BMC Infectious Diseases最新文献

{"title":"Chlorhexidine and benzalkonium chloride: promising adjuncts in combating multidrug resistant Klebsiella pneumoniae in healthcare settings.","authors":"Amal F Makled, Azza Z Labeeb, Heba M Moaz, Asmaa S Sleem","doi":"10.1186/s12879-025-10980-w","DOIUrl":"https://doi.org/10.1186/s12879-025-10980-w","url":null,"abstract":"<p><strong>Background: </strong>Hospital-acquired infections caused by multidrug resistant (MDR) Klebsiella pneumoniae pose a significant global health threat. Effective antisepsis and disinfection protocols are mandatory to prevent these infections. This study aimed to isolate Klebsiella pneumoniae, evaluate antimicrobial susceptibility, and assess the efficacy of selected biocides.</p><p><strong>Methods: </strong>Fifty clinical MDR Klebsiella pneumoniae isolates were collected from various hospital departments. Antimicrobial susceptibility was determined using the disc diffusion method. Minimum inhibitory concentrations (MICs) of chlorhexidine and benzalkonium chloride were measured via agar dilution. Conventional PCR was employed to detect biocide resistance genes (qacE∆1 and cepA).</p><p><strong>Results: </strong>Klebsiella pneumoniae was identified in 19.16% of cases. All isolates exhibited multidrug resistance, with multiple antimicrobial resistance indices ranging from 0.24 to 0.92, reaching up to 1. Benzalkonium chloride MICs significantly increased with resistance, reaching up to 64 µg/mL, while chlorhexidine MICs were consistent across isolates. The qacE∆1 and cepA genes were detected in 62% and 72% of isolates, respectively, with a significant association between qacE∆1 and cephalosporin resistance. No significant correlation was found between biocide MICs and clinical specimen types or hospital units.</p><p><strong>Conclusion: </strong>The cepA gene is closely associated with extensive drug resistance in Klebsiella pneumoniae, emphasizing its role in antimicrobial resistance. Optimized biocide formulations, when properly developed and applied, can play a crucial role in combating and preventing infections caused by multidrug-resistant Klebsiella pneumoniae.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"670"},"PeriodicalIF":3.4,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961225","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":"Predictive nomogram for early detection of invasive fungal disease deterioration --- a 10-year retrospective cohort study.","authors":"Wei Wang, Yan Li, Hua Wang, Yumeng Du, Mengyuan Cheng, Jinyan Tang, Mingliang Wu, Chaomin Chen, Qingwen Lv, Weibin Cheng","doi":"10.1186/s12879-025-11030-1","DOIUrl":"https://doi.org/10.1186/s12879-025-11030-1","url":null,"abstract":"<p><strong>Background: </strong>Invasive fungal disease (IFD) is characterized by its capacity to rapidly escalate to life-threatening conditions, even when patients are hospitalized. However, the precise prognostic significance of baseline clinical characteristics related to the progression outcome of IFD remains elusive.</p><p><strong>Methods: </strong>A retrospective cohort study spanning a duration of 10 years was conducted at two prominent tertiary teaching hospitals in Southern China. Patients with proven IFD were queried and divided into serious and non-serious groups based on the disease deterioration. To establish robust predictive models, patients from the first hospital were randomly assigned to either a training set or an internal validation set, while patients from the second hospital constituted an external test set. To analyze the potential predictors of IFD deterioration and identify independent predictors, the study employed the least absolute shrinkage and selection operator (LASSO) method in conjunction with binary logistic regressions. Based on the outcomes of this analysis, a predictive nomogram was constructed. The performance of the developed model was thoroughly evaluated using the training set, internal validation set, and external test set.</p><p><strong>Results: </strong>A total of 480 cases from the first hospital and 256 cases from the second hospital were included in the study. Among the 480 patients, 81 cases (16.9%) experienced deterioration, and out of those, 45 (55.6%) cases resulted in mortality. Seven independent predictors were identified and utilized to construct a predictive nomogram. The nomogram exhibited excellent predictive performance in all three sets: the training set, internal validation set, and external test set. The area under the receiver operating characteristic curve (AUC) for the training set was 0.88, for the internal validation set was 0.91, and for the external test set was 0.90. The Hosmer-Lemeshow test and Brier score indicated a high goodness of fit for the model. Furthermore, the calibration curve demonstrated a strong agreement between the predicted outcomes from the nomogram and the actual observations. Additionally, the decision curve analysis exhibited that the nomogram provided significant clinical net benefits in predicting IFD deterioration.