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16S rRNA sequencing analysis of the oral and fecal microbiota in colorectal cancer positives versus colorectal cancer negatives in Iranian population. 对伊朗人群中结直肠癌阳性与结直肠癌阴性患者的口腔和粪便微生物群进行 16S rRNA 测序分析。
IF 4.2 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-02-20 DOI: 10.1186/s13099-024-00604-0
Sama Rezasoltani, Mehdi Azizmohammad Looha, Hamid Asadzadeh Aghdaei, Seyedesomayeh Jasemi, Leonardo Antonio Sechi, Maria Gazouli, Amir Sadeghi, Shirin Torkashvand, Reyhaneh Baniali, Hartmut Schlüter, Mohammad Reza Zali, Mohammad Mehdi Feizabadi

Background: Colorectal cancer (CRC) poses a significant healthcare challenge, accounting for nearly 6.1% of global cancer cases. Early detection, facilitated by population screening utilizing innovative biomarkers, is pivotal for mitigating CRC incidence. This study aims to scrutinize the fecal and salivary microbiomes of CRC-positive individuals (CPs) in comparison to CRC-negative counterparts (CNs) to enhance early CRC diagnosis through microbial biomarkers.

Material and methods: A total of 80 oral and stool samples were collected from Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran, encompassing both CPs and CNs undergoing screening. Microbial profiling was conducted using 16S rRNA sequencing assays, employing the Nextera XT Index Kit on an Illumina NovaSeq platform.

Results: Distinct microbial profiles were observed in saliva and stool samples of CPs, diverging significantly from those of CNs at various taxonomic levels, including phylum, family, and species. Saliva samples from CPs exhibited abundance of Calothrix parietina, Granulicatella adiacens, Rothia dentocariosa, and Rothia mucilaginosa, absent in CNs. Additionally, Lachnospiraceae and Prevotellaceae were markedly higher in CPs' feces, while the Fusobacteria phylum was significantly elevated in CPs' saliva. Conversely, the non-pathogenic bacterium Akkermansia muciniphila exhibited a significant decrease in CPs' fecal samples compared to CNs.

Conclusion: Through meticulous selection of saliva and stool microbes based on Mean Decrease GINI values and employing logistic regression for saliva and support vector machine models for stool, we successfully developed a microbiota test with heightened sensitivity and specificity for early CRC detection.

背景:结直肠癌(CRC)是一项重大的医疗挑战,占全球癌症病例的近 6.1%。利用创新生物标志物进行人群筛查,有助于早期发现,这对降低 CRC 发病率至关重要。本研究旨在仔细研究 CRC 阳性个体(CPs)与 CRC 阴性个体(CNs)的粪便和唾液微生物组,通过微生物生物标志物提高 CRC 的早期诊断率:从伊朗德黑兰沙希德-贝赫什提医科大学 Taleghani 医院共收集了 80 份口腔和粪便样本,其中包括接受筛查的 CPs 和 CNs。在 Illumina NovaSeq 平台上使用 Nextera XT 指数试剂盒,利用 16S rRNA 测序分析法进行了微生物谱分析:结果:在氯化石蜡患者的唾液和粪便样本中观察到了不同的微生物特征,与氯化石蜡患者的唾液和粪便样本在不同的分类水平(包括门、科和种)上存在显著差异。氯化石蜡患者的唾液样本中含有大量的Calothrix parietina、Granulicatella adiacens、Rothia dentocariosa和Rothia mucilaginosa,而氯化石蜡患者的唾液样本中没有这些微生物。此外,氯化石蜡粪便中的Lachnospiraceae和Prevotellaceae明显较多,而氯化石蜡唾液中的Fusobacteria门明显较多。相反,CP 粪便样本中的非致病菌 Akkermansia muciniphila 与 CN 相比明显减少:通过根据平均下降 GINI 值对唾液和粪便微生物进行精心筛选,并对唾液采用逻辑回归法,对粪便采用支持向量机模型,我们成功开发出了一种微生物群检测方法,其灵敏度和特异性均有所提高,可用于早期 CRC 检测。
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引用次数: 0
Intestinal metabolites predict treatment resistance of patients with depression and anxiety. 肠道代谢物可预测抑郁症和焦虑症患者的耐药性。
IF 4.2 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-02-09 DOI: 10.1186/s13099-024-00601-3
Juntaro Matsuzaki, Shunya Kurokawa, Chiaki Iwamoto, Katsuma Miyaho, Akihiro Takamiya, Chiharu Ishii, Akiyoshi Hirayama, Kenji Sanada, Shinji Fukuda, Masaru Mimura, Taishiro Kishimoto, Yoshimasa Saito

