BMC Infectious Diseases最新文献

{"title":"Integrating dolutegravir into the national Tanzanian formulary: treatment uptake and virologic outcomes from a longitudinal study.","authors":"Joan Rugemalila, Peter Ponsian, William Chimwege, Autumn D Zuckerman","doi":"10.1186/s12879-026-12962-y","DOIUrl":"https://doi.org/10.1186/s12879-026-12962-y","url":null,"abstract":"<p><strong>Introduction: </strong>The transition to dolutegravir (DTG) antiretroviral therapy (ART) has now become the preferred first-line treatment for people living with HIV (PLHIV) in many low- and middle-income countries. We report virologic outcomes among adolescents and adults who transitioned to DTG-based therapy and those initiated on DTG based ART in Dar es Salaam, Tanzania.</p><p><strong>Methods: </strong>We performed retrospective and prospective data abstraction from an electronic care and treatment database at Muhimbili National Hospital (MNH) for participants aged 15 years and above. Eligible participants were treatment-naïve PLHIV initiating tenofovir-lamivudine-efavirenz (TLE) or tenofovir-lamivudine-dolutegravir (TLD) and treatment-experienced patients with a transition opportunity between March 2019 and August 2019. We assessed baseline differences in patient characteristics before and after weighting with inverse probability weights using the chi-square and Mann-Whitney tests for categorical and continuous variables, respectively. A multivariate robust Poisson regression model was used to evaluate the probability of viral suppression (VS) for participants who transitioned to TLD. Differences in VS rate at follow-up between participants initiating TLE and TLD were assessed using the log-rank test and Kaplan-Meier survival curves.</p><p><strong>Results: </strong>A total of 1,073 participants were included, 284 were initiated on ART, and 789 with a transition opportunity, with a median age of 39 years (IQR 33, 46), and 905 females (83.9%). Participants who transitioned their ART regimen to TLD had a higher rate of achieving VS compared to those who remained on TLE (92.4% versus 84.4%, respectively; p = 0.005). Notably, participants who remained on TLE had a higher proportion of high viral load (VL ≥ 1000 copies/ml), 15.6%, compared to 7.6% of those who transitioned to TLD. In multivariable analysis, participants who were initiated on TLD as their first line ART had 3-fold higher likelihood of VS compared to those new to TLE (adjusted hazard ratio 3.07, 95% CI 1.88-5.03 (p-value < 0.001). Other factors were not significantly associated with VS.</p><p><strong>Conclusion: </strong>VS was higher in participants who transitioned to TLD and those initiated on TLD. Long-term follow-up of treatment-experienced, Integrase inhibitors (INSTI)-naïve and PLHIV who transitioned to the TLD regimen (with unknown viral loads or NRTI resistance) is recommended.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832903","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":"Antimicrobial resistance patterns of Staphylococcus aureus isolates in tertiary hospital in Somalia: a retrospective study.","authors":"Said Mohamed Mohamud, Liban Abdi Nor, Serpil Doğan, Rahma Yusuf, Haji Mohamud, Zerife Orhan, Abdulrahman Nor Abdi, Hassan Omar Hersi, Ahmet Doğan, Mohamed Mukhtar Mohamed","doi":"10.1186/s12879-026-13448-7","DOIUrl":"https://doi.org/10.1186/s12879-026-13448-7","url":null,"abstract":"<p><strong>Background: </strong>Staphylococcus aureus (S. aureus) is a commensal microorganism that is part of the normal human flora but has the potential to cause a wide range of infections, from superficial skin conditions to life-threatening systemic diseases such as bacteremia. The aim of this study was to evaluate the epidemiological characteristics and antimicrobial resistance patterns of S. aureus strains isolated between 2019 and 2024 at a tertiary hospital in Mogadishu, Somalia.</p><p><strong>Methods: </strong>In this retrospective study, a total of 1,381 S. aureus isolates obtained from various clinical specimens submitted from different departments to the Medical Microbiology Laboratory were analyzed. The isolates were identified using standard microbiological methods, and antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion method in accordance with Clinical and Laboratory Standards Institute (CLSI) criteria. Data were statistically analyzed, and a p-value of < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Of the 1,381 S. aureus isolates, 670 (48.51%) were identified as methicillin-resistant Staphylococcus aureus (MRSA), while 711 (51.49%) were methicillin-susceptible Staphylococcus aureus (MSSA). Of the isolates, 55.03% were obtained from male patients and 44.97% from female patients. The highest isolation rate was