Pub Date : 2025-12-01DOI: 10.1016/j.imj.2025.100218
Ronghuang Liao , Lingling Zhang , Danlan Wang , Ni Tan
Microscopic polyangiitis (MPA) is a subtype of anti-neutrophil cytoplasmic antibody-associated vasculitis characterized by inflammatory changes in small vessel walls. Its clinical manifestations are nonspecific, and pulmonary involvement often presents as cough and production of sputum, which can be misdiagnosed as pneumonia. However, to the best of our knowledge, no cases of MPA coexisting with pulmonary hepatitis B virus (HBV) infection have been reported. This report describes the first such case. A 66-year-old man presented with a productive cough, swelling of the finger joints, and bilateral hearing loss. Initial imaging suggested pulmonary infection or malignancy. MPA was diagnosed based on positive myeloperoxidase-ANCA serology and vasculitic changes on histopathological examination of a lung biopsy specimen. Metagenomic next-generation sequencing of biopsy tissue revealed HBV, confirming a concurrent pulmonary HBV infection. Treatment with methylprednisolone, rituximab, and entecavir resulted in a favorable outcome.
{"title":"Microscopic polyangiitis complicated with pulmonary hepatitis B virus infection: A case report and literature review","authors":"Ronghuang Liao , Lingling Zhang , Danlan Wang , Ni Tan","doi":"10.1016/j.imj.2025.100218","DOIUrl":"10.1016/j.imj.2025.100218","url":null,"abstract":"<div><div>Microscopic polyangiitis (MPA) is a subtype of anti-neutrophil cytoplasmic antibody-associated vasculitis characterized by inflammatory changes in small vessel walls. Its clinical manifestations are nonspecific, and pulmonary involvement often presents as cough and production of sputum, which can be misdiagnosed as pneumonia. However, to the best of our knowledge, no cases of MPA coexisting with pulmonary hepatitis B virus (HBV) infection have been reported. This report describes the first such case. A 66-year-old man presented with a productive cough, swelling of the finger joints, and bilateral hearing loss. Initial imaging suggested pulmonary infection or malignancy. MPA was diagnosed based on positive myeloperoxidase-ANCA serology and vasculitic changes on histopathological examination of a lung biopsy specimen. Metagenomic next-generation sequencing of biopsy tissue revealed HBV, confirming a concurrent pulmonary HBV infection. Treatment with methylprednisolone, rituximab, and entecavir resulted in a favorable outcome.</div></div>","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"4 4","pages":"Article 100218"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.imj.2025.100217
Caren Challita , Nour El Moussawi , Maya Dagher , Nelly Rubeiz , Souha S. Kanj
Vulvar tuberculosis is an exceptionally rare manifestation of extrapulmonary Mycobacterium tuberculosis infection. We describe a 28-year-old woman from Republic of the Philippines presenting with a painful vulvar lesion of 3 months' duration unresponsive to several courses of antibiotics for a presumed sexually transmitted disease. A diagnosis of isolated vulvar Mycobacterial tuberculosis was made based on findings of caseating granulomas on vulvar biopsy and positive mycobacterial culture. The patient achieved complete resolution following standard antituberculous therapy. This case highlights the importance of suspecting tuberculosis in chronic vulvar lesions from endemic areas and underscores tissue biopsy and prolonged culture when initial stains are negative.
{"title":"An isolated Mycobacterium tuberculosis vulvar lesion: A case report","authors":"Caren Challita , Nour El Moussawi , Maya Dagher , Nelly Rubeiz , Souha S. Kanj","doi":"10.1016/j.imj.2025.100217","DOIUrl":"10.1016/j.imj.2025.100217","url":null,"abstract":"<div><div>Vulvar tuberculosis is an exceptionally rare manifestation of extrapulmonary <em>Mycobacterium tuberculosis</em> infection. We describe a 28-year-old woman from Republic of the Philippines presenting with a painful vulvar lesion of 3 months' duration unresponsive to several courses of antibiotics for a presumed sexually transmitted disease. A diagnosis of isolated vulvar <em>Mycobacterial tuberculosis</em> was made based on findings of caseating granulomas on vulvar biopsy and positive mycobacterial culture. The patient achieved complete resolution following standard antituberculous therapy. This case highlights the importance of suspecting tuberculosis in chronic vulvar lesions from endemic areas and underscores tissue biopsy and prolonged culture when initial stains are negative.</div></div>","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"4 4","pages":"Article 100217"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chronic viral hepatitis remains a significant global health burden, with accurate assessment of liver fibrosis being crucial for patient management. This study aimed to evaluate the diagnostic accuracy of non-invasive tests (NITs) for liver fibrosis assessment in patients with chronic hepatitis B (HBV), hepatitis B and D co-infection (HBV + HDV), and hepatitis C (HCV) infections.
