Journal of Infection and Public Health最新文献

{"title":"Corrigendum to “Antimicrobial resistance and epidemiological patterns of Streptococcus pyogenes in Türkiye” [J Infect Public Health (2025) Article Number: 102633]","authors":"Nihan Ünübol , Nese Caglayan , Sinan Cebeci , Yeşim Beşli , Banu Sancak , Neval Yurttutan Uyar , Siavosh Salmanzadeh Ahrabi , Masoud Alebouyeh , Tanıl Kocagöz","doi":"10.1016/j.jiph.2025.102977","DOIUrl":"10.1016/j.jiph.2025.102977","url":null,"abstract":"","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 12","pages":"Article 102977"},"PeriodicalIF":4.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dengue virus infection: A systematic review of pathogenesis, diagnosis and management","authors":"Zih-Syuan Yang ,&nbsp;Albright Dew Baua ,&nbsp;Mahmoud Salama Hemdan ,&nbsp;Wanchai Assavalapsakul ,&nbsp;Wen-Hung Wang ,&nbsp;Chun-Yu Lin ,&nbsp;Day-Yu Chao ,&nbsp;Yen-Hsu Chen ,&nbsp;Sheng-Fan Wang","doi":"10.1016/j.jiph.2025.102982","DOIUrl":"10.1016/j.jiph.2025.102982","url":null,"abstract":"<div><div>Dengue fever (DF), caused by the dengue virus (DENV), remains a significant global health threat. Despite its impact, no specific antiviral treatments exist, and accurate diagnosis is critical for effective management. This review explores DENV pathogenesis, diagnostic approaches, and management strategies. Host-virus interactions, including antibody-dependent enhancement (ADE), cross-reactive memory T cells, and anti-DENV NS1 antibodies, are key factors in disease progression. Viral proteins, such as the envelope (E) and NS1, along with genome variations, contribute to disease severity. Diagnostic methods have evolved from conventional assays to rapid serological assays and point-of-care tests, enhancing early detection. However, clinical management remains supportive, focusing on fluid resuscitation tailored to the patient's clinical status, close monitoring of vital signs, and judicious use of blood products for severe cases. This study suggests that a deeper understanding of DENV pathogenesis, improved diagnostic tools, and the development of effective therapeutics are essential for optimizing dengue management.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 12","pages":"Article 102982"},"PeriodicalIF":4.0,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term effects of HCV eradication on lipid profiles associated with MASLD among people with HIV with advanced fibrosis or cirrhosis","authors":"Ana Virseda-Berdices ,&nbsp;Belen Requena ,&nbsp;Juan Berenguer ,&nbsp;Juan Gónzalez-García ,&nbsp;Carolina Gonzalez-Riano ,&nbsp;Cristina Díez ,&nbsp;Victor Hontañón ,&nbsp;Paula Muñoz-García ,&nbsp;Amanda Fernández-Rodríguez ,&nbsp;Coral Barbas ,&nbsp;Salvador Resino ,&nbsp;Rubén Martín-Escolano ,&nbsp;María Ángeles Jiménez-Sousa ,&nbsp;the Marathon Study Group","doi":"10.1016/j.jiph.2025.102981","DOIUrl":"10.1016/j.jiph.2025.102981","url":null,"abstract":"<div><h3>Background</h3><div>Despite successful hepatitis C virus (HCV) clearance, some individuals continue to experience liver disease progression. Metabolic dysfunction-associated steatotic liver disease (MASLD) may play a key role in this ongoing progression. This study aims to characterize the lipidomic profiles associated with MASLD in individuals coinfected with human immunodeficiency virus (HIV) and HCV with advanced fibrosis or cirrhosis after sustained virologic response (SVR).</div></div><div><h3>Methods</h3><div>We conducted cross-sectional studies in fifty-two HIV/HCV-coinfected individuals. Untargeted lipidomics was performed on plasma samples collected at 1 year and 6 years post-SVR using liquid chromatography-mass spectrometry. The primary outcome was MASLD. Statistical analyses included orthogonal partial least squares discriminant analysis (OPLS-DA) and generalized linear models (GLM), with corrections for multiple comparisons.</div></div><div><h3>Results</h3><div>The prevalence of MASLD was 28.9 % one year after SVR, increasing to 44.8 % six years after SVR. OPLS-DA models identified 225 lipids at 1 year and 167 at 6 years, with a VIP score ≥ 1, distinguishing individuals based on MASLD status. Adjusted GLMs confirmed significant associations between MASLD and 116 lipids at 1 year and 49 at 6 years. At 1 year, most significant lipids were glycerophospholipids (GP), with increased phosphatidylcholines (PC) and phosphatidylethanolamines (PE), and decreased lysophosphatidylcholines (LPC) and lysophosphatidylethanolamines (LPE). By 6 years, LPC was the most abundant differential lipid, while triglycerides increased significantly.