BMC Infectious Diseases最新文献

{"title":"Viral suppression in the context of SARS-CoV-2 among children infected with HIV-1 monitored in five health facilities in Benin.","authors":"Edwige Hermione Dagba Gbessin, Michel Kiréopori Gomgnimbou, René Kpemahouton Keke, Haziz Sina, Aldric Afangnihoun, Moussa Bachabi, Abdoul-Salam Ouedraogo, Lamine Baba-Moussa","doi":"10.1186/s12879-025-10830-9","DOIUrl":"10.1186/s12879-025-10830-9","url":null,"abstract":"<p><p>Monitoring the effectiveness of antiretroviral treatment by measuring viral load is a strong recommendation from the WHO following the intensification of this therapy, which, if well managed, improves patients' quality of life. In children, treatment options are limited and virological non-suppression is high. Virological suppression among children living with HIV who were followed at care facilities during the SARS-CoV-2 pandemic is poorly documented in countries with intermediate resources, such as Benin. Methods A longitudinal study was carried out from November 20, 2020, among children under 15 years of age who had been receiving ART for at least six months in five healthcare facilities. TCD4 lymphocytes (LTCD4) count was performed using the CyFlow counter II (from Partec laboratories). Viral load was performed using the Abbott RealTime HIV-1 assay (Abbott Molecular, Inc.). The linear range of 40-10.000.000 copies/ml and a detection limit of 40 copies/ml were defined by the manufacturers. Virological success was assessed as a suppressed viral load (VL < 3log₁₀). For children whose VL₁ ≥ 3log₁₀, WHO 2016 recommendations were applied and therapeutic education sessions were offered for 3 months, after which VL₂ was measured. Children whose (VL₁ and VL₂) ≥ 3log₁₀ were considered not suppressed. Results The mean age of 305 children enrolled was 110 (SD 41.25) months, with a predominance of girls at 52.8% (161/305). The median LTCD4 at study starting was 814 [IQR 544-1118] cells/µl. Overall, 73.11% (223/305) of children achieved virological success at the first viral load measurement, compared to 79.63% (219/275) at the second (03 months after the first). Between the two measurements, 9.83% (30/305) of children did not keep their medical appointments due to SARS-CoV-2 pandemic restrictions. Also, 20.73% (17/82) of non-suppressed children at VL₁ went undetectable. Among the 17.1% (47/275) of unsuppressed children, 10.64% (5/47) were on integrase strand transfer inhibitors as DTG (Dolutegravir). Conclusion This study, conducted in children on ART during the SARS-CoV-2 pandemic, highlighted a high rate of retention in care and viral suppression. However, there are challenges in achieving the UNAIDS third 95 to ensure sustainable viral suppression in children.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"427"},"PeriodicalIF":3.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728292","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":"Anesthetic choice impacts mortality and bacterial clearance in a murine experimental pneumonia model.","authors":"Hunter Gage, Shawn M Hannah, Bryan Hancock, Ingrid Cornax, Jason Munguia, Joshua Olson, Elisabet Bjånes, Raymond Zurich, Alexandria Hoffman, Fatemeh Askarian, Khang Tong, Lin Liu, Victor Nizet, Angela Meier","doi":"10.1186/s12879-025-10785-x","DOIUrl":"10.1186/s12879-025-10785-x","url":null,"abstract":"<p><strong>Background: </strong>Animal models of infectious pneumonia often require the use of anesthetics, but their choice and impact on outcome is rarely discussed. This study investigates the impact of the most commonly used anesthetics on mortality and bacterial clearance in a murine model of Pseudomonas aeruginosa pneumonia.</p><p><strong>Methods: </strong>Isoflurane or ketamine/xylazine were determined to be the most commonly utilized anesthetics for murine pneumonia models. Mice were anesthetized with either ketamine/xylazine or isoflurane during intratracheal infection with P. aeruginosa strains PA14 or PA01. Mortality, bacterial clearance, and lung tissue damage were compared. Additional in vitro assays assessed the effects of ketamine on human whole blood killing, serum killing, and neutrophil functions (reactive oxygen species (ROS) production, neutrophil extracellular trap (NET) production, chemotaxis, and phagocytosis).