BMC Infectious Diseases最新文献

{"title":"Regional difference on rotavirus vaccine coverage in children with diarrhea in Mozambique, before and during COVID-19 pandemic: a cross-sectional analysis.","authors":"Marta Cassocera, Adilson Fernando Loforte Bauhofer, Assucênio Chissaque, Benilde Munlela, Esperança Guimarães, Telma Isaías, Carolina Conjo, Braiton Maculuve, Sérgio Chicumbe, Nilsa de Deus","doi":"10.1186/s12879-025-10750-8","DOIUrl":"10.1186/s12879-025-10750-8","url":null,"abstract":"<p><strong>Background: </strong>Immunization coverage is a global concern for the Immunization Agenda 2030 due to the Coronavirus disease (COVID-19) pandemic. Prior to the pandemic, Mozambique had a positive impact on reducing all-cause diarrhea hospitalization and rotavirus positivity due to vaccination with the monovalent vaccine against rotavirus (Rotarix^®). We evaluated rotavirus vaccine coverage in Mozambican children with diarrhea in four sentinel sites before and during the COVID-19 pandemic.</p><p><strong>Methods: </strong>A cross-sectional analysis between January 2016 and April 2023 was performed using the National Diarrhea Surveillance data from four sentinel sites for children under five years old. The cut-off before and during the COVID-19 period was the date of the first COVID-19 case reported in Mozambique on March 22, 2020. Vaccination cards were used to verify rotavirus immunization status. A two-sample test for equality of proportions of rotavirus coverage before and during the COVID-19 pandemic was performed.</p><p><strong>Results: </strong>During the COVID-19 pandemic, the rotavirus vaccine coverage was 77.3% (133/172), significantly higher than the 68.6% (771/1124) before the pandemic [difference: 8.7% (95% CI: 1.6 to 15.9); p-value = 0.026]. The two sample test for equality of proportions indicates that at the sentinel site in Zambézia province in the center region of the country, the rotavirus vaccine coverage reduced significantly during the pandemic period compared to the pre COVID-19 pandemic period (difference: -28.1%; 95% CI: -47.8 to -8.3; p-value = 0.028).</p><p><strong>Conclusion: </strong>Despite national level increase of the rotavirus vaccine coverage, during the COVID-19 pandemic, there was a significant reduction in the sentinel site in the center region of the country. Future rotavirus interventions should target areas with lowest rotavirus vaccine coverage, also, rotavirus diarrheal cases and severity should be monitored in those settings to evaluate the interventions impact.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"382"},"PeriodicalIF":3.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662388","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":"Evaluation of strongyloidiasis prevalence in immunocompromised patients referred to hospitals: a case study of Iran's capital.","authors":"Zahra Arab-Mazar, Tahereh Kanani, Mahdi Toulabi, Arian Karimi Rouzbahani, Shirzad Fallahi, Anahita Behzadi, Maysam Yousefi, Seyyed Javad Seyyed Tabaei","doi":"10.1186/s12879-024-10431-y","DOIUrl":"10.1186/s12879-024-10431-y","url":null,"abstract":"<p><strong>Background: </strong>Strongyloidiasis is a parasitic disease commonly caused by S. stercoralis. It can lead to serious consequences in immunocompromised patients. This study aimed to investigate the prevalence of S. stercoralis infection in immunocompromised patients referred to selected hospitals.</p><p><strong>Methods and materials: </strong>This was a cross-sectional study in which demographic information, including age, sex, occupation, place of residence, and type of underlying disease, was collected from patients with cancer or who were treated with high doses of corticosteroids for rheumatic diseases. Serum immunoglobulin G (IgG) antibodies against S. stercoralis were measured via enzyme-linked immunosorbent assay (ELISA). For patients with positive antibody tests, stool culture was performed, and the data were analyzed with SPSS software ver. 25.</p><p><strong>Results: </strong>There were included 93 patients in this study, in 11.8% there was administered high doses of corticosteroids due to rheumatic disease and 88.2% had cancer. S. stercoralis-IgG ELISA was positive in 30 patients (32.3%). There was a significant association between the type of disease and a positive IgG antibody test (P ≤ 0.015). Among seropositive patients, only one patient (3.3%) was positive in the stool culture. There was a significant association between the IgG antibody test score and occupation (P ≤ 0.002). Positive IgG antibodies were most common among employees (75%).