BMC Infectious Diseases最新文献

{"title":"Beyond the fever: shotgun metagenomic sequencing of stool unveils pathogenic players in HIV-infected children with non-malarial febrile illness.","authors":"Patricia Nabisubi, Stephen Kanyerezi, Grace Kebirungi, Ivan Sserwadda, Mike Nsubuga, Grace Kisitu, Patricia Ntege Nahirya, Bonny Mulindwa, George P Akabwai, Sylvia Nantongo, Adeodata Kekitiinwa, Edgar Kigozi, Nsubuga Moses Luutu, Fred Ashaba Katabazi, Leymon Kalema, Andrew Katabalwa, Daudi Jjingo, Gerald Mboowa","doi":"10.1186/s12879-025-10517-1","DOIUrl":"10.1186/s12879-025-10517-1","url":null,"abstract":"<p><strong>Background: </strong>Non-malarial febrile illnesses (NMFI) pose significant challenges in HIV-infected children, often leading to severe complications and increased morbidity. While traditional diagnostic approaches focus on specific pathogens, shotgun metagenomic sequencing offers a comprehensive tool to explore the microbial landscape underlying NMFI in this vulnerable population ensuring effective management.</p><p><strong>Methods: </strong>In this study, we employed shotgun metagenomics to analyse stool samples from HIV-infected children at the Baylor Children's Clinic Uganda presenting with non-malarial febrile illness. Samples were collected and subjected to DNA extraction at the Molecular and Genomics Laboratory, Makerere University followed by shotgun metagenomics sequencing at the Chan Zuckerberg Biohub San Francisco. Bioinformatics analysis was conducted to identify and characterise the microbial composition and potential pathogenic taxa associated with NMFI using the CZID pipeline.</p><p><strong>Results: </strong>Our findings reveal a diverse array of microbial taxa in the stool samples of HIV-infected children with NMFI. Importantly, shotgun metagenomics revealed potentially pathogenic players including Trichomonas vaginalis, Candida albicans, Giardia, and Bacteroides in stool from this patient population. This sheds light on the complexities of microbial interactions that potentially underpin non-malarial febrile illness in this group. Taxonomic profiling identified recognised pathogens and comorbidities and revealed possible new correlations with NMFI, shedding light on the pathophysiology of fever in HIV-infected children.</p><p><strong>Conclusion: </strong>Shotgun metagenomics is a valuable method for understanding the gut microbial landscape of NMFI in HIV-infected children, providing a comprehensive approach to pathogen identification and characterisation. By revealing potential pathogenic actors beyond the fever, this work demonstrates how metagenomic sequencing may improve our knowledge of infectious illnesses in vulnerable groups and inspire targeted therapies for better clinical care and outcomes.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"96"},"PeriodicalIF":3.4,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic profiling of extended-spectrum β-Lactamase and carbapenemase-producing Escherichia coli O157:H7 from clinical samples among diarrheal patients in Shashemene, Ethiopia.","authors":"Shimelis Teshome Ayalneh, Biruk Yeshitela Beshah, Yeonji Jeon, Ashenafi Alemu Wami, Seifegebriel Teshome, Solomon Gebreselassie, Se Eun Park, Mekonnen Teferi, Woldaregay Erku Abegaz","doi":"10.1186/s12879-025-10513-5","DOIUrl":"10.1186/s12879-025-10513-5","url":null,"abstract":"<p><strong>Background: </strong>Escherichia coli (E. coli) O157:H7, associated with diarrhea, poses a global health risk. In Ethiopia, where diarrhea is common, there is limited knowledge about these resistant strains and a lack of data on Extended-Spectrum β-Lactamase (ESBL) and carbapenemase production. Understanding the prevalence of antimicrobial resistance genes associated with ESBL and carbapenems is crucial for addressing diarrheal disease. This study aimed to investigate the genetic profile of ESBL and carbapenemase coding gene carriage in E. coli O157:H7 from clinical stool samples and evaluate antimicrobial susceptibility patterns.