</p><p><strong>Conclusions: </strong>The study successfully identified seven independent predictors and developed a predictive nomogram for early assessment of the likelihood of IFD deterioration.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"673"},"PeriodicalIF":3.4,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967371","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":"Detection of septic metastases in catheter-related Staphylococcus aureus bacteremia using 18^FFDG-PET/CT: a before-and-after study.","authors":"Miguel Ángel Verdejo, Andrés Perissinotti, Daniela Malano-Barletta, Cristina Pitart, Guillermo Cuervo, Marta Hernández-Meneses, Marta Bodro, Sabina Herrera, Carolina García-Vidal, Pedro Puerta-Alcalde, José Antonio Martínez, Ana Del Río, Mateu Espasa, David Fuster, Laura Morata, Alex Soriano","doi":"10.1186/s12879-025-11055-6","DOIUrl":"https://doi.org/10.1186/s12879-025-11055-6","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the detection rate of septic metastases in catheter-related S. aureus bacteremia (CR-SAB) episodes by using [18F]FDG-PET/CT.</p><p><strong>Methods: </strong>We conducted a retrospective, before-and-after, single-center study of a prospectively identified catheter-related SAB (CR-SAB) cohort at Hospital Clínic Barcelona. All adult patients hospitalized from January 2006 to December 2022 were included. Primary outcome was the detection of septic metastases before and after integrating [18F]FDG-PET/CT into the diagnostic workflow of CR-SAB in January 2020. Secondary outcomes included 30-day mortality, length of stay, and treatment duration.</p><p><strong>Results: </strong>A total of 598 episodes of CR-SAB were included, 100 in the post-intervention period (2020-2022) and 498 in the pre-intervention period (2006-2019). [18F]FDG-PET/CT scan was performed in 28/100 episodes (28.0%) in post-intervention period, versus 9/498 in pre-intervention period (1.8%). Septic metastases detection rate was higher after [18F]FDG-PET/CT implementation (22/100, 22% vs. 56/498, 11.2% p .004), mainly due to pulmonary septic emboli (13/100, 13.0% vs. 12/498, 2.4% p < .001) and osteoarticular seeding (7/100, 7.0% vs. 11/498, 2.2% p .019). Neither pulmonary septic emboli nor osteoarticular metastases increased 30-day mortality (3/25, 12.0% vs. 57/573, 10.0%, p .732; and 2/18, 11.1% vs. 58/580 10.0%, p .702, respectively). Patients with septic metastases had longer treatment [25.0 (16.0-37.0) vs. 15.0 (13.0-19.0) days, p < .001].</p><p><strong>Conclusions: </strong>[18F]FDG-PET/CT use in patients with CR-SAB was associated with a higher rate of septic metastases diagnosis, mainly pulmonary and osteoarticular, resulting in longer treatment, but no differences in clinical outcomes were observed.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"671"},"PeriodicalIF":3.4,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977607","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: Unexpected hypereosinophilia after sinopharm vaccination: a case report.","authors":"Behnam Dalfardi, Niloofar Khoshnam Rad, Tayebe Mohammad Alizade, Maryam Edalatifard, Sanaz Asadi, Besharat Rahimi","doi":"10.1186/s12879-025-11061-8","DOIUrl":"https://doi.org/10.1186/s12879-025-11061-8","url":null,"abstract":"","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"665"},"PeriodicalIF":3.4,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974171","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 gut microbiota in HIV-infected patients and immune reconstitution following antiretroviral therapy (ART).","authors":"Yuru Shi, Miaomiao Hu, Jing Wu, Ting Liu, Yingjie Qi, Ang Li","doi":"10.1186/s12879-025-10995-3","DOIUrl":"https://doi.org/10.1186/s12879-025-10995-3","url":null,"abstract":"<p><strong>Background: </strong>This study aims to examine the potential link between incomplete immune reconstitution following ART treatment and gut microbiota dysbiosis.</p><p><strong>Methods: </strong>We collected clinical data and fecal samples from 50 HIV patients undergoing ART and 30 untreated patients. Based on the observed immune function reconstruction, we further categorized the ART(+) group into a responder group (n = 30) and a non-responder group (n = 20). The gut microbiota composition differences were assessed using Alpha diversity and Beta diversity analysis, while differential genera were identified through linear discriminant analysis effect size (LEfSe). Subsequently, functional disparities in the gut microbiota were investigated using PICRUSt2 and metagenomeSeq software.