BMC Infectious Diseases最新文献

{"title":"Empirical versus pre-emptive antifungal therapies for invasive fungal infections in critically ill patients.","authors":"Hong Tham Pham, Ronald L Castelino, Tyree H Kiser, Kim-Huong Truong-Nguyen, Minh-Hoang Tran","doi":"10.1186/s12879-025-10816-7","DOIUrl":"10.1186/s12879-025-10816-7","url":null,"abstract":"<p><strong>Background: </strong>The initiation strategy of antifungal therapy (AT) is among the most discussed practices for patients vulnerable to invasive fungal infections (IFI). In low-resource countries, there are also no appropriate consensus or guidelines for this issue. Given this clinical gap, we aimed to investigate the use of empirical and pre-emptive therapy in an Asian intensive care setting.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study (timeframe 2019-2020) on critically ill adults receiving systemic antifungals for ≥ 3 days. The exposure was empirical or pre-emptive therapy of systemic antifungals. The primary outcome was IFI-related mortality (in percentage, including in-hospital death or discharge/transfer with death prognosis). The secondary outcomes included overall rationale of AT (in percentage) and length of AT (LoAT, in days). We used logistic and linear regression to investigate the outcomes and reported the estimates with the 95% confidence interval (95% CI).</p><p><strong>Results: </strong>During a median follow-up of 27 days, among 157 included patients (median age 68, 48.4% being female), we recorded 77 deaths (49.0% [95% CI 41.0-57.1%]) that were related to IFI (60 [51.7%] in the empirical group; 17 [41.5%] in the pre-emptive group; adjusted odds ratio of IFI-related mortality 1.86 [95% CI 0.74 to 4.63; p = 0.184]). The overall rationale of AT was at 45.2% (95% CI 37.2-53.4%; 41.4% [95% CI 32.3-50.9%] in the empirical group; 56.1% [95% CI 40.0-71.5%] in the pre-emptive group; adjusted odds ratio of receiving rational AT: 0.75 [95% CI 0.31 to 1.87]). The median LoAT was 8 days (IQR 6-14; 8 days [IQR 6-13.3] in the empirical group; 9 days [IQR 6-14] in the pre-emptive group; adjusted mean difference - 1.1 days [95% CI -3.2 to 1.0]).</p><p><strong>Conclusion: </strong>Among critically ill patients on systemic antifungals for ≥ 3 days, the proportion of IFI-related mortality was high. The overall rationale of AT was at a low level, with the median LoAT lower than the generally recommended duration of at least 14 days. There were no significant differences in IFI-related mortality, overall rationale of AT, and LoAT between those receiving empirical and pre-emptive therapy.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"395"},"PeriodicalIF":3.4,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11929986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical utility of the FilmArray® meningitis/encephalitis panel in children with suspected central nervous system infection in a low-resource setting - a prospective study in Southwestern Uganda.","authors":"Reza Rasti, Elias Kumbakumba, Deborah Nanjebe, Phuthumani Mlotshwa, Milly Nassejje, John Mzee, Stephen Businge, Gilbert Akankwasa, Dan Nyehangane, Jesper Gantelius, Yap Boum, Andreas Mårtensson, Juliet Mwanga-Amumpaire, Tobias Alfvén, Giulia Gaudenzi","doi":"10.1186/s12879-025-10732-w","DOIUrl":"10.1186/s12879-025-10732-w","url":null,"abstract":"<p><strong>Background: </strong>In low-resource settings, limited laboratory capacity adds to the burden of central nervous system (CNS) infections in children and spurs overuse of antibiotics. The commercially available BioFire® FilmArray® Meningitis/Encephalitis Panel (FA-ME) with its capability to simultaneously detect 14 pathogens in cerebrospinal fluid (CSF), could potentially narrow such a diagnostic gap.</p><p><strong>Methods: </strong>In Mbarara, Uganda, we compared clinical utility (clinical turnaround time [cTAT], microbial yield, and influence on patient outcome and antibiotic exposure) of FA-ME with bacterial culture, in children 0-12 years with suspected CNS infection.</p><p><strong>Results: </strong>Of 212 enrolled children, CSF was sampled from 194. All samples underwent bacterial culture, of which 193 also underwent FA-ME analyses. FA-ME analyses prospectively influenced care for 169 of the 193 patients, and they constituted an 'Index group'. The remaining 43/212 patients constituted a 'Reference group'. Of all 194 CSF-sampled patients, 87% (168) had received antibiotics before lumbar puncture. Median cTAT for FA-ME was 4.2 h, vs. two days for culture. Bacterial yield was 12% (24/193) and 1.5% (3/194) for FA-ME and culture, respectively. FA-ME viral yield was 12% (23/193). Fatality rate was 14% in the Index group vs. 19% in the Reference group (P = 0.20). From clinician receival of FA-ME results, median antibiotic exposure was 6 days for bacteria-negative vs. 13 days for bacteria-positive patients (P = 0.03). Median hospitalization duration was 7 vs. 12 days for FA-ME negative and positive patients, respectively (P < 0.01).