BMC Infectious Diseases最新文献

{"title":"A survey of explainable AI applications in infectious disease diagnosis.","authors":"Hossein Valishirin, Fatemeh Inanloo S A, Kelly A Brayton, Shira L Broschat","doi":"10.1186/s12879-026-14018-7","DOIUrl":"10.1186/s12879-026-14018-7","url":null,"abstract":"<p><p>Artificial intelligence (AI), particularly deep learning, has shown significant promise in accelerating the diagnosis of infectious diseases. However, the inherent \"black box\" nature of deep learning is a major barrier to clinical adoption, preventing trust and accountability. Explainable AI (XAI) tries to address this problem by adding transparency to model decision-making. This paper presents a comprehensive scoping review of XAI applications in infectious disease diagnosis based on literature published between 2023 and 2025. We review studies of major diseases, including COVID-19, tuberculosis, malaria, monkeypox, and dengue, categorizing them by data modality (e.g., imaging, tabular) and the XAI techniques employed (e.g., SHAP, LIME, Grad-CAM). We conclude that XAI methods are effective in identifying clinically relevant features, such as key biomarkers from lab results and pathological regions in medical images, thereby aligning model reasoning with established clinical knowledge. Despite this progress, significant challenges persist, including poor generalizability from small, single-center datasets, the computational overhead of post-hoc methods, and a gap between technical explanations and clinical utility. We outline future directions that should be taken, including the need for standardized evaluation metrics, multi-center validation, and clinician-centered XAI design to facilitate the responsible integration of AI into clinical practice.Clinical trial numberNot applicable.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13685100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227149","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 Nocardia brasiliensis causing septic arthritis in a patient with non-small cell lung adenocarcinoma: a case report.","authors":"Issa Jundi, Wafa Asad, Priyanka Mehotra, Andres Reyes-Corcho","doi":"10.1186/s12879-026-14064-1","DOIUrl":"10.1186/s12879-026-14064-1","url":null,"abstract":"<p><strong>Background: </strong>Nocardia brasiliensis is classically associated with localized cutaneous infection and is a rare cause of disseminated disease. Septic arthritis due to Nocardia species is atypical and has rarely been reported without antecedent trauma. We present a case of N. brasiliensis septic arthritis in a patient with active solid organ malignancy.</p><p><strong>Case presentation: </strong>An 80-year-old male with non-small cell lung adenocarcinoma, chronic obstructive pulmonary disease, and chronic kidney disease stage 3b presented with refractory soft tissue infections of the left upper and right lower extremities despite prior incision and drainage and oral antibiotics. Hospital course was complicated by progressive right knee effusion. Synovial fluid analysis demonstrated 87,000 white blood cells per microliter, 95% neutrophils, glucose less than 20 mg/dL, and no crystals. Nocardia brasiliensis was cultured from multiple noncontiguous sites, including the left upper extremity abscess, right knee synovial fluid, and right lower extremity lesions. Susceptibility testing demonstrated a broad antimicrobial profile but resistance to imipenem and ciprofloxacin. Trimethoprim-sulfamethoxazole and aminoglycosides were relatively contraindicated due to renal function. The patient required right knee arthroscopy with irrigation, debridement, and complete synovectomy, multiple interventional radiology-guided drainages, and prolonged combination antimicrobial therapy with ceftriaxone, linezolid, and minocycline. His course was further complicated by persistent encephalopathy and severe malnutrition requiring enteral nutrition. At the time of reporting, the patient demonstrated clinical improvement of cutaneous and musculoskeletal lesions but remained hospitalized for non-infectious complications.</p><p><strong>Conclusions: </strong>This case highlights that Nocardia brasiliensis can cause disseminated musculoskeletal infection including septic arthritis in immunocompromised patients without clear environmental exposure. In patients with chronic kidney disease, standard first-line therapies may be contraindicated, making early species identification and susceptibility-guided therapy essential, particularly given the potential for carbapenem resistance. The central lesson is that empiric carbapenem therapy may fail in N. brasiliensis and that renal impairment narrows treatment options, so timely identification and susceptibility-directed therapy directly determine management, particularly when advanced malignancy further constrains care.