Journal of Infection and Public Health最新文献

{"title":"Meta-analysis of antifungal resistance patterns of Aspergillus species in Iran","authors":"Ibrahim Bahrami Mianrood ,&nbsp;Farid Javandoust Gharebagh ,&nbsp;Sadegh Khodavaisy ,&nbsp;Maryam Ahmadian ,&nbsp;Ilad Alavi Darazam","doi":"10.1016/j.jiph.2025.102838","DOIUrl":"10.1016/j.jiph.2025.102838","url":null,"abstract":"<div><h3>Background and objectives</h3><div><em>Aspergillus</em> infection has several manifestations, ranging from noninvasive aspergillosis to invasive pulmonary and cerebral aspergillosis. Prophylaxis and treatment regimens for aspergillosis rely on triazoles, echinocandins, and polyenes, with specific efficacies, complications, and resistance patterns. Drug selection presents challenges, including differences in resistance rates, drug interactions, and concerns about side effects with long-term use. <em>Aspergillus</em> resistance to antifungal agents is an international concern and has shown an increasing trend. Each region worldwide has a resistance pattern affecting prevention and treatment regimens.</div></div><div><h3>Methods</h3><div>This meta-analysis started with a systematic search through PubMed, Scopus, Web of Science, Scientific Information Database (SID) and MagIran based on a combination of these keywords with “AND/OR” operators: <em>Aspergillus</em>/<em>Aspergilli</em>, resistance/resistant, susceptibility/susceptible, drug, antimicrobial(s), antifungal(s) and Iran. Search results are reported on the basis of the Preferred Reporting Items for Systematic and Meta-analyses (PRISMA).</div></div><div><h3>Results</h3><div>The pooled resistance rates of <em>Aspergillus fumigatus</em> were 6.97 % for amphotericin B, 1.40 % for caspofungin, 17.61 % for itraconazole, 4.56 % for posaconazole, and 14.68 % for voriconazole. The percentage of resistance in <em>Aspergillus flavus</em> was 13.16 % for amphotericin B, 13.09 % for caspofungin, 10.19 % for itraconazole, 1.23 % for posaconazole, and 0.58 % for voriconazole.</div></div><div><h3>Conclusion</h3><div>Our findings highlight the need for antifungal resistance surveillance in Iran. Treatment decisions should consider resistance patterns, host factors, and drug pharmacokinetics. We recommend establishing antifungal stewardship programs to develop evidence-based guidelines. Based on our findings, we suggest posaconazole or voriconazole for <em>A. fumigatus</em> and <em>A. flavus</em>, amphotericin B as alternative therapy, and caspofungin as salvage therapy.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 9","pages":"Article 102838"},"PeriodicalIF":4.7,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144223417","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":"Catheter-associated urinary tract infections in urethral stricture patients indwelling suprapubic catheter: Insights from a retrospective investigation into specific antibiogram and risk factors","authors":"Jiahao Lin ,&nbsp;Changhao Hou ,&nbsp;Yubo Gu ,&nbsp;Wei Yuan ,&nbsp;Xianjie Xiu ,&nbsp;Zhenwei Yu ,&nbsp;Ruihang Zhang ,&nbsp;Guangyu Mao ,&nbsp;Qiang Fu ,&nbsp;Lujie Song","doi":"10.1016/j.jiph.2025.102833","DOIUrl":"10.1016/j.jiph.2025.102833","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to evaluate the incidence and risk factors of suprapubic catheter-associated bacteriuria (SPCAB) and multidrug-resistant bacteria (MDRB) in patients with urethral strictures, and compare antimicrobial resistance patterns between pathogens isolated from urinary samples and suprapubic catheters.</div></div><div><h3>Methods</h3><div>A retrospective analysis was performed on patients with urethral strictures who had urethral reconstructive surgery with suprapubic catheters from January 2010 to June 2023. Clinical data, bacterial pathogens, and resistance patterns were collected. Heatmaps visualized resistance profiles. Descriptive statistics summarized demographics and perioperative variables; while binary logistic regression models were applied to identify independent risk factors for SPCAB and MDRB.