BMC Infectious Diseases最新文献

{"title":"Clinical courses and outcomes of cerebral toxoplasmosis in HIV-positive patients in Shiraz, Southern Iran: a retrospective study.","authors":"Fatemeh Javvi, Keivan Sahebi, Qasem Asgari, Fattaneh Mikaeili, Aref Teimouri","doi":"10.1186/s12879-025-11231-8","DOIUrl":"https://doi.org/10.1186/s12879-025-11231-8","url":null,"abstract":"<p><strong>Background: </strong>Cerebral toxoplasmosis (CTX) occurs as a latent form of Toxoplasma gondii infection, commonly found in human immunodeficiency virus (HIV)-infected individuals. A proper and timely diagnosis of CTX enables effective treatment, reducing complications and mortality. We aimed to investigate the prevalence, clinical course, and in-hospital mortality rate of CTX in HIV-positive patients admitted to the hospitals of Shiraz University of Medical Sciences (SUMS).</p><p><strong>Methods: </strong>This retrospective study included 876 HIV-positive patients admitted to Namazi and Shahid Faghihi hospitals of SUMS from 2013 to 2022. After reviewing the medical records, the clinical data of CTX patients were extracted and analyzed.</p><p><strong>Results: </strong>Overall, 4.00% of HIV-positive patients were diagnosed with toxoplasmosis, with CTX occurring in 2.17%. The mean age of CTX patients was 37.95 ± 9.32 years, with 57.89% males and 42.11% females. The prevalence of CTX in HIV-positive women (4.32%) was significantly higher than in HIV-positive men (1.59%) (p = 0.04). In 57.89% of CTX patients, the disease was the first manifestation of HIV infection. Focal neurological deficit (52.63%), decreased level of consciousness (52.63%), headache (47.37%), and fever (42.11%) were the most common clinical manifestations of CTX. Age was inversely correlated with CTX diagnosis in logistic regression analysis (p < 0.001). CTX had a 21.05% in-hospital mortality rate.</p><p><strong>Conclusion: </strong>Physicians should be aware of the clinical course and high mortality rate of CTX in HIV-positive patients. Our findings also highlight the importance of implementing HIV screening programs, particularly for at-risk young adults. Future studies should address the limitations of this study by employing larger and more diverse samples.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"817"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dyskalaemia as a predictor of mortality in sepsis: a retrospective cohort study.","authors":"Neslihan Ergün Süzer, Mehmet Özel","doi":"10.1186/s12879-025-11236-3","DOIUrl":"https://doi.org/10.1186/s12879-025-11236-3","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the association between dyskalaemia and 30-day mortality in patients with sepsis and to determine whether potassium disturbances serve as independent prognostic markers in this population.</p><p><strong>Methods: </strong>This retrospective cohort study included adult patients diagnosed with sepsis who were admitted to the emergency department of a tertiary hospital between January 1, 2022, and January 1, 2025. Serum potassium levels at admission were categorized as hypokalemia (< 3.5 mmol/L), normokalemia (3.5-5.0 mmol/L), and hyperkalemia (> 5.0 mmol/L). The primary outcome was 30-day all-cause mortality. Multivariate logistic regression was used to identify independent predictors of mortality, adjusting for confounders. A restricted cubic spline regression model was applied to assess the non-linear relationship between potassium levels and mortality.</p><p><strong>Results: </strong>A total of 1,347 patients were included, of whom 305 (22.6%) died within 30 days. Both hypokalemia and hyperkalemia were significantly associated with increased mortality compared to normokalemia. Dyskalaemia was independently associated with mortality (OR = 2.10, 95% CI: 1.45-3.05, p < 0.001), and a U-shaped relationship was observed between potassium levels and mortality risk. The predictive model demonstrated good calibration (Hosmer-Lemeshow test, p = 0.584) and discrimination (AUROC = 0.840, 95% CI: 0.788-0.879).