Journal of Infection and Public Health最新文献

Background: Pulmonary infectious diseases caused by Mycobacterium species, including Mycobacterium tuberculosis and Mycobacterium avium complex (MAC), remain significant public health threats. However, current gold-standard diagnostics are time-consuming and have limited ability to differentiate these clinically similar presentations. This study investigated serum metabolic distinctions between tuberculosis (TB) and MAC pulmonary disease (MAC-PD) to identify biomarkers with supportive diagnostic value for differential diagnosis.

Methods: We performed LC/MS-based metabolic profiling of 181 serum samples from TB and MAC-PD patients. The study cohort was subsequently divided into a training set (TB, n = 30; MAC-PD, n = 30) and a validation set (TB, n = 51; MAC-PD, n = 70).

Results: Five key metabolites were identified, including four sphingoid base lipids that were decreased in TB compared with MAC-PD, and 2-hydroxyglutaric acid (2-HG), which was increased. Logistic regression using this five-metabolite panel achieved strong discriminatory performance, with an area under the curve of 0.988 (95 % CI: 0.970-1.000) in the training set and 0.997 (95 % CI: 0.991-1.000) in the validation set. Consistent performance across multiple machine learning models reinforces the stability and supportive diagnostic value of the five-metabolite panel.

Conclusions: This study provides a novel approach for the differential diagnosis of two major mycobacterial pulmonary diseases. The identified metabolites, particularly alterations in sphingoid base lipids and 2-HG, demonstrated robust discriminative potential. These findings support their potential role as biomarkers in clinical practice, enabling earlier and more accurate differentiation of TB and MAC-PD.

Neurobrucellosis (NB) and Neurotuberculosis (NT) are rare central nervous system infections, but pose significant diagnostic and therapeutic challenges. If not diagnosed and treated early, they can have high mortality. Clinical presentations for both are nonspecific, mimicking diverse pathologies. Therefore, it is crucial to identify distinguishing features to ensure timely treatment. We conducted a retrospective review of cases of NB and NT admitted to the American University of Beirut Medical Center (AUBMC) between January 1982 and December 2022, identifying 20 patients with NT, and five cases of NB. Their presentation and diagnostic work-up were compared. NT patients were mostly male and presented earlier than NB patients (median symptom duration 150 days). Patients with NT had higher rates of systemic and neurologic symptoms compared to NB. Both groups had hyponatremia. NB patients had higher cerebrospinal fluid lymphocyte counts. Imaging in NT revealed diverse brain abnormalities such as hydrocephalus and small nodules whereas mostly meningeal enhancement in NB. Despite severe presentations no 30-day mortality occurred in either group. Neurological complications were more frequent in NT. Finally, NT patients generally present earlier with more severe symptoms than NB. Due to overlapping features but differing treatments, larger scale studies are crucial to better understand and manage these infections.

Background: Helicobacter pylori (H. pylori) infection is widespread in about half of the world's population, and it has become a major public health problem. There are more and more probiotic studies on the management of H. pylori. This study uses bibliometric analysis to show the current pattern and development trend of research on H. pylori.

Methods: We collected the publications about H. pylori and probiotics from the Web of Science Core Collection(WoSCC), and the database was established until July 11th, 2025. We use MicrosoftExcel to organize a preliminary quantitative overview, CiteSpace and VOSviewer to visualize the writer network, keyword co-occurrence and organization distribution in more detail.

Results: This bibliometrics research contains 295 publications, all of which were published between 2001 and 2025. According to the analysis results, the number of papers in this field is on the rise, and China ranks first in the number of publications and citations. In this field, Helicobacter magazine ranks first in the number of publications and citations, Qinggu and Koga Kanghong are the most active researchers . The most frequently cited paper is "Effects of different probiotic preparations on the side effects related to the treatment of Helicobacter pylori: a parallel group, triple blind and placebo-controlled study". In recent years, the mechanism of probiotics in the treatment of H. pylori has been a research focus.

Conclusions: Our study constitutes the first bibliometric analysis specifically dedicated to research at the intersection of H. pylori and probiotics. By comprehensively synthesizing the current landscape of probiotic research in H. pylori prevention and management, we have delineated the core research orientations and emerging frontiers in this domain. This work offers valuable empirical support to assist researchers in staying abreast of the latest advancements and accelerating the translational development of probiotics in H. pylori eradication strategies.

Background: Scientific evidence should guide adjustments to isolation policies as part of coronavirus disease 2019 (COVID-19) exit strategies. However, such evidence was limited when these strategies were implemented. This study retrospectively evaluated the relaxation of isolation policies in South Korea, aiming to generate evidence to support policy decisions in future pandemic scenarios.

