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How long do bacteria, fungi, protozoa, and viruses retain their replication capacity on inanimate surfaces? A systematic review examining environmental resilience versus healthcare-associated infection risk by “fomite-borne risk assessment” 细菌、真菌、原生动物和病毒在无生命表面的复制能力能保持多久?通过 "飞沫传播风险评估 "对环境复原力与医疗保健相关感染风险进行系统性审查
IF 36.8 1区 医学 Q1 MICROBIOLOGY Pub Date : 2024-10-10 DOI: 10.1128/cmr.00186-23
Axel KramerFranziska LexowAnna BludauAntonia Milena KösterMartin MisailovskiUlrike SeifertMaren EggersWilliam RutalaStephanie J. DancerSimone Scheithauer1Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Greifswald, Germany2Department for Infectious Diseases, Unit 14: Hospital Hygiene, Infection Prevention and Control, Robert Koch Institute, Berlin, Germany3Department of Infection Control and Infectious Diseases, University Medical Center Göttingen (UMG), Georg-August University Göttingen, Göttingen, Germany4Department of Geriatrics, University of Göttingen Medical Center, Göttingen, Germany5Friedrich Loeffler-Institute of Medical Microbiology – Virology, University Medicine Greifswald, Greifswald, Germany6Labor Prof. Dr. G. Enders MVZ GbR, Stuttgart, Germany7Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA8Department of Microbiology, University Hospital Hairmyres, Glasgow, United..
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
Antibiotic tolerance among clinical isolates: mechanisms, detection, prevalence, and significance. 临床分离株的抗生素耐受性:机制、检测、流行率和意义。
IF 19 1区 医学 Q1 MICROBIOLOGY Pub Date : 2024-10-04 DOI: 10.1128/cmr.00106-24
Ashley T Deventer, Claire E Stevens, Amy Stewart, Joanne K Hobbs

SUMMARYAntibiotic treatment failures in the absence of resistance are not uncommon. Recently, attention has grown around the phenomenon of antibiotic tolerance, an underappreciated contributor to recalcitrant infections first detected in the 1970s. Tolerance describes the ability of a bacterial population to survive transient exposure to an otherwise lethal concentration of antibiotic without exhibiting resistance. With advances in genomics, we are gaining a better understanding of the molecular mechanisms behind tolerance, and several studies have sought to examine the clinical prevalence of tolerance. Attempts have also been made to assess the clinical significance of tolerance through in vivo infection models and prospective/retrospective clinical studies. Here, we review the data available on the molecular mechanisms, detection, prevalence, and clinical significance of genotypic tolerance that span ~50 years. We discuss the need for standardized methodology and interpretation criteria for tolerance detection and the impact that methodological inconsistencies have on our ability to accurately assess the scale of the problem. In terms of the clinical significance of tolerance, studies suggest that tolerance contributes to worse outcomes for patients (e.g., higher mortality, prolonged hospitalization), but historical data from animal models are varied. Furthermore, we lack the necessary information to effectively treat tolerant infections. Overall, while the tolerance field is gaining much-needed traction, the underlying clinical significance of tolerance that underpins all tolerance research is still far from clear and requires attention.

摘要 在没有抗药性的情况下,抗生素治疗失败的情况并不少见。最近,人们开始关注抗生素耐受性现象,这是 20 世纪 70 年代首次发现的导致顽固性感染的一个未被重视的因素。耐受性是指细菌种群在短暂接触致命浓度的抗生素后能够存活下来而不表现出抗药性的能力。随着基因组学的进步,我们对耐药性背后的分子机制有了更深入的了解,有几项研究试图检查耐药性的临床流行情况。此外,还尝试通过体内感染模型和前瞻性/回顾性临床研究来评估耐药性的临床意义。在此,我们回顾了有关基因型耐受性的分子机制、检测、流行率和临床意义的现有数据,这些数据的时间跨度约为 50 年。我们讨论了耐受性检测标准化方法和解释标准的必要性,以及方法不一致对我们准确评估问题规模的影响。就耐受性的临床意义而言,研究表明耐受性会导致患者病情恶化(如死亡率升高、住院时间延长),但来自动物模型的历史数据却不尽相同。此外,我们还缺乏有效治疗耐受性感染的必要信息。总之,虽然耐受性领域正在获得亟需的牵引力,但作为所有耐受性研究基础的耐受性的基本临床意义仍远未明确,需要引起重视。
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引用次数: 0
Recent advances in the influenza virus vaccine landscape: a comprehensive overview of technologies and trials. 流感病毒疫苗领域的最新进展:技术与试验综述。
IF 19 1区 医学 Q1 MICROBIOLOGY Pub Date : 2024-10-03 DOI: 10.1128/cmr.00025-24
Tristan W Clark, John S Tregoning, Helen Lister, Tiziano Poletti, Femy Amin, Jonathan S Nguyen-Van-Tam

SUMMARYIn the United Kingdom (UK) in 2022/23, influenza virus infections returned to the levels recorded before the COVID-19 pandemic, exerting a substantial burden on an already stretched National Health Service (NHS) through increased primary and emergency care visits and subsequent hospitalizations. Population groups ≤4 years and ≥65 years of age, and those with underlying health conditions, are at the greatest risk of influenza-related hospitalization. Recent advances in influenza virus vaccine technologies may help to mitigate this burden. This review aims to summarize advances in the influenza virus vaccine landscape by describing the different technologies that are currently in use in the UK and more widely. The review also describes vaccine technologies that are under development, including mRNA, and universal influenza virus vaccines which aim to provide broader or increased protection. This is an exciting and important era for influenza virus vaccinations, and advances are critical to protect against a disease that still exerts a substantial burden across all populations and disproportionately impacts the most vulnerable, despite it being over 80 years since the first influenza virus vaccines were deployed.

