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From pandemic influenza to novel coronaviruses: emerging infectious diseases of the 21st century 从大流行性流感到新型冠状病毒:21世纪新发传染病
IF 1.8 4区 医学 Q3 INFECTIOUS DISEASES Pub Date : 2026-01-15 DOI: 10.1016/j.diagmicrobio.2026.117277
Sijo Asokan , Isiaka Ismaila Damilare , Sunil Kumar , Rohan Kumar Pandey , Gaurav Verma , Nilotpal Banerjee , Guhanraj Radhamanalan , Smitha Vijayan , Teena Jacob , Divya Rajeswary
Emerging infectious diseases have risen significantly in the twenty-first century as ecological disruption, climate change, expanding human–animal interfaces, and global mobility intensify opportunities for pathogen transmission. This review synthesizes historical and contemporary evidence across viral, bacterial, fungal, and parasitic threats to characterize how diverse pathogens emerge and spread. Foundational events such as the 1918 influenza pandemic, mid-century influenza pandemics, the emergence of HIV/AIDS, and the eradication of smallpox provide context for understanding modern disease dynamics. In recent decades, coronaviruses including SARS, MERS, and SARS-CoV-2, pandemic H1N1, avian influenza subtypes, and major arboviruses such as dengue, chikungunya, Zika, West Nile virus, and yellow fever have demonstrated the rapidity with which zoonotic pathogens can disseminate globally. Viral hemorrhagic fevers including Ebola, Marburg, Lassa, and Crimean–Congo hemorrhagic fever remain critical threats, especially in regions with limited health-care capacity. Concurrently, antimicrobial resistance, the emergence of Candida auris, and the climate-driven expansion of endemic mycoses involving Histoplasma, Coccidioides, and Blastomyces highlight the increasing importance of fungal pathogens. Parasitic diseases such as artemisinin-resistant malaria, zoonotic trypanosomiasis, and expanding Leishmania transmission reflect shifting ecological conditions. These patterns are shaped by intersecting drivers including deforestation, wildlife trade, agricultural intensification, urban crowding, conflict, and rapid microbial evolution that enable spillover and sustained transmission. Although advances in genomic surveillance, metagenomic diagnostics, mRNA vaccines, monoclonal antibodies, and broad-spectrum antivirals have strengthened global response capacity, substantial gaps persist in equity, surveillance, and access to countermeasures. Strengthening One Health systems and resilient public health infrastructures is essential to anticipate and mitigate emerging infectious threats.
随着生态破坏、气候变化、人与动物接触面扩大以及全球流动性加剧了病原体传播的机会,21世纪新发传染病显著增加。这篇综述综合了病毒、细菌、真菌和寄生虫威胁的历史和当代证据,以表征各种病原体如何出现和传播。1918年流感大流行、本世纪中叶流感大流行、艾滋病毒/艾滋病的出现和天花的根除等基础性事件为理解现代疾病动态提供了背景。近几十年来,包括SARS、中东呼吸综合征和SARS- cov -2在内的冠状病毒、H1N1大流行、禽流感亚型以及登革热、基孔肯雅热、寨卡病毒、西尼罗河病毒和黄热病等主要虫媒病毒已经证明,人畜共患病原体可以迅速在全球传播。包括埃博拉、马尔堡、拉沙和克里米亚-刚果出血热在内的病毒性出血热仍然是严重威胁,特别是在卫生保健能力有限的地区。与此同时,抗菌素耐药性、耳念珠菌的出现,以及由气候驱动的地方性真菌病(包括组织原体、球虫和芽生菌)的扩大,凸显了真菌病原体日益重要的意义。抗青蒿素疟疾、人畜共患锥虫病和利什曼原虫传播扩大等寄生虫病反映了生态条件的变化。这些模式是由交叉驱动因素形成的,包括森林砍伐、野生动物贸易、农业集约化、城市拥挤、冲突和微生物的快速进化,这些因素使溢出效应和持续传播成为可能。尽管基因组监测、宏基因组诊断、mRNA疫苗、单克隆抗体和广谱抗病毒药物方面的进展加强了全球应对能力,但在公平、监测和获得对策方面仍然存在巨大差距。加强“一个卫生”系统和具有复原力的公共卫生基础设施对于预测和减轻新出现的传染性威胁至关重要。
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引用次数: 0
Construction of a superspectrum for rapid identification of opportunistic human pathogens belonging to the genus Phytobacter using whole-cell MALDI-TOF MS 利用全细胞MALDI-TOF质谱技术构建植物杆菌属机会致病菌的超光谱快速鉴定
IF 1.8 4区 医学 Q3 INFECTIOUS DISEASES Pub Date : 2026-01-15 DOI: 10.1016/j.diagmicrobio.2026.117275
Alana Mazzetti , Helena R.S. D’Espindula , Debora O. Kulek , Karen L. Jones , Leticia Kraft , Theo H.M. Smits , Fabio Rezzonico , Marcelo T. Mira , Marcelo Pillonetto

