BMC Infectious Diseases最新文献

{"title":"An update on toxocariasis in Reunion Island: a retrospective study.","authors":"Fanny Rezungles, Anissa Desmoulin, Yatrika Koumar, Fanny Andry, Rodolphe Manaquin, Patrice Poubeau, Maissa Safiedrine Kassir, Sandrine Picot, Claire Chassagne, Kevin Diallo","doi":"10.1186/s12879-025-11317-3","DOIUrl":"https://doi.org/10.1186/s12879-025-11317-3","url":null,"abstract":"<p><strong>Background: </strong>Although toxocariasis is ubiquitous, its prevalence varies around the world, and even within the same region. In Reunion Island, its seroprevalence was 93% in the late eighties. This study aimed to update these data and to describe the characteristics of patients who underwent Toxocara canis serology in Reunion Island University Hospital.</p><p><strong>Methods: </strong>This retrospective study evaluated all patients who underwent T. canis serology in Reunion Island University Hospital in 2021. The seroprevalence was calculated and the characteristics of patients were compared between cases and controls.</p><p><strong>Results: </strong>A total of 126 patients underwent T. canis serology, mainly for ocular symptoms (47%) and eosinophilia (25%). Of these, 34 (27%) had positive serology and were statistically more likely to be treated (p = 0.07); however, there was no significant difference in improvement between the two groups.</p><p><strong>Conclusions: </strong>Given the decrease in T. canis seroprevalence over the past 30 years, T. canis serology appears to be regaining interest in helping to diagnose patients suspected of infection.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"934"},"PeriodicalIF":3.4,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688848","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":"The contribution of TB rapid diagnostic testing in reducing TB-related mortality in Sub-Saharan Africa- in both Person-Living with HIV and HIV-Negative populations: A 9-year quantitative retrospective analysis.","authors":"Fru McWright Chi, Henri Claude Moungui, Nelson Agweh Musaga, Bertrand Hugo Mbatchou-Ngahane","doi":"10.1186/s12879-025-11310-w","DOIUrl":"10.1186/s12879-025-11310-w","url":null,"abstract":"<p><strong>Background: </strong>A potential contributor to achieving WHO's \"End-TB\" goal of 90% reduction in TB related mortality by 2030, is scale-up of TB Rapid Diagnostic Testing (RDT). Our study evaluated the contribution of RDTs' in reducing TB-related mortality in both PLHIV and the HIV-negative population, from 2015 to 2023 in Sub-Saharan Africa (SSA).</p><p><strong>Methods: </strong>We carried out an 9-year quantitative retrospective analysis of country-level data (annual WHO TB reports) for all countries in SSA reporting to the WHO. We estimated the following parameters: incidence, notification, percentage of undiagnosed TB patients, percentage diagnosis with RDTs, and TB-related mortality. We stratified the reports according to TB incidence (creating incidence strata) and limited further analysis to reports where the percentage of undiagnosed individuals was 30% or less. We then used scatter plots to examine the existence of a relationship between the use of RDTs and TB-related mortality, and quantified the observed relationships via linear regression models.</p><p><strong>Results: </strong>Over the nine years, SSA made great strides toward the 2025 milestones of End-TB disease burden-related targets; TB disease incidence decreased by 14%; TB-related mortality decreased by 27.2%; and TB/HIV-related mortality decreased by 64.1%. Similarly, RDT became the priority TB disease diagnostic modality (66.0% in 2023). We found a consistent inverse relationship between RDT scale-up and TB-related mortality in the HIV-negative population, which was significantly stronger in the higher TB incidence settings (R2 = 0.692, P = 0.003). Following adjustments (R² = 0.883, P = < 0.001), independent predictors of TB related mortality in this population were TB RDT use, TB incidence, TB notification, percentage undiagnosed TB and percentage with drug resistant TB. In contrast, the relationship was weaker and inconsistent in the PLHIV population and was significant only where the TB incidence among PLHIV was very high (R2 = 0.541, P = 0.0239). Following adjustments (R² = 0.944, P < 0.001), just TB incidence and TB treatment coverage in PLHIV were independent predictors of TB mortality in this population.