Open Forum Infectious Diseases最新文献

{"title":"Clinical Characteristics and Mortality Predictors of Group B Streptococcus Bacteremia in Adults: A Multicenter Retrospective Cohort Study in Japan, 2015-2024.","authors":"Kohei Oguni, Hidemasa Akazawa, Shinnosuke Fukushima, Yasuhiro Suzuki, Katsuki Kanai, Yuto Haruki, Kengo Mukuda, Hidemaru Matsumoto, Tatsuya Fujihara, Hideharu Hagiya","doi":"10.1093/ofid/ofag665","DOIUrl":"https://doi.org/10.1093/ofid/ofag665","url":null,"abstract":"<p><strong>Background: </strong>Invasive group B Streptococcus (GBS) infection in nonpregnant adults is increasing, particularly among older adults and those with underlying comorbidities. However, multicenter data on prognostic factors for adult GBS bacteremia in Japan remain limited.</p><p><strong>Methods: </strong>We conducted a multicenter retrospective observational cohort study of adults with GBS bacteremia at 7 hospitals in western Japan between 2015 and 2024. Variables analyzed included clinical characteristics, infection sites, microbiological characteristics, and antimicrobial susceptibility profiles. Univariable and multivariable logistic regression analyses were performed to identify factors associated with 30-day mortality.</p><p><strong>Results: </strong>A total of 442 patients were included. Median age [interquartile range] was 75 [64-84] years, and 83.0% had at least 1 comorbidity. The overall 30-day all-cause mortality for GBS bacteremia was 9.3% (41/442), which rose to 39.3% (11/28) among patients with streptococcal toxic shock syndrome (STSS). In multivariable analysis, STSS was the strongest predictor of death (adjusted odds ratio [aOR], 9.16; 95% confidence interval [CI], 3.28-25.58), followed by immunosuppressive therapy (aOR, 4.62; 95% CI, 1.66-12.86), cirrhosis (aOR, 3.40; 95% CI, 1.23-9.40), respiratory infection (aOR, 3.30; 95% CI, 1.08-10.06), advanced renal dysfunction (aOR, 2.66; 95% CI, 1.09-6.52), and polymicrobial bacteremia (aOR, 2.40; 95% CI, 1.03-5.57), whereas skin and soft tissue infection was associated with lower mortality (aOR, 0.07; 95% CI, 0.01-0.53).</p><p><strong>Conclusions: </strong>Adult GBS bacteremia carries a high burden of short-term mortality, with a wide variety of clinical presentations, necessitating prompt diagnostic and therapeutic intervention.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 10","pages":"ofag665"},"PeriodicalIF":3.8,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13684403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149245759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Manifestations and Outcomes of Hospitalized Patients With Blastomycosis: A Provincial Cohort Study.","authors":"Benjamin Meyers, John Embil, Robert Balshaw, Barret Rush, Christina Tarrant, Kevin Thomas, Tyler MacDonald, Terence Wuerz, Yoav Keynan, Ryan Zarychanski, Philippe Lagacé-Wiens, Sylvain A Lother","doi":"10.1093/ofid/ofag656","DOIUrl":"https://doi.org/10.1093/ofid/ofag656","url":null,"abstract":"<p><strong>Background: </strong>Blastomycosis is a rare but potentially life-threatening infection caused by <i>Blastomyces</i> spp that is endemic in the Canadian provinces of Manitoba and northwestern Ontario. Given evolving epidemiology of endemic mycoses, we sought to evaluate the provincial experience managing inpatients with blastomycosis over time. The objectives were to describe the risk factors and predictors of poor outcomes among patients hospitalized with blastomycosis throughout Manitoba.</p><p><strong>Methods: </strong>We performed a provincial retrospective cohort study by identifying all culture-positive clinical specimens yielding <i>Blastomyces</i> spp within Manitoba, using the Provincial Lab Information System. We included all adult patients who required admission to hospital for infectious manifestations of microbiologically confirmed blastomycosis since 2006. We used a multivariate regression model to predict associations with mortality.</p><p><strong>Results: </strong>Of 317 patients with culture-positive <i>Blastomyces</i> spp, we included 141 hospitalized patients across 7 hospitals. Overall, in-hospital mortality was 24%. The presence of chest pain at presentation to hospital (odds ratio, 3.24 [95% confidence interval, 1.26-8.83]) was associated with mortality. Hospital admissions, intensive care unit admissions, and mortality have a positive temporal trend over the study period.