Clinical Microbiology Reviews最新文献

SUMMARYThe oral microbiota, characterized by its complexity and density, is increasingly recognized for its significant association with respiratory diseases and their pathogenesis. Changes in the oral microbiome, including shifts in the relative abundance of certain harmful microbes, their byproducts, and virulence elements, have been linked to respiratory disease development and progression. The use of oral microbiome indicators and treatments is essential for the detection, prognosis, and management of respiratory illnesses, providing significant practical benefits. Hence, a thorough understanding of the correlation between oral microbiota and respiratory illnesses is imperative for generating novel therapeutic approaches rooted in the oral microbiota to address these ailments. This review summarizes how oral microbiota are connected to respiratory diseases, explores the mechanisms of their influence, and discusses treatment approaches.

SUMMARYVulvovaginal candidiasis (VVC) affects over half of women during their lifetime. There are two categorization systems for VVC: uncomplicated versus complicated and acute versus recurrent. Most uncomplicated or acute cases occur in postpubertal premenopausal girls and women as sporadic vaginitis due to Candida albicans. Complicated VVC includes recurrent, chronic, or severe cases, presence of non-albicans species, and/or disease occurring in people with diabetes, immunosuppression, or pregnancy. These classification systems fail to distinguish the two distinct clinical categories of genital candidiasis: estrogen-dependent VVC and estrogen-independent cutaneous candidiasis. These entities are characterized by different pathogenesis, patient demographics, predisposing conditions, symptoms, signs, investigations, differential diagnosis, treatment, and ancillary measures. The current international and national guidelines on VVC are inadequate in their description of the clinical presentation, role and limitations of culture, biopsy findings, and management of cutaneous candidiasis. Progress toward improved patient outcomes will require the interdisciplinary collaboration of researchers and guideline authors to separate these two entities, unify terminology for each, explore the roles of medications and comorbid dermatoses, detail pragmatic and accessible diagnostic processes, define treatment goals, and discuss the long-term management strategies pertinent to each condition.

SUMMARYHenipaviruses were first identified 30 years ago and have since been associated with over 30 outbreaks of disease in humans. Highly pathogenic henipaviruses include Hendra virus (HeV) and Nipah virus (NiV), classified as biosafety level 4 pathogens. In addition, NiV has been listed as a priority pathogen by the World Health Organization (WHO), the Coalition for Epidemic Preparedness Innovations (CEPI), and the UK Vaccines Research and Development Network (UKVN). Here, we re-examine epidemiological, ecological, clinical, and pathobiological studies of HeV and NiV to provide a comprehensive guide of the current knowledge and application to identify and evaluate countermeasures. We also discuss therapeutic and vaccine development efforts. Furthermore, with case identification, prevention, and treatment in mind, we highlight limitations in research and recognize gaps necessitating additional studies.

SUMMARYStaphylococcus aureus is a major human pathogen. It can cause many types of infections, in particular bacteremia, which frequently leads to infective endocarditis, osteomyelitis, sepsis, and other debilitating diseases. The development of secondary infections is based on the bacterium's ability to associate with endothelial cells lining blood vessels. The success of endothelial colonization and infection by S. aureus relies on its ability to express a wide array of cell wall-anchored and secreted virulence factors. Establishment of endothelial infection by the pathogen is a multistep process involving adhesion, invasion, extravasation, and dissemination of the bacterium into surrounding tissues. The process is dependent on the type of endothelium in different organs (tissues) and pathogenetic potential of the individual strains. In this review, we report an update on the organization of the endothelium in the vessels, the structure and function of the virulence factors of S. aureus, and the several aspects of bacteria-endothelial cell interactions. After these sections, we will discuss recent advances in understanding the specific mechanisms of infections that develop in the heart, bone and joints, lung, and brain. Finally, we describe how neutrophils bind to endothelial cells, migrate to the site of infection to kill bacteria in the tissues, and how staphylococci counteract neutrophils' actions. Knowledge of the molecular details of S. aureus-endothelial cell interactions will promote the development of new therapeutic strategies and tools to combat this formidable pathogen.

SUMMARYMore than 40 types of sexually transmitted human papillomavirus (HPV) infect the oropharyngeal and anogenital mucosa-high-risk types are associated with precancerous and cancerous lesions of the cervix, vagina, vulva, penis, anus, and oropharynx, and low-risk types cause non-malignant disease, such as anogenital warts. Though most HPV infections resolve spontaneously, immunodeficiencies may result in persistent infection and increased risk of HPV-related sequelae. The mechanism by which HPV results in malignant transformation is multifaceted, involving interactions with numerous cellular pathways, the host immune system, and potentially the host microbiome. Vaccination against HPV is highly efficacious in the prevention of infection and related sequelae, and there now exist several approved formulations that protect against both high- and low-risk types. Despite the advent of vaccination, early detection and treatment of cervical and anal precancerous lesions continues to be integral to secondary prevention-molecular HPV testing, cytology, and tissue biopsy allow for triaging of patients, after which appropriate treatment with close follow-up can avert cancer development.