BMC Infectious Diseases最新文献

{"title":"A gold nanoparticle/peptide vaccine designed to induce SARS-CoV-2-specific CD8 T cells: a double-blind, randomized, phase 1 study in Switzerland.","authors":"Juliette Besson, Régine Audran, Maxime Karlen, Alix Miauton, Hélène Maby-El Hajjami, Loane Warpelin-Decrausaz, Loredana Sene, Sylvain Schaufelberger, Vincent Faivre, Mohamed Faouzi, Mary-Anne Hartley, François Spertini, Blaise Genton","doi":"10.1186/s12879-025-10844-3","DOIUrl":"10.1186/s12879-025-10844-3","url":null,"abstract":"<p><strong>Background: </strong>New vaccines with broader protection against SARS-CoV-2 are needed to reduce the risk of immune escape and provide broad and long-lasting cellular immunity. The objectives of the naNO-COVID trial were to evaluate the safety and immunogenicity of a CD8 + T cell, gold nanoparticle-based, peptide COVID-19 vaccine.</p><p><strong>Methods: </strong>A randomized, double-blind, vehicle-controlled, phase 1 trial in healthy adults to receive PepGNP-Covid19 or Vehicle-GNP, followed over 180 days, using a dose-escalation strategy.</p><p><strong>Results: </strong>Twenty participants received PepGNP-Covid19 (low dose [LD] or high dose [HD], n = 10 each) and six Vehicle-GNP (LD or HD, n = 3 each). Vaccinations were safe. No serious adverse events were reported. Most of the adverse events were mild, two adverse events of special interest related to the product (fever and fatigue). Reactogenicity was similar overall between vaccine, comparator, and doses. Virus-specific humoral responses in LD PepGNP-Covid19 and Vehicle-GNP groups coincided with SARS-CoV-2 infections. PepGNP-Covid19 vaccination induced the modulation of Covid19-specific CD137 + CD69 + CD8 + , and an increase at day 35 particularly in central and effector memory T cells in LD group, and in late effector memory cells in HD group.</p><p><strong>Conclusions: </strong>The favourable safety profile and cellular responses observed support further development of PepGNP-Covid19.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov, NCT05113862, approved 09.11.2021.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"472"},"PeriodicalIF":3.4,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802288","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":"Correction: Standard versus double dosing of beta-lactam antibiotics in critically ill patients with sepsis: The BULLSEYE study protocol for a multicenter randomized controlled trial.","authors":"M M B Horstink, D R Geel, C A den Uil, P E Deetman, H Endeman, A Abdulla, T M Bosch, W J R Rietdijk, F W Thielen, J J Haringman, P van Vliet, T A Rijpstra, C Bethlehem, A Beishuizen, A E Muller, B C P Koch","doi":"10.1186/s12879-025-10877-8","DOIUrl":"https://doi.org/10.1186/s12879-025-10877-8","url":null,"abstract":"","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"473"},"PeriodicalIF":3.4,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802291","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":"Prevalence, antimicrobial sensitivity patterns and associated factors of urinary tract infection among patients attending Nekemte Comprehensive Specialized Hospital, Western Ethiopia, 2024: a cross-sectional study.","authors":"Abdi Diriba, Seifu Gizaw, Fedasan Alemu, Kume Tesfaye, Endalu Tesfaye, Motuma Chali, Girmaye Jobir","doi":"10.1186/s12879-025-10788-8","DOIUrl":"10.1186/s12879-025-10788-8","url":null,"abstract":"<p><strong>Background: </strong>Urinary tract infections (UTIs) are a common health problem worldwide, leading to increased morbidity, mortality, and healthcare costs. Data on the prevalence of urinary tract infections, antimicrobial susceptibility patterns, and the associated factors are scarce in the study area. Therefore, the aim of this study was to determine the prevalence, antimicrobial susceptibility patterns and associated factors among urinary tract infections suspected patients.</p><p><strong>Methods: </strong>A hospital-based cross-sectional study was conducted at Nekemte Comprehensive Specialized Hospital, from June to September 2024 among 270 participants. Midstream urine samples were collected under aseptic techniques. Then samples were cultured on blood and MacConkey agars following standard microbiological techniques. Antimicrobial sensitivity testing was performed using the disc diffusion (Kirby-Bauer) method. The data were checked for completeness and consistency, entered into Epi Data version 4.6, and analyzed by Statistical Package for Social Sciences (SPSS) version 26. Logistic regression analysis was performed to determine the associated factors of urinary tract infections. P-value < 0.05 was considered statistically significant.