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The American Society for Microbiology collaboration with the CDC Laboratory Medicine Best Practices initiative for evidence-based laboratory medicine. 美国微生物学会与疾病预防控制中心实验室医学最佳实践倡议合作,开展循证实验室医学研究。
IF 36.8 1区 医学 Q1 MICROBIOLOGY Pub Date : 2024-09-25 DOI: 10.1128/cmr.00065-18
Alice S Weissfeld,Vickie Baselski,Nancy E Cornish,Colleen S Kraft,Mark T LaRocco,Peggy McNult,Irving Nachamkin,James Scott Parrott,Sandra S Richter,Matthew Rubinstein,Michael A Saubolle,Robert L Sautter,James W Snyder,Joanna Taliano,Donna M Wolk
SUMMARYClinical medicine has embraced the use of evidence for patient treatment decisions; however, the evaluation strategy for evidence in laboratory medicine practices has lagged. It was not until the end of the 20th century that the Institute of Medicine (IOM), now the National Academy of Medicine, and the Centers for Disease Control and Prevention, Division of Laboratory Systems (CDC DLS), focused on laboratory tests and how testing processes can be designed to benefit patient care. In collaboration with CDC DLS, the American Society for Microbiology (ASM) used an evidence review method developed by the CDC DLS to develop a program for creating laboratory testing guidelines and practices. The CDC DLS method is called the Laboratory Medicine Best Practices (LMBP) initiative and uses the A-6 cycle method. Adaptations made by ASM are called Evidence-based Laboratory Medicine Practice Guidelines (EBLMPG). This review details how the ASM Systematic Review (SR) Processes were developed and executed collaboratively with CDC's DLS. The review also describes the ASM transition from LMBP to the organization's current EBLMPG, maintaining a commitment to working with agencies in the U.S. Department of Health and Human Services and other partners to ensure that EBLMPG evidence is readily understood and consistently used.
摘要 临床医学已将证据用于患者的治疗决策;然而,实验室医学实践中的证据评估策略却一直滞后。直到 20 世纪末,美国医学研究所(IOM)(现为美国国家医学科学院)和美国疾病控制与预防中心实验室系统部(CDC DLS)才开始关注实验室检验以及如何设计检验流程以利于患者治疗。美国微生物学会(ASM)与 CDC DLS 合作,使用 CDC DLS 开发的证据审查方法来制定实验室检测指南和实践方案。CDC DLS 的方法被称为实验室医学最佳实践(LMBP)计划,采用 A-6 循环方法。ASM 所做的调整被称为循证实验室医学实践指南 (EBLMPG)。本综述详细介绍了 ASM 系统性综述 (SR) 流程是如何与 CDC 的 DLS 合作开发和执行的。本综述还介绍了 ASM 从 LMBP 向该组织当前的 EBLMPG 过渡的情况,并继续致力于与美国卫生与公众服务部的各机构及其他合作伙伴合作,以确保 EBLMPG 的证据易于理解并得到一致使用。
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引用次数: 0
Neurological complications caused by SARS-CoV-2 由 SARS-CoV-2 引起的神经系统并发症
IF 36.8 1区 医学 Q1 MICROBIOLOGY Pub Date : 2024-09-18 DOI: 10.1128/cmr.00131-24
Zehan PangAo TangYujie HeJunfen FanQingmao YangYigang TongHuahao Fan1College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, China2Department of Neurology, Institute of Cerebrovascular Diseases Research, Xuanwu Hospital of Capital Medical University, Beijing, China3School of Life Sciences, Tianjin University, Tianjin, ChinaGraeme N. Forrest
Clinical Microbiology Reviews, Ahead of Print.
临床微生物学评论》,提前出版。
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引用次数: 0
Infections caused by Haemophilus ducreyi: one organism, two stories 杜克雷嗜血杆菌引起的感染:一种生物,两个故事
IF 36.8 1区 医学 Q1 MICROBIOLOGY Pub Date : 2024-09-17 DOI: 10.1128/cmr.00135-24
Jaffar A. Al-TawfiqStanley M. Spinola1Infectious Disease Unit, Specialty Internal Medicine, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia2Department of Medicine, Division of Infectious Diseases, Indiana University School of Medicine, Indianapolis, Indiana, USA3Division of Infectious Diseases, Johns Hopkins University, Baltimore, Maryland, USA4Department of Microbiology and Immunology, Indiana University School of Medicine, Indiana University, Indianapolis, Indiana, USA5Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indiana University, Indianapolis, Indiana, USAGraeme N. Forrest
Clinical Microbiology Reviews, Ahead of Print.
临床微生物学评论》,提前出版。
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引用次数: 0
Anaerobes in diabetic foot infections: pathophysiology, epidemiology, virulence, and management. 糖尿病足感染中的厌氧菌:病理生理学、流行病学、毒力和管理。
IF 19 1区 医学 Q1 MICROBIOLOGY Pub Date : 2024-09-12 Epub Date: 2024-05-31 DOI: 10.1128/cmr.00143-23
Fanny Villa, Hélène Marchandin, Jean-Philippe Lavigne, Sophie Schuldiner, Nicolas Cellier, Albert Sotto, Paul Loubet

