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Changes in fungal taxonomy: mycological rationale and clinical implications. 真菌分类学的变化:真菌学原理和临床意义。
IF 19 1区 医学 Q1 MICROBIOLOGY Pub Date : 2023-12-20 Epub Date: 2023-11-06 DOI: 10.1128/cmr.00099-22
Andrew M Borman, Elizabeth M Johnson

Numerous fungal species of medical importance have been recently subjected to and will likely continue to undergo nomenclatural changes as a result of the application of molecular approaches to fungal classification together with abandonment of dual nomenclature. Here, we summarize those changes affecting key groups of fungi of medical importance, explaining the mycological (taxonomic) rationale that underpinned the changes and the clinical relevance/importance (where such exists) of the key nomenclatural revisions. Potential mechanisms to mitigate unnecessary taxonomic instability are suggested, together with approaches to raise awareness of important changes to minimize potential clinical confusion.

SUMMARY由于分子方法在真菌分类中的应用以及双重命名法的放弃,许多具有医学重要性的真菌物种最近受到并可能继续经历命名法的变化。在这里,我们总结了影响具有医学重要性的关键真菌群的变化,解释了支撑这些变化的真菌学(分类学)原理,以及关键命名修订的临床相关性/重要性(如果存在)。提出了减轻不必要的分类学不稳定性的潜在机制,以及提高对重要变化的认识以最大限度地减少潜在临床混乱的方法。
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引用次数: 0
Klebsiella pneumoniae carbapenemase variants: the new threat to global public health. 肺炎克雷伯菌碳青霉烯酶变体:对全球公共健康的新威胁。
IF 19 1区 医学 Q1 MICROBIOLOGY Pub Date : 2023-12-20 Epub Date: 2023-11-08 DOI: 10.1128/cmr.00008-23
Li Ding, Siquan Shen, Jing Chen, Zhen Tian, Qingyu Shi, Renru Han, Yan Guo, Fupin Hu

Klebsiella pneumoniae carbapenemase (KPC) variants, which refer to the substitution, insertion, or deletion of amino acid sequence compared to wild blaKPC type, have reduced utility of ceftazidime-avibactam (CZA), a pioneer antimicrobial agent in treating carbapenem-resistant Enterobacterales infections. So far, more than 150 blaKPC variants have been reported worldwide, and most of the new variants were discovered in the past 3 years, which calls for public alarm. The KPC variant protein enhances the affinity to ceftazidime and weakens the affinity to avibactam by changing the KPC structure, thereby mediating bacterial resistance to CZA. At present, there are still no guidelines or expert consensus to make recommendations for the diagnosis and treatment of infections caused by KPC variants. In addition, meropenem-vaborbactam, imipenem-relebactam, and other new β-lactam-β-lactamase inhibitor combinations have little discussion on KPC variants. This review aims to discuss the clinical characteristics, risk factors, epidemiological characteristics, antimicrobial susceptibility profiles, methods for detecting blaKPC variants, treatment options, and future perspectives of blaKPC variants worldwide to alert this new great public health threat.

SUMMARYKlebsiella pneumoniae碳青霉烯酶(KPC)变体是指与野生blaKPC型相比氨基酸序列的取代、插入或缺失,它降低了头孢他啶-阿维巴坦(CZA)的效用,头孢他啶是治疗碳青霉烯耐药性肠杆菌感染的先锋抗菌剂。到目前为止,全球已报告了150多种blaKPC变体,其中大多数新变体是在过去3年中发现的,这需要公众警惕。KPC变体蛋白通过改变KPC结构来增强对头孢他啶的亲和力,并削弱对阿维巴坦的亲和力,从而介导细菌对CZA的耐药性。目前,仍然没有指导方针或专家共识来就KPC变异株引起的感染的诊断和治疗提出建议。此外,美罗培南-沃博巴坦、亚胺培南-雷巴坦和其他新的β-内酰胺酶抑制剂组合对KPC变体的讨论很少。这篇综述旨在讨论世界范围内blaKPC变异株的临床特征、危险因素、流行病学特征、抗菌药物敏感性、检测方法、治疗选择和未来前景,以提醒人们注意这一新的巨大公共卫生威胁。
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引用次数: 0
MicroRNAs in infectious diseases: potential diagnostic biomarkers and therapeutic targets. 传染病中的微小RNA:潜在的诊断生物标志物和治疗靶点。
IF 19 1区 医学 Q1 MICROBIOLOGY Pub Date : 2023-12-20 Epub Date: 2023-11-01 DOI: 10.1128/cmr.00015-23
Muneyoshi Kimura, Sagar Kothari, Wajiha Gohir, Jose F Camargo, Shahid Husain

MicroRNAs (miRNAs) are conserved, short, non-coding RNAs that play a crucial role in the post-transcriptional regulation of gene expression. They have been implicated in the pathogenesis of cancer and neurological, cardiovascular, and autoimmune diseases. Several recent studies have suggested that miRNAs are key players in regulating the differentiation, maturation, and activation of immune cells, thereby influencing the host immune response to infection. The resultant upregulation or downregulation of miRNAs from infection influences the protein expression of genes responsible for the immune response and can determine the risk of disease progression. Recently, miRNAs have been explored as diagnostic biomarkers and therapeutic targets in various infectious diseases. This review summarizes our current understanding of the role of miRNAs during viral, fungal, bacterial, and parasitic infections from a clinical perspective, including critical functional mechanisms and implications for their potential use as biomarkers and therapeutic targets.

