BMC Infectious Diseases最新文献

{"title":"Bayesian hierarchical analysis of gender and socioeconomic inequalities in HIV testing uptake in Ghana.","authors":"David Ngmenbelle, Stephen Nimirkpen","doi":"10.1186/s12879-026-14085-w","DOIUrl":"10.1186/s12879-026-14085-w","url":null,"abstract":"<p><strong>Background: </strong>Despite global efforts to reduce HIV/AIDS, sub‑Saharan Africa continues to bear the highest proportion of new infections and HIV‑related morbidity, making HIV testing a critical component of prevention and treatment. Traditional regression analyses have identified gender and socioeconomic inequalities in testing; however, they may be limited by sparse subgroups within hierarchical survey data. This study examines how these inequalities vary across communities in Ghana, providing evidence to guide interventions and policies that promote equitable HIV testing coverage.</p><p><strong>Method: </strong>Data were obtained from the Ghana Demographic and Health Survey, including 22,058 participants. A Bayesian multilevel logistic regression model was used to examine factors associated with HIV testing uptake. Socioeconomic inequalities were assessed using the Erreygers Concentration Index, which was further decomposed to identify key contributors to inequality across wealth groups. Bayesian estimates reported an adjusted Odds Ratio (aOR) and a 95% credible interval, while bivariate analysis used a 5% significance level.</p><p><strong>Results: </strong>Overall, less than 50% of the participants had ever tested for HIV, with testing among men 26.9%(95%CI:25.3,28.6) and women 57.4% (95%CI: 55.9,58.7). The likelihood of HIV testing uptake among men was significantly 83% less (aOR = 0.17; 95% CrI: 0.14, 0.19) compared with women. The findings revealed that men aged 25-29 years had higher odds of HIV testing compared with those aged 15-19 years (aOR = 22.74; 95% CrI: 5.30, 54.32). Similarly, women in the same age group also had higher odds of HIV testing (aOR = 11.01; 95% CrI: 6.82, 18.60). HIV testing uptake showed pro-rich inequality in the study population, with higher inequality among men compared to women. Men contribution reduced overall socioeconomic inequality by 39.7% in HIV testing uptake.</p><p><strong>Conclusion: </strong>HIV testing uptake among Ghanaians remain low, particularly among men. Gender, age, education, residence, and socioeconomic status were factors associated with testing uptake. Moreover, HIV testing was disproportionately concentrated among wealthier populations. These findings suggest the need for equity-focused HIV testing strategies that address both individual and structural barriers, targeting men, rural populations, and socioeconomically disadvantaged groups.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13689124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149242801","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":"Plasmodium falciparum histidine rich protein 2 plasma concentrations from uncomplicated and severe malaria patients estimated by rapid test band intensity.","authors":"Achaporn Yipsirimetee, Chorpaka Tangjaroenpoonsuk, Patpannee Khanthagan, Amornrat Promsongsil, Noppadon Tangpukdee, Borimas Hanboonkunupakarn, Nicholas J White, Arjen M Dondorp, Kesinee Chotivanich","doi":"10.1186/s12879-026-14077-w","DOIUrl":"10.1186/s12879-026-14077-w","url":null,"abstract":"<p><strong>Background: </strong>Unlike peripheral blood parasitaemia, plasma concentrations of PfHRP2 has been established as a measure of total body parasite burden in patients with falciparum malaria, which is prognostic for progression to severe malaria and case fatality. Plasma PfHRP2 concentrations are typically quantified using enzyme-linked immunosorbent assay (ELISA) methods. We assessed whether band intensity on a PfHRP2-based ultrasensitive rapid diagnostic test (RDT) can provide a semi-quantitative measure for plasma PfHRP2 concentrations.</p><p><strong>Methods: </strong>Plasma samples from 60 African patients with severe falciparum malaria and 20 patients with uncomplicated falciparum malaria were assessed for PfHRP2 by ELISA and compared with RDT band intensity, assessed both visually and by digital scanning.</p><p><strong>Results: </strong>Visual readings of RDT band intensity correlated with PfHRP2 plasma concentrations assessed by ELISA in patients with both uncomplicated (ρ = 0.80) and severe falciparum malaria (ρ = 0.61). Digitally assessed RDT band intensity in patients with severe malaria was higher than in patients with uncomplicated falciparum malaria.