Search Results (105)

Background: Early recognition of sepsis-related coagulation derangements may support timely risk stratification in emergency department (ED) patients with suspected infection. Evidence comparing coagulation-oriented scores in unselected “suspected sepsis” populations remains limited, particularly for predicting progression to sepsis, overt thrombotic/hemorrhagic events, and mortality. Methods: We conducted a single-center retrospective cohort study including consecutive ED patients evaluated for sepsis, suspected sepsis, or infection (January 2016–December 2024). Patients with overt disseminated intravascular coagulation (DIC) at admission were excluded. The Sepsis-Induced Coagulopathy (SIC), Japanese Association for Acute Medicine DIC (JAAM-DIC), International Society on Thrombosis and Haemostasis (ISTH) score, and Endothelial Activation and Stress Index (EASIX; and log2-EASIX) were calculated at admission. Outcomes were progression to confirmed sepsis (Sepsis-3), symptomatic coagulopathy (thrombotic and/or hemorrhagic events), and in-hospital mortality. Discrimination was assessed by ROC analysis (AUC with 95% CI) and clinical utility by decision curve analysis (DCA). Results: Among 11.274 patients without overt DIC, all scores showed moderate discrimination for mortality and sepsis progression. SIC performed best for in-hospital mortality (AUC 0.701, 95% CI 0.692–0.710) and for progression to confirmed sepsis (AUC 0.672, 95% CI 0.663–0.681). Prediction of overt thrombotic/hemorrhagic complications was poor across scores; ISTH yielded the highest (yet modest) AUCs for thrombotic events (0.614, 95% CI 0.604–0.623), hemorrhagic events (0.545, 95% CI 0.535–0.554), and combined coagulopathy (0.605, 95% CI 0.596–0.614). DCA suggested net benefit at low-to-intermediate threshold probabilities, particularly for SIC (and JAAM2) in early decision ranges. In the confirmed sepsis subgroup, discrimination attenuated overall; for combined coagulopathy, SIC showed the highest AUC (0.558, 95% CI 0.518–0.597). Conclusions: In ED patients with suspected sepsis and no overt DIC at presentation, SIC provides the strongest performance for early prognostic stratification (mortality and sepsis progression), whereas none of the evaluated scores reliably predict clinically overt thrombotic or hemorrhagic complications. Full article

Soybean rust caused by the fungus Phakopsora pachyrhizi threatens global soybean production, causing yield losses of up to 80%. Race-specific Rpp genes provide short-term resistance due to pathogen variability, whereas partial resistance (PR) offers durable, broad-spectrum protection, though its genetic basis remains unclear. This study aimed to identify genomic regions and candidate genes underlying PR using the Fixed and Random Model Circulating Probability Unification (FarmCPU) genome-wide association study (GWAS) and machine learning (ML) methods, Random Forest (RF) and Support Vector Regression (SVR). A panel of 312 soybean accessions was evaluated under natural infection across six Ugandan environments. Rust index (RI), derived from rust severity and sporulation level, was used to estimate heritability (H²) and rank genotypes through Best Linear Unbiased Predictions (BLUPs), while Best Linear Unbiased Estimators (BLUEs) supported GWAS input. After quality control, 8272 SNPs were analyzed within a ±60 kb linkage disequilibrium (LD) window. Multi-environmental Analysis (MEA) of RI showed significant genetic effects (p < 0.01); H² = 0.57–0.68. Sixty-one loci were detected: six by FarmCPU, 15 by RF, and 41 by SVR. Key genes included Glyma.01G128100 (a WRKY transcription factor) and Glyma. 13G228000, receptor-like kinase) and Glyma.20G173100 (WD40-domain regulator). Integrating ML with GWAS improved locus detection, confirming the polygenic nature of PR and supporting the use of genomic selection and locus pyramiding for durable rust resistance. Full article