Background: The impact of the gut microbiota on neuropsychiatric disorders has gained much attention in recent years; however, comprehensive data on the relationship between the gut microbiome and its metabolites and resistance to treatment for depression and anxiety is lacking. Here, we investigated intestinal metabolites in patients with depression and anxiety disorders, and their possible roles in treatment resistance.

Results: We analyzed fecal metabolites and microbiomes in 34 participants with depression and anxiety disorders. Fecal samples were obtained three times for each participant during the treatment. Propensity score matching led us to analyze data from nine treatment responders and nine non-responders, and the results were validated in the residual sample sets. Using elastic net regression analysis, we identified several metabolites, including N-ε-acetyllysine; baseline levels of the former were low in responders (AUC = 0.86; 95% confidence interval, 0.69-1). In addition, fecal levels of N-ε-acetyllysine were negatively associated with the abundance of Odoribacter. N-ε-acetyllysine levels increased as symptoms improved with treatment.

Conclusion: Fecal N-ε-acetyllysine levels before treatment may be a predictive biomarker of treatment-refractory depression and anxiety. Odoribacter may play a role in the homeostasis of intestinal L-lysine levels. More attention should be paid to the importance of L-lysine metabolism in those with depression and anxiety.

背景:近年来,肠道微生物群对神经精神疾病的影响备受关注;然而,关于肠道微生物群及其代谢物与抑郁症和焦虑症治疗耐受性之间关系的全面数据还很缺乏。在此,我们研究了抑郁症和焦虑症患者的肠道代谢物及其在治疗耐药性中可能扮演的角色:我们分析了 34 名抑郁症和焦虑症患者的粪便代谢物和微生物组。每位患者在治疗期间均采集了三次粪便样本。通过倾向得分匹配,我们分析了九名治疗应答者和九名非应答者的数据,并在剩余样本集中验证了结果。通过弹性净回归分析,我们确定了几种代谢物,包括 N-ε-乙酰赖氨酸;前者在应答者中的基线水平较低(AUC = 0.86;95% 置信区间,0.69-1)。此外,粪便中的 N-ε-乙酰赖氨酸水平与臭味菌的数量呈负相关。N-ε-乙酰赖氨酸水平随着治疗后症状的改善而增加:结论:治疗前的粪便N-ε-乙酰赖氨酸水平可能是难治性抑郁症和焦虑症的预测性生物标志物。厌氧菌可能在肠道 L-赖氨酸水平的平衡中发挥作用。应更加关注 L-赖氨酸代谢对抑郁症和焦虑症患者的重要性。
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引用次数: 0
A systematic review and meta-analysis of protozoan parasite infections among patients with mental health disorders: an overlooked phenomenon. 精神疾病患者原生动物寄生虫感染的系统回顾和荟萃分析:一个被忽视的现象。
IF 4.3 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-01-28 DOI: 10.1186/s13099-024-00602-2
Amir Abdoli, Meysam Olfatifar, Aida Vafae Eslahi, Zeinab Moghadamizad, Rasoul Samimi, Mohammad Amin Habibi, Amir Sam Kianimoghadam, Milad Badri, Panagiotis Karanis

Background: Patients with mental disorders have a high risk of intestinal parasitic infection due to poor hygiene practices. Hence, to better clarify this overlooked phenomenon, the current study is conducted to determine the global prevalence of protozoan parasite infections in patients with mental disorders and investigate the associated risk factors.

Methods: Several databases (PubMed, Scopus, Web of Science, ProQuest, and Google Scholar) were searched for papers published until December 2022. The fixed effect meta-analysis was used to estimate the overall odds ratio (OR) and pooled prevalence was estimated using a random-effects model with a 95% confidence interval (CI).