SUMMARYDiabetic foot infections (DFI) are a public health problem worldwide. DFI are polymicrobial, biofilm-associated infections involving complex bacterial communities organized in functional equivalent pathogroups, all including anaerobes. Indeed, multiple pathophysiological factors favor the growth of anaerobes in this context. However, the prevalence, role, and contribution of anaerobes in wound evolution remain poorly characterized due to their challenging detection. Studies based on culture reviewed herein showed a weighted average of 17% of patients with anaerobes. Comparatively, the weighted average of patients with anaerobes identified by 16S rRNA gene sequencing was 83.8%. Culture largely underestimated not only the presence but also the diversity of anaerobes compared with cultivation-independent approaches but both methods showed that anaerobic Gram-negative bacilli and Gram-positive cocci were the most commonly identified in DFI. Anaerobes were more present in deeper lesions, and their detection was associated with fever, malodorous lesions, and ulcer depth and duration. More specifically, initial abundance of Peptoniphilus spp. was associated with ulcer-impaired healing, Fusobacterium spp. detection was significantly correlated with the duration of DFI, and the presence of Bacteroides spp. was significantly associated with amputation. Antimicrobial resistance of anaerobes in DFI remains slightly studied and warrants more consideration in the context of increasing resistance of the most frequently identified anaerobes in DFI. The high rate of patients with DFI-involving anaerobes, the increased knowledge on the species identified, their virulence factors, and their potential role in wound evolution support recommendations combining debridement and antibiotic therapy effective on anaerobes in moderate and severe DFI.