</div></div><div><h3>Results</h3><div>Among 2809 urine samples, 42.6 % yielded positive cultures. The predominant pathogens in SPCAB were <em>Escherichia coli</em> (18.8 %) and <em>Pseudomonas aeruginosa</em> (11.9 %). Common pathogens exhibited high antimicrobial resistance rates, mirroring patterns observed in suprapubic catheter isolates. Risk factors for SPCAB included duration after suprapubic cystostomy (OR=1.712, <em>P</em> = 0.049), indwelling time of single catheter &gt;15 days (OR=2.870, <em>P</em> = 0.007), absence of catheter colonization (OR=0.079, <em>P</em> &lt; 0.001), and antibiotic use &gt;7 days. For MDRB, significant risk factors comprised duration after suprapubic cystostomy (OR=2.014, <em>P</em> = 0.009), indwelling time of single catheter &gt;30 days (OR=2.541, <em>P</em> = 0.019), absence of MDRB colonization (OR=0.079, <em>P</em> &lt; 0.001), and postoperative sampling.</div></div><div><h3>Conclusions</h3><div>In managing urethral strictures with SPCs, our findings emphasize prioritizing perioperative strategies: early catheter replacement (≤15-day intervals), empirical antimicrobial therapy guided by local resistance patterns. SPC culture-guided interventions may hold potential clinical value for mitigating SPCAB risks, though further validation is warranted.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 9","pages":"Article 102833"},"PeriodicalIF":4.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144195014","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":"Metagenomic next-generation sequencing-based diagnosis of Pneumocystis jirovecii pneumonia in patients without human immunodeficiency virus infection: A dual-center retrospective propensity matched study","authors":"Jin-zhu Wang ,&nbsp;Jiang-bo Wang ,&nbsp;Ding Yuan ,&nbsp;Chang-hua Sun ,&nbsp;Lin-lin Hou ,&nbsp;Yan Zhang ,&nbsp;Xiang-hong Yang ,&nbsp;Hong-xiang Xie ,&nbsp;Yan-xia Gao","doi":"10.1016/j.jiph.2025.102831","DOIUrl":"10.1016/j.jiph.2025.102831","url":null,"abstract":"<div><h3>Background</h3><div><em>Pneumocystis jirovecii</em> pneumonia (PJP), caused by <em>Pneumocystis jirovecii</em> (PJ), is an opportunistic infection prevalent in clinical settings. However, large-scale studies on the efficacy of metagenomic next-generation sequencing (mNGS)-based diagnosis of PJP in patients without human immunodeficiency virus infection (HIV) are lacking.</div></div><div><h3>Methods</h3><div>The study included 168 patients diagnosed with either PJP (84) or other pneumonia types (non-PJP patients; 84) who underwent mNGS-mediated bronchoalveolar lavage fluid (BALF) analysis, Gomori methenamine silver (GMS) staining and peripheral blood 1,3-beta-D-glucan (BDG) testing. Additionally, patients with PJP were categorized into survival (n = 55) and non-survival (n = 29) groups based on a 28-day in-hospital outcome to compare clinical characteristics, inflammatory markers, PJ sequence counts in BALF, and serum BDG levels.</div></div><div><h3>Results</h3><div>Serum BDG levels, the proportion of patients with serum BDG of &gt; 60 pg/mL and &gt; 200 pg/mL were notably higher in the PJP group compared with that in the non-PJP group (all <em>P&lt;</em> 0.05). The sensitivity and specificity of mNGS in diagnosing PJP were higher than those of serum BDG testing (sensitivity: 100 % <em>vs.</em> 63.0 %; specificity: 96.4 % <em>vs.</em> 90.4 %; both <em>P&lt;</em> 0.05). The most common coinfection was viral (30.9 %), followed by bacterial–viral coinfections (13.0 %). Treatment regimens were altered for 83.3 % of patients based on the mNGS results. The patients in the non-survival group showed markedly higher serum BDG levels (142.5 [32.7, 277.7] <em>vs.</em> 123.0 [34.0, 164.0]) and a higher proportion of PJ sequence counts of &gt; 1 × 10⁵ (13.7 % <em>vs.</em> 0, <em>P=</em> 0.005) relative to those in the survival group.