Results: Totally, 131 articles (91 case-control and 40 cross-sectional studies) met the eligibility criteria. Patients with mental disorders were significantly at higher risk for protozoan parasites than healthy controls (OR: 2.059, 1.830-2.317). The highest pooled OR (2.485, 1.413-4.368) was related to patients with neurodevelopmental disorders, and the highest pooled prevalence was detected in patients with neurodevelopmental disorders (0.341, 0.244-0.446), followed by bipolar and related disorders (0.321, 0.000-0.995). Toxoplasma gondii was the most prevalent protozoan parasite (0.343, 0.228-0.467) in cross-sectional studies and the highest pooled OR was related to Cyclospora cayetanensis (4.719, 1.352-16.474) followed by Cryptosporidium parvum (4.618, 2.877-7.412).

Conclusion: Our findings demonstrated that individuals afflicted with mental disorders are significantly more susceptible to acquiring protozoan parasites in comparison to healthy individuals. Preventive interventions, regular screening, and treatment approaches for parasitic diseases should be considered for patients with mental disorders.

背景:由于卫生习惯差,精神障碍患者感染肠道寄生虫的风险很高。因此,为了更好地澄清这一被忽视的现象,本研究旨在确定精神障碍患者原生动物寄生虫感染的全球流行率,并调查相关的风险因素:检索了多个数据库(PubMed、Scopus、Web of Science、ProQuest 和 Google Scholar)中截至 2022 年 12 月发表的论文。采用固定效应荟萃分析法估算总体几率比(OR),并采用随机效应模型估算汇总患病率,得出95%的置信区间(CI):共有 131 篇文章(91 项病例对照研究和 40 项横断面研究)符合资格标准。精神障碍患者感染原生动物寄生虫的风险明显高于健康对照组(OR:2.059,1.830-2.317)。神经发育障碍患者的综合 OR 值最高(2.485,1.413-4.368),神经发育障碍患者的综合感染率最高(0.341,0.244-0.446),其次是双相情感障碍和相关障碍(0.321,0.000-0.995)。在横断面研究中,弓形虫是最常见的原生动物寄生虫(0.343,0.228-0.467),与环孢子虫有关的集合OR值最高(4.719,1.352-16.474),其次是副隐孢子虫(4.618,2.877-7.412):我们的研究结果表明,与健康人相比,精神障碍患者更容易感染原生动物寄生虫。应考虑对精神障碍患者进行寄生虫病的预防干预、定期筛查和治疗。
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引用次数: 0
Cyclic-di-AMP confers an invasive phenotype on Escherichia coli through elongation of flagellin filaments. 环状二-AMP 通过鞭毛蛋白丝的伸长赋予大肠杆菌侵袭表型。
IF 4.2 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-01-24 DOI: 10.1186/s13099-024-00600-4
Rika Tanaka, Jin Imai, Eiji Sugiyama, Shogo Tsubaki, Katsuto Hozumi, Hitoshi Tsugawa

Background: Adherent-invasive Escherichia coli (AIEC) is isolated from patients with Crohn's disease (CD). AIEC can invade the intestinal epithelium, suggesting that it is involved in the development and pathogenesis of CD. However, the mechanism by which AIEC acquired the invasive phenotype remains unknown.

Results: This study was designed to examine the mechanisms of AIEC invasiveness. We found that the flagellin (fliC) expression in AIEC was two-fold higher than that in non-AIEC strains, and this overexpression induced the formation of long-filament flagellin. Deletion of fliC in the AIEC LF82 strain resulted in the disappearance of flagellar filaments and attenuated the motility and invasive ability of the bacterium, suggesting that the formation of long filament flagellin induced by increased fliC expression is required by AIEC to invade the intestinal epithelium. In AIEC and non-AIEC K12 strains cultured in the presence of cyclic-di-AMP (c-di-AMP), the expression of fliC was enhanced, and flagellar filaments were elongated. Stimulation with c-di-AMP enhanced the bacterial motility and ability to invade epithelial cells, even in the non-AIEC K12 strain.

Conclusions: Our findings show that c-di-AMP confers an AIEC-like phenotype on non-AIEC strains by enhancing the expression of fliC. The results should be useful for understanding the pathogenesis of CD.

