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Profile of intestinal fungal microbiota in acute pancreatitis patients and healthy individuals. 急性胰腺炎患者和健康人肠道真菌菌群的分析。
IF 4.3 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-01-08 DOI: 10.1186/s13099-024-00675-z
Meng-Qi Zhao, Miao-Yan Fan, Meng-Yan Cui, Su-Min Chen, Jing-Jing Wang, Ying-Ying Lu, Qiao-Li Jiang

Objective: The gut is involved in the development of acute pancreatitis (AP). Increased focus is being given to the role of gut microbiota in the pathogenesis of AP. Nevertheless, there is currently no available evidence regarding the composition of fungal microorganisms in the intestines of patients with AP.

Methods: In this study, we sequenced ITS rRNA gene amplicons and examined the intestinal fungal microbiota in feces from 11 AP patients (the test group) and 15 healthy people (the control group). Additionally, we examined the relationship between fungus and clinical and biochemical markers.

Results: Results showed a decline in alpha diversity in AP patients. The overall fungal microbiota in the test group was significantly different from that of the control group (P < 0.05). In both groups, the fecal fungal microbiota was dominated by Ascomycota and Basidiomycota phyla. At the genus level, the abundance of Candida was significantly higher in the test group and the abundances of Penicillium, Auricularia, unclassified Eurotiomycetes, Epicoccum and Vishniacozyma were significantly lower. Furthermore, AP patients had a significant decrease in the GMHI score and a significant increase in the MDI index. The co-abundance networks of gut fungus in AP patients showed more interactions and mostly positive correlations than in the control group. There was a strong positive link between Aspergillus and WBC counts, while There was a strong link between unclassified Rozellomycota and IL-6.

Conclusion: Our study provides the first empirical evidence that AP patients have different fecal fungal microbiota, which raises the possibility that mycobiota contribute to the etiology and progression of AP.

目的:肠道参与急性胰腺炎(AP)的发展。肠道菌群在AP发病机制中的作用越来越受到关注。然而,目前还没有关于AP患者肠道真菌微生物组成的证据。方法:在本研究中,我们测序了ITS rRNA基因扩增子,并检测了11名AP患者(试验组)和15名健康人群(对照组)粪便中的肠道真菌微生物群。此外,我们还研究了真菌与临床和生化指标之间的关系。结果:结果显示AP患者α多样性下降。结论:我们的研究首次提供了AP患者粪便真菌菌群存在差异的经验证据,这提出了真菌菌群参与AP病因和进展的可能性。
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引用次数: 0
Washed microbiota transplantation stopped recurrent sepsis in a patient with myelofibrosis: a case report. 洗净菌群移植治疗骨髓纤维化患者复发性败血症1例。
IF 4.3 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-12-27 DOI: 10.1186/s13099-024-00660-6
Yingqi Yang, Luyao Wang, Tianchi Zhuang, Ting Xu, Minghui Ji, Quan Wang

Background: Sepsis represents the most prevalent infectious complication and the primary cause of mortality in myeloproliferative neoplasms (MPN). The risk of sepsis and the difficulty of treatment are significantly increased in MPN patients due to the need for immunomodulators and antibiotics.

Case presentation: On June 9, 2023, a 69-year-old male was admitted to the hospital. Following a battery of tests, the diagnosis of sepsis due to Escherichia coli was ultimately established. The patient was administered amoxicillin clavulanate potassium intravenously. In light of the patient's recurrent sepsis and the likelihood that the source of infection is the intestinal tract, we advised that the patient undergo washed microbiota transplantation (WMT) via a colonic transendoscopic enteral tube (TET).

Conclusions: WMT as the new method of fecal microbiota transplantation (FMT) successfully cured the recurrent sepsis in this case, indicating the novel option for challenging the refractory or serious infections.

背景:脓毒症是骨髓增生性肿瘤(MPN)中最常见的感染性并发症和死亡的主要原因。由于需要免疫调节剂和抗生素,MPN患者脓毒症的风险和治疗难度显著增加。病例介绍:2023年6月9日,一名69岁男性住院。经过一系列检查,最终确定了大肠杆菌引起的败血症的诊断。患者静脉给予阿莫西林克拉维酸钾。考虑到患者复发性败血症和感染源可能是肠道,我们建议患者通过结肠经内镜肠内管(TET)进行洗净菌群移植(WMT)。结论:WMT作为粪便微生物群移植(FMT)的新方法成功治愈了该病例的复发性败血症,为挑战难治性或严重感染提供了新的选择。
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引用次数: 0
Exploring the effects of probiotics on olanzapine-induced metabolic syndrome through the gut microbiota. 通过肠道菌群探讨益生菌对奥氮平诱导代谢综合征的影响。
IF 4.3 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-12-21 DOI: 10.1186/s13099-024-00664-2
Syed Mushraf, Kiran Chawla, Shaik Mohammed Abdul Fayaz, Aranjani Jesil Mathew, Gayam Prasanna Kumar Reddy, Mohandas Rao Kappettu Gadahad, Padmaja A Shenoy, Vasudha Devi, Shalini Adiga, Veena Nayak

