BMC Infectious Diseases最新文献

{"title":"Examining socioeconomic differences in sepsis risk and mediation by modifiable factors: a Mendelian randomization study.","authors":"Vilde Hatlevoll Stensrud, Tormod Rogne, Helene Marie Flatby, Randi Marie Mohus, Lise Tuset Gustad, Tom Ivar Lund Nilsen","doi":"10.1186/s12879-025-11130-y","DOIUrl":"10.1186/s12879-025-11130-y","url":null,"abstract":"<p><strong>Background: </strong>Educational attainment is inversely related to sepsis risk, but the causal nature is still unclear. We therefore conducted the first Mendelian randomization (MR) study of genetically predicted educational attainment on sepsis that also uses a within-family genetic instrument for education. To further explore possible mechanistic pathways that can inform strategies to reduce sepsis risk, we examined the mediating effects of factors that are modifiable or can be prevented.</p><p><strong>Methods: </strong>The association between genetically predicted educational attainment and sepsis was estimated using summary-level data from recent genome-wide association studies. Possible bias due to population stratification, dynastic effects, and assortative mating in the genetic instrument for education was evaluated using summary-level data from a within-sibship genome-wide association study. We used inverse variance weighted MR analysis to estimate the effect of one standard deviation increase in years of education on sepsis risk. The robustness of the findings was assessed in sensitivity analyses, applying weighted median, weighted mode, and MR Egger regression. Finally, we applied multivariable MR analyses to estimate the mediating effects of smoking initiation, alcohol consumption, body mass index, high-density lipoprotein (HDL)-cholesterol, systolic blood pressure and type 2 diabetes.</p><p><strong>Results: </strong>For each standard deviation increase in genetically predicted educational attainment (3.4 years), the odds ratio (OR) for sepsis was 0.72 (95% confidence interval (CI) 0.66 to 0.78). The results of the analysis using the within-sibship genetic instrument and other sensitivity analyses were in line with this finding: within-sibship OR 0.88 (95% CI 0.64 to 1.18), weighted median OR 0.70 (95% CI 0.62 to 0.80), weighted mode OR 0.70 (95% CI 0.43 to 1.13), and MR Egger OR 0.65 (95% CI 0.50 to 0.85). The mediation analysis showed that 56% of the effect of educational attainment on sepsis risk can be explained by modifiable or preventable factors.</p><p><strong>Conclusions: </strong>Higher educational attainment is strongly associated with a reduced risk of sepsis, pointing to important socioeconomic differences in this disease. The results also suggest that interventions targeting modifiable or preventable factors could contribute to reducing the socioeconomic differences in sepsis risk.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"739"},"PeriodicalIF":3.4,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144131871","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":"Factors affecting the severity of respiratory infections: a hospital-based cross-sectional study.","authors":"Yunshao Xu, Li Qi, Jule Yang, Yuping Duan, Mingyue Jiang, Yanxia Sun, Yanlin Cao, Zeni Wu, Wenge Tang, Luzhao Feng","doi":"10.1186/s12879-025-11121-z","DOIUrl":"10.1186/s12879-025-11121-z","url":null,"abstract":"<p><strong>Background: </strong>Acute respiratory infections (ARIs) are a leading cause of global morbidity and mortality, with disease severity influenced by factors such as advanced age, underlying comorbidities, and pathogen type. This report analyzed the association between several clinical variables and disease severity.</p><p><strong>Methods: </strong>A hospital-based cross-sectional study was conducted from September 2023 to April 2024, with data collected from eight districts in Chongqing, China. The study included 1,638 patients with ARIs, including both severe and mild cases. Severe cases were identified using the qSOFA and APACHE II scores, while demographic and clinical data were obtained via questionnaires and hospital records. Pathogen detection was performed using real-time quantitative PCR. Data analysis was carried out using Stata 17.0, with multiple logistic regression models assessing the associations between clinical factors and disease severity.</p><p><strong>Results: </strong>Influenza A was the most prevalent pathogen, detected in 65.1% of severe cases and 32.9% of mild cases (P < 0.001). 