Ababo Demeke, Getu Kassa, Habtamu Gebrie, Samuel Tefera, Eyob Getu, Samuel Jigso Dube, Alem Bayable, Adamu Kassie, Birhanu Muleta, Wondimagene Wolde Eba, Behailu Taye Gebremeskele, Abel Desalegn Demeke
{"title":"Burden of malaria infection among most vulnerable populations in Ethiopia: an umbrella review of systematic reviews and meta-analyses.","authors":"Ababo Demeke, Getu Kassa, Habtamu Gebrie, Samuel Tefera, Eyob Getu, Samuel Jigso Dube, Alem Bayable, Adamu Kassie, Birhanu Muleta, Wondimagene Wolde Eba, Behailu Taye Gebremeskele, Abel Desalegn Demeke","doi":"10.1186/s12879-025-11568-0","DOIUrl":"10.1186/s12879-025-11568-0","url":null,"abstract":"","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"1161"},"PeriodicalIF":3.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173244","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":"Exploring the incidence potential of phenol-soluble modulins among methicillin-resistant Staphylococcus aureus in Lahore, Pakistan.","authors":"Sourat Mudassar, Abida Bano, Farah Asghar, Fadia Waheed, Numan Javed","doi":"10.1186/s12879-025-11350-2","DOIUrl":"10.1186/s12879-025-11350-2","url":null,"abstract":"<p><strong>Background: </strong>Methicillin-resistant Staphylococcus aureus (MRSA) has emerged as a major clinical and epidemiological problem over the past few decades. This study aimed to investigate antibiotic resistance patterns, incidence potential of phenol-soluble modulins (PSMs) genes and explored the associations between miscellaneous clinical specimens of MRSA and the incidence of virulent PSMs genes.</p><p><strong>Methods: </strong>This investigation employed a total of sixty MRSA strains isolated from clinical specimens such as pus aspirates, wound swabs, ear swabs, tissue swabs, blood, and urine. Antibiotic profiling was performed via Kirby-Bauer (KB) disk diffusion method. Genetic analysis was performed for detection of S. aureus-specific 16SrRNA gene, methicillin-resistant mecA and its homologue mecC gene and the virulent determinant PSMs genes psm-α, psm-β, and psm-mec along with agr operon gene via polymerase chain reaction (PCR). Pearson's Chi-square (χ<sup>2</sup>) analysis test was used to determine the associations between various clinical specimens and the incidence of PSMs genes, with a significance threshold set at p < 0.05.</p><p><strong>Results: </strong>Most of MRSA isolates were obtained from pus samples. The incidence of MRSA was more pronounced in males. Notably, the highest percentage of MRSA isolates was isolated from patients aged 21-40 years. Of all isolates (100%) harboured the 16SrRNA and mecA gene, whereas none of those isolates (0%) had the mecC gene. The resistance profiles of MRSA isolates obtained from various clinical specimens were not significantly different (p > 0.05). Furthermore, vancomycin and linezolid were still effective for treating MRSA infections. Those 60 strains had 56/60 (93.4%) psm-α, 54/60 (90%) psm-β, 55/60 (91.6%) psm-mec and (48/60) 80% agr genes. A strong association was detected between the psm-β gene and MRSA strains obtained from pus samples (p = 0.01), as was the case for the psm-mec gene and MRSA strains obtained from pus samples (p = 0.03).</p><p><strong>Conclusion: </strong>The well-informed decisions could be made on the prescription of the best antibiotic therapy, the implementation of efficient control measures, and the development of anti-virulence strategies to stop the dissemination of MRSA in hospitals and clinical settings. The virulence factors PSMs may be considered as potential candidates for treating virulent MRSA infections in patients through anti-virulence strategies.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"1154"},"PeriodicalIF":3.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173404","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}
Micheal Anorue, Chika Ejikeugwu, Chidinma Stacy Iroha, Ebuka Elijah David, Ejike Francis Nwabueze, Ifeanyichukwu Romanus Iroha
