Journal of Infection and Public Health最新文献

{"title":"Seroprevalence of four zoonotic viral diseases in camels in Qatar","authors":"AlMaha A. AlSaiari ,&nbsp;Nada M. Al-Karbi ,&nbsp;Maria K. Smatti ,&nbsp;Ahmed Gawish ,&nbsp;Nahla O. Eltai ,&nbsp;Asmaa A. Althani ,&nbsp;Hadi M. Yassine","doi":"10.1016/j.jiph.2025.103074","DOIUrl":"10.1016/j.jiph.2025.103074","url":null,"abstract":"<div><h3>Background</h3><div>Understanding the dynamics of zoonotic diseases is integral to the One Health approach, as it guides strategies to mitigate the impact of infections on both animal and human health. In Qatar, the circulation of many zoonotic viral infections among animals remains unknown.</div></div><div><h3>Aim</h3><div>This study aimed to investigate the seroprevalence of four zoonotic viral diseases in camels in Qatar: The Middle East respiratory syndrome coronavirus (MERS-CoV), in addition to three arboviruses (arthropod-borne viruses): [West Nile virus (WNV), Crimean-Congo hemorrhagic fever virus (CCHFV), and Rift Valley fever virus (RVFV)].</div></div><div><h3>Methods</h3><div>A total of 186 camel samples were collected from 23 farms at six municipalities in Qatar between 2019 and 2021. Specific anti-virus IgG or IgM antibodies were detected using commercial enzyme-linked immunosorbent assay (ELISA) kits.</div></div><div><h3>Results</h3><div>Overall, we found a high seroprevalence of MERS-CoV IgG in camels (95.1 %), followed by CCHFV IgG (56 %) and WNV IgG (23.3 %). On the other hand, the seropositivity of anti-RVFV IgG was 1.7 %, and none of the tested samples exhibited RVFV-reactive IgM antibodies. Moreover, 97 (52.2 %) camel samples tested positive for at least MERS-CoV- and CCHFV-reactive antibodies. Seroprevalences were comparable irrespective of the animals’ sex. Although MERS-CoV exposure was high in all age groups (&gt;92 %), a statistically significant difference in the anti-MERS-CoV IgG ELISA OD values was observed between samples collected from camels aged 10 years or above compared to those below the age of 5 years (<em>p</em> = 0.018).</div></div><div><h3>Conclusion</h3><div>Our study provided evidence of a relatively high ratio of exposure to MERS-CoV, CCHFV, and WNV in camels in Qatar. To better understand these zoonotic viral diseases, additional studies involving larger animal populations, investigating vector dynamics, and monitoring livestock movements in and out of the country are imperative.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 2","pages":"Article 103074"},"PeriodicalIF":4.0,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145681959","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":"Prevalence and genetic characteristics of Staphylococcus capitis proto-NRCS-A clone among colonizing isolates from healthy individuals in Japan","authors":"Mina Hirose ,&nbsp;Meiji Soe Aung ,&nbsp;Yukito Hirose ,&nbsp;Yasuhiro Nakanishi ,&nbsp;Taisei Kato ,&nbsp;Akihiro Ichimura ,&nbsp;Yoshihito Kurashige ,&nbsp;Sayaka Sakakibara ,&nbsp;Erika Minowa-Suzuki ,&nbsp;Masato Saitoh ,&nbsp;Noriko Urushibara ,&nbsp;Mitsuyo Kawaguchiya ,&nbsp;Nobuhide Ohashi ,&nbsp;Nobumichi Kobayashi","doi":"10.1016/j.jiph.2025.103071","DOIUrl":"10.1016/j.jiph.2025.103071","url":null,"abstract":"<div><h3>Objectives</h3><div><em>S. capitis</em> is among the coagulase-negative staphylococci (CoNS) and a commensal bacterium in humans. However, a virulent clone designated NRCS-A has been reported to be responsible for outbreaks of neonatal sepsis, primarily in Europe. This clone harbors virulence factors <em>nsr</em> and <em>tarJ</em>, and carries a type V SCC<em>mec</em>, showing multiple antimicrobial resistance. This study explored the prevalence of the (proto-)NRCS-A clone in healthy individuals and their genetic characteristics in Japan.