Infectious Medicine最新文献

In a retrospective view, this review examines the impact of mucormycosis on health workers and researchers during the COVID era. The diagnostic and treatment challenges arising from unestablished underlying pathology and limited case studies add strain to healthcare systems. Mucormycosis, caused by environmental molds, poses a significant threat to COVID-19 patients, particularly those with comorbidities and compromised immune systems. Due to a variety of infectious Mucorales causes and regionally related risk factors, the disease's incidence is rising globally. Data on mucormycosis remains scarce in many countries, highlighting the urgent need for more extensive research on its epidemiology and prevalence. This review explores the associations between COVID-19 disease and mucormycosis pathology, shedding light on potential future diagnostic techniques based on the fungal agent's biochemical components. Medications used in ICUs and for life support in ventilated patients have been reported, revealing the challenge of managing this dual onslaught. To develop more effective treatment strategies, it is crucial to identify novel pharmacological targets through “pragmatic” multicenter trials and registries. In the absence of positive mycology culture data, early clinical detection, prompt treatment, and tissue biopsy are essential to confirm the specific morphologic features of the fungal agent. This review delves into the history, pathogens, and pathogenesis of mucormycosis, its opportunistic nature in COVID or immunocompromised individuals, and the latest advancements in therapeutics. Additionally, it offers a forward-looking perspective on potential pharmacological targets for future drug development.

Background

Hand, foot, and mouth disease (HFMD) is a common childhood infectious disease caused by a variety of enteroviruses (EVs). To explore the epidemiological characteristics and etiology of HFMD in Zhengzhou, China, we conducted a systematic analysis of HFMD surveillance data from Zhengzhou Center for Disease Control and Prevention from January 2009 to December 2021 (https://wjw.zhengzhou.gov.cn/).

Methods

Surveillance data were collected from Zhengzhou Center for Disease Control and Prevention from January 2009 to December 2021 (https://wjw.zhengzhou.gov.cn/). Cases were analyzed according to the time of onset, type of diagnosis, characteristics, viral serotype, and epidemiological trends.

Results

We found that the primary causative agent responsible for the HFMD outbreaks in Zhengzhou was Enterovirus A71 (EVA-71) (48.56%) before 2014. After 2015, other EVs gradually became the dominant strains (57.68%). The data revealed that the HFMD epidemics in Zhengzhou displayed marked seasonality, with major peaks occurring from April to June, followed by secondary peaks from October to November, except in 2020. Both the severity and case-fatality ratio of HFMD decreased following the COVID-19 pandemic (severity ‰: 13.46 vs. 0.17; case-fatality ‰: 0.21 vs. 0, respectively). Most severe cases were observed in patients aged 1 year and below, accounting for 45.81%.

Conclusions

Overall, the incidence rate of HFMD decreased in Zhengzhou following the introduction of the EVA-71 vaccine in 2016. However, it is crucial to acknowledge that HFMD prevalence continues to exhibit a distinct seasonal pattern and periodicity, and the occurrence of other EV infections poses a new challenge for children's health.

Fusobacterium vincentii brain abscesses are relatively rare. Here, we report our treatment of an anaerobic brain abscess caused by a mixed infection of Parvimonas micra, Streptococcus constellatus, Fusobacterium vincentii, and Bacteroides heparinolyticus diagnosed by metagenomic next-generation sequencing (mNGS). This is the first reported case of Fusobacterium vincentii in a brain abscess. This case highlights the possibility that oral anaerobic microbes can cause a brain abscess and demonstrates that mNGS has the potential to be deployed to provide rapid infection diagnosis and rationalize antimicrobial therapy for brain abscesses.

Background

An epizootic of highly pathogenic avian influenza A (H5N1) has spread worldwide since 2022. Even though this virus has been extensively studied for many decades, little is known about its evolution in South America.

Methods

Here, we describe the sequencing and characterization of 13 H5N1 genomes collected from wild birds, poultry, and wild mammals in Peru during the genomic surveillance of this outbreak.

Results

The samples belonged to the highly pathogenic avian influenza (H5N1) 2.3.4.4b clade. Chilean and Peruvian samples clustered in the same group and therefore share a common ancestor. An analysis of the hemagglutinin and neuraminidase genes detected new mutations, some dependent upon the host type.

Conclusions

The genomic surveillance of highly pathogenic avian influenza is necessary to promote the One Health policy and to overcome the new problems entailed by climate change, which may alter the habitats of resident and migratory birds.

Background

Until now, there has been limited information on the prevalence and the phylogeny of Borrelia burgdorferi sensu lato in Ixodes ticks in Tunisia, particularly in Ixodes inopinatus.

Methods

The present study aimed to determine the prevalence and the phylogeny of B. burgdorferi s.l., in coexisted I. ricinus and I. inopinatus ticks collected from Northern Tunisia. One hundred questig ticks were collected during winter 2020 by tick-dragging method in Beja gouvernorate located in the north of Tunisia. Real-time PCR panel targeting B. burgdorferi s.l. 23S rRNA gene were performed. Positive DNA samples were subjected to conventional PCRs targeting 457 bp fragment of the Borrelia sp. flagellin (fla) gene using primers FlaF/FlaR. The identified Borrelia sp. isolate underwent partial sequence analysis to determine genospecies and evaluate their phylogenetic position.

