BMC Infectious Diseases最新文献

{"title":"Long-term trends of visceral leishmaniasis incidence and mortality in India 1990-2019: an application of joinpoint and age-period-cohort analysis.","authors":"Deepak Dhamnetiya, Krittika Bhattacharyya, Ravi Prakash Jha, Neha Shri, Mayank Singh, Priyanka Patel","doi":"10.1186/s12879-025-10751-7","DOIUrl":"10.1186/s12879-025-10751-7","url":null,"abstract":"<p><p>Leishmaniasis, a vector-borne disease, remains one of the most significant parasitic disease with potential outbreak and high mortality. Despite improvements in living standards and health infrastructure, there has been a territorial expansion in the incidence and lethality of the disease. However, evidence regarding its control, prevention, and eradication remains limited. Given an understanding of the present status of the disease, this study assesses the trends and patterns in the incidence and mortality of this endemic in India from 1990 to 2019. This study obtained Visceral Leishmaniasis (VL) incidence and mortality data (1990-2019) from the Global Burden of Disease (GBD) study 2019, provided by the Institute for Health Metrics and Evaluation (IHME). To capture the overall changes and sex-specific changes in ASIRs and ASMRs of VL, joinpoint regression analysis was employed for all ages by using joinpoint regression programme version 4.5.0.1. Age-period-cohort analysis is used to estimate the net age, period, and cohort effects on the incidence and mortality of VL from observed age-specific incidence and mortality rates. The APC model was implemented using Stata 16.0, and its fit was assessed using Akaike's Information Criterion (AIC) and Bayesian Information Criterion (BIC). Findings indicate a significant decline in the age-specific incidence and mortality rates for both sex. The highest annual percentage decline in VL incidence and mortality was observed during 2011-2016 for both males and females. (Table 1). Results from the age effect show that the risk of VL incidence and mortality among both genders decreased sharply with advancing age. Period effect indicated a sharp decline in incidence and mortality risk from the period 1990-94 to 2000-04. The cohorts effect showed that compared to earlier birth cohort (1900-04),, the relative risk (RR) of VL incidence increased by 1.5 in male and 1.7 times in females in more recent birth cohort (2015-19), whereas mortality risk decreased by 48% among females. Findings highlight a notable reduction in VL incidence and mortality in the country. The age pattern in the incidence and mortality rates indicates the need for age-specific attention while performing preventive measures and comprehensive strategies. Moreover, strengthening large-scale screening, vector control measures, and public health education is essential to sustain VL elimination efforts.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"1176"},"PeriodicalIF":3.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190746","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":"Intraluminal gas in deep vein thrombosis associated with Rhodotorula mucilaginosa fungemia and Prevotella intermedia bacteremia: a unique clinical case report and literature overview.","authors":"Nima Shariatzadeh, Suchit Chidurala, Samuel Nesemann","doi":"10.1186/s12879-025-11180-2","DOIUrl":"10.1186/s12879-025-11180-2","url":null,"abstract":"<p><p>Intravenous drug use (IVDU) is associated with multiple complications, including thrombus and infection with rare pathogens. Here, we present a unique case of septic thrombophlebitis with gas present within the lumen of the thrombus that was identified from an otherwise unassuming wound via point-of-care ultrasound (POCUS). In conjunction with past literature, this finding raises the possibility of POCUS detection of intraluminal gas as a sensitive indicator of septic thrombophlebitis. Furthermore, the patient's polymicrobial infection with Rhodotorula mucilaginosa and Prevotella intermedia expands the types of pathogens that should be suspected in IVDU-related infections; this case is the first reported Rhodotorula mucilaginosa infection of an IVDU patient with no known immunodeficiency. Though rare, greater attention should be paid to this emerging pathogen in IVDU. This case highlights the importance of a low threshold for using POCUS in patients with IVDU and other risk factors for complex infections.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"1217"},"PeriodicalIF":3.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190752","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":"Immunology of vector-borne diseases: the role of immunopharmacology in controlling viral and parasitic infections.","authors":"Ebrahim Abbasi","doi":"10.1186/s12879-025-11627-6","DOIUrl":"10.1186/s12879-025-11627-6","url":null,"abstract":"<p><strong>Background: </strong>Vector-borne diseases (VBDs) pose a significant global health threat, driven by complex interactions between pathogens, vectors, and host immune responses. Understanding the immunopharmacological mechanisms underlying these interactions is crucial for developing novel therapeutic and preventive strategies. This review explores the immunomodulatory effects of vector saliva, pathogen-induced immune evasion, and host-directed immunotherapies to provide a comprehensive perspective on immune regulation in VBDs.