Methods: We developed an age-stratified deterministic vaccination-extended Susceptible-Exposed-Infectious-Recovered model to simulate counterfactual scenarios related to isolation policy changes during the Omicron wave. Two phases were assessed: partial relaxation of isolation in 2022 and complete lifting of isolation mandates in 2023. Model outputs included confirmed cases and wage loss. Modified cost-effectiveness ratios were calculated as economic savings per additional infection.

Results: Moderate shortening of isolation from 10 to 7 days before the epidemic peak was associated with relatively favorable trade-offs between additional infections and wage loss reduction. In contrast, a more aggressive approach, reducing isolation to 5 days, resulted in a substantially higher number of confirmed cases with only marginal additional economic benefit. Delaying full lifting until July 2023, 1 month after the actual policy change, led to smaller and later epidemic peaks and greater economic gains.

Conclusions: Our findings suggested that both the timing and extent of isolation policy relaxation significantly influence epidemic dynamics and economic-epidemiologic trade-offs. Scenario-based modeling offers a valuable tool for anticipating trade-offs and informing policy decisions. Strengthening real-time surveillance and predictive modeling infrastructure is critical for an adaptive and balanced pandemic response.

Background: Carbapenem-resistant Pseudomonas aeruginosa (CRPA) presents a significant obstacle to effective antimicrobial treatment, particularly when resistance is driven by carbapenemase-producing strains (CPPA). While global carbapenem resistance rates in P. aeruginosa vary widely, from 10 % to 50 %, understanding local and regional patterns is crucial for guiding antimicrobial stewardship efforts. We used whole-genome sequencing (WGS) to characterize the genetic mechanisms of resistance in CRPA isolates.

Methods: From 2019-2021, 221 P. aeruginosa isolates were collected from clinical specimens. Antimicrobial susceptibility was determined using VITEK®2 and E-test. Sixty-six isolates were randomly selected for carbapenemase gene detection via whole-genome sequencing (WGS) after DNA extraction (QIAamp® kit).

Results: Whole-genome sequencing identified a predominance of intrinsic β-lactamases particularly OXA-50-like enzymes, including OXA-50, OXA-486 (53 %), OXA-488, and OXA-485) do not exhibit clinically significant carbapenem-hydrolyzing activity. In contrast, OXA-10 and OXA-232 are acquired OXA-type β-lactamases and are not intrinsic to P. aeruginosa. True carbapenemases were infrequently detected and were limited to IMP-34 (6 %) and VIM-28 (1.5 %). Notably, DHA-1 was identified for the first time in Riyadh. AmpC-like β-lactamases, such as PDC-3, were detected in 45.4 % of isolates. Class A extended-spectrum β-lactamases (ESBLs), including GES-14 (4.5 %) and VEB-9 (7.6 %), were also detected but are not considered carbapenemases. Predominant sequence types (STs) included ST357 (9.8 %), ST235 (8 %), and ST260 and ST244 (6.5 % each). High-risk clones, particularly ST235 and ST357, exhibited elevated carbapenem MICs attributable to the combined effects of intrinsic β-lactamase expression, efflux pump overexpression, and outer membrane permeability defects, rather than carbapenemase production alone.

Conclusion: Carbapenem resistance in the studied P. aeruginosa isolates was predominantly mediated by intrinsic resistance mechanisms, including OXA-50-like and AmpC β-lactamases, together with efflux pump overexpression and permeability defects. True carbapenemases were infrequently detected and were limited mainly to IMP-34 and VIM-28. High-risk clones such as ST235 and ST357 exhibited elevated carbapenem MICs largely independent of carbapenemase production.

Background: Acute mountain sickness (AMS) is a frequent concern for climbers at high altitudes. Since the COVID-19 pandemic, questions have emerged regarding whether prior infection increases susceptibility to AMS.

Methods: We conducted a prospective observational study at the Paiyun Lodge medical station (3402 m) on Jade Mountain (Yushan, 3952 m) between 2023 and 2024. All climbers presenting for medical services were screened. Demographics, comorbidities, ascent characteristics, sleep duration, prophylactic medication, and self-reported COVID-19 history were recorded. AMS was diagnosed clinically and validated using the 2018 Lake Louise AMS Score. Logistic regression and multiple propensity score methods were used to assess associations between COVID-19 history and AMS occurrence and severity.

