BMC Infectious Diseases最新文献

Objective: To analyze the prevalence and subtype distribution of human papillomavirus (HPV) infection in Sanmen County, Zhejiang Province, China, and the correlation between ThinPrep cytologic test (TCT) results.

Methods: A retrospective analysis was conducted on the demographic and clinical data of patients who underwent HPV typing and TCT at Sanmen People's Hospital from January 2020 to December 2022. The HPV infection rate in the region was calculated, and the HPV infection status among patients in different age groups and departments was compared, as well as the relationship between different HPV types and TCT results.

Results: A total of 19,116 patients were included in the study. The overall HPV infection rate was 16.3%, single-type of infection accounted for 82.7% and multiple-type of infection accounted for 17.3%, with a high-risk type infection rate of 12.6% and a low-risk type infection rate of 2.7%. The top six HPV types in positive cases were type 52 at 24.3%, type 58 at 13.4%, type 53 at 12.5%, type 81 at 9.0%, type 16 at 7.3%, and type 68 at 5.8%. The results revealed a significant difference in HPV infection rates among age groups, with the < 25-year group having the highest infection rate at 21.1%. The proportion of abnormal TCT results was 8.0%, there was no significant difference in the comparison of abnormal TCT results among age groups, and no cases of high-grade squamous intraepithelial lesions were found in the < 25-year group. HPV type 16 had the highest positivity rate in cases of high-grade squamous intraepithelial lesion group.

Conclusion: HPV infection in the region is mainly single-type. The most common types were high-risk HPV 52, 58, and 53, with the highest HPV infection rate found in the < 25-year group. High-grade squamous intraepithelial lesion were closely related to infections with HPV 16, 58, 52, and 18.

Background: Cleaning the external urethral orifice in patients with indwelling catheters can effectively reduce the number of local microorganisms. Employing appropriate disinfection strategies can prevent between 17% and 69% of catheter-associated urinary tract infection (CAUTI) cases. However, the optimal antiseptics and their conditions of use (temperature, concentration, and exposure time) remain unclear.

Methods: The suspension quantitative bactericidal test method was employed to evaluate the bactericidal efficacy of two skin and mucous membrane antiseptics, BAC and AEOW, against common pathogens associated with CAUTI in the elderly under various conditions.

Results: Within the observation period, except for the standard strains of E. faecium, other pathogens achieved bactericidal efficacy after being exposed to BAC for 1 min. When the antiseptic is heated to 40 °C, the standard strains of E. faecium can also achieve bactericidal efficacy after being exposed to it for 5 min. Furthermore, upon the addition of 30 g/L bovine serum albumin (BSA) to AEOW, all pathogens except for the clinical strain of E. faecium exhibited bactericidal efficacy within 1 min. When the antiseptic is heated to 40 °C, the clinical strain of E. faecium showed bactericidal efficacy for 3 min. When 3 g/L BSA interference substance was incorporated into AEOW, all pathogens achieved bactericidal efficacy for 30 s.

Conclusion: BAC and AEOW exhibit effective bactericidal activity against common pathogens associated with CAUTI in elderly patients. When used for perineal irrigation, these antiseptics can be heated for improved patient comfort, as temperatures within the range of 40 °C do not affect their disinfection efficacy.

Background: Mucormycosis is a life-threatening complication that occurs in haematopoietic stem cell transplantation (HSCT) recipients. Among mucormycosis patients, those infected with Cunninghamella bertholletiae have the poorest prognosis because of the high virulence and angioinvasive nature of this organism. Despite its high vascular invasiveness, pseudoaneurysm caused by C. bertholletiae in HSCT recipients has rarely been reported.

Case presentation: An 8-year-old HSCT recipient experienced recurrent fever, cough and pain after HSCT. Teicoplanin, acyclovir, posaconazole and caspofungin were used for infection prophylaxis. The sputum, stool, urine, peripheral blood and central venous catheter (CVC) blood culture results were negative. Next-generation sequencing (NGS) of the peripheral blood, pleural effusion and bronchoalveolar lavage fluid revealed the presence of C. bertholletiae, and amphotericin B combined with posaconazole was administered; however, the infection progressed. Fibreoptic bronchoscopies revealed that C. bertholletiae had invaded the bronchial wall, and enhanced computerized tomography (CT) revealed a pseudoaneurysm of the descending aorta resulting from C. bertholletiae. Debridement and vessel replacement were considered but not performed because of the severity of the infection and the patient's poor physical condition. Unfortunately, the patient died from pseudoaneurysm rupture with no presymptoms 56 d after HSCT.

Conclusion: For the first time, we report pseudoaneurysm secondary to C. bertholletiae infection in a HSCT recipient, highlighting the importance of clinical awareness of vessel lesions resulting from C. bertholletiae and emphasizing the value of enhanced CT for the early detection of vessel lesions in this rare infection.