{"title":"Extended spectrum beta-lactamase producing Escherichia coli encoding aminoglycoside and fluoroquinolone resistant genes in urinary tract infection patients in a tertiary hospital in Nigeria.","authors":"Micheal Anorue, Chika Ejikeugwu, Chidinma Stacy Iroha, Ebuka Elijah David, Ejike Francis Nwabueze, Ifeanyichukwu Romanus Iroha","doi":"10.1186/s12879-025-11561-7","DOIUrl":"10.1186/s12879-025-11561-7","url":null,"abstract":"<p><p>Escherichia coli causing urinary tract infections (UTIs) remains the most common bacterial infection diagnosed among outpatients as well as hospitalized patients. This study aimed to detect the extended-spectrum beta-lactamase-producing E. coli habouring aminoglycosides and fluoroquinolone-resistant genes in UTI patients. A total of 372 clean-catch midstream urine samples of patients with UTI attending Alex Ekwueme Federal University Teaching Hospital Abakaliki, Nigeria (AE-FUTHA) was collected. The collected urine samples were processed using standard microbiology and molecular methods to isolate and identify E. coli. Detection of ESBL-producing E. coli was performed using the double-disk synergy test. The ESBL-producing E. coli were subjected to antimicrobial susceptibility testing following the standard Kirby-Bauer disk diffusion method. PCR-specific primers were used to screen for the ESBL, aminoglycosides and fluoroquinolone-resistant genes. Out of the 372 urine samples collected, 84 (22.58%) distinct E. coli isolates were recovered, out of which 24 (28.57%) were ESBL positive. While all the isolates were resistant to amoxicillin/clavulanic acid 24 (100%), others were highly resistant to aztreonam and sulfamethoxazole/trimethoprim 22 (91.7%), ceftriaxone 21 (87.5%), ceftazidime and cefotaxime 16 (66.7%). Resistance to a fluoroquinolone, a ciprofloxacin was observed in 15 (62.5%). Out of the 24 ESBL-positive isolates, 12 were selected based on their resistance to both aminoglycosides and fluoroquinolones antibiotics used. These ESBL-producing E. coli encoded <sub>bla</sub>OXA-1 3 (25%), <sub>bla</sub>SHV 3 (25%) and <sub>bla</sub>TEM 8 (66.7%). Fluoroquinolone genes, qnrA and qnrC were detected in all the isolates 12 (100%), while qnrB was detected in 10 (83.35). Aminoglycoside gene, ant (4')-la was detected in all the isolates 12 (100%), while aph (2\")-ld was haboured by 10 (83.3%). Co-resistance of ESBL, fluoroquinolone and aminoglycoside (blaTEM + qnrA + qnrB + qnrC + ant (4')-la + aph (2\")-lb) was observed in 8(66.7%). E. coli is one of the predominant bacteria isolated from UTI patients in Abakaliki. A high proportion have the ability to produce ESBL and predominantly encoded blaTEM with co-existence of fluoroquinolone gene, qnr and aminoglycoside, ant (4')-la.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"1171"},"PeriodicalIF":3.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173427","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}
Qiongdan Mai, Jinzhou Wen, Yasha Luo, Junfei Guo, Yanting Qin, Weiming Lai, Wenyu Deng, Cunwei Ji, Rongjia Mai, Minling Zheng, Zhenhui Chen, Yuan Chen, Chunming Gu, Li Guo, Hongyu Li, Yuanping Tang, Dongping Huang, Mingyong Luo
{"title":"Molecular epidemiology and increasing macrolide resistance of Bordetella pertussis isolates in Guangzhou, China.","authors":"Qiongdan Mai, Jinzhou Wen, Yasha Luo, Junfei Guo, Yanting Qin, Weiming Lai, Wenyu Deng, Cunwei Ji, Rongjia Mai, Minling Zheng, Zhenhui Chen, Yuan Chen, Chunming Gu, Li Guo, Hongyu Li, Yuanping Tang, Dongping Huang, Mingyong Luo","doi":"10.1186/s12879-025-11577-z","DOIUrl":"10.1186/s12879-025-11577-z","url":null,"abstract":"<p><strong>Background: </strong>Pertussis (whooping cough), a highly contagious respiratory disease caused by Bordetella pertussis, has resurged worldwide and requires increased attention. This study aimed to characterize the molecular epidemiology and antimicrobial susceptibility profiles of B. pertussis isolates circulating in Guangzhou, China.</p><p><strong>Methods: </strong>A total of 91 culture-confirmed pertussis cases in Guangzhou between January 2020 and August 2024 were enrolled and studied. B. pertussis isolates (from January 2020 to May 2024) were recovered from 62 cases. All isolates underwent antigenic genotyping and phylogenetic analysis based on whole-genome sequencing. Antimicrobial susceptibility testing using E-test was performed on 12 representative isolates.