</p><p><strong>Conclusions: </strong>Dyskalaemia was identified as an independent predictor of 30-day mortality in septic patients. These findings highlight the clinical relevance of potassium disturbances in early risk stratification. The observed U-shaped association between potassium levels and mortality supports the potential value of potassium as a prognostic marker. However, whether correcting dyskalaemia improves outcomes remains to be determined.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"865"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of cefoperazone-sulbactam as a component of combination therapy for carbapenem-resistant Acinetobacter baumannii bloodstream infection in intensive care units: a multicenter retrospective propensity score-matched study.","authors":"Sheng-Huei Wang, Yu-Chao Lin, Ming-Cheng Chan, Kuang-Yao Yang, Chau-Chyun Sheu, Biing-Ru Wu, Wei-Hsuan Huang, Jia-Yih Feng, Chia-Min Chen, Zi-Xeng Weng, Chung-Kan Peng, Shih-En Tang","doi":"10.1186/s12879-025-11205-w","DOIUrl":"https://doi.org/10.1186/s12879-025-11205-w","url":null,"abstract":"<p><strong>Background: </strong>In this study, we aimed to evaluate the efficacy of cefoperazone-sulbactam-containing (CSC) combination therapy for carbapenem-resistant Acinetobacter baumannii (CRAB) bloodstream infections (BSI) patients in intensive care unit (ICU).</p><p><strong>Methods: </strong>This multicenter, retrospective cohort study initially included 407 patients with CRAB BSI in the ICU between 2015 and 2019. Patients were divided into the CSC- and non-cefoperazone-sulbactam-containing (NCSC) groups. Outcomes including mortality, clinical failure, and microbiological eradication were compared after time-window bias adjustment and propensity score matching.</p><p><strong>Results: </strong>There was no statistical difference in baseline characteristics and disease severity between the CSC (n = 50) and NCSC groups (n = 150) after propensity score matching. The CSC group had significantly lower rates of all-cause mortality (30.0% vs. 50.0%, p = 0.014) and clinical failure (32.0% vs. 52.0%, p = 0.015) on day 28 than the NCSC group. The CSC regimen was an independent protective factor against 28-day clinical failure (adjusted odds ratio (aOR) = 0.281, 95% confidence interval [CI] = 0.091-0.864, p = 0.027). Kaplan-Meier analysis showed that the CSC group had a significantly longer survival time than the NCSC group (log-rank test, p = 0.028). The subgroup analysis of clinical factors associated with 28-day mortality showed that female patients and those with body mass index > 25, non-smoker status, and C-reactive protein < 30 especially favored the CSC regimen instead of the NCSC regimen.</p><p><strong>Conclusions: </strong>As an alternative to ampicillin-sulbactam, cefoperazone-sulbactam could be considered as components of combination therapy for critically ill patients with CRAB BSI.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"872"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emerging antibiotic resistance in Vibrio cholerae: a study of cholera prevalence and resistance patterns in Zambia's Copperbelt Province.","authors":"David Chisompola, John Nzobokela, Roy Moono, Elijah Chinyante, Allen Chipipa, Nancy Chapuswike, Moses Chakopo, Nswana Mukuma, Martin Chakulya","doi":"10.1186/s12879-025-11259-w","DOIUrl":"https://doi.org/10.1186/s12879-025-11259-w","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Cholera remains a significant public health challenge in Zambia, particularly in the Copperbelt Province, where antibiotic-resistant Vibrio cholerae strains are increasingly threatening treatment efficacy. This study aimed to determine the prevalence of cholera and the antibiotic resistance patterns of V. cholerae isolates at three tertiary hospitals in the region.