Search Results (1,776)

It is mostly known which microorganisms make up the intestinal microbiota and what their role is in the digestive tract. Moreover, there is evidence about the influence of these microorganisms, especially bacteria, on the functioning of the human body in general. Intestinal microbiota is metabolically active and synthesizes numerous molecules that are an important part of biochemical processes in the human body, as well as signaling pathways. Some of these molecules are of lipid origin, which is why new knowledge in the field of lipidomics can help in their more precise identification. It is now clear that the lipid profile of the stool depends on the composition and metabolic activity of the microbiota. Therefore, under changed conditions, such as the existence of an infection, there are changes in the lipid profile of the stool. One of the epidemiologically most important and most studied infections of the digestive tract is Clostridioides difficile infection. This infection is recurrent in a large number of cases; it is related to resistance to antibiotics and their irrational use, and because of that, further research in this area would bring insight into possibly new knowledge that would help in more effective suppression of this infection. Full article

Invasive candidiasis (IC) in Latin America is undergoing a significant epidemiological shift, increasingly driven by non-albicans strains such as Candida tropicalis, Candida parapsilosis, and Candidozyma auris. These pathogens often exhibit multidrug resistance, which complicates treatment and increases mortality. Diagnostic limitations, particularly in rural and public hospitals, delay detection and hinder the provision of rapid care. Environmental pressures, such as climate change and the widespread use of azoles in agriculture, appear to favor the selection of resistant and thermotolerant strains. Migratory birds may also play a role in the environmental transmission of pathogenic fungi. These factors are amplified by socioeconomic inequalities that restrict access to diagnostics and first-line antifungals. To help mitigate this emerging challenge, a One Health-oriented framework combining integrated environmental surveillance, robust antifungal-stewardship programmers, broader diagnostic access, and coordinated cross-sector public health actions should be developed. Reinforcing these pillars could lessen the regional burden of IC and slow the advance of antifungal resistance. Full article

Studies of HIV-1 molecular epidemiology describe significant differences in HIV infection spread across geographical areas. We examined 80 HIV-1 samples from the Jewish Autonomous Region of Russia in 2024. HIV-1 genome sequences for 12 samples revealed a novel HIV-1 called CRF173_63A6. HIV-1 CRF173_63A6 was found to have arisen through recombination between a specific Russian A6 subtype and the recombinant virus CRF63_02A6, which is responsible for the PWID-associated HIV outbreak in the Siberian region of Russia. Phylogenetic analysis of pol sequences previously deposited in Genbank showed that the CRF173_63A6 samples we described are grouped into a common phylogenetic cluster that includes 54 HIV-1 samples isolated in the JAR and other areas of the Russian Far East, indicating a wide distribution of this virus genovariant. This study once again proves the significant contribution of the key PWID group not only to the development of local Russian HIV epidemics, but also to the change in the characteristics of the circulating virus population. Full article

The identification of recent HIV infections among newly diagnosed HIV cases is relevant to both implementing targeted prevention measures and estimating HIV incidence. We analyzed data on new HIV diagnoses in Italy from 2012 to 2023. We selected cases that were tested by at least one of three criteria (test for HIV recency, data on HIV seroconversion, clinical signs of acute HIV infection) to assess the rate of recent (<1 year) HIV infections. We analyzed these cases by gender, age group, nationality, and mode of transmission, and revaluated cases that were initially scored as a late diagnosis but then classified as a recent infection. Out of 36,289 new HIV diagnoses, 17,558 (48.8%) were tested for recent infection by at least one criterion and 3772 (21.5%) were classified as recent. At multivariate analysis, the probability of being recently infected was significantly higher among males, people aged 15–44 years, Italians, individuals diagnosed in Northern and Central Italy, heterosexual males, MSM, and people with a CD4 count ≥ 350 cells/uL at diagnosis. Of 8658 cases initially classified as late diagnoses, 979 (11.3%) were reclassified as recent by the aforementioned criteria. Monitoring recent infections among new HIV diagnoses is beneficial to individuals—because it motivates recently infected people to comply with antiretroviral treatment (which is more effective if started early) and to collaborate to partner notification, and to public health, as it provides evidence of epidemiological changes and stresses the need for targeted prevention in well-defined populations at risk. Full article

