BMC Infectious Diseases最新文献

{"title":"Seroprevalence of hepatitis D among hepatitis B-infected patients attending the viral hepatitis treatment unit in Alexandria, Egypt: a prospective cross-sectional observational study.","authors":"Amany Elyamany, Rasha Ghazala, Mohamed Aboud, Ahmed Kamal","doi":"10.1186/s12879-026-13956-6","DOIUrl":"10.1186/s12879-026-13956-6","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis D virus (HDV) infection accelerates liver illness progression in hepatitis B surface antigen (HBsAg)-positive individuals, yet its prevalence in Alexandria, Egypt, is unknown.</p><p><strong>Methods: </strong>We carried out a prospective cross-sectional observational study on 158 HBsAg-positive adults attending the Alexandria University Viral Hepatitis Treatment Unit (Sept 2022-Aug 2023). All underwent clinical, laboratory, and imaging assessment, and serum total anti-HDV antibodies were detected by ELISA.</p><p><strong>Results: </strong>Anti-HDV antibodies were detected in 19.6% (31/158) of patients (95% CI, 13.4%-26.8%). HDV-positive patients were older (mean 50.9 ± 12.0 vs. 45.3 ± 11.6 years, p = 0.024), had higher ALT (median 38 vs. 32 U/L, p = 0.010) and AST (median 40 vs. 31 U/L, p = 0.009), more frequent significant fibrosis (74.2% vs. 51.2%, p = 0.021), and lower HBV DNA levels (median 0.04 vs. 0.70 × 10³ IU/mL, p = 0.017). Hepatic encephalopathy was more common across HDV-positive participants (12.9% vs. 1.6%, p = 0.014).</p><p><strong>Conclusion: </strong>Nearly one in five HBsAg-positive patients in Alexandria, Egypt, had evidence of HDV exposure, with associations suggesting more advanced liver injury. These findings support universal HDV screening among all HBsAg-positive individuals in Egypt.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13483714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787990","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":"Comparison of nutritional inflammatory indicators for predicting outcomes in patients with sepsis: a retrospective study based on clinical and MIMIC data.","authors":"Lulu Zhang, Longqin Wang, Yuhan Wang, Leiming Xu, Wenwen Sun, Aifeng He","doi":"10.1186/s12879-026-14212-7","DOIUrl":"10.1186/s12879-026-14212-7","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the utility of the prognostic nutrition index (PNI) and the Naples prognostic score (NPS) in predicting the prognosis of patients with sepsis.</p><p><strong>Methods: </strong>A total of 149 clinical patients from Binhai County People's Hospital and 200 patients from the MIMIC-IV database were independently analyzed. Baseline data, including infection sources, causative organisms, and therapeutic interventions (vasoactive drugs, steroids, and RRT), were collected within the first 24 h of ICU admission. Kaplan-Meier curves and hierarchical Cox proportional hazard models (adjusting for SOFA, NLR, and comorbidities) were constructed to identify independent prognostic factors. Model performance was comprehensively evaluated using the C-index, Likelihood Ratio Test, and calibration curves.</p><p><strong>Results: </strong>Both cohorts revealed that patients with low PNI (L-PNI < 32.1) and high NPS (H-NPS) had a significantly increased risk of 28-day mortality. Non-survivors exhibited a higher prevalence of pulmonary infections and higher requirements for vasoactive drugs and RRT (all p < 0.05). Analysis of the independent MIMIC-IV cohort further confirmed that NPS was an independent risk factor while PNI was an independent protective factor, even after adjusting for SOFA scores and individual inflammatory components (VIF < 5). The combined ROC model (PNI + NPS) demonstrated excellent discriminative power with an AUC of 0.805 in the clinical cohort and 0.806 in the MIMIC cohort. Calibration curves showed high agreement between predicted and actual survival probabilities (Hosmer-Lemeshow p > 0.05).</p><p><strong>Conclusions: </strong>PNI and NPS are independent risk factors for 28-day mortality in patients with sepsis. PNI combined with NPS provides greater predictive value for the survival and prognosis of patients with sepsis.</p><p><strong>Clinical trial: </strong>Not applicable.