</p><p><strong>Results: </strong>Mice anesthetized with ketamine/xylazine and infected with PA14 had significantly increased mortality (p = 0.004), and significantly higher bacterial burdens in the blood (p = 0.01) and lungs (p < 0.001). In separate experiments with PA01, mice anesthetized with ketamine/xylazine had significantly increased mortality (p = 0.01), higher bacterial burdens in the blood (p = 0.01), and higher bacterial burdens in the lungs (p = 0.02), along with increased lung tissue pathology (p = 0.03) compared to mice anesthetized with isoflurane. Increased mortality and colony forming units were also observed in mice infected under propofol anesthesia, recovered, and subsequently exposed to ketamine versus control (p = 0.004 and p < 0.001, respectively). Ketamine marginally reduced the killing of PA14 in freshly drawn human whole blood (p = 0.0479), but had no significant effect on the serum's ability to kill PA14. In addition, ketamine reduced in vitro NETosis and chemotaxis (all p < 0.05), but had no significant effect on ROS production or phagocytosis of human neutrophils. These in vitro effects were observed only at supraclinical ketamine concentrations.</p><p><strong>Conclusions: </strong>Our study emphasizes that the choice of anesthetic impacts key outcomes in murine models of pneumonia, and should therefore be an important consideration in experimental design and when comparing results across different studies.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"424"},"PeriodicalIF":3.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728356","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":"Machine learning-based risk prediction model for pertussis in children: a multicenter retrospective study.","authors":"Juan Xie, Run-Wei Ma, Yu-Jing Feng, Yuan Qiao, Hong-Yan Zhu, Xing-Ping Tao, Wen-Juan Chen, Cong-Yun Liu, Tan Li, Kai Liu, Li-Ming Cheng","doi":"10.1186/s12879-025-10797-7","DOIUrl":"10.1186/s12879-025-10797-7","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Pertussis is a highly contagious respiratory disease. Even though vaccination has reduced the incidence, cases have resurfaced in certain regions due to immune escape and waning vaccine efficacy. Identifying high-risk patients to mitigate transmission and avert complications promptly is imperative. Nevertheless, the current diagnostic methods, including PCR and bacterial culture, are time-consuming and expensive. Some studies have attempted to develop risk prediction models based on multivariate data, but their performance can be improved. Therefore, this study aims to further optimize and expand the risk assessment tool to more efficiently identify high-risk individuals and compensate for the shortcomings of existing diagnostic methods.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The aim of this study was to develop a pertussis risk prediction model that is both efficient and has good generalization ability, applicable to different datasets. The model was constructed using machine learning techniques based on multicenter data and screened for key features. The performance and generalization ability of the model were evaluated by deploying it on an online platform. At the same time, this study aims to provide a rapid and accurate auxiliary diagnostic tool for clinical practice to help identify high-risk patients in a timely manner, optimize early intervention strategies, reduce the risk of complications and reduce transmission, thereby improving the efficiency of public health management.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;First, data from 1085 suspected pertussis patients from 7 centers were collected, and ten key features were analyzed using the lasso regression and Boruta algorithm: PDW-MPV-RATIO, SII, white blood cells, platelet distribution width, mean platelet volume, lymphocytes, cough duration, vaccination, fever, and lytic lymphocytes.Eight models were then trained and validated to assess their performance and to confirm their generalization ability with external datasets based on these features. Finally, an online platform was constructed for clinicians to use the models in real time.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The random forest model demonstrated excellent discrimination ability in the validation set, with an AUC of 0.98, and an AUC of 0.97 in the external validation set. Calibration curve and decision curve analysis showed that the model had high accuracy in predicting low-to-medium risk patients, which could help clinicians avoid unnecessary interventions, especially in resource-limited settings. The application of this model can help optimize the early identification and management of high-risk patients and improve clinical decision-making.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The pertussis prediction model devised in this study was validated using multicenter data, exhibited high prediction performance, and was successfully implemented online. Future research should broaden the data sources and incorporate dyn","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"428"},"PeriodicalIF":3.