Background

Members of the genus Phytobacter, part of the Enterobacteriaceae, represent an emerging clinical threat. Standard identification methodologies often fail to accurately identify members of this genus because they are absent from current clinical databases. Molecular techniques are thus pivotal for differentiating Phytobacter from similar genera such as Pantoea, Kluyvera, and Kosakonia. Matrix-assisted laser desorption ionization-time-of-flight mass spectrometry (MALDI-TOF MS) provides a rapid, reliable, and cost-effective method for identification.

Methods

A Phytobacter-specific SuperSpectrum was constructed from 18 well-characterized isolates using standardized culture conditions, protein extraction, and triplicate MALDI-TOF MS acquisition. Only conserved, high-quality peaks were retained in the final model. Its performance was evaluated using 282 retrospective isolates and 23 prospective Phytobacter-suspect isolates. All Phytobacter identifications, along with 154 non-Phytobacter identifications, were benchmarked against API 20E biochemical testing, VITEK-2 automated identification, MALDI-TOF MS current database for in vitro diagnostic analysis, 16S rRNA gene sequencing, and whole-genome sequencing (WGS).

Results

Spectral clustering showed consistent separation of Phytobacter at the genus level. Integration of the new SuperSpectrum into the MALDI-TOF MS SARAMIS database enabled accurate identification, leading to the identification of two retrospective Phytobacter out of 282 Enterobacterales isolates. Finally, prospective testing of 23 contemporary isolates suspected to belong to Phytobacter confirmed their identification against the new reference spectra, achieving 100% concordance with WGS identification, demonstrating the reliability of the updated database for genus-level identification.

