BMC Infectious Diseases最新文献

{"title":"Risk factors for poor outcomes in patients with drug-resistant tuberculosis: a 6-year multicenter prospective study in Zhejiang, China.","authors":"Xuewen Feng, Li Hong, Zhongkang Ji, Cheng Ding, Yanwan Shangguan, Wanru Guo, Songhua Chen, Zebao He, Ying Zhang, Bing Ruan, Kaijin Xu","doi":"10.1186/s12879-025-10802-z","DOIUrl":"10.1186/s12879-025-10802-z","url":null,"abstract":"<p><strong>Background: </strong>At present, the disease burden of drug-resistant tuberculosis (DR-TB) is still heavy in the world. In this study, we aimed to evaluate the success rate of DR-TB patients after standardized treatment and to analyze the risk factors for poor outcomes in Zhejiang, China.</p><p><strong>Methods: </strong>From 2017 to 2021, all culture-confirmed tuberculosis (TB) patients were prospectively enrolled from three designated TB hospitals in Zhejiang, China. Demographic surveys were conducted in all patients, and drug susceptibility of TB strains was tested by fluorescent polymerase chain reaction probe melting curve analysis (MeltPro). DR-TB patients were treated with WHO recommended standardized treatment according to the type of drug resistance, and the outcomes were thoroughly monitored and tracked until June 2023. Binary logistic regression model was used to analyze the related risk factors of poor outcomes in patients with DR-TB. The patients' socio-demographic information, comorbidities, fever, antibiotic use, laboratory test results, lung imaging characteristics and drug resistance characteristics were included in the analysis. A simple TB severity score was developed according to the WHO definition and applied to the analysis.</p><p><strong>Results: </strong>Among 1013 patients with confirmed TB, 779 were sensitive to all of the tested drugs (rifampicin, isoniazid, ethambutol, streptomycin and fluoroquinolones), and 234 were resistant to at least one tested drug. Among the 234 DR-TB patients in the study, 50 patients had poor outcomes (23 cases of failure, 13 cases of death, and 14 patients lost to follow-up), 158 patients were successfully treated (125 cases were cured and 33 cases completed treatment), and 26 were referred to other provinces. The overall treatment success rate was 76.0% (158/208). Multivariate analysis showed that age (AOR 1.03; 95%CI 1.01-1.05), previous TB treatment history (AOR 5.03; 95%CI 1.33-18.99), higher TB severity score (AOR 1.48; 95%CI 1.09-2.03), MDR/RR-TB (AOR 8.34; 95%CI 2.99-23.24) and pre-XDR-TB (AOR 9.50; 95%CI 2.24-40.26) were independent risk factors for poor outcomes in DR-TB patients.</p><p><strong>Conclusions: </strong>The treatment success rate of DR-TB patients in this study reached that of the WHO standard treatment (75%). Physicians should be alert to the possibility of poor outcomes in DR-TB patients with old age, previous TB treatment history, higher TB severity score, MDR/RR-TB or pre-XDR-TB.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"422"},"PeriodicalIF":3.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717825","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":"Usage of post-exposure prophylaxis and its impact on risk behaviors among men who have sex with men in Qingdao, China.","authors":"Rong Su, Yi Liu, Peilong Li, Lin Ge, Meizhen Liao, Yong Fu, Xin Song, Houlin Tang, Dongmin Li","doi":"10.1186/s12879-025-10795-9","DOIUrl":"10.1186/s12879-025-10795-9","url":null,"abstract":"<p><strong>Background: </strong>Men who have sex with men (MSM) are key populations for HIV infection. Post-exposure prophylaxis (PEP) has been confirmed to be an effective measure for preventing HIV transmission. This study aimed to investigate the usage of PEP among MSM in Qingdao and its associated factors, analyze the impact of PEP usage on risk behaviors, and offer insights for HIV prevention.</p><p><strong>Methods: </strong>Between April and August 2021, a cross-sectional survey was conducted in Qingdao, relying on local community-based organizations (CBOs) and employing a snowball sampling method to recruit eligible MSM. We gathered sociodemographic information, behavioral data, and PEP usage details from the participants. The analysis of factors associated with PEP utilization among MSM was performed using a logistic regression model. Subsequently, a follow-up visit was conducted six months later, collecting behavioral information from the participants. Generalized estimating equations fitting Poisson regression were utilized to analyze behavioral changes during the follow-up for PEP users and non-PEP users.