背景:从克罗恩病(CD)患者体内分离出粘附侵袭性大肠杆菌(AIEC)。AIEC 可侵入肠上皮细胞,这表明它与克罗恩病的发展和发病机制有关。然而,AIEC获得侵袭表型的机制仍然未知:本研究旨在探讨 AIEC 的侵袭性机制。我们发现 AIEC 中鞭毛蛋白(fliC)的表达量是非 AIEC 菌株的两倍,这种过量表达会诱导长丝鞭毛蛋白的形成。在AIEC LF82菌株中缺失fliC会导致鞭毛丝消失,并削弱该细菌的运动能力和侵袭能力,这表明fliC表达量增加所诱导的长丝鞭毛蛋白的形成是AIEC侵袭肠上皮细胞所必需的。在环状二-AMP(c-di-AMP)存在下培养的 AIEC 和非 AIEC K12 菌株中,fliC 的表达增强,鞭毛丝伸长。c-di-AMP 的刺激增强了细菌的运动能力和侵袭上皮细胞的能力,即使在非 AIEC K12 菌株中也是如此:我们的研究结果表明,c-di-AMP 通过增强 fliC 的表达,使非 AIEC 菌株具有 AIEC 样表型。结论:我们的研究结果表明,c-di-AMP 可通过增强 fliC 的表达,使非 AIEC 菌株产生类似 AIEC 的表型。
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引用次数: 0
Gut microbial ecology and exposome of a healthy Pakistani cohort 巴基斯坦健康人群的肠道微生物生态和暴露组
IF 4.2 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-01-22 DOI: 10.1186/s13099-024-00596-x
Farzana Gul, Hilde Herrema, Mark Davids, Ciara Keating, Arshan Nasir, Umer Zeeshan Ijaz, Sundus Javed
Pakistan is a multi-ethnic society where there is a disparity between dietary habits, genetic composition, and environmental exposures. The microbial ecology of healthy Pakistani gut in the context of anthropometric, sociodemographic, and dietary patterns holds interest by virtue of it being one of the most populous countries, and also being a Lower Middle Income Country (LMIC). 16S rRNA profiling of healthy gut microbiome of normo-weight healthy Pakistani individuals from different regions of residence is performed with additional meta-data collected through filled questionnaires. The current health status is then linked to dietary patterns through $${chi }^{2}$$ test of independence and Generalized Linear Latent Variable Model (GLLVM) where distribution of individual microbes is regressed against all recorded sources of variability. To identify the core microbiome signature, a dynamic approach is used that considers into account species occupancy as well as consistency across assumed grouping of samples including organization by gender and province of residence. Fitting neutral modeling then revealed core microbiome that is selected by the environment. A strong determinant of disparity is by province of residence. It is also established that the male microbiome is better adapted to the local niche than the female microbiome, and that there is microbial taxonomic and functional diversity in different ethnicities, dietary patterns and lifestyle habits. Some microbial genera, such as, Megamonas, Porphyromonas, Haemophilus, Klebsiella and Finegoldia showed significant associations with consumption of pickle, fresh fruits, rice, and cheese. Our analyses suggest current health status being associated with the diet, sleeping patterns, employment status, and the medical history. This study provides a snapshot of the healthy core Pakistani gut microbiome by focusing on the most populous provinces and ethnic groups residing in predominantly urban areas. The study serves a reference dataset for exploring variations in disease status and designing personalized dietary and lifestyle interventions to promote gut health, particularly in LMICs settings.
巴基斯坦是一个多民族社会,饮食习惯、基因组成和环境暴露之间存在差异。巴基斯坦是人口最多的国家之一,也是中低收入国家(LMIC),因此在人体测量、社会人口和饮食模式的背景下研究巴基斯坦健康肠道的微生物生态很有意义。我们对来自不同居住地区、体重正常的健康巴基斯坦人的健康肠道微生物组进行了 16S rRNA 图谱分析,并通过填写问卷收集了额外的元数据。然后通过$${chi }^{2}$$独立性检验和广义线性潜变量模型(GLLVM)将当前健康状况与膳食模式联系起来,在广义线性潜变量模型中,单个微生物的分布与所有记录的变异源进行回归。为了确定核心微生物群特征,我们采用了一种动态方法,该方法考虑了物种占有率以及假定的样本分组(包括按性别和居住省份分组)的一致性。然后,拟合中性模型揭示了由环境选择的核心微生物组。居住省份是造成差异的一个重要决定因素。研究还证实,男性微生物组比女性微生物组更适应当地的生态位,不同种族、饮食模式和生活习惯的微生物在分类和功能上存在多样性。一些微生物属,如 Megamonas、卟啉单胞菌、嗜血杆菌、克雷伯氏菌和 Finegoldia 与腌菜、新鲜水果、大米和奶酪的食用量有显著关联。我们的分析表明,目前的健康状况与饮食、睡眠模式、就业状况和病史有关。这项研究通过对人口最多的省份和主要居住在城市地区的民族群体的研究,为健康的巴基斯坦核心肠道微生物组提供了一个快照。这项研究提供了一个参考数据集,用于探索疾病状况的变化,设计个性化的饮食和生活方式干预措施,以促进肠道健康,尤其是在低收入和中等收入国家的环境中。
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引用次数: 0
A monoclonal antibody collection for C. difficile typing ? 用于艰难梭菌分型的单克隆抗体集 ?
IF 4.2 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-01-19 DOI: 10.1186/s13099-023-00592-7
Lise Hunault, Patrick England, Frédéric Barbut, Bruno Iannascoli, Ophélie Godon, François Déjardin, Christophe Thomas, Bruno Dupuy, Chunguang Guo, Lynn Macdonald, Guy Gorochov, Delphine Sterlin, Pierre Bruhns
Clostridioides difficile is the leading cause of antibiotic-associated diarrhea and pseudomembranous colitis in adults. Various C. difficile strains circulate currently, associated with different outcomes and antibiotic resistance profiles. However, most studies still focus on the reference strain 630 that does not circulate anymore, partly due to the lack of immunological tools to study current clinically important C. difficile PCR ribotypes. The goal of this study was to generate monoclonal antibodies recognizing various epidemic ribotypes of C. difficile. To do so, we immunized mice expressing human variable antibody genes with the Low Molecular Weight (LMW) subunit of the surface layer protein SlpA from various C. difficile strains. Monoclonal antibodies purified from hybridomas bound LMW with high-affinity and whole bacteria from current C. difficile ribotypes with different cross-specificities. This first collection of anti-C. difficile mAbs represent valuable tools for basic and clinical research.
艰难梭菌是导致成人抗生素相关性腹泻和假膜性结肠炎的主要原因。目前有多种不同的艰难梭菌菌株流行,其结果和抗生素耐药性各不相同。然而,大多数研究仍侧重于不再流通的参考菌株 630,部分原因是缺乏免疫学工具来研究当前临床上重要的艰难梭菌 PCR 核型。本研究的目标是产生能识别艰难梭菌各种流行核型的单克隆抗体。为此,我们用来自不同艰难梭菌菌株的表面层蛋白 SlpA 的低分子量(LMW)亚基免疫表达人类可变抗体基因的小鼠。从杂交瘤中纯化的单克隆抗体以不同的交叉特异性高亲和力结合了艰难梭菌核型的低分子量和全菌。这第一批抗艰难梭菌 mAbs 是基础和临床研究的宝贵工具。
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引用次数: 0
Comprehensive full genome analysis of norovirus strains from eastern India, 2017-2021. 2017-2021 年印度东部诺如病毒毒株全基因组综合分析。
IF 4.2 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-01-18 DOI: 10.1186/s13099-023-00594-5
Mahadeb Lo, Yen Hai Doan, Suvrotoa Mitra, Ritubrita Saha, Shin-Ichi Miyoshi, Kei Kitahara, Shanta Dutta, Tomoichiro Oka, Mamta Chawla-Sarkar