</p><p><strong>Results: </strong>The results of Alpha diversity and Beta diversity revealed significant differences in the composition of gut microbiota among the three groups. Differential genus analysis identified Morganella as an exclusive genus present only in the Non-responder group, exhibiting a significantly higher relative abundance. Correlation analysis demonstrated a positive association between Morganella and LDL levels. The CAZY analysis revealed that glycosyltransferase 25 (GT25) was significantly expressed in the Non-responder group, whereas it was either undetectable or exhibited extremely low expression levels in both the Responder group and the ART(-) group. Importantly, the correlation analysis indicated a positive association between Morganella and GT25 secretion.</p><p><strong>Conclusions: </strong>The ecological imbalance of Morganella might be associated with incomplete immune reconstitution following ART, potentially mediated by GT25 secretions. Consequently, Morganella could serve as a promising biomarker for predicting incomplete immune reconstitution in AIDS patients undergoing ART.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"666"},"PeriodicalIF":3.4,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962064","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":"Atypical causes of respiratory virus infections in Sub-Saharan Africa from 2013- 2023: a systematic review and meta-analysis.","authors":"George Agyei, Philip El-Duah, Jonathan Mawutor Gmanyami, Oscar Lambert, Brice Armel Nembot Fogang, Sherihane Aryeetey, Augustina Sylverken, Rexford Mawunyo Dumevi, Yaw Adu-Sarkodie, Richard Odame Phillips, Christian Drosten, Michael Owusu","doi":"10.1186/s12879-025-11028-9","DOIUrl":"https://doi.org/10.1186/s12879-025-11028-9","url":null,"abstract":"<p><strong>Background: </strong>Atypical respiratory viruses (ARVs) are a diverse group of pathogens that cause respiratory infections through less common mechanisms or in unique epidemiological patterns, unlike the typical viruses like respiratory syncytial virus, influenza and human rhinoviruses. They sometimes present as unusual respiratory illnesses in vulnerable populations with near-fatal outcomes. Several viruses are involved, such as Human metapneumovirus (HMPV), Human Bocavirus (HBoV), Enteroviruses (EVs), Parechovirus (PeV) and Influenza C virus (ICV). This review was done to shed light on ARVs and their possible role in respiratory illness or infections based on studies in Sub-Saharan Africa from 2013 to 2023.</p><p><strong>Methods: </strong>We systematically reviewed atypical causes of respiratory virus infections in Sub-Saharan Africa (SSA) in line with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020 guidelines. We searched PubMed, Web of Science, Google Scholar and Cochrane Library to include studies published from 2013 to 2023 with reports on ARV. The protocol was registered in PROSPERO (ID: CRD42024611183).</p><p><strong>Results: </strong>The review covered 46 SSA countries, with five eligible for the systematic review. The search yielded 548 publications, with only six studies meeting the inclusion criteria. Studies included children and individuals of all age groups. The prevalence of ARVs detected in SSA was as follows: HMPV pooled prevalence was 1.52% (95% CI: 1.07-2.00), EVs pooled prevalence was 15.0% (95% CI: 14.1-15.9), HBoV prevalence was 0.4%, PeV was 20%, and ICV was 1.3% in individuals with respiratory tract infection(s).</p><p><strong>Conclusion: </strong>Our findings suggest testing or diagnostics for ARV infections are very low in SSA. Therefore, surveillance of people suffering from respiratory tract infections, which is lacking, needs to be improved to monitor the prevalence of ARVs and the role they play in respiratory disease outcomes.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"668"},"PeriodicalIF":3.4,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062134","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":"Epidemiological characteristics of RSV in pediatric inpatients with lower respiratory tract infections in Suzhou and their correlation with meteorology and atmospheric pollutants.","authors":"Heting Dong, Yanxia Zou, Mengyao Yan, Huiming Sun, Jiawei Chen, Yongdong Yan, Canhong Zhu, Chuangli Hao, Zhengrong Chen","doi":"10.1186/s12879-025-11075-2","DOIUrl":"https://doi.org/10.1186/s12879-025-11075-2","url":null,"abstract":"<p><strong>Background: </strong>Lower respiratory infections are the leading cause of illness and death in children under 5, primarily due to respiratory syncytial virus(RSV). Climate and pollution influence disease and pathogen prevalence. This study investigates the correlation between meteorological factors, atmospheric pollutants, and RSV infections in children, aiming to implement effective clinical measures and reduce RSV risk in children by enhancing the environment.