BMC Infectious Diseases最新文献

{"title":"Outcomes of non-hospitalized patients with COVID-19 versus seasonal influenza during the fall-winter 2022-2023 period.","authors":"Wan-Hsuan Hsu, Bo-Wen Shiau, Ya-Wen Tsai, Jheng-Yan Wu, Ting-Hui Liu, Po-Yu Huang, Min-Hsiang Chuang, Chih-Cheng Lai","doi":"10.1186/s12879-025-10833-6","DOIUrl":"https://doi.org/10.1186/s12879-025-10833-6","url":null,"abstract":"<p><strong>Background: </strong>The comparability of outcomes for non-hospitalized COVID-19 outpatients during the Omicron wave to outpatients with influenza remains uncertain. This study aims to compare the outcomes of non-hospitalized outpatients with COVID-19 and seasonal influenza during the fall-winter of 2022-2023.</p><p><strong>Methods: </strong>This is a retrospective cohort study using TriNetX, a collaborative clinical research platform. Non-hospitalized outpatients with COVID-19 and seasonal influenza between 01 October 2022 and 31 January 2023 were selected from TriNetX. Propensity score matching (PSM) was used to compare patients receiving corresponding outpatient antiviral treatments. Hazard ratios (HRs) with 95% confidence intervals (CIs) for the primary outcome-a composite of all-cause emergency department (ED) visits, hospitalizations, or mortality during the 30-day follow-up period-were calculated and compared.</p><p><strong>Results: </strong>After PSM, two well-balanced groups of 9,030 patients each were identified. Non-hospitalized COVID-19 patients had a lower risk of primary composites outcomes including all-cause ED visits, hospitalization, or mortality (5.9% vs. 9.2%, HR, 0.661[95% CI, 0.593-0.737]) compared to the influenza group. In addition, the COVID-19 group demonstrated a reduced risk of all-cause ED visits (4.4% vs. 6.6%, HR 0.683[0.601-0.776]), hospitalization (1.7% vs. 2.9%, HR 0.605[0.495-0.739]) and mortality (0.1% vs. 0.2%, HR 0.176[0.052-0.597]), respectively.</p><p><strong>Conclusions: </strong>This study indicates a lower risk of all-cause ED visits, hospitalization, and mortality in the non-hospitalized COVID-19 patients compared to the seasonal influenza group, supporting the current public health strategy of adjusting COVID-19 management based on approaches used for seasonal influenza.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"442"},"PeriodicalIF":3.4,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750937","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":"Low CD4 count was characterized in recent HIV CRF01_AE infection and it rapidly increased to reach a peak in the first year since ART initiation.","authors":"Xue-Ying Zhang, Li Wang, Yue Jiang, Si-Miao Huang, Hong-Rui Zhu, Wei Liu, Jia-Ye Wang, Xiang-Hui Wei, Yi-Lin Zhao, Wen-Juan Wei, Teng Fei, Xiao-Hong Chen, Dan Wang, Jin-Liang Li, Hong Ling, Min Zhuang","doi":"10.1186/s12879-025-10799-5","DOIUrl":"https://doi.org/10.1186/s12879-025-10799-5","url":null,"abstract":"<p><strong>Background: </strong>Currently, most people living with HIV (PLWH) in China have a strong awareness of diagnosis and treatment in the early stage of HIV infection. Subtype-specific virological and immunological features of recently infected PLWH have not yet been elucidated.</p><p><strong>Methods: </strong>Data including CD4 count and viral load (VL) of 1508 anti-retroviral therapy (ART) -naïve PLWH were obtained from the HIV Database and comparatively analyzed among PLWH with different HIV subtypes. The infection status of 402 newly diagnosed and ART-naïve PLWH from a cohort of men who have sex with men (MSM) in China was evaluated using diagnosis records and LAg-Avidity EIA. Based on partial pol genes, HIV genotypes in 120 recent, 68 long-term, and 54 chronic infections were identified. The CD4 count, CD8 count, and VL, as well as trajectories of dynamic CD4 counts during ART of local PLWH with different HIV subtypes, were compared using non-parametric tests.</p><p><strong>Results: </strong>For the HIV database, the CD4 count in PLWH with CRF01_AE was lower than that in PLWH with CRF07_BC or subtype B. For the recently infected local PLWH, CRF01_AE was the dominant HIV subtype (65.83%), followed by CRF07_BC (18.33%) and subtype B (15.83%). Recent CRF01_AE infections showed a lower baseline CD4 count than CRF07_BC infections. During ART for recently infected PLWH, the CD4 count in the CRF01_AE group rapidly increased to reach a peak at the end of the first year post-ART, while the CD4 count in the CRF07_BC group increased slowly to reach a plateau at the end of the third year. The CD4 count in the subtype B group increased significantly to reach a plateau within the first two years and then its trajectory overlapped with that of the CRF07_BC group at the end of the third year post-ART.