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13595518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015456","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":"Incidence of neonatal sepsis among HIV exposed neonates of mothers on integrase strand transfer inhibitors in sub-Saharan Africa: a systematic review and meta-analysis.","authors":"Pebalo Francis Pebolo, Felix Bongomin, Bethan Morgan, Ivaan Pitua, Ritah Nantale, Venice Omona, Joseph Ngonzi, Davidson H Hamer","doi":"10.1186/s12879-026-14230-5","DOIUrl":"10.1186/s12879-026-14230-5","url":null,"abstract":"<p><strong>Introduction: </strong>Human immunodeficiency virus (HIV)-exposed infants face elevated risks of neonatal sepsis, influenced by maternal antiretroviral therapy (ART) regimens. Dolutegravir (DTG), a widely used integrase transfer inhibitor (INSTI), and the preferred first line drugs for management of HIV in pregnancy, has shown potential adverse effects such as hyperglycaemia, which may impact neonatal outcomes including risk of neonatal sepsis. We estimated the pooled incidence of neonatal sepsis among neonates exposed to INSTIs in utero compared to non-INSTIs-based ART regimens.</p><p><strong>Methods and analysis: </strong>A systematic review and meta-analysis were conducted following written as per the PRISMA guidelines. Databases including PubMed/MEDLINE, Embase, Cochrane Library, CINAHL, Global Health and Global Index Medicus were searched for studies published between January 2013 and September 2025. Eligible studies included clinical trials and cohort studies comparing INSTI-based ART regimens with non-INSTI regimens among pregnant women living with HIV. Data were extracted using Covidence software, Cochrane risk of bias (RoB) and Newcastle-Ottawa Scale (NOS) were used to assessed for quality of randomised clinical trials and observational studies, respectively. The certainty of the evidence was assessed using the Grading, Recommendation, Assessment, Development and Evaluation (GRADE) framework.</p><p><strong>Results: </strong>A total of 714 studies were identified and screened based on their titles and abstracts, of which 63 articles underwent full-text review. Ultimately, four studies, comprising 7,636 participants, met the predefined eligibility criteria and were included in the analysis. The pooled odds ratio (OR) for neonatal sepsis among infants exposed to INSTIs was 0.44 (95% confidence interval [CI]: 0.15-1.30, p = 0.137). The test for subgroup difference was not significant (p = 0.358): the pooled OR for dolutegravir was 0.27 (95% CI 0.06-1.23, p = 0.090) and for the single raltegravir study was 0.73 (95% CI 0.16-3.30, p = 0.681).</p><p><strong>Conclusion: </strong>INSTI-based ART was not associated with a significant difference in neonatal sepsis risk compared with non-INSTI regimens. However, the low number of events limited the precision of the estimates, highlighting the need for further research.</p><p><strong>Registration: </strong>This review has been registered with the PROSPERO at https://www.crd.york.ac.uk/PROSPERO/view/CRD420251178411 , registration number CRD420251178411.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13474507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148766170","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 performance of a centrifugation-free stool processing kit in conjunction with Xpert^®MTB/RIF Ultra for paediatric tuberculosis: a multicentre prospective study in five low and middle-income countries.","authors":"Denise Banze, Laura Olbrich, Alia Razid, Zoe Franckling-Smith, Alfred Mfinanga, Nyanda Elias Ntinginya, Issa Sabi, Marriot Nliwasa, Robina Semphere, Elizabeth L Corbett, Joy Sarojini Michael, Valsan Philip Verghese, Stephen M Graham, Pamela Nabeta, Andre Trollip, Rinn Song, Leyla Larsson, Christof Geldmacher, Michael Hoelscher, Heather J Zar, Sofia Viegas, Norbert Heinrich, Celso Khosa","doi":"10.1186/s12879-026-13902-6","DOIUrl":"10.1186/s12879-026-13902-6","url":null,"abstract":"<p><strong>Introduction: </strong>Diagnosing paediatric tuberculosis (TB) remains challenging. Currently available diagnostic tests have limited accuracy, and most sampling methods are invasive. In 2021, the World Health Organization (WHO) endorsed the use of molecular WHO-recommended rapid diagnostic tests (mWRDs) with stool as an initial diagnostic tool for paediatric TB. In this study, we evaluated the diagnostic test accuracy (DTA) of stool samples processed with the Stool Processing Kit (SPK), one of three centrifugation-free methods available at the time.</p><p><strong>Methods: </strong>We conducted a multi-centre prospective diagnostic validation study in South Africa, Tanzania, Malawi, Mozambique, and India. Children (< 15 years) under investigation for TB provided at least two (induced) sputum samples at enrolment, one stool sample, and one nasopharyngeal aspirate (NPA) if aged < 5 years and a chest x-ray. TB testing included Xpert^® MTB/RIF Ultra (Ultra) and culture. Diagnostic classification followed NIH consensus statements. Stool samples were processed using the SPK and tested with Ultra. We calculated DTA in the overall cohort and predefined subgroups of interest.