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13685251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149226946","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":"Developing laboratory indicators to predict the probability of in-hospital progression to severe disease in elderly patients with influenza A virus infection.","authors":"Liu Xiu, Feng Bianying, Zhang Zhifan, Zhou Hao, Zhou Nana, Man Qiuhong","doi":"10.1186/s12879-026-14007-w","DOIUrl":"10.1186/s12879-026-14007-w","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The progression of respiratory viral infections to severe disease, and the associated high mortality in elderly patients, pose a significant clinical challenge. Currently, effective warning tools specific for predicting severe influenza are lacking.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To preliminarily develop a laboratory‑based prediction model using routine clinical laboratory markers to estimate the risk of in-hospital progression to severe disease in elderly patients with influenza A virus infection.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective cohort study was conducted at Shanghai Fourth People's Hospital, affiliated with Tongji University, from March 2023 to February 2025. Data were extracted from the hospital's electronic medical record system. A total of 198 elderly patients (aged &gt; 60 years) with laboratory-confirmed influenza A virus infection were enrolled; those co-infected with other respiratory pathogens were excluded. All patients had complete demographic and outcome data, and laboratory biomarkers were measured within 24 h of admission. The primary outcome was progression to severe influenza, defined according to the Chinese \"Diagnosis and Treatment Protocol for Influenza\" (2025 Edition). Patients were randomly split into a training set and a validation set in a 7:3 ratio. Elastic net regression was employed to select candidate variables for constructing a prognostic model of disease severity. Model performance was evaluated based on discrimination and calibration.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of the 198 elderly hospitalized patients with influenza A virus infection, 50 developed severe disease, while 148 remained non-severe. There were no significant differences in age or sex between the two groups. However, 16 clinical laboratory markers, including procalcitonin, interleukin-6, and albumin, showed significant differences. Using a machine learning-based variable selection procedure, we identified white blood cell count, procalcitonin, interleukin-6, and myoglobin and incorporated them into the prediction model. The model showed discriminatory performance in both the training set (C-index: 0.851, 95% CI: 0.797-0.905) and the validation set (C-index: 0.819, 95% CI: 0.709-0.929). Calibration analysis suggested potentially acceptable calibration at day 14.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;We developed and preliminarily evaluated a laboratory‑based prognostic model to predict the risk of in-hospital progression to severe disease in elderly patients with influenza A virus infection. The model showed moderate discriminative ability in this single‑center cohort. Given the modest sample size and limited number of events, all results should be interpreted with caution and considered preliminary and exploratory. It will be important to conduct external validation in larger, independent cohorts.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Trial registration: &lt;/strong&gt;The study protocol was retrospectively registered with the Chi","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13681849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227115","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 LEN4PrEP study: protocol for a phase 3B, non-randomised clinical trial integrating lenacapavir PrEP within multi-product HIV prevention services in primary care clinics in South Africa.","authors":"Roisin E Drysdale, Catherine E Martin, Mrinmayee Dhar, Siphokazi Dada, Maletsatsi Monametsi, Nthabiseng Koloane, Vusile Butler, Cornelius Nattey, Saiqa Mullick","doi":"10.1186/s12879-026-14082-z","DOIUrl":"10.1186/s12879-026-14082-z","url":null,"abstract":"<p><strong>Introduction: </strong>Despite the scale-up of HIV pre-exposure prophylaxis (PrEP), HIV incidence remains high. The highly effective, twice-yearly subcutaneous injectable lenacapavir for PrEP (L4P) has provided a potential breakthrough for HIV prevention, but there is limited real-world data on uptake, patterns of use and service delivery requirements when offered in public health settings. The LEN4PrEP study will evaluate the integration of L4P within existing multi-product HIV prevention services in real-world settings in South Africa.