Diagnostic microbiology and infectious disease最新文献

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IF 2.1 4区医学 Q3 INFECTIOUS DISEASES

Diagnostic microbiology and infectious disease

Pub Date : 2024-11-22 DOI: 10.1016/S0732-8893(24)00437-1

引用次数: 0

Successful treatment of infections caused by mycobacterium abscessus complex following aesthetic procedures: A case series in China 成功治疗美容手术后的复合脓肿分枝杆菌感染：中国的系列病例

IF 2.1 4区医学 Q3 INFECTIOUS DISEASES

Diagnostic microbiology and infectious disease

Pub Date : 2024-11-19 DOI: 10.1016/j.diagmicrobio.2024.116621

Jianping Zhu, Miaofa Ying, Rui Zhao, Zhenwei Yu

Background

Aesthetic procedure-associated infections caused by Mycobacterium abscessus complex (MABC) have been an emerging concern. However, limited evidence is available on this topic, and there are no standard treatments. The selection of antimicrobial regimens for the effective treatment of MABC infections poses a significant challenge.

Case presentation

In this case series, we present three patients in China who developed MABC infections following various aesthetic procedures. Two patients presented with localized skin and soft tissue infections, whereas one patient developed a disseminated infection. Treatment involved a combination of intravenous amikacin and cefoxitin for more than two weeks, followed by an oral regimen comprising clarithromycin, linezolid, and moxifloxacin based on drug susceptibility testing results. Despite the treatment's efficacy, the patients experienced adverse reactions to the antibiotics, including gastrointestinal symptoms, anaemia, and hearing loss. All patients achieved successful outcomes with shorter treatment courses and no relapse during the 3-year follow-up period.

Conclusion

This case series emphasizes the importance of employing appropriate combination antibiotic therapies based on drug susceptibility testing results for aesthetic procedure-associated infection caused by MABC when specific subspecies are unidentified. The combination of intravenous aminoglycosides and cefoxitin, followed by oral sequential therapy, with the course of treatment specifically tailored to the severity of the infection, provides a valuable treatment reference for patients with MABC infections in China.

背景由复合脓肿分枝杆菌（MABC）引起的美容手术相关感染已成为一个新的关注点。然而，目前有关这一主题的证据有限，也没有标准的治疗方法。在本病例系列中，我们介绍了中国三位在接受各种美容手术后发生脓肿分枝杆菌感染的患者。其中两名患者出现局部皮肤和软组织感染，一名患者出现播散性感染。治疗包括静脉注射阿米卡星和头孢西丁两周以上，然后根据药敏试验结果口服克拉霉素、利奈唑胺和莫西沙星。尽管疗效显著，但患者仍出现了抗生素不良反应，包括胃肠道症状、贫血和听力下降。结论：本系列病例强调了在未确定具体亚种的情况下，根据药物敏感性检测结果采用适当的抗生素联合疗法治疗由 MABC 引起的美容手术相关感染的重要性。静脉注射氨基糖苷类药物和头孢西丁，然后口服序贯疗法，疗程根据感染的严重程度而定，为中国的 MABC 感染患者提供了有价值的治疗参考。

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引用次数: 0

Diagnostic value of metagenomic next-generation sequencing for bronchoalveolar lavage diagnostics in patients with lower respiratory tract infections 元基因组新一代测序在下呼吸道感染患者支气管肺泡灌洗诊断中的诊断价值

IF 2.1 4区医学 Q3 INFECTIOUS DISEASES

Diagnostic microbiology and infectious disease

Pub Date : 2024-11-17 DOI: 10.1016/j.diagmicrobio.2024.116620

Xiaojian Jiang , Hua Guo , Jia Sun , Yuanlin Guan , Ziyang Xie

Background

Current diagnostic methods of lower respiratory tract infections (LRTIs) often lack specificity, underscoring the necessity for advanced technologies such as metagenomic next-generation sequencing (mNGS).