</p><p><strong>Conclusion: </strong>RDT band intensity correlates with plasma PfHRP2 concentration measured by ELISA and may offer a simple method for estimating total parasite burden in patients with falciparum malaria.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13688764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149242818","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":"Antibiotic de-escalation in severe intra-abdominal infections: a single-center retrospective cohort study on safety and prognostic factors.","authors":"Liqin Zhang, Huilin Ye","doi":"10.1186/s12879-026-14080-1","DOIUrl":"10.1186/s12879-026-14080-1","url":null,"abstract":"<p><strong>Background: </strong>Antibiotic de-escalation is a key antimicrobial stewardship strategy aimed at reducing the ecological and adverse effects of broad-spectrum therapy without compromising efficacy. However, its real-world safety and impact on clinical outcomes in patients with severe intra-abdominal infections (IAIs) remain underexplored.</p><p><strong>Methods: </strong>A single-center, retrospective cohort study was conducted from June 2022 to June 2025. Adults with severe IAIs who received initial broad-spectrum antibiotics and achieved source control within 48 h were included. Patients were stratified into de-escalation and non-de-escalation groups on the basis of the antibiotic management strategy. Propensity score matching (1:1) was used to balance baseline characteristics. The primary outcome was clinical cure at 30 days. Secondary outcomes included 28-day mortality, lengths of ICU and hospital stay, antibiotic duration, and the incidence of secondary infections and Clostridioides difficile infection (CDI).</p><p><strong>Results: </strong>Among 405 eligible patients, 212 were matched (106 per group). The de-escalation group had a significantly higher clinical cure rate (79.8% vs. 63.5%; OR 2.24, 95% CI 1.29-3.89; P = 0.004) and lower 28-day mortality (9.6% vs. 21.2%; OR 0.40, 95% CI 0.18-0.88; P = 0.02). De-escalation was also associated with shorter ICU and hospital stays, reduced antibiotic duration, and fewer secondary infections. Multivariable analysis confirmed de-escalation (aOR 2.71, 95% CI 1.48-4.97) and adequate source control (aOR 3.52, 95% CI 1.81-6.85) as independent predictors of clinical cure.</p><p><strong>Conclusion: </strong>Antibiotic de-escalation following adequate source control is associated with improved clinical outcomes and reduced mortality in severe IAIs without increasing the risk of complications. These findings support its integration into antimicrobial stewardship programs for this high-risk population.</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":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13689013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149242799","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":"Prevalence, aetiology and predisposing factors for tinea capitis amongst pupils in rural communities in the Brong Ahafo Region of Ghana.","authors":"Paa Gyasi Hagan, Nana Ayegua Hagan Seneadza, Kwabena Oppong Amoako, Nyonuku Akosua Baddoo, Afua Owusua Darkwah Abrahams, Worlanyo Kudzo Seneadza, Christian Owoo, Margaret Lartey","doi":"10.1186/s12879-026-14110-y","DOIUrl":"10.1186/s12879-026-14110-y","url":null,"abstract":"<p><strong>Background: </strong>Tinea capitis remains a common superficial fungal infection among school-aged children in sub-Saharan Africa. However, up-to-date data on its burden and aetiological agents in many regions of Ghana are limited. This study determined the prevalence, aetiology, and predisposing factors for tinea capitis among primary school children in rural communities in the Brong Ahafo Region of Ghana.</p><p><strong>Methods: </strong>A school-based cross-sectional study was conducted between July and September 2019 among 708 pupils selected through multistage sampling from six rural basic schools in Sunyani, Techiman, and Kintampo North municipalities of the Brong Ahafo Region. Data were collected using structured questionnaires and clinical scalp examinations. Scalp scrapings and hair samples from clinically suspected cases were examined using potassium hydroxide microscopy and cultured on Sabouraud's agar for fungal identification. Logistic regression analyses were performed to identify factors associated with tinea capitis.