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective cross-sectional study was conducted across three major referral hospitals in the Copperbelt Province (Arthur Davison Children's Hospital, Kitwe Teaching Hospital, and Ndola Teaching Hospital) during the cholera outbreak from January to April 2024. Clinical samples from suspected cholera cases were analysed, and antimicrobial susceptibility testing was performed following Clinical Laboratory Standards Institute guidelines and the European committee on antimicrobial susceptibility testing methodology for Vibrio cholerae. To isolate Vibrio cholerae, alkaline peptone water and thiosulfate-citrate-bile salt-sucrose agar were utilized. The isolates were identified based on colony morphology, Gram staining, biochemical testing, and serotyping. Antimicrobial susceptibility testing was conducted by using the Kirby-Bauer disk diffusion method. Descriptive statistics were employed to assess the prevalence of Vibrio cholerae, and chi-square tests were applied with p-values of &lt; 0.05 indicating statistical significance.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of the 892 suspected cases, 334 (37.4%) were confirmed as V. cholerae through culture. The highest number of V. cholerae confirmed cases was recorded at Ndola Teaching Hospital 221 (24.8%), followed by Kitwe Teaching Hospital 88 (9.9%), while Arthur Davison Children's Hospital 25 (2.8%) reported the lowest. High antimicrobial resistance was observed trimethoprim/sulfamethoxazole 69 (74.2%), ampicillin 75 (54.3%), and imipenem 22 (46.8%). In contrast, erythromycin 25 (100%), gentamicin 6 (85.7%) and ciprofloxacin 118 (76.6%) remained highly effective. The overall prevalence of multidrug resistance (MDR) in Vibrio cholerae was 3.7%. Among these, resistance to four or more antibiotics was observed in 3 (1.2%), followed by resistance to the combination of Ciprofloxacin, Ceftazidime, and Tetracycline in 2 (0.8%). All other MDR patterns were detected in a single isolate each (0.4%).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The high prevalence of antibiotic-resistant Vibrio cholerae in the Copperbelt Province underscores the urgent need for enhanced antimicrobial stewardship and robust surveillance systems to inform effective cholera control strategies. Sustainable public health impact can be achieved through targeted immunization campaigns in endemic areas combined with strengthened water, sanitation, and hygiene (WASH) interventions, including improved access to clean water, adequate sanitation infrastructure, hygiene promotion, and supportive policies, which are essential for redu","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"879"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Forecasting tuberculosis in Ethiopia using deep learning: progress toward sustainable development goal evidence from global burden of disease 1990-2021.","authors":"Zinabu Bekele Tadese, Fetlework Gubena Arage, Tigist Kifle Tsegaw, Eyob Akalewold Alemu, Tsegasilassie Gebremariam Abate, Eliyas Addisu Taye","doi":"10.1186/s12879-025-11228-3","DOIUrl":"https://doi.org/10.1186/s12879-025-11228-3","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) is a preventable and treatable disease caused by Mycobacterium tuberculosis, which most often affects lungs and remains the second leading cause of death from infectious diseases worldwide. The National End TB Strategy aims to eliminate the TB epidemic by reducing TB-related deaths by 95% and decreasing incident TB cases by 90% by 2030, using 2015 as the baseline. Tuberculosis is the primary cause of morbidity, ranks third in hospital admissions, and is the second leading cause of death in Ethiopia, following malaria. Hence, this analysis aims to forecast and provide evidence that supports the combined intervention to monitor TB incidence in Ethiopia's progress toward the Sustainable Development Goals.</p><p><strong>Method: </strong>Study employed secondary data analysis from the Global Burden of Disease database (1990-2021) to forecast tuberculosis incidence in Ethiopia. LSTM-based models, including multistep LSTM and hybrid ARIMA + LSTM, were implemented for prediction in TensorFlow frameworks while ARIMA model was built using the statsmodels and pmdarima libraries using the Python programming language. The statistical significance level was set at 0.05 to check data stationarity. Model performance was evaluated using Root Mean Squared Error, Mean Absolute Error, Mean Absolute Percentage Error, and Symmetric Mean Absolute Percentage Error. Finally, the best model was used to forecast the next 9 years from 2021 to 2030.