Journal of Infection in Developing Countries最新文献

{"title":"Development and rapid identification of a self-constructed MALDI-TOF MS library for Mycoplasma pneumoniae clinical isolates.","authors":"Ke Cen, Cong Qin, Jie Wang, Shenghai Wu","doi":"10.3855/jidc.21859","DOIUrl":"10.3855/jidc.21859","url":null,"abstract":"<p><strong>Introduction: </strong>To assess the diagnostic efficacy of matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) for rapid and precise identification of Mycoplasma pneumoniae in clinical microbiology workflows.</p><p><strong>Methodology: </strong>A reference-calibrated MALDI-TOF MS spectral database was generated through a standardized formic acid/acetonitrile extraction protocol from the M. pneumoniae reference strain (M129). Forty-nine prospectively collected M. pneumoniae clinical isolates were obtained from respiratory tract specimens at Hangzhou First People's Hospital during August-October 2023. These isolates optimized the in-house MALDI-TOF MS database for M. pneumoniae identification and validated the diagnostic feasibility of liquid pre-culture coupled with MALDI-TOF MS analysis.</p><p><strong>Results: </strong>When we randomly selected 40 strains for database validation, we found that the first phase validation of the M129-derived spectral database indicated that 87.5% (35/40) of the clinical isolates were initially detected, among which 57.5% (23/40) reached the ≥ 2.0 log value (score) threshold required for species-level identification. Post-optimization through iterative spectral refinement, 100% detection rate (40/40) was attained, with 75% (30/40) meeting strict diagnostic criteria (log(score) ≥ 2.0). The integrated liquid culture-MALDI-TOF MS platform achieved a mean identification time of 9.6 ± 1.4 days, demonstrating a 19.3% reduction in turnaround time compared to traditional chromogenic detection methods (11.9 ± 1.6 days; Independent Samples t-test, p < 0.001).</p><p><strong>Conclusions: </strong>This study establishes MALDI-TOF MS as a CLSI-compliant diagnostic method for M. pneumoniae with superior accuracy and operational efficiency. Optimized liquid culture-MALDI-TOF MS integration reduces diagnostic latency by 2.3 days, enhancing respiratory pathogen management in clinical laboratories.</p>","PeriodicalId":49160,"journal":{"name":"Journal of Infection in Developing Countries","volume":"20 5","pages":"710-716"},"PeriodicalIF":1.2,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148213057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Visceral Leishmaniasis among Wildlife Rangers in Dinder National Park, Sudan.","authors":"Bashir Ibrahim, Mohammed Elmadani, Sahar Hemeda, Mogahid Gadallh A Abdallh, Abd Elbasit Elawad Ahmed","doi":"10.3855/jidc.20568","DOIUrl":"10.3855/jidc.20568","url":null,"abstract":"<p><strong>Introduction: </strong>Visceral leishmaniasis (VL) is a significant public health concern in Sudan, particularly among populations exposed to vector-rich environments. This study aimed to determine the prevalence of VL and associated risk factors among Wildlife Rangers in Dinder National Park, Sudan.</p><p><strong>Methodology: </strong>A descriptive, cross-sectional, community-based study was conducted among all 500 wildlife rangers in Dinder National Park using total population sampling. Data were collected using a pre-prepared and pre-tested questionnaire covering demographic information, risk factors, and clinical signs and symptoms of VL. Data analysis involved descriptive statistics, chi-square tests, and logistic regression to assess the association between VL prevalence and various risk factors.</p><p><strong>Results: </strong>The prevalence of VL was 27.6%. Significant associations were observed between VL prevalence and educational level (p = 0.001), military rank (p = 0.004), with soldiers showing a reduced risk compared to officers (OR = 0.45, 95% CI: 0.27-0.75), and knowledge of (VL signs and symptoms (p = 0.000), with a substantially lower risk among the unaware group (OR = 0.20, 95% CI: 0.10-0.39)., transmission methods (p = 0.000), with lower odds in the unaware group (OR = 0.36, 95% CI: 0.21-0.61), and control measures (p = 0.012), with reduced odds for the unaware group (OR = 0.63, 95% CI: 0.34-1.18).), and sleeping under a mosquito net (p = 0.001), with higher odds in those not using a net (OR = 1.93, 95% CI: 1.28-2.92).