Infectious Disease Reports

18 pages, 293 KiB

Open AccessArticle

Demographical and Clinical Characteristics, Risk Factors, and Prognosis of Adult Patients with Herpes Zoster in Türkiye: A Retrospective, Multi-Center Study (VARICOMP-Adult Study)

by Esin Senol, Alpay Azap, Selda Sayin Kutlu, Murat Kutlu, Ayse Erbay, Pelin Kocyigit, Emine Colgecen, Ozlem Ozbagcivan, Nilsel Ilter, Funda Yetkin, Serpil Sener, Birsen Mutlu, Rebiay Kiran, Nese Saltoglu, Burhan Engin and Ener Cagri Dinleyici

Infect. Dis. Rep. 2025, 17(3), 68; https://doi.org/10.3390/idr17030068 - 11 Jun 2025

Abstract

Introduction: Over the past few decades, the rising incidence of herpes zoster (HZ) rates appears to have been a global phenomenon. In Türkiye, there is a lack of comprehensive studies addressing the HZ burden of disease, risk factors, and clinical characteristics. The aim [...] Read more.

Introduction: Over the past few decades, the rising incidence of herpes zoster (HZ) rates appears to have been a global phenomenon. In Türkiye, there is a lack of comprehensive studies addressing the HZ burden of disease, risk factors, and clinical characteristics. The aim of the VARICOMP-Adult study was to evaluate the clinical and demographic findings of adult patients with HZ. Patients and Methods: We enrolled the medical records of 1955 patients, 1010 females and 945 males, aged between 18 and 97 years between 2009 and 2014. Results: The presence of underlying conditions was present in 35.5% of patients and 345 patients (17.6%) had immunosuppression; 18.0% of patients required hospitalization. The mean age, the presence of underlying conditions, and immunosuppression in hospitalized cases with HZ were higher than those in outpatients. Logistic regression analysis revealed the following risk factors for hospitalization: age, immunosuppression, hypertension, hematological disorders, transplantation, COPD, and the presence of HZ opthalmicus or disseminated disease. We observed seven HZ cases with mortality aged between 58 and 80 years, and all cases had an underlying condition; 9.9% of the entire population reported postherpetic neuralgia (PHN), and age and no previous antiviral medications were the risk factors for PHN. Conclusions: This is the largest nationwide study of adult patients with HZ. Effective healthcare interventions such as antiviral therapy and immunization could prove beneficial in combating disease and treating HZ complications, especially in the high-risk population and individuals of older ages. Full article

(This article belongs to the Special Issue Viral Infectious Diseases: Epidemiology and Prevention through Vaccination)

11 pages, 540 KiB

Open AccessArticle

The New Reality of Infective Endocarditis: Changes in Patient Demographics and Outcomes in South Carolina

by Grant Garrison, Julie Royer, Max Habicht, Sarah Battle, Hana R. Winders, Kayla Antosz, Anna-Kathryn Burch, Majdi N. Al-Hasan, Julie Ann Justo and Pamela Bailey

Infect. Dis. Rep. 2025, 17(3), 67; https://doi.org/10.3390/idr17030067 - 11 Jun 2025

Abstract

Background: Rising rates of opioid use disorder (OUD), usually via injection, has resulted in younger patients being diagnosed with infective endocarditis (IE), with unique treatment challenges. Methods: This retrospective ecological study analyzed hospital discharge and home health records from 2016 to 2022 in [...] Read more.

Background: Rising rates of opioid use disorder (OUD), usually via injection, has resulted in younger patients being diagnosed with infective endocarditis (IE), with unique treatment challenges. Methods: This retrospective ecological study analyzed hospital discharge and home health records from 2016 to 2022 in South Carolina (SC). Cases of IE with concurrent coding for OUD were identified. Differences in patient demographics, hospital characteristics, length of care days, and charges by OUD status were determined using chi-square or t-tests. IE hospitalization rates by OUD status, year, and age group were calculated, and linear regression was used to determine differences by year. Results: There were 8601 acute-care hospitalization records for IE from 2016 to 2022 in the SC dataset, of which 1180 (13.7%) had concurrent OUD coding. Statistically significant differences between patients with and without OUD were identified for sex, age group, race, resident rurality, average number of comorbidities, disposition status, and year (all p < 0.01). The incidence rate of IE increased from 2.5/100,000 in 2016 to 6.9/100,000 in 2022 in patients aged 36 to 49 years with OUD (p = 0.02). Patients with IE and OUD who were discharged home had significantly longer lengths of stay in acute care hospitals (32.9 vs. 15.3 days; p < 0.01) and excessive hospital charges ($308,874 vs. $188,862) compared to those without OUD. Conclusions: Major changes have occurred in the demographics of IE in SC. The increasing incidence rate of IE in younger adults with OUD coupled with prolonged stays at acute care hospitals pose challenges to the healthcare system that require creative solutions. Full article

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16 pages, 1995 KiB

Open AccessReview

Gut Microbiome in Pulmonary Arterial Hypertension—An Emerging Frontier

by Sasha Z. Prisco, Suellen D. Oliveira, E. Kenneth Weir, Thenappan Thenappan and Imad Al Ghouleh

Infect. Dis. Rep. 2025, 17(3), 66; https://doi.org/10.3390/idr17030066 - 9 Jun 2025

Abstract

Pulmonary arterial hypertension (PAH) is an irreversible disease characterized by vascular and systemic inflammation, ultimately leading to right ventricular failure. There is a great need for adjunctive therapies to extend survival for PAH patients. The gut microbiome influences the host immune system and [...] Read more.

