Pub Date : 2025-09-01Epub Date: 2025-06-12DOI: 10.1016/j.imj.2025.100187
Yuan Chen , Qianjin Su , Dawei Zhang , Wenting Wei , Fangfang Zhang , Qi Li , Jinxue Zhang
Background
Patients with COVID-19 exhibited a variety of clinical characteristics. However, there is currently insufficient evidence to delineate the differences in clinical symptomatology between primary infection and reinfection. This study aims to compare the clinical symptom characteristics between primary infection and reinfection during COVID-19.
Methods
This research utilized a convenience sampling method to gather survey data from Chinese individuals aged 18 to 60 years across China. Questionnaire assessments were conducted to collect data on general demographic and clinical information during the COVID-19 pandemic in China. The collected data were analyzed using IBM SPSS 26.0 software.
Results
This study analyzed 1156 patients. During second infection, the frequency of fever, painful muscles, ageusia or anosmia, headache, back pain, feeling hot and cold alternately, general tiredness, tingling extremities, heavy arms or legs, and chest pain symptoms were significantly lower. However, the rate of sneezing, runny nose, and stuffy nose were significantly higher (p < 0.05). The proportion of patients with symptoms lasting 3–4 weeks and a body temperature of 38.1–41.0°C was significantly lower during second infection (p < 0.05). The cases infected with COVID-19 for the second time had a higher proportion of nurses and a higher proportion of individuals who received one or two doses of the COVID-19 vaccine (p < 0.05).
Conclusions
The analysis of COVID-19 cases showed significant differences in demographic and clinical symptom characteristics between the first-time and second-time positive populations. This understanding can help guide changes in management strategies.
{"title":"A comparative analysis of clinical characteristics between primary and recurrent COVID-19 infections in China","authors":"Yuan Chen , Qianjin Su , Dawei Zhang , Wenting Wei , Fangfang Zhang , Qi Li , Jinxue Zhang","doi":"10.1016/j.imj.2025.100187","DOIUrl":"10.1016/j.imj.2025.100187","url":null,"abstract":"<div><h3>Background</h3><div>Patients with COVID-19 exhibited a variety of clinical characteristics. However, there is currently insufficient evidence to delineate the differences in clinical symptomatology between primary infection and reinfection. This study aims to compare the clinical symptom characteristics between primary infection and reinfection during COVID-19.</div></div><div><h3>Methods</h3><div>This research utilized a convenience sampling method to gather survey data from Chinese individuals aged 18 to 60 years across China. Questionnaire assessments were conducted to collect data on general demographic and clinical information during the COVID-19 pandemic in China. The collected data were analyzed using IBM SPSS 26.0 software.</div></div><div><h3>Results</h3><div>This study analyzed 1156 patients. During second infection, the frequency of fever, painful muscles, ageusia or anosmia, headache, back pain, feeling hot and cold alternately, general tiredness, tingling extremities, heavy arms or legs, and chest pain symptoms were significantly lower. However, the rate of sneezing, runny nose, and stuffy nose were significantly higher (<em>p</em> < 0.05). The proportion of patients with symptoms lasting 3–4 weeks and a body temperature of 38.1–41.0°C was significantly lower during second infection (<em>p</em> < 0.05). The cases infected with COVID-19 for the second time had a higher proportion of nurses and a higher proportion of individuals who received one or two doses of the COVID-19 vaccine (<em>p</em> < 0.05).</div></div><div><h3>Conclusions</h3><div>The analysis of COVID-19 cases showed significant differences in demographic and clinical symptom characteristics between the first-time and second-time positive populations. This understanding can help guide changes in management strategies.</div></div>","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"4 3","pages":"Article 100187"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144490372","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 : 2025-09-01Epub Date: 2025-09-04DOI: 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.
{"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 , Jiaming Wang , Long Zhong , Bingcheng Lu , Hongqiang Xie , Bo Yu , 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}
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.
{"title":"Diagnostic yield of polymerase chain reaction on induced sputum for pulmonary tuberculosis: A single-center retrospective cross-sectional study","authors":"Kiartipong Virapongsiri , Dararat Eksombatchai , Monruadee Chatreewarote , 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> < 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":"2025-09-01","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}
Pub Date : 2025-09-01Epub Date: 2025-09-06DOI: 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.