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728288","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":"Correlation between peripheral lymphocyte subsets monitoring and COVID-19 pneumonia in kidney transplant recipients.","authors":"Quan Zhuang, Jiang Zhu, Bo Peng, Yi Zhu, Ke Cheng, Yingzi Ming","doi":"10.1186/s12879-025-10581-7","DOIUrl":"10.1186/s12879-025-10581-7","url":null,"abstract":"<p><strong>Objectives: </strong>In kidney transplant recipients (KTRs), immune monitoring of peripheral lymphocyte subsets (PLS) reflects the real immune status and aids in the diagnosis of the occurrence and development of infectious diseases, including COVID-19. Exploring the PLS of COVID-19 pneumonia in KTRs is important.</p><p><strong>Methods: </strong>In this study, a total of 103 KTRs were divided into mild pneumonia (MP) and severe pneumonia (SP) groups, as well as a stable group. The clinical information and PLS data were assessed via t or Mann-Whitney test and receiver operating curve analysis. Logistic regression was employed to identify the risk factors, and Spearman's correlation analysis was used to identify correlations.</p><p><strong>Results: </strong>Lymphopenia is a common manifestation of COVID-19 in KTRs, and it is positively related to the severity of COVID-19 pneumonia. The CD3 + T-cell count had the highest AUC between the MP and the SP. Multiple PLS measures were found to be independent risk factors for COVID-19 pneumonia progression in KTRs.</p><p><strong>Conclusions: </strong>This study revealed a robust correlation between PLS and severe COVID-19 pneumonia progression in KTRs. PLS monitoring could facilitate real-time diagnosis and therapy for infection, as well as timely and precisive adjustment of immunosuppression instructions, for KTRs with COVID-19.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"426"},"PeriodicalIF":3.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728361","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":"Biological profile and risk factors of mortality in COVID-19 patients at Adlucem hospital in Banka-Bafang, Cameroon: a cross-sectional study.","authors":"Bertin Mamere Atangana Awundja, Boris Ronald Tonou Tchuente, Vervaine Pauline Hagbe, Leila Sandra Nnanga, Linda Kamdem, Dudric Yannick Enonguene Ekedjoum, Onana Messi Hubert Roger, Belomo Maguerrite, Dehayem Patricia, Julius Achidi Ndanji, Leonel Javeres Ntepe Mbah, Evelyn Ngwa Lumngwena, Bienvenu Bongue, Judith Laure Ngondi","doi":"10.1186/s12879-025-10845-2","DOIUrl":"10.1186/s12879-025-10845-2","url":null,"abstract":"<p><strong>Background: </strong>Despite availability of preventive vaccine and global control of the SARS-CoV-19 transmission, continuous emergence of new strains coupled with the increase spread of Mpox poses significant public health threats. Identification of simple factors for stratification and prognostics of hospitalized patients is crucial for management of these patients in limited resource settings. The aim of this study was to assess the biological profile of severe hospitalized COVID-19 patients in Cameroon and identify risk factors for mortality.</p><p><strong>Methods: </strong>A prospective, cross-sectional, analytical study was conducted of a cohort of COVID-19 patients admitted and managed at the Adlucem hospital in Banka-Bafang, Haut-Nkam Department, West Cameroon Region, from 2021 to 2022. The clinical characteristics and biological parameters of patients with COVID-19 were evaluated.</p><p><strong>Results: </strong>Of the 259 cases of COVID-19 included in the study, 68 cases (26.3%) died. The majority of patients who died were over 70 years of age. Key factors predictive of mortality in these patients were leukocytosis (OR = 2.035; 95%CI: 1.161-3.567; p = 0.013), thrombocytosis (OR = 4.286; 95%CI: 1.152-15.950; p = 0.030), hypokalemia (OR = 2.400; 95%CI: 1.143-5.042; p = 0.021), hyponatremia (OR = 2.292; 95%CI: 1.185-4.431; p = 0.014) and hypochloremia (OR = 2.644; 95%CI: 1.188-5.882; p = 0.017).</p><p><strong>Conclusion: </strong>Age, electrolyte imbalance and thrombocytosis were predictive of death in COVID-19 patients in this cohort. Thus, a biological work-up should be considered for risk stratification to ensure efficient management of COVID-19 patients on a case-by-case basis in resource limited settings like Cameroon.