</p><p><strong>Methods: </strong>A total of twenty-nine bacterial isolates obtained from diarrheal patients were subjected to conventional culture and phenotypic (Kirby Bauer disc diffusion method) testing for antimicrobial resistance. Additionally, screening for the production of ESBL (combined disk method) and carbapenemase (modified carbapenem inactivation method) was conducted. Isolates that tested positive for ESBL and carbapenemase production were further analyzed, targeting five genes (bla_NDM, bla_KPC, bla_CTX-M, bla_TEM, and bla_SHV) associated with ESBL and carbapenemase production. Data analysis was performed using SPSS version 27.0, employing logistic regression and descriptive statistics.</p><p><strong>Results: </strong>We analyzed a total of 27 isolates that were ESBL-positive and 12 isolates that were found to produce carbapenemase phenotypically. These isolates were obtained from clinical stool samples and (9/27) 33.3% of the isolates were from under five years children, predominantly from urban areas, and those that have contact with domestic animals. Genes coding ESBL were found in (19/27) 70.4% of the isolates, the most predominant being bla_CTX-M and bla_TEM. Eight isolates carried bla_KPC, but none had bla_NDM, while five isolates carried both bla_CTX-M and bla_TEM genes. bla_SHV-carrying isolates showed phenotypic resistance to ampicillin and cephalosporins, while bla_KPC-carrying isolates exhibited resistance to ampicillin, carbapenems, and tetracycline.</p><p><strong>Conclusion: </strong>This study identifies a significant prevalence of multidrug resistance in E. coli O157:H7, which can be attributed to the presence of resistance genes coding for ESBL and carbapenem production. Key factors contributing to this resistance, such as urban environments, children under the age of five, and domestic animal ownership, have been emphasized. Additionally, this research underscores the urgent need for enhanced surveillance and targeted interventions to address this pressing public health concern.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"90"},"PeriodicalIF":3.4,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999228","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":"Arbovirus exposure and subclinical myocardial dysfunction in an Indigenous population in Northeast Brazil: a cross-sectional study.","authors":"Jandir Mendonça Nicacio, Carlos Dornels Freire de Souza, Ricardo Khouri, Vanessa Cardoso Pereira, Rodrigo Feliciano do Carmo, Pedro Vinícius Amorim de Medeiros Patriota, Sávio Luiz Pereira Nunes, Jeová Cordeiro de Morais Júnior, Manoel Barral-Netto, João Augusto Costa Lima, Anderson da Costa Armstrong","doi":"10.1186/s12879-024-10320-4","DOIUrl":"10.1186/s12879-024-10320-4","url":null,"abstract":"<p><strong>Background: </strong>Human activities, such as urbanization and climate change, have facilitated the spread of arbovirus-carrying vectors, disproportionately affecting vulnerable traditional Indigenous communities.</p><p><strong>Objective: </strong>To explore the relationships between subclinical myocardial dysfunction, assessed by global longitudinal strain (GLS), and comprehensive arbovirus serology in an Indigenous population, while also describing the serological and epidemiological profile of dengue, chikungunya, and Zika viruses.</p><p><strong>Methods: </strong>This ancillary study is part of the first phase (2016-2017) of the Project of Atherosclerosis among Indigenous Populations (PAI), a cross-sectional study involving participants from two Indigenous communities with different degrees of urbanization and a highly urbanized city in Northeast Brazil. We assessed the seroprevalence of dengue, chikungunya, and Zika viruses in the Fulni-ô Indigenous community, the less urbanized and most traditional group. Additionally, we explored the relationship between these viruses and subclinical heart disease, assessed by speckle-tracking echocardiography-derived GLS.</p><p><strong>Results: </strong>One hundred seventy-four participants were included, with a median age of 45.0 years (interquartile range 38.0-55.0). The majority were female (58.6%; n = 102). The prevalence of anti-ZIKV IgG was 95.3%; anti-DENV IgG was 85.8%, and anti-CHIKV IgG was 70.9%. GLS abnormalities were detected in nearly half (48.3%) of the cohort. However, no significant association was found between arbovirus serology and GLS.