{"title":"The growing impact of nontuberculous mycobacteria: A multidisciplinary review of ecology, pathogenesis, diagnosis, and treatment","authors":"Mehdi Roshdi Maleki , Seyyed Reza Moaddab","doi":"10.1016/j.imj.2025.100203","DOIUrl":"10.1016/j.imj.2025.100203","url":null,"abstract":"<div><div>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.</div><div>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.</div><div>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.</div></div>","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"4 3","pages":"Article 100203"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145095302","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 : 2025-07-19eCollection Date: 2025-09-01DOI: 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.
{"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}
<div><h3>Background</h3><div>Cytomegalovirus (CMV) is a common opportunistic pathogen following lung transplantation, associated with post-transplant complications and adverse outcomes. This study aims to evaluate the incidence of CMV DNAemia identified through metagenomic next-generation sequencing (mNGS) during the early postoperative phase of lung transplantation and assess its effects on the short-term outcomes for recipients.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of clinical data from 115 patients who received lung transplants at the Affiliated Wuxi People's Hospital of Nanjing Medical University between May 2020 and November 2023. Based on mNGS-detected CMV DNAemia status, patients were stratified into DNAemia group and normal group. Nonparametric tests (Mann-Whitney <em>U</em>/Wilcoxon signed-rank) and mixed-effects models for intergroup comparisons. Kaplan-Meier survival analysis with log-rank testing for overall survival differences. Univariate logistic regression to identify risk factors for ICU mortality and 90-day mortality. Multivariate logistic regression adjusting for confounders. Propensity score matching (1∶1 optimal nearest neighbor, caliper = 0.25) was implemented to address covariate imbalance, followed by univariate logistic regression analyses in the matched cohort.</div></div><div><h3>Results</h3><div>In the early postoperative period following lung transplantation, CMV DNAemia was detected via mNGS with an incidence rate of 15.7%. The CMV DNAemia group demonstrated a significantly lower 90-day overall survival rate compared to the normal group, with the Log-rank test revealing statistically significant survival differences between groups (<em>p</em> < 0.001). Univariate and multivariate logistic regression analyses identified CMV DNAemia as an independent risk factor for ICU all-cause mortality (OR = 5.00, 95% CI: 1.37–18.27, <em>p</em> = 0.015), while with other pathogens infections independently predicted 90-day all-cause mortality (OR = 3.40, 95% CI: 1.10–10.44, <em>p</em> = 0.033). After propensity score matching, baseline characteristics were well-balanced between the CMV DNAemia and normal groups. In the matched cohort, univariate logistic regression further confirmed CMV DNAemia as an independent risk factor for ICU mortality (OR = 7.43, 95% CI: 1.23–45.00, <em>p</em> = 0.029). Mediation analysis demonstrated that co-pathogen infections mediated the relationship between CMV DNAemia and 90-day all-cause mortality, with a proportion mediated of 20.6% (95% CI: 1.7%–138.5%, <em>p</em> < 0.001).</div></div><div><h3>Conclusions</h3><div>mNGS revealed a higher incidence of early CMV DNAemia post-lung transplantation than previously reported. CMV DNAemia significantly correlates with poor prognosis. Despite limitations in sample size and retrospective design, this study provides novel insights into CMV monitoring and management post-transplantation. Future research should determine