</div></div><div><h3>Methods</h3><div>Staphylococci colonizing on the hand skin and the oral cavity of healthy individuals were isolated and analyzed for the species/subspecies by sequencing of 16S rRNA and <em>arcC</em>. The presence of virulence factors and antimicrobial resistance-associated genes were detected by PCR and sequencing. <em>S. capitis</em> isolates were genetically classified by double-locus (<em>arcC</em>-<em>rpoB</em>) sequence typing and peptide profile of PSMβ.</div></div><div><h3>Results</h3><div>Among 221 isolates of CoNS (19 species) recovered from 444 healthy adults, 82 isolates were identified as <em>S. capitis</em>. Virulence factors associated with the NRCS-A clone, i.e., <em>nsr</em>, <em>tarJ</em>, and <em>ebh</em> were detected in 29 %, 11 %, and 51 % of isolates, respectively, while <em>mecA</em>/SCC<em>mec</em> V was positive in only one isolate harboring solely <em>tarJ</em>. <em>arcC</em> and <em>rpoB</em> were classified into 14 and 10 allelic types, respectively. PSMβ consisted of 3, 4, or 6 units of 44 amino acid-peptide, forming eight different profiles. Both virulence factors <em>nsr</em> and <em>tarJ</em> were detected in 5 isolates (6 %), among which two isolates had the same PSMβ profile and <em>arcC</em>-<em>rpoB</em> types as those of the NRCS-A clone prototype strain CR01. The <em>mecA</em>-positive isolate was classified into the same <em>arcC</em>-<em>rpoB</em> lineage as that of CR01.</div></div><div><h3>Conclusion</h3><div>The present study revealed that SCC<em>mec</em>-negative <em>S. capitis</em> with <em>nsr</em>/<em>tarJ</em> (proto-NRCS-A clone) is distributed at low prevalence to healthy individuals in Japan. These isolates belonged to <em>arcC</em>-<em>rpoB</em> lineages close to that of the NRCS-A clone.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 2","pages":"Article 103071"},"PeriodicalIF":4.0,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145668415","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":"Regulatory mechanism of the oprM gene in colistin resistance of acinetobacter baumannii","authors":"Ling Wang ,&nbsp;Yuting Wang ,&nbsp;Huihuang Xu ,&nbsp;Wenjie Li ,&nbsp;Junshan Ruan","doi":"10.1016/j.jiph.2025.103068","DOIUrl":"10.1016/j.jiph.2025.103068","url":null,"abstract":"<div><h3>Background</h3><div>Colistin resistance in Acinetobacter baumannii (AB) is a serious clinical concern. This study aimed to identify resistance-related genes and assess their effects on resistance, growth, and pathogenicity.</div></div><div><h3>Methods</h3><div>Bioinformatics combined with machine learning identified candidate genes, validated by quantitative real-time PCR. The oprM gene was deleted in a colistin-resistant strain (COL-R) to obtain COL-R-ΔoprM. Minimum inhibitory concentration, growth, and biofilm formation were measured. A mouse lung infection model compared bacterial burden, inflammatory cytokines, and histopathology among the ATCC standard strain, COL-R, and COL-R-ΔoprM, with or without colistin.</div></div><div><h3>Results</h3><div>The oprM gene and F3P16_RS16375 were identified as candidate genes, with oprM expression markedly upregulated in induced COL-R. Deletion of oprM reduced the colistin MIC, and impaired biofilm formation. In vivo, COL-R-ΔoprM showed lower lung bacterial loads than COL-R strains. Compared with the corresponding infection group, the COL-R-∆oprM + COL group significantly reduced the expression levels of TNF-α, IL-1β, and IL-6, improved lung tissue damage, and effectively reduced the bacterial load in lung tissue (P &lt; 0.01), while there was no significant difference in all aspects of the COL-R + COL group (P &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>The oprM gene is a crucial determinant of colistin resistance in AB. Its deletion restores colistin susceptibility, impairs biofilm formation, and attenuates virulence. Targeting oprM may provide a promising approach for treating colistin-resistant AB infections.