Background: Maintaining gut microbial homeostasis is crucial for human health, as imbalances in the gut microbiota (GM) can lead to various diseases, including metabolic syndrome (MS), exacerbated by the use of antipsychotic medications such as olanzapine (OLZ). Understanding the role of the GM in OLZ-induced MS could lead to new therapeutic strategies. This study used metagenomic analysis to explore the impact of OLZ on the GM composition and examined how probiotics can mitigate its adverse effects in a rat model. Changes in weight, blood pressure, and lipid levels, which are key parameters defining MS, were assessed. Additionally, this study investigated serotonin, dopamine, and histopathological changes to explore their possible link with the microbiota-gut-brain axis (MGBA).

Results: OLZ had an antagonistic effect on serotonin and dopamine receptors, and it was consistently found to alter the composition of the GM, with an increase in the relative abundance (RA) of the Firmicutes/Bacteroidetes phyla ratio and TM7 genera, indicating that the anticommonsal action of OLZ affects appetite and energy expenditure, contributing to obesity, dyslipidemia and increased blood pressure, which are core components of MS. Hepatic steatosis and intestinal damage in OLZ-treated rat tissues further indicate its role in MS. Conversely, the administration of probiotics, either alone or in combination with OLZ, was found to mitigate these OLZ-induced symptoms of MS by altering the GM composition. These alterations included increases in the abundances of the taxa Bacteroidetes, Actinobacteria, Prevotella, Blautia, Bacteroides, Bacteroidales, and Ruminococcaceae and a decrease in Firmicute abundance. These changes helped maintain gut barrier integrity and modulated neurotransmitter levels, suggesting that probiotics can counteract the adverse metabolic effects of OLZ by restoring the GM balance. Moreover, this study highlights the modulation of the MGBA by OLZ as a potential mechanism through which probiotics modulate serotonin and dopamine levels, influencing metabolic health.

Conclusion: These findings emphasise the significant impact of OLZ on the GM and its contribution to MS. These findings suggest that interventions targeting the GM, such as probiotics, could mitigate the metabolic side effects of OLZ. Future research should focus on developing integrative treatment approaches that consider the health of the gut microbiome in managing antipsychotic-induced adverse effects.

背景:维持肠道微生物稳态对人类健康至关重要,因为肠道微生物群(GM)的失衡可导致多种疾病,包括代谢综合征(MS),而抗精神病药物如奥氮平(OLZ)的使用会加重代谢综合征。了解GM在olz诱导的MS中的作用可能会导致新的治疗策略。本研究利用宏基因组分析探讨了OLZ对转基因成分的影响,并在大鼠模型中研究了益生菌如何减轻其不良影响。评估体重、血压和血脂水平的变化,这是定义多发性硬化症的关键参数。此外,本研究还研究了血清素、多巴胺和组织病理学变化,以探索它们与微生物-肠-脑轴(MGBA)的可能联系。结果:OLZ对血清素和多巴胺受体具有拮抗作用,并且一直被发现可以改变GM的组成,增加厚壁菌门/拟杆菌门门和TM7属的相对丰度(RA),表明OLZ的反共性作用影响食欲和能量消耗,导致肥胖、血脂异常和血压升高。OLZ处理的大鼠组织中的肝脂肪变性和肠道损伤进一步表明其在MS中的作用。相反,研究发现,益生菌单独或与OLZ联合使用,通过改变GM成分,可以减轻OLZ诱导的MS症状。这些变化包括拟杆菌门、放线菌门、普雷沃氏菌门、蓝杆菌门、拟杆菌门、拟杆菌门和瘤胃球菌科的丰度增加,厚壁菌门的丰度减少。这些变化有助于维持肠道屏障的完整性和调节神经递质水平,这表明益生菌可以通过恢复转基因平衡来抵消OLZ的不良代谢影响。此外,本研究强调了OLZ对MGBA的调节是益生菌调节血清素和多巴胺水平,影响代谢健康的潜在机制。结论:这些发现强调了OLZ对GM的重要影响及其对ms的贡献。这些发现表明,针对GM的干预措施,如益生菌,可以减轻OLZ的代谢副作用。未来的研究应侧重于开发综合治疗方法,考虑肠道微生物群的健康,以管理抗精神病药物引起的不良反应。
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引用次数: 0
A fatal case of Vibrio cholerae-associated diarrhea and bacteremia in a 30-year-old carrier of beta-thalassemia. 一名 30 岁的 beta 型地中海贫血症携带者患霍乱弧菌相关性腹泻和菌血症的致命病例。
IF 4.3 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-12-19 DOI: 10.1186/s13099-024-00655-3
Mohammad Tarequl Islam, Kazi Sumaita Nahar, Nikhat Ara, Suma Mita Biswas, Waliullah, Jarin Tasnim, Mohammad Nazmus Sakib, Abdullah Al-Mamun, Alimul Islam, Anindita Bristi, Marzia Sultana, Dilruba Ahmed, Kimberley D Seed, Andrew Camilli, Tahmeed Ahmed, Munirul Alam

