Advances in Clinical and Experimental Medicine最新文献

{"title":"Awareness and acceptance of respiratory syncytial virus (RSV) vaccination among pregnant women in Poland: Results of an internet-based survey.","authors":"Mateusz Strózik, Hanna Wiciak, Maciej Socha, Jacek Smereka, Tomasz Fuchs","doi":"10.17219/acem/212578","DOIUrl":"https://doi.org/10.17219/acem/212578","url":null,"abstract":"<p><strong>Background: </strong>Respiratory syncytial virus (RSV) is a major cause of severe lower respiratory tract infections in infants, particularly among vulnerable groups such as preterm newborns and infants with underlying medical conditions. The approval of the RSVpreF vaccine for use during pregnancy offers a new strategy for reducing RSV-related morbidity in newborns.</p><p><strong>Objectives: </strong>This study aimed to assess RSV vaccination coverage among pregnant women in Poland, identify factors influencing vaccine hesitancy, and evaluate knowledge regarding the benefits of RSV vaccination.</p><p><strong>Material and methods: </strong>A Computer-Assisted Web Interview (CAWI) survey was conducted among 668 respondents in Poland. An anonymous questionnaire consisting of 23 questions was distributed via social media platforms between July 25 and August 1, 2024. Participants were recruited through Facebook groups and Instagram and included women who had recently given birth or were currently pregnant.</p><p><strong>Results: </strong>Respondents with medical backgrounds more frequently provided correct answers to questions regarding RSV than those without medical training. For example, when asked about methods of treating RSV infection, 109 medical professionals (74.15%) answered correctly, compared with 251 non-medical respondents (48.18%; p < 0.001). Individuals with medical backgrounds and those who received information about vaccination from their physician were more likely to receive the RSV vaccine during pregnancy. In addition, women vaccinated against other diseases, such as influenza and pertussis, were more likely to choose RSV vaccination.</p><p><strong>Conclusions: </strong>Vaccination against RSV during pregnancy is an important strategy for protecting newborns against severe RSV infection and should be promoted as a public health measure. Our findings highlight the need for targeted educational initiatives and public health campaigns to increase awareness and improve vaccination coverage among pregnant women.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148965986","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":"Evaluating adenoma detection and miss rates in tandem colonoscopy: Limitations of surrogate quality indicators.","authors":"Yuesheng Li, Weijian Lun","doi":"10.17219/acem/213311","DOIUrl":"https://doi.org/10.17219/acem/213311","url":null,"abstract":"<p><strong>Background: </strong>The adenoma detection rate (ADR) is a key quality metric in colonoscopy. However, it may not accurately reflect the true number of adenomas and requires pathological evaluation of all detected polyps. The adenoma miss rate (AMR), which quantifies adenomas missed during colonoscopy, may provide a more comprehensive measure of colonoscopy quality.</p><p><strong>Objectives: </strong>To evaluate the effectiveness of ADR and selected surrogate quality indicators (SQIs) in reflecting AMR.</p><p><strong>Material and methods: </strong>In this prospective, cross-sectional, multicenter study, we analyzed asymptomatic individuals aged 50-72 years who underwent tandem colonoscopies using a split-dose bowel preparation regimen. Colonoscopies were performed by 7 endoscopists (experts with >10 years of experience from different institutions) over the last 5 years. Consecutive colonoscopies were performed by the same endoscopist under identical conditions. During the 2nd colonoscopy, polyps missed during the 1st colonoscopy were documented. All removed polyps were subsequently evaluated by a pathologist.</p><p><strong>Results: </strong>We analyzed colonoscopy data from 356 patients (182 (51.12%) males and 174 (48.88%) females), representing a total of 712 colonoscopies. Adenomas were confirmed in 221 participants (62%). The number of adenomas missed during the 1st colonoscopy was 88, whereas 60 participants had at least 1 missed adenoma. No statistically significant variation among endoscopists was observed in the polyp detection rate (range: 48.000-64.000%, p = 0.658) or the adenoma detection rate (range: 54.000-74.000%, p = 0.151). Adenomas per positive participant ranged from 1.05 to 1.89, and adenomas per colonoscopy ranged from 0.70 to 1.44 (p = 0.063). The overall pooled lesion-level AMR was 20.046%. None of the SQIs showed a significant association with AMR (p > 0.050 for all comparisons). Although SQIs and ADR varied among endoscopists, no statistically significant variation in AMR was observed among the 7 endoscopists (p > 0.050).</p><p><strong>Conclusions: </strong>A high ADR alone does not ensure a lower AMR in tandem colonoscopy for colorectal cancer screening. In this limited provider-level sample, no statistically significant association was observed between SQIs and AMR.