</p><p><strong>Conclusions: </strong>Blastomycosis is associated with significant morbidity and mortality, both of which is increased over time. Further studies are needed to evaluate effective diagnostic and treatment strategies to improve outcomes.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 10","pages":"ofag656"},"PeriodicalIF":3.8,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13684396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149245788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimation of Antimicrobial-Resistant <i>Mycoplasma genitalium</i> Infections in People Aged 14-59 Years: Results From the National Health and Nutrition Examination Survey, United States, 2017-2018.","authors":"Lisa E Manhart, Mary Bridget Waters, Christine M Khosropour, Kristen M Kreisel, Anika Parker, Emily D Pollock, Kevin Hybiske, Jørgen S Jensen","doi":"10.1093/ofid/ofag641","DOIUrl":"10.1093/ofid/ofag641","url":null,"abstract":"<p><p><i>Mycoplasma genitalium</i> antimicrobial resistance is common in US sexual health clinics. Population-level prevalence is unknown. We tested National Health and Nutrition Examination Survey (2017-2018) specimens for <i>M genitalium</i> resistance mutations (n = 58). Macrolide resistance prevalence was 42.7% (95% CI, 24.4%-62.7%). Quinolone resistance was not detected. Macrolide resistance testing should guide azithromycin treatment.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 10","pages":"ofag641"},"PeriodicalIF":3.8,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Whole-blood Transcriptional Signature Associated With Obstructive Post-tuberculosis Lung Disease.","authors":"Renee E Newby, Lucy Kijaro, Kimberly A Dill-McFarland, Lilian N Njagi, Wilfred B Murithi, Zipporah Mwongera, Moeko Agata, Jodi Byers, Glenna J Peterson, Kevin P Fennelly, Videlis Nduba, David J Horne, Jerry S Zifodya, Thomas R Hawn","doi":"10.1093/ofid/ofag610","DOIUrl":"10.1093/ofid/ofag610","url":null,"abstract":"<p><strong>Background: </strong>Post-tuberculosis (TB) lung disease (PTLD) affects ∼50% of persons with pulmonary TB (PTB). We recently discovered whole blood transcriptional signatures associated with PTLD. We examined whether a minimum gene signature predicts PTLD as a clinically useful biomarker.</p><p><strong>Methods: </strong>We prospectively enrolled 301 treatment naive adults with newly diagnosed PTB (cohort A). We collected whole blood at 0 and 6-month visits, isolated RNA, and measured a modified MTB host response (HR) signature (mHR) based on expression of DUSP3, GBP5, and TMBIM6. We recorded spirometry at 6 (<i>n</i> = 216) and 12 months (<i>n</i> = 210) after treatment initiation and examined the association of the mHR score with PTLD and Mtb aerosolization. We recruited household contacts of cohort A to compare mHR score with non-PTB participants (cohort B).</p><p><strong>Results: </strong>mHR was associated with TB (<i>P</i> = 4.15e-66) when compared to HHCs, treatment response (<i>P</i> = 1.07e-53), and characteristics including CD4 count (<i>P</i> = .003), bacillary load (<i>P</i> = 3.02e-05), lung cavities (<i>P</i> = 1.59e-04), and lung quadrants involved (<i>P</i> = 3.87e-06). The mHR score was not associated with Mtb aerosolization. In total, 105 (50%) participants had PTLD at 12 months including 61 with restriction, 26 with obstruction, and 18 with mixed obstruction and restriction. Baseline mHR was associated with obstructive PTLD at both 6 (<i>P</i> = .003) and 12 months (<i>P</i> = .012) in bivariate and multivariate analyses. The mHR score was not associated with restrictive lung disease.</p><p><strong>Conclusions: </strong>Baseline mHR was associated with obstructive PTLD at 6 and 12 months and may have applications in targeting treatment and prognostication.