BMC Infectious Diseases最新文献

{"title":"Understanding viral blips in people with HIV on antiretroviral therapy: a nationwide Swedish cohort study of 4,210 individuals.","authors":"Erik Sörstedt, Staffan Nilsson, Anders Sönnerborg, Christina Carlander, Carl Johan Treutiger, Fredrik Månsson, Lena Änghagen, Helena Berggren, Magnus Gisslén, Aylin Yilmaz","doi":"10.1186/s12879-026-14654-z","DOIUrl":"https://doi.org/10.1186/s12879-026-14654-z","url":null,"abstract":"<p><strong>Background: </strong>The pathogenesis and clinical consequences of viral blips are not completely understood. The aim of this large nationwide study was to investigate the incidence of viral blips and factors associated with them, with particular attention to the third (core) agent class-comparing integrase strand transfer inhibitor (INSTI)-based regimens with non-nucleoside reverse transcriptase inhibitor (NNRTI)- and protease inhibitor (PI)-based regimens.</p><p><strong>Methods: </strong>From the Swedish national InfCareHIV cohort, we included treatment-naïve adults who commenced antiretroviral therapy (ART) from 1 January 2007; data were extracted on 30 September 2020. Viral blips were defined as transient plasma HIV RNA levels between 50 and 500 copies/mL preceded and followed by HIV RNA < 50 copies/mL. Virological failure was defined as two consecutive HIV RNA samples > 200 copies/mL or a single sample of HIV RNA > 1,000 copies/mL, in previously suppressed individuals with more than 12 months since ART initiation. Cox regression was used for event analyses.</p><p><strong>Results: </strong>In total, 4,210 individuals were included, of whom 853 (20.3%) had 1-6 registered blips. Median observation time was 5.5 years (range 0.5-13.7). Blip incidence was 4.35 (95% CI 4.02-4.69) per 100 person-years. In a sensitivity analysis applying the narrower definition of 50-199 copies/mL, the incidence was 3.80 (95% CI 3.49-4.11) per 100 person-years. Individuals on INSTIs and NNRTIs had similar risk, while those on PIs had a significantly higher risk of blips (hazard ratio [HR] 1.22, 95% CI 1.03-1.45; p = 0.02). Transient viremia was not associated with an increased risk of subsequent virological failure; individuals with blips had a lower risk than those with continuously undetectable HIV RNA (HR 0.54, 95% CI 0.41-0.71; p < 0.0001).</p><p><strong>Conclusion: </strong>Individuals on INSTI- and NNRTI-based ART had fewer viral blips than those on PI-based ART. In this cohort, transient viremia below 500 HIV RNA copies/mL was not associated with a higher risk of subsequent virological failure.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149226986","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":"Infection or contamination - Clinical attribution of blood culture-positive episodes in neonatal intensive care: an 11-year retrospective single-center study.","authors":"Sarah V Schnee, Florens Lohrmann, Daniel Matheisl, Hendryk Schneider, Markus Hufnagel, Hans Fuchs, Martin Kuntz","doi":"10.1186/s12879-026-14605-8","DOIUrl":"10.1186/s12879-026-14605-8","url":null,"abstract":"<p><strong>Background: </strong>Positive blood cultures in neonatal intensive care do not necessarily indicate clinically relevant bloodstream infection. Interpretation is particularly challenging for coagulase-negative staphylococci (CoNS), which may represent either contamination or clinically relevant infection depending on the clinical context. We aimed to describe how treating teams attributed culture-positive episodes as infection or contamination in routine neonatal care and to examine which clinical, laboratory, and microbiological features were associated with this original clinical attribution. As a secondary aim, we characterized the local epidemiology of culture-positive episodes.</p><p><strong>Methods: </strong>We conducted a retrospective single-center study of all culture-positive episodes occurring between 2014 and 2024 in neonates hospitalized in a German tertiary NICU at the time of blood culture sampling. Original clinical attribution was extracted from documentation recorded during the index episode. Descriptive analyses and exploratory logistic regression were performed.</p><p><strong>Results: </strong>Among 3246 blood cultures, 232 (7.1%) were positive. After accounting for additional follow-up and parallel cultures and other exclusions, 189 unique culture-positive episodes remained for analysis; 125 (66.1%) were attributed as infection and 64 (33.9%) as contamination. Thirty-five episodes (18.5%) occurred during the early-onset period and 154 (81.5%) during the late-onset period. Coagulase-negative staphylococci (CoNS) were detected in 114 episodes (60.3%) and showed the greatest variability in attribution. All 13 CoNS-positive early-onset episodes were attributed as contamination, whereas 64 of 101 CoNS-positive late-onset episodes (63.4%) were attributed as infection. Enterobacterales, Enterococcus faecalis, Staphylococcus aureus, and Candida spp. were almost uniformly attributed as infection, whereas Bacillus spp. and environmental organisms were predominantly attributed as contamination. In late-onset episodes, maximum CRP showed the strongest association with attribution as infection in univariable and multivariable analyses (adjusted OR 4.41, 95% CI 2.59-7.51). Associations with time-to-positivity, CoNS detection, and central vascular catheter presence were weaker and imprecisely estimated after adjustment.