42.0% (165/393) of severe cases had viral and bacterial co-infections, compared to 26.8% (334/1,245) of mild cases (P < 0.001). The most common pathogens in co-infections included influenza A and Streptococcus pneumoniae. Severe cases were more common in rural areas (28.8% vs. 18.1%, P < 0.001) and among older adults (≥ 60 years) (28.2% vs. 13.5%, P < 0.001). Clinical symptoms such as fever (61.8% vs. 40.9%, P < 0.001), cough (68.7% vs. 53.2%, P < 0.001), and dyspnea (34.8% vs. 15.1%, P < 0.001) were significantly more prevalent in severe cases. Logistic regression analysis showed that influenza A (OR: 4.52, 95% CI: 3.51-5.85), Streptococcus pneumoniae (OR: 1.54, 95% CI: 1.28-2.15), and pre-existing cardiovascular diseases (OR: 1.96, 95% CI: 1.28-2.99) were significantly associated with the development of severe outcomes.</p><p><strong>Conclusions: </strong>This study underscores the complex interplay of factors influencing ARI severity, including pathogen type, co-infections, age, and underlying medical conditions. Early identification of high-risk patients, particularly those with bacterial co-infections and cardiovascular comorbidities, is essential for improving clinical outcomes in ARI patients. Targeted treatment and preventative strategies are needed to mitigate severe disease in vulnerable populations.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"735"},"PeriodicalIF":3.4,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12100775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144131873","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":"Genome diversity of SARS-CoV-2 lineages associated with vaccination breakthrough infections in Addis Ababa, Ethiopia.","authors":"Abebe M Aga, Demise Mulugeta, Atsbeha Gebreegziabxier, Girum Taye Zeleke, Aderajew Mekonnen Girmay, Gutema Bulti Tura, Abaysew Ayele, Ahmed Mohammed, Tigist Belete, Tefera Taddele, Rajiha Abubeker, Fanos Tadesse Woldemariyam, Tesfaye Gelanew, Yeweynshet Tesera, Bedasa Gidisa, Jaleta Bulti Tura, Gemechu Tadesse Leta, Abraham Ali, Senait Alemayehu Beshah, Bedasa Wagari Likasa, Jemal Mohammed, Dereje Nigussie","doi":"10.1186/s12879-025-11107-x","DOIUrl":"10.1186/s12879-025-11107-x","url":null,"abstract":"<p><strong>Background: </strong>Extensive vaccination campaigns against COVID-19 have played a significant role in controlling virus spread and preventing severe illness. This study focused on breakthrough infections in vaccinated individuals, raising concerns about vaccine effectiveness against SARS-CoV-2 variant immune escape, with particular attention to lineage distribution among vaccinated and unvaccinated individuals.</p><p><strong>Methods: </strong>A case-control study was conducted from January to April 2023, sequencing 298 samples from participants who tested positive for COVID-19 via rapid diagnostic test (RDT) from 22 health facilities, including vaccinated and unvaccinated cases. Besides clinical and epidemiological data, nasopharyngeal swabs were obtained, and reverse transcription quantitative polymerase chain reaction (RT-qPCR) was conducted to determine Cycle threshold (Ct) values, followed by whole genome sequencing of 298 samples fulfilling sequencing criteria to identify variants of concern and specific virus lineages.</p><p><strong>Results: </strong>Out of 298 samples sequenced, 281 fulfill quality for analysis with 44.8% (126) had received at least one COVID-19 vaccine dose, while 51.9% (146) were not vaccinated, and 3.2% (9) patients had no vaccination records. The analysis showed that all cases were of the Omicron variant, with the XBB.1.5 lineage being the most prevalent (38.4%), followed by FL.2 (9.3%) and XBB.1.9.1.2 (7.8%). The remaining 44.5% comprised a combination of 22 other lineages. The XBB.1.5 variant accounted for 51 (47.2%) cases among vaccinated individuals with at least one dose and 57 (52.8%) among unvaccinated, showing relatively similar prevalence across both groups. The viral load as indicated by the Ct value varied widely, with a significant appearance in the lower ranges (high viral load), suggesting active viral replication. Notably, 25% of samples exhibited high viral loads (Ct values 13-15), showing the high transmissibility of the XBB.1.5 lineage among both vaccinated and unvaccinated populations.</p><p><strong>Conclusion: </strong>The findings emphasize the need for continuous genomic surveillance and regular vaccine updates to address emerging SARS-CoV-2 variants, particularly the immune-evasive XBB lineage. The high prevalence of variants like XBB.1.5 in breakthrough infection underscores the importance of adaptive vaccination strategies and next-generation vaccines to maintain efficacy. Ongoing monitoring of variant dynamics is crucial for informed public health responses, strengthening pandemic preparedness and future outbreak prevention.