</p><p><strong>Results: </strong>The majority of culture-confirmed cases occurred in children under 1 year of age who were unvaccinated or partially vaccinated. Genotypic analysis revealed a significant shift: only 3 isolates (all from 2022) harbored the ptxP1 allele, while the remaining 59 exhibited ptxP3. Three types of pertactin (prn) allele were identified: prn1 (4.84%, 3/62), prn2 (11.29%, 7/62), prn150 (80.65%, 50/62), and 2 untyped prn allele. By 2024, prn150 became the predominant allele. Phylogenetic analysis revealed distinct branches separating ptxP1 and ptxP3 lineages. E-test results demonstrated that all macrolide-resistant isolates (exhibiting MICs > 256 mg/L for erythromycin, azithromycin, and clarithromycin) carried the A2047G mutation in 23S rRNA gene. The proportion of isolates harboring this mutation increased significantly after 2022 and dominated by 2024. All tested isolates displayed low MICs to alternative agents: trimethoprim/sulfamethoxazole (MICs ≤ 0.5/9.5 mg/L), cefoperazone/sulbactam (MICs ≤ 0.064/0.032 mg/L), and piperacillin/tazobactam (MICs ≤ 0.064/4 mg/L). Notably, macrolide-resistant isolates harboring ptxA1-ptxP3-prn150 genotype formed a distinct sub-clone within the ptxP3 clade.</p><p><strong>Conclusions: </strong>Our findings demonstrate the current dominance of macrolide-resistant B. pertussis strain harboring ptxP3 and prn150 in Guangzhou since 2024. This study provides epidemiological and microbiological insights to guide local pertussis control strategies and to offer antimicrobial resistance monitoring efforts.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"1152"},"PeriodicalIF":3.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145172849","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}
Dipesh Dhayfule, Yu-Heng Wu, Akram Ashyani, Ming-Chi Li, Chin-Shiang Tsai, Po-Lin Chen, Torbjörn E M Nordling
{"title":"A meta-analysis of vaccine efficacy from phase III clinical trials of approved vaccines against SARS-CoV-2 and variants.","authors":"Dipesh Dhayfule, Yu-Heng Wu, Akram Ashyani, Ming-Chi Li, Chin-Shiang Tsai, Po-Lin Chen, Torbjörn E M Nordling","doi":"10.1186/s12879-025-11289-4","DOIUrl":"10.1186/s12879-025-11289-4","url":null,"abstract":"<p><strong>Background: </strong>As we emerge from the COVID-19 pandemic and transition to a post-pandemic era, it is crucial to reflect on our experiences and prepare for future pandemics. Here we evaluate the impact of different methods for calculating the vaccine efficacy of COVID-19 vaccines, which has not been done previously.</p><p><strong>Methods: </strong>We conducted a meta-analysis of 38 approved COVID-19 vaccines using data from phase III clinical trials between May 4, 2020, and June 10, 2022. We analyze vaccine efficacy against multiple SARS-CoV-2 variants including the original strain, Alpha, Beta, Delta, and Kappa using multiple endpoints. Clinical endpoints are categorized into a tree structure including asymptomatic infection, symptomatic infection, mild to critical illness, and death. We employ re-estimated vaccine efficacies, including relative risk and Poisson regression with robust error variance, for equitable cross-vaccine comparisons.</p><p><strong>Results: </strong>We re-estimated 63 vaccine efficacies, revealing a 3% to 6% difference in five efficacies compared to the original study. Four efficacies exhibited lower bounds below the critical 50% threshold for the endpoint asymptomatic, symptomatic, moderate, and severe, contrary to the initial reports. However, efficacy consistently surpasses the 50% threshold against symptomatic COVID-19. Overall efficacies range from 34.2% to 100%, 50.3% to 100% against symptomatic, and 66.8% to 100% against severe, and 65% to 95% against variants.</p><p><strong>Conclusions: </strong>Our systematic classification of vaccine endpoints enables more statistically rigorous meta-analyses across studies. Beyond the quantitative results, our study emphasizes the need to standardize the estimation method for robust assessments of vaccine efficacy. We highlight the incompleteness of the knowledge about different vaccine efficacy in the middle of the pandemic, in particular the need to identify variants during the trials and report on multiple endpoints. We encourage all authors to publicly share their data, fostering additional impartial investigations. This data collection enables comparisons with real-world effectiveness data, enabling future studies of the predictive power of efficacy.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"1169"},"PeriodicalIF":3.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173027","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}
Ranya Mulchandani, Simon Packer, Joshua Howkins, Carla Robinson, Theresa Lamagni, Alex Bhattacharya, Rosy Reynolds, Andre Charlett, Colin Brown, Russell Hope, Susan Hopkins, Isabel Oliver