Methods
A prospective study was conducted on 78 patients with chronic viral hepatitis (22 HBV, 34 HBV + HDV, 22 HCV). Participants underwent magnetic resonance elastography (MRE), transient elastography (TE), and serum biomarker testing (APRI, FIB-4, PIIINP, COL4). MRE was used as the reference standard for liver fibrosis staging.
Results
Transient elastography demonstrated the highest diagnostic accuracy for detecting advanced liver fibrosis across all etiologies (AUC 0.95, cutoff 10.2 kPa). The performance of serum biomarkers varied among different viral hepatitis etiologies. In chronic hepatitis B, APRI and FIB-4 showed moderate performance (AUC 0.64), while PIIINP and COL4 demonstrated poor diagnostic accuracy. In HBV + HDV co-infection, all markers showed moderate performance. In chronic hepatitis C, COL4 demonstrated excellent diagnostic accuracy (AUC 0.93), while FIB-4 and APRI showed moderate performance.
Conclusions
This study highlights the complex relationship between viral hepatitis etiologies and the performance of non-invasive fibrosis tests. While TE demonstrates high accuracy across all groups, the utility of serum biomarkers varies significantly. These findings underscore the importance of considering the specific viral etiology when selecting and interpreting NITs for liver fibrosis assessment in chronic viral hepatitis patients.
{"title":"Comparative analysis of non-invasive fibrosis markers: Insights from chronic HBV, HBV+HDV, and HCV infections","authors":"Aziza Saydullaevna Khikmatullaeva , Krestina Stepanovna Brigida , Nargiza Mirzakhidovna Мirrakhimova , Muazzam Alievna Аbdukadirova , Nargiz Sapievna Ibadullaeva , Allabergan Kadirovich Bayjanov , Nataliya Georgiyevna Kan , Malika Erkinovna Khodjaeva , Nargiza Anvarovna Yarmukhamedova , Ulugbek Khudayberdievich Mirzaev","doi":"10.1016/j.imj.2025.100220","DOIUrl":"10.1016/j.imj.2025.100220","url":null,"abstract":"<div><h3>Background</h3><div>Chronic viral hepatitis remains a significant global health burden, with accurate assessment of liver fibrosis being crucial for patient management. This study aimed to evaluate the diagnostic accuracy of non-invasive tests (NITs) for liver fibrosis assessment in patients with chronic hepatitis B (HBV), hepatitis B and D co-infection (HBV + HDV), and hepatitis C (HCV) infections.</div></div><div><h3>Methods</h3><div>A prospective study was conducted on 78 patients with chronic viral hepatitis (22 HBV, 34 HBV + HDV, 22 HCV). Participants underwent magnetic resonance elastography (MRE), transient elastography (TE), and serum biomarker testing (APRI, FIB-4, PIIINP, COL4). MRE was used as the reference standard for liver fibrosis staging.</div></div><div><h3>Results</h3><div>Transient elastography demonstrated the highest diagnostic accuracy for detecting advanced liver fibrosis across all etiologies (AUC 0.95, cutoff 10.2 kPa). The performance of serum biomarkers varied among different viral hepatitis etiologies. In chronic hepatitis B, APRI and FIB-4 showed moderate performance (AUC 0.64), while PIIINP and COL4 demonstrated poor diagnostic accuracy. In HBV + HDV co-infection, all markers showed moderate performance. In chronic hepatitis C, COL4 demonstrated excellent diagnostic accuracy (AUC 0.93), while FIB-4 and APRI showed moderate performance.</div></div><div><h3>Conclusions</h3><div>This study highlights the complex relationship between viral hepatitis etiologies and the performance of non-invasive fibrosis tests. While TE demonstrates high accuracy across all groups, the utility of serum biomarkers varies significantly. These findings underscore the importance of considering the specific viral etiology when selecting and interpreting NITs for liver fibrosis assessment in chronic viral hepatitis patients.</div></div>","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"4 4","pages":"Article 100220"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145750068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.imj.2025.100221
Di Wu , Zhaonian Tan , Yanhui Liu , Mengmeng Ma , Zhitao Chen , Dedong Wang , Lei Luo , Pengzhe Qin
Background
Influenza is a significant public health issue, particularly for vulnerable groups like children and the elderly. Despite widespread vaccination and public health measures, age-specific incidence data-crucial for targeted interventions—are limited in many areas, including Guangzhou. The epidemiological patterns of influenza have also been affected by non-pharmaceutical interventions during the COVID-19 pandemic, underscoring the need for updated local estimates. This study aimed to estimate the age-specific incidence of influenza infection in Guangzhou from 2019 to 2022—a period covering both pre-pandemic and pandemic phases—to inform regionally tailored prevention and control strategies.
