BMC Infectious Diseases[JOURNAL]
Sun
200 papers
Trends and determinants of tuberculosis treatment outcomes among patients at Hargeisa tuberculosis hospital, Somaliland (2019-2024): a multi-year retrospective study.
Murendo C, Ngima F, Osman FM … +6 more , Rakiro N, Abaasiku ML, Karapetyan G, Kimbrough S, Alin AM, Ahmed AA
BMC Infect Dis · 2026 Jun · PMID 42298443 · Full text
BACKGROUND: Tuberculosis (TB) remains a major public health concern in Somaliland, and evidence on multi-year treatment outcomes is limited. This study assessed temporal trends and factors associated with TB treatment ou...
BACKGROUND: Tuberculosis (TB) remains a major public health concern in Somaliland, and evidence on multi-year treatment outcomes is limited. This study assessed temporal trends and factors associated with TB treatment outcomes among patients managed at Hargeisa TB Hospital, Somaliland. METHODS: We conducted a register-based retrospective cohort study using routinely collected data from the Hargeisa TB Hospital treatment registers for patients initiating anti-TB treatment from 2019 to 2024. TB treatment outcomes were dichotomised as successful (cured or treatment completed) versus unsuccessful (death, loss to follow-up, treatment failure). Descriptive analyses were performed to present patient characteristics, while bivariate and multivariate logistic regression models were used to identify variables linked to treatment success. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were calculated, and a p-value of less than 0.05 was considered statistically significant. RESULTS: Across the six-year period, treatment success rates remained above 85%. Significant predictors of treatment outcomes varied by year. Between 2020 and 2024, age consistently predicted outcomes, with patients aged ≥ 55 years significantly less likely to achieve successful treatment (AOR range: 0.24-0.44). HIV-negative patients had up to fourfold higher odds of treatment success (AOR = 4.30; 95% CI: 1.76-10.49; p = 0.001). CONCLUSION: TB treatment success consistently met or exceeded the World Health Organization benchmark of ≥ 85% across all study years. However, older age and TB/HIV co-infection remained associated with reduced treatment success even after stratification by TB type. These findings highlight the need to strengthen TB/HIV service integration and to provide enhanced clinical management and adherence support for older patients.
Evaluating documentation of follow-up laboratory testing in TB treatment monitoring in the Eastern Region of Ghana: a consistency analysis of three facility registers.
Kwabla MP, Dormechele W, Tuglo LS … +6 more , Apenteng OO, Kye-Duodu G, Osei E, Der J, Adusi-Poku Y, Baiden F
BMC Infect Dis · 2026 Jun · PMID 42298440 · Full text
BACKGROUND: The World Health Organization (WHO) recommends systematic follow-up testing for all bacteriologically confirmed pulmonary TB (PTB) cases under treatment to track progress towards successful treatment completi...
BACKGROUND: The World Health Organization (WHO) recommends systematic follow-up testing for all bacteriologically confirmed pulmonary TB (PTB) cases under treatment to track progress towards successful treatment completion. However, this topic has received little attention from researchers. We assessed the extent of documentation of follow-up laboratory testing for TB treatment monitoring. METHODS: Matched and unmatched records of bacteriologically confirmed PTB cases recorded between January 2016 and December 2017 across three TB registers from five districts of the Eastern Region were analyzed to assess documentation of follow-up laboratory testing at recommended treatment time points (months 2/3, 5, and 6/8). A cross-register consistency analysis assessed agreement between follow-up testing records documented in the laboratory register and those recorded in the district TB register, with the laboratory register treated as the reference source. A logistic regression model was used to identify factors associated with documentation of follow-up laboratory testing. RESULTS: A total of 773 bacteriologically confirmed PTB cases were successfully matched across the three registers after record linkage. The mean age was 42.6 years (SD = ± 15.0). More than half of the PTB cases in the district register did not have follow-up test results documented at 2 or 3 months (62.9%, 95% CI: 59.4-66.2, p < 0.001), 5 months (72.5%, 95% CI: 69.2-75.5, p < 0.001), and 6 or 8 months (66.4%, 95% CI: 63.0-69.6, p < 0.001). Similarly, in the laboratory register, 45.8% of cases had missing follow-up laboratory test results at months 2 or 3, 65.9% at month 5, and 99.9% at month 6/8. In the treatment centre registers, 67.1%, 75.9%, and 75.4% of PTB cases did not have follow-up test results documented at months 2 or 3, 5, and 6 or 8, respectively. Cross-register consistency analysis showed that documentation status matched in more than half of the records across the assessed follow-up intervals, with the highest consistency observed at month 6/8 (66.3%; 95% CI: 62.8-69.5; p < 0.001). Adult age groups (15-64 years) had lower odds of having documented follow-up test results than children aged 0-14 years. PTB cases from the Kwahu West Municipality were more likely to have documented follow-up testing results (aOR: 3.9, 95% CI: 2.1-7.1, p < 0.001) compared to cases residing in Akyemansa District. CONCLUSION: Logistic regression analysis showed that documented follow-up testing results were less common among several adult age groups than among children aged 0-14 years. Because this study assessed routine register documentation, this finding should be interpreted as a documentation gap rather than a confirmed absence of testing. Strengthening documentation practices and integrated reporting systems for follow-up testing should therefore be prioritized within the TB control programme.
The clinical features, pathological assessment, and prognostic analysis of autoimmune hepatitis in Chinese persons living with HIV.
