BMC Infectious Diseases最新文献

{"title":"Mortality and clinical outcomes of colistin versus colistin-based combination therapy for infections caused by Multidrug-resistant Acinetobacter baumannii in critically ill patients.","authors":"Marwan J Alwazzeh, Jumanah Algazaq, Fatimah Ali Al-Salem, Fatimah Alabkari, Sara M Alwarthan, Mashael Alhajri, Bashayer M AlShehail, Amani Alnimr, Ahmad Wajeeh Alrefaai, Faten Hussain Alsaihati, Fahd Abdulaziz Almuhanna","doi":"10.1186/s12879-025-10781-1","DOIUrl":"10.1186/s12879-025-10781-1","url":null,"abstract":"<p><strong>Background: </strong>Multidrug-resistant Acinetobacter baumannii emerged as a threatening \"superbug\" with significant morbidity and mortality and limited antimicrobial therapy options. The results of different antibiotic combination studies are heterogeneous and controversial. Further comparative studies are crucial to overcome such difficult-to-treat infections and to improve patient outcomes. This study investigates the mortality and outcomes of colistin versus colistin-based combination therapy for infections caused by Multidrug-resistant Acinetobacter baumannii in critically ill patients.</p><p><strong>Methods: </strong>A retrospective observational study was conducted at an academic tertiary hospital in Khobar City, Eastern Province, Saudi Arabia. Patients who fulfilled the inclusion criteria and were admitted from January 1, 2017, to December 31, 2022, were included. The investigated primary outcome was 30-day mortality, while secondary outcomes were one-year all-cause mortality, clinical cure, microbiologic eradication, and recurrence of Acinetobacter infections. Statistical comparisons were employed, and a P-value of ≤ .05 was considered significant.</p><p><strong>Results: </strong>Of the 178 patients who fulfilled the inclusion criteria, 47 received colistin only, and 131 received colistin in combinations (55 with carbapenems, 53 with tigecycline, and 23 with both). The estimated 30-day mortality rate of the study population was 22.5%, with statistically insignificant differences in 30-day mortality rates when the colistin group compared to cumulative colistin-based combination (23.4% vs. 22.1%; difference, 1.3 percentage points; 95% confidence interval [CI], 0.487-2.371; P = 0.858) or subgroups. However, colistin-based combination groups showed better secondary outcomes, with significantly less all-cause mortality and better clinical cure in colistin combination with carbapenems or tigecycline and less Acinetobacter infection recurrence in combination with carbapenems.</p><p><strong>Conclusions: </strong>The study findings demonstrate the benefits of investigated colistin combination options that result in less one-year all-cause mortality, better clinical cure, higher microbiologic response, and less infection recurrence. However, no significant differences were observed regarding 30-day mortality. In addition, the study highlights the limitations of the available antimicrobial options and the crucial need for new effective antimicrobials and more successful combinations.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"416"},"PeriodicalIF":3.4,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717819","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":"Relationship between coagulopathy score and survival in critically ill patients with liver cirrhosis and sepsis: a retrospective study.","authors":"Tao Wang, Decai Wang, Ruizi Shi, Xintao Zeng, Pei Yang, Xi Chen, Sirui Chen, Chuan Qin, Chidan Wan, Jianjun Wang","doi":"10.1186/s12879-025-10848-z","DOIUrl":"10.1186/s12879-025-10848-z","url":null,"abstract":"<p><strong>Background: </strong>This research focused on exploring the association between coagulopathy scores and the survival outcomes, both short-term and long-term, in individuals diagnosed with liver cirrhosis complicated by sepsis.</p><p><strong>Methods: </strong>This study retrospectively analyzed data from individuals with liver cirrhosis and sepsis who were admitted to the intensive care unit (ICU) at Beth Israel Deaconess Medical Center between 2008 and 2022. The main outcome of interest was all-cause mortality within 28 days post-admission, while the secondary outcome assessed mortality within 90 days. We used the Kaplan-Meier analysis to compare the mortality risk among the different groups. To evaluate the relationship between coagulopathy score and mortality risk in patients with liver cirrhosis and sepsis, a multivariate Cox proportional hazards regression analysis was performed. The predictive performance of the coagulopathy score for short- and long-term all-cause mortality was assessed using receiver operating characteristic (ROC) curve analysis, which included evaluation of its sensitivity, specificity, and area under the curve. Subgroup analyses were performed to evaluate the relationship between coagulopathy score and survival across different groups.