BMC Infectious Diseases最新文献

{"title":"Comparable tolerability, symptom worsening, and treatment completion rates among different Helicobacter pylori eradication regimens in children.","authors":"Neslihan Gürcan Kaya, Suna Selbuz","doi":"10.1186/s12879-026-14033-8","DOIUrl":"10.1186/s12879-026-14033-8","url":null,"abstract":"<p><strong>Background: </strong>The tolerability of Helicobacter pylori (H. pylori)eradication regimens in children remains a clinical concern, particularly regarding gastrointestinal adverse effects and treatment discontinuation. The aim of this study was to compare the tolerability of different H. pylori eradication regimens in children by evaluating treatment-related symptoms, symptom worsening during therapy, and treatment completion rates.</p><p><strong>Methods: </strong>Pediatric patients with endoscopically confirmed H. pylori infection were treated with clarithromycin-based, metronidazole-based, or bismuth-containing regimens. All eradication regimens were administered for 14 days. Symptom severity was graded using a standardized scoring system, and stool pattern was assessed using the Bristol Stool Scale. Symptom worsening was defined as an increase compared with baseline. Within-group comparisons were performed using the Wilcoxon signed-rank test, and between-group differences were analyzed using chi-square or Fisher's exact test. A p value < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>In the overall study population, nausea, vomiting, metalic taste and anorexia scores increased significantly during treatment compared with baseline (Wilcoxon signed-rank test, p < 0.05). However, symptom worsening rates and stool pattern changes did not differ significantly among treatment groups (all p > 0.05). A total of 16 patients discontinued therapy. Discontinuation rates were 9.1% in the clarithromycin-based group, 2.4% in the metronidazole-based group, and 12.0% in the bismuth-containing group, with no statistically significant difference between groups (p = 0.204). Vomiting was the most common reason for treatment interruption, followed by diarrhea.</p><p><strong>Conclusion: </strong>The evaluated H. pylori eradication regimens showed comparable tolerability and treatment completion rates in children. Treatment selection may therefore be guided primarily by eradication efficacy and antimicrobial resistance patterns rather than concerns regarding adverse effects alone.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001290","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":"Spatio-temporal trends of the prevalence of Plasmodium falciparum antimalarial drug resistance markers across sub-Saharan Africa from 2010 to 2024: a systematic review and meta-analysis.","authors":"Francis Emmanuel Towanou Bohissou, Guétawendé Job Wilfried Nassa, Juliana Inoue, Paul Sondo, Toussaint Rouamba, Joanna Yessinou, Jana Held, Halidou Tinto","doi":"10.1186/s12879-026-14233-2","DOIUrl":"10.1186/s12879-026-14233-2","url":null,"abstract":"<p><strong>Background: </strong>The emergence and subsequent spread of antimalarial drug resistance represent a significant threat to the efficacy of artemisinin-based combination therapies (ACTs) in sub-Saharan Africa. Multiple molecular markers have been implicated in resistance to artemisinin and its partner drugs. We conducted a systematic review and meta-analysis of studies published between 2010 and 2024 in sub-Saharan Africa.</p><p><strong>Methods: </strong>The protocol was registered in PROSPERO (CRD42023432718). Studies were identified through PubMed/MEDLINE, Web of Science, Scopus, Embase, and African Journal Online. Study selection, data extraction, and risk-of-bias assessment were performed independently by two reviewers in accordance with the PRISMA 2020 guidelines. Prevalence data for mutations in PfKelch13, Pfcrt, Pfmdr1, and Pfdhfr/Pfdhps were extracted and analysed using random-effects models, with pooled prevalence estimates generated using a generalized linear mixed model (GLMM) with logit transformation. Between-study heterogeneity was assessed using Cochran's Q and I² statistics.