BMC Infectious Diseases最新文献

{"title":"Lipid profile alterations in pulmonary tuberculosis patients with and without diabetes mellitus: a systematic review and meta-analysis.","authors":"Samuel Yahaya, Ibrahim Anyass Goumboundi, Roland Osei Saahene, Kwabena Dankwa, Samuel Acquah, Richard K D Ephraim","doi":"10.1186/s12879-026-14453-6","DOIUrl":"10.1186/s12879-026-14453-6","url":null,"abstract":"<p><strong>Background: </strong>This systematic review and meta-analysis explored lipid alterations associated with tuberculosis-diabetes comorbidity. We quantitatively synthesised the lipid parameters, comparing high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, and total cholesterol among patients with TB-DM comorbidity, TB-only, and DM-only.</p><p><strong>Methods: </strong>Following PRISMA guidelines and a registered protocol (PROSPERO: CRD420261355915), we searched PubMed (n = 150), Scopus (n = 679), and Google Scholar (n = 70) through April 7, 2026. Observational studies reporting lipid parameters were included. Methodological quality was appraised using the Newcastle-Ottawa Scale, and certainty of evidence was evaluated using GRADE. Pooled mean differences and pooled means were estimated using random-effects models, with between-study variance estimated by REML and Hartung-Knapp-adjusted confidence intervals. Heterogeneity was quantified using the I² statistic and τ², and 95% prediction intervals were also calculated.</p><p><strong>Results: </strong>Nine studies comprising 1,494 participants were included. Compared to the TB-only group, patients with TB-DM exhibited higher concentrations of LDL-C (MD = 14.99 mg/dL; 95% CI: 1.28-28.71), TG (MD = 30.13 mg/dL; 95% CI: 17.58-42.67), and TC (MD = 17.29 mg/dL; 95% CI: 5.42-29.16), while HDL-C showed no significant difference (MD = -1.15 mg/dL; 95% CI: -5.07-2.77). A principal sensitivity analysis showed that TG elevation remained robust, whereas LDL-C and TC findings lost statistical significance. In the secondary comparison, TB-DM patients exhibited significantly lower concentrations across all four lipid parameters relative to the DM-only group. Heterogeneity was substantial for the primary comparison (I² >70%) but ranged from 1% to 67% in the secondary comparison. Exploratory subgroup analyses showed statistical differences for LDL-C, TC, and TG, whereas no subgroup difference was found for confounder adjustment, geographic region, or study design. The overall certainty of evidence was rated as very low across all outcomes.</p><p><strong>Conclusion: </strong>The findings suggest that TB-DM may be associated with a higher TG concentration compared to patients with TB alone. Significant associations with LDL-C and TC were also observed but were not robust to sensitivity analyses, while no significant difference was found for HDL-C. Conversely, TB-DM may be associated with a relative reduction in HDL-C, LDL-C, TG, and TC compared to DM-only.</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/PMC13621516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073300","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 decade of endemic human coronaviruses: epidemiological patterns and clinical significance in an adult cohort at a tertiary care hospital in Germany.","authors":"Christian Propach, Mario Hönemann, Vladan Vučinić, Armin Frille, Tom Berthold, Sandra Bergs, Melanie Maier, Corinna Pietsch","doi":"10.1186/s12879-026-14377-1","DOIUrl":"10.1186/s12879-026-14377-1","url":null,"abstract":"<p><strong>Introduction: </strong>The four endemic human coronaviruses (HCoV-OC43, -NL63, -HKU1, and - 229E) are common respiratory pathogens. Studies on HCoV epidemiology in Germany are limited. Therefore, this study aimed to characterize the epidemiology and clinical significance of HCoV-infections in adult patients over 11 seasons at a tertiary care hospital in Germany.</p><p><strong>Methods: </strong>Over 29,000 respiratory specimens were analyzed using nucleic acid amplification assays for respiratory pathogens between 2012 and 2022. Additionally, clinical data were retrospectively retrieved from patient records for cases with confirmed HCoV infections.