</p><p><strong>Results: </strong>A total of 602 MSM were enrolled in this study, with a median age of 30.0 years. Among them, 140 individuals used PEP in the last 6 months, resulting in a usage rate of 23.3% (140/602). Factors associated with PEP usage included monthly income ≥ 5000 RMB (aOR = 2.092, 95%CI: 1.366-3.203) and engaging in group sex ≥ 3 times in the last 6 months (aOR = 1.844, 95%CI: 1.067-3.189). In the follow-up survey, 467 individuals participated, comprising 112 PEP users and 355 non-PEP users. Compared to the baseline, the proportion of non-PEP users with Rush Popper usage frequency ≥ 1 time/week increased from 19.3% to 34.4% during follow-up (RR = 1.671, 95%CI: 1.302-2.146), and the proportion of those engaging in unprotected anal intercourse in the past 6 months increased from 95.5% to 98.6% (RR = 1.029, 95%CI: 1.004-1.056). However, the risk behaviors of PEP users exhibited no significant changes during the study period (P > 0.05).</p><p><strong>Conclusions: </strong>Higher frequency of group sex and higher monthly income emerged as facilitating factors for PEP usage among MSM in Qingdao. Beyond its efficacy in preventing HIV infection, PEP may also play a role in managing the occurrence of risk behaviors among MSM. Consequently, there is a pressing need to intensify efforts to promote PEP uptake among MSM as a strategy to control the spread of HIV.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"421"},"PeriodicalIF":3.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717830","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":"Seroprevalence of anti-SARS-CoV-2 IgG antibodies among children attending the pediatric hospital in Bamako, Mali (BamaCoV-Kids Study).","authors":"Almoustapha Issiaka Maiga, Amadou Kodio, Salimata Alou Ouedraogo, Aliou Baldé, Penda Dembele, Fatoumata Tata Traore, Oumar Dolo, Josué Togo, Yacouba Aba Coulibaly, Mariam Sylla, Robert L Murphy, Anne-Geneviève Marcelin, Vincent Calvez, Abdoul Aziz Diakité, Eve Todesco","doi":"10.1186/s12879-025-10762-4","DOIUrl":"10.1186/s12879-025-10762-4","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to assess the seroprevalence of SARS-CoV-2 among children attending pediatric consultations in Bamako, Mali, using a rapid diagnostic test (RDT) on fingertip or venous blood samples.</p><p><strong>Methods: </strong>A single-center, cross-sectional study was conducted from May to September 2022 at the Pediatric Hospital in Bamako, Mali. Children aged 1 to 15 years underwent phlebotomy or fingertip blood sampling for SARS-CoV-2 antibody testing using the Abbott Panbio COVID-19 IgG/IgM Test. Demographic data and potential risk factors (for children: age, gender, place of residence, household type and size, transport mode; for parents: education, COVID-19 infection and vaccination status, contact with positive cases, and travel) were collected. Categorical variables were compared using Fisher's exact test, and quantitative variables were analyzed using the Mann-Whitney test.</p><p><strong>Results: </strong>A total of 315 children were included, with a median age of 6 years (IQR 3-9 years); 45.7% (144/315) were younger than 6 years, and 54% (170/315) were male. The majority lived in urban areas (89.9%) and used public transportation (85.7%). The overall seroprevalence was 63.5%, with a higher seroprevalence observed among children aged 6 years and older compared to those under 6 years. The odds of having a positive serology were approximately twice as high in children aged ≥ 6 years in both univariable (OR 1.99; 95% CI: 1.25-3.17; P = 0.0014) and multivariable analyses (OR 2.05; 95% CI: 1.28-3.29; P = 0.0028). No significant differences in seropositivity were found for other demographics or risk factors.</p><p><strong>Conclusions: </strong>A substantial proportion of children in Bamako showed evidence of past SARS-CoV-2 infection, underscoring the importance of continued surveillance and preventive measures in this population.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"429"},"PeriodicalIF":3.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728290","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":"Infective endocarditis caused by Streptococcus sinensis diagnosed with next-generation sequencing: a case report and literature review.","authors":"Rong Wang, Bin Niu, Jiaolong Ren, Liaoyun Zhang","doi":"10.1186/s12879-025-10837-2","DOIUrl":"10.1186/s12879-025-10837-2","url":null,"abstract":"<p><strong>Background: </strong>Infective endocarditis (IE) caused by Streptococcus sinensis is rare and challenging to diagnose due to the irregular use of antibiotics and the limitations of conventional diagnostic methods. Metagenomaic next-generation sequencing (mNGS) has emerged as a valuable diagnostic tool, offering significantly enhanced accuracy in identifying elusive pathogens, particularly in blood culture-negative endocarditis (BCNE).