BMC Infectious Diseases最新文献

{"title":"Early combined therapy for COVID-19 in immunocompromised patients: a promising approach against viral persistence and drug resistance.","authors":"Salvatore Rotundo, Francesca Serapide, Lavinia Berardelli, Sara Palma Gullì, Simona Mongiardi, Maria Teresa Tassone, Enrico Maria Trecarichi, Alessandro Russo","doi":"10.1186/s12879-025-11012-3","DOIUrl":"https://doi.org/10.1186/s12879-025-11012-3","url":null,"abstract":"<p><p>Immunocompromised (IC) patients face significant challenges in managing COVID-19 due to their heightened susceptibility to severe illness, persistent infections, and the potential development of drug resistance. Studies indicate that IC patients, particularly those with hematologic malignancies (HM), hematopoietic stem cell transplants (HSCTR), or solid organ transplants (SOTR), experience higher mortality rates and worse outcomes compared to the general population, even post-vaccination. The persistence of the virus in these patients, combined with its rapid mutation, further complicates treatment. Recent evidence supports the use of combined neutralizing monoclonal antibodies (mAbs) and direct-acting antivirals (DAAs) as a more effective approach to viral clearance, reducing mortality, and preventing relapses. However, the rise of resistant variants, especially to mAbs, and concerns about the safety of prolonged or intensive therapies pose ongoing challenges. Monotherapies often fail short to address these issues, highlighting the need for early combined therapy (ECT) with mAbs and DAAs. ECT has shown promise in managing COVID-19 in IC individuals by targeting multiple stages of the viral lifecycle, reducing viral load, and clearing infections at earlier stages, which helps mitigate the risks of severe disease and drug resistance. Continued research is essential to refine these treatment protocols, especially as the virus evolves. Although further studies are needed, current findings suggest that ECT may become the standard of care for managing COVID-19 in severely IC patients, offering better clinical outcomes and hindering viral persistence.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"616"},"PeriodicalIF":3.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962070","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":"Comparative evaluation of five β-Lactamase inhibitors in combination with β-Lactams against multidrug-resistant Mycobacterium tuberculosis in vitro.","authors":"Jie Shi, Danwei Zheng, Ruyue Su, Xiaoguang Ma, Yankun Zhu, Shaohua Wang, Wenjing Chang, Dingyong Sun","doi":"10.1186/s12879-025-10730-y","DOIUrl":"https://doi.org/10.1186/s12879-025-10730-y","url":null,"abstract":"<p><strong>Objective: </strong>Evaluating the activity of six β-lactams in combination with different β-lactamase inhibitors to identify the most potent combination against Mycobacterium tuberculosis(MTB) in vitro.</p><p><strong>Methods: </strong>A total of 105 MDR-TB strains from different regions of Henan province were included in this study.Drug susceptibility of sixβ-lactams alone or in combination with β-lactamase inhibitors was examined by broth dilution method against 105 clinical isolates.Mutations of blaC, ldt_mt1,dacB2and ldt_mt2 were analyzed by PCR and DNA sequencing.</p><p><strong>Results: </strong>Out of the β-lactams used herein, tebipenem was the most effective against MDR-TB and had an MIC₉₀ value of 16 µg/ml.Clavulanic acid, tazobactam, and sulbactam, demonstrated the best synergy with tebipenem, resultingin an 32-fold reduction in theMIC values for 12, 5, and 20 strains, respectively. Simultaneously, these three types ofβ-lactamase inhibitors had the least impact on imipenem.Clavulanic acid caused the maximum 8-fold reduction in the MIC value of imipenem, while tazobactam and sulbactam only resulted in the maximum 4-fold reduction in the MIC value of imipenem. Besides, after the addition ofβ-lactamase inhibitors, the MICs of most β-lactam drugs were reduced more evidently in the presence of avibactamand tazobactamcompared to other β-lactamase inhibitors. In addition, 13.33% (14/105) of isolates harbored mutations in the blaC gene, with three different nucleotide substitutions: AGT333AGG 、AAC638ACCand ATC786ATT. For the strains with a Ser111Arg andAsn213Thrsubstitution inBlaC, a better synergistic effect was observed in the meropenem-clavulanate and in the meropenem-sulbactam combinationsthan that in a synonymous single nucleotide polymorphism (SNP) group.