BMC Infectious Diseases[JOURNAL]
Sun
200 papers
Characteristics of Streptococcus pneumoniae colonising Cypriot children during a period of high PCV10 and PCV13 vaccine coverage: serotypes and antimicrobial resistance.
Ioannou Vassiliadou G, Ladas P, Mendris M … +18 more , Mazeri S, Michail M, Paphiti N, Eracleous E, Iacovides P, Economou C, Hadjigeorgiou C, Tsokkou K, Thomaides S, Skapoullarou P, Iasonidis M, Siama E, Markaki L, Evripidou I, Michos A, Nikolopoulos G, Tsolia M, Koliou Mazeri M
BMC Infect Dis · 2026 Jul · PMID 42401862 · Full text
BACKGROUND: Nasopharyngeal carriage of Streptococcus pneumoniae is a key factor for transmission, invasive disease, and antimicrobial resistance. Data on pneumococcal carriage in children in Cypriot are limited. METHODS:...
BACKGROUND: Nasopharyngeal carriage of Streptococcus pneumoniae is a key factor for transmission, invasive disease, and antimicrobial resistance. Data on pneumococcal carriage in children in Cypriot are limited. METHODS: We conducted a cross sectional study from December 2023 to May 2024, during a period of high PCV10 and PCV13 vaccine coverage in Cyprus, including children aged six months to six years who attended outpatient clinics in Cyprus. Nasopharyngeal swabs were cultured, and Streptococcus pneumoniae isolates were identified using conventional methods and confirmed by polymerase chain reaction. Serotyping was performed using multiplex polymerase chain reaction, latex agglutination, and whole-genome sequencing when needed. Antimicrobial susceptibility was assessed according to European guidelines. Logistic regression was used to identify risk factors for carriage. RESULTS: A total of 809 children were included, 83.85% of whom were fully vaccinated with pneumococcal conjugate vaccines. The overall prevalence of carriage was 35.72%. Recent antibiotic use (OR 1.47, 95% CI 1.03-2.12) and daycare attendance (OR 1.89, 95% CI 1.37-2.63) were associated with increased carriage, whereas receipt of at least one vaccine dose was protective (OR 0.38, 95% CI 0.17-0.82). Among the 290 isolates, 34 distinct serotypes were identified, predominantly non-vaccine types including 15B, 23A, 23B, 24, 6C, and 15A. Most isolates (68%) were not covered by available vaccines. Resistance was highest for erythromycin (54.32%), tetracycline (37.28%), and clindamycin (31.65%). Multidrug resistance occurred in 28.94% of the isolates, mainly in serotypes 24, 15A, and 19A. CONCLUSIONS: Despite extensive vaccination, pneumococcal carriage in Cypriot children remains high, with predominance of non-vaccine serotypes and substantial antimicrobial resistance. Continuous surveillance is essential to guide vaccination and antimicrobial stewardship.
Treatment outcomes and adverse events associated with intermittent versus daily continuation-phase regimens in drug-susceptible tuberculosis patients in Makassar, Indonesia: an observational cohort study.
Sarifah LM, Madolangan J, Ardiansyah A … +7 more , Rauf S, Junus AJ, Alkaff SD, Postma MJ, Alkaff FF, Syahrir M, Arifin B
BMC Infect Dis · 2026 Jul · PMID 42401852 · Full text
BACKGROUND: Indonesia has one of the highest number of tuberculosis (TB) cases globally. The previous treatment policy of the Ministry of Health was to administer TB drugs intermittently (three times per week) during the...
BACKGROUND: Indonesia has one of the highest number of tuberculosis (TB) cases globally. The previous treatment policy of the Ministry of Health was to administer TB drugs intermittently (three times per week) during the continuation phase. Since 2023, the treatment policy has changed to daily dosing during the continuation phase. However, evidence comparing the treatment outcomes and tolerability of these agents remains limited. OBJECTIVE: This study compared patient characteristics, treatment success, and reported adverse events between intermittent and daily regimens among drug-susceptible TB patients. METHODS: An observational cohort study was conducted using secondary data from medical records and the National TB Information System, with prospective ascertainment of adverse events via standardized telephone and face-to-face interviews among a subset of participants. Group comparisons were performed using chi-square tests, t-tests, and multivariable logistic regression (adjusted for age, HIV status, diabetes status, and baseline sputum). RESULTS: A total of 532 drug-susceptible TB patients were included (intermittent n = 247; daily n = 285). The daily group had a higher mean age and a greater proportion of HIV-positive and diabetic patients (p < 0.05). Treatment success rates were comparable between the two groups (87.85% vs. 87.37%; p = 0.850), with no significant association observed in the adjusted analyses (aOR = 1.23 [0.69-2.18]; p = 0.494). Among 327 patients with adverse event data available (61.47%), reported adverse events were more frequent in the daily group (100.00% vs. 84.38%; p < 0.001), particularly nausea/vomiting/fatigue/fever (aOR = 3.03; 95% CI: 1.69-5.55) and itching (aOR = 2.07; 95% CI: 1.27-3.41); however, these findings were based on a subset of participants and may be subject to recall and reporting bias. CONCLUSION: Intermittent and daily continuation-phase regimens showed comparable treatment success in this observational study. Among participants with available adverse event data, daily dosing was associated with more frequently reported adverse events; however, causal inference could not be made due to non-random regimen allocation, baseline differences between groups, incomplete ascertainment of adverse events, and potential recall and reporting bias. These findings suggest the potential importance of routine tolerability monitoring and targeted patient support in programmatic TB care, though confirmation from multicenter prospective studies is needed given the single-center design and incomplete adverse event ascertainment. CLINICAL TRIAL REGISTRATION: Clinical trial number: not applicable.