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"420"},"PeriodicalIF":3.4,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717585","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":"Explainable AI for Symptom-Based Detection of Monkeypox: a machine learning approach.","authors":"Gizachew Mulu Setegn, Belayneh Endalamaw Dejene","doi":"10.1186/s12879-025-10738-4","DOIUrl":"10.1186/s12879-025-10738-4","url":null,"abstract":"<p><strong>Background: </strong>Monkeypox, a viral zoonotic disease, is an emerging global health concern, with rising incidence and outbreaks extending beyond its endemic regions in Central and, West Africa and the world. The disease transmits through contact with infected animals and humans, leading to fever, rash, and lymphadenopathy symptoms. Control efforts include surveillance, contact tracing, and vaccination campaigns; however, the increasing number of cases underscores the necessity for a coordinated global response to mitigate its impact. Since monkeypox has become a public health issue, new methods for efficiently identifying cases are required. The control of monkeypox infections depends on early detection and prediction. This study aimed to utilize Symptom-Based Detection of Monkeypox using a machine-learning approach.</p><p><strong>Methods: </strong>This research presents a machine learning approach that integrates various Explainable Artificial Intelligence (XAI) to enhance the detection of monkeypox cases based on clinical symptoms, addressing the limitations of image-based diagnostic systems. In this study, we used a publicly available dataset from GitHub containing clinical features about monkeypox disease. The data have been analysed using Random Forest, Bagging, Gradient Boosting, CatBoost, XGBoost, and LGBMClassifier to develop a robust predictive model.</p><p><strong>Results: </strong>The study shows that machine learning models can accurately diagnose monkeypox based on symptoms like fever, rash, lymphadenopathy and other clinical symptoms. By using XAI techniques for feature importance, the approach not only achieved high accuracy but also provided transparency in decision-making. This integration of explainable Artificial intelligence (AI) enhances trust and allows healthcare professionals to understand predictions, leading to timely interventions and improved public health responses to monkeypox outbreaks. All Machine learning methods have been compared with the evaluation matrix. The best performance was for the LGBMClassifier, with an accuracy of 89.3%. In addition, multiple Explainable Techniques tools were used to help in examining and explaining the output of the LGBMClassifier model.</p><p><strong>Conclusions: </strong>Our research shows that combining explainable techniques with AI models greatly enhances the accuracy of case detection and boosts the trust of medical professionals. These models result in directly involving the reader and health care professional in the decision-making process, making informed decisions, and efficiently allocating resources by providing insight into the decision-making process. In addition, this study underscores the potential of AI in public health surveillance, particularly in enhancing responses to emerging infectious diseases such as monkeypox.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"419"},"PeriodicalIF":3.4,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717608","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":"Neurocognitive and emotional long-term effects of COVID-19 infections in children and adolescents: results from a clinical survey in Bavaria, Germany.","authors":"Julia Hauke-Gleißner, Irina Jarvers, Silke Jordan, Stephan Gerling, Michael Kabesch, Romuald Brunner, Stephanie Kandsperger","doi":"10.1186/s12879-025-10813-w","DOIUrl":"10.1186/s12879-025-10813-w","url":null,"abstract":"<p><strong>Background: </strong>While children and adolescents typically experience mild symptoms during the acute phase of the COVID-19 infection, some may develop severe post-infectious symptoms. In our study Post-COVID Kids Bavaria we integrated somatic and psychiatric aspects of the post-COVID syndrome to provide a holistic description of symptoms, provide early treatment, and detect possible risk factors associated with post-infectious neurocognitive and emotional impairments.</p><p><strong>Methods: </strong>We conducted an observational study involving 85 pediatric patients aged 12-17 years (M = 12.48, 61.2% female) who had confirmed COVID-19 infections and were experiencing persistent symptoms for at least 4 weeks. Our neuropsychological assessment comprised infection-specific patient interviews, psychopathological examinations, emotional well-being and behavioral difficulty questionnaires, and (computerized) tests assessing concentration, attention, and memory skills. Additionally, patients underwent neurologic, pneumologic, gastrointestinal, and cardiologic assessments.