Wang D, Liu J, Lin S … +7 more , Zhou Q, Zhang M, Liao A, Yu X, Dong X, Min H, Yang X
BMC Infect Dis · 2026 Jun · PMID 42298428 · Full text
PURPOSE: Autoimmune hepatitis (AIH) is an uncommon condition among persons living with HIV (PLWH), and its clinical presentation may be influences by immune reconstitution and viral reactivation, potentially affecting di...
PURPOSE: Autoimmune hepatitis (AIH) is an uncommon condition among persons living with HIV (PLWH), and its clinical presentation may be influences by immune reconstitution and viral reactivation, potentially affecting disease course and prognosis. In this retrospective case series, we aimed to describe the clinical features, pathological findings, treatment approaches, and outcomes of PLWH diagnosed with AIH in Yunnan Province, China, with a focus on region-specific clinical features. METHOD: This single-center retrospective case series included PLWH diagnosed with AIH at Yunnan Provincial Infectious Diseases Hospital between June 2017 and February 2025, based on electronic medical records. AIH was diagnosed according to the simplified International Autoimmune Hepatitis Group criteria (definite ≥ 7 points; probable ≥ 6 points), with cases lacking liver biopsy classified as probable AIH. PLWH with other chronic liver diseases, substantial missing data, or follow-up shorter than 15 months were excluded. RESULT: Among the eight PLWH, seven were female, with a median age of 46.5 years (IQR 39-51). All PLWH had been living with HIV for more than 5 years and were receiving antiretroviral therapy with well-controlled viral loads. Elevated transaminase and immunoglobulin G (IgG) levels were observed in all cases, and four of them presented with jaundice. All cases tested positive for ANA and ASMA autoantibodies; three were positive for LKM-1, two for SLA, and five for EBV-DNA (62.5%), which appeared higher than the ~ 20% reported in the general AIH population. Three PLWH (37.5%) had concomitant autoimmune diseases, including rheumatoid arthritis, Sjögren syndrome, and hyperthyroidism. Serum IL-6 (median 18.9 pg/mL, IQR 14.7-27.8) and IL-7 (median 10.2 pg/mL, IQR 8.7-13.1) levels were elevated. Liver biopsies was performed in six cases, showing inflammatory activity grades A1-A3 and fibrosis stages F0-F4, all consistent with typical features of AIH. The remaining two cases were classified as probable AIH based on the simplified criteria. One PLWH with advanced disease (A3/F4) died early due to acute hepatic failure. Among the six PLWH who received immunosuppressive therapy, five achieved complete remission and one (complicated with Sjögren syndrome) had an incomplete response. During a follow-up of 15-24 months, no relapse was observed in PLWH who achieved complete remission, and SF-36 scores improved. CONCLUSION: In PLWH in Yunnan, China, AIH presents with complex clinical features and may be potentially associated with EBV reactivation and systemic inflammation. However, the small sample size and retrospective design preclude causal inference. Our findings support the value of early non-invasive assessment and generate a hypothesis regarding the potential role of EBV monitoring. Future multiventer prospective cohorts or randomized controlled trials are required to calidate the long-term safety and efficacy of immunosuppressive therapy.
Development of a prediction model for infectious mononucleosis using machine learning algorithms based on blood cell analysis parameters.
Qin Y, Zhang L, Yu H … +6 more , Zhao M, Qian S, Mao Y, Han Q, Sun T, Wang L
BMC Infect Dis · 2026 Jun · PMID 42289658 · Full text
BACKGROUND: Infectious mononucleosis (IM) presents with nonspecific clinical manifestations, leading to frequent misdiagnosis or delayed diagnosis, and is associated with potentially severe complications. Existing etiolo...
BACKGROUND: Infectious mononucleosis (IM) presents with nonspecific clinical manifestations, leading to frequent misdiagnosis or delayed diagnosis, and is associated with potentially severe complications. Existing etiological diagnostic methods are characterized by prolonged turnaround times. This study aims to establish an IM model using eight machine learning algorithms and select the optimal one, so as to further improve the laboratory diagnostic accuracy of IM. METHODS: The study included 234 patients diagnosed with IM from April 2024 to December 2025 as the case group. The control group comprised 478 non-IM subjects, consisting of 236 patients with other pathogenic infections who exhibited reactive lymphocytes on microscopic examination and 242 healthy individuals. Recursive feature elimination (RFE) in conjunction with cross-validation was employed to rank feature importance and select optimal feature variables. Eight machine learning algorithms were trained, and their predictive performance was assessed using the area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), F1 score, Precision-Recall (PR) curve and Confusion Matrix. The contribution of each feature to the model's predictions was quantified using SHapley Additive exPlanation (SHAP) analysis. Subsequently, the model's performance was rigorously externally validated using an independent validation cohort. RESULTS: Three features - Reactive lymphocyte percentage (Reactive lymph%), Lym-Y, and platelet-to-lymphocyte ratio (PLR) - were selected for constructing the IM predictive model. The model constructed using the Adaptive Boosting Classifier(AdaBoost) machine learning algorithm demonstrated the best performance in the test set. It achieved an AUC of 0.928, an accuracy of 0.853, a sensitivity of 0.898, a specificity of 0.832, and an F1 score of 0.800. SHAP consistent with decision feature importance rankings, indicated that Reactive lymph% was the most significant feature in the predictive model; It was associated with an elevated risk of IM. Validation cohort also confirmed the robust performance of the AdaBoost predictive model, with an AUC of 0.923 and an F1 score of 0.797. CONCLUSION: The IM predictive model constructed based on the AdaBoost machine learning algorithm combined with three blood cell analysis parameters exhibits satisfactory predictive efficacy. Based on the established model, the missed laboratory diagnosis rate in IM may potentially be reduced, pending prospective validation.
