Therapeutic Advances in Infectious Disease最新文献

{"title":"Clinical presentation, management, and outcomes of aortic endograft infections: a retrospective descriptive study.","authors":"Haitham Alaithan, Sarwat Khalil, Gustavo Oderich, Larry M Baddour, Muhammad Rizwan Sohail","doi":"10.1177/20499361261465761","DOIUrl":"10.1177/20499361261465761","url":null,"abstract":"<p><strong>Background: </strong>Aortic endograft infection (AEGI) is a rare complication of abdominal endovascular aortic repair (EVAR) and thoracic endovascular aortic repair (TEVAR). Surgical explantation with reconstruction is recommended, but data on medical management remain limited. We present our institutional experience with AEGI.</p><p><strong>Objective: </strong>To describe the clinical presentation, microbiology, management strategies, and outcomes of patients with AEGI, with the aim of addressing current gaps in the literature and informing future research to improve patient outcomes.</p><p><strong>Design: </strong>Retrospective descriptive study.</p><p><strong>Methods: </strong>Adult patients admitted with AEGI at our institution between January 2017 and August 2024 were identified using ICD-10 codes and confirmed using the Management of Aortic Graft Infection Collaboration (MAGIC) diagnostic criteria. Clinical, microbiological, radiographic, treatment, and outcome data were collected and analyzed.</p><p><strong>Results: </strong>We screened 517 patients, and 46 met AEGI criteria (EVAR 54%, TEVAR 46%). Most (63%) presented with late-onset infections (⩾3 months). Fever (54%) and sepsis (48%) were common presenting symptoms. Computed tomography (CT) (85%) was the primary imaging modality. Blood cultures were positive in 54% of the cases, with <i>Staphylococcus aureus</i> being the most common monomicrobial pathogen (24%), and 24% of cases were polymicrobial. The majority (67%) received combined medical and surgical therapy. Chronic antibiotic suppressive therapy was used in 34 (74%), most often tetracyclines (33%). Overall, treatment success rates were similar between surgical and medical groups (58% vs 60%, <i>p</i> = 0.250) with comparable mortality. However, relapses were more frequent in the medical-only group (33% vs 16%, <i>p</i> = 0.185).</p><p><strong>Conclusion: </strong>Most patients presented with late-onset AEGI. Fever was absent in nearly half of cases, and blood cultures were positive in only 54%. Overall, surgical and medical therapy had similar success, though relapses were more frequent in those treated medically alone.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261465761"},"PeriodicalIF":3.8,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13376498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The HIV/AIDS landscape in Bangladesh: an updated review of epidemiological trends, prevention gaps, and key population engagement.","authors":"Tahsin Waseqa, Sumaiya Haque, Ramisa Anjum, Mohammad Shahriar, Mohiuddin Ahmed Bhuiyan","doi":"10.1177/20499361261459589","DOIUrl":"10.1177/20499361261459589","url":null,"abstract":"<p><p>HIV/AIDS in Bangladesh has historically remained below 0.01% prevalence in the general population; however, recent provisional epidemiological data indicate a concerning shift, with the highest annual increase recorded between November 2024 and October 2025 (1891 new cases; 254 AIDS-related deaths), signaling evolving transmission dynamics. Despite an overall low national prevalence, the epidemic remains highly concentrated among key populations, including people who inject drugs (PWID), men who have sex with men (MSM), female sex workers (FSW), transgender individuals, and migrant workers, where prevention and service coverage gaps have been documented. This narrative review synthesizes evidence published between 2015 and 2025 on HIV epidemiology, prevention strategies, testing infrastructure, treatment outcomes, and structural barriers in Bangladesh. Data were drawn from peer-reviewed studies identified through systematic searches of PubMed/MEDLINE, Google Scholar, and Bangladesh-specific repositories, supplemented by national surveillance reports (National AIDS/STD Programme; Integrated Biological and Behavioral Surveys), international agency documents (UNAIDS, WHO, Global Fund), and