</p><p><strong>Result: </strong>According to GBD data, the incidence of TB in Ethiopia shows a long-term downward trend, decreasing from 466.93 cases per 100,000 in 1990 to 185.53 by 2021. The analysis result revealed that multistep LSTM model outperformed all achieving MAE: 5.53, RMSE: 6.74, MAPE: 2.72% and sMAPE:2.76%. The incidence of tuberculosis in Ethiopia is projected to decline slightly through 2030, according to a multi-step LSTM model. The forecast estimates that the TB incidence will be 189 cases per 100,000 people by 2025, decreasing further to 179 by 2030.</p><p><strong>Conclusion: </strong>Overall, the analysis indicates that Ethiopia is still falling short of the national \"END TB strategy\" goal of 90% reduction in TB incidence cases per 100,000 population by 2030. It highlights the necessity for Ethiopia's TB control strategies to improve access to prevention, early diagnosis, and treatment, focusing on high-risk groups and vulnerable populations.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"870"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence, associated factors, and viral load dynamics of hepatitis B virus infection among HIV patients in three healthcare facilities of South Kivu province, eastern Democratic Republic of Congo : Chronic hepatitis B virus among HIV patients in South Kivu province.","authors":"Parvine Basimane Bisimwa, Jean Paulin Mbo Mukonkole, Giscard Wilfried Koyaweda, Cadeau Mugisho Matabishi, Théophile Mitima Kashosi, Omari Mukanga, Denis Mukwege Mukengere, Jean Bisimwa Nachega, Narcisse Patrice Joseph Komas","doi":"10.1186/s12879-025-11233-6","DOIUrl":"https://doi.org/10.1186/s12879-025-11233-6","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis B virus (HBV) significantly impacts public health, particularly among individuals with Human Immunodeficiency Virus (HIV). Co-infection can worsen HBV progression and increase chronic liver disease risks. This study assessed HBV marker frequency, viral load (VL), and associated factors in HIV patients in South Kivu province (Democratic Republic of Congo) to understand the health implications of HBV-HIV co-infection.</p><p><strong>Methods: </strong>This cross-sectional study, from July 1, 2019, to July 30, 2021, included 864 HIV patients aged 18 to 70 years from General Referral Hospital of Panzi (GRH Panzi), Regional Military Hospital of Bukavu (RMH Bukavu), and Fomulac Hospital. Participants, on antiretroviral therapy, ART (TDF/3TC/DTG or AZT/3TC/LPV/r combinations) or newly diagnosed, consented for blood testing for hepatitis B using enzyme-linked immunosorbent assay (ELISA) and VLs using GeneXpert. Data were analyzed with Stata SE 14.0.</p><p><strong>Results: </strong>The study found 8.0% HBsAg positivity among HIV patients in South Kivu, with 41.3% and 14.1% showing Anti-HBc and Anti-HBs, respectively. HBsAg positivity was linked to male gender (AOR = 2.96; p = 0.007), rural origin (AOR = 4.32; p = 0.014), treatment at Fomulac Hospital (AOR = 4.87; p = 0.002), marital status (AOR = 4.55; p = 0.036), lower education (AOR = 57.25; p = 0.002), jaundice history (AOR = 3.98; p = 0.021), and < 5 years of unprotected sex (AOR = 10.96; p = 0.002). The HIV VL average was 3.26 ± 3.57 log₁₀ copies/ml, with no significant difference between HIV-only and co-infected individuals (p = 0.6642). In total, 448 (58.0%) participants on ART had undetectable HIV VLs. For HBV, 43.5% had undetectable, 49.3% low, and 7.2% high VLs. A correlation existed between HIV and HBV VLs; undetectable HIV corresponded to undetectable HBV in 62.5%, and high HIV VLs to high HBV in 50.0%.