</p><p><strong>Conclusions: </strong>The high prevalence of VL among wildlife rangers in Dinder National Park underscores the need for targeted public health intervention. Strategies should include enhancing educational programs, improving awareness of VL prevention and control measures, and ensuring better access to protective measures, such as mosquito nets. Future research should focus on longitudinal studies, detailed environmental assessments, and intervention trials to further reduce the burden of VL in high-risk populations.</p>","PeriodicalId":49160,"journal":{"name":"Journal of Infection in Developing Countries","volume":"20 5","pages":"755-763"},"PeriodicalIF":1.2,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148213027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bacterial profile and antibiotic resistance in pediatric appendicitis: retrospective analysis and associated laboratory and clinical findings.","authors":"Khalid Alzahrani, Tayyaba Batool, Ahmed A Hussein, Abdullah H Alghamdi, Meshal M Alzhrani, Sarah L Alghamdi, Norah S Alharthi, Mohammad Barnawi","doi":"10.3855/jidc.21789","DOIUrl":"10.3855/jidc.21789","url":null,"abstract":"<p><strong>Introduction: </strong>Identifying the bacterial profile in acute appendicitis, which is a common paediatric surgical emergency, can guide antibiotic therapy and improve outcomes. Therefore, the objective of this study is to evaluate the bacterial profile in paediatric appendicitis and its association with clinical and laboratory findings.</p><p><strong>Methodology: </strong>A retrospective study was conducted on paediatric patients (≤ 14 years) who underwent appendectomy at King Fahad Hospital, Al-Baha, from 1 January 2019 to 1 October 2023. Data collected included demographics, clinical presentation, laboratory results, intraoperative findings, bacterial cultures, antibiotic regimens, and outcomes. Kruskal-Wallis and Mann-Whitney tests were performed. The normality of the data was evaluated using the Kolmogorov-Smirnov and Shapiro-Wilk tests. A p < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>In 170 patients (mean age of 10.02 years; 62.9% male), the prevalent symptoms were right lower quadrant pain (94.7%) and nausea or vomiting (80.6%). Preoperative antibiotics were administered in 91.8% of the patients. Peritoneal fluid cultures were positive in 28.8%, and Escherichia coli was the dominant isolate (60.2%). Antibiotic resistance was significantly associated with elevated white blood cell count (p = 0.003), high polymorphonuclear granulocytes (p = 0.032), abscess formation (p = 0.008), and perforation (p = 0.016). The mean hospital stay was 4.5 days, and postoperative complications occurred in 1.8% of patients.</p><p><strong>Conclusions: </strong>E. coli is the predominant pathogen in paediatric appendicitis, with significant resistance in complicated cases. Tailored antibiotic therapy is crucial to reducing complications, but more studies are needed to refine empirical antibiotic selection.</p>","PeriodicalId":49160,"journal":{"name":"Journal of Infection in Developing Countries","volume":"20 5","pages":"703-709"},"PeriodicalIF":1.2,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148213010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing COVID-19 vaccine effectiveness in Türkiye: heterologous, inactivated, and mRNA vaccines.","authors":"Alpay Ari, Zeynep Altinay, Didem Demircan","doi":"10.3855/jidc.21743","DOIUrl":"10.3855/jidc.21743","url":null,"abstract":"<p><strong>Introduction: </strong>This study investigates the effectiveness of different coronavirus disease (COVID-19) vaccines in preventing hospitalization, ICU admissions, and mortality in Türkiye, upon comparing the responses to heterologous, inactivated, and mRNA vaccines.</p><p><strong>Methodology: </strong>Data were gathered from 24,538 individuals, aged ≥ 18 years, whose COVID-19 status was confirmed through PCR testing. An analysis of the survival distributions for six vaccine types showed significant differences in severe disease outcomes, with distinct patterns observed for individuals older and younger than 65 years.</p><p><strong>Results: </strong>Vaccines, including two-dose mRNA, both heterologous and homologous, showed the most protective and durable vaccine effectiveness. Homologous and heterologous inactivated vaccines demonstrated statistically significant reductions in severe COVID-19 outcomes for individuals aged > 65 years compared to unvaccinated individuals.