</p><p><strong>Results: </strong>The study included a total of 2,278 patients. Kaplan-Meier survival analysis demonstrated that individuals with elevated coagulopathy scores exhibited markedly higher rates of ICU mortality, in-hospital mortality, as well as 28-day and 90-day mortality, with all log-rank tests yielding P-values of less than 0.001. The results of the multivariate Cox regression analysis showed that an elevated coagulopathy score was independently linked to higher 28-day and 90-day all-cause mortality, both before and after controlling for potential confounders. ROC curve analysis showed that although the coagulopathy score was slightly less predictive of prognosis than the Model for End-stage Liver Disease score, it significantly outperformed the Sequential Organ Failure Assessment score and the Sepsis-induced Coagulopathy score. Subgroup analysis revealed no significant interaction between the coagulopathy score and survival across the different subgroups.</p><p><strong>Conclusions: </strong>Higher coagulopathy scores in critically ill patients with liver cirrhosis and sepsis were independently associated with poor prognosis. Due to its simplicity and potential predictive value, the coagulopathy score can serve as an effective complement to existing clinical tools for managing critically ill patients with liver cirrhosis and sepsis.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"418"},"PeriodicalIF":3.4,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717823","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":"Impact of the COVID-19 pandemic on the epidemiology and clinical course of tuberculosis: expected and paradoxical consequences.","authors":"Yakov Schwartz, Anna Vyazovaya, Natalya Tursunova, Igor Mokrousov","doi":"10.1186/s12879-025-10793-x","DOIUrl":"10.1186/s12879-025-10793-x","url":null,"abstract":"<p><strong>Background: </strong>This study included tuberculosis (TB) patients from high-burden Russian regions of Siberia and Far East. We aimed to assess the impact of the COVID-19 pandemic on the genotypic structure of Mycobacterium tuberculosis population and on epidemiology and clinical course of tuberculosis in TB and TB/COVID-19 coinfected patients.</p><p><strong>Methods: </strong>A total of 456 M. tuberculosis isolates were studied and submitted to drug susceptibility testing and genotyping. The modern Beijing genotype and its main Russian epidemic and endemic clusters (B0/W148 and Central Asian/Russian), and ancient Beijing sublineage were detected by PCR assays targeting specific molecular markers. Non-Beijing isolates were spoligotyped and compared to SITVIT2 database.</p><p><strong>Results: </strong>More than 80% of strains belonged to the Beijing genotype. Among Beijing strains, genetic clusters B0/W148 and Central-Asian/Russian (94-32) accounted for 94.2% in the pre-pandemic period and 96.6% during the pandemic in the TB group, and 81.5% of TB/COVID-19 group. Moreover, in the pre-pandemic TB group, the ratio of B0/W148 and 94-32 was almost 1:1 (49.7:44.4%), during the pandemic-1.5:1.0 (57.9:38.8%), while in the TB/COVID-19 group, the ratio shifted in favor of the 94-32 cluster and became 1:2 (31.8:65.9%). In TB/COVID patients, the structure of clinical forms shifted from chronic forms (fibrous cavernous TB, tuberculoma) to forms with more active inflammatory and destructive-inflammatory reactions (infiltration, dissemination, cavernous TB). In TB (without COVID-19-coinfection) group, the effectiveness of TB treatment during the pandemic decreased by 20.6% (p = 0.002). In the TB/COVID-19 group, the effectiveness of treatment increased, likely due to the predominance of the less frequently MDR Beijing 94-32 cluster in this group. A statistically significant positive correlation was shown between the detection of the 94-32-cluster and the effectiveness of treatment of patients with TB/COVID-19 (Q = 0.56, p = 0.006).</p><p><strong>Conclusions: </strong>Our results are consistent with the reportedly higher ability of Beijing B0/W148 strains (compared to Beijing 94-32) to acquire resistance to anti-TB drugs, their increased virulence and transmissibility. Thus, the seemingly paradoxical, milder clinical course of TB in patients who further developed COVID-19 is explained by a shift in the ratio of M. tuberculosis subtypes due to syndemic interaction between the two epidemics.