Conclusion

Phytobacter identification by MALDI-TOF MS provides a rapid alternative method for molecular identification of this emerging pathogen.
植物杆菌属的成员,肠杆菌科的一部分,代表了一个新兴的临床威胁。标准的鉴定方法往往不能准确地识别这一属的成员,因为他们不存在于目前的临床数据库。因此,分子技术是区分植物杆菌与类似属(如Pantoea, Kluyvera和Kosakonia)的关键。基质辅助激光解吸电离飞行时间质谱(MALDI-TOF MS)提供了一种快速、可靠、经济的鉴定方法。方法采用标准化培养条件、蛋白提取、三次MALDI-TOF MS采集等方法,对18株植物细菌进行超谱分析。最终模型中只保留了守恒的、高质量的峰。利用282株回顾性分离株和23株疑似植物杆菌的前瞻性分离株对其性能进行了评价。所有Phytobacter鉴定以及154个非Phytobacter鉴定均以API 20E生化测试、vittek -2自动鉴定、MALDI-TOF MS当前体外诊断分析数据库、16S rRNA基因测序和全基因组测序(WGS)为基准。结果光谱聚类显示植物杆菌在属水平上的分离一致。将新的SuperSpectrum整合到MALDI-TOF MS SARAMIS数据库中可以实现准确的鉴定,从而在282株肠杆菌中鉴定出2株回顾性植物杆菌。最后,对23株疑似属于Phytobacter的当代分离物进行前瞻性测试,证实了它们与新的参考光谱的鉴定,与WGS鉴定的一致性达到100%,证明了更新后的数据库用于属水平鉴定的可靠性。结论利用MALDI-TOF质谱法对植物病原菌进行鉴定是一种快速的分子鉴定方法。
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引用次数: 0
Achieving 24-hour reporting turnaround for clinical surveillance detection of eight carbapenemase genes using combined multiplex molecular assays 实现24小时报告周转临床监测检测八个碳青霉烯酶基因使用多重分子联合测定
IF 1.8 4区 医学 Q3 INFECTIOUS DISEASES Pub Date : 2026-01-15 DOI: 10.1016/j.diagmicrobio.2026.117273
Majie C. Foster, Kailee Cummings, Mohammad Y. Khan, Janine Bodnar, Christine Jacobsen, Kara Miller, Nicola Faraci, Shannon Morris, Catharine Prussing, Elizabeth Nazarian, Kimberlee A. Musser
Carbapenemase-producing organisms, including carbapenem-resistant Enterobacterales, Acinetobacter and Pseudomonas species, contribute to over 49,000 infections and >4,000 deaths annually in the United States. The Centers for Disease Control and Prevention recommends surveillance using dual swab testing.
While a culture-first approach is routinely utilized for carbapenemase-producing organism screening, results require 3 workdays or more. In contrast, Wadsworth Center employs a molecular-first algorithm, combining the Cepheid Xpert Carba-R assay with laboratory developed test multiplex PCR. Using shared reagents for efficiency and specimen preservation, this method detects the most prevalent carbapenemase genes, blaKPC, blaNDM, blaVIM, blaOXA-48-like, and blaIMP, as well as Acinetobacter baumannii-associated genes, blaOXA-23-like, blaOXA-24/40-like, and blaOXA-58-like, and produces actionable results in less than one workday. Wadsworth Center’s rapid carbapenemase-producing organism colonization screening algorithm supports prompt healthcare protocol initiation and epidemiological response.
产碳青霉烯酶的生物,包括耐碳青霉烯的肠杆菌、不动杆菌和假单胞菌,每年在美国造成49,000多例感染和4,000例死亡。疾病控制和预防中心建议使用双拭子检测进行监测。虽然碳青霉烯酶产生生物筛选通常采用培养优先方法,但结果需要3个工作日或更长时间。相比之下,Wadsworth中心采用分子优先算法,将造父变星Xpert Carba-R检测与实验室开发的多重PCR检测相结合。为了提高效率和标本保存,该方法使用共享试剂,检测最常见的碳青霉烯酶基因blaKPC、blaNDM、blaVIM、blaoxa -48样和blaIMP,以及鲍曼不动杆菌相关基因blaoxa -23样、blaoxa -24/40样和blaoxa -58样,并在不到一个工作日内产生可操作的结果。Wadsworth中心的快速碳青霉烯酶产生生物定植筛选算法支持快速医疗方案启动和流行病学反应。
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引用次数: 0
Perinephritic and psoas abscess by an unusual coinfection with Trichomonas vaginalis and Lactobacillus johnsonii 由阴道毛滴虫和约氏乳杆菌不寻常的合并感染引起的肾周性脓肿和腰肌脓肿
IF 1.8 4区 医学 Q3 INFECTIOUS DISEASES Pub Date : 2026-01-15 DOI: 10.1016/j.diagmicrobio.2026.117276
Min Quan , Xiaoxia Zhang , Chao Chen , Yu Feng , Xiaoju Lv , Xiaohui Wang , Hui Ye
Trichomoniasis, caused by Trichomonas vaginalis, is a common nonviral sexually transmitted infection that presents with vaginitis, urethritis, cystitis, prostatitis, and rarely perinephric abscess. Here we presented a 49-year-old female with fever and lumbago diagnosed with a coinfection of perinephric and psoas abscess caused by Lactobacillus johnsonii and T. vaginalis, with the etiological diagnosis established using pus culture and metagenomic next-generation sequencing (mNGS). The patient achieved complete recovery following abscess drainage, incision, and combined therapy with metronidazole and piperacillin/tazobactam. Rare manifestations of trichomoniasis are easily misdiagnosed, and mNGS can help identify T. vaginalis quickly and accurately without prediction.
