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VZV Reactivation and Effectiveness of Recombinant Adjuvanted Zoster Vaccine in Allo-HSCT Recipients
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A Retrospective Study of the Effects of COVID-19 Non-Pharmaceutical Interventions on Influenza in Canada
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The Underestimated Threat—Mycobacterium Genavense Infection: A Case Report
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Differential Effects of Human Immunodeficiency Virus Nef Variants on Pulmonary Vascular Endothelial Cell Dysfunction
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Canine Leptospirosis in Flood-Affected Areas of Southern Brazil: Molecular Assessment and Public Health Implications
Journal Description
Infectious Disease Reports
Infectious Disease Reports
is an international, scientific, peer-reviewed open access journal on infectious diseases published bimonthly online by MDPI (from Volume 12 Issue 3 - 2020).
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, ESCI (Web of Science), PubMed, PMC, Embase, and other databases.
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 33.5 days after submission; acceptance to publication is undertaken in 4.9 days (median values for papers published in this journal in the first half of 2025).
- Journal Rank: CiteScore - Q2 (Infectious Diseases)
- Recognition of Reviewers: APC discount vouchers, optional signed peer review, and reviewer names published annually in the journal.
- Benefits of Publishing: We aim to be a leading journal on infectious diseases and to be in the top 20 journals listed in the Journal Citation Report (JCR) in this specific category in the near future.
Impact Factor:
2.4 (2024);
5-Year Impact Factor:
2.2 (2024)
Latest Articles
Sex, Age, and COVID-19 Vaccine Characteristics Associated with Adverse Events After Vaccination and Severity: A Retrospective Analysis
Infect. Dis. Rep. 2025, 17(5), 108; https://doi.org/10.3390/idr17050108 - 3 Sep 2025
Abstract
Background: Although the safety of COVID-19 vaccines has been demonstrated in clinical trials, real-world pharmacovigilance remains essential to detect rare or unexpected adverse events following immunization (AEFI). In Mexico, the national AEFI surveillance system is in place, yet there is limited analysis of
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Background: Although the safety of COVID-19 vaccines has been demonstrated in clinical trials, real-world pharmacovigilance remains essential to detect rare or unexpected adverse events following immunization (AEFI). In Mexico, the national AEFI surveillance system is in place, yet there is limited analysis of state-level data. Objective: To characterize AEFI related to five COVID-19 vaccines and identify factors associated with AEFI type and seriousness in Nuevo León, Mexico. Methods: A retrospective analysis of the State of Nuevo León AEFI database was conducted, including all AEFI reports between December 2020 and June 2022 (n = 2213). Data included patient sex, age, vaccine type (Pfizer/BioNTech, AstraZeneca, Sinovac, Moderna, CanSino), number of doses (1 or ≥2), symptom categories, and AEFI seriousness. Symptoms were classified as local or systemic and grouped by organ systems. Descriptive analysis and binary multivariate logistic regression were used to examine associations between demographic and vaccine-related factors with AEFI type and severity. Odds ratios (OR) with 95% confidence intervals (CI) were estimated. Results: Most AEFI reports involved females aged 19–59 years and occurred after the first vaccine dose. The most frequently reported unexpected adverse events (UAEs) were mild to moderate, including injection-site reactions, headache, chills, fatigue, nausea, fever, dizziness, weakness, myalgia, and tachycardia. The Pfizer/BioNTech vaccine was associated with higher odds of arm pain and lower odds of hemorrhagic events. Receiving ≥2 doses increased the odds of arm pain and systemic symptoms. Less than 3% of AEFIs were classified as serious. Older adults (≥65 years) and second vaccine doses were associated with increased odds of a serious AEFI, while female sex and receiving the Pfizer/BioNTech vaccine were associated with reduced odds. Conclusions: In Nuevo León, most AEFIs related to COVID-19 vaccination were mild to moderate and resolved without complications. Serious AEFIs were uncommon, with older age and second doses associated with higher risk, and female sex and Pfizer/BioNTech vaccination associated with lower risk. These findings provide a local perspective on vaccine safety that complements national and international evidence.
Full article
(This article belongs to the Special Issue Viral Infectious Diseases: Epidemiology and Prevention through Vaccination)
Open AccessArticle
Torque Teno Virus as a Biomarker for Infection Risk in Kidney Transplant Recipients: A Machine Learning-Enabled Cohort Study
by
Sara Querido, Luís Ramalhete, Perpétua Gomes and André Weigert
Infect. Dis. Rep. 2025, 17(5), 107; https://doi.org/10.3390/idr17050107 - 2 Sep 2025
Abstract
Background: Torque Teno Virus (TTV) viremia has been proposed as a marker for infection risk in kidney transplant (KT) recipients. This study aimed to evaluate the prognostic value of TTV levels for predicting infections post-KT. Methods: A cohort of 82 KT patients was
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Background: Torque Teno Virus (TTV) viremia has been proposed as a marker for infection risk in kidney transplant (KT) recipients. This study aimed to evaluate the prognostic value of TTV levels for predicting infections post-KT. Methods: A cohort of 82 KT patients was analyzed. TTV loads were measured before KT and at the time of cutoff analysis (mean time since KT: 20.2 ± 10.3 months). Infections were tracked within six months following the time of cutoff analysis. Univariable analyses and a supervised machine learning approach (logistic regression with leave-one-out cross-validation) were conducted to rigorously assess TTV’s predictive ability for post-transplant infection. Results: Seventy-two patients (87.8%) had detectable TTV before KT. Of these, 30.5% developed infections, predominantly viral. TTV loads increased significantly from 3.35 ± 1.67 log10 cp/mL before KT to 4.53 ± 1.93 log10 cp/mL at the time of cutoff analysis. Infected patients had significantly higher TTV loads (5.39 ± 1.68 log10 vs. 4.16 ± 1.94 log10 cp/mL, p = 0.0057). The optimal TTV threshold for predicting infection at the time of cutoff analysis was 5.16 log10 cp/mL, with 60% sensitivity and 81% specificity. Machine learning models improved performance, with sensitivity and specificity 0.805 and 0.735, respectively. Conclusions: TTV viremia may serve as a biomarker for infection risk, particularly when used with other clinical variables. The identified TTV threshold of 5.16 log10 cp/mL offers a practical tool for clinical decision-making, particularly when integrated with a machine learning model. Further studies with larger cohorts are needed to validate these findings and refine clinical applications.
