Diagnostic microbiology and infectious disease最新文献_第4页

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

Diagnostic microbiology and infectious disease

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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引用次数: 0

Design, validation and evaluation of a triplex real time qualitative PCR assay targeting zoonotic Capnocytophaga species in EDTA whole blood and plasma simulated clinical specimens EDTA全血和血浆模拟临床标本人畜共患病吞噬菌三重实时定性PCR检测方法的设计、验证和评价

IF 1.8 4区医学 Q3 INFECTIOUS DISEASES

Diagnostic microbiology and infectious disease

Pub Date : 2026-01-09 DOI: 10.1016/j.diagmicrobio.2026.117268

A.M. Szewc , A.C. Nicholson , K. Livingston, C. Hopper, J.R. McQuiston

Found in the oral microbiome of cats and dogs, bacteria from the genus Capnocytophaga occasionally infect humans and can cause serious disease or death if not identified and treated promptly. Described here is a real-time triplex qualitative PCR assay designed using gene targets (rplV and secY) identified as diagnostically relevant by analysis of genomes from the Capnocytophaga species. The assay was evaluated on simulated EDTA whole blood samples/plasma and is effective at detecting down to 10 copies per microliter (10000 copies per mL, 4 log/mL) for whole blood samples (rplV /secY), and 1 copy per microliter (1000 copies per mL, 3 log mL) (rplV) and 0.5 copy per microliter (500 copies per mL, 2.69 log mL) (secY) for plasma samples. Analytical sensitivity, specificity, and reproducibility were established in plasmid-spiked simulated EDTA whole blood and plasma specimens, and clinical performance in Capnocytophaga-positive patient samples remains to be determined.

在猫和狗的口腔微生物群中发现，来自嗜糖菌属的细菌偶尔会感染人类，如果不及时发现和治疗，可能导致严重疾病或死亡。本文描述了一种实时三重定性PCR检测方法，该方法使用基因靶标（rplV和secY）设计，通过分析碳吞噬菌物种的基因组，确定了与诊断相关的基因。该方法在模拟EDTA全血样本/血浆中进行了评估，对于全血样本（rplV /secY），有效检测到每微升10个拷贝（10000个拷贝/mL， 4 log/mL），对于血浆样本（rplV /secY），有效检测到每微升1个拷贝（1000个拷贝/mL， 3 log mL）和每微升0.5个拷贝（500个拷贝/mL， 2.69 log mL）。在质粒加标模拟EDTA全血和血浆标本中建立了分析敏感性、特异性和可重复性，在capnocytophaga阳性患者样本中的临床表现仍有待确定。

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引用次数: 0

Significance of parvovirus B19 infection in childhood - collection of demographic data, clinical presentation, diagnostic findings and the impact on patients with hemolytic anemia 小儿细小病毒B19感染的意义——收集人口统计资料、临床表现、诊断结果及对溶血性贫血患者的影响

IF 1.8 4区医学 Q3 INFECTIOUS DISEASES

Diagnostic microbiology and infectious disease

Pub Date : 2026-01-09 DOI: 10.1016/j.diagmicrobio.2026.117263

Lorraine Lawatsch , Michael Baier , Till Milde , Bernd Gruhn

Introduction

Parvovirus B19 is a known cause of erythema infectiosum, aplastic crises and severe anemia, especially in patients with hemolytic anemia. The aim of this study was to investigate the clinical and diagnostic parameters of parvovirus B19 infection in children with and without hemolytic anemia and to record the course of case numbers in recent years.

Methods

We retrospectively included all patients diagnosed with acute parvovirus B19 infection at the Department of Pediatrics, Jena University Hospital, Jena, Germany between 2016 and 2024. Diagnosis was confirmed by positive parvovirus B19 IgM serology and/or PCR testing. Both demographic and clinical data as well as diagnostic parameters were collected and analyzed, focusing on differences between children with and without underlying hemolytic anemia.

