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Immune dysregulation in type 2 diabetes mellitus: Implications for tuberculosis, COVID-19, and HIV/AIDS 2型糖尿病的免疫失调:对结核病、COVID-19和艾滋病毒/艾滋病的影响
Pub Date : 2025-10-06 DOI: 10.1016/j.imj.2025.100211
Uzair Abbas , Harendra Kumar , Niaz Hussain , Ishfaque Ahmed , Rabeel Nawaz Laghari , Misha Tanveer , Mohammad Hadif , Kashaf Fatima , Muhib Ullah Khalid , Khadija Anwar , Mahtab Khan
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.
糖尿病(DM)是一种复杂的多因素疾病,与血糖水平升高、胰岛素敏感性低下和胰岛素分泌不足有关。它对免疫系统有重大影响,使人更容易受到各种传染病的影响。本文综述了慢性炎症与糖尿病患者高血糖水平之间的关系,以及糖尿病在地方性传染病中的易感性和结局。我们关注的是糖尿病对疾病进展的影响,以及这些感染的治疗反应。文献通过PubMed、Scopus和谷歌Scholar检索确定,重点是流行病学、临床和机制研究。这些证据表明,糖尿病的免疫调节与包括结核病、COVID-19和艾滋病毒/艾滋病在内的传染病的结局有着深刻的反比关系。由于与血糖控制相关的免疫系统下调,糖尿病增加了发生严重传染病的风险。有必要了解糖尿病和免疫控制之间的关系,以便制定方法来降低这些风险并改善受影响人群的预后。
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引用次数: 0
Prevalence, microbiological features, and clinical characteristics of Elizabethkingia isolates in a tertiary hospital, Jiangxi Province, China 江西省某三级医院伊莉莎白菌的流行、微生物学特征及临床特征
Pub Date : 2025-09-01 DOI: 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.
背景:在世界范围内,沙门氏菌感染已成为危及生命的医院获得性感染,其特点是发病率上升、耐多药和预后不良。然而,关于中国大陆伊莉莎白菌感染的流行病学和临床特征的信息有限。本研究旨在分析江西省某医院临床分离的伊莉莎白菌(Elizabethkingia)的分子特征、临床特征及药物敏感性。方法于2022年和2023年从某大学附属医院的患者中采集常规方法鉴定的伊莉莎白菌株103株。采用16S rRNA基因测序进行物种鉴定。Vitek质谱的可行性也进行了评估。进行药敏试验、耐药基因鉴定和脉冲场凝胶电泳。结果患者平均年龄61岁(不包括1例13日龄婴儿),男性占75.3%。总共有86.4%的重症监护室病人感染了伊丽莎白金氏菌。生存组与死亡组的COVID-19、呼吸系统疾病、ICU入院率差异有统计学意义(p < 0.05)。对103株分离株进行测序,鉴定出92株按蚊、8株脑膜炎毒杆菌、2株布鲁尼亚伊丽莎白金氏菌和1株新伊丽莎白金氏菌。Vitek MS对按蚊的正确率为87%。超过90%的伊丽莎白菌株对米诺环素敏感,但对其他药物耐药,包括头孢他啶、阿唑南和亚胺培南。抗性基因型分析显示,blaBlaB和blaCME在伊丽莎白菌株中高度流行。分子分型显示29种不同的脉冲场凝胶电泳类型,病房间克隆传播。结论耐多药伊莉莎白菌呈上升趋势。因此,elizabeth ethkingia菌株鉴定需要更大的数据库。该数据库可为后续确定治疗各种伊丽莎白菌株引起的感染的最佳抗菌药物提供参考。我们的脉冲场凝胶电泳模型显示,大多数伊丽莎白菌株具有足够的遗传多样性和克隆传播能力。因此,对这种病原体应给予足够的重视。
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引用次数: 0
Pentavalent rotavirus vaccine effectiveness among children in Shenzhen, China: A population-based test-negative design with directed acyclic graphs bias adjustment 五价轮状病毒疫苗在中国深圳儿童中的有效性:一项基于人群的阴性试验设计,有向无环图偏倚调整
Pub Date : 2025-09-01 DOI: 10.1016/j.imj.2025.100201
Zian Lin , Weiyi Cai , Yanan Liu , Juan Liu , Hongbiao Chen , Shaojian Xu , Qiuju Xie , Danting Lou , Yuying Zhang , Hairong Nan , Jiahui Li , Lixian Su

Background

China's Notifiable Disease Reporting System comprehensively collects data on pediatric acute gastroenteritis cases from all levels of healthcare. This study evaluated the effectiveness of the pentavalent rotavirus vaccine against rotavirus gastroenteritis in children under five years of age during seasonal epidemic periods.

Methods

Using a test-negative design, we analyzed laboratory data from diarrhea patients aged 2–59 months who sought medical care in Longhua District, Shenzhen, Guangdong Province, China between January 2020 and March 2024. Vaccination history and potential confounders, including sex, household registration status, prematurity, and birth weight, were collected retrospectively. Directed acyclic graphs were used to identify adjustment variables. Vaccine effectiveness was calculated as (1 − adjusted odds ratio) × 100 % using unconditional logistic regression, comparing rotavirus-positive cases with rotavirus-negative controls.