</p><p><strong>Results: </strong>Out of 5313 children screened, 975 were enrolled, and data from 817 children recruited between January 2019 and June 2021 were analysed. The overall microbiological confirmation rate was 203/817 (24.9%), and an additional 358/817 (43.8%) were classified as unconfirmed TB and 256/817 (31.3%) were classified as unlikely TB. The median age was 5.3 years (IQR: 2.0-9.2), and 390/817 (47.7%) of participants were under the age of five. 134/817 (16.4%) of children were living with HIV, and 88/817 (10.8%) had severe acute malnutrition (SAM). The overall sensitivity and specificity of SPK/Ultra against a Strict Reference Standard (SRS) were 33.8% (95% CI: 27.6-40.6) and 86.8% (95% CI: 80.5-91.3), respectively. Among children under one year of age and those with SAM, sensitivity was 43.3% (95% CI: 27.4-60.8) and 41.4% (95% CI: 25.5-59.3), respectively, with specificity reaching 100% in young children and 85% (95% CI: 64.0-94.8) in children with SAM. Classic TB symptoms and chest X-ray abnormalities at baseline were associated with increased likelihood of SPK/Ultra positivity.</p><p><strong>Conclusions: </strong>This is one of the largest studies to evaluate stool as an alternative specimen for diagnosing paediatric TB. Although the WHO's target product profile was not fully met, stool testing with SPK/Ultra represents a viable alternative to invasive sampling methods, especially in subgroups of interest.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov, NCT03734172, June 22, 2018.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079444","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":"Wound infections due to factory gunpowder and pyrotechnic explosions in patients with burn injury: risk factors and antimicrobial resistance.","authors":"Jinfu Li, Yueying Fan, Xiangong Jiao, Ming Zou, Zhangjia Jiang, Cheng Li, Shiqiang Jiang, Chiyu Jia","doi":"10.1186/s12879-026-14140-6","DOIUrl":"10.1186/s12879-026-14140-6","url":null,"abstract":"<p><strong>Background: </strong>A substantial obstacle in the treatment of burn patients is the management of burn wound infection (BWI). The objective of this investigation was to assess the antimicrobial susceptibility test results and distribution characteristics of microorganisms isolated from the burn wounds of patients affected by the factory gunpowder and pyrotechnic explosions.</p><p><strong>Methods: </strong>This tertiary burn center conducted a 5-year retrospective observational study of the clinical and laboratory characteristics of pathogenic microorganisms through drug susceptibility tests, species distribution, and timing of wound infections. Two groups of patients were compared: patients with burn wound infection (BWI) versus patients without burn wound infection (Non-BWI).</p><p><strong>Results: </strong>The study enrolled 313 individuals (median age: 47 years), of whom 286 (91.37%) were male. One hundred twenty‑four (39.6%) developed BWI. Multiple regression analysis showed that inhalation injury, length of stay (LOS), and percentage total body surface area (%TBSA) were independent risk factors for developing BWI. The most frequently isolated bacteria were Acinetobacter baumannii (31.6%) and Klebsiella pneumoniae (10.9%). The median time from admission to first pathogen isolation was 12 days (IQR: 4-25 days) for Gram‑negative bacteria, 20 days (IQR: 10-30 days) for Gram‑positive bacteria, and 35 days (IQR: 18.5-59.5 days) for fungi.</p><p><strong>Conclusion: </strong>BWI occurred in 39.6% of gunpowder-related burn patients. Independent risk factors were inhalation injury (OR 4.86), larger %TBSA (OR 1.08), and prolonged LOS (OR 1.09). Gram-negative pathogens predominated (74.4%), with A. baumannii (31.6%) showing near-complete resistance. Gram-negative infections emerged earlier (median 12 days) than Gram-positive (20 days) or fungi (35 days). Based on these findings, our burn unit now initiates early surveillance cultures at day 7 post-admission for high-risk patients, prioritizes empiric Gram-negative coverage (specifically anti-Acinetobacter therapy) in the first two weeks, and has implemented enhanced infection control protocols targeting A. baumannii transmission.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and demographic characteristics of adult patients experiencing virologic failure on antiretroviral therapy in the Blouberg sub-district, South Africa.","authors":"Tshimangadzo Ephraim Mulaisi, Ndidzulafhi Selina Raliphaswa","doi":"10.1186/s12879-026-13909-z","DOIUrl":"10.1186/s12879-026-13909-z","url":null,"abstract":"<p><strong>Background: </strong>Despite widespread access to antiretroviral therapy (ART) in South Africa, achieving and sustaining viral suppression remains challenging, particularly in resource-limited districts. Virologic failure compromises treatment outcomes, increases the risk of HIV drug resistance, and undermines national efforts to achieve the UNAIDS 95-95-95 targets. Understanding the clinical and demographic characteristics of patients experiencing virologic failure is important for strengthening HIV treatment programmes and patient management.