{"title":"Impact of cytomegalovirus DNAemia detected by next-generation sequencing on short-term prognosis after lung transplantation","authors":"Zhongping Xu , Yujiao Zhang , Dapeng Wang, Chenhao Xuan, Zhiyu Li, Hongyang Xu","doi":"10.1016/j.imj.2025.100185","DOIUrl":"10.1016/j.imj.2025.100185","url":null,"abstract":"<div><h3>Background</h3><div>Cytomegalovirus (CMV) is a common opportunistic pathogen following lung transplantation, associated with post-transplant complications and adverse outcomes. This study aims to evaluate the incidence of CMV DNAemia identified through metagenomic next-generation sequencing (mNGS) during the early postoperative phase of lung transplantation and assess its effects on the short-term outcomes for recipients.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of clinical data from 115 patients who received lung transplants at the Affiliated Wuxi People's Hospital of Nanjing Medical University between May 2020 and November 2023. Based on mNGS-detected CMV DNAemia status, patients were stratified into DNAemia group and normal group. Nonparametric tests (Mann-Whitney <em>U</em>/Wilcoxon signed-rank) and mixed-effects models for intergroup comparisons. Kaplan-Meier survival analysis with log-rank testing for overall survival differences. Univariate logistic regression to identify risk factors for ICU mortality and 90-day mortality. Multivariate logistic regression adjusting for confounders. Propensity score matching (1∶1 optimal nearest neighbor, caliper = 0.25) was implemented to address covariate imbalance, followed by univariate logistic regression analyses in the matched cohort.</div></div><div><h3>Results</h3><div>In the early postoperative period following lung transplantation, CMV DNAemia was detected via mNGS with an incidence rate of 15.7%. The CMV DNAemia group demonstrated a significantly lower 90-day overall survival rate compared to the normal group, with the Log-rank test revealing statistically significant survival differences between groups (<em>p</em> < 0.001). Univariate and multivariate logistic regression analyses identified CMV DNAemia as an independent risk factor for ICU all-cause mortality (OR = 5.00, 95% CI: 1.37–18.27, <em>p</em> = 0.015), while with other pathogens infections independently predicted 90-day all-cause mortality (OR = 3.40, 95% CI: 1.10–10.44, <em>p</em> = 0.033). After propensity score matching, baseline characteristics were well-balanced between the CMV DNAemia and normal groups. In the matched cohort, univariate logistic regression further confirmed CMV DNAemia as an independent risk factor for ICU mortality (OR = 7.43, 95% CI: 1.23–45.00, <em>p</em> = 0.029). Mediation analysis demonstrated that co-pathogen infections mediated the relationship between CMV DNAemia and 90-day all-cause mortality, with a proportion mediated of 20.6% (95% CI: 1.7%–138.5%, <em>p</em> < 0.001).</div></div><div><h3>Conclusions</h3><div>mNGS revealed a higher incidence of early CMV DNAemia post-lung transplantation than previously reported. CMV DNAemia significantly correlates with poor prognosis. Despite limitations in sample size and retrospective design, this study provides novel insights into CMV monitoring and management post-transplantation. Future research should determine","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"4 2","pages":"Article 100185"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144297050","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 : 2025-06-01Epub Date: 2025-04-12DOI: 10.1016/j.imj.2025.100178
Weiwei Wu , Wenwen Zhu , Jing Tong , Qiang Zhou , Yanping Xu , Xiuxiu Zhou , Yu Du , Jun Bi , Liguo Zhu
Background
The isolation and culture of Mycoplasma pneumoniae (MP) is time-consuming and has a low success rate. On the basis of the fact that cell lines are susceptible to MP contamination, we explored the possibility of using Hep-2 cell culture for the isolation and culture of MP, to overcome this long-standing technical problem.
Methods
Quantitative Real-time PCR (qPCR) was used to detect MP in the nucleic acid samples of clinically suspected mycoplasma-infected patients. Positive samples were cultured in Hep-2 cells, with the classical commercial MP liquid culture medium serving as a control. For successful isolation of MP, the broth culture medium was used for subculture, then transferred to solid agar medium for isolation. The isolated strains were identified by nucleic acid and whole-genome sequencing.
Results
Among the 20 throat swab samples collected from individuals with influenza-like illness, 10 MP-positive samples were detected by qPCR. Five strains of Mycoplasma were successfully cultured in Hep-2 cells within 7–10 days, while one strain was cultured in commercial MP broth after 21 days, with isolation rates of 50% and 10%, respectively. After repeated subculturing in liquid medium and inoculation onto solid medium, “fried-egg”-like colonies emerged. The isolated strains were identified by nucleic acid and whole-genome sequencing.