</p><p><strong>Conclusion: </strong>High HBV co-infection rates in HIV-positive individuals in South Kivu necessitate regular HBV monitoring including prevention, screening, and vaccination strategies in HIV care. Despite ART managing both infections effectively, further research on HBV-related outcomes is essential for improving co-infected patient care.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"837"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prolonged antiretroviral therapy use and hypertension in a retrospective cross-sectional study-Rakai, Uganda.","authors":"Grace Mongo Bua, Victor Ssempijja, Anthony Ndyanabo, Dorean Nabukalu, Jesca Basiima, Edward Nelson Kankaka, Fred Nalugoda, Gertrude Nakigozi, Joseph Kagaayi, Larry W Chang, Wendy S Post, Thomas C Quinn, Ron Gray, Maria Wawer, Godfrey Kigozi, Steven J Reynolds","doi":"10.1186/s12879-025-11004-3","DOIUrl":"https://doi.org/10.1186/s12879-025-11004-3","url":null,"abstract":"<p><strong>Background: </strong>While antiretroviral therapy (ART) reduces AIDS-related morbidity and mortality, it is unclear if prolonged ART use among people living with HIV (PLHIV) increases the risk of hypertension.</p><p><strong>Objective: </strong>We assessed the association between the duration of ART use and hypertension in the Rakai Community Cohort Study (RCCS).</p><p><strong>Design: </strong>We conducted a cross-sectional study among PLHIV (35-49 years old) on ART in the RCCS who were surveyed between August 2016 and May 2018.</p><p><strong>Methods: </strong>Systolic and diastolic blood pressure (BP) was measured twice, averaged, and classified as any hypertension (systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg), severe or worse hypertension (systolic BP ≥ 160 mmHg or diastolic BP ≥ 100 mmHg), or hypertensive crisis (systolic BP ≥ 180 mmHg or diastolic BP ≥ 110 mmHg). ART duration was categorized as short (0-2 years), moderate (> 2-5 years), or prolonged (> 5 years). We used log-binomial regression to estimate the adjusted prevalence ratio (adjPR) of hypertension associated with ART duration.</p><p><strong>Results: </strong>A total of 1,144 PLHIV on ART with documented BP information were identified in the RCCS, of whom 173 (15.1%) had any hypertension, 64 (5.6%) had at least severe hypertension, and 44 (3.8%) had hypertensive crisis. After controlling for age, sex, and body mass index, the prevalence of having all stages of high BP was increased by at least 42% in participants with more than five years of ART use (any hypertension adjPRs = 1.42 [95% CI = 0.99-2.03]; severe hypertension adjPRs = 1.79 [95% CI = 1.01-3.15]; and hypertensive crisis adjPRs = 2.56 [95% CI = 1.14-5.77]).</p><p><strong>Conclusions: </strong>PLHIV on long-term ART have a higher burden of hypertension, highlighting the need for enhanced screening and integrated management in HIV programs.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"860"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differentiation of Pneumocystis jirovecii pneumonia from colonization: a clinical decision framework incorporating risk stratification and next-generation sequencing thresholds.","authors":"Xiaoyan Sun, Peng Zhang, Kaiyu Zhang","doi":"10.1186/s12879-025-11235-4","DOIUrl":"https://doi.org/10.1186/s12879-025-11235-4","url":null,"abstract":"<p><strong>Objective: </strong>To delineate the clinical differences between Pneumocystis jirovecii pneumonia (PJP) and colonization, identify independent risk factors associated with PJP development, and construct a multidimensional diagnostic model to address the ongoing clinical challenge of accurately distinguishing P. jirovecii infection status in practice.</p><p><strong>Materials and methods: </strong>This retrospective study analyzed the clinical characteristics, imaging findings, and laboratory parameters of patients who tested positive for P. jirovecii by next-generation sequencing (NGS) at the First Hospital of Jilin University between January 2014 and October 2024. Multivariable logistic regression was performed to determine independent predictors of PJP.