Methods
This study analyzed surveillance data on influenza-like illness (ILI) and virological test results from sentinel hospitals in Guangzhou covering the period from 2019 to 2022. A previously established multiplier model was employed, which integrated age-specific consultation rates, influenza positivity rates, as well as parameters related to symptom presentation and detection sensitivity. Monte Carlo simulations were utilized to estimate annual age-stratified influenza infection and incidence rates, accompanied by 95% confidence intervals. The population denominators were derived from the national census conducted in 2020.
Results
7.78% of the total population in Guangzhou were infected by influenza in 2019, 1.40% in 2020, 1.85% in 2021 and 12.13% in 2022 and incidence rates were 5.15% in 2019, 0.93% in 2020, 1.23% in 2021 and 8.04% in 2022. The highest influenza infection and incidence rates were observed in 2022 and the lowest in 2020. Infections in the 0–14 age group were 27.19%, 3.57%, 11.16% and 66.15% during 2019–2022 and respective incidence rates were 18.00%, 2.37%, 7.41% and 43.84%.
Conclusions
0–14-year-old infants and children were the main victims of influenza. Targeted strategies should be developed to prevent the spread in this age group.
{"title":"Estimated incidence of influenza in Guangzhou, China, 2019–2022","authors":"Di Wu , Zhaonian Tan , Yanhui Liu , Mengmeng Ma , Zhitao Chen , Dedong Wang , Lei Luo , Pengzhe Qin","doi":"10.1016/j.imj.2025.100221","DOIUrl":"10.1016/j.imj.2025.100221","url":null,"abstract":"<div><h3>Background</h3><div>Influenza is a significant public health issue, particularly for vulnerable groups like children and the elderly. Despite widespread vaccination and public health measures, age-specific incidence data-crucial for targeted interventions—are limited in many areas, including Guangzhou. The epidemiological patterns of influenza have also been affected by non-pharmaceutical interventions during the COVID-19 pandemic, underscoring the need for updated local estimates. This study aimed to estimate the age-specific incidence of influenza infection in Guangzhou from 2019 to 2022—a period covering both pre-pandemic and pandemic phases—to inform regionally tailored prevention and control strategies.</div></div><div><h3>Methods</h3><div>This study analyzed surveillance data on influenza-like illness (ILI) and virological test results from sentinel hospitals in Guangzhou covering the period from 2019 to 2022. A previously established multiplier model was employed, which integrated age-specific consultation rates, influenza positivity rates, as well as parameters related to symptom presentation and detection sensitivity. Monte Carlo simulations were utilized to estimate annual age-stratified influenza infection and incidence rates, accompanied by 95% confidence intervals. The population denominators were derived from the national census conducted in 2020.</div></div><div><h3>Results</h3><div>7.78% of the total population in Guangzhou were infected by influenza in 2019, 1.40% in 2020, 1.85% in 2021 and 12.13% in 2022 and incidence rates were 5.15% in 2019, 0.93% in 2020, 1.23% in 2021 and 8.04% in 2022. The highest influenza infection and incidence rates were observed in 2022 and the lowest in 2020. Infections in the 0–14 age group were 27.19%, 3.57%, 11.16% and 66.15% during 2019–2022 and respective incidence rates were 18.00%, 2.37%, 7.41% and 43.84%.</div></div><div><h3>Conclusions</h3><div>0–14-year-old infants and children were the main victims of influenza. Targeted strategies should be developed to prevent the spread in this age group.</div></div>","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"4 4","pages":"Article 100221"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-05DOI: 10.1016/j.imj.2025.100215
Qiongbin Mao , Lin Li , Hongling Wen