Correction: Pneumococcal vaccine for prevention of acute otitis media in children: a meta-analysis.
Han L, Gao C, Liu J … +4 more , Li Y, Liu M, Liu H, Wu J
BMC Infect Dis · 2026 Jun · PMID 42288823 · Full text
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Application of BALF combined with tNGS for detecting Chlamydia psittaci in resource-limited areas: lessons learned from the 2025 temporally associated case series investigation.
Li Q, Su G, Yu R … +2 more , Guo J, Hou X
BMC Infect Dis · 2026 Jun · PMID 42288822 · Full text
BACKGROUND: Chlamydia psittaci (Cps) is a neglected zoonotic cause of community-acquired pneumonia (CAP), and its incidence may be underestimated in county-level hospitals lacking rapid diagnostic tools. We evaluated the...
BACKGROUND: Chlamydia psittaci (Cps) is a neglected zoonotic cause of community-acquired pneumonia (CAP), and its incidence may be underestimated in county-level hospitals lacking rapid diagnostic tools. We evaluated the potential utility of targeted next-generation sequencing (tNGS) of bronchoalveolar lavage fluid (BALF) for early Cps detection during a small group of temporally associated cases in rural southwestern China. METHODS: We retrospectively analyzed four nonsevere Cps pneumonia patients admitted to Dafang County People's Hospital between April 19 and May 6, 2025. Epidemiological exposure profiles, clinical data, laboratory results, and chest CT images were extracted. BALF samples were sent to a central reference laboratory for tNGS, covering 226 respiratory pathogens, including three Cps-specific amplicons. The time from symptom onset to appropriate antibiotic adjustment and clinical outcomes were recorded. RESULTS: Patients presented with high fever (39.5-39.6 °C), cough, dyspnea, and patchy ground‒glass opacities on CT. All had recent bird exposure: three through daily visits to live poultry markets or pigeon clubs within 500 m of their homes and one through household parrot breeding (within 3 km). The mean time from symptom onset to hospitalization was 5.25 days (range 3-7), and that from admission to Cps confirmation via tNGS was 2.75 days (range 2-3). Empirical β-lactam therapy failed; prompt switching to doxycycline or fluoroquinolones led to fever resolution within 3-5 days and complete radiographic resolution by 3 months. CONCLUSION: Outsourcing BALF-tNGS to central labs facilitated rapid Cps diagnosis in a county hospital and may have helped reduce the risk of severe disease. This case series suggests that it may be useful to incorporate bird exposure history and accessible molecular diagnostics into CAP care in similar settings.
Clinical spectrum of extrapulmonary tuberculosis at a tertiary care centre in Ghana: a retrospective study.
Appati W, Yao Amenuke DA, Appati A … +1 more , Baiden GA
BMC Infect Dis · 2026 Jun · PMID 42288814 · Full text
BACKGROUND: Extrapulmonary tuberculosis (EPTB) presents with diverse clinical manifestations and remains a diagnostic and public health challenge, particularly in high tuberculosis (TB) burden settings such as Ghana. Und...
BACKGROUND: Extrapulmonary tuberculosis (EPTB) presents with diverse clinical manifestations and remains a diagnostic and public health challenge, particularly in high tuberculosis (TB) burden settings such as Ghana. Understanding its clinical spectrum and associated factors is essential for improved case detection and management. This study aims to describe the epidemiology, clinical spectrum, and associated demographic and clinical factors of EPTB in Ghana. METHODS: We conducted a retrospective review of TB cases seen at the Chest Clinic of Komfo Anokye Teaching Hospital in Ghana between October 2023 and November 2025. Patients were categorised into pulmonary tuberculosis (PTB) and EPTB. The primary outcome was the clinical manifestation of EPTB, categorised by anatomical site of involvement. Multivariate logistic regression was used to identify factors associated with specific EPTB manifestations, and covariates included age categories, sex, and HIV status. Adjusted odds ratios (aORs) were reported, and statistical significance was set at p < 0.05. RESULTS: Among 1,098 patients with TB, 179 (16.3%) had isolated EPTB. Patients with EPTB were less frequently male (52.0% vs. 68.8%; p < 0.001) and had lower HIV prevalence (9.0% vs. 14.9%; p = 0.035). Spinal TB was the predominant EPTB manifestation (73, 40.8%), followed by TB lymphadenitis (52, 29.1%), abdominal TB (34, 19.0%), TB pericarditis (13, 7.3%), and central nervous system (CNS) TB (7, 3.9%). Within the EPTB cohort, individuals aged 35-54 years had higher odds of spinal TB (aOR 3.2, 95% CI: 1.5-6.6, p = 0.002). Male sex (aOR 2.8, 95% CI: 1.4-5.7, p = 0.005) and HIV infection (aOR 4.1, 95% CI: 1.3-12.7, p = 0.014) were independently associated with TB lymphadenitis. No significant demographic or HIV-related associations were identified for abdominal TB or TB pericarditis. CONCLUSION: Isolated EPTB accounted for approximately one-sixth of all TB cases. Spinal TB and TB lymphadenitis were the predominant manifestations. Distinct demographic and HIV-related associations across EPTB phenotypes underscore the clinical heterogeneity of EPTB and highlight the need for studies evaluating concurrent PTB and EPTB disease to better define the full spectrum of TB in Ghana.
Pulmonary tuberculosis mimicking cystic metastases: evolution from multiple cystic cavities to nodules during therapy.
Yang C, Mei C, Chen S … +3 more , Mei M, Quan C, Wang X
BMC Infect Dis · 2026 Jun · PMID 42288790 · Full text
Pulmonary tuberculosis typically exhibits characteristic imaging findings; however, radiological manifestations can be atypical in certain cases, leading to potential misdiagnosis based solely on CT imaging. We describe...