摘要糖尿病足感染(DFI)是一个全球性的公共卫生问题。糖尿病足感染是一种多微生物、生物膜相关性感染,涉及复杂的细菌群落,这些细菌群落由功能相当的病原菌群组成,其中包括厌氧菌。事实上,在这种情况下,多种病理生理因素都有利于厌氧菌的生长。然而,由于厌氧菌的检测难度很大,因此厌氧菌在伤口演变过程中的流行率、作用和贡献仍然不甚明了。本文回顾的基于培养的研究显示,厌氧菌在患者中的加权平均比例为 17%。相比之下,通过 16S rRNA 基因测序鉴定出厌氧菌的患者加权平均比例为 83.8%。与不依赖培养的方法相比,培养法不仅在很大程度上低估了厌氧菌的存在,而且也低估了厌氧菌的多样性,但这两种方法都显示,厌氧革兰阴性杆菌和革兰阳性球菌是 DFI 中最常发现的厌氧菌。厌氧菌更多地出现在较深的病灶中,它们的检测与发热、病灶恶臭、溃疡深度和持续时间有关。更具体地说,Peptoniphilus 菌属的最初大量存在与溃疡愈合受损有关,Fusobacterium 菌属的检测与 DFI 的持续时间显著相关,而 Bacteroides 菌属的存在与截肢显著相关。对 DFI 中厌氧菌的抗菌药耐药性的研究仍然较少,在 DFI 中最常发现的厌氧菌耐药性不断增加的背景下,有必要对其进行更多的研究。DFI患者中涉及厌氧菌的比例很高,人们对所发现的厌氧菌种类、毒力因素及其在伤口演变中的潜在作用有了更多了解,因此建议在中度和重度DFI患者中结合清创和对厌氧菌有效的抗生素治疗。
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引用次数: 0
Clinical Microbiology Reviews: a 21st century vision. 临床微生物学评论:21 世纪的愿景。
IF 19 1区 医学 Q1 MICROBIOLOGY Pub Date : 2024-09-12 Epub Date: 2024-06-20 DOI: 10.1128/cmr.00095-24
Graeme N Forrest
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引用次数: 0
Intestinal biofilms: pathophysiological relevance, host defense, and therapeutic opportunities. 肠道生物膜:病理生理学相关性、宿主防御和治疗机会。
IF 19 1区 医学 Q1 MICROBIOLOGY Pub Date : 2024-09-12 Epub Date: 2024-07-12 DOI: 10.1128/cmr.00133-23
Bernhard Jandl, Satish Dighe, Christoph Gasche, Athanasios Makristathis, Markus Muttenthaler

SUMMARYThe human intestinal tract harbors a profound variety of microorganisms that live in symbiosis with the host and each other. It is a complex and highly dynamic environment whose homeostasis directly relates to human health. Dysbiosis of the gut microbiota and polymicrobial biofilms have been associated with gastrointestinal diseases, including irritable bowel syndrome, inflammatory bowel diseases, and colorectal cancers. This review covers the molecular composition and organization of intestinal biofilms, mechanistic aspects of biofilm signaling networks for bacterial communication and behavior, and synergistic effects in polymicrobial biofilms. It further describes the clinical relevance and diseases associated with gut biofilms, the role of biofilms in antimicrobial resistance, and the intestinal host defense system and therapeutic strategies counteracting biofilms. Taken together, this review summarizes the latest knowledge and research on intestinal biofilms and their role in gut disorders and provides directions toward the development of biofilm-specific treatments.

摘要 人体肠道中蕴藏着种类繁多的微生物,它们与宿主和其他微生物共生共存。这是一个复杂且高度动态的环境,其平衡直接关系到人体健康。肠道微生物群失调和多微生物生物膜与肠道疾病有关,包括肠易激综合征、炎症性肠病和结肠直肠癌。这篇综述涵盖了肠道生物膜的分子组成和组织、细菌交流和行为的生物膜信号网络的机理方面,以及多微生物生物膜的协同效应。它还进一步描述了肠道生物膜的临床意义和相关疾病、生物膜在抗菌药耐药性中的作用、肠道宿主防御系统和对抗生物膜的治疗策略。综上所述,这篇综述总结了有关肠道生物膜及其在肠道疾病中作用的最新知识和研究,并为开发生物膜特异性疗法提供了方向。
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引用次数: 0
Pharmacokinetics and pharmacodynamics of bacteriophage therapy: a review with a focus on multidrug-resistant Gram-negative bacterial infections. 噬菌体疗法的药代动力学和药效学:以耐多药革兰氏阴性菌感染为重点的综述。
IF 19 1区 医学 Q1 MICROBIOLOGY Pub Date : 2024-09-12 Epub Date: 2024-07-29 DOI: 10.1128/cmr.00044-24
Maria Siopi, Dimitrios Skliros, Paschalis Paranos, Nikoletta Koumasi, Emmanouil Flemetakis, Spyros Pournaras, Joseph Meletiadis