Despite its potency in suppressing HIV-1 replication, antiretroviral therapy (ART) cannot eliminate latent viral reservoirs and is associated with several limitations, such as the need for lifelong treatment and the inherent risk of drug resistance. The quest for an HIV-1 cure has progressed from monotherapeutic approaches to the combinations of multimodal strategies, including neutralizing antibodies, precision genome editing, and management of latent reservoirs. Antibody-based interventions primarily involve inducing broadly neutralizing antibodies (bNAbs) through native-like envelope (Env) trimer vaccines, with their efficacy further enhanced by mRNA-lipid nanoparticle delivery systems. Precision genome editing can be achieved by using clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated protein (Cas) along with long-acting slow-effective release antiretroviral therapy. Reservoir-targeted therapies are typically implemented by reactivating latent viruses using the “shock and kill” strategy. Engineered cellular therapies include chimeric antigen receptor T (CAR-T) cells or bispecific antibodies (bsAbs) for subsequent immune clearance, immune system reconstitution via stem cell transplantation, and reversal of T-cell exhaustion using immune checkpoint inhibitors. Despite these advances, challenges remain, including suboptimal immunogenicity of Env vaccines, off-target effects and inefficient delivery of gene editing tools, incomplete reactivation of latent viruses, and limitations of preclinical models. Future research should focus on optimizing synergistic effects by improving Env trimer design, enhancing the targeting specificity of CRISPR systems, and developing preclinical models that more accurately reflect human immunity, thereby facilitating the transition from lifelong ART to a functional cure. This review summarizes recent progress in multimodal synergistic strategies and proposes a framework for an HIV-1 cure that may also offer insights into the treatment of other chronic viral infections.
{"title":"Beyond monotherapy: Combination therapies for HIV-1 cure through joint application of neutralizing antibodies, genome editing, and reservoir management","authors":"Qiongbin Mao , Lin Li , Hongling Wen","doi":"10.1016/j.imj.2025.100215","DOIUrl":"10.1016/j.imj.2025.100215","url":null,"abstract":"<div><div>Despite its potency in suppressing HIV-1 replication, antiretroviral therapy (ART) cannot eliminate latent viral reservoirs and is associated with several limitations, such as the need for lifelong treatment and the inherent risk of drug resistance. The quest for an HIV-1 cure has progressed from monotherapeutic approaches to the combinations of multimodal strategies, including neutralizing antibodies, precision genome editing, and management of latent reservoirs. Antibody-based interventions primarily involve inducing broadly neutralizing antibodies (bNAbs) through native-like envelope (Env) trimer vaccines, with their efficacy further enhanced by mRNA-lipid nanoparticle delivery systems. Precision genome editing can be achieved by using clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated protein (Cas) along with long-acting slow-effective release antiretroviral therapy. Reservoir-targeted therapies are typically implemented by reactivating latent viruses using the “shock and kill” strategy. Engineered cellular therapies include chimeric antigen receptor T (CAR-T) cells or bispecific antibodies (bsAbs) for subsequent immune clearance, immune system reconstitution via stem cell transplantation, and reversal of T-cell exhaustion using immune checkpoint inhibitors. Despite these advances, challenges remain, including suboptimal immunogenicity of Env vaccines, off-target effects and inefficient delivery of gene editing tools, incomplete reactivation of latent viruses, and limitations of preclinical models. Future research should focus on optimizing synergistic effects by improving Env trimer design, enhancing the targeting specificity of CRISPR systems, and developing preclinical models that more accurately reflect human immunity, thereby facilitating the transition from lifelong ART to a functional cure. This review summarizes recent progress in multimodal synergistic strategies and proposes a framework for an HIV-1 cure that may also offer insights into the treatment of other chronic viral infections.</div></div>","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"4 4","pages":"Article 100215"},"PeriodicalIF":0.0,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-02DOI: 10.1016/j.imj.2025.100214
Ippei Sakamaki , Yukie Tanaka , Hiromichi Iwasaki
Background
Tetracyclines, such as minocycline (MINO), are widely used in the treatment of infectious diseases. Japanese spotted fever (JSF) is usually treated with MINO. When MINO alone is ineffective in treating severe cases of JSF with complications, patients can be successfully treated with tetracycline combined with a quinolone such as ciprofloxacin (CPFX). However, the mechanisms underlying the efficacy of combination therapies remain unclear. We focused on cytokine suppression caused by antimicrobial agents.