</p><p><strong>Conclusions: </strong>The results suggest that an early deployment of inactivated vaccines, despite being less advanced, may have played an important role in providing timely protection, mitigating severe outcomes, especially in countries with limited access to novel vaccine technologies. This study provides key insights for shaping future vaccine strategies and public health policies, particularly in regions with varying access to healthcare resources.</p>","PeriodicalId":49160,"journal":{"name":"Journal of Infection in Developing Countries","volume":"20 5","pages":"637-648"},"PeriodicalIF":1.2,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distribution characteristics and genomic epidemiology of carbapenem-resistant Acinetobacter baumannii.","authors":"Ruixiang Luo, Jinpei Lu, Yu Nong, Hong Zhang, Minmin Tian, Yufeng Wang, Shan Huang, Nannan Dai, Yihua Wang","doi":"10.3855/jidc.20580","DOIUrl":"10.3855/jidc.20580","url":null,"abstract":"<p><strong>Introduction: </strong>Carbapenem-resistant Acinetobacter baumannii poses significant challenges in clinical settings due to rapid emergence and limited treatment options. This study aimed to investigate the distribution characteristics and genomic epidemiology of carbapenem-resistant A. baumannii in a regional healthcare context to identify novel trends and genetic determinants.</p><p><strong>Methodology: </strong>A total of 120 clinically isolated strains of carbapenem-resistant A. baumannii were collected in our hospital from July 2021 to June 2023. Distribution characteristics were assessed based on infection sites. Whole genome sequencing was performed to profile resistance genes.</p><p><strong>Results: </strong>The resistance rates of carbapenem-resistant A. baumannii to 15 antibiotics, such as tobramycin and amikacin, increased yearly during the three years (p < 0.05). Respiratory tract and urinary tract infections were dominant. Whole genome sequencing revealed high prevalence rates of β-lactamase genes (AmpC: 82.5%, OXA-23: 70.83%, IMP-1: 54.17%) and efflux system genes (adeB: 78.33%, adeJ: 93.33%, adeG: 90.00%).</p><p><strong>Conclusions: </strong>Our study provides novel insights by identifying significant increases in antibiotic resistance and revealing critical genomic co-occurrence patterns of resistance genes in carbapenem-resistant A. baumannii. These findings enhance the understanding of resistance mechanisms and support targeted strategies for improved prevention, control, and monitoring of nosocomial infections.</p>","PeriodicalId":49160,"journal":{"name":"Journal of Infection in Developing Countries","volume":"20 5","pages":"649-653"},"PeriodicalIF":1.2,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lateral flow immunoassay for rapid detection of carbapenemase-producing E. coli and K. pneumoniae at Cho Ray Hospital, Vietnam.","authors":"Ngoc B Tran, Phu T Truong, Van Th Tran, Dat Q Ngo","doi":"10.3855/jidc.22300","DOIUrl":"10.3855/jidc.22300","url":null,"abstract":"<p><strong>Introduction: </strong>Carbapenem-resistant Escherichia coli and Klebsiella pneumoniae represent an escalating threat to global public health, particularly in Southeast Asia, where antimicrobial resistance (AMR) is highly prevalent. This study aimed to evaluate the diagnostic performance of the NG-Test Carba 5 lateral flow immunoassay for the rapid detection of carbapenemase-producing E. coli and K. pneumoniae.</p><p><strong>Methodology: </strong>A cross-sectional study was conducted using 160 carbapenem-resistant E. coli and K. pneumoniae isolates collected from Cho Ray Hospital in Vietnam. The NG-Test Carba 5 was compared with a composite reference method comprising the modified carbapenem inactivation method (mCIM) and Multiplex Real-time PCR (Entero DR Assay). Diagnostic accuracy was assessed using positive percent agreement (PPA) and negative percent agreement (NPA) with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>The assay showed excellent diagnostic performance, with a PPA of 98.7% (95% CI: 96.24%-99.56%) and an NPA of 100.0% (95% CI: 99.33%-100.0%). No false positives were observed. Three false negatives were identified in isolates co-harboring blaNDM and blaOXA-48. Importantly, no isolates tested positive by mCIM but negative by either the NG-Test Carba 5 or the Entero DR Assay.