</p><p><strong>Results: </strong>Of the 292 patients included in the analysis (210 diagnosed with PJP and 82 classified as colonized), those with PJP had significantly higher rates of immunosuppression (64.4% vs. 9.9%, P < 0.001) and markedly increased P. jirovecii sequence counts from NGS (median: 1,686 vs. 4, P < 0.001).Human immunodeficiency virus coinfection, decreased lymphocyte count, elevated BDG levels, and increased LDH levels were identified as independent risk factors for PJP. A diagnostic model incorporating these four variables demonstrated excellent predictive capability, yielding an area under the receiver operating characteristic curve of 0.892 (P < 0.001; 95% confidence interval: 0.855-0.929). The optimal NGS sequence count threshold for differentiating PJP from colonization was determined to be 37, achieving a sensitivity of 91% and a specificity of 87.8% (area under the receiver operating characteristic curve: 0.964).</p><p><strong>Conclusions: </strong>The developed risk prediction model-comprising lymphocyte count, BDG, and LDH levels-facilitates rapid, pre-NGS clinical risk stratification for PJP, enabling prompt and informed therapeutic decision-making. When NGS results yield a P. jirovecii-specific sequence reads below the cutoff value of 37, a definitive diagnosis of PJP is unlikely. However, such findings should be interpreted in the context of the patient's clinical presentation and assessed using the diagnostic model to ensure an accurate evaluation of infection status.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"874"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High genetic diversity of HIV-1 pol region and molecular transmission networks among people living with HIV-1 in Haikou, South China, 2005-2022.","authors":"Dee Yu, Mu Li, Liangjia Wei, Kaokao Zhu, Rongjing Zhang, Tong Luo, Yi Ning, Hao Liang, Jing Zhang, Li Ye, Bingyu Liang","doi":"10.1186/s12879-025-11184-y","DOIUrl":"https://doi.org/10.1186/s12879-025-11184-y","url":null,"abstract":"<p><strong>Background: </strong>Hainan is experiencing a continuous increase in newly diagnosed HIV-1 infections, highlighting the need for a comprehensive understanding of local transmission dynamics. This study aims to elucidate the genetic diversity and potential HIV-1 molecular transmission networks among people living with HIV-1 in Hainan, China.</p><p><strong>Methods: </strong>We used the HIV-TRACE to infer the transmission dynamics of HIV-1 at a 1.5% gene distance threshold. The role of HIV-1 diversity in transmission networks was assessed through node influence measurement and centrality analysis.</p><p><strong>Results: </strong>A total of 986 pol sequences were included, with CRF07_BC (43.71%) and CRF01_AE (37.12%) emerging as the predominant subtypes. Of these, 586 (59.43%) were clustered into the transmission networks, forming 83 clusters with 155 nodes having high transmission network scores (HTNS). CRF07_BC (adjusted odds ratio, aOR: 1.585, 95%CI: 1.189- 2.113) and CRF65_cpx (aOR: 9.513, 95%CI: 3.694- 24.499) were more likely to cluster in networks and exhibit nodal centrality than CRF01_AE. The CRF65_cpx (88.46%) were more likely to be HTNS (aOR: 57.302, 95%CI:16.869- 194.643) than CRF07_BC.</p><p><strong>Conclusion: </strong>This study highlights the high genetic diversity of HIV-1 and its central role in transmission networks, advocating for targeted prevention strategies and community engagement for high-risk transmission populations, particularly focusing on subtypes CRF07_BC and CRF65_cpx.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"813"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"K. pneumoniae-induced septic embolism and prostatic abscesses in a treatment-naive type 2 diabetic patient: a case report.","authors":"Ye Tian, Yan Chen, Rui Zhai, Jie Gao, Zhongxing Dong, Liulin Wu, Yu He, Mei Hu","doi":"10.1186/s12879-025-11274-x","DOIUrl":"https://doi.org/10.1186/s12879-025-11274-x","url":null,"abstract":"","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"838"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}