</p><p><strong>Methods: </strong>This study included patients with lower respiratory tract infections who were hospitalized in the Department of Respiratory Medicine at Children's Hospital of Soochow University from January 2006 to December 2019 as the research subjects. This study analyzed detection rates across different ages, genders, and seasons, while also examining the relationship of RSV infection between meteorological factors and atmospheric pollutants. RSV was detected using direct immunofluorescence, and an LS-SVM prediction model with lag nonlinear curves was established in conjunction with meteorological data. In this model, monthly average temperature, atmospheric pollutant levels, and average monthly wind speed were used as predictive variables for construction and prediction. A distributed lag nonlinear model (DLNM) was developed, which included the creation of a lag nonlinear curve by integrating meteorological data.</p><p><strong>Results: </strong>A total of 19,637 pediatric cases of lower respiratory tract infections were included in this study. The detection rate of RSV over 14 years averaged 14.9% (2934/19637). The male-to-female ratios for positive detection was 1.2:1. The primary detection season for RSV is winter, with a detection rate of 33.7%. The prevalence of RSV was correlated with climatic factors and atmospheric pollution. Utilizing the monthly average temperature, monthly average wind speed, and levels of atmospheric pollutants as the predictive factors in LS-SVM for model construction and prediction, a DLNM identified that the relative risk (RR) of RSV infection fluctuated with changes in the temperature and wind speed.</p><p><strong>Conclusion: </strong>RSV has the highest detection rate in infants and is often detected during winter.The influence of meteorological factors and atmospheric pollutants on RSV infection rates cannot be overlooked, with observation of a lag effect.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"662"},"PeriodicalIF":3.4,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961396","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":"Genomic insights into the spread of methicillin-resistant Staphylococcus aureus involved in ear infections.","authors":"Zhewei Sun, Jinhong Chen, Chunhong Liu, Yueru Tian, Fuqi Ai, Jiaying Du, Wangxiao Zhou, Wenjun Cao, Ming Guan, Baixing Ding","doi":"10.1186/s12879-025-11052-9","DOIUrl":"https://doi.org/10.1186/s12879-025-11052-9","url":null,"abstract":"<p><strong>Background: </strong>Methicillin-resistant Staphylococcus aureus (MRSA) is a major pathogen causing ear infections. However, genomic epidemiology and determinants influencing transmission of ear infections associated MRSA (EIA-MRSA) in community remain unknown.</p><p><strong>Methods: </strong>In 2020-2021, 105 EIA-MRSA isolates were collected and sequenced from outpatients across different households in Shanghai, China. Antimicrobial susceptibility testing, core genome MLST, and phylodynamic analyses were conducted to characterize EIA-MRSA dissemination.</p><p><strong>Results: </strong>Quinolone resistance was identified as a risk factor for EIA-MRSA spread (OR 9, [95% CI 3-31]). The ST764 clone and two subclones of ST22-PT hypervirulent clone have developed an extensive quinolone-resistant (eQR) phenotype, conferring additional resistance to advanced quinolones due to the accumulation of four mutations in gyrA (S84L and either S85P, E88K, or E88G) and parC (S80F and either E84K or E84G). These ST764- and ST22-PT-eQR isolates were highly transmissible and showed increased resistance to other commonly used antimicrobials, posing potential high-risk clones. The eQR phenotype may be inherent to the ST764 lineage, which emerged in the late 1980s, coinciding with the widespread fluoroquinolone usage. The ST22-PT-eQR subclones emerged in around 2017 and are accumulating resistance genes.</p><p><strong>Conclusion: </strong>Vigilance is crucial for eQR high-risk clones, particularly the convergent ST22-PT-eQR subclones that accumulate resistance and virulence traits, posing risks for ear infections.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"661"},"PeriodicalIF":3.4,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972045","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":"Prevalence and predictors of unsuccessful tuberculosis treatment outcomes among persons with TB/HIV co-infection in Ghana: a 10-year retrospective study.","authors":"Alhaji Ibrahim Cobbinah, Jacob Solomon Idan, Kingsley Boakye, Anthony Enimil, Nicholas Karikari Mensah, Ebenezer Adangabe, Sulemana Baba Abdulai, Charles Martyn-Dickens, Aliyu Mohammed","doi":"10.1186/s12879-025-11054-7","DOIUrl":"https://doi.org/10.1186/s12879-025-11054-7","url":null,"abstract":"<p><strong>Introduction: </strong>Unsuccessful treatment outcomes significantly impact tuberculosis control efforts globally particularly among individuals co-infected with Human Immunodeficiency Virus (HIV). This study aimed to assess the prevalence, trends, and associated factors of unsuccessful Tuberculosis (TB) treatment outcomes among persons with TB/HIV co-infection at Komfo Anokye Teaching Hospital in Ghana over a 10-year period.