Background/Objectives: Inhaled corticosteroids (ICS) increase the risk of pneumonia caused by various pathogens in patients with chronic obstructive pulmonary disease (COPD). Treatment may also increase the risk of infection with non-tuberculous mycobacteria (NTM), although evidence remains limited. The aim of this study was to assess the association between ICS treatment and the risk of NTM isolation among patients with COPD. Methods: This retrospective register-based cohort study included patients with a specialist-verified COPD diagnosis between 2008 and 2021. ICS exposure was based on redeemed prescriptions during the year preceding the index date. Exposure was calculated as the mean daily budesonide-equivalent dose and categorized as none, low, medium, or high. A cause-specific Cox proportional hazards regression model with death as a competing risk was applied, adjusted for potential confounders. Sensitivity analyses included, among others, an inverse probability of treatment weighted model, and a time-dependent Cox regression model. Results: A total of 120,006 patients were included, with a median follow-up time of 4.9 years. During follow-up, 378 (0.32%) patients reached the primary endpoint. Medium- and high-dose ICS were associated with an increased hazard of NTM isolation, with hazard ratios of 1.39 (95% CI 1.06–1.88, p = 0.020) and 1.52 (95% CI 1.14–2.04, p = 0.005), respectively. This association remained significant for high-dose ICS across all sensitivity analyses. Conclusions: In patients with COPD, ICS treatment was associated with an increased and dose-dependent hazard of NTM isolation, particularly at high doses. High-dose ICS should, therefore, be prescribed with caution. Full article

Background/Objectives: Tick-borne encephalitis (TBE) is the most important tick-borne viral central nervous system (CNS) infection in Europe and Asia. Since the introduction of a vaccine in Austria in the late 1970s, sero-epidemiological studies on the true incidence of tick-borne encephalitis virus (TBEV) infection in the population have been difficult, because it was not possible to distinguish between vaccine- and infection-induced antibodies. The goal of our study has been to analyze the sero-epidemiology of TBEV infections, vaccination protection rate, and manifestation index of the disease in the region of interest. Methods: Applying a newly developed anti-TBEV-NS1-IgG assay and the neutralization test, the protection and infection rates in blood donors of the Austrian Federal State of Upper Austria.It is one of the first areas in Austria, where the TBEV vaccine had been rolled out and broadly used. Samples from blood donors of all districts of the Federal State of Upper Austria were screened for anti-TBEV-IgG. Positive sera were differentiated for infection- and vaccine-induced antibodies. The results were matched with donor age, gender, and geographical origin. Results: 2162 samples were analyzed. A total of 87.0% of the blood donors tested showed anti-TBEV-IgG related to past TBEV vaccination. Within the unvaccinated group, a total of 13.3% of male and 9.9% of female blood donors exhibited anti-TBEV-NS1-IgG, indicating a past TBEV infection. The anti-TBE-NS1-IgG seroprevalence was determined at 74/100,000 for the whole population and at 594/100,000 in the non-vaccinated population. The manifestation index (MI) was calculated at 2.8%. The MI is defined as the probability or percentage of infected individuals who develop clinical symptoms of a disease. Conclusions: Our data provide evidence of a continuing high risk of TBEV infection in the Federal state of Upper Austria. The non-vaccinated population has an eightfold higher infection prevalence compared to the whole population. The MI of TBEV for severe infection seems lower as detailed in previous reports. Full article

