Journal of Infection and Public Health最新文献

{"title":"Cutaneous infection caused by Mycobacterium boenickei due to lipolysis injection: A case report","authors":"Jiayi Peng ,&nbsp;Rui Zeng ,&nbsp;Tian Gan,&nbsp;Wenyue Zhang,&nbsp;Ying Shi,&nbsp;Youming Mei,&nbsp;Haiqin Jiang,&nbsp;Jingshu Xiong,&nbsp;Chun Pan,&nbsp;Hongsheng Wang","doi":"10.1016/j.jiph.2025.102872","DOIUrl":"10.1016/j.jiph.2025.102872","url":null,"abstract":"<div><div>Cosmetic injection has emerged as a significant cause of cutaneous infections associated with rapidly growing mycobacteria (RGM). <em>Mycobacterium boenickei</em>, a rare RGM first isolated from a leg wound in the United States in 2004, has been reported in only six strains worldwide. However, clinical cases of <em>M. boenickei</em> infection have not been displayed in detail. Here we report the first detailed case of <em>M. boenickei</em> infection at an injection site following lipolysis treatment in an immunocompetent woman in China. The pathogen was initially identified through <em>rpoB</em> and <em>hsp65</em> sequencing from DNA extracted from skin lesion, which was further confirmed by whole genome sequencing of the culture. The patient was successfully treated with a combination of rifabutin, moxifloxacin, and clarithromycin based on the result of drug susceptibility test. This case report expands the limited literature on uncommon mycobacteria infections and emphasizes the importance of molecular identification and drug susceptibility test in guiding treatment strategies.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 10","pages":"Article 102872"},"PeriodicalIF":4.7,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144535998","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":"Comprehensive molecular characterization of post-COVID condition: Immunoglobulin suppression and persistent SARS-CoV-2 antigens as key pathophysiological drivers","authors":"Alejandro Seco-Gonzalez ,&nbsp;Paula Antelo-Riveiro ,&nbsp;Susana B. Bravo ,&nbsp;M.J. Domínguez-Santalla ,&nbsp;E. Rodríguez-Ruiz ,&nbsp;Ángel Piñeiro ,&nbsp;Rebeca Garcia-Fandino","doi":"10.1016/j.jiph.2025.102870","DOIUrl":"10.1016/j.jiph.2025.102870","url":null,"abstract":"<div><h3>Background</h3><div>Post-COVID condition (PCC), or long COVID, affects a significant proportion of individuals following SARS-CoV-2 infection, yet its molecular framework remains poorly understood. This study aimed to define the molecular profile of PCC by integrating broad proteomic analysis using Sequential Window Acquisition of All Theoretical Mass Spectra (SWATH-MS) with targeted antigen quantification through targeted mass spectrometry (MRM/SRM).</div></div><div><h3>Methods</h3><div>Plasma and pellet fractions from 65 PCC patients, classified as symptomatic or asymptomatic, were analyzed using SWATH-MS with updated SARS-CoV-2 protein libraries (<em>v2022</em> and <em>v2024</em>), enabling a comprehensive profiling of immune- and viral-related proteins. The presence of viral antigens, specifically spike and nucleocapsid proteins, was quantified using MRM/SRM. A protein-concentration-based severity metric using clustering analysis and dimensionality reduction methods was proposed to assess correlations between proteomic alterations and clinical symptoms.</div></div><div><h3>Results</h3><div>A key finding in PCC patients, particularly in symptomatic cases, was a pronounced downregulation of immunoglobulins, including kappa and lambda light chains. SWATH-MS analysis identified six proteins (corresponding to UniProt entries Q8N5F4, LV147, KV311, KVD20, A0A5C2G1U0, and KV315) that strongly correlated with disease severity (R² &gt; 0.9), highlighting their potential as biomarkers. In pellet samples, the protein G1SG72 (ABCE1) emerged as a marker associated with severity, suggesting possible alterations in antiviral responses. The severity metric proposed showed a strong correlation with clinical symptoms, providing a quantifiable measure of PCC severity and enabling effective patient stratification. Additionally, MRM/SRM analysis detected the persistent presence of SARS-CoV-2 antigens, specifically the Spike and Nucleocapsid proteins, in symptomatic PCC patients.</div></div><div><h3>Conclusions</h3><div>This study defines a molecular profile of PCC, marked by immunoglobulin downregulation and the persistence of SARS-CoV-2 antigens, which may contribute to ongoing immune alterations in PCC. The severity metric derived from proteomic profiling provides a tool for categorizing PCC patients based on symptom severity and could support future studies aimed at targeted interventions.