Results

The study revealed a prevalence rate of 28% (28/100) for B. burgdorferi sensu lato in the Ixodes ticks. The prevalence rates across tick species and genders did not show significant variations (p > 0.05). Interestingly, the study underlines the coexistence of I. inopinatus and I. ricinus sharing the same geographic areas in Northern Tunisia. Furthermore, DNA of B. lusitaniae was detected in I. inopinatus ticks for the first time in Tunisia. Revealed B. lusitaniae bacterium is similar to previously identified strains in Mediterranean region, but distinct from those isolated exclusively from countries of Eastern and Central Europe, such as Serbia, Romania, and Poland. This study highlights the prevalence of B. burgdorferi s.l. in I. ricinus/I. inopinatus ticks, and reveals B. lusitaniae in I. inopinatus ticks for the first time in Tunisia.

Conclusion

These findings suggest the involvement of I. inopinatus as a potential vector of this pathogenic genospeciess in Tunisia. This may help understanding the ecology of Ixodes ticks, the natural infection and the transmission dynamics of Borrelia species in this country.

Hemophagocytic lymphohistiocytosis (HLH) syndrome is an uncontrolled activation of macrophages, causing multiorgan dysfunction. The prognosis depends on the cause and the delay of diagnosis and treatment. Several infections can cause HLH, including rickettsia, a gram-negative bacterium. The diagnosis of rickettsia is based on clinical signs, including fever, headache, rash and sometimes tick bite site. The importance of an early diagnosis of rickettsia is the key. We present a case of rickettsia infection complicated with severe HLH occurring in a 21-year-old woman. The diagnosis was confirmed by serology 4 weeks after admission. She was treated with immunoglobulin, corticosteroids, and doxycycline with a favorable outcome.

A 68-year-old-gentleman presented with left hip pain, night sweats, fatigue, and weight loss. He had previously experienced pain with white discharge until he underwent an arthroscopic washout and reduction. The left lower limb was shortened and wasted with limited hip movements. He had recently travelled to Zambia, his country of origin. Imaging demonstrated a large mass with chronic erosions of the acetabulum and femoral head. Synovial biopsy grew Mycobacterium tuberculosis, which was treated with rifampicin, isoniazid, pyrazinamide, and ethambutol for 2 months then 4 months of rifampicin and isoniazid. Whole genome sequencing indicated full sensitivity. Complex reconstructive surgery is scheduled, with a custom femoral head and acetabulum. This case illustrates the importance of considering tuberculosis in patients with erosive joint pathology and a multidisciplinary approach as delayed diagnosis results in high morbidity. Prompt diagnosis using newer modalities such as whole genome sequencing on synovial fluid can enable timely treatment.

Antimicrobials are frequently used in both humans and animals for the treatment of bacterially-generated illnesses. Antibiotic usage has increased for more than 40% from last 15 years globally per day in both human populations and farm animals leading to the large-scale discharge of antibiotic residues into wastewater. Most antibiotics end up in sewer systems, either directly from industry or healthcare systems, or indirectly from humans and animals after being partially metabolized or broken down following consumption. To prevent additional antibiotic compound pollution, which eventually impacts on the spread of antibiotic resistance, it is crucial to remove antibiotic residues from wastewater. Antibiotic accumulation and antibiotic resistance genes cannot be effectively and efficiently eliminated by conventional sewage treatment plants. Because of their high energy requirements and operating costs, many of the available technologies are not feasible. However, the biosorption method, which uses low-cost biomass as the biosorbent, is an alternative technique to potentially address these problems. An extensive literature survey focusing on developments in the field was conducted using English language electronic databases, such as PubMed, Google Scholar, Pubag, Google books, and ResearchGate, to understand the relative value of the available antibiotic removal methods. The predominant techniques for eliminating antibiotic residues from wastewater were categorized and defined by example. The approaches were contrasted, and the benefits and drawbacks were highlighted. Additionally, we included a few antibiotics whose removal from aquatic environments has been the subject of extensive research. Lastly, a few representative publications were identified that provide specific information on the removal rates attained by each technique. This review provides evidence that biosorption of antibiotic residues from biological waste using natural biosorbent materials is an affordable and effective technique for eliminating antibiotic residues from wastewater.

Background

Since the first human infection with H9N2 virus was reported in 1998, the number of cases of H9N2 infection has exceeded one hundred by 2021. However, there is no systematic description of the biological characteristics of H9N2 viruses isolated from humans.

Methods

Therefore, this study analyzed the pathogenicity in mice of all available H9N2 viruses isolated from human cases in China from 2013 to 2021.

Results

Although most of the H9N2 viruses analyzed showed low or no pathogenicity in mice, the leucine to glutamine substitution at residue 226 (L226Q) in the hemagglutinin (HA) protein rapidly emerged during the adaptation of H9N2 viruses, and was responsible for severe infections and even fatalities. HA amino acid 226Q conferred a remarkable competitive advantage on H9N2 viruses in mice relative to viruses containing 226L, increasing their virulence, infectivity, and replication.

Conclusion

Thus, our study demonstrates that the adaptive substitution HA L226Q rapidly acquired by H9N2 viruses during the course of infection in mice contributed to their high pathogenicity.