Conclusions
The use of cell culture enables the rapid and effective isolation and culture of MP, addressing the long-standing challenge of MP cultivation. This advancement may contribute to improved antibiotic development, vaccine research, and the maintenance of global public health security.
{"title":"Innovative exploration of Hep-2 cell culture in the isolation and culture of Mycoplasma pneumoniae","authors":"Weiwei Wu , Wenwen Zhu , Jing Tong , Qiang Zhou , Yanping Xu , Xiuxiu Zhou , Yu Du , Jun Bi , Liguo Zhu","doi":"10.1016/j.imj.2025.100178","DOIUrl":"10.1016/j.imj.2025.100178","url":null,"abstract":"<div><h3>Background</h3><div>The isolation and culture of <em>Mycoplasma pneumoniae</em> (MP) is time-consuming and has a low success rate. On the basis of the fact that cell lines are susceptible to MP contamination, we explored the possibility of using Hep-2 cell culture for the isolation and culture of MP, to overcome this long-standing technical problem.</div></div><div><h3>Methods</h3><div>Quantitative Real-time PCR (qPCR) was used to detect MP in the nucleic acid samples of clinically suspected mycoplasma-infected patients. Positive samples were cultured in Hep-2 cells, with the classical commercial MP liquid culture medium serving as a control. For successful isolation of MP, the broth culture medium was used for subculture, then transferred to solid agar medium for isolation. The isolated strains were identified by nucleic acid and whole-genome sequencing.</div></div><div><h3>Results</h3><div>Among the 20 throat swab samples collected from individuals with influenza-like illness, 10 MP-positive samples were detected by qPCR. Five strains of <em>Mycoplasma</em> were successfully cultured in Hep-2 cells within 7–10 days, while one strain was cultured in commercial MP broth after 21 days, with isolation rates of 50% and 10%, respectively. After repeated subculturing in liquid medium and inoculation onto solid medium, “fried-egg”-like colonies emerged. The isolated strains were identified by nucleic acid and whole-genome sequencing.</div></div><div><h3>Conclusions</h3><div>The use of cell culture enables the rapid and effective isolation and culture of MP, addressing the long-standing challenge of MP cultivation. This advancement may contribute to improved antibiotic development, vaccine research, and the maintenance of global public health security.</div></div>","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"4 2","pages":"Article 100178"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143887033","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}
This retrospective study investigates the effect of glycemic control on immune function and TB dissemination in 1,768 TB patients (2022–2024). Patients were stratified by glycated hemoglobin (HbA1c) levels (≤ 6% vs. > 6%) and fasting blood glucose (FBG) concentrations (< 7 vs. ≥ 7 mmol/L). Lymphocyte subsets (CD3+, CD4+, CD8+ T cells, CD19+ B cells, and CD16+CD56+ natural killer cells) were compared between glycemic control and TB groups. Multiple regression and threshold effect analysis were conducted to assess the effects of HbA1c and CD3+ T cells on TB dissemination and their critical values.
Results
Poor glycemic control was associated with lower cell counts of all lymphocyte subsets in patients with PTB (all p < 0.0001). Similar reductions were observed in patients with concurrent PTB and EPTB (PTB + EPTB) when HbA1c values > 6% (all p < 0.05). When HbA1c values ≤ 6% or FBG concentrations < 7 mmol/L, patients with PTB + EPTB showed lower immune cell counts than PTB (p < 0.05). Multiple regression indicated HbA1c increased TB dissemination risk (OR = 10.95), while CD3+ T cells showed protective effects. Threshold effect analysis identified an HbA1c values ≥ 7.4% for metabolic control and CD3+ T cell thresholds of 387/µL (immune deficiency) and 2,100/µL (immune overactivation).
Conclusions
Poor glycemic control impairs immune cells, while EPTB further reduces immune cell numbers. Integrated glycemic management and immunological monitoring help optimize treatment strategies and improve clinical outcomes, particularly in patients at risk for EPTB.