Pulmonary arterial hypertension (PAH) is an irreversible disease characterized by vascular and systemic inflammation, ultimately leading to right ventricular failure. There is a great need for adjunctive therapies to extend survival for PAH patients. The gut microbiome influences the host immune system and is a potential novel target for PAH treatment. We review the emerging preclinical and clinical evidence which strongly suggests that there is gut dysbiosis in PAH and that alterations in the gut microbiome may either initiate or facilitate the progression of PAH by modifying systemic immune responses. We also outline approaches to modify the intestinal microbiome and delineate some practical challenges that may impact efforts to translate preclinical microbiome findings to PAH patients. Finally, we briefly describe studies that demonstrate contributions of infections to PAH pathogenesis. We hope that this review will propel further investigations into the mechanisms by which gut dysbiosis impacts PAH and/or right ventricular function, approaches to modify the gut microbiome, and the impact of infections on PAH development or progression. Full article

(This article belongs to the Special Issue Pulmonary Vascular Manifestations of Infectious Diseases)

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19 pages, 7883 KiB

Open AccessArticle

Differential Effects of Human Immunodeficiency Virus Nef Variants on Pulmonary Vascular Endothelial Cell Dysfunction

by Amanda K. Garcia, Noelia C. Lujea, Javaria Baig, Eli Heath, Minh T. Nguyen, Mario Rodriguez, Preston Campbell, Isabel Castro Piedras, Edu Suarez Martinez and Sharilyn Almodovar

Infect. Dis. Rep. 2025, 17(3), 65; https://doi.org/10.3390/idr17030065 - 6 Jun 2025

Abstract

Background: Human Immunodeficiency Virus (HIV) infections remain a source of cardiopulmonary complications among people receiving antiretroviral therapy. Still to this day, pulmonary hypertension (PH) severely affects the prognosis in this patient population. The persistent expression of HIV proteins, even during viral suppression, has [...] Read more.

Background: Human Immunodeficiency Virus (HIV) infections remain a source of cardiopulmonary complications among people receiving antiretroviral therapy. Still to this day, pulmonary hypertension (PH) severely affects the prognosis in this patient population. The persistent expression of HIV proteins, even during viral suppression, has been implicated in vascular dysfunction; however, little is known about the specific effects of these proteins on the pulmonary vasculature. This study investigates the impact of Nef variants derived from HIV-positive pulmonary hypertensive and normotensive donors on pulmonary vascular cells in vitro. Methods: We utilized well-characterized Nef molecular constructs to examine their effects on cell adhesion molecule gene expression (ICAM1, VCAM1, and SELE), pro-apoptotic gene expression (BAX, BAK), and vasoconstrictive endothelin-1 (EDN1) gene expression in endothelial nitric oxide synthase (eNOS) nitric oxide and the production and secretion of pro-inflammatory cytokines over 24, 48, and 72 h post-transfections with Nef variants. Results: HIV Nef variants SF2, NA7, and PH-associated Fr17 and 3236 induced a significant increase in adhesion molecule gene expression of ICAM1, VCAM1, and SELE. Pulmonary normotensive Nef 1138 decreased ICAM1 gene expression, but had increased VCAM1. PH Nef ItVR showed a consistent decrease in ICAM1 and no changes in SELE and VCAM1 expression. Further gene expression analyses of pro-apoptotic genes BAX and BAK demonstrated that Nef NA7, SF2, normotensive Nef 1138, and PH Nef Fr8, Fr9, Fr17, and 3236 variants significantly increased gene expression for apoptosis. Normotensive Nef 1138, as well as PH Nef Fr9 and ItVR, all displayed a statistically significant decrease in BAX expression. The expression of EDN1 had a statistically significant increase in samples treated with Nef NA7, SF2, normotensive Nef 2044 and PH Nef 3236, Fr17, and Fr8. Notably, PH-associated Nef variants sustained pro-inflammatory cytokine production, including IL-2, IL-4, and TNFα, while anti-inflammatory cytokine levels remained insufficient. Furthermore, eNOS was transiently upregulated by all Nef variants except for normotensive Nef 2044. Conclusions: The distinct effects of Nef variants on pulmonary vascular cell biology highlight the complex interplay between Nef, host factors, and vascular pathogenesis according to the variants. Full article

(This article belongs to the Special Issue Pulmonary Vascular Manifestations of Infectious Diseases)

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31 pages, 3369 KiB

Open AccessReview

A Comprehensive Review of Progress in Preventing Urinary Infections Associated with the Use of Urinary Catheters: A Dual Analysis of Publications and Patents

by Brunella Corrado, Aniello Cammarano, Stefania Dello Iacono, Emilia Renzi, Rosalba Moretta, Maria Emilia Mercurio, Laura Ascione, Annunziata Cummaro, Caterina Meglio and Luigi Nicolais

Infect. Dis. Rep. 2025, 17(3), 64; https://doi.org/10.3390/idr17030064 - 4 Jun 2025

Abstract

Catheter-associated urinary tract infections (CAUTIs), caused by microbial colonization of catheter surfaces, are among the most common healthcare-associated infections and significantly strain healthcare systems worldwide. This review aimed to provide a comprehensive analysis of the current scientific literature and the patent landscape from [...] Read more.