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 2","pages":"Article 103068"},"PeriodicalIF":4.0,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145616028","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":"Comparing definitions of SARS-CoV-2 infection in a prospective household transmission study","authors":"Jonas Frost ,&nbsp;Bianca Klee ,&nbsp;Sophie Diexer ,&nbsp;Kristin Maria Meyer-Schlinkmann ,&nbsp;Cornelia Gottschick ,&nbsp;Jonas Rosendahl ,&nbsp;Michael Gekle ,&nbsp;Stefan Moritz ,&nbsp;Simone Hettmer ,&nbsp;Jessica I. Hoell ,&nbsp;Irene Moor ,&nbsp;Thomas Frese ,&nbsp;Mascha Binder ,&nbsp;Christine Dierks ,&nbsp;Rafael Mikolajczyk","doi":"10.1016/j.jiph.2025.103069","DOIUrl":"10.1016/j.jiph.2025.103069","url":null,"abstract":"<div><h3>Background</h3><div>Identifying SARS-CoV-2 infections in field studies, especially if they are asymptomatic or reinfections, is challenging. This study aims to compare definitions of an infection and establish an approach to detect reinfections serologically, relying on titre increase.</div></div><div><h3>Methods</h3><div>In a household transmission study in autumn/winter 2022, we collected information on symptoms and two serological samples in a timespan of six to eight weeks from 389 participants of the German digital cohort DigiHero. Blood samples were drawn using dried blood spot cards and analysed in regard to the SARS-CoV-2 S and N antibody. We calculated secondary attack rates (SARs) using three definitions of infection from previous literature, based on reported symptoms or seroconversion, and two approaches accounting for reinfection in serological testing.</div></div><div><h3>Results</h3><div>SARs differed substantially between definitions. High initial seroprevalence in the study population led to underestimation of the SAR by over 20 % when using seroconversion compared to approaches accounting for reinfections. Symptom-based definitions resulted in misclassification likely due to infections with other pathogens and by disregarding asymptomatic cases.</div></div><div><h3>Conclusions</h3><div>This methodological study shows that relying on seroconversion is not adequate in high sero-prevalence settings and symptom-based approaches disregard asymptomatic cases. Approaches accounting for substantial titre increases between two antibody measurements reliably identified infections regardless of seroconversion and symptoms in a longitudinal serological assessment. This method could be useful for other pathogens, where asymptomatic disease and reinfections are common.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 2","pages":"Article 103069"},"PeriodicalIF":4.0,"publicationDate":"2025-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145616027","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":"Nationwide longitudinal evaluation of a machine learning approach for enhanced interpretation of Xpert MTB/RIF ultra rifampicin-resistance results in low bacterial load tuberculosis specimens","authors":"Tai-Han Lin ,&nbsp;Hsing-Yi Chung ,&nbsp;Ming-Jr Jian ,&nbsp;Chih-Kai Chang ,&nbsp;Yun-Wen Lai ,&nbsp;Cherng-Lih Perng ,&nbsp;Feng-Yee Chang ,&nbsp;Yuan-Hao Chen ,&nbsp;Hung-Sheng Shang","doi":"10.1016/j.jiph.2025.103064","DOIUrl":"10.1016/j.jiph.2025.103064","url":null,"abstract":"<div><h3>Background</h3><div>The World Health Organization (WHO) has identified tuberculosis (TB) as the leading cause of death from a single infectious agent. False-positive rifampicin (RIF) resistance results from the Xpert MTB/RIF Ultra assay are common in TB patients with low bacterial loads, especially among HIV-coinfected individuals. Hence, to distinguish genuine RIF resistance from false-positive results, this study developed and validated an artificial intelligence clinical decision support system (AI-CDSS).