Background/Objectives: The aim of the study was to develop a physiologically based pharmacokinetic (PBPK) model to predict gentamicin therapeutic protocols for dogs with varying degrees of renal function impairment, considering the minimum inhibitory concentrations (MICs) of the infecting bacteria. Methods: The PBPK model was built using PK-Sim^® software (OPEN SYSTEMS PHARMACOLOGY), based on pharmacokinetic data available in the literature and information on the physicochemical properties of the drug. Model evaluation included the calculation of the geometric mean fold error (GMFE), weighted and percentage residuals were calculated, as well as the following measures: AFE, AWRi, MWRi, MAWRi, APE%, MPE%, MAPE%, MdPE%, and MdAPE%. Therapeutic efficacy was assessed according to the Probability of Target Attainment (PTA), considering an MIC distribution of 0.25 to 8 μg/mL for different doses (2, 4, 6, 8, and 10 mg/kg) using the PK/PD indices C_max/MIC ≥ 10, AUC/MIC ≥ 50, and AUC/MIC ≥ 110. To compare the pharmacokinetics of gentamicin between healthy dogs and those with decreased renal function, different GFR values corresponding to stages of renal impairment were used, as determined by clinical biomarkers (microalbuminuria, UPC ≥ 2, sCr ≥ 1.2 mg/dL, sCr ≥ 2.4 mg/dL, and sCr ≥ 5 mg/dL). The risk of toxicity was assessed according to AUC_24h ≥ 700 mg·h/L and C_min ≥ 0.5. Results: The model demonstrated good predictive performance, with a GMFE value of 1.13 meeting the double error criterion, and weighted residuals randomly distributed around 0 (p = 0.3792). Through the calculation of PTA, it was observed that efficacy varied according to the PK/PD index used, but values greater than 90% were obtained for MICs up to 4 μg/mL. The model allowed the estimation of protocols for each stage of renal impairment, considering the GFR of each group and the risk of nephrotoxicity, in association with the optimal dose to ensure therapeutic efficacy. Conclusions: These findings make it possible to propose a dose for the treatment of an infection, considering the MIC and the patient’s GFR stage, thereby reducing the risk of adverse effects without compromising treatment efficacy. Full article

Background/Objectives: The role of smoking in household SARS-CoV-2 transmission is controversial. The objective of this study was to analyze the impact of smoking on SARS-CoV-2 index cases and transmission to household contacts. Methods: Prospective cohort study of 227 index cases and 332 household contacts in Catalonia and Navarre (May 2022–December 2024). The primary outcome measure was SARS-CoV-2 infection in contacts, confirmed by rapid antigen and polymerase chain reaction testing. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) for the smoking-infection association were calculated using logistic regression, adjusting for age, vaccination, and previous infection. Results: The cumulative infection incidence in contacts was 38.6%, and was higher in people aged ≥65 years (60.6%) and in smokers (48.6%) vs. non-smokers (33.8%). In the multivariate analysis, index case vaccination (aOR = 0.27; 95%CI: 0.11–0.63) and previous contact infection (aOR = 0.49; 95%CI: 0.30–0.81) were associated with a lower probability of transmission, while smoking by household contacts (aOR = 2.09; 95%CI: 1.19–3.65) and age ≥ 65 years (aOR = 5.13; 95%CI: 2.18–12.09) were associated with an increased risk of infection. The index case smoking status was not statistically significant. Conclusions: Smoking by cohabitants and age ≥ 65 years increase the risk of SARS-CoV-2 infection. Index case vaccination and previous contact infection are associated with reduced intra-household transmission. Full article

Household airborne transmission can be promoted when infectious and susceptible occupants share indoor air for long periods, yet practical infection-risk models often require pathogen-specific parameters that are uncertain. This study proposes a measurement-informed multizone/HVAC-network workflow that identifies inter-room airflow rates (q) from CO₂ tracer time series and estimates an effective first-order non-ventilation aerosol loss rate (λ) by fitting PM_2.5 concentration decay dynamics; the identified parameters are then reused within the same whole-house recirculating network model (vtsim) to compute a steady-state exhaled-air tracer concentration index for scenario comparison. The workflow is demonstrated in a high-insulation, airtight detached house equipped with a duct-type whole-house air-conditioning system with return-air recirculation. The results indicate measurable cross-room dispersion under baseline operation and show that a return-side filtration scenario reduces the steady-state index in non-source rooms relative to baseline under the tested operating assumptions. These findings illustrate how measurement-informed identification can support rapid, threshold-free relative comparison of ventilation/HVAC operation or mitigation scenarios within a specific house, rather than estimating absolute infection probability. Limitations include potential non-uniqueness in inverse identification, simplified treatment of leakage and pressure-drop-induced airflow changes, and the use of a steady-state index for inherently transient residential exposures; further validation across additional houses and HVAC topologies is warranted. Full article