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(This article belongs to the Section Immunology and Vaccines)
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Open AccessCase Report
Hyponatremia Due to VZV-Induced SIADH in an Older Patient: Case Report and Literature Review
by
Zuzanna Żak-Skryśkiewicz, Patrycja Krupińska, Carlo Bieńkowski and Przemysław Witek
Infect. Dis. Rep. 2025, 17(5), 106; https://doi.org/10.3390/idr17050106 - 30 Aug 2025
Abstract
Introduction: Hyponatremia is a common finding in hospitalized patients, especially the elderly. Symptoms of hyponatremia can vary depending on the concentration of sodium in serum as well as the dynamics of its escalation. Hyponatremia can have many etiologies, including medication, vomiting, or diarrhea,
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Introduction: Hyponatremia is a common finding in hospitalized patients, especially the elderly. Symptoms of hyponatremia can vary depending on the concentration of sodium in serum as well as the dynamics of its escalation. Hyponatremia can have many etiologies, including medication, vomiting, or diarrhea, and central nervous system disorders, including tumors, trauma, and infections. Case report: In this case, we present a 74-year-old patient who was admitted to the Department of Internal Medicine with symptomatic, acute, and severe hyponatremia in the course of the syndrome of inappropriate antidiuretic hormone secretion due to varicella zoster virus meningoencephalitis. Clinical improvement and normalization of natremia occurred after the initiation of causal treatment. Conclusion: Given the complexity of the potential causes of hyponatremia and the variety of treatments available, it is essential to thoroughly consider the possible reasons for electrolyte abnormalities, including uncommon ones such as central nervous system infections.
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(This article belongs to the Special Issue Viral Infectious Diseases: Epidemiology and Prevention through Vaccination)
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Open AccessArticle
Health Disparities in Central Line-Associated Bloodstream Infections: Analysis of the U.S. National Inpatient Sample Database (2016–2022)
by
Nicholas Mielke, Ryan W. Walters and Faran Ahmad
Infect. Dis. Rep. 2025, 17(5), 105; https://doi.org/10.3390/idr17050105 - 28 Aug 2025
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Introduction: Central line-associated bloodstream infections (CLABSIs) are a major cause of morbidity and mortality, yet health disparities in CLABSI incidence and outcomes remain understudied. This study evaluates these disparities and their impact on CLABSI rates, in-hospital mortality, hospital length of stay (LOS), and
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Introduction: Central line-associated bloodstream infections (CLABSIs) are a major cause of morbidity and mortality, yet health disparities in CLABSI incidence and outcomes remain understudied. This study evaluates these disparities and their impact on CLABSI rates, in-hospital mortality, hospital length of stay (LOS), and costs using the National Inpatient Sample (NIS) from 2016 to 2022. Methods: We conducted a retrospective analysis of adult hospitalizations using the NIS database that included central venous catheter placement and identified CLABSI using AHRQ’s Patient Safety Indicator 07. Primary outcomes included CLABSI incidence and in-hospital mortality; secondary outcomes were LOS and inflation-adjusted hospital costs. Outcomes were analyzed using logistic and lognormal regression models, focusing on demographic and clinical variables that included sex, race, socioeconomic status, and insurance type. Results: Among 11.5 million CVCs placed between 2016 and 2022, 6.56 million met CLABSI eligibility criteria, with 1 in 400 (0.25%) complicated by CLABSI. Blacks had 29.8% higher adjusted odds of CLABSI than Whites (p < 0.001), whereas Medicaid beneficiaries had 18.4% higher odds compared to those privately insured (p = 0.002). CLABSI was associated with a 97% increase in LOS and an 82% increase in hospital costs (both p < 0.001). In-hospital mortality was 13.3% and did not differ significantly by CLABSI status after adjustment. Discussion: Racial and socioeconomic disparities persist in CLABSI incidence and healthcare resource utilization, with Blacks and Medicaid beneficiaries at the highest risk. Although CLABSI rates returned to pre-pandemic levels in 2022, associated costs and LOS remained elevated. Further research and targeted prevention strategies are needed to reduce health disparities and improve patient outcomes.
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Open AccessArticle
Oral Immunization with Yeast-Surface Display of SARS-CoV-2 Antigens in Pichia pastoris Induces Humoral Responses in BALB/C Mice
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Larissa Silva de Macêdo, Benigno Cristofer Flores Espinoza, Maria da Conceição Viana Invenção, Samara Sousa de Pinho, Lígia Rosa Sales Leal, Micaela Evellin dos Santos Silva, Beatriz Mendonça Alves Bandeira, Pedro Vinícius Silva Novis, Tiago Henrique dos Santos Souza, Julliano Matheus de Lima Maux, Jacinto da Costa Silva Neto, Antonio Carlos de Freitas and Anna Jéssica Duarte Silva
Infect. Dis. Rep. 2025, 17(5), 104; https://doi.org/10.3390/idr17050104 - 27 Aug 2025
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Background/Objectives: The pandemic caused by SARS-CoV-2 boosted the development of different vaccine models. In parallel, yeasts stand out as a vaccine platform in healthcare biotechnology. Species such as Saccharomyces cerevisiae and Pichia pastoris can express heterologous proteins, which are capable of inducing
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Background/Objectives: The pandemic caused by SARS-CoV-2 boosted the development of different vaccine models. In parallel, yeasts stand out as a vaccine platform in healthcare biotechnology. Species such as Saccharomyces cerevisiae and Pichia pastoris can express heterologous proteins, which are capable of inducing specific antibodies and can perform as an attractive vaccine vehicle with immunomodulating properties due to their cell wall composition. Furthermore, the yeast surface display system facilitates antigen presentation to immune cells. We developed an oral vaccine based on P. pastoris displaying a synthetic antigen composed of Spike and Nucleocapsid epitopes. Methods: The vaccine was administered to BALB/c mice. Systemic immune response was measured through antibody detection in blood samples, and mucosal immunity was assessed via IgA levels in feces. Histopathological analysis of intestinal and gastric tissues was also conducted. Results: The yeast-based vaccine elicited a humoral immune response, reflected in the production of neutralizing antibodies and elevated levels of IgG2a and IgG2. No structural alterations or pathological changes were observed in gastrointestinal tissues. Conclusions: This study demonstrates the feasibility of using P. pastoris as an oral vaccine delivery system, supporting previous findings with other yeast species such as Saccharomyces cerevisiae, and highlighting its potential in developing effective mucosal vaccines.