</p><p><strong>Conclusions: </strong>In this setting, clinical FA-ME utility was found in a higher and faster microbial yield and shortened hospitalization and antibiotic exposure of patients without CSF pathology. More epidemiologically customized pathogen panels may increase FA-ME utility locally, although its use in similar settings would require major cost reductions.</p><p><strong>Trial registration: </strong>The trial was registered with clinicaltrials.gov (NCT03900091) in March 2019, and its protocol was published in November 2020.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"396"},"PeriodicalIF":3.4,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690937","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 and spatiotemporal distribution of hepatitis C in southeast coastal areas of China from 2015 to 2022.","authors":"Wei Liu, Qiaoling Lian, Zongqing Li, Xiaoli Lu, Shaobin Wu, Mingya Zhang, Yunjiao Pan, Yixiang Lin, Jianfeng Xie","doi":"10.1186/s12879-025-10778-w","DOIUrl":"10.1186/s12879-025-10778-w","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to analyze the epidemiological characteristics and spatial-temporal distribution characteristics of hepatitis C in Fujian Province, China, from 2015 to 2022, and to provide reference for the risk identification, early warning and prevention and control measures of hepatitis C in Fujian Province.</p><p><strong>Methods: </strong>The incidence data of hepatitis C in Fujian Province from 2015 to 2022 were collected from the China Information System for Disease Control and Prevention. Descriptive epidemiology method and JRP 4.9.1.0 software were used to analyze the epidemiological characteristics of hepatitis C in Fujian Province from 2015 to 2022. ArcGIS 10.8 software was used for spatial autocorrelation analysis of the reported incidence of hepatitis C, and SaTScan 10.1.3 software was used for spatio-temporal scanning analysis.</p><p><strong>Results: </strong>A total of 18,712 cases of hepatitis C were reported in Fujian Province from 2015 to 2022, and the annual reported incidence showed a decreasing trend (AAPC =-10.4, P < 0.001). Males were more affected, accounting for 55.7% (n = 10,429) of all reported hepatitis C cases compared to 44.3% (n = 8,283) for females. Among all age groups, the number of cases in people aged 40-60 was the largest, accounting for 43.2%. Autocorrelation analysis showed that the reported cases of hepatitis C from 2015 to 2022 were clustered, and the global Moran´s I values were all greater than 0 (P < 0.001). Local autocorrelation analysis showed that the high-high concentration area of hepatitis C incidence was relatively fixed and concentrated in the Putian city. The spatial and temporal scanning analysis detected one largest possible agglomeration area, Xiuyu District of Putian city, and two type II agglomeration areas were mainly distributed in economically developed cities along the coastal line.</p><p><strong>Conclusion: </strong>The reported incidence of hepatitis C in Fujian province showed a downward trend from 2015 to 2022, and there were obvious epidemic characteristics and spatial-temporal clustering of hepatitis C. Attention should be paid not only to the key population of 40-60 years old males in rural areas and the key gathering areas in Putian City, but also to the incidence of hepatitis C in southeast coastal areas.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"394"},"PeriodicalIF":3.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11929232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676791","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":"Standard versus double dosing of beta-lactam antibiotics in critically ill patients with sepsis: The BULLSEYE study protocol for a multicenter randomized controlled trial.","authors":"M M B Horstink, D R Geel, C A den Uil, P E Deetman, H Endeman, A Abdulla, T M Bosch, W J R Rietdijk, F W Thielen, J J Haringman, P van Vliet, T A Rijpstra, C Bethlehem, A Beishuizen, A E Muller, B C P Koch","doi":"10.1186/s12879-025-10747-3","DOIUrl":"10.1186/s12879-025-10747-3","url":null,"abstract":"<p><strong>Background: </strong>Sepsis and septic shock are significant global healthcare challenges with high mortality rates. Effective management requires timely and adequate antimicrobial therapy. Beta-lactam antibiotics, commonly used in patients with sepsis, are crucial for treating these infections. However, standard dosing often leads to insufficient plasma levels due to dynamic physiological changes in critically ill patients. Previous randomized controlled trials highlighted the need for timely dose adjustments to improve clinical outcomes. This is the study protocol for the BULLSEYE trial in which we aim to optimize antibiotic treatment during the initial 48 h of sepsis by comparing standard to double dosing of beta-lactam antibiotics.