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 10","pages":"Article 102870"},"PeriodicalIF":4.7,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144563110","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":"Carbapenem resistance gene blaNDM-1 in Escherichia coli, Serratia marcescens and Klebsiella michiganensis strains from a pediatric patient","authors":"Yuanyuan Li ,&nbsp;Xiangkun Zeng ,&nbsp;Mi Zhou ,&nbsp;Yi Liu ,&nbsp;Chen Xu ,&nbsp;Xiaofan Li ,&nbsp;Yunbing Li ,&nbsp;Lili Huang ,&nbsp;Ning Dong","doi":"10.1016/j.jiph.2025.102869","DOIUrl":"10.1016/j.jiph.2025.102869","url":null,"abstract":"<div><div>Carbapenem resistance has a widespread globally. In this study, three bacterial strains including <em>Escherichia coli</em> (SXY-EC), <em>Serratia marcescens</em> (SXY-SM), and <em>Klebsiella michiganensis</em> (SXY-KM) were isolated from a pediatric patient in China. Whole-genome sequencing and resistome analysis revealed the appearance of <em>bla</em>_NDM-1 β-lactamase gene in all these three strains, and conjugation tests confirmed its transferability. Additionally, SXY-SM and SXY-KM harbored two to three other resistance genes, while SXY-EC carried eleven. Notably, the multidrug resistance region containing <em>bla</em>_NDM-1 in plasmid pSXY-EC_NDM1 from SXY-EC was flanked by mobile elements, potentially enabling intermolecular replicative transposition mediated by distinct insertion sequences.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 10","pages":"Article 102869"},"PeriodicalIF":4.7,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144535997","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":"Global, regional, and national burden of varicella-zoster infections in adults aged 70 years and older from 1997 to 2021: Findings from the Global Burden of Disease Study","authors":"Chenchen Yang ,&nbsp;Zhenpeng Guo ,&nbsp;Xiaowei Deng ,&nbsp;Yanling Wei ,&nbsp;Qun Zhang ,&nbsp;Jianming Wang","doi":"10.1016/j.jiph.2025.102868","DOIUrl":"10.1016/j.jiph.2025.102868","url":null,"abstract":"<div><h3>Background</h3><div>Varicella-zoster virus (VZV) infection gives rise to varicella (chickenpox) and herpes zoster (HZ, shingles). Primary VZV infection results in varicella, while HZ occurs as a consequence of latent VZV reactivation. Older adults are at a significantly elevated risk of HZ because of age-related immune senescence. This study was designed to evaluate the global burden and trends of VZV-related diseases (VHZ: varicella and HZ) among adults aged ≥70 years from 1997 to 2021 and to explore the influencing factors. In this specific age group, VHZ predominantly refers to HZ.</div></div><div><h3>Methods</h3><div>Data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021 were employed to estimate the incidence, disability-adjusted life years (DALYs), and rates of VHZ in older adults. Estimated annual percentage changes were utilized to quantify trends, and demographic decomposition analysis was conducted to determine the impacts of population aging, growth, and epidemiological changes.</div></div><div><h3>Results</h3><div>In 2021, a total of 4,539,519 new VHZ cases were reported globally among older adults, with an incidence rate of 918.2 per 100,000. The global DALYs attributable to VHZ amounted to 113,013, corresponding to a DALY rate of 22.9 per 100,000. From 1997 to 2021, although the incidence rate increased slightly, the DALY rate declined significantly. Population growth was the main driver of the increase in the number of cases, whereas enhanced disease management contributed to the reduction in DALYs.</div></div><div><h3>Conclusions</h3><div>From 1997 to 2021, the incidence of VHZ in adults aged ≥70 years increased marginally due to population growth, while the disease burden (measured by DALYs) decreased, probably attributed to improved disease management strategies. These trends were particularly evident in regions with a high Socio-Demographic Index (SDI), potentially associated with vaccination efforts, and significant reductions in DALYs were observed in low- and middle-SDI regions, likely owing to advancements in healthcare.