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Open AccessCase Report
Concomitant Neck and Lung Masses Post Dental Procedure—A Potential Novel Presentation of the Cellulosimicrobium Species in Humans
by
Kevin M. Sheehan, Geraldine Moloney, Olive Murphy, Paul Ryan, Triona Hayes, Madeleine R. Harney, Michael Harney and Oisin O’Connell
Infect. Dis. Rep. 2025, 17(5), 103; https://doi.org/10.3390/idr17050103 - 22 Aug 2025
Abstract
Background: Cellulosimicrobium, formerly known as the Oerskovia genus, is a Gram-positive organism known for its characteristic bright yellow colonies. While abundant in nature, it is very rarely linked to pathogenesis in humans. While there is no classical presentation for Cellulosimicrobium-associated infections,
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Background: Cellulosimicrobium, formerly known as the Oerskovia genus, is a Gram-positive organism known for its characteristic bright yellow colonies. While abundant in nature, it is very rarely linked to pathogenesis in humans. While there is no classical presentation for Cellulosimicrobium-associated infections, cases tend to be foreign body-related or involve immunocompromised patients. Rates of Cellulosimicrobium-associated infections have been hypothesised to rise in the future, due to rising numbers of immunocompromised patients in the community and increasing usage of foreign bodies such as prostheses and long-term catheters. Existing technical difficulties regarding misidentifying cultures as other species (often other coryneforms) may also play a significant role in the low number of documented cases, and this may change in the near future with diagnostic advancements such as whole genomic sequencing. Case Presentation: A 57-year-old immunocompetent Irish male presented with concomitant neck and lung masses. Notably, this was found to be directly following a recent dental procedure. During extensive investigations, Cellulosimicrobium was isolated from biopsied lung tissue using 16S ribosomal ribonucleic acid gene-sequencing analysis. The patient was treated with long-term oral amoxicillin and safely discharged, with both masses showing measurable reductions in size on subsequent imaging. Conclusions: Should Cellulosimicrobium represent the causative pathological organism in this case, then we believe this to represent a potential novel documented presentation of the organism’s pathogenesis in humans. We provide detailed discussion surrounding the successful management of this patient and the evaluation of the evolving differential diagnosis throughout this case.
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(This article belongs to the Section Bacterial Diseases)
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Dressing Impregnated with Chlorhexidine and Vancomycin for the Prophylaxis of Central Venous Catheter-Related Infections—A Randomized Trial
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Giovanna Cerri Lessa, Carolina Comitti Zanella, Gustavo Pessatto Krause, Alexandre Moreira Senter, Paula Hansen Suss, Gabriel Burato Ortis, Thyago Proenca de Moraes and Felipe Francisco Tuon
Infect. Dis. Rep. 2025, 17(4), 102; https://doi.org/10.3390/idr17040102 - 19 Aug 2025
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Background: Central venous catheters (CVCs) are essential in intensive care units (ICUs) for monitoring and administering treatments; however, catheter-related bloodstream infections (CRBSIs) are significant complications, leading to severe outcomes and increased healthcare costs. The objective of this study was to evaluate the effectiveness
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Background: Central venous catheters (CVCs) are essential in intensive care units (ICUs) for monitoring and administering treatments; however, catheter-related bloodstream infections (CRBSIs) are significant complications, leading to severe outcomes and increased healthcare costs. The objective of this study was to evaluate the effectiveness of a simple and inexpensive impregnated dressing (intervention) compared to a non-impregnated dressing in reducing catheter-related infections among critically ill patients using vancomycin and chlorhexidine. Methods: This was a randomized, double-blind, controlled clinical trial in a university hospital in Brazil with 207 beds from June 2022 to October 2023. Patients over 18 years old admitted to the ICU and needing a CVC for a period exceeding 72 h were included. A CVC inserted outside the ICU and the need for two CVCs in the same patient simultaneously were exclusion criteria. One group received an impregnated dressing (intervention) compared to the other group, which received a standard dressing (comparator). The incidence of CRBSIs and the microbiological outcomes were evaluated. The primary endpoint was CRBSI. Results: The clinical trial included 516 patients randomized to receive either the new antimicrobial dressing or a control dressing. The dressing significantly reduced CVC colonization but not CRBSI rates. Conclusions: This new dressing provides enhanced antimicrobial protection but does not decrease CRBSI incidence. Future studies should further explore the cost-effectiveness and long-term benefits of this approach.
