医学最新文献

A 2019 nationwide study in Japan revealed the predominant methicillin-resistant Staphylococcus aureus (MRSA) types in bloodstream infections (BSIs) to be sequence type (ST)8-carrying SCCmec type IV (ST8-MRSA-IV) and clonal complex 1-carrying SCCmec type IV (CC1-MRSA-IV). However, detailed patient characteristics and how these MRSA types evolve over time remain largely unknown. In this long-term single-center study, MRSA strains isolated from blood cultures at Nagasaki University Hospital from 2012 to 2019 were sequenced and analyzed. Additionally, we compared the SCCmec types and patient characteristics identified in this study with previous data from our hospital spanning 2003-2007 and 2008-2011. Over this 16-year period, SCCmec type II decreased significantly from 79.2% to 15.5%, while type IV increased from 18.2% to 65.5%. This shift in SCCmec types was associated with notable changes in severity and outcomes; the sequential organ failure assessment (SOFA) score decreased from 5.8 to 3.1; in-hospital mortality declined from 39.8% to 15.5%. In contrast, no significant changes in patient demographics, such as age, sex, or underlying diseases, were observed. Between 2012 and 2019, the major combinations of SCCmec type and sequence type were ST8-MRSA-IV, ST8-MRSA-I, CC1-MRSA-IV, and ST5-MRSA-II. Additionally, ST8-MRSA-IV was divided into CA-MRSA/J, t5071-ST8-MRSA-IV, and USA300-like clone based on the results of molecular analysis. These major combinations showed similar drug resistance patterns, molecular characteristics, and phylogenetic features to those identified in nationwide surveillance. This study highlights the evolving nature of MRSA types in bloodstream infections, correlating with improved patient outcomes over time.

Alterations in bile acid profile and pathways contribute to hepatic inflammation in cancer cachexia, a syndrome worsening the prognosis of cancer patients. As the gut microbiota impinges on host metabolism through bile acids, the current study aimed to explore the functional contribution of gut microbial dysbiosis to bile acid dysmetabolism and associated disorders in cancer cachexia. Using three mouse models of cancer cachexia (the C26, MC38 and HCT116 models), we evidenced a reduction in the hepatic levels of several secondary bile acids, mainly taurodeoxycholic (TDCA). This reduction in hepatic TDCA occurred before the appearance of cachexia. Longitudinal analysis of the gut microbiota pinpointed an ASV, identified as Xylanibacter rodentium, as a bacterium potentially involved in the reduced production of TDCA. Coherently, stable isotope-based experiments highlighted a robust decrease in the microbial 7α-dehydroxylation (7α-DH) activity with no changes in the bile salt hydrolase (BSH) activity in cachectic mice. This approach also highlighted a reduced microbial 7α-hydroxysteroid dehydrogenase (7α-HSDH) and 12α-hydroxysteroid dehydrogenase (12α-HSDH) activities in these mice. The contribution of the lower production of TDCA to cancer cachexia was explored in vitro and in vivo. In vitro, TDCA prevented myotube atrophy, whereas in vivo hepatic whole transcriptome analysis revealed that TDCA administration to cachectic mice improved the unfolded protein response and cholesterol homeostasis pathways. Coherently, TDCA administration reversed hepatic cholesterol accumulation in these mice. Altogether, this work highlights the contribution of the gut microbiota to bile acid dysmetabolism and the therapeutic interest of the secondary bile acid TDCA for hepatic cholesterol homeostasis in the context of cancer cachexia. Such discovery may prove instrumental in the understanding of other metabolic diseases characterized by microbial dysbiosis. More broadly, our work demonstrates the interest and relevance of microbial activity measurements using stable isotopes, an approach currently underused in the microbiome field.