recent programmatic reports. Both peer-reviewed and grey literature sources were included to capture the full range of available evidence. Findings reveal significant deficiencies across the HIV response cascade. Geographic availability of testing services is limited to 23 of 64 districts, and prevention coverage is suboptimal, reaching just 26% of MSM and male sex workers. Progress along the treatment cascade shows 82% of people living with HIV diagnosed (approximately 14,334 of an estimated 17,480), 74% of those diagnosed receiving antiretroviral therapy, and 91% of those on ART achieving viral suppression, all falling short of global 95-95-95 targets. Behavioral indicators highlight ongoing vulnerabilities; only 14.4% of MSM report condom use with commercial partners in the past 6 months and 27% of female sex workers reporting no condom use at last sexual encounter. Stigma and discrimination continue to undermine the response, with 68% of people living with HIV reporting feelings of shame and 54% reporting guilt related to their diagnosis, adversely affecting testing, disclosure, and care engagement. Despite these challenges, harm reduction programs and a pilot pre-exposure prophylaxis (PrEP) initiative demonstrate substantial promise. Strengthening targeted prevention, expanding testing and treatment access, and addressing stigma, funding constraints, and structural barriers are essential to sustaining Bangladesh's low-prevalence status and advancing toward the goal of ending AIDS as a public health threat by 2030.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261459589"},"PeriodicalIF":3.8,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13338530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vitamin D receptor <i>BsmI</i> haplotype <i>BB</i> confers lower 25(OH)D levels during tuberculosis: a pilot cross-sectional study.","authors":"Dilcia Sambrano, Sandra Martín-Peláez, Kharla Salazar, Priya Patel, Fermín Acosta, Johanna Elizabeth Ku, Anabel Argelis García, Emilio Romero, Yaracelis Cuadra, Stephanie Hawkins, Isolina Martínez, Odemaris Luque, Laura Solís, Geydi Cañate, Mariela Vergara, Lizbeth Garibaldi, Julio Jurado, Amador Goodridge","doi":"10.1177/20499361261458154","DOIUrl":"10.1177/20499361261458154","url":null,"abstract":"<p><strong>Background: </strong>Adequate micronutrient absorption remains key for tuberculosis control.</p><p><strong>Objective: </strong>To evaluate the frequency of vitamin D receptor polymorphisms, <i>FokI</i>, <i>TaqI</i>, and <i>BsmI</i>, and their relationship with total vitamin D and cathelicidin levels in patients with pulmonary tuberculosis (PTB) and healthy controls (HC) in the province of Colon, Panama.</p><p><strong>Design: </strong>Pilot cross-sectional study, PTB (<i>n</i> = 80) and HC (<i>n</i> = 50).</p><p><strong>Methods: </strong>We measured total vitamin D (25-OH-vitamin D, 25(OH)D) and cathelicidin (LL-37) levels by enzyme-linked immunosorbent assays and analyzed vitamin D receptor (VDR) polymorphisms by PCR-RFLP. We compared the total 25(OH)D and cathelicidin levels across participant demographics and explored the associations with vitamin D receptor polymorphisms.</p><p><strong>Results: </strong>We observed no significant difference in vitamin D levels between PTB and HC (median (IQR) = 36.6 (27.6-48.7) ng/mL and 32.5 (18-46.3) ng/mL, respectively, <i>p</i> = 0.067). In terms of sex, vitamin D levels in women were higher in the PTB group compared to HC (median (IQR) = 33.9 (26.8-48.1) versus 19.5 (11.8-33.4) ng/mL, <i>p</i> = 0.002). Regarding LL-37, PTB unemployed participants showed higher levels compared to HC (median (IQR) = 59.4 (42.4-79.3) versus 28.2 (13.9-42.8) ng/mL, <i>p</i> = 0.048), as well as Hispanic PTBs (59.6 (48.2-71.41) versus 38.9 (19.5-49.2) ng/mL, <i>p</i> = 0.014). As for the treatment phase, vitamin D levels in PTB within 1 month of treatment were higher than HC (median (IQR) = 39.9 (28.5-50.51) versus 32.5 (18-46.3) ng/mL, <i>p</i> = 0.06). When stratifying by sex, these differences were observed only in women (median (IQR) = 41.4 (27.9-55.5) versus 19.5 (11.8-33.4) ng/mL for PTB and HC, respectively; <i>p</i> = 0.01). A statistically significant association was observed between the <i>BsmI</i> VDR polymorphism and serum 25-hydroxyvitamin D levels, with a significant difference between PTB and HC (<i>p</i> = 0.004).