observed in the 18-64 year age group. Among clinical specimens, wound samples (47.57%) and blood cultures (37.14%) were the most common. Both MRSA and MSSA isolates were most frequently recovered from outpatient clinics, and a statistically significant difference was observed in distribution across clinical departments (p = 0.004). Antimicrobial susceptibility analysis revealed high resistance rates among MRSA isolates to penicillin G (98.61%), erythromycin (71.11%), and tetracycline (66%), while MSSA isolates showed high resistance to penicillin G (91.51%), tetracycline (53.57%), and levofloxacin (49.61%), while MSSA isolates showed high resistance to penicillin G (91.51%) and tetracycline (53.57%). Very low resistance rates were observed for linezolid, vancomycin, and quinupristin-dalfopristin.</p><p><strong>Conclusion: </strong>S. aureus remains a significant pathogen in the region, particularly due to the high prevalence of MRSA strains. The elevated resistance rates identified in this study underscore the need to tailor empirical treatment strategies based on local antibiogram data. Continuous surveillance and effective antimicrobial stewardship programs are critical for controlling the emergence and spread of antimicrobial resistance.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833147","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":"Seroprevalence, vaccination coverage and associated factors of hepatitis B and C infections among pregnant women in Azare, Bauchi State, Northeast Nigeria.","authors":"Auwal Magaji, Muhammad Abdullahi, Zinat Mahmud, Sabiu Aminu, Amina Auwal","doi":"10.1186/s12879-026-13506-0","DOIUrl":"https://doi.org/10.1186/s12879-026-13506-0","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis B and C virus infections remain major public health challenges, particularly in low- and middle-income countries. Pregnant women are a high-risk group due to the potential for mother-to-child transmission. This study assessed the prevalence of HBV and HCV infections, vaccination coverage, and associated factors among pregnant women in Northeastern Nigeria.</p><p><strong>Methods: </strong>This hospital-based cross-sectional study was conducted between April and November 2025. Blood samples were collected from 423 pregnant women attending selected hospitals, after obtaining socio-demographic information. The samples were screened for HBsAg and anti-HCV antibodies using rapid diagnostic test kits.</p><p><strong>Results: </strong>The prevalence of HBV, HCV, and HBV/HCV co-infection were 9.93%, 4.49%, and 0.95%, respectively. Higher prevalence of HBV (4.96%; 95% CI: 2.89-7.03) and HCV (2.13%; 95% CI: 0.76-3.50) was observed among women aged 25-34 years. Vaccination coverage was relatively low and was significantly associated with educational level (p < 0.001) and place of residence (p < 0.001). Awareness and knowledge of hepatitis infection, transmission routes, and vaccine acceptance were significantly associated with vaccination uptake. The major barriers to vaccination included lack of awareness (42.32%), fear of side effects (22.93%), and misconceptions regarding vaccine necessity (20.57%).</p><p><strong>Conclusion: </strong>HBV and HCV infections remain prevalent among pregnant women in Northeastern Nigeria, with low vaccination coverage and significant gaps in awareness and access to preventive services, demanding targeted health education, improved vaccination access and strengthened antennal programs to reduce the burden of the infections in the area.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833047","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":"Comparative diagnostic performance of saliva PCR and dried blood spot PCR for congenital cytomegalovirus detection: a systematic review and meta-analysis.","authors":"Benedict Osei Tawiah, Enoch Aninagyei, Ibrahim Anyass Goumboundi, Nana Gyeni Ntim, Richard K D Ephraim, Theophilus Adiku","doi":"10.1186/s12879-026-13494-1","DOIUrl":"https://doi.org/10.1186/s12879-026-13494-1","url":null,"abstract":"<p><strong>Background: </strong>Congenital cytomegalovirus (cCMV) infection is a leading cause of non-genetic sensorineural hearing loss and neurodevelopmental impairment. This study aimed to systematically evaluate and compare the diagnostic accuracy of saliva polymerase chain reaction (PCR) and dried blood spot (DBS) PCR for detecting cCMV in newborns.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. PubMed, Cochrane Library, ProQuest, and Google Scholar were searched for studies published between 2010 and 2025. Eligible studies reported sufficient data to construct 2 × 2 contingency tables and used urine PCR or culture as reference standards. Pooled sensitivity, specificity, likelihood ratios, diagnostic odds ratios, and summary receiver operating characteristic (SROC) curves were estimated using random-effects and bivariate models.