</p><p><strong>Results: </strong>During the study period, 469 unique adult cases were identified. HCoV-OC43 (38.6%) and HCoV-NL63 (25.6%) were most frequently detected, followed by HCoV-229E (22.4%) and HCoV-HKU1 (13.4%). HCoVs exhibited strong seasonality, with most detections occurring during the winter months, peaking between January and March. Sporadic detections of HCoV-OC43 and HCoV-NL63 were observed in summer. While HCoV-NL63 was detected year-round, HCoV-OC43 and HCoV-HKU1 displayed a biennial circulation pattern. No consistent pattern was observed for HCoV-229E. Across all HCoV cases HCoV-OC43 were more frequently associated with dyspnea (48.1%, p = 0.004), lower respiratory tract infection (45.3%; p = 0.018), exacerbation of obstructive lung disease (17.6%, p = 0.002), and systemic prednisolone administration (16%, p = 0.007). HCoV-HKU1 infection was more frequently detected in patients with lymphoma (35.6%, p = 0.002) and associated with higher in-hospital mortality (18.6%, p = 0.042). Overall, 119 co-infections (26.0%) were identified, including viral (10.9%) bacterial (10.5%), and fungal (1.7%) pathogens. Co-infections were significantly associated with LRTI (p < 0.001), need for mechanical ventilation (p = 0.001), and ICU admission (p < 0.001).</p><p><strong>Conclusion: </strong>Endemic coronaviruses exhibit complex circulation patterns characterized by distinct seasonality. The cyclic behavior of HCoV-OC43 and HCoV-HKU1 suggests possible immunological interactions within this virus family. The clinical presentation and severity of HCoV infections are highly dependent on the age group, comorbidities of the affected patients, and co-infections.</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/PMC13599198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149029639","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":"Characteristics of solid versus hematologic malignancies in people living with human immunodeficiency virus.","authors":"Andrew M Schwartz, Nour Daoud, Wesley P Jameson, John A Vanchiere, Alexandre E Malek","doi":"10.1186/s12879-026-14236-z","DOIUrl":"10.1186/s12879-026-14236-z","url":null,"abstract":"<p><strong>Purpose: </strong>People living with HIV (PLWH) face increased risks of both AIDS-defining and non-AIDS-defining malignancies. We characterized the age-standardized cancer burden, compared clinical characteristics and survival outcomes between hematologic and solid malignancies in PLWH, and performed a secondary analysis stratifying malignancies by viral oncogenesis.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 166 PLWH diagnosed with cancer at a 407-bed tertiary academic medical center in the southern United States between 2019 and 2025. Age-standardized cancer rates proportions were calculated using the direct standardization method with the US 2000 Standard Population as the reference. Demographic, HIV-related, and clinical variables were compared between hematologic and solid malignancies using univariate and multivariate logistic regression. Cox proportional hazards regression and restricted mean survival time analysis were performed to identify predictors of overall survival. The analysis was repeated for virus-driven versus non-virus-driven malignancies.</p><p><strong>Results: </strong>Among 3,640 HIV-positive patients actively receiving care at our institution, 166 (4.6%) were identified as having both HIV infection and a concurrent malignancy. The age-standardized cancer detection proportion was 888.1 per 100,000 patients (95% CI 753.0-1023.2). Hematologic malignancies occurred at a younger age than solid tumors (median 41 vs. 51 years, p = 0.002) and were associated with higher HIV viral loads, lower CD4 + counts, and poorer antiretroviral therapy adherence. High HIV viral load remained independently associated with hematologic malignancy in multivariate analysis (OR 4.839, 95% CI 1.495-17.58). Kaplan-Meier analysis demonstrated a trend toward lower overall survival among hematologic malignancy patients compared with solid tumor patients (log-rank p = 0.056), which reached significance after age adjustment in multivariate Cox proportional hazards regression (HR 3.00, 95% CI 1.35-6.66, p = 0.007). In the virus-driven analysis, both high HIV viral load and low CD4 + T-cell count were independently associated with virus-driven malignancy, with CD4 + T-cell count demonstrating a particularly strong association (OR 5.129, 95% CI 1.709-17.153, p = 0.005).</p><p><strong>Conclusion: </strong>Immune dysfunction remains strongly associated with hematologic malignancies in PLWH, whereas solid tumors are increasingly associated with age- and lifestyle-related factors. A secondary analysis stratifying malignancies by viral oncogenesis identified consistent associations between immune dysfunction and virus-driven malignancy, further supporting the role of impaired immune surveillance in HIV-associated cancer development.