Results

The incidence of rotavirus gastroenteritis peaked and then progressively declined from January 2020 through March 2023, with no seasonal resurgence observed in the first quarter of 2023. Analysis of 928 epidemic-season cases (674 RV+; 254 RV–) revealed an overall pentavalent rotavirus (RV5) vaccine effectiveness of 79.6 % (95 % CI: 68.9 %–86.6 %). Dose-specific vaccine effectiveness varied substantially: 1 dose vaccine effectiveness registered at 26.7 % (95 % CI: −162.1 %–79.5 %), rising to 76.6 % (95 % CI: 46.2 %–89.8 %) for 2 doses, and reaching 82.7 % (95 % CI: 72.2 %–89.2 %) for 3 doses. Age-stratified analysis showed vaccine effectiveness of 79.5 % (95 % CI: 56.8 %–90.3 %) in children aged 2–11 months, 83.8 % (95 % CI: 66.4 %–92.2 %) for 12–23 months, and 79.6 % (95 % CI: 68.9 %–86.6 %) in those aged 24–35 months, while vaccine effectiveness was 31.2 % (95 % CI: −251.8 %–86.5 %) in children aged 36–59 months.

Conclusions

A three-dose regimen of pentavalent rotavirus vaccine provides significant effectiveness against rotavirus gastroenteritis for children under 36 months of age during epidemic seasons, thereby alleviating the burden on public health systems.
中国的法定疾病报告系统全面收集了各级卫生保健机构的儿童急性胃肠炎病例数据。本研究评估了季节性流行期间五价轮状病毒疫苗对五岁以下儿童预防轮状病毒胃肠炎的有效性。方法采用阴性试验设计,对2020年1月至2024年3月在中国广东省深圳市龙华区就诊的2-59个月腹泻患者的实验室数据进行分析。回顾性收集疫苗接种史和潜在混杂因素,包括性别、户籍状况、早产和出生体重。使用有向无环图来识别调整变量。将轮状病毒阳性病例与轮状病毒阴性对照进行比较,采用无条件logistic回归计算疫苗有效性为(1 -校正优势比)× 100%。结果2020年1月至2023年3月,轮状病毒胃肠炎发病率达到高峰,随后逐渐下降,2023年第一季度未见季节性复发。对928例流行季节病例(RV +病例674例,RV -病例254例)的分析显示,五价轮状病毒(RV5)疫苗的总有效率为79.6% (95% CI: 68.9% - 86.6%)。剂量特异性疫苗的有效性差异很大:1剂疫苗的有效性为26.7% (95% CI: - 162.1% - 79.5%), 2剂疫苗的有效性上升到76.6% (95% CI: 46.2% - 89.8%), 3剂疫苗的有效性达到82.7% (95% CI: 72.2% - 89.2%)。年龄分层分析显示,2-11月龄儿童的疫苗有效性为79.5% (95% CI: 56.8% - 90.3%), 12-23月龄儿童的疫苗有效性为83.8% (95% CI: 66.4% - 92.2%), 24-35月龄儿童的疫苗有效性为79.6% (95% CI: 68.9% - 86.6%), 36-59月龄儿童的疫苗有效性为31.2% (95% CI: - 251.8% - 86.5%)。结论五价轮状病毒疫苗三剂方案在流行季节对36月龄以下儿童预防轮状病毒胃肠炎有显著效果,从而减轻了公共卫生系统的负担。
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引用次数: 0
Effect of fasting duration on mortality after COVID-19 infection: A retrospective analysis at a single institution 禁食时间对COVID-19感染后死亡率的影响:单一机构的回顾性分析
Pub Date : 2025-09-01 DOI: 10.1016/j.imj.2025.100202
Naoko Takaku , Koji Hayashi , Hiromi Hayashi , Toyoaki Miura , Kouji Hayashi , Yasutaka Kobayashi , Mamiko Sato , Ippei Sakamaki

Background

The fasting duration in aspiration pneumonia negatively affects the patient's treatment duration and swallowing function. The relationship among serious COVID-19 infection, fasting duration, and patient prognosis remains unclear. We aimed to determine the effect of the fasting duration on mortality after COVID-19.

Methods

We included patients who underwent rehabilitation after COVID-19 infection between March 1, 2021 and June 30, 2023. We retrospectively extracted data from medical records, including age, sex, albumin levels, fasting duration, Charlson Comorbidity Index (CCI), Revised Hasegawa Dementia Scale score, care level, total hospitalization period, time since disease onset, time to speech therapy intervention, time to death, and ability to eat at disease onset and discharge. Univariate analysis was conducted for each variable. To investigate the relationship between fasting duration and outcomes, we performed logistic regression analysis, adjusting for confounding factors such as age, CCI, and care level. We also divided patients into groups based on fasting duration: ≤ 5 days and > 5 days. We performed logistic regression analysis using fasting duration as the dependent variable and age, CCI, care level, and clinical outcome as independent variables.

Results

There were 71 patients in the survival group and 31 in the mortality group. Fasting duration (p = 0.00826, odds ratio [OR]: 1.01, 95 % confidence interval [CI]: 1.01–1.11) and age (p = 0.0377, OR: 1.07, 95 % CI: 1.001–1.15) were significant independent factors associated with COVID-19 outcomes. In the classification based on fasting duration, higher care level (p < 0.001, OR: 1.65, 95 % CI: 1.24–2.20) and clinical outcome (p < 0.001, OR: 9.19, 95 % CI: 2.80–30.20) were significant independent factors in the group with fasting duration > 5 days.

