Journal of Infection and Public Health最新文献

{"title":"Screening of tuberculosis suspected subjects using real-time PCR, TaqMan method; Northeastern Iran","authors":"Sanaz Ahmadi Ghezeldasht ,&nbsp;Arman Mosavat ,&nbsp;Saman Soleimanpour ,&nbsp;Seyed Abdolrahim Rezaee ,&nbsp;Mohammad Derakhshan","doi":"10.1016/j.jiph.2025.102932","DOIUrl":"10.1016/j.jiph.2025.102932","url":null,"abstract":"<div><h3>Purpose</h3><div>Effective and timely tuberculosis (TB) treatment depends on rapid reliable diagnostic techniques and is crucial for controlling global TB. The present study aimed to determine how many TB presumptive patients may have been missed by conventional sputum smear microscopy and culture methods.</div></div><div><h3>Methods</h3><div>This cross-sectional study was conducted from 2020 to 2021 in northeast Iran. A total of 307 TB presumptive subjects with negative Ziehl-Neelsen (ZN) staining microscopy, and culture tests were evaluated using a lab made real-time PCR (qPCR), TaqMan method. The control group was 21 <em>M. tuberculosis</em> (<em>M.tb)</em> positive subjects from a referral TB center; Northeastern Iran.</div></div><div><h3>Results</h3><div>All cases in TB-positive control group tested positive by qPCR. Out of the 307 negative culture and smear tests individuals, 50 (13.55 %) tested positive using qPCR. Failure rates for microscopy and culture were higher in urine samples; none were positive in smear and culture tests, but six out of 20 (30 %) were qPCR positive. Lower failure rates for conventional tests were observed in sputum samples, with 18 out of 53, and qPCR detected nine more cases. Furthermore, among 61 unculturable samples, one case was positive using qPCR technique. Overall, qPCR demonstrated a 100 % and 83.7 % sensitivity and specificity, respectively.</div></div><div><h3>Conclusions</h3><div>In-house qPCR assays using standard reagents, which are generally available can confirm that this method more practical, time-saving, and feasible for TB-suspected individuals, particularly in extrapulmonary forms such as urine, CSF, and paraffin-embedded samples, compared to direct microscopy and culture.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 11","pages":"Article 102932"},"PeriodicalIF":4.0,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144861045","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 impact of rapid test for macrolide-resistance gene mutation among cases with Mycoplasma pneumoniae in Japan","authors":"Masayuki Murata ,&nbsp;Shin Nishihara ,&nbsp;Daisuke Kitagawa ,&nbsp;Mai Onishi ,&nbsp;Takahiro Mori ,&nbsp;Soshi Hachisuka ,&nbsp;Tenshin Okubo ,&nbsp;Naohiro Yamamoto ,&nbsp;Hiroki Nishikawa ,&nbsp;Masayuki Onaka ,&nbsp;Rika Suzuki ,&nbsp;Ayu Yamamoto ,&nbsp;Ritsuki Uejima ,&nbsp;Soma Suzuki ,&nbsp;Fumihiko Nakamura ,&nbsp;Sayaka Yoshida ,&nbsp;Taito Kitano","doi":"10.1016/j.jiph.2025.102930","DOIUrl":"10.1016/j.jiph.2025.102930","url":null,"abstract":"<div><div>Macrolide-resistant <em>Mycoplasma pneumoniae</em> (MP) infections are reported worldwide. Smart Gene® (SG) Myco, a point-of-care testing tool, detects nucleic acids and macrolide-resistance gene mutations of MP. The objective of this study was to evaluate the clinical impact of the rapid detection of macrolide resistance gene mutations in children with MP. This retrospective study included children ≤ 18 years of age with microbiologically confirmed MP requiring antimicrobial treatment. Clinical outcomes were compared between the SG Myco test and untested groups. A total of 298 participants (121 in the SG Myco test group and 177 in the untested group) were included. Macrolide resistance gene mutations were detected in 47.9 % of patients in the SG Myco-tested group. SG Myco test implementation was positively associated with macrolide use (adjusted odds ratio 2.20 [1.22, 3.99]; <em>p</em> = 0.009) and negatively associated with tetracycline use (adjusted odds ratio 0.41 [0.23, 0.75]; <em>p</em> = 0.003). A significant reduction in tetracycline use was observed following the implementation of the SG Myco test among children and adolescents with MP who required antimicrobial treatment. The results of our study demonstrated that rapid testing of macrolide resistance gene mutations facilitates timely and appropriate antimicrobial selection.