滴虫病由阴道毛滴虫引起,是一种常见的非病毒性性传播感染,表现为阴道炎、尿道炎、膀胱炎、前列腺炎,很少出现肾周脓肿。我们报告了一位49岁的女性患者,她患有发热和腰痛,并被诊断为由约氏乳杆菌和阴道T.引起的肾周和腰肌脓肿合并感染,病因学诊断采用脓液培养和元基因组新一代测序(mNGS)建立。患者经脓肿引流、切开、甲硝唑联合哌拉西林/他唑巴坦治疗后完全康复。滴虫病的罕见表现容易被误诊,而mNGS可以帮助快速准确地识别阴道滴虫而无需预测。
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引用次数: 0
Eighteen-year laboratory-based surveillance of human coronavirus OC43 in a single tertiary hospital in the Republic of Korea: Temporal inflection, seasonal stability, and age-dependent risk 韩国一家三级医院对人冠状病毒OC43的18年实验室监测:时间变异、季节性稳定性和年龄依赖性风险
IF 1.8 4区 医学 Q3 INFECTIOUS DISEASES Pub Date : 2026-01-14 DOI: 10.1016/j.diagmicrobio.2026.117274
Mi-Ru Oh , Ga-Yeon Kim , Jeong Su Han , Jae Kyung Kim
Human coronavirus OC43 (HCoV-OC43), a member of the betacoronavirus genus, is a seasonally circulating respiratory virus that persists globally; however, long-term laboratory-based surveillance data remain limited. We analyzed multiplex real-time PCR test results collected at Dankook University Hospital between 2007 and 2024 to comprehensively evaluate long-term annual trends, seasonal structure, and age-specific detection patterns of HCoV-OC43.
Based on nasopharyngeal swab specimens, the annual positivity rate of HCoV-OC43 ranged from 0.16% to 3.05%. A marked suppression in detection was observed during the COVID-19 pandemic (2020–2021) compared with the pre-pandemic years. This was followed by a partial recovery in 2022–2023; however, detection declined again in 2024 without fully returning to pre-pandemic levels. Seasonal analysis demonstrated a consistent winter predominance throughout the study, with the highest positivity observed in winter (4.44%) and the lowest in summer (1.16%), despite interannual variability. Age-specific analysis revealed highest positivity rates in early childhood 1–4 years (3.12%) and among infants aged 0 years (2.71%), followed by a progressive decline in detection across school-age children, adolescents, adults, and older adults, indicating a clear age-dependent distribution. These findings provide laboratory-based evidence characterizing the temporal, seasonal, and age-related detection patterns of HCoV-OC43 using long-term diagnostic data from a single institution. This information may serve as a reference for interpreting routine respiratory virus testing results and understanding seasonal diagnostic demand and surveillance strategies in clinical practice.
人类冠状病毒OC43 (HCoV-OC43)是冠状病毒属的成员,是一种季节性传播的呼吸道病毒,在全球持续存在;然而,基于实验室的长期监测数据仍然有限。我们分析了2007年至2024年在檀国大学医院收集的多重实时PCR检测结果,以综合评估HCoV-OC43的长期年度趋势、季节性结构和年龄特异性检测模式。基于鼻咽拭子标本,HCoV-OC43年阳性率为0.16% ~ 3.05%。与大流行前相比,在2019冠状病毒病大流行期间(2020-2021年),检测数量明显下降。随后在2022-2023年出现部分复苏;然而,检出率在2024年再次下降,没有完全恢复到大流行前的水平。季节分析表明,尽管存在年际差异,但冬季的阳性率最高(4.44%),夏季的阳性率最低(1.16%)。年龄特异性分析显示,1-4岁幼儿(3.12%)和0岁婴儿(2.71%)的阳性率最高,其次是学龄儿童、青少年、成年人和老年人的阳性率逐渐下降,表明明显的年龄依赖性分布。这些发现提供了基于实验室的证据,利用来自单一机构的长期诊断数据,表征了HCoV-OC43的时间、季节和年龄相关检测模式。这些信息可作为解释常规呼吸道病毒检测结果和了解临床实践中的季节性诊断需求和监测策略的参考。
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引用次数: 0
Molecular detection and phylogenetic analysis of KI polyomavirus and WU polyomavirus in respiratory tract samples from children under five 5岁以下儿童呼吸道KI多瘤病毒和WU多瘤病毒的分子检测及系统发育分析
IF 1.8 4区 医学 Q3 INFECTIOUS DISEASES Pub Date : 2026-01-14 DOI: 10.1016/j.diagmicrobio.2026.117272
Hanife Tutan , Yeşim Tok , Mert Ahmet Kuşkucu