Conclusion

Fasting duration was independently associated with outcomes after COVID-19 infection. Early rehabilitation intervention may contribute to improved clinical outcomes.
背景:吸入性肺炎患者的禁食时间对患者的治疗时间和吞咽功能有负面影响。COVID-19严重感染与禁食时间和患者预后之间的关系尚不清楚。我们的目的是确定禁食时间对COVID-19后死亡率的影响。方法纳入2021年3月1日至2023年6月30日期间接受COVID-19感染后康复治疗的患者。我们回顾性地从医疗记录中提取数据,包括年龄、性别、白蛋白水平、禁食时间、Charlson合并症指数(CCI)、修订长谷川痴呆量表评分、护理水平、总住院时间、发病时间、言语治疗干预时间、死亡时间、发病和出院时的进食能力。对各变量进行单因素分析。为了研究禁食时间与结果之间的关系,我们进行了逻辑回归分析,调整了年龄、CCI和护理水平等混杂因素。我们还根据禁食时间将患者分为≤5天和≤5天两组。我们以禁食时间为因变量,以年龄、CCI、护理水平和临床结果为自变量,进行logistic回归分析。结果生存组71例,死亡组31例。禁食时间(p = 0.00826,比值比[OR]: 1.01, 95%可信区间[CI]: 1.01 - 1.11)和年龄(p = 0.0377, OR: 1.07, 95% CI: 1.001-1.15)是与COVID-19结局相关的重要独立因素。在基于禁食时间的分类中,较高的护理水平(p < 0.001, OR: 1.65, 95% CI: 1.24-2.20)和临床结果(p < 0.001, OR: 9.19, 95% CI: 2.80-30.20)是禁食5天组的显著独立因素。结论空腹时间与COVID-19感染后的预后独立相关。早期康复干预可能有助于改善临床结果。
{"title":"Effect of fasting duration on mortality after COVID-19 infection: A retrospective analysis at a single institution","authors":"Naoko Takaku ,&nbsp;Koji Hayashi ,&nbsp;Hiromi Hayashi ,&nbsp;Toyoaki Miura ,&nbsp;Kouji Hayashi ,&nbsp;Yasutaka Kobayashi ,&nbsp;Mamiko Sato ,&nbsp;Ippei Sakamaki","doi":"10.1016/j.imj.2025.100202","DOIUrl":"10.1016/j.imj.2025.100202","url":null,"abstract":"<div><h3>Background</h3><div>The fasting duration in aspiration pneumonia negatively affects the patient's treatment duration and swallowing function. The relationship among serious COVID-19 infection, fasting duration, and patient prognosis remains unclear. We aimed to determine the effect of the fasting duration on mortality after COVID-19.</div></div><div><h3>Methods</h3><div>We included patients who underwent rehabilitation after COVID-19 infection between March 1, 2021 and June 30, 2023. We retrospectively extracted data from medical records, including age, sex, albumin levels, fasting duration, Charlson Comorbidity Index (CCI), Revised Hasegawa Dementia Scale score, care level, total hospitalization period, time since disease onset, time to speech therapy intervention, time to death, and ability to eat at disease onset and discharge. Univariate analysis was conducted for each variable. To investigate the relationship between fasting duration and outcomes, we performed logistic regression analysis, adjusting for confounding factors such as age, CCI, and care level. We also divided patients into groups based on fasting duration: ≤ 5 days and &gt; 5 days. We performed logistic regression analysis using fasting duration as the dependent variable and age, CCI, care level, and clinical outcome as independent variables.</div></div><div><h3>Results</h3><div>There were 71 patients in the survival group and 31 in the mortality group. Fasting duration (<em>p</em> = 0.00826, odds ratio [OR]: 1.01, 95 % confidence interval [CI]: 1.01–1.11) and age (<em>p</em> = 0.0377, OR: 1.07, 95 % CI: 1.001–1.15) were significant independent factors associated with COVID-19 outcomes. In the classification based on fasting duration, higher care level (<em>p</em> &lt; 0.001, OR: 1.65, 95 % CI: 1.24–2.20) and clinical outcome (<em>p</em> &lt; 0.001, OR: 9.19, 95 % CI: 2.80–30.20) were significant independent factors in the group with fasting duration &gt; 5 days.</div></div><div><h3>Conclusion</h3><div>Fasting duration was independently associated with outcomes after COVID-19 infection. Early rehabilitation intervention may contribute to improved clinical outcomes.</div></div>","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"4 3","pages":"Article 100202"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145095301","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}
引用次数: 0
Global disease and economic burden of main mycobacterial infections in the working-age population from 1990 to 2021 with a forecast to 2045 1990年至2021年工作年龄人口中主要分枝杆菌感染的全球疾病和经济负担,并预测到2045年
Pub Date : 2025-09-01 DOI: 10.1016/j.imj.2025.100199
Jiaxu Gu , Jiaming Wang , Long Zhong , Bingcheng Lu , Hongqiang Xie , Bo Yu , Yang Guo

Background

Mycobacterial infections such as tuberculosis and leprosy pose significant global health challenges, particularly in impoverished regions. These diseases not only cause severe physical symptoms but also lead to psychological and economic burdens. This study assesses the disease and economic burden of these infections among the global working-age population (15–64 years), identifies influencing factors, and predicts trends until 2045 to guide targeted interventions.