</p><p><strong>Aim: </strong>To describe the clinical and demographic characteristics of adults experiencing virologic failure while receiving ART in the Blouberg sub-district of Capricorn District, Limpopo Province.</p><p><strong>Methods: </strong>A quantitative descriptive cross-sectional study was conducted through a retrospective review of 251 adult patient records across four high-volume primary healthcare facilities with viral suppression rates below 85%. Records of adults aged 18 years and older who had been on ART for at least 24 months and had a documented viral load greater than 1000 copies/mL after at least 24 months on ART were included based on predefined eligibility criteria. Data were extracted using a structured tool and analysed using SPSS version 28. Descriptive statistics were used to summarise demographic and clinical characteristics.</p><p><strong>Results: </strong>Among patients included in the study, 73.3% were female. The majority (81.1%) initiated ART with CD4 counts below 350 cells/mm³, while 71.2% were classified as WHO clinical stage 1 or 2 at initiation. Most patients-initiated treatment on efavirenz-based regimen 1a. Elevated 12-month viral load levels (≥ 1000 copies/mL) were observed among 44.2% of patients.</p><p><strong>Conclusion: </strong>Patients experiencing virologic failure were predominantly female, initiated ART with low CD4 counts, and commonly received efavirenz-based regimens. The findings highlight the importance of early HIV diagnosis, strengthened adherence support, timely viral load monitoring, and optimization of ART regimens to improve treatment outcomes in rural settings. Targeted adherence interventions and earlier ART initiation strategies are needed to improve viral suppression outcomes in rural settings.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13505038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148811905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-related quality of life in adults with hepatitis B in sub-Saharan Africa: the added burden of HIV co-infection.","authors":"Edith Okeke, Joan Rugemalila, Mary Duguru, Emuobor Odeghe, Kolawole Oluseyi Akande, Yacouba Cissoko, Morenike A Osundina, Eva Uiso, Ganiyat Oyeleke, Dramane Sogoba, John Rwegasha, Pantong Davwar, Bethann Conover, Edwin Adoga, Hameed Adelabu, Naveeda Adam, Moussa Sekou Keita, Temitope Oke, Elizabeth Nicole Christian, Claudia Hawkins","doi":"10.1186/s12879-026-13973-5","DOIUrl":"10.1186/s12879-026-13973-5","url":null,"abstract":"<p><strong>Background: </strong>Chronic hepatitis B (CHB) affects an estimated 82 million people in sub-Saharan Africa (SSA), where HIV co-infection is common and accelerates liver-related complications. While the clinical outcomes of HBV and HIV/HBV co-infection have been well described in SSA, health-related quality of life (HRQoL) remains less well characterized, particularly among individuals at different stages of infection and treatment exposure.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis of baseline data from a longitudinal observational cohort of adults with HBV, with and without HIV, enrolled at five H2Net Consortium sites in Nigeria, Tanzania, and Mali. Participants were categorized into four groups: HBV mono-infection on treatment (HBV-Tx), HBV mono-infection not on treatment (HBV-NTx), HIV/HBV co-infection on treatment (HIV/HBV-Tx), and HIV/HBV co-infection treatment-naïve (HIV/HBV-NTx). HRQoL was assessed using the SF-36 Health Survey and scored according to RAND guidelines. Multivariable linear regression was used to evaluate associations between HRQoL domains and demographic, clinical, and disease-related factors.</p><p><strong>Results: </strong>Among 884 participants (41% HBV-Tx, 33% HBV-NTx, 23% HIV/HBV-Tx, 3% HIV/HBV-NTx), the mean overall HRQoL score was 77.8 (SD 16.9). HRQoL was highest among participants with HBV-NTx [80.56 (SD 14.67)] and lowest among HIV/HBV-NTx[59.38 (SD 23.67)] (p < 0.01). Across all HRQoL domains, participants with HIV/HBV co-infection reported significantly lower scores compared with those with HBV alone. Energy was the most impaired domain across all groups. In multivariable analyses, HIV/HBV co-infection, both Tx and NTx, was independently associated with lower overall HRQoL and domain specific scores. Elevated fibrosis scores (TE ≥ 7·5kPa/APRI ≥ 1.5), greater comorbidity burden, and older age were also associated with lower overall HRQoL scores and select HRQoL domains.