</p><p><strong>Results: </strong>The overall prevalence of tinea capitis was 15.0% (95% CI: 12.4-17.8), with the highest prevalence observed in Kintampo North Municipality (19.5%). The grey patch variant was the most common clinical presentation (76.8%). Of the 106 samples cultured, 30.2% yielded dermatophytes, predominantly Trichophyton tonsurans (68.8%), followed by Trichophyton rubrum (15.6%). Aspergillus niger was the most common non-dermatophyte isolate. Significant predictors of infection included residence in Kintampo North (aOR = 2.62; 95% CI: 1.66-4.15) and presence of scalp complaints (aOR = 9.10; 95% CI: 5.88-14.29). Not having family members with scalp lesions was protective (aOR = 0.69; 95% CI: 0.52-0.93).</p><p><strong>Conclusion: </strong>Tinea capitis is moderately prevalent among pupils in rural communities of the Brong Ahafo Region of Ghana. The predominance of the anthropophilic dermatophyte T. tonsurans indicates that person-to-person transmission is the principal route of spread, emphasizing the need for school- and household-based control measures. Geographic location, scalp complaints, and a family history of infection were significant predictors of disease. Strengthened surveillance, early case detection, and improved access to systemic antifungal therapy are essential to reduce transmission and the burden of tinea capitis among Ghanaian school children.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13689342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149242780","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":"Data-driven phenotyping of infective endocarditis using unsupervised machine learning: toward a personalized approach.","authors":"Murat Karaçam, Vedat Cicek, Barkın Kültürsay, Almina Erdem, Seda Tanyeri Üzel, Şeref Berk Tuncer, Tezel Kovancı, Feryat İgit, Çağdaş Bulus, Mert Babaoğlu, Muhammet Bulut, Özgür Can Usta, Burak Tay, Muhammed Ensar Aslan, Mustafa Kamil Yemiş, Ahmet Öz, Tufan Çınar, Ulas Bagci","doi":"10.1186/s12879-026-14119-3","DOIUrl":"10.1186/s12879-026-14119-3","url":null,"abstract":"<p><strong>Purpose: </strong>Infective endocarditis (IE) is a heterogeneous disease with diverse clinical presentations, microbiological profiles, and outcomes. Conventional classification systems may not fully capture this complexity. We aimed to identify data-driven clinical phenotypes in IE using an unsupervised machine learning (ML) approach.</p><p><strong>Methods: </strong>In this multicenter retrospective study, 335 patients with definite IE from three hospitals were included. A total of 55 clinical, microbiological, and echocardiographic variables were analyzed. Missing data were imputed using the MissForest algorithm. Clustering was performed using spectral clustering based on a Gower dissimilarity matrix and supported by a Bayesian non-parametric approach. Associations between cluster assignment and clinical outcomes were assessed using regression analyses.</p><p><strong>Results: </strong>Two distinct clusters were identified, reflecting different clinical profiles. Cluster 1 was characterized by native valve endocarditis, a higher burden of comorbidities, inflammatory activation, and larger vegetations. Cluster 2 was characterized by prosthetic valve and device-related IE, higher rates of atrial fibrillation, and larger cardiac dimensions. Cluster assignment was not significantly associated with in-hospital mortality in either unadjusted or adjusted analyses. Increasing age emerged as an independent predictor of in-hospital mortality. In the adjusted model, Cluster 2 was independently associated with longer hospital stay, whereas no significant difference was observed in ICU stay.</p><p><strong>Conclusion: </strong>Unsupervised ML identified two clinically distinct phenotypes in IE, reflecting disease heterogeneity. Although these phenotypes were not associated with major clinical outcomes, they provide a data-driven framework for understanding disease heterogeneity and may contribute to future personalized approaches in the management of IE. Larger prospective studies are needed to determine their clinical applicability.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13689015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149242816","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":"Antibacterial activity of imipenem-encapsulated chitosan/HPMCP nanoparticles against clinical Acinetobacter baumannii isolates.","authors":"Sajad Alizadeh, Majid Baseri Salehi, Nima Bahador","doi":"10.1186/s12879-026-13962-8","DOIUrl":"10.1186/s12879-026-13962-8","url":null,"abstract":"<p><strong>Background: </strong>Multidrug-resistant Acinetobacter baumannii is an important healthcare-associated pathogen, necessitating therapeutic strategies. This study evaluates the antibacterial efficacy of imipenem-encapsulated chitosan/hydroxypropyl methylcellulose phthalate (Imp-Chi) nanoparticles against clinical A. baumannii isolates.