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148904510","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":"Enhancing European governance for health crisis management: A proposal for the effective integration of primary healthcare systems into emergency preparedness and response plans.","authors":"María Pilar Astier-Peña, Ileana Gefaell-Larrondo, Sara Ares-Blanco, Ana Luisa Neves, Davorina Petek, Marina Guisado-Clavero, Ferdinando Petrazzuoli, Snezana Knezevic, Marta Perez-Alvarez, Philippe-Richard Domeyer, Raquel Gomez Bravo","doi":"10.17219/acem/224485","DOIUrl":"10.17219/acem/224485","url":null,"abstract":"<p><strong>Background: </strong>Primary healthcare (PHC) facilities are fundamental components of health systems across Europe, serving as the first point of contact and ensuring continuity of care. However, the COVID-19 pandemic exposed significant gaps in their preparedness for large-scale health crises. Although emergency preparedness frameworks developed by the World Health Organization (WHO) and the European Union existed, they often lacked adequate integration of PHC into comprehensive public health (PH) emergency preparedness and response plans (EPRPs).</p><p><strong>Objectives: </strong>To identify regulatory and operational gaps in the integration of PHC into existing European health EPRPs; to evaluate challenges related to governance and health information system (HIS) interoperability between PHC and PH authorities; and to develop a multilevel governance model to harmonize the role of PHC across the continuum of health crisis management in future PH emergencies.</p><p><strong>Material and methods: </strong>The EURODATA research group conducted a comprehensive analysis of the role of primary care during the COVID-19 pandemic. The study included a review of international and European health policies and emergency preparedness frameworks. The analysis followed the health EPRP framework and focused on regulations, governance structures, HIS interoperability, and the role of PHC. Based on these findings, recommendations were developed to strengthen EPRPs for European PHC systems.</p><p><strong>Results: </strong>The analysis identified limited regulatory guidance on coordination between PHC and PH authorities, insufficient interoperability of HIS, and gaps in local coordination. The proposed EPRP framework addresses these shortcomings by promoting improved governance, integration of information systems, and harmonization of the role of PHC within coordinated health crisis management.</p><p><strong>Conclusions: </strong>Strengthening the role of PHC in health emergency preparedness is essential for building resilient health systems. The proposed EPRP provides actionable strategies to address the identified gaps and improve the integration of PHC into health crisis management. Implementation of these recommendations may enhance the capacity of European PHC systems to respond effectively to both acute and chronic health needs during future crises.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148904555","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":"E-learning preferences of rural general practitioners: A descriptive educational needs assessment. Results of a cross-sectional survey distributed through UK and European rural GP networks.","authors":"Miriam Dolan, Iva Petričušić, Tim Sanders, Joyce Kenkre, Ferdinando Petrazzuoli","doi":"10.17219/acem/224991","DOIUrl":"https://doi.org/10.17219/acem/224991","url":null,"abstract":"<p><strong>Background: </strong>Rural general practitioners (GPs) encounter unique challenges in accessing continuing professional development (CPD). E-learning offers a potential solution by overcoming geographic and time constraints, particularly when the content is relevant to the rural primary care context.</p><p><strong>Objectives: </strong>To identify rural GPs' preferences regarding the format, duration, and content of e-learning and to assess their current engagement with and awareness of CPD specific to rural primary care.</p><p><strong>Material and methods: </strong>A single cross-sectional online survey was distributed through 2 recruitment channels: the Royal College of General Practitioners (RCGP) in the UK and the European Rural and Isolated Practitioners Association (EURIPA), a pan-European network of the World Organization of Family Doctors (WONCA). A total of 157 RCGP members responded to the survey, with an unknown response rate; 30 of 94 active EURIPA members responded after the survey was distributed through its newsletter and Google Group. The survey assessed e-learning engagement, preferred formats and durations, and priority topics. Descriptive statistics were used to summarize the responses.