</p><p><strong>Methods: </strong>The study is a prospective, mixed-methods, phase 3B clinical trial utilizing a non-randomised, open-label, effectiveness-implementation hybrid type 3 design. The study will take place in two fixed primary healthcare facilities and one linked roving mobile clinic in the Tshwane region, South Africa. Clients aged 16-65 years accessing comprehensive sexual and reproductive health services at the sites will be invited to enrol in the prospective cohort and offered a choice of L4P or oral PrEP. Clinical and socio-behavioural data will be collected over 12 months, with participants free to switch, discontinue and restart either PrEP product for the duration of the study. Ongoing safety monitoring will be conducted, with pregnancy and birth outcomes captured from pregnant participants, as well as HIV drug resistance monitoring in those who seroconvert. In-depth qualitative data will be collected from a sub-set of cohort participants to understand reasons for L4P use, as well as from healthcare providers involved in L4P delivery to explore health system requirements for implementation. Outcomes of the study will be guided by the RE-AIM framework and include patterns of use (uptake, adherence, persistence, continuation, switching, re-initiation, discontinuation), effectiveness (pregnancy and birth outcomes, seroconversions, adverse events) and facilitators and barriers to implementation.</p><p><strong>Discussion: </strong>The LEN4PrEP study will provide real-world data on L4P implementation when offered within existing HIV prevention services in public health settings in South Africa, offering a more generalisable reflection on use, service delivery, effectiveness and safety. The data generated can be used alongside programmatic data to inform demand forecasting, training and planning for the national roll-out of L4P.</p><p><strong>Trial registration: </strong>South African National Clinical Trials Registry, DOH-27-102025-4927 ( https://sanctr.samrc.ac.za/TrialDisplay.aspx?TrialID=13831 ). Registered on 22 April 2025.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13682110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227058","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":"Neglected tropical diseases in the Arabian Peninsula: a systematic review of leishmaniasis and rickettsioses.","authors":"Shuaibu Abdullahi Hudu, Mohamed Soliman, Naglaa M Shalaby, Emad A Morad, Ghusun M Alhazimi, Abdulgafar Olayiwola Jimoh","doi":"10.1186/s12879-026-14012-z","DOIUrl":"10.1186/s12879-026-14012-z","url":null,"abstract":"<p><strong>Background: </strong>Vector-borne neglected tropical diseases are still an underrecognized public health problem in the Arabian Peninsula. Of these, leishmaniasis is endemic in multiple regions, while the epidemiology of rickettsial infections remains incompletely understood. This systematic review synthesizes existing evidence on the epidemiology, distribution, and surveillance of these two diseases in the region.</p><p><strong>Methods: </strong>Following PRISMA 2020 guidelines, a systematic review was performed. The protocol was registered with PROSPERO. We searched PubMed/MEDLINE, Scopus, Web of Science, EMBASE, and relevant grey literature for studies published from January 2000 to December 2025 that describe human cases of leishmaniasis or rickettsioses in countries of the Arabian Peninsula. Two reviewers independently screened studies, extracted data, and assessed methodological quality (risk of bias) using validated tools.</p><p><strong>Results: </strong>A total of 44 studies were included. The majority of studies investigated leishmaniasis (n = 31), with fewer on rickettsioses (n = 9) or mixed febrile illness (n = 4). Most publications originated from Saudi Arabia. In the Arabian Peninsula, particularly in Saudi Arabia, cutaneous leishmaniasis remains endemic, with localized transmission hotspots and the coexistence of multiple Leishmania species, including L. major and L. tropica. Evidence for rickettsial infections remains sparse, primarily derived from case reports and serologic surveys.