Methods
THP-1 cells (2 × 105/mL) were stimulated with 0.1 µg/mL lipopolysaccharide (LPS) and various concentrations of CPFX, MINO, or CPFX+MINO. TNF-α levels in the supernatant were measured using enzyme-linked immunosorbent assay (ELISA) after 4 h of stimulation.
Results
MINO or CPFX alone significantly inhibited TNF-α and chemokine production, and their combination exerted an even greater inhibitory effect than either drug alone.
Conclusions
Combination therapy with MINO and CPFX enhanced the inhibitory effects on inflammatory cytokine and chemokine production in vitro. This combination therapy is expected to provide both antimicrobial and anti-inflammatory effects. Enhanced cytokine modulation by antibiotics may be a key mechanism in the treatment of severe infectious diseases such as JSF.
{"title":"Combination of minocycline and ciprofloxacin enhances the inhibitory effect of tumor necrosis factor-alpha production in lipopolysaccharide-stimulated THP-1 monocytic cells","authors":"Ippei Sakamaki , Yukie Tanaka , Hiromichi Iwasaki","doi":"10.1016/j.imj.2025.100214","DOIUrl":"10.1016/j.imj.2025.100214","url":null,"abstract":"<div><h3>Background</h3><div>Tetracyclines, such as minocycline (MINO), are widely used in the treatment of infectious diseases. Japanese spotted fever (JSF) is usually treated with MINO. When MINO alone is ineffective in treating severe cases of JSF with complications, patients can be successfully treated with tetracycline combined with a quinolone such as ciprofloxacin (CPFX). However, the mechanisms underlying the efficacy of combination therapies remain unclear. We focused on cytokine suppression caused by antimicrobial agents.</div></div><div><h3>Methods</h3><div>THP-1 cells (2 × 10<sup>5</sup>/mL) were stimulated with 0.1 µg/mL lipopolysaccharide (LPS) and various concentrations of CPFX, MINO, or CPFX+MINO. TNF-α levels in the supernatant were measured using enzyme-linked immunosorbent assay (ELISA) after 4 h of stimulation.</div></div><div><h3>Results</h3><div>MINO or CPFX alone significantly inhibited TNF-α and chemokine production, and their combination exerted an even greater inhibitory effect than either drug alone.</div></div><div><h3>Conclusions</h3><div>Combination therapy with MINO and CPFX enhanced the inhibitory effects on inflammatory cytokine and chemokine production <em>in vitro</em>. This combination therapy is expected to provide both antimicrobial and anti-inflammatory effects. Enhanced cytokine modulation by antibiotics may be a key mechanism in the treatment of severe infectious diseases such as JSF.</div></div>","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"4 4","pages":"Article 100214"},"PeriodicalIF":0.0,"publicationDate":"2025-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-13DOI: 10.1016/j.imj.2025.100213
Huichao Wu , Menglong Li , Zuolin Lu , Jing Huang , Fuqiang Cui , Ruitai Shao
Background
Enteric infections impose a substantial global health burden annually, especially in countries with inadequate sanitation. This study aims to assess the trends in the burden of enteric infections in China.
Methods
Prevalence, incidence, deaths, and disability-adjusted life years (DALYs) attributed to enteric infections by etiology in China were leveraged from the Global Burden of Disease Study 2021. Temporal trends in the burden of enteric infections from 1990 to 2021 were determined by percent changes and average annual percent change (AAPC). Decomposition analysis for percent changes was conducted to understand the contributions of demographic and epidemiological changes.
Results
In 2021, China bore 75.15 million incidence cases and 5,590 deaths from enteric infections, with age-standardized incidence and mortality rates of 59.04 per 100,000 and 0.44 per 100,000, respectively. Substantial decreases, mainly driven by epidemiological changes, were observed in incidence cases (−74.12%), deaths (−94.09%), and DALYs (−95.60%) from 1990 to 2021. Simultaneously, age-standardized incidence, mortality, and DALY rates showed decreasing trends for enteric infections and the subtypes in China. Diarrheal diseases were consistently the main constituent of the burden of enteric infections in China.
Conclusions
From 1990 to 2021, China has made significant strides in the control of enteric infections. This study underscores the need for continued efforts for the improvement of the health system, and enhanced interventions and health promotion strategies for both young and older populations.