</p><p><strong>Methods: </strong>A. baumannii clinical isolates (n = 105) from hospitalized patients were characterized for antibiotic resistance via broth microdilution and classified as MDR, XDR, or PDR. An exploratory PCR screen was performed for the selected AmpC-family genes mox, cit, and dha. Imp-Chi nanoparticles were synthesized via ionic gelation, characterized for size, zeta potential, morphology, encapsulation efficiency, and drug release. Antibacterial activity was assessed via MIC assays against the A. baumannii clinical isolates. Recoverable bacterial burden in extracellular, cell-associated, and intracellular fractions of A549 and NCI-H292 infection models was quantified, alongside reactive oxygen species (ROS) and cytotoxicity assessments using MTT and LDH assays.</p><p><strong>Results: </strong>Isolates exhibited high resistance to β-lactams (97.1-99.0%), carbapenems (94.3-98.1%), and aminoglycosides (92.4-96.2%), with 77.1% classified as PDR. No significant association was observed between the selected AmpC-family genes and resistance phenotypes (p > 0.05). Imp-Chi nanoparticles (291.3 nm, + 34.9 mV; spherical morphology with smooth surfaces) demonstrated optimal encapsulation efficiency (1.5 µg imipenem) and sustained drug release (70% over 10 h). MICs of Imp-Chi nanoparticles were significantly lower than free imipenem (p < 0.0001; ~0.31-fold reduction); while fractional inhibitory concentration index values clustered around 1.0, supporting an additive or near-additive rather than synergistic interaction, and the nanoparticles also reduced recoverable bacterial CFU across extracellular and host-cell-associated fractions in lung epithelial infection models in vitro. ROS levels in A. baumannii-infected cells decreased to near-baseline levels following Imp-Chi treatment (p < 0.0001). MTT and LDH readouts suggested limited cytotoxicity-associated effects at 100-200 µg/mL and concentration-dependent effects at higher concentrations, with apparent MTT-derived IC₅₀ values of approximately 740 µg/mL; however, nanoparticle-related assay interference and carrier-specific effects were not independently excluded.</p><p><strong>Conclusions: </strong>Imp-Chi nanoparticles reduced imipenem MICs through additive or near-additive antibacterial contributions and may also provide formulation-related delivery advantages, while reducing bacterial burden in lung epithelial infection models and being associated with lower infection-associated ROS levels in vitro.</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":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13688736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149242853","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":"Evaluation of the diagnostic validity of the HIV VISITECT CD4 point-of-care rapid diagnostic test in Uganda.","authors":"Oliver Nakamaanya, Bernard Bagaya, Willy Ssengooba, Erick Thokerunga, Henry Zamarano","doi":"10.1186/s12879-026-14021-y","DOIUrl":"10.1186/s12879-026-14021-y","url":null,"abstract":"<p><strong>Background: </strong>HIV remains highly prevalent in Uganda, where CD4 T-cell counts are central to identifying and managing Advanced HIV Disease (AHD). Instrument-based point-of-care (POC) CD4 platforms face cost and operational constraints in resource-limited settings. The VISITECT CD4 lateral flow immunoassay (LFA) offers a non-instrument-based alternative, but its diagnostic validity against the Pima Analyzer had not been evaluated in Uganda.</p><p><strong>Objectives: </strong>To compare diagnostic validity of the VISITECT CD4 LFA against the Pima Analyzer at the 200 cells/µL AHD threshold and explore factors influencing performance.</p><p><strong>Methods: </strong>A comparative cross-sectional study was conducted between June and August 2023 at three Kampala health centres. Venous blood from 351 HIV-positive adults was tested simultaneously on both platforms. Sensitivity, specificity, PPV, NPV, and likelihood ratios were calculated with 95% CIs using the Pima Analyzer-a point-of-care, not gold-standard, platform-as reference; estimates reflect relative, not absolute, performance.</p><p><strong>Results: </strong>Most participants were female (68.11%), median age 31 years; mean CD4 count was 482 cells/µL (± 283.9) and AHD prevalence 22.79%. VISITECT CD4 LFA showed sensitivity of 86.25% (95% CI: 76.73-92.93), specificity of 90.41% (95% CI: 86.26-93.64), PPV of 72.63% (95% CI: 64.57-79.44), NPV of 95.70% (95% CI: 92.78-97.48), and inter-rater agreement κ = 0.957. No assessed factor significantly modified performance.