Pulmonary tuberculosis typically exhibits characteristic imaging findings; however, radiological manifestations can be atypical in certain cases, leading to potential misdiagnosis based solely on CT imaging. We describe a 59-year-old man who developed a 4-month history of cough and a 2-week fever during postoperative radiotherapy following esophagectomy for esophageal cancer. CT scans revealed multiple, scattered cystic cavities in both lungs, characterized by regular shape and well-defined borders. Following anti-tuberculosis therapy, the pre-existing cystic cavities collapsed and evolved into nodular opacities, a change highly suggestive of cystic metastases given the patient's history of esophageal cancer. A biopsy confirmed granulomatous inflammation, and follow-up at eight months after the initiation of anti-tuberculosis therapy showed near-complete resolution of the lesions. Although cystic pulmonary tuberculosis is rarely reported, this case is notable for its distinct cystic characteristics. To our knowledge, this is the first case to systematically document the transformation of cystic lesions into nodules during anti-tuberculosis therapy-a finding that may raise suspicion for cystic metastases and highlights the diverse and atypical radiological manifestations of tuberculosis in immunocompromised hosts.
Association of Helicobacter pylori infection with elevated low-density lipoprotein cholesterol and fasting glucose: a large-scale analysis of 83,054 participants in central China.
Xie M, Xia J, Zeng Q … +3 more , Ren DJ, Gong Y, Lu YH
BMC Infect Dis · 2026 Jun · PMID 42288787 · Full text
INTRODUCTION: Helicobacter pylori (H. pylori) infection is increasingly recognized for its extragastric metabolic effects. However, its specific association with lipid and glucose dysregulation remains controversial. Thi...
INTRODUCTION: Helicobacter pylori (H. pylori) infection is increasingly recognized for its extragastric metabolic effects. However, its specific association with lipid and glucose dysregulation remains controversial. This study aimed to quantify the independent association between H. pylori infection and key metabolic markers, particularly LDL-C and fasting glucose, in a large-scale Chinese cohort. METHODS: This retrospective cross-sectional study analyzed 83,054 participants from a health management center in a central Chinese city (2021-2025). H. pylori status was determined by the C Urea Breath Test. Multivariable logistic regression was employed to identify independent clinical and metabolic correlates associated with H. pylori positive status, adjusting for age, gender, BMI, and a comprehensive biochemical profile. RESULTS: The overall H. pylori prevalence was 26.55%, with an age-specific peak of 28.80% in the 50-54 cohort. After multivariable adjustment, elevated LDL-C emerged as the strongest independent correlate of H. pylori presence (aOR = 1.34, 95% CI: 1.27-1.41, P< .001). Furthermore, fasting glucose was significantly associated with higher odds of being H. pylori positive (aOR = 1.04, 95% CI: 1.03-1.05, P < .001). In unadjusted analyses, total cholesterol was also significantly higher in the H. pylori-positive group (P = .005); however, in the multivariable model its independent association was attenuated after adjustment for LDL-C (see Table 2). CONCLUSION: H. pylori infection is independently associated with elevated LDL-C and fasting glucose in this large urban population. These findings underscore the role of H. pylori as a systemic metabolic stressor and suggest that H. pylori eradication may offer collateral benefits for cardiovascular and metabolic risk management.
Efficacy and safety of TDF+3TC + EFV‑centric antiretroviral regimens for HIV/HBV co-infection: a systematic review and network meta‑analysis.
Zhang X, Chen J, Fang Y … +4 more , Xie Z, Deng Y, Deng J, Zhou Z
BMC Infect Dis · 2026 Jun · PMID 42288778 · Full text
OBJECTIVE: To evaluate the efficacy and safety of antiretroviral therapy(ART) regimens based on tenofovir(TDF) + lamivudine(3TC) + efavirenz(EFV) in patients co-infected with Human Immunodeficiency Virus (HIV) and Hepati...
OBJECTIVE: To evaluate the efficacy and safety of antiretroviral therapy(ART) regimens based on tenofovir(TDF) + lamivudine(3TC) + efavirenz(EFV) in patients co-infected with Human Immunodeficiency Virus (HIV) and Hepatitis B Virus (HBV), thereby providing evidence-based support for clinical treatment decision-making. METHODS: Relevant studies published from database inception to March 2025 were systematically retrieved from the CNKI, Wanfang, VIP, SinoMed, PubMed, Embase, Web of Science, and Cochrane Library databases. The revised Risk of Bias tool version 2 (ROB2) was used to assess study quality, and all meta-analyses were performed using Stata 18 software. RESULTS: A total of 31 randomized controlled trials (RCTs) involving 2124 participants and 12 treatment interventions were included, with four outcome measures evaluated. The network meta-analysis demonstrated that the TDF + 3TC + EFV triple therapy regimen was superior to the other evaluated regimens in achieving higher HBV DNA and HIV RNA negative conversion rates. In addition, TDF+ 3TC + EFV demonstrated greater efficacy than zidovudine(AZT) + 3TC + EFV in increasing CD4 + lymphocyte counts. The surface under the cumulative ranking curve (SUCRA) analysis indicated that TDF + 3TC + EFV ranked highest in terms of efficacy. Regarding safety, several studies reported various types of adverse events. However, no statistically significant differences were observed among the treatment groups. CONCLUSION: Based on the currently available evidence, this network meta-analysis suggests that the TDF + 3TC + EFV triple regimen demonstrates superior efficacy across multiple outcome measures in patients with HIV/HBV co-infection. Nevertheless, owing to the inherent limitations of the included studies, further high-quality studies are required to confirm its role as a preferred therapeutic option.