</p><p><strong>Results: </strong>Five of the 67 survey participants who answered the question on whether they used any rural primary care-relevant e-learning responded positively (8%). Preferred formats for rural primary care-relevant e-learning included interactive e-modules, webinars, online lectures, and podcasts; the preferred duration was 30-40 min. Priority topics included emergency care, mental health and addiction, multimorbidity and complexity, managing risk and uncertainty, frailty, and telemedicine.</p><p><strong>Conclusions: </strong>Rural GPs favor short, interactive, context-specific e-learning. These findings can guide the design of pan-European rural primary care modules. Future studies should evaluate educational effectiveness and implementation feasibility.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148904560","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":"Global trends and evidence on dyslipidemia in ischemic stroke: An integrative scientometric and meta-analytic review.","authors":"Guo Mao, Ye Mao","doi":"10.17219/acem/213282","DOIUrl":"https://doi.org/10.17219/acem/213282","url":null,"abstract":"<p><p>Dyslipidemia has been identified as an important modifiable risk factor for ischemic stroke (IS); however, inconsistent findings have limited its translational application. This study aimed to integrate scientometric and meta-analytic approaches to provide a comprehensive understanding of lipid abnormalities in IS. A scientometric analysis of 1,962 publications published between 2005 and 2024 revealed evolving research trends, ranging from traditional studies of lipid metabolism to investigations of molecular mechanisms involving high-density lipoprotein (HDL) dysfunction, lipidomics, and precision prevention. A meta-analysis of 13 eligible studies demonstrated that patients with IS had significantly higher levels of total cholesterol (TC; mean difference (MD) = 0.94 mmol/L, 95% confidence interval (95% CI): 0.36-1.52), triglycerides (TG; MD = 0.37 mmol/L, 95% CI: 0.19-0.55), and low-density lipoprotein cholesterol (LDL-C; MD = 0.66 mmol/L, 95% CI: 0.33-0.99), as well as lower levels of high-density lipoprotein cholesterol (HDL-C; MD = -0.30 mmol/L, 95% CI: -0.41 to -0.18), with all comparisons reaching statistical significance (p < 0.001). These findings indicate a strong association between dyslipidemia and the risk of IS. The integration of bibliometric and quantitative evidence underscores the importance of comprehensive lipid screening and management in stroke prevention and provides a dual-framework model linking academic research trends with clinical decision-making.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148904785","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":"Digitally supported physical cancer rehabilitation during and after systemic treatment in South Baltic countries: Protocol for the AMBeR eRehab feasibility study.","authors":"Gunn Ammitzbøll, Sabine Felser, Kathrin Thiele, Hugo Murua Escobar, Aelita Bredelytė, Jan Arnholtz Overgaard, Zofia Sotomska, Hanna Lotzke, Carl Johan Orre, Bartłomiej Baumert, Niels Henrik Holländer, Christian Junghanß, Katarzyna Gierat-Haponiuk, Anna Jamrowska, Dariusz Szplit, Susanne Oksbjerg Dalton","doi":"10.17219/acem/222595","DOIUrl":"https://doi.org/10.17219/acem/222595","url":null,"abstract":"<p><strong>Background: </strong>Research in exercise oncology has consistently provided evidence supporting the integration of exercise into all phases of cancer care. However, less is known about how this can be implemented across different patient populations and healthcare settings. This study aims to generate knowledge about the equitable implementation of digitally supported physical rehabilitation during and after systemic cancer treatment through feasibility testing in 5 South Baltic countries. Methodology. This study is part of the gAMBeRh project (Advanced Modeling of Baltic E-cancer caRe) and is an international, multicenter, prospective study with a hybrid implementation-effectiveness design. It includes 2 single-arm feasibility trials, each aiming to enroll 30 patients undergoing systemic treatment and 30 patients who have completed systemic treatment or are receiving long-term or life-prolonging treatment at each participating site, for a total of 300 adult cancer patients. All tumor groups are eligible, and participants must be .18 years of age. We will use the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework to structure data collection and reporting. Additionally, Group Concept Mapping will be used to evaluate determinants of participation among patients and determinants of intervention delivery among healthcare professionals (HCPs). Enrollment began in September 2024 and is expected to be completed by December 2026. Discussion. While digital solutions have the potential to overcome barriers to integrating exercise into oncology care, inequitable implementation may inadvertently exacerbate disparities in cancer rehabilitation if these innovations remain inaccessible to patients with fewer resources. By evaluating reach, effectiveness, adoption, implementation, and maintenance, as well as the determinants of participation among patients and HCPs, this study will contribute to the evidence base on the implementation of digitally supported physical rehabilitation in cancer care.