</div></div><div><h3>Methods</h3><div>Between January 2021 and March 2025, Taiwan's national TB reference laboratory received 10,353 respiratory specimens nationwide, identifying 2443 MTB-positive samples. The specimens were subjected to Xpert MTB/RIF Ultra testing and RIF resistance was confirmed using GenoType MTBDRplus assays. Molecular features, including cycle threshold (Ct) values, melting temperatures (Tm), and fluorescence intensities of rpoB probes, were analyzed. Three machine learning algorithms: random forest, gradient boosting classifier, and light gradient boosting machine (LGBM) were trained and validated.</div></div><div><h3>Results</h3><div>Ultra initially reported RIF resistance in 174 samples (7.1 %), with the highest false-positive rate of 12.2 % observed in samples with very low bacterial loads. LGBM demonstrated superior diagnostic performance (AUC = 0.99, sensitivity = 0.97, specificity = 0.99, and F1-score = 0.98). Key predictive features included Tm and fluorescence intensity, particularly in the rpoB3 region. Implementing the AI-CDSS significantly improved accuracy and reduced diagnostic turnaround times.</div></div><div><h3>Conclusions</h3><div>By leveraging the LGBM model, AI-CDSS effectively distinguished true RIF resistance from false-positive Xpert Ultra results, particularly among patients with low MTB bacterial loads. This approach enhances clinical decision making, optimizes treatment initiation, and conserves vital multidrug-resistant TB resources.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 2","pages":"Article 103064"},"PeriodicalIF":4.0,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145616064","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":"RSV-associated hospitalizations in Bangladeshi children under five: Unveiling the disease burden","authors":"Mst. Noorjahan Begum ,&nbsp;Yeasir Karim ,&nbsp;Sabik Khair ,&nbsp;Sumaiya Binte Hannan ,&nbsp;Selim Reza Tony ,&nbsp;Nure Sharaf Nower Samia ,&nbsp;Mohammad Jubair ,&nbsp;Shaheen Alam ,&nbsp;Mohammad Hridoy Patwary ,&nbsp;Anisuddin Ahmed ,&nbsp;Md Ariful Islam ,&nbsp;Tanzir Ahmed Shuvo ,&nbsp;Manjur Hossain Khan Jony ,&nbsp;Tahmina Shirin ,&nbsp;Fahmida Chowdhury ,&nbsp;Firdausi Qadri ,&nbsp;Mustafizur Rahman","doi":"10.1016/j.jiph.2025.103067","DOIUrl":"10.1016/j.jiph.2025.103067","url":null,"abstract":"<div><h3>Objectives</h3><div>Respiratory Syncytial Virus (RSV) is a leading cause of acute lower respiratory tract infections among children under five years of age globally. Despite its significant health burden, data on RSV infection in this age group in Bangladesh are limited. This study aims to estimate the prevalence of RSV among hospitalized Bangladeshi children under five years of age and to explore its distribution across key demographic factors, including age, sex, and geographic region.</div></div><div><h3>Methods</h3><div>We designed the study based on the hospital-based influenza surveillance conducted by icddr,b, enrolling children who presented with severe acute respiratory infections (SARI) or influenza-like illness (ILI) symptoms. Both nasopharyngeal and oropharyngeal swabs from each participant were collected and subjected to real-time RT-PCR for RSV detection. Data were analyzed using descriptive statistics, chi-square tests and multiple logistic regression.</div></div><div><h3>Results</h3><div>From October 2022 to December 2024, we enrolled 8203 patients with SARI and ILI, of whom 2758 tested positive for RSV. RSV was detected at a significantly higher proportion among SARI cases 2583 (36 %), compared to ILI cases 175 (16 %) (p &lt; 0.001). Infants under six months exhibited the highest infection proportion (44 %), with prevalence decreasing with age. RSV activity in Bangladesh begins in the southern districts in August and peaks nationwide between October and December.</div></div><div><h3>Conclusions</h3><div>This study highlights a significant RSV burden among children less than six months of age with SARI. These findings emphasize the need for targeted age-specific control measures to reduce hospitalization.