Background: This study aimed to characterize the distribution of mecA, pvl carriage, and agr groups, among clinical Staphylococcus aureus (S. aureus) isolates and to correlate these findings with comprehensive antimicrobial susceptibility profiles. Methods: S. aureus isolates—obtained from various clinical samples between 1 June 2025 and 30 March 2026 at a tertiary hospital in southern Turkey—were identified using the MALDI-TOF VITEK MS system. Antimicrobial susceptibility testing was performed using the VITEK 2 system in accordance with EUCAST standards. Target-specific Real-Time PCR was used for molecular detection of resistance and virulence genes (nuc, mecA, pvl, and agr loci (I–IV)). Results: Among the 100 isolates included, S. aureus identification was confirmed via real-time PCR targeting the nuc. The real-time PCR framework demonstrated a perfect correlation between mecA genotypes and phenotypic resistance profiles. The pvl significantly clustered with the agr group II; pvl-positive strains showed high resistance to erythromycin, fusidic acid, and mupirocin, while clindamycin resistance was limited to pvl-negative strains. Conclusions: These findings characterise the local epidemiological distribution of pvl, agr groups and resistance profiles in S. aureus and confirm the independent association between pvl carriage and the MRSA phenotype. These single-centre data highlight the need for future multicentre studies incorporating sequence-based typing, whilst providing valuable information for institutional surveillance and antibiotic management.
Lower respiratory tract infections (LRTIs) are a leading infectious cause of death in children worldwide. Complete blood count (CBC)-derived inflammatory ratios are low-cost and widely available, yet their reported performance varies. We reviewed 46 PubMed-indexed studies (2016–2026) in children aged 0–18 years with viral, bacterial, or mycobacterial LRTI. The findings were mapped across diagnosis, etiological differentiation, severity, and outcome prediction. The neutrophil-to-lymphocyte ratio (NLR) was the most investigated marker, with the broadest evidence base for severity assessment and for separating bacterial from viral disease, although its performance remained pathogen-, population-, and endpoint-dependent; it was elevated in severe pertussis, tuberculosis, Mycoplasma pneumoniae, Streptococcus pneumoniae, and SARS-CoV-2 infection, whereas findings in respiratory syncytial virus infection were conflicting. The platelet-to-lymphocyte ratio had the next broadest evidence base for severity, and the systemic immune-inflammation index was consistently elevated in Mycoplasma pneumoniae and SARS-CoV-2 infection. No single ratio performed consistently across all etiologies. Ratios governed by one dominant immunopathogenic mechanism behaved predictably; those whose numerator and denominator respond to the same process did not. Cut-offs were neither standardized, age-specific, nor externally validated, and most estimates derived from retrospective cohorts in few countries; reported values therefore represent association and discrimination rather than validated prediction. Standardized, age-specific thresholds are needed before these markers can support routine risk stratification.
Ralstonia pickettii is an opportunistic Gram-negative bacterium associated with healthcare-associated infections, particularly in premature infants and other immunocompromised or critically ill patients. This study aimed to investigate a neonatal intensive care unit outbreak of Ralstonia pickettii bacteremia by describing the clinical characteristics of affected infants, identifying the environmental source, and evaluating the genetic relatedness between clinical and environmental isolates. Hospital records from January 2023 through November 2025 were reviewed; the nine included cases occurred between February 2024 and October 2025. Demographic, clinical, and laboratory data were reviewed. Environmental sampling was performed to identify the source of contamination. Genetic relatedness between clinical and environmental isolates was evaluated using arbitrarily primed polymerase chain reaction (AP-PCR), and the molecular findings were interpreted together with microbiological and epidemiological data. This study was initially designed as a retrospective clinical review and was subsequently expanded to include an outbreak investigation after three temporally clustered cases were identified in October 2025. The outbreak involved nine neonates with Ralstonia pickettii bacteremia. Environmental investigation identified Ralstonia pickettii in both opened and unopened sterile distilled water samples. Clinical and environmental isolates demonstrated highly similar AP-PCR banding patterns, supporting genetic relatedness when interpreted together with microbiological and epidemiological findings. Following removal of the contaminated source and implementation of infection control measures, no additional R. pickettii bacteremia cases were identified. Overall mortality was 44.4%, whereas only one death (11.1%) was considered attributable to Ralstonia pickettii bacteremia. Ralstonia pickettii can cause healthcare-associated outbreaks in neonatal intensive care units. Integration of microbiological, environmental, epidemiological, and molecular findings may facilitate timely outbreak source identification and implementation of effective infection control measures.