</p><p><strong>Conclusions: </strong>This study provides support about the anticipated contributions of RDTs in decreasing TB-related mortality in SSA, highlighting the importance of maximum scaleup (addressing underdiagnosis of TB) and limiting the biased prioritization of PLHIV for these RDTs.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"929"},"PeriodicalIF":3.4,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144681920","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":"Determination of the effect of pyocyanin and Saccharomyces boulardii on gut microbiota and TLR4/MyD88/NF-κB and NLRP3 signaling pathways in sepsis induced by cecal ligation and puncture in rats.","authors":"Mahmut Ucar, Ozgur Celebi, Demet Celebi, Sumeyye Baser, Mustafa Can Guler, Ayhan Tanyeli, Metin Kılıclıoglu, Ahmet Yılmaz, Serkan Yıldırım","doi":"10.1186/s12879-025-11308-4","DOIUrl":"10.1186/s12879-025-11308-4","url":null,"abstract":"<p><p>Sepsis is a life-threatening systemic inflammatory condition marked by a dysregulated host response to infection. The intestinal microbiota plays a pivotal role in maintaining immune homeostasis and epithelial barrier integrity, whereas dysbiosis significantly contributes to the pathogenesis of sepsis. This study investigates the effects of the Pseudomonas aeruginosa-derived metabolite Pyocyanin and the probiotic Saccharomyces boulardii (S. boulardii) on microbial composition and the TLR4/MyD88/NF-κB/NLRP3 signaling axis in a cecal ligation and puncture (CLP)-induced rat model of sepsis. The experimental design assessed the synergistic or antagonistic effects of single and combined treatments using molecular, microbiome, and immunohistochemical parameters to evaluate histopathological damage and microbial ecological dynamics. Seven experimental groups were established following CLP. Intra-abdominal Pyocyanin (10 nmol/g) and oral probiotic (10⁶ CFU/kg) treatments were administered either individually or in combination. Focused Ion Beam - Scanning Electron Microscopy (FIB-SEM) analyses revealed that the amorphous structure of Pyocyanin interacted with the surface of S. boulardii. Western blot analysis showed a 2.3-fold increase in TLR4/NF-κB expression in the CLP group (p ≤ 0.05), which synergistically rose to 4.5-fold with Pyocyanin (p ≤ 0.001), whereas probiotic treatment decreased expression levels by 35%. According to 16 S rRNA sequencing, Pyocyanin reduced α-diversity by increasing Lactobacillaceae abundance to 32.66% (Shannon index: 3.598 vs. 4.433 in control), while S. boulardii enhanced β-diversity by elevating Coriobacteriaceae (5.85%) and Prevotellaceae (10.63%) levels (Tables 2, 3 and 4). PCoA confirmed 41.7% Bray-Curtis dissimilarity between groups at the species level (PERMANOVA R²=0.38, p = 0.002). Histopathologically, severe hepatocyte necrosis (73.2 ± 6.1%, p = 0.0022) and a 4.2-fold increase in hepatic TGF-β expression were observed in the CLP group, whereas epithelial barrier damage was significantly attenuated in the probiotic groups. Immunofluorescence analysis revealed that combined treatment reduced Caspase-8 and TLR4 expression by 28% compared to Pyocyanin alone (p ≤ 0.05). In conclusion, S. boulardii supported microbiota homeostasis by suppressing TLR4/NF-κB signaling, whereas Pyocyanin exacerbated the inflammatory response via NLRP3 activation. These findings provide molecular evidence supporting probiotic-assisted immunomodulatory strategies in sepsis therapy.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"931"},"PeriodicalIF":3.4,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12281731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144681917","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":"HIV self-testing - the path from an innovation to a necessity.","authors":"Muhammad S Jamil, Cheryl Johnson, Karin Hatzold, Thato Chidarikire, Elizabeth L Corbett, Rachel Baggaley, Vincent J Wong","doi":"10.1186/s12879-025-11272-z","DOIUrl":"10.1186/s12879-025-11272-z","url":null,"abstract":"","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"930"},"PeriodicalIF":3.4,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144681918","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":"Respiratory microbiome alterations, coinfections and virus intra-host evolution in a persistently active SARS-CoV-2 