Catheter-associated urinary tract infections (CAUTIs), caused by microbial colonization of catheter surfaces, are among the most common healthcare-associated infections and significantly strain healthcare systems worldwide. This review aimed to provide a comprehensive analysis of the current scientific literature and the patent landscape from 2014 to 2024 on strategies for preventing CAUTIs. A systematic search was conducted using the PRISMA method, which involved searching the Scopus database for scientific evidence and analyzing patent search results on The Lens.org platform. Co-authorship and co-occurrence analysis unveiled key contributors and emerging themes within the scientific community. Simultaneously, an in-depth inspection of patents filed elucidated top origins, applicants, and classifications. Additionally, network analysis based on keywords from papers and patents revealed the scientific scenario and the innovation trends, enriching the understanding of technological advancements. It highlights emerging technologies, key actors, and potential gaps, providing valuable insights for researchers, clinicians, and industry stakeholders, thereby contributing to overcoming barriers to treating CAUTIs. Full article

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11 pages, 2679 KiB

Open AccessArticle

Canine Leptospirosis in Flood-Affected Areas of Southern Brazil: Molecular Assessment and Public Health Implications

by Gabriela Merker Breyer, Nathasha Noronha Arechavaleta, Bruna Corrêa da Silva, Maria Eduarda Rocha Jacques da Silva, Mariana Costa Torres, Laura Cadó Nemitz, Rafaela da Rosa Marques, Fernando Borges Meurer, Gabriela Amanda Linden, Tainara Soares Weyh and Franciele Maboni Siqueira

Infect. Dis. Rep. 2025, 17(3), 63; https://doi.org/10.3390/idr17030063 - 3 Jun 2025

Abstract

Background: Southern Brazil faced massive rains and floods in May 2024, which led to social, infrastructural, and One Health issues affecting over 478 municipalities and 2.3 million people. Exposure to floodwater increased the risk of bacterial infections, including leptospirosis. Despite the zoonotic nature [...] Read more.

Background: Southern Brazil faced massive rains and floods in May 2024, which led to social, infrastructural, and One Health issues affecting over 478 municipalities and 2.3 million people. Exposure to floodwater increased the risk of bacterial infections, including leptospirosis. Despite the zoonotic nature of leptospiral infections, only human leptospirosis is subject to mandatory reporting, while canine cases are less closely monitored. Considering the extent of this climatic event, many emergency shelters were created for rescued dogs, highlighting the need to monitor infectious diseases to mitigate the spread of hazardous pathogens. Methods: We performed a molecular assessment of canine leptospirosis in Porto Alegre and its metropolitan region. A total of 246 dogs rescued from the flooded areas underwent molecular diagnosis targeting lipL32. In addition, positive samples were identified by sequencing of the partial secY gene. Results: A total of 9 (4%) dogs were positive for Leptospira spp. Molecular and phylogenetic analyses of secY from the positive samples determined that the circulating strains belonged to L. interrogans (n = 8)—Icterohaemorrhagiae and Pomona as the suggested serogroups—and L. kirschneri (n = 1). Conclusions: Our findings point out the challenges in diagnosing and controlling leptospirosis during severe climatic events and reinforce the need for preventive sanitary measures to mitigate the dissemination of Leptospira spp., including the adoption of a mandatory notification system for canine leptospirosis. Full article

(This article belongs to the Section Bacterial Diseases)

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12 pages, 2672 KiB

Open AccessCase Report

Tropheryma whipplei and Giardia intestinalis Co-Infection: Metagenomic Analysis During Infection and the Recovery Follow-Up

by Anna Anselmo, Fabiana Rizzo, Elena Gervasi, Luca Corrent, Andrea Ciammaruconi, Silvia Fillo, Antonella Fortunato, Anna Maria Marella, Silvia Costantini, Luca Baldassari, Florigio Lista and Alessandra Ciervo

Infect. Dis. Rep. 2025, 17(3), 62; https://doi.org/10.3390/idr17030062 - 1 Jun 2025

Abstract

Background: Whipple’s disease (WD) is a rare infection caused by Tropheryma whipplei. Diagnosis is challenging and requires a combination of several data sets, such as patient history, clinical and laboratory investigations, and endoscopy with histology analyses. While persistent diarrhea is a common [...] Read more.

Background: Whipple’s disease (WD) is a rare infection caused by Tropheryma whipplei. Diagnosis is challenging and requires a combination of several data sets, such as patient history, clinical and laboratory investigations, and endoscopy with histology analyses. While persistent diarrhea is a common symptom, WD can affect multiple organs. Case description: We present the case of a 66-year-old immunocompetent patient with WD and a history of Helicobacter pylori infection who developed chronic diarrhea. Colonoscopy and histopathological analysis revealed the presence of foamy macrophages with periodic acid-Schiff-positive particles. Subsequently, molecular methods confirmed the clinical WD diagnosis and metagenomic analyses further identified a co-infection with Giardia intestinalis. The patient fully recovered after 14 months of antibiotic therapy. During pharmacological treatment, clinical and laboratory follow-ups were conducted at 6 and 12 months, and microbiome profiles were also analyzed to identify the most abundant species in the samples. Conclusion: The metagenomic analyses showed the eradication of the two pathogens and a progressive restoration to a healthy/balanced status after antibiotic therapy. Full article

