BMC Infectious Diseases最新文献

{"title":"The regulating markers for Brucella spondylitis and tuberculous spondylitis.","authors":"Wei Hu, Nianrong Han, Yanlu Liu, Fengbo Zhang, Aikeremu Wusiman, Yifei Huang","doi":"10.1186/s12879-025-11638-3","DOIUrl":"10.1186/s12879-025-11638-3","url":null,"abstract":"<p><strong>Background: </strong>Exploring the differential mechanism between Brucella spondylitis (BS) and Tuberculous spondylitis (TS) is crucial for the full treatment and management of this disease.</p><p><strong>Methods: </strong>Spinal samples of 14 patients with BS, 13 patients with TS, and 13 controls were recruited. Among them, 4 BS patients, 3 TS patients, and 3 controls were randomly selected for high-throughput sequencing. Differential expression analysis was performed among the three groups to identify the regulatory relationships between lncRNAs and mRNAs. Weighted Gene Co-expression Network Analysis (WGCNA) and enrichment analysis were constructed for the differentially expressed mRNAs (DEmRs) and differentially expressed lncRNAs (DElncRs). Finally, experiments were conducted using the remaining samples for validation.</p><p><strong>Results: </strong>A total of 213 DEmRs and 97 DElncRs were specific to BS, 242 DEmRs and 54 DElncRs were specific to TS. In the identified 16 co-expression modules, the black module showing the highest positive correlation with BS and the lightcyan module showing the highest positive correlation with TS. Enrichment analysis revealed that genes in the black module were primarily associated with the Toll-like receptor signaling pathway. Genes in the lightcyan module were mainly associated with Th1 and Th2 cell differentiation, as well as Th17 cell differentiation. Western blot confirmed increased TLR4 expression in BS, and flow cytometry showed elevated Th2 cells and reduced Th17 cells in TS.</p><p><strong>Conclusion: </strong>CXCL8, CCL3, and CCL4L2 may be involved in the pathological process of BS through TLR4 signaling. Similarly, HLA-DRB3 and HLA-DRB1 may be involved in the pathological process of TS through the regulation of T-cell subgroups.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"1209"},"PeriodicalIF":3.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190839","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":"Nanoparticle-based biosensors coupled with loop-mediated isothermal amplification for rapid, visual, and in-field identification of pathogenic Leptospira.","authors":"Ling Xie, Ying Liu, Xinggui Yang, Shijun Li, Xu Chen","doi":"10.1186/s12879-025-11645-4","DOIUrl":"10.1186/s12879-025-11645-4","url":null,"abstract":"","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"1214"},"PeriodicalIF":3.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190691","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":"Neurological manifestations of Mpox virus during the recent global outbreak: a systematic review.","authors":"Govinda Bhandari, Anush Acharya, Anupam Katuwal Chettri, Sujan Sharma","doi":"10.1186/s12879-025-11631-w","DOIUrl":"10.1186/s12879-025-11631-w","url":null,"abstract":"","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"1188"},"PeriodicalIF":3.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190720","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":"Bedaquiline combined with clofazimine as salvage therapy for 11 patients with nontuberculous mycobacterial lung disease.","authors":"Lan Yao, Yifan He, Jinghui Yang, Xubin Zheng, Xiang Shi, Wei Wei, Guoling Yang, Ruoyan Ying, Wei Sha","doi":"10.1186/s12879-025-11605-y","DOIUrl":"10.1186/s12879-025-11605-y","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to investigate the efficacy and safety of a regimen combining bedaquiline and clofazimine in the treatment of refractory nontuberculous mycobacterial lung disease caused by Mycobacterium avium complex(MAC) or Mycobacterium abscessus subsp. abscessus (here Mab).</p><p><strong>Methods: </strong>In this open-label, prospective pilot study, patients with refractory non-tuberculous mycobacterial pulmonary disease (NTM-PD) were enrolled to receive a regimen of bedaquiline and clofazimine alongside individualized background therapies. No control group was established in the study. Sputum samples were collected for culture at baseline (prior to treatment initiation) and then monthly thereafter. After the initial 6-month period, sputum collection frequency was reduced to every two months until trial completion. The primary end-point was sputum culture conversion rate. However, due to insufficient patient enrollment, we present these findings as a case series.