Evaluation of pediatric patients diagnosed with psoas abscess over the last 20 years in a tertiary care hospital in Türkiye.
Çetin FT, Çay Ü, Kaya Ö … +8 more , Özesen DÖ, Kundakçı B, Ünal A, Oğuz G, Başargan G, Gündeşlioğlu ÖÖ, Alabaz D, Totik N
BMC Infect Dis · 2026 Jul · PMID 42401839 · Full text
INTRODUCTION: Psoas abscess is rare in children. Its nonspecific clinical presentation poses diagnostic challenges. This study aimed to evaluate the clinical and demographic characteristics, as well as the diagnostic and...
INTRODUCTION: Psoas abscess is rare in children. Its nonspecific clinical presentation poses diagnostic challenges. This study aimed to evaluate the clinical and demographic characteristics, as well as the diagnostic and therapeutic processes, of 28 pediatric patients diagnosed with psoas abscess, and to provide a broader perspective for the literature. MATERIALS AND METHODS: The records of 28 patients treated at a tertiary care hospital between January 1, 2005, and December 1, 2025, were reviewed. Age at admission, presenting complaints, clinical and radiological findings, and treatment regimens were analyzed retrospectively. RESULTS: A total of 28 pediatric patients were included over 20 years. The male-to-female ratio was 1:1. Nine patients (32.1%) were younger than 5 years of age. An underlying condition was identified in 18 patients (64.3%). Hip pain was one of the most common findings and was present in all primary cases. Fever was observed more frequently in secondary cases (54.5%) than in primary cases (16.7%). The most commonly identified microorganisms in cultures were gram-positive pathogens, particularly Staphylococcus species. The median length of hospital stay was 38 (21.0-57.5) days. Surgical intervention was performed in 19 patients (67.9%). No mortality was observed. DISCUSSION: Psoas abscess is a rare but serious infection that typically presents with nonspecific symptoms. A high index of suspicion is required for diagnosis. Early initiation of antibiotic therapy and timely drainage are among the most important factors influencing prognosis. There are limited studies on this condition in children, and we believe that our study will contribute to the existing literature.
Chronic refractory ulcer caused by Edwardsiella tarda: a case report and literature review.
Gu Q, Ma D, Wu Y … +3 more , Wu W, Zou J, Zhang C
BMC Infect Dis · 2026 Jul · PMID 42401817 · Full text
BACKGROUND: Post-traumatic Edwardsiella tarda (E. tarda) infections usually have an acute course. Chronic infection is rare. We report a chronic refractory ulcer caused by E. tarda after a freshwater stingray injury. CAS...
BACKGROUND: Post-traumatic Edwardsiella tarda (E. tarda) infections usually have an acute course. Chronic infection is rare. We report a chronic refractory ulcer caused by E. tarda after a freshwater stingray injury. CASE PRESENTATION: A previously healthy 32-year-old male diver sustained a stingray barb puncture wound to the right knee. The wound remained inflamed despite initial treatment and progressed to a deep ulcer with an 8-cm sinus tract. Bacterial culture confirmed E. tarda. Treatment included repeated surgical debridement, negative pressure wound therapy, and intravenous cefuroxime sodium based on susceptibility testing. The wound healed completely after three months, leaving a linear hypertrophic scar. CONCLUSIONS: E. tarda infection should be considered in aquatic animal-related wounds, even in immunocompetent patients. Early pathogen identification, thorough debridement, and targeted antimicrobial therapy are essential. CLINICAL TRIAL NUMBER: Not applicable.
Cytomegalovirus enteritis in a patient with AKI after type B aortic dissection surgery: a case report.
Ge T, Qiu J, Wang Z … +6 more , Zuo H, Zhou K, Yu C, Huang H, Sun T, Xiao Y
BMC Infect Dis · 2026 Jul · PMID 42401812 · Full text
BACKGROUND: Cytomegalovirus (CMV) enteritis is an uncommon clinical entity that frequently predisposes to severe complications, such as gastrointestinal (GI) hemorrhage and perforation, and is associated with substantial...
BACKGROUND: Cytomegalovirus (CMV) enteritis is an uncommon clinical entity that frequently predisposes to severe complications, such as gastrointestinal (GI) hemorrhage and perforation, and is associated with substantial mortality. CASE PRESENTATION: We herein present the management of a case of CMV enteritis in a patient with "relative immunosuppression". The patient had a prior history of abdominal aortic replacement and bypass surgery for a type B aortic dissection, following which he developed acute kidney injury (AKI) stage 3 according to KDIGO guidelines. Approximately five weeks after the operation, he presented with massive gastrointestinal hemorrhage and was subsequently diagnosed with CMV enteritis. Treatment included exploratory laparotomy and antiviral therapy with ganciclovir combined with intravenous immunoglobulin, culminating in a successful recovery. CONCLUSION: This case suggests that post-surgical AKI and stress-induced relative immunosuppression may be contributing factors for CMV enteritis in patients without traditional immunocompromise. CT imaging was valuable for early detection of small bowel bleeding in this patient. Prompt surgical intervention may be life-saving for CMV enteritis with life-threatening hemorrhage, providing essential pathological confirmation, while antiviral therapy remains first-line. CLINICAL TRIAL NUMBER: Not applicable.