{"title":"National trends in burden of enteric infections in China: Shifts from 1990 to 2021","authors":"Huichao Wu , Menglong Li , Zuolin Lu , Jing Huang , Fuqiang Cui , Ruitai Shao","doi":"10.1016/j.imj.2025.100213","DOIUrl":"10.1016/j.imj.2025.100213","url":null,"abstract":"<div><h3>Background</h3><div>Enteric infections impose a substantial global health burden annually, especially in countries with inadequate sanitation. This study aims to assess the trends in the burden of enteric infections in China.</div></div><div><h3>Methods</h3><div>Prevalence, incidence, deaths, and disability-adjusted life years (DALYs) attributed to enteric infections by etiology in China were leveraged from the Global Burden of Disease Study 2021. Temporal trends in the burden of enteric infections from 1990 to 2021 were determined by percent changes and average annual percent change (AAPC). Decomposition analysis for percent changes was conducted to understand the contributions of demographic and epidemiological changes.</div></div><div><h3>Results</h3><div>In 2021, China bore 75.15 million incidence cases and 5,590 deaths from enteric infections, with age-standardized incidence and mortality rates of 59.04 per 100,000 and 0.44 per 100,000, respectively. Substantial decreases, mainly driven by epidemiological changes, were observed in incidence cases (−74.12%), deaths (−94.09%), and DALYs (−95.60%) from 1990 to 2021. Simultaneously, age-standardized incidence, mortality, and DALY rates showed decreasing trends for enteric infections and the subtypes in China. Diarrheal diseases were consistently the main constituent of the burden of enteric infections in China.</div></div><div><h3>Conclusions</h3><div>From 1990 to 2021, China has made significant strides in the control of enteric infections. This study underscores the need for continued efforts for the improvement of the health system, and enhanced interventions and health promotion strategies for both young and older populations.</div></div>","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"4 4","pages":"Article 100213"},"PeriodicalIF":0.0,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145425721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-12DOI: 10.1016/j.imj.2025.100212
Yicheng Peng , Guoyin Fan , Di Jin , Junrong Liang , Yibing Fan , Shuilin Sun
This report describes a case of Q fever with predominantly liver injury presentation. We used targeted next generation sequencing (tNGS) and immunologic methods to identify a case of acute stage infection of Q fever with liver injury; prompt diagnosis and treatment significantly improved the patient's prognosis and life quality. Further, to predict the homology and genetic diversity, the patient's sample was partially sequenced for insertion sequence (IS)1111 gene. Additionally, we reviewed similar cases in the past five years, aiming to provide evidence-based evidence for subsequent accurate diagnosis and treatment.
{"title":"The use of tNGS in the diagnosis of Q fever: A case report and review of cases of liver injury","authors":"Yicheng Peng , Guoyin Fan , Di Jin , Junrong Liang , Yibing Fan , Shuilin Sun","doi":"10.1016/j.imj.2025.100212","DOIUrl":"10.1016/j.imj.2025.100212","url":null,"abstract":"<div><div>This report describes a case of Q fever with predominantly liver injury presentation. We used targeted next generation sequencing (tNGS) and immunologic methods to identify a case of acute stage infection of Q fever with liver injury; prompt diagnosis and treatment significantly improved the patient's prognosis and life quality. Further, to predict the homology and genetic diversity, the patient's sample was partially sequenced for insertion sequence (IS)<em>1111</em> gene. Additionally, we reviewed similar cases in the past five years, aiming to provide evidence-based evidence for subsequent accurate diagnosis and treatment.</div></div>","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"4 4","pages":"Article 100212"},"PeriodicalIF":0.0,"publicationDate":"2025-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145425720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Diabetes mellitus (DM) is a complex and multifactorial disorder associated with elevated blood sugar levels, poor insulin sensitivity, and inadequate insulin production. It has a major impact on the immune system, making a person more susceptible to and influenced by a variety of infectious illnesses. This narrative review summarizes the relationship between chronic inflammation and high glucose levels in DM, on susceptibility and outcomes in endemic infectious diseases. We focused on impact of DM on disease progression, and treatment response in these infections. Literature was identified through searches of PubMed, Scopus, and Google Scholar, focusing on epidemiologic, clinical, and mechanistic studies. The evidences suggest that immune modulation in DM has profound inverse relations with the outcome of infectious diseases including tuberculosis, COVID-19, and HIV/AIDS. DM increases the risk of developing severe forms of infectious diseases due to downregulation of the immune system which is associated with glycemic control. There is a need to understand the relationship between DM and immunological control for developing methods to reduce these risks and improve outcomes for the affected population.
