BMC Infectious Diseases最新文献

Background: Patients with pulmonary tuberculosis (PTB) experience complex and co-occurring symptoms. Understanding the structure of these symptom clusters and their interrelationships is crucial for effective management. This study aimed to map the symptom network and identify core symptoms and clusters among PTB patients in China and targets for precise intervention.

Methods: A convenience sampling method was used to recruit 356 pulmonary tuberculosis patients between November 2024 and April 2025 from Shenzhen Third People's Hospital. Data were collected using a sociodemographic questionnaire and the Chinese version of the Memorial Symptom Assessment Scale (MSAS-C), a valid and reliable instrument (Cronbach's α = 0.87) for this population. Data normality was assessed using Shapiro-Wilk tests; non-normally distributed continuous variables were expressed as median and interquartile range. Exploratory factor analysis was used to identify symptom clusters, and a symptom network was analyzed using the qgraph package in R, with strength centrality serving as the primary metric for identifying core symptoms.

Results: The exploratory factor analysis demonstrated appropriate sampling adequacy, as indicated by a KMO value of 0.643 and a significant Bartlett's test of sphericity (χ²= 661.633, p < 0.001). This study identified four symptom clusters in patients with pulmonary tuberculosis: nutritional deficiency symptoms (eigenvalue = 2.001), inflammatory-related symptoms (eigenvalue = 1.692), somatic discomfort symptoms (eigenvalue = 1.563), and respiratory system-related symptoms (eigenvalue = 1.529). These four clusters collectively accounted for 54.76% of the total variance. The symptom network revealed edge weights ranging from |r| = 0.01 to 0.42, and centrality indices demonstrated good stability (correlation stability coefficient of strength = 0.689). Core symptoms included difficulty sleeping (strength rs = 2.691), fatigue (rs = 2.681), lack of appetite (rs = 2.654), and weight loss (rs = 2.604).

Conclusion: These findings identified four symptom clusters in pulmonary tuberculosis patients, with difficulty sleeping, fatigue, lack of appetite, and weight loss constituting the core symptoms. A targeted management strategy should prioritize these core symptoms through structured monitoring and intervention. Future longitudinal studies are needed to validate symptom dynamics and develop PTB-specific assessment tools.

Clinical trial number: Not applicable.

Background: Human papillomavirus (HPV) infection represents a major public health concern in both women and men, contributing to a substantial anogenital and oropharyngeal disease burden. Nevertheless, comprehensive data on the genotype-specific epidemiology of HPV in the male population in Wuhan, China, are lacking. This study was conducted to address this gap.

Methods: We conducted a retrospective cross-sectional study of 2,999 male subjects undergoing HPV testing at Renmin Hospital of Wuhan University (January 2017 to July 2025) to analyze the prevalence and genotypic distribution of HPV.

Results: Among 2,999 males, overall HPV prevalence was 38.6%, predominantly low-risk single-type infections. The top five genotypes were HPV6, HPV11, HPV16, HPV52, and HPV59. Although 20-39 year-olds comprised the largest proportion of cases, peak prevalence occurred in youth (≤ 20y) and elderly (≥ 60y) groups (P < 0.001 for age difference). HPV6 was the most common genotype in every age stratum.

Conclusion: In this group of males in Wuhan, HPV infection prevalence was relatively high and dominated by low-risk, single-type infections. Adolescents (≤ 20 years) and older men (≥ 60 years) are at highest risk. These findings support enhanced HPV education targeting youth and the elderly and broader promotion of HPV vaccination among males.

Background: Nocardiae are ubiquitous environmental soil pathogens that primarily cause invasive infections by inhalation or direct skin inoculation in immunocompromised patients. This multi-year population-based study compared epidemiological and clinical features of all cases diagnosed in our region.

Methods: Patients were enrolled in our large integrated healthcare region with culture-proven nocardiosis between 2010 and 2021. Clinical chart reviews were conducted to determine the clinical manifestations, risk factors, treatment and mortality including survival analysis.

Results: Ninety-four adults had a mean age of 61 ± 17 years. More cases occurred in males (57%) than females (43%). 96% of cases had underlying co-morbidities including diabetes, liver or renal failure, malignancy, transplant recipients, chronic lung disease, rheumatologic disease, or other inflammatory conditions. Pulmonary (53%) or skin and soft tissue infections (SSTIs) (30%) commonly occurred with infrequent diagnoses of central nervous system infection (CNS) (7%), bloodstream infection (BSI) (6%), and septic arthritis or intra-abdominal infection (IAI) (6%). Diverse Nocardia spp. were isolated, but 3 species complexes caused most cases [56/94 (60%)] including Nocardia farcinica (n = 21, 22.3%), Nocardia cyriacigeorgica (n = 16, 17%) and Nocardia nova (n = 19, 20.2%). Clinical presentation was not unique for individual Nocardia spp.

Infections: Overall mortality was 17.6% with a 1-year mortality of 13.2%. Delayed diagnosis (≥ 30 d) from symptom onset had higher mortality. A trend towards increased mortality occurred for N. farcinica > N. cyriacigeorgica > N. nova complex infections.

Conclusions: Prompt diagnosis of nocardiosis improves patient outcomes. Nocardia species-level identification predicts mortality for major species complexes causing nocardiosis in our region.

Clinica trial number: Not applicable.

Background: Brucellosis is endemic in north-western China, and Brucella spp. bacteraemia is a clinically important manifestation that may indicate more severe disease. However, robust and clinically interpretable predictors to prioritise blood cultures in resource-limited county-level hospitals are lacking. We aimed to compare admission clinical and routine laboratory features between bacteraemic and non-bacteraemic brucellosis and to develop a simple, clinically interpretable model to predict bacteraemia.

Methods: We retrospectively analysed 518 adults with brucellosis admitted to two county-level hospitals in Ningxia, China, from January 2014 to June 2024. Brucellosis was confirmed by blood culture and/or concordant admission serology (Rose Bengal test positivity with a standard tube agglutination test titre ≥ 1:160). Brucella spp. bacteraemia was defined as ≥ 1 positive blood culture obtained at admission; non-bacteraemic infection was defined as all admission blood cultures negative. We compared demographic, clinical, and routine laboratory variables and fitted multivariable logistic regression models with bootstrap internal validation and calibration assessment.

Results: Of 518 patients, 198 were bacteraemic and 320 were non-bacteraemic. Bacteraemic patients were older, more often had acute-onset disease, and more frequently had objectively documented fever and chills than non-bacteraemic patients. They also had higher inflammatory and liver-injury markers and lower albumin concentrations. For single predictors, the area under the receiver operating characteristic curve (AUC, 95% confidence interval) was 0.827 (0.790-0.863) for LDH, 0.749 (0.700-0.799) for CRP, 0.717 (0.670-0.765) for albumin (lower concentrations), and 0.688 (0.638-0.731) for ALT. The combined clinical-laboratory model achieved an AUC of 0.906 (0.878-0.929).

Conclusions: A combined clinical-laboratory model based on readily available admission data showed excellent discrimination for early risk stratification of bacteraemia among adults with brucellosis, with acceptable internal calibration, and warrants external validation in other endemic, resource-limited settings.