Results

Among the 40 pediatric patients included in this study, 14 patients were diagnosed with hemolytic anemia. Children with hemolytic anemia suffered from a significantly greater hemoglobin drop and a significantly higher need for transfusion compared to children without hemolytic anemia. A Poisson regression model, adjusted for observation time, was used to compare case rates between 2016 and 2022 and 2023-2024.The model demonstrated a more than fivefold increase in parvovirus B19 cases in 2023-2024 compared to 2016-2022.

Conclusion

Children with hemolytic anemia, such as spherocytosis, are at higher risk of severe anemia and require more frequently transfusions during acute parvovirus B19 infection. The observed increase in cases after 2022 suggests changing epidemiological patterns and highlights the need for careful surveillance and early diagnostic and therapeutic interventions in affected children.

简介：细小病毒B19是一种已知的传染性红斑、再生危象和严重贫血的病因，特别是在溶血性贫血患者中。本研究旨在探讨溶血性贫血和非溶血性贫血儿童细小病毒B19感染的临床和诊断参数，并记录近年来病例数的变化过程。方法：回顾性纳入2016年至2024年在德国耶拿大学医院儿科诊断为急性细小病毒B19感染的所有患者。细小病毒B19 IgM血清学和/或PCR检测阳性证实诊断。收集和分析了人口统计学和临床数据以及诊断参数，重点关注有和无潜在溶血性贫血的儿童之间的差异。结果：本研究纳入的40例儿童患者中，有14例诊断为溶血性贫血。与没有溶血性贫血的儿童相比，患有溶血性贫血的儿童血红蛋白下降明显更大，输血需求明显更高。使用泊松回归模型（泊松回归模型经观测时间调整）比较2016 - 2022年和2023-2024年的病例率。该模型显示，与2016-2022年相比，2023-2024年细小病毒B19病例增加了五倍多。结论：急性细小病毒B19感染时，溶血性贫血（如球形红细胞增多症）患儿发生严重贫血的风险较高，需要更频繁的输血。2022年后观察到的病例增加表明流行病学模式正在发生变化，并强调需要对受影响儿童进行仔细监测和早期诊断和治疗干预。

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引用次数: 0

A direct comparison of STS-PCR and RFLP for detection and subtyping of human Blastocystis in Iran. 伊朗人囊虫STS-PCR与RFLP检测和分型的直接比较。

IF 1.8 4区医学 Q3 INFECTIOUS DISEASES

Diagnostic microbiology and infectious disease

Pub Date : 2026-01-09 DOI: 10.1016/j.diagmicrobio.2026.117265

Ehsan Karimi, Zohreh Momeni, Vahid Nasiri, Azar Sabokbar

Blastocystis is a genetically diverse unicellular eukaryotic intestinal parasite with no gold-standard diagnostic method. This study, conducted in Iran, is the first to directly compare Sequence-Tagged Site (STS) PCR and restriction fragment length polymorphism (RFLP) for its diagnosis of human. It builds on our previous work with the same cohort. We aimed to evaluate the diagnostic sensitivity and specificity of these methods using nested PCR as the internal reference. In addition, we assessed subtypes and genetic diversity using STS-PCR. A total of 124 fecal samples were included: 64 previously confirmed positive and 60 negative by nested PCR. These were used to evaluate the diagnostic performance of STS-PCR. RFLP was also applied to the nested PCR-negative samples. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and 95% confidence intervals (CIs) were calculated. STS-PCR detected 39 of the 64 specimens that were positive by nested PCR (sensitivity 60.9%, specificity 100%, NPV 71%, PPV 100%). It failed to detect 25 cases, which may be attributable to primer mismatches or PCR inhibitors. RFLP detected 55 of the 64 positive cases (sensitivity 85.9%, specificity 100%, NPV 87%, PPV 100%). STS-PCR uniquely identified nine samples missed by RFLP. All nested PCR-negative samples remained negative by both methods. Sequencing of two STS-PCR false-negative samples confirmed ST1 and ST3. Differences in detection patterns between STS-PCR and RFLP underscore the value of multi-assay molecular analysis in this dataset. Further validation is required to determine whether similar patterns are observed in other populations or laboratory settings.