Background: Scabies is an infestation that can be seen in all age groups, ethnicities, genders, socio-economic groups and in all societies. It is estimated that there are at least 200 million cases worldwide yearly. In this study, we aimed to evaluate the situation before, during and after Covid- 19.

Methods: All patients admitted to our outpatient clinic between January 1, 2017 and April 30, 2024 and patients diagnosed with scabies were included in our study and examined retrospectively. The age and gender of the patients, the number of patients admitted monthly and the number of patients diagnosed with scabies among them were evaluated monthly.

Results: Between January 1, 2017 and April 30, 2024, 257,536 patients applied to our outpatient clinic. Of these patients, 9407 were diagnosed with scabies. When the percentage of cases was evaluated by years, it was observed that it started to increase in 2019, reached high levels and remained stable in 2020-2022, and then continued to rise in the first 4 months of 2023 and 2024.

Conclusion: As a result, we found an increase in the number of scabies cases during the pandemic period. Although the rate of scabies cases is stable between 2020 and 2022, it is seen that the increase continues and will continue in 2023 and the following years.

Background: Primary esophageal tuberculosis is an uncommon manifestation of Mycobacterium tuberculosis infection in Asian adults, often presenting with nonspecific symptoms that can complicate diagnosis. This report details a case of primary esophageal tuberculosis in middle age female, emphasizing the diagnostic value of computed tomography (CT) imaging.

Case presentation: The patient, a 46-year-old female from Sichuan Province, China, experienced recurrent choking and mild retrosternal pain postprandially. She exhibited a weight loss of approximately 1 kg over a week, without additional symptoms such as dysphagia or fever. Esophagoscopy disclosed a small ulcer, and CT imaging revealed esophageal wall thickening with mucosal ulceration. A left thoracic lower and middle esophagectomy was conducted, with postoperative pathology confirming granulomatous inflammation, indicative of tuberculosis.

Conclusions: This case highlights the pivotal role of CT imaging in diagnosing primary esophageal tuberculosis. The imaging modality's ability to delineate subtle mucosal ulcerations and wall thickening provides a crucial diagnostic advantage, facilitating accurate and timely diagnosis of this rare condition.

Background: Invasive Cerebral Aspergillosis (ICA) is a rare fungal infection affecting the brain, primarily seen in individuals with compromised immune systems. Despite various treatment options, substantial cerebral granulomas caused by ICA still result in high mortality and recurrence rates.

Case presentation: We report a rare instance of ICA in a 30-year-old pregnant woman. The infection initiated in the nasal cavity and progressed to form a large intracranial granuloma, leading to brain herniation. Diagnosis was confirmed through histopathology, Polymerase Chain Reaction (PCR), and metagenomic next-generation sequencing (mNGS) following decompressive craniotomy and sinus window drainage surgery. Prompt administration of antifungal medication resulted in a favorable prognosis.

Conclusion: This case highlights the critical roles of mNGS and PCR in the early diagnosis of ICA, as well as the pivotal importance of surgical interventions and prompt initiation of antifungal therapy in enhancing patient outcomes.

Background: Serratia marcescens, a gram-negative bacterium once considered non-pathogenic, is now recognized as a cause of hospital-acquired infections, particularly in immunocompromised patients with outbreaks reported in neonatal intensive care units. In newborns, it can result in severe illness, including sepsis and meningitis. It is well recognized by the production of pink pigment found on drains and other equipment, including breast pumps.

Case report: We report a case of a two-month-old previously healthy infant with upper gastrointestinal bleeding, whose mother had pink-stained expressed breast milk. Cultures of the breast milk and gastrointestinal aspirates of the infant grew S. marcescens. The infant received proton pump inhibitors, blood transfusions, and antibiotics, with successful resolution of the bleeding.

Conclusion: S. marcescens should be considered a potential cause of gastrointestinal bleeding in infants at risk. Although previously known to cause outbreaks in vulnerable infants, pathogenicity in healthy infants is also possible. Maintaining strict hygiene of feeding and breast milk pumping equipment is important to prevent infections in infants.

Introduction: This study aimed to evaluate the epidemiological trends and spatial-temporal distribution of hepatitis C virus (HCV) in mainland China.

Methods: HCV monthly incidence surveillance data from 2004 to 2018 was mainly available from the Public Health Sciences Data Center of China. Five models (Bayesian age-period-cohort, BAPC; Auto-regressive integrated moving average, Auto_arima; Exponential smoothing, ETS; Prophet; Earth) were used to forecast the incidence. Temporal-spatial scanning analysis was conducted to visualize the grading of hepatitis C incidence in mainland China.