</p><p><strong>Results: </strong>A total of 172 studies on PfKelch13, 182 on Pfcrt, 196 on Pfmdr1, and 176 on Pfdhfr/Pfdhps were included. From 2014 to 2023, validated PfKelch13 mutations exhibited marked spatial and temporal heterogeneity, with R622I, R561H, and A675V expanding primarily in East Africa, reaching prevalences of 10-25% in Rwanda, Uganda, and Tanzania. In Central Africa, emergence was observed in 2021 at low levels (below 5%), while West Africa reported only sporadic low-prevalence (below 1%) detections. In contrast, resistance to some partner drugs declined substantially across Africa, with Pfcrt K76T decreasing from 76% (95% CI: 49% - 91%; I² = 97.9%) in 2010 to 9% (95% CI: 8.7% - 9.5%; I² = 96.8%) in 2023 and Pfmdr1 N86Y falling from 34% (95% CI: 26% - 43%; I² = 93.5%) to zero (95% CI: 0% - 11%; I² = 97.1%), with persistent regional heterogeneity. Certain markers of sulfadoxine-pyrimethamine (SP) resistance (Pfdhfr N51I, C59R, S108N and Pfdhps A437G) remained near fixation, whereas Pfdhfr I164L, Pfdhps K540E, and Pfdhps A581G showed pronounced spatial clustering, with the highest prevalence reported in East and parts of Central Africa.</p><p><strong>Conclusion: </strong>Overall, the temporal and regional patterns of antimalarial drug resistance molecular markers across sub-Saharan Africa underscore the need for sustained molecular surveillance tailored to local epidemiological trends of resistance markers.</p><p><strong>Registration: </strong>Protocol registered in the International Prospective Register of Systematic Reviews (PROSPERO; registration number CRD42023432718).</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13545778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148890992","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":"Health-related quality of life in IBD patients with long COVID under China's normalized COVID-19 management.","authors":"Runnan Wang, Lei Lei, Peizhao Liu, Mengxuan Li, Lin Wu, Juanhan Liu, Haiyang Jiang, Jianan Ren, Chaogang Fan, Tao Zheng","doi":"10.1186/s12879-026-14323-1","DOIUrl":"10.1186/s12879-026-14323-1","url":null,"abstract":"<p><strong>Introduction: </strong>Although the COVID pandemic has gradually subsided, many patients have experienced complicated long-term symptoms, collectively known as \"long-COVID\", which is commonly associated with persistent discomfort and decrease in quality of life. Individuals with immune-mediated inflammatory diseases, such as inflammatory bowel disease (IBD), are particularly vulnerable in the context of COVID infection, while the influence from \"long-COVID\" remains unrevealed. This cross-sectional study aims to assess health-related quality of life (HRQoL) among IBD patients with long COVID and to identify factors associated with HRQoL impairment.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted from September 16 to October 10, 2023, among 235 IBD patients who had been treated at Nanjing BenQ Medical Center and Nanjing Jinling Hospital. The survey collected demographic data, COVID-19-related information, and HRQoL assessments using the Short Inflammatory Bowel Disease Questionnaire (SIBDQ). Statistical analyses, including Chi-square tests, non-parametric tests, and multivariate linear regression, were employed to identify factors associated with long COVID and HRQoL.</p><p><strong>Results: </strong>Among 235 participants, 221 (94.04%) reported COVID-19 infection and 15 of 221 (6.79%) met the study definition of long COVID. Vaccination status differed by long-COVID status in an exploratory unadjusted comparison (p = 0.033); this finding was based on only 15 cases and was not adjusted for confounding. Participants with long COVID had a lower median SIBDQ score than those without long COVID (43.00 vs. 53.00; p = 0.009). In the multivariable model, any post-COVID-19 symptoms and symptom duration were entered as nested indicators. A duration of ≥ 4 weeks was associated with an additional 8.52-point lower SIBDQ score beyond the association of any post-COVID-19 symptoms (B=-8.52; 95% CI, -13.85 to -3.18; p = 0.002).</p><p><strong>Conclusion: </strong>Participants meeting the study definition of long COVID reported lower HRQoL than those without long COVID. However, because validated IBD activity measures were not collected, the observed difference cannot be separated from the possible effect of underlying IBD activity. The vaccination finding is exploratory. Larger prospective studies with standardized disease-activity assessment are required to confirm these associations.