infection.","authors":"Lučka Boltežar, Rok Kogoj, Katarina Resman Rus, Alen Suljič, Martin Bosilj, Nataša Knap, Polonca Mali, Janez Tomažič, Tatjana Avšič-Županc, Misa Korva","doi":"10.1186/s12879-025-11355-x","DOIUrl":"10.1186/s12879-025-11355-x","url":null,"abstract":"<p><strong>Background: </strong>Respiratory microbiome alterations, coinfections, and virus intrahost evolution are of great interest in persistently viable SARS-CoV-2 infections in the context of antiviral treatment and immune response. However, samples before, during, and after infection are seldom available to researchers. Therefore, there has been a significant lack of opportunities to comprehensively study microbiota homeostasis, coinfections, and virus intra-host evolution on the consensus and minor variants scale in response to antiviral treatments and patient immune response.</p><p><strong>Case presentation: </strong>A 63-year-old female patient with diffuse large B-cell lymphoma received multiple treatments for SARS-CoV-2 that remained active 169 days. Together, 32 respiratory and 19 serum samples were collected before, during, and after (- 398 to 233 days) COVID-19. Subsets were selected for virus viability testing by culture (20) and subgenomic (sg) RNA (20) measurement, intra-host evolution assessment (18), microbiome composition analysis (28), and coinfection identification (11). IgA/IgG and neutralizing anti-SARS-CoV-2 antibodies were measured 19 times throughout the infection. SARSCoV-2 lineage XBB.1.16.11 persisted and remained viable until 116 days post infection (PI) regardless of treatments. No sgRNA marker tested was suitable for virus viability prediction. IgG/IgA antibodies first appeared after 38 days, but the virus persisted regardless of multiple plasma treatments before neutralizing antibodies appeared (100 days PI) and finally cleared the virus 116 days PI. Consensus-level mutations fluctuated around 102.7 ± 4.0, and minor variants increased from six to 61 with a mutation rate of 4.9 × 10^-3 per site per year, with the highest average number of mutations per gene length in S and E (0.013) with surges after every antiviral treatment. The transversion/transition ratio increased from 0.50 (day 0) to 0.57 (day 24) with a steady decrease to 0.48 (day 147). Mutational signature analysis showed dominance of C > T substitutions consistent with APOBEC antiviral enzyme activity. Upper respiratory microbiota showed three distinct profiles with varying α-/β-diversity and an association of Staphylococcus spp. with COVID-19.</p><p><strong>Conclusions: </strong>These findings further elucidate the dynamics of intra-host viral evolution and complexities of virus clearance in individuals with hematological malignancies and highlight the impact of antiviral treatments on the potential of virus variants emergence in longitudinally infectious patients due to delayed immune response.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"932"},"PeriodicalIF":3.4,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12281699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144681919","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":"Prognostic value of albumin-corrected anion gap in critically ill patients with sepsis-associated liver injury: a retrospective study.","authors":"Jianjun Wang, Yonghai Peng, Zhaohui Hu, Xi Chen, Sirui Chen, Pei Yang, Xintao Zeng, Decai Wang","doi":"10.1186/s12879-025-11321-7","DOIUrl":"10.1186/s12879-025-11321-7","url":null,"abstract":"<p><strong>Background: </strong>Albumin-corrected anion gap (ACAG) is closely associated with the prognosis of many critical illnesses. However, the prognostic value of ACAG in sepsis-associated liver injury (SALI) is poorly understood. We explored the association between ACAG and patient prognosis in individuals diagnosed with SALI.</p><p><strong>Methods: </strong>Data from patients with SALI admitted to the intensive care unit (ICU) between 2008 and 2022 were retrospectively analyzed. ACAG was calculated based on the first measurement of the anion gap and albumin level within 24 h of admission. The optimal cutoff value for ACAG was established using R statistical software. Kaplan-Meier analysis was conducted to compare mortality risks between the two groups, while multivariable Cox proportional hazards regression models were employed to examine the association between ACAG and mortality risk in SALI patients. To assess a potential dose-response relationship, restricted cubic splines (RCS) were applied. Lastly, subgroup analyses were carried out to investigate the correlation between ACAG levels and prognosis across different patient populations.