The aim of this study was to evaluate the factors associated with the occurrence of oral infection sources in patients scheduled for total hip or knee arthroplasty, with the purpose of establishing standardized preoperative dental triage criteria. Materials and Methods: A retrospective research was conducted on a study group of 89 patients diagnosed with hip osteoarthritis and knee osteoarthritis at the Clinical Rehabilitation Hospital (Iasi, Romania). Patients were divided according to the status of their oral cavity: study group (n = 51)—patients with diagnosed oral infection sites (oral foci of infection); control group (n = 38)—patients without oral foci of infection. The statistical analysis included a univariate stage followed by a multivariate binary logistic regression to identify demographic and clinical factors associated with the presence of oral foci of infection. Results: The strongest predictor of the presence of oral foci of infection was and Oral Hygiene Index (OHI) scorer of 2, which increased the risk 14.583-fold, followed by being aged between 50 and 65 years (OR = 4.038), tooth brushing once a day or less (OR = 3.488), and male sex (OR = 3.433). An OHI score of 2 raises the probability of oral infectious pathology to 30.3%, which increases to 85.1% when combined with being aged between 50 and 65 years. Conclusions: The risk factors for the presence or oral foci of infection in patients scheduled for total knee or hip arthroplasty support the inclusion of the preoperative assessment and management of these factors in order to reduce the risk of the postoperative periprosthetic joint infections. Full article

Background: Intravenous vancomycin is a mainstay for prosthetic joint infections, osteomyelitis, and implant-associated infections, yet real-world dosing frequently misses PK/PD targets. We assessed whether a ward-embedded standard operating procedure (SOP) improves target attainment and dosing efficiency. Methods: Single-centre, non-randomized pre-post study in an orthopedic service. SOP mandated weight-adapted loading dose, renal function-adjusted maintenance dosing, a 15–20 mg/L trough target, and scheduled TDM. Adults receiving ≥72 h IV vancomycin were included; major renal failure and incomplete TDM were excluded. Pre-SOP data were retrospective; post-SOP data were prospective (03/2024–06/2025). Primary outcome: proportion of troughs within 15–20 mg/L (first and repeated). Repeated measures were modeled with GEE. Time to first in-range trough used Kaplan–Meier (indexed by measurement number). Results: We included 154 patients (pre-SOP n = 58; post-SOP n = 96); baseline characteristics were broadly similar. Use of a weight-based loading dose rose from 31.0% pre-SOP to 100% post-SOP (p < 0.001). At the first trough, 17.2% vs. 26.0% were within 15–20 mg/L (p = 0.238). Across 847 troughs (pre = 319; post = 528), the in-range proportion increased from 28.2% to 41.7%, with subtherapeutic values declining from 38.2% to 26.3% and supratherapeutic values remaining nearly similar (33.5% → 32.0%). Time to first in-range trough shortened from a median of 4 to 2 measurements (log-rank p < 0.001). Post-SOP measurements had higher odds of being in range (aOR 1.68, 95% CI 1.29–2.20; p < 0.001), with marginal predicted probabilities of 33.4% (pre) vs. 47.8% (post). Dose adjustments per patient decreased from a mean 4.0 to 2.48 (p < 0.001). Conclusions: A pragmatic, orthopedic ward–embedded SOP for intravenous vancomycin improved pharmacologic precision: more measurements within target, fewer subtherapeutic exposures, faster target attainment, and fewer dose changes. These data support protocol-first implementation as an immediately actionable step toward more consistent vancomycin exposure in orthopedic care. Future work should integrate AUC-guided, model-informed precision dosing and evaluate clinical endpoints and generalizability across centres. Full article