</p><p><strong>Conclusion: </strong>the combination of tebipenem and relebactam shows the most potent activity against MDR-TB isolates. In addition, the Ser111Arg and Asn213Thr substitution of BlaC may be associated with increased susceptibility of MDR-TB isolates to meropenem in thepresence of clavulanate and sulbactam.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"619"},"PeriodicalIF":3.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963579","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 for catheter-associated urinary tract infection in an intensive care unit: a matched case-control study.","authors":"Li Yajun, Zhou Xuan, Tian Juan, Tu Rui, Xiao Zuyan, Zhang Bingbing, Zhou Ruiqi, Du Guiqin, Zhao Tao","doi":"10.1186/s12879-025-10839-0","DOIUrl":"https://doi.org/10.1186/s12879-025-10839-0","url":null,"abstract":"<p><strong>Objective: </strong>Catheter-associated urinary tract infections (CAUTIs) are common healthcare-related infections in intensive care units (ICUs). This study investigated the risk factors for CAUTIs in critically ill patients.</p><p><strong>Methods: </strong>This study was a single-centre, retrospective, matched case-control study of patients undergoing indwelling catheterization in the ICU from December 1, 2016, to October 31, 2021. Patients with catheterizations were matched 1:4 with controls that were hospitalized in the ICU during the same period (with a difference in admission time of no more than two months).</p><p><strong>Results: </strong>CAUTI occurred in 18 of 403 patients, with an infection rate of 3.7/per 1000 catheter days. Repeat catheterization of the urinary catheter (OR = 10.09) and days of antibiotic use (OR = 0.13) were independent risk factors for CAUTI (P < 0.05). A total of 31 pathogen strains were detected in urine samples from 18 CAUTI patients. The main pathogens were Gram-positive bacteria (n = 13, 41.9%), fungi (n = 10, 32.3%) and Gram-negative bacteria (n = 7, 22.6%). CAUTI was associated with an increase in hospitalization days by 26 days and an increase in total hospitalization cost of ¥160,000 (P < 0.001).</p><p><strong>Conclusion: </strong>CAUTIs pose an economic and health burden for ICU patients. Repeat catheterization and longer use of antibiotics are to be avoided as much as possible.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"617"},"PeriodicalIF":3.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961123","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":"Relation between serum magnesium and outcome in patients with Escherichia coli sepsis.","authors":"Yan Cao, Bangqi Hu, Wei Zhou, Zhengyu Liu, Yanfang Pei, Jiang Yu, Conglong Hu, Xin Liu, Xiaotong Han, Xiquan Yan, Liudang He, Ning Ding","doi":"10.1186/s12879-025-10979-3","DOIUrl":"https://doi.org/10.1186/s12879-025-10979-3","url":null,"abstract":"<p><strong>Objective: </strong>Escherichia coli (E.coli) is the leading pathogen for deaths associated with antimicrobial resistance, making it the most problematic bacteria for human infections. This study aimed to investigate the association between serum magnesium levels and clinical outcomes in patients with E.coli sepsis.</p><p><strong>Method: </strong>Data of E.coli septic patients were collected from the MIMIC-IV database. Patients were divided into three groups based on tertiles of serum magnesium levels. Three models were utilized, including the raw model (unadjusted), Model I (adjusted for age and gender), and Model II (adjusted for all potential confounding factors). Linear model and two-segment nonlinear model were established to examine the relationship between serum magnesium and 30-day, 60-day, and 90-day mortality rates. Kaplan-Meier survival curve analysis was performed to assess cumulative hazard of mortalities at 30-day, 60-day, 90-day based on tertiles of serum magnesium levels.