BMC Infectious Diseases最新文献

{"title":"Prevalence of bacterial eye infections and multidrug resistance patterns among eye infection suspected patients in Ethiopia: a systematic review and meta-analysis.","authors":"Mihret Tilahun, Alemu Gedefie, Bekele Sharew, Habtu Debash, Agumas Shibabaw","doi":"10.1186/s12879-025-11095-y","DOIUrl":"10.1186/s12879-025-11095-y","url":null,"abstract":"<p><strong>Background: </strong>Bacterial eye infections are major global health issue in developing countries like Ethiopia, poor hygiene, limited healthcare infrastructure, and inadequate treatment options contribute to the increased burden of these infections, leading to significant ocular morbidity and potential blindness. Major bacterial pathogens, including Staphylococcus aureus, Haemophilus influenzae, Streptococcus pneumoniae, and Pseudomonas aeruginosa, are responsible for these infections. The objective of this systematic review and meta-analysis is to synthesize existing literature on the prevalence of bacterial eye infections in Ethiopia, identify common bacterial pathogens, and analyze antibiotic resistance patterns.</p><p><strong>Methods: </strong>Comprehensive search were performed across electronic databases and grey literature using specific search terms. Eligible studies were organized in MS Excel and imported into STATA version 14 for statistical analysis. The pooled prevalence of bacterial eye infections and multidrug resistance patterns was calculated using a random-effects model, with heterogeneity assessed via the I² statistic. Publication bias was evaluated through funnel plots and Egger's test. A sensitivity analysis was conducted to assess the influence of individual studies on the overall effect size.</p><p><strong>Result: </strong>The systematic review and meta-analysis of 19 studies conducted in Ethiopia revealed significant regional variations in the prevalence of bacterial eye infections and multidrug resistance (MDR). The overall pooled prevalence of bacterial eye infections was 54.07%, with substantial heterogeneity (I² = 99.2%). Prevalence rates varied across regions, with the highest in Oromia (62.98%) and the lowest in SNNPR (34.3%). Staphylococcus aureus was the most common pathogen (45.47%), followed by coagulase-negative Staphylococci (36.14%). The pooled prevalence of MDR was 66.06%, with the highest rates in Somali (87.7%) and the lowest in Tigray (37.9%). Subgroup analysis showed higher prevalence in studies before 2020 and with smaller sample sizes.</p><p><strong>Conclusion: </strong>In conclusion, the study highlights a high prevalence of bacterial eye infections and multidrug resistance in Ethiopia, with significant regional variation. These findings highlight the urgent need for targeted interventions and antimicrobial stewardship programs to address the growing challenge of antibiotic resistance in Ethiopia.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"705"},"PeriodicalIF":3.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12083116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075836","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":"Case report of brain death in a child due to COVID-19 and literature review.","authors":"Tiantian Xu, Tian Liang, Jiamin Zhang, Yuqing Yan, Lianwei Lu, Lu Kuang, Changbing Wang, Misi Xiao, Yi Chen, Bing Zhu","doi":"10.1186/s12879-025-11058-3","DOIUrl":"https://doi.org/10.1186/s12879-025-11058-3","url":null,"abstract":"<p><strong>Purpose: </strong>Although COVID-19 typically presents with respiratory symptoms, it can also lead to severe neurological manifestations in children. While case reports of COVID-19-associated encephalopathy (including acute necrotizing encephalopathy) have increasingly appeared, gaps remain regarding optimal management strategies and outcome predictors for children with rapid-onset neurological decline. This report aims to underscore the critical need for standardized clinical approaches to severe pediatric COVID-19-related encephalopathy.</p><p><strong>Methods: </strong>In this case report, We detail the case of an 8-year-old girl who presented with fever, rash, headache, and recurrent seizures. Her diagnostic workup included polymerase chain reaction (PCR) testing for SARS-CoV-2 and a range of neurological assessments: contrast-enhanced computed tomography (CT) to evaluate structural changes, transcranial Doppler ultrasound to assess intracranial hemodynamics, and electroencephalography (EEG) to monitor electrical activity. Intensive therapeutic measures-encompassing mechanical ventilation, hemodynamic support, antimicrobial agents, and corticosteroids-were initiated. In addition, a targeted narrative literature review of pediatric COVID-19-associated neurological complications was conducted to contextualize this presentation.