{"title":"Effect of glycemic control on lymphocyte subsets in the dissemination of pulmonary tuberculosis: A retrospective analysis","authors":"Yujun Lin , Xiaohong Chen , Jiangwei Chen , Di Wu","doi":"10.1016/j.imj.2025.100183","DOIUrl":"10.1016/j.imj.2025.100183","url":null,"abstract":"<div><h3>Background</h3><div>Extrapulmonary tuberculosis (EPTB) complicates pulmonary tuberculosis (PTB) management. Diabetes mellitus impairs immune function, worsening tuberculosis (TB) outcomes.</div></div><div><h3>Methods</h3><div>This retrospective study investigates the effect of glycemic control on immune function and TB dissemination in 1,768 TB patients (2022–2024). Patients were stratified by glycated hemoglobin (HbA1c) levels (≤ 6% vs. > 6%) and fasting blood glucose (FBG) concentrations (< 7 vs. ≥ 7 mmol/L). Lymphocyte subsets (CD3<sup>+</sup>, CD4<sup>+</sup>, CD8<sup>+</sup> T cells, CD19<sup>+</sup> B cells, and CD16<sup>+</sup>CD56<sup>+</sup> natural killer cells) were compared between glycemic control and TB groups. Multiple regression and threshold effect analysis were conducted to assess the effects of HbA1c and CD3<sup>+</sup> T cells on TB dissemination and their critical values.</div></div><div><h3>Results</h3><div>Poor glycemic control was associated with lower cell counts of all lymphocyte subsets in patients with PTB (all <em>p</em> < 0.0001). Similar reductions were observed in patients with concurrent PTB and EPTB (PTB + EPTB) when HbA1c values > 6% (all <em>p</em> < 0.05). When HbA1c values ≤ 6% or FBG concentrations < 7 mmol/L, patients with PTB + EPTB showed lower immune cell counts than PTB (<em>p</em> < 0.05). Multiple regression indicated HbA1c increased TB dissemination risk (OR = 10.95), while CD3<sup>+</sup> T cells showed protective effects. Threshold effect analysis identified an HbA1c values ≥ 7.4% for metabolic control and CD3<sup>+</sup> T cell thresholds of 387/µL (immune deficiency) and 2,100/µL (immune overactivation).</div></div><div><h3>Conclusions</h3><div>Poor glycemic control impairs immune cells, while EPTB further reduces immune cell numbers. Integrated glycemic management and immunological monitoring help optimize treatment strategies and improve clinical outcomes, particularly in patients at risk for EPTB.</div></div>","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"4 2","pages":"Article 100183"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144221469","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 : 2025-06-01Epub Date: 2025-04-30DOI: 10.1016/j.imj.2025.100179
Yu-Hong Yang , Ji-Xu Li , Rui-Chen Wang , Qi-Kai Yin , Shi-Hong Fu , Kai Nie , Qian-Qian Cui , Song-Tao Xu , Qiang Wei , Fan Li , Xing-Zhou Li , Huan-Yu Wang
Backgroud
Coltiviruses are spherical, non-enveloped viruses with 12 double-stranded RNA segments, belonging to the family Spinareoviridae, and predominantly transmitted by ticks. This study isolated and characterized a novel coltivirus, designated Woodland tick reovirus (WLTRV), from Haemaphysalis concinna ticks collected in Helong City, Jilin Province, in Northeastern China.
Methods
SW-13 and Vero cells were used to isolate WLTRV through three blind passages, while seven mammalian cell lines assessed viral growth. Viral morphology was observed by electron microscopy. Next-generation sequencing, 5ʹ and 3ʹ rapid amplification of cDNA ends were used to determine WLTRV whole genome sequences, and phylogenetic methods were used to characterize WLTRV. A real-time quantitative polymerase chain reaction (RT-qPCR) was used to detect WLTRV RNA in ticks.