Bacterial infections leading to bacteremia and septicemic shock constitute an emerging public health concern globally, especially in areas where sanitation is poor and safe drinking water is scarce. Enteric pathogens such as Vibrio cholerae are responsible for many deaths caused by contaminated food and water in these areas. While cholera is the prominent clinical threat posed by V. cholerae, outcomes like bacteremia turning into sepsis and associated morbidity and mortality have been increasing globally in recent times. Here, we report an alarming case of fatal sepsis with a probable association of V. cholerae bacteremia in Bangladesh. In September 2023, a 30-year-old man with a pre-condition of beta-thalassemia presented to a tertiary care hospital with acute diarrhea, abdominal pain, nausea, and fever and died within 36 h of admission with acute cholecystitis, metabolic acidosis, acute kidney injury, pancytopenia, and refractory septic shock with multi-organ dysfunction syndrome. Blood culture detected V. cholerae, which was further characterized as hemolytic, carrying the hemolysin gene and genes for the virulence factor type-three secretion system. The isolate was confirmed as V. cholerae non-O1/O139 (NOVC), which differed in genetic properties from the few contemporary NOVC isolates associated with diarrheal cases in Bangladesh. To manage the diarrhea and septicemic condition, the patient was treated empirically with metronidazole and meropenem. However, antibiotic susceptibility testing showed the strain was susceptible to all the routinely prescribed drugs for V. cholerae infections. To the best of our knowledge, this investigation provides the first molecular description of a fatal case of V. cholerae-associated bacteremia in Bangladesh and underscores the need for comprehensive investigations on bacterial septicemia to prevent future casualties.

细菌感染导致菌血症和脓毒性休克是全球新出现的公共卫生问题,尤其是在卫生条件差和缺乏安全饮用水的地区。在这些地区,霍乱弧菌等肠道病原体是造成许多人因食物和水污染而死亡的原因。霍乱是霍乱弧菌造成的主要临床威胁,而菌血症转化为败血症等结果以及相关的发病率和死亡率近来在全球范围内不断上升。在此,我们报告了孟加拉国一例可能与霍乱弧菌菌血症有关的致命败血症病例。2023 年 9 月,一名 30 岁的男子因急性腹泻、腹痛、恶心和发热前往一家三级医院就诊,入院后 36 小时内死亡,并伴有急性胆囊炎、代谢性酸中毒、急性肾损伤、全血细胞减少和难治性脓毒性休克伴多器官功能障碍综合征。血液培养检测到霍乱弧菌,进一步鉴定为溶血性霍乱弧菌,携带溶血素基因和毒力因子三型分泌系统基因。该分离株被确认为非 O1/O139 型霍乱弧菌(NOVC),其基因特性与孟加拉国腹泻病例中的少数当代 NOVC 分离株不同。为了控制腹泻和败血症,该患者接受了甲硝唑和美罗培南的经验性治疗。然而,抗生素敏感性检测显示,该菌株对所有霍乱弧菌感染的常规处方药均敏感。据我们所知,这项调查首次对孟加拉国一例致命的霍乱弧菌相关菌血症病例进行了分子描述,并强调有必要对细菌性败血症进行全面调查,以防止今后发生伤亡。
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引用次数: 0
Fecal microbiome alterations of mice following immunization with gold nanoparticle vaccines against enterohemorrhagic Escherichia coli. 金纳米颗粒疫苗免疫肠出血性大肠杆菌后小鼠粪便微生物组的改变。
IF 4.3 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-12-19 DOI: 10.1186/s13099-024-00670-4
Sarah Bowser, Itziar Chapartegui-González, Alfredo G Torres

Background: Enterohemorrhagic Escherichia coli (EHEC), a group of enteric pathogenic bacteria that is a major cause of human diarrheal disease, must interact with the diverse intestinal microbiome during colonization and subsequently overcome the environmental challenges to survive and cause disease. While this relationship, and how the microbiome modulates infection of EHEC, has been studied, it is less understood how the microbiome is impacted during treatment for an EHEC infection. One area that is notably lacking in knowledge is how vaccination can impact the intestinal microbiome composition, and therefore, influence vaccine efficacy. We previously developed vaccine formulations consisting of gold nanoparticles (AuNPs) conjugated to various EHEC antigens and tested them in mice models using both EHEC and its murine counterpart Citrobacter rodentium. The goal of this study was to evaluate the relationship between these EHEC vaccines and their effects on the gut microbiome.

Results: We found that immunization with the vaccines or adjuvant-only control did not lead to major alterations in the composition of the fecal microbiome; however, there were measurable variations in individual mice within the same vaccine group housed in separate cages. Also, immunization with one vaccine (AuNP-EscC) prevented both a decrease in the diversity of the fecal microbiome and an increase in detectable C. rodentium following infection compared to control animals.

Conclusions: Overall, our small study argues in favor of evaluating the intestinal microbiome during vaccine development not just for EHEC, but for other enteric pathogens.