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073264","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":"Extending prophylactic antimicrobial use beyond 48 h postoperatively fails to reduce surgical site infections and other healthcare-associated infections in patients undergoing colorectal resection: a Propensity Score Matching study.","authors":"Yujuan Yang, Zhenjie Bao, Zhujun Zhang","doi":"10.1186/s12879-026-14143-3","DOIUrl":"https://doi.org/10.1186/s12879-026-14143-3","url":null,"abstract":"<p><strong>Background: </strong>It is controversial whether antibiotic should be used prophylactically 48 h after colorectal resection. Hence, the association of prophylactic antimicrobial (PA) use beyond 48 h postoperatively with the incidence of surgical site infections (SSI) and other healthcare-associated infections (HAI) in patients receiving colorectal resection surgery was evaluated.</p><p><strong>Methods: </strong>A retrospective analysis was performed on 2691 patients who underwent colorectal resection between March 1, 2023, and December 31, 2025. Patients were categorized into the non-PA beyond 48 h postoperatively group (n = 1934) and the PA beyond 48 h postoperatively group (n = 757) based on whether prophylactic antibiotic use exceeded 48 h postoperatively. Propensity Score Matching (PSM) was used to balance differences in covariates between the two groups, subsequently, the relationship between prophylactic antibiotic use and infection was analyzed.</p><p><strong>Results: </strong>The incidence of surgical site infections (SSI) in patients undergoing colorectal resection was 8.51% (229/2691), while the incidence of other healthcare-associated infections (HAI) was 8.06% (217/2691). After PSM, both non-PA beyond 48 h postoperatively group and PA beyond 48 h postoperatively group were divided into 757 cases each. Multiple regression analysis showed that PA beyond 48 h postoperatively was not associated with SSI(OR = 0.85, 95% CI 0.59 -1.21, P = 0.356) and other HAI (OR = 0.81, 95% CI 0.54-1.23, P = 0.325) after adjustment for the confounding effect of age, sex, diabetes, hypertension, anemia, hypoproteinemia. Subsequent to adjustment for all confounding factors, PA beyond 48 h postoperatively was still not a influence factor for SSI (OR = 0.85, 95% CI 0.59-1.22, P = 0.372) and other HAI (OR = 0.77, 95% CI 0.50-1.18, P = 0.229). The total cost (¥57349.60 vs. ¥55039.10, P = 0.0006) were higher in the PA beyond 48 h postoperatively group than non-PA beyond 48 h postoperatively group, and no statistically significant differences were observed between the two groups in postoperative hospital stay (P > 0.05).</p><p><strong>Conclusion: </strong>Extending prophylactic antimicrobial use beyond 48 h postoperatively following colorectal resection surgery was not associated with lower morbidity rate of SSI and other HAI, nor did it shorten the postoperative hospital stay; however, it resulted in elevated costs. Nonetheless, this study may contribute to the development of strategies for standardizing prophylactic medication management during the perioperative period of colorectal resection.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219978","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":"Baloxavir marboxil versus oseltamivir for influenza A in children aged 5 years and older: a community-based prospective cohort study.","authors":"Wei Li, Min Zhou, Haiyan Ye, Linyan Liu, Jun Yan","doi":"10.1186/s12879-026-14345-9","DOIUrl":"10.1186/s12879-026-14345-9","url":null,"abstract":"<p><strong>Background: </strong>Influenza A places a substantial burden on children. Real-world comparisons of antiviral regimens in community pediatric settings remain limited. This prospective cohort study compared the effectiveness and safety of a single-dose baloxavir marboxil regimen with a standard five-day oseltamivir course in children aged 5 years and older with influenza A, using fever duration as the primary outcome.</p><p><strong>Main body: </strong>In this multicenter, prospective, non-randomized observational cohort study, 750 children aged 5-14 years with reverse transcription-polymerase chain reaction (RT-PCR)-confirmed influenza A were enrolled from eight community health centers in Chongqing, China, between October 2024 and December 2025. Treatment assignment was based on guardian preference rather than randomization. The median duration of fever was shorter in the baloxavir group (22.0 h versus 40.5 h; P < 0.001). In exploratory analyses adjusted for multiple comparisons, baloxavir was associated with a shorter median time to viral clearance (24.0 h vs. 72.0 h; false discovery rate [FDR]-adjusted P < 0.001), a lower total complication rate (3.7% vs. 11.2%; FDR-adjusted P = 0.042), more rapid normalization of inflammatory markers and the CD4+/CD8 + ratio, lower revisit rate (2.1% vs. 6.9%; FDR-adjusted P = 0.003), fewer parental work-absence days (2.0 vs. 3.5 days; FDR-adjusted P < 0.001), and fewer adverse drug reactions (6.7% vs. 15.2%; FDR-adjusted P = 0.049).