囊虫是一种具有遗传多样性的单细胞真核肠道寄生虫，目前尚无金标准诊断方法。这项在伊朗进行的研究首次直接比较了序列标记位点（STS） PCR和限制性片段长度多态性（RFLP）对人类的诊断。它建立在我们之前对同一群人的研究基础上。我们旨在以巢式PCR为内参，评价这些方法的诊断敏感性和特异性。此外，我们使用STS-PCR评估了亚型和遗传多样性。共纳入124份粪便样本，其中64份为巢式PCR阳性，60份为阴性。这些被用来评估STS-PCR的诊断性能。对嵌套pcr阴性样品进行RFLP检测。计算敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）和95%置信区间（CIs）。64例巢式PCR阳性标本中，STS-PCR检出39例（敏感性60.9%，特异性100%，NPV 71%, PPV 100%）。未能检测到25例，这可能是由于引物不匹配或PCR抑制剂。64例阳性病例中，RFLP检出55例（敏感性85.9%，特异性100%，NPV 87%, PPV 100%）。STS-PCR鉴定出RFLP缺失的9份样品。所有嵌套pcr阴性样本两种方法均为阴性。两份STS-PCR假阴性样本测序证实为ST1和ST3。STS-PCR和RFLP之间检测模式的差异强调了该数据集中多测定分子分析的价值。需要进一步验证以确定是否在其他人群或实验室环境中观察到类似的模式。

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引用次数: 0

Parasitological and molecular identification and subtype-specific clinical correlates of Blastocystis sp. in HIV-positive patients: Diagnostic and epidemiological insights from Northwest Iran hiv阳性患者囊虫的寄生虫学和分子鉴定以及亚型特异性临床相关性：来自伊朗西北部的诊断和流行病学见解

IF 1.8 4区医学 Q3 INFECTIOUS DISEASES

Diagnostic microbiology and infectious disease

Pub Date : 2026-01-08 DOI: 10.1016/j.diagmicrobio.2026.117266

Morteza Gholinejad , Rasool Jafari , Arash Aminpour

Objectives

Blastocystis sp. is a commonly detected intestinal protozoan in immunocompromised individuals, including people living with HIV, yet its clinical relevance remains uncertain. This study aimed to determine the prevalence, molecular subtypes, and clinical associations of Blastocystis sp. infection among HIV-positive patients in Northwest Iran.

Methods

In a cross-sectional study, stool samples from 70 HIV-positive patients referred to the Urmia Central Health Centre (2022–2023) were examined using direct microscopy, formalin–ether concentration, and culture. Molecular detection and subtyping were performed via PCR amplification and sequencing of the small subunit ribosomal RNA (SSU rRNA) gene. Associations between infection, gastrointestinal symptoms, and CD4⁺ T-cell counts were statistically analysed.

Results

Blastocystis sp. was identified in 25 (35.7%) of the 70 patients by microscopy and culture. PCR amplification succeeded in 23 (92%) of these 25 isolates. Sequencing revealed three subtypes: ST3 (52.2%), ST2 (30.4%), and ST1 (17.4%). Infection was significantly associated with gastrointestinal manifestations (p < 0.001). Mean CD4⁺ T-cell counts were markedly lower in Blastocystis-positive patients than in uninfected individuals, with the lowest values observed in those infected with ST1 (187.3 ± 156.2 cells/µL).