</p><p><strong>Case presentation: </strong>We reported the case of a 33-year-old male who presented with recurrent intermittent fever lasting over six months. Despite multiple diagnostic attempts, including blood cultures, no causative pathogen was identified. Blood mNGS revealed the presence of S. sinensis, a rare pathogen associated with IE. Echocardiography confirmed vegetation on the mitral and aortic valves, leading to a possible diagnosis of IE. The patient underwent successful surgical valve replacement, and subsequent mNGS of excised valve tissue confirmed the presence of S. sinensis. We administered a tailored antibiotic regimen, and the patient achieved a favorable recovery with no significant complications during follow-up.</p><p><strong>Results: </strong>We identified 11 additional cases of S. sinensis-induced IE through a literature review, including patients from diverse geographic regions and age groups. Most cases were associated with prior dental procedures or poor oral health. Common diagnostic methods included blood culture and 16 S rRNA sequencing, while recent cases utilized mNGS. Treatment typically involved penicillin-based antibiotics combined with gentamicin, with surgical intervention in most cases leading to favorable outcomes.</p><p><strong>Conclusions: </strong>This case highlights the diagnostic value of mNGS in identifying pathogens in IE, particularly when traditional methods fail due to prior antibiotic use. While mNGS has significant advantages in pathogen detection, it cannot replace standard microbiological techniques and should be considered a complementary approach. Integrating mNGS into clinical workflows can improve diagnostic accuracy, especially in BCNE cases, and guide effective treatment strategies.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"425"},"PeriodicalIF":3.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728285","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":"Viral suppression in the context of SARS-CoV-2 among children infected with HIV-1 monitored in five health facilities in Benin.","authors":"Edwige Hermione Dagba Gbessin, Michel Kiréopori Gomgnimbou, René Kpemahouton Keke, Haziz Sina, Aldric Afangnihoun, Moussa Bachabi, Abdoul-Salam Ouedraogo, Lamine Baba-Moussa","doi":"10.1186/s12879-025-10830-9","DOIUrl":"10.1186/s12879-025-10830-9","url":null,"abstract":"<p><p>Monitoring the effectiveness of antiretroviral treatment by measuring viral load is a strong recommendation from the WHO following the intensification of this therapy, which, if well managed, improves patients' quality of life. In children, treatment options are limited and virological non-suppression is high. Virological suppression among children living with HIV who were followed at care facilities during the SARS-CoV-2 pandemic is poorly documented in countries with intermediate resources, such as Benin. Methods A longitudinal study was carried out from November 20, 2020, among children under 15 years of age who had been receiving ART for at least six months in five healthcare facilities. TCD4 lymphocytes (LTCD4) count was performed using the CyFlow counter II (from Partec laboratories). Viral load was performed using the Abbott RealTime HIV-1 assay (Abbott Molecular, Inc.). The linear range of 40-10.000.000 copies/ml and a detection limit of 40 copies/ml were defined by the manufacturers. Virological success was assessed as a suppressed viral load (VL < 3log₁₀). For children whose VL₁ ≥ 3log₁₀, WHO 2016 recommendations were applied and therapeutic education sessions were offered for 3 months, after which VL₂ was measured. Children whose (VL₁ and VL₂) ≥ 3log₁₀ were considered not suppressed. Results The mean age of 305 children enrolled was 110 (SD 41.25) months, with a predominance of girls at 52.8% (161/305). The median LTCD4 at study starting was 814 [IQR 544-1118] cells/µl. Overall, 73.11% (223/305) of children achieved virological success at the first viral load measurement, compared to 79.63% (219/275) at the second (03 months after the first). Between the two measurements, 9.83% (30/305) of children did not keep their medical appointments due to SARS-CoV-2 pandemic restrictions. Also, 20.73% (17/82) of non-suppressed children at VL₁ went undetectable. Among the 17.1% (47/275) of unsuppressed children, 10.64% (5/47) were on integrase strand transfer inhibitors as DTG (Dolutegravir). Conclusion This study, conducted in children on ART during the SARS-CoV-2 pandemic, highlighted a high rate of retention in care and viral suppression. However, there are challenges in achieving the UNAIDS third 95 to ensure sustainable viral suppression in children.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"427"},"PeriodicalIF":3.