C1A cysteine peptidases (CPs) are major contributors to host–parasite crosstalk and have been proposed as anti-trypanosomal chemotherapeutic targets. Trypanosoma evansi is the most widespread animal trypanosome of African origin causing the trypanosomosis known as “Surra” or “derrengadera”. Gelatin zymography combined with peptidase class-specific inhibitors identified four CPs in T. evansi lysates with relative masses of 28, 31, 36 and 40 kDa (p28, p31, p36 and p40). The CPs present in the T. evansi lysate preferentially hydrolyzed the Z-Phe-Arg-AMC fluorogenic substrate over Z-Gly-Arg-AMC and Z-Ala-Arg-AMC, and the hydrolysis of Z-Phe-Arg-AMC was inhibited by the K11777 (also known as SLV213) vinyl sulfone inhibitor with an apparent IC50 of 3.06 nM. Active-site labeling using the 125I-LHVS-PhOH vinyl sulfone inhibitor confirmed the identity of p28, p31, p36 and p40 as cathepsin-like peptidases. Partial purification of the T. evansi p40, analysis of its N-terminal peptide sequence and cross-reactivity with an anti-T. brucei (Tbr)CATL antiserum revealed its orthology to the C1A CPs present in T. b. brucei, T. cruzi, T. dionisii and T. rangeli. Treatment of infected mice with the pan-cathepsin irreversible inhibitor, K11777 (10 mg/day), for 14 (n = 5) or 17 (n = 3) consecutive days was trypanocidal and significantly increased mice survival. These results validate TevCATL as a potential therapeutic target for the treatment of animal trypanosomosis caused by T. evansi.
Background/Objectives: Severe bacterial sepsis and arboviral diseases may present with overlapping manifestations of vascular leakage, hemodynamic instability, thrombocytopenia, and organ dysfunction. We examined whether etiologically distinct severe infections may converge on selected components of immunovascular dysfunction and propose the Severe Infection-Mediated Vascular Activation and Collapse (SIMVAC) model as a hypothesis-generating framework. Methods: This narrative mechanistic review integrates human clinical and physiological studies, translational biomarker evidence, experimental models, and pathogen-specific mechanistic studies, with particular attention to the relative strength of evidence across arboviruses. Results: Dengue provides the strongest arboviral mechanistic support, linking plasma leakage with NS1-mediated endothelial barrier disruption, glycocalyx degradation, tissue-specific vascular effects, and inflammatory amplification. Evidence for yellow fever, West Nile virus, and Zika supports distinct organ-specific or systemic pathways but is less complete, whereas evidence for Mayaro, Oropouche, Venezuelan equine encephalitis, and Rocio viruses remains limited or hypothesis-generating. Candidate points of convergence include glycocalyx injury, Ang-2/Tie2 and S1P dysregulation, complement activation, NETosis, and vWF/ADAMTS13 imbalance. Conclusions: SIMVAC should be regarded as a testable conceptual model rather than a validated syndrome or diagnostic tool. Prospective, pathogen-confirmed studies are required to determine whether reproducible immunovascular signatures exist across severe infections and whether they provide clinically meaningful information beyond conventional etiological and severity assessment.