SUMMARYMicroRNAs(miRNAs)是一种保守的、短的、非编码的RNA,在基因表达的转录后调控中起着至关重要的作用。它们与癌症、神经、心血管和自身免疫性疾病的发病机制有关。最近的几项研究表明,miRNA是调节免疫细胞分化、成熟和激活的关键参与者,从而影响宿主对感染的免疫反应。感染引起的miRNA的上调或下调影响负责免疫反应的基因的蛋白质表达,并可决定疾病进展的风险。最近,miRNA已被探索作为各种传染病的诊断生物标志物和治疗靶点。这篇综述从临床角度总结了我们目前对miRNA在病毒、真菌、细菌和寄生虫感染中的作用的理解,包括其关键的功能机制及其作为生物标志物和治疗靶点的潜在用途。
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引用次数: 0
2023 Acknowledgment of CMR Reviewers. 2023 感谢 CMR 评审员。
IF 36.8 1区 医学 Q1 Medicine Pub Date : 2023-12-20 DOI: 10.1128/cmr.00138-23
Graeme Forrest
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引用次数: 0
Diagnosis and management of cryptococcal meningitis in HIV-infected adults. 成人hiv感染者隐球菌性脑膜炎的诊断和治疗。
IF 36.8 1区 医学 Q1 Medicine Pub Date : 2023-12-20 Epub Date: 2023-11-28 DOI: 10.1128/cmr.00156-22
Thomas C McHale, David R Boulware, John Kasibante, Kenneth Ssebambulidde, Caleb P Skipper, Mahsa Abassi

Cryptococcal meningitis is a leading cause of morbidity and mortality globally, especially in people with advanced HIV disease. Cryptococcal meningitis is responsible for nearly 20% of all deaths related to advanced HIV disease, with the burden of disease predominantly experienced by people in resource-limited countries. Major advancements in diagnostics have introduced low-cost, easy-to-use antigen tests with remarkably high sensitivity and specificity. These tests have led to improved diagnostic accuracy and are essential for screening campaigns to reduce the burden of cryptococcosis. In the last 5 years, several high-quality, multisite clinical trials have led to innovations in therapeutics that have allowed for simplified regimens, which are better tolerated and result in less intensive monitoring and management of medication adverse effects. One trial found that a shorter, 7-day course of deoxycholate amphotericin B is as effective as the longer 14-day course and that flucytosine is an essential partner drug for reducing mortality in the acute phase of disease. Single-dose liposomal amphotericin B has also been found to be as effective as a 7-day course of deoxycholate amphotericin B. These findings have allowed for simpler and safer treatment regimens that also reduce the burden on the healthcare system. This review provides a detailed discussion of the latest evidence guiding the clinical management and special circumstances that make cryptococcal meningitis uniquely difficult to treat.