</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/PMC13613671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149036471","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":"Impact of SARS-CoV-2 infection and viral burden on outcomes in acute decompensated heart failure.","authors":"Mohamad Amer Nashtar, Haris Sehovic, Mohammed Salemdawod, Gizem Garipoglu, Betül Ödemis, Asterios Tzalavras, Martin Steinmetz, Ali Canbay, Mustafa Özçürümez, Varnavas Varnavas, Polykarpos Christos Patsalis, Antonios Katsounas","doi":"10.1186/s12879-026-14407-y","DOIUrl":"10.1186/s12879-026-14407-y","url":null,"abstract":"<p><strong>Background/objectives: </strong>Patients hospitalized with acute decompensated heart failure (ADHF) represent a clinically vulnerable population. However, the impact of concomitant severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the prognostic relevance of viral burden in this setting remain incompletely understood.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study including 2,002 adults hospitalized with ADHF at a tertiary academic center between March 2020 and December 2024. SARS-CoV-2 infection was confirmed by reverse transcription quantitative polymerase chain reaction (RT-qPCR) during the index hospitalization. The primary outcome was in-hospital mortality. Secondary clinical outcomes were ICU admission and invasive mechanical ventilation, while hospital and ICU length of stay were assessed as resource-utilization outcomes. Multivariable regression models adjusted for clinically relevant covariates were used to assess associations between infection status and outcomes. Among infected patients, cycle threshold (Ct) values were analyzed as surrogate markers of viral burden.</p><p><strong>Results: </strong>Of the 2,002 patients included, 246 (12.3%) had confirmed SARS-CoV-2 infection. Compared with uninfected patients, infected individuals had higher in-hospital mortality (32.5% vs. 20.6%), ICU admission (61.4% vs. 50.7%), and invasive mechanical ventilation (6.5% vs. 2.4%) (all p ≤ 0.002). After multivariable adjustment, SARS-CoV-2 infection remained associated with in-hospital mortality (aOR 2.63, p = 0.0002), ICU admission (aOR 1.79, p = 0.0027), and invasive mechanical ventilation (aOR 2.84, p = 0.0017). Infection was also associated with longer hospital stay (aβ + 9.23 days, p < 0.0001) and longer ICU stay (aβ + 7.85 days, p = 0.0017). Among infected patients, lower median Ct values were associated with higher in-hospital mortality (aOR 0.89 per Ct unit, p = 0.0338), while lower minimum Ct values were associated with longer hospital stay (adjusted β - 0.44 days per Ct unit, p = 0.0359).</p><p><strong>Conclusions: </strong>Among patients hospitalized with ADHF, concomitant SARS-CoV-2 infection was associated with substantially worse in-hospital outcomes and greater healthcare resource utilization. The observed associations between lower Ct values and adverse in-hospital outcomes should be considered hypothesis-generating and require prospective validation because Ct values are imperfect surrogate markers of viral burden.</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/PMC13595687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015430","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":"Helcococcus kunzii as a rare etiological agent of spondylodiscitis partially managed with oral antibiotic therapy in a patient with diabetes mellitus: a case report.","authors":"Karen Velázquez-Leonel, Christian Bepperling, Thomas Regnath, Farzam Vazifehdan, Edgar Santos","doi":"10.1186/s12879-026-14341-z","DOIUrl":"10.1186/s12879-026-14341-z","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have reported Helcococcus kunzii infection in a range of clinical conditions, including infective endocarditis, umbilical abscesses, bacteremia, diabetic foot infections, and prosthetic joint infections. Diabetes mellitus has been identified as a predisposing condition for infections caused by this pathogen. We report the first documented case of spondylodiscitis caused by Helcococcus kunzii.