Results
WLTRV grew and exerted cytopathic effects in human (SW-13 and 293T) and mouse (BHK-21 and N2A) cell lines, revealing its potential to infect mammals. Phylogenetic analysis based on RNA-dependent RNA polymerase sequences classified WLTRV within the genus Coltivirus, with a close evolutionary relationship to Tarumizu tick virus. The nucleotide and amino acid sequence homologies between WLTRV and Tarumizu tick virus across the 12 segments analyzed ranged from approximately 44.79% to 69.09% and 33.73% to 75.60%, respectively. WLTRV shared conserved the 5ʹ-terminal (GACAA/UU/A) and 3ʹ-terminal (UGCAGUC) consensus sequences of the genus Coltivirus genomes. Electron microscopy revealed WLTRV as spherical (diameter ∼80 nm), non-enveloped, and morphologically consistent with coltiviruses. Among the 4,717 ticks collected from six towns in the Yanbian Korean Autonomous Prefecture, WLTRV RNA was only detected in H. concinna (0.95% virus-carrying rate) but not in Haemaphysalis japonica, Haemaphysalis longicornis, Ixodes persulcatus, and Dermacentor silvarum.
Conclusions
This study represents the first isolation and identification of WLTRV from H. concinna in the Yanbian Korean Autonomous Prefecture, providing new insights into the genetic diversity and evolution of the genus Coltivirus.
{"title":"Isolation and characterization of a novel coltivirus from Haemaphysalis concinna ticks in Northeastern China","authors":"Yu-Hong Yang , Ji-Xu Li , Rui-Chen Wang , Qi-Kai Yin , Shi-Hong Fu , Kai Nie , Qian-Qian Cui , Song-Tao Xu , Qiang Wei , Fan Li , Xing-Zhou Li , Huan-Yu Wang","doi":"10.1016/j.imj.2025.100179","DOIUrl":"10.1016/j.imj.2025.100179","url":null,"abstract":"<div><h3>Backgroud</h3><div>Coltiviruses are spherical, non-enveloped viruses with 12 double-stranded RNA segments, belonging to the family <em>Spinareoviridae</em>, and predominantly transmitted by ticks. This study isolated and characterized a novel coltivirus, designated Woodland tick reovirus (WLTRV), from <em>Haemaphysalis concinna</em> ticks collected in Helong City, Jilin Province, in Northeastern China.</div></div><div><h3>Methods</h3><div>SW-13 and Vero cells were used to isolate WLTRV through three blind passages, while seven mammalian cell lines assessed viral growth. Viral morphology was observed by electron microscopy. Next-generation sequencing, 5ʹ and 3ʹ rapid amplification of cDNA ends were used to determine WLTRV whole genome sequences, and phylogenetic methods were used to characterize WLTRV. A real-time quantitative polymerase chain reaction (RT-qPCR) was used to detect WLTRV RNA in ticks.</div></div><div><h3>Results</h3><div>WLTRV grew and exerted cytopathic effects in human (SW-13 and 293T) and mouse (BHK-21 and N2A) cell lines, revealing its potential to infect mammals. Phylogenetic analysis based on RNA-dependent RNA polymerase sequences classified WLTRV within the genus <em>Coltivirus</em>, with a close evolutionary relationship to Tarumizu tick virus. The nucleotide and amino acid sequence homologies between WLTRV and Tarumizu tick virus across the 12 segments analyzed ranged from approximately 44.79% to 69.09% and 33.73% to 75.60%, respectively. WLTRV shared conserved the 5ʹ-terminal (GACA<sup>A</sup>/<sub>U</sub><sup>U</sup>/<sub>A</sub>) and 3ʹ-terminal (UGCAGUC) consensus sequences of the genus <em>Coltivirus</em> genomes. Electron microscopy revealed WLTRV as spherical (diameter ∼80 nm), non-enveloped, and morphologically consistent with coltiviruses. Among the 4,717 ticks collected from six towns in the Yanbian Korean Autonomous Prefecture, WLTRV RNA was only detected in <em>H. concinna</em> (0.95% virus-carrying rate) but not in <em>Haemaphysalis japonica, Haemaphysalis longicornis, Ixodes persulcatus</em>, and <em>Dermacentor silvarum</em>.</div></div><div><h3>Conclusions</h3><div>This study represents the first isolation and identification of WLTRV from <em>H. concinna</em> in the Yanbian Korean Autonomous Prefecture, providing new insights into the genetic diversity and evolution of the genus <em>Coltivirus</em>.</div></div>","PeriodicalId":100667,"journal":{"name":"Infectious Medicine","volume":"4 2","pages":"Article 100179"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144138849","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}
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