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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Infectious Diseases".

Deadline for manuscript submissions: 15 August 2026 | Viewed by 9476

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Dr. Agata Skrzat-Klapaczynska

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Guest Editor

Department of Adults’ Infectious Diseases, Medical University of Warsaw, 01-201 Warsaw, Poland
Interests: infectious diseases; HIV; HBV; HCV; epidemiology; viral hepatitis
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Justyna Dominika Kowalska

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Guest Editor

Department of Adults’ Infectious Diseases, Medical University of Warsaw, 01-201 Warsaw, Poland
Interests: HIV; viral hepatitis; STI; Central and Eastern Europe
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Infectious diseases are an extremely diverse field of medicine. Knowledge of the epidemiology of infectious diseases is the basis for strategic planning to reduce them in the context of public health. It is well known that the epidemiology of individual infectious diseases is changing, and the factors causing this are changes in human behaviour, anti-vaccination movements, international conflicts, climate change and others. Awareness and up-to-date knowledge in this area are crucial to achieving the goals of controlling and even ending the epidemic of individual infectious diseases.

In this Special Issue, we invite authors to submit papers on the epidemiology of infectious diseases, in particular recent updates and perspectives.

You may choose our Joint Special Issue in Viruses.

Dr. Agata Skrzat-Klapaczynska
Prof. Dr. Justyna Dominika Kowalska
Guest Editors

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Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

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Keywords

infection prevention and control
infectious diseases epidemiology
public health
novel treatments

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Published Papers (4 papers)

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15 pages, 880 KB

Open AccessArticle

Secondary vs. Primary Spinal Infection in Early Clinical Assessment: A Parsimonious, Leakage-Resistant Modelling Approach with Internal Validation: A Multicenter Retrospective Study

by Merih Can Yilmaz, Ozgur Ozaydin, Cengiz Cokluk and Keramettin Aydin

J. Clin. Med. 2026, 15(5), 1873; https://doi.org/10.3390/jcm15051873 - 28 Feb 2026

Viewed by 263

Abstract

Background and Objectives: Spinal infections represent a heterogeneous group of diseases where primary or secondary etiological classification is fundamental for diagnosis and clinical decision-making. The aim is to present multicenter data evaluating etiological patterns associated with comorbidity. This study investigated the etiological distribution of spinal infections in a multicenter cohort and examined the relationships between chronic kidney disease (CKD) and diabetes mellitus (DM) and primary and secondary spinal infection etiologies, which emerged in the study and are thought to contribute to the literature. Materials and Methods: For this early-phase exploratory modelling study, a ridge-penalized logistic regression (L2) model was trained using repeated nested cross-validation (outer 5-fold stratified CV ×10 repetitions; inner 5-fold CV) to generate out-of-fold (OOF) probabilities. The penalty parameter (C) was optimized by minimizing log-loss. All preprocessing was performed within the CV pipeline to prevent data leakage. A supplementary Firth-penalized analysis was conducted as a plausibility check, using the CKD0/DM0 group as reference. Results: The model demonstrated effective discrimination between spinal infection probabilistic profiles (OOF AUC 0.762; conditional OOF bootstrap 95% CI 0.608–0.885). A contrasting probabilistic profile concordance was observed: DM-only patients had a high likelihood of secondary infection (observed secondary risk 93.3%; mean OOF estimated probability 84.4%), compared to a higher likelihood of primary infection in CKD-only patients (observed secondary risk 15.4%, which translates to a primary risk of 84.6%; mean OOF estimated probability 21.8%). Calibration was near-ideal (intercept 0.069; slope 1.028). Decision curve analysis showed a clear utility between the thresholds of 0.15 and 0.84. There were no CKD+DM+ cases (n = 0); analyses were restricted to supported strata. Conclusions: In this multicenter analysis of spine infections, CKD was predominantly related to primary spine infection etiology, whereas DM was more frequently related to secondary spine infections. These findings emphasize the potential role of comorbidity profiles in etiologic classification and need to be confirmed in larger multicenter cohorts. Full article