</p><p><strong>Case presentation: </strong>We describe a case of spondylodiscitis caused by Helcococcus kunzii in a 62-year-old man with long-standing type 1 diabetes mellitus who presented to the emergency department with severe, immobilizing lumbar pain. Clinical diagnosis of spondylodiscitis was established by magnetic resonance imaging (MRI). Helcococcus kunzii was isolated from four separate blood culture sets. During surgical intervention, two swabs and two tissue samples were collected. H. kunzii was identified in all specimens using MALDI-TOF mass spectrometry (MALDI-TOF MS) with log scores ranging from 2.30 to 2.52. The patient received intravenous β-lactam antibiotics for ten days, followed by 13 weeks of oral β-lactam antibiotics. Follow-up MRI performed before discharge showed no further evidence of spondylodiscitis. At the 3-month follow-up visit, the patient demonstrated clinical improvement.</p><p><strong>Conclusions: </strong>This case demonstrates that H. kunzii should be considered a potential etiological agent of pyogenic spondylodiscitis, particularly in patients with diabetes mellitus and associated comorbidities that may compromise skin barrier integrity. MALDI-TOF MS is essential for accurate identification of this organism and should be considered in cases of atypical spondylodiscitis.</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/PMC13589352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001255","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":"Comment on: Changes in microbiological characteristics of bloodstream infections before and after the COVID-19 pandemic in a tertiary teaching hospital in Iran.","authors":"Sebastiana Silva Sabino, Alexia Máximo Fernandes, Natália Ludendorff Queiroz, Cristiane Silveira de Brito, Lícia Ludendorff Queiroz, Celsa Raquel Villaverde Melgarejo, Paulo P Gontijo Filho, Rosineide Marques Ribas","doi":"10.1186/s12879-026-14075-y","DOIUrl":"10.1186/s12879-026-14075-y","url":null,"abstract":"<p><p>This correspondence comments on study published in this journal investigating bloodstream infection microbiology before and during the COVID-19 pandemic in Iran, contextualized with Brazilian intensive care data: 44.5% developed microbiologically confirmed secondary infections, Gram-negative pathogens predominated, antibiotic resistance reached 79.4%, supporting stronger antimicrobial stewardship globally through coordinated surveillance efforts urgently.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13584543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982207","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":"Predictors and risk factors of typhoid fever in urban informal settlements of Nairobi, Kenya.","authors":"Susan Mutile Kavai, Cecilia Mbae, Michael Mugo, Mary Kariuki, Diana Imoli, Maureen Kawira, Peter Muturi, Collins Kebenei, Kelvin Kering, Amos Njuguna, Samuel Kariuki","doi":"10.1186/s12879-026-14428-7","DOIUrl":"10.1186/s12879-026-14428-7","url":null,"abstract":"<p><p>A clear understanding of the risk factors and key predictors of typhoid fever in endemic, low-resource settings is essential for informing effective prevention strategies and guiding empiric patient management. This study aimed to identify the predictors and risk factors linked to culture-confirmed typhoid fever in Mukuru informal settlements in Nairobi, Kenya. Between November 2020 and July 2025, patients presenting with a fever of ≥ 38 °C, and/or with diarrhea were enrolled at seven health facilities in the Mukuru settlements. Structured questionnaires and case report forms were used to collect socio-demographic, environmental, and clinical data. Blood and stool cultures were performed to confirm the presence of Salmonella Typhi (S. Typhi). The associations between potential risk factors and typhoid positivity were analysed using chi-square tests and multivariable logistic regression to estimate adjusted odds ratios (aOR) with 95% confidence intervals (CI). Of the 8,950 patients enrolled, 131 (1.46%, 95% CI:1.23-1.73%) had S. Typhi positive blood culture. In the adjusted analysis, patients aged 5-16 years (aOR 2.50, 95% CI 1.55-4.04) and those over 16 years (aOR 2.16, 95% CI 1.41-3.31) had significantly higher odds of typhoid infection compared to children under five. Continuous fever (fever ≥ 38 °C for the last 3 days) (aOR 3.48, 95% CI 2.11-5.73), vomiting (aOR 1.89, 95% CI 1.29-2.75), moderate dehydration (aOR 2.95, 95% CI 1.25-6.95), and headache (aOR 1.68, 95% CI 1.12-2.53) were independently associated with typhoid infection. Households with two or more children under five years had increased odds of infection (aOR 1.98, 95% CI 1.28-3.07). Usage of a shared flush toilet was significantly associated with increased odds of typhoid infection (aOR = 2.42, 95% CI: 1.69-3.47, p < 0.001). Our findings demonstrate that typhoid fever in Mukuru informal settlements is driven by factors such as age, unsafe water practices, and shared sanitation. Interventions, such as strengthening water, sanitation, and hygiene (WaSH) infrastructure and practices are vital to reducing typhoid fever risk in these endemic settings.