Results: This study observed 180 months of data from January 2004 and December 2018. A total of 2,278,280 hepatitis C cases and 1771 deaths were reported, with an average annual reported incidence rate of 11.24/100,000. The BAPC model indicated that the indexes (mean absolute error, MAE; mean absolute percentage error, MAPE; mean squared error, MSE; root mean square error, RMSE) in the BAPC model were better than those of the other models (4.33 × 10^- 6, 0.03, 2.34 × 10^- 11, 4.84 × 10^- 6), and annual reported HCV incidence in mainland China would remain at a high level of 17.92/100,000 until 2030. Spatial-temporal aggregation analysis indicated that the time range of the first-class aggregation area was from January 1, 2012 to December 31, 2018, and the aggregation area was in Xinjiang, Qinghai, Gansu, Tibet, Ningxia, Inner Mongolia, Sichuan, Shaanxi, Shanxi, Chongqing, Hebei, Beijing, Henan and Yunnan provinces (relative risk, RR = 2.15, log-likelihood ratio, LLR = 129946.01, P < 0.001).

Conclusions: In summary, this study showed that the incidence of HCV in mainland China continued to be high, and BAPC model suggested that this trend will continue until at least 2030. In order to effectively control the HCV epidemic, it was necessary to strengthen blood safety management, expand screening for high-risk population, improve public awareness of HCV, and provide timely and effective antiviral treatment in potentially high-risk areas.

Background: Long-acting injectable antiretroviral therapy (LAI ART) is a new, and innovative approach to HIV treatment, designed to address several challenges, including the adherence issues associated with daily oral ART. This review synthesizes existing literature on the barriers and strategies for implementing LAI ART in the sub-Saharan Africa region, while identifying key knowledge gaps and research priorities.

Methods: We performed a comprehensive literature search, encompassing electronic databases and grey literature sources. Our review included 18 studies published between 2014 and 2023, focusing on the acceptability, feasibility, effectiveness, and cost-effectiveness of LAI ART in SSA. A narrative synthesis approach was employed for reporting review findings.

Results: Our review revealed a high demand and acceptability of LAI ART among people living with HIV in SSA, particularly those facing stigma and discrimination. LAI ART can improve adherence, retention, and viral suppression while reducing pill burden and frequent clinic visits. Implementation challenges include lack of regulatory approval, high cost, limited supply chain, health system capacity, trained staff, and cold storage facilities. Further research on safety and efficacy, as well as efforts in advocacy, policy, and community engagement, are needed to ensure accessibility and equity.

Conclusion: This review highlights key knowledge gaps and research priorities essential for the successful implementation of LAI ART in sub-Saharan Africa. Addressing these gaps such as evaluating long-term outcomes, understanding drug resistance, and exploring the impact on sexual and reproductive health will be critical to ensuring the broader accessibility, effectiveness, and sustainability of LAI ART in the region. Further research on the experiences and preferences of different subgroups, as well as the interaction with other medications and co-infections, is also needed to inform tailored implementation strategies.

Clinical trials number: Not applicable.

Background: Since the first detection of dengue in 2000, Bangladesh has been facing an increasing number of dengue patients and related deaths every year. This situation warrants the importance of quickly identifying severe dengue patients to expedite necessary medical interventions which could potentially reduce the adverse consequences. The aim of this study was to identify clinical features and laboratory parameters of the severe dengue patients in the 2023 dengue outbreak in Bangladesh.

Methods: This hospital based cross-sectional study included the demographic, clinical and laboratory data of 1313 Dengue patients from several secondary and tertiary hospitals across Bangladesh from August 2023 to December 2023. According to the 2009 WHO classification, dengue cases were classified into severe dengue and non-severe dengue (with and without warning signs). Chi-square test, Fischer's exact test and multiple logistic regression analyses were conducted to identify potential risk factors associated with severe dengue cases.

Results: Of the 1313 patients included in this study, nearly 20% had severe dengue, 36.71% of them were from the 16-25 year age bracket and nearly two-thirds were male. Fever (99.54%) was the most common clinical symptom followed by anorexia (69.54%) and severe headache (66.03%); whereas most common warning signs were severe lethargy (43.64%), persistent vomiting (27.57%), and severe abdominal pain and tenderness (20.03%) across all patients. Gastrointestinal symptoms such as nausea, vomiting, and diarrhea are significantly more common in severe dengue cases compared to non-severe ones. Among the laboratory parameters, decrease of platelet level and increased ALT level was more prominent in severe patients. Multiple logistic regression analysis found that severe abdominal pain, severe lethargy, respiratory distress, altered mental status, decreased urine output, pleural effusion and ascites were positively associated with the development of severe dengue.

Conclusion: This study presents warning signs, clinical symptoms and trends of laboratory parameters associated with severe cases of dengue in Bangladesh that can be used in improving patient management in the future.