</p><p><strong>Conclusion: </strong>Although positive S. stercoralis-IgG antibody tests are common among immunocompromised patients, stool culture results are negative for most seropositive patients, indicating previous infections.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"381"},"PeriodicalIF":3.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662386","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":"Treatment outcomes of patients with uncomplicated malaria and associated factors in Northwest Ethiopia: a prospective follow-up study, 2024.","authors":"Tilahun Bizuayehu Demass, Mulat Addis Beshaw, Getasew Mulat Bantie, Belay Bezabih Beyene, Melaku Tadege, Agumas Alemu Alehegn, Abraham Amsalu Berneh, Mulat Yimer, Amare Alemu Melese, Wondwossen Amogne Degu","doi":"10.1186/s12879-025-10791-z","DOIUrl":"10.1186/s12879-025-10791-z","url":null,"abstract":"<p><strong>Background: </strong>Malaria is the major public health problem in low-income countries like Ethiopia. Despite extensive interventional studies being conducted to attain the 2030 malaria elimination goals, there is limited data on the treatment outcomes of uncomplicated malaria in Ethiopia. Thus, this study aimed to assess the treatment outcomes and associated factors of uncomplicated malaria in Northwest Ethiopia.</p><p><strong>Methods: </strong>This study was conducted in two health centers, Kolla Diba and Forhe-Sankira, located in Dembia and North Achefer Districts, from April to June 2024. Data was collected from 460 study participants who presented with signs and symptoms and from parasitologically confirmed patients. Malaria was confirmed using microscopy and rapid diagnostic tests (RDT). The parasitologically confirmed patients were appointed on the 3rd, 7th, 14th, and 28th days to determine treatment outcomes for those who were parasitemic on the preceding visit or symptomatic at each visit. The collected longitudinal data was entered and cleaned by Epi-data 4.1 and then analyzed using SPSS 25 software. Descriptive statistics were computed. A binary logistic regression model was fitted to identify factors associated with unsuccessful treatment outcomes at a 95% CI, and a p-value ˂ 0.05 was considered significant.</p><p><strong>Results: </strong>Of the 460 study participants, 234 (50.9%) were parasitologically confirmed. Treatment outcomes were determined for 224 (95.7%) patients. Ten patients were lost to follow-up. The overall unsuccessful treatment rate was 18.8%. No previous malaria attack (AOR = 18.62, 95% CI: 5.15, 67.25), being infected by Plasmodium vivax (AOR = 8.58; 95% CI: 2.85, 25.83), and coartem two times for 3 days plus primaquine for 14 days (AOR = 4.84; 95% CI: 1.83, 12.79) were the identified factors for unsuccessful treatment outcomes.</p><p><strong>Conclusions and recommendations: </strong>This study revealed that a higher proportion of patients had an unsuccessful treatment outcome. No previous malarial attack, being infected by Plasmodium vivax, and coartem plus primaquine were the identified factors for unsuccessful treatment outcomes. We recommend that healthcare providers prescribe first-line antimalarial therapy and appoint patients for follow-up evaluation according to the national guidelines to identify treatment failure early.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"387"},"PeriodicalIF":3.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143661930","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":"Brain abscess due to clostridium celerecrescens: first report and literature review.","authors":"Ganzhi Liu, Tiange Chen, Xiaobo Tian, Ying Ai, Ziyang Chen, Jinfang Liu, Zhongyi Sun","doi":"10.1186/s12879-025-10814-9","DOIUrl":"10.1186/s12879-025-10814-9","url":null,"abstract":"<p><strong>Background: </strong>Brain abscess caused by atypical pathogens presents significant diagnostic and therapeutic challenges. The unusual clinical presentations, coupled with incomplete or inaccurate patient histories, often result in misdiagnosis and inappropriate treatment.</p><p><strong>Case presentation: </strong>We report a case of a retained intracranial bamboo foreign body resulting in a brain abscess. A female adolescent presented with a newly developed mass on the eyelid. Medical imaging identified a foreign body that had penetrated the frontal lobes via the transorbital route, leading to the formation of a brain abscess. The foreign body was successfully removed through transnasal endoscopy. Inflamed tissue adherent to the foreign body was cultured and analyzed using metagenomic next-generation sequencing (mNGS), which identified Clostridium celerecrescens as the causative pathogen. The patient fully recovered after surgical debridement and two weeks of antibiotic therapy.