</p><p><strong>Conclusions: </strong>The findings reveal a high prevalence of positive serology for arboviruses and a significant rate of subclinical cardiac dysfunction. There was no significant association between reduced left ventricular longitudinal strain and positive arbovirus serology, likely due to the limited number of participants with indications of acute contact with the viruses studied. However, the unprecedented and relevant results of this study are noteworthy, as they address critical public health issues, particularly in vulnerable populations. Further research is needed to explore these findings in more depth.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"89"},"PeriodicalIF":3.4,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999401","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":"Cardiac hydatid cyst: case series and review of the literature.","authors":"Jingjie Wang, Xing Liu, Yierzhati Aizezi, Wenzhe Li, Jingnan Xu, Yi Wang, Xiangyou Yu","doi":"10.1186/s12879-024-10247-w","DOIUrl":"10.1186/s12879-024-10247-w","url":null,"abstract":"<p><strong>Background: </strong>Echinococcosis is a zoonotic parasitic disease prevalent in pastoral areas, mainly involving the liver and lungs, and rarely affecting the brain and heart. This article describes the diagnosis and treatment of 14 patients with cardiac encapsulated cysts, with the aim of providing insights into the clinical presentation, diagnostic challenges, therapeutic strategies, and outcomes associated with cardiac encapsulated cysts.</p><p><strong>Methods: </strong>This retrospective case series included 13 patients with cardiac and/or cerebral encapsulated cysts.</p><p><strong>Results: </strong>We retrospectively analyzed 14 patients diagnosed with cardiac and pericardial echinococcosis between 2012 and 2024 at our hospital. The patients' average age was 26 years, ranging from 3 to 60 years. Echinococcal cysts were found in various cardiac locations, including the pericardium (5 patients), left ventricle (3 patients), right atrium (2 patients), and apical region of the heart (1 patient). Chest pain (6 patients) was a common symptom if the cyst was in the heart, dyspnea, or cough (3 patients) if it was in the lungs, and epilepsy (1 patient) if it was in the brain. Diagnosis of this condition necessitates the performance of both laboratory tests and imaging procedures. The latter requires the expertise of a trained professional to accurately differentiate between cardiac-encapsulated cysts and other types of cysts. All patients in our study were examined as described above. The recommended course of treatment is typically surgical removal of the cyst and administration of medications to prevent recurrence. In instances where the patient declines to surgery, it is advised that they be provided with medication and scheduled for regular follow-up appointments. In our study, data were lost for two patients. Eight patients underwent open-heart surgery, one underwent craniotomy for epilepsy, one underwent thoracentesis and drainage for pleural effusion, and one patient declined surgery.</p><p><strong>Conclusions: </strong>Cardiac echinococcosis is common in pastoral populations, Surgical excision combined with pharmacological treatment is the best option for the treatment of cardiac echinococcosis.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"91"},"PeriodicalIF":3.4,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combatting Salmonella: a focus on antimicrobial resistance and the need for effective vaccination.","authors":"Junaid Nazir, Tasaduq Manzoor, Afnan Saleem, Ubaid Gani, Sahar Saleem Bhat, Shabir Khan, Zulfqarul Haq, Priyanka Jha, Syed Mudasir Ahmad","doi":"10.1186/s12879-025-10478-5","DOIUrl":"10.1186/s12879-025-10478-5","url":null,"abstract":"<p><strong>Background: </strong>Salmonella infections represent a major global public health concern due to their widespread zoonotic transmission, antimicrobial resistance, and associated morbidity and mortality. This review aimed to summarize the zoonotic nature of Salmonella, the challenges posed by antimicrobial resistance, the global burden of infections, and the need for effective vaccination strategies to mitigate the rising threat of Salmonella.</p><p><strong>Methods: </strong>A systematic review of literature was conducted using databases such as PubMed, Scopus, Web of Science, and Google Scholar. Relevant studies published in English were identified using keywords including Salmonella, vaccination, antimicrobial resistance, and public health. Articles focusing on epidemiology, vaccine development, and strategies to control Salmonella infections were included, while conference abstracts and non-peer-reviewed studies were excluded.