Modelling the impact of climate variability on malaria morbidity in the Tamale Metropolitan Area: a time series analysis.
Zakaria AG, Ziblim SD, Amadu Y
BMC Infect Dis · 2026 Jun · PMID 42288776 · Full text
BACKGROUND: Malaria remains endemic in northern Ghana, with seasonal outbreaks placing significant strain on health facilities in the Tamale Metropolitan Area. Although climatic variability is known to influence malaria...
BACKGROUND: Malaria remains endemic in northern Ghana, with seasonal outbreaks placing significant strain on health facilities in the Tamale Metropolitan Area. Although climatic variability is known to influence malaria transmission, the specific short- and long-run relationships between temperature, rainfall, relative humidity, and malaria outcomes in this setting remain poorly understood. This study models the impact of climate variability on population-adjusted malaria morbidity in the Tamale Metropolitan Area using a time series approach. METHODS: Monthly time series data on laboratory-confirmed malaria morbidity (converted to rates per 1,000 population), as well as temperature, rainfall, and relative humidity, were obtained from the District Health Information Management System and the Ghana Meteorological Agency for the period January 2014 to December 2020 (84 observations). The Autoregressive Distributed Lag (ARDL) bounds testing approach was selected for its ability to handle variables with mixed orders of integration (I(0) and I(1)) and to simultaneously estimate short- and long-run dynamics. No logarithmic transformation was applied, preserving direct interpretation of coefficients as changes in malaria rates per 1,000 population. RESULTS: The ARDL cointegration test confirmed a long-run equilibrium relationship between each climatic variable and malaria morbidity. In the short run, increases in relative humidity, temperature, and rainfall were significantly associated with higher malaria morbidity (p < 0.05 to p < 0.001). In the long run, however, temperature showed a significant inverse relationship: a one-unit (1 °C) increase in temperature was associated with a 0.37 case per 1,000 population decrease in malaria morbidity (p = 0.038). Model diagnostic tests (Ljung-Box and ARCH-LM) indicated that residuals were white noise, supporting model validity. CONCLUSION: Climatic variables, particularly temperature, play a significant but complex role in malaria transmission in the Tamale Metropolitan Area, with opposing short- and long-run effects. These findings support the development of climate-informed early warning systems tailored to northern Ghana. To strengthen local malaria control and climate adaptation strategies, future efforts should integrate intervention coverage and health system data, improve surveillance, and apply advanced time-series methods to better capture non-linear and delayed climate effects. CLINICAL TRIAL: Not applicable.
Impact of the COVID-19 pandemic on hepatitis C care across the cascade of care: a scoping review.
Lamadrid A, Leiva-Escobar I, Soza A … +1 more , Quentin W
BMC Infect Dis · 2026 Jun · PMID 42288770 · Full text
BACKGROUND: The COVID-19 pandemic was associated with widespread health services disruption, including challenges in the management of chronic infectious diseases. However, evidence regarding reported changes in hepatiti...
BACKGROUND: The COVID-19 pandemic was associated with widespread health services disruption, including challenges in the management of chronic infectious diseases. However, evidence regarding reported changes in hepatitis C virus (HCV) care during this period remains limited and fragmented. We aimed to map the available evidence on reported changes in HCV care during the COVID-19 pandemic across the HCV cascade of care. METHOD: We conducted a scoping review following the Arksey and O'Malley methodological framework. Searches of Medline (PubMed), Cochrane Library, Embase, Scopus, Web of Science, and grey literature identified studies reporting pandemic-related changes in HCV diagnosis, linkage to care, treatment, or cure from; March 2020 to March 2025. Data were extracted on the study setting, stage of the cascade of care, and observed changes in HCV care, and synthesized narratively. RESULTS: Twenty-eight studies met the inclusion criteria. Eighteen were conducted in Europe and North America. Most studies found declines in HCV care across all stages of the cascade of care: diagnosis (15 of 21 studies), linkage to care (9 of 10), treatment initiation or completion (18 of 27), and cure (6 of 13). Among the included studies, linkage to care was the stage most consistently reported as disrupted. CONCLUSION: Evidence on reported changes in the HCV cascade of care during the COVID-19 pandemic is limited and geographically skewed toward high-income countries. Available data suggest service reductions across all stages, with linkage to care being the stage most frequently reported as disrupted among the studies that assessed it. Strengthening surveillance, ensuring routine monitoring at all stages of the cascade of care, and building resilient HCV services are critical to safeguarding progress toward the 2030 hepatitis elimination goal.
Epidemiology and antimicrobial resistance analysis of staphylococcus aureus isolated from women, children and neonates in a maternal and child specialty hospital in Southeast China.
Cao S, Chen L, Cao J … +6 more , Wu W, Zheng X, Zeng J, Chen X, Wu J, Ye H
BMC Infect Dis · 2026 Jun · PMID 42288760 · Full text
BACKGROUND: Staphylococcus aureus (S. aureus) is a common bacterium posing a significant global health threat, with methicillin-resistant S. aureus (MRSA) epidemiology varying widely by region, time period, and populatio...