</p><p><strong>Conclusion: </strong>The observed associations between VDR polymorphisms, vitamin D levels, and cathelicidin levels highlight the need for further studies to clarify the role of host genetic and sociodemographic factors in pulmonary tuberculosis susceptibility and immune response.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261458154"},"PeriodicalIF":3.8,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interpretable machine learning models for pre- and postoperative prediction of early intra-abdominal infections after liver transplantation: a multicenter retrospective cohort study.","authors":"Shuang Cao, Hua-Bin Peng, Xin-Zhe Wei, Lei Wang, Ying Liu, Wei Qu, Zhi-Gui Zeng, Hai-Ming Zhang, Lin Wei, Hao-Feng Xiong, Fei Hou, Zhi-Jun Zhu, Wei Gao, Li-Ying Sun","doi":"10.1177/20499361261453152","DOIUrl":"10.1177/20499361261453152","url":null,"abstract":"<p><strong>Background: </strong>Early intra-abdominal infections (EIAIs) are among the most frequent and life-threatening complications following liver transplantation (LT). Early identification of high-risk patients remains challenging, and no standardized risk stratification tool is currently available.</p><p><strong>Objective: </strong>To develop and externally validate interpretable machine learning (ML) models for preoperative and postoperative prediction of EIAIs after LT.</p><p><strong>Design: </strong>A multicenter retrospective cohort study.</p><p><strong>Methods: </strong>A total of 363 adult LT recipients were included (Center 1: <i>n</i> = 285; Center 2: <i>n</i> = 78). EIAIs were defined as intra-abdominal infections occurring within 30 days after LT. From 120 candidate variables, predictors were selected using random forest, LASSO regression, and univariate logistic regression. Seven ML algorithms were evaluated, and stacking ensemble models were selected as the final preoperative (pre-liver transplantation early intra-abdominal infection forecast tool (LIFT)) and postoperative (post-LIFT) models. Internal testing and external validation were performed. Model interpretability was assessed using SHapley Additive exPlanations (SHAP).</p><p><strong>Results: </strong>The stacking models demonstrated superior performance. For pre-LIFT, the areas under receiver operator characteristic curve (ROC) curves (AUCs) were 0.995 ± 0.004 (training), 0.818 ± 0.056 (testing), and 0.796 ± 0.024 (external validation). For post-LIFT, AUCs were 0.996 ± 0.003, 0.847 ± 0.055, and 0.858 ± 0.026, respectively. Both models significantly outperformed model for end-stage liver disease and Child-Turcotte-Pugh scores (all <i>p</i> < 0.05). SHAP analysis revealed that baseline liver dysfunction, inflammatory markers, and immune status were key determinants in the pre-LIFT model, whereas perioperative factors such as intraoperative blood loss, ICU stay, and drainage duration predominated in the post-LIFT model.</p><p><strong>Conclusion: </strong>We developed and externally validated interpretable ML-based models (LIFT) for predicting EIAIs after LT. These models enable individualized risk stratification at both preoperative and postoperative stages and may support personalized infection surveillance and management strategies. Prospective validation is warranted.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261453152"},"PeriodicalIF":3.8,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13305796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment gaps and risk factors for multidrug-resistant Enterobacterales in Belize: a 6-year (2018-2023) nationwide retrospective analysis.","authors":"Innocent Nwachukwu, Camryn Linares, Griseidy Alcoser, Nivi Novelo, Danladi C Husaini","doi":"10.1177/20499361261458469","DOIUrl":"10.1177/20499361261458469","url":null,"abstract":"<p><strong>Background: </strong>Antimicrobial resistance (AMR) in <i>Escherichia coli</i>, <i>Klebsiella pneumoniae</i>, and <i>Enterobacter cloacae</i> is a global threat, yet data from Belize and the wider Caribbean are scarce. Understanding local resistance patterns is critical for effective treatment and stewardship.