{"title":"Immune dysregulation in type 2 diabetes mellitus: Implications for tuberculosis, COVID-19, and HIV/AIDS","authors":"Uzair Abbas , Harendra Kumar , Niaz Hussain , Ishfaque Ahmed , Rabeel Nawaz Laghari , Misha Tanveer , Mohammad Hadif , Kashaf Fatima , Muhib Ullah Khalid , Khadija Anwar , Mahtab Khan","doi":"10.1016/j.imj.2025.100211","DOIUrl":"10.1016/j.imj.2025.100211","url":null,"abstract":"<div><div>Diabetes mellitus (DM) is a complex and multifactorial disorder associated with elevated blood sugar levels, poor insulin sensitivity, and inadequate insulin production. It has a major impact on the immune system, making a person more susceptible to and influenced by a variety of infectious illnesses. This narrative review summarizes the relationship between chronic inflammation and high glucose levels in DM, on susceptibility and outcomes in endemic infectious diseases. We focused on impact of DM on disease progression, and treatment response in these infections. Literature was identified through searches of PubMed, Scopus, and Google Scholar, focusing on epidemiologic, clinical, and mechanistic studies. The evidences suggest that immune modulation in DM has profound inverse relations with the outcome of infectious diseases including tuberculosis, COVID-19, and HIV/AIDS. DM increases the risk of developing severe forms of infectious diseases due to downregulation of the immune system which is associated with glycemic control. There is a need to understand the relationship between DM and immunological control for developing methods to reduce these risks and improve outcomes for the affected population.</div></div>","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"4 4","pages":"Article 100211"},"PeriodicalIF":0.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145371320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01DOI: 10.1016/j.imj.2025.100198
Xiuhua Kang , Huaming Guo , Shanting Zhao , Wenzhen Zhang , Peng Liu , Yanfang Mei , Ling Zeng , Dandan Wei
Background
Elizabethkingia infections have become life-threatening hospital-acquired infections worldwide, marked by rising morbidity, multidrug resistance, and poor prognoses. However, information on the epidemiological and clinical characteristics of Elizabethkingia infections in mainland China is limited. This study aimed to analyze the molecular and clinical characteristics, and drug susceptibility of clinical Elizabethkingia isolates from a hospital in Jiangxi Province, China.
Methods
A total of 103 Elizabethkingia isolates, identified by conventional methods, were collected from patients at a university-affiliated hospital in 2022 and 2023. Species identification was conducted using 16S rRNA gene sequencing. The feasibility of the Vitek MS was also evaluated. Antimicrobial susceptibility testing, resistance gene identification, and pulsed-field gel electrophoresis were performed.
Results
The mean age of the patients was 61 years (excluding one 13-day-old infant) and 75.3 % were men. In total, 86.4 % of patients admitted to the intensive care unit were infected with Elizabethkingia. COVID-19, respiratory disease, and ICU admission were significantly different between the surviving and dying groups (p < 0.05). Sequencing of 103 isolates identified 92 strains of Elizabethkingia anophelis, eight strains of Elizabethkingia meningoseptica, two strains of Elizabethkingia bruuniana, and one strain of Elizabethkingia ursingii. The Vitek MS had a correct identification rate of 87 % for Elizabethkingia anophelis. More than 90 % of the Elizabethkingia isolates were susceptible to minocycline, but resistant to other drugs, including ceftazidime, aztreonam, and imipenem. Resistance genotype analysis showed that blaBlaB and blaCME were highly prevalent in the Elizabethkingia isolates. Molecular typing revealed 29 different pulsed-field gel electrophoresis types with clonal transmission between wards.
Conclusions
Multidrug-resistant Elizabethkingia is being increasingly detected. Therefore, a larger database is required for Elizabethkingia strain identification. This database could be beneficial for the subsequent determination of optimal antimicrobial drugs for treating infections caused by various Elizabethkingia strains. Our pulsed-field gel electrophoresis model showed that most Elizabethkingia isolates exhibit sufficient genetic diversity and clonal transmission. Therefore, adequate attention should be directed towards this pathogen.
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