BMC Infectious Diseases最新文献

{"title":"Epidemiological characteristics, antifungal susceptibility, and mortality factors of candidemia in adults at a tertiary teaching hospital in Zunyi, China (2016-2023).","authors":"Xianghao Chen, Meijing Shen, Qun Feng, Guangwu Yang, Rengui Tian, Shifei Yao, He Zha","doi":"10.1186/s12879-025-11021-2","DOIUrl":"10.1186/s12879-025-11021-2","url":null,"abstract":"<p><strong>Background: </strong>Candidemia, a common nosocomial bloodstream infection caused by Candida species, is associated with a high mortality rate. This study aimed to analyze the epidemiological characteristics, distribution of Candida species, antifungal susceptibility, and mortality risk factors of adult patients with candidemia in Zunyi, China. These findings are expected to inform treatment and prevention strategies for candidemia in this region.</p><p><strong>Methods: </strong>Clinical data, Candida species, antifungal susceptibility profiles, and prognosis of 92 patients with candidemia at the First People's Hospital of Zunyi (the Third Affiliated Hospital of Zunyi Medical University) from January 2016 to December 2023 were retrospectively analyzed. Univariate and multivariate logistic regression analyses were performed to analyze risk factors for patient death.</p><p><strong>Results: </strong>Analysis of 92 candidemia cases revealed an average incidence of 0.19% and mortality rate of 35.87%. Candida albicans was responsible for 33.70% of the infections, whereas non-C. albicans accounted for 66.30% of the total. Non-C. albicans was dominated by C. parapsilosis (31.52%), Nakaseomyces glabratus (18.48%), and C. tropicalis (13.04%). The susceptibility of all Candida species to amphotericin B exceeded 96%. C. albicans and C. parapsilosis showed greater than 70% susceptibility to fluconazole, itraconazole, and voriconazole, whereas C. tropicalis showed less than 60% susceptibility to these antifungal agents. Among the 33 dead patients, C. albicans was associated with a higher mortality rate than non-C. albicans (P = 0.007). Logistic multiple regression analysis showed that cardiovascular disease (OR = 8.913, 95% CI: 1.463-54.289, P = 0.018), kidney disease (OR = 13.672, 95% CI: 2.025-92.326, P = 0.007), and antifungal drug treatment duration less than 7 days (OR = 10.694, 95% CI: 1.841-62.112, P = 0.008) were independent risk factors for mortality in adult patients with candidemia.</p><p><strong>Conclusions: </strong>The mortality rate among patients with candidemia remains high with C. albicans is the predominant pathogen in Zunyi, China. Cardiovascular disease, kidney disease, and antifungal drug treatment duration less than 7 days were independent risk factors for mortality in adult patients with candidemia. Therefore, greater attention should be paid to adult patients with risk factors for mortality to improve the outcomes of adult candidemia.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"726"},"PeriodicalIF":3.4,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118681","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":"Cytomegalovirus and Epstein-Barr virus infections among Jordanians: seroprevalence and associated factors.","authors":"Hassan M Kofahi, Samer F Swedan, Maen Aljezawi","doi":"10.1186/s12879-025-11110-2","DOIUrl":"10.1186/s12879-025-11110-2","url":null,"abstract":"<p><strong>Background: </strong>Cytomegalovirus (CMV) and Epstein-Barr virus (EBV) are widespread infections, with seroprevalence rates varying by region and demographic characteristics. This study aimed to examine the seroprevalence of EBV and CMV in the Jordanian population and explore possible risk factors associated with these infections.</p><p><strong>Methods: </strong>A total of 1,507 individuals were recruited through convenience sampling from hospitals located in the central and northern regions of Jordan. Participants were stratified by age, sex, and geographic area. Blood samples were analyzed for EBV-VCA and CMV IgG antibodies using ELISA. Demographic and socioeconomic information was also collected. To identify potential risk factors, multivariate logistic regression was conducted, focusing on variables such as age, sex, marital status, education level, monthly income, region, and type of residence.