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 2","pages":"Article 103067"},"PeriodicalIF":4.0,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145616029","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":"Malignant pertussis in infants: 4 new cases in French Guiana","authors":"Cédric Ngila Lubunu ,&nbsp;Christelle Samou-Fontcho ,&nbsp;Urbain Agbessy Awanou ,&nbsp;Narcisse Elenga","doi":"10.1016/j.jiph.2025.103065","DOIUrl":"10.1016/j.jiph.2025.103065","url":null,"abstract":"<div><div>Malignant pertussis is a severe form of pertussis characterized by respiratory distress, polyvisceral failure, and marked hyperlymphocytosis. It typically presents with profound leukocytosis, pulmonary hypertension, and respiratory failure. We report four cases of malignant pertussis in young infants. One patient underwent exchange transfusion. The case fatality rate was 50 %. Preventing these severe and often fatal cases—associated with high mortality and significant intensive care costs—relies primarily on vaccination. Immunization should be ensured for all infants and extended to adults at risk of transmitting the infection to unimmunized infants.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 2","pages":"Article 103065"},"PeriodicalIF":4.0,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145616036","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 early dexamethasone administration and mortality in SARS-CoV-2 infection: A cohort study","authors":"Renata Báez-Saldaña ,&nbsp;Ernesto Murillo-Trejo ,&nbsp;Lina Barranco-Garduño ,&nbsp;Juan Carlos Neri-Salvador ,&nbsp;Thalia Jacobo-Vargas ,&nbsp;Ana Laura Bazany-Rivero ,&nbsp;Uriel Rumbo-Nava","doi":"10.1016/j.jiph.2025.103066","DOIUrl":"10.1016/j.jiph.2025.103066","url":null,"abstract":"<div><h3>Background</h3><div>Dexamethasone, or equivalent corticosteroids, are recommended for patients with SARS-CoV-2 pneumonia, regardless of respiratory failure status. However, the effects of giving dexamethasone within the first seven days after symptom onset—during the viremic phase—have not been sufficiently studied in clinical trials or observational studies. As a result, the best timing for starting corticosteroids remains uncertain. This study aimed to evaluate the effect of dexamethasone administration within seven days of symptom onset from SARS-CoV-2 infection on mortality and the need for invasive mechanical ventilation among hospitalized patients with severe pneumonia.</div></div><div><h3>Methods</h3><div>This cohort study included hospitalized patients aged 18 years or older with severe SARS-CoV-2 pneumonia. The exposure was dexamethasone use before hospitalization, and the outcome measures included in-hospital mortality and invasive mechanical ventilation. Patients were monitored until discharge or death in the hospital. Logistic regression was used to evaluate the association between pre-hospitalization dexamethasone administration and mortality.</div></div><div><h3>Results</h3><div>We enrolled 234 patients. The median age was 56 years, and 70.5 % were men. Before hospitalization, dexamethasone was administered to 125 (53 %) patients within the first seven days of symptom onset, which was linked to mortality (OR [95 % CI] 3.58 [1.51–8.48]) and the need for invasive mechanical ventilation (OR [95 % CI] 2.59 [1.46–4.59]), after adjusting for factors such as, sex, Charlson comorbidity index ≥ 3, neutrophil count over 8500 cells/mm^³, and albumin below 3 g/dL.</div></div><div><h3>Conclusion</h3><div>Administering dexamethasone within the first seven days of SARS-CoV-2 infection may be associated with a higher risk of death in hospitalized patients with severe pneumonia. These findings emphasize the importance of carefully timing corticosteroid treatment in COVID-19 patients.