</div></div><div><h3>Conclusions</h3><div>MASLD was common during follow-up, with changes in lipidomic profiles over time suggesting ongoing metabolic disturbances that may contribute to liver disease progression despite SVR. These findings highlight the need for long-term metabolic and liver health monitoring after HCV eradication in these individuals.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 12","pages":"Article 102981"},"PeriodicalIF":4.0,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leprosy with dystrophy in twenty nails: Detection of acid-fast bacilli in nail biopsy","authors":"Hendra Gunawan ,&nbsp;Risa Miliawati Nurul Hidayah ,&nbsp;Kartika Ruchiatan ,&nbsp;Yogi Faldian ,&nbsp;Hermin Aminah Usman ,&nbsp;Dwi Bandang Saskia","doi":"10.1016/j.jiph.2025.102980","DOIUrl":"10.1016/j.jiph.2025.102980","url":null,"abstract":"<div><div>Leprosy is a chronic granulomatous infectious disease caused by <em>Mycobacterium leprae</em> (<em>M. leprae</em>) and/or <em>M. lepromatosis</em> that has a wide spectrum of clinical presentations and multi-organ involvement, primarily on the skin and peripheral nerves. Recent studies have addressed the possibility of nail involvement in leprosy, but to this day limited studies have provided histological evidence confirming the presence of acid-fast bacilli (AFB) in the nail apparatus. A case of lepromatous leprosy-related dystrophy in 20 nails in a 37-year-old male was reported. Physical examination revealed, on all 20 nails, discoloration and damage to the entire nail plate in the form of a thickened and rough surface of nail plates with dense subungual debris. AFB from a slit-skin smear were found. A biopsy of the nail bed, nail matrix, and skin lesion on the left lower leg revealed granulomas composed of foam cells, histiocytes, and lymphocytes. Fite stain was positive and found globi of AFB from the nail bed and matrix, confirming direct effect by AFB. The patient showed clinical improvement following multibacillary multidrug therapy. This case highlights the importance of nail biopsy in diagnosing leprosy-related nail dystrophy and the role of histopathology in confirming bacterial infection.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 12","pages":"Article 102980"},"PeriodicalIF":4.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and molecular epidemiology of Streptococcus pneumoniae infections during and in early recovery phase of COVID-19 pandemic in Hong Kong","authors":"Jade L.L. Teng ,&nbsp;Yuanchao Ma ,&nbsp;Anthony R. Tam ,&nbsp;Elaine Chan ,&nbsp;Hwei Huih Lee ,&nbsp;Tsz Tuen Li ,&nbsp;Wing Ho Li ,&nbsp;Jordan Y.H. Fong ,&nbsp;Man Lung Yeung ,&nbsp;Susanna K.P. Lau ,&nbsp;Patrick C.Y. Woo","doi":"10.1016/j.jiph.2025.102976","DOIUrl":"10.1016/j.jiph.2025.102976","url":null,"abstract":"<div><div>The COVID-19 pandemic has given us an unprecedented opportunity to study the clinical and molecular epidemiology of <em>Streptococcus pneumoniae</em> infections during this period, when its incidence was at its record low and started to rise again when social distancing restriction policies were lifted. A total of 64 non-duplicated <em>S. pneumoniae</em> isolates (May/2020–December/2023) from patients at the Queen Mary Hospital, Hong Kong were included. The commonest clinical manifestation was community-acquired (n = 39) and hospital-acquired (n = 9) pneumonia. The most prevalent serotypes were 3, 19A and 19F (all <em>n</em> = 11). Multilocus sequence typing revealed 34 sequence-types, including four novel ones. Resistome profiling showed that the 64 <em>S. pneumoniae</em> isolates exhibited greater abundance of resistance genes compared to 10,234 <em>S. pneumoniae</em> isolates from other countries. Antimicrobial susceptibility testing showed that the isolates were highly resistant to erythromycin and clindamycin (73.4 % and 62.5 %), concurring with resistome profiling results which showed that 73.4 % and 65.6 % had resistance genes against these two antibiotics. Despite the transient interruption of transmission during the COVID-19 pandemic, <em>S. pneumoniae</em> serotype 3 has remained as one of the most important causes of pneumococcal infections in Hong Kong. <em>S. pneumoniae</em> strains from our patients were more resistant to antibiotics compared to those from Western countries.