</p><p><strong>Results: </strong>The overall seroprevalence was 88.7% for CMV-IgG and 91.0% for EBV-IgG. The seroprevalence of both CMV and EBV increased with age from 62.4% and 70.6%, respectively, in children under five years of age to 100.0% and 96.5% in participants aged 60 years and above. Regression analysis indicated that older age and being ever married (i.e., married, divorced, or widowed) were significantly associated with higher seroprevalence of both viruses. Additionally, having a monthly income of 64.3 JD or more per individual was independently linked to higher EBV seroprevalence.</p><p><strong>Conclusion: </strong>EBV and CMV seroprevalence in Jordan was remarkably high. Age was the most prominent risk factor, with marital status and income contributing as independent predictors. These findings offer a valuable reference point for future public health efforts, including surveillance and vaccination strategies targeting high-risk groups.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"724"},"PeriodicalIF":3.4,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118623","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":"Carbapenem-resistant Enterobacterales bloodstream infections related to death in two Brazilian tertiary hospitals.","authors":"Lorena Galvão de Araujo, Kehvyn Cedeño, Adriele Pinheiro Bomfim, Marcio de Oliveira Silva, Ana Verena Mendes, Maria Goreth Barberino, Edilane Lins Gouveia, Fabianna Márcia M Bahia, Mitermayer Galvão Dos Reis, Joice Neves Reis","doi":"10.1186/s12879-025-11115-x","DOIUrl":"10.1186/s12879-025-11115-x","url":null,"abstract":"<p><strong>Background: </strong>Bloodstream infection (BSI) caused by carbapenem-resistant Enterobacterales (CRE) is a major global public health concern due to its high lethality and limited treatment options. In Brazil, CRE was first reported in 2005, with Klebsiella pneumoniae carbapenemase (KPC) documented in 2009. Despite ongoing reports, data remain limited in several regions.</p><p><strong>Objective: </strong>To describe the lethality rate and epidemiological and clinical characteristics of BSI patients with Enterobacterales BSI and assess carbapenem resistance to identify major risk factors for CRE infection and lethality.</p><p><strong>Methods: </strong>This prospective laboratory-based surveillance study, which was conducted in two tertiary hospitals (April 2016-December 2018), analyzed BSI cases caused by Enterobacterales. Clinical and demographic data were obtained from medical records. The bacterial isolates were identified by mass spectrometry and by VITEK-2^®, with antimicrobial susceptibility testing performed by VITEK-2^®. Logistic regression and Kaplan‒Meier survival analyses were used to assess the impact of CRE BSI on death.</p><p><strong>Results: </strong>Among 252 patients with enterobacterial BSIs were identified, of which 14.3% had CRE. The overall lethality rate was 37.7%. Compared with carbapenem-susceptible Enterobacterales, CRE-associated BSIs were associated with significantly greater lethality (71.6% vs. 28.4%; p < 0.001; OR = 6.53, 95% CI [3.01-15.41]). The association remained significant after adjusting for age, comorbidities, Pitt bacteremia score, Enterobacterales species, BSI type, and sepsis. All CRE BSI cases were hospital-acquired.</p><p><strong>Conclusions: </strong>CRE accounts for 14.3% of BSIs and is strongly associated with increased lethality. Given the limited epidemiological data in Brazil, this study provides valuable epidemiological insights that may inform local treatment protocols for Enterobacterales infections.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"725"},"PeriodicalIF":3.4,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118621","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":"Disseminated chickenpox with multi-organ failure in an immunocompetent adult. a case report and literature review.","authors":"Jaweria Akram, Abdul Qadir, Hadeel Alfar, Theresa Paul, Mamunul Islam, Ali Rahil","doi":"10.1186/s12879-025-11015-0","DOIUrl":"10.1186/s12879-025-11015-0","url":null,"abstract":"<p><strong>Background: </strong>Disseminated varicella infection in adults, particularly those with mild immunosuppression, can lead to severe complications and life-threatening outcomes. Early diagnosis and intervention are critical yet challenging due to atypical presentations.