</p><p><strong>Methods: </strong>A systematic review of peer-reviewed literature was conducted using databases such as PubMed, Scopus, and Web of Science. Studies on host immune responses, vector-mediated immunomodulation, and immunopharmacological interventions were included. Key themes were synthesized to highlight emerging therapeutic approaches, including monoclonal antibodies, immune checkpoint inhibitors, and vector-targeted vaccines.</p><p><strong>Results: </strong>The findings reveal that vector saliva modulates innate and adaptive immunity, altering disease outcomes. Pathogens exploit immune checkpoints to evade host defenses, necessitating targeted immunomodulatory therapies. Advances in monoclonal antibodies, metabolic reprogramming, and microbiome-based interventions offer promising avenues for disease control.</p><p><strong>Discussion: </strong>Future research should integrate systems immunology, AI-driven predictive models, and microbiome-targeted strategies to enhance immunotherapeutic efficacy. Ethical and regulatory challenges must also be addressed to ensure equitable implementation.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"1182"},"PeriodicalIF":3.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190775","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 probable hantavirus infections in clinically suspected dengue patients in a tertiary care hospital in Sri Lanka.","authors":"Erandi Ekanayake, Mihidum Govinna, Shashini Wakkumbura, Yashodha Samarajeewa, Nipuni Arachchige, Achini Weerathunga, Lakmali Rajamanthri, Gaya Ranawaka, Thulani Pattiyakumbura, Dhanushka Dasanayake, Rohitha Muthugala","doi":"10.1186/s12879-025-11617-8","DOIUrl":"10.1186/s12879-025-11617-8","url":null,"abstract":"<p><strong>Background: </strong>Acute febrile illnesses, including dengue fever, are common causes of hospitalization in Sri Lanka. However, a significant proportion of clinically suspected dengue cases tested negative for dengue-specific markers, raising concerns about alternative infectious causes such as hantavirus. This study aimed to detect hantavirus infections among patients clinically suspected of dengue who tested negative for dengue NS1 and IgM antibodies and to analyze the epidemiology of hantavirus infections in febrile patients.</p><p><strong>Methodology: </strong>A descriptive cross-sectional study was conducted at the Department of Virology, National Hospital Kandy, from January to August 2023. A total of 415 serum samples from clinically suspected dengue patients who tested negative for dengue NS1 and IgM antibodies were selected. Hantavirus detection was performed using real-time RT-PCR and IgM antibody testing. Additional tests for flavivirus, alphavirus, and leptospirosis were also conducted. Demographic, clinical, and laboratory data were collected from hantavirus-positive cases.</p><p><strong>Results: </strong>Among the 415 samples, 21 (5.1%) tested positive for hantavirus IgM antibodies. None of the samples tested positive for hantavirus RNA. The demographic analysis revealed no significant difference in age or gender between hantavirus-positive and negative patients. Co-infection with leptospirosis was observed in one patient. In addition to fever, clinical features of hantavirus infection included dry cough (41.2%), vomiting (35.3%), and shortness of breath (23.5%). Laboratory findings showed elevated liver enzymes (AST: 61.5%, ALT: 53.8%), elevated creatinine (50%), and elevated CRP (72.7%).</p><p><strong>Conclusion: </strong>The putative 5.1% hantavirus seropositivity rate among clinically suspected dengue patients suggests that hantavirus should be considered in differential diagnoses. Although no hantavirus RNA was detected, the presence of IgM antibodies and negativity to other potential infections indicates a potential recent infection or probable cases. The study highlights the challenge of diagnosing hantavirus due to its similar presentation to dengue fever and the need for improved diagnostic testing. Early diagnosis and tailored management can improve patient outcomes and guide public health responses. Further studies and expanded diagnostic capabilities are recommended to better understand hantavirus prevalence and to improve clinical care for affected patients.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"1193"},"PeriodicalIF":3.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190683","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 effectiveness of antiviral treatment on household transmission of SARS-CoV-2: a retrospective cohort study using administrative data.","authors":"Kazuhiko Ikeuchi, Makoto Saito, Kazuya Okushin, Yuki Arisato, Toshiyuki Kishida, Shinya Matsumoto, Akira Kado, Hiroshi Yotsuyanagi, Takeya Tsutsumi","doi":"10.1186/s12879-025-11651-6","DOIUrl":"10.1186/s12879-025-11651-6","url":null,"abstract":"<p><strong>Background: </strong>Antiviral treatment reduces influenza transmission and differs in effectiveness among agents. Although SARS-CoV-2 antivirals lower viral shedding, their role in preventing secondary household transmission and the differences between agents remain unclear.