摘要在 2022/23 年度,英国的流感病毒感染率恢复到了 COVID-19 大流行之前的水平,这给本已捉襟见肘的国民医疗服务系统(NHS)带来了沉重负担,因为初诊和急诊就诊人数以及随后的住院人数都有所增加。年龄≤4岁和≥65岁的人群以及有潜在健康问题的人群因流感住院的风险最大。流感病毒疫苗技术的最新进展可能有助于减轻这一负担。本综述旨在通过描述目前在英国和更广泛地区使用的不同技术,总结流感病毒疫苗领域的进展。综述还介绍了正在开发的疫苗技术,包括旨在提供更广泛或更强保护的 mRNA 和通用流感病毒疫苗。对于流感病毒疫苗接种来说,这是一个令人兴奋的重要时代,尽管自首次使用流感病毒疫苗以来已经过去了 80 多年,但这种疾病仍然给所有人群带来沉重负担,对最脆弱人群的影响尤为严重。
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引用次数: 0
Toward better cures for Mycobacterium abscessus lung disease. 为更好地治愈脓肿分枝杆菌肺病而努力。
IF 19 1区 医学 Q1 MICROBIOLOGY Pub Date : 2024-10-03 DOI: 10.1128/cmr.00080-23
Véronique Dartois, Thomas Dick

SUMMARYThe opportunistic pathogen Mycobacterium abscessus (Mab) causes fatal lung infections that bear similarities-and notable differences-with tuberculosis (TB) pulmonary disease. In contrast to TB, no antibiotic is formally approved to treat Mab disease, there is no reliable cure, and the discovery and development pipeline is incredibly thin. Here, we discuss the factors behind the unsatisfactory cure rates of Mab disease, namely intrinsic resistance and persistence of the pathogen, and the use of underperforming, often parenteral and toxic, repurposed drugs. We propose preclinical strategies to build injectable-free sterilizing and safe regimens: (i) prioritize oral bactericidal antibiotic classes, with an initial focus on approved agents or advanced clinical candidates to provide immediate options for desperate patients, (ii) test drug combinations early, (iii) optimize novel leads specifically for M. abscessus, and (iv) consider pharmacokinetic-pharmacodynamic targets at the site of disease, the lung lesions in which drug tolerant bacterial populations reside. Knowledge and tool gaps in the preclinical drug discovery process are identified, including validated mouse models and computational platforms to enable in vitro mouse-human translation. We briefly discuss recent advances in clinical development, the need for readouts and biomarkers that correlate with cure, and clinical trial concepts adapted to the uniqueness of Mab patient populations for new regimen development. In an era when most pharmaceutical firms have withdrawn from antimicrobial drug discovery, the breakthroughs needed to fill the regimen development pipeline will likely come from partnerships between academia, biotech, pharma, non-profit organizations, and governments, with incentives that reward cooperation.

摘要机会性病原体脓肿分枝杆菌(Mab)会导致致命的肺部感染,与肺结核(TB)有相似之处,也有明显的不同之处。与肺结核不同的是,没有一种抗生素被正式批准用于治疗脓肿分枝杆菌病,也没有可靠的治愈方法,而且发现和开发的渠道非常稀少。在此,我们讨论了马布病治愈率不尽人意背后的因素,即病原体的内在抗药性和持久性,以及使用性能不佳、通常是肠外和有毒的再用途药物。我们提出了建立免注射灭菌安全方案的临床前策略:(i) 优先考虑口服杀菌抗生素类别,最初重点关注已获批准的药物或先进的临床候选药物,以便为绝望的患者提供直接选择;(ii) 尽早测试药物组合;(iii) 优化专门针对脓毒症马勃菌的新型先导药物;(iv) 考虑发病部位的药代动力学-药效学目标,即耐药细菌群栖息的肺部病变部位。我们确定了临床前药物发现过程中的知识和工具缺口,包括验证小鼠模型和计算平台,以实现体外小鼠-人体转化。我们简要讨论了临床开发的最新进展、对与治愈相关的读数和生物标志物的需求,以及适应马布病患者群体独特性的临床试验概念,以开发新的治疗方案。在大多数制药公司已退出抗菌药物研发的时代,填补新药研发管道所需的突破很可能来自学术界、生物技术公司、制药公司、非营利组织和政府之间的合作,以及奖励合作的激励机制。
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引用次数: 0
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
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Clinical Microbiology Reviews
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