</p><p><strong>Conclusions: </strong>Clinical attribution of culture-positive episodes was associated with the combined consideration of organism plausibility, inflammatory response, time-to-positivity, and clinical context. CoNS-positive late-onset episodes represented the greatest diagnostic uncertainty. These findings describe real-world clinical attribution rather than diagnostic accuracy and underline the need for more reproducible criteria to support antimicrobial stewardship without compromising the treatment of vulnerable neonates.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: The origin and dissemination of HIV-1 subtype B on Hainan Island, South China, 2007-2024.","authors":"Chunyun Lu, Kaokao Zhu, Nengde Zhang, Mu Li, Shanmei Zhong, Cai Qin, Tong Luo, Rongjing Zhang, Jing Zhang, Yi Ning, Hao Liang, Li Ye, Bingyu Liang, Dee Yu","doi":"10.1186/s12879-026-14376-2","DOIUrl":"10.1186/s12879-026-14376-2","url":null,"abstract":"","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Epstein-barr virus super-infection is associated with increased severity of hemorrhagic fever with renal syndrome.","authors":"Li-Zhu Fang, Bing Qiao, Li-Yan Dong, Ke Zhu, Yu-Hong Dong, Zhi-Jian Yan, Run-Ze Lu, Hui Liang, Jing Jia, Zhao-Guo Wang","doi":"10.1186/s12879-026-14215-4","DOIUrl":"https://doi.org/10.1186/s12879-026-14215-4","url":null,"abstract":"","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13632311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A framework for assessing potential Oropouche virus-associated adverse fetal outcomes.","authors":"Luísa Freire Tanaka, Nayele Benittes de Moura Dutra, Thaísa Regina Rocha Lopes, Rodrigo Feliciano Carmo, Edmilson Ferreira de Oliveira-Filho, Laura Helena Vega Gonzales Gil, José Valter Joaquim Silva Júnior","doi":"10.1186/s12879-026-14420-1","DOIUrl":"10.1186/s12879-026-14420-1","url":null,"abstract":"<p><p>Several reports have suggested Oropouche virus (OROV)-related vertical transmission and adverse fetal outcomes; however, these observations require further investigation. Herein, we propose complementary experimental and epidemiological approaches to better characterize the potential role of OROV infection in fetal and neonatal disorders.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13625472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hyperinflammatory nutritional index as an exploratory combined inflammatory and nutritional marker: associations with cytokines and β2-microglobulin in COVID-19.","authors":"Gülsüm Kaya, Cengiz Karacaer, Cenk Sunu, Hasan Ergenç, Aziz Öğütlü","doi":"10.1186/s12879-026-14525-7","DOIUrl":"10.1186/s12879-026-14525-7","url":null,"abstract":"<p><strong>Background: </strong>COVID-19 is characterized by heterogeneous clinical presentations, ranging from mild disease to severe hyperinflammatory states. While individual inflammatory biomarkers are associated with disease severity, the clinical relevance of combined immunonutritional indices remains unclear.</p><p><strong>Methods: </strong>This observational cross-sectional study included 60 COVID-19 patients categorized as ICU, ward, and outpatient groups. The hyperinflammatory nutritional index (HNI), calculated as CRP × ferritin / albumin, was evaluated alongside cytokines and β2-microglobulin. Correlation and ROC analyses were performed.</p><p><strong>Results: </strong>ICU patients exhibited significantly higher inflammatory markers, cytokines, β2-microglobulin, and HNI levels. HNI showed a strong correlation with ferritin (r = 0.945) and moderate correlations with cytokines. ROC analysis demonstrated a high AUC (0.953) for HNI; however, this finding should be interpreted cautiously given the small sample size and potential mathematical coupling.</p><p><strong>Conclusions: </strong>HNI appears to reflect the combined burden of inflammation and nutritional status rather than an independent biomarker. Its clinical utility beyond individual parameters remains uncertain and requires validation in larger studies.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13625298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors associated with carbapenem-resistant Gram-negative bacterial infections in intensive care units in Jordan.","authors":"Mohammad Gharaibeh, Omar Sayyouh, Mona El-Shokry, Salwa Nasrat, Mohamed Ramadan, Wiam Khraisat, Lina Alamer, Alia Natour, Mohammad Aljbour, Zainab Abushawer, Najla'a Abdallah, Nisreen Migdadi, Suzan Harb, Essam Awad, Enas Bataienh, Suzanne Battah, Ruba Ikermawi, Mayar Said, Mohammad Alhawarat, Tamer Osman","doi":"10.1186/s12879-026-13526-w","DOIUrl":"https://doi.org/10.1186/s12879-026-13526-w","url":null,"abstract":"<p><strong>Background: </strong>Carbapenem-resistant Gram-negative bacteria (CR-GNB) pose major challenges in intensive care units (ICUs) due to limited treatment options and high mortality. Data describing their predictors in Jordan are scarce. This study aimed to identify risk factors associated with CR-GNB infections among ICU patients.