</p><p><strong>Conclusion: </strong>Leishmaniasis remains a public health challenge in the Arabian Peninsula, particularly in Saudi Arabia. In contrast, rickettsioses are likely underdiagnosed due to limited surveillance and diagnostic capacity. Improved, integrated surveillance systems, paired with febrile illness investigations that include diagnostic testing for rickettsial pathogens, will lead to fewer missed cases, contributing to disease detection and control.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13685370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227009","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":"Antimicrobial resistance patterns and difficult-to-treat resistance in uropathogens among diabetic and non-diabetic patients: a cross-sectional study.","authors":"Ankita Priyadarshini, Priyal Kalola, Hemantkumar Patadia","doi":"10.1186/s12879-026-13969-1","DOIUrl":"10.1186/s12879-026-13969-1","url":null,"abstract":"<p><strong>Background: </strong>While antimicrobial resistance (AMR) is a global challenge, data comparing Difficult-to-Treat Resistance (DTR) in diabetic versus non-diabetic urinary tract infection (UTI) patients is scarce. This study uniquely evaluates DTR and first-line resistance patterns to inform targeted empirical treatment strategies for these distinct patient cohorts.</p><p><strong>Methods: </strong>A prospective observational cross-sectional study was conducted from August 2021 to January 2024, at a tertiary care teaching hospital in Vadodara, Gujarat, India. During the period, 2408 patients with symptoms of UTI were screened for urine culture and sensitivity, of which 954 individuals tested positive for UTIs.</p><p><strong>Result: </strong>Of the 2,408 symptomatic patients screened, 954 (39.61%) tested positive. The within-group UTI positivity rate was 27.4% (280/1,023) among diabetic patients and 48.7% (674/1,385) among non-diabetic patients. Among the isolated uropathogens, Escherichia coli (E. coli) (56.78%, 62.90%) was the predominant organism followed by Pseudomonas aeruginosa (P. aeruginosa) (13.57%, 5.78%) and Klebsiella spp. (13.21%, 17.35%) in diabetic and non-diabetic respectively. Among all the isolated uropathogen tetracycline (81.25%) and penicillin (71.86%) groups of antibiotics showed high resistance in diabetic patients, whereas fluoroquinolones had highest resistance in non-diabetic with 67.59%. However, the carbapenem, phosphonic and nitrofuran group of antibiotics showed least resistance in both diabetic and non-diabetic populations. Among all the antimicrobial drugs tested in our study, the first line of drugs was further analyzed, and P. aeruginosa had the highest DTR in both diabetic and non-diabetic individuals.</p><p><strong>Conclusion: </strong>Despite lower culture positivity rates among diabetic patients, diabetic UTI cases demonstrated substantially higher AMR burden and DTR compared to non-diabetics. P. aeruginosa showed highest DTR prevalence. Penicillin and tetracycline resistance were markedly elevated in diabetic UTIs, while nitrofurantoin and fosfomycin maintained high effectiveness in both groups. These findings emphasize that diabetes is strongly associated with greater therapeutic complexity and multidrug resistance burden, necessitating resistance-guided empirical therapy and regional antibiogram surveillance for optimal UTI management.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13685189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227095","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":"Effectiveness of oral and inhaled repurposed and antiviral pharmaceutical treatments for acute SARS-CoV-2 in outpatient settings: a systematic review of 124 randomized trials.","authors":"Banafshe Hosseini, Lesley Anne Pablo, Jolanta Piszczek, Yoav Keynan, Peter Daley, Becky Skidmore, Andrew D Pinto","doi":"10.1186/s12879-026-13901-7","DOIUrl":"10.1186/s12879-026-13901-7","url":null,"abstract":"<p><strong>Background: </strong>Outpatient therapeutics for SARS-CoV-2 remain critical to reducing disease severity, preventing hospitalization, and mitigating long-term complications, yet evidence across trials has been fragmented and evolving.