</p><p><strong>Results: </strong>Salmonella infections result in approximately 95 million global cases annually, with an estimated 150,000 deaths. Regional variations were evident, with higher infection rates in low- and middle-income countries due to poor sanitation and food safety standards. Salmonella Enteritidis and S. Typhimurium were the most prevalent serovars associated with human infections. The review highlighted an alarming rise in multidrug-resistant (MDR) Salmonella strains, particularly due to the overuse of antibiotics in humans and livestock. Despite progress in vaccine development, challenges remain in achieving a universal vaccine that targets diverse Salmonella serovars. Live-attenuated, killed, recombinant, subunit, and conjugate vaccines are currently under development, but limitations such as efficacy, cost, and accessibility persist.</p><p><strong>Conclusions: </strong>Salmonella infections continue to impose a significant burden on global health, exacerbated by rising antimicrobial resistance. There is an urgent need for a multifaceted approach, including improved sanitation, prudent antibiotic use, and the development of affordable, broad-spectrum vaccines. Strengthening surveillance systems and promoting collaborative global efforts are essential to effectively control and reduce the burden of Salmonella.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"84"},"PeriodicalIF":3.4,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999578","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":"Recurrent NTM pulmonary disease despite avoidance of hot spring exposure in a plaque psoriasis patient treated with Secukinumab: a case report.","authors":"Yixiao Wei, Chunlei Wang, Lingtao Chong, Xiaojing Cui","doi":"10.1186/s12879-025-10487-4","DOIUrl":"10.1186/s12879-025-10487-4","url":null,"abstract":"<p><strong>Background: </strong>Recurrent Non-Tuberculous Mycobacterial Pulmonary Disease (NTM-PD) related to treatment with Secukinumab has not been previously documented.</p><p><strong>Case presentation: </strong>Despite adherence to treatment and avoiding hot springs, a plaque psoriasis patient experienced persistent NTM-PD relapses.</p><p><strong>Conclusions: </strong>There is potential association between Secukinumab, an IL-17A inhibitor, and NTM disease, echoing anti-TNF biologics' NTM risk, indicating the urgent need for further research on pathogenic mechanisms and risk factors.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"82"},"PeriodicalIF":3.4,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999547","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":"Lung-specific CRBN knockout attenuates influenza a virus-induced acute lung injury in mice: a potential therapeutic approach.","authors":"Lifang Zhang, Qingchao Zhang, Jiahui Chang, Yunyi Zhou, Wei Wang, Xiliang Wang, Chengyu Jiang, Yanli Zhang","doi":"10.1186/s12879-025-10490-9","DOIUrl":"10.1186/s12879-025-10490-9","url":null,"abstract":"<p><p>Influenza-related acute lung injury is a life-threatening condition primarily caused by uncontrolled replication of the influenza virus and intense proinflammatory responses. Cereblon (CRBN) is a protein known for its role in the ubiquitin-proteasome system and as a target of the drug thalidomide. However, the function of CRBN in influenza virus infection remains poorly understood. In this study, we investigated the impact of CRBN on A/Puerto Rico/8/34 (PR8) influenza virus-induced lung injury and its potential as a therapeutic target. Knocking down CRBN in vitro significantly reduces PR8-induced cell death. Using Sftpc-Cre; Crbn^flox/flox lung-specific Crbn knockout mice, we demonstrated that Crbn deficiency significantly decreased mortality, weight loss, lung pathology, edema, and viral load in PR8-infected mice. PR8-infected Sftpc-Cre; Crbn^flox/flox mice exhibited a marked reduction in lung inflammatory cell infiltration and suppression of MAPK pathway activation, highlighted by a significant downregulation of the MKK4-JNK-c-JUN signaling cascade. Collectively, these findings indicate that CRBN plays a pivotal role in the pathogenesis of influenza-induced lung injury by modulating MAPK pathway signaling, underscoring its therapeutic potential as a target for intervention.