</p><p><strong>Results: </strong>Overall, the majority of patients reported experiencing elevated levels of fatigue (82.4%), loss of motivation (72.9%), concentration and attention deficits (71.8%), a worsened mood (53%), and a higher level of anxiety (31.8%). The most common diagnosis was the post-COVID adjustment disorder (ICD-10 F43.2, U09.9!; 38.8%) followed by the post-COVID attention deficit disorder (ICD-10 F98.80, U09.9!; 23.5%). Neuropsychiatric evaluation primarily identified deficits in sustained attention. There was a significant association between somatic and psychiatric post-COVID diagnoses. Patients with allergies exhibited a higher risk of developing a post-COVID adjustment disorder. For the post-COVID attention deficit disorder, age, sex, obesity, pre-existing psychiatric diagnosis, and the virus variant were relevant factors.</p><p><strong>Conclusions: </strong>Our findings indicate a diverse array of neuropsychiatric symptoms associated with the post-COVID syndrome, emphasizing the interconnectedness between somatic and neuropsychiatric diagnoses. To optimize treatment, comprehensive strategies involving both somatic and psychiatric professionals are crucial for addressing the syndrome's complexity and managing symptoms effectively.</p><p><strong>Study registration: </strong>The study Post-COVID Kids Bavaria was registered with the German Clinical Trials Register (DRKS), funded by the Bavarian State Ministry of Health, Care and Prevention and approved by the Ethics Committee of the University of Regensburg on the 29th of November, 2021 (Reference: 21-2691-101).</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"411"},"PeriodicalIF":3.4,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717821","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":"Serotype distribution of invasive Pneumococcal disease in a tertiary children's hospital in Vietnam.","authors":"Hai Thien Do, Lam Van Nguyen, Nhung Trang Thi Nguyen, Ngoc Bich Thi Hoang, Dien Minh Tran, Hanh Phuong Nguyen","doi":"10.1186/s12879-025-10672-5","DOIUrl":"10.1186/s12879-025-10672-5","url":null,"abstract":"<p><strong>Background: </strong>Invasive pneumococcal disease (IPD) is a leading cause of morbidity and mortality among children worldwide. However, this evidence from Vietnam is rare.</p><p><strong>Methods: </strong>This retrospective cross-sectional study was conducted at a tertiary children's hospital in Vietnam by analysing data of all patients under 18 years old admitted the hospital for IPD from 2019 to 2022. S. pneumoniae isolates or DNA extract from blood or other normally sterile fluids were serotyped. Clinical characteristics, antibiotic susceptibility, serotype distribution, and patient outcomes were analyzed and reported.</p><p><strong>Results: </strong>Among total of 274 children with IPD identified, 232 children under 5 years old accounted for 84.7%. S. pneumoniae serotyping revealed 18 different serotypes, with 6A/B, 19A, 23F, 19F, and 14 being the most prevalent. The coverage rates for PCV7/PCV10, PCV13 and PCV20 were 66.0%, 83.0%, and 87.2%, respectively. Antibiotic resistance rates were high, with nearly 100% resistance to erythromycin and clindamycin, and a 75.3% resistance rate to third-generation cephalosporins. Amongst 24 death cases, 25% of the confirmed deaths attributed to serotype 19F.</p><p><strong>Conclusion: </strong>Paediatric IPD in Vietnam primarily affects children under 5 years old, with high rates of antibiotic resistance. The high pneumococcal conjugate vaccine (PCV) coverage emphasizes the need for universal PCV vaccination in children to enhance IPD prevention. Continued and enhanced surveillance of IPD is essential for better understanding and management.</p><p><strong>Clinical trial number: </strong>not applicable.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"412"},"PeriodicalIF":3.4,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717827","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 lactate to albumin ratio and mortality among sepsis associated acute kidney injury patients.","authors":"Yaotang Wang, Haixia Yu","doi":"10.1186/s12879-025-10838-1","DOIUrl":"10.1186/s12879-025-10838-1","url":null,"abstract":"<p><strong>Background: </strong>Sepsis-Associated Acute Kidney Injury (SA-AKI) has high fatality rates, but clear outcome markers are lacking. The objective of this research was to ascertain the link between lactate-to-albumin ratio (LAR) and mortality in cases of SA-AKI.