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"738"},"PeriodicalIF":3.4,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12102866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144131915","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":"Healthcare-Seeking behavior for sexually transmitted infections among women who initiated sexual intercourse at an early age in 22 Sub-Saharan African Countries: a multilevel analysis of 2018-2024 demographic and health survey data.","authors":"Getachew Teshale, Melak Jejaw, Kaleb Assegid Demissie, Nebebe Demis Baykemagn, Tirualem Zeleke Yehuala, Jenberu Mekurianew Kelkay","doi":"10.1186/s12879-025-11138-4","DOIUrl":"10.1186/s12879-025-11138-4","url":null,"abstract":"<p><strong>Introduction: </strong>Sexually transmitted infections (STIs) represent a significant global public health concern, contributing substantially to illness and mortality, particularly in Sub-Saharan Africa (SSA). Women of reproductive age who initiated sexual intercourse at an early age are at high risk of acquiring STIs. However, comprehensive data on their care-seeking behaviors in SSA are lacking. This study determines the prevalence of STI-related care-seeking behavior and identifies associated factors among these women.</p><p><strong>Method: </strong>This study utilized data from the most recent Demographic and Health Surveys (DHS) conducted in 22 SSA countries between 2018 and 2024. A weighted sample of 54,425 reproductive-age women who initiated sexual intercourse at an early age and reported STIs or related symptoms in the past year was analyzed. A multilevel mixed-effects logistic regression model identified individual and community-level factors, with statistical significance set at *p* < 0.05. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were calculated.</p><p><strong>Results: </strong>The pooled prevalence of STI-related care-seeking behavior among women initiated sexual intercourse at early age in SSA countries was 39.18% (95% CI: 33.25%, 45.03%). Multilevel analysis revealed significant associations with age, education, religion, pregnancy status, employment, household wealth, media exposure, financial barriers, awareness of AIDS/STIs, cervical cancer testing, residence, community education, media exposure, and poverty.</p><p><strong>Conclusion: </strong>STI-related care-seeking behavior remains lower in this population compared to other studies. Associated factors include age, education, religion, pregnancy status, employment, household wealth, media exposure, financial barriers, awareness of AIDS/STIs, cervical cancer testing, residence, and community-level factors such as education, media exposure, and poverty. Public health efforts should prioritize socioeconomically disadvantaged women by strengthening counseling and awareness during cervical cancer screenings and antenatal visits. Policies to improve healthcare access and financial support for these women are essential.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"734"},"PeriodicalIF":3.4,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12100818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126651","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: The spatial-temporal distribution of hepatitis B virus infection in China,2006-2018.","authors":"Liping Jiao, Tuo Shen, Yingzi Han, Wen Liu, Wei Liu, Lin Dang, Mingmin Wei, Yunyun Yang, Jingjing Guo, Meirong Miao, Xiangming Xu","doi":"10.1186/s12879-025-11125-9","DOIUrl":"10.1186/s12879-025-11125-9","url":null,"abstract":"","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"730"},"PeriodicalIF":3.4,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126650","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":"Predicting myocardial damage in children with mycoplasma pneumoniae pneumonia: a retrospective case-control study.","authors":"Tong Ni, Fei Zhao","doi":"10.1186/s12879-025-11132-w","DOIUrl":"10.1186/s12879-025-11132-w","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the clinical indicators that can predict myocardial damage in children with mycoplasma pneumoniae pneumonia (MPP) to help early identification and management.</p><p><strong>Methods: </strong>The clinical data of 123 MPP children admitted from December 2023 to February 2024 in the affiliated Changzhou Children's Hospital of Nantong University were analyzed retrospectively. According to the creatine kinase isoenzyme (CK-MB) level, the children were divided into 61 cases without myocardial damage group and 62 cases with myocardial damage group. Clinical manifestations and laboratory parameters were compared between the two groups. The factors affecting myocardial damage in children with MPP were analyzed by logistic regression. The ROC curve analyzed the predictive value of relevant indicators for myocardial damage in children with MPP.