Conclusions

This study demonstrates a considerable prevalence of Blastocystis sp. among HIV-positive patients in Northwest Iran and a significant association between infection and gastrointestinal symptoms. Reduced CD4⁺ counts may increase susceptibility to Blastocystis infection. Routine laboratory detection of Blastocystis sp. in HIV-infected populations may improve understanding of its clinical relevance in immunocompromised patients.

目的囊虫（blastocystis sp.）是免疫功能低下人群（包括HIV感染者）中常见的肠道原生动物，但其临床意义尚不明确。本研究旨在确定伊朗西北部hiv阳性患者中囊虫感染的患病率、分子亚型和临床相关性。方法采用直接显微镜、福尔马林醚浓度和培养等方法，对2022-2023年在乌尔米亚中心卫生中心就诊的70例hiv阳性患者的粪便样本进行横断面研究。通过小亚单位核糖体RNA （SSU rRNA）基因的PCR扩增和测序进行分子检测和分型。对感染、胃肠道症状和CD4 + t细胞计数之间的关系进行统计学分析。结果70例患者镜检及培养检出囊虫25例（35.7%）。25株菌株中有23株（92%）扩增成功。测序结果显示三种亚型：ST3 (52.2%), ST2（30.4%）和ST1（17.4%）。感染与胃肠道症状显著相关（p < 0.001）。囊胚病阳性患者CD4 + t细胞平均计数明显低于未感染患者，其中ST1感染者CD4 + t细胞平均计数最低（187.3±156.2细胞/µL）。结论本研究表明伊朗西北部hiv阳性患者中囊虫属相当普遍，感染与胃肠道症状之间存在显著关联。CD4 +计数降低可能增加囊虫感染的易感性。在hiv感染人群中进行囊虫的常规实验室检测可以提高对其在免疫功能低下患者中的临床相关性的理解。

{"title":"Parasitological and molecular identification and subtype-specific clinical correlates of Blastocystis sp. in HIV-positive patients: Diagnostic and epidemiological insights from Northwest Iran","authors":"Morteza Gholinejad , Rasool Jafari , Arash Aminpour","doi":"10.1016/j.diagmicrobio.2026.117266","DOIUrl":"10.1016/j.diagmicrobio.2026.117266","url":null,"abstract":"<div><h3>Objectives</h3><div><em>Blastocystis sp</em>. is a commonly detected intestinal protozoan in immunocompromised individuals, including people living with HIV, yet its clinical relevance remains uncertain. This study aimed to determine the prevalence, molecular subtypes, and clinical associations of <em>Blastocystis sp</em>. infection among HIV-positive patients in Northwest Iran.</div></div><div><h3>Methods</h3><div>In a cross-sectional study, stool samples from 70 HIV-positive patients referred to the Urmia Central Health Centre (2022–2023) were examined using direct microscopy, formalin–ether concentration, and culture. Molecular detection and subtyping were performed via PCR amplification and sequencing of the small subunit ribosomal RNA (SSU rRNA) gene. Associations between infection, gastrointestinal symptoms, and CD4⁺ T-cell counts were statistically analysed.</div></div><div><h3>Results</h3><div><em>Blastocystis sp</em>. was identified in 25 (35.7%) of the 70 patients by microscopy and culture. PCR amplification succeeded in 23 (92%) of these 25 isolates. Sequencing revealed three subtypes: ST3 (52.2%), ST2 (30.4%), and ST1 (17.4%). Infection was significantly associated with gastrointestinal manifestations (p < 0.001). Mean CD4⁺ T-cell counts were markedly lower in Blastocystis-positive patients than in uninfected individuals, with the lowest values observed in those infected with ST1 (187.3 ± 156.2 cells/µL).</div></div><div><h3>Conclusions</h3><div>This study demonstrates a considerable prevalence of <em>Blastocystis sp</em>. among HIV-positive patients in Northwest Iran and a significant association between infection and gastrointestinal symptoms. Reduced CD4⁺ counts may increase susceptibility to Blastocystis infection. Routine laboratory detection of <em>Blastocystis sp</em>. in HIV-infected populations may improve understanding of its clinical relevance in immunocompromised patients.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"115 1","pages":"Article 117266"},"PeriodicalIF":1.8,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comparative evaluation of BD MAX™ Enteric Panels and Luminex NxTAG® GPP for the detection of gastrointestinal pathogens in clinical stool samples BD MAX™Enteric Panels和Luminex NxTAG®GPP在临床粪便样本中检测胃肠道病原体的比较评估

