectional analytical study was conducted in Makenéné, Cameroon, including 310 adults stratified by parasitic status and level of alcohol exposure. Infection was diagnosed using Kato-Katz and POC-CCA assays. Alcohol exposure was assessed using the Alcohol Use Disorders Identification Test (AUDIT). Hematological, liver function, oxidative, inflammatory, and fibrogenic profiles were evaluated. RESULTS: Compared with alcohol abuse alone, combined S. mansoni infection and alcohol abuse was associated with reduced erythrocyte and platelet indices (p < 0.05), elevated activities of AST (p < 0.001), ALP (p < 0.01), GGT (p < 0.05), AST/ALT ratio (p < 0.001), and protein concentration (p < 0.001). Relative to schistosomiasis alone, the comorbidity was associated with higher ALT and AST (p < 0.01) and GGT (p < 0.05), but lower total protein (p < 0.05). Both schistosomiasis and alcohol abuse, independently, induced oxidative stress, evidenced by increased malondialdehyde levels (p < 0.001) and decreased catalase activity, GSH, and nitrite levels. This oxidative imbalance was exacerbated in co-exposed individuals who exhibited the lowest catalase activity (p < 0.01) and GSH concentration (p < 0.05). The comorbidity was also characterized by the lowest TNF-α levels (p < 0.05) and the highest TGF-β1 levels (p < 0.001). Procollagen type III N-terminal peptide (P3NP) peaked during S. mansoni infection (p < 0.001) but was less expressed during the comorbidity (p < 0.05). Both S. mansoni infection intensity and alcohol abuse correlate positively with transaminases and malondialdehyde, but negatively with nitrite, catalase, and TNF-α. Infection correlates positively with proteins, TGF-β1, IL-10, and P3NP, while alcohol abuse negatively correlates with IL-10 and SOD. CONCLUSION: S. mansoni infection and alcohol abuse comorbidity exacerbates liver injury beyond either condition alone, with increased liver enzymes, oxidative stress, immune imbalance, and fibrogenesis, highlighting the need for integrated public health strategies to reduce liver-related morbidity in endemic settings.
Malaria Outbreak in Meinit Goldia District, Southwest Ethiopia Peoples Regional State, 2025: Risk factors and epidemiological insights from a case-control study.
Desta NA, Fikadu S, Chemeda G … +1 more , Dimore AL
BMC Infect Dis · 2026 Jun · PMID 42363075 · Full text
BACKGROUND: Malaria remains a severe, life-threatening disease worldwide, with Sub-Saharan Africa bearing the greatest burden. In Ethiopia, recurrent outbreaks cause substantial morbidity and strain local health systems....
BACKGROUND: Malaria remains a severe, life-threatening disease worldwide, with Sub-Saharan Africa bearing the greatest burden. In Ethiopia, recurrent outbreaks cause substantial morbidity and strain local health systems. During WHO Epidemiologic Week 13 of 2025, Meinit Goldia District experienced a sharp increase in cases with delayed investigation and response. This study aimed to verify the outbreak, identify associated risk factors, and inform targeted control measures. METHODS: A community-based case-control study was conducted in Meinit Goldia District from 26 March to 30 June 2025. Descriptive analysis used the district linelist of malaria cases and deaths. A multistage cluster sampling technique with proportional allocation was employed. A total of 145 rapid diagnostic test (RDT) confirmed malaria cases and 145 community-based, RDT negative asymptomatic controls were included in the study. Both case and controls were identified through active house-to-house surveillance in malaria-affected kebeles. Data on socio-demographics, ITN utilization, environmental exposures, and malaria knowledge were collected via interviewer-administered questionnaires using Kobo Collect v2025.3.3. Analyses were performed in STATA v17. Variables with P < 0.25 in bivariable analysis entered multivariable logistic regression; significance was set at P < 0.05. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were reported. Firth's correction was used for exposures with sparse data. RESULTS: Review of the line list from the malaria-affected kebeles identified 3,630 laboratory-confirmed malaria cases, yielding an attack rate (AR) of 274.7 cases per 1,000 population in the eight outbreak-affected villages. The highest attack rates were observed among males (288.2 per 1,000 population) and residents of Mehal Dashi village. At the district level, the overall AR was 71.3 cases per 1,000 population. In multivariable analysis, the following variables were independently associated with malaria: Never utilized ITNs (AOR = 4.882; 95% CI: 2.011-11.847), Living near broken glass bottles (AOR = 4.847; 95% CI: 1.692-13.889), Open deep well near household (AOR = 3.735; 95% CI: 1.273-10.956), Poor knowledge of malaria transmission, signs, symptoms, and prevention/control measures (AOR = 2.847; 95% CI: 1.502-5.397), Sometimes utilized ITNs (AOR = 2.617; 95% CI: 1.204-5.692), and Wearing long protective clothing at night (AOR = 0.123; 95% CI: 0.054-0.280). CONCLUSIONS: The outbreak in Meinit Goldia District was associated with gaps in vector control, local breeding sites, and delayed response. Immediate priorities include targeted ITN distribution and larval source management in high-burden areas, regular IRS, culturally appropriate health education, strengthened early warning and rapid response capacity, and enhanced entomological surveillance.
Lumbosacral necrotizing fasciitis after thoracic drainage: a case report documenting subcutaneous and fascial spread.
Li W, Shen H, Li Q … +3 more , Wu J, Han M, Zhuang Q
BMC Infect Dis · 2026 Jun · PMID 42351019 · Full text
Necrotizing fasciitis (NF) rarely spreads from the chest to the lumbosacral region. We report a fatal case in a 61-year-old man, documented by serial imaging and surgical exploration, that provides strong evidence sugges...