Background: Greek islands face mounting pressures on their marine water resources due to tourism growth, agricultural runoff, climate change, and emerging pollutants. Safeguarding seawater quality is critical for ecosystem integrity, public health, and the sustainability of tourism-based economies. Objectives: This scoping review synthesizes and evaluates the existing research on seawater quality in the Greek islands, with emphasis on pollution sources, monitoring methodologies, and socio-environmental impacts, while highlighting the gaps in addressing emerging contaminants and aligning with sustainable development goals. Methods: A systematic literature search was conducted in Scopus, Google Scholar, ResearchGate, Web of Science, and PubMed for English- and Greek-language studies published over the last two to three decades. The search terms covered physical, chemical, and biological aspects of seawater quality, as well as emerging pollutants. The PRISMA-ScR guidelines were followed, resulting in the inclusion of 178 studies. The data were categorized by pollutant type, location, water quality indicators, monitoring methods, and environmental, health, and tourism implications. Results: This review identifies agricultural runoff, untreated wastewater, maritime traffic emissions, and microplastics as key pollution sources. Emerging contaminants such as pharmaceuticals, PFASs, and nanomaterials have been insufficiently studied. While monitoring technologies such as remote sensing, fuzzy logic, and Artificial Neural Networks (ANNs) are increasingly applied, these efforts remain fragmented and geographically uneven. Notable gaps exist in the quantification of socio-economic impact, source apportionment, and epidemiological assessments. Conclusions: The current monitoring and management strategies in the Greek islands have produced high bathing water quality in many areas, as reflected in the Blue Flag program, yet they do not fully address the spatial, temporal, and technological challenges posed by climate change and emerging pollutants. Achieving long-term sustainability requires integrated, region-specific water governance linked to the UN SDGs, with stronger emphasis on preventive measures, advanced monitoring, and cross-sector collaboration. Full article

Background and Objectives: This retrospective single-center study aimed to evaluate the epidemiological, clinical, and laboratory characteristics of syphilis cases diagnosed at our hospital between 2005 and 2024, with a focus on the performance of serological tests used for diagnosis. The study also sought to characterize changing epidemiological trends of syphilis over this 20-year period. Materials and Methods: Data from 671 patients with confirmed syphilis diagnoses were retrospectively analyzed. Demographic information, transmission routes, co-infection status, and serological test results—including Rapid Plasma Reagin (RPR) and Indirect Hemagglutination Assay (IHA)—were evaluated. Statistical analyses were performed using chi-square and Fisher-based tests, with Bonferroni correction applied for multiple comparisons Results: Of the 671 cases, 74.6% were male and 25.4% female, with the highest incidence in the 22–41 age group. The number of diagnosed cases increased approximately 6-fold after 2016 compared to the preceding years. Unprotected sexual contact was the most common transmission route. HIV co-infection was present in 32.6% of cases, predominantly in males. Significant differences in RPR and IHA titers were observed across clinical stages of syphilis, with notably higher titers in late latent and neurosyphilis cases. Conclusions: The 6-fold increase in syphilis diagnoses since 2016, alongside a high rate of HIV co-infection, underscores the need for targeted prevention and screening programs for high-risk populations. Serological testing remains essential for diagnosis and disease monitoring. Full article

In response to contemporary challenges such as the COVID-19 pandemic, climate change, armed conflicts, and economic instability, healthcare systems worldwide are increasingly confronted with multifaceted and overlapping crises—collectively referred to as polycrisis. These interconnected threats amplify one another, placing unprecedented strain on healthcare infrastructure, governance, and equity. The COVID-19 pandemic alone led to an estimated 16.3 million missed hospitalizations in 2020 and 14.7 million in 2021, revealing systemic vulnerabilities and deepening social inequalities. Armed conflicts, such as in Syria and Gaza, have devastated healthcare access. In Gaza, by mid-2024, 85% of the population had been forcibly displaced, with only 17 of 36 hospitals partially functioning and over 885 healthcare workers killed. Climate change further exacerbates health burdens, with over 86% of urban residents globally exposed to harmful air pollution, contributing to 1.8 million deaths annually. This study introduces a novel perspective by applying social epidemiology to the analysis of polycrisis. While the existing literature often emphasizes political or economic dimensions, our approach highlights how overlapping crises affect population health, social vulnerability, and systemic resilience. By integrating sociodemographic and environmental data, social epidemiology supports crisis-resilient care models, targeted interventions, and equitable health policies. We argue for a stronger mandate to invest in data infrastructure, enhance surveillance, and embed social determinants into health system responses. Full article

Recommender systems on digital platforms profoundly influence user behavior through content dissemination, and their diffusion process is similar to the spreading mechanism of infectious diseases to some extent. In this paper, we use a network-based susceptibility-infection (SI) model to model the propagation dynamics of recommended content, and systematically compare the differences in propagation efficiency among three recommendation strategies based on popularity, collaborative filtering, and content. We constructed scale-free user networks based on real-world clickstream data and dynamically adapted the SI model to reflect the realistic scenario of user engagement decay over time. To enhance the understanding of the recommendation process, we further simulate the visualization changes of the propagation process to show how the content spreads among users. The experimental results show that collaborative filtering performs superior in the initial dissemination, but its dissemination effect decays rapidly over time and is weaker than the other two methods. This study provides new ideas for modeling and understanding recommender systems from an epidemiological perspective. Full article