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Open AccessArticle
The Role of Nutritional Environment in Cryptococcus gattii Titan Cells’ Ultrastructure, Biophysical Properties, Molecular Features, and Virulence in Cryptococcosis
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Igor Avellar-Moura, Glauber R. de S. Araujo, Juliana Godoy, Vinicius Alves, Iara Bastos de Andrade, Juliana Soares, Bruno Pontes and Susana Frases
Infect. Dis. Rep. 2025, 17(4), 101; https://doi.org/10.3390/idr17040101 - 16 Aug 2025
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Background/Objectives: Cryptococcus gattii presents a significant threat to healthy individuals. Titan cell formation, a key virulence factor, is influenced by the nutritional environment and plays a critical role in immune evasion and stress resistance. This study investigates the molecular and biophysical changes in
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Background/Objectives: Cryptococcus gattii presents a significant threat to healthy individuals. Titan cell formation, a key virulence factor, is influenced by the nutritional environment and plays a critical role in immune evasion and stress resistance. This study investigates the molecular and biophysical changes in titanized C. gattii cells grown in nutrient-rich Neurobasal™ medium, a potent inducer of titan cells. Methods: An integrative approach was used, combining scanning electron microscopy, optical tweezers, fluorescence microscopy, and physicochemical methods to analyze C. gattii cells grown in Neurobasal™ medium and minimal media. Results: Cells grown in Neurobasal™ medium exhibited significant differences compared to those grown in minimal media. These included a thicker and more defined polysaccharide capsule, enhanced capsule elasticity, and the secretion of more elastic polysaccharides. Furthermore, cells grown in the enriched medium showed reduced susceptibility to antifungals and delayed mortality in infection models. Conclusions: C. gattii adapts to nutritional cues by forming titan cells, thereby enhancing its pathogenicity. Targeting nutritional sensing pathways may offer novel therapeutic strategies against cryptococcal infections.
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Open AccessArticle
Epstein–Barr Virus Detection in Lymphoproliferative Disorders: Epidemiological Characterization in Western Mexico
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Karel Cesar Licona-Lasteros, Eduardo Navarrete-Medina, Karina Franco-Topete, Sergio Yair Rodriguez-Preciado, Jaime Palomares-Marin, Gerardo Cazarez-Navarro, Ramón Antonio Franco-Topete and Iván Isidro Hernández-Cañaveral
Infect. Dis. Rep. 2025, 17(4), 100; https://doi.org/10.3390/idr17040100 - 14 Aug 2025
Abstract
Background/Objectives: Epstein–Barr virus (EBV) detection patterns in lymphoproliferative disorders (LPDs) show significant geographical variation worldwide. Regional epidemiological data are essential for understanding viral distribution patterns and developing appropriate clinical surveillance strategies. This study aimed to determine EBV detection frequency in LPDs using available
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Background/Objectives: Epstein–Barr virus (EBV) detection patterns in lymphoproliferative disorders (LPDs) show significant geographical variation worldwide. Regional epidemiological data are essential for understanding viral distribution patterns and developing appropriate clinical surveillance strategies. This study aimed to determine EBV detection frequency in LPDs using available molecular and immunohistochemical methods in Western Mexico. Methods: We conducted a cross-sectional study of 200 formalin-fixed paraffin-embedded tissue samples from patients diagnosed with LPDs (2015–2019) at Hospital Civil de Guadalajara. EBV detection combined with real-time PCR targeting the BNTp143 gene and immunohistochemistry for LMP-1 protein. Cases were classified following current WHO criteria. Statistical analysis included multivariate logistic regression, diagnostic concordance assessment, and age-stratified analysis. Results: EBV detection frequency reached 35.5% overall, with marked differences between neoplastic (53.9%) and reactive LPDs (24.2%) (OR: 3.515; 95% CI: 1.859–6.645, p < 0.001). Hodgkin lymphoma showed the highest detection rate (80.6%), significantly exceeding non-Hodgkin lymphoma (39.3%) (OR: 6.43; 95% CI: 2.08–19.41, p = 0.001). Age-stratified analysis revealed predominant adult involvement (49.1% vs. 22.0% in young adults, p = 0.025). We identified three epidemiological categories based on detection probability patterns. Conclusions: This study represents the first comprehensive molecular and immunohistochemical characterization of Epstein–Barr virus in lymphoproliferative disorders from Western Mexico, establishing distinct epidemiological patterns that align with Latin American regional characteristics. The validated methodology provides a reproducible framework for multi-center studies, while the epidemiological data serve as an essential baseline for future longitudinal research and resource optimization in similar healthcare settings.
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(This article belongs to the Section Infection Prevention and Control)
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Spatiotemporal Dynamics of Dengue in the State of Pará and the Socio-Environmental Determinants in Eastern Brazilian Amazon
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Brenda Caroline Sampaio da Silva, Ricardo José de Paula Souza e Guimarães, Bruno Spacek Godoy, Andressa Tavares Parente, Bergson Cavalcanti de Moraes, Marcia Aparecida da Silva Pimentel, Douglas Batista da Silva Ferreira, Emilene Monteiro Furtado Serra, João de Athaydes Silva Junior, Luciano Jorge Serejo dos Anjos and Everaldo Barreiros de Souza
Infect. Dis. Rep. 2025, 17(4), 99; https://doi.org/10.3390/idr17040099 - 11 Aug 2025
Abstract
Background: The Amazon biome exhibits complex arboviral transmission dynamics influenced by accelerating deforestation, climate change, and socioeconomic inequities. Objectives/Methods: This study integrates official epidemiological records with socioeconomic, environmental, and climate variables by applying advanced geostatistical methods (Moran’s I, SaTScan, kernel density estimation) combined
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Background: The Amazon biome exhibits complex arboviral transmission dynamics influenced by accelerating deforestation, climate change, and socioeconomic inequities. Objectives/Methods: This study integrates official epidemiological records with socioeconomic, environmental, and climate variables by applying advanced geostatistical methods (Moran’s I, SaTScan, kernel density estimation) combined with principal component analysis and negative binomial regression to assess the spatiotemporal dynamics of dengue incidence and its association with socio-environmental determinants across municipalities in Pará state (eastern Brazilian Amazon) from 2010 to 2024. Results: Dengue incidence showed an overall decline but with marked epidemic peaks in 2010–2012, 2016, and 2024. The spatial analysis revealed significant clustering (Moran’s I = 0.221, p < 0.01), with persistent high-risk hotspots across most of Pará. Of 144 municipalities, 104 exhibited significant dengue risk, while 58 maintained sustained transmission. Negative binomial regression model identified key determinants: illiteracy, low urbanization, reduced GDP, and climate variables. Conclusions: Dengue transmission in the Amazon is driven by synergistic socio-environmental disruptions, necessitating intersectoral policies that bridge public health surveillance, sustainable land-use governance, and poverty alleviation. Priority actions include targeted vector control in high-risk clusters, coupled with integrated deforestation and climate monitoring to predict outbreak risks. The findings emphasize the urgency of implementing multisectoral interventions tailored to the territorial and socio-environmental complexities of vulnerable Amazonian regions for effective dengue control.