Methods

Using data from the Global Burden of Disease Study (1990–2021), age-standardized prevalence rates and disability-adjusted life years were analyzed for tuberculosis and leprosy. Predictive trends were modeled using the Bayesian age–period–cohort framework, and health inequalities were evaluated using concentration indices. Spearman correlation analysis was used to examine associations with economic and health indicators in the World Bank database.

Results

The prevalence of leprosy declined globally (from 14.426/100,000 to 5.942/100,000), and further reductions were projected. Tuberculosis trends were more complex, with potential increases observed in some age groups. Health inequalities persisted, particularly for leprosy, with higher burdens in low-income regions than high-income regions (concentration index: −0.35). Economic factors such as health expenditure (Spearman's rank correlation coefficient, ρ = −0.557) and universal health coverage (ρ = −0.785) were strongly correlated with disease burden.

Conclusions

Although the burden of mycobacterial infection decreased, disparities remained—especially for tuberculosis. Increased public health investment and targeted strategies are essential for mitigating these inequities and their socioeconomic impact.
结核和麻风病等分枝杆菌感染构成重大的全球卫生挑战,特别是在贫困地区。这些疾病不仅造成严重的身体症状,而且还造成心理和经济负担。本研究评估了全球工作年龄人口(15-64岁)中这些感染的疾病和经济负担,确定了影响因素,并预测了到2045年的趋势,以指导有针对性的干预措施。方法使用全球疾病负担研究(1990-2021)的数据,分析结核病和麻风病的年龄标准化患病率和残疾调整生命年。使用贝叶斯年龄-时期-队列框架对预测趋势进行建模,并使用浓度指数评估健康不平等。使用Spearman相关分析来检查与世界银行数据库中经济和健康指标的关联。结果麻风病全球患病率从14.426/10万下降到5.942/10万,预计将进一步下降。结核病的趋势更为复杂,在某些年龄组中观察到潜在的增加。卫生不平等现象持续存在,特别是麻风病,低收入地区的负担高于高收入地区(集中指数:- 0.35)。经济因素如卫生支出(Spearman等级相关系数,ρ =−0.557)和全民健康覆盖(ρ =−0.785)与疾病负担密切相关。结论结核分枝杆菌感染负担虽有所下降,但仍存在差异,尤其是结核病。增加公共卫生投资和有针对性的战略对于减轻这些不平等及其社会经济影响至关重要。
{"title":"Global disease and economic burden of main mycobacterial infections in the working-age population from 1990 to 2021 with a forecast to 2045","authors":"Jiaxu Gu ,&nbsp;Jiaming Wang ,&nbsp;Long Zhong ,&nbsp;Bingcheng Lu ,&nbsp;Hongqiang Xie ,&nbsp;Bo Yu ,&nbsp;Yang Guo","doi":"10.1016/j.imj.2025.100199","DOIUrl":"10.1016/j.imj.2025.100199","url":null,"abstract":"<div><h3>Background</h3><div>Mycobacterial infections such as tuberculosis and leprosy pose significant global health challenges, particularly in impoverished regions. These diseases not only cause severe physical symptoms but also lead to psychological and economic burdens. This study assesses the disease and economic burden of these infections among the global working-age population (15–64 years), identifies influencing factors, and predicts trends until 2045 to guide targeted interventions.</div></div><div><h3>Methods</h3><div>Using data from the Global Burden of Disease Study (1990–2021), age-standardized prevalence rates and disability-adjusted life years were analyzed for tuberculosis and leprosy. Predictive trends were modeled using the Bayesian age–period–cohort framework, and health inequalities were evaluated using concentration indices. Spearman correlation analysis was used to examine associations with economic and health indicators in the World Bank database.</div></div><div><h3>Results</h3><div>The prevalence of leprosy declined globally (from 14.426/100,000 to 5.942/100,000), and further reductions were projected. Tuberculosis trends were more complex, with potential increases observed in some age groups. Health inequalities persisted, particularly for leprosy, with higher burdens in low-income regions than high-income regions (concentration index: −0.35). Economic factors such as health expenditure (Spearman's rank correlation coefficient, <em>ρ</em> = −0.557) and universal health coverage (<em>ρ</em> = −0.785) were strongly correlated with disease burden.</div></div><div><h3>Conclusions</h3><div>Although the burden of mycobacterial infection decreased, disparities remained—especially for tuberculosis. Increased public health investment and targeted strategies are essential for mitigating these inequities and their socioeconomic impact.</div></div>","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"4 3","pages":"Article 100199"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145049352","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}
引用次数: 0
The growing impact of nontuberculous mycobacteria: A multidisciplinary review of ecology, pathogenesis, diagnosis, and treatment 非结核分枝杆菌日益增长的影响:生态学、发病机制、诊断和治疗的多学科综述
Pub Date : 2025-09-01 DOI: 10.1016/j.imj.2025.100203
Mehdi Roshdi Maleki , Seyyed Reza Moaddab
Nontuberculous mycobacteria (NTM) are emerging pathogens responsible for a growing spectrum of diseases, particularly in individuals with underlying lung disorders or immune suppression. Once considered primarily environmental saprophytes, NTM are now recognized as important causes of pulmonary, cutaneous, lymphatic, and disseminated infections. With more than 200 species identified and regional variations in prevalence, their diagnosis and management present significant clinical and microbiological challenges. The lack of standardized reporting systems and overlapping features with tuberculosis complicate epidemiological understanding and case identification.
This review provides an updated and integrated overview of NTM-associated diseases, emphasizing diagnostic advancements, environmental sources, mechanisms of transmission, host immunity, genetic susceptibility, and therapeutic options. Special attention is given to molecular diagnostic techniques, species-level identification strategies, and the role of gene sequencing in differentiating NTM species. We also highlight the limitations of conventional methods, discuss antimicrobial resistance mechanisms, and summarize current treatment guidelines.
By synthesizing current knowledge across microbiology, clinical medicine, and public health, this review aims to support a multidisciplinary approach to NTM diagnosis and management and address the pressing need for increased awareness, better surveillance, and targeted research on this under-recognized group of pathogens.
非结核分枝杆菌(NTM)是导致越来越多疾病的新兴病原体,特别是在有潜在肺部疾病或免疫抑制的个体中。NTM曾经被认为是主要的环境腐生菌,现在被认为是肺部、皮肤、淋巴和播散性感染的重要原因。由于已确定的物种超过200种,且流行率存在区域差异,因此其诊断和管理面临重大的临床和微生物学挑战。缺乏标准化的报告系统和与结核病重叠的特征使流行病学认识和病例识别复杂化。本文综述了ntm相关疾病的最新和综合综述,重点介绍了ntm相关疾病的诊断进展、环境来源、传播机制、宿主免疫、遗传易感性和治疗选择。特别关注分子诊断技术,物种水平鉴定策略,以及基因测序在区分NTM物种中的作用。我们还强调了传统方法的局限性,讨论了抗菌素耐药机制,并总结了目前的治疗指南。通过综合微生物学、临床医学和公共卫生方面的现有知识,本综述旨在支持NTM诊断和管理的多学科方法,并解决对这一未被认识的病原体群体提高认识、更好的监测和有针对性的研究的迫切需要。
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引用次数: 0
Chikungunya outbreak in Guangdong Province, China, 2025 2025年中国广东省基孔肯雅热暴发
Pub Date : 2025-09-01 DOI: 10.1016/j.imj.2025.100200
Mingyu Luo, Jimin Sun
{"title":"Chikungunya outbreak in Guangdong Province, China, 2025","authors":"Mingyu Luo,&nbsp;Jimin Sun","doi":"10.1016/j.imj.2025.100200","DOIUrl":"10.1016/j.imj.2025.100200","url":null,"abstract":"","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"4 3","pages":"Article 100200"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145049357","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}
引用次数: 0
Diagnostic yield of polymerase chain reaction on induced sputum for pulmonary tuberculosis: A single-center retrospective cross-sectional study 诱导痰聚合酶链反应对肺结核的诊断率:一项单中心回顾性横断面研究
Pub Date : 2025-08-12 DOI: 10.1016/j.imj.2025.100197
Kiartipong Virapongsiri , Dararat Eksombatchai , Monruadee Chatreewarote , Viboon Boonsarngsuk