</p><p><strong>Case presentation: </strong>A previously healthy 26-year-old male presented with severe epigastric and right upper quadrant abdominal pain radiating to the back, nausea, loss of appetite, and constipation. He had been taking oral prednisolone 5 mg daily for 2 weeks prior to symptom onset. Initial evaluation showed mild liver enzyme elevation but normal imaging studies. Within two days, he developed widespread vesicular lesions consistent with varicella, rapidly progressing to fulminant hepatic failure, disseminated intravascular coagulation (DIC), acute renal failure, and acute respiratory distress syndrome (ARDS). Despite intensive management including antiviral therapy, antibiotics, supportive transfusions, and mechanical ventilation, the patient unfortunately passed away due to multi-organ failure.</p><p><strong>Conclusion: </strong>This case emphasizes the importance of early suspicion and diagnosis of varicella infection in adults presenting with atypical symptoms, even low-dose steroid therapy may cause sufficient immunosuppression to predispose individuals to disseminated viral infections. Timely intervention can significantly influence patient outcomes.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"722"},"PeriodicalIF":3.4,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109675","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 association of sepsis bundle compliance with mortality in patients with ICU-acquired sepsis: a cohort study.","authors":"Adam Green, Sharad Patel, Pamela Crabtree, Divyesha Patel, Andrew Hoke, Ricardo Jaime Orozco, George Sangah, Alvin Mercado, Nicole Melchiorre, Mariane Charron, Abhimanyu Chandel, Nitin Puri","doi":"10.1186/s12879-025-11134-8","DOIUrl":"10.1186/s12879-025-11134-8","url":null,"abstract":"<p><strong>Background: </strong>The efficacy of the SEP-1 Bundle has been questioned in the treatment of patients with hospital-acquired sepsis. We aimed to investigate bundle compliance and its association with survival in a subset of patients with HA sepsis: those with ICU-acquired sepsis.</p><p><strong>Methods: </strong>A single-center retrospective cohort study was conducted in a tertiary care referral hospital. Adult patients diagnosed with ICU-acquired sepsis between 1 January 2019 and 31 December 2022 were identified. Survival to hospital discharge adjusted for disease severity based on 3-hour, 6-hour, and total bundle compliance was calculated. Secondary outcomes included the need for mechanical ventilation, vasopressors, initiation of acute hemodialysis, and discharge location.</p><p><strong>Results: </strong>Of 191 patients with ICU-acquired sepsis, 61 patients (31.9%) demonstrated total bundle compliance. There was no difference in survival based on the unadjusted analysis of 3-hour bundle compliance, compliant versus non-compliant (78.9% vs. 67.0%; P = 0.100). However, there was a survival benefit in 6-hour and total bundle, compliance versus non-compliance (82.2% vs. 60.0%, P < 0.001; 86.9% vs. 64.6%, P = 0.002). When adjusted for SOFA and CCI, logistic regression demonstrated similar results: 3-hour compliance (OR: 0.60; 95% CI: 0.29-1.18, P = 0.150), 6-hour compliance (OR: 0.35; 95% CI: 0.17-0.68, P = 0.002) and total compliance (OR: 0.31; 95% CI: 0.13-0.69, P = 0.006). Components of the SEP-1 Bundle that showed a mortality benefit included the collection of \"blood cultures prior to antibiotic administration\" (OR: 0.46; 95% CI 0.22-0.96, P = 0.037) and \"tissue perfusion assessment\" (OR: 0.41; 95% CI 0.18-0.90, P = 0.028).</p><p><strong>Conclusions: </strong>Six-hour and total SEP-1 bundle compliance was associated with increased hospital survival in patients with ICU-acquired sepsis. These findings suggest the importance of sepsis bundle compliance in the ICU environment.</p><p><strong>Clinical trial number: </strong>Not Applicable.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"723"},"PeriodicalIF":3.4,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109681","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":"Emerging antibiotic resistance in bacterial bloodstream infections: a clinical study at the Holy Family Hospital, Nkawkaw, Ghana.","authors":"John Gameli Deku, Israel Bedzina, Prince Kwadade Amankwah, Lilian Kekeli Antor, Kenneth Ablordey, Madrid Alhassan, Akatwum Emmanuel Salifu, Robert Awupoli, Arnold Togiwe Luuse, Enoch Aninagyei, Innocent Afeke, Kwabena Obeng Duedu","doi":"10.1186/s12879-025-11102-2","DOIUrl":"10.1186/s12879-025-11102-2","url":null,"abstract":"<p><strong>Background: </strong>Bacteraemia, a critical bloodstream infection caused by various bacterial pathogens, poses significant health challenges, particularly when compounded by antibiotic resistance. This current study determined the prevalence of bloodstream bacterial isolates and their antibiotic-resistant patterns at the Holy Family Hospital, Nkawkaw, Ghana, spanning a six-year period.