背景:肠出血性大肠杆菌(EHEC)是一组肠道致病菌,是人类腹泻疾病的主要原因,在定植过程中必须与多种肠道微生物相互作用,随后克服环境挑战才能生存和致病。虽然已经研究了这种关系以及微生物组如何调节肠出血性大肠杆菌感染,但在肠出血性大肠杆菌感染治疗期间微生物组如何受到影响尚不清楚。一个明显缺乏知识的领域是疫苗接种如何影响肠道微生物组组成,从而影响疫苗效力。我们之前开发了由金纳米颗粒(AuNPs)结合各种肠出血性大肠杆菌抗原组成的疫苗配方,并在小鼠模型中使用肠出血性大肠杆菌及其小鼠对应物啮齿柠檬酸杆菌进行了测试。本研究的目的是评估这些肠出血性大肠杆菌疫苗及其对肠道微生物组的影响之间的关系。结果:我们发现接种疫苗或只接种佐剂的对照组不会导致粪便微生物组组成的重大改变;然而,在同一疫苗组中,饲养在不同笼子中的单个小鼠存在可测量的差异。此外,与对照动物相比,接种一种疫苗(AuNP-EscC)可以防止感染后粪便微生物群多样性的减少和可检测到的啮齿c的增加。结论:总的来说,我们的小型研究支持在疫苗开发过程中评估肠道微生物组,不仅针对肠出血性大肠杆菌,也针对其他肠道病原体。
{"title":"Fecal microbiome alterations of mice following immunization with gold nanoparticle vaccines against enterohemorrhagic Escherichia coli.","authors":"Sarah Bowser, Itziar Chapartegui-González, Alfredo G Torres","doi":"10.1186/s13099-024-00670-4","DOIUrl":"10.1186/s13099-024-00670-4","url":null,"abstract":"<p><strong>Background: </strong>Enterohemorrhagic Escherichia coli (EHEC), a group of enteric pathogenic bacteria that is a major cause of human diarrheal disease, must interact with the diverse intestinal microbiome during colonization and subsequently overcome the environmental challenges to survive and cause disease. While this relationship, and how the microbiome modulates infection of EHEC, has been studied, it is less understood how the microbiome is impacted during treatment for an EHEC infection. One area that is notably lacking in knowledge is how vaccination can impact the intestinal microbiome composition, and therefore, influence vaccine efficacy. We previously developed vaccine formulations consisting of gold nanoparticles (AuNPs) conjugated to various EHEC antigens and tested them in mice models using both EHEC and its murine counterpart Citrobacter rodentium. The goal of this study was to evaluate the relationship between these EHEC vaccines and their effects on the gut microbiome.</p><p><strong>Results: </strong>We found that immunization with the vaccines or adjuvant-only control did not lead to major alterations in the composition of the fecal microbiome; however, there were measurable variations in individual mice within the same vaccine group housed in separate cages. Also, immunization with one vaccine (AuNP-EscC) prevented both a decrease in the diversity of the fecal microbiome and an increase in detectable C. rodentium following infection compared to control animals.</p><p><strong>Conclusions: </strong>Overall, our small study argues in favor of evaluating the intestinal microbiome during vaccine development not just for EHEC, but for other enteric pathogens.</p>","PeriodicalId":12833,"journal":{"name":"Gut Pathogens","volume":"16 1","pages":"75"},"PeriodicalIF":4.3,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Molecular characterization and risk analysis of Giardia duodenalis assemblages in corticosteroid-treated and non-treated patients in Ismailia, Arab Republic of Egypt. 阿拉伯埃及共和国伊斯梅利亚接受过皮质类固醇治疗和未接受过皮质类固醇治疗的患者中十二指肠贾第虫群的分子特征和风险分析。
IF 4.3 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-12-13 DOI: 10.1186/s13099-024-00668-y
Shahira Abdelaziz Ali Ahmed, Amira Bakr Mokhtar, Samar Farag Mohamed, Marwa Ibrahim Saad El-Din, Catherine O'Dowd Phanis, Stefani Kazamia, Chad Schou, Paweł Gładysz, Anna Lass, Annalisa Quattrocchi, Panagiotis Karanis, Samer Eid Mohamed Gad

Background: Giardia duodenalis (G. duodenalis) is an intestinal protozoan parasite of human and animal hosts. The present study investigated and compared the assemblages of G. duodenalis-infected faecal samples in patients on corticosteroid therapy (POCT) and control patients-not on corticosteroid therapy (CONT) and differentiated its assemblages and/or sub-assemblages' relationship with associated risk factors.

Methods: Utilizing multi-locus sequence typing (MLST) with three loci targeted-triosephosphate isomerase (tpi), ꞵ-giardin (bg), and glutamate dehydrogenase (gdh)-G. duodenalis isolated from POCT and CONT were analyzed. Risk factors linked with Giardia infection and its assemblages were investigated.