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149029677","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":"Uncovering the impact of co-infections on disease severity and mortality in pulmonary cryptococcosis.","authors":"Luling Wu, Xuemin Fu, Ling Weng, Benno Pütz, Renfang Zhang, Li Liu, Yueming Shao, Zhihang Zheng, Jingna Xun, Ximei Han, Ting Wang, Yinzhong Shen, Hongzhou Lu, Bertram Müller-Myhsok, Jun Chen","doi":"10.1186/s12879-026-14444-7","DOIUrl":"10.1186/s12879-026-14444-7","url":null,"abstract":"<p><strong>Background: </strong>Increasing case reports and monocentric studies suggest that co-infections may be associated with poorer outcomes in patients with pulmonary cryptococcosis (PC), including both people living with HIV (PLWH) and HIV-negative individuals. However, systematic cohort-based evidence evaluating the prognostic impact of co-infections remains limited.</p><p><strong>Methods: </strong>Total of 454 patients with PC (239 PLWH and 215 non-HIV) were included to compare clinical characteristics, CT imaging features, and relevant prognostic factors according to their co-infection status.</p><p><strong>Results: </strong>Among non-HIV patients, co-infections were linked to older age (53.42 vs. 45.46 years, p = 0.02), while no age difference was observed among PLWH. No HIV-negative patient had multiple co-infections, and all 1-year deaths occurred in those with bacterial co-infection; in contrast, 20% of PLWH had dual co-infections, most commonly tuberculosis. PLWH more frequently presented with fever and central nervous system symptoms, and co-infected PLWH had greater disease severity, reflected by higher SOFA, CURB-65, and APACHE II scores. Among co-infected patients, disease severity and 52-week median survival were comparable across HIV and dissemination status, although non-HIV patients experienced a markedly longer diagnostic delay [13.5 vs. 2.0 days; p < 0.0001]. Over 52 weeks, Pneumocystis jirovecii pneumonia (PCP), identified only in PLWH, was independently associated with mortality (HR = 3.81; p = 0.002), whereas bacterial co-infection showed a non-significant increase in mortality risk (HR = 1.51; p = 0.44). In the overall cohort, a high-risk APACHE II score was associated with more than a 15-fold increase in mortality, while nodular-plus-patchy CT lesions were associated with a greater than fivefold increase. PLWH had an 11.3-fold higher mortality risk than non-HIV patients, with SOFA score ≥ 2, high-risk APACHE II score, and absence of standard antifungal therapy further associated with poorer survival.</p><p><strong>Conclusion: </strong>Co-infection patterns differed by HIV status: multiple and diverse co-infections were common in PLWH, whereas bacterial co-infections predominated in non-HIV patients. Among co-infected patients, survival was comparable regardless of HIV status or extrapulmonary dissemination. Earlier recognition and timely diagnosis may improve the clinical management of pulmonary cryptococcosis.</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":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975631","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":"Effectiveness and tolerability of low dose clindamycin for treatment of prosthetic joint infections, a retrospective cohort study.","authors":"Jesper Ericsson, Tove Gustafsson, Olof Sköldenberg, Magnus Hedenstierna, Agata Rysinska, Johan Ursing","doi":"10.1186/s12879-026-14378-0","DOIUrl":"10.1186/s12879-026-14378-0","url":null,"abstract":"<p><strong>Background: </strong>Clindamycin is a potential drug for treating prosthetic joint infections, but pharmacokinetic monitoring shows that coadministration with rifampicin significantly reduces clindamycin concentrations. This study aimed to describe the real-world effectiveness and tolerability of clindamycin given alone or in combination with rifampicin or other antibiotics for treatment of PJI.</p><p><strong>Methods: </strong>This single-centre, retrospective cohort study, included patients treated for PJI from 2010 to 2022. PJI was defined according to a modified version of the 2011 Musculoskeletal Infection Society (MSIS) definition that was used clinically during the study period. Patients treated with a clindamycin-based therapy (used when first-line drugs were unsuitable) were included. Data were extracted manually from electronic records. Cure required no clinical or microbiological signs of recurrence of the same bacteria after 24 months of follow-up. Factors affecting treatment outcome were assessed using logistic regression analyses.