</p><p><strong>Methodology: </strong>A hospital-based retrospective study was carried out to review records of bacterial isolates of bloodstream infections and their antibiotic-resistant pattern among patients who visited the Holy Family Hospital between 2018 and 2023. The data was collected into an Excel sheet version 2021, cleaned, and exported to the appropriate statistical software, SPSS v26 for statistical analysis. A P-value less than 0.05 was considered statistically significant for all analyses.</p><p><strong>Results: </strong>Of 3,228 records in this study, the majority (66.0%) were found to be under 1 year of age, while 18.6% were aged 1-10 years. The prevalence of bacteraemia was 8.7% (95% CI: 7.8-9.7%). Klebsiella species was found to be the most prevalent at 30.2%, followed by S. aureus (26.0%). The highest levels of antibiotic resistance were detected against tetracycline (94.5%), penicillin (92.3%), and chloramphenicol (90.9%). Also, significant resistance was also found against vancomycin (88.3%), cefuroxime (86.5%), and cloxacillin (84.4%). Conversely, amikacin demonstrated the highest susceptibility rate (90.5%), followed by ciprofloxacin (75.0%).</p><p><strong>Conclusion: </strong>The study highlights the significant public health burden posed by bacteraemia and the growing challenge of antibiotic resistance. The prevalence of bacteraemia, particularly caused by Gram-negative organisms such as Klebsiella species and E. coli underscores the need for targeted interventions to improve infection control in healthcare settings.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"721"},"PeriodicalIF":3.4,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101059","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 novel pan-Leishmania loop-mediated isothermal amplification (Loopamp) assay for diagnosis of cutaneous and visceral leishmaniasis: a systematic review and meta-analysis.","authors":"Behailu Taye, Habtamu Gebrie, Alayu Bogale, Eyob Getu, Gemechu Churiso","doi":"10.1186/s12879-025-11091-2","DOIUrl":"10.1186/s12879-025-11091-2","url":null,"abstract":"<p><strong>Background: </strong>There is an urgent need for accurate and robust point-of-care (PoC) assays for visceral and cutaneous leishmaniasis (VL and CL). The Loopamp™ Leishmania detection kit (Loopamp), a novel loop-mediated isothermal amplification (LAMP) assay, has shown promise for VL and CL diagnosis using Qiagen and simpler boil-and-spin (B&S) DNA extraction methods. But diagnostic performances were inconsistent across studies. This systematic review and meta-analysis aimed to evaluate the pooled sensitivity and specificity of Loopamp for CL and VL diagnosis.</p><p><strong>Methods: </strong>A comprehensive search of PubMed, Scopus, EMBASE, and Google Scholar was conducted to identify studies that evaluated the diagnostic performance of Loopamp for VL and CL suspects. Using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2), the methodological qualities of the included studies were evaluated. A bivariate random-effects meta-analysis was performed using R and Stata 14.2.</p><p><strong>Results: </strong>Ten studies comprising 18 datasets were included. Sensitivity among individual VL studies ranged from 92 to 100%, while specificity varied from 41 to 100%. For CL, sensitivity varied from 48 to 100% and specificity from 31 to 100%. Pooled sensitivity was 96% (95% CI, 94-98%) for VL and 93% (95% CI, 70-99%) for CL. Pooled specificity was 99% (95% CI, 94-100%) for VL and 87% (95% CI, 55-97%) for CL. Subgroup analysis revealed that whole-blood B&S-Loopamp for VL had similar sensitivity (96%, 95% CI: 93-98%) and specificity (99%, 95% CI: 89-100%) to Qiagen-Loopamp.