Necrotizing fasciitis (NF) rarely spreads from the chest to the lumbosacral region. We report a fatal case in a 61-year-old man, documented by serial imaging and surgical exploration, that provides strong evidence suggesting subcutaneous and fascial spread of infection from a thoracic drainage site. This case highlights a rare but deadly complication and suggests that increased vigilance may be warranted in immunocompromised patients.
Prevalence and biomarker profiles of HBV/HDV coinfection and occult HBV infection among patients attending Bimbilla Hospital, Northern Ghana.
Nyarko ENY, Tachi K, Kumi J … +12 more , Issahaku A, Amakye EK, Anim M, Adusei-Poku M, Assan NA, Sraku IK, Adom M, Lawer IK, Abdul-Karim A, Ofori EK, Asare-Anane H, Obirikorang C
BMC Infect Dis · 2026 Jun · PMID 42350999 · Full text
BACKGROUND & AIMS: Coinfection of hepatitis B virus (HBV) with hepatitis D virus (HDV) may exacerbate liver injury, particularly in resource-limited settings. In Ghana, data on HDV and OBI prevalence, as well as their he...
BACKGROUND & AIMS: Coinfection of hepatitis B virus (HBV) with hepatitis D virus (HDV) may exacerbate liver injury, particularly in resource-limited settings. In Ghana, data on HDV and OBI prevalence, as well as their hepatic impact, remain sparse. This study aimed to determine the prevalence of HDV and OBI using real-time PCR and evaluate their effects on liver-related biomarkers in patients at Bimbila Hospital, Northern Ghana. METHODS: We conducted a cross-sectional study at Bimbilla Hospital, Northern Ghana, between May and December 2024, recruiting 60 consented patients with Hepatitis B Surface Antigen positive and 60 patients with HBsAg-negative status. HBV serology (HBsAg, HBeAg, anti-HBs, total anti-HBc) was performed using a 5-in-1 panel. HBV DNA and HDV RNA were detected by real-time PCR. HDV prevalence was determined among HBsAg-positive participants by real-time PCR detection of HDV RNA, while OBI prevalence was determined among HBsAg-negative participants by the presence of detectable HBV DNA using real-time PCR following serological screening. Liver biochemical, haematological, and inflammatory markers were measured, and fibrotic indices (APRI, FIB-4, PLR, GLR) were computed. Data were analysed using SPSS 26 and GraphPad Prism version 8. RESULTS: HDV RNA was detected in 11/60 HBsAg-positive participants (18.3%, 95% CI 10.66-29.9). OBI occurred in 5/60 HBsAg-negative participants (8.3%, 95% CI 3.6-18.1). Compared to HBV-monoinfected individuals, HBV/HDV-coinfected patients had higher Gamma-Glutamyltransferase (GGT;45.0 vs. 37.0 IU/L, p < 0.05), lower Albumin/Globulin Ratio (A/G;1.21 vs. 1.34, p < 0.05), elevated Granulocyte-to-Lymphocyte Ratio (GLR; 2.60 vs. 1.87, p < 0.05), and higher Platelet-to-Lymphocyte Ratio (PLR; 143.00 vs. 89.87, p < 0.05). HBV/HDV coinfected patients also showed elevated Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT), total bilirubin (TBIL), IBL, AST/ALT ratio (de Ritis), and Aspartate Aminotransferase-to-Platelet Ratio Index (APRI) scores compared to those with OBI. CONCLUSION: In Northern Ghana, HDV coinfection may be associated with significant alterations in GGT, AST, ALT, bilirubin levels, de-Ritis ratio, APRI, PLR, and GLR, with concurrent reduction in the A/G ratio, suggesting significant hepatic and inflammatory disturbances, whereas OBI may show no comparable biomarker alterations. CLINICAL TRIAL: Not applicable.
Pathogen distribution characteristics and risk factors of pulmonary infection associated with immune checkpoint inhibitor therapy in patients with advanced non-small cell lung cancer: a case control study.
Tian R, Cui X, Wang L … +2 more , Yan L, Wang P
BMC Infect Dis · 2026 Jun · PMID 42350998 · Full text
BACKGROUND: To investigate the pathogen distribution and risk factors for pulmonary infection (PI) in patients with advanced non- small cell lung cancer (NSCLC) treated with chemotherapy combined with immune checkpoint i...
BACKGROUND: To investigate the pathogen distribution and risk factors for pulmonary infection (PI) in patients with advanced non- small cell lung cancer (NSCLC) treated with chemotherapy combined with immune checkpoint inhibitors (ICIs). METHODS: Patients with advanced NSCLC who met the inclusion criteria were collected and divided into three groups: chemotherapy with PI group, chemotherapy combined with ICIs with PI group and chemotherapy combined with ICIs without PI group. We displayed the pathogen distribution and infection time of PI for different groups, and explored the risk factors for PI in chemotherapy combined with ICIs group of patients. RESULTS: A total of 239 patients were included in the study, among which there were 30 cases in the chemotherapy with PI group, 68 cases in the chemotherapy combined with ICIs with PI group, and 141 cases in the chemotherapy combined with ICIs without PI group. The results revealed an increased bacterial infection rate of patients in the chemotherapy with PI group (p = 0.003). Data analysis of patients with combined fungal infections showed a statistically significant difference in the incidence of fungal infections between the two groups (Fisher's exact test, p = 0.035). Multivariate logistic regression analysis revealed that low lymphocyte (LYM) counts (P = 0.016) and stage IV disease (P = 0.012) were independent risk factors for patients in the chemotherapy combined with ICIs with PI group, and number of immunotherapy cycles ≥ 5 (P = 0.031) was associated with a reduced likelihood of PI. CONCLUSIONS: In this observational study, bacterial infections were more common with chemotherapy alone, whereas fungal infections predominated in patients receiving chemotherapy plus ICIs. Low lymphocyte count and stage IV disease were associated with higher pulmonary infection risk, while ≥ 5 cycles of immunotherapy was associated with lower risk.