(This article belongs to the Special Issue Infectious Disease Epidemiology: Current Updates and Perspectives)

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14 pages, 558 KB

Open AccessArticle

The Validation of Mortality Risk Indexes for Predicting Long-Term Outcomes in People Living with HIV in a Spanish Cohort (eVIHa)

by Sophia Pinecki Socias, Marc Moragues Serra, Francisca Artigues Serra, Maria Luisa Martin, Javier Murillas, Aroa Villoslada, Adrian Rodriguez, Adelaida Rey, Julia Serra, Laia Vilaplana, Pedro Fernandez, Francisco Fanjul, Aina Millan and Melchor Riera Jaume

J. Clin. Med. 2025, 14(24), 8654; https://doi.org/10.3390/jcm14248654 - 6 Dec 2025

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Background/Objectives: Having access to antiretroviral therapy (ART) has altered the health status of people living with HIV (PLHIV) to that of having a chronic condition, with a greater life expectancy. The development of the Veterans Aging Cohort Study (VACS) Index has allowed for the prediction of 5-year mortality in PLHIV, using both HIV-related and non-HIV-related markers. The modified Charlson Index describes the comorbidity burden and is indicated to predict 10-year mortality. This study validates the Veterans Aging Cohort Study (VACS) Index 1.0 and the modified Charlson Index in a contemporary European cohort, with the aim of better predicting mortality. Methods: An observational, multicenter study was conducted using data from the eVIHa cohort in the Balearic Islands (Spain) from 2000 to 2023. The VACS Index 1.0 and the modified Charlson Index were calculated. Model discrimination was assessed using Harrell’s C-statistic, and observed mortality was estimated using Kaplan–Meier analysis. Results: Of 6913 eligible PLHIV, 4480 (64.8%) had sufficient data for VACS Index calculation and were included in the primary analysis. The excluded group (N = 2433) had significantly higher mortality (27.7% vs. 9.4%) and a greater proportion of people who inject drugs. In the analyzed cohort, the VACS Index 1.0 showed good discrimination for 5-year all-cause mortality (C-statistic: 0.759), outperforming the modified Charlson Index (C-statistic: 0.729). Discrimination was the highest for deaths from liver disease (C: 0.875) and non-HIV-related infections (C: 0.853). Conclusions: In our analyzed cohort, the VACS Index 1.0 accurately predicted 5-year mortality. However, its performance in populations with higher rates of people who inject drugs and irregular follow-up is unknown and likely to be lower. Clinicians should be aware of these limitations when applying the index in practice. Full article

(This article belongs to the Special Issue Infectious Disease Epidemiology: Current Updates and Perspectives)

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16 pages, 395 KB

Open AccessArticle

Serious Adverse Drug Reactions to COVID-19 Vaccines in the Pediatric Population: A Retrospective, Cross-Sectional Study Utilizing the Eudravigilance Database for the European Economic Area

by Grzegorz Nazar, Julia Olszlegier, Aleksandra Kamińska, Katarzyna Plata-Nazar and Wojciech Nazar