Background: Despite efforts to rely on arteriovenous fistulas/grafts for maintenance hemodialysis, a significant number of patients still depend on tunnel hemodialysis catheters for treatment. This poses a risk factor for central line-associated bloodstream infection (CLABSI) and, subsequently, vascular access compromise. Method: We conducted a retrospective study in five dialysis centers to determine the potential factors resulting in vascular access loss, CLABSI incidence, and microbe distribution patterns in Saudi Arabia at centers under the Ministry of National Guard Health Affairs. Adults who regularly received hemodialysis and had positive blood cultures between January 2019 and December 2023 were the subjects of the study. Results: Our study identified the presence of tunnel infection (p < 0.001), the presence of a Gram-negative pathogen (p = 0.036), and a high body mass index (BMI > 30) (p = 0.04) as potential risk factors leading to the loss of tunnel central venous catheters. In contrast, there was a lower probability of central venous catheter loss due to Gram-positive pathogens (p = 0.01). The CLABSI rate was 1.55 per 100 patients per month over a five-year period. Patients with CVC required more hospital treatment and had a significantly higher rate of vascular access loss (p < 0.001). Both central and peripheral blood cultures had nearly identical microbe spectra. Methicillin-sensitive Staphylococcus aureus (MSSA), Methicillin-resistant Staphylococcus aureus (MRSA), and Staphylococcus epidermidis had the highest prevalence rates among Gram-positive organisms. Among the Gram-negative bacteria, Enterobacter cloacae was the most common, followed by Klebsiella pneumonia and Pseudomonas aeruginosa. Conclusions: Our findings indicate the need for rigorous measures and interventions to prevent Gram-negative infections and decrease the reliance on central venous catheters, to decrease infections in hemodialysis patients, and decrease morbidity and cost. Strict hand hygiene, patient education, and surveillance programs are recommended to monitor these patients. Full article

Background: Mongolia is experiencing a rapid epidemiologic transition in which high burdens of micronutrient malnutrition, infection, and cardiometabolic disease are simultaneously prevalent. This cross-sectional study sought to understand how nutritional, lifestyle, and cardiometabolic risk factors are distributed among a population at high-risk for tuberculosis (TB), comprising household contacts (HHCs) and healthcare workers, (HCWs) in Ulaanbaatar, Mongolia, and how these factors are associated with TB infection. Methods: A total of 196 HHCs and 241 HCWs were assessed for latent TB infection (LTBI) using the QuantiFERON-TB Gold Plus (QFT-Plus) assay and for diabetes using fingerprick samples for fasting blood glucose. Participants also underwent assessments of their diet and physical activity, nicotine dependence, body mass index, and serum 25(OH)D concentration. We examined associations between assessed risk factors and LTBI using multivariate logistic regression. Results: The prevalence of LTBI was 47% for both HHCs and HCWs. A total of 54% percent of HHCs and 68% of HCWs had low physical activity levels; 63% of HHCs and 95% of HCWs were overweight or obese; 7% of HHCs and 4% of HCWs had impaired or diabetic fasting blood glucose [FBG]; and 49% of HHCs and 70% of HCWs were vitamin D deficient. In a multivariable analysis of HHCs, LTBI was independently associated with lower serum [25(OH)D], and the odds ratio (OR) was 3.18 (95% CI 1.38–7.79; p = 0.009). In contrast, the probability of LTBI did not differ significantly between vitamin D-deficient and non-deficient HCWs, and the OR was 0.89 (95% CI 0.59–1.37; p = 0.42). In a pooled analysis of HHCs and HCWs, the probability of LTBI did not significantly differ between vitamin D-deficient vs. non-deficient participants. The association between serum [25(OH)D] and LTBI among HHCs and HCWs was significantly modified by fasting blood glucose (FBG), such that a lower vitamin D status was significantly more common among those in the highest tertile of FBG than among those in the lowest tertile of FBG. Conclusions: Nutritional, lifestyle, and cardiometabolic risk factors are highly prevalent among HHCs and HCWs with TB in Ulaanbaatar, Mongolia. These findings underscore the importance of simultaneously controlling TB infection, malnutrition, and cardiometabolic risks among HHCs and HCWs to reduce the disease burden in Mongolia. Full article