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 12","pages":"Article 102976"},"PeriodicalIF":4.0,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dengue virus infected patients can generate false positives in the ‘gold standard’ Leptospira spp. microscopic agglutination test (MAT) and IgG- and IgM- antibody specific immunofluorescence and protein (Western) immunoblot assays due to cross-reactions with their outer surface membrane proteins: Public health concern","authors":"Claudia M. Romero-Vivas,&nbsp;Lissette Hernández Arrieta,&nbsp;Margarett Cuello-Pérez,&nbsp;Andrew K. Falconar","doi":"10.1016/j.jiph.2025.102975","DOIUrl":"10.1016/j.jiph.2025.102975","url":null,"abstract":"<div><h3>Background</h3><div>The dengue viruses (DENVs) and <em>Leptospira</em> spp. both cause large numbers of human infections and fatalities within their widely overlapping distributions, thereby requiring differential diagnoses for appropriate patient therapies.</div></div><div><h3>Methods</h3><div>Many paired acute (S1) and convalescent (S2) phase patients’ sera were tested as potential on-going DENV infections by their IgM and/or IgG antibody reactions and DENV isolations and serotype determinations. The sera from these DENV-confirmed cases were further tested for their abilities to cross-react with the <em>Leptospira</em> spp. of different serovars in the ‘gold standard’ microscopic agglutination test (MAT), immunofluorescence assays (IFAs), IgM-ELISA and protein (Western) immunoblot assays, as well as <em>Leptospira</em> spp. isolation and PCR tests.</div></div><div><h3>Results</h3><div>In this study, 35 % of these patients’ sera were confirmed as on-going DENV infections by their dramatically (&gt;&gt; 4-fold S1 to S2) increased anti-DENV IgM and/or IgG antibody ELISA titres. Of those, 8.6 % also displayed high S2 and/or ≥ 4-fold increased S1 to S2 serum titres using the <em>Leptospira</em> spp. MAT due to their IgM and/or IgG cross-reactions with their 68–72, 38–42 and 18–22 kDa outer surface membrane proteins (OSMPs) identified by SDS-PAGE and protein (Western) blotting after Triton X-114 detergent phase-separations. DENV-1, −2 or −3 serotypes, but not <em>Leptospira</em> spp., were isolated and their sera were negative using a <em>Leptospira</em> spp.-specific PCR and commercial anti-<em>Leptospira</em> spp. IgM-specific ELISA.</div></div><div><h3>Conclusions</h3><div>This is the first report of false-positive anti-<em>Leptospira</em> spp. IgM and/or IgG antibody reactions resulting from on-going primary or secondary DENV infections which may: a) account for some ‘DENV-<em>Leptospira</em> spp. co-infections’ being erroneously reported and b) lead to inappropriate antibiotic therapies, rather than appropriate early supportive therapy for ‘severe dengue’ cases in their widely co-endemic pan-global regions.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 12","pages":"Article 102975"},"PeriodicalIF":4.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145119353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of an antimicrobial stewardship program in primary health care centers in Bahrain – A 5-year experience","authors":"Jameela Alsalman ,&nbsp;Mahmood Alawainati ,&nbsp;Shereen Haji ,&nbsp;Nour Shamas","doi":"10.1016/j.jiph.2025.102971","DOIUrl":"10.1016/j.jiph.2025.102971","url":null,"abstract":"<div><h3>Background</h3><div>Antimicrobial misuse globally challenges healthcare by driving resistance, escalating costs, and worsening outcomes. Antimicrobial stewardship (AMS) programs optimize use. This prospective interventional study outlines a five-year antimicrobial stewardship program (ASP) in Bahrain’s primary health care (PHC) facilities.