European Journal of Clinical Microbiology & Infectious Diseases最新文献

Facing challenges in the fields of microbial detection and antimicrobial resistance (AMR) monitoring, the scientific community is opening new research avenues with the help of cutting-edge technologies such as molecular biology, genomics, proteomics, nanotechnology, and bioinformatics. In this review, we comprehensively collate and elaborate on revolutionary detection methods and AMR surveillance strategies that go beyond traditional microbial culture techniques. These innovative methods have not only improved the sensitivity and speed of detection but also broadened our understanding of the microbial world, providing new weapons in the fight against drug-resistant microorganisms. Through the integration and innovation of interdisciplinary approaches, we are gradually constructing a more precise, efficient, and comprehensive new paradigm for microbial detection and AMR testing.

Chlamydia trachomatis (CT) infections in children present distinct diagnostic challenges, ranging from perinatal conjunctivitis and pneumonia to trachoma and, in older children, sexually transmitted infections. This review systematically evaluates contemporary laboratory methods for detecting CT in children. The methods are categorized by their distinct targets, beginning with morphological identification via stains (e.g., Giemsa, immunofluorescence) with or without culture; followed by immunological detection of antigens or antibodies (e.g., ELISA); and finally, molecular analysis using NAATs for DNA or RT-PCR for RNA. Each technique is rigorously examined based on analytical sensitivity, specificity, turnaround time, and technical requirements, with particular emphasis on age-specific specimen selection, sampling logistics, and ethical-legal considerations-especially in cases of suspected abuse. Our analysis confirms that NAATs, particularly real-time PCR, are the first-line diagnostic choice for their superior sensitivity in detecting asymptomatic and low-bacterial-load infections in children. RNA-based detection is highlighted as the preferred method for treatment monitoring due to its ability to differentiate viable pathogens. In resource-limited settings, rapid antigen tests offer a practical screening solution, though require NAAT confirmation. The review also discusses emerging technologies, including isothermal amplification and biosensors, for point-of-care (POC) testing. By synthesizing current evidence with pediatric-specific guidelines from the CDC, WHO, and European health authorities, this review aims to establish an evidence-based framework to guide optimal test selection, improve early detection, and inform public health strategies to reduce the CT disease burden in children.

Increased antibiotic resistance highlights the need for new, rapid antibiotic susceptibility tests to guide therapy, especially in critical disease such as bloodstream infections and sepsis. This study investigates a new ultra-rapid AST system in multiple clinical laboratories, with respect to accuracy, speed and turnaround time in comparison to commonly used AST systems. The QuickMIC system is compared to the commonly used automated AST systems BD Phoenix™ (BD, USA), MicroScan WalkAway plus (Beckman Coulter, USA) and VITEK^® 2 (bioMérieux, France) by concurrent testing of incoming positive blood-cultures with Gram-negative bacteria in four clinical laboratories located in the EU and USA, on the basis of agreement of results, time-to-result (TTR, analysis time) and turnaround time (TAT, time from blood culture positivity or blood culture processing to actionable result). A total of 155 patient samples were included, totaling 10 species of Gram-negative bacteria. The overall EA and CA between QuickMIC^® GN and each routine AST system was > 95%, while overall bias was within the acceptable range of ± 30%. QuickMIC time-to-result was on average 3 h and 4 min, compared to 9-19 h for the routine systems. The average QuickMIC system turnaround-time ranged from 10 to 11 h 30 min, compared to 22-45 h for the routine systems. The QuickMIC system represents a promising rapid AST technology with potential to reduce time-to-result and overall turnaround-time of clinically actionable AST results compared with the most common routinely used automated AST methods, while maintaining good accuracy and quality of results.

In recent years, the use of antibiotics in pediatric patients has received widespread. Tosufloxacin is a quinolone antimicrobial used to treat pneumonia, otitis media, cholera, and anthrax. Guidelines have recommended that quinolone antimicrobials can be used as alternatives for the treatment of bacterial infections in children. However, due to the potential adverse effects on bones and joints, the clinical application of fluoroquinolones requires further evaluation. This article reviewed the latest clinical evidence on the efficacy and safety of tosufloxacin for treating bacterial infections in children. Pharmacokinetic results suggested that drug clearance and volume of distribution were significantly correlated with body weight in children, and the higher the AUC and C_max, the higher the incidence of adverse drug effects. The efficacy results suggest that for Macrolide-resistant Mycoplasma pneumoniae (MRMP), tosufloxacin may have better efficacy compared to macrolide antibiotics, with minocycline being more efficacious than tosufloxacin. Tosufloxacin has good efficacy in the treatment of otitis media infections in children as well as children under 2 years of age, and it can be used as a second-line choice for children with persistent otitis media. The safety results suggest that the most important adverse effect of tosufloxacin is diarrhea, and there are almost no joint-related adverse effects. The rate of adverse effects of 6 mg/kg tosufloxacin is higher than 4 mg/kg group. Tosufloxacin may be safe and effective in children pneumonia and otitis media, but is less effective than minocycline in MRMP.

Background: Pseudomonas aeruginosa bloodstream infections pose challenges due to recurrence and mortality. Identifying these outcomes may support more targeted empiric therapy.

Methods: A population-based cohort study was conducted in Queensland (2000-2019). Patients were classified into four outcomes. Multinomial (relative risk ratios [RRR]) and binary logistic regression (with odds ratio [OR]) identified baseline factors associated with recurrence and mortality.

Results: Among 5,742 patients with P. aeruginosa BSI, 20.5% died within 30 days, 21.3% died between 30 days and three years, 4.6% experienced recurrence, and 53.6% survived to three years without recurrence. Factors associated with recurrence included malignancy (RRR 3.43; 95% CI 2.55-4.62), metastatic cancer (RRR 2.16; 95% CI 1.27-3.66), and uncomplicated diabetes (RRR 2.25; 95% CI 1.31-3.86). Mortality was associated with malignancy (OR 2.65; 95% CI 2.22-3.16), congestive heart failure (OR 1.67; 95% CI 1.38-2.04), dementia (OR 1.97; 95% CI 1.46-2.65), renal disease (OR 1.85; 95% CI 1.55-2.19), pulmonary disease (OR 1.32; 95% CI 1.08-1.62), and advancing age (OR 1.02; 95% CI 1.02-1.03). Community-onset infections and a genitourinary source were associated with a reduced risk of both recurrence (RRR 0.52; 95% CI 0.33-0.81 and RRR 0.70; 95% CI 0.43-1.14) and mortality (OR 0.68; 95% CI 0.55-0.85 and OR 0.66; 95% CI 0.52-0.84, respectively). Among patients with recurrence, resistance emerged to ceftazidime (10.7%), and ciprofloxacin (10.1%), although most susceptibility profiles remained stable.

Conclusions: Among patients with P. aeruginosa BSI, rates of mortality and clinically relevant recurrence were high. These findings may assist clinicians in making more informed empiric treatment decisions.

We analysed 498 global Aspergillus fumigatus isolates using multilocus variable-number tandem-repeat (MLVA) typing to investigate regional clustering, environmental-clinical overlap, and azole resistance patterns. The dataset, which included 155 newly genotyped Korean strains, revealed extensive genotypic diversity and four distinct phylogeographic clusters. Resistance-associated mutations (TR34/TR46) appeared concentrated within certain clusters that largely comprised isolates from Germany, South Korea, and China, suggesting country-level enrichment rather than broader continental trends. These findings support the presence of geographically structured populations and localised emergence of resistance and demonstrate the utility of MLVA for molecular surveillance, particularly in settings where whole-genome sequencing is limited.