</p><p><strong>Conclusions: </strong>The lateral flow immunoassay demonstrated high diagnostic accuracy in detecting carbapenemase-producing E. coli and K. pneumoniae. Its operational simplicity and excellent performance support its use as a reliable frontline diagnostic tool, with minimal risk of missing rare or emerging carbapenemase genotypes in this setting.</p>","PeriodicalId":49160,"journal":{"name":"Journal of Infection in Developing Countries","volume":"20 5","pages":"654-659"},"PeriodicalIF":1.3,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation of hs-CRP and T lymphocyte subsets with severity and prognosis in elderly pulmonary infection.","authors":"Yi Chen, Zhicong Liu, Yinan Chen, Jianfeng Zhong, Xiaoyong Li, Pengtao Song","doi":"10.3855/jidc.22001","DOIUrl":"10.3855/jidc.22001","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to investigate the correlation between high-sensitivity (hs)-CRP, T lymphocyte subset profiles, disease severity, and treatment outcomes in elderly patients with pulmonary infection.</p><p><strong>Methodology: </strong>The study included 85 elderly patients with respiratory infections (46 non-severe, 39 severe) and 79 healthy controls. The levels of hs-CRP, T lymphocyte subsets (CD4+/CD8+, CD4+, CD8+), and clinical pulmonary infection score (CPIS) were measured. Correlations with disease severity and CPIS were analyzed. Additionally, pre- and post-treatment levels of hs-CRP and T lymphocyte subsets were compared in patients with different treatment responses.</p><p><strong>Results: </strong>Patients had lower CD4+ counts and CD4+/CD8+ ratios, but higher hs-CRP, CD8+, and CPIS levels (p < 0.05) compared to controls. Severe cases had lower CD4+ and CD4+/CD8+, but higher CD8+, hs-CRP, and CPIS, than non-severe cases (p < 0.05). CD4+ and CD4+/CD8+ were negatively correlated with disease severity and CPIS, while hs-CRP and CD8+ were positively correlated (p < 0.05). The patients who responded to treatment (responders) had higher increases in hs-CRP, CD4+, and CD4+/CD8+ after 7 days of treatment, compared to non-responders; while CD8+ levels were lower (p < 0.05). Receiver operating characteristic (ROC) analysis showed that an hs-CRP difference cutoff of 5.31 had the highest predictive value for treatment outcomes, with 86.67% sensitivity and 68.57% specificity.</p><p><strong>Conclusions: </strong>hs-CRP and T lymphocyte subsets are closely associated with disease severity and treatment response in elderly patients with pulmonary infection, and their dynamic monitoring may aid in clinical prognosis evaluation.</p>","PeriodicalId":49160,"journal":{"name":"Journal of Infection in Developing Countries","volume":"20 5","pages":"743-749"},"PeriodicalIF":1.2,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and microbiological features of Streptococcus anginosus group infections: a 7-year retrospective study in Vietnam.","authors":"Kim-Thu Le-Thai, Buu Chau Le, Hoang-Anh Vu, Quoc-Khanh Tran-Le, Quang Minh Ho","doi":"10.3855/jidc.21557","DOIUrl":"10.3855/jidc.21557","url":null,"abstract":"<p><strong>Introduction: </strong>The Streptococcus anginosus group (SAG) is emerging as a significant cause of invasive infections, yet data from Vietnam remain scarce. This study characterized the clinical features and outcomes of SAG infections in Ho Chi Minh City.</p><p><strong>Methodology: </strong>We retrospectively reviewed patients with culture-confirmed SAG infections at the Hospital for Tropical Diseases (January 2017-August 2023). Demographics, clinical, and microbiological data were analyzed.</p><p><strong>Results: </strong>A total of 82 patients (mean age 50.6 ± 16.8 years; 64.6% male) with culture-confirmed SAG infections were included. Comorbidities were present in 56.1% of patients, with diabetes mellitus being the most common (23.2%). S. anginosus was the most frequently isolated species (43.9%), followed by S. constellatus (34.1%) and S. intermedius (22.0%). Bacteremia (35.4%) and intra-abdominal infections (31.7%, mainly hepatic abscesses) were the predominant clinical presentations. Polymicrobial infections occurred in 14.6% of cases, primarily among patients with bacteremia and skin or soft tissue infections. All isolates remained susceptible to ceftriaxone and vancomycin, and 94.3% to ampicillin, but susceptibilities were lower to penicillin (84.3%), erythromycin (65.7%), clindamycin (54.3%), and tetracycline (54.3%). Despite a 92.7% cure rate, 19.5% required drainage procedures, and the 28-day mortality rate was 6.1%.