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 10","pages":"Article 102868"},"PeriodicalIF":4.7,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144563013","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":"Addressing antimicrobial resistance: Structural insights into cefiderocol’s mode of action and emerging resistance mechanisms","authors":"Mohd Zulkifli Salleh","doi":"10.1016/j.jiph.2025.102871","DOIUrl":"10.1016/j.jiph.2025.102871","url":null,"abstract":"<div><div>Cefiderocol represents a significant advancement in the treatment of multidrug-resistant Gram-negative bacterial infections. Its unique uptake mechanism, leveraging bacterial iron transport pathways for membrane permeation, sets it apart from conventional β-lactam antibiotics. Through its siderophore-mediated drug uptake, cefiderocol efficiently bypasses outer membrane barriers, allowing it to target and penetrate resistant pathogens, including those resistant to carbapenems and other antibiotics. This distinct property positions cefiderocol as a promising therapeutic option for infections caused by <em>Pseudomonas aeruginosa</em>, <em>Acinetobacter baumannii</em>, and Enterobacterales. Despite its promise, resistance to cefiderocol is emerging, driven by mutations in penicillin-binding proteins, impaired siderophore transporter systems, and β-lactamase production. These mechanisms disrupt antibiotic binding, compromise iron transport, and enzymatically inactivate cefiderocol, respectively, limiting its efficacy. This review examines cefiderocol's innovative mode of entry, therapeutic potential, and the challenges posed by resistance, offering insights into its role in the fight against multidrug-resistant pathogens.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 9","pages":"Article 102871"},"PeriodicalIF":4.7,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144243319","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 outcomes and safety of 7-day versus 14-day antibiotic therapy for bloodstream infections in adults: A systematic review and meta-analysis with trial sequential analysis","authors":"Chen-Wei Wu ,&nbsp;Chih-Cheng Lai ,&nbsp;Jheng-Yan Wu ,&nbsp;Mei-Chuan Lee","doi":"10.1016/j.jiph.2025.102852","DOIUrl":"10.1016/j.jiph.2025.102852","url":null,"abstract":"<div><div>The optimal duration of antibiotic therapy for bloodstream infections (BSIs) remains uncertain. This meta-analysis with trial sequential analysis (TSA) compared the efficacy and safety of 7-day versus 14-day antibiotic courses in adults. A systematic search of PubMed, Embase, and Cochrane Library identified four randomized controlled trials (4794 patients). The 7-day course showed similar 90-day all-cause mortality (RR 0.94, 95 % CI 0.79–1.12, <em>p</em> = 0.51) and bacteremia relapse rates (RR 1.15, 95 % CI 0.80–1.64, <em>p</em> = 0.45) compared to 14 days. No significant differences were found in adverse events, including acute kidney injury, diarrhea, allergic reactions, and <em>Clostridioides difficile</em> infections. TSA indicated an insufficient information size. While 90-day mortality is an objective endpoint, it may not fully capture clinical recovery or long-term sequelae. Nonetheless, the findings indicate that a 7-day antibiotic course achieves outcomes comparable to a 14-day regimen in non–high-risk patients, supporting shorter durations consistent with antimicrobial stewardship.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 9","pages":"Article 102852"},"PeriodicalIF":4.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144223414","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":"Serological insights into MERS-CoV dynamics of antibody responses during acute and convalescent phases and their clinical relevance for diagnostics and immunity","authors":"Khalid J. Shrwani ,&nbsp;Ahmad M. Alharbi ,&nbsp;Waleed H. Mahallawi ,&nbsp;Ayed Y. Asiri ,&nbsp;Abdullah M. Assiri ,&nbsp;Abdullah Algaissi ,&nbsp;Anwar M. Hashem ,&nbsp;Radi Alsafi ,&nbsp;Mohammed A. Jubran ,&nbsp;Eyad Gadour ,&nbsp;Soha A. Alghamdi ,&nbsp;Ezzuddin A. Okmi ,&nbsp;Nabil Dhayhi ,&nbsp;Hassan A. Asiri ,&nbsp;Zaki M. Eisa ,&nbsp;Nigel Cunliffe ,&nbsp;Qibo Zhang","doi":"10.1016/j.jiph.2025.102854","DOIUrl":"10.1016/j.jiph.2025.102854","url":null,"abstract":"<div><h3>Introduction</h3><div>Middle East respiratory syndrome (MERS) is a zoonotic viral respiratory disease caused by the Middle East respiratory syndrome coronavirus (MERS-CoV), associated with severe clinical outcomes and high mortality.</div></div><div><h3>Objectives</h3><div>Our study examined the kinetics of anti-MERS-CoV IgM and IgG antibodies during the acute and convalescent phases of infection, focusing on their correlations with clinical variables such as age and viral load.