</p><p><strong>Conclusions: </strong>Findings from the AMBeR eRehab study will inform future efforts to digitize cancer rehabilitation while ensuring that inequities are not reproduced.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148904557","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":"Changes in hip joint anatomical shape as a predictor of osteoarthritis.","authors":"Andris Dzerins, Eduards Toms Moritis, Kristine Paegle, Maksims Zolovs, Peteris Studers","doi":"10.17219/acem/214439","DOIUrl":"10.17219/acem/214439","url":null,"abstract":"<p><strong>Background: </strong>Hip osteoarthritis (HOA) is one of the leading causes of musculoskeletal disability worldwide, yet its etiology remains incompletely understood. Its pathogenesis is multifactorial, involving systemic factors and biomechanical alterations of the hip joint that trigger degenerative changes.</p><p><strong>Objectives: </strong>The aim of this study was to identify the most informative radiographic views and the key acetabular and proximal femoral parameters for detecting structural abnormalities of the hip joint that may contribute to the development of HOA.</p><p><strong>Material and methods: </strong>This observational case-control study included 156 patients older than 55 years who underwent total hip arthroplasty for HOA (osteoarthritis (OA) group) and 61 age-matched controls without clinical HOA, recruited from a single center between 2019 and 2022. Patient demographics, clinical history, and hip-specific functional scores were collected. Standardized anteroposterior (AP), frog-leg lateral (LL), and Dunn 45° radiographs were obtained, and multiple radiographic parameters were measured.</p><p><strong>Results: </strong>Asymptomatic contralateral hips in patients with OA had significantly more cam-type deformities (higher alpha angles, lower head-neck offset ratios, and a higher prevalence of pistol-grip deformity) than those in the control group (p < 0.001). In contrast, pincer-type features were more common in the control group. Logistic regression analysis identified higher alpha angles, greater femoral neck diameter, and lower head-neck offset ratios as predictors of OA, whereas a larger femoral head diameter was identified as a protective factor (model area under the curve (AUC) = 0.90). Bone quality was superior in the control group, with longer femoral neck axis lengths and higher Singh indices (p < 0.001).</p><p><strong>Conclusions: </strong>Radiographic markers of cam-type femoroacetabular impingement (FAI) are significantly more prevalent in patients with HOA and may serve as early indicators of disease risk. Dunn and LL views are optimal for detecting these abnormalities. A larger femoral head diameter, as measured on both AP and LL radiographic views, appears to be a protective factor against the development of HOA. Understanding these morphological differences may facilitate earlier diagnosis and support preventive strategies for HOA.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":"1535-1548"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148965995","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":"Integrated single-cell transcriptomics, Mendelian randomization, and machine learning identify CEBPZ as an immune-related biomarker in oral lichen planus.","authors":"Yichen Feng, Shenfeng Wang, Ling Guan, Linlin Wang, Anqi Zou, Zhankui Xing, Tingying Xiao","doi":"10.17219/acem/211565","DOIUrl":"10.17219/acem/211565","url":null,"abstract":"<p><strong>Background: </strong>Oral lichen planus (OLP) is a chronic, immune-mediated oral mucosal disease with complex pathophysiology and potential for malignant transformation. Understanding its molecular basis is critical for the development of precise diagnostic and therapeutic strategies.</p><p><strong>Objectives: </strong>We aimed to identify key immune-related biomarkers and characterize cellular dynamics in OLP, with a particular focus on the role of CEBPZ in disease pathogenesis.</p><p><strong>Material and methods: </strong>We analyzed single-cell RNA sequencing (scRNA-seq) data from OLP lamina propria samples (GSE211630) to identify disease-specific T-cell subpopulations using high-dimensional weighted gene co-expression network analysis (hdWGCNA) for oxidative stress-related gene modules.-data-based Mendelian randomization (SMR) integrated FinnGen genome-wide association study (GWAS; 342,499 Europeans) data with Genotype-Tissue Expression (GTEx) expression quantitative trait loci (eQTL) data to identify causal genes. Machine learning (ML) models (least absolute shrinkage and selection operator (LASSO) and convolutional neural network (CNN)) were developed using bulk RNA-seq datasets (GSE52130 and GSE38616) for diagnostic purposes.