</p><p><strong>Result: </strong>Of the total samples collected, 78/270 (28.9%) had significant bacteriuria. Gram-negative and gram-positive bacteria accounted for 67/78 (85.9%) and 11/78 (14.1%), among which Escherichia coli was the most prevalent, 30/78 (38.5%), followed by Klebsiella species, 26/78 (33.3%). Gram-positive isolates were highly susceptible to gentamicin (100%) and clindamycin (88.9%). Gram-negative bacteria showed high-level susceptibility to amikacin (100%), cefepime (93.3%), and gentamicin (91.0%). The total multidrug resistance identified was 44/78 (56.4%). Female gender, a having history of UTI, and antibiotic use without a prescription were statistically significant with UTI. CONCLUSION AND RECOMMENDATION: Most of the isolated uropathogens were multidrug-resistant. A significant association with UTI was observed with being female, having a previous history of UTI, and using antibiotic without a prescription. Treatment of UTI should be supported by culture and antimicrobial susceptibility patterns.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"474"},"PeriodicalIF":3.4,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802292","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":"Age-specific relationship between HIV and TB treatment outcomes in the West Region of Cameroon: a cross-sectional study.","authors":"Solange Mudih Ngala, Disline Manli Tantoh, Oswald Ndi Nfor, Gamo Djouomo Francis, Adeline Fitame, Yen-Wei Chu","doi":"10.1186/s12879-025-10860-3","DOIUrl":"10.1186/s12879-025-10860-3","url":null,"abstract":"<p><strong>Background: </strong>Co-infection with Mycobacterium tuberculosis (M. tuberculosis) and Human Immunodeficiency Virus (HIV) poses significant global public health challenges, with varying impacts across age cohorts. Evaluating tuberculosis (TB) treatment outcomes, especially among HIV patients across different age groups, is crucial for effective TB management. This study assessed the age-specific relationship between HIV status and TB treatment outcomes among TB patients in Cameroon.</p><p><strong>Methods: </strong>This cross-sectional study included 2,455 TB patients receiving treatments in the West Region of Cameroon between January 2015 and December 2019. Data were extracted from National Tuberculosis Program Registers. The association of TB treatment outcomes with HIV and age was assessed using multivariate logistic regression.</p><p><strong>Results: </strong>TB-HIV co-infection was significantly associated with lower TB treatment success. For HIV patients on antiretroviral therapy (ART), the odds ratio (OR) was 0.463 (95% confidence interval [CI]: 0.367-0.583, Bonferroni-adjusted P < 0.001). For HIV patients not on ART, the OR was 0.077 (95% CI: 0.030-0.200, Bonferroni-adjusted P < 0.001). A significant trend (P < 0.001) further indicated a consistent association between TB-HIV co-infection and treatment status. Older age was significantly associated with slightly lower treatment success (OR: 0.976; 95% CI: 0.969-0.983, Bonferroni-adjusted P < 0.001). TB-HIV co-infection remained significantly associated with lower TB treatment success after age categorization (OR; 95% CI, Bonferroni-adjusted P = 0.498; 0.394-0.631, < 0.001 for HIV patients on ART and 0.081; 0.032-0.210, < 0.001 for those without ART). The interaction between age and HIV was significant (P < 0.001). Age stratification revealed a significantly lower treatment success among HIV patients aged 25 and above, especially those not taking ART: OR (95% CI, Bonferroni-adjusted P) = 0.101 (0.032-0.312, < 0.001) and 0.038 (0.004-0.322, 0.025) for 25-44 and ≥ 45 years, respectively.</p><p><strong>Conclusion: </strong>In this study, HIV status and older age were jointly associated with lower TB treatment success. Notably, treatment success was lower among HIV-positive patients aged 25 and above, especially those not on ART. Effective patient management, routine follow-up, and integration of TB and HIV services could improve TB treatment outcomes, particularly among adult HIV patients not taking ART.</p><p><strong>Trial registration: </strong>Not applicable. This study is observational.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"475"},"PeriodicalIF":3.4,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802289","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":"Rubella seroprevalence among women of childbearing age in Tunis, Tunisia.","authors":"Mouna Louiza Ben Moussa, Manel Hamdoun, Hamza Cherni, Olfa Bahri","doi":"10.1186/s12879-025-10843-4","DOIUrl":"10.1186/s12879-025-10843-4","url":null,"abstract":"<p><strong>Background: </strong>Rubella is considered as a benign childhood infection. Congenital rubella syndrome (CRS) can result from the virus's teratogenic potential, making the infection dangerous for pregnant women, particularly in the first trimester. Immunization is the only effective prevention against rubella and CRS in the absence of specific treatment. Since 2005, the rubella vaccine has been available in Tunisia. This study aimed to assess, eighteen years after the implementation of the program's vaccination in the country, its effect on rubella seroprevalence in women of reproductive age.