</p><p><strong>Results: </strong>Nineteen studies comprising 103,669 neonates were included. Saliva PCR demonstrated high pooled sensitivity (0.95, 95% CI: 0.91-0.97) and perfect specificity (1.00, 95% CI: 0.99-1.00). In contrast, DBS PCR showed lower pooled sensitivity (0.72, 95% CI: 0.45-0.89) while maintaining high specificity (0.99, 95% CI: 0.92-1.00). Subgroup analysis revealed significantly higher sensitivity for saliva PCR compared with DBS PCR (p = 0.004). SROC analysis indicated superior overall diagnostic performance for saliva PCR (AUC = 0.72) relative to DBS PCR (AUC = 0.56). Substantial heterogeneity was observed, particularly among DBS studies.</p><p><strong>Conclusion: </strong>Saliva PCR demonstrates superior sensitivity and overall diagnostic accuracy for early detection of cCMV compared with DBS PCR, while both methods show high specificity. These findings support saliva PCR as the preferred modality for newborn screening where feasible, while DBS PCR may serve as a complementary or alternative approach in large-scale or resource-limited settings.</p><p><strong>Clinical trial: </strong>Not applicable.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833069","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":"Local insights into hepatitis B Virus: genotype distribution and clinical profiles among HIV/HBV co-infected patients in Maputo, Mozambique.","authors":"Lucia Mabalane Chambal, Esperança Sevene, Charlotta Nilsson, Corssino Tchavana, Orvalho Augusto, José Luís João, Elias Manjate, Alice Manjate, João Piedade, Ricardo Parreira","doi":"10.1186/s12879-026-13454-9","DOIUrl":"https://doi.org/10.1186/s12879-026-13454-9","url":null,"abstract":"<p><strong>Introduction: </strong>Hepatitis B virus (HBV) coinfection worsens HIV care outcomes and liver disease risk, but genotype-specific data in the World Health Organization (WHO) Africa Region is limited. To address this gap, we assessed HBV genotype distribution and genotype-specific clinical features in a cohort of people living with HIV (PLHIV) in Maputo City, Mozambique.</p><p><strong>Methods: </strong>This was a sub-analysis of a prospective cohort study that included newly diagnosed, HIV/HBV coinfected patients who were enrolled from May 2021 to November 2023. DNA extraction and partial-genome nested PCR with Sanger sequencing was performed on plasma samples. HBV genotypes were assigned by BLASTn, Geno2pheno, HBVdb, and NCBI-HBV, and phylogeny was inferred with MAFFT-based alignments and maximum likelihood-based phylogenetics. Clinical/laboratory data (Hepatitis B e antigen, HBV viral load, aspartate aminotransferase, alanine aminotransferase, CD4⁺ T cell count, HIV viral load) were recorded. Fibrosis was estimated using the AST-Platelet Ratio Index (APRI) score and WHO thresholds. R was applied for statistical analyses. Group comparisons used Pearson's chi-squared or Fisher's exact and Wilcoxon rank sum tests (complete-case analysis).</p><p><strong>Results: </strong>Of 1,106 newly diagnosed ART-naïve PLHIV, 81 (7.3%) were hepatitis B surface antigen (HBsAg)-positive and genotyping was successful in 55 (68%). Among HBV genotyped patients, the median age was 33.0 years (IQR 30.0, 39.0), 37 (67.3%) were male, 46 (83.6%) had HBV genotype A (subgenotype A1) and 9 (16.4%) genotype E. Median AST, ALT, and APRI scores tended to be higher in genotype E than subgenotype A1 cases, although differences were not statistically significant (AST 71.9 vs. 37.9 U/L; IQR 26.0-118.0 vs. 29.0-98.1; ALT 36.5 vs. 32.6 U/L; IQR 20.4-63.0 vs. 20.2-57.7; APRI 1.3 vs. 0.5; IQR 0.3-1.8 vs. 0.3-1.3). HBV DNA > 2,000 IU/mL occurred in 52.2% of subgenotype A1 and 55.6% of genotype E cases. Most cases were HBeAg-negative (A1: 36/46, 78.3%; E: 6/9, 66.7%).</p><p><strong>Conclusion: </strong>HBV subgenotype A1 and genotype E are prevalent among HIV/HBV coinfected patients in Maputo, often with high HBV DNA levels and evidence of liver injury. Routine HBV screening, simple fibrosis assessment and further research are recommended.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832980","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":"AI-based prediction of dengue incidence using climatic, environmental, and socio-demographic factors: an ensemble random forest approach with agile system development.","authors":"Tri Baskoro Tunggul Satoto, Nur Alvira Pascawati, Roger Frutos, Erizal, Triwibowo Ambar Garjito, Marko Ferdian Salim","doi":"10.1186/s12879-026-13270-1","DOIUrl":"https://doi.org/10.1186/s12879-026-13270-1","url":null,"abstract":"<p><strong>Background: </strong>Dengue transmission in Indonesia is shaped by interacting climatic, environmental, and socio-demographic factors, yet most forecasting systems remain static and vulnerable to data shifts. There is a critical need for adaptive, data-driven early-warning frameworks that integrate multiple predictor domains while preventing methodological biases such as information leakage. This study aimed to develop a Random Forest (RF)-based predictive model embedded within an Agile System Development workflow to forecast monthly dengue case counts in Yogyakarta.