</p><p><strong>Methods: </strong>This open-label, multicenter, randomized controlled trial will compare standard to double dosing of beta-lactam antibiotics (cefuroxime, ceftazidime, ceftriaxone, cefotaxime, amoxicillin, amoxicillin/clavulanic acid, flucloxacillin, meropenem, and piperacillin/clavulanic acid) in critically ill patients with septic shock. Participants will be randomized into two arms: the control arm receiving standard care, and the intervention arm receiving double antibiotic doses for 48 h, irrespective of renal function. Following this period, all patients will receive standard doses as per local protocol. The primary outcome is all cause 28-day mortality, with secondary outcomes including 90-day, 365-day, hospital and ICU mortality, hospital and ICU length of stay, SOFA scores, time to shock reversal, microbiological eradication, clinical cure, pharmacodynamic target attainment, safety, quality of life, and medical consumption.</p><p><strong>Discussion: </strong>The BULLSEYE trial aims to improve sepsis treatment in critically ill patients. Despite anticipated recruitment challenges, its large sample size ensures robust comparability. This pivotal trial could significantly impact sepsis treatment, leading to better clinical outcomes.</p><p><strong>Trial registration: </strong>EU_CT 2024-512950-13-00. Protocol version 2.3, protocol date 09-12-2024. Prospectively registered on 09-01-2025 at Clinicaltrails.gov nr. NCT06766461.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"392"},"PeriodicalIF":3.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11929207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676794","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 case of septic shock caused by drug-resistant Edwardsiella tarda and literature review.","authors":"Yan Zhou, De Ren, Yin Li, Shuiqing Gui","doi":"10.1186/s12879-025-10789-7","DOIUrl":"10.1186/s12879-025-10789-7","url":null,"abstract":"<p><strong>Background: </strong>Edwardsiella tarda (E. tarda) causes highly mortality, which is rare in septic patients. We herein reported a case of septic shock caused by drug-resistant E. tarda.</p><p><strong>Case presentation: </strong>We herein describe a 32-year-old female with septic shock who had the medical history of abortion 1 month ago and \"systemic lupus erythematosus and rheumatoid arthritis\" presented abdominal pain, diarrhea, and dyspnea as the primary symptoms and rapidly deteriorated to MODS following breakfast (undercooked fish porridge) in the ICU. Sepsis surviving bundle was initiated by collecting pathogen culture (sputum, urine and blood samples), empirically broad-spectrum antibiotics administration (Meropenem), along with fluid resuscitation, vasopressor use. E. tarda was confirmed both in blood culture and mNGS (metagenomics next generation sequencing). Thus, the antibiotics were switched to piperacillin-tazobactam according to the susceptibility test that was susceptible to piperacillin-tazobactam and resistant to ampicillin, quinolones and gentamicin. The patient finally recovered and discharged after 18 days of ICU treatment.</p><p><strong>Conclusions: </strong>Empiric antibiotics should be selected with piperacillin-tazobactam and amikacin, and avoid ampicillin, quinolones and gentamicin for suspecting E. tarda infection in southern China. Bacteremia complicated with septic shock caused by E. tarda requires intensive care to improve survival rates.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"393"},"PeriodicalIF":3.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11929179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676788","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 the extent of intrapulmonary spread on chest CT and false-negative results of T-SPOT.TB in pulmonary tuberculosis: a retrospective study.","authors":"Ryo Sato, Naoki Takasaka, Yusuke Hosaka, Taiki Fukuda, Kyota Shinfuku, Makiko Takatsuka, Tsukasa Hasegawa, Masami Yamada, Yumie Yamanaka, Kai Ryu, Takeo Ishikawa, Jun Araya","doi":"10.1186/s12879-025-10777-x","DOIUrl":"10.1186/s12879-025-10777-x","url":null,"abstract":"<p><strong>Background: </strong>The T-SPOT.TB assay is widely used for the adjunctive diagnosis of tuberculosis (TB). However, clinicians often encounter false-negative T-SPOT.TB results. The extent of TB spread may influence host immune functions, which can influence the results of the T-SPOT.TB test. However, few previous reports have investigated the association between radiologic pulmonary tuberculosis (PTB) severity and T-SPOT.TB test results.</p><p><strong>Methods: </strong>We retrospectively investigated patients with culture-confirmed pulmonary TB (PTB) at the Jikei University Daisan Hospital between September 2016 and December 2021. We aimed to clarify the association of PTB severity, according to computed tomography (CT), with the false-negative results of the T-SPOT.TB test.