Emerging Infectious Diseases最新文献

Tickborne infections are challenging to diagnose, particularly among solid organ transplant recipients. We report a US case of donor-derived ehrlichiosis from a living kidney donation that highlights how screening for living donors may miss tickborne infections. Clinicians should consider the epidemiology of the donor when screening donations and evaluating recipients for donor-derived infection.

Reemergence of Oropouche fever in Brazil raises concerns about potential risks for infection in pregnancy. We describe a case series of Oropouche fever in pregnant women and their neonates in Espírito Santo State, Brazil, in 2024. Of 73 pregnancies, 15 pregnancies concluded by the end of the study period; of those, 14 resulted in live births and 1 in spontaneous abortion. Placental reverse transcription PCR tests were positive for Oropouche virus RNA in 5 infections in the third trimester. Two infections occurred in the first trimester, resulting in 1 spontaneous abortion and 1 live birth with corpus callosum dysgenesis. Of 13 infections that occurred in the third trimester, 1 showed possible intrapartum transmission with clinical manifestations in the neonate, whereas the others were asymptomatic. We found no anomalies in third-trimester infections. These findings suggest possible vertical transmission of Oropouche virus and a potential link with spontaneous abortion or malformation.

After 3 cases of Corynebacterium diphtheriae infection associated with intravenous drug use among persons experiencing homelessness (PEH) were reported to the Health Protection Authority in Frankfurt am Main, Germany, in 2023, we examined pathogen spread among PEH. Furthermore, we investigated a possible link with the 2022 outbreak of diphtheria in Europe. From swab samples collected during August–November 2023 from 36 PEH and cutaneous lesions, we detected 3 additional cases of cutaneous toxigenic C. diphtheriae. Sequence type 574 was identified in 5 case-isolates and is genetically associated with 1 of the predominant clusters in identified in the 2022 outbreak. Our findings demonstrate the need for increased detection and monitoring of cutaneous diphtheria and boosting immunity against diphtheria in groups with increased risk for infection. Genomic analyses are valuable for identifying genetic relationships between outbreaks, even when epidemiologic data are scarce.

Candida auris is an emerging fungal pathogen associated with outbreaks in healthcare settings. We report a multiyear outbreak of C. auris in a burn intensive care unit in Illinois, USA, during 2021–2023. We identified 28 C. auris cases in the unit over a 2-year period, despite outbreak response and multimodal mitigation measures. Of the 28 case-patients, 15 (53.6%) were considered colonized and 13 (46.4%) had clinical infections. Phylogenetic analysis of whole-genome sequences revealed 4 distinct clusters of closely related (0–6 SNP differences) genomes containing 3–6 cases. Clusters generally contained temporally related isolates from patients with epidemiologic links; this finding suggests that multiple introductions and within-unit spread over a limited time were responsible for the outbreak, rather than transmission from a long-term source (e.g., persistent environmental contamination or staff carriage). Here, integrated traditional and genomic epidemiology supported C. auris outbreak investigation and response and informed targeted interventions.

We describe emergence of Buruli ulcer in urban Geelong, Victoria, Australia, and examine timing and proximity of human cases to detection of Mycobacterium ulcerans DNA in possum feces. M. ulcerans–positive feces preceded human cases by up to 39 months, constituting an early warning of impending risk for Buruli ulcer.

High-dose isoniazid is recommended to treat multidrug-resistant tuberculosis (MDR TB). Among 958 MDR TB isolates identified in France during 2008–2022, 93.1% exhibited high-level isoniazid resistance, and molecular testing showed limited diagnostic accuracy in predicting resistance. Clinicians should reconsider using high-dose isoniazid in MDR TB treatment because of suboptimal effect and toxicity concerns.

To reconstruct transmission chains of the multidrug-resistant tuberculosis Ch strain, which harbors a unique combination of resistance mutations, we analyzed genomes of 25 isolates from 12 patients with diagnosis during 2006–2022 in Chaco Province, Argentina. Amplification of resistance, high mortality rates, and indications of a wider outbreak raise concerns for surveillance programs.

To elucidate the epidemiology of Sarcocystis spp. parasites in human intestinal infections, we used high-throughput sequencing to investigate human intestinal sarcocystosis cases identified by microscopy in France during 2021–2024. Our results indicate that humans are a definitive host of S. sigmoideus parasites and that occurrence of multiple species in 1 patient is common.

In a longitudinal study in a first-level hospital in Luanda, Angola, we found rifampin-resistant and multidrug-resistant tuberculosis (TB) in 38 (8%, 95% CI 5.7–10.8) of 474 patients with no previous history of TB. Of note, 2 patients (0.4%, 95% CI 0.1–1.5) demonstrated pre–extensively drug-resistant TB.

Complement C5 inhibitors bring an increased risk for Neisseria infections. A novel complement C3 inhibitor, pegcetacoplan, was recently approved to treat paroxysmal nocturnal hemoglobinuria, a condition commonly treated with complement C5 inhibitors. We present a case of meningococcal sepsis in a pegcetacoplan-treated patient with aplastic anemia and paroxysmal nocturnal hemoglobinuria.