SUMMARYDespite the early recognition of their therapeutic potential and the current escalation of multidrug-resistant (MDR) pathogens, the adoption of bacteriophages into mainstream clinical practice is hindered by unfamiliarity with their basic pharmacokinetic (PK) and pharmacodynamic (PD) properties, among others. Given the self-replicative nature of bacteriophages in the presence of host bacteria, the adsorption rate, and the clearance by the host's immunity, their PK/PD characteristics cannot be estimated by conventional approaches, and thus, the introduction of new considerations is required. Furthermore, the multitude of different bacteriophage types, preparations, and treatment schedules impedes drawing general conclusions on their in vivo PK/PD features. Additionally, the drawback of acquired bacteriophage resistance of MDR pathogens with clinical and environmental implications should be taken into consideration. Here, we provide an overview of the current state of the field of PK and PD of bacteriophage therapy with a focus on its application against MDR Gram-negative infections, highlighting the potential knowledge gaps and the challenges in translation from the bench to the bedside. After reviewing the in vitro PKs and PDs of bacteriophages against the four major MDR Gram-negative pathogens, Klebsiella pneumoniae, Acinetobacter baumannii complex, Pseudomonas aeruginosa, and Escherichia coli, specific data on in vivo PKs (tissue distribution, route of administration, and basic PK parameters in animals and humans) and PDs (survival and reduction of bacterial burden in relation to the route of administration, timing of therapy, dosing regimens, and resistance) are summarized. Currently available data merit close scrutiny, and optimization of bacteriophage therapy in the context of a better understanding of the underlying PK/PD principles is urgent to improve its therapeutic effect and to minimize the occurrence of bacteriophage resistance.

摘要尽管噬菌体的治疗潜力很早就得到了认可,而且目前耐多药(MDR)病原体不断增加,但由于不熟悉噬菌体的基本药代动力学(PK)和药效学(PD)等特性,噬菌体在主流临床实践中的应用受到了阻碍。鉴于噬菌体在宿主细菌存在下的自我复制特性、吸附率以及宿主免疫力的清除率,其 PK/PD 特性无法用传统方法估算,因此需要引入新的考虑因素。此外,由于噬菌体类型、制剂和治疗时间各不相同,因此无法对其体内 PK/PD 特征得出一般性结论。此外,还应考虑到 MDR 病原体对噬菌体产生耐药性的弊端对临床和环境的影响。在此,我们概述了噬菌体疗法的 PK 和 PD 领域的现状,重点介绍了其在治疗革兰氏阴性耐药菌感染方面的应用,并强调了在从实验室到临床转化过程中可能存在的知识差距和挑战。在回顾了噬菌体针对四种主要 MDR 革兰氏阴性病原体(肺炎克雷伯氏菌、鲍曼不动杆菌复合体、铜绿假单胞菌和大肠埃希菌)的体外 PKs 和 PDs 之后,总结了体内 PKs(组织分布、给药途径、动物和人类的基本 PK 参数)和 PDs(存活率和细菌负荷的减少与给药途径、治疗时机、给药方案和耐药性的关系)的具体数据。目前可用的数据值得仔细研究,当务之急是在更好地了解基本 PK/PD 原理的基础上优化噬菌体疗法,以提高其治疗效果并最大限度地减少噬菌体耐药性的发生。
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引用次数: 0
The immunobiology of corneal HSV-1 infection and herpetic stromal keratitis. 角膜 HSV-1 感染和疱疹性基质角膜炎的免疫生物学。
IF 19 1区 医学 Q1 MICROBIOLOGY Pub Date : 2024-09-12 Epub Date: 2024-07-30 DOI: 10.1128/cmr.00006-24
Ferrin Antony, Divya Kinha, Anna Nowińska, Barry T Rouse, Amol Suryawanshi