Background and Aim

We aimed to investigate the frequency of KI and WU polyomavirus in respiratory tract samples, the affected groups by these viruses and their clinical characteristics. Although the viruses had been discovered in 2007, their pathogenicity and virulence have not been fully elucidated yet.

Methods

We examined 182 nasopharyngeal aspirate/swab samples obtained pediatric patients younger than five years and sent to our laboratory between 2016 and 2019. The viruses were investigated by nested-polymerase chain reaction using primers targeting partial VP1 gene regions. The positive samples were sequenced using Sanger method for verification and compare the genetic distances between partially amplified gene regions.

Results

KIPyV was detected in seven (3.8%) of 182 samples and WUPyV in two (1.1%). Except one KIPyV positive patient, all positive samples belonged to patients <2 years of age. All positive patients were coinfected mainly by rhinovirus and parainfluenza virus 3. Four of the patients positive for KIPyV had haematologic/oncologic diseases or other immunodeficiency conditions. While all of the sequences of KIPyV isolates were 100% similar, sequences of WUPyV isolates differed at 4 nucleotide positions.

Conclusion

According to the results of our study, the frequency of KIPyV and WUPyV infections is low, simultaneous respiratory tract infections caused by other viral or bacterial pathogens, immunosuppression appears to be a predisposing factors for the KIPyV and WUPyV infections. The partially amplified gene regions were highly conserved in both viruses.
目的探讨KI和WU多瘤病毒在呼吸道感染的频率、感染人群及临床特点。虽然这些病毒早在2007年就被发现,但它们的致病性和毒力尚未完全阐明。方法对2016年至2019年间送到我们实验室的182例5岁以下儿科患者的鼻咽抽吸/拭子样本进行检测。采用巢式聚合酶链反应,利用引物靶向部分VP1基因区域对病毒进行研究。阳性样本采用Sanger法进行测序验证,比较部分扩增基因区域之间的遗传距离。结果182份样本中检出skipyv 7例(3.8%),WUPyV 2例(1.1%)。除1例KIPyV阳性外,其余阳性标本均为2岁患者。所有阳性患者均以鼻病毒和副流感病毒3型为主。KIPyV阳性的患者中有4人患有血液学/肿瘤学疾病或其他免疫缺陷疾病。KIPyV分离株的序列100%相似,而WUPyV分离株的序列在4个核苷酸位置上存在差异。结论根据我们的研究结果,KIPyV和WUPyV感染的频率较低,同时由其他病毒或细菌病原体引起的呼吸道感染,免疫抑制可能是KIPyV和WUPyV感染的易感因素。部分扩增的基因区域在两种病毒中高度保守。
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引用次数: 0
Serological and molecular detection of toxoplasma gondii and Risk factor analysis among the human population of Lahore, Pakistan 巴基斯坦拉合尔人群刚地弓形虫血清学和分子检测及危险因素分析
IF 1.8 4区 医学 Q3 INFECTIOUS DISEASES Pub Date : 2026-01-13 DOI: 10.1016/j.diagmicrobio.2026.117271
Mateen Arshad, Zunera Shafiq, Ghazala Jabeen, Zakia Kanwal, Saima Sharif, Hafsa Javed, Farzana Rashid

Introduction

Toxoplasma gondii has a global epidemiology as a common apicomplexan parasite that affects homoeothermic vertebrates, including humans. It is believed that over one billion individuals are infected globally. The study aimed to determine the seroprevalence and molecular detection of T. gondii among residents of Lahore, Pakistan, and to identify associated demographic and behavioral risk factors.

Methods

A cross-sectional study was conducted in which a total of 800 participants from Lahore were included. Blood samples were collected for serological testing using the Latex Agglutination Test (LAT) and the IgM-specific ELISA whereas molecular detection and genetic characterization were performed on 26 ELISA-positive samples using PCR amplification and SAG1 gene sequencing. Demographic, behavioral, and environmental risk factors were assessed through structured questionnaires. Statistical analyses were conducted using SPSS v26, with significance set at p ≤ 0.05.

Results

The result revealed LAT positivity was 55.5%, whereas ELISA detected 5.9% IgM-positive cases. PCR confirmed active infection in 2 individuals, with rare co-positivity. Higher seroprevalence was observed in females, adults aged 30–49 years, participants with lower education, and those practicing boiled water consumption or owning pets. Notably, fruit and vegetable washing practices were significantly associated with both serological and PCR positivity (p < 0.01). Genetic analysis identified Type I T. gondii strains closely related to the Tg3-DRC-Eg reference strain.