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"417"},"PeriodicalIF":3.4,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717766","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 prognostic model for bloodstream infections in hematological malignancies using Th1/Th2 cytokines.","authors":"Qin Li, Nan Lin, Zuheng Wang, Yuexi Chen, Yuli Xie, Xuemei Wang, Jirui Tang, Yuling Xu, Min Xu, Na Lu, Yiqian Huang, Jiamin Luo, Zhenfang Liu, Li Jing","doi":"10.1186/s12879-025-10808-7","DOIUrl":"10.1186/s12879-025-10808-7","url":null,"abstract":"<p><strong>Objective: </strong>Bloodstream infection (BSI) is a significant cause of mortality in patients with hematologic malignancies(HMs), particularly amid rising antibiotic resistance. This study aimed to analyze pathogen distribution, drug-resistance patterns and develop a novel predictive model for 30-day mortality in HM patients with BSIs.</p><p><strong>Methods: </strong>A retrospective analysis of 231 HM patients with positive blood cultures was conducted. Logistic regression identified risk factors for 30-day mortality. Th1/Th2 cytokines were collected at BSI onset, with LASSO regression and restricted cubic spline analysis used to refine predictors. Seven machine learning(ML) algorithm (XGBoost, Logistic Regression, LightGBM, RandomForest, AdaBoost, GBDT and GNB) were trained using 10-fold cross-validation and model performance was evaluated with the ROC, calibration plots, decision and learning curves and the Shapley Additive Explanations (SHAP) analysis. The predictive model was developed by integrating Th1/Th2 cytokines with clinical features, aiming to enhance the accuracy of 30-day mortality prediction.</p><p><strong>Results: </strong>Among the cohort, acute myeloid leukemia (38%) was the most common HM, while gram negative bacteria (64%) were the predominant pathogens causing BSI. Age, polymicrobial BSI, IL-4, IL-6 and AST levels were significant predictors of 30-day mortality. The Logistic Regression model achieved AUCs of 0.802, 0.792, and 0.822 in training, validation, and test cohorts, respectively, with strong calibration and clinical benefit shown in decision curves. SHAP analysis highlighted IL-4 and IL-6 as key predictors.</p><p><strong>Conclusions: </strong>This study introduces a novel ML-based model integrating Th1/Th2 cytokines and clinical features to predict 30-day mortality in HM patients with BSIs, demonstrating strong performance and clinical applicability.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"415"},"PeriodicalIF":3.4,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717771","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":"Measuring the disease burden of seasonal influenza in Germany 2015 - 2020 using the incidence-based disability-adjusted life years (DALYs).","authors":"Marin Stapic, Ricarda Sophia Schulz, Elena Tamayo-Cuartero, Tobias Kurth, Ralph Brinks","doi":"10.1186/s12879-025-10613-2","DOIUrl":"10.1186/s12879-025-10613-2","url":null,"abstract":"<p><strong>Background: </strong>Seasonal influenza can lead to severe complications and death, resulting in high disease burden each year. The European Centre for Disease Prevention and Control introduced the Burden of Communicable diseases in Europe (BCoDE) project, quantifying the disease burden of infectious diseases in disability-adjusted life years (DALY). DALYs for influenza exceed those of Tuberculosis, HIV, and Invasive pneumococcal disease. As data on disease burden are limited, this study aims to calculate the seasonal influenza burden for Germany between 2015 and 2020.</p><p><strong>Methods: </strong>The BCoDE-toolkit developed by the European Centre for Disease Prevention and Control was used, calculating country-specific DALYs. Information on incidence, population data, and underestimation were taken from the Robert Koch-Institute and the Federal Statistical Office of Germany. Outcome trees were created based on information from a rapid review and previous publications. Baseline, lower-bound and upper-bound scenarios were developed to assess the disease burden under varying conditions.</p><p><strong>Results: </strong>Estimates range from 127,100 DALYs (153 DALYs per 100,000 population) and 1,171,115 DALYs (1,414 DALYs per 100,000 population) depending on the scenario and year examined. The main contributors to the disease burden are sequelae, primarily pneumonia, encephalitis, and myocarditis. The highest burden estimates are observable for infants, children under the age of five and the elderly.