</p><p><strong>Objectives: </strong>To determine antibiotic susceptibility patterns, quantify multidrug resistance (MDR) in outpatient and inpatient settings, identify predictors of empirical treatment failure for urinary tract infections (UTIs), and analyze temporal and geographic trends.</p><p><strong>Design: </strong>Nationwide retrospective analysis of clinical isolates from Belize's public health system (2018-2023).</p><p><strong>Methods: </strong>We analyzed 4591 clinical isolates. MDR was defined as non-susceptibility to ⩾3 drug categories. Multivariable logistic regression identified predictors of the risk of empirical treatment failure for UTIs. Joinpoint regression analyzed temporal trends. Geospatial analysis mapped hotspots of incidence and resistance.</p><p><strong>Results: </strong><i>E. coli</i> was predominant (68%). Among 3005 urinary isolates, 1247 (41.5%) were resistant to both first-line oral antibiotics (ciprofloxacin and trimethoprim-sulfamethoxazole). Extended-spectrum β-lactamase (ESBL) production (adjusted odds ratio (aOR) 8.91, 95% CI 7.40-10.73), infection with <i>K. pneumoniae</i> (aOR 2.85, 95% CI 2.32-3.51) or <i>E. cloacae</i> (aOR 4.12, 95% CI 2.78-6.11), and older age were key predictors. Ciprofloxacin resistance in <i>E. coli</i> increased significantly post-2020 (Annual Percent Change 9.8%, <i>p</i> = 0.02). MDR was prevalent in outpatient settings (42.1% for <i>E. coli</i>, 61.2% for <i>K. pneumoniae</i>). Geospatial analysis revealed the Belize District as the incidence hotspot, while the Toledo District was the ESBL prevalence hotspot (29.5%).</p><p><strong>Conclusion: </strong>Belize faces a notable AMR crisis characterized by a high community burden of MDR Enterobacterales, a critical empirical treatment gap for UTIs, and accelerating resistance trends.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261458469"},"PeriodicalIF":3.8,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13272869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148278664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Secondary spontaneous pneumothorax due to extensive pulmonary tuberculosis in a patient with acute hepatitis B flare: clinical challenges and therapeutic decision making-a case report.","authors":"Loi Trinh Duc, Bang Ngoc Dao, Cong Nguyen Hai","doi":"10.1177/20499361261452939","DOIUrl":"10.1177/20499361261452939","url":null,"abstract":"<p><p>Secondary spontaneous pneumothorax (SSP), particularly when complicated by a persistent air leak, is an uncommon but serious manifestation of active pulmonary tuberculosis. Such cases often require pleural drainage or surgical intervention. Management becomes significantly more challenging when patients present with extensive pulmonary disease, compromised general condition, and severe comorbidities. We describe a 28-year-old male with bilateral extensive pulmonary tuberculosis, persistent right-sided pneumothorax, and a severe acute flare of chronic hepatitis B. Conventional management, including pleural drainage and chemical pleurodesis, was unsuccessful, and the patient's acute hepatic injury precluded the use of standard first-line anti-tuberculosis therapy. The primary clinical dilemma involved balancing the need for surgical repair of the persistent air fistula against the prohibitive perioperative risks posed by his hepatic dysfunction and poor systemic condition. A conservative, individualized medical strategy-comprising modified anti-tuberculosis therapy, supplemental oxygen, nutritional optimization, and comprehensive liver support-was selected. Over 6 months, the patient demonstrated progressive improvement in hepatic function and overall physical status, substantial radiologic recovery of pulmonary lesions, and complete resolution of the right pneumothorax. This case highlights that a carefully tailored, conservative medical approach may yield favorable long-term outcomes in SPP secondary to pulmonary tuberculosis, particularly in patients with significant surgical contraindications. Optimizing anti-tuberculosis therapy remains central to promoting lung parenchymal healing and resolving pneumothorax.