</p><p><strong>Results: </strong>Among 193 patients with PTB, 43 (22.3%) had false-negative T-SPOT.TB results. High rates of false-negative results were noted for 7/18 (38.9%) patients with PTB spread in two lung segments (mild PTB) and 16/39 (41.0%) patients with PTB spread in 19 lung segments (severe PTB). Multivariate logistic regression analysis showed that mild or severe PTB (odds ratio [OR]: 3.23; 95% confidence interval [CI]: 1.46-7.13; P = 0.004) and lymphopenia (OR: 3.33; 95% CI: 1.20-9.26; P = 0.02) were statistically significant risk factors for false-negative results.</p><p><strong>Conclusions: </strong>Mild or severe intrapulmonary lesions on chest CT might be associated with the false-negative results of the T-SPOT.TB assay. Additionally, estimating the intrapulmonary spread of PTB using chest CT could serve as a useful supplementary tool in diagnosing patients with PTB who receive false-negative results on the T-SPOT.TB test.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"391"},"PeriodicalIF":3.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143668748","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":"Lateral-flow device for the diagnosis of invasive aspergillosis: a systematic review and diagnostic meta-analysis.","authors":"Yuqing Fan, Xue Shang, Yan Wang, Yinghua Zhang, Xiuxia Li, Kehu Yang, Haidi Lv, Kangle Guo","doi":"10.1186/s12879-025-10769-x","DOIUrl":"10.1186/s12879-025-10769-x","url":null,"abstract":"<p><strong>Background: </strong>Early diagnosis of invasive aspergillosis (IA) can significantly enhance patient survival rates; however, accurately diagnosing IA remains a formidable challenge. Lateral flow device (LFD), as a non-invasive detection method, have been extensively investigated in numerous clinical studies. The objective of this study was to elucidate the diagnostic accuracy of LFD in detecting IA through a meta-analysis.</p><p><strong>Methods: </strong>The PubMed, Embase, and Web of Science database were searched to obtain clinical studies on the diagnosis of IA by LFD. A random-effects meta-analysis with a bivariate hierarchical model was used, the estimates and 95% confidence intervals (CI) were used to present pooled sensitivity, specificity, and summary receiver operating characteristic curves (SROC).</p><p><strong>Results: </strong>Twenty-five cohort or case-control studies were included. The pooled sensitivity of LFD in the diagnosis of IA was 0.67 (95% CI: 0.57-0.75), specificity was 0.90 (95% CI: 0.85-0.93), diagnostic odds ratio was 15.70 (95% CI: 9.69-25.44), the area under the SROC curve (AUC) was 0.87 (95% CI: 0.82-0.93). Subgroup analysis showed that the sensitivity of bronchoalveolar lavage fluid specimen was higher than serum specimen (0.72, 95% CI: 0.67-0.78 vs. 0.49, 95% CI: 0.41-0.56), bronchoalveolar lavage fluid specimens also have higher diagnostic accuracy (AUC = 0.89).</p><p><strong>Conclusions: </strong>LFD is an effective technique for the detection of IA infection, but attention should be paid to the influence of specimen source on the accuracy of this technique.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"388"},"PeriodicalIF":3.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143668771","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: Isolation, genetic, and biological characterization of human adenovirus type 55 positive isolates from Wuhan, China.","authors":"Jing Xie, Yan Wang, Huan Li, Bingxiu Tan, Zhengying Yu, Lizhong Li, Wei Zhang, Hongbin Song, Leili Jia","doi":"10.1186/s12879-025-10798-6","DOIUrl":"10.1186/s12879-025-10798-6","url":null,"abstract":"","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"389"},"PeriodicalIF":3.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143668750","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":"Efficacy and safety of polymyxin B sulfate versus colistin sulfate in ICU patients with nosocomial pneumonia caused by carbapenem-resistant Acinetobacter baumannii: a multicenter, propensity score-matched, real-world cohort study.","authors":"Wei Bu, Chengyu Wang, Yuan Wu, Peng Zhang, Nengfang Zhang, Ying Han, Xiaona Xu, Sha Li, Yan Cai","doi":"10.1186/s12879-025-10773-1","DOIUrl":"10.1186/s12879-025-10773-1","url":null,"abstract":"<p><strong>Background: </strong>Despite the widespread use of colistin sulfate (CS) in clinical settings in China over recent years, supported by several studies demonstrating its clinical efficacy, there remains a lack of comparative data on the efficacy and safety of polymyxin B sulfate (PMB) versus CS, specifically for carbapenem-resistant Acinetobacter baumannii (CRAB)-caused nosocomial pneumonia.</p><p><strong>Objective: </strong>To compare the efficacy and safety of PMB and CS in intensive care unit (ICU) patients with nosocomial pneumonia caused by CRAB.