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 10","pages":"ofag610"},"PeriodicalIF":3.8,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13678225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Neurohistoplasmosis Successfully Treated With Single High-Dose Liposomal Amphotericin B.","authors":"Tarsila Vieceli, Renata de Bastos Ascenço Soares, Taiguara Fraga Guimarães, João Victor Soares Coriolano Coutinho, Debora Brenda Paes Rocha Sabino, Cassia Silva de Miranda Godoy, Daiane F Dalla-Lana, Luana C Bazana, Nathan C Bahr, Alessandro C Pasqualotto","doi":"10.1093/ofid/ofag659","DOIUrl":"10.1093/ofid/ofag659","url":null,"abstract":"<p><p>Disseminated histoplasmosis is a leading AIDS-related opportunistic mycosis and carries high mortality risk. A simplified induction strategy using single high-dose of liposomal amphotericin B (L-AmB) has shown promise for disseminated disease, but persons with central nervous system (CNS) involvement were excluded from the clinical trial. We describe a 35-year-old man with advanced HIV disease (CD4 24 cells/µL) and a high fungal burden who was diagnosed with disseminated histoplasmosis and, subsequently, culture-confirmed CNS involvement. He was administratively withdrawn from the trial when CNS involvement was noted. He was treated within a randomized trial with a single 10 mg/kg dose of L-AmB, followed by antiretroviral therapy (ART) and itraconazole consolidation therapy, with full clinical recovery, normalization of cerebrospinal fluid biochemistry findings, and microbiological clearance. This suggests that a single high-dose L-AmB induction strategy, combined with effective ART and azole consolidation therapy, may be viable in selected patients with CNS involvement.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 10","pages":"ofag659"},"PeriodicalIF":3.8,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Patients' Voice in <i>Clostridioides difficile</i> Infection: Large Language Model-Assisted Thematic Analysis of Patient Testimonials.","authors":"Javier A Villafuerte-Gálvez, Marco A Noriega, Sena Cakir Colak, Carl V Crawford","doi":"10.1093/ofid/ofag650","DOIUrl":"10.1093/ofid/ofag650","url":null,"abstract":"<p><strong>Background: </strong><i>Clostridioides difficile</i> infection (CDI) imposes a burden that extends well beyond the gastrointestinal tract, yet existing outcome measures only partially capture the patient experience. We used frontier large language models (LLMs) on patient and caregiver narratives at scale to describe how burden shifts with disease course.</p><p><strong>Methods: </strong>We analyzed 189 testimonials from the Peggy Lillis Foundation corpus, sorted into 4 cohorts with recurrence (<i>r</i>) and fulminant (<i>f</i>) severity as axes (rfCDI, fCDI, rCDI, non-rfCDI). Two independent LLMs coded 8 thematic domains, 4 fulminant flags, 13 emerging semantic fields, the dominant dimension, and narrative arcs. Two physicians independently coded a subset for inter-rater reliability (PABAK, Gwet's AC1).</p><p><strong>Results: </strong>Treatment trajectory was the dominant theme in recurrent disease, whereas death and near-death dominated nonrecurrent fulminant narratives. Psychological burden was near-universal in fulminant disease (98.0% in rfCDI, 97.2% in fCDI). Caregiver and bereavement content concentrated in fCDI (66.7%). Diagnostic failure was frequent across recurrent cohorts (47.6-56.1%). Mentions of bacteriotherapy (fecal microbiota transplantation) concentrated in recurrent cohorts (60.2% rfCDI versus 5.6% fCDI). Financial, mental-health, and caregiver burdens were prominent and remain largely unaddressed by guidelines. Human-human reliability was substantial (PABAK 0.79 for semantic fields, 0.76 for domains); arc coding was least reliable.</p><p><strong>Conclusions: </strong>Patient narratives reveal a course-dependent, multidimensional burden in CDI. Concrete gaps exist between what patients prioritize, what guidelines recommend, and what therapy access provides. Frontier-LLM coding, validated against clinicians, offers a reproducible route to translate these priorities into research, care, and policy.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 10","pages":"ofag650"},"PeriodicalIF":3.