Journal of Infection and Public Health最新文献

{"title":"Perinatal HIV exposure is associated with long-term alterations in immune marker levels in children","authors":"José Avendaño-Ortiz ,&nbsp;Judit Ventosa-Cubillo ,&nbsp;Concepción Rodríguez-Jiménez ,&nbsp;Dulce Morales-Pérez ,&nbsp;Rocío Muñoz-Hernández ,&nbsp;Noris Pavía-Ruz ,&nbsp;María L. Navarro ,&nbsp;África Holguín","doi":"10.1016/j.jiph.2026.103168","DOIUrl":"10.1016/j.jiph.2026.103168","url":null,"abstract":"<div><h3>Background</h3><div>HIV-exposed uninfected (HEU) children represent a little-studied growing population. We aimed to determine whether perinatal HIV exposure imparts long-term immune alterations.</div></div><div><h3>Methods</h3><div>A prospective cohort including 91 children (&lt;13 years) from México was classified into four groups: HIV unexposed-uninfected (HUU, n = 25), HEU (n = 25), HIV exposed infected with undetectable (HEI^undetVL, n = 25) or detectable VL (HEI^detVL, n = 16). Sixty-four immune biomarkers were measured in each child: 55 proteins in plasma and 9 mRNAs in paired-dried blood samples</div></div><div><h3>Results</h3><div>Principal Component Analysis revealed that HEU exhibited similarity to HEI^undetVL and higher inter-individual variability than HUU. HEU children exhibited significantly higher levels of IL-17A, TIM-3, P-Selectin and <em>CD14</em> mRNA along with lower levels in Serum amyloid A (SAA), IGFBP-4, myeloperoxidase and tPA compared with HUU. Despite no differences in age at diagnosis, CD4 counts, or ART exposure time between the HIV-exposed and infected groups, active infection (HEI^detVL) was associated with significant alterations in 15 markers, indicating extensive immune dysregulation. These included higher levels of myeloid activation markers (sCD14, sCD163), chemokines (CXCL10), VEGF-A, immune-checkpoints (Galectin-9, <em>PD-1</em> mRNA) and markers of vascular inflammation and coagulation (tPA, ICAM-1, myeloperoxidase, N-GAL, or SAA), as well as lower levels of four immune-checkpoints (sCD86, sCD137, CTLA-4) and MMP-2, compared with HEI^undetVL. Logistic regression models identified SAA, TIM-3 and IGFBP-4 as independently associated with HIV exposure, achieving an accuracy of 82 % in classifying HEU <em>vs.</em> HUU children, whereas downregulated sCD86, combined with elevated Galectin-9 and VEGF-A levels, were independently associated with active HIV viremia, with a classification accuracy of 92.7 %.</div></div><div><h3>Conclusions</h3><div>Perinatal HIV exposure induces persistent immune alterations, even in uninfected children, including elevated cytokines, immune-checkpoints, thrombosis and vascular inflammation markers. These findings suggest that, even without acquiring HIV, exposed children exhibit immunological imprints that may contribute to increased risk of adverse health outcomes.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 4","pages":"Article 103168"},"PeriodicalIF":4.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147307055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PostInfluenza bacterial infections: Epidemiology, mechanistic insights and emerging treatment approaches","authors":"Yueying Chen ,&nbsp;Hong Li ,&nbsp;Jingwen Mu ,&nbsp;Yanchun Peng ,&nbsp;Pasqualina D’Ursi ,&nbsp;Keda Chen ,&nbsp;Yuejuan Zheng","doi":"10.1016/j.jiph.2026.103178","DOIUrl":"10.1016/j.jiph.2026.103178","url":null,"abstract":"<div><div>Influenza virus is one of the most common viruses for respiratory tract infections. Postinfluenza bacterial infections can lead to severe pneumonia and significantly increase the mortality during influenza outbreaks. This review addresses the differences between primary influenza viral infection and postinfluenza bacterial infection and explores the underlying mechanisms of the secondary infection. The mechanisms entail the disruption of the lung barrier and the host immune system by influenza virus, as well as an increase in the availability of nutrients necessary for bacterial proliferation, which collectively lead to increased susceptibility to secondary infections. This review also discusses the current common clinical and novel therapeutic strategies to provide new insights for clinical diagnosis and treatment strategies.