</p><p><strong>Conclusions: </strong>CRF01_AE rapidly reduced CD4 count during the recent HIV infection. The CD4 count of the recently infected individuals with CRF01_AE increased sharply and reached its highest level of recovery within the first year of ART initiation. This study revealed an important time point for estimating CD4 count recovery post-ART in individuals with different HIV subtypes.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"443"},"PeriodicalIF":3.4,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750957","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":"Capillary lactate as a prognostic marker in sepsis: correlation with venous lactate and prediction of outcomes.","authors":"Philip A Joseph, Dinul Doluweera, Amalka Chandraratne, Branavan Balasubramaniam, Varuna Abeyratne, Saman P Hewa, Roshan Rambukwella, Kamani P Wanigasuriya, Jegarajah Indrakumar, Nilanka Perera","doi":"10.1186/s12879-025-10810-z","DOIUrl":"https://doi.org/10.1186/s12879-025-10810-z","url":null,"abstract":"<p><strong>Introduction: </strong>Venous lactate (VL) measured by a blood‒gas analyser is not widely available despite its importance in the management of sepsis. Capillary lactate (CL) measured via a hand-held lactate analyser is a feasible and less expensive option. The aim of this study was to determine the correlation between CL and VL in sepsis patients at 0 h (t₀) and 6 h (t₆) and identify the best CL and lactate clearance cut-off values that predicts a poor outcome.</p><p><strong>Methods: </strong>A descriptive study was conducted recruiting all patients with suspected sepsis (qSOFA ≥ 2 with evidence of infection) admitted to a tertiary care hospital in Sri Lanka between March and June 2022. \"Lactate-plus\", a hand-held lactate analyser, was used to measure CL and VL at t₀ and t₆ of admission. The lactate analyser was tested for accuracy and calibrated in a pilot study of 30 patients by correlating to laboratory lactate values. Patient demographics, clinical data and outcomes during hospitalization and at 28 days were assessed.</p><p><strong>Results: </strong>There were 102 patients with suspected sepsis and a median age of 71.5 (interquartile range: 62-77) years were recruited. Majority were females (n = 52, 51%). Majority of the source of infection was pulmonary (n = 57, 55.9%) and urological (n = 19, 18.6%). Paired CL and VL values significantly correlated at both t₀ and t₆ (p < 0.001). CL at t₀ predicted 28-day mortality with a ROC curve AUC of 0.89 (95% CI: 0.82-0.95, p < 0.05) and 3.5 mmol/L was the best cut-off value with an 85% sensitivity and 78% specificity. CL ≥ 3.5 at t₀ was associated with increased intensive care unit (ICU) admission (p < 0.01), vasopressor requirement (p < 0.0001), and a higher mortality rate (p < 0.001) compared to CL < 3.5. Additionally, a capillary lactate clearance greater than 64% predicted a good outcome, with a 97% sensitivity and 91% specificity.</p><p><strong>Conclusions: </strong>CL measured by a lactate meter correlates well with VL and effectively predicts sepsis outcomes. A CL cut-off ≥ 3.5 mmol/L at admission increases the risk of mortality, vasopressor requirement and ICU admission, making CL a useful tool for risk assessment in sepsis.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"438"},"PeriodicalIF":3.4,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750911","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":"Clinical presentation and treatment outcomes of extrapulmonary nontuberculous mycobacterial infections with rapid and slow growth rates in Cali, Colombia.","authors":"Juanita María Parra-Villamil, Natalia Ramos-Ospina, Sofia Alexandra Montes-Tello, Angie Valeria Torres-Morales, Mabel Moreno-Turriago, José Fernando García-Goez","doi":"10.1186/s12879-025-10681-4","DOIUrl":"https://doi.org/10.1186/s12879-025-10681-4","url":null,"abstract":"<p><strong>Introduction: </strong>The increasing prevalence of extrapulmonary nontuberculous mycobacterial (NTM) infections poses significant challenges in clinical management due to their inherent drug resistance, the need for prolonged antibiotic regimens and the complexities associated with surgical management. Although these infections are infrequent in daily clinical practice, detailed information on associated clinical outcomes is lacking in the local literature.