Enrichment of the high-risk ST131 clone among ciprofloxacin-resistant Escherichia coli in a single-center cohort from Turkey: a molecular surveillance study.
Rakici E, Ozcan M, Ejder N … +2 more , Ari O, Ozgumus OB
BMC Infect Dis · 2026 Jul · PMID 42399835 · Full text
Background Fluoroquinolone resistance in Escherichia coli is increasingly associated with the dissemination of high-risk lineages such as ST131. However, data integrating resistance phenotypes with molecular characterist...
Background Fluoroquinolone resistance in Escherichia coli is increasingly associated with the dissemination of high-risk lineages such as ST131. However, data integrating resistance phenotypes with molecular characteristics remain limited in local clinical settings. This study aimed to describe the distribution of ST131 and associated resistance determinants in a single-center cohort.Methods We analyzed 90 non-duplicate clinical E. coli isolates collected at a tertiary-care hospital in Turkey. Fluoroquinolone resistance was assessed using ciprofloxacin and pefloxacin. Molecular assays targeted phylogenetic groups, ST131 (including H30-Rx), ESBL genes (bla with group assignment), plasmid-mediated quinolone resistance (PMQR) markers, and selected virulence genes. ERIC-PCR was used for genotyping and clustering. Comparative analyses were performed between ciprofloxacin-resistant and -susceptible isolates using appropriate categorical and non-parametric tests.Results Ciprofloxacin resistance was detected in 35/90 isolates (38.9%). Overall, presumptive ST131 (PCR-defined) was identified in 10/90 isolates (11.1%) and was strongly enriched among ciprofloxacin-resistant isolates (25.7% vs. 1.8%, p < 0.001); H30-Rx was also more frequent in ciprofloxacin-resistant isolates (14.3% vs. 1.8%, p = 0.031). CTX-M was detected in 31/90 isolates (34.4%) and was significantly associated with ciprofloxacin resistance (65.7% vs. 14.5%, p < 0.001). Among CTX-M-positive isolates (n = 31), group 1 predominated (87.1%), followed by group 2 (41.9%) and group 9 (6.5%); group 1 + 2 co-detection occurred in 38.7%, and 6.5% remained untypeable. PMQR markers included qnrS (11.1%), qnrB (4.4%), and aac(6')-Ib-cr (8.9%). Phylogroup B2 was dominant (76.7%). ERIC-PCR identified 59 profiles with high diversity (Simpson's index 0.9898); 60.0% of isolates belonged to clusters (largest cluster n = 4), indicating high fingerprint diversity inconsistent with a single dominant outbreak clone.Conclusion Presumptive ST131 isolates were enriched among ciprofloxacin-resistant E. coli in this single-center cohort. These findings reflect local molecular surveillance patterns rather than population-level prevalence. The high ERIC-PCR diversity suggests multiple lineages rather than a single outbreak clone, underscoring the need for sustained molecular surveillance and antimicrobial stewardship.
Association between clinical symptoms and time to pharyngeal PCR negativity among mild omicron COVID-19 patients: a retrospective study.
Feng H, Hong X, Qiu S … +3 more , Ma S, Zhou C, Huang Y
BMC Infect Dis · 2026 Jul · PMID 42399833 · Full text
BACKGROUND: The time to pharyngeal polymerase chain reaction (PCR) negativity (TPCRN) in patients with coronavirus disease 2019 (COVID-19) is influenced by multiple factors. This study aimed to investigate the associatio...
BACKGROUND: The time to pharyngeal polymerase chain reaction (PCR) negativity (TPCRN) in patients with coronavirus disease 2019 (COVID-19) is influenced by multiple factors. This study aimed to investigate the association between clinical symptoms of COVID-19 patients and TPCRN. METHODS: This retrospective study enrolled 486 participants with COVID-19, aged 18-89 years, who were admitted to Shanghai Lingang Makeshift Hospital between April 10, 2022, and May 20, 2022. Clinical data, including patient demographics, clinical symptoms, and TPCRN, were collected and analyzed. RESULTS: This study enrolled COVID-19 patients with a median age of 38 years, consisting of 66.05% males and 33.95% females. Stepwise (forward selection) analyses revealed a positive association between TPCRN and the clinical symptoms of throat pain (B = 1.277, 95% CI = 0.592-1.962, P < 0.001) and diarrhea (B = 1.445, 95% CI = 0.382-2.508, P = 0.008) in COVID-19 patients. Logistic regression analysis indicated that throat pain was associated with a lower 7-day negative nucleic acid conversion rate (OR = 0.584, 95% CI:0.362-0.943, P = 0.028), as was diarrhea (OR = 0.435, 95% CI:0.220-0.860, P = 0.017). CONCLUSION: Our findings indicate that throat pain and diarrhea are associated with a longer time to pharyngeal polymerase chain reaction (PCR) negativity. These results may assist in identifying high-risk patients with delayed viral clearance and provide a reference for optimizing clinical management strategies for this patient population. CLINICAL TRIAL NUMBER: Not applicable.
Prevalence and socio-demographic factors associated with transfusion transmissible infections among voluntary blood donors in Kigali, Rwanda.