Results: In total, 52 G. duodenalis-infected patients were enrolled: 21 POCT and 31 CONT. The mean age was 12.3 years, the majority were male (59.6%), and 73.1% lived in rural areas. The POCT group was 36 times more likely than the CONT group to have a concurrent parasitic infection. About 73% (38/52) of Giardia samples were genotyped and/or sub-genotyped in at least one of the three loci. MLST identified sixteen isolates (42.0%) as assemblage B, ten isolates (26.3%) as assemblage A, and twelve isolates (31.6%) as a mixed infection of A + B and B + E. Most individuals of the POCT group were infected with G. duodenalis assemblage A while most of the CONT group were infected with assemblage B. Sub-assemblage AII was identified by phylogenetic analysis in the isolates of both groups under investigation.

Conclusion: This research advances giardiasis epidemiology in Arab Republic of Egypt (ARE) and reflects how corticosteroid-treated patients differ from those non-treated in Giardia assemblage pattern and their susceptibility to concomitant infection. Overall, Giardia assemblage patterns in this research populations reflect anthroponotic and zoonotic transmission, emphasizing the importance of public health policy and giardiasis prevention of illness transmission, particularly among those on corticosteroid therapy in ARE.

背景:十二指肠贾第虫(Giardia duodenalis)是一种寄生于人类和动物肠道的原生动物寄生虫。本研究调查并比较了接受皮质类固醇治疗(POCT)的患者和未接受皮质类固醇治疗(CONT)的对照患者中十二指肠梭菌感染的粪便样本的组合,并区分了其组合和/或亚组合与相关危险因素的关系。方法:采用多位点序列分型(MLST)技术,对3个位点靶向三磷酸异构酶(tpi)、ꞵ-栀子苷(bg)和谷氨酸脱氢酶(gdh)-G进行分型。对POCT和CONT分离的十二指肠进行分析。调查了与贾第鞭毛虫感染及其组合有关的危险因素。结果:共纳入52例G.十二指肠感染患者,其中POCT 21例,CONT 31例,平均年龄12.3岁,男性居多(59.6%),农村占73.1%。POCT组并发寄生虫感染的可能性是CONT组的36倍。约73%(38/52)的贾第鞭毛虫样本至少在三个位点中的一个进行了基因分型和/或亚基因分型。MLST鉴定16株(42.0%)为组合B, 10株(26.3%)为组合A, 12株(31.6%)为A + B和B + E混合感染。POCT组的大部分个体感染的是十二指肠螺旋体组合A, CONT组的大部分个体感染的是组合b。通过系统发育分析,两组的分离株均鉴定出亚组合AII。结论:本研究促进了阿拉伯埃及共和国(ARE)贾第鞭毛虫病流行病学的发展,反映了皮质类固醇治疗患者与未治疗患者贾第鞭毛虫聚集模式的差异及其对伴发感染的易感性。总体而言,该研究人群中的贾第虫组合模式反映了人传和人畜共患传播,强调了公共卫生政策和贾第虫病预防疾病传播的重要性,特别是在ARE中接受皮质类固醇治疗的人群中。
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引用次数: 0
Efficacy of colistin-based combinations against pandrug-resistant whole-genome-sequenced Klebsiella pneumoniae isolated from hospitalized patients in Egypt: an in vitro/vivo comparative study. 以粘菌素为基础的联合治疗从埃及住院患者中分离出的泛耐药全基因组测序肺炎克雷伯菌的疗效:一项体外/体内比较研究
IF 4.3 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-12-03 DOI: 10.1186/s13099-024-00667-z
Eriny T Attalla, Amal M Khalil, Azza S Zakaria, Rhiannon Evans, Nesrin S Tolba, Nelly M Mohamed

Background: Colistin resistance significantly constrains available treatment options and results in the emergence of pandrug-resistant (PDR) strains. Treating PDR infections is a major public health issue. A promising solution lies in using colistin-based combinations. Despite the availability of in vitro data evaluating these combinations, the in vivo studies remain limited.

Results: Thirty colistin-resistant Klebsiella pneumoniae (ColRKp) isolates were collected from hospitalized patients. Colistin resistance was detected using broth microdilution, and antimicrobial susceptibility was tested using the Kirby-Bauer method against 18 antibiotics. Extremely high resistance levels were detected, with 17% of the isolates being PDR. Virulence profiling, assessed using Anthony capsule staining, the string test, and the crystal violet assay, indicated the predominance of non-biofilm formers and non-hypermucoid strains. The isolates were screened for mcr genes using polymerase chain reaction. Whole-genome sequencing (WGS) and bioinformatics analysis were performed to characterize the genomes of PDR isolates. No plasmid-borne mcr genes were detected, and WGS analysis revealed that PDR isolates belonged to the high-risk clones: ST14 (n = 1), ST147 (n = 2), and ST383 (n = 2). They carried genes encoding extended-spectrum β-lactamases and carbapenemases, blaCTX-M-15 and blaNDM-5, on conjugative IncHI1B/IncFIB plasmids, illustrating the convergence of virulence and resistance genes. The most common mechanism of colistin resistance involved alterations in mgrB. Furthermore, deleterious amino acid substitutions were also detected within PhoQ, PmrC, CrrB, ArnB, and ArnT. Seven colistin-containing combinations were compared using the checkerboard experiment. Synergy was observed when combining colistin with tigecycline, doxycycline, levofloxacin, ciprofloxacin, sulfamethoxazole/trimethoprim, imipenem, or meropenem. The efficacy of colistin combined with either doxycycline or levofloxacin was assessed in vitro using a resistance modulation assay, and in vivo, using a murine infection model. In vitro, doxycycline and levofloxacin reversed colistin resistance in 80% and 73.3% of the population, respectively. In vivo, the colistin + doxycycline combination demonstrated superiority over colistin + levofloxacin, rescuing 80% of infected animals, and reducing bacterial bioburden in the liver and kidneys while preserving nearly intact lung histology.