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261452939"},"PeriodicalIF":3.8,"publicationDate":"2026-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13269731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Precision geospatial targeting for cost-effective tuberculosis case finding in Eastern Uganda: a quasi-experimental study.","authors":"Clark Joshua Brianwong, Diana Cherotin, Lwanga Sssekiswa Zimwanguyiza, Richard Kyakuwa Jjuuko, Patricia Ntege Nahirya, Alexander Mugume, Dithan Kiragga","doi":"10.1177/20499361261456596","DOIUrl":"10.1177/20499361261456596","url":null,"abstract":"<p><strong>Background: </strong>Universal community-based tuberculosis (TB) screening in high-burden settings is resource-intensive and inefficient, frequently missing cases and leading to suboptimal resource allocation. Integrating routine surveillance data with geospatial analytics offers a promising approach to enhance the efficiency and cost-effectiveness of active case finding.</p><p><strong>Objective: </strong>To evaluate whether integrating Uganda's electronic Case-Based Surveillance System (eCBSS) data with geospatial hotspot analytics improves the efficiency, yield and cost-effectiveness of integrated TB case finding (CAST+) in Eastern Uganda.</p><p><strong>Design: </strong>We conducted a quasi-experimental before-and-after study comparing a universal community screening campaign (September 2022) with a geospatially targeted campaign (March 2024) in Eastern Uganda.</p><p><strong>Methods: </strong>We analysed routine eCBSS data from 166 diagnostic and treatment units using a sequential two-stage geospatial approach in Quantum Geographic Information System (QGIS). Statistically significant hotspot parishes were identified using the Getis-Ord Gi* statistic (<i>p</i> < 0.05), followed by the prioritisation of villages reporting > 2 bacteriologically confirmed TB cases (March 2023-February 2024). Comparative effectiveness was assessed with a cluster-adjusted chi-square test (Rao-Scott correction). Cost-effectiveness was evaluated from the provider perspective using inflation-adjusted 2024 USD costs, disability-adjusted life years (DALYs) averted, cost-effectiveness ratios (CERs) and incremental cost-effectiveness ratios (ICERs).</p><p><strong>Results: </strong>The targeted strategy screened 49,373 individuals across 313 villages, compared with 627,082 in 3252 villages under the universal campaign, representing a 92.1% reduction in screening volume. Despite this, TB yield increased by 10% (1.68%-1.85%; <i>p</i> < 0.001). Total inflation-adjusted costs declined by 90.9% (from USD 62,804 to USD 5704), unit cost per TB case fell by 55.2% (USD 82.20-USD 36.80), and cost per DALY averted decreased from USD 4.72 to USD 2.11 (ICER: USD 5.39 per DALY averted). All diagnosed TB cases were initiated on treatment.</p><p><strong>Conclusion: </strong>eCBSS-guided geospatial targeting improved efficiency, precision and cost-effectiveness of TB screening, supporting a shift from universal to targeted TB case finding, and provides programmatic evidence for high-value public health interventions in resource-limited settings.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261456596"},"PeriodicalIF":3.8,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13260787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148253789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bacterial neonatal sepsis, antimicrobial resistance, and risk factors among neonates in Ethiopia: a systematic review and meta-analysis.","authors":"Habtamu Belew, Bantayehu Addis Tegegne, Yonatan Kindie, Adane Tilahun, Mastewal Yechale Mihret, Zigale Hibstu Teffera, Adane Adugna, Gashaw Azanaw Amare, Desalegn Abebaw, Mekuriaw Belayneh, Mamaru Getinet","doi":"10.1177/20499361261451360","DOIUrl":"10.1177/20499361261451360","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Antimicrobial resistance and bacterial neonatal sepsis are major threats causing high morbidity and mortality among neonates in developing countries, including in Ethiopia. Given the lack of comprehensive and synthesized evidence on the magnitude of the bacterial profile, neonatal sepsis, and antimicrobial resistance among neonates, this systematic review and meta-analysis were initiated to address this gap.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The aim of this meta-analysis aims to assess the prevalence, antimicrobial resistance patterns, and risk factors of neonatal sepsis in Ethiopian neonates.