Pregnancy-related cytomegalovirus (CMV) infection may have negative consequences on the developing fetus and child. In Romania, screening for CMV infection is included in the first prenatal evaluation. We aimed to evaluate the seroprevalence rates in pregnant women who underwent screening over 15 years (May 2008–February 2023). We evaluated 28,012 pregnant women, from whom 23,970 (85.57%) had an index CMV screening, and 4082 had at least two presentations during the same or consecutive pregnancies. A total of 32,290 paired anti-CMV IgM/IgG serological tests were performed. Passed infection with IgG positivity represented 90.15% (29,110) of all tests, corresponding to 28,649 women (88.72%). The seroprevalence increased with women’s age, was more frequently associated with rural residence, and decreased in time intervals. A total of 2322 women (9.69%) displaying an IgM/IgG negative pattern were at risk of acquiring the infection during pregnancy. Only 144 out of 2342 (6.14%) women at risk presented twice during the same pregnancy, of which 12 women (0.51%) displayed a pattern of primary infection. Our population from Northwest Romania shows a high rate of immunization against CMV infection and a low risk of primary infection. We found a low adherence to retesting in cases of probable primary CMV infections, which highlights the need for infection mitigation by hygiene measures and improvement of the existing protocols. Full article

Background: Ampicillin plus ceftriaxone (AC) is a first-line treatment for Enterococcus faecalis infective endocarditis (IE). Its administration in outpatient parenteral antibiotic treatment (OPAT) programs is challenging. The design of a ceftriaxone regimen suitable for OPAT requires deep knowledge of ceftriaxone pharmacokinetics (PK). Objective: We aim to explore ceftriaxone PK in elderly patients and propose dose regimens adapted to OPAT to maintain synergistic concentrations (Cs) with ampicillin against E. faecalis. Methods: We conducted a prospective observational pharmacokinetic study on patients (>55 years old) affected by E. faecalis IE. Ceftriaxone free concentration was measured at three time-points: before the administration (C_min) and two and four hours after ceftriaxone administration (C₂ and C₄). Both structural and covariate population pharmacokinetic models were built. Monte Carlo simulations of six ceftriaxone dosages were performed and the probability of target attainment (PTA) of an optimal Cs range was analyzed. The pharmacokinetic/pharmacodynamic index (PK/PD) to predict efficacy was defined as maintaining free ceftriaxone concentrations superior to the Cs at 50–100% of the dosing interval (fT ≥ Cs ≥ 50–100% of the dosing interval). Ceftriaxone dosing regimens were considered optimal if at least 90% of the simulated population was able to achieve the defined PK/PD targets. Results: Twenty-four episodes from 16 patients were included. Mean free ceftriaxone concentration pre-dose, +2 h, and +4 h were C_min = 7.8 ± 6.5 mg/L, C₂ = 34 ± 26.5 mg/L, and C₄ = 22.7 ± 19.7 mg/L, respectively. A two-compartment model with first-order absorption and elimination best described the data. Ceftriaxone one-hour infusions only achieved the minimum PK/PD target when the 2 g/12 h regimen was tested. On the other hand, ceftriaxone continuous infusion maintained a Cs above the PK/PD target for 100% of the dosing interval using ceftriaxone 4–6 g regimens. Conclusions: Our findings suggest that the optimal ceftriaxone exposure may be achieved using high-dose continuous infusions to ensure an ampicillin-killing effect when treating E. faecalis IE. Full article