</p><p><strong>Conclusions: </strong>Infections caused by C. celerecrescens are exceedingly rare in clinical practice. This case highlights the bacterium's ability to adhere to a bamboo foreign body, leading to the formation of a rare brain abscess. mNGS proves to be a valuable diagnostic tool for identifying uncommon infectious agents.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"386"},"PeriodicalIF":3.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of the factors affecting the clinical outcomes of infection and safety of vaccines against SARS-CoV-2 among Egyptian patients.","authors":"Amira A Zidan, Ahmed Yousef Jad, Nermine H Zakaria, Hazem M El-Hariri, Maged El-Setouhy","doi":"10.1186/s12879-024-10362-8","DOIUrl":"10.1186/s12879-024-10362-8","url":null,"abstract":"<p><strong>Background: </strong>Understanding the factors that influence clinical outcomes of COVID-19 and the safety of various vaccines is important to inform public health strategies, particularly in diverse communities. This study aimed to assess the factors affecting the clinical outcomes of COVID-19 and vaccination safety among the Egyptian population.</p><p><strong>Methods: </strong>In a retrospective study, we examined 1597 patients who tested positive for COVID-19. Among them, 1280 patients had received the vaccination, while 317 patients had not. We collected data from medical records, which included clinical characteristics, comorbidities, disease severity, type of vaccination, and adverse hematological effects postvaccination. We calculated the relative risk, odds ratio, and 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Among the 1,597 COVID-19 cases, 74.1% were mild, 24.8% were moderate, and 1.1% were severe. Significant factors for moderate/severe cases included male sex (RR 0.78, 95% CI 0.64-0.95), cardiovascular diseases (RR 1.86, 95% CI 1.32-2.64), respiratory diseases (RR 1.40, 95% CI 1.08-1.82), diabetes mellitus (RR 1.41, 95% CI 1.07-1.86), and previous COVID-19 infection (RR 1.22, 95% CI 1.02-1.46). Vaccination reduced the severity risk, with BBIBP-CorV (Sinopharm) showing a significant protective effect (OR 0.78, 95% CI 0.62-0.98). Clinical presentations varied, with 97.6% having an oxygen saturation ≥ 92%. Logistic regression indicated that male sex and BBIBP-CorV (Sinopharm) vaccination were protective factors. Linear regression revealed that the male sex increased hemoglobin and leucocyte counts, whereas BBIBP-CorV (Sinopharm) decreased leucocyte and platelet counts.</p><p><strong>Conclusion: </strong>Vaccination, particularly with BBIBP-CorV (Sinopharm), significantly reduces COVID-19 severity among Egyptians, despite various clinical presentations and hematological effects.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"384"},"PeriodicalIF":3.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662383","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":"Spatiotemporal variation of under-5 children diarrhea incidence and associated meteorological factors in central Gondar zone, Northwest Ethiopia. A retrospective time series study.","authors":"Gelila Yitageasu, Hailemariam Feleke, Zewudu Andualem, Kidist Asrat, Lidetu Demoze, Zemichael Gizaw","doi":"10.1186/s12879-025-10772-2","DOIUrl":"10.1186/s12879-025-10772-2","url":null,"abstract":"<p><p>Under-5 children's diarrhea is a significant public health threat, and the World Health Organization (WHO) reported that it is the second leading cause of children's death worldwide. In this study area, little is known about the spatiotemporal distribution of under-5 children's diarrhea incidence rates. Therefore, this study was conducted to assess the spatiotemporal variation under-5 diarrhea incidence and associated meteorological factors in the Central Gondar Zone. The data for under-5 diarrhea were obtained from Central Gondar Zone Health Department diarrhea reports from January 2013 to December 2022. Climatic variables were obtained from the West Amhara Meteorological Agency. Every district was covered and given a geocode. The spatial data were created in ArcGIS 10.8.1. Global and local spatial autocorrelation were used to detect hot spots. The Poisson model, which applies the Kulldorff methods