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 11","pages":"Article 102930"},"PeriodicalIF":4.0,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144867262","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":"Regional epidemiologic data call for enhanced attention to Clostridioides difficile infections in Italy: Results from a population-based study","authors":"Fabrizio Stracci ,&nbsp;Camilla Gobbetti ,&nbsp;Gaia Baccarini ,&nbsp;Chiara Lupi ,&nbsp;Antonella Mencacci ,&nbsp;Gabrio Bassotti ,&nbsp;Pierfrancesco Marconi ,&nbsp;Katia Fettucciari ,&nbsp;Silvia Leite ,&nbsp;Alessio Gili ,&nbsp;CLOS working group","doi":"10.1016/j.jiph.2025.102928","DOIUrl":"10.1016/j.jiph.2025.102928","url":null,"abstract":"<div><h3>Background</h3><div><em>Clostridioides difficile (C. difficile</em>) Infection (CDI) is a major public health concern, causing a range of gastrointestinal diseases with increasing global incidence. In Italy, epidemiologic data on <em>Clostridioides difficile</em> CDI, particularly on community-acquired cases, are limited. This study aimed to provide population-based incidence data for CDI in Umbria, Italy, from 2014 to 2022, analyzing trends, demographics, recurrence rates, and 30-day all-cause mortality.</div></div><div><h3>Methods</h3><div>We used laboratory data from all regional public hospitals and local health units. CDI cases were <em>C. difficile</em> strains growing in culture and with toxin genes. The presence of toxin genes was confirmed by Xpert <em>C. difficile</em> Binary Toxin testing. Cases were categorized into hospital-acquired (HA-CDI) or community-acquired (CA-CDI). Incidence rates per 100,000 inhabitants per year were calculated. We analyzed incidence and 30-day mortality trends over a nine-year period. Logistic regression assessed predictors of 30-day mortality.</div></div><div><h3>Results</h3><div>5955 CDI cases were identified (57.7 % female). Overall incidence increased from 48.1 cases per 100,000 inhabitants in 2014–88 cases in 2022 (CA-CDI rose from 25.2 to 39 and HA-CDI from 22.9 to 49.2). The 30-day mortality risk was 17.6 % (1045 deaths). In multivariable analysis, adjusted 30-day all-cause mortality risk was higher among HA-CDI patients compared to CA-CDI (OR 1.8, 95 % CI 1.6–2.1). 30-day mortality risk was also higher for elderly patients and male gender. Moreover, the mortality risk was stable over time. Recurrence occurred in 655 (11 %) of patients.</div></div><div><h3>Conclusions</h3><div>The worrisome finding of increasing incidence of CDI in all settings, including hospital, indicates the urgency of establishing a stable surveillance system for CDIs. Considering the unfavorable trend and high mortality, measures to reduce the risk of CDI would be indicated, particularly in hospital and elderly home care settings where vulnerable patients concentrate.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 11","pages":"Article 102928"},"PeriodicalIF":4.0,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144879789","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":"Performance comparison of two dengue NS1 rapid diagnostic tests against RT-PCR: Sensitivity and specificity across infections and timeframes","authors":"Li-Teh Liu ,&nbsp;Po-Chih Chen ,&nbsp;Chen-Hsuan Lin ,&nbsp;Shi-Ya Huang ,&nbsp;Chun-Hong Chen ,&nbsp;Ching-Yi Tsai ,&nbsp;Ping-Chang Lin ,&nbsp;Cyuan-Ya Yang ,&nbsp;Jih-Jin Tsai","doi":"10.1016/j.jiph.2025.102919","DOIUrl":"10.1016/j.jiph.2025.102919","url":null,"abstract":"<div><h3>Background</h3><div>Dengue virus (DENV) is a mosquito-borne flavivirus that remains a global public health threat, particularly in tropical regions where it is endemic. Accurate and timely diagnosis is critical for optimal patient care and effective outbreak containment. While reverse transcription-polymerase chain reaction (RT-PCR) remains the gold standard for dengue diagnosis, nonstructural protein 1 (NS1) rapid diagnostic tests (RDTs) offer a more accessible alternative. However, their performance may vary with infection type, serotype, and the timing of sample collection.