</div></div><div><h3>Conclusion</h3><div>The mNGS showed superior performance over serum BDG testing and GMS staining in diagnosing PJP in non-HIV patients and identified a broader range of coinfections.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 9","pages":"Article 102831"},"PeriodicalIF":4.7,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144204723","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":"Characterizing pancytopenia in a large Asian cohort of people living with HIV: A 23-year nested case-control study","authors":"Xiangyi Shen ,&nbsp;Xiaojing Song ,&nbsp;Yanling Li ,&nbsp;Xiaoxia Li ,&nbsp;Lianfeng Lu ,&nbsp;Xinmin Duan ,&nbsp;Yang Han ,&nbsp;Ling Luo ,&nbsp;Huiting Liu ,&nbsp;Wei Lv ,&nbsp;Wei Cao ,&nbsp;Taisheng Li","doi":"10.1016/j.jiph.2025.102832","DOIUrl":"10.1016/j.jiph.2025.102832","url":null,"abstract":"<div><h3>Background</h3><div>Pancytopenia, a severe hematologic comorbidity, raises significant clinical concern for increased morbidity and mortality in people living with HIV (PLWH). However, reports on its incidence, risk factors, real-world etiologies, longitudinal characteristics, or management strategies in PLWH are absent. Through a long-term study of a large Asian cohort, this work aims to provide insights into these aspects.</div></div><div><h3>Methods</h3><div>We conducted a nested case-control study involving 1586 PLWH visiting our institution from January 2000 to March 2023. Cases experienced at least one pancytopenia episode, while controls with no such history were matched by age, sex, and HIV transmission route. Demographic, clinical, and laboratory data were analyzed to identify risk factors, etiologies, clinical features, and outcomes regarding pancytopenia.</div></div><div><h3>Results</h3><div>Pancytopenia occurred for 1–3 times in 82 patients (5.17 %), with an annual incidence of 2.82 % and a prevalence of 3.71 %. Advanced disease (WHO Stage 3–4) was an independent risk factor (aOR 2.88, 95 % CI 1.07–7.78, P = 0.03). The leading etiologies of pancytopenia included advanced HIV infection (36.3 %) and medication toxicity (36.3 %); co-infection and malignancy contributed to fewer cases. The majority of pancytopenia episodes occurred once per patient, typically within the early years of HIV diagnosis, did not require hospitalization, and could be resolved with a median of 21 weeks. Resolution of pancytopenia was accompanied by viral control and immune recovery. However, life-threatening anemia (Hgb&lt;65 g/L) was a significant predictor for irreversibility (P = 0.035). A history of pancytopenia significantly impaired patient survival (P = 0.008).</div></div><div><h3>Conclusions</h3><div>Caution is warranted for the occurrence of pancytopenia in PLWH, particularly those with advanced disease. Effective antiretroviral therapy and medication review should be prioritized in managing pancytopenia, along with individualized screening for underlying opportunistic conditions. Attention is needed for patients with a history of pancytopenia due to poorer prognosis.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 8","pages":"Article 102832"},"PeriodicalIF":4.7,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144124205","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":"Gender-specific weight-control behaviors : Utilizing the Narcotics Information Management System and Community Health Survey in 2020","authors":"Kyung Sun Oh ,&nbsp;Euna Han","doi":"10.1016/j.jiph.2025.102830","DOIUrl":"10.1016/j.jiph.2025.102830","url":null,"abstract":"<div><h3>Background</h3><div>The prevalence of obesity and weight management differ by gender in Korea. This study aims to examine these differences by analyzing the patterns of pharmacological prescriptions of narcotic appetite suppressants and non-pharmacological weight control methods across genders.