</p><p><strong>Results: </strong>A total of 421 E.coli septic patients were included and classified into tertiles: Q1(< 1.6 mg/dL), Q2 (1.6-1.9 mg/dL), Q3(> 1.9 mg/dL). In the Model adjusting for all potential confounders, for every 1 mg/dL increase in serum magnesium, there was a significant increase in 30-day, 60-day, and 90-day mortality rates, with odds ratios of 4.01 (95% CI 1.22-13.19, P = 0.022), 4.81 (95% CI 1.59-14.53, P = 0.005), and 4.45 (95% CI 1.52-12.96, P = 0.006) respectively. And linear model is more suitable for describing the relationship between serum magnesium levels and clinical outcomes. Kaplan-Meier analysis revealed that the cumulative hazard of mortalities at 30-day, 60-day, 90-day increased with the prolongation of hospital stay, particularly in the group with the highest serum magnesium level.</p><p><strong>Conclusion: </strong>Increased level of serum magnesium is significantly associated with increased risk of 30-day, 60-day and 90-day mortality in a population of septic patients with E.coli infection.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"618"},"PeriodicalIF":3.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969400","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":"Assessment of in vitro antimicrobial activities of ceftolozane/tazobactam and ceftazidime/avibactam against carbapenem-resistant Pseudomonas aeruginosa clinical isolates.","authors":"Dalia Salem, Ahmed El-Shenawy, Heba Dahroug, Manar Zaiton, Doaa Gamal, Manal Diab","doi":"10.1186/s12879-025-10891-w","DOIUrl":"https://doi.org/10.1186/s12879-025-10891-w","url":null,"abstract":"<p><strong>Background: </strong>Carbapenem resistant Pseudomonas aeruginosa (P. aeruginosa) is a global health concern that poses a challenge to treat in health care facilities. Ceftazidim/avibactam and ceftolozane/tazobactam have a potential role in treatment of multi-drug resistant phenotypes including carbapenem resistant P. aeruginosa. Therefore, we aimed to assess the in vitro antimicrobial activity of ceftazidime/avibactam and ceftolozane/tazobactam against carbapenem-resistant P. aeruginosa (CRPA) strains with different β-lactamase/carbapenemase genes.</p><p><strong>Methods: </strong>Sixty CRPA isolates identified from clinical samples were examined for antimicrobial susceptibility including ceftazidim/avibactam and ceftolozane/tazobactam by Vitek2 compact system, and carbapenemase production by modified carbapenem inactivation method (mCIM) test and carbapenemase producing genes by polymerase chain reaction (PCR).</p><p><strong>Results: </strong>Isolates were resistant to imipenem in 96.7% and meropenem in 88.3%. of isolates. Carbapenemase production by mCIM test was 70% compared to 73.3% by (PCR). Carbapenemase encoding genes bla_NDM, bla_VIM and bla_OXA-48 were detected in 60%, 41.7% and 25% respectively while bla_IMP and bla_KPC weren't identified in this study. Among CRPA, both ceftazidim/avibactam and ceftolozane/tazobactam; were sensitive in only 11.7% of the isolates. Resistance to ceftazidim/avibactam and ceftolozane/tazobactam in isolates owning bla_NDM, bla_VIM, bla_OXA-48 and those having combined bla_NDM, bla_VIM and bla_OXA-48 carbapenemase resistance genes were 97.2%, 92%, 100% and 100% respectively.</p><p><strong>Conclusion: </strong>Modified carbapenem inactivation method test gave satisfactory results and could be used as an alternative to expensive genotypic methods. Ceftazidim/avibactam and ceftolozane/tazobactam were unsuccessful against carbapenem resistant P. aeruginosa isolates carrying carbapenemase genes especially metallo-β lactamase genes. Therefore, it is essential to detect susceptibility patterns to newly introduced β-Lactam/β-Lactamase inhibitor combinations due to the emerging resistance to these therapeutics.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"622"},"PeriodicalIF":3.