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 4","pages":"Article 103178"},"PeriodicalIF":4.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146172263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Next-generation gene therapy for infectious disease: Advances, challenges, and future directions","authors":"Maryam Fattahi ,&nbsp;Fatemeh Pirbadami ,&nbsp;Tahereh Motallebirad ,&nbsp;Zeynab Beheshti ,&nbsp;Davood Azadi","doi":"10.1016/j.jiph.2026.103164","DOIUrl":"10.1016/j.jiph.2026.103164","url":null,"abstract":"<div><div>Infectious diseases, worsened by antimicrobial resistance and limitations of conventional treatments, demand innovative solutions. This systematic review evaluates recent advances in next-generation gene therapy for HIV, HBV, HPV, and multidrug-resistant(MDR) pathogens, while addressing key challenges and future directions. Following PRISMA guidelines, major databases were searched (2015–2025), yielding 1250 records. the114 peer-reviewed studies were included, assessed using the MMAT, and thematically synthesized for therapeutic strategies, efficacy, challenges, and prospects. Findings show CRISPR-based genome editing achieved HIV remission in preclinical and early clinical trials, engineered bacteriophages demonstrated strong efficacy against MDR bacteria, RNAi effectively silenced HBV, and phage-derived depolymerases reduced MDR biofilms. Adverse events included off-target effects, immunogenicity, and scalability issues. Efficacy varied, with CRISPR offering high specificity and phage therapies showing robust lysis. In conclusion, Gene therapy shows strong potential against resistant pathogens, but faces challenges like study heterogeneity, preclinical reliance, delivery barriers, and unequal access in low-and middle-income countries.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 4","pages":"Article 103164"},"PeriodicalIF":4.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146165508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Beyond COVID-19 in people with HIV: Specific miRNA expression profile persist after SARS-CoV-2 clearance” [J Infect Public Health 19 (3) (2026) 103108]","authors":"Sergio Grande-García ,&nbsp;Manuel Llamás-Adán ,&nbsp;Celia Crespo-Bermejo ,&nbsp;Violeta Lara-Aguilar ,&nbsp;Sonia Arca-Lafuente ,&nbsp;Luz Martín-Carbonero ,&nbsp;Pablo Ryan ,&nbsp;Ignacio de los Santos ,&nbsp;María de Lagarde ,&nbsp;Rafael Mican-Rivera ,&nbsp;Santiago Moreno ,&nbsp;Salvador Resino ,&nbsp;Juan Berenguer ,&nbsp;Verónica Briz ,&nbsp;Amanda Fernández-Rodríguez ,&nbsp;on behalf of the Multidisciplinary HIV/Hepatitis Viral Coinfection Group (COVIHEP) and of the CoRIS cohort","doi":"10.1016/j.jiph.2026.103167","DOIUrl":"10.1016/j.jiph.2026.103167","url":null,"abstract":"","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 4","pages":"Article 103167"},"PeriodicalIF":4.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modeling epidemic and economic trade-offs under alternative COVID-19 isolation exit scenarios in South Korea","authors":"Suyoung Jo ,&nbsp;Sung-il Cho ,&nbsp;Asaph Young Chun ,&nbsp;Kyung-Duk Min","doi":"10.1016/j.jiph.2026.103160","DOIUrl":"10.1016/j.jiph.2026.103160","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 4","pages":"Article 103160"},"PeriodicalIF":4.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146125283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between prior COVID-19 infection and acute mountain sickness on Jade Mountain: A prospective observational study (2023−2024)","authors":"Te-Chun Shen ,&nbsp;Mei-Chen Lin ,&nbsp;Bi-Kun Chuang ,&nbsp;Bagkall Haivangang ,&nbsp;Shui-Fei Lu","doi":"10.1016/j.jiph.2026.103152","DOIUrl":"10.1016/j.jiph.2026.103152","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 4","pages":"Article 103152"},"PeriodicalIF":4.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146125361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distinct serum metabolic profiles with supportive diagnostic value in differentiating tuberculosis and Mycobacterium avium complex pulmonary disease","authors":"Keu Eun San Kim ,&nbsp;Ye Jin Lee ,&nbsp;Ji Hae Park ,&nbsp;Nakwon Kwak ,&nbsp;Su-Young Kim ,&nbsp;Byung Woo Jhun ,&nbsp;Jae-Joon Yim ,&nbsp;Sung Jae Shin","doi":"10.1016/j.jiph.2026.103162","DOIUrl":"10.1016/j.jiph.2026.103162","url":null,"abstract":"<div><h3>Background</h3><div>Pulmonary infectious diseases caused by <em>Mycobacterium</em> species, including <em>Mycobacterium tuberculosis</em> and <em>Mycobacterium avium</em> 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.