{"title":"Blood culture positive sepsis in England, 2017-2018: epidemiological assessment of the commissioning for quality and innovation (CQUIN) sepsis indicator.","authors":"Ranya Mulchandani, Simon Packer, Joshua Howkins, Carla Robinson, Theresa Lamagni, Alex Bhattacharya, Rosy Reynolds, Andre Charlett, Colin Brown, Russell Hope, Susan Hopkins, Isabel Oliver","doi":"10.1186/s12879-025-11539-5","DOIUrl":"10.1186/s12879-025-11539-5","url":null,"abstract":"<p><strong>Background: </strong>Sepsis remains a significant clinical and public health concern, necessitating timely identification and targeted management for improved patient outcomes. This study describes the epidemiology of sepsis in emergency department attendees across England by analysing a unique multi-site linked dataset to inform approaches to strengthen surveillance and improve our understanding of clinical outcomes.</p><p><strong>Methods: </strong>An existent study dataset was utilised comprising a sample of paediatric and adult emergency department admissions screened for community-onset sepsis in the Commissioning for Quality and Innovation (CQUIN) program in the 2017/18 financial year linked to Hospital Episode Statistics and Office for National Statistics death registrations. This dataset was linked to the United Kingdom Health Security Agency's Second-Generation Surveillance System for microbiological data. Descriptive analyses were conducted to characterise sepsis screen positives and negatives in CQUIN, including demographic characteristics, clinical presentations, microbiological profiles, and clinical outcomes.</p><p><strong>Results: </strong>Of the 4,027 sepsis-screened emergency admissions included, 2,454 (60.9%) were sepsis screen positive under the CQUIN indicator. Only 11.2% (453/4,027) had a positive blood culture within 2 days of hospital admission. Blood culture positivity rates were 15.2% (373/2,454) and 5.1% (80/1,573) for sepsis screen positive and negative in CQUIN, respectively. Monomicrobial episodes predominated (86.5%), with Escherichia coli and Staphylococcus species being the most commonly isolated bacteria. The study showed a case fatality rate of 17.1% (420/2,454) for sepsis screen positive in CQUIN but revealed no significant difference in all-cause 30-day mortality between sepsis screen positives in CQUIN with and without positive blood cultures. Sepsis screen positives in CQUIN with a focal site of infection code were more likely to have positive blood cultures, except for respiratory infections.</p><p><strong>Conclusions: </strong>This study provides novel insights into the epidemiology of sepsis screening in emergency departments across England, highlighting variability in blood culture positivity rates and microbial profiles. The findings underscore the importance of enhanced surveillance strategies, optimised screening protocols, tailored antimicrobial stewardship practices, and quality improvement initiatives to optimise sepsis management and outcomes. Systemic approaches are needed to address knowledge gaps and inform evidence-based interventions for sepsis care.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"1137"},"PeriodicalIF":3.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173259","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":"Characteristics of Klebsiella pneumoniae and carbapenem-resistant Klebsiella pneumoniae clinical isolates from COVID-19 patients: a single-center retrospective analysis in a tertiary hospital, China.","authors":"Dandan Shi, Zijie Zhou, Liqing Hu, Danying Yan, Chuwen Wang, Jinming Ye, Guoqing Qian","doi":"10.1186/s12879-025-11526-w","DOIUrl":"10.1186/s12879-025-11526-w","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic has exacerbated the complexity of antimicrobial resistance (AMR) challenges. This study aimed to quantify risk factors for carbapenem-resistant Klebsiella pneumoniae (CRKP) acquisition in COVID-19 patients, compare resistance profiles and laboratory biomarkers between carbapenem-susceptible K. pneumoniae (CS-KP) and CRKP strains, and identify clinical indicators predictive of CRKP co-infection.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of COVID-19 patients with KP-positive cultures admitted to a tertiary hospital in China between January 2020 and May 2024. Antimicrobial susceptibility testing and multivariable logistic regression were employed to evaluate resistance patterns and risk factors.