</p><p><strong>Methods: </strong>This retrospective cross-sectional study was performed from January 2021 to December 2023 at Aziza Othmana Hospital (Tunis), which has one of the biggest obstetrical and assisted medical procreation units in Tunisia. Each woman consulting in one of these two units was screened for rubella-IgG antibodies by electrochemiluminescence assay using the Elecsys Rubella IgG Kit and the Cobas e411 analyzer (Roche Diagnostics^®, Mannhein). Woman was considered immunized when titer of IgG was ≥ 10 UI/mL. All samples with titers over 500 UI/mL were tested for specific IgM by the same method.</p><p><strong>Results: </strong>During the study period, 1652 women were enrolled; their age ranged from 18 to 46 years old (33.4 ± 5.3 years). Overall, the proportion of women who were protected against rubella was 93.9%; it was significantly higher among those who were part of the immunization programs (96.6% vs. 93.2%; p = 0.01). The median level of Rubella IgG in this first group was 175 ± 159 IU/mL. Women, who were not caught up by the strategy of vaccination, were seronegative in 6.8% of cases. Rubella IgM antibodies were negative in all the 143 cases tested excluding recent infection.</p><p><strong>Conclusion: </strong>These findings demonstrate the effectiveness of the rubella vaccine, which is administered systematically as part of the national immunization schedule in all one-year-old infants. Nonetheless, the persistent vulnerability for rubellain susceptible women in their reproductive years highlights the importance of their vaccination during the pre-conception or in early postpartum phases.</p><p><strong>Clinical trial: </strong>Not applicable, as this study is not a clinical trial.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"470"},"PeriodicalIF":3.4,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802295","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":"Serum sST2: key biomarkers in COVID-19 patients with implications for coronary artery disease.","authors":"Xueqin Li, Yaxin Tian, Hongyan Cao, Jinfang Cheng","doi":"10.1186/s12879-025-10849-y","DOIUrl":"10.1186/s12879-025-10849-y","url":null,"abstract":"<p><strong>Background: </strong>As the coronavirus disease-2019 (COVID-19) pandemic persists, post-COVID-19 syndrome (PS), characterized by symptoms like chest pain, fatigue, and palpitations, is becoming a significant medical and social issue. COVID-19 patients with existing coronary artery disease (CAD) may face higher risks of complications. It is crucial to assess if PS patients also have CAD, though data is limited.</p><p><strong>Methods: </strong>We studied 75 COVID-19 patients and 68 non-COVID-19 patients admitted to our hospital between 2022/12/20 to 2023/01/20. Demographic, laboratory, and clinical data were collected upon admission. The Gensini score (GS) was used to assess coronary atherosclerosis severity. Patients were categorized by GS and clinical traits to identify potential independent risks linked to CAD and COVID-19 severity.</p><p><strong>Results: </strong>COVID-19 patients with existing CAD had higher levels of serum soluble growth stimulation expression of gene 2 protein (sST2), myeloperoxidase, ALT, AST, PT, B-type natriuretic peptide (BNP), and hypersensitive troponin-I (hs-cTnI), along with longer hospital stays, more ICU admissions, and increased heart failure and ACS morbidity compared to those without CAD. Univariate and multivariate analysis identified sST2 as an independent risk factor for COVID-19 patients with coexisting CAD (odds ratio 1.122). sST2 levels were positively correlated with coronary angiography GS (r = 0.474, p < 0.001) in COVID-19 patients and were significantly higher in cases with GS ≥ 32, regardless of COVID-19 status (p < 0.001) and specifically in COVID-19 patients (p = 0.006). ROC analysis showed sST2 predicted ICU admission, hospital stay duration, and morbidity of HF and ACS similarly to GS.</p><p><strong>Conclusions: </strong>Admission serum sST2 levels should be considered in COVID-19 patients with CAD-like symptoms for treatment planning and could serve as a prognostic biomarker for COVID-19 with co-existing CAD in clinical practice.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"471"},"PeriodicalIF":3.4,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802296","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":"Lung and gut microbiota profiling in intensive care unit patients: a prospective pilot study.","authors":"Antonios Kritikos, Eric Bernasconi, Yangji Choi, Valentin Scherz, Jean-Luc Pagani, Gilbert Greub, Claire Bertelli, Benoit Guery","doi":"10.1186/s12879-025-10825-6","DOIUrl":"10.1186/s12879-025-10825-6","url":null,"abstract":"<p><strong>Background: </strong>The gut and lung microbiomes play crucial roles in host defense and mayserve as predictive markersfor clinical outcomes in critically ill patients. Despite this, the simultaneous dynamics of lung and gut microbiomes during critical illness remain unclear. This study aims to assess the longitudinal changes in lung and gut microbiota among mechanically ventilated ICU patients with and without infection and to identify microbial features predictive of clinical outcomes, including the development of ventilator associated pneumonia (VAP).