</p><p><strong>Short conclusion: </strong>In community-dwelling children with influenza A, baloxavir marboxil was associated with more rapid fever resolution than oseltamivir. Exploratory findings suggested potential benefits regarding viral clearance, complications, healthcare utilization, and tolerability. Because treatment selection was preference-based and open-label, and because influenza A subtype and reduced-susceptibility substitutions were not evaluated, these findings should be interpreted as hypothesis-generating rather than causal.</p><p><strong>Trial registration: </strong>This study was not prospectively registered because it was an observational study. However, the protocol was approved by the relevant ethics committee, and the study was reported following STROBE guidelines for observational research.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149029705","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":"Correction: Correlation between fecal calprotectin levels, disease severity and the hypervirulent ribotype 027 strain in patients with Clostridium difficile infection.","authors":"Avi Peretz, Linda Tkhawkho, Nina Pastukh, Diana Brodsky, Chen Namimi-Halevi, Orna Nitzan","doi":"10.1186/s12879-026-14211-8","DOIUrl":"10.1186/s12879-026-14211-8","url":null,"abstract":"","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863301","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 and epidemiological characteristics of herpes zoster at a tertiary care center compared to population-based data: a ten-year retrospective cohort study.","authors":"Johanna Lenz, Hans Helmut Niller, Sebastian Haferkamp","doi":"10.1186/s12879-026-14185-7","DOIUrl":"10.1186/s12879-026-14185-7","url":null,"abstract":"<p><strong>Background: </strong>Herpes zoster (HZ) results from reactivation of the latent varicella-zoster virus (VZV) and may cause severe pain and serious complications. The risk increases with age, immunosuppression, and certain chronic conditions. Tertiary care centers disproportionately treat patients with such risk profiles, yet data comparing tertiary care populations with population-based cohort studies are limited. This study aimed to provide a comprehensive clinical and epidemiological characterization of HZ patients at a tertiary care center and to compare findings with those from population-based studies.</p><p><strong>Methods: </strong>All patients at the University Hospital Regensburg with an HZ diagnosis (ICD code B02*) between January 2014 and December 2023 were included and subsequently underwent manual chart review for clinical validation and data extraction, yielding 786 cases in 780 patients. We analyzed patient demographics, comorbidities, immunosuppression, anatomical location, complications, hospitalization status, and vaccination status.</p><p><strong>Results: </strong>Of 786 cases, 398 occurred in women and 388 in men, with a median age of 60 years. A total of 13.5% of cases were classified as immunocompromised. The trigeminal nerve was involved in 50.1% of cases, and herpes zoster ophthalmicus (HZO) was present in 41.3%. Most cases, 72.8%, proceeded without complications, with postherpetic neuralgia (PHN) being the most common complication, affecting 8.4% of cases. The hospitalization rate was 57.6%, and HZ vaccination status was documented in fewer than 1% of cases.</p><p><strong>Conclusions: </strong>Compared to published population-based studies, this cohort showed an increased risk profile for severe disease course as immunocompromised patients and cranial manifestations were markedly overrepresented. Despite that, the complication rate was comparable. Early intravenous antiviral therapy during hospitalization may have contributed to this, though retrospective design precludes causal inference. Prospective studies are needed to confirm this hypothesis. The near-total absence of vaccination records indicates a significant documentation gap and underscores the need for systematic vaccination counselling and documentation in tertiary care centers.