</p><p><strong>Materials and methods: </strong>This descriptive observational study examined 17 patients with extrapulmonary NTM infection from the General Mycobacteria Registry of Fundación Valle del Lili University Hospital (FVL), a leading reference care center located in Cali, a city in southwestern Colombia. Notably, Cali is classified as a high-risk area for tuberculosis. The study reviewed a total of 391 patients between 2007 and 2021.</p><p><strong>Results: </strong>A predominance of women with a history of cosmetic surgery was observed, with the skin being the most common site of involvement, especially for M. fortuitum complex and M. abscessus complex. Clarithromycin based therapy was given to 14/18 (82.3%) of the patients. The mean duration of treatment was 4-6 months, for a cure rate of 15/17 (88.2%).</p><p><strong>Conclusion: </strong>The treatment regimens implemented mostly align with the literature recommendations. However, it is essential to note that while the observed cure rate exceeds 80%, this assertion is tempered by the limitation imposed by the lack of confirmatory imaging in some cases. A contributing factor to the higher cure rate observed in this study may be the use of more extensive surgical interventions, with some patients undergoing more than one procedure. Given the limited number of case series on extrapulmonary nontuberculous mycobacterial infections, these findings emphasize the potential importance of surgical management in achieving higher cure rates. The observed cure rate suggests potentially better clinical management of these infections in our region and underscores the need for future research to understand the factors contributing to this comparative therapeutic success.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"444"},"PeriodicalIF":3.4,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750919","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":"Vancomycin versus linezolid for treatment of staphylococcal-associated central nervous system infections.","authors":"Marin Lahouati, Xavier Brousse, Léa Bientz, Grégoire Chadefaux, Véronique Dubois, Charles Cazanave, Fabien Xuereb","doi":"10.1186/s12879-025-10834-5","DOIUrl":"10.1186/s12879-025-10834-5","url":null,"abstract":"<p><strong>Background: </strong>Linezolid and vancomycin are both recommended for the treatment of staphylococcal-associated central nervous system (CNS) infections. However, to date, no data are available comparing the outcomes of patients treated with vancomycin or linezolid for these infections. The aim of this study was to compare the incidence of treatment failure and adverse events (AEs) associated with vancomycin and linezolid in staphylococcal-associated CNS infections.</p><p><strong>Methods: </strong>This retrospective monocentric observational study was conducted between 01/01/2015 and 31/12/2023. All patients with a confirmed staphylococcal associated CNS infection and treated with vancomycin or linezolid were included. Failure of antimicrobial treatment was the primary outcome of interest, defined by a composite criteria: persistence of infection (i.e. positive culture after > 72 h of antimicrobial treatment active on the isolated bacteria), relapse of infection (i.e. new infection with the same bacteria involved in the initial episode) or infection related death. Second outcome of interest was AE incidence related to linezolid or vancomycin. Outcomes were analysed using survival analysis techniques and propensity score.</p><p><strong>Results: </strong>Ninety one patients were included: 51 in vancomycin group and 40 in linezolid group. Infections were mainly meningitis (n = 71; 78%). Median duration of linezolid or vancomycin treatment was 7 days (IQR 4; 13). Treatment failure occurred in 18.6% (n = 17) of patients (infection persisted in 9.8% of patients (n = 9), infection relapsed in 6.6% (n = 6) and infection caused a fatal outcome in 4.4% (n = 4). In the Cox proportional hazards regression model, vancomycin was not associated with treatment failure (aHR 2.90; 95% CI [0.93-9.30]; p = 0.066). Using propensity score, vancomycin was associated with treatment failure (HR 3.28; 95% CI [1.02-10.54]; p = 0.045). Treatment with vancomycin was also associated with AE (HR 8.42; CI 95% [2.44;29.10]; p = 0.019).</p><p><strong>Conclusion: </strong>Patients treated with vancomycin for staphylococcal-associated CNS infections seems to have a higher risk of treatment failure and AE compared to those treated with linezolid. However, given the low statistical power and the observational nature of this study, further research is needed to confirm these findings.