</p><p><strong>Conclusions: </strong>Loopamp demonstrated robust diagnostic performance for VL in whole blood, meeting the 95% sensitivity and 99% specificity criteria outlined in the Target Product Profile (TPP). Similar to Loopamp-Qiagen, Loopamp-B&S performed excellently for VL diagnosis and is feasible to deploy in remote endemic areas. Loopamp showed high sensitivity and good specificity for CL diagnosis but fell short of the 95% sensitivity and 90% specificity required for CL PoC tests. Data on CL are limited, and its effectiveness in New World VL patients is unclear. Future research is needed to address this gap.</p><p><strong>Trial registration: </strong>CRD42023489463.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"718"},"PeriodicalIF":3.4,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12087146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092731","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":"Norwegian scabies seen at the University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State: a case report.","authors":"Chibuzo Obiora Ndiokwelu, Chinonso Bismark Okoro, Paul Tochukwu Nwachukwu, Chioma Laura Odimegwu, Samuel Nkachukwu Uwaezuoke","doi":"10.1186/s12879-025-11053-8","DOIUrl":"10.1186/s12879-025-11053-8","url":null,"abstract":"<p><strong>Background: </strong>Norwegian scabies, also known as crusted scabies, is a severe form of scabies caused by an infestation of the skin by the Sarcoptes scabiei var. hominis mite. It is usually diagnostically challenging because of its rare nature and the potential for misdiagnosis with other skin diseases. This case report presents a rare case of Norwegian scabies seen at the University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State.</p><p><strong>Case presentation: </strong>The patient, a 16-year-old male Human Immunodeficiency Virus (HIV) positive patient, diagnosed with HIV 2 years before presentation but was not adherent to his Anti-retroviral medications, presented with extensive crusted lesions covering the entire body. CD4 + count on admission was 54 cells/mm³ and the viral load was 604 copies/ml and the initial clinical diagnosis was seborrheic hyperkeratosis. The diagnosis was eventually confirmed through skin scrapings and microscopic examination. The patient was then treated with oral ivermectin, topical scabicidal agents, antibiotics, antihistamines, and emollients, with complete clearance of lesions noted after two weeks of treatment.</p><p><strong>Conclusion: </strong>This case highlights the importance of recognizing and promptly treating this apparently rare and diagnostically challenging skin condition in Nigeria.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"720"},"PeriodicalIF":3.4,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101062","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":"Type 2 diabetes mellitus as a predictor of severe outcomes in COVID-19 - a systematic review and meta-analyses.","authors":"Babatunde Fatoke, Amrit Lal Hui, Muhammad Saqib, Mrinal Vashisth, Stephen Olaide Aremu, Dorcas Oluwakemi Aremu, Deborah Bukola Aremu","doi":"10.1186/s12879-025-11089-w","DOIUrl":"10.1186/s12879-025-11089-w","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic has posed significant challenges to global health, with type 2 diabetes mellitus (T2DM) emerging as a key risk factor for adverse outcomes. This study systematically reviews and quantifies the association between T2DM and COVID-19 outcomes, including mortality, severity, and need for mechanical ventilation.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted that adhered to PRISMA guidelines. We searched PubMed, Scopus, Web of Science and Embase for studies published from december 2019 to march 2024. Eligible studies reported on the impact of T2DM on COVID-19 outcomes in the adult population. Data were extracted and analyzed using a random-effects model, and heterogeneity was assessed using the I² statistic. Publication bias was assessed using Egger regression, Kendall's Tau, and the Fail-safe N calculation.</p><p><strong>Results: </strong>Eighteen studies were included in the meta-analysis for mortality, six for severity and five for mechanical ventilation. T2DM was significantly associated with higher mortality (OR = 3.66, 95% CI: 2.20-5.11, p < 0.001), higher severity (OR = 1.97, 95% CI: 1.02-2.92, p < 0.001), and higher need for mechanical ventilation (OR = 2.34, 95% CI: 1.18-3.49, p < 0.001). Heterogeneity was high for mortality (I² = 83.83%) but low for severity and mechanical ventilation (I² = 0%). No significant publication bias was found.