</p><p><strong>Conclusions: </strong>The VISITECT CD4 LFA performed reliably as an AHD screening tool relative to the Pima Analyzer in resource-limited settings, particularly where instrument-based platforms are unavailable. It should complement, not replace, confirmatory testing; improvements in sensitivity and PPV remain warranted.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13685150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227039","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":"Determinants of uptake of praziquantel, chemotherapy for schistosomiasis treatment during mass drug administration in Busia County, Kenya.","authors":"Paul Maina Ndung'u, Titus Watitu, Wyckliff Omondi, Doris Njomo","doi":"10.1186/s12879-026-14051-6","DOIUrl":"10.1186/s12879-026-14051-6","url":null,"abstract":"<p><strong>Background: </strong>Schistosomiasis is a life-threatening parasitic disease that affects nearly 250 million people worldwide, and over 780 million people are at risk of infection globally. Sub-Saharan Africa bears the highest burden, accounting for approximately 280,000 deaths annually. In Kenya, over 17.6 million people are at risk, and approximately 10 million are infected. Busia County, an endemic region, has a prevalence of 17.6%. In past MDAs, the County recorded a praziquantel coverage level of 64.11%, below the WHO-recommended threshold of over 75%. This study aimed to identify the determinants of PZQ uptake during MDA for schistosomiasis treatment in Busia County, Kenya.</p><p><strong>Methods: </strong>An analytical, cross-sectional study was conducted among individuals aged ≥ 10 years who met the inclusion criteria. Multistage sampling was used to sample the study site. The study had a sample size of 660 participants. Quantitative data were collected through structured questionnaires that captured sociodemographic characteristics, knowledge, drug perceptions, and self-reported PZQ uptake. STATA software version 17.0 was used to analyze the data. Ethical clearance was obtained from the KU Scientific and Ethical Review Unit.</p><p><strong>Results: </strong>Data were collected from 613 study participants, corresponding to a response rate of 92.9%. Of the 613 study participants, the majority (53.7%, n = 325) were females. The coverage of PZQ uptake was 62%. Overall, 55.5% demonstrated a high level of knowledge of schistosomiasis. Community sensitization before the MDA was statistically significant predictor of PZQ uptake. Participants who had received sensitization were 41 times more likely to take the medicine compared with those who had not (AOR = 41.65; 95% CI: 12.34-138.3; p < 0.001).</p><p><strong>Conclusion: </strong>The findings indicate that PZQ uptake was below the WHO-recommended level. Effective community sensitization prior to MDA is a critical determinant of improving PZQ coverage and schistosomiasis MDA. Community sensitization should be enhanced to address individual drug-related perceptions in the target community, which leads to better MDA outcomes.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13685162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227159","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":"Ceftazidime-avibactam as a polymyxin-sparing option for multidrug-resistant Gram-negative infections in children: a real-world comparative cohort study.","authors":"Sevgi Aslan Tuncay, Gulsen Akkoc, Ezgi Celikboya, Seyhan Yilmaz, Burcu Parlak, Pinar Canizci Erdemli, Aylin Dizi Isik, Didem Buyuktas Aytac, Meryem Cagla Abaci Capar, Ahmet Furkan Eser, Makbule Nilufer Yalindag Ozturk, Eda Kepenekli, Sevliya Ocal Demir","doi":"10.1186/s12879-026-14049-0","DOIUrl":"10.1186/s12879-026-14049-0","url":null,"abstract":"<p><strong>Background: </strong>Multidrug-resistant (MDR) Gram-negative infections are challenging to treat in children, and polymyxin-based regimens are limited by toxicity. We evaluated the real-world use of ceftazidime-avibactam (CZA) as a potential polymyxin-sparing option for children with MDR Gram-negative infections.</p><p><strong>Methods: </strong>We conducted a single-center retrospective comparative cohort study at a tertiary hospital in Istanbul, Türkiye. Children aged < 18 years who received definitive therapy for microbiologically confirmed MDR Gram-negative infections between January 2022 and May 2024 were included. The primary outcome was 28-day all-cause mortality. Secondary outcomes included clinical response, documented microbiological clearance, acute kidney injury (AKI), drug-induced liver injury (DILI) and one-year all-cause mortality.