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using the JMDC administrative claims database in Japan. The study included married-couple households between 1 April and 31 August 2023, when the Omicron XBB variant was predominant. Households in which at least one person had been diagnosed with Coronavirus Disease 2019 (COVID-19) were included. We excluded households if the index patient did not receive antiviral treatment on day 0, or the spouse was diagnosed on day 0 or 1. The primary outcome was subsequent infection in the spouse by day 7. Cox proportional hazards models were used to estimate hazard ratios (HRs), after adjusting for potential confounders.</p><p><strong>Results: </strong>Of the 326,827 married-couple households, 5,398 met the inclusion criteria. Among them, 1,143 households (21.2%) experienced presumed secondary transmission by day 7. The cumulative transmission rate, estimated using the Kaplan-Meier method, was lower among hospitalized patients (n = 73, 11.0%, 95% confidence interval [CI]: 5.7-20.8%) than among outpatients (n = 5,325, 21.5%, 95% CI: 20.4-22.6%, p = 0.035). Transmission rates did not significantly differ among the outpatient antiviral groups: molnupiravir (n = 3,093, 21.3%, 95% CI: 19.9-22.8%), ensitrelvir (n = 1,907, 21.6%, 95% CI: 19.8-23.6%), and nirmatrelvir/ritonavir (n = 323, 22.8%, 95% CI: 18.6-27.8%, p = 0.74). In multivariable Cox analysis, male sex (adjusted HR 1.43, 95% CI: 1.26-1.63; p < 0.001), history of COVID-19 in the index patient (adjusted HR 0.50, 95% CI: 0.33-0.76; p = 0.001), and history of COVID-19 in the partner (adjusted HR 0.31, 95% CI: 0.21-0.45; p < 0.001) were significantly associated with transmission risk. Hospitalization tended to be associated with a lower risk of transmission (adjusted HR, 0.51; 95% CI, 0.25-1.03; p = 0.062).</p><p><strong>Conclusions: </strong>Household transmission rates were not statistically different among three different outpatient oral antiviral agents. Hospitalization was associated with a trend toward lower transmission rates, possibly due to physical isolation.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"1213"},"PeriodicalIF":3.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190777","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":"Medical complexity and healthcare utilization among patients attending three U.S. post-COVID clinics.","authors":"Miriam A M Nji, Elizabeth M Briones, Anindita Issa, Maureen Tierney, Jeanne Bertolli, Surendra Barshikar, Elizabeth R Unger, Juan Wisnivesky, Quan Vu, David Quimby, Joseph Abrams, Nikhil Jagan, Sasha Manouchehripour, Martin Laguerre, Jennifer R Cope","doi":"10.1186/s12879-025-11424-1","DOIUrl":"10.1186/s12879-025-11424-1","url":null,"abstract":"<p><strong>Background: </strong>Patients who do not fully recover or develop new symptoms following SARS-CoV-2 infection require follow-up and sometimes seek care at specialized multidisciplinary care clinics. We aimed to describe the clinical characteristics and care needs of patients at three such post-COVID clinics.</p><p><strong>Methods: </strong>We conducted a multisite retrospective electronic chart review of 984 patients, aged ≥ 18 years, who visited one of three post-COVID clinics at least 28 days after a clinical or polymerase chain reaction (PCR)-confirmed diagnosis of SARS-CoV-2 infection between January 20, 2020, and March 31, 2021. The clinics were located in Omaha, Nebraska, New York City, New York, and Dallas, Texas. Patient records were obtained through September 30, 2021. Data on clinical evaluations and healthcare provider visits were abstracted by trained clinical personnel using a standardized health record abstraction tool.</p><p><strong>Results: </strong>The median age was 52 years (range 18-89 years), 59.9% were female, and 69.0% were White. Of 984 patients, 79.9% had SARS-CoV-2 infection that was confirmed by PCR, 32.1% had three or more comorbid conditions, and 39.4% had been hospitalized. During post-COVID follow-up, the most common symptoms were shortness of breath (59.2%), post-exertional malaise (45.6%), fatigue (43.2%), and brain fog (42.8%). Nearly one in three patients had a diagnosis of post-viral fatigue syndrome (30.1%), and pulmonary system conditions (24.4%) were also common. Overall, the 984 participants attended 3914 visits (median 3; range 1-46) over a median follow-up period of 107 days (range 1-560) between first and last post-COVID follow-up visits. Of the 984 patients, 64.3% were referred for subspecialty care notably pulmonology, cardiology, and neurology. More than a third of patients were referred for rehabilitation therapy (37.9%) including physical, occupational, speech, and psychotherapy.