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Systematic review and meta-analysis were conducted among Ethiopian neonates.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data source and methods: &lt;/strong&gt;Preferred reporting item for systematic review and meta-analysis &lt;b&gt;(&lt;/b&gt;PRISMA) was used to screen the identified studies. We conducted a systematic search of various electronic databases including PubMed/MEDLINE, Cochrane Library, African Journals Online (AJOL), Web of Science, Grey literature and Google Scholar. The data were extracted in Microsoft Excel using a standardized data extraction format by two authors. The analysis was carried out with STATA version 17. To detect heterogeneity across studies, the &lt;i&gt;I&lt;/i&gt; &lt;sup&gt;2&lt;/sup&gt; and the Cochrane Q test statistics were computed. To determine the overall pooled prevalence, a random-effect meta-analysis model was used. This systematic review and meta-analysis were performed according to the updated guidelines, rigorous meta-analytical methodologies to ensure accuracy and reliability.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 9013 retrieved articles, 20 studies containing 11,754 neonates with a total of 3168 bacterial isolates (837 Gram-positive, 2328 Gram-negative). The predominant bacteria identified were: &lt;i&gt;Klebsiella pneumoniae&lt;/i&gt; (1343), &lt;i&gt;Escherichia coli&lt;/i&gt; (854), &lt;i&gt;Staphylococcus aureus&lt;/i&gt; (356), other &lt;i&gt;Klebsiella&lt;/i&gt; spp (234), CoNS (192), &lt;i&gt;Acinetobacter&lt;/i&gt; species (172), GBS (164). The overall pooled prevalence of bacterial neonatal sepsis and multi-drug resistance (MDR) were 29.92% (25.79-34.05) and 66.20 (55.43-76.97). The subgroup analysis of this systematic review further revealed that the highest prevalence was observed in Oromia (31.62%) and Amhara (31.56%). The isolated bacteria were more resistant to penicillin groups, cephalosporins, and aminoglycosides. Preterm birth AOR = 8.2, 95%CI: 1.12-15.77), premature rupture of membranes (AOR = 4.8, 95%CI: 3.17-12.77), history of urinary tract infection at antenatal care (AOR = 33.21, 95%; 3.2-63.21), and low birth weight (AOR = 13.73, 95%CI: 4.48-31.95) were significantly associated with bacterial neonatal sepsis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Bacterial neonatal sepsis and MDR have been relatively high. Preterm birth, premature rupture of membranes, history of urinary tract infection at antenatal care, and low birth weight were significantly associated. ","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261451360"},"PeriodicalIF":3.8,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13219930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community perspectives on hepatitis B transmission and vaccination among adults in Northwest Ethiopia: a qualitative study.","authors":"Desalegn Addis Mussie, Tigabu Eskeziya Zerihun, Samuel Berihun Dagnew, Abel Temeche Kassaw, Woretaw Sisay Zewdu, Tilaye Arega Moges, Fasil Bayafers Tamene, Samuel Agegnew Wondm, Getachew Yitayew Tarekegn, Teferi Bihonegn Melese","doi":"10.1177/20499361261451362","DOIUrl":"10.1177/20499361261451362","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis B virus (HBV) infection remains a major public health problem in sub-Saharan Africa, including Ethiopia, where adult vaccination uptake is limited. While quantitative studies have assessed knowledge and attitudes, little is known about how culturally embedded beliefs shape community perceptions of HBV transmission and vaccination.</p><p><strong>Objectives: </strong>This study explored adult community perspectives on HBV transmission and vaccination in Northwest Ethiopia.</p><p><strong>Design: </strong>A qualitative study using conventional content analysis.</p><p><strong>Methods: </strong>The study was conducted in Debre Tabor between December 2025 and February 2026. Data were collected through 20 in-depth interviews and six focus group discussions involving 68 adults selected through purposive sampling. Interviews were conducted in Amharic, audio-recorded, transcribed verbatim, translated into English, and analyzed inductively using Open Code software. Trustworthiness was ensured through independent coding, member checking, and reflexive documentation.