</p><p><strong>Results: </strong>The patient tested positive for COVID-19;imaging revealed brain edem, and EEG suggested brain death. Despite aggressive critical care interventions, her condition did not improve, ultimately resulting in brain death. Our review of current literature revealed several reported instances of acute necrotizing encephalopathy in pediatric COVID-19, highlighting a growing body of evidence on the potential for severe central nervous system sequelae.</p><p><strong>Conclusion: </strong>This case highlights the importance of early recognition and close neurological surveillance in pediatric patients with COVID-19. Although accumulating evidence describes COVID-19-related neurological complications such as acute necrotizing encephalopathy, uncertainties persist regarding definitive treatment protocols and long-term outcomes. Greater understanding of the underlying mechanisms and standardized management pathways is imperative to improve prognosis in this vulnerable population.</p><p><strong>Clinical trial: </strong>Not applicable.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"700"},"PeriodicalIF":3.4,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12079884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075806","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":"Crowdsourcing strategies to improve access to HIV pre-exposure prophylaxis in Australia, the Philippines, Thailand and China.","authors":"Warittha Tieosapjaroen, Arturo M Ongkeko, Zhuoheng Yin, Krittaporn Termvanich, Artit Wongsa, Joseph D Tucker, Weiming Tang, Chunyan Li, Ying Zhang, Nina T Castillo-Carandang, Jason J Ong","doi":"10.1186/s12879-025-11065-4","DOIUrl":"https://doi.org/10.1186/s12879-025-11065-4","url":null,"abstract":"<p><strong>Background: </strong>Many Asian countries have yet to scale up HIV pre-exposure prophylaxis (PrEP). Crowdsourcing has a group of individuals solving a specific problem before sharing solutions with the public. This approach enhances community engagement and ownership of the solutions and can be used to generate culturally relevant solutions. We used crowdsourcing to seek innovative strategies to optimise PrEP access by increasing the uptake and effective use of PrEP. This study describes the experiences of crowdsourcing open calls in Australia, the Philippines, Thailand and China.</p><p><strong>Methods: </strong>Four crowdsourcing open calls were conducted between 2021-2023 in Australia, the Philippines, Thailand and China. All open calls entailed: 1) problem identification; 2) committee formation with local groups; 3) community engagement for idea submission (e.g., texts, posters, pitches); 4) evaluation of submissions; 5) awarding incentives to finalists; and 6) solution dissemination via web and social media. We reported the number of total and high-quality submissions. We also identified themes across countries.</p><p><strong>Results: </strong>The Australian, Filipino, Thai and Chinese teams received 9, 22, 9 and 19 eligible submissions, respectively. A total of 3, 10, 7 and 8 submissions had a mean score of 6/10 or greater. Three common solutions emerged across all the finalist ideas: enhanced service access, optimising promotional campaigns, and person-centred promotional materials. The winning ideas from the Australian, Filipino, Thai and Chinese teams were an anonymous online PrEP service, a printed ready-to-wear garment to create awareness about PrEP, PrEP and HIV self-testing kit dispensing kiosks and a poster on PrEP effectiveness, respectively.</p><p><strong>Conclusions: </strong>Crowdsourcing was a promising and versatile tool for developing PrEP strategies in the Asia-Pacific region. Further evaluations via clinical trials can bridge the gap between idea generation and implementation, creating the empirical evidence that is pivotal for the policy adoption of these innovations.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"698"},"PeriodicalIF":3.4,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12079911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075810","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 stratification and conservative management of women aged 25-40 years with cervical intraepithelial neoplasia grade 2(CIN2).","authors":"Huanhua Wang, Ping Jin","doi":"10.1186/s12879-025-11096-x","DOIUrl":"10.1186/s12879-025-11096-x","url":null,"abstract":"<p><strong>Background: </strong>Cervical intraepithelial neoplasia grade 2 (CIN2) can progress to CIN3 or worse (CIN3⁺). Some patients diagnosed with CIN2 from a punch biopsy exhibit varied risks of occult CIN3⁺ in the loop electrosurgical excision procedure (LEEP) specimens following treatment, underscoring the need for risk stratification.