Background: Worldwide, noroviruses are the leading cause of acute gastroenteritis (AGE) in people of all age groups. In India, norovirus rates between 1.4 to 44.4% have been reported. Only a very few complete norovirus genome sequences from India have been reported.

Objective: To perform full genome sequencing of noroviruses circulating in India during 2017-2021, identify circulating genotypes, assess evolution including detection of recombination events.

Methodology: Forty-five archived norovirus-positive samples collected between October 2017 to July 2021 from patients with AGE from two hospitals in Kolkata, India were processed for full genome sequencing. Phylogenetic analysis, recombination breakpoint analysis and comprehensive mutation analysis were also performed.

Results: Full genome analysis of norovirus sequences revealed that strains belonging to genogroup (G)I were genotyped as GI.3[P13]. Among the different norovirus capsid-polymerase combinations, GII.3[P16], GII.4 Sydney[P16], GII.4 Sydney[P31], GII.13[P16], GII.16[P16] and GII.17 were identified. Phylogenetic analysis confirmed phylogenetic relatedness with previously reported norovirus strains and all viruses were analyzed by Simplot. GII[P16] viruses with multiple residue mutations within the non-structural region were detected among circulating GII.4 and GII.3 strains. Comprehensive mutation analysis and selection pressure analysis of GII[P16] viruses showed positive as well as negative selection sites. A GII.17 strain (NICED-BCH-11889) had an untypeable polymerase type, closely related to GII[P38].

Conclusion: This study highlights the circulation of diverse norovirus strains in eastern India. These findings are important for understanding norovirus epidemiology in India and may have implications for future vaccine development.