Attenuated Salmonella strains are a promising gene delivery vector in the development of vaccines targeting various human diseases. For example, the Ty21a vaccine is a Salmonella-based vaccine that elicits a robust local, cellular, and systemic immune response against Salmonella typhi infection. Human immunodeficiency virus (HIV) is responsible for the AIDS pandemic and requires lifelong treatment to manage. Human papillomavirus (HPV) is the cause of the vast majority of cervical cancer cases in the global population. Influenza is a seasonal, pandemic virus that can lead to high death tolls in humans and livestock and considerable financial losses. In this review, we outline current methods of protection and treatment for HIV, HPV, and influenza, as well as how a versatile Salmonella-based gene delivery vector’s mechanism of action can lead to immunity. We also describe several studies that utilize many of these Salmonella-based vector vaccines to provide protection against infection with these viruses, as many of these Salmonella-based vectors exhibit different factors that may enhance their gene delivery, immune responses, and post-delivery clearance out of host cells. Finally, we discuss the benefits and drawbacks of using Salmonella-based vaccines and future directions for these vaccine candidates, as well as the implications of introducing these vaccines into the current landscape.
Objective: To compare the clinical characteristics, healthcare exposures, and antimicrobial susceptibility profiles of pediatric Enterococcus faecium and Enterococcus faecalis infections. Methods: This retrospective study included hospitalized children with E. faecium or E. faecalis isolated from sterile specimens between August 2018 and June 2025. Clinical characteristics and antimicrobial susceptibility were compared. Logistic regression identified factors associated with pathogen species, while negative binomial regression evaluated the association between species and length of hospital stay. Results: Among 167 patients, 98 had E. faecium infection and 69 had E. faecalis infection. No significant annual trend in species distribution was observed. Multi-site infection was more common with E. faecium than with E. faecalis (36.73% vs. 15.94%, p = 0.003). Hematologic malignancy, previous hospitalization, central venous catheterization, immunosuppressive therapy, higher procalcitonin levels, and longer hospitalization were more common in the E. faecium group. In three separate primary logistic regression models adjusted for septic shock, central venous catheterization and hospitalization for ≥14 days before culture positivity were associated with higher odds of E. faecium infection, whereas endotracheal intubation was associated with higher odds of E. faecalis infection. In post hoc sensitivity analyses jointly incorporating these healthcare exposures and either hematologic malignancy or immunosuppressive therapy, only central venous catheterization remained significantly associated with E. faecium infection. E. faecium infection was associated with a 33.8% longer hospital stay (aIRR = 1.338, 95% CI: 1.160–1.543, p < 0.001). E. faecium showed substantially greater resistance to ampicillin and penicillin. Conclusions: Pediatric E. faecium and E. faecalis infections differed in patient profiles, healthcare exposures, antimicrobial susceptibility, and disease burden. Species identification may support clinical assessment and antimicrobial stewardship.
Many people are affected by difficult-to-understand clinical phenomena associated with acute SARS-CoV-2 infection and by post-acute sequelae of COVID-19 (PASC, or long COVID, LC). The mechanisms responsible for the clinical phenomena have not been well established. The host cell receptor for SARS-CoV-2 is human angiotensin-converting enzyme 2 (ACE2), which binds the SARS-CoV-2 spike protein receptor-binding domain (RBD) to initiate infection. We hypothesized that some people may produce anti-RBD antibodies that sufficiently resemble ACE2 structure to have ACE2-like catalytic activity after infection, and such antibodies are hypothesized to contribute to disease pathogenesis. Our previous studies showed that ACE2-like catalytic activity was associated with immunoglobulin in some acute and convalescent COVID-19 patients. ACE2-like catalytic activity correlated with blood pressure changes following a moderate exercise challenge in people convalescing from COVID-19. To further establish that ACE2-like catalytic activity could be attributed to antibodies, we screened human monoclonal antibodies (mAbs) against SARS-CoV-2 spike protein from three different research centers and others purchased from a commercial source for ACE2-like catalytic activity. We identified four human monoclonal antibodies with ACE2-like catalytic activity. The ACE2-like catalytic activity of these mAbs was not inhibited by MLN-4760, a compound that inhibits native human ACE2 catalytic activity, nor by EDTA, unlike native ACE2, a zinc metalloprotease, but was inhibited by an overlapping pool of spike peptides. Enzyme kinetic studies showed that the mAbs had substantially lower Vmax and Km values than native ACE2, consistent with the characteristics of other catalytic antibodies. The data therefore suggested that the antibodies cleave ACE2 substrate via a mechanism different from native ACE2. The identification of specific mAbs with ACE2-like catalytic activity supports the hypothesis that antibodies induced by SARS-CoV-2 infection could help mediate the pathogenesis of COVID-19 and LC, and, more generally, the hypothesis that catalytic antibodies induced by infectious agents can contribute to disease pathogenesis.
