Infectious Diseases

Shigella is common and prolongs diarrhoea in young children; untreated cases show small growth loss

Among 8756 children aged 6–35 months across seven countries, Shigella was the most commonly attributed pathogen (20.6%). Shigella-attributed diarrhoea was associated with prolonged diarrhoea (≥7 days; aPR 1.56, 95% CI 1.34–1.82) and persistent diarrhoea (≥14 days; aPR 1.66, 95% CI 1.03–2.68). There was no overall association with hospitalization or population-level linear growth faltering, but children with Shigella who did not receive effective antibiotics had greater LAZ/HAZ decline over three months (−0.05, 95% CI −0.09 to −0.01). Pathogen-specific diagnosis and access to effective antibiotics may reduce prolonged illness and modest growth impairment in this age group. 1

Older age, bilirubin, and leptospiremia predict in-hospital death from leptospirosis

In a multicenter Thai cohort of 459 confirmed leptospirosis cases, 25 patients (5.4%) died during hospitalization. Independent predictors of in-hospital death included older age, higher total bilirubin, and higher leptospiremia measured on admission. A combined clinical plus pathogen-load model showed good discrimination for mortality risk. Genomic data identified Leptospira interrogans clonal lineage predominating among fatal cases, suggesting genomic surveillance may aid public health and risk stratification. 2

ID clinicians favour short regimens for TB infection but hesitate to adopt new disease regimens

Survey of 349 North American adult ID physicians found 93% prefer ≤4-month regimens for tuberculosis infection. Uptake of newer regimens for TB disease was low; only 1% had used HPMZ for drug-susceptible disease and 5% reported experience with HPMZ. Many clinicians were uncertain about effectiveness of 4- and 6-month disease regimens (≈43% uncertain; 40% unsure about regimen choice for resistant disease). Respondents cited concerns about toxicities, drug interactions, and drug availability as primary barriers to adoption. 3