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728292","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":"Anesthetic choice impacts mortality and bacterial clearance in a murine experimental pneumonia model.","authors":"Hunter Gage, Shawn M Hannah, Bryan Hancock, Ingrid Cornax, Jason Munguia, Joshua Olson, Elisabet Bjånes, Raymond Zurich, Alexandria Hoffman, Fatemeh Askarian, Khang Tong, Lin Liu, Victor Nizet, Angela Meier","doi":"10.1186/s12879-025-10785-x","DOIUrl":"10.1186/s12879-025-10785-x","url":null,"abstract":"<p><strong>Background: </strong>Animal models of infectious pneumonia often require the use of anesthetics, but their choice and impact on outcome is rarely discussed. This study investigates the impact of the most commonly used anesthetics on mortality and bacterial clearance in a murine model of Pseudomonas aeruginosa pneumonia.</p><p><strong>Methods: </strong>Isoflurane or ketamine/xylazine were determined to be the most commonly utilized anesthetics for murine pneumonia models. Mice were anesthetized with either ketamine/xylazine or isoflurane during intratracheal infection with P. aeruginosa strains PA14 or PA01. Mortality, bacterial clearance, and lung tissue damage were compared. Additional in vitro assays assessed the effects of ketamine on human whole blood killing, serum killing, and neutrophil functions (reactive oxygen species (ROS) production, neutrophil extracellular trap (NET) production, chemotaxis, and phagocytosis).</p><p><strong>Results: </strong>Mice anesthetized with ketamine/xylazine and infected with PA14 had significantly increased mortality (p = 0.004), and significantly higher bacterial burdens in the blood (p = 0.01) and lungs (p < 0.001). In separate experiments with PA01, mice anesthetized with ketamine/xylazine had significantly increased mortality (p = 0.01), higher bacterial burdens in the blood (p = 0.01), and higher bacterial burdens in the lungs (p = 0.02), along with increased lung tissue pathology (p = 0.03) compared to mice anesthetized with isoflurane. Increased mortality and colony forming units were also observed in mice infected under propofol anesthesia, recovered, and subsequently exposed to ketamine versus control (p = 0.004 and p < 0.001, respectively). Ketamine marginally reduced the killing of PA14 in freshly drawn human whole blood (p = 0.0479), but had no significant effect on the serum's ability to kill PA14. In addition, ketamine reduced in vitro NETosis and chemotaxis (all p < 0.05), but had no significant effect on ROS production or phagocytosis of human neutrophils. These in vitro effects were observed only at supraclinical ketamine concentrations.</p><p><strong>Conclusions: </strong>Our study emphasizes that the choice of anesthetic impacts key outcomes in murine models of pneumonia, and should therefore be an important consideration in experimental design and when comparing results across different studies.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"424"},"PeriodicalIF":3.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728356","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":"Machine learning-based risk prediction model for pertussis in children: a multicenter retrospective study.","authors":"Juan Xie, Run-Wei Ma, Yu-Jing Feng, Yuan Qiao, Hong-Yan Zhu, Xing-Ping Tao, Wen-Juan Chen, Cong-Yun Liu, Tan Li, Kai Liu, Li-Ming Cheng","doi":"10.1186/s12879-025-10797-7","DOIUrl":"10.1186/s12879-025-10797-7","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Pertussis is a highly contagious respiratory disease. Even though vaccination has reduced the incidence, cases have resurfaced in certain regions due to immune escape and waning vaccine efficacy. Identifying high-risk patients to mitigate transmission and avert complications promptly is imperative. Nevertheless, the current diagnostic methods, including PCR and bacterial culture, are time-consuming and expensive. Some studies have attempted to develop risk prediction models based on multivariate data, but their performance can be improved. Therefore, this study aims to further optimize and expand the risk assessment tool to more efficiently identify high-risk individuals and compensate for the shortcomings of existing diagnostic methods.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The aim of this study was to develop a pertussis risk prediction model that is both efficient and has good generalization ability, applicable to different datasets. The model was constructed using machine learning techniques based on multicenter data and screened for key features. The performance and generalization ability of the model were evaluated by deploying it on an online platform. At the same time, this study aims to provide a rapid and accurate auxiliary diagnostic tool for clinical practice to help identify high-risk patients in a timely manner, optimize early intervention strategies, reduce the risk of complications and reduce transmission, thereby improving the efficiency of public health management.