Uwumuryango P, Sebera E, Gashaija C … +2 more , Gasana J, Andegiorgish AK
BMC Infect Dis · 2026 Jul · PMID 42399831 · Full text
BACKGROUND: Transfusion transmissible infections (TTIs) such as Human Immunodeficiency Virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and syphilis, remain a major public health concern in low-income count...
BACKGROUND: Transfusion transmissible infections (TTIs) such as Human Immunodeficiency Virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and syphilis, remain a major public health concern in low-income countries due to inadequate blood donation systems. This highlights the urgent need for continuous surveillance and a deeper understanding of the factors associated with TTIs in Rwanda. METHODS: A retrospective cross-sectional study analyzed voluntary blood donor records from the National Center for Blood Transfusion (NCBT) in Kigali, Rwanda, spanning January 2019 to December 2023. A census of all available records was used to select 38,345 eligible donors aged 18-60 years. Data were extracted from electronic databases and analyzed using SPSS version 25, with chi-square tests and multivariate logistic regression to identify predictors of transfusion-transmissible infections. RESULTS: The overall prevalence of transfusion-transmissible infections declined from 2019 to 2023, with HBV decreasing from 0.76% to 0.41%, HCV from 0.30% to 0.18%, HIV remaining stable at 0.04%-0.08%, and syphilis slightly increasing to 0.26%. Multivariate analysis showed that male gender was independently associated with HBV (aOR = 2.60, 95% CI: 1.54-4.38, p < 0.001) and HIV (aOR = 3.84, 95% CI: 1.63-9.05, p = 0.002). First-time donor status was independently associated with higher odds of HBV (aOR = 4.09, 95% CI: 2.26-7.39, p < 0.001) and HIV (aOR = 2.95, 95% CI: 0.77-11.34, p < 0.001). Gasabo district was independently associated with lower odds of HBV (aOR = 0.56, 95% CI: 0.34-0.90, p = 0.017) and higher odds of HCV (aOR = 2.34, 95% CI: 1.25-4.40, p = 0.008), relative to Nyarugenge. CONCLUSION: TTI prevalence among Kigali blood donors remained low with declining HBV and HCV trends from 2019 to 2023, while HIV rates stayed consistently low. Male gender, older age, first-time donor status, and specific occupations were independently associated with TTI positivity. Rwanda's blood screening protocols appear effective, though targeted interventions for high-risk groups and continued surveillance are recommended. CLINICAL TRIAL NUMBER: Not applicable.
Letter to the editor regarding clinical characteristics and factors associated with in-hospital post-surgical mortality in COVID-19 patients at a tertiary care center in Karachi, Pakistan.
Rizwan Qayyum R
BMC Infect Dis · 2026 Jul · PMID 42399818 · Full text
A comment on Wagley et al.'s study of post-surgical outcomes in COVID-19 patients in Karachi, highlighting the importance of incorporating COVID-19 severity, timing of surgery, and maternal/fetal outcomes. These consider...
A comment on Wagley et al.'s study of post-surgical outcomes in COVID-19 patients in Karachi, highlighting the importance of incorporating COVID-19 severity, timing of surgery, and maternal/fetal outcomes. These considerations can improve perioperative risk assessment and inform resource allocation in low- and middle-income countries.
A case of Kocuria varians-induced cervical spondylodiscitis with suspected acupuncture-related infection: review and discussion.
Chen L, Zhang T, Chen XY … +2 more , Wang YZ, Li SK
BMC Infect Dis · 2026 Jul · PMID 42399811 · Full text
In this article, a case of cervical spondylitis caused by Kocuria varians is reported, which has not been previously documented in clinical literature regarding cervical infections attributed to this bacterium. A review...
In this article, a case of cervical spondylitis caused by Kocuria varians is reported, which has not been previously documented in clinical literature regarding cervical infections attributed to this bacterium. A review of the patient's medical history revealed prior acupuncture treatment in the cervical and shoulder regions before symptom onset. Despite this, there is no conclusive evidence linking the acupuncture to the infection. The patient ultimately required surgical intervention due to exacerbation of the condition and the manifestation of spinal cord injury symptoms.
Preventive effectiveness of respiratory syncytial virus vaccination in older adults: a multi-institutional cohort study.
Chao CM, Tsai YW, Zhang B … +2 more , Lai CC, Tan CK
BMC Infect Dis · 2026 Jul · PMID 42399810 · Full text
BACKGROUND: This multi-institutional study evaluated the real-world effectiveness of respiratory syncytial virus (RSV) vaccination in preventing RSV infections among adults aged 50 and older. METHODS: Using data from the...
BACKGROUND: This multi-institutional study evaluated the real-world effectiveness of respiratory syncytial virus (RSV) vaccination in preventing RSV infections among adults aged 50 and older. METHODS: Using data from the TriNetX Research Network, we included individuals aged ≥ 50 years between January 1, 2023, and May 31, 2026. Patients were categorized into vaccinated and unvaccinated groups, defined as those receiving any RSV vaccine and any non-RSV vaccine, respectively. After 1:1 propensity score matching, we estimated hazard ratios (HR) for the composite outcome of RSV infection using Cox proportional-hazards models. RESULTS: The study included 179,871 patients in each group after matching. The vaccinated group had a lower risk of RSV infection compared to the unvaccinated group (incidence rate: 0.17 vs. 0.27 per 100 person-years, HR, 0.65; 95% CI, 0.58-0.73). Additionally, the vaccinated group showed lower risks of RSV-associated lower respiratory tract disease (incidence rate: 0.12 vs. 0.19 per 100 person-years, HR, 0.69; 95% CI, 0.60-0.79). Risk reductions were consistent across subgroups defined by age, sex, and comorbidity. CONCLUSIONS: This large real-world study demonstrates the substantial effectiveness of RSV vaccination in preventing infections among older adults, a high-risk population. CLINICAL TRIAL NUMBER: Not applicable.