</p><p><strong>Conclusion: </strong>Adult patients at post-COVID clinics have a wide range of symptoms and conditions that highlight the medical complexity of these patients and their need for high levels of care, including multiple health care visits and referrals for therapy. This underscores the need for well-coordinated, multidisciplinary care, and planning of health resources for post-COVID-19 follow-up care.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"1145"},"PeriodicalIF":3.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145172425","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":"A pilot study evaluating mid-point vancomycin concentrations to estimate pharmacokinetics and area under the curve: a prospective study.","authors":"Aseel AbuSara, Deema Abdelrahman, Wedad Awad, Jennifer Le, Skyler Shapiro, Lama Nazer","doi":"10.1186/s12879-025-11469-2","DOIUrl":"10.1186/s12879-025-11469-2","url":null,"abstract":"<p><strong>Background: </strong>Guidelines recommend monitoring vancomycin by estimating the area under the curve (AUC₂₄) with two levels, peak and trough, preferably using Bayesian software. However, such an approach is not feasible or cost-effective in all settings. In this study, we evaluated the accuracy and precision of estimating AUC₂₄ using a single mid-point level in critically ill cancer patients. We hypothesized that concentrations at the midpoint of the dosing interval may provide insight into the volume of distribution (Vd) and clearance (Cl), capturing pharmacokinetic parameters assessed by the peak and trough concentrations, respectively.</p><p><strong>Methods: </strong>A prospective study that included critically ill cancer patients with stable kidney function who received vancomycin during their ICU stay. Trough, peak, and midpoint concentrations were measured at steady-state. Pharmacokinetic equations from the short infusion model was used to calculate the AUC₂₄, Cl, and Vd using a single midpoint. We also determined AUC₂₄, Cl, and Vd using Bayesian software with peak and trough concentrations. Accuracy and precision of the pharmacokinetic estimations utilizing the mid-point level were determined, with a comparison to the Bayesian approach.</p><p><strong>Results: </strong>We included 91 patients, with a mean age of 53 years ± 17 (SD), 54% were males, and 77% had solid tumors. The mean prescribed vancomycin dose was 15 mg/kg/dose ± 3 (SD). Median AUC₂₄ was 426 mg.dl/hr (IQR 326-559) and 464 mg.dl/hr (IQR 345-664), using the midpoint and Bayesian approach, respectively. The mean Vd was 48 L (± 11) and 45 L (± 13) and Cl was 5 L/hr (± 3) and 5 L/hr (± 2) for both approaches, respectively. The accuracy and precision for the midpoint, against the Bayesian, were: AUC₂₄ (11%, 22%, respectively), Cl (17%, 24%, respectively), and Vd (6%, 9%, respectively).</p><p><strong>Conclusions: </strong>Utilization of mid-point vancomycin levels to calculate pharmacokinetic parameters demonstrated promising findings. Further research with larger and more diverse patient populations is needed to evaluate this approach further.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"1131"},"PeriodicalIF":3.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145172983","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":"Role of biomarkers in predicting mortality in patients with flaviviral disease endemic to South India: a retrospective observational study.","authors":"Nitin Gupta, Pothumarthy Venkata Swathi Kiran, Mohammad Khalid, Tirlangi Praveen Kumar, Prithvishree Ravindra, Rachana Bhat","doi":"10.1186/s12879-025-11509-x","DOIUrl":"10.1186/s12879-025-11509-x","url":null,"abstract":"<p><strong>Background: </strong>Flaviviral infections such as dengue and Kyasanur Forest Disease (KFD) are endemic causes of acute febrile illness in South India, with some cases progressing to severe disease and death.</p><p><strong>Methods: </strong>We conducted a retrospective observational study at a tertiary care centre from June 2023 to June 2024, enrolling 107 adults diagnosed with dengue (NS1/IgM positive) or KFD (Polymerase chain reaction assay-confirmed). Clinical and biomarker data, including haematological, hepatic, renal, inflammatory, and endothelial parameters, were analysed to find differences between the two diseases and identify predictors of 28-day mortality.</p><p><strong>Results: </strong>Eleven patients (10.3%) died within 28 days. KFD patients were older and had higher adrenomedullin and transaminase levels. Dengue cases showed higher SOFA scores and more severe thrombocytopenia. Mortality was associated with elevated coagulation markers, serum creatinine, procalcitonin, and adrenomedullin. Aspartate aminotransferase was more frequently elevated in non-survivors.</p><p><strong>Conclusions: </strong>Combining conventional and novel biomarkers, such as adrenomedullin, may help early identification of high-risk patients, improving prognostication and management of endemic flaviviral infections.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"1162"},"PeriodicalIF":3.