</p><p><strong>Results: </strong>A total of 443 critically ill patients with SALI were included in the lower (n = 342) and higher ACAG (n = 101) groups based on ACAG levels. No statistically significant differences were observed between the two groups regarding age, sex, or ethnicity (P = 0.12, 0.84, and 0.85, respectively). However, patients in the higher ACAG group exhibited a greater propensity for developing respiratory failure. The rates of ICU, in-hospital, 14-day, 28-day, and 90-day mortality were significantly elevated in the higher ACAG group (all P < 0.001). Higher ACAG levels were significantly associated with an increased mortality risk at multiple time points (all P < 0.001). ACAG levels and mortality showed a significant linear relationship. The impact of ACAG on mortality risk remained consistent across subgroups defined by age, sex, hypertension, diabetes, and respiratory failure, with no significant interactions observed (all P for interaction > 0.05).</p><p><strong>Conclusion: </strong>ACAG serves as a significant independent predictor of mortality risk in patients with SALI. ACAG predicts both short-term mortality risk (such as ICU mortality) and long-term mortality risk (such as 90-day mortality). ACAG may serve as a valuable tool for prognostic assessment in patients with SALI with broad applicability.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"928"},"PeriodicalIF":3.4,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667015","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":"COVID-19 infection and its association with severe malaria & dengue: an epidemiological study from Southern India.","authors":"Sara J Ommen, Prasanna Mithra, Rekha T, Nithin Kumar, Ramesh Holla, Naveen Kulal, Mithun Rao, Bhaskaran Unnikrishnan","doi":"10.1186/s12879-025-11324-4","DOIUrl":"10.1186/s12879-025-11324-4","url":null,"abstract":"<p><strong>Background: </strong>Post-Coronavirus Disease-19 (COVID-19) sequelae involve complex biological processes that can alter the progression and clinical outcome of other infectious diseases. However, there is no documented information on the influence of COVID-19 on the development of severe malaria and dengue. Hence, this study was conducted to determine the association between malaria & dengue and previous COVID-19 infection among the adult population of Mangalore Taluk and to describe the socio-demographic and clinical correlates of malaria & dengue.</p><p><strong>Methods: </strong>This case-control study was conducted among 293 participants who were positive for either malaria or dengue from November 2022 to August 2024. Data were collected using a proforma which contained sections on demographic details, clinical profile and comorbidities, history of COVID-19 infection and COVID-19 vaccination status. The participants were categorised into having severe disease and mild to moderate disease based on operational definitions. The data were analysed using the Statistical Package for Social Sciences (SPSS) version 29. Chi-square test was done, and a p-value less than 0.05 was considered statistically significant. Binary Logistic Regression analyses were used and odds ratios were estimated.</p><p><strong>Results: </strong>A total of 293 participants were included in the study with a mean age of 36.7 (SD:14.8) years. Among them, 23.9% (n = 70) had malaria and 76.1% (n = 223) had dengue. Out of those who had malaria, 30% (n = 21) developed severe illness, whereas among those who had dengue 35.8% (n = 80) developed severe dengue. Overall, 58.4% (n = 171) were in the age group of > 30 years. In total, 98.1% (n = 52) of the participants with dengue fever with a history of COVID-19 infection developed severe dengue, (aOR:55.93 (95% CI:7.17-435.92) p < 0.001) compared to those without. Similarly, 85.7% (n = 12) of the participants with a history of COVID-19 infection developed severe malaria (aOR: 263.7 (95% CI: 34.9-1987.4) p < 0.001) compared to those and these differences were found to be statistically significant. In addition, those participants belonging to lower socio-economic classes had higher chances of developing severe dengue than those belonging to the upper socio-economic class (p < 0.001*).