隐球菌性脑膜炎是全球发病率和死亡率的主要原因,特别是在晚期艾滋病患者中。在与晚期艾滋病毒疾病相关的所有死亡中,有近20%是由隐球菌性脑膜炎造成的,疾病负担主要由资源有限国家的人们承担。诊断方面的重大进展带来了低成本、易于使用的抗原检测,具有非常高的灵敏度和特异性。这些检测提高了诊断的准确性,对于减少隐球菌病负担的筛查运动至关重要。在过去的5年里,一些高质量的、多地点的临床试验已经导致了治疗方法的创新,从而简化了方案,使其具有更好的耐受性,并且减少了对药物不良反应的密集监测和管理。一项试验发现,较短的7天脱氧胆酸两性霉素B疗程与较长的14天疗程一样有效,氟胞嘧啶是降低疾病急性期死亡率的重要配套药物。单剂量脂质体两性霉素B也被发现与7天脱氧胆酸两性霉素B疗程一样有效。这些发现使得更简单、更安全的治疗方案成为可能,也减轻了医疗保健系统的负担。这篇综述提供了一个详细的讨论最新的证据指导临床管理和特殊情况下,使隐球菌脑膜炎独特的难以治疗。
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引用次数: 0
Wastewater-based surveillance as a tool for public health action: SARS-CoV-2 and beyond 将废水监测作为公共卫生行动的工具:SARS-CoV-2 及其后
IF 36.8 1区 医学 Q1 Medicine Pub Date : 2023-12-14 DOI: 10.1128/cmr.00103-22
Michael D. ParkinsBonita E. LeeNicole AcostaMaria BautistaCasey R. J. HubertSteve E. HrudeyKevin FrankowskiXiao-Li Pang1Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, Alberta, Canada2Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada3O’Brien Institute of Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada4Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada5Department of Biological Sciences, Faculty of Science, University of Calgary, Calgary, Alberta, Canada6Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada7Advancing Canadian Water Assets, University of Calgary, Calgary, Alberta, Canada8Provincial Health Laboratory, Alberta Health Services, Calgary, Alberta, Canada, Graeme N. Forrest
Clinical Microbiology Reviews, Ahead of Print.
临床微生物学评论》,印刷版前。
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引用次数: 0
Fungal Endocarditis: Pathophysiology, Epidemiology, Clinical Presentation, Diagnosis, and Management. 真菌性心内膜炎:病理生理学,流行病学,临床表现,诊断和管理。
IF 19 1区 医学 Q1 MICROBIOLOGY Pub Date : 2023-09-21 Epub Date: 2023-07-13 DOI: 10.1128/cmr.00019-23
George R Thompson, Jeffrey D Jenks, John W Baddley, James S Lewis, Matthias Egger, Ilan S Schwartz, Johannes Boyer, Thomas F Patterson, Sharon C-A Chen, Peter G Pappas, Martin Hoenigl

Fungal endocarditis accounts for 1% to 3% of all infective endocarditis cases, is associated with high morbidity and mortality (>70%), and presents numerous challenges during clinical care. Candida spp. are the most common causes of fungal endocarditis, implicated in over 50% of cases, followed by Aspergillus and Histoplasma spp. Important risk factors for fungal endocarditis include prosthetic valves, prior heart surgery, and injection drug use. The signs and symptoms of fungal endocarditis are nonspecific, and a high degree of clinical suspicion coupled with the judicious use of diagnostic tests is required for diagnosis. In addition to microbiological diagnostics (e.g., blood culture for Candida spp. or galactomannan testing and PCR for Aspergillus spp.), echocardiography remains critical for evaluation of potential infective endocarditis, although radionuclide imaging modalities such as 18F-fluorodeoxyglucose positron emission tomography/computed tomography are increasingly being used. A multimodal treatment approach is necessary: surgery is usually required and should be accompanied by long-term systemic antifungal therapy, such as echinocandin therapy for Candida endocarditis or voriconazole therapy for Aspergillus endocarditis.

真菌性心内膜炎占所有感染性心内膜炎病例的1%至3%,与高发病率和死亡率(>70%)有关,并在临床护理中提出了许多挑战。念珠菌属是真菌性心内膜炎最常见的病因,超过50%的病例涉及念珠菌属,其次是曲霉菌属和组织浆菌属。真菌性心内膜的重要风险因素包括人工瓣膜、既往心脏手术和注射药物使用。真菌性心内膜炎的体征和症状是非特异性的,诊断需要高度的临床怀疑和明智的诊断测试。除了微生物诊断(例如,念珠菌属的血液培养或曲霉属的半乳甘露聚糖检测和聚合酶链式反应),超声心动图对于评估潜在感染性心内膜炎仍然至关重要,尽管放射性核素成像模式,如18F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描正在越来越多地使用。多模式治疗方法是必要的:通常需要手术,并应伴有长期的全身抗真菌治疗,如棘白菌素治疗念珠菌心内膜炎或伏立康唑治疗曲霉菌心内膜炎。
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引用次数: 0
Bordetella bronchiseptica and Bordetella pertussis: Similarities and Differences in Infection, Immuno-Modulation, and Vaccine Considerations. 支气管败血博德菌和百日咳博德菌:感染、免疫调节和疫苗注意事项的异同。
IF 36.8 1区 医学 Q1 Medicine Pub Date : 2023-09-21 Epub Date: 2023-06-12 DOI: 10.1128/cmr.00164-22
Beatriz Miguelena Chamorro, Karelle De Luca, Gokul Swaminathan, Stéphanie Longet, Egbert Mundt, Stéphane Paul