IF 1.8 4区医学 Q3 INFECTIOUS DISEASES

Diagnostic microbiology and infectious disease

Pub Date : 2026-01-08 DOI: 10.1016/j.diagmicrobio.2026.117267

Javier Guillem , Eliseo Albert , Estela Giménez , Isabel Corrales , David Navarro , Ignacio Torres

Purpose

To compare the diagnostic performance of BD MAX™ Enteric Panels and the Luminex NxTAG® Gastrointestinal Pathogen Panel (GPP) for the detection of enteric pathogens under routine clinical conditions.

Methods

A prospective single-center study analyzed 165 stool samples (one per patient) from individuals with suspected gastrointestinal infection attending the Clínico-Malvarrosa Health Department (Valencia, Spain) between October and November 2023. Samples tested using all BD MAX™ enteric panels (bacterial, viral, and Clostridioides difficile panels) were also processed by Luminex NxTAG® GPP assay. Positive Percentage Agreement (PPA), Negative Percentage Agreement (NPA), Cohen’s κ index were calculated. Discrepant results were investigated using the VIASURE real-time PCR and targeted Next-Generation Sequencing, as appropriate.

Results

Among the 165 samples analyzed, 107 (64.8%) were positive for at least one pathogen by either method, with norovirus (n = 40) and Clostridioides difficile (n = 18) being the most frequently detected targets. Overall, both assays exhibited moderate initial agreement (PPA 69.3%, NPA 90.6%, κ = 0.56), with an average PPA of 78.6%. PPA exceeded 85% for most targets, except for sapovirus. Salmonella spp., and Shiga toxin-producing E. coli (stx1, stx2) (STEC) accounted for most discordant results, often associated with low pathogen loads or analytical variability. After discrepancy resolution, both assays demonstrated comparable diagnostic performance, with a substantial concordance of (κ = 0.79 and 0.77, respectively).

Conclusion

BD MAX™ and Luminex NxTAG® GPP demonstrated comparable accuracy in detecting enteric pathogens, supporting their use in cost-effective, culture-independent molecular diagnosis and their integration within microbiological diagnostic stewardship programs.

目的比较BD MAX™Enteric Panel和Luminex NxTAG®胃肠道病原体面板（GPP）在常规临床条件下对肠道病原体的诊断性能。方法一项前瞻性单中心研究分析了2023年10月至11月期间在西班牙瓦伦西亚Clínico-Malvarrosa卫生部门就诊的疑似胃肠道感染患者的165份粪便样本（每位患者1份）。使用所有BD MAX™肠道面板（细菌、病毒和艰难梭菌面板）测试的样品也通过Luminex NxTAG®GPP检测处理。计算阳性百分数协议（PPA）、阴性百分数协议（NPA）、Cohen’s κ指数。根据需要，使用VIASURE实时PCR和靶向下一代测序来研究差异结果。结果165份样本中有107份（64.8%）至少检出一种病原菌，其中诺如病毒（n = 40）和艰难梭菌（n = 18）是检出最多的目标。总体而言，两种分析均表现出适度的初始一致性（PPA为69.3%，NPA为90.6%,κ = 0.56），平均PPA为78.6%。除萨帕病毒外，大多数目标的PPA均超过85%。沙门氏菌和产志贺毒素大肠杆菌（stx1, stx2）（STEC）是最不一致的结果，通常与低病原体负荷或分析差异有关。在差异解决后，两种检测方法显示出相当的诊断性能，具有实质性的一致性（κ分别为0.79和0.77）。结论bd MAX™和Luminex NxTAG®GPP在检测肠道病原体方面具有相当的准确性，支持它们在具有成本效益的、不依赖培养的分子诊断中的应用，并将其整合到微生物诊断管理计划中。