</div></div><div><h3>Methods</h3><div>We evaluated the diagnostic performance of two NS1 RDTs, Abbott NS1 and PBF NS1, against RT-PCR as the reference standard. A total of 183 dengue-positive and 40 dengue-negative samples were obtained during the 2023 dengue outbreak in Kaohsiung, Taiwan. Sensitivity, specificity, and predictive values were comprehensively assessed based on infection type, serotype, and post-symptom onset (PSO) intervals. Additionally, we analyzed the diagnostic benefits of combining NS1 detection with anti-DENV IgM serology.</div></div><div><h3>Results</h3><div>Abbott NS1 exhibited notably higher sensitivity (87.4 % vs. 83.1 %) and specificity (100 % vs. 97.5 %) compared to PBF NS1, though the differences were not statistically significant. Sensitivity varied by PSO, with Abbott NS1 achieving significantly higher sensitivity beyond three days (97.4 % vs. 76.9 %, P = 0.034). In secondary infections, Abbott NS1 outperformed PBF NS1 (86.8 % vs. 79.2 %). When combined with anti-DENV IgM serology, both RDTs demonstrated improved diagnostic sensitivity, particularly in secondary infections.</div></div><div><h3>Conclusions</h3><div>Our findings underscore the importance of context-specific diagnostic tools. Combining NS1 antigen detection with IgM serology enhances diagnostic accuracy. While Abbott NS1 demonstrated slightly better performance, PBF NS1 remains a viable and non-inferior alternative.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 11","pages":"Article 102919"},"PeriodicalIF":4.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144826372","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-visiting the surgical role in treating chemotherapeutic-resistance pulmonary tuberculosis: Results from a systematic review and meta-analysis.","authors":"Majed Al-Mourgi, Anwar Shams, Majed Wasal Al-Morgi, Ziyad Al-Morgi","doi":"10.1016/j.jiph.2025.102920","DOIUrl":"https://doi.org/10.1016/j.jiph.2025.102920","url":null,"abstract":"<p><strong>Background: </strong>The incidence and prevalence of multi-drug-resistant and extensively drug-resistant pulmonary tuberculosis are increasing, posing profound health concerns; therefore, surgical intervention is gaining popularity again. However, the effectiveness of surgical treatment needs to be reassessed. This study attempted to determine the efficacy of surgical treatment and chemotherapy compared to chemotherapy alone among patients with pulmonary tuberculosis.</p><p><strong>Methods: </strong>A systematic search and meta-analysis were conducted from inception to June 2025 of the existing databases, including PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and Google Scholar. All double-arm studies available in English published between 2005 and August 2019 were included. Among 618 studies, 468 were selected based on abstract review. Eight out of 468 (8/468) studies were double-arm retrospective cohorts and observational studies, which included 1929 persons who matched the inclusion criteria. To measure the success of the surgical intervention, we used the pooled rate ratio, loss of patient follow-up, and the incidence of mortality using the random effects heterogeneity model.</p><p><strong>Results: </strong>Overall, there was no statistically significant difference in the treatment success rate (RR=1.24 (0.98-1.56), p = 0.07) and mortality rate (RR=1.82 (0.31-10.63, p = 0.51) between the two groups. Interestingly, the summary rate ratio (RR=0.41 (0.18-0.93), p = 0.03) showed that the surgical group had a considerably lower loss rate to follow-up than the non-surgical group. There was no evidence of heterogeneity amongst the trials (I2 =0 %, τ2 =0.00, df=2, p = 0.36).</p><p><strong>Conclusions: </strong>The current meta-analysis was the first to use a factor of loss of follow-up collected from several reports as a predictive tool to assess the effectiveness of surgical participation in treating drug-resistant tuberculosis patients. The rate of patient loss to follow-up in the surgical group suggested that the combination approach of surgery and chemotherapy showed a potential superiority over chemotherapy alone.