</p><p><strong>Methods: </strong>We conducted a multicenter retrospective cohort study, including patients diagnosed with CRAB-caused nosocomial pneumonia and treated with intravenous PMB or CS in the ICU of the study hospitals between January 1, 2020, and June 30, 2024. Propensity score matching (PSM) was employed to adjust for potential baseline confounders between cohorts. Multivariate logistic regression analysis and Cox logistic regression analyses were performed to identify for factors potentially influencing the clinical outcomes and adverse events.</p><p><strong>Results: </strong>Following matching, a total of 190 patients were analyzed. There was no statistical significance in the rates of clinical success, microbiological eradication and 28-day mortality between the PMB and CS cohorts. While the incidence of acute kidney injury (AKI) and hepatotoxicity were comparable in both cohorts, but dermal toxicity was significantly higher in patients receiving PMB compared to those receiving CS (18.9% vs. 0%, P < 0.05). Among all the patients, hypertension, baseline renal insufficiency, usage of vasoactive drugs and in combination with three or more antibiotics were independent risk factors associated with AKI; while age, duration of polymyxins ≤ 7 days and Sequential Organ Failure Assessment (SOFA) score were risk factors associated with 28-day all-cause mortality.</p><p><strong>Conclusion: </strong>This study establishes that PMB and CS have similar efficacy in treating CRAB induced nosocomial pneumonia in the ICU settings. The incidence of AKI and hepatotoxicity of both polymyxins are comparable for both polymyxins, although PMB is associated with a significantly higher incidence of skin toxicity. Ensuring adequate therapy duration is key to better outcomes in the treatment of CRAB-induced nosocomial pneumonia in ICU patients, regardless of the type of polymyxins.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"390"},"PeriodicalIF":3.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143668754","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":"Assessment of infection prevention and control management in obstetrics departments in secondary and tertiary hospitals : A cross-sectional study from Guiyang city, China, 2023.","authors":"Rui Tu, Tao Zhao, Xin Yu, Zuyan Xiao, Jiamin Zhou, Juan Tian, Guiqin Du","doi":"10.1186/s12879-025-10598-y","DOIUrl":"10.1186/s12879-025-10598-y","url":null,"abstract":"<p><strong>Background: </strong>Coinfection in pregnancy can lead to serious adverse consequences for maternal and neonatal health. How to timely and effectively control the occurrence of Healthcare-associated Infections (HAI) during maternal hospitalization is one of the critical challenges facing obstetrics department. To evaluate the current status of infection prevention and control management in obstetrics departments in secondary and tertiary medical institutions in Guiyang City. The findings will serve as a basis future improvement.</p><p><strong>Methods: </strong>This cross-sectional study was conducted in Guiyang city, Guizhou Province, China, from July to December 2023. The Guiyang Nosocomial Infection Control and Quality Improvement Center collaborated with 33 medical institutions to collect online survey data. The survey contained five sections, including information about the participating hospitals, basic information on the obstetric department, surveillance of HAIs, the building environment and equipment, and cleaning and disinfection.</p><p><strong>Results: </strong>Out of the 33 hospitals invited to participate, 28 (85.00% response rate) accepted and completed the online survey. There were significant differences in the type and educational backgrounds of infection preventionists between tertiary care and secondary care hospitals (P < 0.001). No other variables showed significant differences.</p><p><strong>Conclusion: </strong>The configuration of full-time Infection Preventionists (IPs) in both tertiary and secondary hospitals in Guiyang City, Guizhou Province, is insufficient, with the situation being particularly severe in secondary hospitals. Additionally, in terms of personnel configuration, secondary hospitals have a high proportion of nursing professionals and lack highly educated talent. Therefore, it is recommended that secondary medical institutions should staff sufficient, professional, and well-structured IPs. Furthermore, secondary hospitals should actively establish a nosocomial infection monitoring system and enhance their information monitoring capabilities. Moreover, establishing LDR (labor, delivery, and recovery) rooms with a focus on comfort can help improve the experience of maternal care, but its role in preventing hospital infections requires further research.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"383"},"PeriodicalIF":3.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662382","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}