Epidemiological characteristics and genotype distribution of low-risk human papillomavirus infection among women in Jingzhou, Central China: a cross-sectional study.
Zheng S, Wu X, Li W … +2 more , Xu X, Gong P
BMC Infect Dis · 2026 Jun · PMID 42350995 · Full text
BACKGROUND: To systematically analyze the epidemiological characteristics and genotype distribution of low-risk human papillomavirus (LR-HPV) infection in Jingzhou, China, and to provide evidence for optimizing regional...
BACKGROUND: To systematically analyze the epidemiological characteristics and genotype distribution of low-risk human papillomavirus (LR-HPV) infection in Jingzhou, China, and to provide evidence for optimizing regional strategies for the prevention and control of HPV-related diseases. METHODS: This retrospective cross-sectional study included 24,027 women who underwent cervical cancer screening and concurrent HPV genotyping at Jingzhou Hospital Affiliated to Yangtze University between October 2022 and September 2025. A flow-through hybridization technique was employed to detect 27 HPV genotypes (17 high-risk and 10 low-risk types). The prevalence and genotype distribution of LR-HPV were analyzed, with further stratification by age and season. RESULTS: The overall HPV infection rate among the 24,027 participants was 25.94% (6,233/24,027), with a LR-HPV infection rate of 10.06% (2,416/24,027). The predominant LR-HPV genotypes were HPV81 (3.33%), HPV61 (2.55%), and HPV44 (1.63%), which differed from the detection rates of the traditionally common LR-HPV types HPV6 (0.82%) and HPV11 (0.32%). The age stratification analysis revealed a U-shaped bimodal distribution of LR-HPV prevalence, with peaks in women aged ≤ 20 years (16.02%) and over 60 years (19.15%) (P < 0.001). Single genotype infections predominated. Seasonally, LR-HPV prevalence was highest in autumn (10.78%) and lowest in summer (9.50%), but the differences were not statistically significant (P > 0.05). CONCLUSION: LR-HPV infection among women in Jingzhou is characterized by a unique regional genotype distribution dominated by HPV81, 61, and 44, with a bimodal age-specific prevalence pattern involving women aged ≤ 20 years and > 60 years. This genotype profile differs from those reported in other regions of China, underscoring the importance of incorporating local epidemiological data into the formulation of regional HPV-related disease prevention and screening strategies. CLINICAL TRIAL NUMBER: Not applicable.
Immunosuppression, resistance burden, and qSOFA on short-term prognosis and difficult clearance in hospitalized patients with Salmonella infection: a single-center retrospective cohort study.
Wang X, Yang S, Lin Y … +13 more , Chen C, Zhan L, Wan Z, Yuan W, Weng Z, Zhang H, Xie M, He X, Guo M, Su Z, Zheng Y, Chen Q, Yu X
BMC Infect Dis · 2026 Jun · PMID 42350993 · Full text
BACKGROUND: Immunosuppressed patients who develop Salmonella infection are more likely to experience bacteremia, sepsis, and treatment failure; however, systematic evidence remains limited regarding how different sources...
BACKGROUND: Immunosuppressed patients who develop Salmonella infection are more likely to experience bacteremia, sepsis, and treatment failure; however, systematic evidence remains limited regarding how different sources of immunosuppression and resistance burden jointly affect early outcomes. Using a source-based classification of immunosuppression, we evaluated the relationships of host severity (qSOFA), pathogen resistance burden, 30-day composite adverse outcomes, and difficult clearance. METHODS: We retrospectively enrolled 232 hospitalized patients with Salmonella infection between October 2014 and January 2026. Patients were stratified as typhoidal/paratyphoidal Salmonella (TS) or nontyphoidal Salmonella (NTS) according to serotype and grouped by the source of immunosuppression. Infection phenotypes were classified as enteric, bloodstream/sepsis, mixed/multisite, or other focal phenotypes. Independent associated factors were identified using multivariable logistic regression. RESULTS: The incidence of the 30-day composite adverse outcome was 10.8% (25/232), and the incidence of difficult clearance was 22.0% (51/232). Immunosuppressed patients were more likely to present with bloodstream or disseminated infection phenotypes, but immunosuppression itself was not an independent determinant of 30-day adverse outcomes. qSOFA ≥ 2 was independently associated with the 30-day composite adverse outcome among patients with available qSOFA data (aOR 5.36, 95% CI 1.56-15.95, P = 0.006). Typhoidal Salmonella was significantly associated with difficult clearance in the primary model. Higher phenotypic resistance burden showed an association with difficult clearance in the primary analysis, but this association was not robust after the score was reconstructed using only high-coverage antimicrobial agents. CONCLUSIONS: In hospitalized patients with Salmonella infection, infection-phenotype distributions varied across sources of immunosuppression, although this observation was exploratory because of small subgroup sizes. The qSOFA-related prognostic findings primarily apply to adult or adult-skewed patients with available qSOFA data. Phenotypic resistance burden may reflect treatment complexity, but its association with difficult clearance should be interpreted cautiously because it lacked robustness in the high-coverage sensitivity analysis.
Prevalence and characteristics of persistent symptoms following hospitalization for COVID-19: a cross-sectional follow-up study.
Okan HD, Kaya G
BMC Infect Dis · 2026 Jun · PMID 42350992 · Full text
BACKGROUND: Although coronavirus disease 2019 (COVID-19) primarily presents as an acute respiratory infection, many patients continue to experience symptoms after the acute phase of the disease. Early persistent symptoms...