</div></div><div><h3>Methods</h3><div>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).</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 4","pages":"Article 103162"},"PeriodicalIF":4.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146131614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bacterial superinfection in pregnant women with severe COVID-19: Prevalence, resistance patterns and outcomes","authors":"Mojtaba Akbari ,&nbsp;Mohammad Shirzadi ,&nbsp;Fatemeh Yazdani ,&nbsp;Samaneh Pourajam ,&nbsp;Majid Hosseinzadeh ,&nbsp;Armita akbari ,&nbsp;Mansour Siavash ,&nbsp;Hamid Solgi","doi":"10.1016/j.jiph.2026.103184","DOIUrl":"10.1016/j.jiph.2026.103184","url":null,"abstract":"<div><h3>Background</h3><div>Pregnant women with severe COVID-19 are at high risk for intensive care unit (ICU) admission and adverse maternal outcomes. Evidence on the burden and impact of bacterial infections in this group is limited.</div></div><div><h3>Methods</h3><div>We conducted a single-center retrospective cohort study of pregnant women with confirmed COVID-19 admitted for ≥ 48 h to the ICU of a referral maternity hospital in Isfahan, Iran, between June and December 2021. Clinical, demographic, microbiological, and outcome data were retrieved from electronic medical records. Bacterial isolates were identified and tested for antimicrobial susceptibility according to CLSI guidelines. Logistic regression was performed to determine factors independently associated with in-hospital mortality.</div></div><div><h3>Results</h3><div>Of 527 pregnant women hospitalized with COVID-19, 71 required ICU admission and were included in the analysis. Bacterial infections were detected in 8 patients (11.3 %), most frequently caused by multidrug-resistant (MDR) <em>Klebsiella pneumoniae</em>. Compared with non-infected patients, women with bacterial superinfections had significantly longer hospital stays (22.4 vs. 10.2 days, p &lt; 0.001) and ICU stays (16.8 vs. 5.2 days, p &lt; 0.001), higher rates of invasive mechanical ventilation (50.0 % vs. 9.5 %, p = 0.002), and increased mortality (37.5 % vs. 9.5 %, p = 0.025). Univariate analyses identified bacterial superinfection, MDR pathogens, carbapenem/vancomycin use, lower admission SpO₂, and carbapenem-resistant <em>K. pneumoniae</em> as predictors of death. In multivariate analysis, only bacterial superinfection (aOR = 13.35, 95 % CI: 1.05–170.06) and lower oxygen saturation at admission (aOR = 1.21 per 1 % decrease, 95 % CI: 1.06–1.38) remained independent predictors of mortality.</div></div><div><h3>Conclusion</h3><div>Bacterial superinfections, especially with multidrug-resistant pathogens, are relatively common in ICU-hospitalized pregnant women with COVID-19 and strongly linked to worse outcomes, including higher mortality. Early detection, infection control, and rational antibiotic use are essential to improve survival.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 4","pages":"Article 103184"},"PeriodicalIF":4.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146776296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serological signals of past dengue exposure in general practice in southern mainland France","authors":"Brahm Delaporte ,&nbsp;Maeliss Champagne ,&nbsp;Ahidjo Ayouba ,&nbsp;David Costa ,&nbsp;Sylvain Pavageau ,&nbsp;Chloé Sikirdji ,&nbsp;Béatrice Lognos ,&nbsp;Karolina Griffiths ,&nbsp;François Carbonnel ,&nbsp;Charlotte Boullé","doi":"10.1016/j.jiph.2026.103185","DOIUrl":"10.1016/j.jiph.2026.103185","url":null,"abstract":"<div><div>The incidence of autochthonous arboviral infections in mainland France, particularly in the southern region of Occitanie, is increasing. Despite mandatory reporting, non-specific symptoms and asymptomatic cases likely lead to case underestimation. This study aimed to assess dengue seroprevalence for the first time in the general population consulting in routine general practice in southern mainland France. We conducted a