Methods

This retrospective study compared bronchoalveolar lavage fluid (BALF) analysis using mNGS and conventional microbiological tests (CMT) to evaluate their effectiveness in pathogen identification and alignment with clinical diagnoses.

Results

In this study involving 369 patients suspected of LTRIs, mNGS identified pathogens in 342 cases (92.7%), showing superior diagnostic performance compared to CMT (58.8%). The positive agreement and negative agreement rates of mNGS were 92.7% and 96.3%, respectively, both significantly higher than those of CMT (both p<0.001). The sensitivity, specificity, positive predictive value, and negative predictive value of mNGS were significantly higher than those of CMT, with values of 99.7% vs. 57.1%, 68.4% vs. 26.3%, 96.5% vs. 87.1%, and 96.3% vs. 6.3%, respectively (all p<0.001). Pathogen detection rates among the patients showed that 89.7% had evidence of LRTIs, with bacterial infections (20.1%), mycoplasma (13.6%), mycobacterium (4.3%), fungal (4.1%), viral (3.3%), and mixed infections (44.4%) being the most common. Furthermore, the study also differentiated the distribution of pathogens between adults and pediatric patients, and assessed the impact of pathogen types on severe outcomes using multivariate logistic regression, revealing that viral and fungal infections were more likely associated with severe symptoms, whereas mycoplasma infections typically presented with milder symptoms.

Conclusions

BALF mNGS proves effective for rapid, comprehensive pathogen detection in LRTIs, warranting its early use for enhanced diagnosis and management, especially across different age groups.

背景下呼吸道感染（LRTIs）的现有诊断方法往往缺乏特异性，这凸显了元基因组下一代测序（mNGS）等先进技术的必要性。方法这项回顾性研究比较了使用 mNGS 和传统微生物检验（CMT）对支气管肺泡灌洗液（BALF）进行的分析，以评估它们在病原体鉴定方面的有效性以及与临床诊断的一致性。结果在这项涉及 369 例疑似 LRTI 患者的研究中，mNGS 鉴定出了 342 例（92.7%）病例中的病原体，与 CMT（58.8%）相比显示出更优越的诊断性能。mNGS 的阳性一致率和阴性一致率分别为 92.7% 和 96.3%，均显著高于 CMT（均 p<0.001）。mNGS 的敏感性、特异性、阳性预测值和阴性预测值均明显高于 CMT，分别为 99.7% vs. 57.1%、68.4% vs. 26.3%、96.5% vs. 87.1%、96.3% vs. 6.3%（均 p<0.001）。患者的病原体检出率显示，89.7%的患者有证据表明患有 LRTI，其中最常见的是细菌感染（20.1%）、支原体感染（13.6%）、分枝杆菌感染（4.3%）、真菌感染（4.1%）、病毒感染（3.3%）和混合感染（44.4%）。此外，该研究还区分了成人和儿童患者的病原体分布，并使用多元逻辑回归评估了病原体类型对严重后果的影响，结果显示病毒和真菌感染更可能与严重症状相关，而支原体感染通常症状较轻。

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引用次数: 0

Pseudallescheria boydii infection of the bloodstream system: First reported case from China 血液系统的假鲍曼不动杆菌（Pseudallescheria boydii）感染：中国首例报告病例。