</p><p><strong>Methods: </strong>We conducted a retrospective observational study of 307 women aged ≤ 40 years, diagnosed with CIN2 via colposcopy-guided punch biopsy where the squamocolumnar junction was visible, and who underwent LEEP within three months. We compared the diagnoses from punch biopsies with the histology of the LEEP specimens and developed a stratified management algorithm based on identified risk factors.</p><p><strong>Results: </strong>The risk of CIN3⁺ in the LEEP specimens for women aged 25-40 years was 24.9% (including one case of cervical microinvasive squamous cell carcinoma), significantly higher than in women under 25 years in univariate analysis (24.9% vs. 7.1%, P < 0.05). Multivariate analysis revealed HPV16/18 (OR 2.61, [95% CI 1.41-4.85]) and HSIL cytology (OR 4.14, [95% CI 2.03-8.47]) as independent risk factors.</p><p><strong>Conclusion: </strong>Patients aged 25-40 years with CIN2 diagnosed in punch biopsy exhibited a substantial risk of CIN3⁺ in LEEP specimens, warranting consideration for surgical intervention, particularly in those with HPV16/18 and HSIL cytology. Approximately 30% of CIN2 patients with HPV16/18 and ASC-US/LSIL, or other high-risk HPV types and HSIL cytology, also showed CIN3⁺, suggesting that treatment should be individualized considering the patient's preferences and adherence. Conversely, the risk was low for those with HPV16/18 and normal cytology or other high-risk HPV types and ASC-US/LSIL, making conservative management a viable option. .</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"696"},"PeriodicalIF":3.4,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972030","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":"In-depth analysis of the risk factors for persistent severe acute respiratory syndrome coronavirus 2 infection and construction of predictive models: an exploratory research study.","authors":"Jia Zhang, Weihua Zhu, Piping Jiang, Feng Ma, Yulin Li, Yuwei Cao, Jiaxin Li, Zhe Zhang, Xin Zhang, Wailong Zou, Jichao Chen","doi":"10.1186/s12879-025-11083-2","DOIUrl":"https://doi.org/10.1186/s12879-025-11083-2","url":null,"abstract":"<p><strong>Background: </strong>Persistent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection differs from long coronavirus disease (COVID-19) (acute symptoms ≥ 12 weeks post-clearance). The Omicron BA.5 variant has a shorter median clearance time (10-14 days) than the Delta variant, suggesting that the traditional 20-day diagnostic threshold may delay interventions in high-risk populations. This study integrated multi-threshold analysis (14/20/30 days), whole-genome sequencing, and machine learning to investigate diagnostic thresholds for persistent SARS-CoV-2 infection and developed a generalizable risk prediction model.</p><p><strong>Methods: </strong>This retrospective study analyzed data from 1,216 patients with COVID-19 hospitalized at Aerospace Center Hospital between January 2021 and October 2024. We used whole-genome sequencing to genotype all COVID-19 cases and to identify major variants (such as Omicron BA. 5, Delta). The outcome, \"persistent SARS-CoV-2 infection,\" was defined as viral nucleic acid positivity ≥ 14 days. Risk factors associated with persistent infection were identified through subgroup analysis with multiple logistic regression (adjusted for age, comorbidities, vaccination status, and virus strain) and machine learning models (70% training, 30% testing dataset).</p><p><strong>Results: </strong>Persistent SARS-CoV-2 infection was identified in 15.5% (188/1,216) of hospitalized COVID-19 patients. Key predictors included comorbidities-hypertension, diabetes, and active malignancy-and immune dysfunction, marked by reduced B-cell and CD4 + T-cell counts. Unvaccinated patients exhibited an 82% higher risk of persistent infection. Elevated inflammatory markers (C-reactive protein and interleukin-6) and bilateral lung infiltrates on computed tomography further distinguished persistent cases. The predictive model demonstrated strong discrimination with an area under the curve (AUC) of 0.847 (95% confidence interval: 0.815-0.879) and an AUC of 0.81 externally in external validation, underscoring its clinical utility for risk stratification.</p><p><strong>Conclusions: </strong>Hypertension, diabetes, malignancy, immunosuppression (low B/CD4 + cells), and non-vaccination are independent risk factors for persistent SARS-CoV-2 infection. Integrating these factors into clinical risk stratification may optimize management of high-risk populations.