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypervirulent <i>Klebsiella pneumoniae</i> Infections in Vancouver, Canada: A Clinical, Microbiological, and Genetic Retrospective Investigation.","authors":"Emma C L Finlayson-Trick, Aleksandra Stefanovic, Michael Payne, Leah Gowland, Jennifer Bilawka, Gordon Ritchie, Samuel D Chorlton, Nancy Matic, Victor Leung, Laura F Mataseje, Marc G Romney, Christopher F Lowe, Patrick Tang","doi":"10.1093/ofid/ofag654","DOIUrl":"https://doi.org/10.1093/ofid/ofag654","url":null,"abstract":"<p><strong>Background: </strong>Hypervirulent <i>Klebsiella pneumoniae</i> (hvKp) is poorly characterized in North America and likely underrecognized. We evaluated a molecular screening approach for hvKp and described the clinical, microbiological, and genomic characteristics of hvKp isolates in Vancouver, Canada.</p><p><strong>Method: </strong>We conducted a retrospective study of sterile-site Kp isolates recovered at a tertiary care center (2018-2024). Archived isolates were screened using polymerase chain reaction (PCR) targeting <i>peg-344</i> and <i>iucA</i>. Whole-genome sequencing was then performed, with hvKp defined as a Kleborate virulence score of ≥3. Clinical data were obtained through chart review. Genomic relatedness was assessed using reference-based multilocus sequence typing.</p><p><strong>Results: </strong>Among 449 isolates, 43 were PCR positive for <i>peg-344</i> and/or <i>iucA</i>, and 38 met criteria for hvKp. Only 5 (13%) cases were suspected at the time of isolation. The molecular screen demonstrated 100% sensitivity and 98.8% specificity for hvKp detection. Compared with classical Kp, hvKp infection was independently associated with travel history (adjusted odds ratio [aOR], 9.73; 95% CI, 2.06-46.04) and residence in Vancouver's Downtown Eastside (DTES; aOR, 3.69; 95% CI, 1.05-12.97), but not with Indo-Pacific country of origin (aOR, 1.77; 95% CI, .49-6.37). Genomic analysis suggested possible local transmission between 2 DTES patients. K1/K2 were the most common capsular serotypes. One ST15 hvKp isolate carried <i>bla</i> _NDM, representing a convergent hypervirulent and carbapenem-resistant strain.</p><p><strong>Conclusions: </strong>Routine molecular screening improved detection of hvKp and revealed evolving epidemiology, including possible clonal transmission. Implementing laboratory-based molecular screening can enhance clinical recognition, guide evaluation for metastatic complications, and monitor the emergence of high-risk strains.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 10","pages":"ofag654"},"PeriodicalIF":3.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Higher Risk of Loss to Follow-up Among Transgender People With HIV in Italy: Findings From the ICONA Cohort.","authors":"Davide Moschese, Marco Muccio, Giuseppe Lapadula, Valentina Mazzotta, Elena Bruzzesi, Andrea Poloni, Massimo Cernuschi, Alessandra Rodano', Silvia Nozza, Antonio Di Biagio, Sergio Lo Caputo, Cristina Mussini, Alessandro Cozzi-Lepri, Roberto Rossotti, Andrea Giacomelli","doi":"10.1093/ofid/ofag640","DOIUrl":"https://doi.org/10.1093/ofid/ofag640","url":null,"abstract":"<p><strong>Background: </strong>Official data on transgender people with human immunodeficiency virus (PWH) in Italy are lacking because gender identity is not recorded in national reports. We aimed to characterize transgender PWH in Italy and assess retention in care and clinical outcomes.</p><p><strong>Methods: </strong>We included PWH enrolled between 2010 and 2023 in 40 Italian Cohort Naive Antiretrovirals centers where gender identity could be reliably ascertained. Transgender PWH were compared with cisgender participants. Univariable and multivariable regression models assessed the association between gender identity and (1) loss to follow-up (LTFU; no visit or exam for ≥18 months) using Fine-Gray models and (2) a composite clinical endpoint including mortality, major adverse cardiovascular events, cancer, acquired immunodeficiency syndrome-defining events, and end-stage kidney and liver disease using Cox models. Sensitivity analyses were restricted to individuals who initiated antiretroviral therapy (ART) from 2016 onward.