IF 2.1 4区医学 Q3 INFECTIOUS DISEASES

Diagnostic microbiology and infectious disease

Pub Date : 2024-11-16 DOI: 10.1016/j.diagmicrobio.2024.116610

Weiwei Hou , Xuanlin Wang , Yiwen Yao , Qi Liu , Xuan Wang , Zujun Sun

Pseudallescheria boydii (P. boydii) is widely found in soil, sewage, decaying organic matter, and feces. Although it is associated with various clinical infections, no bloodstream infection has been reported. A 61-year-old male patient diagnosed with squamous cell carcinoma who is currently undergoing chemotherapy. The patient underwent blood culture sampling due to fever. Microscopic examination, SDA plate morphology, and mass spectrometry analysis confirmed the pathogen as P. boydii, which was further confirmed by internal transcribed spacer DNA sequencing. During treatment, empirical treatment voriconazole was significantly more effective than micafungin in treating P. boydii infection. In vitro antifungal susceptibility testing of the fungal isolates showed a very low MIC for voriconazole. In conclusion, bloodstream infections of P. boydii can occur in immunocompromised patients, and routine mass spectrometry techniques can assist in its rapid and accurate diagnosis. Additionally, empirical antifungal therapy with voriconazole remains effective in treating bloodstream infections caused by P. boydii.

Pseudallescheria boydii（P. boydii）广泛存在于土壤、污水、腐烂的有机物和粪便中。虽然它与各种临床感染有关，但还没有血液感染的报道。一名 61 岁的男性患者被诊断患有鳞状细胞癌，目前正在接受化疗。患者因发烧接受了血液培养采样。显微镜检查、SDA平板形态学和质谱分析证实病原体是波氏杆菌，内转录间隔DNA测序进一步证实了这一点。在治疗过程中，经验疗法伏立康唑治疗波菌感染的效果明显优于米卡芬净。对真菌分离株进行的体外抗真菌药敏试验显示，伏立康唑的 MIC 非常低。总之，免疫力低下的患者可能会感染波氏杆菌，常规质谱技术可帮助快速准确地诊断波氏杆菌。此外，使用伏立康唑进行经验性抗真菌治疗对治疗波氏杆菌引起的血流感染仍然有效。

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引用次数: 0

The relationship between the recurrence rate of genital warts and administration of quadrivalent human papilloma virus vaccine in women 女性生殖器疣复发率与接种四价人类乳头瘤病毒疫苗之间的关系

IF 2.1 4区医学 Q3 INFECTIOUS DISEASES

Diagnostic microbiology and infectious disease

Pub Date : 2024-11-16 DOI: 10.1016/j.diagmicrobio.2024.116607

Fatemeh Momeni Asl , Parvin Ghaffari , Mitra Safari

In this cohort study a total of 203 women with genital warts, who were referred to gynecology clinic of Shahid Muftah in Yasuj city between 2019 and 2022, were examined and treated by a gynecologist and trained for injection of three doses of Gardasil vaccine after treatment. Of these, 138 women completed the study. Half of them who received three doses of the Gardasil vaccine, aligned in vaccinated group and the other half served as the unvaccinated group. In the vaccinated group, 8 individuals (11.6 %) experienced recurrence, compared to 15 individuals (21.7 %) in the unvaccinated group (p = 0.11). The overall number of recurrence among all participants was 23 (16.7 %). The average duration of treatment until recurrence was 43.6 ± 24.7 weeks in the vaccinated group and 16.4 ± 16.5 weeks in the unvaccinated group (P ≤ 0.017), underscoring the vaccine's preventive role in the recurrence of genital warts.

在这项队列研究中，共有 203 名患有生殖器疣的妇女在 2019 年至 2022 年期间被转诊至亚苏杰市 Shahid Muftah 妇科诊所，接受了妇科医生的检查和治疗，并在治疗后接受了注射三剂加卫苗的培训。其中 138 名妇女完成了研究。其中一半接种了三剂加德西疫苗，被归入接种组，另一半为未接种组。接种组中有 8 人（11.6%）复发，而未接种组中有 15 人（21.7%）复发（P = 0.11）。所有参与者中复发的总人数为 23 人（16.7%）。接种疫苗组复发前的平均治疗时间为 43.6 ± 24.7 周，未接种疫苗组为 16.4 ± 16.5 周（P ≤ 0.017），这表明疫苗对生殖器疣复发具有预防作用。

引用次数: 0

Anti-biofilm activity of carvacrol-thymoquinone nanocarriers on vulvovaginal candidiasis isolates 香芹酚-胸腺醌纳米载体对外阴阴道念珠菌分离物的抗生物膜活性