The microbiome of the shrimp’s digestive tract shows differences between healthy and acute hepatopancreatic necrosis disease (AHPND)-affected shrimp. The present study aimed to evaluate the impact of probiotic consumption on the microbial community in experimentally AHPND-infected shrimp. Effective probiotics (EPs) Vibrio alginolyticus (Va32A), V. campbellii (VcHA), and Bacillus pumilus (BPY100) and non-effective probiotics (NEPs) B. pumilus (Bp43, and BpY119), were employed in bioassays with Penaeus vannamei and challenged with AHPND-causing V. parahaemolyticus (Vp_AHPND). Stomach (Sto), intestine (Int), and hepatopancreas (Hep) were analyzed by metabarcoding (16S rRNA gene) to characterize the microbiome and biomarkers. Hep-VcHA showed the highest alpha diversity (Shannon index = 5.88; 166 ASVs), whereas the lowest was for Hep-Bp43 (2.33; 7 ASVs). Proteobacteria, Actinobacteria, Bacteroidetes, and Saccharibacteria were the most abundant phyla. The relative abundance of Vibrio sp. was the highest in the Hep and Int of Bp43, BPY119 and the positive control, followed by Rhodobacteraceae in the EP group. Principle coordinate analysis (PCoA) showed a cluster grouped negative (Sto and Hep) control with almost all organs in the EP group causing 28.79% of the variation. The core microbiome of EP was mainly represented by Rhodobacteraceae, Caldilineaceae, Celeribacter indicus, Illumatobacter, Microbacterium, Ruegeria atlantica, Saccharibacteria sp., Shimia biformata, and Thalassobius mediterraneus, whose relative abundance was enriched by probiotics, which may explain their protective roles against Vp_AHPND, whereas the low survival in the NEP group was associated with a higher diversity of Vibrio spp. Our results present an ecosystem-friendly alternative based on beneficial microorganisms to prevent and control AHPND and probably other bacterial diseases in shrimp farming. Full article

Background: Dental caries is one of the most common oral infections observed worldwide. It is defined as a multifactorial dynamic disease-causing mineral loss of dental hard tissue, which is identified by the caries lesion. Treatment of the caries lesion involves filling the cavity or removing the damaged tooth. Then, the decayed, missing, and filled teeth (DMFT) index is the simplest and most commonly used index to assess the dental caries status. Salivary glands are estrogen dependent and, after menopause, the changes in salivary flow and saliva consistency produce xerostomia, hyposiale, or dryness, common findings among postmenopausal women. Since saliva plays a fundamental role in caries prevention, the postmenopausal decline in salivary secretion may contribute to increased caries incidence. The aim of this systematic review and meta-analysis was to answer the following PICO question: In adult women (P), does the presence of menopause (I), compared to its absence (C), influence dental caries status, assessed using the DMFT index (O)? Methods: The study adhered to PRISMA guidelines. A systematic search was conducted in PubMed/MEDLINE, Scopus, and EMBASE databases. For each study, characteristics and mean difference (MD) with 95% CI were extracted. Meta-analyses were performed using the Revman software (v. 5.4) to calculate pooled MD and 95% CI. Random-effects model meta-analysis was performed. Risk of bias was evaluated using the Newcastle–Ottawa Scale adapted for cross-sectional studies. To estimate variance and heterogeneity between trials, the Higgins I² test was used. The certainty level of the evidence was determined through the GRADE approach. Results: Seven studies fulfilled the inclusion criteria, including 4396 postmenopausal women and 5131 control women. Meta-analysis showed an overall MD = 3.13 (95% CI = 2.12–4.15; p < 0.00001), which suggest that postmenopausal women had a DMFT index 3 units higher than the control group. Conclusions: Menopause was significantly associated with worse dental caries status, probably due to declining estrogen levels affecting salivary function. Further research is needed to confirm mechanisms and evaluate preventive strategies like hormone replacement therapy. Full article