</div></div><div><h3>Methods</h3><div>This study utilized two datasets: the Community Health Survey (CHS), representing non-pharmacological interventions on a national scale, and the Narcotics Information Management System (NIMS), detailing pharmacological practices for weight control. The CHS provided data on obesity, physical activity, nutrition information, and lifestyle behaviors (smoking, drinking, walking), while NIMS data encompassed the use of narcotic appetite suppressants for weight management. A comparative analysis of the two data sources was conducted.</div></div><div><h3>Results</h3><div>Obesity rates were higher among men in their 30 s (51.3 %) and 40 s (46.5 %), whereas women showed increased obesity in their 50 s (25.7 %) and 60 s (31.4 %). Weight control attempts were more prevalent among women, who were more likely to engage in nutritional interventions and pharmacological treatments, particularly opioid appetite suppressants. Over 60 % of these prescriptions were given to women in their 30 s and 40 s, with phendimetrazine and phentermine being the most commonly prescribed. In men, the use of narcotic appetite suppressants was positively associated with high levels of physical activity (β = 9.16, 95 % CI: 2.92–15.41), while in women, prescriptions were associated with favorable health behaviors (β = 11.63, 95 % CI: 3.54–19.73).</div></div><div><h3>Conclusions</h3><div>It is vital to recommend gender- and age-specific weight control strategies, both non-pharmacological and pharmacological. To prevent misuse, societal consensus on the appropriate prescription of narcotic appetite suppressants is crucial.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 8","pages":"Article 102830"},"PeriodicalIF":4.7,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144105489","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":"Lassa fever outbreak in West Africa: Rising regional cases with global implications","authors":"Ashutosh Pareek ,&nbsp;Aaushi Pareek ,&nbsp;Runjhun Singhal,&nbsp;Anil Chuturgoon,&nbsp;Vasso Apostolopoulos","doi":"10.1016/j.jiph.2025.102828","DOIUrl":"10.1016/j.jiph.2025.102828","url":null,"abstract":"","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 8","pages":"Article 102828"},"PeriodicalIF":4.7,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144137912","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":"Epidemiology and diagnostic challenges of fever of unknown origin (FUO) among adults: A multicenter retrospective study in Northern Italy","authors":"Alessandra Mistral De Pascali ,&nbsp;Ludovica Ingletto ,&nbsp;Arianna Succi ,&nbsp;Martina Brandolini ,&nbsp;Laura Dionisi ,&nbsp;Claudia Colosimo ,&nbsp;Giulia Gatti ,&nbsp;Giorgio Dirani ,&nbsp;Silvia Zannoli ,&nbsp;Valeria Frassineti ,&nbsp;Giulia Silvestrini ,&nbsp;Carlo Biagetti ,&nbsp;Francesco Cristini ,&nbsp;Paolo Bassi ,&nbsp;Monica Cricca ,&nbsp;Vittorio Sambri ,&nbsp;Alessandra Scagliarini","doi":"10.1016/j.jiph.2025.102824","DOIUrl":"10.1016/j.jiph.2025.102824","url":null,"abstract":"<div><h3>Background</h3><div>Fever of Unknown Origin (FUO) is broadly defined as a fever with an unidentified cause despite a minimum set of diagnostic investigations. The variability of FUO etiologies across geographic areas, age groups, and decades makes diagnosis challenging and complicates the adoption of a standardized diagnostic approach. Global warming and changing interactions between humans, animals, and the environment are contributing to the emergence and re-emergence of zoonotic infections. Emerging Vector-Borne Disease (VBD) pathogens circulate in Northern Italy, but their prevalence and impact on febrile illnesses remain poorly understood. This study investigated FUO epidemiology, diagnosis, and treatment in three hospitals in Emilia-Romagna (northeastern Italy).</div></div><div><h3>Methods</h3><div>The medical records from 652 patients who were discharged with the International Classification of Diseases, Ninth Revision (ICD-9) codes “780.6 Fever of unknown origin” and “087.9 Relapsing fever, unspecified” between January 2017 and December 2023 were analysed. Results: Among patients discharged with FUO between 2017 and 2023, the mean age was 58 years, and 45 % older than 65 years. Comorbidities were present in 75 %, and 26 % had active cancer. A diagnostic hypothesis was present in 32 % of cases. Diagnostic tests were mainly laboratory-based; 5.9 % had confirmed infections. Antibiotics were used in 62 % of patients mostly penicillin/beta-lactamase inhibitors. FUO discharges peaked in summer.