(This article belongs to the Section Bacterial Diseases)

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22 pages, 1710 KiB

Open AccessReview

Advances in the Treatment of Enterovirus-D68 and Rhinovirus Respiratory Infections

by Vonintsoa L. Rahajamanana, Mathieu Thériault, Henintsoa Rabezanahary, Yesmine G. Sahnoun, Maria Christina Mallet, Sandra Isabel, Sylvie Trottier and Mariana Baz

Infect. Dis. Rep. 2025, 17(3), 61; https://doi.org/10.3390/idr17030061 - 1 Jun 2025

Abstract

Background/Objectives: Enterovirus-D68 (EV-D68) and rhinoviruses are major contributors to respiratory illnesses in children, presenting a spectrum of clinical manifestations ranging from asymptomatic cases to severe lower respiratory tract infections. No specific antiviral treatments are currently approved for these viruses. Method: We conducted a [...] Read more.

Background/Objectives: Enterovirus-D68 (EV-D68) and rhinoviruses are major contributors to respiratory illnesses in children, presenting a spectrum of clinical manifestations ranging from asymptomatic cases to severe lower respiratory tract infections. No specific antiviral treatments are currently approved for these viruses. Method: We conducted a comprehensive literature review of antiviral agents investigated for EV-D68 and rhinovirus infections. Results: Several antiviral candidates are under investigation, each targeting distinct stages of the viral replicative cycle. Capsid-binding agents and monoclonal antibodies prevent viral attachment by blocking receptor-virus interactions. Inhibitors of viral replication proteins disrupt polyprotein processing and replication organelle biogenesis by targeting non-structural viral proteins. Host factor inhibitors impair viral attachment, replication organelle formation, or RNA replication by interfering with critical host pathways. Conclusions: While no specific antivirals are yet approved for EV-D68 and rhinovirus infections, emerging therapeutic candidates offer potential avenues for treatment. Continued preclinical and clinical investigation will be essential to validate these approaches and expand the available options for affected patients. Full article

(This article belongs to the Special Issue Prevention, Diagnosis and Treatment of Infectious Diseases)

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10 pages, 1058 KiB

Open AccessCase Report

The Underestimated Threat—Mycobacterium Genavense Infection: A Case Report

by Jannik Sonnenberg, Gert Gabriels, Ioana Diana Olaru, Sebastian Mühl, Julia Fischer, Hermann Pavenstädt, Jonel Trebicka, Kai-Henrik Peiffer and Phil-Robin Tepasse

Infect. Dis. Rep. 2025, 17(3), 60; https://doi.org/10.3390/idr17030060 - 1 Jun 2025

Abstract

Background/Objectives: Nontuberculous mycobacteria (NTM) represent a heterogeneous group of pathogens with increasing global prevalence and significant geographical variation in species distribution. NTM infections, often affecting immunocompromised individuals, are difficult to diagnose due to nonspecific clinical presentations and laboratory findings. This case study presents [...] Read more.

Background/Objectives: Nontuberculous mycobacteria (NTM) represent a heterogeneous group of pathogens with increasing global prevalence and significant geographical variation in species distribution. NTM infections, often affecting immunocompromised individuals, are difficult to diagnose due to nonspecific clinical presentations and laboratory findings. This case study presents a rare extrapulmonary NTM infection in a 73-year-old man, initially misdiagnosed as sarcoidosis, highlighting the diagnostic and therapeutic challenges posed by such infections. Methods: The patient, a pigeon fancier, presented with recurrent fever and pancytopenia. Extensive diagnostics included blood cultures, bone marrow aspiration, and histopathology. Initial cultures and serological tests remained negative. Results: Bone marrow aspiration revealed epithelioid granulomas, initially leading to the provisional diagnosis of sarcoidosis. However, after six weeks, M. genavense was isolated from mycobacterial blood cultures from bone marrow aspirant. Antimicrobial therapy with azithromycin, rifampicin, and ethambutol was initiated. Following the initiation of appropriate antimycobacterial therapy, the patient developed immune reconstitution inflammatory syndrome (IRIS), which was managed with supportive care. The patient’s condition improved, and no further febrile episodes occurred post-treatment, marking the successful conclusion of NTM therapy. Conclusions: This case underscores the diagnostic complexity of extrapulmonary NTM infections, particularly in immunocompromised patients. Misdiagnosis can delay appropriate treatment. M. genavense, though rare, should be considered in patients with a fever of unknown origin, especially with a background of immunosuppression. Prompt mycobacterial testing and tailored antibiotic therapy are crucial to improving outcomes in NTM infections. Full article

(This article belongs to the Section Tuberculosis and Mycobacteriosis)

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16 pages, 1733 KiB

Open AccessArticle

A Retrospective Study of the Effects of COVID-19 Non-Pharmaceutical Interventions on Influenza in Canada

by Heather MacTavish, Kenzie MacIntyre, Paniz Zadeh and Matthew Betti

Infect. Dis. Rep. 2025, 17(3), 59; https://doi.org/10.3390/idr17030059 - 26 May 2025

Abstract

Background/Objectives: COVID-19 pandemic had a significant impact on endemic respiratory illnesses. Through behavioral changes in populations and government policy, mainly through non-pharmaceutical interventions (NPIs), Canada saw historic lows in the number of influenza A cases from 2020 through 2022. In this study, [...] Read more.