The objective of this study is to gain insight into the current research frontiers, hotspots, and development trends in the field of immunization programs for women and children, and to provide scientific guidance and reference for follow-up research. Based on all the original research papers related to the research on immunization programs for women and children in the Web of Science Core Collection (WoSCC) database, bibliometric studies and visual analysis were carried out to explore the research frontiers, hotspots and development trends, and to analyze the risk factors affecting the vaccination coverage of immunization programs for women and children. Eight hundred forty-three papers obtained from 1,552 institutions in 96 countries/regions from January 1950 to August 2024, coauthored by 4,343 authors. With the largest number of papers published in the United States (408), Centers for Disease Control & Prevention - USA (169), Stokley S (15), and Pediatrics (143). The research frontiers of this discipline area mainly involve risk factors affecting the vaccination coverage of immunization programs for women and children, epidemiological surveillance, intervention research, changes in medical burden, adverse reactions, and vaccine development. Research hotspots mainly include measles, vaccine hesitancy, human papillomavirus, coverage, and pregnant women. The findings of the study informed policymakers, public health experts and researchers about the potential for modifying and improving policy systems and interventions related to the immunization programs for women and children. This had important implications for digital transformation and innovative research in health care providers' clinical practice for the immunization programs for women and children.

How the gut microbiota and immune system maintain intestinal homeostasis in concert with the enteric nervous system (ENS) remains incompletely understood. To address this gap, we assessed small intestinal transit, enteric neuronal density, enteric neurogenesis, intestinal microbiota, immune cell populations and cytokines in wildtype and T-cell deficient germ-free mice colonized with specific pathogen-free (SPF) microbiota, conventionally raised SPF and segmented filamentous bacteria (SFB)-monocolonized mice. SPF microbiota increased small intestinal transit in a T cell-dependent manner. SPF microbiota increased neuronal density in the myenteric and submucosal plexuses of the ileum and colon, similar to conventionally raised SPF mice, independently of T cells. SFB increased neuronal density in the ileum in a T cell-dependent manner, but independently of T cells in the colon. SPF microbiota stimulated enteric neurogenesis (Sox2 expression in enteric neurons) in the ileum in a T cell-dependent manner, but in the colon this effect was T cell-independent. T cells regulated nestin expression in the ENS. SPF colonization increased Th17 cells, RORγT⁺ Treg cells, and IL-1β and IL-17A levels in the ileum and colon. By neutralizing IL-1β and IL-17A, we observed that they control microbiota-mediated enteric neurogenesis but were not involved in the regulation of motility. Together, these findings provide new insights into the microbiota-neuroimmune dialog that regulates intestinal physiology.

Background: Caffeine, identified as a central nervous system stimulant in foods, beverages (coffee, tea, chocolate), and medications, has been focused on its ergogenic properties, enhancing physical performance. The aim of this study was to investigate the association between the caffeine intake (from coffee) and fat-free mass index (FFMI).

Materials and methods: We carried out a cohort study that included 3,466 women and 3,145 men aged ≥20 years who were intaking caffeine. Caffeine intake from coffee were obtained from two 24-hour dietary recall interviews. The FFMI was calculated as FFM (kg) divided by height in m². The caffeine intake was classified into quartiles and combined into 4 groups. Multiple linear regression model analysis and multiple logistic regression model analysis were used to assess associations between the caffeine and FFMI adjusted for potential confounders.

Results: Among the 2,427 participants, males accounted for 52.4%, and females 47.6%. In multiple linear regression model, Model 1 (unadjusted Model (p = 0.041)) and Model 2 (adjusted for age, race, and BMI (p = 0.006)) in women showed a significant relationship between caffeine intake and FFMI. In multivariable models, caffeine intake and FFMI were significantly different (p < 0.05). In sex subgroups, among females, each quartile of caffeine intake was positively correlated with FFMI levels in the average FFMI group in Model 3 (p < 0.001). In age subgroups, each quartile of caffeine intake was positively correlated with FFMI levels in the average FFMI group in Model 3 for individuals aged 20-40 (p = 0.039) and those aged above 40 (p = 0.016). In drinking status subgroups, if they drunk alcohol, each quartile was positively correlated with FFMI levels in the average FFMI group in Model 3 (p < 0.001).

Conclusion: Caffeine intake was mainly positively associated with FFMI, especially in women with above levels of FFMI. Longitudinal studies and randomized controlled trials are needed to establish causality and provide evidence-based recommendations regarding caffeine intake to optimize muscle health.

