Emerging Infectious Diseases最新文献

Mycobacterium decipiens is a newly identified species with high genomic similarity to M. tuberculosis. We report a cutaneous M. decipiens infection in a patient in France who had inflammatory bowel disease being treated with anti-tumor necrosis factor-α therapy. The infection was successfully treated with an oral antimicrobial regimen.

Diseases caused by henipaviruses, exemplified by Hendra virus and Nipah virus, pose a serious risk to public health because of their epidemic potential and high case-fatality rates and the paucity of medical countermeasures to mitigate them. In December 2024, a group of 150 scientists from 16 countries convened in Geelong, Victoria, Australia, to mark the 30th anniversary of the discovery of Hendra virus. The Hendra@30 conference built upon its predecessor conference held in 2019 in Singapore, Nipah@20, by expanding its program across broader disciplines and integrating sessions on human sociology and disease ecology into the main scientific discussions. We describe key highlights from Hendra@30 and reflect on 4 key elements that have advanced henipavirus research and medical countermeasures research and development. We propose that integrating bat ecology into henipavirus research blueprints will enable development of ecologic countermeasures that prevent spillover and will complement existing preparedness and response efforts with evidence-based prevention strategies.

Enhanced arboviral surveillance in Panama revealed an Oropouche virus case, 5 months before the 2025 national outbreak, in samples that tested negative for routinely screened arboviruses. Subsequent contact tracing identified an additional case of Punta Toro virus. Our findings highlight the importance of expanding diagnostic efforts to identify circulating arboviruses.

The emergence of a high-risk New Delhi metallo-β-lactamase 14-producing Klebsiella pneumoniae sequence type 147 clone is of public health concern because of its rapid international spread. We report cross-border emergence and rapid dissemination of that clone in the Canary Islands, Spain, during 2023-2025. We analyzed 30 isolates recovered during 2023 in detail by reviewing clinical and epidemiologic data, conducting whole-genome sequencing to assess clonal relatedness and analyze resistomes, and performing antimicrobial susceptibility testing of novel therapeutic options through reference broth microdilution. The isolates formed a well-defined cluster, with minimal genomic distance and identical resistomes, confirming the local outbreak. Those clones were also closely related to other international New Delhi metallo-β-lactamase 14-producing K. pneumoniae sequence type 147 isolates, supporting the ongoing cross-border expansion of that clone. Aztreonam/avibactam was the most active therapeutic option (MICs <0.125 mg/L). Our findings highlight the need for close monitoring to prevent further dissemination of this clone.

Group A Streptococcus (GAS) causes a variety of diseases in humans but is not widely appreciated as a cause of meningitis. During 1997-2022, ten sites participating in the Active Bacterial Core Surveillance network in the United States identified GAS meningitis cases. We calculated annual incidence and case-fatality rates (CFRs) for 320 of those cases and determined antimicrobial resistance by whole-genome sequencing. Annual incidence of GAS meningitis ranged from 0.02 to 0.07 cases/100,000 persons. Children <1 year of age had the highest average annual incidence, 0.23 cases/100,000 children. GAS meningitis had a higher CFR (19.4%) than meningitis caused by group B Streptococcus, Streptococcus pneumoniae, Neisseria meningitidis, or Haemophilus influenzae. Clindamycin resistance among GAS meningitis isolates increased from 3.2% during 1997-2002 to 17.7% during 2018-2022. Clinicians should be aware that meningitis is an uncommon but severe manifestation of invasive GAS and has a higher CFR than more established meningitis etiologies.