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"83"},"PeriodicalIF":3.4,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999390","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 of HPV vaccination in reducing infection among young Brazilian women.","authors":"Ana Carolina da Silva Santos, Nayara Nascimento Toledo Silva, Ismael Dale Cotrim Guerreiro da Silva, Mariângela Carneiro, Wendel Coura-Vital, Angélica Alves Lima","doi":"10.1186/s12879-024-10284-5","DOIUrl":"10.1186/s12879-024-10284-5","url":null,"abstract":"<p><strong>Background: </strong>Globally, cervical cancer is an increasing public health issue, and vaccination against HPV has proven to be an effective strategy to reduce this neoplasia. The purpose of this study was to assess the effectiveness of the quadrivalent vaccine in reducing the prevalence and incidence of HPV infection in women, aged 18 to 24 years old, in the cities of Ouro Preto and Mariana, Minas Gerais, Brazil.</p><p><strong>Methods: </strong>A concurrent cohort study was performed, with an initial follow-up of 12 to 18 months. The selected young women were interviewed and divided into two groups: vaccinated and unvaccinated. Participants underwent a Pap smear and cervical sample collection for HPV detection, genotyping performed by PCR-RFLP, type-specific PCR, and using the PapilloCheck®. The prevalence of HPV infection was analyzed using the compare proportions test. Poisson and Cox multivariate regression models were used to estimate vaccine effectiveness.</p><p><strong>Results: </strong>There was no significant difference in the overall prevalence of HPV infection between vaccinated and unvaccinated groups (23.6% vs. 18.7%; p = 0.364). However, the prevalence of infection by HPV 6/11, 16 and 18 types in vaccinated young women (1.1%) was lower than in unvaccinated ones (7.5%; p = 0.030). Regarding non-vaccine types, a higher prevalence was identified among vaccinated women (22.5% vs. 11.2%; p = 0.018). The overall incidence of HPV infection was 15.75/100 young women/year in non-immunized women compared to 9.12/100 young women/year among those immunized. The effectiveness of the vaccine was 64.0%, regardless of the viral type, and no vaccinated woman was detected with the specific vaccine HPV-type in follow-up. HPV33/45, related to cross-protection, were detected in 12.3% of vaccinated women and 1.2% of unvaccinated ones (p < 0.001) at baseline. These viral types were identified at follow-up in 2.03/100 young women/year of vaccinated participants and 4.24/100 young women/year of unvaccinated ones.</p><p><strong>Conclusions: </strong>The results showed that the quadrivalent HPV vaccine was effective in reducing the prevalence of vaccine-type HPV and the incidence of infection by any HPV type. Public health policies must encourage vaccination to prevent HPV infection. However, surveillance of HPV infection should be continued to assess the prevalence of different genotypes and the impact of the vaccination program.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"88"},"PeriodicalIF":3.4,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142997975","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":"Combination therapy versus monotherapy: retrospective analysis of antibiotic treatment of enterococcal endocarditis.","authors":"Razan Saman, Christopher P Primus, Robert West, Simon J Woldman, Jonathan A T Sandoe","doi":"10.1186/s12879-025-10451-2","DOIUrl":"10.1186/s12879-025-10451-2","url":null,"abstract":"<p><strong>Background: </strong>Guidelines suggest treating fully penicillin-susceptible Enterococcus faecalis strains causing infective endocarditis with amoxicillin combined with gentamicin or ceftriaxone, but clinical evidence to support this practice is limited and monotherapy cohorts were excluded from studies. We describe antibiotic treatment, complications, and outcomes in patients with Enterococcus faecalis infective endocarditis, specifically comparing monotherapy versus combination therapy.