Conclusion

The present study demonstrates the complementary roles of serological and molecular assays for accurate detection of T. gondii. Key demographic and behavioral factors, particularly hygiene and food-handling practices, influence local infection risk.
简介:刚地弓形虫作为一种影响包括人类在内的恒温脊椎动物的常见顶复合体寄生虫,在全球流行。据信,全球有超过10亿人受到感染。本研究旨在确定巴基斯坦拉合尔居民中弓形虫的血清阳性率和分子检测,并确定相关的人口统计学和行为危险因素。方法:采用横断面研究方法,对来自拉合尔的800名参与者进行研究。采集血样,采用乳胶凝集试验(Latex Agglutination Test, LAT)和igm特异性酶联免疫吸附试验(ELISA)进行血清学检测,对26份ELISA阳性样本采用PCR扩增和SAG1基因测序进行分子检测和遗传鉴定。通过结构化问卷对人口、行为和环境风险因素进行评估。采用SPSS v26进行统计学分析,p≤0.05为显著性。结果:LAT阳性率为55.5%,ELISA阳性率为5.9%。PCR证实2例活动性感染,罕见共阳性。在女性、年龄在30-49岁的成年人、受教育程度较低的参与者、经常喝开水或养宠物的参与者中,血清阳性率较高。值得注意的是,水果和蔬菜清洗方法与血清学和PCR阳性均显著相关(p < 0.01)。遗传分析鉴定出与Tg3-DRC-Eg参考菌株密切相关的I型弓形虫菌株。结论:血清学和分子检测在准确检测弓形虫中具有互补作用。关键的人口和行为因素,特别是卫生和食品处理做法,影响当地感染风险。
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引用次数: 0
Cover 2 - Aims/Scopes, Ed Board 封面2 -目标/范围,教育局
IF 1.8 4区 医学 Q3 INFECTIOUS DISEASES Pub Date : 2026-01-12 DOI: 10.1016/S0732-8893(26)00004-0
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引用次数: 0
Aspergillus fumigatus brain abscess in an immunocompromised patient receiving a second-generation Bruton Tyrosine Kinase inhibitor (BTKi) 接受第二代布鲁顿酪氨酸激酶抑制剂(BTKi)治疗的免疫功能低下患者的烟曲霉脑脓肿。
IF 1.8 4区 医学 Q3 INFECTIOUS DISEASES Pub Date : 2026-01-10 DOI: 10.1016/j.diagmicrobio.2026.117270
Marios Lampros , Eleni Romeo , Christos Kittas , Georgios Kafritsas , George A. Alexiou , Spyridon Voulgaris
Chronic lymphocytic leukemia (CLL) is a frequent type of adult leukemia. Bruton Tyrosine Kinase inhibitors (BTKi) are first-line treatments for CLL. Despite being efficient, BTKi have also been associated with significant side effects, including arrhythmias, hemorrhagic complications, and opportunistic infections. Zanubrutinib is a second-generation BTKi that recently received FDA approval for CLL and is associated with improved outcomes and a better safety profile compared to first-generation BTKi. In the present study, we report a case of a patient with CLL, with an in-range absolute neutrophil count and an isolated Aspergillus fumigatus brain abscess mimicking a brain tumor. The lesion was excised "en bloc", and lesion cultures revealed Aspergillus fumigatus sensitive to amphotericin and voriconazole. The patient received postoperative treatment with voriconazole. While invasive fungal infections with brain involvement have been previously reported, to our knowledge, this is the first documented case of an isolated Aspergillus fumigatus brain abscess in a patient receiving zanubrutinib.
慢性淋巴细胞白血病(CLL)是一种常见的成人白血病。布鲁顿酪氨酸激酶抑制剂(BTKi)是CLL的一线治疗方法。尽管有效,BTKi也有明显的副作用,包括心律失常、出血性并发症和机会性感染。Zanubrutinib是第二代BTKi,最近获得FDA批准用于治疗CLL,与第一代BTKi相比,它具有改善的结果和更好的安全性。在本研究中,我们报告了一例CLL患者,其绝对中性粒细胞计数在一定范围内,并且孤立的烟曲霉脑脓肿模拟脑肿瘤。病灶“整体”切除,病灶培养显示烟曲霉对两性霉素和伏立康唑敏感。术后给予伏立康唑治疗。虽然侵袭性真菌感染累及大脑之前已有报道,但据我们所知,这是第一例在接受扎鲁替尼治疗的患者中发生孤立烟曲霉脑脓肿的病例。
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引用次数: 0