</p><p><strong>Conclusion: </strong>Those with a prior history of COVID-19 infection had higher chances of developing severe malaria and dengue than those without a history of COVID-19 infection.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"927"},"PeriodicalIF":3.4,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of COVID-19 control measures on influenza positivity among patients with acute respiratory infections, 2018-2023: an interrupted time series analysis.","authors":"Wei Chen, Huabin Wang, Xianlin Ten, Miao Fu, Meili Lin, Xiaoping Xu, Yongjun Ma","doi":"10.1186/s12879-025-11279-6","DOIUrl":"10.1186/s12879-025-11279-6","url":null,"abstract":"<p><strong>Background: </strong>After experiencing the global COVID-19 pandemic, whether there have been new changes in the epidemiological characteristics of influenza has become a topic of great concern. This study aims to investigate the impact of implementation and lifting of COVID-19 control measures on influenza positivity among patients with acute respiratory infections (ARI) from 2018 to 2023.</p><p><strong>Methods: </strong>The data were collected from January 2018 to December 2023 in two designated sentinel hospitals in Jinhua. We performed an interrupted time series analysis (ITSA) using a beta regression model and a generalized additive model (GAM), adopting a two-model cross-validation strategy to assess the effect of two major interventions on influenza positivity: the COVID-19 control measures implemented in early 2020 and lifted at the end of 2022. We also analyzed influenza epidemiological characteristics and seasonality before, during, and after the pandemic.</p><p><strong>Results: </strong>A total of 98,244 cases were included in this study, and the overall influenza positivity rate was 39.34%. Females and the 6-17-year age group had higher positivity rates. Before the pandemic, influenza primarily showed a winter peak pattern, whereas during the pandemic, the positivity rate declined significantly with no distinct peak. After the pandemic ended, an unusual dual-peak pattern emerged. The interrupted time series analysis revealed that, following the implementation of non-pharmaceutical interventions (NPIs) in early 2020, influenza positivity immediately decreased significantly in the beta regression model (β = -1.75, p = 0.003). After the lifting of measures in late 2022, a marginally lagged increasing trend was observed in the beta regression model (β = 0.14, p = 0.096) and a significant increasing trend was found in the GAM model (edf = 7.00, p < 0.001). Seasonal effects differed between the models: the beta regression model exhibited significant annual seasonal fluctuations (sin12 = 0.67, p < 0.001), while the GAM model did not exhibit a significant association independent of the time trend.</p><p><strong>Conclusion: </strong>COVID-19 and its control measures substantially reduced influenza positivity rates; however, once these measures were lifted, influenza activity resurged, and its seasonal epidemic pattern changed. The intensity of influenza appeared to exceed pre-pandemic levels, underscoring the importance of NPIs in controlling respiratory infectious diseases. Strengthened surveillance and optimized strategies remain necessary to mitigate the threat of influenza in the post-pandemic era.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"925"},"PeriodicalIF":3.4,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667013","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":"Pre-COVID-19 epidemiology of community respiratory viruses at a single US center reveals sex differences in influenza A and a higher ICU incidence of human metapneumovirus in the elderly population.","authors":"Bibek Koirala, Aline Azar, Brianna Fountain, Melissa McGuirl, Shannon Stock, Marzena Galdzicka, Richard T Ellison","doi":"10.1186/s12879-025-11307-5","DOIUrl":"10.1186/s12879-025-11307-5","url":null,"abstract":"<p><strong>Background: </strong>Few studies have simultaneously examined the epidemiology and sex differences of diverse community respiratory viruses, including human metapneumovirus (HMPV), over more than one season.