</p><p><strong>Results: </strong>Forty-five children were included: 15 received CZA-based therapy and 30 received non-CZA regimens. Mechanical ventilation was required in 40/45 (88.9%) patients, reflecting a critically ill cohort. Steroid exposure within 30 days (46.7% vs. 6.7%; P = 0.003) and prior carbapenem exposure (93.3% versus 56.7%; P = 0.016) were more frequent in the CZA group. Clinical response (73.3% versus 73.3%; P = 1.000) and 28-day all-cause mortality (40.0% versus 40.0%; P = 1.000) were comparable between groups. Documented microbiological clearance, AKI and DILI did not differ significantly. Similar findings were observed in the CZA vs. meropenem plus colistin subgroup.</p><p><strong>Conclusions: </strong>CZA-based therapy showed similar observed outcomes and no clear excess toxicity signal compared with heterogeneous non-CZA regimens, despite preferential use in children with greater recent antimicrobial exposure and clinical complexity. These findings support CZA as a feasible polymyxin-sparing option in selected children.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13688810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149242830","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":"Screening and tuberculosis preventive treatment among household contacts of drug-resistant tuberculosis patients: a scoping review.","authors":"Siling Chen, Lan Luo, Fanghua Gong","doi":"10.1186/s12879-026-14056-1","DOIUrl":"10.1186/s12879-026-14056-1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Drug-resistant tuberculosis (DR-TB) is associated with low treatment success rates and increased mortality. Household contacts (HHCs) face an elevated risk of infection and disease progression due to prolonged exposure. Consequently, systematic screening and tuberculosis preventive treatment (TPT) are critical to interrupt transmission within households. However, screening practices and TPT regimens vary substantially across countries and settings worldwide, and the available evidence remains fragmented. This study aims to synthesize evidence on screening strategies and TPT regimens for HHCs of patients with DR-TB, identify implementation barriers and research gaps, and inform future contact management approaches.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We systematically searched nine databases including PubMed, Embase, and Web of Science. Each database was searched from inception to November 13, 2025. Eligible studies included observational studies (including cohort and cross-sectional studies), implementation studies, and randomized controlled trials reporting on screening approaches or TPT strategies among HHCs of patients with DR-TB. Data extraction was conducted in accordance with the Joanna Briggs Institute (JBI) methodological framework for scoping reviews, and reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) guidelines. Two reviewers independently extracted data using a standardized form, including study characteristics, screening strategies, diagnostic methods, TPT regimens, safety and adherence outcomes, and implementation-related factors. The findings were summarized descriptively and presented as a structured narrative synthesis organized by thematic domains.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 26 studies were included. Most studies (20/26) employed a sequential cascade screening strategy combining symptom assessment, imaging evaluation (when clinically indicated), and molecular or microbiological confirmation, often supplemented by tuberculin skin test (TST) or interferon-gamma release assays (IGRAs) for latent tuberculosis infection (LTBI) detection. Most studies were conducted in high TB burden low- and middle-income countries, particularly in Pakistan, South Africa, and China, with several multicenter studies spanning countries in Africa, Asia, and Latin America. Pediatric studies frequently incorporated gastric aspiration as an adjunct diagnostic method. TPT was implemented in 14 studies, with initiation rates ranging from 2% to 98.8%. Levofloxacin-based regimens were the predominant preventive treatment strategy. Compared with combination regimens, levofloxacin monotherapy generally achieved higher treatment completion rates (68.4%-100% vs. 56%-70.3%). Children experienced fewer adverse events than adults (10% vs. 37%). Frequently reported implementation barriers included resource limitations, transportation difficulties, sti","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13450480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683365","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}