multicenter cross-sectional seroepidemiologic survey in the adult population consulting in routine care in three departments (Hérault, Gard, Pyrénées-Orientales) of Occitanie. Patients completed a brief questionnaire, and two capillary blood drops were collected on filter paper. Multiplex serology (Luminex®) was used to detect IgG antibodies against the four DENV serotypes. A total of 629 participants were enrolled between March and May 2024, with a median age of 54 years, of whom 67 % were female. Nine patients tested positive for anti-DENV IgG, yielding an overall prevalence of 1.43 % (95 %CI: 0.75–2.69), including two participants with no travel history. These findings, although they should be interpreted with caution due to the potential for false positives and cross-reactivity, highlight the possibility of low-level dengue circulation in southern France escaping the surveillance system. This pilot study highlights the need to enhance the arboviral surveillance networks in response to the increasing arboviral threat in France.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 4","pages":"Article 103185"},"PeriodicalIF":4.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147306984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A structured-data algorithm for semiautomated surveillance of surgical site infection after colorectal surgery: A diagnostic accuracy study","authors":"Daniel Casanova-Portoles ,&nbsp;Josep M. Badia ,&nbsp;Carlos G. Forero ,&nbsp;Néstor Sánchez-Martínez ,&nbsp;Manel Romero ,&nbsp;Toni Alonso-Solís ,&nbsp;Enric Limón ,&nbsp;Miquel Pujol ,&nbsp;Joan Sancho","doi":"10.1016/j.jiph.2026.103151","DOIUrl":"10.1016/j.jiph.2026.103151","url":null,"abstract":"<div><h3>Background</h3><div>Manual surveillance of surgical site infections (SSIs) after colorectal surgery is resource-intensive, limiting scalability. Semiautomated algorithms based on structured electronic health record (EHR) data may maintain high case-finding sensitivity while reducing workload.</div></div><div><h3>Methods</h3><div>A retrospective diagnostic-accuracy study was conducted in a teaching hospital participating in a nationwide SSI surveillance programme. All elective colorectal procedures performed between January 2010 and December 2023 were included. SSIs were classified according to CDC-NHSN/ECDC criteria. Eight binary EHR-derived “alerts” were combined into a composite rule (any alert positive). Manual surveillance served as the reference standard. Performance was assessed overall, by SSI depth (superficial, deep, organ/space), and by procedure type (colon vs rectal). Discrimination (AUC), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated with 95 % confidence intervals (CIs).</div></div><div><h3>Results</h3><div>A total of 1213 patients (1085 colon; 128 rectal) were included. The overall SSI incidence was 11.2 % (3.1 % superficial, 1.2 % deep, 6.8 % organ/space). The composite alert achieved an AUC of 0.859 (95 % CI 0.838–0.878) for any SSI, with sensitivity 0.721, specificity 0.876, PPV 0.424, and NPV 0.961. At this operating point, 19 % of procedures would be flagged for manual verification, corresponding to an estimated 81 % reduction in full chart reviews. Discrimination was highest for organ/space infections (AUC 0.919; sensitivity 0.831; specificity 0.911). Performance for deep SSI was intermediate (AUC 0.805), and for superficial SSI, more limited (AUC 0.571). Sensitivity was higher for colon surgery (AUC 0.853) and specificity higher for rectal surgery (AUC 0.881).</div></div><div><h3>Conclusions</h3><div>The structured-data algorithm demonstrated strong overall discrimination and excellent performance for organ/space infections, supporting the feasibility of semiautomated surveillance without compromising detection quality. External and prospective validation, definition of diagnostic safety thresholds, and workload-reduction analyses are required to optimise implementation. Exploration of NLP add-ons may be considered where resources permit. ClinicalTrials.gov: NCT07130656.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 4","pages":"Article 103151"},"PeriodicalIF":4.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146102489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}