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;First, data from 1085 suspected pertussis patients from 7 centers were collected, and ten key features were analyzed using the lasso regression and Boruta algorithm: PDW-MPV-RATIO, SII, white blood cells, platelet distribution width, mean platelet volume, lymphocytes, cough duration, vaccination, fever, and lytic lymphocytes.Eight models were then trained and validated to assess their performance and to confirm their generalization ability with external datasets based on these features. Finally, an online platform was constructed for clinicians to use the models in real time.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The random forest model demonstrated excellent discrimination ability in the validation set, with an AUC of 0.98, and an AUC of 0.97 in the external validation set. Calibration curve and decision curve analysis showed that the model had high accuracy in predicting low-to-medium risk patients, which could help clinicians avoid unnecessary interventions, especially in resource-limited settings. The application of this model can help optimize the early identification and management of high-risk patients and improve clinical decision-making.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The pertussis prediction model devised in this study was validated using multicenter data, exhibited high prediction performance, and was successfully implemented online. Future research should broaden the data sources and incorporate dyn","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"428"},"PeriodicalIF":3.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728288","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":"Correlation between peripheral lymphocyte subsets monitoring and COVID-19 pneumonia in kidney transplant recipients.","authors":"Quan Zhuang, Jiang Zhu, Bo Peng, Yi Zhu, Ke Cheng, Yingzi Ming","doi":"10.1186/s12879-025-10581-7","DOIUrl":"10.1186/s12879-025-10581-7","url":null,"abstract":"<p><strong>Objectives: </strong>In kidney transplant recipients (KTRs), immune monitoring of peripheral lymphocyte subsets (PLS) reflects the real immune status and aids in the diagnosis of the occurrence and development of infectious diseases, including COVID-19. Exploring the PLS of COVID-19 pneumonia in KTRs is important.</p><p><strong>Methods: </strong>In this study, a total of 103 KTRs were divided into mild pneumonia (MP) and severe pneumonia (SP) groups, as well as a stable group. The clinical information and PLS data were assessed via t or Mann-Whitney test and receiver operating curve analysis. Logistic regression was employed to identify the risk factors, and Spearman's correlation analysis was used to identify correlations.</p><p><strong>Results: </strong>Lymphopenia is a common manifestation of COVID-19 in KTRs, and it is positively related to the severity of COVID-19 pneumonia. The CD3 + T-cell count had the highest AUC between the MP and the SP. Multiple PLS measures were found to be independent risk factors for COVID-19 pneumonia progression in KTRs.</p><p><strong>Conclusions: </strong>This study revealed a robust correlation between PLS and severe COVID-19 pneumonia progression in KTRs. PLS monitoring could facilitate real-time diagnosis and therapy for infection, as well as timely and precisive adjustment of immunosuppression instructions, for KTRs with COVID-19.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"426"},"PeriodicalIF":3.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728361","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":"Biological profile and risk factors of mortality in COVID-19 patients at Adlucem hospital in Banka-Bafang, Cameroon: a cross-sectional study.","authors":"Bertin Mamere Atangana Awundja, Boris Ronald Tonou Tchuente, Vervaine Pauline Hagbe, Leila Sandra Nnanga, Linda Kamdem, Dudric Yannick Enonguene Ekedjoum, Onana Messi Hubert Roger, Belomo Maguerrite, Dehayem Patricia, Julius Achidi Ndanji, Leonel Javeres Ntepe Mbah, Evelyn Ngwa Lumngwena, Bienvenu Bongue, Judith Laure Ngondi","doi":"10.1186/s12879-025-10845-2","DOIUrl":"10.1186/s12879-025-10845-2","url":null,"abstract":"<p><strong>Background: </strong>Despite availability of preventive vaccine and global control of the SARS-CoV-19 transmission, continuous emergence of new strains coupled with the increase spread of Mpox poses significant public health threats. Identification of simple factors for stratification and prognostics of hospitalized patients is crucial for management of these patients in limited resource settings. The aim of this study was to assess the biological profile of severe hospitalized COVID-19 patients in Cameroon and identify risk factors for mortality.