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"699"},"PeriodicalIF":3.4,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075783","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":"Epidemiological and clinical characteristics of bacterial co-detection in respiratory syncytial virus-positive children in Wenzhou, China, 2021 to 2023.","authors":"Xiaoxiao Qu, Xuanmei Ye, Jian Yu, Feifei Zheng, Yatian Tang, Fangling Yuan, Qipeng Xie","doi":"10.1186/s12879-025-11086-z","DOIUrl":"https://doi.org/10.1186/s12879-025-11086-z","url":null,"abstract":"<p><strong>Background: </strong>Respiratory syncytial virus (RSV) is a leading cause of respiratory tract infections in young children, posing significant health challenges worldwide. This study aims to analyze the etiological, clinical, and imaging characteristics of RSV infection in children from Wenzhou, China, to better understand its epidemiological profile and provide insights for early diagnosis, monitoring, and clinical interventions.</p><p><strong>Methods: </strong>This retrospective descriptive observational study included 1,063 RSV-positive pediatric inpatients (< 14 years) from the Second Affiliated Hospital of Wenzhou Medical University (December, 2021, and April, 2023). Missing data were addressed using multiple imputation. Patients were grouped by co-infection type (viral or bacterial), and differences in demographic, clinical, and imaging features were analyzed. Univariate and multivariate logistic regression identified risk factors for bacterial co-infection in RSV-positive patients. Predictive features were selected via the Boruta algorithm and modeled using XGBoost, with SHAP applied for interpretability. Pathogen distributions were also compared across age groups in both co-infection subtypes.</p><p><strong>Results: </strong>Among 1,063 hospitalized RSV-positive children, RSV primarily affected those under one year of age, with a substantial proportion of cases (47.3%) showing co-infections. The most frequently detected viral co-pathogen was human rhinovirus (HRV, 42.2%), while Streptococcus pneumoniae (37.3%) was the most common bacterial pathogen. Some children were found to carry multiple pathogens simultaneously. Age-stratified radiographic analysis revealed that bronchitis was the predominant imaging finding across all age groups. Compared with the viral co-infection group, children with bacterial co-infections had longer hospital stays (6.4 vs. 5.4 days), higher white blood cell and neutrophil counts, and lower IgE levels (P < 0.05). Logistic regression analysis identified length of stay, prealbumin (PA), and immunoglobulin E (IgE) as independent predictors of bacterial co-infection. Feature selection using the Boruta algorithm, combined with XGBoost modeling and SHAP interpretation, further confirmed that length of stay, WBC count, neutrophil count, and IgE were the most important predictive variables. Age-specific pathogen analysis showed that influenza A and Streptococcus pneumoniae were predominantly found in children aged 3 to < 6 years (P < 0.05).</p><p><strong>Conclusions: </strong>RSV infections in Wenzhou predominantly occur in infants under one year of age and frequently involve co-infections with viruses and bacteria, particularly rhinovirus and Streptococcus pneumoniae. Early identification of co-infections and tailored interventions are critical to improving patient outcomes.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"697"},"PeriodicalIF":3.4,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075780","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":"Tuberculosis disease characteristics associated with mortality, severe morbidity and unsuccessful treatment in people living with HIV treated for tuberculosis - a secondary analysis of the ANRS 12300 Reflate TB2 trial.","authors":"Robert Akpata, Jean-Baptiste Ntakpe, Eugène Messou, Nathalie De Castro, Corine Chazallon, Isabel Timana, Rodrigo Escada, Sandra Wagner Cardoso, Nilesh Bhatt, Celso Khosa, Didier Laureillard, Giang Do Chau, Frédéric Ello Nogbou, Donald Diomande Glao, Valdilea Veloso, Jean-Michel Molina, Beatriz Grinsztejn, Marcel Zannou, Serge Eholie, Olivier Marcy","doi":"10.1186/s12879-025-10986-4","DOIUrl":"10.1186/s12879-025-10986-4","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis is a severe disease, not only due to its lethality but also to a significant morbidity occurring in people living with HIV (PLWH). If factors associated to mortality, severe morbidity and unsuccessful treatment related to the host are well identified in PLWH, there is scarce knowledge on factors related to the disease itself such as bacillary load, extent of lung involvement and disease dissemination to other organs. We sought to assess whether tuberculosis-related factors were associated with key patient outcomes in PLWH using data from an international clinical trial.</p><p><strong>Methods: </strong>We conducted a secondary analysis of the ANRS 12300 Reflate TB2, an international phase III open-label randomized trial that assessed different antiretroviral regimens in PLWH treated for tuberculosis. We evaluated whether bacillary load (smear positivity grade), extent of lung involvement (cavitation on chest x-ray) and disease dissemination (urine LAM positivity) were associated with mortality using Cox proportional hazard models, and to severe morbidity and unsuccessful tuberculosis treatment using logistic regressions.