</p>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 11","pages":"102920"},"PeriodicalIF":4.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812107","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":"Severe circulatory failure caused by acute cardiac dysfunction in a young man with leptospirosis living in a slum of Rome, Italy (REV JI-PH-D-24–01876R3)","authors":"Salvatore Lucio Cutuli ,&nbsp;Fabiana Rizzo ,&nbsp;Gennaro De Pascale ,&nbsp;Silvia Costantini ,&nbsp;Anna Maria Marella ,&nbsp;Massimo Antonelli ,&nbsp;Alessandra Ciervo","doi":"10.1016/j.jiph.2025.102915","DOIUrl":"10.1016/j.jiph.2025.102915","url":null,"abstract":"<div><div>Leptospirosis may cause severe disease characterized by acute kidney injury, hepatic failure, or multiorgan dysfunction, including cardiac manifestations. The incidence and severity of cardiac involvement in leptospirosis are underreported and poorly understood. Moreover, left ventricular dysfunction is considered a rare complication in seen in leptospirosis cases. We present a case of leptospirosis in a 19-year-old male, living in a slum in Rome-Italy, without a previous cardiovascular history, who developed septic shock, and severe non-ischemic left ventricular systolic dysfunction following leptospirosis infection. In this setting, the patient developed KDIGO stage 3 acute kidney injury and acute circulatory failure, and requiring high dose norepinephrine and dobutamine. Empiric wide-spectrum antibiotic therapy with Piperacillin-Tazobactam was started early after the recognition of sepsis, and was deemed appropriate after the serological confirmation of leptospirosis. Patient’s clinical condition progressively improved and he was discharged after 21 days of hospital stay (6 of those were in the intensive care unit), with full organ function recovery.</div><div>To conclude, this case report supports the need for preventive public health interventions aiming to reduce the burden of environmentally transmitted life-threatening infectious diseases, including leptospirosis, by promoting sanitation and infrastructures, in order to prevent unequal health outcomes.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 11","pages":"Article 102915"},"PeriodicalIF":4.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144772984","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":"Shiga toxin-producing Escherichia coli O26:H11 associated with a cluster of haemolytic uraemic syndrome cases following the mid-July 2021 floods in Belgium","authors":"Florence Crombé ,&nbsp;Tiffany Dierinck ,&nbsp;Angel Rosas ,&nbsp;Alessandro Pellegrino ,&nbsp;Laurence Delbrassinne ,&nbsp;Catherine Ragimbeau ,&nbsp;Joel Mossong ,&nbsp;Naïma Hammami ,&nbsp;Cedric Van Cleemputte ,&nbsp;Arnaud Rouelle ,&nbsp;Francis Delloye ,&nbsp;Bram Vanmechelen ,&nbsp;Denis Piérard","doi":"10.1016/j.jiph.2025.102916","DOIUrl":"10.1016/j.jiph.2025.102916","url":null,"abstract":"<div><h3>Background</h3><div>Flood-related waterborne diseases are an acute consequence of natural disasters, primarily due to contamination of drinking water supplies. With climate change driving an increase in extreme weather events, such as floods, the risk of waterborne disease outbreak is expected to rise. This report summarizes an outbreak investigation of Shiga toxin-producing <em>Escherichia coli</em> (STEC) O26:H11 in the Belgian-Luxembourg following the mid-July 2021 floods.</div></div><div><h3>Methods</h3><div>In summer 2021, STEC O26 isolates referred to the Belgian National Reference Centre (NRC) were first characterized with IS621-typing, followed by whole genome sequencing (WGS)-based core genome multilocus sequence typing (cgMLST). As an outbreak was suspected, a national-level investigation was initiated. A retrospective analysis compared STEC incidence between flooded and non-flooded municipalities in Wallonia.