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"446"},"PeriodicalIF":3.4,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750939","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":"Morphological variability of Escherichia coli colonizing human wounds: a case report.","authors":"Xuejin Wang, Hanyu Wang, Jing Zhang, Yonglu Huang, Yongning Wu, Yang Wang, Rong Zhang","doi":"10.1186/s12879-025-10484-7","DOIUrl":"https://doi.org/10.1186/s12879-025-10484-7","url":null,"abstract":"<p><strong>Background: </strong>Escherichia coli, known for its adaptability, can cause diverse infections. Morphological variants, such as smooth and mucoid forms, correspond to different infection capabilities and antibiotic resistance profiles. This report presents the isolation of two distinct E. coli strains, a smooth strain and a mucoid strain, from a single patient.</p><p><strong>Case presentation: </strong>A 70-year-old woman with a leg wound and lung infection was found to have two E. coli strains: a mucoid strain from her wound and sputum and a smooth strain from her rectal swab. Whole-genome sequencing confirmed genetic similarity between the strains with minor SNPs linked to their morphological differences. Both strains were resistant to β-lactam and quinolone antibiotics, complicating treatment. The patient recovered following treatment with Piperacillin/Tazobactam and regular wound care.</p><p><strong>Conclusion: </strong>This case highlights E. coli's phenotypic plasticity within a single host, impacting infection management and antibiotic response. Understanding the genetic basis of such morphological changes could inform more effective treatment strategies.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"440"},"PeriodicalIF":3.4,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750959","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":"Efficacy and metabolomic analysis of the pneumonia compound formulation against community-acquired pneumonia: an observational controlled before-after clinical trial.","authors":"Ying Zhou, Yi Wei, Jieqiong Wang, Leqian Wang, Meixia Zheng, Fanxuan Zhang, Wenmin Wang, Feihua Huang","doi":"10.1186/s12879-025-10823-8","DOIUrl":"https://doi.org/10.1186/s12879-025-10823-8","url":null,"abstract":"<p><strong>Background: </strong>Pneumonia Compound Formulation (PCF) is a traditional Chinese medicine (TCM) formula used for the clinical treatment of novel coronavirus pneumonia. However, its efficacy and mechanism of action for community-acquired pneumonia (CAP) are unknown. Therefore, the aim of this study was to evaluate the efficacy of PCF combined with antibiotics in the treatment of CAP and to explore its mechanism based on metabolomics.</p><p><strong>Patients and methods: </strong>This prospective controlled study included 100 CAP patients from June to December 2023. Patients were randomized into an antibiotics-only group (NCM, n = 50) and a combined antibiotics and PCF treatment group (CM, n = 50). Clinical data were collected for all participants. The efficacy of the treatments was assessed by comparing traditional Chinese medicine syndrome scores and clinical parameters before and after treatment. Levels of inflammatory mediators (CRP, IL-6, TNF-α) and immunoglobulins (IgA, IgG, IgM) in the plasma were measured using ELISA. Plasma metabolomics analysis was conducted using ultra-performance liquid chromatography-high resolution mass spectrometry (UPLC-HRMS).</p><p><strong>Results: </strong>Both the NCM and CM group improved the clinical symptoms of CAP patients, with the CM group showing more significant improvements. Both groups effectively reduced the levels of the inflammatory mediators CRP, but had no significant impact on immunoglobulin levels. CM group using additional PCF significantly altered glycerophospholipid metabolism in patients, primarily characterized by increased levels of phosphatidylinositol, phosphatidylglycerol, and 1-acyl-sn-glycero-3-phosphoethanolamine, and decreased levels of phosphatidylcholine and phosphatidylethanolamine.</p><p><strong>Conclusions: </strong>PCF is an effective adjunct therapy to antibiotics for the treatment of CAP, enhancing clinical symptom improvement. Its mechanism may involve the regulation of glycerophospholipid metabolism levels in patients, providing a new theoretical basis for the application of PCF in the treatment of CAP.