背景:在世界范围内,诺如病毒是导致各年龄段人群患急性肠胃炎(AGE)的主要原因。在印度,诺如病毒的感染率在 1.4% 到 44.4% 之间。仅有极少数来自印度的诺如病毒完整基因组序列被报道过:对 2017-2021 年间在印度流行的诺如病毒进行全基因组测序,确定流行的基因型,评估进化情况,包括检测重组事件:对 2017 年 10 月至 2021 年 7 月期间从印度加尔各答两家医院的 AGE 患者处收集的 45 份存档诺如病毒阳性样本进行全基因组测序。同时还进行了系统发育分析、重组断点分析和综合突变分析:诺如病毒序列的全基因组分析表明,属于基因组(G)I的毒株基因分型为 GI.3[P13]。在不同的诺如病毒囊膜-聚合酶组合中,确定了 GII.3[P16]、GII.4 Sydney[P16]、GII.4 Sydney[P31]、GII.13[P16]、GII.16[P16]和 GII.17。系统发育分析证实了与以前报告的诺如病毒毒株的系统发育相关性,并对所有病毒进行了辛普洛特分析。在GII.4和GII.3流行毒株中发现了非结构区有多个残基突变的GII[P16]病毒。GII[P16]病毒的综合突变分析和选择压力分析显示了正选择位点和负选择位点。一个 GII.17 株系(NICED-BCH-11889)的聚合酶类型无法定型,与 GII[P38] 关系密切:本研究强调了多种诺如病毒毒株在印度东部的流行情况。这些发现对了解印度的诺如病毒流行病学非常重要,并可能对未来的疫苗开发产生影响。
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引用次数: 0
Temporal changes in the positivity rate of common enteric viruses among paediatric admissions in coastal Kenya, during the COVID-19 pandemic, 2019–2022 2019-2022年COVID-19大流行期间肯尼亚沿海地区儿科住院病人常见肠道病毒阳性率的时间变化
IF 4.2 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-01-04 DOI: 10.1186/s13099-023-00595-4
Arnold W. Lambisia, Nickson Murunga, Martin Mutunga, Robinson Cheruiyot, Grace Maina, Timothy O. Makori, D. James Nokes, Charles N. Agoti
The non-pharmaceutical interventions (NPIs) implemented to curb the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) early in the coronavirus disease 2019 (COVID-19) pandemic, substantially disrupted the activity of other respiratory viruses. However, there is limited data from low-and-middle income countries (LMICs) to determine whether these NPIs also impacted the transmission of common enteric viruses. Here, we investigated the changes in the positivity rate of five enteric viruses among hospitalised children who presented with diarrhoea to a referral hospital in coastal Kenya, during COVID-19 pandemic period. A total of 870 stool samples from children under 13 years of age admitted to Kilifi County Hospital between January 2019, and December 2022 were screened for rotavirus group A (RVA), norovirus genogroup II (GII), astrovirus, sapovirus, and adenovirus type F40/41 using real-time reverse-transcription polymerase chain reaction. The proportions positive across the four years were compared using the chi-squared test statistic. One or more of the five virus targets were detected in 282 (32.4%) cases. A reduction in the positivity rate of RVA cases was observed from 2019 (12.1%, 95% confidence interval (CI) 8.7–16.2%) to 2020 (1.7%, 95% CI 0.2–6.0%; p < 0.001). However, in the 2022, RVA positivity rate rebounded to 23.5% (95% CI 18.2%–29.4%). For norovirus GII, the positivity rate fluctuated over the four years with its highest positivity rate observed in 2020 (16.2%; 95% C.I, 10.0–24.1%). No astrovirus cases were detected in 2020 and 2021, but the positivity rate in 2022 was similar to that in 2019 (3.1% (95% CI 1.5%–5.7%) vs. 3.3% (95% CI 1.4–6.5%)). A higher case fatality rate was observed in 2021 (9.0%) compared to the 2019 (3.2%), 2020 (6.8%) and 2022 (2.1%) (p < 0.001). Our study finds that in 2020 the transmission of common enteric viruses, especially RVA and astrovirus, in Kilifi Kenya may have been disrupted due to the COVID-19 NPIs. After 2020, local enteric virus transmission patterns appeared to return to pre-pandemic levels coinciding with the removal of most of the government COVID-19 NPIs.