IF 2.1 4区医学 Q3 INFECTIOUS DISEASES

Diagnostic microbiology and infectious disease

Pub Date : 2024-11-16 DOI: 10.1016/j.diagmicrobio.2024.116606

Maryam Hajiaghaalizadeh , Mehdi Sheikharabi , Marie Saghaeian Jazi , Raheleh Alhashem , Seyedeh Sedigheh Hosseini

Given the recurrent nature of vulvovaginal candidiasis (VVC), the restricted availability of effective antifungal agents, and the recent rise in drug resistance, this study sought to assess the antifungal efficacy of carvacrol-thymoquinone delivered via a nanocarrier on Candida isolates obtained from patients with VVC. Isolates were identified using phenotypic and genotypic methods. Nanocarriers were synthesized using the thin-film hydration method. The antifungal activity of carvacrol-thymoquinone was evaluated using the broth microdilution method (CLSIM27-A3). The impact of nanocarriers on the biofilm formation capabilities of Candida isolates was assessed using the MTT assay. Data were analyzed using the Mann-Whitney U test. The nanocarrier exhibited a spherical morphology with a diameter measuring 50 nm. The nano-formulated drug combination could inhibit biofilm formation in C. albicans at half the minimum inhibitory concentration and in C. glabrata at the minimum inhibitory concentration. Our results suggest that the carvacrol-thymoquinone nanocarrier can be studied further in vivo for potential use in the treatment of recurrent VVC.

鉴于外阴阴道念珠菌病（VVC）的复发性、有效抗真菌药物的有限性以及近期耐药性的上升，本研究试图评估通过纳米载体递送的香芹酚-胸腺醌对从外阴阴道念珠菌病患者中分离出的念珠菌的抗真菌效果。采用表型和基因型方法对分离株进行鉴定。采用薄膜水合法合成了纳米载体。采用肉汤微稀释法（CLSIM27-A3）评估了香芹酚-胸腺醌的抗真菌活性。采用 MTT 试验评估了纳米载体对念珠菌分离物生物膜形成能力的影响。数据采用 Mann-Whitney U 检验法进行分析。纳米载体呈球形，直径为 50 纳米。纳米药物组合能在最低抑制浓度的一半时抑制白僵菌生物膜的形成，在最低抑制浓度时抑制草履虫生物膜的形成。我们的研究结果表明，可以对香芹酚-胸腺醌纳米载体进行进一步的体内研究，以探索其用于治疗复发性葡萄球菌感染的可能性。

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引用次数: 0

Cytokine-based nomogram for discriminating viral pneumonia from Mycoplasma pneumoniae pneumonia in children 基于细胞因子的儿童病毒性肺炎与肺炎支原体肺炎鉴别提名图。

IF 2.1 4区医学 Q3 INFECTIOUS DISEASES

Diagnostic microbiology and infectious disease

Pub Date : 2024-11-15 DOI: 10.1016/j.diagmicrobio.2024.116611

Xiaoliang Lin, Enhui Xu, Tan Zhang, Qiguo Zhu, Yan Liu, Qiao Tian

For children with pneumonia, differential diagnosis between viral infection and Mycoplasma pneumoniae (MP) infection is difficult. We retrospectively enrolled 336 hospitalized children who were diagnosed with community-acquired pneumonia and whose infection was exclusively viral or MP. We analyzed hematological indicators, biochemical markers, and cytokines. Least absolute shrinkage and selection operator (LASSO) regression analysis and logistic regression analysis were performed to identify and validate the factors that predicted the pathogenic diagnosis. The final predictive model incorporated four factors: tumor necrosis factor-α/interleukin (IL)-10, age, IL-8 and procalcitonin. This predictive model was visualized with a nomogram and had good performance. Using logistic regression analysis, the C-index of this predictive model was 0.878. Using receiver operating characteristic plot, the area under the curve was 0.8785. We established a model with a nomogram to discriminate viral infection from MP infection in hospitalized children with community-acquired pneumonia.