</p><p><strong>Methods: </strong>In this prospective observational study, we analyzed 73 endotracheal aspirates (ETA) and 93 rectal swabs collected from 38 ICU patients over multiple timepoints (intubation, infection onset, post-antibiotic, and extubation/discharge). Patients were categorized into three groups: (1) VAP, (2) other infections, and (3) uninfected controls. Lung and gut microbiota were characterized using 16S rRNA gene sequencing. Primary outcomes included microbial diversity and community composition; secondary outcomes included ICU length of stay and ventilator-free days.</p><p><strong>Results: </strong>Alpha diversity declined more significantly in infected patients than in controls during the ICU stay, with the most pronounced changes in lung microbiota. We found an enrichment of Enterobacteriaceae and other Proteobacteria in the lung microbiome of pneumonia patients, while the gut microbiota remained relatively stable. Relative abundances of key taxa such as Mogibacterium were associated with mechanical ventilation duration.</p><p><strong>Conclusions: </strong>This study reveals that distinct microbial patterns in both lung and gut microbiota are associated with infection and clinical outcomes in critically ill patients. Understanding these dynamics is crucial for developing targeted microbiota interventions, potentially improving outcomes such as VAP prevention and management.</p><p><strong>Trial registration: </strong>Ethics Committee of Canton Vaud, Switzerland (2017-01820).</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"468"},"PeriodicalIF":3.4,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11972518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787447","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":"Clinical efficacy of linezolid in the treatment of tuberculous meningitis: a retrospective analysis and literature review.","authors":"Zhen-Tao Fei, Wei Huang, Dan-Ping Zhou, Yang Yang, Ping Liu, Ning Gan, Ping-Ping He, Dan Ye, Hua-Rui Liu, Xu-Hui Liu, Lu Xia","doi":"10.1186/s12879-025-10874-x","DOIUrl":"10.1186/s12879-025-10874-x","url":null,"abstract":"<p><strong>Background: </strong>Tuberculous meningitis (TBM) is the most severe form of tuberculosis, with high morbidity and mortality. This retrospective study evaluates the clinical efficacy of linezolid in patients with TBM.</p><p><strong>Methods: </strong>We analyzed 99 TBM patients treated at the Shanghai Public Health Clinical Center from June 2013 to March 2020. Patients were divided into two groups: those receiving standard therapy (n = 43) and those receiving standard therapy plus linezolid (n = 56). Clinical outcomes, cerebrospinal fluid parameters, and adverse events were assessed.</p><p><strong>Results: </strong>Of the included patients, 42.4% were female, and the median age was 24.00 (7.00-44.00) years. Baseline characteristics between the two groups were comparable. After six months of treatment, both groups showed improvements in cerebrospinal fluid parameters, with no significant differences in intracranial pressure, white blood cell count, glucose, or chloride levels (all P > 0.05). Adding linezolid significantly reduced cerebrospinal fluid protein levels compared to the standard therapy group (0.873 [0.228-1.591] g/L vs. 0.172 [-0.691-0.559] g/L, P = 0.018), correlating with better 6-month survival (adjusted OR 1.850, 95% CI 1.111-3.081, P = 0.018), with a stronger effect in critically ill patients (1.010 [0.257-2.019] g/L vs. 0.121 [-0.556-0.510] g/L, P = 0.004). Although intracranial lesion resolution rates were higher in the linezolid group, they were not statistically significant (P > 0.05). Adverse event rates were similar between groups (16.1% vs. 18.6%, P = 0.392).</p><p><strong>Conclusion: </strong>Linezolid appears to offer clinical benefits in managing TBM, particularly in critically ill patients, warranting further prospective studies to optimize treatment protocols.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"467"},"PeriodicalIF":3.4,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11972499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787410","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":"Characterization of urinary tract infections among females at a tertiary hospital in Malawi: a retrospective study.","authors":"Pizga Kumwenda, Precious Semu","doi":"10.1186/s12879-025-10842-5","DOIUrl":"10.1186/s12879-025-10842-5","url":null,"abstract":"<p><strong>Background: </strong>Urinary tract infections (UTIs) are among the most common infections in females, with many experiencing at least one episode in their lifetime. About 150 million cases of UTIs occur each year. Lately, the prognosis of UTIs has been poor, largely due to a rise in antimicrobial resistance among common uropathogens. The present study was conducted to describe UTIs in female clients at Zomba Central Hospital in Malawi.