</p><p><strong>Conclusions: </strong>Using a composite health measure like DALY can offer valuable insight into a disease's impact on population health. Our results indicate a high disease burden due to seasonal influenza in Germany, indicating further research into complication rates, underestimation, and intervention programs for vulnerable populations, e.g., vaccination in infants, children under age of five and elderly population.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"413"},"PeriodicalIF":3.4,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717775","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 added value of diagnostics to characterize age-specific patterns of respiratory viral infections and coinfections and to detect emerging threats.","authors":"Alessandra Pierangeli, Ombretta Turriziani, Matteo Fracella, Roberta Campagna, Federica Frasca, Alessandra D'Auria, Carolina Scagnolari, Piergiorgio Roberto, Lilia Cinti, Gabriella D'Ettorre, Giancarlo Ceccarelli, Laura Petrarca, Raffaella Nenna, Fabio Midulla, Gioacchino Galardo, Guido Antonelli","doi":"10.1186/s12879-025-10693-0","DOIUrl":"10.1186/s12879-025-10693-0","url":null,"abstract":"<p><strong>Background: </strong>Pandemic restrictions caused variation in respiratory virus circulation until the winter of 2022/23. The aim of this study was to monitor respiratory virus cases in the 2023/24 epidemic season.</p><p><strong>Methods: </strong>Children and adults attending Sapienza University Hospital for acute respiratory infections (October 2023-June 2024) were tested for respiratory viruses via molecular methods.</p><p><strong>Results: </strong>Of the 1121 patients included, 880 (78%) were positive for rhinovirus (HRV, 32%), Influenza A (IAV, 29%), and respiratory syncytial virus (RSV, 28%). RSV is more common in infants, and IAV is more common in adults, whereas HRV is more common in children aged 1-5 years. IAV, RSV and HRV cocirculate in winter; HRV cases also occur in spring, along with Influenza B (IBV) and other viruses. Despite circulating in the same weeks, the number of observed coinfections was much lower than that predicted for IAV and RSV (p <.0001) and lower also for the IAV/IBV, IBV/RSV and RSV/HRV pairs (p <.0001, p =.0059, p =.015, respectively). IAV and RSV cocirculated with different patterns in different age groups. In fact, in children aged 1-5 years, the RSV peak preceded that of IAV, whereas in older age groups, the RSV peak occurred toward the end of IAV circulation. Sequencing of HRV/EV cases in spring revealed 25 HRV genotypes and two EV-C105 cases.</p><p><strong>Conclusions: </strong>Respiratory viruses can cause age-specific seasonal peaks that are modulated by viral interference phenomena. Molecular diagnostic data should be integrated with surveillance programs to characterize seasonal circulation patterns of common respiratory viruses and to rapidly detect the next pandemic threat.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"404"},"PeriodicalIF":3.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708241","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":"Xenomonitoring as an epidemiological tool supporting post-stop surveillance of albendazole-ivermectin mass drug distribution in the Bougouni-Yanfolila evaluation unit, Sikasso, Mali, in 2023.","authors":"Lamine Soumaoro, Housseini Dolo, Yaya Ibrahim Coulibaly, Siaka Yamoussa Coulibaly, Salif Seriba Doumbia, Moussa Sangaré, Abdallah Amadou Diallo, Abdoul Fatah Diabaté, Michel Emmanuel Coulibaly, Ibrahima Dolo, Massitan Dembélé, Alpha Seydou Yaro, Thomas Nutman","doi":"10.1186/s12879-025-10733-9","DOIUrl":"10.1186/s12879-025-10733-9","url":null,"abstract":"<p><strong>Introduction: </strong>Mali and Guinea share a border and are both endemic for lymphatic filariasis (LF). However, their progress towards eliminating this disease varies. Mali is currently in the LF transmission assessment survey phase (TAS), while Guinea continues to implement mass drug administration (MDA). As the populations of these two countries are closely related, and vectors are present, the emergence of LF is theoretically possible in the Bougouni-Yanfolila evaluation unit (EU). This XenoFil study, which combines xenomonitoring and serosurveillance in health facilities, was used as a surveillance tool to assess LF transmission. The aim is to detect the emergence of LF in cross-border areas within the Bougouni-Yanfolila EU, after the third LF transmission assessment survey (TAS3).