SUMMARYHuman alphaherpesvirus 1 (HSV-1) is a highly successful neurotropic pathogen that primarily infects the epithelial cells lining the orofacial mucosa. After primary lytic replication in the oral, ocular, and nasal mucosal epithelial cells, HSV-1 establishes life-long latency in neurons within the trigeminal ganglion. Patients with compromised immune systems experience frequent reactivation of HSV-1 from latency, leading to virus entry in the sensory neurons, followed by anterograde transport and lytic replication at the innervated mucosal epithelial surface. Although recurrent infection of the corneal mucosal surface is rare, it can result in a chronic immuno-inflammatory condition called herpetic stromal keratitis (HSK). HSK leads to gradual vision loss and can cause permanent blindness in severe untreated cases. Currently, there is no cure or successful vaccine to prevent latent or recurrent HSV-1 infections, posing a significant clinical challenge to managing HSK and preventing vision loss. The conventional clinical management of HSK primarily relies on anti-virals to suppress HSV-1 replication, anti-inflammatory drugs (such as corticosteroids) to provide symptomatic relief from pain and inflammation, and surgical interventions in more severe cases to replace damaged cornea. However, each clinical treatment strategy has limitations, such as local and systemic drug toxicities and the emergence of anti-viral-resistant HSV-1 strains. In this review, we summarize the factors and immune cells involved in HSK pathogenesis and highlight alternate therapeutic strategies for successful clinical management of HSK. We also discuss the therapeutic potential of immunoregulatory cytokines and immunometabolism modulators as promising HSK therapies against emerging anti-viral-resistant HSV-1 strains.

摘要人类α疱疹病毒 1(HSV-1)是一种非常成功的神经性病原体,主要感染口腔粘膜上皮细胞。在口腔、眼部和鼻腔粘膜上皮细胞中进行初级溶解复制后,HSV-1 会在三叉神经节内的神经元中潜伏终身。免疫系统受损的患者会经常从潜伏期重新激活 HSV-1,导致病毒进入感觉神经元,然后在受支配的粘膜上皮细胞表面进行逆行运输和溶解复制。虽然角膜粘膜表面的复发性感染很少见,但它会导致一种慢性免疫炎症,即疱疹性基质角膜炎(HSK)。HSK 会导致视力逐渐下降,严重的患者如果不及时治疗,可能会永久失明。目前,还没有治疗方法或成功的疫苗来预防潜伏或复发的 HSV-1 感染,这给治疗 HSK 和预防视力丧失带来了巨大的临床挑战。HSK的传统临床治疗主要依靠抗病毒药物来抑制HSV-1的复制,使用抗炎药物(如皮质类固醇激素)来缓解疼痛和炎症症状,在病情较重的病例中还需要进行手术治疗,以更换受损的角膜。然而,每种临床治疗策略都有其局限性,如局部和全身药物毒性以及抗病毒 HSV-1 株的出现。在这篇综述中,我们总结了参与 HSK 发病机制的因素和免疫细胞,并强调了成功临床治疗 HSK 的替代治疗策略。我们还讨论了免疫调节细胞因子和免疫代谢调节剂作为HSK疗法的治疗潜力,以对抗新出现的抗病毒HSV-1毒株。
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引用次数: 0
Streptococcus dysgalactiae subsp. equisimilis infection and its intersection with Streptococcus pyogenes. 赤痢链球菌马氏亚种感染及其与化脓性链球菌的交叉感染。
IF 19 1区 医学 Q1 MICROBIOLOGY Pub Date : 2024-09-12 Epub Date: 2024-06-10 DOI: 10.1128/cmr.00175-23
Ouli Xie, Mark R Davies, Steven Y C Tong

SUMMARYStreptococcus dysgalactiae subsp. equisimilis (SDSE) is an increasingly recognized cause of disease in humans. Disease manifestations range from non-invasive superficial skin and soft tissue infections to life-threatening streptococcal toxic shock syndrome and necrotizing fasciitis. Invasive disease is usually associated with co-morbidities, immunosuppression, and advancing age. The crude incidence of invasive disease approaches that of the closely related pathogen, Streptococcus pyogenes. Genomic epidemiology using whole-genome sequencing has revealed important insights into global SDSE population dynamics including emerging lineages and spread of anti-microbial resistance. It has also complemented observations of overlapping pathobiology between SDSE and S. pyogenes, including shared virulence factors and mobile gene content, potentially underlying shared pathogen phenotypes. This review provides an overview of the clinical and genomic epidemiology, disease manifestations, treatment, and virulence determinants of human infections with SDSE with a particular focus on its overlap with S. pyogenes. In doing so, we highlight the importance of understanding the overlap of SDSE and S. pyogenes to inform surveillance and disease control strategies.