Background: Hypervirulent Klebsiella pneumoniae (K. pneumoniae) easily causes bacteremia and liver abscess, and invades the eye via blood circulation to trigger blinding endogenous endophthalmitis. Widespread multidrug resistance limits antibiotic treatment, while traditional capsular polysaccharide vaccines cannot provide cross-serotype protection. Methods: We established a mouse model of intraperitoneal infection-induced endogenous endophthalmitis. BALB/c mice received two intramuscular injections of LNP-encapsulated PstS-YidR fusion mRNA vaccine, followed by challenge with hypervirulent K1 or K2 strains. We monitored body weight, quantified multi-tissue bacterial loads, detected IL-1β, IL-6 and TNF-α, and performed slit-lamp observation and liver/ocular histopathology. Results: The vaccine relieved systemic symptoms and weight loss, suppressed bacterial dissemination across peritoneal, blood, liver, lung and eye tissues, and reduced excessive inflammatory factor release. It alleviated intraocular suppurative lesions, preserved ocular structure, and mitigated liver abscess and hepatocellular necrosis, with equal protective efficacy against K1 and K2 and favorable in vivo safety. Conclusions: The PstS-YidR fusion mRNA vaccine blocks systemic spread and intraocular invasion of hypervirulent K. pneumoniae and alleviates multi-organ inflammatory damage. It serves as a safe candidate vaccine for preventing K1/K2-type hypervirulent Klebsiella infections and endogenous endophthalmitis.
Tick-borne parasitic diseases pose important threats to veterinary and public health, particularly in countries with livestock-dependent economies such as Kyrgyzstan. However, molecular epidemiological data on tick-borne pathogens in Kyrgyzstan is limited. This study investigated the prevalence, genetic diversity, and host–tick–pathogen associations in Chuy Province, Kyrgyzstan. A total of 494 ticks belonging to 6 genera and 10 species were collected from various animal hosts in eight survey areas in central-northern Chuy Province and analyzed using polymerase chain reaction, Sanger sequencing, and phylogenetic analysis. Of the 494 ticks, 35 (7.1%) were infected, including 15 (3.0%) with Babesia species and 20 (4.0%) with Theileria species. The highest positive rates were observed in Rhipicephalus annulatus (13.8%) and Haemaphysalis punctata (12.4%). Molecular analysis identified 4 Babesia species (B. caballi, B. major, B. bigemina, B. occultans) and 2 Theileria species (T. orientalis, T. ovis). Ticks collected from horses had the highest infection rates and greatest diversity of pathogens. T. orientalis was the most common pathogen. T. ovis was exclusively found in ticks collected from sheep. Phylogenetic analysis confirmed that the isolates were closely related to strains circulating in neighboring Central Asian and Eurasian countries. The findings provide foundational data for developing region-specific vector control measures.
Closely related Aspergillus section Nigri species are difficult to resolve taxonomically, while short-read comparisons may be influenced by reference-genome choice. We applied reciprocal genome projection to 31 whole-genome sequencing libraries representing South African clinical section-Nigri isolates, Japanese and USA A. niger-labeled isolates, and A. welwitschiae-labeled isolates. Reads were aligned independently to A. niger ATCC 1015 and A. welwitschiae Aspwel1, followed by reference-specific differential-representation and KEGG analyses. Species-level classification showed substantial overlap between A. niger and A. welwitschiae. The A. welwitschiae–South African comparison identified 44 and 59 effect-qualified features under the respective projections, including 20 reciprocal feature pairs defining a reference-robust A. welwitschiae-associated core. The clinical Japanese–South African comparison identified 116 and 127 features, with 14 concordant KEGG orthologs involving sterol modification, protein prenylation, cofactor metabolism, redox processing, cell-wall turnover and ribosome maturation. No pathway remained significant after false discovery-rate correction; nominal pathway signals were reference-sensitive. Reciprocal projection, therefore, recovered localized cohort-associated genomic differentiation while identifying reference-conditioned effects. These findings represent differential genomic-read representation and do not independently establish copy-number variation, pathway activity, virulence or antifungal resistance.