</p><p><strong>Methods: </strong>Retrospective analysis of prospectively collected cohort of patients with definite or possible infective endocarditis from 2 English centres between 2006 and 2021. The primary outcome was 30-day mortality. Secondary outcomes included acute kidney injury, relapse, and clinical cure.</p><p><strong>Results: </strong>178 individuals were included: median age was 72 years (interquartile range 60-79), male sex majority (138, 78%) and mostly native valve endocarditis (108, 61%). Thirty-nine patients (22%) received monotherapy (penicillin/glycopeptide/linezolid/daptomycin), 128 (72%) combination with gentamicin, 11 (6%) combination with ceftriaxone. Patients on combination therapy with gentamicin had a statistically significant lower 30-day mortality than those treated with monotherapy (21 (16.4%) versus 15 (38.5%) p = 0.035) and higher rates of clinical cure (101 (78.9%) versus 23 (59.0%) p = 0.018). Patient receiving gentamicin were more likely to experience acute kidney injury (64 (50%) versus 11 (28.2%) p = 0.057). Ceftriaxone combination was associated with poor outcomes, but the sample size was small.</p><p><strong>Conclusion: </strong>Patients treated with combination gentamicin therapy had better clinical outcomes than patients treated with monotherapy. Low-dose gentamicin regimens were associated with acute kidney injury. Patients treated with combinations were different to those treated with monotherapy and confounding remains a concern with observational analyses. An adequately powered clinical trial is needed to determine optimal treatment of enterococcal endocarditis.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"92"},"PeriodicalIF":3.4,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999579","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":"Early onset neonatal bloodstream infections in South African hospitals.","authors":"Genevieve Theron, Adrie Bekker, Larisse Bolton, Andrew Whitelaw, Arnoldus Engelbrecht, Louisa Erasmus, Aaqilah Fataar, Chandre Geldenhuys, Marlize Kunneke, Dave Le Roux, Natasha O'Connell, Kessendri Reddy, Natasha Rhoda, Lloyd Tooke, Mark Wates, Thandi Wessels, Angela Dramowski","doi":"10.1186/s12879-024-10406-z","DOIUrl":"10.1186/s12879-024-10406-z","url":null,"abstract":"<p><strong>Background: </strong>Neonatal sepsis is a leading cause of death in low- and middle- income countries (LMIC). Increasing antibiotic resistance in early onset (< 72 h of life) bloodstream infection (EO-BSI) pathogens in LMIC has reduced the effectiveness of the recommended empiric antibiotic regimen (ampicillin plus gentamicin).</p><p><strong>Methods: </strong>We retrospectively analysed blood culture-confirmed EO-BSI episodes at nine neonatal units from three central and six peripheral hospitals in the Western Cape Province, South Africa between 1 January 2017 and 31 December 2018. Clinical and electronic laboratory records were reviewed to determine pathogen profile, empiric antibiotic coverage rates and factors associated with EO-BSI attributable mortality, stratified by hospital type.</p><p><strong>Results: </strong>Of the 8252 blood culture specimens submitted for the investigation of suspected EO-BSI, 136 EO-BSI episodes yielding 141 pathogens were identified with an EO-BSI rate of 1.3 and 0.5 episodes/1000 live births at central and peripheral hospitals respectively. Preterm (93/136; 68.3%) and low birth weight (84/136; 61.8%) neonates were most affected. The predominant pathogens were Streptococcus agalactiae (46/136; 34%), Klebsiella pneumoniae (17/136; 13%), Listeria monocytogenes (11/136; 8%), Acinetobacter baumannii (11/136; 8%) and Escherichia coli (11/136; 8%). The empiric antibiotic (ampicillin plus gentamicin) coverage rate was 64% (95% CI 51-74) at central hospitals and 84% (95% CI 74-94) at peripheral hospitals. Neonates with Gram-negative EO-BSI and discordant empiric antibiotic therapy had almost four-fold and three-fold higher odds of death respectively.</p><p><strong>Conclusion: </strong>Preterm and low birth weight neonates are most vulnerable to EO-BSI and have higher odds of death with Gram-negative pathogens and discordant empiric antibiotic therapy.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"85"},"PeriodicalIF":3.4,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999592","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}