</p><p><strong>Results: </strong>Of 457 participants included in this study, 90 (20.4%) had grade 2 + or 3 + smear positivity, 39 (10.8%) had cavitation on chest X-ray, and 147 (32.2%) had a positive urinary LAM. Overall, 19 (4.2%) participants died, 113 (24.7%) presented severe morbidity, and 33 (7.2%) had unsuccessful tuberculosis treatment. Factors that remained independently associated with mortality were cavitation on chest x-ray (aHR = 7.92, 95% CI, 1.74-35.94, p = .0073) and LAM positivity (aHR = 5.53, 95% CI, 1.09-28.06, p = .0389). The only factor that remained significantly associated with severe morbidity was LAM positivity (aOR = 2.04, 95% CI, 1.06-3.92, p = .0323). No factor remained significantly associated with unsuccessful tuberculosis treatment.</p><p><strong>Conclusions: </strong>In PLWH with tuberculosis enrolled in a trial, tuberculosis disease characteristics related to disease severity were cavitation on chest x-ray and urine LAM positivity. Early identification of these factors could help improve the management of PLWH with tuberculosis and improve their survival.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"695"},"PeriodicalIF":3.4,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12077038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952893","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 safety of azvudine versus nirmatrelvir/ritonavir in hospitalized patients with COVID-19.","authors":"Jin Yang, Jiao Min, Ling Ding, Rong Liu, Ya Yang, Jian-Feng Zhang, Wei Lei","doi":"10.1186/s12879-025-11007-0","DOIUrl":"https://doi.org/10.1186/s12879-025-11007-0","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the effectiveness and safety of two antiviral drugs, azvudine and nirmatrelvir/ritonavir, in treating hospitalized patients with COVID-19.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of patients who were admitted to the First Affiliated Hospital of Soochow University and diagnosed with SARS-CoV-2 infection between December 2022 and February 2023. These patients were treated with either azvudine or nirmatrelvir/ritonavir.</p><p><strong>Results: </strong>The study initially included a total of 1097 patients. After applying a 1:3 propensity score matching, we ultimately included 728 patients, comprising 521 recipients of azvudine and 207 recipients of nirmatrelvir/ritonavir. Among them, 463 patients (88.9%) in the azvudine group and 182 patients (87.9%) in the nirmatrelvir/ritonavir group achieved recovery and discharge, with no significant difference between the two groups (P = 0.816). The median time of improvement was 5.5 days (3.3, 9.0) in the nirmatrelvir/ritonavir group and 5.0 days (4.0, 8.0) in the azvudine group, with no significant difference observed between the two groups (P = 0.732). Furthermore, no significant differences were noted in terms of the time to fever resolution in patients with fever (P = 0.547), the rates of usage of high-flow nasal cannula (P = 0.054), non-invasive mechanical ventilation (P = 0.531), and invasive mechanical ventilation (P = 0.667), the duration of invasive mechanical ventilation usage (P = 0.732), the rate of disease progression (P = 0.602), and hospital length of stay (P = 0.884). Regarding safety outcomes, there was a notable increase in the occurrence of myocardial injury in the nirmatrelvir/ritonavir group (13.5%) compared to the azvudine group (7.3%) (P = 0.012). The two groups did not exhibit differences in the incidence of other adverse events.</p><p><strong>Conclusion: </strong>In hospitalized patients with COVID-19, the effectiveness of azvudine and nirmatrelvir/ritonavir was found to be comparable in various aspects, including the improved discharge rate, the improvement time, time to fever resolution, usage rates of high-flow nasal cannula, non-invasive mechanical ventilation, and invasive mechanical ventilation, rate of disease progression, time to discharge, and hospital length of stay. The occurrence of myocardial injury was higher in nirmatrelvir/ritonavir group compared to azvudine group, while no significant differences were observed in other adverse reactions.