Conclusions: This study represents the first comparative in vitro and in vivo investigation of the efficacy of colistin + doxycycline and colistin + levofloxacin combinations in clinical PDR ColRKp isolates characterized at a genomic level.

背景:粘菌素耐药性极大地限制了现有的治疗选择,并导致了大范围耐药(PDR)菌株的出现。治疗PDR感染是一个重大的公共卫生问题。一个有希望的解决方案是使用基于粘菌素的组合。尽管有评估这些组合的体外数据,但体内研究仍然有限。结果:从住院患者中分离到30株耐粘菌素肺炎克雷伯菌(ColRKp)。采用微量肉汤稀释法检测粘菌素耐药性,采用Kirby-Bauer法检测对18种抗生素的药敏。检测到极高的耐药水平,其中17%的分离株为PDR。利用安东尼胶囊染色、串试验和结晶紫试验评估的毒力分析表明,非生物膜形成菌株和非超粘液样菌株占主导地位。采用聚合酶链反应对分离株进行mcr基因筛选。采用全基因组测序(WGS)和生物信息学分析对PDR分离株的基因组进行了表征。未检测到质粒携带的mcr基因,WGS分析显示PDR分离株属于高危克隆:ST14 (n = 1)、ST147 (n = 2)和ST383 (n = 2)。它们在结合的IncHI1B/IncFIB质粒上携带编码扩展谱β-内酰胺酶和碳青霉烯酶的基因blaCTX-M-15和blaNDM-5,说明了毒力和抗性基因的趋同。粘菌素耐药的最常见机制涉及mgrB的改变。此外,在PhoQ、PmrC、CrrB、ArnB和ArnT中也检测到有害的氨基酸取代。采用棋盘实验对7种含粘菌素组合进行比较。当粘菌素与替加环素、强力霉素、左氧氟沙星、环丙沙星、磺胺甲恶唑/甲氧苄啶、亚胺培南或美罗培南联合使用时,观察到协同作用。粘菌素联合多西环素或左氧氟沙星的疗效在体外通过耐药性调节试验进行评估,在体内通过小鼠感染模型进行评估。在体外,强力霉素和左氧氟沙星分别逆转了80%和73.3%的人群对粘菌素的耐药性。在体内,粘菌素+多西环素联合治疗优于粘菌素+左氧氟沙星,挽救了80%的感染动物,减少了肝脏和肾脏的细菌生物负荷,同时保持了几乎完整的肺组织。结论:本研究首次在基因组水平上比较了粘菌素+多西环素和粘菌素+左氧氟沙星联合治疗临床PDR ColRKp分离株的体外和体内疗效。
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引用次数: 0
Investigation of gut microbiota composition in humans carrying blastocystis subtypes 1 and 2 and Entamoeba hartmanni. 携带囊虫1、2亚型和哈特曼内阿米巴的人肠道菌群组成的调查。
IF 4.3 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-11-29 DOI: 10.1186/s13099-024-00661-5
Lorenzo Antonetti, Federica Berrilli, Veronica Di Cristanziano, Fedja Farowski, Martin Daeumer, Kirsten Alexandra Eberhardt, Maristella Santoro, Massimo Federici, Rossella D'Alfonso

The composition of human gut microbiota is dominated by bacteria which have been extensively studied. The role of intestinal eukaryote microorganisms like Blastocystis, however, remains under investigation. Moreover, the potential impact on gut health related to Blastocystis presence was primarily investigated in symptomatic individuals mainly from industrialized countries, and appears to be mostly beneficial to the host microbiota. Data from surveys conducted in underdeveloped countries with higher prevalence and from asymptomatic individuals could therefore be valuable. The aim of this preliminary study was to analyze the composition of the gut microbiota in relation to the protozoa Blastocystis ST1 and ST2 and Entamoeba hartmanni carriage in asymptomatic subjects living in a semi-urban area of Côte d'Ivoire to add data into the ongoing debate on the role of Blastocystis in host health. The amplification of the V3 and V4 regions of bacterial 16S rDNA genes was performed to obtain the gut microbiota composition, and differential analyses on alpha and beta diversity were performed from the phylum to genus taxonomic level. The analysis revealed that individuals positive for both protozoa exhibited higher alpha and beta diversity compared to those who tested negative. Additionally, their bacterial composition showed a reduction in Bacteroides and an increase in Prevotella 9. Relative abundances of some OTUs, particularly Faecalibacterium, observed in individuals who tested positive for protozoa, were correlated with a good state of health of the gut microbiota. Blastocystis ST1 and ST2 associated with E. hartmanni thus appeared to be related to a state of intestinal eubiosis.