Background/Objectives: COVID-19 pandemic had a significant impact on endemic respiratory illnesses. Through behavioral changes in populations and government policy, mainly through non-pharmaceutical interventions (NPIs), Canada saw historic lows in the number of influenza A cases from 2020 through 2022. In this study, we use historical influenza A data for Canada and three provincial jurisdictions within Canada—Ontario, Quebec, and Alberta—to quantify the effects of these NPIs on influenza A. Methods: We aim to see which base parameters and derived parameters of an SIR model are most affected by NPIs. We fit a simple SIR model to historical influenza data to get average paramters for seasonal influenza. We then compare these parameters to those predicted by fitting influenza cases during the COVID-19 pandemic. Results: We find substantial differences in the effective population size and basic reproduction number during the COVID-19 pandemic. We also see the effects of fatigue and relaxation of NPIs when comparing the years 2020, 2021, and 2022. Conclusions: We find that the effective population size is the main driver of change to disease spread and discuss how these retrospective estimates can be used for future forecasting. Full article

(This article belongs to the Section Viral Infections)

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10 pages, 1371 KiB

Open AccessCase Report

Vasculonecrotic Reaction Caused by Mycobacterium Lepromatosis Infection—A Case Report of an HIV/Leprosy-Coinfected Patient

by Fernando Amador-Lara, Jorge L. Mayorga-Garibaldi, Felipe J. Bustos-Rodríguez, Luz A. González-Hernández, Pedro Martínez-Ayala and Jaime F. Andrade-Villanueva

Infect. Dis. Rep. 2025, 17(3), 58; https://doi.org/10.3390/idr17030058 - 23 May 2025

Abstract

Background: Vasculonecrotic reactions in leprosy are typically associated with type 2 reactions. Differentiating between necrotizing erythema nodosum leprosum (nENL) and Lucio’s phenomenon (LP) can be difficult, as overlapping clinical and histopathological features have been reported. Mycobacterium lepromatosis, a recently identified species causing [...] Read more.

Background: Vasculonecrotic reactions in leprosy are typically associated with type 2 reactions. Differentiating between necrotizing erythema nodosum leprosum (nENL) and Lucio’s phenomenon (LP) can be difficult, as overlapping clinical and histopathological features have been reported. Mycobacterium lepromatosis, a recently identified species causing leprosy, has been sporadically linked to LP. While type 1 reactions are more commonly observed in HIV-coinfected individuals, reports of LP or ENL occurring outside the context of immune reconstitution inflammatory syndrome (IRIS) remain rare. Methods: We report a case of a vasculonecrotic leprosy reaction due to M. lepromatosis in an antiretroviral-naive patient with advanced HIV infection. Results: The patient presented with a two-month history of papules and nodules that progressed to painful necrotic ulcers, accompanied by systemic symptoms. Clinically, the presentation was consistent with nENL; however, histopathological analysis supported a diagnosis of LP. The patient rapidly deteriorated, developing septic shock and dying shortly thereafter. To our knowledge, this is the first reported case of a leprosy-associated vasculonecrotic reaction caused by M. lepromatosis in an HIV-infected individual not associated with IRIS. Conclusions: Vasculonecrotic reactions in leprosy are life-threatening emergencies due to their potential for rapid clinical deterioration and sepsis. In individuals with advanced HIV infection, recognition of these reactions may be challenging, as they can mimic other opportunistic infections, including fungal diseases, malignant syphilis, and disseminated mycobacterial infections. Early identification and prompt treatment are critical to improving outcomes. Full article

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11 pages, 461 KiB

Open AccessReview

Spatial, Social and Serological Factors in the Prevalence and Risk of Leprosy in Areas of High Endemicity: An Integrative Review

by Daniele dos Santos Lages, Isabela Cristina Lana Maciel, Sarah Lamas Vidal and Francisco Carlos Félix Lana

Infect. Dis. Rep. 2025, 17(3), 57; https://doi.org/10.3390/idr17030057 - 22 May 2025

Abstract

Background/Objectives: Leprosy remains a global public health challenge, especially in hyperendemic areas, where spatial, socioeconomic and serological factors influence its persistence. In this study, an integrative review was carried out to analyze the relationship between these factors and the prevalence of Mycobacterium leprae [...] Read more.

Background/Objectives: Leprosy remains a global public health challenge, especially in hyperendemic areas, where spatial, socioeconomic and serological factors influence its persistence. In this study, an integrative review was carried out to analyze the relationship between these factors and the prevalence of Mycobacterium leprae infection, as well as the risk of falling ill. Methods: The integrative search was conducted in the BVS (Medline and LILACS) and Scopus databases, including studies published between 2010 and 2024; PRISMA was followed. Results: The findings indicate that spatial analysis, using geographic information systems, is essential for identifying transmission clusters and targeting control strategies. Poor socioeconomic conditions, such as low income and inadequate sanitation, significantly increase the risk of infection. In addition, serology, especially the detection of Anti-PGL-1 antibodies, has proved to be a promising tool for tracking subclinical infections and improving epidemiological surveillance. However, the integration of spatial, social and serological factors is still limited in the literature. Conclusions: We conclude that multidisciplinary approaches, combining spatial, socioeconomic and serological factors, are fundamental to optimizing control strategies and reducing leprosy transmission in vulnerable populations. Full article

(This article belongs to the Section Neglected Tropical Diseases)

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24 pages, 392 KiB

Open AccessSystematic Review

Long COVID: A Systematic Review of Preventive Strategies

by Sun O. Park and Neha Nanda

Infect. Dis. Rep. 2025, 17(3), 56; https://doi.org/10.3390/idr17030056 - 21 May 2025

Abstract

Background: Since the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in December 2019, long COVID (LC) has become a significant global health burden. While knowledge about LC is accumulating, studies on its prevention are still lacking. Methods: We conducted a systematic [...] Read more.