and SaTScan™9.6, was used to analyze the purely temporal, spatial, and space-time clusters. Spearman correlation and bivariate and multivariable negative binomial regressions were used to analyze the relationships between under-5 diarrhea cases and climatic factors. This study revealed spatial variation in the incidence of under-5 diarrhea, where Dembia, Gondar Zuria, and Chilga districts and Gondar Zuria, East Dembia, and Lay Armacho districts were high-rate spatial clusters between 2013 and 2018 and between 2019 and 2022, respectively. A temporal scan statistic identified 2014-2016 and 2020-2021 as risk periods across all districts. Spatiotemporal scan statistics revealed high-rate clusters in Dembia, Gondar Zuria, Chilga, Wegera, Alefa, Lay Armacho, and West Belesa between 2013 and 2018, and Gondar City, Gondar Zuria, East Dembia, Lay Armacho, and Alefa between 2019 and 2022. This study also revealed positive correlations between the number of individuals with under-5 diarrhea and the average monthly temperature at 0 and 2 lag months, with values of 1.0209 (1.0034-1.0387) and 1.0202 (1.0022-1.0385), respectively. In addition, there was a negative correlation between the number of under-5 diarrhea events and the average monthly rainfall at 0 and 2 lag months, with values of 0.999 (0.9985-0.9996) and 0.9992 (0.9987-0.9997), respectively. In conclusion, there has been spatiotemporal variability in the incidence of diarrhea in children under-5 years of age in the Central Gondar Zone. The mean monthly temperature and rainfall were positively and negatively related to the incidence of diarrhea in children under-5 years of age. Season-specific intervention strategies should be developed to reduce under-5 morbidity and mortality.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"380"},"PeriodicalIF":3.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662390","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":"Clinico-epidemiological and immunological characteristics of rickettsioses in a Sri Lankan patient cohort 2018-2023.","authors":"Nayana Gunathilaka, Nilmini Chandrasena, Hemantha Sudusinghe, Vidusha Nethsara Mudalpath, Deshaka Jayakody, Ranjan Premaratna","doi":"10.1186/s12879-025-10775-z","DOIUrl":"10.1186/s12879-025-10775-z","url":null,"abstract":"<p><strong>Background: </strong>Rickettsioses, caused by intracellular bacteria of the genera Rickettsia and Orientia, are transmitted to humans through arthropod vectors such as ticks, fleas, and mites. Over the past two decades, this disease has been recognized as a significant cause of acute febrile illness in Sri Lanka. However, only a limited number of studies have focused on clinico-epidemiological characteristics of patients and immunological diagnostic approaches for disease confirmation.</p><p><strong>Method: </strong>A cross-sectional study was conducted at the Rickettsial Disease Diagnostic and Research Laboratory (RDDRL), University of Kelaniya, Sri Lanka, from 2018 to 2023 from the clinically suspected patients referred for disease confirmation. Clinical, demographic, epidemiological, biochemical, and laboratory data were collected via a questionnaire by reviewing the archived records. The serological finding of the immunofluorescence assay (IFA) conducted for patients samples were retrieved. The patients who were positive for IFA-IgG (> 1:128 as per presumptive confirmation of acute rickettsial illness) were taken as the test group and the negative group was taken as the control group. Data were analyzed using chi-square tests followed by a Correlation analysis between the variables using Pearson correlation.</p><p><strong>Results: </strong>Out of 1,221 cases, 249 (20.4%) were serologically \"confirmed\" as positive for rickettsial infection. The test group consisted predominantly of males, similar to the control group. Most cases were males and < 9 years of age followed by 10-19 years. Among the age groups, 10-19 years and 50-59 years, categories indicated a significant positive relationship according to the chi-squared statistics (P < 0.05). A seasonal trend was observed, with higher case numbers reported from January to February. Laboratory findings indicated significant differences between test and control groups in leucopenia (P = 0.005, χ²=7.87), increased neutrophil count (P = 0.0004, χ²=12.71), elevated alanine aminotransferase (P = 0.0001, χ²=14.64), elevated aspartate aminotransferase (P = 0.0001, χ²=18.24), urine occult blood (P = 0.024, χ²=5.09), and raised erythrocyte sedimentation rate (P = 0.034, χ²=4.51). Clinical manifestations showed no major deviations. Notably, eschar was more prevalent in O. tsutsugamushi cases (33.3%) compared to SFG rickettsioses (13.3%).