Background

Data on tuberculosis-polymerase chain reaction (TB-PCR) diagnostic yield in induced sputum (IS) samples is limited. This study was conducted to evaluate the diagnostic yield of TB-PCR in IS samples from patients with pulmonary TB and to identify factors that are associated with positive TB-PCR results.

Methods

This retrospective cross-sectional study was conducted at the Faculty of Medicine Ramathibodi Hospital. Patients who underwent IS collection for the diagnosis of pulmonary TB were included. Sputum specimens were obtained for acid-fast bacilli (AFB) smear, TB-PCR (Anyplex Seegene MTB/NTM real-time detection assay or Xpert MTB/RIF assay), and TB culture. Multivariate logistic regression analysis was performed to identify factors associated with IS TB-PCR positivity. The McNemar test was used to compare the diagnostic yield of each test.

Results

A total of 124 IS specimens of patients with pulmonary TB were evaluated. There were 65 (52.4%) men, with a mean age of 55.3 ± 19.5 years. The diagnostic yield of IS TB-PCR for the diagnosis of pulmonary TB was 31.5% (95% confidence interval [CI]: 23.2–39.7). The diagnostic yields were 34.4% (95% CI: 22.0–46.0) for Xpert MTB/RIF and 28.6% (95% CI: 17.8–40.2) for Anyplex MTB/NTM, with no significant difference between the two assays (p = 0.49). TB-PCR had a higher diagnostic yield than AFB smear (31.5% vs. 6.5%, p < 0.01). Logistic regression analysis showed that moderately advanced (adjusted odds ratio [aOR] = 3.73, 95% CI: 1.24–11.21, p = 0.019) and far advanced (aOR = 3.95, 95% CI: 1.05–14.82, p = 0.042) radiographic extent of disease were associated with positive IS TB-PCR.