</p><p><strong>Conclusions: </strong>In this cohort, SAG infection most often present as occult bacteremia or hepatobiliary abscess, frequently in patients with comorbidities, but not restricted to immunocompromised hosts. Empirical β-lactam therapy (ampicillin or ceftriaxone) remains appropriate, although rising penicillin and macrolide resistance and the 15% polymicrobial rate, may warrant broader initial coverage when deep soft-tissue foci are suspected.</p>","PeriodicalId":49160,"journal":{"name":"Journal of Infection in Developing Countries","volume":"20 5","pages":"678-686"},"PeriodicalIF":1.2,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Co-infection with dengue, zika, chikungunya in a six-year-old patient in Bamako, Mali.","authors":"Yacouba Cissoko, Essenam Aa Akakpo, Amadou Koné, Yama Doumbia, Sékou I Doucouré, Mariam Soumaré, Bassirou Diarra, Issa Konaté, Seydou Doumbia, Sounkalo Dao","doi":"10.3855/jidc.16449","DOIUrl":"10.3855/jidc.16449","url":null,"abstract":"<p><strong>Introduction: </strong>The burden of arboviral infections remains underestimated in sub-Saharan Africa due to the similarity of symptoms with malaria and other tropical febrile illnesses. Simultaneous infection with three arboviruses sharing the same vector is rarely reported.</p><p><strong>Case presentation: </strong>We report here the case of a six-year-old girl diagnosed by multiplex real time-polymerase chain reaction for infection involving dengue, zika and chikungunya viruses with no severe symptoms and good clinical improvement with symptomatic treatment in Bamako, Mali.</p><p><strong>Conclusions: </strong>Co-circulation of different arboviruses is possible in urban context where Aedes mosquito vectors are emerging. Further studies are needed to explore the epidemiology and the clinical features of these coinfections.</p>","PeriodicalId":49160,"journal":{"name":"Journal of Infection in Developing Countries","volume":"20 4","pages":"472-476"},"PeriodicalIF":1.3,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rifampicin resistance among the TB Patients in Pakistan: a retrospective cross-sectional study.","authors":"Sobia Faisal, Syed Azizur Rab, Khalid F Muhammad, Ghulam Haider, Munir Alam, Furqan B Irfan","doi":"10.3855/jidc.21471","DOIUrl":"10.3855/jidc.21471","url":null,"abstract":"<p><strong>Introduction: </strong>Rifampicin resistant (RR) tuberculosis (TB) is a key challenge in terms of high morbidity, mortality and socio-economic burden. Pakistan has the sixth highest RR TB prevalence globally. In the absence of a national TB survey during the past decade, this study was conducted to determine prevalence estimates.</p><p><strong>Methodology: </strong>This was a retrospective cross-sectional study (with an analytical component) of the bacteriologically confirmed TB patients whose sputum or other clinical samples were tested for RR (by Xpert® assay) in public-private mix (PPM) settings of 28 districts of Pakistan, from January 2022 to June 2024. Univariate and multivariable logistic regression analyses were performed for analysis.</p><p><strong>Results: </strong>Among the 42,423 patients with bacteriological confirmation by the Xpert, 231 (0.5%) had indeterminate result for RR. The RR TB prevalence was 2.31% among the valid results. Univariate analysis showed that RR TB was significantly associated with province, residence, age, sputum smear microscopy results, and history of TB treatment. Multivariate analysis of significant factors showed that RR TB was significantly associated with the province; Sindh (OR = 1.65) and Khyber-Pakhtunkhwa (OR = 0.51). Risk of RR TB was significantly lower among people above 60 years of age (OR = 0.59) and higher among people previously treated for TB disease (OR = 3.73).</p><p><strong>Conclusions: </strong>Findings support the need for evidence-based strategies aimed at timely diagnosis and management of TB, with greater focus on people at risk of developing RR TB including patients living in RR TB prevalent provinces and among those previously treated for TB.</p>","PeriodicalId":49160,"journal":{"name":"Journal of Infection in Developing Countries","volume":"20 4","pages":"551-559"},"PeriodicalIF":1.3,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147870070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}