</p><p><strong>Methodology: </strong>A retrospective analysis was conducted using national surveillance data from 18 ICUs across 13 public hospitals in Jordan between September 2018 and September 2024. Patients with confirmed Gram-negative infections were included. Laboratory testing followed CLSI M100 standards. Logistic regression was performed to determine independent predictors of carbapenem resistance.</p><p><strong>Results: </strong>Of 1,180 Gram-negative isolates tested, 451 (38%) were carbapenem-resistant. Acinetobacter baumannii and Klebsiella spp. were the predominant resistant pathogens, while E.coli was mainly carbapenem-susceptible. Independent predictors of carbapenem resistance identified by multivariate logistic regression were: ICU-acquired infection (OR: 2.44; 95% CI: 1.31-4.54; p = 0.004), pneumonia (OR: 2.77; 95% CI: 1.48-5.23; p = 0.001), invasive device use (OR: 3.37; 95% CI: 1.28-9.95; p = 0.019), and admission to high-risk ICU units (OR: 3.33; 95% CI: 2.06-5.48; p < 0.001). Mortality was significantly higher among CR-GNB patients (69.8%) compared to carbapenem-susceptible patients (42.0%), with a 3.15-fold increased risk of death (OR: 3.149; 95% CI: 2.392-4.145; p < 0.001).</p><p><strong>Conclusion: </strong>The findings of this study underscore the need for strategies to prevent and control carbapenem-resistant infections, particularly in high-risk populations such as patients with invasive devices and those diagnosed with pneumonia. Enhanced infection control measures, including strict hand hygiene practices, judicious antibiotic stewardship, and proper management of invasive devices, are essential to minimize the transmission of carbapenem-resistant bacteria in healthcare settings.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13632373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emerging predominance of Plasmodium vivax and its contribution to severe malaria in Central Ethiopia: a mixed retrospective-prospective study from two tertiary hospitals.","authors":"Ayto Addisu Negash, Mehreteab T Woudineh, Kassim H Mohammed, Eyob Z Chafamo, Solomon Y Tilahun, Biruk G Awata, Abraraw E Dires, Ashagre E Hundeto, Etsegenet D Dires, Adey A Bogale, Tekiy M Bedore","doi":"10.1186/s12879-026-14383-3","DOIUrl":"10.1186/s12879-026-14383-3","url":null,"abstract":"<p><strong>Background: </strong>Malaria remains a major public health challenge in Ethiopia. While Plasmodium falciparum has historically been associated with severe disease, the clinical importance of Plasmodium vivax is increasingly recognized.</p><p><strong>Objective: </strong>This study aimed to determine the prevalence, species distribution, severity, associated factors, and clinical outcomes of malaria among adults attending emergency departments in Central Ethiopia.</p><p><strong>Methods: </strong>A mixed retrospective-prospective observational study was conducted in the adult emergency departments of two tertiary hospitals from October 1 to December 31, 2025. Severe malaria was defined according to the 2014 World Health Organization (WHO) criteria. The association between malaria species and severe malaria was examined using bivariate logistic regression.</p><p><strong>Results: </strong>Among 318 laboratory-confirmed malaria cases, P. vivax was the predominant species (49.7%), followed by P. falciparum (38.4%) and mixed infections (11.9%). Severe malaria was diagnosed in 65.7% of patients, with severe anaemia (haemoglobin < 5 g/dL) being the most common severity criterion (33.3%). Severe malaria occurred in 65.2% of patients with P. vivax and 67.2% with P. falciparum. No statistically significant association was found between malaria species and severe malaria. Most patients (62.3%) were discharged from the emergency department, while 27.7% were admitted to medical wards. In-hospital mortality was 4.4%.</p><p><strong>Conclusion: </strong>P. vivax was the predominant malaria species among adults presenting to the two tertiary hospitals, and both P. vivax and P. falciparum were associated with substantial severe disease. Severe anaemia was the most common manifestation. Strengthening early diagnosis, prompt treatment, species-specific case management, and appropriate radical cure for P. vivax remains important for malaria control and elimination efforts.</p><p><strong>Clinical trial statement: </strong>This manuscript does not describe a clinical trial.