对于肺炎患儿来说，病毒感染和肺炎支原体（MP）感染之间的鉴别诊断非常困难。我们回顾性地纳入了 336 名被诊断为社区获得性肺炎的住院患儿，这些患儿的感染完全是病毒感染或肺炎支原体感染。我们分析了血液指标、生化指标和细胞因子。我们进行了最小绝对收缩和选择算子（LASSO）回归分析和逻辑回归分析，以确定和验证预测病原体诊断的因素。最终的预测模型包含四个因素：肿瘤坏死因子-α/白细胞介素（IL）-10、年龄、IL-8 和降钙素原。该预测模型采用提名图直观显示，性能良好。通过逻辑回归分析，该预测模型的 C 指数为 0.878。利用接收者操作特征图，曲线下面积为 0.8785。我们利用提名图建立了一个模型，用于区分住院社区获得性肺炎患儿的病毒感染和 MP 感染。

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引用次数: 0

Triple threat: Sequential meningitis infections in an immunosuppressed patient with Morganella morganii, Acinetobacter baumannii, and vancomycin-resistant Enterococcus faecium 三重威胁：一名免疫抑制患者相继感染摩根氏菌、鲍曼不动杆菌和耐万古霉素粪肠球菌引发脑膜炎。

IF 2.1 4区医学 Q3 INFECTIOUS DISEASES

Diagnostic microbiology and infectious disease

Pub Date : 2024-11-15 DOI: 10.1016/j.diagmicrobio.2024.116609

Yasemin Çakır Kıymaz , Eren Kıymaz , Zekeriya Bulut , Seyit Ali Büyüktuna , Nazif Elaldı

Gram-negative bacilli and vancomycin-resistant enterococci (VRE) are rare causative agents in the etiology of bacterial meningitis and can lead to significant mortality due to the difficulty of treatment. This article reports three successive cases of different meningitis clinical presentations in an immunosuppressed patient diagnosed with diffuse large B-cell lymphoma. A 65-year-old male patient was initially followed with Morganella morganii meningitis. Later, the patient was diagnosed with Acinetobacter meningitis and VRE meningitis. Clinical and microbiological success was achieved following a prolonged hospital stay and antibiotic therapy.

革兰氏阴性杆菌和耐万古霉素肠球菌（VRE）是细菌性脑膜炎病因中罕见的致病菌，由于治疗困难，可导致大量死亡。本文报告了一名被诊断为弥漫大 B 细胞淋巴瘤的免疫抑制患者连续三例不同脑膜炎临床表现的病例。一名 65 岁的男性患者最初被诊断为摩根氏菌脑膜炎。后来，患者又被诊断为不动杆菌脑膜炎和 VRE 脑膜炎。经过长期住院和抗生素治疗，临床和微生物学治疗取得了成功。

引用次数: 0

Respiratory syncytial virus: Characteristics, complications and mortality in immunocompetent versus immunocompromised hospitalized adults in Northern Denmark 呼吸道合胞病毒：丹麦北部免疫功能正常与免疫功能低下的住院成年人的特征、并发症和死亡率。

IF 2.1 4区医学 Q3 INFECTIOUS DISEASES

Diagnostic microbiology and infectious disease

Pub Date : 2024-11-15 DOI: 10.1016/j.diagmicrobio.2024.116605

Trine Langfeldt Hagen , Mette Juul Nitschke , Jesper Smit

Background

Respiratory syncytial virus (RSV) is an increasingly well-known cause of severe respiratory symptoms in adults. We aimed to describe characteristics, complications and in-hospital mortality of adults admitted to hospital with RSV-related respiratory symptoms.

Methods

Data were collected from electronic health records in the North Denmark Region for hospitalized adults diagnosed with RSV between April 1st - December 31st 2021. We collected data on characteristics, complications and mortality. Results were compared between immunocompromised and -competent patients.