</p><p><strong>Methods: </strong>Monthly dengue case counts from five districts (2017-2022) were modeled using multi-domain predictors. All preprocessing steps-including imputation, standardization, correlation screening, VIF diagnostics, and Negative Binomial GLM-based feature screening-were performed exclusively on the 2017-2021 training subset, with parameters applied unchanged to the 2022 test set. The GLM served solely as a leakage-free exploratory screening tool. A Random Forest model was trained using optimized hyperparameters (500 trees, max depth 10) and evaluated through temporal testing. Model reliability was assessed using calibration curves, prediction-interval metrics, and a one-month early-warning classification evaluated with sensitivity, specificity, PPV, and NPV.</p><p><strong>Results: </strong>The RF model achieved strong predictive performance (R² = 0.86; RMSE = 5.72), exceeding the GLM benchmark (R² = 0.64). Rainfall lag-1, temperature, and humidity emerged as dominant predictors, complemented by built-up area and population density. Calibration indicated good agreement across routine transmission ranges, with reduced reliability during outbreak peaks. The early-warning component demonstrated high sensitivity (0.82) and strong negative predictive value (0.86), supporting its use as a decision-support indicator of elevated transmission risk.</p><p><strong>Conclusion: </strong>The proposed Agile-AI framework demonstrates the potential to deliver accurate dengue risk predictions with interpretable uncertainty estimates within a flexible, multi-domain early-warning architecture. While external validation and further refinement are required, the framework offers a scalable foundation for adaptive dengue surveillance and targeted vector-control decision support in dynamic tropical settings.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833055","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":"Hepatitis B vaccine uptake, completion, and associated factors among university students in Tanzania: a mixed method study at KCMC University, Moshi, Tanzania.","authors":"Emmanuel Thomas Issangya, Dhahiri Mnzava, Barnabas Gabriel, Basiliana Emidi, Geofrey Nimrod Sigalla, Debora Charles Kajeguka","doi":"10.1186/s12879-026-13501-5","DOIUrl":"https://doi.org/10.1186/s12879-026-13501-5","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis B Virus (HBV) infection remains a significant global public health concern, particularly in sub-Saharan Africa, where prevalence ranges between 6% and 8% among the general population. HBV is a major cause of chronic liver disease, cirrhosis, and hepatocellular carcinoma. Vaccination against HBV is highly effective in preventing infection; however, uptake and completion of the vaccine series remain suboptimal in many countries, including Tanzania. This study aimed to determine the uptake and completion of HBV vaccination and associated factors among students at KCMC University, Moshi, Tanzania.</p><p><strong>Methods: </strong>A mixed-methods study was conducted among 284 students at KCMC University, Tanzania. Data were collected using a pretested structured questionnaire, which captured information on socio-demographic characteristics, knowledge of hepatitis B virus infection and vaccination, and perceptions toward HBV vaccination. Data were analysed using descriptive and inferential statistics. A p-value of < 0.05 was considered statistically significant. Qualitative data were transcribed, thematically analysed, and subjected to content analysis to identify recurring themes and sub-themes.</p><p><strong>Results: </strong>A total of 284 participants were enrolled. with a mean age of 22.9 ± 3.9 years, and 175 (61.6%) were female. Vaccine uptake, defined as receiving at least one dose of the hepatitis B vaccine was 113 (39.8%), and only 68 (23.9%) completed all three doses. Uptake of vaccination was significantly associated with year of study (p < 0.05), program level (p = 0.008), knowledge of hepatitis B (p = 0.001), and awareness of mass vaccination campaigns (p = 0.003). Completion of the vaccine series was higher among bachelor's students (AOR = 1.8, 95% CI: 0.09-0.57, p = 0.001), participants who received training on hepatitis infection (AOR = 2.3, 95% CI: 1.2-7.6, p = 0.021), those knowledgeable about hepatitis B infection and prevention (AOR = 5.34, 95% CI: 2.2-4.7, p = 0.001), and who were aware of mass vaccination campaigns (AOR = 0.22, 95% CI: 0.12-0.27, p = 0.001).