Background: Since the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in December 2019, long COVID (LC) has become a significant global health burden. While knowledge about LC is accumulating, studies on its prevention are still lacking. Methods: We conducted a systematic review following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines to investigate prevention options for LC. We identified fifteen articles on vaccines, seven on antivirals, and six on other interventions after searching for articles in the PubMed/MEDLINE database using the MeSH terms. Results: Most vaccine-related studies demonstrated a protective effect of COVID-19 vaccines against developing LC. Our review found an equivocal effect of antivirals, while metformin had a protective effect in outpatients and corticosteroids were protective in hospitalized patients against LC. Conversely, COVID-19 convalescent plasma and multiple micronutrient supplement did not confer any protection against LC. Conclusions: COVID-19 vaccination is vital as it not only prevents COVID-19 but also reduces the severity of illness and may help prevent LC. Further studies are warranted to shed light on preventive strategies for long COVID. Full article

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12 pages, 1206 KiB

Open AccessSystematic Review

The Neutrophil-to-Lymphocyte Ratio as a Prognostic Biomarker of Fournier’s Gangrene Severity: A Meta-Analysis

by Konstantinos Seretis, Nikolaos Bounas, Konstantinos Sfaelos, Georgios Gaitanis and Ioannis Bassukas

Infect. Dis. Rep. 2025, 17(3), 55; https://doi.org/10.3390/idr17030055 - 15 May 2025

Abstract

Background/Objectives: Fournier’s Gangrene (FG) is a severe and potentially fatal necrotizing infection of the perianal and genital regions, which necessitates prompt therapeutic interventions to prevent disease progression. Accruing evidence from recent research indicates that the neutrophil‒to-lymphocyte ratio (NLR) can predict clinical severity and [...] Read more.

Background/Objectives: Fournier’s Gangrene (FG) is a severe and potentially fatal necrotizing infection of the perianal and genital regions, which necessitates prompt therapeutic interventions to prevent disease progression. Accruing evidence from recent research indicates that the neutrophil‒to-lymphocyte ratio (NLR) can predict clinical severity and mortality risk in patients with critical illnesses across various etiologies. This meta-analysis aimed to assess the efficacy of NLR as a prognostic indicator for mortality in patients with FG. Methods: An electronic literature search was conducted across several databases from their inception to 31 May 2024, following a predetermined protocol. Study quality was evaluated using the Cochrane risk of bias tool. A random-effect model was utilized to synthesize the available data. Results: Twelve studies reporting on 767 patients were included in the meta-analysis. Higher NLR levels at presentation were recorded in non-survivors than in survivors (MD = 4.49 [95% CI: 0.67–8.32]; p = 0.02). A 76% increased mortality risk was detected for patients with an NLR ≥ 8 (1.76 RR [1.35–2.3], p = 0.0001), and the mortality risk was more than twofold greater for patients with an NLR ≥ 10 compared to the remaining patients (RR = 2.31 [1.27–4.21], p = 0.006). All included studies exhibited a moderate to serious risk of bias. Conclusions: This meta-analysis reveals that the NLR represents a promising biomarker that can serve as a prognostic indicator in patients with FG. Future studies should address the establishment of proper disease-specific cutoff values to aid in clinical decision-making. Full article

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13 pages, 1428 KiB

Open AccessArticle

The PJI-TNM Classification as Predictor for Revision-Free Implant Survival Rates in Patients with Periprosthetic Joint Infection of the Hip or Knee Joint

by Frank Sebastian Fröschen, Lisa Greber, Ernst Molitor, Gunnar Thorben Rembert Hischebeth, Alexander Franz and Thomas Martin Randau

Infect. Dis. Rep. 2025, 17(3), 54; https://doi.org/10.3390/idr17030054 - 15 May 2025

Abstract

Background: Periprosthetic joint infections (PJIs) remain a major challenge in arthroplasty. This study tries to evaluate the PJI-TNM classification as predictor for the revision-free implant survival in patients with PJI of the hip or knee joint. Methods: To this end, we perform a [...] Read more.