在 2019 年冠状病毒病(COVID-19)大流行初期,为遏制严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)的传播而实施的非药物干预措施(NPIs)极大地干扰了其他呼吸道病毒的活动。然而,来自中低收入国家(LMICs)的数据有限,无法确定这些非传染性疾病是否也影响了常见肠道病毒的传播。在此,我们调查了 COVID-19 大流行期间,在肯尼亚沿海地区一家转诊医院住院的腹泻患儿中,五种肠道病毒阳性率的变化情况。在2019年1月至2022年12月期间,基利菲县医院共采集了870份13岁以下儿童的粪便样本,并使用实时反转录聚合酶链反应对这些样本进行了轮状病毒A组(RVA)、诺如病毒基因II组(GII)、星状病毒、沙波病毒和腺病毒F40/41型的筛查。使用卡方检验统计量比较了四年中的阳性比例。在 282 个病例(32.4%)中检测到五种病毒中的一种或多种。从 2019 年(12.1%,95% 置信区间(CI)8.7-16.2%)到 2020 年(1.7%,95% 置信区间(CI)0.2-6.0%;P <0.001),RVA 阳性率有所下降。然而,在 2022 年,RVA 阳性率反弹至 23.5%(95% CI 18.2%-29.4%)。诺如病毒 GII 的阳性率在四年中有所波动,2020 年的阳性率最高(16.2%;95% C.I,10.0-24.1%)。2020年和2021年未发现天体病毒病例,但2022年的阳性率与2019年相似(3.1% (95% CI 1.5%-5.7%) vs. 3.3% (95% CI 1.4-6.5%))。与 2019 年(3.2%)、2020 年(6.8%)和 2022 年(2.1%)相比,2021 年(9.0%)的病死率更高(P < 0.001)。我们的研究发现,2020 年,肯尼亚基利菲常见肠道病毒(尤其是 RVA 和星状病毒)的传播可能因 COVID-19 NPIs 而中断。2020 年后,当地的肠道病毒传播模式似乎恢复到流行前的水平,这与大部分 COVID-19 非感染性政府禁令的取消相吻合。
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引用次数: 0
Bacteremia from streptococcus constellatus revealing a gastrointestinal stromal tumor 揭示胃肠道间质瘤的星座链球菌菌血症
IF 4.2 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-01-04 DOI: 10.1186/s13099-023-00593-6
Salvatore Chessa, Elena Belfiori, Giulia Mandis, Enrico Urru, Giovanna Manconi, Angelo Scuteri
Pyogenic Liver Abscesses (PLA) are the most common type of visceral abscess. They generally develop in a context of biliary disease or hematogenous seeding, but a complete diagnostic work-up is always required in order not to miss other important causes, including above all malignancies of the gastro-intestinal tract. Herein, we report a particular case of a 80 years-old immunocompetent woman hospitalized for sepsis. At the end of the diagnostic process, Streptococcus constellatus (Sc) was identified as the cause of sepsis, multiple PLA were found together with a previous unknown ileal malignancy. We speculated about a possible correlation among these three entities (i.e. sepsis from Sc, PLA and tumors). Detection of Sc in blood should raise red flags in clinicians as aggressive clinical presentation are possible.
化脓性肝脓肿(PLA)是最常见的内脏脓肿类型。它们通常是在胆道疾病或血源性播散的情况下发生的,但为了不遗漏其他重要病因,包括胃肠道恶性肿瘤,必须进行全面的诊断检查。在此,我们报告了一例因败血症住院的 80 岁免疫功能正常妇女的病例。在诊断过程的最后阶段,我们发现溃疡链球菌(Sc)是导致败血症的原因,同时还发现了多个 PLA 以及之前未知的回肠恶性肿瘤。我们推测这三个实体(即由 Sc、PLA 和肿瘤引起的败血症)之间可能存在关联。在血液中检测到Sc应引起临床医生的警惕,因为可能会出现侵袭性临床表现。
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引用次数: 0
Gut microbiome dynamics and associations with mortality in critically ill patients. 重症患者肠道微生物群的动态变化及其与死亡率的关系。
IF 4.3 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2023-12-19 DOI: 10.1186/s13099-023-00567-8
Tarik J Salameh, Katharine Roth, Lisa Schultz, Zhexi Ma, Anthony S Bonavia, James R Broach, Bin Hu, Judie A Howrylak