</p><p><strong>Objective: </strong>To systematically identify and evaluate the effectiveness of oral or inhaled pharmaceutical treatments, including repurposed and antiviral therapies, for acute SARS-CoV-2 infection in adult patients managed in outpatient settings.</p><p><strong>Methods: </strong>Comprehensive peer-reviewed searches were conducted in several databases for studies published by March 2024. We included randomized controlled trials evaluating oral or inhaled therapeutics administered to adults with acute SARS-CoV-2 infection in outpatient settings and excluded non-randomized and observational studies. Outcomes of interest included severe clinical outcomes. Random-effects meta-analyses were performed where feasible.</p><p><strong>Results: </strong>A total of 124 randomized controlled trials evaluating 137 therapeutics across 35 countries were included. Most interventions were repurposed agents (n = 88), with 33 antiviral and three combination regimens. Molnupiravir shortened time to recovery and reduced hospitalization in a subgroup pool of unvaccinated, higher-risk outpatients (OR 0.68, 95% CI 0.52-0.89), although this effect attenuated when mostly vaccinated patients was included (OR 0.83, 95% CI 0.58-1.19). Inhaled budesonide and metformin showed modest or setting-specific benefits, while most repurposed drugs, including fluvoxamine, ivermectin, and hydroxychloroquine, had no consistent clinical impact. Safety profiles were class-typical with no new signals identified.</p><p><strong>Conclusions: </strong>Most repurposed and antiviral therapies evaluated in outpatient COVID-19 trials showed no consistent benefit for severe clinical outcomes. Modest or setting-specific effects were observed for inhaled budesonide, metformin, and molnupiravir, with molnupiravir's effect on hospitalization most evident in unvaccinated, higher-risk outpatients and unreplicated for mortality.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13682097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149226993","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":"Controlling nutritional status score as a novel prognostic tool for hospital mortality risk stratification in sepsis: a large-scale retrospective cohort analysis.","authors":"Wei Song, Hai-Bin Yin, Dan Liu, Di-En Yan, Hui-Lei Zeng, Er-Liang Xie","doi":"10.1186/s12879-026-14063-2","DOIUrl":"10.1186/s12879-026-14063-2","url":null,"abstract":"<p><strong>Introduction: </strong>Malnutrition is associated with poor outcomes in critically ill patients. However, the prognostic value of the Controlling Nutritional Status (CONUT) score in sepsis remains unclear. This study aimed to investigate the association between CONUT score and hospital death in sepsis patients.</p><p><strong>Methods: </strong>In this retrospective cohort study, 2,143 sepsis patients from the eICU Collaborative Research Database were categorized into Mild (2-4 points), Moderate (5-8 points), and Severe (9-12 points) malnutrition groups based on the CONUT score. Multivariable logistic regression analysis was used to evaluate the relationship between CONUT score groups and hospital death. Subgroup analyses were performed to assess the stability of the association across different populations. Restricted cubic spline (RCS) analysis was conducted to examine the potential non-linear relationship between CONUT score and hospital death.</p><p><strong>Results: </strong>Hospital death rates increased progressively across malnutrition groups: 8.13% in Mild, 16.14% in Moderate, and 23.27% in Severe groups (P < 0.001). After fully adjusting for confounding factors, compared with the Mild group, the risk of hospital mortality was significantly higher in the Moderate group (adjusted OR: 1.60, 95% CI: 1.07-2.38, P = 0.021) and Severe group (adjusted OR: 2.66, 95% CI: 1.73-4.07, P < 0.001). Subgroup analyses demonstrated consistent associations across different demographic and clinical characteristics (all P for interaction > 0.05). RCS analysis revealed a significant linear dose-response relationship between CONUT score and risk of hospital mortality (P for overall < 0.001, P for nonlinearity = 0.685). Each one-point increase in CONUT score was associated with a 15% higher adjusted odds of hospital mortality (adjusted OR 1.15, 95% CI 1.09-1.21). The fully adjusted model showed good discrimination (AUC 0.773, 95% CI 0.747-0.799) and excellent calibration (Hosmer-Lemeshow P = 0.390).</p><p><strong>Conclusion: </strong>Higher CONUT scores were independently associated with increased risk of hospital mortality in sepsis patients. The CONUT score might serve as a valuable prognostic indicator for risk stratification in sepsis.