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 2","pages":"Article 103066"},"PeriodicalIF":4.0,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145616030","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":"Prevalent fungal pathogens and antifungal resistance in Lebanon: A scoping review","authors":"Yara Khachab ,&nbsp;Majd Bou Ghader ,&nbsp;Vera Tahesh ,&nbsp;Racha Khoumassi ,&nbsp;Elie Salem Sokhn","doi":"10.1016/j.jiph.2025.103062","DOIUrl":"10.1016/j.jiph.2025.103062","url":null,"abstract":"<div><div>Fungal infections are an increasing public health concern in Lebanon, particularly among immunocompromised individuals. Common pathogens include <em>Candida albicans</em>, <em>C. glabrata (Nakaseomyces glabrata)</em>, <em>C. parapsilosis</em>, <em>C. tropicalis</em>, and emerging <em>C. krusei (Pichia Kudriavzevii)</em>, alongside dermatophytes such as <em>Trichophyton</em>, <em>Microsporum</em>, and <em>Epidermophyton</em> species. <em>Aspergillus fumigatus</em>, <em>A. flavus</em>, <em>A. niger</em>, and <em>A. tubingensis</em> are the predominant causes of respiratory and systemic infections. Although azoles, echinocandins, and polyenes remain key antifungal agents, rising resistance particularly azole resistance in <em>Aspergillus</em> and echinocandin resistance in <em>Candida</em> poses a major therapeutic challenge.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 2","pages":"Article 103062"},"PeriodicalIF":4.0,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145616031","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":"Development and validation of a risk stratification score for hemophagocytic syndrome in chronic active Epstein-Barr virus infection: A 10-year retrospective cohort study","authors":"Fei Hu ,&nbsp;Jiayi Zhan ,&nbsp;Meijuan Peng ,&nbsp;Haifeng Hu ,&nbsp;Xuyang Zheng ,&nbsp;Danfeng Ren ,&nbsp;Rui Li ,&nbsp;Hong Du ,&nbsp;Wen Tian ,&nbsp;Zhanhu Bi ,&nbsp;Denghui Yu ,&nbsp;Hongkai Xu ,&nbsp;Xiaofei Yang ,&nbsp;Yan Liang ,&nbsp;Fangfang Li ,&nbsp;Jingtao Hou ,&nbsp;Yingli He ,&nbsp;Jianqi Lian","doi":"10.1016/j.jiph.2025.103061","DOIUrl":"10.1016/j.jiph.2025.103061","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to identify risk factors for the development of hemophagocytic lymphohistiocytosis (HLH) within three years among patients with chronic active Epstein-Barr virus infection (CAEBV) and to construct a risk stratification score.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted involving 165 patients with CAEBV admitted to two infectious disease centers in Northwest China between January 2012 and December 2022, through which we identified independent risk factors for HLH. Cox regression was utilized to establish the nomogram model and generate the risk stratification score. The discrimination and clinical utility of both the nomogram and score models were subsequently assessed using calibration plots, receiver operating characteristic (ROC) curves, decision curve analysis (DCA), and cross-validation.</div></div><div><h3>Results</h3><div>Among the 165 patients, 98 (59.4 %) developed HLH within three years. The median progression time was 405 days (IQR: 217, 740), with cumulative incidence rates of HLH at 1, 2, and 3 years of 41.3 %, 56.1 %, and 65.9 %, respectively. Five independent predictors were identified: cytopenia (HR: 1.70, 95 % CI: 1.07–2.70), EBV-DNA load in plasma (HR: 2.02, 95 % CI: 1.46–2.80), alanine aminotransferase (HR: 1.34, 95 % CI: 1.12–1.60), ferritin (HR: 1.01, 95 % CI: 1.01–1.01), and triglycerides (HR: 1.21, 95 % CI: 1.05–1.38). Both the nomogram and simplified score model demonstrated excellent discrimination (AUC &gt; 0.7) and reliable calibration within a 3-year timeframe. The score model exhibited predictive power comparable to the nomogram, as indicated by net reclassification index and integrated discrimination index analyses.</div></div><div><h3>Conclusion</h3><div>The validated nomogram and score model facilitate rapid HLH risk stratification in CAEBV patients, supporting clinical risk assessment and early intervention.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 3","pages":"Article 103061"},"PeriodicalIF":4.0,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145802284","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}