</p><p><strong>Methods: </strong>We performed a retrospective cohort analysis of 3589 critically ill patients with SA-AKI using the Intensive Care Medical Information Mart IV (MIMIC-IV) database. Patients were categorized into four groups based on the quartiles of LAR. The findings of this study provide baseline data and outcomes regarding in-hospital, 30-day, and 90-day mortality rates for SA-AKI patients in the intensive care unit. We utilized multivariate cox regression analysis to compute the adjusted hazard ratio (HR) and 95% confidence intervals (95% CI). Subgroup analysis and restricted cubic spline curves were employed to further investigate the relationship between LAR and mortality.</p><p><strong>Results: </strong>This study involved 3589 participants with a mean age of 62.5 years. Patients in the LAR group with a Q4 (LAR ≥ 0.95) were associated with an increased risk of in-hospital mortality, 30-day mortality, and 90-day mortality (hazards ratio (HR): 2.11, 95% CI:1.7-2.62; HR: 1.9, 95% CI: 1.55-2.34; HR: 1.91, 95% CI: 1.58-2.31, respectively). Notably, within the subgroup of patients with AKI stages 2 and no CHF patients, the association between LAR and mortality was more pronounced.</p><p><strong>Conclusion: </strong>The research underscores that elevated LAR are linked to heightened mortality risks. Notably, subgroup analyses have demonstrated that the correlation between LAR and mortality is particularly robust in certain patient cohorts, most notably those with stage 2 AKI and those without congestive heart failure (CHF).</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"414"},"PeriodicalIF":3.4,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717562","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":"Effective management of pediatric septic shock: a case study utilizing continuous renal replacement therapy with cytosorb and citrate in a leukemic patient with hyper-interleukin (IL)-6-naemia and severe thrombocytopenia.","authors":"Amir Saeed, Hadis Jafarian, Ali Amanati","doi":"10.1186/s12879-025-10807-8","DOIUrl":"10.1186/s12879-025-10807-8","url":null,"abstract":"<p><strong>Background: </strong>Sepsis is a critical condition characterized by a dysregulated immune response to infection, often resulting in organ dysfunction. Interleukin-6 (IL-6) is a key proinflammatory cytokine associated with sepsis and its complications. This case study explored the use of Continuous Renal Replacement Therapy (CRRT) combined with Cytosorb in managing pediatric patients with leukemia, severe thrombocytopenia, and elevated IL-6 levels.</p><p><strong>Case presentation: </strong>A 10-year-old boy with Fanconi anemia presented with pancytopenia, fever, and necrotic lesions, indicative of mucormycosis. Following the diagnosis of acute myeloid leukemia (AML), the patient experienced severe complications, including septic shock. Despite appropriate treatment, inflammatory markers, such as C-reactive protein (CRP), procalcitonin (PCT), and IL-6, were significantly elevated. CRRT with Cytosorb was initiated to manage hypercytokinemia and improve the patient's clinical status.</p><p><strong>Intervention: </strong>The CRRT procedure utilizes citrate as an anticoagulant because of severe thrombocytopenia. The treatment lasted for 20 h, during which the inflammatory biomarkers were monitored. The post-treatment results indicated a significant reduction in IL-6 levels within 24 h and a decrease in PCT levels at 8 h. CRP levels gradually declined over 40 h.</p><p><strong>Outcome: </strong>The patient exhibited marked clinical improvement, with significant healing of cutaneous lesions and stabilization of inflammatory markers, allowing transfer to the ward for continued chemotherapy.</p><p><strong>Conclusion: </strong>This case suggests that CRRT combined with cytosorb may be a valuable adjunctive therapy for managing complex cases of septic shock. The observed reduction in inflammatory markers, particularly IL-6, warrants further investigation. Concurrent antimicrobial, antifungal, and dexamethasone treatments for IRIS may have influenced the observed outcomes in this single case. Controlled studies are needed to evaluate the specific contribution of Cytosorb-CRRT and assess its long-term efficacy and safety in similar patient populations, particularly in resource-limited settings.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"410"},"PeriodicalIF":3.4,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717604","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}