Background: Critical illness and care within the intensive care unit (ICU) leads to profound changes in the composition of the gut microbiome. The impact of such changes on the patients and their subsequent disease course remains uncertain. We hypothesized that specific changes in the gut microbiome would be more harmful than others, leading to increased mortality in critically ill patients.

Methods: This was a prospective cohort study of critically ill adults in the ICU. We obtained rectal swabs from 52 patients and assessed the composition the gut microbiome using 16 S rRNA gene sequencing. We followed patients throughout their ICU course and evaluated their mortality rate at 28 days following admission to the ICU. We used selbal, a machine learning method, to identify the balance of microbial taxa most closely associated with 28-day mortality.

Results: We found that a proportional ratio of four taxa could be used to distinguish patients with a higher risk of mortality from patients with a lower risk of mortality (p = .02). We named this binarized ratio our microbiome mortality index (MMI). Patients with a high MMI had a higher 28-day mortality compared to those with a low MMI (hazard ratio, 2.2, 95% confidence interval 1.1-4.3), and remained significant after adjustment for other ICU mortality predictors, including the presence of the acute respiratory distress syndrome (ARDS) and the Acute Physiology and Chronic Health Evaluation (APACHE II) score (hazard ratio, 2.5, 95% confidence interval 1.4-4.7). High mortality was driven by taxa from the Anaerococcus (genus) and Enterobacteriaceae (family), while lower mortality was driven by Parasutterella and Campylobacter (genera).

Conclusions: Dysbiosis in the gut of critically ill patients is an independent risk factor for increased mortality at 28 days after adjustment for clinically significant confounders. Gut dysbiosis may represent a potential therapeutic target for future ICU interventions.

背景:重症监护室(ICU)内的重症疾病和护理会导致肠道微生物组的组成发生深刻变化。这种变化对患者及其后续病程的影响仍不确定。我们假设,肠道微生物组的特定变化比其他变化更有害,会导致重症患者的死亡率上升:这是一项针对重症监护室成人重症患者的前瞻性队列研究。我们采集了 52 名患者的直肠拭子,并使用 16 S rRNA 基因测序评估了肠道微生物组的组成。我们对患者的整个重症监护过程进行了跟踪,并在患者进入重症监护室 28 天后对其死亡率进行了评估。我们使用机器学习方法 selbal 来确定与 28 天死亡率关系最密切的微生物类群的平衡:结果:我们发现,四种分类群的比例可用于区分死亡风险较高的患者和死亡风险较低的患者(p = .02)。我们将这一二值化比率命名为微生物组死亡率指数(MMI)。与 MMI 值低的患者相比,MMI 值高的患者 28 天死亡率更高(危险比为 2.2,95% 置信区间为 1.1-4.3),而且在调整了其他 ICU 死亡率预测因素(包括急性呼吸窘迫综合征(ARDS)和急性生理学和慢性健康评估(APACHE II)评分)后,MMI 值仍然显著(危险比为 2.5,95% 置信区间为 1.4-4.7)。死亡率高的原因是厌氧球菌属(属)和肠杆菌科(科)的分类群,而死亡率低的原因是副球菌属和弯曲杆菌属:结论:危重症患者肠道菌群失调是导致其 28 天死亡率增加的独立风险因素。肠道菌群失调可能是未来重症监护病房干预措施的潜在治疗目标。
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引用次数: 0
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Gut Pathogens
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