</div></div><div><h3>Methods</h3><div>A prospective interventional study was conducted in Bahrain’s governmental PHC centers to evaluate the impact of a newly implemented ASP on antimicrobial use and cost. Starting in 2015, the ASP included a situational analysis of prescribing patterns and resources. A multidisciplinary team was formed to guide AMS activities, develop educational programs, establish clinical guidelines, create an electronic prescribing reporting system, and provide feedback on prescribing trends. The study analyzed antimicrobial prescription order reports and evaluated all antimicrobials prescribed between January 2016 and September 2021, assessing antimicrobial prescription per 1000 inhabitants, defined daily doses (DDD) per 1000 inhabitants, and antimicrobial costs.</div></div><div><h3>Results</h3><div>A total of 2032,653 prescription were ordered between January 2016 and September 2021, with penicillins (68.74 %), cephalosporins (18.13 %), and antiparasitics (9.43 %) being the most common. Over 70 % of the PHC prescriptions were from the WHO-recommended Access category for the whole study period. After AMS interventions, prescriptions decreased 4.5-fold, from 67.6 to 15.1 prescriptions per 1000 inhabitants, with statistically significant reductions (P &lt; 0.001) in all antimicrobial classes except nitrofurantoin. The DDD/1000 inhabitants, and cost also decreased significantly (P &lt; 0.001), saving around 4.1 million Bahraini Dinars, ($10.97 million).</div></div><div><h3>Conclusions</h3><div>The first published country wide ASP in primary health care in the Eastern Mediterranean significantly reduced antimicrobial prescriptions and DDD/ 1000 inhabitants. Leadership support, multifaceted interventions, and active multidisciplinary participation are key to sustaining and improving outcomes at a country scale. Further analysis can identify additional gaps and necessary system changes.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 12","pages":"Article 102971"},"PeriodicalIF":4.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145155557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Silent killer strikes during Eid-Ul-Adha: Crimean-Congo hemorrhagic fever outbreak in Khyber Pakhtunkhwa, Pakistan, 2023","authors":"Asad Zia ,&nbsp;Arshad Islam ,&nbsp;Syeda Aiman ,&nbsp;Salman Khan ,&nbsp;Khizar Abdullah Khan ,&nbsp;Mubarak Ali Khan ,&nbsp;Khalid Rehman ,&nbsp;Anwar Ullah ,&nbsp;Muhammad Sohaib ,&nbsp;Aakash Ahmad Khattak ,&nbsp;Muhammad Ishfaq ,&nbsp;Matiullah Khattak ,&nbsp;Massab Umair ,&nbsp;Yasar Mehmood Yousafzai","doi":"10.1016/j.jiph.2025.102974","DOIUrl":"10.1016/j.jiph.2025.102974","url":null,"abstract":"<div><h3>Background</h3><div>Crimean-Congo hemorrhagic fever virus (CCHFV) poses a significant public health threat, particularly in Khyber Pakhtunkhwa, Pakistan, where its prevalence and epidemiological distribution remain poorly documented. This study aimed to investigate the epidemiology, prevalence, and transmission dynamics of the 2023 CCHFV outbreak in Khyber Pakhtunkhwa during the Eid-ul-Adha season.</div></div><div><h3>Methods</h3><div>From April to July 2023, 109 suspected cases were enrolled. Laboratory confirmation was performed using real-time reverse transcription polymerase chain reaction (RT-PCR). Demographic, clinical, and epidemiological data were analyzed to identify high-risk groups and outbreak dynamics.</div></div><div><h3>Results</h3><div>Out of the suspected cases, 15 (13.76 %) were confirmed CCHFV positive, with males comprising 80 % of cases (n = 12). The highest prevalence (33.33 %) was recorded in Peshawar district, and 53 % of cases had a history of animal exposure. A significant spike (5 cases) occurred in the 29th epidemiological week, following Eid-ul-Adha. Clinical symptoms included fever, body aches, confusion, and bleeding episodes. The case fatality rate (CFR) was 26.67 % (male-specific CFR: 33.33 %), while all female patients recovered.</div></div><div><h3>Conclusion</h3><div>These findings underscore the critical public health concern posed by CCHFV in Khyber Pakhtunkhwa. The heightened risk associated with Eid-ul-Adha, coupled with age and gender demographics, necessitates targeted awareness initiatives, preventive strategies, and strengthened surveillance during peak risk periods to mitigate transmission and prevent future outbreaks. However, it’s important to acknowledge the study’s limitations, such as the relatively small sample size, potential selection bias, and the absence of a control group.