</p><p><strong>Methods: </strong>Given that molecular testing for community respiratory viruses was widely performed on patients at UMass Memorial Medical Center between January 2010 and December 2013, a retrospective study was conducted to examine epidemiologic features of positive subjects. Initial testing was done with rapid influenza and respiratory syncytial (RSV) virus antigen testing, with negative testing reflexed to a multiplex nucleic acid amplification platform detecting nine respiratory viruses.</p><p><strong>Results: </strong>Four thousand ninety-eight (50.6%) of 8092 patients tested positive for at least one virus. The majority (75.3%) of individuals testing positive were inpatients. Rhinovirus/enterovirus was most frequently detected; influenza A was more common in older adults and RSV incidence was highest among patients < 5 years of age. Pronounced seasonality was seen with influenza viruses, RSV, HMPV, and parainfluenza 3 virus. Influenza A was significantly more common in females (11.2% vs. 8.1%; p < 0.001), while parainfluenza 1 virus (2.0% vs. 1.2%; p < 0.01), rhinovirus/enterovirus (23.4% vs. 19.9%; p < 0.001) and adenovirus (2.1% vs. 1.5%; p < 0.05) were significantly higher in males. Of the ICU patients with HMPV, many (40.3%) were ≥ 65 years of age.</p><p><strong>Conclusions: </strong>This pre-coronavirus disease 2019 (COVID-19) era study has one of the largest patient populations evaluated for community respiratory virus infections. It confirms known epidemiology, seasonality, and coinfections, and importantly shows a preponderance of influenza A infections among women, contrasting prior studies, which warrants further investigation. It also shows a high HMPV incidence in the ICU among the elderly, underscoring the importance of testing in this population.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"924"},"PeriodicalIF":3.4,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667014","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":"Septic arthritis score (SAS) - a novel clinical prediction model for the probability of septic arthritis in the adult native knee.","authors":"Jonas Tverring, Amelia Johansson, Omid Bornaei, Adam Lantz, Oskar Ljungquist","doi":"10.1186/s12879-025-11306-6","DOIUrl":"10.1186/s12879-025-11306-6","url":null,"abstract":"<p><strong>Background: </strong>Patients presenting with an acutely painful swollen joint represent a diagnostic challenge. We aimed to develop a clinical prediction model for septic arthritis (SA) in the adult native knee.</p><p><strong>Methods: </strong>We screened all synovial cultures in south Sweden in 2020 and 2021. We included cultures taken in the emergency department from adults' native knees where SA was considered a differential diagnosis based on medical chart review. We developed a prediction model using logistic regression and performed internal validation using bootstrapping. We present a nomogram and an online calculator ( http://sascore.org ) for individual risk estimation, net benefit compared to usual care and treatment threshold recommendations.</p><p><strong>Results: </strong>A total of 668 patients were included from 2996 screened synovial cultures. The final septic arthritis score (SAS) included four variables: synovial-to-serum glucose quotient, synovial white blood cell count, abnormal synovial fluid appearance on visual inspection, and triage priority according to Rapid Emergency Triage and Treatment System (RETTS) vital signs. SAS had an optimism-adjusted area under the receiver operating characteristics curve of 0.971 (95% bootstrap confidence interval: 0.957 to 0.987). Clinicians provided empirical intravenous antibiotics to 47 out of 51 patients with a final diagnosis of SA and to 244 out of 617 patients without SA (92% sensitivity, 60% specificity). SAS had 92% sensitivity and 92% specificity at 10% probability for SA treatment threshold and 100% sensitivity and 79% specificity at 2% treatment threshold.</p><p><strong>Conclusion: </strong>The use of SAS would theoretically avoid 50-82% of unnecessary empirical antibiotics as compared to usual care in our cohort with retained or improved identification of actual septic arthritis of the native knee. External validation is warranted before clinical use.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"926"},"PeriodicalIF":3.4,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667016","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}