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13536859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148878973","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":"A rare case of emphysematous cystitis and intravesical fungus balls caused by Candida tropicalis.","authors":"Juanjuan Xie, Shifeng He, Xuan Zhang, Hao Chen, Hong Qian, Xuancai Chen, Yihui Liu, Hao Fu","doi":"10.1186/s12879-026-14218-1","DOIUrl":"10.1186/s12879-026-14218-1","url":null,"abstract":"<p><strong>Background: </strong>The concurrent fungal emphysematous cystitis (EC) and bladder fungus balls in patients with urinary tract infection is rare. Diagnosis and management remain challenging because of nonspecific clinical manifestations, limited imaging features, and the lack of standardized treatment strategies.</p><p><strong>Case presentation: </strong>A 62-year-old woman with poorly controlled type 2 diabetes mellitus (DM) presented with EC and bladder fungus balls caused by Candida tropicalis. Imaging revealed an intravesical mass surrounded by a large amount of gas. Conservative management, including antifungal therapy with fluconazole, insulin therapy, and continuous bladder irrigation with saline, was initially administered. However, persistent pain and intravesical gas required surgical intervention. Cystoscopy revealed multiple free-floating, oval, white fungal balls within the bladder, most measuring approximately 2.0 × 1.5 cm. Using a large-caliber endoscopic access sheath, transurethral cystoscopic irrigation was performed to fragment and evacuate the fungal balls. Postoperatively, the patient received systemic fluconazole therapy and bladder irrigation, resulting in recovery.</p><p><strong>Conclusion: </strong>The coexistence of fungal EC and bladder fungus balls should be considered in patients with DM and refractory or severe urinary tract infections when computed tomography (CT) demonstrates intravesical gas surrounding a bladder mass. Although systemic antifungal therapy, bladder irrigation, and glycemic control are primary treatment options, surgical intervention may be necessary when fungal balls are resistant to irrigation or when clinical improvement is not achieved. Transurethral cystoscopic irrigation using a large-diameter endoscopic access sheath appears to be an effective and safe treatment approach.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13602546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149029739","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":"Identifying factors influencing HIV testing behavior among high-risk elderly men: a mixed-methods study incorporating structural equation modeling and thematic framework.","authors":"Yalan Wang, Renhai Tang, Qunbo Zhou, Yuecheng Yang, Song Duan, Ziyi Yuan, Qishu Wu, Junjie Wang, Duo Shan","doi":"10.1186/s12879-026-14305-3","DOIUrl":"10.1186/s12879-026-14305-3","url":null,"abstract":"<p><strong>Background: </strong>Population ageing has been accompanied by increasing HIV risk among older adults. Timely diagnosis and treatment are essential for improving health outcomes. However, over 65% of HIV cases among older men at elevated risk in China are diagnosed at an advanced stage, largely due to delayed testing. Understanding the factors associated with prior HIV testing among this population is therefore important for promoting earlier diagnosis and developing targeted interventions.</p><p><strong>Methods: </strong>An explanatory sequential mixed-methods study was conducted in Dehong Prefecture between 2024 and 2025. The quantitative phase comprised a cross-sectional survey. Descriptive analyses were used to summarize participant characteristics, and structural equation modeling (SEM) was performed to examine the direct, indirect, and total associations between psychosocial factors and ever-tested status. In the subsequent qualitative phase, in-depth interview data were analyzed using thematic framework analysis to explain and contextualize the quantitative findings.