</div></div><div><h3>Future directions</h3><div>Future research with larger sample sizes and more comprehensive data collection is essential to gain a deeper understanding of the epidemiology and transmission dynamics of CCHFV in this region</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 12","pages":"Article 102974"},"PeriodicalIF":4.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: “Severe angiostrongyliasis with neuropsychiatric symptoms in vulnerable adults: Early diagnosis via next-generation sequencing and successful treatment”","authors":"Nathkapach Kaewpitoon Rattanapitoon,&nbsp;Chutharat Thanchonnang,&nbsp;Patpicha Arunsarn,&nbsp;Schawanya Kaewpitoon Rattanapitoon","doi":"10.1016/j.jiph.2025.102973","DOIUrl":"10.1016/j.jiph.2025.102973","url":null,"abstract":"<div><div>Tang et al. (2025) report on two cases of neuroangiostrongyliasis in vulnerable adults, diagnosed via metagenomic next-generation sequencing (mNGS). We highlight the clinical value of mNGS in detecting atypical presentations, particularly in patients without eosinophilia or classic meningitic signs. While mNGS demonstrates diagnostic potential, its limitations and feasibility in low-resource settings must be acknowledged. We propose a contextualized approach integrating mNGS with cost-effective tools like LAMP and rapid antigen tests, especially for underserved populations.The commentary also calls attention to the risk of underdiagnosed parasitic CNS infections in socioeconomically vulnerable groups and urges broader diagnostic preparedness and targeted surveillance.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 12","pages":"Article 102973"},"PeriodicalIF":4.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association of sepsis with level of care among older people presenting to the emergency department – A national register study in Sweden","authors":"Eric A. Fagermalm ,&nbsp;Daniel R. Smith ,&nbsp;Scott Montgomery ,&nbsp;Pooyan Masarrat ,&nbsp;Lisa Kurland","doi":"10.1016/j.jiph.2025.102942","DOIUrl":"10.1016/j.jiph.2025.102942","url":null,"abstract":"<div><h3>Background</h3><div>Sepsis is potentially fatal and commonly affects older people. However, little is known of the association between surviving sepsis and older patients’ autonomy and dependency following hospital discharge.</div></div><div><h3>Methods</h3><div>A population-based register study using data from five Swedish national registers included emergency department (ED) visits and in-hospital admission of patients aged 65 years of age and older years with infection or sepsis between 2013 and 2020. The consumption of home care services and residential care, as well as mortality, was examined 1, 6 and 12 months after hospital discharge using mixed models.</div></div><div><h3>Findings</h3><div>166,188 ED visits with sepsis (23 %) and non-sepsis infections (77 %). Sepsis was associated with an increased risk of becoming dependent on home care (RR=1.09 [1.03–1.15]), residential care (RR=1.05 [1.0–1.1]) and mortality (RR=1.96 [1.89–2.03]) 12 months after in-hospital discharge compared to being diagnosed with infection only. The level of care one month prior to the index ED visit, among the study population, i.e., patients having attended the ED with sepsis and infection, was associated with risk of sepsis OR = 1.31 [1.27–1.35] for patients dependent on home care, and OR = 2.16 [2.09–2.23] for patients dependent on residential care as compared to patients independent on home care.</div></div><div><h3>Interpretation</h3><div>The current study suggests that sepsis is a major debilitating condition in older survivors, and many patients do not recover former dependency levels, one year after discharge as well as an increased mortality risk. Also, prior dependency on home care or residential care was a risk factor for sepsis for those patients who attended the ED with sepsis and infection.</div></div><div><h3>Funding</h3><div>Funding was obtained through Örebro University, Sweden and the Research Committee of Region Örebro Län, Sweden.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 12","pages":"Article 102942"},"PeriodicalIF":4.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}