Results: A total of 871 patients were included; 52.4 % were aged 20-40 years, 57.3 % were male, and 74.7 % reported a history of COVID-19 infection. Clinically diagnosed AMS occurred in 64.1 % (n = 558), with 274 mild and 284 severe cases. Although crude analyses suggested a borderline association between COVID-19 history and AMS (OR = 1.36, 95 % CI: 1.00-1.87), this was not statistically significant after multivariable adjustment (adjusted OR = 1.34, 95 % CI: 0.96-1.88) or propensity score methods.

Conclusion: Prior COVID-19 infection was not significantly associated with the occurrence and severity of AMS among climbers who sought medical services on Jade Mountain. These findings suggest that a history of mild COVID-19 does not independently increase AMS susceptibility, providing reassurance to mountaineers and aligning with contemporary expert consensus.

Background: Despite the widespread implementation of vaccination programs, pertussis continues to spread and remains a major health threat to infants. The present study aimed to identify risk factors of severe pertussis in children to inform clinical decision-making and the development of prevention strategies.

Methods: This retrospective cohort study included data from paediatric patients diagnosed with pertussis at Beijing You'an Hospital, Capital Medical University (Beijing, China), between January 2006 and December 2023. Multivariable logistic regression was performed to identify independent predictors of severe pertussis, and receiver operating characteristic (ROC) analysis was used to assess discriminative performance.

Results: Data from 219 children with pertussis were divided in 2 groups according to predefined clinical criteria: severe (n = 21) and non-severe (n = 198). Compared with non-severe cases, severe cases experienced longer hospital stays (median 12 versus [vs.] 8 days) and higher rates of fever, cyanosis, sputum production, and respiratory distress. Marked inflammatory differences were observed, as follows: higher neutrophil counts (median 6.83 vs. 3.65 ×10⁹/L); elevated C-reactive protein (median 3.50 vs. 1.00 mg/L); procalcitonin (median 0.12 vs. 0.04 ng/mL); increased neutrophil-to-lymphocyte ratio (NLR; median 0.61 vs. 0.29); and a lower lymphocyte percentage (median 56.9 % vs. 69.5 %) (all p < 0.05). Multivariable analysis identified elevated NLR as an independent predictor of severe pertussis (adjusted odds ratio [OR] 1.884; 95 % confidence interval [CI] 1.157-3.066; P = 0.011). ROC curve analysis yielded an area under the curve (AUC) of 0.745 (95 % CI 0.640-0.850), with an optimal NLR cut-off of 0.475, yielding a sensitivity of 66.7 % and a specificity of 75.5 %.

Conclusion: Elevated NLR was an independent predictor of severe pertussis in children. Future multicentre prospective studies with standardised follow-up periods are warranted to validate these findings.

Background: Burkholderia cepacia complex bacteria are intrinsically multidrug-resistant opportunistic pathogens that pose a growing threat in hospital settings, particularly among immunocompromised patients. Despite its clinical significance, data on sporadic Burkholderia cepacia complex infections outside cystic fibrosis populations and hospital outbreaks remain limited.

Methods: A 22-year retrospective observational cohort study (May 2001-April 2023) was carried out at a tertiary care academic center in the Eastern Province of Saudi Arabia. Adults hospitalized with confirmed Burkholderia cepacia infection and ≥ 72 h of antibiotic therapy were included. Demographics, comorbidities, infection type, microbiological resistance profiles, treatment outcomes, and mortality predictors were analyzed using logistic regression and Kaplan-Meier survival estimates.

Results: Of 189 identified cases, 151 patients met the inclusion criteria (mean age 53 ± 21 years; 57.6 % male). The majority of infections were hospital-acquired (84.8 %), with bloodstream infections (33.1 %) and ventilator-associated pneumonia (26.5 %) being the most prevalent. Resistance was high to piperacillin/tazobactam (73.6 %), ceftazidime (58.6 %), levofloxacin (57.4 %), carbapenems (42.0 %), and trimethoprim-sulfamethoxazole (30.3 %). Clinical resolution was achieved in 82.1 %, but bacteriological eradication occurred in only 56.9 %, with a recurrence rate of 17.2 %. Mortality reached 9.9 % at 14 days, 17.2 % at 30 days, and 35.8 % at one year. Independent predictors of 30-day mortality included advanced age, critical care admission, central venous catheter insertion, mechanical ventilation, and resistance to fluoroquinolones or carbapenems.

Conclusions: Our findings indicate that Burkholderia cepacia complex infections represent a significant clinical challenge due to antibiotic resistance and elevated mortality rates. The data highlight the importance of improving diagnostic and treatment approaches, as well as implementing effective infection control policies, especially for vulnerable hospitalized populations.