BACKGROUND: Although coronavirus disease 2019 (COVID-19) primarily presents as an acute respiratory infection, many patients continue to experience symptoms after the acute phase of the disease. Early persistent symptoms during the post-acute recovery period may adversely affect functional recovery and quality of life. This study aimed to evaluate persistent symptoms in hospitalized COVID-19 patients following completion of the quarantine period. METHODS: This retrospective longitudinal follow-up study evaluated hospitalized COVID-19 patients after completion of quarantine/isolation to determine the prevalence and characteristics of persistent symptoms. Descriptive statistics and chi-square or Fisher's exact tests were used, with p < 0.05 considered statistically significant. RESULTS: A total of 180 patients were included, with a mean age of 50.63 ± 16.90 years, and 52.8% were female. At initial presentation, the most common symptoms were weakness (53.9%), diffuse body/muscle/joint pain (48.9%), cough (48.3%), fever (41.1%), loss of taste and smell (30.0%), headache (28.3%), and dyspnea (24.4%). Persistent symptoms after the quarantine period were observed in 64.9% of patients. The most common persistent symptoms were cough (28.9%), weakness (28.9%), diffuse body/muscle/joint pain (20.0%), loss of taste and smell (13.3%), dyspnea (12.8%), fatigue/exhaustion (12.8%), and headache (11.1%). Significant reductions were observed in several symptoms after the acute phase, including fever, sore throat, headache, diarrhea, and abdominal pain (p < 0.05). CONCLUSIONS: Persistent symptoms were frequently observed during the early post-acute recovery period in hospitalized COVID-19 patients. Respiratory complaints, fatigue, weakness, and musculoskeletal symptoms remained common after the acute infectious period. These findings emphasize the importance of post-discharge follow-up and supportive care strategies in patients recovering from COVID-19. CLINICAL TRIAL NUMBER: Not applicable.
MRSA transmission in hospitals across Alberta, Canada: a comparative study combining unidentified colonized cases upon admission.
Li R, Deardon R, Li N … +2 more , Conly J, Leal J
BMC Infect Dis · 2026 Jun · PMID 42350988 · Full text
BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is a prevalent bacterium in medical settings. It can result in bloodstream infections and other severe illnesses, and patients may have a high risk of dying...
BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is a prevalent bacterium in medical settings. It can result in bloodstream infections and other severe illnesses, and patients may have a high risk of dying from these conditions. This study aimed to examine MRSA transmission in hospitals across Alberta and how undetected colonized patients on admission affect MRSA spread. METHODS: We used a Bayesian compartmental model to simulate MRSA spread across 106 acute care hospitals in Alberta. The model assumes that MRSA spreads through interactions between susceptible individuals and MRSA patients, including both hospital-acquired (HA) and community-acquired (CA) MRSA cases. Data from Edmonton, Calgary, rural Alberta and all regions in Alberta were used to fit the model. We also assumed that a small percentage of patients were colonized upon admission but were not promptly identified in hospitals, and we tested the model assumptions. Transmission rates were estimated using a Bayesian framework with Markov chain Monte Carlo (MCMC) algorithms. We compared transmission rates across several regions in Alberta and assessed the effect of MRSA prevalence at hospital admission on MRSA transmission. RESULTS: When the model fit the data in hospitals in all areas of Alberta, the average number of susceptible people colonized due to patients with HA-MRSA colonization, patients with HA-MRSA infections, patients with CA-MRSA colonization, and patients with CA-MRSA infections per contact per month are around 0.03 (95% CI: (0.001, 0.101)), 0.08 (95% CI: (0.002, 0.278)), 0.01 (95% CI: (0.000, 0.033)) and 0.05 (95% CI: (0.001, 0.182)), respectively. Assuming 0.8 colonized cases per 1000 admissions, the average number of susceptible people who become colonized due to patients with HA-MRSA infections per contact per month in Edmonton, Calgary and rural hospitals are 0.05 (95% CI: (0.001, 0.174)), 0.43 (95% CI: (0.018, 1.152)) and 0.22 (95% CI: (0.007, 0.722)), respectively. Assuming more unidentified colonized cases in hospitals, transmission rates between susceptible people and infected patients increase marginally. CONCLUSION: MRSA transmission rates appear to be marginally higher in Calgary hospitals compared to Edmonton, and rural hospitals seem to have lower transmission rates than in Calgary but higher than in Edmonton, with 95% credible intervals (CIs) overlapping. Our model also suggests that infected patients have a higher probability of transmitting MRSA to susceptible people in most Alberta hospitals.
Expression levels of SARS-CoV-2 IgM, IgG, and neutralizing antibodies in a Chinese cohort and detection of peptide-specific antibodies in COVID-19 patients.
Yang S, Wen X, Lin Y … +2 more , Zhang R, Luo D
BMC Infect Dis · 2026 Jun · PMID 42350987 · Full text
BACKGROUND: Long COVID is a complex multisystem disorder affecting approximately 65 million individuals worldwide, with autoimmune mechanisms implicated in its pathogenesis. This study aimed to elucidate the role of SARS...