Prevalence and factors associated with hepatitis B serostatus disclosure among adults receiving care at Hawassa University Comprehensive Specialized Hospital, southern Ethiopia: a cross-sectional study.
Woldegeorgis BZ, Ekubazgi KW, Urgesa EA
BMC Infect Dis · 2026 Jul · PMID 42399789 · Full text
BACKGROUND: Hepatitis B virus (HBV) infection is a globally prevalent disease and remains a significant public health burden. In Ethiopia, where HBV is endemic, it is a major contributor to chronic liver disease and live...
BACKGROUND: Hepatitis B virus (HBV) infection is a globally prevalent disease and remains a significant public health burden. In Ethiopia, where HBV is endemic, it is a major contributor to chronic liver disease and liver-related mortality. Timely disclosure of serostatus is crucial for preventing intra-family transmission, facilitating contact tracing and vaccination, promoting adherence to follow-up and antiviral therapy, and improving the physical and psychosocial well-being of affected individuals. Therefore, this study aimed to assess the prevalence of HBV serostatus disclosure and identify factors associated with disclosure among adults receiving care at the Gastroenterology clinic of Hawassa University Comprehensive Specialized Hospital. METHODS: An institution-based analytical cross-sectional study was conducted from July 20 to September 30, 2025, to enroll all eligible participants. Data were collected via interviewer-administered, semi-structured questionnaires supplemented by a data abstraction sheet, and analyzed using STATA version 16.1. Poisson regression with robust variance estimation identified factors associated with HBV serostatus disclosure; results were presented as adjusted prevalence ratios (aPR) with 95% confidence intervals (CI), and statistical significance was set at P < 0.05. RESULTS: Of the 245 participants, 171 (69.8%) were male, and the median age was 34 years (interquartile range: 26-45 years). Overall, 46.5% of participants (95% CI: 40.3-52.8%) disclosed their HBV serostatus to at least one contact. Factors independently associated with HBV serostatus disclosure included being female (aPR = 1.46; 95% CI: 1.07-2.00), being ever married (aPR = 1.80; 95% CI: 1.21-2.68), living with chronic HBV for more than five years (aPR = 1.25; 95% CI: 1.11-1.96), having no comorbidities (aPR = 3.24; 95% CI: 1.43-5.39), having normal liver status (aPR = 1.31; 95% CI: 1.00-1.72), and having a higher HBV knowledge score (aPR = 1.07; 95% CI: 1.03-1.12). CONCLUSIONS: The findings indicated that HBV serostatus disclosure was low when compared to other African settings. Disclosure was driven by female gender, being ever married, longer duration of HBV diagnosis, absence of comorbidities, normal liver status and higher HBV knowledge. While the study provided valuable insights into the dynamics of disclosure, its cross-sectional design meant that definitive causal relationships could not be established. CLINICAL TRIAL NUMBER: Not applicable.
DDIT4 upregulation associates with gammadelta T Cells dysfunction in ART-suppressed people living with HIV-1.
Wang H, Ren Z, Wang X … +10 more , Wang R, Sun J, Wang R, Lu X, Jiang T, Zhang X, Dai L, Zhang T, Su B, Li Z
BMC Infect Dis · 2026 Jul · PMID 42399768 · Full text
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Antimicrobial resistance and associated risk factors in urinary tract infections diagnosed in the emergency department: a retrospective observational study.
Açıkalın Arıkan B, Kotanak M, Çalışkan Pala S … +2 more , Arıkan C, Köse Ş
BMC Infect Dis · 2026 Jul · PMID 42393598 · Full text
BACKGROUND: Urinary tract infections (UTIs) are among the most common causes of emergency department admissions and represent a major source of antimicrobial use worldwide. The aim of this study was to determine antimicr...
BACKGROUND: Urinary tract infections (UTIs) are among the most common causes of emergency department admissions and represent a major source of antimicrobial use worldwide. The aim of this study was to determine antimicrobial resistance patterns and associated risk factors among patients diagnosed with UTIs in the emergency department. METHODS: This retrospective observational study included 1,042 adult patients diagnosed with UTIs in the ED of a tertiary referral hospital. Demographic characteristics, clinical findings, urine culture results, antimicrobial susceptibility profiles, and resistance-associated risk factors were analyzed. RESULTS: Gram-negative bacteria accounted for 74.6% of isolates, with Escherichia coli (43.1%) and Klebsiella spp. (22.3%) being the predominant pathogens. High resistance rates were observed for ciprofloxacin (47.6%), ceftriaxone (47.0%), and trimethoprim-sulfamethoxazole (41.3%). ESBL production and carbapenem resistance were detected in 16.9% and 17.9% of Gram-negative isolates, respectively. Recent antibiotic use, indwelling urinary catheterization, and malignancy were identified as independent risk factors for ESBL positivity. Male sex, malignancy, and indwelling urinary catheterization were independently associated with carbapenem resistance. Among Enterococcus spp. isolates, vancomycin resistance remained very low (0.9%), whereas ampicillin resistance was detected in 23.7% of isolates. CONCLUSIONS: These findings underscore the critical importance of incorporating local resistance surveillance into empirical treatment decisions, adopting individualized therapeutic approaches, and strengthening antimicrobial stewardship programs in emergency departments.