Anaplasma phagocytophilum is a tick-borne bacterium and the causative agent of human granulocytic anaplasmosis. Two major variants have been identified in North America: a human pathogenic variant (Ap-ha) that is maintained by small mammals and a nonpathogenic variant (Ap-v1) that is maintained by white-tailed deer (Odocoileus virginianus). Despite white-tailed deer being recognized as the main reservoir of Ap-v1, few studies have directly demonstrated transmission of Ap-v1 from white-tailed deer to feeding I. scapularis ticks, and transmission to feeding larvae remains undescribed. In this study, we collected samples from an outdoor white-tailed deer research facility during an I. scapularis larval questing season in the eastern United States to investigate the variants infecting white-tailed deer and acquisition by feeding larvae. Although both variants were present in questing ticks onsite, white-tailed deer were persistently infected with only Ap-v1 and transferred this variant to feeding I. scapularis larvae with high efficiency. These results support the concept that white-tailed deer play a role in the maintenance of Ap-v1 in nature and highlight the utility of captive white-tailed deer research facilities for studying vector–pathogen–host biology.
Background: The clinical course and mortality risk of COVID-19 in patients with type 2 diabetes (T2D) remain elevated. Understanding its pathogenesis is essential for prognostic and therapeutic strategies. Viral infections can disrupt host glucose and lipid metabolism. This study evaluated changes in glycemic and lipid parameters following COVID-19 infection in T2D patients. Methods: A retrospective analysis was conducted on T2D patients who tested positive for COVID-19 between April 2020 and December 2021. Laboratory results before and after infection were compared to assess changes in glycemic and lipid markers. Results: The study included 969 patients with T2D; 56.7% were female, and the median age was 58 years (IQR: 49–67). Hypertension, asthma, and chronic kidney disease were present in 51.5%, 14.2%, and 7.2% of patients, respectively. Fasting blood glucose did not change significantly from before to after COVID-19 infection [7.9 mmol/L (IQR: 6.2–10.6) vs. 7.8 mmol/L (IQR: 6.2–10.2)], nor did HbA1c [7.6% (IQR: 6.7–9.1) vs. 7.6% (IQR: 6.5–9.2)]. In contrast, modest but statistically significant reductions were observed in triglycerides [1.47 mmol/L (IQR: 1.13–2.00) vs. 1.44 mmol/L (IQR: 1.08–1.94)], total cholesterol [4.3 mmol/L (IQR: 3.67–5.03) vs. 4.1 mmol/L (IQR: 3.55–4.93)], and LDL cholesterol [2.7 mmol/L (IQR: 2.11–3.45) vs. 2.5 mmol/L (IQR: 1.98–3.23)]. HDL cholesterol remained unchanged [1.0 mmol/L (IQR: 0.90–1.21) vs. 1.0 mmol/L (IQR: 0.89–1.22)]. Conclusions: COVID-19 infection was not associated with significant long-term changes in glycemic control among patients with T2D, as fasting blood glucose and HbA1c levels remained broadly stable after infection. In contrast, significant reductions were observed in total cholesterol, LDL cholesterol, and triglyceride levels, while HDL cholesterol remained unchanged. These findings indicate that changes following COVID-19 infection were more apparent in lipid parameters than in glycemic markers.
