The pathogenic and clinical characteristics of community-acquired and hospital-acquired co-infection in patients hospitalized with severe fever with thrombocytopenia syndrome
- 1Department of Clinical Laboratory, First Affiliated Hospital of Anhui Medical University, Hefei, China
- 2Department of Clinical Laboratory, Anhui Public Health Clinical Center, Hefei, China
- 3Department of Cardiology, First Affiliated Hospital of Anhui Medical University, Hefei, China
Abstract
BackgroundCo-infection can accelerate the progression of SFTS, this study aims to analyze the clinical characteristics of SFTS-associated co-infection and identify the associated risk factors.MethodsIn this retrospective study, we analyzed epidemiology, pathogen distribution patterns, and laboratory findings between community-acquired infections (CAIs) and hospital-acquired infections (HAIs) in SFTS patients. Our objectives were to determine the prevalence, characterize clinical manifestations, and identify potential risk factors associated with SFTS co-infection.ResultsAmong 231 SFTS patients, 81 (35.1%) had co-infection. SFTS patients with CAIs exhibited the highest mortality rate (23.4%). Compared to those without co-infection, patients with CAIs had more severe clinical presentation and poorer outcome. Antifungal treatment significantly improved survival in SFTS with CAIs-related fungal infections, but had no benefit in those with HAIs-related fungal infections. Pulmonary infections were associated with reduced survival time in SFTS patients with HAIs but had no significant impact on those with CAIs. Multivariate logistic regression analysis identified several independent risk factors for CAIs in SFTS patients, including diarrhea, cerebral infarction, antifungal therapy, ICU admission, elevated D-Dimer levels, and A/G <1.05. Among SFTS patients with co-infection, A/G <1.05 demonstrated potential predictive value for CAIs (AUC = 0.714, 95% CI: 0.626-0.832). Further analysis revealed that an A/G ratio <1.05 indicated moderate discriminatory performance for SFTS patients with CAIs related pulmonary fungal infections (AUC = 0.799, 95% CI: 0.702-0.896).ConclusionsSFTS patients with CAIs had poorer clinical outcomes than patients without co-infection or those with HAIs. An A/G ratio <1.05 may serve as a supportive marker for identifying patients at increased risk of CAIs and could assist clinical risk stratification.
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BibTeX
@article{xia2026pathogenic,
title = {{The pathogenic and clinical characteristics of community-acquired and hospital-acquired co-infection in patients hospitalized with severe fever with thrombocytopenia syndrome}},
author = {Cuiping Xia and Cuiping Xia and Zhongle Cheng and Zhen Sun and Huijuan Bi and Huijuan Bi and Jilu Shen and Jilu Shen},
journal = {Frontiers in Cellular and Infection Microbiology},
year = {2026},
month = oct,
doi = {10.3389/fcimb.2026.1940837},
url = {https://doi.org/10.3389/fcimb.2026.1940837},
note = {CC BY},
}
RIS
TY - JOUR
TI - The pathogenic and clinical characteristics of community-acquired and hospital-acquired co-infection in patients hospitalized with severe fever with thrombocytopenia syndrome
AU - Cuiping Xia
AU - Cuiping Xia
AU - Zhongle Cheng
AU - Zhen Sun
AU - Huijuan Bi
AU - Huijuan Bi
AU - Jilu Shen
AU - Jilu Shen
PY - 2026
DA - 2026/10/29
JO - Frontiers in Cellular and Infection Microbiology
DO - 10.3389/fcimb.2026.1940837
UR - https://doi.org/10.3389/fcimb.2026.1940837
AB - BackgroundCo-infection can accelerate the progression of SFTS, this study aims to analyze the clinical characteristics of SFTS-associated co-infection and identify the associated risk factors.MethodsIn this retrospective study, we analyzed epidemiology, pathogen distribution patterns, and laboratory findings between community-acquired infections (CAIs) and hospital-acquired infections (HAIs) in SFTS patients. Our objectives were to determine the prevalence, characterize clinical manifestations, and identify potential risk factors associated with SFTS co-infection.ResultsAmong 231 SFTS patients, 81 (35.1%) had co-infection. SFTS patients with CAIs exhibited the highest mortality rate (23.4%). Compared to those without co-infection, patients with CAIs had more severe clinical presentation and poorer outcome. Antifungal treatment significantly improved survival in SFTS with CAIs-related fungal infections, but had no benefit in those with HAIs-related fungal infections. Pulmonary infections were associated with reduced survival time in SFTS patients with HAIs but had no significant impact on those with CAIs. Multivariate logistic regression analysis identified several independent risk factors for CAIs in SFTS patients, including diarrhea, cerebral infarction, antifungal therapy, ICU admission, elevated D-Dimer levels, and A/G <1.05. Among SFTS patients with co-infection, A/G <1.05 demonstrated potential predictive value for CAIs (AUC = 0.714, 95% CI: 0.626-0.832). Further analysis revealed that an A/G ratio <1.05 indicated moderate discriminatory performance for SFTS patients with CAIs related pulmonary fungal infections (AUC = 0.799, 95% CI: 0.702-0.896).ConclusionsSFTS patients with CAIs had poorer clinical outcomes than patients without co-infection or those with HAIs. An A/G ratio <1.05 may serve as a supportive marker for identifying patients at increased risk of CAIs and could assist clinical risk stratification.
SN - 2235-2988
ER -