</p><p><strong>Conclusion: </strong>This study highlights the need for improved awareness, diagnostic facilities, and vector control measures to manage rickettsial infections effectively in Sri Lanka. Understanding epidemiological patterns and clinical manifestations is crucial for developing effective surveillance and prevention strategies.</p><p><strong>Clinical trial: </strong>Not applicable.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"379"},"PeriodicalIF":3.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662385","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":"Liver histological study of patients with chronic hepatitis B virus infection in the grey zone.","authors":"Weijia Lin, Rongrong Ding, Shuangshuang Sun, Wei Lu, Yanbin Wang, Xinlan Zhou, Dan Huang, Xiufen Li, Zhanqing Zhang, Liang Chen","doi":"10.1186/s12879-025-10790-0","DOIUrl":"10.1186/s12879-025-10790-0","url":null,"abstract":"<p><strong>Background and aim: </strong>The natural history of chronic hepatitis B virus (HBV) infection is usually divided into four phases: immune tolerant (IT), immune active (IA), immune carrier (IC), and immune reactive (IR). Many patients still cannot be classified into the four phases, called \"Grey Zone (GZ)\". This study aimed to analyze the liver histological features of the GZ patients to guide antiviral therapy.</p><p><strong>Methods: </strong>We retrospectively analyzed the 1454 patients with chronic HBV infection who underwent liver biopsy. GZ patients with identical serum hepatitis Be antigen (HBeAg) and alanine aminotransferase (ALT) levels as those in the IT, IA, IC, and IR phases were categorized into the IT-GZ, IA-GZ-1, IA-GZ-2, IC-GZ, and IR-GZ groups, respectively. We analyzed and compared the histological distribution of liver in these patients. We evaluated independent influencing factors for significant liver histological changes (SLHC) in patients in the GZ subgroups.</p><p><strong>Results: </strong>Among the 1454 patients, 690(47.5%) patients in GZ. Among the 690 patients of the GZ, 322(46.7%) patients for whom histological examinations indicated SLHC. The proportion of SLHC within the GZ subgroups was as follows: IT-GZ (50.5%), IA-GZ-1 (75.0%), IA-GZ-2 (48.4%), IC-GZ (32.1%), and IR-GZ (59.6%). In the IT-GZ group, the proportion of patients aged ≤ 30 years with SLHC was 47.1%, and in the IC-GZ group, this proportion was 42.1%.</p><p><strong>Conclusions: </strong>46.7% of GZ patients had significant liver histological changes. For HBeAg-negative patients with ALT ≤ 40U/L, HBV DNA ≥ 2000IU/mL, and an age of ≤ 30 years old, antiviral therapy was recommended; if they expressed concern, a liver biopsy was suggested.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"385"},"PeriodicalIF":3.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662387","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":"Survival and risk factor analysis in patients with septic arthritis: a retrospective study of 192 cases.","authors":"Melanie Schindler, Lorenz Huber, Nike Walter, Josina Straub, Siegmund Lang, Dominik Szymski, Susanne Baertl, Dietmar Dammerer, Volker Alt, Markus Rupp","doi":"10.1186/s12879-024-10316-0","DOIUrl":"10.1186/s12879-024-10316-0","url":null,"abstract":"<p><strong>Background: </strong>Septic arthritis (SA) presents a complex clinical challenge, often resulting in significant morbidity and mortality. This study aimed to (1) assess overall mortality rates and (2) identify potential factors contributing to increased mortality risk in patients with SA.</p><p><strong>Methods: </strong>This retrospective study on SA patients treated at a German university hospital between January 1, 2011, and December 31, 2021. Patients were identified using International Classification of Diseases (ICD)-10 codes for septic arthritis, specifically \"M00.-\". The study evaluated mortality rates and analyzed comorbidities, pathogens, and other potential risk factors. Kaplan-Meier survival curves and odds ratios (OR) were calculated to assess mortality risk.