The development of cardiometabolic (CM) diseases is associated with chronic low-grade inflammation, partly linked to alterations of the gut microbiota (GM) and reduced intestinal integrity. The SINFONI project investigates a multifunctional (MF) nutritional strategy's impact combining different bioactive compounds on inflammation, GM modulation and CM profile. In this randomized crossover-controlled study, 30 subjects at CM-risk consumed MF cereal-products, enriched with polyphenols, fibers, slowly-digestible starch, omega-3 fatty acids or Control cereal-products (without bioactive compounds) for 2 months. Metabolic endotoxemia (lipopolysaccharide (LPS), lipopolysaccharide-binding protein over soluble cluster of differentiation-14 (LBP/sCD14), systemic inflammation and cardiovascular risk markers, intestinal inflammation, CM profile and response to a one-week fructose supplementation, were assessed at fasting and post mixed-meal. GM composition and metabolomic analysis were conducted. Mixed linear models were employed, integrating time (pre/post), treatment (MF/control), and sequence/period. Compared to control, MF intervention reduced intestinal inflammation (fecal calprotectin, p = 0.007) and endotoxemia (fasting LPS, p < 0.05), without alteration of systemic inflammation. MF decreased serum branched-chain amino acids compared to control (p < 0.05) and increased B.ovatus, B.uniformis, A.butyriciproducens and unclassified Christensenellaceae.CAG-74 (p < 0.05). CM markers were unchanged. A 2-month dietary intervention combining multiple bioactive compounds improved intestinal inflammation and induced GM modulation. Such strategy appears as an effective strategy to target low-grade inflammation through multi-target approach.

Following reports of mpox infections in Europe and the Americas, the World Health Organisation has declared that mpox constitutes a public health emergency of international concern. Since the mpox virus (MPXV) has been detected in semen of MPX-infected men, this puts healthcare professionals in medically assisted reproduction clinics, such as clinical embryologists and andrologists, at risk of MPX infection by handling semen from infected men. This commentary provides information about MPXV and highlights vigilance steps with regards to processing semen, oocytes, pre-implantation embryos and pregnancies of MPXV infected persons.

Purpose: From an active ageing perspective, investigating how adults use apps and wearables for health purposes might improve well-being strategies supported by widely adopted technologies. This study investigated adults' perceptions of using apps and wearables for health purposes.

Methods: A qualitative interview study was conducted. Adults (+18) using an app/wearable to monitor at least one health variable (e.g. physical activity and diet) were eligible. Transcriptions were analysed using the Reflexive Thematic Analysis.

Results: Nineteen participants (34.3 ± 14.5 years; men/women: 8/11) joined the study and from their transcriptions 5 themes were created: 1) Easy and accurate monitoring of health: balancing users' needs and technological challenges; 2) Self-improvement and motivation: usefulness of rewarding behaviours and gamification towards achievements; 3) Requiring personalized apps and wearables: aesthetics and wearability; 4) Beyond simple monitoring: prevention and care throughout daily life; 5) Awareness of potentially dangerous digital data world: from distress to fixation.

Conclusions: Apps and wearables were highly valued by our participants for effectively managing and enhancing their health and sports performance while ensuring education, motivation, ease of use, safety, and prevention. However, issues such as privacy concerns, wearability, and lack of integration need to be addressed to improve adoption, enhance usability and support active ageing initiatives.

Cancerous tissue is a largely unexplored microbial niche that provides a unique environment for the colonization and growth of specific bacterial communities, and with it, the opportunity to identify novel bacterial species. Here, we report distinct features of a novel Fusobacterium species, F. sphaericum sp. nov. (Fs), isolated from primary colon adenocarcinoma tissue. We acquire the complete closed genome and associated methylome of this organism and phylogenetically confirm its classification into the Fusobacterium genus, with F. perfoetens as its closest neighbor. Fs is phenotypically and genetically distinct, with morphological analysis revealing its coccoid shape, that while similar to F. perfoetens is rare for most Fusobacterium members. Fs displays a metabolic profile and antibiotic resistance repertoire consistent with other Fusobacterium species. In vitro, Fs has adherent and immunomodulatory capabilities, as it intimately associates with human colon cancer epithelial cells and promotes IL-8 secretion. An analysis of the prevalence and abundance of Fs in > 20,000 human metagenomic samples shows that it is a rarely detected member within human stool with variable relative abundance, found in both healthy controls and patients with colorectal cancer (CRC). Our study sheds light on a novel bacterial species isolated directly from the human CRC tumor niche and given its in vitro interaction with cancer epithelial cells suggests that its role in human health and disease warrants further investigation.