Conclusions

Induced sputum TB-PCR is an effective initial method for patients with suspected pulmonary TB who are unable to produce reliable sputum, especially those with moderately advanced or far advanced radiographic extent of disease.
背景:诱导痰(IS)样本中结核聚合酶链反应(TB-PCR)诊断率的数据有限。本研究旨在评估TB- pcr在肺结核患者IS样本中的诊断率,并确定与TB- pcr阳性结果相关的因素。方法回顾性横断面研究在Ramathibodi医院医学院进行。接受IS采集诊断肺结核的患者也包括在内。取痰标本进行抗酸杆菌(AFB)涂片、TB- pcr (Anyplex Seegene MTB/NTM实时检测或Xpert MTB/RIF检测)和TB培养。进行多因素logistic回归分析以确定与IS结核- pcr阳性相关的因素。采用McNemar试验比较各试验的诊断率。结果共对124例肺结核患者的IS标本进行了评价。男性65例(52.4%),平均年龄55.3±19.5岁。IS - TB- pcr诊断肺结核的诊断率为31.5%(95%可信区间[CI]: 23.2 ~ 39.7)。Xpert MTB/RIF的诊断率为34.4% (95% CI: 22.0-46.0), Anyplex MTB/NTM的诊断率为28.6% (95% CI: 17.8-40.2),两种检测方法之间无显著差异(p = 0.49)。TB-PCR的诊断率高于AFB涂片(31.5% vs. 6.5%, p < 0.01)。Logistic回归分析显示,中度晚期(校正优势比[aOR] = 3.73, 95% CI: 1.24-11.21, p = 0.019)和极晚期(aOR = 3.95, 95% CI: 1.05-14.82, p = 0.042)疾病的放射学程度与IS - TB-PCR阳性相关。结论诱导痰结核- pcr对不能产生可靠痰液的疑似肺结核患者,特别是有中晚期或远晚期影像学表现的患者,是一种有效的初始检测方法。
{"title":"Diagnostic yield of polymerase chain reaction on induced sputum for pulmonary tuberculosis: A single-center retrospective cross-sectional study","authors":"Kiartipong Virapongsiri ,&nbsp;Dararat Eksombatchai ,&nbsp;Monruadee Chatreewarote ,&nbsp;Viboon Boonsarngsuk","doi":"10.1016/j.imj.2025.100197","DOIUrl":"10.1016/j.imj.2025.100197","url":null,"abstract":"<div><h3>Background</h3><div>Data on tuberculosis-polymerase chain reaction (TB-PCR) diagnostic yield in induced sputum (IS) samples is limited. This study was conducted to evaluate the diagnostic yield of TB-PCR in IS samples from patients with pulmonary TB and to identify factors that are associated with positive TB-PCR results.</div></div><div><h3>Methods</h3><div>This retrospective cross-sectional study was conducted at the Faculty of Medicine Ramathibodi Hospital. Patients who underwent IS collection for the diagnosis of pulmonary TB were included. Sputum specimens were obtained for acid-fast bacilli (AFB) smear, TB-PCR (Anyplex Seegene MTB/NTM real-time detection assay or Xpert MTB/RIF assay), and TB culture. Multivariate logistic regression analysis was performed to identify factors associated with IS TB-PCR positivity. The McNemar test was used to compare the diagnostic yield of each test.</div></div><div><h3>Results</h3><div>A total of 124 IS specimens of patients with pulmonary TB were evaluated. There were 65 (52.4%) men, with a mean age of 55.3 ± 19.5 years. The diagnostic yield of IS TB-PCR for the diagnosis of pulmonary TB was 31.5% (95% confidence interval [CI]: 23.2–39.7). The diagnostic yields were 34.4% (95% CI: 22.0–46.0) for Xpert MTB/RIF and 28.6% (95% CI: 17.8–40.2) for Anyplex MTB/NTM, with no significant difference between the two assays (<em>p</em> = 0.49). TB-PCR had a higher diagnostic yield than AFB smear (31.5% vs. 6.5%, <em>p</em> &lt; 0.01). Logistic regression analysis showed that moderately advanced (adjusted odds ratio [aOR] = 3.73, 95% CI: 1.24–11.21, <em>p</em> = 0.019) and far advanced (aOR = 3.95, 95% CI: 1.05–14.82, <em>p</em> = 0.042) radiographic extent of disease were associated with positive IS TB-PCR.</div></div><div><h3>Conclusions</h3><div>Induced sputum TB-PCR is an effective initial method for patients with suspected pulmonary TB who are unable to produce reliable sputum, especially those with moderately advanced or far advanced radiographic extent of disease.</div></div>","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"4 3","pages":"Article 100197"},"PeriodicalIF":0.0,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912339","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}
引用次数: 0
Multiplex nucleic acid polymerase assay for eight severe hemorrhagic fever viruses based on dual-probe hybridization and melting curve analysis. 基于双探针杂交和熔融曲线分析的8种重症出血热病毒多重核酸聚合酶检测。
Pub Date : 2025-07-19 eCollection Date: 2025-09-01 DOI: 10.1016/j.imj.2025.100196
Fuli Tan, Yuchang Li, Xiaoping Kang, Yuehong Chen, Sen Zhang, Jing Li, Ye Feng, Xiaokun Li, Runxin Liang, Fei Wang, Xiangdong Li, Tao Jiang

Background: In recent years, frequent outbreaks of infectious diseases caused by hemorrhagic fever viruses have posed serious threats to global public health. The pathogens are variable and highly infectious, such as Sudan ebolavirus (SEBOV), Zaire ebolavirus (ZEBOV), Marburg marburgvirus (MARV), Lassa mammarenavirus (LASV), Rift Valley fever phlebovirus (RVFV), Sin Nombre orthohantavirus (SNV), etc. To improve the efficiency of pathogen detection, a method for simultaneous screening multiplex targets is in a great demand.