人类肠道菌群的组成以细菌为主,已被广泛研究。然而,肠真核微生物如囊虫的作用仍在研究中。此外,囊虫存在对肠道健康的潜在影响主要是在主要来自工业化国家的有症状个体中进行的,并且似乎主要对宿主微生物群有益。因此,在发病率较高的不发达国家和无症状个体进行的调查数据可能是有价值的。本初步研究的目的是分析生活在Côte科特迪瓦半城市地区的无症状患者肠道微生物群的组成与囊虫ST1和ST2原生动物和哈特曼内阿米巴携带的关系,为正在进行的囊虫在宿主健康中的作用的辩论提供数据。对细菌16S rDNA基因的V3和V4区进行扩增,获得肠道菌群组成,并在门和属的分类水平上进行α和β多样性的差异分析。分析显示,与检测结果为阴性的个体相比,两种原生动物均呈阳性的个体表现出更高的α和β多样性。此外,他们的细菌组成表明拟杆菌减少,普雷沃氏菌9增加。在原生动物检测呈阳性的个体中观察到的一些otu的相对丰度,特别是Faecalibacterium,与肠道微生物群的良好健康状态相关。因此,与哈特曼大肠杆菌相关的囊虫ST1和ST2似乎与肠道益生状态有关。
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引用次数: 0
Risk factors for peptic ulcer bleeding one year after the initial episode. 初次发作一年后消化性溃疡出血的危险因素。
IF 4.3 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-11-28 DOI: 10.1186/s13099-024-00669-x
Yu-Xuan Peng, Wen-Pei Chang

Background: Peptic ulcers are a common gastrointestinal disease that could cause death when combined with bleeding. The aim of this study was to identify risk factors for peptic ulcer bleeding (PUB) recurrence after the initial episode.

Methods: This retrospective study analyzed medical records of PUB patients who were admitted through the emergency department between January 1, 2020, and December 31, 2022. A multivariate logistic regression model was used to identify independent risk factors predicting readmission due to recurrent PUB within one year.

Results: A total of 775 PUB inpatient samples were collected, among which 172 and 603 were placed respectively in the readmission group and non-readmission group. Multivariate analysis indicated that PUB inpatients who were aged 70 or above (OR = 1.62, 95% CI: 1.06-2.47), had more severe ulcers (Forrest 1a, 1b, 2a, or 2b) (OR = 2.41, 95% CI:1.57-3.71), had a CCI score of 3 or higher (OR = 2.25, 95% CI:1.45-3.50), had a medical history of peptic ulcers (OR = 3.87, 95% CI:2.56-5.85), had a medical history of cardiovascular disease (CVD) (OR = 2.31, 95% CI:1.53-3.50), or had an international normalized ratio (INR) > 1.2 on admission (OR = 2.14, 95% CI:1.28-3.57) were respectively more likely to be readmitted within a year due to PUB than those who were under the age of 70, had less severe ulcers (Forrest 2c or 3), had a CCI score of less than 3, had no medical history of peptic ulcers, had no medical history of CVD, or had admission INR ≤ 1.2.

Conclusion: This study confirmed that age (≥70 years), Forest classification (Forrest 1a, 1b, 2a, or 2b), multiple comorbidities, a medical history of peptic ulcers, a medical history of CVD, and admission INR > 1.2 were independent risk factors for patient readmission within a year due to recurrent PUB.

背景:消化性溃疡是一种常见的胃肠道疾病,合并出血可导致死亡。本研究的目的是确定初次发作后消化性溃疡出血(PUB)复发的危险因素。方法:本回顾性研究分析了2020年1月1日至2022年12月31日期间通过急诊科入院的PUB患者的医疗记录。多变量logistic回归模型用于确定预测一年内复发性PUB再入院的独立危险因素。结果:共收集PUB住院患者样本775例,其中再入院组172例,非再入院组603例。多因素分析显示,PUB住院患者年龄在70岁及以上(or = 1.62, 95% CI:1.06 - -2.47),更严重的溃疡(福勒斯特1 a、1 b、2或2 b) (or = 2.41, 95% CI: 1.57—-3.71),3或更高的CCI分数(or = 2.25, 95% CI: 1.45—-3.50),有胃溃疡病史(or = 3.87, 95% CI: 2.56—-5.85),心血管疾病(CVD)的病史(or = 2.31, 95% CI: 1.53—-3.50),或有一个国际标准化比率(INR) > 1.2入院时(或= 2.14,95% CI:1.28-3.57)分别比70岁以下、溃疡较轻(Forrest 2c或3)、CCI评分小于3、无消化性溃疡病史、无心血管疾病病史或入院INR≤1.2的患者更容易因PUB在一年内再次入院。结论:本研究证实,年龄(≥70岁)、Forest分类(Forrest 1a、1b、2a或2b)、多种合并症、消化性溃疡病史、心血管疾病病史和入院INR bbb1.2是复发性PUB患者一年内再入院的独立危险因素。
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引用次数: 0
Clonal and horizontal transmission of carbapenem-resistant Enterobacterales strains and genes via flies. 耐碳青霉烯类肠杆菌菌株和基因通过苍蝇的克隆和水平传播。
IF 4.3 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-11-16 DOI: 10.1186/s13099-024-00665-1
Jialiang Xu, Jiaqi Liu, Jiayong Zhao, Tian Tian, Mengyu Wang, Gailing Yuan, Yao Peng, Yuan Zhang, Zhe Li, Biao Kan, Zhenpeng Li, Xin Lu