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(This article belongs to the Topic Vector-Borne Disease Spatial Epidemiology, Disease Ecology, and Zoonoses)
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Open AccessArticle
Antimicrobial Effect of Gentamicin/Heparin and Gentamicin/Citrate Lock Solutions on Staphylococcus aureus and Pseudomonas aeruginosa Clinical Strains
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Daniel Salas-Treviño, Arantxa N. Rodríguez-Rodríguez, María T. Ramírez-Elizondo, Magaly Padilla-Orozco, Edeer I. Montoya-Hinojosa, Paola Bocanegra-Ibarias, Samantha Flores-Treviño and Adrián Camacho-Ortiz
Infect. Dis. Rep. 2025, 17(4), 98; https://doi.org/10.3390/idr17040098 - 6 Aug 2025
Abstract
Background/Objectives: Hemodialysis catheter-related bloodstream infection (HD-CRBSIs) is a main cause of morbidity in hemodialysis. New preventive strategies have emerged, such as using lock solutions with antiseptic or antibiotic capacity. In this study, the antimicrobial effect was analyzed in vitro and with a catheter
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Background/Objectives: Hemodialysis catheter-related bloodstream infection (HD-CRBSIs) is a main cause of morbidity in hemodialysis. New preventive strategies have emerged, such as using lock solutions with antiseptic or antibiotic capacity. In this study, the antimicrobial effect was analyzed in vitro and with a catheter model of lock solutions of gentamicin (LSG), gentamicin/heparin (LSG/H), and gentamicin/citrate (LSG/C) in clinical and ATCC strains of Pseudomonas aeruginosa and Staphylococcus aureus. Methods: The formation, minimum inhibitory concentration, and minimum inhibitory concentration of the biofilm and minimum biofilm eradication concentration of the lock solutions were determined. Additionally, colony-forming unit assays were performed to evaluate the antimicrobial efficacy of the lock solutions in a hemodialysis catheter inoculation model. Results: The minimum inhibitory concentration (MIC) of planktonic cells of both P. aeruginosa and S. aureus for LSG/H and LSG/C was 4 µg/mL. In the minimum biofilm inhibitory concentration (MBIC) tests, the LSG/H was less effective than LSG/C, requiring higher concentrations for inhibition, contrary to the minimum biofilm eradication concentration (MBEC), where LSG/H was more effective. All lock solutions eradicated P. aeruginosa biofilms in the HD catheter model under standard conditions. Nevertheless, under modified conditions, the lock solutions were not as effective versus ATCC and clinical strains of S. aureus. Conclusions: Our analysis shows that the lock solutions studied managed to eradicate intraluminal mature P. aeruginosa in non-tunneled HD catheters under standard conditions. Biofilm inhibition and eradication were observed at low gentamicin concentrations, which could optimize the gentamicin concentration in lock solutions used in HD catheters.
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(This article belongs to the Special Issue Prevention, Diagnosis and Treatment of Healthcare-Associated Infections)
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Biocide Tolerance, Biofilm Formation, and Efflux Pump Activity in Clinical Isolates of Trichosporon asahii
by
Yasmim Passos Lima, Jamile de Paiva Macedo, Alessandra Barbosa Ferreira Machado, Cláudio Galuppo Diniz, Vania Lucia da Silva and Vanessa Cordeiro Dias
Infect. Dis. Rep. 2025, 17(4), 97; https://doi.org/10.3390/idr17040097 - 6 Aug 2025
Abstract
Background: Trichosporon spp. are opportunistic fungi, capable of causing infection, especially in critically ill individuals who often use broad-spectrum antibiotics, invasive devices, and have comorbidities. Objectives The aim of this study was to analyze individuals’ clinical characteristics, evaluate tolerance to biocides, as well
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Background: Trichosporon spp. are opportunistic fungi, capable of causing infection, especially in critically ill individuals who often use broad-spectrum antibiotics, invasive devices, and have comorbidities. Objectives The aim of this study was to analyze individuals’ clinical characteristics, evaluate tolerance to biocides, as well as biofilm formation and efflux pump activity in isolates of Trichosporon asahii. Methods: Clinical isolates of T. asahii collected between 2020 and 2023 from both hospitalized and non-hospitalized individuals, of both sexes, regardless of age, were tested for tolerance to sodium hypochlorite, hydrogen peroxide, benzalkonium chloride, and ethyl alcohol. Efflux pump activity was also assessed using ethidium bromide, and biofilm formation was measured with the Safranin test. Clinical parameters such as outcomes, source, and length of hospitalization were analyzed through electronic medical records. Results: A total of 37 clinical isolates of T. asahii were identified. Thirty-three (83.8%) isolates were from hospitalized individuals, with 81.82% collected in ICUs, an average hospital stay of 35 days, and a mortality rate of 51.6%. The tested strains displayed the largest mean inhibition zone for 2% sodium hypochlorite, indicating lower tolerance. A high level of efflux pump expression was detected among clinical isolates. Biofilm formation was detected in 25/67.5% of the isolates. Conclusions: These findings highlight the clinical relevance of T. asahii, particularly in critically ill individuals, and underscore the pathogen’s ability to tolerate biocides, express efflux pumps, and form biofilms, all of which may contribute to its persistence and pathogenicity in hospital environments. Enhanced surveillance and effective microbial control measures are essential to mitigate the risks associated with T. asahii infections.