Antiretroviral therapy use and CD4 cell count among people who inject drugs living with HIV in southern Vietnam.
Thanh DC, Boettiger DC, Abdul-Quader A … +2 more , Thanh Ha HT, Thang PH
BMC Infect Dis · 2026 Jul · PMID 42393594 · Full text
OBJECTIVES: People who inject drugs (PWID) are central to the HIV epidemic in Vietnam, many delay HIV testing and antiretroviral therapy (ART) until advanced disease. We assessed prevalence and correlates of ART use and...
OBJECTIVES: People who inject drugs (PWID) are central to the HIV epidemic in Vietnam, many delay HIV testing and antiretroviral therapy (ART) until advanced disease. We assessed prevalence and correlates of ART use and low CD4 counts among PWID with HIV. SETTING: Analysis of the 2013 Integrated Behavioral and Biologic Survey in Vietnam. METHODS: Eligible participants were men aged ≥ 18 years who reported recent injecting, were HIV positive, and consented to future viral load (VL) and CD4 testing. Undetectable VL was defined as < 50 copies/ml. Percentages and prevalences were adjusted for sampling method. RESULTS: Of 287 PWID, 55% knew their status. Among these, 88% were on ART, and 82% had undetectable VL. ART use was positively associated with older age (> 40 vs. < 30 years, OR 4.9, 95% CI 1.2-20.5) and opioid substitution therapy (OR 12.7, 95% CI 1.1-141.7). It was negatively associated with living alone (OR 0.1, 95% CI 0.0-0.5), living with a partner versus relatives (OR 0.3, 95% CI 0.1-0.8), higher income (> VND 4.5 vs. < 2.5 million; OR 0.2, 95% CI 0.1-0.7), and recent rehabilitation (OR 0.2, 95% CI 0.1-0.8). Among those not on ART, 16% had CD4 < 200 cells/mm³; longer injecting duration was strongly associated (OR 6.3 for > 10 vs. < 5 years, 95% CI 1.5-27.3). CONCLUSIONS: Suboptimal HIV status awareness, ART uptake, and advanced immunosuppression among untreated PWID highlight the need for strengthened case finding and earlier engagement. Linking treatment, social support, and HIV services in closed settings could improve outcomes.
Optimizing COVID-19 vaccination for older adults: superior efficacy of heterologous regimens in reducing infection and mortality rates among patients aged 80 years and older during the Omicron BA.5/BF.7 outbreak.
Qiu S, Chen Y, Sheng A … +3 more , Shen B, He S, Zheng Y
BMC Infect Dis · 2026 Jul · PMID 42393578 · Full text
BACKGROUND: Following the adjustment of COVID-19 control policies in mainland China, particularly during the Omicron BA.5 and BF.7 waves, evaluating vaccine effectiveness in individuals aged ≥ 80 years is of critical imp...
BACKGROUND: Following the adjustment of COVID-19 control policies in mainland China, particularly during the Omicron BA.5 and BF.7 waves, evaluating vaccine effectiveness in individuals aged ≥ 80 years is of critical importance. PATIENTS AND METHODS: This retrospective study included 2,325 hospitalized patients aged 80 years and older from four hospitals between December 9, 2022, and January 27, 2023. We assessed the associations of vaccination dose, vaccination regimen, and the interval since the last vaccination with SARS-CoV-2 infection and mortality. Univariable and multivariable logistic regression analyses were performed to adjust for baseline imbalances across vaccination groups. An exploratory NAb analysis was conducted in 138 patients with paired serum samples at admission and discharge to evaluate immune responses associated with different vaccination strategies. RESULTS: In the unadjusted analyses, SARS-CoV-2 infection and mortality rates decreased with increasing vaccine doses. After adjustment for age, diabetes, and hyperlipidemia, receipt of 1, 2, and 3 vaccine doses was associated with lower odds of SARS-CoV-2 infection compared with no vaccination, with adjusted ORs of 0.644 (95% CI: 0.445-0.931, P = 0.019), 0.579 (95% CI: 0.407-0.823, P = 0.002), and 0.448 (95% CI: 0.332-0.607, P < 0.001), respectively. Three-dose vaccination was also associated with lower odds of mortality (OR = 0.563, 95% CI: 0.380-0.835, P = 0.004). In the regimen-based model, CoronaVac plus ZF2001 was associated with lower odds of infection (OR = 0.456, 95% CI: 0.235-0.885, P = 0.020) and mortality (OR = 0.410, 95% CI: 0.123-0.878, P = 0.047) after adjustment. In the exploratory NAb subgroup analysis, patients receiving CoronaVac plus ZF2001 showed higher NAb levels at both admission and discharge. CONCLUSIONS: During the Omicron BA.5/BF.7 wave, receipt of three COVID-19 vaccine doses was associated with lower risks of SARS-CoV-2 infection and mortality among hospitalized patients aged 80 years and older. The heterologous regimen of CoronaVac plus ZF2001 was associated with lower risks of infection and mortality and higher NAb levels. These findings support the potential value of optimized booster and heterologous vaccination strategies for improving COVID-19-related outcomes in this high-risk older population. CLINICAL TRIAL: N/A.