</p><p><strong>Results: </strong>The two-year treatment success after clindamycin monotherapy (n = 46) and combination therapy (n = 62) at a typical dose of 300 mg three times daily was 82% (95% confidence interval [CI] 75-90%, n = 89/108). Two-year clindamycin treatment success following DAIR (n = 46), one stage exchange (n = 23) and two stage exchange (n = 32) were 72% (95% CI 58-85%), 91% (95% CI 79-100) and 94% (95% CI 85-100), respectively. Overall treatment success was 80% (95% CI 67-93%, n = 40) for patients receiving clindamycin/rifampicin. Staphylococcus aureus was independently associated with lower treatment success in a multivariable logistic regression OR 0.17 CI (0.05-0.64, p = 0.008). Side-effects were more frequent in patients receiving clindamycin + rifampicin (39%) compared to clindamycin monotherapy (10%) p = 0.002).</p><p><strong>Conclusions: </strong>Clindamycin (300 mg three times daily), administered as monotherapy or in combination with other antibiotics including rifampicin, appeared to be an effective and well-tolerated treatment for PJI. However, these regimens may be less effective in infections caused by S. aureus.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148954713","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":"Retrospective case-control study of haematological indices and inflammatory ratios in the diagnosis of paediatric brucellosis.","authors":"Emine Hafize Erdeniz, Yeter Düzenli Kar","doi":"10.1186/s12879-026-14384-2","DOIUrl":"10.1186/s12879-026-14384-2","url":null,"abstract":"<p><strong>Background: </strong>Brucellosis is a common zoonotic infection in Turkey and other Mediterranean countries. In children, symptoms are usually non-specific, including fever, fatigue, arthralgia, and myalgia, which may complicate diagnosis. Haematological indices and inflammatory ratios have recently been studied as possible supportive markers in infectious diseases, but findings in brucellosis remain inconsistent. This study investigated red cell distribution width (RDW), plateletcrit (PCT), platelet indices, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) in paediatric brucellosis.</p><p><strong>Materials and methods: </strong>This retrospective case-control study included 42 children with brucellosis and 39 healthy controls. Patients were followed at Erzurum Regional Training and Research Hospital between September 2018 and February 2019. Diagnosis was based on compatible clinical findings together with a standard tube agglutination (Wright) titer ≥ 1:160, a positive Brucella Coombs test, or isolation of Brucella spp. from blood culture. Complete blood count parameters were measured using a Sysmex XN-series haematology analyser with a DI-60 morphology modüle. Statistical analyses included the t-test or Mann-Whitney U test for continuous variables and chi-square or Fisher's exact test for categorical variables. Benjamini-Hochberg correction was applied for multiple comparisons. ROC curve analysis and age- and sex-adjusted binary logistic regression were also performed.</p><p><strong>Results: </strong>Thirty patients were male and 12 were female. The median age was 14 years (range 6-17). The most common symptoms were arthralgia (85.7%), weakness (71.4%), and fever (66.7%). RDW, platelet count, and PCT differed significantly between groups in unadjusted analysis, but these differences lost significance after correction for multiple testing (all FDR-adjusted p > 0.18). ROC analysis showed low diagnostic performance overall. RDW demonstrated high specificity (92.3%) but low sensitivity (46.3%). After adjustment for age and sex, only RDW remained independently associated with brucellosis (adjusted OR 2.31, 95% CI 1.30-4.11, p = 0.005). Other haematological indices and inflammatory ratios were not significantly different.</p><p><strong>Conclusion: </strong>Only RDW remained significantly associated with brucellosis after adjustment for age and sex. RDW may provide supportive information together with clinical and serological findings, although larger studies are needed to confirm these results.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13625478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079598","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}