</p><p><strong>Methods: </strong>A retrospective cross-sectional study was conducted using data from the Komfo Anokye Teaching Hospital between January 2012 and December 2022. A total of 1,242 persons with TB/HIV co-infection were included in the study. Unsuccessful treatment outcomes were defined as death, treatment failure, or default. Modified Poisson regression with robust standard errors was performed using Stata version 17.0 to identify predictors of unsuccessful outcomes. Crude and adjusted relative risk ratios with 95% confidence intervals (CI) were reported, and a p-value < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>The prevalence of unsuccessful treatment outcomes for the 10-year period was 24.6% (95% CI: 22.3-27.1). The analysis revealed a decreasing trend of unsuccessful TB treatment outcomes from 47.6% in 2012 to 7.79 in 2022. In the multivariable analysis, older age (≥ 65 years) was associated with a higher risk of unsuccessful outcomes (ARR: 5.6, 95% CI: 2.8-11.1). Conversely, pretreatment weights of 40-54 kg (ARR: 0.5, 95% CI: 0.3-0.7), 55-69 kg (ARR: 0.4, 95% CI: 0.3-0.6), and ≥ 74 kg (ARR: 0.2, 95% CI: 0.1-0.7) were associated with reduced risk. The presence of a treatment supporter also lowered the risk of unsuccessful outcomes (ARR: 0.8, 95% CI: 0.6-0.9).</p><p><strong>Conclusion: </strong>The high prevalence of unsuccessful TB treatment outcomes among persons with TB/HIV co-infection within the 10-year period highlights the need for targeted interventions. Prioritizing care for older patients, improving nutritional support, and promoting treatment supporter involvement will enhance treatment success in Ghana.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"669"},"PeriodicalIF":3.4,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953490","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":"Risk factors and prognostic predictors of recurrent bacterial empyema in patients after surgical treatment.","authors":"Chia-Chi Liu, Yi-Ling Chen, Ching-Yuan Cheng, Chang-Lun Huang, Wei-Heng Hung, Bing-Yen Wang","doi":"10.1186/s12879-025-11077-0","DOIUrl":"https://doi.org/10.1186/s12879-025-11077-0","url":null,"abstract":"<p><strong>Background: </strong>Thoracic empyema is a severe infection with significant morbidity and mortality. Recurrence remains a challenge, impacting patient outcomes and healthcare costs. This study investigated the incidence and prognostic factors of empyema recurrence to enhance management strategies.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on 1,000 patients over 18 years old with stage II or III thoracic empyema who underwent video-assisted thoracoscopic surgery (VATS) decortication between 2011 and 2022 at Changhua Christian Hospital in Taiwan. We excluded patients who had non-bacterial empyema. We also excluded those who experienced contralateral or same-admission recurrences. Clinical data were analyzed to identify factors associated with recurrence and outcomes.</p><p><strong>Results: </strong>Empyema recurred in 46 patients (4.6%), with a median recurrence time of 37.5 days. The recurrent group had higher rates of diabetes mellitus (47.8% vs. 31.7%, p = 0.022), stage III empyema (32.6% vs. 20.1%, p = 0.041), and pleural glucose levels ≤ 40 mg/dL (52.4% vs. 36.9%, p = 0.043). Streptococcus species infections were more prevalent among recurrent cases (p = 0.029). Delays from diagnosis to operation were longer in the recurrent group (10.46 ± 23.46 days). Recurrent patients experienced extended postoperative antibiotic use and longer intensive care unit stays and hospital admissions. Overall survival was significantly lower in the recurrent group during long-term follow-up (p < 0.001).</p><p><strong>Conclusions: </strong>Empyema recurrence after VATS decortication worsens outcomes. Key risk factors include diabetes mellitus, low pleural glucose levels, Streptococcus infection, and delayed surgery. Early diagnosis, prompt surgical intervention, and careful management of comorbidities may be beneficial to reduce recurrence and improve patient outcomes.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"667"},"PeriodicalIF":3.4,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970079","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}