Methods: Utilizing dual-probe hybridization and melting curve analysis, a multiplex nucleic acid polymerase assay for eight hemorrhagic fever viruses test (named the MPA-eight-virus assay) was developed in this study. The sensitivity for each target was improved by optimizing primer and probe selection as well as amplification conditions; the usability of MPA-eight-virus assay was validated by simulated samples preparation and test.

Results: The MPA-eight-virus assay achieved high sensitivity and specificity for the targets, with a limit of detection (LOD) of 1.83-691.00 copies/µL for all eight targets; Notably, the LOD for MARV was 1.83 copies/µL and that for SNV was 9.32 copies/µL.

Conclusions: The MPA-eight-virus assay is high throughput, time-saving, accurate, and cost-effective, making it potentially useful for prevention and control of severe viral hemorrhagic fever.

背景:近年来,由出血热病毒引起的传染病频繁暴发,对全球公共卫生构成严重威胁。病原体是可变的和高传染性的,如苏丹埃博拉病毒(SEBOV)、扎伊尔埃博拉病毒(ZEBOV)、马尔堡马尔堡病毒(MARV)、拉沙乳头状病毒(LASV)、裂谷热白带病毒(RVFV)、sinnombre正汉坦病毒(SNV)等。为了提高病原体的检测效率,迫切需要一种多靶点同时筛选的方法。方法:采用双探针杂交和熔融曲线分析,建立了8种出血热病毒多重核酸聚合酶检测方法(mpa - 8病毒检测)。通过优化引物和探针的选择及扩增条件,提高了对每个靶点的灵敏度;通过模拟样品制备和测试,验证了mpa - 8病毒检测方法的可用性。结果:mpa - 8病毒法对8个靶点均具有较高的灵敏度和特异性,检出限(LOD)为1.83 ~ 691.00 copies/µL;值得注意的是,MARV的LOD为1.83 copies/µL, SNV的LOD为9.32 copies/µL。结论:mpa - 8病毒检测具有高通量、省时、准确、低成本的特点,可用于重症病毒性出血热的预防和控制。
{"title":"Multiplex nucleic acid polymerase assay for eight severe hemorrhagic fever viruses based on dual-probe hybridization and melting curve analysis.","authors":"Fuli Tan, Yuchang Li, Xiaoping Kang, Yuehong Chen, Sen Zhang, Jing Li, Ye Feng, Xiaokun Li, Runxin Liang, Fei Wang, Xiangdong Li, Tao Jiang","doi":"10.1016/j.imj.2025.100196","DOIUrl":"10.1016/j.imj.2025.100196","url":null,"abstract":"<p><strong>Background: </strong>In recent years, frequent outbreaks of infectious diseases caused by hemorrhagic fever viruses have posed serious threats to global public health. The pathogens are variable and highly infectious, such as Sudan <i>ebolavirus</i> (SEBOV), Zaire <i>ebolavirus</i> (ZEBOV), Marburg <i>marburgvirus</i> (MARV), <i>Lassa mammarenavirus</i> (LASV), Rift Valley fever <i>phlebovirus</i> (RVFV), Sin Nombre <i>orthohantavirus</i> (SNV), etc. To improve the efficiency of pathogen detection, a method for simultaneous screening multiplex targets is in a great demand.</p><p><strong>Methods: </strong>Utilizing dual-probe hybridization and melting curve analysis, a multiplex nucleic acid polymerase assay for eight hemorrhagic fever viruses test (named the MPA-eight-virus assay) was developed in this study. The sensitivity for each target was improved by optimizing primer and probe selection as well as amplification conditions; the usability of MPA-eight-virus assay was validated by simulated samples preparation and test.</p><p><strong>Results: </strong>The MPA-eight-virus assay achieved high sensitivity and specificity for the targets, with a limit of detection (LOD) of 1.83-691.00 copies/µL for all eight targets; Notably, the LOD for MARV was 1.83 copies/µL and that for SNV was 9.32 copies/µL.</p><p><strong>Conclusions: </strong>The MPA-eight-virus assay is high throughput, time-saving, accurate, and cost-effective, making it potentially useful for prevention and control of severe viral hemorrhagic fever.</p>","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"4 3","pages":"100196"},"PeriodicalIF":0.0,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12356464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144877754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A foodborne outbreak of Salmonella Paratyphi C in a Chinese middle school: Genomic tracing and epidemiological characterization 中国某中学食源性丙型副伤寒沙门氏菌暴发:基因组追踪和流行病学特征
Pub Date : 2025-06-25 DOI: 10.1016/j.imj.2025.100195
Shuang Wang , Xiaolin Yu , Ming Fang , Hengjie Xie , Lu Liu , Ziqing Liu , Guangjian Wu , Yuzhen Chen , Ti Liu , Peng Yang

Background

Salmonella Paratyphi C is an infrequent etiological agent of enteric fever, with sporadic cases primarily reported in Asia and Africa. Documented outbreaks remain exceedingly rare, and epidemiological data on such events are notably scarce.