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952686","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":"Protocol for nationwide surveillance of Acute Encephalitis Syndrome (AES) in a network of tertiary care hospitals in India.","authors":"Anoop Velayudhan, Harmanmeet Kaur, Rahul Dhodapkar, Labanya Mukhopadhyay, Rizwan S Abdulkader, Sabarinathan R, Valsan Philip Verghese, Lalit Dar, Rakesh Lodha, Ravi V, Sam Joy, Pragya Yadav, Amita Jain, Ajanta Sharma, Kaveri K, Sayantan Banerjee, Anitha Pm, Manjusree S, Bharti Malhotra, Baijayantimala Mishra, Mala Chhabra, Asim Sarfraz, Bashir Fomda, Mahima Mittal, Manoj Murhekar, Nivedita Gupta","doi":"10.1186/s12879-025-10963-x","DOIUrl":"https://doi.org/10.1186/s12879-025-10963-x","url":null,"abstract":"<p><strong>Background: </strong>Advances in laboratory diagnostics have greatly enhanced the understanding of the infectious aetiologies of Acute Encephalitis Syndrome (AES) globally. However, these diagnostic tests are not widely utilized in many public-sector clinical settings in India. Significant gaps thus remain in the knowledge and understanding of the burden, etiological spectrum, and risk factors associated with AES occurring in India.</p><p><strong>Methods: </strong>The current manuscript outlines a protocol designed to characterize the infectious causes of AES in affected regions of India through a network of 12 selected tertiary care hospitals and their associated Virus Research and Diagnostic Laboratories (VRDLs). A standardized tiered testing algorithm accounting for a wide range of possible etiological agents of infectious AES has been developed for use in the protocol, which aims to employ serological and molecular techniques to diagnose AES-causing priority pathogens. Pathogens of interest have been grouped in the testing algorithm into five levels (Levels 1-5) in decreasing order of priority based on their reported incidence. Clinical samples from each patient will be collected at presentation at respective sites, and relevant demographic and clinical data will be obtained from hospital records. Approximately 20% of samples which test negative for Level 1-4 pathogens will be subjected to Next-Generation Sequencing (NGS) to identify less well known/rare infectious causes of AES (Level 5 pathogens). De-identified clinical and laboratory data will be recorded into a web-based portal and managed by a designated nodal laboratory responsible for coordinating and overseeing the surveillance. The protocol ensures quality laboratory testing through an External Quality and Assessment Programme (EQAP).</p><p><strong>Discussion: </strong>Results from this nationwide surveillance will yield crucial data to identify the causes of Acute Encephalitis Syndrome (AES) across India, supporting targeted public health interventions that could help reduce the disease burden. Additionally, this protocol serves as a model for a tiered laboratory algorithm for AES surveillance, providing a framework to guide similar initiatives in other regions.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"615"},"PeriodicalIF":3.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967339","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":"Neutrophil-lymphocyte ratio: a correlation study of its effect on magnetic resonance imaging enhancement patterns in spinal parenchymal tuberculosis.","authors":"Qiulan Shan, Le Zhang, Xuwen Fu, Min Qi, Jialu Wei, Wei Gan, Ying Pu, Lingjun Shen, Xiang Li","doi":"10.1186/s12879-025-10911-9","DOIUrl":"https://doi.org/10.1186/s12879-025-10911-9","url":null,"abstract":"<p><strong>Objective: </strong>To explore the impact of the neutrophil-lymphocyte ratio (NLR) on magnetic resonance imaging (MRI) enhancement patterns in patients with spinal parenchymal tuberculosis.</p><p><strong>Methods: </strong>In this study, a retrospective analysis was conducted on 42 patients diagnosed for the first time with spinal parenchymal tuberculosis at Kunming Third People's Hospital between 2019 and 2024. They were divided into a homogeneous enhancement group and a ring enhancement group based on MRI characteristics and an analysis of their clinical presentations, imaging features and laboratory test results.</p><p><strong>Results: </strong>A total of 42 patients were included in the study, with 30 in the ring enhancement group and 12 in the homogeneous enhancement group. The ring enhancement group exhibited a significantly higher proportion of fever, night sweats and limb sensory/motor dysfunction compared with the homogeneous enhancement group (p < 0.05). For laboratory tests, the ring enhancement group showed remarkably elevated peripheral blood neutrophil counts and NLR, along with markedly reduced lymphocyte counts and proportions (p < 0.05). Additionally, the incidence of perilesional oedema was substantially higher in the ring enhancement group than in the homogeneous enhancement group (p < 0.05).