BACKGROUND: Staphylococcus aureus (S. aureus) is a common bacterium posing a significant global health threat, with methicillin-resistant S. aureus (MRSA) epidemiology varying widely by region, time period, and population. Moreover, antibiotic management strategies differ for vulnerable groups including neonates, children, and pregnant women. This study investigates the clinical distribution and antimicrobial resistance profiles of S. aureus isolates from a maternal-child specialty hospital, with a particular focus on MRSA epidemiology. METHODS: Herein, we retrospectively enrolled all non-duplicate S. aureus isolates recovered in our hospital from October 2020 to August 2024. All isolates were divided into three groups: neonates, children, and women, followed by an analysis of their clinical distributions. Antimicrobial susceptibility testing was conducted via broth microdilution or disk diffusion methods following Clinical and Laboratory Standards Institute (CLSI) criteria, with data analyzed using WHONET 5.6. The chi-square test, Fisher's exact test, Monte Carlo method, and multivariate logistic regression were adopted for statistical analysis using R 4.2.2. RESULTS: A total of 973 S. aureus isolates were studied, of which 65.6% were from inpatients and 28.4% from the neonatal unit. Sputum (37.3%, 363/973) and pus (24.2%, 235/973) were the predominant specimens, with relatively high proportions of isolates from the genital tract (10.3%) and intrauterine sites (6.2%). Of 732 isolates subjected to susceptibility testing, the overall MRSA detection rate was 19.7% (144/732). The risk of MRSA colonization or infection was higher in children (OR = 2.774, P = 0.0049) but lower in the obstetric population (OR = 0.0122, P = 0.0491). Significant differences in susceptibility rates to penicillin, erythromycin and clindamycin were observed among the three subgroups. CONCLUSIONS: S. aureus isolates were predominantly obtained from neonates and lactating mothers, mainly from the lower respiratory tract and skin/soft tissue sites. The high proportion of genital tract and intrauterine colonization/infection may raise possible concerns regarding vertical mother-to-child S. aureus transmission. MRSA demonstrated a moderate overall prevalence, with children carrying a higher risk of MRSA infection or colonization. Collectively, these data underscore the need for sustained MRSA surveillance and age-specific, differentiated prevention strategies for these vulnerable groups.
A polymicrobial opportunistic infection leading to osteolytic destruction and acute respiratory failure: a case report.
Huang Y, Zheng F, Cao W … +5 more , Qiu Y, Pan M, Lin H, Yu H, Zhang J
BMC Infect Dis · 2026 Jun · PMID 42288754 · Full text
BACKGROUND: Polymicrobial infections involving opportunistic pathogens pose major diagnostic challenges, as clinical symptoms and imaging findings are often nonspecific. Comprehensive pathogen identification is essential...
BACKGROUND: Polymicrobial infections involving opportunistic pathogens pose major diagnostic challenges, as clinical symptoms and imaging findings are often nonspecific. Comprehensive pathogen identification is essential for effective management. CASE PRESENTATION: This report describes a case of polymicrobial infection caused by Cryptococcus, Pseudomonas aeruginosa, Aspergillus, and Mycobacterium abscessus in a diabetic patient. A 67-year-old male presented with cough, sputum production, and bone pain. Chest computed tomography revealed a cavitary lesion in the posterior segment of the left lower lobe. Histopathology of lung biopsy confirmed pulmonary cryptococcosis. Respiratory symptoms initially improved with antifungal therapy, but bone pain persisted. After treatment discontinuation, symptoms recurred and worsened, accompanied by fever and respiratory failure. Sputum culture grew Pseudomonas aeruginosa, and next-generation sequencing of bronchoalveolar lavage fluid revealed concurrent infections with Mycobacterium abscessus and Aspergillus fumigatus. Ultimately, the patient recovered and was discharged after targeted therapy. CONCLUSIONS: This case underscores the inadequacy of single-pathogen frameworks in complex polymicrobial infections and highlights the clinical value of repeated assessment and a multimodal diagnostic approach. Early recognition of polymicrobial opportunistic infections may help prevent disease progression and improve clinical outcomes in susceptible patients.
Fulminant Aeromonas caviae bacteremia with migratory myalgia: a case report of a CTX-M-3-producing multidrug-resistant strain.
Guo L, Zhao Z, Li K … +11 more , Huang W, Ma N, Jin X, Gui B, Li Q, Li C, Tang C, Zhao H, Huang J, Gao S, Lin N
BMC Infect Dis · 2026 Jun · PMID 42288750 · Full text
BACKGROUND: Aeromonas caviae is an emerging waterborne pathogen of increasing clinical concern, particularly regarding antimicrobial resistance. While extended-spectrum β-lactamase (ESBL) genes such as bla are well-docum...
BACKGROUND: Aeromonas caviae is an emerging waterborne pathogen of increasing clinical concern, particularly regarding antimicrobial resistance. While extended-spectrum β-lactamase (ESBL) genes such as bla are well-documented in Enterobacterales, they remain uncommon in A. caviae. We report a rare case of fulminant A. caviae bacteremia with atypical clinical manifestations and a complex genomic resistome. CASE PRESENTATION: A 71-year-old man without formal immunodeficiency but with predisposing vulnerabilities (advanced age, prior subtotal gastrectomy) presented with fulminant bacteremia progressing to septic shock and unusual migratory myalgia following a minor paddy field injury. Initial empirical ertapenem therapy at a referring hospital was clinically ineffective. Blood cultures isolated A. caviae with multidrug resistance. Whole-genome sequencing (WGS)-based phylogenomic analysis confirmed species identity (clustering with A. caviae type strain NCTC 12244; bootstrap 100%; average nucleotide identity 98.09%), distinguishing it from closely related species (A. dhakensis, A. hydrophila, A. veronii). WGS identified ESBL genes bla, bla, and bla, alongside aac(6')-Ib-cr and tet(A). The isolate remained susceptible to amikacin and representative carbapenems (imipenem, meropenem). Therapy was successfully switched to biapenem, achieving rapid clinical recovery and microbiological clearance. CONCLUSIONS: A. caviae, an environmental organism, can harbor clinically significant ESBL genes and cause life-threatening infections even in individuals without formal immunodeficiency. Ertapenem failure despite carbapenem class susceptibility suggests that pharmacokinetic/pharmacodynamic factors may contribute to treatment failure in critically ill patients with hypoalbuminemia and acute kidney injury, although direct evidence is lacking. These findings highlight the need for integrated One Health surveillance to monitor antimicrobial resistance gene flow between environmental and human populations, though confirmation through prospective multicentre studies is warranted.