</div></div><div><h3>Conclusion</h3><div>Active hospital-based surveillance are crucial to deepen our current understanding on FUO epidemiology and possible contribution of VBD pathogens while refining the use of antibiotics in the clinical practice.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 8","pages":"Article 102824"},"PeriodicalIF":4.7,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144105490","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":"Risk factors for mortality and implications on therapy for Stenotrophomonas maltophilia bacteraemia","authors":"Matthew Chung Yi Koh ,&nbsp;Jinghao Nicholas Ngiam ,&nbsp;Lionel Hon-Wai Lum ,&nbsp;Nares Smitasin ,&nbsp;Ka Lip Chew ,&nbsp;David Michael Allen","doi":"10.1016/j.jiph.2025.102829","DOIUrl":"10.1016/j.jiph.2025.102829","url":null,"abstract":"<div><h3>Background</h3><div><em>Stenotrophomonas maltophilia</em> is an important nosocomial pathogen. Bacteraemia is associated with significant morbidity, despite antibiotic therapy. Optimal treatment strategies for <em>Stenotrophomonas maltophilia</em> bacteraemia remain ill-defined. Thus, we retrospectively examined the clinical presentation, microbiological characteristics, treatment options to identify risk factors for mortality.</div></div><div><h3>Methods</h3><div>We performed a retrospective single-centre analysis of <em>Stenotrophomonas maltophilia</em> bacteraemia from 1 Jan 2012–30 Jun 2024. Data on the clinical presentation, source of infection, microbiological characteristics, treatment strategies and clinical outcomes were tabulated. Risk factors for in-hospital all-cause mortality were identified by appropriate univariate and multivariable analyses.</div></div><div><h3>Results</h3><div>There were 197 bacteraemia episodes. In-hospital mortality was 41.6 % (n = 82), and did not change significantly over the years. Patients who died were more likely to have prior carbapenem exposure (81.7 % vs 53.0 %, p &lt; 0.001), presentation in an intensive care (ICU) setting (73.2 % vs 15.7 %, p &lt; 0.001), and had a longer duration of fever (8.5 ± 2.5 vs 3.0 ± 3.8 days, p &lt; 0.001). Microbiological isolation from additional sites other than the blood (e.g. sputum culture positivity) also correlated with mortality (39.0 % vs 7.8 %, p &lt; 0.001). Over time, proportion of isolates resistant to fluoroquinolones increased. An initial antimicrobial choice containing trimethoprim-sulfamethoxazole appeared to be more likely to be associated with survival. Only 13 patients (6.6 %) received dual antibiotics initially, so it was unclear if this was associated with better outcomes. On multivariable analysis, ICU onset, elevated C-reactive protein, longer duration of fever and an absence of intervention for source control remained independently associated with mortality.</div></div><div><h3>Conclusions</h3><div>Source control of infection may be critical in improving survival in <em>Stenotrophomonas maltophilia</em> bacteraemia. Future prospective studies should validate important risk factors for mortality and define optimal antimicrobial treatment strategies.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 8","pages":"Article 102829"},"PeriodicalIF":4.7,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144115594","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":"Real-world effectiveness and economic analysis of nirmatrelvir/ritonavir, remdesivir, and molnupiravir for treatment of COVID-19 among ambulatory patients in Thailand","authors":"Sirapat Korwiwattanakan ,&nbsp;Surangkana Samanloh ,&nbsp;Pinyo Rattanaumpawan","doi":"10.1016/j.jiph.2025.102826","DOIUrl":"10.1016/j.jiph.2025.102826","url":null,"abstract":"<div><h3>Background</h3><div>Nirmatrelvir/ritonavir, remdesivir, and molnupiravir are recommended antiviral therapies for non-severe COVID-19 patients at high risk of disease progression. This study evaluated the real-world effectiveness and economic impact of these three antiviral regimens in Thailand.