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引用次数: 0

In vitro antimicrobial susceptibility trends in commonly isolated anaerobic bacteria within the Australian context 在体外抗菌敏感性趋势在澳大利亚的背景下，通常分离的厌氧细菌。

IF 1.8 4区医学 Q3 INFECTIOUS DISEASES

Diagnostic microbiology and infectious disease

Pub Date : 2026-01-08 DOI: 10.1016/j.diagmicrobio.2026.117264

Victoria Jordan , Hemalatha Varadhan

Background

Antibiotic susceptibility testing is often not performed for anaerobic bacteria; empiric antibiotics with anaerobic cover are used if indicated. However, resistance has been described to various commonly used anti-anaerobic agents, so it is important to assess whether this approach remains optimal.

Aim

To determine phenotypic susceptibility profiles of commonly isolated anaerobic bacteria.

Methods

Stored clinical isolates from within Prevotella spp. (n=30), Clostridium perfringens (n=30), Cutibacterium acnes (n=30), underwent susceptibility testing using EUCAST methodology; additionally gram positive anaerobic cocci (GPAC) such as Finegoldia magna (n=11), Parvimonas micra (n=8), and Peptoniphilus spp. (n=9) underwent susceptibility testing using an experimental method, the Thermo Fisher Anaerobe Sensititre broth microdilution plate.

Results

High resistance rates were found in Prevotella spp. to amoxicillin-clavulanate and clindamycin (53.3% and 50% respectively), as well as 43.3% clindamycin resistance in Clostridium perfringens, and notable clindamycin and tetracycline resistance rates in the gram positive anaerobic cocci. Susceptibility was generally otherwise retained for F. necrophorum and the Gram positive anaerobes tested, and to metronidazole for all organisms.

Conclusion

Given relatively high rates of resistance to common agents within Prevotella spp. and with clindamycin to several species tested, anaerobic susceptibility testing should be considered by laboratories in select circumstances, particularly in infections where Prevotella spp. have a significant role or where clindamycin is being considered as the main agent for significant infections.

背景：厌氧菌通常不进行抗生素药敏试验；如有需要，使用经验性抗生素和厌氧覆盖。然而，已经描述了对各种常用抗厌氧剂的耐药性，因此评估这种方法是否仍然是最佳的是很重要的。目的：了解常见厌氧菌的表型敏感性。方法：采用EUCAST方法对临床保存的普雷沃氏菌（30株）、产气荚膜梭菌（30株）、痤疮表皮杆菌（30株）进行药敏试验；另外，革兰氏阳性厌氧球菌（GPAC），如大细粒芽胞菌（n=11）、微细小单胞菌（n=8）和嗜胃杆菌（n=9）采用实验方法，即Thermo Fisher厌氧菌敏感肉汤微稀释板进行药敏试验。结果：普雷沃特菌对阿莫西林-克拉维酸酯和克林霉素的耐药率较高（分别为53.3%和50%），产气荚膜梭菌对克林霉素的耐药率为43.3%，革兰氏阳性厌氧球菌对克林霉素和四环素的耐药率显著。除此之外，对坏死性梭菌和革兰氏阳性厌氧菌的敏感性一般保持不变，对所有微生物的甲硝唑敏感性也保持不变。结论：鉴于普雷沃氏菌对常见药物的耐药率相对较高，而克林霉素对几种被试物种的耐药率较高，实验室应在特定情况下考虑进行厌氧药敏试验，特别是在普雷沃氏菌具有重要作用的感染或克林霉素被认为是重大感染的主要药物的感染中。

