International Journal of Infectious Diseases最新文献

During this 2025/26 Northern Hemisphere influenza season, the predominant influenza A(H3N2) subclade K virus has binding site mutations and postvaccine sera reduced inhibition, raising concerns about antigenic differences with available vaccines. During November 2025- January 2026, 8,455 patients with influenza-like illness (ILI) and 4,479 patients with severe acute respiratory illness (SARI) were identified through 25 sentinel surveillance hospitals in Suzhou City, Jiangsu Province, China. Among enrolled ILI and SARI patients, 4,032 (47.7%) and 697 (15.6%) were influenza positive by RT-PCR, respectively. Of all influenza positives, four were influenza B Victoria and three were influenza A(H1N1)pdm09; all remaining positives were influenza A(H3N2). Among gene sequenced viruses isolated from 44 randomly-selected positive samples during the study period, 95% were influenza A(H3N2) subclade K. Generalized linear regression models indicated Northern Hemisphere 2025/26 influenza vaccines, including A/Croatia/10136RV/2023 (H3N2)-like viruses, reduced risk for influenza-associated outpatient visits by approximately one-half during the November 2025-January 2026 subclade K dominant months. We did not observe statistical significance, although the point estimate suggested a possible one-fifth reduction in influenza-associated hospitalizations. Increasing seasonal influenza vaccine coverage could relieve stress on the medical system during respiratory disease season.

Objective: To investigate the clinical, imaging, and pathological features of osseous cystic echinococcosis(CE) and osseous alveolar echinococcosis(AE) to enhance diagnostic accuracy and differential diagnosis capabilities.

Methods: A retrospective analysis of 58 pathologically confirmed osseous echinococcosis cases was conducted, collecting demographic, clinical, imaging, and histopathological data.

Results: Of 58 patients, 49 (84.48%) had osseous CE and 9 (15.52%) had osseous AE. Both types predominantly affected farmers/herdsmen. The spine was the most commonly affected site (CE: 70.41%, AE:44.44%), and multi-site involvement was common (CE: 71.43%, AE: 88.89%). Osseous CE showed multilocular cystic hypodense lesions (57.97%) on CT and "grape-cluster-like" lesions with long T1/T2 signals (90.16%), with ring-like enhancement of the cyst wall and septa sometimes on MRI. Osseous AE presented heterogeneous density with calcifications(50%) on CT, and MRI showed mixed signals, with calcifications and fibrous components showing low signals on T2WI. Histopathologically, osseous CE specimens contained "laminated membrane"-like material (68.35%); powder-stained plate-like stratum corneum was observed under the microscope (100%). Osseous AE displayed necrotic debris (70.00%); honeycomb-like microcysts were seen within the necrotic background (100%).

Conclusion: Osseous CE and AE share overlapping Clinical features, but exhibit differences in CT/MRI and pathological characteristics. Compared to osseous CE, osseous AE demonstrated broader site distribution, more frequent multisystem involvement, and a more aggressive clinical course with shorter disease duration prior to diagnosis. Mastering the key features is essential for accurate diagnosis.

Background: Human mobility may facilitate dengue transmission, but the contributions of different mobility patterns in China remain unclear.

Methods: We collected dengue data from 2005 to 2023 in China and applied the Getis-Ord Gi* statistic to identify high-incidence provinces. A generalized additive model was used to quantify the effects of intra-provincial, inter-provincial, and international inflows on dengue incidence in high-incidence provinces. Inflows from Southeast Asia were further assessed in Guangdong and Yunnan, where most imported cases are reported.

Results: Dengue distribution expanded northward in China, with high-incidence clusters in Yunnan and southeastern coastal provinces. All patterns of inflow were positively associated with increased dengue risk, with consistent lag effects from day 0 to day 14. International inflow showed the strongest association, with the highest relative risk (RR) in Yunnan (RR = 2.95; 95% CI: 2.68-3.25). The inflows from Southeast Asia were significantly associated with dengue fever in Guangdong (RR = 1.85; 95% CI: 1.81-1.90) and Yunnan (RR = 2.99; 95% CI: 2.48-3.60).

Conclusion: The three population mobility patterns play key roles in dengue transmission in China, which underscores the need for differentiated prevention strategies and collaboration with transportation and customs departments to curb dengue fever at an early stage.

Background: A genetic cluster of eight TB cases residing in various units in a single high-rise apartment block in Singapore was detected. A mass screening exercise for active case finding was conducted, and site assessments and simulations were performed to understand potential transmission routes.

Methods: All eligible persons were offered screening for TB infection. A site survey was conducted to understand potential environmental factors that might have contributed to the intense transmission, and an airflow model of the block was developed to explore possible mechanisms for inter-unit airborne transmission using computational fluid dynamics (CFD) simulations.

Results: Of 739 persons screened, 212 persons (28.7%) had a positive QFT test. Of 212 persons with TB infection, 15 were diagnosed to have TB disease. Of those with a positive culture, six cases were added to the cluster. CFD simulations suggested that inter-unit transmission could be facilitated in scenarios with a lack of cross ventilation within apartments.