</p><p><strong>Trial registration: </strong>ChiCTR2400086283 (2024-06-27).</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"441"},"PeriodicalIF":3.4,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750952","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":"Cefepime versus carbapenem for treating complicated urinary tract infection caused by cefoxitin-nonsusceptible ESCPM organisms: a multicenter, real-world study.","authors":"Liang Chen, Jie Hua, Xiaopu He","doi":"10.1186/s12879-025-10850-5","DOIUrl":"https://doi.org/10.1186/s12879-025-10850-5","url":null,"abstract":"<p><strong>Background: </strong>This investigation aimed to compare the efficacy of cefepime and carbapenem for complicated urinary tract infection (cUTI) caused by presumptive AmpC β-lactamase-producing Enterobacter spp., Serratia marcescens, Citrobacter freundii, Providencia spp., and Morganella morganii (ESCPM).</p><p><strong>Methods: </strong>Data of 458 individuals with cUTI caused by cefoxitin-nonsusceptible [minimum inhibitory concentration (MIC) > 8 µg/mL] and cefepime-susceptible (MIC ≤ 2 µg/mL) ESCPM was acquired from four Chinese hospitals between 2010 and 2022 and were reviewed retrospectively.</p><p><strong>Results: </strong>125 and 333 patients received cefepime and carbapenems, respectively, as antimicrobial therapy. The 28-day treatment failure rate was 15.7% (72/458). The following factors were identified as independent predictors for 28-day therapy: age, cefepime MIC = 2 µg/mL, immunocompromised status, infection source control, appropriate empirical therapy, and days from illness onset to active therapy. In patients who required cefepime MIC ≤ 1 µg/mL, a multivariate logistic model indicated that cefepime was linked with a similar risk of 28-day treatment failure [odd ratio (OR) 1.791, 95% confidence interval (CI) 0.600-5.350, p = 0.296] compared with carbapenems after controlling these predictors. Compared with individuals with cefoxitin-nonsusceptible ESCPM, those with isolates of cefepime (MIC = 2 µg/mL) had an enhanced risk of 28-day treatment failure (OR = 2.579, 95% CI = 1.012-6.572, p = 0.047). A propensity score for treatment analysis validated this relationship.</p><p><strong>Conclusions: </strong>The cefepime and carbapenem had comparable efficacy for treating cUTI caused by cefoxitin-nonsusceptible ESCPM organisms with cefepime MIC ≤ 1 µg/mL, whereas carbapenems are potentially more effective for isolates with cefepime MIC = 2 µg/mL.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"439"},"PeriodicalIF":3.4,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750916","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":"Integrated bioinformatics and experiment validation reveal cuproptosis-related biomarkers and therapeutic targets in sepsis-induced myocardial dysfunction.","authors":"Xuemei Shi, Zhonghan Yan, Ruilin Ding, Fenfen Xia, Yan Du, Xiaojie Wang, Qing Peng","doi":"10.1186/s12879-025-10822-9","DOIUrl":"https://doi.org/10.1186/s12879-025-10822-9","url":null,"abstract":"<p><strong>Background: </strong>Sepsis-induced myocardial dysfunction (SIMD) is a serious sepsis complication with high mortality, yet current diagnostic and therapeutic approaches remain limited. The lack of early, specific biomarkers and effective treatments necessitates exploration of novel mechanisms. Recently, cuproptosis has been implicated in various diseases, but its role in SIMD is unclear. This study aimed to identify cuproptosis-related biomarkers and potential therapeutic agents, supported by animal model validation.</p><p><strong>Methods: </strong>Four GEO datasets (GSE79962, GSE267388, GSE229925, GSE229298) were analyzed using Limma and WGCNA to identify overlapping genes from differentially expressed genes (DEGs), cuproptosis-related DEGs (DE-CRGs), and module-associated genes. Gene Set Enrichment Analysis (GSEA) and single-sample GSEA (ssGSEA) were performed to assess biological functions and immune cell infiltration, respectively. ceRNA and transcription factor networks were constructed to explore gene regulatory mechanisms, while consensus clustering was employed to define cuproptosis-related subtypes. Diagnostic genes were selected through SVM-RFE, LASSO, and random forest models. Additionally, potential gene-targeting agents were predicted using drug-gene interaction analysis. The findings were validated in SIMD animal models through qPCR and immunohistochemical analysis to confirm gene expression.