</div></div><div><h3>Methods</h3><div>Serum samples were collected from PCR-confirmed MERS-CoV patients (n = 23) during both phases and compared to healthy controls (n = 23) using validated ELISA-based assays.</div></div><div><h3>Results</h3><div>IgM levels peaked in the acute phase and declined significantly in the convalescent phase, while IgG levels were sustained and markedly higher during recovery. Correlation analyses revealed positive relationships between antibody levels and patient age (acute IgM: r = 0.56, p &lt; 0.01; convalescent IgG: r = 0.59, p &lt; 0.01) and viral loads (acute IgM: r = 0.97, p &lt; 0.0001; acute IgG: r = 0.87, p &lt; 0.0001; convalescent IgG: r = 0.91, p &lt; 0.0001). These results concluded that age-associated enhancements in antibody responses and the role of humoral immunity in viral clearance.</div></div><div><h3>Conclusion</h3><div>The current study highlights the diagnostic value of anti-MERS-CoV IgM and IgG measurements and their utility in developing therapeutic and vaccine strategies adapted to high-risk populations.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 9","pages":"Article 102854"},"PeriodicalIF":4.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144212405","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":"Chlorhexidine and povidone-iodine: Unmasking the unknown in catheter-related infection prevention, a narrative review","authors":"Bertrand Drugeon ,&nbsp;Claire M. Rickard ,&nbsp;Jessica A. Schults ,&nbsp;Jérémy Guenezan ,&nbsp;Olivier Mimoz","doi":"10.1016/j.jiph.2025.102851","DOIUrl":"10.1016/j.jiph.2025.102851","url":null,"abstract":"<div><div>Healthcare-associated infections remain a major concern, with vascular access devices contributing substantially to infection risk. Effective skin disinfection is essential for preventing catheter-related infections (CRIs). This narrative review compares the efficacy and safety of chlorhexidine gluconate (CHG) and povidone-iodine (PVI), while also addressing often-underexamined factors such as product availability, application techniques, antimicrobial resistance and environmental impact. Evidence supports the use of 2 % CHG in 70 % isopropyl alcohol as the most effective strategy to reduce CRIs, although PVI remains an alternative in patients with CHG intolerance or in low-resource settings. Environmental analyses highlight the higher persistence and potential ecological risk of CHG compared with PVI. Despite widespread guidelines, significant discrepancies persist in recommended concentrations, application methods, and target populations. Based on literature synthesis, we propose standardising the use of 2 % CHG-IPA where feasible, developing tailored recommendations for high-risk groups, and incorporating environmental and economic considerations into future infection prevention strategies.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 9","pages":"Article 102851"},"PeriodicalIF":4.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144223413","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":"Characterization of multidrug resistance in clinical Klebsiella pneumoniae strains carrying drug efflux pumps and multiple repetitive tandem blaKPC-2 core structures","authors":"Xiaoyu Ruan ,&nbsp;Wenji Wang ,&nbsp;Dongguo Wang ,&nbsp;Liman Ma","doi":"10.1016/j.jiph.2025.102850","DOIUrl":"10.1016/j.jiph.2025.102850","url":null,"abstract":"<div><h3>Objective</h3><div>To elucidate the mechanisms of multidrug resistance in clinical <em>Klebsiella pneumoniae</em> strains that harbor drug efflux pumps and contain multiple tandem repeats of the <em>bla</em>_KPC-2 core structure.</div></div><div><h3>Methods</h3><div>The characteristics of strains SC7, SC35, SC38, SC41, SC42, SC67, and SC173 were comprehensively examined. This analysis encompassed antimicrobial susceptibility testing, conjugative transfer experiments, and the detection of beta-lactamase and carbapenemase production. The genomes of these strains were sequenced using both Illumina and Nanopore platforms to generate high-quality genomic data. Subsequently, bioinformatics tools were employed to analyze the mobile genetic elements that carry antibiotic resistance genes.