</div></div><div><h3>Methods</h3><div>This retrospective observational study was conducted at Siriraj Hospital, Thailand. Eligible patients were ambulatory adults (≥15 years old) with non-severe COVID-19 infection, presenting ≥1 risk factor for disease progression, and receiving ≥1 dose of nirmatrelvir/ritonavir, remdesivir, or molnupiravir within 5 days of symptom onset. Subsequently, an economic analysis was performed using data from this study and landmark clinical trials.</div></div><div><h3>Findings</h3><div>During the study period (March-August 2022), there were 374 eligible patients: 104 patients (30.0 %), 114 patients (33.0 %), and 127 patients (37.0 %) received nirmatrelvir/ritonavir, remdesivir, and molnupiravir, respectively. The unfavorable clinical outcomes were significantly higher in the remdesivir group (12.28 %), compared to the nirmatrelvir/ritonavir group (2.88 %), and the molnupiravir group (4.72 %) by pairwise comparison (<em>p-value&lt;0.001</em>). After adjusting for significant comorbidities, no statistically significant difference in unfavorable clinical outcomes was observed among these comparison groups. Economic analysis utilizing the effectiveness of landmark trials under Thai economic data indicated that remdesivir was the preferred option over the other two antivirals. Nirmatrelvir/ritonavir would become the dominant option over remdesivir if its price were to decrease to $108.157 or less per treatment course.</div></div><div><h3>Interpretation</h3><div>Compared to other countries, our study found higher unfavorable outcomes in vaccinated individuals, but lower than previous Thai data. Treatment effects were similar across groups. Our economic analysis favored remdesivir.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 8","pages":"Article 102826"},"PeriodicalIF":4.7,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144105487","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":"COVID-19 vertical transmission from mothers to neonates: A systematic review and meta-analysis of 204 studies","authors":"Fatemeh Movahed ,&nbsp;Fariba Haji Hosseini ,&nbsp;Afshin Heidari ,&nbsp;Masoud Dehbozorgi ,&nbsp;Mina Ataei ,&nbsp;Farnaz Vahidi ,&nbsp;Romina Abyaneh ,&nbsp;Bahar Bajelan ,&nbsp;Mahmood Bakhtiyari ,&nbsp;Arman Shafiee","doi":"10.1016/j.jiph.2025.102825","DOIUrl":"10.1016/j.jiph.2025.102825","url":null,"abstract":"<div><div>This study estimates the prevalence of vertical transmission of SARS-CoV-2 and identifies risk factors for mother-to-neonate transmission. A comprehensive search of PubMed, Scopus, and Web of Science up to May 2024 identified 204 observational studies, out of 28,543 records, that included neonates with confirmed SARS-CoV-2 detection via RT-PCR. The overall vertical transmission rate was 4 % (95 % CI: 4 %–5 %), with notable heterogeneity (I² = 75 %). Transmission varied based on delivery method, income classification, and region, being higher in lower-income areas and cesarean deliveries. Maternal SARS-CoV-2 detection in breast milk was rare. Neonatal SARS-CoV-2-specific IgG antibodies were frequently detected, while IgM antibodies were less common. The findings highlight the infrequency of vertical transmission but underline disparities in healthcare practices. Further high-quality studies, especially in low-income regions, are essential for a deeper understanding of vertical transmission dynamics in diverse clinical settings.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 9","pages":"Article 102825"},"PeriodicalIF":4.7,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144195012","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}