</p><p><strong>Results: </strong>PDHB and DLAT emerged as key cuproptosis-related biomarkers. GSEA indicated upregulation of oxidative phosphorylation and downregulation of chemokine signaling. ssGSEA revealed negative correlations with several immune cell types. A ceRNA network (51 nodes, 56 edges) was constructed. Machine learning identified PDHB, NDUFA9, and TIMMDC1 as diagnostic genes, with PDHB showing high accuracy (AUC = 0.995 in GSE79962; AUC = 0.960, 0.864, and 0.984 in external datasets). Using the DSigDB database, we predicted six drugs that exhibit significant binding activity with PDHB. qPCR and immunohistochemistry confirmed reduced PDHB and DLAT expression in SIMD animal models.</p><p><strong>Conclusion: </strong>This study identifies PDHB and DLAT as cuproptosis-related biomarkers, addressing the diagnostic and therapeutic gaps in SIMD by unveiling novel molecular insights for early intervention and targeted treatment.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"445"},"PeriodicalIF":3.4,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750955","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 of colistin-resistant Enterobacteriaceae isolated from clinical samples in Africa: a systematic review and meta-analysis.","authors":"Yalewayker Gashaw, Zelalem Asmare, Mitkie Tigabie, Asefa Sisay, Ermias Getatachew, Selamyhun Tadesse, Getachew Bitew, Agenagnew Ashagre, Tadesse Misganaw, Muluken Gashaw, Woldeteklehaymanot Kassahun, Zelalem Dejazimach, Abdu Jemal, Solomon Gedfie, Getinet Kumie, Marye Nigatie, Wagaw Abebe, Atitegeb Abera Kidie, Biruk Beletew Abate, Melese Abate Reta, Baye Gelaw","doi":"10.1186/s12879-025-10826-5","DOIUrl":"https://doi.org/10.1186/s12879-025-10826-5","url":null,"abstract":"<p><strong>Background: </strong>Antimicrobial resistance among Enterobacteriaceae poses a significant global threat, particularly in developing countries. Colistin, a critical last-resort treatment for infections caused by carbapenem-resistant and multidrug-resistant strains, is increasingly facing resistance due to inappropriate use of colistin and the spread of plasmid-mediated resistance genes. Despite the significance of this issue, comprehensive and updated data on colistin resistance in Africa is lacking. Thus, the current study was aimed to determine the pooled prevalence of colistin-resistant Enterobacteriaceae in Africa.</p><p><strong>Methods: </strong>A systematic search was conducted across PubMed, Scopus, ScienceDirect, and Google Scholar to identify relevant studies. Forty-one studies reporting on the prevalence of colistin resistance in Enterobacteriaceae isolates from clinical specimens in Africa were included in the analysis. Stata 17 software was used to calculate the pooled prevalence of colistin resistance, employing a random-effects model to determine the event rate of resistance. Heterogeneity across studies was assessed using the I² statistic, and publication bias was evaluated using Egger's test. Subgroup analyses were performed to address any identified heterogeneity.</p><p><strong>Results: </strong>This systematic review analyzed the colistin resistance profile of 9,636 Enterobacteriaceae isolates. The overall pooled prevalence of colistin resistance was 26.74% (95% CI: 16.68-36.80). Subgroup analysis by country revealed significant variability in resistance rates, ranging from 0.5% in Djibouti to 50.95% in South Africa. Species-specific prevalence of colistin resistance was as follows: K. pneumoniae 28.8% (95% CI: 16.64%-41.05%), E. coli 24.5% (95% CI: 11.68%-37.3%), Proteus spp. 50.0% (95% CI: 6.0%-106.03%), and Enterobacter spp. 1.22% (95% CI: -0.5%-3.03%). Analysis based on AST methods revealed significant differences in colistin resistance rates (p = 0.001). The resistance rates varied between 12.60% for the disk diffusion method and 28.0% for the broth microdilution method. Additionally, a subgroup analysis of clinical specimens showed significant variation (p < 0.001) in colistin resistance. Stool specimen isolates had the highest resistance rate at 42.0%, while blood specimen isolates had a much lower resistance rate of 3.58%.</p><p><strong>Conclusions: </strong>Colistin resistance in Enterobacteriaceae is notably high in Africa, with significant variation across countries. This underscores the urgent need for effective antimicrobial stewardship, improved surveillance, and the development of new antibiotics.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"437"},"PeriodicalIF":3.4,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742042","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}