Results

We included 111 patients. Sixty-five percent had comorbidities and 20 % received immunosuppressive drugs. Fifty-three percent had bacterial pneumonia and 61 % needed oxygen support. Mortality was 12 %. There were no differences in complications between the compared groups.

Conclusion

Severe respiratory symptoms were frequent among RSV-patients. Bacterial co-infections were common in the study population and mortality was considerable, regardless of known immunosuppression, thus warranting thorough and early investigations in RSV-positive patients.

背景：呼吸道合胞病毒（RSV）日益成为导致成人出现严重呼吸道症状的原因。我们旨在描述因 RSV 相关呼吸道症状而入院的成人的特征、并发症和院内死亡率：我们从北丹麦地区的电子健康记录中收集了 2021 年 4 月 1 日至 12 月 31 日期间确诊为 RSV 的住院成人的数据。我们收集了有关特征、并发症和死亡率的数据。结果：我们纳入了 111 名患者：我们纳入了 111 名患者。65%的患者患有合并症，20%的患者服用了免疫抑制剂。53%的患者患有细菌性肺炎，61%的患者需要氧气支持。死亡率为12%。两组患者的并发症没有差异：结论：RSV 患者经常出现严重的呼吸道症状。结论：RSV 阳性患者经常出现严重的呼吸道症状，细菌合并感染在研究人群中很常见，无论已知的免疫抑制情况如何，死亡率都很高，因此需要对 RSV 阳性患者进行彻底和早期的检查。

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引用次数: 0

Prevalence of Japanese encephalitis infection in children below 15 years’ age, Bihar 比哈尔邦 15 岁以下儿童感染日本脑炎的流行率。

IF 2.1 4区医学 Q3 INFECTIOUS DISEASES

Diagnostic microbiology and infectious disease

Pub Date : 2024-11-14 DOI: 10.1016/j.diagmicrobio.2024.116579

Maneesh Kumar , Kamal Singh , Roshan Kamal Topno , Major Madhukar , Niyamat Ali Siddiqui , Sanjay Kumar Sinha , Krishna Pandey , Ganesh Chandra Sahoo

Japanese encephalitis (JE) is the leading cause of acute encephalitis syndromes (AES). Although Bihar has comprehensive data on JE, it ranks third behind Uttar Pradesh and Assam in terms of reported cases. We wanted to determine the incidence of JE cases in Bihar and the endemic districts. In Patna, Muzaffarpur and Gaya, Bihar, this study revealed that JEV is one of the major causes of AES and its epidemiology. We analyzed blood and CSF samples from AES patients delivered to a viral diagnostic laboratory between January 2018 and December 2022 for IgM antibodies against JEV using the enzyme immunoassay recommended by NIV, Pune, India. We detected JEV IgM in 193 (8.79 %) of 2195 individuals. Patient demographics included age, gender and place of residence. Most patients were 6–10 years old and had the disease in June. We need to increase awareness initiatives and cross-sector prevention despite the decline in case fatality rate.

日本脑炎（JE）是急性脑炎综合症（AES）的主要病因。虽然比哈尔邦拥有全面的 JE 数据，但就报告病例而言，它仅次于北方邦和阿萨姆邦，排名第三。我们希望确定比哈尔邦和流行区的 JE 病例发病率。在比哈尔邦的巴特那、穆扎法尔布尔和加亚，这项研究揭示了 JEV 是导致 AES 及其流行病学的主要原因之一。我们使用印度浦那 NIV 推荐的酶免疫测定法分析了 2018 年 1 月至 2022 年 12 月间送到病毒诊断实验室的 AES 患者的血液和脑脊液样本，以检测 JEV 的 IgM 抗体。我们在 2195 人中的 193 人（8.79%）中检测到了 JEV IgM。患者的人口统计学特征包括年龄、性别和居住地。大多数患者的年龄在 6-10 岁之间，发病时间在 6 月份。尽管病死率有所下降，但我们仍需要加强宣传和跨部门预防。

引用次数: 0

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