Occupational exposure to blood and body fluids (OEBBF) continues to represent an important public health problem due to the associated medical, social and economic consequences. Young healthcare workers are at high risk of OEBBF because of their lack of experience, hesitation before performing a task and the nature of the task performed. This study aims to comparatively evaluate the knowledge, attitudes and perceptions on OEBBF among students from the Faculty of Medicine and the Faculty of Dental Medicine at Carol Davila University of Medicine and Pharmacy, Bucharest, Romania, during the 2021–2022 academic year in order to facilitate the adaptation of educational materials used in training programs. Out of the 911 students who completed the questionnaire, 55% (502) correctly identified hepatitis B virus (HBV) as having the highest risk of transmission after an OEBBF, with statistically significantly higher percentages among Dental Medicine students (152; 60% vs. 350; 53%; p = 0.003). However, lower percentages of Dental Medicine students recognized the protective concentration of antibodies against HBV (173; 68% vs. 536; 82%; p < 0.001) or reported knowing to be vaccinated against hepatitis B (110; 43% vs. 459; 70%; p < 0.001). Additionally, higher percentages of Dental Medicine students reported not having an antibodies concentration measurement since they started their clinical practice (206; 81% vs. 439; 67%; p < 0.001). If an OEBBF were to occur, 43% (391) reported that they would induce bleeding, either instinctively (210; 23%) or because they considered it necessary (181; 20%). Ninety-three students (10%) reported at least one past OEBBF; 59 (63%) reported it to their supervisors. Statistically significantly higher percentages of Dental Medicine students reported a high perceived risk of exposure compared to Medicine students (117; 46% vs. 202; 31%; p < 0.001), with the finding supported by univariable and multivariable analyses. In conclusion, the reporting frequency of past OEBBF in our study population was low. However, enhanced efforts are required to improve knowledge and awareness regarding OEBBF risk and preventive measures. Additionally, efforts should focus on assessing the level of protection against hepatitis B among Dental Medicine students and on promoting timely reporting to ensure appropriate post-exposure management.
Livestock faeces constitute an important environmental interface within the One Health framework, as bacteria shed by animals are directly exposed to external environmental conditions, where they may persist and subsequently disseminate across the human, animal, and environmental sectors. The ability of these microorganisms to tolerate environmental stresses is therefore critical for their persistence and ecological distribution. In this study, the responses of 5 Pseudomonas putida, 15 Pseudomonas fulva, and 12 Alcaligenes faecalis isolates recovered from livestock faeces to different environmental stress conditions were investigated. Bacterial growth was evaluated under different temperatures, increasing NaCl concentrations, and carbon starvation, while biofilm formation was assessed using the microtiter plate assay. Growth was markedly affected by all stress conditions, although substantial variability was observed among isolates of the same species. Despite reduced growth under the most adverse conditions, all three species remained capable of growing across a wide range of environmental stresses. A. faecalis exhibited greater salt tolerance and biofilm-forming capacity than Pseudomonas spp., with biofilm formation detected in almost all isolates of both species. Furthermore, no statistically significant correlations were detected among the evaluated stress tolerance traits. These findings demonstrate that livestock-associated P. putida, P. fulva, and A. faecalis possess physiological characteristics that promote persistence under diverse environmental conditions, highlighting the potential role of livestock faeces as environmental reservoirs of opportunistic bacteria within the One Health context.
A total of 100 fecal samples collected from cattle in the district of Viana do Castelo, northern Portugal, were molecularly screened for Cryptosporidium spp., Giardia duodenalis, and Blastocystis sp. This study represents the first molecular survey of enteric protozoa in cattle from the district of Viana do Castelo, northern Portugal. Blastocystis sp. was the most frequently detected protozoan and exhibited considerable subtype diversity, including the zoonotic subtype ST3 and the potentially zoonotic subtypes ST10a and ST14, a circumstance highlighting the occurrence in cattle of Blastocystis subtypes with potential public health relevance and the need to further investigate their cross-host transmission dynamics. Giardia duodenalis was detected at a relatively low occurrence, although unsuccessful multilocus sequence typing (MLST) amplification prevented assessment of its assemblages and zoonotic potential. Cryptosporidium spp. were not detected, likely reflecting the predominance of adult cattle in the sampled population. Overall, these findings contribute to the understanding of the molecular epidemiology of enteric protozoa in Portuguese cattle and provide updated baseline geographical data for northern Portugal. Continued molecular surveillance using optimized genotyping approaches and larger, more representative sample sets will be essential to better characterize the diversity, epidemiology, and zoonotic importance of these parasites within a One Health framework.