Determinants of cardiovascular and metabolic noncommunicable diseases among people living with HIV in Rwanda: protocol for the NCOHIRWA prospective cohort study.
Dushimiyimana V, Twagirumukiza M, Durand M … +18 more , Ntusi NAB, Kateera BA, Bigirimana N, Nshimiyimana L, Ndishimye P, Umuhire VN, Karame P, Ndagijimana V, Mucumbitsi J, Dusabimana A, Ingabire C, Uwera YDN, Islam KMM, Hategeka C, Nsanzimana S, Rietzschel E, Callens S, NCOHIRWA Cohort Study Group
BMC Infect Dis · 2026 Jun · PMID 42288743 · Full text
BACKGROUND: Noncommunicable diseases (NCDs), particularly cardiovascular diseases (CVDs), hypertension and diabetes, are major contributors to morbidity and mortality globally and in Rwanda, where the dual burden of HIV...
BACKGROUND: Noncommunicable diseases (NCDs), particularly cardiovascular diseases (CVDs), hypertension and diabetes, are major contributors to morbidity and mortality globally and in Rwanda, where the dual burden of HIV and NCDs is increasing. Evidence remains limited on how biological, behavioural, social, environmental and health-system determinants influence cardiovascular and metabolic outcomes among people living with HIV (PLHIV) in Rwanda. The NCOHIRWA cohort was established to prospectively investigate determinants associated with CVDs, hypertension, diabetes and related NCD outcomes among PLHIV, newly diagnosed PLHIV and people without HIV (PWoH). This manuscript presents the protocol for the NCOHIRWA cohort study. METHODS: The NCOHIRWA study is a prospective cohort with a mixed-methods implemented across 12 health facilities providing HIV and NCD services in Rwanda. Adults aged ≥ 18 years, including PLHIV, newly diagnosed PLHIV and PWoH were enrolled beginning in March 2021 and will be followed longitudinally for 10 years. Baseline and follow-up data capture sociodemographic characteristics, behavioural, psychosocial, family history of NCDs, environmental and health-system factors, and clinical, anthropometric and laboratory measures relevant to cardiovascular and metabolic health. RESULTS: A total of 1,546 participants with complete baseline data were included, comprising 1,234 (79.8%) PLHIV and 312 (20.2%) PWoH. The median age was 44 years (range: 18-81) among PLHIV and 42 years (range: 18-75) among PWoH. Women represented 785 (63.6%) PLHIV and 197 (63.1%) PWoH. Baseline determinants relevant to future NCD outcome analyses included overweight [256 (21.0%) PLHIV versus 75 (24.4%) PWoH], obesity [118 (9.7%) versus 39 (12.6%)], ever smoking [260 (21.1%) versus 55 (17.7%)], family history of hypertension [219 (17.8%) versus 84 (26.9%)] and elevated fasting blood glucose [37 (3.0%) versus 28 (9.1%)]. These baseline characteristics define the cohort profile and provide the foundation for longitudinal analyses of incident cardiovascular and metabolic outcomes. DISCUSSION: This protocol describes the design and baseline profile of the NCOHIRWA cohort study. The cohort is positioned to generate longitudinal evidence on determinants of cardiovascular and metabolic NCDs among PLHIV in Rwanda. As follow-up accrues,the study will support estimation of incident outcomes, identification of risk pathways and development of context-appropriate strategies for integrated HIV and NCD prevention and care. CLINICAL TRIAL NUMBER: Not applicable.
Correction: Comparative evaluation of deep learning models for lung segmentation in chest X-rays: applications in infectious disease screening.
Dubey AK, Jain A, Khan S … +5 more , Kaur M, Panwar A, Alawad MA, Khan J, Alam MN
BMC Infect Dis · 2026 Jun · PMID 42288739 · Full text
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Effectiveness of seasonal mRNA COVID-19 vaccination against post COVID-19 condition between July 2023 and September 2024 among adults aged ≥ 60 years in Germany: a population-based cohort study.
Perumal N, Peine C, Steffen A … +2 more , Wichmann O, Harder T
BMC Infect Dis · 2026 Jun · PMID 42288736 · Full text
BACKGROUND: Some individuals infected with severe acute respiratory syndrome coronavirus 2 experience long-term symptoms, termed post COVID-19 condition (PCC). Pandemic-era studies have demonstrated moderate effectivenes...