摘要赤痢链球菌马氏亚种(SDSE)越来越多地被认为是人类疾病的诱因。疾病表现从非侵袭性表皮和软组织感染到危及生命的链球菌中毒性休克综合症和坏死性筋膜炎。侵袭性疾病通常与并发症、免疫抑制和年龄增长有关。侵袭性疾病的粗发病率接近与之密切相关的病原体化脓性链球菌。使用全基因组测序的基因组流行病学揭示了全球 SDSE 种群动态的重要信息,包括新出现的品系和抗微生物耐药性的传播。它还补充了对 SDSE 和化脓性链球菌之间重叠病理生物学的观察,包括共享毒力因子和移动基因内容,这可能是共享病原体表型的基础。本综述概述了人类感染 SDSE 的临床和基因组流行病学、疾病表现、治疗和毒力决定因素,尤其关注其与化脓性链球菌的重叠。在此过程中,我们强调了了解 SDSE 与化脓性链球菌重叠的重要性,以便为监测和疾病控制策略提供依据。
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引用次数: 0
HIV-associated cancers and lymphoproliferative disorders caused by Kaposi sarcoma herpesvirus and Epstein-Barr virus. 由卡波济肉瘤疱疹病毒和 Epstein-Barr 病毒引起的艾滋病毒相关癌症和淋巴增生性疾病。
IF 19 1区 医学 Q1 MICROBIOLOGY Pub Date : 2024-09-12 Epub Date: 2024-06-20 DOI: 10.1128/cmr.00022-23
Kathryn A Lurain, Ramya Ramaswami, Laurie T Krug, Denise Whitby, Joseph M Ziegelbauer, Hao-Wei Wang, Robert Yarchoan

SUMMARYWithin weeks of the first report of acquired immunodeficiency syndrome (AIDS) in 1981, it was observed that these patients often had Kaposi sarcoma (KS), a hitherto rarely seen skin tumor in the USA. It soon became apparent that AIDS was also associated with an increased incidence of high-grade lymphomas caused by Epstein-Barr virus (EBV). The association of AIDS with KS remained a mystery for more than a decade until Kaposi sarcoma-associated herpesvirus (KSHV) was discovered and found to be the cause of KS. KSHV was subsequently found to cause several other diseases associated with AIDS and human immunodeficiency virus (HIV) infection. People living with HIV/AIDS continue to have an increased incidence of certain cancers, and many of these cancers are caused by EBV and/or KSHV. In this review, we discuss the epidemiology, virology, pathogenesis, clinical manifestations, and treatment of cancers caused by EBV and KSHV in persons living with HIV.

摘要在 1981 年首次报告获得性免疫缺陷综合症(艾滋病)后的几周内,人们发现这些患者通常患有卡波西肉瘤(KS),这是一种迄今为止在美国很少见的皮肤肿瘤。很快,人们发现艾滋病还与 Epstein-Barr 病毒(EBV)引起的高级别淋巴瘤发病率增加有关。十多年来,艾滋病与 KS 的关系一直是个谜,直到卡波西肉瘤相关疱疹病毒(KSHV)被发现并被认为是 KS 的病因。随后又发现 KSHV 可导致其他几种与艾滋病和人类免疫缺陷病毒(HIV)感染相关的疾病。艾滋病病毒感染者/艾滋病患者某些癌症的发病率持续上升,其中许多癌症是由 EBV 和/或 KSHV 引起的。在这篇综述中,我们将讨论 HIV 感染者中由 EBV 和 KSHV 引起的癌症的流行病学、病毒学、发病机制、临床表现和治疗。
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引用次数: 0
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Clinical Microbiology Reviews
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