Cattle tick fever (CTF) is the most important tick-borne disease complex affecting cattle production in tropical and subtropical regions. This study evaluated the enzootic status of CTF in cattle herds from two contrasting climatic regions of Paraíba State, Northeast Brazil, and identified epidemiological factors associated with herd immune status. A cross-sectional serological survey was conducted in 32 cattle herds from two contrasting climatic regions of Paraíba State. All herds were tested for Babesia bovis and Babesia bigemina, whereas 28 herds (14 per region) were evaluated for A. marginale. Herds were classified according to the proportion of seropositive animals for each pathogen as non-immune (≤12.5%), unstable (>12.5% to <75%), or stable (≥75%), and epidemiological factors associated with enzootic status were subsequently investigated using logistic regression models. Antibodies against at least one pathogen were detected in 55.4% (97/175) of the evaluated cattle, with higher overall seroprevalence in the Tropical Humid region (56/85; 65.9%) than in the Semi-arid region (41/90; 45.6%). Antibodies anti-B. bovis showed the lowest prevalence (24/175; 13.7%), whereas anti-A. marginale (60/155; 38.7%) and anti-B. bigemina (58/175; 33.1%) were more frequently detected. No herd was classified as enzootically stable for anti-B. bovis, whereas 6/32 (18.8%) and 3/28 (10.7%) herds achieved enzootic stability for anti-B. bigemina and anti-A. marginale, respectively. Herds composed predominantly of cattle older than five years were 97% less likely to develop protective seropositivity against B. bovis. Dairy production and animal purchase increased the odds of protective seropositivity against B. bigemina by approximately 74-fold and 10-fold, respectively, whereas needle reuse reduced the likelihood of protective seropositivity against A. marginale by 97%. These findings demonstrate that enzootic instability predominates in cattle herds from Paraíba State, indicating that natural pathogen circulation alone has been insufficient to establish consistent herd immunity against the cattle tick fever pathogens.
Background/Objectives: Foodborne diseases account for the majority of infectious disease outbreaks in Yogyakarta, Indonesia, yet remain underexplored epidemiologically. This systematic review aimed to characterize the epidemiological patterns and risk factors of foodborne disease outbreaks in this region between 2006 and 2024. Methods: This systematic review searched electronic databases and grey literature published between 1 January 2006 and 31 December 2024. Eligible studies were reported in English or Indonesian and used descriptive or environmental observational designs. Methodological quality was assessed using a modified Joanna Briggs Institute (JBI) checklist. Searching, screening, and data coding were performed independently by the reviewers. The review followed PRISMA reporting guidelines and was registered with PROSPERO (CRD420251060794). Results: Of 841 studies screened, 99 met the inclusion criteria. The most frequently identified pathogens were Bacillus cereus (43.43%) and Staphylococcus aureus (34.34%), associated with 101 and 97 hospitalizations, respectively. Improper post-cooking storage (77.00%) was the leading contributing factor for Bacillus cereus outbreaks, whereas unsafe food processing practices (76.00%) predominated for Staphylococcus aureus outbreaks. Individual unregistered catering services accounted for the largest proportion of outbreaks. Conclusions: Public health strategies should prioritize strengthening food handlers’ capacity during food processing and post-cooking storage, particularly among individual informal catering services, to sharpen foodborne disease control efforts in Yogyakarta.