</p><p><strong>Conclusion: </strong>The NLR may serve as a potential indicator for assessing MRI enhancement patterns in spinal parenchymal tuberculosis, which is beneficial for identifying patients at different pathological stages of the disease. This study provides novel perspectives for clinical diagnosis and treatment while emphasising the need for further research on the application value of the NLR in tuberculosis.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"621"},"PeriodicalIF":3.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12038924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967455","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":"Management practices and mortality predictors among Klebsiella pneumoniae infections across Lebanese hospitals: a multicenter retrospective study.","authors":"Rania Itani, Hani M J Khojah, Hamza Raychouni, Rahaf Kibrit, Patricia Shuhaiber, Carole Dib, Mariam Hassan, Tareq L Mukattash, Abdalla El-Lakany","doi":"10.1186/s12879-025-11010-5","DOIUrl":"https://doi.org/10.1186/s12879-025-11010-5","url":null,"abstract":"<p><strong>Background: </strong>Klebsiella pneumoniae is a significant cause of both community-acquired and nosocomial infections, leading to high morbidity and mortality rates. The increasing antimicrobial resistance among K. pneumoniae strains poses a critical challenge to effective treatment. This study aimed to assess the appropriateness of initial antimicrobial therapy, determine the 30-day all-cause mortality rate, and identify predictors of mortality among patients infected with K. pneumoniae in Lebanese hospitals.</p><p><strong>Methods: </strong>A multicenter retrospective observational study was conducted across three university hospitals in Beirut, Lebanon. The study included hospitalized adult patients with confirmed K. pneumoniae infections. Kaplan-Meier survival analysis and log-rank tests were used to analyze time-to-mortality. Binary logistic regression was performed to identify predictors of mortality.</p><p><strong>Results: </strong>Of 2,655 cases screened, 410 patients were enrolled, and 395 cases were included in the final analysis of the 30-day mortality after excluding those lost to follow-up. Nearly one-third of the isolates (36.8%) were extended-spectrum β-lactamase (ESBL)-producing, while 6.8% were carbapenem-resistant K. pneumoniae (CRKP). The most commonly prescribed empirical antibiotics were meropenem (31.7%), amikacin (28.5%), and ceftriaxone (22.2%). Around one-third of the patients (32.9%) received inappropriate initial antimicrobial therapy. The 30-day mortality rate was 14.4%. Main predictors significantly associated with mortality in patients with K. pneumoniae infection were solid cancer (adjusted odds ratio [AOR] = 7.82, P < 0.01), coronary artery disease (AOR = 4.81, P = 0.01), age ≥ 65 years (AOR = 4.22, P = 0.02), type II diabetes mellitus (AOR = 3.96, P = 0.01), receiving inappropriate initial antimicrobial therapy (AOR = 2.96, P = 0.02), infection with CRKP isolates (AOR = 2.53, P = 0.03), and having a higher Charlson comorbidity index (AOR = 1.61, P = 0.001).</p><p><strong>Conclusions: </strong>The study highlights the critical need for effective antimicrobial stewardship and tailored infection control protocols to mitigate the high resistance rates and improve patient outcomes in Lebanon. Emphasis should be placed on enhancing the monitoring of local resistance patterns and using these data to guide the selection of appropriate empirical therapy to reduce mortality associated with K. pneumoniae infections.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"620"},"PeriodicalIF":3.