Malaria transmission dynamics, vector diversity, and insecticide resistance profiles in two health districts of southern Benin.
Agonhossou R, Akoton R, Koukpo ZC … +14 more , Ahouandjinou MJ, Zinsou JF, Honkpéhèdji YJ, Adegnika OS, Osse R, Padonou GG, Boussougou-Sambe TS, Mbama Ntabi JD, Lissom A, Nkemngo FN, Ntoumi F, Wondji CS, Borrmann S, Adegnika AA
BMC Infect Dis · 2026 Jul · PMID 42393571 · Full text
BACKGROUND: Malaria transmission in Benin is heterogeneous, influenced by ecological settings and environmental changes affecting Plasmodium spp. prevalence, vector species composition, and insecticide resistance. Compre...
BACKGROUND: Malaria transmission in Benin is heterogeneous, influenced by ecological settings and environmental changes affecting Plasmodium spp. prevalence, vector species composition, and insecticide resistance. Comprehensive local data on transmission dynamics remain limited, particularly in southern Benin. This study assessed malaria transmission, vector diversity, and insecticide resistance in two health districts to support the National Malaria Control Programme in designing targeted and effective vector control strategies. METHODS: A repeated cross-sectional study was conducted in two health districts in southern Benin (Ouidah-Kpomasse-Tori Bossito (OKT) and Adjohoun-Bonou-Dangbo (ABD) districts). In OKT, blood samples were collected from August 2021 to August 2022, while in ABD sampling was conducted from July to November 2024. Human participants were screened for Plasmodium infections using microscopy and rapid diagnostic tests. Adult Anopheles mosquitoes were collected in both districts during rainy and dry seasons using human landing catches. Mosquitoes were morphologically and molecularly identified and screened for Plasmodium spp. Insecticide resistance was assessed through detection of kdr (L1014F) and ace-1 (G119S) mutations, and bioassays with pyrethroids (alpha-cypermethrin and deltamethrin) and synergists (PBO). RESULTS: A total of 1,962 participants were enrolled (OKT 1,577; ABD 385). Overall Plasmodium prevalence was 28.2% in OKT and 21.0% in ABD, with higher prevalence during the rainy season compared to the dry season in OKT (37.0% vs. 20.9%, p < 0.0001). Anopheles gambiae s.l. was the predominant species complex, with seasonal shifts in species composition determined molecularly; An. gambiae s.s. dominating in the rainy season (80.0% in OKT, 54% in ABD), while An. coluzzii predominated in the dry season (92.5% in OKT, 98.3% in ABD). High frequencies of kdr L1014F mutations were detected (0.62-0.93), whereas ace-1 resistance remained low (≤0.13). Plasmodium infection in mosquitoes was rare (<2%), and blood meals showed strong anthropophagy (97.8%). PBO bioassays indicated partial restoration of susceptibility to deltamethrin and alpha-cypermethrin. CONCLUSIONS: Malaria transmission in southern Benin remains sustained by high seasonal prevalence in humans, intense human-vector contact, and widespread pyrethroid resistance in vectors. Seasonal and spatial heterogeneity in vector species composition and resistance profiles highlight the need for adaptive, locally tailored control strategies, including monitoring and management of insecticide resistance. CLINICAL TRIAL REGISTRATION: Not applicable.
Analysis of the pathogen spectrum and epidemiological characteristics of hospitalized children with pneumonia from 2017 to 2024.
Xie J, Xia Z, Liu J … +4 more , Xiao T, Lin X, Wu B, Zhang X
BMC Infect Dis · 2026 Jul · PMID 42393562 · Full text
BACKGROUND: Pneumonia remains a leading cause of hospitalization and morbidity among children worldwide. While the pathogen spectrum and epidemiological patterns of pediatric pneumonia are known to vary by region and ove...
BACKGROUND: Pneumonia remains a leading cause of hospitalization and morbidity among children worldwide. While the pathogen spectrum and epidemiological patterns of pediatric pneumonia are known to vary by region and over time, there is a need for updated, comprehensive data to inform clinical management and public health strategies, particularly given the dynamic nature of respiratory pathogens and evolving diagnostic capabilities. This study aimed to analyze the contemporary pathogen spectrum and epidemiological characteristics of hospitalized children with pneumonia. METHODS: A total of 2,878 children with pneumonia were retrospectively analyzed. Seven common respiratory pathogens [Mycoplasma pneumoniae (MP), Chlamydophila pneumoniae (CP), Legionella pneumophila (LP), Respiratory syncytial virus (RSV), Influenza A virus (IFA), Influenza B virus (IFB), Streptococcus pneumoniae (SP)] were detected using nucleic acid testing, antibody assays, and culture. Differences in distribution across different genders, ages, and seasons were compared. RESULTS: The overall pathogen detection rate was 52.05% (1498/2878). MP was the dominant pathogen (42.39%), followed by IFB (17.23%) and IFA (11.71%). School-aged children had the highest positive rate (62.20%, 1790/2878). MP and IFB peaked in winter, whereas IFA was most common in spring. Mixed infections accounted for 18.49% of all cases, with combinations involving MP and influenza viruses being the most common. CONCLUSIONS: The pathogen spectrum in pediatric pneumonia is primarily dominated by MP and influenza virus, with their distribution exhibiting marked variations according to age and season. Differentiated intervention strategies should be formulated in accordance with these epidemiological characteristics.