Background: Respiratory tract infections (RTIs) caused by viruses are a public health problem, contributing to hospital admissions and morbidity worldwide. The COVID-19 pandemic substantially altered the detection patterns of respiratory viruses through public health interventions. Longitudinal data on these changes and viral seasonality remain limited in Saudi Arabia. This eight-year study evaluated epidemiological and seasonal patterns of major respiratory viruses across the COVID-19 era at a major Saudi tertiary care center. Methods: A retrospective observational study was conducted at King Khalid University Hospital, Riyadh, from October 2017 to December 2025. PCR-confirmed detections for SARS-CoV-2, Influenza A, Influenza B, respiratory syncytial virus (RSV), and human metapneumovirus (HMPV) were extracted from the hospital Laboratory Information System. Demographics, co-detection, seasonality, and length of stay (LOS) were analyzed across four eras spanning the pre-COVID-19, lockdown, restriction, and post-restriction periods using descriptive statistics, the Kruskal–Wallis test, and multivariable negative binomial regression. Results: Among 5708 confirmed respiratory viral detection episodes, SARS-CoV-2 was the most frequently detected (52.5%), followed by Influenza A (19.1%), RSV (16.4%), Influenza B (8.4%), and HMPV (3.6%). Before the pandemic, Influenza A accounted for the largest proportion of detected episodes (71.1%), with detections clustering particularly during autumn and winter seasons, whereas SARS-CoV-2 accounted for the majority of detected episodes during the lockdown and restriction eras (97.4% and 93.2%). The post-restriction era became more diverse, with RSV being detected in substantial proportions (28.3%), showing prominent winter activity. RSV and HMPV predominantly affected children aged 0–5 years, whereas SARS-CoV-2 was more frequently detected among older adults. Among adults, older age was associated with prolonged LOS; Influenza A and HMPV were associated with shorter stays compared to SARS-CoV-2. Among children, no virus was independently associated with LOS after adjustment for age and sex; however, older age was associated with longer hospital stays. Conclusion: The observed detection patterns of major respiratory viruses shifted substantially across the COVID-19 eras, with notable post-restriction diversification among observed positive detections. LOS was associated with age in both adults and children and with virus type among adults, supporting continued surveillance to guide preventive and clinical strategies.
Background/Objectives: Rare histologic subtypes of cervical cancer are uncommon and may be misclassified during initial diagnosis. Their recognition depends on subtype-directed immunohistochemistry, which excludes metastatic mimics, and on high-risk HPV (hrHPV) testing, which establishes HPV status. Published series rarely report how the diagnosis was reached. We therefore documented the full diagnostic work-up, together with treatment and outcomes, in a consecutive single-center series. Methods: This was a retrospective, single-center case series (January 2020–January 2025). Rare tumors were defined per the 2020 WHO Classification as subtypes other than squamous cell carcinoma and usual-type adenocarcinoma. Immunohistochemistry was used to confirm lineage and exclude mimics. hrHPV DNA testing and p16 immunohistochemistry were performed where tissue permitted. A tumor was called HPV-associated only when diffuse block-type p16 positivity accompanied hrHPV DNA; HPV DNA alone was not accepted as evidence of an HPV-driven tumor. Results: Ten patients were included (median age 53 years). There were two signet-ring cell adenocarcinomas, two small cell neuroendocrine carcinomas (SCNECC), two serous adenocarcinomas, and one each of sarcomatoid carcinoma, clear cell carcinoma, granulocytic sarcoma, and poorly differentiated adenosquamous (glassy cell) carcinoma. hrHPV DNA was detected in six of the seven tumors tested. Three of these six were p16-negative: one serous, the clear cell, and the glassy cell carcinoma. Because diffuse block-type p16 expression is a validated surrogate marker of transcriptionally active hrHPV, we classified these three as HPV-independent. This matches the known biology of these histotypes. Lymphovascular space invasion was present in eight patients (80%). Over a median follow-up of 10.5 months, four patients developed distant metastases and three died. Conclusions: Accurate diagnosis of rare cervical tumors requires subtype-directed immunohistochemistry to exclude mimics and hrHPV testing interpreted together with p16; HPV DNA positivity alone does not establish HPV-association. Given the small, heterogeneous series, outcome data are descriptive and hypothesis-generating. We propose a diagnostic algorithm and immunohistochemical framework and advocate centralized review and prospective registries.