</div></div><div><h3>Results</h3><div>The NRC identified a cluster of ten cases infected with STEC O26:H11 (s<em>tx</em>_2a⁺ and <em>eae</em>⁺), with identical IS621-profile. Six were confirmed by WGS; all six isolates of sequence type (ST) 21 were closely related. All six cases developed haemolytic uraemic syndrome (HUS) and resided in the Belgian-Luxembourg, heavily impacted by the mid-July 2021 floods. Retrospective analysis showed an increase in STEC cases in flooded areas of Wallonia. Surveillance questionnaires linked the illness to contaminated tap water that was consumed by all cases. Phylogenetic analysis revealed cross-border spread in the neighbouring Grand Duchy (GD) of Luxembourg. Five Luxembourgish cases, including two STEC-HUS cases, were epidemiologically linked to a same daycare centre.</div></div><div><h3>Conclusions</h3><div>This report describes an HUS cluster of STEC O26:H11 (ST21, <em>stx</em>_2a⁺, <em>eae</em>⁺) in Belgium following severe mid-July 2021 floods. Contaminated tap water was identified as the probable source of infection of the Belgian-Luxembourg cases, with possible secondary person-to-person transmission to children in a GD Luxembourgish daycare centre. This outbreak highlights the importance of sharing molecular typing data between countries and the need for rapid public health interventions following climate-driven disasters.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 11","pages":"Article 102916"},"PeriodicalIF":4.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144780030","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":"Adherence to tuberculosis infection treatment and its impact on prevention of tuberculosis reactivation: A retrospective cohort study from Taiwan.","authors":"Ying-Chun Chien, Chin-Hao Chang, Chin-Chung Shu, Hao-Chien Wang, Chong-Jen Yu","doi":"10.1016/j.jiph.2025.102917","DOIUrl":"https://doi.org/10.1016/j.jiph.2025.102917","url":null,"abstract":"<p><strong>Background: </strong>Treatment for tuberculosis infection (TBI) is often discontinued owing to adverse drug effects. The impact of treatment completion on TB reactivation remains poorly understood.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 1432 patients at one medical centre in Taiwan from 2016 to 2021. Patients with TBI were divided into three groups: non-initiation (N), incomplete treatment (IC), and complete treatment (C). Those exposure to TB but without TBI formed a control group. TB reactivation was analysed using multivariable Cox regression models, with follow-up for up to three years.</p><p><strong>Results: </strong>The overall TB reactivation rate was 2.3 % (34/1432), ranging from 6.1 % in the TBI (N) group (n = 378), 2.1 % in the TBI (IC) group (n = 330), 0.5 % in the TBI (C) group (n = 430), and 0.7 % in the control group (n = 294). TBI treatment was independently associated with a reduced risk of TB reactivation. The adjusted hazard ratio (aHR) for TBI (IC) versus TBI (N) was 0.32 (95 % CI 0.12-0.85, p = 0.022), and for TBI (C) versus TBI (N), the aHR was 0.05 (95 % CI 0.01-0.29, p < 0.001). Each 10 % increase in treatment adherence rate resulted in a 23 % reduction in the risk of TB reactivation (aHR 0.77, 95 % CI 0.67-0.88, p < 0.001).</p><p><strong>Conclusions: </strong>TBI treatment, prescribed to 67 % and completed by 38 % of patients, significantly reduces TB reactivation risk, especially with high adherence. Enhancing adherence, particularly among elderly patients and those with comorbidities, is crucial for improving the effectiveness of TBI treatment.</p>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 11","pages":"102917"},"PeriodicalIF":4.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812106","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":"Effects of intense exercise on innate bacterial killing in close contacts of patients with TB/MDR-TB.","authors":"Saikaew Chuachan, Hutcha Sriplung, Marisa Ponpuak, Virasakdi Chongsuvivatwong","doi":"10.1016/j.jiph.2025.102902","DOIUrl":"https://doi.org/10.1016/j.jiph.2025.102902","url":null,"abstract":"<p><strong>Background: </strong>Close contacts of patients with multidrug-resistant tuberculosis (MDR-TB) face a high infection risk due to limited chemoprophylaxis. Exercise is known to enhance the lung defense mechanisms. This study evaluated whether intense exercise can boost innate bacterial immunity in close contact by improving the in vitro killing of intracellular Mycobacterium tuberculosis.