</p><p><strong>Conclusions: </strong>HRQoL impairments, particularly related to energy, emotional wellbeing, and functional limitations, are common among adults with HBV in SSA and are most pronounced in those with HIV/HBV co-infection. These impairments are not fully captured by clinical or virologic markers alone, underscoring the need for integrated care models that address psychosocial and functional health alongside antiviral treatment, particularly among those with HIV/HBV co-infection.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13584350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982167","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":"An in-depth comparison: first wave of mpox in Rio de Janeiro, Brazil and Lisbon, Portugal.","authors":"Raffaele Junior Aliberti, Mayara Secco Torres da Silva, Valdiléa Gonçalves Veloso, Beatriz Grinsztejn, Rosa Maria Figueiredo Teodósio, Mayumi Duarte Wakimoto","doi":"10.1186/s12879-026-14087-8","DOIUrl":"10.1186/s12879-026-14087-8","url":null,"abstract":"<p><strong>Background: </strong>The 2022 mpox outbreak spread rapidly beyond endemic regions, affecting multiple countries with broadly similar transmission patterns but different public health responses and surveillance systems. We compared laboratory-confirmed mpox infections reported during the first epidemic wave in Rio de Janeiro, Brazil, and Lisbon, Portugal, with particular attention to demographic characteristics, clinical presentation, transmission patterns, hospitalization, and the role of HIV status.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of routinely collected, deidentified surveillance data from national notification systems in Brazil and Portugal. Adults with laboratory-confirmed mpox reported between May and December 2022 were included. Variables were harmonized across datasets, and missing data were retained without imputation. Descriptive analyses were performed by city and HIV status. Group comparisons used Pearson's chi-square test, Fisher's exact test, Mann-Whitney U test, and two proportion Z tests, as appropriate. Data completeness was also explored.</p><p><strong>Results: </strong>A total of 1,614 individuals were included: 960 from Rio de Janeiro and 654 from Lisbon. Mean age was similar in both cities (34.5 vs 34.9 years), but Lisbon had a higher proportion of males (99.4% vs 93.0%). The epidemic curves showed a similar rise-and-decline pattern, with an earlier peak in Lisbon (June 2022) and a later peak in Rio de Janeiro (August 2022). Skin or mucosal lesions were the most frequently reported manifestation in both settings, affecting more than 85% of individuals. Fever was reported more often in Rio de Janeiro, whereas adenopathy and asthenia were more commonly recorded in Lisbon. Within each city, symptom profiles were not significantly different between people living with HIV and those not living with HIV. Hospitalization rates were low overall in both cities (5.7% in Rio de Janeiro and 5.4% in Lisbon), although people living with HIV in Rio de Janeiro had higher odds of hospitalization than those without HIV. Data completeness was generally better in Rio de Janeiro than in Lisbon.</p><p><strong>Conclusions: </strong>Rio de Janeiro and Lisbon experienced similarly shaped first wave mpox epidemics, despite differences in timing, surveillance completeness, and health system context. HIV status did not appear to meaningfully modify acute clinical presentation, while hospitalization risk may have been influenced by differences in immune status and care pathways. These findings highlight the importance of harmonized, high-quality surveillance to support more accurate cross-country comparisons and better targeted public health responses.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975612","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":"Association between prognostic nutritional index and clinical outcomes in patients with pyogenic liver abscess: a retrospective multicenter study.","authors":"Jianguo Wang, Zhenyi Lin, Lintao Chen, Zi Yang, Daqing Li, Yanxin Wan, Rongqian Wu, Yu Zhang, Zhaoqing Du","doi":"10.1186/s12879-026-14123-7","DOIUrl":"10.1186/s12879-026-14123-7","url":null,"abstract":"<p><strong>Background & aims: </strong>Despite advances in therapeutic strategies, pyogenic liver abscess (PLA) remains a life-threatening bacterial infection associated with substantial mortality. The Prognostic Nutritional Index (PNI), a marker of immuno-nutritional status, has been shown to predict outcomes in various diseases. However, its prognostic value in patients with PLA remains unclear.