</p><p><strong>Results: </strong>The incidence of abnormal electrocardiogram (ECG), extrapulmonary manifestations (except myocardial damage), white blood cell count (WBC), neutrophil/lymphocyte ratio (NLR), erythrocyte sedimentation rate (ESR), albumin and other myocardial enzyme parameters in the myocardial damage group were higher than those in the group without myocardial damage (P < 0.05), and the median age and platelet/neutrophil ratio (PNR) were lower than those in the group without myocardial damage (P < 0.05); there was no significant difference in general data such as gender, duration of fever, length of hospital stay, the incidence of severe pneumonia between the two groups (P > 0.05); multivariate logistic regression analysis showed that median age, NLR level and extrapulmonary manifestations (except myocardial damage) were the main factors affecting myocardial damage in children with MPP (P < 0.05); considering the interaction between NLR and PNR. We also performed ROC curve analysis for PNR. Among the univariate factors, PNR had the highest predictive value, and the specificity was as high as 86.9%. The combined area under the curve of the four indicators was 0.747, higher than that of the univariate factor (P < 0.001), with a predictive sensitivity of 83.9% and a specificity of 63.9%.</p><p><strong>Conclusion: </strong>Children with MPP younger than 6.79 years have extrapulmonary manifestations (acute sinusitis, acute otitis media, etc.), NLR > 2.41, and PNR < 44.74 in blood routine are more likely to develop myocardial damage.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"733"},"PeriodicalIF":3.4,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12100917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126653","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":"Therapeutic options for the treatment of post-acute sequelae of COVID-19: a scoping review.","authors":"Yu Bin Seo, Yu Jung Choi, Jun-Won Seo, Eun Jung Kim, Jacob Lee, Joon Young Song","doi":"10.1186/s12879-025-11131-x","DOIUrl":"10.1186/s12879-025-11131-x","url":null,"abstract":"<p><strong>Objectives: </strong>This scoping review aimed to summarize the available studies to address the question of which therapeutic agents can be utilized for patients with post-acute sequelae of COVID-19 (PASC).</p><p><strong>Methods: </strong>We conducted a systematic search in medical databases, including PubMed and Embase, for studies aligned with our objectives published between January 1, 2020, and July 22, 2024. For each study, we summarized the main symptoms targeted, study design, therapeutic regimens, evaluation tools, and clinical outcomes.</p><p><strong>Results: </strong>A total of 413 studies were identified, and 39 studies were included in this review based on relevance to the research objectives. We primarily focused on high-level evidence studies, such as meta-analyses and randomized controlled trials, but observational studies were included when evidence was scarce. Therapeutic agents evaluated included hyperbaric oxygen, ivermectin, metformin, naltrexone, micronutrient supplements, antifibrotic agents, antiviral agents, and selective serotonin reuptake inhibitors (SSRIs). Among these, hyperbaric oxygen, antifibrotic agents, antiviral agents, and SSRIs demonstrated promising results. However, the heterogeneity of PASC symptoms posed challenges in synthesizing findings for specific symptom-based outcomes.</p><p><strong>Conclusion: </strong>Given the heterogeneity of symptoms, this review highlights the need for standardized and targeted research to better address the diverse therapeutic needs of patients with PASC.</p><p><strong>Clinical trial: </strong>Not applicable.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"731"},"PeriodicalIF":3.4,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126654","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":"HPV-associated squamous cell carcinoma and adenocarcinoma in distinct cervical sites: a case report.","authors":"Huihui Chen, Qingyi Wang, Min Kang, Wei Huang, Hao Zhang, Jiaxin Li, Donghan Xu, Lin Zhao, Bowen Wu, Xin Lin, Liqi Li, Yuhong Zheng, Yihao Niu, Jiaqi Zhou, Donghui Huang, Peiyu Yan","doi":"10.1186/s12879-025-11114-y","DOIUrl":"10.1186/s12879-025-11114-y","url":null,"abstract":"<p><strong>Background: </strong>The synchronous occurrence of adenocarcinoma and squamous cell carcinoma in distinct cervical regions is exceptionally rare. This report highlights a case of HPV-associated adenocarcinoma and squamous cell carcinoma at distinct sites in a patient with primary stage IA1 cervical cancer.</p><p><strong>Case presentation: </strong>A 54-year-old female tested HPV type 18 positive in a routine physical exam. Cervical Liquid - based Cytology Test (LCT) showed Atypical Squamous Cells of Undetermined Significance (ASCUS). Colposcopy-directed biopsies revealed moderately differentiated squamous cell carcinoma at multiple sites (3, 6, 9, 12 o'clock positions and the ECC), with a clinical diagnosis of stage IA1. Preoperative abdominal MRI (including contrast enhancement) showed no lymph node enlargement, and urinary CT urography was normal. Squamous cell carcinoma antigen levels were within the normal range.