</p><p><strong>Results: </strong>Overall, 256 transgender and 9922 cisgender PWH were included. Transgender PWH were younger (median 32 vs 39 years, <i>P</i> < .0001), more often assigned male at birth (99.6% vs 82.4%, <i>P</i> < .0001). Transgender PWH had a higher unadjusted risk of LTFU (subdistribution hazard ratio [sHR] 1.88, 95% confidence interval [CI] 1.60-2.22), confirmed after adjustment (adjusted sHR [asHR] 1.41, 95% CI 1.18-1.68) and in the post-2016 subgroup (asHR 1.39, 95% CI 1.11-1.77). Composite endpoint analyses were inconclusive (transgender PWH vs cisgender PWH: overall adjusted hazard ratio [aHR] 1.30 [95% CI .79-2.14], <i>P</i> = .293; post-2016 aHR 1.69 [95% CI .91-3.16], <i>P</i> = .098).</p><p><strong>Conclusions: </strong>Transgender PWH had a substantially higher risk of LTFU than cisgender participants in this national Italian cohort. Tailored interventions are needed to improve retention and health outcomes.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 10","pages":"ofag640"},"PeriodicalIF":3.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Characterization and Outcomes of Pneumonic Plague in Madagascar: A Case Series.","authors":"Mihaja Raberahona, Lisy Hanitra Razananaivo, Tansy Edwards, Tsinjo Fehizoro Razafindrantsinana, Reziky Tiandraza Mangahasimbola, Theodora Mayouya-Gamana, Ravaka Randriamparany, Voahangy Andrianaivoarimanana, Minoarisoa Rajerison, Josephine Bourner, Rindra Randremanana, Peter Horby, Piero Olliaro","doi":"10.1093/ofid/ofag635","DOIUrl":"10.1093/ofid/ofag635","url":null,"abstract":"<p><p>Pneumonic plague is rare compared to bubonic plague; data on clinical presentation and treatment outcomes are scant. We report on 13 prospectively-enrolled suspected pneumonic plague cases (7 laboratory-confirmed, one probable, 5 not-plague) treated with aminoglycoside plus ciprofloxacin for 10 days and discuss findings in the context of the available literature.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 10","pages":"ofag635"},"PeriodicalIF":3.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic Review and Meta-Analysis of Clinical Severity and Population-Specific Outcomes of Human Metapneumovirus Infection.","authors":"Yu Miao, Shangchen Song, Zachary J Madewell, Zhumengmeng Jin, Yumiao Lei, Evelyn Shi, Yixuan Zeng, Mingjing Liu, Ira M Longini, Yang Yang","doi":"10.1093/ofid/ofag634","DOIUrl":"https://doi.org/10.1093/ofid/ofag634","url":null,"abstract":"<p><strong>Background: </strong>Human metapneumovirus (HMPV) is a prevalent respiratory pathogen, but comprehensive estimates of severe clinical outcomes across populations are lacking. We synthesized the proportion of severe outcomes among people with laboratory-confirmed HMPV infection.</p><p><strong>Method: </strong>We searched PubMed, Embase, Web of Science, Scopus, Cochrane Library, medRxiv, bioRxiv, and Google Scholar from inception to 20 January 2026, without language restrictions. Observational studies reporting severe outcomes (hospitalization, intensive care unit [ICU] admission, respiratory support, mechanical ventilation, mortality) in laboratory-confirmed HMPV infection were eligible; studies enrolling only people who are immunocompromised without comparators were excluded. Two reviewers independently extracted data and assessed quality using Joanna Briggs Institute checklists. Pooled proportions were estimated using random-effects generalized linear mixed models with logit transformation. Subgroup analyses examined healthcare setting and age.</p><p><strong>Results: </strong>Ninety-four studies (∼26 000 people who are HMPV positive) were included. Pooled proportions were 48% (95% CI, 20%-78%; 8 studies, n = 1445) for hospitalization; 12% (95% CI, 8%-16%; 26 studies, n = 14 522; Egger <i>P</i> = .03) for ICU admission; 40% (95% CI, 26%-56%; 18 studies, n = 4328) for respiratory support; 8% (95% CI, 5%-13%; 16 studies, n = 5543) for mechanical ventilation; and 3% (95% CI, 2%-5%; 29 studies, n = 13 657; I² = 78.5%) for in-hospital mortality. Mortality was highest among adults (6%).</p><p><strong>Conclusions: </strong>Human metapneumovirus causes substantial hospitalization, ICU admission, and mortality, supporting strengthened surveillance, integration into respiratory virus prevention strategies, and accelerated vaccine development.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"13 10","pages":"ofag634"},"PeriodicalIF":3.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13693478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149271550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}