Conclusions: The possibility of inter-unit transmission suggests that as with routine TB contact tracing that is based on likelihood of exposure, screening may be expanded based on parameters such as proximity to the index, infectivity of the index and the attack rate.

Objectives: The interaction between SARS-CoV-2 variants of concern (VoC) and post-COVID symptom duration remains unexplored. This is the first study to evaluate post-COVID prevalence stratified by VoC and follow-up periods.

Methods: Six databases were searched (12/2019-12/2024) for studies of adults with laboratory-confirmed SARS-CoV-2 and symptoms lasting ≥3 months. Data were stratified by VoC (Alpha through Omicron) and follow-up (<6 vs. ≥6 months) to estimate pooled prevalence using random-effects models.

Results: Pooled prevalence across 35 studies (n=159,000) was 28.5% (95% CI: 21.6-36.0), higher in pre-Omicron (35.5%) than Omicron (22.8%) eras (p=0.04). Symptoms persisted beyond six months in 29.9% of cases. Fatigue was the most prevalent symptom across all VoCs and follow-ups followed by brain fog, dyspnea, and sleep impairment. Pre-Omicron variants were linked to dyspnea and anosmia, while Omicron was associated with brain fog and paresthesia. Most symptoms showed no significant reduction beyond six months. Sleep problems were higher in early pre-Omicron cohorts but improved over time; conversely, palpitations and ocular manifestations increased in later pre-Omicron follow-ups.

Conclusions: Post-COVID condition remains a burden despite vaccination. Distinct symptomatology patterns across VoC and timelines highlight the need for tailored management strategies to mitigate long-term global impacts.

Objectives: European countries implemented highly diverse mitigation policies during the COVID-19 pandemic, ranging from strict nationwide lockdowns to more voluntary approaches. This study aims to understanding how timing, stringency, and comprehensiveness of policy responses influenced epidemic trajectories by applying machine learning-based counterfactual analysis.

Methods: Data from 27 European OECD countries between January 2020 and December 2022 were analysed. Daily epidemiological data, including COVID-19 cases, deaths, effective reproduction number were linked with government response indicators, demographics, vaccination, testing, and mobility data. Temporal Fusion Transformer (TFT) models were applied for multi-horizon time series forecasting by capturing nonlinear relationships between policy response indicators and COVID-19 outcome variables. Simulations were conducted under eight hypothetical response scenarios, ranging from the loosest to the strictest policy bundles. The impacts of policy responses on COVID-19 outcomes were assessed by comparing the counterfactual scenarios with the factual outcomes.

Results: TFT models achieved excellent predictive accuracy (percentage mean absolute error <10%). The strictest responses were associated with reduced daily COVID-19 cases by over 10% in several countries, notably Hungary, Switzerland, and Turkey, while the loosest responses were associated with increased incidence by 10-20%, with the highest value observed in Poland. Associations with mortality were smaller and heterogeneous, with potentially maximum reductions of 7-10% in Belgium, Portugal, and Switzerland under strict scenarios. Over early relaxation from the restrictions might lead to outcomes as adverse as those under continuously loose policies. Feature importance analyses highlighted restrictions on mobility and gatherings, vaccination, testing, and fiscal measures as dominant drivers, alongside country-level factors such as age structure and chronic disease burden.

Conclusions: The TFT-based machine learning framework demonstrated favourable feasibility and interpretability, reinforcing its value in guiding policy decisions. Comprehensive, multi-domain interventions outperformed partial or short-lived restrictions. Lifting measures before achieving sufficient immunity and epidemic control posed substantial risks. Stringent policies reduced transmission, but their impact on mortality was constrained, which might be due to demographic and systemic vulnerabilities. Adaptive, data-driven strategies integrating epidemiology, policy, and structural context are essential to strengthen policy responses against future pandemics.

Matrix metalloproteinases (MMPs) are zinc-dependent proteases that sit at the interface of inflammation, tissue injury, and repair in tuberculosis. In pulmonary tuberculosis, dysregulated MMP activity drives extracellular matrix degradation, cavitation, and remodelling that contribute to post-tuberculosis lung disease. In tuberculous meningitis, MMPs have been implicated in blood-brain barrier disruption and neuroinflammatory injury. Experimental and clinical research consistently link elevated MMPs with radiological damage and adverse outcomes, while mechanistic studies highlight the importance of cellular networks in amplifying matrix-destructive pathways. MMP activity is further shaped by host modifiers, such as co-infection, and the pathological microenvironment characterised by metabolic stress, acidosis and hypoxia. Host-directed therapies are interventions that target dysregulated host immune and tissue injury pathways, rather than Mycobacterium tuberculosis itself, with the aim of limiting pathology and improving clinical outcomes. Preclinical evidence supports modulation of matrix degradation, exemplified by doxycycline-mediated suppression of pathological MMP activity and improved survival in selected pulmonary and central nervous system TB models. Future progress will depend on translating these insights into clinical benefit with carefully designed studies that consider host heterogeneity, co-infection, and disease compartment to refine matrix-targeted host-directed approaches in an era of increasingly personalised medicine.