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pneumococcal serotype distribution and diagnostic yield of serotype-specific urinary antigen detection in adults with CAP in Switzerland, 2016-2021: a prospective cohort study.","authors":"Samuel Etienne, Werner C Albrich, Mathias W Pletz, Marcus Panning, Vivian Suarez Domenech, Frank Eberhardt, Grit Barten-Neiner, Daiana Stolz","doi":"10.1186/s12879-026-14493-y","DOIUrl":"10.1186/s12879-026-14493-y","url":null,"abstract":"<p><strong>Background: </strong>Streptococcus pneumoniae remains the leading bacterial cause of community-acquired pneumonia (CAP) and a major source of morbidity and mortality in adults. Pneumococcal conjugate vaccines (PCVs) have substantially reduced invasive pneumococcal disease, but serotype replacement has led to shifts in pneumococcal CAP epidemiology. In addition, the identification of S. pneumoniae remains challenging. This study investigated pneumococcal serotype distribution, vaccine coverage, and the diagnostic yield of a serotype-specific urinary antigen detection assay (ssUAD) among adults with CAP in Switzerland between 2016 and 2021.</p><p><strong>Methods: </strong>Adult patients enrolled in the Swiss CAPNETZ cohort with available urine samples were analyzed using the Pfizer 24-serotype ssUAD assay. Results were compared with conventional diagnostic methods, including the pneumococcal urinary antigen test (pUAT) and cultures. Serotype distribution, vaccine coverage (PCV13, PCV15, PCV20 and PCV21), and temporal trends were assessed.</p><p><strong>Results: </strong>Among 234 CAP patients, S. pneumoniae was identified by conventional diagnostics (pUAT and cultures combined) in 37 (15.8%). The ssUAD was positive in 35 patients (15.0%). Among patients with available results from both conventional diagnostics and ssUAD (n = 161), the addition of ssUAD increased pneumococcal CAP detection from 18.6% to 29.2% (p = 0.036). Among ssUAD-positive patients, the most frequent serotypes detected by ssUAD were 3 (n = 12), 8 (n = 5), and 11A (n = 4). Based on ssUAD-derived serotype distribution, vaccine coverage was 54.3% for PCV13, 60.0% for PCV15, 91.4% for PCV20, and 85.7% for PCV21. During 2020-2021, the proportion of serotypes not covered by PCV13 increased from 10/28 (35.7%) to 6/7 (85.7%) (p = 0.018).</p><p><strong>Conclusions: </strong>The addition of ssUAD improved S. pneumoniae detection beyond standard methods. Although based on a small number of cases, the shift toward non-PCV13 serotypes underscores the potential benefit of higher-valency vaccines such as PCV20 and PCV21 for adult pneumococcal disease prevention in Switzerland.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149023862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combatting a Tobramycin-resistant Staphylococcus aureus outbreak in a neonatal intensive care unit: the impact of hygiene intervention and antibiotic substitution.","authors":"Anna Jogenfors, Sara Mernelius, Sture Löfgren, Malin Bengnér, Johannes Bengnér, Fredrik Ingemansson, Sofia Wetterbrandt, Andreas Matussek","doi":"10.1186/s12879-026-14481-2","DOIUrl":"10.1186/s12879-026-14481-2","url":null,"abstract":"<p><strong>Background: </strong>Outbreaks of antibiotic-resistant bacteria in neonatal intensive care units (NICUs) is a significant risk to these vulnerable infants. This study describes a decade-long outbreak of tobramycin-resistant Staphylococcus aureus (TRSA) and the interventions implemented to try and resolve it.</p><p><strong>Methods: </strong>A TRSA outbreak was suspected in a Swedish NICU in 2010 when four infants developed bacteremia with TRSA spa type t084. The outbreak was confirmed by point prevalence surveys of infants and staff, and monitored through active screening of infants. Several interventions were implemented to combat the outbreak, e.g. hygiene interventions were implemented (2010, 2014), the NICU was reconstructed (2012-2013), tobramycin was substituted for amikacin (2014) and a continued summary of screening results were distributed as a reminder to adhere to hygiene routines.</p><p><strong>Results: </strong>Retrospective analysis of previous samples revealed TRSA presence as early as 2009. The S. aureus prevalence significantly decreased from 71% (2010-2011) to 52% (2013) following the hygiene intervention and pre-pasteurization of donor human milk (DHM). However, the proportion of TRSA persisted. The proportion of TRSA started to significantly decrease only after the ward was reconstructed and the antibiotic regimen was modified, ultimately leading to the apparent resolution of the outbreak in 2019, five years after the change in antibiotic regimen. No TRSA septicemia cases occurred after the change in antibiotic regimen and TRSA in the environmental screenings were no longer detected after 2012.</p><p><strong>Conclusions: </strong>Our findings underscore the interplay between the ward environment and neonatal colonization, emphasizing that successful outbreak control requires a combination of adherence to hygiene routines, pasteurization of DHM, and a correct antibiotic regimen.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13595557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}