Background: Periprosthetic joint infections (PJIs) remain a major challenge in arthroplasty. This study tries to evaluate the PJI-TNM classification as predictor for the revision-free implant survival in patients with PJI of the hip or knee joint. Methods: To this end, we perform a retrospective study of all consecutive patients with PJI of an inlying hip or knee arthroplasty between January 2015 and December 2019. Results: A total of 443 cases (hip: n = 247; knee n = 196) were identified. In total, 439 patients underwent surgery (DAIR: n = 138 cases (31%), explantation: n = 272 (61%), irrigation with debridement without exchange of implant components: n = 29 (6.5%)). Four patients refused surgical treatment and 39.5% were lost to follow-up. In total, 78 patients died during follow-up and 27 deaths were directly related to PJI/complications during treatment. Patients with inlying “standard”-implants (p < 0.001) and without previous history of PJI (p = 0.002) displayed a significantly higher postoperative revision-free implant survival. In terms of the PJI-TNM subclassification, patients with loosened implants but without soft-tissue defects (T1) displayed the highest revision-free implant survival. In contrast, patients classified as M3 (no surgical treatment possible) displayed an inferior outcome compared to M0, M1, or M2. Patients with different N-subclassifications (“non-human cells”/causative pathogen) did not display differences in revision-free implant survival. Conclusions: The PJI-TNM classification is well suited to classify PJIs. Its complexity allows for more than 500 different combinations of classifications. Further validation data are needed, but to us, the PJI-TNM classification seems to offer the possibility of comparing patients with PJIs. It may, therefore, be a very valuable tool in order to compare cohorts with PJIs and provide individual data for patient specific outcomes. Full article

(This article belongs to the Section Bacterial Diseases)

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9 pages, 1123 KiB

Open AccessCase Report

A Case of Pulmonary Fibrosis and COVID-19-Related Pneumonia in a Pembrolizumab-Treated Patient

by Alberto Zolezzi, Gina Gualano, Annelisa Mastrobattista, Pietro Vittozzi, Virginia Di Bari, Carlotta Cerva, Silvia Mosti, Antonio Lugini, Fabrizio Albarello, Federica Di Stefano, Maria Beatrice Valli and Fabrizio Palmieri

Infect. Dis. Rep. 2025, 17(3), 53; https://doi.org/10.3390/idr17030053 - 12 May 2025

Abstract

Pembrolizumab is used as a first-line treatment of non-small cell lung cancer. Pneumonitis and interstitial lung disease are among the most common immune-related adverse events. The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections on patients with cancer treated with chemotherapy [...] Read more.

Pembrolizumab is used as a first-line treatment of non-small cell lung cancer. Pneumonitis and interstitial lung disease are among the most common immune-related adverse events. The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections on patients with cancer treated with chemotherapy or immune checkpoint inhibitors (ICIs) is not fully known. Blocking immune checkpoints may conversely augment dysfunctional T-cell responses in severe patients and, in turn, mediate immunopathology. Here, we present a case of SARS-CoV-2 infection complicated by acute respiratory distress syndrome (ARDS) and a fibrotic-like pattern in a patient treated with pembrolizumab for lung cancer. The patient showed a dramatic clinical and radiological response after steroid therapy. Further research is needed to better understand the long-term implications of pembrolizumab therapy in patients recovering from coronavirus disease 2019 (COVID-19) and to develop evidence-based guidelines for managing these complex cases. Patients undergoing oncologic immunotherapy might benefit from early high-dose steroid treatment in cases of viral infections, such as SARS-CoV-2. Full article

(This article belongs to the Section Infections in the Immuncompromised Host)

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13 pages, 1944 KiB

Open AccessArticle

Delineating the Significance of Several Inflammatory Markers in a Lung Tuberculosis Cohort During the Active and Post-Tuberculosis Stages of the Disease: An Observational Study in Cape Town, South Africa (2019 to 2024)

by Chrisstoffel Jumaar, Lindiwe Malefane, Steve Jacobs, Olakunle Sanni, Elize Louw, Nicola Baines, Carmen Payne, Sigrid Schulz, Carl Lombard, Merga Feyasa, David Maree, Shantal Windvogel, Hans Strijdom, Benjamin Botha, Brian Allwood and Gerald J. Maarman

Infect. Dis. Rep. 2025, 17(3), 52; https://doi.org/10.3390/idr17030052 - 9 May 2025

Abstract

Background: Pulmonary tuberculosis (TB) frequently leads to long-term lung complications that contribute to increased mortality. Understanding the pathogenesis of post-TB lung impairments is crucial for improving long-term outcomes in TB patients; yet this area remains poorly researched. Methods: Our study assessed circulatory inflammatory [...] Read more.

Background: Pulmonary tuberculosis (TB) frequently leads to long-term lung complications that contribute to increased mortality. Understanding the pathogenesis of post-TB lung impairments is crucial for improving long-term outcomes in TB patients; yet this area remains poorly researched. Methods: Our study assessed circulatory inflammatory markers in patients who completed TB treatment more than one year before enrolment (population 1) and patients receiving in-hospital treatment for active drug-sensitive TB (population 2). Results: IL-6 was seven times higher in both populations compared to the normal range. IL-8 was below the limit of detection (LOD) in population 1, while it was approximately 2.5 times higher in population 2 compared to the normal range. TNF-α was 21 times higher in population 1 and 19 times higher in population 2 compared to the normal range. CRP was almost 49 times higher in both populations, and IL-1Ra was below the LOD in population 1, while it was ~1.5 times higher in population 2 compared to the normal range. Conclusions: These inflammatory biomarkers correlated well with lung function in the post-TB state, and their high levels suggest a persistent pro-inflammatory state post-TB, which may contribute to post-TB lung disease. More research is warranted to better understand this phenomenon, but these findings may highlight a need to consider anti-inflammatory therapy for patients with post-TB lung disease, especially since these high levels of cytokines can directly contribute to lung damage. Full article