BACKGROUND: Some individuals infected with severe acute respiratory syndrome coronavirus 2 experience long-term symptoms, termed post COVID-19 condition (PCC). Pandemic-era studies have demonstrated moderate effectiveness of COVID-19-vaccines in preventing PCC. However, as population immunity has evolved and variant-adapted vaccines have been introduced, estimates of vaccine effectiveness and disease frequency from the post-pandemic era are needed to guide policy-making and communication. METHODS: We investigated whether one mRNA COVID-19 vaccine dose during the 2023/2024 season was associated with reduced PCC risk in the following six months among adults aged ≥ 60 years in Germany. We conducted a retrospective cohort study using nationwide, outpatient claims data and performed descriptive and Poisson regression analyses. RESULTS: In our cohort of 19,121,674 patients, 3,437,701 (18.0%) received one dose of a seasonal COVID-19 vaccine and 36,830 fulfilled the PCC case definition (incidence: 0.2%). Vaccinated individuals were older (median age 75 years) compared to those who were not vaccinated (71 years), with a higher proportion being female (54% vs. 46% male). 0.08% of vaccinated patients were diagnosed with PCC during study follow-up, compared to 0.22% non-vaccinated. One vaccine dose was associated with lower risk (adjusted Risk Ratio 0.37; 95% CI 0.36-0.39) of receiving a PCC diagnosis at six months post-vaccination compared to no vaccination, translating to a vaccine effectiveness of 63%. CONCLUSION: Our results demonstrate a low PCC-incidence and a strong protective association between seasonal COVID-19 vaccination and PCC during the first post-pandemic season. These findings can help improve acceptance of COVID-19-vaccines and support doctors' and patients' decision-making regarding vaccination.
Hepatitis A virus seroprevalence and acute infection: a five-year retrospective analysis from central part of Turkey.
Ezer B, Bülbül R
BMC Infect Dis · 2026 Jun · PMID 42286559 · Full text
BACKGROUND: Hepatitis A virus (HAV) remains an important cause of acute viral hepatitis worldwide, with its epidemiology shifting in countries undergoing socioeconomic development. In Turkey, improvements in sanitation a...
BACKGROUND: Hepatitis A virus (HAV) remains an important cause of acute viral hepatitis worldwide, with its epidemiology shifting in countries undergoing socioeconomic development. In Turkey, improvements in sanitation and the introduction of routine childhood vaccination in 2012 have reduced early-life exposure, potentially creating a susceptible population among adolescents and young adults. This study aimed to evaluate current HAV seroprevalence, acute infection rates, and age-specific susceptibility patterns. METHODS: This retrospective study included individuals tested for anti-HAV IgG and IgM between January 2021 and January 2026 in a tertiary care hospital. Serological analyses were performed using chemiluminescence microparticle immunoassay. Demographic characteristics, clinical unit distributions, and temporal trends were analyzed. Statistical analyses were conducted using SPSS v22.0, with p < 0.05 considered significant. RESULTS: A total of 7,147 individuals were included (median age: 32 years; 57.8% female). Acute HAV infection (IgM positivity) was detected in only 0.25% of cases, with no significant differences by age or gender. Overall HAV-IgG seropositivity was 63.03%, significantly higher in adults than in children (p < 0.001). The lowest immunity was observed in adolescents aged 15-18 years (12.5%), while seropositivity peaked at 100% in individuals ≥ 60 years. A significant temporal fluctuation was noted, with seropositivity declining to 49.5% in 2022 before rising to 68.5% in 2025 (p < 0.001). Susceptibility to infection was highest among adolescents aged 15-18 years (88.6%) and young adults aged 19-30 years (60.0%). CONCLUSIONS: Despite low acute infection rates, a substantial immunity gap exists, particularly among adolescents and young adults (specifically the 15-30 age cohort). This shift reflects changing endemicity patterns and highlights the need for targeted catch-up vaccination strategies to prevent future outbreaks and severe disease in susceptible populations. CLINICAL TRIAL NUMBER: Not applicable.
Adverse events associated with candida infections in secukinumab treatment.
Yu C, Ma T, Wu N … +2 more , Li C, Wang R
BMC Infect Dis · 2026 Jun · PMID 42286536 · Full text
BACKGROUND: Secukinumab, an interleukin-17 A inhibitor widely used in psoriasis and related disorders, has been linked to opportunistic infections. Candida infections are a key safety concern, yet their real-world clinic...
BACKGROUND: Secukinumab, an interleukin-17 A inhibitor widely used in psoriasis and related disorders, has been linked to opportunistic infections. Candida infections are a key safety concern, yet their real-world clinical profiles, risk distribution, and onset patterns remain insufficiently characterized. OBJECTIVES: To evaluate the clinical characteristics, severity, onset patterns, and risk factors of Candida infections associated with secukinumab, thereby informing risk stratification and patient management. METHODS: A retrospective pharmacovigilance analysis was performed using the U.S. Food and Drug Administration Adverse Event Reporting System (FAERS) from Q1 2004 to Q1 2025. Secukinumab reports were retrieved, and Candida-related adverse events were identified using a predefined Candida-specific MedDRA Preferred Term dictionary. Disproportionality analyses were conducted using reporting odds ratios (RORs) with 95% confidence intervals (CIs). Event severity, subgroup characteristics, and time-to-onset were assessed, and Weibull shape parameter modeling was used to characterize risk patterns. RESULTS: We identified 1,075 Candida events (0.8% of all secukinumab reports). Oral, esophageal, and vulvovaginal candidiasis predominated. All eight focal PTs showed significant disproportionality, with genital candidiasis yielding the strongest signal (ROR 19.85; 95% CI 12.91-30.53). Over half of events met criteria for serious outcomes. Stronger reporting signals were observed in females and adults aged 18-64 years. Median onset was 2-3 months, and Weibull β < 1 indicated an early-failure pattern, suggesting heightened risk shortly after treatment initiation. CONCLUSIONS: Candida infections during secukinumab therapy are uncommon but often severe, particularly in defined high-risk groups. Early onset highlights the importance of vigilant monitoring during initial treatment months. Real-world pharmacovigilance remains essential for optimizing biologic safety. CLINICAL TRIAL NUMBER: Not applicable.
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