</p><p><strong>Results: </strong>Among 342 COVID-19 patients with KP-positive, 262 (76.6%) were CSKP and 80 (23.4%) CRKP. Hypertension, prolonged hospitalization, and ICU admission were identified as independent risk factors for CRKP acquisition. CRKP group patients exhibited significantly worse laboratory tests, including elevated inflammatory markers, coagulopathy, and renal dysfunction, providing clinical markers for suspecting the presence of multi-drug resistant bacteria.</p><p><strong>Conclusions: </strong>Our findings reveal KP resistance profiles under COVID-19 pressures and underscore the necessity of early microbiological confirmation and precision antibiotic use.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"1133"},"PeriodicalIF":3.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173288","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":"The relationship between the alveolar epithelial lining fluid concentration of intravenous plus inhaled polymyxin B and clinical efficacy in patients with pneumonia caused by carbapenem-resistant gram-negative bacilli: a prospective cohort study.","authors":"Lili Zhou, Danjie Wang, Xueyong Li, Yu Cheng, Yiqin Lin, Qinyong Weng, Wenwei Wu, Xuanxi Huang, Hongqiang Qiu, Hui Zhang","doi":"10.1186/s12879-025-11515-z","DOIUrl":"10.1186/s12879-025-11515-z","url":null,"abstract":"<p><strong>Background: </strong>Nebulization combined with intravenous polymyxin B (PMB) for carbapenem-resistant gram-negative bacilli (CRGNB) pneumonia still has a number of failures that may be related to insufficient alveolar epithelial lining fluid (ELF) concentration of PMB. This study aimed at determining the relationship between the alveolar ELF concentration of PMB and clinical efficacy after intravenous (IV) plus inhaled (IH) PMB.</p><p><strong>Methods: </strong>Seventy-five patients with pneumonia caused by CRGNB were treated with IH plus IV PMB. Alveolar lavage fluid was collected before and after nebulization, and ELF was calculated according to the urea dilution equation. Differences in clinical outcomes between patients with high and low peak and trough concentrations of ELF concentration of PMB were compared separately according to the ROC curve grouping strategy. The primary outcome was favorable clinical outcome. The secondary outcomes included microbiological outcome and time to bacterial eradication, time to renormalize body temperature, CRGNB-related and all-cause mortality, 28-day survival, length of hospitalization, inflammation marker levels and side effects related to PMB.</p><p><strong>Results: </strong>Clinical efficacy and bacterial clearance were higher in the high ELF peak concentration group than in the low one (total efficacy: 94.44% vs. 48.72%, total bacterial clearance: 63.89% vs. 38.46%, both P < 0.05). The clinical effective rate was higher in the high ELF trough concentration group than in the low one (88.89% vs. 43.33%, P < 0.05). The 28-day survival rate was higher in the high ELF peak and trough concentration group than in the low one (peak: 86.11% vs. 38.46%, trough: 75.56% vs. 40.00%, both P < 0.05).</p><p><strong>Conclusions: </strong>Patients with high PMB alveolar ELF concentrations demonstrated more favorable clinical outcomes than those with low concentrations.</p><p><strong>Trial registration: </strong>This trial was registered. The Chinese trial registration number is ChiCTR2100044087. The date of registration is 9-3-2021. The registered name is that clinical study on intravenous drip and aerosol inhalation of polymyxin B for the treatment of pneumonia due to multidrug-resistant gram-negative bacteria.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"1135"},"PeriodicalIF":3.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173343","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}
Ning Zhu, Shanhong Lin, Yan Zhang, Mei Chen, Limin Chen, Chao Cao