Multiple recurrences of Talaromyces marneffei infection with HLH in an HIV-negative patient: a case report.
Zhu L, Liu Y, Tao R … +1 more , You L
BMC Infect Dis · 2026 Jul · PMID 42393556 · Full text
BACKGROUND: Talaromycosis complicated by hemophagocytic lymphohistiocytosis (HLH) is a life-threatening condition associated with high mortality, yet the management of recurrent disease in HIV-negative patients is not we...
BACKGROUND: Talaromycosis complicated by hemophagocytic lymphohistiocytosis (HLH) is a life-threatening condition associated with high mortality, yet the management of recurrent disease in HIV-negative patients is not well defined. CASE PRESENTATION: We report a 49-year-old man who presented with fever, lymphadenopathy, and an uncommon ulcerative scalp lesion that has been poorly documented in HIV-negative talaromycosis. Talaromyces marneffei (T. marneffei) infection was confirmed by blood culture, and HLH was subsequently diagnosed. Initial induction therapy with amphotericin B deoxycholate (AmB-D) followed by itraconazole (ITZ) maintenance resulted in clinical improvement; however, the patient experienced multiple recurrences over three years, including a recurrence while on ITZ. Immunological evaluation later revealed positive anti-interferon-γ autoantibodies (AIGA). Re-induction with liposomal amphotericin B (L-AmB) followed by maintenance posaconazole (PCZ) resulted in short-term remission, with no recurrence during three months of follow-up. CONCLUSIONS: This case demonstrates the successful management of recurrent talaromycosis with L-AmB induction followed by PCZ maintenance in an HIV-negative patient with AIGA-associated immunodeficiency presenting with initial HLH, highlighting the importance of early diagnosis, individualized antifungal strategies, and the potential utility of PCZ as maintenance therapy in high-risk patients.
Clinical characteristics, causative organisms, and antimicrobial resistance profiles of hospital-acquired invasive gram-negative bacterial infections at a tertiary-care center in Saudi Arabia: a five-year retrospective cohort study (2020-2024).
Awadh AA, Alshokani AA, Ezzaddin AO … +5 more , Bintalib AF, Alwafi MT, Alghamdi AA, Samkri SF, Khan MA
BMC Infect Dis · 2026 Jul · PMID 42393552 · Full text
BACKGROUND: Hospital-acquired gram-negative bacterial (HA-GNB) infections are a leading cause of nosocomial morbidity and mortality, yet local epidemiological data to guide empirical therapy remain limited. METHODS: We c...
BACKGROUND: Hospital-acquired gram-negative bacterial (HA-GNB) infections are a leading cause of nosocomial morbidity and mortality, yet local epidemiological data to guide empirical therapy remain limited. METHODS: We conducted a retrospective cohort study of 377 adult patients with culture-confirmed invasive gram-negative infection acquired ≥ 48 h after admission to King Abdulaziz Medical City (KAMC), Jeddah, Saudi Arabia (2020-2024). Demographics, comorbidities, infection type, microbiology, susceptibility, complications, and outcomes were analyzed using chi-square/Fisher's exact tests and t-tests/Mann-Whitney U tests; multivariable logistic regression was used to identify independent predictors of multidrug-resistant (MDR) infection and in-hospital mortality. Infection types were classified according to U.S. Centers for Disease Control and Prevention / National Healthcare Safety Network (CDC/NHSN) surveillance definitions. RESULTS: Mean age was 64.6 ± 17.7 years (59.4% male). Hypertension (61.0%), diabetes (54.6%), and cardiovascular disease (40.8%) were the commonest comorbidities. Pneumonia predominated (47.1%), followed by bloodstream infection (33.0%), surgical-site infection (15.7%), and ventilator-associated pneumonia (9.6%). Klebsiella pneumoniae (41.9%), Pseudomonas aeruginosa (34.0%), and Escherichia coli (15.4%) were the predominant pathogens. Resistance was highest for ciprofloxacin (44.4%), ceftazidime (40.2%), and cefepime (39.9%), and 34.3% for meropenem. Overall morbidity was 68.6% and mortality 39.9%. Mortality was significantly higher in patients with cardiovascular disease (48.8% vs. 34.3%, p = 0.011), hypertension (45.4% vs. 31.5%, p = 0.015), and COPD (100.0% vs. 39.2%, p = 0.025). Diabetes was strongly associated with multidrug-resistant infection (OR 3.60, 95% CI 1.44-9.04; p = 0.004) and remained an independent predictor in multivariable logistic regression adjusting for age, sex, cardiovascular disease, and pneumonia (adjusted OR 2.82, 95% CI 1.11-7.17). CONCLUSIONS: HA-GNB infections at this Saudi tertiary center are dominated by K. pneumoniae and P. aeruginosa, carry a roughly two-in-five case fatality, and show worrying resistance to commonly used empirical agents. Within the constraints of a single-center, retrospective design, these findings support local antibiogram-informed review of empirical protocols, continued antimicrobial stewardship, and heightened infection-control attention to high-risk subgroups, particularly patients with diabetes and cardiopulmonary comorbidities; confirmation in prospective, multi-center studies is warranted.
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