</p><p><strong>Methods: </strong>Twelve males (20-40 years) from a tuberculosis clinic were randomly assigned to exercise or no-exercise groups. The exercise group performed high-intensity cycling at 70-80 % of heart rate reserve (HRR) for 30-60 min, three days/week for 12 weeks. The no-exercise group engaged in self-directed exercise. Blood monocytes were isolated before and after the program and differentiated into inflammatory M1 and anti-inflammatory M2 macrophages. We infected the isolated monocytes and M1 and M2 macrophages with the mCherry-expressing laboratory reference M. tuberculosis strain H37Rv and a local strain of MDR-TB with a multiplicity of infection (MOI) is 10 for 0 and 72 h, and mycobacterial survival was determined via high content imaging.</p><p><strong>Results: </strong>Mycobacterial survival percentages were normalized to the 0-h infection control. In the exercise group, H37Rv survival was significantly decreased in monocytes, M1, and M2 macrophages compared to that in the no-exercise group. However, the local MDR strain reduced the survival of M1 macrophages but not that of monocytes or M2 macrophages. Additionally, cytokine secretion after H37Rv infection in monocytes showed a significant reduction in IL-1β levels, whereas no significant changes were observed in M1 and M2 macrophages.</p><p><strong>Conclusion: </strong>Intense exercise may enhance mycobacterial killing in individuals exposed to TB, particularly inflammatory M1 macrophages. Promoting intense exercise among close contacts of patients with TB may be beneficial.</p>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 11","pages":"102902"},"PeriodicalIF":4.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799356","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":"Characteristics and prognostic factors of TB loss to follow up (LTFU) in Malaysia – A 5-year retrospective cohort from 2014 to 2018","authors":"Ahmad Yusri Abd Rani ,&nbsp;Nurhuda Ismail ,&nbsp;Yuslina Zakaria ,&nbsp;Mohamad Rodi Isa","doi":"10.1016/j.jiph.2025.102913","DOIUrl":"10.1016/j.jiph.2025.102913","url":null,"abstract":"<div><h3>Background</h3><div>Tuberculosis (TB) loss to follow-up (LTFU) disrupts treatment, compromises patient outcomes, and exacerbates public health challenges. This study evaluates the prevalence, time to LTFU, and prognostic factors of TB LTFU among adults in Malaysia between 2014 and 2018.</div></div><div><h3>Methods</h3><div>A retrospective cohort analysis was conducted using national data from the MyTB database, comprising 97,542 TB patients. Kaplan-Meier analysis determined the time to LTFU, while Cox proportional hazards analysis identified significant prognostic factors.</div></div><div><h3>Results</h3><div>The prevalence of TB LTFU decreased from 7.09 % in 2014 to 5.71 % in 2018. The mean time to LTFU was 54.8 days during intensive phase and 162.5 during continuation phase. Significant risk factors for LTFU included age &lt; 65 years, male gender, urban residence, smoking, diabetes, and initiation of treatment at government facilities. Notably, the absence of Directly Observed Therapy (DOT) during the continuation phase markedly increased LTFU risk (adjusted HR 33.18; 95 % CI: 31.02–35.48).</div></div><div><h3>Conclusion</h3><div>Despite a declining trend in TB LTFU prevalence, younger age, urban residence, and lack of DOT during continuation remain key challenges. Strengthening DOT implementation and targeted interventions for at-risk groups are crucial for reducing TB LTFU and improving treatment adherence.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 11","pages":"Article 102913"},"PeriodicalIF":4.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144772598","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}