</p><p><strong>Results: </strong>A total of 300 participants were included in the quantitative survey, and 30 participated in qualitative interviews. Among the 300 participants, the mean age was 57.2 years, and 57.7% had ever been tested for HIV. Risky sexual behaviors, particularly inconsistent condom use, were common, with reduced sexual pleasure being the main reported reason for condom non-use. In the final SEM, threat perception showed the strongest positive total association with ever-tested status (0.349; p = 0.001), followed by subjective norms (0.295; p = 0.003) and self-efficacy (0.199; p < 0.001). Testing belief had a positive indirect association (0.042; p < 0.001), whereas HIV-related information and behavioral skills showed negative total associations (-0.175; p = 0.009; -0.211; p = 0.015, respectively). Qualitative findings suggested that the negative association with HIV-related information reflected participants' distrust of conflicting information, its limited perceived relevance, and fear-oriented messaging. They also highlighted insufficient knowledge of testing procedures, low confidence in accessing services, and age-related perceptions of HIV risk.</p><p><strong>Conclusion: </strong>Prior HIV testing among older men at elevated risk was associated with threat perception, subjective norms, self-efficacy, testing belief, the interpretation of HIV-related information, and practical testing barriers. Age-sensitive interventions should provide credible and personally relevant information, strengthen social support and self-efficacy, and offer clear, practical guidance on how and where to obtain HIV testing.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13587304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148987900","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":"Multicentre insights into OPAT: a comprehensive analysis of Türkiye's unstructured system.","authors":"Elif Agüloğlu Bali, Belgin Coskun, Halime Araz, Yakup Gezer, Arzu Tarakçı, Feyza Nur Akçin Balan, Lütfiye Nilsun Altunal, Barış Manavlı, Petek Konya, Cihan Semet, Sevda Özdemir Al, Elif Yılmaz İlmin, Çiğdem Mermutluoğlu, Ayşe Şenbaba Kara, Melike Nur Özçelik, Neşe Saltoğlu, Gözde Dalgan, Uğur Önal, Ahmet Doğan, Meryem Sena Toker, Mehmet Çelik, Duygu Çerçioğlu Özdemir, Sibel Karabulut, Süleyman Koç, Yasemin Çakır Kıymaz, Özge Eren Korkmaz, Hacer Demirköse, Büşra Tanır, Eda Alp","doi":"10.1186/s12879-026-14269-4","DOIUrl":"10.1186/s12879-026-14269-4","url":null,"abstract":"<p><strong>Background/objective: </strong>Outpatient parenteral antimicrobial therapy (OPAT) is a well-established, cost-effective treatment modality delivered through structured, multidisciplinary programs worldwide. In Türkiye, no standardized OPAT framework exists; patients continue therapy through emergency departments, primary care facilities, or privately funded nursing services. This is the first multicentre study to evaluate clinical outcomes, treatment adherence, and patient satisfaction with OPAT in Türkiye.</p><p><strong>Methods: </strong>This prospective multicentre study enrolled adult patients receiving OPAT for chronic osteomyelitis, spondylodiscitis, prosthetic joint infection, or urinary tract infection across 20 hospitals in Türkiye between March and August 2024.</p><p><strong>Results: </strong>A total of 265 patients were included (53.2% male; mean age 61.4 ± 13.5 years). Gram-positive pathogens predominated (60.2%); the most frequently used antibiotics were teicoplanin (70.5%), ceftriaxone (16.6%), and aminoglycosides (6.8%). The clinical success rate was 94.3%. ADEs led to treatment discontinuation in only 3 patients (1.1%). OPAT initiated at university hospitals was significantly more likely to be continued via emergency departments than at state hospitals (p = 0.010). Treatment-related adverse events occurred significantly more frequently outside dedicated OPAT units (18% vs. 3.1%; p = 0.030). Patient satisfaction was high overall; however, urinary tract infection patients reported significantly greater satisfaction than those with bone and joint infections across multiple domains. Additionally, patients treated in dedicated OPAT units reported significantly higher satisfaction than those treated in emergency departments across all domains assessed.</p><p><strong>Conclusion: </strong>The absence of a structured OPAT system in Türkiye increases emergency department burden and elevates complication risk. Despite this, high clinical success rates and patient satisfaction support OPAT's potential as a viable alternative to inpatient care. A standardized, multidisciplinary OPAT framework is needed to improve patient safety and optimize healthcare resource utilization.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13587441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148987911","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}