Emerging Infectious Diseases最新文献

Rickettsia sibirica mongolitimonae is an emerging cause of tickborne rickettsiosis. Since the bacterium was first documented as a human pathogen in 1996, a total of 69 patients with this infection have been reported in the literature. Because of the rising rate of R. sibirica mongolitimonae infection cases, we evaluated the epidemiologic and clinical features of 29 patients who had R. sibirica mongolitimonae infections confirmed during 2007–2024 at the Center for Rickettsiosis and Arthropod-Borne Diseases, the reference laboratory of San Pedro University Hospital–Center for Biomedical Research of La Rioja, Logroño, Spain. We also reviewed all cases published in the literature during 1996–2024, evaluating features of 94 cases of R. sibirica mongolitimonae infection (89 in Europe, 4 in Africa, and 1 in Asia). Clinicians should consider R. sibirica mongolitimonae as a potential causative agent of rickettsiosis, and doxycycline should be administered promptly to avoid clinical complications.

Streptococcus pneumoniae infection is considered an uncommon cause of arthritis in adults. To determine the clinical and microbiological characteristics of pneumococcal septic arthritis, we retrospectively studied a large series of cases among adult patients during the 2010–2018 conjugate vaccine era in France. We identified 110 patients (56 women, 54 men; mean age 65 years), and cases included 82 native joint infections and 28 prosthetic joint infections. Most commonly affected were the knee (50/110) and hip (25/110). Concomitant pneumococcal infections were found in 37.2% (38/102) and bacteremia in 57.3% (55/96) of patients, and underlying conditions were noted for 81.4% (83/102). Mortality rate was 9.4% (8/85). The proportion of strains not susceptible to penicillin was 29.1% (32/110). Of the 55 serotyped strains, 31 (56.4%) were covered by standard pneumococcal vaccines; however, several nonvaccine serotypes (mainly 23B, 24F, and 15A) had emerged, for which susceptibility to β-lactams was low.

Despite earlier attempts to define global health, the discipline’s boundaries are unclear, its priorities defined more by funding high-income countries from the Global North than by global health trends. Governance and resource allocation are challenged by movements such as decolonizing global health. Inherent contradictions within global health derive from its historical evolution from tropical medicine and international health, as well as recent trends in infectious diseases. Demographic, socioeconomic, and epidemiologic transitions, including the rise in noncommunicable diseases, have eroded the concept of a binary world of developed and developing countries. Competitive tension has emerged between aspirations for global health security and health equity. Dominant principles should focus on vulnerable populations, transnational challenges such as migration and climate change, appropriate prevention and care, and epidemic preparedness and response capacity. As the 2030 target date for the United Nations Sustainable Development Goals approaches, reconceptualization of global health is required, or the discipline risks losing identity and relevance.

Evolving technology and the development of new devices that can aerosolize water present a risk for new sources of Legionella bacteria growth and spread within industrial settings. We investigated a cluster of legionellosis among employees of a manufacturing facility in South Carolina, USA, and found 2 unique equipment sources of Legionella bacteria. The cluster of cases took place during August–November 2022; a total of 34 cases of legionellosis, including 15 hospitalizations and 2 deaths, were reported. Legionella pneumophila was isolated from 3 devices: 2 water jet cutters and 1 floor scrubber. L. pneumophila sequence type 36 was identified in environmental isolates and 1 patient specimen, indicating that those devices were the likely source of infection. Remediation was ultimately achieved through the development and implementation of a device-specific water management program. Manufacturing facilities that use aerosol-generating devices should consider maintaining updated Legionella water management programs to prevent Legionella bacterial infections.

Neisseria meningitidis is a common commensal bacterium of the nasopharynx that can cause invasive meningococcal disease (IMD). In comparison, N. gonorrhoeae is always a pathogen usually limited to mucosal sites. However, increased evidence for overlapping clinical syndromes is emerging. We compared N. meningitidis samples from a urogenital outbreak in Australia with sequences from the United States and other countries. We conducted phylogenetic analyses to assess relatedness and examine for genomic changes associated with meningococcal adaptation; we collated a total of 255 serogroup Y (MenY), sequence type (ST) 1466 isolate assemblies. Most urogenital isolates originated from Australia; those isolates formed a distinct clade, most closely related genomically to recent US IMD isolates. No specific genomic changes suggested niche adaptation or associated clinical manifestations. The MenY ST1466 N. meningitidis isolates circulating in Australia and the United States are capable of causing both urethritis and invasive meningococcal disease.

To trace evolution of Panton-Valentine leucocidin–positive clonal complex 398 methicillin-resistant Staphylococcus aureus (MRSA) in the Czech Republic, we tested 103 MRSA isolates from humans. Five (4.9%) were Panton-Valentine leucocidin–positive clonal complex 398, sequence types 1232 and 9181. Spread to the Czech Republic may result from travel to or from other countries.

We identified Prototheca spp. microalga in ocular samples of a cat in Spain with nontreatable endogenous endophthalmitis. Within 2 years, the eye lesions progressively worsened and neurologic signs appeared, suggesting systemic spread of the infection. On multitarget sequence analysis, the feline pathogen could not be assigned to any known Prototheca species.

Cefiderocol (FDC), a siderophore-cephalosporin conjugate, is the newest option for treating infection with carbapenem-resistant gram-negative bacteria. We identified a novel mechanism contributing to decreased FDC susceptibility in Klebsiella pneumoniae clinical isolates. The mechanism involves 2 coresident plasmids: pKpQIL, carrying variants of bla_KPC carbapenemase gene, and pKPN, carrying the ferric citrate transport (FEC) system. We observed increasing FDC MICs in an Escherichia coli model system carrying different natural pKpQIL plasmids, encoding different K. pneumoniae carbapenemase variants, in combination with a conjugative low copy number vector carrying the fec gene cluster from pKPN. We observed transcriptional repression of fiu, cirA, fepA, and fhuA siderophore receptor genes in bla_KPC–fec–E. coli cells treated with ferric citrate. Screening of 27,793 K. pneumoniae whole-genome sequences revealed that the fec cluster occurs frequently in some globally distributed different K. pneumoniae carbapenemase–producing K. pneumoniae clones (sequence types 258, 14, 45, and 512), contributing to reduced FDC susceptibility.

Albendazole/ivermectin combination therapy is a promising alternative to benzimidazole monotherapy alone for Trichuris trichiura control. We used fecal DNA metabarcoding to genetically characterize Trichuris spp. populations in patient samples from Côte d’Ivoire showing lower (egg reduction rate <70%) albendazole/ivermectin sensitivity than those from Laos and Tanzania (egg reduction rates >98%). Internal transcribed spacer (ITS) 1 and ITS2 metabarcoding revealed the entire detected Côte d'Ivoire Trichuris population was phylogenetically distinct from T. trichiura found in Laos and Tanzania and was more closely related to T. suis. Mitochondrial genome sequencing of 8 adult Trichuris worms from Côte d’Ivoire confirmed their species-level differentiation. Sequences from human patients in Cameroon and Uganda and 3 captive nonhuman primates suggest this novel species, T. incognita, is distributed beyond Côte d'Ivoire and has zoonotic potential. Continued surveillance by using fecal DNA metabarcoding will be needed to determine Trichuris spp. geographic distribution and control strategies.