Aims: To investigate the global epidemiological characteristics of lower respiratory infection (LRI) burden caused by Streptococcus pneumoniae (SP) from 1990 to 2021. Methods: Using data from the Global Burden of Disease (GBD) study 2021, we systematically analyzed Streptococcus pneumoniae-related (SP-related) LRI burden, focusing on mortality, disability-adjusted life years (DALYs), and temporal trends by age, gender, geographic region, and socio-demographic index (SDI) quintiles. Decomposition analysis assessed the influence of epidemiological shifts, population growth, and aging on age-standardized mortality rates (ASMRs), while an autoregressive integrated moving average (ARIMA) model projected future trends. Results: Between 1990 and 2021, the global SP-related LRI death number decreased from 1,028,083 (95% uncertainty interval (UI): 923,782–1,146,074) to 505,268 (95% UI: 454,335–552,539), and the ASMR dropped from 19.28 (95% UI: 17.32–21.49) to 6.40 (95% UI: 5.76–7.00) per 100,000. The age distribution consistently exhibited a clear two-tiered pattern, gradually shifting from being predominantly composed of young children to being dominated by older adults. Disparities were stark across SDI quintiles, low-SDI regions exhibited up to 100-times-higher under-five mortality than high-SDI regions. Geographic distribution showed the highest ASMRs in sub-Saharan Africa and the lowest in Canada, the United States, and Australia, with Mongolia and Finland showing the largest reductions in mortality. Epidemiological changes were the most significant factor in ASMR reduction. Conclusions: The SP-related LRI burden has decreased globally but remains a major health concern, especially in low-SDI regions. Targeted public health interventions, particularly for neonates and elderly adults, are essential to address persistent disparities and further reduce mortality. Full article

Background/Objectives: We analyzed recent changes in the incidence of glaucoma and associated visual impairment (VI) in Korea over a 16-year period. Methods: We utilized nationwide, longitudinal cohort data from the Korea National Health Insurance System (KNHIS) National Health Screening Cohort from 2004 to 2019 to evaluate the age-standardized incidence rate (SIR) of glaucoma and glaucoma-related VI. VI was determined based on KNHIS health examinations and the National Registry for Visual Disability. The incidence rates were estimated per 100,000 person-years. Joinpoint regression analysis was applied to assess significant changes in incidence trends, and subgroup analyses were conducted by age and sex. Results: The age-SIR of glaucoma increased from 864.1 per 100,000 in 2004 to a peak of 1101.1 in 2016, followed by a decline to 978.9 in 2019. Joinpoint regression identified a significant rise from 2007 to 2015 (annual percent change [APC]: +3.92%), with a subsequent decline (APC: –3.30%). The incidence of glaucoma-related severe VI decreased from 26.23 per 100,000 in 2004 to 8.76 in 2012, remaining stable thereafter at 12.49 in 2019. The VI-to-incidence ratio also declined from 0.030 in 2004 to 0.009 in 2012, which remained stable thereafter at 0.013 in 2019. Females consistently exhibited higher glaucoma incidence but lower VI rates than males. Conclusions: These recent trends highlight the evolving landscape of glaucoma epidemiology in Korea and underscore the need for sustained early detection efforts and optimized patient management. Full article

Streptococcus pyogenes (Group A Streptococcus, GAS) is a major human pathogen capable of causing infections ranging from mild pharyngitis and impetigo to severe invasive diseases such as bacteremia, necrotizing fasciitis, and streptococcal toxic shock syndrome (STSS). Historically, the incidence of GAS infections declined during the early antibiotic era but began rising again from the early 2000s, driven partly by the emergence of hyper-virulent strains such as emm1 and emm12. From 2005 onward, significant increases in GAS infections were reported globally, accompanied by rising antibiotic resistance, particularly to macrolides and tetracyclines. During the COVID-19 pandemic, widespread public health measures led to a sharp decline in GAS infections, including invasive cases, but this trend reversed dramatically in late 2022 and 2023, with surges exceeding pre-pandemic levels, notably in children. Recent data implicate factors such as “immunity debt,” viral co-infections, and the spread of virulent clones like M1UK. Looking forward, continued surveillance of GAS epidemiology, virulence factors, and resistance patterns is critical. Moreover, the emergence of GAS isolates with reduced susceptibility to beta-lactams underscores the need for vigilance despite the absence of fully resistant strains. The development of an effective vaccine remains an urgent priority to reduce GAS disease burden and prevent severe outcomes. Future research should focus on vaccine development, molecular mechanisms of virulence, and strategies to curb antimicrobial resistance. Full article