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"701"},"PeriodicalIF":3.4,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12079968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075777","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":"Utilizing Nanopore direct RNA sequencing of blood from patients with sepsis for discovery of co- and post-transcriptional disease biomarkers.","authors":"Jingni He, Devika Ganesamoorthy, Jessie J-Y Chang, Jianshu Zhang, Sharon L Trevor, Kristen S Gibbons, Stephen J McPherson, Jessica C Kling, Luregn J Schlapbach, Antje Blumenthal, Lachlan J M Coin","doi":"10.1186/s12879-025-11078-z","DOIUrl":"10.1186/s12879-025-11078-z","url":null,"abstract":"<p><strong>Background: </strong>RNA sequencing of whole blood has been increasingly employed to find transcriptomic signatures of disease states. These studies traditionally utilize short-read sequencing of cDNA, missing important aspects of RNA expression such as differential isoform abundance and poly(A) tail length variation.</p><p><strong>Methods: </strong>We used Oxford Nanopore Technologies sequencing to sequence native mRNA extracted from whole blood from 12 patients with definite bacterial and viral sepsis and compared with results from matching Illumina short-read cDNA sequencing data. Additionally, we explored poly(A) tail length variation, novel transcript identification, and differential transcript usage.</p><p><strong>Results: </strong>The correlation of gene count data between Illumina cDNA- and Nanopore RNA-sequencing strongly depended on the choice of analysis pipeline; NanoCount for Nanopore and Kallisto for Illumina data yielded the highest mean Pearson's correlation of 0.927 at the gene level and 0.736 at the transcript isoform level. We identified 2 genes with differential polyadenylation, 9 genes with differential expression and 4 genes with differential transcript usage between bacterial and viral infection. Gene ontology gene set enrichment analysis of poly(A) tail length revealed enrichment of long tails in mRNA of genes involved in signaling and short tails in oxidoreductase molecular functions. Additionally, we detected 240 non-artifactual novel transcript isoforms.</p><p><strong>Conclusions: </strong>Nanopore RNA- and Illumina cDNA-gene counts are strongly correlated, indicating that both platforms are suitable for discovery and validation of gene count biomarkers. Nanopore direct RNA-seq provides additional advantages by uncovering additional post- and co-transcriptional biomarkers, such as poly(A) tail length variation and transcript isoform usage.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"692"},"PeriodicalIF":3.4,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975997","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":"Chemotherapy-induced febrile neutropenia followed by acute hepatitis E virus infection in rectal cancer patient with synchronous liver and lung metastasis: a case report.","authors":"Dongdong Zhang, Zhihong Chen, Jixiang Wu, Ning Ning, Lin Chen, Xiaodong Tian","doi":"10.1186/s12879-025-11097-w","DOIUrl":"10.1186/s12879-025-11097-w","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis E virus (HEV) typically induces self-limiting infection but can establish persistent infection, particularly in patients with compromised immune systems. However, the literature on HEV infection in patients undergoing chemotherapy is limited.</p><p><strong>Case presentation: </strong>A 46-year-old Chinese male patient with rectal cancer underwent ten cycles of chemotherapy and targeted therapy. Routine blood tests revealed grade 4 bone marrow suppression necessitating emergency admission. On the second day following admission, the patient presented with high fever that was determined to be chemotherapy-induced febrile neutropenia (FN). However, despite the recovery of white blood cell counts, the fever persisted, and the levels of aminotransferases and bilirubin continued to rise. Two weeks after admission, next generation sequencing of blood samples revealed evidence of HEV. The patient underwent symptomatic and supportive treatment and was discharged after a 30-day hospitalization. One month after discharge, the transaminase and bilirubin levels were within the normal range.</p><p><strong>Discussion: </strong>The fatality rate of FN is alarmingly high. To prevent progression to sepsis syndrome and potential mortality, it is imperative to initiate empirical treatment with broad-spectrum antibiotics. As the differential diagnosis of elevated liver enzymes in immunocompromised patients encompasses a wide range of possibilities, the exclusion of HEV infection is crucial when diagnosing drug-induced liver injury (DILI).</p><p><strong>Conclusion: </strong>This case highlights the importance of healthcare providers being vigilant in identifying HEV infection in patients with solid tumors who experience FN and DILI. Early implementation of comprehensive supportive treatment is crucial for reducing the duration of disease and enhancing patient prognosis.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"693"},"PeriodicalIF":3.4,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958329","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}