</p><p><strong>Conclusion: </strong>Hepatitis B vaccine uptake and completion among students remain low, indicating gaps in protection against HBV infection. Uptake was significantly associated with year of study, program level, knowledge of hepatitis B, and awareness of vaccination campaigns. Completion was linked to bachelor's level, hepatitis training, and knowledge. Strengthening targeted education, training, and vaccination campaigns is recommended.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832905","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":"When the meningitis-encephalitis panel is negative: off-label joint infection PCR detects CTX-M ESBL-producing Proteus mirabilis in adult meningoencephalitis.","authors":"Márk Kozák, Levente Majoros, Ferenc Bodnár, Rebeka Hodossy-Takács, Lilla Hudák, Lilla Rácz, Viktor Bencs, István Várkonyi","doi":"10.1186/s12879-026-13485-2","DOIUrl":"https://doi.org/10.1186/s12879-026-13485-2","url":null,"abstract":"<p><p>Spontaneous Gram-negative bacillary meningitis in adults is rare and carries high mortality, particularly in elderly patients with significant comorbidities. Although multiplex meningitis-encephalitis (ME) panels have improved diagnostic turnaround time, their limited pathogen spectrum may reduce sensitivity for certain clinically relevant Gram-negative organisms. We report a 78-year-old man presenting with acute meningoencephalitis, septic deterioration, and cerebrospinal fluid (CSF) findings strongly suggestive of bacterial infection. Despite marked neutrophilic pleocytosis and elevated protein levels, the multiplex ME panel was negative. Blood cultures subsequently yielded Proteus mirabilis. Given the discordance between inflammatory CSF findings and routine molecular testing, following interdisciplinary consultation, an off-label BioFire^® Joint Infection multiplex PCR panel was performed directly on CSF. The assay identified Proteus mirabilis harboring a cefotaximase-Munich (CTX-M)-type extended-spectrum β-lactamase (ESBL) resistance determinant. Based on this result, antimicrobial therapy was escalated from ceftriaxone-based empiric treatment to meropenem prior to availability of phenotypic susceptibility data. Despite early pathogen identification and targeted antimicrobial therapy, the patient died due to multiorgan dysfunction secondary to severe sepsis. This case suggests a potential diagnostic limitation of standard ME panels in selected high-risk scenarios and indicates that selective off-label use of broader multiplex PCR platforms may provide additional clinically relevant information in carefully selected patients. In the setting of high clinical suspicion and negative routine multiplex testing, rapid resistance-gene detection may provide actionable information within a decisive therapeutic window and support timely antimicrobial optimization in severe Gram-negative central nervous system infections. Further studies are required to evaluate the diagnostic performance and clinical impact of such approaches. Written informed consent for publication was obtained from the patient's next of kin, and the study was conducted in accordance with institutional and ethical standards.Clinical trial number Not applicable.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833024","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":"Psychosocial predictors of Hepatitis B testing intentions among non -pregnant women of reproductive age in rural Ghana: a Theory of Planned Behaviour approach.","authors":"Vivian Efua Senoo-Dogbey, Delali Adwoa Wuaku, Michael Ashaley Darko","doi":"10.1186/s12879-026-13500-6","DOIUrl":"https://doi.org/10.1186/s12879-026-13500-6","url":null,"abstract":"<p><strong>Introduction: </strong>The Prevention of Mother-To-Child Transmission (PMTCT) of Hepatitis B Virus (HBV) infection is a crucial strategy for achieving global HBV elimination by 2030. As HBV testing forms the foundation of effective PMTCT programs, empowering women of reproductive age to accept HBV testing and screening services is essential. This study applied the Theory of Planned Behaviour to investigate the impact of psychosocial factors, including attitude, subjective norm, perceived behavioural control, and risk perception, on HBV testing intentions among women of reproductive age.