ORIGINAL RESEARCH article
Front. Cell. Infect. Microbiol.
Sec. Clinical Infectious Diseases
This article is part of the Research TopicChallenges and Perspectives for Improved Understanding and Management of Multifaceted Co-InfectionView all 6 articles
Pathogen Spectrum, Clinical Traits and Exploration of Mortality Outcome-Improving Medication Regimens in Coinfection Patients with Severe Fever with Thrombocytopenia Syndrome: A Multicenter Cohort Study
Provisionally accepted
Zibo Fan1Lianhe Lu1Ling Lin2Jianping Duan3
Qun Li1Chuanyun Zhao4Zhenghua Zhao4Yuanni Liu2Yong Zhou3Wei Zhou5Yi Shen6
Zhihai Chen1*
Wei Zhang1*- 1Capital Medical University Beijing Ditan Hospital, Beijing, China
- 2Yantai Qishan hospital, Yantai, China
- 3Qingdao Infectious Disease Hospital, Qingdao, China
- 4Taian City Central Hospital, Tai'an, China
- 5Dalian Public Health Clinical Center, Dalian, China
- 6Dandong Infectious Disease Hospital, Dandong, China
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Purpose: Using a multicenter clinical data, this study aimed to systematically analyze the clinical characteristics, pathogen spectrum, and independent risk/protective factors for coinfection in SFTS patients; additionally, it sought to explore optimal therapeutic regimens to reduce the case fatality rate of SFTS patients with coinfection. Methods: Clinical data of 1,675 patients with SFTS who were hospitalized for the first time, collected from 6 institutions between May 2011 and November 2024, were included and analyzed. Results: The coinfection group had a significantly higher case fatality rate (24.3% vs. 6.7%, P<0.001), with the mixed bacterial-fungal infection subgroup showing the highest mortality risk (Log-rank test, P<0.001). Albumin served as a protective factor against coinfection, with a cutoff value of 32 g/L identified; administering human albumin at this threshold could partially reduce the coinfection rate. Furthermore, on the basis of this protective effect of albumin, the combination of human albumin and corticosteroids was associated with a trend toward improved prognostic survival in coinfected patients. Conclusion:This study found a high proportion of SFTS patients with coinfection, which significantly worsens their clinical prognosis. SFTS currently has no specific therapy; clinical treatment focuses on symptomatic and supportive care, with strict standardization for antibiotics and antifungal use, and attention to patients' nutritional support. Albumin is a key protective factor associated with a lower risk of coinfection in SFTS patients; combined use of human albumin and corticosteroids was associated with a further trend toward better clinical prognosis in coinfected patients.
Keywords: Severe fever with thrombocytopenia syndrome, Coinfection, Bacteria, fungus, Case fatality rate
Received: 19 Sep 2025; Accepted: 10 Nov 2025.
Copyright: © 2025 Fan, Lu, Lin, Duan, Li, Zhao, Zhao, Liu, Zhou, Zhou, Shen, Chen and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Zhihai Chen, chenzhihai0001@126.com
Wei Zhang, snowpine12@126.com
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