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974409","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":"Developing an element system of hospital resilience to medical run in major emerging infectious diseases: a Delphi study.","authors":"Kangyao Cheng, Rui Xie, Ziwei Xu, Yanyan Zhang, Li Gui","doi":"10.1186/s12879-025-10993-5","DOIUrl":"https://doi.org/10.1186/s12879-025-10993-5","url":null,"abstract":"<p><strong>Background: </strong>Major emerging infectious diseases often trigger the \"medical run\", presenting significant challenges to health systems. Developing hospital resilience is crucial for enhancing the capacity to manage such crises. Therefore, this research aimed to construct an element system of hospital resilience to medical run in major emerging infectious diseases.</p><p><strong>Methods: </strong>Utilizing the 4R conceptual model and literature content analysis, a preliminary draft for hospital resilience was developed. Subsequently, a two-round Delphi survey involving 18 Chinese experts across various fields refined this system. The Standard for Conducting And Reporting Delphi Studies (CREDES) guided this process. The weights of each element were determined using the analytic hierarchy process.</p><p><strong>Results: </strong>The effective recovery rate for both Delphi rounds were 100% (18/18), with an authority coefficient of 0.9159. The first round revealed a Kendall's concordance coefficient for total elements of 0.136 (P < 0.05); the second round showed a coefficient of 0.214 (P < 0.05). The final element system included four primary elements (Resourcefulness, Redundancy, Robustness, Recovery), 21 secondary elements, and 65 tertiary elements, with weights of 0.2908, 0.2056, 0.4348, and 0.0688, respectively.</p><p><strong>Conclusions: </strong>This study constructed the element system of hospital resilience to medical run in major emerging infectious diseases. The results are designed to elucidate the components of hospital resilience in the context of major emerging infectious disease, which can help mitigate the impact of medical run. The study will provide hospitals with a checklist and assessment program for enhancing resilience, offering significant implications for the development of hospital training and management strategies.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"612"},"PeriodicalIF":3.4,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969472","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":"Phialophora americana infection in a patient with a compound heterozygous CARD9 mutation.","authors":"Jie Wu, Yang Xiang, Fengming Li, Xiaodong Liu, Ningning Dang, Jing Guo","doi":"10.1186/s12879-025-10973-9","DOIUrl":"https://doi.org/10.1186/s12879-025-10973-9","url":null,"abstract":"<p><p>Phaeohyphomycosis caused by Phialophora americana is relatively rare in clinical practice. Deficiency in the human caspase recruitment domain-containing protein 9 (CARD9) is associated with infections caused by Phialophora americana. In this case, the patient has had a decade-long history of recurrent tinea corporis and recently presented with an invasive, deep subcutaneous infection in the right axilla caused by Phialophora americana. Metagenomic next-generation sequencing (mNGS) confirmed that the pathogen infecting the patient was Phialophora americana. Whole exome sequencing (WES) revealed that the patient had compound heterozygous CARD9 gene mutations, with a c.952-1G > A mutation in intron 6 and a c.184 + 5G > T mutation in intron 2. The expression of the CARD9 protein and the levels of cytokines, including IL-17 and IFN-γ, were observed to be decreased in the patient. After an ineffective treatment with amphotericin B, voriconazole was administered for antifungal therapy and yielded satisfactory results. Following discharge, the patient continued oral voriconazole for ongoing antifungal treatment. One month after discharge, the patient returned to the hospital for a follow-up examination, during which it was observed that the symptoms had been successfully resolved. The novel compound heterozygous mutations may lead to CARD9 deficiency, which in turn results in susceptibility to Phialophora americana infection.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"613"},"PeriodicalIF":3.4,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969490","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}