Objective: This study aimed to compare the clinical profiles and maternal-fetal outcomes of tuberculosis (TB) disease in pregnant women following in vitro fertilization and embryo transfer (IVF-ET) versus natural conception (NC), and identify the associated high-risk factors.

Methods: A retrospective analysis included 133 pregnant women with TB disease, stratified into IVF-ET (n=16) and NC (n=117) groups. Clinical, radiological, and laboratory parameters were evaluated, and logistic regression identified risk factors for stillbirth or preterm birth.

Results: The IVF-ET group exhibited significantly more severe TB manifestations, including higher rates of bilateral pulmonary lesions (100.0% vs. 39.3%), miliary TB (93.8% vs. 5.1%), and TB meningitis (37.5% vs. 3.4%), alongside prolonged hospitalization (median 18.0 vs. 9.0 days, p<0.001). These patients also demonstrated lower lymphocyte, CD4, and CD3 cell counts, as well as lower plasma albumin levels. Adverse fetal outcomes were more frequent in the IVF-ET group (stillbirth: 62.5% vs. 1.7%; preterm birth: 31.2% vs. 8.5%, both p<0.001). IVF-ET was the strongest independent predictor of adverse outcomes (adjusted OR=59.42, p=0.002), with the predictive model achieving an AUC of 0.868 (optimism-corrected AUC of 0.817).

Conclusion: Tuberculosis following IVF-ET is associated with exacerbated disease severity and adverse fetal outcomes, accompanied by reduced cellular immune status and a poorer nutritional-inflammatory profile at presentation (e.g., lower CD3+/CD4+ T-cell counts and albumin levels). Pre-IVF TB screening and heightened vigilance during pregnancy are critical for risk mitigation.

Objective: This study aimed to evaluate the real-world feasibility of contezolid-containing treatment in patients with Gram-positive bacterial bloodstream infections (GPB-BSIs) following cardiac surgery.

Methods: A single-center retrospective analysis was conducted, including 22 patients with post-cardiac surgery GPB-BSIs who received contezolid treatment. The primary outcome was the overall clinical response rate.

Results: The overall clinical response rate of contezolid-containing treatment was 77.3% (17/22, 95% CI: 54.6%-92.2%), with 9 patients achieving cure and 8 achieving improvement. The microbial eradication rate reached 92.6% (25/27, 95% CI: 75.0%-99.1%), particularly 95% (19/20, 95% CI: 75.3%-99.9%) for coagulase-negative staphylococci (CoNS)-the dominant pathogen. The overall adverse event (AE) incidence was 9.1% (2/22, 95% CI: 1.1%-29.2%), involving two Grade II renal injury events with low correlation to contezolid. No cases of new-onset or exacerbated thrombocytopenia were observed, and no patients discontinued treatment due to AEs. The in-hospital mortality was 4.5% (1/22), with median total hospital stay and ICU stay of 11.0 (interquartile range [IQR]: 8.0-16.0) days and 31.0 (IQR: 25.0-45.5) days, respectively.

Conclusion: This study reports the initial clinical experience with contezolid-containing regimens for GPB-BSIs in a complex post-cardiac surgery cohort, supporting its feasibility in this population. These descriptive findings highlight the need for prospective studies to further evaluate its role.

Background: Despite being a major epidemic potential pathogen with recurrent emergence, chikungunya virus (CHIKV) remains neglected in Bangladesh with poor characterization of long-term epidemiology, re-emergence patterns, and prevention policy.

Methods: We screened epidemiological, clinical, and genomic data on CHIKV outbreaks in Bangladesh from 2008 to 2025, integrating documents, national surveillance records, spatiotemporal trends, circulating genotypes, and public health gaps.

Results: Since first documentation in 2008, transmission of CHIKV has been characterized by prolonged inter-outbreak intervals. A major outbreak with >13,000 cases was documented in 2017 followed by a reemergence in 2024-2025 (2000 cases). Cases peaked invariably during post-monsoon months with overlapping temporal and clinical features with dengue outbreaks. After 2015, the Indian Ocean lineage (IOL) sub-clades carrying E1:K211E and E2:V264A mutations with enhanced Aedes aegypti adaptation were reported. Surveillance data indicate substantial underreporting and underdiagnosis prevail due to symptom overlap with other febrile illnesses, limited decentralized diagnostic facilities, and the exclusion of CHIKV from routine national surveillance. Among symptoms, fever and debilitating polyarthralgia affected >95% of symptomatic confirmed cases, with significant long-term (25-40% of patients with more than 6 months) morbidity and subsequent socioeconomic impact.

Conclusions: Bangladesh is experiencing episodic but intensifying CHIKV transmission in recent years after India in the region. Integrating CHIKV into national routine surveillance, expanding affordable and available diagnostics, strengthening genomic surveillance, and implementing a sustained integrated vector management might be critical to reduce the impact of future outbreaks and regional spread.