{"title":"Evaluating the diagnostic efficacy of metagenomic next-generation sequencing in bronchoalveolar lavage fluid for pulmonary cryptococcosis with different clinical and imaging characteristics.","authors":"Ning Zhu, Shanhong Lin, Yan Zhang, Mei Chen, Limin Chen, Chao Cao","doi":"10.1186/s12879-025-11574-2","DOIUrl":"10.1186/s12879-025-11574-2","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to explore the diagnostic value of bronchoalveolar lavage fluid metagenomic next-generation sequencing (BALF-mNGS) in patients with pulmonary cryptococcosis (PC) exhibiting different clinical and imaging characteristics, thereby enhancing clinical physicians' understanding and application of BALF-mNGS in diagnosing PC.</p><p><strong>Methods: </strong>A total of 84 patients with PC and 84 non-cryptococcosis patients admitted to the First Affiliated Hospital of Ningbo University from February 2020 to April 2025 were enrolled in this study. Data on basic demographics, medication history, comorbidities, clinical presentations, laboratory test results, imaging findings, and serological test results were collected. The sensitivity and specificity of BALF-mNGS for diagnosing PC and its diagnostic sensitivity across different clinical features were analyzed.</p><p><strong>Results: </strong>Among the 84 patients with PC, 46 were males and 38 were females. BALF-mNGS results were positive in 72 cases and negative in 12 cases. All 84 non-cryptococcosis patients tested negative using BALF-mNGS. The sensitivity of BALF-mNGS for detecting PC was 85.71%, whereas the specificity and positive predictive value were both 100.00%. Among the 48 patients presenting with cough or sputum, BALF-mNGS was positive in 45 cases, yielding a sensitivity of 93.33%, significantly higher than that of patients without cough or sputum (P < 0.05). Among the 38 patients with lesions located in the right lung, BALF-mNGS was positive in 36 cases, resulting in a sensitivity of 94.74%, higher than that for patients with lesions in the left lung or both lungs (P < 0.05). Of the 57 patients with multiple lesions, 53 tested positive with BALF-mNGS, resulting in a sensitivity of 92.98%, significantly higher than that of patients with single lesions (P < 0.05).</p><p><strong>Conclusions: </strong>BALF-mNGS demonstrated high sensitivity for diagnosing PC, particularly in patients presenting with cough or sputum, right lung lesions, or multiple lesions. This serves as a valuable tool for the early diagnosis of PC.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"1143"},"PeriodicalIF":3.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173384","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":"Immunoglobulin glycosylation profiling for early identification of patients with severe influenza pneumonia.","authors":"Fei Teng, Dian-Geng Li, Wen-Xin Liu, Xin Liu, Guang-Xu Liu, Hao Wang, Hui-Hua Li, Min Zhang, Shu-Bin Guo","doi":"10.1186/s12879-025-11538-6","DOIUrl":"10.1186/s12879-025-11538-6","url":null,"abstract":"<p><strong>Background: </strong>Uncontrolled inflammation can result in severe status and even death in influenza patients, and there is a lack of early clinical evaluation models.</p><p><strong>Methods: </strong>We recruited patients with influenza pneumonia and healthy controls from the emergency departments of three urban teaching hospitals in Beijing, China, during the winter of 2018-2019. Donated plasma samples were screened using protein and lectin microarrays to assess changes in the glycosylation patterns of immunoglobulins. These changes were used to develop and validate an Immunoglobulin Glycosylation Profile for Severe Status Identification Algorithm (IGPSSIA). A combined model of IGPSSIA score and clinical indicators was constructed to identify severe influenza pneumonia cases.</p><p><strong>Results: </strong>We enrolled 114 patients, including 56 in the mild and 58 in the severe groups, and recruited 27 volunteers as healthy controls. We screened out the differentially expressed glycan moieties between the mild and the severe groups and included them in the LASSO regression analysis. In the training set (70% of patients, n = 80), IGPSSIA = 1.113 × [GNL‑IgG4 Man] - 2.499 × [LCA‑IgG1 Man] + 0.029 × [BanLec‑IgA2 Man] + 0.529 × [HHL, AL‑IgM Man] - 2.210 × [sWGA‑IgG GlcNAc] + 0.001 × [PSA‑IgG4 Man] + 0.027 × [Ricin B Chain‑IgG2 Gal & GalNAc]. Finally, we constructed a clinical diagnostic model using age, time interval from onset to admission, lymphocyte count, platelet count and IGPSSIA score, and achieved an AUC of 0.839 (95% CI 0.767-0.911).</p><p><strong>Conclusions: </strong>Changes in immunoglobulin glycosylation profiles can be a promising tool for identifying severe status in patients with influenza pneumonia.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"1167"},"PeriodicalIF":3.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173402","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}