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引用次数: 0

Retrospective study of Acanthamoeba keratitis: Three-year experience with an integrated clinical and diagnostic workflow 棘阿米巴角膜炎的回顾性研究：综合临床和诊断工作流程的三年经验

IF 1.8 4区医学 Q3 INFECTIOUS DISEASES

Diagnostic microbiology and infectious disease

Pub Date : 2026-01-07 DOI: 10.1016/j.diagmicrobio.2025.117247

Margherita Ortalli , Antonio Moramarco , Piera Versura , Giovanna Liguori , Giuseppe Russello , Simone Ambretti , Simone Baiocchi , Giacomo Nigrisoli , Michele Potenza , Luigi Fontana , Tiziana Lazzarotto

Acanthamoeba keratitis (AK) is a rare but sight-threatening corneal infection, caused by free-living protozoa of the genus Acanthamoeba. Although cases are rising in high-income countries, the nonspecific presentation and overlapping features with other keratitis frequently result in misdiagnosis of AK, with poorer outcomes and impaired quality of life. A delayed diagnosis can allow the infection to progress to deeper corneal layers, increasing the risk of severe structural damage and requiring emergency keratoplasty to preserve ocular integrity and regain vision. This retrospective study describes a three-year experience at a Northern Italy tertiary center using an integrated diagnostic workflow combining clinical evaluation, in vivo confocal microscopy, culture, and -since 2024- real-time PCR. Among 39 patients with suspected AK, 11 cases were confirmed. Culture showed 92 % sensitivity in first diagnoses but decreased to 77 % when relapses were included. PCR, introduced as a routine tool in 2024, showed 100 % sensitivity in first diagnoses and proved crucial in detecting low-burden or culture-negative relapses. Confocal microscopy reached a sensitivity and specificity of 82 %. Early targeted anti-amoebic therapy, guided by this integrated approach, contributed to favorable outcomes in most cases, limiting the need for surgical intervention. These findings support the utility of combining methods for timely and accurate diagnosis of AK. Despite ongoing challenges in the clinical management of AK, our findings reinforce the critical value of adopting molecular diagnostics to enable earlier, more accurate identification and targeted treatment.

棘阿米巴角膜炎（AK）是一种罕见但威胁视力的角膜感染，由自由生活的棘阿米巴属原生动物引起。尽管高收入国家的病例正在上升，但非特异性表现和与其他角膜炎的重叠特征经常导致AK的误诊，从而导致预后较差和生活质量受损。延迟诊断可能会使感染进展到更深的角膜层，增加严重结构损伤的风险，需要紧急角膜移植以保持眼部完整性并恢复视力。这项回顾性研究描述了意大利北部三级中心的三年经验，使用综合诊断工作流程，结合临床评估，体内共聚焦显微镜，培养和自2024年以来的实时PCR。在39名怀疑感染AK的病人中，有11人得到确诊。培养在首次诊断中显示92%的敏感性，但当包括复发时下降到77%。PCR于2024年作为常规工具引入，在首次诊断中显示出100%的敏感性，并且在检测低负担或培养阴性复发方面至关重要。共聚焦显微镜达到82%的灵敏度和特异性。在这种综合方法的指导下，早期靶向抗阿米巴治疗在大多数情况下取得了良好的结果，限制了手术干预的需要。这些发现支持联合方法对AK的及时准确诊断的效用。尽管在AK的临床管理中存在持续的挑战，但我们的研究结果强化了采用分子诊断的关键价值，以实现更早，更准确的识别和靶向治疗。

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引用次数: 0

All spinal infections are not always tuberculosis: A rare case of brucella spondylodiscitis in South India 所有的脊柱感染并不总是肺结核：一例罕见的布氏杆菌脊柱椎间盘炎在印度南部。