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173160","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":"Inflammatory parameters in the prediction of sepsis-induced acute kidney injury: a case-control study.","authors":"Dajana Lendak, Dunja Bečejac, Sonja Mitić, Sonja Adamović, Katarina Samardžić, Maria Pete, Vedrana Petrić, Gordana Jovanović, Siniša Sević, Nadica Kovačević","doi":"10.1186/s12879-025-11528-8","DOIUrl":"10.1186/s12879-025-11528-8","url":null,"abstract":"<p><strong>Background: </strong>Although hypovolemia was long considered the main cause of sepsis-induced acute kidney injury (SI-AKI), current theories explore multifactorial causes of injury (inflammation, immune response, ischaemia-reperfusion system and hypovolemia). The aim of this study was to determine the significance of inflammatory parameters (leucocyte, neutrophil, lymphocyte, neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP), procalcitonin (PCT)) and mean-arterial pressure (MAP)) in prediction of SI-AKI development.</p><p><strong>Methods: </strong>A total of 257 septic patients (Sepsis-3 criteria) were included. Patients were divided into two groups based on SI-AKI development (with SI-AKI, n = 133; without SI-AKI, n = 124). All patients had complete blood count with leukocyte formula, CRP, PCT, SOFA and qSOFA score available. Statistical analysis included non-parametric Mann-Whitney test, Spearman's correlations, ROC curve analysis, as well as binary logistic regression in order to identify independent predictors of SI-AKI.</p><p><strong>Results: </strong>CRP (p < 0.001), PCT (p < 0.001) and NLR (p = 0.002) were higher in the SI-AKI group, and showed a significant correlation with creatinine levels (p < 0.001). MAP was significantly lower in the SI-AKI group (p = 0.043). Binary logistic regression analysis showed that CRP and PCT were only independent predictors of SI-AKI, along with SOFA score. ROC curve analysis showed that CRP ≥ 199 mg/L, and PCT ≥ 13ng/L represent the cut-off values for SI-AKI prediction.</p><p><strong>Conclusions: </strong>Obtained results highlight the potential role of the inflammatory response in SI-AKI development.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"1142"},"PeriodicalIF":3.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173505","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":"Adherence to on-demand and daily oral pre-exposure prophylaxis for HIV among men who have sex with men in China: a cross-sectional study.","authors":"Xue Yang, Qizi Liu, Hui Xue, Guang Zhang, Houlin Tang","doi":"10.1186/s12879-025-11557-3","DOIUrl":"10.1186/s12879-025-11557-3","url":null,"abstract":"<p><strong>Background: </strong>Pre-exposure prophylaxis (PrEP) has been effective in reducing HIV transmission in men who have sex with men (MSM). The effectiveness of PrEP is closely related to adherence, whether taken daily or on-demand. In China, there are few studies on PrEP adherence in MSM.</p><p><strong>Methods: </strong>An online survey was conducted on the Heer Health Platform from July 6 to August 30, 2022. Participants were recruited through private messages sent to users who had purchased PrEP on the platform. The primary outcome was the proportion of daily and on-demand PrEP usage. Secondary outcomes included the proportions of high and low adherence to daily and on-demand PrEP among MSM. Univariate analyses were performed using the chi-square test or fisher's exact test, followed by multivariate logistic regression to identify factors associated with PrEP adherence.</p><p><strong>Results: </strong>Among 384 participants, comprising 321 (83.6%) on-demand and 63 (16.4%) daily PrEP users. High adherence was observed in all daily users (100%) versus 81.9% (263) of on-demand users. During their last on-demand PrEP cycle, 8.7% (28/321) did not take the third pill on time, with 60.7% (17/28) delayed by over 2 h. 10.6% (34/321) missed the fourth pill, with 76.5% (26/34) delayed exceeded 2 h. Primary reasons were forgetting and busy schedules. Multivariable logistic regression identified three independent predictors of high adherence among on-demand PrEP users, including regular follow-up during PrEP use, having an HIV-positive sexual partner not on antiretroviral therapy and PrEP consultation (P < 0.05). Besides, statistically significant differences were found in variables such as sexuality, regular follow-up while taking PrEP, the number of male sexual partners in the last six months, the HIV status of the most recent male sexual partner in the past six months, and perceived HIV infection risk between the high adherence groups of on-demand and daily PrEP (P < 0.05).</p><p><strong>Conclusions: </strong>Government and health authorities should continue to increase awareness and promotion of PrEP and condoms use among MSM. Emphasizing the importance of non-missing dose resolutions and regular follow-up can help improve PrEP adherence among MSM.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"1166"},"PeriodicalIF":3.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145172986","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}