(This article belongs to the Special Issue Pulmonary Vascular Manifestations of Infectious Diseases)

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13 pages, 1964 KiB

Open AccessArticle

Stage-Specific Immune Responses to AgB T-Peptides in Patients with Cystic Echinococcosis

by Settimia Sbarra, Ambra Vola, Francesca Tamarozzi, Saeid Najafi-Fard, Alessandra Ludovisi, Antonella Teggi, Emanuele Nicastri, Fabrizio Albarello, Enrico Brunetti, Delia Goletti and Linda Petrone

Infect. Dis. Rep. 2025, 17(3), 51; https://doi.org/10.3390/idr17030051 - 7 May 2025

Abstract

Background: The identification of parasite- and stage-specific antigens is crucial for the development of new diagnostic tests for cystic echinococcosis (CE). We previously analysed the interleukin (IL)-4 response to T-specific peptides corresponding to the immunogenic regions of the five antigen B (AgB) subunits, [...] Read more.

Background: The identification of parasite- and stage-specific antigens is crucial for the development of new diagnostic tests for cystic echinococcosis (CE). We previously analysed the interleukin (IL)-4 response to T-specific peptides corresponding to the immunogenic regions of the five antigen B (AgB) subunits, demonstrating that AgB1 is the most immunogenic protein and that the response to all AgB peptides is associated with viable cysts. However, the response in patients with CE3a (WHO-IWGE) cystic stage was not evaluated and no other immunological factors besides IL-4 were included in the analysis. Methods: Four study groups were defined: “CE3a group” (transitional cysts), “CE3b group” (active cysts), “CE4/CE5 group” (inactive cysts), and “NO CE-group” encompassing patients with non-CE cysts (controls). Whole blood was stimulated in vitro with the five different T-specific peptide pools corresponding to the five AgB subunits and with a pool containing all five peptides’ pools (total pool). IL-4 and other immunological markers were evaluated by ELISA and a multiplex assay, respectively. Results: Twenty-four patients with CE (CE3a-group n = 3; CE3b-group n = 6; CE4/CE5-group n = 15) and 14 subjects with non-CE cysts were enrolled. IL-4 levels in response to AgB1 and AgB3 pools were significantly increased in CE compared to NO CE groups (p = 0.0201, p = 0.0041). Within the CE patients, the highest IL-4 median level was observed in response to the AgB total pool, the AgB3 and AgB4 pools, followed by the AgB1 pool. Moreover, the IL-4 levels in response to the AgB1 pool were found to be significantly higher in the CE3b group compared to the CE4/CE5 group (p = 0.0070), while no differences were found for the CE3a group. As for other cytokines, we found higher IL-7 levels in response to the AgB4 pool in the CE4/CE5 group compared to the CE3b group (p = 0.0012), higher IL-2 levels in response to the AgB1 pool and AgB total pool in CE3b patients compared to controls (p = 0.0016), and higher IL-13 levels in response to the AgB total pool in patients with CE3b and CE4/CE5 cysts compared to NO CE (p = 0.0016; p = 0.0009). Conclusions: These results contribute to a better knowledge of the immune interplay in the presence of CE and may be useful for further exploring the use of recombinant proteins/peptides in cytokine release assays for the diagnosis and follow-up of CE. Full article

(This article belongs to the Section Parasitological Diseases)

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15 pages, 3462 KiB

Open AccessArticle

Exploring the Antibiotic Potential of a Serine Protease from Solanum trilobatum Against Staphylococcus aureus Biofilms

by Manohar Radhakrishnan, Kanal Elamparithi Balu, Lakshminarayanan Karthik, Raghavendra Sashi Krishna Nagampalli, Eswar Kumar Nadendla and Gunasekaran Krishnasamy

Infect. Dis. Rep. 2025, 17(3), 50; https://doi.org/10.3390/idr17030050 - 7 May 2025

Abstract

Background: Multi-antibiotic resistance has become an alarming issue in treating bacterial infections in both community and medical environments. Globally, the scientific community has been exploring multi-antibiotic techniques to find new ways to address this challenge. To address this critical challenge and explore alternative [...] Read more.

Background: Multi-antibiotic resistance has become an alarming issue in treating bacterial infections in both community and medical environments. Globally, the scientific community has been exploring multi-antibiotic techniques to find new ways to address this challenge. To address this critical challenge and explore alternative antibiotic treatments, we investigated the potential of Solanum trilobatum, an edible and medicinally important herb plant in Ayurvedic medicine. Methods: Our research focused on a 60 kDa serine protease isolated and purified from the leaves of S. trilobatum, which showed evidence of possessing hydrolase activity. In this study, we examined the capability of the purified enzyme to eradicate preformed biofilms of S. aureus in combination with ampicillin. Additionally, we assessed the stability of the enzyme in the presence of metal ions and detergents. Results: Enzyme kinetics revealed a Vmax of 48.63 µM/min and a Km of 14.08 µM, indicating efficient enzymatic activity. Furthermore, the enzyme exhibited maximum activity at physiological pH, suggesting its potential effectiveness under physiological conditions. Conclusions: Our preliminary findings highlight the promising role of this enzyme as a potential agent to combat S. aureus biofilms, especially when used in conjunction with ampicillin, as an alternative antibiotic approach. Full article

(This article belongs to the Special Issue New Advances in Drugs/Vaccines against Infectious Diseases)

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