IF 1.8 4区医学 Q3 INFECTIOUS DISEASES

Diagnostic microbiology and infectious disease

Pub Date : 2026-01-06 DOI: 10.1016/j.diagmicrobio.2026.117262

Venkat Narayana Goutham Valapala , Prasanth Bylapudi , Lakshmi Vasantha Poluri , Mrudula Vandana , Supriya Panda , Pavani Dedeepya Singampalli , Uday Kumar Yerramsetty , Vijayalakshmi Payala

A 49-year-old male presented with persistent fever for 20 days, accompanied by chills, headache, and vomiting. Medical history included congenital hearing impairment and speech difficulty, limiting communication; hence, the history was obtained from his wife. On examination, he was irritable, alert, and had neck stiffness without motor or sensory deficits. Cervical spine tenderness prompted a magnetic resonance imaging of the cervical spine, which demonstrated infective spondylodiscitis involving C6–C7. Given the endemic setting, multiple contiguous vertebral involvement, and occupational exposure as a butcher handling unvaccinated goats, differential diagnoses included tuberculous spondylitis and brucellosis. Blood cultures were performed from two sites; the second sample grew Brucella melitensis, identified using the VITEK 2 Compact system after incubation in the BACT/ALERT 3D system and subculture on blood agar. Treatment consisted of gentamicin, doxycycline, and rifampin. The patient became afebrile within 48 h and remained stable. He was discharged with instructions to complete the oral regimen, consisting of doxycycline and rifampin, and to wear a hard cervical collar.

49岁男性，持续发热20天，伴有寒战、头痛和呕吐。病史包括先天性听力障碍和语言障碍，限制交流；因此，这段历史是从他的妻子那里得到的。检查时，他易怒，警觉，颈部僵硬，无运动或感觉缺陷。颈椎压痛提示颈椎磁共振成像，显示感染性脊柱炎累及C6-C7。考虑到该病的流行环境、多处连续椎体受损伤以及作为屠宰未接种疫苗山羊的屠夫的职业暴露，鉴别诊断包括结核性脊柱炎和布鲁氏菌病。从两个部位进行血培养；在BACT/ALERT 3D系统中孵育并在血琼脂上传代后，使用VITEK 2 Compact系统鉴定出布鲁氏菌。治疗包括庆大霉素、强力霉素和利福平。患者在48小时内开始发热并保持稳定。出院时指示他完成口服治疗方案，包括强力霉素和利福平，并戴硬颈套。

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引用次数: 0

A comprehensive review of Candida spp./bacteria interactions within polymicrobial biofilms: resistance and therapeutic strategies 念珠菌/细菌在多微生物生物膜内相互作用的综合综述：耐药性和治疗策略

IF 1.8 4区医学 Q3 INFECTIOUS DISEASES

Diagnostic microbiology and infectious disease

Pub Date : 2026-01-04 DOI: 10.1016/j.diagmicrobio.2026.117251

Amel Halimi , Zahira Zakia Baba Ahmed-Kazi Tani , Mohammed Aissaoui

Fungal infections are mainly caused by opportunistic species of the Candida genus. These yeasts can form polymicrobial biofilms with bacteria on living or inert surfaces, including medical devices. The synergistic or antagonistic interactions within these biofilms promote virulence and resistance to antimicrobials as well as to the host's immune defenses. In response to this resistance, considerable efforts are being made to limit treatment failures. The use of antifungal-antibiotic-natural compound combinations, as well as the modification of medical device surfaces, offer promising solutions.

真菌感染主要由念珠菌属的机会性物种引起。这些酵母菌可以在活的或惰性的表面（包括医疗器械）上与细菌形成多微生物生物膜。这些生物膜内的协同或拮抗相互作用促进了对抗菌剂的毒力和抗性以及对宿主免疫防御的抗性。为了应对这种阻力，正在作出相当大的努力来限制治疗失败。使用抗真菌-抗生素-天然化合物组合，以及修改医疗器械表面，提供了有希望的解决方案。

引用次数: 0