</p><p><strong>Method: </strong>In the Bougouni-Yanfolila EU, we conducted a cross-sectional study to collect mosquitoes in the villages and blood samples from 6 years old and above (≥ 6 years old). In June, August 2022, and January 2023, we conducted three entomological studies in two ecologically distinct villages. The Ifakara type C tent trap (IFAKARA), the gravid trap, and indoor Pyrethrum spray catches were used to collect mosquitoes. For qPCR, mosquito of the same species was sorted into pools of twenty for molecular analysis using qPCR. The infection rate / the parasite prevalence was generated by the PoolScreen^® 2 software. Trained local health workers performed serological surveys using filariasis test strips.</p><p><strong>Results: </strong>In. the two study villages, we collected a total of 4,732 mosquitoes, of which 989 belonged to the species Anopheles gambiae s.l. and 3,743 to species of the genus Culex sp. A total of 264 pools were formed, with the genus Culex spp. accounted for 79.92% (211/264), while the genus Anopheles represented 20.08% (53/264). In June 2022, only one pool (0.53%) of Culex spp. tested positive [95% CI: 0.01-2.89]. Positive Anopheles pools were absent. The blood of ten of the 2056 individuals had positive results [0.49% (10/2056)]. Among the positives, one belonged to 6-7 years, two to that of 8-17 years, and seven to that of 18 years and older. Of the positive volunteers, 0.6% (6/996) were from Yanfolila's border health region. The average cost of XenoFil (entomology combined with serology) is 5,656,244 CFA francs (US$9070), and TAS has an average cost of 6,366,450 CFA francs (US$10209) in a survey conducted in one evaluation unit.</p><p><strong>Conclusions: </strong>The new XenoFil approach proved to be an easy, effective, and relatively cheaper method for integrated LF surveillance in rural areas. From the perspective of integrated LF monitoring, XenoFil is needed for scaling up to other EU.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"405"},"PeriodicalIF":3.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708291","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":"Mpox-XDE: an ensemble model utilizing deep CNN and explainable AI for monkeypox detection and classification.","authors":"Dip Kumar Saha, Sadman Rafi, M F Mridha, Sultan Alfarhood, Mejdl Safran, Md Mohsin Kabir, Nilanjan Dey","doi":"10.1186/s12879-025-10811-y","DOIUrl":"10.1186/s12879-025-10811-y","url":null,"abstract":"<p><p>The daily surge in cases in many nations has made the growing number of human monkeypox (Mpox) cases an important global concern. Therefore, it is imperative to identify Mpox early to prevent its spread. The majority of studies on Mpox identification have utilized deep learning (DL) models. However, research on developing a reliable method for accurately detecting Mpox in its early stages is still lacking. This study proposes an ensemble model composed of three improved DL models to more accurately classify Mpox in its early phases. We used the widely recognized Mpox Skin Images Dataset (MSID), which includes 770 images. The enhanced Swin Transformer (SwinViT), the proposed ensemble model Mpox-XDE, and three modified DL models-Xception, DenseNet201, and EfficientNetB7-were used. To generate the ensemble model, the three DL models were combined via a Softmax layer, a dense layer, a flattened layer, and a 65% dropout. Four neurons in the final layer classify the dataset into four categories: chickenpox, measles, normal, and Mpox. Lastly, a global average pooling layer is implemented to classify the actual class. The Mpox-XDE model performed exceptionally well, achieving testing accuracy, precision, recall, and F1-score of 98.70%, 98.90%, 98.80%, and 98.80%, respectively. Finally, the popular explainable artificial intelligence (XAI) technique, Gradient-weighted Class Activation Mapping (Grad-CAM), was applied to the convolutional layer of the Mpox-XDE model to generate overlaid areas that effectively highlight each illness class in the dataset. This proposed methodology will aid professionals in diagnosing Mpox early in a patient's condition.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"403"},"PeriodicalIF":3.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708239","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 nationwide joint spatial modelling of simultaneous epidemics of dengue, chikungunya, and Zika in Colombia.","authors":"Laís Picinini Freitas, Mabel Carabali, Alexandra M Schmidt, Jorge Emilio Salazar Flórez, Brayan Ávila Monsalve, César García-Balaguera, Berta N Restrepo, Gloria I Jaramillo-Ramirez, Kate Zinszer","doi":"10.1186/s12879-025-10782-0","DOIUrl":"10.1186/s12879-025-10782-0","url":null,"abstract":"<p><strong>Background: </strong>Chikungunya, and Zika emerged in the 2010s in the Americas, causing simultaneous epidemics with dengue. However, little is known of these Aedes-borne diseases (ABDs) joint patterns and contributors at the population-level.