</p><p><strong>Methods: </strong>A total of 405 patients diagnosed with PLA were enrolled in this study. Based on the median PNI value at admission, patients were stratified into the high-PNI group (PNI ≥ 37.15) and low-PNI group (PNI < 37.15). Clinical characteristics, laboratory data, imaging findings, presumed clinical route of PLA, previous hepatobiliary/pancreatic procedure history, treatment modalities, and clinical outcomes were analyzed to evaluate the association between PNI and prognosis.</p><p><strong>Results: </strong>Patients in the low-PNI group were significantly older than those in the high-PNI group (59.07 ± 13.30 years vs. 54.20 ± 13.92 years, P < 0.001) and a higher prevalence of fever (92.08% vs. 85.15%, P = 0.028) was seen in patients with low PNI. The low-PNI group also had a higher frequency of SIRS at admission (32.51% vs. 17.33%, P < 0.001), higher rate of abscess formation with a diameter > 10 cm (16.75% vs. 6.44%, P < 0.001) and a higher frequency of gas formation in abscess (18.22% vs. 6.93%, P = 0.001). Additionally, patients with low PNI had significantly higher complication rates; particularly for formation of pleural effusion and abdominal effusion. Moreover, the length of hospital stay was significantly prolonged (15.70 ± 8.94 days vs. 13.46 ± 7.16 days, P = 0.006), and treatment costs were higher (4130.76 ± 3227.45 USD vs. 3388.60 ± 2975.95 USD, P = 0.017) in the low-PNI group. Multivariate logistic regression analysis revealed that low PNI was associated with prolonged temperature recovery time (OR = 1.589, 95% CI: 1.022-2.470, P = 0.040) and prolonged hospital stay (OR = 1.580, 95% CI: 1.033-2.415, P = 0.035).</p><p><strong>Conclusion: </strong>PNI may serve as a useful marker for early clinical risk stratification in patients with PLA.</p><p><strong>Clinical trial: </strong>Not applicable.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13520278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148839111","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":"Comparative clinical outcomes of pandrug-resistant Acinetobacter baumannii and Klebsiella pneumoniae infections in children.","authors":"İrem Ceren Erbaş, Şilem Özdem Alataş, Ayşe Çakıl Güzin, Hatice Karaoğlu Asrak, Elif Alaçam, Ayşen Hazal Buran, Mahmut Cem Ergon, Nurşen Belet","doi":"10.1186/s12879-026-14128-2","DOIUrl":"10.1186/s12879-026-14128-2","url":null,"abstract":"<p><strong>Background: </strong>The global rise of antimicrobial resistance has become a major public health concern. However, data on the clinical course and outcomes of infections caused by pandrug-resistant (PDR) bacteria in children remain limited. This study aimed to compare the clinical characteristics and treatment outcomes of PDR Acinetobacter baumannii and Klebsiella pneumoniae infections in pediatric patients.</p><p><strong>Methods: </strong>We retrospectively analyzed pediatric cases with PDR A. baumannii and K. pneumoniae infections diagnosed between 2020 and 2023 in a tertiary-care center. Demographic characteristics, infection sites, clinical findings, and outcomes were compared between the two groups using appropriate statistical tests.</p><p><strong>Results: </strong>PDR K. pneumoniae infections occurred in significantly younger children (p = 0.004). PDR K. pneumoniae episodes most commonly involved pneumonia (47.4%) or bloodstream infection (42.1%), with mortality rates of 15.8%. PDR A. baumannii episodes were most frequently associated with pneumonia (65.3%), with mortality rates of 7.7%. Recurrence rates were similar between the two groups (36.8% vs. 26.9%; p = 0.478), and none of the recurrent infections resulted in death. Fever duration was longer in the PDR A. baumannii group (p = 0.009), whereas co-infections and complications were numerically more frequent but did not reach statistical significance (respectively; p = 0.06 and p = 0.08). Ceftazidime-avibactam (CZA) resistance was observed in 63.2% of PDR K. pneumoniae isolates, and all recurrent PDR K. pneumoniae episodes were CZA-resistant; no deaths occurred among recurrent episodes in either group.</p><p><strong>Conclusions: </strong>PDR A. baumannii and K. pneumoniae infections showed comparable severity and mortality in children, although K. pneumoniae affected younger patients and A. baumannii was associated with longer fever duration. Both pathogens were typically identified after prolonged hospitalization and were closely linked to intensive care exposure. The high rate of CZA resistance among PDR K. pneumoniae isolates, including all recurrent PDR K. pneumoniae episodes, was a clinically important finding that may further limit therapeutic options.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13613818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149036542","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}