</p><p><strong>Results: </strong>We identified OLP-specific T-cell populations (clusters 0, 3, 5, 7, 13, and 15) with enhanced migration inhibition factor (MIF) pathway signaling toward B cells and monocytes. Two oxidative stress-associated modules contained hub genes, including CEBPZ. Summary-data-based Mendelian randomization analysis identified 231 OLP-associated genes, with CEBPZ uniquely intersecting LASSO-selected markers (odds ratio (OR) = 1.057, 95% confidence interval (95% CI) = 1.013-1.102, p = 0.010). Machine learning models achieved area under the curve (AUC) values ranging from 0.653 to 0.745, with the CNN model reaching a validation accuracy of 0.735. CEBPZ showed elevated expression in OLP T cells and correlated with enhanced MIF-(CD74+CXCR4) signaling.</p><p><strong>Conclusions: </strong>This integrative approach identifies CEBPZ as a pivotal biomarker linking genetic susceptibility, oxidative stress, and immune dysregulation in OLP. Our diagnostic models offer promising tools for OLP management.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":"1635-1652"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148965991","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":"It takes a society: A biopsychosocial approach to women's brain health.","authors":"Andreia Fonseca De Paiva, Timothy Daly","doi":"10.17219/acem/225365","DOIUrl":"10.17219/acem/225365","url":null,"abstract":"<p><p>Only recently has there been a push for increased funding in women's health, an area that has historically been neglected and underfunded. In this editorial, we argue that the higher risk of poor brain health faced by women can be usefully understood from a biopsychosocial perspective. In addition to biological differences, psychosocial stressors contribute to poorer health outcomes over time. Therefore, we advocate for a broad biopsychosocial approach to health, encompassing biological, psychological, and social factors, to better understand and promote women's brain health and to inform ambitious public health policy and research in this area.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":"1499-1506"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073202","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 characteristics and risk factors for carbapenem-resistant Pseudomonas aeruginosa infection.","authors":"Huilin Xie, Sheng Zhang, Yuzhuo Zhong, Wenling Zhang, Zhen Lei","doi":"10.17219/acem/213798","DOIUrl":"10.17219/acem/213798","url":null,"abstract":"<p><strong>Background: </strong>Pseudomonas aeruginosa (PA) is a major opportunistic pathogen responsible for nosocomial infections, particularly those affecting the lower respiratory tract. The emergence of carbapenem-resistant PA (CRPA) poses a significant global therapeutic challenge, as increasing resistance rates complicate clinical management.</p><p><strong>Objectives: </strong>To investigate the clinical characteristics and antimicrobial resistance profiles of CRPA infections, identify associated risk factors among patients at The Affiliated Hospital of North Sichuan Medical College, and provide evidence for the development of effective prevention and control strategies.</p><p><strong>Material and methods: </strong>A retrospective case-control study was conducted involving 94 patients with CRPA infection (study group) and 50 patients with CSPA infection (control group) between January 2021 and December 2022. Clinical characteristics and risk factors were analyzed using univariate analyses and multivariable logistic regression. Variable selection for the primary model was performed using best-subset selection based on the Bayesian information criterion (BIC).</p><p><strong>Results: </strong>Carbapenem-resistant PA isolates were primarily recovered from lower respiratory tract secretions (77.66%) and were most frequently identified in the intensive care unit (ICU) (41.49%). Compared with CSPA strains, CRPA exhibited significantly higher resistance rates to aztreonam, ciprofloxacin, levofloxacin, and cephalosporins (p < 0.05). Multivariable logistic regression using best-subset selection identified prior exposure to carbapenems (adjusted odds ratio (aOR) = 6.914, 95% confidence interval (95% CI): 2.765-17.290, p < 0.001) and aminoglycosides (aOR = 6.209, 95% CI: 1.701-22.668, p = 0.006) as independent risk factors for CRPA infection.</p><p><strong>Conclusions: </strong>Carbapenem-resistant PA infection imposes a considerable burden in our hospital, particularly among ICU patients. Prior exposure to carbapenems and aminoglycosides significantly increases the risk of CRPA infection. The BIC-selected model identified the same main risk factors as the fully adjusted sensitivity analysis, supporting the consistency of the findings. Strengthening antimicrobial stewardship and tailoring empirical therapy according to local antimicrobial susceptibility patterns are essential to curb resistance and improve clinical outcomes.</p>","PeriodicalId":7306,"journal":{"name":"Advances in Clinical and Experimental Medicine","volume":" ","pages":"1525-1533"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148965942","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}