Background: Antimicrobial resistance (AMR) is one of the most pressing global public health challenges; in particular, the rapid dissemination of carbapenem-resistant Enterobacterales (CRE) is emerging as a significant concern worldwide. Flies, serving as carriers of pathogens, pose a potential threat in the transmission of antibiotic-resistant bacteria (ARB) between animals and humans. The aim of this study was to evaluate and reveal the potential risk of AMR spread by flies.

Methods: A total of 450 flies were collected from four farms, four rural areas, and four urban areas in Dengfeng, Henan, China. To select CRE strains on the surface of flies, three flies sampled from the same geographical location were arbitrarily selected and placed into one tube of brain heart infusion broth (BHI), and the supernatant was screened using CHROMagar™ mSuperCARBA culture medium. Different colors and shapes of colonies were identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and 16S rRNA sequencing. Antimicrobial susceptibility testing for CRE strains was performed using broth microdilution. All CRE strains were whole-genome sequenced. Short-read sequencing was performed using MGISEQ-2000 and long-read sequencing was conducted using GridION.

Results: Totally, 150 BHI tubes were screened for CRE strains, and 33 strains were identified as CRE positive. In 24 mSuperCARBA plates, only one species of CRE strain was isolated from each plate. In three plates, two different species of CRE strains were identified in each plate. In one plate, three different species of CRE strains were simultaneously isolated. Carbapenem resistance genes were detected in 81.8% of CRE strains, and blaNDM-1 was predominant (66.7%). No significant correlations between carbapenem-resistant phenotypes and carbapenem resistance genes were observed. The complete genomes of all 33 strains were obtained. Genome analysis revealed that clonal transmission events may have occurred among different farms and rural areas. Phylogenetic analysis revealed that blaNDM-1 IncFII plasmids could break bacterial species barrier for cross-host transmission in diverse areas.

Conclusions: To understand and control the transmission of AMR from the perspective of One Health, it is imperative to enhance surveillance of ARB, antibiotic resistance genes, and antibiotic-resistant plasmids in flies.

背景:抗菌素耐药性(AMR)是全球公共卫生面临的最紧迫挑战之一;特别是耐碳青霉烯类肠杆菌(CRE)的快速传播正在成为全球关注的一个重大问题。苍蝇作为病原体的载体,对耐抗生素细菌(ARB)在动物和人类之间的传播构成了潜在威胁。本研究旨在评估和揭示苍蝇传播耐抗生素细菌的潜在风险:方法:从中国河南登封的四个农场、四个农村地区和四个城市地区共收集了 450 只苍蝇。为了筛选苍蝇体表的 CRE 菌株,任意选取同一地点的三只苍蝇放入一管脑心输液肉汤(BHI)中,用 CHROMagar™ mSuperCARBA 培养基对上清液进行筛选。通过基质辅助激光解吸/电离飞行时间质谱法和 16S rRNA 测序鉴定不同颜色和形状的菌落。采用肉汤微稀释法对 CRE 菌株进行抗菌药敏感性测试。对所有 CRE 菌株进行了全基因组测序。使用 MGISEQ-2000 进行短线程测序,使用 GridION 进行长线程测序:结果:共对 150 个 BHI 管中的 CRE 菌株进行了筛查,33 株菌株被鉴定为 CRE 阳性。在 24 个 mSuperCARBA 平板中,每个平板只分离出一种 CRE 菌株。在 3 个平板中,每个平板分离出两种不同的 CRE 菌株。在一个平板中,同时分离出三种不同的 CRE 菌株。81.8% 的 CRE 菌株检测到碳青霉烯耐药基因,其中以 blaNDM-1 型为主(66.7%)。碳青霉烯耐药表型与碳青霉烯耐药基因之间未发现明显的相关性。研究人员获得了所有 33 株菌株的完整基因组。基因组分析表明,克隆传播事件可能发生在不同的农场和农村地区。系统发育分析表明,blaNDM-1 IncFII质粒可打破细菌物种屏障,在不同地区进行跨宿主传播:结论:为了从 "一体健康 "的角度了解和控制 AMR 的传播,必须加强对苍蝇中 ARB、抗生素耐药基因和抗生素耐药质粒的监测。
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引用次数: 0
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