BACKGROUND: Long COVID is a complex multisystem disorder affecting approximately 65 million individuals worldwide, with autoimmune mechanisms implicated in its pathogenesis. This study aimed to elucidate the role of SARS-CoV-2-induced autoantibodies and immune dysregulation in the development of Long COVID, focusing specifically on autoimmunity and aberrant immune activation. The investigation sought to explore the underlying mechanisms through serological and peptide-based analyses. METHODS: Serum samples from 315 healthcare workers, serving as a control cohort, were analyzed for the presence of SARS-CoV-2 IgM, IgG, and Neutralizing Antibodies (NAbs), with stratification based on age, gender, vaccination timing, and symptom clusters. Bioinformatic approaches were employed to identify SARS-CoV-2 epitopes with homology to human proteins, screening for epitopes of the SARS-CoV-2 Spike (S) and Nucleocapsid (N) proteins and their human homologous peptides through analyses of hydrophilicity, antigenicity, and homology prediction. An ELISA-based method was utilized to detect antibody responses to these peptides in both COVID-19 infected groups (categorized as mild, moderate, or severe) and an uninfected group. RESULTS: The primary findings indicated a high seropositivity rate for IgG (97%) and Neutralizing Antibodies (94%) among the control group, with notable age-related trends: IgM levels increased with age, whereas IgG and Neutralizing Antibodies showed a decline. Female participants demonstrated higher IgG levels compared to their male counterparts. Antibody levels did not exhibit significant differences across acute or persistent symptom clusters (≥ 6 months post-infection). However, neurological symptoms, whether acute or chronic, were associated with elevated IgG and Neutralizing Antibody titers, suggesting that neurotropic infections may elicit a more robust humoral immune response. Bioinformatic analyses identified 29 potential epitopes within the S protein and 10 within the N protein, with 91 and 24 human homologous peptides, respectively. The detection of peptide-specific antibodies in the serum of the COVID-19 infected group revealed that antibodies against eight peptides displayed a greater than 2.5-fold difference between the COVID-19-infected and uninfected groups. CONCLUSION: These findings underscore age- and gender-related variations in antibody responses, identify immunodominant peptides with potential implications for COVID-19 symptoms, and suggest that cross-reactive antibodies targeting viral-human homologous peptides (e.g., S68-CHL1) may play a role in autoimmune mechanisms associated with COVID-19. TRIAL REGISTRATION: Clinical trial number: Not applicable.
Decentralized point-of-care HBV viral load testing for HBs Ag positive pregnant women in Mali, a prospective study.
Fofana DB, Diallo M, Sissoko H … +11 more , Coulibaly TA, Sissoko MS, Fomba A, Diallo S, Traore A, Diarra B, Maiga AI, Cissoko Y, Doumbia S, Diakité M, Martinaud C
BMC Infect Dis · 2026 Jun · PMID 42350986 · Full text
BACKGROUND: Hepatitis B virus (HBV) infection remains a major public health challenge, particularly in sub‑Saharan Africa, where mother‑to‑child transmission (MTCT) is a leading cause of chronic infection. Perinatal HBV...
BACKGROUND: Hepatitis B virus (HBV) infection remains a major public health challenge, particularly in sub‑Saharan Africa, where mother‑to‑child transmission (MTCT) is a leading cause of chronic infection. Perinatal HBV acquisition carries a high risk of chronic disease, yet prevention efforts are limited by restricted access to HBV DNA testing. Simplified point‑of‑care viral load assays, such as Xpert HBV Viral Load, may strengthen MTCT prevention in resource‑limited settings. METHODS: A cross-sectional study was conducted between June 2024 and May 2025 among pregnant woman attending antenatal care at different levels of the health system pyramid in Mali. The study sites included Referral Health Centers in Commune III of Bamako, Bla, and Sikasso, as well as Community Health Centers in Djibouria (Kéniéba district) and Badialan (Commune III, Bamako). Pregnant women testing positive for HBs Ag by a rapid test were enrolled. Venous blood (4 mL) was collected for HBV viral load quantification using the Xpert assay. Samples from Bla and Sikasso were analyzed in decentralized laboratories, while others were tested at the central UCRC laboratory. RESULTS: Among 2,952 pregnant women screened, 205 were HBsAg positive (prevalence of 6.9%). After excluding hemolyzed samples, 191 women underwent HBV viral load testing. Overall, 64.0% had detectable HBV DNA; among these, 69.9% had viral loads < 2,000 IU/mL, while 5.7% had levels > 200,000 IU/mL. Viral load was not associated with maternal age or gestational age but was significantly associated with antiviral treatment status (p < 0.001). Same-day results were more frequent in decentralized laboratories with on-site GeneXpert testing than in the central laboratory (23.5% vs. 4.4%). However, in both settings, most results were returned after more than four days, with a significant difference in turnaround time distribution (p < 0.001). CONCLUSION: HBV infection remains highly endemic among pregnant women in Mali, with a meaningful proportion presenting with high viral loads associated with increased risk of mother-to-child transmission. Decentralized Xpert HBV viral load testing is feasible and improves turnaround time compared with centralized testing, although operational challenges persist. Expanding decentralized access and addressing system-level barriers could enhance timely clinical decision-making and strengthen mother-to-child transmission (MTCT) prevention.
Trends in methicillin-resistant Staphylococcus aureus detection-rates and antibiotic resistance profiles in a cancer hospital from 2015 to 2024.
Wang H, Huang Q, Tian Q … +5 more , Yang W, Liu A, Tang J, Zhang H, Wu C
BMC Infect Dis · 2026 Jun · PMID 42350984 · Full text
BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is an important antimicrobial-resistant organism in healthcare settings, and long-term surveillance is important for infection prevention and antimicrobial s...
BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is an important antimicrobial-resistant organism in healthcare settings, and long-term surveillance is important for infection prevention and antimicrobial stewardship. Long-term epidemiological data on MRSA remain limited, particularly in cancer specialty hospitals. This study aimed to investigate the distribution and antimicrobial resistance trends of MRSA in a cancer hospital over a ten-year period (2015-2024). METHODS: We analyzed data from clinical isolates obtained at Sichuan Cancer Hospital between 2015 and 2024. Patient demographics, departmental sources, specimen information, hospital-acquired infection classification, and antimicrobial susceptibility testing results were collected. The epidemiological distribution and temporal trends in MRSA resistance were assessed over the study period. RESULTS: Among 13,829 hospitalization records with at least one positive culture, 1,550 Staphylococcus aureus isolates were identified. Of these, 433 were identified as MRSA (detection rate 27.94%). The MRSA detection rate initially increased, peaked at 35.48% in 2018, and then gradually declined; however, the interannual variations were not statistically significant. MRSA was detected across 23 departments. The highest number of MRSA isolates was detected in Surgery, particularly Head and Neck Surgery (54 isolates, 12.47%), followed by Radiotherapy, Internal Medicine, and other departments. Among MRSA detections classified as hospital-acquired infections, the largest number occurred in Head and Neck Surgery (31 cases, 20.95%). The Head and Neck Radiotherapy Ward and Thoracic Surgery Ward also had relatively high numbers of MRSA-associated hospital-acquired infections. The main infection sites among MRSA-associated hospital-acquired infections were the lower respiratory tract (60 cases, 40.54%) and surgical sites (32 cases, 21.62%). Regarding antimicrobial resistance, the resistance rates of MRSA to most tested antimicrobial agents did not show a clear increasing or decreasing trend. MRSA remained fully susceptible to daptomycin, linezolid, tigecycline, and vancomycin (all with 0% resistance). Exploratory analyses showed interannual differences in resistance rates for erythromycin, chloramphenicol, and moxifloxacin, but these findings should be interpreted cautiously. CONCLUSION: This ten-year surveillance study in a cancer specialty hospital showed an average MRSA detection rate of 27.94%, with departmental heterogeneity in MRSA detection and in MRSA-associated hospital-acquired infections. Head and Neck Surgery accounted for the largest number of MRSA-associated hospital-acquired infections, whereas the Neurosurgery Ward had the highest MRSA detection rate. Antimicrobial susceptibility testing showed that resistance rates of MRSA to most agents remained stable. These findings may inform local empirical therapy, antimicrobial stewardship, and department-specific infection prevention strategies, but they should not be interpreted as direct evidence for individualized treatment decisions. CLINICAL TRIAL NUMBER: Not applicable.
The impact of personalized nutritional intake on serum inflammation, immune markers, and recovery time in patients with herpes zoster.
Si C, Li L, Zhang W
BMC Infect Dis · 2026 Jun · PMID 42350981 · Full text
AIM: Herpes zoster (shingles) is a painful viral infection caused by the reactivation of varicella-zoster virus, often leading to prolonged recovery and postherpetic neuralgia. Although antiviral treatments are standard,...
AIM: Herpes zoster (shingles) is a painful viral infection caused by the reactivation of varicella-zoster virus, often leading to prolonged recovery and postherpetic neuralgia. Although antiviral treatments are standard, adjunctive strategies such as personalized nutrition may modulate immune and inflammatory responses, potentially improving outcomes. This retrospective study evaluated the effects of personalized dietary interventions on serum inflammatory and immune markers, recovery time, pain, and quality of life in patients with herpes zoster. Notably, the two treatment arms had unequal sample sizes due to non-randomized assignment in routine clinical practice and adherence-based exclusions; the imbalance was analytically addressed using statistical tests robust to unequal group sizes, and baseline characteristics were comparable between groups. METHODS: This retrospective study evaluated 258 herpes zoster patients at our hospital from April 2019 to April 2023, divided into Standard Diet (n = 136) and Personalized Diet (n = 122) groups. Personalized interventions were based on biological markers, medical history, and lifestyle factors. Key outcomes included changes in serum inflammatory markers (IL-6, IL-17, TNF-α, CRP, IgM, IgA), recovery time metrics, pain levels (VAS score), and quality of life (SF-36). RESULTS: The Personalized Diet Group demonstrated significantly greater reductions in serum IL-6, IL-17, TNF-α, and CRP levels compared to the Standard Diet Group (P < 0.05). Recovery times for vesicle cessation, pain relief, crusting, and overall healing were significantly shorter in the personalized group (P < 0.05). Additionally, personalized dietary interventions were associated with greater improvements in VAS pain scores and quality of life measures, particularly in mental health, social functioning, and role-emotional scores. Anxiety and depression scores (SAS and SDS) improved more significantly in the personalized group (P < 0.05). CONCLUSION: Personalized nutritional dietary recommendations signifcicantly improve inflammatory and immune responses, accelerate recovery, and enhance quality of life in herpes zoster patients.
Analysis of trends and risk factors of HIV incidence in men who have sex with men in Chongqing, China: a retrospective cohort study, 2013-2022.
Tan T, Jia L, Li L … +8 more , Zhang W, He Y, Lin J, Bai C, Tan B, Zhou C, Lu R, Wu G
BMC Infect Dis · 2026 Jun · PMID 42350975 · Full text
BACKGROUND: China has reported a high rate of HIV transmission through male-to-male sexual contact. This study aims to update the trend in HIV incidence density and identify associated risk factors among men who have sex...
BACKGROUND: China has reported a high rate of HIV transmission through male-to-male sexual contact. This study aims to update the trend in HIV incidence density and identify associated risk factors among men who have sex with men (MSM) in Chongqing, China. METHODS: Data on HIV incidence and sexual behaviors were obtained from the Chongqing CDC for MSM from 2013 to 2022. HIV incidence density was calculated biennially, along with the overall incidence rate. Cox proportional hazards regression was used to identify risk factors associated with HIV infection. RESULTS: A total of 2,134 HIV-negative MSM were included in the cohort. The overall HIV incidence density was 4.9 (95% CI: 4.3-5.6)/100 person-years (PYs) from 2013 to 2022. The HIV incidence density among MSM showed a declining trend. Multivariable analysis showed that MSM with a high school education or below (HR 1.57, 95% CI: 1.21-2.03), an anal sex role of versatile (HR 1.38, 95% CI: 1.03-1.85), seeking male sexual partners through offline methods (HR 1.73, 95% CI: 1.34-2.23), engaging in unprotected anal intercourse (HR 1.53, 95% CI: 1.19-1.97), and using rush poppers in the past six months (HR 1.60, 95% CI: 1.09-2.33) were identified as significant risk factors associated with HIV infection. CONCLUSION: The decline in HIV incidence density among MSM from 2013 to 2022 appeared to reflect the impact of comprehensive HIV prevention strategies implemented in Chongqing. Continued efforts to raise awareness of HIV infection, promote condom use, and reduce high-risk sexual behaviors among MSM remain essential public health priorities. CLINICAL TRIAL: Not applicable.