</p><p><strong>Methods: </strong>This was a retrospective cross-sectional study where 340 records of women suffering from UTIs were evaluated. Records were analysed for demographic characteristics, the causative agent of UTIs and their antimicrobial susceptibility profile. Data were cleaned and analysed in Excel 2016.</p><p><strong>Results: </strong>The overall prevalence of UTIs was 48.53%, with age group 15-45 having a higher frequency (53.33%) than other age groups. The most frequently isolated bacteria were Escherichia coli (27.2%), Staphylococcus species (26.5%), Enterobacter species (19.2%), Citrobacter freundii (11.9%), Proteus species (6.0%), Enterococcus species, and Serratia marcescens (4.6%). Comparatively, meropenem and amikacin were effective against most pathogens showing average sensitivity rates of 51% and 56% respectively. Nevertheless, high levels of resistance to ampicillin (87%), ceftriaxone (77%) ciprofloxacin (70%), gentamicin (77%), and cefoxitin (64%) were observed.</p><p><strong>Conclusion: </strong>UTIs remain a significant health concern among females at Zomba Central Hospital, particularly in the reproductive age group. The high prevalence of multidrug-resistant uropathogens, especially against commonly used antibiotics like ampicillin and ceftriaxone, underscores the urgent need for regular antimicrobial resistance surveillance and evidence-based antibiotic stewardship to guide effective treatment strategies.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"466"},"PeriodicalIF":3.4,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787697","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":"Higher prevalence of pulmonary tuberculosis revealed by Xpert MTB/RIF ultra among drug users in Kinshasa, Democratic Republic of Congo.","authors":"Guillaume Bandjondo Nkisi, Doudou Malekita Yobi, Bive Bive Zono, Pius Zakayi Kabututu, Tite Minga Mikobi, Serge Fueza Bisuta","doi":"10.1186/s12879-025-10853-2","DOIUrl":"10.1186/s12879-025-10853-2","url":null,"abstract":"<p><strong>Introduction: </strong>The Democratic Republic of Congo (DRC) is one of the eight countries with the highest burden of tuberculosis (TB) in the world. The public health system is inadequate and the screening for TB in the key and vulnerable population (KVP), including drug users (DU) is not currently done. The present study aimed to determine the prevalence of pulmonary TB among DU in Kinshasa by comparing molecular tests with microscopic techniques.</p><p><strong>Methods: </strong>A cross-sectional study covering 22 townships (out of 24) of Kinshasa was conducted from October to December 2023. Sputum samples were collected from DUs aged ≥ 18 years, clinically suspected of TB, and attending drug consumption sites. The samples were analyzed by both the Acid-fast bacilli (AFB)-Nelseen hot staining and Xpert MTB/RIF Ultra for TB and rifampin-resistance diagnosis.</p><p><strong>Results: </strong>For 399 DUs included in the study, the age range was from 18 to 77 years old, with a median of 31 (IQR: 25-39). Among these DUs, 359 (89%; 95% CI: 86.64- 92.55%) were male. TB prevalence was 3.5% (95% CI: 1.9-5.8%) when the AFB-Nelseen hot staining was used for diagnosis. However, the prevalence was significantly higher at 13.8% (95% CI: 10.6-17.6%) with the Xpert MTB/RIF test (p = 0.000). Xpert MTB-RIF Ultra contributed with an added value of 82% (95% IC: 79.25- 86.47%) to the diagnosis of TB in DUs. The KAPPA test showed a low concordance at 25%. Alcohol, diazepam and tobacco consumption have been identified as practical risks associated with the onset of pulmonary TB (p < 0.05).</p><p><strong>Conclusion: </strong>DUs are a population at risk of TB that should not be neglected among all KVPs in Kinshasa. In this specific population, the determination of TB prevalence was significantly improved with the use of Xpert MTB/RIF Ultra compared to hot AFB-Neelsen staining. Among the DU included in the present study, those who habitually consumed alcohol in its different forms, diazepam for non-medical purposes, and tobacco, were significantly more infected than the others. DUs should be considered for systemic screening for pulmonary TB alongside other key populations such as people living with HIV and Xpert should be maintained as a first-line test instead of microscopy. Further studies also including asymptomatic participants are needed to assess the burden due to pulmonary TB in DUs as well as in their living environment.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"464"},"PeriodicalIF":3.4,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787430","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}