</p><p><strong>Conclusions: </strong>T2DM is associated with significantly worse outcomes in COVID-19 patients, including higher mortality, higher severity and a greater likelihood of needing mechanical ventilation. These findings emphasize the need for targeted interventions and management strategies for individuals with T2DM during the ongoing pandemic. Future research should focus on understanding the underlying mechanisms and exploring strategies to mitigate these risks.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"719"},"PeriodicalIF":3.4,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101088","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":"Tuberculosis mortality and drug resistance among patients under TB treatment before and during COVID-19 in Burundi: a case-control study.","authors":"Arnaud Iradukunda, Fentabil Getnet, Emmanuel Nene Odjidja","doi":"10.1186/s12879-025-11093-0","DOIUrl":"10.1186/s12879-025-11093-0","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The coronavirus SARS-CoV-2 (COVID-19) experience has underscored the consequences of inequalities in health and access to health services across and within countries. Vulnerable population groups have been disproportionately exposed to certain diseases such as tuberculosis (TB) due to service interruptions. The current study aimed to assess TB related mortality and risk of drug resistance during the COVID-19 Pandemic in Burundi.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted an incident case-control study on 362 TB patients, with 181 multidrug resistant TB (MDR-TB) patients and 181 drug susceptible TB (DS-TB) patients. These patients under TB treatment between July 11, 2018, and November 11,2022 (18 months before and 18 months during COVID-19). Baseline and drug susceptibility status data were captured at treatment initiation. Mortality during treatment follow-up TB mortality was compared between categories of drug susceptibility, period (before vs during COVID-19) and regimen phase. A multivariate logistic regression was used to show the predictive risk factors. K-Fold cross-validation was used to evaluate the final model.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A half of TB patients was under 40 years old, with majority of them being unemployed, malnourished and lacking food support during TB treatment. Most of them lived in precarious conditions with limited access to healthcare services. The overall TB-related mortality was 16.0% (95% CI: 12.5%- 20.3%) with 15.5% (95%CI: 10.7%-21.8%) in MDR-TB patients and 16.6% (95% CI: 11.6%-22.9%) in DS-TB patients. Stratified by the period, TB related mortality was 15.3% (95%CI: 11.7%-20.9%) before the COVID-19 pandemic and 17.1% (95%C 11.5%-24.6%) during the COVID-19 pandemic. More than a half of deaths in TB patients occurred during intensive phase of treatment. The risk of MDR-TB was significantly higher (p &lt; 0.05) among patients undergoing treatment during the pandemic, those with a low education level, living in rural areas, unemployed, using public transportation, or living in overcrowded households (big family size,a small number of rooms). Additionally, patients with history of TB, previous treatment failure, and close contact with MDR-TB patients were more likely to have MDR-TB. The likelihood of MDR-TB further increased with the cumulative presence of these risk factors on the same TB patient.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;TB mortality increased during the COVID-19 pandemic, particularly among MDR-TB patients. The odds of MDR-TB encompass a range of socio demographic and clinical factors particularly among economically disadvantaged patients. These findings underscore the need for targeted equity-driven interventions in high-risked populations, especially in the context of emerging outbreaks, in order accelerate TB elimination goals. Additional investigation on TB related mortality should focus on the intensive phase of treatment, which aligns with the 2025 World Healt","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"716"},"PeriodicalIF":3.4,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092651","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}