</div></div><div><h3>Results</h3><div>The analyzed <em>K. pneumoniae</em> strains were found to produce class A carbapenemase and exhibited resistance to nearly all tested antibiotics. This resistance was primarily attributed to the presence of efflux pump genes, such as <em>acrAB-tolC</em>, located on the chromosomes. Additionally, these strains contained one or more repetitive tandem core structures of <em>bla</em>_KPC-2, as well as <em>bla</em>_KPC-2 and/or <em>bla</em>_CTX-M-65 core structures within their genomes. Some plasmids also harbored <em>bla</em>_SHV-12, <em>bla</em>_TEM-1, and <em>rmtB</em>. These genetic structures showed similarities to mobile genetic elements like Tn<em>3</em> and Tn<em>As3</em>. The identification of strain SC67, which possessed seven tandem repeats of the <em>bla</em>_KPC-2 core structure, represents a novel finding and significantly advances our understanding of antibiotic resistance mechanisms. Plasmid transfer assays demonstrated successful conjugation in all strains, with varying average conjugation frequencies. Comparative analyses of the full-length plasmids and the multidrug resistance regions carrying <em>bla</em>_KPC-2 and/or <em>bla</em>_CTX-M-65 revealed a high degree of evolutionary conservation in these core structures.</div></div><div><h3>Conclusions</h3><div>The evolution of these strains is intricately linked to the core structures of <em>bla</em>_KPC-2 and/or <em>bla</em>_CTX-M-65. Moreover, the presence of multiple drug efflux pumps on the chromosomes significantly contributes to their resistance to nearly all commonly used antibiotics. Given these findings, it is imperative to develop and implement effective strategies to curb the dissemination and prevalence of these highly resistant strains.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 10","pages":"Article 102850"},"PeriodicalIF":4.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144548794","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":"Electrocardiographic alterations in patients treated for acute Lassa Fever: Description of results from a phase II clinical trial in Nigeria","authors":"Cyril Erameh ,&nbsp;Oladele Oluwafemi Ayodeji ,&nbsp;Augusto Meneguim ,&nbsp;Kevin Okwaraeke ,&nbsp;Osahogie Edeawe ,&nbsp;Enomen Ekata ,&nbsp;ThankGod Akhigbe ,&nbsp;Nelson Adedosu ,&nbsp;Chukwuyem Abejegah ,&nbsp;Sampson Owhin ,&nbsp;Liasu Ahmed ,&nbsp;Till Omansen ,&nbsp;Meike Pahlmann ,&nbsp;Georg Goliasch ,&nbsp;Alexandre Duvignaud ,&nbsp;Peter Akhideno ,&nbsp;Sylvanus Okogbenin ,&nbsp;Stephan Günther ,&nbsp;Marie Jaspard ,&nbsp;Michael Ramharter ,&nbsp;Mirjam Groger","doi":"10.1016/j.jiph.2025.102858","DOIUrl":"10.1016/j.jiph.2025.102858","url":null,"abstract":"<div><h3>Background</h3><div>Lassa virus (LASV) leads to high case fatality among hospitalized patients in West Africa. While the pathophysiology of the disease is poorly understood, cardiac pathology is suspected to constitute an important feature of severe Lassa Fever (LF). We report an analysis of electrocardiogram (ECG) findings of patients enrolled in a clinical trial comparing ribavirin with favipiravir for the treatment of LF.</div></div><div><h3>Methods</h3><div>This randomized controlled open-label phase II clinical trial conducted at two reference hospitals for LF treatment in Nigeria, assessed the tolerability, safety and pharmacokinetics of favipiravir compared to ribavirin in the treatment of acute LF. Hospitalized adult participants with RT-PCR-confirmed mild LF were eligible to participate. Baseline and follow-up ECG readings were performed.</div></div><div><h3>Findings</h3><div>From August 2021 to October 2022, 40 patients were included in the study (48 % female), and 36 completed the 10-day follow-up period. ECG alterations were similarly distributed between treatment arms and observed in 18 (45 %) participants, namely, T-wave inversion (n = 14; 35 %), conduction disorders (n = 5; 13 %), ST-segment elevation (n = 4; 10 %), and arrythmia (n = 2; 5 %). 36 % (n = 9) of the alterations observed subsided by the end of the study.</div></div><div><h3>Interpretation</h3><div>ECG alterations observed in both treatment arms are compatible with direct cardiac effects of the LASV. The combination of new onset of chest pain combined with the evolution of ECG findings over time are suggestive for the occurrence of perimyocarditis in a subset of patients.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 9","pages":"Article 102858"},"PeriodicalIF":4.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144212406","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}