</p><p><strong>Results: </strong>A total of 11 patients were enrolled in this study, including 8 cases infected with Mycobacterium abscessus subsp. abscessus, 2 with Mycobacterium avium, and 1 with Mycobacterium intracellulare. Nine patients were resistant to clarithromycin. All 11 patients completed 18 months of follow-up. After 6 months of treatment, 45% (5/11) patients achieved culture conversion. However, after 18 months' treatment, only 27% (3/11) maintained culture conversion. Chest CT imaging showed improvement in 5 patients, stability in 4 patients, and progression of lesions in 2 patients. The longest duration of bedaquiline use was 20 months. QTc interval prolongation was observed in 64% (7/11) of patients within 24 weeks, leading to permanent discontinuation of bedaquiline in one patient. The minimum inhibitory concentration (MIC) of bedaquiline ranged from ≤ 0.06 to 0.25 µg/mL prior to treatment, and two patients experienced an increase in MIC from ≤ 0.06 µg/mL to 0.12 µg/mL after treatment. The MICs of clofazimine were between 0.06 and 1 µg/mL.</p><p><strong>Conclusion: </strong>The combination of bedaquiline and clofazimine may offer some clinical benefit in selected cases of advanced Mab and MAC lung diseases, but larger controlled studies are needed to confirm these preliminary findings.</p><p><strong>Trial registration: </strong>This clinical study (ChiCTR2000037403) was registered on the ‌Chinese Clinical Trial Registry‌ website ( http://www.chictr.org.cn ) on ‌August 28, 2020‌.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"1203"},"PeriodicalIF":3.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190613","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 risk factors associated with Toxoplasma gondii infection among blood donors in eastern China.","authors":"Jinsong Gao, Jiaqi Zhang, Hualiang Chen, Wei Ruan, Yan Feng, Qiaoyi Lu, Xiaoxiao Wang, Jianmin Jiang","doi":"10.1186/s12879-025-11559-1","DOIUrl":"10.1186/s12879-025-11559-1","url":null,"abstract":"<p><strong>Background: </strong>Toxoplasmagondii is a zoonotic parasite infecting approximately one-third of blood donors worldwide; hence, a better understanding of the prevalence of and associated risk factors for T. gondii infection among blood donors is necessary. This study, therefore, aimed to elucidate the infection risk in Zhejiang Province, China via cross-sectional investigation combined with a case-control design.</p><p><strong>Methods: </strong>Blood samples were collected from 1807 blood donors for the cross-sectional survey between January 2023 and December 2024 in Zhejiang, eastern China. Enzyme-linked immunosorbent assay and quantitative polymerase chain reaction were used to investigate the prevalence of T. gondii. Questionnaires were used to collect demographic information. In total, 40 seropositive and 40 seronegative participants were selected for risk factor investigation. Univariate and multivariate logistic regression analyses were conducted.</p><p><strong>Results: </strong>The overall prevalence of anti-T. gondii antibodies was 5.9% (95% confidence interval [CI]: 4.9-7.1%), with 100, one, and six participants found to be IgG-positive only (5.5%, 95% CI: 4.5-6.7%), IgM-positive only (0.1%, 95% CI: 0-0.4%), and IgG- and IgM-positive, respectively (0.3%, 95% CI: 0.1-0.8%). All samples were negative for T. gondii as per polymerase chain reaction test results. T. gondii seroprevalence exhibited an age-dependent increase from 2.4% (18-29 years) to 8.2% (50-59 years). Age and occupational distribution patterns varied between eastern and southern regions. Univariate analysis revealed that occupation was a risk factor for T. gondii infection. Repeated blood donation (P = 0.044, OR = 0.243, 95%CI: 0.061-0.964) was negatively associated with T. gondii infection. Multivariate logistic regression demonstrated that age (P = 0.031) and first-time donors (P = 0.011) were significantly associated with higher prevalence rates.</p><p><strong>Conclusion: </strong>Strategies for prevention of transfusion-transmitted toxoplasmosis should be targeted to older and first-time donors. This study provides evidence-based insights to guide prevention strategies and ensure blood safety.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"1202"},"PeriodicalIF":3.