</p><p><strong>Methods: </strong>A hospital-based cross-sectional study was conducted among 400 non-pregnant women aged 18-49 years attending child welfare and family planning clinics in rural northern Ghana. Participants were selected using simple random sampling and completed a structured, pretested questionnaire based on constructs from the Theory of Planned Behaviour. Composite sum scores were computed for each construct, and internal consistency was assessed using Cronbach's alpha. Spearman's correlation and hierarchical multiple regression analyses were performed using SPSS version 26, with statistical significance set at p < .05.</p><p><strong>Results: </strong>The mean age of participants was 27.12 years (SD = 5.8). In the main-effects regression model, attitude (β = 0.650, p < .001), perceived behavioural control (β = 0.275, p < .001), and risk perception (β = 0.061, p = .022) were significant predictors of HBV testing intention, while subjective norms were not statistically significant. The model explained 75.3% of the variance in testing intention (R² = 0.753). When the interaction between attitude and subjective norms was added, the interaction term was statistically significant (β = -0.108, p < .001), accounting for an additional 1.1% of variance (ΔR² = 0.011).</p><p><strong>Conclusion: </strong>Attitude and perceived behavioural control were the primary predictors of HBV testing intention among women of reproductive age in rural northern Ghana. Risk perception showed a smaller association with intention, while subjective norms did not independently predict intention but moderated the relationship between attitude and intention. Interventions aimed at increasing HBV testing intention should prioritise strengthening positive attitudes and enhancing women's perceived ability to access testing services.</p><p><strong>Clinical trial registration: </strong>The study is a cross-sectional study and hence did not involve any experimentation or trial; clinical trial registration was not applicable in this case.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833028","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 value of preoperative CD4⁺ T-cell count in predicting infectious complications after endoscopic lithotripsy for upper urinary tract calculi among human immunodeficiency virus-infected patients.","authors":"Penghui Lai, Enming Shao, Zhe Zhu, Jun Ma, Kewen Chen, Wei Wang","doi":"10.1186/s12879-026-13413-4","DOIUrl":"https://doi.org/10.1186/s12879-026-13413-4","url":null,"abstract":"<p><strong>Background: </strong>To explore whether preoperative CD4⁺ T-cell count is associated with postoperative infectious outcomes after endoscopic lithotripsy for upper urinary tract calculi in human immunodeficiency virus (HIV)-infected patients.</p><p><strong>Methods: </strong>The HIV-infected patients who underwent endoscopic lithotripsy for upper urinary tract stones at Shanghai Public Health Clinical Center from May 2019 to May 2025 were enrolled for this study. The exposure of interest was the preoperative peripheral blood CD4⁺ T-cell count. The primary endpoint was urosepsis. Secondary outcomes included postoperative fever, systemic inflammatory response syndrome (SIRS), and other postoperative complications.</p><p><strong>Results: </strong>A total of 120 patients were enrolled in this study, including 20 patients with a CD4⁺ T-cell count < 200 cells/µL and 100 patients with a CD4⁺ T-cell count ≥ 200 cells/µL. None of the patients developed urosepsis or SIRS postoperatively. The overall rate of postoperative fever was 17.5% (21/120). Fever was observed in 15.0% of the patients with a CD4⁺ T-cell count < 200 cells/µL, compared with 18.0% of those with a CD4⁺ T-cell count ≥ 200 cells/µL, and there was no statistically significant difference (P > 0.05). Logistic regression analysis further showed that CD4⁺ T-cell count was not significantly associated with fever (OR = 1.001, 95% CI: 0.998-1.003, P = 0.586), whereas urine white blood cell count, stone density, and surgical approach were independently associated with fever. Sensitivity analyses using propensity score matching and inverse probability of treatment weighting showed similar results.</p><p><strong>Conclusion: </strong>In this retrospective single-center cohort, preoperative CD4⁺ T-cell count was not significantly associated with postoperative fever after endoscopic lithotripsy in HIV-infected patients. However, because no urosepsis events occurred and the sample size, particularly in the CD4⁺ T-cell count < 200 cells/µL subgroup, was limited, the study could not adequately evaluate the primary endpoint. These findings should therefore be considered exploratory and require confirmation in larger studies incorporating HIV viral load and procedure-specific analyses.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147810908","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}