During the 2024-25 winter season, a universal immunization campaign with nirsevimab was implemented in a region of Italy to prevent respiratory syncytial virus (RSV) infection among infants <12 months of age. We assessed its effects using regional syndromic surveillance data on emergency department visits (EDVs) and hospitalizations for lower respiratory tract infections and RSV infections. We estimated expected burden using an interrupted time series analysis, based on historical trends, and observed values with predictions. Children 1-5 years of age, not eligible for immunization, served as a comparison group. Among infants, EDVs for acute lower respiratory tract infections decreased by 42.7% and hospitalizations decreased by 46.5%, whereas EDVs for RSV infection decreased by 49.3% and hospitalizations decreased by 55.0%. No reductions were observed in children 1-5 years of age, confirming ongoing RSV circulation. Our findings support the effectiveness of universal nirsevimab immunization in reducing severe RSV-related outcomes among infants.

We examined probiotic-associated bacteremia in a cohort of postoperative pediatric cardiac surgery patients in China. Among 16,436 children who underwent cardiac surgery during 2019-2024, a total of 5,034 received probiotics; 6 developed bacteremia with probiotic strains (Bacillus subtilis, Bacillus licheniformis, Lacticaseibacillus rhamnosus). Three cases occurred in children who had not directly received probiotics, suggesting potential cross-contamination or catheter-related transmission. All 6 patients had complex congenital heart disease and central venous catheters; 5 underwent palliative surgery. Fever, elevated C-reactive protein and leukocytes, and use of respiratory support were common. Antibiotic therapy achieved blood-culture clearance in all; 1 death occurred because of underlying cardiac disease, not infection. Our findings conclude probiotic-associated bacteremia is rare and usually resolves with antibiotics; outcomes correlate more with cardiac complexity than bacteremia itself. Maintaining perioperative probiotic use and enhancing infection-control measures, specifically regarding central line care, are recommended to minimize the risk for probiotic-associated bacteremia in pediatric cardiosurgical patients.

Rickettsia lanei is a newly recognized spotted fever group rickettsial species that causes severe Rocky Mountain spotted fever-like illness. We used genome sequencing, enabled by hybridization capture-based target enrichment, to establish Dermacentor occidentalis ticks as the likely source of a human infection with R. lanei in California, USA.

The Minnesota Department of Health identified an outbreak of Legionnaires' disease in a city in northern Minnesota, USA, in April 2023 that continued until chloramine disinfection of the community water system was implemented. Before chloramine disinfection was implemented, Legionella pneumophila was detected in 1 of 16 samples from the drinking water distribution system and in 5 of 10 premise plumbing samples using both cultivation-dependent (Legiolert) and cultivation-independent (digital PCR) assays in this independent investigation. Approximately 11 weeks after disinfection was implemented, all distribution system samples tested negative; however, 1 of 6 Legiolert-tested and 3 of 6 digital PCR-tested premise plumbing samples were positive. After 24 weeks of disinfection, all samples collected from the distribution system and premise plumbing tested negative. Our results show that a community water system supplied by groundwater supported substantial growth of L. pneumophila in premise plumbing and that chloramine disinfection halted the outbreak.

Pulmonary histoplasmosis has traditionally been considered geographically restricted to disease-endemic regions. Taiwan, historically nonendemic, has recently witnessed rising infections. We conducted a retrospective study by reviewing adult patients in Taiwan who had pathologically confirmed pulmonary histoplasmosis during June 1997-December 2024. We analyzed 14 cases with lung involvement. Eight case-patients were male and 6 female; mean age was 56.6 years. Of note, 11 case-patients (78.6%) had no history of travel to histoplasmosis-endemic regions; 10 (71.4%) were immunocompetent. Left upper lobe involvement was most common (n = 4 [28.6%]), with nodular lesions predominating (n = 12 [85.7%]). Most (11 [78.6%]) patients received antifungal therapy, mostly with voriconazole. Outcomes were favorable; 1 (7.1%) patient died. Two additional case-patients without lung involvement exhibited similar demographics and clinical outcomes. Case identification rate has increased since 2015. This 27-year study documents the emergence of pulmonary histoplasmosis in Taiwan, emphasizing the need for heightened clinical suspicion in nonendemic regions.