Bordetella pertussis and Bordetella bronchiseptica belong to the genus Bordetella, which comprises 14 other species. B. pertussis is responsible for whooping cough in humans, a severe infection in children and less severe or chronic in adults. These infections are restricted to humans and currently increasing worldwide. B. bronchiseptica is involved in diverse respiratory infections in a wide range of mammals. For instance, the canine infectious respiratory disease complex (CIRDC), characterized by a chronic cough in dogs. At the same time, it is increasingly implicated in human infections, while remaining an important pathogen in the veterinary field. Both Bordetella can evade and modulate host immune responses to support their persistence, although it is more pronounced in B. bronchiseptica infection. The protective immune responses elicited by both pathogens are comparable, while there are important characteristics in the mechanisms that differ. However, B. pertussis pathogenesis is more difficult to decipher in animal models than those of B. bronchiseptica because of its restriction to humans. Nevertheless, the licensed vaccines for each Bordetella are different in terms of formulation, route of administration and immune responses induced, with no known cross-reaction between them. Moreover, the target of the mucosal tissues and the induction of long-lasting cellular and humoral responses are required to control and eliminate Bordetella. In addition, the interaction between both veterinary and human fields are essential for the control of this genus, by preventing the infections in animals and the subsequent zoonotic transmission to humans.

百日咳博德特氏菌和支气管败血博德氏菌属于博德特菌属,包括其他14种。B.百日咳是引起人类百日咳的原因,百日咳是儿童的严重感染,成人的病情较轻或较慢性。这些感染仅限于人类,目前在全球范围内不断增加。B.支气管败血症与多种哺乳动物的多种呼吸道感染有关。例如,犬传染性呼吸道疾病复合体(CIRDC),其特征是犬的慢性咳嗽。与此同时,它越来越多地与人类感染有关,同时在兽医领域仍然是一种重要的病原体。博德特菌都可以逃避和调节宿主免疫反应,以支持其持久性,尽管它在支气管败血病感染中更为明显。两种病原体引发的保护性免疫反应具有可比性,但其机制有重要特征不同。然而,百日咳杆菌的发病机制在动物模型中比支气管败血病的发病机制更难解读,因为它仅限于人类。尽管如此,每种博德氏菌的许可疫苗在配方、给药途径和诱导的免疫反应方面都不同,它们之间没有已知的交叉反应。此外,需要粘膜组织的靶点以及诱导持久的细胞和体液反应来控制和消除博德氏菌。此外,兽医和人类领域之间的相互作用对于控制该属至关重要,可以防止动物感染和随后的人畜共患传播给人类。
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引用次数: 0
Erratum for Nyaruaba et al., "Digital PCR Applications in the SARS-CoV-2/COVID-19 Era: a Roadmap for Future Outbreaks". Nyaruaba等人的勘误,“数字PCR在SARS-CoV-2/COVID-19时代的应用:未来疫情的路线图”。
IF 36.8 1区 医学 Q1 Medicine Pub Date : 2023-06-21 DOI: 10.1128/cmr.00052-23
Raphael Nyaruaba, Caroline Mwaliko, David Dobnik, Pavel Neužil, Patrick Amoth, Matilu Mwau, Junping Yu, Hang Yang, Hongping Wei
https://doi.org/10.1128/cmr.00168-21
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引用次数: 0
Congenital Syphilis: a Review of Global Epidemiology. 先天性梅毒:全球流行病学回顾。
IF 36.8 1区 医学 Q1 Medicine Pub Date : 2023-06-21 Epub Date: 2023-03-15 DOI: 10.1128/cmr.00126-22
Leeyan S Gilmour, Tony Walls

In 2007, the World Health Organization (WHO) launched a global health initiative for the elimination of mother-to-child transmission (MTCT) of syphilis. This condition is highly preventable through antenatal identification of syphilis infection and treatment with penicillin during pregnancy. This review summarizes the global status of MTCT of syphilis and concludes that this condition remains a significant issue worldwide. There are large variations in case rates by region, with the highest numbers of cases in the African and Eastern Mediterranean regions, where there are also the least data available. There are also pockets of high-incidence areas within the other regions. Although the general trend is of decreasing rates over time, there are concerning indications of consistently increasing congenital syphilis cases in some areas, particularly in areas which have previously had very low case numbers. A concerted effort will be required to achieve the 2007 WHO goal of worldwide elimination of MTCT of syphilis in the near future.

2007 年,世界卫生组织(WHO)发起了消除梅毒母婴传播(MTCT)的全球卫生倡议。通过产前识别梅毒感染并在怀孕期间接受青霉素治疗,这种疾病是完全可以预防的。本综述总结了梅毒母婴传播的全球现状,并得出结论:梅毒母婴传播仍是全球范围内的一个重要问题。各地区的病例率差异很大,非洲和东地中海地区的病例数最多,但这两个地区的数据也最少。其他地区也有一些高发区。虽然随着时间的推移,发病率总体呈下降趋势,但有迹象表明,一些地区的先天性梅毒病例在持续增加,尤其是在以前病例数很少的地区,这一点令人担忧。要在不久的将来实现 2007 年世界卫生组织提出的在全世界消除梅毒母婴传播的目标,还需要各方共同努力。
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引用次数: 0
期刊
Clinical Microbiology Reviews
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