A small, uncontrolled case series without comparator demonstrating feasibility of nanopore sequencing in culture-negative infections, lacking power to establish clinical efficacy or change practice.
A rigorous single-center interrupted time-series study with a large effect size and sustained improvement in a clinically relevant surrogate endpoint, but limited generalizability and requiring multicenter confirmation.
A single-centre observational cohort study with low event rates (one active TB case) and indeterminate IGRA results limiting clinical inference; provides local epidemiological data but insufficient power to establish a screening algorithm or guide practice change.
Retrospective cohort study of 166 ICU patients confirming that rapid time-to-positivity in blood cultures may serve as a marker of illness severity and bacterial burden, though the mortality difference (47% vs 39%, p=0.292) was not statistically significant.
A retrospective cohort study with clear associations between timing of follow-up blood cultures and outcomes (length of treatment, time to culture clearance, and survival in Cox regression), but limited by single-centre design, retrospective conduct, and modest effect sizes that require confirmation in prospective studies.
Single-centre retrospective cohort study with modest sample size (50 patients, 21 with infections) identifying clinical associations with deep-seated LVAD infection but lacking prospective validation, control group, or adjustment for confounders.
Systematic review and meta-analysis of 32 observational studies showing a consistent, statistically significant pooled association (OR 1.92, 95% CI 1.55–2.38, p<0.001) between environmental AMR and human infectious disease outcomes across multiple regions, though causality is not established.
A single case report describing a rare manifestation of neurobrucellosis with clinical and radiological follow-up, raising diagnostic awareness rather than testing a hypothesis or providing generalizable evidence.