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13682032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227098","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":"Adverse fetal and neonatal outcomes and associated factors among malaria infected parturient at Wallaga University Comprehensive Specialized Hospital, Western Ethiopia.","authors":"Dinaol Alemu, Temesgen Tilahun, Gemechu Tiruneh","doi":"10.1186/s12879-026-14088-7","DOIUrl":"10.1186/s12879-026-14088-7","url":null,"abstract":"<p><strong>Background: </strong>Malaria during pregnancy remains a major public health challenge, significantly contributing to poor fetal and neonatal outcomes. This study aimed to determine the prevalence and associated factors of adverse fetal and neonatal outcomes among malaria-infected parturient at Wallaga University Comprehensive Specialized Hospital, Western Ethiopia.</p><p><strong>Methods: </strong>An institution-based retrospective cross-sectional study was conducted using medical records of 271 malaria-infected parturient from March 10, 2024, to March 9, 2025. Data were extracted using a standardized checklist, entered into Microsoft Excel, and analyzed using SPSS version 27. Multivariable logistic regression was employed to identify independent predictors, with statistical significance set at p < 0.05.</p><p><strong>Results: </strong>The prevalence of adverse fetal and neonatal outcomes was 37.27% (95% CI: 32.0%-42.9%), with low birth weight being the most common complication. Independent predictors included residing in rural area (AOR = 4.97; 95% Cl, 1.92-12.90), being primigravida (AOR = 5.41; 95% Cl, 1.95-15.05), having moderate anemia (AOR = 3.25; 95% Cl, 1.46-7.25), having severe anemia (AOR = 4.89; 95% Cl, 1.95-12.29) and having four or fewer antenatal care contacts (AOR = 5.70; 95% Cl, 2.56-12.72).</p><p><strong>Conclusion: </strong>Nearly four in ten study participants experienced adverse fetal and neonatal outcomes. The risk is highest for participants from rural areas, experiencing their first pregnancy, struggling with moderate to severe anemia, or failing to complete at least five antenatal care contacts. Therefore, targeted interventions should prioritize anemia prevention and management, specialized monitoring for primigravidas, and rural outreach to ensure women complete at least five antenatal care contacts.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13685154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227089","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":"Routine urinalysis for early clinical assessment in patients with vegetation-like echocardiographic findings.","authors":"Kilyoon Pack, Kyung Eun Ha, Taeil Yang, Wook-Jin Chung, Mi-Seung Shin, Jeonggeun Moon","doi":"10.1186/s12879-026-14072-1","DOIUrl":"10.1186/s12879-026-14072-1","url":null,"abstract":"<p><strong>Background: </strong>Incidental vegetation-like findings on echocardiography prompt extensive diagnostic evaluation for infective endocarditis (IE), even in patients with low clinical suspicion. Given the association between IE and renal involvement, we evaluated whether routine urinalysis could serve as a simple adjunctive tool to aid early clinical assessment in this setting.</p><p><strong>Methods: </strong>We retrospectively analyzed adults with vegetation-like echocardiographic findings at a tertiary center between 2010 and 2024. Patients were classified as those with confirmed IE [IE (+)] and those in whom IE was ultimately excluded [IE (-)]. Urinalysis parameters at presentation were analyzed, and a simple additive score was constructed.</p><p><strong>Results: </strong>A total of 459 patients were included, comprising 202 with IE (+) and 257 with IE (-). Proteinuria, hematuria, and pyuria were more frequent in IE (+) and remained independently associated with IE in multivariable analysis. An additive score incorporating these variables (1 point each; range 0-3) demonstrated acceptable discriminatory ability (area under the curve, 0.77; 95% CI, 0.72-0.81). A score of 0 showed a relatively high sensitivity (78%) with acceptable specificity (67%).</p><p><strong>Conclusions: </strong>The absence of hematuria, proteinuria, and pyuria on routine urinalysis may serve as a supportive adjunct-not a rule-out test-for early clinical assessment.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001285","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}