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. Full article

Antimicrobial resistance (AMR) has reached a critical situation globally, prompting urgent national responses to this escalating crisis, including the prioritization of novel antibiotic research. In 2016, Japan initiated a national AMR action plan that promoted appropriate antibiotic use in the country and encouraged a national environment conducive to mitigation measures. However, tackling AMR remains difficult. From an epidemiological perspective, this challenge now extends beyond severe infections, impacting common community-acquired infections, including uncomplicated urinary tract infections (uUTls) and gonorrhea. In uUTIs, the rising prevalence of extended-spectrum β-lactamase-producing and fluoroquinolone-resistant Escherichia coli diminishes the effectiveness of current, routinely used oral antibiotics, necessitating an exploration into innovative solutions. Similarly, the growing resistance of Neisseria gonorrhoeae to antibiotics such as azithromycin raises concerns about the efficacy of current therapeutic options for gonorrhea, which is a highly prevalent sexually transmitted infection. In Japan, since the removal of azithromycin as the recommended first-line treatment, there are no oral first-line antibiotics available to treat gonorrhea. Therefore, novel oral antibiotics are urgently needed for both serious and commonly occurring community-acquired infections. This narrative review discusses the limited availability of novel antibiotics in Japan, the distinctive features of the Japanese antibiotic repertoire and AMR epidemiology, and potential alternative oral treatments for community-acquired infections, including uUTIs and gonorrhea. Japan has been making significant advances toward tackling the AMR crisis through an updated national action plan, AMR policy changes, and innovative approaches to developing novel antibiotics. Substantial international cooperation and the engagement of diverse industry sectors are essential to address the pressing issue of AMR. Full article

 Porcine epidemic diarrhea virus (PEDV) continues to circulate globally, causing substantial economic losses to the swine industry. Historically, PEDV strains are classified into the classical G1, epidemic G2, and S-INDEL genotypes. Among these genotypes, the highly virulent and prevalent G2 genotype has been extensively studied. However, recent clinical outbreaks in China necessitate a reevaluation of the epidemiological and evolutionary dynamics of circulating strains. This study analyzed 37 newly sequenced S genes and public sequences to characterize the genetic variations of S-INDEL strains. Our analysis revealed that S-INDEL strains are endemic throughout China, with a phylogenetic analysis identifying two distinct clades: clade 1, comprising early endemic strains, and clade 2, representing a recently dominant, geographically restricted lineage in China. While inter-genotypic recombination has been documented, our findings also demonstrate that intra-genotypic and intra-clade recombination events contributed significantly to the emergence of clade 2, distinguishing its evolutionary pattern from clade 1. A comparative analysis identified 22 clade-specific amino acid changes, 11 of which occurred in the D0 domain. Notably, mutations at positively selected sites—113 and 114 within the D0 domain, a domain associated with pathogenicity—were specific to clade 2. A phylodynamic analysis indicated Germany as the epicenter of S-INDEL dispersal, with China acting as a sink population characterized by localized transmission networks and frequent recombination events. These results demonstrate that contemporary S-INDEL strains, specifically clade 2, exhibit unique recombination patterns and mutations potentially impacting virulence. Continuous surveillance is essential to assess the pathogenic potential of these evolving recombinant variants and the efficacy of vaccines against them.  Full article

This study aimed at proposing a predictive model for real-time monitoring of epidemic dynamics at the municipal scale in Lombardy region, in northern Italy, leveraging Emergency Medical Services (EMS) dispatch data and Geographic Information Systems (GIS) methodologies. Unlike traditional epidemiological models that rely on official diagnoses and offer limited spatial granularity, our approach uses EMS call data (rapidly collected, geo-referenced, and unbiased by institutional delays) as an early proxy for outbreak detection. The model integrates spatial filtering and machine learning (random forest classifier) to categorize municipalities into five epidemic scenarios: from no diffusion to active spread with increasing trends. Developed in collaboration with the Lombardy EMS agency (AREU), the system is designed for operational applicability, emphasizing simplicity, speed, and interpretability. Despite the complexity of the phenomenon and the use of a five-class output, the model shows promising predictive capacity, particularly for identifying outbreak-free areas. Performance is affected by changing epidemic dynamics, such as those induced by widespread vaccination, yet remains informative for early warning. The framework supports health decision-makers with timely, localized insights, offering a scalable tool for epidemic preparedness and response. Full article