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(This article belongs to the Section Fungal Infections)
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Open AccessCase Report
Scrofuloderma, an Old Acquaintance: A Case Report and Literature Review
by
Heiler Lozada-Ramos and Jorge Enrique Daza-Arana
Infect. Dis. Rep. 2025, 17(4), 96; https://doi.org/10.3390/idr17040096 - 6 Aug 2025
Abstract
Scrofuloderma, a cutaneous manifestation of tuberculosis, is a rare but clinically significant form of mycobacterial infection. It typically results from the local spread of Mycobacterium tuberculosis from an infected lymph node or bone area to the overlying skin. This disease is mainly characterized
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Scrofuloderma, a cutaneous manifestation of tuberculosis, is a rare but clinically significant form of mycobacterial infection. It typically results from the local spread of Mycobacterium tuberculosis from an infected lymph node or bone area to the overlying skin. This disease is mainly characterized by chronic granulomatous inflammation, leading to skin ulcers and abscesses. Due to its nonspecific clinical presentation, scrofuloderma can mimic various dermatological conditions, making its diagnosis particularly challenging. This case report presents the clinical course of a patient who was positive for the Human Immunodeficiency Virus (HIV) with a diagnosis of scrofuloderma, managed at a tertiary healthcare center, with follow-up before and after treatment. A literature review was also made, highlighting the importance of maintaining a high index of clinical suspicion and utilizing appropriate diagnostic methods to ensure timely diagnosis.
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(This article belongs to the Section Tuberculosis and Mycobacteriosis)
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Cognitive Screening with the Italian International HIV Dementia Scale in People Living with HIV: A Cross-Sectional Study in the cART Era
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Maristella Belfiori, Francesco Salis, Sergio Angioni, Claudia Bonalumi, Diva Cabeccia, Camilla Onnis, Nicola Pirisi, Francesco Ortu, Paola Piano, Stefano Del Giacco and Antonella Mandas
Infect. Dis. Rep. 2025, 17(4), 95; https://doi.org/10.3390/idr17040095 - 6 Aug 2025
Abstract
Background: HIV-associated neurocognitive disorders (HANDs) continue to be a significant concern, despite the advancements in prognosis achieved through Combination Antiretroviral Therapy (cART). Neuropsychological assessment, recommended by international guidelines for HANDs diagnosis, can be resource-intensive. Brief screening tools, like the International HIV Dementia
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Background: HIV-associated neurocognitive disorders (HANDs) continue to be a significant concern, despite the advancements in prognosis achieved through Combination Antiretroviral Therapy (cART). Neuropsychological assessment, recommended by international guidelines for HANDs diagnosis, can be resource-intensive. Brief screening tools, like the International HIV Dementia Scale (IHDS) and the Montreal Cognitive Assessment (MoCA), are crucial in facilitating initial evaluations. This study aims to assess the Italian IHDS (IHDS-IT) and evaluate its sensitivity and specificity in detecting cognitive impairment in HIV patients. Methods: This cross-sectional study involved 294 patients aged ≥30 years, evaluated at the Immunology Unit of the University of Cagliari. Cognitive function was assessed using the MoCA and IHDS. Laboratory parameters, such as CD4 nadir, current CD4 count, and HIV-RNA levels, were also collected. Statistical analyses included Spearman’s correlation, Receiver Operating Characteristic analysis, and the Youden J statistic to identify the optimal IHDS-IT cut-off for cognitive impairment detection. Results: The IHDS and MoCA scores showed a moderate positive correlation (Spearman’s rho = 0.411, p < 0.0001). ROC analysis identified an IHDS-IT cut-off of ≤9, yielding an Area Under the Curve (AUC) of 0.76, sensitivity of 71.7%, and specificity of 67.2%. At this threshold, 73.1% of patients with MoCA scores below 23 also presented abnormal IHDS scores, highlighting the complementary utility of both cognitive assessment instruments. Conclusions: The IHDS-IT exhibited fair diagnostic accuracy for intercepting cognitive impairment, with a lower optimal cut-off than previously reported. The observed differences may reflect this study cohort’s demographic and clinical characteristics, including advanced age and long-lasting HIV infection. Further, longitudinal studies are necessary to validate these findings and to confirm the proposed IHDS cut-off over extended periods.
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(This article belongs to the Section Sexually Transmitted Diseases)
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Open AccessCase Report
The First Schaalia (Formerly Actinomyces) Canis-Related Osteomyelitis Requiring Surgical Intervention
by
Patrick Nugraha, Tzong-Yang Pan, Paul Di Giovine, Nigel Mann and William Murphy
Infect. Dis. Rep. 2025, 17(4), 94; https://doi.org/10.3390/idr17040094 - 4 Aug 2025
Abstract
Schaalia canis is a Gram-positive, facultatively anaerobic, rod-shaped bacterium originally isolated from the mucosa and skin of dogs. While it is a part of the normal canine oral flora, it has rarely been implicated in human disease, with only one prior case of
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Schaalia canis is a Gram-positive, facultatively anaerobic, rod-shaped bacterium originally isolated from the mucosa and skin of dogs. While it is a part of the normal canine oral flora, it has rarely been implicated in human disease, with only one prior case of cellulitis reported following a dog bite. Case Presentation: We present the case of a 57-year-old immunocompetent man who developed osteomyelitis of the left index finger following a delayed presentation after a dog bite. Despite initial conservative management with empirical oral antibiotics, the infection progressed, eventually requiring surgical debridement and the terminalisation of the finger at the proximal interphalangeal joint. Cultures from intraoperative bone specimens yielded the growth of Schaalia canis, with no other pathogenic organisms identified on the extended culture. Conclusions: This is the first documented case of Schaalia canis-associated osteomyelitis in a human and the first to necessitate a surgical intervention, expanding the known clinical spectrum of this organism. This case underscores the risks of delayed intervention in polymicrobial animal bite wounds and highlights the emerging role of Schaalia species as opportunistic zoonotic pathogens, particularly in the setting of deep, refractory infections.