Methods

This study investigated a paratyphoid fever outbreak caused by S. Paratyphi C at a secondary school in China in 2023. Comprehensive field epidemiological investigations were conducted, including environmental sampling and the collection of clinical specimens. All outbreak-associated isolates underwent antimicrobial susceptibility testing, whole-genome sequencing, and in-depth bioinformatics analysis. Single-nucleotide polymorphism profiling and core genome multilocus sequence typing were employed to elucidate the genetic relatedness of the isolates.

Results

A total of 11 S. Paratyphi C strains, characterized by the antigenic formula 6,7:c:1,5, were recovered from a variety of sample sources. Genomic analyses revealed striking homogeneity across all isolates, with uniform multilocus sequence types, identical antimicrobial resistance patterns, and shared virulence-associated genes. Phylogenetic reconstruction demonstrated a tightly clustered lineage, corroborated by highly similar circular genome structures, suggesting a common source of infection.

Conclusions

This investigation offered critical insights into a rare foodborne outbreak caused by S. Paratyphi C, bridging significant knowledge gaps regarding its epidemiology and genetic characteristics. The findings underscored the global diversity and potential public health threat of S. Paratyphi C, reinforcing the urgent need to enhance food safety monitoring and improve outbreak preparedness strategies both in China and internationally.
C型副伤寒沙门氏菌是一种罕见的肠道热病原体,主要在亚洲和非洲报告散发病例。有记录的疫情仍然极为罕见,关于这类事件的流行病学数据也极为缺乏。方法对2023年发生在中国某中学的C型副伤寒沙门氏菌暴发疫情进行调查。开展了全面的现场流行病学调查,包括环境采样和临床标本采集。所有与疫情相关的分离株均进行了抗菌药敏试验、全基因组测序和深入的生物信息学分析。采用单核苷酸多态性分析和核心基因组多位点序列分型对分离株的遗传亲缘关系进行了分析。结果共检出11株副伤寒沙门氏菌,抗原式分别为6,7:C:1,5。基因组分析显示所有分离株具有惊人的同质性,具有统一的多位点序列类型、相同的抗菌素耐药性模式和共享的毒力相关基因。系统发育重建显示了一个紧密聚集的谱系,由高度相似的环状基因组结构证实,表明一个共同的感染源。结论本研究为一次罕见的由丙型副伤寒沙门氏菌引起的食源性暴发提供了重要见解,弥合了其流行病学和遗传特征方面的重大知识空白。研究结果强调了C型副伤寒沙门氏菌的全球多样性和潜在的公共卫生威胁,强调了在中国和国际上加强食品安全监测和改进疫情防范策略的迫切需要。
{"title":"A foodborne outbreak of Salmonella Paratyphi C in a Chinese middle school: Genomic tracing and epidemiological characterization","authors":"Shuang Wang ,&nbsp;Xiaolin Yu ,&nbsp;Ming Fang ,&nbsp;Hengjie Xie ,&nbsp;Lu Liu ,&nbsp;Ziqing Liu ,&nbsp;Guangjian Wu ,&nbsp;Yuzhen Chen ,&nbsp;Ti Liu ,&nbsp;Peng Yang","doi":"10.1016/j.imj.2025.100195","DOIUrl":"10.1016/j.imj.2025.100195","url":null,"abstract":"<div><h3>Background</h3><div><em>Salmonella</em> Paratyphi C is an infrequent etiological agent of enteric fever, with sporadic cases primarily reported in Asia and Africa. Documented outbreaks remain exceedingly rare, and epidemiological data on such events are notably scarce.</div></div><div><h3>Methods</h3><div>This study investigated a paratyphoid fever outbreak caused by <em>S.</em> Paratyphi C at a secondary school in China in 2023. Comprehensive field epidemiological investigations were conducted, including environmental sampling and the collection of clinical specimens. All outbreak-associated isolates underwent antimicrobial susceptibility testing, whole-genome sequencing, and in-depth bioinformatics analysis. Single-nucleotide polymorphism profiling and core genome multilocus sequence typing were employed to elucidate the genetic relatedness of the isolates.</div></div><div><h3>Results</h3><div>A total of 11 <em>S.</em> Paratyphi C strains, characterized by the antigenic formula 6,7:c:1,5, were recovered from a variety of sample sources. Genomic analyses revealed striking homogeneity across all isolates, with uniform multilocus sequence types, identical antimicrobial resistance patterns, and shared virulence-associated genes. Phylogenetic reconstruction demonstrated a tightly clustered lineage, corroborated by highly similar circular genome structures, suggesting a common source of infection.</div></div><div><h3>Conclusions</h3><div>This investigation offered critical insights into a rare foodborne outbreak caused by <em>S.</em> Paratyphi C, bridging significant knowledge gaps regarding its epidemiology and genetic characteristics. The findings underscored the global diversity and potential public health threat of <em>S.</em> Paratyphi C, reinforcing the urgent need to enhance food safety monitoring and improve outbreak preparedness strategies both in China and internationally.</div></div>","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"4 3","pages":"Article 100195"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144679824","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}
引用次数: 0
期刊
Infectious Medicine
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