J. Clin. Med. 2025, 14(18), 6542; https://doi.org/10.3390/jcm14186542 - 17 Sep 2025

Viewed by 7385

Abstract

Background: During the global fight against the COVID-19 pandemic, vaccinations have been widely recognized as the most effective and generally safe method for preventing the spread of COVID-19. However, it has been reported that children may experience post-vaccination serious adverse drug reactions (SADRs). Thus, we aimed to analyze the risk of SADRs to COVID-19 vaccines in the pediatric population. Methods: In this retrospective, cross-sectional study, 5422 cases of SADRs (n = 5018 for Pfizer BioNTech, Comirnaty and n = 494 for Moderna, Spikevax) were analyzed after 37,344,343 doses of COVID-19 vaccines were administered. This study covered the European Economic Area. The analysis period for both vaccinations and SADRs spanned from 7 December 2020 to 5 October 2023. The analysis encompassed 207 types of SADRs grouped into 12 categories. All estimated real-world reporting rates were reported as normalized per million ADR reports and adjusted using real-world trial-based scaling (APMR). Results: The total estimated real-world reporting rates of SADRs were 5792 APMR for Comirnaty and 5671 for Spikevax. The most commonly reported clinical categories of suspected SADRs for both vaccines were neuropsychiatric, cardiovascular and gastroenterological disorders. The most often reported SADRs encompassed headaches, myocarditis, episodes of syncope, dizziness and dyspnea. Conclusions: According to the data from this study, several SADRs were reported in children following COVID-19 vaccination. The estimated real-world reporting rates of SADRs related to COVID-19 vaccines seem to be rare among children. Additionally, the data suggest that Comirnaty (Pfizer-BioNTech) may have a similar risk profile compared to Spikevax (Moderna). Full article

(This article belongs to the Special Issue Infectious Disease Epidemiology: Current Updates and Perspectives)

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10 pages, 232 KB

Open AccessArticle

Does Early Concordant Antibiotic Treatment Reduce Mortality Among Hospitalized Patients with Carbapenem-Resistant Acinetobacter baumannii Bacteremia? A Retrospective Cohort Study

by Alaa Atamna, Yaara Wazana, Haim Ben-Zvi, Tzippy Shochat, Jihad Bishara and Amir Nutman

J. Clin. Med. 2025, 14(18), 6485; https://doi.org/10.3390/jcm14186485 - 15 Sep 2025

Cited by 1 | Viewed by 930

Abstract

Carbapenem-resistant Acinetobacter baumannii (CRAB) bacteremia is a critical health concern associated with high morbidity and mortality and limited treatment options. Whether early initiation of concordant antibiotic therapy upon recognition of sepsis improves outcomes remains unclear. Methods: We conducted a retrospective cohort study of 413 patients diagnosed with CRAB bacteremia to evaluate the impact of early concordant antibiotic treatment (i.e., administration of in vitro active antibiotics within 24 h of blood culture collection) on 30-day mortality. Multivariable logistic regression was conducted to identify predictors of early concordant treatment and to evaluate its association with 30-day mortality. To address potential confounding by early death, a sensitivity analysis was performed which included only patients who survived at least 48 h after blood culture collection. Results: Among the study cohort, 30% (122/413) received early concordant treatment (all received colistin), while 70% (291/413) received early discordant treatment. The median age of patients receiving early concordant treatment was 69 (interquartile range (IQR), 62–78) years vs. 71 (IQR, 62–81) years in the discordant group (p = 0.1). Patients who received early concordant treatment were more likely to be mechanically ventilated (52% vs. 40%, p = 0.03) and have rectal carriage of multidrug-resistant bacteria (16% vs. 9%, p = 0.06). The 30-day mortality was 63% (260/413). In univariate analysis, survivors were more likely to have received early concordant treatment (38% vs. 25%, p = 0.005); however, this association was not statistically significant in the multivariable model (adjusted odds ratio [aOR] 0.36, 95% confidence interval [CI] 0.13–1.02, p = 0.053). Significant factors associated with 30-day mortality included age ≥65 years (aOR 4; 95% CI 1.1–17, p = 0.04) and SOFA score ≥5 points (aOR 7.14; 95% CI 2–25, p < 0.01). In the sensitivity analysis limited to patients who survived at least 48 h after blood culture collection, early concordant treatment remained unassociated with 30-day mortality (aOR 1.8; 95% CI 0.5–7, p = 0.4). Conclusions: Early concordant antibiotic treatment was not significantly associated with 30-day mortality in patients with CRAB bacteremia. Older age and SOFA score were significant predictors of mortality. Whether this finding reflects the limited efficacy of colistin, which was the predominant empiric antibiotic in this cohort, remains unclear; nevertheless, more effective therapeutic options for CRAB bacteremia are urgently needed to improve patient outcomes. Full article

(This article belongs to the Special Issue Infectious Disease Epidemiology: Current Updates and Perspectives)

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