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(This article belongs to the Section Bacterial Diseases)
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Open AccessArticle
Detection of Microorganisms Causing Human Respiratory Infection Using One-Tube Multiplex PCR
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Isabela L. Lima, Adriana F. Neves, Robson J. Oliveira-Júnior, Lorrayne C. M. G. Honório, Vitória O. Arruda, Juliana A. São Julião, Luiz Ricardo Goulart Filho and Vivian Alonso-Goulart
Infect. Dis. Rep. 2025, 17(4), 93; https://doi.org/10.3390/idr17040093 - 4 Aug 2025
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Background/Objectives: Due to the significant overlap in symptoms between COVID-19 and other respiratory infections, a multiplex PCR-based platform was developed to simultaneously detect 22 respiratory pathogens. Target sequences were retrieved from the GenBank database and aligned using Clustal Omega 2.1 to identify conserved
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Background/Objectives: Due to the significant overlap in symptoms between COVID-19 and other respiratory infections, a multiplex PCR-based platform was developed to simultaneously detect 22 respiratory pathogens. Target sequences were retrieved from the GenBank database and aligned using Clustal Omega 2.1 to identify conserved regions prioritized for primer design. Primers were designed using Primer Express® 3.0.1 and evaluated in Primer Explorer to ensure specificity and minimize secondary structures. A multiplex strategy organized primers into three groups, each labeled with distinct fluorophores (FAM, VIC, or NED), allowing for detection by conventional PCR or capillary electrophoresis (CE). Methods: After reverse transcription for RNA targets, amplification was performed in a single-tube reaction. A total of 340 clinical samples—nasopharyngeal and saliva swabs—were collected from patients, during the COVID-19 pandemic period. The automated analysis of electropherograms enabled precise pathogen identification. Results: Of the samples analyzed, 57.1% tested negative for all pathogens. SARS-CoV-2 was the most frequently detected pathogen (29%), followed by enterovirus (6.5%). Positive results were detected in both nasopharyngeal and saliva swabs, with SARS-CoV-2 predominating in saliva samples. Conclusions: This single-tube multiplex PCR-CE assay represents a cost-effective and robust approach for comprehensive respiratory pathogen detection. It enables rapid and simultaneous diagnosis, facilitating targeted treatment strategies and improved patient outcomes.
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Open AccessArticle
Bedside Risk Scoring for Carbapenem-Resistant Gram-Negative Bacterial Infections in Patients with Hematological Malignancies
by
Sare Merve Başağa, Ayşegül Ulu Kılıç, Zeynep Ture, Gökmen Zararsız and Serra İlayda Yerlitaş
Infect. Dis. Rep. 2025, 17(4), 92; https://doi.org/10.3390/idr17040092 - 1 Aug 2025
Abstract
Background/Objectives: This study aimed to create a ‘carbapenem resistance score’ with the risk factors of carbapenem-resistant Gram-negative bacterial infections (GNBIs) in patients with hematological malignancies. Methods: Patients with carbapenem-resistant and susceptible GNBIs were included in this study and compared in terms of risk
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Background/Objectives: This study aimed to create a ‘carbapenem resistance score’ with the risk factors of carbapenem-resistant Gram-negative bacterial infections (GNBIs) in patients with hematological malignancies. Methods: Patients with carbapenem-resistant and susceptible GNBIs were included in this study and compared in terms of risk factors. Three models of “carbapenem resistance risk scores” were created with statistically significant variables. Results: The study included 154 patients with hospital-acquired GNBIs, of whom 64 had carbapenem-resistant GNBIs and 90 had carbapenem-susceptible GNBIs. Univariate and multivariate analyses identified several statistically significant risk factors for carbapenem resistance, including transfer from another hospital or clinic (p = 0.038), prior use of antibiotics like fluoroquinolones (p = 0.009) and carbapenems (p = 0.001), a history of carbapenem-resistant infection in the last six months (p < 0.001), rectal Klebsiella pneumoniae colonization (p < 0.001), hospitalization for ≥30 days (p = 0.001), and the presence of a urinary catheter (p = 0.002). Notably, the 14-day mortality rate was significantly higher in the carbapenem-resistant group (p < 0.001). Based on these findings, three risk-scoring models were developed. Common factors in all three models were fluoroquinolone use in the last six months, rectal K. pneumoniae colonization, and the presence of a urinary catheter. The fourth variable was transfer from another hospital (Model 1), a history of carbapenem-resistant infection (Model 2), or hospitalization for ≥30 days (Model 3). All models demonstrated strong discriminative power (AUC for Model 1: 0.830, Model 2: 0.826, Model 3: 0.831). For all three models, a cutoff value of >2.5 was adopted as the threshold to identify patients at high risk for carbapenem resistance, a value which yielded high positive and negative predictive values. Conclusions: This study successfully developed three practical risk-scoring models to predict carbapenem resistance in patients with hematological malignancies using common clinical risk factors. A cutoff score of >2.5 proved to be a reliable threshold for identifying high-risk patients across all models, providing clinicians with a valuable tool to guide appropriate empirical antibiotic therapy.