</p><p><strong>Results: </strong>In a cohort of 192 patients diagnosed with SA, 64 patients (33.3%) died during a mean follow-up period of 54.4 ± 42 months. The overall mortality rate was 17.5% at one year, 19.9% at two years, and 28.3% at five years. Patients aged 65 years or older, as well as those with arterial hypertension, congestive heart failure, chronic renal disease, chronic liver disease, malignancy, steroid use and immunosuppression showed significantly higher mortality rates (p < 0.05). Chronic renal disease (OR = 2.80), malignancy (OR = 3.40), and chronic heart failure (OR = 2.62) were identified as significant notably risk factors for mortality.</p><p><strong>Conclusion: </strong>This study highlights a notably high mortality rate among vulnerable patients with SA, particularly those with pre-existing comorbidities. Recognizing and addressing these risk factors early could improve patient outcomes. These results unterscore the need for close monitoring of SA patients, particularly those with chronic organ conditions, and timely intervention for sepsis to reduce mortality risk.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"374"},"PeriodicalIF":3.4,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11916306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656055","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":"Incidence and predictors of vancomycin nephrotoxicity and mortality in patients with chronic liver disease: a two-center retrospective cohort study.","authors":"Reem F Bamogaddam, Ahmad Alamer, Shatha Alqarni, Mohammed M Almotairi, Ali A Almakrami, Alwaleed M Alharbi, Raghad Alamri, Manar Altamimi, Amal Alkhulaif, Raghad Alanazi, Omar A Almohammed, Majed S Al Yami","doi":"10.1186/s12879-025-10763-3","DOIUrl":"10.1186/s12879-025-10763-3","url":null,"abstract":"<p><strong>Background: </strong>Patients with liver disease express multiple pathophysiological variations that alter the pharmacokinetics of numerous drugs. At this time, there is insufficient evidence about the proper dosing of vancomycin in patients with liver disease. This study aimed to assess the risk of acute kidney injury (AKI) during vancomycin therapy and identify predictors of AKI and all-cause mortality among patients with varying degrees of liver dysfunction.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted including patients with chronic liver disease who used vancomycin during hospitalization from January 2016 to January 2024 in two Saudi hospitals. Patients were grouped by the severity of the liver disease (mild liver disease [MLD] or moderate-to-severe liver disease [MSLD] based on the Child-Pugh score). The incidence of AKI, vancomycin mean trough level, and all-cause mortality were compared between the two groups. A multivariable logistic regression model was employed to identify predictors of AKI and mortality.</p><p><strong>Results: </strong>A total of 110 patients treated with vancomycin were included in this study (28 had MLD and 82 had MSLD). A higher incidence of AKI in patients with MSLD than those with MLD was observed (28% vs. 14.3%, respectively; p = 0.1440), but the difference was statistically insignificant. The vancomycin mean trough levels (12.9 ± 5.2 μmol/L vs. 10.2 ± 4.7 μmol/L, p = 0.0143) and the percentage of patients with vancomycin trough level > 13.8 μmol/L (35.4% vs. 10.7%, p = 0.0131) were significantly higher in the MSLD group compared to the MLD group. Having a Creatinine Clearance (CrCl) between 15.1-29.9 ml/min (adjusted Odds ratio [aOR]: 45.5; 95% Confidence interval [CI] 4.99-414.8), and a vancomycin mean trough level > 13.8 μmol/L (aOR: 7.67; 95%CI 2.49-23.63) were associated with a higher risk of AKI development. Similarly, mortality was significantly higher in the MSLD group than in the MLD (23.2% vs. 3.6%, respectively; p = 0.0203). The risk of mortality was associated with having a body mass index (BMI) between 25-29.9 kg/m² (sOR 6.69; 95%CI 1.73-25.8), an albumin level < 25 g/L (aOR: 4.33; 95%CI 1.36-13.8), and a vancomycin mean trough level > 13.8 μmol/L (aOR: 6.13; 95%CI 1.82-20.6).</p><p><strong>Conclusion: </strong>Patients who had MSLD had a higher trough vancomycin levels and mortality than patients who had MLD; and this risk increases as liver disease progresses. Thus, the existence of chronic liver disease should be considered when monitoring toxicity from vancomycin to minimize the risk of adverse outcomes and mortality. Larger studies are needed to closely quantify the risk of vancomycin toxicity among patients with chronic liver disease.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"375"},"PeriodicalIF":3.4,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11916956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656027","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}