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190694","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":"Climate change and antimicrobial resistance: a global-scale analysis.","authors":"Yaqin Ni, Jin Zhao, Yuhua Yuan, Baihuan Feng","doi":"10.1186/s12879-025-11616-9","DOIUrl":"10.1186/s12879-025-11616-9","url":null,"abstract":"<p><strong>Background: </strong>Antimicrobial resistance (AMR) represents a major global health threat. Although regional studies have explored the relationship between climate change and AMR, a comprehensive global analysis incorporating extreme climate events has not yet been conducted.</p><p><strong>Methods: </strong>We analyzed global data from 2000 to 2023, encompassing over 28 million bacterial isolates from eight common pathogens and 14 antibiotic categories. Climate data were sourced from NOAA, and resistance data were obtained from ResistanceMap, ECDC, and PLISA databases. Linear mixed-effects models (LMMs) were applied to evaluate the associations between climate indices and resistance rates.</p><p><strong>Results: </strong>Temperature was consistently positively correlated with resistance rates across most bacterial species. The mean temperature was significantly associated with resistance rates even after adjusting for covariates. Extreme temperature indicators, including intensity indices (TXx, TNx, TXn and TNn), absolute threshold indices (SU, TR and DTR), relative threshold indices (TN90p and TX90p), and duration indices (CSDI and WSDI) exhibited significant positive correlations with resistance rates. In contrast, cold-related indices (FD, ID, TN10p and TX10p) were negatively correlated with resistance rates. Among the precipitation indices, only CDD demonstrated a significant positive association with aggregated AMR after full adjustment; all the other precipitation metrics showed no statistically significant correlation. Furthermore, subgroup analyses of WHO priority pathogens confirmed the robust effect of temperature, but revealed that precipitation indices, particularly CDD, had opposing correlations with resistance across different pathogens.</p><p><strong>Conclusions: </strong>This study provides robust global evidence that rising temperatures and extreme heat are consistent drivers of AMR, whereas the impact of precipitation is complex and pathogen dependent. These findings underscore the need for climate-informed public health strategies that integrate climate surveillance into AMR action plans to develop targeted interventions against these intertwined global threats.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"1191"},"PeriodicalIF":3.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190706","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 hepatitis B and hepatitis C viral infections among refugees in Muzaffarabad, Pakistan.","authors":"Yasir Waheed, Sohail Naser Awan, Fahad Nasser Almajhdi, Bashir Ahmad, Abdul Sami, Dilber Uzun Ozsahin","doi":"10.1186/s12879-025-11636-5","DOIUrl":"10.1186/s12879-025-11636-5","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis B (HB) and Hepatitis C (HC) viral infections, with 328 million cases globally, represent a significant disease burden. Currently, Pakistan has 3.88 million HB and 9.31 million HC cases. High-risk populations like refugees are disproportionately affected by these infections. The objectives of this study were to determine the seroprevalence of hepatitis B surface antigen (HBsAg) and hepatitis C virus antibody (anti-HCV) among Kashmiri refugees in Muzaffarabad, Pakistan, and to identify the key demographic and educational risk factors associated with the seroprevalence in this population.</p><p><strong>Methods: </strong>A cross-sectional study was conducted across eight refugee camps in the Muzaffarabad division, Pakistan. A six-membered team visited each camp to collect blood samples through venipuncture. The seroprevalence of HBsAg and anti-HCV was determined using rapid immunochromatographic test (ICT) kits .