Strongyloides stercoralis in type 2 diabetes mellitus: discordant stool and serologic findings in an endemic Brazilian population 2型糖尿病伴粪类圆线虫:巴西一个地方性人群中不一致的大便和血清学结果
IF 1.8 4区 医学 Q3 INFECTIOUS DISEASES Pub Date : 2026-01-09 DOI: 10.1016/j.diagmicrobio.2026.117269
Jefferson Elias-Oliveira , Émelin Alves dos Santos , Laura Vilela Souza , Bruna Campos da Silva , Márcia Carolina Mazzaro , Joao Batista Alves de Souza , Ivanildes Solange da Costa Barcelos , Rosângela Maria Rodrigues
Strongyloides stercoralis is a neglected soil-transmitted helminth capable of causing hyperinfection and disseminated disease in immunocompromised hosts. Type 2 diabetes mellitus (T2D) is associated with immune dysfunction and may increase susceptibility to strongyloidiasis, although data in diabetic populations remain limited. In endemic areas, discrepancies between stool-based and serologic tests may impair accurate diagnosis. We conducted a cross-sectional study in an endemic area of Central Brazil including 80 adults with T2D and 80 non-diabetic controls. Three stool samples per participant were examined by spontaneous sedimentation (Lutz), Rugai, and agar plate culture. Serum IgG anti-Strongyloides antibodies were detected by ELISA using an alkaline extract of Strongyloides venezuelensis larvae, and ELISA-reactive samples were confirmed by immunoblotting. Intestinal parasites or commensal protozoa were identified in 37.5 % of T2D patients and 32.5 % of controls, with no significant difference. Stool positivity for S. stercoralis was low in both groups (1.2 % in T2D vs 7.5 % in controls). Conversely, IgG ELISA seropositivity was significantly higher among T2D patients (31.2 %) than in controls (16.2 %; p = 0.0122). Among ELISA-reactive samples, immunoblot confirmation was obtained in 60 % of T2D patients and 69 % of controls. These results reveal a clear discordance between parasitologic and serologic findings, particularly in T2D patients, who exhibited increased serologic evidence of S. stercoralis infection despite minimal stool-based detection. In this endemic setting, the combination of ELISA followed by immunoblotting emerges as a valuable complementary strategy for diagnosing strongyloidiasis, especially in individuals with T2D who may present altered immune responses and lower sensitivity to stool-based methods.
粪圆形线虫是一种被忽视的土壤传播蠕虫,能够在免疫功能低下的宿主中引起过度感染和播散性疾病。2型糖尿病(T2D)与免疫功能障碍有关,并可能增加对类圆线虫病的易感性,尽管糖尿病人群的数据仍然有限。在流行地区,基于粪便和血清学检测之间的差异可能会损害准确诊断。我们在巴西中部的一个流行地区进行了一项横断面研究,包括80名成年T2D患者和80名非糖尿病对照组。每个参与者的三个粪便样本通过自然沉降(Lutz),如盖和琼脂平板培养进行检查。采用委内瑞拉圆线虫幼虫碱性提取液,采用ELISA法检测血清中抗圆线虫IgG抗体,免疫印迹法对阳性样品进行检测。T2D患者和对照组中分别有37.5%和32.5%的肠道寄生虫或共生原生动物,差异无统计学意义。两组粪便粪球菌阳性率均较低(T2D组为1.2%,对照组为7.5%)。相反,T2D患者IgG ELISA血清阳性率(31.2%)明显高于对照组(16.2%,p = 0.0122)。在elisa反应样本中,60%的T2D患者和69%的对照组获得免疫印迹确认。这些结果揭示了寄生虫学和血清学发现之间的明显不一致,特别是在T2D患者中,尽管粪便检测很少,但其血清学证据显示粪球菌感染增加。在这种地方性的环境中,ELISA和免疫印迹的结合成为一种诊断圆线虫病的有价值的补充策略,特别是在患有T2D的个体中,他们可能表现出免疫反应改变和对基于粪便的方法敏感性较低。
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Diagnostic microbiology and infectious disease
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