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(This article belongs to the Special Issue Prevention, Diagnosis and Treatment of Healthcare-Associated Infections)
Open AccessReview
Antifungal Agents in the 21st Century: Advances, Challenges, and Future Perspectives
by
Francesco Branda, Nicola Petrosillo, Giancarlo Ceccarelli, Marta Giovanetti, Andrea De Vito, Giordano Madeddu, Fabio Scarpa and Massimo Ciccozzi
Infect. Dis. Rep. 2025, 17(4), 91; https://doi.org/10.3390/idr17040091 - 1 Aug 2025
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Invasive fungal infections (IFIs) represent a growing global health threat, particularly for immunocompromised populations, with mortality exceeding 1.5 million deaths annually. Despite their clinical and economic burden—costing billions in healthcare expenditures—fungal infections remain underprioritized in public health agendas. This review examines the current
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Invasive fungal infections (IFIs) represent a growing global health threat, particularly for immunocompromised populations, with mortality exceeding 1.5 million deaths annually. Despite their clinical and economic burden—costing billions in healthcare expenditures—fungal infections remain underprioritized in public health agendas. This review examines the current landscape of antifungal therapy, focusing on advances, challenges, and future directions. Key drug classes (polyenes, azoles, echinocandins, and novel agents) are analyzed for their mechanisms of action, pharmacokinetics, and clinical applications, alongside emerging resistance patterns in pathogens like Candida auris and azole-resistant Aspergillus fumigatus. The rise of resistance, driven by agricultural fungicide use and nosocomial transmission, underscores the need for innovative antifungals, rapid diagnostics, and stewardship programs. Promising developments include next-generation echinocandins (e.g., rezafungin), triterpenoids (ibrexafungerp), and orotomides (olorofim), which target resistant strains and offer improved safety profiles. The review also highlights the critical role of “One Health” strategies to mitigate environmental and clinical resistance. Future success hinges on multidisciplinary collaboration, enhanced surveillance, and accelerated drug development to address unmet needs in antifungal therapy.
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Open AccessArticle
Long COVID-19: A Concept Analysis
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Sujata Srikanth, Jessica R. Boulos, Diana Ivankovic, Lucia Gonzales, Delphine Dean and Luigi Boccuto
Infect. Dis. Rep. 2025, 17(4), 90; https://doi.org/10.3390/idr17040090 - 29 Jul 2025
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Background/Objectives: In late 2019, the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) caused a pandemic called the ‘coronavirus disease 2019’ (COVID-19). After the acute SARS-CoV-2 infection, many individuals (up to 33%) complained of unexplained symptoms involving multiple organ systems and were diagnosed
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Background/Objectives: In late 2019, the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) caused a pandemic called the ‘coronavirus disease 2019’ (COVID-19). After the acute SARS-CoV-2 infection, many individuals (up to 33%) complained of unexplained symptoms involving multiple organ systems and were diagnosed as having Long COVID-19 (LC-19). Currently, LC-19 is inadequately defined, requiring the formation of consistent diagnostic parameters to provide a foundation for ongoing and future studies of epidemiology, risk factors, clinical characteristics, and therapy. LC-19 represents a significant burden on multiple levels. The reduced ability of workers to return to work or compromised work efficiency has led to consequences at national, economic, and societal levels by increasing dependence on community services. On a personal scale, the isolation and helplessness caused by the disease and its subsequent impact on the patient’s mental health and quality of life are incalculable. Methods: In this paper, we used Walker and Avants’ eight-step approach to perform a concept analysis of the term “Long COVID-19” and define its impact across these parameters. Results: Using this methodology, we provide an improved definition of LC-19 by connecting the clinical symptomology with previously under-addressed factors, such as mental, psychological, economic, and social effects. This definition of LC-19 features can help improve diagnostic procedures and help plan relevant healthcare services. Conclusions: LC-19 represents a complex and pressing public health challenge with diverse symptomology, an unpredictable timeline, and complex pathophysiology. This concept analysis serves as a tool for improving LC-19 definition, but it remains a dynamic disease with evolving diagnostic and therapeutic approaches, requiring deeper investigation and understanding of its long-term effects.
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A Multi-Center Prospective Study on Post-Vaccination Humoral Response to SARS-CoV-2 in Polish Long-Term Care Facility Residents: Associations with COVID-19 Clinical Course and Comorbidities
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Justyna Brodowicz, Piotr Heczko, Estera Jachowicz-Matczak, Mateusz Gajda, Katarzyna Gawlik, Dorota Pawlica-Gosiewska, Bogdan Solnica and Jadwiga Wójkowska-Mach
Infect. Dis. Rep. 2025, 17(4), 89; https://doi.org/10.3390/idr17040089 - 24 Jul 2025
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Background: Vaccination effectively reduces the risk of infection, including COVID-19 yet older adults often receive insufficient attention despite their increased vulnerability. The study aimed to correlate serological results with underlying conditions, vaccination status, and COVID-19 history. Methods: This non-interventional, multicenter study aimed to
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Background: Vaccination effectively reduces the risk of infection, including COVID-19 yet older adults often receive insufficient attention despite their increased vulnerability. The study aimed to correlate serological results with underlying conditions, vaccination status, and COVID-19 history. Methods: This non-interventional, multicenter study aimed to assess vaccination coverage and SARS-CoV-2 antibody levels among residents of eight long-term care facilities (LTCFs) in Southern Poland. Data collection took place between January and June 2022, with 429 participants recruited based on their ability to provide informed consent and their residency in LTCFs. Sociodemographic data, medical history, and COVID-19-related information—including infection history and vaccination status—were collected through surveys. Blood samples were obtained for serological testing using enzyme-linked immunosorbent assays (ELISA) to detect anti-SARS-CoV-2 antibodies. Statistical analysis, including Spearman’s correlation, revealed significant associations between antibody levels and vaccination status, as well as between RT-PCR-confirmed COVID-19 infections and higher antibody titers. Results: Among the seven different qualitative serological, only the Anti-SARS-CoV-2 NCP (IgG) and Anti-SARS-CoV-2 (IgA) tests showed a positive correlation with the Anti-SARS-CoV-2 QuantiVac (IgG) test, which was used as a comparator. A weak correlation was noted with the age of the residents. Conclusions: Our findings suggest that vaccination positively influences antibody responses, underscoring the importance of immunization among LTCF residents. Additionally, certain comorbidities—such as degenerative joint disease and diabetes—showed weak correlations with higher antibody levels. This study provides valuable insights into the humoral immune response to COVID-19 in vulnerable populations residing in LTCFs.
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