</p><p><strong>Results: </strong>A total of 550 sera samples were collected from the refugee population in Muzaffarabad. The overall seroprevalence was 5.82% (32/550) for HBsAg and 4.73% (26/550) for anti-HCV. A higher seroprevalence of HBsAg and anti-HCV was recorded among females 6.12% (15/245), and 6.53% (16/245), respectively, compared to males 5.75% (17/305), and 3.28% (10/305), respectively. A marked increase in seroprevalence of HBsAg and anti-HCV was noted with an increase in age: 1-10 (2.44%) and (2.44%), 41-50 (8.20%) and (6.56%), and 51-60 (8.93%) and (8.93%), respectively. Chi-square test revealed a statistically significant association between age and seroprevalence of HBsAg χ² (degrees of freedom (df):6, N = 550) = 27.22, p = 0.000, and HC χ² (df:6, N = 550) = 15.23, p = 0.019.The level of education impacted the seroprevalence of HBsAg and anti-HCV, resulting in a higher seroprevalence of HBsAg (6.9%) and anti-HCV (5.4%) among uneducated individuals compared to educated individuals (4.71%) and (3.99%), respectively.</p><p><strong>Conclusion: </strong>The seroprevalence of HBsAg and anti-HCV is high among the refugee population of Muzaffarabad, Pakistan. There is a need for the implementation of a robust vaccination program for HB as well as the establishing a hepatitis micro-elimination program among the Kashmiri refugee population of Muzaffarabad, Pakistan.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"1212"},"PeriodicalIF":3.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190755","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":"Chlamydia psittaci pneumonia manifested as pulmonary nodules and cavitary lesions: a case report.","authors":"Haishan Zhong, Danhui Huang, Yuying Lin, Pei Yang, Hongguang Shi, Shuang Yang, Shaoxi Cai, Hangming Dong","doi":"10.1186/s12879-025-11676-x","DOIUrl":"10.1186/s12879-025-11676-x","url":null,"abstract":"<p><strong>Background: </strong>Chlamydia psittaci pneumonia (CPP) typically presents with exudative and consolidative changes on chest computed tomography (CT), including lung consolidation, bronchial air trapping, pleural effusion, and ground-glass opacities. Here, we report an atypical case of CPP manifesting as pulmonary nodules and cavitary lesions, which was subsequently diagnosed through targeted next-generation sequencing (tNGS) of bronchoalveolar lavage fluid (BALF).</p><p><strong>Case presentation: </strong>A previously healthy 16-year-old male adolescent developed a severe cough with scant mucoid sputum, nasal congestion, and rhinorrhea after cleaning his dormitory, with symptoms lasting nearly one month. Initial laboratory tests revealed normal infection-related markers, including white blood cell (WBC) count, interleukin-6 (IL-6), and procalcitonin (PCT), while chest CT showed pulmonary nodules and a small cavitary lesion. Based on the clinical presentation of persistent cough and the absence of significant inflammatory markers, empirical therapy with intravenous doxycycline was initiated, resulting in significant symptom improvement. After discharge, failure to follow the recommended dosing schedule and non-standardized use of oral doxycycline (including missed doses and co-administration with milk) compromised treatment efficacy. A follow-up CT demonstrated partial improvement in the right lung lesion but progression in the left, prompting a switch to cephalosporin, which proved ineffective. Referred to our hospital, bronchoscopy and tNGS of BALF identified Chlamydia psittaci (11 nucleic acid sequence reads), confirming psittacosis. A 14-day course of oral doxycycline led to significant clinical improvement and resolution of pulmonary lesions on follow-up imaging.</p><p><strong>Conclusion: </strong>In clinical practice, CPP should be included in the differential diagnosis for patients presenting with pulmonary nodules and cavitary lesions on imaging, even in the absence of confirmed direct avian exposure. This consideration is particularly crucial when patients exhibit persistent respiratory symptoms coupled with poor clinical response to broad-spectrum antibiotic therapy.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"1215"},"PeriodicalIF":3.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190772","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":"CCR4⁺ memory Tregs and PD-1⁺ T cells as novel immunodiagnostic biomarkers for active tuberculosis.","authors":"Qiang Zhang, Yifan Zhang, Zhenpeng Guo, Zheyue Wang, Huakai Hu, Suya Song, Feifei Hu, Fengyu Tian, Xiaowei Deng, Jianming Wang","doi":"10.1186/s12879-025-11623-w","DOIUrl":"10.1186/s12879-025-11623-w","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB), caused by Mycobacterium tuberculosis(M.tb), remains a major global infectious disease. T cell-mediated immune responses play a crucial role in host defense against TB. Investigating the differentiation and functional status of T cell subsets may help identify novel biomarkers for the diagnosis and prediction of active tuberculosis (ATB).