Predictive value of peripheral lymphocyte subsets in relation to opportunistic infections in people living with HIV/AIDS.
Yuan R, Hu W, Chen Q … +5 more , Zhuang K, Jiao F, Gui X, Xiong Y, Yang R
BMC Infect Dis · 2026 Jun · PMID 42350972 · Full text
BACKGROUND: Opportunistic infections (OIs) remain a major clinical challenge in people living with HIV/AIDS (PLWHA), and CD4⁺ T-cell counts alone may not fully reflect immune dysfunction. This study aimed to establish pr...
BACKGROUND: Opportunistic infections (OIs) remain a major clinical challenge in people living with HIV/AIDS (PLWHA), and CD4⁺ T-cell counts alone may not fully reflect immune dysfunction. This study aimed to establish predictive cut-off values for lymphocyte subsets to improve the assessment of OIs risk in PLWHA. METHODS: Peripheral blood samples were collected to assess lymphocyte subsets using flow cytometry between August 17, 2021, and April 19, 2023. Correlation analysis was performed to identify lymphocyte subset indicators strongly associated with CD4 T-cell counts. Receiver operating characteristic (ROC) analysis was then performed to determine cut-off values for predicting OIs. Finally, the performance of cut-off values was tested in hospitalized PLWHA. RESULTS: Even when CD4 cell counts were above 200 cells/µl or close to normal, patients with abnormal immunological phenotypes had a higher prevalence of OIs. Other lymphocyte subsets have a high positive correlation with CD4 T-cell counts, with the exception of CD3CD8/CD3, CD3HLA-DR/CD3, and CD3CD8HLA-DR/CD8, which are strongly negatively correlated. The correlation coefficients of CD4CD28 cells were particularly close to 1.0. Furthermore, CD4CD28 T lymphocytes demonstrated an AUC of 0.819 with a cut-off of 129 cells/µl, second only to CD4⁺ T cells in terms of AUC. Furthermore, the AUCs for CD3CD4CD45RA, CD3CD4CD45RO, CD3CD4CD25CD127low, CD45RACD3CD4CD25CD127low, and CD45ROCD3CD4CD25CD127low T cells were all > 0.800, with sensitivities exceeding 90%. CONCLUSION: In addition to lymphocyte counts, abnormal lymphocyte phenotype and immune activation status are strongly associated with OIs. The proposed cut-off values for selected lymphocyte subsets may help identify hospitalized PLWHA at increased risk of OIs.
Association between changes in HBsAb levels and hepatic adverse events after HBsAg clearance in non-cirrhotic chronic hepatitis B patients.
Deng W, Chen X, Zhang Z … +10 more , Li X, Cao W, Zhang Y, Wang S, Yao L, Wei X, Wang S, Gao Z, Xie Y, Li M
BMC Infect Dis · 2026 Jun · PMID 42350969 · Full text
OBJECTIVE: The relationship between changes in hepatitis B surface antibody (HBsAb) levels and hepatic adverse events after hepatitis B surface antigen (HBsAg) clearance remains unclear. This study aimed to investigate t...
OBJECTIVE: The relationship between changes in hepatitis B surface antibody (HBsAb) levels and hepatic adverse events after hepatitis B surface antigen (HBsAg) clearance remains unclear. This study aimed to investigate the correlation between HBsAb level changes and hepatic adverse events in non-cirrhotic patients following HBsAg clearance. METHODS: We retrospectively analyzed patients with HBsAg seroclearance achieved via pegylated interferon-alpha (Peg-IFNα) therapy in the Department of Hepatology II at Beijing Ditan Hospital, Capital Medical University, from October 2008 to December 2023. Participants were stratified by baseline HBsAb levels into negative (< 10 mIU/mL), low (10-100 mIU/mL), medium (100-1000 mIU/mL), and high (≥ 1000 mIU/mL) groups. Based on HBsAb trends during follow-up, patients were categorized into declining, stable, and rising groups. The primary endpoint was the incidence of hepatic adverse events after HBsAg clearance. RESULTS: A total of 390 patients were included, with a median age of 38 (32-44) years and a median follow-up of 53.50 (11.00-173.00) months. During follow-up, 4 cases of hepatic adverse events occurred, all in the declining group (4 cases, 3.05%), while none were observed in the stable or rising groups (P = 0.018). Changes in HBsAb levels were inversely correlated with the incidence of hepatic adverse events (rs = -0.125, P = 0.014). CONCLUSION: Declining HBsAb levels after HBsAg clearance may be associated with an increased risk of hepatic adverse events. CLINICAL TRIAL: This study was registered at ClinicalTrials.gov (ID: NCT04301908; registration date: 03/06/2020; https://register. CLINICALTRIALS: gov/).
The HIF-1α-Th17/Treg axis in pediatric infectious mononucleosis: a clinical investigation of metabolic-immune dysregulation.
Yang P, Ni H, Du L … +2 more , Wang M, Pang G
BMC Infect Dis · 2026 Jun · PMID 42350963 · Full text
BACKGROUND: Pediatric infectious mononucleosis (IM) is a systemic inflammatory syndrome typically triggered by primary Epstein-Barr virus (EBV) infection. The disease is characterized by a profound disruption of immune h...