</p><p><strong>Methods: </strong>We applied a novel Poisson-multinomial spatial model to the registered cases of dengue (n = 291,820), chikungunya (n = 75,913), and Zika (n = 72,031) by municipality in Colombia, 2014-2016. This model estimates the relative risk of total ABDs cases and associated factors, and, simultaneously, the odds of presence and contributors of each disease using dengue as a baseline category. This approach allows us to identify combined characteristics of ABDs, since they are transmitted by the same mosquitoes, while also identifying differences between them.</p><p><strong>Results: </strong>We found an increased ABDs risk in valleys and south of the Andes, the Caribbean coast, and borders, with temperature as the main contributor (Relative Risk 2.32, 95% Credible Interval, CrI, 2.05-2.64). Generally, dengue presence was the most probable among the ABDs, although that of Zika was greater on Caribbean islands. Chikungunya and Zika were more likely present than dengue in municipalities with less vegetation (Odds Ratio, OR, 0.75, 95%CrI 0.65-0.86, and 0.85, 95%CrI 0.74-0.99, respectively). Chikungunya tended to be present in more socially vulnerable areas than dengue (OR 1.20, 95%CrI 0.99-1.44) and Zika (OR 1.19, 95%CrI 0.95-1.48).</p><p><strong>Conclusions: </strong>Important differences between the ABDs were identified and can help guide local and context-specific interventions, such as those aimed at preventing cases importation in border and tourism locations and reducing chikungunya burden in socially vulnerable regions.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"406"},"PeriodicalIF":3.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708272","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":"Candidate target genes in sepsis diagnosis and therapy: identifying hub genes with a spotlight on KLRB1.","authors":"Wang Chen, Chen Haoran, Ding Jinqiu, Tang Xinyi, Yu Dian, Xie Yongpeng, Li Xiaomin","doi":"10.1186/s12879-025-10818-5","DOIUrl":"10.1186/s12879-025-10818-5","url":null,"abstract":"<p><strong>Background: </strong>Sepsis, which causes systemic inflammation and organ failure, is one of the leading causes of death in the intensive care unit (ICU) and an urgent social health problem. However, the pathogenesis and molecular mechanism of sepsis are unclear. Therefore, this study aimed to identify candidate Hub genes during sepsis progression and the candidate target genes for sepsis diagnosis and treatment.</p><p><strong>Methods: </strong>GSE54514, GSE57065, GSE69528, GSE95233, and GSE131761 datasets were downloaded from public databases, and the differentially expressed genes (DEGs) between healthy and septic patients in each dataset were screened at adjusted P-value < 0.05 and| log2FC| ≥ 0.58. Subsequently, the obtained DEGs in each dataset were intersected to obtain the Hub genes. In addition, the DEGs between patients with better and poor prognoses in datasets GSE54514 and GSE95233 were analyzed after 28 days. The differential expression of Hub genes in septic patients with good and poor prognoses was detected at adjusted P-value < 0.05 and| log2FC| ≥ 0.58. Finally, real-time quantitative polymerase chain reaction (qRT-PCR) was used to verify the bioinformatics results.</p><p><strong>Results: </strong>In datasets GSE54514, GSE57065, GSE69528, GSE95233 and GSE131761, RNASE2, RNASE3, CTSG, SLPI, TNFAIP6, PGLYRP1 and BLOC1S1 were up-regulated in septic patients, and RPL10A and KLRB1 were down-regulated compared to healthy controls. qRT-PCR confirmed the expression trend of the hub genes except CTSG (which was not differentially expressed). Compared to septic patients with good prognoses, the differential expression of RNASE3 was higher in patients with poor prognoses. Furthermore, qRT-PCR revealed that KLRB1 was the only differentially expressed hub gene with down-regulated expression in sepsis patients with poor prognosis.</p><p><strong>Conclusions: </strong>The candidate Hub genes closely related to sepsis include KLRB1, RNASE2, RNASE3, CTSG, SLPI, TNFAIP6, PGLYRP1, BLOC1S1, and RPL10A. KLRB1 is the most relevant candidate hub gene among these hub genes in the molecular underpinnings of sepsis, which could be targeted for sepsis detection and treatment.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"409"},"PeriodicalIF":3.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708274","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}