</p><p><strong>Methods: </strong>This study enrolled 140 ATB patients and 140 healthy controls (HC) to investigate the immunophenotypic differences in T cell subsets within peripheral blood mononuclear cells (PBMC). Univariate and multivariate analyses were conducted to evaluate the association between T cell subsets and TB infection, as well as their potential value in predicting ATB. Propensity score matching was used to analyze the immunophenotypic differences in PBMC between mild and severe ATB patients.</p><p><strong>Results: </strong>Compared with HC, ATB patients exhibited higher frequencies of CD3⁺ T cells (P < 0.0001), lower frequencies of CD4⁺ central memory T cells (CM) (P < 0.01) and CD8⁺ Effector T cells (P < 0.05), and increased frequencies of CD8⁺ CM (P < 0.01). Expression of programmed cell death protein 1 (PD-1) on CD4⁺ and CD8⁺ T cells was downregulated, while Human Leukocyte Antigen - DR (HLA-DR) expression was upregulated. CCR4⁺ memory regulatory T cells (Tregs), CD8⁺PD-1⁺ T cells, and CD4⁺PD-1⁺ T cells were closely associated with TB infection and showed potential value in predicting ATB. Severe ATB patients had more CD8⁺ HLA-DR⁺ T cells (P < 0.05) and fewer CD4⁺ Effector T cells (P < 0.05).</p><p><strong>Conclusion: </strong>Differentiation and function of T cell subset are associated with TB infection. CCR4⁺ memory Tregs, CD4⁺PD-1⁺ T cells, and CD8⁺PD-1⁺ T cells show potential predictive value for ATB.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"1187"},"PeriodicalIF":3.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190618","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 treatment outcomes in drug-sensitive pulmonary tuberculosis patients in rural eastern China.","authors":"Tian Tian, Jia-Wang Lu, Ting Jiang, Cheng-Yu Li, Zhi-Ao Tian, Qun Xie, Zhong-Hui Chen, Bin Zhang, Rong-Rong Zhang, Xun Zhuang, Guo-Bing Zhu, Gang Qin","doi":"10.1186/s12879-025-11320-8","DOIUrl":"10.1186/s12879-025-11320-8","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to identify risk factors associated with unsuccessful treatment outcomes among newly diagnosed drug-sensitive pulmonary tuberculosis (PTB) patients in rural eastern China and to develop a prediction model for treatment outcomes.</p><p><strong>Methods: </strong>This study analyzed 838 newly diagnosed drug-sensitive PTB patients in rural eastern China (2021-2023). Treatment outcomes (unsuccessful treatment) were assessed using WHO guidelines. The cohort was randomly divided into a training set (70%) and a validation set (30%) for internal validation. Multivariate logistic regression identified predictors, including age, malnutrition, comorbidities, hemoglobin levels, and sputum smear grades. Decision curve analysis (DCA) was performed to evaluate the clinical utility of the prediction model by quantifying the net benefit across a range of threshold probabilities.</p><p><strong>Results: </strong>The prediction model identified six independent predictors of unsuccessful treatment outcomes: diabetes, chronic lung disease, alcohol use, hypoalbuminemia, anemia, and sputum smear grades. The area under the receiver operating characteristic curve (AUC) was 0.754 (95% CI: 0.676-0.833), indicating good discriminative ability. The model demonstrated moderate accuracy across three risk categories. A nomogram was developed to visually represent the model, enabling clinicians to estimate individual patient risk based on these six predictors. Additionally, an online calculator was created to facilitate easy and practical application of the model in clinical settings. Decision curve analysis (DCA) further validated the clinical utility of the model, showing a significant net benefit across a wide range of threshold probabilities (2-54%), supporting its applicability for guiding clinical decision-making.</p><p><strong>Conclusions: </strong>The prediction model serves as a valuable tool for clinicians to identify high-risk PTB patients and tailor interventions effectively. This approach can enhance treatment strategies and contribute to better TB control in rural eastern China.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"1184"},"PeriodicalIF":3.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190707","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}