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"732"},"PeriodicalIF":3.4,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126652","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":"Diagnostic accuracy of non-invasive SARS-CoV-2 screening tests: a national prospective analysis.","authors":"Thomas Althaus, Alexandre Blake, Alizée Costantini, Christian Lavagna, Eva Jacquesson, Guillaume Groshenry, Alexa Troel, Bertrand Vanzo, Olivier Dejoux, Hervé Raps, Patrick Rampal, Eric J Voiglio","doi":"10.1186/s12879-025-11088-x","DOIUrl":"10.1186/s12879-025-11088-x","url":null,"abstract":"<p><strong>Background: </strong>Providing non-invasive, accurate and affordable SARS-CoV-2 tests represents a public health priority, to better control the spread of the virus while protecting healthcare workers. Saliva is a robust alternative to nasopharyngeal (NP) swabs, but there is heterogeneity in collection and pre-analytical methods.</p><p><strong>Methods: </strong>Relying on a national COVID-19 Public Health Programme, we prospectively recruited 3,488 symptomatic and asymptomatic adults attending the Monaco community centre for NP RT-PCR testing from February 2021-2023. Saliva was concomitantly obtained with either a buccal swab or an oral sponge (OS) and analysed by an RT-PCR assay and a fully automated electrochemiluminescence enzyme immunoassay (ECLIA) rapid antigen test (RAT).</p><p><strong>Results: </strong>The sensitivity of the buccal RT-PCR varied according to previous SARS-CoV-2 infection, vaccination, and the presence of symptoms, while it remained around 95% for the OS RT-PCR. The specificity of the buccal RT-PCR approached 100% and was around 95% for the OS-RT PCR. The RAT sensitivity was 66.9% and 69.1% compared to NP and OS RT-PCR assays and increased to 71% and 97% in case of a high viral load (Ct < 25), respectively.</p><p><strong>Conclusions: </strong>RT-PCR assay using OS saliva showed high accuracy in symptomatic and non-symptomatic adults, including the identification of negative nasopharyngeal swabs. This method allows self-collection without any prior conditions for the patient nor laboratory pre-analytical steps. The ECLIA RAT offers high throughput but is only useful in individuals with high viral loads. Our findings encompassed the latest SARS-CoV-2 omicron subvariants, such as BA.4&5 and the XBB series.</p><p><strong>Trial registration: </strong>Registry: ClinicalTrials.gov.</p><p><strong>Registration number: </strong>NCT05074745. Registration date: 12-10-2021.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"727"},"PeriodicalIF":3.4,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118644","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":"Development of a risk prediction model for secondary infection in severe/critical COVID-19 patients.","authors":"Yinmei Zhang, Mingmei Lin, Zhenchao Wu, Zhongyu Han, Liyan Cui, Jiajia Zheng","doi":"10.1186/s12879-025-11112-0","DOIUrl":"10.1186/s12879-025-11112-0","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to develop a predictive model for secondary infections in patients with severe or critical COVID-19 by analyzing clinical characteristics and laboratory indicators.</p><p><strong>Method: </strong>A total of 307 patients with severe or critical COVID-19 admitted to Peking University Third Hospital from December 2022 to February 2023 were retrospectively analyzed, including 156 patients with secondary infection and 151 patients without secondary infection. The Boruta algorithm identified significant variables, and eight machine learning models were evaluated based on area under the curve (AUC) performance. The optimal model selected was further assessed, with model interpretability provided using SHapley Additive exPlanations (SHAP).</p><p><strong>Result: </strong>Nine predictive factors were identified: Mechanical Ventilation, Procalcitonin (PCT), Interleukin-8 (IL-8), Interleukin-6 (IL-6), Blood Urea Nitrogen, Glucose, Creatine Kinase, Lactate Dehydrogenase, and Mean Platelet Volume (MPV). The random forest model demonstrated the best performance, with further evaluation showing an average AUC of 0.981 (CI 0.965-0.998) on the training set and 0.836 (CI 0.761-0.912) on the test set. SHAP analysis identified MPV, PCT, and IL-8 as the strongest predictors of secondary infections.</p><p><strong>Conclusion: </strong>We developed an effective predictive model for secondary infection risk in severe COVID-19 patients using readily available clinical parameters, enabling early clinical intervention. This machine learning approach demonstrates potential for improving patient management.</p><p><strong>Clinical trial: </strong>This study does not involve clinical trial interventions. Therefore, clinical trial registration was not applicable.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"728"},"PeriodicalIF":3.4,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118641","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}