BACKGROUND: Pediatric infectious mononucleosis (IM) is a systemic inflammatory syndrome typically triggered by primary Epstein-Barr virus (EBV) infection. The disease is characterized by a profound disruption of immune homeostasis, which can be characterized by the balance between pro-inflammatory Th17 cells and suppressive Treg cells. While hypoxia-inducible factor-1α (HIF-1α) is known to direct T-cell behavior in various inflammatory conditions, its specific role in the immunopathology of IM remains largely uncharacterized. This study aims to investigate the systemic expression of HIF-1α in pediatric IM and evaluate its correlation with the Th17/Treg homeostatic axis. METHODS: In this prospective case-control study, we enrolled pediatric patients with acute IM and healthy, age- and sex-frequency-matched controls. Peripheral blood CD4 T-cell subsets (Th17: CD3CD4IL-17A; Treg: CD3CD4CD25CD127) were quantified via multi-color flow cytometry. Systemic levels of HIF-1α, IL-17A, and TGF-β1 were determined by enzyme-linked immunosorbent assay (ELISA). The relationship between metabolic stabilization and immune phenotype was evaluated using Spearman correlation analysis. RESULTS: The final analysis included 40 IM patients and 37 healthy controls. Compared to the controls, IM patients exhibited a significant systemic accumulation of HIF-1α (p < 0.001) and IL-17A concentrations (p = 0.008), alongside a marked expansion of Th17 cells (p < 0.001) and a significant increase in the Th17/Treg ratio (p < 0.001). Conversely, the IM cohort experienced significantly depletions in Treg frequencies (p < 0.001) and TGF-β1 levels (p = 0.005). Correlation analysis revealed that serum HIF-1α was correlated significantly positively with Th17 frequency, the Th17/Treg ratio, and IL-17A levels and significantly negatively with Treg frequency and TGF-β1 levels. CONCLUSIONS: Our findings reveal a significant systemic stabilization of HIF-1α in pediatric IM patients, which reflects an immunometabolic signature associated with the acute viral response. The significant correlation between HIF-1α and the shift in T-cell subsets suggests that HIF-1α may be seen as systemic sensor of disease severity in EBV infection. The results provide a theoretical foundation for targeting metabolic pathways to restore immune homeostasis in hyper-inflammatory viral diseases.
A single-center study of a waterborne tularemia outbreak among adults and children in Turkiye.
Mert K, Öztürk F
BMC Infect Dis · 2026 Jun · PMID 42343287 · Full text
PURPOSE: Tularemia is a zoonotic disease that can cause both sporadic cases and outbreaks. This study aims to analyze a waterborne tularemia outbreak in eastern of Turkiye during January and February 2025 and to evaluate...
PURPOSE: Tularemia is a zoonotic disease that can cause both sporadic cases and outbreaks. This study aims to analyze a waterborne tularemia outbreak in eastern of Turkiye during January and February 2025 and to evaluate adult and pediatric tularemia patients, highlighting the differences and similarities between the two patient populations. METHODS: The study included patients who presented to Malazgirt State Hospital during the tularemia outbreak and were diagnosed with tularemia. Data on age, gender, clinical and laboratory findings, antibiotic regimens/durations and complications were collected and analyzed. RESULTS: The study included 56 participants (mean age 24.6 ± 20.5 years, 44% female, 51% adult). No significant difference was found in the distribution of tularemia type between adult and pediatric patients (p = 0.198); the predominant type in both groups was the oropharyngeal form. Lymphadenopathy (LAP) was more frequent in adult patients (p < 0.05), abdominal pain was more frequent in pediatric patients (p < 0.001), and no significant differences were found in other clinical findings. Leukocytosis was significantly more frequent in pediatric patients compared to adults (p = 0.016). Treatment duration was statistically significantly longer in adult patients compared to pediatric patients (p < 0.001). One of the patients was pregnant who was treated with azithromycin and a healthy delivery was achieved. There were no cases resulting in sepsis or death. CONCLUSIONS: Our study demonstrated that tularemia can cause different clinical presentations in adult and pediatric patient groups. Despite this clinical diversity, we emphasized the critical role of recognizing the common transmission route and source in epidemic control.
Identifying risk factors for adverse drug reactions in HIV/AIDS patients using LASSO regression modeling.
Huang S, Gong L, Qi H … +2 more , Zhou G, Sun J
BMC Infect Dis · 2026 Jun · PMID 42343277 · Full text
OBJECTIVE: We perform a real-world study to investigate the incidence, clinical manifestations, suspected drugs, and associated risk factors of adverse drug reactions (ADRs) among Acquired Immunodeficiency Syndrome (AIDS...
OBJECTIVE: We perform a real-world study to investigate the incidence, clinical manifestations, suspected drugs, and associated risk factors of adverse drug reactions (ADRs) among Acquired Immunodeficiency Syndrome (AIDS) patients in the Chinese population. METHODS: 918 patients were enrolled in this retrospective study. All suspected ADRs were assessed for causality using the World Health Organization-Uppsala Monitoring Centre system. We employed least absolute shrinkage and selection operator (LASSO) regression to identify risk factors for ADRs in patients with HIV/AIDS. RESULTS: 210 of 918 patients experienced ADRs, with an incidence rate of 22.88%. Subsequently, standardized classification of ADRs was conducted using the Medical Dictionary for Regulatory Activities (MedDRA), revealing that blood and lymphatic system disorders were the most predominant manifestation, accounting for 5.77%. As to the type of drugs, Antibacterial (26.34%) and antiviral drugs (24.55%) were the most frequent causes for ADRs. Through the LASSO regression, the number of medications administered during hospitalization (odds ratio [OR] = 1.64, 95% confidence interval [CI]: 1.25-2.19) was identified as a significant influencing factor of ADRs in HIV patients. CONCLUSION: This study analyzed the specific manifestations of ADRs and their suspected drugs in hospitalized AIDS patients. More importantly, it revealed the potential correlation between the occurrence of ADRs and the number of medications administered during hospitalization in those patients. These findings provide a basis for clinical risk stratification management and offer reference data for optimizing treatment regimens.
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