</p><p><strong>Results: </strong>Three major themes emerged: (1) fragmented knowledge and moral framing of risk, (2) coexistence of biomedical and cultural explanatory models, and (3) the vaccine paradox-acknowledged benefits amid persistent barriers. A dominant culturally embedded belief attributed HBV to bat exposure (\"wof zura\"), often reducing the perceived relevance of vaccination. Although participants recognized disease severity, perceived personal susceptibility was low and frequently linked to moral behavior. Structural barriers including limited awareness of adult vaccination, cost concerns, and uncertainty about service availability further constrained uptake. Healthcare provider recommendation and community-based health education were identified as key facilitators.</p><p><strong>Conclusion: </strong>HBV vaccination decisions among adults are shaped by culturally grounded explanatory beliefs, low perceived susceptibility, and structural barriers. Context-sensitive health education and strengthened provider-initiated recommendations are critical for improving adult HBV vaccine uptake, thereby contributing to the global goal of eliminating viral hepatitis as a public health threat by 2030.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261451362"},"PeriodicalIF":3.8,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13213124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Duration of antimicrobial therapy in cardiovascular implantable electronic device associated systemic infections: a retrospective analysis.","authors":"Emily Y Xiao, Patrick T Lynch, Sarwat Khalil, Derrick A Draeger, Alexandra M Lewis, Faiz M Baqai, Mihail G Chelu, M Rizwan Sohail","doi":"10.1177/20499361261451368","DOIUrl":"10.1177/20499361261451368","url":null,"abstract":"<p><strong>Background: </strong>While the need for complete device removal is well-established for cardiovascular implantable electronic device (CIED) infections, there is insufficient evidence on the optimal duration of antimicrobial therapy.</p><p><strong>Objectives: </strong>To examine how antimicrobial duration affects clinical outcomes of patients presenting with CIED-associated bacteremia and lead endocarditis.</p><p><strong>Design: </strong>This is a retrospective cohort study conducted at a quaternary care hospital in Houston, TX, USA.</p><p><strong>Methods: </strong>Patients who underwent device removal for a primary indication of bacteremia or lead endocarditis over a 10-year period were stratified by prescribed duration of antibiotics as ⩽2 weeks or >2 weeks post-extraction. Measured outcomes included all-cause mortality at 90 days, recurrent bacteremia, infectious complications, and hospital length of stay.</p><p><strong>Results: </strong>Of 747 patients who underwent lead extraction at Baylor St. Luke's Medical Center between June 2013 and December 2023, 79 cases met the inclusion criteria. Baseline characteristics were similar between cohorts. Mean duration of antibiotics prescription was 12.6 versus 38.6 days. There was no observed difference in survival (HR 0.693, 95% CI 0.085-5.652, <i>p</i> = 0.438), recurrent bacteremia (7% vs 6%, <i>p</i> = 0.952), infectious complications (27% vs 30%, <i>p</i> = 0.817), and hospital length of stay (mean 9.9 vs 13.3, <i>p</i> = 0.360) between the ⩽2 weeks and >2 weeks cohort, respectively. Five patients had recurrence, all of whom had bacteremia from <i>Staphylococcus aureus</i> or <i>Serratia</i> sp. and an underlying left ventricular assist device or valve replacement.</p><p><strong>Conclusion: </strong>Shorter duration of antibiotics after complete CIED removal had similar rates of mortality or recurrent bacteremia. Recurrence was associated with bacteremia from high-risk organisms with potential for secondary seeding of other cardiovascular prostheses. Larger prospective studies are needed to explore these findings.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"13 ","pages":"20499361261451368"},"PeriodicalIF":3.8,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13198637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148018121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}