</p><p><strong>Methods: </strong>A prospective, cross-sectional, analytical study was conducted of a cohort of COVID-19 patients admitted and managed at the Adlucem hospital in Banka-Bafang, Haut-Nkam Department, West Cameroon Region, from 2021 to 2022. The clinical characteristics and biological parameters of patients with COVID-19 were evaluated.</p><p><strong>Results: </strong>Of the 259 cases of COVID-19 included in the study, 68 cases (26.3%) died. The majority of patients who died were over 70 years of age. Key factors predictive of mortality in these patients were leukocytosis (OR = 2.035; 95%CI: 1.161-3.567; p = 0.013), thrombocytosis (OR = 4.286; 95%CI: 1.152-15.950; p = 0.030), hypokalemia (OR = 2.400; 95%CI: 1.143-5.042; p = 0.021), hyponatremia (OR = 2.292; 95%CI: 1.185-4.431; p = 0.014) and hypochloremia (OR = 2.644; 95%CI: 1.188-5.882; p = 0.017).</p><p><strong>Conclusion: </strong>Age, electrolyte imbalance and thrombocytosis were predictive of death in COVID-19 patients in this cohort. Thus, a biological work-up should be considered for risk stratification to ensure efficient management of COVID-19 patients on a case-by-case basis in resource limited settings like Cameroon.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"420"},"PeriodicalIF":3.4,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717585","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":"Explainable AI for Symptom-Based Detection of Monkeypox: a machine learning approach.","authors":"Gizachew Mulu Setegn, Belayneh Endalamaw Dejene","doi":"10.1186/s12879-025-10738-4","DOIUrl":"10.1186/s12879-025-10738-4","url":null,"abstract":"<p><strong>Background: </strong>Monkeypox, a viral zoonotic disease, is an emerging global health concern, with rising incidence and outbreaks extending beyond its endemic regions in Central and, West Africa and the world. The disease transmits through contact with infected animals and humans, leading to fever, rash, and lymphadenopathy symptoms. Control efforts include surveillance, contact tracing, and vaccination campaigns; however, the increasing number of cases underscores the necessity for a coordinated global response to mitigate its impact. Since monkeypox has become a public health issue, new methods for efficiently identifying cases are required. The control of monkeypox infections depends on early detection and prediction. This study aimed to utilize Symptom-Based Detection of Monkeypox using a machine-learning approach.</p><p><strong>Methods: </strong>This research presents a machine learning approach that integrates various Explainable Artificial Intelligence (XAI) to enhance the detection of monkeypox cases based on clinical symptoms, addressing the limitations of image-based diagnostic systems. In this study, we used a publicly available dataset from GitHub containing clinical features about monkeypox disease. The data have been analysed using Random Forest, Bagging, Gradient Boosting, CatBoost, XGBoost, and LGBMClassifier to develop a robust predictive model.</p><p><strong>Results: </strong>The study shows that machine learning models can accurately diagnose monkeypox based on symptoms like fever, rash, lymphadenopathy and other clinical symptoms. By using XAI techniques for feature importance, the approach not only achieved high accuracy but also provided transparency in decision-making. This integration of explainable Artificial intelligence (AI) enhances trust and allows healthcare professionals to understand predictions, leading to timely interventions and improved public health responses to monkeypox outbreaks. All Machine learning methods have been compared with the evaluation matrix. The best performance was for the LGBMClassifier, with an accuracy of 89.3%. In addition, multiple Explainable Techniques tools were used to help in examining and explaining the output of the LGBMClassifier model.</p><p><strong>Conclusions: </strong>Our research shows that combining explainable techniques with AI models greatly enhances the accuracy of case detection and boosts the trust of medical professionals. These models result in directly involving the reader and health care professional in the decision-making process, making informed decisions, and efficiently allocating resources by providing insight into the decision-making process. In addition, this study underscores the potential of AI in public health surveillance, particularly in enhancing responses to emerging infectious diseases such as monkeypox.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"419"},"PeriodicalIF":3.4,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717608","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}